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What changed in VIEMED HEALTHCARE, INC.'s 10-K — 2024 vs 2025

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Paragraph-level year-over-year comparison of VIEMED HEALTHCARE, INC.'s 2024 and 2025 10-K annual filings, covering the Business, Risk Factors, Legal Proceedings, Cybersecurity, MD&A and Market Risk sections. Every new, removed and edited paragraph is highlighted side-by-side so you can see exactly what management changed in the 2025 report.

+253 added−234 removedSource: 10-K (2026-03-04) vs 10-K (2025-03-10)

Top changes in VIEMED HEALTHCARE, INC.'s 2025 10-K

253 paragraphs added · 234 removed · 150 edited across 8 sections

Item 1. Business

Business — how the company describes what it does

33 edited+28 added−27 removed75 unchanged
Biggest changeOxygen therapy may be performed in the home or in another setting. ◦ Sleep apnea management provides sleep solutions and/or equipment such as Positive Airway Pressure (“PAP”), the AutoPAP (automatic continuous positive airway pressure), and BiPAP machines. • In-home sleep testing : Viemed provides in home sleep apnea testing services, which is an alternative to the traditional sleep lab testing environment. • Healthcare staffing : Viemed provides healthcare staffing and recruitment services to supplement the workforce needs of third-party healthcare facilities by utilizing its network of healthcare professionals.
Biggest changeOxygen therapy may be performed in the home or in another setting. ◦ Sleep apnea management provides sleep solutions and/or equipment such as Positive Airway Pressure (“PAP”), the AutoPAP (automatic continuous positive airway pressure), and BiPAP machines.
Additionally, Viemed patient related capital expenditures can be financed through its existing commercial credit facilities comprised of a revolving credit facility of up to $30.0 million, a delayed draw term loan facility of up to $30 million, and an accordion feature allowing the Company to increase the size of such facilities by up to an additional $30 million, subject to certain conditions, for a total borrowing capacity of up to $90 million.
Additionally, Viemed patient related capital expenditures can be financed through its existing commercial credit facilities comprised of a revolving credit facility of up to $30.0 million, a delayed draw term loan facility of up to $30.0 million, and an accordion feature allowing the Company to increase the size of such facilities by up to an additional $30.0 million, subject to certain conditions, for a total borrowing capacity of up to $90.0 million.
If we are unable Page 12 to expand coverage of our products by additional commercial payors, or if third-party payors that currently cover or reimburse for our products reverse or limit their coverage in the future, our business and results of operations could be adversely affected. Competition The respiratory care industry is highly competitive.
If we are unable to expand coverage of our products by additional commercial payors, or if third-party payors that currently cover or reimburse for our products reverse or limit their coverage in the future, our business and results of operations could be adversely affected. Page 12 Competition The respiratory care industry is highly competitive.
If our operations are found to be in violation of any of the health regulatory laws described above or any other laws that apply to us, we may be subject to penalties, including potentially significant criminal and civil and administrative penalties, damages, fines, disgorgement, imprisonment, exclusion from participation in government healthcare programs, contractual damages, reputational harm, administrative burdens, diminished profits and future earnings and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our business, financial condition and our results of operations.
If our operations are found to be in violation of any of the health regulatory laws described below or any other laws that apply to us, we may be subject to penalties, including potentially significant criminal and civil and administrative penalties, damages, fines, disgorgement, imprisonment, exclusion from participation in government healthcare programs, contractual damages, reputational harm, administrative burdens, diminished profits and future earnings and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our business, financial condition and our results of operations.
Page 8 The Ethics in Patient Referrals Act, commonly known as the “Stark Law,” prohibits a physician from making referrals for certain “designated health services” payable by Medicare to an entity, including a company that furnishes DME, in which the physician or an immediate family member of such physician has an ownership or investment interest or with which the physician has entered into a compensation arrangement, unless a statutory exception applies.
The Ethics in Patient Referrals Act, commonly known as the “Stark Law,” prohibits a physician from making referrals for certain “designated health services” payable by Medicare to an entity, including a company that furnishes DME, in which the physician or an immediate family member of such physician has an ownership or investment interest or with which the physician has entered into a compensation arrangement, unless a statutory exception applies.
Travel Act (which in some instances addresses private-sector or commercial bribery both within and outside the United States). We could be held liable under the FCPA and other anti-corruption laws for the illegal activities of our employees, representatives, contractors, collaborators, agents, subsidiaries, or affiliates, even if we did not explicitly authorize such activity.
Travel Act (which in some instances addresses private-sector or commercial bribery both within and outside the United States). Page 10 We could be held liable under the FCPA and other anti-corruption laws for the illegal activities of our employees, representatives, contractors, collaborators, agents, subsidiaries, or affiliates, even if we did not explicitly authorize such activity.
Significant Customers For the years ended December 31, 2024 and 2023, Viemed had no customers that accounted for 10% or more of its consolidated revenue streams. Viemed earns revenues by seeking reimbursement from Medicare and private health insurance companies, with the Medicare program of the United States government being the primary entity making payments.
Significant Customers For the years ended December 31, 2025 and 2024, Viemed had no customers that accounted for 10% or more of its consolidated revenue streams. Viemed earns revenues by seeking reimbursement from Medicare and private health insurance companies, with the Medicare program of the United States government being the primary entity making payments.
Page 7 Competitive Bidding Process The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 required the Secretary of Health and Human Services ("HHS") to establish and implement programs under which competitive acquisition areas are established throughout the United States for purposes of awarding contracts for the furnishing of competitively priced items of durable medical equipment.
Competitive Bidding Process The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 required the Secretary of Health and Human Services ("HHS") to establish and implement programs under which competitive acquisition areas are established throughout the United States for purposes of awarding contracts for the furnishing of competitively priced items of durable medical equipment.
Page 9 State fraud and abuse provisions . Many states have also adopted some form of anti-kickback and anti-referral laws and false claims acts that apply regardless of payor, in addition to items and services reimbursed under Medicaid and other state programs. In some states, these laws apply and we believe that we are in compliance with such laws.
State fraud and abuse provisions . Many states have also adopted some form of anti-kickback and anti-referral laws and false claims acts that apply regardless of payor, in addition to items and services reimbursed under Medicaid and other state programs. In some states, these laws apply and we believe that we are in compliance with such laws.
In addition to criminal penalties, violation of this statute may result in collateral administrative sanctions, including exclusion from participation in Medicare, Medicaid and other federal healthcare programs. Federal False Claims Act and Civil Monetary Penalties Law .
In addition to criminal penalties, violation of this statute may result in collateral administrative sanctions, including exclusion from participation in Medicare, Medicaid and other federal healthcare programs. Page 9 Federal False Claims Act and Civil Monetary Penalties Law .
A coverage determination for a product, which establishes the indications that will be covered, and any restrictions or limitations, can be developed at the national level by CMS through a National Coverage Determination (“NCD”) or at the local level through a Local Coverage Determination (“LCD”) by a regional DME MAC.
A coverage determination for a product, which establishes the indications that will be covered, and any restrictions or limitations, can be developed at the national level by CMS through a NCD or at the local level through a Local Coverage Determination (“LCD”) by a regional DME MAC.
The common shares of Viemed trade on the Nasdaq Capital Market under the trading symbol "VMD". Viemed’s registered and records office is located at Suite 2800, Park Place, 666 Burrard Street, Vancouver, British Columbia V6C 2Z7 Canada and its principal executive office is located at 625 E. Kaliste Saloom Road, Lafayette, Louisiana 70508.
The common shares of Viemed trade on the Nasdaq Stock Market LLC ("NASDAQ") under the trading symbol "VMD". Viemed’s registered and records office is located at Suite 2800, Park Place, 666 Burrard Street, Vancouver, British Columbia V6C 2Z7 Canada and its principal executive office is located at 625 E. Kaliste Saloom Road, Lafayette, Louisiana 70508.
Viemed provides home medical equipment through the following service programs: ◦ Respiratory disease management , including treatment of Chronic Obstructive Pulmonary Disease (“COPD”), aims to improve quality of life and reduce hospital readmissions by using proven methodology and leading technologies, such as non-invasive ventilation (“NIV”), percussion vests, and other therapies.
Viemed provides home medical equipment through the following service programs: ◦ Respiratory disease management , including treatment of Chronic Obstructive Pulmonary Disease (“COPD”), is designed to improve quality of life and reduce hospital readmissions by using proven methodology and leading technologies, such as non-invasive ventilation (“NIV”), percussion vests, and other therapies.
Page 10 In 2009, Congress passed the American Recovery and Reinvestment Act of 2009 (“ARRA”) which included sweeping changes to HIPAA, including an expansion of HIPAA’s privacy and security standards.
In 2009, Congress passed the American Recovery and Reinvestment Act of 2009 (“ARRA”) which included sweeping changes to HIPAA, including an expansion of HIPAA’s privacy and security standards.
Revenues from Medicare and Medicaid accounted for 43% and 46%, respectively, of revenue for the years ended December 31, 2024 and 2023. Because Medicare criteria is extensive, we have a team dedicated to educating prescribers to help them understand how Medicare policy affects their patients and the medical record documentation needed to meet both NCD and LCD requirements.
Revenues from Medicare and Medicaid accounted for 40% and 43%, respectively, of revenue for the years ended December 31, 2025 and 2024. Because Medicare criteria is extensive, we have a team dedicated to educating prescribers to help them understand how Medicare policy affects their patients and the medical record documentation needed to meet both NCD and LCD requirements.
Employees At December 31, 2024, Viemed had 1,179 permanent employees, in addition to temporary employees and independent contractors engaged through the Company's healthcare staffing and recruitment services to supplement the workforce needs of third-party healthcare facilities. Viemed's human capital resources are a critical component of its business strategy.
Employees At December 31, 2025, Viemed had 1,382 permanent employees, in addition to temporary employees and independent contractors engaged through the Company's healthcare staffing and recruitment services to supplement the workforce needs of third-party healthcare facilities. Viemed's human capital resources are a critical component of its business strategy.
Accrediting bodies that are approved by CMS will perform audits of these policies and procedures every three years. Should a company fall out of compliance with the requirements of the accrediting body, expulsion from the Medicare program could follow.
Accrediting bodies that are approved by CMS historically performed audits of these policies and procedures every three years. Should a company fall out of compliance with the requirements of the accrediting body, expulsion from the Medicare program could follow.
Viemed's respiratory care programs are designed specifically for payors to have the ability to treat patients in the home for less total cost and with a superior quality of care.
Viemed's care programs are designed specifically to treat patients in the home for less total cost and with a superior quality of care.
Viemed expects to continue to be a solution to the rising health costs in the United States by offering more cost-effective, home-based solutions while increasing the quality of life for patients fighting serious respiratory diseases. Corporate Information Viemed Healthcare, Inc. is a holding company incorporated in British Columbia under the Business Corporations Act in December 2016.
Viemed expects to continue to be a solution to the rising health costs in the United States by offering more cost-effective, home-based solutions while increasing the quality of life for patients managing chronic and complex health conditions. Corporate Information Viemed Healthcare, Inc. is a holding company incorporated in British Columbia under the Business Corporations Act in December 2016.
In December 2008, we became a Durable, Medical Equipment, Prosthetics, Orthotics, and Supplies accredited Medicare supplier by the Accreditation Commission for Health Care for our solutions. Our Medicare accreditation must be renewed every three years through passage of an on-site inspection. We last renewed our accreditation with Medicare in August 2024.
In December 2008, we became a Durable, Medical Equipment, Prosthetics, Orthotics, and Supplies ("DMEPOS") accredited Medicare supplier by the Accreditation Commission for Health Care for our solutions. Historically, our Medicare accreditation had to be renewed every three years through passage of an on-site inspection.
As part of the competitive bidding process, single payment amounts (“SPAs”) replace the current Medicare DME fee schedule payment amounts for selected items in certain areas of the country. The SPAs are determined by using bids submitted by DME suppliers.
As part of the competitive bidding process, single payment amounts (“SPAs”) replace the current Medicare DME fee schedule payment amounts for selected items in certain areas of the country. The SPAs are determined by using bids submitted by DME suppliers. Page 7 CMS has modified the scope and timing of the competitive bidding program over time.
Certain of these states require that durable medical equipment providers maintain an in-state location. Most of our state licenses are renewed on an annual basis.
Licensure Several states require that DME providers be licensed in order to sell products to patients in that state. Certain of these states require that durable medical equipment providers maintain an in-state location. Most of our state licenses are renewed on an annual basis.
Maintaining our accreditation and Medicare enrollment requires that we comply with numerous business and customer support standards. If we are found to be out of compliance with accreditation standards, our enrollment status in the Medicare program could be jeopardized, up to and including termination.
If we are found to be out of compliance with accreditation standards during an annual site visit, our enrollment status in the Medicare program could be jeopardized, up to and including termination.
The Company currently serves patients in all 50 states of the United States. Viemed anticipates expanding its workforce of respiratory therapists ("RTs") to support the Company's growth and ensure the high service model is maintained in the home. As of December 31, 2024, we employed 404 licensed RTs, representing approximately 34% of our company-wide employee count.
Viemed anticipates expanding its workforce of licensed clinical practitioners, including respiratory therapists ("RTs") to support the Company's growth and ensure the high service model is maintained in the home. As of December 31, 2025, the Company employed 401 licensed RTs, representing approximately 29% of the Company-wide employee count.
With respect to our ventilator products, an NCD for the DME Reference List, which has been effective since April 1, 2003, indicates that ventilators, including our products, are covered for the treatment of neuromuscular diseases, thoracic restrictive diseases, and chronic respiratory failure consequent to chronic obstructive pulmonary disease.
With respect to ventilators, NCD 280.1, Durable Medical Equipment Reference List, which has been effective since April 1, 2003, provides for Medicare coverage of ventilators for the treatment of neuromuscular diseases, thoracic restrictive diseases, and chronic respiratory failure consequent to COPD.
Viemed's services include respiratory disease management (through the rental of various HME devices), neuromuscular care, in-home sleep testing and sleep apnea treatment, oxygen therapy, the sale of associated supplies, and healthcare staffing services. Viemed expects to grow through expansion of existing service areas as well as in new territories through a cost efficient launch that reduces location expenses.
Viemed's services include respiratory disease management (through the rental of various HME devices), neuromuscular care, in-home sleep testing and sleep apnea treatment, oxygen therapy, the sale of associated supplies, women’s health products and services, and healthcare staffing services.
The RT licensure and AARC membership ensure that Viemed is able to provide patients with in-home respiratory care services, equipment setup, training, and on-call services with state-of-the-art clinical protocols. Additionally, Viemed’s Chief Medical Officer, Dr. William Frazier, is a board-certified pulmonary disease specialist and oversees clinical protocols. Viemed sources hardware from vendors and pairs them with industry leading respiratory therapy.
Viemed’s patients are served by RTs who are each licensed members of the American Association for Respiratory Care (“AARC”). The RT licensure and AARC membership ensure that Viemed is able to provide patients with in-home respiratory care services, equipment setup, training, and on-call services with state-of-the-art clinical protocols. Additionally, Viemed’s Chief Medical Officer, Dr.
Item 1. Business Company Overview Viemed Healthcare, Inc. (the "Company" or "Viemed"), through its subsidiaries, is a provider of home medical equipment ("HME") and post-acute respiratory healthcare services in the United States. The Company’s primary service offerings are focused on effective in-home treatment with clinical practitioners providing therapy and counseling to patients in their homes using cutting edge technology.
Item 1. Business Company Overview Viemed Healthcare, Inc. (the "Company" or "Viemed"), through its subsidiaries, is a provider of home medical equipment ("HME") and post-acute healthcare services in the United States, with a focus on respiratory, chronic care, and women’s health products and services.
While the NCD for the DME Reference List has been updated, no separate NCD has been issued for ventilators. On September 11, 2024, CMS initiated a national coverage analysis (NCA) for noninvasive positive pressure ventilation (NIPPV) in the home for treating chronic respiratory failure (CRF) due to COPD. A decision is anticipated in 2025, though delays are possible.
In addition, on September 11, 2024, CMS initiated a national coverage analysis to evaluate noninvasive positive pressure ventilation in the home for the treatment of chronic respiratory failure associated with COPD. CMS issued a proposed decision memorandum on March 11, 2025, followed by a final NCD on June 9, 2025.
Accreditation Many payors require accreditation under payor contracts. If we lose accreditation at any location, it could have an adverse impact on our reimbursement under payor contracts. Fraud and Abuse Regulations Federal Anti-Kickback and Self-Referral Laws .
Accreditation Many payors require accreditation under payor contracts. Additionally, it is possible that state Medicaid programs, commercial payors, and Medicare Advantage Organizations could follow the Medicare Program’s lead and implement more stringent accreditation requirements with increased oversight. If we lose accreditation at any location, it could have an adverse impact on our reimbursement under payor contracts.
The emerging nature of the market presents risks that vendors may not be able to provide equipment to satisfy demand. Viemed has historically funded patient related capital expenditures through cash generated from operations or financing through an affiliate of its primary vendors.
William Frazier, is a board-certified pulmonary disease specialist and oversees clinical protocols. Viemed sources respiratory equipment from vendors and pairs them with industry leading respiratory therapy. Viemed has historically funded patient related capital expenditures through cash generated from operations or financing through an affiliate of its primary vendors.
On October 27, 2020, CMS announced that it had removed 13 of the 15 remaining product categories from Round 2021, including oxygen and PAP devices, because the payment amounts did not achieve expected savings.
Non-invasive ventilators were previously included as a product category in Round 2021; however, prior to implementation, CMS removed non-invasive ventilators from the program. CMS subsequently removed a substantial number of additional product categories from Round 2021, including oxygen equipment and PAP devices, after determining that the program did not achieve expected savings.
While Viemed plans to continue investigating and introducing new complementary products and services and further expanding the coverage of existing products, home ventilation (both invasive and non-invasive) is expected to continue to represent the majority of Viemed’s revenue.
While Viemed continues to evaluate and introduce new complementary products and services and expand existing offerings, respiratory care services, including home ventilation, are expected to continue to represent a significant portion of Viemed’s revenue, alongside contributions from other product and service offerings.
Removed
Viemed’s primary objective is to focus on the organic growth of the business and thereby solidify its position as one of the United States' largest providers of in-home therapy for patients suffering from respiratory diseases.
Added
The Company’s primary service offerings are focused on effective in-home treatment with clinical practitioners providing therapy and counseling to patients in their homes using cutting edge technology. Viemed’s primary objective is to drive growth by increasing the number of patients served and the level of care provided through its technology-enabled, home-based clinical care and chronic disease management model.
Removed
Patients suffering from neuromuscular or respiratory diseases experience severe difficulty in breathing and require assistance from a ventilator to effectively move air in and out of their lungs. Invasive and non-invasive ventilation differ in how the air is delivered to the person. Invasive ventilation delivers air via a tube inserted into the windpipe.
Added
Viemed seeks to grow through expansion of existing service areas as well as in new territories through a cost efficient launch that reduces location expenses. The Company currently serves patients in all 50 states of the United States.
Removed
Non-invasive ventilation delivers air through a sealed mask that can be placed over the mouth. The Centers for Medicare and Medicaid Services (“CMS”) Medicare National Coverage Determinations Manual stipulates that ventilators are covered for the treatment of conditions associated with neuromuscular diseases, thoracic restrictive diseases, and chronic respiratory failure consequent to chronic obstructive pulmonary disease.
Added
Viemed provides in home sleep apnea testing services, which is an alternative to the traditional sleep lab testing environment. ◦ Women’s health provides breast pumps and related lactation equipment and supplies, including fulfillment and support services, to eligible patients as part of its home medical equipment offerings. • Healthcare staffing : Viemed provides healthcare staffing and recruitment services to supplement the workforce needs of third-party healthcare facilities by utilizing its network of healthcare professionals.
Removed
Ventilators are also included in Medicare’s Frequently & Substantially Serviced payment category and are reimbursed under the Healthcare Common Procedure Coding System (“HCPCS”) codes E0465 (invasive ventilation), E0466 (non-invasive ventilation), E0467 (multi-function ventilation) and E0468 (dual-function ventilation). Viemed’s patients are served by RTs who are each licensed members of the American Association for Respiratory Care (“AARC”).
Added
Patients with neuromuscular conditions or chronic respiratory diseases may experience severe difficulty breathing and require ventilatory support to assist with effective air exchange. Ventilatory support may be delivered invasively, through a tube inserted into the airway, or non-invasively, through a sealed mask placed over the nose and/or mouth.
Removed
In order to ensure that Medicare beneficiaries only receive medically necessary and appropriate items and services, the Medicare program has adopted a number of documentation requirements. For example, the DME Medicare Administrative Contractor (“MAC”) Supplier Manuals provide that clinical information from the “patient’s medical record” is required to justify the initial and ongoing medical necessity for the provision of DME.
Added
Medicare coverage for ventilators is addressed under National Coverage Determination (“NCD”) 280.1, Durable Medical Equipment Reference List, which provides for coverage of ventilators for the treatment of neuromuscular diseases, thoracic restrictive diseases, and chronic respiratory failure consequent to COPD.
Removed
Some DME MACs, CMS staff and government subcontractors have taken the position, among other things, that the “patient’s medical record” refers not to documentation maintained by the DME supplier but instead to documentation maintained by the patient’s physician, healthcare facility or other clinician, and that clinical information created by the DME supplier’s personnel and confirmed by the patient’s physician is not sufficient to establish medical necessity.
Added
In addition, the Centers for Medicare & Medicaid Services (“CMS”) has issued a separate NCD establishing specific national coverage criteria for non-invasive positive pressure ventilation (“NIPPV”), respiratory assist devices (“RADs”), and home mechanical ventilators (“HMVs”) used in the home for the treatment of chronic respiratory failure related to COPD.
Removed
It may be difficult, and sometimes impossible, for us to obtain documentation from other healthcare providers. Moreover, auditors’ interpretations of these policies are inconsistent and subject to individual interpretation.
Added
The COPD-specific NCD includes defined clinical criteria for initial and continued coverage, including documentation of medical necessity and ongoing patient use. Coverage for ventilator use outside the scope of the COPD-specific NCD continues to be governed by NCD 280.1 and applicable Medicare policies, including determinations by Medicare Administrative Contractors.
Removed
This is then translated to individual supplier error rates and aggregated into a Durable Medical Equipment, Prosthetics, Orthotics and Supplies (“DMEPOS”) industry error rate, which is significantly higher than other Medicare provider/supplier types. High error rates lead to further audit activity and regulatory burdens.
Added
We last renewed our accreditation with Medicare in August 2024, meaning our next renewal is scheduled for August 2027. Once our current term of accreditation expires, we will become subject to updated accreditation requirements promulgated via federal rulemaking in December of 2025.
Removed
DME MACs continue to conduct extensive pre-payment and post-payment reviews across the DME industry and have determined a wide range of error rates. DME MACs have repeatedly cited documentation insufficiencies as the primary reason for claim denials.
Added
Beginning in 2027, Viemed’s business locations will be subject to new, unannounced accreditation surveys and reaccreditation processes every 12 months. Additionally, any new business locations Viemed opens will be subject to immediate survey (as opposed to 30 days after beginning operations). Maintaining our accreditation and Medicare enrollment requires that we comply with numerous business and customer support standards.
Removed
If these or other burdensome positions are generally adopted by auditors, DME MACs, other contractors or CMS in administering the Medicare program, we would have the right to challenge these positions as being contrary to law.
Added
Additionally, CMS has implemented additional requirements for Medicare-enrolled DMEPOS suppliers involved in certain transactions. If a DMEPOS supplier undergoes a change in majority ownership within 36 months of its initial Medicare enrollment or its most recent change in majority ownership, the Medicare enrollment will not transfer to the new owner.
Removed
If these interpretations of the documentation requirements are ultimately upheld, however, it could result in our making significant refunds and other payments to Medicare and our future revenues from Medicare may be significantly reduced. We have adjusted certain operational policies to address the current expectations of Medicare and its contractors.
Added
A change in majority ownership is any direct transfer of 50% or more of a DMEPOS supplier’s ownership interest. In such cases, the prospective majority owner must obtain a new Medicare enrollment and undergo a new accreditation process.
Removed
We cannot predict the adverse impact, if any, these interpretations of the Medicare documentation requirements or our revised policies might have on our operations, cash flow, and capital resources, but such impact could be material. CMS maintains a Master List of Items Frequently Subject to Unnecessary Utilization.
Added
This new rule could impact our strategic growth plan, which involves the acquisition of other businesses, as these hurdles in securing a new Medicare enrollment or completing a new accreditation process could delay successful post-closing operations for certain acquisition transactions.
Removed
This list identifies items that could potentially be subject to prior authorization as a condition of Medicare payment. CMS has added home ventilators used with a non-invasive interface to the Master List of Items Frequently Subject to Unnecessary Utilization. If CMS requires prior authorization requirements for noninvasive home ventilation, it could materially impact our business.
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In those circumstances, these additional administrative steps could hinder the purchased entity’s ability to commence operations and seek reimbursement for services provided to Medicare beneficiaries. Accordingly, Viemed’s overall financial performance could be negatively impacted in those circumstances.
Removed
In 2019, CMS included non-invasive ventilator products on the list of products subject to the competitive bidding program in Round 2021.
Added
As a result, Viemed has continued to furnish non-invasive ventilators, oxygen equipment, and PAP devices in its Medicare-accredited service areas without being subject to competitive bidding contract limitations for those products. The Round 2021 competitive bidding contracts expired on December 31, 2023.
Removed
On March 9, 2020, CMS announced that due to the COVID-19 pandemic, the United States President's exercise of the Defense Production Act, public concern regarding access to ventilators, and the non-invasive ventilators product category being new to the competitive bidding program, non-invasive ventilators were removed as a product category from Round 2021.
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CMS has since issued updated guidance regarding the next round of the DMEPOS Competitive Bidding Program, indicating that the upcoming round will be limited to product categories within the Nationwide Remote Item Delivery (“RID”) program.
Removed
As a result of these announcements, we retain the ability to continue to furnish non-invasive ventilators and oxygen and PAP devices for all of our Medicare accredited areas. However, we are uncertain if non-invasive ventilators and oxygen and PAP devices will be included in future competitive bidding programs.
Added
CMS has identified the next round RID categories to include certain Class II continuous glucose monitors and insulin pumps, urological supplies, ostomy supplies, hydrophilic urinary catheters, and select off-the-shelf braces.
Removed
The current Round 2021 contracts expired on December 31, 2023 and CMS has not announced a new round of competitive bidding. Historically, CMS announces new rounds of competitive bidding and starts the process approximately 18 months prior to the contract start date.
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Viemed does not furnish products within these categories and, based on currently available information, does not expect the next round of competitive bidding to apply to, or have a material impact on, its products or services. The timing, scope, and structure of future competitive bidding rounds beyond the announced RID-focused program remain subject to change.
Removed
We cannot predict the outcome of the competitive bidding process for contracted supplier selection or the impact of the competitive bidding process on reimbursements to our existing customers. Licensure Several states require that DME providers be licensed in order to sell products to patients in that state.
Added
CMS may modify product categories, geographic coverage, or program requirements in future rounds, and we cannot predict whether respiratory-related products may be included in subsequent competitive bidding programs or the potential impact of any such inclusion on reimbursement rates, supplier participation, or our results of operations.
Removed
In March 2010, the Affordable Care Act (“ACA”) was enacted into law in the United States.
Added
Reimbursement levels and coverage criteria under Medicare, Medicaid, and other government healthcare programs are governed by a statutory and regulatory framework shaped by multiple federal healthcare and budget laws, including the Patient Protection and Affordable Care Act, as amended (“ACA”), the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”), the Deficit Reduction Act of 2005 (“DRA”), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (“MMA”).
Removed
This healthcare reform, which included a number of provisions aimed at improving the quality and decreasing the cost of healthcare, has resulted in significant reimbursement cuts in Medicare payments to hospitals and other healthcare providers in the healthcare reimbursement system, evolving toward value- and outcomes-based reimbursement methodologies.
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These statutes, together with subsequent legislative, regulatory, and administrative actions, have influenced reimbursement methodologies, coverage standards, and program administration, including an increased emphasis on medical necessity criteria, utilization controls, and value- and outcomes-based reimbursement models.
Removed
It is uncertain what long-term consequences these provisions will have on patient access to new technologies and what impact these provisions will have on Medicare reimbursement rates.
Added
CMS and other federal agencies continue to implement and refine coverage policies, reimbursement frameworks, and supplier participation requirements through rulemaking, guidance, and coverage determinations, which may affect utilization patterns, coverage criteria, and reimbursement levels for home-based healthcare services.
Removed
Other elements of the ACA, including comparative effectiveness research, an independent payment advisory board and payment systems reform, including shared savings pilots and other reforms, may result in fundamental changes to federal healthcare reimbursement programs.
Added
Legislative and regulatory actions at the federal and state levels may be undertaken from time to time to contain or reduce healthcare spending, including through changes to reimbursement methodologies, coverage criteria, program funding, or supplier requirements, which could reduce reimbursement levels or otherwise limit coverage for certain products and services.
Removed
The Tax Cuts and Jobs Act of 2017 ("TCJA") repealed penalties for noncompliance with the requirement for insurance coverage known as the “individual mandate.” This change could affect whether individuals enroll in health plans and could impact insurers with which we contract. Other changes to the ACA could impact the number of patients who have access to our products.
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Page 8 In addition, in 2025, Congress enacted the federal budget reconciliation legislation commonly referred to as the One Big Beautiful Bill Act (“OBBBA”), which includes a range of statutory and policy changes affecting federal healthcare programs.
Removed
Existing and additional legislative or administrative reforms, or any repeal of provisions, of the U.S. healthcare reimbursement systems may significantly reduce reimbursement or otherwise impact coverage for our medical devices, or adverse decisions relating to our products by administrators of such systems in coverage or reimbursement issues could have an adverse impact on our financial condition and results of operations.

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Item 1A. Risk Factors

Risk Factors — what could go wrong, per management

43 edited+44 added−42 removed148 unchanged
Biggest changeThere are delays in reimbursement from the time we provide services to the time we receive reimbursement or payment for these services. Delays may result from changes by third-party payors to data submission requirements or requests by fiscal intermediaries for additional data or documentation, among other issues.
Biggest changePage 19 Delays in reimbursement due to claims submission reimbursement processes may cause liquidity problems. There are delays in reimbursement from the time we provide services to the time we receive reimbursement or payment for these services.
As a result of increased post-payment reviews of claims we submit to Medicare and Medicaid for our services, we may incur additional costs and may be required to repay amounts already paid to us. We are subject to regular post-payment inquiries, investigations and audits of claims we submit to Medicare and Medicaid for payment for our services.
As a result of post-payment reviews of claims we submit to Medicare and Medicaid for our services, we may incur additional costs and may be required to repay amounts already paid to us. We are subject to regular post-payment inquiries, investigations and audits of claims we submit to Medicare and Medicaid for payment for our services.
Page 17 The federal government and all states in which we currently operate regulate various aspects of our business. Our operations also are subject to state laws governing, among other things, distribution of medical equipment and certain types of home health activities, and we are required to obtain and maintain licenses in each state to act as a DME supplier.
The federal government and all states in which we currently operate regulate various aspects of our business. Our operations also are subject to state laws governing, among other things, distribution of medical equipment and certain types of home health activities, and we are required to obtain and maintain licenses in each state to act as a DME supplier.
Revenue we receive from third-party payors as well as Medicare and Medicaid is subject to potential retroactive reduction. Payments we receive from governmental healthcare programs, including Medicare and Medicaid, and private third-party payors can be retroactively adjusted after examination during the claims settlement process or as a result of post-payment audits and subsequent recoupment.
Page 18 Revenue we receive from third-party payors as well as Medicare and Medicaid is subject to potential retroactive reduction. Payments we receive from governmental healthcare programs, including Medicare and Medicaid, and private third-party payors can be retroactively adjusted after examination during the claims settlement process or as a result of post-payment audits and subsequent recoupment.
This volatility may impact the price at which shareholders can sell their common shares. Our common shares are listed and posted for trading on the Nasdaq Capital Market. Securities of small-cap and healthcare companies have experienced substantial volatility in the past, often based on factors unrelated to the financial performance or prospects of the companies involved.
This volatility may impact the price at which shareholders can sell their common shares. Our common shares are listed and posted for trading on the NASDAQ. Securities of small-cap and healthcare companies have experienced substantial volatility in the past, often based on factors unrelated to the financial performance or prospects of the companies involved.
We may face increased competition for attractive acquisition candidates, which may limit the number of acquisition opportunities available to us or lead to the payment of higher prices for acquisitions. Without successful acquisitions, our future growth rate could decline. In addition, we cannot guarantee that any future acquisitions, if consummated, will result in further growth.
Page 16 We may face increased competition for attractive acquisition candidates, which may limit the number of acquisition opportunities available to us or lead to the payment of higher prices for acquisitions. Without successful acquisitions, our future growth rate could decline. In addition, we cannot guarantee that any future acquisitions, if consummated, will result in further growth.
We insure some of our risk with respect to security breaches but the occurrence of any of the foregoing events could have a material adverse effect on our business, results of operations and our financial condition. Page 20 Our products may be subject to future rounds of Medicare's Competitive Bidding Program, which may negatively affect our business and financial condition.
We insure some of our risk with respect to security breaches but the occurrence of any of the foregoing events could have a material adverse effect on our business, results of operations and our financial condition. Our products may be subject to future rounds of Medicare's Competitive Bidding Program, which may negatively affect our business and financial condition.
Our dependence on key suppliers puts us at risk of interruptions in the availability of the equipment we need for our services, which could reduce our revenue and adversely affect our results of operations. We require the timely delivery of a sufficient supply of equipment we use to perform our home treatment of patients.
Page 14 Our dependence on key suppliers puts us at risk of interruptions in the availability of the equipment we need for our services, which could reduce our revenue and adversely affect our results of operations. We require the timely delivery of a sufficient supply of equipment we use to perform our home treatment of patients.
As a result, the potential costs associated with legal actions against us could adversely affect our business, financial condition, results of operations, cash flows or prospects. Insurance and claims expenses could significantly reduce our profitability. Our business is subject to a number of risks and hazards generally.
As a result, the potential costs associated with legal actions against us could adversely affect our business, financial condition, results of operations, cash flows or prospects. Page 15 Insurance and claims expenses could significantly reduce our profitability. Our business is subject to a number of risks and hazards generally.
Although we believe our practices are compliant with applicable safe harbors, we cannot assure you that a government regulator will not take the position that some of our practices do not meet all of the narrow criteria of an applicable safe harbor and otherwise violate the Anti-Kickback Statute.
Although we believe our practices are compliant with Page 22 applicable safe harbors, we cannot assure you that a government regulator will not take the position that some of our practices do not meet all of the narrow criteria of an applicable safe harbor and otherwise violate the Anti-Kickback Statute.
Further, as we are no longer an emerging growth company, our independent registered public accounting firm is required to formally attest to the effectiveness of our internal control over financial reporting pursuant to Section 404 of the Sarbanes-Oxley Act.
Further, as we are no longer an emerging growth company, our independent registered public accounting firm is required to formally attest to the effectiveness of our internal control over financial Page 24 reporting pursuant to Section 404 of the Sarbanes-Oxley Act.
We may not be able to gain access into certain ACOs. If we are not included in these programs, or if ACOs establish programs that overlap with our services, we could experience an adverse effect on our operations and financial condition.
We may Page 23 not be able to gain access into certain ACOs. If we are not included in these programs, or if ACOs establish programs that overlap with our services, we could experience an adverse effect on our operations and financial condition.
Page 24 In the future, we may attempt to obtain financing or further increase our capital resources by issuing additional shares of our common shares or by offering debt or other equity securities, including senior or subordinated notes, debt securities convertible into equity or shares of preferred stock.
In the future, we may attempt to obtain financing or further increase our capital resources by issuing additional shares of our common shares or by offering debt or other equity securities, including senior or subordinated notes, debt securities convertible into equity or shares of preferred stock.
Each of our subsidiaries that employ an average of at least 50 full-time employees in a calendar year are required to offer a minimum level of health coverage for 95% of our full-time employees in 2024 or be subject to an annual penalty.
Each of our subsidiaries that employ an average of at least 50 full-time employees in a calendar year are required to offer a minimum level of health coverage for 95% of our full-time employees in 2025 or be subject to an annual penalty.
Furthermore, responding to Page 18 governmental investigations, audits and reviews can also require us to incur significant legal and document production expenses, regardless of whether the particular investigation, audit or review leads to identification of underlying noncompliance or wrongdoing.
Furthermore, responding to governmental investigations, audits and reviews can also require us to incur significant legal and document production expenses, regardless of whether the particular investigation, audit or review leads to identification of underlying noncompliance or wrongdoing.
We will incur increased costs as a result of operating as a U.S. public reporting company, and our management is required to devote substantial time to new compliance initiatives. As a U.S. public reporting company, we will incur significant legal, accounting and other expenses.
Page 25 We will incur increased costs as a result of operating as a U.S. public reporting company, and our management is required to devote substantial time to new compliance initiatives. As a U.S. public reporting company, we will incur significant legal, accounting and other expenses.
Page 21 The Federal False Claims Act prohibits, in part, any person from knowingly presenting or causing to be presented a false claim for payment to the federal government, or knowingly making or causing to be made a false statement to get a false claim paid.
The Federal False Claims Act prohibits, in part, any person from knowingly presenting or causing to be presented a false claim for payment to the federal government, or knowingly making or causing to be made a false statement to get a false claim paid.
These post-payment reviews have increased as a result of government cost-containment initiatives. These additional post-payment reviews may require us to incur costs to respond to requests for records and to pursue the reversal of payment denials, and ultimately may require us to refund amounts paid to us by Medicare or Medicaid that are determined to have been overpaid.
These post-payment reviews may increase as a result of government cost-containment initiatives, may require us to incur costs to respond to requests for records and to pursue the reversal of payment denials, and ultimately may require us to refund amounts paid to us by Medicare or Medicaid that are determined to have been overpaid.
If we fail to achieve certain volume of sales, prices of ventilators may increase, leading to reduced revenue and profitability. The industry is subject to a high level of regulatory scrutiny, and government or manufacturer recalls could adversely affect our ability to provide products and services and achieve revenue targets.
If we fail to achieve certain volume of sales, prices of medical equipment may increase, leading to reduced revenue and profitability. The industry is subject to a high level of regulatory scrutiny, and government or manufacturer recalls could adversely affect our ability to provide products and services and achieve revenue targets.
Working capital management, including prompt and diligent billing and collection, is an important factor in our results of operations and liquidity. System problems, Medicare or Medicaid issues or industry trends may extend our collection period, adversely impact our working capital. Our working capital management procedures may not successfully negate this risk.
Such timing delays may cause working capital shortages. Working capital management, including prompt and diligent billing and collection, is an important factor in our results of operations and liquidity. System problems, Medicare or Medicaid issues or industry trends may extend our collection period, adversely impact our working capital. Our working capital management procedures may not successfully negate this risk.
The HIPAA privacy and security regulations also require healthcare providers like us to notify affected individuals, the HHS Secretary, and in some cases, the media, when PHI has been “breached”, as defined by HIPAA. Many states have similar breach notification laws.
Page 20 The HIPAA privacy and security regulations also require healthcare providers like us to notify affected individuals, the HHS Secretary, and in some cases, the media, when PHI has been “breached,” as defined by HIPAA. Many states have similar breach notification laws.
Reimbursement rates for our services, like much of the United States healthcare market, are subject to reductions.
The reimbursement rates offered are outside of our control. Reimbursement rates for our services, like much of the United States healthcare market, are subject to reductions.
Specific integration risks relating to our acquisition of other businesses may include: difficulties related to combining previously separate businesses into a single unit, including patient transitions, product and service offerings, distribution and operational capabilities and business cultures; availability of financing to the extent needed to fund acquisitions; customer loss and other general business disruption; managing the integration process while completing other independent acquisitions or dispositions; diversion of management’s attention from day-to-day operations; assumption of liabilities of an acquired business, including unforeseen or contingent liabilities or liabilities in excess of the amounts estimated; failure to realize anticipated benefits and synergies, such as cost savings and revenue enhancements; potentially substantial costs and expenses associated with acquisitions and dispositions; and failure to retain and motivate key employees difficulties in establishing and applying our internal control over financial reporting and disclosure controls and procedures to an acquired business.
Specific integration risks relating to our acquisition of other businesses may include: difficulties related to combining previously separate businesses into a single unit, including patient transitions, product and service offerings, distribution and operational capabilities and business cultures; availability of financing to the extent needed to fund acquisitions; customer loss and other general business disruption; managing the integration process while completing other independent acquisitions or dispositions; diversion of management’s attention from day-to-day operations; delaying post-closing operations due to being required to obtain a new Medicare enrollment and undergo a new accreditation process with respect to certain acquisition candidates that are Medicare-enrolled DMEPOS suppliers; assumption of liabilities of an acquired business, including unforeseen or contingent liabilities or liabilities in excess of the amounts estimated; failure to realize anticipated benefits and synergies, such as cost savings and revenue enhancements; potentially substantial costs and expenses associated with acquisitions and dispositions; and failure to retain and motivate key employees difficulties in establishing and applying our internal control over financial reporting and disclosure controls and procedures to an acquired business.
Page 22 We may be similarly impacted by increased enrollment of Medicare and Medicaid beneficiaries in managed care plans, shifting away from traditional fee-for-service models. Under the managed Medicare program, also known as Medicare Advantage, the federal government contracts with private health insurers to provide Medicare benefits.
We may be similarly impacted by increased enrollment of Medicare and Medicaid beneficiaries in managed care plans, shifting away from traditional fee-for-service models. Under the managed Medicare program, also known as Medicare Advantage, the federal government contracts with private health insurers to provide Medicare benefits. Insurers may choose to offer supplemental benefits and impose higher plan costs on beneficiaries.
If we fail to comply with state and federal fraud and abuse laws, including anti-kickback laws, false claims acts, self-referral prohibitions, and anti-inducement laws, we could face substantial penalties and our business, operations and financial condition could be adversely affected.
Any of these outcomes could reduce revenue, adversely affect cash flows, and negatively impact our results of operations. If we fail to comply with state and federal fraud and abuse laws, including anti-kickback laws, false claims acts, self-referral prohibitions, and anti-inducement laws, we could face substantial penalties and our business, operations and financial condition could be adversely affected.
Market events and conditions, including disruptions in the international credit markets and other financial systems and the deterioration of global economic conditions, could impede our access to capital or increase the cost of capital.
Market events and conditions, including disruptions in the international credit markets and other financial systems and the deterioration of global economic conditions, could impede our access to capital or increase the cost of capital. These disruptions could, among other things, make it more difficult for us to obtain, or increase our cost of obtaining, capital and financing for our operations.
Our ability to manage growth effectively will require us to continue to implement and improve our operational and financial systems and to expend, train and manage our employee base. We must maintain effective disclosure controls and procedures.
As we grow, we may be subject to growth-related risks including capacity constraints and pressure on our internal systems and controls. Our ability to manage growth effectively will require us to continue to implement and improve our operational and financial systems and to expend, train and manage our employee base. We must maintain effective disclosure controls and procedures.
See “Business–Government Regulation” in Item 1 for more information. The ultimate content, timing or effect of any healthcare reform legislation and the impact of potential legislation on us is uncertain and difficult, if not impossible, to predict.
At the federal level, Congress has continued to propose or consider healthcare budgets that substantially reduce payments under the Medicare and Medicaid programs. See “Business–Government Regulation” in Item 1 for more information. The ultimate content, timing or effect of any healthcare reform legislation and the impact of potential legislation on us is uncertain and difficult, if not impossible, to predict.
A limited trading market for common shares may cause fluctuations in the market value of those common shares to be exaggerated, leading to price volatility in excess of that which would occur in a more active trading market.
A limited trading market for common shares may cause fluctuations in the market value of those common shares to be exaggerated, leading to price volatility in excess of that which would occur in a more active trading market. Although our common shares are quoted on the NASDAQ, the volume of trades on any given day has historically been limited.
Page 23 Risks Related to our Common Shares If we fail to establish and maintain proper disclosure or internal controls, our ability to produce accurate financial statements and supplemental information, or comply with applicable regulations could be impaired. As we grow, we may be subject to growth-related risks including capacity constraints and pressure on our internal systems and controls.
Risks Related to our Common Shares If we fail to establish and maintain proper disclosure controls and procedures or internal control over financial reporting, our ability to produce accurate financial statements and supplemental information, or comply with applicable regulations could be impaired.
Because we have no current plans to pay cash dividends on our common shares, investors may not receive any return on their investment unless the value of our common shares appreciates.
These requirements increase our legal and financial compliance costs and will make some activities more time-consuming and costly. Because we have no current plans to pay cash dividends on our common shares, investors may not receive any return on their investment unless the value of our common shares appreciates.
If our common shares are removed from various stock indices, the volume of trading in our shares may decrease materially as well as the prices at which our shares trade.
As a result, shareholders might not have been able to sell or purchase our common shares at the volume, price or time desired. If our common shares are removed from various stock indices, the volume of trading in our shares may decrease materially as well as the prices at which our shares trade.
These disruptions Page 16 could, among other things, make it more difficult for us to obtain, or increase our cost of obtaining, capital and financing for our operations. Access to additional capital may not be available to us on terms acceptable to us, or at all. Our strategic growth plan, which involves the acquisition of other businesses, may not succeed.
Access to additional capital may not be available to us on terms acceptable to us, or at all. Our strategic growth plan, which involves the acquisition of other businesses, may not succeed.
Our development and the business (including acquisitions) may require additional financing, which may involve high transaction costs, dilution to shareholders, high interest rates or unfavorable terms and conditions.
Our development and the business (including acquisitions) may require additional financing, which may involve high transaction costs, dilution to shareholders, high interest rates or unfavorable terms and conditions. Failure to obtain sufficient financing may result in the delay or indefinite postponement of our business plans and our business, financial condition, results of operations and prospects may be adversely affected.
These payors attempt to control healthcare costs by contracting with healthcare providers to obtain services on a discounted basis. We believe that this trend will continue and may limit reimbursement for healthcare services. Additionally, from time to time our contracts with payors are Page 19 terminated, amended or renegotiated, sometime unilaterally through policies.
Initiatives undertaken by industry and government to contain healthcare costs affect our profitability. These payors attempt to control healthcare costs by contracting with healthcare providers to obtain services on a discounted basis. We believe that this trend will continue and may limit reimbursement for healthcare services.
In recent years, many legislative proposals have been introduced or proposed in Congress and in some state legislatures that would affect major changes in the healthcare system, either nationally or at the state level. At the federal level, Congress has continued to propose or consider healthcare budgets that substantially reduce payments under the Medicare and Medicaid programs.
Healthcare reform laws significantly affect the U.S. healthcare services industry. In recent years, many legislative proposals have been introduced or proposed in Congress and in some state legislatures that would affect major changes in the healthcare system, either nationally or at the state level.
If we or other providers involved in claims submission reimbursement processes have information system problems or issues that arise with Medicare or Medicaid or private health insurers, we may encounter delays in our payment cycle. Such timing delays may cause working capital shortages.
Delays may result from changes by third-party payors to data submission requirements or requests by fiscal intermediaries for additional data or documentation, among other issues. If we or other providers involved in claims submission reimbursement processes have information system problems or issues that arise with Medicare or Medicaid or private health insurers, we may encounter delays in our payment cycle.
Similarly, enrollment in managed Medicaid plans is also growing, as states are increasingly relying on managed care organizations to deliver Medicaid program services as a strategy to control costs and manage resources. We may experience increased competition for managed care contracts due to state regulation and limitations.
More than one half of Medicare beneficiaries were enrolled in a Medicare Advantage plan in 2025; a figure that continues to grow. Similarly, enrollment in managed Medicaid plans is also growing, as states are increasingly relying on managed care organizations to deliver Medicaid program services as a strategy to control costs and manage resources.
In 2024, approximately 57% of our revenues were derived collectively from managed care plans, commercial health insurers, workers’ compensation payors, and other private pay revenue sources while approximately 43% of our revenues were derived from Medicare and Medicaid. Initiatives undertaken by industry and government to contain healthcare costs affect our profitability.
In 2025, approximately 50% of our revenue was associated with managed care plans, commercial health insurers, workers’ compensation payors, and other third-party payor arrangements while approximately 40% of our revenues were derived from Medicare and Medicaid. The remaining portion of our patient revenue was generated from patient private pay and other sources.
Viemed cannot predict what additional actions will be required of the Company by the FDA or other state or federal agencies related to the recall. We conduct all of our operations through our United States subsidiaries and our ability to extract value from these subsidiaries may be limited. We conduct all of our operations through our United States subsidiaries.
Additionally, the market for financing ventilators and other supplies we need could be more difficult in the future. We conduct all of our operations through our United States subsidiaries and our ability to extract value from these subsidiaries may be limited. We conduct all of our operations through our United States subsidiaries.
Our dependence on third-party suppliers involves several additional risks, including limited control over pricing, availability, quality and delivery schedules. In the coming months and/or years, limitations on control over pricing and limited availability of materials may create uncertainty if the new Presidential administration proceeds with implementing tariffs that apply to U.S. trading partners.
Our dependence on third-party suppliers involves several additional risks, including limited control over pricing, availability, quality and delivery schedules.
If CMS requires prior authorization for our products, our revenue and cash flow could be negatively impacted. CMS maintains a Master List of Items Frequently Subject to Unnecessary Utilization. This list identifies items that could potentially be subject to prior authorization as a condition of Medicare Payment.
CMS maintains a Master List of Items Frequently Subject to Unnecessary Utilization (the “Master List”) that identifies certain DMEPOS items that CMS has determined may warrant additional utilization controls, including prior authorization, as a condition of Medicare payment.
Historically medical equipment has been exempted from tariffs, but it is unclear if that will continue to be the case. To the extent Page 14 tariffs create challenges on sourcing medical equipment from foreign manufacturers, we can attempt to source equipment from domestic manufacturers when practicable.
To date, we have not experienced a material adverse impact on operating costs or supply availability attributable to tariffs. To the extent tariffs create challenges on sourcing medical equipment from foreign manufacturers, we can attempt to source equipment from domestic manufacturers when practicable.
Removed
The reimbursement rates offered are outside of our control. The CARES Act previously introduced a blended rate for HME furnished in non-rural or contiguous non-competitive bidding areas that is based on 75% of the adjusted fee schedule amount and 25% of the unadjusted fee schedule amount. The 75/25 blended Medicare reimbursement rate expired on December 31, 2023.
Added
A reduction or elimination of coverage or reimbursement of our products by third-party payors, including Medicare, in the future could adversely affect our business and results of operations. A substantial portion of our revenues are derived from reimbursement by Medicare and other third-party payors for our ventilator products and services.
Removed
Efforts to extend the blended rate through H.R. 5555 and S. 1294 gained strong bipartisan support and advanced through key congressional committees. However, these provisions were ultimately excluded from the legislative package passed at the end of the 118th Congress.
Added
Currently, ventilators are covered under the NCD for the DME Reference List, effective since April 1, 2003, for the treatment of neuromuscular diseases, thoracic restrictive diseases, and chronic respiratory failure resulting from COPD.
Removed
As a result, reimbursement rates for affected products have reverted to rates in place prior to the implementation of the 75/25 blend, adjusted for inflation, leading to lower reimbursement levels in certain markets where we operate. Industry stakeholders, including leading advocacy organizations, continue to push for legislative relief in the 119th Congress.
Added
On June 9, 2025, CMS finalized a new NCD establishing clear medical necessity criteria for NIPPV in the home for treatment of chronic respiratory failure related to COPD. We actively participated in the national coverage analysis process, including submission of formal comments and ongoing engagement with CMS, the Department of Health and Human Services, and members of Congress.
Removed
Given that the most recent government funding package extends only through March 14, 2025, future opportunities may arise to reintroduce Medicare reimbursement relief as part of broader healthcare negotiations. However, there is no certainty that such efforts will succeed, or that reimbursement rates will be restored to previous levels.
Added
The final NCD may significantly affect patient access, reimbursement, and utilization of ventilator therapies. Because Medicare coverage policies often influence commercial payors, including Medicare Advantage plans, changes to Medicare policy may have broader implications across our payer base.
Removed
In addition, there are a limited number of manufacturers of the equipment used for home treatment of patients with ventilation respiratory therapy, which has been further exacerbated by Philips Respironics' January 2024 decision to discontinue of many of its respiratory products.
Added
Any reduction or elimination of coverage or reimbursement by Medicare or other third-party payors, or an inability to maintain or expand coverage with additional commercial payors, could materially and adversely impact our business, financial condition, and results of operations.
Removed
Additionally, the market for financing ventilators and other supplies we need could be more difficult in the future. On June 14, 2021, Royal Philips (“Philips”), one of our largest suppliers of BiPAP and CPAP and mechanical ventilator devices, initiated a voluntary recall notification with the U.S.
Added
While certain medical equipment and components have historically been excluded from tariff regimes or subject to exemptions, trade measures may be expanded, reclassified, or implemented with limited notice, and suppliers may increase prices to reflect higher input costs, compliance requirements, or logistics constraints. These developments could increase our equipment and supply costs and reduce product availability.
Removed
Food and Drug Administration (“FDA”) for certain Philips BiPAP and CPAP and mechanical ventilator devices that we distribute and sell. Philips initiated this recall to address potential health risks related to the polyester-based polyurethane (“PE-PUR”) sound abatement foam component in these devices.
Added
Adverse global macroeconomic conditions, including supply chain disruptions, tariffs, and fluctuations in foreign currency exchange rates, could negatively impact our operations, costs, and profitability. Our business may be affected by a range of global macroeconomic conditions, including newly imposed tariffs, disruptions to the supply chain, and fluctuations in foreign currency exchange rates.
Removed
The PE-PUR sound abatement foam, which is used to reduce sound and vibration in these affected devices, may break down and potentially enter the device’s air pathway and may off-gas certain chemicals. If this occurs, black debris from the foam or certain chemicals released into the device’s air pathway may be inhaled or swallowed by the person using the device.
Added
While nearly all of our revenues are generated within the United States and denominated in U.S. dollars, we rely on both domestic and international suppliers for the medical equipment and supplies we rent and sell to patients.
Removed
In July 2021, the FDA identified the Philips recall as a Class I recall, the most serious type of recall. Patients using these devices have been instructed to contact their health care provider and doctor about a suitable treatment for their condition. As of December 2023, Philips has announced remediation of 99% of actionable sleep therapy device registrations.
Added
As a result, our cost structure and operational efficiency are subject to global market dynamics that may influence the availability and pricing of key products. We are exposed to trade policy and tariff developments primarily through the pricing actions and sourcing decisions of our suppliers rather than through direct import activity.
Removed
We cannot predict the potential legal, regulatory, and financial risks that may arise out of the recall. For example, we may be asked to notify patients of the recall, retrieve recalled devices from patients, and/or provide replacement devices, resulting in additional unreimbursed costs.
Added
While certain medical equipment and components have historically been excluded from tariff regimes or subject to exemptions, trade measures may be expanded, reclassified, or implemented with limited notice, and suppliers may increase prices to reflect higher input costs, compliance requirements, or logistics constraints. These developments could increase our equipment and supply costs and reduce product availability.
Removed
Some patients may discontinue use of their device, which could affect our ability to continue billing for service.
Added
To date, we have not experienced a material adverse impact on operating costs or supply availability attributable to tariffs. However, the timing, scope, and duration of future actions remain uncertain, and we continue to monitor these developments and evaluate their potential operational and financial effects.
Removed
Viemed has been named in and may be subject to future litigation related to the recall, including individual and putative class action claims related to personal injury for devices affected by the recall as well as claims regarding repair and replacement of devices affected by the recall.
Added
Additionally, global supply chain constraints continue to pose risks to our ability to acquire essential equipment and components in a timely and efficient manner. Factors such as raw material shortages, longer lead times from suppliers, and increased transportation expenses may limit our responsiveness to patient needs and may affect our ability to scale our business effectively.
Removed
Failure to obtain sufficient financing may result in the delay or indefinite postponement of our business plans and our business, financial condition, results of operations and Page 15 prospects may be adversely affected.
Added
Although our operations are primarily domestic, we are indirectly exposed to foreign currency exchange rate fluctuations through our international sourcing activities.
Removed
We may be negatively impacted by inflation. Current and anticipated inflationary effects may have an adverse effect on our business and be influenced by various factors, including general cost increases, disruptions in our supply chain, and governmental stimulus or fiscal policies.
Added
Changes in the value of the U.S. dollar relative to other currencies, including the Canadian dollar and Chinese yuan, may impact the prices we pay to suppliers, which could increase our cost of goods sold and reduce our gross margins.
Removed
The services and products we provide to patients are subject to fluctuations based on the costs of materials, labor, and transportation, including fuel expenses. The rising costs of our services and products can be attributed, in part, to increased shipping expenses and general inflationary trends.
Added
If these macroeconomic pressures persist or worsen, our ability to manage supply continuity, control costs, and meet patient demand could be adversely affected. As a result, our financial condition, operating results, and long-term strategic objectives may be negatively impacted. Page 17 Risks Relating to Government Regulation Healthcare reform legislation and/or executive action may affect our business.
Removed
Moreover, there is uncertainty regarding our ability to pass on these increased costs to customers to mitigate inflationary pressures. Sustained increases in inflation could impact the overall demand for our products and services, as well as our labor, equipment, and product costs, potentially affecting our profit margins.
Added
In addition, the current Presidential administration has, since taking office, pursued executive actions and policy initiatives intended to change the structure, priorities, and funding of various federal agencies and programs.
Removed
This, in turn, could have adverse consequences for our business, financial position, results of operations, and cash flows. Despite recent inflationary trends, we cannot accurately predict whether these patterns will persist. Future volatility in general price inflation and its impact on material availability, shipping, warehousing, and operational overhead could further impact financial results.
Added
Changes in agency funding levels, staffing capacity, rulemaking priorities, enforcement practices, or administrative processes could influence reimbursement policy, audit activity, prior authorization requirements, claims adjudication timelines, and the interpretation or implementation of applicable laws and regulations.
Removed
We attempt to address these pressures through our inflation-linked reimbursement contracts, negotiation, leveraging our purchasing power and embracing technology, such as our proprietary clinical management platform. Risks Relating to Government Regulation Healthcare reform legislation and/or executive action may affect our business. Healthcare reform laws significantly affect the U.S. healthcare services industry.
Added
It is difficult to predict the extent to which these actions may be implemented, modified, or delayed, including as a result of litigation or changes in political priorities, or the ultimate impact on healthcare providers.
Removed
Additionally, the new Presidential administration has begun its term with actions aimed at reforming government, including reductions in size and funding for many executive agencies.

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Item 1C. Cybersecurity

Cybersecurity — threats and controls disclosure

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Biggest changePrior to their current roles with the Company, our CIO, CTO, and CISO held various information technology and cybersecurity positions with other healthcare services and healthcare technology companies. They have collectively obtained various industry-recognized certifications, including the Certified Security Compliance Specialist, Certified Cyber Security Architect, and Certified HIPAA Professional designations.
Biggest changePrior to joining the Company, our CIO held information technology leadership roles, including at a publicly traded company, and our CISO held information technology and cybersecurity roles in healthcare services and healthcare technology organizations. They have collectively obtained various industry-recognized certifications, including the Certified Security Compliance Specialist, Certified Cyber Security Architect, and Certified HIPAA Professional designations.
Our information systems management team, comprising the Chief Information Officer (CIO), Chief Technology Officer (CTO), and Chief Information Security Officer (CISO), collectively possesses over 50 years of extensive experience in information technology and cybersecurity.
Our information systems management team, comprising the Chief Information Officer (CIO) and Chief Information Security Officer (CISO), collectively possesses over 50 years of extensive experience in information technology and cybersecurity.
These frameworks guide our focus on: (i) cultivating organizational understanding to manage cybersecurity risks, (ii) implementing safeguards to fortify our systems, (iii) promptly detecting cybersecurity incidents, (iv) responding effectively to incidents, and (v) ensuring a swift recovery from any cybersecurity event. Where appropriate, these processes and policies are seamlessly integrated into our overarching risk management systems.
These frameworks guide our focus on: (i) cultivating organizational understanding to manage cybersecurity risks, (ii) implementing safeguards to protect our systems, (iii) promptly detecting cybersecurity incidents, (iv) responding effectively to incidents, and (v) ensuring a swift recovery from any cybersecurity event. Where appropriate, these processes and policies are seamlessly integrated into our overarching risk management systems.
Upon identification, we conduct thorough due diligence to fortify these relationships. Our comprehensive insurance portfolio includes cybersecurity insurance to provide an additional layer of protection. For further insights into the cybersecurity risks we confront, please refer to Item 1A.
Upon identification, we conduct thorough due diligence to manage these relationships. Our comprehensive insurance portfolio includes cybersecurity insurance to provide an additional layer of protection. For further insights into the cybersecurity risks we confront, please refer to Item 1A.
The CISO holds the position of the Information Security Officer and directs cybersecurity operations. To enhance governance and oversight, we have established a Security Oversight Committee, chaired by the Information Security Officer and joined by key stakeholders such as our Chief Information Officer and General Counsel.
The CISO holds the position of the Information Security Officer and directs cybersecurity operations. To enhance governance and oversight, we have established a Security Oversight Committee, chaired by the Information Security Officer and joined by key stakeholders such as our CIO and General Counsel.
Regular tabletop exercises, conducted at least annually, test the effectiveness of our processes, with senior management actively participating. Valuable insights gained from these exercises are incorporated to refine and bolster our cybersecurity measures. Identification of critical third-party relationships vulnerable to cybersecurity threats is an integral part of our risk management program.
Regular tabletop exercises, conducted at least annually, test the effectiveness of our processes, with senior management actively participating. Valuable insights gained from these exercises are incorporated to refine and bolster our cybersecurity measures. Identification of critical third-party relationships that may present heightened cybersecurity risk is an integral part of our risk management program.
Item 1C. Cybersecurity Risk Management and Strategy We have implemented robust processes and policies dedicated to assessing, identifying, and effectively managing material risks associated with cybersecurity threats. Our cybersecurity program is designed and evaluated based on recognized frameworks such as the National Institute of Standards and Technology and the Center for Internet Security.
Item 1C. Cybersecurity Risk Management and Strategy We have implemented robust processes and policies designed to assess, identify, and effectively manage material risks associated with cybersecurity threats. Our cybersecurity program is designed and evaluated based on recognized frameworks such as the National Institute of Standards and Technology (NIST) and the Center for Internet Security (CIS).

Item 2. Properties

Properties — owned and leased real estate

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Biggest changeItem 2. Properties We own our headquarters, consisting of approximately 77,000 square feet, which is located on an approximately 8.2-acre parcel in Lafayette, Louisiana. We also own and occupy a 16,000 square foot office building and a 16,000 square foot climate-controlled warehouse located in Lafayette, Louisiana.
Biggest changeItem 2. Properties We own our headquarters, consisting of approximately 77,000 square feet, located on an approximately 8.2-acre parcel in Lafayette, Louisiana. We also own and occupy a 16,000 square foot office building and a 16,000 square foot climate-controlled warehouse also located in Lafayette, Louisiana.

Item 3. Legal Proceedings

Legal Proceedings — active lawsuits and investigations

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Biggest changeItem 3. Legal Proceedings From time to time, we may be subject to various ongoing or threatened legal actions and other proceedings, including those that arise in the ordinary course of business, which may include employment matters, breach of contract disputes, as well as governmental and regulatory matters.
Biggest changeItem 3. Legal Proceedings From time to time, we may be subject to legal actions and other proceedings, including those that arise in the ordinary course of business, which may include employment matters, breach of contract disputes, as well as governmental and regulatory matters.
Please read Note 9 to the Financial Statements, included in Part II, Item 8, of this Annual Report on Form 10-K for more information. Such matters are subject to many uncertainties and to outcomes that are not predictable with assurance and that may not be known for extended periods of time.
Please read Note 9 to the Financial Statements, included in Part II, Item 8, of this Annual Report on Form 10-K for more information. Such matters are subject to uncertainties and outcomes that are not predictable with assurance and that may not be known for extended periods of time.
In the opinion of management, the outcome of such routine ongoing litigation is not expected to have a material adverse effect on our results of operations or financial condition.
In the opinion of management, the outcome of such matters is not expected to have a material adverse effect on our results of operations or financial condition.

Item 5. Market for Registrant's Common Equity

Market for Common Equity — stock, dividends, buybacks

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Biggest changeThe following graph compares the total cumulative return on funds invested in Common Shares of the Corporation, compared to the total cumulative return of (i) the cumulative total return of the Russell 2000 Index and (ii) the cumulative total return of the S&P Healthcare Services Select Industry Index, in each case, for the period from December 31, 2019 to December 31, 2024: Page 29 Dec 31, 2019 Dec 31, 2020 Dec 31, 2021 Dec 31, 2022 Dec 31, 2023 Dec 31, 2024 Viemed Healthcare, Inc. $ 100 $ 125 $ 84 $ 122 $ 127 $ 129 Russell 2000 Index $ 100 $ 118 $ 135 $ 106 $ 121 $ 140 S&P Healthcare Services Select Industry Index $ 100 $ 133 $ 146 $ 116 $ 122 $ 123 Recent Sales of Unregistered Equity Securities None.
Biggest changeThe following graph compares the total cumulative return on funds invested in common shares of the Company with the total cumulative return of (i) the Russell 2000 Index and (ii) the S&P Healthcare Services Select Industry Index, in each case, for the period from December 31, 2020 to December 31, 2025: Dec 31, 2020 Dec 31, 2021 Dec 31, 2022 Dec 31, 2023 Dec 31, 2024 Dec 31, 2025 Viemed Healthcare, Inc. $ 100 $ 67 $ 97 $ 101 $ 103 $ 96 Russell 2000 Index $ 100 $ 114 $ 89 $ 103 $ 118 $ 126 S&P Healthcare Services Select Industry Index $ 100 $ 109 $ 87 $ 92 $ 93 $ 110 Page 29 Recent Sales of Unregistered Equity Securities None.
Item 5. Market For Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Market Information The common shares of Viemed trade on the Nasdaq Capital Market under the symbol "VMD". Shareholders We had thirteen shareholders of record as of February 14, 2025.
Item 5. Market For Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Market Information The common shares of Viemed are listed for trading on the Nasdaq Stock Market LLC under the symbol "VMD". Shareholders We had thirteen shareholders of record as of January 27, 2026.

Item 7. Management's Discussion & Analysis

Management's Discussion & Analysis (MD&A) — revenue / margin commentary

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Biggest changePage 33 Results of Operations Comparison of the Years Ended December 31, 2024 and 2023: The following table summarizes our results of operations for the years ended December 31, 2024 and 2023: Year Ended December 31, 2024 % of Total Revenue 2023 % of Total Revenue $ Change % Change Revenue $ 224,257 100.0 % $ 183,008 100.0 % $ 41,249 22.5 % Cost of revenue 91,054 40.6 % 70,225 38.4 % 20,829 29.7 % Gross profit 133,203 59.4 % 112,783 61.6 % 20,420 18.1 % Selling, general and administrative 106,199 47.4 % 87,884 48.0 % 18,315 20.8 % Research and development 3,068 1.3 % 2,782 1.5 % 286 10.3 % Stock-based compensation 6,285 2.8 % 5,849 3.2 % 436 7.5 % Depreciation and amortization 1,483 0.6 % 1,391 0.8 % 92 6.6 % Loss (gain) on disposal of property and equipment (1,905) (0.8) % 645 0.4 % (2,550) (395.3) % Other expense (income), net 173 0.1 % (98) (0.1) % 271 (276.5) % Income from operations 17,900 8.0 % 14,330 7.8 % 3,570 24.9 % Non-operating income and expenses Income (expense) from investments (954) (0.4) % 485 0.3 % (1,439) (296.7) % Interest expense, net (776) (0.4) % (424) (0.2) % (352) 83.0 % Net income before taxes 16,170 7.2 % 14,391 7.9 % 1,779 12.4 % Provision for income taxes 4,761 2.1 % 4,148 2.3 % 613 14.8 % Net income $ 11,409 5.1 % $ 10,243 5.6 % $ 1,166 11.4 % Net income attributable to noncontrolling interest 144 0.1 % — — % 144 NM Net income attributable to Viemed Healthcare, Inc. $ 11,265 5.0 % $ 10,243 5.6 % $ 1,022 10.0 % Revenue The following table summarizes our revenue for the years ended December 31, 2024 and 2023: Year Ended December 31, 2024 % of Total Revenue 2023 % of Total Revenue $ Change % Change Net revenue from rentals Ventilator rentals, non-invasive and invasive $ 124,577 55.6 % $ 108,258 59.2 % $ 16,319 15.1 % Other home medical equipment rentals 48,651 21.7 % 38,315 20.9 % 10,336 27.0 % Net revenue from sales and services Equipment and supply sales 30,896 13.7 % 25,770 14.1 % 5,126 19.9 % Service revenues 20,133 9.0 % 10,665 5.8 % 9,468 88.8 % Total net revenue $ 224,257 100.0 % $ 183,008 100.0 % $ 41,249 22.5 % For the year ended December 31, 2024, revenue totaled $224.3 million, an increase of $41.2 million (or 22.5%) from the comparable period in 2023.
Biggest changePage 34 Results of Operations Comparison of the Years Ended December 31, 2025 and 2024: The following table summarizes our results of operations for the years ended December 31, 2025 and 2024: Year Ended December 31, 2025 % of Total Revenue 2024 % of Total Revenue $ Change % Change Revenue $ 270,280 100.0 % $ 224,257 100.0 % $ 46,023 20.5 % Cost of revenue 114,822 42.5 % 91,054 40.6 % 23,768 26.1 % Gross profit 155,458 57.5 % 133,203 59.4 % 22,255 16.7 % Selling, general and administrative 121,366 44.9 % 106,199 47.4 % 15,167 14.3 % Research and development 3,017 1.1 % 3,068 1.3 % (51) (1.7) % Stock-based compensation 9,132 3.4 % 6,285 2.8 % 2,847 45.3 % Depreciation and amortization 1,485 0.5 % 1,483 0.6 % 2 0.1 % Gain on disposal of property and equipment (2,239) (0.8) % (1,905) (0.8) % (334) 17.5 % Other expense (income), net (252) (0.1) % 173 0.1 % (425) (245.7) % Income from operations 22,949 8.5 % 17,900 8.0 % 5,049 28.2 % Non-operating income and expenses Income (loss) from investments — — % (954) (0.4) % 954 (100.0) % Interest expense, net (1,182) (0.4) % (776) (0.4) % (406) 52.3 % Net income before taxes 21,767 8.1 % 16,170 7.2 % 5,597 34.6 % Provision for income taxes 6,391 2.4 % 4,761 2.1 % 1,630 34.2 % Net income $ 15,376 5.7 % $ 11,409 5.1 % $ 3,967 34.8 % Net income attributable to noncontrolling interest 442 0.2 % 144 0.1 % 298 206.9 % Net income attributable to Viemed Healthcare, Inc. $ 14,934 5.5 % $ 11,265 5.0 % $ 3,669 32.6 % Revenue The following table summarizes our revenue for the years ended December 31, 2025 and 2024: Year Ended December 31, 2025 % of Total Revenue 2024 % of Total Revenue $ Change % Change Net revenue from rentals Ventilator rentals, non-invasive and invasive $ 136,749 50.6 % $ 124,577 55.6 % $ 12,172 9.8 % Other home medical equipment rentals 58,386 21.6 % 48,651 21.7 % 9,735 20.0 % Net revenue from sales and services Equipment and supply sales 50,254 18.6 % 30,896 13.7 % 19,358 62.7 % Service revenues 24,891 9.2 % 20,133 9.0 % 4,758 23.6 % Total net revenue $ 270,280 100.0 % $ 224,257 100.0 % $ 46,023 20.5 % For the year ended December 31, 2025, revenue totaled $270.3 million, an increase of $46.0 million (or 20.5%) from the comparable period in 2024.
General Matters In this Annual Report on Form 10-K, unless the context otherwise requires, the terms the "Company," "we," "us" and "our" refer to Viemed Healthcare, Inc. and subsidiaries in which it has a controlling financial interest. We were incorporated on December 14, 2016 pursuant to the Business Corporations Act (British Columbia).
General Matters In this Annual Report on Form 10-K, unless the context otherwise requires, the terms "Company," "we," "us" and "our" refer to Viemed Healthcare, Inc. and subsidiaries in which it has a controlling financial interest. We were incorporated on December 14, 2016 pursuant to the Business Corporations Act (British Columbia).
An accordion feature allows the Company to increase the size of such facilities by up to an additional $30.0 million, subject to certain conditions, for a total borrowing capacity of up to $90 million.
An accordion feature allows the Company to increase the size of such facilities by up to an additional $30.0 million, subject to certain conditions, for a total borrowing capacity of up to $90.0 million.
On May 28, 2024, the Company entered into a First Amendment to the 2022 Senior Credit Facilities that (a) extends the delayed draw term loan commitment expiration date to November 29, 2025, from its initial expiration date of May 29, 2024, and (b) provides for other technical amendments.
On May 28, 2024, the Company entered into a First Amendment to the 2022 Senior Credit Facilities that extends the delayed draw term loan commitment expiration date to November 29, 2025, from its initial expiration date of May 29, 2024, and provides for other technical amendments.
Trends Affecting our Business Home medical equipment markets are witnessing sustained expansion, with a notable focus on the complex respiratory and Obstructive Sleep Apnea ("OSA") device segments. Analysts in the industry anticipate a consistent and robust growth trajectory, projecting Compound Annual Growth Rates ("CAGR") of approximately 6% for respiratory devices and 8% for OSA devices.
Trends Affecting Our Business Demographic and Market Trends Home medical equipment markets are witnessing sustained expansion, with a notable focus on the complex respiratory and Obstructive Sleep Apnea ("OSA") device segments. Analysts in the industry anticipate a consistent and robust growth trajectory, projecting Compound Annual Growth Rates ("CAGR") of approximately 6% for respiratory devices and 8% for OSA devices.
Future volatility in general price inflation and its impact on material availability, shipping, warehousing, and operational overhead could further impact financial results. Viemed attempts to address these pressures through its inflation-linked reimbursement contracts, negotiation, leveraging its purchasing power and embracing technology, such as its proprietary clinical management platform.
Future volatility in general price inflation and its impact on material availability, shipping, warehousing, and operational overhead could further impact financial results. Viemed attempts to manage these pressures through its inflation-linked reimbursement contracts, negotiation, leveraging its purchasing power, and embracing technology, such as its proprietary clinical management platform.
For discussion on results of operations and financial condition pertaining to 2022 and year-over-year comparisons between 2023 and 2022, please refer to “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of our Annual Report on Form 10-K for the year ended December 31, 2023.
For discussion on results of operations and financial condition pertaining to 2023 and year-over-year comparisons between 2024 and 2023, please refer to “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of our Annual Report on Form 10-K for the year ended December 31, 2024.
Recently Issued Accounting Pronouncements See Note 2 – Summary of Significant Accounting Policies of the Notes to Consolidated Financial Statements for a description of recently issued accounting pronouncements, including the expected dates of adoption and estimated effects on our results of operations, financial positions and cash flows.
Recently Issued Accounting Pronouncements See Note 2 – Summary of Significant Accounting Policies of the Notes to Consolidated Financial Statements for a description of recently issued accounting pronouncements, including the expected dates of adoption and estimated effects on our results of operations, financial positions and cash flows. Page 41
We expect to continue to be a solution to the rising health care costs in the United States by offering more cost-effective, home-based solutions while increasing the quality of life for patients fighting serious respiratory diseases.
We expect to continue to be a solution to the rising health care costs in the United States by offering more cost-effective, home-based solutions while increasing the quality of life for patients fighting serious chronic diseases.
Page 32 The below table highlights summary financial and operational metrics for the last eight quarters (expressed in thousands of U.S. Dollars, except operational information).
Page 33 The below table highlights summary financial and operational metrics for the last eight quarters (expressed in thousands of U.S. Dollars, except operational information).
Matching employer contributions to the 401(k) plan totaled $1.6 million and $1.4 million for the years ended December 31, 2024 and 2023, respectively. Off Balance Sheet Arrangements The Company has no material undisclosed off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on its results of operations or financial condition.
Matching employer contributions to the 401(k) plan totaled $1.9 million and $1.6 million for the years ended December 31, 2025 and 2024, respectively. Off Balance Sheet Arrangements The Company has no material undisclosed off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on its results of operations or financial condition.
Discussion in this Form 10-K includes results of operations and financial condition for 2024 and 2023 and year-over-year comparisons between 2024 and 2023.
Discussion in this Form 10-K includes results of operations and financial condition for 2025 and 2024 and year-over-year comparisons between 2025 and 2024.
The net income adjustments primarily consisted of $25.4 million of depreciation and amortization, $6.3 million of stock-based compensation, and an impairment loss on debt investment of $1.3 million, partially offset by a $3.8 million change in deferred tax asset and a $1.9 million gain on disposal of property and equipment.
The net income adjustments primarily consisted of $25.4 million of depreciation and amortization, $6.3 million of stock-based compensation, and an impairment loss on debt investment of $1.3 million, partially offset by a $3.8 million deferred income tax benefit, and a $1.9 million gain on disposal of property and equipment.
(b) Represents transaction costs and expenses related to acquisition and integration efforts associated with recently announced or completed acquisitions. (c) Represents impairments of the fair value of investment and litigation-related assets. Liquidity and Capital Resources Cash and cash equivalents at December 31, 2024 was $17.5 million, compared to $12.8 million at December 31, 2023.
(b) Represents transaction costs and expenses related to acquisition and integration efforts associated with recently announced or completed acquisitions. (c) Represents impairments of the fair value of investment and litigation-related assets. Liquidity and Capital Resources Cash and cash equivalents at December 31, 2025 was $13.5 million, compared to $17.5 million at December 31, 2024.
There were no outstanding borrowings under the 2022 Revolving Credit Facility as of December 31, 2024.
There were no outstanding borrowings under the 2022 Revolving Credit Facility as of December 31, 2025.
The proceeds of the 2022 Term Loan Facility and any additional term loans established in accordance with the 2022 Senior Credit Facilities may be used to finance permitted acquisitions and to pay transaction fees, costs and expenses related to such acquisitions. Outstanding borrowings under the 2022 Term Loan Facility were $4.6 million as of December 31, 2024.
The proceeds of the 2022 Term Loan Facility and any additional term loans established in accordance with the 2022 Senior Credit Facilities may be used to finance permitted acquisitions and to pay transaction fees, costs and expenses related to such acquisitions. Outstanding borrowings under the 2022 Term Loan Facility were $12.9 million as of December 31, 2025.
In calculating Adjusted EBITDA, certain items (mostly non-cash) are excluded from net income including depreciation and amortization of capitalized assets, net interest expense (income), stock based compensation, transaction costs, impairment of assets, and taxes.
In calculating Adjusted EBITDA, certain items (mostly non-cash) are excluded from net income attributable to Viemed Healthcare, Inc. including depreciation and amortization of capitalized assets, net interest expense, stock based compensation, transaction costs, impairment of assets, and taxes.
Our services include respiratory disease management (through the rental of various HME devices), neuromuscular care, in-home sleep testing and sleep apnea treatment, oxygen therapy, the sale of associated supplies, and healthcare staffing services.
Viemed's services include respiratory disease management (through the rental of various HME devices), neuromuscular care, in-home sleep testing and sleep apnea treatment, oxygen therapy, the sale of associated supplies, women’s health products and services, and healthcare staffing services.
Revenue derived from the rental and sale of home medical equipment represented a combined 91.0% and 94.2%, respectively, of Viemed’s 2024 and 2023 revenue. Page 31 Our primary sources of capital to date have been from operating cash flows.
Revenue derived from the rental and sale of home medical equipment represented a combined 90.8% and 91.0%, respectively, of Viemed’s 2025 and 2024 revenue. Page 31 Our primary sources of capital to date have been from operating cash flows.
We derive the majority of our revenue through the rental of non-invasive and invasive ventilators which represented 55.6% and 59.2% of our revenue for the years ended December 31, 2024 and 2023, respectively. We combine the benefits of home ventilation support with licensed RTs to drive improved patient outcomes and reduce costly hospital readmissions.
We derive a significant portion of our revenue through the rental of non-invasive and invasive ventilators which represented 50.6% and 55.6% of our revenue for the years ended December 31, 2025 and 2024, respectively. We combine the benefits of home ventilation support with licensed RTs to drive improved patient outcomes and reduce costly hospital readmissions.
These value-based contracts leverage data analytics to demonstrate the cost-effectiveness and quality of durable medical goods and provide evidence-based data to payors demonstrating the long-term benefits and cost savings associated with the use of certain medical goods.
These value-based contracts leverage data analytics to demonstrate the cost-effectiveness and quality of durable medical goods and provide evidence-based data to payors demonstrating the long-term benefits and cost savings associated with the use of certain medical goods. Regulatory and Policy Developments Regulatory and policy developments remain a key area of focus.
Subsequent to the HomeMed acquisition, principal payments on the 2022 Revolving Credit Facility were $5.0 million. Principal payments on the 2022 Term Loan Facility (as defined below) were $0.3 million. Additionally, principal payments on acquired loans were $0.8 million during the year ended December 31, 2024.
Principal payments on the 2022 Term Loan Facility (as defined below) were $0.3 million. Additionally, principal payments on acquired loans were $0.8 million during the year ended December 31, 2024.
Our respiratory care programs are designed specifically for payors to have the ability to treat patients in the home for less total cost and with a superior quality of care.
Viemed's care programs are designed specifically to treat patients in the home for less total cost and with a superior quality of care.
Page 38 Net Cash Provided by (Used in) Financing Activities Net cash used in financing activities during the year ended December 31, 2024 was $3.7 million. Proceeds from the 2022 Revolving Credit Facility (as defined below) were $3.0 million, which was used to fund the HomeMed acquisition.
Net cash used in financing activities during the year ended December 31, 2024 was $3.7 million. During the period, proceeds from the 2022 Revolving Credit Facility (as defined below) were $3.0 million, which were used to fund the HomeMed acquisition. Subsequent to the HomeMed acquisition, principal payments on the 2022 Revolving Credit Facility were $5.0 million.
The 2022 Senior Credit Facilities also include certain financial covenants, which generally include, but are not limited to the following: • Consolidated Total Leverage Ratio ( defined generally as total indebtedness to adjusted EBITDA) of not greater than (i) for any fiscal quarter ending during the period from the closing date to and including December 31, 2024, 2.75 to 1.0 and (ii) for any fiscal quarter ending on and after March 31, 2025, 2.50 to 1.0, subject to certain adjustments following a material acquisition. • Consolidated Fixed Charge Coverage Ratio ( defined generally as (a) adjusted EBITDA minus capital expenditures minus cash taxes to (b) the sum of scheduled principal payments plus cash interest expense plus restricted payments) of not less than 1.25:1.0.
The 2022 Senior Credit Facilities also include certain financial covenants, which generally include, but are not limited to the following: • Consolidated Total Leverage Ratio ( defined generally as total indebtedness to adjusted EBITDA) of not greater than (i) for any fiscal quarter ending during the period from the closing date to and including December 31, 2024, 2.75 to 1.0 and (ii) for any fiscal quarter ending on and after March 31, 2025, 2.50 to 1.0, subject to certain adjustments following a material acquisition.
Interest Expense, Net For the year ended December 31, 2024, net interest expense totaled $0.8 million, an increase of $0.4 million from the comparable period in 2023. The increase in net interest expense is primarily due to outstanding borrowings as a result of debt issued to fund acquisitions.
Interest Expense, Net For the year ended December 31, 2025, net interest expense was $1.2 million, an increase of $0.4 million from the comparable period in 2024. The increase in net interest expense is primarily due to outstanding borrowings as a result of debt issued to fund the Lehan acquisition.
The following table presents our material contractual obligations and commitments to make future payments as of December 31, 2024: Within 12 Months Beyond 12 Months Debt Obligations, including interest $ 758 $ 4,720 Lease Obligations 1,054 2,237 Total $ 1,812 $ 6,957 Except for the funding of potential acquisitions and investments, we anticipate that our operating cash flows will satisfy our material cash requirements for the 12 months after December 31, 2024.
The following table presents our material contractual obligations and commitments to make future payments as of December 31, 2025: Within 12 Months Beyond 12 Months Debt Obligations, including interest $ 2,578 $ 12,456 Lease Obligations 1,442 2,615 Total $ 4,020 $ 15,071 Except for the funding of potential acquisitions and investments, we anticipate that our operating cash flows will satisfy our material cash requirements for the 12 months after December 31, 2025.
The Company acquired and cancelled 142,985 common shares at a cost of $1.1 million to satisfy employee income tax withholding associated with RSUs vestings while proceeds from the exercise of options during the year ended December 31, 2024 were $1.0 million. Net cash provided by financing activities during the year ended December 31, 2023 was $2.8 million.
The Company acquired and cancelled 142,985 common shares at a cost of $1.1 million to satisfy employee income tax withholding obligations associated with the vesting of RSUs, while proceeds from the exercise of options during the year ended December 31, 2024 were $1.0 million.
For the year ended December 31, 2024, we generated revenues of $224.3 million and had net income of $11.4 million, compared to revenues of $183.0 million and net income of $10.2 million for the year ended December 31, 2023. Net revenue increased $41.2 million (or 22.5% ) from the comparable period in 2023.
For the year ended December 31, 2025, we generated revenues of $270.3 million and had net income of $15.4 million, compared to revenues of $224.3 million and net income of $11.4 million for the year ended December 31, 2024. Net revenue increased $46.0 million (or 20.5% ) from the comparable period in 2024.
Cash Flows The following table summarizes our cash flows for the periods indicated: Year Ended December 31, 2024 2023 Net Cash provided by (used in): Operating activities $ 39,089 $ 45,212 Investing activities (30,699) (52,113) Financing activities (3,689) 2,826 Net increase (decrease) in cash and cash equivalents $ 4,701 $ (4,075) Net Cash Provided by Operating Activities Net cash provided by operating activities during the year ended December 31, 2024 was $39.1 million, resulting from net income of $11.4 million, increased by net income adjustments of $27.3 million and offset by an increase in non-cash working capital of $0.4 million.
Cash Flows The following table summarizes our cash flows for the periods indicated: Year Ended December 31, 2025 2024 Net Cash provided by (used in): Operating activities $ 51,916 $ 39,089 Investing activities (50,166) (30,699) Financing activities (5,789) (3,689) Net increase (decrease) in cash and cash equivalents $ (4,039) $ 4,701 Net Cash Provided by Operating Activities Net cash provided by operating activities during the year ended December 31, 2025 was $51.9 million, resulting from net income of $15.4 million, increased by net income adjustments of $38.8 million and offset by an increase in non-cash working capital of $2.3 million.
Net cash used for capital expenditures during the period was $23.5 million and consisted of $26.1 million of purchases of property and equipment, partially offset by $2.6 million of sales proceeds from the disposal of property and equipment. Purchases of property and equipment were primarily related to medical equipment rented to our patients.
Net cash used for capital expenditures during the period was $27.5 million and consisted of $37.8 million of purchases of property and equipment, partially offset by $10.3 million of sales proceeds from the disposal of property and equipment. Purchases of property and equipment were primarily related to medical equipment placed with patients under our rental arrangements.
Net cash used in investing activities also included $3.0 million of net cash paid for the acquisition of East Alabama HomeMed, LLC ("HomeMed") and $1.0 million for an equity investment.
Net cash used in investing activities also included $3.0 million of net cash paid for the acquisition of East Alabama HomeMed, LLC ("HomeMed") and $1.0 million related to an equity investment. Page 39 Net Cash Used in Financing Activities Net cash used in financing activities during the year ended December 31, 2025 was $5.8 million.
Net cash used in investing activities during the year ended December 31, 2023 was $52.1 million , primarily due to the net cash paid for the acquisition of HMP of $28.6 million .
Net Cash Used in Investing Activities Net cash used in investing activities during the year ended December 31, 2025 was $50.2 million, primarily due to the net cash paid for the acquisition of Lehan of $26.3 million.
We expect to grow through expansion of existing service areas as well as in new territories through a cost-efficient launch that reduces location expenses. We currently serve patients in all 50 states. Viemed anticipates expanding its workforce of RTs to support the Company's growth and ensure the high service model is maintained in the home.
We expect to grow through expansion of existing service areas as well as in new territories through a cost efficient launch that reduces location expenses. We currently serve patients in all 50 states.
The following table is a reconciliation of Net income, the most directly comparable GAAP measure, to Adjusted EBITDA, on a historical basis for the periods indicated: For the quarter ended December 31, 2024 September 30, 2024 June 30, 2024 March 31, 2024 December 31, 2023 September 30, 2023 June 30, 2023 March 31, 2023 Net Income attributable to Viemed Healthcare, Inc. $ 4,316 $ 3,878 $ 1,468 $ 1,603 $ 3,477 $ 2,919 $ 2,330 $ 1,517 Add back: Depreciation & amortization 6,366 6,408 6,309 6,285 5,918 5,975 5,207 4,762 Interest expense (income) 147 225 254 150 256 237 (20) (49) Stock-based compensation (a) 1,521 1,712 1,620 1,432 1,534 1,453 1,471 1,391 Transaction costs (b) 11 12 221 110 61 177 94 206 Impairment of assets (c) — 125 2,173 — — — — — Income tax expense 1,881 1,594 768 518 1,599 1,320 728 501 Adjusted EBITDA $ 14,242 $ 13,954 $ 12,813 $ 10,098 $ 12,845 $ 12,081 $ 9,810 $ 8,328 (a) Represents non-cash, equity-based compensation expense associated with option and RSU awards.
The following table is a reconciliation of net income attributable to Viemed Healthcare, Inc., the most directly comparable GAAP measure, to Adjusted EBITDA, on a historical basis for the periods indicated: For the quarter ended December 31, 2025 September 30, 2025 June 30, 2025 March 31, 2025 December 31, 2024 September 30, 2024 June 30, 2024 March 31, 2024 Net Income attributable to Viemed Healthcare, Inc. $ 5,639 $ 3,513 $ 3,157 $ 2,625 $ 4,316 $ 3,878 $ 1,468 $ 1,603 Add back: Depreciation & amortization 7,570 7,539 6,891 6,613 6,366 6,408 6,309 6,285 Interest expense, net 364 507 132 179 147 225 254 150 Stock-based compensation (a) 2,300 2,180 2,341 2,311 1,521 1,712 1,620 1,432 Transaction costs (b) 139 847 53 85 11 12 221 110 Impairment of assets (c) — — — — — 125 2,173 — Income tax expense 2,191 1,535 1,713 952 1,881 1,594 768 518 Adjusted EBITDA $ 18,203 $ 16,121 $ 14,287 $ 12,765 $ 14,242 $ 13,954 $ 12,813 $ 10,098 (a) Represents non-cash, equity-based compensation expense associated with option and RSU awards.
Net cash provided by operating activities during the year ended December 31, 2023 was $45.2 million, resulting from net income of $10.2 million, increased by net income adjustments of $27.2 million and a change in non-cash working capital of $7.8 million.
Net cash provided by operating activities during the year ended December 31, 2024 was $39.1 million, resulting from net income of $11.4 million, increased by net income adjustments of $27.3 million and offset by an increase in non-cash working capital of $0.4 million.
As of December 31, 2024, we employed 404 licensed RTs, representing approximately 34% of our company-wide employee count. Beyond fulfilling its internal staffing needs, Viemed also provides healthcare staffing and recruitment services, offering tailored workforce solutions to external healthcare institutions and partners seeking qualified clinical professionals.
Beyond fulfilling its internal staffing needs, Viemed also provides healthcare staffing and recruitment services, offering tailored workforce solutions to external healthcare institutions and partners seeking qualified clinical professionals.
Proceeds from the 2022 Term Loan Facility (as defined below) were $5.0 million and proceeds from the 2022 Revolving Credit Facility (as defined below) were $8.0 million, which were used to partially fund the cash acquisition of HMP. During the year ended December 31, 2023, principal payments on the 2022 Senior Credit Facilities (as defined below) were $6.1 million.
During the period, proceeds from the 2022 Term Loan Facility (as defined below) were $9.0 million and proceeds from the 2022 Revolving Credit Facility (as defined below) were $13.0 million, which were used to partially fund the cash acquisition of Lehan.
For the quarter ended December 31, 2024 September 30, 2024 June 30, 2024 March 31, 2024 December 31, 2023 September 30, 2023 June 30, 2023 March 31, 2023 Financial Information: Revenue $ 60,695 $ 58,004 $ 54,965 $ 50,593 $ 50,739 $ 49,402 $ 43,311 $ 39,556 Gross Profit $ 36,138 $ 34,371 $ 32,892 $ 29,802 $ 32,111 $ 30,562 $ 26,106 $ 24,004 Gross Profit % 60 % 59 % 60 % 59 % 63 % 62 % 60 % 61 % Net Income attributable to Viemed Healthcare, Inc. $ 4,316 $ 3,878 $ 1,468 $ 1,603 $ 3,477 $ 2,919 $ 2,330 $ 1,517 Cash and Cash Equivalents (As of) $ 17,540 $ 11,347 $ 8,807 $ 7,309 $ 12,839 $ 10,078 $ 10,224 $ 23,544 Total Assets (As of) $ 177,069 $ 169,526 $ 163,947 $ 154,875 $ 154,895 $ 149,400 $ 149,117 $ 124,634 Adjusted EBITDA (1) $ 14,242 $ 13,954 $ 12,813 $ 10,098 $ 12,845 $ 12,081 $ 9,810 $ 8,328 Operational Information: Vent Patients (2) 11,795 11,374 10,905 10,450 10,327 10,244 10,005 9,337 PAP Therapy Patients (3) 21,338 19,478 17,349 15,726 14,900 14,788 13,313 8,097 Sleep Resupply Patients (4) 24,478 22,143 20,185 18,904 18,902 18,544 12,572 7,279 (1) Refer to "Non-GAAP Financial Measures" section below for definition of Adjusted EBITDA.
For the quarter ended December 31, 2025 September 30, 2025 June 30, 2025 March 31, 2025 December 31, 2024 September 30, 2024 June 30, 2024 March 31, 2024 Financial Information: Revenue $ 76,181 $ 71,914 $ 63,056 $ 59,129 $ 60,695 $ 58,004 $ 54,965 $ 50,593 Gross Profit $ 44,103 $ 41,345 $ 36,731 $ 33,279 $ 36,138 $ 34,371 $ 32,892 $ 29,802 Gross Profit % 58 % 57 % 58 % 56 % 60 % 59 % 60 % 59 % Net Income attributable to Viemed Healthcare, Inc. $ 5,639 $ 3,513 $ 3,157 $ 2,625 $ 4,316 $ 3,878 $ 1,468 $ 1,603 Cash and Cash Equivalents (As of) $ 13,501 $ 11,123 $ 20,016 $ 10,160 $ 17,540 $ 11,347 $ 8,807 $ 7,309 Total Assets (As of) $ 199,154 $ 202,360 $ 184,603 $ 178,079 $ 177,069 $ 169,526 $ 163,947 $ 154,875 Adjusted EBITDA (1) $ 18,203 $ 16,121 $ 14,287 $ 12,765 $ 14,242 $ 13,954 $ 12,813 $ 10,098 Operational Information: Vent Patients (2) 12,259 12,372 12,152 11,809 11,795 11,374 10,905 10,450 PAP Therapy Patients (3) 34,528 31,891 26,260 22,899 21,338 19,478 17,349 15,726 Sleep Resupply Patients (4) 36,561 33,518 25,246 22,941 24,478 22,143 20,185 18,904 (1) Refer to "Non-GAAP Financial Measures" section below for definition of Adjusted EBITDA.
Page 36 Non-GAAP Financial Measures The Company uses Adjusted EBITDA, which is a financial measure that is not prepared in accordance with generally accepted accounting principles in the United States ("GAAP"). Adjusted EBITDA should be considered in addition to, not as a substitute for, or superior to, financial measures calculated in accordance with GAAP.
Adjusted EBITDA should be considered in addition to, not as a substitute for, or superior to, financial measures calculated in accordance with GAAP.
The overall increase in selling, general and administrative expense as compared to the prior period is primarily attributable to additional employee related expenses to accommodate the overall growth of the Company, which was partially due to the acquisition of Home Medical Products, Inc. (“HMP”) on June 1, 2023.
The overall increase in selling, general and administrative expense as compared to the prior period is primarily attributable to additional employee-related expenses to support the Company's overall growth and the inclusion of operating expenses from the Lehan acquisition completed on July 1, 2025.
The primary changes in working capital were an increase in accrued liabilities of $5.0 million, a decrease in prepaid expenses and other assets of $2.2 million, and a net increase in income taxes payable of $2.2 million, partially offset by an increase in net accounts receivable of $1.1 million.
The primary change in non-cash working capital was a decrease in net income tax payable of $4.1 million, partially offset by an increase in net accounts receivable of $1.2 million.
However, gross profit percentage is likely to be negatively impacted by the continued diversification of our product and service offerings. Selling, General and Administrative Expense Selling, general and administrative expenses as a percentage of revenue improved to 47.4% for the year ended December 31, 2024 compared to 48.0% for the year ended December 31, 2023.
Selling, General and Administrative Expense Selling, general and administrative expenses as a percentage of revenue improved to 44.9% for the year ended December 31, 2025 compared to 47.4% for the year ended December 31, 2024.
Selling, general and administrative expenses totaled $106.2 million for the year ended December 31, 2024, an increase of $18.3 million (or 20.8%) from the comparable period in 2023. The improvement in selling, general, and administrative expenses as a percentage of revenue is attributable to economies of scale and improvements in operational efficiencies.
Selling, general and administrative expenses totaled $121.4 million for the year ended December 31, 2025, an increase of $15.2 million (or 14.3%) from the comparable period in 2024. The decrease in selling, general, and administrative expenses as a percentage of revenue reflects continued operating leverage and efficiency gains.
As we continue to invest in research and development related projects to support our technology initiatives, we expect that the associated costs will remain consistent in 2025 relative to 2024 costs. Stock-Based Compensation For the year ended December 31, 2024, stock-based compensation totaled $6.3 million, an increase of $0.4 million (or 7.5%) from the comparable period in 2023.
Research and Development Costs For the year ended December 31, 2025, research and development costs totaled $3.0 million, a decrease of $0.1 million (or 1.7%) from the comparable period in 2024. Based on our current project pipeline and planned investment levels, we expect that the associated costs will remain relatively consistent in 2026.
Net Cash Used in Investing Activities Net cash used in investing activities during the year ended December 31, 2024 was $30.7 million. Net cash used for capital expenditures during the period was $27.5 million and consisted of $37.8 million of purchases of property and equipment, partially offset by $10.3 million of sales proceeds from the disposal of property and equipment.
Net cash used for capital expenditures during the period was $23.8 million and consisted of $40.0 million of purchases of property and equipment, partially offset by $16.2 million of sales proceeds from the disposal of property and equipment. Net cash used for capital expenditures represents a decrease of $3.6 million, or 13%, compared to 2024.
Loss (gain) on disposal of property and equipment For the year ended December 31, 2024, gain on disposal of property and equipment totaled $1.9 million compared to loss on disposal of property and equipment of $0.6 million for the year ended December 31, 2023.
Gain on disposal of property and equipment For the year ended December 31, 2025, gain on disposal of property and equipment totaled $2.2 million compared to $1.9 million for the year ended December 31, 2024. In both periods, the gains were primarily attributable to proceeds from the sale of recalled ventilators back to the manufacturer.
The net income adjustments primarily consisted of $21.9 million of depreciation and amortization, $5.8 million of stock-based compensation, and $1.0 million of distributions of earnings received from equity method investments, partially offset by a $1.4 million deferred income tax benefit.
The net income adjustments primarily consisted of $28.6 million of depreciation and amortization, $9.1 million of stock-based compensation, and a $3.1 million deferred income tax expense, partially offset by a $2.2 million gain on disposal of property and equipment.
The Company has also historically utilized short term financing arrangements with suppliers that could be extended over a longer term if there was a need for additional liquidity. Page 37 The Company had historically utilized Change Healthcare, a subsidiary of UnitedHealth Group, to submit patient claims to certain non-Medicare payors for reimbursement.
The Company has also historically utilized short term financing arrangements with suppliers that could be extended over a longer term if there was a need for additional liquidity. Page 38 On June 6, 2025, the Company's Board of Directors authorized and approved a share repurchase program.
Additionally, principal payments on acquired loans were $4.6 million during the year ended December 31, 2023. The Company acquired and cancelled 75,235 common shares at a cost of $0.6 million to satisfy employee income tax withholding associated with RSUs vestings while proceeds from the exercise of options during the year ended December 31, 2023 were $1.3 million.
In addition, the Company repurchased and cancelled common shares totaling $13.2 million pursuant to the Share Repurchase Program authorized by the Board on June 6, 2025 (the "2025 Share Repurchase Program") and paid $1.7 million to satisfy employee income tax withholding obligations associated with the vesting of restricted stock units ("RSUs"), while proceeds from the exercise of options during the year ended December 31, 2025 were $1.4 million.
Income (expense) from investments For the year ended December 31, 2024, expense from investments totaled $1.0 million compared to income from investments of $0.5 million from the comparable period in 2023. The change is primarily driven by a loss recognized on a debt investment during the current year.
Page 36 Income (loss) from investments The $1.0 million loss from investments in the prior year ended December 31, 2024 primarily reflects a loss recognized on a debt investment. No investment-related loss was recorded for the year ended December 31, 2025.
Our full-time employee count increased from 996 on December 31, 2023 to 1,179 on December 31, 2024, an increase o f 18% . Employee compensation expenses increased $13.3 million (or 21% ) as a result of the increase in our employee headcount and increases in incentive and volume-based compensation.
Our full-time employee count increased from 1,179 as of December 31, 2024 to 1,382 as of December 31, 2025, an increase of 17%, reflecting both organic expansion and acquired operations. As a result, employee compensation expense increased by $9.7 million, or 13%, during the year.
Page 34 Cost of Revenue and Gross Profit For the year ended December 31, 2024, cost of revenue totaled $91.1 million, an increase of $20.8 million (or 29.7%) from the comparable period in 2023. Gross profit percentage decreased from approximately 61.6% to approximately 59.4% from the year ended December 31, 2023 to the year ended December 31, 2024, respectively.
Services revenue increased by $4.8 million (or 23.6%) primarily due to the growth of healthcare staffing offerings. Page 35 Cost of Revenue and Gross Profit Cost of revenue for the year ended December 31, 2025 was $114.8 million, an increase of $23.8 million (or 26.1%) compared to the same period in 2024.
Overview We provide an array of home medical equipment, services and supplies, specializing in post-acute respiratory care services in the United States. Our primary objective is to focus on the organic growth of the business and thereby solidify our position as one of the United States’ largest providers of in-home therapy for patients suffering from respiratory diseases.
Overview We provide an array of home medical equipment, services and supplies, specializing in post-acute respiratory care services in the United States. Viemed’s primary objective is to drive growth by increasing the number of patients served and the level of care provided through its technology-enabled, home-based clinical care and chronic disease management model.
Our annual estimated effective tax rate for 2024 is 29.4% . Net Income For the year ended December 31, 2024, net income was $11.4 million, an increase of $1.2 million (or 11.4%) from the comparable period in 2023. The increase in net income was primarily a result of the organic growth of the business and expansion of the patient base.
Net Income For the year ended December 31, 2025, net income was $15.4 million, an increase of $4.0 million (or 34.8%) from the comparable period in 2024.
The Company was in compliance with all covenants under the 2022 Senior Credit Facilities in effect at December 31, 2024. Page 39 Use of Funds Our principal uses of cash are funding the purchase of rental assets and other capital purchases, the repayment of debt, funding of acquisitions, operations, and other working capital requirements.
Use of Funds Our principal uses of cash are funding the purchase of rental assets and other capital purchases, the repayment of debt, the repurchase of shares of our common stock, the funding of acquisitions, operations, and other working capital requirements. Our contractual obligations primarily relate to the repayment of existing debt and contractual obligations for operating leases.
We expect to utilize positive cash flow to further reduce outstanding debt which would result in a reduction in net interest expense in 2025 relative to 2024. Page 35 Provision for Income Taxes For the year ended December 31, 2024, the provision for income taxes was a $4.8 million expense, compared to a $4.1 million expense during the 2023 period.
Provision for Income Taxes For the year ended December 31, 2025, the provision for income taxes was a $6.4 million expense, compared to a $4.8 million expense during the 2024 period. The increase in income tax expense was primarily attributable to higher pre-tax income. Our annual effective tax rate was 29.4% for both 2025 and 2024.
Additionally, rental revenue from other Home Medical Equipment (HME) increased by $10.3 million (or 27.0%) due to an expanding patient base, robust demand for Positive Airway Pressure (PAP) therapy, oxygen therapy, and percussion vest services.
Ventilator rental revenue increased by $12.2 million (or 9.8%), primarily as a result of higher patient volumes and sustained demand for ventilation services. Rental revenue from other HME increased by $9.7 million (or 20.0%), reflecting an expanding patient base and strong demand for PAP, oxygen, and airway clearance therapies.
Net cash used for capital expenditures represents a $3.9 million, or 17%, increase year over year. Purchases of property and equipment were primarily related to medical equipment rented to our patients.
Purchases of property and equipment were primarily related to medical equipment placed with patients under our rental arrangements. Net cash used in investing activities during the year ended December 31, 2024 was $30.7 million.
Removed
Impact of Inflation The Company faces current and potential future inflationary pressures driven by factors such as general cost increases, supply chain disruptions, and governmental policies. The manufacturing and distribution costs of Viemed's patient equipment are affected by rising material, labor, and transportation expenses, including fuel costs.
Added
Viemed expects to expand its workforce of licensed clinical practitioners, including RTs, to support the Company's growth and ensure the high service model is maintained in the home. As of December 31, 2025, we employed 401 licensed RTs, representing approximately 29% of our company-wide employee count.
Removed
Persistent inflation may impact overall demand, increase operating costs, and affect profit margins, potentially adversely affecting Viemed's business and financial performance. In its 2025 DMEPOS Fee Schedule, CMS announced the fee schedule adjustment based on the annual change to the Consumer Pricing Index for all urban areas.
Added
In particular, ventilator coverage has received renewed attention from the Centers for Medicare & Medicaid Services (“CMS”). Although ventilators have historically been included under the NCD for the Durable Medical Equipment Reference List, there was previously no dedicated policy specifically addressing ventilator use.
Removed
Items that were subject to the competitive bidding program in former competitive bidding areas will receive a 2.9% reimbursement rate increase. Items that were subject to the competitive bidding program in non-competitive bidding areas received a 3.0% reimbursement rate increase. Items not subject to the competitive bidding program received a 2.4% reimbursement rate increase.
Added
On September 11, 2024, CMS initiated a national coverage analysis to evaluate noninvasive positive pressure ventilation in the home for the treatment of chronic respiratory failure associated with chronic obstructive pulmonary disease. CMS issued a proposed decision memorandum on March 11, 2025, followed by a final NCD on June 9, 2025.
Removed
The primary driver of this growth was our ventilator rental revenue, which increased by $16.3 million (or 15.1%) due to higher patient volumes associated with strong demand for ventilation services.
Added
We actively participated in this process through formal comments and engagement with CMS, the U.S. Department of Health and Human Services (“HHS”), and members of Congress. The final NCD establishes specific medical necessity criteria for ventilator use that are expected to influence patient access, reimbursement, and utilization patterns.
Removed
Equipment and supply sales grew by $5.1 million (or 19.9%) largely attributable to the success of our sleep resupply program, which was further enhanced by the integration of resupply programs from acquisitions. Furthermore, services revenue experienced an increase of $9.5 million (or 88.8%), primarily due to the growth of healthcare staffing offerings.
Added
In addition to affecting traditional Medicare, the NCD may also influence coverage determinations and reimbursement policies under commercial insurance and Medicare Advantage plans that reference or align with CMS coverage criteria. These changes may have a material impact on our business.
Removed
While ventilator rentals continue to make up the majority of our revenue, the growth of PAP and oxygen related sales, as well as our healthcare staffing offerings, is contributing to the diversity of our overall revenue mix.
Added
Page 32 In addition, CMS has proposed comprehensive reforms to the Medicare Competitive Bidding Program for DMEPOS, along with related updates to supplier accreditation standards and Medicare provider enrollment requirements. The proposals are intended to modernize the program by refining payment methodologies, contract award processes, and supplier oversight.
Removed
As we continue to expand geographically into new territories and further expand our presence in our existing territories, we expect continued growth in our active ventilator patient base and other home medical offerings.
Added
Although the final scope and timing of these reforms remain subject to CMS rulemaking, providers with greater scale, infrastructure, and compliance capabilities are generally positioned to compete more effectively under a restructured Competitive Bidding Program. Larger operators may benefit from economies of scale that support service obligations, enable pricing flexibility, and enhance administrative efficiency relative to smaller suppliers.
Removed
The decrease in gross profit percentage is primarily due to migration of the revenue mix associated with product and service diversification. In 2025, gross profit in absolute dollars is expected to continue increasing, supported by overall revenue growth, subsiding inflationary cost pressures, and favorable reimbursement rate adjustments.
Added
The federal budget reconciliation legislation, known as the One Big Beautiful Bill Act (OBBBA), signed into law on July 4, 2025, introduces a broad set of statutory and policy changes that may affect the healthcare industry and our operations.
Removed
We expect that selling, general and administrative expenses as a percentage of revenue will continue to improve in 2025 due to increased efficiencies and costs optimization efforts. Research and Development Costs For the year ended December 31, 2024, research and development costs totaled $3.1 million, an increase of $0.3 million (or 10.3%) from the comparable period in 2023.
Added
Key provisions include revisions to Medicaid renewal and eligibility rules, adjustments to Medicaid state-directed payments and provider tax frameworks, new cost-sharing requirements, reduced home equity thresholds for long-term care eligibility, expanded telehealth coverage, and state waivers to support home and community-based services.
Removed
We anticipate that as we expand our workforce, incorporating stock-based awards as a component of employee compensation, stock-based compensation expenses will rise correspondingly. Historically, revenue growth has outpaced the growth in stock-based compensation. As we transition more of our stock-based compensation from phantom stock liability awards to equity awards, we expect stock-based compensation expense to increase in 2025.
Added
The OBBBA also establishes a Rural Health Transformation program aimed at improving access and care coordination in underserved communities. Implementation of Pay-As-You-Go (“PAYGO”) rules could result in future adjustments to Medicare and Medicaid spending, including cost containment measures or payment reductions that may impact providers.
Removed
The gain primarily resulted from proceeds related to the sale of recalled ventilators back to the manufacturer. We anticipate additional future gains from the disposal of eligible devices, as the proceeds from these disposals are expected to exceed their net book value.

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Item 7A. Quantitative and Qualitative Disclosures About Market Risk

Market Risk — interest-rate, FX, commodity exposure

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Biggest changeOutstanding borrowings subject to interest rate fluctuations under the 2022 Term Loan Facility were $4.6 million as of December 31, 2024. There were no outstanding borrowings under the 2022 Revolving Credit Facility as of December 31, 2024.
Biggest changeOutstanding borrowings subject to interest rate fluctuations under the 2022 Term Loan Facility were $12.9 million as of December 31, 2025. There were no outstanding borrowings under the 2022 Revolving Credit Facility as of December 31, 2025.
Based on our outstanding borrowings, an immediate 100 basis point change in interest rates would not have a material effect on our net income. Page 40 VIEMED HEALTHCARE, INC. INDEX TO CONSOLIDATED FINANCIAL STATEMENTS
Based on our outstanding borrowings, an immediate 100 basis point change in interest rates would not have a material effect on our net income. Page 42 VIEMED HEALTHCARE, INC. INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

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