Revenue Growth
Total revenue of $1.42 billion in Q1 2026, up ~11% year-over-year, with same-store revenue up 8% (same-store = 284 skilled nursing facilities in operation since 2025).
Strong Profitability and Margin Expansion
Net income of $80.7 million (up $52.3 million vs $28.5 million prior year, ~+183% YoY); adjusted EBITDA of $170 million (up $72.8 million, +75% YoY); adjusted EBITDAR of $266 million; diluted EPS $0.50 vs $0.17 prior year (increase of $0.33, ~+194%).
Operating Leverage
Cost of services rose to $1.07 billion (+5% YoY) while revenue grew ~11%, driving meaningful operating leverage; total operating expenses increased ~5.8% YoY despite continued investment in infrastructure and personnel.
Occupancy and Skilled Mix Improvements
Overall portfolio occupancy 90.9% (vs 89.2% prior year). Same-store occupancy improved from 89.6% to 90.8%. Skilled mix increased to 30.5%, up 90 basis points YoY. Mature facilities: 94.8% occupancy and 33% skilled mix; ramping facilities averaging 88.9% occupancy; new facilities averaging 82.7% occupancy with 26.5% skilled mix as they integrate.
Clinical Quality Progress
222 facilities rated 4- or 5-stars under CMS at quarter end (up from 207 a year earlier); mature-facility average CMS rating 4.4 vs industry average ~3.6 — demonstrating sustained clinical performance and improvement.
One-time / Program Benefits Recognized but Separately Disclosed
Included ~$16.3 million of net EBITDA benefit from California WQIP payments in adjusted EBITDA; excluding WQIP, adjusted EBITDA still increased by ~$57 million YoY in Q1 — management explicitly separating these payments from guidance due to timing uncertainty.
Strong Balance Sheet and Liquidity
Approximately $800 million of available liquidity at quarter end (including ~$250 million cash), net leverage ~0.1x; deployed $86.5 million in strategic real estate investments during the quarter.
Capital Allocation Optionality
Board approved a $250 million share repurchase authorization; management retains flexibility on pace and structure of buybacks and continues to pursue disciplined M&A pipeline.
Operating Model and Talent Development
Platform of 223 facilities across 17 states (~35,000 total beds, ~31.9k patients daily); continued focus on locally led, centrally supported model and leadership development (40 administrators-in-training) to support integration and scale.
Cash Generation
Reported cash from operating activities of $236 million in Q1; adjusted for a $50 million prepaid acquisition timing item, operating cash would still be ~$186 million — indicating strong cash generation relative to EBITDA.