Q4 2021 Greenbrook TMS Inc Earnings Call

April 1, 2022

Operator: Welcome to the GreenBrook T.M.S Inc. Fiscal 2021 results conference call and webcast.

All lines are currently on mute to prevent any background noise.

I would like to remind you that this conference is being recorded today and is also being webcast on the company's website at www.greenbrooktms.com under the investor's section events.

Greenberg T M S dot com under the investors section events.

After the speakers' remarks, there'll be a question and answer session.

Analysts and investors are reminded that additional questions can be directed to the company at investorrelations@greenbrooktms.com.

This call contains forward-looking statements, which reflect the current expectations or beliefs of the company based on currently available information.

Forward-looking statements are subject to a number of risks and uncertainties that may cause the actual results of the company to differ materially from those discussed in the forward-looking statements.

The forward looking statements.

Factors that could cause actual results or events to differ materially from current expectations are discussed in the risk factors section of the company's annual report on Form 20-F for the fiscal year ending December 31st, 2021, and the risks and uncertainties section of the management discussion and analysis for the fiscal years ended December 31st, 2021, 2020, and 2019, which is included in the annual report and the company's other materials filed with the Canadian Securities recruits tree [inaudible] Exchange Commission from time to time, which are available on SEDAR, Edgar and on the company's website.

December 31st 'twenty, 'twenty, one and the risks and uncertainties section of the management discussion and analysis for the fiscal years ended December 31st 2021 'twenty 'twenty and 2019.

Which is included in the annual report and the company's other materials filed with the Canadian Securities recruits tree.

So where do you come to you ethics, Tuesdays and exchange Commission from time to time.

Which are available on SEDAR, Edgar and on the company's website.

Any forward-looking statements speak only as of the date on which should it is made and the company disclaims any intent or obligation to update any forward-looking statements unless required by law.

I would like to turn the meeting over to Mr. Bill Leonard, President and Chief Executive Officer of GreenBrook TMS and Erns Loubser, Chief Financial Officer. Go ahead please Mr.Leonard.

Bill Leonard: Thank you Blue and thank you to everyone for joining our conference call and webcast today.

Despite the challenging operating environment over the past two years, our business continued to grow steadily with revenue increasing by 21% in the fiscal year 2021 to a record $52.2 million as compared to fiscal 2020 and by 42% in Q4, 2021 to a record of $14 million as compared to Q4 2020.

$14 million as compared to Q4 2020.

We are extremely proud of our dedicated team who consistently delivers the highest level of patient care in a very challenging operating environment.

Mental health remains a key focus in the US with the right unmet need for the treatment at an all-time high and we have the right platform to serve this need.

We are excited about the ongoing rollout of our SPRAVATO program at select TMS centers, which continued through Q4 2021.

This program builds on our long-term business plan of utilizing our existing networks of TMS centers to deliver new and innovative treatments to patients suffering from MDD and other mental health disorders.

Providing SPRAVATO at our TMS centers enables us to leverage capacity in an existing platform, which effectively enhances our profit margins.

As of March 31, 2022, the company has expanded its offerings to SPRAVATO to 23 TMS centers across the US.

On October 1st, 2021, the company completed the acquisition of achieved TMS East and achieve TMS Central LLC, which includes the acquisition of 17 active TMS centers.

We are very excited about this acquisition as it strengthens our presence in new England and in the Central United States.

This acquisition secures robust payor contracts, brand recognition, physician reputation, and a strong management team within these regions.

We also expect the acquisition to serve as a foundation for continued growth within these regions and to realize operational synergies by leveraging our established infrastructure and adjacent regions.

From a development perspective, we added 31 active TMS centers in fiscal year 2021, including, as I mentioned, 17 active TMS centers acquired as part of the achieve TMS East and Central acquisition.

As of December 31, 2021, our footprint consisted of 149 centers in 17 states.

And now, for a more detailed review of the company's financial and operating performance, I will turn it over to our CFO Erns Loubser.

Erns Loubser: Thank you Bill. As Bill mentioned, annual revenue increased by 21% to a record $52.2 million as compared to fiscal 2020, and quarterly revenue increased by 42% to a record $14 million as compared to Q4 2020.

Average revenue per treatment increased 5% to 231 in fiscal 2021 as compared to fiscal 2020 and by 26% to do 229 in Q4 2021 as compared to Q4 of 2020.

The increase was primarily attributable to three key factors: the normalization of the adjustment to variable consideration estimates driven by stronger collections, more favorable rates negotiated in established markets, and a favorable payer mix.

Primarily of troubled attributable to three key factors the normalization of the adjustment to variable consideration estimates driven by stronger collections.

More favorable rates negotiated in established markets and a favorable payer mix.

Same region sales growth was 19% in fiscal 2021, one as compared to -1.5% in fiscal 2020.

Fiscal 2021 resulted in the entity-wide regional operating loss of only 300,000, a 51% reduction in the loss as compared to fiscal 2020. This is a result of increase in revenue offset by an increase in direct center and regional costs as a result of operating 147 active centers as at December 31, 2021 as compared to 106 inactive TMS centers at December 31, 2020.

This is a result of increase in revenue offset by an increase in direct center and regional costs as a result of operating 147 active centers. At December 31, 2021 as compared to 106 inactive P. M. S. N. Two at December 31, 'twenty 'twenty.

At December 31, 2021 as compared to 106 inactive P. M. S. N. Two at December 31, 'twenty 'twenty.

Q4, 2021 resulted in entity-wide regional operating income of 40,000, a turnaround as compared to the entity-wide regional operating loss of 2.05 million in Q4 of 2020.

Two point over $5 million in Q4 'twenty 'twenty.

Corporate G&A and full fiscal 2021 increased 36% to 20.7 million as compared to $15.1 million in fiscal 2020. This was predominantly due to one-time costs related to financing and acquisition activities during the year.

The loss for the period and comprehensive loss decreased by 18% during fiscal 2021 to $24.9 million as compared to fiscal 2020.

From a balance sheet perspective that comes from receivable balance remained stable, despite the revenue growth, which as I mentioned points to strong collections.

We maintained adequate capitalization through fiscal 2021 with the completion of a private placement for gross proceeds of $23.5 million public offering for gross proceeds of $13.2 million and the forgiveness of the PPP loan.

As of December 31, 2021, we had approximately $11.9 million of cash on hand, including restricted cash related to the GBT East and Central acquisition as Bill mentioned.

Moving to our core operating metrics. We saw continued year-over-year growth in all key operating metrics. As of the end of fiscal 2021, the total TMS center increased by 19% to 149 from 125 a year ago.

Compared to fiscal 2020, the number of consultations performed increased 25% to 14,108. The number of TMS treatments performed increased 15% to 226,286 and new patient starts increased by 18% to 6,429.

From a quarterly perspective, the number of consultations performed remained stable at approximately 3,500 over the number of TMS treatments performed during the quarter increased by 13% to 61,416. New patients starts also increased by 17% to 2,667, pointing to stronger conversion rates in the quarter.

Three and a half thousands over the number of Tms treatments performed during the quarter increased by 13% to 61416, new patients thoughts also increased by 17% 2667, pointing to stronger conversion rates in the quarter.

As Bob mentioned market conditions were challenging in fiscal 2021 but we remain optimistic as we are currently seeing positive trends in patient activity with operating conditions starting to normalize in fiscal 2022. Back to you, Bill.

Bill Leonard: Thanks, Erns. As I mentioned, despite the challenges we faced over the past two years, we saw continued growth in both revenue and patient treatments. SPRAVATO program adds to our repertoire of innovative treatments, building on the company's long-term business plans of utilizing our centers' network as a platform to serve patients suffering from major depressive disorder, OCD, and other mental health disorders.

From major depressive disorder, OCD and other mental health disorders.

I would like to reiterate that we are extremely proud of our dedicated team. They continue to deliver the highest level of patient care in a very challenging operating environment. Most importantly, our business is a needed one. Mental health treatment demand is at unprecedented levels. Our business fundamentals remain sound and we are positioned better than ever to serve the unmet need in mental health support across the United States.

We're excited to continue our growth plans through 2022 with specific focus on enhanced utilization of our established TMS Center platform. We have now treated over 22,000 patients with over 790,000 treatments performed; a significant positive impact on the lives of so many patients suffering from mental health disorders.

So many patients suffering from mental health disorders.

We look forward to keep you updated on the progress of the company. Thank you for your time today and with that operator, we will now take questions.

Operator: Thank you. At this time, to ask a question, you will need to press star one on your telephone. Again that is star one to ask a question. To withdraw your question just press the pound key. Please stand by while we compile the Q&A roster. Again that is star one to ask a question.

Please stand by while we compile the Q&A roster.

Yeah.

Again that is star one to ask a question.

Your first question comes from the line of Frank Takkinen from Lake Street Capital. Your line is now open.

Frank Takkinen: Bill and Erns, thanks for taking my questions. Congrats on the progress. You've done pretty well in a tough environment here.

Pretty well in a tough environment here.

I wanted to just start on the comments around a specific focus on enhanced utilization of established TMS Center platform. I think this makes a lot of sense, obviously, there's a lot of opportunity and just improving same-store sales metrics in the established networks. Maybe dig a little bit deeper into this and how you're thinking about focusing growth there as well as new center additions in established regions.

I think this makes a lot of sense, obviously, there's a lot of opportunity and just improving same-store sales metrics in the established networks. Maybe dig a little bit deeper into this and how you're thinking about focusing growth there as well as new center additions in established regions.

Same store sales metrics in the established networks, maybe dig a little bit deeper into this and how you're thinking about focusing growth there as well as a new center additions in established regions.

Bill Leonard: Sure. Thanks for the question Frank and thank you for joining. Really, as we said in the call, we opened up about six regions prior to kind of COVID starting, right around that timeframe. And that group has yet to kind of see the ramp based on the kind of operating conditions that we've seen in our other centers around the country during normal business times. So for us, the focus instead of just new centers across the country is really getting that group of centers to kind of begin to mature and ramp like we've seen in our previous marketplaces. Obviously, our focus is direct to our consumer and our focus is our work with the community-based physicians, but we really believe that is the significant upside since those kind of costs are already built-in, management in place, physicians in place, and really a greater chance for us to kind of run towards profitability with that group kind of ramping up versus brand new startup costs.

Meyer to kind of Covid, starting right around that timeframe and that group has yet to kind of see the ramp based on the kind of operating conditions that we've seen in our other centers. Centers around the country during normal business times, so for us the focus instead of just new centers across the country is really getting that group of centers to kind of begin to mature and ramp like we've seen in our previous marketplaces, obviously, a focus on direct to consumer and our focus and our work with the community based physicians, but we really believe that as the <unk>.

Centers around the country during normal business times, so for us the focus instead of just new centers across the country is really getting that group of centers to kind of begin to mature and ramp like we've seen in our previous marketplaces, obviously, a focus on direct to consumer and our focus and our work with the community based physicians, but we really believe that as the <unk>.

Again upside since those kind of costs are already built in management in place physicians in place and really a greater chance for us to kind of run towards profitability with that group kind of ramping up versus brand new startup cost.

Frank Takkinen: Perfect. That's helpful. And then maybe just to ask a little bit more specifically on COVID impacts. Can you talk to I [inaudible] impacts in the fourth quarter, and how those trends continued into the first quarter of 2022?

I want to leave.

Impacts. <unk> fourth quarter, and how those trends continued into the first quarter of 2022.

<unk> fourth quarter, and how those trends continued into the first quarter of 2022.

Bill Leonard: Yeah, I'll start it off and kick it over to Erns on the actual numbers. But I think the reality in 2021 was we were booked in, with COVID-19 all companies were booked in with COVID from the start, and then the Omicron came back at the end and that was challenging to be honest with you. From a contagious factor, Omicron was much more difficult to handle based on the facts of the infection rate and was impacting our doctors, our staff, and patients and midstream. A patient would end up getting COVID-19 and have to kind of start and stop treatments or move away from. So from that and you combine that with a balance you get with the labor market, really the impact kind of started in mid-November and carried into the quarter. But like we said on the call, we thought we did a tremendous job with our care team in kind of working through those challenges. Erns, do you want to add a little bit more detail to that?

The infection rate and was impacting our doctors, our staff and patients and midstream a patient would end up getting a COVID-19 and have to kind of start and stop treatments or move away from so from that and you combine that with a balance you get what the labor market, but really the impact kind of started in mid November and carried into the quarter, but.

Well like we said on the call. We thought we did a tremendous job with our care team and kind of working through those challenges are and do you want to add a little bit more detail to that.

Erns Loubser: Yeah, of course. As Bill mentioned, and as we previously spoke on the quarter, we saw a very strong October and kind of geared up for a pull forward what we expected to be a very strong Q4. But mid-November to December we really saw the patient treatments drop off and the reason for that is as Bill mentioned, not necessarily this time due to lockdowns, but the community-based physicians that we work with closing down their practices. A depressed patient is mostly known for not wanting to leave their house and staff getting sick. So we were in a pretty good trajectory and then December was not a good month. That has spilled over a little bit into January and February, but we're seeing, as I mentioned, really good progress as blocking conditions continued to normalize in March 2022.

As Bill mentioned, we saw we as we previously spoke on the quarter, we saw a very strong October .

And kind of get a pull forward, what where you expect it to be a very strong Q4.

But mid November to December we really saw the patient treatments drop off and the reason for that.

And not only not necessarily just on due to lockdowns, but.

The community based physicians that we work with closing down their practices are depressed patient is a majority of the non for not wanting to leave the house and stuff getting sick. So we were in a pretty good trajectory and then December was not a good month that has spilled over a little bit into January and February , but we're seeing as I.

Mentioned.

Really good progress.

Blocking conditions continued to normalize and in March 2022.

Frank Takkinen: Perfect. And then just last one from me, I wanted to ask on SPRAVATO, congrats on getting to that 23 figure on time by the end of the quarter. Maybe just talk a little bit about early feedback you're getting, I'm assuming not much of it is anecdotal, but talk to any feedback you're getting, and then how should we be thinking about your rollout plans as to SPRAVATO beyond the 23 that you've established so far into 2022?

Time by the end of the quarter, maybe just talk a little bit about early feedback you're getting I'm, assuming not much of it is anecdotal but talk to any feedback you're getting and then how should we be thinking about your rollout plans is to provide them beyond the 23 that you've established so far into 2022.

Bill Leonard: Yeah, absolutely Frank. Ultimately, patients want to feel better, so it's important to have a variety of treatment options that best fits that patient's preferences. The response from both our community-based physicians and the patients themselves has been fantastic.

The response from both our community based physicians and the patients himself has been fantastic.

If you look at it, with TMS therapy, we store a really good treatment in our core product and treatment we offer. It's durable and patients can fit it into their daily schedule between work or normal activities and return to their normal activities. For SPRAVATO, sometimes it's easier for patients just to carve out a couple of days and want a more rapid response.

So overall, we're really optimistic from the early response from both patients and our community providers as it relates to expansion of the treatment modalities on our GreenBrook platform.

In terms of what's next for SPRAVATO, I think for right now, we kind of had a staggered rollout in Q1 of 23 centers, some of them coming on board kind of late March. The focus which is the message through the company for the whole year is utilization. So it will get those operators to ramp up SPRAVATO. As for current expansions, we will continue to look at adding SPRAVATO for additional centers on a case-by-case basis.

On a case by case basis.

That 23 were put in place really represent the shortest time to ramp up due to physician coverage and footprint. So we will continue to look at some other opportunities but for now, that focus will be to kind of continue to kind of increase utilization, both on SPRAVATO and also on TMS therapy.

Frank Takkinen: Perfect, I'll stop there. Thanks for taking my questions and congrats again on all the progress.

Bill Leonard: Thanks.

Operator: Your next question comes from Noel Atkinson from Clarus Securities. Your line is now open.

Your next question comes from Noel Atkinson from Clarus Securities. Your line is now open.

Noel John Atkinson: Hi, Good morning, Bill and Erns, and thanks for taking our questions this morning. Just following up on the prior questions about SPRAVATO, I was wondering if you could just remind us again about what you're seeing for relative average procedure revenue for SPRAVATO versus TMS procedures.

Just following up on the prior questions about to provide and I was wondering if you could just remind us again about what youre seeing for relative average procedure revenue for survival versus Tms procedures.

Erns Loubser: So Noel, as we've previously said, we don't break that out currently. But it is just kind of just above the average that we see [inaudible] times, so it's just above the TMS average for a treatment.

But it is just kind of.

Just above the average that would be seen times is just above the Tms Tms average on Florida for a treatment.

Noel John Atkinson: Okay.

Erns Loubser: So-- Go ahead.

Go ahead.

Noel John Atkinson: Please continue.

Erns Loubser: No, no, just one. So from a modeling perspective, kind of the assumption is that rates will remain stable with the obvious potential for upside based on that reimbursement as it becomes a bigger part of our business.

Rates will remain stable with the obvious potential for upside based on that reimbursement as it becomes a bigger part of our business.

Noel John Atkinson: Okay. In prior comments, management is targeting 5% to 10% of total revenue from SPRAVATO on a run-rate basis exiting 2022, you folks still hoping to be able to achieve that?

In prior comments.

Management.

Targeting 5% to 10% of total revenue from spear battle on a run rate basis exiting 2022, you folks still hoping to be able to achieve that.

Erns Loubser: That's correct, yes. So our plan is-- that's the same time, we said we had targeted the 23 centers by early 2022, we've obviously met that target and our SPRAVATO program is on target. So we believe we should still be coming in that range.

We should still be coming in in that range.

Noel John Atkinson: Okay. It looks like you did some cost reductions in December, reduced some staff, that sort of thing. I was wondering if you could give us a sense of kind of what the dollar cost savings were from some of those actions. On a quarterly basis, how much of that we would sort of see as fresh savings in the Q1 results?

You also it looks like you did some cost reductions.

December .

Some staff that sort of thing I was wondering if you could give us a sense of.

What the dollar cost savings were from some of those actions.

Quarterly basis, how much did spill into.

That we would sort of see as fresh savings and in the Q1 results.

Erns Loubser: So I think our savings-- Good question Noel. Our savings is due to the corporate G&A level and really, as I mentioned, we grew that 36%, but there was about 2 million of one-time costs in there, so really flattening that off in terms of we've got capacity and we've got all the pieces in play. So we want to keep that number on a quarterly and annualized basis steady stable going into 2022, so that's the number one.

In terms of we've got capacity and we've got all the pieces in play so we want to keep that number on a quarterly and annualized basis steady stable going into 2022. So that's the that's the number one and then the cost saving.

And then cost of saving on the regional and direct center side is really related to, as Bill mentioned, utilization of existing established cost base. And then also, we had some rationalization of our sales force to make sure we reward the staff of Holman performers and rationalize the not-so-good performers, so you'll see that in the cost line item from a utilization perspective. So once again, the similar dynamic, we want to keep the regional line item flat, but scale the revenue.

To make sure we reward the stop of Holman performers and rationalize the not so good performance performers. So so you'll see that in the cost line item from a utilization perspective. So once again the similar dynamic we want to keep the regional line item are flat, but scale the revenue.

Noel John Atkinson: Okay. And then just before I jump back into the queue here, the average rate so it's bounced around a little bit through 2021, and part of that was or I guess a material proportion of that was the ability to collect on accounts receivable, it looks like you still have a fair amount of sort of the legacy, the little longer aged accounts receivable. So is there potential for improvement on the average rate in 2022 as you start to collect again or are we kind of at the sort of the typical collection run rate here?

Okay, and then just before I jump back into the queue here.

The average rate so.

Bounced around a little bit through 2021, and part of that was I guess a material proportion of that was.

So.

Is there a potential for improvement on the average rate in 2022 as you start to collect again or are we kind of.

At the sort of the.

Erns Loubser: No, I think there's certainly in terms of from a new business perspective, I think all our average revenue per treatment is representative. What we've said before we continue to collect on aged receivables and changes we've made in our revenue cycle team has yielded significant results as well. So there is definitely upside as it relates to collecting on those older accounts.

What can what what we've said before we continue to collect on aged receivables and changes we've made in already that revenue cycle team has yielded significant results as well. So so there is definitely upside as it relates to collecting on those older older accounts.

Noel John Atkinson: Okay, great. That's it from me. Thanks so much.

Erns Loubser: Thanks, Noel.

Operator: As a reminder, to ask that question you will need to press star one on your telephone keypad. Again, that is star one to ask a question.

Your next question comes from the line of Marie Thibault from BTIG. Your line is now open.

Marie Thibault: Hello Bill and Erns. Thanks for taking the questions and congrats on the progress here.

Thanks for taking the questions and congrats on the progress here.

I wanted to ask a first question here on--You called out stronger conversion rates during Q4, I would love to hear what factors are influencing that or what efforts are driving that success.

You've called out stronger conversion rates during Q4, I would love to hear what factors are influencing that or or what efforts are driving that.

Bill Leonard: Sure, I mean really the conversion rates are something we monitor and measure every day. We have real-time data on the performance. We're constantly working and training that group of individuals at our call center and at our centers. The focus on that area is to really value and trust every lead that comes in to kind of give it your best effort. As you know Marie and cover in this industry, it's really hard to kind of get a patient in the door. When they finally have that courage do so, you have to give them every opportunity to kind of make that happen. The patient today is a little bit different in the sense that a little bit of a low-hanging fruit is gone and you're dealing with a patient that has probably failed 6, 7, 8 cycles of meds, so it's much harder to get them into the center, but once they get into the center and get through the council process. Our conversion rates are fantastic once we get them into the chair from console to conversion. So that's something we constantly work with. That process is done on a front end by a call center and then moves into the patient consult center where the patient can see the center, see the equipment, and have a chance to meet the doctor. That is, again, something we monitor and kind of lead in major everyday.

The focus on that area is to really value and trust every lead that comes in to kind of give it your best effort.

As you know Murray and cover in this industry.

It's really hard to kind of get a patient in the door. When they finally have that courage do so you'll have to give them every opportunity to kind of make that happen.

<unk> today is a little bit different in the sense that a little bit of a low hanging fruit is gone and you're dealing with a patient that is probably fell 678 cycles of meds.

So it's much harder to get them into the center, but once they get into the center and get through the council process. Our conversion rates are fantastic once we get them into the chair from console to conversion. So that's something we constantly work with.

That process is done on a front end by a call center and then moves into the patient consult center where the patient can see the center, see the equipment, and have a chance to meet the doctor. That is, again, something we monitor and kind of lead in major everyday.

As you can see the center see the see the equipment and have a chance to meet the Doctor that is again something we've met we monitor in MA kind of lead in major everyday.

Marie Thibault: Okay. It sounds like some cumulative efforts coming together there, sounds good.

A couple of questions here then on SPRAVATO. I'm curious about the competitive landscape you're seeing first for SPRAVATO around the 23 centers where you have it. As well as how it's maybe changing, if at all, kind of the inflow of patients coming into your centers, whether SPRAVATO's drawing them in and then they're learning about TMS that way. Just curious about how that's sort of changing the dynamic of patient attraction of TMS centers.

That's sort of changing the dynamic of patient attraction gonna peanuts centers.

Bill Leonard: Yeah, really good question. Obviously, our physicians are comfortable with scripting for SPRAVATO as it is a drug, so that is something the psychiatric base is used to doing. So if you look on the Janssen website, there's a significant amount of doctors that are providing SPRAVATO to their patients.

Scripting force Rabato as it as a drug so that is something the psychiatric basis used to doing.

So it does have a if you look on the Janssen website theres a significant amount of doctors that are.

Providing is provided to their patients with that said we have not.

With said, there's competition in CMS as well, but we have not seen an impact to our rollout. In fact, we've done a great job in terms of not only rolling it out but really created utilization at some of our early centers in a pilot.

As far as what that's done for the patient, I think I looked at that in my earlier comments, which is the response from both patients and our community-based physicians, who work with us has been outstanding.

And from my end, it's really giving that patient a chance to come in and our physician deciding what is best for them, whether it be TMS therapy or whether it would be SPRAVATO. What we're seeing it's expanded our capture area in terms of the number of patients that are calling in. We have a significant amount of the calls coming in on SPRAVATO. We do some direct-to-consumer work with SPRAVATO and we work closely with the manufacturers on also patients in the pipeline. So for me, I'm really optimistic about the rollout of both the combination of SPRAVATO and TMS therapy. It gives us the opportunity to kind of decide what is best for that patient in terms of a treatment modality and they actually do complement each other and actually cross kind of refer to each other in a sense that a patient may come in for TMS but at the moment they need a quicker onset of action, may go to SPRAVATO to start and then switch over to TMS. So we think it's a theater system for both and again, the response has been really strong from both patients who have worked with GreenBrook in the past or new patients, and more importantly, the community-based referrals working with us.

We're seeing it it's expanded our capture area in terms of the number of patients that are calling in.

We have a significant amount of the calls coming in once for motto. We do some we do do some direct to consumer work, what's bravado and we work closely with the manufacturers on also patients in the pipeline. So for me I'm I'm I'm really optimistic about the rollout of both the combination of <unk> and Tms therapy. It gives us the opportunity.

Decide what is best for that patient in terms of a treatment modality and they actually do complement each other and actually cross kind of.

Refer to each other in a sense that a patient may come in at for Tms.

But not at the moment they need a quicker onset of action may go to provider to start and then switch over to Gms. So we think it's a theater system for both and again. The response has been really strong from both patients.

Who have worked with green broken a path for new patients and more importantly, the community based referrals working with us.

Marie Thibault: Okay, very good. Thanks for all that color, very helpful. One last quick one for me then here. Just curious of any impact from sort of that macroeconomic environment we're seeing today. I know you are further away from certainly a supply chain logistics in input costs, but I'm curious of rates or any impact with sort of how you think about real estate, anything that we should be aware of on the macroeconomic side. Thanks again for taking the question.

<unk> costs, but I'm curious in rates or any impact with sort of how you think about real estate anything that we should be aware of on the macroeconomic.

Thanks again for taking the question.

Erns Loubser: But I think in terms of as you mentioned-- Thanks Marie, very good question. As you mentioned, we've been shielded from the supply. We're lucky in that way that there's a short supply of the devices. I think the only impact, which has been globally experience by all companies in the labor market, it's obviously challenging, especially kind of at odds admission level. I think the benefits that we have is that we really offer quality employee employment. We offer that individual a lot of patient facetime and a really valuable experience to enhance their career and to a certain extent that is mitigated kind of some of the challenges that we've experienced in the labor market. That would be the main one that's impacted us.

We're lucky in that way that there's a domino a short supply of the devices I think the only impact which has been globally.

Experience by oil companies as the labor market, that's it's obviously challenging.

Especially kind of at odds admission level I think the benefits that we have is that we really.

Offer quality employee employment, we offer that.

Individual a lot of.

Patient Facetime, and a really valuable experience to enhance a korea and to a certain extent that is mitigated as kind of some of the challenges that we've experienced in the labor market, but that would be the main one that's impacted us.

Marie Thibault: Thank you.

Operator: There are no further questions at this time. I would like to turn the call back over to Mr. Leonard.

Bill Leonard: Thank you very much for joining the call today. We look forward to keeping you updated on the progress of the company, and really have a good start to spring and we'll talk to you all in a couple of months. Thanks Operator.

And and really have a good start to spring and we'll talk to you all in a couple of months. Thanks operator.

Operator: Ladies and gentlemen, this concludes today's conference call. Thank you for participating, you may now disconnect.

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Q4 2021 Greenbrook TMS Inc Earnings Call

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