Ensign Group Inc (ENSG) 2024 Q2 法說會逐字稿

Hello, and welcome to The Ensign Group Inc Q2 2024 earnings call.

您好，歡迎參加 Ensign Group Inc 2024 年第二季財報電話會議。

At this time, I would like to turn the call over to Mr. Keetch. Please go ahead.

這時，我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 at ensigngroup.net. A replay of this call will also be available on our website until 5:00 PM Pacific on Friday, August 30, 2024.

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 8 月 30 日星期五下午 5:00（太平洋時間）在我們的網站上提供。

We want to remind anyone that may be listening to a replay of this call that all statements made are as of today, July 26, 2024, and these statements have not been nor will be updated subsequent to today's call. 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.

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 7 月 26 日），並且這些聲明在今天的電話會議之後尚未更新，也不會更新。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。

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.

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。

Except as required by federal securities laws, Ensign and its independent 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.

除聯邦證券法要求外，Ensign 及其獨立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 a service center, provide accounting, payroll, human resources, information technology, legal, risk management and other services to the other independent subsidiaries through contractual relationships with such subsidiaries.

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。

In addition, our captive insurance subsidiary, which we refer to as the insurance captive, provides certain claims made coverage to our operating companies for general and professional liability as well as for workers' compensation insurance liabilities.

此外，我們的自保保險子公司（我們稱為保險自保）向我們的營運公司提供某些索賠，涵蓋一般責任和專業責任以及工人賠償保險責任。

Ensign also owns Standard Bearer Healthcare REIT Inc, which is a captive real estate investment trust that invests in health care properties and enters into lease agreements with certain independent subsidiaries of Ensign as well as third-party tenants that are unaffiliated with the Ensign Group.

Ensign 還擁有 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 Ensign 集團無關的第三方租戶簽訂租賃協議。

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 Inc and the insurance captive are operated by separate independent companies that have their own management employees and assets.

Ensign、公司、我們、我們的和我們這些字詞指的是 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 Inc 和保險自保公司均由擁有自己的管理員工和資產的獨立公司營運。

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

此處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-Q.

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表格 10-Q 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？

Thanks, Chad, and thank you all for joining us today. We're thrilled to report another record quarter and are excited about the continued momentum our teams have created across our entire portfolio. We're an awe of our local leaders and how they continue to consistently drive outstanding clinical and financial performance as they work together with their cluster partners to practice proven operational principles.

謝謝查德，也謝謝大家今天加入我們。我們很高興報告又一個創紀錄的季度，並對我們的團隊在整個投資組合中創造的持續動力感到興奮。我們對當地領導者以及他們在與集群合作夥伴合作實踐行之有效的運營原則時如何持續不斷地推動卓越的臨床和財務業績感到敬畏。

We're very pleased to see our growth over the prior year quarter in occupancy and skilled mix days in our same store and transitioning operations, particularly in our Managed Care population. Our same store occupancy, which reached 80.8% for the quarter, an increase of 2.8% over the prior year quarter.

我們非常高興地看到我們同一家商店的入住率和熟練混合天數以及轉型運營方面比去年同期有所增長，特別是在我們的管理式護理人群中。本季我們的同店入住率達到 80.8%，比去年同期成長 2.8%。

In addition, we saw an increase in the same store and transitioning skilled service revenue during the quarter of 6.8% and 6.0% respectively. With that pace of growth, we are as excited as ever about the incredible amount of built-in upside that exists in our portfolio as so many of our operations continue to march towards occupancy levels that dozens of our most mature same store operations regularly achieve, which are in the 90%-plus range.

此外，本季同店和過渡技術服務收入分別成長 6.8% 和 6.0%。隨著這種成長速度，我們對我們的投資組合中存在的令人難以置信的內在優勢感到興奮，因為我們的許多業務繼續朝著我們數十家最成熟的同店業務經常達到的入住率水平邁進，都在 90% 以上的範圍內。

I also want to emphasize that for 25 years, we have acquired lower occupancy operations at very attractive prices, which has resulted in an enormous long-term ramp and value creation. So we've consolidated occupancies where they are. We get very excited about the significant organic growth potential that is inherent in our existing portfolio.

我還想強調，25 年來，我們以極具吸引力的價格收購了入住率較低的業務，從而實現了巨大的長期成長和價值創造。所以我們已經整合了他們所在的位置。我們對現有投資組合固有的巨大有機成長潛力感到非常興奮。

As our operators continue to build on a solid foundation of strong clinical results, cultural excellence and sustainable real estate expenses, we are confident that our partners will continue to capitalize on the occupancy and skilled mix growth, inherent in our portfolio which will allow us to consistently achieve the results that we have delivered over time.

隨著我們的營運商繼續建立強大的臨床結果、卓越文化和永續房地產支出的堅實基礎，我們相信我們的合作夥伴將繼續利用我們投資組合中固有的入住率和技術組合成長，這將使我們能夠持續實現我們長期以來所交付的成果。

Also, as you saw in our press release yesterday, we've been busy acquiring new operations and are transitioning and recently acquired buckets now represent 27% of our total operational beds. Again, we want to emphasize that this represents massive organic growth potential within those existing growth buckets.

此外，正如您在昨天的新聞稿中看到的那樣，我們一直忙於收購新業務並正在進行轉型，最近收購的水桶現在占我們總營運床位的 27%。我們想再次強調，這代表了現有成長桶內巨大的有機成長潛力。

To give some perspective, our occupancy and skilled mix days for the skilled nursing operations in the transitioning bucket were 75.7% and 21.7%, respectively. While our same store occupancy and skilled mix days were 80.8% and 31.5%, respectively. As we've shown over two decades, we expect our teams to continue to unlock the significant upside in each of these new operations as they mature.

從一些角度來看，我們在過渡桶中熟練護理操作的佔用率和熟練混合天數分別為 75.7% 和 21.7%。而我們的同店入住率和熟練混合天數分別為 80.8% 和 31.5%。正如我們二十年來所展示的那樣，我們期望我們的團隊隨著這些新業務的成熟，繼續釋放其顯著的優勢。

Our focus on customers second continues to ensure that our caregivers and their teams are recognized for their amazing daily achievements, which has now resulted in lower turnover for the 11th quarter in a row and also a decrease in the use of staffing agencies for the sixth quarter in a row.

我們對客戶的關注其次，繼續確保我們的護理人員及其團隊因其驚人的日常成就而得到認可，這導致營業額連續第 11 個季度下降，並且第 6 季度人才中介機構的使用量也有所減少連續。

And all of this has occurred while our teams have simultaneously been assisting the newly acquired operations integrate into their local clusters and begin the process of improving clinically and financially.

所有這一切都發生在我們的團隊同時協助新收購的業務整合到當地集群並開始臨床和財務改進過程的同時。

Due to our solid results, including our stable skilled mix and growing occupancy, as well as continued strength from our recent acquisitions, we are increasing and narrowing our annual 2024 earnings guidance to between $5.38 to $5.50 per diluted share, up from $5.29 to $5.47 per diluted share.

由於我們穩健的業績，包括穩定的技能組合和不斷增長的入住率，以及最近收購帶來的持續實力，我們將2024 年年度盈利指引從每股5.29 美元上調至5.47 美元，調整至稀釋後每股5.38 美元至5.50 美元之間。

This new midpoint of our 2024 earnings guidance represents an increase of more than 14% over our 2023 results and is 31% higher than our 2022 results. We are also raising our annual revenue guidance to between $4.20 billion to $4.22 billion, up from our previous guidance of $4.13 billion to $4.17 billion.

我們 2024 年獲利指引的新中點比 2023 年業績成長了 14% 以上，比 2022 年業績成長了 31%。我們也將年度收入指引從先前的 41.3 億美元至 41.7 億美元提高至 42.0 億美元至 42.2 億美元。

We are also excited about the upcoming year and are confident that our partners will continue to manage and innovate while balancing the addition of newly acquired operations. This performance is not due to some large event or even a singular transformative transaction, but instead is the result of consistent growth and performance quarter after quarter.

我們也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管理和創新，同時平衡新收購業務的增加。這項業績並不是由於某個重大事件，甚至不是單一的變革性交易，而是逐季持續成長和業績的結果。

All of these achievements are entirely due to the efforts and commitment of our local leadership teams, caregivers, field resources and service center partners. There are so many opportunities in front of us to improve in the expense management and drive occupancy and skilled mix as we continue to successfully unlock value in all of our operations.

所有這些成就都完全歸功於我們當地領導團隊、護理人員、現場資源和服務中心合作夥伴的努力和承諾。隨著我們繼續成功地在所有業務中釋放價值，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。

We remain poised to again showcase our ability to find, acquire and transition performing and underperforming operations by applying proven Ensign principles developed over 25 years.

我們仍然準備好透過應用 25 年來成熟的 Ensign 原則，再次展示我們尋找、收購和轉型績效和績效不佳業務的能力。

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

接下來，我將請查德補充一些關於我們近期成長的額外見解。查德?

Thanks, Barry. We continued to add to our growing portfolio and are very excited about the 10 new operations and six real estate assets we added during the quarter, bringing the number of operations acquired during the year to 15.

謝謝，巴里。我們繼續增加不斷增長的投資組合，並對本季新增的 10 個新業務和 6 個房地產資產感到非常興奮，使全年收購的業務數量達到 15 個。

These new acquisitions include the following new operations, three in Colorado, three in Tennessee, two in Arizona, two in Kansas, two in Utah, one in Iowa, one in Nevada and one in Texas, totaling 1,326 new skilled nursing beds, 202 senior living units and 43 new LTACH beds.

這些新收購包括以下新業務：科羅拉多州3 個、田納西州3 個、亞利桑那州2 個、堪薩斯州2 個、猶他州2 個、愛荷華州1 個、內華達州1 個、德克薩斯州1 個，總計1,326 個新的熟練護理床位、202 個高級護理床位居住單元和 43 個新 LTACH 床位。

Of these 15 new operations, seven of them included the real estate assets which were acquired by Standard Bearer and leased to an Ensign affiliated operator. Each of these additions were all carefully selected amongst the many opportunities available to us and were chosen because of the huge clinical and financial potential.

在這 15 項新業務中，其中 7 項包括由 Standard Bearer 收購並出租給 Ensign 附屬營運商的房地產資產。這些新增的每一項都是我們從眾多可用機會中精心挑選出來的，並且是因為巨大的臨床和財務潛力而被選擇的。

We continue to prioritize growth in our established geographies as it allows our clusters to work together with their acute care partners to provide a comprehensive solution to their health care needs. In particular, we are very excited to grow in Arizona, where we have a deep and long-standing relationships with the largest hospital systems in the state.

我們繼續優先考慮現有地區的成長，因為這使我們的集群能夠與其急診護理合作夥伴合作，為他們的醫療保健需求提供全面的解決方案。特別是，我們非常高興能夠在亞利桑那州發展，我們與該州最大的醫院系統建立了深厚而長期的合作關係。

However, we are also excited to build the clusters in new states or in markets where we have significant room to add more density and expect additional growth in some of our newer markets in the next several months. We continue to see a very healthy pipeline of new acquisition opportunities and are lining up some exciting new additions that we expect to close in the third and fourth quarters.

然而，我們也很高興能夠在新的州或市場中建立集群，在這些州或市場中，我們有很大的空間來增加密度，並預計在未來幾個月內我們的一些新市場將進一步增長。我們繼續看到一個非常健康的新收購機會管道，並正在排隊一些令人興奮的新增加，我們預計將在第三和第四季完成。

Our scalable decentralized growth model is not dependent on a centralized team of experts, but instead is driven by local leadership. In times like these when deal opportunities are abundant, we rely on a proven set of deal criteria, including a deep local knowledge of their respective health care markets to ensure that we remain disciplined and grow in a very healthy way.

我們可擴展的去中心化成長模式並不依賴集中的專家團隊，而是由當地領導層驅動。在交易機會充足的時代，我們依靠一套行之有效的交易標準，包括對各自醫療保健市場的深入了解，以確保我們保持紀律並以非常健康的方式成長。

One of the foundational elements of our consistent performance has been to insist that the prices we pay are commensurate with the historical operational performance, which will result in a cost structure that allows us to achieve healthy returns over a long period of time. However, we do not just grow for the sake of growth or acquire revenue or by earnings.

我們始終如一的業績的基本要素之一是堅持我們支付的價格與歷史經營業績相稱，這將形成一個成本結構，使我們能夠在很長一段時間內實現健康的回報。然而，我們不僅僅是為了成長而成長，也不僅僅是為了獲得收入或獲利而成長。

Accordingly, we will sacrifice short-term margins and metrics growth for the long-term built-in organic upside. As we have consistently communicated, executed and delivered, our intention is to continue to grow when we see deals that will be accretive to shareholders for years to come.

因此，我們將犧牲短期利潤和指標成長來換取長期的內在有機成長。正如我們一貫的溝通、執行和交付，我們的目的是當我們看到未來幾年將為股東帶來增值的交易時，我們的目標是繼續成長。

We continue to provide additional disclosure on Standard Bearer, which is currently comprised of 115 owned properties. Of these assets, 86 are leased to an Ensign affiliated operator and 30 are leased to third-party operators.

我們繼續提供有關 Standard Bearer 的更多披露，該公司目前由 115 處自有房產組成。在這些資產中，86 項出租給 Ensign 附屬業者，30 項出租給第三方業者。

All of these properties are subject to triple net long-term leases and generated rental revenue of $23.4 million for the quarter, of which $19.2 million was derived from an Ensign affiliated operation. Also, for the quarter, we reported $14.5 million in FFO and as of the end of the quarter had an EBITDAR to rent coverage ratio of 2.4 times.

所有這些物業均受三重淨長期租賃約束，本季度產生的租金收入為 2,340 萬美元，其中 1,920 萬美元來自 Ensign 附屬業務。此外，本季的 FFO 為 1,450 萬美元，截至本季末，EBITDAR 與租金覆蓋率之比為 2.4 倍。

And with that, I'll (technical difficulty) Spencer, our COO, to add more color on operations. Spencer?

有了這個，我將（技術難度）我們的營運長 Spencer 為營運增添更多色彩。斯賓塞？

Thanks, Chad, and hello, everyone. I'm excited to present two operational examples that can hopefully give you deeper insight into the incredible work that our affiliate teams are doing day and night to continue to achieve the consistent results that we see quarter after quarter.

謝謝查德，大家好。我很高興向您介紹兩個營運範例，希望它們能讓您更深入地了解我們的聯盟團隊日以繼夜所做的令人難以置信的工作，以繼續實現我們每個季度看到的一致結果。

As Barry mentioned earlier, more than a fourth of all of our operations are either in the recently acquired or transitioning categories. Because of that, the first facility I'll highlight is a transitioning facility called Arrowhead Springs Healthcare located in San Bernardino, California.

正如巴里之前提到的，我們超過四分之一的業務屬於最近收購或轉型的類別。因此，我要重點介紹的第一個設施是位於加州聖貝納迪諾的一個名為 Arrowhead Springs Healthcare 的過渡設施。

When it was acquired in February of 2022, this 119 beds SNF suffered from low occupancy and a poor reputation in the healthcare community. Despite the tremendous challenges Executive Director, Jeff Beltran and COO, Iman Bravo, together with the Arrowhead leadership team saw the facilities potential and systematically went to work.

當它於 2022 年 2 月被收購時，這家擁有 119 個床位的 SNF 入住率低，在醫療保健界聲譽不佳。儘管面臨巨大的挑戰，執行董事 Jeff Beltran 和營運長 Iman Bravo 以及 Arrowhead 領導團隊看到了設施的潛力，並有系統地開始工作。

First year was difficult as the team put themselves into establishing clinical systems, remodeling the building and forging partnerships with local hospitals and Managed Care organizations. The results have been astounding.

第一年很困難，因為團隊致力於建立臨床系統、重塑建築並與當地醫院和管理式醫療組織建立合作關係。結果令人震驚。

For example, CMS overall star rating has increased from three stars at acquisition to five stars today. Overall occupancy has jumped from 76% at acquisition to over 96% in Q2 of this year, with skilled Medicare and Managed Care days increasing by over 56% over the prior year quarter.

例如，CMS 的整體星級評級已從收購時的三顆星升至如今的五顆星。整體入住率從收購時的 76% 躍升至今年第二季的 96% 以上，熟練醫療保險和管理式護理天數比去年同期增加了 56% 以上。

As you would expect, growing census has increased the need for additional staffing. Because Arrowhead has become a great place to work, they've been able to hire and retain employees and reduced spending on contract nursing labor from over $140,000 per month a year ago to $0 last month.

正如您所預料的那樣，不斷擴大的人口普查增加了對額外人員的需求。由於 Arrowhead 已成為一個理想的工作場所，他們能夠僱用和留住員工，並將合約護理工的支出從一年前的每月 140,000 美元以上減少到上個月的 0 美元。

Not surprisingly, as the facility become healthy, so have earnings with EBITDAR improving by 95% over prior year quarter. Turnaround at Arrowhead is a great example of the meaningful progress being made at so many of our newly acquired and transitioning operations.

毫不奇怪，隨著設施變得健康，EBITDAR 收益也比去年同期提高了 95%。Arrowhead 的轉虧為盈是我們許多新收購和轉型業務取得有意義進展的一個很好的例子。

Grateful for the work being done and excited to watch as these operations continue to improve and contribute to our organization for years to come. As excited as we are about these transitioning facilities, we're equally enthusiastic about the ongoing growth we see in our same store operations, which continued to reach new heights.

感謝所做的工作，並很高興看到這些業務在未來幾年不斷改進並為我們的組織做出貢獻。正如我們對這些過渡設施感到興奮一樣，我們對同店營運的持續成長也同樣充滿熱情，並不斷達到新的高度。

One example of this is Rainier Rehabilitation in Puyallup, Washington, led by CEO, Brett Watson, and CEO, Staci Chapman. Despite being acquired a decade ago, the team at Rainier continues to find ways to improve quality and grow earnings. The foundation at Rainier is an obsession with clinical excellence.

其中一個例子是位於華盛頓州皮阿拉普的雷尼爾康復中心，由執行長 Brett Watson 和執行長 Staci Chapman 領導。儘管十年前被收購，雷尼爾團隊仍在繼續尋找提高品質和增加收入的方法。雷尼爾的基礎是對卓越臨床的執著。

This shows in its CMS five-star rating for health inspections, quality measures and overall. In fact, the Rainier team has scored deficiency free in their past two annual surveys. In spite of Washington having one of the most difficult survey environments in the entire nation.

這體現在 CMS 在健康檢查、品質措施和整體方面的五星級評級。事實上，雷尼爾團隊在過去的兩次年度調查中都沒有發現缺陷。儘管華盛頓擁有全國最困難的調查環境之一。

Because of the strong clinical reputation, Rainier has become the number one facility in the state for ventilator dependent and other high-acuity patients. Managed Care organizations and hospital systems have taken notice and Rainier has been awarded numerous preferred provider contracts in recent years.

由於良好的臨床聲譽，雷尼爾醫院已成為該州針對呼吸器依賴患者和其他高風險患者的第一個醫療機構。管理式醫療組織和醫院系統已經注意到了這一點，雷尼爾近年來獲得了許多首選供應商合約。

As a result, occupancy and skilled mix continued to increase and the facility recently hit its maximum operational capacity and had to start a waiting list for admissions.

結果，入住率和技術人員組合持續增加，該設施最近達到了最大營運能力，不得不啟動入場等候名單。

In the second quarter, this mature operation grew revenues by 17% and its EBIT by 34% over prior year quarter. Perhaps Rainier's most impressive contribution comes from the culture that they've established. People want to be part of Rainier.

第二季度，與去年同期相比，這項成熟業務的收入成長了 17%，息稅前利潤成長了 34%。也許雷尼爾最令人印象深刻的貢獻來自於他們所建立的文化。人們想成為雷尼爾的一部分。

Their turnover rate for employees scores among the best in Washington and when people do leave, it's often to take on increased responsibility at sister facilities or new acquisitions. For example, Staci and the Rainier team have trained multiple nurses who are now transforming care at sister facilities as directors of nursing and continuing to spread Rainier's influence and impact far beyond the facility.

他們的員工流動率在華盛頓名列前茅，當人們離開時，通常會在姊妹工廠或新收購的工廠中承擔更多的責任。例如，史塔西和雷尼爾團隊培訓了多名護士，他們現在正在姐妹機構中擔任護理總監，轉變護理方式，並繼續將雷尼爾的影響力傳播到機構之外。

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 it up for 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，然後我們將開放提問。蘇珊娜？

Thank you, Spencer, and good morning, everyone. Detailed financials for the quarter are contained in our 10-Q and press release filed yesterday. Some additional highlights for the quarter include GAAP diluted earnings per share was $1.22, an increase of 8.9%.

謝謝你，史賓塞，大家早安。該季度的詳細財務資訊包含在我們昨天提交的 10 季財務報告和新聞稿中。本季度的一些其他亮點包括 GAAP 攤薄後每股收益為 1.22 美元，成長 8.9%。

Adjusted diluted earnings per share was $1.32, an increase of 13.8%. Consolidated GAAP revenues and adjusted revenues were both $1 billion, an increase of 12.5%. GAAP net income was $71 million, an increase of 11%. Adjusted net income was $76.4 million, an increase of 15.3%.

調整後攤薄每股收益為 1.32 美元，成長 13.8%。合併 GAAP 收入和調整後收入均為 10 億美元，成長 12.5%。GAAP 淨利潤為 7,100 萬美元，成長 11%。調整後淨利為 7,640 萬美元，成長 15.3%。

Other key metrics as of June 30, 2024, included cash and cash equivalents with $477.3 million and cash flow from operations of $112.2 million. The company paid a quarterly cash dividend of $0.06 per common share. We have a long history of paying dividends and have increased the annual dividend for 21 consecutive years.

截至 2024 年 6 月 30 日的其他關鍵指標包括現金和現金等價物 4.773 億美元以及營運現金流 1.122 億美元。該公司支付每股普通股 0.06 美元的季度現金股利。我們派息歷史悠久，已連續21年增加年度股利。

We also continued to delever our portfolio, achieving a lease adjusted net debt to EBITDA ratio of 1.99 times. Delevering in periods of growth is particularly noteworthy and demonstrates our commitment to disciplined growth as we believe that we can continue to achieve sustainable growth in the long run.

我們也持續去槓桿化投資組合，實現租賃調整後淨債務與 EBITDA 的 1.99 倍。成長時期的去槓桿化尤其值得注意，這反映了我們對紀律性成長的承諾，因為我們相信從長遠來看，我們能夠繼續實現永續成長。

In addition, we currently have approximately $573 million of available capacity under our line of credit, which when combined with cash on the balance sheet gives us over $1 billion of dry powder for future growth. We also own 120 assets, of which 115 are held by Standard Bearer and 96 of which are owned completely debt-free and are gaining significant value over time, adding even more liquidity to help with future growth.

此外，我們目前的信貸額度下擁有約 5.73 億美元的可用產能，加上資產負債表上的現金，為我們未來的成長提供了超過 10 億美元的乾粉。我們還擁有 120 項資產，其中 115 項由標準持有者持有，其中 96 項資產完全無債務，並且隨著時間的推移不斷獲得巨大的價值，增加更多的流動性以幫助未來的成長。

We also wanted to remind you that CMS minimum staffing rule, which is if revised will have a multiyear phase-in period. It will have no material impact on us in 2024.

我們也想提醒您，CMS 最低人員配置規則如果修訂，將有一個多年的逐步實施期。到2024年，它不會對我們產生實質影響。

As Barry mentioned, we are increasing and narrowing our annual 2024 earnings guidance to between $5.38 to $5.50 per diluted share, up from $5.29 to $5.47 per diluted share. We are also raising our annual revenue guidance to between $4.2 billion and $4.22 billion, up from the previous guidance of $4.13 billion to $4.17 billion.

正如 Barry 所提到的，我們正在將 2024 年年度獲利指引從每股稀釋每股 5.29 美元上調至 5.47 美元，並將其縮小至每股 5.38 美元至 5.50 美元。我們也將年度收入指引從先前的 41.3 億美元至 41.7 億美元提高至 42 億至 42.2 億美元。

We have evaluated multiple scenarios and based on the strength in our performance and a strong momentum increasing in occupancy and skilled mix as well as the continued progress on agency management and other operational initiatives, we are confident that we can achieve these results.

我們評估了多種情景，基於我們的業績實力、入住率和技能組合的強勁增長勢頭，以及機構管理和其他運營舉措的持續進展，我們有信心能夠實現這些成果。

Our 2024 guidance is based on diluted weighted average common shares outstanding of approximately 58.5 million, a tax rate of 25%. The inclusion and acquisitions closed and expected to close in 2024. The inclusion of management's expectations for Medicare and Medicaid reimbursement rates, net of provider tax with the primary exclusions coming from stock-based compensation, litigation and system implementation.

我們的 2024 年指引基於稀釋後加權平均已發行普通股約 5850 萬股，稅率為 25%。納入和收購已完成，預計將於 2024 年完成。納入管理階層對醫療保險和醫療補助報銷率的預期，扣除提供者稅，主要排除來自股票薪酬、訴訟和系統實施的費用。

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

其他可能影響季度業績的因素包括報銷系統的變化、國家預算的延遲和變化、入住率和技能組合的季節性、整體經濟的影響、人口普查和人員配置、我們收購活動的短期影響、保險的變化通話等因素。

And with that, I'll turn the call back over to Barry, Barry?

然後我會把電話轉回給巴里，巴里？

And as we wrap up, I must reiterate again 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 are always impressed by their incredible industry leading leadership as they focus on supporting our collective mission to dignified post-acute care in new and innovative ways.

在我們結束時，我必須再次重申，我們非常榮幸和感激能夠與這些創紀錄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。他們令人難以置信的行業領先領導力始終給我們留下了深刻的印象，因為他們專注於支持我們以新穎和創新的方式提供有尊嚴的急性後護理的集體使命。

This commitment has blessed the lives of so many, including our own. We're excited about our future because of these amazing partners, and we have complete faith in them and the culture they have collectively built and continue to improve.

這項承諾造福了許多人的生活，包括我們自己。由於這些出色的合作夥伴，我們對我們的未來感到興奮，我們對他們以及他們共同建立並不斷改進的文化充滿信心。

We'll now turn it over to the Q&A portion of our call. Sarah, can you give us instructions on how to proceed?

我們現在將其轉入電話會議的問答部分。莎拉，您能給我們指示如何進行嗎？

(Operator Instructions) Tao Qiu, Macquarie.

（操作員說明） 邱濤，麥格理。

Hey, thank you. My first question is on occupancy momentum and [upside]. Last quarter Ensign's occupancies have surpassed pre-pandemic levels. You had another 200 basis point-plus occupancy growth this quarter, which is above pre-pandemic averages.

嘿，謝謝你。我的第一個問題是關於入住率和[上行]。上個季度，Ensign 的入住率已超過疫情前的水平。本季入住率又成長了 200 個基點以上，高於疫情大流行前的平均值。

So in the prepared remarks, Barry, you alluded to the upside compared to the more mature operations at 90% occupancy. I'm wondering if you could share with us your thoughts on current momentum, the amount of time it typically takes to unlock the upside and also the key hurdles you need to clear to get there?

巴里，在準備好的發言中，您提到了與 90% 入住率的更成熟營運相比的優勢。我想知道您是否可以與我們分享您對當前勢頭的看法，釋放上升空間通常需要多長時間，以及實現這一目標需要克服的關鍵障礙？

We've been seeing steady occupancy growth for a long time now, obviously, through the recovery period of the pandemic but even since. And you can see this in hospital occupancy data that's been coming out recently, the demand is strong. We're seeing that translate at the post-acute level as well. And it's getting back to pre-pandemic occupancy level. Really was -- obviously a focus for a long time.

顯然，在大流行的恢復期，甚至從那以後，我們已經看到入住率在很長一段時間內穩定成長。你可以從最近公佈的醫院入住率數據中看到這一點，需求很強。我們也看到這種情況在急性期後的水平也發生了變化。而且入住率正在恢復到疫情前的水準。確實是——顯然是很長一段時間的焦點。

But it's not really a ceiling, as you remember, leading up to the pandemic, our occupancy growth was strong that time as well, and we see those trends continuing now. And also, I'd point out that we expect typically more seasonality than I think we've been seeing the last two summer seasons.

但這並不是真正的上限，正如您所記得的那樣，在大流行之前，我們的入住率增長當時也很強勁，而且我們看到這些趨勢現在仍在繼續。而且，我想指出的是，我們預計季節性因素通常比我認為的過去兩個夏季要多。

And we haven't seen a sharper decline in occupancy, which is another indicator to us that demand is strong and will continue to be strong for us throughout the rest of this year.

我們還沒有看到入住率大幅下降，這對我們來說是另一個指標，表明需求強勁，並將在今年剩餘時間內繼續強勁。

Got it. That's helpful. And the second question is on investment. Could you update us on the current pipeline in terms of volume, pricing and breakdown between stable versus turnaround opportunities, portfolio versus individual transactions and leased versus owned deals?

知道了。這很有幫助。第二個問題是關於投資。您能否向我們介紹目前管道的數量、定價以及穩定與週轉機會、投資組合與個人交易以及租賃與自有交易之間的細分？

Sure. So the pipeline is very healthy. 15 so far this year. We always close our acquisitions at the beginning of the month for lots of kind of operational and billing reasons. But we anticipate there will be some more announcements coming up here and literally next week.

當然。所以管道非常健康。今年到目前為止已有 15 個。由於各種營運和計費原因，我們總是在月初結束收購。但我們預計下週還會有更多公告發布。

And then lining up for the rest of the year, there's always a kind of a Q3, Q4 push to for a lot of sellers want to get deals done in this tax year. So you'll see an increase in activity. In terms of the deals, they're really all over the board, Tao. They come from the small moms and pops. There are some regional portfolios too that we're well down the road and preparing to close on as well.

然後在今年剩下的時間裡，總是會有一種第三季、第四季的推動，因為許多賣家希望在本納稅年度完成交易。所以你會看到活動增加。就交易而言，他們確實是全面的，Tao。他們來自小媽媽和爸爸。我們還有一些區域投資組合正在順利進行中，並準備關閉。

So you'll see us participate in some in a larger way than just a mom-and-pop deal in a few of our states. In terms of geography, as we said in the prepared remarks, 7 out of the 14 states that we're in saw growth. I think you'll continue to see that distribution across multiple markets, which is really an important point.

因此，您將看到我們以更大的方式參與其中，而不僅僅是我們幾個州的夫妻店交易。就地理而言，正如我們在準備好的發言中所說，我們所在的 14 個州中有 7 個州出現了成長。我認為您將繼續看到跨多個市場的分佈，這確實是重要的一點。

It's really help healthy for us to grow in that way because our local approach to transitioning is a scalable approach. And when we grow in Colorado, it doesn't -- we don't feel it in Washington or other parts of the company, right? So we're really excited about the deal opportunities and where they are.

以這種方式發展確實有助於我們的健康成長，因為我們當地的轉型方法是一種可擴展的方法。當我們在科羅拉多州發展時，我們在華盛頓或公司的其他部門沒有感受到這一點，對嗎？因此，我們對交易機會及其所在位置感到非常興奮。

Obviously, the states we're in, there's tons of room to continue to expand and add density in those states. We'll continue to do that, but you'll also see us making some additions in new states and growing in some of our newer states throughout the rest of the year as well.

顯然，我們所處的州有大量的空間可以繼續擴張和增加密度。我們將繼續這樣做，但您也會看到我們在今年剩餘時間內在新的州進行了一些補充，並在一些較新的州進行了增長。

Got it. Sounds like it's very broad-based. And lastly, I want to ask about on the Chevron Doctrine, which Supreme Court just overturned. I think it will have lasting impact on many current and pending healthcare regulations.

知道了。聽起來它的基礎非常廣泛。最後，我想問最高法院剛剛推翻的雪佛龍主義。我認為這將對許多當前和懸而未決的醫療保健法規產生持久影響。

Could you comment on the latest thinking on the minimum staffing standards and any other regulations that SNF industry could contest in the future? And also, given the current election cycle, your expectation on future regulatory landscape? Thank you.

您能否評論一下關於最低人員配置標準的最新想法以及 SNF 行業未來可能提出異議的任何其他法規？另外，考慮到目前的選舉週期，您對未來監管格局的期望是什麼？謝謝。

I would say there's just been a slight change in our confidence since our last quarter and that would -- our confidence has increased obviously since last quarter because of the Chevron ruling. The same attorney that brought that case before the Supreme Court is the same attorney that's representing [aka] and our industry lawsuit related to the minimum staffing rule.

我想說，自上個季度以來，我們的信心略有變化，而且由於雪佛龍的裁決，自上個季度以來，我們的信心明顯增強。向最高法院提起該案件的同一位律師也是代表[又名]和我們與最低人員配置規則相關的行業訴訟的同一位律師。

And it does play a significant impact. Our case was strong before that ruling, it's even stronger because of that ruling. And so, our confidence is only increased as that ruling has come out. We still feel really good about legislative options that are on the table for us as well with the bill that's essentially passed through Congress and the Senate and is waiting now for next steps.

而且它確實發揮著重大影響。在該裁決之前，我們的理由很充分，由於該裁決，我們的主張更加有力。因此，隨著裁決的公佈，我們的信心只會增強。我們仍然對擺在我們面前的立法選擇以及基本上已通過國會和參議院並正在等待下一步行動的法案感到非常滿意。

And look, I think, just overall, there's a unified front that our association has, leading edge has and the rest of the industry has and making sure that overreaching legislation like this or not even legislation overreaching regulatory mandates don't really have a place in what we're trying to do as an industry to improve quality care because this doesn't advance quality care. So we'll continue to join with our partners in the fight against this, and we feel good about the direction we're headed.

我認為，總體而言，我們的協會擁有統一戰線，具有領先優勢，而行業其他公司也擁有這樣的優勢，並確保像這樣的過度立法，甚至超越監管授權的立法，都不會真正佔有一席之地。作為一個行業，我們正在努力提高護理質量，因為這並不能提高護理品質。因此，我們將繼續與我們的合作夥伴一起對抗這個問題，我們對我們前進的方向感到滿意。

Scott Fidel, Stephens.

斯科特·菲德爾，史蒂芬斯。

Hi, everyone. Thanks. Actually, wanted first question just to follow up on the comment, Barry, that you made around not necessarily seeing the typical seasonality playing out here entering the summer, which makes you feel pretty confident about demand? And was hoping that you could maybe flesh out what you're seeing on the demand side at this point?

大家好。謝謝。事實上，我想問第一個問題只是為了跟進巴里的評論，你的評論不一定會看到典型的季節性進入夏季，這讓你對需求感到非常有信心？您是否希望能夠充實此時在需求上所看到的內容？

And in particular, just thinking about some of the other observations that we've heard around the industry recently, particularly from some of the managed Medicaid companies who have talked about seeing an uptick in utilization amongst their populations and then also some rising acuity as well in the Medicaid population. Obviously, there's been effects from redetermination.

特別是，想想我們最近在行業內聽到的一些其他觀察結果，特別是來自一些管理醫療補助公司的觀察，他們談到看到其人口的利用率有所上升，然後敏銳度也有所提高在醫療補助人口中。顯然，重新決定產生了影響。

So I was hoping maybe you could double-click on the demand dynamic and then also around that acuity dynamic. Obviously, that's something that Ensign focuses on around the higher acuity patients. And whether in general, you're seeing a trend towards more of those types of patients potentially represented here for services?

所以我希望你可以雙擊需求動態，然後也圍繞著敏銳度動態。顯然，這是 Ensign 重點關注的高風險患者的問題。總體而言，您是否看到了更多此類患者可能在這裡接受服務的趨勢？

Great question, Scott. And we definitely are seeing an increase in the acuity profile across all payer groups, including Medicaid, which is why we've spent a great deal of time, or our leaders has spent a great deal of time looking at and trying to find ways to enhance services -- acuity services for those types of patients, which include behavioral health and subacute services and others. That segment of our skilled population continues to grow.

好問題，史考特。我們確實看到包括醫療補助在內的所有付款群體的敏銳度有所提高，這就是為什麼我們花費了大量時間，或者我們的領導者花費了大量時間來研究並試圖找到方法加強服務——為此類患者提供急性服務，包括行為健康和亞急性服務等。我們的這部分技術人員仍在不斷成長。

You pointed out, Managed Care and particularly Medicare Advantage, there's recent study out that show that their penetration is now over 50%. And I'll tell you that from our perspective, we've long kind of embraced this movement to Medicare Advantage. We know that it's going to continue to grow and be a more significant payer for us.

您指出，管理式醫療，特別是 Medicare Advantage，最近的研究表明，它們的滲透率現在超過 50%。我會告訴你，從我們的角度來看，我們長期以來一直支持這項 Medicare Advantage 運動。我們知道它將繼續成長並成為我們更重要的支付者。

And we've seen that play out because we've embraced the relationships that we have with them. We've done all that we can to try to adapt the way we operate and how we measure things to align with the things that are important to them and their members.

我們已經看到了這種情況的發生，因為我們已經接受了與他們的關係。我們已竭盡全力嘗試調整我們的運作方式和衡量事物的方式，以使其與對他們及其成員重要的事情保持一致。

And as a result of that, we've seen really solid growth in our patient population, our payer mix as we partnered closely with Medicare Advantage and Managed Care payers. So I have point that out as one area of growth for us that has been significant and continues to be increasingly significant in our leader strategy in each of their markets.

因此，隨著我們與 Medicare Advantage 和管理式醫療付款人密切合作，我們的患者人數和付款人組合都實現了真正穩健的成長。因此，我指出，這是我們成長的一個領域，在我們每個市場的領導者策略中，這一領域一直很重要，而且將繼續變得越來越重要。

But overall, as we're in the middle of summer, I can tell you that demand is strong and our occupancy -- overall occupancy, both on a consolidated basis and on a same store basis continue to show solid improvement even at a time when we normally don't. And all of those factors for us are important in the landscape as we look forward through the rest of this year.

但總的來說，由於我們正處於夏季中期，我可以告訴您，需求強勁，我們的入住率——整體入住率，無論是在綜合基礎上還是在同一家商店的基礎上，都繼續顯示出堅實的改善，即使在這個時候我們通常不會。當我們展望今年剩餘時間時，所有這些因素對我們來說都很重要。

Okay, great. And then final question, just wanted to ask a bit about on the labor side and you had mentioned the improvements in both turnover and agency, temp labor now on a pretty sustained basis. I was hoping you could talk about at this point sort of looking at the second quarter where your agency utilization was relative to peak?

好的，太好了。最後一個問題，只是想問一些關於勞動力方面的問題，您提到了營業額和代理、臨時工現在相當持續的改善。我希望您現在能談談第二季度您的機構利用率相對於高峰的情況？

And then also, in terms of wage trends. Maybe you can give us an update what you're seeing and what you're expecting now for wage trends for the full year and whether that's changed at all from the initial outlook that was embedded in your guidance?

然後，就薪資趨勢而言。也許您可以向我們提供您所看到的最新情況以及您現在對全年工資趨勢的預期，以及這是否與您指導中包含的最初展望相比發生了變化？

I'll let others comment if I don't cover all of that, but we -- wage trends are very positive. We've seen a massive moderation from the wage inflation that we saw over the last couple of years and that moderation has been happening over the last, I would say, year or so.

如果我沒有涵蓋所有這些，我會讓其他人發表評論，但我們的薪資趨勢非常積極。我們看到過去幾年薪資通膨大幅放緩，我想說，這種放緩是在過去一年左右的時間裡發生的。

We're now back down to what I would call more normal trends of wage inflation that are in the low to mid-single digit range as opposed to even double-digit trends that we were seeing historically through the worst of the wage inflation period.

我們現在回到了我所說的更正常的薪資通膨趨勢，即低至中個位數的範圍，而不是我們歷史上在薪資通膨最嚴重時期看到的兩位數趨勢。

And then obviously, we talked about this in our prepared remarks, turnover has been solidly improving over many, many quarters as has our use of nursing agency. We're not back down to pre-COVID nurse agency utilization levels. And most of that has to do with the acquisitions that we've been taking on overtime, they tend to be more troubled in this area than we've seen historically.

顯然，我們在準備好的發言中談到了這一點，在許多季度中，營業額一直在穩步改善，我們對護理機構的使用也是如此。我們不會回落到新冠疫情爆發前護理師機構的使用率水準。其中大部分與我們一直在加班進行的收購有關，他們在這方面往往比我們歷史上看到的更加困難。

Our leaders have taken the challenge on and have dealt with it in a pretty magnificent way. But as we take on growth, we're still seeing a lot of facilities that we're taking with pretty significant agency challenges that we're having to help manage as we integrate those into our portfolio.

我們的領導人接受了這項挑戰，並以相當出色的方式應對了它。但隨著我們的成長，我們仍然看到許多設施面臨相當重大的機構挑戰，當我們將這些設施整合到我們的投資組合中時，我們必須協助管理這些挑戰。

So that will keep us from probably getting back to where we were historically for a while, maybe another year or two because I don't see those trends in the industry as a whole dramatically improving from where they are today.

因此，這可能會讓我們在一段時間內（也許是一兩年）無法回到歷史水平，因為我認為整個行業的趨勢不會比今天有顯著改善。

But that said, if you were to take a look at where we are in a same store basis with agency, we've made massive strides and we're not too far above where we were on a pre-pandemic basis. So that's all super positive for us.

但話雖如此，如果你看看我們與代理商在同一家商店的情況，我們已經取得了巨大的進步，而且我們與大流行前的水平相差不遠。所以這對我們來說都是非常積極的。

And with regards to the consensus, I think what we've seen is really baked -- has been baked in that everything's coming within the range other than obviously we did raise and so that has -- because we did have a little bit of experience of having a little bit better on the occupancy front. And then really realizing this result of the additional occupancy through the earnings.

關於共識，我認為我們所看到的確實已經成熟了——已經成熟了，除了顯然我們確實籌集了資金之外，一切都在範圍內，所以這已經——因為我們確實有一點經驗在入住率方面有一點好轉。然後透過收入真正實現額外入住率的結果。

Okay, great. That was helpful. And then just last question. Just on the upgraded outlook that you provided, it does seem like that would imply expectations for a bit of an incremental margin improvement in the back half of the year. Obviously, you've got the strong accelerating top line growth as well.

好的，太好了。這很有幫助。然後是最後一個問題。就您提供的升級前景來看，這似乎確實意味著預計下半年利潤率將有所改善。顯然，您的收入也出現了強勁的加速成長。

Just wanted to -- just get your update on it, whether there's any seasonality that we should be thinking about around the EBITDA margin trends in the back half of the year or whether you expect those to be relatively consistent in the third and fourth quarter?

只是想了解您的最新情況，我們是否應該考慮下半年 EBITDA 利潤率趨勢的季節性，或者您是否預計第三季和第四季的趨勢相對一致？

Yeah. I think when we look out for the year and we're looking at the overall guidance, it's going to be relatively consistent, obviously, with Q4 being stronger, like at least has been. And so, it's very consistent with what we've always put out there on the margin and on the overall.

是的。我認為，當我們展望今年並考慮整體指導時，顯然，第四季度的表現會更加強勁，至少會是這樣，相對一致。因此，它與我們一直在邊緣和整體上發布的內容非常一致。

Ben Hendrix, RBC Capital Markets.

本‧亨德里克斯，加拿大皇家銀行資本市場部。

Just a quick follow-up question on the acquisitions in the quarter, clearly more M&A toward some newer markets. Wondering if you can give us an idea of the critical mass necessary in a new market to get the cluster flywheel, if you will, rolling such that -- I guess I'm trying to figure out at what point does like the Tennessee market start to realize the same synergies, the same efficiencies from the cluster model that you might see in Arizona? When do we reach that critical mass?

只是一個關於本季收購的快速後續問題，顯然更多的併購針對一些較新的市場。想知道您是否能給我們一個新市場中獲得集群飛輪所需的臨界質量的概念，如果您願意的話，滾動這樣的——我想我正試圖弄清楚田納西州市場在什麼時候開始實現與亞利桑那州集群模型相同的協同效應和效率？我們什麼時候才能達到臨界質量？

Yeah. It's a great question, and I'll let these guys chime in, too. So certainly, three to four buildings is an ideal cluster size, five is a large cluster. You get past that then you start getting almost too big and you need to have another cluster. So just in terms of how we look at it, that's the perfect size.

是的。這是一個很好的問題，我也會讓這些人插嘴。因此，可以肯定的是，三到四座建築物是理想的集群規模，五座建築物是一個大型集群。當你過了這個階段之後，你就開始變得太大了，你需要擁有另一個群集。因此，就我們如何看待它而言，這是完美的尺寸。

And the reason for that is you want to have -- as these groups get together, they have full access into each other's performance. And if it's too big, it's a little easier to fly under the radar, so to speak. So having it be the right size is certainly important. As we look at new states and new markets, certainly the cluster is very important part of that.

原因是你希望——當這些團體聚集在一起時，他們可以完全了解彼此的表現。可以這麼說，如果它太大，就更容易在雷達下飛行。因此，擁有合適的尺寸當然很重要。當我們審視新的州和新的市場時，集群無疑是其中非常重要的一部分。

But also there's sort of a market strategy too, which is having resources that are unique to the state and that geography and the bigger we get an estate, the more we can justify additional resources, clinical, financial, other folks that aren't necessarily in a building, but that are there to assist and help these the clusters function and have all the best practices and information that they need to be the top operator in the state. So that's the other part of it.

但也有一種市場策略，即擁有該州和地理位置獨有的資源，我們獲得的遺產越大，我們就越能證明額外的資源是合理的，臨床、財務和其他不一定的資源在建築物中，但它們可以協助和幫助這些集群發揮作用，並擁有成為該州頂級運營商所需的所有最佳實踐和資訊。這就是它的另一部分。

So speaking of Tennessee, we have a cluster now. We certainly want to continue to grow clusters. And as we do that, then we can start justifying additional market resources. So we see Tennessee is a state that could be Bandera like which is Arizona. It's a very attractive market for us.

說到田納西州，我們現在有一個集群。我們當然希望繼續發展集群。當我們這樣做時，我們就可以開始證明額外的市場資源是合理的。所以我們看到田納西州可能是班德拉州，就像亞利桑那州一樣。這對我們來說是一個非常有吸引力的市場。

We've got a top-notch leader, Tyler Albertson, who's been an Ensign leader for a very long time and just very talented and building that team that we're talking about. So we're looking closely at deals in Tennessee and expect to have some announcements there -- hopefully throughout the year.

我們有一位一流的領導者，泰勒·艾伯森，他擔任少尉領導者很長一段時間，非常有才華，正在建立我們正在談論的團隊。因此，我們正在密切關注田納西州的交易，並期望​​在那裡發布一些公告——希望全年都能實現。

And obviously, these things come in stages. We've have to digest things in a way before you can take the next step, but we've got three there. And next step would be to add more, kind of get a market then sort of get our feet under us again, and then do it like that is how I would anticipate that playing out.

顯然，這些事情是分階段進行的。在你採取下一步之前，我們必須以某種方式消化一些事情，但我們已經有了三個。下一步將是添加更多內容，獲得市場，然後再次站穩腳跟，然後按照我預期的方式進行。

Anything I missed there, Spencer or Barry?

史賓塞或巴里，我錯過了什麼嗎？

And then just also following up on your commentary on the Chevron ruling. I mean, clearly a lot of focus on implications for the minimum staffing, but I was thinking more broadly and longer-term for implications for rate setting.

然後跟進您對雪佛龍裁決的評論。我的意思是，顯然很多人都關注對最低人員配置的影響，但我更廣泛、更長遠地思考對費率設定的影響。

It seems like especially during their transition to PDPM few years back, there's lot of rebasing around, I guess, budget neutrality assumptions and what have you. I just wanted to see what your thoughts are there and how the rate-setting environment might change into this rule? Thanks.

我想，尤其是在幾年前向 PDPM 過渡期間，似乎圍繞預算中性假設等進行了許多重新調整。我只是想看看你的想法是什麼，以及利率設定環境會如何改變這個規則？謝謝。

We don't anticipate any changes on how rate-setting will move forward. I think those groups work independently and our anticipation is that we'll continue to see very typical methodology and attitude towards rates going forward and we are still in an inflationary environment.

我們預期利率制定方式不會有任何變化。我認為這些團體獨立工作，我們的預期是，我們將繼續看到非常典型的方法和對未來利率的態度，而我們仍然處於通膨環境中。

And I think CMS is aware of that. And I think trying to do the right thing as far as rates go at a CMS level and as far as at a state level, when you look at kind of where we were even with FMAP funding to supplement a lot of our Medicaid rates and where we are today, where FMAP has now gone, we're actually right where we were even with the supplemental funding.

我認為 CMS 意識到了這一點。我認為，就 CMS 層級和州層級的費率而言，嘗試做正確的事情，當您看到我們用 FMAP 資金來補充大量醫療補助費率的情況時，以及在哪裡我們今天的處境，雖然FMAP已經消失了，但即使有補充資金，我們實際上還是在原來的位置。

Meaning, we've been made whole on a average state-by-state basis. And all -- we have really good visibility into where rates are headed on a state-by-state basis, which gives us pretty good confidence about stability in rates overall.

這意味著，我們已經在各州的平均基礎上變得完整。總而言之，我們對各州的利率走向有很好的了解，這讓我們對整體利率的穩定性充滿信心。

This concludes the question-and-answer session as well as today's call. We thank you for joining. You may now disconnect.

問答環節和今天的電話會議到此結束。我們感謝您的加入。您現在可以斷開連線。