Ensign Group Inc (ENSG) 2025 Q4 法說會逐字稿

Ladies and gentlemen, thank you for joining us, and welcome to the Ensign Group Inc fourth quarter fiscal year 2025 earnings conference call. (Operator Instructions) I will now hand the conference over to Mr. Keetch. Please go ahead.

女士們、先生們，感謝各位的到來，歡迎參加 Ensign Group Inc 2025 財年第四季財報電話會議。（操作說明）我現在將會議交給基奇先生。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 February 27, 2026. We want to remind anyone that might be listening to a replay of this call that all the statements made are as of today, February 5, 2026, and these statements have not been nor will be updated subsequent to today's call.

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2026年2月27日下午5:00。我們想提醒所有可能正在收聽本次電話會議重播的人士，所有聲明均截至今日（2026 年 2 月 5 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 the 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 the SEC filings for a more complete discussion of factors that could impact our results. 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.

聽眾不應過度依賴前瞻性陳述，建議查閱美國證券交易委員會的文件，以更全面地了解可能影響我們績效的因素。除聯邦證券法要求外，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。

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.

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。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。

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. Ensign also owns Standard Bearer Healthcare REIT, 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.

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某些索賠發生製保險，涵蓋一般責任險、職業責任險以及工傷賠償保險責任。Ensign 還擁有 Standard Bearer Healthcare REIT，這是一個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。

The words Ensign, company, we, our and us refer to the Ensign Group Inc and its consolidated subsidiaries. All of our independent subsidiaries, the Service Center, Standard Bearer Healthcare REIT and the insurance captive are operated by separate independent companies that have their own management, employees and assets. References here into the consolidated company and its assets and activities as well as the use of 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.

Ensign、公司、我們、我們的和我們指的是 Ensign Group Inc 及其合併子公司。我們所有的獨立子公司，包括服務中心、Standard Bearer Healthcare REIT 和保險自保公司，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。在此提及合併後的公司及其資產和活動，以及使用「我們」、「我們的」等字眼，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 in the exclusion of GAAP reports. A GAAP to non-GAAP reconciliation is available in yesterday's press release and available in our Form 10-K.

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，但不應依賴這些措施來排除 GAAP 報告。昨天的新聞稿中提供了 GAAP 與非 GAAP 的調整表，我們的 10-K 表格中也提供了調整表。

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

接下來，我將把電話交給我們的執行長巴里·波特。巴里？

Thanks, Chad, and thank you all for joining us today. We're excited to report another record year and record quarter in several key areas. To start, I want to highlight the extraordinary clinical outcomes achieved by our dedicated and talented caregivers. None of the results, which we will discuss today are possible without the outstanding work being done by these amazing nurses, therapists, dietitians, food service professionals, activities coordinators and the many others whose unwavering commitment shapes the daily care experience for thousands of patients across our portfolio. It's difficult to convey in words how so many individuals work so hard to achieve such amazing outcomes through so many small moments of selfless service.

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年份和季度。首先，我想專注於我們敬業且才華洋溢的醫護人員所取得的卓越臨床成果。今天我們將要討論的所有成果，都離不開這些傑出的護士、治療師、營養師、餐飲服務專業人員、活動協調員以及其他許多人員的辛勤工作，他們的堅定奉獻塑造了我們旗下數千名患者的日常護理體驗。很難用語言來形容這麼多人是如何透過無數無私奉獻的小事，辛勤工作，最終取得如此驚人的成就的。

Having a front row seat to these amazing people is humbling to say the least. And while the point of these quarterly calls is to provide investors a financial update, let there be no mistake that our consistent financial results would not be possible without a relentless patient-focused culture that drives our frontline partners to deliver the highest quality clinical outcomes supported by a family-like atmosphere where everyone genuinely cares about one another. There are several measurements that showcase our clinical excellence. For example, according to the most recently published CMS data, same-store Ensign-related operations 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 only possible by achieving sustained clinical performance over time.

能近距離接觸這些了不起的人，真是令人感到無比榮幸。雖然這些季度電話會議的目的是向投資者提供財務更新，但毫無疑問，如果沒有以患者為中心的堅定不移的文化，我們不可能取得持續的財務業績。這種文化激勵著我們的第一線合作夥伴提供最高品質的臨床結果，並在一個像家庭一樣的氛圍中，讓每個人都真心關懷彼此。有多項指標可以反映我們的臨床卓越性。例如，根據 CMS 最新公佈的數據，與 Ensign 相關的同店營運在年度調查結果中，州級表現比同業高出 24%，縣級表現高出 33%，成績斐然。只有透過長期持續的臨床表現，才能取得如此卓越的成績。

In that same data set, Ensign affiliated operations also maintained a 19% advantage in overall four and five star rated buildings when compared to their peers. This is particularly noteworthy given that the majority of these communities were one and two star facilities at the time of acquisition. In addition, our same-store operations continue to outperform their industry peers and five-star quality measure results by delivering 22% better results on a national level and 17% above the state level. Together, these results underscore our ability to become the provider of choice in our communities by delivering consistently better quality of care, creating long-term value across our portfolio, and we'll expand on that more throughout this call. This clinical strength depends upon attracting and retaining top-notch talent in every operation.

在同一資料集中，與同業相比，Ensign 旗下企業在四星級和五星級建築的整體評級方面也保持了 19% 的優勢。考慮到這些社區在收購時大多是一星級或二星級設施，這一點尤其值得注意。此外，我們的同店營運表現繼續優於行業同行，並在五星級品質指標方面取得了優異成績，在全國範圍內比同行高出 22%，在州一級高出 17%。這些結果共同凸顯了我們有能力透過持續提供更高品質的醫療服務，在我們的業務組合中創造長期價值，成為我們社區的首選醫療服務提供者，我們將在本次電話會議中對此進行更詳細的闡述。這種臨床實力取決於在各個營運環節中吸引和留住頂尖人才。

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. On the retention side, we continue to experience improvements in turnover, stable wage growth and lower staffing agency usage even in the face of increased occupancy. We are especially proud of the exceptionally low turnover amongst our directors of nursing. Over the past few years, DON turnover has declined by 33%, placing us amongst the performers in the industry and reinforcing the stability and leadership consistency that drives high-quality care. 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.

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。在員工留任方面，即使入住率上升，我們也持續看到員工流動率改善、薪資穩定成長以及人力資源機構使用率下降。我們尤其為護理主任極低的流動率感到自豪。過去幾年，護理部主任 (DON) 的更替率下降了 33%，使我們躋身行業領先行列，並鞏固了推動高品質護理的穩定性和領導層的一致性。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。

Our clinical achievements are bearing fruit in many ways. On the census front, our same-store and transitioning occupancy increased to 83.8% and 84.9% during the quarter, which are both all-time highs. On the skilled mix front, we saw an increase across all payers. More specifically, skilled days increased for both our same-store and transitioning operations by 8.5% and 10%, respectively, over the prior year quarter. We also saw Medicare revenue increased for both our same-store and transitioning operations by 15.7% and 11.3%, respectively, and an increase in our same-store Medicare days of 11% over the prior year quarter.

我們的臨床成果正在多方面結出碩果。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 83.8% 和 84.9%，均為歷史最高水準。在技​​能組合方面，我們看到所有支付方的技能組合均有所增加。更具體地說，與去年同期相比，我們同店和轉型業務的熟練工時分別增加了 8.5% 和 10%。我們也看到，同店和過渡業務的 Medicare 收入分別成長了 15.7% 和 11.3%，同店 Medicare 天數比去年同期成長了 11%。

In addition, we saw managed care revenue increase for both our same-store and transitioning operations by 8.9% and 15%, respectively. The primary reason for these improvements is expanding the trust of the communities our teams serve through the clinical outcomes that they have achieved that I described earlier.

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 8.9% 和 15%。這些改進的主要原因是，透過我前面提到的臨床成果，增強了我們團隊所服務社區的信任。

As each operation solidifies the reputation in their respective markets, they are not only seeing more patients but they are 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. In addition, we believe we are just now starting to see increased demand for our services related to the strong demographic trends. These powerful tailwinds will only bolster our census momentum we're seeing across our portfolio, giving us confidence in the long-term growth opportunity ahead.

隨著各家診所在各自市場中不斷鞏固聲譽，他們不僅接待的患者越來越多，而且還被委以重任，照顧病情越來越複雜的患者，其中包括更多比例的聯邦醫療保險、管理式醫療和其他需要專業技能的患者。此外，我們認為，隨著強勁的人口趨勢，我們現在才剛開始看到對我們服務的需求不斷增長。這些強勁的順風只會增強我們投資組合中正在出現的普查勢頭，讓我們對未來的長期成長機會充滿信心。

While we are thrilled with our current record same-store occupancy, we are 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. As we point out during each of our earnings calls with specific facility examples, it's not uncommon to see some of our most mature operations consistently achieve and maintain occupancies in the high to mid-90s. Although many of our acquisitions in 2025 are in states that have higher occupancy levels, including California, Alaska, Utah and Washington, their occupancy levels are far below the average levels that we see from our mature campuses in these states. The organic potential in our portfolio continues to remain one of compelling opportunities to continue to drive results.

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。我們公司仍有 83% 的內生成長潛力，即使停止收購，也能維持持續的獲利和收入成長。正如我們在每次獲利電話會議上以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實現並保持 90% 以上的入住率並不罕見。儘管我們在 2025 年收購的許多項目都位於入住率較高的州，包括加州、阿拉斯加州、猶他州和華盛頓州，但它們的入住率遠低於我們在這些州的成熟園區的平均入住率。我們投資組合中的有機成長潛力仍然是持續推動績效成長的極具吸引力的機會之一。

In addition, we continue to acquire new operations with massive long-term upside with many more in the works. Since 2024, we have successfully sourced, underwritten, closed and transitioned 82 new operations across several markets, many of which are already performing at or above our expectations. We're very humbled by what we were able to accomplish in 2025, and we are eager to continue to drive organic improvements and take advantage of the acquisition opportunities that we see on the horizon. We are issuing our annual 2026 earnings guidance of $7.41 to $7.61 per diluted share and annual revenue guidance of $5.77 billion to $5.84 billion. The midpoint of this 2026 earnings guidance represents an increase of 14.3% over our 2025 results and is 36.5% higher than our 2024 results.

此外，我們也持續收購具有巨大長期成長潛力的新業務，還有更多收購項目正在籌備中。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 82 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。我們對 2025 年的成就深感榮幸，並渴望繼續推動自身發展，抓住即將到來的收購機會。我們發布 2026 年年度每股收益預期為 7.41 美元至 7.61 美元（攤薄後），年度營收預期為 57.7 億美元至 58.4 億美元。2026 年獲利預期中位數比 2025 年的業績成長 14.3%，比 2024 年的業績成長 36.5%。

We look forward to 2026 with confidence that our partners will continue to manage and innovate while balancing the addition of newly acquired operations. This annual guidance comes on top of the extraordinary growth we experienced in the last few years. To put this performance in perspective, over the last five years, our total adjusted revenue increased by $2.7 billion or 111%, representing a 16% compounded annual growth rate, while our diluted adjusted earnings per share grew by $3.44 from 2020 to 2025, representing a 16% compounded annual growth rate.

我們有信心展望 2026 年，我們的合作夥伴將繼續進行管理和創新，同時平衡新收購業務的並進。這份年度業績指引是在我們過去幾年取得非凡成長的基礎上發布的。為了更全面地了解這一業績，過去五年，我們的調整後總收入增長了 27 億美元，增幅達 111%，複合年增長率達 16%；而從 2020 年到 2025 年，我們的稀釋調整後每股收益增長了 3.44 美元，複合年增長率同樣為 16%。

In addition, we have seen adjusted net income grow by 121% with a compounded annual growth rate of 17%. This performance is not due to some large event or a single transformative transaction but instead is the result of steady consistent growth and performance quarter after quarter, which comes from a collective belief and commitment that is held by all of our partners to expand our mission in a methodical and thoughtful way.

此外，我們看到調整後的淨收入成長了 121%，複合年增長率為 17%。這項業績並非源自於某些重大事件或單一的變革性交易，而是每季持續穩定成長和業績提升的結果，這源自於我們所有合作夥伴共同秉持的信念和承諾，即以有條不紊、深思熟慮的方式拓展我們的使命。

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 had another significant few months on the acquisition front, adding 17 new operations, which includes 12 real estate assets during the quarter and since. These include a seven-building portfolio in Utah, three in Texas, two in Arizona, two in Colorado and one in each of Alabama, Kansas and Wisconsin. In total, we added 1,371 new skilled nursing beds across seven states. This growth brings the number of operations in our recently acquired group of operations to 21.7% of our entire portfolio.

謝謝你，巴里。在收購方面，我們又迎來了重要的幾個月，新增了 17 家企業，其中包括本季及之後新增的 12 項房地產資產。其中包括猶他州的七棟建築、德州的三棟建築、亞利桑那州的兩棟建築、科羅拉多州的兩棟建築，以及阿拉巴馬州、堪薩斯州和威斯康辛州各一棟建築。我們在七個州共新增了 1371 張專業護理床位。這一成長使我們近期收購的業務集團的業務數量占我們全部業務組合的 21.7%。

We were thrilled to complete these acquisitions that span across so many distinct health care markets. In each case, our local clusters are prepared to execute on their specialized building-by-building transition plans several months in advance. Overall, our growth this quarter continues to demonstrate our ability to take on multi-facility portfolios as well as our traditional singles and doubles.

我們很高興完成了這些涵蓋許多不同醫療保健市場的收購。在每種情況下，我們的本地集群都已做好準備，提前幾個月執行其專門的逐棟建築過渡計劃。總體而言，本季我們的成長繼續證明了我們有能力承接多處房產組合以及我們傳統的單間和雙間房產。

We continue to learn from and perfect our transition process and believe that those lessons are showing through in the performance of our recently acquired operations. As we've shown during the quarter and the last few years, our building-by-building approach transition works for single operations, small portfolios and larger portfolios, particularly when a large deal spans several markets and geographies.

我們不斷從過渡過程中學習並完善自身，相信這些經驗教訓正在我們最近收購的業務的表現中體現。正如我們在本季和過去幾年所展示的那樣，我們逐棟建設的轉型方法適用於單一營運、小型投資組合和大型投資組合，尤其是在大型交易跨越多個市場和地區的情況下。

We've also shown that in certain strategic situations, paying higher prices can be justified for performing assets that have newer physical plants. And while some of those deals may take a bit longer to generate the returns we expect, we've seen these deals pay off over time as our operators implement the proper clinical systems and cultural changes.

我們也證明，在某些策略情況下，為擁有較新廠房的優質資產支付更高的價格是合理的。雖然有些交易可能需要更長時間才能產生我們預期的回報，但隨著我們的營運商實施適當的臨床系統和文化變革，我們已經看到這些交易隨著時間的推移而獲得回報。

In the Stonehenge acquisition, for example, the purchase price represented a premium over our historical acquisitions in Utah. However, the high quality of the assets, the strong clinical and financial performance as well as the synergies with our existing footprint in several markets justified a higher price while still leaving room for midterm and long-term upside. And yet just a few months after closing, these operations are performing well ahead of schedule and contributing to both the strength of our clusters in Utah and the company's overall performance.

例如，在巨石陣的收購中，購買價格比我們在猶他州的歷史收購價格高出一倍。然而，這些資產的高品質、強勁的臨床和財務表現，以及與我們在多個市場現有業務的協同效應，都證明了更高的價格是合理的，同時仍然為中長期上漲留出了空間。然而，在專案完成幾個月後，這些業務的運作就遠遠超出了預期，並為我們在猶他州的業務集群的實力以及公司的整體業績做出了貢獻。

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, including small deals to larger portfolios and where it makes sense, higher-priced strategic assets. As we look at the current pipeline, we continue to see opportunities that include everything from larger portfolios, landlords looking to replace current tenants, nonprofits looking to divest of their post-acute assets and a steady flow of our traditional onesie-twosies.

雖然我們肯定會繼續評估和考慮任何可行的交易，但我們也對今年以來的發展方式感到非常滿意，我們在許多州進行了大量交易，包括小型交易、大型投資組合，以及在合理的情況下，收購價格更高的戰略資產。從目前的市場來看，我們不斷看到各種機會，包括更大的投資組合、希望更換現有租戶的房東、希望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小型房產交易。

We have several new additions lining up for Q1 of 2026, and our local leadership teams and their deal partners here at the service center are working together to source, underwrite and carefully select the right opportunities. We continue to have lots of success in closing 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 and choose us because they believe in our mission to dignify post-acute care. We are also pleased to announce a few unique new construction projects we recently completed both in California.

我們有幾項新的項目計劃於 2026 年第一季推出，我們當地的領導團隊和他們在服務中心的交易夥伴正在共同努力，尋找、評估和仔細選擇合適的機會。我們不斷成功地與賣家達成交易，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，他們選擇我們是因為他們相信我們提升康復後護理尊嚴的使命。我們也很高興地宣布，我們最近在加州完成了一些獨特的新建項目。

The first project involved working together with Omega Healthcare REIT to take advantage of several acres of vacant land on one of our leased properties. With their support and the expertise of our team of health care construction experts, we completed a 40-bed addition at Vista Knoll Specialized Healthcare in Vista, California. The expansion added much needed capacity to our specialty care unit and significantly strengthened our ability to meet the community's growing needs. Only a few months after opening, the new wing has already achieved 98.3% occupancy. We are also thrilled to have recently completed the construction and obtained the license to operate a replacement facility to one of our high-performing skilled nursing operations in San Diego County.

第一個項目是與 Omega Healthcare REIT 合作，利用我們租賃物業中的幾英畝空地。在他們的支持和我們醫療保健建築專家團隊的專業知識的幫助下，我們在加州維斯塔的維斯塔諾爾專科醫療中心完成了 40 個床位的擴建工程。此次擴建為我們的專科護理部門增加了急需的容量，並大大增強了我們滿足社區日益增長的需求的能力。新翼樓開放僅幾個月，入住率就已達 98.3%。我們也很高興地宣布，我們最近完成了聖地牙哥縣一家業績卓越的專業護理機構的替代設施的建設，並獲得了營運許可證。

Grossmont Post Acute in La Mesa, California, which is located next to Sharp Grossmont Hospital is a pillar of the local La Mesa healthcare community. But the operation was housed in an aging building and the landlord had determined to replace that aging building with new medical office space. Several years ago, we acquired land next door and endeavor to build a brand-new replacement building across the street from the original location. After several years and lots of hard work, we successfully completed the construction and we'll be moving all the patients and staff to a brand-new state-of-the-art building that will replace the old building while also adding 15 beds to the original license. We are thrilled for the city of La Mesa that we were able to find a way to continue at considerable investment to provide these critical post-acute services to the community for decades to come.

位於加州拉梅薩的格羅斯蒙特復健中心毗鄰夏普格羅斯蒙特醫院，是拉梅薩當地醫療保健社區的支柱。但診所位於一棟老舊的建築內，房東決定用新的醫療辦公空間取代這棟老舊建築。幾年前，我們收購了隔壁的土地，並努力在原址對面建造一座全新的替代建築。經過數年的努力和辛勤工作，我們成功完成了建設，我們將把所有病人和工作人員搬到一座全新的現代化大樓，這座大樓將取代舊大樓，同時在原有許可證的基礎上增加 15 張床位。我們非常高興能夠為拉梅薩市找到一種方法，透過大量的投資，在未來幾十年繼續為社區提供這些重要的康復後服務。

We are also grateful for the support of our partners at Sharp Grossmont Hospital and look forward to finding ways to continue to provide service to their patients. Both cases illustrate that there are several ways that we can carefully and selectively invest our capital to enhance our service offerings to the communities we serve. We will continue to look for opportunities to add beds to successful operations and where appropriate, to invest in newer construction in markets we know well. Our local leaders continue to recruit future CEOs for Ensign affiliated operations, and we have a deep bench of CEOs and training that are eagerly preparing for their opportunity to lead. During the quarter, we again reached an all-time high for AITs in our pipeline.

我們也感謝夏普格羅斯蒙特醫院的合作夥伴的支持，並期待找到繼續為他們的患者提供服務的方法。這兩個案例都表明，我們可以透過多種方式謹慎、選擇性地投資資本，以增強我們為所服務社區提供的服務。我們將繼續尋找機會，在營運成功的專案中增加床位，並在適當的時候，在我們熟悉的市場投資建造新的專案。我們當地的領導者繼續為 Ensign 附屬機構招募未來的 CEO，我們擁有一群優秀的 CEO 人才，並且正在接受培訓，他們都渴望抓住機會擔任領導職務。本季度，我們的在研產品數量再次創下歷史新高。

This high-quality influx of leadership talent, combined with our decentralized transition model allows us to grow without being limited by typical corporate bottlenecks. We also continue to store enough dry powder on our balance sheet to fund a significant amount of growth, including adding even more real estate assets to our portfolio. Therefore, our unique acquisition and transition strategy puts us in an excellent position to continue growing in a healthy and sustainable way. Lastly, we are also pleased with the continued growth of Standard Bearer, which added 12 new assets during the quarter and since. Standard Bearer is now comprised of 154 owned properties, of which 120 are leased to an Ensign affiliated operator and 35, which are leased to third-party operators.

大量高品質的領導人才湧入，加上我們分散式的過渡模式，使我們能夠在不受典型企業瓶頸限制的情況下成長。我們的資產負債表上也繼續儲備足夠的可用資金，以支持大量的成長，包括為我們的投資組合增加更多的房地產資產。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。最後，我們也對 Standard Bearer 的持續成長感到滿意，該公司在本季及之後新增了 12 項資產。Standard Bearer 目前擁有 154 個物業，其中 120 處租賃給 Ensign 旗下營運商，35 處租賃給第三方營運商。

We were excited to add to 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. Going forward, Standard Bearer will 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 that high-quality third parties are interested in operating under a lease.

我們很高興能夠拓展與非關聯運營商的合作關係，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。展望未來，Standard Bearer 將與我們現有的營運合作夥伴以及我們正在發展的新關係共同努力，以收購由 Ensign 將營運的業務以及高品質第三方有興趣以租賃方式運營的設施組成的投資組合。

Collectively, Standard Bearer generated rental revenue of $34.5 million for the quarter, of which $29.3 million was derived from Ensign affiliated operations. For the quarter, Standard Bearer reported $20.4 million in FFO and as of the end of the quarter, had an EBITDAR to rent coverage ratio of 2.6 times. And with that, I'll turn the call over to Spencer, our COO, to add more color around operations.

Standard Bearer 本季共計創造了 3,450 萬美元的租賃收入，其中 2,930 萬美元來自 Ensign 的關聯業務。該季度，Standard Bearer 報告的 FFO 為 2,040 萬美元，截至季度末，其 EBITDAR 與租金覆蓋率之比為 2.6 倍。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。

Spencer?

斯賓塞？

Thanks, Chad, and hello, everyone. I wanted to share two outstanding operations that have achieved sustained financial growth due to their consistent emphasis on clinical outcomes and staff development. South Bay Post Acute located near San Diego, California is a 98-bed skilled nursing operation that has been an Ensign affiliate since 2014. Like many of our same-store operations, the South Bay team, led by CEO, Lisa Simmons; and COO, Connie Narvaez, maintains a consistent focus on improving both clinical and financial performance year after year. The facility has long been recognized for strong quality outcomes as reflected in its five-star CMS ratings for quality measures, health inspections and overall performance.

謝謝查德，大家好。我想分享兩家傑出的醫療機構，它們透過持續重視臨床結果和員工發展，實現了持續的財務成長。位於加州聖地牙哥附近的南灣復健護理中心是一家擁有 98 個床位的專業護理機構，自 2014 年以來一直是 Ensign 的附屬機構。與我們許多同店營運一樣，由執行長 Lisa Simmons 和首席營運長 Connie Narvaez 領導的 South Bay 團隊，始終專注於逐年提高臨床和財務表現。該機構長期以來因其卓越的品質成果而備受認可，其在品質指標、健康檢查和整體表現方面均獲得了 CMS 五星級評級。

Over the past year, the team identified an opportunity to expand its community impact by developing specialized capabilities to care for bariatric patients, a growing but historically underserved population in post-acute care. Successfully serving this population required a disciplined clinical and operational strategy.

過去一年，該團隊發現了一個擴大其社區影響力的機會，即發展專門的能力來照顧肥胖症患者，這是一個不斷增長但長期以來在急性後期護理方面服務不足的群體。成功服務這群人需要一套嚴謹的臨床和營運策略。

The facility leadership team started by visiting a highly successful Ensign affiliate that has become the top-performing bariatric operation in Arizona. Building on what they learned, South Bay remodeled rooms, invested in specialized equipment and engaged both external experts and its in-house therapy team to develop protocols and provide staff training to safely and effectively treat bariatric patients. The team also expanded behavioral health support and implemented both group and individual therapies tailored to this population.

該機構領導團隊首先參觀了一個非常成功的 Ensign 附屬機構，該機構已成為亞利桑那州業績最好的減肥手術機構。南灣醫院在吸取經驗的基礎上，改造了病房，投資了專用設備，並聘請了外部專家和內部治療團隊，制定了治療方案，並為員工提供培訓，以安全有效地治療肥胖症患者。該團隊還擴大了行為健康支持，並實施了針對該族群的團體和個人治療。

By addressing the clinical and operational challenges that hospitals face when placing bariatric patients, South Bay positioned itself as a reliable solution for complex discharges. These efforts contributed to both improved patient outcomes and measurable reputational improvement. Health plans and referring acute partners have taken note, and South Bay has recently been awarded additional high reimbursement contracts. These clinical accomplishments have inevitably resulted in financial growth. In the fourth quarter, earnings before income tax increased 127% compared to the prior year quarter.

透過解決醫院在安置肥胖症患者時面臨的臨床和營運挑戰，南灣醫院將自己定位為複雜出院流程的可靠解決方案。這些努力既改善了患者的治療效果，也顯著提升了醫院的聲譽。醫療保險計劃和轉診急性病合作夥伴都注意到了這一點，南灣最近獲得了更多高額報銷合約。這些臨床成就必然帶來了經濟成長。第四季度，稅前利潤比上年同期成長了127%。

Notably, this growth occurred in an operation that transitioned more than a decade ago and entered the year with very high occupancy. While overall occupancy increased modestly from 96% to 97%, the more meaningful impact occurred in payer and acuity mix. Skilled revenue mix increased 25%, driven in part by an 86% increase in Medicare days, while managed care volume grew 22%. With a continued focus on staff well-being and comprehensive high-quality care, the South Bay team is demonstrating how clinical specialization can drive sustainable occupancy, skilled mix improvement and financial performance and allow a long-time affiliate to elevate year-over-year results a decade after acquisition. The second highlight is Shoreline Health and Rehabilitation located in North Seattle, Washington.

值得注意的是，這一成長發生在一個十多年前轉型且年初入住率非常高的企業中。雖然整體入住率從 96% 略微上升到 97%，但更有意義的影響發生在支付方和病情嚴重程度構成方面。熟練醫療收入佔比增長了 25%，部分原因是 Medicare 服務天數增長了 86%，而醫療管理業務量增長了 22%。南灣團隊持續關注員工福祉和提供全面的高品質護理，正在證明臨床專業化如何能夠推動可持續的入住率、技能組合的改善和財務業績，並使一家長期附屬機構在收購十年後逐年提升業績。第二個亮點是位於華盛頓州西雅圖北部的海岸線健康與復健中心。

This is an example of an operation that recently moved from transitioning into our same-store category. Since acquisition, the 114-bed skilled nursing operation has been led by CEO, Clayton South; and COO, Ruby Cor Shoreline is an excellent example of maintaining a disciplined focus on finding, developing and retaining exceptional care staff. For example, in 2025, the facility's CMS nursing turnover rate was 60% lower than the state average and the tenure of frontline staff was over seven years on average, remarkable in an industry that is challenged by high turnover. This resulted in significant decreases in overtime costs and allowed Shoreline to operate with zero registry staffing for the second consecutive year.

這是一個近期從轉型進入我們同店類別的營運案例。自收購以來，這家擁有 114 個床位的專業護理機構一直由執行長 Clayton South 和首席營運長 Ruby Cor 領導。 Shoreline 就是一個很好的例子，它總是專注於尋找、培養和留住優秀的護理人員。例如，到 2025 年，該機構的 CMS 護理師流動率比州平均低 60%，第一線員工的平均任期超過 7 年，這在流動率高的行業中是相當了不起的。這使得加班成本大幅降低，並讓 Shoreline 連續第二年實現了零註冊人員配備。

Having stable satisfied staff results in better care, fewer patients returning to acute hospitals and cost savings for health plans and hospital systems alike. Throughout the year, Shoreline served as a preferred provider within the Providence Swedish and University of Washington Health Systems, which allowed facility leaders to meet monthly with acute providers and learn ways to become the solution to their challenges.

擁有穩定且滿意的員工隊伍，可以帶來更好的護理，減少患者再次入院治療的情況，並為醫療保險計劃和醫院系統節省成本。在這一年中，Shoreline 一直是 Providence Swedish 和華盛頓大學健康系統的首選供應商，這使得各機構的領導者能夠每月與急性護理供應商會面，學習如何成為他們所面臨挑戰的解決方案。

A clear example of this partnership occurred when the hospitals expressed difficulty placing patients requiring TPN, a complex and resource-intensive service that is normally provided only in the acute care setting. Ruby and her team evaluated the clinical requirements, implemented additional staff training and coordinated closely with their physician group and pharmacy partners. As a result, Shoreline is now the only facility in the North Seattle area accepting TPN patients.

這種合作關係的一個明顯例子是，當醫院表示難以安置需要 TPN 的患者時，TPN 是一種複雜且資源密集的服務，通常只在急性護理環境中提供。Ruby 和她的團隊評估了臨床需求，實施了額外的員工培訓，並與他們的醫生團隊和藥房合作夥伴密切協調。因此，Shoreline 現在是西雅圖北部地區唯一接收 TPN 患者的醫療機構。

This capability has also driven admissions across a broader range of skilled diagnoses. By investing in its workforce and positioning itself as a solution to hospital discharge constraints, Shoreline continues to strengthen its standing as a high-performing clinically sophisticated provider of choice in its market. As a result of all those efforts, the Shoreline team achieved record financial performance for four consecutive quarters. In Q4, Shoreline's revenues increased by 11% compared to the prior year quarter, while EBIT rose by nearly 33% over the same period, while overall occupancy growth was modest and occupancy remains below 74%. The team executed on their strategy to increase clinical capabilities and care for higher acuity skilled patients, which allowed skilled revenue mix to grow to 70%.

這項能力也推動了更多需要專業診斷的患者的入院治療。透過投資員工隊伍並將自身定位為解決醫院出院限制的方案，Shoreline 不斷鞏固其作為市場上高績效、臨床技術精湛的首選醫療服務提供者的地位。由於這些努力，Shoreline 團隊連續四個季度取得了創紀錄的財務表現。第四季度，Shoreline 的營收比去年同期成長了 11%，息稅前利潤比去年同期成長了近 33%，但整體入住率成長不大，入住率仍低於 74%。該團隊執行了提高臨床能力和護理更高危重症患者的策略，使高風險收入佔比增長到 70%。

Medicare days increased 24% and managed care improved 103% over prior year quarter. Because of this acuity strategy, Shoreline accomplished record results in 2025 and has significant opportunity to continue to increase occupancy and grow results long into the future. With that, I'll turn the time over to Suzanne to provide more detail on the company's financial performance and our guidance.

Medicare 服務天數較上年同期成長 24%，醫療管理服務改善 103%。由於這一敏銳的策略，Shoreline 在 2025 年取得了創紀錄的業績，並且在未來很長一段時間內有很大的機會繼續提高入住率和業績成長。接下來，我將把時間交給蘇珊，讓她詳細介紹公司的財務表現和我們的指導。

And then we'll open it up for some questions. Suzanne?

然後我們會開放提問環節。蘇珊？

Thank you, Spencer, and good morning, everyone. Detailed financials for the year and the quarter are contained in our 10-K and press release filed yesterday. Some additional highlights for the year and the quarter compared to the prior year include the following for the year, GAAP diluted earnings per share was $5.84, an increase of 14.1%. Adjusted diluted earnings per share was $6.57, an increase of 19.5%. Consolidated revenue was $5.1 billion, an increase of 18.7%. GAAP net income was $344 million, an increase of 15.4% and adjusted net income was $386.6 million, an increase of 20.6%.

謝謝你，史賓塞，大家早安。年度和季度的詳細財務數據已包含在我們昨天提交的 10-K 表格和新聞稿中。與前一年相比，本年度和本季的其他亮點包括：本年度 GAAP 稀釋後每股收益為 5.84 美元，成長 14.1%。調整後的稀釋每股收益為 6.57 美元，成長 19.5%。合併收入為 51 億美元，成長 18.7%。GAAP淨利為3.44億美元，成長15.4%；調整後淨利為3.866億美元，成長20.6%。

For the quarter, GAAP diluted earnings per share was $1.61, an increase of 18.4%. Adjusted diluted earnings per share was $1.82, an increase of 22.1%. Consolidated revenue was $1.4 billion, an increase of 20.2%. GAAP net income was $95.5 million, an increase of 19.8%. Adjusted net income was $107.8 million, an increase of 23.2%.

本季，GAAP稀釋後每股收益為1.61美元，成長18.4%。調整後的稀釋每股收益為 1.82 美元，成長 22.1%。合併收入為 14 億美元，成長 20.2%。GAAP淨利為9,550萬美元，成長19.8%。調整後淨收入為 1.078 億美元，成長 23.2%。

Other key metrics as of December 31, 2025, include cash and cash equivalents of $504 million and cash flow from operations of $564 million. During 2025, we spent more than $500 million to execute on our strategic growth plan. We made these investments from a position of strength as shown by our record low lease adjusted net debt-to-EBITDA ratio of 1.77 times after taking these investments into consideration.

截至 2025 年 12 月 31 日，其他關鍵指標包括現金及現金等價物 5.04 億美元，以及經營活動產生的現金流量 5.64 億美元。2025年，我們投入超過5億美元用於執行我們的策略成長計畫。我們之所以進行這些投資，是因為我們的財務狀況非常穩健，經調整後的租賃淨債務與 EBITDA 比率創歷史新低，僅為 1.77 倍（已將這些投資考慮在內）。

Our continued ability to maintain low leverage even during periods of significant acquisition is particularly noteworthy and demonstrates our commitment to disciplined growth as well as our belief that we can continue to achieve sustainable growth in the long run. In addition, we have more than $590 million available on our line of credit, which when combined with our cash on our balance sheet, gives us over $1 billion in dry powder for future investments.

即使在進行重大收購期間，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實現永續成長。此外，我們還有超過 5.9 億美元的可用信貸額度，加上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 160 assets, 136 of which are completely debt-free. They are gaining significant value over time and adding even more liquidity to help with future growth. During the quarter, the company increased its dividend for the 23rd consecutive year and paid a quarterly cash dividend of $0.065 per common share. We have a long history of paying dividends. And as the company's liquidity remains strong, we plan to continue our long history of paying dividends into the future.

我們也擁有 160 項資產，其中 136 項完全沒有債務。隨著時間的推移，它們的價值顯著提升，並增加了更多流動性，以幫助未來的成長。本季度，該公司連續第 23 年提高股息，並支付了每股普通股 0.065 美元的季度現金股息。我們有著悠久的派發股利歷史。由於公司流動性依然強勁，我們計劃繼續維持長期以來派發股息的傳統。

As Barry mentioned, we provided our annual 2026 earnings guidance between $7.41 to $7.61 per diluted share and our annual revenue guidance between $5.77 billion and $5.84 billion. We have evaluated multiple scenarios and based upon our strength in our performance and 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，我們給出的 2026 年年度每股收益預期為 7.41 美元至 7.61 美元（稀釋後），年度收入預期為 57.7 億美元至 58.4 億美元。我們已經評估了多種方案，並且基於我們強大的業績和入住率及技能人才組合方面取得的積極勢頭，以及在勞動力、代理管理和其他運營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 2026 guidance is based on diluted weighted average common shares outstanding of approximately 60 million, a tax rate of 25%, the inclusion of acquisitions closed and expected to be closed during the first quarter of 2026, the inclusion of management's expectation for reimbursement rates with the primary exclusions coming from stock-based compensation and amortization of system implementation costs. 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 the general economy on census and staffing, short-term impact of our acquisition activities, variations in insurance accruals and other factors.

我們對 2026 年的業績預期是基於約 6,000 萬股稀釋加權平均流通普通股、25% 的稅率、已完成和預計在 2026 年第一季完成的收購、管理層對報銷率的預期，主要排除項為股票選擇權費用和系統實施成本攤銷。其他可能影響季度業績的因素包括報銷制度的變化、州預算的延遲和變化、入住率和技能組合的季節性變化、總體經濟對人口普查和人員配備的影響、我們收購活動的短期影響、保險計提的變化以及其他因素。

And now I'll turn it back over to Barry. Barry?

現在我把麥克風交還給巴瑞。巴里？

Thanks, Suzanne. As we wrap up, we can't emphasize how -- enough how incredibly honored and grateful we are to work alongside our operational leaders and our service center team here that are behind these record-setting results. We never cease to be amazed by their impressive resiliency as they focus on supporting one another in new and innovative ways. Their commitment has blessed the lives of so many, including our own, and we're excited about our future because of these amazing partners. We have complete faith in them and the culture that they've collectively built.

謝謝你，蘇珊。最後，我們無法充分強調，我們多麼榮幸和感激能夠與我們的營運領導和客戶服務中心團隊並肩工作，正是他們創造了這些破紀錄的成績。他們展現出的驚人韌性總是讓我們感到驚嘆，他們不斷以創新方式互相支持。他們的付出造福了許多人，包括我們自己，我們因為這些了不起的合作夥伴而對未來充滿期待。我們完全信任他們以及他們共同建立的文化。

With that, we'll turn it over to our Q&A portion of the call. Operator, will you please provide instructions on the Q&A.

接下來，我們將進入電話會議的問答環節。操作員，請您提供問答方面的說明。

(Operator Instructions)

（操作說明）

Clarke Murphy, Truist Securities.

克拉克墨菲，Truist Securities。

Congrats on the quarter and the guide. Just wanted to start out on M&A. It sounds like you're perhaps seeing some more opportunities to come around with a more diverse group of sellers than you've talked about in the past. So can you guys just talk about what you're seeing in terms of the pipeline, valuations, et cetera? And has anything changed about how you guys are approaching opportunities? And then finally, just are there any markets or geographies in particular, where you're seeing opportunity?

恭喜你本季業績和指南發布。只是想開始了解併購方面的內容。聽起來你似乎看到了更多與更多樣化的賣家群體合作的機會，這與你過去談到的情況有所不同。那麼，你們能談談你們目前在專案儲備、估值等方面看到的情況嗎？你們對待機會的方式有沒有什麼改變？最後，您是否特別關注某些市場或地區，並認為這些地區有機會？

Yes. I appreciate the question. So we certainly are seeing a pretty healthy pipeline. I would probably describe the market as seller-friendly in terms of values have risen. And I think because of that, a lot of people are bringing their stuff for sale.

是的。感謝您的提問。所以，我們目前確實看到產品線發展勢頭良好。就房價上漲而言，我可能會將當前市場描述為對賣方有利。我認為也因為如此，很多人都把自己的東西拿來出售。

So we're seeing new deals frequently that are opportunities for us. So -- and yes, I would also say that pricing has definitely gone up. All that said, as I said in my prepared remarks, we are seeing tons of our traditional onesie-twosies and smaller portfolios in addition to that, some larger ones. I wouldn't say that the way we've looked at deals has changed. I would just kind of point out, though, is, again, as we talked about in the prepared remarks, when there are high-quality assets that newer construction, have higher occupancies and higher skilled mix, those sometimes deserve a premium.

因此，我們經常看到新的交易機會。所以——是的，我也要說價格肯定上漲了。綜上所述，正如我在準備好的演講稿中所說，我們看到了大量的傳統小型投資組合，除此之外，還有一些較大的投資組合。我不會說我們看待交易的方式改變了。不過，我想指出的是，正如我們在準備好的發言稿中提到的，當出現高品質的資產，例如新建的、入住率更高的、技能水平更高的房產時，這些房產有時理應獲得溢價。

And we've recently shown that we would do that in the Utah acquisition that we closed during the quarter. And so -- and those are performing really well. So for us, when we talk about disciplined growth, we definitely are looking to make sure that there's a pathway both in the short run, medium range and the long term to create shareholder value. But the total cost of the acquisition, it means when you're buying an older asset, sometimes the amount you have to spend to bring it up to current standards and then maintain it over time, the CapEx spend can actually be quite heavy.

我們最近在猶他州的收購案中已經證明了這一點，該收購案是我們本季完成的。所以——而且它們的表現都非常出色。因此，對我們來說，當我們談到穩健成長時，我們肯定是在尋求確保在短期、中期和長期內都有一條創造股東價值的途徑。但收購的總成本，意味著當你購買一項較舊的資產時，有時你必須花費一定金額才能使其達到當前標準，然後隨著時間的推移進行維護，資本支出實際上可能相當高昂。

And so buying newer assets can be something that we're looking to do. And so that's not necessarily new but I just wanted to highlight that as something we're seeing. But certainly excited about the opportunities that we have for 2026.

因此，收購較新的資產可能是我們正在考慮的事情。所以這雖然不是什麼新鮮事，但我只是想強調我們正在看到的這種現象。但對於2026年我們所擁有的機遇，我感到非常興奮。

Okay. Great. And then just kind of shifting gears a little bit. Can you guys give us some color on things you're doing on the labor environment, specifically your agency labor continues to come down. You guys talked about the director of nurse and the CEOs and training where you continue to have success. Can you just kind of talk about some of the drivers there and how we should think about continued improvement going forward on the labor front?

好的。偉大的。然後就稍微轉換一下話題。你們能否詳細介紹一下你們在勞動環境方面所採取的措施，特別是你們的派遣員工數量持續下降的情況？你們談到了護士長、執行長和培訓，以及你們持續成功的面向。您能否談談其中的一些驅動因素，以及我們應該如何考慮在勞工方面持續改善？

Yes. Great question. A couple of things. I mean there's -- you've got your macro environmental factors, which can influence. But I'd say the way to think about it is health care, especially for us, is a very locally driven business.

是的。問得好。有幾件事。我的意思是，宏觀環境因素也會產生影響。但我認為，看待這個問題的方式是，醫療保健，尤其對我們來說，是一個非常本地化的行業。

And as we do better at things like our initiative to decrease Director of Nursing turnover, what you've got is you've got this stability of leadership. You've got relationships that allow the frontline caregivers to feel like they found a home and they can produce great care outcomes. So we believe that focusing on leadership stability then allows those COO and CEO caliber leaders to create environments where people want to stay.

隨著我們在降低護理主任流動率等措施上做得越來越好，我們就擁有了穩定的領導階層。你們建立的人際關係讓第一線護理人員感覺像找到了家一樣，他們也能取得良好的照護效果。因此，我們認為，專注於領導層的穩定性，可以讓那些首席營運長和執行長級別的領導者創造出人們願意留下的環境。

We're very optimistic about both our ability to continue to make progress and have good stability in our labor and also in our ability to, as we acquire facilities, have that same model, have the similar results where with time and with the right people, you're going to see labor numbers get better and better. And I would just say, I guess, the final thing is, with this, you've got agency but you've also got overtime, and we're excited to see that overtime is moving in the same direction.

我們對自身能力充滿信心，相信能夠繼續取得進步，保持勞動力的穩定；同時，隨著我們收購設施，我們也能採用同樣的模式，取得類似的成果，隨著時間的推移和合適人才的加入，勞動力狀況將會越來越好。最後我想說的是，有了這項政策，你既擁有了自主權，也獲得了加班費，我們很高興看到加班費也朝著同一個方向發展。

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，加拿大皇家銀行資本市場。

Congrats on the quarter. Just wanted to ask a reimbursement question, specifically on Medicare fee-for-service, the Part A piece. We've gotten some questions over the new value-based purchasing program metrics and how those factor in. I would assume that you're pretty well positioned that given some of the nursing turnover and retention commentary you've provided. But then just looking at some of the other measures that have kind of rolled on to the program like the health care associated infections, just wondering kind of how you're faring there and what your outlook is given that you do have a higher acuity patient base versus the rest of the industry. Any comments or observations into the year?

恭喜你本季取得佳績。我想問一個關於報銷的問題，特別是關於醫療保險按服務收費的A部分。我們收到了一些關於新的基於價值的採購計劃指標以及這些指標如何發揮作用的問題。鑑於你對護理人員流動和留任情況的一些評論，我認為你在這方面處於相當有利的地位。但是，考慮到其他一些措施也已納入該計劃，例如醫療保健相關感染，我想知道你們在這方面做得如何，以及鑑於你們的患者群體病情比業內其他機構更為嚴重，你們的前景如何。今年有什麼評論或看法嗎？

It's a great question, Ben. I think when we kind of look across any time a new program is implemented, we get excited when the state or the federal government looks to quality and looks for us to be measured upon quality. And this is another one where when we can look at the quality metrics and it's clearly outlined, we have an opportunity to showcase how we can do it and have our clinical leaders really lead out on that. And so when we look at these quality metrics, we -- like we always do, have dashboards and other things that allow us then to ensure that we are measuring those outcomes and measuring them and giving that information to our frontline staff and then show that we can do it really, really well.

這是一個很好的問題，本。我認為，每當有新計畫實施時，我們都會感到興奮，因為州政府或聯邦政府重視質量，並希望我們以品質來衡量。而在這方面，當我們能夠查看品質指標並清楚地了解它們時，我們就有機會展示我們是如何做到的，並讓我們的臨床領導者真正發揮領導作用。因此，當我們查看這些品質指標時，我們——就像我們一直以來所做的那樣——會使用儀錶板和其他工具來確保我們能夠衡量這些結果，並將這些資訊提供給我們的第一線員工，然後向他們展示我們能夠做得非常出色。

Yes. And I'd just say with -- I echo what Suzanne said, and with these changes that they make in things like value-based purchasing, the nice thing is we have signals from them years in advance. We know for the most part, where they're going. And so this isn't something that caught us off guard. These are things we've been focused on building foundations to deal with and to be exceptional at for years.

是的。我只想說——我同意 Suzanne 的說法，隨著他們在價值導向型採購等方面做出的這些改變，好處是我們能提前幾年收到他們的訊號。我們大致知道他們要去哪裡。所以這件事並沒有讓我們措手不及。多年來，我們一直致力於為應對這些挑戰打下堅實的基礎，並力求在這些方面做到卓越。

And so again, that starts with great quality, local leadership and then having the ability to kind of see around the corner of what's coming, which CMS signals. And so I'm very encouraged that we'll be able to continue to up our quality and do well in these programs.

所以，這一切又回到了高品質、本地領導力以及預見未來趨勢的能力上，CMS 就是這種能力的體現。因此，我非常有信心我們能夠繼續提高質量，並在這些項目中取得好成績。

And because we've got a world-class team of clinicians and data services folks that are able to analyze and package the data and create dashboards and tools that our clinicians on the front lines can use. Our ability to adapt to these changes is probably unlike any other post-acute provider. It's an amazing thing to see how our teams are able to kind of assimilate all these changes and get the information assembled in a really useful kind of ready-to-use way.

因為我們擁有一支世界一流的臨床醫生和數據服務人員團隊，他們能夠分析和包裝數據，並創建第一線臨床醫生可以使用的儀表板和工具。我們適應這些變化的能力可能是其他任何一家復健護理機構都無法比擬的。令人驚訝的是，我們的團隊能夠消化所有這些變化，並將資訊整理成一個真正有用且隨時可用的形式。

Appreciate that commentary. Just a quick follow-up. Is there a risk that these types of programs could steepen the ramp on some of these turnaround acquisition opportunities?

感謝您的評論。再補充一點。這些類型的計劃是否有可能加快某些扭虧為盈收購機會的步伐？

I mean, I think that's more a function of the changes we see in acuity that kind of steepen the ramp. When you take on acquisitions that are historically averse to acuity, that's the bigger kind of challenge that we see rather than these kind of unique nuances in how CMS measures things. So for us, our focus is on improving capabilities first and making sure clinical leadership and all the right tools are implemented so that there's an alignment of the direction we're headed. Our leaders are almost uniformly focused on bringing capabilities up to speed when we go into a building. And then as they do that, everything else kind of falls into place because all of the systems that they're able to lean on through our one clinical program align with kind of what they're already trying to do.

我的意思是，我認為這更多地與我們看到的視力變化有關，這些變化會使變化曲線更加陡峭。當你收購那些歷來對敏銳度有所抵觸的公司時，我們看到的挑戰遠比 CMS 衡量事物方式上的這些獨特細微差別要大得多。因此，我們的重點首先是提高能力，確保臨床領導力和所有正確的工具得到落實，從而使我們前進的方向保持一致。我們的領導幾乎一致地專注於在我們進入大樓時迅速提升各項能力。然後，當他們這樣做的時候，其他一切都會迎刃而解，因為他們能夠透過我們的一個臨床計畫所依賴的所有系統都與他們已經嘗試做的事情相一致。

Raj Kumar, Stephens.

Raj Kumar，史蒂芬斯。

Maybe just one on kind of clicking into the commentary around just further expansion and opportunity with same-store occupancy and that being able to sustain kind of the organic growth momentum you've seen over the past couple of years. Seeing how 2025 showcased 200 basis points of improvement. I'm just kind of curious on what the magnitude in terms of guidance is kind of baked into 2026. And then maybe just any color on seasonality expectations would be helpful as well.

或許可以稍微深入探討一下關於進一步擴張和同店入住率提升以及能否維持過去幾年所看到的自然增長勢頭的評論。2025 年的數據顯示出 200 個基點的改善。我只是有點好奇，2026 年的指導方針的規模究竟有多大。或許，用顏色來表示季節性預期也會有所幫助。

Yes, it's a great question. I think that our expectation is that 2026 will, in many ways, mirror what we saw in 2025. We always kind of caution about seasonality, and it's somewhat of an unpredictable factor when it comes to what the summer months will look like in the end. But we're coming off of a couple of really strong years in those months that -- where seasonality has been much lighter. We'll always see skilled mix decline in the middle of the year. But I think the way we look at our -- we forecast our progress in the future, we kind of see overall occupancy headed in a similar direction to what we saw progress through last year.

是的，這是一個很好的問題。我認為，我們預計 2026 年將在許多方面與 2025 年的情況類似。我們總是對季節性因素保持謹慎，因為夏季最終會是什麼樣子，這是一個難以預測的因素。但過去幾年，這些月份的銷售業績都非常強勁，季節性影響也小得多。年中時，我們總會看到技能型勞動力的組成出現下滑。但我認為，從我們看待未來發展的方式來看，我們預測未來的發展趨勢，整體入住率的發展方向與去年的發展趨勢類似。

Got it. And then maybe just kind of thinking about some of the incremental investments in 2026. I'm just curious on maybe any kind of utilization or integration of AI across different functions of the operations or any build-out of clinical capabilities? And then also maybe just on the one point around some of the construction projects, whether or not that's -- if there's kind of something in the future around that or these are just more opportunistic in nature that you highlighted today and how we should kind of think about that from the longer-term perspective?

知道了。然後或許可以考慮一下 2026 年的一些增量投資。我只是好奇人工智慧是否會在營運的不同職能部門中得到某種形式的利用或整合，或者是否會在臨床能力方面得到任何提升？另外，關於一些建設項目，我們是否應該從長遠角度考慮一下——這些項目在未來是否會產生某種影響，或者它們只是像您今天強調的那樣，具有更多的投機性質？

Yes. Look, AI is kind of the buzzword of the day for sure. We have been highly involved in looking at opportunities where we can leverage mostly our existing partnerships with a lot of our enterprise providers for our different software systems, ERP, our clinical documentation systems and things like that to kind of leverage the data and information that we have in a more effective way.

是的。你看，人工智慧現在絕對是個熱門詞彙。我們一直積極尋找機會，利用我們與眾多企業供應商（包括我們的各種軟體系統、ERP、臨床文件系統等）的現有合作關係，以更有效的方式利用我們擁有的數據和資訊。

And we've already achieved a lot of great advances in some of those areas, both on the financial side and also now looking more into the clinical side. I think our inclination will be to kind of leverage what our enterprise partners are doing first but we have also undertaken several projects using more kind of off-the-shelf solutions that AI can provide us that are cost effective and allow us to be a little more nimble.

我們在其中一些領域已經取得了許多重大進展，無論是在財務方面，還是現在正在更多地關注臨床方面。我認為我們傾向於先利用企業合作夥伴正在做的事情，但我們也開展了幾個項目，使用人工智慧可以為我們提供更多現成的解決方案，這些方案成本效益高，並且使我們能夠更加靈活。

We've got a lot of those projects underway. And we've got a great committee and thought leadership assembled that provides us steering and guidance to make sure that we're choosing the right projects in an effective and again, thoughtful and deliberate way that will be primarily helpful to those that have a lot of kind of mundane administrative things that can be solved with some of that technology. But looking more into the future, we're really excited about how we can leverage the data that we have about our patients and residents and use that information and leverage that information by our caregivers to make better and more nimble clinical decisions. So there's some exciting things that are kind of on the horizon in that area for us that we look forward to.

我們正在進行很多這樣的計畫。我們組建了一個優秀的委員會和思想領袖團隊，為我們提供指導，確保我們以有效、周全和深思熟慮的方式選擇正確的項目，這將主要幫助那些有很多瑣碎的行政事務可以通過一些技術來解決的人。但展望未來，我們非常興奮地看到，我們可以利用我們擁有的關於患者和居民的數據，並讓我們的護理人員利用這些資訊做出更好、更靈活的臨床決策。所以，在這個領域，有一些令人興奮的事情即將發生，我們非常期待。

Yes. On the construction question, we are really excited about the projects that we talked about today, and there's really kind of two categories there. One is adding beds to existing operations where there's clearly demand for extra beds but also land and capability to build. So that's something we're looking at doing. And the second was a replacement facility.

是的。關於建設方面的問題，我們對今天討論的項目感到非常興奮，這些項目實際上可以分為兩大類。一種方法是在現有營運場所增加床位，因為那裡顯然需要額外的床位，但同時也需要土地和能力來建造床位。所以這是我們正在考慮要做的事情。第二個是替代設施。

Building a brand-new building is really time-consuming and expensive, especially when you're starting with an empty operation and going through the Medicare certification process is costly. So where you can do a replacement facility and essentially you start with a new building, but you've moved the staff and the patients over on day one, it makes for a whole lot quicker return on that significant investment. So those are two things we're looking at. We've recently beefed up our kind of construction capabilities, bringing in some experts that do this stuff. And it's always kind of -- anyone that's done any new construction understands that especially COVID and everything, having third parties that are not necessarily aligned with you on how to manage costs and all that can be challenging.

建造一棟全新的建築非常耗時且耗力，尤其是在從零開始運作的情況下，辦理醫療保險認證的過程也成本高昂。所以，如果你可以重建一個設施，基本上是從一座新建築開始，但第一天就把員工和病人都轉移過去，那麼這項重大投資就能更快獲得回報。所以，這是我們目前關注的兩件事。我們最近加強了這方面的施工能力，並引進了一些這方面的專家。而且，任何進行過新建工程的人都知道，尤其是在新冠疫情等各種因素的影響下，第三方在成本控制等方面未必與你保持一致，這可能會帶來挑戰。

And so we've kind of learned some lessons through doing this that having that capability in-house would be really helpful. So we're assessing our portfolio and trying to pick a handful of projects like this that would be sort of the lowest hanging fruit. And it obviously won't ever kind of compare to kind of our overall acquisition strategy but it is an important tool that we have and one that we'll do more and more of, especially in our most mature markets.

因此，透過這樣做，我們學到了一些教訓，那就是擁有內部這種能力真的很有幫助。所以我們正在評估我們的投資組合，並試著挑選一些像這樣的、最容易實現的項目。顯然，它永遠無法與我們的整體收購策略相提並論，但它是我們擁有的一個重要工具，我們將越來越多地使用它，尤其是在我們最成熟的市場中。

A.J. Rice, UBS.

A.J. Rice，瑞銀集團。

This is James on for A.J. I just wanted to see if you can provide an update on the traction you're seeing in taking on managed care patients on the behavioral health side as some of these MCOs have had some trouble finding facilities to place these patients? And just any update on up there?

我是 James，替 A.J. 來。我想請您報告一下，您在接收行為健康方面的管理式醫療病患方面進展如何？因為有些管理式醫療機構在尋找安置這些患者的機構方面遇到了一些困難。上面那邊有什麼最新消息嗎？

I mean I think a good example of what you're asking about is, again, we referred to this in our highlighted remarks, although we didn't give a lot of detail on what the purpose for the new addition was at Vista Knoll but that new unit we just constructed that's now essentially full after just a couple of months is entirely dedicated to behavioral patient use and highlights the growing need that you're mentioning, James.

我的意思是，我認為你所問的一個很好的例子是，我們在重點評論中也提到了這一點，雖然我們沒有詳細說明Vista Knoll新擴建部分的用途，但我們剛剛建造的那個新單元，在短短幾個月內就基本滿了，完全用於行為健康患者，這突顯了你提到的日益增長的需求，James。

So there is a need out there, no question. I would say that it's a focus of ours to do it in a deliberate and thoughtful way in markets that make sense. We have -- and we've mentioned this in prior calls but we've got a strategy to do just that in some of our more mature markets like California, Arizona and Texas. With some others that are looking at it closely, too, and we do it certainly in careful partnership with the managed care plans that are having those needs.

所以，市場確實存在這種需求，這點毋庸置疑。我認為，我們的重點是在合理的市場中，以深思熟慮的方式開展業務。我們已經制定了策略，將在加州、亞利桑那州和德克薩斯州等一些較成熟的市場中實施此策略。我們也曾在先前的電話會議中提到過這一點。還有一些人也密切關注此事，我們當然會與有這些需求的醫療管理計畫進行謹慎的合作。

And so it's something that I think you'll probably hear more about as we go into the future. I wouldn't call it something that's a critical core strategy, rather, it's a strategy that certain markets are focused on implementing based on the needs that they're seeing.

所以，我認為隨著時間的推移，你可能會聽到更多關於這方面的消息。我不會稱之為關鍵的核心策略，而是一項某些市場根據自身需求而著重實施的策略。

Yes. And I would just add, it's not just behavioral health but really looking at the specialty programs where there's a need. So it's really partnership like we always have of working with the managed care organizations to see what their needs are and then developing with them solutions to meet those needs.

是的。我還要補充一點，這不僅是行為健康問題，而是要真正關注那些有需求的專科課程。所以，這其實是一種夥伴關係，就像我們一直以來與醫療管理機構合作一樣，了解他們的需求，然後與他們一起制定解決方案來滿足這些需求。

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。