GMR Solutions (GMRS) Registration filing summary

Company overview and business model

• Largest provider of emergency medical services (EMS) and integrated out-of-hospital care in the U.S., serving 1,400 counties and over 60% of the U.S. population.

• Operates a national, fully integrated air and ground EMS platform with over 7,400 ground vehicles and 513 aircraft.

• Handles approximately 5.5 million patient encounters annually, with 84% emergent and 16% non-emergent care.

• Revenue model is primarily fee-for-service, diversified across 650+ commercial payors and 600+ locations.

• Offers innovative solutions such as Nurse Navigation and Transport.Net to optimize care delivery and resource utilization.

Financial performance and metrics

• 2025 revenue: $5.74 billion; net income: $206.2 million; Adjusted EBITDA: $1.19 billion.

• Revenue decreased 4% year-over-year due to divestitures; net income increased 911%; Adjusted EBITDA up 8%.

• As of December 31, 2025: $609 million in cash, $5.05 billion in long-term debt, $259.5 million retained deficit.

• Net transport revenue per ambulance transport: $1,332 in 2025, up from $1,191 in 2024.

• Payor mix (2025): 59% commercial, 32% government (24% Medicare, 8% Medicaid), 2% self-pay.

Use of proceeds and capital allocation

• Net proceeds of ~$415 million from IPO (at $15/share) to redeem Series B Preferred Stock and repay $665.8 million of 2032 First Lien Term Loan.

• Concurrent $500 million private placement of warrants, proceeds to repay additional debt.

• Additional borrowing capacity of $695 million under A&R ABL Facility as of year-end 2025.