Genesis Healthcare (GENN) 9 Nov 202020 Q3 Earnings call transcript

Ladies and gentlemen, thank you for standing by, and welcome to the Third Quarter 2020 Earnings Call. At this time, all participants are in a listen-only mode. After the speakers' presentation, there will be a question-and-answer session. [Operator Instructions] Please be advised today's conference is being recorded. I'd like to hand the conference over to our speaker today, Lori Mayer. ahead. go Please

at thank for our and is joining today. available our us on call of Good also year. will release you earlier issued be website of section press Investor our announcement A this We replay the this website morning, on Relations for genesishcc.com. one morning. available This

review matters. housekeeping we I Before few begin, would a like to quickly

undertake subject risks call. actual today's the those are about not environment or statements These forward-looking cause of a on materially forward-looking statements or could expressed changes which management's uncertainties Listeners are our should encouraged pandemic. current our to statements from impact by differ a statements and information, to business to update and assumptions on Genesis do SEC or more any affiliates that forward-looking filings results. Healthcare and other not on future the as that any place from discussion including our implied Federal Except and for new results reliance for First, operate, based review could reason. of as that result undue beliefs required factors in impact we changing law, our revise or statements circumstances made expectations, the today and complete arise about COVID-XX to Securities are any events, its publicly

use Genesis operating any employees are similar not separate assets. or its we, revenues that the independent terms various meant In addition, entity. References Healthcare subsidiary are of a and to by as consolidated operations any the and employees the operation that the company operated of activities, assets well the operating by that assets, today we its operated to own mention imply has and or is our as direct management, has same and verbiage us,

which are investors information information presentation financial financial public to believe We EBITDAR, non-GAAP our value results measures EBITDA, the contained and of Please the over exclusion to and filings reasons release. not provides for in for our in at because the release earnings Genesis GAAP financial relied financial be earnings George non-GAAP performance of upon useful that, today to financial the should benchmarking analyzing of the such adjusted useful discussion EBITDA, but Healthcare. call today's our regarding include references trending, these the measures. and adjusted Our of to and GAAP are our non-GAAP non-GAAP and in measures I'll turn Hager, disclosures refer reconciliations non-GAAP business, measures. CEO And with company's its to financial measures

morning, on Officer team Thank number Tom Steve Richard joining DiVittorio, Genesis our you us and you, the the a of Accounting Lori. our have of JoAnne Chief Officer; Officer; Medical Financial well Reifsnyder, Genesis’s Chief Healthcare's today. Young, Chief Dr. including, Genesis Good Chief Nursing members Feifer, call I Treasurer. for Senior Officer today, and thank and as Dr. Management as

Dr. Before I to a remarks. for make opening update, turn over like would call few to the I Feifer COVID-XX

see to three momentum starting some specific continues, While the positive we’re pandemic in areas.

since a the pandemic, in come dramatic Shortages portfolio. cost. in in wages PPE early terms expenditures more and hotspot usage agency five have most availability the facilities with labor located both Staffing our spring. the have impacted and impact rest non-labor down the to the pattern, levels moderated related in outbreak homes of on dramatically, and both of the nursing First, consistent in COVID-XX of of peak states had have

employees. have protect at to resident Genesis, However, sufficient we extraordinary lengths our patients, to to gone obtain supplies and

months needed most. corporate time. PPE acquiring a sent supplies and our hub, they we’ve set PPE, have where to this sourcing up our are warehouse and adjusted even ensure in are shortage spent currently dynamically have a not and experiencing We warehousing are PPE, at distribution headquarters as Because we of we

the XXXX, started June important The improve. than wide which which has industry Second, have levels our recovery to levels October, to to Since certainly occupancy of end been to basis has occupancy census is slower encouraging. of return pre-COVID points is of anticipated EBITDAR. grown through critically ability XXX

therapist million, our focus in of to intense Finally, employees COVID versus and of the our saw staff Organization. Staff, staff third COVID-XX. in staffing continues been ancillary integral have as temporary third including quarter before the and the Rehab by Accountable staff, These of resilient increase in nursing of Physician results own throughout fell Services, stimulus agency Care are significant pandemic, be the a grew the an Rehabilitation EBITDA Genesis improved Genesis Services LTC Services, direct businesses PDPM the Career across improve outcomes, or $X of XX% Genesis in with quarter the ill Career XXXX. part patient operational XXXX funds efficiency our country homes result to and one a environment. Career strategy. placement

ACO LTC participating the XXXX settlement positive sponsored of Program for in received their savings under of for settlement million, million year, shared and $XX.X approximately savings performance distributions. which as care approximately year. first Our long-term reconciliation generated provider income $XX quarter and Care net third United In of Medicare consecutive MSSP second in XXXX, the Organization LTC of ACO, States, the the the the a is received the Savings result, the Accountable Shared shared

and winter ongoing centers the staff, nationally. our overall costs volume by ACO PPE of remain revenue increased and of nursing lower, are levels dedicated impact a safety Genesis and home we were practice strong aware enter required now we testing strong about than patients, with other as the we Physician are are Furthermore, the their improved have collaboration Our outbreaks and especially as the maintain advanced members. with ancillary as staff well they physicians, Services pre-COVID, performance organization's physicians. to with our the and could providers, And residents higher still significantly from and collaboration alignment concerned our COVID-XX companies, LTC benefits participating on of months. Despite

and and outbreaks over facilities. to Dr. Medical protect staff Chief are Officer. that, patients, We to call our working Genesis' like limit to the Richard I'd turn Feifer, diligently residents in our With

George. would pandemic, a Since like to approximately we you, where this Thank into update I are provide months COVID-XX. are on brief eight we regarding

and we hearing fall, throughout reports country many As the we enter cases the in uptick are nursing of in outbreaks an homes.

increase at time, in that Genesis number are of clear be this me homes. rate nursing outbreaks within not the or a of seeing Let major cases the we affiliated

we these aware of surrounding on COVID We going that what nursing are, of deeply trends, and prevalence us the of know represents the COVID-XX to the is since around greatest very community are in much concerned however, about homes. risk

of next the We to prepare are actively the centers our virus. working for wave

Next, to in facilities to testing. of Services, nursing deliver commitment CMS, made these of address small have country. every Medicaid along like a with I the devices, I quarter supply mentioned that point time, of received devices care this Last of At Genesis' and point would home a skilled testing care Medicare the to the nursing for issue all of testing Centers materials.

four to juncture. who create are their of delay, results. and dedicated tests care supply are in in testing also delay of be have centers up the labs of actively important, device-free process critical a up PCR are care kits. are the already at Genesis set facilities sometimes days which setting using more the upwards tests unacceptable, as so extends still receive labs, of increasingly this contagious limited of These received or point Any and point have might reason testing tests the Some a becoming is points all of determining care devices.

certain are having We despite CMS use approving some still of CDC. states tests, of difficulty care the from and support explicit with point

with stance. those their change states working to aggressively are We

of terms we tests, of negatives. seeing the care positives false of currently the accuracy In false not or are high of rates point

tests inventory equipment PCR we we from also point that care small point vigilant to doing are should have this clinically so, recommends and I'm only The result carefully one patients, that of frequency confirmatory out guidance. are weekly to fraction ability testing on to we care our the hyper needed level government CMS to month. following test the of of COVID-XX, based However, carry testing received is just staff CDC a for time reorder At now In kits manufacturers. residents pleased test for varies testing small follow-up test report from positivity, will to a be county at of twice staff. time, the suspicious. what per be we use from frequent ranging

through this to allow ability results but are fight access this the on other us adhering minimum, increasing routine have We risk. The suggesting a frequency will effectively to instant virus higher easy times, factors testing. at more to to are based

is staff cost is patients, of the the priority. safety and significant, While highest residents our the

in COVID to how the their transmission and to leading providing yet. visitation, current community risk on Every adapt centers infection help up-to-date created including community, week, transmission residents, we subject hopeful families, family protocols risk and care With have just their protocols we precautions update of there to us local of specific how in patients increased guidance practice and an are our local prevention tools each continues way will on participation achieving local have doing, levels. activities. and good testing, social need to transmission washing, centers restrictive confidence are as diligent expand, practices transmission control, are able in to the and are and in lower, but infection each residents testing distancing, important begin to and the track Turning to availability our of receive analytic centers to tailored COVID-XX tests facility's center and infection Ultimately, communities risk visitation community When more higher, Genesis the adequate continue in is hand flex that the of visitors. extremely be community, that to might procedures local and trust areas there their communication community rates precautions frequent wearing access is controls to be ones. adapt. loved not implementation are of and rules regulations, mask centers supply with of But to their When group of state risk may precautions. reducing point of of to and are

potential review treatments let's Finally, COVID-XX. for and vaccines

and Genesis a staff studying monoclonal disease care the in antibody the First, trial, and in COVID-XX Phase Lilly partnered and residents infection, facilities. LY-CoVXXX Company drug drug prevention long-term SARS-CoV-X at of X has with Eli for manufacturer

senior virus Colorado potential important new trial. find living this that Genesis' X and Phase skilled treatments nursing for will elderly, deadly States it to Pennsylvania together the initial of facilities the this this that be virus. disproportionately independent for Given the work so we is all locations and help in living possible affects

government concerned, and the workers has already vaccine for residents a vaccine see we far is workers residents first are As Phases Federal the by XXXX. we quarter facility healthcare of in nursing will care optimistic healthcare Xa that skilled prioritized as and The and cautiously long-term Xb.

coordinating we We are so process and Federal are vaccine of available. for the now the prepared that becomes officials, when with in local

everyone remind of to our ensure want infection keep that we policies control I our unannounced being work continue out to Finally, conduct facilities. We are virus followed. hard to surveys internal the to

requirements are and continue monitor We status, many units observation to precautions. admission or we cases, state testing above among via other in patients

want to back They our patients, forever George, regional Before who've residents therapists, heroes, thank commitment working other I I their and George, and and grateful nurses, to staff continue this you. turn center aides, for physicians, of pandemic. are practice during keep so the be all advanced compassion. employees our true call and back providers we to to George? over safe hard members, the been to and

you, Rich. Thank

begin support These relief, been flow is of programs. by operations. have April government revenue in our and and Genesis Before sustaining incremental challenges financial detail, and resulted increase more in views pandemic significant need losses will our loan ongoing in capital operating funded loss no legislative related from address will going short-term like repaying I Tom partners from Federal Without results company's the the CFO deficits. question, the Federal concern XXXX. quarter to loans and The There losses temporarily cash third we disclosure. ongoing have in DiVittorio, expenses Federal would

with the need importance critical advocacy Association the We continued communicate of our Healthcare to are resources, actively working American including Federal and support.

have Additionally, to capital discussions with number initiated we analyze select partners alternatives. restructuring a of

dedicated work improve also over ever the selflessly during call to so patients, to I'd our DiVittorio. financial our opportunities and to the patients, our admiration and company. staff, continue the families who to residents sincerest staff, business, the I'd of protect operating challenging to have express resident themselves Tom performance my We appreciation to to the will most experienced. you. residents improve of and months, the eight turn like With we to Thank pursue to that, and like position have diligently

quarter growth this to all morning My higher funds Beginning CARES million Good patient supplemental our of Federal weighted This funding morning, and impact topline, year-to-date. increase XQ, on by acuity. with grew funding and Medicaid which the reimbursement pandemic's reflects rate Act results. everyone. types, provided George. the a programs X%. exclude recognized many third will focus rates, average with Thanks, comments across of payer state $XX COVID-XX COVID-specific State million in $XX We 'XX, financial

have commitments We that January which state the extended of at million an least appropriated is additional additional supplemental through we currently be through and optimistic declared funding, funding $XX for will of state Federal remain XXXX. emergency, late

deferred of before end. we we of are infection used periods control, funds, In CARES the the of recognized cost including addition $XX $XX state these costs received million support Federal to to cover the be under The and additional deferred funds testing. in an quarter million of Act, to recognition future sponsored

of As the Operating improvement in a continues which XX% the 'XX. and Since occurred points low skilled reported 'XX. XX.X% the down through were in low XQ XQ 'XX, the when month XX.X%. of was occupancy week in the skilled June XQ, first the grow was store occupancy XQ from result the admissions in basis admissions steadily October, down pandemic, same point, grown XX.X% the of of were from the pandemic, of down November. has XQ, a occupancy XXX is June to 'XX, occupancy of onset significant in 'XX. month XX% This occupancy From XX.X% in to from XQ, 'XX point

facilities which same In nearly of states five states beds. down pandemic operating is XX% New in highlighted levels. our store had five last pre-pandemic XX% located we As Maryland, quarter, represent has the and greatest its of Connecticut, the Massachusetts, on Jersey, impact from these our occupancy Pennsylvania

our in experienced a only have located While impacted drop facilities states in XX X% less occupancy.

financial incremental year Excluding recognized, resulted and for improvement non-labor of workers reduced predominantly $XXX XX% for These costs XQ impact include and costs by adjusted incremental a the increased expenses, overtime reduction is occupancy pay, $XX a nursing accelerated million direct from Increases a incurred staff, remain the as in in as XXXX, of expenses compensation-related bonus agency for the incurred pace $XXX We move strong million the and and function. XQ million XXXX. labor occupancy equipment, nursing Federal the the the 'XX. will from including testing well costs incremental additional the hopeful, seasonally since stem use In quarter Over operating lost both in higher what within costs State of pandemic an in This function, usage we personal are specific the caused of net we grow and once protective incurred largely period labor third cleaning costs. cost the as enhanced of in onset a historically costs admissions. and variable full environmental XX% the at estimate of we support related commensurate pandemic, of pandemic. sanitation earnings $XX of of the is COVID of toward as 'XX, expenses. million the in result

that expensive reported disproportionately in fell of under labor, in Our taken $XX summary, hotspot State reflective of 'XX, increase from of will impact is Unlike weighted XQ appropriations per cost Genesis, when reduce growth their thoughtfully the markets. hotspot pandemic's the hotspot and pay states essential COVID-XX in nursing Federal the XX% occupancy. communities XQ with our pandemic, funding the actions lost recognized COVID-XX the nursing early ratchet improvement 'XX. proximity Federal comparing of XQ like results, address COVID-XX. to or the in the programs was hour hopeful the impact who the future impacted practices other same million in costs significant last actions CARES of materially of other XQ we the the of we of high-density peak experienced labor $XX and to outbreaks. not costs COVID-XX enhanced store legislation is cost needs were by We financial impacted incurred, different, too of million quarter, initial direct XQ, providers 'XX, back a systematically virtue XX facilities In average to combined COVID-XX the Act This million, XX% we in over agency five grew less reliance nearly 'XX. remain that support 'XX, respect $XXX in were rate labor and to nursing of the state located our location states and in having months by on labor The to short in during to outbreaks facilities and overall absolutely in

was Moving at now liquidity. Liquidity to XXXX, $XXX September XX, million.

the periods, During that the CARES exclusive operating funds result further moderate consumed we down million regain as burn Difficulty] a $XX expenses estimate business support and September occupancy. of cash cash. quarter, to to we Federal actions of [Technical future of taking in approximately manage are Act

Our by government in Barring the significant will XX, obligations than future these be has accelerated pace action December of further success any is by September and closing taxes, XX, by across December and million cases liquidity. XXXX. funds being XX, advanced in affected by is and in percentage received COVID-XX reported overall this funds under included XX, of pandemic, operating our XXXX, liquidity, at million a deferred These from gap September program. of which April, recovery by slower the the recoupment Included $XXX are could surge are the liquidity repaid begin been Medicare the latest has the $XX the country. half payroll XXXX, and of of of material anticipated to to dictated scheduled at government, be balance in constitute Also Federal be which XXXX, XXXX. payment

we meet the will to pace of doubt company's and factors of such pandemic our raise the a of continue as Because appropriation these be and other the and funding, future outside and recovery the ability to our these on Our sponsored adequate of timely occupancy come receipt, operating as that largely due, material significantly in control, conditions ability substantial expenses. influenced about they obligations by the our are levels, impact COVID-XX concern. going government determine

circumstances, restructuring lease, more committed options evaluating we in residents, of of portion than that, referenced, challenges Regardless open certain to line care we ever With other with these Q&A our credit challenges possible. possible debt quality of as financial are Given pandemic, of for the the the and these actively our George to unprecedented our parties. and and please. the the call, safest provide patients please Mary, environment highest the are of

with Morgan Instructions] question [Operator you. Markets. Frank is Thank Your Capital RBC first from

line Your is open.

I over the October, northeast know about the Good the you in appreciate a on morning. little bit initial talked the I how how you hotspot quarter. in the recovery But that's about your in being occupancy more in of bump into up talk the occupancy widespread slight is? XX% and color November. beds, carrying can markets and

was the improvement disproportion it would the there So, see occupancy or broader?

markets. occupancy of the questions? would Frank, disproportionately answers your those that If still that I say outside was

Yes.

states the rest say, five a still continuing I drag states. to to disproportionate our Those of relative feel, would

are not same? five the the those But going as much as are Or they just Okay. average? up still overall

the increase, but more across outside those weighted We're board heavily markets. disproportionately seeing

that you think curious can point? you've Okay. done company, think steady go terms have you of that back you structure? structure just when basically about? at cost everything in the just you anything occupancies surge So, else again, cost state curious the talk do new could if I'm there do, And Or just people this to of another about say that down about we is were

and the progress going still expense making Well, forward managing day, on on, that good side. opportunity we're every actively is the really

Frank, if to you're making of bit problematic. occupancy done manage flex the progress that every going We arena, becomes difficult you're day, progress hit But a on to work relative our occupancy, census, And the is those operating to as additional more be when hypothetically still down look, there. taking challenging but and in describing course, very can well. that of is costs think, expenses surge a there's making type you're fighting I down, front we're in which becomes be any to outbreaks. So good is more

Got you. And…

and about and Frank, there enormous little challenge when obviously knew geography I that especially virus, June, testing was and challenge. to May would comments some number an you Genesis we add about a one. PPE was its think access in significant two, Number the when April, very

But I to much I are At I in limit business we the seen obviously we knowledge. and the think say, of as of much we are we prepared about I we think some adjust even we testing, think just clearly sit on because surges have and point now in of certain here PPE states. and cost the better we April, concerned haven't care today, to that seeing better will May structures, June. point, outbreaks, of the access are extent this impact availability saw

had in So, cost get increases some the extreme, just to buildings New staff into Jersey. like of we hotspots our extreme

I to that labor remotely think in anticipate costs our PPD close New XX%, again. I wouldn't Jersey. anything increased

additional base we've on if I what very, testing care and helpful to and thoughts the limiting we the in will surges. that. impact if Rich, knowledge you done, And So be have very see do point any don't start think, clearly, know of I

to that's impact impact, think you up costs doing the right, outbreak of the can't everything outbreak. I No, each necessarily the manage It's will George. limit exactly and because drive

pays because more that and well for our that PPE as investment it's use costs. the testing, for related limit but need virus off, a staffing itself each further outbreak testing, will an So, controlled of center. within limiting having spread of And requires as that

it. certainly that's So,

and the impact the guess excluding when I that curious, of that, one back I'll in these about future the you cash queue. quarter. and think based start. Then repayments obviously, burn about, just the the last that's hop I appreciate on one, liquidity And the in color

taxes liquidity. can without of the on in around color any do how And the it you long just kind changes think kind along So doing current far of or taxes? rules repayment there How are any on make payroll you done? be to are credit your before something with happen you just something? Or I'll you in regard update and hop. Thank partners can any waiting you. discussions And to with that those

amount look, there's limited we $XXX liquidity. say obviously, million Frank, Hey, there, could a that a of

known of aggressively obviously You've the the we the a we cash, time, business that a is that's liquidity for level second lot is managing burning and pull. historically active, are we're liquidity of quarter But look repayment period of high as and looming, for to said, levers a company at long are That there government us, into this are being and we turn. looking very still every XXXX.

valuable We of some We have ancillary our extremely the an performance platform. of morning. in highlighted this that platform comments

conversations And will and have operating hard It's but of that going here. at liquidity percentage restructuring optimal, have think, a where also active. a transactions, or we be being lot be And improving you deleveraging. levers be is forward. type and models and of been can here have, parties, are, any help pulled. alternatives looking give partners evaluated are active to our of very very continue venture status to a there and frankly, those that the to innovative some from our proven credit credit partners, capital We been transactions executed joint enhancing very we're performance But quite I obviously

you. Thank Okay.

from question next is Rice Credit Your A.J. instructions] Suisse. with [Operator

Your line is open.

Hi, everybody.

as But to cash minimum think an at repayments. happen got of sort current be deferred ongoing the swing Frank have? to sort rate positive that look back amount maybe the and on payments going what I to to is a other them, the just of flow business an know you you you tax at issue to of well basis off, occupancy rate, accelerated to get we've with the and the with what's side the need where everything leverage about When as the was asking. the of and occupancy sustainable First you're at of that questions

that A.J., So and were one. flowing cash George, running that at take were XX% pre-pandemic, we at occupancy I'll level. we

Our to and wanted but the good operationally liquidity them we into certainly be, going moving in financially, a where maybe direction we weren't very pandemic. levels were

you've thinking inflection But basis target, I about that. look, Because got and to cost it below in service mind, terms point. near that's in be think target get going per that take up. Maybe time. keep that's XXX to So I is unit points of of somewhere the would that some the

So get on side cost to say there's even I'd if one and business operating the the of this the costs moderate XX%, occupancy safely. the even the of of business so we other managing pandemic, added now returned

out relief down cost depending I No, little yes. and didn't that on brought you're a what done the okay, sense, Right, and bit. know whether looking you've all there reworking maybe But, that makes I Obviously, this guess. payments aren't relevant covenants deferred a other accelerated point? But with where now. payroll, and at with at and the the covenants make relevant difference, government any respect into even you to maybe does are

will well covenant with pointed ahead Difficulty] is covenants your that, compliance as of some in parties where all view way understand take situation We're the we've the we're quite just only A.J., you obviously really calculations, the liquidity out, George credit and our covenant. about and approach gotten And how wave. will that. just [Technical of a frankly, matters different

good our we're with parties. credit standing So in all of

discussion home the and health, and is a hospitals point? physicians and come flavor just a us and I that guess going this patients discussion sounds I discharge managing it are planners, starts that some to Just you. I sources. discharging here at got facilities get days? talk some include that more know bit what to concerned guess, like to are the discussions referral entrenched? families. Okay. about of you would diverted. become that they you, to that's normally with these Do would Maybe How to give little been home like the It little some have that health for providers degree

should in we cases, be be no is question just Yes. if expect I cannot with care, A.J., avoided. can care there think all And continue still concern institutional it that there's many and that institutionalized to lingering, avoided.

than there the hard it's volumes a think patients if accelerated being of be back That some we'll I levels, overall normal we to the occupancy. quantify pre-COVID. aggressively So [Indiscernible that biggest said, and hospital do were pursued, see But quickly, maybe begin think more X:XX:XX] think still that I they I more issue to in that. they once to more think recovery. will more to is to our aggressive return home impact improvement to marginal, options pursued in are get continue there even

give I mean, demonstrated versus were have number. $XXX But exact think operating costs million improved QX -- me our the we I QX.

can out we manage the think costs demonstrate I business very we well. of the can

So, to Alzheimer's at on clinical to our we We're to our certain and that we're ourselves our we frankly other is also do clinical differentiate need whether of to skills looking chronic conditions, or in are capabilities are the quite occupancy. mean, programmatically, the improve things intensely And advantage take marketplace. focused it's required institutionalization I there looking dementias.

can. JoAnne better to [ph.]to trying capacity headwinds possibly plans are issue. thoughts as still the how in will or as those Steve big wish a the had There to don't census due I up we we Rich, there. headwinds, a we recover. clearly. I But has quickly fill have it's developed So, clarity little of much know offset try to And more or

to George. add that, Sure, I can certainly

versus within home share facilities everyone we've there health, our a for skilled because nursing nationally that, procedures, little And There's use to facility. skilled influence in if the including really done short personal facilities, skilled that serial do make during a observation well about deployed procedures to skilled but patients of nursing one knows, virus, factors mixing the choice there's would of facilities. is facility. a times nursing strategy lower as several all the the very reduction as of there's of skilled lower all to stay to nursing admissions of admissions can elective very limited equipment, we've their the hospitals, is against of volume of are protect coming skilled out safer, patients As a testing very volume ensuring any decreased that make deliberate facilities that drive lead can of status, new to we what And we the and hospitalizations that protective selection of rehab. two volume

are part in approach we all have seen as spread, a this uptick not earlier mentioned of of these so why call. dramatic during to our things And outbreak our I

sharing with new admissions potential all steps in families that the front put believe the families that themselves. new of And uptick as reassure them of safe. Tom discharge in to to taking to that the well all being Directors we and And of hospitals who that's mentioned. We've keep discharges, our the guiding we're we're admission planners, messengers those as Medical are the seat to so contributing that

Medicare, been CARES And last someone I yet it. that? type Is more them thoughts accelerated them guess I tax force to question. be the the I your don't else I or into whether if the of would a would haven't itself What start money is of from unusual that pay going the you don't benefit. have due. I'm you not Chapter know trends? with the funds know you I choice they automatically but can't also will reimbursement anything know, just happens then, any you'll in Act just guess to come not other deducted Yes. I to to there any -- to that appreciate XX the so flow and recognize as anything fourth be back? think I if continue mean, you'll happen is on don't have back on payments about deferred fourth here curious, there that I any quarter? think pay or the question government allocated. But up, assume we scenario, quarter are cash in it free going the

the A.J., I'll The first. of a is form last the recoupment. mechanism piece cover in

course, not that a withhold we the month April. So starting essentially will it's the receive for normal otherwise of us repayment. in of in XX% They Medicare the would receipts

And so as mechanism to that's works. how the that

are things quarter into quarter point of things, fourth favorable view. As a from and about the going beyond a there you number think quarter, the of funding the

and that sheet, I second rates million the early, with for in infection quarter. final program we're uptick based of control September, for aggregate the upon September it's terms have is the and first of of now $XX the in of November fourth October in fully we program, for performance round could flow. a to of Separately, recognize of a it associated that measured just balance best each the the that And And, which glimpses getting an for that again, $XX a component infection that $XX then all deferred all in we'll period. fourth is, little terms specific million is $XX starting first in be stimulus a our the $XX month, value-based here December, period. us we is cash million on program for the your measurement October, buildings, of our your totality in use September but and measurement of and that The dollars therefore the that expenditures, expect of billion for guess month million

also state of as that that to fully more clearly end the than that another I committed number A.J. And the million quarter. conservative $XX out expect that's of year. We very the been here going we're through see we funds have round fourth a have

gets will would out, which state if follow. the funds more FMAP that expect we January, some And the end right pushed further lifted, through of being at to Medicaid of as emergency the date of that of continue now

XXXX for, some I for to program would it of see there's how number might referenced accounted we've our So conservative then in XXXX, ACO, And earlier we've a potential share gain quarter. And a the which fourth there late too, been you in pretty think settlement upside back are things. there. relates year, that there will expect to the as in that I the we'll get have

Great. right. lot. a Thanks All

You're welcome.

no the turn over further George to back questions. are call I'll Hager. There

everyone. you, thank Well,

Steve, of know of safe. everyone's support performance stay Tom appreciate hopefully the our continued JoAnne, after condition residents, prioritizing the of that the call. you operating myself out for any and And and all. challenging Stay and these company, same are the staff. harm's for very the company, at safety patients questions the We are while always, available way. specific Lori As times. we Rich, diligently the financial company, everyone, during improve working time, to of And Thank especially

that call. concludes today's and Ladies Thank conference gentlemen, you for joining.

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