Ensign Group Inc (ENSG) 2025 Q3 法說會逐字稿

Ladies and gentlemen, thank you for joining us, and welcome to The Ensign Group Q3 earnings call. (Operator Instructions).

女士們、先生們，感謝各位的到來，歡迎參加 Ensign 集團第三季​​財報電話會議。（操作說明）

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

此時，我想把電話交給基奇先生。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 November 30, 2025.

謝謝接線員，歡迎各位。我們昨天發布了獲利新聞稿，您可以在我們網站ensigngroup.net的投資者關係欄位中查看。本次電話會議的錄音重播也將保留在我們網站上，直至太平洋時間2025年11月30日下午5:00。

We want to remind anyone that may be listening to a replay of this call that all statements made are as of today, November 4, 2025, and these statements have not been or will be updated subsequent to today's call.

我們想提醒所有可能正在收聽本次電話會議重播的人士，所有聲明均截至 2025 年 11 月 4 日，這些聲明在今天的電話會議之後沒有也不會進行更新。

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.

此外，今天所做的任何前瞻性聲明均基於管理層目前對我們業務和我們經營環境的預期、假設和信念。這些聲明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上明示或暗示的結果有重大差異。

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.

聽眾不應過度依賴前瞻性陳述，我們鼓勵他們查閱我們向美國證券交易委員會提交的文件，以更全面地了解可能影響我們績效的因素。除聯邦證券法另有規定外。

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. In addition, The Ensign Group, Inc., is a holding company with no direct operating assets, employees or revenues.

Ensign 及其獨立子公司不承諾在因新資訊、未來事件、情況變化或任何其他原因而發生變更時公開更新或修訂任何前瞻性聲明。此外，Ensign Group, Inc. 是一家控股公司，沒有直接的營運資產、員工或收入。

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 independent subsidiaries through contractual relationships. 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.

我們的一些獨立子公司（統稱為服務中心）透過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，我們的專屬保險子公司（我們稱之為專屬保險公司）為我們的營運公司提供一般責任險、職業責任險以及工傷賠償保險責任的某些索賠保障。

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. The words Ensign, company, we, our and us refer to The Ensign Group, Inc., and its consolidated subsidiaries.

Ensign 還擁有 Standard Bearer Healthcare REIT, Inc.，這是一家專屬房地產投資信託基金，投資於醫療保健地產，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。「Ensign」、「本公司」、「我們」、「我們的」及「我們」均指 Ensign 集團有限公司及其合併子公司。

All our independent subsidiaries, the Service Center, Standard Bearer and the insurance captive are operated by separate independent companies that have their own management, employees and assets. References herein to the consolidated company and its assets and activities as well as use of the words we, us, 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.

我們所有的獨立子公司、服務中心、標準承保公司和自保保險公司均由獨立的公司經營，這些公司擁有自己的管理階層、員工和資產。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」等詞語，並不意味著，也不應被解釋為 Ensign 集團擁有直接的經營資產、員工或收入，或任何子公司由 Ensign 集團經營。

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 on our Form 10-Q.

此外，我們也使用非GAAP指標來補充我們的GAAP報告。我們認為，結合我們的 GAAP 結果來看，這些措施可以更全面地了解我們的業務，但不應完全依賴這些措施而忽略 GAAP 報告。昨天的新聞稿中提供了 GAAP 與非 GAAP 的調整表，也可以在我們的 10-Q 表格中找到。

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

接下來，我將把電話交給我們的執行長巴里·波特。

Barry?

巴里？

Thanks, Chad, and thank you all for joining us today. We're pleased to report another record quarter in several key areas. Before we jump into some of the financial highlights, I do want to provide some more detail about the primary driver of our success, which is the extraordinary outcomes achieved by the dedicated and talented clinical teams.

謝謝查德，也謝謝各位今天蒞臨我們的節目。我們很高興地宣布，在幾個關鍵領域，我們迎來了一個創紀錄的季度。在我們深入探討一些財務亮點之前，我想更詳細地介紹我們成功的主要驅動力，那就是敬業且才華橫溢的臨床團隊所取得的非凡成果。

While we are always trying to highlight our clinically driven culture, sometimes the financial outcomes take the forefront on calls like this. We do feel, however, it's important to point out again that our clinical performance continues to be the key differentiator for us.

雖然我們一直努力強調以臨床為導向的文化，但有時在這樣的電話會議中，財務結果會成為首要考慮因素。不過，我們認為有必要再次強調，我們的臨床表現仍是我們最大的優勢。

Simply put, our consistent financial results would not be possible without a relentless patient-focused culture that strives to deliver the highest quality clinical outcomes. According to the most recently published CMS data, same-store Ensign affiliated facilities outperformed their peers in their annual survey results by an impressive 24% at the state level and 33% at the county level. This exceptional performance is not just a snapshot.

簡而言之，如果沒有以病人為中心的、力求提供最高品質臨床結果的不懈努力，我們就不可能取得持續的財務表現。根據 CMS 最新公佈的數據，Ensign 旗下同店醫療機構在年度調查結果中，州級表現比同行高出 24%，縣級表現高出 33%，成績斐然。這種卓越的表現並非曇花一現。

It reflects the sustained clinical excellence of our local leadership teams and caregivers. In that same CMS data set, Ensign-affiliated operations also maintained a 10% advantage in overall 4- and 5-star rated buildings when compared to their peers. What makes this especially notable is that the majority of these communities were 1- and 2-star facilities at the time of acquisition. Together, these results demonstrate our consistent ability to elevate quality of care, strengthen operational execution and create long-term value across our portfolio.

這體現了我們當地領導團隊和醫護人員持續卓越的臨床水準。在同一個 CMS 資料集中，與同業相比，Ensign 旗下企業在 4 星級和 5 星級建築的整體評級方面也保持了 10% 的優勢。尤其值得注意的是，這些社區在被收購時大多是 1 星級和 2 星級設施。這些結果共同證明了我們始終有能力提升醫療​​品質、加強營運執行力並在我們的所有業務組合中創造長期價值。

We can't emphasize enough how hard our teams are working every day to give our patients and their families the best service possible while developing and sharing best practices with their peers in their own clusters and markets and beyond. These efforts are bearing fruit and showing through in several ways.

我們不能再贅述我們的團隊每天都在多麼努力地工作，為我們的患者及其家人提供最好的服務，同時還在各自的集群和市場以及更廣泛的範圍內開發和分享最佳實踐。這些努力正在取得成效，並在多個方面有所體現。

On the census front, our same-store and transitioning occupancy increased to 83% and 84.4% during the quarter, which were both all-time highs. The primary reason for this growth in occupancy is due to the fact that our teams are capturing more market share by earning the trust of the communities they serve through the clinical outcomes described earlier.

在人口普查方面，本季我們的同店入住率和過渡入住率分別增至 83% 和 84.4%，均為歷史最高水準。入住率成長的主要原因是，我們的團隊透過前面描述的臨床成果贏得了他們所服務社區的信任，從而獲得了更大的市場份額。

As each operation earns and solidifies the reputation as the facility of choice in their respective markets, they're not only seeing more patients, but they're also being entrusted to care for more and more medically complex patients, which includes a larger share of Medicare, managed care and other skilled patients.

隨著每家醫院在各自的市場中贏得併鞏固其作為首選機構的聲譽，它們不僅接待了更多的病人，而且還被委託照顧越來越多病情複雜的病人，其中包括更大比例的聯邦醫療保險、管理式醫療和其他需要專業護理的病人。

In addition, we believe we're just now starting to see the increased demand for our services related to the strong demographic trends. As we look ahead, these demographic trends are undeniable. The US population aged 80 and older, our core population is projected to grow by more than 50% over the next decade from roughly 13 million today to over 20 million by 2035.

此外，我們認為，隨著強勁的人口趨勢，我們現在才開始看到對我們服務的需求不斷增長。展望未來，這些人口趨勢是不可否認的。美國80歲及以上人口（即我們的核心人口）預計將在未來十年內增長50%以上，從目前的約1300萬增長到2035年的2000多萬。

At the same time, the ratio of seniors to middle-age family members is expected to decline by nearly 40%, creating sustained and growing demand for the kind of skilled nursing and rehabilitation services offered in our facilities every day.

同時，老年人與中年家庭成員的比例預計將下降近 40%，這將對我們機構每天提供的專業照護和復健服務產生持續增長的需求。

These powerful tailwinds will only bolster the census momentum we're seeing across our portfolio, giving us confidence in the long-term growth and opportunity ahead. On the skilled mix front, we saw skilled days increase for both our same-store transitioning operations by 5.1% and 10.9%, respectively, over the prior year quarter.

這些強勁的順風只會加強我們投資組合中正在看到的普查勢頭，讓我們對未來的長期成長和機會充滿信心。在熟練技工組合方面，與上一季相比，我們同店轉型營運的熟練技工天數分別增加了 5.1% 和 10.9%。

We also saw Medicare revenue increase for both our same-store and transitioning operations by 10% and 8.8%, respectively, and an increase in our same-store Medicare days by 4.2% over the prior year quarter. In addition, we saw managed care revenue increased for both our same-store and transitioning operations by 7.1% and 24.3%, respectively. These improvements in skilled mix in our same-store operations and the even larger improvements in our transitioning operations highlight our ability to capture a portion of the enormous upside inherent in our existing portfolio.

我們也看到，我們的同店和轉型業務的 Medicare 收入分別成長了 10% 和 8.8%，我們的同店 Medicare 天數比去年同期成長了 4.2%。此外，我們的同店營運和轉型營運的醫療管理收入分別成長了 7.1% 和 24.3%。我們在同店營運中技能組合的這些改進，以及我們在轉型營運中更大的改進，凸顯了我們能夠抓住現有投資組合中蘊含的巨大成長潛力的一部分的能力。

The combination of strong demand for our services and our efforts to be best-in-class in our markets creates a pathway to continue to produce long-term sustainable growth. At the same time, we continue to acquire new operations with massive long-term upside. Since 2024, we have successfully sourced, underwritten, closed and transitioned 73 new operations across several markets, many of which were already performing at or above our expectations. Our opportunity to continue adding new operations to our portfolio remains solid. However, as Chad will discuss in a minute, the deal market does fluctuate.

市場對我們服務的強勁需求，以及我們力爭成為市場一流企業的努力，共同為我們持續實現長期可持續成長鋪平了道路。同時，我們持續收購具有巨大長期成長潛力的新業務。自 2024 年以來，我們已成功在多個市場尋找、承保、完成和過渡了 73 個新業務，其中許多業務的表現已經達到或超過了我們的預期。我們持續在業務組合中增加新業務的機會依然穩固。然而，正如查德稍後將要討論的那樣，交易市場確實會波動。

In our 26-year history, we've seen periods of time when capital seems to flood into the industry, which can temporarily raise prices to irrational levels. A close look at our history will show in an environment like that, we have remained disciplined and taken a slower pace to growth, avoiding the addition of what we believe to be overpriced deals. Instead, our local leaders spend fewer hours on transitioning newly acquired assets and shift their focus towards enhancing our capabilities within our same-store and transitioning portfolio.

在我們 26 年的發展歷程中，我們曾多次看到資本湧入該行業，這可能會暫時將價格推高到非理性水平。仔細回顧我們的歷史就會發現，在這樣的環境下，我們始終保持自律，放慢成長步伐，避免進行我們認為價格過高的交易。相反，我們的本地領導者減少了在新收購資產過渡上花費的時間，並將重點轉移到提高我們同店和過渡投資組合的能力。

Over time, we have experienced very consistent growth in revenue and earnings, even though the deal market has been and will continue to be choppy. While we're thrilled with our current record same-store occupancy, we're actually excited that it's as low as it is. At 83%, we have enough organic growth potential left in our organization to sustain our consistent earnings and revenue growth, even if we stopped acquiring during periods of irrational pricing.

隨著時間的推移，儘管交易市場一直並將繼續動盪不安，但我們的收入和利潤一直保持著非常穩定的成長。雖然我們對目前創紀錄的同店入住率感到非常高興，但實際上，我們很高興它的入住率這麼低。我們組織內部仍有 83% 的有機成長潛力，足以維持我們持續的利潤和收入成長，即使我們在非理性定價時期停止收購。

To illustrate this opportunity, reaching a minimum of 85% occupancy in same-store would be like adding 8 new 100-bed operations and at a minimum of 88%, it would be the equivalent of adding 17. This kind of organic growth is even more powerful than acquisitions because it expands census without adding new fixed overhead, driving stronger and more efficient margin improvement.

為了說明這一機遇，同店入住率達到 85% 就相當於新增 8 家 100 床位的新店，而達到 88% 就相當於新增 17 家。這種內生成長甚至比收購更有力，因為它在不增加新的固定開支的情況下擴大了用戶規模，從而推動了更強勁、更有效率的利潤率提升。

As we point out during each of our earnings calls each quarter with specific facility examples, it's not uncommon to see some of our most mature operations consistently achieve and maintain occupancies in mid- to high-90s.

正如我們在每個季度的收益電話會議上用具體設施實例所指出的那樣，我們一些最成熟的營運項目持續達到並保持 90% 以上的入住率並不罕見。

As we grow, our local leaders are always on a lookout to attract and develop new partners into post-acute care, including administrators and training, nursing and therapy leaders and other key contributors. We are encouraged by the deep bench of incredible talent that continues to flow into our organization, and we look forward to working with them to continue to achieve our mission to dignify post-acute care.

隨著我們的發展，我們的本地領導一直在尋找和培養新的合作夥伴進入復健護理領域，包括管理人員和培訓人員、護理和治療領導者以及其他關鍵貢獻者。我們很高興看到大量優秀人才不斷湧入我們的組織，並期待與他們攜手合作，繼續實現我們提升康復後護理尊嚴的使命。

On the labor front, we do continue to experience improvements in turnover, stable wage growth and lower staffing agency usage even in the face of increased occupancy. As we've said before, our people are at the heart of our efforts and seeing these metrics consistently improve is critical to maintaining our path of success and to achieve industry-leading results.

在勞動力方面，儘管入住率上升，但我們仍然看到人員流動率有所改善，薪資成長穩定，人力資源機構的使用率下降。正如我們之前所說，我們的員工是我們工作的核心，而這些指標的持續改善對於維持我們的成功之路並取得業界領先的成果至關重要。

After another stronger-than-expected quarter, we are again raising our 2025 earnings guidance to between $6.48 to $6.54 per diluted share, up from our previously raised guidance of $6.34 to $6.46 per diluted share. The new mid-point of this increased 2025 earnings guidance represents an increase of 18.4% over our 2024 results and is 36.5% higher than our 2023 results.

在又一個強於預期的季度之後，我們再次將 2025 年的盈利預期上調至每股攤薄收益 6.48 美元至 6.54 美元，高於此前上調的每股攤薄收益 6.34 美元至 6.46 美元的預期。此次上調後的 2025 年獲利預期中位數比 2024 年的業績成長 18.4%，比 2023 年的業績成長 36.5%。

We are also increasing our annual revenue guidance to $5.05 billion to $5.07 billion, up from $4.99 billion to $5.02 billion to account for our current quarter performance and acquisitions we anticipate closing through the end of the year.

我們同時將年度營收預期從 49.9 億美元至 50.2 億美元上調至 50.5 億美元至 50.7 億美元，以反映我們本季的業績以及我們預計在年底前完成的收購。

We're excited about the trajectory we are on for the year and look forward to continuing our consistent march towards great clinical and financial results. This increased guidance is due to the continued execution of our growth model with organic growth stemming from continued strength in occupancy and skilled mix as we head into the fourth quarter, which is typically one of our strongest quarters.

我們對今年的發展軌跡感到興奮，並期待繼續穩步邁向卓越的臨床和財務表現。此次業績預期上調是由於我們持續執行成長模式，有機成長源自於入住率和高技能人才組合的持續強勁成長，而第四季通常是我們業績最好的季度之一。

In addition, many of our new acquisitions are performing well ahead of schedule, which highlights our continued commitment to our locally driven transition strategy and also points towards solid underwriting and investment decisions.

此外，我們許多新收購的專案都提前完成了預期目標，這凸顯了我們對在地化轉型策略的持續承諾，也顯示了我們穩健的承銷和投資決策。

We are excited about our performance so far this year and are confident that our partners will continue to execute and innovate while balancing the addition of newly acquired operations. We are eager to continue to drive organic improvements and take advantage of the acquisition opportunities we see on the horizon.

我們對今年迄今的業績感到興奮，並相信我們的合作夥伴將繼續執行和創新，同時兼顧新收購業務的增加。我們渴望繼續推動自身業務的有機成長，並抓住我們所看到的未來​​收購機會。

The combination of improvements in occupancy and skilled mix in our more mature operations and the long-term upside in our newly acquired operations highlights the enormous organic potential we see in our existing portfolio.

我們成熟業務的入住率和技能型員工組成不斷提高，加上我們新收購業務的長期成長潛力，凸顯了我們現有投資組合中蘊藏的巨大內生潛力。

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

接下來，我將請查德就我們近期的成長補充一些見解。查德?

Thank you, Barry. We accelerated our growth by adding 22 new operations, including 10 real estate assets during the quarter and since. These include two larger deals, an 11-building portfolio in California and a 7-building portfolio in Utah. It also includes some single facility opportunities with one in Alabama, one in Wisconsin, one in Iowa and one in Idaho. In total, we added 1,857 new skilled nursing beds and 109 senior living units across 6 states.

謝謝你，巴里。本季及以後，我們透過新增 22 項業務（包括 10 項房地產資產）加速了成長。其中包括兩筆較大的交易，分別是加州的 11 棟建築組合和猶他州的 7 棟建築組合。它還包括一些單體設施的投資機會，分別位於阿拉巴馬州、威斯康辛州、愛荷華州和愛達荷州。我們在 6 個州共新增了 1857 張專業照護床位和 109 個老年生活單元。

This growth brings a number of operations acquired during 2025 and since to 45. We are thrilled to complete the 11-building portfolio in California during the quarter after many months of preparing to transition these operations. These new acquisitions allow us to serve areas of California that we've been looking to enter for years.

這一成長使得 2025 年及之後收購的業務數量達到 45 家。經過數月的準備，我們很高興在本季完成了加州 11 棟建築的交接工作。這些新的收購使我們能夠服務我們多年來一直想進入的加州地區。

Consistent with other similar regional portfolios we've acquired in the past, our local team is prepared to execute on their specialized building-by-building transition plans several months in advance. So far, we've been very pleased with the progress in these transitions. As long-term operators, we've never sold a skilled nursing operation.

與過去我們收購的其他類似區域投資組合一致，我們的本地團隊已做好準備，提前幾個月執行其專門的逐棟建築過渡計劃。到目前為止，我們對這些過渡工作的進展非常滿意。作為長期經營者，我們從未出售過任何專業護理機構。

When we agree to operate a new facility, we make a commitment to the staff, patients and the larger health care community that we are there for the long haul. Our company was founded in California, and these additions only serve to deepen our commitment to the growing populations of seniors in this great state that will benefit from our high-quality health care services over the coming decades.

當我們同意經營新機構時，我們就向員工、病患和更廣泛的醫療保健界承諾，我們將長期存在下去。我們公司創立於加州，這些新增業務只會加深我們對這個偉大州日益增長的老年人口的承諾，在未來幾十年裡，他們將受益於我們高品質的醫療保健服務。

We were also thrilled to close on the Stonehenge portfolio in Utah. We have admired these operations for many years and are honored to continue their legacy as one of the most reputable providers in the state of Utah. This strategic acquisition adds high-quality, newer constructed properties to our existing footprint and a very important state for us.

我們也很高興完成了猶他州巨石陣地產專案的收購。多年來，我們一直很欣賞這些企業的運營，並很榮幸能夠延續他們的輝煌，成為猶他州最負盛名的供應商之一。此次策略性收購為我們現有的商業版圖增添了高品質、新建的物業，並為我們非常重要的一個州帶來了新的資產。

The locations are a perfect fit with our existing clusters and introduce us into a few new markets. We are also thrilled to add these assets to Standard Bearer's growing real estate portfolio. This acquisition is a perfect example of how our locally driven acquisition strategy works best.

這些地點與我們現有的產業群聚完美契合，並為我們開拓了一些新的市場。我們也十分高興能將這些資產納入 Standard Bearer 不斷成長的房地產投資組合中。此次收購完美詮釋了我們以本地市場為主導的收購策略如何發揮最佳效果。

This off-market transaction was a multi-year process that would not have happened with a traditional centralized deal team. This opportunity came to our organization because of a very long-standing relationship between the sellers and our local leaders, who then worked together with our team at the service center to structure a win-win deal for us and the sellers.

這筆場外交易歷時數年，如果由傳統的集中式交易團隊進行，是不可能實現的。我們組織之所以能獲得這個機會，是因為賣家和我們當地的領導之間有著非常長期的合作關係，他們隨後與我們的服務中心團隊合作，為我們和賣家製定了雙贏的交易。

We are excited to add our second facility in Alabama and look forward to watching that market grow as we add strength and experience to our local team there. Because our growth over the last several quarters spans across many states and markets, it leaves us with significant bandwidth to grow in almost all of our markets.

我們很高興在阿拉巴馬州增設第二家工廠，並期待隨著我們當地團隊實力和經驗的增強，見證該市場的發展。由於我們過去幾季的成長遍及多個州和市場，這給我們留下了相當大的發展空間，幾乎可以在所有市場實現成長。

We continue to prioritize markets that we know best, while simultaneously and meticulously expanding into new markets. Overall, our growth this quarter continues to demonstrate our ability to take on multi-facility portfolios as well as our traditional singles and doubles, which when taken collectively, are equivalent to a large transformative acquisition.

我們將繼續優先發展我們最熟悉的市場，同時謹慎地拓展新市場。總體而言，本季我們的成長繼續證明我們有能力承接多設施投資組合以及我們傳統的單項和雙項業務，這些業務加在一起相當於一次大型的變革性收購。

We've shown that our approach to transitioning each operation as a complex health care business works on single operations, small portfolios and on a larger scale, particularly when a larger deal spans several markets and geographies.

我們已經證明，我們將每項業務轉型為複雜的醫療保健業務的方法，適用於單一業務、小型投資組合以及更大規模的業務，尤其是在涉及多個市場和地區的大型交易中。

While we certainly will continue to evaluate and consider any deal that's out there, we are also very comfortable growing the way we've grown this year with lots of transactions across many states, which are typically more reasonably priced and don't carry the complexities that sometimes accompany the acquisition of a large company.

雖然我們肯定會繼續評估和考慮任何可行的交易，但我們也非常樂意像今年這樣透過在許多州進行大量交易來實現成長，這些交易通常價格更合理，而且不會像收購大型公司那樣複雜。

As we look at the current pipeline, we continue to see opportunities that include everything from small to midsized owner-operated portfolios, landlords looking to replace current tenants, non-profits looking to divest of their post-acute assets and a steady flow of traditional onesie-twosies. However, we've also seen some trends in the last few months that show that pricing in certain areas has become too rich to support the fundamentals of the operations.

從目前的專案儲備來看，我們不斷看到各種機會，包括小型到中型的業主經營投資組合、尋求更換現有租戶的房東、尋求剝離其康復資產的非營利組織，以及源源不斷的傳統小型和中型企業。然而，在過去的幾個月裡，我們也看到了一些趨勢，顯示某些地區的定價過高，無法支撐營運的基本面。

We must and will remain committed to staying disciplined and true to the principles that have contributed to our consistent success, including ensuring that we pay prices that will allow the operations to have enough of the necessary resources to invest in the building and the clinical systems in order to achieve the highest possible clinical outcomes.

我們必須並將繼續致力於保持自律，忠於那些促成我們持續成功的原則，包括確保我們支付的價格能夠讓營運部門擁有足夠的必要資源來投資於建築和臨床系統，從而實現盡可能高的臨床效果。

With that said, we have several deals lining up for the first quarter of 2026 and our local leadership and their deal partners at the service center work together to source and underwrite reasonably priced deals with sellers who are not just interested in receiving top dollar, but care deeply about the quality and reputation of the company they select to inherit their legacy.

也就是說，我們有幾筆交易正在籌備中，預計將於 2026 年第一季完成。我們當地的領導層及其在服務中心的交易夥伴共同努力，尋找並承銷價格合理的交易，這些賣家不僅對獲得最高價格感興趣，而且非常關心他們選擇繼承其遺產的公司的品質和聲譽。

Our local leaders continue to recruit future CEOs for Ensign affiliated operations, and we have a deep bench of CEOs in training that are eagerly preparing for an opportunity to lead. During the quarter, we reached an all-time high for AITs in our pipeline.

我們當地的領導人繼續為 Ensign 附屬機構招募未來的 CEO，我們還有一群優秀的 CEO 正在接受培訓，他們渴望有機會領導公司。本季度，我們的在研項目數量達到了歷史最高水準。

This high-quality influx of local talent, combined with our decentralized transition model allows us to grow without being limited by typical corporate bottlenecks. Therefore, our unique acquisition and transition strategy puts us in an excellent position to continue growing in a healthy and sustainable way.

大量優質本地人才的湧入，加上我們分散式的轉型模式，使我們能夠在不受典型企業瓶頸限制的情況下成長。因此，我們獨特的收購和轉型策略使我們處於非常有利的地位，能夠以健康和永續的方式繼續發展。

Lastly, we are pleased with the continued growth of Standard Bearer, which added 11 new assets during the quarter and since, including one skilled nursing asset that we acquired in Texas that will be operated by a high-quality third-party tenant pursuant to a triple net lease.

最後，我們對 Standard Bearer 的持續成長感到滿意，該公司在本季度及之後新增了 11 項資產，其中包括我們在德克薩斯州收購的一項專業護理資產，該資產將由一家高品質的第三方租戶根據三方淨租賃協議運營。

Standard Bearer is now comprised of 149 owned properties, 115 are leased to an Ensign affiliated operator and 35 are leased to third-party operators. We were excited to add our growing list of relationships with unaffiliated operators, which further diversifies our tenant base and helps our organization as a whole continue to advance our mission by working closely with like-minded operators that want to make a difference in this industry.

Standard Bearer 目前擁有 149 處房產，其中 115 處租賃給 Ensign 旗下營運商，35 處租賃給第三方營運商。我們很高興能夠與更多非關聯運營商建立合作關係，這進一步豐富了我們的租戶群體，並幫助我們整個組織透過與志同道合、希望在這個行業有所作為的運營商緊密合作，繼續推進我們的使命。

Going forward, Standard Bearer will continue to work together with our existing operating partners and new relationships we are developing in order to acquire portfolios comprised of operations that Ensign would operate and facilities at third parties that are interested in operating under a lease.

展望未來，Standard Bearer 將繼續與我們現有的營運合作夥伴以及我們正在發展的新關係攜手合作，以收購由 Ensign 將運營的業務以及有興趣以租賃方式運營的第三方設施組成的投資組合。

Collectively, Standard Bearer generated rental revenue of $32.6 million for the quarter, of which $27.6 million was derived from Ensign affiliated operations. For the quarter, Standard Bearer reported $19.3 million in FFO and as of the end of the quarter, had an EBITDAR to rent coverage ratio of 2.5 times.

Standard Bearer 本季共計創造了 3,260 萬美元的租賃收入，其中 2,760 萬美元來自 Ensign 的關聯業務。該季度，Standard Bearer 報告的 FFO 為 1,930 萬美元，截至季度末，其 EBITDAR 與租金覆蓋率為 2.5 倍。

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

接下來，我將把電話交給我們的營運長史賓塞，讓他詳細介紹一下營運狀況。斯賓塞？

Thanks, Chad, and hello, everyone. As always, we'd like to share a few examples of how operations in various stages of their maturity are contributing to our outstanding results. It's the aggregation of achievements like these that comprise the Ensign story.

謝謝查德，大家好。像往常一樣，我們想分享一些例子，說明處於不同成熟階段的運作是如何為我們取得優異成績的。正是這些成就的積累，構成了《旗幟》的故事。

And we believe these examples are the best way to explain how we produce consistent results over time. As Barry and Chad both mentioned, one of the biggest drivers of Ensign's consistent growth that our same-store operations are continually pushing for quality and improvement year after year.

我們相信，這些例子是解釋我們如何長期取得穩定成果的最佳方式。正如 Barry 和 Chad 都提到的那樣，Ensign 持續成長的最大驅動力之一是我們的同店營運部門年復一年地不斷追求品質和改進。

A great example of that diligence is Beacon Harbor Healthcare & Rehabilitation located in Rockwall, Texas. Beacon is led by Executive Director, Cory Blomquist; and his clinical partner, COO, Don Thompson, who has guided a remarkably stable leadership team since the facility joined Ensign back in 2019. Beacon has long been a strong clinical and financial performer, and the team has been executing a thoughtful multiyear strategy to make the facility the clear provider of choice in their community.

位於德州羅克沃爾的 Beacon Harbor Healthcare & Rehabilitation 就是這種勤勉精神的絕佳例證。Beacon 由執行董事 Cory Blomquist 領導；他的臨床合作夥伴兼營運長 Don Thompson 自該機構於 2019 年加入 Ensign 以來，一直領導著一支非常穩定的領導團隊。Beacon 一直以來在臨床和財務方面都表現出色，團隊也一直在執行一項深思熟慮的多年策略，以使該機構成為其所在社區的首選醫療服務提供者。

First and foremost, they've focused on taking care of their caregivers. Despite operating in a tough labor market, Beacon enjoys turnover well below state averages, runs low overtime and hasn't used a single nursing agency shift all year. Because their staff feel valued and supported, that care naturally extends to their patients.

首先，他們把重點放在了照顧他們的護理人員上。儘管在嚴峻的勞動力市場中運營，Beacon 的員工流動率遠低於州平均水平，加班時間很少，並且全年都沒有使用過任何護理機構的輪班。因為員工覺得自己受到重視和支持，這種關懷自然而然地延伸到他們的病人身上。

Second, the team has maintained their 5-star CMS quality rating, while growing their reputation for clinical excellence. They've also expanded their medical partnerships, adding cardiology, pulmonology and nephrology specialists and strengthened relationships with local hospitals, which enabled them to participate successfully in multiple ACOs and expanded managed care partnerships.

其次，該團隊保持了其 5 星級 CMS 品質評級，同時不斷提升其在臨床卓越方面的聲譽。他們還擴大了醫療合作夥伴關係，增加了心臟病學、肺病學和腎臟科專家，並加強了與當地醫院的關係，這使他們能夠成功參與多個 ACO 並擴大管理式醫療合作夥伴關係。

The results speak for themselves. Occupancy has increased from 69.4% in Q3 of 2024 to 77.7% in Q3 of 2025, with Medicare days up 11% and managed care days up 21%. As the team has methodically executed their plan, earnings have followed. Q3 EBIT is up nearly 45% from the prior year quarter. Even more exciting is the fact that the operation still is less than 80% occupied and is primed to experience even more growth in coming years.

結果不言而喻。入住率從 2024 年第三季的 69.4% 上升到 2025 年第三季的 77.7%，其中 Medicare 入住天數增加了 11%，管理式醫療入住天數增加了 21%。隨著團隊有條不紊地執行計劃，收益也隨之而來。第三季息稅前利潤較上年同期成長近45%。更令人興奮的是，該項目目前的入住率不到 80%，並且預計在未來幾年將迎來更大的成長。

With a stable leadership team, strong labor practices and a culture that puts people first, Beacon Harbor stands as a powerful example of how sustained organic growth continues to drive Ensign forward. The second example highlights the kind of transformational growth we often see in our newly acquired operations when they're led by strong local leaders with clear shared vision.

憑藉著穩定的領導團隊、強大的勞工製度和以人為本的企業文化，Beacon Harbor 成為了 Ensign 如何持續有機成長的有力例證。第二個例子突顯了我們在新收購的業務中經常看到的變革性成長，這些業務是由具有清晰共同願景的強大本地領導者領導的。

River Park Post Acute in Chandler, Arizona, was acquired in May of 2024. Prior to transition, the facility primarily served long-term care residents and had limited visibility in the local health care community. It operated at three stars and struggled with census and referrals. That changed quickly under Executive Director, [Arjun Purvis] and Director of Nursing, Rhonda Gilbert.

位於亞利桑那州錢德勒的 River Park Post Acute 於 2024 年 5 月被收購。轉型前，該機構主要服務長期照護居民，在當地醫療保健界知名度有限。它以三星級運營，但在人口普查和轉診方面遇到了困難。在執行董事 [Arjun Purvis] 和護理主任 Rhonda Gilbert 的領導下，情況迅速發生了變化。

Together they united the team around a bold vision to become a beacon of quality in Chandler by caring for more complex skilled patients. They went to work strengthening hospital partnerships, enhancing the facility's appearance and raising clinical standards. Rhonda and her team focused on the fundamentals, training frontline caregivers, setting high expectations and establishing 7-day a week on-site physician group coverage.

他們團結團隊，朝著一個大膽的願景邁進，那就是透過照顧病情更複雜的技術型患者，成為錢德勒市的優質醫療標竿。他們著手加強與醫院的合作關係，改善醫院的形象，並提高臨床標準。Rhonda 和她的團隊專注於基本要素，培訓第一線護理人員，設定高期望值，並建立每週 7 天的現場醫生團隊服務。

Confidence grew, and with it, the facility's reputation. In just 15-months, River Park has achieved two successful CMS surveys, including one deficiency free, a rare feat even among established operations. They've also advanced from three stars to five stars overall and in quality measures.

信心增強了，隨之而來的是該機構的聲譽也提升了。短短 15 個月內，River Park 就成功通過了兩次 CMS 調查，其中一次沒有發現任何缺陷，即使在成熟的營運機構中，這也是一項罕見的成就。他們的整體評級和品質指標也從三星提升到了五星。

Operationally, the turnaround has been just as impressive. Occupancy rose from 76.3% in Q3 of 2024 to 97.1% in Q3 of 2025. Skilled mix days increased from 40.7% to 67.5%, with Medicare days up 18.9% and managed care up 176%, adding more than 20 managed care patients per day compared to the prior year. Both clinical and operational gains have translated into extraordinary financial results. Revenues are up 54% and EBIT is up 376% year-over-year.

從營運層面來看，公司的轉變同樣令人印象深刻。入住率從 2024 年第三季的 76.3% 上升到 2025 年第三季的 97.1%。熟練護理混合天數從 40.7% 增加到 67.5%，其中 Medicare 天數增加了 18.9%，管理式護理天數增加了 176%，與前一年相比，每天增加了 20 多名管理式護理患者。臨床和營運方面的進步都轉化為了卓越的財務表現。營收年增 54%，息稅前利潤年增 376%。

River Park story is a vivid reminder that when clinical excellence comes first, results follow quickly. It also shows the potential that exists in so many of our new acquisitions when talented local leaders are empowered, supported by our resource teams and backed by a culture that believes in doing the right thing for every patient every time.

River Park 的故事生動地提醒我們，當臨床卓越放在首位時，成果就會迅速到來。這也表明，當我們賦予有才華的本地領導者權力，並得到我們資源團隊的支持，以及秉持著「始終為每位患者做正確的事情」的文化理念時，我們許多新收購的企業都蘊藏著巨大的潛力。

With that, I will 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 Suzanne，讓她詳細介紹公司的財務表現和我們的預期，然後我們將開放提問環節。蘇珊？

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 the following: GAAP diluted earnings per share was $1.42, an increase of 6%. Adjusted diluted earnings per share was $1.64, an increase of 18%. Consolidated GAAP revenue and adjusted revenues were both $1.3 billion, an increase of 19.8%. GAAP net income was $83.8 million, an increase of 6.9%. And adjusted net income was $96.5 million, an increase of 18.9%.

謝謝你，史賓塞，大家早安。本季度的詳細財務數據已包含在我們昨天提交的 10-Q 表格和新聞稿中。本季其他亮點包括：GAAP稀釋後每股收益為1.42美元，成長6%。調整後的稀釋每股收益為 1.64 美元，成長 18%。合併後的GAAP營收和調整後的營收均為13億美元，成長了19.8%。GAAP淨利為8,380萬美元，成長6.9%。經調整後的淨收入為 9,650 萬美元，成長了 18.9%。

Other key metrics as of September 30, 2025, include cash and cash equivalents of $443.7 million and cash flows from operations of $381 million. During the 9-months ended September 30, 2025, we spent more than $240 million to execute on our strategic growth plan, most of which have been in the works for months. We made these investments from a position of strength as shown by the lease adjusted net debt-to-EBITDA ratio of 1.86 times after taking these investments into consideration.

截至 2025 年 9 月 30 日，其他關鍵指標包括現金及現金等價物 4.437 億美元，以及經營活動產生的現金流量 3.81 億美元。截至 2025 年 9 月 30 日的 9 個月內，我們花費了超過 2.4 億美元來執行我們的策略成長計劃，其中大部分計劃已經籌備了數月。我們之所以進行這些投資，是因為我們的財務狀況良好，經租賃調整後的淨債務與 EBITDA 比率為 1.86 倍（已考慮這些投資的影響）。

Our continued ability to maintain low leverage even during periods of significant growth is particularly noteworthy and demonstrates our commitment to disciplined growth as well as our belief that we can continue to achieve growth in the long run. In addition, we currently have approximately $593 million of available capacity under our line of credit, which, when combined with the cash on our balance sheet, gives us over $1 billion in dry powder for future investments.

即使在顯著成長時期，我們仍能維持較低的槓桿率，這一點尤其值得注意，這表明我們致力於穩健成長，也顯示我們相信能夠長期持續成長。此外，我們目前在信貸額度下還有約 5.93 億美元的可用額度，加上我們資產負債表上的現金，我們擁有超過 10 億美元的可用資金，可用於未來的投資。

We also own 155 assets, of which 149 are held by Standard Bearer and 131 of which are owned completely debt-free and gaining significant value over time, adding even more liquidity to help with future growth. The company paid a quarterly cash dividend of $0.0625 per share for common stock.

我們還擁有 155 項資產，其中 149 項由 Standard Bearer 持有，131 項完全無債務，並且隨著時間的推移不斷增值，從而增加了更多流動性，有助於未來的增長。該公司按季度向普通股股東支付了每股 0.0625 美元的現金股息。

We have a long history of paying dividends and have increased the annual dividend for 22 consecutive years. In addition, we currently have a stock repurchase plan in place. Also on October 1, 2025, the annual Medicare market basket net rate increased by 3.2%. We continue to work with both state and federal levels to ensure that our seniors and the workforce that supports their daily needs have a voice in the ever-evolving health care landscape.

我們有著悠久的派發股利歷史，並且已經連續 22 年提高年度股利。此外，我們目前也制定了股票回購計畫。2025 年 10 月 1 日，Medicare 年度市場籃子淨費率上漲了 3.2%。我們將繼續與州和聯邦各級政府合作，以確保我們的老年人和為他們提供日常服務的員工在不斷變化的醫療保健領域擁有發言權。

We are pleased with the outcomes of the 2025 rate year and feel optimistic that state and federal governments will continue to recognize the importance of properly funding the health care needs of the ever-growing senior population.

我們對 2025 年費率年度的結果感到滿意，並樂觀地認為州政府和聯邦政府將繼續認識到為不斷增長的老年人口的醫療保健需求提供適當資金的重要性。

As Barry mentioned, we are increasing our annual 2025 earnings guidance to between $6.48 to $6.54 per diluted share, and our annual revenue guidance between $5.05 billion and $5.07 billion. We have evaluated multiple scenarios and based on the strength of our performance and the positive momentum we have seen in occupancy and skilled mix as well as continued progress on labor, agency management and other operational initiatives, we have confidence that we can achieve these results.

正如巴里所提到的，我們將 2025 年年度獲利預期提高至每股攤薄收益 6.48 美元至 6.54 美元，年度營收預期提高至 50.5 億美元至 50.7 億美元。我們已經評估了多種方案，並且基於我們強勁的業績、入住率和技能型人才組合方面取得的積極勢頭，以及在勞動力、機構管理和其他營運舉措方面取得的持續進展，我們有信心能夠實現這些結果。

Our 2025 guidance is based on diluted weighted average common shares outstanding of approximately 59 million, a tax rate of 25%, the inclusion of acquisitions closed and expected to be closed through the end of the year, the inclusion of management's expectations for reimbursement rates and with the primary exclusion coming from stock-based compensation.

我們對 2025 年的業績預期是基於約 5,900 萬股稀釋加權平均流通普通股、25% 的稅率、已完成和預計在年底前完成的收購、管理層對報銷率的預期，以及主要排除股票選擇權費用。

Additionally, other factors that could impact quarterly performance include variations in reimbursements, delays and changes in state budgets, seasonality in occupancy and skilled mix, the influence on the general economy, census and staffing, the short-term impact of our acquisition activities, variation in insurance accruals and other factors. And with that, I'll turn it back over to Barry. Barry?

此外，其他可能影響季度業績的因素包括報銷額的變化、州預算的延遲和變化、入住率和技能組合的季節性、對整體經濟的影響、人口普查和人員配備、我們收購活動的短期影響、保險計提的變化以及其他因素。那麼，我就把麥克風交還給巴瑞了。巴里？

Thanks, Suzanne. As we wrap up, we just want to re-emphasize how grateful we are for our operational leaders, our clinicians, our field resources, our service center partners and most importantly, our frontline staff.

謝謝你，蘇珊。最後，我們想再次強調，我們非常感謝我們的營運領導、臨床醫生、現場資源、服務中心合作夥伴，以及最重要的，我們的第一線員工。

So much is being done every day to improve the lives of those we care for, and those stories inspire all of us. Their level of dedication in creating an amazing experience for our residents and one another is truly remarkable.

每天都有很多人為改善我們所關心的人的生活而努力，這些故事激勵著我們所有人。他們為我們的居民和彼此創造美好體驗的奉獻精神令人欽佩。

They are on a mission to dignify post-acute care in the eyes of the world and they show it through their collective ownership, which has led to these results. Looking ahead, we couldn't be more optimistic about our ability to continue our steady path forward as we build up the momentum from this quarter.

他們的使命是提升世界對復健護理的尊重，他們透過集體所有製來體現這一點，並取得了這些成果。展望未來，我們對能夠繼續穩步前進充滿信心，因為我們將延續本季的發展勢頭。

And with that, we'll now turn it over to the Q&A portion of our call. Operator, would you please provide the instructions for Q&A.

接下來，我們將進入電話會議的問答環節。操作員，請提供問答環節的操作說明。

(Operator Instructions)

（操作說明）

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，加拿大皇家銀行資本市場。

Hey, can you guys hear me. Now?

嘿，你們聽得到我說話嗎？現在？

Can hear you, yeah.

能聽到你說話。

Yeah, sorry about. I appreciate the commentary about the managed care growth. How should we think about the room to run on the skilled mix side, specifically in the same-store portfolio? And what have you guys seen as a sustainable like fully ramped skill mix in some of your higher-performing facilities? Maybe a Beacon would be a good example of that?

是啊，真抱歉。我同意您對醫療管理發展的評論。我們該如何看待技能組合方面的發展空間，尤其是在同店產品組合方面？你們在一些高績效的訓練設施中，看到了哪些可持續的、技能全面提升的組合方式？或許信標就是一個很好的例子？

Yeah, it's a great question. I mean, I guess I would point you back to just the growth we've seen over the past several years. It's a steady and consistent growth and one that we expect to see continue. I mean, certainly, when you look at it on a same-store basis, 5.1% growth is a big jump in days. But it's -- as you look backwards, it's not entirely abnormal when you look at different quarters.

是的，這是一個很好的問題。我的意思是，我想我應該讓你回顧我們過去幾年所取得的成長。這是一個穩步持續的成長，我們預計這種成長勢頭將會繼續下去。我的意思是，當然，從同店銷售額來看，5.1% 的成長在短短幾天內就是一個巨大的飛躍。但是——當你回顧過去時，你會發現，從不同的角度來看，這種情況並非完全不正常。

But we are pleased with how it's growing, and it's growing not just in managed care, it's growing in Medicare as well and other skills. So look, I would tell you, just fundamentally, it's -- that's our business. We -- when we dive into these transitions and even look at how we continuously evolve on a same-store basis, the constant thought is how to add more services that meet the needs of our acute providers and our managed care partners.

但我們對它的發展現狀感到滿意，而且它不僅在醫療管理領域發展，在聯邦醫療保險和其他技能領域也發展。所以你看，我會告訴你，從根本上講，這就是我們的業務。當我們深入研究這些轉型，甚至審視我們如何在同一家門市的基礎上不斷發展時，我們始終思考的是如何增加更多服務，以滿足我們的急性照護提供者和我們的醫療管理合作夥伴的需求。

And so what you see is kind of a result of what we all work towards. Our operators are thoughtfully engaged in discussions with these partners to figure out what services are needed, how to add new skill sets, new programs, new capabilities that allow them not just to take the patients, but to achieve the outcomes that are being sought. Spencer or Suzanne, do you guys have any other comments you want to add to that?

所以你現在看到的，其實是我們所有人努力的成果。我們的營運人員與這些合作夥伴進行深入的討論，以確定需要哪些服務，如何增加新的技能、新的專案、新的能力，使他們不僅能夠接收病人，還能實現所期望的結果。Spencer 或 Suzanne，你們還有什麼要補充的嗎？

I would just add, you referenced Beacon, the example that I shared earlier. I would say in a lot of these facilities, you don't see necessarily a cap happen even after 5-years. There is potential, for example, in Beacon for that skilled mix to continue to ramp up. There's still over occupancy potential as well. But I would say we have so many of our facilities that are more mature, but still have substantial upside on overall census, but especially on skilled.

我還要補充一點，你提到了 Beacon，也就是我之前分享的例子。我認為在很多這樣的設施中，即使過了 5 年，你也不一定能看到人數上限的出現。例如，Beacon 地區有潛力繼續擴大這種技能型人才隊伍。目前仍有超額入住的潛力。但我認為，我們有很多設施雖然比較成熟，但在整體入住率方面仍有很大的提升空間，尤其是在熟練護理方面。

That really is, like Barry mentioned, when you increase your clinical capacities and you climb the acuity chain, you're going to see that skilled growth even faster than your overall growth. And that's what I hope and I expect we'll continue to see in coming years.

就像巴里提到的那樣，當你提高臨床能力並提陞技能水平時，你會發現你的技能成長速度甚至比你的整體成長速度還要快。我希望並期待在未來幾年繼續看到這種情況。

If you look at it from a days basis, that same store and the current quarter is saying that only 31.7% of our same-store days are from skilled. And so the opportunity that we have to grow skilled across the same-store portfolio is very large, and that's why we get super excited about the organic growth not just from the skilled mix, but also from the occupancy mix, as we said in our prepared remarks, sitting at only 83% and that opportunity to have basically tons of buildings actually added if we sold it up to the markets that Barry mentioned.

如果按天來看，同一家商店和本季的數據表明，我們同店營業日中只有 31.7% 來自熟練技工。因此，我們有機會在同一家門市組合中發展技能型人才，這是非常大的機會。正因如此，我們對有機成長感到非常興奮，不僅來自技能型人才的組成，也來自入住率的組成。正如我們在準備好的演講稿中所說，目前的入住率只有 83%，如果我們將其出售給 Barry 提到的市場，實際上就有機會增加大量的建築物。

Appreciate that. Just a quick follow-up in some of your newer markets, like particularly I was saying about Alabama as you expand into that market. Can you talk about the managed care contracting environment that you see initially in those types of new markets? And how much you comment on how much of a lift it is to try to get those -- that contracting backdrop up to par with some of your more mature markets?

謝謝。我只想快速跟進一下你們的一些新市場，特別是我剛才提到的阿拉巴馬州市場，你們正在向該市場擴張。您能否談談您在這些新興市場中最初看到的醫療管理合約環境？您認為在經濟萎縮的背景下，要讓這些市場達到一些更成熟市場的水平，需要付出多大的努力？

I'll start and others can add in. It's a process, right? I mean I think, we have relationships with a lot of the contractors because in some of these states like Tennessee, there is overlap with other states that we're already in, but it still takes time to get those contracts in place, and it takes time to make sure that we're ready for the patients, right?

我先開始，其他人可以補充。這是一個過程，對吧？我的意思是，我認為我們與許多承包商都有合作關係，因為在像田納西州這樣的一些州，與我們已經開展業務的其他州存在重疊，但仍然需要時間來落實這些合同，也需要時間來確保我們為患者做好準備，對吧？

As we talked about in the prepared remarks, we're in a clinical business and growing our clinical care sets takes time. And then those partnerships to bond take up the time. And so again, you see acquisitions coming in at that lower skilled mix, you see them at lower rates. And then over time, we're able to grow it.

正如我們在準備好的演講稿中所說，我們從事的是臨床業務，發展我們的臨床護理服務需要時間。然後，建立夥伴關係又會佔用時間。因此，你會發現收購對象往往是技能水準較低的群體，收購價格也較低。然後隨著時間的推移，我們就能發展壯大它。

A.J. Rice, UBS

A.J. Rice，瑞銀集團

How about that? Can you hear me?

怎麼樣？你聽得到我嗎？

I can hear you.

我能聽到你說話。

We got you now.

我們現在抓到你了。

So I'm on the Zoom and it's a little tricky there to figure that out. I'm sorry, just a question maybe on the deal activity that you've seen this year. It sounds like the California and the Utah deals, were things that you've been pursuing for -- or thinking about for quite a while.

我現在正在使用 Zoom，但是要弄清楚這一點有點棘手。不好意思，我有一個關於您今年看到的交易活動的問題。聽起來，加州和猶他州的交易是你一直在努力爭取——或者考慮了很久的事情。

And I wondered if there is anything in the current environment, that's allowing some of this deal activity to come through, that seems like it's on a little bit of a heightened pace is our expectations between buyers and sellers as to pricing or whatever more in sync now. And you mentioned a couple of markets where you were seeing expectations elevated. I wondered are there are other buyers stepping in? Or are those deals just not getting done at this point?

我想知道，在當前的環境下，是否有什麼因素促成了這些交易活動的進行，使得交易活動似乎以更快的速度推進，是不是因為買賣雙方對價格或其他方面的預期現在更加一致了。您提到了一些市場，在這些市場中，您觀察到預期會增加。我想知道是否有其他買家介入？或者說，這些交易目前根本無法達成？

Yeah. Great question. So on the deals that we were able to close, I wouldn't say there's any special market conditions that made these happen when they did. I think it's just a matter of thinking of the Utah deal as an example, the seller there, I mean these could be pretty emotional decisions for these sellers that have built these businesses over many years. And for him, and there's a couple of owners.

是的。問得好。所以就我們最終達成的這些交易而言，我不會說有什麼特殊的市場條件促成了這些交易的發生。我認為這只是一個以猶他州交易為例的問題，那裡的賣家，我的意思是，對於那些多年來建立起這些企業的賣家來說，這些決定可能相當情緒化。對他來說，還有幾個老闆。

But I think it was just a long process of kind of preparing themselves to sort of sell their business and move on to something else. And so in a lot of these cases, it's very much driven by who they're choosing to inherit their legacy. And so yes, that's kind of that example.

但我認為這只是一個漫長的過程，他們一直在為出售自己的企業並轉向其他領域做準備。因此，在許多情況下，這很大程度上取決於他們選擇誰來繼承他們的遺產。是的，這就是那個例子。

California, obviously, that was unique because that was a portfolio that had about 30 buildings in it, and we were just taking a portion of it with the 11 buildings. So that was complicated just because there were so many moving parts with multiple operators, all trying to get their licenses, et cetera.

顯然，加州的情況比較特殊，因為那是一個包含大約 30 棟建築的投資組合，而我們只是拿走了其中的一部分，也就是 11 棟建築。所以事情很複雜，因為涉及的環節太多，有多個運營商，都在努力獲得許可證等等。

So in terms of some of the other states, I mean, we definitely have seen pockets of pricing that we think is not supported by the fundamentals. Texas has been one of those where we've seen some financial buyers come in and start to cobble together portfolios at prices that just don't make any sense, long term. And so our focus, AJ, is just we're going to stay disciplined.

所以就其他一些州而言，我的意思是，我們確實看到一些地區的定價，我們認為這些定價沒有基本面支撐。德州就是其中之一，我們看到一些金融買家湧入，開始以一些從長遠來看毫無道理的價格拼湊投資組合。所以，AJ，我們現在的重點就是保持自律。

And as Barry mentioned, we can have a choppy deal environment. But because of our multiple levers we have to pull, we're not dependent on deals just to continue our path that we've been on. So really excited about the deals we were able to close this year. And we already have some lined up for -- we have some that will close yet this year. And then we have some that are lining up for Q1 of next year.

正如巴里所提到的，我們可能會面臨動盪的交易環境。但由於我們有多種手段可以利用，我們並不依賴交易來繼續我們一直在走的道路。我對今年達成的交易感到非常興奮。我們已經安排了一些——我們還有一些項目將在今年完成。還有一些項目正在籌備中，預計將於明年第一季啟動。

Kind of hard to predict beyond that, what the pipeline for '26 will look like. But I think our approach will stay the same. And we're opportunistic in our approach and pricing is a major factor, and we'll just stay true to our principles.

很難預測2026年的發展前景。但我認為我們的方法不會改變。我們採取的是機會主義策略，定價是一個重要因素，我們將始終堅持我們的原則。

Okay. Maybe one other area. We talked before, and it seemed like it's more in the early stages, demo stages. But with this tightness in capacity and behavioral health, it sounded like you had some managed care companies asking you whether you could potentially take some of those residents, they're having trouble finding places on an inpatient psych unit or a facility to place them. I wondered if there was any update in those discussions? And are you seeing any traction with that?

好的。或許還有另一個領域。我們之前聊過，感覺它還處於早期階段，演示階段。但由於收容能力和心理健康方面的緊張狀況，聽起來好像有一些醫療管理公司問過你是否可以接收一些居民，因為他們很難在住院精神病房或機構找到安置他們的地方。我想知道那些討論是否有任何最新進展？你在這方面看到任何進展嗎？

Yeah, lots of traction, AJ. We continue to add behavior units in several of our facilities in states like Arizona and California. We've got long-standing relationships with county programs with managed care partners and we continue to build on those and add more capacity as they have demand for it. It is certainly an area that we've got a lot of experience and success with and one we hope to continue to look at growing.

是的，牽引力很強，AJ。我們繼續在亞利桑那州和加利福尼亞州等地的幾家機構中增設行為矯正單元。我們與縣級醫療管理合作夥伴建立了長期合作關係，我們將繼續鞏固這些關係，並根據他們的需求增加更多服務能力。這無疑是我們擁有豐富經驗和成功案例的領域，也是我們希望繼續發展壯大的領域。

Raj Kumar, Stephens.

Raj Kumar，史蒂芬斯。

Hi, I just want to make sure I'm coming through.

你好，我只是想確認一下我的意思表達清楚了。

I appreciate all the commentary on the clinical and quality performance differentiation for Ensign. Maybe just kind of wanted to focus on the higher acuity and the skill mix uptrend over the past few years. And overall, when you kind of look at your local markets, do you get a sense that your facilities are taking market share from other care settings, kind of thinking about inpatient rehab facilities that serve more higher acuity members. Do you get a sense that there's some market share gain from that? Or is it just predominantly being driven by just the demographic demand trends?

我非常感謝大家對 Ensign 在臨床和品質表現方面的差異化所做的評論。或許只是想重點放在過去幾年更高的敏銳度和技能組合的上升趨勢。總的來說，當你審視當地市場時，你是否感覺你的機構正在從其他護理機構（例如為病情更嚴重的患者提供服務的住院康復機構）那裡搶佔市場份額？你覺得這樣做能帶來一定的市佔率成長嗎？或者說，這主要只是人口需求趨勢所驅動的？

Yeah. I wouldn't say that there's a major shift between care settings necessarily. I mean, remember, we operated as an acute LTAC and we -- while there are certain patients that we could take in a skilled nursing setting, I wouldn't say there's a massive shifting of settings necessarily. I think it's more a function of just the increasing demand for higher acuity patients.

是的。我並不認為護理環境之間必然有重大轉變。我的意思是，別忘了，我們是一家急性長期照護機構，雖然有些病人我們可以轉到專業護理機構接受治療，但我不會說這必然會帶來大規模的機構轉變。我認為這更多是由於對病情更嚴重的患者的需求不斷增加所致。

We're seeing -- when you look at the demographics you're seeing certainly more patients in our target demographic, but we're also seeing more chronic illnesses and more comorbidities with our patients. And that's driven us to make sure that we adapt and can pivot and make sure that we've got the right training, the right personnel, the right ability to care for those patients and continue to add more and more of those complex services.

我們看到——從人口統計數據來看，我們的目標群體中的患者數量確實更多了，但我們也看到我們的患者患有更多的慢性疾病和更多的合併症。正是這種動力促使我們不斷調整和轉型，確保我們擁有合適的訓練、合適的人員、合適的能力來照顧這些患者，並不斷增加這些複雜的服務。

Got it. And then maybe just one more on kind of the organic growth potential ahead that you framed in your prepared remarks. Just maybe wondering if you could frame it from a market share perspective in terms of what the market share is in your mature markets? How much more room there is on that front? And then kind of maybe thinking about those transitioning and newly acquired facilities and the market share gain potential there?

知道了。然後，或許可以再就您在準備好的發言稿中提到的未來有機成長潛力再談一點。或許您可以從市場佔有率的角度來談談，例如您在成熟市場中的市佔率是多少？這方面還有多少提升空間？然後或許可以考慮那些正在轉型和新收購的設施，以及它們在這些地區獲得市場份額的潛力？

Certainly, the organic opportunity is obviously something we pointed out and for good reason. There is massive upside in every one of our key markets for growth as we continue to develop and evolve. Suzanne mentioned establishing those managed care partnerships and how that takes some time. And as you kind of get through those hoops and establish those relationships, those gains happen over a long, long period of time. It's not something that happens in a year or even 2-years.

當然，有機成長的機會顯然是我們指出的，而且是有充分理由的。隨著我們不斷發展和進步，我們所有主要市場都蘊藏著巨大的成長潛力。蘇珊娜提到了建立這些醫療管理合作關係，以及這需要一些時間。當你克服重重困難並建立起這些關係之後，這些收益會在很長很長一段時間內逐漸顯現。這不是一年甚至兩年內就能發生的事。

It's something that happens over many years. Because even as you add new services, you've got to make sure that the results align with the addition of those services and that your partners, especially our managed care partners are satisfied with the outcomes that we're getting.

這是多年累積的結果。因為即使你增加了新的服務，你也必須確保結果與這些新增服務相符，並且你的合作夥伴，特別是我們的醫療管理合作夥伴，對我們所取得的成果感到滿意。

So it's a long-standing evolution, but there's a ton of upside. We try to point out in our examples, how even some of the most mature buildings continue to make those gains. That's why -- there's usually at least one or two examples of buildings that we've had for a long, long period of time like Beacon, that have continued to evolve over the course of almost 10-years now and see gains, not just in an overall occupancy standpoint, but growth -- continued growth in skilled mix as they refine and adjust and add new services.

所以這是一個長期演變的過程，但前景非常廣闊。我們在例子中試圖指出，即使是一些最成熟的建築也能繼續取得這些進展。這就是為什麼——我們通常至少會找到一兩棟像 Beacon 這樣已經存在了很長時間的建築，它們在近 10 年的時間裡不斷發展，不僅在整體入住率方面取得了進步，而且在技能組合方面也取得了持續增長，因為它們不斷改進、調整併增加新的服務。

So I don't know, Spencer, anything you want to add to that?

所以，史賓塞，你還有什麼要補充的嗎？

I think that's great. And there really is -- there's also this tailwind that's been going for a long, long time that we're working hard to make sure that we position ourselves right for. And that's this desire of payers to find the lowest-paying setting where high acuity services can be offered.

我覺得這很棒。確實如此——我們還面臨著一股持續了很長時間的順風，我們正在努力確保我們能夠抓住這股順風帶來的機會。這就是為什麼支付方希望找到能夠提供高水準醫療服務且支付費用最低的場所的原因。

And whether it's the latest ACO models that come out from CMS or whether it's just managed care doing what they do, that's something that really positions us to continue to do what Beacon is starting to do. They're part of a couple of ACOs, by example. As we continue to position ourselves as a high-quality, low-cost alternatives to some of these other settings, it really makes a difference and it gives us a lot of hope for the long run.

無論是 CMS 最新推出的 ACO 模式，還是醫療管理機構的日常運作，這都讓我們能夠繼續做 Beacon 正在做的事情。例如，他們是幾個ACO（責任醫療組織）的成員。當我們繼續將自己定位為高品質、低成本的替代方案，以取代其他一些場所時，這確實會產生影響，也讓我們對長遠發展充滿希望。

Clarke Murphy, Truist Securities

克拉克墨菲，Truist Securities

Hey everyone. So just wanted to come back to you guys continue to deliver really solid results and your newer facilities have been a particular area of strength. Can you just kind of give us a sense for if there are any common themes behind how quickly your new facilities are contributing to your overall results?

大家好。所以，我只是想再次感謝你們，你們一直都取得了非常紮實的成績，而且你們的新設施尤其出色。您能否大致介紹一下，您的新設施為何能如此迅速地為整體業績做出貢獻，其背後是否存在任何共同的主題？

And then I kind of wanted to just touch on your expansion a little bit in the Southeast. Anything you guys have noticed in that region that's meaningfully different than you thought or expected in terms of demand trends, labor availability, ability to attract clinical talent or just kind of anything else in the Southeast?

然後，我還想稍微談談你們在東南部的擴張情況。你們有沒有註意到東南地區在需求趨勢、勞動力供應、吸引臨床人才的能力或其他方面，與你們想像或預期的有什麼顯著不同？

Maybe I can start a little bit and then Barry and Spencer can add in. I mean, I think when you look at that recently acquired bucket, we -- after the acquisitions that we just announced this week, we'll have 68 locations in that recently acquired bucket.

或許我可以先做一點，然後巴里和史賓賽再加入。我的意思是，如果你看一下最近收購的那些地點，在我們本週剛宣布的收購之後，我們將有 68 個地點屬於最近收購的那些地點。

And so when you were looking at the revenue contribution, it's quite significant compared to prior years with over mix. If you just look at through the quarter, we had about 15.5% of our revenue coming from that recently acquired bucket, and it will be even higher (inaudible) that in Q4. It's a large portion of what we're dealing (inaudible) acquisitions been contributing.

因此，從收入貢獻的角度來看，與往年產品組合過於多元化的情況相比，這項貢獻相當顯著。如果只看本季度，我們約有 15.5% 的營收來自最近收購的業務，而且第四季這個比例還會更高（聽不清楚）。這是我們處理的大部分事情（聽不清楚）收購所貢獻的。

Now we've always said when they first come on with us, it takes a while to turn. And I think the managed care comments that we've been talking about, and that process that we've been talking about, and those clinical systems that we've been talking about are all part of that. And so that contribution at the beginning is pretty light when you start to go down to the bottom line, but over time, it grows.

我們一直都說，他們剛加入我們的時候，需要一段時間才能改變觀念。我認為我們一直在談論的醫療管理評論、我們一直在談論的流程以及我們一直在談論的臨床系統都是其中的一部分。因此，在初期階段，當你開始深入分析最終結果時，這部分貢獻相當少，但隨著時間的推移，它會成長。

I mean I think if you zoom out and look at our margins, in spite of the fact that these new acquisitions, and there have been a lot of them aren't really contributing nearly what they should be or what they will, our margins have stayed steady, which speaks to how well they were transitioned because usually, we see somewhat of a drag when we acquired the pace that we have been over the last many months.

我的意思是，如果你從更宏觀的角度來看我們的利潤率，儘管這些新的收購（而且收購數量很多）並沒有真正貢獻到它們應該貢獻的或將會貢獻的金額，但我們的利潤率仍然保持穩定，這說明它們的過渡非常順利，因為通常情況下，當我們以過去幾個月來的速度進行收購時，我們會看到一些拖累。

So they're certainly ahead of schedule from that perspective, but I would tell you that they're nowhere near what their potential will be, obviously. But contributing in a way that is pretty exciting for us as they come in ahead of their pro forma expectations.

所以從這個角度來看，他們的進度肯定超前了，但我必須說，他們顯然還遠遠沒有達到他們的潛力。但他們的表現超出了預期，這讓我們感到非常興奮。

But as you look at the Southeast and our growing portfolio in that market, we're pretty excited about it. All of those transitions in Alabama and Tennessee have been really, really good transitions. They're not all contributing yet, but we see the potential.

但當我們審視東南地區以及我們在該市場不斷成長的業務時，我們感到非常興奮。阿拉巴馬州和田納西州的所有這些過渡都非常非常成功。雖然他們目前還沒有全部做出貢獻，但我們看到了他們的潛力。

We have some amazing leaders out there, a couple of great market leaders and also some really great facility leaders who are really kind of moving the dial and showing some pretty significant signs of what we could be out there, which gives us a lot more confidence to keep growing out there. We continue to look for opportunities to strengthen that Southeast portfolio and add some more buildings.

我們有一些非常優秀的領導者，幾位傑出的市場領導者，還有一些非常優秀的設施領導者，他們正在真正地推動變革，並展現出我們未來發展的巨大潛力，這讓我們更有信心繼續發展壯大。我們將繼續尋找機會，加強我們在東南地區的投資組合，並增加一些樓盤。

Yeah, I'd just add to your first question about, is there a process change? When you understand how we acquire, the process really is, you've got -- it's operations driven. You've got, in any given market, a large amount of operators and clinicians that are part of the acquisition, underwriting and transitioning process.

是的，我只想補充你的第一個問題，流程是否有改變？當你了解我們的收購方式時，你會發現整個過程實際上是由營運驅動的。在任何特定市場中，都有大量的營運商和臨床醫生參與收購、承銷和過渡過程。

And as you'd expect, as we have all those people doing it and as we've taken on deal over the last 4- or 5-years, we've learned a lot. And that gets shared. And our job is to make sure that there's a forum for best practice sharing. And we think what you see with some of these is that you see lessons learned that are being applied.

正如你所預料的那樣，由於我們有這麼多人參與其中，並且在過去 4 到 5 年裡我們接手了許多交易，我們學到了很多東西。而且這些資訊會被分享出去。我們的工作是確保有一個分享最佳實踐的平台。我們認為，從這些案例中可以看出，人們吸取了教訓並正在應用這些教訓。

And so while we're not guaranteeing that all acquisitions will go ever more smoothly. On the aggregate, you're seeing good practices from operators that are shared widely and then put into practice, and we've been really pleased with what's come of that with the speed of our improvements.

因此，雖然我們不能保證所有的收購都會越來越順利。總的來說，我們看到營運商們廣泛分享並實踐了良好的做法，我們對這些做法帶來的改進速度感到非常滿意。

Great. And then just another quick one for me. Just -- I appreciate some of the higher-level labor comments that you guys gave. But is there anything that you can tell us a little bit more specifically in terms of metrics around wage inflation, turnover? Are you guys still not using any contract labor to achieve continued solid results? And just anything that you guys are doing on the labor front to drive improvement? Thanks.

偉大的。然後我再快速地吃一個。我只是——我很感謝你們提出的一些關於高層次勞動方面的意見。但是，在薪資通膨、人員流動等指標方面，您能否更具體地告訴我們一些資訊？你們至今仍不使用任何合約工來取得持續穩定的業績嗎？你們在勞工方面都做了哪些工作來推動改善？謝謝。

Go ahead, Spencer. You can start, and I'll follow up.

請繼續，斯賓塞。你可以先開始，我會跟進。

Yeah. I'll start maybe really granularly and then we can go up from there. We are using some contract labor. It's very, very minimal. It's less than one-fifth of what we used just a couple of years ago kind of in the staffing crisis.

是的。我可能會先從非常細緻入微的地方開始，然後我們再逐步深入。我們聘用了一些合約工。它非常非常簡潔。這還不到我們幾年前在人員短缺危機期間所用量的五分之一。

What we tend to see is our new acquisitions of the three buckets tend to use the most. It's still relatively less than it used to be. But our same-store is very, very, very minimal. I mean it's the small minority of our same store that has any contract labor right now.

我們通常看到的是，我們新購買的三種桶裝水往往使用量最大。雖然仍然比以前少，但仍然相對較少。但我們的同店銷售額非常、非常、非常低。我的意思是，現在我們這家店裡只有極少數人會僱用合約工。

Yeah. And just to add, certainly, it's close to pre-COVID level. But I would add that wage inflation is back to normal levels, low to mid-single digits. And as we saw before, turnover is probably, I think, on its fourth year of decline for us and just really solid overall labor trends.

是的。另外補充一點，目前確實接近新冠疫情前的水準。但我還要補充一點，薪資通膨已經恢復到正常水平，處於個位數低到中等水平。正如我們之前所看到的，我認為，我們的員工流動率可能已經連續第四年下降，而且整體勞動市場趨勢非常穩健。

There are no further questions at this time. This concludes today's call. Thank you for attending. You may now disconnect.

目前沒有其他問題了。今天的電話會議到此結束。謝謝各位的出席。您現在可以斷開連線了。