Financial Data and Key Metrics Changes - For Q4 2025, revenue was $1.36 billion, a 12% increase year-over-year. Net income was $59.8 million, with adjusted EBITDAR at $237.7 million and adjusted EBITDA at $142.1 million [23] - For the full year 2025, total revenue reached $5.29 billion, representing a 29% growth compared to 2024. Net income was $191.5 million, with diluted earnings per share at $1.22. Adjusted EBITDAR totaled $883.9 million, and adjusted EBITDA was $505 million [24] Business Line Data and Key Metrics Changes - Total occupancy for the year averaged 89.1%, with mature facilities at 94.9% occupancy, up from 94.4% the previous year. Ramping facilities averaged 86.3% occupancy, down from over 93% in the prior year [24][25] - New facilities averaged 81.1% occupancy compared to 82.8% in 2024, reflecting the onboarding and stabilization period for recently acquired facilities [25] Market Data and Key Metrics Changes - PACS operates 321 facilities across 17 states, caring for over 31,700 patients daily, supported by over 47,000 team members [7] - The company maintains a strong balance sheet with a net leverage of approximately 0.3 times, enhancing durability and flexibility for future investments [8][28] Company Strategy and Development Direction - The company focuses on integrating and optimizing its expanded portfolio, investing in people and clinical capabilities, and maintaining disciplined capital allocation for acquisitions [9][22] - PACS aims to serve as a responsible consolidator in the fragmented skilled nursing landscape, leveraging demographic trends that indicate sustained growth in the aging population [9] Management's Comments on Operating Environment and Future Outlook - Management expresses optimism for 2026, expecting steady organic growth and margin expansion through improved occupancy and skilled mix across the portfolio [30] - The company anticipates revenue for 2026 to be in the range of $5.65 billion to $5.75 billion, representing nearly an 8% growth over 2025 [29] Other Important Information - The company executed 8 strategic acquisitions in 2025, enhancing local scale and density within existing markets [5] - PACS has a robust pipeline for potential acquisitions, with a disciplined approach to evaluating distressed facilities [38] Q&A Session Summary Question: Can you discuss payer conversations and share gain opportunities? - Management highlighted that as facilities improve quality metrics, they become attractive partners for insurers, leading to stronger contract negotiations [34][35] Question: What is the M&A pipeline outlook? - The company expects to acquire about 5 facilities per quarter in 2026, focusing on underperforming assets with low occupancy [37] Question: Are there opportunities for more de novo activity? - While acquisitions remain the primary growth strategy, management is open to de novo developments if they make sense in certain states [41] Question: What are the pricing trends in the M&A environment? - Management noted that while prices have increased due to inflation, they are starting to plateau, allowing for selective and opportunistic acquisitions [43]

Financial Data and Key Metrics Changes - Revenue for Q4 2025 was $1.36 billion, a 12% increase year-over-year, while total revenue for the full year reached $5.29 billion, representing a 29% growth over 2024 [23][24] - Net income for Q4 was $59.8 million, and for the full year, it was $191.5 million, with diluted earnings per share at $1.22 [23][24] - Adjusted EBITDAR for Q4 was $237.7 million, and adjusted EBITDA was $142.1 million, while for the full year, adjusted EBITDAR totaled $883.9 million and adjusted EBITDA was $505 million [23][24] Business Line Data and Key Metrics Changes - Total occupancy for the year averaged 89.1%, with mature facilities achieving 94.9% occupancy, up from 94.4% the previous year [24][19] - Ramping facilities averaged 86.3% occupancy, down from over 93% in the prior year, reflecting the transition of facilities into ramping status [24][25] - New facilities averaged 81.1% occupancy compared to 82.8% in 2024, indicating ongoing stabilization efforts [25] Market Data and Key Metrics Changes - PACS operates 321 facilities across 17 states, caring for over 31,700 patients daily, supported by over 47,000 team members [7][19] - The company has a total of 35,379 operating beds, with 32,854 skilled nursing beds and 2,525 assisted living beds [18] Company Strategy and Development Direction - The company aims to continue integrating and optimizing its expanded portfolio, investing in people and clinical capabilities, and maintaining disciplined capital allocation [9][22] - The focus remains on enhancing quality ratings and operational excellence, with a commitment to being a responsible consolidator in the skilled nursing landscape [9][10] - The company plans to pursue selective acquisitions while maintaining a strong balance sheet, ending 2025 with net leverage of approximately 0.3 times [8][30] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism for 2026, expecting steady organic growth and margin expansion through improved occupancy and skilled mix [30][31] - The company is well-positioned to adapt to changes in the healthcare landscape, including value-based purchasing programs and the Transforming Episode Accountability Model [56][59] - Management highlighted the importance of local leadership and clinical quality as key drivers for future success [10][56] Other Important Information - The company executed 8 strategic acquisitions in 2025, enhancing local scale and density within existing markets [5][18] - The average CMS Quality Measure Star rating for mature facilities improved to 4.4, above the industry average of approximately 3.5 [10][11] - The company has a robust pipeline for future acquisitions, with a disciplined approach to evaluating opportunities [40][46] Q&A Session Summary Question: Discussion on payer conversations and share gain opportunities - Management indicated that high-quality care positions the company as an attractive partner for insurers, enhancing negotiation power for contracts [35][36] Question: Details on the M&A pipeline - The company plans to acquire about 5 facilities per quarter in 2026, focusing on underperforming assets with low occupancy [38][39] Question: Potential for increased de novo activity - While acquisitions remain the primary growth strategy, management acknowledged opportunities for de novo developments in certain states [43][44] Question: Pricing environment for M&A opportunities - Management noted that while prices have increased due to inflation, they are starting to plateau, allowing for selective and opportunistic acquisitions [46][47] Question: Impact of value-based purchasing programs - Management expressed confidence that their clinical quality positions them well to benefit from reimbursement tied to quality metrics [54][56] Question: Observations on the Transforming Episode Accountability Model - Management believes their established clinical model positions them favorably as hospitals become more aware of post-acute care providers [58][59]