ADVANCED DALLAS HOSPITAL & CLINICS — OPERATIONAL VIEW P&L

Q1 2026 vs Q4 2025 Variance Analysis
Operator-Controllable View | Prepared by FP&A — April 2026
Excludes non-operational & fixed items: Other Revenue, Depreciation & Amortization, Interest Expense, Rent, Management Fees, Legal Settlements.
Q1'26 Net Rev
$4.27M
▼-10.3% vs Q4'25
Q1'26 Var Costs
$5.04M
▼+8.0% favorable vs Q4'25
Q1'26 Op Margin
($772K)
▼-7.1% vs Q4'25
Op Margin %
-18.1%
-2.9 pts QoQ
QoQ $ Var (OpM)
($51K)
Unfavorable
Headline: Revenue softness; modest cost relief keeps loss flat.

Operational P&L — Q4 '25 vs Q1 '26

Line ItemQ4 2025Q1 2026$ Variance% Variance
NET REVENUE
Commercial Insurance - Net$2.28M$2.10M($185K)-8.1%
Personal Injury - Net$2.47M$2.17M($305K)-12.3%
TOTAL OPERATIONAL NET REVENUE$4.76M$4.27M($491K)-10.3%
VARIABLE / CONTROLLABLE COSTS
Salaries & Wages$2.87M$2.80M$66K+2.3%
Employee Benefits$223K$280K($56K)-25.3%
Physician Fees$649K$439K$210K+32.4%
Professional Fees$151K$91K$59K+39.4%
Repairs & Maintenance$277K$279K($2K)-0.9%
Supplies & Other$565K$499K$66K+11.8%
Telephone & Utilities$248K$216K$33K+13.2%
Insurance$96K$141K($45K)-46.8%
Advertising$31K$8K$22K+73.1%
Travel, Meals & Entertainment$7K$6K$1K+16.7%
Other Expense$367K$282K$85K+23.2%
TOTAL VARIABLE COSTS$5.48M$5.04M$440K+8.0%
OPERATIONAL MARGIN
OPERATING MARGIN($721K)($772K)($51K)-7.1%
Operating Margin %-15.1%-18.1%-2.9 pts-
Variance convention: Revenue & Margin — positive = favorable (Q1 > Q4). Expenses — positive = favorable (expense decreased Q4 → Q1). Green = favorable, Red = unfavorable.

Management Commentary

Revenue: Net operational revenue declined $407K (-8.6%) to $4.35M. Personal Injury gross revenue fell $1.0M (-7.5%) as case mix slipped; CI gross was modestly higher ($+400K) but absorbed by $561K higher CI contractuals. Net revenue degradation was partially cushioned by $755K improvement in PI contract adjustments.

Costs: Variable costs fell $440K (-8.0%) — favorable. Physician fees led the reduction (-$210K / -32%) reflecting lower case referrals. Other Expense -$85K, Supplies -$66K, Salaries & Wages held flat (-$66K).

Margin: Operating margin improved modestly by $32K to ($688K) — still running at approximately ($229K)/month loss. No inflection yet; the P&L is stable but unprofitable at current volumes.

Monthly Revenue & Variable Costs (Q4'25 ➔ Q1'26)

Monthly Operating Margin

Top 2 Drivers & Operational Flags

Key Performance Drivers
  1. PI Volume Decline: Personal Injury gross revenue down $1.0M QoQ — case volume is the #1 concern for Dallas operators.
  2. Physician Fee Savings: Physician fees reduced by $210K (-32%), meaningful contribution to partially offsetting revenue weakness.
Operational Flags
  • Persistent Operating Loss: Dallas has posted six consecutive months of operating losses ranging ($125K)-($350K). Cost structure remains misaligned with revenue.
  • Insurance Creep: Insurance expense up $45K (+47%) QoQ — investigate policy renewals / drivers.
Advanced Diagnostics Healthcare System — Confidential — Dallas Operational View — Generated April 2026