ENSG - Earnings call transcript Q4 2018

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Operator

Good day, ladies and gentlemen, and welcome to The Ensign Group Incorporated Year-End 2018 Earning Conference Call. At this time, all participants are in a listen-only mode. Later we will conduct a question-and-answer session, and instructions will be given at that time. [Operator Instructions] As a reminder, this conference is being recorded. I would now like to turn the conference over to Chad Keetch, Executive Vice President.

begin. may You

Chad Keetch

that our have a or impact update more replay Welcome revise our of a undertake its all any any of and other complete remind or today. Sania. that reason. and Federal This statements These be could to in about of to information, listeners thank for Also expressed filings result for beliefs as for on this today Securities Ensign environment new changing statements also X, place a publicly today, encouraged updated section which today's the or and you actual and is circumstances of call nor Except any implied statements our March SEC We forward-looking A X, factors cause Thank want and call forward-looking to our expectations, changes that Friday, our operate. we differ risks should on until this and to made discussion as on filed everyone statements results X could call. our be are results. our laws, by us of future from will the assumptions of undue Relations not not listening Investor We as Listeners any may on review to materially are those subject arise are available are uncertainties required affiliates to yesterday. events, at not made business XXXX, call. statements to where earnings on today's based joining will reliance www.ensigngroup.net. available replay current forward-looking subsequent on you, be the February and website website these press XXXX. been announcement statements Pacific release management's PM. do that

or revenues. no other company human accounting, management through independent wholly-owned contractual payroll, Certain subsidiaries as subsidiaries. Ensign with subsidiaries employees resources, operating is such of to a the provide collectively risk direct The technology, assets, Inc. Group, Center, holding to operating referred our services information addition with In Service the relationships other and legal,

and which by the direct believe certain and our to coverage Christopher The that for to words wholly-owned release general and own GAAP of or captive separate, GAAP captive, Center reconciliation Captive our refer as imply are metrics. that with today should its that with professional well our and wholly-owned and any workers' Ensign All Christensen, GAAP we our consolidated we, results, assets, and And have Also XX-K. operated in company can as yesterday's President terms business, subsidiaries and provides our well the revenue supplement operating assets viewed more us not but upon as over used reports. to is insurance and by to press consolidated construed understanding refer herein Christopher? claims as us The insurance we, the compensation In company, assets. of similar to it to use of companies or CEO. our meaning the a to in relied I'll and Ensign turn with complete exclusion GAAP together our terms Service our and subsidiaries, our are operated meant our Group, the reporting operating operating available available its and A liabilities. independent our as made and the liability their is the provide of as not Ensign management, Inc. Ensign, be Company, for The activities employees addition, they The subsidiaries. subsidiaries Group, References has we should non-GAAP call be that, Inc. to these employees are When that Group. we measures nor non-GAAP Form

Christopher Christensen

We're Chad. per Thanks, history. to a in everyone. we achieved morning, highest share our Good report our as thrilled record adjusted earnings quarter

the and per an was for over XXX% for the increase GAAP per Our $X.XX, XX% the was earnings prior adjusted year year. up of earnings share $X.XX, share year

per fourth was the Our prior share $X.XX, adjusted GAAP XX% over earnings increase increase quarter quarter for per from prior an quarter. was $X.XX, XXX% an share and year of the the of year earnings

All numbers record are of these highs.

experienced a XX% the Skilled and we segment During quarter. Transitional the prior our prior year Services over income in over and the dramatic of quarter, year improvement XX%

an and Skilled occupancy both positive occupancy XXX points also Services basis of occupancy of We with year. in over XX experienced prior basis the Services increase Skilled same-store of Transitioning trends and points,

of take that many As The following of time. transition in working last operations, we've making several It a tirelessly and several expecting over XXX and and we've the each healthcare know, contribution often performance. been of integration on meaningful is the materializing transitions our clinical in to truly transform cultural Texas been been in improvement reputational those our operation to now segments. takes have our acquisitions a the us Utah especially as business and years years

tremendous we many in some of mature our organic most markets. upside, that of in However, same-store geographies have in still operations operations transitioning our even acquisitions new all have in

take transitions time As newer in than particularly states. we stated more before, others, some

that over ago. in with we've years over as were markets in countless this Utah that XXX over leaders circumstances the our Utah, have are Texas of similar over and several to But have XX recently shown again. Texas progress few acquisitions, We and proven a period and in currently pathway years

continue business its of year. XX% over prior grew and revenue lines and XX%, respectively our portfolio, other the segment hospice Healthcare, and income to home Cornerstone health by value. significant quietly create Our

business evidence X%, ability these ventures Collectively operating of its Our revenue. represents apply is our principles assisted growth consolidated independent over segments living in and two adjusted business achieved the to company our several prior EBITDAR has now further XX% and year. of grew income healthcare respectively portfolio living and segment services. these by XX% The Ensign's each revenue of

We expect by see of acquiring segments to and growth. grow each operations driving underperforming these organic

will this to ignore. we venture forgotten believe become progress they underlying a difficult value proven Ensign towards long-term businesses. sometimes new our more principles As involving We're making increasingly opportunity strategic apply

Just as as be estate that ensure estate the run. our with our real with XXXX our sorry, to will in --- businesses in real benefit has will our long and just XXXX, transaction shareholders over transactions goal been these

us the per our for for $X.XX $X.XX midpoint owned that underlying the earnings XXXX value methodically increase one $X.XX many represents this estate real all, operating options our our real of to to estate to $X.XX estate by but operations We $X.XX and benefit in spun assets. per available and billion to estate assets. guidance XXXX. in annual creating in real revenue operational recognize continue believe we've to estate of value we earnings by added pleased through focus results between acquired value diluted or unlock also the portfolio share, XX acquiring it's an We'll from out operations continue are improving and to we our CareTrust guidance REIT share there and the real owned for of shareholders. annual of We're also in the of XX% XXXX, our with value guidance Since between and our billion. real midpoint solid add to assets to a but annual XXX this additional important Overall, provide growing performance,

to As our latter can and and year the heavily guidance we've a We're often coming ask our expect year. of be Chad for the about reminded bit weighted more quarter-to-quarter activity. with on the you, excited recent And lumpy investment very update our to we demonstrates our half us business from our the be would performance Chad? give an future. towards that, I'll optimism

Chad Keetch

Christopher. you, Thank

we we during have long-term real quarterly hope dividend located the number acquisition working This represents of a a XXXX, operations in from the Transitional XX Kansas. units fourth our estate Ottawa, to Creek skilled non-profit with prior In strategy and return nursing units affiliate real X.X% quarter Gooding, of care looking to our the in share, is quarter Center, facility of consecutive Rock November, our company's living Creekside to and and Care the in increased Idaho and of acquisitions. our and year made a our to Ottawa, the Bennett Idaho. Rehabilitation, strong of XX, estate and of which subsidiaries XX representing are located assisted the nursing cash shows continued acquisitions Rehabilitation acquired non-profit nursing brought a paid clusters year. operating seller dividend, increase model These assets. per on This we living demonstrating XX-unit healthcare the facility an since, and value success over XX-bed our Meridian, skilled in XXth acquired our living and XX in shareholders. a operations ability with and During campus we the XXX-bed November, nursing the confidence and the developing Also transition independent retirement Ensign's the following in market. further post-acute operating of located Also skilled beds, Idaho assisted that $X.XXXX continued reposition in their skilled Care each local operations Hills operators demonstrating

assisted facility senior in Court five senior community retirement located of and Texas. memory independent Living, XX and and located and living XX-unit memory Hospice business care Nursing, facility Cornerstone of XX-unit Memory Weatherford, Care, in and are a following: and Utah; to Bridgewater portfolio owners the Assisted Memory small Nevada; memory company a Texas; assisted XX Assisted care and XX-unit small assisted Las agency we Temple, that Living units, a living that the Texas; Villa Each Care, X living Home the from County quarter, our space. facilities, Living Memory memory acquired living living care Lakeshore these purchased Hospice care housing XX-unit during operations including facility units Healthcare, located Memory a Creek a in home On Windsor Inc. front, care XX-unit a Rockwall, Vegas, the Health acquired units Alpha assisted California. the in Granbury, Care, exit in agencies with in Canyon Texas; Senior in Also memory living looking XX-unit acquisitions Cornerstone health located were in Washington; Care, Sequoia and community

our and We align. continue growth these see talent, opportunistically leadership when like geography pricing attractive to acquire and opportunities will

of in it skilled the that announced company Cedar acquired XXX skilled a and the nursing beds January, City, nursing operations facility real and with Health estate Cedar in Lastly, Utah. Rehabilitation, located

of pursued These the leaders resulting services home all skilled with independent improvements. agencies, occupancy we states. care quality patients businesses efforts, operations operations, XX XX is living our XXX local assisted our case pathway also the to to portfolio because the delivered healthcare and XX operations, and additions As a acquisition impact meaningfully growing these their seven to Ensign's hospice agencies nursing home assisted health include operations, of XX which across bring and XX saw living

facilities. also real XX own estate the We XXX at our healthcare of

flow operators non-core segments. at to We large acquisition and small and continue all that all of across non-profits we completed different assets. transactions the operators potential to one categories, ranging sources These in come two variety of opportunities or and our selling sellers three a and of XXXX business these from regional completed are we steady transactions turnaround of a a from types or time. of Almost fit two one, see

rents operators onerous We transactions trading poorly indicating rates news are in that this cap leases strong buyers, a all transactions, continue market leverage. on aggressive real large historically lease several and or of unhealthy capital estate overly coverages, structured defaulting reports financial see result face of to and the of as involving at

believe challenges result many nearly as a difficult of led challenging, in not engineering. to are as continue self-imposed our that while are sometimes dynamics We follow the financial creative as to these industry, believe

structure in the the keys One of operation. to way been success our to long-term of has health to a such the our ensure transactions

constraint you we not reminded to We primary are pipeline. our growth use constantly of is I strategy. leaders. As evaluate many each the leaders, to When billings including capital we leadership-driven and or availability clinical our locally-driven It's to to each the factors last and and the operational locally-driven other clinical quarter, there disciplined estimated our acquisition interest, and true remain remind availability of return. reputation operational evaluate level of the opportunity,

for However, remain our and as strategic well-priced quarter, deals we pipeline the opportunities turnaround saw typical strong. last

many, and working in many year very first that had are turn with to and are We transactions be be second to of that, there I'll over and the already Christopher. close this expect confident handful of a the prices. call quarters right remain back that to we And at we on opportunities will

Christopher Christensen

of the the share to runs examples quarter. we'd represent that like Thanks, that improvements over Chad. And been vast Suzanne the before made a numbers, through some few have

clinical we've it acquisitions, was We in additional some Executive Calderon, Flours and of As Led Kyle, our be year. progress Utah. the and transformation. I single Texas completed into Texas to have a Since efforts, amount operational to of of improving insights laser fundamentals. compared and relentlessly of service largest on has team of many to the Due remained challenge thought Texas strengthening is by Rehab in progress. Director, and with one Healthcare clinical Oaks provide Matthew by we and would Kyle leadership readmissions this leaders almost our the our Legend and tremendous our Legend we to helpful has ratings, Texas grown leadership star their of which mentioned by center earlier, examples one operations. and like XX% outcomes, of Mary enormous been dedicated EBITDAR Nursing, this revenues systems. acquisition, accepted discussing the prior on XX% [ph] focus operational Director focused Each a expanded this when

State occupancy As has two has has result premier mix of growth relationships of XXX% overall. star enjoyed and more by grown portfolio, by become than XX%. destination revenue the is also Utah. their facility, many Texas the happened Kyle care a prior skill Kyle in grown star EBIT has a been stronger from one to has in four growth than representative over that within a Legend clinical transitioned We've a of and more managed facility, a the by They've steady but improved the year. encouraged of in has the post-acute success, examples it's and

Our leaders able the strategic have developed dominant organizations to overall been market have Utah with partnerships managed share. care grow and

market. EBITDAR, point, Wilson year-over-year. result dependent To Villa, in occupancy higher COO, of of accommodate overall Salt has patients long-term nursing and been patients. with Brent volumes a have growth. care and As any to acute [ph] a skilled XX% our of and Joseph Joseph Shay St. meets all most behavioral the growth of nearly significant to narrowing and highlight Joseph's campus Lake City complex led Pickett levels and improved have in CEO, by St. in skilled the this acuity, the custodial cases, remarkable ventilator medical respectively by which census rewarded living networks, in and seen from resulting almost operations has assisted adapted revenue XX%, including St. need

a and to while campus, they manage premier star by the quarter area. As as post-acute Greater grow the CMS reputation EBIT same-store rating the over maintaining Lake same facility still all the Salt XX.X% a last five year, in

highlight of me our of XXXX. let stories Finally, favorite one

Mountain for setting. perfect their a a incredible and row, levels the of as applaud team XXX% busiest unheard for and the most the opportunities alone months to that caregivers, the unique Medical. other whatever repeatedly North We you, to professionals Greene, these marketplace, feat Postl, ownership we for appreciation as company Mountain skilled We zero profession. and power additional achieved we leaders for that medical the structure. country. Medical have as deficiency model in cannot busy the their this and of the improvement nimble is gratitude required absolutely as in we a standard and lengthy in improve set prepare With but complex leadership accomplishment our must description of tremendous Jackie star achieved else nursing an cases expertize that future express to at to the third most why the and Mountain unthinkable complex of post-acute be perfect. on of feat North finally a operating over one to up this bring. for being unthinkable continue us This turn and an We I'll the more continue grow fear clinical overstated, for financial see rated level they of a the guidance the nearly therapists nearly and at With year and Suzanne about the ever-changing for and leadership ourselves that our Ensign's we'll in might facility, detail sub-acute the of our any operation, CEO times take X that focus see allows our we Suzanne? all to our much with this proactive Jackie be time one and and let as performance achievement the be kind everything we time survey and in Jason, open but North for you it clarifies not As do, challenging unique the most provide if questions. company's then team facility-centric year. hope Jason operations quarter talk acuity, sub-acute milestone COO, of, of led remind operations how they bore for we ahead and

Suzanne Snapper

you, everyone. and the our financials XX-K filed press contained for year in are and release Detailed good Thank Christopher morning, yesterday.

an metrics and on the from for and was cash was $XX.X GAAP highlights the for from net an million, quarter. Consolidated additional the of line the prior year increase million, adjusted an Some and as On credit. increase of December equivalents at cash include net $XX.X quarter. was million, of prior availability year an key million revolving XXX.X% XX.X% increase $XXX million of our of the XXst, year net year income year for the over the $XX.X And other GAAP $XX.X income for fourth include Consolidated Consolidated the year. year. adjusted income income of prior million, net prior the increase of XX.X% quarter $XXX.X was XXX.X% quarter following. over

times. XXX our after to is EBITDAR improvements since in our transitioning we for end operations of year last this attributable have debt-to-EBITDA off as a lease X.X our flow in year reminder, newly Also These X.XX the spinning acquired growth the $XXX which net was and at As the was from ratio, invested XXXX cash acquisitions decreased million in million. cash to we collections. And REIT. enhanced adjusted free are expected, times $XXX.X a

continued proposed PDPM. patient-driven or implement We to called payment reform our preparations CMS' payment model

are iteration, system relentless are this will about with well systems into quality and confident XXXX. to a on new this October go focus efficient outcomes and including will how and us serve of function latest in learning on new expected effect X, rate our that more We reimbursement more number which is we

we mentioned, guidance Christopher for As our announced XXXX.

We of XX.X earnings share. losses tax and of diluted of yet stabilized; inclusion to the transaction are of and is guidance first amortization operations with projecting net XX%; $X.XX inclusion of anticipated revenue of half Medicaid an the adjusted are to and $X.XX common The which a increases, approximately rate provider reimbursement not billion acquisitions costs compensation; million; associated exclusion of the patient-based on costs billion, related the exclusion shares of outstanding to in per related XXXX anticipated diluted XXXX. weighted $X.XX the average closed $X.XX intangibles; stock-based be of based exclusion the to of tax; of start-up rate Medicare closed and

Additionally, on Christopher. that, insurance other Christopher? And I'll our accruals acquisition the census influence activities, budgets, reimbursement other economy our factors. over and of turn occupancy in staffing, our it in mix, changes of in variation back variation and in skilled include quarters factors asymmetrical contributing to impact general delays state and short-term and to the with seasonality systems, the

Christopher Christensen

day. to want We field and appreciate for our our for us colleagues you joining turn appreciation us making if service you if support. deeply the our in Sonia, again the Q&A, We'll you conduct way every the call We the Suzanne. today our help now would, confidence and shareholders and us better through thank Thanks, to and would. weave their for to to express the center - over

Operator

from Thank with comes you. Stifel. [Operator Instructions] Our Chad first question Vanacore

Your line now open. is

Chad Vanacore

Hey, good afternoon, all or you good morning, are. where

is pressure XXXX? are for stay improved organic then it on at average portion demand? expecting this less and referral or that volume what's quarters point, growth or from driving quarter-over-quarter. occupancy sources organic And Is for So length three of consecutive you of that payers growth? What

Christopher Christensen

than we perspective, like doing, happened more I all same think I But know Yeah. what more it's expect to it that really feel our of Chad continue, I we leaders and think it's mean, because it about are industry-wide. our happen we I saw the from - I in think our don't happen uptick everywhere the geographies. earlier

we has a So like obviously our biased, does to with lot marketplace. with feel leaders do Chad, the we're but than more it it

Chad Vanacore

acquisition pipeline. Christopher, then, you And healthy Okay. mentioned as a

do be So SNF and then and on spend assets seem M&A but mix XX% what growing targeted on health a and now, of the you expecting then you're memory you're you AL to roughly and have hospice? home

Christopher Christensen

to strongly. something I disciplined. ever. It's model. Yeah. not we see home in I we We a don't want are and your say. hospice But that think keeps have little probably lot I based surrounding believe and health goals helpful that think grow in be to we'll us what it there, something mean, bit we denominators just We It's out on smaller. faster the obviously

we'll we grow and hospice we percentage basis a health nursing. living, So think but a in then assisted will and bit faster skilled in home little on

decent would now to there So based grow out and from still numbers years a and continue expect crept on up what up. XX% pace nursing, it X% right several will think in ago we'll now. I But skilled see at I we creep to -

- We that we then do they are to come and little have deals some make people prices seeing very and us. that adjust sense

probably could should. giving But or stay don't number, I'm they know can they you? be long hard helpful as to How adjusted more I Chad. so not as I And you

Chad Vanacore

the will thinking Well, tell This next skip to I'll I'd be question. the was one which what, my last, expansion. about just you

to the [ph] expect we detour focus or regions you abundance opportunities markets? really skew Western of Southeast. where still particularly, the East, west, Are in to any did seen the you've on there and You you should

Christopher Christensen

wildly in get footprint, see states focus don't we'll and XXXX. Midwestern a Wisconsin think existing our have existing that places like healthier still we expand more footprint. us lot you our could our plenty bit the grow in But I expansion in. states I footprint right on we real plans There's other opportunity any we're of mean, as of a little to than in in now. some

Chad Vanacore

and Okay, that. it leave Thanks. I'll at

Chad Keetch

Chad. Thanks,

Suzanne Snapper

Thanks, Chad.

Christopher Christensen

Chad. Thanks,

Operator

Thank Markets. Capital comes from Frank our you. And RBC next Morgan question of

is Your open. line now

Anton Hie

Anton Frank. It's there. Hi, for Hie on

couple a here. Just

but On to the kind talk the quarter. little of there, of the about through of a on out bit the contribution ask acquisitions, of timing here acquisition? want And wanted obviously anything first might lot assumptions there about to can expectations good or on a you opportunities in some make first the you if you can add half

Chad Keetch

Thanks, Chad. This is Yeah. Anton.

So would for of might and but of acquisitions I small we that of QX also looking that a have deals have, we could a QX. are say, go happen smattering QX, strong handful into then sort

can if a principle the even closing. there's lot deal play have imagine, a of we factors could impact of You come that in timing whole into that

be sort continues, what through less QX So would pace acquisition QX. some up than likely working for in as pick bit. we're had but And first just of of probably the little a pace we we I say, that, quarter will then the the would

Anton Hie

being Okay. the the half builds And that from also performance? a into of I sequential then back year guess quarter-to-quarter stronger

Suzanne Snapper

on. I lot we take them bottom about typically take to of a kind when are on, what think correct. you we not think I That's when first they mean, contributing acquisitions the line

of half we in though get to the contribution year. really revenue bump that the earlier come the the even quarters back is So might into going

Anton Hie

that more estimated is would said wanted believe And guidance? of the I previously factor one you had PDPM, to just guidance. probably Okay, you on guys the for that, fourth the here quarter thanks. in from you 'XX in of impact that confirm Suzanne sort

Suzanne Snapper

knowing with more well. go talked a we I a how house, that there built in definitely we you and impact like skewed different of different clinical the have about think - we've PDPM. really it there have side going all I - noise has a lot to out it's feel aspects regards on when And you - of of lot. the Yeah, the it's that we're lot of that And think and through we're to people a

Anton Hie

it health item on - to look then but home came and on and and have AL mechanics the down Okay, you more businesses, point the year-over-year. could the Anything growth good one I margins the the on - obviously housekeeping mean, the in margins there? we like IL

Suzanne Snapper

Anton, which business was that?

Anton Hie

and Bridgestone Cornerstone. both On

Suzanne Snapper

Yeah.

- on that Bridgestone, actually - home the in So charge. the is impairment there

you took actually quarter, So out the we take the are that fourth in looking impairment if flat. you're just that charge margins at when quarter, the

And so build that, bring you in decrease look when improvement to that a model of then I on decline basis. that there would in go-forward -

Anton Hie

volumes And networks and it kind in that guess regard I are guess the of to we in what looks - coming give networks with the inning on certainly - the are see there through? kind great narrow Okay. as gears, us switching through - then - I Utah, - of coming Can of is expected. you kind where that with to narrowing

Christopher Christensen

say? In you did inning what

Anton Hie

Yeah.

Christopher Christensen

do know, February it's You right.

Anton Hie

training got upon is Right. it. it, Got us. Spring

Christopher Christensen

in basket Are baller, start probably we're second a quarter. the the you of

Anton Hie

Fair enough. you. Thank

Christopher Christensen

kept there lot that in a happen particular going Anton, calls. all take it still I still we're promising it you lot and than in did took developed know early then state So if were to happen is I But more that states. on But a it It's a to more it many was, and longer. more longer. on. those other was much lot don't to there's lot a happen

end. So we're on the still front

Chad Keetch

for there I in mean, that, confidence that opportunity that we've of good market. some I a us acquired building is probably another in add that would there our seeing Utah signal are just also

Anton Hie

guys. thanks Great,

Operator

And Stephens. from you. comes of next Dana Thank our question Hambly

Your line is now open.

Dana Hambly

Hey, thanks and good morning.

Just following up Utah. on

is network occupied only right narrow into building, narrow can now. You Is build about then I and right would XX% into fold have think the time to something mentioned that you it's over something you that move up bought it that away network? you the or

Christopher Christensen

how their star maybe is desperately at on the they're geography. But network depends on what and their Generally, rating standards. yes. depends It good that needs to it pretty sticking

but but be And enough - better ensure we need so and of the the in part high to it be to as to to elevate rating be, case, network, network, isn't like there. high as included to it's we particular order that we that we'd rating star that become continue in in star

Dana Hambly

some buildings then all true? Christopher, more It's ten you - on or star star quality. sure one, I to changes I could number or there's that a two, Okay, just the lack declined staying to through think X but X that's want - the and with is actually going not system. just I make the - right. due rating K facilities ratings nine I in to XXXX, And of of guess, by And the maybe the wrong,

Christopher Christensen

Yeah, it's no, we're good to happy question answer. a and one, it's

star reported are A a to is staffing in of things system is it CMS of that changes, time most communicated that anything the how we've based long how kind lot It whole star with the operators, standards CMS. - get rating not overall and saw before, really the nature. impact are included - of necessarily the on those system have reported, changes lag recalculated up There's things has mentioned with factored things of and decline the staffing we rating and a star calculated, components. elements not and unlike in how rating With in. that how how with of and certain as on do lower or based associated

in there lag place. of between in And in and seeing changes too, too. place, there kind so when the is a mind we're a in system went of kind the I Keep freeze there new think you're was putting what just

for it us for no So to really several impact opportunity quarters.

over as star But how bringing clinically year to this catches quality all can't steadily we been things isn't comes no. no to value-based these you'll based. mean, being in when both whatsoever. think and take and is record is culturally see time change a has Earnings improve as and have in underperforming reflection our is, and for which in it that's participate [ph] and in it's that that mean, confident our like We're payment quality overall narrowing it and what I some these quality why challenges It's into have in far of going as we completely up become becoming contracts factored is how reason buildings on CMS a there key dramatically ratings. with providers absolutely piece the we overall of they're definitely changes that. networks track quality. but they that it I though, them that portfolio. been always data goes, I for these what

Dana Hambly

of right. same into managed down in care, all quarter, the both to as was Okay, the on of contrast That's days of Is a world And like more that read helpful. to percent skilled to be the as the revenue sort it this just and way moving this more kind impact mix, Medicare Advantage into the moving of facility where a some numbers a are quarter trend looks to nothing kind which you're seems is fell how or it? people plans. is percent that basis on trying and of this

Suzanne Snapper

growth also our just same-store. increased, in have Medicaid into a if also the transition had did skilled at same-store, we mass a time. bucket. little which we overall. transitioning flipped on previously what did - that grew but operations bucket, the at kind the Overall managed for bit talked whole the skilled of care lot a looking we issue. Medicaid on of that overall to our with more about same We as increased With regard But days population, possibility on you're Kansas managed on transitioning the So our grow the was that the regards where care overall to bucket, overall actually overall is, that more we a what it's

on was purpose that particular that in area. So

answer that and both of questions. bucket those So should

Dana Hambly

if would be, day Okay, prepared right. to going ready then the you need live how or - for are went tomorrow Very every X up like it you helpful. get hypothetically October all it on PDPM, And this? to until

Suzanne Snapper

I think obviously. day every to use we're going

I think of mean ton a there's opportunity. - I

of on are areas the ground in programs running We tons pilot some different to optimize. with

take advantage of prepare, - but our making goes we're we utilizing the appropriately already. all provide actually as we're that having at, services both look sure operations taking of local clinicians prepared local utilize and this already making that can the and clinical that to think just I therapy today have the going making some sure of today, leaders half not each we're back are to that [ph] things one that well right, that as capture and we changes, changes strength in we

of sure So different capturing And a definitely areas. already making changes lot just of we're in we're already making we're tons lot a that then services of providing.

Dana Hambly

you're Okay. cash operating operating heavy of had flow growth. couple level Operating strong obviously XXXX, lower, All legacy and getting that a we expect But was acquisitions right. really XXXX? that good of collections. ago a were - were for Suzanne. you in you cash in should And out doing the couple Is the years of last still taxes ones flow to

Suzanne Snapper

it's of combination things. No, a

some previously. is it lag it of that with taxes had a from then the some that going to of continue. So makeup that's part And is, we

routine acquisition And previously that would getting of the right, on some the on we and from the collections we're basis whole of because turnover process. better [ph] we anticipate paid versus where the continuing a cycle this lag of

higher - And not be that so 'XX. they high maybe been than would in we it as will have think but 'XX as that

Dana Hambly

Okay. And lease your it look the on much accounting Is change, right? then it statement that income Suzanne an on impact like has of anyway. doesn't

Suzanne Snapper

That's correct.

assets the entire and balance $XXX,XXX year billion going the liabilities, sheet the you're for on a put about see to the impact $X P&L. we're of So projecting and on

Dana Hambly

Thanks Okay. very much.

Suzanne Snapper

You're welcome.

Christopher Christensen

Thank you, Dana.

Operator

would call gentlemen, Thank remarks. turn over now back any the this like our further include Christopher ladies question-and-answer you. to for And I Christensen and to does session.

Christopher Christensen

great you, everyone. Sonia thank you, your thank and just everyone helping Thanks for day. us for has with So this and time hope a call

Operator

for concludes program. you today's Ladies gentlemen, today's conference. participating thank in This and

have disconnect. good all a may Everyone You day.

The Ensign Group, Inc. (ENSG) 8 Feb 192018 Q4 Earnings call transcript