Ensign Group Inc (ENSG) 2023 Q4 法說會逐字稿

Thank you for standing by. My name is Jessica, and I will be your conference operator today. At this time, I would like to welcome everyone to the Ensign Q4 2023 earnings call. (Operator Instructions)

謝謝你的支持。我叫潔西卡，今天我將擔任你們的會議操作員。此時此刻，我謹歡迎大家參加 Ensign 2023 年第四季財報電話會議。（操作員說明）

I would now like to turn the call over to Mr. Keetch. Please go ahead.

我現在想把電話轉給基奇先生。請繼續。

Thank you, operator, and welcome, everyone. We filed our earnings press release yesterday, and it is available on the Investor Relations section of our website that ensigngroup.net. A replay of this call will also be available on our website until 5:00 PM Pacific on Friday, March 1, 2024. We want to remind anyone that may be listening to a replay of this call that all statements made are as of today, February 2, 2024, and these statements have not been or will be updated subsequent to today's call.

謝謝運營商，歡迎大家。我們昨天提交了收益新聞稿，可在我們網站 ensigngroup.net 的投資者關係部分取得。本次電話會議的重播也將於 2024 年 3 月 1 日星期五太平洋時間下午 5:00 之前在我們的網站上提供。我們想提醒任何可能正在收聽本次電話會議重播的人，所有聲明均截至今天（2024 年 2 月 2 日），並且這些聲明尚未或將在今天的電話會議後更新。

Also, any forward-looking statements made today are based on management's current expectations, assumptions, and beliefs about our business and the environment in which we operate. These statements are subject to risks and uncertainties that could cause our actual results to materially differ from those expressed or implied on today's call. Listeners should not place undue reliance on forward-looking statements and are encouraged to review our SEC filings for a more complete discussion of factors that could impact our results. Except as required by federal securities laws, Ensign and its subsidiaries do not undertake to publicly update or revise any forward-looking statements where changes arise as a result of new information, future events, changing circumstances, or for any other reason.

此外，今天所做的任何前瞻性陳述均基於管理層目前對我們的業務和營運環境的預期、假設和信念。這些陳述存在風險和不確定性，可能導致我們的實際結果與今天電話會議中明示或暗示的結果有重大差異。聽眾不應過度依賴前瞻性陳述，並鼓勵聽眾查看我們向 SEC 提交的文件，以更全面地討論可能影響我們業績的因素。除聯邦證券法要求外，Ensign 及其子公司不承諾公開更新或修改因新資訊、未來事件、情況變化或任何其他原因而發生變化的任何前瞻性聲明。

In addition, the Ensign Group, Inc., is a holding company with no direct operating assets, employees, or revenues. Certain of our independent subsidiaries, collectively referred to as the service center, provide accounting, payroll, human resources, information technology, legal, risk management, and other services to the other independents subsidiaries through contractual relationships with such subsidiaries. In addition, our captive insurance subsidiary, which we refer to as the insurance captive, provide certain claims-made coverage to our operating companies for general and professional liability, as well as for workers' compensation insurance liabilities.

此外，Ensign Group, Inc. 是一家控股公司，沒有直接營運資產、員工或收入。我們的某些獨立子公司（統稱為服務中心）透過與其他獨立子公司的合約關係向其他獨立子公司提供會計、薪資、人力資源、資訊科技、法律、風險管理和其他服務。此外，我們的自保子公司（我們稱之為保險自保）為我們的營運公司提供某些索賠保險，涵蓋一般責任和專業責任以及工傷賠償保險責任。

Ensign and also on Standard Bearer Healthcare, REIT, Inc., which is a captive real estate investment trust that invests in healthcare properties and enters into lease arrangements with certain independent subsidiary of Ensign, as well as third-party tenants that are unaffiliated with the Ensign Group. The words Ensign, company, we, our, and us refer to the Ensign Group, Inc., and its consolidated subsidiaries. All of our independent subsidiaries, the Service Center, Standard Bearer Healthcare REIT, and the insurance captive are operated by separate independent companies that have their own management, employees, and assets.

Ensign 以及 Standard Bearer Healthcare, REIT, Inc.，這是一家專屬房地產投資信託公司，投資於醫療保健物業，並與 Ensign 的某些獨立子公司以及與該公司無關的第三方租戶簽訂租賃安排英賽集團.Ensign、公司、我們、我們的和我們這些字詞均指 Ensign Group, Inc. 及其合併子公司。我們所有的獨立子公司、服務中心、Standard Bearer Healthcare REIT 和保險自保公司均由擁有自己的管理階層、員工和資產的獨立公司營運。

References herein to the consolidated company and its assets and activities as well as the use of words we, us, and our and similar terms are not meant to imply nor should it be construed as meaning that the Ensign Group has direct operating assets, employees, or revenue or that any of the subsidiaries are operated by the Ensign Group.

本文中提及的合併公司及其資產和活動以及使用「我們」、「我們的」和類似術語並不意味著也不應被解釋為意味著 Ensign 集團擁有直接營運資產、員工、或收入或任何子公司由Ensign 集團營運。

Also, we supplement our GAAP reporting with non-GAAP metrics. When viewed together with our GAAP results, we believe that these measures can provide a more complete understanding of our business, but they should not be relied upon to the exclusion of GAAP reports. A GAAP to non-GAAP reconciliation is available in yesterday's press release and is available in our Form 10-K.

此外，我們也以非 GAAP 指標來補充我們的 GAAP 報告。當與我們的 GAAP 結果一起查看時，我們相信這些措施可以提供對我們業務的更全面的了解，但不應依賴它們來排除 GAAP 報告。昨天的新聞稿和我們的 10-K 表格中提供了 GAAP 與非 GAAP 調整表。

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

接下來，我會將電話轉給我們的執行長巴里波特 (Barry Port)。巴里？

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

謝謝查德，也謝謝大家今天加入我們。

Our local teams have once again posted impressive clinical and financial results and continue to build remarkable momentum in each market across our portfolio. Our success is entirely due to the efforts and commitment of those leadership teams, caregivers, field resources, and service center partners. One of our most important priorities is to support those that care for our patients every day.

我們的本地團隊再次取得了令人印象深刻的臨床和財務成果，並繼續在我們的產品組合的每個市場中建立顯著的勢頭。我們的成功完全歸功於這些領導團隊、護理人員、現場資源和服務中心合作夥伴的努力和承諾。我們最重要的優先事項之一是支持那些每天照顧我們病人的人。

After another record quarter, we're excited about the many opportunities to continue to capture the enormous potential inherent in our portfolio as we relentlessly focus on our operational fundamentals, both in existing operations and the growing number of new acquisitions.

在又一個創紀錄的季度之後，我們對繼續抓住我們投資組合固有的巨大潛力的許多機會感到興奮，因為我們不懈地關注我們的營運基本面，無論是在現有業務還是不斷增加的新收購中。

We are pleased to see same-store occupancy of 79.9%, which grew by 240 basis points over the prior-year quarter. In addition, we saw an improvement in occupancy on a sequential basis of 40 basis points over the third quarter. We saw increased volume in our combined same-store and transitioning managed care revenue and managed care census, which increased during the quarter by 12.3% and 3.5%, respectively, over the prior-year quarter as a result of strengthen relationships with our managed care partners and quality outcomes.

我們很高興看到同店入住率達到 79.9%，比去年同期成長 240 個基點。此外，我們還發現入住率比第三季季比提高了 40 個基點。我們看到，我們的同店和轉型管理式醫療收入以及管理式醫療普查的合併銷量有所增加，由於與我們的管理式醫療的關係得到加強，該季度比去年同期分別增長了 12.3% 和 3.5%合作夥伴和高品質成果。

As expected, we saw an increase in our skilled mix during the quarter as our same-store days for the quarter increased by 110 basis points sequentially over the third quarter. We are encouraged by the continued strength in our skilled mix as it demonstrates that continuously increasing demand for skilled post-acute services. By applying proven cultural and operational principles, our local leaders continue to retain and recruit high-caliber individuals, which they want to achieve tremendous success across our growing footprint. We continue to be encouraged by the reduction in our use of third-party nursing agencies, which improved again for the fourth quarter in a row, representing a reduction in agency usage of 58% since its peak in December 2022.

正如預期的那樣，本季我們的技能組合有所增加，本季同店營業天數比第三季連續增加了 110 個基點。我們對我們的技術組合的持續實力感到鼓舞，因為這表明對熟練的急性後服務的需求不斷增加。透過應用經過驗證的文化和營運原則，我們的當地領導者繼續留住和招募高素質人才，他們希望這些人才在我們不斷增長的足跡中取得巨大成功。我們對第三方護理機構使用量的減少持續感到鼓舞，這種情況連續第四季度再次改善，機構使用量自 2022 年 12 月的高峰以來減少了 58%。

We're also thrilled to see lower turnover for the third year in a row, which is a result of our local leaders' focus on our customer second philosophy, which has and will continue to result in better patient care and outcomes. Likewise, we are also encouraged to see the pace of wage inflation continued to slow, along with improvement in our ability to successfully recruit new talent.

我們也很高興看到營業額連續第三年下降，這是我們當地領導人關注客戶至上理念的結果，這種理念已經並將繼續帶來更好的患者護理和結果。同樣，我們也很高興看到薪資上漲的速度持續放緩，同時我們成功招募新人才的能力也有所提升。

As of the end of the quarter, we saw net new hires increased by approximately 6,000 employees over the course of the year, which is particularly impressive given that from the start of the pandemic in 2020 until December 2023, there's been a 9% reduction in employment for the skilled nursing sector. We are confident that by being true to our cultural values, strong clinical results, and proven operating principles that the near- and long-term future is bright. We are humbled by what we were able to accomplish in 2023, but we are eager to continue to drive improvements in our existing portfolio and take advantage of the acquisition opportunities that we see on the horizon.

截至本季末，我們看到全年淨新員工增加了約6,000 名員工，考慮到從2020 年大流行開始到2023 年12 月，新員工數量減少了9%，這一數字尤其令人印象深刻。熟練護理部門的就業。我們相信，透過忠於我們的文化價值、強大的臨床結果和經過驗證的操作原則，近期和長期的未來都是光明的。我們對 2023 年所取得的成就感到謙卑，但我們渴望繼續推動現有投資組合的改進，並利用我們即將看到的收購機會。

We are issuing our 2024 earnings guidance $5.29 to $5.47 per diluted share and annual revenue guidance of $4.13 billion to $4.17 billion. The midpoint of this 2024 earnings guidance represents an increase of 13% over our 2023 results and is 30% higher than our 2022 results.

我們發布的 2024 年攤薄收益指引為每股 5.29 美元至 5.47 美元，年度營收指引為 41.3 億美元至 41.7 億美元。2024 年獲利指引的中位數比我們 2023 年的業績成長 13%，比我們 2022 年的表現高出 30%。

The annual guidance comes on top of the extraordinary growth we experienced in the last few years. To put this performance in perspective since we spun off the Pennant Group in 2019, we have seen adjusted EPS growth by 168% with a compound annual growth rate of 28%. The performance is not due to some large event or single transformative transaction, but instead, is the result of consistent growth and performance quarter after quarter, which comes from following the proven Ensign principles.

年度指導是在我們過去幾年經歷的非凡增長的基礎上發布的。從我們 2019 年分拆 Pennant Group 以來的表現來看，調整後每股盈餘成長了 168%，複合年增長率為 28%。業績並不是由於某個大型事件或單一的變革性交易，而是每季持續成長和業績的結果，而這來自於遵循經過驗證的 Ensign 原則。

We are excited about the upcoming year and confident that our partners will continue to apply our proven locally driven healthcare model. As we evaluate our expanding portfolio, we continue to see enormous organic growth potential within our existing portfolio and are very excited about the continued growth in occupancies that we experienced during the fourth quarter and that continued so far in the first quarter of this year.

我們對即將到來的一年感到興奮，並相信我們的合作夥伴將繼續應用我們經過驗證的本地驅動的醫療保健模式。在評估不斷擴大的投資組合時，我們繼續看到現有投資組合中巨大的有機成長潛力，並對第四季度和今年第一季迄今的入住率持續成長感到非常興奮。

There are so many opportunities in front of us to improve in expense management and drive occupancy and skilled mix as we continue to successfully unlock value in the dozens of recently acquired operations. We are poised to, again, showcase our ability to find, acquire, and transition performing and underperforming operations type of applying for Ensign principles developed over two decades. When we consider the health of our organization, combined with our culture and proven local leadership strategy, we are well-positioned to have another outstanding year in 2024.

隨著我們繼續成功地在最近收購的數十家業務中釋放價值，我們面前有許多機會來改善費用管理、提高入住率和技能組合。我們準備再次展示我們尋找、獲取和轉變績效和績效不佳營運類型的能力，這些營運類型適用於二十年來發展的 Ensign 原則。當我們考慮組織的健康狀況，結合我們的文化和行之有效的當地領導策略時，我們完全有能力在 2024 年再創輝煌。

Next, I will ask Chad to provide some additional insights regarding our recent growth. Chad?

接下來，我將請乍得提供一些有關我們近期成長的額外見解。查德?

Thank you, Barry. We are very excited about the three new operations and one real estate asset we added during the quarter and since, bringing the number of operations acquired since 2022 to 54. These new operations include a healthcare campus in Houston, Texas, which included the real estate assets that were required by Standard Bearer; one operation in Kansas; one operation in Nevada; and our first campus in Tennessee, totaling an additional 528 new operational beds. These additions were all carefully selected amongst the many opportunities available to us and were chosen because of the huge clinical and financial potential.

謝謝你，巴里。我們對本季及此後增加的三項新業務和一項房地產資產感到非常興奮，這使得自 2022 年以來收購的業務數量達到 54 家。這些新業務包括位於德州休士頓的一個醫療保健園區，其中包括標準持有者所需的房地產資產；堪薩斯州的一項業務；在內華達州開展一項業務；以及我們位於田納西州的第一個校區，總共新增 528 個可用床位。這些新增內容都是我們從眾多可用機會中精心挑選出來的，因為其巨大的臨床和財務潛力。

Following our recent SNF growth in 2023, occupancy and skilled mix days for the skilled nursing operations in the recently acquired bucket were 77.6% and 27.5%, respectively, for the quarter. When compared to our same-store occupancy and skilled mix days of 79.9% and 30.9%, respectively, there is enormous upside in each of these new operations as they continue to transform into same-store caliber operations. We also remind you that there is nothing about the designation of same store within our three buckets that should be seen as a cap on the occupancies that our more mature operations can achieve.

繼 2023 年 SNF 成長之後，本季最近收購的熟練護理機構的佔用率和熟練混合天數分別為 77.6% 和 27.5%。與我們分別為 79.9% 和 30.9% 的同店入住率和熟練混合天數相比，隨著這些新業務繼續轉型為同店水準業務，它們都有巨大的上升空間。我們也提醒您，在我們的三個類別中指定同一家商店不應被視為對我們更成熟的營運可以實現的入住率的限制。

Our leaders consistently drive remarkable improvement in our most mature assets, many of which achieve and maintain occupancies well under the 90%-plus range as they seek and deliver on opportunities to expand their clinical capabilities into new functional areas and provide alternatives to long hospital stays. We are very optimistic about the organic growth potential within our existing portfolio, including our new acquisitions.

我們的領導者不斷推動我們最成熟資產的顯著改善，其中許多資產的入住率遠低於90% 以上，因為他們尋求並提供機會，將其臨床能力擴展到新的功能領域，並提供長期住院的替代方案。我們對現有投資組合（包括新收購）的有機成長潛力非常樂觀。

Because Tennessee is our first new state and several years, I thought I would just briefly highlight our new market program. As most of you know, the foundational principle of our entire strategy is a recognition that post-acute care is it locally driven business, and the success or failure of any operation is largely determined by the quality of the leadership and the vision of the team leading each unique multibillion dollar business. Because we believe that so deeply, we take entering into a new state very seriously.

因為田納西州是我們的第一個新州，而且已經好幾年了，所以我想我只是簡單地強調我們的新市場計劃。正如你們大多數人所知，我們整個策略的基本原則是認識到急性後護理是本地驅動的業務，任何業務的成功或失敗在很大程度上取決於領導層的素質和團隊的願景領導每一項獨特的數十億美元業務。因為我們深信這一點，所以我們非常認真地對待進入一個新的狀態。

Long before we acquired our first asset in Tennessee, one of the most trusted and tenured leaders in our organization, Tyler Albertson, identified that market as one was extraordinary potential. For years, Tyler successfully operated one of our flagship operations in California and later lead one of our most dynamic markets in Southern California, developed the business plan for Ensign's growth in Tennessee, and presented it to his partners. That business plan was debated and discussed and ultimately approved by his peers.

早在我們在田納西州收購第一筆資產之前，我們組織中最值得信賴和最資深的領導者之一泰勒·艾伯森 (Tyler Albertson) 就發現該市場具有非凡的潛力。多年來，Tyler 成功經營了我們在加州的旗艦業務之一，後來領導了我們在南加州最具活力的市場之一，為Ensign 在田納西州的發展制定了業務計劃，並將其提交給他的合作夥伴。該商業計劃經過辯論和討論，最終得到了他的同事的批准。

Tyler carefully prepared to replace himself in his existing role as a market leader in Southern California and only after was clear that he was leaving his old role in better hands and he found it. Tyler moved his family to Tennessee to begin the process of learning the dynamics of the market, meeting new talent and evaluating acquisition opportunities.

泰勒精心準備接替自己作為南加州市場領導者的現有角色，只有在明確他將把原來的角色交給更好的人接手之後，他才發現了這一點。泰勒舉家搬到田納西州，開始了解市場動態、結識新人才並評估收購機會。

After many months of preparation and after evaluating dozens of opportunities, Tyler and partners from other supporting geographies agreed to acquire our first building as of January 1. So far, the transition has gone well, and we fully expect all his hard work and preparation to pay off. Over the next several months, as Tyler and his team have resources transition the initial acquisition, we anticipate that they will acquire additional operations to build a cluster of facilities over the next few quarters.

經過數月的準備和評估數十個機會後，泰勒和來自其他支援地區的合作夥伴同意從 1 月 1 日起收購我們的第一棟大樓。到目前為止，過渡進展順利，我們完全期望他的所有努力和準備都能得到回報。在接下來的幾個月裡，隨著泰勒和他的團隊擁有資源來過渡最初的收購，我們預計他們將在接下來的幾個季度內收購更多的業務來建造一系列設施。

As we have seen recently in South Carolina, eventually, this will grow into multiple clusters, which will eventually comprise a sizable market. We can't wait to watch Tyler and his team of leaders and caregivers apply Ensign's operating principles in this new market and look forward to Tennessee becoming another reflection of the template of growth both and development we've seen across our footprint over the last 25 years. We also remind you that we are now in 14 states and have significant bandwidth to grow in the other 36 states.

正如我們最近在南卡羅來納州看到的那樣，最終，這將發展成為多個集群，最終將構成一個相當大的市場。我們迫不及待地想看到 Tyler 和他的領導者和護理人員團隊在這個新市場中應用 Ensign 的營運原則，並期待田納西州成為我們過去 25 年來在足跡中看到的增長和發展模板的另一個反映年。我們也提醒您，我們現在已在 14 個州開展業務，並且在其他 36 個州擁有大量的發展空間。

The pipeline for new deals remains strong. We are lining up several exciting opportunities and expect to announce several deals over the coming months, and we remain poised to grow with over $1 billion in dry powder for future investments.

新交易的管道依然強勁。我們正在尋找幾個令人興奮的機會，並預計在未來幾個月內宣布幾項交易，並且我們仍然準備好以超過 10 億美元的乾粉來實現未來投資的成長。

Our local leaders continue to recruit future CEOs of Ensign-affiliated operations, and we have a deep bench of CEOs and training that are eagerly preparing for their opportunity to lead. We continue to see evidence that many operators in this industry are struggling, and we expect that the operating environment will translate into many near- and long-term opportunities to both lease and acquire post-acute care assets.

我們的當地領導者繼續招募 Ensign 附屬業務的未來首席執行官，我們擁有一大批首席執行官和培訓人員，正在熱切地為他們的領導機會做好準備。我們繼續看到有證據表明該行業的許多營運商正在苦苦掙扎，我們預計營運環境將轉化為許多租賃和收購急診後護理資產的近期和長期機會。

However, we do not set arbitrary growth goals and will remain true to our disciplined acquisition strategy only growing when we have the right leaders in place and the pricing is right.

然而，我們不會設定任意的成長目標，並且將堅持我們嚴格的收購策略，只有在我們擁有合適的領導者並且定價合適的情況下才會成長。

We continue to provide additional disclosure on Standard Bearer, which is comprised of 108 properties owned by the company and leased to 79 affiliated skilled nursing and senior living operations and 30 operations that are leased to third-party operators. Each of these properties are subject to triple-net long-term leases and together generated rental revenue of $21.9 million for the quarter, of which $17.7 million was derived from Ensign-affiliated operations. Also for the quarter, we reported $14.2 million in FFO and as of the of the quarter had an EBITDAR to rent coverage ratio of 2.2 times.

我們繼續提供有關 Standard Bearer 的更多披露，該公司由該公司擁有並租賃給 79 家附屬熟練護理和老年生活運營商的 108 處房產以及租賃給第三方運營商的 30 處房產組成。這些物業中的每一個都受到三重淨長期租賃的約束，本季總共產生了 2,190 萬美元的租金收入，其中 1,770 萬美元來自 Ensign 附屬業務。同樣在本季度，我們報告的 FFO 為 1,420 萬美元，截至本季度，EBITDAR 與租金覆蓋比率為 2.2 倍。

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

接下來，我會將電話轉給我們的營運長 Spencer，為營運增添更多色彩。斯賓塞？

Thank you, Chad, and hello, everyone. As was mentioned earlier, the continued success we experienced during the fourth quarter was a result of continued improvements in occupancy and staffing, combined with hundreds of small but meaningful innovations by facility leaders and clusters. Today, I'd like to share two examples that demonstrate how diverse geographies and business lines are maturing and in turn, providing more and more opportunities for growth and expansion as we enter 2024.

謝謝查德，大家好。如前所述，我們在第四季度取得的持續成功得益於入住率和人員配備的持續改善，以及設施領導者和集群的數百項小而有意義的創新。今天，我想分享兩個例子，展示多元化的地域和業務線如何日益成熟，並反過來為我們進入 2024 年提供越來越多的成長和擴張機會。

The first facility highlight is The Healthcare Resort of Topeka Campus. This 94-bed skilled nursing and senior living campus has consistently grown since opening in 2016. While the facility has maintained a high census and been successful for many years, going into 2023 CEO, Ben Leiker; and Director of Nursing, Amanda Perron, together with their interdisciplinary team, developed a strategy to take performance to the next level by leveraging their reputation and the stability in nurse staffing to improve skilled mix in the SNF and improve revenue quality in their senior living.

第一個設施亮點是托皮卡校區的醫療度假村。這個擁有 94 個床位的專業護理和老年生活園區自 2016 年開業以來不斷發展壯大。雖然該設施多年來一直保持著較高的人口普查水平並取得了成功，但進入 2023 年首席執行官 Ben Leiker；護理總監Amanda Perron 與他們的跨學科團隊一起制定了一項策略，透過利用他們的聲譽和護理人員配置的穩定性來改善SNF 的技能組合併提高老年人生活的收入質量，從而將績效提升到一個新的水平。

The strategy involves concerted efforts to develop clinical programs that met their local hospitals discharge needs, as well as strengthening partnerships with key managed care plans and conveners. As a result, the senior living section of the campus maintained 100% occupancy for all of 2023, and the campus grew revenues by 13.4% over prior-year quarter.

該策略包括共同努力製定滿足當地醫院出院需求的臨床計劃，以及加強與主要管理式醫療計劃和召集人的合作夥伴關係。因此，園區的老年生活區在 2023 年全年維持了 100% 的入住率，園區收入比去年同期成長了 13.4%。

During that same period, skilled mix days improved by 17%, driven specifically by an increase in managed care days of more than 40%. This growth in acuity was accompanied by an equal focus on recruiting and retention, which led to one of the lowest turnover rates in the market and zero agency staffing during all of 2023. The stability in staffing resulted in great regulatory performance, including no survey deficiencies and allowed the facility to avoid much of the cost associated with orienting and training new staff. As a result, HCR Topeka accomplished its best ever EBIT performance for 2023, including 70% EBIT growth in Q4 over the prior-year quarter.

在同一時期，熟練的混合工​​作天數增加了 17%，特別是管理式護理工作天數增加了 40% 以上。敏銳度的成長伴隨著對招聘和保留的同等關注，這導致了 2023 年全年代理機構人員配置為市場上最低的之一和零。人員配置的穩定性帶來了良好的監管績效，包括沒有調查缺陷，並使設施避免了與新員工指導和培訓相關的大部分成本。因此，HCR Topeka 實現了 2023 年有史以來最好的息稅前利潤表現，其中第四季度的息稅前利潤比去年同期增長了 70%。

The second example comes from Riverside, California. The Grove Healthcare and Wellness Center is a thriving campus, which includes 38 skilled nursing beds and 90 senior living units. Led by Executive Director, Michelle Mora, the skilled nursing portion has been operated as an Ensign affiliate since 2009. However, in April 2022, the Grove Senior Living portion was acquired from Pennant Group. And over the past 18 months, the unified campus has been enjoying exceptional growth.

第二個例子來自加州河濱市。格羅夫醫療保健中心是一個欣欣向榮的園區，擁有 38 個專業護理床位和 90 個老年生活單元。在執行董事 Michelle Mora 的領導下，熟練護理部門自 2009 年以來一直作為 Ensign 附屬機構運作。然而，2022 年 4 月，Grove Senior Living 部分被從 Pennant Group 收購。在過去 18 個月裡，統一校園一直在取得非凡的發展。

As they have operated more as a healthcare campus, DON, Maria Manolo, and her team are able to provide integrated and comprehensive care to more and more acute residents within the senior living. At the same time, the SNF portion of the campus has been able to utilize the senior living to safely discharge residents to lower levels of care, which has allowed for more skilled admissions and has increased the skilled mix by 14% and revenues by 23% in Q4 2023 compared to the same quarter for 2022.

由於他們更多地作為醫療保健園區運營，DON、Maria Manolo 和她的團隊能夠為老年生活中越來越多的急性居民提供全面和全面的護理。同時，校園的 SNF 部分能夠利用老年生活區將居民安全地轉至較低級別的護理機構，從而允許更多技術人員入院，並將技術人員組合增加 14%，收入增加 23% 2023 年第第四季與2022 年同季相比。

Over the past year, community partners, including managed care plans, have taken note, and occupancy has frequently hit 100%, in large part due to an 88% increase in Managed Care Census over prior-year quarter. Perhaps the most important aspect of the Grove's success story is incredibly supportive culture at the team has developed. For example, 100% of the Grove's employees voluntarily contribute a portion of their paychecks to elevate charities, our charitable fund that provides emergency assistance for employee and crisis. The same employees have also bound together to eliminate agency staffing and reduce turnover, which in turn have contributed to a 103% increase in EBIT over prior-year quarter at the skilled nursing and to an all-time record EBIT for the campus as a whole.

在過去的一年裡，包括管理式醫療計劃在內的社區合作夥伴已經注意到這一點，入住率經常達到100%，這在很大程度上是由於管理式醫療普查比去年同期增長了88% 。也許格羅夫成功故事中最重要的方面是團隊中令人難以置信的支持文化的發展。例如，格羅夫 100% 的員工自願將部分工資捐給慈善機構，我們的慈善基金為員工和危機提供緊急援助。這些員工也聯合起來，消除了機構人員配置並減少了人員流動，這反過來又使熟練護理人員的息稅前利潤比上年同期增長了103%，並創造了整個園區息稅前利潤的歷史最高記錄。

These examples demonstrate the strength of our operating model. And how frontline leaders and their local teams are innovating and providing healthcare solutions to their communities and to the residents they serve.

這些例子證明了我們營運模式的優勢。以及第一線領導者和他們的當地團隊如何創新並為他們的社區和他們所服務的居民提供醫療保健解決方案。

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

接下來，我將把時間交給蘇珊娜，提供有關公司財務業績和我們的指導的更多詳細信息，然後我們將提出一些問題。蘇珊娜？

Thanks, Spencer, and good morning, everyone. Detailed financials for the year and the quarter are contained in our 10-K and press release filed yesterday. Some additional highlights for the year include consolidated GAAP revenues and adjusted revenues were both $3.73 billion, an increase of 23%. GAAP diluted earnings per share was $3.65, and GAAP net income was $209.4 million.

謝謝斯賓塞，大家早安。本年度和本季的詳細財務資訊包含在我們昨天提交的 10-K 和新聞稿中。今年的一些其他亮點包括綜合 GAAP 收入和調整後收入均為 37.3 億美元，成長 23%。GAAP 攤薄後每股收益為 3.65 美元，GAAP 淨利為 2.094 億美元。

Adjusted diluted earnings per share for Dan and $0.77, an increase of 15.2%, and adjusted net income was 273.59.

調整後攤薄每股收益為丹和0.77美元，成長15.2%，調整後淨利為273.59。

Adjusted diluted earnings per share was $4.77, an increase of 15.2%, and adjusted net income was $273.5 million, an increase of 16%. Highlights for the quarter include consolidated GAAP revenues and adjusted earnings were both $980.4 million, an increase of 21%. GAAP diluted earnings per share was $0.38, and GAAP net income was $21.7 million. Adjusted diluted earnings per share was $1.28, an increase of 16.4%, and adjusted net income was $73.7 million, an increase of 17.5%.

調整後稀釋每股盈餘為4.77美元，成長15.2%，調整後淨利為2.735億美元，成長16%。該季度的亮點包括綜合 GAAP 收入和調整後收益均為 9.804 億美元，成長 21%。GAAP 攤薄後每股收益為 0.38 美元，GAAP 淨利為 2,170 萬美元。調整後稀釋每股盈餘為1.28美元，成長16.4%，調整後淨利為7,370萬美元，成長17.5%。

Other key metrics as of December 31, 2023, include cash and cash equivalents of $509.6 million and cash flow from operations of $376.7 million. We continue to de-lever our portfolio, achieving a lease adjusted net debt-to-EBITDA ratio of 1.98 times, which is particularly noteworthy given the amount of growth we have taken on over this last year.

截至 2023 年 12 月 31 日的其他關鍵指標包括現金和現金等價物 5.096 億美元以及營運現金流 3.767 億美元。我們繼續對投資組合進行去槓桿化，實現租賃調整後淨債務與 EBITDA 比率達到 1.98 倍，考慮到我們去年的成長量，這一點尤其值得注意。

In addition, we currently have over $593 million of available capacity on our line of credit, which when combined with our cash on our balance sheet, give us over $1 billion of dry powder and future investments. We also own 113 assets, of which 108 are held by Standard Bearer and 89 of which are owned completely debt free and continue to gain significant value over time, adding even more liquidity to help our future growth.

此外，我們目前的信貸額度擁有超過 5.93 億美元的可用容量，加上資產負債表上的現金，將為我們提供超過 10 億美元的乾粉和未來投資。我們還擁有 113 項資產，其中 108 項由標準持有者持有，其中 89 項完全無債務，並隨著時間的推移繼續獲得巨大價值，增加更多流動性以幫助我們未來的成長。

During the quarter, we increased our quarterly cash dividend to $0.06 per share, marking the 21st consecutive annual dividend increase. Given our strength, we plan to continue our 22-year history of paying dividends in the future.

本季度，我們將季度現金股息提高至每股 0.06 美元，這是連續 21 次年度股息成長。鑑於我們的實力，我們計劃未來繼續延續22年的派息歷史。

CMS continues to review the thousands of comments they have received, and they look to finalize a federal minimum staffing rule. However, if the rule is implemented, we do not expect the relative impact in 2024.

CMS 繼續審查他們收到的數千條評論，並希望最終確定聯邦最低人員配置規則。然而，如果該規則得到實施，我們預計 2024 年不會產生相對影響。

Also, during the quarter, we settled a litigation matter that we previously disclosed. We are pleased to put this matter behind us and look forward to focusing solely on our mission of providing compassionate care to patients and achieving our goal of setting the standard for high-quality healthcare services throughout the industry.

此外，在本季度，我們解決了先前披露的一項訴訟問題。我們很高興將此事拋諸腦後，並期待著專注於為患者提供富有同情心的護理的使命，並實現為整個行業製定高品質醫療服務標準的目標。

As Barry mentioned, we are providing our annual guidance of $5.29 to $5.47 per diluted share and annual revenue guidance of $4.13 billion to $4.17 billion. We have evaluated multiple scenarios and based on the strength in our performance and positive momentum, we've seen in occupancy and skilled mix as well as some additional strengths in Medicaid and managed care programs.

正如巴里所提到的，我們提供的年度指引為稀釋後每股 5.29 美元至 5.47 美元，年度收入指引為 41.3 億美元至 41.7 億美元。我們評估了多種情景，並根據我們的業績優勢和積極勢頭，我們看到了入住率和技能組合以及醫療補助和管理式醫療計劃的一些額外優勢。

We have confidence that we can achieve these results are 2024 guidance is based on diluted weighted average common shares outstanding of 58.59, a tax rate of 25% from the inclusion of acquisitions. Closed in the first half of 2024, the inclusion of management's expectations for Medicare and Medicaid reimbursement net of provider tax, and with the primary exclusions coming from stock-based compensation and certain expenses related to specific litigation matters arising outside the normal course of business.

我們有信心在 2024 年取得這些成果，指引的基礎是稀釋後加權平均已發行普通股 58.59 股，以及納入收購的 25% 稅率。該計劃於2024 年上半年完成，納入了管理層對扣除提供者稅後的醫療保險和醫療補助報銷的預期，並且主要排除了基於股票的薪酬以及與正常業務過程之外產生的特定訴訟事項相關的某些費用。

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

此外，其他可能影響季度業績的因素，包括報銷制度的變化、國家預算的延遲和變化、入住率和技能組合的季節性、整體經濟、人口普查和人員配置的影響、我們收購活動的短期影響、變化和保險費用以及其他因素。

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

這樣，我會把它轉回給巴里。巴里？

Thanks, Suzanne. As we wrap up, I can't emphasize enough how incredibly honored and grateful we are to work alongside our facility leaders, field resources, clinical partners, and service center team that are behind these record setting results. We never cease to be amazed by their impressive resiliency as they focus on supporting one another in new and innovative ways. Their commitment has blessed the lives of so many, including our own.

謝謝，蘇珊娜。在我們結束時，我無法充分強調我們是多麼的榮幸和感激，能夠與這些創紀錄的結果背後的設施領導、現場資源、臨床合作夥伴和服務中心團隊一起工作。我們始終對他們令人印象深刻的韌性感到驚訝，因為他們專注於以新穎和創新的方式相互支持。他們的承諾造福了許多人的生活，包括我們自己。

We're excited about our future because of our amazing partners, and we have complete faith in them and the culture that they have collectively built.

我們對我們的未來感到興奮，因為我們有出色的合作夥伴，我們對他們以及他們共同建立的文化充滿信心。

We'll now turn it over to the Q&A portion of our call. Operator, can you please instruct the audience on the Q&A procedure?

我們現在將其轉入電話會議的問答部分。接線員，您能指導觀眾的問答程序嗎？

(Operator Instructions) Andy Hendricks, RBC Capital Markets.

（操作員說明）Andy Hendricks，RBC 資本市場。

Thank you very much. Great quarter, guys. Suzanne, I was hoping you could follow-up on some of your comments on the top-line guidance, really good revenue outlook there. And we're just wondering if we could kind of break down a little bit more of the drivers there? For example, what you're thinking about in terms of how of occupancy phases through the year? Also, you mentioned the rate backdrop and strong Medicaid reimbursement. Just want to kind of see what you're seeing there, and how sustainable that is in the next couple of years? And then just any commentary on contribution from recent acquisitions that we could see ramp-up this year? Thanks a lot.

非常感謝。很棒的季度，夥計們。蘇珊娜，我希望你能跟進你對頂線指導的一些評論，那裡的收入前景非常好。我們只是想知道是否可以分解更多的驅動程式？例如，您對一年中的入住階段有何看法？此外，您還提到了費率背景和強大的醫療補助報銷。只是想看看您在那裡看到了什麼，以及未來幾年的可持續性如何？那麼，對今年我們可能會看到的近期收購貢獻的評論有何評論？多謝。

Yeah. Thanks, Ben. It's a great question. As we looked at the guidance for this year, a couple of things that we're taking consideration. As you know, we have historically given you guys some visibility into revenue by breaking it out into the three buckets: same-store, transitioning, and recently acquired. And as we kind of look at those three different buckets, what we're kind of projecting for a great rate, our overall growth in each one of the bucket is mid-single digits kind of in that same-store bucket and that transitioning bucket kind of high-single digits and then in the recently acquired low-double digits.

是的。謝謝，本。這是一個很好的問題。當我們查看今年的指導時，我們正在考慮一些事情。如您所知，我們歷來透過將收入分為三個部分來讓大家了解收入：同店、轉型和最近收購。當我們看看這三個不同的桶子時，我們預計會有一個很高的成長率，我們每個桶的整體成長都是中個位數，在同店桶和過渡桶中一種高個位數，然後是最近獲得的低兩位數。

As we stated in the remarks, acquisitions work, including during the first half of the year so not a ton of acquisitions. And as we stated in previous years, when we bring those acquisitions in, we're really bringing in that revenue, and it's going to kind of hit on that margin line as we don't expect a lot from in those first years.

正如我們在評論中所說，收購是有效的，包括在今年上半年，所以不會進行大量收購。正如我們前幾年所說，當我們進行這些收購時，我們確實帶來了收入，而且它會影響利潤線，因為我們對最初幾年的期望不會很高。

For occupancy, continued growth is what we are anticipating in 2024. And with that seasonality all built into that. Overall, we're really excited about where we're positioned on rates. One of the strongest rate years that we've had was in 2023, as you know, lot of that comes in the late third quarter, early fourth quarter. So most of that rate growth will then push into 2024 and then really looking at some continued nice growth in the kind of late Q3, Q4 of 2024 as well. Not as probably strong as what we saw in late 2023, but relatively strong compared to historical.

對於入住率而言，我們預計 2024 年將持續成長。季節性因素都融入其中。總的來說，我們對我們在費率上的定位感到非常興奮。如您所知，我們經歷過的利率最高的年份之一是 2023 年，其中許多發生在第三季末、第四季初。因此，大部分成長率將延續到 2024 年，然後在 2024 年第三季末、第四季真正看到一些持續的良好成長。可能不如我們在 2023 年底看到的那麼強勁，但與歷史相比相對較強。

You asked about contribution from acquisitions. Obviously, the ones that -- we obviously have some visibility into some deals that will do this year, and we don't expect much if any contribution from those. The ones that we acquired last year, overall, are ahead of schedule, largely due to the North American transition and went extremely well.

您詢問了收購帶來的貢獻。顯然，我們顯然對今年將進行的一些交易有一定的了解，而且我們預計這些交易不會有太多貢獻（如果有的話）。總體而言，我們去年收購的專案提前了，這主要歸功於北美的轉型，並且進展非常順利。

So some of our optimism in our guidance comes from the kind of accelerated growth. And we saw from those buildings that will continue throughout this year as they mature.

因此，我們的指導中的一些樂觀情緒來自於加速成長。我們從這些建築中看到，隨著它們的成熟，它們將在今年繼續存在。

Thank you very much. Just one quickly, we are also getting questions. I know the legal settlement kind of have brought into the spotlight, some of the typical kind of legal activity that happens in the healthcare industry. We're also getting questions on -- we noticed that there was another kind of DOJ, or DOJ/CID issue that might have been raised earlier this month regarding Medicare and Texas Medicaid. Just wondering to see if that's kind of a similar situation, if that's something that's related to this issue that you just settled, or if it's separate, just your take on that? Thank you.

非常感謝。快說一句，我們也收到了問題。我知道法律和解已經成為人們關注的焦點，醫療產業中發生的一些典型的法律活動。我們還收到以下問題 - 我們注意到本月早些時候可能提出了另一種與醫療保險和德克薩斯州醫療補助有關的司法部或司法部/刑事調查局問題。只是想知道這是否是一種類似的情況，是否與您剛剛解決的這個問題有關，或者如果是單獨的，您對此有何看法？謝謝。

Yes. I mean, the settlement from earlier that we've been disclosing firm for years now was related to this resolution on a on a case from 2018 that began as a relator initiated DOJ inquiry.

是的。我的意思是，我們多年來一直在披露的早期和解協議與針對 2018 年一起案件的這項決議有關，該案件始於一名關係者發起的司法部調查。

And when the DOJ declined to intervene that turn into a civil case that just did stretched and stretched over many years. And we brought in a mediator earlier this year to find a suitable resolution. And we found one and this saves us from additional defense costs, which was significant time and distraction as well because there's a large breadth to the scope of it, and it allows us to move forward that any over paying of liability. So we just felt like that the costs and the timing of distraction made it important for us to just get that one behind us.

當司法部拒絕幹預時，這件事變成了民事案件，並且持續了很多年。今年早些時候，我們聘請了一名調解員來尋找合適的解決方案。我們找到了一個，這使我們免於額外的辯護費用，這也需要大量的時間和分心，因為它的範圍很廣，並且它使我們能夠繼續推進任何超額支付的責任。所以我們只是覺得分心的代價和時間讓我們必須把它拋在身後。

So that's one. And we, like I said, we've disclosed that over the course of many years in our filings. This new one is unrelated. And while there are some references to some Texas Medicaid issues, it's a fairly general inquiry. This is healthcare, whenever you're dealing with government payers, there's always the chance that they're going to ask questions and do audits. We don't know what kind of -- what's driving it necessarily. We don't have a whole lot of details on it, and we have retained really good outside counsel to help represent us on it and get to the bottom of what they are asking for. But yes, it is totally unrelated to the prior settlement.

這就是其中之一。正如我所說，我們多年來在我們的文件中披露了這一點。這個新的與此無關。雖然其中提到了一些德州醫療補助問題，但這是一個相當普遍的調查。這就是醫療保健，每當您與政府付款人打交道時，他們總是有機會提出問題並進行審計。我們不知道是什麼推動了它的發展。我們沒有太多的細節，但我們聘請了非常優秀的外部顧問來幫助我們代表我們並弄清楚他們的要求。但是，是的，這與之前的解決方案完全無關。

Thank you very much for that, and I appreciate you taking the questions.

非常感謝您的回答，也感謝您提出問題。

Thank you very much.

非常感謝。

Scott Fidel, Stephens.

斯科特·菲德爾，史蒂芬斯。

Okay. Thank you. Actually, just wanted to start, just double click on Ben's question just on the Medicaid rates and one state and specifically, you had an important California rebasing process that was underway for a while and I think at this point, you should have pretty strong visibility into that. Maybe if you can give us an update on sort of how that is playing out, and how you expect that to impact revenue, cost, and margins in '24?

好的。謝謝。實際上，只是想開始，只需雙擊本關於醫療補助費率和一個州的問題，具體來說，您有一個重要的加州重新設定過程，該過程已經進行了一段時間，我認為在這一點上，您應該具有相當強的可見性進入那個。或許您可以為我們介紹一下這種情況的最新進展，以及您預計這將如何影響 24 年的收入、成本和利潤？

Great question, Scott. Obviously, California was one of the few states, just to refresh everyone's memory, that continue to pay out the additional 10% estimate in 2023. What the state has done, it's really gone and said, hey, how do we continue to make sure that we make operators in a great position. And so, they went through a process of instituting a rebase program that starts January 1, 2024. At the same time as that, they also went and re-upped their supplemental program that they haven't had in place for a couple of years now.

好問題，史考特。顯然，加州是少數幾個在 2023 年繼續支付額外 10% 預估費用的州之一，只是為了喚起大家的記憶。國家所做的事情，它真的消失了，並說，嘿，我們如何繼續確保我們使運營商處於有利地位。因此，他們經歷了從 2024 年 1 月 1 日開始實施變基計畫的過程。同時，他們也重新加強了幾年來一直沒有實施的補充計畫。

And so, really, how we are looking at those and how the state is really looking at that is a combination of those two really make up the overall state rate. And so we will have some folks that will enter into the rebasing program, where their rates will be raised and based upon kind of that cost that are there any increase in cost that we've seen. And then as a part of that program, they will also have to do some additional costs for benefits and other things, but overall, really, really happy with that.

因此，實際上，我們如何看待這些問題以及州政府如何真正看待這些問題，這兩者的結合確實構成了州的整體利率。因此，我們將有一些人加入重新定基計劃，他們的費率將提高，並且基於我們所看到的成本是否有任何增加。然後，作為該計劃的一部分，他們還必須為福利和其他事情支付一些額外費用，但總的來說，他們真的非常滿意。

On top of that, we'll also be having a supplemental program that allows us to earn additional funds for quality improvement. So all that goes into effect in January. So January 1, it went into effect.

最重要的是，我們還將有一個補充計劃，使我們能夠賺取額外的資金來提高品質。所以所有這些都會在一月生效。所以1月1日起，它就開始生效了。

The state where it's at right now is it actually is with the CMS for their state approval because every everything has to get all of our Medicaid rates approved. And so overall, we're really excited about the combination of those two programs together. There might be a little bit of hit on margin because there is some costs associated with getting some of that revenue. But overall, feel really great about the additional revenue that's going to come through and the cost that we pay for it.

現在所在的州實際上正在向 CMS 申請州批准，因為一切都必須得到我們所有醫療補助費率的批准。總的來說，我們對這兩個項目的結合感到非常興奮。利潤率可能會受到一些影響，因為獲得部分收入會產生一些成本。但總的來說，我們對即將帶來的額外收入以及我們為此付出的成本感到非常高興。

Okay. Great. And then next question, just want to ask you just on EBITDA margin and on cost of services. First, in the fourth quarter, I know that you have the deferred comp program that can affect that. I think your slide deck literally just came out, so we haven't had a chance to review that yet. But maybe just walk through the interplay for us of the deferred comp program on the 4Q margin. And then talk about in your outlook for 2024, how you sort of see core EBITDA margins trending between the low and the high end of the ranges?

好的。偉大的。下一個問題只是想問您 EBITDA 利潤率和服務成本。首先，在第四季度，我知道你的延期補償計畫可能會影響這一點。我認為您的幻燈片剛剛發布，所以我們還沒有機會對其進行審查。但也許只是為我們介紹一下延遲補償計畫對第四季利潤的交互作用。然後談談您對 2024 年的展望，您如何看待核心 EBITDA 利潤率在區間低端和高端之間的趨勢？

Starting with the 2023, the best kind of clarity that we try to give you is in, like we mentioned -- like you mentioned that in the investor deck slides 46 and 47, actually, one slide gives you on a quarterly basis, and the other slide gives it to you on a year-to-date basis. Looking at Q4 specifically, when we go back and look at the -- if you take Q3 relative to Q4, we had a 50 basis input increase in cost of services. When you break down that 50 basis points, 30 of those basis points are related to the DCP. And remember that the amount with those earnings really is just offset below the line.

從2023 年開始，我們試圖為您提供的最好的清晰度是，就像我們提到的那樣，就像您在投資者幻燈片46 和47 中提到的那樣，實際上，一張幻燈片按季度為您提供，並且另一張幻燈片為您提供了年初至今的數據。具體來看第四季度，當我們回過頭來看看——如果相對於第四季來看第三季度，我們的服務成本增加了 50 個基點。當你細分這 50 個基點時，其中 30 個基點與 DCP 相關。請記住，這些收入的金額實際上只是在該線以下抵消。

So this isn't -- it's an accounting thing, not necessarily an earnings thing. And so when you look at it, it's neutralized below the line. So those 30 basis points are in net income. Those are neutralized, so that's just a P&L placement. And then the other 20 basis points, really, are what we've been talking about all year long. This recently acquired operations, when they make up a more significant portion of the overall cost, you're going to have the margin impacted by that. And you can see that our recently acquired operations continue to make up a significant portion of our cost.

所以這不是——這是會計問題，不一定是收益問題。所以當你看它時，它在線下被中和了。所以這 30 個基點是淨利。這些已被抵消，因此這只是損益表。然後其他 20 個基點確實是我們一整年都在談論的內容。最近收購的業務，當它們佔總成本的較大部分時，您的利潤率將受到影響。您可以看到我們最近收購的業務繼續占我們成本的很大一部分。

And again, quarter-over-quarter-over-quarter-over-quarter increase were a higher percentage of our overall revenue. A couple of other things with Q3 to Q4. You always have a little bit higher cost associated with benefits and GLPL, and we did have some COVID costs. So you've got some a little bit of noise to make up that additional 20 basis points up there, but that kind of rounds out 2023.

同樣，環比成長占我們總收入的比例更高。Q3 到 Q4 的其他一些事情。與福利和 GLPL 相關的成本總是較高一些，而且我們確實有一些新冠肺炎成本。因此，你有一些噪音來彌補額外的 20 個基點，但這種情況會在 2023 年結束。

Pushing into 2024, what we tried to get to you guys to do is neutralize that at deferred comp impact, kind of getting that out of there because, again, that is below the line and above the line. And so kind of making that all neutralized, really, think that the overall neutralized effect will have really consistent margins to what we saw in 2023 and before. Overall, consistent to slightly improved on the top end.

進入 2024 年，我們試圖讓你們做的就是在遞延的補償影響中抵消這種影響，從而擺脫這種影響，因為同樣，這是在線下和線上。如此一來，所有這些都被抵消了，真的，我認為整體抵消效應將與我們在 2023 年及之前看到的情況具有真正一致的利潤。總體而言，高端方面保持一致或略有改善。

Okay. Great. Very helpful. Then just last question. In 2023, you had really significant growth in both operating cash flow and free cash flow as well. We're just trying to think about how to model off of that, given, again, a very sort of sharp uplift in operating cash flow. So any guidance you can give us on thinking about operating cash flow, any sort of working capital or other items that we should be contemplating as we’re trying to trend out our cash flow forecast for 2024?

好的。偉大的。很有幫助。然後就是最後一個問題。2023 年，營運現金流和自由現金流都出現了顯著成長。考慮到營運現金流的急劇上升，我們只是想考慮如何對此進行建模。那麼，在我們嘗試制定 2024 年現金流預測趨勢時，您可以為我們提供有關營運現金流、任何類型的營運資金或其他我們應該考慮的項目的指導嗎？

Yeah. As you kind of think through it, obviously, in Q1, we always have a significant hit in cash for a couple of different reasons, right? That's when you see the outflow of our incentives go out, all the year-end incentives get paid out in Q1, so you'd anticipate that outflow going into Q1. It will be a little bit different pattern that we saw in 2023. Remember in 2023, we were able to defer a lot of our taxes all the way to Q4. And so you're going to see those taxes really be spread out throughout the year in 2024.

是的。正如您仔細思考的那樣，顯然，在第一季度，由於多種不同的原因，我們的現金總是受到重大打擊，對吧？那時您會看到我們的激勵措施流出，所有年終激勵措施都會在第一季支付，因此您預計流出會進入第一季。這將與我們在 2023 年看到的模式略有不同。請記住，在 2023 年，我們能夠將大量稅款一直推遲到第四季。因此，到 2024 年，您將看到這些稅收真正分散到全年。

And other than now, we just don't have as much lumpiness other than the timing of when we'll pay out the settlement of litigation matter that we disclosed. There's a little unclarity there. So that will -- probably my best guess would be maybe late Q2, early Q3, but that will be in there.

除了現在之外，除了我們披露的支付訴訟事項和解費用的時間之外，我們沒有太多的麻煩。那裡有一點不清楚。所以，我最好的猜測可能是第二季末、第三季初，但那會在那裡。

But other than that, I think we'll have nice, more steady cash flow. But those are some of the things that will make it a little bumpy in Q1 and then kind of steadied out throughout the rest of the year.

但除此之外，我認為我們將擁有良好、更穩定的現金流。但這些因素會讓第一季的情況變得有些坎坷，然後在今年剩下的時間裡趨於穩定。

Got it. So overall, probably fair to think about operating cash flows, just trying to generally consistent with our earnings in 2024.

知道了。因此，總體而言，考慮營運現金流可能是公平的，只是試圖與我們 2024 年的收益基本一致。

Correct, with the exception of Q1. That's a little bit a hit I talked about. And then the other things being that the DOJ.

正確，但 Q1 除外。我所說的這有點受歡迎。然後其他的事情是司法部。

Actually, for the overall year. Okay. All right. Great. Well, thanks a lot. Appreciate it.

事實上，就全年而言。好的。好的。偉大的。嗯，非常感謝。欣賞它。

Thank you, Scott.

謝謝你，斯科特。

Thank you. And that is currently other questions that we have in our queue. At this point, I would like to hand the call back over to Barry for some closing remarks.

謝謝。這是目前我們隊列中的其他問題。現在，我想將電話轉回給巴里，讓他發表一些結束語。

Awesome. Thanks, operator, and thanks, everyone, for joining us today. We appreciate your support, as always, look forward to an amazing 2024.

驚人的。謝謝操作員，也謝謝大家今天加入我們。我們感謝您一如既往的支持，期待美好的 2024 年。

Thank you. And ladies and gentlemen, that does conclude today's call. Thanks again for joining. You may now disconnect.

謝謝。女士們、先生們，今天的電話會議到此結束。再次感謝您的加入。您現在可以斷開連線。