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 third quarter of 2024, reporting GAAP
diluted earnings per share of $1.34 and adjusted earnings per
share(1) of $1.39, both for the quarter ended September 30, 2024.
Highlights Include:
- GAAP net income was $78.4 million,
an increase of 22.8% over the prior year quarter. Adjusted net
income(1) was $81.1 million for the quarter, an increase of 17.7%,
over the prior year quarter.
- GAAP diluted earnings per share for
the quarter was $1.34, an increase of 20.7% over the prior year
quarter. Adjusted diluted earnings per share(1) was $1.39, an
increase of 15.8%, over the prior year quarter.
- Same Facilities and Transitioning
Facilities occupancy increased by 2.8% and 4.8%, respectively, over
the prior year quarter. In addition, Same Facilities and
Transitioning Facilities occupancy increased by 1.1% and 1.6%,
respectively, sequentially over the second quarter.
- Same Store and Transitioning
Facilities skilled service revenue increased by 7.3% and 7.5%,
respectively, over the prior year quarter.
- Same Facilities and Transitioning
skilled days increased by 6.1% and 17.0%, respectively, over the
prior year quarter. Same Facilities and Transitioning skilled days
increased by 2.6% and 3.4%, respectively, sequentially over the
second quarter.
- Same Facilities and Transitioning
Facilities managed care revenue increased by 11.2% and 22.4%
respectively, over the prior year quarter.
- Consolidated GAAP and adjusted
revenue for the quarter were both $1.08 billion, an increase of
15.0% over the prior year quarter.
- Standard Bearer(2) revenue was
$24.4 million for the quarter, an increase of 16.4% over the prior
year quarter. FFO was $14.8 million for the quarter, an increase of
8.6% over 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 on Form
10-Q.
Operating Results
“Our local leaders continue to consistently
drive outstanding clinical and financial performance and we are
happy to report another record quarter,” said Barry Port, Ensign’s
Chief Executive Officer. “We are particularly impressed with these
results when we’ve added 53 new operations across several markets
in our recently acquired bucket. Our model leans heavily on local
clusters and existing operations to support our newly acquired
operations, and yet these local clusters have shown their strength
by simultaneously integrating the new operations into their
clusters while achieving outstanding results in existing
operations. More specifically, during the quarter we saw same store
occupancies grow to 81.7%, a 2.8% increase over the prior year
quarter, establishing new high-water mark for same store occupancy,
which is especially noteworthy during a quarter where we
historically have experienced seasonally softer occupancies. We
also saw skilled mix days increase for both our same store and
transitioning operations by 3.3% and 14.1%, respectively, over the
prior year quarter. The growth was not due to any one relationship
or market but instead, the improvement was across all payors. In
addition, our managed care census grew by 9.1% and 23.2% for our
same store and transitioning operations, respectively, over the
prior year quarter, which is a very important and growing part of
our business and points to the trust our leaders are continuing to
gain by achieving high quality outcomes,” Port added.
“As we look ahead, we couldn’t be more excited
about the opportunity we have to unlock the enormous upside we see
in our existing portfolio. One of the keys to our success over time
has been to have several paths to achieving consistent results that
do not depend on new acquisitions. Our local CEOs and COOs are
relentlessly working to improve and adapt to the needs of their
markets, and in doing so, they continue to pull various levers to
increase skilled mix and drive occupancies towards the levels of
dozens of our most mature same store operations, many of which are
much higher than our same store average. At the same time, and as
we demonstrated this quarter, we are prepared for, and will
continue to acquire lower occupancy operations at very attractive
prices, which provides a significant long-term ramp with years of
upside,” Port said.
Port added, “Due to our solid skilled mix and
occupancy growth during the quarter, as well as continued strength
from our recent acquisitions, we are raising and narrowing our
annual 2024 earnings guidance to between $5.46 to $5.52 per diluted
share, up from $5.38 to $5.50 per diluted share. The new midpoint
of our 2024 earnings guidance represents an increase of more than
15.1% of our 2023 results and is 32.6% higher than our 2022
results. We are also increasing our annual revenue guidance to
between $4.25 billion to $4.26 billion, up from our previous
guidance of $4.20 billion to $4.22 billion to account for our
current quarter growth and acquisitions we anticipate closing by
the end of the year. We are excited about finishing out 2024 and
look forward to 2025 with confidence that our partners will
continue to manage and innovate while balancing the addition of
newly acquired operations.”
Speaking to the Company’s growth, Chad Keetch,
Ensign’s Chief Investment Officer and Executive Vice President
said, “As we expected, we continued to add to our growing portfolio
and are very excited about the twelve new operations, including
three real estate assets, we added during the quarter and since,
bringing the number of operations acquired during the year to 27.
We continue to see a very healthy pipeline of new acquisition
opportunities and are making progress on several additions that we
expect to close in the fourth quarter and into next year. We remain
committed, especially in times when there are lots of opportunities
in front of us, to rely on a proven set of deal criteria that
ensure we remain disciplined and grow in a healthy way. We have and
will continue to grow when we see deals that will be accretive to
shareholders in both the near- and long-term. We are also excited
to build clusters in new states or in markets where we have
significant room to add more density and expect additional growth
in some of our newer markets in the next several months.”
Suzanne Snapper, Ensign’s Executive Vice
President and Chief Financial Officer reported that the Company’s
liquidity remains strong with approximately $532.1 million of cash
on hand and $572.1 million of available capacity under its
line-of-credit. Ms. Snapper also indicated that, “Management’s
annual 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 certain charges
that arise outside of the business, acquisition related costs 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
Quarterly Report on Form 10-Q for the period ended September 30,
2024, 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. “We were very happy to
complete several new acquisitions during the quarter and since
across four of our 14 states. We continue to prioritize growth in
our established geographies as it allows our clusters to work
together with their acute care partners to provide a comprehensive
solution to their healthcare needs. In particular, we are very
excited to grow in Colorado where we have deep and long-standing
relationships with the healthcare community.”
The recent acquisitions include the following
leased operations:
- Prairie Ridge Health and Rehabilitation, a 102-bed skilled
nursing facility located in Overland Park, Kansas;
- City Park Healthcare and Rehabilitation Center, a 125-bed
skilled nursing facility located in Denver, Colorado;
- Desert Willow Health and Rehabilitation Center, a 106-bed
skilled nursing facility located in Pueblo, Colorado;
- Junction Creek Health and Rehabilitation Center, a 133-bed
skilled nursing facility located in Durango, Colorado;
- Pelican Pointe Health and Rehabilitation Center, a 104-bed
skilled nursing facility located in Windsor, Colorado;
- Riverbend Health and Rehabilitation Center, a 100-bed skilled
nursing facility located in Loveland, Colorado;
- Broadview Health and Rehabilitation Center, a 100-bed skilled
nursing facility located in Greeley, Colorado;
- Westlake Lodge Health and Rehabilitation Center, a 107-bed
skilled nursing facility located in Greeley, Colorado; and
- Linden Place Health and Rehabilitation Center, a 110-bed
skilled nursing facility located in Longmont, Colorado.
Standard Bearer also announced the following
real estate acquisitions, all of which are operated by an
Ensign-affiliate effective as of the acquisition date:
- Holly Heights Care and Rehabilitation, a 133-bed skilled
nursing facility located in Denver, Colorado;
- Greater Southside Health and Rehabilitation, a 76-bed skilled
nursing facility located in Des Moines, Iowa; and
- St. Joseph Rehabilitation and Care Center and Skyview Villa
Assisted Living, a healthcare campus with 83 bed skilled nursing
beds and 20 assisted living units in Norfolk, Nebraska.
Ensign's growing portfolio consists of 323
healthcare operations, 30 of which also include senior living
operations, across 14 states. Ensign now owns 122 real estate
assets, 92 of which it operates. Keetch noted that Ensign’s overall
strategy will continue to include both leasing and acquiring the
real estate and that the Company is actively looking for performing
and underperforming operations in several states.
The Company continues to provide additional
disclosure on Standard Bearer, which is comprised of 117 owned
properties. Of these assets, 88 are leased to an Ensign-affiliated
operator and 30 are leased to third-party operators. Keetch noted
that each of these properties are subject to triple-net, long-term
leases and generated rental revenue of $24.4 million for the
quarter, of which $20.2 million was derived from Ensign affiliated
operations. For the quarter, Ensign reported $14.8 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, October 25,
2024, at 10:00 a.m. Pacific time (1:00 p.m. Eastern time) to
discuss Ensign’s third quarter 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, November 29,
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 323 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, emergency and
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. UNAUDITED CONDENSED
CONSOLIDATED STATEMENTS OF INCOME |
|
|
Three Months Ended September 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
(In thousands, except per share data) |
REVENUE |
|
|
|
|
|
|
|
Service revenue |
$ |
1,076,092 |
|
|
$ |
935,324 |
|
|
$ |
3,111,151 |
|
|
$ |
2,733,343 |
|
Rental revenue |
|
5,684 |
|
|
|
5,467 |
|
|
|
17,082 |
|
|
|
15,634 |
|
TOTAL REVENUE |
$ |
1,081,776 |
|
|
$ |
940,791 |
|
|
$ |
3,128,233 |
|
|
$ |
2,748,977 |
|
Expense: |
|
|
|
|
|
|
|
Cost of services |
|
859,992 |
|
|
|
741,069 |
|
|
|
2,479,615 |
|
|
|
2,160,080 |
|
Rent—cost of services |
|
54,792 |
|
|
|
50,357 |
|
|
|
159,940 |
|
|
|
146,754 |
|
General and administrative expense |
|
56,180 |
|
|
|
51,127 |
|
|
|
169,532 |
|
|
|
156,448 |
|
Depreciation and amortization |
|
21,474 |
|
|
|
18,446 |
|
|
|
61,619 |
|
|
|
53,154 |
|
TOTAL EXPENSES |
$ |
992,438 |
|
|
$ |
860,999 |
|
|
$ |
2,870,706 |
|
|
$ |
2,516,436 |
|
Income from operations |
|
89,338 |
|
|
|
79,792 |
|
|
|
257,527 |
|
|
|
232,541 |
|
Other income (expense): |
|
|
|
|
|
|
|
Interest expense |
|
(2,024 |
) |
|
|
(2,024 |
) |
|
|
(6,028 |
) |
|
|
(6,083 |
) |
Interest income |
|
7,607 |
|
|
|
5,259 |
|
|
|
21,151 |
|
|
|
12,785 |
|
Other income (expense) |
|
3,753 |
|
|
|
(982 |
) |
|
|
7,686 |
|
|
|
2,237 |
|
Other income, net |
$ |
9,336 |
|
|
$ |
2,253 |
|
|
$ |
22,809 |
|
|
$ |
8,939 |
|
Income before provision for income taxes |
|
98,674 |
|
|
|
82,045 |
|
|
|
280,336 |
|
|
|
241,480 |
|
Provision for income taxes |
|
20,107 |
|
|
|
18,077 |
|
|
|
61,628 |
|
|
|
53,453 |
|
NET INCOME |
$ |
78,567 |
|
|
$ |
63,968 |
|
|
$ |
218,708 |
|
|
$ |
188,027 |
|
Less: net income attributable to noncontrolling interests |
|
123 |
|
|
|
105 |
|
|
|
422 |
|
|
|
319 |
|
Net income attributable to The Ensign Group,
Inc. |
$ |
78,444 |
|
|
$ |
63,863 |
|
|
$ |
218,286 |
|
|
$ |
187,708 |
|
|
|
|
|
|
|
|
|
NET INCOME PER SHARE ATTRIBUTABLE TO THE ENSIGN GROUP
INC. |
|
|
|
|
|
|
|
Basic |
$ |
1.38 |
|
|
$ |
1.14 |
|
|
$ |
3.86 |
|
|
$ |
3.38 |
|
Diluted |
$ |
1.34 |
|
|
$ |
1.11 |
|
|
$ |
3.76 |
|
|
$ |
3.28 |
|
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING |
|
|
|
|
|
|
|
Basic |
|
56,776 |
|
|
|
55,829 |
|
|
|
56,553 |
|
|
|
55,582 |
|
Diluted |
|
58,444 |
|
|
|
57,337 |
|
|
|
58,125 |
|
|
|
57,245 |
|
|
THE ENSIGN GROUP, INC. UNAUDITED CONDENSED
CONSOLIDATED BALANCE SHEETS (In thousands) |
|
|
September 30, 2024 |
|
December 31, 2023 |
|
|
|
|
ASSETS |
|
|
|
Current assets: |
|
|
|
Cash and cash equivalents |
$ |
532,066 |
|
$ |
509,626 |
Accounts receivable—less allowance for doubtful accounts of $9,822
and $9,348 at September 30, 2024 and December 31, 2023,
respectively |
|
554,091 |
|
|
485,039 |
Investments—current |
|
38,969 |
|
|
17,229 |
Prepaid income taxes |
|
25,960 |
|
|
3,830 |
Prepaid expenses and other current assets |
|
45,844 |
|
|
31,206 |
Total current assets |
$ |
1,196,930 |
|
$ |
1,046,930 |
Property and equipment, net |
|
1,217,689 |
|
|
1,090,771 |
Right-of-use assets |
|
1,904,181 |
|
|
1,756,430 |
Insurance subsidiary deposits and investments |
|
115,496 |
|
|
92,687 |
Deferred tax assets |
|
65,193 |
|
|
67,124 |
Restricted and other assets |
|
45,753 |
|
|
40,205 |
Intangible assets, net |
|
6,676 |
|
|
6,525 |
Goodwill |
|
77,241 |
|
|
76,869 |
TOTAL ASSETS |
$ |
4,629,159 |
|
$ |
4,177,541 |
LIABILITIES AND EQUITY |
|
|
|
Current liabilities: |
|
|
|
Accounts payable |
$ |
90,274 |
|
$ |
92,811 |
Accrued wages and related liabilities |
|
353,563 |
|
|
332,568 |
Lease liabilities—current |
|
93,868 |
|
|
82,526 |
Accrued self-insurance liabilities—current |
|
57,989 |
|
|
54,664 |
Other accrued liabilities |
|
169,195 |
|
|
168,228 |
Current maturities of long-term debt |
|
4,051 |
|
|
3,950 |
Total current liabilities |
$ |
768,940 |
|
$ |
734,747 |
Long-term debt—less current maturities |
|
142,577 |
|
|
145,497 |
Long-term lease liabilities—less current portion |
|
1,777,566 |
|
|
1,639,326 |
Accrued self-insurance liabilities—less current portion |
|
126,037 |
|
|
111,246 |
Other long-term liabilities |
|
63,092 |
|
|
49,408 |
Total equity |
|
1,750,947 |
|
|
1,497,317 |
TOTAL LIABILITIES AND EQUITY |
$ |
4,629,159 |
|
$ |
4,177,541 |
|
THE ENSIGN GROUP, INC. UNAUDITED CONDENSED
CONSOLIDATED STATEMENTS OF CASH FLOWS (In thousands) |
|
The following table presents selected data from our condensed
consolidated statements of cash flows for the periods
presented: |
|
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
|
|
NET CASH PROVIDED BY/(USED IN): |
|
Operating activities |
$ |
246,730 |
|
|
$ |
291,397 |
|
Investing activities |
|
(223,465 |
) |
|
|
(137,754 |
) |
Financing activities |
|
(825 |
) |
|
|
(2,043 |
) |
Net increase in cash and cash equivalents |
$ |
22,440 |
|
|
$ |
151,600 |
|
Cash and cash equivalents beginning of period |
|
509,626 |
|
|
|
316,270 |
|
Cash and cash equivalents at end of period |
$ |
532,066 |
|
|
$ |
467,870 |
|
|
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 EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Net income attributable to The Ensign Group, Inc. |
$ |
78,444 |
|
|
$ |
63,863 |
|
|
$ |
218,286 |
|
|
$ |
187,708 |
|
Non-GAAP adjustments |
|
|
|
|
|
|
|
Stock-based compensation expense(a) |
|
9,183 |
|
|
|
7,237 |
|
|
|
26,406 |
|
|
|
22,691 |
|
Litigation(b) |
|
(555 |
) |
|
|
2,783 |
|
|
|
(1,425 |
) |
|
|
1,965 |
|
Cost of services - loss on long-lived assets and gain on business
interruption recoveries |
|
486 |
|
|
|
(259 |
) |
|
|
2,335 |
|
|
|
(1,009 |
) |
Cost of services - acquisition related costs(c) |
|
239 |
|
|
|
150 |
|
|
|
518 |
|
|
|
722 |
|
General and administrative - costs incurred related to system
implementations |
|
89 |
|
|
|
— |
|
|
|
2,522 |
|
|
|
875 |
|
Depreciation and amortization - patient base(d) |
|
236 |
|
|
|
135 |
|
|
|
449 |
|
|
|
182 |
|
Provision for income taxes on Non-GAAP adjustments(e) |
|
(6,981 |
) |
|
|
(4,946 |
) |
|
|
(16,157 |
) |
|
|
(13,274 |
) |
Non-GAAP Net Income |
$ |
81,141 |
|
|
$ |
68,963 |
|
|
$ |
232,934 |
|
|
$ |
199,860 |
|
|
|
|
|
|
|
|
|
Average number of diluted shares outstanding |
|
58,444 |
|
|
|
57,337 |
|
|
|
58,125 |
|
|
|
57,245 |
|
|
|
|
|
|
|
|
|
Diluted Earnings Per Share |
$ |
1.34 |
|
|
$ |
1.11 |
|
|
$ |
3.76 |
|
|
$ |
3.28 |
|
|
|
|
|
|
|
|
|
Adjusted Diluted Earnings Per Share |
$ |
1.39 |
|
|
$ |
1.20 |
|
|
$ |
4.01 |
|
|
$ |
3.49 |
|
|
|
|
|
|
|
|
|
Footnotes: |
|
|
|
|
|
|
|
(a) Represents stock-based compensation expense incurred. |
|
|
|
|
|
Three Months EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Cost of services |
$ |
6,007 |
|
|
$ |
5,053 |
|
|
$ |
17,326 |
|
|
$ |
15,271 |
|
General and administrative |
|
3,176 |
|
|
|
2,184 |
|
|
|
9,080 |
|
|
|
7,420 |
|
Total Non-GAAP adjustment |
$ |
9,183 |
|
|
$ |
7,237 |
|
|
$ |
26,406 |
|
|
$ |
22,691 |
|
|
|
|
|
|
|
|
|
(b) Represents specific proceedings and adjustments arising outside
of the ordinary course of business. |
|
Three Months EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Cost of services |
$ |
— |
|
|
$ |
— |
|
|
$ |
(1,634 |
) |
|
$ |
(818 |
) |
General and administrative |
|
(555 |
) |
|
|
2,783 |
|
|
|
209 |
|
|
|
2,783 |
|
Total Non-GAAP adjustment |
$ |
(555 |
) |
|
$ |
2,783 |
|
|
$ |
(1,425 |
) |
|
$ |
1,965 |
|
|
|
|
|
|
|
|
|
(c) Represents costs incurred to acquire operations that are not
capitalizable. |
(d) Represents amortization expenses related to patient base
intangible assets at newly acquired skilled nursing and senior
living facilities. |
(e) 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 EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Consolidated Statements of Income Data: |
|
|
|
|
|
|
|
Net income |
$ |
78,567 |
|
|
$ |
63,968 |
|
|
$ |
218,708 |
|
|
$ |
188,027 |
|
Less: Net income attributable to noncontrolling interests |
|
123 |
|
|
|
105 |
|
|
|
422 |
|
|
|
319 |
|
Interest income |
|
7,607 |
|
|
|
5,259 |
|
|
|
21,151 |
|
|
|
12,785 |
|
Add: Provision for income taxes |
|
20,107 |
|
|
|
18,077 |
|
|
|
61,628 |
|
|
|
53,453 |
|
Depreciation and amortization |
|
21,474 |
|
|
|
18,446 |
|
|
|
61,619 |
|
|
|
53,154 |
|
Interest expense |
|
2,024 |
|
|
|
2,024 |
|
|
|
6,028 |
|
|
|
6,083 |
|
EBITDA |
$ |
114,442 |
|
|
$ |
97,151 |
|
|
$ |
326,410 |
|
|
$ |
287,613 |
|
Adjustments to EBITDA: |
|
|
|
|
|
|
|
Stock-based compensation expense |
|
9,183 |
|
|
|
7,237 |
|
|
|
26,406 |
|
|
|
22,691 |
|
Litigation(a) |
|
(555 |
) |
|
|
2,783 |
|
|
|
(1,425 |
) |
|
|
1,965 |
|
Loss on long-lived assets and gain on business interruption
recoveries |
|
486 |
|
|
|
(259 |
) |
|
|
2,335 |
|
|
|
(1,009 |
) |
Acquisition related costs(b) |
|
239 |
|
|
|
150 |
|
|
|
518 |
|
|
|
722 |
|
Costs incurred related to system implementations |
|
89 |
|
|
|
— |
|
|
|
2,522 |
|
|
|
875 |
|
ADJUSTED EBITDA |
$ |
123,884 |
|
|
$ |
107,062 |
|
|
$ |
356,766 |
|
|
$ |
312,857 |
|
Rent—cost of services |
|
54,792 |
|
|
|
50,357 |
|
|
|
159,940 |
|
|
|
146,754 |
|
ADJUSTED EBITDAR |
$ |
178,676 |
|
|
|
|
$ |
516,706 |
|
|
|
|
|
|
|
|
|
|
|
(a) Litigation relates to specific proceedings and adjustments
arising outside of the ordinary course of business. (b) Costs
incurred to acquire operations that are not capitalizable. |
The table below reconciles income before provision for income taxes
to Adjusted EBT for the periods presented: |
|
|
Three Months EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
|
|
|
|
|
|
|
|
Consolidated statements of income data: |
(In thousands) |
Income before provision for income taxes |
$ |
98,674 |
|
|
$ |
82,045 |
|
|
$ |
280,336 |
|
|
$ |
241,480 |
|
Stock-based compensation expense |
|
9,183 |
|
|
|
7,237 |
|
|
|
26,406 |
|
|
|
22,691 |
|
Litigation(a) |
|
(555 |
) |
|
|
2,783 |
|
|
|
(1,425 |
) |
|
|
1,965 |
|
Loss on long-lived assets and gain on business interruption
recoveries |
|
486 |
|
|
|
(259 |
) |
|
|
2,335 |
|
|
|
(1,009 |
) |
Acquisition related costs(b) |
|
239 |
|
|
|
150 |
|
|
|
518 |
|
|
|
722 |
|
Costs incurred related to system implementations |
|
89 |
|
|
|
— |
|
|
|
2,522 |
|
|
|
875 |
|
Depreciation and amortization - patient base(c) |
|
236 |
|
|
|
135 |
|
|
|
449 |
|
|
|
182 |
|
ADJUSTED EBT |
$ |
108,352 |
|
|
$ |
92,091 |
|
|
$ |
311,141 |
|
|
$ |
266,906 |
|
|
(a) Litigation relates to specific proceedings and adjustments
arising outside of the ordinary course of business. (b) Costs
incurred to acquire operations that are not capitalizable. (c)
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 September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TOTAL FACILITY RESULTS: |
(Dollars in thousands) |
Skilled services revenue |
$ |
1,033,113 |
|
|
$ |
902,967 |
|
|
$ |
130,146 |
|
|
14.4 |
% |
Number of facilities at period end |
|
282 |
|
|
|
258 |
|
|
|
24 |
|
|
9.3 |
% |
Number of campuses at period end(1) |
|
29 |
|
|
|
26 |
|
|
|
3 |
|
|
11.5 |
% |
Actual patient days |
|
2,407,709 |
|
|
|
2,190,540 |
|
|
|
217,169 |
|
|
9.9 |
% |
Occupancy percentage — Operational beds |
|
80.9 |
% |
|
|
78.9 |
% |
|
|
2.0 |
% |
|
2.5 |
% |
Skilled mix by nursing days |
|
29.7 |
% |
|
|
29.1 |
% |
|
|
0.6 |
% |
|
2.1 |
% |
Skilled mix by nursing revenue |
|
48.5 |
% |
|
|
48.4 |
% |
|
|
0.1 |
% |
|
0.2 |
% |
|
Three Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
SAME FACILITY RESULTS:(2) |
(Dollars in thousands) |
Skilled services revenue |
$ |
756,424 |
|
|
$ |
705,059 |
|
|
$ |
51,365 |
|
|
7.3 |
% |
Number of facilities at period end |
|
193 |
|
|
|
193 |
|
|
|
— |
|
|
— |
% |
Number of campuses at period end(1) |
|
25 |
|
|
|
25 |
|
|
|
— |
|
|
— |
% |
Actual patient days |
|
1,743,823 |
|
|
|
1,696,360 |
|
|
|
47,463 |
|
|
2.8 |
% |
Occupancy percentage — Operational beds |
|
81.7 |
% |
|
|
79.5 |
% |
|
|
2.2 |
% |
|
2.8 |
% |
Skilled mix by nursing days |
|
31.6 |
% |
|
|
30.6 |
% |
|
|
1.0 |
% |
|
3.3 |
% |
Skilled mix by nursing revenue |
|
50.2 |
% |
|
|
49.6 |
% |
|
|
0.6 |
% |
|
1.2 |
% |
|
Three Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TRANSITIONING FACILITY
RESULTS:(3) |
(Dollars in thousands) |
Skilled services revenue |
$ |
127,869 |
|
|
$ |
118,904 |
|
|
$ |
8,965 |
|
|
7.5 |
% |
Number of facilities at period end |
|
40 |
|
|
|
40 |
|
|
|
— |
|
|
— |
% |
Number of campuses at period end(1) |
|
1 |
|
|
|
1 |
|
|
|
— |
|
|
— |
% |
Actual patient days |
|
337,906 |
|
|
|
330,468 |
|
|
|
7,438 |
|
|
2.3 |
% |
Occupancy percentage — Operational beds |
|
76.9 |
% |
|
|
73.4 |
% |
|
|
3.5 |
% |
|
4.8 |
% |
Skilled mix by nursing days |
|
21.8 |
% |
|
|
19.1 |
% |
|
|
2.7 |
% |
|
14.1 |
% |
Skilled mix by nursing revenue |
|
38.9 |
% |
|
|
35.3 |
% |
|
|
3.6 |
% |
|
10.2 |
% |
|
Three Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
RECENTLY ACQUIRED FACILITY
RESULTS:(4) |
(Dollars in thousands) |
Skilled services revenue |
$ |
148,820 |
|
|
$ |
77,978 |
|
|
$ |
70,842 |
|
NM |
Number of facilities at period end |
|
49 |
|
|
|
24 |
|
|
|
25 |
|
NM |
Number of campuses at period end(1) |
|
3 |
|
|
|
— |
|
|
|
3 |
|
NM |
Actual patient days |
|
325,980 |
|
|
|
159,694 |
|
|
|
166,286 |
|
NM |
Occupancy percentage — Operational beds |
|
81.3 |
% |
|
|
84.3 |
% |
|
NM |
|
NM |
Skilled mix by nursing days |
|
28.0 |
% |
|
|
35.3 |
% |
|
NM |
|
NM |
Skilled mix by nursing revenue |
|
47.8 |
% |
|
|
57.2 |
% |
|
NM |
|
NM |
|
Three Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
FACILITY CLOSED RESULTS:(5) |
(Dollars in thousands) |
Skilled services revenue |
$ |
— |
|
|
$ |
1,026 |
|
|
$ |
(1,026 |
) |
|
NM |
Actual patient days |
|
— |
|
|
|
4,018 |
|
|
|
(4,018 |
) |
|
NM |
Occupancy percentage — Operational beds |
|
— |
% |
|
|
82.8 |
% |
|
NM |
|
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,
2021.(3) Transitioning Facility results represent all facilities
purchased from January 1, 2021 to December 31, 2022.(4)
Recently Acquired Facility (Acquisitions) results represent all
facilities purchased on or subsequent to January 1, 2023.(5)
Facility Closed results represent one closed operation during 2024
due to the transitioning of an intermediate care facility program
to group home setting, which is included in All Other category. The
operation revenue was excluded from Same Facilities results for the
three months ended September 30, 2023 for comparison purposes. |
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TOTAL FACILITY RESULTS: |
(Dollars in thousands) |
Skilled services revenue |
$ |
2,994,000 |
|
|
$ |
2,638,090 |
|
|
$ |
355,910 |
|
|
13.5 |
% |
Number of facilities at period end |
|
282 |
|
|
|
258 |
|
|
|
24 |
|
|
9.3 |
% |
Number of campuses at period end(1) |
|
29 |
|
|
|
26 |
|
|
|
3 |
|
|
11.5 |
% |
Actual patient days |
|
6,962,308 |
|
|
|
6,363,107 |
|
|
|
599,201 |
|
|
9.4 |
% |
Occupancy percentage — Operational beds |
|
80.4 |
% |
|
|
78.3 |
% |
|
|
2.1 |
% |
|
2.7 |
% |
Skilled mix by nursing days |
|
30.2 |
% |
|
|
30.7 |
% |
|
(0.5)% |
|
(1.6)% |
Skilled mix by nursing revenue |
|
48.8 |
% |
|
|
50.6 |
% |
|
(1.8)% |
|
(3.6)% |
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
SAME FACILITY RESULTS:(2) |
(Dollars in thousands) |
Skilled services revenue |
$ |
2,244,572 |
|
|
$ |
2,096,752 |
|
|
$ |
147,820 |
|
|
7.0 |
% |
Number of facilities at period end |
|
193 |
|
|
|
193 |
|
|
|
— |
|
|
— |
% |
Number of campuses at period end(1) |
|
25 |
|
|
|
25 |
|
|
|
— |
|
|
— |
% |
Actual patient days |
|
5,157,784 |
|
|
|
5,000,020 |
|
|
|
157,764 |
|
|
3.2 |
% |
Occupancy percentage — Operational beds |
|
81.2 |
% |
|
|
79.0 |
% |
|
|
2.2 |
% |
|
2.8 |
% |
Skilled mix by nursing days |
|
31.8 |
% |
|
|
32.1 |
% |
|
(0.3)% |
|
(0.9)% |
Skilled mix by nursing revenue |
|
50.2 |
% |
|
|
51.6 |
% |
|
(1.4)% |
|
(2.7)% |
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
TRANSITIONING FACILITY
RESULTS:(3) |
(Dollars in thousands) |
Skilled services revenue |
$ |
374,989 |
|
|
$ |
350,048 |
|
|
$ |
24,941 |
|
|
7.1 |
% |
Number of facilities at period end |
|
40 |
|
|
|
40 |
|
|
|
— |
|
|
— |
% |
Number of campuses at period end(1) |
|
1 |
|
|
|
1 |
|
|
|
— |
|
|
— |
% |
Actual patient days |
|
995,438 |
|
|
|
969,585 |
|
|
|
25,853 |
|
|
2.7 |
% |
Occupancy percentage — Operational beds |
|
75.5 |
% |
|
|
72.6 |
% |
|
|
2.9 |
% |
|
4.0 |
% |
Skilled mix by nursing days |
|
21.7 |
% |
|
|
20.9 |
% |
|
|
0.8 |
% |
|
3.8 |
% |
Skilled mix by nursing revenue |
|
38.4 |
% |
|
|
38.7 |
% |
|
(0.3)% |
|
(0.8)% |
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
RECENTLY ACQUIRED FACILITY
RESULTS:(4) |
(Dollars in thousands) |
Skilled services revenue |
$ |
373,865 |
|
|
$ |
188,216 |
|
|
$ |
185,649 |
|
NM |
Number of facilities at period end |
|
49 |
|
|
|
24 |
|
|
|
25 |
|
NM |
Number of campuses at period end(1) |
|
3 |
|
|
|
— |
|
|
|
3 |
|
NM |
Actual patient days |
|
807,004 |
|
|
|
379,708 |
|
|
|
427,296 |
|
NM |
Occupancy percentage — Operational beds |
|
82.0 |
% |
|
|
85.2 |
% |
|
NM |
|
NM |
Skilled mix by nursing days |
|
30.3 |
% |
|
|
38.3 |
% |
|
NM |
|
NM |
Skilled mix by nursing revenue |
|
51.0 |
% |
|
|
61.2 |
% |
|
NM |
|
NM |
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Change |
|
% Change |
|
|
|
|
|
|
|
|
FACILITY CLOSED RESULTS:(5) |
(Dollars in thousands) |
Skilled services revenue |
$ |
574 |
|
|
$ |
3,074 |
|
|
$ |
(2,500 |
) |
|
NM |
Actual patient days |
|
2,082 |
|
|
|
13,794 |
|
|
|
(11,712 |
) |
|
NM |
Occupancy percentage — Operational beds |
|
52.6 |
% |
|
|
90.7 |
% |
|
NM |
|
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,
2021.(3) Transitioning Facility results represent all facilities
purchased from January 1, 2021 to December 31, 2022.(4)
Recently Acquired Facility (Acquisitions) results represent all
facilities purchased on or subsequent to January 1, 2023.(5)
Facility Closed results represent a closed operation during the
nine months ended September 30, 2024 due to the transitioning of an
intermediate care facility program to group home setting, which is
included in All Other category. The operation revenue was excluded
from Same Facilities results for the nine months ended September
30, 2024 and 2023 for comparison purposes. |
|
THE ENSIGN GROUP, INC. SKILLED NURSING AVERAGE
DAILY REVENUE RATES AND PERCENT OF SKILLED NURSING REVENUE AND DAYS
BY PAYOR (Unaudited) |
|
The following tables reflect 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 September 30, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SKILLED NURSING AVERAGE DAILY REVENUE RATES |
Medicare |
$ |
751.70 |
|
$ |
719.45 |
|
$ |
703.43 |
|
$ |
682.72 |
|
$ |
836.11 |
|
$ |
861.36 |
|
$ |
761.27 |
|
$ |
735.66 |
Managed care |
|
553.94 |
|
|
543.40 |
|
|
525.98 |
|
|
529.60 |
|
|
582.80 |
|
|
626.63 |
|
|
553.85 |
|
|
546.36 |
Other skilled |
|
631.53 |
|
|
581.59 |
|
|
566.54 |
|
|
484.78 |
|
|
618.15 |
|
|
424.56 |
|
|
625.47 |
|
|
562.61 |
Total skilled revenue |
|
635.52 |
|
|
612.95 |
|
|
609.64 |
|
|
586.49 |
|
|
724.79 |
|
|
746.45 |
|
|
644.15 |
|
|
622.12 |
Medicaid |
|
292.95 |
|
|
277.34 |
|
|
272.74 |
|
|
256.72 |
|
|
305.33 |
|
|
297.45 |
|
|
291.49 |
|
|
275.09 |
Private and other payors |
|
280.39 |
|
|
262.53 |
|
|
240.69 |
|
|
237.31 |
|
|
328.69 |
|
|
348.46 |
|
|
280.84 |
|
|
262.97 |
Total skilled nursing revenue |
$ |
399.86 |
|
$ |
378.34 |
|
$ |
342.49 |
|
$ |
317.22 |
|
$ |
425.50 |
|
$ |
460.15 |
|
$ |
395.24 |
|
$ |
374.85 |
(1) The rates are based on contractually agreed-upon amounts or
rates, excluding the estimates of variable consideration under the
revenue recognition standard, Financial Accounting Standards Board
(FASB) Accounting Standards Codification (ASC) Topic 606 and state
relief funding during the three months ended September 30,
2023. |
|
Nine Months Ended September 30, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SKILLED NURSING AVERAGE DAILY REVENUE RATES |
Medicare |
$ |
748.98 |
|
$ |
713.73 |
|
$ |
698.74 |
|
$ |
670.68 |
|
$ |
846.75 |
|
$ |
859.42 |
|
$ |
759.90 |
|
$ |
724.85 |
Managed care |
|
550.36 |
|
|
529.39 |
|
|
524.39 |
|
|
518.66 |
|
|
585.08 |
|
|
613.87 |
|
|
550.73 |
|
|
532.41 |
Other skilled |
|
623.28 |
|
|
592.05 |
|
|
516.66 |
|
|
494.20 |
|
|
610.19 |
|
|
480.91 |
|
|
613.37 |
|
|
576.60 |
Total skilled revenue |
|
632.93 |
|
|
610.20 |
|
|
599.35 |
|
|
588.55 |
|
|
736.74 |
|
|
751.07 |
|
|
641.47 |
|
|
618.43 |
Medicaid |
|
295.40 |
|
|
272.75 |
|
|
270.47 |
|
|
248.33 |
|
|
303.66 |
|
|
286.80 |
|
|
292.35 |
|
|
269.05 |
Private and other payors |
|
280.71 |
|
|
262.31 |
|
|
249.88 |
|
|
237.21 |
|
|
331.04 |
|
|
347.78 |
|
|
281.39 |
|
|
261.99 |
Total skilled nursing revenue |
$ |
401.33 |
|
$ |
380.01 |
|
$ |
339.45 |
|
$ |
318.15 |
|
$ |
437.60 |
|
$ |
469.52 |
|
$ |
396.61 |
|
$ |
375.58 |
(1) The rates are based on contractually agreed-upon amounts or
rates, excluding the estimates of variable consideration under the
revenue recognition standard, Financial Accounting Standards Board
(FASB) Accounting Standards Codification (ASC) Topic 606 and state
relief funding during the nine months ended September 30,
2023. |
The following tables set forth our percentage of
skilled nursing patient revenue and days by payor source for the
periods presented:
|
Three Months Ended September 30, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING REVENUE |
Medicare |
20.1 |
% |
|
20.7 |
% |
|
19.9 |
% |
|
17.3 |
% |
|
29.9 |
% |
|
40.9 |
% |
|
21.5 |
% |
|
22.0 |
% |
Managed care |
20.7 |
|
|
20.2 |
|
|
14.5 |
|
|
13.1 |
|
|
12.7 |
|
|
12.1 |
|
|
18.8 |
|
|
18.6 |
|
Other skilled |
9.4 |
|
|
8.7 |
|
|
4.5 |
|
|
4.9 |
|
|
5.2 |
|
|
4.2 |
|
|
8.2 |
|
|
7.8 |
|
Skilled mix |
50.2 |
% |
|
49.6 |
% |
|
38.9 |
% |
|
35.3 |
% |
|
47.8 |
% |
|
57.2 |
% |
|
48.5 |
% |
|
48.4 |
% |
Private and other payors |
7.4 |
|
|
7.9 |
|
|
8.3 |
|
|
9.4 |
|
|
8.4 |
|
|
6.5 |
|
|
7.6 |
|
|
8.0 |
|
Medicaid |
42.4 |
|
|
42.5 |
|
|
52.8 |
|
|
55.3 |
|
|
43.8 |
|
|
36.3 |
|
|
43.9 |
|
|
43.6 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
Three Months Ended September 30, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING DAYS |
Medicare |
10.7 |
% |
|
10.9 |
% |
|
9.7 |
% |
|
8.0 |
% |
|
15.2 |
% |
|
21.9 |
% |
|
11.2 |
% |
|
11.2 |
% |
Managed care |
14.9 |
|
|
14.1 |
|
|
9.4 |
|
|
7.8 |
|
|
9.2 |
|
|
8.9 |
|
|
13.4 |
|
|
12.7 |
|
Other skilled |
6.0 |
|
|
5.6 |
|
|
2.7 |
|
|
3.3 |
|
|
3.6 |
|
|
4.5 |
|
|
5.1 |
|
|
5.2 |
|
Skilled mix |
31.6 |
% |
|
30.6 |
% |
|
21.8 |
% |
|
19.1 |
% |
|
28.0 |
% |
|
35.3 |
% |
|
29.7 |
% |
|
29.1 |
% |
Private and other payors |
10.5 |
|
|
11.5 |
|
|
11.9 |
|
|
12.5 |
|
|
11.0 |
|
|
8.5 |
|
|
10.8 |
|
|
11.5 |
|
Medicaid |
57.9 |
|
|
57.9 |
|
|
66.3 |
|
|
68.4 |
|
|
61.0 |
|
|
56.2 |
|
|
59.5 |
|
|
59.4 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
Nine Months Ended September 30, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING REVENUE |
Medicare |
20.7 |
% |
|
22.9 |
% |
|
19.5 |
% |
|
21.4 |
% |
|
33.4 |
% |
|
43.4 |
% |
|
22.1 |
% |
|
24.2 |
% |
Managed care |
20.4 |
|
|
20.1 |
|
|
14.2 |
|
|
12.1 |
|
|
13.1 |
|
|
13.4 |
|
|
18.7 |
|
|
18.5 |
|
Other skilled |
9.1 |
|
|
8.6 |
|
|
4.7 |
|
|
5.2 |
|
|
4.5 |
|
|
4.4 |
|
|
8.0 |
|
|
7.9 |
|
Skilled mix |
50.2 |
% |
|
51.6 |
% |
|
38.4 |
% |
|
38.7 |
% |
|
51.0 |
% |
|
61.2 |
% |
|
48.8 |
% |
|
50.6 |
% |
Private and other payors |
7.2 |
|
|
7.5 |
|
|
8.7 |
|
|
8.8 |
|
|
7.8 |
|
|
6.2 |
|
|
7.5 |
|
|
7.6 |
|
Medicaid |
42.6 |
|
|
40.9 |
|
|
52.9 |
|
|
52.5 |
|
|
41.2 |
|
|
32.6 |
|
|
43.7 |
|
|
41.8 |
|
TOTAL SKILLED NURSING |
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
100.0 |
% |
|
Nine Months Ended September 30, |
|
Same Facility |
|
Transitioning |
|
Acquisitions |
|
Total |
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PERCENTAGE OF SKILLED NURSING DAYS |
Medicare |
11.1 |
% |
|
12.2 |
% |
|
9.5 |
% |
|
10.2 |
% |
|
17.2 |
% |
|
23.7 |
% |
|
11.6 |
% |
|
12.6 |
% |
Managed care |
14.9 |
|
|
14.4 |
|
|
9.2 |
|
|
7.4 |
|
|
9.8 |
|
|
10.2 |
|
|
13.5 |
|
|
13.1 |
|
Other skilled |
5.8 |
|
|
5.5 |
|
|
3.0 |
|
|
3.3 |
|
|
3.3 |
|
|
4.4 |
|
|
5.1 |
|
|
5.0 |
|
Skilled mix |
31.8 |
% |
|
32.1 |
% |
|
21.7 |
% |
|
20.9 |
% |
|
30.3 |
% |
|
38.3 |
% |
|
30.2 |
% |
|
30.7 |
% |
Private and other payors |
10.4 |
|
|
11.0 |
|
|
12.0 |
|
|
11.8 |
|
|
10.3 |
|
|
8.3 |
|
|
10.6 |
|
|
10.9 |
|
Medicaid |
57.8 |
|
|
56.9 |
|
|
66.3 |
|
|
67.3 |
|
|
59.4 |
|
|
53.4 |
|
|
59.2 |
|
|
58.4 |
|
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 tables set forth our service revenue by payor source
and as a percentage of total service revenue for the periods
presented: |
|
|
Three Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Revenue |
|
% of Revenue |
|
Revenue |
|
% of Revenue |
Medicaid(1)(2) |
$ |
425,642 |
|
39.6 |
% |
|
$ |
374,838 |
|
40.1 |
% |
Medicare |
|
263,594 |
|
24.5 |
|
|
|
237,531 |
|
25.4 |
|
Medicaid — skilled |
|
65,907 |
|
6.1 |
|
|
|
62,452 |
|
6.6 |
|
Total Medicaid and Medicare |
$ |
755,143 |
|
70.2 |
% |
|
$ |
674,821 |
|
72.1 |
% |
Managed care |
|
202,528 |
|
18.8 |
|
|
|
170,747 |
|
18.3 |
|
Private and other(3) |
|
118,421 |
|
11.0 |
|
|
|
89,756 |
|
9.6 |
|
SERVICE REVENUE |
$ |
1,076,092 |
|
100.0 |
% |
|
$ |
935,324 |
|
100.0 |
% |
(1) Medicaid payor includes revenue for senior living operations.
(2) Medicaid payor includes revenue related to state relief funding
during the three months ended September 30, 2023. (3) Private and
other also includes revenue from senior living operations and all
revenue generated in other ancillary services. |
|
Nine Months Ended September 30, |
|
|
2024 |
|
|
|
2023 |
|
|
Revenue |
|
% of Revenue |
|
Revenue |
|
% of Revenue |
Medicaid(1) |
$ |
1,227,565 |
|
39.5 |
% |
|
$ |
1,074,883 |
|
39.3 |
% |
Medicare |
|
788,046 |
|
25.3 |
|
|
|
733,335 |
|
26.8 |
|
Medicaid — skilled |
|
192,185 |
|
6.2 |
|
|
|
182,394 |
|
6.7 |
|
Total Medicaid and Medicare |
$ |
2,207,796 |
|
71.0 |
% |
|
$ |
1,990,612 |
|
72.8 |
% |
Managed care |
|
581,654 |
|
18.7 |
|
|
|
488,511 |
|
17.9 |
|
Private and other(2) |
|
321,701 |
|
10.3 |
|
|
|
254,220 |
|
9.3 |
|
SERVICE REVENUE |
$ |
3,111,151 |
|
100.0 |
% |
|
$ |
2,733,343 |
|
100.0 |
% |
(1) Medicaid payor includes revenue for senior living operations.
(2) Medicaid payor includes revenue related to state relief funding
during the nine months ended September 30, 2023. (3) Private and
other also includes revenue from senior living operations and all
revenue 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 EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
2023 |
|
|
|
2024 |
|
|
2023 |
|
Statements of Income Data: |
|
|
|
|
|
|
|
Segment income(a) |
$ |
128,489 |
|
$ |
117,816 |
|
|
$ |
377,483 |
|
$ |
348,169 |
|
Depreciation and amortization |
|
11,541 |
|
|
9,936 |
|
|
|
32,988 |
|
|
28,417 |
|
EBITDA |
$ |
140,030 |
|
$ |
127,752 |
|
|
$ |
410,471 |
|
$ |
376,586 |
|
Adjustments to EBITDA: |
|
|
|
|
|
|
|
Stock-based compensation expense |
|
5,783 |
|
|
4,879 |
|
|
|
16,690 |
|
|
14,740 |
|
Litigation(b) |
|
— |
|
|
— |
|
|
|
2,100 |
|
|
— |
|
Gain on business interruption recoveries |
|
— |
|
|
(259 |
) |
|
|
— |
|
|
(1,009 |
) |
ADJUSTED EBITDA |
$ |
145,813 |
|
$ |
132,372 |
|
|
$ |
429,261 |
|
$ |
390,317 |
|
|
|
|
|
|
|
|
|
(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 EndedSeptember 30, |
|
Nine Months EndedSeptember 30, |
|
|
2024 |
|
|
2023 |
|
|
2024 |
|
|
2023 |
|
|
|
|
|
|
|
|
Rental revenue generated from third-party tenants |
$ |
4,195 |
|
$ |
4,004 |
|
$ |
12,588 |
|
$ |
11,576 |
Rental revenue generated from Ensign's independent
subsidiaries |
|
20,234 |
|
|
16,976 |
|
|
57,396 |
|
|
49,035 |
TOTAL RENTAL REVENUE |
$ |
24,429 |
|
$ |
20,980 |
|
$ |
69,984 |
|
$ |
60,611 |
Segment income(a) |
|
7,274 |
|
|
7,165 |
|
|
21,892 |
|
|
21,517 |
Depreciation and amortization |
|
7,484 |
|
|
6,429 |
|
|
21,479 |
|
|
18,528 |
FFO(b) |
$ |
14,758 |
|
$ |
13,594 |
|
$ |
43,371 |
|
$ |
40,045 |
|
|
|
|
|
|
|
|
(a) Segment income reflects profit or loss from operations before
provision for income taxes, excluding gain or loss from sale of
real estate, insurance recoveries and impairment of long-lived
assets. Included in Standard Bearer expenses for the three and nine
months ended September 30, 2024 is the management fee of $1.5
million and $4.2 million, respectively, and interest of $5.5
million and $14.8 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 three and nine months ended
September 30, 2023 is the management fee of $1.3 million and $3.7
million, respectively, and interest of $3.4 million and $9.1
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 sale of real estate, insurance recoveries
related to real estate and impairment of long-lived 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)
interest income, (b) provision for income taxes, (c) depreciation
and amortization and (d) interest expense. Adjusted EBITDA consists
of net income before (a) interest income, (b) provision for income
taxes, (c) depreciation and amortization, (d) interest expense, (e)
stock-based compensation expense, (f) acquisition related costs,
(g) costs incurred related to system implementations, (h)
litigation arising outside of the ordinary course of business and
(i) loss on long-lived assets and gain on business interruption
recoveries. Adjusted EBITDAR consists of net income before (a)
interest income, (b) provision for income taxes, (c) depreciation
and amortization, (d) interest expense, (e) rent-cost of services,
(f) stock-based compensation expense, (g) acquisition related
costs, (h) costs incurred related to system implementations, (i)
litigation arising outside of the ordinary course of business and
(j) loss on long-lived assets and gain on business interruption
recoveries. Adjusted EBT consists of net income before (a)
provision for income taxes, (b) stock-based compensation expense,
(c) acquisition related costs, (d) costs incurred related to system
implementations, (e) litigation arising outside of the ordinary
course of business, (f) loss on long-lived assets and gain on
business interruption recoveries and (g) 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, gains or losses from the sale of real estate,
insurance recoveries related to real estate and impairment of
long-lived assets. 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 10 2024 まで 11 2024
Ensign (NASDAQ:ENSG)
過去 株価チャート
から 11 2023 まで 11 2024