ENSG - Earnings call transcript Q3 2024

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Operator

Greetings, and welcome to The Ensign Group, Inc.

Third Quarter 2024 Earnings Conference Call. [Operator Instructions] At this time, I would like to turn the call over to Mr. Keetch.

Chad Keetch

Thank you, operator, and welcome, everyone. press Relations and at section earnings on is ensigngroup.net. our Investor the of filed release it yesterday, available We our website our A be call this website on replay p.m. until will X:XX of available also Friday, on November Pacific XXXX. XX, be want call. these to replay listening been statements statements are have of may October today, will all a as that not remind of that updated call XX, We today's to made be subsequent anyone to this XXXX, or and

undue based are environment on reliance current forward-looking are from any our operate. forward-looking cause filings to could and those today SEC on Also, results our risks review or the made encouraged results. and our assumptions and These our differ that to a of today's factors expressed discussion to about could place in management's more call. beliefs impact complete for uncertainties on subject statements expectations, we statements that materially not and actual statements business implied Listeners are should which

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

a In employees no or The holding revenues. Group, addition, Inc. direct Ensign is with company operating assets,

subsidiaries information independent Certain legal, other risk referred subsidiaries, Center, other contractual to resources, to collectively payroll, such of subsidiaries. the human technology, independent provide management our as relationships the accounting, Service services with and through

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

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

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

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

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

Barry Port

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

achieving and drive record new operations. operations in consistently and operations these resource new acquired added performance, own their are report and their results particularly markets our their integrating to happy and quarter. into simultaneously across outstanding to bucket, yet leaders Our we've outstanding strength several recently leaders XX while another these clinical with have continue local that given our by impressed in financial results We're teams shown we clusters

the decision-making for operations. years well our take for have that transition heavily as acquired as around lead these those our support clusters been well, know model us local provide on a leaned to our and existing following As operations on newly acquisitions

distressed were time new our our continue and and of perfect to acquisitions, we deal underwriting process, which them, transition are we the to almost at earlier. contribute acquired beginning improve As all

to the leading strong all return sooner, noteworthy high occupancies leaders a same-store and allows X.X% specifically, building we our increase to over their across This saw quarter, to our quarter, seasonally performance for is focus during operational softer same-store This have the quarter transitioning to same-store prior-year a we our buckets. occupancy. new a during establishing historically experienced XX.X%, grow especially where occupancies. watermark More

translated skilled X.X% in sources skilled which over days by We the payer of also X.X% saw prior-year growth increased operations. all for revenue same-store our increase which operations, all to our a quarter, same-store across

the a transitioning our our We gain our and to quarter. consistent grew important census for and to outcomes. is respectively, business Managed leaders are growing high-quality care over prior-year care point by trust achieving managed of the and X.X% occupancy operations, very by our the continuing same-store simultaneously increases and XX.X% part

As excited we existing in upside our ahead, the couldn't look be the to about we have we more organic enormous opportunities unlock portfolio.

achieve One not over of do acquisitions. multiple financial to the consistency new has entirely on to keys that our have been depend ways time to success

In their of by see if revenue growth. local based fact, COOs who from in of to both adapt working and relentlessly disciplined rate growth markets. to period EBITDAR acquisitions, our steady growth, back a varies revenue Also, acquisition time, of very over generated the made and even our a increased on CEOs market for This during look purely though was possible XX% even busy are you conditions. organic quarter our needs you is the activity improve and will

which increase most mix above to so, do pull various most they same-store to occupancies levers average. are dozens our closer and higher achieved the continue drive well our skilled they occupancies by of same-store to operations, and of As mature

prepared demonstrated occupancy XXXX of to operations and diluted provides earnings XXXX to with same annual acquire which of attractive between of quarter, occupancy for $X.XX in our we continue our diluted continued to results per midpoint significant an lower more to skilled guidance our prices, are XXXX earnings our per strength time, of narrowing our XX.X% operations increase solid at mix new as and as long-term very well recent to and share. our from The we upside. $X.XX acquisitions, than ramp and XXXX will is we results. growth our a higher $X.XX are Due guidance existing this At than represents raising from as up the and $X.XX XX.X% share, years

balancing We current $X.XX by acquisitions are to ] acquired revenue of the for increasing and newly addition billion our manage $X.XX We're also annual previous growth anticipate partners will operations. and we upcoming guidance confident billion billion, our $X.XX the while about (sic) between that to $X.XX of the end year. the our to billion, are from [ account excited $X.XX year up continue and to our of quarter and closing $X.X billion guidance innovate billion

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

Chad Keetch

Barry. you, Thank

Bearer estate Of nursing and to added living Nebraska. an assets leased X we the Iowa in in acquisitions quarter added expected, in of Standard assets operations our them Ensign during the acquired X include real affiliated and and to we the XX bringing during portfolio X Kansas, As in skilled X acquired included are and our excited and since, X the year we of units about operator. we in very XX new new Colorado, and These the continue that number grow real estate following: X were X beds the operations of new operations, by these states. In X,XXX senior XX. XX total, new to

selected financial all were chosen amongst additions the were huge available clinical many us because These and the and opportunities carefully of to potential.

expect committed, We grow pipeline we We on way. into a times of close to remain when see of and of fourth several progress in the in additions and are healthy in especially us that continue a making there quarter and year. very lots opportunities disciplined to remain healthy are opportunities new acquisition in front to next

team Our decentralized individuals few of driven supported but not a by local and is office, a growth model scalable resources. by an leadership in instead on is dependent dedicated

help facilities opportunities are to on become operationalizing In in times these, proven that to plans deal them of choice who knowledge ensure buy-in those a and have local we set care of a health respective when like markets. specific markets of the criteria, rely including their deep are abundant, their acquisitions deal

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

growth their we've prioritize again quarter, to our needs. in geographies As provide their established care as care to solution acute clusters we with it allows our to and comprehensive continue shown this work health together partners to

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

near the we and be see in continue will will and both shareholders have when We accretive deals long grow to that term. to

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

All Ensign rent had from the in reported are EBITDAR the to we X.Xx. million generated affiliated Also to of $XX.X of FFO of and derived the as and leases these $XX.X operations. triple-net, of the rental was ratio for properties revenue coverage $XX.X for long-term an which quarter, end quarter, million subject of quarter, million of

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

Spencer Burton

and everyone. Chad, Thanks, hello,

occurring of with mentioned, throughout to growth the Chad we've year continued in and As concentration welcome Midwest. Colorado acquisitions a the large the

now facilities XX.X% account up of service from year our acquired for revenue, ago. fact, over In X.X% newly total a

X, transformation you Nursing Center licensed tremendous CEO nursing in an the was facility is RNCR is was Today, acquisition and Ensign-affiliated and into Colorado. the a the the following skilled some of became the Collins, operating transferred quarters I've XXXX. highlight who and Rehab Fort to a during Truax, that that, XX-bed to To that the today Upon located do I'd chosen work first experienced successful facility a transition, like building insights acquired state an RNCR, of first Colorado give nearby, acquisition. occurs August to Rockies, recent administrator. Todd in

long-time lack fundamentals. and and compassionate to her manage Case. facility He needed team DON, with Sarah the and but information intelligent a including basic team were talented many tools Sarah joined and operating some leadership professionals, committed

transition, the to began access increased together and daily, local leaders beautifully. data cluster Todd, from transparent with weekly the nearby the monthly facilities, department including Following The education, support reporting. empower to and team responded RNCR partners, team with to

skilled transition and labor occupancy They increasing XX%. other is while which sat went The controlling at XX% mix now been have remarkable. work results Occupancy, simultaneously expenses. and variable to at rightsizing on

by period, care has increased XXX% same to RNCR narrow join that plans During network. and managed major health census over invited their have

skilled have a only is expense the small growth. grown, nearly story. team And and margins RNCR As a by financial of as mix part have carefully increased transition success result, the XXX%, occupancy has EBIT managed but the

led has in turn facility RNCR one and the in health status to Clinically, embraced education, additional achieving inspection training and best the scores the recently from has CMS. state X-star having which of overall

recently transition. were improve at the On nearby also acquired front, has plummeted the CNA facilities, facility graduates staffing the past and staffing but which employee helping program, since few Further, the months. nursing own certification its opened are situation not turnover only strengthening are at the over RNCR, recently

While is innovate transforming equally heightened their the of the as that enormous to potential needs communities. clinical an continue mature important story, is of acquisitions exciting unlocked part Ensign's and meet be teams can

Arizona comes and one subacute nursing from was skilled is campus Metro Rehabilitation mature that more acquired Phoenix, XXX-bed operations the XXXX. and Our second Acute large area. Post of Peoria a facility back in highlight in our

], and Glazier and together Mark of improved CEO, COO, and [ community's years, X with become facility Elliser their their results consistently Katherine clinical team, choice. past financial the have Over

hospitals. allows But pursue the formula to the and XX% X-star revenues and finding, relentlessly ladder quality, has is to CMS climb by execute. of EBIT prior-year Peoria retaining for the the already but physicians, Peoria's at by plans in It needs and and health from The compared acuity with meet allowed strong Their overall multidisciplinary excellence. bar team to evident starts hard is developing in commit which set, the Peoria talent. team turn, to This, quarter, quality the high despite and simple understand, to the grew rating measures health incredible inspections, community quarter. during and foundation XX% clinical to

and subacute growing result QX demand, only major has services of The In been traditional provides of facilities to a expanded This managed and XX and combination high year. preferred address bedside needing one acuity demand addition Peoria center. in last beds and increases for care, exceptional the status opened dialysis has every evidenced remodeled advanced completely license from fact, of quality patients skilled Peoria few system skilled facility of consistently which To a with in long-term made by to wing and strong and dialysis. wound provider is a for attain XX% Medicare for mix subacute ventilator today, care, in days XX% hospital ago, care care services, few for days years count its Arizona.

completely and That Peoria being the for in of course new percentage the overall covered operations over demonstrate continued leaders Today, Peoria. hard and and upside of resource is list Service of prior-year up the a enormous like through work, Center wing admission is campus XX commitment and Facilities occupancy points is from full, and now to same-store the waiting accessed empowered quarter XX% averaged discipline that the support the vision partners. quarter. local long X, there

on financial detail that, the our And to I'll more for Snapper, turn over time Suzanne? results. with Suzanne our CFO,

Suzanne Snapper

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

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

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

We ratio a lease portfolio, achieving our net continue of also adjusted delever to record low debt-to-EBITDA X.XXx.

achieve noteworthy of our significant Our as periods commitment ability to growth long is and growth our sustainable can to particularly continue we delever in disciplined that in the even belief to well growth demonstrates as run.

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

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

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

to also We are our billion. annual between billion raising $X.XX revenue to guidance $X.XX

occupancy based that and we've continued momentum have can performance, the strength as these on evaluated management We and well the we positive mix operational skilled in and scenarios agency we progress as our multiple upon results. the initiatives, seen in other confident feel achieve

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

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

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

Barry Port

Suzanne. Thanks,

collective our post-acute many mission reiterating has As do behind we for in own. commitment industry-leading come. of are grateful we incredible including results. to wrap many on leaders, and to lives care team innovative we new and ways center blessed people, work field up, as normally leadership to alongside their as focus the so resources, how supporting our of record-setting This they clinical in are awe honored dignify our generations that incredibly we'll service partners We're facility these end by and

amazing another why of future build in legacy the have who and the power and people for alongside good. confidence excited impact enduring because is an has long-term about We work our which these a opportunity care will that model industry truly first, about have our one partners. to We're staying the we

we'll improve, turn have our them the We they and call. of culture to in complete portion now faith continue collectively to and built the and it Q&A over have

listeners you procedure? Q&A instruct the Allie, can the please on

Operator

from Instructions] Tao Macquarie. question [Operator our first comes from Qiu

Tao Qiu

occupancy So above the levels. pre-pandemic is same-store already

about across of distribution portfolio? one, your high an point occupancy terms be to, us the think in of Would same-store idea I you number same-store historically, the give able occupancy was XX%. of

could demographic acuity your us quantify from base potential second, and the here the increase initiative And you for patient you given upside strong the to care momentum earlier? higher trend, to managed alluded

Barry Port

Yes.

I high our think pre-COVID XX.X%. watermark was

yes, we So are above that.

where as we've growth. We our higher occupancy today, much albeit limits, far As where excited potential than about are why we is so that -- just we been. for it's there know so is

there's bucket, mature at that look the and are more we try range, operations years improvement quarters, course script. even examples and the stories why that's even which portfolio have those some look and mature many of XX% many, many, into that we amongst in over our at our most is point you operations out well operations, the to continued happened and our in As same-store of in

sicker us the frankly speak opportunity we've time continue our deliver care, a drive model, kind of that is potential, to what our needs is on, a kind to of we're continue steady which play To which It of of mix there's skilled that out norms and is into Tao, for broken post-COVID as is past just basis patient yes, what to sicker and goes ever-increasing partners to the acuity. seeing acute state to and acuity. great need, the

and meet are. pointed Peoria, needs. are ever-changing our the managed other service adapt to with leaders with partners. things by of to our tied the in local touch what dialysis and services adding example in like partners those And continue Spencer and needs out they in care Our They're hospital bedside lines subacute as

the that is COVID you we And they'll continue since of many what quarters as what move see over, do our stay aligned. gradually can that's mix higher. again, so to higher skilled does continue course And and to

Tao Qiu

you demand terms and Suzanne, an of the you're or XXXX expecting could some give it. the from discussion on information in Got Medicaid you any And expected of us state could on in timing supplemental months states share next the quality rate? few among quarters? payment the update the payments, early your

Suzanne Snapper

Sure.

think of guys supplemental in to as rate. recognize look payments. we for know, supplemental payment the how note the Medicaid our we one us you And of I things at

we're So the every supplemental payments rates have quarter, within embedded we disclosing. that

estimate payment and actually programs days the we the that in, supplemental the for performance particular we're that quality of that receiving the programs based state every the we upon of quarter of amount anticipate For and we that have. the

And so every we're actually rates embedded disclosing. day, quarter, we supplemental the have every rate Medicaid in that

rates, you supplemental of the look we dollars As kind a talked in went year, changes about away. lot last of as through FMAP

were of lot as base replaced in rates those as well rates. raise combination A of by supplemental a

probably most California. January all the went being, really just last For this of now with those matter of a normal year of part, the effect course program. it's normal gosh, the programs through going in supplemental into one with And that

most their their program with rate supplemental year. consistent update base program states So

So the current That program X. their is year Texas, had we rate for just example, September in quarter, updated.

And so real good surprises. all effect those. yes, that in performance And No went September. into really in overall

we in I think current those when changes. accrual timing estimate the of And that the changes, the then of true-ups of sometimes the quarter. can take it

Operator

comes from next Capital Your Ben question RBC from Hendrix Markets.

Benjamin Hendrix

of has questions. up tuck-ins the little seems A like a picked of pace of couple kind bit. It M&A-related

driving know fluidity that's Any acceleration. comments to or the sellers? have is you there structurally transaction anything in there it more structurally, wanted anything among market? kind that's the something be Is got there? incenting kind there's anything a whether if sentiment just -- I among in change of staffing Is minimum First, -- of

Chad Keetch

all of this I that, mean, to is Chad. yes

out smaller will But that's that's much like, mean, think just all that And in not one those we I that's with true. I constant there. is we pretty just exhaustion we much, always constant thing for with especially industry the sure, going things I staffing, And it's to sellers definitely of think to stuff this that, some kind harder operators, nonetheless, happen. change. -- up all the keep feel hear it's are from changes. for confident sentiment of minimum of have

of to got a part looking stable it. of that of to kind what of maybe they're sort there's and we through that's and are and COVID it get time. time folks can where say push So like they and also they maybe good I'd see little then at more maybe through now where sell Maybe a feel feeling conditions they before their were a had and a spot it's for I to lot stable now they post-COVID, is a businesses. came think enough

of a seeing and because amount us and estate lot too, they're real true, a definitely large So right? And a where aggressive looking the now, distressed rent of coming that. someone it's we're replacement. opportunities they're payments over that paying, to But deals, there's aren't through always overpaid not distressed find Ben, of for

of those, lots too. so And

in So it's teams, we of we're bigger across stayed of -- as growth, as pretty to we to XX local steady, just we our we're those local our as percentage it, local our markets a that grow, grow kind very on we've comfortably in. pace expect because now will grow of we a of lot and our can terms get capacity acquisitions, right? capacity of So all that states leaning right, they lean the XX on with in grows actually of heavily we have but it. grow also these terms grow have teams approach and operations. And those with factors. do transition And this

Benjamin Hendrix

dialysis bought just in Got the with we associate you. on you you profile all? care of couple that know capabilities LTAC ago. a follow-up changing I of acquisitions LTAC. mentioned the like at which targeting And like quarters higher-level Is typically you're an Peoria, a then And that.

you presence. have and markets in cluster -- already strong expanding there Is you're then where also

acuity kind I'm in wondering opportunities? into the of these scope you're if higher maybe terms of broadening of So some

Chad Keetch

I question. really. say would great a not That's

of I really was think a set the unique thing circumstances. LTAC

down work, maybe our model going road, we part, we for at. look the And that most great. something similar prove been. could And targets the very that's what can But to are so far, they've that's if

post of to happen acuity acquisition. efforts the of chain lot A sort move the up

And wouldn't of new the I definitely in while the been states. of is fruit, will hanging that and And lots see we're too our there's so opportunity. in also We in, acquisition though, to remarks, of different think said states near grow we're say, in but in lowest my some targeting in of even we type room necessarily for new some newer do opportunities first a that kind to have and preference say I I that that's I long continue future growth haven't lots markets. that. you'll this prepared markets that states are adding in to

So of looking we're are expanding kind in deals that's just -- at, also the geographical the of we set part terms of our of footprint.

Operator

David question next comes MacDonald from Truist. from Your

David MacDonald

A questions. couple of

up fair you Just that activity Ben's amount you just Tennessee state been want obviously, with ask the anything answer question update that those on of going? a up provide how follow of Just is regards there on fell? to the call there? last and high-level how then any kind guess follow Is deeper of specific I Colorado on thoughts to a that's would to that And just Or you an gave, there. on kind and little specifically, could guys to out? just M&A

Chad Keetch

Yes.

we that. well, we of a a Colorado know example is track And said, I and really as and priority is know in perfect have our markets always So record. that strong grow to we

otherwise. a it's of we've divided grown, team while have markets. just a that state of X recently amazing -- and it just so in And we've been We've clinical for leaders, we've into both as an and kind

leadership by that, more gives So we that sort -- our and bandwidth. of

structural an of grown and And Arizona in there of important places, and for and too. California other prepare thing Texas sort of growth. some we've done typical that we've how been that's that's to And

And some our with in the our right? I strength to larger, just so that combining take guess, there reputation the team, prepared we were Opportunistically, opportunities of just of come kind acquisitions deal up, Colorado. strength of

we happened love, really about other state there's have than and and great take. it's super nothing to So some that we unique there that up a prepared to deals be come Colorado are

Tennessee, terms new still obviously, we're of in the So to state.

X that grow states definitely have for there. future. Continuing was that's that one I in, to in And of buildings the as one state. in prepare earlier We the to future growth we to alluding near plan

point to about something announce a you'll the to we gotten excited anything in But yet, but on really there soon see front. that haven't momentum have We Tennessee.

team first again, And is leadership X Our there, buildings class. having just a is start. just obviously

continue also in that And resources Carolina we're us other extra to really strength to market extra that excited will there, as allow as we and build the that of South and of grow and country part about parts well. that

Barry Port

in that other of spent at us preparation and got in thing and to in good record these working new is interests have interest geographies effectively we've interest enter track we some look I'd are the that with leaders experienced new leader And David, have time have with align with add states one to their market states. organization. leading we've other to the And a that, which program, that a prepares leaders

XX-plus methodical with It's next surprised geographies prepared are combined some pipeline, jump in. AITs you for growth year. us in to that, not if don't that the approach see other take be states. We rapidly new we but entering we'll And to in a say that, pretty

David MacDonald

out, the about other XXXX? potential guys. of that see just opportunities you you, any of conversations lay I I just one XXXX, out any early but obviously high-level preliminary front you to guess, growth comments and in just for put headwinds about you And Look, anything realize curious, and I'm tailwinds XXXX kind just any point Okay. haven't would high-level

Barry Port

enough kind comment Service the a about from growth -- field Center mean at last that that to opportunities, how our I a bench much market for opportunities. in seeing and that handle so a my we we're what But perspective be the able sure think the that we see support and are every almost progress growth. pretty attractive I pleased make talent can't here we perspective. with same-store tried across to of excited the got certainly as of in we're both so to speaks preparation building aside, acquisition are portfolio we've leadership We overemphasize from we've that that. solid in environment to also we transitioning

those all our well hand. but the go improve There's operations with balance fundamentals organic hand growth having of before, in in X really solid ever and than continue nicely same-store as to along to buckets, to that we're solid having we of and fact which opportunity better growth speaks our things have able X kind

about XXXX. feel we to do lot we of a We to the we overly headed about but horizon. always, need don't we're pretty feel confident. things to excited improve good want where certainly So for There's be

Operator

The Scott from from next comes question Stephens. Fidel

Scott Fidel

of modeling Medicare as question, other the from quarter, the on we interested any call-outs P&L make want coming any round First of just year, either you'd rate just for around to perspective, considerations call-outs? the out new for obviously, rest have 'XX, just you the but sort the for fourth in FY

the seasonal want And modeling when that cash dynamics cash then just perspective, you highlight also from to any flow flows?

Suzanne Snapper

Scott. Great Yes. question,

think QX that pretty just basket When are kind it we we the the supplemental supplementals to changes going QX. mentioned, lot above coming will net Medicare bit be of pretty upon into and ebbs a little in Medicaid ended of with we the we're that of market to and slightly look in where based the that have rate I happening payments, a a QX about we're some increases not talked rate, QX state due QX that up at even between because there of flows you As I the rate and the states rate October what X, in steady in.

the with at just it usually pretty usually well. into consistent quarter, we mix QX With we we're and had of steady model well. state really skilled continued looking as other there of acquisitions a growth kind And that's as is in So higher margins to of regards end rounding have lot in the a bit a there. QX. and coming we little out occupancy then things, as into Obviously, seasonality

a to that that in reminder everything then And have payment year. for the cash we of out those then coming pretty full the for state. going did And We So XX towards a beginning out is just do else earlier QX. the we that acquisitions large going in in settlement quarter a flow, steady anticipate the QX. flipping

Scott Fidel

Interested your in follow-up question. the the in sort you on provide trends out discussion in the care denials, levels and that's marketplace wanted thoughts both then to Medicare commercial managed Okay. Advantage. of just Great. And some my insurer if just around claims of of around

against the acute has the of some of hospital have and the been managed been Most care the side barbs hospitals. companies then commentary from sort trading

denial side, interested seeing of be claims and on from your insurers terms and post-acute authorization with prior those would and been trends definitely terms perspective, what been the skilled more sort how you've engaging health the with interactions So type nursing in of of of the just have in them?

Barry Port

to say back that I And relationship. There deals Look, this indicative the hearing a partners. frankly, with really, the as and community how large And our care all what congressional generally when levels least stay in healthy you're coding care managed authorizations. fairly you're at is Yes. far negative. length and think there's not it's is with and with and topic managed forth on that commentary we of the providers entirely as of reporting rate provider at work nothing new working and there, on

a we are they're and trust and make what to a and there's has based a how when build to so things with trust healthy authorizations changes mostly and have structure to that of foundation and built try that we levels process seeking that Our that that, in of outcomes. that's within work been like embrace sure it is that for we understand approach to that looking seek really kind to

what us will that And really difficult you, as tell said, discussions healthy. it's spotlight have those kind lately of think the -- probably as on because put this to we for isn't want that's I for managed providers. for sometimes what the are conflicting. probably accountability there But There providers as is they patient for quite are sometimes the look, much and the I want care

somewhat the always be conversation that one-sided shouldn't It be and tends to sometimes, case.

look, the healthy think, I helpful. and around So dialogue is this

how impact care. and on there the of out and think workings on to hands terms inner that I with the the some in those be balances the some checks should providers patient play are of

confident So always the because meaningful relationships is feel our in about at and with of there's providers, the managed helpful. to day, accountability think healthy us look, the impact end we probably space but care no I

Operator

Thank you. That concludes our today's attending call. for Q&A session. Thank you so much

You may now disconnect. Have a wonderful day.

The Ensign Group, Inc. (ENSG) 25 Oct 242024 Q3 Earnings call transcript