Advocat Announces 2011 Second Quarter and Six Months Results

August 9, 2011 at 12:00 AM EDT

BRENTWOOD, Tenn., Aug. 9, 2011 (GLOBE NEWSWIRE) -- Advocat Inc. (Nasdaq:AVCA) a premier provider of long term care services primarily in the Southeast and Southwest, today announced its results for the second quarter ended June 30, 2011. On August 9, 2011, the Company declared a third quarter dividend of 5.5 cents per common share. The dividend will be paid October 14, 2011 to shareholders of record on September 30, 2011.

For the second quarter of 2011 compared to the second quarter of 2010, key highlights include the following:

  • Revenue increased 10.7%, to $79.2 million, compared to $71.5 million.
  • Skilled census, representing total Medicare and managed care patients, increased 10.7% to an average of 685 patients per day, a record high for the Company. Skilled census was 16.5% of total census in the second quarter of 2011 compared to 14.8% in 2010.
  • Medicare revenues increased 29% compared to the second quarter of 2010, as a result of increased patient census, changes in patient acuity levels, and the effects of the skilled nursing rate adjustments in October 2010.
  • The Company is incurring expenses that are expected to benefit future periods. Results for the second quarter of 2011 included investments totaling approximately $1.7 million for expenses related to our strategic growth initiatives. While the Company is already experiencing an increase in skilled mix and operating results, we expect results from these investments will fully develop in future periods.
  • Net income from continuing operations was $2.9 million compared to $987,000, or $0.48 per diluted common share compared to $0.15 per diluted common share in 2010.   
  • Funds provided by operations were $6.4 million versus $3.1 million or $1.08 compared to $0.53 per diluted common share in 2010.

Funds provided by operations is a non-GAAP performance measurement. A reconciliation of funds provided by operations to net income is included in the financial tables accompanying this press release.

CEO Remarks

William R. Council, President and Chief Executive Officer, remarked, "Our operating results for 2011 are off to a strong start with growth in skilled mix average daily census of over 10%. The sharp increase in this metric indicates that the strategic investments to improve skilled mix and occupancy are providing the benefits that we expect. Our investment in technology, personnel and training is not only improving our performance but also building the foundation to support higher census and skilled mix in future periods.  Despite the upfront investment these initiatives required this period, we saw a strong second quarter, with funds provided by operations of $6.4 million or $1.08 per diluted common share."

Commenting on the recently announced Medicare rate cut, Mr. Council continued, "We are very disappointed in the recent CMS decision to reduce Medicare rates by 11.1%.  Our profession proposed a reasonable alternative that would have provided for a stabilized adjustment period. We are reviewing our operations to determine how we might potentially mitigate the negative impact of the CMS rate reductions. We will continue to analyze the rate changes and make appropriate operational changes."

Other Highlights for the Quarter Ended 2011

The following table summarizes key revenue and census statistics for the quarter: 

  Quarter Ended
  June 30,
   2011 2010
Total occupancy 77.3% 78.2%
As a percent of total census:    
Medicare census 14.6% 13.5%
Managed care census 1.9% 1.3%
As a percent of total revenues:    
Medicare revenues 35.9% 30.8%
Medicaid revenues 47.7% 53.6%
Managed care revenues 3.9% 2.7%
Average rate per day:    
Medicare $464.71 $389.13
Medicaid $150.66 $145.32
Managed care $403.50 $389.14

Patient Revenues

Medicare revenues increased $6.4 million in the second quarter of 2011 compared to the same period in 2010, as a result of serving a greater number of Medicare patients, changes in patient acuity levels, and rate adjustments implemented by CMS in October 2010. The increase in the total Medicare census and the acuity of our patient mix is primarily attributable to the investments we have made to improve our skilled care offerings. These investments and the costs of caring for these patients resulted in cost increases as discussed below. 

Medicaid average daily census was 4.4% lower in 2011, decreasing revenue by $1.7 million in the second quarter of 2011. The average Medicaid rate per patient day for 2011 increased 3.7% compared to 2010 resulting in a revenue increase of $1.3 million in 2011. This increase is the result of rate increases in certain states, partially funded by increased provider taxes, and increasing patient acuity levels. The decrease in Medicaid census reflects our focus on improving our skilled mix.

Managed care rates and census contributed approximately $1.0 million of the total revenue increase.   The average managed care rate per patient day for 2011 increased 3.7% compared to 2010 and managed care average daily census increased 44.4%.


Expenses for 2011 include approximately $1.7 million for investment spending in operating initiatives to improve skilled mix and occupancy. The $1.7 million consists of approximately $0.7 million in nursing center staffing costs to improve our ability to market to and care for high acuity patients, $0.4 million for costs of additional wages that resulted from the transition to the new MDS 3.0 patient assessment tool, and additional administrative costs of $0.6 million for oversight and execution of these initiatives. In addition, we increased therapy staffing costs by $1.2 million to support the current skilled census and provide the support for additional increases in skilled census over the long term. While the Company is already experiencing an increase in skilled mix and operating results, there is typically a time delay between incurring such expenses and fully attaining the revenues and cash flows expected from these initiatives and developments. 

Operating expense increased to $59.7 million in 2011 from $56.4 million in 2010, an increase of $3.3 million, or 5.9%. The increase in operating expense is primarily attributable to cost increases associated with our increased revenue as well as investment in operating initiatives focused on improving our skilled mix and occupancy. Operating expense decreased to 75.5% of revenue in 2011, compared to 78.9% of revenue in 2010.    

The largest component of operating expense is wages, which increased to $37.4 million in 2011 from $34.5 million in 2010, an increase of $2.9 million, or 8.6%. The increase in wages was primarily due to labor costs associated with the 10.7% increase in Medicare and managed care patients, competitive labor markets in most of the areas in which we operate and regular merit and inflationary raises for personnel (increase of approximately 3.1% for the quarter). As discussed above, we also increased facility staffing as part of our initiatives to further improve occupancy and skilled mix. 

General and administrative expenses were approximately $6.1 million in 2011, compared to $5.1 million in 2010, an increase of $1.0 million, or 21.0%. Costs of our strategic initiatives accounted for approximately $0.6 million, including compensation costs related to new positions of approximately $0.4 million, costs related to the implementation of electronic medical records of approximately $0.1 million, and travel expenses of $0.1 million. Performance-based incentive expense was $0.2 million higher in 2011.   

Highlights for the Six Months Ended June 30, 2011:

  • Revenue for the period increased to $156.3 million from $141.6 million or approximately 10.3%.
  • Net income from continuing operations rose to $3.4 million from $1.7 million or approximately 100%.
  • Net income from continuing operations per diluted share increased to $0.54 from $0.26 or approximately 108%.
  • Funds provided by operations increased to $9.6 million from $6.4 million, an increase of approximately 50%.

Facility Renovations 

As of June 30, 2011, the Company has completed renovations at fifteen facilities. The Company is developing plans for additional renovation projects. A total of $22.4 million has been spent on the renovation program to date, with $15.2 million financed through Omega, $6.1 million financed with internally generated cash, and $1.1 million financed with long-term debt. A table is included with this press release summarizing operating results at renovated nursing centers.

As part of the Company's plans to develop additional renovation projects, the Company entered into an amendment to the Master lease with Omega in April 2011 under which Omega agreed to provide an additional $5.0 million to fund renovations to four nursing centers located in Arkansas, Kentucky, Ohio and Texas that are leased from Omega. The Company has four projects under way at this time, with completion dates late this year or early next year.  

Electronic Medical Records

During the second half of 2010, the Company developed a plan to introduce EMR to all its facilities. The Company expects to complete its EMR implementation plan during the remainder of 2011. It is anticipated that our investment in EMR will provide operational improvements through automation of record keeping and improvement in clinical records quality. During the six months ended June 30, 2011, we capitalized $0.6 million related to the EMR initiative and expensed $0.5 million in training costs. The Company expects to have total expenses during 2010 and 2011 related to implementing its electronic medical record system of between $1.8 million and $2.0 million and total capital expenditures during this period of approximately $3.6 million.

Conference Call Information

A conference call has been scheduled for Wednesday, August 10, 2011 at 9:00 A.M. Central time (10:00 A.M. Eastern time) to discuss second quarter 2011 results. 

The conference call information is as follows:

Date:   Wednesday, August 10, 2011
Time:   9:00 A.M. Central, 10:00 A.M. Eastern
Webcast Links:
Dial in numbers:   (877) 674-2413 (domestic) or (708) 290-1366 (International)
    The Operator will connect you to Advocat Inc.'s Conference Call

The call will consist of remarks from management as well as a question and answer session. In addition to the questions posed during the live call, management will also be addressing questions submitted by email. If you would like to submit a question please email it to before the start of the call.

A replay of the conference call will be accessible two hours after its completion through August 17, 2011 by dialing 955-859-2056(domestic) or 404-537-3406(International)and entering passcode 83718509. 


The "forward-looking statements" contained in this release are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are predictive in nature and are frequently identified by the use of terms such as "may," "will," "should," "expect," "believe," "estimate," "intend," and similar words indicating possible future expectations, events or actions. These forward-looking statements reflect our current views with respect to future events and present our estimates and assumptions only as of the date of this release. Actual results could differ materially from those contemplated by the forward-looking statements made in this release. In addition to any assumptions and other factors referred to specifically in connection with such statements, other factors, many of which are beyond our ability to control or predict, could cause our actual results to differ materially from the results expressed or implied in any forward-looking statements, including but not limited to, our ability to successfully construct and operate the new nursing center in West Virginia, our ability to increase census at our renovated facilities, changes in governmental reimbursement, including the impact of a recently announced final rule that is expected to result in a 11.1% reduction in Medicare reimbursement as of October 2011, government regulation, the impact of federal health care reform or any future health care reform, any increases in the cost of borrowing under our credit agreements, our ability to comply with covenants contained in those credit agreements, the outcome of professional liability lawsuits and claims, our ability to control ultimate professional liability costs, the accuracy of our estimate of our anticipated professional liability expense, the impact of future licensing surveys, the outcome of proceedings alleging violations of laws and regulations governing quality of care or violations of other laws and regulations applicable to our business, costs and impacts associated with the implementation of our electronic medical records plan, the costs of investing in our business initiatives and development, our ability to control costs, changes to our valuation of deferred tax assets, changes in occupancy rates in our facilities, changing economic and competitive conditions, changes in anticipated revenue and cost growth, changes in the anticipated results of operations, the effect of changes in accounting policies, as well as other risk factors detailed in the Company's Securities and Exchange Commission filings. The Company has provided additional information in its Annual Report on Form 10-K for the fiscal year ended December 31, 2010, as well as in its Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission, which readers are encouraged to review for further disclosure of other factors. These assumptions may not materialize to the extent assumed, and risks and uncertainties may cause actual results to be different from anticipated results. These risks and uncertainties also may result in changes to the Company's business plans and prospects. Advocat Inc. is not responsible for updating the information contained in this press release beyond the published date, or for changes made to this document by wire services or Internet services.

Advocat provides long term care services to patients in 46 skilled nursing centers containing 5,364 licensed nursing beds, primarily in the Southeast and Southwest. For additional information about the Company, visit Advocat's web site:

-Financial Tables to Follow-

 (In thousands)
 June 30,December 31
ASSETS:  (Unaudited)  
Current Assets    
Cash and cash equivalents$8,786 $8,862
Receivables, net27,584 23,801
Deferred income taxes 4,723 4,207
Other current assets6,152 5,965
Total current assets47,245 42,835
Property and equipment, net42,326 38,180
Deferred income taxes11,131 12,408
Acquired leasehold interest, net9,188 9,380
Other assets, net5,675 3,153
TOTAL ASSETS$115,565 $105,956
Current Liabilities    
Current portion of long-term debt and capitalized lease obligations $527 $582
Trade accounts payable5,103 3,120
Accrued expenses:    
Payroll and employee benefits11,696 11,047
Current portion of self-insurance reserves8,278 7,379
Other current liabilities3,860 4,479
Total current liabilities29,464 26,607
Noncurrent Liabilities    
Long-term debt and capitalized lease obligations, less current portion25,946 23,819
Self-insurance reserves, less current portion11,418 11,659
Other noncurrent liabilities17,531 16,748
Total noncurrent liabilities54,895 52,226
(In thousands, except per share data)
 For the Three MonthsFor the Six Months
 Ended June 30,Ended June 30,
  (Unaudited) (Unaudited) (Unaudited) (Unaudited)
PATIENT REVENUES, NET  $79,172 $71,492 $156,302 $141,644
Operating  59,742 56,388 120,599 111,790
Lease 5,727 5,636 11,441 11,238
Professional liability 1,081 997 2,772 2,411
General and administrative  6,124 5,063 12,178 9,765
Depreciation and amortization 1,565 1,432 3,121 2,848
  74,239 69,516 150,111 138,052
OPERATING INCOME 4,933 1,976 6,191 3,592
Interest expense, net (582) (415) (1,033) (811)
Debt retirement costs (112) (127)
  (582) (415) (1,145) (938)
  4,351 1,561 5,046 2,654
PROVISION FOR INCOME TAXES (1,412) (574) (1,661) (960)
NET INCOME  2,937 977 3,375 1,885
PREFERRED STOCK DIVIDENDS (86) (86) (172) (172)
NET INCOME FOR COMMON STOCK $2,851 $891 $3,203 $1,713
Per common share — basic        
Income from continuing operations $0.49 $0.16 $0.56 $0.27
Income from discontinued operations  ―  0.03
  $0.49 $0.16 $0.56 $0.30
Per common share — diluted        
Income from continuing operations $0.48 $0.15 $0.54 $0.26
Income from discontinued operations  ―  0.03
  $0.48 $0.15 $0.54 $0.29
Basic 5,778 5,726 5,765 5,722
Diluted 5,934 5,874 5,906 5,894
 (In thousands, except per share data)
 Three Months EndedSix Months Ended
 June 30,June 30,
  (Unaudited) (Unaudited) (Unaudited) (Unaudited)
NET INCOME $2,937 $977 $3,375 $1,885
Income (loss) from discontinued operations (2) (10) (10) 191
Net income from continuing operations 2,939 987 3,385 1,694
Adjustments to reconcile net income from continuing operations to funds provided by operations:        
Depreciation and amortization 1,565 1,432 3,121 2,848
Provision for doubtful accounts  625 452 1,194 940
Deferred income tax provision 964 118 1,073 64
Provision for self-insured professional liability, net of cash payments (60) (264) 6 (193)
Stock-based compensation 202 137 403 333
Amortization of deferred balances 38 45 84 121
Provision for leases in excess of cash payments 112 222 225 447
Other  79 127
FUNDS PROVIDED BY OPERATIONS $6,385 $3,129 $9,570 $6,381
Basic $1.11 $0.55 $1.66 $1.12
Diluted $1.08 $0.53 $1.62 $1.08
Basic 5,778 5,726 5,765 5,722
Diluted 5,934 5,874 5,906 5,894
Advocat provides financial measures using accounting principles generally accepted in the United States (GAAP) and using adjustments to GAAP (non-GAAP). These non-GAAP measures are not measurements under GAAP. These measurements should be considered in addition to, but not as a substitute for, the information contained in our financial statements prepared in accordance with GAAP. Funds Provided by Operations is defined as net income from continuing operations adjusted for the cash effect of professional liability and other non-cash charges and is measured before the effects of capital additions, debt payments or dividends to preferred or common shareholders. Funds Provided by Operations per share is defined as Funds Provided by Operations divided by the weighted average common shares outstanding. Management believes that Funds Provided by Operations is an important performance measurement because it eliminates the effect of actuarial assumptions on our professional liability reserves, includes the cash effect of professional liability payments, and does not include the effects of other non-cash charges. Since the definition of Funds Provided by Operations may vary among companies and industries, it should not be used as a measure of performance among companies.
June 30, 2011
     For the Three Months Ended June 30, 2011
     Skilled        MedicareMedicaid
     Nursing        Room andRoom and
 As ofWeightedOccupancy  2011BoardBoard
 June 30, 2011Average(Note 1)  Q2RevenueRevenue
 LicensedAvailableDaily LicensedAvailableMedicareRevenue PPDPPD
RegionNursingNursingCensusNursingNursingUtilization($ in millions) (Note 2) (Note 2)
 BedsBeds  BedsBeds        
Alabama (Note 3) 790 783 705 89.30% 90.10% 16.60% $15.50 $493.84 $170.59
Arkansas 1,311 1,183 929 70.80% 78.50% 18.00% 17.5 423.87 149.43
Kentucky (Note 4) 778 757 683 87.80% 90.30% 13.50% 14.1 464.78 173.04
Tennessee 617 586 512 83.00% 87.40% 17.00% 10.3 449.07 147.54
Texas 1,868 1,676 1,318 70.60% 78.60% 10.90% 21.8 497.92 128.95
Total 5,364 4,985 4,147 77.30% 83.20% 14.60% $79.20 $464.71 $150.66
Note 1:

The number of Licensed Nursing Beds is based on the licensed capacity of the facility. The Company has historically reported its occupancy based on licensed nursing beds. The number of Available Nursing Beds represents licensed nursing beds less beds removed from service. Available nursing beds is subject to change based upon the needs of the facilities, including configuration of patient rooms, common usage areas and offices, status of beds (private, semi-private, ward, etc.) and renovations. Occupancy is measured on a weighted average basis.
Note 2:  These Medicare and Medicaid revenue rates include room and board revenues but do not include any ancillary revenues related to these patients. 
Note 3: The Alabama region includes nursing centers in Alabama and Florida.
Note 4: The Kentucky region includes nursing centers in Kentucky, West Virginia and Ohio. 
June 30, 2011
     Medicare Average Daily 
Renovation — Completion Date2011Prior2011Prior
1st renovation — January 2006 84.3% 64.9% 16 8
2nd renovation — July 2006 60.1% 71.2% 10 12
3rd renovation — August 2006 78.3% 45.1% 9 5
4th renovation — October 2006 81.6% 71.9% 11 9
5th renovation — February 2007 66.5% 56.2% 11 8
6th renovation — April 2007 57.0% 47.5% 15 13
7th renovation — July 2007 73.3% 85.0% 11 17
8th renovation — January 2008 70.5% 50.9% 13 9
9th renovation — October 2008 86.7% 83.0% 15 17
10th renovation — November 2008 87.9% 80.8% 15 12
11th renovation — March 2009 76.2% 62.5% 12 7
12th renovation — November 2009 92.0% 86.7% 24 24
13th renovation — January 2010 96.6% 95.6% 8 5
14th renovation — July 2010 95.5% 77.6% 32 12
15th renovation — August 2010 73.3% 68.8% 25 19
Total 77.9% 69.8% 227 177
 (1) Occupancy based on licensed beds.         
 (2) Last Twelve Months prior to commencement of construction.        
CONTACT:  Company Contact:

          William R. Council, III

          President and CEO

          (615) 771-7575


          Investor Relations:

          Cameron Associates

          Rodney O'Connor

          (212) 554-5470