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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
_____________________________
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.
For the quarterly period ended June 30, 2023.
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.
    For the transition period from                      to                     .
Commission file number: 001-38900
__________________________
THE PENNANT GROUP, INC.

(Exact Name of Registrant as Specified in Its Charter)
Delaware
83-3349931
(State or Other Jurisdiction of(I.R.S. Employer
Incorporation or Organization)Identification No.)
1675 East Riverside Drive, Suite 150, Eagle, ID 83616
(Address of Principal Executive Offices and Zip Code)
(208) 506-6100
(Registrant’s Telephone Number, Including Area Code)
None
(Former name, former address and former fiscal year, if changed since last report)
________________
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.001 per sharePNTGNasdaq Global Select Market
Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes No
Indicate by check mark whether the registrant has submitted electronically, every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes No

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act:
Large accelerated filerAccelerated filerNon-accelerated filerSmaller reporting companyEmerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by a check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No
As of August 7, 2023, 29,850,343 shares of the registrant’s common stock were outstanding.




Table of Contents
THE PENNANT GROUP, INC.
QUARTERLY REPORT ON FORM 10-Q
FOR THE THREE AND SIX MONTHS ENDED JUNE 30, 2023
TABLE OF CONTENTS




Table of Contents
PART I. FINANCIAL INFORMATION
Item I. Financial Statements
THE PENNANT GROUP, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(unaudited, in thousands, except par value)

June 30, 2023December 31, 2022
Assets
Current assets:
Cash $2,838 $2,079 
Accounts receivable—less allowance for doubtful accounts of $957 and $592, respectively
57,252 53,420 
Prepaid expenses and other current assets11,549 18,323 
Total current assets71,639 73,822 
Property and equipment, net27,252 26,621 
Right-of-use assets260,730 260,868 
Deferred tax assets, net214 2,149 
Restricted and other assets10,940 10,545 
Goodwill83,614 79,497 
Other indefinite-lived intangibles61,025 58,617 
Total assets$515,414 $512,119 
Liabilities and equity
Current liabilities:
Accounts payable$12,037 $13,647 
Accrued wages and related liabilities22,848 23,283 
Operating lease liabilities—current17,412 16,633 
Other accrued liabilities16,180 16,684 
Total current liabilities68,477 70,247 
Long-term operating lease liabilities—less current portion246,307 247,042 
Other long-term liabilities7,779 6,281 
Long-term debt, net59,153 62,892 
Total liabilities381,716 386,462 
Commitments and contingencies
Equity:
Common stock, $0.001 par value; 100,000 shares authorized; 30,251 and 29,799 shares issued and outstanding, respectively, at June 30, 2023; and 30,149 and 29,692 shares issued and outstanding, respectively, at December 31, 2022
29 29 
Additional paid-in capital102,886 99,764 
Retained earnings25,931 21,284 
Treasury stock, at cost, 3 shares at June 30, 2023 and December 31, 2022
(65)(65)
Total Pennant Group, Inc. stockholders’ equity128,781 121,012 
Noncontrolling interest4,917 4,645 
Total equity133,698 125,657 
Total liabilities and equity$515,414 $512,119 
See accompanying notes to condensed consolidated financial statements.

1


Table of Contents
THE PENNANT GROUP, INC.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(unaudited, in thousands, except for per-share amounts)

Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
Revenue$132,281 $116,316 $258,745 $230,226 
Expense
Cost of services106,176 92,716 208,778 182,978 
Rent—cost of services9,836 9,078 19,433 19,129 
General and administrative expense8,791 9,741 17,496 19,774 
Depreciation and amortization1,214 1,279 2,494 2,426 
Loss on asset dispositions and impairment, net
3 6,617 3 6,708 
Total expenses126,020 119,431 248,204 231,015 
Income (loss) from operations6,261 (3,115)10,541 (789)
Other income (expense):
Other income (expense)35 (35)65 (32)
Interest expense, net(1,453)(821)(2,859)(1,450)
Other (expense), net(1,418)(856)(2,794)(1,482)
Income (loss) before provision for income taxes4,843 (3,971)7,747 (2,271)
Provision (benefit) for income taxes1,921 (1,375)2,828 (833)
Net income (loss)2,922 (2,596)4,919 (1,438)
Less: net income attributable to noncontrolling interest125 80 272 224 
Net income (loss) and other comprehensive income attributable to The Pennant Group, Inc. $2,797 $(2,676)$4,647 $(1,662)
Earnings (loss) per share:
Basic$0.09 $(0.09)$0.16 $(0.06)
Diluted$0.09 $(0.09)$0.15 $(0.06)
Weighted average common shares outstanding:
Basic29,809 28,605 29,780 28,589 
Diluted30,193 28,605 30,171 28,589 

See accompanying notes to condensed consolidated financial statements.
2


Table of Contents

THE PENNANT GROUP, INC.
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY
(unaudited, in thousands)
Common StockAdditional Paid-In CapitalRetained EarningsTreasury StockNon-controlling Interest
SharesAmountSharesAmountTotal
Balance at December 31, 202230,149 $29 $99,764 $21,284 3 $(65)$4,645 $125,657 
Net income attributable to The Pennant Group, Inc.— — — 1,850 — — — 1,850 
Net income attributable to noncontrolling interests— — — — — — 147 147 
Share-based compensation— — 1,367 — — — — 1,367 
Issuance of common stock from the exercise of stock options26 — 203 — — — — 203 
Net issuance of restricted stock28 — — — — — — — 
Balance at March 31, 202330,203 $29 $101,334 $23,134 3 $(65)$4,792 $129,224 
Net income attributable to The Pennant Group, Inc.— — — 2,797 — — — 2,797 
Net income attributable to Non-Controlling Interests— — — — — — 125 125 
Stock-based compensation— — 1,303 — — — — 1,303 
Issuance of common stock from the exercise of stock options38 — 249 — — — — 249 
Net issuance of restricted stock10 — — — — — — — 
Balance at June 30, 202330,251 $29 $102,886 $25,931 3 $(65)$4,917 $133,698 

Common StockAdditional Paid-In CapitalRetained EarningsTreasury StockNon-controlling Interest
SharesAmountSharesAmountTotal
Balance at December 31, 202128,826 $28 $95,595 $14,641 3 $(65)$4,045 $114,244 
Net income attributable to The Pennant Group, Inc.— — — 1,014 — — — 1,014 
Net income attributable to noncontrolling interests— — — — — — 144 144 
Share-based compensation— — 2,440 — — — — 2,440 
Issuance of common stock from the exercise of stock options21 1 89 — — — — 90 
Net issuance of restricted stock2 — — — — — — — 
Balance at March 31, 202228,849 $29 $98,124 $15,655 3 $(65)$4,189 $117,932 
Net loss attributable to The Pennant Group, Inc.— — — (2,676)— — — (2,676)
Net income attributable to Non-Controlling Interests— — — — — — 80 80 
Share-based compensation— — 2,380 — — — — 2,380 
Issuance of common stock from the exercise of stock options33 — 271 — — — — 271 
Net issuance of restricted stock4 — — — — — — — 
Balance at June 30, 202228,886 $29 $100,775 $12,979 3 $(65)$4,269 $117,987 

See accompanying notes to condensed consolidated financial statements.
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THE PENNANT GROUP, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(unaudited, in thousands)
Six Months Ended June 30,
20232022
Cash flows from operating activities:
Net income (loss)$4,919 $(1,438)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization2,494 2,426 
Amortization of deferred financing fees261 260 
Impairment of long-lived assets 214 
Provision for doubtful accounts349 380 
Share-based compensation2,670 4,820 
Deferred income taxes2,365 1,017 
Change in operating assets and liabilities, net of acquisitions:
Accounts receivable(2,631)406 
Prepaid expenses and other assets5,610 (7,049)
Operating lease obligations182 13 
Accounts payable(732)1,794 
Accrued wages and related liabilities(435)(34)
Other accrued liabilities(99)7,832 
Contract liabilities (CARES Act advance payments) (6,211)
Other long-term liabilities580 469 
Net cash provided by operating activities15,533 4,899 
Cash flows from investing activities:
Purchase of property and equipment(3,973)(7,863)
Cash payments for business acquisitions(7,261)(775)
Other8 (112)
Net cash used in investing activities(11,226)(8,750)
Cash flows from financing activities:
Proceeds from Revolving Credit Facility94,000 41,000 
Payments on Revolving Credit Facility(98,000)(39,500)
Issuance of common stock upon the exercise of options452 361 
Net cash (used in) provided by financing activities(3,548)1,861 
Net increase (decrease) in cash 759 (1,990)
Cash beginning of period2,079 5,190 
Cash end of period$2,838 $3,200 

See accompanying notes to condensed consolidated financial statements.

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THE PENNANT GROUP, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - (Continued)
(unaudited, in thousands)
Six Months Ended June 30,
20232022
Supplemental disclosures of cash flow information:
Cash paid during the period for:
Interest$2,857 $1,187 
Income taxes$160 $55 
Lease liabilities$17,898 $18,256 
Right-of-use assets obtained in exchange for new operating lease obligations$8,329 $1,385 
Non-cash adjustment to right-of-use assets and lease liabilities from lease modifications$ $6,522 
Non-cash adjustment to right-of-use assets and lease liabilities from lease terminations and assignments$ $(42,515)
Non-cash investing activity:
Capital expenditures in accounts payable$402 $1,100 

See accompanying notes to condensed consolidated financial statements.

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THE PENNANT GROUP INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(In thousands, except per share data and operational senior living units)


1. DESCRIPTION OF BUSINESS
The Pennant Group, Inc. (herein referred to as “Pennant,” the “Company,” “it,” or “its”), is a holding company with no direct operating assets, employees or revenue. The Company, through its independent operating subsidiaries, provides healthcare services across the post-acute care continuum. As of June 30, 2023, the Company’s subsidiaries operated 101 home health, hospice and home care agencies and 51 senior living communities located in Arizona, California, Colorado, Idaho, Iowa, Montana, Nevada, Oklahoma, Oregon, Texas, Utah, Washington, Wisconsin and Wyoming.

Certain of the Company’s subsidiaries, collectively referred to as the Service Center, provide accounting, payroll, human resources, information technology, legal, risk management, and other services to the operations through contractual relationships.

Each of the Company’s affiliated operations are operated by separate, independent subsidiaries that have their own management, employees and assets. References herein to the consolidated “Company” and “its” assets and activities are not meant to imply, nor should they be construed as meaning, that Pennant has direct operating assets, employees or revenue, or that any of the subsidiaries are operated by Pennant.

2. BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Basis of Presentation - The accompanying unaudited condensed consolidated financial statements of the Company (the “Interim Financial Statements”) reflect the Company’s financial position, results of operations and cash flows of the business. The Interim Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) and pursuant to the regulations of the Securities and Exchange Commission (“SEC”). Management believes that the Interim Financial Statements reflect, in all material respects, all adjustments which are of a normal and recurring nature necessary to present fairly the Company’s financial position, results of operations, and cash flows for the periods presented in conformity with GAAP. The results reported in these Interim Financial Statements are not necessarily indicative of results that may be expected for the entire year.

The Condensed Consolidated Balance Sheet as of December 31, 2022 is derived from the Company’s annual audited Consolidated Financial Statements for the fiscal year ended December 31, 2022, which should be read in conjunction with these Interim Financial Statements. Certain information in the accompanying footnote disclosures normally included in annual financial statements was condensed or omitted for the interim periods presented in accordance with GAAP.

All significant intercompany transactions and balances between the various legal entities comprising the Company have been eliminated in consolidation. The Company presents noncontrolling interests within the equity section of its Condensed Consolidated Balance Sheets and the amount of consolidated net income that is attributable to the Company and the noncontrolling interest in its Condensed Consolidated Statements of Income.

The Company consists of various limited liability companies and corporations established to operate home health, hospice, home care, and senior living operations. The Interim Financial Statements include the accounts of all entities controlled by the Company through its ownership of a majority voting interest.

Estimates and Assumptions - The preparation of the Interim Financial Statements in conformity with GAAP requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the Interim Financial Statements and the reported amounts of revenue and expenses during the reporting periods. The most significant estimates in the Interim Financial Statements relate to revenue, intangible assets and goodwill, right-of-use assets and lease liabilities for leases greater than 12 months, self-insurance reserves, and income taxes. Actual results could differ from those estimates.

CARES Act: The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) was enacted on March 27, 2020 in the United States. The CARES Act allowed for deferred payment of the employer-paid portion of social security taxes through the end of 2020, with 50% due on December 31, 2021 and the remainder due on December 31, 2022. The Company deferred approximately $7,836 of the employer-paid portion of social security taxes, all of which was repaid by December 31, 2022. The CARES Act also expanded the Centers for Medicare & Medicaid Services’ (“CMS”) ability to provide accelerated/advance payments intended to increase the cash flow of healthcare providers and suppliers impacted by COVID-19. During 2020, the Company applied for and received $27,997 in funds under the Accelerated and Advance Payment (“AAP”) Program, all of which was recouped as of June 23, 2022.
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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)



State relief funding. The Company receives state relief funding through programs from various states, including healthcare relief funding under the American Rescue Plan Act (ARPA), and other state specific relief programs. The funding generally incorporates specific use requirements primarily for direct patient care including labor related expenses that are attributable to the COVID-19 pandemic or are associated with providing patient care.

These funds are recognized as a reduction of cost of services expenses when related expenses are incurred. As of June 30, 2023 and December 31, 2022, the Company had $1,469 and $1,479 in unapplied state relief funds, respectively. The unapplied state relief funds received are recorded in other accrued liabilities. The Company recognized state relief funding totaling $1,397 and $2,082 for the three and six months ended June 30, 2023, respectively, and $584 and $1,246 for the three and six months ended June 30, 2022, respectively, which the Company recognized as a reduction of cost of services expense.

3. TRANSACTIONS WITH ENSIGN
On October 1, 2019, The Ensign Group, Inc. (“Ensign”) completed the separation of Pennant (the “Spin-Off”). Pennant and Ensign continue to partner in the provision of services along the healthcare continuum.

The Company incurred costs of $192 and $465 for the three and six months ended June 30, 2023, and $458 and $1,101 for the three and six months ended June 30, 2022, respectively, that related primarily to shared services at proximate operations.

Expenses related to room and board charges at Ensign skilled nursing facilities for hospice patients were $1,014 and $1,954 for the three and six months ended June 30, 2023, respectively, and $648 and $1,223 for the three and six months ended June 30, 2022, respectively, and are included in cost of services.

The Company’s independent operating subsidiaries leased 29 communities from subsidiaries of Ensign under a master lease arrangement as of June 30, 2023 and June 30, 2022. See further discussion below at Note 8, Leases.

On January 27, 2022, affiliates of the Company entered into certain operations transfer agreements (collectively, the “Transfer Agreements”) with affiliates of Ensign, providing for the transfer of the operations of five senior living communities (the “Transaction”). The Transfer Agreements required one of the transferors to place $6,500 in escrow to cover post-closing capital expenditures and operating losses related to one of the communities, and such escrow was funded by an initial payment by the transferor at closing followed by eight equal monthly installments. The Company recorded the amount in loss on asset dispositions and impairment, net during the three months ended June 2022. The Transaction closed in April 2022.

4. NET INCOME (LOSS) PER COMMON SHARE
Basic net income (loss) per share is computed by dividing net income (loss) attributable to stockholders of the Company by the weighted average number of outstanding common shares for the period. The computation of diluted net income (loss) per share is similar to the computation of basic net income (loss) per share except that the denominator is increased to include the number of additional common shares that would have been outstanding if the dilutive potential common shares had been issued.

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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


The following table sets forth the computation of basic and diluted net income (loss) per share for the periods presented:

Three Months Ended June 30,Six Months Ended June 30,
 2023202220232022
Numerator: 
Net income (loss) attributable to The Pennant Group, Inc.$2,797 $(2,676)$4,647 $(1,662)
Denominator:
Weighted average shares outstanding for basic net income per share29,809 28,605 29,780 28,589 
Plus: assumed incremental shares from exercise of options and assumed conversion or vesting of restricted stock(a)
384  391  
Adjusted weighted average common shares outstanding for diluted income per share30,193 28,605 30,171 28,589 
Earnings Per Share:
Basic net income (loss) per common share$0.09 $(0.09)$0.16 $(0.06)
Diluted net income (loss) per common share$0.09 $(0.09)$0.15 $(0.06)
(a)
The diluted per share amounts do not reflect common equivalent shares outstanding of 2,312 and 2,158 for the three and six months ended June 30, 2023, respectively, and 3,832 and 3,806 for the three and six months ended June 30, 2022, respectively, because of their anti-dilutive effect.
5. REVENUE AND ACCOUNTS RECEIVABLE
Revenue is recognized when services are provided to the patients at the amount that reflects the consideration to which the Company expects to be entitled from patients and third-party payors, including Medicare, Medicaid, Commercial and managed care programs (Medicare Advantage and Managed Medicaid plans), in exchange for providing patient care. The healthcare services in home health and hospice patient contracts include routine services in exchange for a contractual agreed-upon amount or rate. Routine services are treated as a single performance obligation satisfied over time as services are rendered. As such, patient care services represent a bundle of services that are not capable of being distinct within the context of the contract. Additionally, there may be ancillary services which are not included in the rates for routine services, but instead are treated as separate performance obligations satisfied at a point in time, if and when those services are rendered.

Revenue recognized from healthcare services are adjusted for estimates of variable consideration to arrive at the transaction price. The Company determines the transaction price based on contractually agreed-upon amounts or rates, adjusted for estimates of variable consideration. The Company uses the expected value method in determining the variable component that should be used to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net revenue only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net service revenue in the period such variances become known.

Combined revenue from the Medicare and Medicaid programs accounted for 62.8% and 62.4% of the Company’s revenue for the three and six months ended June 30, 2023, respectively, and 62.8% and 62.4% for the three and six months ended June 30, 2022, respectively. The Company records revenue from these governmental and managed care programs as services are performed at their expected net realizable amounts under these programs. The Company’s revenue from governmental and managed care programs is subject to audit and retroactive adjustment by governmental and third-party agencies. Consistent with healthcare industry accounting practices, any changes to these governmental revenue estimates are recorded in the period the change or adjustment becomes known based on final settlement.

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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


Disaggregation of Revenue

The Company disaggregates revenue from contracts with its patients by reportable operating segments and payors. The Company has determined that disaggregating revenue into these categories achieves the disclosure objectives to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors.

The Company’s service specific revenue recognition policies are as follows:

Home Health Revenue

Medicare Revenue

Net service revenue is recognized in accordance with the Patient Driven Groupings Model (“PDGM”). Under PDGM, Medicare provides agencies with payments for each 30-day payment period provided to beneficiaries. If a beneficiary is still eligible for care after the end of the first 30-day payment period, a second 30-day payment period can begin. There are no limits to the number of periods of care a beneficiary who remains eligible for the home health benefit can receive. While payment for each 30-day payment period is adjusted to reflect the beneficiary’s health condition and needs, a special outlier provision exists to ensure appropriate payment for those beneficiaries that have the most expensive care needs. The payment under the Medicare program is also adjusted for certain variables including, but not limited to: (a) a low utilization payment adjustment if the number of visits is below an established threshold that varies based on the diagnosis of a beneficiary; (b) a partial payment if the patient transferred to another provider or the Company received a patient from another provider before completing the period of care; (c) adjustment to the admission source of claim if it is determined that the patient had a qualifying stay in a post-acute care setting within 14 days prior to the start of a 30-day payment period; (d) the timing of the 30-day payment period provided to a patient in relation to the admission date, regardless of whether the same home health provider provided care for the entire series of episodes; (e) changes to the acuity of the patient during the previous 30-day payment period; (f) changes in the base payments established by the Medicare program; (g) adjustments to the base payments for case mix and geographic wages; and (h) recoveries of overpayments.

The Company adjusts Medicare revenue on completed episodes to reflect differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation and other reasons unrelated to credit risk. Therefore, the Company believes that its reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered.

In addition to revenue recognized on completed episodes and periods, the Company also recognizes a portion of revenue associated with episodes and periods in progress. Episodes in progress are 30-day payment periods that begin during the reporting period but were not completed as of the end of the period. As such, the Company estimates revenue and recognizes it on a daily basis. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per period of care or episode of care and the Company’s estimate of the average percentage complete based on the scheduled end of period and end of episode dates.

Non-Medicare Revenue

Episodic Based Revenue - The Company recognizes revenue in a similar manner as it recognizes Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs. These rates can vary based upon the negotiated terms.

Non-episodic Based Revenue - Revenue is recognized on an accrual basis based upon the date of service at amounts equal to its established or estimated per visit rates, as applicable.

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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


Hospice Revenue

Revenue is recognized on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are calculated as daily rates for each of the levels of care the Company delivers. Revenue is adjusted for an inability to obtain appropriate billing documentation or authorizations acceptable to the payor and other reasons unrelated to credit risk. Additionally, as Medicare hospice revenue is subject to an inpatient cap and an overall payment cap, the Company monitors its provider numbers and estimates amounts due back to Medicare if a cap has been exceeded. The Company regularly evaluates and records these adjustments as a reduction to revenue and an increase to other accrued liabilities.

Senior Living Revenue

The Company has elected the lessor practical expedient within ASC Topic 842, Leases and therefore recognizes, measures, presents, and discloses the revenue for services rendered under the Company’s senior living residency agreements based upon the predominant component, either the lease or non-lease component, of the contracts. The Company has determined that the services included under the Company’s senior living residency agreements each have the same timing and pattern of transfer. The Company recognizes revenue under ASC Topic 606, Revenue from Contracts with Customers for its senior residency agreements, for which it has determined that the non-lease components of such residency agreements are the predominant component of each such contract.

The Company’s senior living revenue consists of fees for basic housing and assisted living care. Accordingly, the Company records revenue when services are rendered on the date services are provided at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For residents under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered.

Revenue By Payor

Revenue by payor for the three months ended June 30, 2023 and 2022, is summarized in the following tables:

Three Months Ended June 30, 2023
Home Health and Hospice Services
Home Health ServicesHospice ServicesSenior Living ServicesTotal RevenueRevenue %
Medicare$23,920 $40,294 $ $64,214 48.5 %
Medicaid2,466 4,682 11,783 18,931 14.3 
Subtotal26,386 44,976 11,783 83,145 62.8 
Managed care15,837 1,417  17,254 13.1 
Private and other(a)
6,235 169 25,478 31,882 24.1 
Total revenue$48,458 $46,562 $37,261 $132,281 100.0 %
(a)Private and other payors in the Company’s home health and hospice services segment includes revenue from all payors generated in the Company’s home care operations.

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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


Three Months Ended June 30, 2022
Home Health and Hospice Services
Home Health ServicesHospice ServicesSenior Living ServicesTotal RevenueRevenue %
Medicare$23,464 $34,234 $ $57,698 49.6 %
Medicaid2,732 3,859 8,752 15,343 13.2 
Subtotal26,196 38,093 8,752 73,041 62.8 
Managed care14,260 1,153  15,413 13.3 
Private and other(a)
5,529 113 22,220 27,862 23.9 
Total revenue$45,985 $39,359 $30,972 $116,316 100.0 %
(a)Private and other payors in the Company’s home health and hospice services segment includes revenue from all payors generated in the Company’s home care operations.

Revenue by payor for the six months ended June 30, 2023 and 2022, is summarized in the following tables:

Six Months Ended June 30, 2023
Home Health and Hospice Services
Home Health ServicesHospice ServicesSenior Living ServicesTotal RevenueRevenue %
Medicare$47,296 $77,674 $ $124,970 48.3 %
Medicaid4,657 9,280 22,625 36,562 14.1 
Subtotal51,953 86,954 22,625 161,532 62.4 
Managed care31,769 2,611  34,380 13.3 
Private and other(a)
12,526 286 50,021 62,833 24.3 
Total revenue$96,248 $89,851 $72,646 $258,745 100.0 %
(a)Private and other payors in the Company’s home health and hospice services segment includes revenue from all payors generated in the Company’s home care operations.

Six Months Ended June 30, 2022
Home Health and Hospice Services
Home Health ServicesHospice ServicesSenior Living ServicesTotal RevenueRevenue %
Medicare$44,821 $67,955 $ $112,776 49.0 %
Medicaid5,238 7,124 18,375 30,737 13.4 
Subtotal50,059 75,079 18,375 143,513 62.4 
Managed care27,512 1,937  29,449 12.7 
Private and other(a)
11,066 166 46,032 57,264 24.9 
Total revenue$88,637 $77,182 $64,407 $230,226 100.0 %
(a)Private and other payors in the Company’s home health and hospice services segment includes revenue from all payors generated in the Company’s home care operations.

Balance Sheet Impact

Included in the Company’s Condensed Consolidated Balance Sheets are contract assets, comprised of billed accounts receivable and unbilled receivables, which are the result of the timing of revenue recognition, billings and cash collections, as well as, contract liabilities, which primarily represent payments the Company receives in advance of services provided.

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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


Accounts receivable, net as of June 30, 2023 and December 31, 2022 is summarized in the following table:

June 30, 2023December 31, 2022
Medicare$32,516 $31,321 
Medicaid13,216 10,700 
Managed care9,705 9,370 
Private and other2,772 2,621 
Accounts receivable, gross58,209 54,012 
Less: allowance for doubtful accounts(957)(592)
Accounts receivable, net$57,252 $53,420 

Concentrations - Credit Risk

The Company has significant accounts receivable balances, the collectability of which is dependent on the availability of funds from certain governmental programs, primarily Medicare and Medicaid. These receivables represent the only significant concentration of credit risk for the Company. The Company does not believe there are significant credit risks associated with these governmental programs. The Company believes that an appropriate allowance has been recorded for the possibility of these receivables proving uncollectible, and continually monitors and adjusts these allowances as necessary. The Company’s gross receivables from the Medicare and Medicaid programs accounted for approximately 78.6% and 77.8% of its total gross accounts receivable as of June 30, 2023 and December 31, 2022, respectively. Combined revenue from reimbursement under the Medicare and Medicaid programs accounted for 62.8% and 62.4% for the three and six months ended June 30, 2023, respectively, and 62.8% and 62.4% of the Company’s revenue for the three and six months ended June 30, 2022, respectively.

Practical Expedients and Exemptions

As the Company’s contracts have an original duration of one year or less, the Company uses the practical expedient applicable to its contracts and does not consider the time value of money. Further, because of the short duration of these contracts, the Company has not disclosed the transaction price for the remaining performance obligations as of the end of each reporting period or when the Company expects to recognize this revenue. In addition, the Company has applied the practical expedient provided by ASC 340, Other Assets and Deferred Costs, and all incremental customer contract acquisition costs are expensed as they are incurred because the amortization period would have been one year or less.

6. BUSINESS SEGMENTS
The Company classifies its operations into the following reportable operating segments: (1) home health and hospice services, which includes the Company’s home health, hospice and home care businesses; and (2) senior living services, which includes the operation of assisted living, independent living and memory care communities. The reporting segments are business units that offer different services and are managed separately to provide greater visibility into those operations. The Company’s Chief Executive Officer, who is the Company’s Chief Operating Decision Maker (“CODM”), reviews financial information at the operating segment level. The Company also reports an “all other” category that includes general and administrative expense from the Company’s Service Center.

As of June 30, 2023, the Company provided services through 101 affiliated home health, hospice and home care agencies, and 51 affiliated senior living operations. The Company evaluates performance and allocates capital resources to each segment based on an operating model that is designed to maximize the quality of care provided and profitability. The Company’s Service Center provides various services to all lines of business. The Company does not review assets by segment and therefore assets by segment are not disclosed below.

The CODM uses Segment Adjusted EBITDAR from Operations as the primary measure of profit and loss for the Company's reportable segments and to compare the performance of its operations with those of its competitors. Segment Adjusted EBITDAR from Operations is net income (loss) attributable to the Company's reportable segments excluding interest expense, provision for income taxes, depreciation and amortization expense, rent, and, in order to view the operations performance on a comparable basis from period to period, certain adjustments including: (1) costs at start-up operations, (2) share-based compensation, (3) acquisition related costs and credit allowances, (4) the costs associated with transitioning
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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


operations, (5) unusual, non-recurring or redundant charges, and (6) net income attributable to noncontrolling interest. General and administrative expenses are not allocated to the reportable segments, and are included as “All Other”, accordingly the segment earnings measure reported is before allocation of corporate general and administrative expenses. The Company's segment measures may be different from the calculation methods used by other companies and, therefore, comparability may be limited.
The following tables present certain financial information regarding the Company’s reportable segments, general and administrative expenses are not allocated to the reportable segments and are included in “All Other” for the three and six months ended June 30, 2023 and 2022:

Home Health and Hospice ServicesSenior Living ServicesAll OtherTotal
Three Months Ended June 30, 2023
Revenue$95,020 $37,261 $ $132,281 
Segment Adjusted EBITDAR from Operations$15,681 $11,680 $(7,885)$19,476 
Three Months Ended June 30, 2022
Revenue$85,344 $30,972 $ $116,316 
Segment Adjusted EBITDAR from Operations$15,728 $8,771 $(7,870)$16,629 

Home Health and Hospice ServicesSenior Living ServicesAll OtherTotal
Six Months Ended June 30, 2023
Revenue$186,099 $72,646 $ $258,745 
Segment Adjusted EBITDAR from Operations$30,093 $21,921 $(15,399)$36,615 
Six Months Ended June 30, 2022
Revenue$165,819 $64,407 $ $230,226 
Segment Adjusted EBITDAR from Operations$29,676 $18,203 $(16,016)$31,863 

The following table provides a reconciliation of Segment Adjusted EBITDAR from Operations to income from operations:

Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
Segment Adjusted EBITDAR from Operations$19,476 $16,629 $36,615 $31,863 
Less: Depreciation and amortization1,214 1,279 2,494 2,426 
Rent—cost of services9,836 9,078 19,433 19,129 
Other expense35 (35)65 (32)
Adjustments to Segment EBITDAR from Operations:
Less: Costs at start-up operations(a)
65 377 268 508 
Share-based compensation expense and related taxes(b)
1,354 2,380 2,773 4,820 
Acquisition related costs and credit allowances(c)
72 14 104 14 
Costs associated with transitioning operations(d)
538 6,691 585 5,934 
Unusual, non-recurring or redundant charges(e)
226 40 624 77 
Add: Net income attributable to noncontrolling interest125 80 272 224 
Condensed Consolidated Income (Loss) from Operations$6,261 $(3,115)$10,541 $(789)
(a)Represents results related to start-up operations. This amount excludes rent and depreciation and amortization expense related to such operations.
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THE PENNANT GROUP, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS - (Continued)


(b)
Share-based compensation expense and related payroll taxes incurred. Share-based compensation expense and related payroll taxes are included in cost of services and general and administrative expense.
(c)
Non-capitalizable costs associated with acquisitions and credit allowances for amounts in dispute with the prior owners of certain acquired operations.
(d)
During the six months ended June 30, 2023, an affiliate of the Company placed its memory care units into transition and is actively seeking to sublease the units to an unrelated third party. The amount above represents the net operating impact attributable to the units in transition. The amounts reported exclude rent and depreciation and amortization expense related to such operations and include legal settlement costs associated with one of the entities transitioned to Ensign.

During January 2022, affiliates of the Company entered into Transfer Agreements with affiliates of Ensign, providing for the transfer of the operations of certain senior living communities (the “Transaction”) from affiliates of the Company to affiliates of Ensign. The closing of the Transaction was completed in two phases with the transfer of two operations on March 1, 2022 and the remainder transferred on April 1, 2022. The amount above represents the net impact on revenue and cost of service attributable to all of the transferred entities. The amounts reported exclude rent and depreciation and amortization expense related to such operations.
(e)
Represents unusual or non-recurring charges for legal services, implementation costs, integration costs, and consulting fees in general and administrative expenses.

Costs identified as redundant or non-recurring incurred by the Company for additional services provided by Ensign. All amounts are included in general and administrative expense. Fees incurred were $192 and $465 for the three and six months ended June 30, 2023, respectively, and $458 and $1,101 for the three and six months ended June 30, 2022, respectively.

7. ACQUISITIONS
The Company is focused on acquiring operations that are complementary to the Company’s current businesses, accretive to the Company’s business or otherwise advance the Company’s strategy. The results of all the Company’s independent operating subsidiaries are included in the Interim Financial Statements subsequent to the date of acquisition. Acquisitions are accounted for using the acquisition method of accounting.

2023 Acquisitions

During the six months ended June 30, 2023, the Company expanded its operations with the addition of three home health agencies, one hospice agency, two home care agencies, and two senior living communities. In connection with the addition of the two senior living communities, the Company entered into a new long-term “triple-net” lease. A subsidiary of the Company entered into a separate operations transfer agreement with the prior operator of each acquired operation as part of each transaction.

The fair value of assets for two home health agencies , two home care agencies, and one hospice agency acquired were mostly concentrated in goodwill and intangible assets and as such, these transactions were classified as business combinations in accordance with ASC Topic 805, Business Combinations (“ASC 805”). The purchase price for the business combinations was $7,261, which consisted of equipment and other assets of $1,027, goodwill of $4,117, and indefinite-lived intangible assets of $2,012 related to Medicare and Medicaid licenses, and other intangible assets of $186 less assumed liabilities of $81. The Company anticipates that the total goodwill recognized will be fully deductible for tax purposes.

One home health agency acquired was a Medicare license and is considered an asset acquisition. The fair value of the home health license acquired was $210 and was allocated to indefinite-lived intangible assets.

There were no material acquisition costs that were expensed related to the business combinations during the six months ended June 30, 2023.

2022 Acquisitions

During the six months ended June 30, 2022, the Company expanded its operations with the addition of one home health agency. The purchase price for this home health acquisition was $775.

The fair value of assets for home health acquisitions was mostly concentrated in goodwill and intangible assets and as such, these transactions were classified as business combinations in accordance with ASC Topic 805. The purchase price for the business combinations was $775, which consisted of equipment and other assets of $11, goodwill of $520, and indefinite-lived intangible assets of $244 related to Medicare and Medicaid licenses. The Company anticipates that the total goodwill recognized will be fully deductible for tax purposes. There were no material acquisition costs that were expensed related to the business combinations during the six months ended June 30, 2022.

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8. PROPERTY AND EQUIPMENT—NET
Property and equipment, net consist of the following:

June 30, 2023December 31, 2022
Land$96 $96 
Building1,890 1,890 
Leasehold improvements19,670 18,759 
Equipment27,559 25,532 
Furniture and fixtures1,217 1,151 
50,432 47,428 
Less: accumulated depreciation(23,180)(20,807)
Property and equipment, net$27,252 $26,621 

Depreciation expense was $1,211 and $2,486 for the three and six months ended June 30, 2023, respectively, and $1,264 and $2,396 for the three and six months ended June 30, 2022, respectively.

The Company measures certain assets at fair value on a non-recurring basis, including long-lived assets, which are evaluated for impairment. Long-lived assets include assets such as property and equipment, operating lease assets and certain intangible assets. The inputs used to determine the fair value of long-lived assets in the impairment analysis are considered Level 3 measurements due to their subjective nature. Management has evaluated its long-lived assets and determined there was no impairment recorded during the three and six months ended June 30, 2023 and 2022.

9. GOODWILL AND OTHER INDEFINITE-LIVED INTANGIBLE ASSETS
The following table represents activity in goodwill by segment for the six months ended June 30, 2023:

Home Health and Hospice ServicesSenior Living ServicesTotal
December 31, 2022$75,855 $3,642 $79,497 
Additions4,117  4,117 
June 30, 2023$79,972 $3,642 $83,614 

Other indefinite-lived intangible assets consist of the following:

June 30, 2023December 31, 2022
Trade name$1,571 $1,385 
Medicare and Medicaid licenses59,454 57,232 
Total$61,025 $58,617 

No goodwill or intangible asset impairments were recorded during the three and six months ended June 30, 2023 and 2022.

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10. OTHER ACCRUED LIABILITIES
Other accrued liabilities consist of the following:

June 30, 2023December 31, 2022
Refunds payable$2,122 $2,244 
Deferred revenue1,819 1,592 
Resident deposits3,040 4,315 
Property taxes975 1,027 
Deferred state relief funds1,469 1,479 
Accrued self-insurance liabilities4,231 3,546 
Other2,524 2,481 
Other accrued liabilities$16,180 $16,684 

Refunds payable includes payables related to overpayments, duplicate payments and credit balances from various payor sources. Deferred revenue occurs when the Company receives payments in advance of services provided. Resident deposits include refundable deposits to residents.

11. DEBT
Long-term debt, net consists of the following:
June 30, 2023December 31, 2022
Revolving Credit Facility$60,500 $64,500 
Less: unamortized debt issuance costs(a)
(1,347)(1,608)
Long-term debt, net$59,153 $62,892 
(a)
Amortization expense for debt issuance costs was $130 and $261 for the three and six months ended June 30, 2023, respectively, and $130 and $260 for the three and six months ended June 30, 2022, respectively, and is recorded in interest expense, net on the Condensed Consolidated Statements of Income.

On February 23, 2021, Pennant entered into an amendment to its existing credit agreement (as amended, the “Credit Agreement”), which provides for an increased revolving credit facility with a syndicate of banks with a borrowing capacity of $150,000 (the “Revolving Credit Facility”). On June 12, 2023, Pennant entered into a second amendment to the Credit Agreement that modified the reference rate from LIBOR to Standard Overnight Financing Rate (“SOFR”). The interest rates applicable to loans under the Revolving Credit Facility are, at the Company’s election, either (i) Adjusted Term SOFR (as defined in the Credit Agreement) plus a margin ranging from 2.25% to 3.25% per annum or (ii) Base Rate plus a margin ranging from 1.25% to 2.25% per annum, in each case, based on the ratio of Consolidated Total Net Debt to Consolidated EBITDA (each, as defined in the Credit Agreement). In addition, Pennant pays a commitment fee on the undrawn portion of the commitments under the Revolving Credit Facility which ranges from 0.35% to 0.50% per annum, depending on the Consolidated Total Net Debt to Consolidated EBITDA ratio of the Company and its subsidiaries. The Company is not required to repay any loans under the Credit Agreement prior to maturity in 2026, other than to the extent the outstanding borrowings exceed the aggregate commitments under the Credit Agreement. As of June 30, 2023, the Company’s weighted average interest rate on its outstanding debt was 7.97%. As of June 30, 2023, the Company had available borrowing on the Revolving Credit Facility of $85,314, which is net of outstanding letters of credit of $4,186.

The fair value of the Revolving Credit Facility approximates carrying value, due to the short-term nature and variable interest rates. The fair value of this debt is categorized within Level 2 of the fair value hierarchy based on the observable market borrowing rates.

The Credit Agreement is guaranteed, jointly and severally, by certain of the Company’s independent operating subsidiaries, and is secured by a pledge of stock of the Company's material independent operating subsidiaries as well as a first lien on substantially all of each material operating subsidiary's personal property. The Credit Agreement contains customary covenants that, among other things, restrict, subject to certain exceptions, the ability of the Company and its independent operating subsidiaries to grant liens on their assets, incur indebtedness, sell assets, make investments, engage in acquisitions,
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mergers or consolidations, amend certain material agreements and pay certain dividends and other restricted payments. Financial covenants require compliance with certain levels of leverage ratios that impact the amount of interest. As of June 30, 2023, the Company was compliant with all such financial covenants.

12. OPTIONS AND AWARDS
Outstanding options and restricted stock awards of the Company were granted under the 2019 Omnibus Incentive Plan (the OIP) and Long-Term Incentive Plan (the LTIP”, and together with the OIP, the “Pennant Plans”).

Under the Pennant Plans, stock-based payment awards, including employee stock options, restricted stock awards (“RSA”), and restricted stock units (“RSU” and together with RSA, “Restricted Stock”) are issued based on estimated fair value. The following disclosures represent share-based compensation expense relating to employees of the Company’s subsidiaries and non-employee directors who have awards under the Pennant Plans.

Total share-based compensation expense for all Plans for the three and six months ended June 30, 2023 and 2022 was:

Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
Share-based compensation expense related to stock options$984 779 $1,834 $1,621 
Share-based compensation expense related to Restricted Stock180 1,502 357 3,021 
Share-based compensation expense related to Restricted Stock to non-employee directors139 99 479 178 
Total share-based compensation$1,303 $2,380 $2,670 $4,820 

In future periods, the Company estimates it will recognize the following share-based compensation expense for unvested stock options and unvested Restricted Stock as of June 30, 2023:

Unrecognized Compensation ExpenseWeighted Average Recognition Period
(in years)
Unvested Stock Options$12,296 3.5
Unvested Restricted Stock2,751 4.0
Total unrecognized share-based compensation expense$15,047 

On July 25, 2022 the Company modified certain outstanding RSUs granted to the former chief executive officer of the Company in connection with the Spin-off. All the RSUs had an original vesting date of October 1, 2022. The modification resulted in the forfeiture of 250 outstanding RSUs and accelerated the vesting on the remaining 943 RSUs from October 1, 2022 to July 31, 2022. The modification of the award resulted in a net reduction of share-based compensation expense related to the awards of $3,812 recorded in general and administrative expense in the third quarter of 2022.

Stock Options

Under the Pennant Plans, options granted to employees of the subsidiaries of Pennant generally vest over five years at 20% per year on the anniversary of the grant date. Options expire ten years after the date of grant.

The Company uses the Black-Scholes option-pricing model to recognize the value of stock-based compensation expense for share-based payment awards under the Plans. Determining the appropriate fair-value model and calculating the fair value of stock-based awards at the grant date requires considerable judgment, including estimating stock price volatility and expected option life. The Company develops estimates based on historical data and market information, which can change significantly over time.

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The fair value of each option is estimated on the grant date using a Black-Scholes option-pricing model with the following weighted average assumptions for stock options granted as of June 30:

Grant YearOptions GrantedRisk-Free Interest Rate
Expected Life(a)
Expected Volatility(b)
Dividend YieldWeighted Average Fair Value of Options
2023656 4.0 %6.541.6 % %$6.78 
2022298 2.2 %6.539.9 % %$6.60 
(a)
Under the midpoint method, the expected option life is the midpoint between the contractual option life and the average vesting period for the options being granted. This resulted in an expected option life of 6.5 years for the options granted.
(b)Because the Company’s equity shares have been traded for a relatively short period of time, expected volatility assumption was based on the volatility of related industry stocks.

The following table represents the employee stock option activity during the six months ended June 30, 2023:

Number of
Options
Outstanding
Weighted
Average
Exercise Price
Number of
Options Vested
Weighted
Average
Exercise Price
of Options
Vested
December 31, 20222,219 20.76 973 $16.90 
Granted656 14.03 
Exercised(63)7.18 
Forfeited(37)22.22 
Expired(34)20.13 
June 30, 20232,741 $19.29 1,054 $18.17 

Restricted Stock

A summary of the status of Pennant’s non-vested Restricted Stock, and changes during the six months ended June 30, 2023, is presented below:

Non-Vested Restricted StockWeighted Average Grant Date Fair Value
December 31, 2022418 $14.26 
Granted42 11.42 
Vested(78)12.53 
Forfeited(3)15.30 
June 30, 2023379 $14.29 

13. LEASES
The Company’s independent operating subsidiaries lease 51 senior living communities and its administrative offices under non-cancelable operating leases, most of which have initial lease terms ranging from 15 to 25 years. Most of these leases contain renewal options, most involve rent increases and none contain purchase options. The lease term excludes lease renewals because the renewal rents are not at a bargain, there are no economic penalties for the Company to renew the lease, and it is not reasonably certain that the Company will exercise the extension options. The Company’s independent operating subsidiaries leased 29 communities from subsidiaries of Ensign (the “Ensign Leases”) under a master lease arrangement as of June 30, 2023 and June 30, 2022. Each of the leases have an initial term of between 14 and 20 years from the lease commencement date. The total amount of rent expense included in rent - cost of services paid to subsidiaries of Ensign was $3,333 and $6,749 for the three and six months ended June 30, 2023, respectively, and $3,006 and $6,490 for the three and six months ended June 30, 2022, respectively. In addition to rent, each of the operating companies are required to pay the following: (1) all
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impositions and taxes levied on or with respect to the leased properties (other than taxes on the income of the lessor); (2) all utilities and other services necessary or appropriate for the leased properties and the business conducted on the leased properties; (3) all insurance required in connection with the leased properties and the business conducted on the leased properties; (4) all community maintenance and repair costs; and (5) all fees in connection with any licenses or authorizations necessary or appropriate for the leased properties and the business conducted on the leased properties.

Fourteen of the Company’s affiliated senior living communities, excluding the communities that are operated under the Ensign Leases (as defined herein), are operated under three separate master lease arrangements. Under these master leases, a breach at a single community could subject one or more of the other communities covered by the same master lease to the same default risk. Failure to comply with Medicare and Medicaid provider requirements is a default under several of the Company’s leases and master leases. With an indivisible lease, it is difficult to restructure the composition of the portfolio or economic terms of the master lease without the consent of the landlord.

As further described in Note 3, on January 27, 2022, affiliates of the Company entered into Transfer Agreements with affiliates of Ensign, providing for the transfer of the operations of five senior living communities. The closing of the Transaction was completed in two phases with the transfer of two operations on March 1, 2022 and the remainder transferred on April 1, 2022. As a result of the lease terminations, the Company reduced both the right of use assets and the lease liabilities by $42,515. Four of the terminated leases were part of a master lease agreement. As a result of the transferred leases being removed from the master lease arrangement, the remaining lease components under the master lease arrangement were modified which resulted in a net increase to the lease liability and ROU asset balance of $6,522 for the six months ended June 30, 2022.

On July 7, 2023 the Company modified one of its master leases, which included nine locations, with an unrelated party to extend the term of the master lease from September 30, 2035 to March 31, 2038.

The components of operating lease cost, are as follows:

Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
Operating Lease Costs:
Community Rent—cost of services$8,462 $7,837 $16,736 $16,626 
Office Rent—cost of services1,374 1,241 2,697 2,503 
Rent—cost of services$9,836 $9,078 $19,433 $19,129 
General and administrative expense$104 $74 $197 $155 
Variable lease cost (a)
$1,761 $1,298 $3,491 $2,873 
(a)
Represents variable lease cost for operating leases, which costs include property taxes and insurance, common area maintenance, and c