Ensign Group Reports $4.26 Billion Revenue for 2024, 14.2% Increase Year-Over-Year

Ensign Group, Inc. reported total revenue of $4.26 billion for the year ended December 31, 2024, a 14.2% increase compared to the $3.73 billion reported in 2023. This increase stemmed from a 2.7% rise in Same Facilities occupancy and a 4.1% increase in Transitioning Facilities occupancy, coupled with higher daily revenue rates and the impact of 31 new operations acquired during the year. The company's skilled services segment generated $4.08 billion in revenue, while the Standard Bearer segment, its captive REIT, contributed $95.1 million. Net income attributable to Ensign Group, Inc. was $298 million, representing a 7% margin, up from 5.6% in 2023.

Operating expenses for the skilled services segment totaled $3.24 billion, representing 79.5% of revenue, slightly higher than the 79.1% in 2023. This increase was attributed to higher labor costs, increased insurance expenses, and higher deferred compensation investment program expenses. Standard Bearer's rental revenue increased by 15.3% to $95.1 million, driven by real estate purchases and annual rent increases. Funds from Operations (FFO) for Standard Bearer rose 8% to $58.6 million. The "All Other" category, encompassing senior living, ancillary services, and other operations, saw revenue increase by 23.8% to $192.9 million.

Significant developments during the year included the expansion into two new states (Tennessee and Alabama), adding 3,030 skilled nursing beds and 218 senior living units. Post-year-end, seven more skilled nursing operations were added, increasing capacity by another 682 beds. Standard Bearer expanded its real estate portfolio by $131.9 million during the year and a further $50.9 million post-year-end, primarily through acquisitions and exercising purchase options. The company also launched Insignia Pathway, a public charity focused on supporting the post-acute care workforce.

The company's key performance indicators showed an overall skilled nursing occupancy rate of 80.5% for 2024, up from 78.5% in 2023. The skilled mix, representing the proportion of high-acuity patients, was 48.6% of revenue and 29.9% of patient days in 2024. The company noted that seasonal fluctuations and the acquisition of lower-occupancy facilities historically impact overall occupancy rates. The company also highlighted its average daily revenue rates across various payor types, noting increases driven by market basket increases and a shift toward higher-acuity patients.

The 10-K filing extensively details significant risks related to government regulation, including changes to Medicare and Medicaid reimbursement rates, increased enforcement activities, and new minimum staffing mandates. Other risks identified include competition, cybersecurity threats, litigation, and the potential for inadequate insurance coverage. The company also discussed its liquidity and capital resources, highlighting its cash flow from operations, credit facility, and mortgage loans as primary sources of liquidity. The filing concludes with information on executive compensation, stock repurchases, and other corporate governance matters, all of which are incorporated by reference to the company's proxy statement.