Medical Facilities Corp

TSX:DR

Earnings Call Transcript

[Operator]

Good morning, everyone. Welcome to the Medical Facilities Corporation's 2025 First Quarter Earnings Call. After management's remarks, this call will include a question and answer session, whereby qualified equity analysts will be permitted to ask questions. Before turning the call over to management, listeners are reminded that today's call may contain forward-looking statements within the meaning of the safe harbor provisions of Canadian provincial securities laws. Forward-looking statements involve risks and uncertainties, and undue reliance should not be placed on such statements. Certain material factors or assumptions are applied in making forward-looking statements, and actual results may differ materially from those expressed or implied in such statements. For additional information, please consult the MD&A for this quarter, the Risk Factors section of the annual information form and Medical Facilities' other filings with Canadian securities regulators. Medical Facilities does not undertake to update any forward-looking statements, except as required by applicable law. Such statements speak only as of the date made here. I would now like to turn the meeting over to Mr. Jason Redman, President and CEO of Medical Facilities. Please go ahead, Mr. Redman.

[Jason Redman, executive]

Thank you, operator, and good morning, everyone. Joining me on the call is our Chief Financial Officer, David Watson. As usual, please note that all dollar amounts that follow are in U.S. dollars, unless otherwise specified. Earlier this morning, we reported our first quarter results. Our news release, financial statements and MD&A are available on our website and have been filed on SEDAR+. As you know, there has been a great amount of economic uncertainty these past few months, both in Canada and the U.S. Despite this uncertainty, we are proud to report that our first quarter performance was in line with the strong first quarter we had last year, which benefited from additional surgical day due to the leap year. In the first quarter of this year, we had facility service revenue of $81.7 million, which was essentially on par with the prior year, and EBITDA of $17.3 million, which represented an increase of 0.7%.

It's also worth noting that even with 1 less surgical day, our surgical cases were up 2.2% in the quarter. In keeping with our strategic focus on returning capital to shareholders, it should be no surprise that the highlight of the quarter was a successful return of $42.3 million of the proceeds from the sale of Black Hills Surgical Hospital to shareholders through our substantial issuer bid. Under the SIB, we purchased and canceled just under 3.4 million common shares, which represented approximately 14.7% of the issued and outstanding common shares on a non-diluted basis as of the close of business on February 23, 2025, which was the last full trading day prior to the date we announced the amended terms of the SIB. During the quarter, we also repurchased 182,600 common shares under our normal course issuer bid, returning an additional $2 million to shareholders and further demonstrating our commitment to shareholder value. Our financial position remains very strong, with a consolidated cash balance of $65.7 million at quarter end, providing MFC the stability and flexibility to navigate the evolving economic environment, while continuing to drive operational excellence and simultaneously exploring options on how best to allocate the remaining capital from the sale of Black Hills Surgical Hospital.

Before passing the call to David, I want to give a shout out to Arkansas Surgical Hospital, which has ranked fifth in the U.S. in terms of lowest hospital readmission rate according to CMS. ASH was also recently named a finalist by AY Magazine for Best Doctor-owned Hospital and Best Specialty Hospital in Arkansas. With that, I would now like to turn the call over to David to review our financial results for the quarter. David?

[David N. Watson, executive]

Thank you, Jason. Good morning, everyone. Please note that the income statement variances, I will be discussing this morning are for continuing operations and therefore, exclude Black Hills Surgical Hospital, which is treated as discontinued operations in the financial results for the quarter ended March 31, 2024. Our facility service revenue of $81.7 million was on par with the first quarter of last year, despite the prior year's first quarter, including an extra day from the leap year. This was attributable to higher surgical case volumes, which were up 2.2% in the quarter.

Observation cases increased 6.8% and outpatient cases increased 4.8%, while inpatient cases were down 17% and pain management cases were down 8.3% in the quarter. Total operating expenses were down slightly, declining $0.2 million as higher consolidated salaries and benefits were more than offset by reductions in drugs and supplies and G&A expenses. Consolidated salaries and benefits were up 3.1%, mainly due to higher benefit costs from increased health plan utilization, along with annual merit raises and market-driven wage growth for both clinical and nonclinical staff. These increases were partially offset by a reduction in physician salaries due primarily to a physician becoming a full owner in a facility. Drugs and supplies were down 1.7%, mainly due to one fewer operating day compared to the same period last year as well as a case mix comprised of lower acuity procedures, cost-saving measures at certain facilities and increased vendor rebates. These factors were partially offset by the higher surgical case volume in the quarter. Finally, G&A expenses were down 3.8%, mainly due to lower corporate level costs related to share-based compensation plans.

Additional savings came from lower rental expense and reduced spending on contracted services. These decreases were partially offset by higher repairs and maintenance expenses. Looking at our profitability for the quarter. Income from operations was flat year-over-year at $13 million, while EBITDA was up 0.7% to $17.3 million.

Turning to our balance sheet. At the end of March, we had consolidated net working capital of $35.9 million and cash and cash equivalents of $65.7 million compared to net working capital of $76.4 million and cash and cash equivalents of $108.5 million at the end of 2024. The change in consolidated net working capital was mainly due to the completion of the substantial issuer bid during the quarter, resulting in a decrease in cash and cash equivalents. In addition to our strong cash position at quarter end, we have no corporate level bank debt after retiring the balance on our corporate credit facility near the end of 2024. This concludes our prepared remarks. We would now like to open the call up for questions. Operator?

[Operator]

[Operator Instructions] Your first question comes from Sahil Dhingra, an analyst from RBC. Please go ahead.

[Unknown Analyst]

This is Sahil for [indiscernible]. So my first question is when we're looking at the facilities revenue, so for OS, Oklahoma Surgical Hospital, we see the revenues were down, while other hospitals were up. So could you please comment, if there is any structural issue with OS? Or was it onetime and normal quarterly fluctuations that we see?

[David N. Watson, executive]

[indiscernible], thanks for the question. Yes, Oklahoma Spine during the first quarter, we saw lower surgical case volume. Nothing unusual there. It was just timing during the quarter. It was also impacted by case and payer mix and it was just the mix of cases during the period.

[Unknown Analyst]

Okay. Okay. So going forward, you would expect growth in this segment, right?

[David N. Watson, executive]

I would say I didn't experience anything or we didn't see anything unusual during the quarter. It was primarily timing. So I wouldn't necessarily look to view that as a trend.

[Unknown Analyst]

Okay. Great. That is helpful. And then my second question is related to the capital allocation. So I think previously, you had mentioned that the amount of funds received from the sale of Black Hills that is not distributed under the SIB, it would be given as a special dividend to shareholders. What's the latest thinking on the remaining amount?

[David N. Watson, executive]

Thanks. So as we've said before, if the capital cannot be allocated, doing a special dividend is our last resort. My preference is to continue to remain active in the NCIB as much as possible and continue repurchase of shares and also look for opportunities to reinvest back in the business in an accretive manner for our shareholders. But if we can't find alternate uses for the capital that's better use, then the Board will definitely look at doing a special dividend.

[Unknown Analyst]

And as a follow-up, when you mentioned the reinvestment into the business, are you looking at an acquisition or normal reinvestment in the existing facilities?

[David N. Watson, executive]

Yes. No acquisitions, Sal. Just normal reinvestments back into the business. We're always looking for ways that we can enhance our operations, improve efficiency, invest in technologies, invest in our people and also attract and retain positions that we have. So if there's ways that we can deploy that capital in those manners, and it's something that we will -- that's our first alternative for allocation of money.

[Unknown Analyst]

Okay. And I have two more questions. I'll lump them together. One is, is there any -- are you experiencing any change in competition at any of your facilities? And the other one I have is, I think last quarter, we discussed a bit on this under the current administration, are you seeing risks related to site neutrality or any other proposals which might impact the reimbursement for different procedures under Medicaid or Medicaid, if you could comment there.

[Jason Redman, executive]

Sure. I'll take the one on the competitive environment. So right now, we're not seeing any significant changes in the competitive environment. I think all the markets that we've operated in have typically been competitive. We haven't seen any change in that, nor have we seen any lost cases to our competition. So our facilities continue to perform very well. They continue to be ranked very highly, and our folks have done a very good job at managing the base and maintain their competitive environment. So we're very comfortable with how they've how they've executed. In terms of the impact of site neutrality, as you know, this has been contemplated for a very long period of time. Legislation has been discussed numerous times. We don't have any further indication that site neutrality is coming, but it's something that's definitely on our radar. We watch very closely to see if it could be an impact. I think right now, it's too premature to assess it. But I mean, depending on how significant it was, I mean, it could have an impact on the business for sure.

[Unknown Analyst]

Okay. Okay. Great. And nothing on -- and you're not seeing any further challenges on the reimbursement side?

[Jason Redman, executive]

No, not right now. And to answer your question on the Medicaid, Medicaid represents a very small portion of our business. So even if there were changes to Medicaid reimbursement, we don't expect a material impact on our business going forward.

[Operator]

So there are no further questions at this time. So I will now turn the call over to Mr. Jason Redman. Please continue.

[Jason Redman, executive]

Thank you, operator, and thank you all for joining us this morning. We appreciate your continued support and look forward to updating you on our progress throughout the year. Have a great day.

Ladies and gentlemen, this concludes today's conference call. Thank you for your participation. You may now disconnect. Thank you.