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8-K - 8-K - ENSIGN GROUP, INCq32014form8k.htm



The Ensign Group Reports Quarterly Adjusted Earnings of $0.44 per Share

Conference Call and Webcast Scheduled for November 6, 2014 at 10:00 am PT

MISSION VIEJO, Calif., Nov. 5, 2014 (GLOBE NEWSWIRE) -- The Ensign Group, Inc. (Nasdaq:ENSG), the parent company of the Ensign™ group of skilled nursing, rehabilitative care services, assisted and independent living, home health, hospice care and urgent care companies, today reported operating results for the third quarter of 2014.

Quarterly Financial Highlights:

Consolidated revenues were up 13.8% over the prior year quarter to a record $260.8 million in the quarter;

Adjusted consolidated EBITDAR was $38.8 million, an increase of 10.4% over the prior year quarter;

Transitioning skilled revenue grew by 6.4% over the prior year quarter to $9.7 million in the quarter and transitioning occupancy was 71.3%, an increase of 103 basis points over the prior year quarter;

Same-store skilled revenue grew by 7.2% over the prior year quarter to $91.5 million in the quarter and same-store occupancy was 81.9%, an increase of 156 basis points over the prior year quarter; and

Cornerstone Healthcare, Inc., our home health and hospice subsidiary, grew its revenues by 45.6% over the prior year quarter to $14.1 million in the quarter.

Operating Results

Citing the marked improvements in the quarter in both same-store and transitioning skilled revenue and occupancy, Ensign's President and Chief Executive Officer Christopher Christensen said, "We are grateful that our operators have continued their relentless efforts to grow same store occupancy year over year, but our improvement in our transitioning facilities shows increasing strength in some of our transitions that were slower to turn." He added that "these results not only demonstrate the significant organic growth potential that exists in many of our operations but they also allow us to approach our anticipated acquisition growth from a position of greater strength."

Mr. Christensen also reported that operating results are running on schedule and that Management is reaffirming 2014 annual revenue guidance of $1.01 billion to $1.025 billion. "While third quarter results were solid, given our census-cyclical business and the timing of various reimbursement increases discussed last quarter, we expect many of the improvements to occur in the fourth quarter," he added.

Ensign's balance sheet further improved, with cash on hand of $39.2 million at the end of the third quarter and net cash from operations of $66.7 million through September 30, 2014. Adjusted EBITDAR grew by 10.4% over the prior year quarter t $38.8 million. Fully diluted GAAP earnings per share were $0.38 for the quarter and adjusted net income was $10.2 million or $0.44 per diluted share for the quarter.

A discussion of the company's use of non-GAAP financial measures is set forth below. A reconciliation of net income to adjusted EBITDAR and adjusted EBITDA, as well as a reconciliation of GAAP earnings per share and net income to adjusted net earnings per share and adjusted net income, appear in the financial data portion of this release.

More complete information is contained in the Company's 10-Q, which was filed with the SEC today and can be viewed on the Company's website at http://www.ensigngroup.net.

2014 and 2015 Guidance

Management affirmed 2014 revenue and earnings guidance, projecting revenue at $1.01 billion to $1.025 billion and net





income of $50.1 million to $51.2 million and $2.16 to $2.21 per diluted share for the year. The guidance is based on the impact of the separation of Ensign's healthcare business and certain real estate assets that was completed on June 1, 2014, which resulted in an increase in rent and diluted weighted average common shares, and a reduction in depreciation and interest expenses. The guidance also assumes, among other things, acquisitions closed through the end of the year, anticipated Medicare and Medicaid reimbursement rate increases net of provider taxes, and tax rates of 38.5%. It excludes acquisition-related costs and amortization costs related to intangible assets, acquired start-up losses at newly-created operations and transaction-related costs connected with the spin-off.

Management also updated its 2015 annual guidance, projecting revenues of $1.20 billion to $1.25 billion in revenues and net income of $58.1 million to $60.2 million and $2.44 to $2.53 per diluted share for 2015. Mr. Christensen noted that due to certain transactional delays in a few acquisitions, some of the acquisitions it anticipated to be closed by the end of 2014 are now expected to close early in 2015. The 2015 guidance is based on diluted weighted average common shares outstanding of 23.8 million and assumes, among other things, anticipated Medicare and Medicaid reimbursement rate increases net of provider taxes, tax rates of 38.5% and acquisitions anticipated to be closed by the end of the first quarter in 2015. It also excludes acquisition-related costs and amortization costs related to intangible assets acquired and start-up losses at newly created operations.

Quarter Highlights

Dividend Declared

During the quarter, the company's Board of Directors declared a quarterly cash dividend of $0.07 per share of Ensign common stock. Ensign has been a dividend-paying company since 2002 and has increased its dividend every year.

Acquisition Growth

During the quarter and since, the company acquired one skilled nursing operation, one assisted living and memory care operation, and one hospice agency and one home health agency. The following operations were added during the quarter:

In Washington, Beacon Hill Rehabilitation, a 67-bed skilled nursing operation in Longview;

In Colorado, Namaste Hospice located in Denver, adding to Ensign's subsidiary already operating a home health agency in that market;

In California, Angeles Home Health Care, a home health agency in Los Angeles, adding to Ensign's subsidiary already operating a hospice agency in that market; and

In Arizona, Sherwood Village Assisted Living and Memory Care, a 135-unit assisted living and operation in Tucson.

In the Seattle area, Ensign's urgent care subsidiary, Immediate Clinic Healthcare, Inc., also opened two new urgent care clinics.

These acquisitions brought Ensign's growing portfolio to 127 healthcare facilities, ten hospice companies, eleven home health agencies and fourteen urgent care clinics across 12 states.

During the quarter Ensign also announced that it has agreed to purchase nine skilled nursing and assisted living facilities, a home health agency and a private home care business from Shea Family Care, the largest provider of a complete continuum of post-acute healthcare services in the San Diego market. Ensign will purchase and retain the real estate in two of the nine operations and will assume long-term leases on the remaining facilities, one of which will include an option to purchase the real estate. The acquisition is expected to be effective in the fourth quarter of 2014 and remains subject to the completion of certain regulatory approvals and other closing conditions.

The closing of the Shea Family transaction will bring Ensign's growing portfolio to 136 healthcare facilities (eleven of which will be owned), ten hospice companies, twelve home health agencies, two home care businesses and fourteen urgent care clinics across 12 states. Management reaffirmed that Ensign is actively seeking additional opportunities to acquire real estate or to lease both well-performing and struggling skilled nursing, assisted living and other healthcare related businesses across the United States.






Conference Call

A live webcast will be held on Thursday, November 6, 2014 at 10:00 a.m. Pacific Time (1:00 p.m. Eastern) to discuss Ensign's third quarter financial results. To listen to the webcast, or to view any financial or statistical information required by SEC Regulation G, please visit the Investors section of the Ensign website at http://investor.ensigngroup.net. The webcast will be recorded, and will be available for replay via the website until 5:00 p.m. Pacific Time on Friday, November 28, 2014.

About Ensign

The Ensign Group, Inc.'s independent operating subsidiaries provide a broad spectrum of skilled nursing and assisted living services, physical, occupational and speech therapies, home health and hospice services, urgent care services and other rehabilitative and healthcare services at 127 facilities, ten hospice companies, eleven home health businesses and fourteen urgent care clinics in California, Arizona, Texas, Washington, Utah, Idaho, Colorado, Nevada, Iowa, Nebraska, Oregon and Wisconsin. Each of these operations is operated by a separate, independent operating subsidiary that has its own management, employees and assets. References herein to the consolidated "company" and "its" assets and activities, as well as the use of the terms "we," "us," "its" and similar verbiage, are not meant to imply that The Ensign Group, Inc. has direct operating assets, employees or revenue, or that any of the facilities, the home health and hospice businesses, the Service Center or the captive insurance subsidiary are operated by the same entity. More information about Ensign is available at http://www.ensigngroup.net.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995:

This press release contains, and the related conference call and webcast will include, forward-looking statements that are based on management's current expectations, assumptions and beliefs about its business, financial performance, operating results, the industry in which it operates and other future events. Forward-looking statements can often be identified by words such as "anticipates," "expects," "intends," "plans," "predicts," "believes," "seeks," "estimates," "may," "will," "should," "would," "could," "potential," "continue," "ongoing," similar expressions, and variations or negatives of these words. These forward-looking statements include, but are not limited to, statements regarding growth prospects, future operating and financial performance, and the entry into final settlement documents. They are not guarantees of future results and are subject to risks, uncertainties and assumptions that could cause actual results to materially and adversely differ from those expressed in any forward-looking statement.

These risks and uncertainties relate to the company's business, its industry and its common stock and include: reduced prices and reimbursement rates for its services; its ability to acquire, develop, manage or improve facilities, its ability to manage its increasing borrowing costs as it incurs additional indebtedness to fund the acquisition and development of facilities; its ability to access capital on a cost-effective basis to continue to successfully implement its growth strategy; its operating margins and profitability could suffer if it is unable to grow and manage effectively its increasing number of facilities; competition from other companies in the acquisition, development and operation of facilities; and the application of existing or proposed government regulations, or the adoption of new laws and regulations, that could limit its business operations, require it to incur significant expenditures or limit its ability to relocate its facilities if necessary. Readers should not place undue reliance on any forward-looking statements and are encouraged to review the company's periodic filings with the Securities and Exchange Commission, including its Form 10-Q, which was filed today, for a more complete discussion of the risks and other factors that could affect Ensign's business, prospects and any forward-looking statements. Except as required by the federal securities laws, Ensign does not undertake any obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events, changing circumstances or any other reason after the date of this press release.

Contact Information

Investor/Media Relations, The Ensign Group, Inc., (949) 487-9500, ir@ensigngroup.net.

SOURCE: The Ensign Group, Inc.






THE ENSIGN GROUP, INC.
GAAP and ADJUSTED CONDENSED CONSOLIDATED STATEMENT OF INCOME
(In thousands, except per share data)
 
Three Months Ended
September 30, 2014
 
Nine Months Ended
September 30, 2014
 
As Reported
 
Non-GAAP Adj.
 
As Adjusted
 
As Reported
 
Non-GAAP Adj.
 
As Adjusted
Revenue
$
260,841

 
(3,617
)
(4)(5) 
$
257,224

 
$
750,537

 
(10,094
)
(4)(5) 
$
740,443

Expense:
 
 
 
 
 
 
 
 
 
 
 
Cost of services (exclusive of facility rent, general and administrative and depreciation and amortization expense shown separately below)
209,737

 
(4,256
)
(1)(4)(5) 
205,481

 
601,532

 
(11,686
)
(1)(4)(5) 
589,846

Facility rent—cost of services
18,176

 
(410
)
(6) 
17,766

 
30,008

 
(1,539
)
(6) 
28,469

General and administrative expense
12,956

 
(31
)
(2)(3)(4) 
12,925

 
44,370

 
(9,035
)
(2)(3)(4) 
35,335

Depreciation and amortization
4,677

 
(380
)
(7) 
4,297

 
21,343

 
(895
)
(7) 
20,448

Total expenses
245,546

 
(5,077
)
 
240,469

 
697,253

 
(23,155
)
 
674,098

Income from operations
15,295

 
1,460

 
16,755

 
53,284

 
13,061

 
66,345

Other income (expense):
 
 
 
 
 
 
 
 
 
 
 
Interest expense
(407
)
 
46

 
(361
)
 
(12,490
)
 
6,471

 
(6,019
)
Interest income
142

 

 
142

 
435

 

 
435

Other expense, net
(265
)
 
46

 
(219
)
 
(12,055
)
 
6,471

 
(5,584
)
Income before provision for income taxes
15,030

 
1,506

 
16,536

 
41,229

 
19,532

 
60,761

Tax impact of non-GAAP adjustments
 
 
581

(8) 
 
 
 
 
7,520

(8) 
 
Tax true-up for effective tax rate
 
 
(872
)
(9) 
 
 
 
 
(2,410
)
(9) 
 
Provision for income taxes
6,659

 
(291
)
 
6,368

 
18,284

 
5,110

 
23,394

Net income
8,371

 
1,797

 
10,168

 
22,945

 
14,422

 
37,367

Less: net (loss) income attributable to noncontrolling interests
(535
)
 
523

 
(12
)
 
(1,494
)
 
1,563

 
69

Net income attributable to The Ensign Group, Inc.
$
8,906

 
$
1,274

 
$
10,180

 
$
24,439

 
$
12,859

 
$
37,298

Attributable to The Ensign Group, Inc.
 
 
 
 
 
 
 
 
 
 
 
Net income attributable to The Ensign Group, Inc.
8,906

 
1,274

 
10,180

 
24,439

 
12,859

 
37,298

Loss from discontinued operations, net of income tax benefit

 

 

 

 

 

Income from continuing operations attributable to The Ensign Group, Inc.
$
8,906

 
$
1,274

 
$
10,180

 
$
24,439

 
$
12,859

 
$
37,298

Net income per share
 
 
 
 
 
 
 
 
 
 
 
Basic:
 
 
 
 
 
 
 
 
 
 
 
Net income attributable to The Ensign Group, Inc.
0.40

 
 
 
0.45

 
1.10

 
 
 
1.67

Loss from discontinued operations, net of income tax benefit

 
 
 

 

 
 
 

Income from continuing operations attributable to The Ensign Group, Inc.
$
0.40

 
 
 
$
0.45

 
$
1.10

 
 
 
$
1.67

Diluted:
 
 
 
 
 
 
 
 
 
 
 
Net income attributable to The Ensign Group, Inc.
0.38

 
 
 
0.44

 
1.06

 
 
 
1.62

Loss from discontinued operations, net of income tax benefit

 
 
 

 

 
 
 

Income from continuing operations attributable to The Ensign Group, Inc.
$
0.38

 
 
 
$
0.44

 
$
1.06

 
 
 
$
1.62

Weighted average common shares outstanding:
 
 
 
 
 
 
 
 
 
 
 
Basic
22,415

 
 
 
22,415

 
22,282

 
 
 
22,282

Diluted
23,186

 
 
 
23,186

 
23,014

 
 
 
23,014

 
 
 
 
 
 
 
 
 
 
 
 
(1) Represents acquisition-related costs of $85 and $219 for the three and nine months ended September 30, 2014, respectively.
(2) Represents costs of $31 and $93 for the three and nine months ended September 30, 2014, respectively, incurred to recognize income tax credits.
(3) Represents costs of $8,871 for the nine months ended September 30, 2014, incurred related to the Company's spin-off of real estate assets to CareTrust REIT (CTRE) (the Spin-Off). As the Spin-Off was completed in the second quarter of 2014, there was no costs associated with the Spin-Off for the three months ended September 30, 2014.
(4) Represents revenues and expenses incurred at the three independent living operations transferred to CTRE on June 1, 2014 in connection with the Spin Off,





excluding rent expense recognized in note (6) below.
(5) Represents revenues and expenses incurred at newly opened urgent care centers, excluding rent expense recognized in note (6) below and depreciation expense recognized in note (7) below.
(6) Represents straight-line rent amortization for newly opened urgent care centers and the three independent living operations transferred to CTRE included in Note (4).
(7) Represents depreciation expense at newly opened urgent care centers and amortization costs related to patient base intangible assets at skilled nursing and assisted living facilities.
(8) Represents the tax impact of non-GAAP adjustments noted in (1) - (7) at the Company's year to date effective tax rate of 38.5% for the three and nine months ended September 30, 2014.
(9) Represents an adjustment to the provision for income taxes to our current year to date effective rate to 38.5% for the three and nine months ended September 30, 2014.





THE ENSIGN GROUP, INC.
GAAP and ADJUSTED CONDENSED CONSOLIDATED STATEMENT OF INCOME
(In thousands, except per share data)
 
Three Months Ended
September 30, 2013
 
Nine Months Ended
September 30, 2013
 
As Reported
 
Non-GAAP Adj.
 
As Adjusted
 
As Reported
 
Non-GAAP Adj.
 
As Adjusted
Revenue
$
229,261

 
(1,265
)
(8) 
$
227,996

 
$
667,548

 
(4,164
)
(8)(9) 
$
663,384

Expense:
 
 
 
 
 
 
 
 
 
 
 
Cost of services (exclusive of facility rent, general and administrative and depreciation and amortization expense shown separately below)
186,172

 
(2,341
)
(1)(2)(3)(9) 
183,831

 
538,146

 
(8,757
)
(1)(2)(3)(9)(10) 
529,389

Charges related to U.S. Government inquiries

 

(4) 

 
33,000

 
(33,000
)
(4) 

Facility rent—cost of services
3,404

 
(180
)
(6) 
3,224

 
10,056

 
(688
)
(5)(6) 
9,368

General and administrative expense
10,601

 
(1,746
)
(7)(8) 
8,855

 
28,321

 
(2,968
)
(7)(8) 
25,353

Depreciation and amortization
8,795

 
(364
)
(11) 
8,431

 
25,198

 
(1,176
)
(11)(12) 
24,022

Total expenses
208,972

 
(4,631
)
 
204,341

 
634,721

 
(46,589
)
 
588,132

Income from operations
20,289

 
3,366

 
23,655

 
32,827

 
42,425

 
75,252

Other income (expense):
 
 
 
 
 
 
 
 
 
 
 
Interest expense
(3,181
)
 
 
 
(3,181
)
 
(9,441
)
 
 
 
(9,441
)
Interest income
141

 
 
 
141

 
363

 
 
 
363

Other expense, net
(3,040
)
 

 
(3,040
)
 
(9,078
)
 

 
(9,078
)
Income before provision for income taxes
17,249

 
3,366

 
20,615

 
23,749

 
42,425

 
66,174

Tax impact of non-GAAP adjustments
 
 
1,296

(13) 

 
 
 
16,334

(13) 

Tax true-up for effective tax rate
 
 
34

(14) 

 
 
 
(2,297
)
(14) 

Provision for income taxes
6,607

 
1,330

 
7,937

 
11,440

 
14,037

 
25,477

Income from continuing operations
10,642

 
2,036

 
12,678

 
12,309

 
28,388

 
40,697

Loss from discontinued operations, net of income tax benefit
(30
)
 
 
 
(30
)
 
(1,804
)
 
 
 
(1,804
)
Net income
10,612

 
2,036

 
12,648

 
10,505

 
28,388

 
38,893

Less: net income (loss) attributable to noncontrolling interests
148

 
 
 
148

 
(179
)
 
 
 
(179
)
Net income attributable to The Ensign Group, Inc.
$
10,464

 
$
2,036

 
$
12,500

 
$
10,684

 
$
28,388

 
$
39,072

Attributable to The Ensign Group, Inc.
 
 
 
 
 
 
 
 
 
 
 
Net income attributable to The Ensign Group, Inc.
10,464

 
2,036

 
12,500

 
10,684

 
28,388

 
39,072

Loss from discontinued operations, net of income tax benefit
(30
)
 

 
(30
)
 
(1,804
)
 

 
(1,804
)
Income from continuing operations attributable to The Ensign Group, Inc.
$
10,494

 
$
2,036

 
$
12,530

 
$
12,488

 
$
28,388

 
$
40,876

Net income per share
 
 
 
 
 
 
 
 
 
 
 
Basic:
 
 
 
 
 
 
 
 
 
 
 
Net income attributable to The Ensign Group, Inc.
0.48

 
 
 
0.57

 
0.49

 
 
 
1.79

Loss from discontinued operations, net of income tax benefit

 
 
 

 
(0.08
)
 
 
 
(0.08
)
Income from continuing operations attributable to The Ensign Group, Inc.
$
0.48

 
 
 
$
0.57

 
$
0.57

 
 
 
$
1.87

Diluted:
 
 
 
 
 
 
 
 
 
 
 
Net income attributable to The Ensign Group, Inc.
0.47

 
 
 
0.56

 
0.48

 
 
 
1.75

Loss from discontinued operations, net of income tax benefit

 
 
 

 
(0.08
)
 
 
 
(0.08
)
Income from continuing operations attributable to The Ensign Group, Inc.
$
0.47

 
 
 
$
0.56

 
$
0.56

 
 
 
$
1.83

Weighted average common shares outstanding:
 
 
 
 
 
 
 
 
 
 
 
Basic
21,941

 
 
 
21,941

 
21,857

 
 
 
21,857

Diluted
22,409

 
 
 
22,409

 
22,316

 
 
 
22,316

 
 
 
 
 
 
 
 
 
 
 
 
(1) Represents acquisition-related costs of $38 and $264 for the three and nine months ended September 30, 2013.
(2) Represents costs of $19 and $103 for the three and nine months ended September 30, 2013, incurred to recognize income tax credits.





(3) Represents additional costs incurred related to a class action lawsuit settlement of $915 and $1,524 for the three and nine months ended September 30, 2013.
(4) Represents the Company's U.S. Department of Justice (DOJ) inquiry settlement reserve recorded in the first quarter of 2013.
(5) Represents straight-line rent amortization for the first six months of 2013 for one newly constructed facility which began operations during the first quarter of 2013. This facility began operating at full capacity during the third quarter and therefore, third quarter results were not included in the three or nine month periods above.
(6) Represents straight-line rent amortization for newly opened urgent care centers.
(7) Represents legal costs incurred in connection with the ongoing investigation into the billing and reimbursement processes of some of our subsidiaries being conducted by the DOJ.
(8) Represents expenses incurred in connection with the Company's proposed spin-off of its real estate assets to a newly formed publicly traded real estate investment trust (REIT).
(9) Represents revenues and expenses incurred at newly opened urgent care centers, less rent expense recognized in note (6) above and depreciation expense recognized in note (11) below.
(10) Represents revenues and expenses for the first six months of 2013 incurred at one newly constructed facility which began operations during the first quarter of 2013, less rent expense recognized in note (5) above and depreciation expense recognized in Note (12) below. This facility began operating at full capacity during the third quarter and therefore, third quarter results were not included in the three or nine month periods above.
(11) Represents depreciation expense at newly opened urgent care centers and amortization costs related to patient base intangible assets at skilled nursing and assisted living facilities acquired. Patient base intangible assets are amortized over a period of four to eight months, depending on the classification of the patients and the level of occupancy in a new acquisition on the acquisition date.
(12) Represents depreciation expense for the first six months of 2013 at one newly constructed facility which began operations during the first quarter of 2013. This facility began operating at full capacity during the third quarter and therefore, third quarter results were not included in the three or nine month periods above.
(13) Represents the tax impact of non-GAAP adjustments noted in (1) —(12) at the Company's year to date effective tax rate of 38.5% for the three and nine months ended September 30, 2013.
(14) Represents an adjustment to the provision for income taxes to our current year to date effective rate to 38.5% for the three and nine months ended September 30, 2013.






THE ENSIGN GROUP, INC.
RECONCILIATION OF NET (LOSS) INCOME TO EBITDA, EBITDAR, ADJUSTED EBITDA AND
ADJUSTED EBITDAR
(in thousands)
(Unaudited)
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2014
 
2013
 
2014
 
2013
Consolidated Statements of Income Data:
 
 
 
 
 
 
 
Net income
$
8,371

 
$
10,612

 
$
22,945

 
$
10,505

Less: net (loss) income attributable to noncontrolling interests
(535
)
 
148

 
(1,494
)
 
(179
)
Loss from discontinued operations

 
30

 

 
1,804

Interest expense, net
265

 
3,040

 
12,055

 
9,078

Provision for income taxes
6,659

 
6,607

 
18,284

 
11,440

Depreciation and amortization
4,677

 
8,795

 
21,343

 
25,198

EBITDA
$
20,507

 
$
28,936

 
$
76,121

 
$
58,204

Facility rent—cost of services
18,176

 
3,404

 
30,008

 
10,056

EBITDAR
$
38,683

 
$
32,340

 
$
106,129

 
$
68,260

 
 
 
 
 
EBITDA
$
20,507

 
$
28,936

 
$
76,121

 
$
58,204

Adjustments to EBITDA:
 
 
 
 
 
 
 
Charge related to the U.S. Government inquiry(a)

 

 

 
33,000

Expenses related to the Spin-Off(b)

 
1,648

 
8,871

 
1,857

Legal costs(c)

 
98

 

 
1,111

Settlement of class action lawsuit(d)

 
915

 

 
1,524

Urgent care center (earnings) losses(e)
31

 
105

 
3

 
1,447

Earnings at three operations transferred to REIT(f)

 

 
(122
)
 

Loss at skilled nursing facility not at full operation(g)

 

 

 
1,256

Acquisition related costs(h)
85

 
38

 
219

 
264

Costs incurred to recognize income tax credits(i)
31

 
19

 
93

 
103

Rent related to items (e), (f) and (g) above (j)
410

 
180

 
1,539

 
687

Adjusted EBITDA
$
21,064

 
$
31,939

 
$
86,724

 
$
99,453

Facility rent—cost of services
18,176

 
3,404

 
30,008

 
10,056

Less: rent related to items (e), (f) and (g) above (j)
(410
)
 
(180
)
 
(1,539
)
 
(687
)
Adjusted EBITDAR
$
38,830

 
$
35,163

 
$
115,193

 
$
108,822

 
 
 
 
 
 
 
 
(a) Charges related to our resolution of any claims connected to the DOJ settlement.
(b) Expenses incurred in connection with the Company's spin-off of its real estate assets to a newly formed publicly traded real estate investment trust (REIT).
(c) Legal costs incurred in connection with the settlement of the investigation into the billing and reimbursement processes of some of our subsidiaries conducted by the DOJ.
(d) Settlement of a class action lawsuit regarding minimum staffing requirements in the State of California.
(e) Results at newly opened urgent care centers, excluding rent, depreciation, interest and income taxes.
(f) Results at three independent living facilities which were transferred to CareTrust REIT as part of the Spin-Off transaction, excluding rent, depreciation, interest and income taxes.
(g) Losses incurred through the second quarter of 2013 at one newly constructed skilled nursing facility which began operations during the first quarter of 2013, excluding rent, depreciation, interest and income taxes.
(h) Costs incurred to acquire an operation which are not capitalizable.
(i) Costs incurred to recognize income tax credits which contributed to a decrease in effective tax rate.
(j) Rent related to newly opened urgent care centers, one newly constructed skilled nursing facility which began operations during the first quarter of 2013, and the three independent living facilities which were transferred to CareTrust REIT as part of the Spin-Off transaction, not included in items (e), (f) and (g) above.






THE ENSIGN GROUP, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands)
 
September 30,
 
December 31,
 
2014
 
2013
Assets
 
 
 
Current assets:
 
 
 
Cash and cash equivalents
39,206

 
65,755

Restricted cash — current
6,652

 

Accounts receivable — less allowance for doubtful accounts of $19,452 and $16,540 at September 30, 2014 and December 31, 2013, respectively
120,647

 
111,370

Investments — current
5,883

 
5,511

Prepaid income taxes
5,078

 
9,915

Prepaid expenses and other current assets
8,432

 
9,213

Deferred tax asset — current
8,033

 
9,232

Total current assets
193,931

 
210,996

Property and equipment, net
127,448

 
479,770

Insurance subsidiary deposits and investments
18,170

 
16,888

Escrow deposits
600

 
1,000

Deferred tax asset
11,493

 
4,464

Restricted and other assets
8,449

 
9,804

Intangible assets, net
6,560

 
5,718

Goodwill
25,719

 
23,935

Other indefinite-lived intangibles
10,509

 
7,740

Total assets
$
402,879

 
$
760,315

 
 
 
 
Liabilities and equity
 
 
 
Current liabilities:
 
 
 
Accounts payable
27,783

 
23,793

Accrued wages and related liabilities
48,159

 
40,093

Accrued self-insurance liabilities — current
15,642

 
15,461

Other accrued liabilities
26,751

 
25,698

Current maturities of long-term debt
110

 
7,411

Total current liabilities
118,445

 
112,456

Long-term debt — less current maturities
3,307

 
251,895

Accrued self-insurance liabilities — less current portion
33,658

 
33,642

Fair value of interest rate swap

 
1,828

Deferred rent and other long-term liabilities
3,151

 
3,237

Total equity
244,318

 
357,257

Total liabilities and equity
$
402,879

 
$
760,315








THE ENSIGN GROUP, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)

The following table presents selected data from our consolidated statements of cash flows for the periods presented:
 
Nine Months Ended
September 30,
 
2014
 
2013
Net cash provided by operating activities
$
66,687

 
$
57,110

Net cash used in investing activities
(99,407
)
 
(57,046
)
Net cash provided by financing activities
6,171

 
5,248

Net (decrease) increase in cash and cash equivalents
(26,549
)
 
5,312

Cash and cash equivalents at beginning of period
65,755

 
40,685

Cash and cash equivalents at end of period
$
39,206

 
$
45,997








THE ENSIGN GROUP, INC.
SELECT PERFORMANCE INDICATORS
(Unaudited)

The following tables summarize our selected performance indicators, along with other statistics, for each of the dates or periods indicated:
 
Three Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Total Facility Results:
 
 
 
 
 
 
 
Revenue
$
260,841

 
$
229,261

 
$
31,580

 
13.8
%
Number of facilities at period end
127

 
119

 
8

 
6.7
%
Actual patient days
994,995

 
940,054

 
54,941

 
5.8
%
Occupancy percentage — Operational beds
77.7
%
 
77.4
%
 
 
 
0.3
%
Skilled mix by nursing days
27.1
%
 
26.0
%
 
 
 
1.1
%
Skilled mix by nursing revenue
50.2
%
 
49.7
%
 
 
 
0.5
%
 
Three Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Same Facility Results(1):
 
 
 
 
 
 
 
Revenue
$
189,230

 
$
178,797

 
$
10,433

 
5.8
%
Number of facilities at period end
82

 
82

 

 
%
Actual patient days
713,682

 
701,049

 
12,633

 
1.8
%
Occupancy percentage — Operational beds
81.9
%
 
80.3
%
 
 
 
1.6
%
Skilled mix by nursing days
28.7
%
 
27.4
%
 
 
 
1.3
%
Skilled mix by nursing revenue
51.8
%
 
51.3
%
 
 
 
0.5
%
 
Three Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Transitioning Facility Results(2):
 
 
 
 
 
 
 
Revenue
$
36,333

 
$
33,141

 
$
3,192

 
9.6
%
Number of facilities at period end
25

 
25

 

 
%
Actual patient days
160,025

 
157,705

 
2,320

 
1.5
%
Occupancy percentage — Operational beds
71.3
%
 
70.3
%
 
 
 
1.0
%
Skilled mix by nursing days
19.6
%
 
19.2
%
 
 
 
0.4
%
Skilled mix by nursing revenue
41.4
%
 
39.8
%
 
 
 
1.6
%
 
Three Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Recently Acquired Facility Results(3):
 
 
 
 
 
 
 
Revenue
$
35,278

 
$
16,504

 
$
18,774

 
NM
Number of facilities at period end
20

 
11

 
9

 
NM
Actual patient days
121,288

 
63,072

 
58,216

 
NM
Occupancy percentage — Operational beds
65.9
%
 
67.5
%
 
 
 
NM
Skilled mix by nursing days
24.1
%
 
20.8
%
 
 
 
NM
Skilled mix by nursing revenue
45.9
%
 
45.8
%
 
 
 
NM





 
Three Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Transferred to CareTrust(4):
 
 
 
 
 
 
 
Revenue
$

 
$
819

 
$
(819
)
 
NM
Actual patient days

 
18,228

 
(18,228
)
 
NM
Occupancy percentage — Operational beds


 
75
%
 


 
NM
___________________
(1)
Same Facility results represent all facilities purchased prior to January 1, 2011.
(2)
Transitioning Facility results represents all facilities purchased from January 1, 2011 to December 31, 2012.
(3)
Recently Acquired Facility (or “Acquisitions”) results represent all facilities purchased on or subsequent to January 1, 2013.
(4)
Transferred to CareTrust results represent the results at three independent living facilities which were transferred to CareTrust REIT as part of the Spin-Off transaction on June 1, 2014. These results were excluded from Same Facility and Transitioning Facility for the three months ended September 30, 2013 for comparison purposes.


 
Nine Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Total Facility Results:
 
 
 
 
 
 
 
Revenue
$
750,537

 
$
667,548

 
$
82,989

 
12.4
%
Number of facilities at period end
127

 
119

 
8

 
6.7
%
Actual patient days
2,895,265

 
2,701,513

 
193,752

 
7.2
%
Occupancy percentage — Operational beds
77.9
%
 
77.3
%
 
 
 
0.6
%
Skilled mix by nursing days
27.6
%
 
26.6
%
 
 
 
1.0
%
Skilled mix by nursing revenue
50.9
%
 
50.4
%
 
 
 
0.5
%
 
Nine Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Same Facility Results(1):
 
 
 
 
 
 
 
Revenue
$
563,303

 
$
535,278

 
$
28,025

 
5.2
%
Number of facilities at period end
82

 
82

 

 
%
Actual patient days
2,115,181

 
2,078,207

 
36,974

 
1.8
%
Occupancy percentage — Operational beds
81.8
%
 
80.2
%
 
 
 
1.6
%
Skilled mix by nursing days
29.3
%
 
28.0
%
 
 
 
1.3
%
Skilled mix by nursing revenue
52.5
%
 
51.8
%
 
 
 
0.7
%
 
Nine Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Transitioning Facility Results(2):
 
 
 
 
 
 
 
Revenue
$
104,933

 
$
96,249

 
$
8,684

 
9.0
%
Number of facilities at period end
25

 
25

 

 
%
Actual patient days
473,841

 
460,949

 
12,892

 
2.8
%
Occupancy percentage — Operational beds
71.2
%
 
69.3
%
 
 
 
1.9
%
Skilled mix by nursing days
19.9
%
 
19.8
%
 
 
 
0.1
%
Skilled mix by nursing revenue
41.4
%
 
40.7
%
 
 
 
0.7
%





 
Nine Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Recently Acquired Facility Results(3):
 
 
 
 
 
 
 
Revenue
$
81,053

 
$
33,390

 
$
47,663

 
NM
Number of facilities at period end
20

 
11

 
9

 
NM
Actual patient days
278,227

 
107,210

 
171,017

 
NM
Occupancy percentage — Operational beds
65.6
%
 
64.4
%
 
 
 
NM
Skilled mix by nursing days
23.2
%
 
19.9
%
 
 
 
NM
Skilled mix by nursing revenue
46.2
%
 
46.4
%
 
 
 
NM
 
Nine Months Ended
September 30,
 
 
 
 
 
2014
 
2013
 
 
 
 
 
(Dollars in thousands)
 
Change
 
% Change
Transferred to CareTrust(4):
 
 
 
 
 
 
 
Revenue
$
1,248

 
$
2,631

 
$
(1,383
)
 
NM
Actual patient days
28,016

 
55,147

 
(27,131
)
 
NM
Occupancy percentage — Operational beds

70.3
%
 
76.5
%
 


 
NM

_______________________
(1)
Same Facility results represent all facilities purchased prior to January 1, 2011.
(2)
Transitioning Facility results represents all facilities purchased from January 1, 2011 to December 31, 2012.
(3)
Recently Acquired Facility (or “Acquisitions”) results represent all facilities purchased on or subsequent to January 1, 2013.
(4)
Transferred to CareTrust results represent the results at three independent living facilities which were transferred to CareTrust REIT as part of the Spin-Off transaction on June 1, 2014. The five months results of the three independent living facilities were excluded from Same Facility and Transitioning Facility for the nine months ended September 30, 2014 for comparison purposes. The nine months results of the three independent living facilities were excluded from Same Facility and Transitioning Facility for the nine months ended September 30 2013 for comparison purposes.






THE ENSIGN GROUP, INC.
SKILLED NURSING AVERAGE DAILY REVENUE RATES AND
PERCENT OF SKILLED NURSING REVENUE AND DAYS BY PAYOR

The following table reflects the change in skilled nursing average daily revenue rates by payor source, excluding services that are not covered by the daily rate:
 
Three Months Ended
September 30,
 
Same Facility
 
Transitioning
 
Acquisitions
 
Total
 
%
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
Change
Skilled Nursing Average Daily Revenue Rates:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
$
560.92

 
$
550.66

 
$
484.03

 
$
467.35

 
$
512.84

 
$
475.17

 
$
546.67

 
$
535.03

 
2.2
 %
Managed care
412.44

 
403.44

 
417.71

 
383.64

 
465.20

 
468.39

 
418.22

 
406.35

 
2.9
 %
Other skilled
446.54

 
467.02

 
834.01

 
690.75

 
316.85

 

 
436.48

 
471.27

 
(7.4
)%
Total skilled revenue
489.91

 
487.50

 
478.48

 
458.82

 
459.08

 
472.20

 
485.93

 
484.01

 
0.4
 %
Medicaid
181.89

 
173.47

 
162.31

 
164.02

 
168.06

 
145.78

 
178.30

 
170.81

 
4.4
 %
Private and other payors
191.81

 
187.04

 
170.35

 
167.05

 
187.45

 
150.75

 
185.52

 
178.62

 
3.9
 %
Total skilled nursing revenue
$
271.41

 
$
261.26

 
$
226.54

 
$
221.60

 
$
241.15

 
$
214.51

 
$
262.64

 
$
253.35

 
3.7
 %


 
Nine Months Ended
September 30,
 
Same Facility
 
Transitioning
 
Acquisitions
 
Total
 
%
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
Change
Skilled Nursing Average Daily Revenue Rates:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
$
561.42

 
$
557.23

 
$
476.04

 
$
467.66

 
$
504.91

 
$
490.67

 
$
546.34

 
$
541.89

 
0.8
 %
Managed care
411.33

 
396.02

 
411.71

 
390.30

 
462.66

 
465.71

 
415.80

 
397.77

 
4.5
 %
Other skilled
439.24

 
465.01

 
806.09

 
686.13

 
311.85

 

 
437.26

 
468.85

 
(6.7
)%
Total skilled revenue
490.55

 
489.22

 
472.14

 
460.87

 
463.57

 
481.76

 
486.96

 
486.20

 
0.2
 %
Medicaid
181.62

 
174.96

 
161.40

 
163.32

 
159.70

 
136.42

 
177.50

 
172.24

 
3.1
 %
Private and other payors
192.36

 
186.92

 
172.08

 
167.62

 
178.34

 
147.77

 
185.33

 
179.35

 
3.3
 %
Total skilled nursing revenue
$
273.09

 
$
264.16

 
$
226.12

 
$
223.28

 
$
233.19

 
$
207.52

 
$
263.80

 
$
256.68

 
2.8
 %























The following tables set forth our percentage of skilled nursing patient revenue and days by payor source for the three months ended September 30, 2014 and 2013:
 
Three Months Ended
September 30,
 
Same Facility
 
Transitioning
 
Acquisitions
 
Total
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
Percentage of Skilled Nursing Revenue:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
28.9
%
 
30.2
%
 
31.9
%
 
33.5
%
 
22.5
%
 
25.9
%
 
28.6
%
 
30.4
%
Managed care
15.8

 
15.5

 
7.7

 
5.1

 
17.6

 
19.9

 
15.1

 
14.5

Other skilled
7.1

 
5.6

 
1.8

 
1.2

 
5.8

 

 
6.5

 
4.8

Skilled mix
51.8

 
51.3

 
41.4

 
39.8

 
45.9

 
45.8

 
50.2

 
49.7

Private and other payors
7.4

 
7.9

 
21.5

 
22.2

 
11.8

 
13.2

 
9.3

 
9.8

Quality mix
59.2

 
59.2

 
62.9

 
62.0

 
57.7

 
59.0

 
59.5

 
59.5

Medicaid
40.8

 
40.8

 
37.1

 
38.0

 
42.3

 
41.0

 
40.5

 
40.5

Total skilled nursing
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
Three Months Ended
September 30,
 
Same Facility
 
Transitioning
 
Acquisitions
 
Total
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
Percentage of Skilled Nursing Days:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
14.0
%
 
14.3
%
 
14.9
%
 
15.9
%
 
10.6
%
 
11.7
%
 
13.7
%
 
14.4
%
Managed care
10.4

 
10.0

 
4.2

 
3.0

 
9.2

 
9.1

 
9.5

 
9.0

Other skilled
4.3

 
3.1

 
0.5

 
0.3

 
4.3

 

 
3.9

 
2.6

Skilled mix
28.7

 
27.4

 
19.6

 
19.2

 
24.1

 
20.8

 
27.1

 
26.0

Private and other payors
10.4

 
11.1

 
28.7

 
29.6

 
15.2

 
18.7

 
13.2

 
13.9

Quality mix
39.1

 
38.5

 
48.3

 
48.8

 
39.3

 
39.5

 
40.3

 
39.9

Medicaid
60.9

 
61.5

 
51.7

 
51.2

 
60.7

 
60.5

 
59.7

 
60.1

Total skilled nursing
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%




























The following tables set forth our percentage of skilled nursing patient revenue and days by payor source for the nine months ended September 30, 2014 and 2013:
 
Nine Months Ended
September 30,
 
Same Facility
 
Transitioning
 
Acquisitions
 
Total
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
Percentage of Skilled Nursing Revenue:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
30.2
%
 
31.3
%
 
32.7
%
 
35.0
%
 
22.9
%
 
30.3
%
 
29.9
%
 
31.7
%
Managed care
15.7

 
15.1

 
6.9

 
4.7

 
19.5

 
16.1

 
15.1

 
13.9

Other skilled
6.6

 
5.4

 
1.8

 
1.0

 
3.8

 

 
5.9

 
4.8

Skilled mix
52.5

 
51.8

 
41.4

 
40.7

 
46.2

 
46.4

 
50.9

 
50.4

Private and other payors
7.3

 
7.6

 
22.0

 
21.9

 
11.8

 
13.9

 
9.2

 
9.4

Quality mix
59.8

 
59.4

 
63.4

 
62.6

 
58.0

 
60.3

 
60.1

 
59.8

Medicaid
40.2

 
40.6

 
36.6

 
37.4

 
42.0

 
39.7

 
39.9

 
40.2

Total skilled nursing
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
Nine Months Ended
September 30,
 
Same Facility
 
Transitioning
 
Acquisitions
 
Total
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
 
2014
 
2013
Percentage of Skilled Nursing Days:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
14.7
%
 
14.9
%
 
15.6
%
 
16.7
%
 
10.6
%
 
12.8
%
 
14.4
%
 
15.0
%
Managed care
10.5

 
10.0

 
3.8

 
2.7

 
9.8

 
7.1

 
9.6

 
9.0

Other skilled
4.1

 
3.1

 
0.5

 
0.4

 
2.8

 

 
3.6

 
2.6

Skilled mix
29.3

 
28.0

 
19.9

 
19.8

 
23.2

 
19.9

 
27.6

 
26.6

Private and other payors
10.3

 
10.8

 
28.8

 
29.1

 
15.5

 
19.8

 
13.0

 
13.5

Quality mix
39.6

 
38.8

 
48.7

 
48.9

 
38.7

 
39.7

 
40.6

 
40.1

Medicaid
60.4

 
61.2

 
51.3

 
51.1

 
61.3

 
60.3

 
59.4

 
59.9

Total skilled nursing
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%
 
100.0
%






THE ENSIGN GROUP, INC.
REVENUE BY PAYOR SOURCE

The following table sets forth our total revenue by payor source and as a percentage of total revenue for the periods indicated:
 
 
 
 
Three Months Ended September 30,
 
 
 
 
 
Nine Months Ended September 30,
 
 
 
 
2014
 
2013
 
2014
 
2013
 
 
$
 
%
 
$
 
%
 
$
 
%
 
$
 
%
 
 
(Dollars in thousands)
 
(Dollars in thousands)
Revenue:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicaid
 
$
91,707

 
35.2
%
 
$
81,802

 
35.7
%
 
$
260,986

 
34.8
%
 
237,301

 
35.5
%
Medicare
 
78,056

 
29.9

 
72,138

 
31.5

 
231,860

 
30.9

 
218,214

 
32.7

Medicaid-skilled
 
13,614

 
5.2

 
9,204

 
4.0

 
36,575

 
4.9

 
26,616

 
4.0

Total
 
183,377

 
70.3

 
163,144

 
71.2

 
529,421

 
70.6

 
482,131

 
72.2

Managed Care
 
36,562

 
14.0

 
30,886

 
13.5

 
105,316

 
14.0

 
87,446

 
13.1

Private and Other(1)
 
40,902

 
15.7

 
35,231

 
15.3

 
115,800

 
15.4

 
97,971

 
14.7

Total revenue
 
$
260,841

 
100.0
%
 
$
229,261

 
100.0
%
 
$
750,537

 
100.0
%
 
$
667,548

 
100.0
%
(1) Private and other payors includes revenue from urgent care centers and other ancillary businesses.

Discussion of Non-GAAP Financial Measures

EBITDA consists of net income (loss) from continuing operations, adjusted for net losses attributable to noncontrolling interests, before (a) interest expense, net, (b) provisions for income taxes, and (c) depreciation and amortization. EBITDAR consists of EBITDA adjusted to exclude facility rent-cost of services. Adjusted EBITDA and EBITDAR are EBITDA and EBITDAR adjusted for non-core business items. The Company believes that the presentation of EBITDA, EBITDAR, adjusted EBITDA, adjusted EBITDAR, adjusted net income and adjusted earnings per share provides important supplemental information to management and investors to evaluate the Company's operating performance. The Company believes disclosure of adjusted net income per share, EBITDA, EBITDAR, adjusted EBITDA and adjusted EBITDAR has economic substance because the excluded revenues and expenses are infrequent in nature and are variable in nature, or do not represent current revenues or cash expenditures. A material limitation associated with the use of these measures as compared to the GAAP measures of net income and diluted earnings per share is that they may not be comparable with the calculation of net income and diluted earnings per share for other companies in the Company's industry. These non-GAAP financial measures should not be relied upon to the exclusion of GAAP financial measures. For further information regarding why the Company believes that this non-GAAP measure provides useful information to investors, the specific manner in which management uses this measure, and some of the limitations associated with the use of this measure, please refer to the Company's Report on Form 10-Q filed today with the SEC. The Form 10-Q is available on the SEC's website at www.sec.gov or under the "Financial Information" link of the Investor Relations section on Ensign's website at http://www.ensigngroup.net.