Total Revenue

+15.5% (from $980,378K to $1,132,252K)

Total revenue increased due to strong operational performance that built on the previous year's base. This growth reflects both the positive momentum from 2023 and further enhancements in pricing, occupancy, or service mix, enabling a 15.5% jump in revenue. " "

Operating Income (EBIT)

+341% (from $22,826K to $100,777K)

Operating income surged due to a combination of revenue leverage and a dramatic cut in SG&A expenses. The substantial drop in SG&A (from $106,557K to $55,611K) led to much higher margins compared to the prior period’s low EBIT. " "

SG&A Expenses

-48% decline (from $106,557K to $55,611K)

A nearly 50% reduction in SG&A expenses indicates effective cost‐control and improved operational efficiency. This steep decline compared to Q4 2023 helped boost profitability and reflects deliberate initiatives to trim overhead costs. " "

Net Income & EPS (Basic)

Net Income: +266% (from $21,823K to $79,750K); EPS: from $0.38 to $1.40 (+267%)

Improved operating income and cost management combined to drive a significant jump in net income and EPS. Lower SG&A costs and an improved operating margin amplified the bottom line, raising EPS markedly from $0.38 to $1.40 compared to the previous period. " "

D&A Expenses

+17% (from $19,233K to $22,519K)

The increase in D&A expenses reflects additional depreciation and amortization from capital investments and newly acquired assets. This uptick is consistent with the company’s continued investment strategy, building on prior period capital outlays. " "

Interest Expense

+13% (from $2,004K to $2,258K)

Higher interest expense is likely driven by increased financing costs or additional debt incurred to support growth initiatives. This rise aligns with a strategic expansion that has elevated the cost of financing compared to Q4 2023. " "

Net Change in Cash

Negative net change of -$67,468K (reversal vs. positive trends previously)

The negative change in cash signals a reversal from prior positive trends, likely due to increased investing outflows. Heavy capital expenditures or operational expansion investments in Q4 2024 absorbed cash, despite strong operating performance. " "

Revenue Guidance

FY 2024

$4.20 billion to $4.22 billion " "

$4.25 billion to $4.26 billion " "

raised

Earnings Guidance (EPS)

FY 2024

$5.38 to $5.50 per diluted share " "

$5.46 to $5.52 per diluted share " "

raised

Earnings per Diluted Share

FY 2025

no prior guidance

$6.16 to $6.34 " "

no prior guidance

Revenue Guidance

FY 2025

no prior guidance

$4.83 billion to $4.91 billion " "

no prior guidance

Acquisition Pipeline

Described as “very healthy” across Q1–Q3 with multiple acquisitions driven by a disciplined, decentralized approach and strong local leadership " " "

Continued strong deal flow in Q4 with numerous acquisitions lined up, even as licensing delays are noted; the disciplined acquisition strategy remains front‐and‐center " "

Consistently strong with reaffirmed optimism and disciplined execution despite minor delays

Integration Risks

Acknowledged consistently in Q1–Q3; integration challenges were managed by local leadership and a decentralized model, helping absorb distressed operations effectively " " "

Q4 reinforced its disciplined integration strategy by ensuring the right leadership and prudent price-setting remain in place, thereby handling integration risks as before " "

Stable and positive; the integration process remains effective across periods

Occupancy and Skilled Mix Trends

Q1–Q3 discussions highlighted consistent occupancy growth, surpassing pre-pandemic levels in some cases, and noted seasonal variations with strong skilled mix improvements " " "

In Q4, occupancy was reported as flat compared to the record highs of Q3, with expectations that the historical seasonal trends (strong Q4 and Q1 performance) will continue into the next period "

Stable performance with persistent seasonal patterns and minor period-to-period variance

Labor Cost Improvements

Throughout Q1–Q3, improvements were noted in reduced wage inflation, lower third-party agency usage, and improved turnover—all reflecting a positive trend in labor cost management " "

Q4 continued with steady labor cost improvements driven by a stabilized labor market and effective talent retention strategies, supporting ongoing cost containment "

Gradually improving; the positive labor market trends remain consistent

Staffing/Minimum Staffing Regulations

Prior quarters (Q1–Q3) discussed minimal material impact from staffing mandates thanks to phased implementations and optimistic legal outcomes regarding regulatory changes " " "

In Q4, the company incorporated the second year of the California Workforce Standards program into guidance, indicating a more defined operational understanding and maintaining manageable regulatory impact "

Stable outlook with evolving regulatory details that are being proactively managed

Reimbursement Policy Adjustments and Insurer Claims/Authorization Challenges

Q3 provided a detailed discussion on insurer disputes and coding challenges, while Q1 and Q2 briefly touched upon variations in reimbursement systems " "

Q4 did not specifically address insurer claims or authorization challenges but mentioned readiness for potential Medicaid reimbursement adjustments " "

Shifted focus away from insurer claims with reduced emphasis; more attention now on Medicaid reimbursement preparedness

Regulatory Delays, Licensing, and Compliance Issues

Regulatory challenges were intermittently noted—with Q2 mentioning the Chevron doctrine and Q1 addressing CMS staffing rule adaptations—while Q3 had little direct discussion on these issues " "

Q4 emphasized significant licensing delays and regulatory approvals (especially related to Medicaid and ownership changes) that temporarily impact acquisition cash flows " "

Heightened focus in Q4; increased attention on licensing delays and compliance issues compared to earlier quarters

Cash Flow Management and Settlement Outflow Impacts

Q3 briefly noted an upcoming large settlement payment, while Q1 and Q2 provided liquidity metrics without detailing settlement impacts " "

Q4 discussed temporary cash flow impacts caused by licensing delays and an unusual settlement outflow that had a material effect on Q4’s cash flow "

Emerging focus; Q4 brings new, detailed discussion on settlement outflows and its temporary cash flow impact

Capital Allocation and Dry Powder for Future Investments

Consistently across Q1–Q3, the company emphasized strong liquidity with over $1 billion in dry powder supported by solid cash balances, robust credit lines, and disciplined debt metrics " " "

Q4 maintained this robust liquidity position with continued reference to over $1 billion available for future investments, confirming the steady capital allocation strategy "

Consistent and highly positive; the financial flexibility and capital allocation strategy remain unchanged and strong

Market Expansion and Diversification into New Segments

Q1–Q3 discussions focused on geographic expansion and diversification—acquiring operations in multiple states, including LTAC facilities, and building clusters to underpin growth " " " "

Q4 expanded further into new geographies including first-time entries (e.g., Alabama, Alaska, Oregon) while continuing to build on a disciplined acquisition and diversification strategy "

Steady expansion with an increased emphasis on entering new states; diversification efforts remain consistent with a nuanced geographic focus