The Ensign Group, Inc. (Nasdaq: ENSG), the parent company of the
Ensign(TM) group of companies, which provide post-acute healthcare
services and invest in the long-term healthcare industry, primarily
in skilled nursing and senior living facilities, announced
operating results for the fiscal and fourth quarter of 2023,
reporting GAAP diluted earnings per share of $3.65 and adjusted
earnings per share(1) of $4.77 for the year. Ensign also reported
GAAP diluted earnings per share of $0.38 and adjusted earnings per
share(1) of $1.28 for the quarter ended December 31, 2023.
Highlights Include:
- Consolidated GAAP and adjusted revenues for the year were $3.73
billion, an increase of 23.3% over the prior year. Consolidated
GAAP and adjusted revenues for the quarter were $980.4 million, an
increase of 21.1% over the prior year quarter.
- GAAP diluted earnings per share was $3.65 or the year and $0.38
for the quarter, both of which include the impact of certain
litigation matters arising outside the ordinary course of business.
- Adjusted diluted earnings per share(1) was $4.77 for the year
and $1.28 for the quarter, an increase of 15.2% and 16.4% over the
prior year and prior year quarter, respectively.
- GAAP net income was $209.4 million for the year and $21.7 for
the quarter, both of which includes the impact of certain
litigation matters arising outside the ordinary course of business.
- Adjusted net income(1) was $273.5 million for the year and
$73.7 million for the quarter, an increase of 16.0% and 17.5% over
the prior year and prior year quarter, respectively.
- Same store and transitioning occupancy both increased by 3.2%
over the prior year and increased by 2.4% and 1.5%, respectively,
over the prior year quarter.
- Total skilled services(2) revenue was $3.58 billion for the
year, an increase of 23.1% over the prior year, and was $940.8
million for the quarter, an increase of 21.0% over the prior year
quarter.
- Same store and transitioning combined managed care revenue
increased by 12.3% and managed care census increased by 3.5%, both
over the prior year quarter.
- Standard Bearer(2) revenue was $82.5 million for the year, an
increase of 13.1% from the prior year, and $21.9 million for the
quarter, an increase of 12.7% from the prior year quarter. FFO was
$54.3 million for the year, an increase of 9.7% from the prior
year, and $14.2 million for the quarter, an increase of 9.4% from
the prior year quarter.
(1) See "Reconciliation of GAAP to Non-GAAP Financial
Information". (2) Our Skilled Services and Standard
Bearer Segments are defined and outlined in Note 8 of Item 8.
Financial Statements and Supplementary Data on Form 10-K.
Operating Results
“Our local teams have once again posted
impressive clinical and financial results and continue to build
remarkable momentum in each market across our portfolio,” said
Barry Port, Ensign’s Chief Executive Officer. “We were pleased to
see same store occupancy of 79.9%, which grew by 240 basis points
over the prior year quarter. In addition, we saw an improvement in
occupancy on a sequential basis of 40 basis points over the third
quarter. As expected, we also saw an increase in our skilled mix
during the quarter as our same store days for the quarter increased
by 110 basis points sequentially over the third quarter. Our
success is entirely due to the efforts and commitment of those
leadership teams, caregivers, field resources and service center
partners. After another record quarter, we are excited about the
many opportunities to continue to capture the enormous potential
inherent in our portfolio as we relentlessly focus on our
operational fundamentals, both in existing operations and the
growing number of new acquisitions,” Port added.
“We are very humbled by what we were able to
accomplish in 2023, but we are eager to continue to drive
improvements in our existing portfolio and to take advantage of the
acquisition opportunities that we see on the horizon. We are
issuing our annual 2024 earnings guidance of $5.29 to $5.47 per
diluted share and annual revenue guidance of $4.13 billion to $4.17
billion. The midpoint of this 2024 earnings guidance represents an
increase of 13% over our 2023 results and is 30% higher than our
2022 results. When we consider the current health of our
organization, combined with our culture and proven local leadership
strategy, we are well-positioned to have another outstanding year
in 2024," Port said.
Chad Keetch, Ensign’s Chief Investment Officer
and Executive Vice President noted the progress the Company is
making with its newly acquired operations. He said, “As we
expected, we continued to add to our growing portfolio and are very
excited about the three new operations and one real estate asset we
added during the quarter and since, bringing the number of
operations acquired since 2022 to 54. Looking closer at these new
operations, occupancy and skilled mix days for the skilled nursing
operations in the recently acquired bucket were 77.6% and 27.5%,
respectively, for the quarter. When compared to our same store
occupancy and skilled mix days of 79.9% and 30.9%, respectively,
there is enormous upside in each of these new operations as they
continue to transform into ‘same store’ caliber
operations.”
Speaking to the Company’s financial
health, Suzanne Snapper, Ensign’s Executive Vice President and
Chief Financial Officer reported that the Company’s liquidity
remains strong with approximately $509.6 million of cash on hand
and $593.7 million of available capacity under its line-of-credit.
Ms. Snapper also indicated that, “Management’s guidance is based on
diluted weighted average common shares outstanding of approximately
58.5 million and a 25.0% tax rate. In addition, the guidance
assumes, among other things, normalized health insurance costs and
management’s current expectations regarding reimbursement rates. It
also excludes one-time charges, including certain expenses related
to litigation matters arising outside of the ordinary course of
business, acquisition-related costs and amortization costs related
to intangible assets acquired and share-based compensation.”
A discussion of the Company's use of non-GAAP
financial measures is set forth below. A reconciliation of net
income to adjusted EBT, EBITDA, adjusted EBITDAR, adjusted EBITDA
and FFO for Standard Bearer, as well as, a reconciliation of GAAP
earnings per share, net income to adjusted net income and adjusted
net earnings per share appear in the financial data portion of this
release. More complete information is contained in the company’s
Annual Report on Form 10-K for the year ended December 31, 2023,
which is expected to be filed with the SEC today and can be viewed
on the Company’s website at http://www.ensigngroup.net.
Growth and Real Estate
Highlights
Mr. Keetch added additional commentary on the
Company’s continued acquisition activity. “The pipeline for new
deals remains strong. We are lining up several exciting
opportunities and expect to announce several deals over the coming
months. We remain poised to grow with over a billion dollars in dry
powder for future investments and our local leaders continue to
recruit future CEOs of Ensign affiliated operations. We currently
have a deep bench of CEO’s-in-training that are eagerly preparing
for their opportunity to lead. We continue to see evidence that
many operators in this industry are struggling, and we expect that
the operating environment will translate into many near and
long-term opportunities to both lease and acquire post-acute care
assets. However, as we’ve said before, we do not set arbitrary
growth goals and will remain true to our disciplined acquisition
strategy, only growing when we have the right leaders in place and
the pricing is right.”
The recent acquisitions include the following
operations:
- Providence Place, a 45-bed skilled nursing facility located in
Kansas City, Kansas;
- Hearthstone Health and Rehabilitation, a 125-bed skilled
nursing facility located in Sparks, Nevada;
- TriState Health and Rehabilitation Center, a 116-bed skilled
nursing facility located in Harrogate, Tennessee; and
- Champions Healthcare at Willowbrook, a healthcare campus
consisting of a 98-bed skilled nursing facility and a 144-bed
assisted living facility located in Houston, Texas, which included
the real estate assets that were acquired by Standard Bearer.
Ensign's growing portfolio consists of 299
healthcare operations, 27 of which also include senior living
operations, across 14 states. Ensign now owns 113 real estate
assets, 83 of which it operates. Keetch noted that Ensign’s overall
strategy will continue to include both leasing and acquiring real
estate and that the Company is actively looking for performing and
underperforming operations in several states.
The Company continues to provide additional
disclosures on Standard Bearer, which is comprised of 108
properties owned by the Company and leased to 79 affiliated skilled
nursing and senior living operations and 30 operations that are
leased to third party operators (numbers reflect one shared campus
that is jointly used by the Company and a third party operator).
Keetch noted that each of these properties are subject to
triple-net, long-term leases and generated rental revenue of $21.9
million for the quarter, of which $17.7 million was derived from
Ensign affiliated operations. For the quarter, Ensign reported
$14.2 million in FFO.
The Company paid a quarterly cash dividend of
$0.06 per share of Ensign common stock. Ms. Snapper noted that the
Company’s liquidity remains strong and that the Company plans to
continue its long history of paying dividends into the future,
noting that in December of 2023 the Company increased the annual
dividend for the 21st consecutive year.
Conference Call
A live webcast will be held Friday, February 2,
2024 at 10:00 a.m. Pacific time (1:00 p.m. Eastern time) to discuss
Ensign’s fourth quarter and fiscal year of 2023 financial results.
To listen to the webcast, or to view any financial or statistical
information required by SEC Regulation G, please visit the
Investors Relations section of Ensign’s website at
http://investor.ensigngroup.net. The webcast will be recorded and
will be available for replay via the website until 5:00 p.m.
Pacific time on Friday, March 1, 2024.
About Ensign™
The Ensign Group, Inc.'s independent
subsidiaries provide a broad spectrum of skilled nursing and senior
living services, physical, occupational and speech therapies and
other rehabilitative and healthcare services at 299 healthcare
facilities in Arizona, California, Colorado, Idaho, Iowa, Kansas,
Nebraska, Nevada, South Carolina, Tennessee, Texas, Utah,
Washington and Wisconsin. As part of its investment strategy, the
Company will also acquire, lease and own healthcare real estate to
service the post-acute care continuum through acquisition and
investment opportunities in healthcare properties. Ensign’s new
business venture operating subsidiaries also offer several other
post-acute-related services, including mobile x-ray, non-emergency
transportation services, long-term care pharmacy and other
consulting services also across several states. Each of these
operations is operated by a separate, independent subsidiary that
has its own management, employees and assets. References herein to
the consolidated "Company" and "its" assets and activities, as well
as the use of the terms "we," "us," "its" and similar verbiage, are
not meant to imply that The Ensign Group, Inc. has direct operating
assets, employees or revenue, or that any of the facilities, the
Service Center, Standard Bearer or the captive insurance subsidiary
are operated by the same entity. More information about Ensign is
available at http://www.ensigngroup.net.
Safe Harbor Statement under the Private
Securities Litigation Reform Act of 1995:
This press release contains, and the related
conference call and webcast will include, forward-looking
statements that are based on management’s current expectations,
assumptions and beliefs about its business, financial performance,
operating results, the industry in which it operates and other
future events. Forward-looking statements can often be identified
by words such as "anticipates," "expects," "intends," "plans,"
"predicts," "believes," "seeks," "estimates," "may," "will,"
"should," "would," "could," "potential," "continue," "ongoing,"
similar expressions, and variations or negatives of these words.
These forward-looking statements include, but are not limited to,
statements regarding growth prospects, future operating and
financial performance, and acquisition activities. They are not
guarantees of future results and are subject to risks,
uncertainties and assumptions that could cause actual results to
materially and adversely differ from those expressed in any
forward-looking statement.
These risks and uncertainties relate to the
Company’s business, its industry and its common stock and include:
reduced prices and reimbursement rates for its services; its
ability to acquire, develop, manage or improve operations, its
ability to manage its increasing borrowing costs as it incurs
additional indebtedness to fund the acquisition and development of
operations; its ability to access capital on a cost-effective basis
to continue to successfully implement its growth strategy; its
operating margins and profitability could suffer if it is unable to
grow and manage effectively its increasing number of operations;
competition from other companies in the acquisition, development
and operation of facilities; its ability to defend claims and
lawsuits, including professional liability claims alleging that our
services resulted in personal injury, and other regulatory-related
claims; and the application of existing or proposed government
regulations, or the adoption of new laws and regulations, that
could limit its business operations, require it to incur
significant expenditures or limit its ability to relocate its
operations if necessary. Additionally, our business and operations
continue to be impacted by the unprecedented nature of the changes
in the regulations and environment, as such, we are unable to
predict the full extent and duration of the financial impact of
these changes on our business, financial condition and results of
operations. Therefore, our actual results could differ materially
and adversely from those expressed in any forward-looking
statements as a result of various factors. Readers should not place
undue reliance on any forward-looking statements and are encouraged
to review the Company’s periodic filings with the Securities and
Exchange Commission, including its Form 10-Q and 10-K, for a more
complete discussion of the risks and other factors that could
affect Ensign’s business, prospects and any forward-looking
statements. Except as required by the federal securities laws,
Ensign does not undertake any obligation to publicly update or
revise any forward-looking statements, whether as a result of new
information, future events, changing circumstances or any other
reason after the date of this press release.
Contact Information
Investor/Media Relations, The Ensign Group, Inc., (949) 487-9500,
ir@ensigngroup.net.
SOURCE: The Ensign Group, Inc.
THE ENSIGN
GROUP, INC. CONSOLIDATED STATEMENTS OF INCOME |
|
|
Three Months
Ended December 31, |
|
Year Ended
December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
(In thousands, except per share data) |
REVENUE |
|
|
|
|
|
|
|
Service revenue |
$ |
974,728 |
|
|
$ |
805,325 |
|
|
$ |
3,708,071 |
|
|
$ |
3,008,711 |
|
Rental revenue |
|
5,650 |
|
|
|
4,207 |
|
|
|
21,284 |
|
|
|
16,757 |
|
TOTAL REVENUE |
$ |
980,378 |
|
|
$ |
809,532 |
|
|
$ |
3,729,355 |
|
|
$ |
3,025,468 |
|
Expense: |
|
|
|
|
|
|
|
Cost of services |
|
781,158 |
|
|
|
633,529 |
|
|
|
2,941,238 |
|
|
|
2,354,434 |
|
Rent—cost of services |
|
50,604 |
|
|
|
41,152 |
|
|
|
197,358 |
|
|
|
153,049 |
|
General and administrative expense |
|
106,557 |
|
|
|
42,775 |
|
|
|
263,005 |
|
|
|
158,805 |
|
Depreciation and amortization |
|
19,233 |
|
|
|
16,880 |
|
|
|
72,387 |
|
|
|
62,355 |
|
TOTAL EXPENSES |
$ |
957,552 |
|
|
$ |
734,336 |
|
|
$ |
3,473,988 |
|
|
$ |
2,728,643 |
|
Income from operations |
|
22,826 |
|
|
|
75,196 |
|
|
|
255,367 |
|
|
|
296,825 |
|
Other income (expense): |
|
|
|
|
|
|
|
Interest expense |
|
(2,004 |
) |
|
|
(2,067 |
) |
|
|
(8,087 |
) |
|
|
(8,931 |
) |
Other income |
|
10,460 |
|
|
|
4,322 |
|
|
|
25,482 |
|
|
|
1,195 |
|
Other income (expense), net |
$ |
8,456 |
|
|
$ |
2,255 |
|
|
$ |
17,395 |
|
|
$ |
(7,736 |
) |
Income before provision for income taxes |
|
31,282 |
|
|
|
77,451 |
|
|
|
272,762 |
|
|
|
289,089 |
|
Provision for income taxes |
|
9,459 |
|
|
|
16,932 |
|
|
|
62,912 |
|
|
|
64,437 |
|
NET INCOME |
$ |
21,823 |
|
|
$ |
60,519 |
|
|
$ |
209,850 |
|
|
$ |
224,652 |
|
Less: net income (loss) attributable to noncontrolling
interests |
|
132 |
|
|
|
48 |
|
|
|
451 |
|
|
|
(29 |
) |
Net income attributable to The Ensign Group,
Inc. |
$ |
21,691 |
|
|
$ |
60,471 |
|
|
$ |
209,399 |
|
|
$ |
224,681 |
|
|
|
|
|
|
|
|
|
NET
INCOME PER SHARE ATTRIBUTABLE TO THE ENSIGN GROUP
INC. |
|
|
|
|
|
|
|
Basic |
$ |
0.39 |
|
|
$ |
1.10 |
|
|
$ |
3.76 |
|
|
$ |
4.09 |
|
Diluted |
$ |
0.38 |
|
|
$ |
1.06 |
|
|
$ |
3.65 |
|
|
$ |
3.95 |
|
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING |
|
|
|
|
|
|
|
Basic |
|
56,083 |
|
|
|
55,087 |
|
|
|
55,708 |
|
|
|
54,887 |
|
Diluted |
|
57,555 |
|
|
|
56,973 |
|
|
|
57,323 |
|
|
|
56,871 |
|
THE ENSIGN
GROUP, INC. CONSOLIDATED BALANCE SHEETS (In
thousands) |
|
|
December 31, |
|
|
2023 |
|
|
2022 |
|
|
|
|
ASSETS |
|
|
|
Current
assets: |
|
|
|
Cash and cash equivalents |
$ |
509,626 |
|
$ |
316,270 |
Accounts receivable—less allowance for doubtful accounts of $9,348
and $7,802 at December 31, 2023 and 2022, respectively |
|
485,039 |
|
|
408,432 |
Investments—current |
|
17,229 |
|
|
15,441 |
Prepaid expenses and other current assets |
|
35,036 |
|
|
40,982 |
Total current assets |
|
1,046,930 |
|
|
781,125 |
Property and equipment, net |
|
1,090,771 |
|
|
992,010 |
Right-of-use assets |
|
1,756,430 |
|
|
1,450,995 |
Insurance subsidiary deposits and investments |
|
92,687 |
|
|
67,652 |
Deferred tax assets |
|
67,124 |
|
|
39,643 |
Restricted and other assets |
|
40,205 |
|
|
37,291 |
Intangible assets, net |
|
6,525 |
|
|
6,437 |
Goodwill |
|
76,869 |
|
|
76,869 |
TOTAL ASSETS |
$ |
4,177,541 |
|
$ |
3,452,022 |
LIABILITIES AND EQUITY |
|
|
|
Current
liabilities: |
|
|
|
Accounts payable |
$ |
92,811 |
|
$ |
77,087 |
Accrued wages and related liabilities |
|
332,568 |
|
|
289,810 |
Lease liabilities—current |
|
82,526 |
|
|
65,796 |
Accrued self-insurance liabilities—current |
|
54,664 |
|
|
48,187 |
Other accrued liabilities |
|
168,228 |
|
|
97,309 |
Current maturities of long-term debt |
|
3,950 |
|
|
3,883 |
Total current liabilities |
|
734,747 |
|
|
582,072 |
Long-term debt—less current maturities |
|
145,497 |
|
|
149,269 |
Long-term lease liabilities—less current portion |
|
1,639,326 |
|
|
1,355,113 |
Accrued self-insurance liabilities—less current portion |
|
111,246 |
|
|
83,495 |
Other
long-term liabilities |
|
49,408 |
|
|
33,273 |
Total equity |
|
1,497,317 |
|
|
1,248,800 |
TOTAL LIABILITIES AND EQUITY |
$ |
4,177,541 |
|
$ |
3,452,022 |
THE ENSIGN GROUP, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
The following table presents selected data from
our consolidated statements of cash flows for the periods
presented:
|
Year Ended
December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
|
|
NET CASH PROVIDED BY/(USED IN): |
(In thousands) |
Operating activities |
$ |
376,666 |
|
|
$ |
272,513 |
|
Investing activities |
|
(182,698 |
) |
|
|
(186,182 |
) |
Financing activities |
|
(612 |
) |
|
|
(32,262 |
) |
Net increase in cash and cash equivalents |
|
193,356 |
|
|
|
54,069 |
|
Cash and
cash equivalents beginning of period |
|
316,270 |
|
|
|
262,201 |
|
Cash and cash equivalents at end of period |
$ |
509,626 |
|
|
$ |
316,270 |
|
THE ENSIGN GROUP, INC. UNAUDITED
RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION
(In thousands, except per share data)
RECONCILIATION OF GAAP TO NON-GAAP NET
INCOME
The following table reconciles GAAP net income to
Non-GAAP net income for the periods presented:
|
Three Months
Ended December 31, |
|
Year Ended
December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
Net income
attributable to The Ensign Group, Inc. |
$ |
21,691 |
|
|
$ |
60,471 |
|
|
$ |
209,399 |
|
|
$ |
224,681 |
|
Non-GAAP adjustments |
|
|
|
|
|
|
|
Stock-based compensation expense(a) |
|
8,076 |
|
|
|
6,039 |
|
|
|
30,767 |
|
|
|
22,720 |
|
Litigation(b) |
|
58,816 |
|
|
|
68 |
|
|
|
60,781 |
|
|
|
4,280 |
|
Cost of services - gain on sale of assets and business interruption
recoveries |
|
(123 |
) |
|
|
(913 |
) |
|
|
(1,132 |
) |
|
|
(4,380 |
) |
Cost of services - acquisition related costs(c) |
|
92 |
|
|
|
253 |
|
|
|
814 |
|
|
|
669 |
|
Interest expense - write-off of deferred financing fees(d) |
|
— |
|
|
|
— |
|
|
|
— |
|
|
|
566 |
|
General and administrative - costs incurred related to new systems
implementation |
|
88 |
|
|
|
682 |
|
|
|
963 |
|
|
|
1,072 |
|
Depreciation and amortization - patient base(e) |
|
173 |
|
|
|
107 |
|
|
|
355 |
|
|
|
320 |
|
Provision for income taxes on Non-GAAP adjustments(f) |
|
(15,142 |
) |
|
|
(3,990 |
) |
|
|
(28,416 |
) |
|
|
(14,215 |
) |
Non-GAAP Net Income |
$ |
73,671 |
|
|
$ |
62,717 |
|
|
$ |
273,531 |
|
|
$ |
235,713 |
|
|
|
|
|
|
|
|
|
Average number of diluted shares outstanding |
|
57,555 |
|
|
|
56,973 |
|
|
|
57,323 |
|
|
|
56,871 |
|
|
|
|
|
|
|
|
|
Diluted Earnings Per Share |
|
|
|
|
|
|
|
Net Income |
$ |
0.38 |
|
|
$ |
1.06 |
|
|
$ |
3.65 |
|
|
$ |
3.95 |
|
|
|
|
|
|
|
|
|
Adjusted Diluted Earnings Per Share |
|
|
|
|
|
|
|
Net Income |
$ |
1.28 |
|
|
$ |
1.10 |
|
|
$ |
4.77 |
|
|
$ |
4.14 |
|
|
|
|
|
|
|
|
|
Footnotes: |
|
|
|
|
|
|
|
(a) Represents stock-based compensation expense incurred. |
|
|
|
|
|
Three Months Ended December 31, |
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
Cost of services |
$ |
5,351 |
|
|
$ |
3,959 |
|
|
$ |
20,622 |
|
|
$ |
14,897 |
|
General and administrative |
|
2,725 |
|
|
|
2,080 |
|
|
|
10,145 |
|
|
|
7,823 |
|
Total Non-GAAP adjustment |
$ |
8,076 |
|
|
$ |
6,039 |
|
|
$ |
30,767 |
|
|
$ |
22,720 |
|
|
|
|
|
|
|
|
|
(b) Litigation
relates to specific proceedings arising outside of the ordinary
course of business, which excludes the portion attributable to
non-controlling interests. |
|
Three Months Ended December 31, |
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
Cost of services |
$ |
4,600 |
|
|
$ |
68 |
|
|
$ |
3,782 |
|
|
$ |
4,280 |
|
General and administrative |
|
54,216 |
|
|
|
— |
|
|
|
56,999 |
|
|
|
— |
|
Total Non-GAAP adjustment |
$ |
58,816 |
|
|
$ |
68 |
|
|
$ |
60,781 |
|
|
$ |
4,280 |
|
|
|
|
|
|
|
|
|
(c) Represents
costs incurred to acquire operations that are not
capitalizable. |
(d) Represents the
write-off of deferred financing fees associated with the amendment
of the Credit Facility. |
(e) Included in
depreciation and amortization are amortization expenses related to
patient base intangible assets at newly acquired skilled nursing
and senior living facilities. |
(f) Represents an
adjustment to the provision for income tax to our historical year
to date effective tax rate of 25.0%. |
THE ENSIGN GROUP, INC. UNAUDITED
RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION
(In thousands)
The table below reconciles net income to EBITDA,
Adjusted EBITDA and Adjusted EBITDAR for the periods presented:
|
Three Months
Ended December 31, |
|
Year Ended
December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
Consolidated Statements of Income Data: |
|
|
|
|
|
|
|
Net income |
$ |
21,823 |
|
|
$ |
60,519 |
|
|
$ |
209,850 |
|
|
$ |
224,652 |
|
Less: net
income (loss) attributable to noncontrolling interests |
|
132 |
|
|
|
48 |
|
|
|
451 |
|
|
|
(29 |
) |
Add: Other (income) expense, net |
|
(8,456 |
) |
|
|
(2,255 |
) |
|
|
(17,395 |
) |
|
|
7,736 |
|
Provision for income taxes |
|
9,459 |
|
|
|
16,932 |
|
|
|
62,912 |
|
|
|
64,437 |
|
Depreciation and amortization |
|
19,233 |
|
|
|
16,880 |
|
|
|
72,387 |
|
|
|
62,355 |
|
EBITDA |
$ |
41,927 |
|
|
$ |
92,028 |
|
|
$ |
327,303 |
|
|
$ |
359,209 |
|
Adjustments to EBITDA: |
|
|
|
|
|
|
|
Stock-based compensation expense |
|
8,076 |
|
|
|
6,039 |
|
|
|
30,767 |
|
|
|
22,720 |
|
Litigation(a) |
|
58,816 |
|
|
|
68 |
|
|
|
60,781 |
|
|
|
4,280 |
|
Gain on sale of assets and business interruption recoveries |
|
(123 |
) |
|
|
(913 |
) |
|
|
(1,132 |
) |
|
|
(4,380 |
) |
Acquisition related costs(b) |
|
92 |
|
|
|
253 |
|
|
|
814 |
|
|
|
669 |
|
Costs incurred related to new systems implementation |
|
88 |
|
|
|
682 |
|
|
|
963 |
|
|
|
1,072 |
|
ADJUSTED EBITDA |
$ |
108,876 |
|
|
$ |
98,157 |
|
|
$ |
419,496 |
|
|
$ |
383,570 |
|
Rent—cost of services |
|
50,604 |
|
|
|
41,152 |
|
|
|
197,358 |
|
|
|
153,049 |
|
ADJUSTED EBITDAR |
$ |
159,480 |
|
|
|
|
$ |
616,854 |
|
|
|
|
|
|
|
|
|
|
|
(a) Litigation relates to specific proceedings
arising outside of the ordinary course of business, which excludes
the portion attributable to non-controlling interests. (b) Costs
incurred to acquire operations that are not capitalizable.
THE ENSIGN GROUP, INC. UNAUDITED
RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION
(In thousands)
The table below reconciles income before provision
for income taxes to Adjusted EBT for the periods presented:
|
Three Months Ended December 31, |
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
|
|
|
|
|
|
|
|
ConsolidatedStatements of Income
Data: |
(In thousands) |
Income before provision for income taxes |
$ |
31,282 |
|
|
$ |
77,451 |
|
|
$ |
272,762 |
|
|
$ |
289,089 |
|
Stock-based
compensation expense |
|
8,076 |
|
|
|
6,039 |
|
|
|
30,767 |
|
|
|
22,720 |
|
Litigation(a) |
|
58,816 |
|
|
|
68 |
|
|
|
60,781 |
|
|
|
4,553 |
|
Gain on sale
of assets and business interruption recoveries |
|
(123 |
) |
|
|
(913 |
) |
|
|
(1,132 |
) |
|
|
(4,380 |
) |
Write-off of deferred financing fees(b) |
|
— |
|
|
|
— |
|
|
|
— |
|
|
|
566 |
|
Acquisition related costs(c) |
|
92 |
|
|
|
253 |
|
|
|
814 |
|
|
|
669 |
|
Costs incurred related to new systems implementation |
|
88 |
|
|
|
682 |
|
|
|
963 |
|
|
|
1,072 |
|
Depreciation and amortization - patient base(d) |
|
173 |
|
|
|
107 |
|
|
|
355 |
|
|
|
320 |
|
ADJUSTED EBT |
$ |
98,404 |
|
|
$ |
83,687 |
|
|
$ |
365,310 |
|
|
$ |
314,609 |
|
(a) Litigation relates to specific proceedings
arising outside of the ordinary course of business, which includes
the portion attributable to non-controlling interests. (b)
Represents the write-off of deferred financing fees associated with
the amendment of the Credit Facility. (c) Costs incurred to acquire
operations that are not capitalizable. (d) Included in depreciation
and amortization are amortization expenses related to patient base
intangible assets at newly acquired skilled nursing and senior
living facilities.
THE ENSIGN GROUP, INC. UNAUDITED
SELECT PERFORMANCE INDICATORS
The following tables summarize our selected
performance indicators for our skilled services segment along with
other statistics, for each of the dates or periods presented:
|
Three Months
Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TOTAL FACILITY RESULTS: |
(Dollars in thousands) |
Skilled services revenue |
$ |
940,765 |
|
|
$ |
777,648 |
|
|
$ |
163,117 |
|
21.0 |
% |
Number of facilities at period end |
|
259 |
|
|
|
234 |
|
|
|
25 |
|
10.7 |
% |
Number of campuses at period end(1) |
|
27 |
|
|
|
26 |
|
|
|
1 |
|
3.8 |
% |
Actual patient days |
|
2,227,888 |
|
|
|
1,956,091 |
|
|
|
271,797 |
|
13.9 |
% |
Occupancy percentage — Operational beds |
|
79.2 |
% |
|
|
76.2 |
% |
|
|
|
3.0 |
% |
Skilled mix by nursing days |
|
29.5 |
% |
|
|
30.9 |
% |
|
|
|
(1.4)% |
Skilled mix by nursing revenue |
|
49.0 |
% |
|
|
51.1 |
% |
|
|
|
(2.1)% |
|
Three Months Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
SAME FACILITY RESULTS:(2) |
(Dollars in thousands) |
Skilled services revenue |
$ |
713,342 |
|
|
$ |
660,420 |
|
|
$ |
52,922 |
|
8.0 |
% |
Number of facilities at period end |
|
189 |
|
|
|
189 |
|
|
|
— |
|
— |
% |
Number of campuses at period end(1) |
|
24 |
|
|
|
24 |
|
|
|
— |
|
— |
% |
Actual patient days |
|
1,668,368 |
|
|
|
1,619,163 |
|
|
|
49,205 |
|
3.0 |
% |
Occupancy percentage — Operational beds |
|
79.9 |
% |
|
|
77.5 |
% |
|
|
|
2.4 |
% |
Skilled mix by nursing days |
|
30.9 |
% |
|
|
32.7 |
% |
|
|
|
(1.8)% |
Skilled mix by nursing revenue |
|
50.3 |
% |
|
|
53.0 |
% |
|
|
|
(2.7)% |
|
Three Months Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TRANSITIONING FACILITY
RESULTS:(3) |
(Dollars in thousands) |
Skilled services revenue |
$ |
64,924 |
|
|
$ |
59,672 |
|
|
$ |
5,252 |
|
8.8 |
% |
Number of facilities at period end |
|
22 |
|
|
|
22 |
|
|
|
— |
|
— |
% |
Number of campuses at period end(1) |
|
1 |
|
|
|
1 |
|
|
|
— |
|
— |
% |
Actual patient days |
|
166,349 |
|
|
|
162,237 |
|
|
|
4,112 |
|
2.5 |
% |
Occupancy percentage — Operational beds |
|
76.5 |
% |
|
|
75.0 |
% |
|
|
|
1.5 |
% |
Skilled mix by nursing days |
|
20.4 |
% |
|
|
22.4 |
% |
|
|
|
(2.0)% |
Skilled mix by nursing revenue |
|
37.4 |
% |
|
|
40.1 |
% |
|
|
|
(2.7)% |
|
Three Months Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
RECENTLY ACQUIRED FACILITY
RESULTS:(4) |
(Dollars in thousands) |
Skilled services revenue |
$ |
162,499 |
|
|
$ |
57,556 |
|
|
$ |
104,943 |
|
NM |
Number of facilities at period end |
|
48 |
|
|
|
23 |
|
|
|
25 |
|
NM |
Number of campuses at period end(1) |
|
2 |
|
|
|
1 |
|
|
|
1 |
|
NM |
Actual patient days |
|
393,171 |
|
|
|
174,691 |
|
|
|
218,480 |
|
NM |
Occupancy percentage — Operational beds |
|
77.6 |
% |
|
|
66.9 |
% |
|
|
|
NM |
Skilled mix by nursing days |
|
27.5 |
% |
|
|
21.3 |
% |
|
|
|
NM |
Skilled mix by nursing revenue |
|
48.3 |
% |
|
|
40.3 |
% |
|
|
|
NM |
(1) Campus represents a facility that offers both skilled
nursing and senior living services. Revenue and expenses related to
skilled nursing and senior living services have been allocated and
recorded in the respective operating segment. (2) Same
Facility results represent all facilities purchased prior to
January 1, 2020. (3) Transitioning Facility results
represent all facilities purchased from January 1, 2020 to
December 31, 2021. (4) Recently Acquired Facility
(Acquisitions) results represent all facilities purchased on or
subsequent to January 1, 2022.
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TOTAL FACILITY RESULTS: |
(Dollars in thousands) |
Skilled services revenue |
$ |
3,578,855 |
|
|
$ |
2,906,215 |
|
|
$ |
672,640 |
|
23.1 |
% |
Number of facilities at period end |
|
259 |
|
|
|
234 |
|
|
|
25 |
|
10.7 |
% |
Number of campuses at period end(1) |
|
27 |
|
|
|
26 |
|
|
|
1 |
|
3.8 |
% |
Actual patient days |
|
8,590,995 |
|
|
|
7,243,781 |
|
|
|
1,347,214 |
|
18.6 |
% |
Occupancy percentage — Operational beds |
|
78.5 |
% |
|
|
75.3 |
% |
|
|
|
3.2 |
% |
Skilled mix by nursing days |
|
30.4 |
% |
|
|
31.8 |
% |
|
|
|
(1.4)% |
Skilled mix by nursing revenue |
|
50.2 |
% |
|
|
52.0 |
% |
|
|
|
(1.8)% |
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
SAME FACILITY RESULTS:(2) |
(Dollars in thousands) |
Skilled services revenue |
$ |
2,771,633 |
|
|
$ |
2,569,807 |
|
|
$ |
201,826 |
|
7.9 |
% |
Number of facilities at period end |
|
189 |
|
|
|
189 |
|
|
|
— |
|
— |
% |
Number of campuses at period end(1) |
|
24 |
|
|
|
24 |
|
|
|
— |
|
— |
% |
Actual patient days |
|
6,563,672 |
|
|
|
6,299,331 |
|
|
|
264,341 |
|
4.2 |
% |
Occupancy percentage — Operational beds |
|
79.2 |
% |
|
|
76.0 |
% |
|
|
|
3.2 |
% |
Skilled mix by nursing days |
|
31.9 |
% |
|
|
33.0 |
% |
|
|
|
(1.1)% |
Skilled mix by nursing revenue |
|
51.4 |
% |
|
|
53.3 |
% |
|
|
|
(1.9)% |
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TRANSITIONING FACILITY
RESULTS:(3) |
(Dollars in thousands) |
Skilled services revenue |
$ |
251,872 |
|
|
$ |
231,100 |
|
|
$ |
20,772 |
|
9.0 |
% |
Number of facilities at period end |
|
22 |
|
|
|
22 |
|
|
|
— |
|
— |
% |
Number of campuses at period end(1) |
|
1 |
|
|
|
1 |
|
|
|
— |
|
— |
% |
Actual patient days |
|
655,659 |
|
|
|
625,085 |
|
|
|
30,574 |
|
4.9 |
% |
Occupancy percentage — Operational beds |
|
76.1 |
% |
|
|
72.9 |
% |
|
|
|
3.2 |
% |
Skilled mix by nursing days |
|
21.4 |
% |
|
|
23.1 |
% |
|
|
|
(1.7)% |
Skilled mix by nursing revenue |
|
38.5 |
% |
|
|
41.4 |
% |
|
|
|
(2.9)% |
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
RECENTLY ACQUIRED FACILITY
RESULTS:(4) |
(Dollars in thousands) |
Skilled services revenue |
$ |
555,350 |
|
|
$ |
105,308 |
|
|
$ |
450,042 |
|
NM |
Number of facilities at period end |
|
48 |
|
|
|
23 |
|
|
|
25 |
|
NM |
Number of campuses at period end(1) |
|
2 |
|
|
|
1 |
|
|
|
1 |
|
NM |
Actual patient days |
|
1,371,664 |
|
|
|
319,365 |
|
|
|
1,052,299 |
|
NM |
Occupancy percentage — Operational beds |
|
76.8 |
% |
|
|
67.9 |
% |
|
|
|
NM |
Skilled mix by nursing days |
|
27.5 |
% |
|
|
24.3 |
% |
|
|
|
NM |
Skilled mix by nursing revenue |
|
49.3 |
% |
|
|
42.8 |
% |
|
|
|
NM |
(1) Campus represents a facility that offers both skilled
nursing and senior living services. Revenue and expenses related to
skilled nursing and senior living services have been allocated and
recorded in the respective operating segment.(2) Same Facility
results represent all facilities purchased prior to January 1,
2020. (3) Transitioning Facility results represent all
facilities purchased from January 1, 2020 to December 31,
2021. (4) Recently Acquired Facility (Acquisitions) results
represent all facilities purchased on or subsequent to
January 1, 2022.
THE ENSIGN GROUP, INC. SKILLED
NURSING AVERAGE DAILY REVENUE RATES AND PERCENT OF SKILLED NURSING
REVENUE AND DAYS BY PAYOR (Unaudited)
The following table reflects the change in skilled
nursing average daily revenue rates by payor source, excluding
services that are not covered by the daily rate(1):
|
Three Months
Ended December 31, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SKILLED NURSING AVERAGE DAILY REVENUE RATES |
Medicare |
$ |
746.68 |
|
$ |
707.77 |
|
$ |
722.56 |
|
$ |
674.10 |
|
$ |
818.63 |
|
$ |
638.98 |
|
$ |
760.57 |
|
$ |
700.23 |
Managed care |
|
556.84 |
|
|
513.04 |
|
|
565.95 |
|
|
528.38 |
|
|
572.76 |
|
|
468.44 |
|
|
559.23 |
|
|
511.90 |
Other skilled |
|
608.23 |
|
|
593.50 |
|
|
547.36 |
|
|
516.52 |
|
|
384.50 |
|
|
433.23 |
|
|
571.93 |
|
|
578.36 |
Total skilled revenue |
|
633.89 |
|
|
605.95 |
|
|
638.68 |
|
|
605.32 |
|
|
665.51 |
|
|
545.94 |
|
|
639.33 |
|
|
602.22 |
Medicaid |
|
283.87 |
|
|
263.11 |
|
|
277.73 |
|
|
263.75 |
|
|
270.16 |
|
|
221.30 |
|
|
280.85 |
|
|
258.91 |
Private and other payors |
|
265.72 |
|
|
253.50 |
|
|
251.38 |
|
|
246.51 |
|
|
271.20 |
|
|
207.31 |
|
|
265.52 |
|
|
248.24 |
Total skilled nursing revenue |
$ |
390.10 |
|
$ |
374.35 |
|
$ |
347.93 |
|
$ |
338.50 |
|
$ |
378.93 |
|
$ |
288.74 |
|
$ |
384.97 |
|
$ |
363.73 |
(1) These rates exclude state relief funding.
|
Year Ended December 31, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SKILLED NURSING AVERAGE DAILY REVENUE RATES |
Medicare |
$ |
722.96 |
|
$ |
694.63 |
|
$ |
696.37 |
|
$ |
668.05 |
|
$ |
788.00 |
|
$ |
652.15 |
|
$ |
733.47 |
|
$ |
691.25 |
Managed care |
|
537.29 |
|
|
510.18 |
|
|
536.93 |
|
|
501.73 |
|
|
555.55 |
|
|
455.19 |
|
|
539.25 |
|
|
508.53 |
Other skilled |
|
598.35 |
|
|
576.46 |
|
|
529.08 |
|
|
530.18 |
|
|
441.89 |
|
|
429.84 |
|
|
575.34 |
|
|
563.56 |
Total skilled revenue |
|
617.55 |
|
|
598.14 |
|
|
615.58 |
|
|
593.66 |
|
|
660.87 |
|
|
521.24 |
|
|
623.70 |
|
|
595.26 |
Medicaid |
|
275.82 |
|
|
259.89 |
|
|
270.67 |
|
|
254.08 |
|
|
256.51 |
|
|
227.21 |
|
|
272.14 |
|
|
257.67 |
Private and other payors |
|
263.81 |
|
|
250.80 |
|
|
253.15 |
|
|
248.63 |
|
|
263.71 |
|
|
199.34 |
|
|
262.93 |
|
|
248.54 |
Total skilled nursing revenue |
$ |
383.56 |
|
$ |
370.57 |
|
$ |
342.57 |
|
$ |
332.09 |
|
$ |
368.46 |
|
$ |
296.15 |
|
$ |
378.02 |
|
$ |
363.97 |
(1) These rates exclude state relief funding and
include sequestration reversal of 1% for the second quarter in 2022
and 2% for the first quarter of 2022.
The following tables set forth our percentage of
skilled nursing patient revenue and days by payor source for the
periods presented:
|
Three Months
Ended December 31, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING REVENUE |
Medicare |
21.0 |
% |
|
25.4 |
% |
|
20.4 |
% |
|
23.9 |
% |
|
30.0 |
% |
|
23.4 |
% |
|
22.5 |
% |
|
25.1 |
% |
Managed
care |
20.2 |
|
|
19.2 |
|
|
12.3 |
|
|
13.2 |
|
|
13.7 |
|
|
10.3 |
|
|
18.6 |
|
|
18.1 |
|
Other skilled |
9.1 |
|
|
8.4 |
|
|
4.7 |
|
|
3.0 |
|
|
4.6 |
|
|
6.6 |
|
|
7.9 |
|
|
7.9 |
|
Skilled mix |
50.3 |
|
|
53.0 |
|
|
37.4 |
|
|
40.1 |
|
|
48.3 |
|
|
40.3 |
|
|
49.0 |
|
|
51.1 |
|
Private and other payors |
7.6 |
|
|
7.0 |
|
|
8.9 |
|
|
7.9 |
|
|
8.2 |
|
|
8.6 |
|
|
7.9 |
|
|
7.2 |
|
Medicaid |
42.1 |
|
|
40.0 |
|
|
53.7 |
|
|
52.0 |
|
|
43.5 |
|
|
51.1 |
|
|
43.1 |
|
|
41.7 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
Three Months Ended December 31, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING DAYS |
Medicare |
11.0 |
% |
|
13.4 |
% |
|
9.8 |
% |
|
12.0 |
% |
|
13.9 |
% |
|
10.6 |
% |
|
11.4 |
% |
|
13.1 |
% |
Managed
care |
14.2 |
|
|
14.0 |
|
|
7.6 |
|
|
8.5 |
|
|
9.0 |
|
|
6.4 |
|
|
12.8 |
|
|
12.9 |
|
Other skilled |
5.7 |
|
|
5.3 |
|
|
3.0 |
|
|
1.9 |
|
|
4.6 |
|
|
4.3 |
|
|
5.3 |
|
|
4.9 |
|
Skilled mix |
30.9 |
|
|
32.7 |
|
|
20.4 |
|
|
22.4 |
|
|
27.5 |
|
|
21.3 |
|
|
29.5 |
|
|
30.9 |
|
Private and other payors |
11.3 |
|
|
10.5 |
|
|
12.4 |
|
|
10.8 |
|
|
11.4 |
|
|
12.0 |
|
|
11.4 |
|
|
10.5 |
|
Medicaid |
57.8 |
|
|
56.8 |
|
|
67.2 |
|
|
66.8 |
|
|
61.1 |
|
|
66.7 |
|
|
59.1 |
|
|
58.6 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
Year Ended December 31, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING REVENUE |
Medicare |
22.5 |
% |
|
26.0 |
% |
|
21.8 |
% |
|
24.9 |
% |
|
31.0 |
% |
|
20.4 |
% |
|
23.8 |
% |
|
25.7 |
% |
Managed
care |
20.1 |
|
|
19.2 |
|
|
12.6 |
|
|
12.6 |
|
|
13.3 |
|
|
9.9 |
|
|
18.5 |
|
|
18.3 |
|
Other skilled |
8.8 |
|
|
8.1 |
|
|
4.1 |
|
|
3.9 |
|
|
5.0 |
|
|
12.5 |
|
|
7.9 |
|
|
8.0 |
|
Skilled mix |
51.4 |
|
|
53.3 |
|
|
38.5 |
|
|
41.4 |
|
|
49.3 |
|
|
42.8 |
|
|
50.2 |
|
|
52.0 |
|
Private and other payors |
7.5 |
|
|
7.0 |
|
|
8.6 |
|
|
8.1 |
|
|
8.0 |
|
|
6.4 |
|
|
7.6 |
|
|
7.0 |
|
Medicaid |
41.1 |
|
|
39.7 |
|
|
52.9 |
|
|
50.5 |
|
|
42.7 |
|
|
50.8 |
|
|
42.2 |
|
|
41.0 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
Year Ended December 31, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING DAYS |
Medicare |
11.9 |
% |
|
13.9 |
% |
|
10.7 |
% |
|
12.4 |
% |
|
14.5 |
% |
|
9.3 |
% |
|
12.3 |
% |
|
13.5 |
% |
Managed
care |
14.4 |
|
|
14.0 |
|
|
8.0 |
|
|
8.3 |
|
|
8.8 |
|
|
6.4 |
|
|
13.0 |
|
|
13.1 |
|
Other skilled |
5.6 |
|
|
5.1 |
|
|
2.7 |
|
|
2.4 |
|
|
4.2 |
|
|
8.6 |
|
|
5.1 |
|
|
5.2 |
|
Skilled mix |
31.9 |
|
|
33.0 |
|
|
21.4 |
|
|
23.1 |
|
|
27.5 |
|
|
24.3 |
|
|
30.4 |
|
|
31.8 |
|
Private and other payors |
11.0 |
|
|
10.4 |
|
|
11.7 |
|
|
10.8 |
|
|
11.1 |
|
|
9.5 |
|
|
11.0 |
|
|
10.3 |
|
Medicaid |
57.1 |
|
|
56.6 |
|
|
66.9 |
|
|
66.1 |
|
|
61.4 |
|
|
66.2 |
|
|
58.6 |
|
|
57.9 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
THE ENSIGN GROUP, INC. UNAUDITED
REVENUE BY PAYOR SOURCE
The following table sets forth our service
revenue by payor source and as a percentage of total service
revenue for the periods presented:
|
Three Months Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Revenue |
|
% of Revenue |
|
Revenue |
|
% of Revenue |
Medicaid(1) |
$ |
384,566 |
|
39.5 |
% |
|
$ |
320,065 |
|
39.7 |
% |
Medicare |
|
252,414 |
|
25.9 |
|
|
|
222,151 |
|
27.6 |
|
Medicaid — skilled |
|
63,269 |
|
6.4 |
|
|
|
54,523 |
|
6.8 |
|
Total Medicaid and Medicare |
|
700,249 |
|
71.8 |
|
|
|
596,739 |
|
74.1 |
|
Managed care |
|
177,618 |
|
18.2 |
|
|
|
136,674 |
|
17.0 |
|
Private and other(2) |
|
96,861 |
|
10.0 |
|
|
|
71,912 |
|
8.9 |
|
SERVICE REVENUE |
$ |
974,728 |
|
100.0 |
% |
|
$ |
805,325 |
|
100.0 |
% |
(1) Medicaid payor includes revenue for senior
living operations and revenue related to state relief funding. (2)
Private and other payors also includes revenue from senior living
operations and all payors generated in other ancillary
services.
|
Year Ended December 31, |
|
|
2023 |
|
|
|
2022 |
|
|
Revenue |
|
% of Revenue |
|
Revenue |
|
% of Revenue |
Medicaid(1) |
$ |
1,459,449 |
|
39.4 |
% |
|
$ |
1,183,156 |
|
39.3 |
% |
Medicare |
|
985,749 |
|
26.6 |
|
|
|
832,160 |
|
27.7 |
|
Medicaid — skilled |
|
245,663 |
|
6.6 |
|
|
|
200,878 |
|
6.7 |
|
Total Medicaid and Medicare |
|
2,690,861 |
|
72.6 |
|
|
|
2,216,194 |
|
73.7 |
|
Managed care |
|
666,129 |
|
18.0 |
|
|
|
525,710 |
|
17.5 |
|
Private and other(2) |
|
351,081 |
|
9.4 |
|
|
|
266,807 |
|
8.8 |
|
SERVICE REVENUE |
$ |
3,708,071 |
|
100.0 |
% |
|
$ |
3,008,711 |
|
100.0 |
% |
(1) Medicaid payor includes revenue for senior
living operations and revenue related to state relief funding. (2)
Private and other payors also includes revenue from senior living
operations and all payors generated in other ancillary
services.
THE ENSIGN GROUP, INC. UNAUDITED
RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION BY SEGMENT
(In thousands)
Skilled Services
The table below reconciles net income to EBITDA
and Adjusted EBITDA for the skilled services reportable segment for
the periods presented:
|
Three Months Ended December 31, |
|
Year Ended December 31, |
|
|
2023 |
|
|
2022 |
|
|
|
2023 |
|
|
|
2022 |
|
Statements of Income Data: |
|
|
|
|
|
|
|
Segment income(a) |
$ |
116,756 |
|
$ |
106,460 |
|
|
$ |
464,925 |
|
|
$ |
408,732 |
|
Depreciation and amortization |
|
10,349 |
|
|
8,813 |
|
|
|
38,766 |
|
|
|
33,224 |
|
EBITDA |
$ |
127,105 |
|
$ |
115,273 |
|
|
$ |
503,691 |
|
|
$ |
441,956 |
|
Adjustments to EBITDA: |
|
|
|
|
|
|
|
Business interruption recoveries |
|
— |
|
|
(913 |
) |
|
|
(1,009 |
) |
|
|
(913 |
) |
Stock-based compensation expense |
|
5,164 |
|
|
3,823 |
|
|
|
19,904 |
|
|
|
14,394 |
|
Litigation(b) |
|
4,600 |
|
|
— |
|
|
|
4,600 |
|
|
|
— |
|
ADJUSTED EBITDA |
$ |
136,869 |
|
$ |
118,183 |
|
|
$ |
527,186 |
|
|
$ |
455,437 |
|
|
|
|
|
|
|
|
|
(a) Segment income reflects profit or loss from
operations before provision for income taxes and impairment charges
from operations. General and administrative expenses are not
allocated to the skilled services segment for purposes of
determining segment profit or loss. (b) Litigation relates to
specific proceedings arising outside of the ordinary course of
business.
Standard Bearer
The following table sets forth details of
operating results for our revenue and earnings, and their
respective components, by Standard Bearer for the periods
presented:
|
Three Months Ended December 31, |
|
Year Ended December 31, |
|
|
2023 |
|
|
2022 |
|
|
2023 |
|
|
2022 |
|
|
|
|
|
|
|
|
Rental
revenue generated from third-party tenants |
$ |
4,198 |
|
$ |
3,790 |
|
$ |
15,774 |
|
$ |
14,970 |
Rental revenue generated from Ensign independent subsidiaries |
|
17,677 |
|
|
15,624 |
|
|
66,712 |
|
|
57,967 |
TOTAL RENTAL REVENUE |
$ |
21,875 |
|
$ |
19,414 |
|
$ |
82,486 |
|
$ |
72,937 |
Segment income(a) |
|
7,548 |
|
|
7,192 |
|
|
29,065 |
|
|
27,871 |
Depreciation and amortization |
|
6,677 |
|
|
5,815 |
|
|
25,205 |
|
|
21,613 |
FFO(b) |
$ |
14,225 |
|
$ |
13,007 |
|
$ |
54,270 |
|
$ |
49,484 |
|
|
|
|
|
|
|
|
(a) Segment income reflects profit or loss from
operations before provision for income taxes, excluding gain or
loss from sale of real estate and insurance recoveries and charges
from real estate. Included in Standard Bearer expenses for the
quarter and year ended December 31, 2023 is the management fee of
$1.3 million and $5.0 million, respectively, and interest of $3.8
million and $12.9 million, respectively, from intercompany
agreements between Standard Bearer and the Company and its
independent subsidiaries, including the Service Center. Included in
Standard Bearer expenses for the quarter and year ended December
31, 2022 is the management fee of $1.2 million and $4.4 million,
respectively, and interest of $2.5 million and $8.6 million,
respectively, from intercompany agreements between Standard Bearer
and the Company and its independent subsidiaries, including the
Service Center.
(b) FFO, in accordance with the definition used
by the National Association of Real Estate Investment Trusts, means
net income attributable to common stockholders, computed in
accordance with U.S. GAAP, excluding gains or losses from sales of
real estate and impairment of depreciable real estate assets, while
including depreciation and amortization related to real estate to
earnings.
Discussion of Non-GAAP Financial
Measures
EBITDA consists of net income before (a) other
(income) expense, net, (b) provisions for income taxes and (c)
depreciation and amortization. Adjusted EBITDA consists of net
income before (a) other (income) expense, net, (b) provisions for
income taxes, (c) depreciation and amortization, (d) stock-based
compensation expense, (e) acquisition related costs, (f) costs
incurred related to new systems implementation, (g) litigation and
(h) gain on sale of assets and business interruption recoveries.
Adjusted EBITDAR consists of net income before (a) other (income)
expense, net, (b) provisions for income taxes, (c) depreciation and
amortization, (d) rent-cost of services, (e) stock-based
compensation expense, (f) acquisition related costs, (g) costs
incurred related to new systems implementation, (h) litigation and
(i) gain on sale of assets and business interruption recoveries.
Adjusted EBT consists of (a) income before provision for income
taxes, (b) stock-based compensation expense, (c) acquisition
related costs, (d) costs incurred related to new systems
implementation, (e) litigation, (f) gain on sale of assets and
business interruption recoveries, (g) write-off of deferred
financing fees and (h) depreciation and amortization of patient
base intangible assets. Funds from Operations (FFO) for our
Standard Bearer segment consists of segment income, excluding
depreciation and amortization related to real estate. The Company
believes that the presentation of adjusted net income, adjusted
earnings per share, EBITDA, adjusted EBITDA, adjusted EBT and FFO
provides important supplemental information to management and
investors to evaluate the Company’s operating performance. Adjusted
EBITDAR is a financial valuation measure that is not specified in
GAAP. This measure is not displayed as a performance measure as it
excludes rent expense, which is a normal and recurring operating
expense. The Company believes disclosure of adjusted net income,
adjusted net income per share, EBITDA, adjusted EBITDA, adjusted
EBITDAR, adjusted EBT and FFO has substance because the excluded
revenues and expenses are infrequent in nature and are variable in
nature, or do not represent current revenues or cash expenditures.
A material limitation associated with the use of these measures as
compared to the GAAP measures of net income and diluted earnings
per share is that they may not be comparable with the calculation
of net income and diluted earnings per share for other companies in
the Company's industry. These non-GAAP financial measures should
not be relied upon to the exclusion of GAAP financial measures. For
further information regarding why the Company believes that this
non-GAAP measures provide useful information to investors, the
specific manner in which management uses these measures, and some
of the limitations associated with the use of these measures,
please refer to the Company's periodic filings with the Securities
and Exchange Commission, including its Annual Report on Form 10-K
and Quarterly Report on Form 10-Q. The Company’s periodic filings
are available on the SEC's website at www.sec.gov or under the
"Financials" link of the Investor Relations section on Ensign’s
website at http://www.ensigngroup.net.
Ensign (NASDAQ:ENSG)
過去 株価チャート
から 5 2024 まで 6 2024
Ensign (NASDAQ:ENSG)
過去 株価チャート
から 6 2023 まで 6 2024