Core Insights - The article discusses the investment potential in specific companies, highlighting their market positions and financial performance [1][2][3] Company Analysis - The companies mentioned have shown significant growth in their stock prices, indicating strong investor interest and market confidence [1] - Financial metrics such as revenue and profit margins are analyzed to assess the companies' operational efficiency and profitability [2] - The article emphasizes the importance of conducting thorough due diligence before making investment decisions based on the presented information [3] Industry Trends - The overall industry is experiencing shifts that could impact future performance, including regulatory changes and market demand fluctuations [1][2] - Emerging technologies and innovations within the industry are identified as potential growth drivers for the companies discussed [3]

Financial Data and Key Metrics Changes - GAAP diluted earnings per share increased by 6% to $1.42, while adjusted diluted earnings per share rose by 18% to $1.64 [33] - Consolidated GAAP revenue and adjusted revenues both reached $1.3 billion, marking a 19.8% increase [33] - GAAP net income was $83.8 million, up 6.9%, and adjusted net income increased by 18.9% to $96.5 million [33] - Cash and cash equivalents stood at $443.7 million, with cash flows from operations at $381 million [33] - The lease-adjusted net debt-to-EBITDA ratio was 1.86 times, indicating low leverage during significant growth [34] Business Line Data and Key Metrics Changes - Same-Store occupancy increased to 83%, while transitioning occupancy reached 84.4%, both all-time highs [8] - Skilled days increased by 5.1% for Same-Store operations and 10.9% for transitioning operations compared to the prior year [10] - Medicare revenue grew by 10% for Same-Store and 8.8% for transitioning operations, with Same-Store Medicare days up by 4.2% [10] - Managed care revenue increased by 7.1% for Same-Store and 24.3% for transitioning operations [10] Market Data and Key Metrics Changes - Ensign-affiliated facilities outperformed peers by 24% at the state level and 33% at the county level in CMS data [7] - The U.S. population aged 80 and older is projected to grow by over 50% by 2035, creating sustained demand for skilled nursing services [9] Company Strategy and Development Direction - The company emphasizes a clinically driven culture as a key differentiator, focusing on delivering high-quality clinical outcomes [6] - Ensign has successfully sourced, underwritten, and transitioned 73 new operations since 2024, indicating a solid opportunity for growth [11] - The company plans to continue acquiring new operations while maintaining a disciplined approach to avoid overpriced deals [12][24] Management's Comments on Operating Environment and Future Outlook - Management raised 2025 earnings guidance to between $6.48-$6.54 per diluted share, reflecting an 18.4% increase over 2024 results [16] - The company is optimistic about long-term growth driven by demographic trends and strong demand for services [10] - Management noted improvements in labor metrics, including turnover and stable wage growth, which are critical for maintaining success [15] Other Important Information - Standard Bearer Healthcare REIT generated rental revenue of $32.6 million for the quarter, with $27.6 million from Ensign-affiliated operations [27] - The company paid a quarterly cash dividend of $0.0625 per share and has a history of increasing dividends for 22 consecutive years [35] Q&A Session Summary Question: How should we think about the room to run on the skilled mix side? - Management noted that there is significant potential for growth in skilled mix, with only 31.7% of same-store days currently from skilled [48] Question: Can you talk about the managed care contracting environment in new markets? - Management indicated that establishing managed care contracts takes time, but relationships in overlapping states facilitate the process [51] Question: What is the current deal activity and pricing environment? - Management stated that while some areas have seen elevated pricing, they remain disciplined and focused on reasonable deals [62] Question: Are there updates on behavioral health capacity discussions? - Management confirmed ongoing traction in adding behavioral units in several facilities, indicating strong demand [64] Question: What common themes are behind the performance of new facilities? - Management highlighted that new acquisitions are contributing positively, with a significant portion of revenue coming from recently acquired facilities [85]

Financial Data and Key Metrics Changes - GAAP diluted earnings per share increased by 6% to $1.42, while adjusted diluted earnings per share rose by 18% to $1.64 [33] - Consolidated GAAP revenue and adjusted revenues both reached $1.3 billion, marking a 19.8% increase [33] - GAAP net income was $83.8 million, up 6.9%, and adjusted net income increased by 18.9% to $96.5 million [33] - Cash and cash equivalents stood at $443.7 million, with cash flows from operations at $381 million [33] - The lease-adjusted net debt-to-EBITDA ratio was 1.86x, indicating low leverage during significant growth [34] Business Line Data and Key Metrics Changes - Same-store occupancy increased to 83%, while transitioning occupancy reached 84.4%, both all-time highs [8] - Skilled days increased by 5.1% for same-store operations and 10.9% for transitioning operations compared to the prior year [10] - Medicare revenue grew by 10% for same-store and 8.8% for transitioning operations, with managed care revenue increasing by 7.1% and 24.3%, respectively [10] Market Data and Key Metrics Changes - Ensign-affiliated facilities outperformed peers by 24% at the state level and 33% at the county level in CMS data [7] - The U.S. population aged 80 and older is projected to grow by over 50% by 2035, creating sustained demand for skilled nursing services [9] Company Strategy and Development Direction - The company emphasizes a clinically driven culture as a key differentiator, focusing on delivering high-quality clinical outcomes [6] - Ensign plans to continue acquiring new operations while enhancing capabilities within existing facilities, maintaining a disciplined approach to growth [12][24] - The company is committed to expanding its presence in markets with strong demographic trends, particularly in California and Utah [20][21] Management's Comments on Operating Environment and Future Outlook - Management raised 2025 earnings guidance to between $6.48-$6.54 per diluted share, reflecting an 18.4% increase over 2024 results [16] - The company is optimistic about long-term growth driven by strong occupancy and skilled mix improvements [17] - Management highlighted the importance of maintaining relationships with managed care partners to enhance service offerings [51] Other Important Information - The company paid a quarterly cash dividend of $0.0625 per share and has a history of increasing dividends for 22 consecutive years [35] - Standard Bearer generated rental revenue of $32.6 million for the quarter, with $27.6 million from Ensign-affiliated operations [27] Q&A Session Summary Question: How should we think about the room to run on the skilled mix side, specifically in the same-store portfolio? - Management noted that there is significant potential for growth in skilled mix, with only 31.7% of same-store days currently from skilled [48] Question: Can you talk about the managed care contracting environment in new markets like Alabama? - Management indicated that establishing managed care contracts takes time, but relationships in overlapping states facilitate the process [51] Question: Is there anything in the current environment allowing for heightened deal activity? - Management stated that while there are no special market conditions, they remain disciplined in their approach to acquisitions, focusing on reasonable pricing [62] Question: Are you seeing traction in discussions regarding behavioral health capacity? - Management confirmed ongoing traction in adding behavioral units in several facilities, driven by demand from managed care partners [64] Question: What common themes are behind how quickly new facilities contribute to overall results? - Management highlighted that while new acquisitions initially contribute less, they are transitioning ahead of schedule and show significant potential for future growth [87]

Financial Data and Key Metrics Changes - The company reported GAAP diluted earnings per share of $1.42, an increase of 6% year-over-year, and adjusted diluted earnings per share of $1.64, an increase of 18% [32] - Consolidated GAAP revenue and adjusted revenues were both $1.3 billion, reflecting a 19.8% increase [32] - GAAP net income was $83.8 million, up 6.9%, while adjusted net income reached $96.5 million, an increase of 18.9% [32] - Cash and cash equivalents stood at $443.7 million, with cash flows from operations amounting to $381 million [32] - The company raised its 2025 earnings guidance to between $6.48-$6.54 per diluted share, up from a previous range of $6.34-$6.46 [16][36] Business Line Data and Key Metrics Changes - Same-Store occupancy increased to 83%, while transitioning occupancy rose to 84.4%, both representing all-time highs [8] - Skilled days increased for Same-Store operations by 5.1% and for transitioning operations by 10.9% year-over-year [10] - Medicare revenue increased by 10% for Same-Store operations and 8.8% for transitioning operations [10] - Managed care revenue saw increases of 7.1% for Same-Store and 24.3% for transitioning operations [10] Market Data and Key Metrics Changes - Ensign-affiliated facilities outperformed peers by 24% at the state level and 33% at the county level according to CMS data [7] - The U.S. population aged 80 and older is projected to grow by over 50% in the next decade, creating sustained demand for skilled nursing services [9] Company Strategy and Development Direction - The company continues to focus on organic growth through improved occupancy and skilled mix, with a strong emphasis on clinical excellence [10][11] - Ensign has successfully sourced, underwritten, and transitioned 73 new operations since 2024, indicating a solid pipeline for future growth [11][12] - The company maintains a disciplined approach to acquisitions, avoiding overpriced deals while enhancing capabilities within existing operations [12][23] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the long-term growth potential driven by demographic trends and the company's ability to capture market share [9][10] - The company is confident in achieving its revised earnings guidance due to strong performance and positive momentum in occupancy and skilled mix [36] - Management highlighted improvements in labor metrics, including turnover and stable wage growth, which are critical for maintaining operational success [15] Other Important Information - Standard Bearer Healthcare REIT generated rental revenue of $32.6 million for the quarter, with $27.6 million from Ensign-affiliated operations [25] - The company has a long history of paying dividends, having increased the annual dividend for 22 consecutive years [35] Q&A Session Summary Question: How should we think about the room to run on the skilled mix side, specifically in the same-store portfolio? - Management noted that there is substantial potential for skilled mix growth in facilities like Beacon, with ongoing efforts to add services that meet the needs of acute providers and managed care partners [45][48] Question: Can you talk about the managed care contracting environment in new markets like Alabama? - Management indicated that establishing managed care partnerships takes time, but they have relationships in overlapping states that facilitate this process [50] Question: What is driving the heightened pace of deal activity this year? - Management clarified that the recent deals were driven by long-standing relationships and emotional decisions from sellers rather than special market conditions [58][60] Question: Are you seeing any traction with managed care companies regarding behavioral health? - Management confirmed ongoing traction in adding behavioral units in several facilities, indicating strong relationships with county programs and managed care partners [63]

E N S I G N G R O U P INVESTOR PRESENTATION N o v e m b e r 2 0 2 5 w w w . e n s i g n g r o u p . n e t R: 105 G: 127 B: 87 #697F57 R: 172 G:200 B: 182 #ACC8B6 R: 0 G: 79 B: 103 #004F67 R: 153 G: 153 B: 204 #9999CC R: 252 G: 97 B: 92 #FC615C Primary Colors R: 0 G: 195 B: 255 #00C3FF R: 49 G: 131 B: 146 #008598 R: 68 G: 108 B: 120 # 446c78 R: 173 G: 106 B: 156 # b06a9b R: 148 G: 145 B: 147 #949193 R: 69 G: 110 B: 83 # 456E53 R: 41 G: 97 B: 99 # 296163 R: 47 G: 94 B: 84 # 2F5E54 Prevent Page Cut-off: File > ...

Financial Performance - GAAP diluted earnings per share for Q3 2025 was $1.42, a 6.0% increase year-over-year, while adjusted diluted earnings per share was $1.64, an 18.0% increase year-over-year[5] - GAAP net income for the quarter was $83.8 million, up 6.9% from the prior year, and adjusted net income was $96.5 million, an 18.9% increase year-over-year[5] - Consolidated GAAP and adjusted revenue for the quarter was $1.30 billion, an increase of 19.8% over the prior year[5] - Total revenue for Q3 2025 reached $1,296,405, a 19.9% increase from $1,081,776 in Q3 2024[22] - Service revenue increased to $1,289,779 in Q3 2025, up 19.8% from $1,076,092 in Q3 2024[22] - Net income attributable to The Ensign Group, Inc. for Q3 2025 was $83,844, representing a 6.3% increase from $78,444 in Q3 2024[28] - Non-GAAP net income for Q3 2025 was $96,474, a 19.0% increase compared to $81,141 in Q3 2024[28] - Adjusted EBITDA for Q3 2025 reached $151,090,000, up 22.0% from $123,884,000 in Q3 2024[34] - Total expenses for Q3 2025 were $1,200,187, a 20.9% increase from $992,438 in Q3 2024[22] Revenue Growth - Total skilled services revenue reached $1.24 billion for the quarter, representing a 19.9% increase compared to the prior year[5] - The company raised its annual 2025 earnings guidance to between $6.48 and $6.54 per diluted share, reflecting an 18.4% increase over 2024 results[8] - Annual revenue guidance was increased to $5.05 billion to $5.07 billion, up from $4.99 billion to $5.02 billion, accounting for current quarter growth and anticipated acquisitions[8] - Skilled services revenue for Q3 2025 was $1,239,096,000, representing a 19.9% increase from $1,033,113,000 in Q3 2024[39] - For the three months ended September 30, 2025, total service revenue reached $1,289,779,000, a 19.8% increase from $1,076,092,000 in 2024[49] - For the nine months ended September 30, 2025, total service revenue was $3,678,233,000, a 18.2% increase from $3,111,151,000 in 2024[51] Operational Metrics - Same Facilities and Transitioning Facilities occupancy rates improved to 83.0% and 84.4%, marking increases of 2.1% and 3.6% respectively from the prior year[5] - The number of facilities at the end of Q3 2025 increased to 314, up 11.3% from 282 in Q3 2024[39] - Actual patient days in Q3 2025 totaled 2,772,062, a 15.1% increase from 2,407,709 in Q3 2024[39] - Occupancy percentage for operational beds improved to 82.3% in Q3 2025, compared to 80.9% in Q3 2024[39] - The number of recently acquired facilities increased to 56, up from 24 in 2024, marking a substantial expansion[41] Cash Flow and Liquidity - Operating cash flow for the nine months ended September 30, 2025, was $380,950, up 54.4% from $246,730 in the same period of 2024[26] - Ensign's liquidity remains strong with approximately $443.7 million in cash and $592.6 million available under its line of credit[9] - The company reported a net decrease in cash and cash equivalents of $20,930 for the nine months ended September 30, 2025[26] Dividends and Shareholder Returns - The company paid a quarterly cash dividend of $0.0625 per share of common stock, indicating a commitment to continue dividend payments in the future[13] Non-GAAP Financial Measures - Adjusted EBITDA excludes stock-based compensation expense, acquisition-related costs, and other specific expenses to provide a clearer view of operating performance[59] - The company believes that adjusted financial measures provide important supplemental information for evaluating operating performance[59] - The company acknowledges that non-GAAP financial measures may not be comparable with similar measures from other companies in the industry[59] - The company emphasizes that these non-GAAP measures should not be relied upon to the exclusion of GAAP financial measures[59]

Core Insights - The Ensign Group, Inc. reported strong operating results for Q3 2025, with GAAP diluted earnings per share of $1.42 and adjusted earnings per share of $1.64, reflecting increases of 6.0% and 18.0% respectively compared to the prior year quarter [1][7]. Operating Results - The company achieved record financial results driven by exceptional healthcare outcomes from its clinical teams, emphasizing a patient-focused culture [4]. - Occupancy rates for same store and transitioning facilities reached all-time highs of 83.0% and 84.4%, respectively, attributed to increased market share and trust from communities [5]. - The company has added 73 new operations since 2024, many of which are performing above expectations, indicating significant organic growth potential [6]. Financial Performance - Total skilled services revenue for the quarter was $1.24 billion, a 19.9% increase year-over-year, while consolidated GAAP and adjusted revenue reached $1.30 billion, up 19.8% [7]. - GAAP net income for the quarter was $83.8 million, a 6.9% increase from the previous year, and adjusted net income was $96.5 million, up 18.9% [7]. - The company raised its annual earnings guidance for 2025 to between $6.48 and $6.54 per diluted share, reflecting an 18.4% increase over 2024 results [8]. Acquisition Growth - The company accelerated growth by adding 22 new operations during the quarter, bringing the total for 2025 to 45, with a focus on both multi-facility portfolios and single facility opportunities [9][10]. - Ensign's liquidity remains strong, with approximately $443.7 million in cash and $592.6 million available under its line-of-credit [9]. Real Estate and Portfolio Expansion - Ensign's portfolio now consists of 369 healthcare operations across 17 states, with 155 real estate assets, indicating a robust strategy for both leasing and acquiring healthcare real estate [12]. - Recent acquisitions include several skilled nursing and senior living facilities in California and Texas, enhancing the company's operational footprint [11][12]. Dividend and Financial Health - The company declared a quarterly cash dividend of $0.0625 per share, maintaining a strong history of dividend payments [14]. - The financial statements indicate a solid cash flow position, with net cash provided by operating activities amounting to $380.95 million for the nine months ended September 30, 2025 [29].

Operations and Expansion - As of September 30, 2025, the company operates 361 skilled nursing and senior living facilities, with a total of 37,076 operational skilled nursing beds and 3,401 senior living units[166]. - During the nine months ended September 30, 2025, the company expanded operations by adding 28 stand-alone skilled nursing operations and five stand-alone senior living operations, contributing 3,384 operational skilled nursing beds and 313 operational senior living units[171]. - Subsequent to September 30, 2025, the company added eight stand-alone skilled nursing operations, increasing operational skilled nursing beds by 428[172]. - Standard Bearer Healthcare REIT, Inc. added $228.9 million of real estate associated with 15 stand-alone skilled nursing operations and one stand-alone senior living operation during the nine months ended September 30, 2025[175]. - The company expanded into Alabama, Alaska, and Oregon in the first quarter of 2025, enhancing its national presence in attractive markets[173]. - The company’s real estate portfolio includes 148 owned properties, with 112 facilities operated and managed by the company and 36 leased to third-party operators[166]. - The company reported a total of 37,076 operational beds at the end of Q3 2025, with available patient days increasing to 3,367,685 from 2,974,651 in Q3 2024[191]. - The company continues to acquire underperforming skilled nursing operations and integrate them with its operational principles[326]. - The company aims to reach full clinical and financial potential for each operation through diligent efforts with existing and recently acquired operations[326]. Financial Performance - Total service revenue for Q3 2025 reached $1,289.8 million, up from $1,076.1 million in Q3 2024, representing a year-over-year growth of approximately 19.8%[194]. - For the nine months ended September 30, 2025, total service revenue was $3,678.2 million, compared to $3,111.2 million for the same period in 2024, reflecting a growth of approximately 18.2%[196]. - Total revenue for the three months ended September 30, 2025, increased by $214.6 million, or 19.8%, compared to the same period in 2024[324]. - Diluted GAAP earnings per share grew by 6.0%, from $1.34 to $1.42, for the three months ended September 30, 2025, compared to the same period in 2024[324]. - Adjusted EBITDA for the nine months ended September 30, 2025, was $435,086,000, up from $356,766,000 in the same period of 2024[329]. - Adjusted EBT for the three months ended September 30, 2025, was $128,721,000, compared to $108,352,000 in Q3 2024, reflecting a 18.5% increase[347]. - Net income for the three months ended September 30, 2025, was $83,911,000, an increase of 6.0% from $78,567,000 in 2024[349]. - The company reported a decrease in total expenses to 92.6% of total revenue for Q3 2025, compared to 91.7% in Q3 2024[328]. Revenue Sources - Medicaid revenue for Q3 2025 was $501.7 million, an increase from $416.2 million in Q3 2024, while Medicare revenue rose to $303.3 million from $263.6 million[194]. - Managed care revenue for Q3 2025 was $238.0 million, up from $202.5 million in Q3 2024, indicating a growth of approximately 17.5%[194]. - The skilled services segment accounted for 71.4% of total service revenue for the nine months ended September 30, 2025, slightly down from 72.9% in the same period of 2024[196]. - Skilled nursing average daily revenue rates for Medicare increased to $792.47 in 2025 from $750.49 in 2024, representing a growth of 5.3%[362]. - Total skilled nursing revenue rose to $420.16 million in 2025, up from $395.24 million in 2024, reflecting an increase of 6.3%[362]. - The average daily revenue for Medicaid increased to $304.16 in 2025 from $294.55 in 2024, showing a rise of 3.0%[362]. - Overall, the company demonstrated a positive trend in skilled nursing revenue across various payor sources, indicating strong operational performance[362]. Regulatory and Compliance - The company settled wage-related violations for $12,000 pending court approval during the three months ended September 30, 2025[179]. - The OBBB establishes a limit of $1.0 million for home equity that can be exempted from calculating an individual's eligibility for Medicaid in seeking long-term care starting January 1, 2028[208]. - States must conduct Medicaid eligibility redeterminations every six months starting in the first quarter of 2027, rather than annually[206]. - The Medicare Access and CHIP Reauthorization Act (MACRA) introduces two separate conversion factors for Medicare-participating providers, impacting reimbursement for therapeutic services[218]. - The Skilled Nursing Facility Quality Reporting Program (SNF QRP) imposes a 2.0% payment reduction for facilities that fail to submit required quality data[228]. - CMS has increased penalties for Special Focus Facilities (SFFs) that fail to improve performance, with heightened scrutiny and oversight lasting three years post-graduation from the program[296]. - CMS is intensifying survey and enforcement activities, focusing on facilities with substandard care or repeat violations of standards[298]. Market Trends and Future Outlook - The company continues to focus on expanding its skilled nursing and rehabilitation services, which are critical for maintaining revenue growth and profitability[192]. - For fiscal year 2026, CMS has finalized a 3.2% increase to SNF PPS payment rates, based on a final SNF market basket of 3.3% and adjustments[213]. - The company anticipates lower overall occupancy during years of growth due to historically lower rates at Recently Acquired Facilities[361]. - The company has made progress on initiatives related to increasing occupancy and the acuity of patients served in its facilities[326].

Core Insights - The Ensign Group, Inc. has acquired The Health Center of Eastview, a 90-bed skilled nursing facility in Birmingham, Alabama, effective November 1, 2025, which is under a long-term, triple net lease with a third-party landlord [1] - In a separate transaction on the same day, Ensign acquired the real estate and operations of seven skilled nursing facilities in Utah, expanding its portfolio significantly [3] - These acquisitions increase Ensign's total healthcare operations to 369 across 17 states, including 47 senior living operations, with 155 real estate assets owned by its subsidiaries [4] Company Expansion - The CEO of Ensign expressed enthusiasm about expanding in the Alabama market and building on recent growth in the Southeast [2] - The President of Southstone Healthcare LLC, an Ensign subsidiary, highlighted the commitment to providing high-quality care at the newly acquired facility [3] Strategic Focus - Ensign is actively seeking further acquisition opportunities in real estate and healthcare-related businesses, targeting both well-performing and struggling skilled nursing and senior living facilities across the United States [4]

Core Insights - The Ensign Group, Inc. has acquired the real estate and operations of seven skilled nursing facilities in Utah, enhancing its portfolio and market presence in the state [1][2] - The acquisition includes properties that are newer constructions, which align well with Ensign's existing operations and introduce new markets [2] - In addition to the Utah facilities, Ensign also acquired the operations of a 90-bed skilled nursing facility in Birmingham, Alabama, which will be operated under a long-term triple net lease [3] Company Expansion - Following these acquisitions, Ensign's portfolio now consists of 369 healthcare operations, including 47 senior living operations across 17 states [4] - Ensign subsidiaries, including Standard Bearer, own a total of 155 real estate assets [4] - The company is actively pursuing further acquisition opportunities in skilled nursing, senior living, and other healthcare-related businesses throughout the United States [4] Operational Strategy - Ensign's CEO expressed confidence in the integration of the new facilities, emphasizing the potential for collaboration with existing staff and caregivers to enhance service quality [2][3] - The company aims to leverage its resources and expertise to provide high-quality services to the communities served by the newly acquired facilities [3]