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Text: During the call today, we will refer to some non-GAAP financial measures, such as NAREIT FFO, adjusted FFO, FAD and EBITDA.
Reconciliations of these non-GAAP measures to the most comparable measure under generally accepted accounting principles as well as an explanation of the usefulness of the non-GAAP measures are available under the Financial Information section of our website at www.
In addition, certain operator coverage and financial information that we discuss is based on data provided by our operators that has not been independently verified by Omega.
Today, I will discuss the pandemic and the related government response and support, our fourth-quarter financial results, the vaccine rollout, and our new Brookdale relationship.
The allocation and distribution of additional government funding, along with communication and evolution of clinical protocols has been critical in protecting and saving lives as we combat this unprecedented deadly pandemic.
Continued federal and state government support will be critical for the skilled nursing and assisted living care settings.
The latest round of CARES Act funding targeted operators that have been disproportionately impacted by the pandemic.
We believe at least $23 billion of CARES Act funding under the Provider Relief Fund remains unallocated.
We are hopeful that new legislation will add to Provider Relief Funding and hopefully will support the industry through its 2021 recovery.
Turning to our financial results.
We are very pleased with our fourth-quarter results.
Our adjusted FFO of $0.81 per share and our funds available for distribution of $0.77 per share allow us to maintain our quarterly dividend of $0.67 per share.
The payout ratio is 83% of adjusted FFO and 87% of funds available for distribution.
Additionally, for the fourth quarter and in January, we collected virtually all of our contractual rents.
We continue to gather vaccine rollout data from our operators and can report the following.
As of January 31, based on 92% of our facilities reporting in, 95% of facilities have conducted or are scheduled within the next week for first-dose clinics.
The vaccination rate for residents is approximately 69%, and the vaccination rate for staff is approximately 36%.
For most facilities, the second-dose clinic, which occurs 21 days after the first dose, will also incorporate a new day of first doses for those residents or staff who are not available or who are not prepared for the vaccination during the first round clinic.
We are very pleased to have established a relationship with Brookdale via the senior housing facilities and related master lease that we have acquired from Healthpeak.
We believe that Brookdale is exceptionally well equipped to address the current COVID-19 environment and to prosper as we emerge from the pandemic.
They have an excellent leadership team; substantial liquidity to sustain and grow their operations; low rate, long-dated secured debt tied to their owned assets; and valuable integrated home health and hospice companies.
We look forward to working with the Brookdale team and possibly identifying new opportunities where we might partner in the future.
Turning to our financials for the fourth quarter.
Our NAREIT FFO on a diluted basis was $173 million or $0.73 per share for the quarter as compared to $176 million or $0.77 per diluted share for the fourth quarter of 2019.
Revenue for the fourth quarter was approximately $264 million before adjusting for the nonrecurring writedown of straight-line receivables as well as other nonrecurring favorable revenue items.
Revenue for the quarter included approximately $12 million of noncash revenue.
We collected over 99% of our contractual rent, mortgage and interest payments for the fourth quarter and for January as well, excluding, of course, rental payments due from Daybreak, which is under a forbearance agreement and has not been making payments.
Our G&A expense was $10.4 million for the fourth quarter of 2020, in line with our estimated quarterly G&A expense of between $9.5 million and $10.5 million.
Interest expense for the quarter was $56 million, with a $4 million increase over the third quarter of 2020, primarily resulting from our October issuance of $700 million of 3.375% senior notes due February 2031.
Our note issuance was leverage-neutral as proceeds were used to repay LIBOR-based borrowings, some of which were hedged.
As a result of the repayments, we terminated $225 million of LIBOR-based swaps and recorded approximately $12 million in early extinguishment of debt.
Our balance sheet remains strong.
Throughout 2020, we continued to take steps to improve our liquidity.
Our October bond issuance repaid $683 million of short-term LIBOR-based borrowings.
borrowings outstanding under our $1.25 billion credit facility and had approximately $163 million in cash and cash equivalents.
We have no bond maturities until August 2023.
In March 2020, we entered into $400 million of 10-year interest rate swaps at an average swap rate of approximately 0.87%.
These swaps expire in 2024 and provide us with significant cost certainty when we refinance our 2023 bond maturity.
In the fourth quarter, we issued 4.2 million shares of common stock through our ATM program, generating $151 million in net cash proceeds.
But we believe our actions to date provide us with flexibility to weather a potential prolonged impact COVID-19 on our business.
It also provides significant liquidity to fund potential acquisitions.
In 2021, we will continue to evaluate any additional steps that may be necessary to maintain adequate liquidity.
At December 31, approximately 95% of our $5.2 billion in debt was fixed and our funded debt to adjusted annualized EBITDA was five times.
Our fixed charge coverage ratio was 4.3 times.
When adjusting to include a full quarter of contractual revenue for new investments completed during the quarter as well as eliminating revenue related to assets sold in the quarter, our pro forma leverage would be roughly 4.99 times.
It's important to note, we have lowered our leverage five consecutive quarters with the goal of maintaining our leverage at less than five times.
As of December 31, 2020, Omega had an operating asset portfolio of 949 facilities with over 95,000 operating beds.
These facilities were spread across 69 third-party operators and located within 39 states and the United Kingdom.
Trailing 12-month operator EBITDARM and EBITDAR coverage for our core portfolio increased during the third quarter of 2020 to 1.87 times and 1.51 times, respectively, versus 1.84 times and 1.48 times, respectively, for the trailing 12-month period ended June 30, 2020.
These numbers were negatively impacted by a number of external factors as a direct result of COVID-19, including a significant drop in patient census and a dramatic spike in operating expenses, particularly labor costs and personal protective equipment, or PPE.
These negative results were more than offset in the second and third quarters by the positive impact of federal stimulus funds, which were distributed in accordance with the CARES Act.
During the third quarter, our operators cumulatively recorded approximately $102 million in federal stimulus funds as compared to approximately $175 million recorded during the second quarter.
Trailing 12-month operator EBITDARM and EBITDAR coverage would have decreased during the third quarter of 2020 to 1.53 times and 1.18 times, respectively, as compared to 1.61 times and 1.26 times, respectively, for the second quarter when excluding the benefit of any federal stimulus funds.
EBITDAR coverage for the stand-alone quarter ended September 30, 2020 for our core portfolio was 1.44 times, including federal stimulus funds, and 0.97 times excluding the $102 million of federal stimulus funds versus 1.87 times and 1.05 times with and without the $175 million in federal stimulus funds, respectively, for the second quarter.
Overall, operator performance continued to be significantly affected in the third and fourth quarters of 2020 due to the ongoing impact of COVID-19.
While the third quarter and the start of the fourth quarter of 2020 saw moderating of new COVID cases, the spike in outbreaks reported nationwide during the holiday season did not spare nursing home residents and employees late in the fourth quarter.
Cumulative occupancy percentage for our core portfolio were at a pre-COVID rate of 84% in January of 2020, flattened out to around 75% throughout the fall months and subsequently dropped to 72.9% in December of 2020.
Based upon what Omega has received in terms of occupancy reporting for January to date, occupancy has continued to decline slightly, averaging approximately 72.1%.
We are cautiously optimistic that the rollout of vaccines, which began in late December of 2020 and has continued in earnest throughout January 2021, will provide an important catalyst for improving occupancy statistics as infection rates decline and visitation restrictions begin to ease.
In addition to COVID's negative effect on occupancy, the virus has also caused a significant spike in operating expenses, particularly labor costs and PPE.
Per patient day operating expenses for our core portfolio increased approximately $40 from pre-COVID levels in January 2020 to November 2020; the latest stats available.
Turning to new investments.
On November 1, 2020, Omega completed a $78 million purchase lease transaction for 7 skilled nursing facilities in Virginia.
The facilities were added to an existing operator's master lease for an initial cash yield of 9.5% with 2% annual escalators.
New investments for the year ended December 31, 2020 totaled approximately $260 million including $113 million in capital expenditures.
Turning to subsequent events.
As mentioned by Taylor, on January 20, 2021, Omega closed on the purchase of 24 senior housing facilities from Healthpeak for $510 million.
The acquisition included the assumption of an in-place master lease with Brookdale Senior Living, the leading operator of senior living communities throughout the United States.
The portfolio primarily consists of assisted living, independent living and memory care facilities with a total of 2,552 units located across 11 states.
The facilities will generate approximately $43.5 million in contractual 2021 cash rent with annual escalators of 2.4%.
During the fourth quarter of 2020, Omega divested 16 facilities for total proceeds of $64 million.
For the year ended December 31, 2020, Omega strategically divested a total of 35 facilities for $181 million.
Last, but certainly not least, I would once again like to recognize and applaud our operators' tireless, selfless efforts, particularly those employees on the front line.
Since our last earnings call, the $175 billion Provider Relief Fund was increased by $3 billion as a result of the $900 billion stimulus package signed in December 2020.
Of that fund, approximately $23 billion remains unallocated.
In terms of previously allocated funds still in the process of being paid out, as previously mentioned, on July 22, a Medicare-certified nursing home targeted infection control fund of $5 billion was announced.
$2.5 billion was paid out in August and an additional $2 billion was set up as a quality incentive payment program with payments based on a facility's ability to maintain a rate of infection below the county infection rate and a death rate below a national performance threshold for nursing home residents.
Payments are made based on monthly performance from September through December.
The September payout was made in October at $330 million, with the October payout being made in December at $530 million and the November payout just starting to go out last week.
With respect to the Phase 2 general distribution announced in September, due to the fact that HHS hadn't previously tracked assisted living facilities, a lengthy tax identification process delayed the payout for many assisted living providers to December and early January.
This allocation was an application process for up to 2% of 2019 patient revenues from Medicaid, children's health insurance program and assisted living providers.
The $20 billion Phase 3 general distribution announced in October was increased to $24.5 billion once all applications were received and reviewed.
Available to all healthcare providers previously eligible for payouts, both SNFs and ALFs were able to apply.
$10 billion was paid out in December with the remainder expected to be paid out within the coming weeks.
Payouts were based on the change in net operating income related to patient care for the first half of 2020 as compared to the first half of 2019, with a stated payout of 88%.
That said, all previous federal stimulus money received offset these numbers, bringing that percentage down substantially for many.
In addition to financial support, with COVID cases on the rise in the latter part of the year and the corresponding increased testing requirements, the federal government's efforts to provide more cost-effective testing capabilities through the distribution of rapid antigen test has been critical.
Supplies provided by the government, coupled with easier and cheaper access to testing supplies, has provided for quicker turnaround of test results, and therefore, the ability to respond timelier to outbreaks.
It cannot be stressed enough how crucial the government support thus far has been to the long-term care industry during this turbulent time.
However, even post vaccine rollout, the effects of this pandemic will be long-lasting.
We are hopeful that the new administration will recognize the urgency of this matter and will quickly expand on support efforts to this vital industry.
In conjunction with Maplewood Senior Living, we have completed work on our ALF memory care high-rise at Second Avenue in 93rd Street, Manhattan.
The opening of the project is pending licensure by the New York State Department of Health.
We are in ongoing communication with the DOH and understand that while they are conducting licensure surveys, and it is reasonable to expect ours shortly, the challenges of the ongoing pandemic is understandably forcing a reallocation of resources.
The final project cost is expected to be approximately $310 million.
The COVID-19 pandemic posed a certain challenges unique to senior housing operators, including increased costs, the challenges of managing COVID-positive patients and meaningful practical limitations on admissions.
While they very much appreciate the help they have received, private pay senior housing operators have not seen the level of government support provided to other areas of senior care.
We saw challenges to our senior housing occupancy throughout the third quarter, with variations tied to when and where COVID outbreaks were encountered.
However, we have seen evidence of stabilization and strengthening of census in certain markets.
By example, our Maplewood portfolio, which is concentrated in the early affected Metro New York and Boston markets, saw meaningful census erosion early in the pandemic, with second quarter census hitting a low point of 80.4% in early June.
That said, their portfolio occupancy had returned to 84.5% at the end of August and increased further to 85.6% in the month of November.
We find this resiliency and occupancy to be encouraging, but still have a way to go before the pandemic-driven top and bottom line risk to our ALF operators is behind us.
Including the land and CIP at the end of the fourth quarter, Omega's senior housing portfolio totaled $1.6 billion of investment on our balance sheet.
This total does not include our recent Brookdale investment, which closed after year end.
All of our senior housing assets are in triple-net master leases.
and U.K. As expected, this portfolio on a stand-alone basis had its trailing 12-month EBITDAR lease coverage fall four basis points to 1.12 times in the third quarter of 2020.
With COVID outbreaks affecting different markets at different times, it is reasonable to think that coverage may see additional downward pressure during the course of the pandemic before we see a rebound.
While we remain constructive about the prospects of senior housing, the COVID-19 outbreak has warranted a far more selective approach to ground-up development.
While we make further progress on our existing ongoing developments, we continue to work with our operators on strategic reinvestment in our existing assets.
We invested $19.4 million in the fourth quarter in new construction and strategic reinvestment.
$12.8 million of this investment is predominantly related to our active construction projects.
The remaining $6.6 million of this investment was related to our ongoing portfolio capex reinvestment program.

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compname reports q4 adjusted ffo per share of $0.81.
q4 adjusted ffo per share $0.81.
q4 ffo per share $0.73.

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