Extendicare Announces 2023 Third Quarter Results

MARKHAM, Ontario, Nov. 09, 2023 (GLOBE NEWSWIRE) -- Extendicare Inc. (โ€œExtendicareโ€ or the โ€œCompanyโ€) (TSX: EXE) today reported results for the three and nine months ended September 30, 2023. Results are presented in Canadian dollars unless otherwise noted.

Third Quarter Highlights

  • Home health care volume growth continued, with Q3 average daily volume (โ€œADVโ€) of 27,378, an increase of 1.0% from Q2 2023 and 9.3% from Q3 2022.
  • Long-term care (โ€œLTCโ€) occupancy continued steady recovery, improving to 97.8%, an increase of 60 bps from Q2 2023 and 430 bps from Q3 2022.
  • Adjusted EBITDA(1) increased $10.7 million to $20.8 million, reflecting growth in home health care ADV, rate increases, moderation in LTC costs, higher occupancy and growth in managed services, partially offset by higher administrative costs.
  • The Revera transactions closed, adding 56 LTC homes and approximately 7,000 beds to the managed services portfolio, 25 of which were acquired through a 15% managed interest in a limited partnership joint venture with Axium LTC Limited Partnership (โ€œAxiumโ€).
  • The sale of four redevelopment projects into a limited partnership joint venture with Axium closed, with Extendicare retaining a 15% managed interest, establishing the joint venture to support the redevelopment of Extendicareโ€™s Class C homes.

Subsequent to Q3

  • Extendicare commenced construction in October on a new 256-bed LTC home to replace a 240-bed Class C home in Ottawa. It is currently anticipated that the redevelopment project will be sold to Axium JV.

โ€œClosing our transactions with Axium and Revera marks a major milestone in our strategic transformation,โ€ said Dr. Michael Guerriere, President and Chief Executive Officer. โ€œThe trend of positive sequential growth we are seeing across our operating segments confirms the compelling market opportunity emanating from the growing demand for seniorsโ€™ care. The new construction project is the first of many being pursued, and demonstrates the organic growth potential of our pipeline of redevelopment opportunities and our commitment to move quickly to pursue them in partnership with Axium.โ€

Completed Strategic Transactions with Revera and Axium

The Company closed the previously announced Axium transaction on September 13, 2023, selling four Class C redevelopment projects comprising an aggregate of 960 LTC beds currently under construction to Axium Extendicare LTC LP (โ€œAxium JVโ€), a limited partnership joint venture with Axium, with Extendicare retaining a 15% managed interest. The aggregate purchase price, net of Extendicareโ€™s 15% retained interest, was $147.3 million, comprised of cash proceeds of $59.0 million, the assumption of debt of $72.3 million and certain other liabilities and construction related holdbacks, net of taxes and certain closing costs. The net book value of the property and equipment related to the four projects was $135.8 million, resulting in a gain, net of taxes, certain closing costs and other costs of $8.7 million. The Company will continue to undertake all development activities in respect of these joint venture homes and will provide managed services to operate the homes upon completion of construction.

Additionally, the Company closed the previously announced Revera transactions on August 1, 2023, which added 56 LTC homes and approximately 7,000 beds to the higher margin managed services segment, 25 of which were acquired through a 15% managed interest in a limited partnership joint venture, Axium Extendicare LTC II LP (โ€œAxium JV IIโ€). The total aggregate cash consideration paid was approximately $32.6 million, net of holdbacks, plus assumption of approximately $37.1 million in debt (Extendicareโ€™s share of joint venture debt).

Axium JV and Axium JV II are both limited partnership joint ventures between Axium, holding an 85% interest, and Extendicare, holding a 15% managed interest.

Seizing Redevelopment Opportunities in Ontario

Subsequent to the end of the quarter and under the enhanced capital funding subsidy that was in place until August 31, 2023, Extendicare commenced construction on a new 256-bed LTC home in Ottawa. The estimated development costs for the project are $102.2 million.

Together with the four projects already under construction in Sudbury, Kingston, Stittsville and Peterborough, these five projects will replace 1,074 Class C LTC beds with 1,216 new beds. In addition to the Companyโ€™s remaining 15 projects to replace 2,211 Class C beds with 3,032 new beds across Ontario, the Company has the option to purchase all future Revera LTC redevelopment projects undertaken in connection with Reveraโ€™s 30 Class C LTC homes currently being managed by the Company.

While the enhanced capital funding subsidy expired at the end of August 2023 and further funding has not yet been announced, we continue to advance the balance of our redevelopment portfolio to be ready to make use of any future enhancements to the governmentโ€™s capital funding program.

Improved Performance Across Operating Segments

ParaMed grew in Q3, overcoming the seasonal softness usually experienced in the summer months. ADV in the third quarter was 27,378, a 1% increase from Q2 2023 and up 9.3% from Q3 2022. This marks the fourth quarter of sequential growth, demonstrating continued strong demand for our services. ParaMed NOI margin recovery continued in Q3 up 120 bps from Q2 2023 to 9.8%, reflecting the operating leverage inherent in our scalable back-office and cloud-based platform.

Our LTC operations continued to recover from pandemic related impacts. Overall occupancy in the third quarter was up 60 bps to 97.8% from Q2 2023, with improvements in preferred occupancy reflecting strong demand. Progress on recruiting care professionals enabled us to reduce the use of agency labour in our homes. Accordingly, NOI margin improved to 8.7%, up from 7.8% in Q2 2023, excluding the impact of COVID-19 funding and related costs.

Managed services results benefited from the close of the Revera and Axium transactions in the quarter.

Q3 2023 Financial Highlights (all comparisons with Q3 2022)

  • Revenue increased 4.4% or $13.6 million to $322.5 million, driven primarily by LTC flow-through funding increases, higher LTC occupancy, growth in home health care ADV, rate increases and growth in managed services, partially offset by COVID-19 funding of $22.0 million recognized in Q3 2022.
  • NOI(1) increased 49.7% or $11.7 million to $35.2 million, reflecting revenue growth, partially offset by higher operating costs across all segments.
  • Adjusted EBITDA(1) increased $10.7 million to $20.8 million, reflecting the improvements in NOI noted above, partially offset by higher administrative costs of $0.9 million.
  • In connection with the Revera and Axium transactions, the Company recognized other income of $5.0 million in Q3 2023 compared with an expense of $3.6 million in Q3 2022; the favourable year-over-year change of $8.6 million related to a gain on sale of assets to Axium JV of $9.1 million, partially offset by a $0.5 million increase in strategic transformation costs.
  • Earnings from continuing operations increased $16.2 million to $11.8 million, driven by the after-tax impact of the improvement in Adjusted EBITDA and other income, partially offset by higher depreciation and amortization.
  • AFFO(1) was $12.3 million ($0.14 per basic share) compared with $2.1 million ($0.02 per basic share), reflecting the improvement in earnings, partially offset by higher maintenance capex.

Nine Months 2023 Financial Highlights (all comparisons with Nine Months 2022)

  • Revenue increased 4.8% or $43.6 million to $954.8 million, driven primarily by LTC flow-through funding increases, higher prior year LTC funding of $3.7 million, improved LTC occupancy, growth in home health care ADV of 7.7%, rate increases and growth from managed services, partially offset by lower COVID-19 funding of $65.5 million.
  • NOI(1) improved 24.6% or $21.4 million to $108.2 million; excluding the impact of a higher recovery of COVID-19 costs of $4.4 million and prior year LTC funding of $3.7 million, net of workers compensation rebates of $3.9 million received in Q2 2022, NOI improved by $17.2 million, reflecting LTC funding increases and higher occupancy, growth in home health care ADV and rates, and growth from managed services, partially offset by higher operating costs across all segments.
  • Adjusted EBITDA(1) increased $18.2 million to $66.5 million, reflecting the improvements in NOI noted above, partially offset by higher administrative costs of $3.2 million.
  • Other (income) expense was near zero compared to an expense of $5.2 million in 2022; the favourable year-over-year change related to the gain on sale of assets to Axium JV of $9.1 million, partially offset by a $3.9 million increase in strategic transformation costs.
  • Earnings from continuing operations increased $22.2 million to $25.4 million, driven by the after-tax impact of the improvement in Adjusted EBITDA, lower net finance costs, and the favourable change in other (income) expense of $5.2 million.
  • AFFO(1) of $42.2 million ($0.49 per basic share) was up from $24.3 million ($0.27 per basic share), reflecting the improvement in earnings and the impact of the normal course issuer bid (โ€œNCIBโ€) activity in 2022, partially offset by higher maintenance capex. Excluding the impact to AFFO of the net higher recovery of COVID-19 costs, prior year LTC funding, and workers compensation rebates, AFFO per basic share increased $0.18 to $0.33 from $0.15 in the prior year.

Business Updates

The following is a summary of Extendicareโ€™s revenue, NOI(1) and NOI margins(1) by business segment for the three and nine months ended September 30, 2023 and 2022.

(unaudited)Three months ended September 30ย Nine months ended September 30
(millions of dollarsย ย 2023ย ย ย ย 2022ย ย ย ย 2023ย ย ย ย 2022ย 
unless otherwise noted)RevenueNOIMarginย RevenueNOIMarginย RevenueNOIMarginย RevenueNOIMargin
Long-term care191.716.68.7%ย 192.313.97.2%ย 581.764.211.0%ย 573.758.110.1%
Home health care118.111.69.8%ย 107.85.24.8%ย 341.928.18.2%ย 313.216.15.1%
Managed services12.77.055.2%ย 8.84.550.9%ย 31.215.951.1%ย 24.212.752.3%
ย 322.535.210.9%ย 308.923.57.6%ย 954.8108.211.3%ย 911.286.89.5%
Note: Totals may not sum due to rounding.

Long-Term Care

The average occupancy of our LTC homes has continued to recover, improving to 97.8% in Q3 2023, up 430 bps from 93.5% in Q3 2022 and up 60 bps from 97.2% in Q2 2023.

NOI and NOI margin in Q3 2023 were $16.6 million and 8.7%, respectively, up from $13.9 million and 7.2% in Q3 2022, reflecting improved alignment of costs with funding and increased occupancy, partially offset by higher operating costs.

Home Health Care

Home health care ADV of 27,378 in Q3 2023 was up 9.3% from Q3 2022 and 1.0% from Q2 2023, overcoming the seasonal softness usually experienced in the summer months.

Revenue was $118.1 million in Q3 2023, up 9.6% from Q3 2022, driven by growth in ADV and rate increases, partially offset by reduced COVID-19 funding of $3.3 million.

NOI and NOI margin were $11.6 million and 9.8% respectively, in Q3 2023, up from $5.2 million and 4.8% in Q3 2022. Excluding the impact of unfunded COVID-19 costs of $0.7 million in Q3 2022, NOI improved by $5.7 million and NOI margin improved by 410 bps from 5.7% in Q3 2022, reflecting higher volumes and rates, partially offset by higher wages and benefits.

Managed Services

Following the closing of the Revera and Axium transactions and other changes to Extendicare Assistโ€™s client base, Extendicare Assist has management contracts with 73 homes comprising 9,962 beds at the end of Q3 2023, up from 50 homes and 5,959 beds at the end of Q3 2022, and provides a further 53 homes with consulting and other services. The number of third-party beds served by SGP increased to approximately 128,900 at the end of Q3 2023, up 20.5% from Q3 2022 and 11.6% from Q2 2023.

Revenue increased by $3.9 million or 44.3% to $12.7 million from Q3 2022, largely due to the addition of managed homes as a result of the Revera and Axium transactions and other new SGP clients, partially offset by Extendicare Assist clients that reduced their scope of services. NOI increased by $2.5 million to $7.0 million with an NOI margin of 55.2% in the quarter compared to 50.9% in Q3 2022.

Financial Position

Extendicare is well positioned with strong liquidity of cash and cash equivalents on hand of $96.3 million and access to a further $75.8 million in undrawn demand credit facilities as at September 30, 2023.

Normal Course Issuer Bid

As at November 8, 2023, the Company had purchased for cancellation 1,398,033 Common Shares year to date, at a cost of $8.8 million, or $6.29 per share. Purchases include 770,533 Common Shares under the current NCIB that provides the Company with flexibility to purchase for cancellation up to 7,273,707 Common Shares until June 29, 2024.

Since June 2022, the Company has purchased 6,409,213 Common shares at a cost of $43.8 million. Decisions regarding the quantity and timing of purchases of Common Shares are based on market conditions, share price and the outlook for capital needs.

Select Financial Information

The following is a summary of the Companyโ€™s consolidated financial information for the three and nine months ended September 30, 2023 and 2022.

(unaudited)Three months ended
September 30
ย Nine months ended
September 30
(thousands of dollars unless otherwise noted)2023ย 2022ย ย 2023ย 2022ย 
Revenue322,529ย 308,889ย ย 954,776ย 911,184ย 
Operating expenses287,319ย 285,363ย ย 846,532ย 824,341ย 
NOI(1)35,210ย 23,526ย ย 108,244ย 86,843ย 
NOI margin(1)10.9%7.6%ย 11.3%9.5%
Administrative costs14,440ย 13,492ย ย 41,720ย 38,549ย 
Adjusted EBITDA(1)20,770ย 10,034ย ย 66,524ย 48,294ย 
Adjusted EBITDA margin(1)6.4%3.2%ย 7.0%5.3%
Other income (expense)5,048ย (3,587)ย 28ย (5,202)
Share of profit from investment in joint ventures598ย โˆ’ย ย 598ย โˆ’ย 
Earnings (loss) from continuing operations11,831ย (4,362)ย 25,362ย 3,193ย 
per basic and diluted share ($)0.14ย (0.04)ย 0.30ย 0.04ย 
Earnings from operating activities of
ย  discontinued operations
โˆ’ย 96ย ย โˆ’ย 134ย 
Gain on sale of discontinued operations, net of taxโˆ’ย โˆ’ย ย โˆ’ย 67,920ย 
Net earnings (loss)11,831ย (4,266)ย 25,362ย 71,247ย 
per basic share ($)0.14ย (0.04)ย 0.30ย 0.79ย 
per diluted share ($)0.14ย (0.04)ย 0.30ย 0.75ย 
AFFO(1)12,290ย 2,112ย ย 42,166ย 24,254ย 
per basic share ($)0.14ย 0.02ย ย 0.49ย 0.27ย 
per diluted share ($)0.14ย 0.02ย ย 0.47ย 0.27ย 
Maintenance capex4,895ย 4,240ย ย 9,670ย 8,352ย 
Cash dividends declared per share0.12ย 0.12ย ย 0.36ย 0.36ย 
Payout ratio(1)82%501%ย 72%132%
Weighted average number of shares (000โ€™s)ย ย ย ย ย 
Basic85,009ย 89,178ย ย 85,218ย 89,794ย 
Diluted95,870ย 100,079ย ย 96,106ย 100,799ย 

Extendicareโ€™s disclosure documents, including its Managementโ€™s Discussion and Analysis (โ€œMD&Aโ€), may be found on SEDAR+ at www.sedarplus.ca under the Companyโ€™s issuer profile and on the Companyโ€™s website at www.extendicare.com under the โ€œInvestors/Financial Reportsโ€ section.

November Dividend Declared

The Board of Directors of Extendicare today declared a cash dividend of $0.04 per share for the month of November 2023, which is payable on December 15, 2023, to shareholders of record at the close of business on November 30, 2023. This dividend is designated as an โ€œeligible dividendโ€ within the meaning of the Income Tax Act (Canada).

Conference Call and Webcast

On November 10, 2023, at 11:30 a.m. (ET), Extendicare will hold a conference call to discuss its 2023 third quarter results. The call will be webcast live and archived online at www.extendicare.com under the โ€œInvestors/Events & Presentationsโ€ section. Alternatively, the call-in number is 1-800-319-4610 or 416-915-3239. A replay of the call will be available approximately two hours after completion of the live call until midnight on November 24, 2023. To access the rebroadcast dial 1-800-319-6413 followed by the passcode 0466#.

About Extendicare

Extendicare is a leading provider of care and services for seniors across Canada, operating under the Extendicare, ParaMed, Extendicare Assist, and SGP Purchasing Partner Network brands. We are committed to delivering quality care throughout the health continuum to meet the needs of a growing seniors population. We operate or provide managed services to a network of 126 long-term care homes and retirement communities (53 owned/73 managed services), provide approximately 9.7 million hours of home health care services annually, and provide group purchasing services to third parties representing approximately 128,900 beds across Canada. Extendicare proudly employs approximately 22,000 qualified, highly trained and dedicated individuals who are passionate about providing high quality care and services to help people live better.

Non-GAAP Measures

Certain measures used in this press release, such as โ€œnet operating incomeโ€, โ€œNOIโ€, โ€œNOI marginโ€, โ€œAdjusted EBITDAโ€, โ€œAdjusted EBITDA marginโ€, โ€œAFFOโ€, and โ€œpayout ratioโ€, including any related per share amounts, are not measures recognized under GAAP and do not have standardized meanings prescribed by GAAP. These measures may differ from similar computations as reported by other issuers and, accordingly, may not be comparable to similarly titled measures as reported by such issuers. These measures are not intended to replace earnings (loss) from continuing operations, net earnings (loss), cash flow, or other measures of financial performance and liquidity reported in accordance with GAAP. Such items are presented in this document because management believes that they are a relevant measure of Extendicareโ€™s operating performance and ability to pay cash dividends.

Management uses these measures to exclude the impact of certain items, because it believes doing so provides investors a more effective analysis of underlying operating and financial performance and improves comparability of underlying financial performance between periods. The exclusion of certain items does not imply that they are non-recurring or not useful to investors.

Detailed descriptions of these measures can be found in Extendicareโ€™s Q3 2023 MD&A (refer to โ€œNon-GAAP Measuresโ€), which is available on SEDAR+ at www.sedarplus.ca and on Extendicareโ€™s website at www.extendicare.com.

The reconciliations for certain non-GAAP measures included in this press release are outlined as follows:

The following table provides a reconciliation of AFFO, which includes discontinued operations, to โ€œnet cash from (used in) operating activitiesโ€, which the Company believes is the most comparable GAAP measure to AFFO.

(unaudited)ย Three months ended
September 30
ย Nine months ended
September 30
(thousands of dollars)2023ย 2022ย ย 2023ย 2022ย 
Net cash from operating activities7,223ย 943ย ย 4,244ย 66,598ย 
Add (Deduct):ย ย ย ย ย 
Net change in operating assets and liabilities, including
ย  ย interest, and taxes
5,901ย 2,620ย ย 39,935ย (38,776)
Other expense4,072ย 3,587ย ย 9,092ย 5,202ย 
Current income tax on items excluded from AFFO(679)(944)ย (2,009)(1,371)
Depreciation for office leases(791)(771)ย (2,388)(2,181)
Depreciation for FFEC (maintenance capex)(3,455)(2,173)ย (7,945)(6,837)
Additional maintenance capex(1,240)(2,067)ย (1,525)(1,515)
Principal portion of government capital funding534ย 917ย ย 2,037ย 3,134ย 
Adjustments for joint ventures725ย โˆ’ย ย 725ย โˆ’ย 
AFFO12,290ย 2,112ย ย 42,166ย 24,254ย 

The following table provides a reconciliation of โ€œearnings from continuing operations before income taxesโ€ to Adjusted EBITDA and โ€œnet operating incomeโ€, which excludes discontinued operations.

(unaudited)ย Three months ended
September 30
ย Nine months ended
September 30
(thousands of dollars)2023ย 2022ย ย 2023ย 2022
Earnings (loss) from continuing operations before
ย ย income taxes
13,668ย (5,042)ย 32,539ย 5,868
Add (Deduct):ย ย ย ย ย ย 
Depreciation and amortization9,023ย 7,558ย ย 23,547ย 23,867
Net finance costs3,725ย 3,931ย ย 11,604ย 13,357
Other (income) expense(5,048)3,587ย ย (28)5,202
Share of profit from investment in joint ventures(598)โˆ’ย ย (598)โˆ’
Adjusted EBITDA20,770ย 10,034ย ย 66,524ย 48,294
Administrative costs14,440ย 13,492ย ย 41,720ย 38,549
Net operating income35,210ย 23,526ย ย 108,244ย 86,843
ย ย ย ย ย ย ย ย ย 

Forward-looking Statements

This press release contains forward-looking statements concerning anticipated future events, results, circumstances, economic performance or expectations with respect to Extendicare and its subsidiaries, including, without limitation, statements regarding its business operations, business strategy, growth strategy, results of operations and financial condition, including anticipated timelines and costs in respect of development projects; statements relating to the agreements entered into with Axium and its affiliates, Axium JV and/or Axium JV II in respect of the acquisition, disposition, ownership, operation and redevelopment of LTC homes in Ontario; and in particular statements in respect of the impact of COVID-19 on the Companyโ€™s operating costs, staffing, procurement, occupancy levels and volumes in its home health care business. Forward-looking statements can often be identified by the expressions โ€œanticipateโ€, โ€œbelieveโ€, โ€œestimateโ€, โ€œexpectโ€, โ€œintendโ€, โ€œobjectiveโ€, โ€œplanโ€, โ€œprojectโ€, โ€œwillโ€, โ€œmayโ€, โ€œshouldโ€ or other similar expressions or the negative thereof. These forward-looking statements reflect the Companyโ€™s current expectations regarding future results, performance or achievements and are based upon information currently available to the Company and on assumptions that the Company believes are reasonable. The Company assumes no obligation to update or revise any forward-looking statement, except as required by applicable securities laws. These statements are not guarantees of future performance and involve known and unknown risks, uncertainties and other factors that may cause actual results, performance or achievements of the Company to differ materially from those expressed or implied in the statements. For further information on the risks, uncertainties and assumptions that could cause Extendicareโ€™s actual results to differ from current expectations, refer to โ€œRisks and Uncertaintiesโ€ and โ€œForward Looking-Statementsโ€ in Extendicareโ€™s Q3 2023 MD&A filed by Extendicare with the securities regulatory authorities, available at www.sedarplus.ca and on Extendicareโ€™s website at www.extendicare.com. Given these risks and uncertainties, readers are cautioned not to place undue reliance on Extendicareโ€™s forward-looking statements.

Extendicare contact:
David Bacon, Senior Vice President and Chief Financial Officer
T: (905) 470-4000
E: david.bacon@extendicare.com
www.extendicare.com

Endnote
(1)See the โ€œNon-GAAP Measuresโ€ section of this press release and the Companyโ€™s Q3 2023 MD&A, which includes the reconciliation of such non-GAAP measures to the most directly comparable GAAP measures.

ย 


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