The Pennant Group Q4 2024 Earnings Report

The Pennant Group EPS Results

• Actual EPS: $0.18
• Consensus EPS: $0.24
• Beat/Miss: Missed by -$0.06
• One Year Ago EPS: $0.22

The Pennant Group Revenue Results

• Actual Revenue: $188.89 million
• Expected Revenue: $185.83 million
• Beat/Miss: Beat by +$3.06 million
• YoY Revenue Growth: N/A

The Pennant Group Announcement Details

• Quarter: Q4 2024
• Date: 2/27/2025
• Time: After Market Closes
• Conference Call Date: Friday, February 28, 2025
• Conference Call Time: 12:00PM ET

The Pennant Group (NASDAQ:PNTG) (NASDAQ: PNTG) is a publicly traded holding company that provides specialized services to the asset management industry. Through its operating subsidiaries, the company delivers outsourced fund administration, securities lending, prime brokerage, and capital markets solutions designed to support hedge funds, private equity firms, mutual funds and other institutional investors. By leveraging a combination of technology platforms and industry expertise, The Pennant Group helps clients streamline middle- and back-office processes, enhance operational efficiency and manage regulatory requirements.

Key service offerings include fund accounting and reporting, trade settlement and reconciliation, risk monitoring, securities lending programs and execution support across a range of asset classes. The company’s proxy advisory and compliance services assist sponsors in meeting governance and disclosure standards, while its capital introduction team facilitates connections between emerging managers and potential investors. Together, these capabilities enable managers of both traditional and alternative investment vehicles to focus on portfolio performance rather than administrative burdens.

Headquartered in New York City, The Pennant Group was established in the mid-2010s to consolidate several boutique service providers under a unified platform. It operates primarily in the United States, serving a diverse client base that spans domestic and offshore funds. The company’s leadership team comprises professionals with extensive experience in fund operations, securities markets and regulatory oversight, positioning The Pennant Group to address evolving industry challenges and drive growth through strategic partnerships and service innovation.

The Pennant Group Q4 2024 Earnings Call Transcript

Key Takeaways

• In 2024, Pennant delivered record revenue of $695.2 million (up 27.6%) and adjusted EPS of $0.94, exceeding updated guidance.
• The home health & hospice segment grew Q4 revenue 32.9% to $142 million and same‐store admissions rose 14.4%, supported by a 4.1‐star average CMS rating.
• Senior living revenue climbed 20% in Q4 to $46.9 million with occupancy up 30 bps to 78.8% and average revenue per occupied room rising 8.6%.
• Pennant expanded its footprint through strategic partnerships and acquisitions, including a JV with John Muir Health, a management agreement with Hartford HealthCare, and the $80 million Signature Healthcare deal.
• An $1.7 million atypical Q4 hospice cap expense weighed on margins, with management expecting some residual drag in 2025 while working to adjust patient mix.

Presentation

[Operator]

for standing by. Welcome to the Pennant Group Fourth Quarter twenty twenty four Earnings Call. At this time, all participants are in listen only mode. After the speakers' presentation, there will be a question and answer session. To ask a question during this session, you will need to press 11 on your telephone. Please be advised that today's conference is being recorded. I would like to hand the conference over to your first speaker today, Kirk Cheney. Please go ahead.

[Kirk Cheney, Executive Vice President, General Counsel and Corporate Secretary at The Pennant Group]

Thank you, Marvin. Welcome, everyone, and thank you for joining us today. Here with me today, I have Brent Garesulli, our CEO John Goughner, our President and COO and Lynette Waldam, our CFO. Before we begin, I have a few housekeeping matters. We filed our earnings press release and 10 K yesterday.

[Kirk Cheney, Executive Vice President, General Counsel and Corporate Secretary at The Pennant Group]

This announcement is available on the Investor Relations section of our website at www.pennantgroup.com. A replay of this call will also be available on our website until 5PM Mountain Time on 02/28/2026. We want to remind anyone who may be listening to a replay of this call that all statements made are as of today, 02/28/2025, and these statements will not be updated after today's call. Also, any forward looking statements made today are based on management's current expectations, assumptions and beliefs about our business and the environment in which we operate. These statements are subject to risks and uncertainties that could cause our actual results to materially differ from those expressed or implied on today's call.

[Kirk Cheney, Executive Vice President, General Counsel and Corporate Secretary at The Pennant Group]

Listeners should not place undue reliance on forward looking statements and are encouraged to review our SEC filings for a more complete discussion of factors that could impact our results. Except as required by federal securities laws, Pennant and its affiliates do not undertake to publicly update or revise any forward looking statements where changes arise from new information, future events, changing circumstances or for any other reason. In addition, the Pennant Group Inc. Is a holding company with no direct operating assets, employees or revenues. Certain of our independent subsidiaries, collectively referred to as the Service Center, provide administrative support services to the other operating subsidiaries through contractual relationships with such subsidiaries.

[Kirk Cheney, Executive Vice President, General Counsel and Corporate Secretary at The Pennant Group]

The words Pennant, Company, We, Our and Us refer to the Pennant Group Inc. And its consolidated subsidiaries. All of our operating subsidiaries and the service center are operated by separate independent companies that have their own management, employees and assets. References herein to the consolidated company and its assets and activities as well as the use of the terms we, us, our and similar terms do not imply that any of the subsidiaries are operated directed by the Pennant Group. Also, we supplement our GAAP reporting with non GAAP metrics.

[Kirk Cheney, Executive Vice President, General Counsel and Corporate Secretary at The Pennant Group]

When viewed together with our GAAP results, we believe that these measures can provide a more complete understanding of our business, but they should not be relied upon to the exclusion of GAAP reports. A GAAP to non GAAP reconciliation is available in yesterday's press release and is available in our 10 K. And with that, I'll turn the call over to Brent Gheerstoli, our CEO. Brent?

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Thanks, Kirk, and welcome, everyone, to our fourth quarter twenty twenty four earnings call. This has been a remarkable year for Pennant. Thanks to the dedication of our local leaders and teams who care for our patients and residents each day. We are so grateful for everything you do to provide life changing service. We are pleased to announce strong fourth quarter results to conclude a year of record breaking performance.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Our Q4 adjusted earnings per share of $0.24 contribute to full year 2024 adjusted earnings per share of $0.94 which exceeds our updated earnings guidance midpoint of $0.93 As a reminder, we raised guidance twice during 2024. Our full year consolidated results include revenue of $695,200,000 an increase of $150,300,000 or 27.6% over the prior year and adjusted EBITDA of 53,300,000 an improvement of $12,600,000 or 30.9% over the prior year. 2024 was an eventful year for Pennant. We launched transformative partnerships, including a joint venture with John Muir Health in the Bay Area, which is now successfully transitioned and contributing positively to our results and a management agreement with Hartford HealthCare in Connecticut, which we view as a foundational relationship for future expansion in the Eastern United States. We completed numerous strategic home health and hospice acquisitions, including the $80,000,000 purchase of Signature Healthcare at Home, a large provider of home health and hospice services in the Pacific Northwest.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

We also made opportunistic senior living acquisitions and added attractive real estate assets to our portfolio. We strengthened our capital structure, enable additional growth by upsizing our credit facility and completing a follow on equity offering. Through all of this, we significantly expanded our same store operations and continued to add key individuals who will lead us to new heights in the future. Throughout 2024, we remain focused on five key initiatives: leadership development, employee experience, clinical excellence, margin and growth. We've effectively made progress in each of these areas during the year.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

The most important initiative continues to be leadership development, which ultimately drives performance in the other four areas. As a leadership company, we believe that attracting and developing talented leaders is paramount for growth and success. For this reason, we continue to invest meaningfully in our leadership development programs. Notably, in 2024, we added 66 leaders to our CEO and training program and launched a clinical leadership training program that included 40 participants. We were not only successful in recruiting and developing new leaders, but also in the continued development of existing local leaders who achieved record numbers of C level designations in the year.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

In total, 45 local leaders earned C level designations in their operations, including 18 local CEOs. As we've explained before, CEOs and other C level leaders earned this designation by behaving as true owners and creating financial, clinical and cultural value. In the process, they typically generate higher annual earnings than our non CEO Executive Directors along with better clinical and cultural outcomes. Following a monumental year, we are excited about the significant progress we've made and expect to build upon it throughout 2025. We are also focused on quickly and effectively transitioning newly acquired operations and have the bench strength, capital and deal flow to support substantial acquisitional growth. We continue to entertain numerous potential opportunities across our existing markets and beyond. Turning to 2025 guidance. As we announced in our press release yesterday, we are providing guidance for the full year. We anticipate full year revenue in the range of $800,000,000 to $865,000,000 and adjusted earnings per share in the range of $1.03 to $1.11 The midpoint of $1.07 represents 13.8% growth on our 2024 adjusted earnings and 46.6% growth over our 2023 results.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Our 2025 guidance is based on the compelling momentum in both our segments, the readiness of our local leaders to drive organic and inorganic growth and the significant upside we expect to continue to unlock in our existing operations. The guidance is annual, not quarterly, and it reflects an anticipated ramp throughout the year, particularly as we transition a significant number of recently acquired operations. With that, I'll turn the call over to John to provide more detail on our fourth quarter operational results.

[John Gochnour, President & COO at The Pennant Group]

Thank you, Brent, and good morning, everyone. I'm pleased to report that the strength that has characterized both of our business segments throughout 2024 continued in the fourth quarter. Turning first to our Home Health and Hospice segment. Top line revenue for the full year increased to $519,500,000 a $125,000,000 or 31.7% increase over the prior year, while revenue for the quarter increased to $142,000,000 a $35,100,000 or 32.9% increase over the prior year quarter. Earnings growth reflected similarly strong improvement as adjusted EBITDA of $80,700,000 represented an increase of $20,500,000 or 34.1% over the prior year, and fourth quarter adjusted EBITDA of $21,300,000 dollars increased $4,700,000 or 27.9% over the prior year quarter.

[John Gochnour, President & COO at The Pennant Group]

Both our home health and hospice businesses grew rapidly as our local teams attracted outstanding clinical staff, built strong partnerships and differentiated themselves by offering effective clinical solutions to the community. Home health admissions hit a new high of 15,959, an increase of 40.9%. Medicare admissions increased to a record 6,443, an increase of 30.1%. Medicare revenue per episode increased 9.9% each over the prior year quarter. This overall growth was driven by strong transitions in our new operations and ongoing momentum in our existing portfolio as same store admissions grew 14.4% and same store Medicare admissions grew 6.1% each over the prior year quarter.

[John Gochnour, President & COO at The Pennant Group]

At our hospice operations, admissions increased 21.7% to 3,090 and hospice ADC increased 23.2 to 3,445, resulting in strong revenue growth even as our revenue per episode decreased by 1.6% each over the prior year quarter. In our same store hospice operations, admissions grew 10.4% and ADC grew 9.6% each over the prior year quarter. This ADC growth represents the ninth consecutive quarter of ADC increase as our hospice programs continue to meet the needs of the communities they serve. We attribute much of the outperformance of our home health and hospice business to our local leaders' relentless focus on quality clinical outcomes, evidenced by the fact that 83% of our agencies have a real time star rating of four stars or above. Our average CMS reported star rating of 4.1 significantly exceeds the national average of three point zero and our CMS reported potentially preventable hospitalization rate of eight point seven percent is 120 basis points better than the national average of nine point nine percent.

[John Gochnour, President & COO at The Pennant Group]

As a result of our strong clinical outcomes, we are poised to benefit in 2025 from the expansion of CMS' home health value based purchasing program. As we have described in past calls, we often experience lumpiness in our operating margin as we acquire and transition underperforming assets. Despite the potential margin pressure that could have resulted from record acquisitional growth in 2024, Our adjusted EBITDA margin improved 10 basis points year over year to 15.7%, which contributed positively to the Home Health and Hospice segment's adjusted EBITDA increase of $20,500,000 In addition, we achieved this improvement despite an atypical hospice cap expense in the fourth quarter of 1,700,000 Excluding this expense, our fourth quarter adjusted EBITDA margin would have increased from 15% to 16.2%. With the significant number of acquisitions completed in 2023 and 2024 and ongoing efforts to drive efficiency through technology and improved management, we are poised to create additional whole dollar value and unlock latent potential for margin improvement in 2025. Our senior living business continued its ascent as we improved operational results while also taking advantage of favorable acquisition opportunities.

[John Gochnour, President & COO at The Pennant Group]

Senior Living segment revenue improved to $175,800,000 an increase of $25,300,000 or 16.8% over the prior year and $46,900,000 in the fourth quarter, a $7,800,000 or 20% increase over the prior year quarter. Full year senior living segment adjusted EBITDA improved to $16,200,000 a $3,900,000 or 31.9% increase over the prior year and $4,200,000 for the fourth quarter, an increase of $800,000 or 23.4% over the prior year quarter. On the year, occupancy rose 30 basis points to 78.8% As we have focused on quality of revenue, including both room and board and level of care, we have continued to drive improved average revenue per occupied room, which climbed to 4,961 in the fourth quarter, an increase of three ninety three or 8.6% over the prior year quarter. On the growth front, through our investment in our leadership development program, the health and momentum in our markets and portfolio companies and the balance sheet transactions we completed this year, we are well positioned to take advantage of opportunistic acquisitions in both segments. In the fourth quarter, we entered into long term triple net leases for three senior living communities in the Green Bay area of Wisconsin, bringing 125 additional units into our portfolio.

[John Gochnour, President & COO at The Pennant Group]

These acquisitions reflect our disciplined approach to growth with experienced leaders ready to step in healthy, geographically proximate clusters ready to embrace the operations and implement the tenant model and attract the rents with significant upside. These buildings have performed well out of the gate and are well positioned to be accretive to our short and long term senior living results. After quarter end, on 01/01/2025, we closed on the purchase of Signature Healthcare at Homes Oregon assets, which completes the two stage transaction. The Washington and Idaho operations, which we purchased on August 1, are transitioning well and contributing positively to our results, and we anticipate a similar trajectory for the Oregon operations. We pursued this deal because we knew that Signature was a quality company with talented clinicians, strong leaders and the strategic footprint whose culture aligned exceptionally well with Pennant.

[John Gochnour, President & COO at The Pennant Group]

Our experience has confirmed those expectations. We are excited for the bright future that we can create in Oregon, Washington and Idaho as our signature partners become C level leaders in the unique tenant operating model. On 02/01/2025, we closed an additional three senior living deals, one in Idaho and two in Texas, each under a long term triple net lease. The Idaho acquisition adds 68 units to our portfolio in the fast growing Boise area. The lease provides an option to purchase the underlying real estate at a predetermined price, making it an attractive way to add to our real estate portfolio as we create value through the operational transformation.

[John Gochnour, President & COO at The Pennant Group]

The acquisitions in Kerbal and Tomball, Texas add 120 units to our senior living portfolio. These are attractive Class A buildings in growing population centers that significantly overlap with our home health and hospice agencies, creating unique opportunities to build tenant continuum of care. With that, I'll hand it over to Lynette for a review of the financials. Lynette?

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

Thank you, John, and good morning, everyone. Detailed financial results for the full year and three months ended 12/31/2024, are contained in our 10 K and press release filed yesterday. For the full year ended 12/31/2024, we reported total GAAP revenue of $695,200,000 an increase of $150,300,000 or 27.6% over the prior year GAAP diluted earnings per share of $0.7 and adjusted diluted earnings per share of $0.94 As a reminder, our 2024 full year guidance included total revenue between $665,300,000 dollars and $706,500,000 adjusted earnings per diluted share between $0.9 and $0.96 and adjusted EBITDA between $51,900,000 and $55,200,000 We delivered on this guidance with adjusted EBITDA of $53,300,000 a $12,600,000 or 30.9% increase over the prior year and non GAAP adjusted earnings per diluted share of 0.94 an increase of 28.8% over the prior year. Our cash generation remains strong. The fourth quarter was a prolific quarter for cash accumulation including $20,600,000 in net cash generated from operating activities and $17,200,000 in free cash flow.

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

Based on our solid operational performance, the positive impacts of our credit facility upsize and our equity offering in October 2024, we are well positioned for future growth with a healthy balance sheet and ample dry powder to deploy. Key metrics for the full year ended 12/31/2024 include $245,800,000 available on our revolving line of credit and $24,200,000 in cash on hand at year end, zero times net debt to adjusted EBITDA and cash flows provided from operations of $39,300,000 for the year. As we mentioned in our press release, we are providing full year 2025 guidance of revenue of

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

$800,000,000 to $865,000,000 adjusted EBITDA of $63,100,000 to $68,200,000 and adjusted earnings per share of $1.03 and $1.11 to $1.11 Our guidance incorporates current operations and organic growth, diluted weighted average shares outstanding of approximately 36,000,000 and a 25.5 percent effective tax rate. Our 2025 annual guidance anticipates an EPS increase quarter over quarter and is based on a ramp in home health and hospice ADC, occupancy and rate improvement in senior living, anticipated reimbursement rate adjustments, level interest rates and inflation consistent with 2024. It does not include unannounced acquisitions and excludes start up operations, share based compensation, acquisition related costs and one time implementation and unusual items. Now it's my pleasure to spotlight a few operations and their leaders who have demonstrated exceptional performance in 2024. Their stories illustrate the remarkable results that can occur when local leaders behave as owners and drive operational excellence.

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

At Big Sky Home Health and Hospice, future CEO, Janie White future CCO, Ama Sankey and future COO, Jenna Loya have built an operation that is an employer and provider of choice in the Missoula Montana healthcare continuum. Since Jamie took the helm of Big Sky in 2022, Big Sky added home health services to its offering, decreased turnover by more than 50% and improved its employee engagement score to 88% in 2024. Clinically, Big Sky has achieved a real time star rating of 4.5, a hospice composite score of 100 and hospice cap score of 84.5%, each well above national benchmarks. In addition, Big Sky received the full 5% positive revenue adjustment for home health performance under CMS's value based purchasing program. These excellent clinical and cultural outcomes coupled with solutions designed to meet the needs of their local continuum have driven twenty twenty four results that reflect a 145% increase in revenue and a 410% increase in EBITDA over the past two years.

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

In Whittier, California, future CEO, Yissy Barbara Aguirre and Wellness Director, Kathleen McDonald have created an exceptional community at Whittier Glen Assisted Living. This community has clearly become an employer of choice with employee satisfaction scores of 92% and Turner has improved 35 year over year and is significantly better than industry averages. Whittier's cultural strength has led to exceptional clinical outcomes, increasing resident safety and satisfaction. Ultimately, this impacts financial results. Year over year, Whittier's revenue has increased 16% and EBITDA has increased 147%. Now I'd like to hand it back to Brent.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Thank you, Lynette. As you can see, we've had a remarkable year and are primed for success in 2025 and beyond. With that, we'll open it up for questions. Marvin, can you please instruct the audience on the Q and A procedure?

[Operator]

Thank you. And our first question comes from the line of Scott Fidel of Stephens. Your line is now open.

[Scott Fidel, Managing Director at Stephens Inc]

Okay. Thanks. Hi, everyone. A couple of questions here for me. Maybe the first one just within the 2025 outlook, thought it would be helpful if you want to walk us through how you're embedding expectations for same store revenue growth for home health, hospice and senior living within the guidance?

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

On the same store front for revenue, we're projecting about a 7% increase in revenue for those same store. And same store includes when I'm looking at that, it's the entire portfolio. So same store, new store with the exception of Signature the signature ads. We are looking at signature as kind of a separate piece.

[Scott Fidel, Managing Director at Stephens Inc]

Yes. Okay. And then just like around that 7%, I guess, you might not have the specifics, but any or Brent and John, like directionally how would you think about home health, hospice and SL either being sort of over or under that 7% aggregate same store growth?

[John Gochnour, President & COO at The Pennant Group]

Yes. I'm happy to jump in, Scott. This is John and just share from a home health and hospice perspective, obviously, recent trends over the last two years would suggest that we've got opportunity to improve on that number. We wanted to recognize the fact that we have a lot going on from a transition standpoint and we're always sensitive to that. But when you look at our growth this year, it was really record breaking to have a 40% increase in home health admissions, to grow our revenue by 30%.

[John Gochnour, President & COO at The Pennant Group]

We're feeling really optimistic about the opportunity that we have to continue to drive growth within those same store operations. On the senior living side, I think you see our ability to continue to push rate improvement. While that's ameliorated a little bit our occupancy growth, the quality of revenue, our ability to capture care's revenue more accurately, our ability to still pass through room and board increases. That's what gives us a lot of optimism in both segments that from a same store standpoint, we can continue to push growth.

[Scott Fidel, Managing Director at Stephens Inc]

Okay. Thanks, John. Then my second question, I guess, we have to have the obligatory question around sort of the legislative funding environment in Washington and the discussion there. Appreciate your payer mix disclosures. In 2024, you had Medicaid mix right at around 13%.

[Scott Fidel, Managing Director at Stephens Inc]

Maybe if you could sort of, I guess, sort of give us some details there. I mean, that would seem to be mostly home care, right, that I would suspect within that. Maybe sort of talk about, I guess, sort of contribution to earnings relative to the 13% revenue mix? And then sort of how your assessment would be around the exposure or not to some of the different funding or savings options that the GOP is considering currently in D. C?

[John Gochnour, President & COO at The Pennant Group]

Yes, Scott. Appreciate the question. And I think it's an important one for us to consider. Just to highlight sort of and add some color to the 13%, That's primarily driven by the Medicaid business in our senior living business. And so you can add a couple more percent for our home care for a total of about 15% of our business that would be exposed to potential impact from Medicare.

[John Gochnour, President & COO at The Pennant Group]

On the earnings front, I would say we have been able to identify and find some fairly favorable programs on the senior living side, but these are all programs that are designed to serve the communities that are so important to our nation's future, that are vulnerable and that need a place to stay in a low cost setting. And so as we look at what the administration is doing, they're looking at every opportunity to save money. We appreciate that. They've been fairly consistent in saying that Medicare won't be touched, that Medicaid, they're looking for fraud, waste and abuse, not to cut these essential services for critical patient populations. And so we're optimistic that as they look at places to cut, they're going to identify that the services we provide home health, hospice, home care, non skilled home care and senior living all represent sort of a lower expenditure of Medicaid dollars and offer opportunities to actually save money because of the high touch nature of our care, the fact that it's the lowest cost setting and the fact that it helps keep patients out of the hospital and higher acuity settings.

[John Gochnour, President & COO at The Pennant Group]

And so we remain optimistic that from an impact standpoint that that's going to hold true. The final thing I'll say is we have endured a number of changes throughout the history of the time that Brett and I have been doing this for over thirteen years. And during that time, we've gone through multiple changes, the change from to PDGM. We've received ARPA funding on the senior living side. We've had that taken away.

[John Gochnour, President & COO at The Pennant Group]

Throughout all of those changes, I think our model has shown its resilience. Our local operators have the transparent visibility to be able to understand how payment changes impact their patient mix and resident mix, and they have the visibility to adjust those as those changes occur. And so as much as obviously this is it's very pertinent in our space right now, We feel confident that we're well positioned to adjust to any changes that do occur. But again, it's a fairly modest amount of our revenue that is potentially implicated by any Medicaid cuts.

[Scott Fidel, Managing Director at Stephens Inc]

Okay.

[Scott Fidel, Managing Director at Stephens Inc]

Thanks, John. And then just one final one for me, if I can. I know you guys called out a couple of times anticipating an earnings ramp over the course of the year. I know that's generally been the pattern the last couple of years. So just wanted to confirm or not whether there's any different level or magnitude of ramp that you're thinking about for this year versus the last couple of years?

[Scott Fidel, Managing Director at Stephens Inc]

And then if you could give us your thinking around operating cash flow and CapEx for $25,000,000 and then that's it for me. Thanks.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Yes. And I'll let Lynette take the question on cash flow and CapEx. But in general, yes, we expect to see a similar ramp to what we have seen in years past. That being said, because of all of the new transitions and larger acquisitions we've done in the really the end of the year, I think it may be a little more of an aggressive ramp over the year. So beginning of the year, we're trying to integrate these operations.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

And so from that perspective, yes, it'll be similar to years past, but maybe a little lighter at the beginning of the year and more aggressive toward the end of the year.

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

On the operating cash flow front, we're looking at mid to high 40s for operating cash flow. And then as we look at CapEx expenditures is similar to what we've experienced this year or in 2024.

[Scott Fidel, Managing Director at Stephens Inc]

Okay. As a percentage of revenue or absolute dollars, Lynette?

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

Absolute dollars.

[Scott Fidel, Managing Director at Stephens Inc]

Okay.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Just a little color on that. So we've spent a lot of time over the last several years really reinvesting in our buildings. And so that's why we're seeing a little bit of just an overall flattening in the CapEx spend. And then some of these newer acquisitions or newer buildings that we brought on are nicer Class A buildings that don't necessarily require as much CapEx spend. So anyway, that's what's kind of built into that as well.

[Scott Fidel, Managing Director at Stephens Inc]

All right. That's good to hear. So probably important call out there. So it seems like free cash flow then should probably ramp. We'll see that a little more pronounced to 25 relative to 24, it sounds like.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Yes.

[Scott Fidel, Managing Director at Stephens Inc]

Yes. Okay, great. Thank you.

[John Gochnour, President & COO at The Pennant Group]

Thanks, Scott.

[Operator]

Thank you. One moment for our next question. Our next question comes from the line of Stephen Baxter of Wells Fargo. Your line is now open.

[Stephen Baxter, Senior Equity Research Analyst at Wells Fargo]

Hi, thanks. Kind of a similar theme question, just on the guidance assumptions. I was hoping you could help us think about, when we look at the drivers of EBITDA margin improvement, I guess, how do we think about the balance between what's being driven by some of the recently acquired assets? How do we think about what's in there on a maybe a same store basis for home health and hospice business? And then also the same store type trends that you'd expect within senior living? And then I have a follow-up. Thank you.

[Lynette Walbom, Chief Financial Officer at The Pennant Group]

When we're thinking about margin, I would say that there will be some impact as we've had these acquisitions at the end of twenty twenty four and then beginning of twenty twenty five that will as we bring those operations closer to our EBITDA margin, there will be some noise there. But when we look at where we think we'll end up on that home health margin, it's similar to where we're at this year in that 15% high 15%, low 16% EBITDA margin. And then with senior living, we're looking at that margin increasing throughout the year, again, as we drive occupancy and just improve some of our cost control measures and moving that margin closer to that 10.5%.

[Stephen Baxter, Senior Equity Research Analyst at Wells Fargo]

Got it. Okay. Thank you. And then just to kind of discuss the hospice cap issue a little bit more. I know these popped up in the past and you guys have the operational methods to kind of remediate that.

[Stephen Baxter, Senior Equity Research Analyst at Wells Fargo]

So I guess just how do we think about the operational changes you make to deal with that and how long that kind of persists throughout 2025? I'm just trying to think about how much of a drag there might be that might be sort of transient within the 2025 outlook as well? Thank you.

[John Gochnour, President & COO at The Pennant Group]

Yes, appreciate that question, Stephen. And I think as you look at hospice cap, historically hospice cap, we have not operated with significant hospice cap. Uniquely, about 88% of the cap impact that we accrued in 2024 came from California, a state where because the wage index is tied to the reimbursement, our reimbursement increases at a faster rate than the hospice cap allowance increases. And that's what that is just a fact, right, that we have to address and deal with. Our focus has been on how do we change the underlying mix of our patients.

[John Gochnour, President & COO at The Pennant Group]

We are we're in this business to serve patients who are terminally ill throughout their disease prognosis. It's impossible to verify that. We all saw former President Jimmy Carter, who is on hospice for a significantly longer time than the six months that are expected. And we want to be the partner of choice for every patient in the communities we serve. That said, there are certain referral sources who generally refer patients that are later along in their disease prognosis and our focus is on continuing to develop and build those relationships where we can take more acute patients and balance out those patients that identify the need for hospice care earlier on in their disease prognosis and ensure that we avoid cumulative hospice cap.

[John Gochnour, President & COO at The Pennant Group]

As far as the impact on last year, we called it out, it was somewhat pronounced, $1,700,000 in the fourth quarter. That's a very significant and atypical expense and affected our margin. As we go into 2025, we have been on for several months, we've been focused on adjusting those referral patterns and we'll continue to do that. I would expect some continued drag in 2025, but our focus is on managing our business in such a way as to eliminate as much of that cap as possible in 2025 and whatever residual there may be would be from the 2024 cap year. And I would estimate that as potentially about a third of what we experienced this year, potentially less than that if we manage it effectively.

[John Gochnour, President & COO at The Pennant Group]

So we're focused on again changing the referral source, making sure that we're the partner of choice in our communities that we serve. And I'll emphasize that this really only affects a couple of agencies. Most of our agencies operate well below the cap and those agencies that are affected are in those higher reimbursement geographies where we simply have less time to care for the patients because of the design of the hospice cap allowance.

[Operator]

Thank you. One moment for our next question. Our next question comes from the line of Ben Hendricks of RBC Capital Markets. Your line is now open.

[Ben Hendrix, Equity Research - Healthcare Services and Managed Care at RBC Capital Markets]

Great. Thank you very much. I wanted to turn back to the Senior Living segment. Clearly, you're seeing really strong rate momentum there. And I know you've outlined initiatives in the past to kind of focus and optimize mix towards potentially maybe more AL mix.

[Ben Hendrix, Equity Research - Healthcare Services and Managed Care at RBC Capital Markets]

Just wanted to get an idea of kind of what inning were in there with our same store portfolio and kind of how you're thinking about those opportunities as you look for M and A in the future? Thanks.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Yes, great question, Ben. And I think we kind of touched on this in our script, but one of the things that we saw in 2024 was a real focus on driving revenue quality. And so what that means is some of the resident population or just in general bringing in folks in at a higher rate, It plateaued a little bit some of our occupancy growth. The great thing though is we're in a much better position now than we've ever been. I also mentioned the investments in our buildings and trying to create an experience that is to the expectations of our residents.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

And so those investments coupled with continued investments on the technology front, trying to build out our sales cycle and really being able to capture new and different residents in the communities that we're in. We feel really good about where we're at. I mean, in terms of like inning, we're still kind of in the early stages of this. And I think as we really start to ramp up these efforts and execute on what we've implemented, that's why we're optimistic that going into 2025, we'll continue to see that ramp up in occupancy. And the other thing just to bear in mind is, we have a significant number of our operations that are in the high 80s or low 90s in terms of their occupancy.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

So we know that we know how to make it happen. It's just a matter of helping to build those local teams and giving them the tools and resources to be able to effectively build their occupancy at the local level as well. And so again, we're confident that we've got kind of the foundation in place. And so this should be a year that we continue to grow off of.

[Ben Hendrix, Equity Research - Healthcare Services and Managed Care at RBC Capital Markets]

Great. Thank you.

[Operator]

Thank you. I'm showing no further questions at this time. I would now like to turn it back to Brent Casoli for closing remarks.

[Brent Guerisoli, Chief Executive Officer at The Pennant Group]

Okay. Well, thank you, Marvin, and thank you, everyone, for joining us today.

[Operator]

Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.

Participants

Executives

• Kirk Cheney, Executive Vice President, General Counsel and Corporate Secretary
• Brent Guerisoli, Chief Executive Officer
• John Gochnour, President & COO
• Lynette Walbom, Chief Financial Officer

Analysts

• Scott Fidel, Managing Director at Stephens Inc
• Stephen Baxter, Senior Equity Research Analyst at Wells Fargo
• Ben Hendrix, Equity Research - Healthcare Services and Managed Care at RBC Capital Markets