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PACS Group, Inc. Reports Third Quarter 2025 Results

Completes Restatement of Previously Issued Financial Statements and Now Current with SEC Filing Obligations

Audit Committee Completes Investigation

Conference Call and Webcast Scheduled for Today, November 19, 2025, at 5:30 pm ET.

PACS Group, Inc. (NYSE: PACS) (“PACS” or the “Company”), which together with its subsidiaries is one of the largest post-acute healthcare companies in the United States, announced operating results for the third quarter of 2025. The Company has completed the previously announced Restatement of its financial statements for the three months ended March 31, 2024, and for the three and six months ended on June 30, 2024 (the “Restatement”), and is current with its SEC filing obligations.

Third Quarter 2025 Financial Highlights

  • Revenue was $1.34 billion, an increase of 31.0% over prior year.
  • Net income was $52.3 million.
  • Adjusted EBITDA was $131.5 million.
  • Adjusted EBITDAR was $226.6 million.

Year-to-Date 2025 Financial Highlights

  • Revenue was $3.93 billion, an increase of 36.4% over prior year period.
  • Net income was $131.7 million.
  • Adjusted EBITDA was $363.0 million.
  • Adjusted EBITDAR was $646.2 million.

Full Year 2024 Financial Highlights (includes Restatement)

  • Revenue was $4.09 billion, an increase of 31.4% over full year 2023.
  • Net income was $55.3 million.
  • Adjusted EBITDA was $279.5 million.
  • Adjusted EBITDAR was $564.4 million.

Third Quarter Select KPIs

  • The Company had 192 facilities, or 68.6%, of its skilled nursing portfolio achieve a 4 or 5 star CMS Quality Measure Star rating.
  • Mature facilities occupancy was 94.8%, compared to an industry average of 79%.
  • Mature facilities skilled mix was 33.0%.
  • Cash provided by operations was $407.6 million for the nine months ended September 30, 2025
  • As of September 30, 2025, $355.7 million of cash and cash equivalents, compared to $157.7 million as of December 31, 2024.

“Since its founding, PACS has been focused on its mission to revolutionize the delivery, leadership, and quality of post-acute care nationally. Our strong third quarter and year-to-date results demonstrate the underlying strength of our business model and the relentless execution of our team to deliver on our mission,” said Jason Murray, PACS’s Chief Executive Officer. “Our performance validates our core strengths – our commitment to clinical and operational excellence, industry-leading talent and a strategy designed for sustainable growth. I am proud to lead a team that has executed with excellence during what has been a challenging and dynamic period for the company. With the Restatement and Audit Committee investigation now complete, we are moving forward with a strong financial foundation, enhanced controls and an even stronger conviction in our ability to drive meaningful growth and create value for shareholders. We thank our stakeholders for their support and trust in PACS, and we remain committed to providing the quality care that our patients have come to expect from us.”

Full-Year 2025 Business Outlook

Based on information available today, PACS is providing the following guidance for full year 2025:

  • Revenue expected to be in the range of $5.25 billion to $5.35 billion
  • Adjusted EBITDA expected to be in the range of $480 million to $490 million

As of today, PACS's growing portfolio comprises 320 healthcare operations across 17 states. PACS owns 51 facilities and holds 38 purchase options on leased facilities and 21 purchase options through partnerships. The Company’s strategy remains focused on expanding its footprint through a balanced approach to leasing and acquiring real estate. In addition, PACS is actively evaluating opportunities to acquire both high-performing and underperforming operations across multiple states, with the goal of driving growth and unlocking long-term value.

“Our third-quarter and year-to-date 2025 revenue growth reflects the operational excellence across our portfolio that continues to drive demand for our services,” said Mark Hancock, PACS’s Interim Chief Financial Officer. “We thank our Audit Committee and advisors for their work and recommendations that have helped accelerate our maturation as a public company. We remain confident that our locally-led, centrally-supported model, coupled with enhanced compliance and controls, will increase our ability to deliver high-touch, high-quality care to our patients and strengthen our communities. With our exceptionally talented team, we are focused on continuing to execute our strategy to drive value for shareholders and the rest of the healthcare ecosystem.”

2024 and 2025 Annual and Quarterly Filings Made

  • Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2024.
  • Annual Report on Form 10-K for the year ended December 31, 2024 including restated financial statements for the three months ended March 31, 2024, and the three and six months ended June 30, 2024.
  • Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2025.
  • Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2025.
  • Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2025.

The Company is current with its SEC reporting obligations.

Revenue Restatement

  • $14.9 million reduction for the three-month period ended March 31, 2024.
  • $46.1 million reduction for the three-month period ended June 30, 2024.

Audit Committee Investigation

The independent Audit Committee of the PACS Board of Directors, assisted by external counsel and forensic accountants retained by the Audit Committee, has completed its previously disclosed independent investigation concerning allegations made in a short seller report against the Company and management, as well as other matters identified during the course of the investigation. Additional details regarding the scope and outcome of the independent investigation are included in the Company’s Form 10-Q for the period ended September 30, 2025, filed with the SEC today, November 19, 2025.

Murray continued, “In November 2024, the Company’s independent Audit Committee, supported by external counsel and advisors, began an independent investigation of the allegations made in a short seller report. That work has concluded. The Committee’s work and its resulting recommendations, which have been or are being implemented, reinforce our commitment to transparency, accountability, and strong governance. Now our focus is squarely on the future – executing our strategy, delivering exceptional care, and continuing to build trust with our stakeholders. PACS moves forward with confidence, strength, and an unwavering commitment to doing things the right way.”

Earnings Conference Call Details

A live webcast will be held November 19, 2025, at 5:30 p.m. Eastern time to discuss PACS’s third quarter financial results. To listen to the webcast please visit the Investors Relations section of PACS’s website at https://IR.pacs.com or by dialing 877-407-0621 / +1 215-268-9899. The webcast will be recorded and will be available for replay via the website for 30 days following the call.

About PACS™

PACS Group, Inc. is a holding company investing in post-acute healthcare facilities, professionals, and ancillary services. Founded in 2013, PACS Group is one of the largest post-acute platforms in the United States. Its independent subsidiaries operate 320 post-acute care facilities across 17 states serving over 31,000 patients daily. References herein to the consolidated “Company,” as well as the use of the terms “we,” “us,” “our,” “its” and similar verbiage, refer to PACS Group, Inc. and its consolidated subsidiaries, taken as a whole. PACS Group, Inc. and its subsidiaries that are not licensed healthcare providers do not provide healthcare services to patients, residents or any other person, and do not direct or control the provision of services provided or the operations of those provider subsidiaries. All healthcare services are provided solely by its applicable subsidiaries that are licensed healthcare providers, under the direction and control of licensed healthcare professionals in accordance with applicable law. More information about PACS is available at https://IR.pacs.com. The information on our website is not part of this press release.

Forward-Looking Statements Disclaimer

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. We intend such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. All statements contained in this press release other than statements of historical fact, including statements regarding our strategy, future financial condition, future results of operations, projected costs, prospects, plans, objectives of management, expected market growth, and other statements that are not historical facts, are forward-looking statements. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “shall,” “should,” “expects,” “plans,” “anticipates,” “could,” “intends,” “target,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” “goal,” “objective,” “seeks,” or “continue,” or the negative of these terms or other similar expressions. Forward-looking statements are neither promises nor guarantees and are based on management’s current expectations, estimates, forecasts and assumptions and on trends that we believe may affect our business, results of operations, financial condition and prospects. These statements are subject to risks, uncertainties and other important factors that may cause actual results to differ materially from those expressed or implied by the forward-looking statements, including, without limitation, our dependence on third party payors, including adverse changes in patient acuity and payor mix, payment methodologies and cost containment initiatives; our potential inability to obtain full reimbursement for services billed under consolidated billing or bundled payments; our exposure to increased labor costs, staffing shortages of nurses, nurse assistants and other skilled personnel, and impacts from national labor unions; state or federal regulatory actions affecting healthcare services, facility construction, expansion or acquisition; our ability to attract and retain patients and to compete effectively with other healthcare providers; internal audits and reviews that may result in billing adjustments, repayments, fines or other corrective actions; ongoing and future investigations and litigation; the limitations and variability of our insurance and self insurance programs; risks relating to the restatement of our financial statements; a material weakness in our internal control over financial reporting and risks related to remediation or the emergence of additional weaknesses; failures to provide consistently high quality care or employee conduct that adversely affects patient health, safety or clinical treatment; reliance on information technology and the risk that failures, inadequacies or interruptions could disrupt operations; reliance on internally calculated operational metrics that may be subject to measurement challenges or perceived inaccuracies; our ability to complete, integrate and realize expected benefits from acquisitions or partnerships and potential liabilities or regulatory issues arising from such transactions; the disposition of underperforming or non-strategic operating subsidiaries and the revenue impact of such dispositions; geographic concentration of facilities that exposes us to local economic downturns, regulatory changes or natural disasters; risks associated with leased real property, including lease terminations, extensions and special charges; failure to generate sufficient cash flow to meet long term debt, mortgage and lease obligations and covenants, which could lead to defaults or loss of facilities; our ability to obtain additional capital on acceptable terms, or at all; extensive and evolving legal and regulatory compliance obligations and the potential costs to achieve or maintain compliance; substantial control of the company by our founders, which may result in conflicts of interest or the appearance of conflicts; and our status as a “controlled company” under NYSE rules and the governance implications of relying on applicable exemptions. These and other important factors are described under the heading “Risk Factors” in our Annual Report on Form 10 K for the year ended December 31, 2024, and in other filings that we make with the Securities and Exchange Commission from time to time. Any forward-looking statements contained in this press release speak only as of the date hereof. We undertake no obligation to update any forward looking statements contained herein to reflect events or circumstances after the date of this press release or to reflect new information or the occurrence of unanticipated events, except as required by law.

PACS GROUP, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

(dollars in thousands, except for share and per share values)

 

Unaudited

 

 

 

September 30,

 

December 31,

 

2025

 

2024

ASSETS

 

 

 

Current Assets:

 

 

 

Cash and cash equivalents

$

355,672

 

$

157,674

Accounts receivable, net

 

628,280

 

 

641,775

Other receivables

 

66,428

 

 

74,746

Prepaid expenses and other current assets

 

76,369

 

 

64,066

Total Current Assets

 

1,126,749

 

 

938,261

Property and equipment, net

 

1,133,849

 

 

990,580

Operating lease right-of-use assets

 

3,000,426

 

 

2,994,519

Insurance subsidiary deposits and investments

 

80,300

 

 

66,258

Escrow funds

 

24,418

 

 

25,122

Goodwill and other indefinite-lived assets

 

68,061

 

 

67,061

Other assets

 

193,089

 

 

161,108

Total Assets

$

5,626,892

 

$

5,242,909

 

 

 

 

LIABILITIES AND EQUITY

 

 

 

Current Liabilities:

 

 

 

Accounts payable

$

205,479

 

$

175,062

Accrued payroll and benefits

 

252,539

 

 

146,177

Current operating lease liabilities

 

150,651

 

 

136,232

Current maturities of long-term debt

 

7,474

 

 

14,852

Current portion of accrued self-insurance liabilities

 

120,914

 

 

75,966

Line of credit

 

100,000

 

 

142,000

Refund liability

 

181,133

 

 

145,795

Other accrued expenses

 

179,431

 

 

142,348

Total Current Liabilities

 

1,197,621

 

 

978,432

Long-term operating lease liabilities

 

2,962,999

 

 

2,935,773

Long-term debt, less current maturities, net of deferred financing fees

 

245,903

 

 

250,984

Accrued self-insurance liabilities, less current portion

 

177,480

 

 

164,979

Other liabilities

 

165,973

 

 

197,050

Total Liabilities

$

4,749,976

 

$

4,527,218

Commitments and contingencies

 

 

 

Equity:

 

 

 

Common stock: $0.001 par value; 1,250,000,000 shares authorized; 156,615,144 shares issued and outstanding as of September 30, 2025, and 155,177,511 shares issued and outstanding as of December 31, 2024

 

157

 

 

155

Additional paid-in capital

 

621,288

 

 

591,363

Retained earnings

 

249,877

 

 

118,036

Total stockholders' equity

 

871,322

 

 

709,554

Noncontrolling interest in subsidiary

 

5,594

 

 

6,137

Total Equity

$

876,916

 

$

715,691

Total Liabilities and Equity

$

5,626,892

 

$

5,242,909

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF INCOME

(dollars in thousands, except for share and per share values)

 

Three Months Ended

September 30,

 

Nine Months Ended

September 30,

 

2025

 

2024

 

2025

 

2024

Revenue

 

 

 

 

 

 

 

Patient and resident service revenue

$

1,344,302

 

 

$

1,024,276

 

 

$

3,930,168

 

 

$

2,878,946

 

Other revenues

 

265

 

 

 

2,029

 

 

 

785

 

 

 

2,900

 

Total Revenue

$

1,344,567

 

 

$

1,026,305

 

 

$

3,930,953

 

 

$

2,881,846

 

Operating Expenses

 

 

 

 

 

 

 

Cost of services

 

1,046,262

 

 

 

849,599

 

 

 

3,090,932

 

 

 

2,347,738

 

Rent - cost of services

 

95,107

 

 

 

72,632

 

 

 

283,250

 

 

 

200,954

 

General and administrative expense

 

102,528

 

 

 

70,587

 

 

 

301,579

 

 

 

254,167

 

Depreciation and amortization

 

14,401

 

 

 

10,523

 

 

 

40,284

 

 

 

27,893

 

Total Operating Expenses

$

1,258,298

 

 

$

1,003,341

 

 

$

3,716,045

 

 

$

2,830,752

 

Operating income

$

86,269

 

 

$

22,964

 

 

$

214,908

 

 

$

51,094

 

Other (Expense) Income

 

 

 

 

 

 

 

Interest expense

 

(8,529

)

 

 

(9,029

)

 

 

(19,787

)

 

 

(35,040

)

Gain on lease termination

 

 

 

 

 

 

 

 

 

 

8,046

 

Other income (expense), net

 

(1,444

)

 

 

19,721

 

 

 

2,517

 

 

 

16,256

 

Total Other (Expense) Income, Net

$

(9,973

)

 

$

10,692

 

 

$

(17,270

)

 

$

(10,738

)

Income before provision for income taxes

 

76,296

 

 

 

33,656

 

 

 

197,638

 

 

 

40,356

 

Provision for income taxes

 

23,966

 

 

 

17,446

 

 

 

65,962

 

 

 

21,203

 

Net Income 

$

52,330

 

 

$

16,210

 

 

$

131,676

 

 

$

19,153

 

Less:

 

 

 

 

 

 

 

Net (loss) income attributable to noncontrolling interest

 

(76

)

 

 

590

 

 

 

(165

)

 

 

594

 

Net Income Attributable To PACS Group, Inc.

$

52,406

 

 

$

15,620

 

 

$

131,841

 

 

$

18,559

 

Net Income Per Share Attributable To PACS Group, Inc.

 

 

 

 

 

 

 

Basic

$

0.33

 

 

$

0.10

 

 

$

0.84

 

 

$

0.13

 

Diluted

$

0.32

 

 

$

0.10

 

 

$

0.80

 

 

$

0.13

 

Weighted-Average Common Shares Outstanding

 

 

 

 

 

 

 

Basic

 

156,575,127

 

 

 

153,124,371

 

 

 

156,034,409

 

 

 

143,804,609

 

Diluted

 

164,709,367

 

 

 

158,453,331

 

 

 

165,492,441

 

 

 

145,737,883

 

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(dollars in thousands)

 

The following table presents selected data from our condensed consolidated statements of cash flows for the periods presented:

 

Nine Months Ended

September 30,

 

2025

 

2024

Net cash provided by/(used in):

 

 

 

Operating activities

$

407,614

 

 

$

302,751

 

Investing activities

 

(145,879

)

 

 

(338,345

)

Financing activities

 

(63,521

)

 

 

(21,098

)

Net change in cash

 

198,214

 

 

 

(56,692

)

Cash, cash equivalents, and restricted cash - beginning of period

 

160,842

 

 

 

118,704

 

Cash, cash equivalents, and restricted cash - end of period

$

359,056

 

 

$

62,012

 

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED KEY SKILLED SERVICES METRICS

We categorize our facilities into three cohorts. Mature facilities are defined as facilities purchased more than 36 months prior to a respective measurement date. Ramping facilities are defined as facilities purchased within 18 to 36 months prior to a respective measurement date. New facilities are defined as facilities purchased or built less than 18 months prior to a respective measurement date.

The following tables present key skilled services metrics by category for all facilities, Mature facilities, Ramping facilities and New facilities as of and for the three months ended September 30, 2025 and 2024:

 

Total Facility Results

 

Three Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

1,310,933

 

 

$

1,010,277

 

 

$

300,656

 

29.8

%

Skilled mix by revenue

 

48.0

%

 

 

50.5

%

 

 

 

(2.5

)%

Skilled mix by nursing patient days

 

28.2

%

 

 

29.3

%

 

 

 

(1.1

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

2,994,628

 

 

 

2,399,563

 

 

 

595,065

 

24.8

%

Actual patient days

 

2,664,033

 

 

 

2,171,432

 

 

 

492,601

 

22.7

%

Occupancy rate (operational beds)

 

89.0

%

 

 

90.5

%

 

 

 

(1.5

)%

Number of facilities at period end

 

290

 

 

 

249

 

 

 

41

 

16.5

%

Number of operational beds at period end

 

32,677

 

 

 

27,467

 

 

 

5,210

 

19.0

%

 

Mature Facility Results

 

Three Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

746,242

 

 

$

315,154

 

 

$

431,088

 

136.8

%

Skilled mix by revenue

 

55.4

%

 

 

54.3

%

 

 

 

1.1

%

Skilled mix by nursing patient days

 

33.0

%

 

 

32.1

%

 

 

 

0.9

%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

1,481,700

 

 

 

690,783

 

 

 

790,917

 

114.5

%

Actual patient days

 

1,404,408

 

 

 

652,967

 

 

 

751,441

 

115.1

%

Occupancy rate (operational beds)

 

94.8

%

 

 

94.5

%

 

 

 

0.3

%

Number of facilities at period end

 

149

 

 

 

80

 

 

 

69

 

86.3

%

Number of operational beds at period end

 

16,406

 

 

 

8,515

 

 

 

7,891

 

92.7

%

 

Ramping Facility Results

 

Three Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

282,160

 

 

$

432,870

 

 

$

(150,710

)

 

(34.8

)%

Skilled mix by revenue

 

40.6

%

 

 

54.2

%

 

 

 

(13.6

)%

Skilled mix by nursing patient days

 

22.0

%

 

 

31.2

%

 

 

 

(9.2

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

725,220

 

 

 

934,132

 

 

 

(208,912

)

 

(22.4

)%

Actual patient days

 

624,612

 

 

 

877,092

 

 

 

(252,480

)

 

(28.8

)%

Occupancy rate (operational beds)

 

86.1

%

 

 

93.9

%

 

 

 

(7.8

)%

Number of facilities at period end

 

62

 

 

 

93

 

 

 

(31

)

 

(33.3

)%

Number of operational beds at period end

 

8,116

 

 

 

10,686

 

 

 

(2,570

)

 

(24.1

)%

 

New Facility Results

 

Three Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

282,531

 

 

$

262,253

 

 

$

20,278

 

 

7.7

%

Skilled mix by revenue

 

35.6

%

 

 

40.4

%

 

 

 

(4.8

)%

Skilled mix by nursing patient days

 

23.6

%

 

 

24.0

%

 

 

 

(0.4

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

787,708

 

 

 

774,648

 

 

 

13,060

 

 

1.7

%

Actual patient days

 

635,013

 

 

 

641,373

 

 

 

(6,360

)

 

(1.0

)%

Occupancy rate (operational beds)

 

80.6

%

 

 

82.8

%

 

 

 

(2.2

)%

Number of facilities at period end

 

79

 

 

 

76

 

 

 

3

 

 

3.9

%

Number of operational beds at period end

 

8,155

 

 

 

8,266

 

 

 

(111

)

 

(1.3

)%

The following tables present key skilled services metrics by category for all facilities, Mature facilities, Ramping facilities and New facilities as of and for the nine months ended September 30, 2025 and 2024:

 

Total Facility Results

 

Nine Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

3,843,153

 

 

$

2,849,806

 

 

$

993,347

 

34.9

%

Skilled mix by revenue

 

49.1

%

 

 

51.2

%

 

 

 

(2.1

)%

Skilled mix by nursing patient days

 

28.9

%

 

 

29.4

%

 

 

 

(0.5

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

8,824,037

 

 

 

6,788,832

 

 

 

2,035,205

 

30.0

%

Actual patient days

 

7,846,851

 

 

 

6,165,899

 

 

 

1,680,952

 

27.3

%

Occupancy rate (operational beds)

 

88.9

%

 

 

90.8

%

 

 

 

(1.9

)%

Number of facilities at period end

 

290

 

 

 

249

 

 

 

41

 

16.5

%

Number of operational beds at period end

 

32,677

 

 

 

27,467

 

 

 

5,210

 

19.0

%

 

Mature Facility Results

 

Nine Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

2,147,833

 

 

$

877,803

 

 

$

1,270,030

 

144.7

%

Skilled mix by revenue

 

56.4

%

 

 

55.0

%

 

 

 

1.4

%

Skilled mix by nursing patient days

 

33.7

%

 

 

32.2

%

 

 

 

1.5

%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

4,238,699

 

 

 

1,959,687

 

 

 

2,279,012

 

116.3

%

Actual patient days

 

4,025,794

 

 

 

1,850,627

 

 

 

2,175,167

 

117.5

%

Occupancy rate (operational beds)

 

95.0

%

 

 

94.4

%

 

 

 

0.6

%

Number of facilities at period end

 

149

 

 

 

80

 

 

 

69

 

86.3

%

Number of operational beds at period end

 

16,406

 

 

 

8,515

 

 

 

7,891

 

92.7

%

 

Ramping Facility Results

 

Nine Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

807,434

 

 

$

1,227,925

 

 

$

(420,491

)

 

(34.2

)%

Skilled mix by revenue

 

41.9

%

 

 

55.9

%

 

 

 

(14.0

)%

Skilled mix by nursing patient days

 

22.8

%

 

 

32.7

%

 

 

 

(9.9

)%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

2,047,146

 

 

 

2,613,520

 

 

 

(566,374

)

 

(21.7

)%

Actual patient days

 

1,764,784

 

 

 

2,467,398

 

 

 

(702,614

)

 

(28.5

)%

Occupancy rate (operational beds)

 

86.2

%

 

 

94.4

%

 

 

 

(8.2

)%

Number of facilities at period end

 

62

 

 

 

93

 

 

 

(31

)

 

(33.3

)%

Number of operational beds at period end

 

8,116

 

 

 

10,686

 

 

 

(2,570

)

 

(24.1

)%

 

New Facility Results

 

Nine Months Ended September 30,

 

2025

 

2024

 

Change

 

% Change

 

 

 

 

 

 

 

 

 

(dollars in thousands)

Skilled nursing services revenue

$

887,886

 

 

$

744,078

 

 

$

143,808

 

 

19.3

%

Skilled mix by revenue

 

38.2

%

 

 

39.3

%

 

 

 

(1.1

)%

Skilled mix by nursing patient days

 

24.7

%

 

 

22.3

%

 

 

 

2.4

%

Occupancy for skilled nursing services:

 

 

 

 

 

 

 

Available patient days

 

2,538,192

 

 

 

2,215,625

 

 

 

322,567

 

 

14.6

%

Actual patient days

 

2,056,273

 

 

 

1,847,874

 

 

 

208,399

 

 

11.3

%

Occupancy rate (operational beds)

 

81.0

%

 

 

83.4

%

 

 

 

(2.4

)%

Number of facilities at period end

 

79

 

 

 

76

 

 

 

3

 

 

3.9

%

Number of operational beds at period end

 

8,155

 

 

 

8,266

 

 

 

(111

)

 

(1.3

)%

The following tables present additional detail regarding our skilled mix, including our percentage of nursing patient days and revenue by payor source for all facilities, Mature facilities, Ramping facilities and New facilities for the three months ended September 30, 2025 and 2024:

 

 

Three Months Ended September 30,

Skilled mix by revenue

 

Mature

 

Ramping

 

New

 

Total

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

Medicare

 

39.6

%

 

37.0

%

 

27.8

%

 

36.6

%

 

18.9

%

 

23.7

%

 

32.7

%

 

33.3

%

Managed care

 

15.8

 

 

17.3

 

 

12.8

 

 

17.6

 

 

16.7

 

 

16.7

 

 

15.3

 

 

17.2

 

Skilled mix

 

55.4

 

 

54.3

 

 

40.6

 

 

54.2

 

 

35.6

 

 

40.4

 

 

48.0

 

 

50.5

 

Medicaid

 

35.7

 

 

38.4

 

 

49.9

 

 

37.4

 

 

53.7

 

 

50.4

 

 

42.6

 

 

41.2

 

Private and other

 

8.9

 

 

7.3

 

 

9.5

 

 

8.4

 

 

10.7

 

 

9.2

 

 

9.4

 

 

8.3

 

Total

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

 

Three Months Ended September 30,

Skilled mix by nursing patient days

 

Mature

 

Ramping

 

New

 

Total

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

Medicare

 

21.0

%

 

18.5

%

 

12.4

%

 

18.5

%

 

11.1

%

 

11.4

%

 

16.6

%

 

16.4

%

Managed care

 

12.0

 

 

13.6

 

 

9.6

 

 

12.7

 

 

12.5

 

 

12.6

 

 

11.6

 

 

12.9

 

Skilled mix

 

33.0

 

 

32.1

 

 

22.0

 

 

31.2

 

 

23.6

 

 

24.0

 

 

28.2

 

 

29.3

 

Medicaid

 

57.7

 

 

59.6

 

 

67.8

 

 

59.7

 

 

64.2

 

 

65.3

 

 

61.6

 

 

61.4

 

Private and other

 

9.3

 

 

8.3

 

 

10.2

 

 

9.1

 

 

12.2

 

 

10.7

 

 

10.2

 

 

9.3

 

Total

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

The following tables present additional detail regarding our skilled mix, including our percentage of nursing patient days and revenue by payor source for all facilities, Mature facilities, Ramping facilities and New facilities for the nine months ended September 30, 2025 and 2024:

 

 

Nine Months Ended September 30,

Skilled mix by revenue

 

Mature

 

Ramping

 

New

 

Total

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

Medicare

 

41.0

%

 

37.3

%

 

30.0

%

 

37.7

%

 

20.8

%

 

22.9

%

 

33.9

%

 

33.6

%

Managed care

 

15.4

 

 

17.7

 

 

11.9

 

 

18.2

 

 

17.4

 

 

16.4

 

 

15.2

 

 

17.6

 

Skilled mix

 

56.4

 

 

55.0

 

 

41.9

 

 

55.9

 

 

38.2

 

 

39.3

 

 

49.1

 

 

51.2

 

Medicaid

 

35.0

 

 

38.1

 

 

48.7

 

 

36.3

 

 

51.9

 

 

51.5

 

 

41.9

 

 

40.9

 

Private and other

 

8.6

 

 

6.9

 

 

9.4

 

 

7.8

 

 

9.9

 

 

9.2

 

 

9.0

 

 

7.9

 

Total

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

 

Nine Months Ended September 30,

Skilled mix by nursing patient days

 

Mature

 

Ramping

 

New

 

Total

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

Medicare

 

21.8

%

 

18.5

%

 

13.9

%

 

19.3

%

 

11.6

%

 

10.3

%

 

17.4

%

 

16.4

%

Managed care

 

11.9

 

 

13.7

 

 

8.9

 

 

13.4

 

 

13.1

 

 

12.0

 

 

11.5

 

 

13.0

 

Skilled mix

 

33.7

 

 

32.2

 

 

22.8

 

 

32.7

 

 

24.7

 

 

22.3

 

 

28.9

 

 

29.4

 

Medicaid

 

57.1

 

 

59.7

 

 

67.1

 

 

58.3

 

 

64.0

 

 

67.1

 

 

61.2

 

 

61.4

 

Private and other

 

9.2

 

 

8.1

 

 

10.1

 

 

9.0

 

 

11.3

 

 

10.6

 

 

9.9

 

 

9.2

 

Total

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

 

100.0

%

The following table presents average daily rates by payor source, excluding services that are not covered by the daily rate, for the three months ended September 30, 2025 and 2024:

 

Three Months Ended September 30,

Average daily rate

Mature

 

Ramping

 

New

 

Total

2025

 

2024

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

Medicare

$

988.41

 

$

947.82

 

$

991.53

 

$

982.32

 

$

746.97

 

$

880.10

 

$

950.49

 

$

949.62

Managed care

 

686.21

 

 

603.54

 

 

595.45

 

 

684.92

 

 

586.21

 

 

560.68

 

 

642.83

 

 

623.48

Total for skilled patient payors (1)

 

878.36

 

 

802.49

 

 

819.35

 

 

861.20

 

 

661.91

 

 

712.35

 

 

824.34

 

 

805.90

Medicaid

 

324.26

 

 

305.80

 

 

326.92

 

 

310.83

 

 

366.42

 

 

326.88

 

 

335.43

 

 

314.41

Private and other

 

495.26

 

 

416.36

 

 

418.77

 

 

455.01

 

 

385.54

 

 

365.64

 

 

446.20

 

 

414.55

Total (2)

$

523.14

 

$

474.28

 

$

444.63

 

$

495.71

 

$

438.53

 

$

423.64

 

$

484.57

 

$

467.98

__________________

(1)

 

Represents weighted average of revenue generated by Medicare and managed care payor sources.

(2)

 

Represents weighted average.

The following table presents average daily rates by payor source, excluding services that are not covered by the daily rate, for the nine months ended September 30, 2025 and 2024:

 

Nine Months Ended September 30,

Average daily rate

Mature

 

Ramping

 

New

 

Total

2025

 

2024

 

2025

 

2024

 

2025

 

2024

 

2025

 

2024

Medicare

$

984.00

 

$

942.70

 

$

981.22

 

$

971.79

 

$

773.80

 

$

910.87

 

$

946.64

 

$

950.39

Managed care

 

682.71

 

 

604.12

 

 

604.84

 

 

671.59

 

 

577.61

 

 

565.06

 

 

637.92

 

 

621.24

Total for skilled patient payors (1)

 

877.92

 

 

798.75

 

 

833.92

 

 

848.20

 

 

670.02

 

 

725.35

 

 

823.56

 

 

804.11

Medicaid

 

322.18

 

 

299.12

 

 

330.12

 

 

309.23

 

 

350.65

 

 

314.85

 

 

331.95

 

 

308.12

Private and other

 

492.48

 

 

396.81

 

 

425.86

 

 

430.88

 

 

380.83

 

 

355.44

 

 

443.96

 

 

395.91

Total (2)

$

525.23

 

$

468.14

 

$

454.83

 

$

496.61

 

$

432.96

 

$

410.54

 

$

485.22

 

$

462.27

__________________

(1)

 

Represents weighted average of revenue generated by Medicare and managed care payor sources.

(2)

 

Represents weighted average.

Key Skilled Services Metrics

We monitor the below key skilled services metrics across all of our facilities and by Mature facilities, Ramping facilities, and New facilities.

  • Skilled nursing services revenue — Skilled nursing services revenue reflects the portion of patient and resident service revenue generated from all patients in skilled nursing facilities, excluding revenue generated from our assisted and independent living services.
  • Skilled mix — We measure both revenue and nursing patient days by payor. Medicare and managed care patients, whom we refer to as high acuity patients, typically require a higher level of skilled nursing care. As a result, Medicare and managed care reimbursement rates are typically higher than those from other payors. In most states, Medicaid reimbursement rates are generally the lowest of all payor types. Changes in the payor mix can significantly affect our revenue and profitability. To monitor this performance, we evaluate two different measures of skilled mix:
    • Skilled mix by revenue — Skilled mix by revenue represents the portion of routine revenue generated from treating high acuity Medicare and managed care patients. Routine revenue refers to skilled nursing services revenue generated by contracted daily rates charged for skilled nursing services. Services provided outside of routine contractual agreements are recorded separately as ancillary revenue, including Medicare Part B therapy services, and are not routine revenue. The inclusion of therapy and other ancillary treatments in the contracted daily rate varies by payor source and by contract. Revenue associated with calculating skilled mix is based on contractually agreed-upon amounts or rates, excluding the estimates of variable consideration under the revenue recognition standard, Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 606, Revenue from Contracts with Customers.
    • Skilled mix by nursing patient days — Skilled mix by nursing patient days represents the number of days our high acuity Medicare and managed care patients receive skilled nursing services at skilled nursing facilities as a percentage of the total number of days that patients from all payor sources receive skilled nursing services at skilled nursing facilities for any given period.
  • Occupancy — The total number of patients occupying a bed in a skilled nursing facility as a percentage of the beds in such facility that are available for occupancy during the period.
  • Number of facilities — The total number of skilled nursing facilities that we operate.
  • Number of operational beds — The total number of operational beds associated with the skilled nursing facilities that we own.

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION

(dollars in thousands)

 

 

Three Months Ended

September 30,

 

Nine Months Ended

September 30,

 

2025

 

2024

 

2025

 

2024

Net income

$

52,330

 

 

$

16,210

 

 

$

131,676

 

 

$

19,153

 

Less: Net (loss) income attributable to noncontrolling interest

 

(76

)

 

 

590

 

 

 

(165

)

 

 

594

 

Add: Interest expense

 

8,529

 

 

 

9,029

 

 

 

19,787

 

 

 

35,040

 

Provision for income taxes

 

23,966

 

 

 

17,446

 

 

 

65,962

 

 

 

21,203

 

Depreciation and amortization

 

14,401

 

 

 

10,523

 

 

 

40,284

 

 

 

27,893

 

EBITDA

$

99,302

 

 

$

52,618

 

 

$

257,874

 

 

$

102,695

 

Adjustments to EBITDA:

 

 

 

 

 

 

 

Acquisition related costs

 

101

 

 

 

845

 

 

 

310

 

 

 

1,537

 

Gain on lease termination

 

 

 

 

 

 

 

 

 

 

(8,046

)

Stock-based compensation expense

 

12,516

 

 

 

12,304

 

 

 

38,322

 

 

 

103,240

 

Loss from equity method investment

 

 

 

 

 

 

 

 

 

 

2,736

 

Forfeiture of seller's note

 

 

 

 

500

 

 

 

 

 

 

500

 

Bargain purchase gain

 

 

 

 

(17,185

)

 

 

 

 

 

(17,185

)

Legal and other costs

 

19,596

 

 

 

 

 

 

66,460

 

 

 

 

Adjusted EBITDA

$

131,515

 

 

$

49,082

 

 

$

362,966

 

 

$

185,477

 

Rent - cost of services

 

95,107

 

 

 

72,632

 

 

 

283,250

 

 

 

200,954

 

Adjusted EBITDAR

$

226,622

 

 

 

 

$

646,216

 

 

 

PACS GROUP, INC. AND SUBSIDIARIES

UNAUDITED RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION

(dollars in thousands)

 

 

Year ended December 31,

 

2024

 

2023

 

2022

 

 

 

 

 

 

Net income

$

55,344

 

 

$

112,882

 

$

150,496

Less: Net (loss) income attributable to noncontrolling interest

 

(416

)

 

 

8

 

 

Add: Interest expense

 

44,341

 

 

 

49,919

 

 

25,538

Provision for income taxes

 

46,210

 

 

 

44,435

 

 

56,549

Depreciation and amortization

 

40,809

 

 

 

25,632

 

 

22,311

EBITDA

$

187,120

 

 

$

232,860

 

$

254,894

Adjustments to EBITDA:

 

 

 

 

 

Acquisition related costs

 

2,506

 

 

 

998

 

 

201

Lease termination fees

 

 

 

 

 

 

421

Loss resulting from debt restructuring

 

 

 

 

3,628

 

 

Gain on lease termination

 

(8,046

)

 

 

 

 

Stock-based compensation

 

115,544

 

 

 

 

 

Loss from equity method investment

 

2,736

 

 

 

 

 

Forfeiture of seller's note

 

500

 

 

 

 

 

Bargain purchase gain

 

(17,185

)

 

 

 

 

Legal and other costs

 

9,727

 

 

 

 

 

Employee Retention Tax Credit

 

(14,599

)

 

 

 

 

Disaster relief payment

 

1,154

 

 

 

 

 

Adjusted EBITDA

$

279,457

 

 

$

237,486

 

$

255,516

Rent - cost of services

 

284,953

 

 

 

216,711

 

 

160,003

Adjusted EBITDAR

$

564,410

 

 

 

 

 

Non-GAAP Financial Measures

In addition to our results provided throughout that are determined in accordance with GAAP, we also present the following non-GAAP financial measures: EBITDA, Adjusted EBITDA and Adjusted EBITDAR (collectively, Non-GAAP Financial Measures). EBITDA and Adjusted EBITDA are performance measures. Adjusted EBITDAR is a valuation measure. These Non-GAAP Financial Measures have no standardized meaning defined by GAAP, and therefore have limitations as analytical tools, and they should not be considered in isolation, or as a substitute for analysis of our results as reported in accordance with GAAP. You should review the reconciliation of net income to the Non-GAAP Financial Measures in the table above, together with our current quarter condensed combined/consolidated financial statements and the related notes in their entirety, and should not rely on any single financial measure. Additionally, other companies may define these or similar Non-GAAP Financial Measures with the same or similar names differently, and because these Non-GAAP Financial Measures are not standardized, it may not be possible to compare these financial measures to those of other companies. A reconciliation of Adjusted EBITDA guidance to Net Income on a forward-looking basis cannot be provided without unreasonable efforts, as the Company is unable to provide reconciling information with respect to provision for income taxes, interest expense, depreciation and amortization, and certain other expenses that are not representative of our underlying operating performances, all of which are adjustments to Adjusted EBITDA.

Performance Measures

We use EBITDA and Adjusted EBITDA to facilitate internal comparisons of our historical operating performance on a more consistent basis, as well as for business planning and forecasting purposes. In addition, we believe the presentation of EBITDA and Adjusted EBITDA is useful to investors, analysts and other interested parties in comparing our operating performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our ongoing operating performance.

EBITDA – We calculate EBITDA as net income, adjusted for net losses attributable to noncontrolling interest, before: interest expense; provision for income taxes; and depreciation and amortization.

Adjusted EBITDA – We calculate Adjusted EBITDA as EBITDA further adjusted for non-core business items, which for the reported periods includes, to the extent applicable, costs incurred to acquire operations that are not capitalizable, lease termination fees, losses incurred from debt restructuring, gains on lease termination, stock-based compensation expense, loss from equity method investment, forfeiture of a seller’s note, recognition of a bargain purchase gain, legal and other costs, recognition of Employee Retention Tax Credit (ERTC), disaster relief payment, and certain one-time expenses that are not representative of our underlying operating performance. Costs related to acquisitions include costs related to our acquisition of SNF facilities and providers, including related costs such as legal fees, financial and tax due diligence, consulting and escrow fees. The loss related to our equity method investment is a loss allocated to us from a discrete disposal recognized by one of our equity method investments. The bargain purchase gain was recognized as part of our acquisition from the former operator Prestige. Legal and other costs include legal and professional fees incurred associated with the Audit Committee’s independent investigation and with other ongoing investigations. The adjustment related to the ERTC represents the recognition of the tax credit against labor as the statute of limitations surrounding the uncertainty of the qualifications, for a portion of the funds received, expired. The disaster relief payment was made to support facilities impacted by Hurricane Helene.

Valuation Measure

We use Adjusted EBITDAR as a measure to determine the value of prospective acquisitions and to assess the enterprise value of our business without regard to differences in capital structures and leasing arrangements. In addition, we believe that Adjusted EBITDAR is also a commonly used measure by investors, analysts and other interested parties to compare the enterprise value of different companies in the healthcare industry without regard to differences in capital structures and leasing arrangements, particularly for companies with operating and finance leases. For example, finance lease expenditures are recorded in depreciation and interest and are therefore removed from Adjusted EBITDA, whereas operating lease expenditures are recorded in rent expense and are therefore retained in Adjusted EBITDA. Adjusted EBITDAR is a financial valuation measure that is not specified in GAAP, and is not displayed as a performance measure as it excludes rent expense, which is a normal and recurring cash operating expense, and is therefore presented only for the current period. While we believe that Adjusted EBITDAR provides useful insight regarding our underlying operations, excluding the impact of our operating leases, we must still incur cash operating expenses related to our operating leases and rent and such expenses are necessary to operate our leased operations. As a result, Adjusted EBITDAR may understate the extent of our cash operating expenses for the respective period relative to our actual cash needs to operate our leased operations and business.

Adjusted EBITDAR – We calculate Adjusted EBITDAR as Adjusted EBITDA less rent-cost of services.

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