The Ensign Group, Inc.

Hello, everyone. Thank you for joining us and welcome to the Ensign Group Q2 earnings call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star 1 to raise your hand. To withdraw your question, press star 1 again. I will now hand the conference over to Mr. Keetch. Please go ahead.

Thank you, operator, and welcome, everyone. We filed our earnings press release on Monday, and it is available on the investor relations section of our website at ensigngroup.net. A replay of this call will also be available on our website until 5 p.m. Pacific on August 28, 2026. We want to remind anyone that may be listening to a replay of this call that all statements made are as of today, July 29, 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. Thank you. Thank you for joining us. 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 professional liability as well as for workers' compensation insurance liabilities. Enzyme also owns Standard Bear Healthcare Rate, Inc., 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 Ensign Company, We, Our, and Us refer to the Ensign Group, Inc., and its consolidated subsidiaries. All of our independent subsidiaries, the Service Center, Standard Bearer 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 the words we, us, and our in similar terms, are not meant to imply, nor should it be construed as meaning, that the Ensign Group has direct operating assets, employees, or revenue, or that any of the subsidiaries are operated by the Ensign Group. Also, we supplement our gap reporting with non-gap metrics. When viewed together with our gap results, we believe that these measures can provide a more complete understanding of our business, but they should not be relied upon to the exclusion of gap reports. A gap to non-gap reconciliation is available on Monday's press release and is available in our Form 10Q. With that, I'll turn the call over to Barry Port, our CEO. Barry? Thanks, Chad.

Before we get into our record results for the quarter, we want to spend a little time discussing what drives all of this consistency, namely the mission that our organization was founded on and strives to achieve every day. At Insign, we talk a lot about our mission, which is to dignify post-acute care in the eyes of the world through moments of truth. That mission is much more than a statement on a wall. It is the guiding principle behind nearly every decision that's made across our organization. We believe the best way to transform post-acute care is by consistently delivering exceptional outcomes and experiences that redefine what residents, families, and healthcare partners expect from skilled nursing. Our core values provide the foundation for that work, creating a shared culture that empowers nearly 60,000 partners to lead with compassion, accountability, ownership, and a relentless commitment to excellence. If you visit one of our operations, nearly every single employee knows the value acronym, CAPLICO, and what each letter stands for. While CAPLICO may have begun as a set of values, over time it has become an operating discipline that influences hiring decisions, leadership development, employee retention, clinical execution, and ultimately the experience of residents and families. Together our mission and values inspire local teams to strengthen each other and elevate care. We believe culture is not separate from performance. It is the foundation that makes sustainable clinical, operational, and financial performance possible. At the center of our clinical strategy is an integrated care model that empowers every healthcare discipline to participate fully in making our residents' lives better. We call this model One Clinical. In this model, therapy isn't an ancillary department. It's one half of our clinical brain. As opposed to most of the industry that outsources therapy or treats therapy as a separate department to fulfill a singular purpose, our therapists work alongside nursing as equal clinical partners. bringing their expertise into every aspect of resident care. Together with our physician partners and our interdisciplinary teams, there is a continuous evaluation of emerging clinical evidence, sharing of best practices, and development of advanced clinical pathways that improve outcomes across our operations. Rather than treating diagnoses in isolation, they coordinate every discipline around a common set of goals, restoring function, improving quality of life, reducing avoidable complications and helping residents achieve the best possible outcome. While it may sound like a program, it's much more than that. It is a clinical operating model that guides how our affiliated operations deliver care every day. And we believe it is one of the most important differentiators of our organization that has been developed over decades. This integrated approach influences everything from fall prevention and wound care Thank you for joining us. We believe this clinical patient-centric model is a durable competitive advantage that is uniquely perpetuated and refined through peer accountability in our cluster model. And the proof of all this expertise and efficiency is evidenced in the outcomes. According to the most recently published Centers for Medicare and Medicaid Services data for our same store facilities, we achieved quality measure ratings that were 23% above the average in the states that we operate in. Likewise, these operations achieved CMS Cycle 1 survey inspection results that outperformed the average of facilities in our operating states by 18% and exceeded county-level averages by 26%. In addition, rehospitalization rates and long-stay emergency department visits were better than the national average by 15% and 24%, respectively, supporting successful resident recovery and continuity of care. We also have zero CMS special focus facilities, having graduated several acquisitions that we acquired with that designation. We ended the quarter with over 80% of our skilled nursing operations earning a CMS quality measure rating of four or five stars, exceeding the national averages in every single one of the 15 quality measurement categories, including all five claim-based measurements. This is also especially notable given that many of our acquisitions were one and two star when we took them over. Importantly, all these measures come from a variety of objective sources, including CMS measures, claims-based metrics, regulatory surveys, occupancy trends, and referral behavior. Whether viewed through quality ratings, We believe the consistency of these outcomes provides compelling evidence that our operating model is delivering meaningful results for residents and healthcare partners alike. These results are not the product of any single initiative. They reflect the cumulative impact of our operating model, our one clinical approach, the integration of therapy and nursing, investments in technology and clinical tools, and the local leadership culture that drives accountability and execution at the bedside every day. The strength of our clinical model ultimately depends on the quality and stability of our people. One of our foundational Caplico core values is customer second, the belief that by taking extraordinary care of our employees, they in turn will provide exceptional care to our residents. We have long believed that outstanding resident outcomes begins with engaged, supported, and empowered caregivers who know they are loved and appreciated. We are especially proud of the continued improvement in employee and leadership stability. In particular, our director of nursing turnover continues to improve and our overall RN retention rate is also 8% better than the average across our 17 state footprint using CMS reported data. Similarly, administrator turnover is an impressive 46% lower than the CMS measured state average. We believe this level of leadership stability is one of the key differentiators of our organization. It creates continuity for our caregivers and residents and reinforces accountability at the local level and allows the investments we make in our clinical programs, technology, and resources to translate into consistently superior quality outcomes, care efficiency, regulatory performance, and financial results. Thank you. Thank you. Thank you. Thank you. As each operation solidifies its reputation in its respective market, they are not only being chosen to care for more and more patients, but they are also being entrusted to care for increasingly complex cases, including a larger share of Medicare, managed care and other skilled patients. Patients, families, hospital systems, physicians and managed care organizations continue to choose and many more. In healthcare, trust is ultimately expressed through patient choice and referral behavior. Hospitals, physicians, managed care organizations, patients and families make decisions every day about where care will be delivered. Thank you for joining us. Thank you for joining us. also managed care revenue increased by 6.1% and 16.2% respectively for same-store and transitioning operations over the prior year quarter, with skilled mixed days up 6.2% and 9.4% respectively from the second quarter of 2025. The primary driver of these improvements continues to be the expanding trust from the communities we serve earned through consistent clinical outcomes. Thank you for joining us. We also continue to benefit from powerful demographic tailwinds, which we expect will further support the census momentum we are seeing across our portfolio. while we are pleased with our current same store occupancy, we're equally excited about the remaining organic growth opportunity as we clinically and culturally transform these operations. At 84% occupancy, we still have meaningful runway with many of our most mature operations consistently achieving occupancy in the mid 90% range. This embedded growth remains one of the most compelling drivers of our long-term performance. reflecting the strength of our same-store operations, continued operational momentum across our portfolio, and the ability of our local teams to deliver strong clinical outcomes that deepen referral relationships and support sustainable growth, along with the contribution from acquisitions, We are increasing our annual 2026 earnings guidance to $7.75 to $7.85 per diluted share, up from our previous guidance of $7.48 to $7.62, which we increased last quarter. We are also increasing our annual revenue guidance to 5.87 billion to 5.92 billion, up from 5.81 billion to 5.86 billion. The midpoint of our earnings guidance represents an 18.7% increase over 2025 and a 41.8% growth rate over 2024. We remain highly confident in 2026 and expect our local teams to continue executing, innovating, and integrating new operations while delivering strong results. While we are proud of these results, we also recognize there's always more to learn and more work to do. We remain focused on helping our local leaders find better ways to care for residents, support caregivers, and strengthen the operations they serve. Next, I'll ask Spencer to add some operational insights regarding our operations. Spencer?