Healthcare Services Group, Inc.

Welcome to Healthcare Services Group 2024 First Quarter Earnings Conference Call. The matters discussed on today's conference call include forward-looking statements about the business prospects of Healthcare Services Group, Inc. For Healthcare Services Group, Inc.' 's most recent forward-looking statement notice, please refer to the press release issued this morning, which can be found on our website, www.hcsg.com. Actual results may differ materially from those expressed or implied as a result of various risk uncertainties and important factors, including those discussed in the Risk Factors MDMA and other sections of the Annual Report on Form 10-K and the Healthcare Services Group Incorporated's other SEC filings. And as indicated in our most recent forward-looking statement notice, additionally, management will be discussing certain non-GAAP financial measures. A reconciliation of these items to US GAAP can be found in this morning's press release. I'd now like to hand over the conference to the President and CEO, Ted Wall, and Chief Communication Officer, Matt McKee. Please go ahead.

Thank you and good morning, everyone. Matt McKee and I appreciate you joining us today. We released our first quarter results this morning and plan on filing our 10Q by the end of the week. Today, in my opening remarks, I'll first discuss our Q1 financial highlights and key accomplishments, including the change healthcare disruption and the temporary impact it had on our customers, cash collections, and cash flow. I'll then share our perspective on the latest industry trends and developments. And then lastly, I'll provide an update on our Q2 priorities and outlook for the rest of the year. I'll then turn the call over to Matt for a more detailed discussion on the quarter. So with that overview, I'd like to now discuss our Q1 financial highlights and key accomplishments. Our team delivered strong first quarter results, building on our positive momentum in 2023. For the three months ended March 31st, 2024, We reported revenue of $423.4 million in line with expectations, net income and diluted EPS of $15.3 million and 21 cents, adjusted net income and adjusted diluted EPS of $16.5 million and 22 cents, and adjusted EBITDA of $28.9 million, a 10.7% increase over Q1 of 2023. During the quarter, we managed adjusted cost of services under 86% and continued to grow our new business and manager and training pipelines. We remain confident that we will deliver on our goal of year-over-year growth in 2024 with the majority of those new business ads expected in the second half of the year. On the cash collections front, Q1 has historically been our most challenging quarter, especially on the heels of Q4, which typically sees our strongest collections. The first quarter seasonality is anticipated and accounted for in our cash flow forecasting. However, what was unanticipated was the February change healthcare cyber attack. The resulting disruption had a far-reaching impact across the healthcare landscape and affected the claim submissions and billing activities of long-term and post-acute care providers, many of whom are HCSG customers. In spite of these first quarter headwinds, Anticipated or otherwise, we achieved 95% cash collections and would have met our first quarter cash flow estimates if not for the change healthcare issue. While this event was disruptive during the quarter, we are confident that the impact on our customers is temporary. We expect to make up for any cash collection delays in the months ahead, which is why we're reiterating our previously shared 2024 cash flow range of $40 to $55 million. I'd like to now share our perspective on the latest industry trends and developments. Industry fundamentals continue to trend positively, highlighted by a slow but steady increase in workforce availability with the industry adding nearly 100,000 jobs since the beginning of 2023. At the current pace, the sector's workforce will match the 1.6 million pre-pandemic employee levels by the end of 2025. Rising occupancy, which now sits at 79%, 12 points higher than the January 2021 low, and just 1% under pre-pandemic levels, and a stable reimbursement environment, which includes CMS's recently proposed 4.1% increase in Medicare rates for fiscal year 2025, as well as continued positive reimbursement trends at the state level. Reimbursement rates are especially important at this stage of the recovery in helping to offset the increased cost of doing business driven by persistent inflation and the higher cost of capital. On the regulatory front, CMS published its final minimum staffing rule earlier this week. There is a growing list of stakeholders opposed to the rule, including healthcare industry leaders, trade associations like ACA, MedPAC members, and a bipartisan group of legislators, including nearly every R and a growing number of Ds. The reasons for their opposition include the unfunded nature of the mandate, the one-size-fits-all approach, the apparent disregard for the realities of present and future nursing availability, and the near certainty that if implemented, the rule would lead to facility closures and ultimately reduce access to care, especially in rural areas. We believe it's highly likely the rule will not be implemented or will undergo significant revision during the extended phase-in period, especially given the inevitability of litigation and potential for legislation or administration change. As far as our outlook for Q2 and the second half of 2024, our top three priorities continue to be as follows. The first is managing adjusted cost of services in line with our target of 86%. We do not take operational execution for granted, but have full faith in the ability of our operators to deliver the services on budget. It took a considerable amount of work in 2022 to modify our contracts to better capture wage inflation and cost increases in our pricing on a closer to real-time basis. Those contract enhancements along with recent positive trends in customer experience, systems adherence, regulatory compliance, and budget discipline, provide strong operating momentum heading into the second quarter. We expect Q2 adjusted cost of services to be at or below 86%. Our second priority is delivering year-over-year growth by executing on our organic growth strategy through hiring, training, and developing future management candidates converting opportunities from our sales pipeline into new business ads, and retaining our existing facility business. We estimate a Q2 adjusted revenue range of $420 to $430 million and remain confident that we will deliver on our goal of year-over-year growth in 2024, with the majority of those new business ads expected in the second half of the year. The third priority is collecting what we build. we view cash collections as a lagging indicator of industry recovery. While our recent trends have improved compared to 2022 and the first half of 2023, and if not for the change healthcare disruption, we would have met our Q1 cash flow estimates, this remains an area of opportunity for the company in 2024. We continue to expect some choppiness throughout the year ahead, but anticipate our cash collections gaining strength throughout 2024 and further still into 2025. We estimate a Q2 adjusted cash flow range of 5 to 15 million and reiterate our previously shared 2024 adjusted cash flow range of 40 to 55 million. As we round the turn of what has been a prolonged recovery for the industry, the company's underlying fundamentals are stronger than ever, and we remain focused on executing on our strategic priorities to drive growth and deliver meaningful shareholder value in the year ahead. So, with those introductory comments, I'll turn the call over to Matt for a more detailed discussion on the quarter.

Thanks, Ted, and good morning, everyone. Revenue was $423.4 million, in line with the company's expectations of $420 to $430 million. The company estimates Q2 revenue in the range of $420 to $430 million. Housekeeping and laundry and dining and nutrition segment revenues were $190.5 million and $232.9 million, respectively. Housekeeping and laundry and dining and nutrition segment margins were 9.7% and 7.6%, respectively. Cost of services was $358.9 million. Adjusted cost of services was $357.3 million, or 84.4%. The company's goal is to continue to manage adjusted cost of services in the 86% range. SG&A was $46.9 million. Adjusted SG&A was $42.8 million, or 10.1%. And the company's goal continues to be achieving adjusted SG&A in the 8.5% to 9.5% range. Net income and diluted earnings per share were $15.3 million and 21 cents, respectively. Adjusted net income and adjusted diluted earnings per share were $16.5 million and 22 cents, respectively. Adjusted EBITDA was $28.9 million, or 6.8%. This is a 10.7% increase over Q1 of 2023. Q1 cash flow and adjusted cash flow used in operations were $26 million and $9.2 million, respectively. DSO for the quarter was 88 days. Also, as part of our adjusted results, we adjust for the impact of the change in the payroll accrual. But since it will still be included in our reported cash flow from operations, we would point out that the Q2 payroll accrual is 15 days. That compares to the eight days in the first quarter of 2024 and the 13 days that we had in Q2 of 2023. But again, the payroll accrual only relates to quarter-to-quarter timing. So with those opening remarks, we'd now like to open up the call for questions.