Executive Summary

Q4 2024 net operating revenues were $369.35M (+22.7% y/y), driven by same‑facility growth and the White Oak acquisition; adjusted diluted EPS rose to $1.66 vs $1.03 y/y, while GAAP diluted EPS declined to $0.39 due to unrealized losses in marketable securities .
Sequentially, revenues accelerated (Q2→Q3→Q4: $300.66M → $340.20M → $369.35M), with EBIT (operating income) improving to $26.56M and EBIT margin expanding vs Q3 (7.2% in Q4 vs 6.2% in Q3) .
No formal guidance provided; the company declared a quarterly dividend of $0.61 per share payable April 25, 2025 (record date March 28, 2025) .
NHC does not hold earnings calls, limiting intra‑quarter narrative and Street engagement; consensus estimates for Q4 2024 were unavailable via S&P Global .

What Went Well and What Went Wrong

What Went Well

Strong adjusted profitability: Non‑GAAP net income was $25.95M (+62.7% y/y) and adjusted diluted EPS was $1.66 (vs $1.03 y/y), reflecting operational strength excluding marketable securities volatility .
Revenue mix and pricing: Net patient revenues reached $357.34M in Q4 (+26.2% y/y), with per diem rates higher across payer categories (Medicare $607.67, Medicaid $279.02, Private Pay $321.12); average skilled nursing per diem rose to $350.72 .
Strategic M&A executed: White Oak portfolio acquisition (Aug 1, 2024) added scale across 22 operations and contributed to the revenue step‑up in H2 2024 .

What Went Wrong

GAAP optics pressured by markets: GAAP diluted EPS fell to $0.39 from $1.83 y/y, primarily due to $25.33M of unrealized losses on marketable equity securities in Q4 (vs $12.00M gains y/y) .
Labor cost intensity: Salaries, wages and benefits increased to $234.32M in Q4 (vs $186.56M y/y), reflecting industry‑wide cost pressures and expanded footprint .
Limited investor communication: NHC does not host earnings calls, constraining guidance clarity and real‑time color for investors .

Financial Results

Sequential Quarterly Comparison (Q2 2024 → Q3 2024 → Q4 2024)

Metric	Q2 2024	Q3 2024	Q4 2024
Net Operating Revenues and Grant Income ($USD Millions)	$300.66	$340.20	$369.35
Net Patient Revenues ($USD Millions)	$279.92	$328.67	$357.34
Other Revenues ($USD Millions)	$11.30	$11.52	$12.01
Income from Operations ($USD Millions)	$22.52	$21.05	$26.56
GAAP Net Income Attributable ($USD Millions)	$26.84	$42.79	$6.08
GAAP Diluted EPS ($USD)	$1.73	$2.73	$0.39
Non‑GAAP Net Income ($USD Millions)	$15.61	$19.91	$25.95
Adjusted Diluted EPS ($USD)	$1.00	$1.27	$1.66
EBIT Margin % (Income from Ops / Revenues)	7.5% (22.52/300.66)	6.2% (21.05/340.20)	7.2% (26.56/369.35)
Net Income Margin % (GAAP NI / Revenues)	8.9% (26.84/300.66)	12.6% (42.79/340.20)	1.6% (6.08/369.35)

Year‑over‑Year Comparison (Q4 2023 → Q4 2024)

Metric	Q4 2023	Q4 2024
Net Operating Revenues and Grant Income ($USD Millions)	$300.91	$369.35
Net Patient Revenues ($USD Millions)	$282.99	$357.34
Other Revenues ($USD Millions)	$17.92	$12.01
Income from Operations ($USD Millions)	$20.12	$26.56
GAAP Net Income Attributable ($USD Millions)	$28.41	$6.08
GAAP Diluted EPS ($USD)	$1.83	$0.39
Non‑GAAP Net Income ($USD Millions)	$15.96	$25.95
Adjusted Diluted EPS ($USD)	$1.03	$1.66

Segment/Revenue Mix

Metric	Q2 2024	Q3 2024	Q4 2024
Net Patient Revenues ($USD Millions)	$279.92	$328.67	$357.34
Other Revenues ($USD Millions)	$11.30	$11.52	$12.01
Government Stimulus Income ($USD Millions)	$9.45	$0.00	$0.00

KPIs – Skilled Nursing Per Diems and Patient Days

KPI	Q2 2024	Q3 2024	Q4 2024
Medicare Per Diem ($)	$577.71	$578.12	$607.67
Managed Care Per Diem ($)	$447.96	$459.94	$490.41
Medicaid Per Diem ($)	$264.49	$290.00	$279.02
Private Pay Per Diem ($)	$312.91	$323.36	$321.12
Average Skilled Nursing Per Diem ($)	$338.86	$350.85	$350.72
Total Skilled Nursing Patient Days	567,297	673,378	728,486
Footnote – Missouri facility exit	Exit effective Mar 1, 2024 (per diem and days disclosed)	Exit highlighted with comparative 2023 metrics	Exit highlighted with comparative 2023 metrics

Balance Sheet Highlights (Year‑End 2024)

Cash, cash equivalents and marketable securities: $216.19M; Restricted cash and marketable securities: $163.80M; Total assets: $1.52B; Debt: $137.00M; Equity: $980.16M .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Dividend per Common Share	Q1 2025 (paid in April 2025)	N/A	$0.61 per share; record 3/28/2025; payable 4/25/2025	Maintained vs Q4 declared per share ($0.61)

No formal revenue/margin/OpEx/tax guidance was provided in the Q4 materials .

Earnings Call Themes & Trends

NHC does not host earnings calls; themes below reflect multi‑quarter operating disclosures.

Topic	Previous Mentions (Q2 and Q3)	Current Period (Q4)	Trend
Acquisition/Integration	White Oak closed Aug 1, 2024; 21 operations cited in Q3 materials; revenue step‑up visible	White Oak described as 22 operations (incl. LTC pharmacy) contributing to FY growth	Scaling contribution ↑
Pricing/Per Diems	Average per diem rose to $338.86 (Q2); payer‑mix per diems up	Average per diem rose to $350.85 (Q3)	Average per diem at $350.72 (Q4)
Volume/Patient Days	567,297 (Q2) total days	673,378 (Q3)	728,486 (Q4)
Labor Costs	Salaries/wages: $180.08M (Q2)	$213.40M (Q3)	$234.32M (Q4)
Portfolio Actions	Missouri SNF exit noted across disclosures (context for comps)	Missouri SNF exit reiterated with Q4 comps	Portfolio optimization ongoing

Management Commentary

“Net operating revenues and grant income for the year ended December 31, 2024 totaled $1,307,382,000… due to a 9.4% increase in same‑facility net operating revenues, as well as the August 1, 2024 acquisition of White Oak Manor.” .
“For the quarter ended December 31, 2024, adjusted net income… was $25,954,000 compared to $15,955,000 for the same period in 2023, an increase of 62.7%.” .
White Oak operations consist of 22 healthcare operations, including 15 SNFs, two assisted living, four independent living facilities, and a long‑term care pharmacy .

Q&A Highlights

NHC does not hold earnings calls; there was no Q4 2024 Q&A, and thus no management guidance clarifications or tone signals in a call format .

Estimates Context

Wall Street consensus estimates for Q4 2024 (EPS, revenue, EBITDA) were unavailable via S&P Global; NHC’s practice of not hosting earnings calls may contribute to limited Street coverage for intra‑quarter estimates .

Key Takeaways for Investors

Core operations strong on an adjusted basis: Q4 adjusted diluted EPS of $1.66 and non‑GAAP net income of $25.95M underscore underlying momentum despite GAAP volatility from marketable securities .
Sequential acceleration: Net operating revenues climbed each quarter in 2024 H2, reaching $369.35M in Q4; patient days and per diem rates support the top‑line step‑up .
Cost vigilance needed: Salaries/wages rose to $234.32M in Q4; margin expansion vs Q3 came from revenue scale, but labor inflation remains a watch item for FY25 .
Portfolio scaling: White Oak integration broadened footprint and contributed to revenue growth; continued integration execution is a medium‑term driver .
Balance sheet: Year‑end cash and marketable securities of $216.19M, restricted of $163.80M, and $137.00M debt support flexibility for operations and selective investments .
Communication gap: No earnings call limits near‑term narrative catalysts; dividend continuity ($0.61 per share for Q1 2025) offers income visibility while fundamentals drive medium‑term thesis .
Focus areas: Monitor payer‑mix/pricing, labor cost containment, and realized vs unrealized investment impacts given marketable securities sensitivity to GAAP EPS optics .

Notes: All figures are GAAP unless otherwise noted; non‑GAAP reconciliations provided by NHC. Year‑over‑year comps incorporate the Missouri SNF exit and White Oak acquisition dynamics disclosed in the company’s releases .

NATIONAL HEALTHCARE CORP (NHC)·Q4 2024 Earnings Summary