The Ensign Group, Inc.

Ladies and gentlemen, thank you for joining us and welcome to the Enzyme Group, Inc. fourth quarter fiscal year 2025 earnings conference call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please raise your hand. If you have dialed into today's call, please press star nine to raise your hand and star six to unmute. I will now hand the conference over to Mr. Keech. Please go ahead.

Thank you, operator, and welcome, everyone. We filed our earnings press release yesterday, and it is available on the investor relations section of our website at anzinegroup.net. A replay of this call will also be available on our website until 5 p.m. Pacific on February 27, 2026. We want to remind anyone that might be listening to a replay of this call that all the statements made are as of today, February 5, 2026, and these statements have not been or will be updated subsequent to today's call. Also, any forward-looking statements made today are based on management's current expectations, assumptions, and beliefs about our business and the environment in which we operate. These statements are subject to the risks and uncertainties that could cause our actual results to materially differ from those expressed or implied on today's call. Listeners should not place under-reliance on forward-looking statements and are encouraged to review the SEC filings for a more complete discussion of factors that could impact our results. Except as required by federal securities laws, Enzyme and its independent subsidiaries do not undertake to publicly update or revise any forward-looking statements where changes arise as a result of new information, future events, changing circumstances, or for any other reason. In addition, the Enzyme Group, Inc. is a holding company with no direct operating assets, employees, or revenues. Certain of our independent subsidiaries collectively referred to as a service center provide accounting, payroll, human resources, information technology, legal risk management, and other services to the other independent subsidiaries through contractual relationships. In addition, our captive insurance subsidiary, which we refer to as the insurance captive, provides certain claims made coverage to our operating companies for general and professional liability, as well as for work and compensation insurance liabilities. Enzyme also owns Standard Bear Healthcare REIT, which is a captive real estate investment trust that invests in healthcare properties and enters into lease agreements with certain independent subsidiaries of Enzyme, as well as third-party tenants that are unaffiliated with the Enzyme Group. The words Enzyme Company, We, Our, and Us refer to the Enzyme Group and its consolidated subsidiaries. All of our independent subsidiaries, the Service Center, Standard Brewery Healthcare REIT, and the Insurance Captive are operated by separate independent companies that have their own management employees and assets. References herein to the consolidated company and its assets and activities as well as the use of words we, us, our, and similar terms are not meant to imply, nor should it be construed as meaning that the enzyme group has direct operating assets, employees, or revenue, or that any of the subsidiaries are operated by the enzyme group. Also, we supplement our GAAP reporting with non-GAAP metrics. When viewed together with our GAAP results, we believe that these measures can provide a more complete understanding of our business, but they should not be relied upon in the exclusion of GAAP reports. A GAAP to non-GAAP reconciliation is available in yesterday's press release and available in our Form 10-K. And with that, I'll turn the call over to Barry Porter, our CEO. Barry?

Thanks, Chad, and thank you all for joining us today. We're excited to report another record year and record quarter in several key areas. To start, I want to highlight the extraordinary clinical outcomes achieved by our dedicated and talented caregivers. None of the results which we will discuss today are possible. without the outstanding work being done by these amazing nurses, therapists, dietitians, food service professionals, activities coordinators, and the many others whose unwavering commitment shapes the daily care experience for thousands of patients across our portfolio. It's difficult to convey in words how so many individuals work so hard to achieve such amazing outcomes through so many small moments of selfless service. Having a front row seat to these amazing people is humbling to say the least. And while the point of these quarterly calls is to provide investors a financial update, let there be no mistake that our consistent financial results would not be possible without a relentless patient focused culture that drives our frontline partners to deliver the highest quality clinical outcomes supported by a family like atmosphere where everyone genuinely cares about one another. There are several measurements that showcase our clinical excellence. For example, according to the most recently published CMS data, same store Ensign affiliated operations outperform their peers in their annual survey results by an impressive 24% at the state level and 33% at the county level. This exceptional performance is only possible by achieving sustained clinical performance over time. In that same data set, Ensign affiliated operations also maintained a 19% advantage in overall four and five star rated buildings when compared to their peers. This is particularly noteworthy given that the majority of these communities were one and two star facilities at the time of acquisition. In addition, our same store operations continue to outperform their industry peers in five star quality measure results by delivering 22% better results on a national level and 17% above the state level. Together, these results underscore our ability to become the provider of choice in our communities by delivering consistently better quality of care, getting long-term value across our portfolio, and we'll expand on that more throughout this call. This clinical strength depends upon attracting and retaining top-notch talent in every operation. We are encouraged by the deep bench of incredible talent that continues to flow into our organization. And we look forward to working with them to continue to achieve our mission to dignify post-acute care. On the retention side, we continue to experience improvements in turnover, stable wage growth, and lower staffing agency usage, even in the face of increased occupancy. We are especially proud of the exceptionally low turnover amongst our directors of nursing. Over the past few years, DON turnover has declined by 33%. placing us among performers in the industry and reinforcing the stability and leadership consistency that drives high quality care. As we've said before, our people are at the heart of our efforts and seeing these metrics consistently improve is critical to maintaining our path of success and to achieve industry leading results. Our clinical achievements are bearing fruit in many ways. On the census front, our same-store and transitioning occupancy increased to 83.8% and 84.9% during the quarter, which are both all-time highs. On the skilled mix front, we saw an increase across all payers. More specifically, skilled days increased for both our same-store and transitioning operations by 8.5% and 10%, respectively, over the prior year quarter. We also saw Medicare revenue increase for both our same store and transitioning operations by 15.7% and 11.3% respectively, and an increase in our same store Medicare days of 11% over the prior year quarter. In addition, we saw managed care revenue increase for both our same store and transitioning operations by 8.9% and 15% respectively. The primary reason for all these improvements is expanding the trust of the communities our teams serve through the clinical outcomes that they have achieved that I described earlier. As each operation solidifies the reputation in their respective markets, they are not only seeing more patients, but they are also being entrusted to care for more and more medically complex patients, which includes a larger share of Medicare, managed care, and other skilled patients. In addition, we believe we are just now starting to see increased demand for our services related to the strong demographic trends. These powerful tailwinds will only bolster our census momentum we're seeing across our portfolio, giving us confidence in a long-term growth opportunity ahead. While we are thrilled with our current record same-store occupancy, we are actually excited that it's as low as it is. At 83%, we have enough organic growth potential left in our organization to sustain our consistent earnings and revenue growth, even if we stopped acquiring. As we point out during each of our earnings calls with specific facility examples, it's not uncommon to see some of our most mature operations consistently achieve and maintain occupancies in the high to mid-90s. Although many of our acquisitions in 2025 are in states that have higher occupancy levels, including California, Alaska, Utah, and Washington, their occupancy levels are far below the average levels that we see from our mature campuses in these states. The organic potential in our portfolio continues to remain one of our most compelling opportunities to continue to drive results. In addition, we continue to acquire new operations with massive long-term upside with many more in the works. Since 2024, we have successfully sourced, underwritten, closed, and transitioned 82 new operations across several markets, many of which are already performing at or above our expectations. We're very humbled by what we were able to accomplish in 2025, and we are eager to continue to drive organic improvements and take advantage of the acquisition opportunities that we see on the horizon. We are issuing our annual 2026 earnings guidance of $7.41 to $7.61 per diluted share and annual revenue guidance of 5.77 billion to 5.84 billion. The midpoint of this 2026 earnings guidance represents an increase of 14.3% over our 2025 results and is 36.5% higher than our 2024 results. We look forward to 2026 with confidence that our partners will continue to manage and innovate while balancing the addition of newly acquired operations. This annual guidance comes on top of the extraordinary growth we experienced in the last few years. To put this performance in perspective, over the last five years, our total adjusted revenue increased by $2.7 billion, or 111%, representing a 16% compounded annual growth rate while our diluted adjusted earnings per share grew by $3.44 from 2020 to 2025, representing a 16% compounded annual growth rate. In addition, we have seen adjusted net income grow by 121% with a compounded annual growth rate of 17%. This performance is not due to some large event or a single transformative transaction. but instead as the result of steady, consistent growth and performance quarter after quarter, which comes from a collective belief and commitment that is held by all of our partners to expand our mission in a methodical and thoughtful way. Next, I'll ask Chad to add some additional insights regarding our recent growth. Chad? Thank you, Barry.