Annual report pursuant to Section 13 and 15(d)

Consolidated Statements of Cash Flows

v3.21.1
Consolidated Statements of Cash Flows - USD ($)
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Cash flows used in operating activities:    
Net loss from continuing operations $ (17,643,707) $ (46,582,952)
Adjustments to reconcile net loss to net cash used in operations:    
Depreciation and amortization 700,993 795,202
Loss on receivables sold to factors 1,228,955 1,361,053
Stock-based compensation (51,899)
Penalty for non-payment of note payable and debentures 9,850 6,893,940
Amortization of debt discount, including modification of warrants 122,885 16,223,474
Other income from HHS Provider Relief Funds (8,020,969)
Change in fair value of derivative instrument 105,076
Net gain from legal settlements (671,613)
Gain on extinguishment of debt (2,041,038)
Impairment of intangible asset 250,000
Gain on purchase of hospital and medical center (250,000)
Loss on disposal of property and equipment 5,293
Loss from discontinued operations (696,067) (1,450,869)
Changes in operating assets and liabilities:    
Accounts receivable 1,446,117 (999,493)
Prepaid expenses and other current assets (148,035) 78,333
Inventory 168,929 156,485
Security deposits (26,482) (90,289)
Accounts payable and checks issued in excess of bank balance 1,538,826 6,230,117
Accrued expenses 7,798,653 3,553,372
Income tax assets and liabilities (712,580) (38,408)
Net cash used in operating activities of continuing operations (16,689,990) (14,066,858)
Net cash (used in) provided by operating activities of discontinued operations (100,539) 537,813
Net cash used in operating activities (16,790,529) (13,529,045)
Cash flows (used in) provided by investing activities:    
Purchases of property and equipment (370,890) (127)
Purchase of hospital and medical center (658,537)
Proceeds from the sale of property and equipment 82,000
Net cash used in investing activities of continuing operations (288,890) (658,664)
Net cash of investing activities of discontinued operations
Net cash used in investing activities (288,890) (658,664)
Cash flows provided by (used in) financing activities:    
Proceeds from receivables sold under accounts receivable sales agreements 2,114,375 2,650,000
Receivables paid under accounts receivable sales agreements (1,723,453) (2,804,896)
Proceeds from issuance of related party note payable and advances 7,628,553 16,669,455
Proceeds from issuance of debentures 3,845,000
Payments of debentures (920,000)
Payments of related party note payable and advances (4,187,387) (2,310,000)
Proceeds from notes payable 1,198,835 1,600,000
Payments on notes payable (1,590,250) (5,005,795)
HHS Provider Relief Funds 12,542,691
Proceeds from Paycheck Protection Program notes payable 2,264,201
Redemption of Series G Preferred Stock (100)
Payments on finance lease obligations (200,709) (143,931)
Payments of financing fees on note payable (100,000)
Payments on right of use operating lease obligations (137,847) (53,939)
Cash paid for fractional shares in connection with reverse stock split (684)
Net cash provided by financing activities of continuing operations 16,988,325 14,345,794
Net cash provided by (used in) financing activities of discontinued operations 99,514 (143,361)
Net cash provided by financing activities 17,087,839 14,202,433
Net increase in cash 8,420 14,724
Cash at beginning of period 16,933 2,209
Cash at end of period $ 25,353 $ 16,933