Sabra Health Care REIT Inc (SBRA) 2023 Q4 法說會逐字稿

Good day, every one, My name is Mandy, and I will be your conference operator today. At this time, I'd like to welcome everyone to the Sabra fourth quarter 2023 earnings call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question-and-answer session.(Operator Instructions) I would now like to turn the call over to Lukas Hartwich, SVP, Finance. Please go ahead, Mr. Herbert.

大家好，我叫曼迪，今天我將擔任你們的會議操作員。此時此刻，我歡迎大家參加 Sabra 2023 年第四季財報電話會議。所有線路均已靜音，以防止任何背景噪音。演講者發言後，將進行問答環節。（操作員說明）我現在想將電話轉給財務高級副總裁 Lukas Hartwich。請繼續，赫伯特先生。

Thank you and good morning. Before we begin, I want to remind you that we will be making forward-looking statements in our comments and in response to your questions concerning our expectations regarding our future financial position and results of operations, including our earnings guidance for 2024 and our expectations regarding our tenants and operators in our expectations regarding our acquisition, disposition and investment plans.

謝謝你，早安。在開始之前，我想提醒您，我們將在我們的評論中做出前瞻性陳述，並回答您有關我們對未來財務狀況和經營業績的預期的問題，包括我們對 2024 年的盈利指引以及我們對我們的租戶和營運商對我們的收購、處置和投資計畫的期望。

These forward-looking statements are based on management's current expectations and are subject to risks and uncertainties that could cause actual results to differ materially, including the risks listed in our Form 10-K for the year ended December 31, 2023, as well as in our earnings press release included as Exhibit 99.1 to the Form 8-K we furnished to the SEC yesterday. We undertake no obligation to update our forward-looking statements to reflect subsequent events or circumstances, and you should not assume later in the quarter that the comments we make today are still valid. In addition, references will be made during this call to non-GAAP financial results.

這些前瞻性陳述是基於管理階層目前的預期，並受到可能導致實際結果產生重大差異的風險和不確定性的影響，包括我們截至2023 年12 月31 日止年度的10-K 表格中列出的風險，以及我們的收益新聞稿包括我們昨天向 SEC 提供的 8-K 表格中的附件 99.1。我們沒有義務更新我們的前瞻性陳述以反映後續事件或情況，您不應在本季度稍後假設我們今天發表的評論仍然有效。此外，本次電話會議也將提及非公認會計準則財務表現。

Investors are encouraged to review these non-GAAP financial measures as well as the explanation and reconciliation of these measures to the comparable GAAP results included on the Financials page of the Investors section of our website at Sotera Health.com. Our Form 10 K earnings release and supplement can also be accessed in the Investors section of our website.

我們鼓勵投資者查看這些非 GAAP 財務指標，以及這些指標與可比較 GAAP 結果的解釋和調節，這些結果包含在我們 Sotera Health.com 網站投資者部分的財務頁面上。我們的 10 K 表格收益發布和補充也可以在我們網站的投資者部分訪問。

And with that, let me turn the call over to Rick Matros, CEO. President and Chair of Sabra Health Care REIT.

接下來，讓我將電話轉給執行長 Rick Matros。Sabra 醫療保健房地產投資信託基金總裁兼主席。

Thanks, Lucas. Good, everybody. Appreciate you joining us. We're pleased to report continuing stability and organic growth in our portfolio. In our skilled portfolio, occupancy is up 50 basis points sequentially and 290 basis points year over year our EBITDA rent coverage is up 0.1 point sequentially, with similar improvement in our top 10 in the aggregate. While labor is tough, the improvement over the last year is material contract labor is down 29% on a patient day basis. And nursing all in is up just 4.3% on a patient day basis. And the combination of that coming down and our revenue per patient day growing at the rate that has been growing the skilled portfolio has put us in a position where in the aggregate, our portfolio's margins are pretty much where they were at pre pandemic.

謝謝，盧卡斯。好，大家。感謝您加入我們。我們很高興地報告我們的投資組合持續穩定和有機成長。在我們的熟練投資組合中，入住率環比增長了 50 個基點，同比增長了 290 個基點，我們的 EBITDA 租金覆蓋率環比增長了 0.1 個百分點，在我們的前 10 名總體中也有類似的改善。雖然勞動力很艱苦，但與去年相比有所改善的是，以患者日計算，材料合約勞動力下降了 29%。以患者日計算，護理總費用僅增加 4.3%。這種下降以及我們每個病人每天的收入以不斷增長的熟練投資組合的速度增長，使我們處於這樣的境地：總體而言，我們投資組合的利潤率幾乎與大流行前的水平相同。

And so the really good news there is we're not even at pre-pandemic occupancy. So we see a really a really terrific opportunity ahead of us in terms of margins improving over where they were on a pre pre pandemic. We also continue to see improve it in the senior housing lease portfolio occupancy is up 130 basis points sequentially and direct rent coverage jump 0.11. Talya will talk in detail about our SHOP portfolio for both skilled and senior housing portfolios. We expect occupancy to exceed pre-pandemic levels, as I said, but the reason is on different for each of the two different asset classes. So for skilled, it's a demographic coupled with a declining product and for senior housing, it's a demographic combined with the negligible new supply for the foreseeable future. We appreciated that CMS in numerous states have been capturing cost increases in reimbursement rates, and we're optimistic that we'll continue at the state level this summer and for fiscal year 2025 for CMS, our behavioral and specialty hospital portfolios had stable port stable performance. We have provided full year guidance for the first time since before the pandemic with 5% and 6% increases in normalized FFO and normalized FFO respectively. At the midpoint of guidance. We're also starting to see more investment opportunities, but no clear trends as of yet.

因此，真正的好消息是，我們甚至還沒有達到疫情前的入住率。因此，就利潤率而言，我們看到了一個非常好的機會，比疫情前的水平有所改善。我們也持續看到高級房屋租賃組合入住率的改善，較上季上升 130 個基點，直接租金覆蓋率躍升 0.11。 Talya 將詳細討論我們針對技能住房和老年住房投資組合的 SHOP 產品組合。正如我所說，我們預計入住率將超過大流行前的水平，但對於兩種不同的資產類別，原因各不相同。因此，對於技術人員來說，這是一個人口結構加上不斷下降的產品；對於老年住房來說，這是一個人口結構加上可預見的未來可忽略不計的新供應。我們讚賞許多州的CMS 一直在應對報銷率方面的成本增加，我們樂觀地認為我們將在今年夏天繼續在州一級進行，並且對於CMS 的2025 財年，我們的行為和專科醫院投資組合具有穩定的港口穩定表現。自疫情爆發前以來，我們首次提供全年指引，標準化 FFO 和標準化 FFO 分別成長 5% 和 6%。處於指導的中點。我們也開始看到更多的投資機會，但目前還沒有明確的趨勢。

And with that, I will turn the call over to Talya.

然後，我會將電話轉給塔莉亞。

Thank you, Rick. Sabra's entire wholly owned managed senior housing portfolio, maintained positive momentum in the fourth quarter with mid to high-teens percentage growth in revenue and cash net operating income on a year-over-year basis. This was a function of continued occupancy and RevPAR gains, coupled with moderating expenses, quarterly occupancy in independent living, assisted living and memory care in our managed portfolio is the highest it has been since the second quarter of 2020.

謝謝你，瑞克。Sabra 的整個全資管理高級住房投資組合在第四季度保持了積極的勢頭，收入和現金淨營業收入同比增長了中到高百分比。這是持續入住率和每間可用房收入增長的結果，加上費用的減少，我們管理的投資組合中獨立生活、輔助生活和記憶護理的季度入住率達到了2020 年第二季度以來的最高水平。

Sabra's same-store wholly owned portfolio currently consists of 51 properties, of which 28 are independent living and 23 are assisted living memory care communities. The headline numbers for this portfolio, excluding nonstabilized assets and government stimulus are as follows. Occupancy for the fourth quarter of 2023 was 81.2%, a year-over-year increase of 130 basis points, the highest occupancy for this portfolio over the past five quarters. Revenue for in the fourth quarter of 2023 increased by 4% over the fourth quarter of 2022.

Sabra的同店全資投資組合目前由51處房產組成，其中28處為獨立居住，23處為輔助生活記憶護理社區。此投資組合的總體數據（不包括不穩定資產和政府刺激措施）如下。2023年第四季的入住率為81.2%，年增130個基點，是該投資組合過去五個季度以來的最高入住率。2023年第四季的營收比2022年第四季成長4%。

Current increases for asking rents and renewals are in the 5% to 7% range more moderate than prior years. As anticipated, cash NOI for the quarter grew 12.2% over fourth quarter 2022 more recently in January 2020. For this portfolio's cash NOI posted an increase of more than 25% compared to January 2023. The performance of Sabra same-store assisted living portfolio was attributable to strong gains made by nearly every one of the operators managing these communities. While the foundation was set by our spirit portfolio, which was transitioned from Enlivant in mid 2023, nearly every operator was able to drive RevPAR while managing export in Spirit portfolio. About half of our same store assisted living portfolio experienced cash NOI growth of 14.5% sequentially and 21% year-over-year.

目前租金要價和續租的漲幅在 5% 至 7% 之間，比前幾年更為溫和。正如預期的那樣，該季度的現金 NOI 比 2022 年第四季度增長了 12.2%，最近的時間是 2020 年 1 月。與 2023 年 1 月相比，該投資組合的現金 NOI 成長了 25% 以上。Sabra 同店輔助生活組合的表現歸功於幾乎每位管理這些社區的業者所取得的強勁收益。雖然我們的烈酒產品組合奠定了基礎（該產品組合於 2023 年中期從 Enlivant 過渡），但幾乎每個業者都能夠在管理烈酒產品組合出口的同時提高 RevPAR。我們約一半的同店輔助生活投資組合的現金 NOI 較上季成長 14.5%，較去年同期成長 21%。

We continue to see operational financial and cultural improvement in these communities since the transition, the same-store pool of properties in our unconsolidated joint venture with Sienna, excluding non-stabilized assets and government stimulus had 2.5% higher occupancy in the fourth quarter on a year over year basis with a 159% increase in cash NOI in the same periods, the drivers are occupancy increases and 5.7% higher RevPAR, coupled with 9.1% lower exports leading to cash NOI margin expansion of 12.7% in the fourth quarter on a year over year basis, our net leased stabilized senior housing portfolio continues to perform well with occupancy well above pre-pandemic levels.

自轉型以來，我們繼續看到這些社區的營運財務和文化得到改善，我們與Sienna 的未合併合資企業中的同店物業池（不包括不穩定資產和政府刺激措施）在第四季度的入住率比去年同期成長了2.5%。同期現金 NOI 年增 159%，驅動因素是入住率增加和 RevPAR 提高 5.7%，加上出口下降 9.1%，導致第四季度現金 NOI 利潤率同比增長 12.7%與去年相比，我們的淨租賃穩定高級住房投資組合繼續表現良好，入住率遠高於大流行前的水平。

And steadily improving rent coverage. At the end of the fourth quarter, Sabra's total investment in behavioral health remained approximately $800 million. I want to point out that the trailing 12-month statistics in the supplemental one quarter in arrears for our behavioral health portfolio shows a slight downward trend over the prior quarter for both occupancy and rent coverage. This is largely a function of changes in the pool of properties, including the addition of our Monroeville residential treatment center to the stabilized pool in the second quarter. Monroeville currently operates at a lower occupancy rate than the rest of the pool, but continues to cover its rent payment.

並穩步提高租金覆蓋率。截至第四季末，Sabra 在行為健康方面的總投資仍約為 8 億美元。我想指出的是，我們的行為健康投資組合拖欠的補充季度的過去 12 個月的統計數據顯示，入住率和租金覆蓋率較上一季略有下降。這在很大程度上是財產池變化的結果，包括第二季將我們的門羅維爾住宅治療中心添加到穩定池中。門羅維爾目前的入住率低於其他地區，但仍能繼續支付租金。

And with that, I will turn the call over to Michael Costa, Sabra's Chief Financial Officer.

接下來，我會將電話轉給 Sabra 財務長 Michael Costa。

Thanks, Dahlia. For the fourth quarter of 2023, we recognized normalized FFO per share of $0.32 and normalized AFFO per share of $0.33 during the quarter we saw an $800,000 decrease in cash rents compared to the third quarter, primarily due to the sale of a portfolio of 13 skilled nursing and two senior housing assets during the third quarter. Also during the fourth quarter, we updated our estimates of performance based compensation, which resulted in an increase to general and administrative expense totaling $5.1 million, of which $3.8 million relates to the first three quarters of 2023 and has normalized out of our fourth quarter normalized FFO and normalized AFFO. These amounts were partially offset by a $300,000 increase in normalized AFFO from our managed senior housing portfolio as a result of improved rates and occupancy.

謝謝，大麗花。2023 年第四季度，我們確認每股標準化FFO 為0.32 美元，每股標準化AFFO 為0.33 美元，該季度現金租金比第三季度減少了80 萬美元，主要是由於出售了由13 名技術人員組成的投資組合第三季的護理和兩項高級住房資產。同樣在第四季度，我們更新了基於績效的薪酬估計，這導致一般和管理費用總計增加510 萬美元，其中380 萬美元涉及2023 年前三個季度，並且已從第四季度的正常化水平恢復正常。FFO 和標準化 AFFO。由於費率和入住率的提高，我們管理的高級住房投資組合中標準化 AFFO 增加了 30 萬美元，部分抵消了這些金額。

This quarter, we are pleased to introduce full year earnings guidance for the first time since the start of the pandemic throughout the pandemic, Sabra and many of our peers did not issue full year guidance because the uncertain operating landscape in the industry made it difficult to project expected financial performance with a high level of conviction as an industry interest 2024 with a much improved operational environment. And as Sabra specifically interest 2024, with the majority of our portfolio transitions and repositioning is behind us, we have a much clearer line of sight into the expected performance of our portfolio for the coming year. Our estimated ranges for the full year 2020 for performance on a diluted per share basis are as follows. Net income $0.53 to $0.57, FFO $1.33 to $1.37, normalized FFO of $1.34 to $1.38 normalized FFO $1.38 to $1.42 and normalized adjusted FFO of $1.39 to $1.43. As a reminder, our guidance does not assume any acquisition or disposition activity.

本季度，我們很高興自疫情爆發以來首次推出全年盈利指引。在整個大流行期間，Sabra 和我們的許多同行並未發布全年盈利指引，因為行業運營環境的不確定性使得我們很難項目預計2024 年的財務表現將成為產業利益，營運環境將大大改善。由於 Sabra 特別關注 2024 年，我們的大部分投資組合轉型和重新定位已經過去，因此我們對來年投資組合的預期表現有了更清晰的認識。我們對 2020 年全年稀釋每股業績的估計範圍如下。淨利潤為 0.53 美元至 0.57 美元，FFO 為 1.33 美元至 1.37 美元，標準化 FFO 為 1.34 美元至 1.38 美元，標準化 FFO 為 1.38 美元至 1.42 美元，標準化調整後 FFO 為 1.39 美元至 1.43 美元。提醒一下，我們的指南不假設任何收購或處置活動。

I also want to point out a few things on our 2024 guidance. At the midpoint of our normalized FFO and normalized AFFO ranges, we expect to realize year-over-year growth of approximately 5% and 6%, respectively, which would be the 1st year of earnings growth for Sabra since the start of the pandemic, our guidance also assumes a return to a more normalized run rate of cash G&A of approximately $36.8 million in 2024 compared to $39.5 million in 2023. As discussed on previous earnings calls, we have no floating rate debt outside of balances on our line of credit.

我還想指出有關 2024 年指導的一些事項。在我們標準化的 FFO 和標準化的 AFFO 範圍的中點，我們預計將分別實現約 5% 和 6% 的同比增長，這將是 Sabra 自大流行開始以來第一年實現盈利增長，我們的指導還假設2024 年現金管理費用將恢復到約3,680 萬美元，而2023 年為3,950 萬美元。正如之前的財報電話會議所討論的那樣，除了信用額度餘額之外，我們沒有浮動利率債務。

Therefore, we expect cash interest expense in 2024 to remain consistent with 2023 with any variability coming from changes in outstanding borrowings on our line of credit. Our current quarterly dividend of $0.3 per share would represent an 85% payout using the midpoint of our normalized AFFO guidance. Our expected earnings growth throughout our guidance range would also reduce our leverage from current levels and closer to our long-term average target.

因此，我們預計 2024 年的現金利息支出將與 2023 年保持一致，但我們的信貸額度中未償還借款的變化會導致任何變化。我們目前的季度股息為每股 0.3 美元，相當於我們標準化 AFFO 指引中位數的 85%。我們在整個指導範圍內的預期獲利成長也將使我們的槓桿率從當前水平降低並接近我們的長期平均目標。

Now briefly turning to the balance sheet. Our net debt to adjusted EBITDA ratio was 5.74 times as of December 31, 2023. And as noted earlier and on previous calls, we expect leverage to naturally decrease as the performance in our portfolio continues its recovery from the pandemic. We remain committed to a long-term average leverage target of 5 times and are confident we can achieve that target over time without needing to access the capital markets.

現在簡單地轉向資產負債表。截至 2023 年 12 月 31 日，我們的淨負債與調整後 EBITDA 比率為 5.74 倍。正如之前和之前的電話會議中所指出的，隨著我們投資組合的業績繼續從大流行中復蘇，我們預計槓桿率會自然下降。我們仍然致力於 5 倍的長期平均槓桿目標，並有信心隨著時間的推移我們可以實現該目標，而無需進入資本市場。

As of December 31, 2023, we are in compliance with all of our debt covenants and have ample liquidity of $947 million, consisting of unrestricted cash and cash equivalents of $41 million and available borrowings of $906 million under our revolving credit facility.

截至 2023 年 12 月 31 日，我們遵守所有債務契約，擁有 9.47 億美元的充足流動性，其中包括 4,100 萬美元的不受限制的現金和現金等價物以及循環信貸安排下的 9.06 億美元的可用借款。

Finally, on February 1, 2024, Sabra's Board of Directors declared a quarterly cash dividend of $0.3 per share of common stock. The dividend will be paid on February 29, 2024 to common stockholders of record as of the close of business on February 13, 2024. The dividend is adequately covered and represents a payout of 91% of our fourth quarter normalized FFO per share. And as noted earlier, this payout percentage is expected to improve in 2024.

最後，Sabra 董事會於 2024 年 2 月 1 日宣布季度現金股利為每股普通股 0.3 美元。該股將於2024年2月29日支付給截至2024年2月13日收盤時在冊的普通股股東。股息已充分支付，相當於第四季度標準化 FFO 每股股息的 91%。如前所述，這一支付比例預計將在 2024 年有所改善。

And with that, we'll open up the lines for Q&A.

至此，我們將開放問答線路。

(Operator Instructions)

（操作員說明）

Joshua Dennerlein, Bank of America.

約書亞·登納林，美國銀行。

This is Tal Grant on behalf of Josh Dennerlein. I first question I wanted to ask about the relationship with Ignite on what are you seeing in terms opportunities going forward with either expanding or deepening this relationship? Or if you can touch on any other relationships you're hoping to expand on?

我是塔爾·格蘭特，代表喬許·丹納林。我想問的第一個問題是關於與 Ignite 的關係，您認為擴大或深化這種關係的未來機會是什麼？或者您可以談談您希望擴展的任何其他關係？

Sure. I'm happy to take that we have been working with Ignite since we transitioned and civils a nursing home properties in Oklahoma to them several times before the pandemic and have always been interested in working with them. We have we did a small tack-on deal to our Oklahoma buildings. We've looked at several other deals now. We've we announced the deal that we closed on last year. And we continue to look for opportunities with them. We are not the only reason with whom they have a relationship. So they I think they balance a balance this all out and look for the best terms they can get they like to negotiate, but it's up, but it's -- but we have tremendous respect for their capabilities as operators and are endeavoring to do more with them.

當然。我很高興地看到，自從我們在大流行之前多次將俄克拉荷馬州的療養院房產移交給他們以來，我們一直在與 Ignite 合作，並且一直有興趣與他們合作。我們對俄克拉荷馬州的建築進行了一項小型附加交易。我們現在已經考慮了其他幾筆交易。我們已經宣布了去年完成的交易。我們將繼續與他們一起尋找機會。我們並不是他們與我們建立關係的唯一原因。所以他們我認為他們在這一切之間取得了平衡，並尋找他們可以談判的最佳條款，但已經結束了，但我們非常尊重他們作為運營商的能力，並正在努力與他們做更多的事情他們。

Great. And just I know you made a few comments on the SHOP business, but I was wondering if you could expand a little bit on how you're seeing there play out into 2024, either in terms of margins or occupancy.

偉大的。我知道您對商店業務發表了一些評論，但我想知道您是否可以詳細說明您對 2024 年商店業務的看法，無論是在利潤率還是入住率方面。

I think we all wish we could see really rapid increases on the revenue side and add decreases or no increases on the expense side. What I think where what we really are starting to see, however, is consistent growth on the top line and through both occupancy and RevPAR growth. And I think importantly, we're still starting to see that expenses per occupied room export is declining. And I think that's a really key metric, which is why I added it to my talking points this morning. And to me that signals that the breakeven point is it is being moved over so that we are now starting to get the benefit of operating leverage.

我認為我們都希望能夠看到收入方面真正快速成長，而支出方面減少或不增加。然而，我認為我們真正開始看到的是收入以及入住率和每間可出租客房收入的持續增長。我認為重要的是，我們仍然開始看到每個佔用房間的出口費用正在下降。我認為這是一個非常關鍵的指標，這就是為什麼我今天早上將其添加到我的談話要點中。對我來說，這表明盈虧平衡點正在轉移，因此我們現在開始獲得營運槓桿的好處。

Great. Thank you for the color.

偉大的。謝謝你的顏色。

Nick Yulico, Scotiabank.

尼克尤利科，豐業銀行。

Thanks for the questions. This is Elmer chain on with Nick. I'm touching on Ignite again in a different way, but you had a fairly active quarter acquiring that portfolio. Could you just talk about whether this transaction was more so a credit driven transaction versus maybe the operator needing capital to expand? And did you assume any mortgage debt in the process?

感謝您的提問。這是艾爾默和尼克的聯繫。我以不同的方式再次談到 Ignite，但您在一個相當活躍的季度收購了該投資組合。您能否談談這筆交易是否更多的是信用驅動的交易，而不是運營商需要資本來擴張？在此過程中您是否承擔了任何抵押貸款債務？

And so we did not assume any mortgage debt and that's one two, it's not credit driven. It's really based on operation operations and stick at their very conservative look forward on what they can do with these buildings with these are newer buildings, and they are buildings that the team at Ignite actually had open when they were at their prior employer. So there's a tremendous amount of familiarity. The two buildings are very close to one another on. So there's there's really good geographic coverage there. Does that help you got it?

因此，我們沒有承擔任何抵押貸款債務，這是一二，它不是由信貸驅動的。它實際上是基於營運運作，並堅持他們非常保守的期望，他們對這些建築物可以做什麼，這些是較新的建築物，而且它們是Ignite 團隊在他們之前的雇主時實際上已經開放的建築物。所以有很大的熟悉感。兩棟建築距離非常近。所以那裡有非常好的地理覆蓋範圍。這對你有幫助嗎？

Yes, that helps. Thank you. And then I guess just on the seniors housing managed businesses, well, I know you mentioned maybe seeing increased rent growth in the 5% to 7% of pain, and you talked about seeing occupancy gains hopefully to pre pandemic levels. Is that was that a target for 2024 embedded in 24 days? Or is that more so like a two-to-three-year objective?

是的，這有幫助。謝謝。然後我想就老年人住房管理業務而言，我知道您提到租金可能會在 5% 至 7% 的痛苦中增長，並且您談到入住率有望升至大流行前的水平。這就是 24 天內設定的 2024 年目標嗎？或者這更像是一個兩到三年的目標？

I mean, I wouldn't say it would be a two to three-year objective. I think the best way to think about it. If you look back over the last couple of quarters where we put that bridge to illustrate the remaining upside in our portfolio. A healthy amount of that upside for the senior housing managed business specifically is captured in our 2024 guidance and particularly in the year-end run rate. So by the time we get to the end of 2024, you know, the vast majority of that upsize the recapture was a little bit left to capture in '25 and beyond.

我的意思是，我不會說這將是一個兩到三年的目標。我認為最好的思考方式是。如果你回顧過去幾個季度，我們用這座橋樑來說明我們投資組合的剩餘優勢。我們的 2024 年指導特別是年終運作率體現了老年住房管理業務的健康成長空間。因此，到 2024 年底時，您知道，奪回規模的絕大多數都需要在 25 年及以後進行。

Got it. Okay. Thank you.

知道了。好的。謝謝。

Austin Wurschmidt, KeyBanc Capital Markets.

Austin Wurschmidt，KeyBanc 資本市場。

Great, thanks. And just wanted to hit back on sort of the senior housing managed portfolio and maybe put a finer point on what are you assuming for same-store NOI growth for the year within that segment of the business?

萬分感謝。只是想回擊高級住房管理投資組合，也許可以更具體地說明您對該業務領域今年同店 NOI 成長的假設是什麼？

Yes. So we didn't we didn't disclose that obviously in our in our release. And I think if you look at what glove our peers have put out, I think just general and industry sentiment of, call it double digit, low 10s, even mid 10s growth. I think that feels about right. And for our portfolio, I think is probably a good assumption to use when you're looking at our silver specific portfolio.

是的。所以我們沒有在我們的新聞稿中明確披露這一點。我認為，如果你看看我們的同行推出的手套，我認為一般和行業情緒，稱之為兩位數、低 10 年代，甚至 10 年代中期的增長。我認為這種感覺是對的。對於我們的投資組合，我認為當您查看我們的白銀特定投資組合時，這可能是一個很好的假設。

That's helpful. And I guess given sort of the acceleration you've seen now in the last couple of quarters. Does that? Yes, certainly a good jumping off point heading into the year. So from here, I mean, should we assume something more consistent with historical seasonality levels? Or do you think you can kind of outperform historic seasonality just given the strength you're seeing and maybe some of the catch-up from the operator transitions that happened last year.

這很有幫助。我想考慮到您在過去幾個季度中看到的加速。是嗎？是的，這無疑是進入今年的一個很好的起點。因此，我的意思是，從這裡開始，我們是否應該假設一些與歷史季節性水平更一致的東西？或者，考慮到您所看到的實力以及去年發生的運營商轉型的一些追趕，您是否認為您可以超越歷史季節性。

I think that you're going to you're always going to have seasonality. I think one of Rick's points at the top of the call was about the lack of new supply. So what you have is you had a larger denominator, call it pre pandemic. You now have that same denominator and you have more people in the cohort and more people moving into occupancies increasing. And what I referenced about operating leverage is really going to be part of the story that leads to what Mike was talking about with respect to NOI. growth. In other words, the more you fill the buildings and it's more it's not a completely static pool, but it's but the pool of your audience and your resident numbers are moving up and your number of beds available remains as remaining relatively static. At the moment, you're going to get the benefit of operating leverage because that incremental resident has a much higher pull through to the bottom line.

我認為你總會有季節性。我認為里克在電話會議中最重要的觀點之一是缺乏新的供應。所以你有一個更大的分母，稱之為大流行前。現在，您的分母相同，隊列中有更多的人，並且有更多的人進入入住率不斷增加的情況。我提到的關於營運槓桿的內容實際上將成為麥克所談論的關於 NOI 的故事的一部分。生長。換句話說，建築物越多，它就不是一個完全靜態的池，但它的觀眾池和居民數量正在增加，而可用床位的數量仍然保持相對靜態。目前，您將獲得營運槓桿的好處，因為增量居民對利潤的拉動要大得多。

The other point I would make about guidance is obviously we felt we've had enough trends in our asset classes to provide full year guidance, but it's still impossible to predict as you've been hearing exactly how much that how much or how quickly things are going to improve continue to improve. So hopefully, if you know, if we've erred, we've been conservative in our assumptions.

關於指導我想說的另一點是，顯然我們認為我們的資產類別已經有足夠的趨勢來提供全年指導，但仍然無法預測，因為你已經聽到了到底有多少、多少或多快的事情將會改進繼續改進。所以希望，如果你知道，如果我們犯了錯誤，我們的假設是保守的。

That all makes a lot of sense. And just one last one I wanted to hit on was you know sort referenced of coverage is certainly trending positively across the overall portfolio. It does look like HealthSmart group has seen kind of continued to trend lower now for several quarters since they've been on that top 10 list. And just wondering if you could share any detail as to what's driving that and when you might expect that to stabilize or even see a reversal?

這一切都很有道理。我想指出的最後一點是，您知道，在整個投資組合中，引用的報導肯定呈現正面趨勢。自從進入前 10 名名單以來，HealthSmart 集團似乎已經連續幾季呈現下降趨勢。只是想知道您是否可以分享任何細節，說明是什麼推動了這一趨勢，以及您預計何時會穩定下來，甚至會出現逆轉？

Yes, they are. But they've really been benefiting from PRS and that's dropped off completely. So that's actually been a big factor there. Really they are really good operators are in a really tough environment in Texas. So we don't have any concerns about them going forward, and we think that things will level out for them and then start and improving again.

是的，他們是。但他們確實從 PRS 中受益，而且這種受益完全消失了。所以這其實是一個重要因素。事實上，他們是非常優秀的營運商，在德州的環境非常艱難。因此，我們對他們的未來沒有任何擔憂，我們認為他們的情況會趨於平穩，然後再次開始並有所改善。

Very good. Appreciate the detail. Thank you.

非常好。欣賞細節。謝謝。

Your next question comes from the line of Michael Griffin with Citi. Your line is open.

你的下一個問題來自花旗集團的麥可‧格里芬。您的線路已開通。

Great, thanks. And just wanted to ask about the acquisition of the environment heading into 2024. We know in the past you've talked about potentially being a net acquirer in the year ahead, but you didn't include any acquisition expectations in your guidance? Just wanted to get a sense of how deep the pipeline is and sort of where you see yields for both on the skilled side and then anything on senior housing.

萬分感謝。只是想詢問 2024 年環境的收購情況。我們知道您過去曾談論過未來一年可能成為淨收購方，但您的指導中沒有包含任何收購預期？只是想了解管道有多深，以及技術方面和高級住房方面的收益在哪裡。

And so I'll start on.

那我就開始吧。

So in terms of being a net acquirer, that is that is our goal for this year and on and all the asset classes in skilled and senior housing and behavioral as those opportunities present themselves.

因此，就成為淨收購者而言，這就是我們今年及以後的目標，以及科技和老年住房和行為領域的所有資產類別，因為這些機會本身就出現了。

So I want to reiterate that even though we've focused a lot over the past year plus on diversifying the portfolio. And obviously, our skilled exposure is at the lowest point. It's been in our history and will continue to drop. So we're not going to bypass doing skilled deals. We're actively looking for skilled deals and so on because we're dropping so low our skilled exposure, we're really able to do more skilled deals and still have a much more diversified route than we've ever had before. So everything is really about earnings growth this year. And so we're not going to put any sort of false guardrails are or boundaries around what are the asset classes that we're currently in.

因此，我想重申，儘管我們在過去的一年裡非常注重投資組合的多元化。顯然，我們的技術暴露處於最低點。它已經成為我們的歷史，並將繼續下降。因此，我們不會迴避進行熟練的交易。我們正在積極尋找技術交易等，因為我們的技術風險敞口已經降得很低了，我們確實能夠進行更多的技術交易，並且仍然擁有比以前更加多樣化的路線。因此，今年一切都與獲利成長有關。因此，我們不會對我們目前所處的資產類別設置任何虛假的護欄或界限。

And in terms of the depth of the acquisition pipeline and a couple of things, I'd say one senior housing market is very active. And it's a very active mid-last year. It has since the end since the start of 2024, it has them everyone's reengaged with a different perspective on pricing because there was a bid-ask spread that really made everything come to a halt. But now it feels like there's there are a lot of assets on the market. So there are groups that are that have to refinance or or sell because of their situation with their lender. And so we're seeing a lot of fairly new newer assets on the market on the senior housing front, skilled nursing. And I'd say the dynamics are different. We see them. We don't see that much from product quality marketed by the brokerage firms. What we have found is that those transactions are happening off market and it's been it's been incumbent upon us to insert ourselves into those relationships more actively in order to capture opportunities on on skilled nursing and they're competitive as they are on senior housing, but it's active.

就收購管道的深度和一些事情而言，我想說高級住房市場非常活躍。去年年中非常活躍。自 2024 年初以來，每個人都重新以不同的角度看待定價，因為買賣價差確實讓一切都陷入了停頓。但現在感覺市場上有很多資產。因此，有些團體由於與貸方的關係而不得不進行再融資或出售。因此，我們在高級住房、熟練護理等市場上看到了許多相當新的資產。我想說動力是不同的。我們看到他們了。我們從經紀公司行銷的產品品質中看不到那麼多。我們發現，這些交易是在市場外進行的，我們有責任更積極地融入這些關係中，以便抓住熟練護理方面的機會，而且它們與高級住房方面一樣具有競爭力，但是它是活躍的。

Great. That's helpful.

偉大的。這很有幫助。

And then maybe, Rick, just back to your points in your prepared remarks about field margins and being back at pre them pre-pandemic levels, I realize I think you're still about 500 basis points of occupancy below where you were pre-COVID on. So I guess just given I think the expectation for more occupancy uplift here in the near and medium term, where could we see margins get to in that business?

也許，瑞克，回到你準備好的關於領域利潤率的評論中的觀點，並回到大流行前的水平，我意識到我認為你的入住率仍比新冠疫情前的水平低約500 個基點在。因此，我想，鑑於我認為近期和中期內入住率將上升的預期，我們可以看到該業務的利潤率在哪裡？

It's hard to predict where they can get to. But on a few basis points above where they were pre-pandemic is certainly a few percentage points, certainly not and out of the realm of possibilities of really your question really is just how long it's going to take to get there. And it's interesting, right, because over the past couple of years, there's been so much focus on senior housing and how it's great because you're pushing through these your 10% rate increases and it's private pay and they've gotten the advantage of it over the skilled nursing space. But the fact of the matter is, is the cost report process at the state level. The market basket process at the federal level has a time lag, but that time lag now has been catching up as we saw this past summer this past October first, and we're going to see that again this year. So you're getting some base at least compared to historical trends some really nice outsized rate increases at a lot of the states and with CMS. And remember, this year's fiscal year market basket increase will not have the parity adjustment. So that's going to help even more. So our revenue per patient day, it has really grown very, very nicely over the past couple of years. And our non-nursing labor, it's been relatively flat it's been really modest inflation. And now we're seeing, as I mentioned, just under 4.5% inflation on nursing over the last year or so on. That's really helped to compensate for the occupancy. So but again, how far occupancy can go, we believe we can go beyond pre-pandemic levels, at least in a number of different markets where we're starting to see access issues on so that I think the margin uplift will be even greater than a few percentage points.

很難預測他們能到達哪裡。但在疫情大流行前的幾個基點上，它們肯定是幾個百分點，當然不是，而且超出了可能性的範圍，你的問題實際上是需要多長時間才能到達那裡。這很有趣，對吧，因為在過去的幾年裡，人們非常關注老年住房以及它的好處，因為你正在推動這些你的 10% 的利率上漲，這是私人支付，他們已經獲得了優勢它超過了熟練的護理空間。但事實是，州級的成本報告流程。聯邦層級的市場籃子流程有一個時間滯後，但現在這個時間滯後已經趕上，正如我們在去年夏天、今年十月看到的那樣，今年我們將再次看到這種情況。因此，至少與歷史趨勢相比，在許多州和 CMS 中，您得到了一些非常好的大幅利率成長的基礎。請記住，本財政年度的市場籃子增量不會有平價調整。所以這會有更多幫助。因此，在過去幾年中，我們每位患者每天的收入確實成長得非常非常好。我們的非護理勞動力相對持平，通膨非常溫和。正如我所提到的，現在我們看到，在過去一年左右的時間裡，護理費用的通貨膨脹率略低於 4.5%。這確實有助於補償佔用率。因此，但同樣，入住率能走多遠，我們相信我們可以超越大流行前的水平，至少在許多不同的市場上，我們開始看到准入問題，所以我認為利潤率的提升將會更大比幾個百分點。

Great. That's it for me. Thanks for the time.

偉大的。對我來說就是這樣。謝謝你的時間。

Yes.

是的。

Your next question comes from the line of Vikram Malhotra with Min Xu Ho.

你的下一個問題來自 Vikram Malhotra 和 Min Xu Ho 的對話。

Your line is open up new and thanks for taking the question. Maybe just first on the guidance incentives, obviously, the first a time post-COVID. So I'm just wondering, can you give us some specifics on what's baked into the low end?

您的熱線已開通，感謝您提出問題。也許首先是指導激勵措施，顯然，這是新冠疫情之後的第一次。所以我只是想知道，你能給我們一些關於低階產品的具體細節嗎？

The high end?

高端？

You talked about low 10s, same store growth. But but what else is specifically back to reach either the lower high end high end anyway, is it put is those potential credit issue baked in or not?

您談到了低 10 倍的同店成長。但是，無論如何，還有什麼特別要回到較低的高端高端，這些潛在的信貸問題是否已經解決？

Yes, I wouldn't say there's any credit issue baked in or not. And I think the reason the range is largely dictated by what Rick said earlier on the call, which is it's hard to predict where this is going to shake out. If we knew with certainty, we just put out one number, hey, so there is some uncertainty being baked in there of where we're going to end up over the course of the remainder of this year. So we're just providing ourselves some some cushion there and some a reasonable amount of cushion, but nothing too broad for that. So that's where it's at. It's not any credit issues or anything like that.

是的，我不會說是否有任何信用問題。我認為這個範圍很大程度上是由里克早些時候在電話會議上所說的話決定的，那就是很難預測這將在哪裡發生。如果我們確定地知道，我們只需給出一個數字，嘿，所以我們在今年剩餘時間的最終結果存在一些不確定性。所以我們只是為自己提供一些緩衝和一些合理數量的緩衝，但沒有太廣泛的範圍。這就是它所在的地方。這不是任何信用問題或類似的問題。

Okay. And then just on the regulatory side, two things, if you could any updated thoughts on and how you see the minimum staffing final ruling shaking out component wise or timing wise?

好的。然後就監管方面而言，有兩件事，您是否能對最低人員配置最終裁決有任何最新的想法以及您如何看待組件明智或時間明智的決定？

And then, Rick, I think you you alluded to the fact that there's going to be a good, a decent Medicare bump, should we think about it as a 4% to 5% this year? Is that fair?

然後，Rick，我想你提到了這樣一個事實，即醫療保險將會有一個良好的、體面的增長，我們今年應該將其視為 4% 到 5% 嗎？這樣公平嗎？

Thanks.

謝謝。

On the Medicare, Bob, I don't want to get ahead of CMS, obviously on anything, but we were at 4.1% last year with the parity adjustment. So I think something north of that is reasonable because there was still a lot of inflation to capture. So I don't think that's an unreasonable assumption.

在醫療保險方面，鮑勃，我不想在任何事情上領先 CMS，但去年我們進行平價調整後達到了 4.1%。因此，我認為超出這一範圍的情況是合理的，因為仍有大量通膨需要應對。所以我不認為這是一個不合理的假設。

And on the other minimum staffing, there's no update really in terms of timing they said in 2024, we'll have the final the final rule. But I think it's fair to say that at this point, we don't believe no matter how much they water water down and maybe they don't order down. But to the extent that they do, we don't think any staffing mandate is acceptable and particularly given the fact that our nurses out there. So I think the industry will take a very strong stand and do whatever it thinks is necessary to ensure it's defeat. We've got bipartisan support in Congress because the fact of the matter is even though they are not funding, let's assume it was in place, even though they're not funding it upfront, the cost report process at the state level and also at the federal level, we'll eventually capture those increased costs as costs and and that will show up in increased rates. So it actually will cost the government billions of dollars a year, even if they are funding it sort of upfront just because of how the cost of product cost report process works. So I think on from a legislative perspective, that's a big issue. I think the fairness of it and the lack of availability of nurses with certainly no movement on the Hill relative to even having some controlled immigration for skilled workers that would be really helpful to us. And I think all those factor into why we're getting so much bipartisan support from Washington on there, not being a staffing mandate Great.

至於其他最低人員配置，他們所說的 2024 年時間安排並沒有真正的更新，我們將制定最終規則。但我認為可以公平地說，在這一點上，無論他們澆多少水，我們都不相信，也許他們也沒有訂購。但就他們這樣做而言，我們認為任何人員配置授權都是不可接受的，特別是考慮到我們的護理人員在那裡。因此，我認為該行業將採取非常強硬的立場，並採取一切其認為必要的措施來確保其失敗。我們在國會得到了兩黨的支持，因為事實是，即使他們沒有提供資金，讓我們假設它已經到位，即使他們沒有預先提供資金，州一級的成本報告流程也是如此在聯邦層面，我們最終會將這些增加的成本視為成本，這將體現在增加的費率中。因此，政府實際上每年要花費數十億美元，即使他們只是因為產品成本報告流程的運作方式而預先提供資金。所以我認為從立法角度來看，這是一個大問題。我認為這很公平，而且缺乏護士，而且國會山上肯定沒有任何活動，相對於對技術工人進行一些受控移民來說，這對我們確實有幫助。我認為所有這些因素都解釋了為什麼我們從華盛頓那裡得到瞭如此多的兩黨支持，而不是人員配置授權。

And sorry, one last clarification in the in the I remember last call you had mentioned there may be a few more transitions, smaller ones. So I'm I'm just wondering if you can help us roughly quantify the benefit of the transition that have already been completed in 2023 and what the benefit is in 24? And are there any additional transitions planned?

抱歉，最後一次澄清是在我記得上次通話中您提到的，可能會有更多的過渡，更小的過渡。所以我只是想知道您是否可以幫助我們粗略地量化 2023 年已經完成的過渡的好處以及 24 年的好處是什麼？是否有任何額外的過渡計劃？

Yes.

是的。

I mean, in terms of the transitions that we talked about last quarter, I think if you look at the trend from our when we first put out this bridge in this for the second quarter that we put out in the third quarter, you saw that that number came down because we started capturing a little bit of that as a large number in totality. I think that's like $4 million or two, I think. But the total upside for that piece of the pie was like 4 million. We capture a little bit of in Q three a little bit in Q4. And I think similar with the with my comments on shop, I think by the time we get to the end of the year, we'll see most of that are captured. But again, it's small dollars in the grand scheme of things.

我的意思是，就我們上季度討論的過渡而言，我認為如果您從我們在第三季度推出的第二季度首次推出這座橋時的趨勢來看，您會看到這個數字之所以下降，是因為我們開始將其中的一小部分作為一個整體來捕獲。我想這大概是 400 萬美元或 200 萬美元。但這塊蛋糕的總收益約為 400 萬美元。我們在第三季度中捕獲了一點，在第四季度中捕獲了一點。我認為與我對商店的評論類似，我認為到年底時，我們會看到大部分內容都被捕獲。但同樣，從宏偉的計劃來看，這只是小錢。

Your next question comes from the line of Rich Anderson with Wedbush. Your line is open.

你的下一個問題來自里奇·安德森（Rich Anderson）和韋德布什（Wedbush）的對話。您的線路已開通。

Thanks. Good morning. Out there. So Rick, you mentioned investment opportunities, but no clear trends. Can you what did you mean by that? I mean, do you talk about like what types of assets you might buy? I know there's been some talk about that in this call, but you do have like sort of a defined kind of pipeline that you're looking at? Or is that still sort of hard hard to quantify? I'm just curious what more color you can lend on the external growth front for this year?

謝謝。早安.在那裡。Rick，您提到了投資機會，但沒有明確的趨勢。你能告訴我你這是什麼意思嗎？我的意思是，您是否談論過您可能會購買哪些類型的資產？我知道在這次電話會議中對此進行了一些討論，但您確實有某種您正在考慮的已定義的管道？或者說這仍然很難量化？我只是好奇今年你還能在外部成長方面增添什麼色彩？

Sure. So I want to what I tell you is points. We're not seeing much in terms of quality, skilled nursing deals out there. So it's hard to predict kind of the volume and exactly where cap rates are going to settle. And although we think cap rates will stay in the 9% to 10% range, I don't think we're going to see the eight handle stuff that you saw in our pre-pandemic days. So but we just haven't had. So we're not seeing enough volume out there. And in all three of our asset classes. Obviously, as I said, we're seeing more of the senior housing side for us to be able to determine what we might be able how much we might be able to get done and also because of the pandemic on prior to the pandemic, we never included on acquisition assumptions and guidance. But we would sometimes say outside of guidance, you know, we think we're going to get x-amount of investments done this year and we think most will be in the third and fourth quarter or provide some color like that. But given the pandemic, we just don't have enough data at trend data to even determine how we're going to do 200 million this year. We're going to do 400 billion this year. It's just kind of impossible at this point. Hopefully as we get a little bit further into the year, and we'll be able to be have a little bit more granularity on where we think things may go. We will have the first quarter earnings call, not that far out from now.

當然。所以我想告訴你的是積分。我們沒有看到太多高品質、熟練的護理交易。因此，很難預測交易量的大小以及資本化率將穩定在什麼水準。儘管我們認為資本化率將保持在 9% 至 10% 的範圍內，但我認為我們不會看到大流行前幾天看到的八個手把的情況。所以，但我們只是還沒有。所以我們沒有看到足夠的數量。在我們所有三個資產類別中。顯然，正如我所說，我們看到了更多的老年住房方面的情況，以便我們能夠確定我們能夠做什麼，我們能夠完成多少工作，而且由於大流行之前的大流行，我們從未包含在收購假設和指導中。但我們有時會說，在指導之外，你知道，我們認為今年我們將完成一定數量的投資，我們認為大多數投資將在第三和第四季度進行，或提供類似的顏色。但考慮到這場流行病，我們沒有足夠的趨勢數據來確定今年我們將如何做 2 億。今年我們要做4000億。在這一點上這是不可能的。希望隨著今年的進展，我們能夠對事情的發展方向有更詳細的了解。距離現在不遠了，我們將召開第一季財報電話會議。

And hopefully we'll have a little bit more data than that we can share take Exxon thinks in terms of the spread investing opportunity, if you say nine handle on that on sniffs, something lower than that on senior housing, but what do you what do you think the range of in return spread the spread to your cost of capital will be? Is it like it should be required to be?

希望我們能獲得比我們可以分享的更多的數據，就埃克森美孚認為的利差投資機會而言，如果你說嗅探方面有九個處理，比高級住房的處理要低一些，但你做什麼您認為回報利差與您的資本成本之間的利差範圍是多少？這是應該被要求的嗎？

I should say for you to pull the trigger on something that you like to that have to be 200 plus basis points. Are that asking too much? I'm just I'm just curious where your mind is that in terms of the accretive nature of your external growth?

我應該說，如果你要扣下板機去做你喜歡的事情，就必須有 200 個基點以上。這要求太高了嗎？我只是很好奇，就你的外在成長的增值性質而言，你的想法在哪裡？

Yes. So we don't have a set number at our current cost of capital for the deals we're seeing are accretive to us. That's amazing. We just want them to be accretive and on. And I think as we look out over the course of this year, everybody is still in recovery. So we can do like on the skilled side, like we just did with Ignite still in the 9% to 10% range. And we know there's more upside on even though you might say, hey, do you want to start out with a bigger spread, we're going to get a bigger spread over time as the industry continues to recover and on the shop side, there's still a lot of upside there as well. So it may be a little bit tighter on day one. But as long as we know, we know the operator, we know the market and we can see the upside there. We can see what the performance was pre-pandemic and then it's worth it to us because as I said, you know, as we keep kind of hammering home out, we just we need to get back to strong earnings growth.

是的。因此，對於我們看到的對我們有利的交易，我們目前的資本成本沒有一個固定的數字。太棒了。我們只是希望它們能夠不斷增值並持續下去。我認為，當我們展望今年的過程時，每個人仍處於恢復期。所以我們可以在熟練的方面做類似的事情，就像我們剛剛對 Ignite 所做的那樣，仍然在 9% 到 10% 的範圍內。我們知道還有更多的好處，即使你可能會說，嘿，你想一開始就擴大價差嗎？隨著時間的推移，隨著行業的持續復甦，我們將獲得更大的價差，而在商店方面，還有很多好處。所以第一天可能會有點緊張。但只要我們了解，我們了解營運商，我們了解市場，我們就能看到那裡的好處。我們可以看到大流行前的表現，然後這對我們來說是值得的，因為正如我所說，你知道，隨著我們不斷努力，我們只需要恢復強勁的獲利成長。

And last question for me on you mentioned in the release a 1.72 times dorm coverage in your skilled space, excluding provider relief funds. Is that it is that in arrears number? Is that a 3Q or 4Q number it's a it's a 12-month number as of September 30th.

我問的最後一個問題在發布中提到，您的技術領域的宿舍覆蓋率為 1.72 倍，不包括提供者救濟資金。難道就是那個欠費號碼嗎？這是第三季還是第四季的數字，是截至 9 月 30 日的 12 個月的數字。

Okay. So I took note of the fact that it that that same equivalent number was 1.61 times in their third quarter release it that's quite a credit improvement. It doesn't get the benefit of the Medicare yet your starting point in October one, if it starts, it's the third quarter annualized. So what would you say is the reason for that big pop in coverage? Is there any moving parts in there that we should know about?

好的。因此，我注意到這樣一個事實：在第三季發布的數據中，相同的等效數字是 1.61 倍，這是一個相當大的信用改善。它沒有得到醫療保險的好處，但你的起點是 10 月，如果開始的話，那就是第三季的年度化。那麼您認為報道如此受歡迎的原因是什麼？其中是否有我們應該了解的活動部件？

Well, there were a couple of things on a lot of our operators experienced larger than average Medicaid rates in July and August. So that starts to impact impacted. And labor really has moderated quite a bit again, and we always keep saying this, it's still really tough out there or to make light of it. But it has moderated, I think a little bit more than we would have expected. So I think the combination of slower labor growth and stronger revenue per patient day growth, particularly on the Medicaid side is what contributed to it connect.

嗯，我們的許多業者在 7 月和 8 月經歷了高於平均醫療補助費率的情況。所以這開始產生影響。勞動力確實再次放緩了很多，我們總是不斷地說，外面的事情仍然很艱難，或者要輕視它。但它已經有所緩和，我認為比我們預期的要多一些。因此，我認為勞動力成長放緩和每位患者日收入成長強勁（特別是在醫療補助方面）相結合，促成了這種關聯。

Could you be starting to tease a two times number if things continue to go in the right direction from your lips rich content.

如果事情繼續從你的嘴裡豐富的內容朝著正確的方向發展，你可能會開始取笑兩倍的數字。

Thank you.

謝謝。

Thanks.

謝謝。

Your next question comes from the line of Michael strike with Green Street. Your line is open.

你的下一個問題來自邁克爾與格林街的罷工路線。您的線路已開通。

Thanks and good morning. Maybe one on the Shin portfolio. So coverage levels are now back to 2019 are spot levels mostly captured in that trailing 12 month figure at this point? And if not, should we expect any more meaningful improvement in coverages in that business?

謝謝，早安。也許是 Shin 投資組合中的一個。那麼，現在的覆蓋範圍水準已回到 2019 年，目前的現貨水準是否主要反映在過去 12 個月的數據中？如果不是，我們是否應該期待該業務的覆蓋範圍出現更有意義的改善？

Sorry, for which portfolio for additional portfolio or the senior housing lease portfolio.

抱歉，哪個投資組合是附加投資組合還是高級房屋租賃投資組合。

A guy that's got it.

一個有能力的人。

And again, that is a data plan or I'm sorry, can you repeat the question because now that I know what portfolio you're talking about?

再說一次，這是一個數據計劃，或者很抱歉，你能重複這個問題嗎？因為現在我知道你在談論什麼投資組合了？

I can probably handle constructible model science.

我也許可以處理可建構的模型科學。

Yes, sorry about that coverage levels. They're back to 2019 in the senior housing lease portfolio, again, are spot levels mostly captured and that trailing month 12-month figure? And if not, should we expect any more meaningful improvement in coverages in that business?

是的，對覆蓋範圍感到抱歉。高級房屋租賃投資組合再次回到 2019 年，主要是現貨水準還是過去 12 個月的數據？如果不是，我們是否應該期待該業務的覆蓋範圍出現更有意義的改善？

I think I think we're optimistic that coverage will continue to improve as operating leverage continues to own Strathmore and ally to buy online.

我認為我們樂觀地認為，隨著營運槓桿繼續擁有斯特拉斯莫爾和在線購買的盟友，覆蓋範圍將繼續改善。

Okay.

好的。

Fair enough.

很公平。

Yes.

是的。

Okay.

好的。

Good to know. And then maybe one on contract labor. I know you mentioned it's down pretty meaningfully in aggregate, but have you seen any pockets in your portfolio that have started to see agency labor utilization maybe come back up in recent months?

很高興知道。然後也許是一份關於合約工的問題。我知道您提到總體而言下降幅度相當大，但是您是否看到您的投資組合中的任何部分已經開始看到機構勞動力利用率可能在最近幾個月回升？

I'm not all Terry coming up. You certainly have markets where it's still bad, but we're not seeing increases. I mean, anecdotally, we may there may be a facility here or there but by operator, we're not really seeing increases over the past few months and temporary labor. I think over the holidays, they might have a little bit of a spike, but that's not that's not a typical for the holidays, but it came right back down.

我不只是特里來了。當然，有些市場仍然很糟糕，但我們沒有看到成長。我的意思是，有趣的是，我們可能在這裡或那裡有一個設施，但對於營運商來說，我們並沒有真正看到過去幾個月和臨時勞動力的增加。我認為在假期期間，它們可能會出現一點高峰，但這並不是假期的典型情況，但它很快就會回落。

We're really seeing I was reading your housing front, very it's almost zeroing out of agency or or at least back down to it should have no not so-called normal levels of unaffected by the last few years. And because we're seeing also at the same time, I'm more net hires. I'm filling of positions that had been that had been vacant for some time, better retention, which is what the net hires is about. And um and overall, just stronger ability to hire, retain and come and compensate a permanent employees.

我們確實看到我正在閱讀您的住房方面，它幾乎已經從機構中歸零，或者至少回到了過去幾年不應該受到影響的所謂正常水平。而且因為我們同時看到，我的淨招募人數更多。我正在填補已經空缺一段時間的職位，更好地保留人才，這就是淨招聘的目的。嗯，總的來說，僱用、留住、來和補償永久員工的能力更強。

Great. Thanks for the time.

偉大的。謝謝你的時間。

Thank you.

謝謝。

Again, if you'd like to ask a question, star then the number one on your telephone keypad.

再次強調，如果您想提問，請在電話鍵盤上的數字 1 上加註星號。

Your next question comes from the line of Connor silver ski with Wells Fargo. Your line is open.

您的下一個問題來自富國銀行的康納銀色滑雪系列。您的線路已開通。

I thank you for the time. Maybe just to bounce back on the investment environment. It's been a pretty common theme among health care re earnings that the propensity to invest in 2024 is a dramatic improvement from, say, years prior and in that context, it seems like solvers messaging here is maybe a little bit more conservative than others. So I'm wondering when you say that in skilled nursing in particular, there are less high-quality opportunities coming across the desk. Do you feel that that's more due to increased competition in the space? Or is that more of a function of just the pricing disconnect?

我感謝你的時間。也許只是為了恢復投資環境。醫療保健收入中一個非常普遍的主題是，2024 年的投資傾向比幾年前有了顯著改善，在這種背景下，解決者傳遞的訊息似乎比其他人更保守一些。因此，我想知道您何時說，特別是在熟練護理領域，辦公桌上的高品質機會較少。您是否認為這更多是由於該領域競爭加劇所致？還是這更多的是定價脫節的結果？

Between potential sellers and buyers.

潛在賣家和買家之間。

I don't think it's necessarily either. I think that for those that don't have to sell, they've just been waiting for more recovery. I really think it's as simple as that. So we fully expect to see more opportunities in the skilled space and better quality opportunities. But if you haven't had to sell, we might as well hang in there or wait for on top line and margins to improve more the other.

我認為也不一定。我認為對於那些不必出售的人來說，他們只是在等待更多的復甦。我真的認為事情就這麼簡單。因此，我們完全期望在技術領域看到更多的機會和更高品質的機會。但如果你還沒有不得不出售，我們不妨堅持下去，或者等待營收和利潤率進一步改善。

The other thing I'd add to that is we thought a lot there was a lot of buying back private investors in the skilled space when cap rates were really cheap and bridge to HUD was was flowing in unprecedented amounts. And that, of course, has shifted in the last, whatever, six, six, eight months. And now the opportunity to provide debt or to sometimes provide equity in a sale leaseback format has reemerged, which is where the retailer can play and so that I think that explains why you're seeing other reach provide various levels of debt in terms of the cap stack.

我要補充的另一件事是，我們認為，當上限利率非常便宜並且與 HUD 的橋樑以前所未有的數量流動時，技術領域有很多私人投資者回購。當然，這種情況在過去的六、六、八個月裡發生了變化。現在，提供債務或有時以售後回租形式提供股權的機會已經重新出現，這就是零售商可以發揮作用的地方，因此我認為這解釋了為什麼您會看到其他範圍在以下方面提供不同水平的債務：帽堆棧。

And then why you're seeing us probably have seen more opportunities on sale leasebacks going for you to note, Gartner, they are more conservative than our peers, I guess, shows the impact of the pandemic. And our mentality is because we've never been accused of being more conservative than our peers.

然後，為什麼您看到我們可能看到了更多售後回租的機會，請注意，Gartner，他們比我們的同行更加保守，我想，這表明了這一流行病的影響。我們的心態是因為我們從未被指責比同齡人更保守。

Understood. I appreciate the color there. And maybe one more. This is taking a bit more of a long-term forward outlook. I have seen on Nick, Matt, for example, some markets where occupancy is getting quite high. And I'm wondering if we could expect to see certain states are released some certificate of needs within the next several years and allow for some more construction activity and saying that under the context, too, of knowing that it's cost prohibitive at the moment to really generate a return of construction activity, but it seems like there are some markets where you're kind of hitting carrying capacity. So just curious to hear any thoughts you have on that dynamic?

明白了。我很欣賞那裡的顏色。也許還有一個。這需要更多的長期前瞻性展望。例如，我在尼克、馬特身上看到，有些市場的入住率非常高。我想知道我們是否可以期望看到某些州在未來幾年內發布一些需求證明，並允許進行更多的建設活動，並說在知道目前成本過高的情況下，確實產生了建築活動的回報，但似乎有些市場的承載能力受到了影響。所以只是想聽聽您對此動態有何想法？

Yes. So it's a yes, up what I would say, yes, there are more. Obviously, there are actually quite a few markets like that. I think our portfolio in the aggregate, it is getting closer to 40%, 40% of the operators are or close to it or where their occupancy was pre-pandemic. But there's no talk right now in the States relative to changing skill. And obviously, there's going to be a huge crisis in the country. And as you noted, we're already seeing it from an app in terms of the access problems in certain markets. And so there's going to have to be something different at this at the state level and perhaps the federal level as well, that being the cost of building skilled nursing facilities is exorbitant, given the level of regulation. Some states obviously have of additional regulation on top of federal regulation. So it makes it even more expensive. California is a great example of that. So you've got that issue, then you've got this. You've got the COA issue as well. So yes, so it's just it's hard to see anything proactive happening at the level of the government until things get really, really bad. And you have a bunch of bad headlines because people can't get access to care. I just don't think I think everything is more focused than ever on the election cycles in the short term. And I just I just don't we haven't heard it and I just don't see it cutter. I think it's just and it will keep on growing occupancy. And then as I said, there will be some really bad headlines and then maybe there'll be some changes, which will probably take years, right? So I think you've got a really nice run ahead of you on the skilled side for occupancy.

是的。所以這是肯定的，我想說的是，是的，還有更多。顯然，這樣的市場其實有很多。我認為我們的投資組合總體上已經接近 40%，40% 的營運商處於或接近這個水平，或者他們的入住率處於大流行前。但目前美國還沒有關於改變技能的討論。顯然，這個國家將會出現一場巨大的危機。正如您所指出的，我們已經從應用程式中看到了某些市場的存取問題。因此，州一級甚至聯邦一級在這方面必須有所不同，考慮到監管水平，建設熟練護理設施的成本過高。有些州顯然在聯邦監管之外還有額外的監管。因此它變得更加昂貴。加州就是一個很好的例子。所以你有這個問題，然後你就有這個。您也遇到了 COA 問題。所以是的，所以在事情變得非常非常糟糕之前，很難看到政府層級發生任何積極主動的事情。由於人們無法獲得護理，因此出現了一堆糟糕的頭條新聞。我只是不認為一切都比以往任何時候都更關注短期的選舉週期。我只是不知道，我們沒有聽說過，我只是沒有看到它。我認為這是合理的，而且入住率將會繼續增長。然後正如我所說，將會出現一些非常糟糕的頭條新聞，然後可能會發生一些變化，這可能需要數年時間，對嗎？因此，我認為在技術方面，您在入住率方面已經取得了非常好的進展。

I appreciate the color. I guess all roads lead to increasing occupancy in the years ahead?

我很欣賞它的顏色。我想未來幾年所有道路都會導致佔用率增加？

Actually, Tom?

事實上，湯姆?

Yes.

是的。

And per member before the pandemic, the industry just based on demographics and and the curve at that point, what was the current rate of decline in supply, which has obviously accelerated the industry was projected to be effectively full 2025, 2026, and the pandemic has pushed that out. But nothing's changed since there except that the number of closed facilities has actually increased, right. So yes, and effectively, full is a little bit different for different buildings, but it's sort of low to mid 90s.

在大流行之前，該行業僅基於人口統計數據和當時的曲線，當前供應量下降的速度是多少，這明顯加速了該行業預計將在 2025 年、2026 年和大流行期間有效實現滿載已經把它推出了。但自那時以來，除了關閉設施的數量實際上有所增加之外，一切都沒有改變，對吧。所以，是的，實際上，對於不同的建築來說，full 有點不同，但它有點像 90 年代中低端。

Yes.

是的。

There are no further questions at this time. I will now turn the call back over to Rick Matros.

目前沒有其他問題。我現在將把電話轉回給 Rick Matros。

Thank you for joining us today. As usual, we're all available for follow-up and on those that are going to be in Florida. We'll look forward to seeing everybody at the conference next week. Thank you.

感謝您今天加入我們。像往常一樣，我們都可以進行後續活動以及將在佛羅裡達州進行的活動。我們期待在下週的會議上見到大家。謝謝。

This concludes today's conference call. You may now disconnect.

今天的電話會議到此結束。您現在可以斷開連線。

Not only that, yes, Gap, many are now we do and a lot of buzz there. Why the yes.

不僅如此，是的，Gap，我們現在做了很多事情，而且那裡有很多嗡嗡聲。為什麼是的。