2/20/2025

speaker
Aaron
Conference Operator

Good day. My name is Aaron and I will be your conference operator for today. At this time I would like to welcome everyone to the 2024 Sabra fourth quarter earnings call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks there will be a question and answer session. If you would like to ask a question during this time simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question press star followed by the number one again. With that I would like to now turn the call over to Lucas Hartwich EVP Finance. Mr. Hartwich please go ahead.

speaker
Lucas Hartwich
EVP Finance

Thank you and good morning. Before we begin I want to remind you that we will be making forward-looking statements in our comments and in response to your questions concerning our expectations regarding our future financial position and results of operations including our earnings guidance for 2025 and our expectations regarding our tenants and operators and our expectations regarding our acquisition disposition and investment plans. These forward-looking statements are based on management's current expectations and are subject to risks and uncertainties that could cause actual results to differ materially including the risks listed in our form 10k for the year ended December 31st 2024 as well as in our earnings press release included as exhibit 99.1 to the form 8k we furnished at the SEC yesterday. We undertake no obligation to update our forward-looking statements to reflect subsequent events or circumstances and you should not assume later in the quarter that the comments we make today are still valid. In addition references will be made during this call to non-GAAP financial results. Investors are encouraged to review these non-GAAP financial measures as well as the explanation and reconciliation of these measures to the comparable GAAP results included on the financials page of the investor section of our website at SabraHealth.com. Our form 10k earnings release and supplement can also be accessed in the investor section of our website and with that let me turn the call over to Rick Matros CEO President and Chair of Sabra Healthcare Reads.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Thanks Lucas appreciate it. Thanks everybody for joining the call we appreciate it. Let me start by sending out love and prayers to the Bebas family. Their bodies will return to Israel today. May the memories of

speaker
Unknown
Unknown

Kfeer and Ariel and Shiri be a blessing. Thanks for allowing me that. So moving on to Sabra

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

first I want to comment on the promotions that we announced this week for Kara, Lucas and Anna. We're really blessed to have the three of them as part of our team. They're fantastic and they exemplify everything that's good and important about Sabra and also exemplifies the depth of our team and just really appreciate them and look forward to working with them in the years ahead. Moving on to the performance for the quarter. Sabra delivered what's been a success a succession of a number of great quarters in a row. Our senior housing and skilled portfolio continue to strengthen. Workforce availability does remain a challenge to the sector but our tenants have been able to implement strategies to mitigate those challenges and labor has stabilized. Our shop same store occupancy was at 80 basis points sequentially with margins of 20 basis points. Our shop cash NOI was at 17.9 percent for the quarter. Our senior housing triple net coverage stayed steady at 1.36. Our skilled occupancy was at 60 basis points sequentially with skilled mix up 30 basis points. Our EBITDA coverage hit an all-time high at 2.09. Our skilled margins are now higher than we've seen in years. Our top 10 had another strong quarter. The 2025 will continue to build upon the strategy we successfully executed in 2024 as evidenced by our 7 percent -over-year normalized AFFO growth. We would anticipate a higher volume of deals in 2025. The increased volume we started to see before year-end has accelerated since with more opportunities than we've seen in quite a long time. The opportunities are primarily shopped but we are seeing more skilled opportunities. The fact that we had nothing new to announce this particular quarter shouldn't reflect on what we think will get done this year. We fully anticipate to have a busy year and a year that will have higher volumes than we had last year. Let me move on to the regulatory and political environment. The political environment's potential impact on our business has been an overhang but I'd like to make a couple of points. First, the threat of Medicaid cuts. We take that very seriously. While any actions that may be taken are unpredictable, there are natural guardrails in place and I want to go through some of those guardrails. As it pertains specifically to Medicaid cuts, Congress has been historically protective of the elderly population, particularly those vulnerable institutionalized folks. The Medicaid budget, inclusive of matching funds, is critical to the governors of all states, both red and blue. And in fact, the red states have been the greater recipients of Medicaid access, the expansion of Medicaid access in recent years. So in addition to the bipartisan support that we've always had in Congress, the governors of the states, again, both red and blue, will be united to protect the elderly in our facilities and the Medicaid budgets that are so critical to them. We have a robust lobbying effort that we expect will be successful and a couple of other things I think to point out in terms of how much in the beginning of the process we're in. The House budget has $880 million of unspecified Medicaid cuts. The Senate version has no Medicaid cuts and overturns the staffing mandate. So you've got opposite sides of the spectrum. You have no specificity on where those Medicaid cuts are. So a very, very long way to go. Finally, as I noted earlier, I think the final guardrail for us is the strength of our portfolio. Having margins, rent coverage, shop margins where they are, with organic growth still to come in both those segments, I think puts us in a very good position to withstand anything that may happen going forward. And with that, I will turn the poll over to Talia.

speaker
Talia [Last Name Unknown]
Unknown

Thank you, Rick. Sabra's managed senior housing portfolio had another solid quarter. The total managed portfolio, including non-stabilized communities and joint venture assets at Share, had sequential revenue growth of 3.5 percent, cash and OI growth of 5.4 percent, with margin expansion of 50 basis points. These statistics demonstrate sequential improvement in operating results that reflect the continued recovery in Sabra's senior housing portfolio. In the fourth quarter, we added one property to Sabra's managed portfolio. We see opportunities for external growth setting up well alongside internal growth. Sabra's same store managed senior housing portfolio, including joint venture assets at Share, continued its strong performance this quarter. The key numbers are revenue for the quarter grew 7.4 percent year over year, with our Canadian communities growing revenue by 10.6 percent in the same period. Both of these results are consistent with the growth statistics we reported last quarter. Fourth quarter occupancy in our same store portfolio grew by 2.3 percent year over year. Notably, our domestic portfolio occupancy grew 2.8 percent during that period, while our Canadian portfolio grew 1.2 percent in the same period. Rent poor in the fourth quarter of 2024 continued to rise with an increase of 4.5 percent year over year, while export rose a near 0.6 percent for the same period. Total expenses for the same store portfolio rose 3.4 percent in the fourth quarter on a year over year basis. Insurance costs have the largest increased among all expenses, but represent less than 3 percent of total expenses. Labor costs, which represent more than 50 percent of expenses, grew 2.1 percent in the quarter on a year over year basis. Cash NOI for the quarter grew 17.9 percent year over year, just above last quarter's results. In our U.S. communities, cash NOI grew 15.2 percent on a year over year basis, while in our Canadian communities, cash NOI for the quarter increased 26.9 percent over the same period, benefiting from the continuous strong performance of our joint venture properties. Overall, we expect to see revenue growth continue to outpace expense growth, as it has in recent quarters, resulting in ongoing growth in cash NOI margins to continue to expand across the portfolio as the senior housing industry builds revenue by balancing occupancy and rate, and expenses, especially labor costs, remain stable. With this as a backdrop, we are seeing significant transaction volume in the senior housing space. Virtually all of the deals are structured to transact as managed rather than leased properties. Our cost of capital now allows us to pursue these opportunities, which can generally be described as newer, nearly stabilized senior housing communities that offer care to residents. Our now leased, stabilized senior housing portfolio also continues to do well with strong rent coverage reflecting the underlying operational recovery. And with that, I will turn the call over to Mike Costa, Sabra's Chief Financial Officer.

speaker
Mike Costa
Chief Financial Officer

Thanks, Talia. For the fourth quarter of 2024, we recognized normalized FFO per share of 35 cents and normalized FFO per share of 36 cents. Normalized FFO totaled $86.9 million this quarter, which is in line with the third quarter. I would like to highlight a few key components of this quarter's earnings. Cash rental income for our triple net portfolio totaled $90 million for the quarter, which was down $1.8 million due to timing of cash basis tenant rents and the impact of asset sales. Cash NOI from our managed senior housing portfolio totaled $24.1 million for the quarter compared to $22.9 million last quarter. This increase was driven primarily by continued sequential same store growth, as well as the impact of a 92 unit property acquired at the beginning of the fourth quarter. Recurring cash G&A was $10.2 million this quarter and slightly better than the $10.4 million per quarter run rate we've provided on the last several calls. Normalized FFO per share and normalized FFO per share were $1.39 and $1.44 respectively for the full year, which represents 7% year over year growth. This growth is a result of steady performance improvements in our managed senior housing portfolio, continued stability in our triple net portfolio, and disciplined capital allocation, three factors that we expect to contribute to further growth in 2025 as illustrated in our full year 2025 guidance. Our full year 2025 guidance on a diluted per share basis is as follows. Net income $0.67 to $0.70. FFO $1.42 to $1.45. Normalized FFO $1.43 to $1.46. AFFO $1.47 to $1.50. And normalized FFO $1.48 to $1.51. At the midpoint, we expect both normalized FFO per share and normalized AFFO per share to increase approximately 4% over 2024. It is important to note that our guidance does not assume any 2025 investment, disposition, or capital markets activity. There are a few other important assumptions in our guidance that I would like to point out. Cash NOI growth in our triple net portfolio is expected to be low single digit in line with contractual escalators. Additionally, our guidance assumes no additional tens are placed on cash basis for revenue recognition. Cash NOI growth for our same store managed senior housing portfolio is expected to be in the low to mid teens. As the portfolio gets closer to full recovery, this growth rate may decelerate and as a result, our guidance assumes the growth rate in the first half of the year will be higher than the growth rate in the second half of the year. General and administrative expenses is expected to be approximately $50 million and includes $11 million of stock-based compensation expense. The weighted average share count assumed in our guidance is approximately 240 million and 241 million shares for normalized FFO and normalized AFFO respectively and is in line with our fourth quarter weighted average share count after adjusting for the timing of ATM share issuances during the quarter. Now briefly turning to the balance sheet. Our net debt to adjusted EBITDA ratio was 5.27 times as of December 31, 2024, a decrease of 0.03 times from September 30, 2024, and a decrease of nearly half a turn from December 31, 2023. This improvement in our leverage is driven primarily by the continued NOI growth in our managed senior housing portfolio, accretive capital recycling, and prudent use of our ATM to fund growth. As of December 31, 2024, we are in compliance with all of our debt covenants and have ample liquidity of $980 million, consisting of unrestricted cash and cash equivalents of $60.5 million, available borrowings under our revolving credit facility of $893.4 million, and $26.1 million related to shares outstanding under Ford sales agreements under our ATM program. As of December 31, 2024, we also had $382.8 million available under the ATM program. Finally, on February 3, 2025, Sobri's board of directors declared a quarterly cash dividend of 30 cents per share of common stock. The dividend will be paid on February 28, 2025, to common stockholders of record as we close the business on February 14, 2025. The dividend is adequately covered and represents a payout of 83% of our fourth quarter normalized ASFO per share. And with that, we'll open up the lines for Q&A.

speaker
Aaron
Conference Operator

Thank you. Ladies and gentlemen, once again, if you would like to ask a question today, remember it's hitting star plus the number one on your telephone keypad. Our first question for today comes from the line of Farrell Granith with Bank of America. Your line is live.

speaker
Farrell Granith
Bank of America

Hi, thank you so much. My first question is in regards to the occupancy for your shop portfolio. Just looking ahead to 2025, what are your thoughts of the pacing of the occupancy, either in acceleration or deceleration, just generally in the senior housing space?

speaker
Talia [Last Name Unknown]
Unknown

You know, it's an interesting question because what we're seeing is operators managing, balancing out pushing rate versus occupancy because they can't, not everyone can do both at the same time. And so that's, so it's very hard for me to sit here and handicap which is, you know, how much occupancy is going to increase versus focus on revenue increases by driving rev core. We're seeing very strong, we have seen very strong increases in our Canadian portfolio which is now seem to be stable, getting ramping down in terms of the rate of growth. But there's still plenty of room in our domestic portfolio and I think that certainly in IL it will continue to get pushed. On the occupancy side in AL, I think there's definitely continued, there'll be continued push but a desire also to raise rev core at the same time.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yeah, and Farrell, the only other thing I would add is, so the way I would look at it is, it's not going to be a deceleration, it's just a function of how much it's going to accelerate to Talia's point.

speaker
Farrell Granith
Bank of America

Great, thank you for that. And also, I know you made some comments on the opportunity set that you're seeing in 25, an increase in it, both the mix of shop and the SNFs. I was curious if, are you seeing any impacts in pricing when it's coming to SNFs specifically due to the current environment?

speaker
Talia [Last Name Unknown]
Unknown

It's interesting you say that. We were just at the ECAP conference a week, 10 days ago. I would say that the transaction market in skilled nursing is robust right now. There is a lot of money chasing deals and opportunities still. Whether lenders and the healthcare reits are able to continue to participate in that right now in a creative fashion is the big challenge, how to figure that out.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

So it's the strategic buyers that are chasing the money. That's what the issue is from a competitive perspective. So they're valuing these assets not just based on the nursing facility, but on the revenue it generates for all their sort of businesses. So they're operating entities, so they're able to pay up. So as Talia said, it's been pretty frothy for those guys.

speaker
Farrell Granith
Bank of America

Okay, thank you so much.

speaker
Aaron
Conference Operator

Thank you for your questions. Our next question comes from the line of John Kilichowski with Wells Fargo. Your line is live.

speaker
John Kilichowski
Wells Fargo

Thank you. Good afternoon. Maybe just to follow up that last question, Rick, just from your opening remarks, it sounds like you feel a lot more confident in the acquisition pipeline this year versus last year. At least you expect an acceleration. I'm curious what you're seeing or what's changed quarter over quarter or from the past couple months till now that makes you feel confident in your ability to accelerate these deals, given, like you said, it's pretty frothy for some of your competition to bid up on deals.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

I'll make a couple of comments and turn it over to Talia. First, we're not doing the kinds of deals that some of our competitors are doing. There's been a lot of loan volume and we're just, as we've talked about in quarters past, and I think you know, John, we're just not interested in pursuing that unless there's a very specific reason that's tied to one of our operators. So if you take all that volume away, it changes the picture for everybody. But just to remind everyone, last year there were a couple of things. One, acquisition opportunities were just starting to pick up over the course of the year, particularly on the shop side, and our cost of capital was improving over the course of the year. So this year, we enter into it in a much different place where there's much higher deal volume and our cost of capital allows us to do the deals that we would like to do.

speaker
Talia [Last Name Unknown]
Unknown

Sure. I mean, how's this? I'm clearing at least 10 confidentiality agreements a week and we're only in mid-February. There's just a lot of deals coming into the market and there's a few sources for them for the most part. One source is a lot of private equity firms that have assets that have either are at funds that are at end of life or beyond. Similar to other kinds of investors, there are P funds that have just decided it's the price is good enough now, let's just get out. So we're seeing quite a bit of that because there's been enough of a recovery to recoup and just exit. We're also starting to see green shoots on some interesting refinancing recapitalization opportunities because three months ago, you recall four months ago, everyone expected interest rates to be declining. And actually what's happened is that has reversed and interest rates have gone up in the 10 years at about a 4.5 now. So opportunities to refinance and not do much on the cash in refi to refinance out banks that have loans, that sort of disappeared. And now we're seeing more refis looking for press equity, mezzanine debt, et cetera. So there's sort of a new stream of opportunities coming in. But there's the recovery, but sort of you really pull back, zoom out here for a sec. There's been enough of a recovery that people that have wanted to exit can finally hit a number that feels okay and they can exit as opposed to continue to carry. And they're really willing to do that. And that's really the break point that we've hit over the last few months.

speaker
John Kilichowski
Wells Fargo

Okay, got it. I appreciate the detailed answer. And then just one more from me on the shop guide. Earlier in the opening remarks, there was a comment made about the back half maybe experiencing some modest deceleration in that growth, just given it gets harder, the comp year over year. How do we pair that with the fact that in this business, there should be greater operating leverage as you hit those sort of higher occupancy marks? And I think you're at 85.8. And kind of once you reach those higher 80 marks, we've always heard in this business, you really start to see the operating leverage of the business shine that maybe should allow for more growth. So could you help us sort of pair those two comments together?

speaker
Mike Costa
Chief Financial Officer

Yeah, I think it's us trying to be a little bit conservative in those assumptions. I think that's a big component of it. I'm not going to hide that fact. But also, I mean, last year, we saw quite a bit of occupancy growth year over year. We're sitting at about 85.5 as of the fourth quarter. If you think that this thing stabilizes in the upper 80s, low 90s, you're starting to get to a point where those occupancy gains aren't going to be as easy to come by versus where they were a year or two ago. So it's just us trying to be conservative on those assumptions and that growth. Still acknowledging the fact, as you pointed out and as Talia pointed out, that the operating leverage kicking in is something that not only are we seeing right now, but we expect to see even more so as occupancy continues to get closer to that, you know, call it 90 percent level. So that's effectively it. I mean, I don't think there's much more to look into it besides that.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Your point is correct,

speaker
Mike Costa
Chief Financial Officer

John.

speaker
Talia [Last Name Unknown]
Unknown

Yeah, that's why I noted that export has increased 0.6 percent, which is essentially it's essentially flat, which goes to operating leverage.

speaker
Unknown
Unknown

OK, great. Thank you. Thank you for your questions.

speaker
Aaron
Conference Operator

Our next question is from the line of Nick Joseph with City Research. Your line is live.

speaker
Michael Griffin
City Research

Hey there, it's Michael Griffin here with Nick. Rick, I think in your opening remarks, you've talked a little bit about some strategies that your operators have implemented to effectively mitigate costs. Can you maybe expand on that a bit, you know, what some of these initiatives could be and is there the opportunity within operators in your portfolio to share best practices, just given your cost mitigation is going to remain to be a focus?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

I think it's a couple of things. One, in terms of recruiting, they've embraced digital marketing for recruiting in very many cases, which has been really helpful getting just more people into the door to be considered. The other is I think there's been a complete revamping of the onboarding processes with all of our operators. So the onboarding process has been lengthened. There typically are mentors that are assigned to new employees, and I think that's really helped get some traction with longevity. So I think those are the two main things, obviously, we saw in 2022, a rebasing of wages. And so that's kind of normalized since then. So, you know, we've always competed with the service sector, but I think the rebasing of the wages during COVID has made our operators a more attractive destination as opposed to other service kinds of positions. So it's really those things.

speaker
Michael Griffin
City Research

Yeah, that's that's an helpful context there. Appreciate it. And then maybe just going back to the acquisition pipeline, Talia, you talked a bit about looking at more stabilized product that had a care component. Should we read into that, that the pipeline is tilted maybe more toward AL relative to IL within the managed portfolio? And what kind of yields or IRRs are you underwriting to for prospective transactions?

speaker
Talia [Last Name Unknown]
Unknown

So I'd say that we're seeing I think. I think that assets with care components are by definition doing better now. So recovery has really affected them now because they're able to charge rate. That's part of as opposed to necessarily drive to maximum occupancy. Of course, they have a higher cost structure, but there's there's been a lot of those built oftentimes. They're IL, AL memory care, by the way. So that is, in fact, what we're seeing mostly. We are seeing some standalone IL, but not that much. And I'm sorry, what was the second part of the question? Oh, what I'm driving to.

speaker
Michael Griffin
City Research

You know, yields or IRR is what you're underwriting to.

speaker
Talia [Last Name Unknown]
Unknown

We're still seeing deals that that going in might be seven to seven and a half, but stabilize it above that. And that's that's that's still happening.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

And I would also just know or reiterate really strategically, we are focused on increasing our shop exposure, but within our shop exposure to to your point, your question, you should see over time our increase in our IL, IL decrease,

speaker
Unknown
Unknown

which should help our growth numbers as well. Great. That's it for me. Thanks for the time.

speaker
Aaron
Conference Operator

Our next question is from the line of Alan Werschmidt with KeyBank Capital Markets, your line is live.

speaker
Austin Werschmidt
KeyBank Capital Markets

Hey, everybody, it's Austin Werschmidt here. Hey, going back, going back to your comment about kind of full recovery in the shop portfolio, my sense was that was was an occupancy comment. I guess can you kind of share where margins and then why stack up relative to occupancy and what kind of the full recovery and future upside entails for those metrics as well?

speaker
Talia [Last Name Unknown]
Unknown

But I think I went through where we are today in my comments. I think I think there's visibility on on getting somewhere close to where we were pre pandemic here now and in senior housing.

speaker
Austin Werschmidt
KeyBank Capital Markets

Got it. But particularly

speaker
Talia [Last Name Unknown]
Unknown

particularly in those assets where you can really drive rate, which is based on location, et cetera, vintage, things like that.

speaker
Austin Werschmidt
KeyBank Capital Markets

I mean, are there any regions or operators specifically that have already surpassed, I guess, the full recovery point and would give you even more confidence about the balance of the portfolio, being able to grow again beyond what you're deeming to be kind of full recovery?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yeah, I think we we definitely have operators both in our senior housing and our skill portfolio that has surpassed where they were pre pandemic. And and so we look to do more deals with them. But our portfolio has gotten so strong. And a lot of that happened with some of the steps that we took during the pandemic that all of our operators are on that path. Some are just further ahead than others. But we're at the point right now where we don't have stragglers that we had pre pandemic. And it's also why we've been as selective, selective as we've been in terms of the deals that we've done both in terms of market operator and the age of the assets that we're buying. So we think with everything that we did last year and actually we had a lot of actually in 2022 as well, we've really enhanced the quality of the portfolio from a market asset and operator perspective.

speaker
Austin Werschmidt
KeyBank Capital Markets

And then just last one, you know, Rick, you mentioned kind of you expect to do more investments this year relative to last year. I mean, how significant of a year over year increase could we see given all the reasons that Talia highlighted around, you know, what's going on in private equity and with, you know, higher interest rates today?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Before before the pandemic, if you exclude some of the really big moves that we made, we typically did several hundred million a year that we'd like to get. I'm not going to predict that will exactly be there this year, but that's certainly a goal for us is to get back to the level of investments that we did on a routine basis prior to the pandemic.

speaker
Austin Werschmidt
KeyBank Capital Markets

That's all for me. Very helpful. Thank you.

speaker
Aaron
Conference Operator

Thank you for your questions. Our next question comes from the line of Vikram Malhotra with Mizuho. Your line is live.

speaker
Georgie
Vikram

Hey, this is Georgie on from Vikram. Just on the external growth pipeline, can you just talk about what does the competition look like for stabilized assets in the senior housing?

speaker
Talia [Last Name Unknown]
Unknown

Mostly the health care rates for the nicer assets, the institutional quality assets, I'd say below that kind of quality level. I think you've probably got some high net worth. We're not seeing private equity in the states right now, though there are starting, there's starting to be rumblings of them. They're coming back. It's hard to be a levered buyer right now. There's just not enough spread between the cost of debt and and cap rate.

speaker
Georgie
Vikram

That's helpful. I just have one more on the shop portfolio. Can you just provide more color on what January rent bumps were compared to last year?

speaker
Talia [Last Name Unknown]
Unknown

I don't have the exact numbers for the portfolio with me, but it's been it's sort of in the four to five percent range is what we're seeing in our larger operators and they're achieving those.

speaker
Mike Costa
Chief Financial Officer

Yeah. And the other thing to point out, too, is that rent bumps aren't all done on January. Right. It varies operator operator. Right.

speaker
Talia [Last Name Unknown]
Unknown

Some do them on an anniversary date of the of the lease. Some do them in January. It varies.

speaker
Unknown
Unknown

Mike's right. Great. Thank you. Thank you for your questions. Our

speaker
Aaron
Conference Operator

next question comes from the line of Juan Sanabria with BMO Capital Markets. Your line is live.

speaker
Juan Sanabria
BMO Capital Markets

Hi. Thanks for the time. Just hoping you could talk a little bit about the infrastructure, the platform. Godin seems to call for kind of flat GNA. So just curious how you guys are investing in the system that it seems to be a strength at the reach to have the platforms in the capital to invest behind the business. So presumably that the moat will get wider as that happens over time. I'm just curious on your latest initiatives around being a leader in shop.

speaker
Mike Costa
Chief Financial Officer

Yeah, I mean, look, we've been in shop for a while now and we established the infrastructure several years ago and we started our foray into that. So from a systems perspective, from a technology perspective, from a personnel perspective, those are pretty well established to the point where

speaker
Unknown
Unknown

adding

speaker
Mike Costa
Chief Financial Officer

additional scale in there, you know, any additional costs are going to be really incremental. It's not anything major to take on, you know, larger portfolios or more operators, whatever it may be. And that's where probably the biggest impact, I would say, from a GNA perspective, that would be on the shop side. To extent there's any triple net, you know, we could absorb that without adding any headcount, you know, realistically. So does that answer your question, Juan? Yeah,

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

I would just add one that on from a systems perspective, we're continually upgrading and improving our system so that the technology that we have in place continues to get better, allows us to provide different levels of support to our operators to interact differently, to have more visibility, to have more predictability as we start building artificial intelligence capabilities into our systems.

speaker
Juan Sanabria
BMO Capital Markets

You said the key word there. Just curious on the 25s, you talked about acquisitions ramping up. But curious if there's any dispositions, you had some sales in the fourth quarter, which we didn't necessarily model. So just curious how we should be thinking about sales and dispositions for 25s.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yes, the dispositions that we had in the quarter, sort of ordinary course of business, I think what we talked about the last several quarters, that we had one SNF portfolio that's still in the process of being sold, that's about 50 million. Other than that, what we've said is that everything else is ordinary course of business, an ordinary course of business for us historically has been sort of 50 to 100 million plus a year in disposition. So there was nothing kind of unusual about it. And you can tell by the number of facilities and what was a relatively small proceed number that they

speaker
Unknown
Unknown

weren't producing very much. Thank you. Thank you for your questions.

speaker
Aaron
Conference Operator

Our next question is from the line of Richard Anderson with Wedbush. Your line is live.

speaker
Richard Anderson
Wedbush

Thanks. Good morning out there. So I want to talk about the-

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Rich, I just want to first say to you

speaker
Richard Anderson
Wedbush

that

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

a few quarters ago, three quarters ago, I believe, you said, can you foresee the day when your coverage is over two times?

speaker
Richard Anderson
Wedbush

So that's all the questions I have. No, just kidding. So on the pipeline, I want to talk about the accretive dilutive math on that. Like you look at your trading around 12 times forward, AFFO, that's like an eightish type of AFFO yield. I don't know if you'd think about it that way, but would you say you're breakeven in the first year of investment and grow from there? Or I'm just curious how you think about that from an accretive dilution standpoint.

speaker
Mike Costa
Chief Financial Officer

Yeah, I mean, based on where our stock is at right now, as well as where we could issue debt at or using any kind of leverage, somewhere in the low to mid sevens on a going in yield is breakeven or slightly accretive. You mean a

speaker
Richard Anderson
Wedbush

blend? You mean a blend low to mid sevens?

speaker
Mike Costa
Chief Financial Officer

Yeah, a blend of equity at today's prices plus debt. We think we could go in with initial yield to somewhere low to mid sevens and be breakeven to slightly accretive. But like Talia mentioned earlier, there's also opportunities that we're looking at where it's around that level, but there is also some growth baked into it. So it's not only just looking at that initial yield, but looking at the long-term growth profile and how that compares to the expectations built into our cost of capital.

speaker
Richard Anderson
Wedbush

Okay, so Michael, if you're due 500 million this coming year, would it be safe to say half of that is funded with equity, more or less?

speaker
Mike Costa
Chief Financial Officer

The numbers I've been throwing out usually is like 60-40 equity debt, just to keep our leverage where it's at, or around five times.

speaker
Richard Anderson
Wedbush

Okay, and then Rick, back to you, big picture. You mentioned the spread between the House and the Senate in terms of Medicaid, unspecified, who knows exactly what is actually in that line of thinking from the House perspective. But if it's so wide like that, isn't there a concern that at least there'll be some of it to find a middle ground between those two governing bodies? I'm just curious how we get through this and avoid... Any kind of disruption at all?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

So fair question. So, and this is probably not going to sound great because the numbers are so enormous. Anything over a trillion

speaker
Unknown
Unknown

would be some cause for worry. If anything under a trillion... Ladies and gentlemen, we have

speaker
Aaron
Conference Operator

lost our main speaker line. Please hold and we'll work to get them back. I'll put you back into hold music until we have them back on with us.

speaker
Unknown
Unknown

Give us one second, we'll be right back on. Thank

speaker
Unknown
Unknown

you. There's no turning back Even while we think We will find you Acting on your best behavior Turn your back on mother nature Everybody wants to rule the world It's my only life It's my only hope Help me to decide Help me make the most out of freedom and my pleasure Nothing ever lasts forever Everybody wants to rule the world There's a rule where the light won't bite you For the end was the one kind that was made there When they do, I'll be right, D

speaker
Aaron
Conference Operator

.I.G. So glad we've all been created So sad they'd have to be created Everybody wants to rule the world

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yeah, so what I was saying was You're talking about really big numbers here. If the numbers over a trillion It creates a lot of concern, regardless of how the Medicaid cuts are giving out. So it gets better as big as the 880 billion sounds. But since you're starting with zero at the Senate and 880 at the house, that number is going to come down. So hopefully it goes away, particularly when the governors start getting involved in the fight. But it's going to come down. So given how strong the portfolio's performance is With rent coverage and the margins and it's continuing to improve and still got room to grow ahead of it I think that will be okay, even if there's some kind of a hit. So does that answer your question?

speaker
Richard Anderson
Wedbush

Yeah, it does. And how would you parlay that into Medicare? You know, different forces at work, but just curious.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yeah, it's different forces at work. I think everything's being tested right now at the courts. You know, they can't just do this if they want to do it. They may try to, but they can't just do it. There's statutory issues and Congress has to be involved. So I actually think that I have less concerns about Medicare than I do about some kind of hit on Medicaid. Even though I'm more optimistic and pessimistic about Medicaid or certainly the overall impact of it.

speaker
Richard Anderson
Wedbush

Okay. And much respect to you. You know as

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

well as I do, I mean, you're all over this kind of stuff politically like I am. I mean, we're living in a time that's completely unpredictable, right? So, you know, I just tend to fall back on the bipartisan support, the lobbying efforts, the fact that this statutory, you've got states involved as well as both chambers of Congress. It's just not going to be that simple to hurt people who are most dependent upon government aid.

speaker
Richard Anderson
Wedbush

Fair enough. And just wanted to say much respect to your opening comments on this call, by the way. Thanks, everybody.

speaker
Aaron
Conference Operator

Thank you. Thank you. Thank you. Our next question is from the line of Alex Sajan with Baird Equity Research. Your line is live.

speaker
Michael Stroyak
Green Street

Hello, and thanks for taking my question. I'll echo what Rich said, you know, respect to those opening comments. And to your point, the world's unpredictable in so many different facets. But, you know, my question is, do you expect specialty and behavior coverage to improve as the year progresses?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

I think it's just going to kind of meagre around where it is. I think a lot of the fluctuations are the behavioral hospitals we have, which it's just a really dynamic business. The coverage is fantastic. So there's no sort of concerning trends. But, yeah, I think it's just going to kind of meander around where it is. I don't think it's going to be consequential.

speaker
Michael Stroyak
Green Street

Got it. And kind of changing tack, but what is the current size of the cash basis tenant base? And then did the dispositions in the quarter include tenants on cash basis?

speaker
Unknown
Unknown

So in terms of

speaker
Mike Costa
Chief Financial Officer

the cash basis tenant base, I like to quantify that in, I put it in two buckets. There's really the ones that we're really focused on are the ones that are not paying us full rent and paying us random amounts, you know, month to month, quarter to quarter. And that component of the cash basis tenant pool is, you know, a couple percentage points, you know, I know it's less than five percent of our in a way. And regarding your question on some of the sales that we had in the quarter, yes, that was related to some of our cash

speaker
Unknown
Unknown

basis tenants. All right. Thank you. Thank you. Our next question is from the line

speaker
Aaron
Conference Operator

of Michael Stroyak with Green Street. Your line is live.

speaker
Unknown
Unknown

Thanks and good morning. Maybe one on the transaction market. Is there any recurring theme on potential deals that the company has looked at and then ultimately passed on, particularly within shop? Is it also just a function of price like what you're seeing with transactions or maybe something else that leads to not closing on these deals?

speaker
Talia [Last Name Unknown]
Unknown

I think there are a couple of characteristics that we're focused on. One is the quality of the asset itself of the of the real estate and that we look at vintage of the asset as well. So that's that's one thing we look at the market and we look at frankly long term viability of the asset. It's those are those are critical factors. The shop, what we're seeing now generally is high quality assets. And it's an opportunity, as Rick described earlier, to improve our portfolio over time to add really high quality assets.

speaker
Unknown
Unknown

I guess on the on those high quality assets that you're bidding on, is it just a function of different cap rates that you're describing versus where the deals ultimately trade at?

speaker
Talia [Last Name Unknown]
Unknown

I think the band of cap rates is fairly narrow. Oftentimes the seller or the operator have an ability to. To sway where who the buyer will be and so relationships come to bear here. We're also seeing off market deals where relationships are definitely part of the discussion.

speaker
Unknown
Unknown

Got it. Okay. And then maybe one just on coverage levels. The magnitude of the coverage increase during the quarter seemed really outsized relative to the actual occupancy gains we saw. Can you can you just help us understand what drove such a healthy step up in coverages?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yeah, I think it's where occupancy kicked in. It was a big jump in terms of the impact on operating leverage. Really kind of as simple as that. Lucas, Medicaid. Yeah, that's the Medicaid increases that have kicked in. And then the market basket. The market basket as well. Oh, no, not the market. I'm sorry. But the Medicaid increases that kicked in in July and August really had the biggest impact. So it's this next quarter since we report a quarter. And I think that's the only reason why we're seeing this kind of impact. It's really, really important to understand that there's a lot of areas that you also see impact from the Medicare market basket.

speaker
Unknown
Unknown

Got it. That's helpful. Thank you.

speaker
Aaron
Conference Operator

Thank

speaker
Unknown
Unknown

you.

speaker
Aaron
Conference Operator

Our next question is from the line of Aaron Hecht with JMP securities.

speaker
Unknown
Unknown

Hey, guys. Go ahead. Thank you. I was just

speaker
Aaron Hecht
JMP Securities

looking at your loan book. It looks like it's around 400 million. Sounded like that's not an area you want to be focused on. And the maturity date ranges are pretty wide. Is there anything coming up soon in terms of maturities? And do you expect those to convert to ownership or do you just

speaker
Unknown
Unknown

recycle out of those as they come due?

speaker
Talia [Last Name Unknown]
Unknown

So there's nothing imminent in that loan pool. I think individually there are some that we like to refine, redeploy the capital and others that where we have an opportunity to buy, in which case we'll consider that when that window opens. There's nothing really actionable there at this moment.

speaker
Aaron Hecht
JMP Securities

Okay. Yeah, I was really looking at the three mortgage loans and it looks like the first maturity dates in 26 and that's the big bucket. Is there a big maturity in 26 or is that more back end weighted?

speaker
Talia [Last Name Unknown]
Unknown

There's a maturity at the end of 26. So it's essentially two years away. Just under two years away.

speaker
Unknown
Unknown

Any scope of size on that? It's the majority. Yeah, it's about 300 million. It's the majority of

speaker
Mike Costa
Chief Financial Officer

that bucket.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

CRCA Loans. So that discussion is going to be that they want to take us out, which would be fine. And they want to have a conversation about flipping it into a triple net. We might have that conversation as well. So that one just remains to be seen. We're happy with how things are going there, the loans performing. So just sort of

speaker
Unknown
Unknown

play it as it goes along. Okay, thanks Rick. Appreciate that. Yeah.

speaker
Aaron
Conference Operator

Thank you for your question. Ladies and gentlemen, if you do have a question, remember it's star followed by the number one on your touch tone keypad. We have our next question from the line of Omotayo Yokosanya with Deutsche Bank. Your line is live.

speaker
Omotayo Yokosanya
Deutsche Bank

Yes. Good afternoon everyone. Great comment at the beginning of the call for sure Rick. So speaking on this topic of Medicare and Medicaid, what are your thoughts around if they are eventually to get cut? Are they kind of more in fact a shift program versus kind of classic Medicare and Medicaid or on the skilled nursing side? Does that all kind of depend on this trillion dollar number you're talking about? Or how do we kind of think about that?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Say it one more time, Ty. Are you breaking up a little bit?

speaker
Omotayo Yokosanya
Deutsche Bank

Sure. So I was talking about again the potential Medicare and Medicaid cuts that we've been discussing on the call. And just speaking to that, in terms of the potential amount, is it possible in any way that all the cuts just kind of boil down more towards like the shift program or than anything else versus cuts to Medicaid, Medicaid that was in fact skilled nursing? How do we kind of handicap the probability of something like that happening?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Yeah, so I think that's a fair question. And I think the answer is yes, there are other programs out there like CHIPS Medicaid expansion generally that probably get targeted first. Some of the home-based and community programs get targeted first as well. So yeah, I think that's a fair statement, which goes to some of why we feel at least comfortable that even if something does happen, it won't be anything that sort of creates real damage to the space or the portfolio. And the other thing I didn't mention in my opening remarks is depending on what the final number is and what sectors get hit, you may see sectors kind of uniting together in their lobbying efforts. There may be some common cause here as well. So I'm not even sure that you'll see lobbying efforts that are completely independent of each other. So, both in the sectors from organizations like AARP, there's going to be a lot of activity here around any potential cuts that affect the indigent and the elderly.

speaker
Omotayo Yokosanya
Deutsche Bank

I thought for one other one, I know it's still pretty early, but any thoughts at this point about how Robert Kennedy may want to run CMS and what the implications are for the industry?

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

I have zero idea how to predict anything about this dude. But ask Elon, maybe he's got more insight than I do.

speaker
Unknown
Unknown

I appreciate it.

speaker
Aaron
Conference Operator

Thank you for your questions. We have no further questions at this time, so I'd like to turn the call back over to Mr.

speaker
Rick Matros
CEO, President, and Chair of Sabra Healthcare Reads

Matros. Thanks everybody for your time today. Appreciate the support as always, and we'll look forward to seeing many of you at the city conference. Thank you.

speaker
Aaron
Conference Operator

Thank you and ladies and gentlemen, that will end Sabra's 2024 Fourth Corridor Earnings Call. Have a great rest of your day. Take care.

Disclaimer

This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

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