Extendicare Q1 2026 Earnings Report

Extendicare EPS Results

• Actual EPS: C$0.42
• Consensus EPS: N/A
• Beat/Miss: N/A
• One Year Ago EPS: N/A

Extendicare Revenue Results

• Actual Revenue: $465.22 million
• Expected Revenue: N/A
• Beat/Miss: N/A
• YoY Revenue Growth: N/A

Extendicare Announcement Details

• Quarter: Q1 2026
• Date: 5/7/2026
• Time: After Market Closes
• Conference Call Date: Friday, May 8, 2026
• Conference Call Time: 11:30AM ET

Extendicare (TSE:EXE), operating solely in Canada, is the largest private-sector owner and operator of long-term care (LTC") homes and one of the largest private-sector providers of publicly funded home health care services.

Extendicare Q1 2026 Earnings Call Transcript

Key Takeaways

• Positive Sentiment: Closed the CAD 570 million acquisition of CBI (April 1), adding ~10 million hours of service, ~8,500 team members and a pro forma ~CAD 478 million in revenue and ~CAD 61.9 million adjusted EBITDA, materially expanding Western Canada scale and synergy opportunities via its tech-enabled platform.
• Positive Sentiment: Strengthened capital structure by issuing CAD 450 million 5‑year senior unsecured notes at 4.345% (BBB, stable) and amending facilities to an unsecured revolver, leaving pro forma liquidity of ~CAD 211 million and a pro forma net debt/adjusted EBITDA of ~2.8x, with management prioritizing near‑term deleveraging.
• Positive Sentiment: Home health (ParaMed) delivered a 32.7% volume increase and a normalized NOI margin improvement of 300 bps to 13.3%, driven by strong organic demand and recent acquisitions, though management expects organic growth to eventually moderate.
• Positive Sentiment: AFFO (adjusted) rose to CAD 0.276 per share (up 56% YoY) and the payout ratio declined to 41% on a trailing twelve‑month basis, improving cash flow coverage and allocation flexibility.
• Negative Sentiment: Q1 results were aided by approximately CAD 8.7 million of net favorable out‑of‑period retroactive funding (partly offset by wage adjustments), and managed services revenue fell due to Revera's home sales, which tempers the comparability of reported performance.

Presentation

[Operator]

Thank you for standing by. This is the conference operator. Welcome to Extendicare Inc.'s first quarter 2026 analyst conference call. As a reminder, all participants are in listen only mode, and the conference is being recorded. After the presentation, there will be an opportunity to ask questions. To join the question queue, you may press star one on your telephone keypad. Should you need assistance during the conference call, you may reach an operator by pressing star zero. I would now like to turn the conference over to Jillian Fountain, Vice President, Investor Relations. Please go ahead.

[Jillian Fountain, VP of Investor Relations at Extendicare]

Thank you, operator, and good morning, everyone. Welcome to Extendicare's 2026 first quarter results conference call. Joining me today are Extendicare's President and Chief Executive Officer, Michael Guerriere, and Executive Vice President and Chief Financial Officer, David Bacon. Our Q1 results were released yesterday and are available on our website, as is a live audio webcast of today's call, along with an accompanying slide presentation. An archive recording will also be available on our website following the call today. As well, replay numbers and passcodes have been provided in our press release for those wishing to access an archive recording by phone until midnight on May 22nd.

[Jillian Fountain, VP of Investor Relations at Extendicare]

Before we get started, please be reminded that today's call may include forward-looking statements and non-GAAP and other financial measures. Such forward-looking statements involve known and unknown risks and uncertainties that may cause actual results to differ materially from those expressed or implied today.

[Jillian Fountain, VP of Investor Relations at Extendicare]

We have identified such factors as well as details of non-GAAP and other financial measures in our public filings with the securities regulators and suggest that you refer to those filings. With that, I will turn the call over to Michael.

[Michael Guerriere, President and CEO at Extendicare]

Thank you, Jillian. Good morning. Our first quarter results demonstrate the various components of our strategy working in concert. Strong organic growth in Home Healthcare augmented by acquisitions, progressing our long-term care construction activities in our joint venture with Axium, and organic growth in SGP, all benefiting from the operating leverage that results from a technology-enabled back office. Subsequent to the quarter, we closed the CAD 570 million acquisition of CBI and completed the sale of CAD 450 million in unsecured notes supported by a BBB credit rating from DBRS. These transactions provide us with new opportunities for growth and additional capital flexibility as we work to meet the increasing care needs of an aging population.

[Michael Guerriere, President and CEO at Extendicare]

The ParaMed segment delivered volume growth of 32.7% over the prior year quarter, reflecting the addition of Closing the Gap and strong underlying organic growth. Higher volumes, combined with the scalability of our technology-enabled back office, drove an NOI margin of 13.3% after adjusting for out-of-period items, a 300 basis point increase over the prior year quarter. Our long-term care NOI margins improved by 90 basis points from the prior year to 10.9% after adjusting for out-of-period items, with occupancy unchanged at 97.5%. managed service revenues declined year-over-year due to Revera's sale of its remaining C bed portfolio, some to Extendicare and the balance to another operator. Third party and joint venture beds served by SGP grew to over 157,000, up 6% from the prior year.

[Michael Guerriere, President and CEO at Extendicare]

Managed services NOI margins were 54.6%, remaining in line with our expectations of 50%-55% margins for this segment. Driven by the strength of these results, AFFO, adjusted for out of period items, increased to CAD 0.276 per share, up 56% year-over-year, driving our payout ratio down to 41% on a trailing 12-month basis. Turning to slide four. We closed the CBI acquisition on April 1st. CBI Home Health is highly complementary to ParaMed as it materially expands our presence in Western Canada and introduces business models that offer new avenues for organic growth. The combination of the two companies provides an opportunity to achieve significant synergies as we manage additional volumes using our highly scalable technology platform.

[Michael Guerriere, President and CEO at Extendicare]

The added scale will enable further investments in technology, enabling us to provide reliable, high-quality services more efficiently to the thousands of people that rely on us for care each day. The transaction adds CBI's approximately 10 million hours of service and 8,500 team members to our Home Health segment, which, as previously disclosed, generated an estimated CAD 478 million in revenue and CAD 61.9 million in adjusted EBITDA on a pro forma basis in the 12 months ending June 2025. Turning to slide five. We continue to advance our Ontario long-term care redevelopment agenda through our joint venture with Axium. We currently have seven projects under construction, two of which will open this year. At the end of May, we will welcome residents to Extendicare Beauclaire in Ottawa, followed later in the year by Extendicare Forest Trail in Peterborough.

[Michael Guerriere, President and CEO at Extendicare]

Together, these two homes will deliver 576 new and upgraded beds. We remain on track to open 4 new homes in 2027, delivering an additional 832 beds. In February, we completed the sale of our vacated West End Villa in Ottawa for CAD 12.1 million, realizing a CAD 9.8 million post-tax gain. This sale is another example of the capital recycling potential of our redevelopment strategy, as we can invest these proceeds in new projects to advance our redevelopment pipeline. We continue to progress an additional 17 projects which are at varying stages of planning and development under the Ontario Long-Term Care Home Capital Development Program. We are actively working with government to put in place the necessary funding and other considerations required to begin construction on additional homes to fully realize our redevelopment agenda.

[Michael Guerriere, President and CEO at Extendicare]

I'll now turn the call over to our CFO, David Bacon, to discuss our financial results in more detail.

[David Bacon, EVP and CFO at Extendicare]

Thanks, Michael. I'll start with a brief overview of our consolidated results, review our individual business segments, and provide an update on the recent changes to our capital structure. Our consolidated results for the quarter included approximately CAD 8.7 million in net favorable out-of-period items related to retroactive funding in both LTC and Home Health, partially offset by retroactive wage adjustments in Home Health. The impact of the out-of-period items is summarized in the appendix to our presentation.

[David Bacon, EVP and CFO at Extendicare]

Our consolidated Q1 revenue increased by 24.2% to CAD 465.2 million, driven by 32.7% growth in our Home Health care volumes, reflecting the organic growth in the acquisition of Closing the Gap last July, the acquisition of 9 LTC homes in June of 2025, long-term care funding enhancements, partially offset by the closure of the West End Villa home that was vacated when we opened Extendicare Crossing Bridge in the Axium joint venture, and lower management fees resulting from Revera's sale last year of the LTC homes that we previously managed. Excluding out-of-period items, our Q1 NOI improved by CAD 16.7 million or 38.3%, reflecting the revenue growth partially offset by higher operating costs.

[David Bacon, EVP and CFO at Extendicare]

Excluding the impact of out-of-period items, our Q1 adjusted EBITDA increased by CAD 15.2 million or 52%, reflecting the improvement in our NOI, partially offset by higher admin costs. Our Q1 AFFO improved by 65% to CAD 32.7 million. When out-of-period items are excluded from both periods, our AA- Q1 AFFO increased by CAD 11.4 million or 76% from the prior year, reflecting the improved after-tax earnings, partially offset by the cash impact of our annual settlements of our share-based compensation. The corresponding AFFO per basic share was CAD 0.276 this quarter, an increase of 56% from the prior year, and was impacted by the December equity offering, which, on a pro forma basis, reduced AFFO by approximately CAD 0.035. Turning to our individual segments, Home Health care continues to deliver strong performance.

[David Bacon, EVP and CFO at Extendicare]

The Q1 results were impacted by out-of-period revenue of CAD 1.7 million and related costs of CAD 900,000 for a net impact of CAD 800,000. Last year's Q1 results were impacted by out-of-period revenue and offsetting costs of CAD 11 million, as well as workers' compensation rebates of CAD 3.9 million. Excluding these out-of-period impacts, our Q1 revenue increased by CAD 56.5 million or 38% year-over-year, driven by organic growth and the acquisition of Closing the Gap. Corresponding Q1 NOI improved by CAD 12 million or 78%, driven by the revenue growth, partially offset by increased wages and benefits. On the same basis, excluding the out-of-period items, our NOI margins increased 300 basis points to 13.3% in the quarter.

[David Bacon, EVP and CFO at Extendicare]

Turning to our long-term care segment, the Q1 results were impacted by out-of-period funding of CAD 7.9 million this year compared to workers' compensation rebates of CAD 2.7 million in last year's quarter. Excluding out-of-period impacts, revenue increased by CAD 37.9 million or 19%, driven by the contribution of CAD 32.5 million from the nine LTC homes acquired last June and the timing of envelope spending, partially offset by the closure of the West End Villa home in February as a result of the opening of Crossing Bridge in the joint venture.

[David Bacon, EVP and CFO at Extendicare]

On the same basis, NOI increased by CAD 5.8 million or 31%, driven by the increases in revenue and the contribution of approximately CAD 3.5 million in NOI from the nine LTC homes acquired, partially offset by a higher operating costs and the closure of the redeveloped C Class home. Corresponding NOI margins increased 90 basis points over the prior year period to 10.3% in the quarter. Turning to our managed services segment, the anticipated decline in revenue in NOI this quarter reflects the termination of the management contracts resulting from Revera's sale of 30 LTC homes last year, nine of which we acquired are now included in our LTC segment. Our managed services revenue decreased CAD 2.4 million to CAD 16.2 million, and NOI declined CAD 1.1 million to CAD 8.9 million.

[David Bacon, EVP and CFO at Extendicare]

Despite the reduction in the number of managed homes, earnings benefited from 6% organic growth in SGP clients and our increased management fees from the newly opened home in the joint venture. Turning to Slide 11. On April 1st, we closed the CBI acquisition utilizing the committed upsize senior credit facility as well as cash on hand, which included the CAD 191.5 million in net proceeds from our December 2012 equity issuance. The addition of CBI meaningfully increases Extendicare's scale and diversifies our earnings base, helping to broaden our access to the capital markets. On April 14th, we successfully completed an inaugural investment-grade credit offering, issuing CAD 450 million senior unsecured notes priced at 4.345% on a five-year term maturing April 2031.

[David Bacon, EVP and CFO at Extendicare]

Both the company and the notes received a BBB rating, stable rating from Morningstar DBRS. We used approximately CAD 427.7 million of the net proceeds to fully repay the delayed draw term loan and to repay a portion of the revolving credit facility that we had drawn to fund the CBI acquisition on April 1st. In conjunction with the notes offering and the repayment of the delayed draw term loan, we amended our senior secured credit facilities to establish an unsecured credit facility structure that ranks pari passu with the notes. The new CAD 250 million unsecured revolving facility provides us with lower credit spreads than our former senior secured credit facility and extends the maturity for a new three-year term to April 2029. Turning to Slide 12 for a look at our credit metrics and liquidity position.

[David Bacon, EVP and CFO at Extendicare]

We continue to maintain a prudent capital structure following the closing of the CBI acquisition and our new unsecured credit structure. We have improved our maturity profile with the maturity of our new revolving facility extended to April 2029 and the five-year notes maturing in April 2031. We do intend to consider early prepayments of certain of our senior secured mortgages, including those that mature in 2027, to further improve our maturity profile outlook and improve our weighted cost of debt. Our pro forma liquidity position as of March is approximately CAD 211 million, comprised of approximately CAD 67 million in cash on hand and CAD 161 million available on our unsecured revolving credit facility. This reflects the CBI acquisition and the notes offering and related to credit facility changes that I had outlined on the prior slide.

[David Bacon, EVP and CFO at Extendicare]

Our pro forma debt to adjusted EBITDA as of March 31st, 2026 is approximately 2.8x, reflecting the incremental debt we have taken on in 2025 and 2026 to fund our acquisitions, as well as the full-year impact to EBITDA of our 2025 acquisitions and the pro forma adjusted EBITDA of CAD 61.9 million from CBI. We are comfortable with this leverage at this level and have the opportunity to further delever, given our strong free cash flow profile and our capital-efficient redevelopment model, or to add leverage in support of accretive acquisitions as necessary. We are pleased with the strength of our capital structure and are well positioned to continue to pursue our growth agenda.

[David Bacon, EVP and CFO at Extendicare]

We will remain disciplined in our approach to allocating capital, balancing our objectives to drive growth and create shareholder value, but also managing leverage commensurate with our new triple B stable rating. With that, I'll pass it back to Mike for his closing remarks.

[Michael Guerriere, President and CEO at Extendicare]

Thank you, David. The closing of the CBI transaction, together with the recent transformation of our capital structure, creates meaningful new opportunities for Extendicare as we work to expand access to care for the growing number of Canadians who depend on us. Our Q1 results represent a strong start to 2026, with our strategy delivering across all business segments. For the remainder of the year, we will be intently focused on completing the integration of Closing the Gap and advancing the integration of CBI, while continuing to deliver high-quality care to those we serve. The demographic realities of the aging population are driving sustained demand for our services, and the scale and efficiency of our operations position us well to meet it.

[Michael Guerriere, President and CEO at Extendicare]

In a healthcare sector facing real challenges, we are confident that our scale and mix of services will help relieve pressure on hospital capacity by delivering care in the most appropriate and cost-effective settings. We will continue to build capacity to ensure that everyone in Canada receives the care they need to live their best lives. My sincere thanks to our growing team, including our new colleagues from CBI, for their commitment to advancing this important mission. With that, we welcome any questions that you might have.

[Operator]

We will now begin the question-and-answer session. To join the question queue, you may press star then one on your telephone keypad. You will hear a tone acknowledging your request. If you're using a speaker phone please pick up your handset before pressing any keys. To withdraw your question please press star then two.

[Operator]

The first question comes from Kyle McPhee with ATB Cormark. Please go ahead.

[Kyle McPhee, Analyst at ATB Cormark]

Hello, everyone. Great update. First one from me on your Home Health care business. You didn't report the organic change in hours of service this quarter, I think backing out what I think came with Closing the Gap, it looks like organic growth for hours of service was up by just over 20% year-over-year. Even more momentum than we've seen in recent quarters. I think we all know the seniors demand seeing Home Health care taking share from LTC. Last quarter, you highlighted the acute care bed theme. Anything else worth highlighting here that benefited Q1, you know, whether it's temporary or durable?

[Michael Guerriere, President and CEO at Extendicare]

Well, Kyle, we've consistently been predicting that the volume growth would be driven by two major factors. One being the underlying demographic growth trend in the population that we serve primarily, which is around 4% a year, and then the failure of long-term care to keep up with that demographic trend. Home care is expanding to fill that gap. You know, we've often thought that mid to high single digits is the kind of the long run organic growth trajectory that we would expect. It's been higher than that, I think partly because we're still filling the gap that emerged over the pandemic and backing up into acute care hospitals. We're seeing that start to be relieved in different provinces.

[Michael Guerriere, President and CEO at Extendicare]

We do think the organic growth is going to slow down. We just can't predict when. We seem to predict that every quarter and it just hasn't happened yet. We do expect that that's going to happen soon. You know, as far as the Closing the Gap numbers. As Closing the Gap becomes more and more integrated with the rest of our operation, our ability to really discern which volumes or which to be able to segment that out has passed. You know, we're just going to continue to report it on a combined basis from here forward.

[Kyle McPhee, Analyst at ATB Cormark]

Got it. Okay. Then just shifting to another topic. You have a very resilient business model given the nature of demand, and you're shielded from things like energy costs, which is not a big cost bucket for you. That's what I wanted to check in on. I think one cost bucket for your Home Healthcare platform is presumably vehicle fuel, your caregiver driving around to patients' homes. Can you offer any color on whether or not the inflationary fuel environment will eat into any of your Home Healthcare margins? I'm not sure if it would be Extendicare eating the fuel cost hit or the caregivers or the payers, or if it's even a big enough cost bucket to matter.

[Michael Guerriere, President and CEO at Extendicare]

Well, the most important cost driver for us is labor costs. It's approximately 85% of our cost structure. Any fuel cost impact is going to be small. We do reimburse our staff for travel costs, so it may have, you know, some impact on our cost going forward, but I don't think it would be material enough to call it out.

[Kyle McPhee, Analyst at ATB Cormark]

Okay. Appreciate the color. I'll pass the line. Thanks.

[Operator]

The next question comes from Jonathan Kelcher with TD Cowen. Please go ahead.

[Jonathan Kelcher, Analyst at TD Cowen]

Thanks. just a quick follow-up on that last one. When you reimburse for travel costs, is that kinda like a dollar or a dollar amount per kilometer or how does that work?

[Michael Guerriere, President and CEO at Extendicare]

Yes, that's how we structure it.

[Jonathan Kelcher, Analyst at TD Cowen]

Okay. Just sticking with the Home Healthcare. Like, do you have a sense of how big the gap is between what you're trying to fill and the, and the demand?

[Michael Guerriere, President and CEO at Extendicare]

It's Jonathan, it's really hard to see that, to know how much home care is required to offset the pressure on hospitals. It's difficult for a couple of reasons. One is some of the pent-up demand is hidden in the form of waiting lists that we don't have visibility to. The second is that it's difficult to know how many hours of care those people would require to be able to remain safely independent in their own homes. That combination of things makes it very difficult.

[Michael Guerriere, President and CEO at Extendicare]

I'll candidly say that we expected the volume growth to moderate long before now. It has been a surprise to us, to, you know, to the degree to which it has, you know, continued to increase, and we just don't know when it will slow down, but we're quite certain it will at some point.

[Jonathan Kelcher, Analyst at TD Cowen]

Okay. That's helpful. What's, I guess in meeting that, you're adding labor. Like, what's the capacity constraint on labor? Are you running into issues, or is it still going very well?

[Michael Guerriere, President and CEO at Extendicare]

It's different for different groups. You know, the majority of home care employees are PSWs and, you know, in recent years we've had very good luck with adding to our PSW team. Partly because we've partnered with colleges, and we have a large number of students who are doing part of their training in our operations, which gives us a leg up when it comes to recruiting. We have been able to recruit everything we need on that front. Where we've had more difficulty is in the allied health side of Home care, physiotherapists, occupational therapists. They're in very, very short supply. That, you know, that has been a significant challenge and we're continuing to struggle with that.

[Michael Guerriere, President and CEO at Extendicare]

Because it's a small, very small part of our volumes overall, it really isn't affecting our overall performance.

[Jonathan Kelcher, Analyst at TD Cowen]

Okay. That's, that's helpful. That's it for me. I'll turn it back. Thanks.

[Operator]

The next question comes from Tom Callaghan with BMO. Please go ahead.

[Tom Callaghan, Analyst at BMO]

Thanks. Morning, guys. Maybe just following up on Jonathan's question there on labor. Like, I guess, you know, you've been very open about the fact that you do expect a slowdown or a return to more seasonality. I'm just curious on the PSW side. Like, if we continue to grow here kind of sequentially 4%, 5%, 6% a quarter, you know, is that something you can kind of support into 2027 with the current labor? Or just kinda how are you thinking about that if we are or remain in a situation where that volume growth, you know, kinda continues to come through like it has?

[Michael Guerriere, President and CEO at Extendicare]

Yeah. We believe that we'll have access to enough new recruits to be able to do that. We're also very focused on retention, and we've had very good luck over the last two or three years reducing turnover in our staff. We've also invested quite heavily in our own training capability to be able to support onboarding and therefore have a flexibility in our ability to increase the workforce in tandem with any demand for services that we're seeing from hospitals and from doctors' offices. You can see that in how quickly our organic, you know, volume growth has increased.

[Michael Guerriere, President and CEO at Extendicare]

We've been more planning on the, you know, sort of mid to high single digit growth front, but we're able to flex our recruiting to meet demand as it comes in. We expect that that will continue to be the case as we go forward. As I said to Jonathan, I mean, that the exceptions are allied health, like physiotherapy and also in some of the more remote and rural regions of the country that we serve, it can be a challenge to get staff. Those challenges really aren't reflected in our results.

[Tom Callaghan, Analyst at BMO]

Got it. Thanks, Michael. Maybe follow-up for me is just on capital allocation post CBI there. You know, in prepared marks, I think you mentioned both you're comfortable with current leverage on a pro forma basis, but also kinda gonna focus on integration here. Just, you know, how are we thinking about capital allocation over the balance of the year and into 2027?

[David Bacon, EVP and CFO at Extendicare]

Yeah. I think our focus, you know, as Mike said, will be on the integration. I think from a capital perspective, you know, there's a natural delevering I think that we'll focus on over the next few quarters as we do integrate the business and pay down the revolver. So you'll see the 2.8x, you know, come down a bit. So that'll be kind of first priority as to where we put our capital to give us, you know, more dry powder and liquidity. I think what we've said is, you know, as we get back into 2027, we do still think there's opportunities on the acquisition front.

[David Bacon, EVP and CFO at Extendicare]

We'll, you know, we're hopeful that, when we're ready to turn that back on, that there's, you know, we still think there's good fragmentation out there and good opportunities for accretive acquisition. We'll turn our, you know, redirect the capital back to that. For the next few quarters, it'll be integration and delevering will be the focus.

[Tom Callaghan, Analyst at BMO]

Okay. Great. Thanks. I'll pass it back. Appreciate the call.

[Operator]

The next question comes from Tal Woolley with CIBC. Please go ahead.

[Tal Woolley, Analyst at CIBC]

Hey, good afternoon. These, you know, the CBI pro forma numbers, you know, we were given when you started the deal process. You know, they're almost a year stale now. Is it fair to say that that CAD 62 million in NOI is likely not the current run rate? Can you give us any sort of estimate of where that might be tracking right now?

[David Bacon, EVP and CFO at Extendicare]

Tal. You know, good question. They are a bit dated. I think it'd be fair to say that, you know, over half the business in CBI is in Ontario and Ontario Health at Home contracts. I don't think it's a big leap to suggest that that business has performed similarly to what we've seen with ourselves and CTG. The Western business that we pick up has a slightly different mix to it. The SCS business within CBI, as we've said prior, wouldn't be growing at that same pace, but still growth. The business is definitely performing better.

[David Bacon, EVP and CFO at Extendicare]

I think our, you know, our preference is to wait and you'll see a full quarter in Q2, given we closed April 1st, and we can talk more about that improvement. I think directionally, you know, it's not unreasonable to conclude that the business is probably doing better than the CAD 62 million we bought at.

[Tal Woolley, Analyst at CIBC]

For sure. Then Michael, you know, the Ontario came in and, you know, extended the funding for the old Class C ward beds for another several years on a sliding scale. I'm just wondering, it kind of reminds me a bit of the Class C license extensions that it was all supposed to fall off a cliff in 2025, now they've subsequently been extended. What's your perspective on what those beds could be used for? Is the industry thinking about how to repurpose some of these assets to maybe make them more useful? Whether it's to help with hospital overload or long-term care overload.

[Tal Woolley, Analyst at CIBC]

Appreciating that they're probably not in the shape to do everything they were originally designed to do.

[Michael Guerriere, President and CEO at Extendicare]

Tal, David runs this portfolio for us, so I'm just gonna ask him to comment on this. He's closer to it.

[Tal Woolley, Analyst at CIBC]

Okay.

[David Bacon, EVP and CFO at Extendicare]

Yeah. Yeah. Just, I mean, in terms of the C beds, a couple of points. Yes, they've extended that funding out for a few years. Obviously that's a positive for us. You know, we don't have a lot of third and fourth ward beds today, just over 200 in total. Almost half of those are going to be put back in service with the homes that we already have under construction. From a financial point of view, for us, it's helpful that it's been extended. We also don't have a lot there. From a repurposing point of view, you know, it's a good question.

[David Bacon, EVP and CFO at Extendicare]

I think that what we've seen in our, in our redevelopment to date is that people are buying our old C bed homes and repurposing them for other social purposes. Not long-term care, you know, affordable housing, multi-family housing. To date, every C bed home we've sold is still there and being repurposed to use for housing. I think that's something that we're seeing, and I think other operators that are redeveloping are seeing the same thing, is that people are finding new uses for them. You know, I think that, you know, there has been some conversations in the sector with the ministry and the OLTCA about, you know, are there other ways we could extend using these homes for periods of time to help with transition?

[David Bacon, EVP and CFO at Extendicare]

You know, in the GTA, for example, people are gonna need to, it's hard to find land. If you can rebuild potentially on the existing land you own, but you may need to decant the old home for a while in order to build the new one. There has been some discussions, but I think it's fair to say that in the end, there's a reason there's an Ontario Long-Term Care Home Capital Development Program, which is we think all these homes as they serve. You know, all these homes should be redeveloped, and they should be taken out of service, as, you know, as long-term care homes. That's what we're committed to do.

[David Bacon, EVP and CFO at Extendicare]

We have seen repurposing of the facilities in a number of cases for other social purposes, which is not what we expected when we first set out, but it seems to be happening, more commonly.

[Tal Woolley, Analyst at CIBC]

Okay. The Sudbury asset sale, do you have a rough estimate of the NOI contribution from that building?

[David Bacon, EVP and CFO at Extendicare]

For the Sudbury 2, the new one?

[Tal Woolley, Analyst at CIBC]

No, no, for the, for the sale. Like.

[David Bacon, EVP and CFO at Extendicare]

I see.

[Tom Callaghan, Analyst at BMO]

The building's generating, roughly how much NOI right now?

[David Bacon, EVP and CFO at Extendicare]

Oh, for Extendicare York? Yeah, that again, we don't ever talk about NOI on a per home basis, but I think again, I'd encourage you to go back to, you know, kind of just average NOI per bed. If you look at our beds, You know, NOI for LTC divided by sort of our total beds will give you a bit of a proxy given the, given the size of that home.

[Tal Woolley, Analyst at CIBC]

Okay.

[David Bacon, EVP and CFO at Extendicare]

I think the current home is about 278 beds. You know, on average, if you just do the math, it's about CAD 10,000 to CAD 11,000 to CAD 12,000 a bed. That'd give you a bit of a proxy, so.

[Tal Woolley, Analyst at CIBC]

Okay. Just lastly, you guys have been hanging on to a lot of cash here as you've been waiting for the CBI deal to close. you know, Extendicare has kinda historically held a lot of cash, I would say over the course of its history. Just kinda wondering, like, you know, with the business mix changing, what's the right level you think going forward?

[David Bacon, EVP and CFO at Extendicare]

Yeah, no, it's a great question. I think there's been a huge shift this quarter with, you know, part of our plan to move, you know, with CBI in particular. A couple of years ago, we moved into a secured credit facility. You know, now we've moved into the unsecured with a CAD 250 million revolver. You know, I do think you'll see us running sort of more modest cash balances and, you know, using the revolver for, you know, again, 2027 and beyond smaller tuck-in type acquisitions. I don't think you'll see us, you know, carrying as much cash as we historically had. Obviously quite purposeful with sort of how high our cash balances got late last year with the equity offering for CBI.

[David Bacon, EVP and CFO at Extendicare]

You know, in the deck, it shows pro forma after you've washed through all the subsequent events with buying CBI and the debt, the bond deal. We have about CAD 67 million of cash and about CAD 160 million left on the revolver. You know, sort of a more modest cash position than certainly what we've been running at for the last little while.

[Tal Woolley, Analyst at CIBC]

Okay, that's great. Thanks very much, gentlemen.

[David Bacon, EVP and CFO at Extendicare]

Yeah.

[Operator]

The next question comes from Lorne Kalmar with Desjardins. Please go ahead.

[Lorne Kalmar, Analyst at Desjardins]

Thanks. Good afternoon, congrats on a great result this quarter. On the Home Health care margins, I'm sorry if I missed this. You know, if you guys are cutting at these ADV growth levels that are above expectations, is it fair to assume that so long as that continues, you can actually achieve margins in excess of the 13% sort of long-term average target that you provided previously?

[David Bacon, EVP and CFO at Extendicare]

Yeah, I think a couple of things, just to put into context there. Just, you know, this quarter we were 13.3% when you normalize it. If you go back the last few quarters, normalized, we are running just over 13. For the full year last year, we did 12.8%. I think we've said in past calls that we do believe this will be, you know, 50-100 basis point improvement over time in that business as we continue to grow, integrate the acquisitions, invest more in sort of efficiency gains through technology. I think, you know, I think that, you know, we're still into a 13% margin business.

[David Bacon, EVP and CFO at Extendicare]

The one thing I and I think we talked about this at Q4, with this double-digit growth we've been experiencing now for what we've, you know, is an extended period of time, you know, we've been able to grow a lot with the back office we have. The back office is a bit of a step function. If we, you know, with the sustained levels of growth organically, if that stretches in, we will need to put some additional investments into the back office to support just that higher volume. I think the, you know, I think the end result is still the same. This will be a higher, you know, this can be a modestly higher business.

[David Bacon, EVP and CFO at Extendicare]

I think that given the sustained growth in volumes, I think that 50-100 basis points might be stretched out or a little further out because I do think we need to, we're gonna need to put some investment back into just the supporting functions and back office that are, you know, been doing a lot to support the growth, but it's now run for pretty hot for a while and needs some more investment. We're not changing what we've said. I think it's just the timing. I think, you know, we're now running at that just above 13, probably moderates here for a little bit before, you know, before we'd see some of those increases we've talked about in the past kicking in.

[Lorne Kalmar, Analyst at Desjardins]

Do you expect if I recall correctly, I know I'm still kinda new to the story here, but, there typically is a little bit of seasonality in Home Health. Is the idea that, you know, with the environment being what it is, that seasonality kinda goes away until things start to normalize?

[David Bacon, EVP and CFO at Extendicare]

I mean, the underlying things that happen that gave us those seasonal patterns in the past still happen. They've just been masked with 5%-6% sequential growth quarter-over-quarter. There's still the holiday, still fall. There's still snow storms in December and January. We still, you know, we still have, you know, certainly in home care, we still give every, you know, all of our non-unionized people get their raises on January 1st, and we don't get rate increases till later in the year. All those things still happen. I think they've just been masked.

[Michael Guerriere, President and CEO at Extendicare]

You know, the quarter-over-quarter patterns are important, but we really try and focus when we think about the business, think about outlook and planning. We really try to look at, you know, a TTM kind of four kind of rolling basis to just knock all that out. But it has been masked for the last couple of years, just given the sequential pace of growth.

[Lorne Kalmar, Analyst at Desjardins]

Okay. appreciate that. Maybe just switching over to the LTC redevelopments, you called out you got basically the entire pipeline, with the exception of Sudbury, expect to be finished in call it the next 12 or so months. How are you thinking about new project initiations? What can we sort of expect on that front over the balance of the year?

[Michael Guerriere, President and CEO at Extendicare]

Yeah, I think for this year, you know, we've got two scheduled to open, which are on track. We hope to bring at least 1 more project in by the end of the year. We're very active on the 17. I think that, you know, 1 by the end of the year is probably quite, you can expect that. There's a few that are quite close behind, but may probably don't make the cutoff for 2026. I think you'll have to see a more robust number of new starts next year. We're pretty confident that we'll get another one going in the fall.

[Lorne Kalmar, Analyst at Desjardins]

Okay. Maybe just last one on Sudbury. Can you give us maybe a rough idea of what the development costs that you've had to incur so far for that project are?

[David Bacon, EVP and CFO at Extendicare]

Yeah. The best proxy I can give you, if you look at the financial statements, we have in the, in our property plant equipment note, you're gonna have a construction in progress category that's in there. That's probably the best the best place to look to date. It's not, it's not purely just this project, 'cause we also have some larger scale kinda leasehold improvement, capital improvement projects that go on through our maintenance CapEx. You know, you're looking in the sort of CAD 20 million-CAD 25 million range. You'll see about CAD 30 million in our construction in progress, but that's not all Sudbury.

[Lorne Kalmar, Analyst at Desjardins]

Okay. Thank you so much. I will turn it back.

[Michael Guerriere, President and CEO at Extendicare]

Yep.

[Operator]

Once again, if you have a question, please press star then one. The next question comes from Giuliano Thornhill with National Bank. Please go ahead.

[Giuliano Thornhill, Analyst at National Bank]

Hey, guys. Good afternoon, everyone. I'm just wondering on the volume and kind of the strong volume, like the risks there. Would you say the reduction in ALC volumes or funding or possibly labor, out of the three, which do you think is the biggest risk to a sequential step down, whenever that does happen?

[Michael Guerriere, President and CEO at Extendicare]

Well, it could really come from one of two things. It could come from the benefit of additional services tailing off in terms of not seeing as much reduction in demand for service in the hospital sector. I think that one is important, like just what, you know, how much benefit are we getting from the additional home care expenditures. The other is gonna be a fiscal consideration. This has been growing quite a bit faster than government expected. They are seeing the benefit because this is the lowest cost way of managing the aging demographic. Nonetheless, it is still, you know, accelerating costs and governments have fiscal challenges.

[Michael Guerriere, President and CEO at Extendicare]

I think it'll be one of those two things that will moderate the growth pace at this point. I think governments are very encouraged by what they're seeing, and that's why they keep putting one investment on top of another. You saw CAD 1.1 billion in the fall economic statement in Ontario. You saw another CAD 1.1 billion in the spring budget. You know, they're seeing the benefit and making, you know, further investment. I think it's just a question of, you know, at what point does the benefit that they're seeing in the hospitals and kind of the policy agenda intersect to slow things down again. It's very tough to tell what's going to drive that.

[Michael Guerriere, President and CEO at Extendicare]

The reduction in ALC patients in Ontario was absolutely unprecedented over the last year. I've never seen that before. It took the ALC numbers down to levels that haven't been seen since long before the pandemic. I think this is a, you know, very large-scale social experiment to see how far we can improve things. It is nice that all the poll results show that people vastly prefer to get care in their own homes than to go into institutions of any sort. We are aligned with both the kind of fiscal imperatives, but also the preferences of the voting public. I think both of those things are reasons for optimism.

[Giuliano Thornhill, Analyst at National Bank]

Just on that, do you have any visibility into like the number of ALC patients, or could you give us like sense of what that year-over-year reduction has been? Is that still that 17% that you mentioned last quarter?

[Michael Guerriere, President and CEO at Extendicare]

I think it was 14%.

[Giuliano Thornhill, Analyst at National Bank]

14%, yeah.

[Michael Guerriere, President and CEO at Extendicare]

That's the last number that I've heard from government sources.

[Giuliano Thornhill, Analyst at National Bank]

Okay, thanks. I'm just wondering kinda what does this all the strain on the hospitals and capacity constraints, like how does that translate to policy risks for your LTC side? Do you think you're going to see more solid support for the operational aspect of the business because it is part of the system going forward?

[Michael Guerriere, President and CEO at Extendicare]

Yeah. Well, we have seen that. I mean, the degree to which the government has elevated staffing levels since the pandemic has been remarkable and has been the case across multiple provinces. 20%-30% increase in staffing overall for the long-term care sector. Recently, the Alberta government, the premier in Alberta announced a 15,000 bed, 10-year agenda for that province. We're seeing capital expenditures for long-term care spinning up in Alberta. I think the government is very clear-minded that long-term care is far less expensive than acute care beds, and that home care is far less expensive than long-term care. I expect the investments to continue.

[Michael Guerriere, President and CEO at Extendicare]

I mean, that's why we ended on in our investor deck this quarter with the demographic chart. I mean, that doubling and then tripling of the demographic that we care for is something that the healthcare system has to grapple with. The only way they can do that is to keep up with the curve and keep expanding the capacity in this sector. Otherwise, we know what happens. The acute care hospital system just gets completely blocked by people who should be better cared for elsewhere.

[Giuliano Thornhill, Analyst at National Bank]

Just with the kinda state of all of that, which you just stated, I'm just wondering, does that really eliminate any obsolescence risk of your Class C portfolio? just 'cause I know some of them are a little more rurally located and smaller markets and maybe smaller buildings. I'm just wondering if like the issues in the hospitals really remove that overhanging risk that could be there.

[Michael Guerriere, President and CEO at Extendicare]

Sorry, you were saying obsolescence risk?

[Giuliano Thornhill, Analyst at National Bank]

Yes.

[Michael Guerriere, President and CEO at Extendicare]

Do you mean that they won't be redeveloped?

[Giuliano Thornhill, Analyst at National Bank]

Yes.

[Michael Guerriere, President and CEO at Extendicare]

Yeah, no, First of all, I think that, you know, the C beds have to be maintained somehow until they're replaced. The thought that we could have them removed from the system, I just don't think there's a great risk of that. What I would say is that if any particular operator fails to redevelop their own C beds, that the government will seek another operator to step in and replace them that way. It's not necessarily obsolescence, it would be that, you know, some other operator would win new licenses to replace those C beds. I don't think that's a risk for Extendicare. In fact, I think that there's a potential opportunity for greenfield sites for us, where other operators have failed to step up.

[Michael Guerriere, President and CEO at Extendicare]

At the moment, our 17 project pipeline is all replacements for our own homes, with significant additions of beds to each of those projects to expand capacity.

[Giuliano Thornhill, Analyst at National Bank]

All right. Thanks, guys. I'll turn it back.

[Operator]

This concludes the question and answer session. I would like to turn the conference back over to Jillian Fountain for any closing remarks. Please go ahead.

[Jillian Fountain, VP of Investor Relations at Extendicare]

Thank you, operator. That concludes our call for today. This presentation is available on our website, along with a link to a replay of the call. Thank you all for joining us, and please don't hesitate to reach out if you have any questions. Goodbye.

[Operator]

This concludes today's conference call. You may disconnect your lines. Thank you for participating, and have a pleasant day.

Participants

Executives

• David Bacon, EVP and CFO
• Jillian Fountain, VP of Investor Relations
• Michael Guerriere, President and CEO

Analysts

• Giuliano Thornhill, Analyst at National Bank
• Jonathan Kelcher, Analyst at TD Cowen
• Kyle McPhee, Analyst at ATB Cormark
• Lorne Kalmar, Analyst at Desjardins
• Tal Woolley, Analyst at CIBC
• Tom Callaghan, Analyst at BMO