Delaware | 001-33757 | 33-0861263 | ||||
(State or other jurisdiction of incorporation) | (Commission File Number) | (IRS Employer Identification No.) | ||||
27101 Puerta Real, Suite 450, Mission Viejo, CA | 92691 | |||||
(Address of principal executive offices) | (Zip Code) |
o | Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) | |
o | Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) | |
o | Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) | |
o | Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) |
Exhibit No. | Description | |
Press Release of the Company dated August 3, 2017 |
Dated: August 9, 2017 | THE ENSIGN GROUP, INC. | |||
By: | /s/ Suzanne D. Snapper | |||
Suzanne D. Snapper | ||||
Chief Financial Officer | ||||
Exhibit No. | Description | |
Press Release of the Company dated August 3, 2017 |
• | Consolidated EBITDA increased 10.4% to $32.6M and adjusted EBITDA increased 169 basis points to $38.1M over the prior year quarter; |
• | Same store managed care revenue for transitional and skilled services grew by 10.8%, with growth of 5.5% in managed care days, over the prior year quarter; |
• | Same store skilled mix revenue for transitional and skilled services as a percentage of revenue for all segments increased 56 basis points to 51.6% over the prior year quarter; |
• | Transitioning revenue for transitional and skilled services increased 8.2% to $77.8M, with occupancy growth of 268 basis points to 73.9%, over the prior year quarter; |
• | Transitioning Medicare and Medicaid skilled revenue for transitional and skilled services increased 8.2% and 16.9%, respectively, over the prior year quarter; |
• | Transitioning Medicare and Medicaid skilled days increased 2.9% and 27.0%, respectively, over the prior year quarter; |
• | Bridgestone Living LLC, Ensign's assisted and independent living subsidiary, grew its segment income by 12.1% to $3.7 million over the prior year quarter; and |
• | Cornerstone Healthcare, Inc., Ensign's home health and hospice subsidiary, grew its segment income by 13.2% to $4.9 million and revenue by $6.1 million or 21.5% to $34.6 million all over the prior year quarter. |
• | On April 1, 2017, Rehabilitation Center of Des Moines, a 74-bed skilled nursing operation in Des Moines, Iowa; |
• | On May 1, 2017, Meadow View Nursing and Rehabilitation, a 112-bed skilled nursing facility in Nampa, Idaho; |
• | Also on May 1, 2017, Voto Home Health, a Medicare-certified home health agency servicing King County, Washington; |
• | On June 1, 2017, Heritage Park Healthcare and Rehabilitation, a 115-bed skilled nursing facility in Roy, Utah and Wide Horizons Intermediate Care Facility, an 83-bed intermediate care facility for individuals with intellectual disability in Ogden, Utah; |
• | On June 16, 2017, Meadowcreek Senior Living, a 37-unit assisted living facility in Lancaster, Texas; Paris Chalet Senior Living, a 37-unit assisted living facility in Paris, Texas; Maple Meadows Assisted Living, a 19-unit assisted living facility in Fond du Lac, Wisconsin; North Point Senior Living, a 19-unit assisted living facility in Kenosha, Wisconsin; and Lake Pointe Villa Assisted Living, a 19-unit assisted living facility in Oshkosh, Wisconsin; |
• | On July 1, 2017, The Villas at Sunny Acres, a post-acute care and retirement community with 134 skilled nursing beds, 35 assisted living units and 198 independent living units set on 64 acres in Thornton, Colorado; and Medallion Post Acute Rehabilitation, a 60-bed skilled nursing operation, and Medallion Villas, a 44-unit assisted living and 64-unit independent living operation, both set on a single healthcare campus in Colorado Springs, Colorado; and |
• | On August 1, 2017, Parkside Senior Living, a 20-unit assisted living facility in Neenah, Wisconsin. |
Three Months Ended June 30, | Six Months Ended June 30, | ||||||||||||||
2017 | 2016 | 2017 | 2016 | ||||||||||||
Revenue | $ | 448,279 | $ | 410,517 | $ | 890,019 | $ | 793,750 | |||||||
Expense: | |||||||||||||||
Cost of services | 366,946 | 330,538 | 722,433 | 636,846 | |||||||||||
Charge related to class action lawsuit | — | — | 11,000 | — | |||||||||||
(Gain)/losses related to operational closures | (1,286 | ) | — | 2,731 | 7,935 | ||||||||||
Rent—cost of services | 32,585 | 30,741 | 64,485 | 57,732 | |||||||||||
General and administrative expense | 17,253 | 19,657 | 38,523 | 37,045 | |||||||||||
Depreciation and amortization | 10,750 | 9,772 | 21,264 | 18,069 | |||||||||||
Total expenses | 426,248 | 390,708 | 860,436 | 757,627 | |||||||||||
Income from operations | 22,031 | 19,809 | 29,583 | 36,123 | |||||||||||
Other income (expense): | |||||||||||||||
Interest expense | (3,053 | ) | (1,446 | ) | (6,498 | ) | (2,816 | ) | |||||||
Interest income | 288 | 278 | 578 | 513 | |||||||||||
Other expense, net | (2,765 | ) | (1,168 | ) | (5,920 | ) | (2,303 | ) | |||||||
Income before provision for income taxes | 19,266 | 18,641 | 23,663 | 33,820 | |||||||||||
Provision for income taxes | 6,886 | 7,278 | 8,326 | 13,167 | |||||||||||
Net income | 12,380 | 11,363 | 15,337 | 20,653 | |||||||||||
Less: net income attributable to noncontrolling interests | 163 | 37 | 279 | 155 | |||||||||||
Net income attributable to The Ensign Group, Inc. | $ | 12,217 | $ | 11,326 | $ | 15,058 | $ | 20,498 | |||||||
Net income per share | |||||||||||||||
Basic: | $ | 0.24 | $ | 0.23 | $ | 0.30 | $ | 0.41 | |||||||
Diluted: | $ | 0.23 | $ | 0.22 | $ | 0.29 | $ | 0.39 | |||||||
Weighted average common shares outstanding: | |||||||||||||||
Basic | 50,705 | 50,274 | 50,736 | 50,476 | |||||||||||
Diluted | 52,548 | 51,931 | 52,593 | 52,134 | |||||||||||
Dividends per share | $ | 0.0425 | $ | 0.0400 | $ | 0.0850 | $ | 0.0800 | |||||||
June 30, 2017 | December 31, 2016 | ||||||
Assets | |||||||
Current assets: | |||||||
Cash and cash equivalents | $ | 33,476 | $ | 57,706 | |||
Accounts receivable—less allowance for doubtful accounts of $39,759 and $39,791 at June 30, 2017 and December 31, 2016, respectively | 243,248 | 244,433 | |||||
Investments—current | 13,643 | 11,550 | |||||
Prepaid income taxes | 10,343 | 302 | |||||
Prepaid expenses and other current assets | 23,135 | 19,871 | |||||
Total current assets | 323,845 | 333,862 | |||||
Property and equipment, net | 490,386 | 484,498 | |||||
Insurance subsidiary deposits and investments | 25,899 | 23,634 | |||||
Escrow deposits | 23,925 | 1,582 | |||||
Deferred tax asset | 23,013 | 23,073 | |||||
Restricted and other assets | 13,329 | 12,614 | |||||
Intangible assets, net | 34,184 | 35,076 | |||||
Goodwill | 73,159 | 67,100 | |||||
Other indefinite-lived intangibles | 24,444 | 19,586 | |||||
Total assets | $ | 1,032,184 | $ | 1,001,025 | |||
Liabilities and equity | |||||||
Current liabilities: | |||||||
Accounts payable | $ | 32,915 | $ | 38,991 | |||
Accrued charge related to class action lawsuit | 11,000 | — | |||||
Accrued wages and related liabilities | 72,701 | 84,686 | |||||
Accrued self-insurance liabilities—current | 21,010 | 21,359 | |||||
Other accrued liabilities | 58,787 | 58,763 | |||||
Current maturities of long-term debt | 8,165 | 8,129 | |||||
Total current liabilities | 204,578 | 211,928 | |||||
Long-term debt—less current maturities | 284,465 | 275,486 | |||||
Accrued self-insurance liabilities—less current portion | 48,658 | 43,992 | |||||
Deferred rent and other long-term liabilities | 11,119 | 9,124 | |||||
Deferred gain related to sale-leaseback | 12,403 | — | |||||
Total equity | 470,961 | 460,495 | |||||
Total liabilities and equity | $ | 1,032,184 | $ | 1,001,025 |
Six Months Ended June 30, | |||||||
2017 | 2016 | ||||||
Net cash provided by operating activities | 24,920 | 36,828 | |||||
Net cash used in investing activities | (48,626 | ) | (99,857 | ) | |||
Net cash (used in) provided by financing activities | (524 | ) | 54,979 | ||||
Net (decrease) increase in cash and cash equivalents | (24,230 | ) | (8,050 | ) | |||
Cash and cash equivalents at beginning of period | 57,706 | 41,569 | |||||
Cash and cash equivalents at end of period | $ | 33,476 | $ | 33,519 |
THE ENSIGN GROUP, INC. | ||||||||||||||||||||||||||||||
REVENUE BY SEGMENT | ||||||||||||||||||||||||||||||
The following table sets forth our total revenue by segment and as a percentage of total revenue for the periods indicated: | ||||||||||||||||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||||||||||||||||
$ | % | $ | % | $ | % | $ | % | |||||||||||||||||||||||
(Dollars in thousands) | (Dollars in thousands) | |||||||||||||||||||||||||||||
Transitional and skilled services | $ | 375,217 | 83.7 | % | $ | 340,417 | 82.9 | % | $ | 747,556 | 84.0 | % | $ | 655,631 | 82.6 | % | ||||||||||||||
Assisted and independent living facilities | 33,009 | 7.4 | 30,708 | 7.5 | 65,355 | 7.3 | 60,877 | 7.7 | ||||||||||||||||||||||
Home health and hospice services: | ||||||||||||||||||||||||||||||
Home health | 17,871 | 4.0 | 14,416 | 3.5 | 34,922 | 3.9 | 28,324 | 3.6 | ||||||||||||||||||||||
Hospice | 16,750 | 3.7 | 14,077 | 3.4 | 31,832 | 3.6 | 26,835 | 3.4 | ||||||||||||||||||||||
Total home health and hospice services | 34,621 | 7.7 | 28,493 | 6.9 | 66,754 | 7.5 | 55,159 | 7.0 | ||||||||||||||||||||||
All other (1) | 5,432 | 1.2 | 10,899 | 2.7 | 10,354 | 1.2 | 22,083 | 2.7 | ||||||||||||||||||||||
Total revenue | $ | 448,279 | 100.0 | % | $ | 410,517 | 100.0 | % | $ | 890,019 | 100.0 | % | $ | 793,750 | 100.0 | % | ||||||||||||||
(1) Includes revenue from services generated in our other services segment and ancillary services for both the three and six months ended June 30, 2017 and 2016 and urgent care centers for three and six months ended June 30, 2016. | ||||||||||||||||||||||||||||||
THE ENSIGN GROUP, INC. | ||||||||||
SELECT PERFORMANCE INDICATORS | ||||||||||
(Unaudited) |
Three Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Total Facility Results: | ||||||||||||||
Transitional and skilled revenue | $ | 375,217 | $ | 340,417 | $ | 34,800 | 10.2 | % | ||||||
Number of facilities at period end | 155 | 148 | 7 | 4.7 | % | |||||||||
Number of campuses at period end* | 21 | 18 | 3 | 16.7 | % | |||||||||
Actual patient days | 1,232,842 | 1,136,724 | 96,118 | 8.5 | % | |||||||||
Occupancy percentage — Operational beds | 74.7 | % | 75.6 | % | (0.9 | )% | ||||||||
Skilled mix by nursing days | 30.7 | % | 31.3 | % | (0.6 | )% | ||||||||
Skilled mix by nursing revenue | 52.1 | % | 52.7 | % | (0.6 | )% |
Three Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Same Facility Results(1): | ||||||||||||||
Transitional and skilled revenue | $ | 240,404 | $ | 236,717 | $ | 3,687 | 1.6 | % | ||||||
Number of facilities at period end | 93 | 93 | — | — | % | |||||||||
Number of campuses at period end* | 11 | 11 | — | — | % | |||||||||
Actual patient days | 767,862 | 768,324 | (462 | ) | (0.1 | )% | ||||||||
Occupancy percentage — Operational beds | 78.2 | % | 77.8 | % | 0.4 | % | ||||||||
Skilled mix by nursing days | 30.2 | % | 30.2 | % | — | % | ||||||||
Skilled mix by nursing revenue | 51.6 | % | 51.1 | % | 0.5 | % |
Three Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Transitioning Facility Results(2): | ||||||||||||||
Transitional and skilled revenue | $ | 77,827 | $ | 71,946 | $ | 5,881 | 8.2 | % | ||||||
Number of facilities at period end | 37 | 37 | — | — | % | |||||||||
Number of campuses at period end* | 3 | 3 | — | — | % | |||||||||
Actual patient days | 245,387 | 238,892 | 6,495 | 2.7 | % | |||||||||
Occupancy percentage — Operational beds | 73.9 | % | 71.2 | % | 2.7 | % | ||||||||
Skilled mix by nursing days | 36.1 | % | 37.0 | % | (0.9 | )% | ||||||||
Skilled mix by nursing revenue | 55.1 | % | 57.6 | % | (2.5 | )% |
Three Months Ended June 30, | |||||||||||||
2017 | 2016 | ||||||||||||
(Dollars in thousands) | Change | % Change | |||||||||||
Recently Acquired Facility Results(3): | |||||||||||||
Transitional and skilled revenue | $ | 56,813 | $ | 30,981 | $ | 25,832 | NM | ||||||
Number of facilities at period end | 25 | 18 | 7 | NM | |||||||||
Number of campuses at period end* | 7 | 3 | 4 | NM | |||||||||
Actual patient days | 219,044 | 125,481 | 93,563 | NM | |||||||||
Occupancy percentage — Operational beds | 65.3 | % | 73.4 | % | NM | ||||||||
Skilled mix by nursing days | 26.2 | % | 28.0 | % | NM | ||||||||
Skilled mix by nursing revenue | 49.7 | % | 54.0 | % | NM |
Three Months Ended June 30, | |||||||||||||
2017 | 2016 | ||||||||||||
(Dollars in thousands) | Change | % Change | |||||||||||
Facility Closed Results(4): | |||||||||||||
Skilled nursing revenue | $ | 173 | $ | 773 | $ | (600 | ) | NM | |||||
Actual patient days | 549 | 4,027 | (3,478 | ) | NM | ||||||||
Occupancy percentage — Operational beds | 50.0 | % | 46.6 | % | NM | ||||||||
Skilled mix by nursing days | 13.8 | % | 7.6 | % | NM | ||||||||
Skilled mix by nursing revenue | 35.6 | % | 19.1 | % | NM |
(1) | Same Facility results represent all facilities purchased prior to January 1, 2014. |
(2) | Transitioning Facility results represents all facilities purchased from January 1, 2014 to December 31, 2015. |
(3) | Recently Acquired Facility (Acquisitions) results represent all facilities purchased on or subsequent to January 1, 2016. |
(4) | Facility Closed results represents closed operations during the second quarter of 2017 and 2016, for which the results were excluded from Same Facility results and Recently Acquired results for the three months ended June 30, 2017 and 2016, for comparison purposes. |
Six Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Total Facility Results: | ||||||||||||||
Transitional and skilled revenue | $ | 747,556 | $ | 655,631 | $ | 91,925 | 14.0 | % | ||||||
Number of facilities at period end | 155 | 148 | 7 | 4.7 | % | |||||||||
Number of campuses at period end* | 21 | 18 | 3 | 16.7 | % | |||||||||
Actual patient days | 2,442,106 | 2,189,460 | 252,646 | 11.5 | % | |||||||||
Occupancy percentage — Operational beds | 74.8 | % | 76.2 | % | (1.4 | )% | ||||||||
Skilled mix by nursing days | 31.4 | % | 31.9 | % | (0.5 | )% | ||||||||
Skilled mix by nursing revenue | 52.7 | % | 53.6 | % | (0.9 | )% |
Six Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Same Facility Results(1): | ||||||||||||||
Transitional and skilled revenue | $ | 480,543 | $ | 471,615 | $ | 8,928 | 1.9 | % | ||||||
Number of facilities at period end | 93 | 93 | — | — | % | |||||||||
Number of campuses at period end* | 11 | 11 | — | — | % | |||||||||
Actual patient days | 1,529,579 | 1,552,937 | (23,358 | ) | (1.5 | )% | ||||||||
Occupancy percentage — Operational beds | 78.3 | % | 78.6 | % | (0.3 | )% | ||||||||
Skilled mix by nursing days | 30.6 | % | 30.6 | % | — | % | ||||||||
Skilled mix by nursing revenue | 51.8 | % | 52.3 | % | (0.5 | )% |
Six Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Transitioning Facility Results(2): | ||||||||||||||
Transitional and skilled revenue | $ | 156,222 | $ | 144,693 | $ | 11,529 | 8.0 | % | ||||||
Number of facilities at period end | 37 | 37 | — | — | % | |||||||||
Number of campuses at period end* | 3 | 3 | — | — | % | |||||||||
Actual patient days | 489,694 | 479,134 | 10,560 | 2.2 | % | |||||||||
Occupancy percentage — Operational beds | 74.2 | % | 71.4 | % | 2.8 | % | ||||||||
Skilled mix by nursing days | 37.2 | % | 37.2 | % | — | % | ||||||||
Skilled mix by nursing revenue | 56.1 | % | 57.8 | % | (1.7 | )% |
Six Months Ended June 30, | |||||||||||||
2017 | 2016 | ||||||||||||
(Dollars in thousands) | Change | % Change | |||||||||||
Recently Acquired Facility Results(3): | |||||||||||||
Transitional and skilled revenue | $ | 108,924 | $ | 37,092 | $ | 71,832 | NM | ||||||
Number of facilities at period end | 25 | 18 | 7 | NM | |||||||||
Number of campuses at period end* | 7 | 3 | 4 | NM | |||||||||
Actual patient days | 417,258 | 145,956 | 271,302 | NM | |||||||||
Occupancy percentage — Operational beds | 65.6 | % | 71.6 | % | NM | ||||||||
Skilled mix by nursing days | 27.1 | % | 30.1 | % | NM | ||||||||
Skilled mix by nursing revenue | 51.4 | % | 55.7 | % | NM |
Six Months Ended June 30, | |||||||||||||
2017 | 2016 | ||||||||||||
(Dollars in thousands) | Change | % Change | |||||||||||
Facility Closed Results(4): | |||||||||||||
Skilled nursing revenue | $ | 1,867 | $ | 2,231 | $ | (364 | ) | NM | |||||
Actual patient days | 5,575 | 11,433 | (5,858 | ) | NM | ||||||||
Occupancy percentage — Operational beds | 34.3 | % | 52.3 | % | NM | ||||||||
Skilled mix by nursing days | 46.7 | % | 10.7 | % | NM | ||||||||
Skilled mix by nursing revenue | 71.6 | % | 23.2 | % | NM |
(1) | Same Facility results represent all facilities purchased prior to January 1, 2014. |
(2) | Transitioning Facility results represents all facilities purchased from January 1, 2014 to December 31, 2015. |
(3) | Recently Acquired Facility (Acquisitions) results represent all facilities purchased on or subsequent to January 1, 2016. |
(4) | Facility Closed results represents closed operations during the six months ended 2017 and 2016, for which the results were excluded from Same Facility results and Recently Acquired results for the six months ended June 30, 2017 and 2016, for comparison purposes. |
Three Months Ended June 30, | |||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||||||||||
Skilled Nursing Average Daily Revenue Rates: | |||||||||||||||||||||||||||||||
Medicare | $ | 596.97 | $ | 577.63 | $ | 549.52 | $ | 526.88 | $ | 500.71 | $ | 489.55 | $ | 567.65 | $ | 555.11 | |||||||||||||||
Managed care | 449.02 | 427.66 | 451.06 | 436.42 | 416.10 | 396.68 | 444.65 | 427.43 | |||||||||||||||||||||||
Other skilled | 478.83 | 467.65 | 359.28 | 367.44 | 600.90 | — | 446.94 | 440.25 | |||||||||||||||||||||||
Total skilled revenue | 518.72 | 505.49 | 473.86 | 460.83 | 468.32 | 456.59 | 500.59 | 489.49 | |||||||||||||||||||||||
Medicaid | 211.39 | 212.92 | 215.68 | 194.08 | 161.53 | 150.39 | 203.49 | 202.11 | |||||||||||||||||||||||
Private and other payors | 197.62 | 205.79 | 230.22 | 228.18 | 187.83 | 156.03 | 199.90 | 201.41 | |||||||||||||||||||||||
Total skilled nursing revenue | $ | 302.13 | $ | 301.00 | $ | 310.14 | $ | 295.97 | $ | 246.53 | $ | 237.14 | $ | 293.84 | $ | 292.40 |
Six Months Ended June 30, | |||||||||||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||||||||||
Skilled Nursing Average Daily Revenue Rates: | |||||||||||||||||||||||||||||||
Medicare | $ | 596.51 | $ | 577.00 | $ | 544.27 | $ | 524.33 | $ | 501.42 | $ | 483.73 | $ | 566.07 | $ | 556.51 | |||||||||||||||
Managed care | 443.23 | 426.48 | 445.57 | 437.62 | 419.45 | 389.81 | 440.45 | 427.65 | |||||||||||||||||||||||
Other skilled | 477.49 | 466.79 | 363.37 | 368.61 | 497.72 | — | 446.23 | 439.46 | |||||||||||||||||||||||
Total skilled revenue | 516.43 | 502.96 | 470.80 | 460.90 | 469.99 | 452.19 | 498.60 | 488.82 | |||||||||||||||||||||||
Medicaid | 212.83 | 203.83 | 217.15 | 194.46 | 156.66 | 153.09 | 204.17 | 198.28 | |||||||||||||||||||||||
Private and other payors | 200.55 | 203.04 | 226.52 | 229.05 | 192.42 | 163.09 | 202.29 | 203.59 | |||||||||||||||||||||||
Total skilled nursing revenue | $ | 303.92 | $ | 295.51 | $ | 312.31 | $ | 296.74 | $ | 247.96 | $ | 244.96 | $ | 296.08 | $ | 291.81 |
Three Months Ended June 30, | |||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||
Percentage of Skilled Nursing Revenue: | |||||||||||||||||||||||
Medicare | 25.8 | % | 27.9 | % | 25.3 | % | 25.5 | % | 32.3 | % | 37.3 | % | 26.7 | % | 28.2 | % | |||||||
Managed care | 17.3 | 15.8 | 22.5 | 25.0 | 17.1 | 16.7 | 18.3 | 17.8 | |||||||||||||||
Other skilled | 8.5 | 7.4 | 7.3 | 7.1 | 0.3 | — | 7.1 | 6.7 | |||||||||||||||
Skilled mix | 51.6 | 51.1 | 55.1 | 57.6 | 49.7 | 54.0 | 52.1 | 52.7 | |||||||||||||||
Private and other payors | 8.1 | 8.1 | 6.9 | 7.2 | 13.7 | 10.9 | 8.7 | 8.1 | |||||||||||||||
Quality mix | 59.7 | 59.2 | 62.0 | 64.8 | 63.4 | 64.9 | 60.8 | 60.8 | |||||||||||||||
Medicaid | 40.3 | 40.8 | 38.0 | 35.2 | 36.6 | 35.1 | 39.2 | 39.2 | |||||||||||||||
Total skilled nursing | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Three Months Ended June 30, | |||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||
Percentage of Skilled Nursing Days: | |||||||||||||||||||||||
Medicare | 13.2 | % | 14.4 | % | 14.3 | % | 14.3 | % | 15.9 | % | 18.1 | % | 13.9 | % | 14.8 | % | |||||||
Managed care | 11.7 | 11.1 | 15.5 | 16.9 | 10.2 | 9.9 | 12.2 | 12.1 | |||||||||||||||
Other skilled | 5.3 | 4.7 | 6.3 | 5.8 | 0.1 | — | 4.6 | 4.4 | |||||||||||||||
Skilled mix | 30.2 | 30.2 | 36.1 | 37.0 | 26.2 | 28.0 | 30.7 | 31.3 | |||||||||||||||
Private and other payors | 12.0 | 12.5 | 9.3 | 9.4 | 18.0 | 16.7 | 12.5 | 12.3 | |||||||||||||||
Quality mix | 42.2 | 42.7 | 45.4 | 46.4 | 44.2 | 44.7 | 43.2 | 43.6 | |||||||||||||||
Medicaid | 57.8 | 57.3 | 54.6 | 53.6 | 55.8 | 55.3 | 56.8 | 56.4 | |||||||||||||||
Total skilled nursing | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Six Months Ended June 30, | |||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||
Percentage of Skilled Nursing Revenue: | |||||||||||||||||||||||
Medicare | 26.3 | % | 28.0 | % | 25.6 | % | 26.0 | % | 33.7 | % | 39.5 | % | 27.3 | % | 28.2 | % | |||||||
Managed care | 17.3 | 16.8 | 23.2 | 24.5 | 17.6 | 16.2 | 18.6 | 18.4 | |||||||||||||||
Other skilled | 8.2 | 7.5 | 7.3 | 7.3 | 0.1 | — | 6.8 | 7.0 | |||||||||||||||
Skilled mix | 51.8 | 52.3 | 56.1 | 57.8 | 51.4 | 55.7 | 52.7 | 53.6 | |||||||||||||||
Private and other payors | 8.0 | 8.1 | 6.5 | 6.9 | 13.7 | 11.3 | 8.5 | 8.1 | |||||||||||||||
Quality mix | 59.8 | 60.4 | 62.6 | 64.7 | 65.1 | 67.0 | 61.2 | 61.7 | |||||||||||||||
Medicaid | 40.2 | 39.6 | 37.4 | 35.3 | 34.9 | 33.0 | 38.8 | 38.3 | |||||||||||||||
Total skilled nursing | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
Six Months Ended June 30, | |||||||||||||||||||||||
Same Facility | Transitioning | Acquisitions | Total | ||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||
Percentage of Skilled Nursing Days: | |||||||||||||||||||||||
Medicare | 13.4 | % | 14.3 | % | 14.7 | % | 14.7 | % | 16.7 | % | 20.0 | % | 14.3 | % | 14.7 | % | |||||||
Managed care | 11.9 | 11.6 | 16.3 | 16.6 | 10.3 | 10.1 | 12.5 | 12.5 | |||||||||||||||
Other skilled | 5.3 | 4.7 | 6.2 | 5.9 | 0.1 | — | 4.6 | 4.7 | |||||||||||||||
Skilled mix | 30.6 | 30.6 | 37.2 | 37.2 | 27.1 | 30.1 | 31.4 | 31.9 | |||||||||||||||
Private and other payors | 11.9 | 12.2 | 8.9 | 8.9 | 17.6 | 17.1 | 12.2 | 11.8 | |||||||||||||||
Quality mix | 42.5 | 42.8 | 46.1 | 46.1 | 44.7 | 47.2 | 43.6 | 43.7 | |||||||||||||||
Medicaid | 57.5 | 57.2 | 53.9 | 53.9 | 55.3 | 52.8 | 56.4 | 56.3 | |||||||||||||||
Total skilled nursing | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % |
THE ENSIGN GROUP, INC. | ||||||||||
SELECT PERFORMANCE INDICATORS | ||||||||||
(Unaudited) | ||||||||||
The following tables summarize our selected performance indicators for our assisted and independent living segment along with other statistics, for each of the date or periods indicated: | ||||||||||
Three Months Ended June 30, | ||||||||||||||
2017 | 2016 | Change | % Change | |||||||||||
(Dollars in thousands) | ||||||||||||||
Revenue | $ | 33,009 | $ | 30,708 | $ | 2,301 | 7.5 | % | ||||||
Number of facilities at period end | 46 | 40 | 6 | 15.0 | % | |||||||||
Number of campuses at period end | 21 | 18 | 3 | 16.7 | % | |||||||||
Occupancy percentage (units) | 77.4 | % | 76.0 | % | 1.4 | % | ||||||||
Average monthly revenue per unit | $ | 2,799 | $ | 2,757 | $ | 42 | 1.5 | % |
Six Months Ended June 30, | ||||||||||||||
2017 | 2016 | |||||||||||||
(Dollars in thousands) | Change | % Change | ||||||||||||
Revenue | $ | 65,355 | $ | 60,877 | $ | 4,478 | 7.4 | % | ||||||
Number of facilities at period end | 46 | 40 | 6 | 15.0 | % | |||||||||
Number of campuses at period end | 21 | 18 | 3 | 16.7 | % | |||||||||
Occupancy percentage (units) | 77.1 | % | 75.9 | % | 1.2 | % | ||||||||
Average monthly revenue per unit | $ | 2,818 | $ | 2,752 | $ | 66 | 2.4 | % |
THE ENSIGN GROUP, INC. | ||||||||||
SELECT PERFORMANCE INDICATORS | ||||||||||
(Unaudited) | ||||||||||
The following tables summarize our selected performance indicators for our home health and hospice segment along with other statistics, for each of the date or periods indicated: | ||||||||||
Three Months Ended June 30, | ||||||||||||||
2017 | 2016 | Change | % Change | |||||||||||
(Dollars in thousands) | ||||||||||||||
Home health and hospice revenue: | ||||||||||||||
Home health services | $ | 17,871 | $ | 14,416 | $ | 3,455 | 24.0 | % | ||||||
Hospice services | 16,750 | 14,077 | 2,673 | 19.0 | ||||||||||
Total home health and hospice revenue | $ | 34,621 | $ | 28,493 | $ | 6,128 | 21.5 | % | ||||||
Home health services: | ||||||||||||||
Average Medicare Revenue per Completed Episode | $ | 3,140 | $ | 2,950 | $ | 190 | 6.4 | % | ||||||
Hospice services: | ||||||||||||||
Average Daily Census | 1,020 | 898 | 122 | 13.6 | % |
Six Months Ended June 30, | ||||||||||||||
2017 | 2016 | Change | % Change | |||||||||||
(Dollars in thousands) | ||||||||||||||
Home health and hospice revenue | ||||||||||||||
Home health services | $ | 34,922 | $ | 28,324 | $ | 6,598 | 23.3 | % | ||||||
Hospice services | 31,832 | 26,835 | 4,997 | 18.6 | ||||||||||
Total home health and hospice revenue | $ | 66,754 | $ | 55,159 | $ | 11,595 | 21.0 | % | ||||||
Home health services: | ||||||||||||||
Average Medicare Revenue per Completed Episode | $ | 3,058 | $ | 2,937 | $ | 121 | 4.1 | % | ||||||
Hospice services: | ||||||||||||||
Average Daily Census | 1,011 | 871 | 140 | 16.1 | % |
Three Months Ended June 30, | Six Months Ended June 30, | ||||||||||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | ||||||||||||||||||||||||||
$ | % | $ | % | $ | % | $ | % | ||||||||||||||||||||||
(Dollars in thousands) | (Dollars in thousands) | ||||||||||||||||||||||||||||
Revenue: | |||||||||||||||||||||||||||||
Medicaid | $ | 152,637 | 34.0 | % | $ | 139,226 | 33.9 | % | $ | 300,908 | 33.8 | % | $ | 262,867 | 33.1 | % | |||||||||||||
Medicare | 128,151 | 28.6 | 119,443 | 29.1 | 258,072 | 29.0 | 229,721 | 28.9 | |||||||||||||||||||||
Medicaid-skilled | 24,913 | 5.6 | 20,661 | 5.0 | 47,930 | 5.4 | 42,327 | 5.3 | |||||||||||||||||||||
Total | 305,701 | 68.2 | 279,330 | 68.0 | 606,910 | 68.2 | 534,915 | 67.3 | |||||||||||||||||||||
Managed Care | 74,925 | 16.7 | 65,178 | 15.9 | 150,486 | 16.9 | 129,721 | 16.4 | |||||||||||||||||||||
Private and Other(1) | 67,653 | 15.1 | 66,009 | 16.1 | 132,623 | 14.9 | 129,114 | 16.3 | |||||||||||||||||||||
Total revenue | $ | 448,279 | 100.0 | % | $ | 410,517 | 100.0 | % | $ | 890,019 | 100.0 | % | $ | 793,750 | 100.0 | % | |||||||||||||
(1) Private and other payors also includes revenue from all payor generated in other ancillary services for both the three and six months ended June 30, 2017 and 2016 and urgent care centers for the three and six months ended June 30, 2016. |
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||
Net income attributable to The Ensign Group, Inc. | $ | 12,217 | $ | 11,326 | $ | 15,058 | $ | 20,498 | ||||||||
Non-GAAP adjustments | ||||||||||||||||
Results at urgent care centers, including noncontrolling interests(a) | — | 47 | — | (148 | ) | |||||||||||
Costs incurred for facilities currently being constructed and other start-up operations(b) | 3,365 | 2,794 | 7,907 | 5,592 | ||||||||||||
Results related to closed operations and operations not at full capacity, including continued obligations and closing expense(c) | (457 | ) | 219 | 5,130 | 8,403 | |||||||||||
Share-based compensation expense(d) | 2,376 | 2,780 | 4,600 | 4,665 | ||||||||||||
Legal costs and charges related to the settlement of the class action lawsuit(e) | 163 | — | 11,163 | — | ||||||||||||
Cost of services - Insurance reserve in connection with the settlement of a general liability claim(f) | — | 1,586 | — | 1,586 | ||||||||||||
General and administrative - Acquisition related costs(g) | 360 | 748 | 448 | 893 | ||||||||||||
General and administrative - Costs incurred related to new systems implementation and professional service fees(h) | — | 269 | — | 947 | ||||||||||||
Depreciation and amortization - Patient base(i) | 115 | 713 | 151 | 991 | ||||||||||||
Interest expense - Write off of deferred financing fees(j) | — | — | — | 225 | ||||||||||||
Provision for income taxes on Non-GAAP adjustments(k) | (2,054 | ) | (3,422 | ) | (10,508 | ) | (8,758 | ) | ||||||||
Non-GAAP Net Income | $ | 16,085 | $ | 17,060 | $ | 33,949 | $ | 34,894 | ||||||||
Diluted Earnings Per Share As Reported | ||||||||||||||||
Net Income | $ | 0.23 | $ | 0.22 | $ | 0.29 | $ | 0.39 | ||||||||
Average number of shares outstanding | 52,548 | 51,931 | 52,593 | 52,134 | ||||||||||||
Adjusted Diluted Earnings Per Share | ||||||||||||||||
Net Income | $ | 0.31 | $ | 0.33 | $ | 0.65 | $ | 0.67 | ||||||||
Average number of shares outstanding | 52,548 | 51,931 | 52,133 | 52,210 | ||||||||||||
Footnote: | ||||||||||||||||
(a) Represent operating results at urgent care centers, including noncontrolling interest. | ||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||
Revenue | $ | — | $ | (7,042 | ) | $ | — | $ | (14,642 | ) | ||||||
Cost of services | — | 6,226 | — | 12,751 | ||||||||||||
Rent | — | 554 | — | 1,116 | ||||||||||||
Depreciation and amortization | — | 304 | — | 603 | ||||||||||||
Non-controlling interest | — | 5 | — | 24 | ||||||||||||
Total Non-GAAP adjustment | $ | — | $ | 47 | $ | — | $ | (148 | ) | |||||||
(b) Represent operating results for facilities currently being constructed and other start-up operations. |
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||
Revenue | $ | (15,912 | ) | $ | (6,894 | ) | $ | (28,879 | ) | $ | (10,653 | ) | ||||
Cost of services | 15,055 | 7,343 | 28,653 | 12,464 | ||||||||||||
Rent | 3,934 | 2,165 | 7,596 | 3,488 | ||||||||||||
Depreciation and amortization | 288 | 180 | 537 | 293 | ||||||||||||
Total Non-GAAP adjustment | $ | 3,365 | $ | 2,794 | $ | 7,907 | $ | 5,592 | ||||||||
(c) Represent results at closed operations and operations not at full capacity during the three and six months ended June 30, 2017 and 2016, including the fair value of continued obligation under the lease agreement and related closing expenses of $4.0 million and $7.9 million during the six months ended June 30, 2017 and 2016, respectively. Included in the three and six months ended June 30, 2017 results is the loss recovery of $1.3 million of certain losses related to a closed facility in prior year. | ||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||
Revenue | $ | (172 | ) | $ | — | $ | (2,544 | ) | $ | (105 | ) | |||||
Losses related to operational closures | (1,286 | ) | — | 2,731 | 7,935 | |||||||||||
Cost of services | 903 | 207 | 4,177 | 501 | ||||||||||||
Rent | 85 | 2 | 696 | 58 | ||||||||||||
Depreciation and amortization | 13 | 10 | 70 | 14 | ||||||||||||
Total Non-GAAP adjustment | $ | (457 | ) | $ | 219 | $ | 5,130 | $ | 8,403 | |||||||
(d) Represent share-based compensation expense incurred. | ||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||
Cost of services | $ | 1,338 | $ | 1,316 | $ | 2,573 | $ | 2,529 | ||||||||
General and administrative | 1,038 | 1,464 | 2,027 | 2,136 | ||||||||||||
Total Non-GAAP adjustment | $ | 2,376 | $ | 2,780 | $ | 4,600 | $ | 4,665 | ||||||||
(e) Legal costs and charges incurred in connection with the settlement of the class action lawsuit. | ||||||||||||||||
(f) Included in cost of services are insurance reserves in connection with the settlement of a general liability claim. | ||||||||||||||||
(g) Included in general and administrative expense are costs incurred to acquire an operation which are not capitalizable. | ||||||||||||||||
(h) Included in general and administrative expense are costs incurred related to new systems implementation and income tax credits which contributed to a decrease in effective tax rate. | ||||||||||||||||
(i) Included in depreciation and amortization are amortization expenses related to patient base intangible assets at newly acquired skilled nursing and assisted living facilities. | ||||||||||||||||
(j) Included in interest expense are write-offs of deferred financing fees associated with the amendment of credit facility for the three and six months ended June 30, 2016. | ||||||||||||||||
(k) Represents an adjustment to provision for income tax to our historical year to date effective tax rate of 35.5%, resulting from adoption of ASU 2016-09, for the three and six months ended June 30, 2017 and 38.5% for the three and six months ended June 30, 2016. |
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2017 | 2016 | 2017 | 2016 | |||||||||||||
Consolidated Statements of Income Data: | ||||||||||||||||
Net income | $ | 12,380 | $ | 11,363 | $ | 15,337 | $ | 20,653 | ||||||||
Less: net income attributable to noncontrolling interests | 163 | 37 | 279 | 155 | ||||||||||||
Interest expense, net | 2,765 | 1,168 | 5,920 | 2,303 | ||||||||||||
Provision for income taxes | 6,886 | 7,278 | 8,326 | 13,167 | ||||||||||||
Depreciation and amortization | 10,750 | 9,772 | 21,264 | 18,069 | ||||||||||||
EBITDA | $ | 32,618 | $ | 29,544 | $ | 50,568 | $ | 54,037 | ||||||||
Adjustments to EBITDA: | ||||||||||||||||
Results related to closed operations and operations not at full capacity, including continued obligations and closing expenses(a) | (555 | ) | 206 | 4,364 | 8,331 | |||||||||||
Results related to facilities currently being constructed and other start-up operations(b) | (857 | ) | 449 | (226 | ) | 1,812 | ||||||||||
Urgent care center earnings(c) | — | (811 | ) | — | (1,867 | ) | ||||||||||
Legal costs and charges related to the settlement of the class action lawsuit(d) | 163 | — | 11,163 | — | ||||||||||||
Share-based compensation expense(e) | 2,376 | 2,780 | 4,600 | 4,665 | ||||||||||||
Insurance reserve in connection with the settlement of claims(f) | — | 1,586 | — | 1,586 | ||||||||||||
Acquisition related costs(g) | 360 | 748 | 448 | 893 | ||||||||||||
Costs incurred related to new systems implementation and professional service fee(h) | — | 269 | — | 947 | ||||||||||||
Rent related to items(a),(b) and (c) above | 4,019 | 2,721 | 8,292 | 4,662 | ||||||||||||
Adjusted EBITDA | $ | 38,124 | $ | 37,492 | $ | 79,209 | $ | 75,066 | ||||||||
Rent—cost of services | 32,585 | 30,741 | 64,485 | 57,732 | ||||||||||||
Less: rent related to items(a), (b), and (c) above | (4,019 | ) | (2,721 | ) | (8,292 | ) | (4,662 | ) | ||||||||
Adjusted EBITDAR | $ | 66,690 | $ | 65,512 | $ | 135,402 | $ | 128,136 | ||||||||
(a) | Represent results at closed operations and operations not at full capacity during the three and six months ended June 30, 2017 and 2016, including the fair value of continued obligation under the lease agreement and related closing expenses of $4.0 million and $7.9 million for the six months ended June 30, 2017 and 2016, respectively. Included in the three and six months ended June 30, 2017 results is the loss recovery of $1.3 million of certain losses related to a closed facility in prior year. |
(b) | Represents results related to facilities currently being constructed and other start-up operations. This amount excludes rent, depreciation and interest expense. |
(c) | Operating results at urgent care centers for the three and six months ended June 30, 2016. This amount excludes rent, depreciation, interest expense and the net loss attributable to the variable interest entity associated with our urgent care business. |
(d) | Legal costs and charges incurred in connection with the settlement of the class action lawsuit. |
(e) | Share-based compensation expense incurred. |
(f) | Insurance reserves in connection with the settlement of a general liability claim. |
(g) | Costs incurred to acquire operations which are not capitalizable. |
(h) | Costs incurred related to new systems implementation and income tax credits which contributed to a decrease in effective tax rate. |
THE ENSIGN GROUP, INC. | |||||||||||||||||||||||||
RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION | |||||||||||||||||||||||||
(In thousands) | |||||||||||||||||||||||||
(Unaudited) | |||||||||||||||||||||||||
The table below reconciles net income from operations to EBITDA, Adjusted EBITDA and Adjusted EBITDAR for each reportable segment for the periods presented: | |||||||||||||||||||||||||
Three Months Ended June 30, | |||||||||||||||||||||||||
Transitional and Skilled Services | Assisted and Independent Services | Home Health and Hospice | |||||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||||||
Statements of Income Data: | |||||||||||||||||||||||||
Income from operations, excluding general and administrative expense(a) | $ | 31,704 | $ | 32,835 | $ | 3,657 | $ | 3,263 | $ | 4,923 | $ | 4,349 | |||||||||||||
Less: net income attributable to noncontrolling interests | — | 86 | — | ||||||||||||||||||||||
Depreciation and amortization | 7,204 | 6,792 | 1,492 | 983 | 230 | 229 | |||||||||||||||||||
EBITDA | $ | 38,908 | $ | 39,627 | $ | 5,149 | $ | 4,246 | $ | 5,067 | $ | 4,578 | |||||||||||||
Adjustments to EBITDA: | |||||||||||||||||||||||||
Costs at facilities currently being constructed and other start-up operations(b) | (1,256 | ) | 77 | 271 | 364 | 128 | 8 | ||||||||||||||||||
Results related to closed operations and operations not at full capacity, including continued obligations and closing expenses(c) | (657 | ) | 206 | — | — | — | — | ||||||||||||||||||
Share-based compensation expense(d) | 992 | 1,119 | 233 | 97 | 86 | 97 | |||||||||||||||||||
Insurance reserve in connection with the settlement of claims(e) | 1,586 | — | — | ||||||||||||||||||||||
Less: rent related to item(b) and (c)above | 3,720 | 1,465 | 289 | 691 | 10 | — | |||||||||||||||||||
Adjusted EBITDA | $ | 41,707 | $ | 44,080 | $ | 5,942 | $ | 5,398 | $ | 5,291 | $ | 4,683 | |||||||||||||
Rent—cost of services | 26,733 | 22,565 | 5,323 | 7,182 | 426 | 369 | |||||||||||||||||||
Less: rent related to items(b) and(c) above | (3,720 | ) | (1,465 | ) | (289 | ) | (691 | ) | (10 | ) | — | ||||||||||||||
Adjusted EBITDAR | $ | 64,720 | $ | 65,180 | $ | 10,976 | $ | 11,889 | $ | 5,707 | $ | 5,052 | |||||||||||||
Six Months Ended June 30, | |||||||||||||||||||||||||
Transitional and Skilled Services | Assisted and Independent Services | Home Health and Hospice | |||||||||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | 2016 | ||||||||||||||||||||
Statements of Income Data: | |||||||||||||||||||||||||
Income from operations, excluding general and administrative expense(a) | $ | 63,494 | $ | 60,431 | $ | 8,096 | $ | 6,523 | $ | 9,217 | $ | 7,525 | |||||||||||||
Less: net income attributable to noncontrolling interests | — | — | 94 | — | |||||||||||||||||||||
Depreciation and amortization | 14,157 | $ | 12,031 | $ | 3,115 | $ | 2,046 | $ | 466 | $ | 496 | ||||||||||||||
EBITDA | $ | 77,651 | $ | 72,462 | $ | 11,211 | $ | 8,569 | $ | 9,589 | $ | 8,021 | |||||||||||||
Adjustments to EBITDA: | |||||||||||||||||||||||||
Costs at facilities currently being constructed and other start-up operations(b) | (1,066 | ) | 1,301 | 616 | 472 | 224 | 39 | ||||||||||||||||||
Results related to closed operations and operations not at full capacity, including continued obligations and closing expenses(c) | 3,749 | 8,331 | — | — | 513 | — | |||||||||||||||||||
Share-based compensation expense(d) | 2,020 | 2,145 | 323 | 192 | 174 | 138 | |||||||||||||||||||
Insurance reserve in connection with the settlement of claims(e) | — | 1,586 | — | — | — | — | |||||||||||||||||||
Less: rent related to item(b) and (c)above | 6,900 | 2,466 | 1,223 | 1,059 | 168 | 18 | |||||||||||||||||||
Adjusted EBITDA | $ | 89,254 | $ | 88,291 | $ | 13,373 | $ | 10,292 | $ | 10,668 | $ | 8,216 | |||||||||||||
Rent—cost of services | 52,679 | 41,548 | 10,631 | 14,185 | 978 | 747 | |||||||||||||||||||
Less: rent related to items(b) and(c) above | (6,900 | ) | (2,466 | ) | (1,223 | ) | (1,059 | ) | (168 | ) | (18 | ) | |||||||||||||
Adjusted EBITDAR | $ | 135,033 | $ | 127,373 | $ | 22,781 | $ | 23,418 | $ | 11,478 | $ | 8,945 | |||||||||||||