Financial Data and Key Metrics Changes - The company reported normalized FFO per share of $0.37 and normalized AFFO per share of $0.38, representing a 6% improvement over the same period in 2024 [20][22] - Total normalized FFO and normalized AFFO for the quarter were $89.2 million and $91.6 million respectively, reflecting strong sequential growth from increased NOI [20][22] - The net debt to adjusted EBITDA ratio was five times as of June 30, 2025, a decrease of 0.19 times from March 31, 2025 [24][26] Business Line Data and Key Metrics Changes - The managed senior housing portfolio contributed nearly 21% of total annualized cash NOI, with cash NOI for the quarter growing 17.1% year over year in the same store portfolio [14][18] - Cash rental income from the triple net portfolio increased by $2.3 million from the first quarter, driven by a $1.4 million increase in percentage rents [20][21] - The occupancy rate in the same store portfolio was 86% compared to 84.6% in 2024, with cash NOI growth expected to be in the low to mid-teens for the same store managed senior housing portfolio [16][24] Market Data and Key Metrics Changes - The average Medicaid rate increase is expected to be around 3.5%, with the top five skilled nursing tenants averaging just above 5% [9][12] - The Medicare market saw an upward revision from 2.8% to 3.2%, which is considered unusual but positive for the company [9][12] - The Canadian portfolio's RevPAR increased by 6.8% year over year, with occupancy above 90% for over five quarters [17][18] Company Strategy and Development Direction - The company aims to increase its SHOP (Senior Housing Operating Portfolio) from 20% to 30% by 2026, requiring approximately $1 billion in investments [11][12] - The focus is on acquiring well-performing newer senior housing communities that cater to the baby boomer generation, as the supply-demand equation remains constrained [15][18] - The company is not interested in building a loan book or engaging in complex joint venture structures, preferring straightforward traditional deals [36][104] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the investment pipeline, targeting $4.5 billion in investments for the year, with a strong deal flow expected to continue [11][70] - The company noted that the operational recovery in skilled nursing and senior housing has allowed for robust pricing, despite some challenges in the market [46][92] - Management remains optimistic about future occupancy and NOI growth, anticipating improvements as the transition from the holiday portfolio stabilizes [65][66] Other Important Information - The company declared a quarterly cash dividend of $0.30 per share, representing a payout of 79% of the second quarter normalized AFFO per share [27][28] - The company has ample liquidity of approximately $1.2 billion, consisting of unrestricted cash and available borrowings [27][26] Q&A Session Summary Question: Investment guidance and pipeline - Management indicated confidence in reaching the $400 million to $500 million investment range for the year, depending on timing [30][31] Question: Same store SHOP NOI growth - Management noted that the same store SHOP NOI growth is running at the high end of expectations, with hopes for upside [38][40] Question: Skilled nursing opportunities - Management clarified that while pricing is not an issue, the focus is on finding quality assets in the right markets [32][34] Question: Holiday transition impact - Management explained that the transition of holiday assets has had an impact on occupancy and NOI, but they expect improvements moving forward [44][65] Question: Labor market conditions - Management reported wage increases of around 4% across both skilled nursing and senior housing portfolios, with no significant labor market issues identified [96][99] Question: Operator selection criteria - Management emphasized the importance of understanding operators' outcomes and their willingness to grow as key selection criteria for new operators [103][104]

Financial Data and Key Metrics Changes - The second quarter adjusted funds from operations (AFFO) were $0.77 per share, and funds available for distribution (FAD) were $0.74 per share, reflecting strong revenue and EBITDA growth primarily driven by acquisitions and active portfolio management [6][10][11] - Revenue for the second quarter was $283 million, up from $253 million in the previous year, attributed to new investments, operator restructurings, and annual escalators [10][11] - Net income for the second quarter was $140 million or $0.46 per share, compared to $117 million or $0.45 per share for the previous year [10] - NAREIT FFO for the second quarter was $213 million or $0.70 per share, compared to $189 million or $0.72 per share for the previous year [11] - The company raised and narrowed its 2025 AFFO guidance to a range of $3.40 to $3.70 per share [6][14] Business Line Data and Key Metrics Changes - The senior housing portfolio has grown to 396 facilities, representing 38% of the total operating facility portfolio [8] - The trailing twelve-month operator EBITDAR coverage for the core portfolio remained flat at 1.51 times, indicating operators' ability to cover rent [22] - Genesis filed for Chapter 11 bankruptcy, but Omega expects to receive full monthly contractual rent during this period [8][24] Market Data and Key Metrics Changes - The company has over $2 billion in liquidity with low leverage, positioning it well for growth in both senior housing and skilled nursing portfolios [9] - The UK market continues to be a significant driver of new investment activity, accounting for approximately $392 million or 65% of total new investments [29][30] Company Strategy and Development Direction - The company is focused on active portfolio management, seeking to divest underperforming facilities and source operators better suited for certain facilities [77] - Omega is exploring various investment structures to create incremental value and align interests with operators [77][94] - The company is optimistic about the long-term growth potential in both skilled nursing and senior housing sectors, supported by demographic trends [33][77] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to weather potential challenges from Medicaid funding cuts due to strong fundamentals and lobbying efforts [33][35] - The company anticipates continued improvements in coverage metrics based on preliminary results from April and May [66] Other Important Information - The company has entered into derivative instruments to mitigate foreign currency fluctuations on income from UK investments [18] - The One Big Beautiful Bill Act (OBBBA) signed into law is seen as a positive development for the industry, particularly for skilled nursing [32] Q&A Session Summary Question: Details on the investment pipeline and yields - The investment pipeline remains strong with yields around 10% across various asset classes [38] Question: Expected rent trajectory for Maplewood - Maplewood's rent is expected to increase as occupancy grows and operational efficiencies are realized [41][43] Question: Changes in balance sheet strategy - The company opted for debt issuance instead of equity to fund upcoming bond maturities, maintaining a leverage-neutral position [46][47] Question: Confidence in Genesis assets during bankruptcy - The master lease structure prevents Genesis from selectively rejecting assets, ensuring stability in rent payments [84][85] Question: Dividend increase considerations - The board is considering a dividend increase once the payout ratio is in the 80% range [82] Question: Labor market conditions - Operators are experiencing normal inflationary wage increases, with CNAs being the most challenging positions to fill [71][72]

Core Insights - Ensign Group reported adjusted earnings per share (Non-GAAP) of $1.59, exceeding estimates of $1.55, and GAAP revenue of $1.23 billion, slightly above the $1.22 billion expectation, marking an 18.5% increase year-over-year [1][2] - The company raised its full-year earnings and revenue guidance, indicating strong growth driven by organic improvements and acquisitions [1][10] Financial Performance - Adjusted earnings per share (Non-GAAP) increased by 20.5% year-over-year from $1.32 to $1.59 [2] - Revenue rose by 18.3% from $1.04 billion in Q2 2024 to $1.23 billion in Q2 2025 [2] - Net income grew by 18.9% from $71.0 million in Q2 2024 to $84.4 million in Q2 2025 [2] - Adjusted EBITDA increased by 25.1% from $117.2 million to $146.6 million [2] - Funds from Operations (Standard Bearer) rose by 26.6% from $14.5 million to $18.4 million [2] Business Overview - Ensign Group operates over 300 healthcare facilities, including skilled nursing and senior living communities, focusing on post-acute care services across the U.S. [3] - The company employs a decentralized management approach, empowering local leaders while pursuing growth through selective acquisitions [4] Operational Highlights - Same-facility skilled services revenue increased by 6.5%, and revenue from transitioning facilities rose by 11.6% [5] - Total operational bed occupancy improved to 81.3%, up 1.2 percentage points year-over-year, while recently acquired facilities reached 74.3% occupancy [6] - Managed care revenue grew by 11.8% at same facilities and 27.8% at transitioning operations [6] Strategic Focus - The company relies heavily on government reimbursements, with Medicaid and Medicare accounting for 69.8% of service revenue [7] - Ensign Group is actively engaging with policymakers regarding reimbursement rates and regulatory issues [7] - The company raised its quarterly dividend to $0.0625 per share, marking the 22nd consecutive year of dividend increases [7][12] Future Guidance - Management raised guidance for adjusted (non-GAAP) earnings per share to a range of $6.34–$6.46 and revenue to $4.99–$5.02 billion, assuming continued integration of recent acquisitions [10] - The company anticipates a high pace of acquisition activity, with both lease and ownership opportunities in the pipeline [10]

Financial Data and Key Metrics Changes - The normalized FFO per share for Q1 2025 was $0.35, up from $0.34 in Q1 2024, representing a year-over-year increase of 2.9% [13] - The normalized AFFO per share for Q1 2025 was $0.37, compared to $0.35 in Q1 2024, indicating a year-over-year increase of 5.7% [13] - Cash rental income from the triple net portfolio totaled $90 million for the quarter, up from $89 million in Q1 2024 [13] - Cash NOI from the managed senior housing portfolio increased to $24.1 million in Q1 2025 from $19.1 million in Q1 2024, a year-over-year increase of 26.3% [14] Business Line Data and Key Metrics Changes - Skilled nursing and triple net senior housing EBITDARM rent coverage reached 2.19 and 1.41, respectively, with behavioral health coverage at 3.77, marking the highest levels since year-end 2023 [5] - Skilled occupancy increased by 80 basis points sequentially, while the skilled mix improved by 10 basis points [6] - Triple net senior housing occupancy rose by 50 basis points sequentially [7] - The same store managed senior housing portfolio's revenue grew by 6.3% year-over-year, with occupancy increasing from 82.6% in Q1 2024 to 85.4% in Q1 2025 [10] Market Data and Key Metrics Changes - The domestic portfolio occupancy was 83%, gaining 340 basis points year-over-year, while the Canadian portfolio occupancy was 90.9%, adding 140 basis points [10] - RevPAR in the same store portfolio increased by 2.8% year-over-year, with Canadian RevPAR growing by 4.9% [10] - Cash NOI growth in US communities was 14.4% year-over-year, while Canadian communities saw a 24.7% increase [11] Company Strategy and Development Direction - The company is focusing on a busy deal pipeline primarily in senior housing, with over $200 million in awarded deals expected to close this quarter, surpassing the total for all of 2024 [7][8] - The strategy includes entering new relationships with proven operators and maintaining a selective approach to acquisitions [33][56] - The company aims to balance its portfolio between senior housing and skilled nursing, emphasizing the importance of operational recovery and predictable earnings [80][86] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about continued occupancy growth and potential Medicaid rate increases in the summer, which could enhance coverage [90] - The company remains cautious about the skilled nursing facility (SNF) market due to ongoing uncertainties regarding Medicaid reimbursement [70] - Management believes that the current operating environment will support improved coverage for the foreseeable future, despite potential challenges [90] Other Important Information - The company declared a quarterly dividend of $0.30 per share, representing a payout of 81% of the first quarter normalized AFFO per share [18] - The net debt to adjusted EBITDA ratio improved to 5.19 times as of March 31, 2025, down from 5.27 times at the end of 2024 [16] Q&A Session Summary Question: Update on skilled nursing facility sale - Management confirmed that the expected $50 million skilled nursing facility sale is still on track, although regulatory hurdles have delayed the process [20] Question: Trajectory of RevPOR and expense growth - Management indicated that as occupancy increases, pricing power is expected to improve, leading to potential revenue growth [22][23] Question: Guidance and deal flow - Management reiterated that current acquisitions are not included in guidance until closed, maintaining a conservative approach to projections [28][29] Question: Competition in the transaction market - Management noted a robust pipeline of deals, primarily in senior housing, with private equity firms as frequent sellers [34][37] Question: Genesis exposure and NOI - Management reported that the impact of Genesis on NOI is negligible, with no missed payments and improved operations since subleasing to a trusted operator [50] Question: SNF acquisition attractiveness - Management highlighted challenges in acquiring SNFs, particularly those with financial difficulties, making them less attractive for investment [68] Question: SHOP portfolio occupancy trends - Management expects occupancy to pick up in the second quarter, particularly in Canadian assets, as seasonal factors improve [72] Question: Interest in large portfolios - Management emphasized a commitment to maintaining a simple and predictable strategy, focusing on smaller, manageable deals rather than large portfolios [80][81]

Financial Data and Key Metrics Changes - For Q1 2025, normalized FFO per share was $0.35 and normalized AFFO per share was $0.37, compared to $0.34 and $0.35 in Q1 2024, representing a year-over-year increase of 79% for both metrics [14][15] - Cash rental income from the triple net portfolio totaled $90 million, up from $89 million in Q1 2024, despite the disposal of $115 million of real estate from the portfolio last year [15] - Cash NOI from the managed senior housing portfolio totaled $24.1 million, compared to $19.1 million in Q1 2024, driven by strong occupancy and margin gains [15][12] Business Line Data and Key Metrics Changes - Skilled nursing and triple net senior housing EBITDARM rent coverage reached new highs at 2.19 and 1.41, respectively, with behavioral health coverage at 3.77 [5] - Skilled occupancy increased by 80 basis points sequentially, while triple net senior housing occupancy rose by 50 basis points [6] - Revenue for the same store managed senior housing portfolio grew 6.3% year-over-year, with occupancy at 85.4% compared to 82.6% in Q1 2024 [11] Market Data and Key Metrics Changes - The domestic portfolio occupancy was 83%, gaining 340 basis points year-over-year, while the Canadian portfolio occupancy was 90.9%, adding 140 basis points [11] - RevPAR in the same store portfolio increased by 2.8% year-over-year, with Canadian RevPAR growing by 4.9% [11] - The company noted a robust deal pipeline, with over $200 million in awarded deals, which is more than the total for all of 2024 [7][8] Company Strategy and Development Direction - The company is focusing on internal and external growth opportunities in senior housing, with little new supply expected in the coming years [10] - Management emphasized a commitment to maintaining a balanced portfolio between senior housing and skilled nursing, avoiding large portfolio acquisitions to keep operations predictable [78] - The company is actively using its ATM program to raise equity for funding growth, with a focus on accretive capital [16][18] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about continued occupancy growth and potential Medicaid rate increases in the summer, which could enhance coverage [86] - The company is cautious about the skilled nursing facility (SNF) market due to challenges in structuring leases around underperforming assets [66][68] - Management believes that the current operating environment will allow for improved coverage and revenue growth, despite potential headwinds from provider taxes [85] Other Important Information - The Board of Directors declared a quarterly dividend of $0.30 per share, representing a payout of 81% of the first quarter normalized AFFO per share [19] - The company has ample liquidity of over $1 billion, consisting of unrestricted cash and available borrowings [18] Q&A Session Summary Question: Update on skilled nursing facility sale - Management confirmed that the expected $50 million skilled nursing facility sale is still on track, though regulatory hurdles have delayed the process [21] Question: Trajectory of RevPOR and expense growth - Management expects occupancy to rise, which will allow for increased pricing power, while expenses are anticipated to remain stable [22][23] Question: Guidance on acquisitions and SHOP performance - Management reiterated that acquisitions are not included in current guidance until closed, and reaffirmed expectations for low to mid-teens cash NOI growth [27][28] Question: Insights on transaction market and deal flow - Management noted a robust pipeline of deals, primarily in senior housing, with private equity firms as frequent sellers [31][33] Question: Details on $200 million of awarded deals - All awarded deals are domestic, primarily in the Eastern U.S., with growth potential embedded in the assets [40][41] Question: Changes in underwriting criteria - Management stated that underwriting criteria remain unchanged, focusing on cost of capital and accretive deals [60] Question: Concerns regarding SNF acquisitions - Management highlighted challenges in acquiring SNFs due to financial instability and the difficulty in structuring leases [66][68] Question: Expectations for SHOP occupancy cadence - Management anticipates an increase in occupancy as seasonal factors improve, particularly in Canadian assets [70] Question: Interest in large portfolio acquisitions - Management confirmed a commitment to smaller, more manageable deals to maintain operational simplicity and predictability [78] Question: Medicare reimbursement impacts - Management expressed confidence that Medicare will not be significantly impacted by current government budget discussions [97]