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Text: Investors are urged to carefully review various disclosures made by NHI and its periodic reports filed with the Securities and Exchange Commission, including the risk factors and other information disclosed in NHI's Form 10-Q for the quarter ended March 31, 2020.
sec.gov or on NHI's website at www.
First and foremost, we are deeply grateful to all the front-line heroes that are tirelessly combating COVID-19 every day, despite the great risk to themselves and their families.
At NHI, we have long admired the senior housing and skilled nursing organizations and their staff that go to great lengths to keep our senior population safe and smiling.
Never has this been truer than today.
As a tribute, we have published some of our favorite caregiver and resident photos on the cover of our supplemental.
I hope you'll take a look.
Reputations are made during a crisis and I see operators making good decisions and taking action based on the principles they value, selflessly caring for their residents, nurturing a company culture that appreciates employees, and providing leadership and comfort to the employees and families of their residents.
I believe that when history reflects back on our industry and its practices during this time, there will be operators that are hailed as heroes.
That said, the challenges posed to our operators and our business by this pandemic are very real and it is difficult to say with any degree of accuracy, when we will return to a more normal operating environment.
Our operators have done an admirable job in limiting the spread of COVID-19.
As of May 5th, we had 192 active resident cases in 37 buildings.
To put that in some perspective, NHI has over 20,000 residents being cared for in all of our properties; so, less than 1%.
As our operators have implemented their protocols and taken appropriate actions to prevent or limit the spread of the virus, the result has been a significant downturn in inquiries, tours and move-ins.
This is having a negative impact on occupancy.
Kevin will give details on that later.
On the cost side of the equation, it should not surprise anyone that our operators are spending more, particularly for labor and PPE suppliers.
This is obviously pressuring our operators' margins and we are prepared to help them weather this storm, where and when necessary.
In April, NHI received 99.7% of its contractual rent, and so far in May, we have collected approximately 94%, which is in line with our expectations as we typically see a portion of collections through the 15th of the month depending on underlying lease terms.
As this pandemic unfolds, NHI is committed to transparency with the investment community.
To that end, we have enhanced occupancy disclosure on Bickford, Holiday and Senior Living Communities, which Kevin will touch on in more detail.
We were the first to detail the incident of COVID-19 in our communities and we will continue to provide weekly updates to our website as long as it is material.
But given that the scope and spread of COVID-19 is so uncertain, NHI has limited visibility to the financial impact it could cause.
And as a result, we are withdrawing our previously issued 2020 guidance.
Regarding the dividend, our Board is committed to our dividend policy and we will consider the August dividend in mid-June.
Beginning with our net income per diluted common share for the quarter ending March 31, 2020 we achieved $1.37 per share in earnings, inclusive of the gain on sale, compared to $0.83 per share for the same period in 2019.
Turning to our three FFO performance metrics for the first quarter, NAREIT FFO increased 3.1% to $1.35, normalized FFO increased 3.8% to $1.36 and adjusted FFO or AFFO increased 5.7% to $1.29.
Cash NOI is the metric we use to measure our performance.
We define cash NOI as GAAP revenue excluding straight-line rent, excluding escrow funds received from tenants, and excluding lease incentive and commitment fee amortizations.
For the quarter ending March 31, cash NOI increased 9.2% to $76.3 million compared to $69.8 million in the prior year.
Our increase in first quarter 2020 cash NOI was reflective of our organic NOI growth from lease escalators and the effects from our post-Q1 2019 investments including the recent Timber Ridge joint venture investment, as well as the continued fulfillment of our commitments.
A reconciliation of cash NOI can be found on Page 17 of our Q1 2020 SEC filed supplement.
G&A expense for the 2020 first quarter increased 7.4% over the prior first quarter to $4.3 million.
The increase in G&A was spread across several areas, including the expansion of our asset management team, other payroll expense increases and expenses associated with a higher use of outside consultants.
Turning to the balance sheet, we ended the quarter with $1.55 billion in total debt, of which a little over 90% was unsecured.
At March 31, we had $142 million of capacity on our $550 million revolver.
NHI also had $46 million in cash, resulting in a net debt of $1.5 billion or $67.6 million [Phonetic] higher than our net debt at December 31.
This increase was largely due to the Timber Ridge acquisition, which closed at the end of January.
At quarter end, we also had approximately $24.2 million in restricted 1031 account, not included in our cash equivalents, but recorded in other assets, which originated from the sale of eight Brookdale properties in January.
Our debt capital metrics for the quarter ending March 31, were net debt to annualized EBITDA of 4.7 times, which is unchanged from the fourth quarter, weighted average debt maturity of 3.7 years and our fixed charge coverage ratio at 5.8 times compared to 5.7 times in the fourth quarter of 2019.
For the quarter ending March 31, our weighted average cost of debt was 3.3%.
Stock combined markets over the last month are not where we'd like them to be.
However, during the first quarter, we filed a new automatic shelf registration and refreshed our ATM program, giving us $500 million in new ATM capacity.
Together, our investment-grade credit ratings, including a recently affirmed stable outlook from Fitch, our new shelf also includes an indenture, which positions us during [Phonetic] a novel public debt offering when market conditions improve.
While currently very expensive, we do consider the public equity and debt markets is open to us and another source of liquidity.
David brings 23 years of accounting experience to NHI with his recent CAO roles at MedEquities Realty Trust and Healthcare Reality Trust and through his experiences as Audit Senior Manager at Ernst & Young.
We have been updating active resident cases in our communities on a weekly basis, but I wanted to add a little more context.
As Eric mentioned, we had 37 buildings with one or more active resident cases, including 20 senior housing properties and 17 SNFs.
Within the 20 senior housing properties, 14 were need-driven properties and six were discretionary properties.
37 properties span 13 unique operators in 18 different states.
We had a total of 192 active resident cases, which included 97 cases in our SNFs, 40 cases in the skilled nursing wings at our CCRCs and senior living campuses, and 55 cases at our senior housing properties.
We are in constant contact with our operating partners and are confident they are following their own infectious disease protocols and are acting in accordance with CDC guidelines, state health agency regulation and in some case, more so.
Overall, we have been very pleased and grateful for the efforts of our operators to prevent or limit the spread of COVID-19 in their communities.
The relatively low incidence is not surprising to us and is really a testament to our operators, whose mission is to keep our senior population safe.
Regarding the CARES Act, several of our operators -- of our senior housing operators have been approved for have received funds from the Paycheck Protection Program.
As it turns out, the triple net lease structure is beneficial when applying for these loans.
Our SNF operators are also benefiting from the CARES Act.
Payments from the Provider Relief Fund averaging approximately $150,000 per building, the 2% Medicare sequestration suspension and the 6.2% increase in the FMAP help improve near-term liquidity for the SNFs.
Turning to collections, April collections were 99.7%, and so far in May, we have collected approximately 94%, which is in line with our expectations as we typically see a portion of collections through the 15th of the month depending on the underlying lease terms.
At this point, nobody is past due.
We speak frequently with our operators and are working to creatively find solutions that benefit them at this unprecedented time and that makes sense for our shareholders.
We do have credit enhancements in our leases with many of our senior housing operators, which total approximately $38.7 million in cash in addition to guarantees and we have excellent credit from our SNF operators.
Turning to the performance of our different asset classes and larger operators, our needs-driven senior housing operators were early to act to this pandemic and have limited the spread of the virus so far.
As of our last weekly update, 14 assisted living and senior living campuses had active resident cases with most of the communities limited to less than five cases per community.
Bickford, which represents 17% of our annualized cash revenue, has seen a slight downtick in their move-out rates, but like much of the industry, their lead volume and tours were down more than 40%, which impacts the rate of new move-ins and occupancy.
Bickford's average occupancy on a same community basis was 87.3% in the first quarter and 86.6% for March.
Occupancy further declined in April by 130 basis points to 85.3%.
Our entrance fee communities have fared somewhat better as the resident turnover is much lower and the residents tend to be younger and healthier relative to other property types.
But they are not immune to the impact of COVID-19 and we have had four entrance fee communities with active resident cases as of our last weekly update, though like assisted living, the number of cases per community is limited.
Senior living communities, which represents 16% of our revenue had first quarter average occupancy of 80.4%, which ticked up slightly to 80.6% in March, but dropped to 79% in April as multiple entrance fee sales have been delayed due to the pandemic.
Our independent living communities have experienced a similar decline in leads, tours and move-ins as our assisted living operators.
The incidence of COVID-19 is relatively low in independent living and we had only two properties with active resident cases as of the last update.
Holiday Retirement, which represents 11% of our annualized cash revenue, had an average occupancy of 87.3% in the first quarter and 86.7% in March.
The April average occupancy declined by 170 basis points to 85%.
Bickford, SLC and Holiday represent approximately 56% of our senior housing units.
On a combined basis, those three saw average occupancy decline by 150 basis points from March to April, which is a good proxy for the rest of the senior housing portfolio.
The skilled nursing portfolio, which represents 26% of our annualized cash revenue is anchored by two excellent credits in NHC and The Ensign Group.
As of our last weekly update, 17 of our 78 SNFs had active resident cases.
We have seen more instances of outbreaks in some of our SNFs, which is expected given the higher acuity patient population and the more frequent contact caregivers have with the patients and residents.
Given the short average length of stay for Medicare patients and the temporary stay on elective procedures, SNF occupancies have generally declined by more than what we are seeing in senior housing.
However, there is more government financial support for the SNF industry.
NHC, which accounts for 12% of annualized cash revenue, has received funds from the Provider Relief Fund.
The company also expects to gain liquidity through the Medicare Accelerated Payment Program, the Medicare sequestration suspension, the payroll tax deferral and supplemental Medicaid payments.
Overall, we feel very comfortable with the credit in our SNF portfolio.
The pace of deals have stalled and everything indicates that this will continue for the next several months as true price discovery is near impossible to determine right now.
Our focus for the more immediate future is to continue funding existing commitments and extreme asset management by creatively providing guidance and assistance to our operators, if needed.
For the longer term, we continue to have conversations with existing and new operators and expect that our pipeline will be ready to support significant external growth when some normalcy returns to the market.
I do want to express my gratitude and admiration for all of our operators and the front-line heroes that accomplished truly amazing acts of courage and their residents and patients every day.
With that, I'll hand the call back over to Eric.
Looking internally, you should know that NHI's management team and Board have deep experience managing during times of crisis.
I believe our balance sheet and liquidity, together with strong lender and market relationships, puts us on firm footing.

user
compname posts q1 earnings per share of $1.37.
compname says q1 2020 gaap net income attributable to common stockholders of $1.37 per diluted common share - sec filing.
qtrly affo of $1.29 per diluted common share.
withdrawing its full year 2020 guidance.

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