TruBridge - 10-K annual report 2025

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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

FORM 10-K


☒			ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934

FOR THE FISCAL YEAR ENDED December 31, 2025


☐			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934

FOR THE TRANSITION PERIOD FROM TO .

Commission file number: 001-41992

TruBridge, Inc.

(Exact Name of Registrant as Specified in Its Charter)


Delaware						74-3032373
(State or Other Jurisdiction of Incorporation or Organization)						(I.R.S. Employer Identification No.)

54 St. Emanuel Street, Mobile, Alabama						36602
(Address of Principal Executive Offices)						(Zip Code)

(251) 639-8100

(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:


Title of each class	Trading symbol	Name of each exchange on which registered
Common Stock, par value $.001 per share	TBRG	The NASDAQ Stock Market LLC

Securities registered pursuant to Section 12(g) of the Act:

None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ¨ No x

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ¨ No x

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes x No ¨

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes x No ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of "large accelerated filer," accelerated filer,” "smaller reporting company," and "emerging growth company" in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer

Accelerated filer

Non-accelerated filer

Smaller reporting company

☒

Emerging Growth Company

☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨

Indicate by check mark whether the registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control of financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☒

If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction of an error to previously issued financial statements. ☒

Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant's executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☒

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes ☐ No x

The aggregate market value of common stock held by non-affiliates of the registrant at June 30, 2025 was $247,987,565.

As of March 26, 2026, the registrant had outstanding 14,906,825 shares of its common stock.

DOCUMENTS INCORPORATED BY REFERENCE IN THIS FORM 10-K:

Certain information required by Part III of this Annual Report on Form 10-K (“Form 10-K”) is incorporated herein by reference from the registrant’s definitive Proxy Statement for the 2026 Annual Meeting of Stockholders (the “2026 Proxy Statement”), to the extent described herein, or in the event

the 2026 Proxy Statement is not filed with the Securities and Exchange Commission (the “SEC”) by April 30, 2026, such information will be provided by an amendment to this Form 10-K to be filed with the SEC no later than April 30, 2026.

TABLE OF CONTENTS


Item No.		Page No.
Special Note Regarding Forward-Looking Statements		5

PART I
1	Business	7
	Overview	7
	Industry Dynamics	7
	Strategy	9
	Our Products and Services	10
	Software Development	14
	Product Strategy	14
	System Implementation and Training	15
	Commercial	15
	Backlog	16
	Competition	16
	Health Information Security and Privacy Practices	17
	Intellectual Property	18
	Human Capital	18
	Material Government Regulations	20
	Executive Officers	21
	Company Web Site	21
1A.	Risk Factors	22
1B.	Unresolved Staff Comments	44
1C.	Cybersecurity	44
2	Properties	45
3	Legal Proceedings	46
4	Mine Safety Disclosures	46

PART II
5	Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities	47
6	Reserved	48
7	Management’s Discussion and Analysis of Financial Condition and Results of Operations	48
7A.	Quantitative and Qualitative Disclosures about Market Risk	59
8	Financial Statements and Supplementary Data	60
9	Changes in and Disagreements with Accountants on Accounting and Financial Disclosure	109
9A.	Controls and Procedures	109
9B.	Other Information	111
9C.	Disclosure Regarding Foreign Jurisdictions that Prevent Inspections	111

PART III
10	Directors, Executive Officers and Corporate Governance	112
11	Executive Compensation	112
12	Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters	113
13	Certain Relationships and Related Transactions, and Director Independence	113
14	Principal Accountant Fees and Services	113


PART IV
15	Exhibits and Financial Statement Schedules	114
16	Form 10-K Summary	114
SIGNATURES		114
*Certain information required by Part III of this Form 10-K is incorporated herein by reference from the 2026 Proxy Statement, to the extent described herein, or in the event the 2026 Proxy Statement is not filed with the SEC by April 30, 2026, such information will be provided by an amendment to this Form 10-K to be filed with the SEC no later than April 30, 2026.

SPECIAL NOTE REGARDING FORWARD LOOKING STATEMENTS

This Annual Report on Form 10-K contains forward-looking statements within the meaning of the "safe harbor" provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements can be identified generally by the use of forward-looking terminology and words such as "expects," "anticipates," "estimates," "believes," "predicts," "intends," "plans," "potential," "may," "continue," "should," "will" and words of comparable meaning. Without limiting the generality of the preceding statement, all statements in this Annual Report relating to estimated and projected earnings, margins, costs, expenditures, cash flows, growth rates and future financial results are forward-looking statements. We caution investors that any such forward-looking statements are only predictions and are not guarantees of future performance. Certain risks, uncertainties and other factors may cause actual results to differ materially from those projected in the forward-looking statements. The following is a summary of the principal risks that could adversely affect our business, financial condition, results of operations and cash flows.

Risks Related to Our Industry

•saturation of our target market and hospital consolidations;

•unfavorable economic or market conditions that may cause a decline in spending for information technology and services;

•significant legislative and regulatory uncertainty in the healthcare industry;

•exposure to liability for failure to comply with regulatory requirements;

Risks Related to Our Business

•transition to a subscription-based recurring revenue model and modernization of our technology;

•competition with companies that have greater financial, technical and marketing resources than we have;

•potential future acquisitions that may be expensive, time consuming, and subject to other inherent risks;

•our ability to attract and retain qualified personnel in a global workforce;

•disruption from periodic restructuring of our sales force;

•slower than anticipated development of the market for Financial Health services;

•our potential inability to manage our growth in the new markets we may enter;

•our potential failure to effectively implement a new enterprise resource planning software solution;

•exposure to numerous and often conflicting laws, regulations, policies, standards or other requirements through our domestic and international business activities;

•potential litigation against us and investigations;

•our use of offshore third-party resources;

•competitive and litigation risk related to the use of artificial intelligence;

•potential inability to identify and implement any potential strategic alternatives in a timely manner or at all;

Risks Related to Our Products and Services

•potential failure to develop new products or enhance current products that keep pace with market demands;

•exposure to claims if our products fail to provide accurate and timely information for clinical decision-making;

•exposure to claims for breaches of security and viruses in our systems;

•undetected errors or problems in new products or enhancements;

•our potential inability to convince customers to migrate to current or future releases of our products;

•failure to maintain our margins and service rates;

•increase in the percentage of total revenues represented by service revenues, which have lower margins;

•exposure to liability in the event we provide inaccurate claims data to payors;

•exposure to liability claims arising out of the licensing of our software and provision of services;

•dependence on licenses of rights, products and services from third parties;

•a failure to protect our intellectual property rights;

•exposure to significant license fees or damages for intellectual property infringement;

•service interruptions resulting from loss of power and/or telecommunications capabilities;

Risks Related to Our Indebtedness

•our potential inability to secure additional financing on favorable terms to meet our future capital needs;

•substantial indebtedness that may adversely affect our business operations;

•our ability to incur substantially more debt;

•pressures on cash flow to service our outstanding debt;

•restrictive terms of our credit agreement on our current and future operations;

Risks Related to Our Common Stock and Other General Risks

•changes in and interpretations of financial accounting matters that govern the measurement of our performance;

•the potential for our goodwill or intangible assets to become impaired;

•quarterly fluctuations in our financial results due to various factors;

•volatility in our stock price;

•failure to maintain effective internal control over financial reporting;

•inherent limitations in our internal control over financial reporting;

•vulnerability to significant damage from natural disasters;

•exposure to market risk related to interest rate changes;

•potential material adverse effects due to macroeconomic conditions;

•we do not anticipate paying dividends on our common stock; and

•actions of activist stockholders against us could be disruptive and costly, or potentially cause uncertainty about the strategic direction of our business.

For more information about the risks described above and other risks affecting us, see “Risk Factors” beginning on page 22 of this Annual Report. We also caution investors that the forward-looking information described herein represents our outlook only as of this date, and we undertake no obligation to update or revise any forward-looking statements to reflect events or developments after the date of this Annual Report.

PART I


ITEM 1.			BUSINESS

Overview

Founded in 1979, TruBridge, Inc. (“TruBridge” or the “Company”) is a leading provider of healthcare solutions and services for community hospitals, their clinics and other healthcare systems. Previously named Computer Programs and Systems, Inc., the Company changed its name to TruBridge, Inc. on March 4, 2024 in a Company-wide rebranding and legal entity consolidation. TruBridge is a trusted partner to more than 1,500 healthcare organizations with a broad range of technology-first solutions that address the unique needs and challenges of diverse communities, promoting equitable access to quality care and fostering positive outcomes. TruBridge has over four decades of experience in connecting providers, patients and communities with innovative data-driven solutions that create real value by supporting both the financial and clinical side of healthcare delivery. Our industry leading HFMA Peer Reviewed® suite of revenue cycle management (RCM) offerings combine unparalleled visibility and transparency to enhance productivity and support the financial health of healthcare organizations across all care settings. We support efficient patient care with electronic health record (EHR) product offerings that successfully integrate data between care settings. Above all, we believe in the power of community and encourage collaboration, connection, and empowerment with our customers. We clear the way for care.

The Company’s legal structure includes TruBridge, Inc., the parent company, with Viewgol, LLC ("Viewgol"), TruBridge Healthcare Private Limited, iNetXperts, Corp. d/b/a Get Real Health, Healthcare Resource Group, Inc. ("HRG"), Healthland Holding Inc. (“HHI”) and Healthland, Inc. as its wholly-owned direct and indirect subsidiaries. The Company operates its business in two operating segments, which are also our reportable segments: Financial Health and Patient Care. These segments contribute towards the combined focus of improving the health of the communities we serve as follows:

•The Financial Health reporting segment focuses on providing business management, consulting, and managed IT services along with its complete RCM solution for all care settings, regardless of their primary healthcare information solutions provider. This reporting segment includes the operation of Viewgol, TruBridge Healthcare Private Limited, HRG, HHI, and Healthland.

•The Patient Care segment provides comprehensive acute care EHR solutions and related services for community hospitals, and their physician clinics. The Patient Care segment also offers comprehensive patient engagement and empowerment technology solutions through the Get Real Health entity to improve patient outcomes and engagement strategies with care providers.

Our companies currently support community hospitals and other healthcare systems with a geographically diverse patient mix within the domestic community healthcare market. Our target market for our Financial Health and Patient Care solutions includes community hospitals with fewer than 400 acute care beds, and their clinics, as well as independent or small to medium sized chains of skilled nursing facilities. Approximately 98% of our acute care hospital Patient Care customer base is comprised of hospitals with fewer than 100 beds. During 2025, we generated revenues of $346.8 million from the sale of our products and services.

See Note 18 to the consolidated financial statements included herein for additional information on our two reportable segments.

Industry Dynamics

The healthcare industry is the largest industry in the United States economy, comprising approximately 18.0% of the U.S. gross domestic product in 2024 according to the Centers for Medicare and Medicaid Services (“CMS”). CMS estimates that national health spending is projected to grow at an average annual rate of 5.8% through 2033 and will reach $8.6 trillion in 2033.

Hospital expenditures grew by 8.9% to approximately $1.6 trillion in 2024, dramatically slower than the 10.4% growth rate in 2023. According to the American Hospital Association’s AHA Hospital Statistics, 2026 Edition, there are approximately 4,600 community hospitals in the United States that are in our target market of hospitals with fewer than 400 beds, with approximately 3,000 of those having fewer than 100 acute care beds. In addition, there is a market of small specialty hospitals that focus on discrete medical areas such as surgery, rehabilitation and long-term acute care.

The healthcare industry is constantly challenged by changing economic dynamics, increased regulation and pressure to improve the quality of care. These factors create an environment of escalating costs of care which, because of their heavy reliance on Medicare and Medicaid programs, our hospital clients have limited ability to recover through reimbursement changes. However, we believe healthcare providers can successfully address these issues with the help of our advanced medical

information systems, including our Financial Health solutions and our suite of complementary services. Specific examples of the challenges and opportunities facing healthcare providers include the following:

Changing Economic Dynamics

The healthcare industry is heavily influenced by legislative and regulatory initiatives of the federal and state governments. These initiatives have a particularly significant impact on our customer base, as community hospitals generate a significant portion of their revenues from beneficiaries of the Medicare and Medicaid programs. Consequently, even small changes in federal and state programs have a disproportionate effect on community hospitals as compared to larger facilities where greater portions of their revenues are generated from beneficiaries of private insurance programs.

Medicare and Medicaid funding and reimbursements fluctuate annually and, with projected growth in healthcare costs, will continue to be scrutinized as the federal and state governments attempt to control the costs and growth of the program. As the federal government seeks to further limit deficit spending in the future due to fiscal restraints, it will likely continue to place constraints on healthcare spending programs such as Medicare and Medicaid matching grants, which will place further cost pressures on hospitals and other healthcare providers. Further reductions in reimbursements from these programs could lead to hospitals postponing expenditures on information technology and may motivate hospitals to revisit long-held cost structures, which could positively impact demand for Financial Health solutions and services.

While legislative and regulatory initiatives are placing significant pressure on the related reimbursements, community hospitals are also faced with likely increased demand for Medicare and Medicaid services. Medicare Advantage enrollment in rural communities has quadrupled since 2010 and reached approximately 48% of rural Medicare beneficiaries in 2024, with penetration already exceeding 50% in several states. At the same time, recent analyses indicate that Medicare Advantage plans reimburse rural hospitals at only about 90% of traditional Medicare rates and impose increasingly demanding prior authorization and other administrative requirements, which can delay or deny payment and further strain already fragile rural providers. The challenges posed by this dual-threat are complicated by the shift away from volume-based reimbursement towards value-based reimbursement, linking reimbursement to quality measurements and outcomes. The increasing prevalence of high deductible health plans and value-based reimbursement models is transforming domestic healthcare delivery into a more patient-centric experience. This transformation brings about new and increased data needs, resulting in additional regulatory demands for data that patients find useful in decision-making. These new regulatory demands increase regulatory risks and compliance burdens for TruBridge and our clients, but also pose opportunities for TruBridge to provide additional value-added products and services to our target market.

To compete in the continually changing healthcare environment, providers are increasingly using technology in order to help maximize the efficiency of their business practices, to assist in enhancing patient care, and to maintain the privacy and security of patient information. Healthcare providers are placing increased demands on their information systems to accomplish these tasks. We believe that information systems must facilitate management of patient information across administrative, financial and clinical tasks and must also effectively interface with a variety of payor organizations within the increasingly complex reimbursement environment.

The American Recovery and Reinvestment Act of 2009

In 2009, the U.S. federal government enacted the American Recovery and Reinvestment Act (the “ARRA”), which included the Health Information Technology for Economic and Clinical Health Act (“HITECH”). HITECH authorized the EHR incentive program, which provided significant incentive funding to physicians and hospitals that have adopted and are appropriately using technology such as our EHR solutions. The end result of the ARRA has been to accelerate the adoption of EHR technology nationwide, significantly increasing industry-wide penetration rates and our penetration rates within our existing customer base for our current menu of applications. As a result, the revenue opportunities for new customer additions have greatly diminished, as have our opportunities for add-on sales to existing customers.

Continued Push for Improved Patient Care

With the increased pressure to improve the quality of healthcare and reduce costs, there is a general shift towards value-based reimbursement, which increases the demand for information technology solutions for clinical decision support. This migration toward clinical decision support solutions is further supported by the ARRA.

In the face of decreasing revenue and increasing pressure to improve patient care, healthcare providers are in need of management tools and related services that (1) increase efficiency in the delivery of healthcare services, (2) reduce medical errors, (3) effectively track the cost of delivering services so that those costs can be properly managed and (4) increase the speed and rate of reimbursement. A hospital’s failure to adequately invest in a modern medical information system could result

in fewer patient referrals, cost inefficiencies, lower than expected reimbursement, increased malpractice risk and possible regulatory infractions. Additionally, we believe that the industry will continue to increase its utilization of third party services that contribute to the achievement of these and other objectives necessary for success in the current environment. We believe these dynamics should allow for future revenue growth for both our information technology solutions and our complementary suite of services.

Rural Health Transformation Program

Federal and state governments have introduced a variety of initiatives intended to support rural and community healthcare providers through infrastructure modernization, workforce support, and operational improvement programs. Among these initiatives are multi-year rural health transformation programs administered at the state level, including the Rural Health Transformation Program (“RHTP”) signed into law on July 4, 2025.

The RHTP represents an emerging source of federal and state-directed funding for rural and community hospitals that may indirectly affect demand for the Company’s products and services, including through a dedicated federal rural health fund of approximately $50 billion to be deployed over multiple years. RHTP initiatives are designed to encourage operational modernization, care coordination, and financial sustainability among participating providers. While participation, funding levels, and program structures vary by state, these initiatives generally emphasize improved access to care, operational efficiency, and the effective use of technology, including investments in revenue cycle capabilities, interoperability, data and analytics, and virtual care infrastructure. While the Company does not rely on RHTP or similar programs as a primary source of revenue, management believes our focus on rural and community healthcare markets and our integrated technology and services portfolio align with the types of capabilities healthcare providers may seek as they evaluate and pursue transformation initiatives supported by such programs.

Recent Developments

We and our Board of Directors (“Board”) have been engaged in a strategic review process over the past several months with the assistance of outside financial and legal advisors. We have considered a wide range of alternatives to maximize shareholder value, including, but not limited to, the sale of all or part of the Company or its assets, a joint venture or other business combination, share repurchases and organic growth investments. A strategic committee of the Board has engaged in discussions with third parties regarding potential transactions. There can be no assurance that any transaction will be entered into or consummated in connection with these discussions or the strategic review process. In addition, if we do enter into definitive agreements with respect to a potential transaction, consummation of the potential transaction may be subject to a number of conditions, including approval by our stockholders and regulatory approval. For further information, see Item 1A, Risk Factors — “We may not be successful in identifying and implementing any potential strategic alternatives in a timely manner, or at all, and the strategic review process and any strategic transactions that we may pursue could have negative consequences.”

Strategy

Our primary objectives are to increase the market share of our Financial Health solutions and services, maintain a strong retention rate within our Patient Care client base while pursuing competitive and vulnerable Patient Care replacement opportunities, and further establish our position as a leading provider of patient engagement solutions. The acquisition of Viewgol in October 2023, which entity’s operations are almost entirely focused on the ambulatory setting, creates additional market expansion opportunities, and diversifies our Financial Health business. These objectives are all in support of our corporate strategy, centered around the following components:

Core Growth

Our core growth initiatives include cross-selling Financial Health solutions and services into our existing sizeable Patient Care client base and expanding our Financial Health market share with sales to new community hospitals, particularly those with 100 to 400 beds, where we believe our solutions are well aligned with market needs and demonstrate strong product-market fit.

Over the course of our more than 45-year history, we have developed a significant customer base of community hospitals. This customer base is our most valuable asset, providing not only the critical mass necessary to scale our development, client support and service resources to meet the evolving needs of our customers, but also serving as fertile ground for our cross-selling efforts for additional value-added solutions and services. Our most significant cross-selling opportunities are in the Financial Health business, where we utilize our industry-leading Financial Health services and solutions to improve the financial health of our Patient Care clients by improving cash flow metrics in the face of the myriad cost and reimbursement challenges facing healthcare organizations. Our operational expertise and technology tools provide proven results in improving claim acceptance rates, accelerating payments from third party payors, and increasing private pay collections.

Margin Optimization

Margin optimization efforts support our core growth as we routinely seek, find, and execute on initiatives that modernize our business, increasing our efficiency and resulting in cost savings. These efforts allow us to reinvest in additional growth opportunities and enable better positioning on pricing flexibility.

Chief among our margin optimization initiatives are parallel work streams dedicated to

•Standardizing and Automating Workflows: We are improving efficiency and consistency across all operations by standardizing workflows and integrating automation to enhance our services’ accuracy and speed.

•Leveraging Offshore Resources: We are strategically utilizing offshore talent to reduce costs and mitigate the risks associated with over-reliance on a single domestic talent pool. As we scale our global workforce management team, we also reduce our dependence on staffing partners. This gives us better control over maintaining high-quality service and ensures our standards are consistently met.

Digital Innovation

In addition to our core growth and margin optimization initiatives is a focus on identifying new innovation and larger adjacency opportunities, driven by demand for patient engagement, industry insights, reporting and analytics technology.

As today's patients and providers have a more collaborative approach to healthcare, our patient engagement offerings provide a secure ecosystem that supports home care, clinicians, and the patients they serve by providing tools and analytics to provide a complete view of patients' health and improve health outcomes. In addition to supporting improved care, our patient engagement platform provides financial benefits to providers and hospital systems through increased revenue opportunities and digital transformation of workflows to fill staffing gaps. This platform gives healthcare providers the insights and tools they need to provide efficient, cost-effective care as they collaborate with today's growing population of engaged patients.

Underpinning each of the three components to our strategy is a capital allocation strategy designed to afford the flexibility necessary to be adaptive and opportunistic with future investment decisions. Such flexibility is necessary if we are to continue to bring timely products and services to a rapidly changing healthcare landscape. We serve the needs of multiple stakeholder groups as customers benefit from the related products and services, our employees benefit from expanded opportunities for development, and our stockholders benefit from the increasing diversity in revenue sources.

Artificial Intelligence

We see both the value and risk of generative AI being leveraged in healthcare delivery and are committed to ensuring our client population is not left behind as this rapidly advancing technology is being implemented and adopted. We are active members of TRAIN (Trustworthy and Responsible AI Network), representing our customers alongside large Integrated Delivery Networks (“IDN”) and health systems to help shape the governance and controls to implement AI safely, as well as allowing us a broad view of what is happening in the arena of healthcare in order to keep pace with the developments in the areas of denials management, AI assisted coding, Gen AI chart summarization and more. We are planning to release our first denials prediction model to the public during the first quarter of 2026, and several pilots are unfolding within our innovation team to drive value for our clients out of this technology. We also have several strategic partners we are in discussions with to integrate their solutions into our ecosystem.

Our Products and Services

Financial Health

We offer Financial Health services which can be grouped into the following categories:

•Revenue Cycle Management (“RCM”) Products. Our RCM solutions empower providers and caregivers in hospitals, healthcare systems, clinics and skilled nursing organizations to accelerate their revenue cycle through a suite of comprehensive, web-based solutions designed to improve financial operations and staff productivity and increase reimbursement. Our RCM products include the following offerings:

◦Patient Liability Estimates. Improve patient satisfaction, maximize point-of-service collections, and equip staff with the ability to provide transparent pricing with the Patient Liability Estimate module.

◦Eligibility Verification. Reduce claim denials and carrier rejections by performing on-demand eligibility look-ups, assuring the care provided is covered.

◦Claim Scrubbing and Submission. A powerful claim management solution for submitting, validating, and processing a healthcare facility’s claims with ease and with a high quality of edits.

◦Remittance Management. Remittance advice can be effortlessly gathered and managed with the Electronic Remittance Advice Retrieval and Remittance Management modules, simplifying workflow and involvement.

◦Denial/Audit Management. Equips healthcare facilities with the tools necessary to combat denied and audited claims, assisting organizations in recovering lost revenue.

◦Contract Management. Allows healthcare facilities to take control over complex healthcare contracts by prospectively pricing every claim submitted to payers, retrospectively pricing every remittance to ensure proper payment was received, and modeling proposed contract terms during payer negotiations.

•RCM Services. Our RCM services span a healthcare enterprise’s revenue cycle and provide clients with a strong alternative to in-house operations. These services leverage our deep service and technology experience and are designed to allow clients to streamline their administrative staffing while improving operational efficiencies. Our RCM services include the following service offerings: Accounts Receivable Management, Private Pay Service, Medical Coding, Revenue Cycle Consulting, and other additional Insurance and Patient Billing Services.

•Consulting and Business Management Services. Our consulting and business management services are designed to help healthcare organizations by assessing their needs, setting goals, and creating an action plan to achieve those goals, and, if needed, implementing the action plan. Many of our professional consultants have decades of experience and all are skilled in adopting new technologies, redesigning processes, educating staff, and providing interim or on-going management services. Our consulting and business management services include the following service offerings: Consulting, Business Intelligence, Staffing, and Administrative.

•Managed IT Services. Our managed IT services provide a range of services designed to meet the IT needs of community healthcare enterprises. The pace of technological change can be overwhelming. Our services allow clients to affordably maintain an advanced IT infrastructure, meet regulatory requirements, and reduce risk. Our managed IT services include the following service offerings: Cloud Services, Backup and Recovery, Collaboration and Connectivity, Security Services, Systems Management, and Help Desk.

•Encoder Solutions. Our encoder technology and services support the hospital, consulting and payer markets. Our encoder solution is known for its knowledge-based coding methodology, which presents coding guidance and references at the point of coding, helping to improve coding accuracy and productivity.

Patient Care

Acute Care Software Systems

We offer healthcare IT solutions designed to cater to the specific needs of community hospital organizations under the software solution platform TruBridge EHR.

TruBridge EHR

Within TruBridge EHR, we offer a full array of software applications using one fully integrated system designed to streamline the flow of information to the primary functional areas of community hospitals. We intend to continue to enhance our existing software applications and develop new applications as required by evolving industry standards and the changing needs of our clients. Pursuant to our client support agreements, we provide our clients with software enhancements and upgrades periodically on a when-and-if-available basis. See “Acute Care Support and Maintenance Services.” These enhancements enable each client, regardless of its original installation date, to have the benefit of our most advanced products available. Our software applications within TruBridge EHR:

•provide automated processes that improve clinical workflow and support clinical decision-making;

•allow healthcare providers to efficiently input and easily access the most current patient medical data in order to improve quality of care and patient safety;

•integrate clinical, financial and patient information to promote efficient use of time and resources, while eliminating dependence on paper medical records;

•provide tools that permit healthcare organizations to analyze past performance, model new plans for the future and measure and monitor the effectiveness of those plans;

•provide for rapid and cost-effective implementation, whether through the installation of an in-house system or through our Software as a Service (“SaaS”) services; and

•increase the flow of information by replacing centralized data over which there is limited control with broad-based, secure access by clinical and administrative personnel to data relevant to their functional areas.

Our software applications within Trubridge EHR are grouped for support purposes according to the following general functional categories described below:

•Patient Management. Our patient management software enables a hospital to identify a patient at any point in the healthcare delivery system and to collect and maintain patient information throughout the entire process of patient care on an enterprise-wide basis. Our applications also assist with patient support registration, patient accounting, and other functions related to record controls and data access management. The TruBridge EHR single database structure permits authorized hospital personnel to simultaneously access appropriate portions of a patient’s record from any point on the system.

•Financial Accounting. Our financial accounting software provides a variety of business office applications designed to efficiently track and coordinate information needed for managerial decision-making, including accounts payable, budgeting, executive information system and other functions related to financial decision making.

•Clinical. Our clinical software automates record keeping and reporting for many clinical functions including laboratory, radiology, physical therapy, respiratory care and pharmacy. These products eliminate tedious paperwork, calculations and written documentation while allowing for easy retrieval of patient data and statistics.

•Patient Care. Our patient care applications allow hospitals to create computerized "patient files" in place of the traditional paper file systems. This software enables physicians, nurses and other hospital staff to improve the quality of patient care through increased access to patient information, assistance with projected care requirements and feedback regarding patient needs. Our software also addresses current safety initiatives in the healthcare industry such as the transition from written prescriptions and physician orders to computerized physician order entry.

•Enterprise Applications. We provide software applications that support the products described above and are useful to all areas of the hospital. These applications include: ad hoc reporting, automatic batch and real-time system backups, an integrated fax system, archival data repository, document scanning and Microsoft Office integration, and an Application Portal.

Centriq

Centriq is a web-based acute-care EHR platform. We discontinued support and services of the Centriq platform as of December 31, 2024 except for a few customers who have not migrated to another EHR platform. A majority of clients that used Centriq have already migrated to the TruBridge EHR platform.

Acute Care Support and Maintenance Services

After EHR installation, we provide software application support, hardware maintenance, continuing education and related services pursuant to a support agreement using our collaborative support model. The following services are provided to TruBridge EHR customers:

• Total System Support. We believe the quality of continuing customer support is one of the most critical considerations in the selection of an information system provider. We provide hardware, technical and

software support for all aspects of our system, which gives us the flexibility to take the necessary course of action to resolve any issue. Unlike our competitors who use third-party services for hardware and software support, we provide a single, convenient and efficient resource for all of our customers’ system support needs. In order to minimize the impact of a system problem, we train our customer service personnel to be technically proficient, courteous and prompt. Because a properly functioning information system is crucial to a hospital’s operations, our support teams are available 24 hours per day to assist customers with any problem that may arise. Customers can also use the Internet to directly access our support system.

• National Client Conference. All of our customers have the opportunity to attend our annual National Client Conference. TruBridge hosts this conference to provide educational sessions, product demonstrations, and one-on-one time with application experts. The conference also allows important time for networking among customers and TruBridge staff across all business platforms.

• Continuing Education. Effective learning tools are a key factor in successful EHR adoption and allowing clients to get the most out of a software investment. Therefore, ongoing learning and training is a cornerstone to our “total solution” and a key competitive differentiator. Our ongoing learning and training offerings also address some of the unique needs of community hospitals - limited resources and staff with cross-department responsibilities and budget and time constraints - all of which require a customized approach to learning and training. To meet these needs, we offer customers online content that can be accessed at any time, scheduled online interactive classroom presentations, on-campus training at our facilities, educational sessions during user group conferences, and scheduled regional training sessions.

• Software Releases. We are committed to providing our customers with software and technology solutions that will continue to meet their information system needs. To accomplish this purpose, we continually work to enhance and improve our application programs and we provide software updates to customers at no additional cost. The benefit of these seamlessly integrated enhancements is that each customer, regardless of its original installation date, uses the most advanced software available. Through this process, we can keep our customers up-to-date with the latest operational innovations in the healthcare industry as well as with changing governmental regulatory requirements. Another benefit of this "one system" concept is that our customer service teams can be more effective in responding to customer needs because they maintain a complete understanding of and familiarity with the one system that all customers use.

Purchasing a new information technology system requires the expenditure of a substantial amount of capital and other resources, and many customers are concerned that these systems will become obsolete as technology changes. Our periodic product updates eliminate our customers’ concerns about system obsolescence. We believe providing this benefit is a strong incentive for potential customers to select our products over the products of our competitors.

• Hardware Replacement. As part of our general support agreements, we are also committed to promptly replacing malfunctioning system hardware in order to minimize the effect of operational interruptions. By offering replacements of all hardware used in our system, we believe we are better able to meet and address all of the information technology needs of our customers.

• Cloud Electronic Health Record (Cloud EHR). We offer Cloud EHR services to customers via remote access telecommunications. Cloud EHR is a SaaS configuration and is a monthly subscription to access and use application software maintained by TruBridge in a cloud environment. Under this configuration, a customer is able to obtain access to an advanced EHR without a significant initial capital outlay. We store and maintain all Cloud EHR customers’ critical patient and administrative data.

• Forms and Supplies. In addition to our support services, we offer our customers the standard and customized forms that they need for their patient and financial records, as well as the supplies necessary to support the operation of their server and peripheral equipment. Furnishing these forms and supplies helps us to achieve our objective of being a one-source solution for a hospital’s complete healthcare information system requirements.

•InstantPHR. Our interactive portal is designed to serve all patient populations and health organizations' needs. Ideal for chronic disease management, maintaining wellness goals, and meeting federal mandates, this

solution is flexible enough to grow and change as industry trends dictate. InstantPHR can be integrated into nearly any existing EHR system to improve care and outcomes for individuals and professionals alike.

•CHBase™. This powerful tool funnels data from multiple sources into one platform. Patients have the ability to contribute data from their favorite apps and home health devices and combine it with clinical data from providers. This combined data can then be pulled into patient-oriented health applications or population health management and customer analytics. This process makes data comprehensive and relevant, thus maximizing its value to the entire care circle. Additionally, innovators have the capability to create, develop and connect other systems and applications through the CHBase APIs.

For additional details on our products, service, and support offerings, visit www.trubridge.com.

For the results of operations by segment, refer to Note 18 to the consolidated financial statements included herein.

Software Development

The healthcare information technology industry is characterized by rapid technological change requiring us to continually make investments to update, enhance and improve our products and services. Software development costs are accounted for in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 350-40, Internal-Use Software, and ASC 985-20, Costs of Software to be Sold, Leased, or Marketed. Under ASC 350-40, software development costs related to preliminary project activities and post-implementation and maintenance activities are expensed as incurred. We capitalize direct costs related to application development activities that are probable to result in additional functionality according to ASC 350-40. We amortize capitalized software values on a straight-line basis over five years. We test for impairment in the event of changes in circumstances that could impact recoverability. Under ASC 985-20, costs incurred before technological feasibility are expensed as research and development. Costs incurred after technological feasibility and before the product is available for general release to customers are capitalized. Capitalized costs are amortized based on the current and expected future revenue for each software solution with minimum annual amortization equal to the straight-line amortization over the estimated economic life of the solution, which is estimated to be five years.

Total product development expenses included in our consolidated results of operations were approximately $32.6 million, $35.4 million and $38.8 million during the years ended December 31, 2025, 2024 and 2023, respectively. We capitalized software development costs of approximately $15.4 million, $16.2 million and $21.4 million during the years ended December 31, 2025, 2024 and 2023, respectively.

See Note 5 to the consolidated financial statements included herein for additional information on software development costs.

Product Strategy

TruBridge continues to refine its product and technology strategy through focused investments in market research, client feedback loops, competitive analysis, and an enterprise roadmap that spans our Financial Health and Patient Care portfolios. Our near-term priorities are to (i) scale an enterprise analytics platform that replaces legacy reporting, (ii) operationalize high-impact AI use cases within revenue cycle and internal support workflows, and (iii) deepen interoperability to meet rising patient-access expectations and regulatory requirements. This strategy is designed to strengthen retention in the community and specialty hospital segments while creating a foundation for new growth offerings.

Enterprise Analytics

In 2024, we delivered “foundational” of TruBridge Analytics, replacing our legacy Business Intelligence solution and migrating 109 clients to a modern data platform stack that enables near‑real‑time dashboards and reporting. The next phases extend beyond financial KPIs to clinical, quality, and operational insights, with continued optimization of user workflows across clinical and revenue cycle teams. This program responds directly to long‑standing client pain points—historically inaccessible data, rigid filtering, and performance issues—and positions TruBridge to deliver actionable, multi‑domain analytics at scale.

AI‑driven Operations

We advanced two production‑grade innovations hosted on Databricks: (i) a Patient Support Bot—an internally facing LLM assistant for our call‑center teams aimed at lowering ticket resolution times; and (ii) a Denials Management model that predicts specific claim denials for our Centralized Business Office.

Consistent with these efforts, we have run internal and client‑facing sessions (e.g., “Denials prediction” working meetings and demos) and weekly analytics touch‑points with external advisors to validate use cases, surface operational constraints, and guide rollout sequencing. These forums ensure our models address genuine payer‑reimbursement friction and are integrated into day‑to‑day revenue cycle workflows.

Patient Access Interoperability

Market activity among foundation‑model vendors entering healthcare is increasing connectivity requests to our First Healthcare Interoperability Resource (“FHIR”) APIs for patient‑access use cases. We are observing new inbound interest from third parties and preparing for higher volumes as health‑specific experiences gain traction. In parallel, we are coordinating patient‑access integration pathways (FHIR R4 and nationwide networks such as CommonWell, and Carequality) and strengthening internal processes to ensure timely responses that satisfy information‑blocking compliance.

System Implementation and Training

Conversion Services. When a client purchases or leases one of our systems, we convert their existing data to the new system. Our knowledge of hospital data processing, in conjunction with extensive in-house technical expertise, allows us to accomplish this task in a cost effective manner. When we install a new system, the data conversion has already occurred so that the system is immediately operational. Our goal is for each client to be productive on day one in order to eliminate time and money wasted on the costly and inefficient task of maintaining the same data on parallel systems. Our services also relieve the hospital staff of the time-consuming burden of data conversion. The conversion process is the initial phase of our long-term partnership and overall client experience.

Training. In order to integrate the new system and to ensure its success, we spend approximately sixteen weeks providing individualized training remotely and on-site at the go-live. We provide hardware and software application training for all hospital users, including staff members and healthcare providers, during all hospital shifts. We employ nurses, medical technicians, and providers along with our technical training staff in order to help us communicate more effectively with our clients during the training process. This training phase is also part of the overall client experience that is provided to all of our clients.

Commercial

Key Markets

The target market for our Financial Health product and services extends beyond hospitals of less than 100 beds, where we have historically focused our Patient Care efforts. We are acutely focused on our vision of selling our Financial Health solution to both our existing customer base, as well as to the 4,600 hospitals of 400 beds or under in the United States.

Our strategy to grow our Financial Health business is centered around leveraging our established sales relationships within our substantial Patient Care customer base in order to cross sell Financial Health solutions and services. In addition, we target hospitals of 400 beds and under that use competitor EHRs and manage their Financial Health operations in-house. The hospitals are under increasing financial pressure caused by fluctuating patient volumes and increasing self-pay accounts. As we integrate solutions and capabilities from our acquisition of Viewgol, our goal in the ambulatory market is to grow market share in those specific specialties where we have demonstrated success, while building support of ambulatory needs for current clients.

A core initiative to our growth plan is to maintain a strong retention rate across our Patient Care base and pursue conservative growth of new Patient Care clients, as they are critical to driving cross-sales of our Financial Health solutions and services. We target hospitals under 100 beds in the United States that we believe are currently using select vendors that we have determined are vulnerable based on a variety of factors.

The target market for our Patient Care systems consists of community hospitals with fewer than 200 acute care beds, with a primary focus on hospitals with fewer than 100 acute care beds. In the United States, there are approximately 3,800 community hospitals with fewer than 200 acute care beds, with approximately 3,000 having fewer than 100 acute care beds. In addition, we market our products to small specialty hospitals in the United States that focus on discrete medical areas such as behavioral health, surgery, rehabilitation and long-term acute care. Approximately 98% of our existing acute care clients are hospitals with fewer than 100 acute care beds.

Our patient engagement efforts continue to focus on growing the number of registered patient users with existing clients in the international market while also continuing to grow through our Patient Care client base in the domestic market.

The following table presents our revenues generated from clients located within the U.S. ("Domestic") and all foreign countries, in total ("International").


	Year ended December 31,
(In thousands)	2025		2024		2023
Sales revenues:
Domestic	$	340,984	$	336,381	$	330,577
International(1)	5,852		5,824		6,387
	$	346,836	$	342,205	$	336,964

(1) International sales revenues are related to the Caribbean nation of St. Maarten, the islands of Turks and Caicos, the British Overseas Territory of Anguilla, Canada, England, Australia, the United Arab Emirates and the Netherlands.

Sales Resources

We have shifted our sales strategy from product-specific, business-unit aligned teams to a regional, enterprise-focused model in which sales personnel are responsible for selling the full portfolio of the Company’s offerings, including services, technology solutions, and RCM and EHR products, within defined territories. Many of our sales personnel are hired from within the Company and have previous experience in client support roles. We believe this experience positions them to more effectively sell our products and services within our target markets. We have also added some talent from outside the Company, creating a depth of experience we believe will enhance the effectiveness of the teams. A significant portion of the compensation for all sales personnel is commission based except for administrative support staff.

During the third quarter of 2025, the Company consolidated its go-to-market and commercial functions, including marketing, sales, partnerships, and client success, into a single integrated organization and appointed a new Chief Business Officer to lead this function. This organizational change is intended to enhance alignment across all market-facing teams, improve accountability for end-to-end revenue performance, and support more coordinated execution of the Company’s growth strategy, including both new customer acquisition and cross-selling of the Company’s portfolio of solutions to existing customers. Management believes that a unified commercial organization under a single executive leader will provide a tighter linkage between demand creation, sales execution, and customer retention and expansion initiatives.

Additionally, as noted above, the Company maintains dedicated sales and client management teams supporting both operating segments. We have continued to evolve our commercial organization to support coordinated engagement across multiple solutions and services, with an emphasis on long-term client relationships and enterprise-level client management.

This structure is intended to improve alignment across sales, account management, and client support functions, supporting consistency in execution and long-term client satisfaction, and ensuring a smooth client engagement experience.

Backlog

Backlog consists of revenues we reasonably expect to recognize over the next twelve months under existing contracts. The revenues to be recognized may relate to a combination of one-time fees for system sales and recurring fees for support and maintenance and RCM services. As of December 31, 2025, we had a twelve-month backlog of approximately $6.0 million in connection with non-recurring system sales and approximately $332.0 million in connection with recurring fees under support and maintenance and RCM services. As of December 31, 2024, we had a twelve-month backlog of approximately $8.0 million in connection with non-recurring system sales and approximately $328.0 million in connection with recurring fees under support and maintenance and RCM services. There are certain contracts that are included in the backlog that are excluded from the remaining performance obligations as disclosed in Note 2 to the consolidated financial statements included herein.

Competition

The market for our products and services is competitive, and we expect additional competition from established and emerging companies in the future. Our market is characterized by rapidly changing technology, global shifts in the healthcare system, evolving user needs and impactful regulatory and reimbursement changes. We believe the principal competitive factors that hospitals, and clinics consider when choosing between us and our competitors are:

•perceived level of product and system security;

•product features, functionality and performance;

•range of services offered;

•level of client service and satisfaction;

•ease of integration and speed of implementation;

•product price;

•cost of services offered;

•results of services engagements;

•knowledge of the healthcare industry;

•training provided;

•sales and marketing efforts; and

•company reputation.

We believe that we compete favorably with our competitors on these factors. Our principal competitors for Financial Health solutions include RelayHealth Corp, SSI Group, LLC, Quadax Inc., Change Healthcare Holdings, Inc., Availity, LLC, Waystar Technologies, Inc., Experian, and Navicure, Inc. Our principal competitors in the business management, consulting and managed IT services market are Resolution Health, Inc., The Outsource Group Inc., Patient Focus, Inc., Xtend Healthcare Inc., Ensemble Health Partners, and FinThrive, Inc. These companies all focus on providing services to the healthcare market, and the services they offer are comparable in scope to the competing services we offer. Secondary competitors in the Financial Health space include ARx LLC, Citadel Outsource Group LLC, Patient Matters, LLC, KIWI-TEK, LLC, and Aviacode Inc. The primary competitors for our encoder solutions include Solventum and Optum.

Our principal competitors in the Patient Care market are Oracle Cerner Corporation, Medical Information Technology, Inc. ("Meditech"), and MEDHOST, Inc. These companies compete with us directly in our target market of small and midsize hospitals. They offer comparable products and systems that address the needs of hospitals in the markets we serve. Our secondary competitors in the Patient Care market include N. Harris Computer Corporation and Epic Systems Corporation. These companies are significantly larger than we are, and they typically sell their products and services to larger hospitals outside of our target market. However, they will sometimes compete with us directly or, more commonly, when a larger health system who uses a system from one of these companies will offer it to a smaller hospital as part of a merger or alliance. In the patient engagement market, our competitors include Get Well Network/Healthloop, Apollo Care Connect, Bridge Patient Portal, eClinicalWorks Patient Portal, Influence Health, and InteliChart

We also face competition from providers of practice management systems, general decision support and database systems and other segment-specific applications. Any of these companies as well as other technology or healthcare companies could decide at any time to specifically target hospitals within our target market.

Health Information Security and Privacy Practices

The Health Insurance Portability and Accountability Act (“HIPAA”) is a federal law governing the use, disclosure, transmission and storage of certain individually identifiable health information, referred to as "protected health information," and was enacted for the purpose of, among other things, protecting the privacy and security of protected health information. As directed by HIPAA, the Department of Health and Human Services (the "DHHS") has promulgated standards and rules for certain electronic health transactions, code sets, data security, unique identification numbers and privacy of protected health information. HIPAA and the standards promulgated by DHHS apply to certain health plans, healthcare clearinghouses and healthcare providers (referred to as "covered entities"), which include virtually all of our clients. The Health Information Technology for Economic and Clinical Health Act ("HITECH") and its implementing regulations published in January 2013 significantly expand HIPAA by extending privacy and security standards to "business associates" of healthcare providers that are covered entities. Under HITECH, business associates are required to establish administrative, physical and technical safeguards and are subject to direct penalties for violations. Certain of our services frequently require us to act as a healthcare clearinghouse and/or a business associate to the healthcare providers that we serve. As a result, we are covered by the patient privacy and security standards of HIPAA and HITECH and subject to oversight by DHHS. We believe that we have taken all necessary steps to comply with HIPAA and HITECH, as they apply to us as a business associate, but it is important to note that DHHS could, at any time in the future, adopt new rules or modify existing rules in a manner that could require us to change our systems or operations.

Protecting individually identifiable health information and other sensitive data is a critical and essential function of TruBridge’s operations and its software solutions. A variety of industry-standard approaches that meet or exceed regulatory requirements such as HIPAA and HITECH are employed. In order to avoid unauthorized access for the life span of this data, diverse methods of identification, authentication, authorization and encryption are utilized at various points throughout the operating system, application software and hardware. These methods and processes are shared amongst servers and other end-user devices and are complemented by change management processes and tools, which allow the software change control cycle to be a formal, defined process.

In addition to HIPAA and HITECH, many states have enacted patient confidentiality laws that protect against the unauthorized disclosure of confidential medical information, with many others adopting or considering further legislation in this area, including privacy safeguards, security standards, and data security breach notification requirements. Such state laws, if more stringent than HIPAA and HITECH requirements, are not preempted by the federal requirements, and we must comply with them even though they may be subject to different interpretations by various courts and other governmental authorities. For example, the California Confidentiality of Medical Information Act has several standards that go beyond those set forth under HIPAA and HITECH and their regulations.

Intellectual Property

We regard some aspects of our internal operations, software and documentation as proprietary, and rely primarily on a combination of contract and trade secret laws to protect our proprietary information. We believe, because of the rapid pace of technological change in the computer software industry, trade secret and copyright protection is less significant than factors such as the knowledge, ability and experience of our employees, frequent software product enhancements and the timeliness and quality of our support services. The source code for our proprietary software is protected as a trade secret. We enter into confidentiality or license agreements with our vendors, consultants and clients, and control access to and distribution of our software, documentation and other proprietary information. We cannot guarantee that these protections will be adequate or that our competitors will not independently develop technologies that are substantially equivalent or superior to our technology.

The Company endeavors to protect its intellectual property rights and maintain certain trademarks, trade names, service marks and other intellectual property rights, including Clear the Way for Care, TruBridge, MyCareCorner, and others. Trademark and service mark registrations must generally be renewed every five to ten years and we renew the registration of trademarks that we deem to have continuing value to our business.

We do not believe our software products or other TruBridge proprietary rights infringe on the property rights of third parties. However, we cannot guarantee that third parties will not assert infringement claims against us with respect to current or future software products or that any such assertion may not require us to enter into royalty arrangements or result in costly litigation.

Human Capital

As of December 31, 2025, we had over 3,500 dedicated employees, approximately half of which are in each of the U.S. and India. While most of our workforce operates remotely throughout the U.S. and India, we also have a strong presence in our Alabama offices. We pride ourselves on maintaining excellent employee relations, with no collective bargaining agreements or labor union representations, and a history of smooth operations without work stoppages.

Our mission is to attract, develop, and retain top talent in order to deliver unparalleled service experiences. By enhancing the employee experience, we not only support our customers better but also safeguard the long-term interests of our stockholders. We are committed to fostering an engaged, purpose-driven culture where every employee has the opportunity to achieve professional success.

Total Rewards

We offer competitive wages and comprehensive benefit, as well as wellness programs designed to meet the diverse needs of our employees. Our compensation program includes a mix of fixed and variable pay, such as base salary, bonuses, commissions, and merit increases. We also provide stock-based compensation to attract, retain, and motivate key leaders.

Our benefit and wellness programs focus on physical, emotional, financial, and social well-being. We offer a wide array of benefits, including comprehensive health and welfare insurances, a 401(k) plan with employer match, generous time-off policies, and more. We implemented Health Advocate services in 2025, which offer an enhanced Employee Assistance Program, Wellbeing Platform, and Benefits Advocate assistance to all employees. Our Pay it Forward (Earned Time Off donation) program, launched in April 2023, has been a tremendous success, with 414 employees donating over 13,888 hours to support colleagues during personal or family medical crises.

Growth and Development

We are committed to the growth of our people by providing opportunities to cultivate talent, measure performance, and identify candidates for new roles. In 2025, we launched the Growth Hub, a redesigned learning platform that provides employees with streamlined access to over 30,000 industry-specific courses. The Growth Hub was developed to help employees more easily identify and engage with content aligned to their individual development goals and targeted skill gaps, supporting our commitment to continuous learning and career growth. To further support that effort, we also implemented Docebo Harmony AI Search to greatly enhance discoverability and efficiency for learners, directly improving the end-user experience through reducing search time by an estimated 60 to 80% and enabling natural-language queries for instant access to relevant resources. On average, each employee completed approximately 15 hours of training in 2025, covering topics such as leadership development, technical skills, and compliance.

Our performance architecture ties individual financial rewards to contributions to our company's success. This includes setting goals, evaluating progress, and gaining feedback from leaders, promoting sustained evolution and retention of our talent base. In 2025, we enhanced our performance management approach by implementing new resources and development programs to support leaders in conducting year-end reviews, applying rating frameworks consistently, and facilitating performance discussions. These initiatives were designed to strengthen leadership capability, promote accountability, and support employee development in the subsequent performance cycle. Management monitors the effectiveness of these practices to ensure alignment with organizational objectives and to inform continuous improvements in workforce performance and talent development.

Employee Recruitment

Our talent strategy emphasizes the development and advancement of employees from within, supported by targeted external hiring to address emerging skills and business needs. We prioritize internal mobility and career progression through structured development programs, talent review and succession planning, while selectively recruiting external talent to complement existing capabilities and support organizational growth. Our predominantly remote work environment enables access to a broader labor market and supports workforce flexibility, allowing us to attract qualified professionals across diverse geographies. Management monitors workforce trends, including hiring, retention, and skill gaps, to ensure alignment of our talent strategy with business objectives and evolving market demands.

Communication and Engagement

To support our geographically diverse workforce, we use multiple communication channels, including email, an employee hotline, and weekly all-employee communications to promote timely and consistent information sharing. Monthly business updates are designed to support alignment across functions and reinforce company priorities.

The Company periodically engages independent third-party firms to administer employee listening and culture surveys. In 2025, the Listening Survey achieved a participation rate of a majority of the employee population. Survey results reflected year-over-year favorable trends in several areas of workplace culture, including employee intent to remain with the Company and perceived sense of accomplishment. Specifically, 82% of respondents indicated an intent to stay with TruBridge, and 75% reported a feeling of accomplishment in their work.

The Company continues to monitor areas of opportunity identified through survey results. Career development and growth remain a focus area, with 67% of respondents reporting positive perceptions of career growth opportunities and 68% reporting positive perceptions of development opportunities. Management uses these insights to inform ongoing human capital initiatives and workforce planning efforts.

Global Workforce Integration

Since our acquisition of Viewgol in October 2023, we have continued to expand our global workforce, which totaled more than 1,800 employees in India as of December 31, 2025. These employees primarily work remotely, with most based in the Mumbai area supporting our Financial Health services clients. In 2026, we expect to further expand our presence in India through the launch of a Global Capability Center (“GCC”). The GCC opened in February 2026 with an initial focus on supporting the Financial Health business, with planned future expansion into additional business units and corporate functions.

In 2025, we completed the integration of Viewgol’s operations by aligning the India workforce with our broader organizational structure. We standardized reporting and business operations, strengthened cross regional cultural integration, and conducted an in-depth review of compensation and benefits to ensure global alignment while accounting for differences between U.S. and Indian labor markets. We also enhanced employee development and retention efforts through expanded professional

development opportunities, integration of our TruPortal platform, and leadership programs designed to build future leadership talent.

We are also advancing initiatives that support cultural integration and employee engagement. In 2026, we plan to continue offering leadership development opportunities and promoting inclusion across our workforce. These efforts align with our broader objective of establishing a unified corporate culture that supports TruBridge’s global workforce strategy.

Material Government Regulations

Our business operations are subject to various federal, state and international laws, and our products and services are governed by a number of rules and regulations. For example, we are affected by the following regulations:

•As discussed above, HIPAA, HITECH and state-specific security and privacy standards affect our claims transmission services, since those services must be structured and provided in a way that supports our clients’ compliance obligations.

•The United States Food and Drug Administration (the “FDA”) has determined that certain of our solutions, such as our ImageLink® and Blood Administration products, are medical devices that are actively regulated under the Federal Food, Drug and Cosmetic Act, as amended.

•The use of our solutions by physicians for electronic prescribing and electronic routing of prescriptions via the Surescripts network to pharmacies is governed by federal and state laws. States have differing regulations that govern the electronic transmission of certain prescriptions and prescription requirements.

•The federal Anti-Kickback Statute (“AKS”) (See 42 U.S.C. § 1320a-7b) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs. The CMS has stated that kickbacks have led to overutilization and increased costs of healthcare services, corruption of medical decision making, steering patients away from valid services or therapies and unfair, non-competitive service delivery. Certain of our products and services may be reimbursed by federal healthcare programs such that referrals of business for such products and services may implicate, or have the appearance of implicating, the AKS. Examples of prohibited kickbacks include receiving financial incentives such as discounts or gifts for referrals. Possible penalties for violating the AKS include fines of up to $25,000 per violation, up to five years in jail, and exclusion from Medicare and Medicaid care program business.

•The federal False Claims Act (“FCA”) imposes civil liability for false bills or requests for payment in the healthcare delivery system for any company that: (i) knowingly presents or causes to be presented to the federal government a false or fraudulent claim for payment or approval; (ii) knowingly makes, uses or causes to be made or used a false record or statement material to a false or fraudulent claim; (iii) knowingly makes, uses or causes to be made or used a false record or statement material to an obligation to pay the government, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the federal government; or (iv) conspires to commit the above acts. The federal government has used the FCA to prosecute a wide variety of alleged false claims and fraud allegedly perpetrated against Medicare and state healthcare programs, including a variety of billing and coding errors and fraud. The penalties for a violation of the FCA range from $5,500 to $11,000 (adjusted for inflation) for each false claim, plus up to three times the amount of damages caused by each false claim, which can be as much as the amounts received directly or indirectly from the government for each such false claim. Per claim FCA penalties can range from $13,508 to $27,894 for penalties assessed after January 15, 2024. Additionally, the Fraud Enforcement and Recovery Act (“FERA”) provides that FCA liability attaches when a company knowingly retains historic improper payments (overpayments/overprovisions) even if the individual or entity did not make claim for such payments. An overpayment impermissibly retained could subject TruBridge to liability under the FCA, exclusion from government healthcare programs and penalties under the federal Civil Monetary Penalty Law. In addition to actions being brought under the FCA by government officials, the FCA also allows a private individual with direct knowledge of fraud to bring a whistleblower, or qui tam, lawsuit on behalf of the government for violations of the FCA. In addition to the FCA, various states have adopted their own analogs of the FCA.

Although there is no assurance that existing or future government laws, rules and other regulations applicable to our operations, products or services will not have a material adverse effect on our capital expenditures, results of operations and competitive position, we do not currently anticipate materially increased expenditures in response to government regulations or future material impacts to our results or competitiveness. These regulations and related risks are described in more detail below under “Risk Factors” beginning on page 22 of this Annual Report.

Executive Officers

Set forth below is a list of the current executive officers of TruBridge and a brief explanation of each individual’s principal employment during the last five years.

Christopher L. Fowler – President and Chief Executive Officer. Christopher L. Fowler, age 50, was appointed as our President and Chief Executive Officer, and a member of the Board of Directors in July 2022. Mr. Fowler began his career with TruBridge in May 2000 as a Software Support Representative and later as a manager of Financial Software Services. From August 2004 until March 2008, Mr. Fowler served as Assistant Director and Director of Business Management Services. Mr. Fowler served as TruBridge’s Vice President – Business Management Services from March 2008 until the formation of TruBridge in January 2018, after which time he served as its President. He then served as Chief Operating Officer of the Company from November 2015 through June 2022.

Vinay Bassi – Chief Financial Officer and Treasurer. Vinay Bassi, age 55, was appointed as our Chief Financial Officer, Secretary and Treasurer in January 2024. Effective July 2024, Mr. Bassi no longer serves as the Secretary, and Mr. Plessner was named as Secretary. Prior to joining TruBridge, Mr. Bassi served as Chief Financial Officer for the Audience Measurement division at Nielsen Holdings plc and held various finance and corporate development positions in that company since 2016. Prior to joining Nielsen in 2016, Mr. Bassi worked in corporate development at Avaya Inc. from 2004 to 2016. He began his career as an Auditor at PricewaterhouseCoopers LLP and spent time at Standard and Poor's and Citigroup.

Mike Daughton - Chief Business Officer. Mike Daughton, age 52, was appointed as our Chief Business Officer in October 2025. Mr. Daughton is a seasoned healthcare technology executive with more than two decades of experience leading commercial strategy, scaling revenue organizations, and driving enterprise value creation across growth-oriented healthcare services platforms. Prior to joining TruBridge, he served as Chief Commercial Officer of EnableComp from 2024 to 2025, where he led the transformation of the commercial organization and growth strategy. From 2011 to 2023, Mr. Daughton held senior executive leadership roles at AQuity Solutions (formerly M*Modal), including Chief Commercial Officer, where he led global sales, marketing, and client management initiatives through multiple strategic transactions, including the acquisition by 3M and a subsequent sale to IKS Health. Earlier in his career, Mr. Daughton held leadership roles at Optum (UnitedHealth Group) and Thomson Reuters.

Kevin Plessner - General Counsel, Secretary and Corporate Compliance Officer. Kevin Plessner, age 44, was appointed as our General Counsel in January 2022. He was also appointed as our Corporate Compliance Officer in May 2024. Mr. Plessner joined TruBridge as part of the Get Real Health acquisition in 2019. He served as General Counsel at Get Real Health from 2013 until the 2019 acquisition, at which point he became Corporate Counsel at TruBridge.

David B. Harse – General Manager, Patient Care. David B Harse, age 49, was appointed as General Manager of our Patient Care business unit in November 2022. Prior to joining TruBridge, Mr. Harse served as SVP and General Manager of Patient Engagement at HealthMark from 2021 to 2022. Prior to joining HealthMark, Mr. Harse worked at Cerner Corporation, now Oracle Health, in various positions from 1999 to 2021.

Merideth Wilson – General Manager, Financial Health. Merideth Wilson, age 53, was appointed General Manager of our Financial Health business unit in January 2025. Prior to joining TruBridge, Ms. Wilson held various senior executive leadership roles with Experian, serving as Executive Vice President and General Manager of Experian Employer Services, 2023-2024; Chief Operating Officer (COO) of Experian Health, 2020-2023; General Manager of Revenue Cycle Solutions of Experian Health, 2014-2020; and Vice President of Payer Contract Management Solutions and Services of Experian Health, 2012-2014. In addition, she has held various product management and strategic marketing leadership positions at Medical Present Value, Inc. (MPV); MedQuist Inc. (now Solventum); VHA/Novation; and Bank of America.

Company Web Site

The Company maintains a web site at http://www.trubridge.com. The Company makes available on its web site, free of charge, its Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and all amendments to those reports, as soon as it is reasonably practicable after such material is electronically filed with the Securities and Exchange Commission. The Company is not including the information contained on or available through its web site as a part of, or incorporating such information into, this Annual Report on Form 10-K.


ITEM 1A.			RISK FACTORS

These are not the only risks and uncertainties that we face. Our business, financial condition, operating results, and stock price can be materially and adversely affected by a number of factors, whether currently known or unknown, including, but not limited to, those described below. Any one or more of such factors could directly or indirectly cause our actual financial condition and operating results to vary materially from our past or anticipated future financial condition or operating results.

RISKS RELATED TO OUR INDUSTRY

There are a limited number of acute care hospitals in our primary target market. Saturation or consolidation in the healthcare industry could result in the loss of existing clients, a reduction in our potential client base and downward pressure on the prices of our products and services.

The limited number of hospitals with fewer than 200 acute care beds in our general target market for our product and service offerings has resulted in an ever narrowing market for new system installations and add-on sales which could materially and adversely impact our business, financial condition and operating results.

Our primary objectives are to increase the market share of our Financial Health services in the 100 to 400 bed space, aggressively pursue competitive and vulnerable Patient Care replacement or enhancement opportunities, and differentiate our products and services on a client experience basis that enables us to sell a broader set of services into a loyal base of clients that are our advocates. Also, by offering solutions down market to ambulatory care and specialty care, we are attempting to broaden our target market focus. Although we have formulated strategic responses for capitalizing on each of the identified opportunities, there is no guarantee that such responses will ultimately prove successful. Additionally, to the extent that these opportunities fail to develop or develop more slowly than expected, our business, financial condition and operating results could be materially and adversely impacted.

Furthermore, many healthcare providers have consolidated to create larger healthcare delivery enterprises with greater market power. If this consolidation continues, we could lose existing clients and could experience a decrease in the number of potential purchasers of our products and services. The loss of existing and potential clients due to industry consolidation could cause our revenue growth rate to decline.

Economic, market and other factors may cause a decline in spending for information technology and services by our current and prospective clients which may result in less demand for our products, lower prices and, consequently, lower revenues and a lower revenue growth rate.

The purchase of our healthcare solutions and services involves a significant financial commitment by our clients. At the same time, the healthcare industry faces significant financial pressures that could adversely affect overall spending on healthcare information technology and services. To the extent spending for healthcare information technology and services declines or increases slower than we anticipate, demand for our products and services, as well as the prices we charge, could be adversely affected. Accordingly, we cannot assure you that we will be able to increase or maintain our revenues or our revenue growth rate.

There is significant uncertainty in the healthcare industry, both as a result of recently enacted legislation and changing government regulation, which may have a material adverse impact on the businesses of our hospital clients and ultimately on our business, financial condition and results of operations.

The healthcare industry is subject to changing political, economic and regulatory influences that may affect the procurement processes and operation of healthcare facilities, including our hospital clients. During the past decade, the healthcare industry has been subject to increased legislation and regulation of, among other things, reimbursement rates, payment programs, information technology programs and certain capital expenditures (collectively, the "Health Reform Laws").

The Health Reform Laws contain various provisions which impact us and our clients. Some of these provisions have a positive impact, by expanding the use of electronic health records in certain federal programs, for example, while others, such as reductions in reimbursement for certain types of providers, have a negative impact due to fewer available resources. Among other things, the Health Reform Laws provide for the expansion of Medicaid eligibility, mandate material changes to the delivery of healthcare services and reduce the reimbursement paid for such services in order to generate savings in the Medicare program. The Health Reform Laws also modify certain payment systems to encourage more cost-effective, quality-based care and a reduction of inefficiencies and waste, including through various tools to address fraud and abuse. The continued increase in fraud and abuse penalties is expected to adversely affect participants in the healthcare sector, including us. The Health Reform Laws will continue to affect hospitals differently depending upon the populations they serve and their payor mix. Our

target market of community hospitals typically serve higher uninsured populations than larger urban hospitals and rely more heavily on Medicare and Medicaid for reimbursement.

The Health Reform Laws are leading to significant changes in the healthcare system, but the full impact of the legislation and of further statutory and regulatory actions to reform healthcare on our business is unknown. As a result, there can be no assurances that the legislation will not adversely impact either our operational results or the manner in which we operate our business. We believe some healthcare industry participants have reduced their investments or postponed investment decisions, including investments in our solutions and services.

Cost-containment measures instituted by healthcare providers as a result of regulatory reform or otherwise could result in a reduced allocation of capital funds. Such a reduction could have an adverse effect on our ability to sell our systems and related services. Additionally, the current presidential administration has implemented the "Department of Government Efficiency" ("DOGE"), an advisory commission focused on restructuring and streamlining government agencies and reducing or eliminating regulations and federal government programs and other expenditures, which has also given rise to separate efforts at the state level to reduce government spending. In March 2025, in accordance with the DOGE Workforce Optimization Initiative, DHHS announced a significant agency restructuring, reducing the DHHS workforce and consolidating divisions of the agency. Pressures on and uncertainty surrounding the U.S. federal and state annual appropriations, holds on congressionally authorized spending, or interruptions in the distribution of governmental funds, could adversely affect our financial results due to the reliance of many of our customers on payments from third-party healthcare payors, including Medicare, Medicaid, and other government-sponsored programs.

On July 4, 2025, the U.S. signed into law the OBBBA, which included significant reforms to Medicaid, including an estimated $1 trillion in reduced federal Medicaid spending from 2025 through 2034, the imposition of work requirements for certain adult enrollees, more frequent eligibility redeterminations, and increased cost-sharing for beneficiaries. The OBBBA also implements additional eligibility rules on government health plans, expands administrative procedures around enrollment, modifies how states can obtain federal funding for Medicaid and no longer extends Affordable Care Act premium subsidies. Additional federal and state guidance is expected to be issued in order to implement these OBBBA provisions, most of which have effective dates in 2027 and 2028. These changes are expected to reduce overall Medicaid enrollment and access to care. Any decrease in the number of insured patients or reimbursement levels could adversely affect our community hospital clients, which could adversely affect demand for our products and services. In addition, some members of Congress have proposed measures intended to accelerate the shift from traditional Medicare to Medicare Advantage, or repealing the Affordable Care Act or eliminating some of its consumer protections. Changes in governmental administration, including changes in agency structures and staffing, such as reduction or elimination of personnel and agencies, may also result in changes to established rulemaking conventions and timelines, including for regularly issued reimbursement rules, among other effects. We cannot predict what effect, if any, such additional changes or reforms might have on our business, financial condition and results of operations.

As existing regulations mature and become better defined, we anticipate that these regulations will continue to directly affect certain of our products and services, but we cannot fully predict the effect at this time. We have taken steps to modify our products, services and internal practices as necessary to facilitate our compliance with the regulations, but there can be no assurance that we will be able to do so in a timely or complete manner. Achieving compliance with these regulations could be costly and distract management’s attention and divert other Company resources, and any noncompliance by us could result in civil and criminal penalties.

The healthcare industry is heavily regulated at the local, state and federal levels. Our failure to comply with regulatory requirements could create liability for us, result in adverse publicity and negatively affect our business.

The healthcare industry is heavily regulated and is constantly evolving due to the changing political, legislative and regulatory landscapes. In some instances, the impact of these regulations on our business is direct to the extent that we are subject to these laws and regulations ourselves. However, these regulations also impact our business indirectly as, in a number of circumstances, our solutions, devices and services must be capable of being used by our clients in a way that complies with those laws and regulations, even though we may not be directly regulated by the specific healthcare laws and regulations. There is a significant number of wide-ranging regulations, including regulations in the areas of healthcare fraud, e-prescribing, claims processing and transmission, medical devices, the security and privacy of patient data, the ARRA meaningful use program, patient access rights and interoperability standards, that may be directly or indirectly applicable to our operations and relationships or the business practices of our clients. Specific areas that are subject to increased regulation include, but are not limited to, the following:

Healthcare Fraud. Federal and state governments continue to enhance regulation of and increase their scrutiny over practices potentially involving healthcare fraud, waste and abuse by healthcare providers whose services are reimbursed by Medicare, Medicaid and other government healthcare programs. Our healthcare provider clients are subject to laws and regulations regarding fraud and abuse that, among other things, prohibit the direct or indirect payment or receipt of any remuneration for patient referrals, or arranging for or recommending referrals or other business paid for in whole or in part by these federal or state healthcare programs. Federal enforcement personnel have substantial funding, powers and remedies to pursue suspected or perceived fraud and abuse. The effect of this government regulation on our clients is difficult to predict. Many of the regulations applicable to our clients and that may be applicable to us, including those relating to marketing incentives offered in connection with medical device sales may be interpreted or applied by a prosecutorial, regulatory or judicial authority in a manner that could broaden their applicability to us or require our clients to make changes in their operations or the way in which they deal with us. If such laws and regulations are determined to be applicable to us and if we fail to comply with any applicable laws and regulations, we could be subject to civil and criminal penalties, sanctions or other liabilities, including exclusion from government healthcare programs, which could have a material adverse effect on our business, results of operations and financial condition. Even an unsuccessful challenge by a regulatory or prosecutorial authority of our activities could result in adverse publicity, could require a costly response from us and could adversely affect our business, results of operations and financial condition.

E-Prescribing. The use of our solutions by physicians for electronic prescribing and electronic routing of prescriptions via the Surescripts network to pharmacies is governed by federal and state laws. States have differing regulations that govern the electronic transmission of certain prescriptions and prescription requirements. Standards adopted by the National Council for Prescription Drug Programs and regulations adopted by the CMS related to "EPrescribing and the Prescription Drug Program" set forth implementation standards for the transmission of electronic prescriptions. These standards are detailed and broad, and cover not only routing transactions between prescribers and pharmacies, but also electronic eligibility, formulary and benefits inquiries. In general, regulations in this area can be burdensome and evolve regularly, meaning that any potential benefits to our clients from utilizing such solutions and services may be superseded by a newly-promulgated regulation that adversely affects our business model. Our efforts to provide solutions that enable our clients to comply with these regulations could be time consuming and expensive.

Claims Processing and Transmission. Our system electronically transmits medical claims by physicians to patients’ payors for immediate approval and reimbursement. In addition, we offer business management services that include the manual and electronic processing and submission of medical claims by healthcare providers to patients’ payors for approval and reimbursement. Federal and state laws provide that it is a violation for any person to submit, or cause to be submitted, a claim to any payor, including, without limitation, Medicare, Medicaid and all private health plans and managed care plans, seeking payment for any service or product that overbills or bills for items that have not been provided to the patient. The federal civil False Claims Act, which may be enforced through civil whistleblower or qui tam actions and imposes significant civil penalties, treble damages and potential exclusion from government health care programs against individuals or entities for, among other things, knowingly presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent or for making a false record or statement material to an obligation to pay the federal government or for knowingly and improperly avoiding, decreasing or concealing an obligation to pay money to the federal government. There is also the federal Criminal False Claims Act, which is similar to the federal Civil False Claims Act and imposes criminal liability on those that make or present a false, fictitious or fraudulent claim to the federal government.

We have in place policies and procedures that we believe assure that all claims that are transmitted by our system and through our services are accurate and complete, provided that the information given to us by our clients is also accurate and complete. If, however, we do not follow those procedures and policies, or they are not sufficient to prevent inaccurate claims from being submitted, we could be subject to substantial liability including, but not limited to, civil and criminal liability. Additionally, any such failure of our billing and collection services to comply with these laws and regulations could adversely affect demand for our services and could force us to expend significant capital, research and development, and other resources to address the failure.

Where we are permitted to do so, we calculate charges for our billing and collection services based on a percentage of the collections that our clients receive as a result of our services. To the extent that violations or liability for violations of these laws and regulations require intent, it may be alleged that this percentage calculation provides us or our employees with incentive to commit or overlook fraud or abuse in connection with submission and payment of reimbursement claims. CMS has stated that it is concerned that percentage-based billing services may encourage billing companies to commit or to overlook fraudulent or abusive practices.

A portion of our business involves billing Medicare claims on behalf of our clients. In an effort to combat fraudulent Medicare claims, the federal government offers rewards for reporting of Medicare fraud which could encourage others to subject us to a charge of fraudulent claims, including charges that are ultimately proved to be without merit.

As discussed below, the HIPAA security and privacy standards also affect our claims transmission services, since those services must be structured and provided in a way that supports our clients’ HIPAA compliance obligations.

Regulation of Medical Devices. The United States FDA has determined that certain of our solutions, such as our ImageLink® and Blood Administration® products, are medical devices that are actively regulated under the Federal Food, Drug and Cosmetic Act, as amended. If other of our solutions are deemed to be actively regulated medical devices by the FDA, we could be subject to extensive requirements governing pre- and post-marketing activities including registration of the applicable manufacturing facility and software and hardware products, application of detailed record-keeping and manufacturing standards, application of the medical device excise tax, and FDA approval or clearance prior to marketing. Complying with these medical device regulations is time consuming and expensive, and our marketing and other sales activities could be subject to unanticipated and significant delays. Further, it is possible that the FDA may become more active in regulating software and medical devices that are used in the healthcare industry. If we are unable to obtain the required regulatory approvals for any such software or medical devices, our short- to long-term business plans for these solutions or medical devices could be delayed or canceled and we could face FDA refusal to grant pre-market clearance or approval of products; withdrawal of existing clearances and approvals; fines, injunctions or civil penalties; recalls or product corrections; production suspensions; and criminal prosecution. FDA regulation of our products could increase our operating costs, delay or prevent the marketing of new or existing products, and adversely affect our revenue growth.

Security and Privacy of Patient Information. Federal, state and local laws regulate the privacy and security of patient records and the circumstances under which those records may be released. These regulations govern both the disclosure and use of confidential patient medical record information and require the users of such information to implement specified security and privacy measures. United States regulations currently in place governing electronic health data transmissions continue to evolve and are often unclear and difficult to apply.

In the United States, HIPAA regulations require national standards for some types of electronic health information transactions and the data elements used in those transactions, security standards to ensure the integrity and confidentiality of health information, and standards to protect the privacy of individually identifiable health information. Covered entities under HIPAA, which include healthcare organizations such as our clients, and our claims processing, transmission and submission services, are required to comply with the privacy standards, transaction regulations and security regulations. Moreover, HITECH and associated regulatory requirements extend many of the HIPAA obligations, formerly imposed only upon covered entities, to business associates as well. As a business associate of our clients who are covered entities, we are in most instances already contractually required to ensure compliance with the HIPAA regulations as they pertain to the handling of covered client data. However, the extension of these HIPAA obligations to business associates by law has created a direct liability risk related to the privacy and security of individually identifiable health information.

Evolving HIPAA and HITECH-related laws or regulations could restrict the ability of our clients to obtain, use or disseminate patient information. This could adversely affect demand for our solutions and devices if they are not re-designed in a timely manner in order to meet the requirements of any new interpretations or regulations that seek to protect the privacy and security of patient data or enable our clients to execute new or modified healthcare transactions. We may need to expend additional capital and software development and other resources to modify our solutions to address these evolving data security and privacy issues. Furthermore, our failure to maintain the confidentiality of sensitive personal information in accordance with the applicable regulatory requirements could damage our reputation and expose us to claims, fines and penalties.

Federal and state statutes and regulations have granted broad enforcement powers to regulatory agencies to investigate and enforce compliance with these privacy and security laws and regulations. Federal and state enforcement personnel have substantial funding, powers and remedies to pursue suspected or perceived violations. If we fail to comply with any applicable laws or regulations, we could be subject to civil penalties, sanctions or other liability. Enforcement investigations, even if meritless, could have a negative impact on our reputation, cause us to lose existing clients or limit our ability to attract new clients.

ARRA Meaningful Use Program. The ARRA initially required "meaningful use of certified electronic health record technology" by healthcare providers by 2015 in order to receive limited incentive payments and to avoid related reduced reimbursement rates for Medicare claims. Related standards and specifications are subject to interpretation by the entities designated to certify such technology. While a combination of our solutions has been certified as meeting stage one, stage two, and stage three standards for certified electronic health record technology, the regulatory standards to achieve certification will continue to

evolve over time. We may incur increased development costs and delays in delivering solutions if we need to upgrade our software or healthcare devices to be in compliance with these varying and evolving standards. In addition, further delays in interpreting these standards may result in postponement or cancellation of our clients’ decisions to purchase our software solutions. If our software solutions are not compliant with these evolving standards, our market position and sales could be impaired and we may have to invest significantly in changes to our software solutions.

Interoperability Standards. Our clients are concerned with and often require that our software and systems be interoperable with other third party healthcare information technology systems. Market forces or governmental or regulatory authorities could create software interoperability standards that would apply to our software and systems, and if our software and systems are not consistent with those standards, we could be forced to incur substantial additional development costs. For example, the HITECH Act contains interoperability standards that healthcare providers are required to adhere to in order to receive stimulus funds from the federal government under the ARRA. Compliance with these and related standards is becoming a competitive requirement and, although a combination of our solutions has been certified as meeting all such required interoperability standards to date, maintaining such compliance with these varying and evolving rules may result in increased development costs and delays in upgrading our client software and systems. To the extent these rules are narrowly construed, subsequently changed or supplemented, or that we are delayed in achieving certification under these evolving rules for applicable products, our clients may postpone or cancel their decisions to purchase or implement our software and systems.

As it relates specifically to interoperability, we are a member of CommonWell Health Alliance ("CommonWell"), a not-for-profit trade association comprised of healthcare information technology vendors devoted to the notion that patient data should be safely, securely and immediately available to patients and healthcare providers to support better care delivery, regardless of where that care occurs. CommonWell is committed to fostering standards that make this possible, and to having healthcare information technology companies embed these capabilities natively and cost effectively into their EHR systems. Despite our membership in CommonWell, there is no guarantee that we will successfully manage the interoperability of our software and systems with third-party health IT providers.

Patient Access Rights. In March 2020, the Office of National Coordinator for Health Information Technology ("ONC") of the DHHS released the "21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, Final Rule." The rule implements several of the key interoperability provisions included in the 21st Century Cures Act. Specifically, it calls on developers of certified EHRs and health IT products to adopt standardized APIs, which will help allow individuals to securely and easily access structured and unstructured EHI formats using smartphones and other mobile devices. This provision and others included in the final rule create a potentially lengthy list of certification and maintenance of certification requirements that developers of EHRs and other health IT products have to meet in order to maintain approved federal government certification status. Meeting and maintaining this certification status could require additional development costs.

The ONC rule also implements the information blocking provisions of the 21st Century Cures Act, including identifying reasonable and necessary activities that do not constitute information blocking. Under the 21st Century Cures Act, the DHHS has the regulatory authority to investigate and assess civil monetary penalties of up to $1,000,000 against health IT developers and/or providers found to be guilty of "information blocking." This oversight and authority to investigate claims of information blocking creates significant risks for us and our clients and could potentially create substantial new compliance costs. The

DHHS may impose penalties for information blocking that has occurred after September 1, 2023, and the ONC and the DHHS released a final rule in June 2024 listing certain disincentives for actors that conduct information blocking.

Standards for Submission of Healthcare Claims. CMS requires all providers, payors, clearinghouses and billing services to utilize patient codes for reporting medical diagnosis and inpatient procedures, referred to as ICD-10 codes when submitting claims for payment. ICD-10 codes affect medical diagnosis and inpatient procedure coding for everyone covered by HIPAA, not just those who submit Medicare or Medicaid claims. Claims for services must use ICD-10 codes for medical diagnosis and inpatient procedures or they will not be paid. While we have successfully implemented the use of ICD-10 codes within our products and services since their initial mandate in 2015, the possibility exists for similar future mandates by CMS. If our products and services do not accommodate CMS mandates at any future date, clients may cease to use those products and services that are not compliant and may choose alternative vendors and products that are compliant. This could adversely impact future revenues.

Finally, with the change in presidential administrations in 2025, there is substantial uncertainty as to how, if at all, the new administration will seek to modify or revise the requirements and policies of the DHHS, CMS, the FDA and other regulatory agencies with jurisdiction over our products and services.

RISKS RELATED TO OUR BUSINESS

Our strategy to transition to a subscription-based recurring revenue model and continued modernization of our technology may adversely affect our near-term revenue growth and results of operations.

As we transition more of our offerings to leverage cloud technologies, we may incur disruption and be less competitive as we transition existing clients to new product offerings, which could impact revenue and profitability. We believe we must continue to dedicate a significant amount of resources to our research and development efforts to maintain our competitive position, and oftentimes, successful investments require several years before generating significant revenue. We expect our ongoing shift from a software license model to a subscription-based services revenue model to create a recurring revenue stream that is more predictable. The transition, however, creates changes related to the timing of revenue recognition compared to historical patterns. We also incur certain expenses associated with the infrastructures of our cloud-based offerings in advance of our ability to recognize the revenues associated with these offerings, which may adversely affect our near-term reported revenues, results of operations, and cash flows. A decline in renewals of recurring revenue offerings in any period may not be immediately reflected in our results for that period but may result in a decline in our revenue and results of operations in future periods.

Competition with companies that have greater financial, technical and marketing resources than we have could result in a loss of clients and/or a lowering of prices for our products, causing a decrease in our revenues and/or market share.

Our competitors are identified in the “Business-Competition” section of this Annual Report. A number of these companies compete with us directly in our target market of small and midsize hospitals. They offer products and systems that are comparable to our solutions and address the needs of hospitals in the markets we serve. Some competitors are significantly larger than we are, and they typically sell their products and services to larger hospitals outside of our target market. However, they will sometimes compete with us directly or, more commonly, a larger health system who uses a system provided by one of these competitors will offer it to a smaller hospital as part of a merger or alliance.

We also face competition from providers of practice management systems, general decision support and database systems, and other segment-specific applications. Any of these companies, as well as other technology or healthcare companies could decide at any time to specifically target hospitals within our target market.

A number of existing and potential competitors are more established than we are and have greater name recognition and financial, technical and marketing resources. Products of our competitors may have better performance, lower prices and broader market acceptance than our products. We expect increased competition that could cause us to lose clients, lower our prices to remain competitive and, consequently, experience lower revenues, revenue growth and profit margins.

We recently completed the acquisition of Viewgol, and we may engage in future acquisitions. Such strategic acquisitions may be expensive, time consuming, and subject to other inherent risks which may jeopardize our ability to realize anticipated benefits.

We may acquire additional businesses, technologies and products if we determine that these additional businesses, technologies and products are likely to serve our strategic goals. Acquisitions have inherent risks, which may have a material adverse effect on our business, financial condition, operating results or prospects, including, but not limited to the following:

•significant acquisition and integration costs;

•failure to achieve projected synergies and performance targets;

•potentially dilutive issuances of our securities, the incurrence of debt and contingent liabilities and amortization expenses related to intangible assets with indefinite useful lives, which could adversely affect our results of operations and financial condition;

•using cash as acquisition currency may adversely affect interest or investment income, which may in turn adversely affect our earnings and/or earnings per share;

•difficulty in fully or effectively integrating the acquired technologies, software products, services, business practices or personnel, which would prevent us from realizing the intended benefits of the acquisition;

•failure to maintain uniform standard controls, policies and procedures across acquired businesses;

•difficulty in predicting and responding to issues related to product transition such as development, distribution and client support;

•the possible adverse effect of such acquisitions on existing relationships with third party partners and suppliers of technologies and services;

•the possibility that staff or clients of the acquired companies might not accept new ownership and may transition to different technologies or attempt to renegotiate contract terms or relationships, including maintenance or support agreements;

•the assumption of known and unknown liabilities;

•the possibility that the due diligence process in any such acquisition may not completely identify material issues associated with product quality, product architecture, product development, intellectual property issues, key personnel issues or legal and financial contingencies, including any deficiencies in internal controls and procedures and the costs associated with remedying such deficiencies;

•difficulty in entering geographic and/or business markets in which we have no or limited prior experience;

•diversion of management’s attention from other business concerns; and

•the possibility that acquired assets become impaired, requiring us to take a charge to earnings which could be significant.

A failure to successfully integrate acquired businesses or technology in a timely manner could, for any of these reasons, have an adverse effect on our financial condition and results of operations. As a result, we may not be able to realize the expected benefits that we seek to achieve from the acquisitions, which could also affect our ability to service our debt obligations. In addition, we may be required to spend additional time or money on integration that otherwise would be spent on the development and expansion of our business. In addition, we have in the past, and may in the future, enter into negotiations for acquisitions that are not ultimately consummated. Those negotiations could results in diversion of management time and significant out-of-pocket costs.

As we grow our global workforce, if we are unable to attract and retain qualified personnel, our business and operating results will suffer.

Our future performance depends in significant part upon the continued service of our key development, client services and senior management personnel and successful recruitment of new talents. These personnel have specialized knowledge and skills with respect to our business and our industry. The industry in which we operate is characterized by a high level of employee mobility and aggressive recruiting of skilled personnel. There can be no assurance that our current employees will continue to work for us. Additionally, most of our hospital clients have small information technology staff, and they depend on us to service and support their systems. Future difficulty in attracting, training and retaining capable client service and support personnel could cause a decrease in the overall quality of our client service and support. That decrease would have a negative effect on client satisfaction which could cause us to lose existing clients and could have an adverse effect on our new client sales. The loss of clients due to inadequate client service and support would negatively impact our ability to continue to grow our business.

Creating and maintaining a global organization and managing a geographically dispersed workforce requires substantial management effort and significant additional investment in our infrastructure. As globalization continues, competition for talent in those countries has increased, which may impact our ability to retain these employees and increase our compensation-related expenses. Significant growth in the technology sector in India has increased competition to attract and retain skilled employees and has led to a commensurate increase in compensation expense arising from our India operations. Our efforts to attract, develop, integrate and retain highly skilled employees may be compounded by intensified restrictions on travel, immigration or the availability of work visas. If we are unable to continue to leverage the skills and experience of our international workforce, particularly in India, we may be unable to provide our solutions at an attractive price and our business could be materially and negatively impacted.

We periodically have restructured our sales force, which can be disruptive.

We continue to rely heavily on our direct sales force. Periodically, we have restructured or made other adjustments to our sales force in response to factors such as product changes, geographical coverage and other internal considerations, including a reorganization in 2025 as described in the “Business-Commercial” section of this Annual Report. Change in the structures of

the sales force and sales force management can result in temporary lack of focus and reduced productivity that may affect revenues in one or more quarters. Future restructuring of our sales force could occur, and if so we may again experience the adverse transition issues associated with such restructuring.

The markets for our Financial Health service offerings may develop more slowly than we expect.

Our success depends, in part, on the willingness of healthcare organizations to implement integrated solutions for the areas in which we provide services. Some organizations may be reluctant or unwilling to implement our solutions for a number of reasons, including failure to perceive the need for improved revenue cycle operations, lack of knowledge about the potential benefits our solutions provide, concerns over the cost of using an external solution, or as a result of investments or planned investments in internally developed solutions, choosing to continue to rely on their own internal resources.

If we are unable to manage our growth in the new markets we may enter, our business and financial results could suffer.

Our future financial results will depend in part on our ability to profitably manage our business in new markets that we may enter. We are engaging in the strategic identification of, and competition for, growth and expansion opportunities in new markets or offerings. In order to successfully execute on these future initiatives, we will need to, among other things, manage changing business conditions and develop expertise in areas outside of our business's traditional core competencies. Difficulties in managing future growth in new markets could have a significant negative impact on our business, financial condition and results of operations.

Our international business activities and processes expose us to numerous and often conflicting laws, regulations, policies, standards or other requirements, and to risks that could harm our business, financial condition and results of operations.

Our subsidiary, Get Real Health, sells patient engagement technology to hospital systems and government agencies in Canada, Australia, England, the United Arab Emirates and the Netherlands, directly and through resellers, and we have had limited sales of Patient Care software to government agencies in Canada and the Caribbean. Our subsidiary, Viewgol, provides Financial Health analytics and complementary outsourcing services in India. Our business in these countries is subject to numerous risks inherent in international business operations. Among others, these risks include:

•data protection and privacy regulations regarding access by government authorities to customer, partner, or employee data;

•data residency requirements (the requirement to store certain data only in and, in some cases, also to access such data only from within a certain jurisdiction);

•conflict and overlap among tax regimes;

•possible tax constraints impeding business operations in certain countries;

•expenses associated with the localization of our products and compliance with local regulatory requirements;

•discriminatory or conflicting fiscal policies;

•operational difficulties in countries with a high corruption perception index;

•difficulties enforcing intellectual property and contractual rights in certain jurisdictions;

•country-specific software certification requirements;

•the difficulty of managing and staffing our international operations and the increased travel, infrastructure and legal compliance costs associated with multiple international locations;

•differing labor and employment regulations, especially where foreign labor laws are more advantageous to employees as compared to the U.S.;

•compliance with various industry standards; and

•market volatilities or workforce restrictions due to changing laws and regulations resulting from political decisions.

Wages in India are increasing at a faster rate than those in many countries, including the United States. In addition, with the significant increase in the numbers of foreign businesses that have established operations in India, the competition to attract and

retain employees there has increased significantly. As a result, we may be unable to cost-effectively retain our current employee base in India or hire additional new talent. In addition, India has experienced significant inflation, low growth in gross domestic product and shortages of foreign exchange. India also has experienced civil unrest and terrorism and, in the past, has been involved in conflicts with neighboring countries.

Our operations in India may also expose us to risks associated with leasing and operating physical facilities, included uncertainties related to lease enforceability, regulatory approvals, infrastructure reliability, cost escalation, and local real estate practices, which could increase operating costs or disrupt our business activities.

As we expand into new countries and markets, these risks could intensify. The application of the respective local laws and regulations to our business is sometimes unclear, subject to change over time, and often conflicting among jurisdictions. Additionally, these laws and government approaches to enforcement are continuing to change and evolve, just as our products and services continually evolve. Compliance with these varying laws and regulations could involve significant costs or require changes in products or business practices. Non-compliance could result in the imposition of penalties or cessation of orders due to alleged non-compliant activity. We do not believe we have engaged in any activities sanctionable under these laws and regulations, but governmental authorities could use considerable discretion in applying these statutes and any imposition of sanctions against us could be material. One or more of these factors could have an adverse effect on our operations globally or in one or more countries or regions, which could have an adverse effect on our business, financial condition and results of operations.

We face the risks and uncertainties that are associated with investigations and litigation against us, which may adversely impact our marketing, distract management and have a negative impact upon our business, results of operations and financial condition.

We face the risks associated with litigation concerning the operation of our business. For example, companies in our industry, including many of our competitors, have been subject to litigation based on allegations of the federal False Claims Act (“FCA”) and their state analogs, in addition to patent infringement or other violations of intellectual property rights. As described in more detail above, the FCA imposes civil liability for the knowing receipt or retention of payment from federal health care payers where the receipt of such payment is knowingly false or fraudulent. The FCA incentivizes private individuals, including our employees, to report such false claims to the government by offerings “whistleblowers” monetary compensation should the government recoup payments for false claims. Additionally, patent holding companies often engage in litigation to seek to monetize patents that they have obtained. As the number of competitors, patents and patent holding companies in our industry increases, the functionality of our products and services expands, and we enter into new geographies and markets, the number of intellectual property rights-related actions against us is likely to continue to increase. The uncertainty associated with substantial unresolved litigation may have an adverse effect on our business. In particular, such litigation could impair our relationships with existing clients and our ability to obtain new clients. Defending such litigation may result in a diversion of management's time and attention away from business operations, which could have an adverse effect on our business, results of operations and financial condition. Such litigation may also have the effect of discouraging potential acquirers from bidding for us or reducing the consideration such acquirers would otherwise be willing to pay in connection with an acquisition.

There can be no assurance that such litigation will not result in liability in excess of our insurance coverage, that our insurance will cover such claims or that appropriate insurance will continue to be available to us in the future at commercially reasonable rates.

Investigations may lead to future requests for information and ultimately the assertion of claims or the commencement of legal proceedings against us, which themselves may lead to material fines, penalties or other material liabilities. In addition, our responses to these and any future requests require time and effort, which can result in additional cost to us. Given the highly-regulated nature of our industry, we have been and may, from time to time, be subject to subpoenas, requests for information, or investigations from various government agencies.

Our use of offshore labor resources could expose us to risks that could have a material adverse effect on our operating costs.

Our reliance on an international workforce exposes us to business disruptions caused by the political and economic environment in those regions. Terrorist attacks and acts of violence or war may directly affect our workforce or contribute to general instability. Our global business services operations require us to comply with local laws and regulatory requirements, which are complex and of which we may not always be aware, and expose us to foreign currency exchange rate risk. Our global business services operations may also subject us to trade restrictions, reduced or inadequate protection for intellectual property rights, security breaches, and public health events, and other factors which may adversely affect our business. Negative developments in any of these areas could increase our operating costs or otherwise harm our business. In addition, local laws

and customs in countries in which we contract with third-party partners may differ from those in the U.S. For example, it may be a local custom for businesses to engage in practices that are prohibited by our internal policies and procedures or U.S. laws and regulations applicable to us, such as the Foreign Corrupt Practices Act ("FCPA"). The FCPA generally prohibits U.S. companies from giving or offering money, gifts, or anything of value to a foreign official to obtain or retain business and requires businesses to make and keep accurate books and records and a system of internal accounting controls. We cannot guarantee that our employees, contractors, and agents will comply with all of our FCPA compliance policies and procedures. If we or our employees, contractors, or agents fail to comply with the requirements of the FCPA or similar legislation, government authorities in the U.S. and elsewhere could seek to impose civil or criminal fines and penalties which could have a material adverse effect on our business, operating results, and financial condition.

Offshore outsourcing is a politically sensitive topic in the U.S. For example, various domestic organizations and public figures have expressed concern about a perceived association between offshore outsourcing providers and the loss of jobs in the U.S. Current or prospective customers may elect to perform such outsourced services themselves or may be discouraged from transferring these services from onshore to offshore providers to avoid negative perceptions that may be associated with using an offshore provider. Any slowdown or reversal of existing industry trends towards offshore outsourcing, and the resulting need to relocate aspects of our services from our global business services operations to the U.S., where operating costs are higher, would increase the cost of delivering our services.

We utilize artificial intelligence, which could expose us to liability or adversely affect our business, especially if we are unable to compete effectively with others in adopting artificial intelligence.

We utilize artificial intelligence, including generative artificial intelligence, machine learning, and similar tools and technologies that collect, aggregate, analyze, or generate data or other materials or content (collectively, “AI”) in connection with our business. There are significant risks involved in using AI and no assurance can be provided that our use of AI will enhance our products or services, produce the intended results, or keep pace with our competitors. For example, AI algorithms may be flawed, insufficient, of poor quality, rely upon incorrect or inaccurate data, reflect unwanted forms of bias, or contain other errors or inadequacies, any of which may not be easily detectable; AI has been known to produce false or “hallucinatory” inferences or outputs; our use of AI can present ethical issues and may subject us to new or heightened legal, regulatory, ethical, or other challenges; and inappropriate or controversial data practices by developers and end-users, or other factors adversely affecting public opinion of AI, could impair the acceptance of AI solutions, including those incorporated in our products and services. Despite training and risk management efforts, there is a possibility that employees might misuse AI, either intentionally or unintentionally. Additionally, given the nature of our citizen-facing services, we are vulnerable to potential adversarial attacks. If the AI tools that we use are deficient, inaccurate, or controversial, we could incur operational inefficiencies, competitive harm, legal liability, brand or reputational harm, or other adverse impacts on our business and financial results. If we do not have sufficient rights to use the data or other material or content on which the AI tools we use rely, we also may incur liability through the violation of applicable laws and regulations, third-party intellectual property, data privacy, or other rights, or contracts to which we are a party.

While we believe that AI technologies present opportunities for improving our operations and enhancing our product offerings, the successful implementation of AI technology requires significant investment in talent, infrastructure, and ongoing research and development. Developing, testing and deploying AI systems may also increase the cost profile of our products due to the nature of the computing costs involved in such systems. Market acceptance, understanding, and valuation and consumer perceptions of platforms, products, and programs that incorporate AI technologies is uncertain and the perceived value of AI technologies could be inaccurate. Given the rapid and uncertain pace at which AI is evolving, the costs associated with AI-related investments may be difficult to forecast and may have negative impact on our financial results. Conversely, if we are unable to make adequate investments related to AI or unable to make them in a timely manner, our financial results and competitive position in the market may be adversely impacted. Clients may decide to use AI and other new tools and technologies themselves, including in open-source and other products, tools and content, rather than engaging us. Furthermore, services, technologies or methodologies that are developed by competitors may render our services noncompetitive or obsolete. Technological developments and competitive pressures could significantly reduce demand for our services, thereby materially and adversely affecting our business, financial condition and results of operations.

In addition, AI regulation is rapidly evolving worldwide as legislators and regulators increasingly focus on these powerful emerging technologies. The technologies underlying AI and its uses are subject to a variety of laws and regulations, including intellectual property, data privacy and security, consumer protection, competition, and equal opportunity laws, and are expected to be subject to increased regulation and new laws or new applications of existing laws and regulations. AI is the subject of ongoing review by various U.S. governmental and regulatory agencies, and various U.S. states and other foreign jurisdictions are applying, or are considering applying, their platform moderation, data privacy, and security laws and regulations to AI or are considering general legal frameworks for AI. Beginning January 1, 2026, two new state laws – California’s Generative

Artificial Intelligence: Training Data Transparency Act (“AB 2013”) and the Texas Responsible Artificial Intelligence Governance Act (“TRAIGA”) – will impose novel requirements on AI developers and users. AB 2013 requires public disclosure of detailed information about the training data used in generative AI models, which, if applicable to us, may impact the confidentiality of proprietary information and could affect our competitive position. TRAIGA establishes broad obligations for both developers and deployers of AI systems, including civil rights protections, regulatory oversight, and the creation of an AI governance council. Further, the Colorado Artificial Intelligence Act, set to take effect in February 2026, will regulate AI systems that make consequential decisions. These state-level initiatives reflect a growing trend toward AI regulation in the absence of federal legislation. We may not be able to anticipate how to respond to these rapidly evolving frameworks, and we may need to expend resources to adjust our operations or offerings in certain jurisdictions if the legal frameworks are inconsistent across jurisdictions. Furthermore, because AI technology itself is highly complex and rapidly developing, it is not possible to predict all of the legal, operational, or technological risks that may arise relating to the use of AI.

We may not be successful in identifying and implementing any potential strategic alternatives in a timely manner, or at all, and the strategic review process and any strategic transactions that we may pursue could have negative consequences.

We have been engaged in a strategic review process over the past several months with the assistance of outside financial and legal advisors. We have considered a wide range of alternatives to maximize shareholder value, including, but not limited to, the sale of all or part of the Company or its assets, a joint venture or other business combination, share repurchases and organic growth investments. A strategic committee of the Board has engaged in discussions with third parties regarding potential transactions. Despite the Board and management devoting significant efforts to identify and evaluate potential strategic alternatives, there can be no assurance that any discussions or the strategic review process will result in us pursuing any transaction, investment or strategy or that we will be able to successfully enter into a definitive agreement or consummate any particular transaction, investment or strategy on attractive terms, on a timely basis, or at all. There is no deadline or definitive timetable set for the completion of the strategic alternatives process. Further, any sale of control transaction or other strategic transactions that we may pursue could have a variety of negative consequences, and we may enter into a transaction that yields unexpected results that adversely affect our business or decrease the remaining cash available for use in our business. Any potential transaction would be dependent on a number of factors that may be beyond our control, including market conditions, industry trends, the interest of third parties in a potential transaction with us, obtaining stockholder approval and regulatory approval, and the availability of financing to third parties in a potential transaction with us on reasonable terms. There can be no assurance that any particular course of action, business arrangement or transaction, or series of transactions, will be pursued, successfully consummated, lead to increased stockholder value, or achieve the anticipated benefits or results.

The process of continuing to evaluate strategic alternatives may be costly, time-consuming and complex, and we may incur significant legal, accounting and advisory fees and other expenses, some of which may be incurred regardless of whether we successfully enter into a transaction. We may also incur additional unanticipated expenses in connection with this process. Any such expenses will decrease the remaining cash available for use in our business.

If we are not successful in entering into or consummating a strategic transaction, or if our plans are not executed in a timely fashion, this may cause reputational harm and the value of our securities may be adversely impacted. In addition, speculation regarding any developments related to the review of strategic alternatives and perceived uncertainties associated with such review could cause our stock price to fluctuate significantly.

RISKS RELATED TO OUR PRODUCTS AND SERVICES

Our failure to develop new products or enhance current products in response to market demands could adversely impact our competitive position and require substantial capital resources to correct.

The needs of hospitals in our target market are subject to rapid change due to government regulation, trends in clinical care practices and technological advancements. As a result of these changes, our products may quickly become obsolete or less competitive. New product introductions and enhancements by our competitors that more effectively or timely respond to changing industry needs may weaken our competitive position.

We continually redesign and enhance our products to incorporate new technologies and adapt our products to ever-changing hardware and software platforms. Often we face difficult choices regarding which new technologies to adopt. If we fail to anticipate or respond adequately to technological advancements, or experience significant delays in product development or introduction, our competitive position could be negatively affected. Moreover, our failure to offer products acceptable to our target market could require us to make significant capital investments and incur higher operating costs to redesign our products, which could negatively affect our financial condition and operating results.

Our products assist clinical decision-making and related care by capturing, maintaining and reporting relevant patient data. If our products fail to provide accurate and timely information, our clients could assert claims against us that could result in substantial cost to us, harm our reputation in the industry and cause demand for our products to decline.

We provide products that assist clinical decision-making and related care by capturing, maintaining and reporting relevant patient data. Our products could fail or produce inaccurate results due to a variety of reasons, including unexpected service disruptions, mechanical error, product flaws, faulty installation and/or human error during the initial data conversion. If our products fail to provide accurate and timely information, clients and/or patients could sue us to hold us responsible for losses they incur from these errors. These lawsuits, regardless of merit or outcome, could result in substantial cost to us, divert management’s attention from operations and decrease market acceptance of our products. We attempt to limit by contract our liability for damages arising from negligence, errors or mistakes. Despite this precaution, such contract provisions may not be enforceable or may not otherwise protect us from liability for damages. We maintain general liability insurance coverage, including coverage for errors or omissions. However, this coverage may not be sufficient to cover one or more large claims against us or otherwise continue to be available on terms acceptable to us. In addition, the insurer could disclaim coverage as to any future claim.

Breaches of security and viruses in our systems could result in client claims against us and harm to our reputation causing us to incur expenses and/or lose clients.

In the course of our business operations, we compile and transmit confidential information, including patient health information. We have included security features in our systems that are intended to protect the privacy and integrity of this information. Despite the existence of these security features, our system may experience break-ins and similar disruptive problems that could jeopardize the security of information stored in and transmitted through the information technology networks of our clients. In addition, the other systems with which we may interface, such as the Internet and related systems, may be vulnerable to security breaches, viruses, programming errors or similar disruptive problems. Based on the size of our company, the industry in which we operate, and the overall percentage of impacted companies in the same or similar industry, it is probable there will be attempts to breach our security. Healthcare information has become a prime target for attackers based on the value of the information and, therefore, has the potential to increase the risk of us experiencing a cyber attack. Additionally, we use third-party service providers to provide some services that involve the storage or transmission of data, such as SaaS, cloud computing, and internet infrastructure and bandwidth, and these providers face various cybersecurity threats and may suffer cybersecurity incidents or other security breaches.

Cyber-attacks are increasing in number and sophistication, are well-financed, in some cases supported by state actors, and are designed to not only attack, but also to evade detection. Since the techniques used to obtain unauthorized access to systems, or to otherwise sabotage them, change frequently and are often not recognized until launched against a target, we may be unable to anticipate these techniques or to implement adequate preventative measures. The emergence and maturation of AI capabilities may also lead to new and/or more sophisticated methods of attack, including fraud that relies upon “deep fake” impersonation technology or other forms of generative automation that may scale up the efficiency or effectiveness of cyber threat activity.

Our systems have experienced various immaterial breaches in the past, including ransomware, denial-of-service, malware, and phishing. Also, our business partners have experienced security breaches, which is disruptive for our customers. While these events have not had an adverse impact on our business or financial condition, security breaches such as these could have a material adverse effect on our financial condition, as, (a) clients could sue us for breaches of security involving our system due to the sensitivity of the medical information we compile and transmit; (b) actual or perceived security breaches in our system could harm the market perception of our products which could cause us to lose existing and prospective clients; and (c) the effect of security breaches and related issues could disrupt our ability to perform certain key business functions and could potentially reduce demand for our products and services. Accordingly, we have expended significant resources toward establishing and enhancing the security of our related infrastructures and we have enhanced our cybersecurity risk management program and disclosure controls and procedures, as discussed under "Cybersecurity." However, no assurance can be given that these efforts will be sufficient to protect against a breach or other cybersecurity incident. Also, maintaining and enhancing our infrastructure security may require us to expend significant capital in the future.

Our networks have been, and likely will continue to be, subject to Distributed Denial of Service ("DDoS") attacks. Recent industry experience has demonstrated that DDoS attacks continue to grow in size and sophistication and have the ability to widely disrupt services. In recent years, the size of DDoS attacks has grown rapidly. While we have adopted mitigation techniques, procedures and strategies to defend against DDoS attacks, there can be no assurance that we will be able to defend against every attack, especially as the attacks increase in size and sophistication. Any attack, even if only partially successful, could disrupt our networks, increase response time, negatively impact our ability to meet our service level obligations, and generally impede our ability to provide reliable service to our customers and the broader internet community.

There have been recent disruptions in billing and data systems in healthcare (e.g., the cybersecurity incident affecting Change Healthcare). Such cybersecurity events which materially disrupt the healthcare system upon which our business relies could adversely affect our business if such disruption is widespread and continues for an extended period of time. Cyber incidents could also include the use of AI to launch more automated, targeted and coordinated attacks on targets.

New products that we introduce or enhancements to our existing products may contain undetected errors or problems that could affect client satisfaction and cause a decrease in revenues.

Highly complex software products such as ours sometimes contain undetected errors or failures when first introduced or when updates and new versions are released. Tests of our products may not detect bugs or errors because it is difficult to simulate our clients’ wide variety of computing environments. Despite extensive testing, from time to time we have discovered defects or errors in our products. Defects or errors discovered in our products could cause delays in product introductions and shipments and unexpected service disruptions, result in increased costs and diversion of development resources, require design modifications, decrease market acceptance or client satisfaction with our products, cause a loss of revenue, result in legal actions by our clients and cause increased insurance costs.

We may not be successful in convincing customers to migrate to current or future releases of our products, which may lead to reduced services and maintenance revenues and less future business from existing customers.

Our customers may not be willing to incur the costs or invest the resources necessary to complete upgrades to current or future releases of our products. This may lead to our loss of services and maintenance revenues and future business from customers that continue to operate prior versions of our products or choose to no longer use our products.

Failure to maintain our margins and service rates for implementation services could have a material adverse effect on our operating performance and financial condition.

A significant portion of our revenues is derived from implementation services. If we fail to scope our implementation projects correctly, our services margins may suffer. We bill for implementation services predominately on an hourly or daily basis (time and materials) and sometimes under fixed price contracts, and we generally recognize revenue from those services as we perform the work. If we are not able to maintain the current service rates for our time and materials implementation services, without corresponding cost reductions, or if the percentage of fixed price contracts increases and we underestimate the costs of our fixed price contracts, our operating performance may suffer. The rates we charge for our implementation services depend on a number of factors, including the following:

•perceptions of our ability to add value through our implementation services;

•complexity of services performed;

•competition;

•pricing policies of our competitors and of systems integrators;

•the use of globally sourced, lower-cost service delivery capabilities within our industry; and

•economic, political and market conditions.

Services revenues carry lower gross margins than license revenues and an overall increase in services revenues as a percentage of total revenues could have an adverse impact on our business.

Because our service revenues have lower gross margins than do our license revenues, an increase in the percentage of total revenues represented by service revenues could have a detrimental impact on our overall gross margins and could adversely affect operating results.

We may be subject to liability in the event we provide inaccurate claims data to payors.

We offer electronic claims submission services as part of our business management services. While we have implemented certain product features designed to maximize the accuracy and completeness of claims submissions, these features may not be sufficient to prevent inaccurate claims data from being submitted to payors. Should inaccurate claims data be submitted to payors, we may be subject to liability claims.

We may experience liability claims arising out of the licensing of our software and provision of services.

Our agreements normally contain provisions designed to limit our exposure to potential liability claims and generally exclude consequential and other forms of extraordinary damages. However, these provisions could be rendered ineffective, invalid or unenforceable by unfavorable judicial decisions or by federal, state, local or foreign laws or ordinances. For example, we may not be able to avoid or limit liability for disputes relating to product performance or the provision of services. If a claim against us were to be successful, we may be required to incur significant expense and pay substantial damages, including consequential or punitive damages, which could have a material adverse effect on our business, operating results and financial condition. Even if we prevail in contesting such a claim, the accompanying publicity could adversely affect the demand for our products and services.

We also rely on certain technology that we license from third parties, including software that is integrated with our internally developed software. Although these third parties generally indemnify us against claims that their technology infringes on the proprietary rights of others, such indemnification is not always available for all types of intellectual property. Often such third-party indemnifiers are not well capitalized and may not be able to indemnify us in the event that their technology infringes on the proprietary rights of others. As a result, we may face substantial exposure if technology we license from a third party infringes on another party’s proprietary rights. Defending such infringement claims, regardless of their validity, could result in significant cost and diversion of resources.

We are dependent on our licenses of rights, products and services from third parties, disruptions of which may cause us to discontinue, delay or reduce product shipments.

We are increasingly dependent upon licenses for some of the technology used in our products as well as other products and services from third-party vendors, and the costs of these licenses have increased in recent years. Most of these arrangements can be continued/renewed only by mutual consent and may be terminated for any number of reasons. We may not be able to continue using the technology, products or services made available to us under these arrangements on commercially reasonable terms or at all. As a result, we may have to discontinue, delay or reduce product shipments or services provided until we can obtain equivalent technology or services. Most of our third-party licenses are non-exclusive. Our competitors may obtain the right to use any of the business elements covered by these arrangements and use these elements to compete directly with us. In addition, if our vendors choose to discontinue providing their technology, products or services in the future or are unsuccessful in their continued research and development efforts, we may not be able to modify or adapt our own products. The operation of our products would be impaired if errors occur in third party technology or content that we incorporate, and we may incur additional costs to repair or replace the defective technology or content. It may be difficult for us to correct any errors in third party products because the products are not within our control.

Because we believe that proprietary rights are material to our success, misappropriation of these rights could limit our ability to compete effectively and adversely affect our financial condition.

We are heavily dependent on the maintenance and protection of our intellectual property and we rely largely on a combination of confidentiality provisions in our client agreements, employee nondisclosure agreements, trademark and trade secret laws and other measures to protect our intellectual property. Additionally, our software is not patented or copyrighted. Although we attempt to control access to our intellectual property, unauthorized persons may attempt to copy or otherwise use our intellectual property. There can be no assurance that the legal protections and precautions we take will be adequate to prevent misappropriation of our technology or that competitors will not independently develop technologies equivalent or superior to ours. Monitoring unauthorized use of our intellectual property is difficult, and the steps we have taken may not prevent unauthorized use. If our competitors gain access to our intellectual property, our competitive position in the industry could be damaged. An inability to compete effectively could cause us to lose existing and potential clients and experience lower revenues, revenue growth and profit margins. Third parties could obtain patents that may require us to negotiate licenses to conduct our business, and the required licenses may not be available on reasonable terms or at all. We also rely on nondisclosure agreements with certain employees, and we cannot be certain that these agreements will not be breached or that we will have adequate remedies for any breach.

If we are deemed to infringe on the intellectual property rights of third parties, we could incur unanticipated expense and be prevented from providing our products and services if we cannot obtain licenses to these rights on commercially acceptable terms.

We do not believe that our operations or products infringe on the intellectual property rights of others. However, there can be no assurance that others will not assert infringement or trade secret claims against us with respect to our current or future products. Many participants in the technology industry have an increasing number of patents and patent applications and have frequently demonstrated a readiness to take legal action based on allegations of patent and other intellectual property infringement. Further, as the number and functionality of our products increase, we believe we may become increasingly subject to the risk of infringement claims. If infringement claims are brought against us, these assertions could distract management. We may have to spend a significant amount of money and time to defend or settle those claims. In addition, claims against third parties from which we purchase software could adversely affect our ability to access third-party software for our systems.

If we were found to infringe on the intellectual property rights of others, we could be forced to pay significant license fees or damages for infringement. If we were unable to obtain licenses to these rights on commercially acceptable terms, we would be required to discontinue the sale of our products that contain the infringing technology. Our clients would also be required to discontinue the use of those products. We are unable to insure against this risk on an economically feasible basis. Even if we were to prevail in an infringement lawsuit, the accompanying publicity could adversely impact the demand for our products. Under some circumstances, we agree to indemnify our clients for some types of infringement claims that may arise from the use of our products.

Interruptions in our power supply and/or telecommunications capabilities could disrupt our operations, cause us to lose revenues and/or increase our expenses.

We currently have backup generators to be used as alternative sources of power in the event of a loss of power to our facilities. If these generators were to fail during any power outage, we would be temporarily unable to continue operations at our facilities. This would have adverse consequences for our clients who depend on us for system support, business management, and managed IT and professional services. Any such interruption in operations at our facilities could damage our reputation, harm our ability to retain existing clients and obtain new clients, and result in lost revenue and increased insurance and other operating costs.

We also have clients for whom we store and maintain computer servers containing critical patient and administrative data. Those clients access this data remotely through telecommunications lines. If our power generators fail during any power outage or if our telecommunications lines are severed or impaired for any reason, those clients would be unable to access their mission critical data causing an interruption in their operations. In such event our remote access clients and/or their patients could seek to hold us responsible for any losses. We would also potentially lose those clients, and our reputation could be harmed.

RISKS RELATED TO OUR INDEBTEDNESS

Volatility in and disruption to the global capital and credit markets and tightened lending standards may adversely affect our ability to access credit in the future, the cost of any credit obtained in the future, and the financial soundness of our clients and our business.

Domestic and international events have frequently resulted in volatility and disruption to the global capital and credit markets, often adversely affecting the availability, terms and cost of credit. Although we believe that our operating cash flow and financial assets will give us the ability to meet our financing needs for the foreseeable future, there can be no assurance that the volatility and disruption in the global capital and credit markets will not impair our liquidity or increase the costs of any future borrowing.

Our business could also be negatively impacted to the extent that our hospital clients continue to face tight capital and credit markets and other disruptions resulting from the deteriorating macroeconomic conditions or cuts in Medicare and Medicaid funding. Hospitals may modify, delay or cancel plans to purchase our software systems or services. Additionally, if hospitals’ operating and financial performance deteriorates, or if they are unable to make scheduled payments or obtain credit, they may not be able to pay, or may delay payment of, accounts receivable owed to us. Any inability of clients to pay us for our products and services may adversely affect our earnings and cash flow.

Tightened lending standards and the absence of third-party credit has resulted in many of our hospital clients seeking financing arrangements from us to purchase our software systems and services. These financing arrangements impact our short-term operating cash flow and cash available. Should the requests for these financing arrangements continue or increase, our business

could be negatively impacted by our inability to finance these arrangements. In addition, the absence of credit could negatively impact our existing financing receivables should our clients with financing arrangements be unable to meet their obligations.

Our substantial indebtedness may adversely affect our available cash flow and our ability to operate our business, remain in compliance with debt covenants and make payments on our indebtedness.

As of December 31, 2025, we had approximately $166.6 million in principal amount of indebtedness, which includes $69.1 million under our term loan facility and $97.5 million borrowed under our revolving credit facility. We also had $82.5 million of unused commitments under our revolving credit facility as of December 31, 2025.

Our substantial indebtedness increases the possibility that we may be unable to generate cash sufficient to pay, when due, the principal of, interest on or other amounts due in respect of our indebtedness. Our substantial indebtedness, combined with our other financial obligations and contractual commitments, could have important consequences. For example, it could:

•make it more difficult for us to satisfy our obligations with respect to our indebtedness, and any failure to comply with the obligations under any of our debt instruments, including restrictive covenants, could result in an event of default under such instruments;

•make us more vulnerable to adverse changes in general economic, industry and competitive conditions and adverse changes in government regulation;

•require us to dedicate a substantial portion of our cash flow from operations to payments on our indebtedness, thereby reducing the availability of our cash flow to fund working capital, capital expenditures, acquisitions and other general corporate purposes;

•limit our flexibility in planning for, or reacting to, changes in our business and the industry in which we operate;

•place us at a competitive disadvantage compared to our competitors that are less highly leveraged and therefore able to take advantage of opportunities that our indebtedness prevents us from exploiting; and

•limit our ability to borrow additional amounts for working capital, capital expenditures, acquisitions, debt service requirements, execution of our business strategy or other purposes.

Any of the above listed factors could have a material adverse effect on our business, prospects, results of operations and financial condition. Furthermore, our interest expense could increase if interest rates increase because our debt bears interest at floating rates, which could adversely affect our cash flows. If we do not have sufficient earnings to service our debt, we may be required to refinance all or part of our existing debt, sell assets, borrow more money or sell securities, none of which we can guarantee we will be able to do.

In addition, the credit agreement governing our term loan facility and revolving credit facility contains restrictive covenants that limit our ability to engage in activities that may be in our long-term best interests. See "The terms of the credit agreement governing our term loan facility and revolving credit facility may restrict our current and future operations, particularly our ability to respond to changes in our business or to take certain actions."

Despite our current indebtedness levels, we and our subsidiaries may still be able to incur substantially more debt, which could exacerbate the risks associated with our substantial leverage.

We and our subsidiaries may be able to incur substantial additional indebtedness in the future, including secured indebtedness. Although the credit agreement governing our term loan facility and revolving credit facility contains restrictions on the incurrence of additional indebtedness, these restrictions are subject to a number of significant qualifications and exceptions, and the indebtedness incurred in compliance with these restrictions could be substantial. If new debt is added to our or our subsidiaries’ current debt levels, the related risks that we face would be increased.

To service our indebtedness, we will require a significant amount of cash. Our ability to generate cash depends on many factors beyond our control, and any failure to meet our debt service obligations could have a material adverse effect on our business, prospects, results of operations and financial condition.

Our ability to pay interest on and principal of our debt obligations principally depends upon our operating performance. As a result, prevailing economic conditions and financial, business and other factors, many of which are beyond our control, will affect our ability to make these payments.

If we do not generate sufficient cash flow from operations to satisfy our debt service obligations, we may have to undertake alternative financing plans, such as refinancing or restructuring our indebtedness, selling assets, reducing or delaying capital investments or capital expenditures or seeking to raise additional capital. Our ability to restructure or refinance our debt, if at all, will depend on the condition of the capital markets and our financial condition at such time. Any refinancing of our debt could be at higher interest rates and may require us to comply with more onerous covenants, which could further restrict our business operations. In addition, the terms of existing or future debt instruments may restrict us from adopting some of these alternatives. Our inability to generate sufficient cash flow to satisfy our debt service obligations, or to refinance our obligations at all or on commercially reasonable terms, could affect our ability to satisfy our debt obligations and have a material adverse effect on our business, prospects, results of operations and financial condition.

The terms of the credit agreement governing our term loan facility and revolving credit facility may restrict our current and future operations, particularly our ability to respond to changes in our business or to take certain actions.

Our term loan facility and revolving credit facility contain, and any future indebtedness of ours would likely contain, a number of restrictive covenants that impose significant operating restrictions, including restrictions on our ability to engage in acts that may be in our best long-term interests.

The credit agreement governing our term loan facility and revolving credit facility includes covenants restricting, among other things, our ability to:

•incur additional debt;

•incur liens and encumbrances;

•pay dividends on our equity securities or payments to redeem, repurchase or retire our equity securities;

•enter into restrictive agreements;

•make investments, loans and acquisitions;

•merge or consolidate with any other person;

•dispose of assets;

•enter into sale and leaseback transactions;

•engage in transactions with our affiliates; and

•materially alter the business we conduct.

The operating restrictions and covenants in these debt agreements and any future financing agreements may adversely affect our ability to finance future operations or capital needs or to engage in other business activities. The credit agreement requires compliance with a consolidated net leverage ratio test and a fixed charge coverage ratio test. The calculation of the fixed charge coverage ratio was amended on March 10, 2023, and the Company received waivers of the Company’s failure to comply with the fixed charge coverage ratio as an event of default as of September 30, 2023 and December 31, 2023 from Regions Bank, as administrative agent, and various other lenders. Any failure by us to comply with this or another covenant in the future may result in an event of default. There can be no assurance that we will be able to continue to comply with this covenant or obtain amendments to avoid future covenant violations, or that such amendments will be available on commercially acceptable terms.

Our ability to comply with these covenants may be affected by events beyond our control, and any material deviations from our forecasts could require us to seek waivers or amendments of covenants, alternative sources of financing or reductions in expenditures. In addition, the outstanding indebtedness under our term loan facility and revolving credit facility is, subject to certain exceptions, secured by security interests in substantially all of our and the subsidiary guarantors’ tangible and intangible assets (subject to certain exceptions). A breach of any of the restrictive covenants in the credit agreement governing our term loan facility and revolving credit facility would result in a default, and our lenders may elect to declare all outstanding borrowings, together with accrued interest and other fees, to be immediately due and payable, or enforce and foreclose on their security interest and liquidate some or all of such pledged assets. The lenders under our term loan facility and revolving credit facility also have the right in these circumstances to terminate any commitments they have to provide further borrowings.

RISKS RELATED TO OUR COMMON STOCK AND OTHER GENERAL RISKS

We are subject to changes in and interpretations of financial accounting matters that govern the measurement of our performance, one or more of which could adversely affect our business, financial condition, cash flows, revenue and results of operations.

Based on our reading and interpretations of relevant guidance, principles or concepts issued by, among other authorities, the American Institute of Certified Public Accountants, the Financial Accounting Standards Board and the Securities and Exchange Commission, we believe revenue received pursuant to our current sales and licensing contract terms and business arrangements have been properly recognized. However, there continue to be issued interpretations and guidance for applying the relevant standards to a wide range of sales and licensing contract terms and business arrangements that are prevalent in the software industry. Future interpretations or changes by the regulators of existing accounting standards, including Financial Accounting Standards Board ("FASB") Accounting Standards Codification ("ASC") Topic 606, Revenue from Contracts with Customers, or changes in our business practices could result in changes in our revenue recognition and/or other accounting policies and practices that could adversely affect our business, financial condition, cash flows, revenue and results of operations.

We may be required to record additional significant charges to earnings if our goodwill or intangible assets become impaired.

We are required under U.S. generally accepted accounting principles ("U.S. GAAP") to test our goodwill for impairment annually or more frequently if indicators for potential impairment exist. Indicators that are considered include significant changes in performance relative to expected operating results, significant changes in the use of the assets, significant negative industry, or economic trends, or a significant decline in the Company's stock price and/or market capitalization for a sustained period of time. In addition, we periodically review our intangible assets for impairment when events or changes in circumstances indicate that the carrying value may not be recoverable. Factors that may be considered a change in circumstances indicating that the carrying value of our intangible assets may not be recoverable include slower growth rates, the loss of significant clients, or divestiture of a business or asset for less than its carrying value. We may be required to record a significant charge to earnings in our consolidated financial statements during the period in which any impairment of our goodwill or intangible assets is determined. We recorded a goodwill impairment charge of $35.9 million in the fourth quarter of 2023, $21.9 million of which was associated with our post-acute Patient Care reporting unit and $14.0 million of which was associated with our acute Patient Care reporting unit. These impairment charges had a significant negative effect on our consolidated net income for the year ended December 31, 2023. We subsequently sold our post-acute Patient Care business in January 2024. The Company finalized the accounting for the sale and a material gain or loss was not recorded in 2024 since the related asset impairments were recorded in 2023.

Exclusive of our post-acute Patient Care reporting unit, which was disposed of in January 2024, we have remaining goodwill of $172.6 million as of December 31, 2025. Any future impairment charges could have a material adverse impact on our results of operations. There are inherent uncertainties in management's estimates, judgments and assumptions used in assessing recoverability of goodwill and intangible assets. Any changes in key assumptions, including failure to meet business plans, a deterioration in the market, or other unanticipated events and circumstances, may affect the accuracy or validity of such estimates and could potentially result in an impairment charge.

The unpredictability of our quarterly operating results may cause us to fail to meet revenues or earnings expectations which could cause the price of our common stock to fluctuate or decline.

There is no assurance that consistent quarterly growth in our business will occur. Our quarterly revenues may fluctuate and may be difficult to forecast for a variety of reasons. For example, prospective clients often take significant time evaluating our system and related services before making a purchase decision. Moreover, a prospective client who has placed an order for our system could decide to cancel that order or postpone installation of the ordered system. If a prospective client delays or cancels a scheduled system installation during any quarter, we may not be able to schedule a substitute system installation during that quarter. The amount of revenues that would have been generated from that installation will be postponed or lost. The possibility of delays or cancellations of scheduled system installations could cause our quarterly revenues to fluctuate.

The following factors may also affect demand for our products and services and cause our quarterly revenues to fluctuate:

•changes in client budgets and purchasing priorities;

•the ability of our clients to obtain financing for the purchase of our products;

•the financial stability of our clients;

•the specific mix of software, hardware and services in orders from clients;

•the timing of new product announcements and product introductions by us and our competitors;

•market acceptance of new products, product enhancements and services from us and our competitors;

•product and price competition;

•our success in expanding our sales and marketing programs;

•the availability and cost of system components;

•delay of revenue recognition to future quarters due to an increase in the sales of our remote access SaaS services;

•the length of sales cycles and installation processes;

•changes in revenue recognition or other accounting guidelines employed by us and/or established by the Financial Accounting Standards Board or other rulemaking bodies;

•accounting policies concerning the timing of recognition of revenue;

•personnel changes; and

•general market and economic factors.

Variations in our quarterly revenues may adversely affect our operating results. In each fiscal quarter, our expense levels, operating costs and hiring plans are based on projections of future revenues and are relatively fixed. Because a significant percentage of our expenses are relatively fixed, a variation in the timing of systems sales, implementations and installations can cause significant variations in operating results from quarter to quarter. As a result, we believe that interim period-to-period comparisons of our results of operations are not necessarily meaningful and should not be relied upon as indications of future performance. Further, our historical operating results are not necessarily indicative of future performance for any particular period.

In addition, from time to time, we may release earnings guidance or other forward-looking statements in our earnings releases, earnings conference calls or otherwise regarding our future performance that represent our management's estimates as of the date of release. Some or all of the assumptions of any future guidance that we furnish may not materialize or may vary significantly from actual future results. Any failure to meet guidance or analysts' expectations could have a material adverse effect on the trading price or trading volume of our common stock.

Our common stock price has periodically experienced significant volatility, which could result in substantial losses for investors purchasing shares of our common stock and in litigation against us.

Volatility may be caused by a number of factors including but not limited to:

•actual or anticipated quarterly variations in operating results;

•rumors about our performance, software solutions, or merger and acquisition activity;

•changes in expectations of future financial performance or changes in estimates of securities analysts;

•governmental regulatory action;

•healthcare reform measures;

•client relationship developments;

•purchases or sales of Company stock;

•changes occurring in the markets in general;

•macroeconomic conditions, both nationally and internationally; and

•other factors, many of which are beyond our control.

Furthermore, the stock market in general, and the market for software, healthcare and high technology companies in particular, has experienced significant volatility in recent years that often has been unrelated to the operating performance of particular companies. These broad market and industry fluctuations may adversely affect the trading price of our common stock, regardless of actual operating performance.

Moreover, in the past, securities class action litigation has often been brought against a company following periods of volatility in the market price of its securities. We may in the future be the target of similar litigation. Securities litigation could result in substantial costs and divert management’s attention and resources.

As a result of the inherent limitations in our internal control over financial reporting, misstatements due to error or fraud may occur and not be detected.

Our disclosure controls and procedures are designed to provide reasonable assurance that information required to be disclosed by us in reports we file with or submit to the SEC under the Securities Exchange Act of 1934 (“Exchange Act”) is accumulated and communicated to management and recorded, processed, summarized, and reported within the time periods specified in SEC rules and forms. We believe that any disclosure controls and procedures or internal controls and procedures, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met. These inherent limitations include the realities that judgments in decision-making can be faulty and that breakdowns can occur because of simple error or mistake. In addition, controls can be circumvented by the individual acts of some persons, by collusion of two or more people, or by an unauthorized override of the controls.

Most of our facilities are located in an area vulnerable to hurricanes and tropical storms, and the occurrence of a severe hurricane, similar storm or other natural disaster could cause damage to our facilities and equipment, which could require us to cease or limit our operations.

A portion of our facilities and employees are located within 30 miles of the coast of the Gulf of Mexico. Our facilities are vulnerable to significant damage or destruction from hurricanes and tropical storms. Such disasters may become more frequent and/or severe as the result of climate change. We are also vulnerable to damage from other types of disasters, including tornadoes, fires, floods and similar events. If any disaster were to occur, our ability to conduct business at our facilities could be seriously impaired or completely destroyed. This would have adverse consequences for our clients who depend on us for system support or business management, consulting and managed IT services. Also, the servers of clients who use our remote access services could be damaged or destroyed in any such disaster. This would have potentially devastating consequences to those clients. Although we have an emergency recovery plan, including back-up systems in remote locations, there can be no assurance that this plan will effectively prevent the interruption of our business due to a natural disaster. Furthermore, the insurance we maintain may not be adequate to cover our losses resulting from any natural disaster or other business interruption. Moreover, we could be affected by climate change and other environmental issues to the extent such issues adversely affect the general economy, adversely impact our supply chain or increase the costs of supplies needed for our operations, or otherwise result in disruptions impacting the communities in which our facilities are located.

We are exposed to market risk related to interest rate changes.

We are exposed to market risk related to changes in interest rates as a result of the floating interest rates applicable to the outstanding debt under our term loan facility and revolving credit facility. The interest rate for the outstanding debt under our term loan facility and revolving credit facility as of December 31, 2025 was 5.92%. Each of our credit facilities continues to bear interest at a rate per annum equal to an applicable margin plus, at our option, either (1) the Adjusted Secured Overnight Financing Rate ("SOFR") rate for the relevant interest period, subject to a floor of 0.0%, (2) an alternate base rate determined by reference to the greater of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). The applicable margin for SOFR loans and the letter of credit fee ranges from 1.5% to 3.0%. The applicable margin for base rate loans ranges from 0.5% to 2.0%, in each case based on the Company's consolidated net leverage ratio. A one hundred basis point change in interest rate on our borrowings outstanding as of December 31, 2025 would result in a change in interest expense of approximately $1.7 million annually.

Macroeconomic conditions could have a materially adverse impact on our business, financial condition, or results of operations.

Uncertain global or regional economic conditions have and may in the future adversely impact our business. Uncertainty in the economic environment or other unfavorable changes in economic conditions, such as inflation, fluctuating interest rates, recession, slowing growth, increased unemployment, changes or uncertainty in fiscal monetary or trade policy, implementation of new or increased tariffs, retaliatory tariffs by other countries or other trade restrictions, or currency fluctuations, may negatively impact consumer confidence and spending causing our customers to stop or postpone purchases. Our ability to forecast our operating results, make business decisions and execute our business strategy could be adversely impacted by challenging macroeconomic conditions. If a recession occurs, economies weaken, or inflationary trends continue, our business and operating results could be materially adversely affected.

Moreover, a potential U.S. federal government shutdown resulting from budgetary decisions, a prolonged continuing resolution, breach of the federal debt ceiling, or a potential U.S. sovereign default may increase uncertainty and volatility in the global economy and financial markets. Weak economic conditions or significant uncertainty regarding the stability of financial markets could adversely impact our business, financial condition and operating results.

We continue to have identified material weaknesses in our internal control over financial reporting. If we fail to remediate these material weaknesses and do not develop and maintain effective internal control over financial reporting, we may not be able to accurately report our financial results in a timely manner, which may adversely affect investor confidence in us and may adversely affect our business, financial condition and results of operations.

As detailed in prior filings with the SEC and in Item 9A in this Form 10-K, we did not sufficiently design and maintain effective control activities related to the accounting for revenue recognition and related costs, capitalization of software development costs, and non-routine transactions.

We are required to maintain effective internal control over financial reporting (“ICFR”) and disclosure controls and procedures (“DC&P”). As of December 31, 2025, management identified material weaknesses in our ICFR related to (i) revenue recognition, including controls to identify and evaluate contract modifications, validate manual interventions, ensure completeness and accuracy of information used in billing and revenue recognition, timely record credits, rebills and similar revenue‑related adjustments, and evaluate terms affecting recognition over-time versus point-in-time; (ii) capitalized software development costs, including controls to determine and document technological feasibility, cease capitalization when products are available for general release, support the population and allocation of capitalizable costs with complete and accurate project data, and expense maintenance and support activities as incurred; and (iii) non-routine transactions, including stock-based payment arrangements and other technical accounting areas. Because of these material weaknesses, our management determined our ICFR were not effective as of December 31, 2025, and our independent registered public accounting firm has issued an adverse opinion on the effectiveness of our ICFR as of that date.

As reflected in this Form 10-K, we have made revisions to our previously issued financial statements for the years ended December 31, 2024 and 2023 to address certain errors in those financial statements. However, these material weaknesses could result in a material misstatement of our annual or interim financial statements that may not be prevented or detected on a timely basis and that, therefore, could in the future result in a restatement of previously issued financial statements. We are undertaking remediation efforts; however, remediation will require significant time and resources, and we can provide no assurance as to when these efforts will be completed or that they will prevent future material weaknesses. If we are unable to remediate the existing material weaknesses and to develop and maintain effective ICFR and DC&P, we could lose investor confidence in the accuracy and completeness of our financial reports, the market price of our common stock could decline, and we could be subject to sanctions or investigations by the SEC or other regulatory authorities. Failure to remedy any material weakness in our ICFR, to maintain effective DC&P, or to implement or maintain other effective control systems required of public companies, also could restrict our future access to the capital markets.

We do not anticipate paying any dividends on our common stock.

We do not anticipate paying any cash dividends on our common stock in the foreseeable future. If we do not pay cash dividends, you would receive a return on your investment in our common stock only if the market price of our common stock is greater at the time you sell your shares than the market price at the time you bought your shares.

Actions of activist stockholders against us could be disruptive and costly. The possibility that activist stockholders may wage proxy contests or seek representation on our Board could cause uncertainty about the strategic direction of our business.

Stockholders may from time to time engage in proxy solicitations, submit stockholder proposals or Board nominations or otherwise attempt to effect changes, assert influence, or acquire some level of control over us. We have been and may continue

to be subject to activism in the future. For example, in early 2025, we engaged in a process with two of our significant stockholders, which culminated in our entering into a cooperation agreement with each of these stockholders and resulting changes in our corporate governance. The stockholders agreed to customary standstill provisions during the term of the cooperation agreement, which expired in December 2025. We entered into a new cooperation agreement with one of these stockholders in January 2026, which provided for additional governance changes and an extension of the standstill provisions. Activist stockholders may seek to effect changes in our strategic direction, and how our Company is governed, through changes to our Board or otherwise. While our Board and management team will continue to strive to maintain constructive, ongoing communications with our stockholders, and welcome their views and opinions with the goal of enhancing value for all stockholders, activist campaigns that seek to further replace members of our Board or bring about changes in our strategic direction could have an adverse effect on us because:

•Responding to actions by activist stockholders, including related litigation and settlement of activism, can disrupt our operations, can be costly and time-consuming, and can divert the attention of our Board and senior management team from the pursuit of business objectives, which could adversely affect our results of operations and financial condition;

•Perceived uncertainties as to our future direction as a result of changes to the composition of our Board may lead to the perception of an adverse change in the direction of the business, instability, or lack of continuity, which may be exploited by our competitors, result in the loss of potential business opportunities, cause concern for our current or potential clients and vendors, and make it more difficult to attract and retain qualified personnel and business partners;

•These types of actions could cause significant fluctuations in our stock price based on temporary or speculative market perceptions or other factors that do not necessarily reflect the underlying fundamentals and prospects of a particular business; and

•If individuals are elected to our Board with a specific agenda, it may adversely affect our ability to effectively implement our business strategy and to create additional value for our stockholders.


ITEM 1B.			UNRESOLVED STAFF COMMENTS

None.


ITEM 1C.			CYBERSECURITY

Our business operations, including the provision of the products and services described above, involve the compilation and transmission of confidential information, including patient health information. We also collect and store other sensitive data such as credit card, insurance, and other information. We have included security features in our systems that are intended to protect the privacy and integrity of this information, but our systems may be vulnerable to security breaches, viruses, programming errors and other similar disruptive problems.

The Board of Directors is responsible for exercising oversight of management’s identification of, and planning for, the material risks facing the Company, and we believe our risk management policies and procedures are adequate to ensure that relevant information about cybersecurity risks and incidents is appropriately reported and disclosed. In 2017, the Board authorized the formation of a Cybersecurity Committee, which is now known as the Governance, Risk & Compliance (“GRC”) Committee. Our cybersecurity risk management process, which are discussed in greater detail below, are led by the GRC Committee. The GRC Committee is currently comprised of the Chief Technology and Innovation Officer, Chief Financial Officer, General Managers of the business units, Corporate Security Officer, Corporate Privacy Officer, and General Counsel and Corporate Compliance Officer. The GRC Committee generally meets weekly, and has a formal meeting quarterly, to discuss the primary security and compliance-related risks currently facing the Company, including cybersecurity risks. The General Counsel and Corporate Compliance Officer then provides updates to the Board at each regular quarterly meeting. Annually, the full Board participates in cybersecurity training and discusses the internal incident management process with the GRC Committee.

In 2020, the Board created the Innovation and Technology Committee to aid the Board in its duties to assess and oversee the management of risks in the areas of information technology, information and data security, cybersecurity, disaster recovery, data privacy and business continuity. This committee oversees the GRC Committee’s activities relating to information technology and cybersecurity matters, and seeks to enhance communication and coordination of efforts between the Board and management in these areas. The members of the Innovation and Technology Committee monitor the prevention, mitigation, detection, and remediation of cybersecurity incidents through their management of and participation in the cybersecurity risk management process described below, including the operation of our incident response plan.

Additionally, we have a Security Operations Center ("SOC") to oversee several initiatives designed to improve our cybersecurity protection, readiness and response. The Company partnered with a third party to provide Security as a Service ("SECaaS") to assist our internal SOC in reducing the likelihood and impact of a cybersecurity attack. The SOC oversees penetration testing, vulnerability scanning, intrusion prevention, endpoint and insider threat detection, log management and other cybersecurity-related projects. The Company also consulted with third parties to achieve ISO 27001 certification related to information security management, which was achieved starting in 2020 and maintained every year since.

Our SOC team members have over 35 years of combined work experience in various roles involving managing information security, developing cybersecurity strategy, implementing effective information and cybersecurity programs, and developing and overseeing programs and policies related to various areas, including incident response, eDiscovery, forensic investigations, log analysis, malware analysis, risk management, physical security, and enterprise security operations, as well as several relevant degrees and certifications, including Masters degrees in Cybersecurity and Information Assurance, Bachelors degrees in Information Technology, BS Information Systems and Cybersecurity, Certified Information Systems Security Professional, Certified Ethical Hacker, Computer Hacking Forensic Investigator, A+, Network+, Security+, MS Sentinel, a Degree in forensic science and others being worked on. Prior work experience, knowledge, skills, or background for the SOC team include: law enforcement, DoD contractor work in cybersecurity, heavy involvement in numerous large scale intrusion investigations, published author of an Intrusion Analysis book, presentations at numerous conferences focused on cybersecurity, hundreds of forensic analysis cases, prior employment by other companies as cybersecurity/SOC analysts, and continuous on the job training

We have a cybersecurity-specific risk assessment process, which helps identify our cybersecurity threat risks by comparing our process to industry standards and best practices standards set by the National Institute of Standards and Technology (“NIST”) and the International Organization for Standardization (“ISO”), as well as by engaging experts to attempt to infiltrate our information systems, as such term is defined in Item 106(a) of Regulation S-K. Our cybersecurity program includes controls

designed to identify, protect against, detect, respond to and recover from information and cybersecurity incidents, as such term is defined in Item 106(a) of Regulation S-K, and to provide for the availability of critical data and systems and to maintain regulatory compliance. These controls include the following activities:

a.closely monitor emerging data protection laws and implement changes to our processes designed to comply;

b.conduct annual customer data handling and use requirements training for all our employees;

c.conduct annual cybersecurity management and incident training for employees involved in our systems and processes that handle sensitive data;

d.conduct regular phishing email simulations for all employees and all contractors with access to corporate email systems to enhance awareness and responsiveness to such possible threats;

e.through policy, practice and contract (as applicable), require employees, as well as third-parties who provide services on our behalf, to protect customer information and data;

f.run tabletop exercises to simulate a response to a cybersecurity incident and use the findings to improve our processes and technologies;

g.leverage the NIST and ISO incident handling frameworks to help us identify, protect, detect, respond, and recover when there is an actual or potential cybersecurity incident; and

h.maintain multiple layers of controls, including embedding security into our technology investments.

We perform periodic internal and third-party assessments to test our cybersecurity controls and regularly evaluate our policies and procedures surrounding our handling and control of personal data and the systems we have in place to help protect us from cybersecurity or personal data breaches, and we perform periodic internal and third-party assessments to test our controls and to help us identify areas for continued focus, improvement, and/or compliance. An example of the assessment we use is the ISO 27001 assessment that was implemented starting in 2020. Our team is continually evaluating our technology vendors and tools to ensure that we are managing evolving threats to the best of our ability.

Our processes also address cybersecurity threat risks associated with our use of third-party service providers, including those in our supply chain or who have access to our customer and employee data or our systems. Third-party risks are included within our enterprise risk management program, as well as our cybersecurity-specific risk identification program, both of which are discussed above. In addition, cybersecurity considerations affect the selection and oversight of our third-party service providers. We perform diligence on third-parties that have access to our systems, data or facilities that house such systems or data, and continually monitor cybersecurity threat risks identified through such diligence. Additionally, we generally require those third parties that could introduce significant cybersecurity risk to us to agree by contract to manage their cybersecurity risks in specified ways, and to agree to be subject to cybersecurity audits, which we conduct as appropriate. Finally, all users employed by or contracted to the Company are required to complete annual cybersecurity education and training, which includes identifying suspicious emails, internet threats, telecommunication threats and ransomware.

We describe whether and how risks from identified cybersecurity threats, including as a result of any previous cybersecurity incidents, have materially affected or are reasonably likely to materially affect us, including our business strategy, results of operations, or financial condition, under the heading “Breaches of security and viruses in our systems could result in client claims against us and harm to our reputation causing us to incur expenses and/or lose clients” included as part of our risk factor disclosures at Item 1A of this Annual Report on Form 10-K,which disclosure is incorporated by reference herein. Although we maintain cybersecurity insurance to reduce potential financial losses that may stem from cybersecurity incidents, the costs related to cybersecurity threats or disruptions may not be fully insured.


ITEM 2.			PROPERTIES

In April 2021, the Company relocated its principal executive office pursuant to a sublease for 20,093 square feet of office space in downtown Mobile, Alabama. In June 2022, the downtown location lease agreement was modified from a sublease to a lease with the property owners. In addition to the downtown and another location in Mobile, Alabama, we lease office space in Ridgeland, Mississippi. The Ridgeland lease is set to expire in February 2026. We believe our existing facilities are sufficient for our current needs.

Previously, the Company held property located on approximately 16.5 acres in Mobile, Alabama, which included approximately 135,500 square feet of office space spread throughout numerous buildings and 11.3 acres of undeveloped real property adjacent to the buildings. The majority of the buildings were sold in October 2024, and the one remaining 3,500 square foot building was sold in April 2025. The remaining 11.3 acres are held for sale.


ITEM 3.			LEGAL PROCEEDINGS

From time to time, the Company is involved in routine litigation that arises in the ordinary course of business. Management does not believe it is reasonably possible that such matters will have a material adverse effect on the Company’s financial statements.

On February 13, 2026, VG Sellers, Inc. (the "Seller") brought a civil action in the Delaware Chancery Court against the Company alleging breaches of the Securities Purchase Agreement (the "SPA") governing the Company’s acquisition of Viewgol, LLC in October 2023 (the "Viewgol Acquisition"). Among other claims, the Seller alleges that it is entitled to an additional payment of up to $31.5 million pursuant to the earnout provisions set forth in the SPA, based on the Seller's assertion that Viewgol, LLC achieved certain financial targets for the year ended December 31, 2024 (such payment, the "2024 Earnout Payment"). The Company believes that the Seller is not entitled to any portion of the 2024 Earnout Payment. On March 10, 2026, the Company filed its Answer to Seller’s Complaint and filed Counterclaims against Seller that, among other things, seek a declaration that Seller is not entitled to any portion of the 2024 Earnout Payment; assert a claim against the Seller’s former owners for breach of the SPA; and seek compensatory damages and other remedies as a result of wrongdoing by Seller and its former owners.


ITEM 4.			MINE SAFETY DISCLOSURES

Not applicable.

PART II


ITEM 5.			MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES

Market for TruBridge Common Stock

As of March 26, 2026, there were approximately 99 registered holders of our common stock, as provided to us by our transfer agent. This number does not include the number of beneficial owners whose shares are held in “street” names by broker-dealers and other institutions who hold shares on behalf of their clients. As of March 26, 2026, there were 14,906,825 shares of common stock outstanding.

TruBridge’s common stock is listed on the NASDAQ Global Select Market under the symbol “TBRG.” Prior to March 4, 2024, TruBridge's common stock was listed under the symbol “CPSI.”

Dividends

On September 4, 2020, our Board of Directors opted to indefinitely suspend all quarterly dividends. The indefinite suspension of quarterly dividends was concurrent with the authorization of a stock repurchase program, aligning with the Company's capital allocation strategy that prioritizes flexibility to allow for more opportunistic uses of capital. Our Board of Directors will take into account such matters as general business conditions, capital needs, our financial results, available liquidity and such other factors as our Board of Directors may deem relevant in future dividend declarations. Additionally, the terms of our Credit Agreement restrict our ability to pay dividends and make share repurchases. Refer to Note 13 of the consolidated financial statements included herein for additional detail regarding our credit facilities.

Purchases of Equity Securities

On September 4, 2020, our Board of Directors approved a stock repurchase program under which we could repurchase up to $30.0 million of our common stock through September 3, 2022. On July 27, 2022, the Board of Directors extended the expiration date of the stock repurchase program to September 4, 2024. The share repurchase program expired according to its terms on September 4, 2024. The Company repurchased 49,789 shares during 2023, and no shares during 2024 and 2025 pursuant to the share repurchase program. Any future stock repurchase transactions may be made through open market purchases, privately-negotiated transactions, or otherwise in compliance with Rule 10b-18 under the securities Exchange Act of 1934, as amended.


ITEM 6.			[Reserved]


ITEM 7.			MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

You should read the following discussion of our financial condition and results of operations in conjunction with the "Selected Financial Data" and our financial statements and the related notes included elsewhere in this Annual Report. This discussion and analysis contains forward-looking statements that involve risks, uncertainties and assumptions. Our actual results may differ materially from those anticipated in these forward-looking statements as a result of many factors, including but not limited to those set forth under "Risk Factors" and elsewhere in this Annual Report.

Background

During much of the Company's history, our strategy, operations, and financial results have been largely associated with developments in the electronic health record ("EHR") industry. With the rapid maturity of the EHR industry and the increasing prevalence of and demand for outsourced revenue cycle management ("RCM") services and complementary solutions, we've seen our strategy, operations, and financial results naturally evolve to become more heavily associated with RCM, with RCM-related revenues comprising 64% of our consolidated revenue for 2025. In recognition of this significant shift in strategic focus, Computer Programs and Systems, Inc. changed its corporate name to TruBridge, Inc. on March 4, 2024. Contemporaneous with this name change, the former wholly-owned subsidiaries Evident, LLC, TruBridge, LLC, and TruCode, LLC were merged into the parent company, while the former wholly-owned subsidiary Rycan Technologies, Inc. was merged into its parent and another wholly-owned subsidiary, Healthland Holding Inc. With these changes, the Company's remaining legal structure includes TruBridge, Inc., the parent company, with Viewgol, LLC ("Viewgol"), TruBridge Healthcare Private Limited, iNetXperts, Corp. d/b/a Get Real Health, Healthcare Resource Group, Inc. ("HRG"), Healthland Holding Inc. and Healthland, Inc. as its wholly-owned direct and indirect subsidiaries.

Founded in 1979, TruBridge is a leading provider of healthcare services and solutions for community hospitals, their clinics and other healthcare systems. Our combined companies are focused on helping improve the health of the communities we serve, connecting communities for a better patient care experience, and improving the financial operations of our customers.

The Company operates its business in two operating segments, which are also our reportable segments: Financial Health and Patient Care. These reporting segments contribute towards the combined focus of improving the health of the communities we serve as follows:

•The Financial Health reporting segment focuses on providing business management, consulting, and managed IT services along with a complete RCM solution for all care settings, regardless of their primary healthcare information solutions provider.

•The Patient Care segment provides comprehensive acute care EHR solutions and related services for community hospitals and their physician clinics. The Patient Care segment also offers comprehensive patient engagement and empowerment technology solutions to improve patient outcomes and engagement strategies with care providers.

Our companies currently support community hospitals and other healthcare systems with a geographically diverse patient mix within the domestic community healthcare market. Our target market for our Financial Health and Patient Care solutions includes community hospitals with fewer than 400 acute care beds and their clinics, as well as independent or small to medium sized chains of skilled nursing facilities. Approximately 98% of our Patient Care hospital customer base is comprised of hospitals with fewer than 100 beds.

See Note 18 to the consolidated financial statements included herein for additional information on our two reportable segments.

Management Overview

Strategy

Our core strategy is to achieve meaningful long-term revenue growth by cross-selling Financial Health services into our existing Patient Care customer base, expanding Financial Health market share with sales to new community hospitals and larger health systems, and pursuing competitive Patient Care takeaway opportunities. We may also seek to grow through acquisitions of businesses, technologies or products if we determine that such acquisitions are likely to help us meet our strategic goals.

Our growth strategy is heavily dependent on our ability to cross-sell Financial Health services to our Patient Care customer base. As such, retention of our existing Patient Care customers is a key component of our long-term growth strategy by protecting this base of potential Financial Health customers, while at the same time serving as a leading indicator of our market position and stability of revenues and cash flows.

We determine retention rates by reference to the amount of beginning-of-period Patient Care recurring revenues that have not been lost due to customer attrition from our production environment customer base. Production environment customers are those that are using our applications to document live patient encounters, as opposed to legacy environment customers that have view-only access to historical patient records. Since 2019, these retention rates have consistently remained in the mid-to-high 90th percentile ranges. Specifically, we achieved retention rates between 92.1% and 98.2% in 2021 through 2025, as EHR product consolidation has led to an increase in attrition from our non-flagship products during recent years (retention for our flagship EHR product was approximately 97.2% in 2025). We have increased customer retention efforts by enhancing support services, investing in tooling and instrumentation to proactively monitor for potential disruptions, and deploying in-application experience software that delivers application-specific insights while using our products.

As we pursue meaningful long-term revenue growth by leveraging Financial Health as a growth agent, we are placing ever-increasing value in further developing our already significant recurring revenue base to further stabilize our revenues and cash flows. As such, maintaining and growing recurring revenues are key components of our long-term growth strategy, aided by the aforementioned focus on customer retention. This includes a renewed focus on driving demand for subscriptions for our existing technology solutions and expanding the footprint for Financial Health services beyond our Patient Care customer base.

While the combination of revenue growth and operating leverage is expected to result in increased margin realization, we also look to increase margins through specific cost containment measures where appropriate as we continue to leverage opportunities for greater operating efficiencies.

Industry Dynamics

Turbulence in the U.S. and worldwide economies and financial markets impacts almost all industries. While the healthcare industry is not immune to economic cycles, we believe it is more significantly affected by U.S. regulatory and national health initiatives. In recent years, there have been significant changes to provider reimbursement by the U.S. federal government, followed by commercial payers and state governments. There is increasing pressure on healthcare organizations to reduce costs and increase quality while replacing the fee-for-service reimbursement model in part by enrolling in an advanced payment model that incentivizes high-quality, cost effective-care via value-based reimbursement. This pressure could further encourage adoption of healthcare IT and increase demand for business management, consulting, and managed IT services, as the future success of these healthcare providers is greatly dependent upon their ability to engage patient populations and to coordinate patient care across a multitude of settings, while optimizing operating efficiency along the way.

Additionally, healthcare organizations with a large dependency on Medicare and Medicaid populations, such as community hospitals, have been affected by the challenging financial condition of the federal government and many state governments and government programs. Accordingly, we recognize that prospective hospital clients often do not have the necessary capital to make investments in information technology while those with the necessary capital have become more selective in their investments. Despite these challenges, we believe healthcare IT will be an area of continued investment due to its unique potential to improve safety and efficiency and reduce costs while meeting current and future regulatory, compliance and government reimbursement requirements.

Patient Care License Model Preferences

Much of the variability in our periodic revenues and profitability has been and will continue to be due to changing demand for different license models for our technology solutions, with variability in operating cash flows further impacted by the financing decisions within those license models. Our technology solutions are generally deployed in one of two license models: (1) perpetual licenses, for which the related revenue is recognized effectively upon installation, and (2) “Software as a Service” or “SaaS” arrangements, including our Cloud Electronic Health Record (“Cloud EHR”) offering, which generally result in revenue being recognized monthly as the services are provided over the term of the arrangement.

The overwhelming majority of our historical Patient Care installations have been under a perpetual license model, but customer demand has dramatically shifted towards a SaaS license model in the past several years. SaaS license models made up only 12% of annual new acute care Patient Care installations in 2018, increasing to 100% during 2022 through 2025. These SaaS offerings are attractive to our clients because this configuration allows them to obtain access to advanced software products without a significant initial capital outlay. We expect this trend to continue for the foreseeable future, with the resulting impact on the Company’s financial statements being reduced Patient Care revenues in the period of installation in exchange for

increased recurring periodic revenues (reflected in Patient Care revenues) over the term of the SaaS arrangement. This naturally places downward pressure on short-term revenue growth and profitability metrics, but benefits long-term revenue growth and profitability which, in our view, is consistent with our goal of delivering long-term shareholder value.

For customers electing to purchase our technology solutions under a traditional perpetual license, we have historically made financing arrangements available on a case-by-case basis, depending on the various aspects of the proposed contract and customer attributes. These financing arrangements have comprised the majority of our perpetual license installations over the past several years, and include short-term payment plans and longer-term lease financing through us or third-party financing companies. The aforementioned shift in customer preference towards SaaS arrangements has significantly reduced the frequency of new financing arrangements for customer purchases under a perpetual license. When combined with scheduled payments on existing financing arrangements, the reduced frequency of new financing arrangements has resulted in a substantial reduction in financing receivables during 2025.

For those perpetual license clients not seeking a financing arrangement, the payment schedule of the typical contract is structured to provide for a scheduling deposit due at contract signing, with the remainder of the contracted fees due at various stages of the installation process (delivery of hardware, installation of software and commencement of training, and satisfactory completion of a monthly accounting cycle or end-of-month operation by each respective application, as applicable).

Margin Optimization Efforts

Our core growth strategy includes margin optimization by identifying opportunities to further improve our cost structure by executing against initiatives related to organizational realignment, expanded use of offshore resources and the use of automation to increase the efficiency and value of our associates' efforts. Specifically, since 2021, we have implemented a reduction in force intended to more effectively align our resources with business priorities and the Scaled Agile Framework® throughout our EHR product development, implementation and support functions to enhance cohesion, time-to-market and customer satisfaction. This framework is a set of organization and workflow patterns intended to guide enterprises in scaling lean and agile practices and promote alignment, collaboration, and delivery across large numbers of agile teams.

Additionally, margin optimization initiatives of expanded utilization of offshore resources and automation have commenced and, to date, have provided meaningful efficiencies to our operations, particularly within the Financial Health business. As a service organization, Financial Health's cost structure is heavily dependent upon human capital, subjecting it to the complexities and risks associated with this resource. Chief among these complexities and risks is the ever-present pressure of wage inflation, which has compelled the Company to make compensation adjustments that are outside of historical norms. Prior to our October 2023 acquisition of Viewgol, we were solely reliant upon third-party partnerships for offshore resources, increasing both the execution risk of this initiative and the related cost of scaling this labor force. Since taking over the operations of Viewgol following the Earnout period in 2025, we have greatly enhanced our control over the resource availability for this initiative and we expect to achieve meaningful per-unit cost efficiencies.

We believe that our efforts towards margin optimization are well-timed, enabling a rapid response to actual or expected wage inflation in order to preserve Financial Health profitability, but we cannot guarantee that these efforts will fully eliminate any related margin deterioration.

In addition to wage inflation, we are a party to contracts with certain third-party suppliers and vendors that allow for annual price adjustments indexed to inflation. While we continually seek to proactively manage controllable expenses, inflationary pressure on costs has led to, and could lead to, erosion of margins.

2025 Financial Overview

We generated revenues of $346.8 million from the sale of our products and services during 2025, compared to $342.2 million during 2024. The increase was primarily due to incremental revenue generated from new bookings across both segments, partially offset by customer attrition. Net income (loss) increased by $25.3 million to a net income of $4.4 million during 2025, compared to a net loss of $20.9 million during 2024. This was driven by an increase in operating income of $14.5 million primarily due to (i) revenue growth, (ii) reduction in costs due to the global offshore initiative and labor cost optimization, (iii) lower severance and other non-recurring charges, and (iv) lower depreciation and amortization, including $2.9 million of accelerated amortization of software development costs associated with the sunset of one of the Company’s products in the second quarter of 2024. In addition, interest expense declined by $3.9 million. Corresponding to this increased profitability, net cash provided by operating activities increased by $5.8 million, from $31.1 million provided by operations during 2024 to $37.0 million provided by operations during 2025. Total investment in capital expenditures, excluding proceeds from sale of property and equipment, decreased by $1.0 million, or 5%, to $17.1 million during 2025, compared to $18.1 million during 2024. Total capitalized software development costs decreased by $0.7 million, or 4%, compared to 2024, driven by reductions in product development labor and offshore cost through optimization initiatives. Purchases of property and equipment decreased by $0.3 million, or 20%, from the prior year period due to fewer purchases of computer equipment.

Results of Operations

The following table sets forth certain items included in our results of operations for each of the three years in the period ended December 31, 2025, expressed as a percentage of our total revenues for these periods:


	Year ended December 31,
	2025				2024				2023
(In thousands)	Amount		% Sales		Amount		% Sales		Amount		% Sales
INCOME DATA:
Revenues:
Financial Health	$	221,657	63.9	%	$	217,366	63.5	%	$	193,334	57.4	%
Patient Care	125,179		36.1	%	124,839		36.5	%	143,630		42.6	%
Total revenues	346,836		100.0	%	342,205		100.0	%	336,964		100.0	%
Expenses
Costs of revenue (exclusive of amortization and depreciation)
Financial Health	113,891		32.8	%	116,738		34.1	%	109,881		32.6	%
Patient Care	49,083		14.2	%	52,182		15.2	%	65,682		19.5	%
Total costs of revenue (exclusive of amortization and depreciation)	162,974		47.0	%	168,920		49.4	%	175,563		52.1	%
Product development	32,557		9.4	%	35,449		10.4	%	38,827		11.5	%
Sales and marketing	23,509		6.8	%	25,907		7.6	%	27,531		8.2	%
General and administrative	80,687		23.3	%	76,992		22.5	%	76,153		22.6	%
Amortization	25,185		7.3	%	27,220		8.0	%	24,377		7.2	%
Depreciation	1,092		0.3	%	1,346		0.4	%	1,946		0.6	%
Goodwill impairment	—		—	%	—		—	%	35,913		10.7	%
Trademark impairment	—		—	%	—		—	%	2,342		0.7	%
Total expenses	326,004		94.0	%	335,834		98.1	%	382,652		113.6	%
Operating income (loss)	20,832		6.0	%	6,371		1.9	%	(45,688)		(13.6)	%
Other income (expense):
Other income (expense)	(4,647)		(1.3)	%	(670)		(0.2)	%	745		0.2	%


Interest expense	(12,316)		(3.6)	%	(16,169)		(4.7)	%	(12,521)		(3.7)	%
Total other expense	(16,963)		(4.9)	%	(16,839)		(4.9)	%	(11,776)		(3.5)	%
Income (loss) before taxes	3,869		1.1	%	(10,468)		(3.1)	%	(57,464)		(17.1)	%
Provision (benefit) for income taxes	(485)		(0.1)	%	10,477		3.1	%	(9,331)		(2.8)	%
Net income (loss)	$	4,354	1.3	%	$	(20,945)	(6.1)	%	$	(48,133)	(14.3)	%

2025 Compared to 2024

Revenues

Total revenues for the year ended December 31, 2025 increased by $4.6 million, or 1%, compared to the year ended December 31, 2024.

Total revenues were comprised of the following for the years ended December 31, 2025 and 2024:


	Year ended December 31,
(In thousands)	2025		2024
Recurring revenues
Financial Health	$	217,783	$	212,054
Patient Care	109,370		111,325
Total recurring revenues	327,153		323,379
Non-recurring revenues
Financial Health	3,874		5,312
Patient Care	15,809		13,514
Total non-recurring revenues	19,683		18,826
Total revenues	$	346,836	$	342,205

Financial Health revenues increased by $4.3 million, or 2%, compared to 2024. Recurring Financial Health revenues increased by $5.7 million compared to the prior year period, primarily due to an increase in revenue generated by bookings, partially offset by customer attrition. Non-recurring Financial Health revenues decreased by $1.4 million, primarily due to fewer short-term consulting projects compared to the prior year period.

Patient Care revenues increased by $0.3 million, or 0%, from the prior year period, primarily due to an increase in revenue from EHR installations, new SaaS contracts, and migrations to SaaS arrangements, partially offset by the impact of the sunset of our Centriq product and the sale of AHT. Centriq and AHT revenue accounted for $3.6 million in 2025, compared to $8.6 million in 2024. Patient Care revenue excluding Centriq and AHT was $121.6 million in 2025, up 5% from $116.3 million in 2024. Recurring Patient Care revenues decreased by $2.0 million, or 2%, compared to 2024. The decrease was driven by the decline in revenue due to the Centriq sunset and customer attrition in the Patient Engagement business, partially offset by revenue generated by bookings. Non-recurring Patient Care revenues increased by $2.3 million, or 17%, compared to 2024. This increase was due to an increase in installation revenue from new contracts.

Costs of Revenue (exclusive of amortization and depreciation)

Total costs of revenue (exclusive of amortization and depreciation) decreased by $5.9 million compared to 2024. As a percentage of total revenues, costs of revenue (exclusive of amortization and depreciation) decreased to 47% during 2025 compared to 49% during 2024.

Costs associated with our Financial Health revenues decreased by $2.8 million, or 2%, compared to 2024, driven by a reduction in domestic labor costs as a result of the transition to the global workforce and the effects of the 2024 cost optimization initiative.

Costs associated with our Patient Care revenues decreased by $3.1 million, or 6%, compared to 2024, primarily due to cost optimization efforts including reductions to labor costs, software costs, and travel expense.

Product Development

Product development expenses consist primarily of compensation and other employee-related costs (including stock-based compensation) and infrastructure costs incurred, but not capitalized, for new product development and product enhancements. Product development costs decreased by $2.9 million, or 8%, compared to 2024, primarily due to reductions in labor, offshore, and cloud expenses as a result of cost optimization initiatives.

Sales and Marketing

Sales and marketing costs decreased by $2.4 million, or 9%, compared to 2024, driven by lower commissions due to the product mix of bookings.

General and Administrative

General and administrative expenses increased by $3.7 million, or 5%, compared to 2024. The increase was mainly driven by increased payroll and stock-based compensation and professional service fees, partially offset by a decrease in severance and lower bad debt expense.

Amortization & Depreciation

Combined amortization and depreciation expense decreased by $2.3 million, or 8%, primarily due to $2.9 million of accelerated amortization of software development costs associated with the sunset of one of the Company’s products in the second quarter of 2024.

Total Other Expense

Total other expense of $17.0 million in 2025 increased from $16.8 million in 2024. The increase was driven by a $4.0 million increase to other expense driven by change in fair value of contingent consideration. This was partially offset by a decrease in loss on real estate sale in 2024, and a $3.9 million reduction in interest expense, primarily from lower debt.

Income (Loss) Before Taxes

As a result of the foregoing factors, income (loss) before taxes improved to income of $3.9 million in 2025, compared to a loss of $10.5 million in 2024.

(Benefit) Provision for Income Taxes

Our effective income tax rates for 2025 and 2024 were (13)% and (100%), respectively. Our effective tax rate for 2025 was primarily impacted by changes in the federal and state valuation allowances and research and development tax credits recorded on deferred tax assets as of December 31, 2025. This valuation allowance is recorded as, in the judgment of management, the deferred tax assets are not more likely than not to be realized.

Net Income (Loss)

Net Income (loss) for 2025 improved by $25.3 million to income of $4.4 million, or $0.29 per basic and diluted share, compared to a loss of $20.9 million, or a loss of $1.41 per basic and diluted share, for 2024.

Supplemental Segment Information

Our reportable segments have been determined in accordance with ASC 280 - Segment Reporting. We have two reportable operating segments: Financial Health and Patient Care. We evaluate each of our two operating segments based on segment revenues and segment adjusted EBITDA.

Adjusted EBITDA consists of GAAP net income (loss) as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangible assets; (iv) stock-based compensation; (v) severance and other non-recurring charges; (vi) interest expense and other income, net; (vii) impairment of goodwill; (viii) impairment of trademark intangibles; (ix) change in fair value of contingent consideration; (x) loss (gain) on disposal of property and equipment; (xi) gain on sale of AHT; and (xii) the (benefit) provision for income taxes. The segment measurements provided to and evaluated by the chief operating decision maker ("CODM") are described in Note 18 to the consolidated financial statements. These results should be considered in addition to, and not as a substitute for, results reported in accordance with GAAP.

The following table presents a summary of the revenues and Adjusted EBITDA of our two operating segments for the years ended December 31, 2025 and 2024.


	Year Ended December 31,				Change
	2025		2024		$		%
(In thousands)
Revenues by segment:
Financial Health	$	221,657	$	217,366	$	4,291	2	%
Patient Care	125,179		124,839		340		—	%


Adjusted EBITDA by segment:
Financial Health	$	39,978	$	36,845	$	3,133	9	%
Patient Care	28,691		19,054		9,637		51	%

Segment Revenues

Refer to the corresponding discussion of revenues for each of our reportable segments previously provided under the Revenues heading of this Management's Discussion and Analysis. There are no intersegment revenues to be eliminated in computing segment revenue.

Segment Adjusted EBITDA - Year Ended December 31, 2025 Compared with Year Ended December 31, 2024

Financial Health Adjusted EBITDA increased by $3.1 million, or 9%, compared to 2024. This increase was due to year over year growth from new bookings and a reduction in domestic labor costs as a result of the transition to the global workforce, partially offset by increased product development and administrative costs.

Patient Care Adjusted EBITDA increased by $9.6 million, or 51%, compared to 2024. This increase was primarily a result of an increase in installation and SaaS revenues and cost optimization efforts across labor costs, software costs, travel expense and product development expense.

2024 Compared to 2023

For a discussion and analysis of changes in financial condition and results of operations for the year ended December 31, 2024 as compared to the year ended December 31, 2023, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 2024, filed with the SEC on March 17, 2025.

Liquidity and Capital Resources

Sources of Liquidity

As of December 31, 2025, our principal sources of liquidity consisted of cash and cash equivalents of $24.9 million and our remaining borrowing capacity under the revolving credit facility of $82.5 million, compared to $12.3 million of cash and cash equivalents and $43.6 million of remaining borrowing capacity under the revolving credit facility as of December 31, 2024. In January 2016, we entered into a syndicated credit agreement which provided for a $125 million term loan facility and a $50 million revolving credit facility. On June 16, 2020, we entered into an Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $185 million, which included a $75 million term loan facility and a $110 million revolving credit facility. On May 2, 2022, we entered into a First Amendment to the Amended Restated Credit Agreement that further increased the aggregate principal amount of our credit facilities to $230 million, which included a $70 million term loan facility and a $160 million revolving credit facility. On November 25, 2025, we entered into a further Amended and Restated Credit Agreement (the “Amended Credit Agreement”; capitalized terms used but not defined herein shall have the meanings ascribed to them in the Amended Credit Agreement). The Amended Credit Agreement includes a five-year term that matures in November 2030 and increased the aggregate principal amount of our credit facilities to $250 million, including a $70 million term loan facility and a $180 million revolving credit facility. The Amended Credit Agreement provides incremental facility capacity of $75 million, subject to certain conditions.

As of December 31, 2025, we had $166.6 million in principal amount of indebtedness outstanding under the credit facilities. We believe that our cash and cash equivalents of $24.9 million as of December 31, 2025, our future operating cash flows, and

our remaining borrowing capacity under the revolving credit facility of $82.5 million as of December 31, 2025, taken together, provide adequate resources to fund ongoing cash requirements for the next twelve months and beyond. We cannot provide assurance that our actual cash requirements will not be greater than we expect as of the date of filing of this Annual Report on Form 10-K. If sources of liquidity are not available or if we cannot generate sufficient cash flow from operations during the next twelve months, we may be required to obtain additional sources of funds through additional operational improvements, capital market transactions, asset sales or financing from third parties, a combination thereof or otherwise. We cannot provide assurance that these additional sources of funds will be available or, if available, would have reasonable terms.

Additionally, the Amended Credit Agreement requires compliance with a consolidated net leverage ratio test and a fixed charge coverage ratio test. The calculation of the fixed charge coverage ratio was amended on March 10, 2023, and the Company received waivers of the Company’s failure to comply with the fixed charge coverage ratio as an event of default as of September 30, 2023 and December 31, 2023 from Regions Bank, as administrative agent, and various other lenders. The Company’s management has implemented enhanced financial forecasting and covenant‑monitoring procedures, increased the frequency of lender communications, strengthened executive monitoring over liquidity planning, and adopted cost‑management initiatives intended to maintain adequate covenant cushions, but there is no guarantee that the Company will remain in compliance or obtain amendments to avoid future covenant violations. Any failure by us to comply with the ratios or another covenant may result in an event of default, which may require us to obtain additional sources of funds as described above.

Aside from normal operating cash requirements, obligations under our Credit Agreement (as discussed below) and operating leases, and opportunistic uses of capital in share repurchases and business acquisition transactions, we do not have any material cash commitments or planned cash commitments. Although the Company currently has no obligations related to planned acquisitions, the Company's strategy includes the potential for future acquisitions, which may be funded through draws on the credit facilities or the use of the other sources of liquidity described above.

Operating Cash Flow Activities

Net cash provided by operating activities increased by $5.8 million from $31.1 million for 2024 to $37.0 million for 2025, as the Company’s net income (loss) increased by $25.3 million. The increase in cash flows provided by operations was primarily driven by the increased collections from improved working capital management partially offset by the timing of income tax payments.

Investing Cash Flow Activities

Net cash used in investing activities was $14.7 million during 2025, compared to net cash provided by investing activities of $5.1 million during 2024. Net cash used in investing activities reflects investments in software development of $15.8 million and purchases of property and equipment of $1.3 million, partially offset by sale of business of $2.1 million and sale of property and equipment of $0.3 million. Net cash provided by investing activities for 2024 included proceeds from sale of business of $21.4 million and property and equipment of $2.5 million, partially offset by investments in software development of $16.5 million and purchases of property and equipment of $1.6 million.

Financing Cash Flow Activities

During 2025, our financing activities were a net use of cash in the amount of $9.7 million, as long-term debt principal payments of $189.0 million and $1.9 million used to repurchase shares of our common stock (to fund required tax withholding related to the vesting of restricted stock) were partially offset by $112.9 million in borrowings from our revolving line of credit and $68.4 million in net proceeds from long-term debt. During 2024, our financing activities were a net use of cash in the amount of $27.7 million, as long-term debt principal payments of $56.3 million and $0.4 million used to repurchase shares of our common stock (to fund required tax withholding related to the vesting of restricted stock) were partially offset by $29.5 million in borrowings from our revolving line of credit.

Stock Repurchases

On September 4, 2020, our Board of Directors approved a stock repurchase program to repurchase up to $30.0 million in aggregate amount of the Company's outstanding shares of common stock through open market purchases, privately-negotiated transactions, or otherwise in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended. On July 27, 2022, our Board of Directors extended the expiration of the stock repurchase program to September 4, 2024. The share repurchase program expired according to its terms on September 4, 2024. These shares could be purchased from time to time throughout the duration of the stock repurchase program depending upon market conditions. Our ability to repurchase any shares in future periods is subject to approval of a new repurchase program by our Board of Directors and compliance with the terms of our Amended and Restated Credit Agreement. Concurrent with the authorization of this stock repurchase program in September 2020, the Board of Directors opted to indefinitely suspend all quarterly dividends.

Common Stock Rights Agreement

On March 26, 2024, the Board of Directors declared a dividend of one right (a “Right”) for each of the Company’s issued and outstanding shares of common stock. The dividend was paid to the stockholders of record at the close of business on April 4, 2024. The complete description and terms of the Rights were set forth in the Rights Agreement, dated as of March 26, 2024, by and between the Company and ComputerShare Trust Company, N.A. as rights agent, as amended by the Amendment to the Rights Agreement dated as of April 22, 2024 (as amended, the “Rights Agreement”). On February 11, 2025, the Company and Computershare Trust Company, N.A. entered into the Second Amendment to the Rights Agreement. The amendment terminated the Rights Agreement by accelerating the expiration time of the Rights Agreement to expire on February 12, 2025. At the time of the termination of the Rights Agreement, all of the Rights, which were previously distributed to holders of the Company’s issued and outstanding common stock, par value $0.001, pursuant to the Rights Agreement, expired.

Each Right initially entitled the registered holder, subject to the terms of the Rights Agreement, to purchase from the Company one half of a share of common stock, at an exercise price of $28.00 for each one half of a share of common stock (equivalent to $56.00 for each whole share of common stock), subject to certain adjustments. The Rights would only become exercisable upon the occurrence of certain events as described in the Rights Agreement, which did not occur prior to the Rights expiring on February 12, 2025.

The Company analyzed the terms governing the Rights under ASC 480, Distinguishing Liabilities from Equity, and concluded that the Rights were a freestanding financial instrument that qualified for liability classification. Specifically, the provisions within the Rights Agreement provided for scenarios outside of the Company’s control that could require the Company to settle a portion of the Rights in cash, rather than in shares of common stock.

Credit Agreement

As of December 31, 2025, we had $69.1 million in principal amount outstanding under the term loan facility and $97.5 million in principal amount outstanding under the revolving credit facility. Each of our credit facilities bears interest at a rate per annum equal to an applicable margin plus, at our option, either (1) Term SOFR for the relevant interest period, subject to a floor of 0.0%, (2) an alternate base rate determined by reference to the greater of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). The applicable margin for SOFR loans and the letter of credit fee ranges from 1.5% to 3.0%. The applicable margin for base rate loans ranges from 0.5% to 2.0%, in each case based on the Company's consolidated net leverage ratio.

Principal payments with respect to the term loan facility are due on the last day of each fiscal quarter beginning December 31, 2025, with quarterly principal payments of approximately $0.9 million through September 30, 2030, and the outstanding principal balance due on the term loan maturity date of November 25, 2030, or such earlier date as such obligations may become due and payable pursuant to the terms of the Amended Credit Agreement. Any principal outstanding under the revolving credit facility is due and payable on the revolving loan maturity date of November 25, 2030, or such earlier date as such obligations may become due and payable pursuant to the terms of the Amended Credit Agreement.

Our credit facilities under the Amended Credit Agreement are secured pursuant to the Amended and Restated Pledge and Security Agreement, dated as of November 25, 2025, among the parties identified as obligors therein and Regions, as collateral agent, on a first priority basis by a security interest in substantially all of the tangible and intangible assets (subject to certain exceptions) of the Company and certain subsidiaries of the Company, as guarantors (collectively, the “Subsidiary Guarantors”), including certain registered intellectual property and the capital stock of certain of the Company’s direct and indirect subsidiaries. Our obligations under the Amended Credit Agreement are also guaranteed by the Subsidiary Guarantors. Refer to Note 13 of the consolidated financial statements included herein for additional detail regarding our credit facilities.

Bookings

Bookings is a key operational metric used by management to assess the relative success of our sales generation efforts, and were as follows for the years ended December 31, 2025 and 2024, respectively:


(In thousands)	2025		2024
Financial Health(1)	$	47,727	$	48,860
Patient Care(2)	35,201		33,214
Total Bookings	$	82,928	$	82,074

(1) Generally calculated as the annual contract value
(2) Generally calculated as the total contract value for system sales and SaaS, and annual contract value for maintenance and support

Financial Health bookings during 2025 decreased by $1.1 million, or 2%, compared to 2024, driven by a reduction of net-new bookings of $8.0 million, partially offset by an increase in cross-sell bookings of $6.9 million, primarily from the Encoder solution. The reduction in net-new bookings included a decrease in Viewgol bookings of $0.4 million.

Patient Care bookings during 2025 increased by $2.0 million, or 6%, compared to 2024. This increase was primarily driven by acute care net-new bookings, which increased by $4.5 million, or 48%, offset by cross-sell bookings, which decreased by $2.5 million, or 10%, compared to 2024.

“Net-new bookings” represent bookings from outside the Company’s core client base, and “cross-sell bookings” represent bookings from existing customers. In each case, such bookings are generally comprised of recurring revenues to be recognized ratably over a twelve-month period and an average timeframe for bookings-to-revenue conversion of four to six months following contract execution.

Annual Contract Value

Effective January 2025, the Company began providing bookings on an Annual Contract Value (“ACV”) basis in addition to the reported bookings amounts, which has historically represented a mix of ACV and Total Contract Value (“TCV”) for Patient Care bookings. This new methodology of reporting total bookings at ACV represents the newly contracted revenue that is expected to be recognized over a twelve-month period. Over the course of 2025, the Company has provided total bookings under both methodologies for year-over-year comparability before fully transitioning to ACV in 2026.

The table below represents bookings using the ACV methodology for the year ended December 31, 2025:


(In thousands)	2025
Financial Health	47,727
Patient Care	23,162
Total bookings	$	70,889

Reported bookings may be subject to adjustments and potential cancellations prior to the satisfaction of the obligations to our customers. Our metrics may vary significantly from period to period for reasons unrelated to our operating performance and may differ from similarly titled measures presented by other companies.

Critical Accounting Policies and Estimates

General

Our discussion and analysis of our financial condition and results of operations are based on our financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States of America. We are required to make some estimates and judgments that affect the preparation of these financial statements. We base our estimates on historical experience and on various other assumptions that we believe to be reasonable under the circumstances, but actual results may differ from these estimates under different assumptions or conditions.

Revenue Recognition

Revenue is recognized upon transfer of control of promised products or services to clients in an amount that reflects the consideration we expect to receive in exchange for those products and services. We enter into contracts that can include various combinations of products and services, which are generally distinct and accounted for as separate performance obligations. The Company employs the 5-step revenue recognition model under ASC 606, Revenue from Contracts with Customers, to: (1) identify the contract with the client, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when (or as) the entity satisfies a performance obligation. Refer to Note 2 to the consolidated financial statements included herein for further discussion regarding our revenue recognition policies and significant judgments involved in our application of ASC 606. Although we believe that our approach to estimates and judgments regarding revenue recognition is reasonable, actual results could differ and we may be exposed to increases or decreases in revenue that could be material.

Business Combinations, including Purchased Intangible Assets

The Company accounts for business combinations at fair value. Acquisition costs are expensed as incurred and recorded in general and administrative expenses. Measurement period adjustments relate to adjustments to the fair value of assets acquired and liabilities assumed based on information that we should have known at the time of acquisition. All changes to purchase accounting that do not qualify as measurement period adjustments are included in current period earnings.

The fair value amount assigned to an intangible asset is based on an exit price from a market participant’s viewpoint, and utilizes data such as discounted cash flow analysis and replacement cost models. We review acquired intangible assets for impairment whenever events or changes in circumstances indicate that the carrying amount of such assets may not be recoverable.

Goodwill

Goodwill and other long‑lived assets represent a significant portion of the Company’s total assets. Goodwill represents the excess of consideration paid over the estimated fair value of the identifiable net tangible and intangible assets acquired in business combinations. Goodwill is not amortized and is evaluated for impairment at least annually as of October 1, or more frequently if events or changes in circumstances indicate that the carrying value of goodwill may not be recoverable.

We evaluate goodwill for impairment at the reporting unit level in accordance with ASC Topic 350, Intangibles – Goodwill and Other (“ASC 350”). The Company has identified two reporting units, Patient Care and Financial Health. All assets and liabilities are assigned to their respective reporting units based on management’s judgment.

ASC 350 permits an entity to first perform a qualitative assessment to determine whether it is more likely than not (a likelihood of greater than 50 percent) that the fair value of a reporting unit is less than its carrying amount. If the qualitative assessment indicates that it is more likely than not that the fair value of the reporting unit exceeds its carrying amount, no further testing is required. If the qualitative assessment indicates otherwise, a quantitative goodwill impairment test is performed, in which the estimated fair value of the reporting unit is compared to its carrying amount, including goodwill. An impairment charge is recognized for the amount by which the carrying amount exceeds fair value.

For the annual goodwill impairment assessment performed during the year ended December 31, 2025, the Company elected to perform a qualitative assessment. In performing this assessment, management considered relevant events and circumstances, including, but not limited to, macroeconomic conditions, industry and market considerations, trends in market capitalization and share price, cost factors, overall financial performance of the reporting units, changes in forecasts, Company‑specific events, and changes in the carrying amount of net assets. Based on this assessment, management concluded that it was more likely than not that the fair value of each reporting unit exceeded its respective carrying amount.

In evaluating the results of the qualitative assessment, management also considered the outcomes of prior quantitative goodwill impairment analyses, including the extent to which estimated fair values exceeded carrying values and the sensitivity of those valuations to changes in key assumptions. The most recent quantitative assessment indicated that the reporting units had reasonable headroom. The Company’s most recent quantitative goodwill impairment test was performed as of October 1, 2024, and utilized both income and market approaches to estimate the fair value of each reporting unit. Under each valuation approach, the estimated fair value exceeded the respective carrying value, and no impairment was recorded.

The determination of whether goodwill is impaired involves significant judgment and estimates, including the identification of reporting units, the assignment of assets and liabilities, the estimation of future cash flows, discount rates, growth assumptions, and market‑based valuation inputs. Given the substantial excess of fair value over carrying amounts, we believe the likelihood of obtaining materially different results based on a change of assumptions to be low.

Software Development Costs

Software development costs are accounted for in accordance with ASC 350-40, Internal-Use Software and ASC 985-20, Costs of Software to be Sold, Leased, or Marketed. Under ASC 350-40, software development costs related to preliminary project activities and post-implementation and maintenance activities are expensed as incurred. We capitalize direct costs related to application development activities that are probable to result in additional functionality according to ASC 350-40. Capitalized costs are amortized on a straight-line basis over five years. We test for impairment whenever events or changes in circumstances that could impact recoverability occur. Under ASC 985-20, costs incurred before technological feasibility are expensed as research and development. Costs incurred after technological feasibility and before the product is available for general release to customers are capitalized according to ASC 985-20. Capitalized costs are amortized based on the current and expected future revenue for each software solution with minimum annual amortization equal to the straight-line amortization over the estimated economic life of the solution, which is estimated to be five years. We periodically reassess the estimated economic life and the recoverability of our capitalized software costs. If we determine that capitalized amounts are not recoverable based on the expected net cash flows to be generated from sales of the applicable software solutions, the amount by which the unamortized capitalized costs exceed the net realizable value is written off as a charge to earnings.

Quantitative and Qualitative Disclosures about Market and Interest Rate Risk

Our exposure to market risk relates primarily to the potential fluctuations in the Secured Overnight Financing Rate ("SOFR") which replaced the British Bankers Association London Interbank Offered Rate ("LIBOR") as the benchmark interest rate for our credit facilities. We had $166.6 million of outstanding borrowings under our credit facilities with Regions Bank at December 31, 2025. The term loan facility and revolving credit facility bear interest at a rate per annum equal to an applicable margin plus, at our option, either (1) Term SOFR for the relevant interest period, subject to a floor of 0.0%, (2) an alternate base rate determined by reference to the greatest of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). Accordingly, we are exposed to fluctuations in interest rates on borrowings under our credit facilities. A one hundred basis point change in interest rate on our borrowings outstanding as of December 31, 2025 would result in a change in interest expense of approximately $1.7 million annually.

We did not have investments as of December 31, 2025. We do not currently utilize derivative financial instruments to manage our interest rate risks.

Recent Accounting Pronouncements

Reference is made to Note 2 to the consolidated financial statements for a discussion of accounting pronouncements that have been recently issued which we have not yet adopted.


ITEM 7A.			QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

The information required by this Item is contained in Item 7 herein under the heading "Quantitative and Qualitative Disclosures about Market and Interest Rate Risk."


ITEM 8.			FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

Index to Financial Statements



			Page


Report of KPMG LLP, Independent Registered Public Accounting Firm, (PCAOB ID Number 185) on Internal Control Over Financial Reporting			61

Report of KPMG LLP, Independent Registered Public Accounting Firm, on Consolidated Financial Statements			63

Report of Grant Thornton LLP, Independent Registered Public Accounting Firm, (PCAOB ID Number 248) on Consolidated Financial Statements			65

Consolidated Balance Sheets — December 31, 2025 and 2024			66

Consolidated Statements of Operations — Years ended December 31, 2025, 2024 and 2023			67

Consolidated Statements of Comprehensive Income (Loss) — Years ended December 31, 2025, 2024 and 2023			68

Consolidated Statements of Stockholders’ Equity — Years ended December 31, 2025, 2024 and 2023			69

Consolidated Statements of Cash Flows — Years ended December 31, 2025, 2024 and 2023			70

Notes to Consolidated Financial Statements			72

Index to Financial Statement Schedules

Schedule II — Valuation and Qualifying Accounts			109

All other schedules to the financial statements required by Article 9 of Regulation S-X are not applicable and therefore have been omitted.

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Stockholders and Board of Directors

TruBridge, Inc.:

Opinion on Internal Control Over Financial Reporting

We have audited TruBridge, Inc. and subsidiaries' (the Company) internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission. In our opinion, because of the effect of the material weaknesses, described below, on the achievement of the objectives of the control criteria, the Company has not maintained effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the consolidated balance sheet of the Company as of December 31, 2025, the related consolidated statements of operations, comprehensive income (loss), stockholders’ equity, and cash flows for the year ended December 31, 2025, and the related notes and financial statement schedule II (collectively, the consolidated financial statements), and our report dated March 30, 2026 expressed an unqualified opinion on those consolidated financial statements.

A material weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a material misstatement of the company’s annual or interim financial statements will not be prevented or detected on a timely basis. The material weaknesses related to the accounting for revenue recognition and related costs, capitalization of software development costs, and non-routine transactions have been identified and included in management’s assessment. The material weaknesses were considered in determining the nature, timing, and extent of audit tests applied in our audit of the 2025 consolidated financial statements, and this report does not affect our report on those consolidated financial statements.

Basis for Opinion

The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Management's Report on Internal Control Over Financial Reporting. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audit also included performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.

Definition and Limitations of Internal Control Over Financial Reporting

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

/s/ KPMG LLP

Atlanta, Georgia

March 30, 2026

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Stockholders and Board of Directors

TruBridge, Inc.:

Opinion on the Consolidated Financial Statements

We have audited the accompanying consolidated balance sheet of TruBridge, Inc. and subsidiaries (the Company) as of December 31, 2025, the related consolidated statements of operations, comprehensive income (loss), stockholders’ equity, and cash flows for the year ended December 31, 2025, and the related notes and financial statement schedule II (collectively, the consolidated financial statements). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2025, and the results of its operations and its cash flows for the year ended December 31, 2025, in conformity with U.S. generally accepted accounting principles.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the Company’s internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission, and our report dated March 30, 2026 expressed an adverse opinion on the effectiveness of the Company’s internal control over financial reporting.

Basis for Opinion

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these consolidated financial statements based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud. Our audit included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audit also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audit provides a reasonable basis for our opinion.

Critical Audit Matter

The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements that was communicated or required to be communicated to the audit committee and that: (1) relates to accounts or disclosures that are material to the consolidated financial statements and (2) involved our especially challenging, subjective, or complex judgments. The communication of a critical audit matter does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.

Revenue Recognition

As discussed in Note 2 to the consolidated financial statements, the Company recognizes revenue when control of the promised products or services is transferred to customers in an amount that reflects the consideration the Company expects to receive in exchange for those products or services. The Company derives revenue from multiple sources, including software licenses, Software-as-a-Service (SaaS) subscriptions, professional services, and support and maintenance arrangements. Revenue from these arrangements is recognized either at a point in time or overtime depending on the nature of the promised products or services and the contractual terms. Certain arrangements include implementation or professional services, hosted SaaS solutions, and ongoing support services, each of which may have different service delivery patterns.

We identified the evaluation of the timing of revenue recognition for certain revenue streams as a critical audit matter. Challenging auditor judgment was required to evaluate the Company’s determination of the timing of revenue recognition for these revenue streams because of the manual nature of the Company’s revenue recognition processes.

The following are the primary procedures we performed to address this critical audit matter. For certain revenue contracts, we assessed the timing of revenue recognition by reading the underlying customer agreements and evaluating the Company’s assessment of the contractual terms and conditions in accordance with revenue recognition requirements. For certain revenue transactions, we compared the amounts recognized for consistency with the underlying documentation, including contracts or payment and transaction support.

/s/ KPMG LLP

We have served as the Company’s auditor since 2025.

Atlanta, Georgia

March 30, 2026

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

Board of Directors and Stockholders

TruBridge, Inc.

Opinion on the financial statements

We have audited the consolidated balance sheet of TruBridge, Inc. (a Delaware corporation) and subsidiaries (the “Company”) as of December 31, 2024, and the related consolidated statements of operations, comprehensive income (loss), stockholders’ equity, and cash flows for the years ended December 31, 2024 and December 31,2023, and the related notes and financial statement schedule included under Item 15(a) (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2024, and the results of its operations and its cash flows for each of the two years in the period ended December 31, 2024, in conformity with accounting principles generally accepted in the United States of America.

Basis for opinion

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s consolidated financial statements based on our audits. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.


/s/ GRANT THORNTON LLP

We served as the Company’s auditor from 2004 to 2024.

Atlanta, Georgia
March 17, 2025 (except for Note 2 and Note 5, as to which the date is March 30, 2026)

TRUBRIDGE, INC.

CONSOLIDATED BALANCE SHEETS

(In thousands, except per share data)


	December 31, 2025		December 31, 2024
Assets
Current assets:
Cash and cash equivalents	$	24,850	$	12,324

Accounts receivable, net of allowance for credit losses of $6,003 and $5,861	54,970		52,952
Current portion of financing receivables, net of allowance for credit losses of $606 and $417	2,437		4,663
Inventories	623		767

Prepaid income taxes	7,240		2,991
Prepaid expenses and other current assets	14,078		19,386
Assets held for sale	445		606
Total current assets	104,643		93,689
Property and equipment, net	2,476		2,294
Software development costs, net	42,262		39,451
Operating lease right-of-use assets	2,010		3,092
Financing receivables, less current portion, net of allowance for credit losses of $256 and $21	494		232
Other assets, less current portion	13,553		7,786
Intangible assets, net	64,517		76,707
Goodwill	172,573		172,573

Total assets	$	402,528	$	395,824
Liabilities and Stockholders’ Equity
Current liabilities:
Accounts payable	$	19,554	$	15,040
Current portion of long-term debt	3,384		2,980
Current portion of deferred revenue	9,210		13,678
Accrued vacation	4,882		4,770
Income taxes payable	235		3,538
Other accrued liabilities	20,694		15,994

Total current liabilities	57,959		56,000
Long-term debt, less current portion	161,241		168,598
Operating lease liabilities, less current portion	1,346		2,293
Other long-term liabilities	1,438		—
Deferred tax liabilities	2,583		1,863
Total liabilities	224,567		228,754
Commitments and contingencies (Note 16)
Stockholders’ equity:
Common stock, $0.001 par value per share; 30,000 shares authorized; 15,677 shares issued at December 31, 2025 and 15,522 shares issued at December 31, 2024	15		15
Additional paid-in capital	209,727		201,066
Accumulated deficit	(12,223)		(16,577)
Accumulated other comprehensive (loss) income	(133)		45
Treasury stock, 689 shares at December 31, 2025 and 619 shares at December 31, 2024	(19,425)		(17,479)
Total stockholders’ equity	177,961		167,070
Total liabilities and stockholders’ equity	$	402,528	$	395,824

The accompanying notes are an integral part of these consolidated financial statements.

TRUBRIDGE, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

(In thousands, except per share data)


	Year ended December 31,
	2025		2024		2023
Revenues:
Financial Health	$	221,657	$	217,366	$	193,334
Patient Care	125,179		124,839		143,630
Total revenues	346,836		342,205		336,964
Expenses:
Costs of revenue (exclusive of amortization and depreciation):
Financial Health	113,891		116,738		109,881
Patient Care	49,083		52,182		65,682
Total costs of revenue (exclusive of amortization and depreciation)	162,974		168,920		175,563
Product development	32,557		35,449		38,827
Sales and marketing	23,509		25,907		27,531
General and administrative	80,687		76,992		76,153
Amortization	25,185		27,220		24,377
Depreciation	1,092		1,346		1,946
Goodwill impairment	—		—		35,913
Trademark impairment	—		—		2,342
Total expenses	326,004		335,834		382,652
Operating income (loss)	20,832		6,371		(45,688)
Other (expense) income:
Interest expense	(12,316)		(16,169)		(12,521)
Other (expense) income	(4,647)		(670)		745


Total other expense	(16,963)		(16,839)		(11,776)
Income (loss) before taxes	3,869		(10,468)		(57,464)
(Benefit) provision for income taxes	(485)		10,477		(9,331)
Net income (loss)	$	4,354	$	(20,945)	$	(48,133)
Net income (loss) per share - basic	$	0.29	$	(1.41)	$	(3.32)
Net income (loss) per share - diluted	$	0.29	$	(1.41)	$	(3.32)
Weighted average shares outstanding used in per common share computations:
Basic	14,488		14,300		14,187
Diluted	14,488		14,300		14,187

The accompanying notes are an integral part of these consolidated financial statements.

TRUBRIDGE, INC.

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)

(In thousands)


	Year ended December 31,
	2025		2024		2023
Net income (loss)	$	4,354	$	(20,945)	$	(48,133)
Other comprehensive income (loss):
Foreign currency translation adjustment	(178)		45		—
Comprehensive income (loss)	$	4,176	$	(20,900)	$	(48,133)

The accompanying notes are an integral part of these consolidated financial statements.

TRUBRIDGE, INC.

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY

(In thousands)


	Common Shares	Common Stock		Additional Paid-in Capital		Accumulated Earnings (Deficit)		Accumulated Comprehensive Income		Treasury Stock		Total Stockholders’ Equity
























































Balance at December 31, 2022	14,913	$	15	$	192,275	$	52,501	$	—	$	(14,500)	$	230,291
Net loss	—	—		—		(48,133)		—		—		(48,133)

Issuance of restricted stock	210	—		—		—		—		—		—
Forfeiture of restricted stock	(2)	—		—		—		—		—		—
Stock-based compensation	—	—		3,271		—		—		—		3,271
Treasury stock purchases	—	—		—		—		—		(2,575)		(2,575)
Balance at December 31, 2023	15,121	$	15	$	195,546	$	4,368	$	—	$	(17,075)	$	182,854
Net loss	—	—		—		(20,945)		—		—		(20,945)
Foreign currency translation adjustments	—	—		—		—		45		—		45

Issuance of restricted stock	503	—		—		—		—		—		—
Forfeiture of restricted stock	(102)	—		—		—		—		—		—
Stock-based compensation	—	—		5,520		—		—		—		5,520
Treasury stock purchases	—	—		—		—		—		(404)		(404)
Balance at December 31, 2024	15,522	$	15	$	201,066	$	(16,577)	$	45	$	(17,479)	$	167,070
Net income	—	—		—		4,354		—		—		4,354
Foreign currency translation adjustments	—	—		—		—		(178)		—		(178)

Issuance of restricted stock	205	—		—		—		—		—		—
Forfeiture of restricted stock	(50)	—		—		—		—		—		—
Stock-based compensation	—	—		8,661		—		—		—		8,661
Treasury stock purchases	—	—		—		—		—		(1,946)		(1,946)
Balance at December 31, 2025	15,677	$	15	$	209,727	$	(12,223)	$	(133)	$	(19,425)	$	177,961

The accompanying notes are an integral part of these consolidated financial statements.

TRUBRIDGE, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

(In thousands)


	Year ended December 31,
	2025		2024		2023
Operating Activities
Net income (loss)	$	4,354	$	(20,945)	$	(48,133)
Adjustments to net income (loss):
Provision for expected credit losses	3,002		3,669		1,920
Deferred taxes	716		2,205		(11,210)
Stock based compensation	8,661		5,520		3,271
Depreciation	1,092		1,346		1,946
Gain on sale of business	(53)		(1,529)		—
Amortization of acquisition-related intangibles	12,190		12,505		16,426
Amortization of software development costs	12,995		14,715		7,951
Amortization of deferred finance costs	512		504		359
Change in fair value of contingent consideration	5,000		(1,044)		—
Goodwill impairment	—		—		35,913
Trademark impairment	—		—		2,342
Loss on extinguishment of debt	304		—		—
(Gain) loss on disposal of property and equipment	(120)		3,895		117
Non-cash operating lease costs	1,106		2,273		1,602
Changes in operating assets and liabilities (net of acquired assets and liabilities):
Accounts receivable	(4,758)		895		(7,839)
Financing receivables	1,701		(68)		2,659
Inventories	144		(292)		309
Prepaid expenses and other assets	(2,956)		2,475		(6,698)
Accounts payable	4,965		3,734		3,075
Deferred revenue	(3,490)		2,557		(2,601)
Operating lease liabilities	(1,143)		(1,842)		(2,063)
Other liabilities	(167)		(2,411)		1,894
Income taxes, net	(7,089)		2,979		(1,762)
Net cash provided by operating activities	36,966		31,141		(522)
Investing Activities
Sale of business, net of cash and cash equivalents sold	2,102		21,410		—
Purchases of property and equipment	(1,321)		(1,643)		(346)
Proceeds from sale of property and equipment	300		2,475		—
Purchase of business, net of cash received	—		(664)		(36,705)
Investment in software development	(15,806)		(16,463)		(21,478)
Net cash (used in) provided by investing activities	(14,725)		5,115		(58,529)
Financing Activities

Proceeds from long-term debt	70,000		—		—
Payments of long-term debt principal	(57,250)		(7,500)		(3,500)
Proceeds from revolving line of credit	112,868		29,497		67,023
Payments of revolving line of credit	(131,784)		(48,803)		(5,000)
Debt issuance cost	(1,603)		(529)		—


Treasury stock purchases	(1,946)		(404)		(2,575)
Net cash (used in) provided by financing activities	(9,715)		(27,739)		55,948
Increase (decrease) in cash and cash equivalents	12,526		8,517		(3,103)
Change in cash and cash equivalents included in assets sold	$	—	$	(41)	$	—
Cash and cash equivalents at beginning of year	12,324		3,848		6,951
Cash and cash equivalents at end of year	$	24,850	$	12,324	$	3,848

Continued on following page.

TRUBRIDGE, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS - (Continued)

(In thousands)


	Year ended December 31,
	2025		2024		2023
Supplemental disclosure of cash flow information:
Cash paid for interest	$	14,117	$	16,222	$	9,298
Cash paid for income taxes, net of refunds	$	6,042	$	5,261	$	3,659

The accompanying notes are an integral part of these consolidated financial statements.

TRUBRIDGE, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

DECEMBER 31, 2025

1. NATURE OF OPERATIONS

Founded in 1979, TruBridge, Inc. (“TruBridge” or the “Company”) is a leading provider of healthcare solutions and services for community hospitals, their clinics and other healthcare systems. Previously named Computer Programs and Systems, Inc., the Company changed its name to TruBridge, Inc. on March 4, 2024 in a Company-wide rebranding and legal entity consolidation. Pursuant to this consolidation, the former wholly-owned subsidiaries Evident, LLC, TruBridge, LLC and TruCode LLC were merged into the parent company, while the former wholly-owned subsidiary Rycan Technologies, Inc. was merged into its parent and another wholly-owned subsidiary, Healthland Holding Inc. With these changes, the Company’s remaining legal structure includes TruBridge, Inc., the parent company, with Viewgol, LLC (“Viewgol”), TruBridge Healthcare Private Limited, iNetXperts, Corp. d/b/a Get Real Health, Healthcare Resource Group, Inc. (“HRG”), Healthland Holding Inc. (“HHI”), and Healthland, Inc., as its wholly-owned direct and indirect subsidiaries. Our combined companies are focused on helping improve the health of the communities we serve, connecting communities for a better patient care experience, and improving the financial operations of our customers.

•The Financial Health reporting segment focuses on providing business management, consulting, and managed IT services, along with a complete RCM solution for all care settings, regardless of their primary healthcare information solutions providers. This reporting segment includes the operation of Viewgol, TruBridge Healthcare Private Limited, HRG, HHI and Healthland.

•The Patient Care segment provides comprehensive acute care EHR solutions and related services for community hospitals and their physician clinics. In January 2024, the Company disposed of its interest in American HealthTech, Inc. (“AHT”), its post-acute care electronic health record (“EHR”) business, refer to Note 3 - Business Combinations and Disposals for more information. The Patient Care segment also offers comprehensive patient engagement and empowerment technology solutions to improve patient outcomes and engagement strategies with care providers.

2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Principles of Consolidation

The consolidated financial statements of TruBridge include the accounts of the Company and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated.

Cash and Cash Equivalents

Cash and cash equivalents can include time deposits and certificates of deposit with original maturities of three months or less that are highly liquid and readily convertible to a known amount of cash. These assets are stated at cost, which approximates market value, due to their short duration or liquid nature.

Presentation

Reportable Segments Presentation Changes

In May 2024, the Company realigned its reporting structure due to certain organizational changes. As a result, the Company changed from three reportable segments of (i) Revenue Cycle Management (“RCM”), (ii) Electronic Health Records (“EHR”), and (iii) Patient Engagement to two reportable segments of (i) RCM and (ii) EHR. The Patient Engagement segment results have been transitioned into the EHR segment. As part of the realignment, the reportable segment naming convention was updated. The previously reported RCM segment has been updated to Financial Health, and the former EHR segment has been updated to Patient Care. The change in reportable segments is intended to improve connectivity and alignment between the two business units to better serve our clients and more accurately reflect how the Company’s management views and operates the business. All prior segment information has been recast to reflect the Company's new segment structure and current period presentation. Refer to Note 18 - Segment Reporting for more information.

Revision of Previously Issued Financial Statements

During the preparation of the financial statements for the fiscal year ended December 31, 2025, the Company’s management identified immaterial misstatements affecting its previously issued consolidated financial statements as of and for the years ended December 31, 2024 and December 31, 2023, and the condensed consolidated financial statements for the quarters ended March 31, June 30, and September 30, 2025. These misstatements were related primarily to the timing of revenue recognition and associated contract costs, and the recognition of capitalized software development costs, as well as other unrelated immaterial misstatements. As a result, the Company made revisions to its previously issued consolidated financial statements for the years ended December 31, 2024 and December 31, 2023, filed within this Annual Report on Form 10-K, in order to recognize such revenues and costs in the appropriate fiscal year.

The Company assessed the materiality of these errors on the prior period consolidated financial statements in accordance with SEC Staff Accounting Bulletin (“SAB”) No. 99 (Topic 1M), “Materiality” and SAB No. 108 (Topic 1N), “Considering the Effects of Prior Year Misstatements when Quantifying Misstatements in the Current Year Financial Statements.” In its assessment, the Company concluded based on quantitative and qualitative analysis that these errors were not material to the Company’s consolidated financial statements for the 2025, 2024, and 2023 fiscal years or any interim periods therein.

As described above, the Company made corrections, as disclosed in the table below, to the consolidated financial statements as of and for the year ended December 31, 2024.


	2024
(In thousands, except per share data)	As previously reported		Impact of revision		As adjusted
Consolidated Statement of Operations
Revenue:
Financial Health	$	217,672	$	(306)	$	217,366
Patient Care	124,974		(135)		124,839
Total revenue	$	342,646	$	(441)	$	342,205
Costs of revenue (exclusive of amortization and depreciation):
Financial Health	116,891		(153)		116,738
Patient Care	51,640		542		52,182
Total costs of revenue (exclusive of amortization and depreciation)	$	168,531	$	389	$	168,920
Product development	34,456		993		35,449
Sales and marketing	27,059		(1,152)		25,907
Amortization	27,627		(407)		27,220
Operating income	6,635		(264)		6,371
Loss before taxes	(10,204)		(264)		(10,468)
Provision from income taxes	10,235		242		10,477
Net loss	(20,439)		(506)		(20,945)
Net loss per share - basic	$	(1.38)	$	(0.03)	$	(1.41)
Net loss per share - diluted	$	(1.38)	$	(0.03)	$	(1.41)

Consolidated Balance Sheet
Accounts receivable	$	53,753	$	(801)	$	52,952
Prepaid income taxes	2,886		105		2,991
Prepaid expenses and other current assets	15,275		4,111		19,386
Software development costs, net	41,474		(2,023)		39,451
Deferred revenue	10,653		3,025		13,678
Deferred tax liabilities	1,871		(8)		1,863
Accumulated deficit	(14,952)		(1,625)		(16,577)

Consolidated Statement of Equity
Net loss	$	(20,439)	$	(506)	$	(20,945)
Accumulated deficit	(14,952)		(1,625)		(16,577)

Consolidated Statement of Cash Flows
Net loss	$	(20,439)	$	(506)	$	(20,945)
Deferred taxes	1,859		346		2,205
Amortization of software development costs	15,122		(407)		14,715
Accounts receivable	94		801		895
Prepaid expenses and other assets	3,576		(1,101)		2,475
Deferred revenue	2,580		(23)		2,557
Income taxes, net	3,083		(104)		2,979
Investment in software development	(17,457)		994		(16,463)

As described above, the Company made corrections, as disclosed in the table below, to the consolidated financial statements for the year ended December 31, 2023.


	2023
(In thousands, except per share data)	As previously reported		Impact of revision		As adjusted
Consolidated Statement of Operations
Revenue:
Financial Health	$	192,325	$	1,009	$	193,334
Patient Care	143,630		—		143,630
Total revenue	$	335,955	$	1,009	$	336,964
Costs of revenue (exclusive of amortization and depreciation):
Financial Health	110,192		(311)		109,881
Patient Care	65,676		6		65,682
Total costs of revenue (exclusive of amortization and depreciation)	$	175,868	$	(305)	$	175,563
Product development	37,246		1,581		38,827
Sales and marketing	28,049		(518)		27,531
Amortization	24,522		(145)		24,377
Operating loss	(46,084)		396		(45,688)
Loss before taxes	(57,860)		396		(57,464)
Benefit from income taxes	(9,426)		95		(9,331)
Net loss	(48,434)		301		(48,133)
Net loss per share - basic	$	(3.34)	$	0.02	$	(3.32)
Net loss per share - diluted	$	(3.34)	$	0.02	$	(3.32)









Consolidated Statement of Equity
Net loss	$	(48,434)	$	301	$	(48,133)
Accumulated earnings (deficit)	5,487		(1,119)		4,368

Consolidated Statement of Cash Flows
Net loss	$	(48,434)	$	301	$	(48,133)
Deferred taxes	(11,305)		95		(11,210)
Amortization of software development costs	8,096		(145)		7,951
Accounts receivable	(7,839)		—		(7,839)
Prepaid expenses and other assets	(4,554)		(2,144)		(6,698)
Deferred revenue	(2,913)		312		(2,601)
Investment in software development	(23,059)		1,581		(21,478)

Accounts Receivable and Allowance for Credit Losses

Accounts receivable includes billed and unbilled receivables, net of allowance for credit losses. Billed accounts receivable are recorded at invoiced amounts and do not bear interest. Unbilled receivables relate to revenue earned in advance of invoicing per contractual terms with customers. The Company had $19.6 million and $15.4 million of unbilled accounts receivable, net of allowance for credit losses of $0.3 million and $0.1 million as of December 31, 2025 and December 31, 2024, respectively.

The Company establishes a general allowance for credit losses based on its historical collection experience, a review in each period of the aging status of the then-outstanding accounts receivable, and external market factors. To measure expected losses, account receivables are grouped by shared risk characteristics and the days past due. In the case of a bankruptcy filing or other similar event indicating the collectability of specific customer accounts is no longer probable, a specific allowance for credit losses may be recorded to reduce the related receivable to the amount expected to be recovered. Uncollectible receivables are written-off in the period that management believes it has exhausted its ability to collect payment from the customer.

Financing Receivables

Financing receivables are comprised of short-term payment plans and sales-type leases. Short-term payment plans are stated at the amount the Company expects to collect and do not bear interest. Sales-type leases are initially recorded at the present value of the related minimum lease payments.

An allowance for credit losses has been established for our financing receivables based on the historical level of customer defaults under such arrangements. In the case of a bankruptcy filing or other similar event indicating the collectability of specific customer accounts is no longer probable, a specific reserve may be recorded to reduce the related receivable to the amount expected to be recovered. Customer payments are considered past due if a scheduled payment is not received within contractually agreed upon terms, with amounts reclassified to accounts receivable when they become due. As a result, we evaluate the credit quality of our financing receivables on an ongoing basis utilizing an aging of receivables and write-offs, customer collection experience, the customer’s financial condition and known risk characteristics impacting the respective customer base, as well as existing economic conditions, to determine if any further allowance is necessary. Amounts are specifically charged off once all available means of collection have been exhausted.

Inventories

Inventories are stated at lower of cost or net realizable value using the average cost method. The Company’s inventories are comprised of computer equipment, forms and supplies.

Property and Equipment

Property and equipment is recorded at cost, less accumulated depreciation. Additions and improvements to property and equipment that materially increase productive capacity or extend the life of an asset are capitalized. Maintenance, repairs and minor renewals are expensed as incurred. Upon retirement or other disposition of such assets, the related costs and accumulated depreciation are removed from the respective accounts and any resulting gain or loss is included in the results of operations.

Depreciation expense is computed using the straight-line method over the asset’s useful life, which is generally 5 years for computer equipment, furniture, and fixtures and 30 years for buildings. Leasehold improvements are depreciated over the shorter of the asset’s useful life or the remaining lease term. The Company reviews for the possible impairment of long-lived assets whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Depreciation expense is included in operating expenses in the consolidated statements of operations.

Business Combinations

We apply business combination accounting when we acquire a business. Business combinations are accounted for at fair value. The associated acquisition costs are expensed as incurred and recorded in general and administrative expenses; restructuring costs associated with a business combination are expensed as incurred; contingent consideration is measured at fair value at the acquisition date, with changes in fair value after the acquisition date affecting earnings; changes in deferred tax asset valuation allowances and income tax uncertainties after the measurement period affect income tax expense; and goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired. The accounting for business combinations requires estimates and judgments as to expectations for future cash flows of the acquired business, and the allocation of those cash flows to identifiable intangible assets, in determining the estimated fair value for assets and liabilities acquired. The fair values assigned to tangible and intangible assets acquired and liabilities assumed, are based on management's estimates and assumptions, including valuations that utilize customary valuation procedures and techniques. If the actual results differ from the estimates and judgments used in these estimates, the amounts recorded in the financial statements could result in a possible impairment of the intangible assets and goodwill, or require acceleration of the amortization expense of finite-lived intangible assets. The results of the acquired businesses' operations are included in the consolidated statements of operations of the combined entity beginning on the date of the acquisition. We have applied this acquisition method to the transactions described in Note 3 - Business Combinations and Disposals.

Goodwill

Goodwill is recorded as the difference, if any, between the aggregate consideration paid for an acquisition and the fair value of the identifiable net tangible and intangible assets acquired. Goodwill is not amortized but is evaluated for

impairment annually or more frequently if indicators of impairment are present or changes in circumstances suggest that impairment may exist. We test annually for impairment as of October 1.

As part of our annual goodwill impairment test, we first assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If we conclude that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, we conduct a quantitative goodwill impairment assessment, which compares the fair value of the reporting unit with its carrying amount, including goodwill. If the carrying amount of the reporting unit exceeds its fair value, an impairment charge is recognized for the amount by which the carrying amount exceeds the total amount of goodwill allocated to that reporting unit. If the fair value of the reporting unit exceeds its carrying amount, the goodwill of the reporting unit is not considered to be impaired.

Purchased Intangible Assets

Purchased intangible assets are acquired in connection with a business acquisition, and are amortized over their estimated useful lives based on the pattern of economic benefit expected from each asset. We concluded for certain purchased intangible assets that the pattern of economic benefit approximated the straight-line method, and therefore, the use of the straight-line method was appropriate, as the majority of the cash flows will be recognized ratably over the estimated useful lives and there is no degradation of the cash flows over time.

We assess the recoverability of intangible assets whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recoverable. The carrying amount is not recoverable if it exceeds the undiscounted sum of cash flows expected to result from the use and eventual disposition of the asset. If the asset is not recoverable, the impairment loss is measured by the excess of the asset's carrying amount over its fair value. During the fourth quarter of 2023, the Company committed to the Company-wide rebranding and legal entity consolidation initiative that culminated in the change of the Company’s corporate name to “TruBridge, Inc.” on March 4, 2024. As a result of this initiative, it was expected that certain of the Company’s brand names and related trademarks would cease to be used, resulting in total trademark impairment recorded during the year ended December 31, 2023 of $2.3 million. Of the total trademark impairment charge, $1.0 million is derived from our Financial Health segment and $1.3 million is derived from our Patient Care segment.

We determined there was no impairment to purchased intangible assets as of December 31, 2025 and 2024.

Revenue Recognition

The Company recognizes revenue at the amount to which it expects to be entitled when control of its products or services is transferred to its customers. Control is generally transferred when the Company has a present right to payment and the title and the significant risks and rewards of ownership of products or services are transferred to its customers. A performance obligation is a promise to transfer a distinct product or service to the customer and is the unit of accounting for its customer contracts. The transaction price, comprised of variable consideration or fixed fees, or a combination of both, is allocated to each performance obligation for revenue recognition as control is transferred. For the most part, contracts carry an initial term of one to seven years with auto renewal provisions on an annual basis thereafter. In some cases, contracts carry shorter terms, for example, when the customer may terminate for convenience after the initial term with a 30 to 90-day notice period. Customer invoices are generally due within 30 to 60 days from the date of invoice.

Nature of Products and Services and Related Contractual Provisions

•Financial Health

The Company’s Financial Health segment provides various RCM services sold on a modular or comprehensive end-to-end basis, RCM software and related services, and other information technology and related managed services. The Company’s RCM services include accounts receivable management, electronic billing, statement processing, medical coding, claims editing and submission, insurance denials and appeals management, payroll processing, collections, and related analytics and business intelligence reporting, among other services for certain components of the RCM process. RCM services fees may be variable based on a percentage of customer collections each month, variable based on specified rates per unit each month, or at a fixed monthly rate over the term. When not bundled with other Financial Health or Patient Care service offerings, there is a single stand ready performance obligation to provide the applicable RCM services over the contract term, and the related revenue is recognized over time since the customer is simultaneously receiving and consuming the benefits of the service. RCM services revenue related to fixed fees is recognized ratably over the contract term, since the Company is standing ready to provide the services each month and time is the best output measure of performance. Certain RCM services revenue derived from contracts with fees based on a variable rate per unit may be recognized each month as invoiced because they relate specifically to efforts to

satisfy the RCM services each month and allocating the variable fees entirely to the monthly services is consistent with the allocation objective when considering all performance obligations and payment terms in the contract. When variable fees (e.g., collections-based fees) do not relate specifically to efforts to satisfy the RCM services, revenue related to the estimated fees is recognized ratably over the contract term, since the Company is standing ready to provide the services each month and time is the best output measure of performance.

The Financial Health segment’s RCM software contracts provide cloud-based access to Software as a Service (“SaaS”) applications, content and related support, transaction processing services, term licenses to software and related services, and implementation services. Contracts that provide RCM SaaS, content and related support, do not grant the customer a right to take possession of the software. Transaction processing services and implementation services are also included in RCM SaaS contracts. Fees for RCM SaaS contracts may be variable based on specified rates per unit each month or quarter, at a fixed price payable monthly, quarterly, or annually over the term, or a combination of both variable and fixed fees. RCM SaaS contract revenue is recognized over time since the customer is simultaneously receiving and consuming the benefits for each of the services in the contract. Revenue related to fixed fees for RCM SaaS, content and related support is recognized ratably over the contract term, since the Company is standing ready to provide the services each month and time is the best output measure of performance. Revenue related to variable RCM SaaS and transaction processing services is generally recognized each month as invoiced because it relates specifically to efforts to satisfy the RCM SaaS and transaction processing performance obligations each month and allocating the variable fees entirely to the monthly services is consistent with the allocation objective when considering all performance obligations and payment terms in the contract. When variable fees do not relate specifically to efforts to satisfy the RCM SaaS and transaction processing services, revenue related to the estimated fees is recognized ratably over the contract term, since the Company is standing ready to provide the services each month and time is the best output measure of performance.

RCM term software licenses are sold with stand ready obligations to maintain compliance with frequent regulatory updates on a when and if available basis, as well as content updates, support, and implementation services. Fees for term software license contracts are generally fixed and payable monthly, quarterly, or annually over the term. The customer has the right to use the RCM software on its own premises in its term license contracts, and the related license and stand ready regulatory update service are considered a single performance obligation that, along with the other stand ready content, support and implementation services, are recognized over time since the customer is simultaneously receiving and consuming the benefits of the software and services in the contract. Revenue for term licenses and regulatory update services, content updates, and support is recognized ratably over the contract term, since the Company is standing ready to provide the services each month and time is the best output measure of performance.

Implementation services related to RCM SaaS and term software licenses include software installation, configuration, training and related activities. Fees for RCM software implementation services are fixed and are invoiced at or near contract execution and/or completion of the services. These implementation services are recognized over time by applying an input measure of progress since the customer simultaneously receives and consumes the benefits of the service.

The Company provides information technology (“IT”) managed services, including provisioning IT environments for its customers and providing the related cloud/hosting services and other related managed services. Fees for IT managed services are generally fixed and due monthly over the contract term. Revenue related to fixed fees for IT managed services is recognized ratably over the contract term, since the Company is standing ready to provide the services each month and time is the best output measure of performance.

•Patient Care

The Company’s Patient Care segment provides software and related services to acute care hospitals and various healthcare organizations. The Patient Care segment’s software contracts provide cloud-based access to SaaS applications, content and related support, perpetual licenses to software and related services, and implementation services. Patient Care contracts that provide SaaS, content and related support do not grant the customer a right to take possession of the software. Implementation services in Patient Care SaaS contracts include software installation, integration, and customization services that are proprietary in nature and are integral to the related performance obligation. The Patient Care SaaS and implementation services are not distinct and are considered a single performance obligation for recognition of the related revenue. Fees for Patient Care SaaS contracts are generally fixed with payments due monthly over the term, and the related revenue is recognized over time since the customer is simultaneously receiving and consuming the benefits for each of the services in the contract. Revenue related to each of the Patient

Care SaaS performance obligations is recognized ratably over the contract term since the Company is standing ready to provide the services each month and time is the best output measure of performance.

Patient Care perpetual software licenses, pursuant to which customers take possession of the software, are sold with content updates, support, and implementation services. Implementation services in Patient Care software license contracts include software installation, integration, and customization services that are proprietary in nature and are integral to the related software license. The Patient Care software licenses and implementation services are not distinct and are considered a single performance obligation for recognition of the related revenue. Fees for perpetual software license contracts are generally fixed and payable upon completion of installation for the software license with monthly payments related to content and support services over the term. Revenue allocated to the combined perpetual licenses and implementation services performance obligation is recognized over time by applying an input measure of progress over the implementation period since the customer simultaneously receives and consumes the benefits of the service. Revenue allocated to the stand ready content and support performance obligations is recognized ratably over time since the customer is simultaneously receiving and consuming the benefits of those stand ready services in the contract and time is the best output measure of performance. Revenue allocated to certain “add on” perpetual licenses when the related implementation services are distinct is recognized at a point in time upon transfer to the customer when the software has been made available to the customer and the license term has begun.

For the sale of third-party products and services where the Company obtains control of the products and services before transferring them to the customer, the Company recognizes revenue based on the gross amount billed to customers. The Company considers multiple factors when determining whether it obtains control of the third-party products and services, including, but not limited to, evaluating if it can establish the price of the product, whether it retains inventory risk for tangible products, whether it integrates the product or service into its solutions, or whether it has the responsibility for ensuring acceptability of the product or service. For the most part, the Company takes control of the third-party products or services prior to transfer to the customer; however, when it does not, the Company recognizes the related revenue as an agent, net of the costs of those products and services.

The Company’s revenue is recorded net of estimated returns, customer refunds, credits or concessions based on the Company’s expectations and historical experience. The Company excludes from revenue all taxes assessed by a governmental agency that are both imposed on and concurrent with the specific revenue-producing transaction (for example, sales and use taxes). In essence, the Company is reporting these amounts collected on behalf of the applicable government agency on a net basis as though they are acting as an agent. The taxes collected and not yet remitted to the governmental agency are included in accrued expenses in the accompanying consolidated balance sheets.

Significant Judgments

The Company uses a five-step process in determining how revenue is recognized, which requires judgment and estimates. These judgments and estimates include identifying performance obligations in the contract, determining whether the performance obligations are distinct, determining the stand-alone selling prices (“SSPs”) in order to allocate the transaction price to each distinct performance obligation, determining the timing of revenue recognition for distinct performance obligations, and estimating the amount of variable consideration to include in the transaction price.

For contracts with multiple performance obligations, each of which represent promises within a contract that are distinct, the Company allocates revenue to all distinct performance obligations based on their relative SSPs. The Company’s products and services included in its contracts with multiple performance obligations are, for the most part, sold separately at observable prices to similarly situated customers within a sufficiently narrow range to determine the SSP for those products and services.

When observable prices are not available, SSPs are established that reflect the Company’s best estimates of what the selling prices of the performance obligations would be if they were sold regularly on a stand-alone basis to similarly situated customers. Observable prices are not available for the Company’s implementation services, and the Company’s process for estimating SSPs without observable prices considers multiple factors that may vary depending upon the unique facts and circumstances related to that performance obligation, including, when applicable, the estimated cost to provide the performance obligation, margins for similar services sold on a standalone basis by the Company, service-specific business objectives, and competitor or other relevant market pricing and margins.

When pricing is highly variable or uncertain, the Company applies the residual approach to determining SSP by subtracting the SSP of other services from the total transaction price to arrive at the SSP for the performance obligations with highly variable or uncertain pricing. The Company’s Patient Care perpetual and term licenses and the related non-distinct

implementation services are never sold separately and are proprietary in nature, and the related selling price of these products and services is highly variable or uncertain. Therefore, the SSP of these products and services is estimated using the residual approach.

For all content update and support services, RCM SaaS and transaction processing services, and RCM software with stand ready regulatory update services, the Company’s performance obligations are only sold in conjunction with other performance obligations that are transferred to the customer over the same time period with the same time-based measure of progress and it is unnecessary to determine the SSP for each performance obligation. Rather, the SSP is determined for the bundle of performance obligations that share those characteristics.

The functionality of certain software licenses is dependent upon the related regulatory compliance and other updates included with these software solutions. Judgment is required to determine whether the software license is considered distinct and accounted for separately, or not distinct and accounted for together with the related updates and recognized over time.

Contract Balances

The timing of invoicing to customers often differs from the timing of revenue recognition and these timing differences can result in receivables, contract assets, or contract liabilities (deferred revenue) on the Company’s consolidated balance sheets. For contracts that are invoiced in arrears, the Company has an unconditional right to consideration for all products and services transferred to the customer. That unconditional right to consideration is reflected in accounts receivable in the accompanying consolidated balance sheets.

Contract liabilities are reflected in deferred revenue in the accompanying consolidated balance sheets and reflect amounts allocated to performance obligations that have not yet been satisfied related to RCM software with stand ready regulatory updates, Patient Care and RCM SaaS, content updates, and support services. During the year ended December 31, 2025, we recognized revenue of $8.0 million that was included in deferred revenue at December 31, 2024. During the year ended December 31, 2024, we recognized revenue of $5.5 million that was included in deferred revenue at December 31, 2023. Because the Company’s deferred revenue generally arises from advance payments on a monthly, quarterly, or annual basis, there is no material portion of deferred revenue at each balance sheet date that will not be recognized in revenue within the subsequent year.

Contract assets arise when the Company recognizes revenue for amounts which cannot yet be billed under the terms of the contract with the customer, primarily related to the Company’s RCM services. Because the Company generally is able to invoice contractual fees within a few months of the time that contract assets have been recognized, there is no material portion of contract assets at each balance sheet date that will not be recognized as a receivable or realized in cash within the subsequent year. There are no material contract assets in the consolidated balance sheets at December 31, 2025 and 2024.

The Company has elected the practical expedient to exclude any financing component from consideration for contracts where, at contract inception, the period between the transfer of products or services and the timing of the related payment is not expected to exceed one year. Because the Company’s contracts generally include monthly, quarterly, or annual fees, or in the case of perpetual or term licenses that are transferred at a point in time, the fees are due in close proximity to the license transfer, the Company has determined that there are no contracts that include a significant financing component.

Variable Consideration

The Company includes variable consideration in its transaction price when there is a basis to reasonably estimate the amount of the fee and it is probable there will not be a significant reversal. These estimates are generally made using the expected value method based on historical experience and are measured at each reporting date. The Company’s otherwise fixed consideration in its customer contracts may vary when performance bonuses and penalties related to service level agreements, refunds or credits are provided, or in connection with certain concessions. Although the Company does not have a recent history of incurring material adjustments to the transaction price for these forms of variable consideration, it has estimated the amount of variable consideration related to these items considering the probability of a significant subsequent reversal of revenue and adjusted the transaction price accordingly.

Some of the Company’s variable fees in its contracts meet the criteria to be recognized each month as invoiced because the variable consideration relates specifically to the Company’s efforts to satisfy the related performance obligation each month and allocating the variable fees entirely to the monthly services is consistent with the allocation objective when considering all performance obligations and payment terms in the contract. However, the majority of the Company’s RCM services do not meet these criteria for direct allocation, and the Company has estimated these variable collections-based

fees for recognition as the performance obligation is satisfied, constraining this estimate based on the probability of a significant subsequent reversal of revenue. In estimating and constraining these variable fees, the Company observed that the amount of collections generating the fees 1) was highly susceptible to factors outside the Company’s and customer’s influence, including the actions of third parties and the customer’s local economy and other related business and demographic trends, 2) was not expected to be resolved for a long period of time due to contracts that spanned multiple years in many cases, and 3) contained historical information of limited predictive value.

There was no material revenue recognized for the years ended December 31, 2025 and 2024 related to changes in estimated variable consideration that existed at December 31, 2024 and 2023. The Company generally does not allow product returns other than under assurance-type warranties, and the Company does not have a substantial history of product returns.

Remaining Performance Obligations

The Company identifies performance obligations at contract inception so that it can monitor and account for the obligations over the life of the contract. Remaining performance obligations represent the portion of the transaction price in a contract allocated to products and services not yet transferred to the customer. As of December 31, 2025, approximately $173.4 million of revenue is estimated to be recognized in the future from contractual transaction prices allocated to remaining performance obligations.

At December 31, 2025, the Company expects to recognize revenue on approximately 39% of the remaining performance obligations within the next year, 83% during the period one to three years from the balance sheet date, with the remainder recognized thereafter.

The Company has elected not to disclose the value of remaining performance obligations for contracts with variable consideration when the contract qualifies to recognize revenue in an amount for which the Company has the right to invoice or when the variable consideration has been allocated entirely to a wholly unsatisfied performance obligation, including to an unsatisfied performance obligation that includes a distinct product or service that forms part of a series of distinct products or services. In addition, the Company has elected not to disclose the value of remaining performance obligations for contracts with performance obligations that are expected, at contract inception, to be satisfied over a period that does not exceed one year. These exclusions to the remaining performance obligations are not excluded in the backlog.

Disaggregated Revenue

The Company reports certain disaggregated revenue information in order to depict the timing and manner in which its products and services are transferred to customers and based upon the nature of its products and services, including consideration of how the uncertainty of revenue and cash flow is affected by economic factors. The Company principally operates in a single industry within North America and disaggregates its revenue for each reportable segment based upon the timing and manner in which its products and services are transferred and secondarily based upon the nature of those products and services. The Company’s recurring revenue streams include its RCM services, which are primarily labor-based services under long-term contracts. Its recurring revenue also includes SaaS and related services, including non-distinct term software licenses and support, generally provided under long-term contracts and the related renewals thereof. The Company’s non-recurring revenue streams include revenue from perpetual software licenses and the related non-distinct implementation services, implementation services across all of its software solutions, and other professional services. This non-recurring revenue is generally recognized within a year of the execution of the related customer contract.

A summary of the Company’s revenue disaggregated based on these considerations is as follows for the years ended December 31, 2025, 2024, and 2023:


(In thousands)	2025		2024		2023
Recurring revenue
Financial Health
RCM services	$	169,981	$	164,877	$	140,910
Medical coding technology and services	34,251		32,977		32,160
Hosting and other services	13,551		14,200		14,295
Patient Care
Support and related services	70,761		75,960		100,201
SaaS	38,609		35,365		29,695
Total	$	327,153	$	323,379	$	317,261

Non-recurring revenue
Financial Health
Consulting and other services	$	3,874	$	5,312	$	5,969
Patient care
Software system licenses and related services	13,232		13,166		12,870
Professional services and other	2,577		348		864
Total	$	19,683	$	18,826	$	19,703
Total Revenue	$	346,836	$	342,205	$	336,964

Customer Contract Costs

The Company capitalizes incremental costs to obtain a contract with a customer if it expects to recover those costs. The incremental costs to obtain a contract are those that the Company incurs to obtain a contract with a customer that it would not have otherwise incurred if the contract were not obtained (e.g., a sales commission). The Company capitalizes the costs incurred to fulfill a contract only if those costs meet all of the following criteria:

•The costs relate directly to a contract or anticipated contract that can be specifically identified.

•The costs generate or enhance resources of the Company that will be used in satisfying (or in continuing to satisfy) performance obligations in the future.

•The costs are expected to be recovered.

Sales commissions incurred by the Company across all of its major revenue streams were generally determined to be incremental costs to obtain the related contracts, which are deferred and amortized ratably over the estimated economic benefit period. For these sales commissions that are incremental costs to obtain the related contracts where the period of amortization would have been recognized over a period that is one year or less, the Company elected the practical expedient to expense those costs as incurred. Commission costs that are deferred are classified as current or non-current assets based on the timing of when the Company expects to recognize the expense and are included in prepaid expenses and other current assets and other assets, net of current portion, respectively, in the accompanying consolidated balance sheets. The carrying amounts of deferred commissions at December 31, 2025 and 2024 were approximately $11.7 million and $10.6 million, respectively.

Qualifying fulfillment costs related to certain upfront costs incurred in RCM services and Patient Care SaaS contracts are capitalized. These capitalized fulfillment costs are deferred and amortized ratably over an estimated economic benefit period of five years. Fulfillment costs that meet the criteria for capitalization are classified as current or non-current assets based on the timing of when the Company expects to recognize the expense and are included in prepaid expenses and other current assets and other assets, net of current portion, respectively, in the accompanying consolidated balance sheets. The carrying amounts of deferred fulfillment costs at December 31, 2025 and 2024 were approximately $1.1 million and $1.3 million, respectively.

Amortization of contract costs for the years ended December 31, 2025, 2024, and 2023 was $6.3 million, $6.7 million, and $5.6 million, respectively. No impairment losses related to contract costs were recognized for the years ended December 31, 2025, 2024, and 2023.

Stock-Based Compensation

The Company accounts for stock-based compensation according to the provisions of ASC 718, Compensation – Stock Compensation, which establishes accounting for stock-based awards exchanged for employee services. Accordingly, stock-based compensation cost is measured at the grant date based on the fair value of the award, and is recognized as an expense over the employee’s or non-employee director’s requisite service period. The Company accounts for forfeitures as they occur by reversing the related expense.

Software Development Costs

Our software solutions are offered to our clients through SaaS delivery models, traditional perpetual licenses, and term licenses. Development costs associated with the solutions offered exclusively through a SaaS model are accounted for in accordance with ASC 350-40, Internal Use Software. All other client solution development costs are accounted for in accordance with ASC 985-20, Costs of Software to be Sold, Leased, or Marketed.

Under ASC 350-40, software development costs related to preliminary project activities and post-implementation and maintenance activities are expensed as incurred. We capitalize direct costs related to application development activities that are probable to result in additional functionality. Capitalized costs are amortized on a straight-line basis over five years. We test for impairment whenever events or changes in circumstances that could impact recoverability occur.

Under ASC 985-20, software development costs incurred in creating computer software solutions are expensed until technological feasibility has been established upon completion of a detailed program design or, in the absence of a detailed program design, upon completion of a product design and working model of the software product. Thereafter, all software development costs incurred through the software’s general release date are capitalized and subsequently recorded at the lower of amortized cost or net realizable value. Capitalized costs are amortized based on the current and expected future revenue for each software solution with minimum annual amortization equal to the straight-line amortization over the estimated economic life of the solution, which is estimated to be five years.

See Note 5 - Software Development for further information relating to our software development costs.

Income Taxes

We account for income taxes in accordance with ASC 740, Accounting for Income Taxes. Under this topic, deferred income taxes are determined utilizing the asset and liability approach. This method gives consideration to the future tax consequences associated with differences between financial accounting and tax bases of assets and liabilities. The effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. We recognize interest and penalties accrued related to unrecognized tax benefits in the consolidated statements of operations as a component of the (benefit) provision for income taxes.

We also make a provision for uncertain income tax positions in accordance with the ASC 740, Accounting for Income Taxes. These provisions require that a tax position taken in a tax return be recognized in the financial statements when it is more likely than not (i.e., a likelihood of more than fifty percent) that the position would be sustained upon examination by tax authorities. A recognized tax position is then measured at the largest amount of benefit that is greater than fifty percent likely of being realized upon settlement. The topic also requires that changes in judgment that result in subsequent recognition, derecognition, or change in a measurement date of a tax position taken in a prior annual period (including any related interest and penalties) be recognized as a discrete item in the interim period in which the change occurs.

Valuation allowances are recorded when, in the opinion of management, it is more likely than not that all or a portion of the deferred tax assets will not be realized. These valuation allowances can be impacted by changes in tax laws, changes to statutory tax rates, and future taxable income, and are based on our judgment, estimates, and assumptions.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires that management make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosures of contingent assets and liabilities at

the date of the financial statements, and the reported revenues and expenses during the reporting periods. Actual results could differ from those estimates.

Segment Reporting

Operating segments are identified as components of an enterprise about which separate discrete financial information is evaluated by the chief operating decision maker, which we refer to as the "CODM", or decision-making group in assessing performance and making decisions regarding resource allocation. The Company has prepared operating segment information based on the manner in which management disaggregates the Company's operations for making internal operating decisions. For more information, see Note 18 - Segment Reporting.

New Accounting Standards Adopted in 2025

In December 2023, the FASB issued ASU 2023-09, “Income Taxes (Topic 740): Improvements to Income Tax Disclosures” (“ASU 2023-09”), which requires public entities to provide disclosure of disaggregated information in the entity’s tax rate reconciliation, as well as disclosure of income taxes paid disaggregated by jurisdiction. The Company has adopted ASU 2023-09 prospectively for the year ended December 31, 2025. The Company has updated the presentation in Note 8 - Income Taxes to adhere to the requirements.

New Accounting Standards Yet to be Adopted

In November 2024, the FASB issued ASU No. 2024-03, “Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses” (“ASU 2024-03”), which requires additional disclosure of certain costs and expenses within the notes to the financial statements. The new standard is effective for annual periods beginning after December 15, 2026 and interim periods beginning in the first quarter of fiscal year 2028. Early adoption is permitted. The new standard is to be applied on a prospective basis, but retrospective application is permitted. The Company is currently evaluating the impact of adopting ASU 2024-03.

In September 2025, the FASB issued ASU 2025-06, “Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software” (“ASU 2025-06”), which is intended to increase the operability of the recognition guidance considering different methods of software development. The guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2027, with early adoption permitted. The Company is currently evaluating the impact of adopting ASU 2025-06.

In December 2025, the FASB issued ASU No. 2025‑11, “Interim Reporting (Topic 270): Narrow‑Scope Improvements” (“ASU 2025‑11”), which improves the navigability of the required interim disclosures and clarifies when that guidance is applicable. The ASU is effective for interim reporting periods within annual reporting periods beginning after December 15, 2027. The amendments can be applied either (1) prospectively or (2) retrospectively to any or all prior periods presented in the financial statements. The Company is currently evaluating the impact of adopting ASU 2025-11.

3. BUSINESS COMBINATIONS AND DISPOSALS

Sale of American HealthTech, Inc.

On January 16, 2024, we entered into a Stock Purchase Agreement (the “Purchase Agreement”), by and among the Company, American HealthTech, Inc. a Mississippi corporation (“AHT”), and Healthland Inc., a Minnesota corporation and an indirect, wholly-owned subsidiary of the Company (“Healthland”) and PointClickCare Technologies USA Corp., a Delaware corporation (“Buyer”). The Transaction (hereinafter defined) also closed on January 16, 2024. Under the Purchase Agreement, Buyer purchased from Healthland all of the issued and outstanding capital stock of AHT (the “Transaction”), with AHT becoming a wholly-owned subsidiary of Buyer. Prior to this transaction, results for AHT were reported within our Patient Care operating segment.

The Purchase Agreement provided for an aggregate purchase price (the “Purchase Price”) of $25.0 million (the “Base Cash Consideration”), subject to adjustments based on working capital, cash, indebtedness and transaction expenses of AHT. Additionally, pursuant to the Purchase Agreement, a total of approximately $3.8 million was withheld from the Base Cash Consideration at the closing and deposited by Buyer into various escrow accounts with an escrow agent, including $2.5 million as a general indemnity escrow and $1.0 million as a special indemnity escrow. Based upon the adjustments and the various escrow holdbacks, Buyer paid a net amount of approximately $21.4 million to Healthland at the closing. The Purchase Price was subject to a post-closing true-up. In connection with the closing of the Transaction, Buyer provided offers of employment to certain key employees of the Company that primarily supported AHT’s business. During 2024, we

incurred approximately $0.3 million of expenses related to this disposal reported in our consolidated statements of operations.

As part of the divestiture, as of January 16, 2024 we entered into a transition services agreement (“TSA”) with Buyer to assist them in the transition of certain functions, including, but not limited to, information technology, finance and accounting, for an initial period of 18 months, with certain services being completed prior to the 18-month period. In addition to the agreed upon services, the TSA allows for additional services to be offered by the Company pursuant to a mutually agreed upon amendment to the TSA. In July 2025, the parties entered into an agreement in order to extend the TSA for an additional 120 days, which expired in November 2025. No other amendments had been executed as of December 31, 2025. The Company has $0.6 million in receivables from Buyer for the TSA services reflected under the caption “Accounts receivable” in the consolidated balance sheet as of December 31, 2025.

For the years ended December 31, 2025 and 2024, the Company had recorded a $0.1 million and $1.5 million gain on sale, respectively, which is reflected under the caption “Other income (expense)” in the consolidated statement of operations.

During the first quarter of 2025, the Company received the general indemnity escrow of $2.5 million, partially offset by a payment of $0.3 million for an adjustment to the working capital.

The following table presents the pretax loss for AHT that is included in our consolidated statement of operations for the years ended December 31, 2025 and 2024:


	December 31,
(In thousands)	2025		2024

Pretax loss	$	—	$	(246)

Acquisition of Viewgol, LLC

On October 16, 2023, we acquired all of the assets and liabilities of Viewgol, LLC, a Delaware limited liability company (“Viewgol”), pursuant to a Securities Purchase Agreement dated October 16, 2023. Based in Frisco, Texas, Viewgol is a provider of ambulatory RCM analytics and complementary outsourcing services with an extensive offshore presence we use to accommodate the growing demand for RCM services by our acute care customers.

Consideration for the acquisition included cash (net of cash of the acquired entity) of $37.4 million (inclusive of seller's transaction expenses). Also included in the acquisition consideration were contingent earnout payments of (i) up to $21.5 million based on the Viewgol business achieving earnings before interest, taxes, depreciation, and amortization and other adjustments specified in the Securities Purchase Agreement of $6.0 million or more during fiscal year 2024 (the “EBITDA Earnout Amount”), and (ii) up to $10.0 million based on the number of productive agents the Viewgol business hires in India in fiscal year 2024 (the “Offshore Earnout Amount”). At the completion of the contingent earnout period in 2024, no earnout payments were made to the former Viewgol shareholders.

Our acquisition of Viewgol was treated as a purchase in accordance with ASC 805, Business Combinations, which requires allocation of the purchase price to the estimated fair values of assets and liabilities acquired in the transaction. Our allocation of the purchase price was based on management's judgment after evaluating several factors, including a valuation assessment.

The allocation of the purchase price paid for Viewgol was as follows:


(In thousands)	Purchase Price Allocation as of December 31, 2023		Purchase Price Allocation as of December 31, 2024
Acquired cash	$	1,449	$	1,449
Accounts receivable	2,233		2,233
Prepaid expenses	132		132
Property and equipment	1,112		1,112
Intangible assets	17,720		17,720
Goodwill	17,263		17,927
Accounts payable and accrued liabilities	(711)		(711)
Contingent consideration	(1,044)		(1,044)
Net assets acquired	$	38,154	$	38,818

In April 2024, the Company paid an additional $0.7 million for working capital adjustments which is reflected under the caption “Goodwill” in the consolidated balance sheet.

The intangible assets in the table above are being amortized on a straight-line basis over their estimated useful lives. The amortization is included in amortization of acquisition-related intangibles in our consolidated statements of operations.

The fair value measurements of tangible and intangible assets and liabilities (including those related to contingent consideration) were based on significant inputs not observable in the market and thus represent Level 3 measurements within the fair value measurement hierarchy (see Note 17 - Fair Value). Level 3 inputs included, among others, discount rates that we estimated would be used by a market participant in valuing these assets and liabilities, projections of revenues and cash flows, client attrition rates and market comparables.

As of December 31, 2025, the Company has recorded, within other accrued liabilities, a contingent consideration liability of $5.0 million, representing management’s estimate of the fair value of the earn-out obligation. The Company will continue to evaluate this matter and adjust the estimated fair value of the contingent consideration liability as necessary based on developments in the dispute and any new information that becomes available. Refer to Note 16 of the consolidated financial statements included herein for additional detail regarding the contingent consideration.

Our consolidated statements of operations for the years ended December 31, 2025, 2024 and 2023 include revenues of $19.6 million, $20.0 million and $3.8 million, respectively, and net income of $10.7 million, $8.1 million, and $0.3 million, respectively, attributed to the acquired business since the October 16, 2023 acquisition date.

4. PROPERTY AND EQUIPMENT

Property and equipment were comprised of the following at December 31, 2025 and 2024:


(In thousands)	2025		2024

Buildings and improvements	$	52	$	52

Computer equipment	11,855		10,963
Leasehold improvements	246		246
Office furniture and fixtures	530		540
Construction in progress	381		—
Automobiles	18		18


	13,082		11,819
Less: accumulated depreciation	(10,606)		(9,525)
Property and equipment, net	$	2,476	$	2,294

Assets Held for Sale

ASC Topic 360-10, Property, Plant and Equipment — Overall, requires a long-lived asset to be classified as “held for sale” in the period in which certain criteria are met. The Company classifies real estate assets as held for sale after the following conditions have been satisfied: (1) management, having the appropriate authority, commits to a plan to sell the asset, (2) the asset is available for immediate sale in its present condition, (3) the Company has initiated an active program to sell the asset, (4) it is probable the sale of the asset will be completed within one year, and (5) it is unlikely the plan to sell the asset will change.

During the fourth quarter of 2024, the Company committed to a plan to sell land and certain building and improvements located in Mobile, Alabama and determined the assets met the criteria for classification as held for sale as of December 31, 2024. As of December 31, 2025 and December 31, 2024, the Company recorded the assets held for sale at their fair value of $0.4 million and $0.6 million, respectively, which equals the estimated fair value less costs to sell the property of $0.1 million, which is included in “Assets held for sale” in the accompanying consolidated balance sheets. The write-down of the assets to fair value resulted in the Company recognizing a loss on assets held for sale of $0.5 million during the year ended December 31, 2024, which is included in “Other income (expense)” in the accompanying consolidated statements of operations. In April 2025, the Company sold the building and a portion of the land for $0.3 million. Prior to the sale, the carrying value of the assets sold included in “Assets held for sale” was $0.2 million. The remaining unsold land has an estimated fair value of approximately $0.4 million.

5. SOFTWARE DEVELOPMENT

Software development costs are accounted for in accordance with ASC 350-40, Internal-Use Software and ASC 985-20, Costs of Software to be Sold, Leased, or Marketed.

For software intended for internal use, software development costs are capitalized in accordance with ASC 350-40, Internal Use Software. Software development costs related to preliminary project activities and post-implementation and maintenance activities are expensed as incurred. Direct costs related to the application and development activities that are probable to result in additional functionality are capitalized.

For software intended for external customers, costs incurred before technological feasibility are expensed as research and development. Costs incurred after technological feasibility and before the product is available for general release to customers are capitalized in accordance with ASC 985-20, Costs of Software to Be Sold, Leased, or Marketed.

We estimate the useful life of our capitalized software and amortize its value on a straight-line basis over that estimated life of five years. If the actual useful life of the asset is determined to be shorter than our estimated useful life, we will amortize the remaining book value over the remaining useful life, or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Amortization begins when the related features are placed in service.

Software development costs, net was comprised of the following at December 31, 2025 and 2024:


(In thousands)	2025		2024
Software development costs	$	77,671	$	66,230
Less: accumulated amortization	(35,409)		(26,779)
Software development costs, net	$	42,262	$	39,451

6. OTHER ACCRUED LIABILITIES

Other accrued liabilities were comprised of the following at December 31, 2025 and 2024:


(In thousands)	2025		2024
Salaries and benefits	$	9,753	$	9,050
Severance	2,444		1,702
Commissions	594		1,191
Accrued interest	—		2,314
Contingent consideration	5,000		—
Other	2,131		793
Operating lease liabilities, current portion	772		944
Other accrued liabilities	$	20,694	$	15,994

The Company has implemented certain cost savings initiatives and, as a result, incurred approximately $4.3 million and $7.1 million of severance costs during the years ended December 31, 2025 and 2024, respectively. These costs were included in general and administrative expenses in the consolidated statements of operations. During the years ended December 31, 2025 and 2024, the Company paid severance of $3.6 million and $11.4 million, respectively.

7. NET INCOME (LOSS) PER SHARE

The Company presents basic and diluted earnings per share ("EPS") data for its common stock. Basic EPS is calculated by dividing the net income (loss) attributable to stockholders of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted EPS is determined by adjusting the net income (loss) attributable to stockholders of the Company and the weighted average number of shares of common stock outstanding during the period for the effects of all dilutive potential common shares, including awards under stock-based compensation arrangements.

The Company's unvested restricted stock awards (see Note 9 - Stock-Based Compensation and Equity) are considered participating securities under ASC 260, Earnings Per Share, because they entitle holders to non-forfeitable rights to dividends until the awards vest or are forfeited. When a company has a security that qualifies as a "participating security," ASC 260 requires the use of the two-class method when computing basic EPS. The two-class method is an earnings allocation formula that determines EPS for each class of common stock and participating security according to dividends declared (or accumulated) and participation rights in undistributed earnings. In determining the amount of net income (loss) to allocate to common stockholders, income (loss) is allocated to both common stock and participating securities based on their respective weighted average shares outstanding for the period, with net income (loss) attributable to common stockholders ultimately equaling net income (loss) less net income attributable to participating securities. Diluted EPS for the Company's common stock is computed using the more dilutive of the two-class method or the treasury stock method.

The following is a calculation of the basic and diluted EPS for the Company's common stock, including a reconciliation between net income (loss) and net income (loss) attributable to common stockholders for the years ended December 31, 2025, 2024, and 2023:


(In thousands, except for per share data)	2025		2024		2023
Basic EPS
Numerator
Net income (loss)	$	4,354	$	(20,945)	$	(48,133)
Less: Net (income) loss attributable to participating securities	(145)		785		1,083
Net income (loss) attributable to common stockholders	$	4,209	$	(20,160)	$	(47,050)
Denominator
Weighted average shares outstanding used in basic per common share computations	14,488		14,300		14,187
Basic EPS	$	0.29	$	(1.41)	$	(3.32)

Diluted EPS
Numerator


Net income (loss) attributable to common stockholders for diluted EPS	$	4,209	$	(20,160)	$	(47,050)
Denominator
Weighted average shares outstanding used in basic per common share computations	14,488		14,300		14,187
Weighted average effect of dilutive securities:
Performance share awards	—		—		—
Weighted average shares outstanding used in diluted per common share computations	14,488		14,300		14,187
Diluted EPS	$	0.29	$	(1.41)	$	(3.32)

8. INCOME TAXES

Income (loss) before taxes by jurisdiction consisted of the following at December 31, 2025, 2024, and 2023:


(In thousands)	2025		2024		2023
Federal	$	2,021	$	(11,310)	$	(57,464)

Foreign	1,848		842		—
Total	$	3,869	$	(10,468)	$	(57,464)

The components of the income tax (benefit) provision for the years ended December 31, 2025, 2024, and 2023 were as follows:


(In thousands)	2025		2024		2023
Current provision:
Federal	$	(2,418)	$	4,925	$	1,661
State	412		3,086		218
Foreign	805		261		—
Deferred provision:
Federal	523		(1,780)		(8,801)
State	285		3,985		(2,409)
Foreign	(92)		—		—
Total income tax (benefit) provision	$	(485)	$	10,477	$	(9,331)

The difference between the effective tax rate reflected in the (benefit) provision for income taxes and the U.S. federal statutory rate was as follows for the year ended December 31, 2025 pursuant to the prospective application of ASU 2023-09:


	2025
(In thousands)	Amount		Percent
Income taxes at U.S. federal statutory rate	$	812	21.0	%
State and local income tax, net of federal income tax effect (1)	551		14.3	%
Foreign tax effects:
India:
Statutory tax rate differential	74		1.9	%
Tax receivable true up	332		8.6	%
Other	(81)		(2.1)	%
Nondeductible or nontaxable items:
Stock-based compensation (2)	(719)		(18.6)	%
Limitations on executive compensation	607		15.7	%
Other	59		1.5	%
Tax credits:
R&D tax credit	(667)		(17.2)	%
Change in valuation allowance	(4,681)		(121.0)	%
Changes in unrecognized tax benefits	106		2.7	%
Other reconciling items
Capital loss write off	2,854		73.8	%
Fixed asset basis adjustment	172		4.4	%
Other	96		2.5	%
Total income tax (benefit) provision	$	(485)	(12.5)	%
(1) During the year ended December 31, 2025, state taxes in Texas and Missouri made up the majority (greater than 50%) of the tax effect in this category (state and local income tax).
(2) Stock-based compensation is classified as a part of the “Nondeductible or nontaxable items” section and represents both windfalls and shortfalls on the Company’s restricted stock awards.

The difference between income taxes at the U.S. federal statutory income tax rate of 21% for the years ended December 31, 2024, and 2023, and the total income tax provision (benefit) reported in the consolidated statements of operations for such years is as follows (prior to the adoption of ASU 2023-09):


(In thousands)	2024		2023
Income taxes at U.S. federal statutory rate	$	(2,200)	$	(12,068)
State income tax, net of federal tax effect	6,411		(2,249)
Foreign rate differential on pretax book income	75		—
Provision-to-return adjustments	(152)		(999)

Tax credits	(1,084)		(2,481)
Capital loss on sale of AHT stock	(3,175)		—

Goodwill impairment	—		7,542
Stock-based compensation	772		65

Change in valuation allowance	9,514		—
Non-deductible compensation - section 162(m)	97		15
Other	219		844
Total income tax provision (benefit)	$	10,477	$	(9,331)

Deferred tax assets and liabilities were comprised of the following as of December 31, 2025 and 2024:


(In thousands)	2025		2024
Deferred tax assets:
Accounts receivable and financing receivables	$	1,818	$	1,781

Stock-based compensation	1,545		1,003
Deferred revenue	183		988
Research expenditures	19,585		26,449
Accrued liabilities	1,327		236


Lease liabilities	517		561
Capital loss on sale of AHT stock	—		3,323
Credits	1,043		891
Other	3,946		2,938
Net operating loss	4,333		1,835
Deferred tax assets	34,297		40,005
Less: Valuation allowance	9,357		13,585
Total deferred tax assets	$	24,940	$	26,420
Deferred tax liabilities:
Intangible assets	$	12,437	$	15,118
Capitalized software	10,208		9,993
Fixed assets	150		237
Right of use asset	491		$	796
Other	4,237		$	2,139
Total deferred tax liabilities	$	27,523	$	28,283
Total net deferred tax liability	$	(2,583)	$	(1,863)

On July 4, 2025, H.R. 1, or the “One Big Beautiful Bill Act” (“OBBBA”), was signed into law in the U.S., which contains a broad range of tax reform provisions affecting businesses. For the Company, the most significant impact relates to the immediate expensing of domestic research and development expenditures. The OBBBA reduced the Company’s 2025 expected current tax liability as a result of the ability to deduct domestic research and development expenses.

The Company has federal net operating loss carryforwards of $8.9 million and state net operating loss carryforwards of $49.6 million. $8.1 million of the federal net operating losses will be carried forward indefinitely and $0.8 million of the federal net operating losses will expire in 2036. $10.7 million of the state net operating losses will be carried forward indefinitely and $38.9 million of the state net operating losses will expire on various dates beginning in 2026 through 2055.

Deferred income taxes arise from the temporary differences in the recognition of income and expenses for tax purposes. A valuation allowance is established when the Company believes that it is more likely than not that some portion of its deferred tax assets will not be realized. The valuation allowance for deferred tax assets as of December 31, 2025 and 2024 was $9.4 million and $13.6 million, respectively. The net change in the total valuation allowance during the year ended December 31, 2025 was a decrease of $4.2 million. The valuation allowance as of December 31, 2025 is recorded as, in the judgment of management, the deferred tax assets are not more likely than not to be realized. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets depends on the generation of future taxable income and capital gains during the periods in which those temporary differences are deductible.

The Company asserts that any foreign earnings will be indefinitely reinvested. The Company has not recorded a liability for taxes associated with these undistributed earnings. If the Company determines that all or a portion of such foreign earnings are no longer indefinitely reinvested, the Company may be subject to additional foreign withholding taxes and U.S. state income taxes. The Company has not determined the potential deferred tax liability on its indefinitely reinvested foreign earnings, as such a determination is not practicable.

Income tax payments, net of refunds, of $6.0 million, $5.3 million, and $3.7 million were made in December 31, 2025, 2024, and 2023, respectively.

Income tax payments, net of refunds, by jurisdiction for the year ended December 31, 2025 were as follows (pursuant to the prospective application of ASU 2023-09):


(In thousands)	2025
U.S. federal	$	5,600
State:
Alabama	(772)
Texas	305
Other	233
State subtotal	(233)
Foreign:
India	676
Total cash paid for income taxes (net of refunds)	$	6,042

The Company continues to assess whether it is more likely than not that a tax position will be sustained upon examination based on the technical merits of the position. If the more-likely-than-not threshold is met, a company must measure the tax position to determine the amount to recognize in the consolidated financial statements.

A reconciliation of the beginning and ending amount of unrecognized tax benefits was as follows for the year ended December 31, 2025:


(In thousands)	2025
Unrecognized tax benefits at beginning of year	$	355
Increases related to tax positions taken in current year	55
Increases related to tax positions taken in prior years	12
Decreases related to tax positions taken in prior years (including releases)	—
Decreases related to settlements	—
Unrecognized tax benefits at end of year	$	422

The federal returns for tax years 2022 through 2024 remain open to examination. Tax years 2021 through 2024 remain open to examination by certain other taxing jurisdictions to which the Company is subject. Additional years may be open to the extent attributes are being carried forward to an open year.

9. STOCK-BASED COMPENSATION AND EQUITY

The Company's stock-based compensation awards are in the form of restricted stock and performance share awards granted pursuant to the Company's Second Amended and Restated 2019 Incentive Plan (the "Plan"). Stock-based compensation cost is measured at the grant date based on the fair value of the award, and is recognized as an expense over the employee’s or non-employee director’s requisite service period. As of December 31, 2025, there was a total of 2,012,219 shares of common stock reserved under the Plan for issuance under future equity awards, assuming maximum payout of performance share awards outstanding as of December 31, 2025.

During each of the years ended December 31, 2025, 2024, and 2023, the Company recorded $0.3 million, $0.3 million, and $0.7 million, respectively, in net incremental stock-based compensation expense as a result of modifications of equity awards. The modifications extended the vesting period of equity awards which otherwise would have been forfeited by twelve to eighteen months requiring no additional service performance from these individuals, other than compliance with certain restrictive covenants.

As of December 31, 2025, the performance metrics applicable to both the 2025 and 2024 performance share awards were deemed probable of achievement resulting in expense recognition of 200% of the grant date fair value. The Company recorded incremental compensation expense of $1.6 million for the year ended December 31, 2025 related to both the 2025 and 2024 performance share awards.

The following table details total stock-based compensation expense for the years ended December 31, 2025, 2024 and 2023, included in the consolidated statements of operations:


(In thousands)	2025		2024		2023
Costs of sales	$	1,554	$	721	$	745
Operating expenses	7,107		4,799		2,526
Pre-tax stock-based compensation expense	8,661		5,520		3,271
Less: income tax effect	—		(1,159)		(687)
Net (after tax) stock-based compensation expense	$	8,661	$	4,361	$	2,584

As of December 31, 2025, there was $9.6 million of unrecognized compensation cost related to unvested or unearned, as applicable, equity awards granted under the Plan, which is expected to be recognized over a weighted-average period of 1.8 years.

Restricted Stock

The Company grants restricted stock to executive officers, certain key employees and non-employee directors under the Plan with the fair value of the awards representing the fair value of the common stock on the date the restricted stock is granted. Shares of restricted stock generally vest in equal annual installments over the applicable vesting period, which ranges from one to three years. The Company records expenses for these grants on a straight-line basis over the applicable vesting periods.

A summary of restricted stock activity under the Plan during the years ended December 31, 2025, 2024 and 2023 is as follows:


	Shares	Weighted-Average Grant-Date Fair Value
Unvested stock outstanding at January 1, 2023	281,161	$	32.24
Granted	210,351	26.44

Vested	(145,529)	31.35
Forfeited	(2,668)	29.23
Unvested stock outstanding at December 31, 2023	343,315	$	29.08
Granted	502,866	10.07

Vested	(175,040)	29.18
Forfeited	(101,804)	21.21
Unvested stock outstanding at December 31, 2024	569,337	$	14.34
Granted	205,278	27.22

Vested	(268,538)	20.05
Forfeited	(50,468)	21.30
Unvested stock outstanding at December 31, 2025	455,609	$	22.56

Performance Share Awards

The Company grants performance share awards to executive officers and certain key employees under the Plan. The vesting of the awards is contingent upon the Company’s achievement of performance goals predetermined by the Compensation Committee of the Board of Directors at the time the award is issued, which is considered a performance condition. Compensation expense for the performance share awards is recognized based on management’s current expectation of achievement of the cumulative adjusted operating cash flows performance condition, using the grant-date fair value that incorporates the total shareholder return ("TSR") market condition. The Company reassesses the expected payout each reporting period and records any cumulative catch-up (true-up or true-down) adjustments in the period of change; previously recognized compensation cost is reversed if the requisite service is not completed or if the cumulative adjusted operating cash flows payout is ultimately determined to be zero. At the end of a three-year performance period, the number of shares of common stock earned and issuable under each award will be determined based on the achievement of the performance conditions outlined in the award. The awards will be cancelled if none of the performance conditions are met at the end of the performance period.

The number of shares of common stock issued under the awards will be dependent upon which level of the performance objective is met, as defined by the terms of the award. In the event that the Company's financial performance meets the predetermined targets for the performance objectives of the performance share awards, the Company will issue each award recipient the number of shares of common stock equal to the target award specified in the individual's underlying performance share award agreement. In the event the financial results of the Company exceed the predetermined targets, additional shares up to the maximum award may be issued. In the event the financial results of the Company fall below the predetermined targets, a reduced number of shares may be issued. If the financial results of the Company fall below the minimum threshold performance levels, no shares may be issued. Additionally, if the Company meets the performance condition for vesting, the total number of shares issuable for the performance share award may be increased, decreased, or unchanged based on the Company’s TSR, as defined in the award agreement, compared to a small-cap market index. This is considered a market condition as it is dependent upon the Company’s performance as compared to market results.

The recipients of performance share awards do not receive dividends or possess voting rights during the performance period and, accordingly, the fair value of the performance share awards is the quoted market value of TruBridge’s common stock on the grant date less the present value of the expected dividends not received during the relevant period.

The TSR performance metric described above meets the definition of a market condition. A third-party appraiser prepares a Monte Carlo simulation pricing model to determine the fair value of this market condition, which is recognized ratably over the three-year service period. The per unit or share fair value of the TSR modifier was estimated using the following assumptions:


Award Year	Expected Life (yrs)	Dividend Rate		Risk-Free Interest Rate		Expected Price Volatility (1)
2025	3	—	%	3.89	%	48.05	%
2024	3	—	%	4.50	%	41.53	%

(1) Historical volatility is the basis for the expected volatility assumption.

Expense related to performance share awards is recognized using straight-line amortization over the three-year performance period based on the estimated achievement of the Company-specific performance goals assessed each reporting period. In the event the Company determines it is no longer probable that the minimum performance level will be achieved, all previously recognized compensation expense related to the applicable awards is reversed in the period such a determination is made.

A summary of performance share award activity under the Plan for the years ended December 31, 2025, 2024 and 2023, is as follows, based on the target award amounts set forth in the performance share award agreements:


	Shares at target	Weighted-Average Grant-Date Fair Value
Performance share awards outstanding at January 1, 2023	252,375	$	31.84
Granted	122,071	31.21
Forfeited or unearned	(100,655)	27.46

Performance share awards outstanding at December 31, 2023	273,791	$	33.17
Granted	323,461	10.60
Forfeited or unearned	(145,471)	20.31

Performance share awards outstanding at December 31, 2024	451,781	$	19.02
Granted	113,008	32.57
Forfeited or unearned	(103,858)	34.45

Performance share awards outstanding at December 31, 2025	460,931	$	25.10

Stock Repurchases

On September 4, 2020, our Board of Directors approved a stock repurchase program under which we may repurchase up to $30.0 million of our common stock through September 3, 2022. On July 27, 2022, the Board of Directors extended the expiration date of the stock repurchase program to September 4, 2024. The share repurchase program expired according to its terms on September 4, 2024. The Company did not repurchase any shares during 2025 or 2024, under the share repurchase program. Any future stock repurchase transactions may be made through open market purchases, privately-negotiated transactions, or otherwise in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended. Any repurchase activity will depend on many factors, such as the availability of shares of our common stock, general market conditions, the trading price of our common stock, alternative uses for capital, the Company's financial performance, compliance with the terms of our Amended and Restated Credit Agreement and other factors. Concurrent with the authorization of this stock repurchase program in September 2020, the Board of Directors opted to indefinitely suspend all quarterly dividends.

We repurchased 69,843 and 46,980 shares during the years ended December 31, 2025 and 2024, respectively, to fund required tax withholdings related to the vesting of restricted stock.

Common Stock Rights Agreement

On March 26, 2024, the Board of Directors declared a dividend of one right (a “Right”) for each of the Company’s issued and outstanding shares of common stock. The dividend was paid to the stockholders of record at the close of business on April 4, 2024. The complete description and terms of the Rights were set forth in the Rights Agreement, dated as of March 26, 2024, by and between the Company and Computershare Trust Company, N.A. as rights agent, as amended by the Amendment to the Rights Agreement dated as of April 22, 2024 (as amended, the “Rights Agreement”). On February 11, 2025, the Company and Computershare Trust Company, N.A. entered into the Second Amendment to the Rights Agreement. The amendment terminated the Rights Agreement by accelerating the expiration time of the Rights Agreement to expire on February 12, 2025. At the time of the termination of the Rights Agreement, all of the Rights, which were previously distributed to holders of the Company’s issued and outstanding common stock, par value $0.001, pursuant to the Rights Agreement, expired.

10. CONCENTRATION OF CREDIT RISK

Financial instruments, which potentially subject the Company to concentration of credit risk, consist principally of temporary cash investments and trade receivables (including financing receivables). The Company places its temporary cash investments with credit-worthy, high-quality financial institutions.

The Company’s customer base is concentrated in the healthcare industry. Customers are primarily located throughout the United States. The Company requires no collateral or other security to support customer trade receivables. An allowance for credit losses for trade receivables and an allowance for credit losses for financing receivables have been established for potential credit losses based on historical collection experience.

The Company maintains its cash and cash equivalents in bank deposit accounts, which, at times, may exceed federally insured limits. The Company has not experienced any losses in such accounts and does not believe it is exposed to any significant credit risk on cash and cash equivalents.

11. FINANCING RECEIVABLES

Short-Term Payment Plans

The Company provides fixed monthly payment arrangements ("short-term payment plans") over terms ranging from three to twelve months for certain add-on software installations. As a practical expedient, we do not adjust the amount of consideration recognized as revenue for the financing component as unearned income when we expect payment within one year or less. These receivables, included in the current portion of financing receivables, were comprised of the following on December 31, 2025 and 2024:


(In thousands)	2025		2024
Short-term payment plans, gross	$	1,293	$	1,521
Less: allowance for credit losses	(65)		(76)
Short-term payment plans, net	$	1,228	$	1,445

Long-Term Financing Arrangements

Additionally, the Company provides financing for purchases of its information and patient care systems to certain healthcare providers under long-term financing arrangements expiring in various years through 2028. Under long-term financing arrangements, the transaction price is adjusted by a discount rate that reflects market conditions and that would be used for a separate financing transaction between the Company and licensee at contract inception, and takes into account the credit characteristics of the licensee and market interest rates as of the date of the agreement. As such, the amount of fixed fee revenue recognized at the beginning of the license term will be reduced by the calculated financing component. As payments are received from the licensee, the Company recognizes a portion of the financing component as interest income, reported as other income in the consolidated statements of operations. These receivables typically have terms from two to seven years.

The decrease in long-term financing arrangement balances during 2025 is primarily a result of the continued evolution of customer licensing preferences. Although the overwhelming majority of our historical Patient Care installations prior to 2019 were made under a perpetual license model, the dramatic shift in customer preferences to a SaaS license model began during 2019 with 49% of the year's new acute Patient Care installations being performed in a SaaS model, compared to only 12% in 2018. The shift in customer preference toward a SaaS model has since continued, with SaaS installations representing 100% of new acute Patient Care installations in 2024 and 2025. Due to the nature of the revenue recognition requirements for SaaS arrangements, coupled with recurring monthly payments, these arrangements do not give rise to long-term financing arrangements.

The components of these receivables were as follows on December 31, 2025 and 2024:


(In thousands)	2025		2024
Long-term financing arrangements, gross	$	2,591	$	4,100
Less: allowance for credit losses	(797)		(362)
Less: unearned income	(91)		(288)
Long-term financing arrangements, net	$	1,703	$	3,450

Future minimum payments to be received subsequent to December 31, 2025 are as follows:


(In thousands)
2026	$	1,828
2027	708
2028	55
2029	—
2030	—
Thereafter	—
Total minimum payments to be received	2,591
Less: allowance for credit losses	(797)
Less: unearned income	(91)
Receivables, net	$	1,703

Credit Quality of Financing Receivables and Allowance for Credit Losses

The following table is a rollforward of the allowance for credit losses for the years ended December 31, 2025 and 2024:


(In thousands)	Beginning Balance		Provision		Charge-offs		Miscellaneous Adjustments		Sale of AHT		Ending Balance
December 31, 2025	$	438	$	365	$	—	$	59	$	—	$	862
December 31, 2024	$	416	$	397	$	(373)	$	—	$	(2)	$	438

The Company’s financing receivables are comprised of a single portfolio segment, as the balances are all derived from short-term payment plan arrangements and long-term financing arrangements within our target market of rural and community hospitals. The Company evaluates the credit quality of its financing receivables based on a combination of factors, including, but not limited to, customer collection experience, economic conditions, the customer’s financial condition, and known risk characteristics impacting the respective customer base of community hospitals, the most notable of which relate to enacted and potential changes in Medicare and Medicaid reimbursement rates as community hospitals typically generate a significant portion of their revenues and related cash flows from beneficiaries of these programs. In addition to specific account identification, the Company utilizes historical collection experience to establish the allowance for credit losses. Financing receivables are written off only after the Company has exhausted all collection efforts.

Customer payments are considered past due if a scheduled payment is not received within contractually agreed upon terms. To facilitate customer collection and credit monitoring efforts, financing receivable amounts are invoiced and reclassified to trade accounts receivable when they become due, with all invoiced amounts placed on nonaccrual status. As a result, all past due amounts related to the Company’s financing receivables are included in trade accounts receivable in the accompanying consolidated balance sheets. The following is an analysis of the age of financing receivables amounts (excluding short-term payment plans) that have been reclassified to trade accounts receivable and were past due as of December 31, 2025 and 2024:


(In thousands)	1 to 90 Days Past Due		91 to 180 Days Past Due		181 + Days Past Due		Total Past Due
December 31, 2025	$	935	$	298	$	1,002	$	2,235
December 31, 2024	$	1,272	$	317	$	815	$	2,404

From time to time, the Company may agree to alternative payment terms outside of the terms of the original financing receivable agreement due to customer difficulties in achieving the original terms. In general, such alternative payment arrangements do not result in a re-aging of the related receivables. Rather, payments pursuant to any alternative payment arrangements are applied to the already outstanding invoices beginning with the oldest outstanding invoices as the payments are received.

Because amounts are reclassified to trade accounts receivable when they become due, there are no past due amounts included within current portion of financing receivables, net or financing receivables, less current portion in the accompanying consolidated balance sheets.

The Company utilizes an aging of trade accounts receivable as the primary credit quality indicator for its financing receivables, which is facilitated by the reclassification of customer payment amounts to trade accounts receivable when they become due. The table below categorizes customer financing receivable balances (excluding short term payment plans), none of which are considered past due, based on the age of the oldest payment outstanding that has been reclassified to trade accounts receivable:


(In thousands)	December 31, 2025		December 31, 2024
Stratification of uninvoiced client financing receivables based on aging of related trade accounts receivable:
Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due	$	1,201	$	1,208
Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due	458		259
Uninvoiced client financing receivables related to trade accounts receivable that are 181+ Days Past Due	841		1,316
Total uninvoiced client financing receivables balances of clients with a trade accounts receivable	$	2,500	$	2,783
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	—		1,029
Total financing receivables with contractual maturities of one year or less	1,293		1,521
Less: allowance for credit losses	(862)		(438)
Total financing receivables	$	2,931	$	4,895

12. INTANGIBLE ASSETS AND GOODWILL

Our purchased definite-lived intangible assets as of December 31, 2025 and 2024 are summarized as follows:


Total	December 31, 2025
(In thousands)	Customer Relationships		Trademark		Developed Technology		Non-compete Agreements		Total
Gross carrying amount, beginning of period	$	116,470	$	7,720	$	31,900	$	1,620	$	157,710

Accumulated amortization	(59,898)		(5,378)		(24,404)		(1,171)		(90,851)
Accumulated impairment	—		(2,342)		—		—		(2,342)

Net intangible assets as of December 31, 2025	$	56,572	$	—	$	7,496	$	449	$	64,517


	December 31, 2024
(In thousands)	Customer Relationships		Trademark		Developed Technology		Non-compete Agreements		Total
Gross carrying amount, beginning of period	$	116,470	$	7,720	$	31,900	$	1,620	$	157,710

Accumulated amortization	(50,260)		(5,378)		(22,177)		(846)		(78,661)
Accumulated impairment	—		(2,342)		—		—		(2,342)

Net intangible assets as of December 31, 2024	$	66,210	$	—	$	9,723	$	774	$	76,707

The following table represents the remaining amortization of definite-lived intangible assets as of December 31, 2025:


(In thousands)
For the year ended December 31,
2026	$	11,518
2027	10,496
2028	10,203
2029	10,095
2030	6,676
Due thereafter	15,529
Total	$	64,517

The following table sets forth the change in the carrying amount of goodwill by segment for the years ended December 31, 2024 and 2025:


(In thousands)	Financial Health		Patient Care		Total





Gross value at December 31, 2024	79,084		128,738		207,822
Goodwill acquired	664		—		664
Accumulated impairment	—		(35,913)		(35,913)
Carrying value at December 31, 2024	$	79,748	$	92,825	$	172,573

Gross value at December 31, 2025	79,748		128,738		$	208,486
Accumulated impairment	—		(35,913)		(35,913)
Carrying value at December 31, 2025	$	79,748	$	92,825	$	172,573

Our reporting units assessed for impairment of goodwill on October 1, 2023 included: RCM (formerly the “TruBridge” reporting unit), Acute Care EHR, Post-acute care EHR (comprised solely of AHT, which was disposed in January 2024), and Patient Engagement (formerly a component of the “TruBridge” reporting unit). We did not identify any events or

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circumstances that would require interim goodwill impairment testing prior to October 1, 2023. Based on our quantitative assessment as of October 1, 2023, we determined that there was no impairment of goodwill for the TruBridge reporting unit. However, quantitative evaluations of the fair values of each of our remaining three reporting units, using a combination of the income and market valuation approaches, resulted in impairment conclusions as follows:

•Our Acute Care EHR reporting unit was assessed goodwill impairment charges of $6.4 million due to deteriorating market conditions, the related impact to the cost of capital, and lowered expectations regarding long-term margin potential.

•Our Post-acute care EHR reporting unit was assessed goodwill impairment charges of $2.2 million due to deteriorating market conditions, the related impact to the cost of capital, and revised expectations regarding the long-term persistence of elevated customer attrition levels.

•Our Patient Engagement reporting unit was assessed goodwill impairment charges of $7.6 million due to deteriorating market conditions, the related impact to the cost of capital, and revised expectations regarding long-term growth prospects as sales pipelines have been stubborn to develop to the robust levels previously anticipated.

During the fourth quarter of 2023, the decision to accept an offer for the sale of AHT that was well below the related reporting unit’s carrying value was considered a triggering event requiring reassessment of the reporting unit’s goodwill, resulting in an additional goodwill impairment charge of $19.7 million. Lastly, management considered the continued decrease in the Company’s market capitalization since our most recent quantitative analysis dated October 1, 2023 to be a triggering event warranting a further quantitative goodwill impairment analysis as of December 31, 2023. As a result of this updated quantitative goodwill impairment analysis, management concluded that there was no further impairment to goodwill.

During the first quarter of 2024, our share price experienced a sustained decline resulting in a decrease in our market capitalization. This decline in share price was identified as a triggering event requiring a quantitative assessment for goodwill impairment in all of our reporting segments.

We assessed goodwill in each of our reporting segments for impairment as of March 31, 2024, by using a combination of the income and market valuation approaches. Under the income approach, we used a discounted cash flow model, which utilizes present values of cash flows to estimate fair value. Our forecasted cash flows reflected conditions as of March 31, 2024, and reflected management’s anticipated business outlook for each reporting unit, which requires the use of estimates. The market approach applied selected trading multiples of companies comparable to the respective reporting units to the Company’s financial measures. Trading multiples selected for each reporting unit varied from the low end of the range of guideline public companies up to the median depending on the specific characteristics of each reporting unit. The income approach was given significantly more weight in determining the fair values. The approaches, which qualify as Level 3 within the fair value hierarchy, incorporate a number of market participant assumptions including, but not limited to, future cash flows, growth rates, and discount rates. The assumptions about future cash flows and growth rates are based on the Company’s forecasts and long-term plans. Discount rate assumptions are based on an assessment of the inherent risk of the respective reporting units. These quantitative evaluations of the fair values of each of our reporting units resulted in no impairment as of March 31, 2024. Given that the fair values of the reporting units are based on management’s best estimates, if actual results should differ from those estimates, impairment charges may be required in future periods.

On May 14, 2024, the Company announced a reorganization of its operating and reporting segment structure. As a result, the Company changed from three operating and reportable segments of (i) RCM, (ii) EHR and (iii) Patient Engagement to two operating and reportable segments of (i) Financial Health and (ii) Patient Care. This restructuring resulted in another triggering event requiring a quantitative assessment for goodwill impairment in our reporting units immediately pre- and post-reorganization as of that date. We utilized the same goodwill valuation approach as described above. These quantitative evaluations of the fair values of the goodwill in each of our reporting units resulted in no impairment.

We performed our annual assessment for impairment of goodwill and determined that there was no impairment as of December 31, 2025.

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13. LONG-TERM DEBT

Long-term debt was comprised of the following at December 31, 2025 and 2024:


(In thousands)	December 31, 2025		December 31, 2024
Term loan facility	$	69,125	$	56,375
Revolving credit facility	97,500		116,415

Debt obligations	166,625		172,790
Less: debt issuance costs	(2,000)		(1,212)
Debt obligation, net	164,625		171,578
Less: current portion	(3,384)		(2,980)
Long-term debt	$	161,241	$	168,598

As of December 31, 2025, the carrying value of debt approximates the fair value due to the variable interest rate which reflects market rates. The interest rate for the outstanding debt under our term loan facility and revolving credit facility as of December 31, 2025 was 5.92%.

Credit Agreement

In conjunction with our acquisition of Healthland Holding Inc. in January 2016, we entered into a syndicated credit agreement with Regions Bank ("Regions") serving as administrative agent, which provided for a $125 million term loan facility and a $50 million revolving credit facility. On June 16, 2020, we entered into an Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $185 million, including a $75 million term loan facility and a $110 million revolving credit facility. On May 2, 2022, we entered into a First Amendment (the "First Amendment") to the Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $230 million, which included a $70 million term loan facility and a $160 million revolving credit facility. In addition, the interest rate provisions of the First Amendment reflect the transition from the London Interbank Offered Rate ("LIBOR") to the Secured Overnight Financing Rate ("SOFR") as the new benchmark interest rate for each loan. On November 25, 2025, we entered into a further Amended and Restated Credit Agreement (the “Amended Credit Agreement”; capitalized terms used but not defined herein shall have the meanings ascribed to them in the Amended Credit Agreement) that increased the aggregate principal amount of our credit facilities to $250 million, including a $70 million term loan facility and a $180 million revolving credit facility. The Amended Credit Agreement provides incremental facility capacity of $75 million, subject to certain conditions.

Each of our credit facilities bears interest at a rate per annum equal to an applicable margin plus, at our option, either (1) Term SOFR for the relevant interest period, subject to a floor of 0.0%, (2) an alternate base rate determined by reference to the greater of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). The applicable margin for SOFR loans and the letter of credit fee ranges from 1.5% to 3.0%. The applicable margin range for base rate loans ranges from 0.5% to 2.0%, in each case based on the Company's consolidated net leverage ratio. The Amended Credit Agreement removed the “SOFR Adjustment” that had been included in the Term SOFR calculation.

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Anticipated annual future maturities of the term loan facility and revolving credit facility are as follows as of December 31, 2025:


(In thousands)
2026	$	3,500
2027	3,500
2028	3,500
2029	3,500
Thereafter	152,625
	$	166,625

Our obligations under the Amended Credit Agreement are secured pursuant to the Amended and Restated Pledge and Security Agreement, dated as of November 25, 2025, among the parties identified as obligors therein and Regions, as collateral agent, on a first priority basis by a security interest in substantially all of the tangible and intangible assets (subject to certain exceptions) of the Company and certain subsidiaries of the Company, as guarantors (collectively, the “Subsidiary Guarantors”), including certain registered intellectual property and the capital stock of certain of the Company’s direct and indirect subsidiaries. Our obligations under the Amended Credit Agreement are also guaranteed by the Subsidiary Guarantors.

The Amended Credit Agreement, includes a number of restrictive covenants that, among other things and in each case subject to certain exceptions and baskets, impose operating and financial restrictions on the Company and the Subsidiary Guarantors, including the ability to incur additional debt; incur liens and encumbrances; make certain restricted payments, including paying dividends on the Company's equity securities or payments to redeem, repurchase or retire the Company's equity securities (which are subject to our compliance, on a pro forma basis to give effect to the restricted payment, with the consolidated fixed charge coverage ratio and consolidated net leverage ratio described below); enter into certain restrictive agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into sale and leaseback transactions; engage in transactions with affiliates; and materially alter the business we conduct. The Amended Credit Agreement also contains customary representations and warranties, affirmative covenants and events of default.

Under the Amended Credit Agreement, the Company is required to maintain a minimum Consolidated Fixed Charge Coverage Ratio of 1.25:1:00, to be measured as of the end of the fiscal quarter.

Also under the Amended Credit Agreement, the Company is required to comply with a maximum consolidated net leverage ratio of (i) 3.75:1.00 as of the fiscal quarters ending December 31, 2025 through September 30, 2026 and (ii) 3.50:1:00 as of the fiscal quarters ending December 31, 2026 and thereafter, to be measured as of the end of each fiscal quarter. In connection with any acquisition by the Company exceeding $25 million, the Company may elect to increase the maximum permitted consolidated net leverage ratio for the fiscal quarter in which the acquisition occurs and each of the following three fiscal quarters by 0.50:1.00 above the otherwise permitted maximum. The Company is permitted to voluntarily prepay the credit facilities at any time without penalty, subject to customary “breakage” costs with respect to prepayments of SOFR rate loans made on a day other than the last day of any applicable interest period. The Amended Credit Agreement includes several standard mandatory prepayment requirements, including the following: (i) if revolving borrowings, letters of credit, or swingline loans exceed their respective limits, the excess must be repaid immediately; (ii) the Company must prepay 100% of net cash proceeds from asset sales or involuntary losses that exceed $2.5 million in a year, unless those proceeds are reinvested in property useful in the Company’s business within 365 days; (iii) 100% of net proceeds from new debt must be prepaid; and (iv) 50% of net proceeds from equity transactions must be prepaid unless the Company’s most recent consolidated net leverage ratio is 3.25:1.0 or lower, in which case the equity‑related prepayment is not required.

14. BENEFIT PLANS

In January 1994, the Company adopted the CPSI 401(k) Retirement Plan that covers all eligible employees of the Company. The plan allows eligible employees to contribute up to 60% of their pre-tax earnings up to the statutory limit prescribed by the Internal Revenue Service. The Company matches a discretionary amount determined by the Board of Directors. The Company contributed approximately $3.0 million, $3.5 million, and $3.8 million to the plan for the years ended December 31, 2025, 2024 and 2023, respectively.

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15. OPERATING LEASES

The Company leases office space in various locations in Alabama, Pennsylvania, and Mississippi. These leases have terms expiring from 2026 through 2029 but do contain optional extension terms. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet. We recognize lease expense on a straight-line basis over the lease term.

Supplemental balance sheet information related to operating leases is as follows:


(In thousands)	December 31, 2025		December 31, 2024
Operating lease right-of-use assets:
Operating lease right-of-use assets	$	2,010	$	3,092
Operating lease liabilities:
Other accrued liabilities	772		944
Operating lease liabilities, net of current portion	1,346		2,293
Total operating lease liabilities	$	2,118	$	3,237
Weighted average remaining lease term in years	2.90		3.60
Weighted average discount rate	3.9%		4.1%

Because our leases do not provide a readily determinable implicit rate, we use our incremental borrowing rate based on the information available at the lease commencement date in determining the present value of lease payments. The incremental borrowing rate is the estimated rate incurred to borrow on a collateralized basis over a similar term and amount equal to the lease payments in a similar economic environment. We used the incremental borrowing rate on January 1, 2019, for operating leases that commenced prior to that date.

The future minimum lease payments payable under these operating leases subsequent to December 31, 2025 are as follows:


(In thousands)
2026	$	840
2027	709
2028	462
2029	231
2030	—
Thereafter	—
Total lease payments	2,242
Less imputed interest	(124)
Total	$	2,118

Total rent expense for the years ended December 31, 2025, 2024, and 2023 was $1.1 million, $1.8 million, and $1.8 million, respectively, is included in operating expense in the consolidated statement of operations.

Total cash paid for amounts included in the measurement of lease liabilities within operating cash flows from operating leases for the years ended December 31, 2025, 2024, and 2023 was $1.1 million, $1.8 million, and $1.8 million, respectively.

16. COMMITMENTS AND CONTINGENCIES

From time to time, the Company is involved in routine litigation that arises in the ordinary course of business. While many of these matters involve inherent uncertainty, we evaluate legal proceedings on a regular basis and accrue a liability for such matters when appropriate. Any such accruals are adjusted thereafter to reflect changed circumstances.

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On February 13, 2026, VG Sellers, Inc. (the "Seller") brought a civil action in the Delaware Chancery Court against Company alleging breaches of the Securities Purchase Agreement (the "SPA") governing the Company’s acquisition of Viewgol, LLC in October 2023 (the "Viewgol Acquisition"). Among other claims, the Seller alleges that it is entitled to an additional payment of up to $31.5 million pursuant to the earnout provisions set forth in the SPA, based on the Seller's assertion that Viewgol, LLC achieved certain financial targets for the year ended December 31, 2024 (such payment, the "2024 Earnout Payment"). The Company believes that the Seller is not entitled to any portion of the 2024 Earnout Payment. On March 10, 2026, the Company filed its Answer to Seller’s Complaint and filed Counterclaims against Seller that, among other things, seek a declaration that Seller is not entitled to any portion of the 2024 Earnout Payment; assert a claim against the Seller’s former owners for breach of the SPA; and seek compensatory damages and other remedies as a result of wrongdoing by Seller and its former owners. As of December 31, 2025, the Company accrued $5.0 million associated with the resolution of this matter. It is reasonably possible that the estimate will change in the near term and the effect of the change could be material and therefore we can provide no assurance as to the scope and outcome of these matters.

17. FAIR VALUE

ASC 820, Fair Value Measurement, establishes a framework for measuring fair value and expands financial statement disclosures about fair value measurements. Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction in the principal (or most advantageous) market at the measurement date under current market conditions (that is an exit price), regardless of whether that price is directly observable or estimated using another valuation technique. The Codification does not require any new fair value measurements, but rather applies to all other accounting pronouncements that require or permit fair value measurements. The Codification requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories:

Level 1: Quoted market prices in active markets for identical assets or liabilities.

Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data.

Level 3: Unobservable inputs that are not corroborated by market data.

The Company believes that the carrying amounts of cash and cash equivalents, accounts receivable, accounts payable and current portion of long-term debt approximate their fair value due to their short-term nature.

As of December 31, 2025, we estimated the fair value of contingent consideration that represents a potential earnout payment to Viewgol’s former equity holders based on information available to management as of the reporting date. Refer to Note 16 of the consolidated financial statements included herein for additional detail regarding contingent consideration. We did not have any other instruments that required fair value measurement as of December 31, 2025.

The following table summarizes the carrying amount and fair value of the contingent consideration at December 31, 2025:


			Fair Value at December 31, 2025 Using
(In thousands)	Carrying Amount at 12/31/25		Quoted Price in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Description
Contingent consideration	$	5,000	$	—	$	—	$	5,000
Total	$	5,000	$	—	$	—	$	5,000

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The following table summarizes the carrying amount and fair value of the contingent consideration at December 31, 2024:

Fair Value at December 31, 2024 Using

(In thousands)

Carrying Amount at 12/31/24

Quoted Price in Active Markets for Identical Assets (Level 1)

Significant Other Observable Inputs (Level 2)

Significant Unobservable Inputs (Level 3)

Description

Contingent consideration

—

Total

—

18. SEGMENT REPORTING

Our chief operating decision maker (“CODM”) utilizes two operating segments, “Financial Health” and “Patient Care,” based on our two distinct business units with unique market dynamics and opportunities. These two segments are distinct business units with unique market dynamics and opportunities. They represent the components of the Company for which separate financial information is available and is utilized on a regular basis by the CODM in assessing segment performance and in allocating the Company's resources.

The Company’s CODM is its Chief Executive Officer. The CODM uses revenues and Adjusted EBITDA to assess the performance of and allocated resources to each of the reportable segments during the annual budgeting and forecasting process. The significant expenses regularly reviewed by the CODM include costs of revenues, product development, sales and marketing, and general and administrative expenses. Monthly, the CODM considers forecast-to-actual variances for each of revenues and Adjusted EBITDA to assess the performance for each segment. The CODM believes Adjusted EBITDA is a useful measure to assess the performance and liquidity of the Company, as it provides meaningful operating results by excluding the effects of expenses that are not reflective of the Company’s operating business performance. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis.

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“Adjusted EBITDA” consists of GAAP net income (loss) as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangible assets; (iv) stock-based compensation; (v) severance and other non-recurring charges; (vi) interest expense and other income, net; (vii) impairment of goodwill; (viii) impairment of trademark intangibles; (ix) change of fair value of contingent consideration; (x) (gain) loss on disposal of property and equipment; (xi) gain on sale of AHT; and (xii) the provision (benefit) for income taxes. There are no intersegment revenues to be eliminated in computing segment revenue.

The CODM does not evaluate operating segments nor make decisions regarding operating segments based on assets. Consequently, we do not disclose total assets by reportable segment.

The following table presents a summary of the revenues and Adjusted EBITDA of our two operating segments for the years ended December 31, 2025, 2024, and 2023:


	Year Ended December 31,
(In thousands)	2025		2024		2023
Revenues:
Financial Health	$	221,657	$	217,366	$	193,334
Patient Care	125,179		124,839		143,630
Total consolidated revenues	346,836		342,205		336,964

Less:
Financial Health expenses (excluding stock-based compensation expense):
Cost of revenue (excluding depreciation and amortization)	$	113,101	$	116,342	$	108,187
Product development	12,681		8,644		9,985
Sales and marketing	14,278		15,855		16,715
General and administrative expenses	41,619		39,680		34,008
Total Financial Health expenses	$	181,679	$	180,521	$	168,895
Patient Care expenses (excluding stock-based compensation expense):
Cost of revenue (excluding depreciation and amortization)	$	48,319	$	51,857	$	65,122
Product development	18,675		25,898		28,836
Sales and marketing	8,108		9,354		10,823
General and administrative expenses	21,386		18,676		18,941
Total Patient Care expenses	$	96,488	$	105,785	$	123,722
Total segment expenses	$	278,167	$	286,306	$	292,617

Adjusted EBITDA by Segment:
Financial Health	39,978		36,845		24,439
Patient Care	28,691		19,054		19,908
Total Adjusted EBITDA	$	68,669	$	55,899	$	44,347

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The following table reconciles Adjusted EBITDA to income (loss) before taxes:


	Year Ended December 31,
(In thousands)	2025		2024		2023
Total Adjusted EBITDA	$	68,669	$	55,899	$	44,347
Less:
Interest expense and other, net	12,136		15,517		11,659
Depreciation expense	1,092		1,346		1,946
Amortization of software development costs	12,995		14,715		7,951
Amortization of acquisition-related intangibles	12,190		12,505		16,426
Stock-based compensation	8,661		5,520		3,271
Severance and other non-recurring charges	12,899		15,442		22,186
Impairment of goodwill	—		—		35,913
Impairment of trademark intangibles	—		—		2,342
Change in fair value of contingent consideration	5,000		(1,044)		—
(Gain) loss on disposal of property and equipment	(120)		3,895		117
Gain on sale of AHT	(53)		(1,529)		—
Income (loss) before taxes	$	3,869	$	(10,468)	$	(57,464)

108

SCHEDULE II

TRUBRIDGE, INC.

VALUATION AND QUALIFYING ACCOUNTS

(In thousands)


Description		Balance at beginning of period		Additions charged to cost and expenses (1)		Deductions (2)		Balance at end of period
Allowance for credit losses deducted from accounts receivable in the balance sheet	2023	$	2,854	$	2,053	$	(879)	$	4,028
	2024	$	4,028	$	3,268	$	(1,435)	$	5,861
	2025	$	5,861	$	2,637	$	(2,495)	$	6,003

(1) Adjustments to allowance for change in estimates.

(2) Uncollectible accounts written off, net of recoveries.


Description		Balance at beginning of period		Additions charged to cost and expenses (1)		Deductions (2)		Balance at end of period
Allowance for credit losses deducted from financing receivables in the balance sheet	2023	$	549	$	(133)	$	—	$	416
	2024	$	416	$	397	$	(375)	$	438
	2025	$	438	$	365	$	59	$	862

(1) Adjustments to allowance for change in estimates.

(2) Uncollectible accounts written off, net of recoveries.


ITEM 9.			CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE

None.


ITEM 9A.			CONTROLS AND PROCEDURES.

Evaluation of Disclosure Controls and Procedures

We evaluated the effectiveness of the design and operation of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”)) as of December 31, 2025. Disclosure controls and procedures are designed to provide reasonable assurance that the information required to be disclosed by us in reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the rules and forms promulgated by the Securities and Exchange Commission, and that such information is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions regarding required disclosure.

Our management, including our Chief Executive Officer and Chief Financial Officer, does not expect that our disclosure controls and procedures or our internal control over financial reporting will prevent all errors and all fraud due to inherent limitations of internal controls. Because of such limitations, there is a risk that material misstatements will not be prevented or detected on a timely basis by internal control over financial reporting. However, these inherent limitations are known features of the financial reporting process. Therefore, it is possible to design safeguards into the process to reduce, though not eliminate, this risk.

Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures as of December 31, 2025. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were not effective as of December 31, 2025 due to the material weaknesses in internal control over financial reporting described below.

Management’s Report on Internal Control Over Financial Reporting

Management is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rule 13a-15(f) and 15d-15(e) under the Exchange Act. The Company’s management, with the participation of the Chief

109

Executive Officer and our Chief Financial Officer, under the oversight of our Board of Directors, evaluated the effectiveness of the Company’s internal control over financial reporting as of December 31, 2025 using the framework in Internal Control – Integrated Framework (2013), issued by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”). Based on that evaluation, management concluded that the Company’s internal control over financial reporting was not effective as of December 31, 2025 due to the material weaknesses in internal control over financial reporting, described below.

The Company’s internal control over financial reporting includes those policies and procedures that:

(i)pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company;

(ii)provide reasonable assurance that transactions are recorded to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the Company are being made only in accordance with authorizations of management and directors of the Company; and

(iii)provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the Company’s assets that could have a material effect on the financial statements.

Based on the assessment described above, management concluded that our internal control over financial reporting (“ICFR”) was not effective as of December 31, 2025 due to the following material weaknesses:

We did not sufficiently design and maintain effective control activities related to the accounting for revenue recognition and related costs, capitalization of software development costs, and non-routine transactions.

Management concluded that these material weaknesses resulted primarily from ineffective risk assessment and the selection and development of appropriate control activities due to an insufficient number of personnel with the appropriate training and expertise in certain accounting matters and internal controls over financial reporting.

The material weaknesses described above resulted in misstatements which were corrected prior to the issuance of the consolidated financial statements contained in this Annual Report on Form 10-K. These material weaknesses created a reasonable possibility that a material misstatement in our consolidated financial statements would not be prevented or detected on a timely basis. Therefore, management has concluded that we did not maintain effective internal control over financial reporting as of December 31, 2025.

Our independent registered public accounting firm, KPMG LLP, who audited the consolidated financial statements of the Company as of and for the year ended December 31, 2025, issued an adverse opinion on the effectiveness of the Company’s internal control over financial reporting. KPMG LLP’s report appears on page 61 of this Annual Report on Form 10-K.

Management’s Remediation Plan

We are committed to remediating these material weaknesses as quickly as practicable. Under the oversight of the Audit Committee, management has commenced a remediation program designed to improve our risk assessment process and strengthen the design, documentation, and operation of key controls. We will not consider these remediation efforts complete until the relevant controls have been fully designed and implemented and have operated effectively for a sufficient period of time for management to test and conclude that the material weaknesses have been remediated.

With respect to the material weakness related to the Company’s revenue business cycle and related costs, management is redesigning and implementing an enhanced suite of controls across the end-to-end revenue lifecycle to address the deficiencies described below. During 2025, the Company began implementing system and process enhancements intended to improve the completeness and timeliness of contract data and strengthen billing and revenue recognition workflows. Management is also pursuing implementation of an enterprise resource planning system and has engaged external advisors with relevant expertise to support evaluation of ASC 606 application and the design and implementation of controls responsive to identified risks.

110

Planned remediation actions include enhancing controls over: (i) contract lifecycle activities and related accounting conclusions, (ii) billing and revenue recognition processes (including key manual inputs), (iii) completeness and accuracy of key data and reports used in revenue processes, (iv) timely identification and accounting for billing adjustments and customer credits, and (v) contract-related cost accounting.

With respect to the material weakness related to capitalized software development costs, the Company is designing and implementing software development lifecycle controls to ensure software costs are capitalized or expensed based on consistently applied and documented criteria and supported by reliable information. These actions include implementing standardized stage gate documentation for capitalization start and stop points, strengthening classification procedures to distinguish capitalizable development and enhancement work from noncapitalizable maintenance and support work, and implementing controls to validate the completeness and accuracy of key information used in capitalization and allocation processes derived from project management systems and reports. The Company also expects to provide training and technical accounting support to product development personnel to promote consistent application of these requirements.

With respect to the material weakness related to non-routine transactions, management is implementing enhancements to its controls over the identification, evaluation, documentation, and review of non-routine and complex transactions that require significant accounting judgment, including stock-based payment arrangements and other technical accounting areas. These efforts are intended to strengthen management’s risk assessment, control design, and oversight processes by standardizing required analyses and documentation, clarifying roles and responsibilities, and enhancing review and approval requirements for key conclusions and estimates.

Remediation actions are ongoing and include, or are expected to include: (i) formalizing and standardizing workflows, documentation requirements, and evidence retention for non-routine transactions; (ii) strengthening review and approval controls over significant judgments, assumptions, and calculations (including use of specialists where appropriate); and (iii) enhancing the control environment through additional training and technical accounting support resources, including targeted training for relevant personnel and the use of external advisors to support complex evaluations.

Management also expects to address people factors contributing to the material weakness by augmenting resources and providing targeted training on internal control execution and review.

Changes in Internal Control over Financial Reporting

There were no changes in our internal control over financial reporting during the fourth quarter ended December 31, 2025 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.


ITEM 9B.			OTHER INFORMATION.

(a) None.

(b) Rule 10b5-1 Trading Arrangements

From time to time, members of the Company's Board of Directors and officers of the Company may enter into Rule 10b5-1 trading plans, which allow for the purchase or sale of common stock under pre-established terms at times when directors and officers might otherwise be prevented from trading under insider trading laws or because of self-imposed blackout periods. Such trading plans are intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act and comply with the Company's insider trading policy. During the three months ended December 31, 2025, none of the Company’s directors or officers adopted or terminated a “Rule 10b5-1 trading arrangement” or a “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408 of Regulation S-K.


ITEM 9C.			DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS.

None.

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PART III


ITEM 10.			DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE

We have adopted a Code of Business Conduct and Ethics applicable to all of our directors, officers (including our Chief Executive Officer and senior financial officers) and employees which also includes a separate code of ethics with additional guidelines and responsibilities applicable to our Chief Executive Officer and senior financial officers, known as the Code of Ethics for CEO and Senior Financial Officers. Copies of the Code of Business Conduct and Ethics and the Code of Ethics for CEO and Senior Financial Officers are available on TruBridge’s web site at www.trubridge.com in the "Corporate Information" section under "Corporate Governance." We intend to disclose any amendments to the Code of Business Conduct and Ethics, as well as any waivers for executive officers or directors, on our website.

We have adopted an Insider Trading Policy governing the purchase, sale, and other disposition of our securities by our directors, officers, and employees, and by the Company. We believe this policy is reasonably designed to promote compliance with insider trading laws, rules, and regulations and listing standards applicable to the Company. A copy of our Insider Trading Policy is filed as Exhibit 19 to this Form 10-K.

Other information required by this Item regarding executive officers is included in Part I of this Form 10-K under the caption "Executive Officers" in accordance with Instruction 3 to Paragraph (b) of Item 401 of Regulation S-K.

Other information required by this Item is incorporated by reference pursuant to General Instruction G(3) of Form 10-K from the 2026 Proxy Statement to be filed with the SEC pursuant to Regulation 14A, or in the event the 2026 Proxy Statement is not filed with the SEC by April 30, 2026, such information will be provided by an amendment to this Form 10-K to be filed with the SEC no later than April 30, 2026.


ITEM 11.			EXECUTIVE COMPENSATION

The information required by this Item is incorporated by reference pursuant to General Instruction G(3) of Form 10-K from the 2026 Proxy Statement to be filed with the SEC pursuant to Regulation 14A, or in the event the 2026 Proxy Statement is not filed with the the SEC by April 30, 2026, such information will be provided by an amendment to this Form 10-K to be filed with the SEC no later than April 30, 2026.

112


ITEM 12.			SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS

Securities Authorized for Issuance Under Equity Compensation Plans

The following table summarizes the securities that have been authorized for issuance as of December 31, 2025 under our Second Amended and Restated 2019 Incentive Plan (the “2019 Plan”), which was previously approved by our stockholders. The 2019 Plan is described in Note 9 to the consolidated financial statements included herein.

Plan Category

Number of securities to be issued upon exercise of outstanding options, warrants and rights
(a)

Weighted-average exercise price of outstanding options, warrants and rights
(b)

Number of securities remaining available for future issuance under equity compensation plans (excluding securities reflected in column (a))

Equity compensation plans approved by stockholders

460,931 (1)

N/A

2,012,219 (2)

Equity compensation plans not approved by stockholders

None

Total

460,931 (1)

N/A

2,012,219 (2)

(1) Represents 460,931 target performance share awards outstanding under the 2019 Plan as of December 31, 2025. The number of shares of common stock earned and issuable under each performance share award will be determined at the end of a three-year performance period, based on the Company's achievement of performance goals predetermined by the Compensation Committee of the Board of Directors. Does not include 455,609 time-based restricted stock awards outstanding under the 2019 Plan as of December 31, 2025.

(2) Represents shares of common stock issuable pursuant to the 2019 Plan, assuming maximum payout of performance share awards outstanding as of December 31, 2025.

The additional information required by this Item is incorporated by reference pursuant to General Instruction G(3) of Form 10-K from the 2026 Proxy Statement to be filed with the SEC pursuant to Regulation 14A, or in the event the 2026 Proxy Statement is not filed with the SEC by April 30, 2026, such information will be provided by an amendment to this Form 10-K to be filed with the SEC no later than April 30, 2026.


ITEM 13.			CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE

The information required by this Item is incorporated by reference pursuant to General Instruction G(3) of Form 10-K from the 2026 Proxy Statement to be filed with the SEC pursuant to Regulation 14A, or in the event the 2026 Proxy Statement is not filed with the SEC by April 30, 2026, such information will be provided by an amendment to this Form 10-K to be filed with the SEC no later than April 30, 2026.


ITEM 14.			PRINCIPAL ACCOUNTANT FEES AND SERVICES

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PART IV


ITEM 15.			EXHIBITS AND FINANCIAL STATEMENT SCHEDULES

(a)(1) and (2) and (c) – Financial Statements and Financial Statement Schedules.

Financial Statements: The Financial Statements and related Financial Statements Schedule of TruBridge are included herein in Part II, Item 8.

(a)(3) and (b) – Exhibits.

The exhibits listed on the Exhibit Index beginning on page 116 of this Annual Report on Form 10-K are filed herewith or are incorporated herein by reference.


ITEM 16.			FORM 10-K SUMMARY

None.

SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized, on this the 30th day of March, 2026.



TRUBRIDGE, INC.

By:						/s/ Christopher L. Fowler
						Christopher L. Fowler
						President and Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.

114

Name

Title

Date

/s/ Christopher L. Fowler

President, Chief Executive Officer and Director (principal executive officer)

March 30, 2026

Christopher L. Fowler

/s/ Vinay Bassi

Chief Financial Officer and Treasurer
(principal financial officer)

March 30, 2026

Vinay Bassi

/s/ Vita MacIntyre

Controller
(principal accounting officer)

March 30, 2026

Vita MacIntyre

/s/ Glenn P. Tobin

Chairperson of the Board

March 30, 2026

Glenn P. Tobin

/s/ Mark V. Anquillare

Director

March 30, 2026

Mark V. Anquillare

/s/ Regina M. Benjamin

Director

March 30, 2026

Regina M. Benjamin

/s/ Jerry G. Canada

Director

March 30, 2026

Jerry G. Canada

/s/ David A. Dye

Director

March 30, 2026

David A. Dye

/s/ Christopher T. Hjelm

Director

March 30, 2026

Christopher T. Hjelm

/s/ Damien Leonard

Director

March 30, 2026

Damien Leonard

/s/ Amy O’Keefe

Director

March 30, 2026

Amy O’Keefe

/s/ Andris Upitis

Director

March 30, 2026

Andris Upitis

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Exhibit Index

Effective as of March 4, 2024, we changed our name to TruBridge, Inc. By operation of law, any reference to “Computer Programs and Systems, Inc.” or “CPSI” in these exhibits should be read as “TruBridge” as set forth in the Exhibit List below.


Exhibit Number						Description

2.1						Securities Purchase Agreement, dated as of October 16, 2023, by and among Computer Programs and Systems, Inc., Viewgol, LLC, VG Sellers, Inc. and Travis Douglas Huffman, Kristen Closson and Harry Hopkinds (filed as Exhibit 2.1 to CPSI’s Current Report on Form 8-K dated October 17, 2023 and incorporated herein by reference)

2.2						Stock Purchase Agreement, dated as of January 16, 2024, by and among Computer Programs and Systems, Inc., PointClickCare Technologies USA Corp., Healthland Inc., and American HealthTech, Inc. (filed as Exhibit 2.1 to CPSI’s Current Report on Form 8-K dated January 17, 2024 and incorporated herein by reference)

3.1						Certificate of Incorporation (filed as Exhibit 3.4 to CPSI’s Registration Statement on Form S-1 (Registration No. 333-84726) and incorporated herein by reference)

3.2						Certificate of Amendment to Certificate of Incorporation (filed as Exhibit 3.1 to TruBridge’s Current Report on Form 8-K dated March 4, 2024 and incorporated herein by reference)

3.3						Second Certificate of Amendment to Certificate of Incorporation (filed as Exhibit 3.1 to TruBridge’s Current Report on Form 8-K dated May 8, 2025 and incorporated herein by reference)

3.4						Second Amended and Restated Bylaws dated October 25, 2024 (filed as Exhibit 3.1 to TruBridge’s Current Report on Form 8-K dated October 25, 2024 and incorporated herein by reference)

4.1						Description of Securities Registered under Section 12 of the Securities Exchange Act of 1934 (filed as Exhibit 4.1 to CPSI's Annual Report on Form 10-K for the period ended December 31, 2019 and incorporated herein by reference)

4.2						Rights Agreement, dated as of March 26, 2024, by and between TruBridge, Inc. and Computershare Trust Company, N.A., as Rights Agent (filed as Exhibit 4.1 to TruBridge’s Current Report on Form 8-K dated March 26, 2024 and incorporated herein by reference)

4.3						Amendment to the Rights Agreement, dated as of April 22, 2024, by and between TruBridge, Inc. and Computershare Trust Company, N.A., as Rights Agent (filed as Exhibit 4.2 to TruBridge’s Current Report on Form 8-K dated April 23, 2024 and incorporated herein by reference)

4.4						Second Amendment to the Rights Agreement, dated as of February 11, 2025, by and between TruBridge, Inc. and Computershare Trust Company, N.A., as Rights Agent (filed as Exhibit 4.3 to TruBridge’s Current Report on Form 8-K dated February 11, 2025 and incorporated herein by reference)

10.1						Termination of Sublease Agreement, dated June 9, 2022, by and between Computer Programs and Systems, Inc. and Red Square LLC (filed as Exhibit 10.01 to TruBridge ’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated her e in by reference)

10.2						Single Tenant/Stand Alone Absolute Net Lease, dated June 9, 2022, by and between Computer Programs and Systems, Inc. and Santa Teresa Capital, LLC (filed as Exhibit 10.02 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.3						Form of Indemnity Agreement entered into by CPSI and each of its non-employee directors (filed as Exhibit 10.1 to CPSI’s Quarterly Report on Form 10-Q for the period ended September 30, 2002 and incorporated herein by reference)

10.4*						Computer Programs and Systems, Inc. Amended and Restated 2019 Incentive Plan (filed as Exhibit 5.1 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2023 and incorporated herein by reference)

10.5*						Form of Non-Employee Director Restricted Stock Award Agreement under the 2019 Incentive Plan (filed as Exhibit 10.05 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

116


10.6*						Form of Restricted Stock Award Agreement under the 2019 Incentive Plan (for grants in 2021, 2022, and 2023) (filed as Exhibit 10.6 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2023 and incorporated herein by reference)

10.7*						Form of Performance Share Award Agreement under the 2019 Incentive Plan (for grants in 2021, 2022, and 2023) (filed as Exhibit 10.8 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2023 and incorporated herein by reference)

10.8*						Form of Restricted Stock Award Agreement under the 2019 Incentive Plan (for grants in 2024 and 2025) (filed as Exhibit 10.09 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.9*						Form of Performance-Based Cash Bonus Award Agreement under the 2019 Incentive Plan (for grants in 2024) (filed as Exhibit 10.10 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.10*						Form of Performance Share Award Agreement under the 2019 Incentive Plan (for grants in 2024) (filed as Exhibit 10.11 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.11*						Form of Performance-Based Cash Bonus Award Agreement under the 2019 Incentive Plan (for grants in 2025) (filed as Exhibit 10.12 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.12*						Form of Performance Share Award Agreement under the 2019 Incentive Plan (for grants in 2025) (filed as Exhibit 10.13 to TruBridge’s Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.13						TruBridge, Inc. Second Amended and Restated 2019 Incentive Plan (filed as Exhibit 10.1 to TruBridge’s Quarterly Report on Form 10-Q for the period ended September 30, 2025 and incorporated herein by reference)

10.14*						Employment Agreement, dated July 1, 2022, by and between the Company and Christopher L. Fowler (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated July 7, 2022 and incorporated herein by reference)

10.15*						Restricted Stock Award Agreement, dated July 1, 2022, by and between the Company and Christopher L. Fowler (filed as Exhibit 10.2 to CPSI’s Current Report on Form 8-K dated July 7, 2022 and incorporated herein by reference)

10.16*						Offer of Employment for David Harse, dated October 14, 2022

10.17*						Form of Executive Severance Agreement entered into between Computer Programs and Systems, Inc. and each executive officer (other than Christopher L. Fowler) (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated June 26, 2023 and incorporated herein by reference)

10.18*						Offer of Employment for Vinay Bassi, dated October 18, 2023 (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated November 7, 2023 and incorporated herein by reference)

10.19*						Cash Retention Agreement, dated November 1, 2023, between Computer Programs and Systems, Inc. and Vinay Bassi (filed as Exhibit 10.2 to CPSI’s Current Report on Form 8-K dated November 7, 2023 and incorporated herein by reference)

10.20*						General Release of Claims, dated December 31, 2023, entered into by Matthew J. Chambless (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated January 5, 2024 and incorporated herein by reference)

10.21*						Cash Retention Agreement, dated March 27, 2024, between TruBridge, Inc. and Vita MacIntyre (filed as Exhibit 10.1 to TruBridge’s Current Report on Form 8-K dated April 1, 2024 and incorporated herein by reference)

10.22*						Offer of Employment for Merideth Wilson, dated October 10, 2024

10.23*						General Release of Claims, dated December 31, 2024, entered into by David A. Dye (filed as Exhibit 10.23 to TruBridge's Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.24*						Offer of Employment for Michael Daughton, dated September 24, 2025

117


10.25*						Form of General Release (as required by Executive Severance Agreement) (filed as Exhibit 10.1 to TruBridge’s Current Report on Form 8-K dated October 1, 2025 and incorporated herein by reference)

10.26*						Chief Sales Officer Compensation Plan for Dawn M. Severance (Jan. 1, 2024 – Dec. 31, 2024) (filed as Exhibit 10.9 to TruBridge's Annual Report on Form 10-K for the period ended December 31, 2023 and incorporated herein by reference)

10.27*						Chief Sales Officer Compensation Plan for Dawn M. Severance (Jan. 1, 2025 – Dec. 31, 2025) (filed as Exhibit 10.16 to TruBridge's Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

10.28						Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among Computer Programs and Systems, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated June 18, 2020 and incorporated herein by reference)

10.29						Amended and Restated Pledge and Security Agreement, dated as of June 16, 2020, by and among the parties identified as Obligors therein and Regions Bank, as collateral agent (filed as Exhibit 10.2 to CPSI’s Current Report on Form 8-K dated June 18,2020 and incorporated herein by reference)

10.30						First Amendment, dated as of May 2, 2022, to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among Computer Programs and Systems, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.1 to CPSI’s Current Report on 8-K dated May 3, 2022 and incorporated herein by reference)

10.31						Second Amendment, dated as of March 10, 2023, to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among Computer Programs and Systems, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.22 to CPSI's Annual Report on Form 10-K for the period ended December 31, 2022 and incorporated herein by reference)

10.32						Waiver (of Amended and Restated Credit Agreement), dated as of November 8, 2023, by and among Computer Programs and Systems, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.1 to CPSI’s Quarterly Report on Form 10-Q for the period ended September 30, 2023 and incorporated herein by reference)

10.33						Third Amendment, dated as of January 16, 2024, to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among Computer Programs and Systems, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated January 17, 2024 and incorporated herein by reference)

10.34						Fourth Amendment, dated as of February 29, 2024, to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among Computer Programs and Systems, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.1 to CPSI’s Current Report on Form 8-K dated February 29, 2024 and incorporated herein by reference)

10.35						Amended and Restated Credit Agreement, dated as of November 25, 2025, by and among TruBridge, Inc., certain of its subsidiaries, as guarantors, certain lenders named therein, and Regions Bank, as administrative agent and collateral agent (filed as Exhibit 10.1 to TruBridge’s Current Report on Form 8-K dated November 25, 2025 and incorporated herein by reference)

10.36						Amended and Restated Pledge and Security Agreement, dated as of November 25, 2025, by and among the parties identified as Obligors therein and Regions Bank, as collateral agent (filed as Exhibit 10.2 to TruBridge’s Current Report on Form 8-K dated November 25, 2025 and incorporated herein by reference)

10.37						Cooperation Agreement, dated as of February 11, 2025, by and between Trubridge, Inc. and Pinetree Capital Ltd. and L6 Holdings Inc. (filed as Exhibit 10.1 to TruBridge’s Current Report on Form 8-K dated February 11, 2025 and incorporated herein by reference)

10.38						Cooperation Agreement, dated as of February 11, 2025, by and between Trubridge, Inc. and Ocho Investments LLC (filed as Exhibit 10.2 to TruBridge’s Current Report on Form 8-K dated February 11, 2025 and incorporated herein by reference)

118


10.39						Cooperation Agreement, dated as of January 7, 2026, by and between TruBridge, Inc. and Pinetree Capital Ltd. and L6 Holdings Inc. (filed as Exhibit 10.1 to TruBridge’s Current Report on Form 8-K dated January 7, 2026 and incorporated herein by reference)

16.1						Letter from Grant Thornton LLP to the Securities and Exchange Commission dated July 1, 2025 (filed as Exhibit 16.1 to TruBridge’s Current Report on Form 8-K dated June 25, 2025 and incorporated herein by reference)

19.1						TruBridge, Inc. Insider Trading Policy (filed as Exhibit 19.01 to TruBridge's Annual Report on Form 10-K for the period ended December 31, 2024 and incorporated herein by reference)

21.1						Subsidiaries of the registrant

23.1						Consent of KPMG LLP, Independent Registered Public Accounting Firm

23.2						Consent of Grant Thornton LLP, Independent Registered Public Accounting Firm

31.1						Certification of the Chief Executive Officer pursuant to Rule 13a-14(a)/15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002

31.2						Certification of the Chief Financial Officer pursuant to Rule 13a-14(a)/15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002

32.1						Certifications of Chief Executive Officer and Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

97						Computer Programs and Systems, Inc. Policy for the Recovery of Erroneously Awarded Compensation (filed as Exhibit 97 to TruBridge’s Annual Report on Form 10-K/A for the period ended December 31, 2023 and incorporated herein by reference)

101						The following consolidated financial statements from the Company’s Annual Report on Form 10-K for the years ended December 31, 2025, 2024, and 2023, formatted in Inline XBRL: (i) the Consolidated Balance Sheets; (ii) the Consolidated Statements of Operations; (iii) the Consolidated Statements of Comprehensive Income (Loss); (iv) the Consolidated Statements of Stockholders' Equity; (v) the Consolidated Statements of Cash Flows; and (vi) the Notes to the Consolidated Financial Statements

104						Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)


*			Management compensation plan or arrangement

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TruBridge - 10-K annual report 2025

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