Advocat Announces 2009 Third Quarter Results

Revenue and Income Increased, and Fourth Quarter Dividend is Declared


BRENTWOOD, Tenn., Nov. 9, 2009 (GLOBE NEWSWIRE) -- Advocat Inc. (Nasdaq:AVCA) today announced its results for the third quarter and nine months ended September 30, 2009. A fourth quarter dividend of $0.05 per share was declared on November 3, 2009 and will be paid in January 2010 to shareholders of record on December 31, 2009.

Highlights for Third Quarter 2009

Key Highlights for the third quarter of 2009 compared to the third quarter of 2008 include the following:



 * Revenue increased 6.7% to $77.1 million in 2009 compared to
   $72.2 million in 2008.
 * Occupancy increased to 77.1% in 2009 compared to 75.3% in the
   third quarter of 2008 and 76.6% in the second quarter of 2009.
 * Medicare rates increased 4.4% compared to 2008 as a result of
   annual inflation adjustments and the acuity levels of Medicare
   patients in the Company's nursing centers.
 * Medicaid rates increased 5.4% in 2009 compared to 2008 as a
   result of rate increases in certain states, increasing patient
   acuity levels and provider tax increases.
 * Net income from continuing operations was $1.1 million in 2009
   up $0.7 million from 2008, or $0.18 per diluted common share
   compared to $0.10 per diluted common share in 2008.
 * Funds provided by operations were $3.0 million in 2009 compared
   to $2.3 million in the third quarter of 2008.

CEO Remarks

William R. Council, III, noted, "We continue to make steady progress in this difficult economic environment. I'm pleased that we have been able to increase occupancy in this difficult economy, and we are containing costs wherever possible. The renovated facilities are performing very well and we are adding sites to the program. Our new facility in Paris, Texas has done very well, with census increasing 28% since the opening in late August."

Mr. Council continued, "In the four years since we embarked upon a renovation program we have completed improvements on 12 nursing centers, and we continue to be pleased with the results of this program. For the third quarter of 2009 compared to the last twelve months prior to commencement of the renovation, the average return on investment for the eleven renovations completed prior to the beginning of the third quarter of 2009 was 41%. We are very pleased with the completion of the Brentwood Terrace replacement facility in Paris, Texas, with completion on time and under budget. The response the brand new state-of-the-art facility has generated as well as the community's support have been extremely gratifying."

Other Highlights for the Third Quarter 2009

Revenues increased to $77.1 million in 2009 from $72.2 million in 2008, an increase of $4.9 million, or 6.7%. This increase is primarily due to increased Medicaid rates in certain states, increased Medicaid census, and Medicare rate increases.

The following table summarizes key revenue and census statistics for continuing operations for each period:



                                                     Three Months Ended
                                                        September 30,
                                                      ----------------
                                                        2009     2008
                                                      -------  -------
 Skilled nursing occupancy                              77.1%    75.3%
 Medicare census as percent of total                    12.3%    12.6%
 Managed care census as percent of total                 1.2%     1.2%
 Medicare revenues as percent of total                  29.7%    30.4%
 Medicaid revenues as percent of total                  55.2%    54.5%
 Managed care revenue as percent of total                2.6%     2.4%
 Medicare average rate per day                        $402.69  $385.86
 Medicaid average rate per day                        $147.73  $140.19
 Managed care average rate per day                    $375.63  $338.39

The Company's average rate per day for Medicare Part A patients increased 4.4% in 2009 compared to 2008 as a result of annual inflation adjustments and the acuity levels of Medicare patients in its nursing centers, as indicated by RUG level scores, which were higher in 2009 than in 2008. The Company's average rate per day for Medicaid patients increased 5.4% in 2009 compared to 2008 as a result of rate increases in certain states, partially funded by increased provider taxes, and increasing patient acuity levels.

Key expense items for the third quarter include:



 * Operating expense increased to $61.8 million in 2009 from
   $58.3 million in 2008, an increase of $3.5 million, or 6.1%.
   Operating expense decreased to 80.2% of revenue in 2009,
   compared to 80.7% of revenue in 2008.
 * The largest component of operating expenses is wages, which
   increased to $37.4 million in 2009 from $35.6 million in 2008,
   an increase of $1.8 million, or 5.1%.  Wages increased primarily
   because of labor costs associated with increased census and
   patient acuity levels, competitive labor markets in most of the
   areas in which the Company operates and regular merit and
   inflationary raises for personnel (increase of approximately 1.6%
   for the period).
 * Cash expenditures for professional liability costs were
   $1.4 million in 2009 compared to $1.7 million for 2008.
 * Employee health insurance costs were approximately $0.8 million
   higher in 2009 compared to 2008, a 54.5% increase in costs.
 * Provider taxes increased approximately $0.7 million in 2009,
   primarily a result of new rate legislation in Florida.
 * Transition of residents and operations to the newly constructed
   Brentwood Terrace replacement facility and the increase in
   census at this new building resulted in approximately
   $0.2 million in increased operating costs for additional wages,
   maintenance, advertising and travel that are not expected to be
   incurred in future periods.
 * Bad debt expense was $0.3 million lower in 2009 compared to 2008.
 * General and administrative expense totaled $4.6 million in 2009
   and in 2008.  As a percentage of revenue, general and
   administrative expense decreased to 6.0% in 2009 from 6.4% in
   2008.

Funds provided by operations were $3.0 million in 2009 compared to $2.3 million in the third quarter of 2008; this improvement resulted primarily from the Company's operating income and revenue increases as a result of increased occupancy and average daily rate.

Revenue and Income Highlights for Nine Months

Revenue increased to $226.9 million in 2009 from $214.5 million in 2008, an increase of $12.4 million, or 5.8%. This increase is primarily due to increased Medicaid rates in certain states, Medicare rate increases, and increased Medicaid census, partially offset by the effects of lower Medicare census.

Income from continuing operations before income taxes was $4.0 million for nine months ended September 30, 2009 compared to $6.9 million for the same period in 2008. The major difference was attributable to professional liability expense which was $7.1 million in 2009 compared to $636,000 in 2008. The diluted income per common share from continuing operations was $0.38 and $0.71 for 2009 and 2008, respectively.

Replacement Facility

In August 2009, the Company completed construction of Brentwood Terrace, a new 119 bed nursing center, replacing an older facility. The daily census as of October 31, 2009 increased to 86 compared to 67 as of August 25, 2009, the day we moved into the facility, and Medicare census increased to 10 compared to 7. For the third quarter of 2009, average daily census increased to 72 compared to 37 for the second quarter of 2008, when we began construction, and Medicare average daily census increased to 8 compared to 3.

Facility Renovation Update

During 2005, Advocat began an initiative to complete strategic renovations of certain facilities to improve occupancy, quality of care and profitability. Management developed a plan to begin with those facilities with the greatest potential for benefit, and began the renovation program during the third quarter of 2005. As of September 30, 2009, renovation projects have been completed at eleven facilities, a twelfth was completed in the fourth quarter of 2009, and work has commenced on projects at two additional nursing centers, including a 15 bed expansion at one nursing center. Plans for additional renovation projects are in development.

A total of $15.6 million has been spent on the eleven completed renovations, with $10.0 million financed through Omega, $4.5 million financed with internally generated cash, and $1.1 million financed with long-term debt.

A table is included with this press release summarizing operating results at renovated nursing centers.

Conference Call Information

A conference call has been scheduled for Tuesday, November 10, 2009 at 9:00 A.M. Central time (10:00 A.M. Eastern time) to discuss third quarter 2009 results.

The conference call information is as follows:



 Date:             Tuesday, November 10, 2009
 Time:             9:00 A.M. Central, 10:00 A.M. Eastern
 Webcast Links:    www.streetevents.com
                   www.earnings.com
                   www.irinfo.com/avc

 Dial in numbers:  888-679-8033 (domestic) or
                   617-213-4846 (International)
 Passcode:         96156913

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

Please use the following link to pre-register and view important information about this conference call. Pre-registering is not mandatory, but is recommended as it will provide you immediate entry into the call and will facilitate the timely start of the call. Pre-registration takes only a few minutes and you may pre-register at any time, including up to and after the call start time. To pre-register, please go to:

https://www.theconferencingservice.com/prereg/key.process?key=PQECVX3VA

A replay of the conference call will be accessible two hours after its completion through November 17, 2009 by dialing 888-286-8010 (domestic) or 617-801-6888 (international) and entering passcode 96087248.

FORWARD-LOOKING STATEMENTS

The "forward-looking statements" contained in this release are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are predictive in nature and are frequently identified by the use of terms such as "may," "will," "should," "expect," "believe," "estimate," "intend," and similar words indicating possible future expectations, events or actions. These forward-looking statements reflect the Company's current views with respect to future events and present its estimates and assumptions only as of the date of this release. Actual results could differ materially from those contemplated by the forward-looking statements made herein. In addition to any assumptions and other factors referred to specifically in connection with such statements, other factors, many of which are beyond our ability to control or predict, could cause our actual results to differ materially from the results expressed or implied in any forward-looking statements including, but not limited to, our expected refinancing in the ordinary course of business our revolving line of credit coming due in August 2010, our ability to arrange appropriate financing and successfully construct and operate the replacement facility for the recently acquired facility in West Virginia, our ability to increase census at our renovated facilities, changes in governmental reimbursement, government regulation and health care reforms, any increases in the cost of borrowing under our credit agreements, our ability to comply with covenants contained in those credit agreements, the outcome of professional liability lawsuits and claims, our ability to control ultimate professional liability costs, the accuracy of our estimate of our anticipated professional liability expense, the impact of future licensing surveys, the outcome of regulatory proceedings alleging violations of laws and regulations governing quality of care or violations of other laws and regulations applicable to our business, our ability to control costs, changes to our valuation of deferred tax assets, changes in occupancy rates in our facilities, changing economic and competitive conditions, changes in anticipated revenue and cost growth, changes in the anticipated results of operations, the effect of changes in accounting policies as well as other risk factors detailed in the Company's Securities and Exchange Commission filings. The Company has provided additional information in its Annual Report on Form 10-K for the fiscal year ended December 31, 2008, as well as in its Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission, which readers are encouraged to review for further disclosure of other factors. These assumptions may not materialize to the extent assumed, and risks and uncertainties may cause actual results to be different from anticipated results. These risks and uncertainties also may result in changes to the Company's business plans and prospects. Advocat Inc. is not responsible for updating the information contained in this press release beyond the published date, or for changes made to this document by wire services or Internet services.

Advocat provides long term care services to patients in 50 skilled nursing centers, primarily in the Southeast and Southwest. For additional information about the Company, visit Advocat's web site: http://www.irinfo.com/avc.



                              ADVOCAT INC.
                 CONDENSED CONSOLIDATED BALANCE SHEETS
                            (In thousands)

                                                    Sept. 30, Dec. 31,
                                                      2009      2008
                                                    --------  --------
                                                  (Unaudited)
 ASSETS:
 Current Assets
  Cash and cash equivalents                         $ 12,126  $  7,598
  Receivables, net                                    25,290    23,503
  Current portion of note receivable                      --       466
  Deferred income taxes                                4,511     3,967
  Other current assets                                 4,347     3,345
                                                    --------  --------
   Total current assets                               46,274    38,879

 Property and equipment, net                          37,161    37,456
 Deferred income taxes                                13,768    13,899
 Note receivable, net                                     --     3,486
 Acquired leasehold interest, net                      9,860    10,149
 Other assets, net                                     2,728     3,040
                                                    --------  --------
 TOTAL ASSETS                                       $109,791  $106,909
                                                    ========  ========

 LIABILITIES AND SHAREHOLDERS' EQUITY:
 Current Liabilities
  Current portion of long-term debt                 $  3,567  $  2,238
  Trade accounts payable                               5,352     4,600
  Accrued expenses:
   Payroll and employee benefits                      10,884     9,545
   Current portion of self-insurance reserves          7,842     6,469
   Other current liabilities                           5,127     5,142
                                                    --------  --------
   Total current liabilities                          32,772    27,994
 Noncurrent Liabilities
  Long-term debt, less current portion                25,328    30,172
  Self-insurance reserves, less current portion       11,432    10,212
  Other noncurrent liabilities                        13,920    13,089
                                                    --------  --------
   Total noncurrent liabilities                       50,680    53,473
 PREFERRED STOCK                                       6,617     7,891

 SHAREHOLDERS' EQUITY                                 19,722    17,551
                                                    --------  --------
 TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY         $109,791  $106,909
                                                    ========  ========


                              ADVOCAT INC.
                      CONSOLIDATED INCOME STATEMENTS
                              (Unaudited)
                  (In thousands, except per share data)

                               For the Three Months For the Nine Months
                                Ended September 30, Ended September 30,
                                  2009      2008      2009      2008
                                --------  --------  --------  --------
 PATIENT REVENUES, NET          $ 77,058  $ 72,206  $226,867  $214,517
                                --------  --------  --------  --------
 EXPENSES:
  Operating                       61,824    58,297   179,452   169,832
  Lease                            5,869     5,753    17,430    17,203
  Professional liability             902       278     7,099       636
  General and administrative       4,618     4,642    13,992    13,848
  Depreciation and amortization    1,528     1,355     4,412     3,914
                                --------  --------  --------  --------
                                  74,741    70,325   222,385   205,433
                                --------  --------  --------  --------
 OPERATING INCOME                  2,317     1,881     4,482     9,084
                                --------  --------  --------  --------
 OTHER INCOME (EXPENSE):
  Foreign currency transaction
   gain                               --      (126)      191      (293)
  Other income                        --        --       549        --
  Interest income                      5        91       159       371
  Interest expense                  (456)     (692)   (1,423)   (2,226)
                                --------  --------  --------  --------
                                    (451)     (727)     (524)   (2,148)
                                --------  --------  --------  --------

 INCOME FROM CONTINUING
  OPERATIONS BEFORE INCOME TAXES   1,866     1,154     3,958     6,936

 PROVISION FOR INCOME TAXES         (727)     (480)   (1,519)   (2,452)
                                --------  --------  --------  --------
 NET INCOME FROM CONTINUING
  OPERATIONS                       1,139       674     2,439     4,484
 DISCONTINUED OPERATIONS:
  Operating loss, net of tax
   benefit of $6, $4, $9 and
   $23, respectively                  (7)       (4)      (14)      (35)
                                --------  --------  --------  --------

 NET INCOME                        1,132       670     2,425     4,449
 PREFERRED STOCK DIVIDENDS           (86)      (86)     (258)     (258)
                                --------  --------  --------  --------

 NET INCOME FOR COMMON STOCK    $  1,046  $    584  $  2,167  $  4,191
                                ========  ========  ========  ========

 NET INCOME PER COMMON SHARE:
  Per common share - basic
   Income from continuing
    operations                  $   0.19  $   0.10  $   0.38  $   0.74
   Loss from discontinued
    operations                     (0.01)       --        --        --
                                --------  --------  --------  --------
                                $   0.18  $   0.10  $   0.38  $   0.74
                                ========  ========  ========  ========
  Per common share - diluted
   Income from continuing
    operations                  $   0.18  $   0.10  $   0.38  $   0.71
   Loss from discontinued
    operations                        --        --        --        --
                                --------  --------  --------  --------
                                $   0.18  $   0.10  $   0.38  $   0.71
                                ========  ========  ========  ========

 COMMON STOCK DIVIDENDS DECLARED
  PER SHARE OF COMMON STOCK     $   0.10  $     --  $   0.10  $     --
                                ======================================

 WEIGHTED AVERAGE COMMON SHARES:
  Basic                            5,676     5,671     5,675     5,700
                                ========  ========  ========  ========
  Diluted                          5,747     5,859     5,742     5,919
                                ========  ========  ========  ========


                              ADVOCAT INC.
                      FUNDS PROVIDED BY OPERATIONS
                              (Unaudited)
                             (In thousands)


                                Three Months Ended   Nine Months Ended
                                   September 30,       September 30,
                                ------------------  ------------------
                                  2009      2008      2009      2008
                                --------  --------  --------  --------
 NET INCOME                     $  1,132  $    670  $  2,425  $  4,449
 Discontinued operations              (7)       (4)      (14)      (35)
                                --------  --------  --------  --------
 Net income from continuing
  operations                       1,139       674     2,439     4,484
  Adjustments to reconcile net
   income from continuing
   operations to funds provided
   by operations:
  Depreciation and amortization    1,528     1,355     4,412     3,914
  Provision for doubtful
   accounts                          357       661     1,798     1,684
  Deferred income tax provision
   (benefit)                          75       320      (413)      273
  Provision (benefit) for
   self-insured professional
   liability, net of cash
   payments                         (656)   (1,605)    2,459    (3,636)
  Stock-based compensation           162       234       556       645
  Amortization of deferred
   balances                           93       105       283       335
  Provision for leases in excess
   of cash payments                  324       454       978     1,371
  Noncash gain on settlement of
   contingent liability               --        --      (549)       --

  Other                               --        99      (232)      197
                                --------  --------  --------  --------
 FUNDS PROVIDED BY OPERATIONS   $  3,022  $  2,297  $ 11,731  $  9,267
                                ========  ========  ========  ========
 Reconciliation of funds
  provided by operations to
  cash flow from
  operating activities:
 Funds provided by operations   $  3,022  $  2,297  $ 11,731  $  9,267
 Changes in other assets and
  liabilities affecting
  operating activities:
 Receivables, net                   (629)     (283)   (3,585)    1,140
 Prepaid expenses and other
  assets                            (238)      558      (153)     (133)
 Trade accounts payable and
  accrued expenses                   369     1,854     1,564    (1,365)
                                --------  --------  --------  --------
 Net cash provided by operating
  activities of continuing
  operations                    $  2,524  $  4,426  $  9,557  $  8,909
                                ========  ========  ========  ========

Advocat provides financial measures using accounting principles generally accepted in the United States (GAAP) and using adjustments to GAAP (non-GAAP). These non-GAAP measures are not measurements under GAAP. These measurements should be considered in addition to, but not as a substitute for, the information contained in our financial statements prepared in accordance with GAAP. Funds Provided by Operations is defined as cash flow from operating activities before changes in other assets and liabilities affecting operating activities. Management believes that Funds Provided by Operations is an important measurement of the Company's performance because it eliminates the effect of actuarial assumptions on our professional liability reserves, includes the cash effect of professional liability payments, and does not include the effects of deferred tax benefit and other non-cash charges. Since the definition of Funds Provided by Operations may vary among companies and industries, it should not be used as a measure of performance among companies.



                              ADVOCAT INC.
                      SELECTED OPERATING STATISTICS
                           SEPTEMBER 30, 2009
                               (Unaudited)

                                           For the Three Months Ended
                                               September 30, 2009
                                          ----------------------------
                                          Skilled
                             As of        Nursing       Occupancy
                      September 30, 2009  Weighted       (Note 1)
                      ------------------  Average   ------------------
                      Licensed  Available  Daily    Licensed  Available
 Region                 Beds      Beds     Census     Beds      Beds
 ---------------------------------------------------------------------
 Alabama                   711       704       616     86.6%     87.5%
 Arkansas                1,311     1,183       968     73.8%     81.8%
 Florida                   502       462       396     78.9%     85.8%
 Kentucky (Note 4)         775       742       648     83.6%     87.4%
 Tennessee                 617       586       486     78.8%     83.0%
 Texas                   1,868     1,676     1,337     71.9%     80.7%
                      --------  --------  --------  --------  --------
 Total                   5,784     5,353     4,451     77.1%     83.4%
                      ========  ========  ========  ========  ========

                                      For the Three Months Ended
                                          September 30, 2009
                                --------------------------------------
                                                    Medicare  Medicaid
                                                    Room and  Room and
                                           2009 Q3    Board     Board
                                          Revenue   Revenue   Revenue
                                           ($ in       PPD       PPD
                                Medicare  millions)   2009      2009
 Region                       Utilization (Note 2)  (Note 3)  (Note 3)
 ---------------------------------------------------------------------
 Alabama                           13.3%  $   11.7  $ 409.30  $ 163.87
 Arkansas                          14.2%      16.1    377.55    144.97
 Florida                            8.5%       7.8    415.77    180.62
 Kentucky (Note 4)                 11.7%      12.5    412.72    172.69
 Tennessee                         14.2%       8.3    386.81    138.03
 Texas                             11.3%      20.4    421.32    121.22
                                --------  --------  --------  --------
 Total                             12.3%  $   76.8  $ 402.69  $ 147.73
                                ========  ========  ========  ========

 Note 1:  The number of "Licensed beds" is based on the licensed
          capacity of the facility. The Company has historically
          reported its occupancy based on licensed beds. The number of
          "Available Beds" represents "licensed beds" less beds removed
          from service. "Available beds" is subject to change based
          upon the needs of the facilities, including configuration of
          patient rooms and offices, status of beds (private,
          semi-private, ward, etc.) and renovations.

 Note 2:  Total revenue for regions excludes approximately $0.3 million
          of ancillary services and other revenue for the three month
          period ended September 30, 2009.

 Note 3:  These Medicare and Medicaid revenue rates include room and
          board revenues but do not include any ancillary revenues
          related to these patients.

 Note 4:  The Kentucky region includes nursing centers in Kentucky,
          West Virginia and Ohio.


                              ADVOCAT INC.
          SELECTED OPERATING STATISTICS OF RENOVATED FACILITIES
                           SEPTEMBER 30, 2009
                              (Unaudited)

                                                      Medicare Average
                                       Occupancy(1)    Daily Census
                                      Q3      LTM(2)    Q3      LTM(2)
   Renovation - Completion Date      2009     Prior    2009     Prior
 ---------------------------------------------------------------------
 1st  renovation  -  January 2006     85.8%    64.9%     12.9      8.1
 2nd  renovation  -  July 2006        71.3%    71.2%     14.1     12.3
 3rd  renovation  -  August 2006      66.4%    45.1%     10.3      5.3
 4th  renovation  -  October 2006     82.4%    71.9%      9.9      8.6
 5th  renovation  -  February 2007    65.8%    56.2%      9.9      8.0
 6th  renovation  -  April 2007       52.6%    47.5%      9.6     12.7
 7th  renovation  -  July 2007        86.4%    85.0%     13.4     17.4
 8th  renovation  -  January 2008     74.8%    50.9%     10.6      8.9
 9th  renovation  -  October 2008     86.6%    83.0%     17.2     17.2
 10th renovation  -  November 2008    87.1%    80.8%     14.9     12.2
 11th renovation  -  March 2009       63.2%    62.5%     11.3      7.0
                                    -------  -------  -------  -------
        Total                         74.7%    66.5%    134.1    117.7
                                    -------  -------  -------  -------

 (1)  Occupancy based on licensed beds.
 (2)  Last Twelve Months prior to commencement of construction.


            

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