Financial Data and Key Metrics Changes - For Q4 2025, revenue increased by 17% year-over-year to $397.6 million, with organic growth at 12% [15] - Adjusted EBITDA grew 53% year-over-year to $39.5 million, with margins expanding to 9.9% [18] - Full-year adjusted EBITDA for 2025 was $115 million, exceeding guidance of $104 million-$106 million [20] - The company increased its cash balance to $66 million, up from $36 million in the previous quarter [18] Business Line Data and Key Metrics Changes - The company served over 205,000 residents, a 10% increase year-over-year [15] - Script volume grew by 14% year-over-year, with vaccine script volumes up 3% [15][16] - Gross profit rose 27% to $85.5 million, with gross margins expanding to 21.5% from 19.8% [15] Market Data and Key Metrics Changes - The company anticipates a revenue forecast of $1.4 billion-$1.42 billion for 2026, reflecting new pricing from the IRA [13][21] - The long-term care pharmacy environment is evolving with ongoing consolidation and increasing operational complexity [10] Company Strategy and Development Direction - The company plans to offset anticipated EBITDA impacts from the IRA in 2026 and is focused on maintaining service levels and cash flow [9][10] - The company is actively engaged in discussions for potential acquisitions and greenfield startups to expand its operational footprint [19][53] - The company aims to balance profit contributions between generics and branded drugs, with 92% of prescriptions being generic [30] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's growth momentum despite industry changes, with a focus on durable growth and margin expansion [12][13] - The demographic shift with the aging population is expected to create a tailwind for the company [10] - Management acknowledged the challenges posed by the IRA but believes the company's scale and operational discipline will provide stability [10] Other Important Information - The company performed over 100,000 clinical interventions benefiting approximately 74,000 residents, demonstrating its operational and clinical value [6] - The company administered over 120,000 vaccines during the third and fourth quarters, with improved profitability year-over-year [8] Q&A Session Summary Question: Can you help us understand what's durable, what's vaccine, what's non-recurring in the quarter? - Management indicated that the run rate for EBITDA is approximately $110 million, with variability in Q4 not projected to continue [26] Question: Did the vaccine program contribute more this year than last year? - Management confirmed that the vaccine program continued to be significant in Q4, with improved reimbursement and profitability [28] Question: What were you able to get done from a contracting standpoint to better balance the two profit streams? - Management noted progress in aligning gross margin dollars with the high volume of generic prescriptions [30] Question: Is the gap between potential margin and realized margin still what it was a couple of quarters ago? - Management indicated that the gap has increased to approximately 90 basis points, reflecting investments for future profitability [31] Question: Can you discuss the opportunity around share gain with struggling competitors? - Management acknowledged potential opportunities arising from competitors facing challenges, particularly in the context of bankruptcy [42] Question: Are you seeing efficiencies and improvements in labor inflation? - Management clarified that efficiencies are primarily due to scaling the existing platform rather than improvements in labor inflation [43]