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8-K - FORM 8-K - ENSIGN GROUP, INC | c20959e8vk.htm |
Exhibit 99.1
The Ensign Group Reports Record Quarter; Q2 2011 Earnings of $0.60 per Share
Conference Call and Webcast Scheduled for August 4, 2011 at 10:30 am PT
MISSION VIEJO, California August 3, 2011 The Ensign Group, Inc. (Nasdaq: ENSG), the parent
company of the Ensign group of skilled nursing, rehabilitative care services, home health, hospice
care and assisted and independent living companies, today reported record results for the second
quarter of 2011.
Financial Highlights for the Quarter Include:
| Same-store skilled mix revenue increased 429 basis points to 56.5%; |
||
| Due to the Companys growth and a significant increase in skilled mix, consolidated
EBITDAR climbed 28.6% to $33.1 million, with consolidated EBITDAR margins improving by 147
basis points to 17.8% and same-store EBITDAR margins increasing by 143 basis points to
18.4%; |
||
| Total revenue was a record $186.3 million, up 18.0% over the same quarter in 2010; |
||
| Consolidated net income climbed 34.9% to $13.0 million, or a record $0.60 per diluted
share; |
||
| Same-store occupancy grew by 41 basis points to 82.4%; and |
||
| Management increased 2011 annual revenue guidance, projecting revenues of $755 million
to $770 million, and reaffirmed earnings guidance at $2.15 to $2.25 per diluted share for
the year. |
Operating Results
Ensigns President and Chief Executive Officer Christopher Christensen thanked the organizations
many leaders and key members for their exceptional results, both clinical and financial. Their
efforts have not only produced record operating results today, but have also laid a solid
foundation for continued growth in months and years to come, regardless of any obstacles the future
may hold, he said.
He also addressed the anticipated impact of the recently-announced CMS 2012 final rule, which is
calculated to cut Medicare reimbursement to skilled nursing facilities by a surprising 11.1% for
fiscal 2012. Despite the broader pain that will be afflicting the industry starting October 1, we
are pleased to report that Ensign was built for exactly times like these. Our unique business model
acknowledges, as a foundational principle, the unpredictability of operating in an environment
dominated by government payors, said Mr. Christensen.
We have always worked to elevate the quality of our local leadership and empowered them to make
the decisions on the fly which are necessary to respond appropriately to all manner of changes in
their marketplaces, and we are confident that we can adjust quickly and effectively to this
change, he added.
He also noted that Ensign has historically avoided overleveraging its balance sheet or overpaying
for its real estate. This allows us to translate our operating margins into the highest and most
reliable net margins in the industry, he said, adding that with these margins the Company is well
positioned to weather these changes and even turn them to competitive advantages.
Mr. Christensen also stated, Most importantly, our business model focuses on moving the struggling
facilities we typically acquire with their low census, even lower skilled mix and acuity, and
their correspondingly low average reimbursement rates to higher-occupancy, higher-acuity,
higher-reimbursement and higher-quality-of-care operating standards. This steady movement allows us
to constantly mine the huge organic upside in our growing portfolio, in ways that often more-than
offset temporary challenges in reimbursement or other changes. He noted that Ensign has
consistently produced double-digit growth in key operating metrics year after year, even in years
when we have made very few acquisitions, faced reimbursement headwinds, or experienced other
challenges.
Discussing the record results, Chief Financial Officer Suzanne Snapper reported that, although
consolidated occupancy was essentially flat for the quarter as the Company has layered in a spate
of new acquisitions since the first of the year, consolidated skilled census continues to grow,
with a 10.5% increase in overall skilled days.
Ms. Snapper also reported that Ensigns balance sheet carried an industry-low net-debt-to-EBITDAR
ratio of 1.83x as of quarter end, and that the company continues to generate strong cash flow with
cash on hand at quarter end of $38.1 million, and net cash from operations of $27.4 million for the
six months. She noted further that the Company had acquired a previously-reported $150 million
credit facility in July, and that even after using half of the facility to refinance existing debt
and make acquisitions, Ensigns balance sheet carries an industry-low net-debt-to-EBITDAR ratio of
approximately 2.3x.
In other results, consolidated EBITDA grew by 34.1% to $29.7 million. Overall EBITDAR margins
increased 147 basis points to 17.8% for the quarter.
Net income was $13.0 million for the quarter, as the companys consolidated net income margin
climbed 87 basis points to reach 7.0%, despite the expected downward pull of certain
recently-acquired facilities that are still in turnaround mode.
Fully diluted GAAP earnings per share were a record $0.60 for the quarter, compared to $0.46 per
share in the prior year. Adjusted non-GAAP earnings for the quarter were $0.61, compared to $0.47
per share in the prior year.
A discussion of the companys use of non-GAAP financial measures is set forth below. A
reconciliation of net income to EBITDAR and EBITDA, as well as a reconciliation of GAAP earnings
per share and net income to adjusted net earnings per share and adjusted net income, appear in the
financial data portion of this release.
More complete information is contained in the Companys 10-Q, which was filed with the SEC today
and can be viewed on the Companys website at
http://www.ensigngroup.net.
2011 Guidance Revised
Management increased 2011 annual revenue guidance, projecting revenues of $755 million to $770
million, based on the recent growth in Ensigns portfolio and the continuing shift in its patient
mix toward a higher-acuity patient base. Earnings guidance was left unchanged at $2.15 to $2.25 per
diluted share for the year.
Explaining the updated guidance, Ms. Snapper said, The updated guidance takes into account the
initial projected effects of the CMS final rule issued last Friday, as well as corresponding
offsets produced by recent acquisitions, the continuing acuity shift across our portfolio, interest
savings under our new credit facility, and other savings we expect to achieve. We plan to continue
working through the changes imposed by the final rule and our responses to them during the current
quarter.
2
The guidance is based on diluted weighted average common shares outstanding of 21.7 million and
assumes, among other things, no additional acquisitions or dispositions beyond those made to date,
an aggregate 1.0% projected decline in overall Medicaid reimbursement rates including expected
provider tax increases, and taking into account the impact of variations in actual facility (versus
aggregate state) rate changes in states like California which have facility-specific rates and
Texas which has a patient-specific rate, and that tax rates do not materially increase. It excludes
acquisition-related costs and amortization costs related to intangible assets acquired. It also
excludes the effects of a one-time non-recurring charge associated with the prepayment of an
existing mortgage, which was made after the end of the quarter.
Quarter Highlights
During the quarter, the companys Board of Directors declared a quarterly cash dividend of $0.055
per share of Ensign common stock, consistent with the preceding quarter. Ensign has been a
dividend-paying company since 2002.
On July 18, Management announced that Ensign and its operating subsidiaries had secured a
$150,000,000 senior credit facility from a five-bank lending consortium arranged by SunTrust
Robinson Humphrey, Inc. and Wells Fargo Securities, LLC. The five-year credit facility includes a
$75,000,000 revolving credit line that replaced Ensigns expiring $50,000,000 accounts receivable
line. It also included a $75,000,000 term loan component, approximately $40,000,000 of which was
deployed immediately to refinance an existing mortgage that had been secured by six of Ensigns
facilities, for a longer term and at an interest rate reduction of more than 300 basis points. The
other approximately $35,000,000 was used to fund fees associated with the financing and subsequent
acquisitions.
During and after the quarter Management also announced the acquisition of 13 long-term care
facilities, a home health business, and a home health and hospice business, in six separate
transactions since March 31. The acquisitions expanded Ensigns growing footprint into three new
states: Nevada, Iowa and Nebraska. The facilities and businesses were purchased with cash.
On May 15, an Ensign subsidiary acquired Symbii Home Health and Hospice, a well-regarded home
health and hospice agency based in Sandy, Utah, with branch offices in the cities of Layton and
Orem, Utah. Management characterized the acquisition as an affirmation of Ensigns satisfaction to
date with the growth and development of its home health and hospice businesses. Symbii is operated
by a subsidiary of Cornerstone Healthcare, Inc., Ensigns home health and hospice-based portfolio
subsidiary, joining Horizon Home Health and Hospice, Ensigns existing home health and hospice
operation in Idaho, and Custom Care Hospice, Ensigns hospice operation in Dallas, Texas.
On June 1, Ensign expanded into Nevada by acquiring Grand Court Las Vegas, a 152-unit assisted and
independent living facility in Las Vegas, Nevada. Management confirmed that Ensign expects the
facility, which had an occupancy rate of approximately 85% at acquisition, to be operationally
accretive to earnings in 2011.
On July 18, Ensign expanded into Iowa and Nebraska by acquiring nine long-term care properties and
a small home health business from Careage Management, LLC, a well-regarded long-term care provider
located in Sioux Falls, Iowa. The nine homes include 549 skilled nursing beds and 72 assisted
living units. They have a relatively high private-pay census, and rely less on state Medicaid
programs for revenues than most Ensign acquisitions have done historically. Management confirmed
that Ensign expects the portfolio, which had an occupancy rate of approximately 74% at acquisition,
to be operationally accretive to earnings in 2011.
3
On August 1, Ensign acquired Hurricane Health and Rehabilitation Center, a 48-bed skilled nursing
facility in Hurricane, Utah. Hurricane Health had an occupancy rate of approximately 75% at
acquisition, and is expected to be operationally accretive to earnings starting immediately.
Also on August 1, Ensign acquired Lakeland Hills Independent & Assisted Living Community, a
167-unit assisted and independent living facility in Dallas, Texas. Lakeland is operated by a
subsidiary of Bridgestone Living, Inc., Ensigns seniors housing subsidiary. Bridgestone and Ensign
have expanded Ensigns assisted and independent living base at an accelerated pace over the past
twelve months, with significant acquisitions in Denver, Colorado, Ventura, California, Las Vegas,
Nevada, Abilene, Texas, Salt Lake City, Utah, and now Dallas. Bridgestone expects operations in the
Lakeland property, which had an occupancy rate of approximately 89% at acquisition, to be
operationally accretive to earnings starting immediately.
Finally, on August 1 Ensign acquired Oceanview Healthcare and Rehabilitation Center, a 134-bed
skilled nursing facility in Texas, City Texas, which will be operated by a subsidiary of Ensigns
Texas-based Keystone Care, Inc. portfolio company. Oceanview had an occupancy rate of approximately
70% at acquisition, and is expected to be operationally accretive to earnings in 2011.
The acquisitions brought Ensigns growing portfolio to 99 facilities, 70 of which are Ensign-owned,
with Ensign affiliates holding purchase options on eight of Ensigns 29 leased facilities.
Management reaffirmed that Ensign is actively seeking additional opportunities to acquire both
well-performing and struggling long-term care operations across the United States.
Conference Call
A live webcast will be held on Thursday, August 4, 2011 at 10:30 a.m. Pacific Time (1:30 p.m.
Eastern Time) to discuss Ensigns second quarter 2011 financial results. To listen to the webcast,
or to view any financial or statistical information required by SEC Regulation G, please visit the
Investors section of the Ensign 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,
August 26, 2011.
About Ensign
The Ensign Group, Inc.s independent operating subsidiaries provide a broad spectrum of skilled
nursing and assisted living services, physical, occupational and speech therapies, home health and
hospice services, and other rehabilitative and healthcare services for both long-term residents and
short-stay rehabilitation patients at 99 facilities, three hospice companies and three home health
businesses in California, Arizona, Texas, Washington, Utah, Idaho, Colorado, Nevada, Iowa and
Nebraska. Each of these facilities is operated by a separate, wholly-owned independent operating
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 home health and hospice businesses, the
Service Center 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 managements 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,
4
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. 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 companys 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 facilities, its ability to manage its increasing borrowing costs as it
incurs additional indebtedness to fund the acquisition and development of facilities; 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 facilities; competition from other companies in the
acquisition, development and operation of facilities; 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
facilities if necessary. Readers should not place undue reliance on any forward-looking statements
and are encouraged to review the companys periodic filings with the Securities and Exchange
Commission, including its Form 10-Q, which was filed today, for a more complete discussion of the
risks and other factors that could affect Ensigns business, prospects and any forward-looking
statements. Except as required by 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 posting of this
press release.
Contact Information (Media Only)
Robert East, Westwicke Partners LLC, (443) 213-0500,
bob.east@westwickepartners.com, or Gregory
Stapley, Investor/Media Relations, The Ensign Group, Inc.,
(949) 487-9500, ir@ensigngroup.net.
SOURCE: The Ensign Group, Inc.
5
THE ENSIGN GROUP, INC.
GAAP AND ADJUSTED CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(In thousands, except per share data)
GAAP AND ADJUSTED CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(In thousands, except per share data)
Three Months Ended | Six Months Ended | |||||||||||||||||||||||
June 30, 2011 | June 30, 2011 | |||||||||||||||||||||||
As | Non- | As | As | Non- | As | |||||||||||||||||||
Reported | GAAP Adj. | Adjusted | Reported | GAAP Adj. | Adjusted | |||||||||||||||||||
Revenue |
$ | 186,326 | $ | 186,326 | $ | 369,269 | $ | 369,269 | ||||||||||||||||
Expense: |
||||||||||||||||||||||||
Cost of services (exclusive of
facility rent and depreciation and
amortization shown separately below) |
145,637 | (133 | )(1) | 145,504 | 288,792 | (204 | )(1) | 288,588 | ||||||||||||||||
Facility rentcost of services |
3,433 | 3,433 | 7,049 | 7,049 | ||||||||||||||||||||
General and administrative expense |
7,592 | 7,592 | 14,993 | 14,993 | ||||||||||||||||||||
Depreciation and amortization |
5,546 | (339 | )(2) | 5,207 | 10,605 | (559 | )(2) | 10,046 | ||||||||||||||||
Total expenses |
162,208 | (472 | ) | 161,736 | 321,439 | (763 | ) | 320,676 | ||||||||||||||||
Income from operations |
24,118 | 472 | 24,590 | 47,830 | 763 | 48,593 | ||||||||||||||||||
Other income (expense): |
||||||||||||||||||||||||
Interest expense |
(2,739 | ) | (2,739 | ) | (5,466 | ) | (5,466 | ) | ||||||||||||||||
Interest income |
75 | 75 | 130 | 130 | ||||||||||||||||||||
Other expense, net |
(2,664 | ) | (2,664 | ) | (5,336 | ) | (5,336 | ) | ||||||||||||||||
Income before provision for income taxes |
21,454 | 472 | 21,926 | 42,494 | 763 | 43,257 | ||||||||||||||||||
Provision for income taxes |
8,478 | 187 | (3) | 8,665 | 16,772 | 302 | (3) | 17,074 | ||||||||||||||||
Net income |
$ | 12,976 | 285 | $ | 13,261 | $ | 25,722 | 461 | $ | 26,183 | ||||||||||||||
Net income per share: |
||||||||||||||||||||||||
Basic |
$ | 0.62 | $ | 0.63 | $ | 1.23 | $ | 1.25 | ||||||||||||||||
Diluted |
$ | 0.60 | $ | 0.61 | $ | 1.19 | $ | 1.22 | ||||||||||||||||
Weighted average common shares
outstanding: |
||||||||||||||||||||||||
Basic |
20,909 | 20,909 | 20,881 | 20,881 | ||||||||||||||||||||
Diluted |
21,579 | 21,579 | 21,535 | 21,535 | ||||||||||||||||||||
(1) | Represents acquisition-related costs expenses. |
|
(2) | Represents amortization costs related to patient base intangible assets acquired. Patient
base intangible assets are amortized over a period of four to eight months, depending on the
classification of the patients and the level of occupancy in a new acquisition on the
acquisition date. |
|
(3) | Represents the tax impact of acquisition costs and patient base non-GAAP adjustments
represented in entries (1) and (2). |
6
THE ENSIGN GROUP, INC.
RECONCILIATION OF NET INCOME TO EBITDA AND EBITDAR
(in thousands)
RECONCILIATION OF NET INCOME TO EBITDA AND EBITDAR
(in thousands)
The table below reconciles net income to EBITDA and EBITDAR for the periods presented:
Three Months Ended | Six Months Ended | |||||||||||||||
June 30, | June 30, | |||||||||||||||
2011 | 2010 | 2011 | 2010 | |||||||||||||
Consolidated Statement of Income Data: |
||||||||||||||||
Net income |
$ | 12,976 | $ | 9,619 | $ | 25,722 | $ | 18,967 | ||||||||
Interest expense, net |
2,664 | 2,245 | 5,336 | 4,458 | ||||||||||||
Provision for income taxes |
8,478 | 6,230 | 16,772 | 12,356 | ||||||||||||
Depreciation and amortization |
5,546 | 4,023 | 10,605 | 7,978 | ||||||||||||
EBITDA |
$ | 29,664 | $ | 22,117 | $ | 58,435 | $ | 43,759 | ||||||||
Facility rentcost of services |
3,433 | 3,616 | 7,049 | 7,191 | ||||||||||||
EBITDAR |
$ | 33,097 | $ | 25,733 | $ | 65,484 | $ | 50,950 | ||||||||
7
THE ENSIGN GROUP, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS AND STATEMENTS OF CASH FLOWS
(In thousands)
CONDENSED CONSOLIDATED BALANCE SHEETS AND STATEMENTS OF CASH FLOWS
(In thousands)
June 30, | December 31, | |||||||
2011 | 2010 | |||||||
Assets |
||||||||
Current assets: |
||||||||
Cash and cash equivalents |
$ | 38,111 | $ | 72,088 | ||||
Accounts receivableless allowance for doubtful
accounts of $11,068 and $9,793 at June 30, 2011 and
December 31, 2010, respectively |
77,696 | 69,437 | ||||||
Prepaid income taxes |
1,427 | 1,333 | ||||||
Prepaid expenses and other current assets |
7,072 | 7,175 | ||||||
Deferred tax assetcurrent |
10,147 | 9,975 | ||||||
Total current assets |
134,453 | 160,008 | ||||||
Property and equipment, net |
321,745 | 262,527 | ||||||
Insurance subsidiary deposits and investments |
16,261 | 16,358 | ||||||
Escrow deposits |
1,450 | 14,422 | ||||||
Deferred tax asset |
6,669 | 4,987 | ||||||
Restricted and other assets |
10,504 | 6,509 | ||||||
Intangible assets, net |
4,202 | 4,070 | ||||||
Goodwill |
11,751 | 10,339 | ||||||
Other indefinite-lived intangibles |
1,241 | 672 | ||||||
Total assets |
$ | 508,276 | $ | 479,892 | ||||
Liabilities and stockholders equity
Current liabilities: |
||||||||
Accounts payable |
$ | 19,455 | $ | 17,897 | ||||
Accrued wages and related liabilities |
35,059 | 37,377 | ||||||
Accrued self-insurance liabilitiescurrent |
11,518 | 11,480 | ||||||
Other accrued liabilities |
13,142 | 13,557 | ||||||
Current maturities of long-term debt |
3,026 | 3,055 | ||||||
Total current liabilities |
82,200 | 83,366 | ||||||
Long-term debtless current maturities |
137,124 | 139,451 | ||||||
Accrued self-insurance liabilitiesless current portion |
31,438 | 25,920 | ||||||
Deferred rent and other long-term liabilities |
2,643 | 2,952 | ||||||
Stockholders equity |
254,871 | 228,203 | ||||||
Total liabilities and stockholders equity |
$ | 508,276 | $ | 479,892 | ||||
The following table presents selected data from our condensed consolidated statement of cash
flows for the periods presented:
Six Months Ended | ||||||||
June 30, | ||||||||
2011 | 2010 | |||||||
(In thousands) | ||||||||
Net cash provided by operating activities |
$ | 27,446 | $ | 14,903 | ||||
Net cash used in investing activities |
(58,245 | ) | (25,153 | ) | ||||
Net cash used in financing activities |
(3,178 | ) | (2,252 | ) | ||||
Net decrease in cash and cash equivalents |
(33,977 | ) | (12,502 | ) | ||||
Cash and cash equivalents at beginning of period |
72,088 | 38,855 | ||||||
Cash and cash equivalents at end of period |
$ | 38,111 | $ | 26,353 | ||||
8
THE ENSIGN GROUP, INC.
SELECT PERFORMANCE INDICATORS
(Dollars in thousands)
SELECT PERFORMANCE INDICATORS
(Dollars in thousands)
The following tables summarize our selected performance indicators, along with other
statistics, for each of the dates or periods indicated:
Three Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Total Facility Results: |
||||||||||||||||
Revenue |
$ | 186,326 | $ | 157,948 | $ | 28,378 | 18.0 | % | ||||||||
Number of facilities at period end |
87 | 81 | 6 | 7.4 | % | |||||||||||
Actual patient days |
746,995 | 667,858 | 79,137 | 11.8 | % | |||||||||||
Occupancy percentage Operational beds |
79.2 | % | 79.3 | % | (0.1) | % | ||||||||||
Skilled mix by nursing days |
26.3 | % | 24.8 | % | 1.5 | % | ||||||||||
Skilled mix by nursing revenue |
52.7 | % | 48.2 | % | 4.5 | % |
Three Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Same Facility Results(1): |
||||||||||||||||
Revenue |
$ | 139,926 | $ | 127,044 | $ | 12,882 | 10.1 | % | ||||||||
Number of facilities at period end |
60 | 60 | | | % | |||||||||||
Actual patient days |
519,334 | 517,898 | 1,436 | 0.3 | % | |||||||||||
Occupancy percentage Operational beds |
82.4 | % | 81.9 | % | 0.5 | % | ||||||||||
Skilled mix by nursing days |
29.5 | % | 27.9 | % | 1.6 | % | ||||||||||
Skilled mix by nursing revenue |
56.5 | % | 52.2 | % | 4.3 | % |
Three Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Transitioning Facility Results(2): |
||||||||||||||||
Revenue |
$ | 28,166 | $ | 24,852 | $ | 3,314 | 13.3 | % | ||||||||
Number of facilities at period end |
17 | 17 | | | % | |||||||||||
Actual patient days |
128,207 | 126,249 | 1,958 | 1.6 | % | |||||||||||
Occupancy percentage Operational beds |
71.7 | % | 70.6 | % | 1.1 | % | ||||||||||
Skilled mix by nursing days |
17.2 | % | 14.1 | % | 3.1 | % | ||||||||||
Skilled mix by nursing revenue |
39.4 | % | 31.0 | % | 8.4 | % |
Three Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Recently Acquired Facility Results(3): |
||||||||||||||||
Revenue |
$ | 18,234 | $ | 6,052 | $ | 12,182 | NM | |||||||||
Number of facilities at period end |
10 | 4 | 6 | NM | ||||||||||||
Actual patient days |
99,454 | 23,711 | 75,743 | NM | ||||||||||||
Occupancy percentage Operational beds |
74.5 | % | 75.8 | % | NM | |||||||||||
Skilled mix by nursing days |
17.0 | % | 13.8 | % | NM | |||||||||||
Skilled mix by nursing revenue |
38.6 | % | 28.8 | % | NM |
(1) | Same Facility results represent all facilities purchased prior to January 1, 2008. |
|
(2) | Transitioning Facility results represents all facilities purchased from January 1, 2008 to
December 31, 2009. |
|
(3) | Recently Acquired Facility (or Acquisitions) results represent all facilities purchased on
or subsequent to January 1, 2010. |
9
Six Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Total Facility Results: |
||||||||||||||||
Revenue |
$ | 369,269 | $ | 312,122 | $ | 57,147 | 18.3 | % | ||||||||
Number of facilities at period end |
87 | 81 | 6 | 7.4 | % | |||||||||||
Actual patient days |
1,478,480 | 1,316,942 | 161,538 | 12.3 | % | |||||||||||
Occupancy percentage Operational beds |
79.9 | % | 79.4 | % | 0.5 | % | ||||||||||
Skilled mix by nursing days |
26.3 | % | 25.4 | % | 0.9 | % | ||||||||||
Skilled mix by nursing revenue |
52.8 | % | 49.0 | % | 3.8 | % |
Six Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Same Facility Results(1): |
||||||||||||||||
Revenue |
$ | 280,145 | $ | 253,908 | $ | 26,237 | 10.3 | % | ||||||||
Number of facilities at period end |
60 | 60 | | | % | |||||||||||
Actual patient days |
1,041,109 | 1,032,196 | 8,913 | 0.9 | % | |||||||||||
Occupancy percentage Operational beds |
83.0 | % | 82.1 | % | 0.9 | % | ||||||||||
Skilled mix by nursing days |
29.5 | % | 28.4 | % | 1.1 | % | ||||||||||
Skilled mix by nursing revenue |
56.6 | % | 52.8 | % | 3.8 | % |
Six Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Transitioning Facility Results(2): |
||||||||||||||||
Revenue |
$ | 55,556 | $ | 49,356 | $ | 6,200 | 12.6 | % | ||||||||
Number of facilities at period end |
17 | 17 | | | % | |||||||||||
Actual patient days |
256,390 | 250,159 | 6,231 | 2.5 | % | |||||||||||
Occupancy percentage Operational beds |
72.1 | % | 70.4 | % | 1.7 | % | ||||||||||
Skilled mix by nursing days |
16.8 | % | 14.3 | % | 2.5 | % | ||||||||||
Skilled mix by nursing revenue |
38.7 | % | 31.5 | % | 7.2 | % |
Six Months Ended | ||||||||||||||||
June 30, | ||||||||||||||||
2011 | 2010 | |||||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||||
Recently Acquired Facility Results(3): |
||||||||||||||||
Revenue |
$ | 33,568 | $ | 8,858 | $ | 24,710 | NM | |||||||||
Number of facilities at period end |
10 | 4 | 6 | NM | ||||||||||||
Actual patient days |
180,981 | 34,587 | 146,394 | NM | ||||||||||||
Occupancy percentage Operational beds |
75.3 | % | 76.0 | % | NM | |||||||||||
Skilled mix by nursing days |
16.3 | % | 16.5 | % | NM | |||||||||||
Skilled mix by nursing revenue |
37.8 | % | 31.4 | % | NM |
(4) | Same Facility results represent all facilities purchased prior to January 1, 2008. |
|
(5) | Transitioning Facility results represents all facilities purchased from January 1, 2008 to
December 31, 2009. |
|
(6) | Recently Acquired Facility (or Acquisitions) results represent all facilities purchased on
or subsequent to January 1, 2010. |
10
THE ENSIGN GROUP, INC.
SKILLED NURSING AVERAGE DAILY REVENUE RATES AND
PERCENT OF SKILLED NURSING REVENUE AND DAYS
BY PAYOR
SKILLED NURSING AVERAGE DAILY REVENUE RATES AND
PERCENT OF SKILLED NURSING REVENUE AND DAYS
BY PAYOR
The following table reflects the change in the skilled nursing average daily revenue rates by
payor source, excluding services that are not covered by the daily rate:
Three Months Ended June 30, | ||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | % | ||||||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | 2011 | 2010 | 2011 | 2010 | Change | ||||||||||||||||||||||||||||
Skilled Nursing Average
Daily Revenue Rates: |
||||||||||||||||||||||||||||||||||||
Medicare |
$ | 641.77 | $ | 548.05 | $ | 539.48 | $ | 440.66 | $ | 514.91 | $ | 392.61 | $ | 618.67 | $ | 527.95 | 17.2 | % | ||||||||||||||||||
Managed care |
366.85 | 344.42 | 444.41 | 416.98 | 402.16 | 361.13 | 375.04 | 348.56 | 7.6 | % | ||||||||||||||||||||||||||
Other skilled |
539.38 | 539.19 | 414.68 | | 569.69 | 622.49 | 534.76 | 541.75 | (1.3) | % | ||||||||||||||||||||||||||
Total skilled revenue |
529.72 | 468.30 | 508.13 | 436.21 | 506.85 | 405.46 | 526.05 | 463.57 | 13.5 | % | ||||||||||||||||||||||||||
Medicaid |
167.57 | 162.87 | 160.38 | 155.86 | 163.80 | 158.65 | 165.84 | 161.22 | 2.9 | % | ||||||||||||||||||||||||||
Private and other payors |
187.55 | 183.50 | 170.51 | 175.81 | 169.41 | 166.79 | 181.33 | 180.74 | 0.3 | % | ||||||||||||||||||||||||||
Total skilled nursing revenue |
$ | 276.36 | $ | 250.40 | $ | 221.51 | $ | 198.23 | $ | 223.31 | $ | 194.30 | $ | 262.43 | $ | 238.54 | 10.0 | % |
Six Months Ended June 30, | ||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | % | ||||||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | 2011 | 2010 | 2011 | 2010 | Change | ||||||||||||||||||||||||||||
Skilled Nursing Average
Daily Revenue Rates: |
||||||||||||||||||||||||||||||||||||
Medicare |
$ | 640.81 | $ | 549.52 | $ | 529.47 | $ | 442.14 | $ | 511.12 | $ | 383.86 | $ | 617.00 | $ | 529.91 | 16.4 | % | ||||||||||||||||||
Managed care |
365.92 | 342.39 | 442.81 | 415.10 | 416.57 | 365.36 | 373.77 | 346.62 | 7.8 | % | ||||||||||||||||||||||||||
Other skilled |
535.91 | 542.84 | 431.88 | | 571.77 | 623.46 | 533.18 | 545.41 | (2.2) | % | ||||||||||||||||||||||||||
Total skilled revenue |
529.01 | 468.17 | 502.26 | 436.98 | 505.11 | 402.81 | 524.83 | 463.68 | 13.2 | % | ||||||||||||||||||||||||||
Medicaid |
167.07 | 162.73 | 158.28 | 156.73 | 161.10 | 173.45 | 164.85 | 161.75 | 1.9 | % | ||||||||||||||||||||||||||
Private and other payors |
187.27 | 182.66 | 172.80 | 172.01 | 164.62 | 175.56 | 181.14 | 179.91 | 0.7 | % | ||||||||||||||||||||||||||
Total skilled nursing revenue |
$ | 276.10 | $ | 251.58 | $ | 217.94 | $ | 199.15 | $ | 218.03 | $ | 211.67 | $ | 261.34 | $ | 240.63 | 8.6 | % |
11
The following tables set forth our percentage of skilled nursing patient revenue and days by
payor source for the three months ended June 30, 2011:
Three Months Ended June 30, | ||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | |||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | 2011 | 2010 | 2011 | 2010 | |||||||||||||||||||||||||
Percentage of Skilled Nursing Revenue: |
||||||||||||||||||||||||||||||||
Medicare |
38.4 | % | 33.5 | % | 28.3 | % | 25.4 | % | 34.5 | % | 20.5 | % | 36.7 | % | 31.8 | % | ||||||||||||||||
Managed care |
14.9 | 15.0 | 10.5 | 5.6 | 2.7 | 4.7 | 13.5 | 13.2 | ||||||||||||||||||||||||
Other skilled |
3.2 | 3.7 | 0.6 | | 1.4 | 3.6 | 2.5 | 3.2 | ||||||||||||||||||||||||
Skilled mix |
56.5 | 52.2 | 39.4 | 31.0 | 38.6 | 28.8 | 52.7 | 48.2 | ||||||||||||||||||||||||
Private and other payors |
7.0 | 8.1 | 10.7 | 12.8 | 17.0 | 16.5 | 8.2 | 9.1 | ||||||||||||||||||||||||
Quality mix |
63.5 | 60.3 | 50.1 | 43.8 | 55.6 | 45.3 | 60.9 | 57.3 | ||||||||||||||||||||||||
Medicaid |
36.5 | 39.7 | 49.9 | 56.2 | 44.4 | 54.7 | 39.1 | 42.7 | ||||||||||||||||||||||||
Total skilled nursing |
100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | ||||||||||||||||
Three Months Ended June 30, | ||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | |||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | 2011 | 2010 | 2011 | 2010 | |||||||||||||||||||||||||
Percentage of Skilled Nursing Days: |
||||||||||||||||||||||||||||||||
Medicare |
16.5 | % | 15.3 | % | 11.6 | % | 11.5 | % | 14.9 | % | 10.1 | % | 15.5 | % | 14.4 | % | ||||||||||||||||
Managed care |
11.3 | 10.9 | 5.2 | 2.6 | 1.5 | 2.6 | 9.4 | 9.0 | ||||||||||||||||||||||||
Other skilled |
1.7 | 1.7 | 0.4 | | 0.6 | 1.1 | 1.4 | 1.4 | ||||||||||||||||||||||||
Skilled mix |
29.5 | 27.9 | 17.2 | 14.1 | 17.0 | 13.8 | 26.3 | 24.8 | ||||||||||||||||||||||||
Private and other payors |
10.2 | 11.0 | 13.9 | 14.5 | 22.4 | 19.2 | 11.8 | 12.0 | ||||||||||||||||||||||||
Quality mix |
39.7 | 38.9 | 31.1 | 28.6 | 39.4 | 33.0 | 38.1 | 36.8 | ||||||||||||||||||||||||
Medicaid |
60.3 | 61.1 | 68.9 | 71.4 | 60.6 | 67.0 | 61.9 | 63.2 | ||||||||||||||||||||||||
Total skilled nursing |
100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | ||||||||||||||||
12
The following tables set forth our percentage of skilled nursing patient revenue and days by
payor source for the six months ended June 30, 2011:
Six Months Ended June 30, | ||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | |||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | 2011 | 2010 | 2011 | 2010 | |||||||||||||||||||||||||
Percentage of Skilled Nursing Revenue: |
||||||||||||||||||||||||||||||||
Medicare |
38.4 | % | 34.0 | % | 28.0 | % | 25.8 | % | 33.6 | % | 21.3 | % | 36.6 | % | 32.5 | % | ||||||||||||||||
Managed care |
15.0 | 15.1 | 10.1 | 5.7 | 2.7 | 5.5 | 13.5 | 13.4 | ||||||||||||||||||||||||
Other skilled |
3.2 | 3.7 | 0.6 | | 1.5 | 4.6 | 2.7 | 3.1 | ||||||||||||||||||||||||
Skilled mix |
56.6 | 52.8 | 38.7 | 31.5 | 37.8 | 31.4 | 52.8 | 49.0 | ||||||||||||||||||||||||
Private and other payors |
7.1 | 7.9 | 10.8 | 12.3 | 17.0 | 16.6 | 8.2 | 8.8 | ||||||||||||||||||||||||
Quality mix |
63.7 | 60.7 | 49.5 | 43.8 | 54.8 | 48.0 | 61.0 | 57.8 | ||||||||||||||||||||||||
Medicaid |
36.3 | 39.3 | 50.5 | 56.2 | 45.2 | 52.0 | 39.0 | 42.2 | ||||||||||||||||||||||||
Total skilled nursing |
100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | ||||||||||||||||
Six Months Ended June 30, | ||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | |||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | 2011 | 2010 | 2011 | 2010 | |||||||||||||||||||||||||
Percentage of Skilled Nursing Days: |
||||||||||||||||||||||||||||||||
Medicare |
16.5 | % | 15.6 | % | 11.5 | % | 11.6 | % | 14.3 | % | 11.7 | % | 15.5 | % | 14.7 | % | ||||||||||||||||
Managed care |
11.3 | 11.1 | 5.0 | 2.7 | 1.4 | 3.2 | 9.4 | 9.3 | ||||||||||||||||||||||||
Other skilled |
1.7 | 1.7 | 0.3 | | 0.6 | 1.6 | 1.4 | 1.4 | ||||||||||||||||||||||||
Skilled mix |
29.5 | 28.4 | 16.8 | 14.3 | 16.3 | 16.5 | 26.3 | 25.4 | ||||||||||||||||||||||||
Private and other payors |
10.5 | 10.9 | 13.6 | 14.3 | 22.5 | 20.0 | 11.9 | 11.8 | ||||||||||||||||||||||||
Quality mix |
40.0 | 39.3 | 30.4 | 28.6 | 38.8 | 36.5 | 38.2 | 37.2 | ||||||||||||||||||||||||
Medicaid |
60.0 | 60.7 | 69.6 | 71.4 | 61.2 | 63.5 | 61.8 | 62.8 | ||||||||||||||||||||||||
Total skilled nursing |
100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | ||||||||||||||||
13
THE ENSIGN GROUP, INC.
REVENUE BY PAYOR SOURCE
The following table sets forth our total revenue by payor source and as a percentage of total
revenue for the periods indicated:
Three Months Ended | Six Months Ended | |||||||||||||||||||||||||||||||
June 30, | June 30, | |||||||||||||||||||||||||||||||
2011 | 2010 | 2011 | 2010 | |||||||||||||||||||||||||||||
$ | % | $ | % | $ | % | $ | % | |||||||||||||||||||||||||
Revenue: |
||||||||||||||||||||||||||||||||
Medicaid |
$ | 67,080 | 36.0 | % | $ | 64,002 | 40.5 | % | $ | 133,306 | 36.1 | % | $ | 125,656 | 40.3 | % | ||||||||||||||||
Medicare |
68,964 | 37.0 | 50,589 | 32.1 | 136,605 | 37.0 | 101,711 | 32.6 | ||||||||||||||||||||||||
Medicaid-skilled |
4,296 | 2.3 | 4,624 | 2.9 | 8,706 | 2.4 | 9,041 | 2.9 | ||||||||||||||||||||||||
Total |
140,340 | 75.3 | 119,215 | 75.5 | 278,617 | 75.5 | 236,408 | 75.8 | ||||||||||||||||||||||||
Managed Care |
24,175 | 13.0 | 20,222 | 12.8 | 48,317 | 13.1 | 40,791 | 13.0 | ||||||||||||||||||||||||
Private and Other |
21,811 | 11.7 | 18,511 | 11.7 | 42,335 | 11.4 | 34,923 | 11.2 | ||||||||||||||||||||||||
Total revenue |
$ | 186,326 | 100.0 | % | $ | 157,948 | 100.0 | % | $ | 369,269 | 100.0 | % | $ | 312,122 | 100.0 | % | ||||||||||||||||
Discussion of Non-GAAP Financial Measures
EBITDA consists of net income before (a) interest expense, net, (b) provisions for income taxes,
and (c) depreciation and amortization. EBITDAR consists of net income before (a) interest expense,
net, (b) provisions for income taxes, (c) depreciation and amortization, and (d) facility rent-cost
of services. The Company believes that the presentation of EBITDA and EBITDAR provides important
supplemental information to management and investors to evaluate the Companys operating
performance. The Company believes disclosure of adjusted non-GAAP net income and non-GAAP diluted
earnings per share has economic substance because the excluded expenses are infrequent in nature
and are variable in nature, or do not represent current 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 Companys 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 measure provides useful
information to investors, the specific manner in which management uses this measure, and some of
the limitations associated with the use of this measure, please refer to the Companys Report on
Form 10-Q filed today with the SEC. The Form 10-Q is available on the SECs website at www.sec.gov
or under the Financial Information link of the Investor Relations section on Ensigns website at
http://www.ensigngroup.net.
14