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8-K - FORM 8-K - ENSIGN GROUP, INCd867687d8k.htm

Exhibit 99.1

 

 

LOGO

The Ensign Group Reports Adjusted Annual Earnings of $2.18 per Share; Reaffirms 2015 Guidance

Conference Call and Webcast Scheduled for today, February 9, 2015 at 10:00 am ET

MISSION VIEJO, California – February 9, 2015 – The Ensign Group, Inc. (Nasdaq: ENSG), the parent company of the Ensign™ group of skilled nursing, rehabilitative care services, home health, home care, hospice care, assisted living and urgent care companies, today reported operating results for the fourth quarter and full year 2014.

Quarter and Fiscal Year Highlights Include:

 

    Adjusted annual earnings per share was $2.18, at the midpoint of Management’s annual guidance of between $2.16 and $2.21 per share;

 

    Consolidated revenues were up 16.8% over the prior year quarter to a record $276.9 million in the quarter;

 

    Adjusted consolidated EBITDAR was $44.0 million, an increase of 8.5% over the prior year quarter;

 

    Transitioning skilled mix days grew by 118 basis points over the prior year quarter to 19.8% for the quarter and transitioning occupancy was 71.8%, an increase of 121 basis points over the prior year quarter;

 

    Same-store skilled mix days grew by 179 basis points over the prior year quarter to 29.3% for the quarter and same-store occupancy was 82.3%, an increase of 137 basis points over the prior year quarter; and

 

    Cornerstone Healthcare, Inc., our home health and hospice subsidiary, grew its Adjusted EBITDA by 97.8% over the prior year to $10.2 million.

Operating Results

“We are proud to report that we saw improvements across our same store, transitioning and newly acquired buckets, all during a historic year in which we completed a significant spin-off of CareTrust REIT, Inc. and experienced one of our most active acquisition years ever,” said Ensign’s President and Chief Executive Officer Christopher Christensen. He lauded the local operational leadership teams and all of their field-based and Service Center partners for continuing their relentless focus on clinical and financial performance while also supporting the transition of the newly acquired operations in several markets. “This year has been another true test of our flexibility, responsiveness and resilience and even though there were some pockets that need improvement, overall the strength inherent in Ensign’s business model shone through, demonstrating the scalability of Ensign’s unique approach to growth,” he added.

 

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“We are also pleased to report that operating results met annual earnings guidance, with adjusted earnings per share of $2.18 for the year,” Mr. Christensen added. He noted further that the adjusted earnings results were at the midpoint of Management’s guidance.

In the fourth quarter of 2014, Ensign realigned its operating segments to include a transitional, skilled and assisted living services segment, a home health, home care and hospice segment, and an “all other” segment. Mr. Christensen indicated that “we are anxious to share more detail on the performance of these expanding operations and believe that this additional disclosure will demonstrate the expanding influence these service offerings will have on our entire organization.”

Chief Financial Officer Suzanne Snapper reported that “our balance sheet remained strong, with approximately $50 million currently available of our $150 million revolving line of credit.” She also reported that consolidated adjusted EBITDAR for the year grew by 6.7% to $159.4 million, with EBITDAR margins for the quarter of 16.1%. Fully diluted GAAP earnings per share were $0.49 for the quarter and adjusted net income was $12.8 million or $0.55 per diluted share for the quarter. Fully diluted GAAP earnings per share were $1.56 for the year and adjusted net income was $50.2 million or $2.18 per diluted share for the year.

A discussion of the company’s use of non-GAAP financial measures is set forth below. A reconciliation of net income to EBITDAR and 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 Annual Report on Form 10-K for the year ended December 31, 2014, which is expected to be filed with the SEC today and can be viewed on the company’s website at http://www.ensigngroup.net.

2015 Guidance Reaffirmed

Management also reaffirmed its 2015 annual guidance, projecting revenues of $1.20 billion to $1.25 billion and net income of $58.1 million to $60.2 million and $2.44 to $2.53 per diluted share for 2015. The 2015 guidance is based on diluted weighted average common shares outstanding of 23.8 million as of December 31, 2014 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, stock based compensation and start-up losses at newly-created operations.

Quarter Highlights

During the quarter, the company’s Board of Directors declared a quarterly cash dividend of $0.075 per share of Ensign common stock, an increase from the prior quarterly cash dividend of $0.07 per share. Ensign has been a dividend-paying company since 2002 and has increased its dividend every year for 13 years.

 

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Also during the quarter and since, the company announced the acquisition of thirteen skilled nursing operations, four assisted living operations, two independent living operations, two home health agencies, two hospice agencies, one private home care business and two urgent care businesses, including:

 

    In San Diego, California, nine skilled nursing and assisted living operations, 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.

 

    Also in San Diego, California, Guardian Angel Hospice, a Medicare and Medi-Cal certified hospice agency.

 

    In Scottsdale, Arizona, Alarys Home Health, a Medicare and Medicaid certified home health agency.

 

    In Pueblo, Colorado, Riverwalk Post-Acute and Rehabilitation, a 60-bed skilled nursing operation, Rock Canyon Respiratory and Rehabilitation Center, an 81-bed skilled nursing operation with a subacute unit, and the Villas at Rock Canyon, a 17-bed independent living and assisted living operation.

 

    In Lubbock, Texas, Mildred and Shirley L. Garrison Geriatric Education and Care Center, a 103-bed skilled nursing operation.

 

    Also in Lubbock, Texas, Hospice of the South Plains a hospice agency serving patients throughout the South Plains area of Northwest Texas.

 

    In Colorado Springs, Colorado, Integrity Urgent Care, consisting of two urgent care clinics and our first acquisition of an urgent care clinic in the state of Colorado.

 

    In Abilene, Texas, Mesa Springs Healthcare, a 44-acre post-acute care campus comprised of a 75-bed skilled nursing operation and 60 independent living homes.

 

    In Omaha, Nebraska, Skyline Nursing and Rehabilitation, a 100-bed skilled nursing operation, and Skyline Assisted and Independent Living, an independent living, assisted living, and seniors apartment operation with 209 units.

These acquisitions brought Ensign’s growing portfolio to 143 facilities, eighteen of which are owned, eleven hospice agencies, thirteen home health agencies, two home care businesses and sixteen urgent care clinics spread over twelve 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 today, Monday, February 9, 2015 at 10:00 a.m. Eastern Time to discuss Ensign’s fourth quarter and fiscal year 2014 financial results, and management’s 2015 guidance. To listen to the webcast, or to view any financial or statistical information required by SEC Regulation G, please visit the Investors section of Ensign’s 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, March 27, 2015.

 

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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 home care services, hospice services, urgent care services and other rehabilitative and healthcare services at 143 facilities, eleven hospice agencies, thirteen home health agencies, two home care businesses, sixteen urgent care clinics and a mobile x-ray and diagnostic company, located 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 terms, 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 acquisition activities. 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-K, 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.

 

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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 STATEMENTS OF INCOME

(In thousands, except per share data)

 

     Three Months Ended
December 31, 2014
    Year Ended
December 31, 2014
 
     As Reported     Non-GAAP
Adj.
    As Adjusted     As Reported     Non-GAAP
Adj.
    As Adjusted  

Revenue

   $ 276,869      $ (4,409 )(4)(5)    $ 272,460      $ 1,027,406      $ (14,505 )(4)(5)    $ 1,012,901   

Expense:

            

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

     221,137        (5,060 )(1)(4)(5)      216,077        822,669        (16,966 )(1)(4)(5)      805,703   

Facility rent—cost of services

     18,480        (402 )(6)      18,078        48,488        (1,941 )(6)      46,547   

General and administrative expense

     12,525        (200 )(2)(3)(4)      12,325        56,895        (9,234 )(2)(3)(4)      47,661   

Depreciation and amortization

     5,087        (371 )(7)      4,716        26,430        (1,265 )(7)      25,165   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

  257,229      (6,033   251,196      954,482      (29,406   925,076   

Income from operations

  19,640      1,624      21,264      72,924      14,901      87,825   

Other income (expense):

Interest expense

  (486   46      (440   (12,976   6,517      (6,459

Interest income

  159      —        159      594      —        594   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Other expense, net

  (327   46      (281   (12,382   6,517      (5,865

Income before provision for income taxes

  19,313      1,670      20,983      60,542      21,418      81,960   

Tax Effect on Non-GAAP Adjustments

  643 (8)    8,246 (8) 

Tax True-up for Effective Tax Rate

  (1,082 )(9)    (3,492 )(9) 
    

 

 

       

 

 

   

Provision for income taxes

  8,517      (439   8,078      26,801      4,754      31,555   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income

  10,796      2,109      12,905      33,741      16,664      50,405   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Less: net (loss) income attributable to noncontrolling interests

  (715   807      92      (2,209   2,370      161   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to The Ensign Group, Inc.

$ 11,511      1,302    $ 12,813    $ 35,950      14,294    $ 50,244   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Attributable to The Ensign Group, Inc.

Net income attributable to The Ensign Group, Inc.

  11,511      1,302      12,813      35,950      14,294      50,244   

Loss from discontinued operations, net of income tax benefit

  —        —        —        —        —        —     
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

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

$ 11,511    $ 1,302    $ 12,813    $ 35,950    $ 14,294    $ 50,244   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income per share:

Basic:

Net income attributable to The Ensign Group, Inc.

$ 0.51    $ 0.57    $ 1.61    $ 2.25   

Loss from discontinued operations, net of income tax benefit

  —        —        —        —     
  

 

 

     

 

 

   

 

 

     

 

 

 

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

$ 0.51    $ 0.57    $ 1.61    $ 2.25   
  

 

 

     

 

 

   

 

 

     

 

 

 

Diluted:

Net income attributable to The Ensign Group, Inc.

$ 0.49    $ 0.55    $ 1.56    $ 2.18   

Loss from discontinued operations, net of income tax benefit

  —        —        —        —     
  

 

 

     

 

 

   

 

 

     

 

 

 

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

$ 0.49    $ 0.55    $ 1.56    $ 2.18   
  

 

 

     

 

 

   

 

 

     

 

 

 

Weighted average common shares outstanding:

Basic

  22,519      22,519      22,341      22,341   
  

 

 

     

 

 

   

 

 

     

 

 

 

Diluted

  23,378      23,378      23,095      23,095   
  

 

 

     

 

 

   

 

 

     

 

 

 

 

(1) Represents acquisition-related costs of $453 and $672 for the three months and year ended December 31, 2014, respectively.
(2) Represents costs of $45 and $138 for the three months and year ended December 31, 2014, respectively, incurred to recognize income tax credits.
(3) Represents costs of $9,026 and $155 for the three months and year ended December 31, 2014, incurred related to the Company’s spin-off of real estate assets to CareTrust REIT (CTRE) (the Spin-Off).
(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 months and year ended December 31, 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 months and year ended December 31, 2014.

 

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THE ENSIGN GROUP, INC.

GAAP and ADJUSTED CONDENSED CONSOLIDATED STATEMENTS OF INCOME

Including Adjustments for Discontinued Operations

(In thousands, except per share data)

 

     Three Months Ended
December 31, 2013
    Year Ended
December 31, 2013
 
     As Reported     Non-GAAP
Adj.
    As Adjusted     As Reported     Non-GAAP
Adj.
    As Adjusted  

Revenue

   $ 237,008        (1,524 )(9)(10)    $ 235,484      $ 904,556        (5,688 )(9)(10)    $ 898,868   

Expense:

            

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

     187,843        (2,478 )(1)(2)(9)(10)      185,365        725,989        (11,235 )(1)(2)(9)(10)      714,754   

Charges related to U.S. Government inquiries

     —          —          —          33,000        (33,000 )(4)      —     

Facility rent—cost of services

     3,557        (321 )(5)(6)      3,236        13,613        (1,009 )(5)(6)      12,604   

General and administrative expense

     11,782        (2,180 )(3)(7)(8)      9,602        40,103        (5,148 )(3)(7)(8)      34,955   

Depreciation and amortization

     8,711        (210 )(11)(12)      8,501        33,909        (1,386 )(11)(12)      32,523   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     211,893        (5,189     206,704        846,614        (51,778     794,836   

Income from operations

     25,115        3,665        28,780        57,942        46,090        104,032   

Other income (expense):

            

Interest expense

     (3,346       (3,346     (12,787       (12,787

Interest income

     143          143        506          506   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Other expense, net

     (3,203       (3,203     (12,281       (12,281

Income before provision for income taxes

     21,912        3,665        25,577        45,661        46,090        91,751   

Tax Effect on Non-GAAP Adjustments

       1,411 (13)          17,745 (13)   

Tax True-up for Effective Tax Rate

       (127 )(14)          (2,422 )(14)   
    

 

 

       

 

 

   

Provision for income taxes

     8,563        1,284        9,847        20,003        15,323        35,326   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income from continuing operations

     13,349        2,381        15,730        25,658        30,767        56,425   

Loss from discontinued operations, net of income tax benefit

     —            —          (1,804       (1,804
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     13,349        2,381        15,730        23,854        30,767        54,621   

Less: net income (loss) attributable to noncontrolling interests

     (7       (7     (186       (186
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to The Ensign Group, Inc.

   $ 13,356        2,381      $ 15,737      $ 24,040        30,767      $ 54,807   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Attributable to The Ensign Group, Inc.

            

Net income attributable to The Ensign Group, Inc.

     13,356        2,381        15,737        24,040        30,767        54,807   

Loss from discontinued operations, net of income tax benefit

     —            —          (1,804       (1,804
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

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

   $ 13,356        2,381      $ 15,737      $ 25,844        30,767      $ 56,611   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net (loss) income per share

            

Basic:

            

Net income attributable to The Ensign Group, Inc.

     0.61          0.71        1.10          2.50   

Loss from discontinued operations, net of income tax benefit

     —            —          (0.08       (0.08
  

 

 

     

 

 

   

 

 

     

 

 

 

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

   $ 0.61        $ 0.71      $ 1.18        $ 2.58   
  

 

 

     

 

 

   

 

 

     

 

 

 

Diluted:

            

Net income attributable to The Ensign Group, Inc.

     0.59          0.70        1.07          2.45   

Loss from discontinued operations, net of income tax benefit

     —            —          (0.08       (0.08
  

 

 

     

 

 

   

 

 

     

 

 

 

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

   $ 0.59        $ 0.70      $ 1.16        $ 2.53   
  

 

 

     

 

 

   

 

 

     

 

 

 

Weighted average common shares outstanding:

            

Basic

     22,028          22,028        21,900          21,900   
  

 

 

     

 

 

   

 

 

     

 

 

 

Diluted

     22,507          22,507        22,364          22,364   
  

 

 

     

 

 

   

 

 

     

 

 

 

 

(1) Represents acquisition-related costs of $10 and $288 for the three and year ended December 31, 2013.
(2) Represents costs of $42 and $145 for the three and year ended December 31, 2013, incurred to recognize income tax credits.
(3) Represents additional costs incurred related to a class action lawsuit settlement of $0 and $1,524 for the three and year ended December 31, 2013.
(4) Charges related to our efforts to achieve a global, company-wide, resolution of any claims connected to the U.S. Department of Justice (DOJ) investigation.
(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 and fourth quarter results were not included in the three or year ended 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 incurred for the first six months of 2013 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 and fourth quarter results were not included in the three or year ended 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 in the first quarter of 2013. This facility began operating at full capacity during the third quarter and therefore, third and fourth quarter results were not included in the three or year end 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 year ended December 31, 2013.
(14) Represents an adjustment to the provision for income taxes to our current year to date effective rate to 40.9% and 37.9% for the three and year ended December 31, 2013.

 

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THE ENSIGN GROUP, INC.

RECONCILIATION OF NET INCOME TO EBITDA, EBITDAR, Adjusted EBITDA and Adjusted EBITDAR

(in thousands)

(Unaudited)

The table below reconciles net income to EBITDA, EBITDAR, Adjusted EBITDA and Adjusted EBITDAR for the periods presented:

 

     Three Months Ended
December 31,
    Year Ended
December 31,
 
     2014     2013     2014     2013  

Consolidated Statements of Income Data:

        

Net income

   $ 10,796      $ 13,349      $ 33,741      $ 23,854   

Less: net loss attributable to noncontrolling interests

     (715     (7     (2,209     (186

Loss from discontinued operations

     —          —          —          1,804   

Interest expense, net

     327        3,203        12,382        12,281   

Provision for income taxes

     8,517        8,563        26,801        20,003   

Depreciation and amortization

     5,087        8,711        26,430        33,909   
  

 

 

   

 

 

   

 

 

   

 

 

 

EBITDA

   $ 25,442      $ 33,833      $ 101,563      $ 92,037   
  

 

 

   

 

 

   

 

 

   

 

 

 

Facility rent—cost of services

     18,480        3,557        48,488        13,613   
  

 

 

   

 

 

   

 

 

   

 

 

 

EBITDAR

   $ 43,922      $ 37,390      $ 150,051      $ 105,650   
  

 

 

   

 

 

   

 

 

   

 

 

 

EBITDA

   $ 25,442      $ 33,833      $ 101,563      $ 92,037   

Adjustments to EBITDA:

        

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

     —          —          —          33,000   

Expenses related to the Spin-Off(b)

     155        2,192        9,026        4,050   

Legal costs(c)

     —          (13     —          1,098   

Settlement of class action lawsuit(d)

     —          —          —          1,524   

Impairment of goodwill and other indefinite-lived intangibles(e)

     —          490          490   

Urgent care center (earnings) losses(f)

     (609     406        (389     1,844   

Earnings at three operations transferred to REIT(g)

     —          —          (122     —     

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

     —          —          —          1,256   

Acquisition related costs(i)

     453        10        672        288   

Costs incurred to recognize income tax credits(j)

     45        42        138        145   

Rent related to items (f), (g) and (h) above (k)

     402        322        1,941        1,009   
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

   $ 25,888      $ 37,282      $ 112,829      $ 136,741   
  

 

 

   

 

 

   

 

 

   

 

 

 

Facility rent—cost of services

     18,480        3,557        48,488        13,613   

Less: related to items (f), (g) and (h) above (k)

     (402     (322     (1,941     (1,009
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDAR

   $ 43,966      $ 40,517      $ 159,376      $ 149,345   
  

 

 

   

 

 

   

 

 

   

 

 

 

 

(a) Charges related to our resolution of any claims connected to the DOJ settlement.
(b) Expenses incurred in connection with the Spin-Off.
(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) Impairment charges to goodwill for a skilled nursing facility in Utah during the year ended December 31, 2013.
(f) Operating results at newly opened urgent care centers. This amount excluded rent, depreciation, interest and income taxes. The results also excluded the net loss attributable to the variable interest entity associated with our urgent care business of approximately $2.2 million.
(g) Results at three independent living facilities which were transferred to CareTrust as part of the Spin-Off, excluding rent, depreciation, interest and income taxes.
(h) 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.
(i) Costs incurred to acquire an operation which are not capitalizable.
(j) Costs incurred to recognize income tax credits which contributed to a decrease in effective tax rate.
(k) 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 as part of the Spin-Off, not included in items (f), (g) and (h) above.

 

7


THE ENSIGN GROUP, INC.

RECONCILIATION OF NET INCOME TO EBITDA, EBITDAR, Adjusted EBITDA and Adjusted EBITDAR

(in thousands)

(Unaudited)

The table below reconciles net income to EBITDA, EBITDAR, Adjusted EBITDA and Adjusted EBITDAR for each reportable segment for the periods presented:

 

     Year Ended
December 31,
    Year Ended
December 31,
 
     2014     2013     2014      2013  
     TSA Services     Home Health and Hospice  

Statements of Income Data:

         

Income from operations

   $ 126,011      $ 97,777      $ 9,701       $ 4,776   

Depreciation and amortization

     21,669        30,595        539         400   
  

 

 

   

 

 

   

 

 

    

 

 

 

EBITDA

$ 147,680    $ 128,372    $ 10,240    $ 5,176   
  

 

 

   

 

 

   

 

 

    

 

 

 

Facility rent—cost of services

  45,955      11,931      779      777   
  

 

 

   

 

 

   

 

 

    

 

 

 

EBITDAR

$ 193,635    $ 140,303    $ 11,019    $ 5,953   
  

 

 

   

 

 

   

 

 

    

 

 

 

EBITDA

$ 147,680    $ 128,372    $ 10,240    $ 5,176   

Adjustments to EBITDA:

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

  —        33,000      —        —     

Impairment of goodwill and other indefinite-lived intangibles(b)

  —        490      —        —     

Settlement of class action lawsuit(c)

  1,524   

Earnings at three operations transferred to REIT(d)

  (122   —        —        —     

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

  —        1,256      —        —     

Acquisition related costs(f)

  672      288      —        —     

Rent related to items (d) and (e) above (g)

  406      158      —        —     
  

 

 

   

 

 

   

 

 

    

 

 

 

Adjusted EBITDA

$ 148,636    $ 165,088    $ 10,240    $ 5,176   
  

 

 

   

 

 

   

 

 

    

 

 

 

Facility rent—cost of services

  45,955      11,931      779      777   

Less: related to items (d) and (e) above (g)

  (406   (158   —        —     
  

 

 

   

 

 

   

 

 

    

 

 

 

Adjusted EBITDAR

$ 194,185    $ 176,861    $ 11,019    $ 5,953   
  

 

 

   

 

 

   

 

 

    

 

 

 

 

(a) Charges related to our resolution of any claims connected to the DOJ settlement.
(b) Impairment charges to goodwill for a skilled nursing facility in Utah during the year ended December 31, 2013.
(c) Settlement of a class action lawsuit regarding minimum staffing requirements in the State of California.
(d) Results at three independent living facilities which were transferred to CareTrust as part of the Spin-Off, excluding rent, depreciation, interest and income taxes.
(e) 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.
(f) Costs incurred to acquire an operation which are not capitalizable.
(g) Rent related to the three independent living facilities which were transferred to CareTrust as part of the Spin-Off and one newly constructed skilled nursing facility which began operations during the first quarter of 2013, not included in items (d) above.

 

8


THE ENSIGN GROUP, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(In thousands)

 

     Year Ended December 31,  
     2014      2013  

Assets

     

Current assets:

     

Cash and cash equivalents

   $ 50,408       $ 65,755   

Restricted cash — current

     5,082         —     

Accounts receivable — less allowance for doubtful accounts of $20,438 and $16,540 at December 31, 2014 and 2013, respectively

     130,051         111,370   

Investments — current

     6,060         5,511   

Prepaid income taxes

     2,992         9,915   

Prepaid expenses and other current assets

     8,434         9,213   

Deferred tax asset — current

     10,615         9,232   
  

 

 

    

 

 

 

Total current assets

  213,642      210,996   

Property and equipment, net

  149,708      479,770   

Insurance subsidiary deposits and investments

  17,873      16,888   

Escrow deposits

  16,153      1,000   

Deferred tax asset

  11,509      4,464   

Restricted and other assets

  6,833      9,804   

Intangible assets, net

  35,568      5,718   

Goodwill

  30,269      23,935   

Other indefinite-lived intangibles

  12,361      7,740   
  

 

 

    

 

 

 

Total assets

$ 493,916    $ 760,315   
  

 

 

    

 

 

 

Liabilities and equity

Current liabilities:

Accounts payable

  33,186      23,793   

Accrued wages and related liabilities

  56,712      40,093   

Accrued self-insurance liabilities — current

  15,794      15,461   

Other accrued liabilities

  24,630      25,698   

Current maturities of long-term debt

  111      7,411   
  

 

 

    

 

 

 

Total current liabilities

  130,433      112,456   

Long-term debt — less current maturities

  68,279      251,895   

Accrued self-insurance liabilities — less current portion

  34,166      33,642   

Fair value of interest rate swap

  —        1,828   

Deferred rent and other long-term liabilities

  3,235      3,237   

Total equity

  257,803      357,257   
  

 

 

    

 

 

 

Total liabilities and equity

$ 493,916    $ 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:

 

     Year Ended December 31  
     2014     2013  

Net cash provided by operating activities

   $ 82,880      $ 37,424   

Net cash used in investing activities

     (172,851     (65,235

Net cash provided by financing activities

     72,624        52,881   
  

 

 

   

 

 

 

Net (decrease) increase in cash and cash equivalents

  (15,347   25,070   

Cash and cash equivalents at beginning of period

  65,755      40,685   
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

$ 50,408    $ 65,755   
  

 

 

   

 

 

 

 

9


THE ENSIGN GROUP, INC.

REVENUE BY SEGMENTS

The following table sets forth our total revenue by segments and as a percentage of total revenue for the periods indicated:

 

     Three Months Ended December 31,  
     2014     2013  
     Revenue
Dollars
     Revenue
Percentage
    Revenue
Dollars
     Revenue
Percentage
 

Transitional, skilled and assisted living services:

          

Skilled nursing facilities

   $ 240,654         86.9   $ 211,359         89.8

Assisted and independent living facilities

     13,134         4.8        11,352         4.5   
  

 

 

    

 

 

   

 

 

    

 

 

 

Total transitional, skilled and assisted living services

$ 253,788      92.5    $ 222,711      94.3   

Home health and hospice services:

Home health

$ 8,639      2.9 $ 6,328      2.4   

Hospice

  7,442      2.4      4,697      2.0   
  

 

 

    

 

 

   

 

 

    

 

 

 

Total home health and hospice services

$ 16,081      5.3    $ 11,025      4.4   

All other (1)

  7,000      2.2      3,272      1.3   
  

 

 

    

 

 

   

 

 

    

 

 

 

Total revenue

$ 276,869      100.00 $ 237,008      100.0
  

 

 

    

 

 

   

 

 

    

 

 

 

 

(1) Includes revenue from services provided at our urgent care clinics and a mobile x-ray and diagnostic company.

 

     Years Ended December 31,  
     2014     2013  
     Revenue
Dollars
     Revenue
Percentage
    Revenue
Dollars
     Revenue
Percentage
 

Transitional, skilled and assisted living services:

          

Skilled nursing facilities

   $ 901,470         87.7   $ 812,348         89.8

Assisted and independent living facilities

     48,848         4.8        40,931         4.5   
  

 

 

    

 

 

   

 

 

    

 

 

 

Total transitional, skilled and assisted living services

  950,318      92.5      853,279      94.3   

Home health and hospice services:

Home health

  29,577      2.9      21,978      2.4   

Hospice

  24,939      2.4      17,784      2   
  

 

 

    

 

 

   

 

 

    

 

 

 

Total home health and hospice services

  54,516      5.3      39,762      4.4   

All other (1)

  22,572      2.2      11,515      1.3   
  

 

 

    

 

 

   

 

 

    

 

 

 

Total revenue

$ 1,027,406      100.00 $ 904,556      100.00
  

 

 

    

 

 

   

 

 

    

 

 

 

 

(1) Includes revenue from services provided at our urgent care clinics and a mobile x-ray and diagnostic company.

 

10


THE ENSIGN GROUP, INC.

SELECT PERFORMANCE INDICATORS

(Unaudited)

The following tables summarize our selected performance indicators for our transitional, skilled and assisted living segment along with other statistics, for each of the dates or periods indicated:

 

     Three Months Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Total Facility Results:

        

Skilled nursing revenue

   $ 240,654      $ 211,359      $ 29,295        13.9

Assisted and independent living revenue

     13,134        11,352        1,782        15.7
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 253,788    $ 222,711    $ 31,077      14.0
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  136      119      17      14.3

Actual patient days

  1,026,493      947,138      79,355      8.4

Occupancy percentage — Operational beds

  78.2   78.0   0.2

Skilled mix by nursing days

  27.8   26.0   1.8

Skilled mix by nursing revenue

  50.4   49.1   1.3
     Three Months Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Same Facility Results(1):

        

Skilled nursing revenue

   $ 186,686      $ 176,987      $ 9,699        5.5

Assisted and independent living revenue

     4,386        4,305        81        1.9
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 191,072    $ 181,292    $ 9,780      5.4
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  82      82      —        —  

Actual patient days

  717,403      706,457      10,946      1.5

Occupancy percentage — Operational beds

  82.3   80.9   1.4

Skilled mix by nursing days

  29.3   27.5   1.8

Skilled mix by nursing revenue

  51.9   50.4   1.5
     Three Months Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Transitioning Facility Results(2):

        

Skilled nursing revenue

   $ 25,497      $ 23,976      $ 1,521        6.3

Assisted and independent living revenue

     4,625        4,405        220        5.0
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 30,122    $ 28,381    $ 1,741      6.1
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  25      25      —        —  

Actual patient days

  160,931      158,212      2,719      1.7

Occupancy percentage — Operational beds

  71.8   70.5   1.2

Skilled mix by nursing days

  19.8   18.6   1.2

Skilled mix by nursing revenue

  41.6   40.5   1.1
     Three Months Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Recently Acquired Facility Results(3):

        

Skilled nursing revenue

   $ 28,471      $ 10,396      $ 18,075        173.9

Assisted and independent living revenue

     4,123        1,815        2,308        127.2
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 32,594    $ 12,211    $ 20,383      166.9
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  29      11      18      NM   

Actual patient days

  148,159      64,651      83,508      NM   

Occupancy percentage — Operational beds

  68.3   69.2   NM   

Skilled mix by nursing days

  26.6   21.6   NM   

Skilled mix by nursing revenue

  48.5   47.1   NM   
     Three Months Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Transferred to CareTrust(4):

        

Skilled nursing revenue

   $ —        $ —        $ —          NM   

Assisted and independent living revenue

     —          827        (827     NM   
  

 

 

   

 

 

   

 

 

   

Total transitional, skilled and assisted living revenue

$ —      $ 827    $ (827   NM   
  

 

 

   

 

 

   

 

 

   

Actual patient days

  —        17,818      NM   

Occupancy percentage — Operational beds

  —        73.4   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 as part of the Spin-Off on June 1, 2014. These results were excluded from Same Facility and Transitioning Facility for the three months ended December 31, 2014 and 2013 for comparison purposes.

 

     Year Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Total Facility Results:

        

Skilled nursing revenue

   $ 901,470      $ 812,348      $ 89,122        11.0

Assisted and independent living revenue

     48,848        40,931        7,917        19.3
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 950,318    $ 853,279    $ 97,039      11.4
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  136      119      17      14.3

Actual patient days

  3,921,758      3,648,651      273,107      7.5

Occupancy percentage — Operational beds

  78.0   77.5   0.5

Skilled mix by nursing days

  27.6   26.4   1.2

Skilled mix by nursing revenue

  50.8   50.0   0.8
     Year Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Same Facility Results(1):

        

Skilled nursing revenue

   $ 724,422      $ 688,184      $ 36,238        5.3

Assisted and independent living revenue

     17,456        16,493        963        5.8
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 741,878    $ 704,677    $ 37,201      5.3
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  82      82      —        —  

Actual patient days

  2,832,584      2,784,664      47,920      1.7

Occupancy percentage — Operational beds

  81.9   80.4   1.5

Skilled mix by nursing days

  29.3   27.9   1.4

Skilled mix by nursing revenue

  52.4   51.4   1.0
     Year Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Transitioning Facility Results(2):

        

Skilled nursing revenue

   $ 99,326      $ 96,454      $ 2,872        3.0

Assisted and independent living revenue

     18,171        16,467        1,704        10.3
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 117,497    $ 112,921    $ 4,576      4.1
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  25      25      —        —  

Actual patient days

  634,772      619,161      15,611      2.5

Occupancy percentage — Operational beds

  71.3   69.6   1.7

Skilled mix by nursing days

  19.8   19.5   0.3

Skilled mix by nursing revenue

  41.5   40.7   0.8
     Year Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Recently Acquired Facility Results(3):

        

Skilled nursing revenue

   $ 77,722      $ 27,710      $ 50,012        180.5

Assisted and independent living revenue

     11,974        4,512        7,462        165.4
  

 

 

   

 

 

   

 

 

   

 

 

 

Total transitional, skilled and assisted living revenue

$ 89,696    $ 32,222    $ 57,474      178.4
  

 

 

   

 

 

   

 

 

   

 

 

 

Number of facilities at period end

  29      11      18      NM   

Actual patient days

  426,386      171,861      254,525      NM   

Occupancy percentage — Operational beds

  66.5   66.2   NM   

Skilled mix by nursing days

  24.4   20.5   NM   

Skilled mix by nursing revenue

  47.0   46.6   NM   
     Year Ended
December 31,
    Change     % Change  
     2014     2013      
     (Dollars in thousands)      

Transferred to CareTrust(4):

        

Skilled nursing revenue

   $ —        $ —        $ —          NM   

Assisted and independent living revenue

     1,247        3,459        (2,212     NM   
  

 

 

   

 

 

   

 

 

   

Total transitional, skilled and assisted living revenue

$ 1,247    $ 3,459    $ (2,212   NM   
  

 

 

   

 

 

   

 

 

   

Actual patient days

  28,016      72,965      NM   

Occupancy percentage — Operational beds

  70.3   75.7   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 as part of the Spin-Off on June 1, 2014. These results were excluded from Same Facility and Transitioning Facility for the year ended December 31, 2014 and 2013 for comparison purposes.

 

11


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 the skilled nursing average daily revenue rates by payor source, excluding services that are not covered by the daily rate:

 

     Three Months Ended December 31, 2014  
     Same Facility      Transitioning      Acquisitions      Total  
     2014      2013      2014      2013      2014      2013      2014      2013  

Skilled Nursing Average Daily Revenue Rates:

                       

Medicare

   $ 570.73       $ 568.56       $ 494.99       $ 480.56       $ 531.97       $ 488.00       $ 556.58       $ 552.37   

Managed care

     414.69         404.09         410.24         407.70         446.51         466.26         419.19         408.26   

Other skilled

     443.97         432.54         835.03         720.73         335.63         253.00         436.62         439.21   

Total skilled revenue

     492.59         493.75         485.66         477.34         465.54         477.47         488.76         491.43   

Medicaid

     188.51         184.34         168.51         157.96         176.67         146.17         184.92         179.18   

Private and other payors

     195.75         188.72         169.23         165.96         189.73         153.29         187.98         179.57   

Total skilled nursing revenue

   $ 278.44       $ 270.03       $ 231.58       $ 219.83       $ 255.35       $ 219.15       $ 269.91       $ 260.54   
     Year Ended December 31,  
     Same Facility      Transitioning      Acquisitions      Total  
     2014      2013      2014      2013      2014      2013      2014      2013  

Skilled Nursing Average Daily Revenue Rates:

                       

Medicare

   $ 563.94       $ 560.04       $ 480.80       $ 470.74       $ 514.38       $ 489.75       $ 549.12       $ 544.51   

Managed care

     412.21         398.02         411.33         394.51         456.29         465.95         416.74         400.44   

Other skilled

     440.54         456.19         812.83         697.96         321.63         253.00         437.08         460.76   

Total skilled revenue

     491.20         490.35         475.57         464.84         464.31         480.12         487.55         487.53   

Medicaid

     183.36         177.35         163.22         161.95         165.44         139.92         179.45         174.04   

Private and other payors

     193.22         187.38         170.50         167.20         182.06         149.74         185.79         179.40   

Total skilled nursing revenue

   $ 274.48       $ 265.65       $ 227.25       $ 222.42       $ 240.86       $ 211.74       $ 265.41       $ 257.67   

 

12


The following tables set forth our percentage of skilled nursing patient revenue and days by payor source for the three months ended December 31, 2014 and 2013:

 

     Three Months Ended December 31,  
     Same Facility     Transitioning     Acquisitions     Total  
     2014     2013     2014     2013     2014     2013     2014     2013  

Percentage of Skilled Nursing Revenue:

                

Medicare

     28.2     30.4     32.9     34.1     22.4     26.3     28.0     30.6

Managed care

     16.3        14.6        7.0        4.7        21.2        20.8        15.9        13.8   

Other skilled

     7.4        5.4        1.7        1.7        4.9        —          6.5        4.7   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Skilled mix

     51.9        50.4        41.6        40.5        48.5        47.1        50.4        49.1   

Private and other payors

     7.2        7.6        20.6        22.2        10.5        13.4        9.0        9.5   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Quality mix

     59.1        58.0        62.2        62.5        59.0        60.5        59.4        58.6   

Medicaid

     40.9        42.0        37.8        37.5        41.0        39.5        40.6        41.4   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total skilled nursing

     100.0     100.0     100.0     100.0     100.0     100.0     100.0     100.0
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
     Three Months Ended December 31,  
     Same Facility     Transitioning     Acquisitions     Total  
     2014     2013     2014     2013     2014     2013     2014     2013  

Percentage of Skilled Nursing Days:

                

Medicare

     13.8     14.4     15.4     15.6     10.8     11.8     13.6     14.4

Managed care

     10.9        9.7        4.0        2.5        12.1        9.8        10.2        8.8   

Other skilled

     4.6        3.4        0.4        0.5        3.7        —          4.0        2.8   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Skilled mix

     29.3        27.5        19.8        18.6        26.6        21.6        27.8        26.0   

Private and other payors

     10.4        10.9        28.2        29.2        14.1        19.2        13.0        13.8   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Quality mix

     39.7        38.4        48.0        47.8        40.7        40.8        40.8        39.8   

Medicaid

     60.3        61.6        52.0        52.2        59.3        59.2        59.2        60.2   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

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 year ended December 31, 2014 and 2013:

 

     Year Ended December 31,  
     Same Facility     Transitioning     Acquisitions     Total  
     2014     2013     2014     2013     2014     2013     2014     2013  

Percentage of Skilled Nursing Revenue:

                

Medicare

     29.7     31.1     32.8     34.8     22.7     28.8     29.4     31.4

Managed care

     15.9        14.9        6.9        4.7        20.1        17.8        15.3        13.9   

Other skilled

     6.8        5.4        1.8        1.2        4.2        —          6.1        4.7   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Skilled mix

     52.4        51.4        41.5        40.7        47.0        46.6        50.8        50.0   

Private and other payors

     7.2        7.7        21.5        21.9        11.3        13.8        9.1        9.5   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Quality mix

     59.6        59.1        63.0        62.6        58.3        60.4        59.9        59.5   

Medicaid

     40.4        40.9        37.0        37.4        41.7        39.6        40.1        40.5   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total skilled nursing

     100.0     100.0     100.0     100.0     100.0     100.0     100.0     100.0
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
     Year Ended December 31,  
     Same Facility     Transitioning     Acquisitions     Total  
     2014     2013     2014     2013     2014     2013     2014     2013  

Percentage of Skilled Nursing Days:

                

Medicare

     14.4     14.7     15.5     16.4     10.6     12.4     14.2     14.8

Managed care

     10.7        10.0        3.8        2.7        10.7        8.1        9.7        8.9   

Other skilled

     4.2        3.2        0.5        0.4        3.1        —          3.7        2.7   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Skilled mix

     29.3        27.9        19.8        19.5        24.4        20.5        27.6        26.4   

Private and other payors

     10.3        10.8        28.7        29.1        15.0        19.6        13.1        13.7   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Quality mix

     39.6        38.7        48.5        48.6        39.4        40.1        40.7        40.1   

Medicaid

     60.4        61.3        51.5        51.4        60.6        59.9        59.3        59.9   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total skilled nursing

     100.0     100.0     100.0     100.0     100.0     100.0     100.0     100.0
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

13


THE ENSIGN GROUP, INC.

SELECT PERFORMANCE INDICATORS

(Unaudited)

The following tables summarize our selected performance indicators for our home health and hospice segment along with other statistics, for each of the dates or periods indicated:

 

     Three Months Ended December 31,  
     2014      2013      Change      % Change  

Results:

           

Home health and hospice revenue

           

Home health services:

   $ 8,639       $ 6,328       $ 2,311         36.5

Hospice services:

     7,442         4,697         2,745         58.4
  

 

 

    

 

 

    

 

 

    

 

 

 

Total home health and hospice revenue

$ 16,081    $ 11,025    $ 5,056      45.9

Home health services:

Medicare Episodic Admissions

  1,768      1,487      281      18.9

Average Medicare Revenue per Completed Episode

  2,945      2,905      39.48      1.4

Hospice services:

Average Daily Census

  493      312      181      58.0
     Year Ended December 31,  
     2014      2013      Change      % Change  

Results:

           

Home health and hospice revenue

           

Home health services:

   $ 29,577       $ 21,978       $ 7,599         34.6

Hospice services:

     24,939         17,784         7,155         40.2
  

 

 

    

 

 

    

 

 

    

 

 

 

Total home health and hospice revenue

$ 54,516    $ 39,762    $ 14,754      37.1

Home health services:

Medicare Episodic Admissions

  5,221      4,090      1,131      27.7

Average Medicare Revenue per Completed Episode

  2,840      2,746      94      3.4

Hospice services:

Average Daily Census

  420      302      118      39.0

 

14


Discussion of Non-GAAP Financial Measures

EBITDA consists of net income before (a) interest expense, net, (b) provisions for income taxes, and (c) depreciation and amortization. EBITDAR consists of net income before (a) interest expense, net, (b) provisions for income taxes, (c) depreciation and amortization, and (d) facility rent-cost of services. Adjusted EBITDA consists of net income before (a) interest expense, net, (b) provisions for income taxes, (c) depreciation and amortization, and, (d) discontinued operations, (e) development and operational losses associated with newly-developed operations which have not achieved stabilization, (f) impairment charges, (g) charges related to the DOJ settlement, (h) expenses incurred in connection with the company’s proposed spin-off of real estate assets, (i) settlement of a class action lawsuit and (j) normalized tax rate. Adjusted EBITDAR consists of net income before (a) interest expense, net, (b) provisions for income taxes, (c) depreciation and amortization, and (d) facility rent-cost of services, (e) , discontinued operations, (f) development and operational losses associated with newly-developed operations which have not achieved stabilization, (g) impairment charges, (h) charges related to the DOJ settlement, (i) expenses incurred in connection with the company’s proposed spin-off of real estate assets, (j) settlement of a class action lawsuit and (k) normalized tax rate. 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 periodic filings with the Securities and Exchange Commission, including its Annual Report on Form 10-K. The company’s periodic filings are 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.

 

15