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HealthStream Announces Third Quarter 2022 Results

HealthStream, Inc. (Nasdaq: HSTM), a leading provider of workforce and provider solutions for the healthcare industry, announced today results for the third quarter ended September 30, 2022.

  • Revenues of $67.3 million in the third quarter of 2022, up 5% from $64.1 million in the third quarter of 2021
  • Operating income of $2.4 million in the third quarter of 2022, up 33% from $1.8 million in the third quarter of 2021
  • Net income of $3.7 million in the third quarter of 2022, up 144% from $1.5 million in the third quarter of 2021
  • Earnings per share (EPS) of $0.12 per share (diluted) in the third quarter of 2022 compared to $0.05 per share (diluted) in the third quarter of 2021
  • Adjusted EBITDA1 of $12.7 million in the third quarter of 2022, up 2% from $12.5 million in the third quarter of 2021

1 Adjusted EBITDA is a non-GAAP financial measure. A reconciliation of adjusted EBITDA to net income and disclosure regarding why we believe adjusted EBITDA provides useful information to investors is included later in this release.

Financial Results:

Third Quarter 2022 Compared to Third Quarter 2021

Revenues for the third quarter of 2022 increased by $3.2 million, or five percent, to $67.3 million, compared to $64.1 million for the third quarter of 2021.

Revenues from our Workforce Solutions segment were $54.1 million for the third quarter of 2022, an increase of six percent compared to $51.2 million for the third quarter of 2021. The workforce segment experienced growth in several product categories, including contributions from recent acquisitions, which was partially offset by declines from the legacy resuscitation business.

Revenues from our Provider Solutions segment were $13.2 million for the third quarter of 2022, an increase of two percent compared to $12.9 million for the third quarter of 2021. This revenue growth of $0.3 million was primarily attributable to an increase in subscription revenues which was partially offset by a $0.5 million decrease in professional services revenue.

Prior to the Company adopting ASU 2021-08 on January 1, 2022, generally accepted accounting principles (GAAP) required companies to adjust beginning balances of acquired deferred revenue as part of “fair value” accounting. Following the adoption of ASU 2021-08, contracts acquired in any acquisition completed on or after January 1, 2022 will be measured as if the Company had originated the contract such that the Company will no longer record deferred revenue write-downs associated with acquired businesses (for acquisitions completed prior to January 1, 2022, the Company will continue to record deferred revenue write-downs associated with fair value accounting for periods on and after January 1, 2022 consistent with past practice). During the third quarter of 2022, HealthStream reported a reduction of $46,000 to revenue and operating income and a reduction of $36,000 to net income as a result of deferred revenue write-downs from acquisitions completed prior to the adoption of this new accounting standard. During the third quarter of 2021, HealthStream reported a reduction of $0.8 million to revenue and operating income and a reduction of $0.6 million to net income as a result of deferred revenue write-downs from prior acquisitions.

Operating income was $2.4 million for the third quarter of 2022, up 33 percent from $1.8 million in the third quarter of 2021. The improvement in operating income was primarily attributable to higher revenues, as discussed above, reductions in office lease costs, and an increase in capitalized labor associated with software development activities. Partially offsetting these improvements were increases in personnel for product development, sales and marketing, higher travel expenses, and incremental expenses associated with recent acquisitions.

Other income includes a $2.7 million gain in the third quarter of 2022 associated with the sale of a company in which we owned a minority equity interest.

Net income was $3.7 million in the third quarter of 2022, up 144 percent from $1.5 million in the third quarter of 2021, and EPS was $0.12 per share (diluted) in the third quarter of 2022, compared to $0.05 per share (diluted) for the third quarter of 2021. Net income and EPS were positively impacted in the amount of $2.1 million and $0.07 per share (diluted), respectively, from the gain associated with the sale of our minority equity interest as set forth above.

Adjusted EBITDA was $12.7 million for the third quarter of 2022, up two percent from $12.5 million in the third quarter of 2021. The gain associated with the sale of the minority investment mentioned above is not included in the calculation of adjusted EBITDA.

On September 30, 2022, the Company had cash and cash equivalents and marketable securities of $51.8 million. Capital expenditures incurred during the third quarter of 2022 were $6.1 million.

Year-to-Date 2022 Compared to Year-to-Date 2021

For the first nine months of 2022, revenues were $198.3 million, an increase of three percent over revenues of $192.4 million for the first nine months of 2021. Operating income for the first nine months of 2022 increased by ten percent to $9.4 million, compared to $8.5 million for the first nine months of 2021. The increase in operating income was primarily attributable to higher revenues coupled with lower royalties expense related to the decline in legacy resuscitation revenues and lower facilities costs associated with closing certain leased satellite offices. We also experienced higher costs associated with personnel, commissions, travel, software, amortization, and a $1.0 million non-recurring, non-cash benefit during the first quarter of 2021 related to the reduction of paid time off (PTO) expense resulting from modifications to the Company’s PTO policy. Net income for the first nine months of 2022 increased to $9.6 million, compared to $6.2 million for the first nine months of 2021. Earnings per share were $0.31 per share (diluted) for the first nine months of 2022, compared to $0.20 per share (diluted) for the first nine months of 2021. Adjusted EBITDA decreased by two percent to $39.8 million for the first nine months of 2022, compared to $40.6 million for the first nine months of 2021.

Other Business Updates

On September 30, 2022, we had approximately 5.35 million contracted subscriptions to hStream, our emerging technology platform. hStream technology enables healthcare organizations and their respective workforces to easily connect to and gain value from the growing HealthStream ecosystem of applications, tools, and content.

Financial Outlook for 2022

The Company is updating its guidance for 2022 for certain of the measures set forth below. Specifically, in relation to the consolidated revenue guidance range below, we are forecasting revenues for the fourth quarter of 2022 to increase approximately 6.0 (six) percent over the fourth quarter of 2021, and revenues for the full year 2022 to increase approximately 3.8 (three and eight tenths) percent over 2021. For a reconciliation of projected adjusted EBITDA, a non-GAAP financial measure defined later in this release, to projected net income (the most comparable GAAP measure) for 2022, see the table included on page ten of this release.

 

 

Full Year 2022 Guidance

Revenue

 

 

 

 

 

 

 

 

 

 

Workforce Solutions

 

$

212.5

 

-

 

$

214.0

 

million

Provider Solutions

 

 

53.0

 

-

 

 

53.5

 

million

Consolidated

 

$

265.5

 

-

 

$

267.5

 

million

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA2

 

$

52.0

 

-

 

$

53.5

 

million

 

 

 

 

 

 

 

 

 

 

 

Capital Expenditures

 

$

25.5

 

-

 

$

26.5

 

million

 

2 Adjusted EBITDA is a non-GAAP financial measure. A reconciliation of projected adjusted EBITDA to projected net income (the most comparable GAAP measure) is included later in this release.

The Company’s guidance for 2022 as set forth above reflects the Company’s assumptions regarding, among other things, the COVID-19 pandemic and current economic conditions as noted below and increased Company expenses in 2022 compared to 2021 associated with growth in staffing levels, lower employee turnover, and the resumption of employee travel. This consolidated guidance does not include the impact of any future acquisitions that we may complete during 2022.

The Company’s financial guidance assumes that public health conditions associated with the pandemic and general economic conditions (including conditions impacting healthcare organizations) do not deteriorate during the remainder of 2022.

Commenting on third quarter 2022 results, Robert A. Frist, Jr., Chief Executive Officer, HealthStream, said, “Our financial performance in the third quarter of 2022 showed year-over-year increases in each of the major categories we highlight in our earnings release, which include record quarterly revenues and increasing revenue growth rates compared to the first half of the year. This is an exciting time for HealthStream as we are seeing new competitive benefits emerge from our innovative platform strategy, which we believe is paving the way for increased, long-term value for our customers and shareholders.”

A conference call with Robert A. Frist, Jr., Chief Executive Officer, Scott A. Roberts, Chief Financial Officer and Senior Vice President, and Mollie Condra, Vice President of Investor Relations and Corporate Communications, will be held on Tuesday, October 25, 2022, at 9:00 a.m. (ET). Participants may access the conference call live via webcast using this link: https://edge.media-server.com/mmc/p/nhw4jxrt. To participate via telephone, please register in advance using this link:

https://register.vevent.com/register/BIcc5e74ae1c47469f9080fceb6eedb482. A replay of the conference call and webcast will be archived on the Company’s website in the Investor Relations section under “Events & Presentations.”

Use of Non-GAAP Financial Measures

This press release presents adjusted EBITDA, a non-GAAP financial measure used by management in analyzing the Company’s financial results and ongoing operational performance. In order to better assess the Company’s financial results, management believes that net income excluding the impact of the deferred revenue write-downs associated with fair value accounting for acquired businesses (as discussed in greater detail below) and before interest, income taxes, stock based compensation, depreciation and amortization, changes in fair value of, including gains (losses) on the sale of, non-marketable equity investments, and the de-recognition of non-cash expense resulting from the PTO expense reduction in the first quarter of 2021 (“adjusted EBITDA”) is a useful measure for evaluating the operating performance of the Company because adjusted EBITDA reflects net income adjusted for certain GAAP accounting, non-cash and/or non-operating items which may not, in any such case, fully reflect the underlying operating performance of our business. We also believe that adjusted EBITDA is useful to investors to assess the Company’s ongoing operating performance and to compare the Company’s operating performance between periods. In addition, short-term cash incentive bonuses and certain performance-based equity awards grants are based on the achievement of adjusted EBITDA (as defined in applicable bonus and equity grant documentation) targets.

As noted above, the definition of adjusted EBITDA includes an adjustment for the impact of the deferred revenue write-downs associated with fair value accounting for acquired businesses. Prior to the Company early adopting ASU 2021-08 effective January 1, 2022, following the completion of any acquisition by the Company, the Company was required to record the acquired deferred revenue at fair value as defined in GAAP, which typically resulted in a write-down of the acquired deferred revenue. When the Company was required to record a write-down of deferred revenue, it resulted in lower recognized revenue, operating income, and net income in subsequent periods. Revenue for any such acquired business was deferred and was typically recognized over a one-to-two-year period following the completion of any particular acquisition, so our GAAP revenues for this one-to-two-year period would not reflect the full amount of revenues that would have been reported if the acquired deferred revenue was not written down to fair value. Management believes that including an adjustment in the definition of adjusted EBITDA for the impact of the deferred write-downs associated with fair value accounting for businesses acquired prior to the January 1, 2022 effective date of the Company's adoption of ASU 2021-08 provides useful information to investors because the deferred revenue write-down recognized in periods after an acquisition may, given the nature of this non-cash accounting impact, cause our GAAP financial results during such periods to not fully reflect our underlying operating performance and thus adjusting for this amount may assist in comparing the Company’s results of operations between periods. Following the adoption of ASU 2021-08, contracts acquired in an acquisition completed on or after January 1, 2022 will be measured as if the Company had originated the contract (rather than the contract being measured at fair value) such that, for such acquisitions, the Company will no longer record deferred revenue write-downs associated with acquired businesses (for acquisitions completed prior to January 1, 2022, the Company will continue to record deferred revenue write-downs associated with fair value accounting for periods on and after January 1, 2022 consistent with past practice). At the current time, the Company intends to continue to include an adjustment in the definition of adjusted EBITDA for the impact of deferred revenue write-downs from business acquired prior to January 1, 2022 given the ongoing impact of such deferred revenue on our financial results.

Adjusted EBITDA is a non-GAAP financial measure and should not be considered as a measure of financial performance under GAAP. Because adjusted EBITDA is not a measurement determined in accordance with GAAP, adjusted EBITDA is susceptible to varying calculations. Accordingly, adjusted EBITDA, as presented, may not be comparable to other similarly titled measures of other companies and has limitations as an analytical tool.

This non-GAAP financial measure should not be considered a substitute for, or superior to, measures of financial performance, which are prepared in accordance with GAAP. Investors are encouraged to review the reconciliation of adjusted EBITDA to net income (the most comparable GAAP measure), which is set forth below in this release.

About HealthStream

HealthStream (Nasdaq: HSTM) is dedicated to improving patient outcomes through the development of healthcare organizations’ greatest asset: their people. Our unified suite of solutions is contracted by healthcare organizations across the U.S. for workforce development, training & learning management, nurse & staff scheduling, clinical education, credentialing, privileging, provider enrollment, performance assessment, and managing simulation-based education programs. HealthStream’s corporate office is in Nashville, Tennessee. For more information, visit http://www.healthstream.com or call 800-521-0574.

HEALTHSTREAM, INC.

Condensed Consolidated Statements of Income

(In thousands, except per share data)

(Unaudited)

 

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30,

2022

 

 

September 30,

2021

 

 

September 30,

2022

 

 

September 30,

2021

 

Revenues, net

 

$

67,285

 

 

$

64,091

 

 

$

198,290

 

 

$

192,374

 

Operating costs and expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cost of revenues (excluding depreciation and amortization)

 

 

23,374

 

 

 

22,585

 

 

 

67,606

 

 

 

68,053

 

Product development

 

 

11,476

 

 

 

10,344

 

 

 

32,470

 

 

 

30,205

 

Sales and marketing

 

 

11,365

 

 

 

10,232

 

 

 

32,652

 

 

 

28,713

 

Other general and administrative expenses

 

 

9,096

 

 

 

10,004

 

 

 

27,856

 

 

 

29,445

 

Depreciation and amortization

 

 

9,592

 

 

 

9,141

 

 

 

28,334

 

 

 

27,443

 

Total operating costs and expenses

 

 

64,903

 

 

 

62,306

 

 

 

188,918

 

 

 

183,859

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operating income

 

 

2,382

 

 

 

1,785

 

 

 

9,372

 

 

 

8,515

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other income (loss), net

 

 

2,543

 

 

 

(99

)

 

 

2,945

 

 

 

(250

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income before income tax provision

 

 

4,925

 

 

 

1,686

 

 

 

12,317

 

 

 

8,265

 

Income tax provision

 

 

1,259

 

 

 

186

 

 

 

2,675

 

 

 

2,033

 

Net income

 

$

3,666

 

 

$

1,500

 

 

$

9,642

 

 

$

6,232

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income per share:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic

 

$

0.12

 

 

$

0.05

 

 

$

0.31

 

 

$

0.20

 

Diluted

 

$

0.12

 

 

$

0.05

 

 

$

0.31

 

 

$

0.20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average shares of common stock outstanding:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic

 

 

30,570

 

 

 

31,558

 

 

 

30,672

 

 

 

31,538

 

Diluted

 

 

30,662

 

 

 

31,684

 

 

 

30,717

 

 

 

31,609

 

HEALTHSTREAM, INC.

Condensed Consolidated Balance Sheets

(In thousands)

(Unaudited)

 

 

 

September 30,

 

 

December 31,

 

 

 

2022

 

 

2021

 

ASSETS

 

 

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

48,257

 

 

$

46,905

 

Marketable securities

 

 

3,587

 

 

 

5,041

 

Accounts and unbilled receivables, net

 

 

32,670

 

 

 

34,920

 

Prepaid and other current assets

 

 

19,837

 

 

 

19,979

 

Total current assets

 

 

104,351

 

 

 

106,845

 

 

 

 

 

 

 

 

 

 

Capitalized software development, net

 

 

35,537

 

 

 

32,412

 

Property and equipment, net

 

 

15,658

 

 

 

17,950

 

Operating lease right of use assets, net

 

 

23,343

 

 

 

25,168

 

Goodwill and intangible assets, net

 

 

269,888

 

 

 

271,706

 

Deferred tax assets

 

 

601

 

 

 

601

 

Deferred commissions

 

 

26,377

 

 

 

24,012

 

Other assets

 

 

5,442

 

 

 

8,059

 

Total assets

 

$

481,197

 

 

$

486,753

 

 

 

 

 

 

 

 

 

 

LIABILITIES AND SHAREHOLDERS’ EQUITY

 

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

 

 

Accounts payable, accrued and other liabilities

 

$

27,805

 

 

$

26,534

 

Deferred revenue

 

 

77,585

 

 

 

73,816

 

Total current liabilities

 

 

105,390

 

 

 

100,350

 

Deferred tax liabilities

 

 

18,761

 

 

 

18,146

 

Deferred revenue, non-current

 

 

1,264

 

 

 

1,583

 

Operating lease liability, noncurrent

 

 

24,041

 

 

 

26,178

 

Other long-term liabilities

 

 

1,459

 

 

 

1,477

 

Total liabilities

 

 

150,915

 

 

 

147,734

 

 

 

 

 

 

 

 

 

 

Shareholders’ equity:

 

 

 

 

 

 

 

 

Common stock

 

 

253,934

 

 

 

270,791

 

Accumulated other comprehensive (loss) income

 

 

(1,416

)

 

 

106

 

Retained earnings

 

 

77,764

 

 

 

68,122

 

Total shareholders’ equity

 

 

330,282

 

 

 

339,019

 

Total liabilities and shareholders' equity

 

$

481,197

 

 

$

486,753

 

HEALTHSTREAM, INC.

Condensed Consolidated Statements of Cash Flows

(In thousands)

(Unaudited)

 

 

 

Nine Months Ended

 

 

 

September 30,

 

 

September 30,

 

 

 

2022

 

 

2021

 

Operating activities:

 

 

 

 

 

 

 

 

Net income

 

$

9,642

 

 

$

6,232

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

 

 

 

Depreciation and amortization

 

 

28,334

 

 

 

27,443

 

Stock-based compensation

 

 

2,609

 

 

 

2,260

 

Amortization of deferred commissions

 

 

7,826

 

 

 

6,900

 

Deferred income taxes

 

 

1,225

 

 

 

2,066

 

Provision for credit losses

 

 

400

 

 

 

99

 

Gain on sale of fixed assets

 

 

(25

)

 

 

 

Loss on equity method investments

 

 

621

 

 

 

258

 

Non-cash paid time off expense

 

 

 

 

 

(1,011

)

Change in fair value of non-marketable equity investments

 

 

(3,596

)

 

 

 

Other

 

 

30

 

 

 

132

 

Changes in assets and liabilities:

 

 

 

 

 

 

 

 

Accounts and unbilled receivables

 

 

2,273

 

 

 

13,907

 

Prepaid and other assets

 

 

(9,370

)

 

 

(8,959

)

Accounts payable, accrued and other liabilities

 

 

1,514

 

 

 

(6,668

)

Deferred revenue

 

 

1,597

 

 

 

(6,223

)

Net cash provided by operating activities

 

 

43,080

 

 

 

36,436

 

 

 

 

 

 

 

 

 

 

Investing activities:

 

 

 

 

 

 

 

 

Business combinations, net of cash acquired

 

 

(4,009

)

 

 

(731

)

Changes in marketable securities

 

 

1,424

 

 

 

4,708

 

Payments to acquire equity method investments

 

 

 

 

 

(1,750

)

Proceeds from sale of fixed assets

 

 

26

 

 

 

 

Proceeds from sale of non-marketable equity investments

 

 

3,494

 

 

 

 

Purchases of property and equipment

 

 

(1,570

)

 

 

(2,602

)

Payments associated with capitalized software development

 

 

(17,392

)

 

 

(16,577

)

Net cash used in investing activities

 

 

(18,027

)

 

 

(16,952

)

 

 

 

 

 

 

 

 

 

Financing activities:

 

 

 

 

 

 

 

 

Taxes paid related to net settlement of equity awards

 

 

(518

)

 

 

(471

)

Repurchases of common stock

 

 

(23,137

)

 

 

 

Payment of cash dividends

 

 

 

 

 

(19

)

Net cash used in financing activities

 

 

(23,655

)

 

 

(490

)

 

 

 

 

 

 

 

 

 

Effect of exchange rate changes on cash and cash equivalents

 

 

(46

)

 

 

(101

)

Net increase in cash and cash equivalents

 

 

1,352

 

 

 

18,893

 

Cash and cash equivalents at beginning of period

 

 

46,905

 

 

 

36,566

 

Cash and cash equivalents at end of period

 

$

48,257

 

 

$

55,459

 

Reconciliation of GAAP to Non-GAAP Financial Measures(1)

(In thousands)

(Unaudited)

 

 

 

Three Months Ended

September 30,

 

 

Nine Months Ended

September 30,

 

 

 

2022

 

 

2021

 

 

2022

 

 

2021

 

GAAP net income

 

$

3,666

 

 

$

1,500

 

 

$

9,642

 

 

$

6,232

 

Deferred revenue write-down

 

 

46

 

 

 

805

 

 

 

223

 

 

 

3,657

 

Interest income

 

 

(124

)

 

 

(24

)

 

 

(155

)

 

 

(64

)

Interest expense

 

 

33

 

 

 

33

 

 

 

99

 

 

 

99

 

Income tax provision

 

 

1,259

 

 

 

186

 

 

 

2,675

 

 

 

2,033

 

Stock-based compensation expense

 

 

918

 

 

 

861

 

 

 

2,609

 

 

 

2,260

 

Depreciation and amortization

 

 

9,592

 

 

 

9,141

 

 

 

28,334

 

 

 

27,443

 

Change in fair value of non-marketable equity investments

 

 

(2,653

)

 

 

 

 

 

(3,596

)

 

 

 

Non-cash paid time off expense

 

 

 

 

 

 

 

 

 

 

 

(1,011

)

Adjusted EBITDA

 

$

12,737

 

 

$

12,502

 

 

$

39,831

 

 

$

40,649

 

 

(1) Adjusted EBITDA is a non-GAAP financial measure. A reconciliation of projected adjusted EBITDA to projected net income (the most comparable GAAP measure) is included later in this release.

Reconciliation of GAAP to Non-GAAP Financial Measures

Financial Outlook for 2022

(In thousands)

(Unaudited)

 

 

 

Low

 

 

High

 

Net income

 

$

10,800

 

 

$

11,700

 

Deferred revenue write-down

 

 

300

 

 

 

300

 

Interest income

 

 

(200

)

 

 

(200

)

Interest expense

 

 

100

 

 

 

100

 

Income tax provision

 

 

3,100

 

 

 

3,400

 

Change in fair value of non-marketable equity investments

 

 

(3,600

)

 

 

(3,600

)

Stock-based compensation expense

 

 

3,600

 

 

 

3,700

 

Depreciation and amortization

 

 

37,900

 

 

 

38,100

 

Adjusted EBITDA

 

$

52,000

 

 

$

53,500

 

This press release includes certain forward-looking statements (statements other than solely with respect to historical fact), including statements regarding expectations for financial performance for 2022 as well as the anticipated impact of the COVID-19 pandemic on our financial results, that involve risks and uncertainties regarding HealthStream. These statements are based upon managements beliefs, as well as assumptions made by and data currently available to management. This information has been, or in the future may be, included in reliance on the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. The Company cautions that forward-looking statements involve known and unknown risks, uncertainties, and other factors that may cause the actual results, performance, or achievements to be materially different from future results, performance, or achievements expressed or implied by the forward-looking statements, including, without limitation, as the result of developments related to the COVID-19 pandemic, including, without limitation, related to the length and severity of the pandemic; current economic challenges impacting the U.S. economy, including with respect to recessionary concerns, inflationary pressures, competitive labor market conditions and supply chain shortages and disruptions, and the impact of the pandemic and current economic conditions on healthcare organizations; as well as risks referenced in the Companys Annual Report on Form 10-K for the year ended December 31, 2021, filed on February 28, 2022, and in the Companys other filings with the Securities and Exchange Commission from time to time. Consequently, such forward-looking information should not be regarded as a representation or warranty or statement by the Company that such projections will be realized. Many of the factors that will determine the Companys future results are beyond the ability of the Company to control or predict. Readers should not place undue reliance on forward-looking statements, which reflect managements views only as of the date hereof. The Company undertakes no obligation to update or revise any such forward-looking statements.

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