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ORGANIZATION AND BASIS OF PRESENTATION | 12 Months Ended
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Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract] |
ORGANIZATION AND BASIS OF PRESENTATION | 1. ORGANIZATION AND BASIS OF PRESENTATION The accompanying consolidated financial statements include the financial statements of Concord Medical Services Holdings Limited (the “Company”) and its subsidiaries, consolidated variable interest entity (the “VIE”) and subsidiaries of the VIE, which are collectively referred to as the “Group”. The Company was incorporated under the laws of the Cayman Islands on November 27, 2007. The Group is principally engaged in the leasing of radiotherapy and diagnostic imaging equipment, provision of management services to hospitals and provision of premium cancer and proton treatment services.
| (a) |  | Details of the Company’s principle subsidiaries as of December 31, 2019 are as follows:
|  |  |  |  |  | Percentage of |  |
|  | Date of |  | Place of |  | ownership by |  |
Entities |  | establishment/acquisition |  | establishment |  | the Company |  | Principal activities
Subsidiaries |  |  |  |  |  |  |  |
Ascendium Group Limited (“Ascendium”) |  | September 10, 2007 |  | British Virgin Islands (“BVI”) |  | 100 | % | Investment holding
China Medical Services Holdings Limited (“CMS Holdings”) |  | July 18, 2008 |  | Hong Kong |  | 100 | % | Investment holding
King Cheers Holdings Limited (“King Cheers”) |  | May 18, 2001 |  | Hong Kong |  | 100 | % | Investment holding
Shenzhen Aohua Medical Technology Development Co., Ltd. (“Aohua Technology ”) |  | February 21, 2008 |  | PRC |  | 60 | % | Leasing of medical equipment and provision of management services
Shanghai Medstar Financial Leasing Company Limited ("Shanghai Medstar") |  | March 21, 2003 |  | PRC |  | 100 | % | Leasing of medical equipment and provision of management services
Beijing MeizhongJiahe Hospital Management Co., Ltd. (“MHM”) * |  | July 23, 2008 |  | PRC |  | 60 | % | Provision of management services
Beijing Yundu Internet Technology Co., Ltd. (“Yundu”) |  | July 26, 2007 |  | PRC |  | 60 | % | Provision of management services
Tianjin Concord Medical Technology Limited (“Tianjin Concord Medical”) |  | April 22, 2010 |  | PRC |  | 100 | % | Leasing of medical equipment and provision of management services
Guangzhou Jinkangshenyou Investment Co., Ltd. (“JKSY”) |  | August 12, 2010 |  | PRC |  | 100 | % | Leasing of medical equipment and provision of management services
Guangzhou Concord Cancer Center Co., Ltd ("Guangzhou Concord Cancer Hospital") |  | June 29, 2011 |  | PRC |  | 48 | % | Medical treatment and service business
CCM (Hong Kong) Medical Investments Limited (“CCM (HK)”) |  | June 03, 2013 |  | Hong Kong |  | 100 | % | Investment holding
Shanghai Concord Cancer Center Co., Ltd (“SHC”) |  | March 17, 2014 |  | PRC |  | 60.26 | % | Medical treatment and service business
Datong Meizhong Jiahe Cancer Center (“DTMZ”) |  | October 23, 2014 |  | PRC |  | 60 | % | Medical treatment and service business
Wuxi Concord Medical Development Ltd. ("Wuxi Concord”) |  | December 29, 2015 |  | PRC |  | 100 | % | Provision of management services
|  |  |  |  |  | Percentage of |  |
|  | Date of |  | Place of |  | ownership by |  |
Entities |  | establishment/acquisition |  | establishment |  | the Company |  | Principal activities
Beijing Concord Medical Technology Ltd.(“BJCMT”) |  | January 4, 2016 |  | PRC |  | 100 | % | Provision of management services
Guofu Huimei (Tianjin) Investment Management Partnership Firm (LP) (“Guofu Huimei”) (note 4) |  | October 8, 2018 |  | PRC |  | 100 | % | Investment holding
Beijing Century Friendship Science & Technology Development Co., Ltd (“Beijing Century Friendship”) (note 4) |  | October 8, 2018 |  | PRC |  | 60 | % | Provision of management services and investment holding
Beijing Proton Medical Center Co., Ltd (“BPMC”) (note 4) |  | October 8, 2018 |  | PRC |  | 58 | % | Medical treatment and service business
Shanghai Meizhong Jiahe Cancer Center Co., Ltd. (“CMCC”) (note 4) |  | October 8, 2018 |  | PRC |  | 55.42 | % | Medical treatment and service business
Tianjin Jiatai Entity Management Limited Partnership ("Tianjin Jiatai") (note 4) |  | November 18,2019 |  | PRC |  | 100 | % | Investment holding
Shanghai Rongchi Medical Management Limited ("SH Rongchi") (note 4) |  | November 18,2019 |  | PRC |  | 99.90 | % | Investment holding and provision of management services
Oriental Light Group Limited ("Oriental") (note 4) |  | November 18,2019 |  | BVI |  | 99.90 | % | Investment holding
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. ("SH MZJH") (note 4) |  | November 18,2019 |  | PRC |  | 93.15 | % | Medical treatment and service business
Wuxi Meizhong Jiahe Cancer Center Co., Ltd. ("Wuxi MZJH") (note 4) |  | November 18,2019 |  | PRC |  | 98.93 | % | Medical treatment and service business
Heze Meizhong Jiahe Cancer Center Co., Ltd. ("Heze MZJH") (note 4) |  | November 18,2019 |  | PRC |  | 100 | % | Medical treatment and service business
ZR ConcordHealthcare Investment Fund SP (“SP”) |  | November 2016 |  | Cayman Islands |  | 99.93 | % | Investment holding
US Proton Therapy Holdings Limited (“Proton BVI”) |  | May 16, 2011 |  | BVI |  | 99.93 | % | Investment holding
US Proton Therapy Holdings Limited (“US Proton”) |  | June 29, 2011 |  | United States of America |  | 99.93 | % | Investment holding
Concord Medical Services (International) Pte. Ltd. (“China Medstar”) (formerly known as China Medstar Pte. Limited) |  | August 8, 2003 |  | Singapore |  | 99.93 | % | Investment holding
Concord Healthcare Singapore Pte. Ltd. (“CHS”) |  | April 1, 2015 |  | Singapore |  | 99.93 | % | Medical treatment and service business
*On March 26, 2018 and July 10, 2018, the Group entered into agreements with CICC Capital Management Company Limited (“CICC Capital”), a wholly-owned subsidiary of China International Capital Corporation Limited (“CICC”), and six other investors (“Other Investors”). Pursuant to the agreements, CICC Capital and Other Investors make a strategic investment and subscribe new issued 100,000,000 shares of the Group’s subsidiary MHM, with total consideration of RMB1,500,000 . CCIC Capital subscribes 60,000,000 shares of MHM while Other Investors subscribe 40,000,000 shares of MHM. After the completion of all transactions mentioned above, the Group’s equity shares in MHM had been diluted from 85.34% to 60%. Pursuant to the agreement, CCIC Capital and Other Investors can request the Group to redeem their interests in MHM upon the occurrence of certain events (i.e. failure to complete a qualified IPO by June 30, 2025 or failure to start hospital business in Guangzhou Cancer Center Hospital and BPMC by September 30, 2021). The same right is also given to the existing noncontrolling interest shareholder. Given these events are not solely within the control of MHM, the noncontrolling interests of CCIC Capital and Other Investors are contingently redeemable noncontrolling interests and are classified as mezzanine equity. The noncontrolling interests of other existing noncontrolling interests’ holders are also reclassified from permanent equity to mezzanine equity as contingently redeemable noncontrolling interests. The Group accounts for the changes in accretion to the redemption value in accordance with ASC Topic 480, Distinguishing Liabilities from Equity. The Group elects to use the effective interest method to account for the changes of redemption value over the period from the date of issuance to the earliest redemption date of the noncontrolling interest.
| (b) |  | Establishment of Onshore Fund and Offshore Fund
Establishment of onshore fund In January 2016, the Group and Zhongrong Guofu Investment Management Company Limited (“ZR Guofu”) established an onshore fund, namely Guofu Huimei. The registered capital of Guofu Huimei is RMB1,009,000, of which RMB746,001and RMB262,999 were subscribed by ZR Guofu and the Group, for 73.93% and 26.07% equity interest, respectively. General partners of the Guofu Huimei are Shanghai Medstar and ZR Guofu. Further in April 2017, the Group and ZR Guofu entered into a supplemental contract to the framework agreement, pursuant to which, Guofu Huimei will be used as the platform to invest and provide loans to some domestic entities engaging in hospital business. During 2017, Guofu Huimei acquired 78.31% equity interest of Beijing Century Friendship which holds 55% equity interest of BPMC at consideration of RMB388,500, 54.8% equity interest of CMCC at consideration of RMB182,100, 28.77% equity interest of Tianjin Jiatai at consideration of RMB106,500 and established SH Rongchi with share capital of RMB695,305 with Tianjin Jiatai. The profit or loss of these domestic entities engaging in hospital business is shared proportionally among investors based on the percentage of their respective subscribed share capital. In addition, the Group’s share in Beijing Century Friendship, certain construction in progress and certain prepaid land lease payments are pledged to secure the capital contribution from ZR Guofu. Establishment of offshore fund In November 2016, the Company entered into a framework agreement with ZR Guofu to establish an offshore fund, namely SP, for the purpose of acquiring several hospital businesses of the Group, including 100% shares of CHS through China Medstar, 70% shares of Guangzhou Concord Cancer Hospital through CMS Holdings and 59.51% shares of PTC-Houston Management, LP (“PTC”) through Proton (BVI), collectively the “CCM Hospital Businesses”. ZR Guofu will provide management and consultation services on the funds and the Group will continue to manage the CCM Hospital Businesses. ZR Guofu subscribes Class A shares of SP with a consideration of RMB521,396, while the Group subscribes Class B shares of the SP using 1) creditor’s rights of RMB166,299 due from CCM Hospital Business and 2) RMB7,500 cash as consideration. Pursuant to the supplemental contract, the 75% equity interest in SP held by the ZR Guofu is contractually required to be repurchased by the Group at the end of four years from the establishment of SP in November 2016 at a consideration equivalent to the investment cost of RMB521,396. ZR Guofu is also entitled to an annual premium at 15% for its capital contribution of RMB521,396 in SP in the form of interest expense and consultation expense. The offshore fund SP was determined as a variable interest entity as the cash injection from ZR Guofu of RMB521,396 was not equity at risk. As the Company maintains the power to direct the activities that most significantly affect SP’s economic performances through supplemental contracts agreed terms and absorbs the expected losses of SP, the Company is the primary beneficiary of SP and consolidates SP and its subsidiaries under by ASC 810-10 Consolidation: Overall. The 75% equity interest held by the ZR Guofu in SP is accounted for as a liability recorded as “Mandatorily redeemable noncontrolling interests” in the Company’s consolidated balance sheets as a result of the mandatory redemption feature and is carried at the redemption value at the end of each reporting date as determined in accordance with the contract terms from the day of on which control is transferred to the Company. The 15% annual premium is accrued as an interest expense and consultation expense during each reporting period. In November 2017, ZR Guofu transferred its rights to the mandatorily redeemable noncontrolling interest in SP to Tianjin Jiatai. In December 2017, CMS Holdings redeemed the mandatory redeemable noncontrolling interest from ZR Guofu of RMB97,106 to withdraw the CCM Hospital Businesses. On November 29, 2018, the PTC business had been disposed by Proton (BVI) (note 15). As of December 31, 2018 and 2019, only CHS was retained in the CCM Hospital Businesses. Repurchase of onshore fund In June 2018, MHM entered into agreements with Guofu Huimei to purchase its 78.31% equity interests in Beijing Century Friendship which holds 55% equity interest of BPMC and 54.8% equity interest in CMCC at a consideration of RMB388,500 and RMB182,100 respectively. Meanwhile, ZR Guofu and Guofu Huimei reached an agreement pursuant to which ZR Guofu will withdraw its original investments in Guofu Huimei, amounting to RMB746,000. Therefore, MHM hold 100% equity interest of Beijing Century Friendship, 80% equity interest of BPMC and 90% equity interests of CMCC upon execution and closing of the agreement and the Group became the sole shareholder of Guofu Huimei (note 4). After the withdrawal, ZR Guofu is no longer part of the onshore fund Guofu Huimei and the domestic hospital businesses. Repurchase of offshore fund During 2019, Tianjin Jiatai made total capital injections of RMB34,540 (US$5,105) to SH MZJH, leading to an increase in Tianjin Jiatai’s holding interest from 56.77% to 78.34%.On July 22, 2019, Wuxi Concord entered into an agreement with Tianjin Jiatai, to purchase all its 90% equity interests in Wuxi MZJH at a consideration of RMB27,000. After the acquisition, Wuxi MZJH became a wholly owned subsidiary of the Group. On August 23, 2019, Wuxi Concord further injected capital of RMB82,100 to Wuxi MZJH. On November 13, 2019, Guofu Huimei entered into agreements with ZR Guofu, pursuant to which ZR Guofu would withdraw its investment of 77.18% equity interests in Tianjin Jiatai at a consideration of RMB421,730. As a result of ZR’s withdrawal, the Group became the sole shareholder of Tianjin Jiatai and its subsidiaries, SH MZJH, Heze MZJH, SH Rongchi and Oriental, including Wuxi MZJH (collectively, the “Tianjin Jiatai Group”). The transaction is accounted for as a business acquisition of Tianjin Jiatai Group by the Group (note 4). Immediately prior to the acquisition of Tianjin Jiatai Group on November 18, 2019, the rights to the mandatory redeemable to noncontrolling interest in SP held by Tianjin Jiatai amounted to RMB434,216. The mandatorily redeemable noncontrolling interest , being a preexisting relationship between the parties, was settled as a result of the business combination. Upon the completion of the acquisition and the settlement of mandatorily redeemable noncontrolling interest , SP is no longer a VIE. However, the Group continues to consolidate SP under the voting model. (c) VIE disclosures Creditors of the VIE and its subsidiaries have no recourse to the general credit of the primary beneficiaries of the VIE and its subsidiaries, and such amounts have been parenthetically presented on the face of the consolidated balance sheets. The VIE and its subsidiaries operating the hospital business are recognized in the Company’s consolidated financial statements. The Company has not provided any financial or other support that it was not previously contractually required to provide to the VIE and its subsidiaries during the periods presented. The VIE structure ceased on November 18, 2019 (note 1b). The following tables represent the financial information of the VIE and its subsidiaries as of December 31, 2018 and 2019 and for the years ended December 31, 2018 and 2019 before eliminating the intercompany balances and transactions between the VIE and its subsidiaries and other entities within the Group (the net revenue, net loss and cashflow information for the whole year 2019 instead of for the period from January 1 to November 18, 2019 was presented since the results are not materially different):
|  | As at December 31,
|  | 2018 |  | 2019 |  | 2019
|  | RMB |  | RMB |  | US$
ASSETS |  |  |  |  |  |
Current assets: |  |  |  |  |  |
Cash |  | 15,935 |  | — |  | —
Accounts receivable |  | 4,494 |  | — |  | —
Inventories |  | 1,946 |  | — |  | —
Prepayments and other current assets |  | 1,986 |  | — |  | —
Amount due from inter-companies* |  | 80,523 |  | — |  | —
Total current assets |  | 104,884 |  | — |  | —
Non-current assets: |  |  |  |  |  |
Property, plant and equipment, net |  | 281,395 |  | — |  | —
Intangible assets, net |  | 100 |  | — |  | —
Long-term investments |  | 31,496 |  | — |  | —
Other non-current assets |  | 464 |  | — |  | —
Total non-current assets |  | 313,455 |  | — |  | —
Total assets |  | 418,339 |  | — |  | —
|  | As at December 31,
|  | 2018 |  | 2019 |  | 2019
|  | RMB |  | RMB |  | US$
Current liabilities: |  |  |  |  |  |
Accounts payable |  | 462 |  | — |  | —
Accrued expenses and other liabilities |  | 42,681 |  | — |  | —
Income tax payable |  | 2,870 |  | — |  | —
Total current liabilities |  | 46,013 |  | — |  | —
Non-current liabilities: |  |  |  |  |  |
Accrued unrecognized tax benefits and surcharge, non-current portion |  | 20,208 |  | — |  | —
Mandatorily redeemable noncontrolling interests |  | 434,216 |  | — |  | —
Total non-current liabilities |  | 454,424 |  | — |  | —
Total liabilities |  | 500,437 |  | — |  | —
|  | For the Years Ended December 31,
|  | 2017 |  | 2018 |  | 2019 |  | 2019
|  | RMB |  | RMB |  | RMB |  | US$
Net revenues |  | 28,673 |  | 41,350 |  | 34,196 |  | 4,912
Net loss |  | (141,188) |  | (95,788) |  | (114,225) |  | (16,407)
|  | For the Years Ended December 31,
|  | 2017 |  | 2018 |  | 2019 |  | 2019
|  | RMB |  | RMB |  | RMB |  | US$
Net cash used in operating activities |  | (54,113) |  | (260,884) |  | (24,640) |  | (3,539)
Net cash generated from (used in) investing activities |  | (5,582) |  | 221,130 |  | (10,107) |  | (1,452)
Net cash generated from financing activities |  | 56,787 |  | 41,886 |  | 20,820 |  | 2,991
Exchange rate effect on cash, net |  | 748 |  | 600 |  | 304 |  | 44
Decrease (increase) in cash and cash equivalents |  | (2,160) |  | 2,732 |  | (13,623) |  | (1,957)

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