NRCMEDIUM SIGNALFINANCIAL10-K

NRC Health shows deteriorating operational performance with meaningfully lower operating income and reduced cash generation, while debt levels increased substantially.

The company's core profitability declined notably despite achieving higher net income, suggesting potential one-time benefits or tax effects that masked underlying operational challenges. The combination of reduced operating cash flow, higher debt levels, and compressed stockholders' equity indicates mounting financial pressure that could constrain future growth investments and shareholder returns.

Comparing 2026-03-05 vs 2025-03-17View on EDGAR →
FINANCIAL ANALYSIS

NRC Health experienced a challenging period with operating income declining meaningfully to $22.6M while SG&A expenses grew 22% to $54.8M, indicating margin compression from higher costs. Despite operational headwinds, net income grew modestly to $30.0M, likely due to non-operational factors. The balance sheet weakened notably with debt rising 65% to $36.8M and stockholders' equity falling by more than half to $14.0M, while operating cash flow dropped 24% to $26.4M, signaling reduced cash generation capacity.

FINANCIAL STATEMENT CHANGES
Total Debt
Balance Sheet
+64.9%
$22.3M→$36.8M

Debt increased 64.9% — substantial leverage increase; assess whether deployed for growth or covering losses.

Stockholders Equity
Balance Sheet
-55.3%
$31.3M→$14.0M

Equity declined sharply — large losses, buybacks, or write-downs reducing book value significantly.

Operating Income
P&L
-35.8%
$35.2M→$22.6M

Operating income deteriorated sharply — investigate whether driven by one-time charges or structural cost issues.

Share Buybacks
Cash Flow
-34.8%
$30.9M→$20.2M

Buyback activity reduced 34.8% — capital being redeployed elsewhere or cash conservation underway.

Net Income
P&L
+31%
$22.9M→$30.0M

Net income grew 31% — bottom-line growth signals improving overall business health.

Capital Expenditure
Cash Flow
-30.7%
$15.4M→$10.7M

Capex reduced 30.7% — investment cycle winding down or capital discipline; may improve near-term free cash flow.

Operating Cash Flow
Cash Flow
-23.6%
$34.6M→$26.4M

Operating cash flow softened — monitor whether temporary working capital timing or structural deterioration.

SG&A Expense
P&L
+22%
$44.9M→$54.8M

SG&A increased modestly — likely reflects growth-related hiring or sales expansion investment.

Total Liabilities
Balance Sheet
+19.4%
$101.3M→$120.9M

Liabilities increased 19.4% — monitor debt-to-equity ratio and interest coverage.

LANGUAGE CHANGES
NEW — 2026-03-05
PRIOR — 2025-03-17
ADDED
Securities and Exchange Commission within 120 days after December 31, 2025.
General For nearly 45 years, NRC Health has led the charge to humanize healthcare and support organizations in their understanding of each unique individual.
NRC Health s commitment to Human Understanding helps leading healthcare systems improve their operations through understanding each person they serve not as point-in-time insights, but as an ongoing relationship.
We believe access to, analysis of, and acting on our extensive individual-driven information is increasingly valuable as healthcare providers need to better understand and engage the people they serve to create long-term relationships, build loyalty, and improve processes.
Our expertise includes efficient capture, transmittal, analysis, and interpretation of critical data elements from millions of healthcare consumers and thousands of clinicians.
Our portfolio of subscription-based solutions provides actionable information, analysis, and workflow enablement tools to healthcare organizations across a range of mission-critical, constituent-related elements, including patient experience, service recovery, care transitions, employee engagement, reputation management, rounding, and brand loyalty.
We partner with customers across the continuum of healthcare services and believe this cross-continuum positioning is a unique and an increasingly important capability as the evolving healthcare landscape drives its constituents towards a more collaborative and integrated service model.
We have a broad and diversified customer base that is distributed across the United States.
Our ten largest customers collectively accounted for 20%, 17%, and 15% of our total revenue in 2025, 2024, and 2023, respectively.
We believe we have achieved a market leadership position through our nearly 45 years of industry innovation and experience, as well as our long-term, recurring revenue relationships (solutions that are used or required by a customer each year) with many of the healthcare industry s largest organizations.
REMOVED
NRC Health s commitment to Human Understanding helps leading healthcare systems get to know each person they serve not as point-in-time insights, but as an ongoing relationship.
We believe access to, and analysis of, our extensive consumer-driven information is increasingly valuable as healthcare providers need to better understand and engage the people they serve to create long-term relationships and build loyalty.
Our expertise includes the efficient capture, transmittal, analysis, and interpretation of critical data elements from millions of healthcare consumers.
We partner with clients across the continuum of healthcare services and believe this cross-continuum positioning is a unique and an increasingly important capability as evolving payment models drive healthcare providers and payers towards a more collaborative and integrated service model.
We have a broad and diversified client base that is distributed primarily across the United States.
Our ten largest clients collectively accounted for 17%, 15%, and 15% of our total revenue in 2024, 2023 and 2022, respectively.
We believe we have achieved a market leadership position through our more than 40 years of industry innovation and experience, as well as our long-term, recurring revenue relationships (solutions that are used or required by a client each year) with many of the healthcare industry s largest organizations.
Human Understanding Solutions Healthcare experiences are human experiences.
Market Insights is a syndicated survey that provides clients with an independent third-party source of information that is used to understand consumer perception and preferences and optimize marketing strategies.
Our Marketing solutions provide clients with on-demand tools to measure brand value and build brand equity in their markets, evaluate and optimize advertising efficacy and consumer recall, and tailor research to obtain the real time voice of customer feedback to support branding and loyalty initiatives.
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