The Ensign Group Meets Consensus of $0.60 Per Share; Increases 2015 Guidance and Issues 2016 Guidance

MISSION VIEJO, Calif., Nov. 03, 2015 (GLOBE NEWSWIRE) — 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 third quarter of 2015 with quarterly adjusted earnings of $0.60 per share.

Quarter Highlights Include:

  • Consolidated adjusted net income climbed 55.7% over the prior year quarter to $15.9 million, and adjusted earnings per share of $0.60 outpaced the prior year quarter of $0.44 per share by almost 37%;
  • Consolidated adjusted EBITDAR was $57.0 million for the quarter, an increase of 46.9%;
  • Same-store skilled revenue grew by 6.4% over the prior year quarter, with a skilled revenue mix of 52.8%, and managed care days increased by 12.45% over the prior year quarter;
  • Transitioning revenue grew by 18.2% over the prior year quarter, driving skilled revenue mix to 42.4%, and transitioning occupancy increased by 205 basis points over the prior year quarter;
  • Cornerstone Healthcare, Inc., our home health and hospice subsidiary, grew its revenue by $10.7 million, an increase of 73.1%; and
  • Consolidated revenues for the quarter were up $90.2 million or 34.6% over the prior year quarter to $351.1 million.

Operating Results

Ensign’s President and Chief Executive Officer, Christopher Christensen, congratulated the organization’s leaders and their teams for outstanding clinical and financial performance during the quarter. “In the midst of unprecedented growth, our team of expert operators and clinicians across the organization have been relentless at driving record improvements in our same-store operations while successfully transitioning dozens of new operations,” he said. “It’s important to emphasize that while our newly acquired facilities almost always create a short-term drag on earnings, we were able to offset that impact by achieving solid results in our same store and transitioning operations,” he added.

“As our balance sheet and income statement demonstrate, we remain as disciplined as ever in our approach to growth, even as our ability to transition more and more operations grows with our organization,” Mr. Christensen highlighted. He also pointed out that the quarter’s results, “demonstrated again that our ability to transition new operations and to drive organic growth within our existing portfolio, even in the midst of significant growth, remains as strong as ever.”  

He also reiterated that as of November 1, 2015, the company had 64 operations in the recently acquired bucket, which is the highest number of operations in that category in the organization’s history. “Our recent growth puts us in a very strong position for continued organic improvement in 2016 and beyond as these recently acquired and transitioning operations continue to mature for years to come,” Christensen said.

Chief Financial Officer Suzanne Snapper reported that Ensign’s balance sheet remains strong in spite of our record acquisition activity, with its conservative adjusted net-debt-to-EBITDAR ratio of 3.27x at quarter end.  “It’s remarkable that we transitioned so many acquisitions, protected our balance sheet and simultaneously achieved record-setting same store growth,” she said.  She also added “as a result of our ever improving discipline, we continue to have flexibility under our revolving line of credit, with approximately $93.0 million of availability and a built-in expansion option that adds liquidity.” She further noted that the company continues to generate strong cash flow, with cash on hand of $40.1 million on September 30, 2015.

Ms. Snapper also reported that consolidated revenues in the quarter were up 34.6% over the prior year quarter to a record $351.1 million and consolidated adjusted EBITDAR for the quarter grew by 46.9% to $57.0 million, with adjusted EBITDAR margins for the quarter of 16.5%.  Fully diluted adjusted earnings per share were $0.60 for the quarter and adjusted net income was $15.9 million.

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.

Quarter Highlights

During the quarter, Ensign paid a quarterly cash dividend of $0.075 per share of its common stock. Ensign has been a dividend-paying company since 2002 and has increased its dividend every year for 13 years.

Also during the quarter and since, Ensign announced the acquisition of 12 skilled nursing operations, 20 assisted and independent living operations, one home health business, and one hospice agency, including:

  • In Arizona, seven skilled nursing operations with a total of 864 skilled nursing beds and three independent and assisted living operations with a total of 770 units, all under a new long-term master lease;
  • In Olympia, Washington, the operations and real estate of Olympia Transitional Care and Rehabilitation, a 135-bed skilled nursing operation;
  • In Westlake Village, California, Buena Vista Hospice, a Medicare and Medi-Cal certified hospice agency serving the Ventura County area;
  • In Wisconsin, fifteen assisted and independent living operations with a total of 761 units, all under a long-term master lease with an option to purchase the real estate;
  • In Orange and Whittier, California, two assisted living operations with a total of 188 units under a long-term lease;
  • In Arizona, a Medicare and Medi-Cal certified home health agency serving the Western Arizona and Eastern California areas;
  • In Kansas, The Healthcare Resortin Kansas City, Kansas, featuring a 70-bed licensed transitional care operation and 30 private assisted living suites under a long-term lease;
  • In Chandler and Scottsdale, Arizona, Chandler Post Acute and Rehabilitation, a 120-bed skilled nursing facility, and Shea Post Acute Rehabilitation Center, a 105-bed skilled nursing facility under a long-term lease;
  • In West Columbia, South Carolina, the operations and real estate of Millennium Post Acute Rehabilitation, a 125-bed skilled nursing facility; and
  • In El Cajon, California, the underlying real estate of Somerset Subacute and Rehabilitation, a 46-bed skilled nursing facility that has been operated under a lease arrangement since December 2014.

Mr. Christensen noted, “We are thrilled about our recent entry into Kansas and South Carolina and we look forward to additional growth opportunities in both states.”  He noted that Ensign takes a leadership-driven approach in all its acquisitions, particularly in new states, and added, “We look forward to working together with long-time Ensign leaders as we build a strong clinical and financial foundation from which we will continue to grow.” 

These acquisitions bring Ensign’s growing portfolio to 182 healthcare operations, twenty-nine of which are owned, fourteen hospice agencies, fifteen home health agencies, three home care businesses and seventeen urgent care clinics across 14 states.  Mr. Christensen reaffirmed that Ensign continues to actively seek transactions to acquire real estate and to lease both well-performing and struggling skilled nursing, assisted living and other healthcare related businesses in new and existing markets.

2015 Guidance

Management increased its 2015 annual revenue guidance to between $1.31 billion and $1.33 billion and its net income guidance to a range of $66.2 million to $67.6 million.  Management also raised its 2015 annual earnings per share guidance to between $2.53 and $2.58 per diluted share for 2015.  Management’s guidance is based on diluted weighted average common shares outstanding of 26.2 million and assumes, among other things, anticipated Medicare and Medicaid reimbursement rate increases net of provider taxes, tax rates of 38.5% and acquisitions closed. It also excludes acquisition-related costs and amortization costs related to intangible assets acquired, stock based compensation, implementation costs for system improvements, costs incurred to recognize income tax credits, a one-time break-up fee earned in an unsuccessful bankruptcy auction and costs incurred for facilities currently being constructed and other start-up operations.

2016 Guidance

Management also provided guidance for 2016, with annual revenue guidance of between $1.53 billion and $1.58 billion and its net income guidance to a range of $77.8 million to $82.0 million.  Management also provided 2016 annual earnings per share guidance to between $2.87 and $3.01 per diluted share for 2016.  Management’s guidance is based on diluted weighted average common shares outstanding of 27.1 million and assumes, among other things, anticipated Medicare and Medicaid reimbursement rate increases net of provider taxes, tax rates of 38.5% and acquisitions closed. It also excludes acquisition-related costs and amortization costs related to intangible assets acquired, stock based compensation, implementation costs for system improvements, costs incurred to recognize income tax credits and costs incurred for facilities currently being constructed and other start-up operations.

Conference Call

A live webcast will be held Wednesday, November 4, 2015 at 10:00 a.m. Pacific time (1:00 p.m. Eastern time) to discuss Ensign’s third quarter 2015 financial results. To listen to the webcast, or to view any financial or statistical information required by SEC Regulation G, please visit the Investors Relations 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, November 27, 2015.

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 182 skilled and assisted living operations, fourteen hospice agencies, fifteen home health agencies, three home care businesses and seventeen urgent care clinics in California, Arizona, Texas, Washington, Utah, Idaho, Colorado, Nevada, Iowa, Nebraska, Oregon, Wisconsin, Kansas and South Carolina. 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 operations, 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 operations, its ability to manage its increasing borrowing costs as it incurs additional indebtedness to fund the acquisition and development of operations; 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 operations; competition from other companies in the acquisition, development and operation of facilities; its ability to defend claims and lawsuits, including professional liability claims alleging that our services resulted in personal injury, and other regulatory-related claims; 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 operations 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, 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.

THE ENSIGN GROUP, INC.
GAAP and ADJUSTED CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(In thousands, except per share data)
 
       
  Three Months Ended
September 30, 2015
  Nine Months Ended
September 30, 2015
 
  As Reported   Non-GAAP Adj.   As Adjusted   As Reported   Non-GAAP Adj.   As Adjusted  
Revenue $ 351,086     $ (6,366 )   (5 ) $ 344,720       968,671     $ (20,007 )   (5 ) $ 948,664    
Expense:                        
Cost of services (exclusive of facility rent, general and administrative and depreciation and amortization expense shown separately below)   280,545       (8,481 ) (1)(3)(5) (8)   272,064       770,293       (23,998 ) (1)(3)(5) (8)   746,295    
Rent—cost of services   24,500       (540 )   (6 )   23,960       62,531       (1,556 )   (6 )   60,975    
General and administrative expense   17,165       (1,565 ) (2)(3)(4) (9)   15,600       46,917       (2,888 ) (2)(3)(4) (9)   44,029    
Depreciation and amortization   7,288       (521 )   (7 )   6,767       20,185       (1,694 )   (7 )   18,491    
Total expenses   329,498       (11,107 )     318,391       899,926       (30,136 )     869,790    
Income from operations   21,588       4,741       26,329       68,745       10,129       78,874    
Other income (expense):                        
Interest expense   (802 )     46       (756 )     (2,035 )     138       (1,897 )  
Interest income   242             242       603             603    
Other expense, net   (560 )     46       (514 )     (1,432 )     138       (1,294 )  
Income before provision for income taxes   21,028       4,787       25,815       67,313       10,267       77,580    
Tax Effect on Non-GAAP Adjustments       1,844               3,953        
Tax True-up for Effective Tax Rate       226               82        
Provision for income taxes   7,869       2,070       9,939       25,833       4,035       29,868    
Net income   13,159       2,717     (10 )   15,876       41,480       6,232     (10 )   47,712    
Less: net (loss) income attributable to noncontrolling interests   (313 )     335       22       (351 )     494       143    
Net income attributable to The Ensign Group, Inc. $ 13,472       2,382     $ 15,854     $ 41,831       5,738     $ 47,569    
Net income per share:                        
Basic: $ 0.53         $ 0.62     $ 1.67         $ 1.90    
Diluted $ 0.51         $ 0.60     $ 1.61         $ 1.83    
Weighted average common shares outstanding:                        
Basic   25,572           25,572       24,991           24,991    
Diluted   26,535           26,535       25,940           25,940    
               
(1)  Represents acquisition-related costs of $203 and $793 for the three and nine months ended September 30, 2015, respectively.              
(2)  Represents costs of $84 and $136 for the three and nine months ended September 30, 2015, respectively, incurred to recognize income tax credits.          
(3)  Represents stock-based compensation expense of $1,722 and $4,948 for the three and nine months ended September 30, 2015, respectively.          
(4)  Represents costs of $836 and $1,983 for the three and nine months ended September 30, 2015, respectively, incurred related to new systems implementation.      
(5)  Represents revenues and expenses incurred at 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 urgent care centers included in Note (5).                      
(7)  Represents depreciation expense at urgent care centers and amortization costs related to patient base intangible assets at skilled nursing and assisted living facilities.      
(8)  Represents costs incurred for facilities currently being constructed and newly-built operations during the three and nine months ended September 30, 2015.      
(9)  Represents breakup fee, net of costs, received in connection with a public auction in which we were the priority bidder.              
(10)  Represents the adjustment to provision for income tax to our historical year to date effective tax rate of 38.5% for the three and nine months ended September 30, 2015.    
                         

 

THE ENSIGN GROUP, INC.
GAAP and ADJUSTED CONDENSED CONSOLIDATED STATEMENTS 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          
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 Effect on Non-GAAP Adjustments       581               7,520              
Tax True-up for Effective Tax Rate       (872 )             (2,410 )            
Provision for income taxes   6,659       (291 )     6,368       18,284       5,110       23,394          
Net income   8,371       1,797     (8 )   10,168       22,945       14,422       (8   )   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          
Net income per share                              
Basic:   0.40           0.45       1.10           1.67          
Diluted:   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 adjustment to provision for income tax to our historical year to date effective tax rate of 38.5% for the three and nine months ended September 30, 2014.        
                               

 

                                                                                                                                         
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
September 30,
  Nine Months Ended
September 30,
                                                                                                                         
    2015       2014       2015       2014                                                                                                                            
Consolidated Statements of Income Data:                                                                                                                                        
Net income $ 13,159     $ 8,371     $ 41,480     $ 22,945                                                                                                                            
Less: net loss attributable to noncontrolling interests   (313 )     (535 )     (351 )     (1,494 )                                                                                                                          
Interest expense, net   560       265       1,432       12,055                                                                                                                            
Provision for income taxes   7,869       6,659       25,833       18,284                                                                                                                            
Depreciation and amortization   7,288       4,677       20,185       21,343                                                                                                                            
EBITDA $ 29,189     $ 20,507     $ 89,281     $ 76,121                                                                                                                            
Rent—cost of services   24,500       18,176       62,531       30,008                                                                                                                            
EBITDAR $ 53,689     $ 38,683     $ 151,812     $ 106,129                                                                                                                            
                                                                                                                                         
EBITDA $ 29,189     $ 20,507     $ 89,281     $ 76,121                                                                                                                            
Adjustments to EBITDA:                                                                                                                                        
Expenses related to the Spin-Off(a)         8,871                                                                                                                            
Stock-based compensation expense(b)   1,722         4,948                                                                                                                              
Costs incurred related to new systems implementation(c)   836         1,983                                                                                                                              
Urgent care center (earnings) loss(d)   (418 )     31       (1,982 )     3                                                                                                                            
Costs at facilities currently being constructed and start-up operations(e)   918         1,526                                                                                                                              
Earnings at three operations transferred to REIT (f)         (122 )                                                                                                                          
Acquisition related costs(g)   203       85       793       219                                                                                                                            
Breakup fee, net of costs, received in connection with a public auction(h)       (1,019 )                                                                                                                            
Costs incurred to recognize income tax credits(i)   84       31       136       93                                                                                                                            
Rent related to item(d) and (f) above   540       410       1,556       1,539                                                                                                                            
Adjusted EBITDA $ 33,074     $ 21,064     $ 97,222     $ 86,724                                                                                                                            
Rent—cost of services   24,500       18,176       62,531       30,008                                                                                                                            
Less: rent related to items (d) and (f) above   (540 )     (410 )     (1,556 )     (1,539 )                                                                                                                          
Adjusted EBITDAR $ 57,034     $ 38,830     $ 158,197     $ 115,193                                                                                                                            
                                                                                                                                         
(a)  Expenses incurred in connection with the Spin-Off.                                                                                                                                        
(b)  Stock-based compensation expense incurred during the three and nine months ended September 30, 2015.  Adjusted EBITDA and EBITDAR for the three and nine months ended September 30, 2014 did not include non-GAAP adjustment related to stock-based compensation expense of $1.4 million and $3.8 million, respectively.  If adjusted for stock-based compensation expense, Adjusted EBITDA for the three and nine months ended September 30, 2014 would have been $22.4 million and $90.5 million, respectively, and Adjusted EBITDAR for the three and nine months ended September 30, 2014 would have been $40.2 million and $119.0 million, respectively.  EBITDA for the nine months ended September 30, 2014 reflects four month increase in rent expense as a result of the Spin-Off compared to nine months increase in rent expense for the nine months ended September 30, 2015.
(c)  Costs incurred related to new systems implementation.                                                                                                                                        
(d)  Operating results at urgent care centers.  This amount for the three and nine months ended September 30, 2015 excluded rent of $0.5 million and $1.6 million, respectively, and depreciation expense of $0.3 million and 0.9 million, respectively. This amount for the three and nine months ended September 30, 2014 excluded rent of $0.4 million and $1.1 million, respectively, and depreciation expense of $0.2 million and $0.5 million, respectively. The results also excluded the net loss attributable to the variable interest entity associated with our urgent care business of approximately $0.3 million and  $0.5 million for the three and nine months ended September 30, 2015, respectively, and $0.5 million and $1.6 million for the three and nine months ended September 30, 2014, respectively. Operating loss excluding the net loss attributable to the variable interest entity associated with our urgent care business for the three and nine months ended September 30, 2015 were $0.4 million for both periods.
(e)  Costs incurred for facilities currently being constructed and start-up operations during the three and nine months ended September 30, 2015.
(f)  Results at three independent living facilities which were transferred to CareTrust as part of the Spin-Off transaction, excluding rent, depreciation, interest and income taxes.
(g)  Costs incurred to acquire operations which are not capitalizable.                                                                                                                                        
(h)  Breakup fee, net of costs, received in connection with a public auction in which we were the priority bidder.
(i) Costs incurred to recognize income tax credits which contributed to a decrease in effective tax rate.
                                                                                                                           

 

                                   
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:  
                                   
    Three Months Ended
September 30,
  Three Months Ended
September 30,
  Nine Months Ended
September 30,
  Nine Months Ended
September 30,
 
      2015       2014       2015       2014       2015       2014       2015       2014    
    TSA Services   Home Health and Hospice   TSA Services   Home Health and Hospice  
Statements of Income Data:                                  
Income from operations, excluding general and administrative expense(a)   $ 36,226     $ 27,262     $ 4,067     $ 2,707     $ 108,592     $ 95,566     $ 9,738     $ 6,792    
Depreciation and amortization     5,542       3,459       258       124       15,368       17,920       703       371    
EBITDA   $ 41,768     $ 30,721     $ 4,325     $ 2,831     $ 123,960     $ 113,486     $ 10,441     $ 7,163    
Rent—cost of services     23,574       17,507       332       203       59,950       28,144       866       568    
EBITDAR   $ 65,342     $ 48,228     $ 4,657     $ 3,034     $ 183,910     $ 141,630     $ 11,307     $ 7,731    
                                   
EBITDA   $ 41,768     $ 30,721     $ 4,325     $ 2,831     $ 123,960     $ 113,486     $ 10,441     $ 7,163    
Adjustments to EBITDA:                                  
Stock-based compensation expense(b)     997         59         2,890         181      
Costs at facilities currently being constructed and start-up operations(c)     836             1,983          
Earnings at three operations transferred to REIT (d)               (122 )      
Acquisition related costs(e)     203       85           793       219        
Rent related to item(d) above(f)               406        
Adjusted EBITDA   $ 43,804     $ 30,806     $ 4,384     $ 2,831     $ 129,626     $ 113,989     $ 10,622     $ 7,163    
Rent—cost of services     23,574       17,507       332       203       59,950       28,144       866       568    
Less: rent related to items(d) above(f)               (406 )      
Adjusted EBITDAR   $ 67,378     $ 48,313     $ 4,716     $ 3,034     $ 189,576     $ 141,727     $ 11,488     $ 7,731    
                                   
(a) General and administrative expenses are not allocated to any segment for purposes of determining segment profit or loss. 
(b) Stock-based compensation expense incurred during the three and nine months ended September 30, 2015.
(c) Costs incurred for facilities currently being constructed and start-up operations during the three and nine months ended September 30, 2015.
(d) 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.
(e) Costs incurred to acquire operations which are not capitalizable.  
                                   

 

THE ENSIGN GROUP, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
 (In thousands)
 
  September 30,
2015
  December 31,
2014
 
Assets        
Current assets:        
Cash and cash equivalents $ 40,069     $ 50,408    
Restricted cash — current     5,082    
Accounts receivable — less allowance for doubtful accounts of $27,595 and $20,438 at September 30, 2015 and December 31, 2014, respectively   192,016       130,051    
Investments — current   4,500       6,060    
Prepaid income taxes   6,792       2,992    
Prepaid expenses and other current assets   15,417       8,434    
Deferred tax asset — current   10,736       10,615    
Total current assets   269,530       213,642    
Property and equipment, net   257,164       149,708    
Insurance subsidiary deposits and investments   30,050       17,873    
Escrow deposits   2,310       16,153    
Deferred tax asset   10,597       11,509    
Restricted and other assets   8,177       6,833    
Intangible assets, net   47,223       35,568    
Goodwill   39,736       30,269    
Other indefinite-lived intangibles   17,716       12,361    
Total assets $ 682,503     $ 493,916    
         
Liabilities and equity         
Current liabilities:        
Accounts payable   34,699       33,186    
Accrued wages and related liabilities   65,475       56,712    
Accrued self-insurance liabilities — current   17,069       15,794    
Other accrued liabilities   43,492       24,630    
Current maturities of long-term debt   613       111    
Total current liabilities   161,348       130,433    
Long-term debt — less current maturities   69,209       68,279    
Accrued self-insurance liabilities — less current portion   36,938       34,166    
Deferred rent and other long-term liabilities   3,811       3,235    
Total equity   411,197       257,803    
Total liabilities and equity $ 682,503     $ 493,916    
         
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, 
    2015       2014    
Net cash provided by operating activities $ 13,300     $ 66,688    
Net cash used in investing activities   (120,576 )     (99,408 )  
Net cash provided by financing activities   96,937       6,171    
Net decrease in cash and cash equivalents   (10,339 )     (26,549 )  
Cash and cash equivalents at beginning of period   50,408       65,755    
Cash and cash equivalents at end of period $ 40,069     $ 39,206    
         

 

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 September 30,     Nine Months Ended September 30,  
    2015     2014     2015     2014  
    Revenue Dollars   Revenue Percentage     Revenue Dollars   Revenue Percentage     Revenue Dollars   Revenue Percentage     Revenue Dollars   Revenue Percentage  
    (Dollars in thousands)
TSA Services:                                        
Skilled nursing facilities   $ 289,475     82.5 %   $ 228,134     87.5 %   $ 819,655     84.6 %   $ 660,816     88.1 %
Assisted and independent living facilities     27,686     7.9       12,259     4.7       57,916     6.0       35,714     4.8  
Total TSA services     317,161     90.4       240,393     92.2       877,571     90.6       696,530     92.9  
Home health and hospice services:                                        
Home health     12,794     3.6       7,655     2.9       34,452     3.6       20,938     2.8  
Hospice     12,456     3.5       6,930     2.7       29,057     3.0       17,497     2.3  
Total home health and hospice services     25,250     7.1       14,585     5.6       63,509     6.6       38,435     5.1  
All other (1)     8,675     2.5       5,863     2.2       27,591     2.8       15,572     2.0  
Total revenue   $ 351,086     100.0 %   $ 260,841     100.0 %   $ 968,671     100.0 %   $ 750,537     100.0 %
(1) Includes revenue from services provided at our urgent care clinics and a mobile x-ray and diagnostic operation.        
                           

 

THE ENSIGN GROUP, INC.
SELECT PERFORMANCE INDICATORS
(Unaudited)
                     
                 
The following tables summarize our selected performance indicators for our TSA services segment along with other statistics, for each of the dates or periods indicated:  
                 
  Three Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Total Facility Results:                  
Skilled nursing revenue $ 289,475     $ 228,134     $ 61,341       26.9   %                  
Assisted and independent living revenue   27,686       12,259       15,427       125.8   %        
Total transitional, skilled and assisted living revenue $ 317,161     $ 240,393     $ 76,768       31.9   %        
Number of facilities at period end   178       127       51       40.2   %      
Actual patient days   1,317,323       994,995       322,328       32.4   %      
Occupancy percentage — Operational beds   77.9 %     77.7 %         0.2   %      
Skilled mix by nursing days   30.2 %     27.1 %         3.1   %    
Skilled mix by nursing revenue   52.5 %     50.2 %         2.3   %      
  Three Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Same Facility Results(1):                  
Skilled nursing revenue $ 213,329     $ 200,376     $ 12,953       6.5   %  
Assisted and independent living revenue   7,972       7,903       69       0.9   %  
Total transitional, skilled and assisted living revenue $ 221,301     $ 208,279     $ 13,022       6.3   %      
Number of facilities at period end   101       101       %      
Actual patient days   840,094       838,198       1,896       0.2   %    
Occupancy percentage — Operational beds   81.1 %     80.7 %         0.4   %  
Skilled mix by nursing days   30.1 %     27.9 %         2.2   %  
Skilled mix by nursing revenue   52.8 %     51.2 %         1.6   %  
  Three Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Transitioning Facility Results(2):                  
Skilled nursing revenue $ 16,806     $ 15,622     $ 1,184       7.6   %  
Assisted and independent living revenue   3,155       2,987       168       5.6   %  
Total transitional, skilled and assisted living revenue $ 19,961     $ 18,609     $ 1,352       7.3   %      
Number of facilities at period end   17       17       %      
Actual patient days   101,868       100,089       1,779       1.8   %    
Occupancy percentage — Operational beds   68.4 %     66.3 %         2.1   %  
Skilled mix by nursing days   20.8 %     18.4 %         2.4   %  
Skilled mix by nursing revenue   42.4 %     39.5 %         2.9   %  
  Three Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Recently Acquired Facility Results(3):                  
Skilled nursing revenue $ 59,340     $ 12,136     $ 47,204     NM (4)  
Assisted and independent living revenue   16,559       1,369       15,190     NM    
Total transitional, skilled and assisted living revenue $ 75,899     $ 13,505     $ 62,394     NM    
Number of facilities at period end   60       9       51     NM    
Actual patient days   375,361       56,708       318,653     NM  
Occupancy percentage — Operational beds   74.2 %     62.6 %       NM    
Skilled mix by nursing days   33.7 %     27.3 %       NM  
Skilled mix by nursing revenue   54.4 %     46.3 %       NM    
_______________________                
(1)  Same Facility results represent all facilities purchased prior to January 1, 2012.                
(2)  Transitioning Facility results represents all facilities purchased from January 1, 2012 to December 31, 2013.          
(3)  Recently Acquired Facility (or “Acquisitions”) results represent all facilities purchased on or subsequent to January 1, 2014.        
(4) Not meaningful.                
 
  Nine Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Total Facility Results:                  
Skilled nursing revenue $ 819,655     $ 660,816     $ 158,839       24.0   %  
Assisted and independent living revenue   57,916       35,714       22,202       62.2   %  
Total transitional, skilled and assisted living revenue $ 877,571     $ 696,530     $ 181,041       26.0   %  
Number of facilities at period end   178       127       51       40.2   %  
Actual patient days   3,515,719       2,895,265       620,454       21.4   %  
Occupancy percentage — Operational beds   78.2 %     77.9 %         0.3   %  
Skilled mix by nursing days   30.2 %     27.6 %         2.6   %  
Skilled mix by nursing revenue   52.9 %     50.9 %         2.0   %  
  Nine Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Same Facility Results(1):                  
Skilled nursing revenue $ 633,684     $ 596,576     $ 37,108       6.2   %  
Assisted and independent living revenue   23,826       23,609       217       0.9   %  
Total transitional, skilled and assisted living revenue $ 657,510     $ 620,185     $ 37,325       6.0   %  
Number of facilities at period end   101       101       %  
Actual patient days   2,480,148       2,484,026       (3,878 )     (0.2 ) %  
Occupancy percentage — Operational beds   81.0 %     80.6 %         0.4   %  
Skilled mix by nursing days   30.4 %     28.4 %         2.0   %  
Skilled mix by nursing revenue   53.4 %     51.8 %         1.6   %  
  Nine Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Transitioning Facility Results(2):                  
Skilled nursing revenue $ 49,436     $ 45,798     $ 3,638       7.9   %  
Assisted and independent living revenue   9,568       8,633       935       10.8   %  
Total transitional, skilled and assisted living revenue $ 59,004     $ 54,431     $ 4,573       8.4   %  
Number of facilities at period end   17       17       %  
Actual patient days   304,159       294,738       9,421       3.2   %  
Occupancy percentage — Operational beds   68.8 %     65.8 %         3.0   %  
Skilled mix by nursing days   20.8 %     18.9 %         1.9   %  
Skilled mix by nursing revenue   42.5 %     40.2 %         2.3   %  
  Nine Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Recently Acquired Facility Results(3):                  
Skilled nursing revenue $ 136,535     $ 18,442     $ 118,093     NM (5)  
Assisted and independent living revenue   24,522       2,224       22,298     NM    
Total transitional, skilled and assisted living revenue $ 161,057     $ 20,666     $ 140,391     NM    
Number of facilities at period end   60       9       51     NM    
Actual patient days   731,412       88,485       642,927     NM  
Occupancy percentage — Operational beds   73.7 %     60.1 %       NM    
Skilled mix by nursing days   33.5 %     27.0 %       NM  
Skilled mix by nursing revenue   54.4 %     45.8 %       NM    
  Nine Months Ended
September 30,
         
    2015       2014            
  (Dollars in thousands)   Change   % Change  
Transferred to CareTrust(4):                  
Skilled nursing revenue $     $     $     NM  
Assisted and independent living revenue         1,248       (1,248 )   NM    
Total transitional, skilled and assisted living revenue $     $ 1,248     $ (1,248 )   NM  
Actual patient days         28,016         NM    
Occupancy percentage — Operational beds         70.3 %       NM  
_______________________                
(1)  Same Facility results represent all facilities purchased prior to January 1, 2012.                
(2)  Transitioning Facility results represents all facilities purchased from January 1, 2012 to December 31, 2013.          
(3)  Recently Acquired Facility (or “Acquisitions”) results represent all facilities purchased on or subsequent to January 1, 2014.        
(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 for the nine months ended September 30, 2014 for comparison purposes.
(5) Not meaningful.                                    

 

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 September 30,  
  Same Facility   Transitioning   Acquisitions   Total    
    2015       2014       2015       2014       2015       2014       2015       2014      
Skilled Nursing Average Daily Revenue Rates:                                  
Medicare $ 562.35     $ 552.96     $ 488.67     $ 472.72     $ 521.96     $ 532.44     $ 549.74     $ 546.65          
Managed care   421.17       412.94       457.91       475.05       436.13       445.64       426.75       418.22          
Other skilled   451.25       453.22       316.70       253.00       357.12       317.07       430.03       436.48          
Total skilled revenue   493.20       489.94       476.00       473.31       460.00       433.51       484.90       485.92          
Medicaid   189.65       179.00       177.61       167.13       195.11       184.92       189.82       178.30          
Private and other payors   194.95       188.31       139.45       151.65       202.54       211.53       191.20       185.52          
Total skilled nursing revenue $ 281.65     $ 266.96     $ 233.66     $ 220.82     $ 285.08     $ 255.97     $ 279.09     $ 262.64          
                                   
  Nine Months Ended September 30,  
  Same Facility   Transitioning   Acquisitions   Total    
    2015       2014       2015       2014       2015       2014       2015       2014      
Skilled Nursing Average Daily Revenue Rates:                                  
Medicare $ 566.01     $ 553.02     $ 484.84     $ 462.74     $ 528.84     $ 523.84     $ 555.32     $ 546.34      
Managed care   417.87       411.51       459.78       468.86       446.32       436.29       426.19       415.80      
Other skilled   465.47       446.24       322.97       253.00       363.39       311.99       446.08       437.26      
Total skilled revenue   498.96       490.22       474.72       464.93       467.83       426.88       492.12       486.96      
Medicaid   189.03       178.69       174.22       163.54       194.98       184.32       188.78       177.50      
Private and other payors   193.65       188.92       145.79       152.25       207.32       205.11       191.48       185.33      
Total skilled nursing revenue $ 283.74     $ 268.42     $ 232.21     $ 218.67     $ 287.72     $ 252.00     $ 280.70     $ 263.80      

 

                                                   
The following tables set forth our percentage of skilled nursing patient revenue and days by payor source for the three and nine months ended September 30, 2015 and 2014:
                                                   
  Three Months Ended September 30,    
  Same Facility   Transitioning   Acquisitions   Total    
  2015   2014   2015   2014   2015   2014   2015   2014    
Percentage of Skilled Nursing Revenue:                                                  
Medicare 28.6 %   29.4 %   26.8 %   25.3 %   25.6 %   18.8 %   27.9 %   28.6 %    
Managed care 16.4     15.1     15.4     14.2     22.5     16.8     17.6     15.1      
Other skilled 7.8     6.7     0.2         6.3     10.7     7.0     6.5      
Skilled mix 52.8     51.2     42.4     39.5     54.4     46.3     52.5     50.2      
Private and other payors 8.1     9.1     9.6     11.9     7.4     9.6     8.0     9.3      
Quality mix 60.9     60.3     52.0     51.4     61.8     55.9     60.5     59.5      
Medicaid 39.1     39.7     48.0     48.6     38.2     44.1     39.5     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    
  2015   2014   2015   2014   2015   2014   2015   2014    
Percentage of Skilled Nursing Days:                                                  
Medicare 14.3 %   14.2 %   12.8 %   11.8 %   14.0 %   9.0 %   14.2 %   13.7 %    
Managed care 10.9     9.8     7.9     6.6     14.7     9.6     11.5     9.5      
Other skilled 4.9     3.9     0.1         5.0     8.7     4.5     3.9      
Skilled mix 30.1     27.9     20.8     18.4     33.7     27.3     30.2     27.1      
Private and other payors 11.8     12.9     16.0     17.4     10.4     11.6     11.8     13.2      
Quality mix 41.9     40.8     36.8     35.8     44.1     38.9     42.0     40.3      
Medicaid 58.1     59.2     63.2     64.2     55.9     61.1     58.0     59.7      
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    
  2015   2014   2015   2014   2015   2014   2015   2014    
Percentage of Skilled Nursing Revenue:                                                  
Medicare 30.3 %   30.6 %   27.1 %   25.2 %   24.9 %   17.8 %   29.2 %   29.9 %    
Managed care 15.8     15.0     15.2     15.0     23.4     17.9     17.0     15.1      
Other skilled 7.3     6.2     0.2         6.1     10.1     6.7     5.9      
Skilled mix 53.4     51.8     42.5     40.2     54.4     45.8     52.9     50.9      
Private and other payors 8.2     9.1     9.8     11.9     8.6     8.2     8.4     9.2      
Quality mix 61.6     60.9     52.3     52.1     63.0     54.0     61.3     60.1      
Medicaid 38.4     39.1     47.7     47.9     37.0     46.0     38.7     39.9      
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    
  2015   2014   2015   2014   2015   2014   2015   2014    
Percentage of Skilled Nursing Days:                                                  
Medicare 15.2 %   14.9 %   13.0 %   11.9 %   13.6 %   8.6 %   14.8 %   14.4 %    
Managed care 10.7     9.8     7.7     7.0     15.1     10.4     11.2     9.6      
Other skilled 4.5     3.7     0.1         4.8     8.0     4.2     3.6      
Skilled mix 30.4     28.4     20.8     18.9     33.5     27.0     30.2     27.6      
Private and other payors 12.0     12.8     15.6     17.0     11.9     10.1     12.3     13.0      
Quality mix 42.4     41.2     36.4     35.9     45.4     37.1     42.5     40.6      
Medicaid 57.6     58.8     63.6     64.1     54.6     62.9     57.5     59.4      
Total skilled nursing 100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %    
                                                   

 

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  September 30,              
    2015       2014     Change   % Change              
  (Dollars in thousands)                      
Results:                            
Home health and hospice revenue                            
Home health services: $ 12,794     $ 7,655     $ 5,139       67.1   %          
Hospice services:   12,456       6,930       5,526       79.7                
Total home health and hospice revenue   25,250       14,585       10,665       73.1   %          
Home health services:                            
Medicare Episodic Admissions   1,856       1,328       528       39.8   %          
Average Medicare Revenue per Completed Episode $ 2,920     $ 2,984     $ (64 )     (2.1 ) %          
Hospice services:                            
Average Daily Census   764       451       313       69.4   %          
                             
  Nine Months Ended  September 30,              
    2015       2014     Change   % Change              
  (Dollars in thousands)                      
Results:                            
Home health and hospice revenue                            
Home health services: $ 34,452     $ 20,938     $ 13,514       64.5   %          
Hospice services:   29,057       17,497       11,560       66.1                
Total home health and hospice revenue $ 63,509     $ 38,435     $ 25,074       65.2   %          
Home health services:                            
Medicare Episodic Admissions   5,343       3,845       1,498       39.0   %          
Average Medicare Revenue per Completed Episode $ 2,960     $ 2,936     $ 24       0.8   %          
Hospice services:                            
Average Daily Census   622       408       214       52.5   %          

 

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,
 
  2015     2014     2015     2014
  $   %     $   %     $   %     $   %  
Revenue: (Dollars in thousands)     (Dollars in thousands)  
Medicaid $ 114,106     32.5 %   $ 91,707     35.2 %   $ 316,608     32.7 %   $ 260,986     34.8 %
Medicare   101,212     28.8       78,056     29.9       290,964     30.0       231,860     30.9  
Medicaid—skilled   18,924     5.4       13,614     5.2       51,206     5.3       36,575     4.9  
Total   234,242     66.7       183,377     70.3       658,778     68.0       529,421     70.6  
Managed care   54,411     15.5       36,562     14.0       148,374     15.3       105,316     14.0  
Private and other(1)   62,433     17.8       40,902     15.7       161,519     16.7       115,800     15.4  
Total revenue $ 351,086     100.0 %   $ 260,841     100.0 %   $ 968,671     100.0 %   $ 750,537     100.0 %
(1)  Private and other payors in our “All Other” category includes revenue from urgent care centers, mobile x-ray and diagnostic operations and other ancillary businesses.
                                       

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) rent-cost of services. Adjusted EBITDA consists of net income before (a) interest expense, net, (b) provisions for income taxes, (c) depreciation and amortization, (d) costs incurred for operations currently being constructed and other start-up operations, (e) expenses incurred in connection with the Spin-Off, (f) stock-based compensation expense, (g) costs incurred related to new systems implementation, (h) breakup fee, net of costs, received in connection with a public auction in which we were the priority bidder, (i) costs incurred to recognize income tax credits which contributed to a decrease in effective tax rate, (j) costs incurred to acquire operations which are not capitalized, (k) operating results at urgent care centers,  excluding depreciation, interest and income taxes and (l) results at three independent living operations which were transferred to Care Trust REIT as part of the Spin-Off transaction, excluding rent, depreciation, interest and income taxes.  Adjusted EBITDAR consists of net income before (a) interest expense, net, (b)provisions for income taxes, (c) depreciation and amortization, (d) rent-cost of services, (e) costs incurred for facilities currently being constructed and other start-up operations, (f) expenses incurred in connection with the Spin-Off, (g) stock-based compensation expense, (h) costs incurred related to new systems implementation, (i) breakup fee, net of costs, received in connection with a public auction in which we were the priority bidder , (j) costs incurred to recognize income tax credits which contributed to a decrease in effective tax rate, (k) costs incurred to acquire operations which are not capitalized, (l) operating results at urgent care centers,  excluding rent, depreciation, interest and income taxes and (m) results at three independent living operations which were transferred to Care Trust REIT as part of the Spin-Off transaction, excluding rent, depreciation, interest and income taxes. 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 Quarterly Report on Form 10-Q. 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.

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

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