(State or other jurisdiction of incorporation) | (Commission File Number) | (IRS Employer Identification No.) |
(Address of principal executive offices) | (Zip Code) |
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) | ||||||||
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) | ||||||||
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) | ||||||||
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) |
Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
Exhibit No. | Description | |||||||
Press Release of the Company dated February 1, 2024 | ||||||||
104 | Cover Page Interactive Data File - the cover page XBRL tags are embedded within the Inline XBRL document. |
Dated: February 1, 2024 | THE ENSIGN GROUP, INC. | |||||||||||||
By: | /s/ Suzanne D. Snapper | |||||||||||||
Suzanne D. Snapper | ||||||||||||||
Chief Financial Officer, Executive Vice President and Director (principal financial officer and accounting officer and duly authorized officer) | ||||||||||||||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
(In thousands, except per share data) | |||||||||||||||||||||||
REVENUE | |||||||||||||||||||||||
Service revenue | $ | 974,728 | $ | 805,325 | $ | 3,708,071 | $ | 3,008,711 | |||||||||||||||
Rental revenue | 5,650 | 4,207 | 21,284 | 16,757 | |||||||||||||||||||
TOTAL REVENUE | $ | 980,378 | $ | 809,532 | $ | 3,729,355 | $ | 3,025,468 | |||||||||||||||
Expense: | |||||||||||||||||||||||
Cost of services | 781,158 | 633,529 | 2,941,238 | 2,354,434 | |||||||||||||||||||
Rent—cost of services | 50,604 | 41,152 | 197,358 | 153,049 | |||||||||||||||||||
General and administrative expense | 106,557 | 42,775 | 263,005 | 158,805 | |||||||||||||||||||
Depreciation and amortization | 19,233 | 16,880 | 72,387 | 62,355 | |||||||||||||||||||
TOTAL EXPENSES | $ | 957,552 | $ | 734,336 | $ | 3,473,988 | $ | 2,728,643 | |||||||||||||||
Income from operations | 22,826 | 75,196 | 255,367 | 296,825 | |||||||||||||||||||
Other income (expense): | |||||||||||||||||||||||
Interest expense | (2,004) | (2,067) | (8,087) | (8,931) | |||||||||||||||||||
Other income | 10,460 | 4,322 | 25,482 | 1,195 | |||||||||||||||||||
Other income (expense), net | $ | 8,456 | $ | 2,255 | $ | 17,395 | $ | (7,736) | |||||||||||||||
Income before provision for income taxes | 31,282 | 77,451 | 272,762 | 289,089 | |||||||||||||||||||
Provision for income taxes | 9,459 | 16,932 | 62,912 | 64,437 | |||||||||||||||||||
NET INCOME | $ | 21,823 | $ | 60,519 | $ | 209,850 | $ | 224,652 | |||||||||||||||
Less: net income (loss) attributable to noncontrolling interests | 132 | 48 | 451 | (29) | |||||||||||||||||||
Net income attributable to The Ensign Group, Inc. | $ | 21,691 | $ | 60,471 | $ | 209,399 | $ | 224,681 | |||||||||||||||
NET INCOME PER SHARE ATTRIBUTABLE TO THE ENSIGN GROUP INC. | |||||||||||||||||||||||
Basic | $ | 0.39 | $ | 1.10 | $ | 3.76 | $ | 4.09 | |||||||||||||||
Diluted | $ | 0.38 | $ | 1.06 | $ | 3.65 | $ | 3.95 | |||||||||||||||
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING | |||||||||||||||||||||||
Basic | 56,083 | 55,087 | 55,708 | 54,887 | |||||||||||||||||||
Diluted | 57,555 | 56,973 | 57,323 | 56,871 |
December 31, | |||||||||||
2023 | 2022 | ||||||||||
ASSETS | |||||||||||
Current assets: | |||||||||||
Cash and cash equivalents | $ | 509,626 | $ | 316,270 | |||||||
Accounts receivable—less allowance for doubtful accounts of $9,348 and $7,802 at December 31, 2023 and 2022, respectively | 485,039 | 408,432 | |||||||||
Investments—current | 17,229 | 15,441 | |||||||||
Prepaid expenses and other current assets | 35,036 | 40,982 | |||||||||
Total current assets | 1,046,930 | 781,125 | |||||||||
Property and equipment, net | 1,090,771 | 992,010 | |||||||||
Right-of-use assets | 1,756,430 | 1,450,995 | |||||||||
Insurance subsidiary deposits and investments | 92,687 | 67,652 | |||||||||
Deferred tax assets | 67,124 | 39,643 | |||||||||
Restricted and other assets | 40,205 | 37,291 | |||||||||
Intangible assets, net | 6,525 | 6,437 | |||||||||
Goodwill | 76,869 | 76,869 | |||||||||
TOTAL ASSETS | $ | 4,177,541 | $ | 3,452,022 | |||||||
LIABILITIES AND EQUITY | |||||||||||
Current liabilities: | |||||||||||
Accounts payable | $ | 92,811 | $ | 77,087 | |||||||
Accrued wages and related liabilities | 332,568 | 289,810 | |||||||||
Lease liabilities—current | 82,526 | 65,796 | |||||||||
Accrued self-insurance liabilities—current | 54,664 | 48,187 | |||||||||
Other accrued liabilities | 168,228 | 97,309 | |||||||||
Current maturities of long-term debt | 3,950 | 3,883 | |||||||||
Total current liabilities | 734,747 | 582,072 | |||||||||
Long-term debt—less current maturities | 145,497 | 149,269 | |||||||||
Long-term lease liabilities—less current portion | 1,639,326 | 1,355,113 | |||||||||
Accrued self-insurance liabilities—less current portion | 111,246 | 83,495 | |||||||||
Other long-term liabilities | 49,408 | 33,273 | |||||||||
Total equity | 1,497,317 | 1,248,800 | |||||||||
TOTAL LIABILITIES AND EQUITY | $ | 4,177,541 | $ | 3,452,022 |
Year Ended December 31, | |||||||||||
2023 | 2022 | ||||||||||
NET CASH PROVIDED BY/(USED IN): | (In thousands) | ||||||||||
Operating activities | $ | 376,666 | $ | 272,513 | |||||||
Investing activities | (182,698) | (186,182) | |||||||||
Financing activities | (612) | (32,262) | |||||||||
Net increase in cash and cash equivalents | 193,356 | 54,069 | |||||||||
Cash and cash equivalents beginning of period | 316,270 | 262,201 | |||||||||
Cash and cash equivalents at end of period | $ | 509,626 | $ | 316,270 |
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Net income attributable to The Ensign Group, Inc. | $ | 21,691 | $ | 60,471 | $ | 209,399 | $ | 224,681 | |||||||||||||||
Non-GAAP adjustments | |||||||||||||||||||||||
Stock-based compensation expense(a) | 8,076 | 6,039 | 30,767 | 22,720 | |||||||||||||||||||
Litigation(b) | 58,816 | 68 | 60,781 | 4,280 | |||||||||||||||||||
Cost of services - gain on sale of assets and business interruption recoveries | (123) | (913) | (1,132) | (4,380) | |||||||||||||||||||
Cost of services - acquisition related costs(c) | 92 | 253 | 814 | 669 | |||||||||||||||||||
Interest expense - write-off of deferred financing fees(d) | — | — | — | 566 | |||||||||||||||||||
General and administrative - costs incurred related to new systems implementation | 88 | 682 | 963 | 1,072 | |||||||||||||||||||
Depreciation and amortization - patient base(e) | 173 | 107 | 355 | 320 | |||||||||||||||||||
Provision for income taxes on Non-GAAP adjustments(f) | (15,142) | (3,990) | (28,416) | (14,215) | |||||||||||||||||||
Non-GAAP Net Income | $ | 73,671 | $ | 62,717 | $ | 273,531 | $ | 235,713 | |||||||||||||||
Average number of diluted shares outstanding | 57,555 | 56,973 | 57,323 | 56,871 | |||||||||||||||||||
Diluted Earnings Per Share | |||||||||||||||||||||||
Net Income | $ | 0.38 | $ | 1.06 | $ | 3.65 | $ | 3.95 | |||||||||||||||
Adjusted Diluted Earnings Per Share | |||||||||||||||||||||||
Net Income | $ | 1.28 | $ | 1.10 | $ | 4.77 | $ | 4.14 | |||||||||||||||
Footnotes: | |||||||||||||||||||||||
(a) Represents stock-based compensation expense incurred. | |||||||||||||||||||||||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Cost of services | $ | 5,351 | $ | 3,959 | $ | 20,622 | $ | 14,897 | |||||||||||||||
General and administrative | 2,725 | 2,080 | 10,145 | 7,823 | |||||||||||||||||||
Total Non-GAAP adjustment | $ | 8,076 | $ | 6,039 | $ | 30,767 | $ | 22,720 | |||||||||||||||
(b) Litigation relates to specific proceedings arising outside of the ordinary course of business, which excludes the portion attributable to non-controlling interests. | |||||||||||||||||||||||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Cost of services | $ | 4,600 | $ | 68 | $ | 3,782 | $ | 4,280 | |||||||||||||||
General and administrative | 54,216 | — | 56,999 | — | |||||||||||||||||||
Total Non-GAAP adjustment | $ | 58,816 | $ | 68 | $ | 60,781 | $ | 4,280 | |||||||||||||||
(c) Represents costs incurred to acquire operations that are not capitalizable. | |||||||||||||||||||||||
(d) Represents the write-off of deferred financing fees associated with the amendment of the Credit Facility. | |||||||||||||||||||||||
(e) Included in depreciation and amortization are amortization expenses related to patient base intangible assets at newly acquired skilled nursing and senior living facilities. | |||||||||||||||||||||||
(f) Represents an adjustment to the provision for income tax to our historical year to date effective tax rate of 25.0%. | |||||||||||||||||||||||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Consolidated Statements of Income Data: | |||||||||||||||||||||||
Net income | $ | 21,823 | $ | 60,519 | $ | 209,850 | $ | 224,652 | |||||||||||||||
Less: net income (loss) attributable to noncontrolling interests | 132 | 48 | 451 | (29) | |||||||||||||||||||
Add: Other (income) expense, net | (8,456) | (2,255) | (17,395) | 7,736 | |||||||||||||||||||
Provision for income taxes | 9,459 | 16,932 | 62,912 | 64,437 | |||||||||||||||||||
Depreciation and amortization | 19,233 | 16,880 | 72,387 | 62,355 | |||||||||||||||||||
EBITDA | $ | 41,927 | $ | 92,028 | $ | 327,303 | $ | 359,209 | |||||||||||||||
Adjustments to EBITDA: | |||||||||||||||||||||||
Stock-based compensation expense | 8,076 | 6,039 | 30,767 | 22,720 | |||||||||||||||||||
Litigation(a) | 58,816 | 68 | 60,781 | 4,280 | |||||||||||||||||||
Gain on sale of assets and business interruption recoveries | (123) | (913) | (1,132) | (4,380) | |||||||||||||||||||
Acquisition related costs(b) | 92 | 253 | 814 | 669 | |||||||||||||||||||
Costs incurred related to new systems implementation | 88 | 682 | 963 | 1,072 | |||||||||||||||||||
ADJUSTED EBITDA | $ | 108,876 | $ | 98,157 | $ | 419,496 | $ | 383,570 | |||||||||||||||
Rent—cost of services | 50,604 | 41,152 | 197,358 | 153,049 | |||||||||||||||||||
ADJUSTED EBITDAR | $ | 159,480 | $ | 616,854 | |||||||||||||||||||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Consolidated Statements of Income Data: | (In thousands) | ||||||||||||||||||||||
Income before provision for income taxes | $ | 31,282 | $ | 77,451 | $ | 272,762 | $ | 289,089 | |||||||||||||||
Stock-based compensation expense | 8,076 | 6,039 | 30,767 | 22,720 | |||||||||||||||||||
Litigation(a) | 58,816 | 68 | 60,781 | 4,553 | |||||||||||||||||||
Gain on sale of assets and business interruption recoveries | (123) | (913) | (1,132) | (4,380) | |||||||||||||||||||
Write-off of deferred financing fees(b) | — | — | — | 566 | |||||||||||||||||||
Acquisition related costs(c) | 92 | 253 | 814 | 669 | |||||||||||||||||||
Costs incurred related to new systems implementation | 88 | 682 | 963 | 1,072 | |||||||||||||||||||
Depreciation and amortization - patient base(d) | 173 | 107 | 355 | 320 | |||||||||||||||||||
ADJUSTED EBT | $ | 98,404 | $ | 83,687 | $ | 365,310 | $ | 314,609 |
Three Months Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
TOTAL FACILITY RESULTS: | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 940,765 | $ | 777,648 | $ | 163,117 | 21.0 | % | |||||||||||||||
Number of facilities at period end | 259 | 234 | 25 | 10.7 | % | ||||||||||||||||||
Number of campuses at period end(1) | 27 | 26 | 1 | 3.8 | % | ||||||||||||||||||
Actual patient days | 2,227,888 | 1,956,091 | 271,797 | 13.9 | % | ||||||||||||||||||
Occupancy percentage — Operational beds | 79.2 | % | 76.2 | % | 3.0 | % | |||||||||||||||||
Skilled mix by nursing days | 29.5 | % | 30.9 | % | (1.4) | % | |||||||||||||||||
Skilled mix by nursing revenue | 49.0 | % | 51.1 | % | (2.1) | % |
Three Months Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
SAME FACILITY RESULTS:(2) | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 713,342 | $ | 660,420 | $ | 52,922 | 8.0 | % | |||||||||||||||
Number of facilities at period end | 189 | 189 | — | — | % | ||||||||||||||||||
Number of campuses at period end(1) | 24 | 24 | — | — | % | ||||||||||||||||||
Actual patient days | 1,668,368 | 1,619,163 | 49,205 | 3.0 | % | ||||||||||||||||||
Occupancy percentage — Operational beds | 79.9 | % | 77.5 | % | 2.4 | % | |||||||||||||||||
Skilled mix by nursing days | 30.9 | % | 32.7 | % | (1.8) | % | |||||||||||||||||
Skilled mix by nursing revenue | 50.3 | % | 53.0 | % | (2.7) | % |
Three Months Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
TRANSITIONING FACILITY RESULTS:(3) | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 64,924 | $ | 59,672 | $ | 5,252 | 8.8 | % | |||||||||||||||
Number of facilities at period end | 22 | 22 | — | — | % | ||||||||||||||||||
Number of campuses at period end(1) | 1 | 1 | — | — | % | ||||||||||||||||||
Actual patient days | 166,349 | 162,237 | 4,112 | 2.5 | % | ||||||||||||||||||
Occupancy percentage — Operational beds | 76.5 | % | 75.0 | % | 1.5 | % | |||||||||||||||||
Skilled mix by nursing days | 20.4 | % | 22.4 | % | (2.0) | % | |||||||||||||||||
Skilled mix by nursing revenue | 37.4 | % | 40.1 | % | (2.7) | % |
Three Months Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
RECENTLY ACQUIRED FACILITY RESULTS:(4) | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 162,499 | $ | 57,556 | $ | 104,943 | NM | ||||||||||||||||
Number of facilities at period end | 48 | 23 | 25 | NM | |||||||||||||||||||
Number of campuses at period end(1) | 2 | 1 | 1 | NM | |||||||||||||||||||
Actual patient days | 393,171 | 174,691 | 218,480 | NM | |||||||||||||||||||
Occupancy percentage — Operational beds | 77.6 | % | 66.9 | % | NM | ||||||||||||||||||
Skilled mix by nursing days | 27.5 | % | 21.3 | % | NM | ||||||||||||||||||
Skilled mix by nursing revenue | 48.3 | % | 40.3 | % | NM |
Year Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
TOTAL FACILITY RESULTS: | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 3,578,855 | $ | 2,906,215 | $ | 672,640 | 23.1 | % | |||||||||||||||
Number of facilities at period end | 259 | 234 | 25 | 10.7 | % | ||||||||||||||||||
Number of campuses at period end(1) | 27 | 26 | 1 | 3.8 | % | ||||||||||||||||||
Actual patient days | 8,590,995 | 7,243,781 | 1,347,214 | 18.6 | % | ||||||||||||||||||
Occupancy percentage — Operational beds | 78.5 | % | 75.3 | % | 3.2 | % | |||||||||||||||||
Skilled mix by nursing days | 30.4 | % | 31.8 | % | (1.4) | % | |||||||||||||||||
Skilled mix by nursing revenue | 50.2 | % | 52.0 | % | (1.8) | % |
Year Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
SAME FACILITY RESULTS:(2) | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 2,771,633 | $ | 2,569,807 | $ | 201,826 | 7.9 | % | |||||||||||||||
Number of facilities at period end | 189 | 189 | — | — | % | ||||||||||||||||||
Number of campuses at period end(1) | 24 | 24 | — | — | % | ||||||||||||||||||
Actual patient days | 6,563,672 | 6,299,331 | 264,341 | 4.2 | % | ||||||||||||||||||
Occupancy percentage — Operational beds | 79.2 | % | 76.0 | % | 3.2 | % | |||||||||||||||||
Skilled mix by nursing days | 31.9 | % | 33.0 | % | (1.1) | % | |||||||||||||||||
Skilled mix by nursing revenue | 51.4 | % | 53.3 | % | (1.9) | % |
Year Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
TRANSITIONING FACILITY RESULTS:(3) | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 251,872 | $ | 231,100 | $ | 20,772 | 9.0 | % | |||||||||||||||
Number of facilities at period end | 22 | 22 | — | — | % | ||||||||||||||||||
Number of campuses at period end(1) | 1 | 1 | — | — | % | ||||||||||||||||||
Actual patient days | 655,659 | 625,085 | 30,574 | 4.9 | % | ||||||||||||||||||
Occupancy percentage — Operational beds | 76.1 | % | 72.9 | % | 3.2 | % | |||||||||||||||||
Skilled mix by nursing days | 21.4 | % | 23.1 | % | (1.7) | % | |||||||||||||||||
Skilled mix by nursing revenue | 38.5 | % | 41.4 | % | (2.9) | % |
Year Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | Change | % Change | ||||||||||||||||||||
RECENTLY ACQUIRED FACILITY RESULTS:(4) | (Dollars in thousands) | ||||||||||||||||||||||
Skilled services revenue | $ | 555,350 | $ | 105,308 | $ | 450,042 | NM | ||||||||||||||||
Number of facilities at period end | 48 | 23 | 25 | NM | |||||||||||||||||||
Number of campuses at period end(1) | 2 | 1 | 1 | NM | |||||||||||||||||||
Actual patient days | 1,371,664 | 319,365 | 1,052,299 | NM | |||||||||||||||||||
Occupancy percentage — Operational beds | 76.8 | % | 67.9 | % | NM | ||||||||||||||||||
Skilled mix by nursing days | 27.5 | % | 24.3 | % | NM | ||||||||||||||||||
Skilled mix by nursing revenue | 49.3 | % | 42.8 | % | NM |
Three Months Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | 2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||||||||||||||||||||||
SKILLED NURSING AVERAGE DAILY REVENUE RATES | |||||||||||||||||||||||||||||||||||||||||||||||
Medicare | $ | 746.68 | $ | 707.77 | $ | 722.56 | $ | 674.10 | $ | 818.63 | $ | 638.98 | $ | 760.57 | $ | 700.23 | |||||||||||||||||||||||||||||||
Managed care | 556.84 | 513.04 | 565.95 | 528.38 | 572.76 | 468.44 | 559.23 | 511.90 | |||||||||||||||||||||||||||||||||||||||
Other skilled | 608.23 | 593.50 | 547.36 | 516.52 | 384.50 | 433.23 | 571.93 | 578.36 | |||||||||||||||||||||||||||||||||||||||
Total skilled revenue | 633.89 | 605.95 | 638.68 | 605.32 | 665.51 | 545.94 | 639.33 | 602.22 | |||||||||||||||||||||||||||||||||||||||
Medicaid | 283.87 | 263.11 | 277.73 | 263.75 | 270.16 | 221.30 | 280.85 | 258.91 | |||||||||||||||||||||||||||||||||||||||
Private and other payors | 265.72 | 253.50 | 251.38 | 246.51 | 271.20 | 207.31 | 265.52 | 248.24 | |||||||||||||||||||||||||||||||||||||||
Total skilled nursing revenue | $ | 390.10 | $ | 374.35 | $ | 347.93 | $ | 338.50 | $ | 378.93 | $ | 288.74 | $ | 384.97 | $ | 363.73 |
Year Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | 2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||||||||||||||||||||||
SKILLED NURSING AVERAGE DAILY REVENUE RATES | |||||||||||||||||||||||||||||||||||||||||||||||
Medicare | $ | 722.96 | $ | 694.63 | $ | 696.37 | $ | 668.05 | $ | 788.00 | $ | 652.15 | $ | 733.47 | $ | 691.25 | |||||||||||||||||||||||||||||||
Managed care | 537.29 | 510.18 | 536.93 | 501.73 | 555.55 | 455.19 | 539.25 | 508.53 | |||||||||||||||||||||||||||||||||||||||
Other skilled | 598.35 | 576.46 | 529.08 | 530.18 | 441.89 | 429.84 | 575.34 | 563.56 | |||||||||||||||||||||||||||||||||||||||
Total skilled revenue | 617.55 | 598.14 | 615.58 | 593.66 | 660.87 | 521.24 | 623.70 | 595.26 | |||||||||||||||||||||||||||||||||||||||
Medicaid | 275.82 | 259.89 | 270.67 | 254.08 | 256.51 | 227.21 | 272.14 | 257.67 | |||||||||||||||||||||||||||||||||||||||
Private and other payors | 263.81 | 250.80 | 253.15 | 248.63 | 263.71 | 199.34 | 262.93 | 248.54 | |||||||||||||||||||||||||||||||||||||||
Total skilled nursing revenue | $ | 383.56 | $ | 370.57 | $ | 342.57 | $ | 332.09 | $ | 368.46 | $ | 296.15 | $ | 378.02 | $ | 363.97 |
Three Months Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | 2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||||||||||||||||||||||
PERCENTAGE OF SKILLED NURSING REVENUE | |||||||||||||||||||||||||||||||||||||||||||||||
Medicare | 21.0 | % | 25.4 | % | 20.4 | % | 23.9 | % | 30.0 | % | 23.4 | % | 22.5 | % | 25.1 | % | |||||||||||||||||||||||||||||||
Managed care | 20.2 | 19.2 | 12.3 | 13.2 | 13.7 | 10.3 | 18.6 | 18.1 | |||||||||||||||||||||||||||||||||||||||
Other skilled | 9.1 | 8.4 | 4.7 | 3.0 | 4.6 | 6.6 | 7.9 | 7.9 | |||||||||||||||||||||||||||||||||||||||
Skilled mix | 50.3 | 53.0 | 37.4 | 40.1 | 48.3 | 40.3 | 49.0 | 51.1 | |||||||||||||||||||||||||||||||||||||||
Private and other payors | 7.6 | 7.0 | 8.9 | 7.9 | 8.2 | 8.6 | 7.9 | 7.2 | |||||||||||||||||||||||||||||||||||||||
Medicaid | 42.1 | 40.0 | 53.7 | 52.0 | 43.5 | 51.1 | 43.1 | 41.7 | |||||||||||||||||||||||||||||||||||||||
TOTAL SKILLED NURSING | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Three Months Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | 2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||||||||||||||||||||||
PERCENTAGE OF SKILLED NURSING DAYS | |||||||||||||||||||||||||||||||||||||||||||||||
Medicare | 11.0 | % | 13.4 | % | 9.8 | % | 12.0 | % | 13.9 | % | 10.6 | % | 11.4 | % | 13.1 | % | |||||||||||||||||||||||||||||||
Managed care | 14.2 | 14.0 | 7.6 | 8.5 | 9.0 | 6.4 | 12.8 | 12.9 | |||||||||||||||||||||||||||||||||||||||
Other skilled | 5.7 | 5.3 | 3.0 | 1.9 | 4.6 | 4.3 | 5.3 | 4.9 | |||||||||||||||||||||||||||||||||||||||
Skilled mix | 30.9 | 32.7 | 20.4 | 22.4 | 27.5 | 21.3 | 29.5 | 30.9 | |||||||||||||||||||||||||||||||||||||||
Private and other payors | 11.3 | 10.5 | 12.4 | 10.8 | 11.4 | 12.0 | 11.4 | 10.5 | |||||||||||||||||||||||||||||||||||||||
Medicaid | 57.8 | 56.8 | 67.2 | 66.8 | 61.1 | 66.7 | 59.1 | 58.6 | |||||||||||||||||||||||||||||||||||||||
TOTAL SKILLED NURSING | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Year Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | 2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||||||||||||||||||||||
PERCENTAGE OF SKILLED NURSING REVENUE | |||||||||||||||||||||||||||||||||||||||||||||||
Medicare | 22.5 | % | 26.0 | % | 21.8 | % | 24.9 | % | 31.0 | % | 20.4 | % | 23.8 | % | 25.7 | % | |||||||||||||||||||||||||||||||
Managed care | 20.1 | 19.2 | 12.6 | 12.6 | 13.3 | 9.9 | 18.5 | 18.3 | |||||||||||||||||||||||||||||||||||||||
Other skilled | 8.8 | 8.1 | 4.1 | 3.9 | 5.0 | 12.5 | 7.9 | 8.0 | |||||||||||||||||||||||||||||||||||||||
Skilled mix | 51.4 | 53.3 | 38.5 | 41.4 | 49.3 | 42.8 | 50.2 | 52.0 | |||||||||||||||||||||||||||||||||||||||
Private and other payors | 7.5 | 7.0 | 8.6 | 8.1 | 8.0 | 6.4 | 7.6 | 7.0 | |||||||||||||||||||||||||||||||||||||||
Medicaid | 41.1 | 39.7 | 52.9 | 50.5 | 42.7 | 50.8 | 42.2 | 41.0 | |||||||||||||||||||||||||||||||||||||||
TOTAL SKILLED NURSING | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Year Ended December 31, | |||||||||||||||||||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | 2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||||||||||||||||||||||
PERCENTAGE OF SKILLED NURSING DAYS | |||||||||||||||||||||||||||||||||||||||||||||||
Medicare | 11.9 | % | 13.9 | % | 10.7 | % | 12.4 | % | 14.5 | % | 9.3 | % | 12.3 | % | 13.5 | % | |||||||||||||||||||||||||||||||
Managed care | 14.4 | 14.0 | 8.0 | 8.3 | 8.8 | 6.4 | 13.0 | 13.1 | |||||||||||||||||||||||||||||||||||||||
Other skilled | 5.6 | 5.1 | 2.7 | 2.4 | 4.2 | 8.6 | 5.1 | 5.2 | |||||||||||||||||||||||||||||||||||||||
Skilled mix | 31.9 | 33.0 | 21.4 | 23.1 | 27.5 | 24.3 | 30.4 | 31.8 | |||||||||||||||||||||||||||||||||||||||
Private and other payors | 11.0 | 10.4 | 11.7 | 10.8 | 11.1 | 9.5 | 11.0 | 10.3 | |||||||||||||||||||||||||||||||||||||||
Medicaid | 57.1 | 56.6 | 66.9 | 66.1 | 61.4 | 66.2 | 58.6 | 57.9 | |||||||||||||||||||||||||||||||||||||||
TOTAL SKILLED NURSING | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Three Months Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | ||||||||||||||||||||||
Revenue | % of Revenue | Revenue | % of Revenue | ||||||||||||||||||||
Medicaid(1) | $ | 384,566 | 39.5 | % | $ | 320,065 | 39.7 | % | |||||||||||||||
Medicare | 252,414 | 25.9 | 222,151 | 27.6 | |||||||||||||||||||
Medicaid — skilled | 63,269 | 6.4 | 54,523 | 6.8 | |||||||||||||||||||
Total Medicaid and Medicare | 700,249 | 71.8 | 596,739 | 74.1 | |||||||||||||||||||
Managed care | 177,618 | 18.2 | 136,674 | 17.0 | |||||||||||||||||||
Private and other(2) | 96,861 | 10.0 | 71,912 | 8.9 | |||||||||||||||||||
SERVICE REVENUE | $ | 974,728 | 100.0 | % | $ | 805,325 | 100.0 | % |
Year Ended December 31, | |||||||||||||||||||||||
2023 | 2022 | ||||||||||||||||||||||
Revenue | % of Revenue | Revenue | % of Revenue | ||||||||||||||||||||
Medicaid(1) | $ | 1,459,449 | 39.4 | % | $ | 1,183,156 | 39.3 | % | |||||||||||||||
Medicare | 985,749 | 26.6 | 832,160 | 27.7 | |||||||||||||||||||
Medicaid — skilled | 245,663 | 6.6 | 200,878 | 6.7 | |||||||||||||||||||
Total Medicaid and Medicare | 2,690,861 | 72.6 | 2,216,194 | 73.7 | |||||||||||||||||||
Managed care | 666,129 | 18.0 | 525,710 | 17.5 | |||||||||||||||||||
Private and other(2) | 351,081 | 9.4 | 266,807 | 8.8 | |||||||||||||||||||
SERVICE REVENUE | $ | 3,708,071 | 100.0 | % | $ | 3,008,711 | 100.0 | % |
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Statements of Income Data: | |||||||||||||||||||||||
Segment income(a) | $ | 116,756 | $ | 106,460 | $ | 464,925 | $ | 408,732 | |||||||||||||||
Depreciation and amortization | 10,349 | 8,813 | 38,766 | 33,224 | |||||||||||||||||||
EBITDA | $ | 127,105 | $ | 115,273 | $ | 503,691 | $ | 441,956 | |||||||||||||||
Adjustments to EBITDA: | |||||||||||||||||||||||
Business interruption recoveries | — | (913) | (1,009) | (913) | |||||||||||||||||||
Stock-based compensation expense | 5,164 | 3,823 | 19,904 | 14,394 | |||||||||||||||||||
Litigation(b) | 4,600 | — | 4,600 | — | |||||||||||||||||||
ADJUSTED EBITDA | $ | 136,869 | $ | 118,183 | $ | 527,186 | $ | 455,437 | |||||||||||||||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||||||||||
Rental revenue generated from third-party tenants | $ | 4,198 | $ | 3,790 | $ | 15,774 | $ | 14,970 | |||||||||||||||
Rental revenue generated from Ensign independent subsidiaries | 17,677 | 15,624 | 66,712 | 57,967 | |||||||||||||||||||
TOTAL RENTAL REVENUE | $ | 21,875 | $ | 19,414 | $ | 82,486 | $ | 72,937 | |||||||||||||||
Segment income(a) | 7,548 | 7,192 | 29,065 | 27,871 | |||||||||||||||||||
Depreciation and amortization | 6,677 | 5,815 | 25,205 | 21,613 | |||||||||||||||||||
FFO(b) | $ | 14,225 | $ | 13,007 | $ | 54,270 | $ | 49,484 | |||||||||||||||
P:XBU/5
M ,?+=WFT'Z^6$KTWPK\-?"W@G!T+0;'3I.GG10CS?QD.6/YUT]% !1110 44
M44 %>
Cover Document |
Feb. 01, 2024 |
---|---|
Cover [Abstract] | |
Document Type | 8-K |
Document Period End Date | Feb. 01, 2024 |
Entity Registrant Name | Ensign Group, Inc |
Entity Incorporation, State or Country Code | DE |
Entity File Number | 001-33757 |
Entity Tax Identification Number | 33-0861263 |
Entity Address, Address Line One | 29222 Rancho Viejo Road, Suite 127, |
Entity Address, City or Town | San Juan Capistrano, |
Entity Address, State or Province | CA |
Entity Address, Postal Zip Code | 92675 |
City Area Code | 949 |
Local Phone Number | 487-9500 |
Written Communications | false |
Soliciting Material | false |
Pre-commencement Tender Offer | false |
Pre-commencement Issuer Tender Offer | false |
Title of 12(b) Security | Common Stock, par value $0.001 per share |
Trading Symbol | ENSG |
Security Exchange Name | NASDAQ |
Entity Emerging Growth Company | false |
Entity Central Index Key | 0001125376 |
Amendment Flag | false |
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