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Sabra to Expand its Relationship with Ensign and Avamere

Sabra Health Care REIT, Inc. (“Sabra”) (Nasdaq: SBRA) announced that it will transition the 24-property portfolio previously leased to North American Health Care, Inc. (“North American”) to two of Sabra’s existing tenants, The Ensign Group (“Ensign”) (Nasdaq: ENSG) and the Avamere Family of Companies (“Avamere”).

After giving effect to this transition, Ensign will become one of Sabra’s largest tenants, representing about 8% of Annualized Cash NOI, while Avamere will remain one of Sabra’s largest tenants, also accounting for roughly 8% of Annualized Cash NOI.

Sabra believes this transition represents a unique opportunity to improve the long-term value of this high-quality real estate portfolio, noting the enhanced credit profile that supports its rental income, highlighted by Ensign’s corporate guaranty and $5 billion equity market capitalization.

The transition of these facilities to Ensign operating companies and Avamere is expected to be completed by February 1, 2023 and remains subject to the completion of certain regulatory approvals and other closing conditions. Sabra expects to recognize a total of $14.7 million in revenue from these facilities during the fourth quarter through the end of the transition period, which approximates the rent Sabra would have received during this timeframe under the previous leases with North American.


  • Ensign will add 20 properties located in California to two master leases with Ensign operating companies with initial terms of 18 and 20 years, each with an accompanying corporate guarantee from The Ensign Group, Inc.
  • The initial annual rent attributable to the 20 properties will be $29.4 million, with CPI-based annual rent escalators not to exceed 2.5%
  • Avamere will add 4 properties located in Washington to its existing master lease, which includes 9 other properties in Washington, with an initial term of 13 years
  • The initial annual rent attributable to the 4 additional properties leased to Avamere will be $5.1 million, with an annual rent escalator of 2.75%
  • Pro-forma for this transition, EBITDARM coverage for the trailing twelve months ended June 30, 2022 on the 24 properties is 1.68X

Commenting on the news, Rick Matros, CEO and Chair of Sabra, said, "This is an opportunity to expand our relationship with Ensign, substantially improving the credit profile of our portfolio. Importantly, adding the four properties to Avamere’s existing Washington facilities enhances that portfolio as well, even more so after consideration of the recent increase in Washington’s Medicaid rates of nearly 20%."

Barry Port, Ensign’s Chief Executive Officer added, “We are honored that Sabra will be entrusting us with the operation of this portfolio and are very excited to expand our growing relationship with them. These California operations are a perfect fit with our existing footprint in one of our strongest and most mature markets. We look forward to working together with the outstanding leaders and teams already in place in these operations to build on the strong clinical and operational reputations they have earned in their communities.”

Also commenting on the announcement, Rick Miller, CEO of Avamere, stated “Sabra has been, and continues to be a valuable, highly regarded and collaborative partner to Avamere, our valued workforce, and our customers. We are eager to add Avamere’s unparalleled culture of quality patient centered care with the outstanding leadership and care teams at these newly acquired facilities. The North American portfolio represents the right geographic and strategic fit for Avamere in our growing Pacific Northwest footprint that aligns with our relationships with local hospitals and Med Advantage partners.”

About Sabra

Sabra Health Care REIT, Inc., a Maryland corporation, operates as a self-administered, self-managed real estate investment trust (a "REIT") that, through its subsidiaries, owns and invests in real estate serving the healthcare industry throughout the United States and Canada.

About Ensign(TM)

The Ensign Group, Inc.'s independent operating subsidiaries provide a broad spectrum of skilled nursing and senior living services, physical, occupational and speech therapies and other rehabilitative and healthcare services at 269 healthcare facilities in Arizona, California, Colorado, Idaho, Iowa, Kansas, Nebraska, Nevada, South Carolina, Texas, Utah, Washington and Wisconsin. More information about Ensign is available at

About Avamere

Founded in 1995 and based in Wilsonville, Oregon, the Avamere Family of Companies provides private duty, skilled home health, SNF at home and hospice services, independent, assisted living and memory care management, contract rehabilitation, skilled and transitional care facility operations, and mobile diagnostics, with a mission to enhance lives. Today Avamere’s diverse companies operate in over 300 locations across 20 states with over 10,000 employees. For more information, visit


This release contains “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. Any statements that do not relate to historical or current facts or matters are forward-looking statements. These statements may be identified, without limitation, by the use of “expects,” “believes,” “intends,” “should” or comparable terms or the negative thereof. Examples of forward-looking statements include all statements regarding the effects of the portfolio transition from North American to Ensign and Avamere, including the expected impact of the transition on the long-term value and credit profile of the portfolio and the expected timing of the transition.

Sabra’s actual results may differ materially from those projected or contemplated by the Company’s forward-looking statements as a result of various factors, including, among others, the risks and uncertainties found in its filings with the Securities and Exchange Commission, including in Part I, Item 1A of the Company’s Annual Report on Form 10-K for the year ended December 31, 2021. Sabra does not intend, and undertakes no obligation, to update any forward-looking information to reflect events or circumstances after the date of this release or to reflect the occurrence of unanticipated events, unless required by law to do so.


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