Dave Sedgwick
Analyst · BMO Capital Markets
Thanks, Greg, and good morning, everybody. In Q2, our skilled nursing operators reported continued occupancy recovery. Looking at the facility level data through May, 18% of our SNFs and campuses are at or above 100% of their pre-COVID occupancy, and are moving in the right direction. For the SNF portfolio overall, occupancy has grown from January 4 of about 67% to around 70% in June, for a rate of recovery of about 60 bps per month. If that rate held constant, we would be looking at approximately next April to May to return to our pre-pandemic occupancy levels of 77.7%. But we expect it to fluctuate a bit, due to a few factors like the Delta waves concerns, which we hope will be short-lived, seasonality, Q3 usually being the softest quarter for skilled nursing census for example, and a reported inability in some market to admit patients due to staff shortages, which we think may be beginning to resolve. On the skilled mix front, at quarter-end, our operators were still roughly a150 bps above the pre-pandemic skilled mix norm, which continues to help offset some of the revenue loss, while occupancy recovers. Seniors housing occupancy is a somewhat different story. Before COVID, average occupancy in our portfolio was 84.5%. We appeared to hit a low point in March of 73.5%, and that level has held steady through June. While we expect seniors housing occupancy to recover and actually exceed pre-pandemic numbers at some point, as Greg mentioned, it will not happen nearly as quickly for assisted living as it is happening for skilled. As a reminder, seniors housing only accounts for about 17% of our portfolio. Next, let me talk about our lease coverage. In yesterday's supplemental, we continued our enhanced COVID-era disclosure, wherein we tried to be as transparent and helpful as possible by reporting lease coverage on an EBITDAR and EBITDARM basis, both excluding CARES Act funding and including and amortizing the CARES Act funds received today. Since last quarter's supplemental, HHS updated the utilization and reporting guidelines for the CARES Act, so this supplemental's amortization methodology follows the updated guidance and provides a pretty reassuring picture for most, if not all, of our skilled nursing tenants. Looking at the COVID-era numbers. Overall portfolio EBITDAR coverage, excluding CARES Act funds, was essentially flat from the immediately preceding quarter, ticking down slightly from 2.12 times for the nine months ending on 12/31/2020 to 2.07 times for the 12 months ending 03/31/2021. However, both of these numbers are considerably higher than the same pre-pandemic number which was 1.92 times for the 12 months ending on 03/31/2020. The relative strength comes from several of our skilled nursing operators including Ensign, which has done an amazing job throughout. Predictably, if you've been watching our coverage disclosures, our seniors housing operators are facing strong headwinds right now. Our current assisted living operators were improving operations and coverage, leading up to the pandemic, and they all largely held their own through 2020. But January's sharp decrease in occupancy, coupled with elevated labor costs, had made a challenging operating environment that much harder. I'd like to point out on the Top 10 coverage slide, that Noble's coverage is not apples-to-apples with last quarters supplemental. We've removed two facilities from their coverage calculation as we are pursuing a sale of one, and the other has been undergoing a major remodel and has not been open for operating. Noble did not pay July rent, and has requested a short-term deferral for July, August and part of September, backed by a plan to have all deferred rent paid before the end of the year. As we sit here today, we have not agreed to the deferral request, but are having positive discussions with them about their plan and path forward. All of our assisted living tenants have been very communicative and open with us about their situations and their efforts to weather the storm. For Noble, this has made it much easier for us to work with them as they chart a positive path forward, and we have reason to believe that they will continue to improve operationally, barring any major fallout from the current Delta wave. Shifting from our portfolio to the broader picture, we have a positive update regarding the remaining provider relief funds. First, we enjoyed a defensive win when Congress agreed not to tap into the unobligated provider relief funds to help pay for its current infrastructure bill. Second, it had previously been reported that roughly $24 billion remained in the provider relief funds. On July 19th, the Government Accountability Office reported a much higher amount of unobligated funds of $43.7 billion. In addition, there remains another $8 billion in relief funds earmarked for rural providers, bringing the total unallocated and undistributed funds to about $52 billion. As far as timing goes, we don't know. But we do understand that a program is at the White House for final approval which would assist providers based on lost income and increased expenses during the second half of 2020 and the first quarter of 2021. Given D.C.s current attention to the infrastructure bill, our understanding is, that movement toward final approval and execution will wait until the current infrastructure bill is done. Another positive development is that CMS has agreed to not change the PDPM formula until at least October 2022. This is certainly welcome news for a sector that is still very much battling the effects of the pandemic. Finally, the Delta variant war, as I mentioned, we'll leave the predictions to the scientists and statisticians, but we can say both, based on the report this week from the American Health Care Association and the anecdotal reports from our tenants, that infection rates among nursing facility residents and staff are not climbing at anywhere near the rate being experienced in the general population, and so far nursing homes remain some of the safest places to be in America. With high vaccination rates, accurate rapid testing on site, which we did not have this time last year, and full infection protocols in place, we are hopeful that the Delta wave will be nothing like the original outbreaks in 2020. With that, I'll pass the call over to Mark to talk about investments. Mark?