American Health Associates - Chapter 11 Case Summary

Business Description

Headquartered in Davie, FL, American Health Associates Holdings, Inc. ("AHA Holdings"), along with its twelve Debtor affiliates (collectively, the "Debtors"), operates in the healthcare diagnostic space, providing clinical laboratory and mobile imaging services directly to patients in their homes, nursing home facilities, and hospitals.

• The Debtors serve over 2,700 healthcare facilities across 23 states, including more than 2,260 skilled nursing or other long-term care facilities, with operations spanning four regions—Midwest, South, Northeast, and West—and particularly dense coverage in the Midwest and South.
• A large number of the individuals the Debtors serve are dual-enrolled in Medicaid and Medicare and are often located in rural, out-of-reach areas.

A significant portion of the Debtors' client facilities are located in rural and underserved areas where alternative laboratory services are either unavailable or would require significant travel. Many of these skilled nursing facilities depend entirely on the Debtors for diagnostic testing, and there is no current laboratory infrastructure that the Debtors are aware of in numerous rural areas that could rapidly absorb the Debtors' specimen volume in the event of a service disruption.

As of the Petition Date, the Debtors employed 1,047 people. In 2024, the Debtors reported revenue of $101.2 million, declining to $97.6 million in 2025. Total cash collections for January and February of 2026 were $12.6 million.

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Corporate History

Debbie Martin, the Debtors' Chief Executive Officer, founded the Debtors in October 1990. Over time, Martin positioned the Debtors to provide clinical laboratory and mobile imaging services, aiming to deliver high-quality care at the bedside. The mobile imaging business was acquired separately in 2021.

• Christopher Martin has served as President of all thirteen Debtors since 2013. Shortly after stepping into the role, he led the acquisition of MEDLAB in 2014, expanding the Debtors' nursing home laboratory offerings.

Organizational Structure

The thirteen Debtors share common management and ownership. AHA Holdings serves as the holding company of the remaining twelve entities, with American Health Associates Parent, LLC serving as the parent company.

• American Health Associates Parent, LLC owns 100% of the equity interests in American Health Holdings, LLC, American Health Holdings II, LLC, and American Health Holdings IV, LLC, and 75% of American Health Holdings III, LLC (collectively, the "Holdings Debtors"). Non-Debtor MXD/AHA, JV, LLC owns the remaining 25% of American Health Holdings III, LLC.
• The Holdings Debtors own 100% of the equity interests in the remaining Debtors, which are the operating entities.

The various Debtors are Florida and Delaware entities, with their principal place of business at 15712 SW 41st St., Suite 16, Davie, FL 33331.

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Operations Overview

The Debtors deliver a health-at-bedside model, leveraging 89 leased vehicles and employee-owned cars to provide mobile phlebotomy and laboratory services and portable X-ray exams directly to patients. Test results are generally delivered within hours of completing an exam, which is critical as physicians rely on these results to make life-and-death clinical decisions.

• Without the Debtors' services, patients would need to be transported to regional hospitals, disrupting continuity of care and straining already overburdened emergency systems.
• In many of the rural communities the Debtors serve, the Debtors' operations augment and in some cases effectively supplant rural hospital diagnostics operations that lack the capacity, test menu, or turnaround time to serve the volume and acuity of testing required by skilled nursing facility patients.

The Debtors process tens of thousands of specimens daily across their laboratory network.

Facilities and Equipment

The Debtors do not own any real property. The Company leases fourteen laboratories in core geographic areas across the United States, which work in unison with traveling practitioners to provide reliable and quick diagnostic results upon completion of a patient exam.

• The Debtors also lease thirty spin sites where blood is spun as part of the testing process, and maintain eight draw locations and six office locations.
• All vehicles are leased from Enterprise and do not have significant liquidation value. Laboratory equipment is also generally leased.

Workforce

As of the Petition Date, the Debtors employ 1,047 employees across the following categories by approximate percentage:

• Phlebotomy: 48%; Laboratory Operations: 15%; Billing and Revenue Cycle: 5%; Courier and Logistics: 3.5%; Customer Service: 3%; Corporate and Administrative: approximately 2%; Imaging/Radiology: 1.5%; Sales and Marketing: 1.5%; IT and Technology: 1.5%; and Unclassified: approximately 19%.
  • The Unclassified category primarily consists of field phlebotomy and laboratory staff not yet assigned formal titles in the payroll system.

The employees are essential to the Debtors' healthcare business and play a critical role in providing patient care. According to the Debtors, failure to pay prepetition wages would negatively impact employee morale and likely result in turnover, causing immediate and pervasive damage to the business.

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Prepetition Obligations

As of the Petition Date, the Debtors have three secured creditors: City National Bank ("CNB"), National Biz Capital, and Forward Financing, LLC (collectively, the "Lenders"). The Lenders hold UCC liens on certain assets of the Debtors. The Debtors' assets primarily consist of accounts receivable with a book value of approximately $39 million, falling almost entirely into three categories: nursing home clients, Medicare, and health insurers. The Debtors also hold inventory with a book value of $1.1 million, consisting of testing reagents, test tubes, phlebotomy supplies, and other materials used in laboratory testing.

Secured Debt — City National Bank

• CNB serves as the primary secured lender for American Health S, LLC and American Health MW, LLC. Under the security agreement entered into between these parties, CNB provides a revolving loan in the maximum principal amount of $9,632,274.00.
  • As of the Petition Date, CNB holds a secured claim in the asserted principal amount of at least $9,632,274.00.
  • CNB also maintains an interest in the Debtors' cash collateral through the deposit accounts the Debtors hold at the bank.

Merchant Cash Advance Lenders

• The remaining two lenders, National Biz Capital and Forward Financing, LLC, are merchant cash advance lenders (the "MCA Lenders").
  • National Biz Capital holds a claim for $1,840,642.75, and Forward Financing, LLC holds a claim for $229,905.00.
  • The Debtors dispute both MCA Lenders' claims.

The Debtors contend that both CNB and the MCA Lenders are over-secured. The Debtors project positive cash flow and require the use of cash collateral to pay ongoing business expenses, asserting that failure to meet operating expenses, including payroll, will result in immediate and irreparable harm to the estates.

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Events Leading to Bankruptcy

Covenant Default and Foreclosure Proceedings

On July 1, 2025, CNB, the Debtors' senior secured lender, instituted foreclosure proceedings due to the Debtors' default on a Fixed Charge Coverage Ratio requirement under the secured loan. The loan required a maintenance ratio of not less than 1.25 to 1.00.

• Those proceedings prompted the Debtors to seek bankruptcy protection.

Chapter 11 Filing

On April 17, 2026, each of the Debtors filed a voluntary petition for relief under Chapter 11 of the Bankruptcy Code in the U.S. Bankruptcy Court for the Southern District of Florida, Fort Lauderdale Division.

• The Debtors will continue to operate their businesses and manage their affairs as debtors in possession.