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PACS Group, Inc. Reports First Quarter 2024 Results

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PACS Group, one of the largest post-acute healthcare companies in the U.S., announced its Q1 2024 results. The company reported a net income of $49.1 million, a 30.7% increase from the previous year, and GAAP earnings per share of $0.38, up 31%. Revenue for the quarter rose by 31.9% to $934.7 million.

Adjusted EBITDA was $88.5 million, a 34% increase, and Adjusted EBITDAR reached $152.5 million. Total facilities occupancy was 91.1%, with notable increases in ramping and mature facilities. The company added 10 operating facilities, enhancing its portfolio to 218 healthcare operations.

CEO Jason Murray highlighted the importance of clinical excellence and CFO Derick Apt noted significant revenue growth from adding 5,194 beds. PACS projects 2024 revenue between $3.65 billion and $3.75 billion, with Adjusted EBITDA between $351 million and $361 million.

Positive
  • Net income increased by 30.7% to $49.1 million.
  • GAAP earnings per share rose 31% to $0.38.
  • Revenue increased by 31.9% to $934.7 million.
  • Adjusted EBITDA grew by 34% to $88.5 million.
  • Adjusted EBITDAR reached $152.5 million.
  • Total facilities occupancy was 91.1%.
  • Added 10 operating facilities and 5,194 beds over the year.
  • Positive Medicare and Medicaid daily rate increases of 11.0% and 5.3%, respectively.
  • Revenue guidance for 2024 is between $3.65 billion and $3.75 billion.
  • Adjusted EBITDA guidance for 2024 is between $351 million and $361 million.
Negative
  • No explicit mention of any financial or operational risks.
  • No detailed breakdown of facilities' performance impacting overall results.
  • Potential investor concern over dependence on Medicare and Medicaid rate increases.

Insights

The substantial improvement in net income and GAAP revenue for PACS Group, Inc. is noteworthy. GAAP earnings per share increased by 31.0% and net income rose by 30.7%, indicating a significant enhancement in the company's profitability. The increase in Adjusted EBITDA and EBITDAR also reflects strong operational performance. The company's addition of 10 new operating facilities and a rise in occupancy rates suggest that PACS is effectively expanding its market presence. Financially, the guidance for full-year revenue of $3.65 billion to $3.75 billion and Adjusted EBITDA of $351 million to $361 million outlines a promising outlook. However, investors should be cautious about the heavy reliance on Medicare and Medicaid reimbursements, which can be politically and economically volatile.

PACS Group's expansion strategy is a double-edged sword. The addition of 5,194 beds and a 35.3% increase in patient days indicate robust growth. However, the healthcare sector is heavily regulated and maintaining high occupancy rates, particularly in skilled nursing and assisted living, can be challenging. The company's focus on clinical excellence, as evidenced by 158 facilities receiving 4 or 5-star CMS Quality Measures ratings, is a positive indicator of their commitment to quality care. This high level of service can drive revenue growth and patient trust. Nonetheless, the rapid expansion could strain resources and operational efficiency if not managed meticulously.

PACS's real estate strategy of mixing wholly-owned properties and leased facilities provides a balanced approach to asset management. Owning 47 real estate assets with an option to purchase an additional 27 indicates a solid foundation for future expansion. The acquisition of 12 real estate properties over the last 15 months aligns well with the industry trend of healthcare companies increasingly investing in real estate to control costs and enhance long-term stability. However, the challenge lies in integrating these properties smoothly into existing operations. The strategy's success depends on how effectively PACS can manage the blend of wholly-owned and leased properties while maintaining high occupancy and quality care standards.

Conference Call and Webcast scheduled for tomorrow, May 14, 2024, at 4:00 pm ET.

FARMINGTON, Utah--(BUSINESS WIRE)-- PACS Group, Inc. (NYSE: PACS) (“PACS” or the “Company”), which together with its subsidiaries is one of the largest post-acute healthcare companies in the United States, announced operating results for the first quarter of 2024, reporting net income of $49.1 million, Adjusted EBITDA of $88.5 million and Adjusted EBITDAR of $152.5 million.

Highlights:

  • GAAP earnings per share for the quarter was $0.38, an increase of 31.0% over the prior year quarter.
  • GAAP net income was $49.1 million, an increase of 30.7% over the prior year quarter.
  • Consolidated GAAP revenue for the quarter was $934.7 million, an increase of 31.9% over the prior year quarter.
  • EBITDA and Adjusted EBITDA for the quarter was $96.3 million and $88.5 million, representing increases of 47.0% and 34.0%, respectively, over the prior year quarter. Adjusted EBITDAR for the quarter was $152.5 million.

Select KPIs:

  • Total Facilities occupancy was 91.1% during the first quarter of 2024. Ramping and Mature Facilities occupancy increased by 1.8% and 1.4%, respectively, over the prior year quarter.
  • Average Medicare and Medicaid daily rates increased 11.0% and 5.3%, respectively, for the three months ended March 31, 2024, as compared to the prior year quarter.
  • In the three months ended March 31, 2024 we added 10 operating facilities, including 1,334 and 174 skilled nursing and assisted living beds, respectively.

“We’re proud of our teams across the country and their continued dedication to the clinical excellence that drives our financial results. We look forward to carrying that momentum through 2024,” said Jason Murray, PACS’s Chief Executive Officer. “We had a very strong quarter, highlighted by 158 of our facilities having a 4 or 5 star CMS Quality Measures rating. We believe this is a key driver of our revenue growth year over year of 31.9% or $226.3 million on a same quarter basis.”

“Our revenue growth was also driven in significant part by our adding 5,194 beds to the company over the last year, leading to a 35.3% increase in patient days year-over-year. Additionally, our occupancy remained strong across all facilities — 91.1% in the first quarter of 2024,” said Derick Apt, PACS’s Chief Financial Officer. “We're also proud of our teams for adding 68 facilities and 12 real estate acquisitions over the last 15 months, bringing total operated facilities to 218 and wholly owned properties to 35.”

Business Outlook

Based on information available as of May 13, 2024, PACS is providing the following guidance for full year 2024:

  • Revenue of $3.65 billion to $3.75 billion
  • Adjusted EBITDA of $351 million to $361 million

PACS's growing portfolio consists of 218 healthcare operations, 16 of which also include senior living operations, across 9 states. PACS owns 47 real estate assets with purchase options on an additional 27 real estate assets, including both wholly owned and owned in a joint venture. Apt noted that PACS’s overall strategy will continue to include both leasing and acquiring real estate and that the Company is actively considering opportunities to acquire both performing and underperforming operations in several states.

A discussion of the Company's use of non-GAAP financial measures and reconciliation to the most directly comparable GAAP measure is set forth below. A reconciliation of Adjusted EBITDA guidance to Net Income on a forward-looking basis cannot be provided without unreasonable efforts, as the Company is unable to provide reconciling information with respect to provision for income taxes, interest expense, depreciation and amortization, acquisition related costs, gain on lease termination, and other adjustment items all of which are adjustments to Adjusted EBITDA. Further discussion about the Company's results is contained in its Quarterly Report on Form 10-Q for the period ended March 31, 2024, which is expected to be filed with the SEC today and can be viewed on the Company’s website at https://IR.pacs.com.

Earnings Conference Call Details

A live webcast will be held Tuesday, May 14, 2024, at 4:00 p.m. Eastern time to discuss PACS’s first quarter financial results. To listen to the webcast please visit the Investors Relations section of PACS’s website at https://IR.pacs.com. The webcast will be recorded and will be available for replay via the website for 30 days following the call.

About PACS™

PACS Group, Inc. is a holding company investing in post-acute healthcare facilities, professionals, and ancillary services. Founded in 2013, PACS Group is one of the largest post-acute platforms in the United States. Its independent subsidiaries operate over 200 post-acute care facilities across nine states serving over 22,000 patients daily. References herein to the consolidated “Company,” as well as the use of the terms “we,” “us,” “our,” “its” and similar verbiage, refer to PACS Group, Inc. and its consolidated subsidiaries, taken as a whole. PACS Group, Inc. and its subsidiaries that are not licensed healthcare providers do not provide healthcare services to patients, residents or any other person, and do not direct or control the provision of services provided or the operations of those provider subsidiaries. All healthcare services are provided solely by its applicable subsidiaries that are licensed healthcare providers, under the direction and control of licensed healthcare professionals in accordance with applicable law. More information about PACS is available at https://IR.pacs.com. The information on our website is not part of this press release.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995:

This press release contains, and other communications of the Company may contain, forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements can be identified by the fact that they do not relate strictly to historical or current facts. Forward-looking statements often use words such as “believe,” “expect,” “anticipate,” “intend,” “estimate,” “project,” “outlook,” “forecast,” “target,” “trend,” “plan,” “goal,” or other words of comparable meaning or future-tense or conditional verbs such as “may,” “will,” “should,” “would,” or “could.”

Statements concerning the Company’s future are forward-looking statements, and are based on management’s current expectations, assumptions and beliefs about the Company’s business, financial performance, operating results, the industry in which we operate and possible future events. These statements include, but are not limited to, statements regarding the Company’s anticipated growth prospects and future operating and financial performance. Forward-looking statements convey the Company’s expectations, intentions, or forecasts about future events, circumstances, results, or aspirations. Forward-looking statements are not guarantees of future results and are subject to risks, uncertainties and assumptions, which may change over time and many of which are beyond the Company’s control, and that could cause the Company’s actual results to materially and adversely differ from those expressed in any forward-looking statement, including our dependence on reimbursement from third-party payors and the impact of changes in the acuity mix of patients in our facilities and changes in payor mix and payment methodologies and new cost containment initiatives; failure to be reimbursed for all services for which each facility bills; increased competition for, or shortage of, nurses, nurse assistants or other skilled personnel; state efforts to regulate or deregulate the healthcare services industry or the construction expansion, or acquisition of healthcare facilities; numerous risks related to the expiration of COVID-19 PHE and surrounding wind-down and uncertainty; failure to attract patients and residents to compete effectively with other healthcare providers; risks associated with our review and audit of the care delivery, recordkeeping and billing processes of our operating subsidiaries; risks associated with litigation; our reliance on information technology; our inability to complete future facility or business acquisitions at attractive prices or at all; risks associated with undertaking acquisitions; risks associated with leased real property; our reliance on payments from third-party payors, including Medicare, Medicaid and other governmental healthcare programs and private insurance organizations; reforms to the U.S. healthcare system; various government and third-party payor reviews, auditors and investigations; risks associated with being a “controlled company,” and the other risks described in our Quarterly Report on Form 10-Q for the three months ended March 31, 2024 and other SEC filings.

These documents are available in the Investor Relations section of the Company’s website at www.pacs.com (information on the website is not incorporated by reference into this presentation and should not be considered part of this document).

You should not place undue reliance on forward-looking statements. The information in this press release is provided as of today’s date only, and, except as required by federal securities law, we do not undertake to publicly update or revise any forward-looking statements, whether as a result of new information, future events, changing circumstances or for any other reason after today.

PACS GROUP, INC. AND SUBSIDIARIES

CONDENSED COMBINED/CONSOLIDATED BALANCE SHEETS

(dollars in thousands, except for share values)

 

 

(unaudited)

 

 

 

March 31,
2024

 

December 31,
2023

ASSETS

 

 

 

Current Assets:

 

 

 

Cash and cash equivalents

$

81,213

 

$

73,416

Accounts receivable, net

 

622,737

 

 

547,807

Other receivables

 

66,014

 

 

52,259

Prepaid expenses and other current assets

 

61,761

 

 

48,665

Total Current Assets

 

831,725

 

 

722,147

Property and equipment, net

 

660,157

 

 

577,528

Operating lease right-of-use assets

 

2,175,169

 

 

2,007,812

Insurance subsidiary deposits and investments

 

25,201

 

 

Escrow funds

 

21,456

 

 

15,649

Goodwill and other indefinite-lived assets

 

65,291

 

 

65,291

Other assets

 

87,329

 

 

124,312

Total Assets

$

3,866,328

 

$

3,512,739

 

 

 

 

LIABILITIES AND EQUITY

 

 

 

Current Liabilities:

 

 

 

Accounts payable

$

157,000

 

$

140,947

Accrued payroll and benefits

 

143,811

 

 

92,234

Current operating lease liabilities

 

113,617

 

 

109,438

Current maturities of long term debt

 

16,837

 

 

16,822

Current portion of accrued self-insurance liabilities

 

29,210

 

 

27,536

Other accrued expenses

 

71,073

 

 

69,949

Total Current Liabilities

 

531,548

 

 

456,926

Long-term operating lease liabilities

 

2,123,865

 

 

1,961,997

Accrued benefits, less current portion

 

6,738

 

 

6,738

Lines of credit

 

537,000

 

 

520,000

Long-term debt, less current maturities, net of deferred financing fees

 

230,855

 

 

195,708

Accrued self-insurance liabilities, less current portion

 

154,892

 

 

146,167

Other liabilities

 

147,837

 

 

123,477

Total Liabilities

$

3,732,735

 

$

3,411,013

Commitments and contingencies

 

 

 

Equity:

 

 

 

PACS Group, Inc. stockholders' equity:

 

 

 

Common stock - 64,361,693,000 shares authorized, $0.001 par value, 128,723,386 shares issued and outstanding as of March 31, 2024 and December 31, 2023

 

129

 

 

129

Accumulated other comprehensive income

 

201

 

 

Retained earnings

 

127,661

 

 

95,997

Total stockholders' equity

 

127,991

 

 

96,126

Noncontrolling interest in subsidiary

 

5,602

 

 

5,600

Total Equity

$

133,593

 

$

101,726

Total Liabilities and Equity

$

3,866,328

 

$

3,512,739

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED CONDENSED COMBINED/CONSOLIDATED STATEMENTS OF INCOME AND COMPREHENSIVE INCOME

(dollars in thousands, except for share and per share values)

 

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

 

Revenue

 

 

 

Patient and resident service revenue

$

934,298

 

 

$

707,826

 

Additional funding

 

 

 

 

375

 

Other revenues

 

423

 

 

 

241

 

Total Revenue

$

934,721

 

 

$

708,442

 

 

 

 

 

Operating Expenses

 

 

 

Cost of services

 

735,992

 

 

 

538,772

 

Rent - cost of services

 

63,961

 

 

 

45,104

 

General and administrative expense

 

46,906

 

 

 

59,442

 

Depreciation and amortization

 

7,902

 

 

 

5,829

 

Total Operating Expenses

$

854,761

 

 

$

649,147

 

 

 

 

 

Operating Income

$

79,960

 

 

$

59,295

 

 

 

 

 

Other (Expense) Income

 

 

 

Interest expense

 

(15,391

)

 

 

(10,636

)

Gain on lease termination

 

8,046

 

 

 

 

Other income, net

 

440

 

 

 

440

 

Total Other Expense, net

$

(6,905

)

 

$

(10,196

)

 

 

 

 

Income before provision for income taxes

 

73,055

 

 

 

49,099

 

Provision for income taxes

 

(23,915

)

 

 

(11,501

)

 

 

 

 

Net Income

$

49,140

 

 

$

37,598

 

Less:

 

 

 

Net income attributable to noncontrolling interest

 

2

 

 

 

1

 

Net income attributable to PACS Group, Inc.

$

49,138

 

 

$

37,597

 

 

 

 

 

Net income per common share attributable to PACS Group, Inc.

 

 

 

Basic and diluted

$

0.38

 

 

$

0.29

 

 

 

 

 

Weighted-average shares outstanding

 

 

 

Basic and diluted

 

128,723,386

 

 

 

128,723,386

 

 

 

 

 

Other comprehensive income, net of tax:

 

 

 

Unrealized gain on available-for-sale debt securities, net of tax

$

201

 

 

$

 

Total other comprehensive income

 

201

 

 

 

 

Comprehensive income

$

49,341

 

 

$

37,598

 

Less:

 

 

 

Comprehensive income attributable to noncontrolling interest

 

2

 

 

 

1

 

Comprehensive income attributable to PACS Group, Inc.

$

49,339

 

 

$

37,597

 

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED CONDENSED COMBINED/CONSOLIDATED STATEMENTS OF CASH FLOWS

(dollars in thousands)

 

The following table presents selected data from our condensed consolidated statements of cash flows for the periods presented:

 

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

 

Net cash provided by/(used in):

 

 

 

Operating activities

$

58,787

 

 

$

79,290

 

Investing activities

 

(118,669

)

 

 

(57,554

)

Financing activities

 

34,453

 

 

 

14,915

 

Net change in cash

 

(25,429

)

 

 

36,651

 

Cash, cash equivalents, and restricted cash - beginning of period

 

118,704

 

 

 

98,206

 

Cash, cash equivalents, and restricted cash - end of period

$

93,275

 

 

$

134,857

 

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED KEY SKILLED SERVICES METRICS

 

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

 

 

Change

 

% Change

 

(Dollars in thousands)

Total facility results:

 

 

 

 

 

 

 

Skilled nursing services revenue

$

927,456

 

 

$

705,574

 

 

$

221,881

 

31.4

%

Skilled mix by revenue

 

52.0

%

 

 

63.7

%

 

 

 

(11.7

)%

Skilled mix by nursing patient days

 

29.8

%

 

 

40.3

%

 

 

 

(10.5

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

2,164,061

 

 

 

1,586,384

 

 

 

577,677

 

36.4

%

Actual patient days

 

1,970,602

 

 

 

1,456,412

 

 

 

514,190

 

35.3

%

Occupancy rate (operational beds)

 

91.1

%

 

 

91.8

%

 

 

 

(0.7

)%

Number of facilities at period end

 

212

 

 

 

174

 

 

 

38

 

21.8

%

Number of operational beds at period end

 

24,315

 

 

 

19,121

 

 

 

5,194

 

27.2

%

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

 

 

Change

 

% Change

 

(Dollars in thousands)

Mature facility(1) results:

 

 

 

 

 

 

 

Skilled nursing services revenue

$

286,419

 

 

$

271,541

 

 

$

14,877

 

5.5

%

Skilled mix by revenue

 

55.6

%

 

 

65.8

%

 

 

 

(10.2

)%

Skilled mix by nursing patient days

 

32.5

%

 

 

42.0

%

 

 

 

(9.5

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

634,543

 

 

 

596,042

 

 

 

38,501

 

6.5

%

Actual patient days

 

600,003

 

 

 

555,494

 

 

 

44,509

 

8.0

%

Occupancy rate (operational beds)

 

94.6

%

 

 

93.2

%

 

 

 

1.4

%

Number of facilities at period end

 

65

 

 

 

63

 

 

 

2

 

3.2

%

Number of operational beds at period end

 

6,973

 

 

 

6,665

 

 

 

308

 

4.6

%

(1)

Mature facilities represent facilities purchased more than 36 months before the date presented.

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

 

 

Change

 

% Change

 

(Dollars in thousands)

Ramping facility(1) results:

 

 

 

 

 

 

 

Skilled nursing services revenue

$

403,938

 

 

$

33,207

 

 

$

370,731

 

1116.4

%

Skilled mix by revenue

 

57.6

%

 

 

63.3

%

 

 

 

(5.7

)%

Skilled mix by nursing patient days

 

34.1

%

 

 

38.0

%

 

 

 

(3.9

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

825,990

 

 

 

82,025

 

 

 

743,965

 

907.0

%

Actual patient days

 

784,834

 

 

 

76,478

 

 

 

708,356

 

926.2

%

Occupancy rate (operational beds)

 

95.0

%

 

 

93.2

%

 

 

 

1.8

%

Number of facilities at period end

 

84

 

 

 

18

 

 

 

66

 

366.7

%

Number of operational beds at period end

 

9,380

 

 

 

1,838

 

 

 

7,542

 

410.3

%

(1)

Ramping facilities represent facilities purchased within 18-36 months of the date presented.

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

 

 

Change

 

% Change

 

(Dollars in thousands)

New facility(1) results:

 

 

 

 

 

 

 

Skilled nursing services revenue

$

237,099

 

 

$

400,826

 

 

$

(163,727

)

 

(40.8

)%

Skilled mix by revenue

 

38.4

%

 

 

62.4

%

 

 

 

(24.0

)%

Skilled mix by nursing patient days

 

21.4

%

 

 

39.3

%

 

 

 

(17.9

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

703,528

 

 

 

908,317

 

 

 

(204,789

)

 

(22.5

)%

Actual patient days

 

585,765

 

 

 

824,440

 

 

 

(238,675

)

 

(28.9

)%

Occupancy rate (operational beds)

 

83.3

%

 

 

90.8

%

 

 

 

(7.5

)%

Number of facilities at period end

 

63

 

 

 

93

 

 

 

(30

)

 

(32.3

)%

Number of operational beds at period end

 

7,962

 

 

 

10,618

 

 

 

(2,656

)

 

(25.0

)%

(1)

New facilities represent facilities purchased less than 18 months from the date presented.

 

 

Three Months Ended March 31,

Skilled mix by revenue

 

Mature

 

Ramping

 

New

 

Total

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

Medicare

 

37.6

%

 

50.3

%

 

39.2

%

 

42.4

%

 

22.1

%

 

46.3

%

 

34.3

%

 

47.6

%

Managed care

 

18.0

 

 

15.5

 

 

18.4

 

 

20.9

 

 

16.3

 

 

16.1

 

 

17.7

 

 

16.1

 

Skilled mix

 

55.6

 

 

65.8

 

 

57.6

 

 

63.3

 

 

38.4

 

 

62.4

 

 

52.0

 

 

63.7

 

Medicaid

 

37.8

 

 

29.4

 

 

35.2

 

 

29.8

 

 

52.7

 

 

31.7

 

 

40.5

 

 

30.7

 

Private and other

 

6.6

 

 

4.8

 

 

7.2

 

 

6.9

 

 

8.9

 

 

5.9

 

 

7.5

 

 

5.6

 

Total

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

 

Three Months Ended March 31,

Skilled mix by nursing patient days

 

Mature

 

Ramping

 

New

 

Total

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

Medicare

 

18.6

%

 

28.8

%

 

20.2

%

 

22.3

%

 

9.7

%

 

26.2

%

 

16.6

%

 

27.0

%

Managed care

 

13.9

 

 

13.2

 

 

13.9

 

 

15.7

 

 

11.7

 

 

13.1

 

 

13.2

 

 

13.3

 

Skilled mix

 

32.5

 

 

42.0

 

 

34.1

 

 

38.0

 

 

21.4

 

 

39.3

 

 

29.8

 

 

40.3

 

Medicaid

 

59.4

 

 

50.2

 

 

56.9

 

 

51.1

 

 

68.6

 

 

52.4

 

 

61.2

 

 

51.5

 

Private and other

 

8.1

 

 

7.8

 

 

9.0

 

 

10.9

 

 

10.0

 

 

8.3

 

 

9.0

 

 

8.2

 

Total

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

Three Months Ended March 31,

 

Mature

 

Ramping

 

New

 

Total

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 

2024

 

 

2023

Medicare

$

937.66

 

$

845.94

 

$

968.59

 

$

836.27

 

$

917.80

 

$

863.92

 

$

949.23

 

$

855.41

Managed care

 

601.48

 

 

569.00

 

 

660.85

 

 

587.46

 

 

558.19

 

 

604.14

 

 

614.99

 

 

589.76

Total for skilled patient payors (1)

 

794.16

 

 

758.81

 

 

843.08

 

 

733.66

 

 

721.10

 

 

777.52

 

 

800.91

 

 

767.90

Medicaid

 

295.05

 

 

283.07

 

 

308.88

 

 

256.67

 

 

308.60

 

 

296.15

 

 

304.70

 

 

289.23

Private and other

 

380.32

 

 

299.68

 

 

408.15

 

 

278.98

 

 

354.26

 

 

350.11

 

 

382.61

 

 

326.93

Total (2)

$

464.08

 

$

484.08

 

$

500.21

 

$

440.48

 

$

401.37

 

$

489.75

 

$

459.83

 

$

485.00

(1)

Represents weighted average of revenue generated by Medicare and managed care payor sources.

(2)

Represents weighted average.

Key Skilled Services Metrics

We monitor the below key skilled services metrics across all of our facilities and by Mature facilities, Ramping facilities, and New facilities. Mature facilities are defined as facilities purchased more than 36 months prior to a respective measurement date. Ramping facilities are defined as facilities purchased within 18 to 36 months prior to a respective measurement date. New facilities are defined as facilities purchased less than 18 months prior to a respective measurement date.

  • Skilled nursing services revenue — Skilled nursing services revenue reflects the portion of patient and resident service revenue generated from all patients in skilled nursing facilities, excluding revenue generated from our assisted and independent living services. 
  • Skilled mix  — We measure both revenue and nursing patient days by payor. Medicare and managed care patients, whom we refer to as high acuity patients, typically require a higher level of skilled nursing care. As a result, Medicare and managed care reimbursement rates are typically higher than those from other payors. In most states, Medicaid reimbursement rates are generally the lowest of all payor types. Changes in the payor mix can significantly affect our revenue and profitability. To monitor this performance, we evaluate two different measures of skilled mix: 
  • Skilled mix by revenue — Skilled mix by revenue represents the portion of routine revenue generated from treating high acuity Medicare and managed care patients. Routine revenue refers to skilled nursing services revenue generated by contracted daily rates charged for skilled nursing services. Services provided outside of routine contractual agreements are recorded separately as ancillary revenue, including Medicare Part B therapy services, and are not routine revenue. The inclusion of therapy and other ancillary treatments in the contracted daily rate varies by payor source and by contract. Revenue associated with calculating skilled mix is based on contractually agreed-upon amounts or rates, excluding the estimates of variable consideration under the revenue recognition standard, Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 606.
  • Skilled mix by nursing patient days — Skilled mix by nursing patient days represents the number of days our high acuity Medicare and managed care patients receive skilled nursing services at skilled nursing facilities as a percentage of the total number of days that patients from all payor sources receive skilled nursing services at skilled nursing facilities for any given period.
  • Occupancy — The total number of patients occupying a bed in a skilled nursing facility as a percentage of the beds in such facility that are available for occupancy during the period.
  • Number of facilities — The total number of skilled nursing facilities that we operate. 
  • Number of operational beds — The total number of operational beds associated with the skilled nursing facilities that we own.

 

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION

(dollars in thousands)

 

 

Three Months Ended March 31,

 

 

2024

 

 

 

2023

Net income

$

49,140

 

 

$

37,598

Less: net income attributable to noncontrolling interest

 

2

 

 

 

1

Add: Interest expense

 

15,391

 

 

 

10,636

Provision for income taxes

 

23,915

 

 

 

11,501

Depreciation and amortization

 

7,902

 

 

 

5,829

EBITDA

$

96,346

 

 

$

65,563

Acquisition related costs

 

207

 

 

 

503

Gain on lease termination

 

(8,046

)

 

 

Adjusted EBITDA

$

88,507

 

 

$

66,066

Rent - cost of services

 

63,961

 

 

 

45,104

Adjusted EBITDAR

$

152,468

 

 

 

Non-GAAP Financial Measures

In addition to our results provided throughout that are determined in accordance with GAAP, we also present the following non-GAAP financial measures: EBITDA, Adjusted EBITDA and Adjusted EBITDAR (collectively, Non-GAAP Financial Measures). EBITDA and Adjusted EBITDA are performance measures. Adjusted EBITDAR is a valuation measure. These Non-GAAP Financial Measures have no standardized meaning defined by GAAP, and therefore have limitations as analytical tools, and they should not be considered in isolation, or as a substitute for analysis of our results as reported in accordance with GAAP. You should review the reconciliation of net income to the Non-GAAP Financial Measures in the table below, together with our audited combined/consolidated financial statements and the related notes in their entirety, and should not rely on any single financial measure. Additionally, other companies may define these or similar Non-GAAP Financial Measures with the same or similar names differently, and because these Non-GAAP Financial Measures are not standardized, it may not be possible to compare these financial measures to those of other companies.

Performance Measures

We use EBITDA and Adjusted EBITDA to facilitate internal comparisons of our historical operating performance on a more consistent basis, as well as for business planning and forecasting purposes. In addition, we believe the presentation of EBITDA and Adjusted EBITDA is useful to investors, analysts and other interested parties in comparing our operating performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our ongoing operating performance.

EBITDA – We calculate EBITDA as net income, adjusted for net losses attributable to noncontrolling interest, before: other expense, net; provision for income taxes; and depreciation and amortization.

Adjusted EBITDA – We calculate Adjusted EBITDA as EBITDA further adjusted for non-core business items, which for the reported periods includes, to the extent applicable, costs incurred to acquire operations that are not capitalizable, gains on lease termination, and certain one-time expenses that are not representative of our underlying operating performance. Costs related to acquisitions include costs related to our acquisition of SNF facilities and providers, including related costs such as legal fees, financial and tax due diligence, consulting and escrow fees.

Valuation Measure

We use Adjusted EBITDAR as a measure to determine the value of prospective acquisitions and to assess the enterprise value of our business without regard to differences in capital structures and leasing arrangements. In addition, we believe that Adjusted EBITDAR is also a commonly used measure by investors, analysts and other interested parties to compare the enterprise value of different companies in the healthcare industry without regard to differences in capital structures and leasing arrangements, particularly for companies with operating and finance leases. For example, finance lease expenditures are recorded in depreciation and interest and are therefore removed from Adjusted EBITDA, whereas operating lease expenditures are recorded in rent expense and are therefore retained in Adjusted EBITDA. Adjusted EBITDAR is a financial valuation measure that is not specified in GAAP, and is not displayed as a performance measure as it excludes rent expense, which is a normal and recurring cash operating expense, and is therefore presented only for the current period. While we believe that Adjusted EBITDAR provides useful insight regarding our underlying operations, excluding the impact of our operating leases, we must still incur cash operating expenses related to our operating leases and rent and such expenses are necessary to operate our leased operations. As a result, Adjusted EBITDAR may understate the extent of our cash operating expenses for the respective period relative to our actual cash needs to operate our leased operations and business.

Adjusted EBITDAR – We calculate Adjusted EBITDAR as Adjusted EBITDA less rent-cost of services.

Investor/Media Relations, PACS Group, Inc., 385-988-3596, IR@pacs.com

Source: PACS Group, Inc.

FAQ

What were PACS Group's Q1 2024 earnings?

PACS Group reported a net income of $49.1 million and GAAP earnings per share of $0.38 for Q1 2024.

How much did PACS Group's revenue increase in Q1 2024?

Revenue increased by 31.9% to $934.7 million in Q1 2024 compared to the same period last year.

What is PACS Group's revenue guidance for 2024?

PACS Group's revenue guidance for 2024 is between $3.65 billion and $3.75 billion.

What is PACS Group's projected Adjusted EBITDA for 2024?

PACS Group's projected Adjusted EBITDA for 2024 is between $351 million and $361 million.

How many facilities did PACS Group add in Q1 2024?

PACS Group added 10 operating facilities in Q1 2024.

PACS Group, Inc.

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FARMINGTON