Earnings call transcript Q1 2023

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Operator

Good day, and thank you for standing by. Welcome to The Ensign Group Inc. Q1 2023 Earnings Conference Call [Operator Instructions] Please be advised that today's conference is being recorded.

I would now like to hand the conference over to your speaker today, Mr. Keetch. ahead. go Please

Chad Keetch

replay are and April May Pacific XXXX. release Gigi, Investor We We our website ensigngroup.net. call filed section that be will XXXX, Thank to on listening be of available statements XX, and welcome, it been press our want A the at this yesterday, our listeners X:XX have today, today's the this Friday, nor updated is a earnings all that as call of and these also p.m. you, at made website will everyone. of on statements may available Relations XX, subsequent to remind of call. replay not any to be on

for are could encouraged Except new revise our SEC management's future Also, the to affiliates its required any our materially subject could on should current not more other those business about of and information, for undertake Ensign actual place in forward-looking and publicly statements any environment to call. that expressed do to Listeners or any as where or forward-looking These reason. and events, our beliefs reliance laws, risks statements federal forward-looking assumptions made statements on and on impact cause by we securities results. as undue statements result results factors based expectations, operate. a which of uncertainties are today's from not review complete discussion or and changing today arise a to our differ implied that filings update circumstances are changes

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

to as professional invests arrangements certain and owned liabilities. and owns care trust coverage which as independent and as we captive captive workers' operating and properties certain insurance for Ensign insurance subsidiaries Standard the Ensign insurance in with are The The consolidated as subsidiary, health to third-party our our well Group, provides refer tenants Healthcare into liability company, Inc. lease Ensign our claims that made words of well which enters a Ensign real also The subsidiaries. investment captive, is we, Bearer estate general REIT, Inc., to unaffiliated with us refer Group. addition, wholly Ensign compensation In for that its companies as

All their have Healthcare of and the owned and Center, by Inc. own Bearer independent management, companies Service are our the subsidiaries, insurance operating employees operated captive assets. Standard separate wholly REIT that

as we, company assets has the construed nor it should operated any by Group. Ensign subsidiaries are meant meaning the Inc. revenue terms well of our be The activities or are herein use we to its that -- and to or and The us, operating the Group, direct assets, Ensign References consolidated use of today that employees not imply words similar and as may as

is business, A available our supplement our the is complete GAAP to reconciliation exclusion our GAAP we upon that be can Form provide to measures believe relied non-GAAP together GAAP release viewed metrics. press in and non-GAAP of available results, a GAAP Also, with we XX-Q. reporting yesterday's understanding with these our of on not they reports. When more should but

to CEO. over Port, Barry that, turn our the call Barry? I'll And with

Barry Port

and Thanks, joining thank for everyone, Chad, us today. you,

occupancy services of Our continued led constant driven they in Yet as in changes improvement that strategy consecutive quarter. for local examples leaders pleased particularly to excellence transitioning year respectively, were our We quarter, each prior through same-store census. operations the increasing in with skilled X.X%, and in X.X% overall and the locally over by again, teams to achieved of be ninth and growth markets. revenue skilled occupancies, care their continue our we and sequential navigate health

quarter, continue pre-COVID end occupancy reached to given of As achieved disruption XX.X% same-store of to our particularly markets. in was are our we the XXXX. record closer and results the get occupancy level, XX.X% ongoing quarter at in The this the our of labor leaders the March which impressive,

is improving headwinds have fourth in for the turnover still year-over-year-over-year, market of is we agency Although labor our significantly row. our month these a labor challenges, trending utilization and from down

to strong with also and care, managed relationships stronger increased outcome. better to We of clinical build continue clinical due capabilities coordination our care partners

the mix skilled the quarter. skilled As operations quarter, during a same-store grew days and by X.X%, X.X% prior year and our result, over mix revenue respectively,

increased saw in during census managed XX.X%, we increased revenue, care by and same-store X% managed addition, care and In volume quarter the our respectively. which

expanding see existing As our potential ever within operations we organic evaluate growth our portfolio, we more before. than

we here, will we that outstanding and As and we performance. the follow achieve fundamentals consistently to are that financial cultural relentlessly continue got clinical confident us protect

elevated As our last services we and to post-acute quarter, within continuum the are both continue showing to care. census indicated revenue important compared pre-COVID that mix high-quality of when remains for levels, see we skilled just how

the performance the of many to sustainable are to We financially become they in the for of facility services. a our Throughout in demonstrated their and combined time exit acquire as we've communities can time closed quickly. In find, organization's operators performance results. being take cases, and many ability, or them, however, allows sheet and increasing history, and the choice this at it either quarters to are This to ability of increase turmoil more growth with acquisitions is transition times demand foundation acquisition, a the clinically in operations. the improve us mix see often the struggling when to for forced sometimes industry. to are skilled acquire contributes clinical if in happen strong choosing it pleased demonstrates the the of balance at can number of place our market acquired we Most some we we skilled continuous and operations the post-acute solid newly

When operated North we strong last that, American operations a inherit operations going by health During and the indicated us the the clinical were to that were we transitioned that most quarter, care. an we year, for reputation clinical we to leaders. part, with team XX announced previously deal came California outstanding of

opportunities We the of like challenges some agency the our some staffing well most to as also acquisition management prior deals, noted that front. higher-than-normal we expected additional recent expense to related on as

results. large to schedule to months of with is performing X operations -- our We that and of are pleased belts report already contributing this our acquisition ahead just under is

operations work to the months, including contribution typical to they drive year, pressures we this to potential continued with will on new partners during have make XX organization next some over We excited the forward occupancy the that While challenges really some the to will more XX are efficiencies. our to together are face to continue to opportunity these during summer look years.

incubator Ensign retain post-acute give seen while our better us of opportunities, allows the great culture our the This greater one business family. opportunities outstanding entrepreneurial explore care and proven all improvement is program new elements of leaders, attract investment Ensign new keeping the businesses In within we've to helps and momentum. and which leaders ventures, our that

hospice in ventures have to small home we've with represent the health a and potential our these new the become currently, business, our business, While these very past percentage of collectively opportunities shown significant. overall as

our recent to stronger-than-expected growth skill strong solid our very Due mix as occupancy as results sequential and well from acquisitions.

per increase We guidance $X.XX represents up XXXX over our share. diluted an our our to $X.XX is midpoint from share, higher new XX% $X.XX per of XXXX to are annual diluted XXXX of our guidance XXXX and XX% increasing earnings results and between $X.XX This than results. earnings

$X.XX up $X.XX $X.XX to billion from our annual revenue We $X.XX and raising are to billion, of previous billion also our billion. guidance between guidance

the year front. excited draw are that confident to about the challenges continue manage innovate, We will the lingering on upcoming our partners and labor and

Our extremely is never healthy, our leadership has local organization been operations and clinical stronger. and

Our practiced approach will XXXX innovate us local we and we grow. can confidence that to gives continue and culture and since that

built that our times these. model some is we While dynamics near-term fluctuations, quarterly can lead like remind market to for you

We have see throughout expect that and to seen continue beyond. and fully XXXX

some I'll regarding Chad ask growth. add Chad? additional to insights recent Next, our

Chad Keetch

you, Thank Barry.

skilled an X,XXX breadth operations skilled the the operations operational Colorado, to portfolio X company quarter, XX additional nursing XXX adding nursing adding operational new the During in in California, and added beds.

can totaling As we we growth months, as see discipline evaluate our is beds. X,XXX we last operations paying off that new XX the over added XX have

to remain to opportunities XX already are patient, to and of see principles While to pleased and communities, the existing for we the adjust the careful our health fundamental presented into continue line. to stick have We their that confident we care own months, with model growth remain several of will contributing literally workforce market-specific new these developing operations and bottom allow form including we're XX leaders their our been retaining while last strategies needs hundred over our medical most and local attracting methods professionals to staff. operating to to to

current its We opportunities help of forward continue operation with reach each generation new given look enormous together for markets. potential. working our and to to the are time, next financial labor to take we particularly all to creating each But clinical expect leaders acquisition, transitions the and

opportunities place the wide pace We recently within Washington, existing our a of our including priority very last new mature opportunities footprint of and most of are Arizona, see the on large, portfolios small to these highest continue the and the months. range excited some growth over seen to up additions Colorado. have always and Texas We medium-sized and picking markets. about few

new states in service we markets we targets, we've to in acquisition in select years. for those enhance us carefully we that and that been already markets offerings exposure give As operate prioritize our or

entering trust as as continue often gain care challenging the take look we've at is community. new of new well, time said states to We the to before, can and local states health but

southern continue Carolina, to With South be in Ensign footprint enjoy hope states. to the success continue build we will able nearby that the we in to that we

from to Our Group, properties real and Standard to for skilled are Pennant to that Inc. comprised of leases $XX.X senior leased and XXX living was million estate subject affiliated operations. the derived operations the and of of is triple-net investment revenue which assets, living affiliated Ensign these rental is leased of XX long-term senior $XX.X which generated are operations nursing million trust, now owned quarter, XX Bearer Each

produced the EBITDAR Bearer of Standard an the coverage ratio in of FFO of X.Xx. as quarter, and to end had rent million $XX.X the for quarter Also

more for Looking forward, we growth are in even XXXX. prepared

real our is With some if front new of pricing the of the hope some states, recent opportunities seeing are influx on and both we participate in estate to right. the opportunities in operational the core we which compelling

have we increased healthy powder a lot markets. And and of model, dozens grow operating driven our amount lots locally we our a on have of with cash across agreement bandwidth dry to grow. of With hand, to of credit

We more and of industry-wide the expect to on the to lead horizon long-term the future. changes near some in even opportunities

share. dividend history Lastly, of during the And to per reminder, paid increased future. XX-year we quarter, dividend continue for we cash dividends the December, of we year. the a strength, in consecutive our And as our into XXth our a paying plan annual given $X.XXXX

We growth the we have our particularly X.XXx, adjusted a achieving is also ratio the portfolio, to impressive taken lease debt-to-EBITDA in year. of of which continue given last delever net amount

we Currently, when million sheet, line cash million dry than balance future for which more the under combined of in available $XXX over $XXX our gives investments. on have us powder credit, in our capacity with

and which of time, adds to more XXX are of held assets, with gaining own liquidity which are significant are by XXX help value also debt-free over future growth. which XX Bearer Standard owned even us completely We and

that, around more color operations. to with Burton, COO, Spencer? our the turn our I'll And over to Spencer add call

Spencer Burton

opening the to Barry that Thank and the how you, success leaders share a Chad, and of our are ongoing spite serve. needs locally in and significant ability facility his market I'd significance finding in like examples driven their the they few In of remarks, opportunities by customizing challenges. emphasized leadership the to hello, everyone. operations to illustrate thrive communities

was The November acquired from Amarillo of of COVID XXXX height West Texas. in during The first launch medical of example the the pandemic. comes

just drastically building of the with mightily them over census the clinical reputation And In a strengthening was had spite struggling and reputation residents, local clinical have skilled capabilities. culture improved. And in and a X a poor facility of challenges, low work its the and results operation community. XXX-bed of went staffing XX past this transition, to the challenges, years, On the our team patients.

completely become been Amarillo. has decreased staff in example, census medical of With for post-acute has For eliminating improve clinical choice and turnover as lodge also the an labor. able the mix talent, while to contract increased skilled facility professionals significantly employer has

driving naturally now mix results. the is facility a In XXXX. enjoys up over of financial The of on XX% in XX%, QX, from XX%. skilled emphasis quality occupancy And averaged QX

improved by to quarterly learn over But aren't prior team impressive. XX% and you'd new yet. and The hungry their and CEO, improving are Cantrell approaches drastically, results EBIT revenue Carol net Tusik] year and They respectively, expect, and and As [DOM, remain apply and XXX%, outcomes to satisfied to up results. quarter. humble Chris

that note. of managed programs increased the at Amarillo Montecito, to her nurse gained preferred Medicare to And with and solutions launch. Ensign traveled from an as has last and Arizona leadership competence relentlessly multiple entire that the since worked when Amarillo medical affiliated to example care by visit grown XX%, partners. she Carol care taking leads to have Carol organization days monthly visit, hospital One an high incredible provider in admissions providing days by inspired. XXX% community and acuity health that was plans. occurred year managed status care have facility team build clinical the is to The unique have by offer and facility Mesa, high-acuity

Not and lines. share logsitary opportunities endless the for the enormous improvement practices, operators peer-to-peer, state medical also for transitioning operations, only as it come best the upside our even demonstrates seek illustrate in that across does

Speaking example of best with Ensign affiliated XXXX. is practices, operation an been our second since facility that's

in time, North again. bar Mountain Phoenix, Medical has raised that innovated and over During over and Arizona the

level heal of residents LTAC them expensive patients carrying normally overall acute received an that this have acuity. the allows has also dialysis. an CMS wounds while facility Today, in while ever-increasing team require require more complex consistently They multiple their During many quality X-star also these bedside much and would maintain team surveys or XXX% patients accomplished past stay to and of of care care decade, wound for The this that hospital. in-house for respiratory care, X deficiency has done to and ratings. a

organization while top concurrently For has years, facilities added performing has needs entire mix that as the the grown North Mountain acuity, in serve been of and one skilled capabilities the clinical community it mature growing ways of the quintessential this, is the revenues. improve exists the the even boundless potential most In same-store spite in continues of find example performance. operations. that to It to facility

respectable XX%, to mix QX of skilled CEO, the to XX% Jackie in also from an year, North increasing by example, team For this Green, COO, Bowen; Mountain incredible Jeremy and led grew while occupancy XX%. revenue a over

team eliminated develops their caregivers the those on training hiring credentials. supporting successfully increase, nurses. agency team processes on occupancy and and currently As gain and caregivers focus dependence as and The and additional can innovative retention skills proactively then they for attracting

Despite Mountain rate as the in being lowest family in feel the the environment, skilled having North makes a among turnover market. like employee very facility facilities nursing Phoenix each busy evidenced

invariably and As cultural North achieve in Mountain to clinical results continues financial measures, follow. excellence

of examples XX% entire by organization an while For example, pulling enormous to continue example grew its increased in many demonstrating have provide North our results. different to helpful over excellence QX, that Mountain We the to continuum potential partners. total meet that by continues of the EBIT net levers order while care year facility of these their some XX.X% hope the revenue in same in illustrating health the period. are grow operations quarter, for the operators local legacy to are prior needs the to

the on and for company's over up guidance, With more then to Suzanne? our we'll and open provide financial time to that, detail the I'll Suzanne turn performance questions.

Suzanne Snapper

quarter our Spencer, contained yesterday. you, and Thank release XX-Q everyone. Detailed in morning, for financials good and press the filed are

was increase was GAAP include diluted quarter the the $X.XX, per increase Adjusted of for XX%. per share XX.X%. $X.XX, an diluted an highlights share earnings of additional following: earnings Some

increase $XXX.X net and GAAP $XX.X an was million, revenues XX.X%. of XX.X% increase was GAAP were both an million, income XX.X%. net income adjusted of adjusted increase of and $XX.X an Consolidated revenues million,

credit. cash Other line a $XXX and key and of $XX.X of flow million, operations equivalents availability as metrics revolving March million include of from on XXXX XX, of million $XXX cash cash of

wanted of of also reimbursement matters. and We the address current to status state emergency the

we continued Medicaid May the a public increase year, majority the health have XXXX, funding of smooth programs the the will or ending either end relatively rate ensuring the adopted emergency throughout that on operate the of With Medicaid XX, enhanced and transition. states

earnings to we revenue and annual billion of providing As of updated $X.XX are Barry share annual guidance per to diluted $X.XX guidance mentioned, $X.XX $X.XX billion.

have on evaluated strength in programs multiple Medi occupancy -- positive additional Medicaid based as We skilled in the led scenarios the guidance. as mix seen to in and some the have performance our strength and increase momentum and in our and we've strong and well

Our date, based of and management's tax; average approximately of a diluted compensation. provider inclusion to of of reimbursement $XX.X XX%; Medicaid coming is weighted of rate inclusion exclusion expectations outstanding stock-based guidance acquisitions from the tax XXXX rates primary common of and shares Medicare million; on with the the net closed

quarterly our reimbursement changes state factors budget, census other the factors. influence variations XX the performance accruals, and other that acquisition general the activities, Additionally, of impact of include seasonality could staffing, and skilled short-term COVID in variations economy on insurance in impact systems, delays and in occupancy in mix, and surges the

I'll And back to it Barry? turn with over that, Barry.

Barry Port

another amazing resources, Thanks, how them sacrifice, to emphasize us always to team many. honor of to part one blessed we members, and to face witness the help Suzanne. service our in leaders, a clinical minute and so in a commitment and and rolled the to grateful extra are that the work field workloads many their months be and staff. picked facility I astounding their up of made incredibly for absolutely of coworkers, in them have incredible an effort and us support again It's center the patients Their Many important of of operations honored their can't last to effort. It's and take witness communities other enough the has sacrifices alongside benefit up outcomes. their staffing organization. have we sleeves and that partners of serving lives just thank challenges, transition dozens to

we as Just the certainly seen in most ahead. expect past, some we've challenges

However, have learned strength. our foundational that to of with all to loved continuing show those us future continue that to and our We're dedication forward on look their we the on have lean care we the about we'll lessons build to will our ones. excited entrusted and

procedure? And over the to the the Q&A now instruct you audience portion. Q&A call we'll the Gigi, on can turn please

Operator

line [Operator Instructions] the comes Our Stephens. from first question from Scott of Fidel

Scott Fidel

wanted to process that's bit in down dig as just of wind rebating and First underway just enhanced particular, the is question, focus in going to a taxes just a here. on process that Medicaid and little lot hopefully the a obviously, how

some So of intel for hearing efforts terms from those the be underlying for in to it the the would updated what properly FMAP and SNFs from the market. to around structure you rebased facing get cost get great in you're Texas rates are that

Barry Port

Yes.

that. in is kind September. Texas of go but little the into nuance place the cliff So With rate there's like until not the new won't that structure of down a FMAP a stepping se, support, per

be we of where that funding. have we been expense-related been are when for headed, that, and accounting potentially. we means a apply is to accounting the So FMAP. going FMAP That's between Scott, we've where gap been events. there's caveat kind We've for The how to

exists. that between which when natural that of And exists reserve natural also accrue there's means so kind there's a it. occurs the expense a how and we there for lag

the we off, start So of have drop won't in expenses. revenues will to there gap won't continued coming a it offset a but all where there the be be

been ongoing The will some additional on. be method some leaning session combination about some there's this and still there's So unknowns. discussion of some still kind for still grants. again, and bridge conservative funding, potential said, accounting is of, That we've legislative there control cost a

though, said, don't that lot that a know about. there in might we've that already funding. gap scenario, accounted there's be So for of a projections. Worst-case a bit our we in But

shouldn't we year. of the there so And in outlook the disruption how be see kind for any

Suzanne Snapper

will the end just the that period low the from of we're September of of happen end as X. guidance, the to rates clear, emergency in when the anticipating state we be And have of the Yes. GAAP

the support little months some taken coming those of continued support in low kind bit the and that's So kind that high end, through. of we've in more and a summer of

in and that updated for accounted guidance putting that of provided the guidance. we've all So the

Scott Fidel

the rates, just permanent appreciate rates necessary a sort in ultimately get sentiment FY have that just FMAP bridge those to wind-down of Understood. confident the you on that Maybe around updated we the any terms to color that extent basis? And when will of be on in dynamics. cover just rebased the XXXX to

Suzanne Snapper

I'm Yes, can some them, and speak Barry this. and of color on to start, add I'll going

looking it Arizona, from increase to as states, at from starting They actually talked nice stay in a the well with of still they've job. to we through phasing is think wind another X% increase really the the down that of FMAP -- did see as every the They're I already with again about year. this last out X.X done larger great probably what we're them -- the consistent kind year down quarter.

one that's larger states. our of So

some kept and talking optimistic process down in ones Utah's it with lot that Texas, They're place thing. of there, wind thing same looking through that a the -- to big As California those in so going we're we've we about place additional are how doing yes, on been to the they're discussion get talked funding then the just rebasing for year. entire of same about. at There's in And regards FMAP. about. the also California,

the So are we positioned. feel states good really where about

not they're be well, states states as as as impact positioned won't And some smaller the so smaller of also their but big.

Scott Fidel

question. Then follow-up just a

just through extraordinary margin you were properties. any or additional quarter decline additional second of the around expenses. Clearly, American and Obviously, in if still some playing rates we of the what in we'll the you year-over-year. Medicaid walk will you're the assuming incurring to some Maybe around year. of North year. quarter, mention the the expenses the did probably also you rebased us coming of bridge be out in the the margins we see be as that move EBITDA could dynamics first over And in sort that integration did Just later course

actually I'm For costs terms example, have up it looked there been the may like comps. of SG&A there year-over-year. assuming in in bumped acquisition-related some

So any visibility too. that be into would helpful,

Suzanne Snapper

Absolutely. have kind little years, that drive talking that large for been when of services. acquisitions, And of with cost higher. the of is think a obviously, And even bit services I as services that's particularly of to -- starting cost we've we have a more seen drive last to period in the we've for of acquisitions couple higher a of those spend, as that quarters, level agency up cost going what even of going time.

continue And after get go in a so quarter those as our agency get would to of we lower agency expect really down we and period acquisitions base to time. be then over that quarter, to

annual that have that the of that QX. quarter. kind have some funding couple gap that a the of help additional costs associated acquisitions But also to the current so with bump of our offset in with things. up we top of SG&A, we the -- on have meeting that, is maybe One the And going in

things all higher throughout the of first together of other that than make the expect would kind the we So year. little quarters bit those some quarter a

Scott Fidel

I pipeline, and be more definitely it a here. the like of comments if to still very then deals potentially Chad squeeze still And there's could one here, in done a lot around from seems caught active just

want from spring you'd approaching that just that Is as thinking in minimum HHS. there? influence sort have that expected, something given before maybe just thinking visibility approaching fuel requirements I those How some interested your pricing still of on large the industry does is would to deals? of that I deal staffing out in how consistent waiting thinking additional your clearly, in are the factor doing Or the that on Just guess, about look generally, in Or you some guess, pricing? variables to transactions? still you're are

Barry Port

mean Yes. last uptick say, I seen so Appreciate even Great opportunities we're excited just an certainly months the X.X in think I in and Scott, just that about investors. or and long-term I'd question. have it.

just underwrite to necessarily these even We're looking down XX opportunities, even not to or we're to So XX, when a all to road. we're a growth years looking forward XX, or quarter up X, the X going year years.

with sometimes part and the earnings. talked That's And deal. certainly, so even expect we in will we've of that, have a short-term we our drag acquire, as -- that mind just as about, on that

So certainly, through those mean are and I staffing and through we challenges continuing that. COVID, grow even grew to

of as and the think have on mean, happens in pricing, I some certainly, deals going supply we've that's increases, to that. to what started terms the already I of impact pricing. see

I comments, we've noted how with think of the we I are just pleased my in the done. deals performance

And a we not to performance to of careful does always the we're We're start really pay. with for that prices lot that going pay create.

the tower markets. So that outlook know the and looking because -- advantage are ivory in their it's certainly, program is operators Barry an that future. ground gives and our and best what for us forecasting on I some acquisition operator-driven Suzanne think not the Chad and are into These

continue are served inevitable in And create the that other And is great or lead for well to requirements I heavily change industry. formas so those minimum pay. And think has our price frankly, those in approach us. what well us staffing to conservative will whatever pro service to changes developing that they're ultimately opportunities going our involved we're such and

Operator

One moment for next our question.

Our line next question of the Capital comes Hendrix from Markets. Ben RBC from

Benjamin Hendrix

runway bridging Amarillo the labor to with about facility. there? what how thinking line I operations was you sequential new I'm quarter, the be there you exposure a backdrop more in higher assets. California legacy you're the at significantly just the generally then any improvement facilities. you And if talk those your agency the and in Last little California was noted to described wondering bit about there in could labor wondering if agency

Barry Port

overall chime question, There's anything acquisitions. to still great that's too those in say. Ben, lot there's a wood pretty a good a and -- if -- in our look, let chop It's got Yes. and new of I'll But he's to improvement. of certainly Spencer the we're opportunity you And to a environment, news as we California lot is in the have of on reflective of mentioned. steady improve. it's state I mean, path -- a of the

state a and is we'll I see. row, with least think go basis, basis a per that a whole really California on which this now the several months challenge away at But quickly. dollar both in patient encouraging deal to year. a day won't the It on in of is throughout

of the efforts back are Just attract into that around facilities. get and because certified space more strategic get us to the of programs them the into number in and our to nature workers space allow workers the how CNA have of

have around So -- that. we efforts we have

enhance our strengthened have just around so cultural spend benefits employees practices so the lose how around and keep that people we can don't coupled we have. the best rewarding get how and how recognizing principles programs that ones We time and to engaged how efforts them excited to that and our our with sharing we incentive about we our have space, to

the have backdrop. made, it's is progress by that? being what we're to about not answer on a we're anything So say, and encouraged it. you needless simple Spencer, to doing labor But do to add

Spencer Burton

Yes.

we capabilities Just put staffing. their recent staffing, great that's -- clinical joined measure as exciting to their additional leaders, partners our through really into really really those tools, and staffing. effort most this We've us abilities because around clinical give optimizing we data have some that developing acquisition, additional fine-tune great

two, staff needed things you have those of one, to on great that's agency really care. hopefully, being effect improving number number provide And isn't care. of, the used All eliminate that

into lot of lot come have of to think across there's we some those said, use. to in work encouraged, of I But and We're a as these board. the be ever like Barry seeing, got energy tools it. a things we're we've And acquisitions play. to done going more so And

to get So I'm we'll better. continue confident

Suzanne Snapper

board I across California acquisitions, acquisitions but just And we've that quality seeing that Yes. throughout that the not we're had. applies think the

that's think our I comes. So where help

Benjamin Hendrix

are with backdrop one had just rate just your then thoughts thinking parity Ensign into what ask to to regulatory what get rule. the if proposal come you're on in heading just to going I from PM how I second more have of specifically? sneak could I And wanted the on the in. CMS of We've thoughts And Medicare. staffing the impact your that's the minimum phase could year

Suzanne Snapper

increased We offsetting expect thought. is we we very consistent part, because the ended labor the market would what what it's a up and on the adjustment. with of higher basket So first parity that, increase, with then which

when up of where look it we final with to that consistent would and ended we're having end forward originally released guidance, part be we're up So thought rule. is we pleased the very and

Barry Port

federal to the that move staffing mean this, minimum something say White is sooner. this. on would just the I forward CMS House I Ben. On following the it's actually of expected directive We this clear with

reasonably. into like giving or providing I of hope be involved pragmatic can are a at level, ideas is the and imagine and be on ways a next aligns much table point try And feedback and months make implemented the something then implement seat discussion. that starting this this something solution practical something are And something at we'll CMS will go a or the our more to able ideas in We that's very will discuss national a at released to weeks that's that phase that behind this. is with whatever have find it that what to some our and be a

be there it's We've pretty minimum concrete adapting when be doing productive phase-in exceptions other a use details a the worrying things around we give But the a you whole And of historically been There to good something I anything long don't what just a probably most nothing. that. we're always We imagine know don't come also lot what spend at out. would that with around think isn't will about not time. that of ifs. around hypotheticals. it's and time of really yet any our of hard on ourselves host would I sort.

long see adapt and comes out, story we'll and accordingly. it feedback, we'll we're closely. what giving We're short, So watching

Operator

to would Thank the to turn Barry back like conference for over now you. I closing remarks.

Barry Port

Gigi, you, we and and good Have joining everyone day. a Thank today us time us the on for thank call. want with spending to their

Operator

Thank This for concludes you today's participating. conference call.

You disconnect. may now

The Ensign Group, Inc. (ENSG) 27 Apr 232023 Q1 Earnings call transcript