Financial Data and Key Metrics Changes - For Q4 2025, the company reported revenue of $397.6 million, a 17% year-over-year increase, with organic growth of 12% [19] - Adjusted EBITDA grew 53% year-over-year to $39.5 million, with margins expanding to 9.9% [22] - Full-year 2025 adjusted EBITDA was $115 million, exceeding previous guidance [25] - The company increased its cash balance to $66 million, up from $36 million in Q3 2025 [22] Business Line Data and Key Metrics Changes - The company served over 205,000 residents, a 10% increase year-over-year [19] - Script volume grew 14% year-over-year, with vaccine script volumes up 3% [19][20] - Gross profit rose 27% to $85.5 million, with gross margins expanding to 21.5% from 19.8% [19] Market Data and Key Metrics Changes - The company anticipates a revenue forecast of $1.4 billion to $1.42 billion for 2026, reflecting new pricing impacts from the IRA [26] - The long-term care pharmacy environment is evolving with ongoing consolidation and increasing operational complexity [13] Company Strategy and Development Direction - The company plans to continue investing in acquisitions and greenfield startups while enhancing data analytics capabilities [8] - The company aims to offset anticipated EBITDA impacts from the IRA and maintain service levels during industry transitions [12][11] - The focus remains on supporting partners with reliable execution amid industry changes [14] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's growth momentum despite industry challenges, raising 2026 adjusted EBITDA guidance to $120 million-$124 million [17][26] - The demographic shift with the aging population is expected to create incremental tailwinds for the company [13] - Management is closely monitoring the operational complexities introduced by the IRA [11] Other Important Information - The company completed three acquisitions mid-year, contributing to reported revenue growth of 18% for the full year [6] - The company achieved a full-year return on equity of 27% [8] Q&A Session Summary Question: Can you help us understand the durable aspects of Q4 results? - Management indicated that the run rate for EBITDA is approximately $110 million, with variability in Q4 not projected to continue [32] 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 profitability [34] Question: What progress has been made in balancing profit contributions between generics and branded drugs? - Management noted progress in aligning gross margin dollars with the high volume of generic prescriptions [36] Question: Is the gap between potential margin and realized margin still the same? - Management indicated that the gap has increased to approximately 90 basis points [37] Question: Can you discuss opportunities arising from competitors facing challenges? - Management acknowledged potential opportunities from competitors in distress, particularly in the context of ongoing bankruptcy processes [48] Question: Are you seeing efficiencies in labor costs? - Management stated that efficiencies are primarily due to scaling the existing platform rather than improvements in labor inflation [49] Question: How is the integration of recently acquired facilities progressing? - Management reported faster ramp-up and integration of recently acquired facilities, particularly in the Pacific Northwest [56] Question: What is the outlook for M&A opportunities given the current market conditions? - Management expressed a robust pipeline for M&A in 2026, while remaining disciplined in their approach [60]

Financial Data and Key Metrics Changes - For Q4 2025, the company reported revenue of $397.6 million, a 17% year-over-year increase, with organic growth of 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 [20] Business Line Data and Key Metrics Changes - The company served over 205,000 residents, a 10% increase year-over-year, with script volume growing 14% [15] - Vaccine script volumes increased by 3% year-over-year, contributing to improved profitability due to better purchasing and reimbursement [16] - Adjusted SG&A was 13% of revenue, down from 13.7% in the previous year, reflecting increased scale efficiencies [17] Market Data and Key Metrics Changes - The company anticipates continued pressure in the long-term care pharmacy ecosystem due to the IRA, but believes its scale and local service model will provide stability [10] - The demographic shift, with the first cohort of the "silver tsunami" entering their 80s, is expected to create a tailwind for the company [10] Company Strategy and Development Direction - The company plans to continue investing in acquisitions and greenfield startups while enhancing data analytics capabilities [6] - The focus remains on supporting partners with consistent, reliable execution amid industry changes [11] - The company is raising its 2026 adjusted EBITDA guidance to $120 million-$124 million, reflecting confidence in continued growth momentum [13] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in offsetting anticipated EBITDA impacts from the IRA in 2026 [9] - The company is closely monitoring operational complexities introduced by the IRA and aims to avoid disruptions to service levels and cash flow [10] - Management highlighted the importance of maintaining service continuity amid industry consolidation and operational changes [48] Other Important Information - The company increased its cash balance by approximately $60 million, reflecting strong cash generation [6] - Full-year return on equity was 27%, underscoring a disciplined approach to capital allocation [7] Q&A Session Summary Question: Can you help us understand what's durable, what's vaccine, and what's non-recurring in the quarter? - Management indicated that the run rate for adjusted EBITDA is approximately $110 million, with certain positive variabilities not projected to continue [25] 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 contributing to profitability [27] Question: What were you able to get done from a contracting standpoint to better balance profit streams? - Management noted progress in aligning gross margin dollars with the high percentage of generic prescriptions dispensed [29] Question: Is the gap between potential margin and realized margin still what it was a couple of quarters ago? - Management reported that the gap has increased to approximately 90 basis points, reflecting ongoing investments for future profitability [30] Question: Can you discuss the opportunity around share gain with struggling competitors? - Management acknowledged potential opportunities arising from industry disruptions, including bankruptcy filings among competitors [41] Question: Are you seeing efficiencies and improvements in labor inflation? - Management indicated that efficiencies are primarily driven by scaling the existing labor force rather than improvements in labor inflation [42] Question: How do you ensure continuity of service amid operational changes? - Management emphasized that industry consolidation provides opportunities to maintain service and meet new operating groups [48]