SAN JUAN CAPISTRANO, Calif., March 04, 2024 (GLOBE NEWSWIRE) -- The Ensign Group, Inc. (NASDAQ:ENSG), the parent company of the Ensign™ group of companies, which invest in and provide skilled nursing and senior living services, physical, occupational and speech therapies, other rehabilitative and healthcare services, and real estate, announced today that it acquired the operations of Park Post Acute, a 135-bed skilled nursing facility located in Parker, Colorado and Oakwood Care and Rehabilitation, a 170-be ...

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Shares of The Ensign Group, Inc. (ENSG) rose 4.7% since it reported fourth-quarter 2023 results on Feb 1, 2024. The quarterly results benefited on the back of higher skilled service revenues, an increase in skilled mix and improved occupancies. An impressive adjusted earnings per share (EPS) guidance for 2024 may have boosted investors’ sentiment about the stock. However, the upside was partly offset by a significant rise in overall expenses.ENSG reported a fourth-quarter 2023 adjusted EPS of $1.28, which b ...

Financial Data and Key Metrics Changes - Consolidated GAAP revenues and adjusted revenues for the year were both $3.73 billion, an increase of 23% [35] - GAAP diluted earnings per share was $3.65, and GAAP net income was $209.4 million [35] - Adjusted diluted earnings per share was $4.77, an increase of 15.2%, and adjusted net income was $273.5 million, an increase of 16% [61] - Cash and cash equivalents stood at $509.6 million, with cash flow from operations at $376.7 million [36] - The company achieved a lease adjusted net debt-to-EBITDA ratio of 1.98x [36] - The quarterly cash dividend was increased to $0.06 per share, marking the twenty-first consecutive annual dividend increase [37] Business Line Data and Key Metrics Changes - Same-store occupancy was 79.9%, growing by 240 basis points year-over-year and 40 basis points sequentially [7] - Managed care revenue and managed care census increased by 12.3% and 3.5%, respectively, over the prior year quarter [7] - Skilled mix days improved by 17%, driven by a 40% increase in managed care days [59] - The senior living section maintained 100% occupancy for all of 2023, with revenues growing by 13.4% over the prior year quarter [18] Market Data and Key Metrics Changes - The company is now operating in 14 states, with significant potential for growth in the remaining 36 states [31] - The pipeline for new deals remains strong, with over $1 billion available for future investments [15] Company Strategy and Development Direction - The company focuses on a locally driven healthcare model, emphasizing the importance of leadership quality in operations [13] - Plans to continue improving expense management and driving occupancy in recently acquired operations [10] - The company is committed to a disciplined acquisition strategy, only pursuing growth when the right leaders and pricing are in place [16] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the future, citing strong clinical results and cultural values as key drivers [9] - The company anticipates continued organic growth potential within its existing portfolio and is optimistic about the upcoming year [10] - Management noted that many operators in the industry are struggling, presenting opportunities for acquisitions [32] Other Important Information - The company settled a litigation matter, allowing it to focus on its mission of providing high-quality healthcare services [38] - The company has over $593 million of available capacity on its line of credit, contributing to its liquidity for future growth [62] - CMS is reviewing comments for a federal minimum staffing rule, but the company does not expect it to impact operations in 2024 [63] Q&A Session Summary Question: Can you break down the top-line guidance and its drivers? - Management projected mid-single digits growth in same-store revenue, high-single digits in transitioning, and low-double digits in recently acquired operations [42] Question: What is the status of the California Medicaid rebasing process? - The state is undergoing a re-base program starting January 1, 2024, which is currently awaiting CMS approval [84] Question: How will the recent legal settlement impact future operations? - The recent settlement was unrelated to a new DOJ inquiry, which is a general audit and not expected to significantly impact operations [73]

Ensign Group (ENSG) came out with quarterly earnings of $1.28 per share, beating the Zacks Consensus Estimate of $1.27 per share. This compares to earnings of $1.10 per share a year ago. These figures are adjusted for non-recurring items.This quarterly report represents an earnings surprise of 0.79%. A quarter ago, it was expected that this provider of nursing and rehabilitative care services would post earnings of $1.18 per share when it actually produced earnings of $1.20, delivering a surprise of 1.69%.O ...

SAN JUAN CAPISTRANO, Calif., Feb. 01, 2024 (GLOBE NEWSWIRE) -- The Ensign Group, Inc. (NASDAQ:ENSG), the parent company of the Ensign(TM) group of companies, which provide post-acute healthcare services and invest in the long-term healthcare industry, primarily in skilled nursing and senior living facilities, announced operating results for the fiscal and fourth quarter of 2023, reporting GAAP diluted earnings per share of $3.65 and adjusted earnings per share(1) of $4.77 for the year. Ensign also reported ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 _____________________________ FORM 10-K ☒ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934. For the fiscal year ended December 31, 2023. OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934. For the transition period from to . Commission file number: 001-33757 _____________________________ THE ENSIGN GROUP, INC. (Exact Name of Registrant as Specified in Its Cha ...

SAN JUAN CAPISTRANO, Calif., Jan. 30, 2024 (GLOBE NEWSWIRE) -- The Ensign Group, Inc. (NASDAQ:ENSG), the parent company of the Ensign™ group of companies, which invest in and provide skilled nursing and senior living services, physical, occupational and speech therapies, other rehabilitative and healthcare services, and real estate, announced today that it expects to issue its fourth quarter and fiscal year 2023 financial results on Thursday, February 1, 2024. Conference Call Ensign invites current and pros ...

SAN JUAN CAPISTRANO, Calif., Jan. 30, 2024 (GLOBE NEWSWIRE) -- The Ensign Group, Inc. (Nasdaq: ENSG), the parent company of the Ensign™ group of companies, which invest in and provide skilled nursing and senior living services, physical, occupational and speech therapies, other rehabilitative and healthcare services, and real estate, announced today that it expects to issue its fourth quarter and fiscal year 2023 financial results on Thursday, February 1, 2024. Conference Call Ensign invites current and pro ...

PART I. Financial Information [Item 1. Financial Statements (unaudited)](index=3&type=section&id=Item%201.%20Financial%20Statements%20(unaudited)) This section presents the unaudited condensed consolidated financial statements, including balance sheets, income, equity, and cash flow statements, with detailed notes [Condensed Consolidated Balance Sheets](index=3&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) Total assets increased to $4.08 billion, liabilities to $2.62 billion, and equity to $1.47 billion by September 30, 2023 Condensed Consolidated Balance Sheet Highlights (in thousands) | Account | Sep 30, 2023 | Dec 31, 2022 | | :--- | :--- | :--- | | **Total Current Assets** | $994,347 | $781,125 | | Cash and cash equivalents | $467,870 | $316,270 | | **Total Assets** | **$4,081,981** | **$3,452,022** | | **Total Current Liabilities** | $671,797 | $582,072 | | Long-term lease liabilities | $1,657,955 | $1,355,113 | | **Total Liabilities** | **$2,616,539** | **$2,203,222** | | **Total Equity** | **$1,465,442** | **$1,248,800** | [Condensed Consolidated Statements of Income](index=4&type=section&id=Condensed%20Consolidated%20Statements%20of%20Income) Q3 2023 total revenue grew 22.2% to $940.8 million, with diluted EPS at $1.11, and nine-month revenue reached $2.75 billion Financial Performance Highlights (in thousands, except per share data) | Metric | Q3 2023 | Q3 2022 | Nine Months 2023 | Nine Months 2022 | | :--- | :--- | :--- | :--- | :--- | | **Total Revenue** | $940,791 | $770,005 | $2,748,977 | $2,215,936 | | Income from operations | $79,792 | $74,287 | $232,541 | $221,629 | | **Net Income Attributable to Ensign** | $63,863 | $56,179 | $187,708 | $164,210 | | **Diluted EPS** | $1.11 | $0.99 | $3.28 | $2.89 | [Condensed Consolidated Statements of Stockholders' Equity](index=5&type=section&id=Condensed%20Consolidated%20Statements%20of%20Stockholders'%20Equity) Total equity increased to $1.47 billion by Q3 2023, driven by net income and employee stock awards, offset by dividends - Key drivers of the change in stockholders' equity during the first nine months of 2023 include net income of **$187.7 million**, employee stock award compensation of **$22.7 million**, and dividends declared of **$9.7 million**[11](index=11&type=chunk) [Condensed Consolidated Statements of Cash Flows](index=7&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) Net cash from operations increased to $291.4 million, with cash and equivalents rising by $151.6 million to $467.9 million by Q3 2023 Cash Flow Summary (Nine Months Ended Sep 30, in thousands) | Activity | 2023 | 2022 | | :--- | :--- | :--- | | Net Cash Provided by Operating Activities | $291,397 | $222,337 | | Net Cash Used in Investing Activities | ($137,754) | ($143,771) | | Net Cash Used in Financing Activities | ($2,043) | ($31,903) | | **Net Increase in Cash** | **$151,600** | **$46,663** | | **Cash and Cash Equivalents, End of Period** | **$467,870** | **$308,864** | [Notes to Condensed Consolidated Financial Statements](index=10&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements) This section provides detailed disclosures on business operations, accounting policies, revenue, segments, debt, leases, and legal contingencies - As of September 30, 2023, the company's subsidiaries operated **295 facilities** with approximately **30,500 skilled nursing beds** and **3,000 senior living units**. The real estate portfolio includes **112 owned properties**[21](index=21&type=chunk) - Revenue from Medicare and Medicaid programs accounted for **72.8% of total service revenue** for the nine months ended September 30, 2023[62](index=62&type=chunk)[65](index=65&type=chunk) - During the nine months ended September 30, 2023, the company expanded its operations by adding **24 stand-alone skilled nursing operations**, adding **2,340 operational beds**[88](index=88&type=chunk) - The company is vigorously defending a lawsuit from a qui tam relator alleging violations of the False Claims Act (FCA) and/or the Anti-Kickback Statute (AKS), after the Department of Justice declined to intervene[177](index=177&type=chunk) [Management's Discussion and Analysis of Financial Condition and Results of Operations](index=49&type=section&id=Item%202.%20Management's%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management discusses the company's financial condition, operating results, liquidity, and capital resources, covering business overview, industry trends, and regulatory environment [Overview and Recent Activities](index=50&type=section&id=Overview%20and%20Recent%20Activities) Ensign operates 295 facilities with occupancy nearing pre-pandemic levels, recognized $10.3 million in state relief, and approved a new $20 million stock repurchase program - Combined Same Facilities and Transitioning Facilities occupancy reached **79.2%**, a **2.9% increase** from the prior year quarter and nearing the pre-pandemic level of **80.1%** in March 2020[203](index=203&type=chunk) State Relief Funding Recognized as Revenue (in millions) | Period | 2023 | 2022 | | :--- | :--- | :--- | | Three Months Ended Sep 30 | $10.3 | $21.4 | | Nine Months Ended Sep 30 | $55.1 | $63.5 | - A new stock repurchase program for up to **$20.0 million** was approved by the Board of Directors on August 29, 2023[206](index=206&type=chunk) [Key Performance Indicators and Revenue Sources](index=52&type=section&id=Key%20Performance%20Indicators%20and%20Revenue%20Sources) Key metrics include skilled mix (29.1% days, 48.4% revenue) and 78.9% occupancy, with Skilled Services and Standard Bearer as segments, and Medicare/Medicaid as primary revenue sources Skilled Mix and Occupancy (Skilled Nursing Services) | Metric | Q3 2023 | Q3 2022 | Nine Months 2023 | Nine Months 2022 | | :--- | :--- | :--- | :--- | :--- | | Skilled Mix (Days) | 29.1% | 31.6% | 30.7% | 32.1% | | Skilled Mix (Revenue) | 48.4% | 51.6% | 50.6% | 52.3% | | Occupancy Percentage | 78.9% | 75.7% | 78.3% | 75.0% | - The company's two reportable segments are Skilled Services (operation of skilled nursing facilities) and Standard Bearer (real estate properties). Other operations like senior living are reported under "All Other"[219](index=219&type=chunk)[220](index=220&type=chunk) [Government Regulation and Industry Trends](index=58&type=section&id=Government%20Regulation%20and%20Industry%20Trends) The industry faces extensive regulatory changes, including proposed minimum staffing mandates, a 4.0% net increase in SNF PPS rates, and the phasing out of COVID-19 PHE waivers - On September 1, 2023, CMS issued a proposed rule to establish minimum staffing standards for long-term care facilities, including **0.55 HPRD for RNs** and **2.45 HPRD for nurse aides**, and a **24/7 on-site RN requirement**[252](index=252&type=chunk)[525](index=525&type=chunk) - The SNF PPS Final Rule for FY 2024 provides a net increase of **4.0%** in Medicare payments, which includes a **6.4% market basket update** offset by a **2.3% parity adjustment recalibration**[246](index=246&type=chunk)[276](index=276&type=chunk) - The end of the Public Health Emergency (PHE) on May 11, 2023, triggered a gradual phase-down of the temporary increase in Federal Medical Assistance Percentage (FMAP) funding, which will be completely phased out by the end of 2023[204](index=204&type=chunk)[261](index=261&type=chunk) [Results of Operations](index=78&type=section&id=Results%20of%20Operations) Q3 2023 total revenue grew 22.2% year-over-year, driven by acquisitions and occupancy gains, while cost of services increased due to acquisition and staffing expenses Q3 2023 vs Q3 2022 Revenue Growth | Segment | Revenue Change ($M) | % Change | | :--- | :--- | :--- | | Skilled Services | +$163.6 | +22.1% | | Standard Bearer | +$2.2 | +12.0% | | All Other | +$7.3 | +22.9% | | **Total Revenue** | **+$170.8** | **+22.2%** | - Revenue from operations acquired since October 1, 2022, increased consolidated service revenue by **$117.3 million** in Q3 2023 compared to Q3 2022[362](index=362&type=chunk) - For the nine months ended Sep 30, 2023, skilled services cost of services increased to **78.9% of revenue** from **77.9%** in the prior year, driven by new acquisitions, higher liability reserves, and wage expenses[404](index=404&type=chunk) [Liquidity and Capital Resources](index=93&type=section&id=Liquidity%20and%20Capital%20Resources) The company maintains strong liquidity with $467.9 million in cash and a $600 million undrawn credit facility, supported by $291.4 million in operating cash flow - As of September 30, 2023, the company had cash and cash equivalents of **$467.9 million** and no outstanding debt under its **$600 million** revolving credit facility[421](index=421&type=chunk)[428](index=428&type=chunk) - Cash provided by operating activities increased by **$69.1 million** to **$291.4 million** for the nine months ended September 30, 2023, compared to the prior year, primarily due to higher net income and deferral of income tax payments[423](index=423&type=chunk) - The company deferred approximately **$50.0 million** of 2023 federal and California estimated tax payments, which were paid in October 2023[414](index=414&type=chunk) [Quantitative and Qualitative Disclosures About Market Risk](index=97&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) The company's primary market risk is interest rate exposure from its variable-rate credit facility, though fixed-rate debt and low-risk investments mitigate this - The company is exposed to interest rate risk through its **$600.0 million** revolving credit facility, which has variable rates tied to SOFR. However, there were no outstanding borrowings as of September 30, 2023[437](index=437&type=chunk)[439](index=439&type=chunk) - The company's **$153.4 million** in mortgage loans and promissory notes are at fixed interest rates, reducing exposure to interest rate fluctuations[439](index=439&type=chunk) [Controls and Procedures](index=99&type=section&id=Item%204.%20Controls%20and%20Procedures) Management concluded that disclosure controls and procedures were effective as of September 30, 2023, with no material changes in internal control over financial reporting - The Chief Executive Officer and Chief Financial Officer concluded that the company's disclosure controls and procedures were effective as of the end of the period covered by the report[442](index=442&type=chunk) - No changes occurred during the quarter that have materially affected, or are reasonably likely to materially affect, the company's internal control over financial reporting[443](index=443&type=chunk) PART II. Other Information [Legal Proceedings](index=99&type=section&id=Item%201.%20Legal%20Proceedings) The company faces various legal and regulatory proceedings, including a qui tam lawsuit, patient care litigation, and class actions, with uncertain but potentially material adverse outcomes - The company is defending a lawsuit from a qui tam relator alleging violations of the False Claims Act (FCA) and Anti-Kickback Statute (AKS) related to medical director relationships, after the DOJ declined to intervene in April 2020[449](index=449&type=chunk)[451](index=451&type=chunk) - The company and its subsidiaries are subject to an increasing number of claims and lawsuits, including professional liability, elder abuse, and class action "staffing" suits, which have the potential for large verdicts and settlements[452](index=452&type=chunk)[458](index=458&type=chunk) - As of September 30, 2023, **41** of the company's independent operating subsidiaries had regulatory reviews (RAC, TPE, etc.) scheduled or in process to audit Medicare billings and potential overpayments[461](index=461&type=chunk) [Risk Factors](index=103&type=section&id=Item%201A.%20Risk%20Factors) This section details significant business and industry risks, including reimbursement changes, staffing mandates, litigation, and stock ownership risks like dividend policy and anti-takeover provisions [Risks Related to our Business and Industry](index=103&type=section&id=Risks%20Related%20to%20our%20Business%20and%20Industry) The company faces substantial risks from potential Medicare/Medicaid reimbursement reductions, federal staffing mandates, labor shortages, extensive litigation, and cybersecurity threats - Reductions in reimbursement rates or changes to rules from Medicare and Medicaid, which accounted for a combined **72.8% of service revenue** in the first nine months of 2023, could materially harm financial results[468](index=468&type=chunk)[476](index=476&type=chunk) - Proposed federal minimum staffing mandates, if enacted, are expected to adversely affect labor costs, the ability to maintain patient capacity, and profitability due to increased demand for a limited supply of nurses[525](index=525&type=chunk)[526](index=526&type=chunk) - The company is subject to government reviews, audits, and investigations, including a pending qui tam lawsuit, which could result in significant fines, refunds, and potential exclusion from Medicare/Medicaid programs[494](index=494&type=chunk)[502](index=502&type=chunk)[575](index=575&type=chunk) [Risks Related to Ownership of our Common Stock](index=149&type=section&id=Risks%20Related%20to%20Ownership%20of%20our%20Common%20Stock) Risks for common stock owners include dividend payment ability, restricted by credit agreements, and anti-takeover provisions that could affect stock price - The company's ability to pay dividends is subject to operational performance and is restricted by its Amended Credit Agreement in the event of a default[648](index=648&type=chunk) - Anti-takeover provisions, including a classified board and "blank check" preferred stock, could discourage or prevent a change in control, potentially limiting the stock price[649](index=649&type=chunk)[651](index=651&type=chunk) [Other Information](index=150&type=section&id=Item%205.%20Other%20Information) This section discloses President & COO Spencer W. Burton's Rule 10b5-1 trading plan for potential stock sales and gifts of up to 8,280 shares - On September 12, 2023, President & COO Spencer W. Burton entered into a Rule 10b5-1 trading plan for the potential sale of up to **8,280 shares** of common stock between December 14, 2023, and August 30, 2024[652](index=652&type=chunk) [Exhibits](index=151&type=section&id=Item%206.%20Exhibits) This section provides an index of exhibits filed with the Form 10-Q, including corporate governance documents and CEO/CFO certifications - The exhibits include certifications from the CEO and CFO pursuant to Sections 302 and 906 of the Sarbanes-Oxley Act of 2002[657](index=657&type=chunk)