ENSG - Earnings call transcript Q2 2024

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Operator

Hello, and welcome to The Ensign Group, Inc. Q2 2024 Earnings Call. At this time, I would like to turn the call over to Mr. Keetch. Please go ahead.

Chad Keetch

welcome, and operator, you, everyone. Thank earnings We is at yesterday, it release on filed ensigngroup.net. the website our available our Investor and of press Relations section A available also X:XX replay call website p.m. our until be of this on will on Friday, August Pacific XXXX. XX,

may XXXX, on anyone of that have been and made these to statements to of as statements updated call current subsequent call. listening nor made that statements want operate. a we be to and We today about today, expectations, management's forward-looking all beliefs the based be are assumptions remind replay will this July environment and Also, XX, not are today's business any which our in

and not are encouraged statements on could implied expressed for impact cause our that and or could results place forward-looking complete today's statements our from that review These a risks of our Listeners call. undue more those subject discussion on are reliance should uncertainties filings SEC to to to actual materially results. differ factors

as forward-looking or required to revise events new circumstances federal or future its other and any arise update publicly not Ensign any subsidiaries information, laws, do where a independent result undertake changes changing as of Except reason. for statements securities by

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

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

us Inc. we, The company, consolidated Ensign, Group, to refer subsidiaries. our Ensign words its The and and

Center, subsidiaries of their References the All are of our have employees not to that imply use and operated and independent Healthcare own and that REIT by employees and or construed the activities insurance Ensign to are independent its management, terms separate subsidiaries, should by has the companies consolidated as meaning assets. assets, the the as revenue operating captive us, and nor herein Standard Group it assets well we, company the operated the words Group. Bearer The that or similar are our as Ensign be direct of any meant Service

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

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

Barry Port

operational clinical principles. cluster partners of they to are their practice with and local all they our you portfolio. the our quarter thrilled entire created continue consistently teams performance We're us for outstanding all thank in and report leaders joining record across another excited have as Chad, We're Thanks, and together today. momentum our how drive financial to work continued about to and proven

in and operations, in pleased prior growth and see very our mix managed in quarter particularly transitioning days same-store the our care population. skilled our year to We're over occupancy

X.X% quarter. the over XX.X% an Our the same-store occupancy, year which quarter, reached of for prior increase

that ever growth, the as operations of in about we and the that continue the skilled X.X%, excited amount respectively. revenue many of X.X% quarter we an and of With built-in portfolio as our our upside service saw that in transitioning exists increase levels incredible addition, pace most also so for In same-store acquired are operations attractive XX-plus of during as that occupancy our lower which XX an to years, towards occupancy resulted emphasize want march value ramp at the we dozens range. mature in which of creation. to very percent same-store I in are regularly in enormous long-term have has achieved, operations prices,

they inherent the about very So potential in with is our are, excited consolidated occupancies existing that organic growth where get significant portfolio. we

clinical to will a are allow and on results capitalize solid consistently we cultural occupancy estate our continue we to over that us partners skilled sustainable inherent will have achieve operators that delivered the As mix strong growth our in on time. continue and excellence results, foundation the to expenses, build of confident real which our portfolio,

you growth mix nursing release our new we've To skilled some were buckets. our and represent as Again, organic bucket total perspective, acquiring XX.X%, for and yesterday, in and represents transitioning buckets saw potential in existing been operational those respectively. Also, our and transitioning to emphasize recently press XX% the days this give that want occupancy our the growth beds. operations busy XX.X% massive now skilled operations within of we acquired

While mix days and XX.X% were skilled occupancy and respectively. same-store our XX.X%,

upside over each new operations we've mature. shown they expect As continue to our to we of decades, unlock significant as teams in X the these

into acquired sixth begin and has row for and ensure the for for of row. that operations staffing been of achievements, quarter financially. a this all integrate of amazing on the in their has are teams in our in in And process use improving their XXth teams clusters resulted clinically caregivers and our the the recognized customer the also occurred a second to local focus quarter decrease lower Our while assisting a now which simultaneously their agencies daily continues newly have and turnover

to per to $X.XX to our XXXX as skilled increasing well more narrowing than from XXXX from of increase Due our and acquisitions, growing recent our represents diluted our over higher we than earnings including and occupancy between midpoint continued our solid stable earnings mix as results, to strength and are XX% results. guidance is annual $X.XX $X.XX XX% up XXXX share, new guidance $X.XX our results This an share. our XXXX per diluted of

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

We due is singular are result partners a are confident continue that performance to operations. the after and while transaction, year This about consistent and growth of upcoming manage our excited also quarter or addition but not innovate event will newly-acquired of the large performance instead balancing the is even to transformative some and quarter.

remain are in to front service-center of efforts drive these and occupancy the improve All expense due of many commitment and our management field partners. teams, operations. proven developed our leadership to so XX in as skilled mix years. we by unlock Ensign to are our opportunities us ability over There value poised an achievements in showcase the caregivers, to all acquire again local to resources successfully entirely and principles find, operations, and applying and transition continue of We underperforming performing

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

Chad Keetch

Barry. Thanks,

because living the XXX Standard in skilled Colorado, new XX These XX We acquisitions X include number X add totaling X these were these operations, Iowa, Utah, an carefully the included in were of new X very acquired nursing Texas, operations leased were XX. additions beds. Kansas, beds, the in chosen X operator. all new X about the affiliated Ensign and to new by new are X of to and estate the to assets, Of in amongst in Arizona, clinical X,XXX senior in to Bearer in X during to in new Each and financial the which Nevada available Tennessee, of assets and units bringing huge operations, X real LTAC quarter, growing year many portfolio our opportunities following and and of us estate and operations them continue added potential. during excited the X real selected acquired we the XX

have and established We health it deep are allows with continue as in hospital needs. we where together systems a work state. relationships particular, to care grow In growth in to partners our to to provide acute solution comprehensive our clusters largest the Arizona, their long-standing very with to their a care we prioritize in the excited geographies

in clusters some room our and states the significant in also of next are to or have we excited growth where we several add additional in expect markets density However, build newer more markets to in months. new

We some exciting up continue are to additions fourth see new quarters. a very and healthy pipeline to we lining of acquisition close new expect third that opportunities and the in

grow centralized local leadership. Our scalable, a in to on local of deal set we like that a health decentralized but knowledge these, opportunities and is are their ensure In growth markets dependent respective disciplined is by abundant, experts, driven healthy we deep times including criteria, of a when on not instead very deal remain rely of model way. care a proven team

historical to consistent result insist a the performance to of performance, we are foundational elements structure with over long of that prices been the cost returns the which achieve of in operational pay period us that a allows One time. healthy will our has commensurate

growth do will organic short-term revenue or for of the built-in However, Accordingly, grow upside. or the growth sacrifice sake metrics earnings. acquire we and we just by not margins for long-term

grow our when delivered to continue will come. for to consistently deals shareholders be executed to accretive to we communicated, As we is intention see have and years that

to an these We leased Ensign-affiliated which properties, assets, and disclosure XXX is of are provide Bearer, leased to additional comprised third-party operators. are of Standard currently on continue owned XX operator to XX

of All we which $XX.X the of Spencer, properties coverage the operation. million triple-net more quarter, the that, of leases an $XX.X are of end quarter operations. and EBITDAR Also, million X.Xx. And for from around with as these And COO, had to was subject rental rent turn $XX.X long-term I'll to color add Spencer? in the of generated an to Ensign-affiliated million for quarter, our FFO. reported revenue of to derived ratio

Spencer Burton

and into achieve day incredible you to affiliate give we examples hopefully our hello, deeper teams doing excited quarter are X night after everyone. to Thanks, the that to insight consistent continue that see Chad, work present and operational can that I'm quarter. results the

categories. X/X jeff either suffered systematically of the Executive and I'll highlight Springs ], acquired bed Iman February to and XXXX, poor occupancy or first a [ our earlier, located went facility operations Healthcare, XXX Beltran, mentioned As together leadership the team community. tremendous facility a of more California. transitioning in COO, from called and it care in Bravo of the that, Barry the San in all Despite health is was Arrowhead challenges, acquired facilities saw recently Arrowhead with Director, in low work. When of are the than this potential Bernardino, a SNF transitioning the reputation Because

and poured have results The local been with year was building First as themselves difficult systems, clinical care hospitals astounding. the into remodeling organizations. managed establishing partnerships forging team the and

has occupancy prior CMS from stars at QX jumped quarter. Overall overall XX% For to example, increased care year. over over Medicare star acquisition stars X from this X in year over XX% managed increasing has of With rating days XX% at the skilled acquisition and today. by to

increased As expect, need labor retain you contract to per additional and employees growing has because hire has to from place been year would spending great over Arrowhead the month $X they've staffing. to reduce and work, census a last ago $XXX,XXX month. become able for nursing a But on

with and Not earnings, improving Turnaround Arrowhead have acquired of surprisingly, the a great as our the year at quarter. prior so XX% being many newly facility progress operations. is has meaningful made by over at become example so healthy, transitioning of EBITDAR

for Grateful years operations continue improve and excited these as to and for done being organization to to contribute work to come. watch our the

CEO, we as and ongoing in rehabilitation we're same-store COO, these enthusiastic this is are Rainier new our to of growth example Chapman. about Now heights. excited transitioning which reach as Brett see Washington, the continue Puyallup, in operations, we One about by Watson; equally led Staci facilities,

team This a excellence. being with X-star Despite quality to to shows its health obsession at at decade ways The ago, foundation grow measures overall. is and Rainier CMS in earnings. and continues find rating acquired for an the improve Rainier quality inspections, clinical

the team in state strong In the in spite Washington facility nation. survey most the has has past entire of of deficiency environments for free high-acuity surveys. annual patients. ventilator-dependent clinical fact, difficult the #X Because reputation, the scored other become one Rainier X the In having Rainier and of in their

preferred and provider care numerous systems recent awarded have in taken Managed organizations notice, years. Rainier hospital and contracts has been

admissions. hit mix As occupancy to and and a operational waiting recently and a to capacity for maximum result, list had facility the skilled increase start its continued

on year In quarter. grew operation revenues by they've Rainier's its most from by prior the want XX% and XX% the culture established. second quarter, perhaps mature that People contribution comes over this people EBIT best And to acquisitions. But impressive responsibility do increased leave, when to or be scores Their new turnover for Washington. it's part often of rate take employee among facilities at Rainier. the in sister

far and directors nursing who multiple and at the have facilities team spread the as impact continuing Staci Rainier's nurses facility. Rainier sister now are to trained care influence beyond example, transforming For of and

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

Suzanne Snapper

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

for operations increase of equivalents $XX key from diluted per $X.XX, common million share and earnings net an as increase GAAP paid million, cash $X $X.XX Adjusted $XX.X GAAP $XXX.X quarter the XX.X%. an earnings of XX%. metrics both of XXXX, company was The X.X%. an increase June cash of of per was additional increase an and income highlights a Consolidated share. Some was quarterly was Adjusted GAAP cash of include increase flow billion, per were of an revenues dividend cash of share XX.X%. Other $X.XX, XX.X%. adjusted revenues diluted XX, include million. income $XXX.X and of net million,

We annual XX a dividend history for dividends and the increased years. of consecutive have have long paying

We adjusted debt-to-EBITDA to growth growth lease Delevering net that we commitment a delever noteworthy and our demonstrates sustainable growth and is in portfolio, particularly continue our the can X.XXx. of achieving of disciplined run. believe periods long also continued to we as achieve to ratio

$X currently under on $XXX of future of our investments. us of which cash for we have with addition, In powder balance dry available combined when sheet, approximately give credit, over line the capacity million billion

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

in remind will CMS revised period to a rule, us no you which wanted XXXX. impact and staffing on material have if that have multiyear also minimum We will phase-in

narrowing per to As $X.XX diluted we our to per $X.XX are up and increasing between guidance annual Barry share, earnings share. mentioned, to XXXX diluted $X.XX $X.XX from

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

based agency initiatives, as on performance and the in management that evaluated progress we are see can We the skilled achieve these multiple confident our have on well scenarios results. and operational and strong we occupancy as strength the continued momentum we and in mix other

implementation. Other could acquisition economy general and turn Barry? the systems, seasonality impact in state back short-term I'll to delays that, reimbursement our budgets, and tax exclusions on of mix, to outstanding acquisitions closed of management's quarterly of Medicare of tax; over that Our common approximately and and skilled XX%, performance XXXX variations staffing, guidance based occupancy the inclusion inclusion in is in the impact on insurance from with the XX.X million, in include average a compensation, census stock-based expectations XXXX, the activities, Barry. factors. And of with factors call diluted variations weighted in of influence reimbursement litigation and shares for and expected the rates and close rate coming calls provider primary and Medicaid net of changes system other

Barry Port

Thanks ,Suzanne.

up, partners we work facility again field record-setting alongside incredibly wrap we are grateful resources, service that center leaders, our are how and must results. these team reiterate behind to and clinical As honored I

of we instructions complete including Q&A and We our Sara, can are collective they our how to to the incredible excited and leadership of have you own. the turn to commitment collectively built new give the future partners, ways. This post-acute lives over and us amazing to have on these their proceed? culture they it call. now of improve. We'll has supporting in so about them continue always by faith portion as focus innovative impressed care our and industry-leading many, dignify blessed our in on We're because mission

Operator

[Operator Qiu the question of from comes Macquarie. line Instructions] first Your with Tao

Tao Qiu

first Last My on and occupancy is question pre-pandemic upside. surpassed Ensign levels. momentum quarter, occupancies have

another is occupancy had quarter, pre-pandemic XXX-plus basis which You point growth this averages. above

with need you clear upside on prepared to to amount the to and thoughts the momentum, Barry, hurdles typically more of the wondering the key compared occupancy. and unlock in to upside also your time to it could operations you So if get alluded remarks, the share you takes the I'm mature XX% there? current us

Barry Port

Yes. demand Thanks, was that's strong, for a through obviously, focus growth obviously We've out our it's recently. you this great time. coming can level a level But occupancy that Tao. The is we're really the now, translate -- steady ceiling. pandemic, period been long seeing at hospital of and a seeing back It's as it's -- post-acute long well. pre-pandemic the And at time really for been a even getting since not in a to -- but occupancy see question. recovery occupancy we the data

leading remember, out more that I point well. trends we you time than up the us seeing last occupancy, continuing to in growth we've those another think and we which X I'd rest seasons, at seen year. occupancy to as also, see us our summer throughout to expect the strong is And for And As strong strong pandemic, haven't typically seasonality been of was the now. continue will decline be that kind just we this of demand that indicator that, and is a sharper

Tao Qiu

Got opportunities in individual pricing you portfolio the the stable turnaround question That's Could of versus on deals? update it. versus leased on transactions versus helpful. and investment. And breakdown current is owned volume, and pipeline between terms second us

Chad Keetch

Sure. Yes.

a year. lot in up the to then push done rest this deals of QX, of the always But so get anticipate So lots of tax of beginning We more far a want this kind close there'll a -- and the you'll sellers some of so to that be we our the operational at pipeline for week. kind of is reasons. next lining literally for coming here year, XX sort for very month healthy, there's up of QX -- year. acquisitions -- the always And billing announcements

an activity. increase see you'll in So

In all pops. board, down road they're as terms moms the small the of and Tao. deals, too, well. from were portfolios, that They There close the are over come well really regional on to and some the preparing

So our just states. in you'll a than see us deal some a participate mom-and-pop -- way of larger in a few in

terms of XX geography, the saw in in And said in, out prepared as growth. we're the of states that we X remarks,

we distribution sort important markets, to really really that We'll you'll you'll really opportunities throughout newer which local excited there's deal It's continue are. states making healthy parts grow states. approach of us it's rest in -- in or transitioning is for our to tons in our point. when Obviously, see expand across right? So grow to additions of company, well. in because the feel growing that of other that some think the continue of and it of of year -- kind us an about doesn't they we're some to states continue see Washington also where room approach is we're way in to Colorado, a in the do we and But density it scalable I states to and multiple add the that. are in new the those as don't

Tao Qiu

it. based. broad very Got it's sound It like

to doctrine, want about Supreme which Chevron the ask I Lastly, Court just overturned.

on the you the care staffing latest contest current the also, And and landscape. standards think cycle, the Could the your other I given that SNF thinking many any future in minimum regulatory on health you pending comment lasting regulations. impact election expectation current on have industry future? could regulations and on

Barry Port

would change our attorney minimum ACA rule same the just related -- of is since it has there's to would Chevron Supreme since that play significant before been confidence Court last our the confidence does lawsuit ruling. representing, and impact. brought industry in that say the our case obviously, quarter, increased, a staffing quarter and and slight because same that's attorney I last a the The that our

stronger before case Our ruling. because ruling. of even strong that was It's that

kind out. passed are Congress it's has us come And that's so and as for confidence steps. for through our table bill essentially Senate we and the of that only with that a as We feel good the -- still increased really next waiting ruling legislative has well, now options about on

or of our sure association the a And there's this to overreaching [indiscernible] and not quality trying this even front that an legislation care has just overreaching really has, look, making industry care. I to mandates has advance have as -- unified think place don't improve like a doesn't regulatory that legislation leading the industry overall, rest do what we're quality a in because

with partners direction our the the So and we'll in good feel about we we're against continue to fight this, join headed.

Operator

comes from the next with Stephens. Scott line question Your of Fidel

Scott Fidel

we've that typical what wanted and question, managed on amongst of hoping seeing heard industry up And you also some demand. just the which Actually in talked well not in feel companies maybe around have their you an demand side the the And some makes acuity observations of here you're from that pretty as summer, around particular, at from entering confident utilization about thinking was about who uptick just follow first other necessarily to the on the I recently, playing Medicaid effects Barry, the some that comment, point. redetermination. been out out in about then seeing rising the Medicaid particularly population. Obviously, there's seasonality seeing the you can flesh made and this populations

something to more patients. on around services? a And then of whether maybe those sort I was on dynamic. focuses of So representing the you're potentially you towards types Obviously, and that's seeing double-click the here that higher-acuity Ensign trend in for also around demand that patients dynamic of hoping acuity general, could

Barry Port

services subacute others. to looking population services and our ways at payer skilled the acuity of leaders question, groups, grow. Scott. segment great trying types and spent enhance is including definitely of spent to we increase a we've deal deal continues to for And time Great of our Medicaid, an all -- profile have in behavioral health services find which time why acuity are those great patients, across which include That seeing a of or and

going we've you is a And of to in and You that We grow us, kind recent embraced their pointed significant continue perspective, payer penetration -- Advantage, there that Medicare Advantage. particular, we've our seen movement over care, for and there's it's managed now Medicare know more be embraced a that play this tell out we've study I'll that showed long from out out. Because XX%. that to to the measure with operate to way members. important align things result their partnered that we of are the as We've all we as and we've And to in to we a relationships that payers. how and with really mix them try things that, seen done managed that have them. can adapt we population, payer with our and closely growth to Medicare we patient solid care our Advantage the

So of that our strategy one of been out I in summer, is us to we're kind that tell you demand continues point that significant would strong increasingly as and markets. I overall, area significant in growth their in has of consolidated leader as rest the of on for middle important can the be and But kind in as show us continue a to time of same-store of are year. solid look for overall when factors occupancy occupancy, both even the a those basis in all improvement a through of landscape normally on we at don't. our this basis, we each forward And

Scott Fidel

point, on seeing for guidance. embedded whether expecting in of your wanted Okay. of if talk labor from I sort you're this trends, at year and quarter, you're give turnover could terms wage agency then maybe now to the outlook that's question. full agency basis. the where and the update Great. to was a what and and about, pretty then improvements your what for about also you an the ask the on at just bit at had now was a you utilization wage relative sort of And in labor trends all looking could on second you both in changed us And side, a mentioned was hoping [indiscernible] I initial that sustained follow-up peak.

Barry Port

over or opposed back that are I'll But positive. last kind would I would inflation mid of We're the low that very the massive Yes. say, range And double-digit -- let happening of I wage wage from cover are that. even low year seen through We've wage-inflation single if trends last, period. we now saw trends been so. has trends we were normal moderation that couple others the the what as And the call worst to moderation we a don't down over years. that I -- comment the all mid-single-digit more inflation of in of to of seeing historically to wage

our this to But in agency we this prepared that turnover area remarks, many, our and we acquisitions agency having we've of quarters our on to We're use way. back we're with obviously, help that levels, we those then been pretty over than -- taking take to taking we've has challenges of as seen with portfolio. that improving many more they nursing over pretty and to have growth, as into it significant manage most on And as utilization solidly facilities has talked been has still challenge the pre-COVID leaders in taken a that the lot magnificent our about with in do agency. historically. We on dealt nurse not troubled we're be of integrate have we're seeing tend down time, a

getting that probably were agency on too because with a we to where today. massive where to historically X made whole, same-store on trends far or not basis. where we're look in are So a basis and said, pre-pandemic a industry were back are were above we've a take if we from improving at But dramatically you while, maybe strides for don't that us year the another those see as from keep a we where will they I

super all for that's So positive us.

Suzanne Snapper

kind -- did than -- obviously, regards coming to everything think other baked consensus, within we've seen is we with what in of the And -- I is the been really has baked range raise.

because additional the occupancy did of then bit earnings. so experience bit a on And of the really through the occupancy we realizing the little results front of that have better -- and having has little a

Scott Fidel

got And outlook well. half a the the helpful. strong the incremental provided, last expectations would improvement then bit as just you've the that that year. of it for upgraded was margin That like question, of imply Great. growth seem Obviously, just line top on in Okay. back accelerating you does

Just that or about in just of whether if on the third you fourth we the get of update sort whether be expect any back seasonality and half EBITDA margin the year consistent thinking wanted in should there's your quarter? trends be the to those to relatively around

Suzanne Snapper

Yes.

with we're when think going be the of the has year, and relatively it consistent, stronger QX to at for overall been. out it's like obviously, looking being we kind guidance, always I look

overall. And put margin what with the the we've always it's on there so on consistent and very out

Operator

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

Benjamin Hendrix

you I you same the that figure the towards question such acquisitions us I an in -- synergies, markets Kind what same that see the at you could out necessary critical of point quick the if I'm some reach cluster I a get Just when mass? the guess does the might trying follow-up efficiencies give like to newer M&A will, that clearly, get market from kind Tennessee cluster flywheel, Arizona? we the do of, idea of if in the start kind the realize markets. wondering model mass more new rolling a to critical on was quarter, of in to

Chad Keetch

too. question. Yes, I'll chime let in, these it's great a guys

is buildings X a to size, X an large cluster is ideal X certainly, cluster. kind So of

cluster. then start you another pass that, have you big almost need and getting to too get You

is so for to -- each fly So of other's at have into and little the of in to if a of these kind as of under access that's it, too how -- just perfect size. And terms performance. that radar, And big, -- speak. full want it's look just sort the you have we they reason together, to easier it's get it groups the kind

size right certainly the be it is having important. So

have the can these a need financial, and help clinical, there assist more additional that they the we practices aren't best to to are folks information state, the building, cluster but resources, and strategy, very the kind is that the having clusters there's operator top important market the is a As that. a to in bigger But resources are also get the of of new and unique certainly, too, we states markets, that in necessarily look in and state. be which sort geography. at the all of we part in justify other function state And new that

the of that's other So part it.

So do clusters. just sort have want we speaking grow start market as can certainly continue to a We additional cluster now. resources. And of then we to of that, buying we Tennessee,

Tennessee attractive an talking got for [ It's very see could top-notch very about. ], state for us. which Arizona. that a time and we're a long that Bandera as talented in we that team We've be Albrechtsen leader, So just a very who's Tyler leader been a market is building like, Ensign

kind would come Okay. expect get way hopefully, to sort or under us a out. Anything more step would like then next Barry. -- do add The We we're at year. feet in our Tennessee have sort throughout Spencer of to be in there. again how X I next and playing some kind that before things so got these missed of the there, No? of it than of stages. kind market there, the get you closely we've anticipate that, things sort deals digest I have is But and obviously, And to a of in of step. announcements looking So can take

Benjamin Hendrix

mean, focus of budget rate rate-setting you wanted PDPM there neutrality a ruling. have -- years around, what of might the and what Great. term and environment your during to just change a to on assumptions And implications broadly like, minimum a for especially into seems back, your lot for few implications are see then in I this commentary transition there's more Chevron on I'm lot on longer thoughts how rebasing following the staffing. clearly, rule? guess, I also setting for the it just But up the thinking

Barry Port

any forward. anticipate on will how move rate We don't setting changes

and as aware independently groups And far are of supplemental even we'll rates I still look inflationary as And has overall. work gone, those on rates very that. where And do as are actually we state I in were -- for of you trying in level, confidence with going think the CMS where to with mean even we've basis. as today, forward. headed of where rates at level. we our we're at state-by-state and a that on of basis, go kind methodology rates on right at an good typical we funding Medicaid whole attitude I a all towards is and made think FMAP see thing stability far rates funding, have been -- FMAP when the which And a a average a where where an environment. visibility I to anticipation meaning kind were is supplement kind continue our lot into our pretty about really now right we good we're us state-by-state CMS to of think gives

Operator

the This today's well session as concludes for thank We joining. as you call. question-and-answer

now disconnect You may lines. your

The Ensign Group, Inc. (ENSG) 26 Jul 242024 Q2 Earnings call transcript