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Extendicare REIT

exe.un · TSX Financial Services
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Ticker exe.un
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Sector Financial Services
Industry REIT - Healthcare Facilities
Employees 10,000+
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FY2019 Annual Report · Extendicare REIT
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Extendicare Inc. 
2019 ANNUAL REPORT

Board of Directors

executives

Alan D. Torrie GN, HR
NON-EXECUTIVE CHAIRMAN, CHAIR OF THE GOVERNANCE AND 
NOMINATING COMMITTEE

Norma Beauchamp INV, QR

Margery O. Cunningham A

Michael R. Guerriere
PRESIDENT AND CHIEF EXECUTIVE OFFICER

Sandra L. Hanington A, GN, QR
CHAIR OF THE QUALITY AND RISK COMMITTEE

Alan R. Hibben A, GN, INV
CHAIR OF AUDIT COMMITTEE

Donna E. Kingelin HR, QR
CHAIR OF THE HUMAN RESOURCES COMMITTEE

Samir Manji INV

Al Mawani A, HR, INV
CHAIR OF THE INVESTMENT COMMITTEE

COMMITTEES

A  Audit 
GN  Governance and Nominating 
HR  Human Resources 
INV  Investment 
QR  Quality and Risk

Michael R. Guerriere 
PRESIDENT AND CHIEF EXECUTIVE OFFICER

David E. Bacon 
SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER

John Toffoletto
SENIOR VICE PRESIDENT, CHIEF LEGAL OFFICER &  
CORPORATE SECRETARY

Leslie Sarauer
SENIOR VICE PRESIDENT AND CHIEF HUMAN RESOURCES OFFICER

Elaine E. Everson
VICE PRESIDENT, CORPORATE DEVELOPMENT

Jillian E. Fountain
VICE PRESIDENT, INVESTOR RELATIONS

Michael A. Harris
VICE PRESIDENT, LONG-TERM CARE OPERATIONS

Gary Loder
VICE PRESIDENT, EXTENDICARE ASSIST AND SGP PURCHASING 
PARTNER NETWORK

Mark Lugowski
VICE PRESIDENT, ESPRIT LIFESTYLE COMMUNITIES

Ali Mir
VICE PRESIDENT, PARAMED OPERATIONS

Tracey Mulcahy
VICE PRESIDENT, QUALITY, RISK AND INNOVATION

Prakash Patel
VICE PRESIDENT, FINANCE OPERATIONS

Mark Trenholm
VICE PRESIDENT, FINANCE

March 30, 2020

FELLOW EXTENDICARE SHAREHOLDERS,

We find ourselves in  
an extraordinary time,  
navigating the uncharted  
perils of a global pandemic.

The world is changing quickly at a pace and scale 
unimaginable only a few short weeks ago. Extendicare 
is on the front lines of the battle with the virus, with 
the protection and care of our residents, clients and 
staff our paramount priority. We have well honed 
procedures for infection control, practiced over many 
years protecting seniors from annual waves of influenza 
and other viral threats. These techniques are well suited 
to preventing the spread of COVID-19, and are deployed 
across our homes, communities and offices.

The pandemic is affecting our business in numerous 
ways. Our business volumes may be impacted as 
access to our homes and communities is restricted and 
non-essential home health care services suspended 
where prudent. At the same time, we are experiencing 
increases in demand as hospitals look to our homes, 
retirement communities and home health care services 
as a safe place to manage hospital patients as they 
endeavour to create greater capacity for COVID-19 
admissions. We are incurring additional costs as we use 
more masks, gloves and gowns, and incur greater staff 
absenteeism as they self-isolate when circumstances 
warrant. However, governments are making new 
funding announcements in an effort to mitigate the 
increased costs incurred in managing the virus and 
launching new programs to encourage virtual home 
health care, creating new opportunities to treat our 
clients at a distance. Also, we are seeing major volatility

in the labour market, which may impact recruiting, 
retention and engagement of staff both positively and 
negatively.

At this point, it is impossible to project the net impact  
of these changes on our business. That said, we have 
the benefit of being an essential service where over 90% 
of our business lines are government funded. Although 
it is hard to see how long this crisis will last and how it 
will end, our services will continue to be in high demand 
once the crisis passes. 

At Extendicare, we  
continue to be committed  
to helping people live better 
by delivering high quality 
care to Canada’s growing  
seniors’ population. 

We provide services directly to seniors across the 
continuum of care, ranging from home health care to 
retirement living and long-term care (LTC). We also use our 
proven expertise and experience to assist other LTC and 
retirement owners to operate their homes with particular 
focus on quality improvement, efficient operations, use of 
technology and cost-effective purchasing.

Extendicare’s business is underpinned by government 
revenue and a strong balance sheet. To drive improved 
performance and profitability, we constantly monitor 
industry advancements and adapt our operations to take 
advantage of new technology, adding new systems to 
improve performance and drive organic growth. 

In 2019, we continued to invest in our future and 
positioned Extendicare for long-term success. Our long-
term care operations continued to deliver high quality 
care for seniors. Occupancy in our LTC homes averaged 

over 97% in 2019, generating more than half our total 
revenue and delivering stable margins. 

On the home health care front, we made significant 
progress in transforming our ParaMed home health care 
operations through a $12 million investment in cloud-
based software. While these costs put pressure on our 
2019 home health care margins, they set us up for the 
future by creating capacity for growth and put ParaMed 
at the forefront of the home health care industry. 

Our retirement living business performed strongly in 
2019, with brisk lease up activity in our newly added and 
expanded communities. Since November 2018 we have 
added 281 new suites with the expansion of Douglas 
Crossing, and the opening of two new communities, 
Bolton Mills and The Barrieview. 

Our B2B services are also an important part of our 
growth strategy. In 2019, we continued to grow this high 
margin segment of our business, most notably through 
a 27% increase in the number of beds served by our 
SGP Purchasing Partner Network.

Looking forward, as the COVID-19 challenge recedes, 
we see growth opportunities across all segments of 
our business. The number of seniors aged 75 or over in 
Canada is expected to grow at 4% per year, putting even 
more strain on our already stretched health care system. 
Expansion of home health care and long-term care will 
be essential to avoid overwhelming the acute health 
care system with services that can be provided more 
effectively in the community setting. 

The Ontario government understands the importance 
of adding new beds and redeveloping existing beds 
to address the growing need for services. We are 
working closely with the government to advance 
the redevelopment program. Extendicare has 21 
redevelopment projects that are well positioned to play 
a meaningful part in addressing the shortage of senior 
care beds in Ontario. 

B2C: DIRECT SERVICES TO SENIORS

B2B: CONTRACT & CONSULTING SERVICES

LONG TERM  
CARE

HOME  
HEALTH CARE

RETIREMENT  
LIVING

GROUP PURCHASING  
SERVICES

CONTRACT SERVICES  
& CONSULTING

58Long-term care  

centres owned

>9M

Home Health Care  
hours delivered (TTM)

11Retirement

communities owned

>71K

Third-party
residents served

53Homes under  

contract

With our ParaMed transformation substantially 
complete, we expect to fully participate in the growing 
seniors market with increased volume of care hours and 
improving margins. As the healthcare industry evolves, 
we expect to see increased integration and collaboration 
between home health care providers and doctors and 
hospitals. As the only home health care provider with 
scale and a cloud-based technology platform, our 
ability to provide integrated care services is a strategic 
advantage that positions us well to respond quickly to 
market opportunities as they arise. 

Continued lease up of our new retirement communities 
and the planned expansion in Port Hope will contribute 
strongly to our overall performance.

Our well-established processes and scale can provide 
valuable assistance to smaller service providers through 
our B2B offerings. We expect to continue to develop 
opportunities to grow SGP and Extendicare Assist 
through additional services and product offerings and 
by expanding the geographic reach of our sales team.

We are building a strong 
foundation to drive growth 
and shareholder value. 

Extendicare is well positioned to provide high quality 
care to Canada’s growing seniors’ population. 

In closing, WE want to  
pay tribute to our 22,000  
team members across the  
country who are going 
above and beyond during 
this difficult time to care 
for those who depend on us. 

While we are completely focused on addressing 
the COVID-19 challenge in the near term, we remain 
confident in our future. Once we emerge from this crisis, 
demographic tailwinds and the investments we have 
made in our business will provide a variety of future 
growth opportunities. As a leader in the industry, we 
will play an important part in improving the accessibility 
of seniors’ care services. Our focus on helping people 
live better will drive sustainable value creation for 
Extendicare’s shareholders for years to come.

Their dedication and commitment to the Extendicare 
mission sets an example for all of us to do everything 
in our power to protect our neighbours, our families 
and our way of life. We are also grateful to our advisors, 
business partners and Board of Directors for their 
tireless efforts in support of Extendicare and its mission.

Dr. Michael Guerriere 
PRESIDENT & CEO

Alan Torrie 
CHAIRMAN

MANAGEMENT’S DISCUSSION AND ANALYSIS 

Year ended December 31, 2019 

Extendicare Inc. 
Dated:  February 27, 2020 

 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
Management’s Discussion and Analysis 

Year ended December 31, 2019 
Dated:  February 27, 2020 

TABLE OF CONTENTS    
Basis of Presentation ........................................................... 1 
Additional Information ........................................................ 2 
Forward-looking Statements ............................................... 2 
Non-GAAP Measures ......................................................... 3 
Business Strategy ................................................................ 4 
Significant 2019 Events and Developments ........................ 5 
  Changes Affecting Results ......................................... 32 
Business Overview .............................................................. 6 
  Related Party Transactions .............................................. 35 
Key Performance Indicators .............................................. 10 
Select Annual Information ................................................ 13 
  Risks and Uncertainties ................................................... 35 
Select Quarterly Financial Information ............................. 14     Accounting Policies and Estimates ................................. 44 

  2019 Fourth Quarter Financial Review ........................... 15 
  2019 Financial Review.................................................... 19 
  Adjusted Funds from Operations .................................... 24 
  Liquidity and Capital Resources ..................................... 26 
  Other Contractual Obligations and Contingencies .......... 30 
  Update of Regulatory and Funding 

BASIS OF PRESENTATION  

This Management’s Discussion and Analysis (MD&A) provides information on Extendicare Inc. and its subsidiaries, and 
unless the context otherwise requires, references to “Extendicare”, the “Company”, “we”, “us” and “our” or similar terms 
refer to Extendicare Inc., either alone or together with its subsidiaries. The Company’s common shares (the “Common 
Shares”) are listed on the Toronto Stock Exchange (TSX) under the symbol “EXE”. The registered office of Extendicare is 
located at 3000 Steeles Avenue East, Suite 700, Markham, Ontario, Canada, L3R 9W2. 

The Company and its predecessors have been in operation since 1968, helping Canadians live better through a commitment 
to quality care. The Company is the largest private-sector operator of long-term care homes in Canada and we believe is the 
largest private-sector provider of publicly funded home health care services in Canada through its wholly owned subsidiary 
ParaMed Inc. (ParaMed). In addition, the Company owns and operates retirement communities under the Esprit Lifestyle 
Communities brand, provides contract services and consulting to third-party long-term care (LTC) homes and retirement 
communities through its Extendicare Assist division and provides group purchasing services to third-party clients through 
its SGP Purchasing Partner Network (SGP) division. The Company’s qualified and highly trained workforce of 
approximately 22,000 individuals is passionate about providing high quality services to help people live better.  

The Company has prepared this MD&A to provide information to current and prospective investors of the Company to 
assist them to understand the Company’s financial results for the year ended December 31, 2019. This MD&A should be 
read in conjunction with the Company’s audited consolidated financial statements for the year ended 2019 and 2018, and 
the notes thereto, prepared in accordance with International Financial Reporting Standards (IFRS). The annual and interim 
MD&A, financial statements and notes thereto are available on the Company’s website at www.extendicare.com. All 
currencies are in Canadian dollars unless otherwise indicated. Except as otherwise specified, references to years indicate the 
fiscal year ended December 31, 2019, or December 31 of the year referenced. 

The discussion and analysis in this MD&A are based upon information available to management as of February 27, 2020. 
This MD&A should not be considered all-inclusive, as it excludes changes that may occur in general economic, political 
and environmental conditions. Additionally, other events may or may not occur, which could affect the Company in the 
future. 

Effective January 1, 2019, the Company adopted IFRS 16 “Leases”, as described under “Accounting, Policies and 
Estimates – New Accounting Policies Adopted”. The Company has applied IFRS 16 using the modified retrospective 
approach, under which the comparative information presented has not been restated and continues to be reported under 
International Accounting Standard (IAS) 17 “Leases”. Certain practical expedients were selected on transition. The 
transition did not result in any retrospective adjustment to opening retained earnings on January 1, 2019.  

Lease costs for the prior year have been reclassified under administrative costs to conform with the current year 
presentation. The impact of adopting this standard on net earnings and overall cash flow is neutral; however, the principal 
payment of the lease liabilities is presented in financing activities (previously reflected as operating activities). 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

1 

 
 
   
 
 
 
  
 
 
 
 
 
 
In connection with the adoption of IFRS 16, the Company has amended its definition of funds from operations (FFO) by 
including a deduction for “depreciation for office leases”. As a result, the impact of the adoption of IFRS 16 on the 
determination of FFO and adjusted funds from operations (AFFO) is not material.  

ADDITIONAL INFORMATION 

Additional information about the Company, including its latest Annual Information Form, may be found on SEDAR’s 
website at www.sedar.com under the Company’s issuer profile and on the Company’s website at www.extendicare.com. 
A copy of this and other public documents of the Company are available upon request to the Corporate Secretary of the 
Company. 

FORWARD-LOOKING STATEMENTS 

Information provided by the Company from time to time, including in this Annual Report, contains or may contain 
forward-looking statements concerning anticipated future events, results, circumstances, economic performance or 
expectations with respect to the Company, including, without limitation:  statements regarding its business operations, 
business strategy, growth strategy, results of operations and financial condition; statements relating to the expected annual 
revenue, net operating income yield (NOI Yield) to be derived from development projects and AFFO to be derived from 
acquisitions and development projects; and statements relating to indemnification provisions in respect of disposed 
operations. Forward-looking statements can be identified by the expressions “anticipate”, “believe”, “estimate”, “expect”, 
“intend”, “objective”, “plan”, “project”, “will” or other similar expressions or the negative thereof. These forward-looking 
statements reflect the Company’s current expectations regarding future results, performance or achievements and are based 
upon information currently available to the Company and on assumptions that the Company believes are reasonable.  

Although forward-looking statements are based upon estimates and assumptions that the Company believes are reasonable 
based upon information currently available, these statements are not representations or guarantees of future results, 
performance or achievements of the Company and are inherently subject to significant business, economic and competitive 
uncertainties and contingencies. In addition to the assumptions and other factors referred to specifically in connection with 
these forward-looking statements, the risks, uncertainties and other factors that could cause the actual results, performance 
or achievements of the Company to differ materially from those expressed or implied by the forward-looking statements, 
include, without limitation, the following:  changes in the overall health of the economy and changes in government; the 
ability of the Company to attract and retain qualified personnel; changes in the health care industry in general and the long-
term care industry in particular because of political, legal and economic influences; changes in applicable accounting 
policies; changes in regulations governing the health care and long-term care industries and the compliance by the 
Company with such regulations; changes in government funding levels for health care services; the ability of the Company 
to renew its government licenses and customer contracts; changes in labour relations and costs; changes in tax laws; 
resident care and class action litigation, including the Company’s exposure to punitive damage claims, increased insurance 
costs and other claims; the ability of the Company to maintain and increase resident occupancy levels and business 
volumes; changes in competition; changes in demographics and local environment economies; changes in foreign exchange 
and interest rates; changes in the financial markets, which may affect the ability of the Company to refinance debt; and the 
availability and terms of capital to the Company to fund capital expenditures and acquisitions; changes in the anticipated 
outcome and benefits of dispositions, acquisitions and development projects, including risks relating to completion; and 
those other risks, uncertainties and other factors identified in the Company’s other public filings with the Canadian 
securities regulators available on SEDAR’s website at www.sedar.com under the Company’s issuer profile.  

The forward-looking statements contained in this Annual Report are expressly qualified by this cautionary statement. Given 
these risks and uncertainties, readers are cautioned not to place undue reliance on the forward-looking statements of the 
Company. The forward-looking statements speak only as of the date of this Annual Report. Except as required by 
applicable securities laws, the Company assumes no obligation to update or revise any forward-looking statements, whether 
as a result of new information, future events or otherwise. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

2 

 
  
 
 
 
  
 
 
 
NON-GAAP MEASURES  

The Company assesses and measures operating results and financial position based on performance measures referred to as 
“net operating income”, “net operating income margin”, “EBITDA”, “Adjusted EBITDA”, “Adjusted EBITDA margin”, 
“earnings before depreciation, amortization, and other expense”, “earnings (loss) from continuing operations before 
separately reported items, net of taxes”, “Funds from Operations” and “Adjusted Funds from Operations”. These measures 
are commonly used by the Company and its investors as a means of assessing the performance of the core operations in 
comparison to prior periods. They are presented by the Company on a consistent basis from period to period, thereby 
allowing for consistent comparability of its operating performance. In addition, the Company assesses its return on 
investment in development activities using the non-GAAP financial measure “NOI Yield”. These measures are not 
recognized under GAAP and do not have standardized meanings prescribed by GAAP. These non-GAAP measures are 
presented in this document because either:  (i) management believes that they are a relevant measure for users of the 
Company’s financial statements to assess the Company’s operating performance and ability to pay cash dividends; or 
(ii) certain ongoing rights and obligations of the Company may be calculated using these measures. Such non-GAAP 
measures may differ from similar computations as reported by other issuers, and accordingly, may not be comparable to 
similarly titled measures as reported by such issuers. They are not intended to replace earnings (loss) from continuing 
operations, net earnings (loss), cash flow, or other measures of financial performance and liquidity reported in accordance 
with GAAP.  

References to “net operating income”, or “NOI”, in this document are to revenue less operating expenses, and this value 
represents the underlying performance of the operating business segments. References to “net operating income margin” 
are to net operating income as a percentage of revenue.  

References to “EBITDA” in this document are to earnings (loss) from continuing operations before net finance costs, 
income taxes, depreciation and amortization. References to “Adjusted EBITDA” in this document are to EBITDA adjusted 
to exclude the line item “other expense”, and as a result, is equivalent to the line item “earnings before depreciation, 
amortization, and other expense” reported on the consolidated statements of earnings. References to “Adjusted EBITDA 
Margin” are to Adjusted EBITDA as a percentage of revenue. Management believes that certain lenders, investors and 
analysts use EBITDA, Adjusted EBITDA and Adjusted EBITDA margin to measure a company’s ability to service debt 
and meet other payment obligations, and as a common valuation measurement.  

References to “earnings (loss) from continuing operations before separately reported items, net of tax” in this document 
are to earnings (loss) from continuing operations, excluding the following separately reported line items:  “foreign 
exchange and fair value adjustments” and “other expense”. These line items are reported separately and excluded from 
certain performance measures, because they are transitional in nature and would otherwise distort historical trends. They 
relate to the change in the fair value of or gains and losses on termination of convertible debentures and interest rate 
agreements, as well as gains or losses on the disposal or impairment of assets and investments, and foreign exchange gains 
or losses on capital items. In addition, these line items may include acquisition related costs, restructuring charges, proxy 
related costs and the write-off of unamortized deferred financing costs on early retirement of debt. The above separately 
reported line items are reported on a pre-tax and on an after-tax basis as a means of deriving earnings (loss) from operations 
and related earnings per share excluding such items.  

“Funds from Operations”, or “FFO”, is defined as Adjusted EBITDA less depreciation for furniture, fixtures, equipment 
and computers, or “depreciation for FFEC”, depreciation for office leases, accretion costs, net interest expense and current 
income taxes. Depreciation for FFEC is considered representative of the amount of maintenance (non-growth) capital 
expenditures, or “maintenance capex”, to be used in determining “Funds from Operations”, as the depreciation term is 
generally in line with the life of these assets. FFO is a recognized earnings measure that is widely used by public real estate 
entities, particularly by those entities that own and/operate income-producing properties. Management believes that certain 
investors and analysts use FFO, and as such has included FFO to assist with their understanding of the Company’s 
operating results.  

“Adjusted Funds from Operations”, or “AFFO”, is defined as FFO plus:  i) the reversal of non-cash deferred financing and 
accretion costs; ii) the reversal of non-cash share-based compensation; iii) the principal portion of government capital 
funding; iv) amounts received from income support arrangements; and v) the reversal of income or loss of the captive 
insurance company that was included in the determination of FFO, as those operations are funded through investments held 
for U.S. self-insured liabilities, which are not included in the Company’s reported cash and short-term investments. In 
addition, AFFO is further adjusted to account for the difference in total maintenance capex incurred from the amount 
deducted in the determination of FFO. Since the Company’s actual maintenance capex spending fluctuates on a quarterly 
basis with the timing of projects and seasonality, the adjustment to AFFO for these expenditures from the amount of 
depreciation for FFEC already deducted in determining FFO, may result in an increase to AFFO in the interim periods 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

3 

 
 
 
 
 
 
reported. Management believes that AFFO is a relevant measure of the ability of the Company to earn cash and pay cash 
dividends to shareholders.  

Both FFO and AFFO are subject to other adjustments, as determined by management in its discretion, that are not 
representative of the Company’s operating performance.  

References to “payout ratio” in this document are to the ratio of dividends declared per share to AFFO per basic share. 

References to “NOI Yield” in this document are to a financial measure used by the Company to assess its return on 
investment in development activities. NOI Yield is defined by the Company as the estimated stabilized NOI of a 
development property in the first year it achieves expected stabilized occupancy divided by the estimated Adjusted 
Development Costs, as defined below. Management believes that this is a relevant measure of the Company’s total 
economic return of a development project. 

“Adjusted Development Costs” is defined as development costs on a GAAP basis (which includes the cost of land, hard 
and soft development costs, furniture, fixtures and equipment) plus/minus cumulative net operating losses/earnings 
generated by the development property prior to achieving expected stabilized occupancy, plus an estimated imputed cost 
of capital during the development period through to the expected stabilized occupancy.  

Reconciliations of “earnings (loss) from continuing operations before income taxes” to “Adjusted EBITDA” and “net 
operating income” are provided under “Select Quarterly Financial Information”, “2019 Fourth Quarter Financial Review” 
and “2019 Financial Review”. 

Reconciliations of “earnings from continuing operations” to “FFO” and “AFFO” are provided under “Adjusted Funds from 
Operations”. 

Reconciliations of “net cash from operating activities” to “AFFO” are provided under “Adjusted Funds from Operations – 
Reconciliation of Net Cash from Operating Activities to AFFO”.  

BUSINESS STRATEGY  

Our vision is to be the leading provider of care and services to seniors in Canada. We strive to provide quality, person-
centred care through compassionate caregivers across the continuum of care – offering the services seniors need wherever 
they need it as they age and their care needs change – and to be an employer of choice in the communities in which we 
operate.  

Our LTC business provides high quality care in the homes we own and operate across the country. Capital investment is 
focused on redeveloping our older LTC homes in the portfolio that will proceed when the economics are favourable. We 
also provide contract services and consulting to a growing list of third-party LTC homes and retirement communities 
through our Extendicare Assist division. Both our operations and our Extendicare Assist clients are supported by our SGP 
Purchasing Partner Network division. We intend to continue to grow our third-party services offerings to gain market share 
and capitalize on the organic growth in the Canadian seniors care market.   

Our core long-term care services are complemented by a market leading home health care platform operating under the 
ParaMed brand. Demand for home care is growing in tandem with the aging of the population, trending at an average 
market growth of 4% per year, according to Statistics Canada. Strategic investments in systems and processes are designed 
to enable volume growth in line with the market, while improving efficiency and resulting profitability.  

Our private-pay retirement business operates under the Esprit Lifestyle Communities brand. We continue to grow Esprit 
through new developments and expansions in secondary markets where supply and demand dynamics are favourable.  

We are continually enhancing our operations to provide excellent care to the growing number of Canadian seniors. These 
enhancements broaden the range of services available to seniors, while driving improved profitability and greater 
diversification for the Company. We believe that the effective execution of this strategy will provide an appropriate and 
consistent return to our shareholders who have demonstrated their belief in our mission by investing in the Company. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

4 

 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
SIGNIFICANT 2019 EVENTS AND DEVELOPMENTS  

Completed Projects  

In October 2019, the Company opened and welcomed its first residents to The Barrieview, its 124-suite retirement living 
community in Barrie, Ontario, offering 78 independent living (IL) suites, 23 assisted living (AL) suites and 23 memory care 
(MC) suites. Based on the strong pre-sale activity and initial occupancy experienced at The Barrieview, management is 
projecting achieving stabilized occupancy of 95% by the end of 2020, earlier than originally anticipated. Management 
estimates the Adjusted Development Costs for this project to be $35.4 million, with an estimated stabilized annual NOI of 
$3.1 million and a corresponding NOI Yield of 8.7%. 

Projects under Development  

The Company is undertaking a 59-suite expansion of Empire Crossing Retirement Community (63 suites) in Port Hope, 
Ontario that is anticipated to break ground in the second quarter of 2020. The project includes enhancements and upgrades 
of the common amenities, which together with the efficiencies of operating a larger community, are anticipated to generate 
incremental revenue and costs savings. Management estimates the Adjusted Development Costs for this project to be 
$24.9 million, with an expected stabilized occupancy of the 122-suite retirement community of 95% and an estimated 
incremental stabilized annual NOI of $2.0 million.  

The Company continues to pursue the redevelopment of its 21 Class C LTC homes in Ontario in terms of pre-construction 
activities. Management is working closely with the Ontario government and the Ontario Long Term Care Association (the 
“OLTCA”) to improve the building program, including potential changes to the application and licensing process and the 
capital funding subsidy required to advance our projects. Management believes that the Ontario government is well aware 
of the critical state of long-term care and the pressing need for additional LTC beds, as discussed further under “Update of 
Regulatory and Funding Changes Affecting Results – Ontario LTC Redevelopment and Expansion”.  

Financing Activity 

In April 2019, the Company secured a Canadian Mortgage and Housing Corporation (CMHC) insured mortgage in the 
amount of $16.0 million, inclusive of fees, on Lynde Creek Manor Retirement Community that had been acquired in April 
2018. The mortgage carries a fixed rate of 2.81% per annum, maturing in September 2029. 

In June 2019, the Company renewed its corporate head office lease for a term of 10 years with renewal options, resulting in 
the recognition of a right-of-use asset and lease liability of $10.3 million, in accordance with IFRS 16. 

In October 2019, the Company refinanced its construction loan in the amount of $9.0 million on Cedar Crossing Retirement 
Community that had opened in November 2016, with a CMHC-insured mortgage in the amount of $9.3 million, inclusive 
of fees, that matures in September 2029 and carries a fixed rate of 2.49% per annum.  

ParaMed – Bill 148 Funding Update  

In June 2019, the Company received confirmation from the Local Health Integration Networks (LHINs) of the amount of 
additional funding they would provide to offset increased costs associated with Bill 148, the Fair Workplaces, Better Jobs 
Act, 2017 (Ontario) in 2018. The incremental funding was in excess of that estimated by the Company for the period ended 
December 31, 2018, resulting in a $2.2 million increase in revenue recorded in the three months ended June 30, 2019. For 
further information, refer to the discussion under “Update of Regulatory and Funding Changes Affecting Results – Ontario 
Home Health Care Funding”. 

ParaMed – Transformation  

Our home health care business, ParaMed, accounted for 37.4% of our revenue in 2019, or 34.4% excluding the British 
Columbia (B.C.) operations, which ceased in January 2020. Demand for home health care services in Canadian markets is 
continuing to increase, but legacy information technology systems and processes are preventing us from fully capitalizing 
on this opportunity.  

Our legacy scheduling technology has impaired our ability to give our staff full time hours, adversely impacting staff 
retention. This, coupled with competition for personal support workers (PSWs) and nurses, has prevented us from accepting 
growing client referrals. To address these issues we are investing over $12 million to transform ParaMed’s business (the 
“ParaMed Transformation”), including the implementation of a new cloud-based system to optimize scheduling and 
automate work processes, which will improve scheduling for our valued staff, reduce turnover, increase capacity and allow 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

5 

 
 
 
 
 
 
 
 
 
for more care referrals to be accepted. At year end, 89% of the targeted business volumes were supported by the new 
platform, with the balance to be completed by the end of the first quarter of 2020. 

The following table summarizes the costs incurred in respect of the ParaMed Transformation, including the ongoing costs 
of the three legacy systems to be decommissioned once the new system is implemented in all ParaMed offices. In 2019, 
Adjusted EBITDA was impacted by approximately $5.9 million ($2.3 million at the NOI level), as compared to 
approximately $3.3 million ($2.3 million at the NOI level) in 2018. Management anticipates that the remaining costs 
associated with the completion of the ParaMed Transformation project will total approximately $1.2 million ($0.5 million 
at the NOI level).  

ParaMed Transformation Costs 
(millions of dollars) 
Operating expenses (1) 
Administrative costs 
Adjusted EBITDA 

Three months ended December 31 
2018 
 0.5   
 0.4   
 0.9   

2019 
 0.5  
 0.9  
 1.4  

2019 
 2.3  
 3.6  
 5.9  

Years ended December 31 
2017 
 1.6  
 –  
 1.6  

2018 
 2.3  
 1.0  
 3.3  

(1)  The operating expenses reflect the impact on net operating income. 

The Company expects this investment will drive increased revenue growth and ultimately improve margins in the business. 
Management is focused on completing the systems implementation stage of the project in early 2020. It is anticipated that 
the new system, coupled with the ongoing training and optimization of the new platform, will drive volume increases in 
2020, excluding the impact of the B.C. exit, with margin improvements coming later in the year.   

ParaMed – B.C. Contract Expiration 

As previously announced in March 2019, the Company received notice from Fraser Health and Vancouver Coastal Health, 
both regional health authorities in B.C. (the “Health Authorities”), that the Health Authorities would be bringing their home 
support services in-house, and as a result, would not be renewing contracts with private sector home support agencies, 
including ParaMed. Consequently, ParaMed transferred and ceased providing services to the B.C. Health Authorities at the 
end of January 2020. In connection with the expiration of the contracts, the Company recorded a charge of $1.4 million in 
the three months ended March 31, 2019, primarily for facilities related costs. 

For the three months ended December 31, 2019, ParaMed’s B.C. operations contributed revenue of $13.3 million and net 
operating income of $0.1 million, as compared to revenue of $11.6 million and a net operating loss of $0.2 million for the 
three months ended December 31, 2018. For the year ended December 31, 2019, ParaMed’s B.C. operations contributed 
revenue of $50.7 million and a net operating loss of $0.3 million, as compared to revenue of $45.5 million and a net 
operating loss of $0.1 million for the year ended December 31, 2018. In addition, the B.C. operations incurred lease costs of 
approximately $0.4 million annually.  

BUSINESS OVERVIEW  

As at December 31, 2019, the Company owned and operated 58 LTC homes and 11 retirement living communities, through 
its Extendicare and Esprit Lifestyle Communities divisions, respectively, and provided contract services to 53 LTC homes 
and retirement communities for third parties through Extendicare Assist. In total, Extendicare operated or provided contract 
services to a network of 122 LTC homes and retirement communities across four provinces in Canada, with capacity for 
15,787 residents. The majority of these homes are in Ontario and Alberta, which accounted for approximately 77% and 
11% of residents served, respectively.  

In addition to providing group purchasing services to the Company’s own operations, SGP supports third-party clients 
representing approximately 64,800 senior residents across Canada, as at December 31, 2019.  

With respect to the Company’s home health care operations, ParaMed delivered approximately 10.6 million hours of home 
health care services in 2019. Excluding the B.C. operations, ParaMed’s business volumes were approximately 9.3 million 
in 2019, operating from 34 locations across five provinces (29 in Ontario, 2 in Alberta, 1 in Manitoba, 1 in Nova Scotia and 
1 in Quebec).  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

6 

 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
The following table summarizes the LTC homes and retirement communities operated by the Company and those for which 
it provided contract services to, as at December 31, 2019. Included are nine LTC homes in Ontario that the Company 
operates under 25-year lease arrangements, with full ownership obtained at the end of the leases, which expire between 
2026 and 2028. In addition to the homes listed in the following table, the Company owns land adjacent to its retirement 
residence at Lynde Creek in Whitby, Ontario, on which there is an enclave of 113 townhomes, known as Lynde Creek 
Village, that are leased by the Company to seniors under life leases.  

By Province 
Owned/Leased  
Ontario 
Alberta 
Saskatchewan 
Manitoba 

Contract Services 
Ontario 
Alberta 
Manitoba 

Total 

Long-term Care 
No. of  Resident 
Homes  Capacity 

Retirement Living 
No. of  Resident 
Homes  Capacity 

Chronic Care Unit 
No. of  Resident 
Homes  Capacity 

Total 
No. of  Resident 
Homes  Capacity 

 34  
 14  
 5  
 5  
 58  

 42  
 1  
 2  
 45  
 103  

 5,207   
 1,519   
 649   
 762   
 8,137   

 5,442   
 102   
 168   
 5,712   
 13,849   

 7  
 –  
 4  
 –  
 11  

 6  
 1  
 –  
 7  
 18  

 708   
 –   
 341   
 –   
 1,049   

 660   
 109   
 –   
 769   
 1,818   

 –  
 –  
 –  
 –  
 –  

 1  
 –  
 –  
 1  
 1  

 –   
 –   
 –   
 –   
 –   

 120   
 –   
 –   
 120   
 120   

 41  
 14  
 9  
 5  
 69  

 49  
 2  
 2  
 53  
 122  

 5,915  
 1,519  
 990  
 762  
 9,186  

 6,222  
 211  
 168  
 6,601  
 15,787  

(1)  The homes are categorized based on the predominant level of care provided, the type of licensing and the type of funding provided. For example,  
      two LTC homes with retirement wings have been categorized as LTC homes. In addition, government-funded supportive living suites have  
      been categorized as LTC homes due to the nature of the regulatory oversight and government-determined fee structure.  

The following reflects the change in operating capacity of the LTC homes and retirement communities during 2019 and 
2018. During 2019, the Company opened Bolton Mills Retirement Community (112 suites) in Bolton, Ontario in January, 
and The Barrieview Retirement Community (124 suites) in Barrie, Ontario in October. 

Long-term Care and Retirement Living 
As at beginning of year 
Contract services added 
Contract services ceased 
Retirement living 
Long-term care 
As at end of year 

Operating Segments 

No. of  
Homes 
 120  
 1  
 (1) 
 2  
 –  
 122  

2019   
Resident 
Capacity 
 15,447   
 164   
 (60)  
 236   
 –   
 15,787   

No. of  
Homes 
 116  
 4  
 (1) 
 1  
 –  
 120  

2018 
Resident 
Capacity 
 15,004  
 524  
 (243) 
 138  
 24  
 15,447  

The Company reports the following segments within its Canadian operations:  i) long-term care; ii) retirement living; 
iii) home health care; iv) contract services, consulting and group purchasing as “other Canadian operations”; and v) the 
Canadian corporate functions and any intersegment eliminations as “corporate Canada”. For financial reporting purposes, 
the Company’s owned and operated homes are reported under the “long-term care” or the “retirement living” operating 
segment based on the predominant level of care provided. The Company’s managed homes are reported under the “other 
Canadian operations” segment, as the revenue from those operations is earned on a fee-for-service basis. 

The Company continues to group its remaining U.S. operations as one segment, consisting of its wholly owned Bermuda-
based captive insurance company, Laurier Indemnity Company, Ltd. (the “Captive”) that insured the Company’s U.S. 
general and professional liability risks up to the date of the sale of the Company’s U.S. business in 2015 (the “U.S. Sale 
Transaction”). The Captive’s expense incurred or release of reserves for U.S. self-insured liabilities as well as the disposed 
U.S. businesses are presented as discontinued operations, while the Captive’s costs to administer and manage the settlement 
of the remaining claims are reported as continuing operations within the U.S. segment. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

7 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
The following summarizes the contribution of the business segments to the Company’s consolidated revenue and net 
operating income for 2019 and 2018.  

Operating 
Segments 
Long-term care 
Retirement living 
Home health care 
Other Canadian  
Remaining U.S.  

Revenue 
57.3% 
3.9% 
36.7% 
2.1% 
0.0% 

Three months ended December 31 
2018 
NOI 
57.2%  
6.9%  
24.1%  
11.0%  
0.8%  

  Revenue 
57.0% 
3.1% 
37.8% 
2.0% 
0.1% 

2019 
NOI 
62.4%  
9.1%  
18.0%  
10.5%  
0.0%  

  Revenue 
56.9% 
3.6% 
37.4% 
2.1% 
0.0% 

Years ended December 31 
2018 
NOI 
54.5% 
6.7% 
28.4% 
10.1% 
0.3% 

  Revenue 
56.5% 
3.0% 
38.5% 
2.0% 
0.0% 

2019 
NOI 
58.0%  
8.6%  
23.5%  
9.9%  
0.0%  

Excluding ParaMed’s B.C. operations, the long-term care operations represented 59.6% of consolidated revenue and 57.9% 
of consolidated NOI for the 2019 year, while the home health care operations represented 34.4% and 23.7%, respectively. 

The following describes the operating segments of the Company. 

LONG-TERM CARE  

The Company owns and operates for its own account 58 LTC homes with capacity for 8,137 residents, inclusive of a stand-
alone designated supportive living home (140 suites) and a designated supportive living wing (60 suites) in Alberta and two 
retirement wings (76 suites) in Ontario.  

In Canada, provincial legislation and regulations closely control all aspects of the operation and funding of LTC homes and 
government-funded supportive living homes, including the fee structure, subsidies, the adequacy of physical homes, 
standards of care and accommodation, equipment and personnel. A substantial portion of the fees paid to providers of these 
services are funded by provincial programs, with a portion to be paid by the resident. Nobody is refused access to long-term 
care due to an inability to pay. A government subsidy, generally based on an income test, is available for residents who are 
unable to afford the resident co-payment. In Alberta, designated supportive living homes provide an alternative setting for 
residents not yet requiring the needs of a more expensive LTC home. Such homes are licensed, regulated and funded by 
Alberta Health Services (AHS) in a similar manner to LTC homes, including a government-determined fee structure. 

In Ontario, long-term care operators have the opportunity to receive additional funding through higher accommodation 
rates charged to residents for private and semi-private accommodation, at maximum preferred accommodation rates that are 
fixed by the government. Long-term care operators are permitted to designate up to 60% of the resident capacity of a home 
as preferred accommodation and charge higher accommodation rates that vary according to the structural classification of 
the LTC home.  

The following summarizes the composition of the owned/leased LTC homes operated by the Company in Ontario, as at 
December 31, 2019, as well as the maximum preferred differential rates per diem for each classification of bed that took 
effect July 1, 2019. 

Ontario Owned/Leased 
New 
Class C (1) 

No. of 
Homes 
13 
21 
34 

Private 
$26.64 premium 
1,106 
– 
1,106 

Private 
$19.17 premium 
– 
476 
476 

Semi-private 

$8.52 premium  Basic/Other 
741 
– 
1,412 
1,396 
2,153 
1,396 

Total 
1,847 
3,284 
5,131 

Composition of Beds 

(1)  Beds in operation of 3,284 exclude 3 beds held in abeyance. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

8 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RETIREMENT LIVING  

Under the Esprit Lifestyle Communities brand, the Company owned and operated 11 retirement communities with 
1,049 suites as at December 31, 2019. Four of these communities (341 suites) are located in Saskatchewan and seven 
communities (708 suites) are located in Ontario. Plans are under way for a 59-suite expansion of the Company’s 63-suite 
Empire Crossing Retirement Community in Port Hope, Ontario (see “Significant 2019 Events and Development – Projects 
under Development”).   

The Company’s retirement communities provide accommodation and services to private-pay residents at rates set by the 
Company based on the services provided and market conditions. The monthly fees vary depending on the type of 
accommodation, level of care and services chosen by the resident and the location of the retirement community. Residents 
are able to choose the living arrangements best suited to their personal preference and needs, as well as the level of care and 
support they receive as their needs evolve over time.  

HOME HEALTH CARE  

The Company provides home health care services through ParaMed, whose professionals and staff members are skilled 
in providing complex nursing care, occupational, physical and speech therapy and assistance with daily activities to 
accommodate clients of all ages living at home.  

Provincial governments fund a wide range of home health care services and contract these services to providers such as 
ParaMed. ParaMed receives approximately 98% of its revenue from contracts tendered by locally administered provincial 
agencies, with the remainder coming from private-pay clients. ParaMed delivered approximately 10.6 million hours of 
service in 2019, of which approximately 81% were provided in Ontario, 12% in B.C., 4% in Alberta, and the balance were 
provided in Manitoba, Nova Scotia and Quebec. As previously noted, ParaMed transferred its operations in B.C. and ceased 
providing services to the B.C. Health Authorities at the end of January 2020 (refer to the discussion under “Significant 
2019 Events and Developments – ParaMed – B.C. Contract Expiration”). Excluding the B.C. operations, ParaMed 
delivered approximately 9.3 million hours of service in 2019, with Ontario and Alberta representing approximately 92% 
and 5%, respectively.  

OTHER CANADIAN OPERATIONS  

The Company’s other Canadian operations are composed of its contract services and consulting provided by Extendicare 
Assist and group purchasing services provided by SGP Purchasing Partner Network.  

Contract Services and Consulting 

Through its Extendicare Assist division, the Company leverages its expertise in operating LTC homes and retirement 
communities in providing a wide range of contract services and consulting to third parties. Extendicare Assist partners with 
not-for-profit and for-profit organizations, hospitals and municipalities seeking to improve their management practices, 
quality of care practices and operating efficiencies. Extendicare Assist provides a broad range of services aimed at meeting 
the needs of its partners, including:  financial administration, record keeping, regulatory compliance and purchasing. In 
addition, Extendicare Assist provides consulting services to third parties for the development and redevelopment of LTC 
homes. 

Extendicare Assist’s contract services portfolio consisted of 53 LTC homes and retirement communities with capacity for 
6,601 residents as at December 31, 2019 (December 31, 2018 – 53 homes with capacity for 6,497 residents).  

Group Purchasing Services 

Through SGP, the Company offers cost-effective purchasing contracts to other senior care providers for food, capital 
equipment, furnishings, cleaning and nursing supplies and office products. SGP negotiates long-term and high volume 
contracts with suppliers that provide members with preferred pricing, thereby providing a cost-effective means to secure 
quality national brand-name products, along with a range of innovative services. As at December 31, 2019, SGP provided 
services to third parties representing approximately 64,800 senior residents across Canada (December 31, 2018 – 51,100 
seniors).   

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

9 

 
 
 
 
 
 
 
 
 
 
 
U.S. REMAINING OPERATIONS – CAPTIVE INSURANCE COMPANY 

Prior to the U.S. Sale Transaction, the Company self-insured certain risks related to general and professional liability of its 
disposed U.S. operations through the Captive. The obligation to settle such claims relating to the period prior to the closing 
of the U.S. Sale Transaction, including claims incurred but yet to be reported, remains with the Company, which continues 
to be funded through the Captive. The majority of the risks that the Company self-insured relating to the U.S. operations are 
long-term in nature, and accordingly, claim payments for any particular policy year can occur over a long period of time. 
Any expense incurred or release of reserves for U.S. self-insured liabilities are presented as discontinued operations, while 
the costs to administer and manage the settlement of the remaining claims are reported as continuing operations within the 
U.S. segment.  

As at December 31, 2019, the accrual for U.S. self-insured general and professional liabilities was $12.2 million 
(US$9.4 million) as compared to $37.1 million (US$27.2 million) as at December 31, 2018, and the investments held for 
U.S. self-insured liabilities totalled $27.6 million (US$21.2 million) as compared to $67.9 million (US$49.8 million) as at 
December 31, 2018, with the decline in each primarily reflecting the “run off” of the self-insured liabilities and release of 
reserves. In 2019, the Company released $12.2 million (US$9.2 million) of reserves for self-insured liabilities, and 
transferred $26.7 million (US$20.0 million) of cash previously held for investment by the Captive to the Company for 
general corporate use. Subsequent to December 31, 2019, the Company initiated the repatriation of US$7.0 million from 
the Captive, which is expected to be received in the second quarter of 2020. For further information on the self-insured 
liabilities, refer to the discussion under “Accrual for U.S. Self-insured Liabilities” found within the “Liquidity and Capital 
Resources” section of this MD&A. 

KEY PERFORMANCE INDICATORS  

In addition to those measures identified under “Non-GAAP Measures”, management uses certain key performance 
indicators in order to compare the financial performance of the Company’s continuing operations between periods. In 
addition, we assess the operations on a same-store basis between the reported periods. Such performance indicators may not 
be comparable to similar indicators presented by other companies. Set forth below is an analysis of the key performance 
indicators and a discussion of significant trends when comparing the Company’s financial results from continuing 
operations. 

The following is a glossary of terms for some of the Company’s key performance indicators: 

“Occupancy” is measured as the percentage of the number of earned resident days (or the number of occupied suites in the 
case of a retirement community) relative to the total available resident days. Total available resident days is the number of 
beds (or suites in the case of a retirement community) available for occupancy multiplied by the number of days in the 
period;  

“Stabilized” is the classification by the Company of an LTC home or retirement community that has achieved and 
sustained its expected stabilized occupancy level for three consecutive months, which level varies from project to project;  

“Lease-up” is any LTC home or retirement community not classified as stabilized;  

“Non same-store” or “NSS”, generally refers to those homes, communities or businesses that were not continuously 
operated by the Company since the beginning of the previous fiscal year or have been classified as held for sale; and 

“Same-store” or “SS” generally refers to those homes, communities or businesses that were continuously operated by the 
Company since the beginning of the previous fiscal year, and which are not classified as held for sale. 

Long-term Care 

The following table provides the average occupancy levels of the LTC operations for the past eight quarters.  

Long-term Care Homes 
Average Occupancy (%) 
Total LTC 
Ontario LTC 

Total operations 
Preferred Accommodation (1) 
“New” homes – private 
“C” homes – private 
“C” homes – semi-private  

2019 
Year 
Q3 
96.9%  97.5%  97.9%  97.8%  97.5% 

Q4 

Q2 

Q1 

Q1 
96.4% 

Q2 
97.2% 

Q3 
97.8% 

Q4 
97.6% 

2018 
Year 
97.3% 

97.5%  98.2%  98.5%  98.2%  98.1% 

97.1% 

97.7% 

98.3% 

98.2% 

97.8% 

95.1%  96.3%  95.9%  95.8%  95.8% 
96.2%  93.8%  94.2%  93.1%  94.3% 
65.3%  65.6%  66.5%  66.7%  66.0% 

96.3% 
97.4% 
65.2% 

96.7% 
97.3% 
65.7% 

97.6% 
97.8% 
66.5% 

96.6% 
97.6% 
66.1% 

96.8% 
97.5% 
65.9% 

(1)  Average occupancy reported for the available private and semi-private rooms reflects the percentage of residents occupying those beds and paying   
       the respective premium rates. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

10 

 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The average occupancy at the Company’s LTC homes was 97.8% for the three months ended December 31, 2019, as 
compared to 97.6% for the three months ended December 31, 2018, and 97.9% for the three months ended September 30, 
2019. For the year, average occupancy was slightly higher at 97.5% as compared to 97.3% in 2018. In terms of the 
quarterly trends throughout the year, slightly lower occupancy levels are to be expected during the winter months as a result 
of outbreaks, which can lead to a temporary freeze on admissions. In addition, occupancy levels for the three months ended 
March 31, 2018, were impacted by the fill-up of a 24-bed addition to one of the LTC homes that opened in February 2018, 
yet achieved stabilized occupancy levels in April 2018.  

In Ontario, overall government funding is occupancy-based, but once the average occupancy level of 97% or higher for the 
calendar year is achieved, operators receive government funding based on 100% occupancy. In 2019, the Company’s LTC 
homes in Ontario achieved an overall average occupancy of 98.1%, with all but one home achieving the 97% occupancy 
threshold.  

In addition, the Company’s Ontario LTC homes receive premiums for preferred accommodation. The average occupancy of 
private beds in the “New” homes was 95.8% for the three months ended December 31, 2019, as compared to 96.6% for the 
three months ended December 31, 2018. For the year, the average occupancy of the “New” private beds was 95.8% as 
compared to 96.8% in 2018. The average occupancy of the private beds at the Company’s Class C homes was 93.1% for 
the three months ended December 31, 2019, as compared to 97.6% for the three months ended December 31, 2018. For the 
year, the average occupancy of the Class C private beds was 94.3% as compared to 97.5% in 2018.  

Retirement Living  

The following table summarizes the composition of the Company’s eleven retirement communities in operation as at 
December 31, 2019. During the three months ended December 31, 2019, Douglas Crossing and Yorkton Crossing achieved 
stabilized occupancy and The Barrieview opened at the beginning of October. Consequently, three of the retirement 
communities were in lease-up and three of the retirement communities were classified as non same-store. 

Retirement Communities 
Cedar Crossing 
Douglas Crossing 
Empire Crossing 
Harvest Crossing 
Riverbend Crossing 
Stonebridge Crossing 
Yorkton Crossing 
Lynde Creek Manor 
West Park Crossing 
The Barrieview 
Bolton Mills 
Total suites 
Total communities 

AS AT OCCUPANCY 

Location 
Simcoe, ON 
Uxbridge, ON 
Port Hope, ON 
Tillsonburg, ON 
Regina, SK 
Saskatoon, SK 
Yorkton, SK 
Whitby, ON 
Moose Jaw, SK 
Barrie, ON 
Bolton, ON 

Total 
 68   
 148   
 63   
 100   
 67   
 116   
 79   
 93   
 79   
 124   
 112   
 1,049   
 11   

  Stabilized  Lease-up 

  Same-store  Non Same-store 

 68   
 148   
 63   
 100   
 67   
 116   
 79   
 93   

 734  
 8  

 79   
 124   
 112   
 315   
 3   

 68   
 148   
 63   
 100   
 67   
 116   
 79   

 79   

 720  
 8  

 93  

 124  
 112  
 329  
 3  

The following table provides the combined occupancy of the Company’s stabilized and lease-up retirement communities at 
the end of each of the past eight quarters, based on their classification at December 31, 2019.  

Retirement Communities 
As at Occupancy (%) – total 
Stabilized communities 
Lease-up communities 

Q1 
80.9% 
91.0% 
41.9% 

Q2 
83.8% 
92.5% 
50.3% 

Q3 
86.6% 
94.1% 
57.6% 

2019  
Q4 
85.6% 
95.1% 
63.5% 

Q1 
80.8% 
83.2% 
62.0% 

Q2 
86.0% 
88.7% 
62.0% 

Q3 
89.5% 
91.6% 
70.9% 

2018 
Q4 
88.6% 
89.8% 
77.2% 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

11 

 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The occupancy of the stabilized communities was 95.1% as at December 31, 2019, as compared to 94.1% as at September 
30, 2019, and to 89.8% as at December 31, 2018. The improvement from the end of last year reflects the lease-up of 
Douglas Crossing and Yorkton Crossing and the maintenance of stable occupancy levels at the six other retirement 
communities in that category. The completion of the 45-suite addition at Douglas Crossing in November 2018 resulted in a 
sequential decline in occupancy as at December 31, 2018 from September 30, 2018. The occupancy of the three lease-up 
communities increased to 63.5% as at December 31, 2019, as compared to 57.6% as at September 30, 2019. The opening of 
Bolton Mills (112 suites) in January 2019, resulted in a decline in occupancy of the lease-up communities from 77.2% at 
December 31, 2018.  

AVERAGE OCCUPANCY  

The following table provides the average occupancy of the retirement communities in total and for each of the stabilized 
and lease-up groupings for the past eight quarters. The average occupancy of the stabilized communities grew to 94.9% for 
the three months ended December 31, 2019, as compared to 89.8% for the same prior year period. The sequential trend in 
the average occupancy of the stabilized communities experienced in the three months ended December 31, 2018 from the 
three months ended September 30, 2018, reflects the opening of the 45-suite addition at Douglas Crossing. The sequential 
trend in the average occupancy of the lease-up communities from the end of 2018 reflects the impact of the opening of 
Bolton Mills (112 suites) in January 2019 and The Barrieview (124 suites) in October 2019.  

Retirement Communities 
Average Occupancy (%) – total 
Stabilized communities 
Lease-up communities 

Q1 
79.3% 
90.7% 
35.7% 

Q2 
82.0% 
91.4% 
45.8% 

Q3 
85.5% 
94.0% 
52.7% 

Q4 
81.7% 
94.9% 
50.7% 

2019 
Year 
82.1% 
92.7% 
46.9% 

Q1 
80.4% 
82.6% 
64.0% 

Q2 
84.4% 
87.1% 
61.5% 

Q3 
87.9% 
90.1% 
69.0% 

Q4 
88.4% 
89.8% 
76.1% 

2018 
Year 
85.5% 
87.6% 
67.7% 

Home Health Care 

The following table provides the service volumes of the Company’s home health care operations in total and excluding the 
B.C. operations, for the past eight quarters.  

Home Health Care 
Service Volumes 
Total 
Hours of service (000’s) 
Hours per day 
Excluding B.C. 
Hours of service (000’s) 
Hours per day 

Q1 

Q2 

Q3 

Q4 

2019 
Year 

Q1 

Q2 

Q3 

Q4 

2018 
Year 

 2,595.3  
 28,837  

 2,660.5  
 29,236  

 2,652.7  
 28,834  

 2,661.2    10,569.7   
 28,958   
 28,926  

 2,705.0  
 30,055  

 2,734.8  
 30,053  

 2,708.6  
 29,441  

 2,750.0    10,898.4  
 29,859  
 29,891  

 2,291.9  
 25,465  

 2,340.0  
 25,714  

 2,322.5  
 25,245  

 2,329.2  
 25,318  

 9,283.6   
 25,435   

 2,408.7  
 26,763  

 2,430.1  
 26,704  

 2,402.0  
 26,108  

 2,441.6  
 26,539  

 9,682.4  
 26,527  

ParaMed’s average daily hours of service for the three months ended December 31, 2019, increased by 0.3% from the three 
months ended September 30, 2019. In comparison to 2018, ParaMed’s average daily hours of service declined by 3.2% for 
the three months ended December 31, 2019, and declined by 3.0% for the year. Excluding the B.C. operations, the average 
daily volumes declined by 4.1% over 2018, due to the challenges experienced with ParaMed’s Ontario operations. We 
continue efforts to build capacity to address these challenges and to take advantage of the significant organic growth 
opportunity that exists across Canada (refer to the discussion under “Significant 2019 Events and Developments – ParaMed 
– Transformation”).   

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

12 

 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SELECTED ANNUAL INFORMATION 

The following is a summary of selected annual financial information for each of the past three years. 

(thousands of dollars unless otherwise noted) 
Financial Results 
Revenue 

Earnings before depreciation, amortization and  
  other expense (Adjusted EBITDA) 
Earnings from continuing operations 
per basic and diluted share ($) 

Earnings (loss) from discontinued operations 

Net earnings 

per basic and diluted share ($) 

AFFO 

per basic share ($) 
Cash dividends declared 

per share ($) 

Financial Position (at year end) 
Total assets 
Total non-current liabilities 
Long-term debt 
Long-term debt, including current portion 

2019 

2018 

2017 

 1,131,950   

 1,120,007   

 1,097,331  

 91,111   
 17,051   
 0.19   
 11,579   

 28,630   
 0.32   

 52,600   
 0.590   
 42,672   
 0.480   

 888,800   
 497,515   
 422,535   
 556,306   

 94,238   
 8,084   
 0.09   
 23,654   

 31,738   
 0.36   

 57,751   
 0.653   
 42,351   
 0.480   

 896,324   
 543,359   
 454,344   
 528,970   

 97,597  
 31,712  
 0.36  
 (29,580) 

 2,132  
 0.02  

 58,495  
 0.659  
 42,583  
 0.480  

 934,281  
 588,804  
 476,404  
 536,068  

Financial Results – The selected information provided for each of the years under the heading “Financial Results” reflects 
the classification of disposed U.S. operations as discontinued. The financial results for 2018 reflected a decline in earnings 
from continuing operations of $23.6 million, largely impacted by other expenses totalling $20.2 million that included an 
impairment charge of $16.2 million pre-tax in respect of certain of the Company’s retirement communities and long-term 
care homes, costs associated with the redemption of convertible debentures and the acquisition of a retirement community, 
a net change in foreign exchange and fair value adjustments of $3.1 million pre-tax and a decline in Adjusted EBITDA. The 
decrease in Adjusted EBITDA reflects an improvement from Canadian operations of $1.5 million, offset by a decline from 
U.S. operations due to lower investment income from the Captive as it winds down.  

Financial Position – Since the end of 2017, total assets and non-current liabilities have declined largely due to the “run 
off” of the U.S. self-insured liabilities and related investments held by the Captive and an impairment charge recorded in 
2018.  

A comparison between the 2019 and 2018 financial results is provided in the discussion under the headings “2019 Financial 
Review” and “Liquidity and Capital Resources”. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

13 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SELECT QUARTERLY FINANCIAL INFORMATION  

The following is a summary of select quarterly financial information for the past eight quarters.  

(thousands of dollars unless otherwise noted) 
Revenue 

Q4 
 290,895  

Q3 
 282,733  

Q2 
 284,053  

Net operating income 

NOI margin 

Adjusted EBITDA 

Adjusted EBITDA margin 

Earnings (loss) from continuing operations 

per basic and diluted share ($) 
Earnings from discontinued operations 
Net earnings 

per basic and diluted share ($) 

AFFO 

per basic share ($) 
Maintenance Capex  
Cash dividends declared 

per share ($) 

Weighted Average Number of Shares 

Basic 
Diluted 

 32,877  
11.3% 

 22,998  
7.9% 

 4,893  
 0.05  
 5,195  
 10,088  
 0.11  

 11,365  
 0.127  
 6,028  
 10,701  
 0.120  

 34,867  
12.3% 

 23,588  
8.3% 

 5,247  
 0.06  
 2,012  
 7,259  
 0.08  

 13,693  
 0.153  
 3,056  
 10,680  
 0.120  

 35,320  
12.4% 

 24,973  
8.8% 

 5,854  
 0.07  
 2,471  
 8,325  
 0.10  

 14,927  
 0.168  
 2,312  
 10,657  
 0.120  

2019 
Q1 
 274,269   

 30,386   
11.1%  

 19,552   
7.1%  

 1,057   
 0.01   
 1,901   
 2,958   
 0.03   

 12,615   
 0.142   
 916   
 10,634   
 0.120   

2018 
Q1 
 288,793   280,302   279,488   271,424  

Q4 

Q3 

Q2 

 32,863  
11.4% 

 35,492  
12.7% 

 36,307  
13.0% 

 29,322  
10.8% 

 22,538  
7.8% 

 24,393  
8.7% 

 27,330  
9.8% 

 19,977  
7.4% 

 (9,055) 
 (0.10) 
 15,562  
 6,507  
 0.07  

 12,570  
 0.142  
 4,202  
 10,612  
 0.120  

 7,598  
 0.08  
 975  
 8,573  
 0.10  

 13,379  
 0.151  
 3,639  
 10,591  
 0.120  

 5,975  
 0.07  
 5,852  
 11,827  
 0.14  

 17,133  
 0.194  
 3,783  
 10,570  
 0.120  

 3,566  
 0.04  
 1,265  
 4,831  
 0.05  

 14,669  
 0.166  
 1,051  
 10,578  
 0.120  

 89,467  
 99,850  

 89,253  
 99,614  

 89,039  
 99,415  

 88,825   
 99,186   

 88,612  
 98,962  

 88,412  
 98,788  

 88,208  
 98,595  

 88,379  
 99,688  

The following is a reconciliation of “earnings (loss) from continuing operations before income taxes” to Adjusted EBITDA 
and “net operating income”.   

(thousands of dollars) 
Earnings (loss) from continuing  
  operations before income taxes 
Add (Deduct): 
Depreciation and amortization 
Net finance costs 
Other expense 
Adjusted EBITDA 
Add (Deduct): 
Administrative costs 
Net operating income 

Q4 

Q3 

Q2 

2019 
Q1 

Q4 

Q3 

Q2 

2018 
Q1 

 6,878  

 7,488  

 8,057  

 1,813   

 (12,327) 

 10,135  

 9,131  

 5,380  

 10,597  
 5,523  
 –  
 22,998  

 9,861  
 6,239  
 –  
 23,588  

 9,705  
 6,236  
 975  
 24,973  

 9,427   
 6,883   
 1,429   
 19,552   

 10,184  
 8,039  
 16,642  
 22,538  

 9,014  
 5,244  
 –  
 24,393  

 8,235  
 6,591  
 3,373  
 27,330  

 7,837  
 6,580  
 180  
 19,977  

 9,879  
 32,877  

 11,279  
 34,867  

 10,347  
 35,320  

 10,834   
 30,386   

 10,325  
 32,863  

 11,099  
 35,492  

 8,977  
 36,307  

 9,345  
 29,322  

There are a number of factors affecting the trend of the Company’s quarterly results from continuing operations. With 
respect to the core operations, while year-over-year quarterly comparisons will generally remain comparable, sequential 
quarters can vary materially for seasonal and other trends. The significant factors that impact the results from period to 
period are as follows:  
•  Ontario long-term care funding tied to flow-through funding envelopes requires revenue be deferred until it is matched 
with the related costs for resident care in the periods in which the costs are incurred, resulting in a fluctuation in 
revenue and operating expenses by quarter, with both generally being at their lowest in the first quarter and at their 
highest in the fourth quarter;  

•  Ontario long-term care providers generally receive annual flow-through funding increases and case mix index 

adjustments effective April 1st and accommodation funding increases effective July 1st, and Alberta long-term care 
providers generally receive annual inflationary rate increases and acuity-based funding adjustments on April 1st and 
accommodation funding increases effective July 1st;  

•  maintenance capex spending, which impacts AFFO, fluctuates on a quarterly basis with the timing of projects and 

seasonality and is generally at its lowest in the first quarter and its highest in the fourth quarter;  

• 
• 

utility costs are generally at their highest in the first quarter and their lowest in the second and third quarters; and 

certain line items that are reported separately due to their transitional nature that would otherwise distort the 
comparability of the historical trends, being “other expense” and “foreign exchange and fair value adjustments”. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

14 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2019 FOURTH QUARTER FINANCIAL REVIEW  

The following provides a breakdown of the consolidated statement of earnings between the Canadian and remaining U.S. 
operations.  

(thousands of dollars) 
Revenue 
Operating expenses 
Net operating income 
Administrative costs 
Adjusted EBITDA 
Depreciation and amortization 
Other expense 
Earnings (loss) before net finance costs 
  and income taxes 
Interest expense (net of capitalized interest) 
Interest revenue 
Accretion 
Foreign exchange and fair value adjustments 
Net finance costs (income) 
Earnings (loss) from continuing 
  operations before income taxes 
Income tax expense (recovery) 
Current 
Deferred 
Total income tax expense (recovery) 
Earnings (loss) from continuing operations 
Earnings from discontinued operations 
Net earnings 
Earnings (loss) from continuing operations 
Add (Deduct) (1): 
Foreign exchange and fair value adjustments 
Other expense 
Earnings (loss) from continuing operations 
  before separately reported items, 
  net of taxes 

Canada 
 290,895  
 258,018  
 32,877  
 9,350  
 23,527  
 10,597  
 –  

 12,930  
 7,623  
 (1,004) 
 303  
 (444) 
 6,478  

U.S. 
 –  
 –  
 –  
 529  
 (529) 
 –  
 –  

 (529) 
 –  
 –  
 90  
 (1,045) 
 (955) 

2019 
Total 
 290,895   
 258,018   
 32,877   
 9,879   
 22,998   
 10,597   
 –   

 12,401   
 7,623   
 (1,004)  
 393   
 (1,489)  
 5,523   

Three months ended December 31 
Total 
  Change 
 2,102  
 2,088  
 14  
 (446) 
 460  
 413  
 (16,642) 

2018 
Total 
 288,793   
 255,930   
 32,863   
 10,325   
 22,538   
 10,184   
 16,642   

U.S. 
 277  
 –  
 277  
 339  
 (62) 
 –  
 –  

  Canada 
 288,516  
 255,930  
 32,586  
 9,986  
 22,600  
 10,184  
 16,642  

 (4,226) 
 6,685  
 (926) 
 299  
 1,289  
 7,347  

 (62) 
 –  
 –  
 336  
 356  
 692  

 (4,288)  
 6,685   
 (926)  
 635   
 1,645   
 8,039   

 16,689  
 938  
 (78) 
 (242) 
 (3,134) 
 (2,516) 

 6,452  

 426  

 6,878   

 (11,573) 

 (754) 

 (12,327)  

 19,205  

 1,068  
 917  
 1,985  
 4,467  
 –  
 4,467  
 4,467  

 –  
 –  
 –  
 426  
 5,195  
 5,621  
 426  

 1,068   
 917   
 1,985   
 4,893   
 5,195   
 10,088   
 4,893   

 2,001  
 (5,273) 
 (3,272) 
 (8,301) 
 –  
 (8,301) 
 (8,301) 

 –  
 –  
 –  
 (754) 
 15,562  
 14,808  
 (754) 

 2,001   
 (5,273)  
 (3,272)  
 (9,055)  
 15,562   
 6,507   
 (9,055)  

 (933) 
 6,190  
 5,257  
 13,948  
 (10,367) 
 3,581  
 13,948  

 (255) 
 –  

 (1,045) 
 –  

 (1,300)  
 –   

 715  
 12,153  

 356  
 –  

 1,071   
 12,153   

 (2,371) 
 (12,153) 

 4,212  

 (619) 

 3,593   

 4,567  

 (398) 

 4,169   

 (576) 

(1)  The separately reported items being added to or deducted from earnings (loss) from continuing operations are net of income taxes, and are 
       non-GAAP measures. Refer to the discussion of non-GAAP measures. 

The following provides a reconciliation of “earnings (loss) from continuing operations before income taxes” to “Adjusted 
EBITDA” and “net operating income”. 

(thousands of dollars) 
Earnings (loss) from continuing 
  operations before income taxes 
Add (Deduct): 
Depreciation and amortization 
Net finance costs (income) 
Other expense 
Adjusted EBITDA 
Add (Deduct): 
Administrative costs 
Net operating income 

Canada 

U.S. 

2019 
Total 

  Canada 

Three months ended December 31 
Total 
  Change 

2018 
Total 

U.S. 

 6,452  

 426  

 6,878   

 (11,573) 

 (754) 

 (12,327)  

 19,205  

 10,597  
 6,478  
 –  
 23,527  

 9,350  
 32,877  

 –  
 (955) 
 –  
 (529) 

 10,597   
 5,523   
 –   
 22,998   

 10,184  
 7,347  
 16,642  
 22,600  

 –  
 692  
 –  
 (62) 

 10,184   
 8,039   
 16,642   
 22,538   

 413  
 (2,516) 
 (16,642) 
 460  

 529  
 –  

 9,879   
 32,877   

 9,986  
 32,586  

 339  
 277  

 10,325   
 32,863   

 (446) 
 14  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

15 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following is an analysis of the consolidated results from operations for the three months ended December 31, 2019, as 
compared to the three months ended December 31, 2018. Refer to the discussion that follows under “Summary of Results 
of Operations by Segment” for an analysis of the revenue and net operating income by operating segment, including the 
components of non same-store revenue and net operating income.  

Revenue 

Revenue grew by $2.1 million or 0.7% to $290.9 million for the three months ended December 31, 2019, driven primarily 
by LTC funding enhancements, expansion of the retirement living operations and growth in other Canadian operations, 
partially offset by a decline in home health care volumes.  

Operating Expenses 

Operating expenses increased by $2.1 million or 0.8% to $258.0 million for the three months ended December 31, 2019. 
The increase in operating expenses was driven by increased costs of resident care, expansion of the retirement living 
operations and higher labour and utility costs, partially offset by the impact of lower home health care volumes delivered 
and favourable year-end labour accrual adjustments. Labour costs, including the favourable year-end adjustments declined 
by $1.1 million over the same prior year period and represented 84.0% of operating expenses as compared to 85.1% for the 
three months ended December 31, 2018, and labour costs as a percentage of revenue were 74.5% for the three months 
ended December 31, 2019, and 75.4% for the same prior year period. 

Net Operating Income  

Net operating income was unchanged at $32.9 million for the three months ended December 31, 2019, and represented 
11.3% of revenue as compared to 11.4% for the three months ended December 31, 2018, reflecting funding enhancements, 
timing of spending under the Ontario flow through envelopes, growth of the retirement living and other Canadian 
operations and year-end adjustments for labour accruals, offset by lower home health care volumes and increased back 
office operating costs.  

Administrative Costs  

Administrative costs declined by $0.5 million or 4.3% to $9.9 million for the three months ended December 31, 2019. The 
comparability of administrative costs between periods was impacted by higher ParaMed Transformation costs of 
$0.5 million ($0.9 million for the three months ended December 31, 2019, as compared to $0.4 million for the same prior 
year period), and the adoption of IFRS 16, which reduced administrative costs by $0.8 million. Excluding the $0.3 million 
favourable net impact of these factors, administrative costs decreased by $0.2 million.  

Adjusted EBITDA 

Adjusted EBITDA increased by $0.5 million to $23.0 million for the three months ended December 31, 2019, as compared 
to $22.5 million for the three months ended December 31, 2018, and represented 7.9% of revenue as compared to 7.8%, 
respectively, reflecting flat net operating income and lower administrative costs of $0.5 million. The comparability of 
Adjusted EBITDA between periods was impacted by higher ParaMed Transformation costs of $0.5 million, year-end 
accrual adjustments of $0.9 million and the adoption of IFRS 16 of $0.8 million, for a net favourable impact of 
$1.2 million. Excluding these factors, Adjusted EBITDA declined by $0.7 million to $22.7 million, or 7.8% of revenue for 
the three months ended December 31, 2019, as compared to $23.4 million, or 8.1% of revenue for the same prior year 
period, reflecting growth in net operating income of the LTC and retirement living operations and lower administrative 
costs, offset by lower volumes and net operating income of the home health care operations.  

Depreciation and Amortization 

Depreciation and amortization costs increased by $0.4 million to $10.6 million for the three months ended December 31, 
2019, and included higher costs of $0.6 million as a result of the adoption of IFRS 16.  

Other Expense 

Other expense of $16.6 million for the three months ended December 31, 2018, related primarily to an impairment charge 
in respect of certain of the Company’s retirement communities and LTC homes.  

Net Finance Costs  

Net finance costs decreased by $2.5 million to $5.5 million for the three months ended December 31, 2019, primarily due to 
a net favourable change in foreign exchange and fair value adjustments related to the Captive’s investments and interest 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

16 

 
 
 
 
 
 
 
 
 
rate swaps aggregating to $3.1 million and lower accretion costs in connection with the decline in the accrual for U.S. self-
insured liabilities, partially offset by higher net interest costs of $0.8 million. Net interest costs were negatively impacted by 
a reduction in the amount of capitalized interest of $0.4 million following the completion of two retirement communities, 
the adoption of IFRS 16 of $0.2 million and an increase in debt levels. 

Income Taxes  

The income tax provision was $2.0 million for the three months ended December 31, 2019, representing an effective tax 
rate of 28.9%, as compared to a provision of $3.3 million and an effective tax rate of 26.5% for the three months ended 
December 31, 2018. The effective tax rate of the Canadian operations was 30.8% for the three months ended December 31, 
2019, as compared to 28.3% for the three months ended December 31, 2018, and was impacted by, among other things, 
foreign exchange and fair value adjustments and other items reported separately as “other expense”, as noted above. The 
effective tax rate of the Canadian operations, excluding the impact of separately reported items, was 29.9% for the three 
months ended December 31, 2019, as compared to 28.2% for the same prior year period.  

Earnings from Continuing Operations 

Earnings from continuing operations of $4.9 million ($0.05 per basic share) for the three months ended December 31, 2019, 
was up by $13.9 million from a loss of $9.0 million (loss of $0.10 per basic share) for the three months ended December 
31, 2018, largely impacted by the impairment charge incurred in 2018 and favourable change in foreign exchange and fair 
value adjustments.  

Discontinued Operations  

Earnings from discontinued operations relate to the former U.S. operations and were $5.2 million for the three months 
ended December 31, 2019, which included the release of $5.5 million of the Captive’s reserves, partially offset by the 
impact of discount rate adjustments. The $15.5 million reported for the three months ended December 31, 2018, included 
the release of $7.1 million of the Captive’s reserves, the favourable impact of discount rate adjustments of $1.1 million, a 
$3.6 million reduction in indemnification provisions and other items and a net tax recovery of $5.9 million.  

Summary of Results of Operations by Segment  

The following summarizes the Company’s segmented “revenue”, “operating expenses” and “net operating income”, 
followed by an analysis of the operating performance of each of the Company’s operating segments.  

Three months ended December 31 
(thousands of dollars) 

Long-term  Retirement 
Living 

Care 

Home 
Other  
Health  Canadian  Corporate 
Canada 

Care  Operations 

Total 
Canada 

Total 
U.S. 

Total 

2019 
Revenue 
Operating expenses 
Net operating income 
NOI margin % 

2018 
Revenue 
Operating expenses 
Net operating income 
NOI margin % 

Change 
Revenue 
Operating expenses 
Net operating income  

 166,656  
 146,135  
 20,521  
12.3% 

 164,656  
 145,849  
 18,807  
11.4% 

 11,356  
 8,363  
 2,993  
26.4% 

 106,699  
 100,778  
 5,921  
5.5% 

 9,039  
 6,761  
 2,278  
25.2% 

 109,012  
 101,097  
 7,915  
7.3% 

 2,000  
 286  
 1,714  

 2,317  
 1,602  
 715  

 (2,313) 
 (319) 
 (1,994) 

 6,184  
 2,742  
 3,442  
55.7% 

 5,808  
 2,223  
 3,585  
61.7% 

 376  
 519  
 (143) 

 –  
 –  
 –  
 –  

 290,895  
 258,018  
 32,877  
11.3% 

 –  
 –  
 –  
 –  

 290,895  
 258,018  
 32,877  
11.3% 

 1  
 –  
 1  
100.0% 

 288,516  
 255,930  
 32,586  
11.3% 

 277  
 –  
 277  
100.0% 

 288,793  
 255,930  
 32,863  
11.4% 

 (1) 
 –  
 (1) 

 2,379  
 2,088  
 291  

 (277) 
 –  
 (277) 

 2,102  
 2,088  
 14  

LONG-TERM CARE OPERATIONS 

Net operating income from the long-term care operations was $20.5 million for the three months ended December 31, 2019, 
as compared to $18.8 million for the three months ended December 31, 2018, an increase of $1.7 million or 9.1%, with an 
NOI margin of 12.3% and 11.4%, respectively. Results included favourable labour accrual adjustments of approximately 
$1.4 million recorded this quarter, excluding which the net operating income would have been $19.1 million, with an NOI 
margin of 11.5%. Revenue grew by $2.0 million, or 1.2%, of which approximately $1.5 million related to the Ontario 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

17 

 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
flow-through funding envelopes, and was therefore directly offset by increased costs of resident care, and the balance was 
from other funding enhancements. Operating expenses increased by $0.3 million, or 0.2%, due primarily to higher labour, 
utilities and other costs of resident care, partially offset by the labour accrual adjustments. Excluding the accrual 
adjustments, labour costs as a component of operating expenses increased by $0.3 million over the three months ended 
December 31, 2018, and represented 80.5% of operating expenses for the three months ended December 31, 2019, as 
compared to 81.2% for the same prior year period.  

RETIREMENT LIVING OPERATIONS 

The following table summarizes the breakdown of the same-store and non same-store operating results of the retirement 
living operations.  

Retirement Living 
(thousands of dollars unless otherwise noted) 

Same-store 
Revenue  
Operating expenses 
Net operating income / margin % 
Average occupancy / weighted average available suites 

Non Same-store 
Revenue 
Operating expenses  
Net operating income / margin % 
Average occupancy / weighted average available suites 

Total 
Revenue 
Operating expenses 
Net operating income / margin % 
Average occupancy / weighted average available suites 

2019 

Three months ended December 31 
Change 
2018 

 9,043   
 6,086   
 2,957  
95.8% 

 2,313   
 2,277   
 36  
50.6% 

 11,356   
 8,363   
 2,993  
81.7% 

32.7%  
 720   

 1.6%  
 328   

26.4%  
 1,048   

 7,885   
 5,695   
 2,190  
88.3% 

 1,154   
 1,066   
 88  
89.5% 

 9,039   
 6,761   
 2,278  
88.4% 

27.8%  
 702   

7.6%  
 93   

25.2%  
 795   

 1,158  
 391  
 767  
 18  

 1,159  
 1,211  
 (52) 
 235  

 2,317  
 1,602  
 715  
 253  

Net operating income from the retirement living operations was $3.0 million for the three months ended December 31, 
2019, as compared to $2.3 million for the three months ended December 31, 2018, an increase of $0.7 million or 31.4%, 
reflecting growth in occupancy of same-store operations to 95.8% from 88.3%. Net operating income from non same-store 
operations reflect the impact of early lease-up and pre-opening losses from Bolton Mills and The Barrieview.  

HOME HEALTH CARE OPERATIONS 

Net operating income from the home health care operations was $5.9 million for the three months ended December 31, 
2019, as compared to $7.9 million for the three months ended December 31, 2018, a decrease of $2.0 million or 25.2%, 
with an NOI margin of 5.5% and 7.3%, respectively. Total labour costs as a component of total operating expenses 
decreased by $1.3 million and represented 91.7% of operating expenses for the three months ended December 31, 2019, as 
compared to 92.8% for the same prior year period. For the three months ended December 31, 2019, results reflect a 3.2% 
decline in average daily volumes and increased back office operating costs compared to the same prior year period, and 
approximately $0.5 million of out-of-period adjustments related to benefit cost accrual adjustments and private-pay 
customer receivable provisions. Excluding the net impact of the out-of-period accrual adjustments and ParaMed 
Transformation costs of $0.5 million, net operating income would have been $6.9 million this period as compared to 
$8.4 million in the same prior year period, with an NOI margin of 6.5% as compared to 7.7%, respectively. After further 
excluding the impact of the B.C. operations, net operating income would have been $6.8 million this period as compared to 
$8.6 million in the same prior year period, with an NOI margin of 7.3% as compared to 8.9%, respectively. Refer to the 
discussion under “Significant 2019 Events and Developments – ParaMed – B.C. Contract Expiration”.  

OTHER CANADIAN OPERATIONS 

Net operating income from the contract services, consulting and group purchasing operations declined by $0.1 million to 
$3.4 million for the three months ended December 31, 2019, as compared to three months ended December 31, 2018, with 
revenue growth of 6.5% due to an increase in clients served offset by increased costs to support operations.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

18 

 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2019 FINANCIAL REVIEW 

The following provides a breakdown of the consolidated statement of earnings between the Canadian and remaining U.S. 
operations. 

(thousands of dollars) 
Revenue 
Operating expenses 
Net operating income 
Administrative costs 
Adjusted EBITDA 
Depreciation and amortization 
Other expense 
Earnings (loss) before net finance costs 
  and income taxes 
Interest expense (net of capitalized interest) 
Interest revenue 
Accretion 
Foreign exchange and fair value adjustments 
Net finance costs (income) 
Earnings (loss) from continuing 
  operations before income taxes 
Income tax expense (recovery) 
Current 
Deferred 
Total income tax expense 
Earnings (loss) from continuing operations 
Earnings from discontinued operations 
Net earnings 
Earnings (loss) from continuing operations 
Add (Deduct) (1): 
Foreign exchange and fair value adjustments 
Other expense 
Earnings (loss) from continuing operations 
  before separately reported items, 
  net of taxes 

Canada 
 1,131,950  
 998,500  
 133,450  
 41,151  
 92,299  
 39,590  
 2,404  

U.S. 

2019 
Total 
 –    1,131,950   
 998,500   
 –  
 133,450   
 –  
 42,339   
 1,188  
 91,111   
 (1,188) 
 39,590   
 –  
 2,404   
 –  

Canada 
 1,119,602  
 986,023  
 133,579  
 38,570  
 95,009  
 35,270  
 20,195  

Years ended December 31 
Total 
  Change 
 11,943  
 12,477  
 (534) 
 2,593  
 (3,127) 
 4,320  
 (17,791) 

2018 
Total 
 1,120,007   
 986,023   
 133,984   
 39,746   
 94,238   
 35,270   
 20,195   

U.S. 
 405  
 –  
 405  
 1,176  
 (771) 
 –  
 –  

 50,305  
 28,733  
 (3,688) 
 1,195  
 2,081  
 28,321  

 (1,188) 
 –  
 –  
 648  
 (4,088) 
 (3,440) 

 49,117   
 28,733   
 (3,688)  
 1,843   
 (2,007)  
 24,881   

 39,544  
 27,584  
 (3,761) 
 1,250  
 (149) 
 24,924  

 (771) 
 –  
 –  
 1,628  
 (98) 
 1,530  

 38,773   
 27,584   
 (3,761)  
 2,878   
 (247)  
 26,454   

 10,344  
 1,149  
 73  
 (1,035) 
 (1,760) 
 (1,573) 

 21,984  

 2,252  

 24,236   

 14,620  

 (2,301) 

 12,319   

 11,917  

 8,287  
 (1,102) 
 7,185  
 14,799  
 –  
 14,799  
 14,799  

 –  
 –  
 –  
 2,252  
 11,579  
 13,831  
 2,252  

 8,287   
 (1,102)  
 7,185   
 17,051   
 11,579   
 28,630   
 17,051   

 8,129  
 (3,894) 
 4,235  
 10,385  

 –  
 –  
 –  
 (2,301) 
 –    23,654  
 10,385    21,353  
 (2,301) 
 10,385  

 8,129   
 (3,894)  
 4,235   
 8,084   
 23,654   
 31,738   
 8,084   

 158  
 2,792  
 2,950  
 8,967  
 (12,075) 
 (3,108) 
 8,967  

 1,732  
 2,070  

 (4,088) 
 –  

 (2,356)  
 2,070   

 (523) 
 15,165  

 (98) 
 –  

 (621)  
 15,165   

 (1,735) 
 (13,095) 

 18,601  

 (1,836) 

 16,765   

 25,027  

 (2,399) 

 22,628   

 (5,863) 

(1)  The separately reported items being added to or deducted from earnings (loss) from continuing operations are net of income taxes, and are 
       non-GAAP measures. Refer to the discussion of non-GAAP measures. 

The following provides a reconciliation of “earnings (loss) from continuing operations before income taxes” to “Adjusted 
EBITDA” and “net operating income”. 

(thousands of dollars) 
Earnings (loss) from continuing 
  operations before income taxes 
Add (Deduct): 
Depreciation and amortization 
Net finance costs (income) 
Other expense 
Adjusted EBITDA 
Add (Deduct): 
Administrative costs 
Net operating income 

Canada 

U.S. 

2019 
Total 

Canada 

Years ended December 31 
Total 
  Change 

2018 
Total 

U.S. 

 21,984  

 2,252  

 24,236   

 14,620  

 (2,301) 

 12,319   

 11,917  

 39,590  
 28,321  
 2,404  
 92,299  

 –  
 (3,440) 
 –  
 (1,188) 

 39,590   
 24,881   
 2,404   
 91,111   

 35,270  
 24,924  
 20,195  
 95,009  

 –  
 1,530  
 –  
 (771) 

 35,270   
 26,454   
 20,195   
 94,238   

 4,320  
 (1,573) 
 (17,791) 
 (3,127) 

 41,151  
 133,450  

 1,188  
 –  

 42,339   
 133,450   

 38,570  
 133,579  

 1,176  
 405  

 39,746   
 133,984   

 2,593  
 (534) 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

19 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following is an analysis of the consolidated results from operations for 2019 as compared to 2018. Refer to the 
discussion that follows under “Summary of Results of Operations by Segment” for an analysis of the revenue and net 
operating income by operating segment, including the components of non same-store revenue and net operating income.  

Summary of Factors Impacting Comparability 

To assist in the analysis, the following is a summary of items impacting the comparability of results from operations 
between periods: 

•  ParaMed Bill 148 funding:  incremental revenue of $2.2 million recognized in the three months ended June 30, 2019, 

related to 2018 for Bill 148. 

•  ParaMed Transformation costs:   

o  operating expenses included $2.3 million in each of 2019 and 2018; and 
o 

administrative costs were higher by $2.6 million ($3.6 million in 2019 as compared to $1.0 million in 2018);  

•  Severance costs:  reduced administrative costs by $0.6 million ($1.1 million in 2019 as compared to $1.7 million in 

2018).    

•  Adoption of IFRS 16 in 2019:  reduced administrative costs by $2.9 million in 2019 (which was offset by higher 

depreciation costs of $2.6 million and interest costs of $0.5 million). 

•  Year-end adjustments in 2019:  reduced operating expenses by $0.6 million related to adjustments recorded in the 

three months ended December 31, 2019, primarily related to favourable labour accrual adjustments. 

The net impact of the above items was an increase of $2.8 million in net operating income (net favourable of $0.5 million in 
2019 as compared to costs of $2.3 million in 2018) and an increase of $3.7 million in Adjusted EBITDA ($1.3 million in 
2019 as compared to $5.0 million in 2018).  

Revenue 

Revenue grew by $12.0 million or 1.1% to $1,132.0 million in 2019. Excluding the factors impacting comparability 
discussed above, revenue increased by $9.8 million, or 0.9%, driven primarily by LTC funding enhancements, expansion of 
the retirement living operations and growth in other Canadian operations, partially offset by a decline in home health care 
volumes. 

Operating Expenses 

Operating expenses increased by $12.5 million or 1.3% to $998.5 million in 2019. Total labour costs increased by 
$6.8 million over 2018 and represented 85.5% and 86.0% of operating expenses for 2019 and 2018, respectively, and as a 
percentage of revenue were 75.5% and 75.7%, respectively. Excluding the factors impacting comparability of $0.6 million 
discussed above, the increase in operating expenses of $13.1 million was driven by higher costs of resident care, expansion 
of the retirement living operations and higher labour costs, partially offset by the impact of lower home health care volumes 
delivered.  

Net Operating Income  

Net operating income declined by $0.5 million or 0.4% to $133.5 million in 2019 and represented 11.8% of revenue as 
compared to 12.0% in 2018. Excluding the factors impacting comparability of $2.8 million discussed above, net operating 
income declined by $3.3 million to $133.0 million, or 11.8% of revenue in 2019, as compared to $136.3 million, or 12.2% 
of revenue in 2018, reflecting funding enhancements and growth of the retirement living and other Canadian operations, 
offset by lower home health care volumes and increased back office operating costs.  

Administrative Costs  

Administrative costs increased by $2.6 million or 6.5% to $42.3 million in 2019. Excluding the factors impacting 
comparability of $0.9 million discussed above, administrative costs increased by $3.5 million, primarily due to higher 
compensation costs and professional fees.   

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

20 

 
 
 
 
 
 
 
 
 
Adjusted EBITDA 

Adjusted EBITDA declined by $3.1 million to $91.1 million in 2019 and represented 8.0% of revenue as compared to 8.4% 
in 2018, reflecting the $0.5 million decline in net operating income and $2.6 million increase in administrative costs. 
Excluding the factors impacting comparability of $3.7 million discussed above, Adjusted EBITDA declined by $6.8 million 
to $92.4 million, or 8.2% of revenue in 2019, as compared to $99.2 million, or 8.9% of revenue in 2018, reflecting growth 
in net operating income of the LTC and retirement living operations, offset by lower volumes and net operating income of 
the home health care operations and higher administrative costs.  

Depreciation and Amortization 

Depreciation and amortization costs increased by $4.3 million to $39.6 million in 2019, of which $2.6 million was a result 
of the adoption of IFRS 16, and the balance was due to higher capital expenditures in prior periods.  

Other Expense 

Other expense of $2.4 million in 2019 related to costs associated with the ParaMed B.C. Contract Expiration of 
$1.4 million recorded in the three months ended March 31, 2019, and costs of $1.0 million recognized in the three months 
ended June 30, 2019, in connection with a representation and standstill agreement entered into with the Sandpiper group 
pursuant to which two nominees of the Sandpiper group were appointed to the Company’s board of directors (the “Board of 
Directors” or “Board”) and certain standstill covenants were provided in favour of the Company. Other expense of 
$20.2 million in 2018 related to an impairment charge of $16.2 million in respect of certain of the Company’s retirement 
communities and LTC homes, costs associated with the redemption of convertible debentures and costs related to the 
acquisition of a retirement community. 

Net Finance Costs  

Net finance costs decreased by $1.6 million to $24.9 million in 2019, primarily due to a favourable net change in foreign 
exchange and fair value adjustments related to the Captive’s investments and interest rate swaps aggregating to $1.8 million 
and lower accretion costs in connection with the decline in the accrual for U.S. self-insured liabilities, partially offset by 
higher interest expense due to a reduction in capitalized interest of $0.6 million, increased debt levels and the adoption of 
IFRS 16 in the amount of $0.5 million.  

Income Taxes  

The income tax provision was $7.2 million in 2019, representing an effective tax rate of 29.6%, as compared to a provision 
of $4.2 million and an effective tax rate of 34.4% in 2018. The effective tax rate of the Canadian operations was 32.7% in 
2019, as compared to 29.0% in 2018, and was impacted by, among other things, foreign exchange and fair value 
adjustments and other items reported separately as “other expense”, as noted above. The effective tax rate of the Canadian 
operations, excluding the impact of separately reported items, was 29.7% in 2019 as compared to 27.8% in 2018.  

Earnings from Continuing Operations 

Earnings from continuing operations of $17.1 million ($0.19 per basic share) in 2019 was up by $9.0 million from 
$8.1 million ($0.09 per basic share) in 2018, largely impacted by the above noted impairment charge incurred in 2018 and 
the favourable change in foreign exchange and fair value adjustments, partially offset by an increase in depreciation costs, 
and decline in earnings from the home health care operations due to higher back office operating costs and ParaMed 
Transformation costs and lower business volumes.  

Discontinued Operations  

Earnings from discontinued operations relate to the former U.S. operations and were $11.6 million in 2019 as compared to 
$23.6 million in 2018. The 2019 after-tax earnings include the release of $12.2 million of the Captive’s reserves, partially 
offset by the impact of discount rate adjustments. The 2018 after-tax earnings of $23.6 million include the release of 
$13.0 million of the Captive’s reserves, the favourable impact of discount rate adjustments of $1.1 million, a $3.6 million 
decrease in indemnification provisions and other items and a net tax recovery of $5.9 million.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

21 

 
 
 
 
 
 
 
 
 
 
Summary of Results of Operations by Segment  

The following summarizes the Company’s segmented “revenue”, “operating expenses” and “net operating income”, 
followed by an analysis of the operating performance of each of the Company’s operating segments.  

Years ended December 31 
(thousands of dollars) 

Long-term  Retirement 
Living 

Care 

Home 
Other  
Health  Canadian  Corporate 
Canada 

Care  Operations 

Total 
Canada 

Total 
U.S. 

Total 

2019 
Revenue 
Operating expenses 
Net operating income 
NOI margin % 

2018 
Revenue 
Operating expenses 
Net operating income 
NOI margin % 

Change 
Revenue 
Operating expenses 
Net operating income  

 643,785  
 566,375  
 77,410  
12.0% 

 632,533  
 559,489  
 73,044  
11.5% 

 41,276  
 29,844  
 11,432  
27.7% 

 422,995  
 391,646  
 31,349  
7.4% 

 23,894  
 10,635  
 13,259  
55.5% 

 –   1,131,950  
 998,500  
 –  
 133,450  
 –  
11.8% 
 –  

 –   1,131,950  
 998,500  
 –  
 133,450  
 –  
11.8% 
 –  

 33,412  
 24,430  
 8,982  
26.9% 

 431,343  
 393,354  
 37,989  
8.8% 

 22,291  
 8,750  
 13,541  
60.7% 

 23   1,119,602  
 986,023  
 133,579  
11.9% 

 –  
 23  
100.0% 

 405   1,120,007  
 986,023  
 133,984  
12.0% 

 –  
 405  
100.0% 

 11,252  
 6,886  
 4,366  

 7,864  
 5,414  
 2,450  

 (8,348) 
 (1,708) 
 (6,640) 

 1,603  
 1,885  
 (282) 

 (23) 
 –  
 (23) 

 12,348  
 12,477  
 (129) 

 (405) 
 –  
 (405) 

 11,943  
 12,477  
 (534) 

LONG-TERM CARE OPERATIONS 

Net operating income from the long-term care operations was $77.4 million in 2019 as compared to $73.0 million in 2018, 
an increase of $4.4 million or 6.0%, with an NOI margin of 12.0% and 11.5%, respectively. Results included favourable 
labour accrual adjustments of approximately $1.1 million recorded in 2019, excluding which the net operating income 
would have been $76.3 million, with an NOI margin of 11.9%. Revenue grew by $11.3 million, or 1.8%, of which 
approximately $6.7 million related to the Ontario flow-through funding envelopes, and was therefore directly offset by 
increased costs of resident care, and the balance was from other funding enhancements. Operating expenses increased by 
$6.9 million, or 1.2%, due primarily to higher labour, utilities and other costs of resident care, partially offset by the labour 
accrual adjustments. Excluding the accrual adjustments, labour costs as a component of operating expenses increased by 
$5.3 million or 1.2% over 2018, and represented 82.3% of operating expenses in 2019 as compared to 82.5% in 2018.  

RETIREMENT LIVING OPERATIONS 

The following table summarizes the breakdown of the same-store and non same-store operating results of the retirement 
living operations.  

Retirement Living 
(thousands of dollars unless otherwise noted) 

Same-store 
Revenue  
Operating expenses 
Net operating income / margin % 
Average occupancy / weighted average available suites 

Non Same-store 
Revenue 
Operating expenses  
Net operating income (loss) / margin % 
Average occupancy / weighted average available suites 

Total 
Revenue 
Operating expenses 
Net operating income / margin % 
Average occupancy / weighted average available suites 

2019 

32.9%  
 720   

 –   
 236   

27.7%  
 956   

 34,725   
 23,290   
 11,435  
93.0% 

 6,551   
 6,554   
 (3) 
48.9% 

 41,276   
 29,844   
 11,432  
82.1% 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

Years ended December 31 
Change 

2018 

 29,615   
 21,320   
 8,295  
84.7% 

 3,797   
 3,110   
 687  
93.0% 

 33,412   
 24,430   
 8,982  
85.5% 

28.0%  
 683   

18.1%  
 68   

26.9%  
 750   

 5,110  
 1,970  
 3,140  
 37  

 2,754  
 3,444  
 (690) 
 168  

 7,864  
 5,414  
 2,450  
 206  

22 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Net operating income from the retirement living operations was $11.4 million in 2019 as compared to $9.0 million in 2018, 
representing an increase of $2.4 million or 27.3%. This improvement was driven primarily by growth in average occupancy 
from same-store operations to 93.0% in 2019 as compared to 84.7% for the same prior year period, partially offset by a 
decline in contribution from non same-store operations of $0.7 million, due to early lease-up and pre-opening losses from 
Bolton Mills and The Barrieview.  

HOME HEALTH CARE OPERATIONS 

Net operating income from the home health care operations declined by $6.6 million or 19.2% to $31.3 million in 2019 
over 2018, with an NOI margin of 7.4% and 8.8%, respectively. Total labour costs as a component of total operating 
expenses decreased by $3.5 million and represented 92.3% of operating expenses compared to 92.8% in 2018. Excluding 
the factors impacting comparability of $1.7 million discussed under “– Summary of Factors Impacting Comparability”, net 
operating income declined by $8.3 million to $32.0 million, or 7.6% of revenue, in 2019, as compared to $40.3 million, or 
9.3% of revenue, in 2018. The decline in net operating income related primarily to a 3.0% decline in average daily volumes 
and higher back office operating costs. After further excluding the impact of the B.C. operations, net operating income for 
2019 would have been $32.3 million as compared to $40.3 million in 2018, with an NOI margin of 8.7% compared to 
10.5%, respectively. Refer to the discussion under “Significant 2019 Events and Developments – ParaMed – B.C. Contract 
Expiration”. 

OTHER CANADIAN OPERATIONS 

Net operating income from the contract services, consulting and group purchasing operations declined by $0.3 million or 
2.1% to $13.3 million in 2019 over 2018, with revenue growth of 7.2% due to an increase in clients served, offset by 
increased costs to support operations.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

23 

 
 
 
 
 
 
 
 
ADJUSTED FUNDS FROM OPERATIONS 

The following provides a reconciliation of “net earnings” to FFO and AFFO. A reconciliation of “net cash from operating 
activities” to AFFO is also provided under “Reconciliation of Net Cash from Operating Activities to AFFO”.  

(thousands of dollars unless otherwise noted) 
Net earnings 
Add (Deduct): 
Depreciation and amortization 
Depreciation for FFEC (maintenance capex) (1) 
Depreciation for office leases (2) 
Other expense (continuing operations) 
Other income (discontinued operations) 
Foreign exchange and fair value adjustments 
Current income tax expense (recovery) on other expense, 
  foreign exchange and fair value adjustments (3) 
Deferred income tax expense 
FFO 
Amortization of deferred financing costs 
Accretion costs 
Non-cash share-based compensation 
Principal portion of government capital funding 
Amounts offset through investments held for  
  self-insured liabilities (4) 
Additional maintenance capex (1) 
AFFO 
Per Basic Share ($) 
FFO 
AFFO 
Per Diluted Share ($) 
FFO 
AFFO 
Dividends ($) 
Declared 
Declared per share ($) 
Weighted Average Number of Shares (thousands) 
Basic 
Diluted 
Current income tax expense included in FFO 
Total maintenance capex (1) 

Three months ended 
December 31 
Change 
 3,581   

2018 
 6,507  

 10,184  
 (1,882) 
 –  
 16,642  
 (9,663) 
 1,645  

 413   
 27   
 (621)  
 (16,642)  
 4,468   
 (3,134)  

 (12,076) 
 830  
 12,187  
 391  
 635  
 214  
 1,300  

 10,777   
 1,379   
 248   
 45   
 (242)  
 162   
 69   

 163  
 (2,320) 
 12,570  

 366   
 (1,853)  
 (1,205)  

 0.137  
 0.142  

 0.002   
 (0.015)  

 0.137  
 0.138  

 0.002   
 (0.014)  

2019 
 10,088  

 10,597  
 (1,855) 
 (621) 
 –  
 (5,195) 
 (1,489) 

 (1,299) 
 2,209  
 12,435  
 436  
 393  
 376  
 1,369  

 529  
 (4,173) 
 11,365  

 0.139  
 0.127  

 0.139  
 0.124  

Years ended 
December 31 
2018  Change 
 (3,108) 

 31,738  

 35,270  
 (7,422) 
 –  
 20,195  
 (17,755) 
 (247) 

 (11,805) 
 1,936  
 51,910  
 1,736  
 2,878  
 430  
 5,200  

 4,320  
 524  
 (2,588) 
 (17,791) 
 6,176  
 (1,760) 

 10,226  
 (1,724) 
 (5,725) 
 (22) 
 (1,035) 
 1,168  
 286  

 850  
 (5,253) 
 57,751  

 338  
 (161) 
 (5,151) 

 0.587  
 0.653  

 (0.069) 
 (0.063) 

 0.587  
 0.634  

 (0.069) 
 (0.062) 

2019 
 28,630  

 39,590  
 (6,898) 
 (2,588) 
 2,404  
 (11,579) 
 (2,007) 

 (1,579) 
 212  
 46,185  
 1,714  
 1,843  
 1,598  
 5,486  

 1,188  
 (5,414) 
 52,600  

 0.518  
 0.590  

 0.518  
 0.572  

 10,701  
 0.120  

 10,612  
 0.120  

 89   
 –   

 42,672  
 0.480  

 42,351  
 0.480  

 321  
 –  

 89,467  
 99,850  
 1,075  
 6,028  

 88,612   
 98,962   
 2,075  
 4,202  

 (1,000)  
 1,826   

 89,148  
 99,539  
 8,552  
 12,312  

 88,403   
 98,753   
 8,205  
 12,675  

 347  
 (363) 

(1)  The aggregate of the items “depreciation for FFEC” and “additional maintenance capex” represents total actual maintenance capex incurred 
       in the period. An amount equivalent to depreciation for FFEC, or furniture, fixtures, equipment and computers, is deducted in determining 
       FFO, and the difference from the actual total maintenance capex incurred is adjusted for in determining AFFO. 

(2)  Represents depreciation recognized on adoption of IFRS 16 related to office leases. 

(3)  Represents current income tax with respect to items that are excluded from the computation of FFO and AFFO, such as foreign exchange and 
       fair value adjustments, and other expense. 

(4)  Represents AFFO of the Captive that decreases/(increases) the Captive’s investments held for self-insured liabilities not impacting the Company’s 
       reported cash and short-term investments.   

AFFO 2019 Financial Review  

For the three months ended December 31, 2019, AFFO declined by $1.2 million, or 9.6%, to $11.4 million ($0.127 per 
basic share) from $12.6 million ($0.142 per basic share) for the three months ended December 31, 2018, impacted by an 
increase in maintenance capex of $1.8 million and net interest costs of $0.8 million, partially offset by lower current taxes 
of $1.0 million. Current income taxes this quarter were impacted by favourable year-end accrual adjustments and deferred 
tax timing differences.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

24 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
For 2019, AFFO declined by $5.2 million, or 8.9%, to $52.6 million ($0.590 per basic share) from $57.8 million 
($0.653 per basic share) in 2018, impacted by the decline in Adjusted EBITDA, partly driven by reduced volumes and 
lower net operating income in the home health care operations and higher administrative costs, and increased net interest 
costs.  

Excluding the impact of the previously noted factors, AFFO declined by $1.8 million, or 13.9%, to $11.4 million for the 
three months ended December 31, 2019 and by $7.0 million, or 11.2%, to $55.3 million from $62.3 million for the year 
ended December 31, 2019. 

A discussion of the factors impacting net earnings and Adjusted EBITDA can be found under “2019 Fourth Quarter 
Financial Review” and “2019 Financial Review”.  

The effective tax rate on FFO was 15.6% in 2019 as compared to 13.6% in 2018. The Company’s current income taxes for 
2018 benefitted from favourable timing differences and the utilization of tax loss carryforwards. In 2020, the Company 
expects the effective tax rate on FFO will be in the range of 14% to 16%. The determination of FFO includes a deduction 
for current income tax expense and does not include deferred income tax expense. As a result, the effective tax rates on 
FFO can be impacted by:  adjustments to estimates of annual deferred timing differences, particularly when dealing with 
cash-based tax items versus accounting accruals; changes in the proportion of earnings between taxable and non-taxable 
entities; book-to-file adjustments for prior year filings; and the ability to utilize loss carryforwards.  

Maintenance capex was $6.0 million for the three months ended December 31, 2019, as compared to $4.2 million for the 
three months ended December 31, 2018, and as compared to $3.0 million for the three months ended September 30, 2019, 
representing 2.1%, 1.5% and 1.1% of revenue, respectively. Maintenance capex was $12.3 million in 2019 as compared to 
$12.7 million in 2018, representing 1.1% of revenue in each year. These costs fluctuate on a quarterly and annual basis with 
the timing of projects and seasonality. Management monitors and prioritizes the capital expenditure requirements of its 
properties throughout the year, taking into account the urgency and necessity of the expenditure. In 2020, the Company 
expects to spend in the range of $11 million to $13 million in maintenance capex, as compared to $12.3 million in 2019.  

Reconciliation of Net Cash from Operating Activities to AFFO  

The following provides a reconciliation of “net cash from operating activities” to AFFO.  

(thousands of dollars) 
Net cash from operating activities 
Add (Deduct): 
Net change in operating assets and liabilities, including interest, 
  taxes and payments for U.S. self-insured liabilities 
Current income tax on items excluded from AFFO (1) 
Depreciation for office leases (2) 
Depreciation for FFEC (maintenance capex) (3) 
Additional maintenance capex (3) 
Principal portion of government capital funding 
Amounts offset through investments held for self-insured liabilities (4) 
AFFO 

Three months ended 
December 31 
2018 
 1,189   

2019 
 4,996  

Years ended 
December 31 
2018 
 39,473  

2019 
 45,190  

 12,419  
 (1,299) 
 (621) 
 (1,855) 
 (4,173) 
 1,369  
 529  
 11,365  

 26,196   
 (12,076)  
 –  
 (1,882)  
 (2,320)  
 1,300   
 163   
 12,570   

 17,215  
 (1,579) 
 (2,588) 
 (6,898) 
 (5,414) 
 5,486  
 1,188  
 52,600  

 36,708  
 (11,805) 
 – 
 (7,422) 
 (5,253) 
 5,200  
 850  
 57,751  

(1)  Represents current income tax with respect to items that are excluded from the computation of AFFO, such as foreign exchange and fair value 
       adjustments, and other expense. 
(2)  Represents depreciation recognized on adoption of IFRS 16 related to office leases. 

(3)  The aggregate of the items “depreciation for FFEC” and “additional maintenance capex” represents total actual maintenance capex incurred in  
       the period. An amount equivalent to depreciation for FFEC, or furniture, fixtures, equipment and computers, is deducted in determining FFO,  
       and the difference from the actual total maintenance capex incurred is adjusted for in determining AFFO. 

(4)  Represents AFFO of the Captive that decreases/(increases) its investments held for self-insured liabilities not impacting the Company’s reported 
       cash and short-term investments. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

25 

 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LIQUIDITY AND CAPITAL RESOURCES  

Sources and Uses of Cash 

The following summarizes the sources and uses of cash between continuing and discontinued operations for 2019 and 2018.  

(thousands of dollars unless otherwise noted) 
Cash provided by operating activities, 
  before working capital changes 
  and interest and income taxes 
Net change in operating assets and liabilities 

Accounts receivable 
Other assets 
Accounts payable and accrued liabilities 

Interest, taxes and claims payments 

Interest paid 
Interest received 
Income taxes paid 
Payments for U.S. self-insured liabilities 

Net cash from (used in) operating activities 
Net cash from (used in) investing activities 
Net cash used in financing activities 
Foreign exchange gain (loss) on U.S. cash held 
Increase (decrease) in cash and  
  short-term investments 
Cash and short-term investments at 
  beginning of year 
Cash and short-term investments at 
  end of year 

Continuing  Discontinued 

2019 
Total 

  Continuing  Discontinued 

2018 
Total 

 92,708  

 200  
 1,133  
 (6,165) 
 (4,832) 

 (27,933) 
 3,677  
 (5,661) 
 –  
 (29,917) 
 57,959  
 –  
 (28,668) 
 (727) 

 28,564  

 65,893  

 94,457  

 –  

 –  
 –  
 –  
 –  

 –  
 –  
 –  
 (12,769) 
 (12,769) 
 (12,769) 
 12,769  
 –  
 –  

 –  

 –  

 –  

 92,708   

 94,668  

 –  

 94,668  

 200   
 1,133   
 (6,165)  
 (4,832)  

 (27,933)  
 3,677   
 (5,661)  
 (12,769)  
 (42,686)  
 45,190   
 12,769   
 (28,668)  
 (727)  

 (8,172) 
 (536) 
 2,210  
 (6,498) 

 (28,383) 
 3,785  
 (8,862) 
 –  
 (33,460) 
 54,710  
 (70,289) 
 (48,763) 
 2,079  

 –  
 –  
 –  
 –  

 –  
 –  
 –  
 (15,237) 
 (15,237) 
 (15,237) 
 15,237  
 –  
 –  

 (8,172) 
 (536) 
 2,210  
 (6,498) 

 (28,383) 
 3,785  
 (8,862) 
 (15,237) 
 (48,697) 
 39,473  
 (55,052) 
 (48,763) 
 2,079  

 28,564   

 (62,263) 

 –  

 (62,263) 

 65,893   

 128,156  

 –  

 128,156  

 94,457   

 65,893  

 –  

 65,893  

As at December 31, 2019, the Company had cash and short-term investments on hand of $94.5 million, reflecting an 
increase in cash of $28.6 million from the beginning of the year. Cash flow generated from the operating activities of the 
continuing operations of $57.9 million was in excess of cash dividends paid of $37.2 million. 

Net cash from operating activities of the continuing operations was a source of cash of $57.9 million in 2019, up 
$3.2 million or 5.9% as compared to a source of cash of $54.7 million in 2018. The increase in cash between periods was 
primarily due to a reduction in net income taxes paid and favourable net change in operating assets and liabilities, partially 
offset by lower earnings between periods.  

Net cash from investing activities of the continuing operations was break even in 2019, as compared to a use of cash of 
$70.3 million in 2018. The 2019 activity included the repatriation of cash of $26.7 million (US$20.0 million) from the 
Captive and collection of other assets, offset by purchases of property, equipment and other intangible assets of 
$33.2 million. The 2018 activity included cash from the Captive of $9.7 million (US$7.5 million) and collection of other 
assets, offset by the acquisition of a retirement community for $33.8 million and purchases of property, equipment and 
other intangible assets of $50.6 million. The table that follows summarizes the capital expenditures. Growth capex, 
excluding acquisitions, relates to the construction of new beds, building improvements or other capital projects, all of which 
are aimed at earnings growth. Maintenance capex relates to the actual capital expenditures incurred to sustain and upgrade 
existing property and equipment. Management monitors and prioritizes the capital expenditure requirements of its 
properties throughout the year, taking into account the urgency and necessity of the expenditure. In 2020, the Company is 
projecting to spend in the range of $11 million to $13 million in maintenance capex and in the range of $25 million to 
$28 million in growth capex related primarily to the planned expansion of Empire Crossing Retirement Community, LTC 
redevelopment and other growth initiatives.  

(thousands of dollars) 
Growth capex 
Deduct: capitalized interest 
Growth capex, excluding capitalized interest 
Maintenance capex 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

2019 
 21,595   
 (725)  
 20,870   
 12,312   
 33,182   

2018 
 39,291  
 (1,318) 
 37,973  
 12,675  
 50,648  

26 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
Net cash from financing activities of the continuing operations was a use of cash of $28.7 million in 2019, down 
$20.1 million, as compared to a use of cash of $48.8 million in 2018. The 2019 activity included debt repayments of 
$35.7 million and cash dividends paid of $37.2 million, partially offset by the issuance of mortgages on two retirement 
communities in the aggregate of $25.3 million and draws on construction financing of $20.7 million. The 2018 activity 
included debt repayments of $33.2 million, cash dividends paid of $37.4 million, Common Shares acquired for cancellation 
under a normal course issuer bid at a cost of $6.3 million and financing costs primarily in connection with the issuance 
and redemption of convertible debentures, partially offset by draws on construction financing of $23.0 million and the 
issuance of a $10.5 million mortgage on a retirement community. For information on the change in long-term debt, refer to 
“– Long-term Debt”.  

Discontinued operations reflect the payment of claims for U.S. self-insured liabilities as a component of net cash from 
operating activities, which payments are funded by the Captive’s investments held for self-insured liabilities. Changes in 
the Captive’s investments are reported as a component of net cash from investing activities, as those invested funds are not 
included in cash and short-term investments. 

Capital Structure 

SHAREHOLDERS’ EQUITY 

The following summarizes shareholders’ equity for 2019 and 2018. 

(thousands of dollars unless otherwise noted) 
Shareholders’ Equity 
Common Shares 
Equity portion of convertible debentures 
Contributed surplus 

Accumulated deficit at beginning of year 
Adoption of new standard on financial instruments 
Net earnings 
Dividends declared 
Equity portion of redeemed convertible debentures 
Purchase of Common Shares in excess of book value and other 
Accumulated deficit at end of year 

Accumulated other comprehensive loss 
Shareholders’ equity 
 Au 

Share Information (thousands) 
Common Shares (TSX symbol: EXE) (1) 

2019 

2018 

 498,116  
 7,085  
 3,675  
 508,876  

 (368,147) 
 –  
 28,630  
 (42,672) 
 –  
 –  
 (382,189) 

 (11,273) 
 115,414  

 492,064  
 7,085  
 2,706  
 501,855  

 (365,084) 
 4,334  
 31,738  
 (42,351) 
 5,573  
 (2,357) 
 (368,147) 

 (7,717) 
 125,991  

February 26 , 
2020 
89,383.9 

December 31, 
2019 
89,232.5 

December 31, 
2018 
88,490.0 

(1)  Closing market value per the TSX on February 26, 2020, was $8.25. 

As at February 26, 2020, the Company had $126.5 million in aggregate principal amount of convertible subordinate 
debentures outstanding that mature in April 2025 (the “2025 Debentures”), which in the aggregate are convertible into 
10,326,531 Common Shares.  

DIVIDENDS   

The declaration and payment of dividends by the Company is at the discretion of the Board as to the amount and timing of 
dividends to be declared and paid, after consideration of a number of factors, including results of operations, requirements 
for capital expenditures and working capital, future financial prospects of the Company, debt covenants and obligations and 
any other factors deemed relevant by the Board. If the Board determines that it would be in the Company’s best interests, it 
may modify the amount and frequency of dividends to be distributed to holders of Common Shares (Shareholders).  

The Company declared cash dividends of $0.48 per share in 2019, consistent with that declared in 2018, representing 
$42.7 million and $42.3 million in dividends declared for each period respectively. In 2019, dividends paid in cash totalled 
$37.2 million and $5.4 million were by way of 693,466 Common Shares issued under the Company’s dividend 
reinvestment plan (the “DRIP”), as compared to $37.4 million in cash and $4.9 million by way of 650,361 Common Shares 
issued under the DRIP in 2018.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

27 

 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Compared to AFFO of $52.6 million in 2019, dividends declared of $42.7 million represented a payout ratio of 81%, as 
compared to a payout ratio of 73% in 2018. The increase in the payout ratio was primarily due to the decline in earnings in 
2019. For further information on AFFO, refer to the discussion under “Adjusted Funds from Operations”.  

NORMAL COURSE ISSUER BID (NCIB) 

During 2019, the Company purchased no Common Shares under its NCIB that expired on January 14, 2020, for which it 
sought and received approval from the TSX to purchase up to 8,830,000 Common Shares. 

During 2018, under its NCIB that expired on January 14, 2019, for which the Company sought and received approval from 
the TSX to purchase up to 8,770,000 Common Shares, the Company purchased an aggregate of 703,585 Common Shares at 
a weighted average price of $8.89 per share, for a total cost of $6.3 million. 

In January 2020, the Company received approval from the TSX to renew its NCIB to purchase for cancellation up to 
8,000,000 Common Shares (representing approximately 10% of its public float) through the facilities of the TSX, and 
through alternative Canadian trading systems, in accordance with TSX rules. The NCIB commenced on January 15, 2020, 
and provides the Company with flexibility to purchase Common Shares for cancellation until January 14, 2021, or on such 
earlier date as the NCIB is complete. The actual number of Common Shares purchased under the NCIB and the timing of 
any such purchases will be at the Company’s discretion. Subject to the TSX’s block purchase exception, on any trading 
day, purchases under the NCIB will not exceed 42,703 Common Shares. As at February 27, 2020, the Company has not 
acquired any Common Shares under its NCIB.  

Long-term Debt  

CONTINUITY OF LONG-TERM DEBT 

Long-term debt totalled $556.3 million as at December 31, 2019, as compared with $529.0 million as at December 31, 
2018, representing an increase of $27.3 million, consisting of an increase in lease liabilities of $16.8 million primarily due 
to the renewal of the corporate head office lease ($10.3 million) and the adoption of IFRS 16 ($5.8 million), mortgage 
financings on two retirement communities in the aggregate of $25.3 million and draws on construction loans, partially 
offset by debt repayments. The long-term debt activity for 2018 included a $10.5 million mortgage on a retirement 
community and the refinancing of $126.5 million of convertible debentures for seven years to 2025, draws on construction 
loans, partially offset by debt repayments. The Company and its subsidiaries are in compliance with all of their respective 
financial covenants as at December 31, 2019. Details of the components, terms and conditions of long-term debt are 
provided in Note 12 of the audited consolidated financial statements.  

The following summarizes the changes in the carrying amounts of long-term debt for 2019 and 2018.     

(millions of dollars) 
Long-term debt at beginning of year, prior to deferred financing costs 
Issue of long-term debt 
Construction loans 
Mortgages 
2025 Debentures at face value  
Lease liabilities on adoption of IFRS 16 
Lease liabilities 
Redemption of convertible debentures at face value 
Repayment of long-term debt 
Change in equity component of convertible debentures and other 

Deferred financing costs at end of year 
Long-term debt at end of year 
Less: current portion 

2019 
 537.4  

 20.7  
 25.3  
 –  
 5.8  
 11.0  
 –  
 (35.7) 
 0.2  
 564.7  
 (8.4) 
 556.3  
 (133.8) 
 422.5  

2018 
 541.8  

 23.0  
 10.5  
 126.5  
 –  
 –  
 (126.5) 
 (33.2) 
 (4.7) 
 537.4  
 (8.4) 
 529.0  
 (74.7) 
 454.3  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

28 

 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
CREDIT FACILITIES  

The Company’s wholly owned subsidiary, ParaMed Inc., has a demand credit facility in the amount of $65.0 million 
(the “ParaMed Credit Facility”) that is secured by the assets of its home health care business and is available for general 
corporate purposes by the Company. The ParaMed Credit Facility has no financial covenants, but does contain normal and 
customary terms. The entire $65.0 million was available and unutilized as at December 31, 2019.  

Extendicare Inc. has a demand credit facility in the amount of $47.3 million (the “Extendicare Credit Facility”) that is 
secured by 13 Class C LTC homes in Ontario and is guaranteed by certain Canadian subsidiaries of Extendicare. As at 
December 31, 2019, the Company had letters of credit totalling $43.6 million issued under the Extendicare Credit Facility, 
of which $38.1 million secure the defined benefit pension plan obligations and the balance were issued in connection with 
obligations relating to recently acquired homes and those homes under development. The letter of credit to secure the 
pension plan obligations renews annually in May based on an actuarial valuation. The Extendicare Credit Facility has no 
financial covenants, but does contain normal and customary terms including annual re-appraisals of the homes that could 
limit the maximum amount available.  

LONG-TERM DEBT MATURITIES AND WEIGHTED AVERAGE INTEREST RATES  

The following table presents the principal, or notional, amounts and related weighted average interest rates by year of 
maturity, of the Company’s long-term debt obligations as at December 31, 2019. The Company had an aggregate of 
$64.6 million drawn on construction loans at the end of 2019, which are repayable on demand and, in any event, are to be 
fully repaid by the earlier of achieving stabilized occupancy as defined by the agreements and specified dates. 
Consequently, these loans are reflected as current and due in 2020 in the following table. Permanent financing for each of 
the communities may be sought upon maturity of the construction financing.   

(millions of dollars unless otherwise noted) 
Convertible Debentures (at face value) 
Fixed rate 
Average interest rate 
Long-term Debt 
Fixed rate (including fixed through swap) 
Average interest rate 
Variable rate (construction loans) 
Average interest rate 
Lease Liabilities 
Fixed rate 
Average interest rate 

2020 

2021 

2022 

2023 

2024 

After 
2024 

Total 

 –  
 –  

 –  
 –  

 –  
 –  

 –  
 –  

 –  
 –  

 126.5  
5.00% 

 126.5  
5.00%  

 60.8  
3.75% 
 64.6  
4.41% 

 15.9  
4.06% 
 –  
 –  

 59.4  
3.75% 
 –  
 –  

 46.4  
4.03% 
 –  
 –  

 6.0  
4.89% 
 –  
 –  

 104.7  
4.50% 
 –  
 –  

 293.2  
4.18%  
 64.6  
4.41%  

Fair 
Value 

 132.6  

 290.1  

 64.6  

 9.9  
6.39% 

 11.0  
6.16% 

 10.0  
6.73% 

 10.1  
6.83% 

 10.5  
6.88% 

 34.7  
6.53% 

 86.2  
6.83%  

 95.7  

Management has limited the amount of debt that may be subject to changes in interest rates, with all of the debt currently at 
fixed rates, other than the construction loans of $64.6 million. The Company’s variable-rate mortgages and term loan, 
aggregating $82.0 million at the end of 2019, have effectively been converted to fixed rate financings with interest rate 
swaps over the full term. As at December 31, 2019, the net carrying value of the interest rate swaps was a net asset of 
$0.8 million (including a liability of $0.7 million).  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

29 

 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
The following summarizes key metrics of consolidated long-term debt as at December 31, 2019 and 2018.  

(thousands of dollars unless otherwise noted) 
Weighted average interest rate of long-term debt outstanding 
Weighted average term to maturity of long-term debt outstanding 
Trailing twelve months consolidated net interest coverage ratio(1) 
Trailing twelve months consolidated interest coverage ratio(2) 
Debt to Gross Book Value (GBV) 
Total assets (carrying value) 
Accumulated depreciation on property and equipment 
Accumulated amortization on other intangible assets 
GBV 
Debt (3) 
Debt to GBV 
(1)  Net interest coverage ratio is defined as Adjusted EBITDA divided by net interest (interest expense before reduction of capitalized interest,  
       net of interest revenue). The adoption of IFRS 16 has not had a material impact on the interest coverage ratios. 

December 31, 2019 
 4.7%     
 6.7 yrs  
 3.5 X    
 3.1 X    

 888,800        
 251,403        
 23,951        
 1,164,154        
 570,536        
 49.0%    

December 31, 2018 
 4.9%    
 7.4 yrs 
 3.7 X   
 3.2 X   

 896,324       
 226,417       
 18,509       
 1,141,250       
 544,111       
 47.7%   

(2)  Interest coverage ratio is defined as Adjusted EBITDA divided by interest expense before reduction of capitalized interest.  The adoption of  
       IFRS 16 has not had a material impact on the interest coverage ratios. 
(3)  Debt includes convertible debentures at face value of $126.5 million, and excludes deferred financing costs. 

Future Liquidity and Capital Resources  

The Company’s consolidated cash and short-term investments on hand was $94.5 million as at December 31, 2019, as 
compared with $65.9 million as at December 31, 2018, representing an increase of $28.6 million. In addition, the Company 
had $65.0 million available to draw under its ParaMed Credit Facility. Cash and short-term investments exclude restricted 
cash of $2.4 million and $27.6 million (US$21.2 million) of investments held by the Captive to support the accrual for U.S. 
self-insured liabilities of $12.2 million (US$9.4 million). Subsequent to December 31, 2019, the Company initiated the 
repatriation of US$7.0 million from the Captive, which is expected to be received in the second quarter of 2020.  

As at December 31, 2019, the Company had construction financings in the aggregate of up to $77.7 million that are secured 
on three retirement communities (Douglas Crossing, Bolton and The Barrieview), of which $64.6 million was drawn. As at 
December 31, 2019, the Company had incurred approximately $98.4 million of the estimated $99.1 million of Adjusted 
Development Costs for these three retirement communities.  

Management believes that cash from operating activities and future debt financings will be sufficiently available  to support 
the Company’s ongoing business operations, maintenance capex and debt repayment obligations. Growth through 
redevelopment of the LTC homes over the next few years, strategic acquisitions and developments will necessitate the 
raising of funds through debt and equity financings. Decisions will be made on a specific transaction basis and will depend 
on market and economic conditions at the time. 

OTHER CONTRACTUAL OBLIGATIONS AND CONTINGENCIES 

Property and Equipment Commitments  

The Company had outstanding commitments of $0.6 million at December 31, 2019, in connection with retirement 
communities under development in Ontario. 

Defined Benefit Pension Plan Obligations  

The Company has a registered defined benefit plan and a supplementary plan covering certain executives, both of which 
have been closed to new entrants since 2000. The accrued benefit liability on the statement of financial position as at 
December 31, 2019, was $36.5 million (2018 – $36.1 million). The registered defined benefit plan was in an actuarial 
deficit of $2.8 million, with plan assets of $5.3 million and accrued benefit obligations of $8.1 million as at December 31, 
2019 (2018 – an actuarial deficit of $2.6 million with plan assets of $5.1 million and accrued benefit obligations of 
$7.7 million). The accrued benefit obligations of the supplementary plan were $33.7 million as at December 31, 2019 (2018 
– $33.5 million). The Company does not set aside assets in connection with the supplementary plan and the benefit 
payments will be paid from cash from operations. The benefit obligations under the supplementary plan are secured by a 
letter of credit totalling $38.1 million as at December 31, 2019 (2018 – $38.0 million). This letter of credit renews annually 
in May based on an actuarial valuation of the pension obligations. The annual benefit payments under the supplementary 
pension plan to be funded from cash from operations over the next five years are expected to be in the range of $2.0 million 
to $3.4 million, and the annual contributions to the registered pension plan are less than $0.1 million. Since the majority of 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

30 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
the accrued benefit obligations represent obligations under the non-registered supplementary plan, which is not required to 
be funded, changes in future market conditions are not expected to have a material adverse effect on the Company’s cash 
flow requirements with respect to its pension obligations, or on its pension expense.  

Accrual for U.S. Self-insured Liabilities  

The obligation to settle U.S. self-insured general and professional liability claims relating to the period prior to the closing 
of the U.S. Sale Transaction, including claims incurred but yet to be reported, remains with the Company, which continues 
to be funded through the Captive. Consequently, the balance of the accrual for self-insured liabilities and the related 
investments held for self-insured liabilities remain on the consolidated statement of financial position. However, any 
expense incurred or release of reserves for U.S. self-insured liabilities are presented as discontinued operations, while the 
Captive’s costs to administer and manage the settlement of the remaining claims are reported as continuing operations 
within the U.S. segment. 

Management regularly evaluates and semi-annually engages an independent third-party actuary to determine the 
appropriateness of the carrying value of this liability. The most recent independent actuarial review was conducted at the 
end of 2019, which confirmed the adequacy of the Company’s reserves. 

As at December 31, 2019, the accrual for U.S. self-insured general and professional liabilities was $12.2 million 
(US$9.4 million) as compared to $37.1 million (US$27.2 million) at the beginning of the year. The decline of 
US$17.8 million reflected claim payments of US$9.6 million and a release of reserves of US$9.2 million, partially offset 
by accretion of the discounted liability and change in discount factor applied.  

During 2018, payments for self-insured liabilities were $15.2 million (US$11.8 million) and $13.0 million (US$9.9 million) 
in reserves were released and reflected in discontinued operations.  

Most of the risks that the Company self-insures are long-term in nature, and accordingly, claim payments for any particular 
policy year occur over a long period of time. However, management estimates and allocates a current portion of the accrual 
for self-insured liabilities on the statement of financial position. As at December 31, 2019, management estimated that 
approximately $3.6 million of the accrual for U.S. self-insured general and professional liabilities will be paid within the 
next twelve months. As the timing of payments is not directly within management’s control, estimates could change in the 
future.  

The Captive holds investments sufficient to support the accrual for self-insured liabilities and to meet required statutory 
solvency and liquidity ratios. These invested funds are reported in other assets and totalled $27.6 million (US$21.2 million) 
as at December 31, 2019, as compared to $67.9 million (US$49.8 million) at the beginning of the year. During 2019, the 
Captive transferred US$20.0 million of cash previously held for investment to the Company for general corporate use and 
initiated repatriation of a further US$7.0 million, which is expected to be received in the second quarter of 2020. 
Management believes there are sufficient invested funds held to meet estimated current claims payment obligations. 

Legal Proceedings, Claims and Regulatory Actions  

The Company and its consolidated subsidiaries are defendants in various actions and proceedings that are brought against 
them from time to time in connection with their operations.  

As previously disclosed, in April 2018, the Company was served with a statement of claim alleging negligence by the 
Company in the operation of its long-term care homes and its provision of care to residents and seeking $150.0 million in 
damages. The claim sought an order certifying the claim as a class action pursuant to the Class Proceedings Act (Ontario). 
By order of the Ontario Superior Court of Justice the class proceeding was discontinued on October 25, 2018. Following 
the discontinuance, the plaintiff who commenced the class proceeding still has the option to pursue a claim on her own 
behalf while others may also do so separately on their own behalf. Since July 2019, certain individual plaintiffs have served 
the Company with statements of claim alleging negligence by the Company in the operation of certain of its long-term care 
homes and its provision of care to certain residents. The Company intends to defend itself against any and all such 
individual claims and does not believe the outcome on any or all such claims would have a material adverse impact on its 
business, results of operations or financial condition and in any event believes that any potential liability would be resolved 
within the limits of its insurance coverage. 

On September 19, 2018, the Company was served with a statement of claim seeking an order certifying the claim as a class 
action pursuant to the Class Proceedings Act (Ontario). The claim alleges that the Company failed to properly apply certain 
required medical equipment sterilization protocols at one or more of its home health care clinics and seeks $20.0 million in 
damages. The Company does not believe that the lawsuit or the damages sought have merit. The Company intends to 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

31 

 
 
 
 
 
 
 
 
 
 
vigorously defend itself against the claim and does not believe the outcome will have a material adverse impact on its 
business, results of operations or financial condition and in any event believes that any potential liability would be resolved 
within the limits of its insurance coverage.  

The provision of health care services is subject to complex government regulations. Every effort is made by the Company 
to prevent deficiencies in the quality of patient care through quality assurance strategies and to remedy any such 
deficiencies cited by government inspections within the applicable prescribed period of time. The Company accrues for 
costs that may result from investigations, or any possible related litigation, to the extent that an outflow of funds is probable 
and a reliable estimate of the amount of the associated costs can be made. 

UPDATE OF REGULATORY AND FUNDING CHANGES AFFECTING RESULTS  

In Canada, provincial legislation and regulations closely control all aspects of operation and funding of long-term care 
homes and publicly funded home health care services, including the fee structure, subsidies, the adequacy of physical 
homes, standards of care and accommodation, equipment and personnel. A substantial portion of the fees paid to providers 
of these services are funded by provincial programs, with a portion to be paid by residents or clients. Each province has a 
different system for managing the services provided. In some provinces, the government has delegated responsibility for the 
funding and administration of health care programs, such as long-term care and home health care, to regional health 
authorities. As a result, there can be significant variability in the regulations governing the provision of and reimbursement 
for care from location to location. The Company is unable to predict whether governments will adopt changes in their 
funding or regulatory programs, and if adopted and implemented, the impact, if any, such changes will have on the 
Company’s business, results of operations and financial condition.  

In most provinces, a license must be obtained from the applicable provincial ministry in order to operate LTC homes and 
retirement communities. In Ontario, license terms for LTC homes are issued for a fixed term of not more than 30 years, 
after which the license may or may not be renewed. License terms for Class B and C homes in Ontario are set to expire in 
June 2025, unless the license terms are extended or the homes are redeveloped to the government’s new design standards 
wherein a new license will be issued upon successful application, as discussed further below under “– Ontario LTC 
Redevelopment and Expansion”. In general, the issuance of new licenses for LTC beds is infrequent because of the funding 
implications for the provincial governments, while the issuance of licenses for retirement communities is less restrictive as 
the funding for these services is generally private-pay. In addition to, or in some provinces in place of, the license 
procedure, LTC operators in Alberta, Manitoba, Ontario and Saskatchewan are required to sign service contracts that 
incorporate service expectations with the applicable provincial health authority. A failure of the Company’s operating 
licences or contracts to be renewed or conditionally renewed may have a material adverse impact on the business, results of 
operations and financial condition of the Company.  

The People’s Health Care Act, 2019 (Bill 74) 

In April 2019, Bill 74, The People’s Health Care Act, 2019 (Ontario), received Royal Assent, resulting in the creation of 
the Ontario Health agency to act as a central point of accountability and oversight for the province’s public health care 
system. Organizations to be integrated into Ontario Health include Cancer Care Ontario, Health Quality Ontario, eHealth 
Ontario, Health Shared Services Ontario and the LHINs. LHIN functions that involve the oversight of home and 
community care, including long-term care, are anticipated to move to Ontario Health. 

Bill 74 also introduces the creation of Ontario Health Teams (OHTs), which are groups of health care providers, such as 
primary care and hospitals, home care and long-term care and mental health and addictions supports, who will be ultimately 
clinically and fiscally responsible for delivering the full continuum of care to patients. In April 2019, the government 
provided a guidance document for interested applicants, Ontario Health Teams: Guidance for Health Care Providers and 
Organizations, that provides an overview of the intended structure of the OHTs, recognizing that the framework will be 
further developed as the new health care model becomes operational.  

The Ministry of Health’s application process for groups of providers interested in becoming an OHT is ongoing. The 
Company continues to participate in the various stages and be involved in a variety of such groups across the province as it 
continues to explore growth opportunities. 

All of ParaMed’s government funded business in Ontario is currently governed by contracts with the LHINs. These 
contracts may be impacted by the integration of the LHINs into the new agency and may need to be assigned or reissued.  

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Although the treatment of these contracts is not yet known, and while any change in home care contracting and associated 
government operating models would represent a significant change, the underlying market demand is such that it is likely 
that there would be minimal disruption to ParaMed’s business service provision; however, the Company is unable to predict 
the nature and extent such changes will have on the Company’s business, results of operations and financial condition.  

Ontario LTC Redevelopment and Expansion  

In Ontario, the Company’s largest LTC market, management seeks to advance the redevelopment of its 21 Class C LTC 
homes (3,287 beds) under the Ministry of Long-Term Care’s (MOLTC) redevelopment program. The license terms for 
these 21 Class C LTC homes are set to expire in June 2025, unless they are redeveloped to the government’s new design 
standards. Given the significant backlog in demand for long-term care, the lack of alternative care environments and license 
extension precedents to-date, management is of the view that it is likely that licenses will be extended until redevelopment 
can be completed; however, there can be no assurance that this will be the case. 

As part of the 2019 Ontario Budget, released in April 2019, the government announced $1.75 billion in additional funding 
over five years to add 15,000 new LTC beds and to redevelop 15,000 existing LTC beds. We are encouraged by the 
importance the Ontario Government has put on LTC, and we will continue to apply for allocations of new beds to leverage 
the redevelopment of our older homes and to initiate new campus of care opportunities. 

In May 2019, the Ontario government announced updates to the Construction Funding Subsidy Policy for Long-Term Care 
Homes, 2019, which among other things, increased the base per diem funding from $16.65 to $18.03 for LTC homes with 
161 or more beds. LTC homes with between 40% and 60% of beds designated as basic accommodation are eligible to 
receive an additional per diem subsidy of up to $3.50. Where variances from design requirements are permitted, reductions 
in the per diem subsidy may apply. Further updates to the policy may be made in 2020 to reflect changes in market 
conditions and construction cost inflation. 

Each of the Company’s 21 redevelopment projects is unique, with the overall redevelopment program involving a 
combination of new construction and retrofits. Each project is being carefully appraised to ensure strong economic 
fundamentals prior to proceeding with construction. Factors such as construction costs, adequacy of the government capital 
funding subsidies, availability of financing and the timing of project approvals will affect the sequencing and the duration 
of the redevelopment program. Management is working closely with the Ontario government with the goal of accelerating 
the Company’s redevelopment projects. Projects are in various stages of planning and approvals, but none are under 
construction at present. 

Once completed, redeveloped homes are expected to realize the benefit of improved performance and extended license 
terms. The extent to which such redevelopment plans are not implemented or proceed on significantly different timing, 
terms or government funding than currently anticipated, could have an adverse effect on the business, results of operations 
and financial condition of the Company.  

Ontario LTC Funding  

Ontario is the Company’s largest market for its senior care services. Funding for LTC homes in Ontario is based on 
reimbursement for the level of care assessed to be required by the residents, in accordance with scheduled rates. The 
MOLTC allocates funds through “funding envelopes”, specifically:  nursing and personal care (NPC); programs and 
support services (PSS); and accommodation (which includes a sub-envelope for raw food). The funding for the NPC and 
PSS envelopes is generally adjusted annually based on the acuity of residents as determined by a classification assessment 
of resident care needs. The NPC, PSS and food envelopes are “flow-through” envelopes, whereby any deviation in actual 
costs from scheduled rates is either absorbed by the provider (if actual costs exceed funding allocations) or is returned to 
the MOLTC (if actual costs are below funding allocations). With respect to the accommodation envelope, providers retain 
any excess funding received over costs incurred. The province sets the rates for standard accommodation, as well as the 
maximum premiums that providers can charge and retain for semi-private and private accommodation (preferred 
accommodation) and these premiums vary according to the structural classification of the LTC home. Long-term care 
providers are permitted to designate up to 60% of the resident capacity of a home as preferred accommodation. The 
accommodation rates are substantially paid for by the resident; however, the province guarantees funding for beds 
designated as standard accommodation through resident subsidies. Overall government funding is occupancy-based, but 
once the average occupancy level of 97% or higher for the calendar year is achieved, operators receive government funding 
based on 100% occupancy.  

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In May 2019, the MOLTC announced an overall funding increase for long-term care providers of 1% for the flow-through 
and accommodation envelopes, retroactive to April 1, 2019, which represents additional accommodation envelope (non-
flow through) revenue for the Company of approximately $1.1 million. In addition, the MOLTC had indicated plans to 
eliminate the structural compliance premium (SCP) funding of $5.00, $2.50 and $1.00 per diem for eligible Class A, B and 
C beds, respectively, effective October 1, 2019. However, the MOLTC has since deferred that change until April 1, 2020. 
The Company currently receives annual SCP funding of $1.3 million.  

In addition, effective July 1, 2019, the MOLTC implemented a 2.3% increase in the maximum preferred accommodation 
premiums that may be charged by long-term care providers. For older LTC beds that are not classified as “New” or “A” 
beds, the maximum daily preferred accommodation premiums increased to $8.52 and $19.17 for semi-private and private 
rooms, respectively. For newer LTC beds that are classified as “New” or “A” beds, the maximum daily preferred 
accommodation premiums increased to $12.78 and $26.64 for semi-private and private rooms, respectively. Refer to the 
table under “Business Overview – Operating Segments – Long-term Care” for a summary of the classification of the 
Company’s LTC beds in Ontario.  

As announced in December 2019 and implemented on January 1, 2020, the Ministry of Health implemented changes to the 
reimbursement model for pharmacies providing professional services to residents of LTC homes in Ontario. The 
reimbursement model shifts from a fee-for-service model to a fixed fee-per-bed capitation model. The new model 
reimburses pharmacies for all medication dispensing and professional service activities including, medication reviews, 
medication assessments, and education seminars on a capitated basis.   

Similar capitation-based reimbursement models are in place in other provinces in Western Canada where the Company 
operates. To adjust to the new reimbursement model in Ontario, pharmacy operators are evaluating existing workflows and 
looking for opportunities to streamline operations and deliver the same service level using technology and virtual meetings. 
While the Company continues to work with pharmacy operators to assess the impact of the workflow changes, it is not 
anticipated that these changes will have a material adverse impact on the business, results of operations or financial 
condition of the Company. 

Alberta LTC Funding  

Alberta is the Company’s second largest market for its senior care services. Since April 2010, AHS has been using an 
activity-based funding system for continuing care homes that includes the measurement of a resident’s acuity through the 
use of a resident assessment instrument – minimum data set, or RAI-MDS, to determine the resident’s level of care and 
resources required. The Alberta Continuing Care Association is actively engaged in discussions with the Alberta 
government and AHS to further enhance care funding to accommodate higher expenses within continuing care, and to 
revise the existing funding model used within continuing care.  

The Alberta government’s 2019-20 budget released in October 2019 imposed a four-year funding freeze for AHS. In 
February 2020, an independent comprehensive review of AHS (the “AHS Performance Review”) was released, which 
includes a number of recommendations for AHS to potentially reduce costs and improve system performance. AHS has 
until May 2020 to develop a long-term implementation plan in response to the AHS Performance Review. As well, in 
February 2020, the Alberta Health Minister launched a formal review of the continuing care system, which currently has 
separate legislation for home health care, supportive living and long-term care. The Company is unable to predict whether 
the Alberta government or AHS will adopt changes in their funding or regulatory programs, and if adopted and 
implemented, the impact, if any, such changes will have on the Company’s business, results of operations and financial 
condition.  

On July 1, 2019, the annual accommodation charge (the portion paid directly by residents of long-term care and designated 
supportive living homes) increased by 1.6%, based on inflation as reflected by Alberta’s CPI, representing additional 
annual revenue for the Company of approximately $0.5 million.  

In November 2019, AHS announced adjustments to government funding for providers of long-term care and designated 
supportive living homes retroactive to October 1, 2019, rather than to April 1, 2019, the start of the government’s fiscal 
year. The funding changes represent additional annual revenue to the Company of approximately $0.4 million.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

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Ontario Home Health Care Funding 

Ontario is ParaMed’s largest market, representing approximately 92% of its annual service volumes (following the exit 
from B.C.), of which approximately 98% are received from government-funded contracts at specified rates, making 
ParaMed the largest private-sector provider of publicly funded home health care in the province. ParaMed’s government-
funded business in Ontario is currently obtained through evergreen contracts with the LHINs. In 2019, the Ontario 
government announced plans to integrate the LHINs into a newly created Ontario Health agency to act as a central point of 
accountability and oversight for the province’s public health system. For further information, refer to the discussion above 
under “– The People’s Health Care Act, 2019 (Bill 74)”.   

The enactment of Bill 148, the Fair Workplaces, Better Jobs Act, 2017 (Ontario) in November 2017, resulted in a number 
of amendments to the Employment Standards Act (ESA) that included:  an increase in the minimum wage and revisions to 
vacation, public holiday pay and personal leave entitlements that took effect January 1, 2018. Bill 148 necessitated changes 
in the manner in which the Company managed its workforce and had a significant financial impact on the Company’s home 
health care operations, although such impact was subsequently reduced with the enactment of Bill 47, Making Ontario 
Open for Business Act, 2018 (Ontario) in November 2018.  

In response to increased costs associated with Bill 148, the Ontario government provided enhanced funding to contracted 
service providers, including ParaMed. During 2018, the Company received $2.0 million of additional funding for the three 
months ended March 31, 2018, and continued to estimate an accrual for incremental funding beyond that date. During 
2019, the Company received additional funding from the LHINs related to 2018 that was in excess of that estimated by the 
Company for the period ended December 31, 2018, resulting in a $2.2 million increase in revenue recorded in the three 
months ended June 30, 2019.  

In shaping the delivery of health care to Canadians, both the federal and provincial governments have stated that home 
health care is an area that merits further investment to ensure that more health care services are available in the home. As 
part of its initiative to improve and make the health care system more efficient, the Ontario government has noted that 
insufficient capacity in the health care system, like home care, is contributing to the problem of hallway health care in the 
province. In the 2019 Ontario Budget, released in April 2019, the government announced an additional $267 million for 
home and community care, focused on increasing front-line care delivery, such as personal support services, nursing, 
therapy and other professional services at home and in the community, in an effort to reduce waitlists for long-term care. As 
governments continue to recognize the benefits of this segment of the Canadian health care system, management believes 
that ParaMed is well-positioned to take advantage of the significant organic growth opportunity that exists today and that 
steps we are taking to position ParaMed as the employer of choice for caregivers will further enhance the Company’s 
position. In addition, ParaMed continues to assess private-pay home health care opportunities that may enable it to further 
leverage its platform.  

RELATED PARTY TRANSACTIONS 

As previously disclosed, the Company’s former President and Chief Executive Officer stepped down from his position on 
October 22, 2018. In connection therewith, the Company recorded a charge of $1.7 million in the three months ended 
September 30, 2018, representing a cash payment of $2.9 million, partially offset by the reversal of $1.2 million in respect 
of forfeited performance share units. 

RISKS AND UNCERTAINTIES  

The risks and uncertainties described below could adversely affect the business, results of operations and financial 
condition of the Company, cause the trading price of the Company’s securities to decline and cause the actual outcome of 
matters to differ materially from the expectations of the Company regarding future results, performance or achievements 
reflected in information in this MD&A and other information provided by the Company from time to time. The risks and 
uncertainties described below, which is not an exhaustive description of the risks and uncertainties faced by the Company, 
should be carefully considered by investors. 

General Business Risks 

The Company is subject to general business risks inherent in the senior care industry, including:  changes in government 
regulation and oversight; changing consumer preferences; fluctuations in occupancy levels and business volumes; the 
ability of the Company to renew its government licenses and customer contracts; changes in government funding and 
reimbursement programs, including the ability to achieve adequate government funding increases; changes in labour 
relations and costs; increases in other operating costs; competition from other senior care providers; changes in 
neighbourhood or location conditions and general economic conditions; health related risks, including disease outbreaks 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

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(for example COVID-19 if it progresses) and control risks; changes in accounting principles and policies; the imposition of 
increased taxes or new taxes; capital expenditure requirements; and changes in the availability and cost of both short- and 
long-term financing, which may render refinancing of long-term debt difficult or unattractive. Any one of, or a combination 
of, these factors may adversely affect the business, results of operations and financial condition of the Company.  

In addition, there are inherent legal, reputational and other risks involved in providing accommodation and health care 
services to seniors. The vulnerability and limited mobility of some seniors enhances such risks. Such risks include fires or 
other catastrophic events at a Company location which may result in injury or death, negligent or inappropriate acts by 
employees or others who come into contact with the residents and clients, and unforeseen events at locations at which the 
Company operates that result in damage to the Company’s brand or reputation or to the industry as a whole. 

Risks Related to Growth and Redevelopment Activities  

The Company expects that it will continue to have opportunities to acquire businesses and properties, develop properties, 
redevelop or expand existing LTC homes, and grow its home health care, private-pay retirement, contract services, 
consulting and group purchasing businesses, but there can be no assurance that this will be the case.  

The number of licensed LTC beds are restricted by the provinces and any new licenses are awarded through a request for 
proposal process. The provinces also regulate the manner in which LTC homes are developed and redeveloped. If 
regulatory approvals are required in order to expand operations (via development or otherwise) or redevelop operations of 
the Company, the inability of the Company to obtain the necessary approvals, changes in standards applicable to such 
approvals and possible delays and expenses associated with obtaining such approvals could adversely affect the ability of 
the Company to expand or redevelop and, accordingly, to maintain or increase its revenue and earnings. 

Approximately 40% of the Company’s owned LTC beds are in older Ontario homes that are subject to redevelopment. In 
Ontario, licenses for LTC homes are issued for a fixed term of not more than 30 years, after which the license may or may 
not be renewed. LTC operators are to be notified of license renewals at least three years prior to the maturity date. License 
terms for Class B and C LTC homes in Ontario are set to expire in June 2025, unless the license terms are extended or the 
homes are redeveloped to the government’s new design standards wherein a new license will be issued upon successful 
application. Given the significant backlog in demand for long-term care, the lack of alternative care environments and 
license extension precedents to-date, management is of the view that it is likely that licenses will be extended until 
redevelopment can be completed; however, there can be no assurance that this will be the case. The Company has 21 Class 
C LTC homes with 3,287 beds that it is seeking to redevelop under the government’s redevelopment program (see “Ontario 
LTC Redevelopment and Expansion” under the heading “Update of Regulatory and Funding Changes Affecting Results”). 
The extent to which such redevelopment plans are not implemented or proceed on significantly different timing, terms or 
government funding than currently anticipated, could have an adverse effect on the business, results of operations and 
financial condition of the Company.  

The success of the business acquisition and development activities of the Company, including the expansion of its private-
pay retirement operations, will be determined by numerous factors, including the ability of the Company to identify suitable 
acquisition targets, competition for acquisition and development opportunities, purchase price, ability to obtain external 
sources of funding or adequate financing on reasonable terms, the financial performance of the businesses or homes after 
acquisition or development, and the ability of the Company to effectively integrate and operate the acquired businesses or 
homes. Acquired businesses or homes, and development projects, may not meet financial or operational expectations due to 
the possibility that the Company has insufficient management expertise to engage in such activities profitably or without 
incurring inappropriate amounts of risk, unexpected costs or delays associated with their acquisition or development, as 
well as the general investment risks inherent in any real estate investment or business acquisition. Moreover, new 
acquisitions may require significant management attention, place additional demands on the Company’s resources, systems, 
procedures and controls, and capital expenditures that would otherwise be allocated by the Company in a different manner 
to existing businesses. Any failure by the Company to identify suitable candidates for acquisition, successfully complete 
development projects, secure financing, or operate the new businesses effectively may have an adverse effect on the 
business, results of operations and financial condition of the Company.  

The success of the Company’s ability to grow its contract services, consulting, group purchasing and home health care 
businesses, including the private-pay home health care segment, will be determined by numerous factors, including the 
ability of the Company to retain, renew and secure new contracts, identify suitable markets, develop competitive services 
and marketing and pricing strategies, attract and retain residents and clients, and hire, retain and motivate key personnel. 
Changes in government funding policies and regulatory changes, the risks related to which are described below under 
“Risks Related to Government Funding and Regulatory Changes”, in addition to the financial performance of these 
businesses, also impact the Company’s growth potential. Any failure by the Company to grow or operate its businesses 
effectively may have an adverse effect on the business, results of operations and financial condition of the Company.   

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

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Risks Related to Occupancy and Business Volumes  

Senior care providers compete primarily on a local and regional basis with many other health care, long-term care and 
retirement living providers, including large publicly held companies, privately held companies, not-for-profit organizations, 
hospital-based LTC units, rehabilitation hospitals, home health care agencies, and rehabilitative therapy providers. The 
Company’s ability to compete successfully varies from location to location and depends on a number of factors, including 
the number of competitors in the local market, the types of services available, the Company’s local reputation for quality 
care, the commitment and expertise of its staff, the Company’s local service offerings, the cost of care in each locality, and 
the physical appearance, location, age and condition of its residences. Increased competition could limit the Company’s 
ability to attract and retain residents and clients and thus maintain or increase occupancy levels and business volumes. An 
inability to continue to attract residents and clients could have an adverse effect on the business, results of operations and 
financial condition of the Company. 

Risks Related to Government Funding and Regulatory Changes  

The Company’s earnings are highly reliant on government funding and reimbursement programs, and the effective 
management of staffing and other costs of operations, which are strictly monitored by government regulatory authorities. 
See “Update of Regulatory and Funding Changes Affecting Results”. Given that the Company operates in a labour-
intensive industry, where labour costs account for a significant portion of the Company’s operating costs (approximately 
86% in 2019), government funding constraints, or funding enhancements that are not commensurate with increased costs, 
could have a significant adverse effect on the Company’s results from operations and cash flows. The Company is unable to 
predict whether governments will adopt changes in their funding and regulatory programs, and if adopted and implemented, 
the impact, if any, such changes will have on the Company’s business, results of operations and financial condition.  

Health care providers are subject to surveys, inspections, audits and investigations by government authorities to ensure 
compliance with applicable laws and licensure requirements of the various government funding programs. Long-term care 
operators and publicly funded home health care providers must comply with applicable regulations that, depending on the 
jurisdiction in which they operate, may relate to such matters as staffing levels, client care related operating standards, 
occupational health and safety, client confidentiality, billing and reimbursement, along with environmental and other 
standards. Retirement communities are also subject to extensive government regulation and oversight, licensure 
requirements and the potential for regulatory change. The government review process is intended to determine compliance 
with survey and certification requirements, and other applicable laws. Remedies for survey deficiencies can be levied based 
upon the scope and severity of the cited deficiencies and range from notices of deficiencies to revocation of licenses or 
termination of contracts. The revocation of a license by authorities or the cancellation of a service contract due to 
inadequate performance by the operator has been historically infrequent and is usually preceded by a series of warnings, 
notices and other sanctions.  

Non-compliance with applicable laws and licensure requirements could result in adverse consequences, including severe 
penalties, which may include criminal sanctions and fines, civil monetary penalties and fines, administrative and other 
sanctions, including reimbursement of government funding or exclusion from participation in government funded 
programs, or one or more third-party payor networks, and reputational damage to the Company. These penalties could have 
a material adverse effect on the business, results of operations and financial condition of the Company.  

The Company accrues for costs that may result from investigations, or any possible related litigation, to the extent that an 
outflow of funds is probable and a reliable estimate of the amount of associated costs can be made; however, there can be 
no assurance that such accruals are accurate or sufficient.  

With respect to home health care services, 98% of ParaMed’s revenue is from contracts tendered by locally administered 
provincial agencies, at specified billing rates and, among other things, quality operating and performance standards. Home 
health care service providers must ensure their key performance indicators are meeting or exceeding provincial targets in 
order to continue to receive their allocated funding volumes and/or retain their contracts. Contracts with qualified service 
providers are generally awarded through a competitive bidding model. Any failure by ParaMed to retain its government 
contracts, including in connection with any regulatory or other funding changes, may have an adverse effect on the 
business, results of operations and financial condition of the Company. 

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The majority of ParaMed’s business volumes are generated in Ontario and Alberta, representing 92% and 5%, respectively, 
based on volumes delivered in 2019 excluding the recently exited B.C. operations. In Alberta, government contracts have 
specified termination dates and or/renewal periods, following which they are put out to tender. In Ontario, the government 
implemented new open-ended contracts in 2012 that are evergreen contracts provided that the service provider remains in 
good standing. New contracts in Ontario are awarded under a bidding process to prequalified service providers. Under this 
regime, all of ParaMed’s government contracts in Ontario have remained in effect. In 2019, the Ontario government created 
the Ontario Health agency to act as central point of accountability and oversight for the provinces’ public health care 
system. All of ParaMed’s government funded business in Ontario is currently governed by contracts with the LHINs. These 
contracts may be impacted by the integration of the LHINs into the new agency and may need to be assigned or reissued. 
Although the treatment of these contracts is not yet known, and while any change in home care contracting and associated 
government operating models would represent a significant change, the underlying market demand is such that it is likely 
that there would be minimal disruption to ParaMed’s business service provision; however, the Company is unable to predict 
the nature and extent such changes will have on the Company’s business, results of operations and financial condition. For 
further information, refer to the discussion under “Update of Regulatory and Funding Changes Affecting Results – The 
People’s Health Care Act, 2019 (Bill 74)”. 

Risks Related to Dependence on Key Personnel  

The success of the Company depends, to a significant extent, on the efforts and abilities of its executive officers and other 
members of management, as well as its ability to attract and retain qualified personnel to manage existing operations and 
future growth. Although the Company has entered into employment agreements with certain of its key employees, it cannot 
be certain that any of these individuals will not voluntarily terminate his or her employment with the Company. The loss of 
an executive officer or other key employee could negatively affect the Company’s ability to develop and pursue its business 
strategy, which could have a material adverse effect on the business, results of operations and financial condition of the 
Company.  

CONFLICTS OF INTEREST 

The Company’s Board of Directors may, from time to time, in their individual capacities deal with parties with whom the 
Company may be dealing, or may be seeking investments similar to those desired by the Company. The relevant constating 
documents of the Company contain conflict of interest provisions requiring the Company’s directors to disclose material 
interests in material contracts and transactions and to refrain from voting thereon. 

Risks Related to Labour Intensive Business 

AVAILABILITY AND COST OF PERSONNEL  

The senior care industry is labour intensive, with approximately 86% of the Company’s operating costs represented by 
labour costs. The Company competes with other health care providers in attracting and retaining qualified and skilled 
personnel to manage and operate its businesses. The health care industry continues to face shortages of qualified personnel, 
such as nurses, certified nurse’s assistants, nurse’s aides and therapists, particularly in non-urban settings. This shortage 
along with general inflationary pressures may require the Company to enhance its pay and benefits package to compete 
effectively for qualified personnel. The Company may not be able to recover such added costs through increased 
government funding and reimbursement programs, or through increased rates charged to residents and clients. In addition, 
the Company has contracted out select dietary and housekeeping services provided in some of its homes. Should the 
Company become dissatisfied with the quality or cost of such contracted services, it may need to terminate the related 
contracts and recruit replacement staff at an incremental cost and potential business disruption. The inability to retain 
and/or attract qualified personnel and meet minimum staffing levels may result in:  a reduction in occupancy levels and 
volume of services provided; the use of staffing agencies at added costs; an increased risk in the inability to provide 
continuity of care between the Company’s staff and its residents and clients; and an increased risk of the Company being 
subject to fines and penalties. An increase in personnel costs or a failure to attract, train and retain qualified and skilled 
personnel could adversely affect the business, results of operations and financial condition of the Company.  

WORKPLACE HEALTH AND SAFETY 

The Company recognizes that ensuring a healthy and safe workplace minimizes injuries and other risks its employees may 
face in carrying out their duties, improves productivity and helps to minimize any liability or penalties which could be 
incurred in connection with workplace injuries. The Company has health and workplace safety programs in place and has 
established policies and procedures aimed at ensuring compliance with applicable legislative requirements. Failure to 
comply with appropriate and established workplace health and safety policies and procedures or applicable legislative 
requirements could result in increased workplace injury-related liability and penalties and reputational damage to the 

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Company and thus have a material adverse effect on the business, results of operations and financial condition of the 
Company. 

LABOUR RELATIONS  

The Company employs approximately 22,000 individuals, of whom approximately 69% are represented by labour unions. 
Labour relations with the unions are governed by numerous collective bargaining agreements with different unions. Upon 
expiration of the collective bargaining agreements, the Company may not be able to negotiate collective agreements on 
satisfactory terms. There can be no assurance that the Company will not at any time, whether in connection with the 
renegotiation of a collective bargaining agreement or otherwise, experience strikes, other labour disruptions or any other 
type of conflict with unions or employees which could have a material adverse effect on the Company’s business, operating 
results and financial condition. The homes that the Company operates are generally subject to legislation that prohibits both 
strikes and lock-outs, and requires compulsory arbitration to settle labour disputes. In jurisdictions where strikes and 
lockouts are permitted, certain essential services regulations apply which provide for the continuation of resident care and 
most services.  

There can be no assurance that employees who are not currently unionized will not, in the future, become unionized, the 
result of which could increase the Company’s labour costs, which could have a material adverse effect on the business, 
results of operations and financial condition of the Company.   

Risks Related to Liability and Insurance   

Operating in the senior care industry exposes the Company to an inherent risk of claims of wrongful death, personal injury, 
professional malpractice and other potential claims being brought by the Company’s residents, clients, and employees. 
From time to time, the Company is subject to lawsuits alleging, among other claims, that the Company did not properly 
treat or care for a client or resident, that the Company failed to follow internal or external procedures that resulted in harm 
to a client or resident, or that the Company’s employees mistreated the Company’s residents or clients resulting in harm. In 
addition, attempts to advance class action lawsuits have become prevalent in the Canadian marketplace, including senior 
care. There can be no assurance that the Company will not face risks of this nature. Refer to the discussion under “Other 
Contractual Obligations and Contingencies – Legal Proceedings, Claims and Regulatory Actions”.  

The Company maintains business and property insurance policies in amounts and with such coverage and deductibles as 
deemed appropriate, based on the nature and risks of the business, historical experience and industry standards. There can 
be no assurance, however, that claims in excess of the insurance coverage, or in excess of the Company’s reserves, or 
claims not covered by the insurance coverage will not arise or that the liability coverage will continue to be available on 
acceptable terms. Furthermore, there are certain types of risks, generally of a catastrophic nature, such as war, non-certified 
acts of terrorism, or environmental contamination, which are either uninsurable or are not insurable on an economically 
viable basis. A successful claim against the Company not covered by, or in excess of, such insurance, or in excess of the 
Company’s reserves for self-insured retention levels, could have a material adverse effect on the business, results of 
operations and financial condition of the Company. Claims against the Company, regardless of their merit or eventual 
outcome, may also have a material adverse effect on the ability of the Company to attract residents and clients, or maintain 
favourable standings with regulatory authorities. 

Prior to the U.S. Sale Transaction, the Company self-insured certain risks related to general and professional liability of its 
disposed U.S. business through the Captive, its Bermuda-based captive insurance company. The obligation to settle any 
such claims relating to the period prior to the closing of the U.S. Sale Transaction, including claims incurred but yet to be 
reported, remains with the Company, which continues to be funded through the Captive.  

Risks Related to Privacy of Client Information and Cyber Security 

As a custodian of a large amount of personal information, including health information, relating to its residents, clients and 
employees, the Company is exposed to the potential loss, misuse or theft of any such information. If the Company were 
found to be in violation of federal and provincial laws protecting the confidentiality of patient health information, it could 
be subject to sanctions and civil or criminal penalties, which could increase its liabilities, harm its reputation and have a 
material adverse effect on the business, results of operations and financial condition of the Company. In addition, cyber 
attacks against large organizations are increasing in sophistication and are often focused on financial fraud, compromising 
sensitive data for inappropriate use or disrupting business operations. The Company mitigates this risk by deploying 
appropriate information technology systems, including controls around logical access, physical access and data 
management, and training its employees relating to safeguarding of sensitive information.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

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The Company has deployed operational technology solutions enabling process automation, electronic health record data 
collection and automated business intelligence. Technology deployments also present security and privacy risks that must 
be managed proactively and effectively to prevent breaches that can have an adverse impact on the Company’s reputation 
and results of operations. To counter internet-based and internal security threats, the Company invests in cyber defense 
technologies to identify risks to its network, software and hardware systems. Extendicare partners with leading technology 
security firms to mitigate identified risks and develop contingency plans. As security threats to the Company’s financial, 
client and employee data increase and evolve, the Company adjusts and adopts new counter-measures in an effort to ensure 
it maintains high privacy and security standards. The Company’s risk and exposure to these matters cannot be fully 
mitigated because of, among other things, the evolving nature of these threats. As cyber threats continue to evolve, the 
Company may be required to expend additional resources to continue to modify or enhance protective measures or to 
investigate and remediate any security vulnerabilities. 

Although to date the Company has not experienced any material losses relating to cyber attacks or other information 
security breaches, there can be no assurance that the Company will not incur such losses in the future and any such losses 
may have a material adverse effect on the business, results of operations and financial condition of the Company.  

Risks Related to Tax Rules and Regulations  

The Company is subject to audits from federal, state and provincial tax jurisdictions and is therefore subject to risk in the 
interpretation of tax legislation and regulations. Tax rules and regulations are complex and require careful review by the 
Company’s tax management and its external tax consultants. Differences in interpretation of tax rules and regulations could 
result in tax assessments and penalties for the untimely payment of the determined tax liability, which could have a material 
adverse effect on the business, results of operations and financial condition of the Company. 

Risks Related to Financing  

DEBT FINANCING 

Due to the level of real property ownership by the Company, a significant portion of the consolidated cash flow of the 
Company is devoted to servicing debt, and there can be no assurance that the Company will continue to generate sufficient 
cash flow from operations to meet required interest and principal payments. If the Company were unable to meet its 
required interest or principal payments, it could be required to seek renegotiation of such payments or obtain additional 
equity, debt or other financing.  

The Extendicare Credit Facility is a demand facility in the amount of $47.3 million that is secured by 13 Class C LTC 
homes in Ontario and is guaranteed by certain Canadian subsidiaries of Extendicare. As at December 31, 2019, Extendicare 
had letters of credit totalling $43.6 million issued under the Extendicare Credit Facility, of which $38.1 million secured the 
defined benefit pension plan obligations. The Extendicare Credit Facility has no financial covenants, but does contain 
normal and customary terms, including annual re-appraisals of the homes that could limit the maximum level of the line of 
credit and other restrictions on Extendicare’s subsidiaries making certain payments, investments, loans and guarantees. A 
demand for repayment of amounts drawn on the line of credit could inhibit the flow of cash dividends by the Company on a 
temporary basis until alternative financing is obtained.   

The Company cannot predict whether future financing will be available, what the terms of such future financing will be 
(including, whether it will result in a higher cost of borrowing – see “Interest Rates” below) or whether its existing debt 
agreements will allow for the timely arrangement and implementation of such future financing. If the Company were 
unable to obtain additional financing or refinancing when needed or on satisfactory terms, it could have a material adverse 
effect on the business, results of operations and financial condition of the Company. 

DEBT COVENANTS 

The Company and its subsidiaries are in compliance with all of their respective financial covenants as at December 31, 
2019. However, there can be no assurance that future covenant requirements will be met. The Company’s bank lines and 
other debt may be affected by its ability to remain in compliance. If the Company does not remain in compliance with its 
financial covenants, its ability to amend the covenants or refinance its debt may be affected.  

INTEREST RATES  

The Company has limited the amount of debt that may be subject to changes in interest rates. All of the Company’s long-
term debt is at fixed rates, other than its construction loans that had an aggregate balance of $64.6 million drawn as at 
December 31, 2019. The Company primarily finances its properties through fixed-rate mortgages and considers securing 
interest rate swap agreements for any variable-rate debt to mitigate exposure to interest rate changes. The Company’s 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

40 

 
 
 
 
 
 
 
 
variable-rate mortgages and term loan, aggregating $82.0 million as at December 31, 2019, have effectively been converted 
to fixed rate financings with interest rate swaps over the full term. The Company maintains risk management control 
systems to monitor interest rate risk attributable to its outstanding or forecasted debt obligations as well as any offsetting 
hedge positions. The Company does not enter into financial instruments for trading or speculative purposes.  

Risks Related to Real Property Ownership  

REAL PROPERTY OWNERSHIP 

All real property investments are subject to a degree of risk. They are affected by various factors, including geographic 
concentration, changes in general economic conditions (such as the availability of mortgage financing) and in local 
conditions (such as an oversupply of space or a reduction in demand for real estate in the area), the attractiveness of the 
properties to residents, competition from other available space and various other factors. In addition, fluctuations in interest 
rates could have a material adverse effect on the business, results of operations and financial condition of the Company. 

The Company owns, or operates under 25-year lease arrangements whereby ownership transfers at the end of the lease 
term, 100% of its LTC homes and retirement communities, excluding those to which it provides contract services. LTC 
homes and retirement communities are limited in terms of alternative uses; therefore, their values are directly driven by the 
cash flow from operations. All but 11 of the Company’s 69 homes owned by it at December 31, 2019, are government-
funded senior care homes. The value of the real property depends, in part, on government funding, license terms, and 
reimbursement programs. In addition, overbuilding in any of the market areas in which the Company operates could cause 
its homes to experience decreased occupancy or depressed margins, which could have a material adverse effect on the 
business, results of operations and financial condition of the Company. Moreover, certain significant expenditures relating 
to real property ownership, such as real estate taxes, maintenance costs and mortgage payments, represent liabilities that 
must be met regardless of whether the property is producing any income.  

Real property investments are relatively illiquid, thereby limiting the ability of the Company to vary its portfolio in a timely 
manner in response to changed economic or investment conditions. By specializing in LTC homes and retirement 
communities, the Company is exposed to adverse effects on these segments of the real estate market. There is a risk that the 
Company would not be able to sell its real property investments or that it may realize sale proceeds below their current 
carrying value. 

CAPITAL INTENSIVE INDUSTRY  

The Company must commit a substantial portion of its funds to maintain and enhance its property and equipment to meet 
regulatory standards, operate efficiently and remain competitive in its markets. During 2019, the company incurred 
$12.3 million in maintenance capex, and expects to spend in the range of $11 million to $13 million in 2020 to sustain and 
upgrade its existing property and equipment. In addition to recurring maintenance capex, the Company invests in 
enhancements of existing properties aimed at earnings growth and improved profitability, including redevelopment of LTC 
homes under provincial programs. See “– Risks Related to Growth and Redevelopment Activities”. These, as well as other 
future capital requirements, could adversely impact the amount of cash available to the Company and have a material 
adverse effect on the business, results of operations and financial condition of the Company. 

Risks Related to Environmental, Health and Safety Laws  

The Company is subject to various environmental, health and safety laws and regulations, both as an owner of real property 
and as a provider of health care services, governing the storage, handling, use, and disposal of equipment, materials and 
waste products. The Company may become liable for the costs of removal or remediation of certain hazardous, toxic, or 
regulated substances present at, released on or disposed of from its properties or other service locations, regardless of 
whether or not the Company knew of, or was responsible for, their presence, release or disposal. The failure to remove, 
remediate, or otherwise address such substances, if any, may adversely affect operations or the ability to sell such properties 
or to borrow using such properties as collateral, and could potentially result in claims by public or private parties, including 
by way of civil action, and have a material adverse effect on the business, results of operations and financial condition of 
the Company.  

With respect to the Company’s pre-1980 properties, management has determined that future costs could be incurred for 
possible asbestos remediation at these sites. Appropriate remediation procedures may be required to remove potential 
asbestos-containing materials, consisting primarily of floor and ceiling tiles, in connection with any major renovation or 
demolition. Based upon current assumptions, the estimated fair value of the decommissioning provision related to the 
asbestos remediation was approximately $10.7 million undiscounted, or $9.5 million discounted, as at December 31, 2019, 
refer to Note 11 of the audited consolidated financial statements.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

41 

 
 
 
 
 
 
 
 
Environmental, health and safety laws may change and the Company may become subject to more stringent laws in the 
future. Compliance with more stringent environmental, health and safety laws, which may be more rigorously enforced, 
could have a material adverse effect on the business, results of operations and financial condition of the Company. 

Risks Related to the Common Shares and Debentures 

UNPREDICTABILITY AND VOLATILITY OF THE COMMON SHARE PRICE 

A publicly traded company does not necessarily trade at values determined by reference to the underlying value of its 
business. The prices at which the Common Shares will trade cannot be predicted. The market price of the Common Shares 
could be subject to significant fluctuations in response to variations in quarterly operating results, dividends and other 
factors beyond the control of the Company. The annual yield on the Common Shares, represented as the ratio of annual 
dividend to the market price per Common Share, as compared to the annual yield on other financial instruments, may also 
influence the price of the Common Shares in the public trading markets. In addition, the securities markets have 
experienced significant price and volume fluctuations from time to time in recent years that often have been unrelated or 
disproportionate to the operating performance of particular issuers. These broad fluctuations may adversely affect the 
market price of the Common Shares. 

CASH DIVIDENDS ARE NOT GUARANTEED AND MAY FLUCTUATE WITH THE PERFORMANCE OF THE 
COMPANY  

The declaration and payment of dividends by the Company is at the discretion of the Board as to the amount and timing of 
dividends to be declared and paid, after consideration of a number of factors, including results of operations, requirements 
for capital expenditures and working capital, future financial prospects of the Company, debt covenants and obligations and 
any other factors deemed relevant by the Board. All of these factors are susceptible to a number of risks and other factors 
beyond the control of the Company. The amount of funds available for distribution will fluctuate with the performance of 
the Company. If the Board determines that it would be in the Company’s best interests, it may reduce the amount and 
frequency of dividends to be distributed to Shareholders and such reductions may significantly effect the market value of 
the Common Shares.   

A high dividend yield results in a higher cost of capital incurred by the Company in raising capital through the issue of 
Common Shares to fund future growth and equally can inhibit the ability of the Company to grow through acquisition or 
new developments. Therefore, the Board also has to balance the dividend yield relative to its growth plans and need to raise 
capital.   

Funds available for dividends are driven by cash generated from operations and may be dependent upon the Company’s 
plan for growth-based capital expenditures. The timing and amount of capital expenditures will directly affect the amount 
of cash available for dividends to Shareholders. Dividend payments to Shareholders may be reduced, or even eliminated, at 
times when the Company cannot access the capital markets for raising cash and/or when Directors deem it necessary to 
make significant capital or other expenditures. The Company may be required to reduce dividends or access the capital 
markets in order to accommodate these items. There can be no assurance that sufficient capital will be available on 
acceptable terms to the Company for necessary or desirable capital expenditures. 

COMPANY STRUCTURE 

The Company does not carry on business directly, but does so indirectly through its subsidiaries. The Company has no 
major assets of its own, other than the LTC homes that it leases to Extendicare (Canada) Inc. (ECI) and the direct and 
indirect interests it has in its subsidiaries (including ECI, ParaMed and the subsidiaries that own and operate the Company’s 
retirement communities), all of which are separate legal entities. The Company is therefore financially dependent on lease 
payments that it receives from ECI and dividends and other distributions it receives from all of its subsidiaries. 

FUTURE ISSUES OF COMMON SHARES AND PREFERRED SHARES AND DILUTION 

The Company’s articles permit the issuance of an unlimited number of Common Shares and a number of preferred shares of 
the Company (the “Preferred Shares”), issuable in series, equal to 50% of the number of Common Shares that are issued 
and outstanding, for the consideration and on the terms and conditions that the Board may determine without Shareholder 
approval. Shareholders have no pre-emptive rights in connection with such future issues. Future issues of Common Shares 
and/or Preferred Shares could be dilutive to the interests of Shareholders and could adversely affect the prevailing market 
price of the Common Shares. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

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LEVERAGE AND RESTRICTIVE COVENANTS IN CURRENT AND FUTURE INDEBTEDNESS 

The ability of the Company to pay dividends is subject to applicable laws and contractual restrictions contained in the 
instruments governing any indebtedness of the Company (including its subsidiaries). The degree to which the Company is 
leveraged could have important consequences to Shareholders, including: (i) that the Company’s ability to obtain additional 
financing in the future for working capital, capital expenditures or acquisitions may be limited; (ii) that a significant portion 
of the Company’s cash flow from operations may be dedicated to the payment of the principal of, and interest on, its 
indebtedness; (iii) that certain of the Company’s borrowings could be financed at variable rates of interest, which exposes 
the Company to the risk of increased interest rates; and (iv) that the Company may be more vulnerable to economic 
downturns and be limited in its ability to withstand competitive pressures. These factors may reduce funds available for the 
Company to pay dividends.  

CHANGES  IN  THE  COMPANY’S  CREDITWORTHINESS  MAY  AFFECT  THE  VALUE  OF  THE  COMMON 
SHARES 

The perceived creditworthiness of the Company may affect the market price or value and the liquidity of the Common 
Shares. 

MATTERS AFFECTING TRADING PRICES FOR THE DEBENTURES 

The 2025 Debentures are listed on the TSX. No assurance can be given that an active or liquid trading market for the 2025 
Debentures will develop or be sustained. If an active or a liquid market for the 2025 Debentures fails to develop or be 
sustained, the prices at which the 2025 Debentures trade may be adversely affected. Whether or not the 2025 Debentures 
will trade at lower prices depends on many factors, including liquidity of the 2025 Debentures, prevailing interest rates and 
the markets for similar securities, the market price of the Common Shares, general economic conditions, and the 
Company’s financial condition, historic financial performance and future prospects.  

The Company may determine to redeem outstanding 2025 Debentures for Common Shares or to repay outstanding 
principal amounts thereunder at maturity of the 2025 Debentures by issuing additional Common Shares. Accordingly, 
Shareholders may suffer dilution.  

DEBENTURES – CREDIT RISK AND PRIOR RANKING INDEBTEDNESS; ABSENCE OF COVENANT 
PROTECTION 

The likelihood that purchasers of the 2025 Debentures will receive payments owing to them under the terms of the 2025 
Debentures will depend on the Company’s financial condition and creditworthiness. In addition, the 2025 Debentures are 
unsecured obligations of the Company and are subordinate in right of payment to all of the Company’s existing and future 
senior indebtedness. Therefore, if the Company becomes bankrupt, liquidates its assets, reorganizes or enters into certain 
other transactions, the Company’s assets will be available to pay its obligations with respect to the 2025 Debentures only 
after it has paid all of its senior indebtedness in full. There may be insufficient assets remaining following such payments to 
pay amounts due on any or all of the 2025 Debentures then outstanding. The 2025 Debentures are also effectively 
subordinate to claims of creditors of the Company’s subsidiaries except to the extent the Company is a creditor of such 
subsidiaries ranking at least pari passu with such other creditors. The trust indenture, pursuant to which the Company 
issued the 2025 Debentures (the “Indenture”) does not prohibit or limit the ability of the Company or its subsidiaries to 
incur additional debt or liabilities (including senior indebtedness) or to make distributions except in respect of distributions 
where an event of default caused by the failure to pay interest when due has occurred and such default has not been cured or 
waived. The Indenture does not contain any provision specifically intended to protect holders of 2025 Debentures in the 
event of a future leveraged transaction involving the Company or any of its subsidiaries.  

CONVERSION OF THE DEBENTURES FOLLOWING CERTAIN TRANSACTIONS  

In the case of certain transactions, the 2025 Debentures will become convertible into the securities, cash or property 
receivable by a Shareholder under the transaction. The change could substantially lessen or eliminate the value of the 
conversion privilege associated with the 2025 Debentures in the future. For example, if the Company were acquired in a 
cash merger, the 2025 Debenture would become convertible solely into cash and would no longer be convertible into 
securities whose value would vary depending on the Company’s future prospects and other factors.  

REDEMPTION OF THE DEBENTURES PRIOR TO MATURITY  

The 2025 Debentures may be redeemed, at the option of the Company, at any time and from time to time, at a price equal to 
the principal amount thereof plus accrued and unpaid interest.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

43 

 
 
 
 
 
 
 
 
INABILITY OF THE COMPANY TO PURCHASE THE DEBENTURES IN CASH ON A CHANGE OF CONTROL 

If a change of control of the Company occurs, debentureholders will have the right to require the Company to redeem the 
2025 Debentures in an amount equal to 101% of the principal amount of the 2025 Debentures plus accrued and unpaid 
interest until the date of redemption. If holders of 2025 Debentures holding 90% or more of all the 2025 Debentures 
exercise their right to require the Company to redeem such 2025 Debentures, the Company may acquire the remaining 2025 
Debentures on the same terms. In such event, the conversion privilege associated with the 2025 Debentures would be 
eliminated. Although the Company may be required to purchase all outstanding 2025 Debentures upon the occurrence of a 
change of control, it is possible that following a change of control, the Company will not have sufficient funds at that time 
to make any required purchase of outstanding 2025 Debentures or that restrictions contained in other indebtedness will 
restrict those purchases.  

ACCOUNTING POLICIES AND ESTIMATES  

Critical Accounting Policies and Estimates  

A full discussion of the Company’s critical accounting policies and estimates is provided in Note 3 of the audited 
consolidated financial statements for the year ended December 31, 2019, and under the heading “Future Changes in 
Accounting Policies” that follows this section. 

Management considers an understanding of the Company’s accounting policies to be essential to an understanding of its 
financial statements because their application requires significant judgement and reliance on estimations of matters that are 
inherently uncertain, which affect the application of the accounting policies and reported amounts. Estimates and 
underlying assumptions are reviewed on an ongoing basis giving consideration to past experience and other factors that 
management believes are reasonable under the circumstances. Accordingly, actual results could differ from those estimated. 
The estimates and assumptions, which have a significant risk of causing a material adjustment to the carrying amount of 
assets and liabilities, are discussed below. 

VALUATION OF PURCHASE PRICE ALLOCATION FOR ACQUISITIONS  

Fair value is the price that would be received when selling an asset, or paid when transferring a liability in an orderly 
transaction (that is other than in a forced or liquidation sale) between market participants at the measurement date under 
current market conditions. The fair value measurement is based on the presumption that the transaction takes place either:  
in the principal market for the asset or liability; or in the absence of a principal market, in the most advantageous market for 
the asset or liability. The principal or the most advantageous market must be accessible by the Company.  

The fair value of an asset or a liability is measured using the assumptions that market participants would use when pricing 
the asset or liability assuming that market participants act in their economic best interests. The Company uses valuation 
techniques that are appropriate in the circumstances and for which sufficient data are available to measure fair value, 
maximizing the use of relevant observable inputs and minimizing the use of unobservable inputs. The techniques used to 
estimate future cash flows will vary from one situation to another depending on the circumstances surrounding the asset or 
liability in question. Management assesses fair value based on estimated discounted cash flow projections and available 
market information (including the historical operating results and anticipated trends, local markets and economic 
conditions). 

As discussed below under the heading “Valuation of Cash Generating Units and Impairment”, an impairment loss is 
recognized when the carrying amount of an asset is not recoverable. The impairment loss is determined as the excess of the 
carrying value over its estimated recoverable amount.  

Intangible assets with indefinite lives are also required to be assessed at a minimum annually, comparing the estimated 
recoverable amount to the carrying value to determine if an impairment loss is required to be recognized.  

VALUATION OF CASH GENERATING UNITS AND IMPAIRMENT  

Non-financial assets consist of property and equipment, intangible assets with finite lives, intangible assets with indefinite 
lives and goodwill. Property and equipment represents approximately 60% of the Company’s total assets as at December 
31, 2019, and goodwill and other intangibles represent approximately 10%. A CGU is defined to be the smallest group of 
assets that generates cash inflows from continuing use that is largely independent of the cash inflows of other assets. The 
Company has identified the home health care segment and each individual LTC home and retirement community as a CGU.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

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Goodwill and indefinite-life intangibles are tested annually, except in the year of acquisition, and other assets are assessed 
for impairment when indicators of impairment exist. If any such indication exists, then the asset’s recoverable amount is 
reassessed. For goodwill, and intangible assets that have indefinite useful lives or that are not yet available for use, the 
recoverable amount is estimated annually at the same time or more frequently if warranted. An impairment loss is 
recognized in net earnings if the carrying amount of an asset or its related CGU, or group of assets on the same basis as 
evaluated by management, exceeds its estimated recoverable amount. The recoverable amount of an asset or a CGU is the 
greater of its value in use and its fair value less costs to sell.  

The determination of recoverable amounts can be significantly impacted by estimates related to current market valuations, 
current and future economic conditions in the geographical markets of each CGU, and management’s strategic plans within 
each of its markets. Estimates and assumptions used in the determination of any impairment loss are based upon 
information that is known at the time, along with future outlook. When impairment tests are performed, the estimated 
useful lives of the assets are reassessed, with any change accounted for prospectively. Actual results can differ from these 
estimates and can have either a positive or negative impact on the estimate, and impact whether an impairment situation 
exists.  

In 2018, the Company performed the impairment assessment of its operations and recognized a pre-tax impairment charge 
of property and equipment in the amount of $16.2 million in respect of certain of its Saskatchewan retirement communities 
($15.9 million) and of its LTC homes ($0.3 million).  

VALUATION OF INDEMNIFICATION PROVISIONS 

As a result of the U.S. Sale Transaction, the Company has indemnified certain obligations of its former U.S. operations 
related to tax, a corporate integrity agreement, and other items. As at December 31, 2019, the Company had remaining 
provisions totalling $7.4 million or US$5.7 million (2018 – $13.7 million or US$10.1 million) and an indemnification 
receivable of $1.3 million (2018 – $2.0 million). The estimates of these items are assessed every reporting period based on 
management’s best estimate of the ultimate costs or recovery of such items, and any changes to the estimates are reflected 
as part of other expense in the results of discontinued operations. There were no valuation changes to the indemnifications 
during 2019 (2018 – favourable changes of $3.8 million), refer to Note 21 of the audited consolidated financial statements. 
Actual results can differ materially from the estimates made due to a number of factors, including the assumptions used by 
management and other market forces.  

SELF-INSURED LIABILITIES OF DISCONTINUED OPERATIONS  

The obligation to settle any U.S. self-insured general and professional liability claims relating to the period prior to the July 
2015 closing of the U.S. Sale Transaction, including claims incurred but yet to be reported, remains with the Company, 
which continues to be funded through the Captive. The accrual for U.S. self-insured liabilities of the Company’s former 
U.S. operations is based on management’s best estimate of the ultimate cost to resolve general and professional liability 
claims, using historical information and industry data, supported by actuarial projections, advice from legal counsel, 
consultants and external risk management. Actual results can differ materially from the estimates made due to a number of 
factors, including the assumptions used by management and other market forces.  

Management regularly evaluates and periodically engages an independent third-party actuary to determine the 
appropriateness of the carrying value of this liability. Assumptions underlying the determination of the liability are limited 
by the uncertainty of predicting future events and assessments regarding expectations of several factors. Such factors 
include, but are not limited to:  the frequency and severity of claims, which can differ materially by jurisdiction; trends in 
claims along with unique and identifiable settlements; the effectiveness of the claims management process; and the 
outcome of litigation. Therefore, management’s estimate of the accrual for general and professional liability claims is 
significantly influenced by assumptions that are subject to judgement by management and the actuary, which may cause the 
expense to fluctuate significantly from one reporting period to another. Differences between the ultimate claims costs and 
our historical expense for loss and actuarial assumptions and estimates could have a material adverse effect on our business, 
results of operations and financial condition. 

As at December 31, 2019, the accrual for self-insured general and professional liabilities was $12.2 million or 
US$9.4 million (2018 – $37.1 million or US$27.2 million) supported by investments held by the Captive of $27.6 million 
or US$21.2 million (2018 – $67.9 million or US$49.8 million). Changes in the level of retained risk and other significant 
assumptions that underlie management’s estimates could have a material effect on the future carrying value of the self-
insured liabilities. For example, a 1% variance in the accrual for U.S. self-insured liabilities at December 31, 2019, would 
have impacted the Company’s net earnings from discontinued operations by approximately $0.1 million. For further 
information refer to the discussion under the heading “Other Contractual Obligations and Contingencies – Accrual for U.S. 
Self-Insured Liabilities”. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

45 

 
 
 
 
 
 
 
TAX UNCERTAINTIES  

Tax uncertainties are evaluated on the basis of whether it is more likely than not that a tax position will ultimately be 
sustained upon examination by the relevant taxing authorities. Tax uncertainties are measured using a probability adjusted 
or expected value model whereby amounts are recorded if there is any uncertainty about a filing position, determined by 
multiplying the amount of the exposure by the probability that the entity’s filing position will not be sustained. The 
assessment of tax uncertainties relies on estimates and assumptions and may involve a series of judgements about future 
events. New information may become available that causes the Company to change its judgement regarding the adequacy 
of existing tax liabilities. Such changes to tax liabilities will impact tax expense in the period that such a determination is 
made.  

DEFERRED TAX ASSETS AND LIABILITIES  

The Company uses the asset and liability method of accounting for deferred income taxes, which takes into account the 
differences between financial statement treatment and tax treatment of certain transactions, assets and liabilities. Deferred 
tax assets and liabilities are recognized to reflect the expected future tax consequences attributed to differences between the 
financial statement carrying amounts of existing assets and liabilities and their respective tax values as well as available tax 
loss carryforwards. Deferred tax assets and liabilities are measured using the substantively enacted tax rates anticipated to 
apply in the periods that the temporary differences are expected to be recovered or settled. The ultimate realization of 
deferred tax assets is dependent upon if the generation of future taxable income is probable during the periods in which 
those temporary differences become deductible. Management considers the scheduled reversal of deferred tax liabilities, 
projected future taxable income and tax planning strategies in making this assessment. As at December 31, 2019, the 
Company had recognized deferred tax assets totalling $12.7 million (2018 – $9.7 million). Management believes that it is 
more likely than not that the Company will realize the benefits of these deductible differences. In addition, as at December 
31, 2019, there were capital losses available for Canadian income tax purposes of $41.7 million (2018 – $42.1 million) that 
have not been tax benefited and are available indefinitely to apply against future capital gains.  

New Accounting Policies Adopted   

The following new standards were adopted effective January 1, 2019, and have been applied in preparing the financial 
results for the year ended December 31, 2019. These accounting standards are summarized below, and are more fully 
described in Note 4 of the audited consolidated financial statements. 

LEASES 

Effective January 1, 2019, the Company adopted IFRS 16 “Leases”, which supersedes IAS 17 “Leases” and related 
interpretations. This new standard requires a lessee to recognize assets and liabilities for all leases with a term of more than 
12 months, unless the underlying asset is of low value, using a single accounting model, thereby eliminating the distinction 
between operating and finance leases. The nature and timing of the related expense has changed as IFRS 16 replaces the 
straight-line lease costs with a depreciation charge for right-of-use assets and interest expense on lease liabilities. 

Lease costs for the prior year have been reclassified under administrative costs to conform with the current year 
presentation. The impact of adopting this standard on net earnings and overall cash flow is neutral; however, the principal 
payment of the lease liabilities is presented in financing activities (previously reflected as operating activities).  

The Company has applied IFRS 16 using the modified retrospective approach, under which the comparative information 
presented has not been restated. Certain practical expedients were selected on transition. The transition did not result in any 
retrospective adjustment to opening retained earnings on January 1, 2019.  

Transition 

At transition, for leases classified as operating leases under IAS 17, lease liabilities were measured at the present value of 
the remaining lease payments, discounted at the Company’s incremental weighted average borrowing rate as at January 1, 
2019, of 4.86%. Right-of-use assets were measured at an amount equal to the lease liability. For leases that were classified 
as finance leases under IAS 17, the carrying amount of the right-of-use assets and the lease liability as at January 1, 2019, 
was the carrying amount of the lease assets and lease liability immediately before the date of initial application. These are 
accounted for using IFRS 16 from that date.  

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

46 

 
 
 
 
 
 
 
 
 
 
The Company used the following practical expedients when applying IFRS 16 to leases previously classified as operating 
leases under IAS 17: 
• 

applied the exemption not to recognize right-of-use assets and liabilities for leases with less than 12 months of lease 
term;  
applied the exemption not to recognize right-of-use assets and liabilities for leases that are of low value;  
excluded initial direct costs from measuring the right-of-use asset as at January 1, 2019; and  
used hindsight as at January 1, 2019, when determining the lease term if the contract contains options to extend or 
terminate the lease. 

• 
• 
• 

INCOME TAXES  

On June 7, 2017, the IASB issued IFRIC Interpretation 23 “Uncertainty over Income Tax Treatments”. The interpretation 
provides guidance on the accounting for current and deferred tax liabilities and assets in circumstances in which there is 
uncertainty over income tax treatments. Effective January 1, 2019, the Company adopted the IFRIC Interpretation 23, with 
no material impact on the consolidated financial statements.  

Future Changes in Accounting Policies 

On October 22, 2018, the IASB issued amendments to IFRS 3 “Business Combinations”, that seek to clarify whether a 
transaction results in an asset or a business acquisition. The amendments apply to businesses acquired in annual reporting 
periods beginning on or after January 1, 2020. Earlier application is permitted. The Company intends to adopt the 
amendments for the annual period beginning on January 1, 2020.  

Disclosure Controls and Procedures   

Management is responsible for establishing and maintaining a system of disclosure controls and procedures (DC&P) to 
provide reasonable assurance that all material information relating to the Company is gathered and reported to senior 
management, including the Chief Executive Officer (CEO) and Chief Financial Officer (CFO), on a timely basis so that 
appropriate decisions can be made regarding public disclosure. 

An evaluation of the effectiveness of the DC&P was conducted as at December 31, 2019, by management under the 
supervision of the Company’s CEO and CFO. Based on this evaluation, the CEO and CFO have concluded that the 
Company’s disclosure controls and procedures, as defined by National Instrument 52-109, Certification of Disclosures in 
Issuers’ Annual and Interim Filings, were effective as at December 31, 2019.  

Internal Control over Financial Reporting  

Management is also responsible for establishing and maintaining adequate internal controls over financial reporting (ICFR) 
to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial reports for 
external purposes in accordance with IFRS. 

Management, under the supervision of the Company’s CEO and CFO, has evaluated the effectiveness of our ICFR using 
the 2013 Integrated Control framework as published by the Committee of Sponsoring Organizations of the Treadway 
Commission. Based on this evaluation, management has concluded that our ICFR were effective and that there were no 
material weaknesses in the Company’s ICFR as at December 31, 2019. 

In designing such controls, it should be recognized that due to inherent limitations, any controls, no matter how well 
designed and operated, can provide only reasonable assurance of achieving the desired control objectives and may not 
prevent or detect misstatements. Additionally, management is required to use judgement in evaluating controls and 
procedures. 

Extendicare Inc. – 2019 Management’s Discussion and Analysis 

47 

 
 
 
 
 
 
 
 
 
 
... helping people live better

CONSOLIDATED FINANCIAL STATEMENTS  
AND NOTES 

Year ended December 31, 2019 

Extendicare Inc. 
Dated:  February 27, 2020 

Management’s Responsibility for Consolidated Financial Statements 

The accompanying consolidated financial statements of Extendicare Inc. (“Extendicare” or the “Company”) and other 
financial information contained in this Annual Report are the responsibility of management. The consolidated financial 
statements have been prepared in conformity with International Financial Reporting Standards, using management’s best 
estimates and judgements, where appropriate. In the opinion of management, these consolidated financial statements reflect 
fairly the financial position, results of operations and cash flows of Extendicare within reasonable limits of materiality. The 
financial information contained elsewhere in this Annual Report has been reviewed to ensure consistency with that in the 
consolidated financial statements. 

A system of internal accounting and administrative controls is maintained by management to provide reasonable assurance 
that assets are safeguarded against loss from unauthorized use or disposition and that financial records are properly 
maintained to provide accurate and reliable consolidated financial statements. 

The board of directors of Extendicare (the “Board of Directors”) is responsible for ensuring that management fulfills its 
responsibilities for financial reporting and internal controls. The Board of Directors carries out this responsibility principally 
through its independent Audit Committee comprised of unrelated and outside directors. The Audit Committee meets regularly 
during the year to review significant accounting and auditing matters with management and the independent auditors and to 
review and approve the interim and annual consolidated financial statements of Extendicare. 

The consolidated financial statements have been audited by KPMG LLP, which has full and unrestricted access to the Audit 
Committee. KPMG’s report on the consolidated financial statements follows.  

MICHAEL GUERRIERE 
President and Chief Executive Officer 

February 27, 2020 

DAVID BACON 
Senior Vice President and 
Chief Financial Officer  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements

1

KPMG LLP 
100 New Park Place, Suite 1400 
Vaughan, ON  L4K 0J3 
Tel 905-265 5900 
Fax 905-265 6390 
www.kpmg.ca 

Independent Auditors’ Report 

To the Shareholders of Extendicare Inc.  

Opinion 

We have audited the consolidated financial statements of Extendicare Inc. (the Entity), which 
comprise: 











the  consolidated  statements  of  financial  position  as  at  December  31,  2019  and
December 31, 2018

the consolidated statements of earnings and comprehensive income (loss) for the years
then ended

the consolidated statements of changes in equity for the years then ended

the consolidated statements of cash flows for the years then ended

and notes to the consolidated financial statements, including a summary of significant
accounting policies

(Hereinafter referred to as the “financial statements”). 

In our opinion, the accompanying financial statements present fairly, in all material respects, 
the consolidated financial position of the Entity as at December 31, 2019 and December 31, 
2018,  and  its  consolidated  financial  performance  and  its  consolidated  cash  flows  for  the 
years then ended in accordance with International Financial Reporting Standards (IFRS). 

Basis for Opinion    

We  conducted  our  audit  in  accordance  with  Canadian  generally  accepted  auditing 
standards.   Our  responsibilities  under  those  standards  are  further  described  in  the 
“Auditors’  Responsibilities  for  the  Audit  of  the  Financial  Statements”  section  of  our 
auditors’ report.   

We  are  independent  of  the  Entity  in  accordance  with  the  ethical  requirements  that  are 
relevant to our audit of the financial statements in Canada and we have fulfilled our other 
ethical responsibilities in accordance with these requirements. 

We believe that the audit evidence we have obtained is sufficient and appropriate to provide 
a basis for our opinion. 

Other Information 

Management is responsible for the other information. Other information comprises: 

KPMG LLP is a Canadian limited liability partnership and a member firm of the KPMG network of independent member firms affiliated 
with KPMG International Cooperative (“KPMG International”), a Swiss entity. KPMG Canada provides services to KPMG LLP. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements

2





the information included in Management’s Discussion and Analysis filed with the relevant
Canadian Securities Commissions.

the  information,  other  than  the  financial  statements  and  the  auditors’  report  thereon,
included in a document likely to be entitled “Annual Report”.

Our opinion on the financial statements does not cover the other information and we do not 
and will not express any form of assurance conclusion thereon.  

In connection with our audit of the financial statements, our responsibility is to read the other 
information  identified  above  and,  in  doing  so,  consider  whether  the  other  information  is 
materially inconsistent with the financial statements or our knowledge obtained in the audit 
and remain alert for indications that the other information appears to be materially misstated.   

We obtained the information included in Management’s Discussion and Analysis filed with 
the  relevant  Canadian  Securities  Commissions  as  at  the  date  of  this  auditors’  report.   If, 
based on the work we have performed on this other information, we conclude that there is a 
material  misstatement  of  this  other  information,  we  are  required  to  report  that  fact  in  the 
auditors’ report. 

We have nothing to report in this regard. 

The  information,  other  than  the  financial  statements  and  the  auditors’  report  thereon, 
included in a document likely to be entitled “Annual Report” is expected to be made available 
to us after the date of this auditors’ report. If, based on the work we will perform on this other 
information, we conclude that there is a material misstatement of this other information, we 
are required to report that fact to those charged with governance. 

Responsibilities  of  Management  and  Those  Charged  with  Governance  for  the 
Financial Statements 

Management  is  responsible  for  the  preparation  and  fair  presentation  of  the  financial 
statements in accordance with International Financial Reporting Standards (IFRS), and for 
such internal control as management determines is necessary to enable the preparation of 
financial statements that are free from material misstatement, whether due to fraud or error. 

In preparing the financial statements, management is responsible for assessing the Entity’s 
ability  to  continue  as  a  going  concern,  disclosing  as  applicable,  matters  related  to  going 
concern and using the going concern basis of accounting unless management either intends 
to liquidate the Entity or to cease operations, or has no realistic alternative but to do so. 

Those  charged  with  governance  are  responsible  for  overseeing  the  Entity’s  financial 
reporting process. 

Auditors’ Responsibilities for the Audit of the Financial Statements 

Our objectives are to obtain reasonable assurance about whether the financial statements 
as a whole are free from material misstatement, whether due to fraud or error, and to issue 
an auditors’ report that includes our opinion.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements

3

Reasonable assurance  is  a  high  level  of  assurance,  but  is  not  a  guarantee  that  an  audit 
conducted in accordance with Canadian generally accepted auditing standards will always 
detect a material misstatement when it exists.  

Misstatements can arise from fraud or error and are considered material if, individually or in 
the aggregate, they could reasonably be expected to influence the economic decisions of 
users taken on the basis of the financial statements. 

As part of an audit in accordance with Canadian generally accepted auditing standards, we 
exercise professional judgment and maintain professional skepticism throughout the audit.  

We also: 



Identify  and  assess  the  risks  of  material  misstatement  of  the  financial  statements,
whether due to fraud or error, design and perform audit procedures responsive to those
risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for
our opinion.

The risk of not detecting a material misstatement resulting from fraud is higher than for
one resulting from error, as fraud may involve collusion, forgery, intentional omissions,
misrepresentations, or the override of internal control.

 Obtain an understanding of internal control relevant to the audit in order to design audit
procedures  that  are  appropriate  in  the  circumstances,  but  not  for  the  purpose  of
expressing an opinion on the effectiveness of the Entity's internal control.

 Evaluate  the  appropriateness  of  accounting  policies  used and  the  reasonableness  of

accounting estimates and related disclosures made by management.

 Conclude on the appropriateness of management's use of the going concern basis of
accounting and, based on the audit evidence obtained, whether a material uncertainty
exists related to events or conditions that may cast significant doubt on the Entity's ability
to continue as a going concern. If we conclude that a material uncertainty exists, we are
required to draw attention in our auditors’ report to the related disclosures in the financial
statements  or,  if  such  disclosures  are  inadequate,  to  modify  our  opinion.  Our
conclusions are based on the audit evidence obtained up to the date of our auditors’
report. However, future events or conditions may cause the Entity to cease to continue
as a going concern.

 Evaluate  the  overall  presentation,  structure  and  content  of  the  financial  statements,
including the disclosures, and whether the financial statements represent the underlying
transactions and events in a manner that achieves fair presentation.

 Communicate with those charged with governance regarding, among other matters, the
planned  scope  and  timing  of  the  audit  and  significant  audit  findings,  including  any
significant deficiencies in internal control that we identify during our audit.

 Provide those charged with governance with a statement that we have complied with
relevant ethical requirements regarding independence, and communicate with them all

Extendicare Inc. – 2019 Annual Consolidated Financial Statements  

 4

relationships  and  other  matters  that  may  reasonably  be  thought  to  bear  on  our 
independence, and where applicable, related safeguards. 

 Obtain  sufficient  appropriate  audit  evidence  regarding  the  financial  information  of  the
entities  or  business  activities  within  the  group  Entity  to  express  an  opinion  on  the
financial statements. We are responsible for the direction, supervision and performance
of the group audit. We remain solely responsible for our audit opinion.

Chartered Professional Accountants, Licensed Public Accountants 
The engagement partner on the audit resulting in this auditors’ report is Paola Cipolla 
Vaughan, Canada 
February 27, 2020 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements                                                                                         5

Extendicare Inc. 
Consolidated Statements of Financial Position 
As at December 31 
(in thousands of Canadian dollars) 

notes 

2019 

2018 

Assets 
Current assets 

Cash and short-term investments 

Restricted cash 

Accounts receivable 

Income taxes recoverable 
Other assets 
Total current assets 

Non-current assets 

Property and equipment 
Goodwill and other intangible assets  
Other assets  
Deferred tax assets 
Total non-current assets 

Total assets 
Liabilities and Equity 
Current liabilities 

Accounts payable and accrued liabilities 
Income taxes payable 
Long-term debt 
Provisions 
Total current liabilities 

Non-current liabilities 
Long-term debt 
Provisions 
Other long-term liabilities 
Deferred tax liabilities 
Total non-current liabilities 

Total liabilities 
Share capital 
Equity portion of convertible debentures 
Contributed surplus 
Accumulated deficit 
Accumulated other comprehensive loss 
Shareholders’ equity 
Total liabilities and equity 
See accompanying notes to consolidated financial statements. 
Commitments and contingencies (Note 23). 

Approved by the Board 

7 

10 

8 

9 

10 

22 

12 

11 

12 

11 

13 

22 

15 

12 

14 

 94,457 

 2,441 

 50,382 

 15,958 
 20,661 
 183,899 

 530,527 
 89,874 
 71,752 
 12,748 
 704,901 
 888,800 

 136,922 
 1,606 
 133,771 
 3,572 
 275,871 

 422,535 
 25,541 
 35,187 
 14,252 
 497,515 
 773,386 
 498,116 
 7,085 
 3,675 
 (382,189) 
 (11,273) 
 115,414 
 888,800 

 65,893 

 2,290 

 50,570 

 17,316 
 21,465 
 157,534 

 514,849 
 95,200 
 118,996 
 9,745 
 738,790 
 896,324 

 133,654 
 1,073 
 74,626 
 17,621 
 226,974 

 454,344 
 42,595 
 35,077 
 11,343 
 543,359 
 770,333 
 492,064 
 7,085 
 2,706 
 (368,147) 
 (7,717) 
 125,991 
 896,324 

Alan D. Torrie 

Chairman 

Michael Guerriere 

President and Chief Executive Officer  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

6 

 
 
 
 
 
 
  
 
  
 
 
 
 
 
  
 
 
 
  
 
  
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Extendicare Inc. 
Consolidated Statements of Earnings 
Years ended December 31 

(in thousands of Canadian dollars except for per share amounts) 
CONTINUING OPERATIONS 
Revenue 
Operating expenses 
Administrative costs  
Total expenses 
Earnings before depreciation, amortization, and other expense 
Depreciation and amortization 
Other expense 
Earnings before net finance costs and income taxes 
Interest expense 

Interest revenue 
Accretion 
Foreign exchange and fair value adjustments 
Net finance costs 
Earnings before income taxes 
Income tax expense (recovery) 
Current  
Deferred 
Total income tax expense 
Earnings from continuing operations 

DISCONTINUED OPERATIONS 
Earnings from discontinued operations, net of income taxes 
Net earnings 

Basic and Diluted Earnings per Share 
Earnings from continuing operations 
Net earnings 

See accompanying notes to consolidated financial statements. 

notes 

2019 

2018 

 998,500 
 42,339 

16, 28   1,131,950   1,120,007 
 986,023 
 39,746 
17   1,040,839   1,025,769 
 94,238 
 35,270 
 20,195 
 38,773 
 27,584 

 91,111 
 39,590 
 2,404 
 49,117 
 28,733 

18 

 (3,688) 
 1,843 
 (2,007) 
 24,881 
 24,236 

 8,287 
 (1,102) 
 7,185 
 17,051 

 (3,761) 
 2,878 
 (247) 
 26,454 
 12,319 

 8,129 
 (3,894) 
 4,235 
 8,084 

 11,579 
 28,630 

 23,654 
 31,738 

 0.19 
 0.32 

 0.09 
 0.36 

19 

22 

21 

20 

20 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

7 

 
 
 
 
 
 
 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
  
 
 
 
  
 
  
 
 
 
Extendicare Inc. 
Consolidated Statements of Comprehensive Income 
Years ended December 31 

(in thousands of Canadian dollars) 

Net earnings 

Other comprehensive loss, net of income taxes 
Items that will not be reclassified to profit or loss: 

Defined benefit plan actuarial losses, net of taxes 

Items that are or may be reclassified subsequently to profit or loss: 

Net change in foreign currency translation adjustment 

Total items that are or may be reclassified subsequently to profit or loss 
Other comprehensive income (loss), net of tax 
Total comprehensive income 
See accompanying notes to consolidated financial statements. 

notes 

2019 

 28,630 

2018 
 31,738 

22, 24 

 (1,043) 

 (373) 

 22 

 (2,513) 
 (2,513) 
 (3,556) 
 25,074 

 1,841 
 1,841 
 1,468 
 33,206 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

8 

 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
 
 
 
 
 
 
 
Extendicare Inc. 
Consolidated Statements of Changes in Equity 
Years ended December 31 

(in thousands of Canadian dollars) 
Balance at January 1, 2019 
DRIP 
Share-based compensation 
Net earnings 
Dividends declared 
Other comprehensive loss 
Balance at December 31, 2019 

notes 

15 

14 

Number of 
Shares 
 88,489,984  
 693,466  
 49,062  
 – 
 – 
 – 
   89,232,512  

Share 
Capital 
 492,064  
 5,423  
 629  
 – 
 – 
 – 
 498,116  

Equity Portion 
of Convertible 
Debentures 
 7,085  
 – 
 – 
 – 
 – 
 – 
 7,085  

Contributed 
Surplus 
 2,706  
 – 
 969  
 – 
 – 
 – 
 3,675  

Accumulated 
Other 
Comprehensive 
Income (Loss) 
 (7,717) 
 – 
 – 
 – 
 – 
 (3,556) 
 (11,273) 

Accumulated 
Deficit 
 (368,147) 
 – 
 – 
 28,630 
 (42,672) 
 – 
 (382,189) 

Shareholders' 
Equity 
 125,991  
 5,423  
 1,598  
 28,630 
 (42,672) 
 (3,556) 
 115,414 

Number of 
Shares 
 88,523,290  
 – 
 88,523,290  
 650,361  
 (703,585) 
 19,918  

(in thousands of Canadian dollars) 
Balance at January 1, 2018, previously 

notes 

d 

14 

15 

15 

Adoption of new standard (1) 
Balance at January 1, 2018 
DRIP 
Purchase of shares for cancellation 
Share-based compensation 
Redemption of convertible 
  debentures 
Issuance of convertible debentures 
Net earnings 
Dividends declared 
Other comprehensive income 
Balance at December 31, 2018 
See accompanying notes to consolidated financial statements. 
(1) Adoption of new standard on financial instruments – IFRS 9. 

 – 
 – 
 – 
 – 
 – 
   88,489,984  

12 

12 

Equity portion 
of convertible 
debentures 
 5,573  
 – 
 5,573  
 – 
 – 
 – 

 (5,573) 
 7,085  
 – 
 – 
 – 
 7,085  

Contributed 
surplus 
 2,437  
 – 
 2,437  
 – 
 – 
 269  

 – 
 – 
 – 
 – 
 – 
 2,706  

Accumulated 
deficit 
 (365,084) 
 4,334  
 (360,750) 
 – 
 (2,357) 
 – 

 5,573  
 – 
 31,738  
 (42,351) 
 – 
 (368,147) 

Accumulated 
other 
comprehensive 
income (loss) 
 (4,851) 
 (4,334) 
 (9,185) 
 – 
 – 
 – 

Shareholders' 
equity 
 128,956  
 – 
 128,956  
 4,928  
 (6,260) 
 427  

 – 
 – 
 – 
 – 
 1,468  
 (7,717) 

 – 
 7,085  
 31,738  
 (42,351) 
 1,468  
 125,991  

Share 
capital 
 490,881  
 – 
 490,881  
 4,928  
 (3,903) 
 158  

 – 
 – 
 – 
 – 
 – 
 492,064  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

9 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Extendicare Inc. 
Consolidated Statements of Cash Flows 
Years ended December 31 

(in thousands of Canadian dollars) 
Operating Activities 
Net earnings 
Adjustments for: 

Depreciation and amortization 
Share-based compensation 
Deferred taxes 
Current taxes 
Net finance costs 
Other expense 
Foreign exchange and fair value adjustments 

Net change in operating assets and liabilities 

Accounts receivable 
Other assets 
Accounts payable and accrued liabilities 

Payments for self-insured liabilities 
Interest paid 
Interest received 
Income taxes paid 
Net cash from operating activities 
Investing Activities 
Purchase of property, equipment and other intangible assets 
Acquisitions 
Decrease in investments held for self-insured liabilities 
Decrease in other assets 
Net cash from (used in) investing activities 
Financing Activities 
Issuance of long-term debt 
Repayment of long-term debt 
Decrease (increase) in restricted cash 
Purchase of securities for cancellation 
Dividends paid 
Financing costs 
Other 
Net cash used in financing activities 
Increase (decrease) in cash and short-term investments 
Cash and short-term investments at beginning of year 
Foreign exchange gain (loss) on cash held in foreign currency 
Cash and short-term investments at end of year 
See accompanying notes to consolidated financial statements. 

notes 

2019 

2018 

 28,630 

 31,738 

8, 9 
14 
22 
22 
12 

19 

8, 9 
6 

 39,590 
 1,598 
 212 
 6,973 
 26,888 
 (9,175) 
 (2,007) 
 92,709 

 200 
 1,133 
 (6,166) 
 87,876 
 (12,769) 
 (27,933) 
 3,677 
 (5,661) 
 45,190 

 (33,182) 
 – 
 40,464 
 5,487 
 12,769 

 45,987 
 (35,658) 
 (151) 
 – 
 (37,218) 
 (1,628) 
 – 
 (28,668) 
 29,291 
 65,893 
 (727) 
 94,457 

 35,270 
 430 
 1,936 
 (3,600) 
 26,701 
 2,440 
 (247) 
 94,668 

 (8,172) 
 (536) 
 2,210 
 88,170 
 (15,237) 
 (28,383) 
 3,785 
 (8,862) 
 39,473 

 (50,648) 
 (33,767) 
 24,163 
 5,200 
 (55,052) 

 159,998 
 (159,674) 
 10 
 (6,258) 
 (37,424) 
 (5,886) 
 471 
 (48,763) 
 (64,342) 
 128,156 
 2,079 
 65,893 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

10 

 
 
 
 
 
 
  
 
  
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
Notes to Consolidated Financial Statements 
YEAR ENDED DECEMBER 31, 2019 

General Information and Nature of the Business………………………………………………………….…. 

12  

Basis of Preparation…………………………………………………………………………………………….. 

12  

Significant Accounting Policies………………………………………………………………………………… 

13 

New Accounting Policies Adopted………………………………………………………………………..……. 

Future Changes in Accounting Policies……………………………………………………………………….. 

Acquisition………………………………………………………………………………………………………. 

Accounts Receivable……………………………………………………………………………………………. 

20 

21 

21 

22 

Property and Equipment………………………………………………………………………………………. 

22  

Goodwill and Other Intangible Assets…………………………………………………………………………. 

23 

Other Assets…………………………………………………………………………………………………….. 

23  

Provisions………………………………………………………………………………………………………… 

24  

Long-term Debt…………………………………………………………………………………………………. 

25  

Other Long-term Liabilities……………………………………………………………………………………. 

28  

Share-based Compensation…………………………………………………………………………………….. 

28  

Share Capital……………………………………………………………………………………………………. 

29  

Revenue………………………………………………………………………………………………………….. 

Expenses by Nature…………………………………………………………………………………………….. 

Other Expense…………………………………………………………………………………………………... 

Foreign Exchange and Fair Value Adjustments…………………………………………………….…...…… 

Earnings per Share……………………………………………………………………………………………... 

Discontinued Operations……………………………………………………………………………………….. 

30 

30 

30  

31  

32  

32  

Income Taxes……………………………………………………………………………………………………. 

33 

Commitments and Contingencies……………………………………………………………………………… 

35  

Employee Benefits……………………………………………………………………………………………… 

25  Management of Risks and Financial Instruments……………………………………………………………. 

Capital Management…………………………………………………………………………………………… 

Related Party Transactions……………………………………………………………………………………. 

Segmented Information………………………………………………………………………………………… 

44  

Significant Subsidiaries………………………………………………………………………………………… 

45 

36 

38 

43 

43 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

26 

27 

28 

29 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

11 

 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

1.  GENERAL INFORMATION AND NATURE OF THE BUSINESS 

The common shares (the “Common Shares”) of Extendicare Inc. (“Extendicare” or the “Company”) are listed on the 
Toronto Stock Exchange (TSX) under the symbol “EXE”. The Company and its predecessors have been operating since 
1968, providing care and services to seniors throughout Canada. The Company has repositioned itself as a leading provider 
of care and services across Canada, committed to delivering quality care throughout the health continuum to meet the needs 
of a growing seniors’ population. The registered office of the Company is located at 3000 Steeles Avenue East, Suite 700, 
Markham, Ontario, Canada, L3R 9W2.  

2.  BASIS OF PREPARATION 

a)  Statement of Compliance 

The consolidated financial statements have been prepared in accordance with International Financial Reporting Standards 
(IFRS). These consolidated financial statements were approved by the board of directors (the “Board”) on February 27, 
2020.  

b)  Basis of Measurement  

The consolidated financial statements have been prepared on the historical cost basis except for financial assets and 
liabilities classified at fair value through profit or loss.  

The Company’s consolidated financial statements are presented in Canadian dollars, which is the Company’s functional 
currency. All financial information presented in dollars has been rounded to the nearest thousand, unless otherwise noted. 

c)  Use of Estimates and Judgement  

The preparation of consolidated financial statements in conformity with IFRS requires management to make judgements, 
estimates and assumptions that affect the application of accounting policies and the reported amounts of assets and 
liabilities, disclosures of contingent assets and liabilities at the date of the consolidated financial statements, and the 
reported amounts of revenue and expenses during the reporting period. Estimates and underlying assumptions are reviewed 
on an ongoing basis.  

Revisions to accounting estimates are recognized in the period in which the estimates are revised and in any future periods 
affected. 

The more subjective of such estimates are:  

• 

• 
• 
• 
• 
• 
• 
• 

• 

determination of the lease term for leases that include renewal options and the appropriate discount rate used to 
recognize lease liability; 
valuation of purchase price allocation for acquisition; 
valuation of indemnification provisions; 
valuation of self-insured liabilities;  
valuation of equity portion of convertible debentures; 
valuation of financial assets and liabilities; 
valuation of share-based compensation;  
determination of the recoverable amount of cash generating units (CGUs) subject to an impairment test; 
and 
accounting for tax uncertainties and the tax rates used for valuation of deferred taxes 

In addition, the assessment of contingencies and provisions are subject to judgement. The recorded amounts for such items 
are based on management’s best available information and are subject to assumptions and judgement, which may change as 
time progresses; accordingly, actual results could differ from estimates.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

12 

  
  
 
 
 
 
 
 
 
  
Notes to Consolidated Financial Statements  

3.  SIGNIFICANT ACCOUNTING POLICIES 

The accounting policies set out below have been applied consistently to all periods presented in these consolidated financial 
statements, except for those detailed in Note 4. 

a)  Basis of Consolidation  

The consolidated financial statements include the accounts of Extendicare and its wholly owned subsidiaries. All material 
intercompany transactions and balances have been eliminated. The financial statements of Extendicare’s subsidiaries are 
included within the Company’s consolidated financial statements from the date that control commences until the date that 
control ceases, and are prepared for the same reporting period as the Company, using consistent accounting policies. 

The acquisition method of accounting is used to account for the acquisition of businesses. Consideration transferred on the 
acquisition is measured as the fair value of the assets given, equity instruments issued and liabilities incurred or assumed on 
the date of the acquisition and transaction costs are expensed as incurred. Identified assets acquired and liabilities assumed 
are measured at their fair value on the acquisition date. The excess of fair value of consideration given over the fair value of 
the identifiable net assets acquired is recorded as goodwill, with any gain on a bargain purchase being recognized in net 
earnings on the acquisition date.  

b)  Foreign Currency  

The assets and liabilities of foreign operations are translated at exchange rates at the reporting date. The income and 
expenses of foreign operations are translated at average rates of exchange for the period. The resulting translation 
adjustments are included in accumulated other comprehensive income (AOCI) in shareholders’ equity.  

Transactions in foreign currencies are translated at exchange rates at the dates of the transactions. Monetary assets and 
liabilities denominated in foreign currencies at the reporting date are retranslated to the functional currency at the exchange 
rate at that date. Non-monetary assets and liabilities denominated in foreign currencies that are measured at fair value are 
retranslated at the exchange rate at the date that the fair value was determined.  

c)  Cash and Short-term Investments 

Cash and short-term investments include unrestricted cash and short-term investments less bank overdraft and outstanding 
cheques. Short-term investments, comprised of money market instruments, have a maturity of 90 days or less from their 
date of purchase. 

d)  Property and Equipment 

Property and equipment is stated at cost less accumulated depreciation and accumulated impairment losses.  

Cost includes expenditures that are directly attributable to the acquisition or development of the asset. Homes that are 
constructed or under construction include all incurred expenditures for the development and other direct costs related to the 
acquisition of land, development and construction of the homes, including borrowing costs of assets meeting certain criteria 
that are capitalized until the home is completed for its intended use.  

Property and equipment are classified into components when parts of an item have different useful lives. The cost of 
replacing a component of an item is recognized in the carrying amount of the item if there is a future economic benefit and 
its cost can be measured reliably. Any undepreciated carrying value of the assets being replaced will be derecognized and 
charged to net earnings upon replacement. The costs of the day-to-day maintenance of property and equipment are 
recognized in net earnings as incurred. 

Depreciation and amortization are computed on a straight-line basis based on the useful lives of each component of 
property and equipment. Depreciation of long-term care (LTC) homes or retirement communities under construction 
commences in the month after the home is available for its intended use based upon the useful life of the asset, as outlined 
in the following table. Land and Construction in Progress are not depreciated. The depreciation methods, useful lives and 
residual values are reviewed at least annually, and adjusted if appropriate.  

The Company acquires in-place leases in connection with the acquisitions of operating retirement communities. These 
assets are stated at the amounts determined upon acquisition and are amortized on a straight-line basis, based upon a review 
of the residents’ average length of stay. In-place leases are a component of building and are generally depreciated over a 
three-year period. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

13 

 
 
 
 
 
 
 
 
 
 
  
 
 
Notes to Consolidated Financial Statements  

Land improvements 
Buildings: 

Building components: 

Structure and sprinklers systems 
Roof, windows and elevators 
HVAC and building systems 
Flooring and interior upgrades 
In-place leases 

Building improvements and extensions 

  10 to 25 years 

  50 years 
 25 years 
 15 to 25 years 
 5 to 15 years 
 1 to 3 years 
  5 to 30 years  

Furniture and equipment: 

Furniture and equipment 
Computer equipment 
Leasehold improvements 

e)  Government Grants 

  5 to 15 years 
  3 to 5 years 
  Term of the lease and renewal that is reasonably certain to be exercised 

Government grants are recognized depending on the purpose and form of the payment from the government.  

Forgivable loans issued by the government are accounted for as government grants if there is reasonable assurance the 
Company will meet the terms for forgiveness of the loan. Forgivable loans granted by a provincial or health authority body 
for the construction of a senior care centre, where the grants are received throughout the duration of the construction 
project, are netted with the cost of property and equipment to which they relate when such payments are received. 

Capital funding payments for the development of a senior care centre that are received from a provincial body subsequent 
to construction over extended periods of time are present valued and are recorded as notes, mortgages and amounts 
receivable included in other assets, with an offset to the cost of property and equipment upon inception; as these grants are 
received over time, the accretion of the receivable is recognized in interest revenue as part of net finance costs within net 
earnings.  

f)  Leases   

The Company recognizes a right-of-use asset and a lease liability at the lease commencement date. The right-of-use asset is 
initially measured at cost, and subsequently at cost less any accumulated depreciation and impairment losses and adjusted 
for certain remeasurements of the lease liability. The lease liability is initially measured at the present value of the lease 
payments that are not paid at the commencement date, discounted using the interest rate implicit in the lease or, if that rate 
cannot be readily determined, the Company’s incremental borrowing rate. Generally, the Company uses its incremental 
borrowing rate as the discount rate. 

The lease liability is subsequently increased by the interest cost through accretion and decreased by lease payments made. It 
is remeasured when there is a change in future lease payments arising from a change in an index or rate, or as appropriate, 
changes in the assessment of whether a purchase or extension option is reasonably certain to be exercised or a termination 
option is reasonably certain not to be exercised. 

The Company has applied judgement to determine the lease term for leases that include renewal options. The assessment of 
whether there is reasonable certainty to exercise such options impacts the lease term, which significantly affects the amount 
of right-of-use assets and lease liabilities recognized.  

g)  Goodwill and Other Intangible Assets 

GOODWILL 

Goodwill represents the excess amount of consideration given over the fair value of the underlying net assets acquired in a 
business combination and is measured at cost less accumulated impairment losses. Goodwill is not amortized but is tested 
for impairment on an annual basis or more frequently if there are indicators that goodwill may be impaired.  

OTHER INTANGIBLE ASSETS 

Other intangible assets that are acquired are recorded at fair value determined upon acquisition, and if the assets have finite 
useful lives are measured at cost less accumulated amortization and accumulated impairment losses.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

14 

    
   
   
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Intangible assets with finite lives are amortized based on cost. Subsequent expenditures are capitalized only if a future 
benefit exists. All other expenditures, including expenditures on internally generated goodwill, are recognized in net 
earnings as incurred. 

Intangible assets with indefinite useful lives are measured at cost without amortization. 

Customer relationships acquired in connection with the purchase of a Canadian home health care business represent the 
intangible asset underlying the various contracts in the business. These assets are being amortized over the estimated useful 
lives over 15 years.  

Non-compete agreements acquired through acquisitions are amortized on a straight-line basis over the period until the 
agreement expires. 

Computer software is amortized over five to seven years and internally developed software over its useful life.  

Amortization methods and useful lives are reviewed at least annually and are adjusted when appropriate. 

h)  Impairment  

Impairment of financial and non-financial assets is assessed on a regular basis. All impairment losses are charged to other 
expense as part of earnings before net finance costs and income taxes.  

NON-FINANCIAL ASSETS  

Non-financial assets consist of property and equipment, intangible assets with finite lives, intangible assets with indefinite 
lives and goodwill.  

The carrying amounts of non-financial assets are reviewed at each reporting date to determine whether there is any 
indication of impairment. If any such indication exists, then the asset’s recoverable amount is estimated to determine the 
extent of the impairment, if any. For goodwill, and intangible assets that have indefinite useful lives or those that are not yet 
available for use, the recoverable amount is estimated annually at the same time or more frequently if warranted. An 
impairment loss is recognized in net earnings if the carrying amount of an asset or its related CGU, or group of assets on the 
same basis as evaluated by management, exceeds its estimated recoverable amount. A CGU is defined to be the smallest 
group of assets that generates cash inflows from continuing use that is largely independent of the cash inflows of other 
assets. The Company has identified the home health care segment and each individual LTC home and retirement 
community as a CGU.  

The recoverable amount of an asset or a CGU is the greater of its value in use and its fair value less costs to sell. In 
assessing value in use, the estimated future cash flows are discounted to their present value using a pre-tax discount rate 
that reflects current market assessments of the time value of money and the risks specific to the asset or CGU. Goodwill 
and indefinite life intangible assets are allocated to their respective CGUs for the purpose of impairment testing. Indefinite 
life intangible assets and corporate assets that do not generate separate cash flows and are utilized by more than one CGU, 
are allocated to each CGU for the purpose of impairment testing and are not tested for impairment separately. 

Impairment losses recognized in respect of CGUs are allocated first to reduce the carrying amount of any goodwill 
allocated to the CGU and then to reduce the carrying amounts of the assets in the CGU on a pro rata basis. Impairment 
losses on goodwill cannot be reversed. In respect of other non-financial assets, impairment losses recognized in prior 
periods are assessed at each reporting date for any indications that the loss has decreased or no longer exists. An 
impairment loss is reversed if there has been a change in the estimates used to determine the recoverable amount. An 
impairment loss is reversed only to the extent that the asset’s carrying amount does not exceed the carrying amount that 
would have been determined, net of depreciation or amortization, if no impairment loss had been recognized (Note 3(m)). 

FINANCIAL ASSETS  

Financial assets are reviewed at each reporting date using the expected credit loss (ECL) impairment model which applies 
to all financial assets except for investments in equity securities. 

The Company has elected to use the simplified approach and calculates impairment loss on account receivable when there 
has been a significant increase in credit risk of lifetime ECL. The other ECL models applied to other financial assets also 
require judgement, assumptions and estimations on changes in credit risks, forecasts of future economic conditions and 
historical information on the credit quality of the financial asset. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

15 

 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Impairment losses are recorded in operating expenses in the consolidated statement of earnings with the carrying amount of 
the financial asset reduced through the use of impairment allowance accounts. 

i)  Employee Benefits 

DEFINED BENEFIT PLANS 

Defined benefit plans are post-employment plans with a defined obligation to employees in return for the services rendered 
during the term of their employment with the Company. The net obligation of these plans is calculated separately for each 
plan by estimating the present value of future benefit that employees have earned in return for their service in the current 
and prior periods. Past service costs are recognized during the period in which they are incurred, and the fair value of any 
plan assets are deducted. The discount rate used in deriving the present value is the yield at the reporting date on AA credit-
rated corporate bonds that have maturity dates approximating the Company’s obligations and are denominated in the same 
currency in which the benefits are expected to be paid.  

The calculation of the future benefit of the plan is performed annually by a qualified actuary using the projected unit credit 
method. When the calculation results in a benefit to the plan, the recognized asset is limited to the present value of 
economic benefits available in the form of reductions in future contributions to the plan.  

All actuarial gains and losses arising from defined benefit plans are recognized in OCI during the period in which they are 
incurred.  

DEFINED CONTRIBUTION PLANS 

The Company has corporate specific and multi-employer defined benefit pension plans, as well as deferred compensation 
plans. Multi-employer defined benefit pension plans are accounted for as defined contribution plans as the liability per 
employer is not available. Deferred compensation plans are also accounted for as defined contribution plans. Defined 
contribution plans are post-employment plans where the costs are fixed and there are no legal or constructive obligations to 
pay further amounts. Obligations for such contributions are recognized as employee benefit expense in net earnings during 
the periods in which services are rendered by employees.  

SHORT-TERM EMPLOYEE BENEFITS 

The Company has vacation, paid sick leave and short-term disability plans along with other health, drug and welfare plans 
for its employees. These employee benefit obligations are measured on an undiscounted basis and are expensed as the 
related services are rendered. 

j)  Share-Based Compensation 

EQUITY-SETTLED LONG-TERM INCENTIVE PLANS  

Awards for deferred share units (DSUs) and performance share units (PSUs) are a share-based component of director and 
executive compensation, which are accounted for based on the intended form of settlement. Under a long-term incentive 
plan (LTIP), the Board has the discretion to settle the DSU and PSU awards in cash, market-purchased Common Shares, or 
Common Shares issued from treasury. Based on the Board’s intention to settle the awards in Common Shares issued from 
treasury, the PSU and DSU awards are accounted for as equity-settled awards. Settlement of the DSUs and PSUs are net of 
any applicable taxes and other source deductions required to be withheld by the Company, which amounts are anticipated to 
approximate 50% of the fair value of the award on the redemption date. The compensation expense for these equity-settled 
awards is prorated over the vesting or performance period, with a corresponding increase to contributed surplus. The fair 
value of each award is measured at the grant date. Forfeitures are estimated at the grant date and are revised to reflect 
changes in expected or actual forfeitures. In addition, PSU and DSU participants are credited with dividend equivalents in 
the form of additional units when dividends are paid on Common Shares in the ordinary course of business.  

k)  Provisions 

A provision is recognized when there is a present legal or constructive obligation as a result of a past event, it is probable 
that an outflow of economic benefits will be required to settle the obligation, and that obligation can be measured reliably. 
If the effect of the time value of money is material, provisions are discounted using a current pre-tax rate that reflects the 
current market assessments of the time value of money and the risks specific to the obligation. The increase in the provision 
due to passage of time is recognized as accretion and recognized as part of net finance costs. Provisions are reviewed on a 
regular basis and adjusted to reflect management’s best current estimates. Due to the judgemental nature of these items, 
future settlements may differ from amounts recognized. Provisions comprise estimated self-insured liabilities, 
decommissioning provisions and other legal claims and obligations. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

16 

 
 
 
 
 
 
  
Notes to Consolidated Financial Statements  

SELF-INSURED LIABILITIES 

As a result of the U.S. Sale Transaction, the Company no longer self-insures, but retained the associated obligation relating 
to the self-insured liabilities. The accrual for self-insured liabilities includes the estimated costs of both reported claims and 
claims incurred but not yet reported. The provision for self-insured liabilities is based on estimates of loss based upon 
assumptions made by management supported by actuarial projections and the advice of external risk management and legal 
counsel. The accrual for self-insured liabilities is discounted based on the projected timing of future payment obligations. 

DECOMMISSIONING PROVISIONS  

Management has determined that future costs could be incurred for possible asbestos remediation of the Company’s pre-
1980 constructed homes. Although asbestos is currently not a health hazard in any of these homes, appropriate remediation 
procedures may be required to remove potential asbestos-containing materials, consisting primarily of floor and ceiling 
tiles, in connection with any major renovation or demolition. 

The fair value of the decommissioning provision related to asbestos remediation is estimated by computing the present 
value of the estimated future costs of remediation based on estimated expected dates of remediation. The computation is 
based on a number of assumptions, which may vary in the future depending upon the availability of new information, 
changes in technology and in costs of remediation, and other factors. 

INDEMNIFICATION PROVISIONS 

Indemnification provisions include management’s best estimate of amounts required to indemnify for obligations related to 
tax, a corporate integrity agreement (CIA), and other items, resulting from the U.S. Sale Transaction. 

l)  Fair Value Measurement 

The Company measures certain financial instruments at fair value at each balance sheet date. Fair value is the price that 
would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the 
measurement date under current market conditions. The fair value measurement is based on the presumption that the 
transaction to sell the asset or transfer the liability takes place either: in the principal market for the asset or liability; or in 
the absence of a principal market, in the most advantageous market for the asset or liability. 

The Company uses valuation techniques that are appropriate in the circumstances and for which sufficient data are available 
to measure fair value, maximizing the use of relevant observable inputs and minimizing the use of unobservable inputs.  

All assets and liabilities for which fair value is measured or disclosed in the consolidated financial statements are 
categorized within the following fair value hierarchy: 

Level 1 –  quoted (unadjusted) market prices in active markets for identical assets or liabilities; 
Level 2 –  inputs other than quoted market prices included in Level 1 that are observable for the asset or liability, either 

directly (as prices) or indirectly (derived from prices); or 

Level 3 –  unobservable inputs such as inputs for the asset or liability that are not based on observable market data. 

Each type of fair value is categorized based on the lowest level input that is significant to the fair value measurement in its 
entirety, categorization of which is re-assessed at the end of each reporting period. For the purpose of fair value disclosures, 
the Company has determined classes of assets and liabilities on the basis of the nature, characteristics and risks of the asset 
or liability and the level of the fair value hierarchy as explained above. 

m) Financial Instruments 

FINANCIAL ASSETS AND LIABILITIES 

Financial assets are classified as measured at fair value through profit and loss (FVTPL), fair value through other 
comprehensive income (FVOCI), or amortized cost. The classification depends on the Company’s business model for 
managing its financial instruments and the characteristics of the contractual cash flows associated with the instruments.  

Financial assets and liabilities classified as measured at amortized cost are initially recognized at fair value (net of any 
transaction costs) and are subsequently measured at amortized cost using the effective interest method less allowance for 
credit losses for financial assets.   

Financial assets classified as measured at FVOCI are initially recognized at fair value and transaction costs are recognized 
in net earnings.  Subsequently, unrealized gains and losses are recognized in other comprehensive income.  Upon 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

17 

 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

derecognition, realized gains and losses are reclassified from other comprehensive income and are recognized in net 
earnings for debt instruments and remain in other comprehensive income for equity investments.  Interest income, foreign 
exchange gains/losses and impairments from debt instruments as well as dividends from equity investments are recognized 
in net earnings.   

Financial assets and liabilities classified as measured at FVTPL are initially recognized at fair value and transaction costs 
are recognized in net earnings, along with gains and losses arising from changes in fair value. 

A debt instrument is classified as FVOCI if is not designated as at FVTPL, is held within a business model with the purpose 
of holding assets to collect contractual cash flows and selling prior to maturity; and its contractual terms give rise on 
specified dates to cash flows that are solely payments of principal and interest on the principal amount outstanding. 

Financial liabilities are measured as FVTPL if they are classified as held for trading or are designated as such. Other non-
derivative financial liabilities are classified as amortized cost. Derivative financial liabilities are classified as FVTPL. 

DERIVATIVE FINANCIAL INSTRUMENTS 

Derivative financial instruments are used to manage risks from fluctuations in exchange rates and interest rates. All 
derivative instruments, including embedded derivatives that must be separately accounted for, are valued at their respective 
fair values in the consolidated financial statements.  

The Company currently does not have any fair-value, cash-flow or net investment hedges. 

n)  Revenue 

The Company recognizes revenue for the transfer of goods or services to customers at an amount that reflects the 
consideration expected to be received for those goods or services. The Company generates revenue primarily from the 
provision of services to residents, rental income, home health care services, contract services, consulting and group 
purchasing services.  

i.  Long-term Care 

Services provided to residents include the provision of accommodation and meals, assistance with activities of daily living 
and continuing care. Programs and services are offered to all residents and specialty programs are offered for those with 
behavioural needs. Revenue from our LTC segment is regulated by provincial authorities and provincial programs fund a 
substantial portion of these fees with a co-payment for accommodation being paid by the residents. Accommodation and 
services are delivered as a bundle and revenue is recognized over time, typically on a monthly basis, which reflects when 
the services are provided. The frequency that funding is received depends on the jurisdiction in which the LTC home 
operates and it varies between a monthly or more frequent basis; and payments from residents are typically due at the 
beginning of each month. 

In some cases, the Company’s funding is based on occupancy levels achieved or certain policy conditions being met such 
as spending or staffing hour requirements. In these cases, the Company estimates the amount of funding that it expects to be 
entitled to for the services provided. 

ii.  Home Health Care 

Home health care services provided include complex nursing care, occupational, physical and speech therapy and assistance 
with daily activities to accommodate clients living at home. Revenue from the home health care segment is also regulated 
by provincial authorities. Revenue is derived from both government and private-pay clients. Performance obligations are 
satisfied as services are delivered and revenue is therefore recognized over time, typically as the services provided to the 
customer. Private-pay services provided are invoiced at the end of each month based on the services provided, and the 
billing frequency of government-funded services varies between monthly and bi-weekly depending on the jurisdiction in 
which the Company operates. 

iii.  Retirement Living 

Retirement living revenue is primarily derived from private-pay residents. Residents are charged monthly fixed fees based 
on the type of accommodation, level of care and services chosen by the resident and the location of the retirement 
community. These fixed fees are allocated to the lease and the service components. Payments are due at the beginning of 
each month.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

18 

 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Accommodation revenue is recognized on a straight-line basis over the lease term, beginning when a resident has the right 
to use the retirement community. Revenue allocated to the services is recognized over time, typically on a monthly basis, as 
this corresponds to the period in which services are provided. The Company may also provide additional services to 
residents on an as-requested basis, at rates established by the Company based upon market conditions. Revenue for such 
services is recognized as the services are provided to the residents. 

iv.  Other Services 

The Company also offers contract services, consulting and group purchasing services to third parties. Rates are set by the 
contracts, and these contracts are typically accounted for as a single performance obligation because goods or services are 
delivered concurrently. Revenue is recognized over time, typically on a monthly basis, which reflects when the services are 
provided. 

o)  Finance Costs and Finance Income 

Finance costs include: interest expense on long-term debt; accretion of the discount on provisions, decommissioning 
provisions and convertible debentures; losses on the change in fair value of financial assets and liabilities designated as 
FVTPL; and losses in foreign exchange on non-Canadian based financial assets.  

Finance income includes interest income on funds invested, gains on the change in fair value of financial assets and 
liabilities designated as FVTPL, accretion on deferred consideration and gains in foreign exchange on non-Canadian based 
financial assets. 

p)  Income Taxes 

The Company and its subsidiaries are subject to income taxes as imposed by the jurisdictions in which they operate, in 
accordance with the relevant tax laws of such jurisdictions. The provision for income taxes for the period comprises current 
and deferred tax.  

Current income tax is calculated on the basis of the tax laws enacted or substantively enacted at the end of the reporting 
period in the jurisdictions in which the Company operates. Deferred income tax is calculated using tax rates anticipated to 
apply in the periods that the temporary differences are expected to reverse.  

The income tax rates used to measure deferred tax assets and liabilities are those rates enacted or substantially enacted at 
the reporting date and are recognized to the extent that it is probable that future taxable profit will be available against 
which the temporary differences can be utilized.  

Current and deferred income tax assets and liabilities are offset when there is a legally enforceable right of offset; and the 
income taxes are levied by the same taxation authority on either the same taxable entity or different taxable entities, which 
intend either to settle current tax liabilities and assets on a net basis or to realize the assets and settle the liabilities 
simultaneously, for each future period in which significant amounts of deferred tax liabilities or assets are expected to be 
settled or recovered.  

The ultimate realization of deferred tax assets is dependent upon if the generation of future taxable income is probable 
during the periods in which those temporary differences become deductible. Management considers the scheduled reversal 
of deferred tax liabilities, projected future taxable income and tax planning strategies in making this assessment. 

International Financial Reporting Interpretations Committee (IFRIC) Interpretation 23, Uncertainty over Income Tax 
Treatments, was effective for reporting periods beginning on or after January 1, 2019. IFRIC 23 clarifies the recognition 
and measurement requirements under IAS 12, Income Taxes, when there is uncertainty over income tax treatments. As at 
January 1, 2019, the Company applied IFRIC 23, and there was no material impact on the Company’s consolidated 
financial statements as there are no known material uncertain tax positions.  

q)  Discontinued Operations 

A discontinued operation is a component of the Company’s business that represents a separate major line of business or 
geographical area of operations that has been disposed of or is held for sale. Classification as a discontinued operation 
occurs upon disposal or earlier, if the operation meets the criteria to be classified as held for sale. When an operation is 
classified as a discontinued operation, the comparative statements of earnings and cash flow information is re-presented as 
if the operation had been discontinued from the start of the comparative period. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

19 

 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

4.  NEW ACCOUNTING POLICIES ADOPTED 

Leases 

Effective January 1, 2019, the Company adopted IFRS 16 “Leases”, which supersedes IAS 17 “Leases” and related 
interpretations. This new standard requires a lessee to recognize assets and liabilities for all leases with a term of more than 
12 months, unless the underlying asset is of low value, using a single accounting model, thereby eliminating the distinction 
between operating and finance leases. The nature and timing of the related expense has changed as IFRS 16 replaces the 
straight-line lease costs with a depreciation charge for right-of-use assets and interest expense on lease liabilities. 

Lease costs for the prior year have been reclassified under administrative costs to conform with the current year 
presentation. The impact of adopting this standard on net earnings and overall cash flow is neutral; however, the principal 
payment of the lease liabilities is presented in financing activities (previously reflected as operating activities).  

The Company has applied IFRS 16 using the modified retrospective approach, under which the comparative information 
presented has not been restated. Certain practical expedients were selected on transition. The transition did not result in any 
retrospective adjustment to opening retained earnings on January 1, 2019.  

DEFINITION OF A LEASE 

Under IFRS 16, a contract is, or contains, a lease if the contract conveys a right to control the use of an identified asset for a 
period of time in exchange for consideration. On transition to IFRS 16, the Company elected to apply the practical 
expedient to grandfather the assessment of which transactions are leases, whereby IFRS 16 applies only to contracts that 
were previously identified as leases. Contracts that were not identified as leases under IAS 17 and related interpretations 
were not reassessed. Therefore, the definition of a lease under IFRS 16 has been applied only to contracts that were entered 
into or changed on or after January 1, 2019.  

RIGHT-OF-USE ASSETS AND LEASE LIABILITIES 

The Company has lease agreements for office space and office equipment. As a lessee, lease arrangements were previously 
classified as operating or finance leases based on the assessment of whether the lease transferred substantially all the risks 
and rewards of ownership. Under IFRS 16, the Company recognizes right-of-use assets and lease liabilities for all material 
and long-term leases on the consolidated statement of financial position. 

TRANSITION 

At transition, for leases classified as operating leases under IAS 17, lease liabilities were measured at the present value of 
the remaining lease payments, discounted at the Company’s incremental weighted average borrowing rate as at January 1, 
2019, of 4.86%. Right-of-use assets were measured at an amount equal to the lease liability. For leases that were classified 
as finance leases under IAS 17, the carrying amount of the right-of-use assets and the lease liability as at January 1, 2019, 
was the carrying amount of the lease assets and lease liability immediately before the date of initial application. These are 
accounted for using IFRS 16 from that date. 

The Company used the following practical expedients when applying IFRS 16 to leases previously classified as operating 
leases under IAS 17: 

• 

• 
• 
• 

applied the exemption not to recognize right-of-use assets and liabilities for leases with less than 12 months of 
lease term;  
applied the exemption not to recognize right-of-use assets and liabilities for leases that are of low value;  
excluded initial direct costs from measuring the right-of-use asset as at January 1, 2019; and  
used hindsight as at January 1, 2019, when determining the lease term if the contract contains options to extend or 
terminate the lease. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

20 

 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

IMPACTS ON FINANCIAL STATEMENTS 

i. 

Impacts on transition 

On transition to IFRS 16, the Company recognized additional right-of-use assets and lease liabilities of $5.8 million. 

Right-of-use assets presented in property and equipment 
Lease liabilities – current portion presented in current portion of long-term debt 
Lease liabilities – long-term portion presented in long-term debt 

January 1, 
2019 
 5,780 
 2,305 
 3,475 

The weighted average discount rate applied to the total lease liabilities recognized on transition was 4.86%, representing the 
Company’s incremental borrowing rate at January 1, 2019.   

Operating lease commitments balance, December 31, 2018 

Operating lease commitments discounted using the incremental borrowing rate 
Finance lease liabilities balance, December 31, 2018 
Recognition exemption for: 

Leases relating to termination of home healthcare operations in B.C.  
Short-term and low value leases 

Lease liabilities balance, January 1, 2019 

Income Taxes 

 7,874 

 7,138 
 80,992 

 (1,045) 
 (313) 
 86,772 

On June 7, 2017, the IASB issued IFRIC Interpretation 23 “Uncertainty over Income Tax Treatments”. The interpretation 
provides guidance on the accounting for current and deferred tax liabilities and assets in circumstances in which there is 
uncertainty over income tax treatments. Effective January 1, 2019, the Company adopted the IFRIC Interpretation 23, with 
no material impact on the interim condensed consolidated financial statements. 

5.  FUTURE CHANGES IN ACCOUNTING POLICIES 

Definition of a Business (Amendments to IFRS 3) 

On October 22, 2018, the IASB issued amendments to IFRS 3 Business Combinations, that seek to clarify whether a 
transaction results in an asset or a business acquisition. The amendments apply to businesses acquired in annual reporting 
periods beginning on or after January 1, 2020. Earlier application is permitted. The Company intends to adopt the 
amendments for the annual period beginning on January 1, 2020.  

6.  ACQUISITION 

On April 11, 2018, the Company completed the acquisition of Lynde Creek Retirement Community for $33.8 million, 
which included $31.2 million property and equipment, $2.9 million intangible assets, net of ($0.3 million) working capital. 
The acquired community, located in Whitby, Ontario, consists of Lynde Creek Manor, a retirement residence offering 93 
independent and assisted living suites; Lynde Creek Village, a life lease seniors’ community of 113 townhomes; and 
3.7 acres of adjacent land for expansion.  This acquisition was funded by cash on hand and is accounted for as a business 
combination. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

21 

  
 
 
 
 
 
  
 
 
 
 
 
  
 
  
 
Notes to Consolidated Financial Statements  

7.  ACCOUNTS RECEIVABLE 

Trade receivables 
Other receivables 
Accounts receivable - net of allowance (Note 25(a)) 

8.  PROPERTY AND EQUIPMENT 

2019 
 38,633 
 11,749 
 50,382 

2018 
 39,894 
 10,676 
 50,570 

Land & Land 
Improvements 

 51,128 
 58 
 4,401 
 (70) 
 (1,123) 
 3,886 
 58,280 
 58,280 

 – 
 58,280 
 247 
 (197) 
 3,080 
 61,410 

Land & Land 
Improvements 

 4,096 
 554 
 (70) 
 4,580 
 4,580 

Buildings 

 544,510 
 7,579 
 26,309 
 (7,828) 
 (14,566) 
 31,157 
 587,161 
 587,161 

 5,780 
 592,941 
 14,030 
 (980) 
 33,746 
 639,737 

Buildings 

 177,928 
 21,680 
 (7,828) 
 191,780 
 191,780 

Furniture & 

Leasehold 
Equipment  Improvements 

  Construction 
in Progress 
(CIP) 

 65,088 
 5,628 
 490 
 (8,966) 
 (469) 
 1,276 
 63,047 
 63,047 

 – 
 63,047 
 6,147 
 (5,213) 
 2,543 
 66,524 

 2,337 
 32 
 – 
 (442) 
 – 
 – 
 1,927 
 1,927 

 – 
 1,927 
 139 
 (955) 
 – 
 1,111 

 31,794 
 35,376 
 – 
 – 
 – 
 (36,319) 
 30,851 
 30,851 

 – 
 30,851 
 21,666 
 – 
 (39,369) 
 13,148 

Furniture & 

Leasehold 
Equipment  Improvements 

  Construction 
in Progress 
(CIP) 

 31,013 
 6,204 
 (8,966) 
 28,251 
 28,251 

 1,852 
 396 
 (442) 
 1,806 
 1,806 

 – 
 – 
 – 
 – 
 – 

Total 

 694,857 
 48,673 
 31,200 
 (17,306) 
 (16,158) 
 – 
 741,266 
 741,266 

 5,780 
 747,046 
 42,229 
 (7,345) 
 – 
 781,930 

Total 

 214,889 
 28,834 
 (17,306) 
 226,417 
 226,417 

Cost or Deemed Cost 
January 1, 2018 
Additions 
Acquisitions (Note 6) 
Write-off of fully depreciated assets 
Impairment loss (Note 18) 
Transfer from CIP 
December 31, 2018 
January 1, 2019 
Recognition of right-of-use assets on 

initial application of IFRS 16 

Adjusted January 1, 2019 
Additions 
Write-off of fully depreciated assets 
Transfer from CIP 
December 31, 2019 

Accumulated Depreciation 
January 1, 2018 
Additions 
Write-off of fully depreciated assets 
December 31, 2018 
January 1, 2019 
Recognition of right-of-use assets on 

initial application of IFRS 16 

 – 
 4,580 
 647 
 (197) 
 5,030 

 – 
 191,780 
 24,775 
 (980) 
 215,575 

Adjusted January 1, 2019 
Additions 
Write-off of fully depreciated assets 
December 31, 2019 
Carrying amounts 
At December 31, 2018 
At December 31, 2019 
The right-of-use assets included in buildings were $97.8 million (2018 – $81.0 million) with accumulated depreciation of 
$39.6 million (2018 – $32.2 million).  

 395,381 
 424,162 

 34,796 
 37,012 

 30,851 
 13,148 

 53,700 
 56,380 

 121 
 (175) 

 514,849 
 530,527 

 – 
 28,251 
 6,474 
 (5,213) 
 29,512 

 – 
 226,417 
 32,331 
 (7,345) 
 251,403 

 – 
 1,806 
 435 
 (955) 
 1,286 

 – 
 – 
 – 
 – 
 – 

During 2019, new and renewed leases have been recognized as right-of-use asset within Buildings is $11.0 million with 
accumulated depreciation of $2.6 million. The additions include $10.3 million recognized in connection with the renewed 
lease for its corporate office for 10 years with renewal options.   

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

22 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

During 2019, the Company capitalized $0.7 million of borrowing costs related to development projects under construction 
at an average capitalization rate of 4.5% (2018 – $1.5 million at 4.9%).  

9.  GOODWILL AND OTHER INTANGIBLE ASSETS 

Goodwill 
Balance at beginning of year 
Balance at end of year 
Other Intangible Assets 
Gross carrying value at beginning of year 
Additions 
Acquisitions (Note 6) 
Disposal 
Write-off of fully amortized assets 
Gross carrying value at end of year 
Accumulated amortization at beginning of year 
Amortization 
Write-off of fully amortized assets 
Accumulated amortization at end of year 
Net carrying value at end of year 
Goodwill and other intangible assets 

10.  OTHER ASSETS 

Investments held for self-insured liabilities 
Amounts receivable and other assets 
Interest rate swaps 

less: current portion 

2019 

2018 

 51,675 
 51,675 

 51,675 
 51,675 

 62,034 
 1,933 
 – 
 – 
 (1,817) 
 62,150 
 18,509 
 7,259 
 (1,817) 
 23,951 
 38,199 
 89,874 

 56,455 
 3,292 
 2,925 
 (484) 
 (154) 
 62,034 
 12,229 
 6,434 
 (154) 
 18,509 
 43,525 
 95,200 

2019 
 27,562 
 63,371 
 1,480 
 92,413 
 (20,661) 
 71,752 

2018 
 67,938 
 69,967 
 2,556 
 140,461 
 (21,465) 
 118,996 

Investments Held for Self-insured Liabilities 

After the sale of our U.S. business in 2015 (the “U.S. Sale Transaction”), as part of its continuing operations, the Company 
retained its wholly owned Bermuda-based captive insurance company, Laurier Indemnity Company, Ltd. (the “Captive”), 
which, along with third-party insurers, insured the Company’s U.S. general and professional liability risks up to the date of 
the U.S. Sale Transaction.  

The Company holds U.S. dollar-denominated investments within the Captive for settlements of the self-insured liabilities 
that are subject to insurance regulatory requirements.  

As at December 31, 2019, the investment portfolio comprises cash of $6.3 million (December 31, 2018 – $5.8 million), 
money market funds of $21.2 million (December 31, 2018 – $53.8 million), and investment-grade corporate securities $nil 
(December 31, 2018 – $8.3 million). Certain of these investments in the amount of $2.7 million (December 31, 2018 – 
$35.1 million), have been pledged as collateral for letters of credit issued by the banker of the Captive in favour of ceding 
companies. As at December 31, 2019, all investments were carried at fair value, with changes in fair value reflected in 
earnings. 

Amounts Receivable and Other Assets 

Amounts receivable and other assets include discounted amounts receivable due from the government of Ontario with 
respect to construction funding subsidies for long-term care homes, totalling $47.9 million (December 31, 2018 – 
$53.3 million) of which $5.8 million (December 31, 2018 – $5.5 million) is current. These subsidies represent funding for a 
portion of long-term care home construction costs over a 20-year or 25-year period. The weighted average remaining term 
of this funding is 14 years.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

23 

  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Also included in amounts receivable and other assets is a $1.3 million receivable as at December 31, 2019 (2018 – 
$2.0 million), resulting from the U.S. Sale Transaction. The remaining balance of $14.2 million primarily relates to prepaid 
expenses and deposits (2018 – $14.7 million).  

Interest Rate Swaps  

The interest rate swaps include swap contracts relating to mortgages, with notional amount totalling $82.1 million, to lock 
in the rates between 3.11% and 5.04% for the full term of the loans being five to ten years (Note 12). 

All interest rate swap contracts are measured at fair value through profit or loss, and hedge accounting has not been applied. 
Changes in fair value are recorded in the statements of earnings (Note 19). As at December 31, 2019, the interest rate swaps 
were valued at a net asset of $0.8 million (2018 – $2.0 million), including a liability of $0.7 million (2018 – $0.5 million) 
(Notes 12 and 13).   

11.  PROVISIONS 

January 1, 2018 
Provisions released 
Provisions used 
Accretion 
Effect of movements in exchange rates 
December 31, 2018 
Less: current portion 

January 1, 2019 
Provisions released 
Provisions used 
Accretion 
Effect of movements in exchange rates 
December 31, 2019 
Less: current portion 

Accrual for Self- 

Indemnification  Decommissioning 

insured Liabilities 
 61,135 
 (14,132) 
 (15,237) 
 1,631 
 3,741 
 37,138 
 (12,286) 
 24,852 
 37,138 
 (11,579) 
 (12,769) 
 648 
 (1,277) 
 12,161 
 (3,572) 
 8,589 

Provisions 
 22,679 
 (3,832) 
 (6,587) 
 – 
 1,453 
 13,713 
 (5,335) 
 8,378 
 13,713 
 – 
 (5,757) 
 – 
 (530) 
 7,426 
 – 
 7,426 

Provisions 
 9,185 
 – 
 (15) 
 195 
 – 
 9,365 
 – 
 9,365 
 9,365 
 – 
 (34) 
 195 
 – 
 9,526 
 – 
 9,526 

Total 
 92,999 
 (17,964) 
 (21,839) 
 1,826 
 5,194 
 60,216 
 (17,621) 
 42,595 
 60,216 
 (11,579) 
 (18,560) 
 843 
 (1,807) 
 29,113 
 (3,572) 
 25,541 

Accrual for Self-Insured Liabilities  

The obligation to settle U.S. self-insured general and professional liability claims relating to the period prior to the closing 
of the U.S. Sale Transaction, including claims incurred but yet to be reported, remains with the Company, which it intends 
to fund through the Captive. Consequently, the balance of the accrual for self-insured liabilities and the related investments 
held for self-insured liabilities (Note 10) remain on the consolidated statement of financial position. However, any expense 
incurred or release of reserves for U.S. self-insured liabilities are presented as discontinued operations; while the Captive’s 
costs to administer and manage the settlement of the remaining claims are reported as continuing operations within the U.S. 
segment. 

The accrual for self-insured liabilities is based on management’s best estimate of the ultimate cost to resolve general and 
professional liability claims. Actual results can differ materially from the estimates made due to a number of factors 
including the assumptions used by management and other market forces. 

As at December 31, 2019, the accrual for self-insured general and professional liabilities was $12.2 million 
(US$9.4 million) compared to $37.1 million (US$27.2 million) as at December 31, 2018. The decline represented mainly 
claim payments and the release of reserves (Note 21).  

Indemnification Provisions 

As a result of the U.S. Sale Transaction, the Company agreed to indemnify certain obligations of the U.S. operations related 
to tax, a corporate integrity agreement (the “CIA”), and other items. Any revisions to these estimates are reflected as part of 
other expense in discontinued operations (Note 21). As at December 31, 2019, the remaining provisions totalled 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

24 

 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

$7.4 million (US$5.7 million) (2018 – $13.7 million or US$10.1 million). Actual results can differ materially from the 
estimates made due to a number of factors including the assumptions used by management and other market forces.  

Decommissioning Provisions 

The decommissioning provisions relate to possible asbestos remediation of the Company’s pre-1980 constructed homes. An 
estimated undiscounted cash flow amount of approximately $10.7 million (December 31, 2018 – $10.5 million) was 
discounted using a rate of 1.64% (December 31, 2018 – 1.98%) over an estimated time to settle of 6 years. This represents 
management’s best estimate and actual amounts may differ. 

12.  LONG-TERM DEBT  

Convertible unsecured subordinated debentures 
CMHC mortgages 
Non-CMHC mortgages 
Construction loans 
Lease liabilities 

Deferred financing costs 
Total debt, net of deferred financing costs 
Less: current portion 
Long-term debt, net of deferred financing costs 

Interest Rate  Year of Maturity 
2025 
2020 - 2037 
2020 - 2038 
on demand 
2020 - 2034 

5.0% 
2.49% - 7.70% 
3.11% - 5.64% 
variable 
2.28% - 7.19% 

2019 
 120,675 
 128,878 
 164,349 
 64,601 
 86,208 
 564,711 
 (8,405) 
 556,306 
 (133,771) 
 422,535 

2018 
 119,775 
 114,083 
 169,670 
 52,866 
 80,992 
 537,386 
 (8,416) 
 528,970 
 (74,626) 
 454,344 

Convertible Unsecured Subordinated Debentures 

In April 2018, the Company issued $126.5 million aggregate principal amount of 5.00% convertible unsecured 
subordinated debentures due April 30, 2025 (the “2025 Debentures”), with a conversion price of $12.25 per Common Share 
(the “Offering”). The initial offering for $110.0 million of the 2025 Debentures closed on April 17, 2018, and the exercise 
of the over-allotment option for $16.5 million debentures closed on April 25, 2018. The debt and equity components of the 
2025 Debentures were bifurcated as the financial instrument is considered a compound instrument with $119.2 million 
classified as a liability and the residual $7.3 million classified as equity attributable to the conversion option. The liability 
portion of the 2025 Debentures is recorded at amortized cost. The fees and transaction costs allocated to the debt 
component are amortized over the term of the 2025 Debentures using the effective interest rate method and are recognized 
as part of net finance costs. 

Interest on the 2025 Debentures is payable semi-annually in April and October. The 2025 Debentures may not be redeemed 
by the Company prior to April 30, 2021, except in the event of the satisfaction of certain conditions after a change of 
control has occurred. On or after May 1, 2021 but prior to April 30, 2023, these debentures may be redeemed by the 
Company in whole at any time or in part from time to time, at a price equal to the principal amount thereof plus accrued and 
unpaid interest, on a notice of not more than 60 days and not less than 30 days prior, provided that the volume-weighted 
average trading price of the Common Shares on the TSX for the 20 consecutive trading days ending on the fifth trading day 
immediately preceding the date on which notice of redemption is given is not less than 125% of the conversion price. On 
and after May 1, 2023, these debentures may be redeemed by the Company in whole at any time or in part from time to 
time, at a price equal to the principal amount thereof plus accrued and unpaid interest, on a notice of not more than 60 days 
and not less than 30 days prior. 

Upon the occurrence of a change of control, whereby more than 66.67% of the Common Shares are acquired by any person, 
or group of persons acting jointly, each holder of the 2025 Debentures may require the Company to purchase their 
debentures at 101% of the principal plus accrued and unpaid interest. If 90% or more of the debentureholders do so, the 
Company has the right, but not the obligation, to redeem all the remaining outstanding 2025 Debentures. 
The net proceeds from the Offering of $120.9 million, together with cash on hand, was used by the Company to finance the 
redemption of its 2019 Debentures on April 30, 2018. The redemption price of the 2019 Debentures was equal to the sum 
of the outstanding aggregate principal amount of $126.5 million and all accrued and unpaid interest thereon for a total of 
$127.1 million. As a result of the early redemption of the 2019 Debentures, the unaccreted liability of $1.4 million was 
expensed (Note 18), and the related equity portion of $5.6 million was classified as part of accumulated deficit. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

25 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

CMHC Mortgages 

The Company has various mortgages insured through the Canada Mortgage and Housing Corporation (CMHC) program. 
The CMHC mortgages are secured by several Canadian financial institutions at rates ranging from 2.49% to 7.70% with 
maturity dates through to 2037. 

In April 2019, the Company secured a CMHC-insured mortgage of $16.0 million, inclusive of fees, on the Lynde Creek 
Manor Retirement Community, that matures in September 2029, with a fixed rate of 2.81% per annum. 

In October 2019, the Company secured a CMHC-insured mortgage of $9.3 million, inclusive of fees, on the Cedar Crossing 
Retirement Community, that matures in September 2029, with a fixed rate of 2.49% per annum. 

In August 2018, the Company renewed maturing mortgages of $8.3 million. These renewed mortgages mature in August 
2022, with a fixed rate of 2.96%. 

Non-CMHC Mortgages 

The Company has a number of conventional mortgages on certain long-term care homes, at rates ranging from 3.11% to 
5.64%.  Some of these mortgages have a requirement to maintain a minimum debt service coverage ratio. In September 
2018, the Company secured financing of $10.5 million on a retirement community in Ontario. This financing has a 10-year 
term. In conjunction with securing this financing, the Company entered into an interest rate swap contract to lock in the 
interest rate at 5.04% for the full term of this financing. Also, during the 2018 third quarter, the Company reduced the 
balances on mortgages of three communities by a total of $8.6 million. 

Construction Loans 

Construction loans of $77.7 million are available for three retirement home developments at Bolton, Uxbridge, and Barrie 
and provide for additional letter of credit facilities of $0.8 million, $0.8 million, and $1.0 million respectively, at rates 
ranging from 2.25% to 2.50% if utilized. Construction loans are interest-only based on 30-day banker’s acceptance (BA) 
plus 2.25% to 2.50%, with no standby fee.  

The construction loans are payable on demand and, in any event, are to be fully repaid by the earlier of achieving stabilized 
occupancy as defined by the agreements and specified dates between late 2019 and 2021 for Bolton and Uxbridge; and by 
the earlier of September 2023 and three months following stabilized occupancy as defined by the agreement for Barrie. 
During 2019, the Company repaid the construction loan balance relating to Cedar Crossing and refinanced it with a CMHC 
mortgage mentioned above. 

All construction loans have been reflected as current.  

As at December 31, 2019, an aggregate of $64.6 million was drawn on the construction loans, leaving $13.1 million 
available; in addition, letters of credit totalling $1.3 million were issued under credit facilities, leaving $1.3 million 
available.  

Lease Liabilities 

Lease liabilities as at December 31, 2019 include leases on long-term care homes and the liability related to office leases in 
connection with IFRS 16 (Note 4). The Company operates nine Ontario long-term care homes, which were built between 
2001 and 2003, under 25-year lease arrangements. The liability associated with the office leases will be amortized over the 
remaining lease terms ranging up to 15 years.  

Balance, December 31, 2018 
Initial recognition of lease liabilities upon transition to IFRS 16  
Reclassification of finance lease to lease liabilities upon adoption of IFRS 16 
Net additions 
Principal payments of lease liabilities  
Balance, December 31, 2019 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

Amount 
 - 
 5,780 
 80,992 
 10,316 
 (10,880) 
 86,208 

26 

 
 
 
 
 
 
 
 
 
 
  
 
 
 
  
Notes to Consolidated Financial Statements  

Credit Facilities 

The Company has two demand credit facilities totalling $112.3 million, secured by either 13 Class C long-term care homes 
in Ontario or the assets of the home health care business. Neither of these facilities has financial covenants but do contain 
normal and customary terms. As at December 31, 2019, $38.1 million of the facilities secure the Company’s defined benefit 
pension plan obligations, $5.5 million was issued in connection with obligations relating to long-term care homes and 
retirement living communities, leaving $68.7 million unutilized. 

Deferred Financing Costs  

Deferred financing costs are deducted against long-term debt and are amortized using the effective interest rate method over 
the term of the debt.  

Below is a summary of the deferred financing costs: 

Convertible unsecured subordinated debentures 
CMHC mortgages 
Non-CMHC mortgages 
Lease liabilities 
Total deferred financing costs 
Less: current portion 

Principal Repayments – Debentures, Mortgages and Loans 

2019 
 4,002 
 3,122 
 1,107 
 174 
 8,405 
 (1,557) 
 6,848 

Year 
2020 
2021 
2022 
2023 
2024 
2025 and beyond 

Principal Repayments – Lease Liabilities 

Year 
2020 
2021 
2022 
2023 
2024 
2025 and beyond 
Total undiscounted lease liabilities as at December 31, 2019 
Interest on lease liabilities 
Total present value of minimum lease payment 

2018 
 4,774 
 2,017 
 1,419 
 206 
 8,416 
 (1,404) 
 7,012 

Amount 
 125,392 
 15,857 
 59,411 
 46,444 
 5,978 
 231,246 
 484,328 

Amount 
 15,236 
 15,652 
 14,010 
 13,440 
 13,175 
 40,008 
 111,521 
 (25,313) 
 86,208 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

27 

 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Long-term Debt Continuity 

Balance, beginning of the year 
Initial recognition of lease liabilities upon transition to IFRS 16  
Issuance of long-term debt 
New lease liabilities 
Accretion and other 
Repayments 
Early redemption of the convertible debentures 
Addition - deferred financing costs 
Amortization of deferred financing costs and other 
Balance, end of the year 

Interest Rates 

2019 
 528,970 
 5,780 
 45,987 
 10,316 
 900 
 (35,658) 
 - 
 (1,628) 
 1,639 
 556,306 

2018 
 536,068 
 - 
 159,998 
 - 
 912 
 (159,674) 
 (5,596) 
 (5,886) 
 3,148 
 528,970 

The weighted average interest rate of all long-term debt as at December 31, 2019, was approximately 4.7% (December 31, 
2018 – 4.9%). As at December 31, 2019, 88.6% of the long-term debt, including interest rate swaps, was at fixed rates 
(December 31, 2018 – 90.2%).  

Financial Covenants 

The Company is subject to external requirements for certain of its loans on debt service coverage. The Company was in 
compliance with all these covenants as at December 31, 2019. 

13.  OTHER LONG-TERM LIABILITIES 

Accrued pension plan obligation (Note 24) 
Interest rate swaps (Note 10) 
Other 

14.  SHARE-BASED COMPENSATION 

2019 
 32,609 
 702 
 1,876 
 35,187 

2018 
 33,486 
 523 
 1,068 
 35,077 

The Company’s share-based compensation, which includes deferred share units (DSUs) and performance share units 
(PSUs), and prior to 2019, share appreciation rights (SARs) was an expense of $1.7 million for 2019 (2018 –$0.2 million). 

The carrying amounts of the Company’s share-based compensation arrangements are recorded in the consolidated 
statements of financial position as follows: 

Contributed surplus – DSUs 
Contributed surplus – PSUs 

2019 
 2,594 
 1,081 
 3,675 

2018 
 1,914 
 792 
 2,706 

Equity-settled Long-term Incentive Plan 

The Company’s long-term incentive plan (the “LTIP”) provides for a share-based component of executive and director 
compensation designed to encourage a greater alignment of the interests of the Company’s executives and directors with its 
shareholders, in the form of PSUs for employees and DSUs for non-employee directors.  

PSUs and DSUs granted under the LTIP do not carry any voting rights. DSUs vest immediately upon grant and PSUs vest 
three years from the date of grant. During 2019, the Company settled PSUs totalling 61,285, of which 12,223 were settled 
in cash to cover withholding taxes payable ($0.1 million) and 49,062 were settled with Common Shares issued from 
treasury.  

An aggregate of 4,338,912 Common Shares are reserved and available for issuance pursuant to the LTIP. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

28 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Subsequent to December 31, 2019, the Company settled DSUs totalling 48,234, of which 14,471 were settled in cash to 
cover withholding taxes payable and 33,763 were settled with Common Shares issued from treasury. 

DSU and PSU activity is as follows: 

Units outstanding, beginning of period 
Granted 
Reinvested dividend equivalents 
Forfeited 
Settled 
Units outstanding, end of period 
Weighted average fair value of units granted during 
the period at grant date 

Deferred Share Units  
2018  
2019 
 134,369  
 239,725 
 109,744  
 82,384 
 10,498  
 14,920 
 –  
 – 
 (14,886)  
 – 
 239,725 
 337,029 

Performance Share Units 
2018 
 342,944 
 192,116 
 26,007 
 (367,126) 
 (5,032) 
 188,909 

2019 
 188,909 
 292,581 
 17,889 
 (38,573) 
 (61,285) 
 399,521 

$8.26 

$7.36  

$9.62 

$9.33 

DSUs are fair valued at the date of grant using the previous day’s closing trading price of the Common Shares. The grant 
date values of PSUs awarded were based on the fair values of one award comprised of two equal components being the 
adjusted funds from operations (AFFO) and total shareholder return (TSR). The fair values of the AFFO component were 
measured using the previous day’s closing trading price of the Common Shares. The fair values of the TSR component 
were measured using the Monte Carlo simulation method.  

PSUs granted and the assumptions used to determine the grant date values are as follows: 

Grant date 
Vesting date 
PSUs granted 
Fair value of AFFO component 
Fair value of TSR component 
Grant date fair value 

Expected volatility of the Company’s Common Shares 
Expected volatility of the Index 
Risk-free rate 
Dividend yield 

15.  SHARE CAPITAL 

Balance at beginning of year 
Transactions with shareholders 

DRIP 
Purchase of shares for cancellation 
Share-based compensation 

Balance at end of year 

Common Shares 

2019 
May 31, 2019  
May 31, 2022  
 292,581  
$4.04  
5.58  
$9.62  

20.49%  
9.42%  
1.40% 
nil 

2018 
March 15, 2018 
March 15, 2021 
 192,116 
$4.36 
4.97 
$9.33 

23.66% 
12.20% 
1.84% 
nil 

2018 
Amount 
 490,881 

 4,928 
 (3,903) 
 158 
 492,064 

Shares 
 88,489,984 

2019 
Amount 
 492,064  

Shares 
 88,523,290 

 693,466 
 – 
 49,062 
 89,232,512 

 5,423  
 –  
 629  
 498,116  

 650,361 
 (703,585) 
 19,918 
 88,489,984 

Each Common Share is transferable and represents an equal and undivided beneficial interest in the assets of the Company. 
Each Common Share entitles the holder to one vote at all meetings of shareholders of the Company. Shareholders are 
entitled to receive dividends from the Company if, as and when declared by the Board. During 2019 and 2018, the 
Company declared cash dividends of $0.48 per share. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

29 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Dividend Reinvestment Plan 

The Company has a Dividend Reinvestment Plan (DRIP) pursuant to which shareholders who are Canadian residents may 
elect to reinvest their cash distributions in additional Common Shares. During 2019, the Company issued 693,466 Common 
Shares at a value of $5.4 million in connection with the DRIP (2018 – 650,361 Common Shares at a value of $4.9 million).  

Normal Course Issuer Bid (NCIB) 

During 2019, under the NCIB that commenced on January 15, 2019 and ended on January 14, 2020, the Company did not 
purchase any Common Shares. During 2018, under the NCIB that commenced on January 15, 2018 and ended on 
January 14, 2019, the Company acquired and cancelled 703,585 Common Shares at an average price of $8.89 per share, for 
a total cost of $6.3 million.  

In January 2020, the Company received approval from the TSX to renew its NCIB to purchase for cancellation up to 
8,000,000 Common Shares (representing approximately 10% of its public float) through the facilities of the TSX, and 
through alternative Canadian trading systems, in accordance with TSX rules. The NCIB commenced on January 15, 2020, 
and provides the Company with flexibility to purchase Common Shares for cancellation until January 14, 2021, or on such 
earlier date as the NCIB is complete. The actual number of Common Shares purchased under the NCIB and the timing of 
any such purchases will be at the Company’s discretion. Subject to the TSX’s block purchase exception, on any trading 
day, purchases under the NCIB will not exceed 42,703 Common Shares.  

16.  REVENUE 

Long-term care 
Retirement living 
Home health care 
Other Canadian operations 
Total revenue 

2019 
 643,785 
 41,276 
 422,995 
 23,894 
 1,131,950 

2018 
 632,533 
 33,412 
 431,343 
 22,719 
 1,120,007 

Funding for the Company’s LTC homes and home health care services is regulated by provincial authorities. Revenue from 
provincial programs represented approximately 69% of the Company’s long-term care revenue (2018 – 70%), and 
approximately 98% of the home health care revenue for both 2019 and 2018. 

Retirement living includes accommodation revenue of approximately $16.6 million (2018 – $13.5 million) and services 
revenue of approximately $24.7 million  (2018 – $19.9 million). Service revenue represents a combination of monthly 
service fees paid by the residents, including proceeds retained by the Company upon the sale of homes in the life lease 
community. 

17.  EXPENSES BY NATURE 

Employee wages and benefits 
Food, drugs, supplies and other variable costs 
Property based and leases 
Other 

Total operating expenses and administrative costs 

18.  OTHER EXPENSE 

Termination of B.C. market home health care contracts 
Other costs 
Impairment  
Loss on early redemption of convertible debt 
Acquisition costs 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

2019 
 876,651 
 53,872 
 48,942 
 61,374 
 1,040,839 

2018 
 868,089 
 52,181 
 49,974 
 55,525 
 1,025,769 

2019 
 1,429 
 975 
 – 
 – 
 – 
 2,404 

2018 
 – 
 484 
 16,158 
 2,511 
 1,042 
 20,195 

30 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Termination of B.C. market home health care contracts  

In the first quarter of 2019, the Company received notice from Fraser Health and Vancouver Coastal Health, both regional 
health authorities in British Columbia (the “Health Authorities”), that the Health Authorities will be bringing their home 
support services in-house, and as a result will not be renewing contracts with private sector home support agencies, 
including ParaMed Inc. (ParaMed), the Company’s home health care operations. Consequently, ParaMed’s contracts with 
the B.C. Health Authorities will expire in March 2020. The Company recognized a $1.4 million provision in the first 
quarter of 2019 for costs to be incurred in connection with the contract expiration. 

Other costs 

In the second quarter of 2019, the Company incurred other costs of $1.0 million in connection with a representation and 
standstill agreement it entered into dated April 22, 2019 (the “Sandpiper Agreement”), with Sandpiper Real Estate Fund 2 
Limited Partnership, Sandpiper Real Estate Fund 3 Limited Partnership, Sandpiper GP 2 Inc., and Sandpiper GP 3 Inc., 
(collectively, the “Sandpiper Group”).  

Impairment  

In the 2018 fourth quarter, the Company recorded a pre-tax impairment charge of $16.2 million ($11.8 million after tax), in 
respect of certain of its retirement communities ($15.9 million), and LTC homes ($0.3 million). 

The impairment charge for the retirement living operations relates to the write down of the carrying value of the property 
and equipment of three Saskatchewan retirement communities that were acquired in late 2015 and early 2016; two of which 
were newly opened at that time and are still in lease up. These communities have not performed as expected, primarily due 
to competitive market conditions, impacting rates, occupancy and labour and benefit costs.  

The determination of recoverable amounts can be significantly impacted by estimates related to current market valuations, 
current and future economic conditions in the geographical markets of each CGU, and management’s strategic plans within 
each of its markets. Estimates and assumptions used in the determination of the impairment loss for both the retirement 
communities and LTC homes were based upon information that was known at the time, along with the future outlook. The 
Company completes the assessment of the impairment amount of each of these properties (each being a CGU), by 
comparing the recoverable amount (in this case the value in use) of each CGU, determined using the direct capitalization 
method, to their carrying values. The direct capitalization method divides the estimated stabilized net operating income, 
after adjusting for management fee and capital maintenance, by appropriate market capitalization rates, ranging from 5.56% 
and 8.75%, derived from a combination of third-party information and industry trends. The fair value is a Level 3 valuation 
(Note 25(b)). 

Loss on early redemption of convertible debt 

In 2018, upon the early redemption of the 2019 Debentures, the unaccreted liability of $1.4 million and the associated 
unamortized finance costs of $1.1 million were expensed. 

Acquisition costs 

In 2018, the Company acquired the Lynde Creek Retirement Community, and incurred transaction costs of $1.0 million. 

19.  FOREIGN EXCHANGE AND FAIR VALUE ADJUSTMENTS 

Gain on Foreign Exchange and Investments 

Gains on foreign exchange and investments was $3.3 million for 2019 (2018 – $1.2 million). These include: FX gain (loss) 
related to deferred consideration and other balances in connection with the U.S. Sale Transaction that are denominated in 
U.S. dollars (Note 21); gain (loss) on fair value adjustments on investments held for self-insured liabilities; and a foreign 
exchange gain recognized upon repatriation of funds from the Captive.  

Fair Value Adjustments 

Fair value adjustments relate to interest rate swap contracts on certain mortgages are a loss of $1.3 million in 2019 
(2018 – loss of $1.0 million) (Note 10).  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

31 

 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

20.  EARNINGS PER SHARE 

Basic earnings per share (EPS) is calculated by dividing the net earnings for the period by the weighted average number of 
shares outstanding during the period, including vested DSUs awarded that have not settled. Diluted EPS is calculated by 
adjusting the net earnings and the weighted average number of shares outstanding for the effects of all dilutive instruments. 
The Company’s potentially dilutive instruments include the convertible debentures and equity-settled compensation 
arrangements. The number of shares included with respect to the PSUs is computed using the treasury stock method. The 
convertible debentures and equity-settled compensation arrangements would be antidilutive and as such, these are not 
included in the calculation of diluted EPS. 

The following table reconciles the numerator and denominator of the basic and diluted earnings per share computation.  

Numerator for Basic and Diluted Earnings per Share 
Earnings from continuing operations 
Net earnings for basic earnings per share 
Less: earnings from discontinued operations, net of tax 
Earnings from continuing operations for basic earnings per share 
Add: after-tax interest on convertible debt 
Earnings from continuing operations for diluted earnings per share 

Net earnings 
Net earnings for basic earnings per share 
Add: after-tax interest on convertible debt 
Net earnings for diluted earnings per share 
Denominator for Basic and Diluted Earnings per Share 
Actual weighted average number of shares 
DSUs 
Weighted average number of shares for basic earnings per share 
Shares issued if all convertible debt was converted 
PSUs 
Total for diluted earnings per share 
Basic and Diluted Earnings per Share (in dollars) 
Earnings from continuing operations 
Earnings from discontinued operations 
Net earnings 

21.  DISCONTINUED OPERATIONS 

Earnings from Discontinued Operations 
Earnings before income taxes 
Income tax recovery 
Earnings from discontinued operations 

Cash Flows from Discontinued Operations 
Net cash from operating activities 
Net cash from investing activities 
Net cash from financing activities 
Effect on cash flows 

2019 

2018 

 28,630 
 (11,579) 
 17,051 
 6,117 
 23,168 

 31,738 
 (23,654) 
 8,084 
 6,681 
 14,765 

 28,630 
 6,117 
 34,747 

 31,738 
 6,681 
 38,419 

 88,868,741 
 279,173 
 89,147,914 
 10,326,531 
 64,886 
 99,539,331 

 88,233,092 
 170,363 
 88,403,455 
 10,326,531 
 22,844 
 98,752,830 

 0.19 
 0.13 
 0.32 

 0.09 
 0.27 
 0.36 

2019 

2018 

 11,579 
 – 
 11,579 

 17,755 
 5,899 
 23,654 

2019 

2018 

 (12,769) 
 12,769 
 – 
 – 

 (15,237) 
 15,237 
 – 
 – 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

32 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Earnings from discontinued operations includes the release of a portion of the accrual for self-insured liabilities and the 
valuation change to the indemnification provisions of $11.6 million and $nil respectively in 2019 (2018 – $14.1 million and 
$3.8 million). The balance of the earnings related to the impact of discount rate adjustments on the Captive’s reserves.  

In December 2018, the Company sold one of the remaining U.S. legal entities and realized a capital loss for U.S. tax 
purposes of approximately US$20 million available to carryback against a 2015 capital gain, resulting in a tax recovery of 
$9.7 million (US$7.1 million). 

22.  INCOME TAXES 

Tax Recognized in Net Earnings 

Current Tax Expense (Recovery) 
Current year 
Items related to discontinued operations (Note 21) 
Utilization of losses 
Other adjustments 

Deferred Tax Expense (Recovery) 
Origination and reversal of temporary difference 
Items related to discontinued operations (Note 21) 
Utilization of losses 
Other adjustments 

Total tax expense (recovery) 
Tax expense from continuing operations 
Tax recovery from discontinued operations 

2019 

2018 

 8,422 
 (1,314) 
 (233) 
 98 
 6,973 

 (1,520) 
 1,314 
 101 
 317 
 212 
 7,185 
 7,185 
 – 
 7,185 

 8,921 
 (11,729) 
 (924) 
 132 
 (3,600) 

 (4,406) 
 5,830 
 629 
 (117) 
 1,936 
 (1,664) 
 4,235 
 (5,899) 
 (1,664) 

Tax Recognized in Other Comprehensive Income 

Before Tax 

Tax 
Recovery 

Net of Tax  

Before Tax 

2019  

2018 

Tax 
Recovery 

Net of Tax 

 (2,513) 
 (1,419) 
 (3,932) 

 – 
 376 
 376 

 (2,513)  
 (1,043)  
 (3,556)  

 1,841 
 (507) 
 1,334 

 – 
 134 
 134 

 1,841 
 (373) 
 1,468 

Foreign currency translation  
difference for foreign operations 
Defined benefit plan actuarial gains 

Effective Tax Rate  

The major factors that caused variations from the expected combined Canadian federal and provincial statutory income tax 
rates were as follows: 

Earnings from continuing operations before income taxes 
Income taxes at statutory rates of 26.5% 
Income tax effect relating to the following items: 

Tax rate variance of foreign subsidiaries 
Non-deductible items 
Non-taxable income (loss) 
Prior year adjustment 
Other items 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

2019 
 24,236 
 6,423 

2018 
 12,319 
 3,265 

 (595) 
 886 
 56 
 413 
 2 
 7,185 

 610 
 517 
 (107) 
 42 
 (92) 
 4,235 

33 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

Summary of Operating and Capital Loss Carryforwards  

The company’s Canadian corporate subsidiaries have $12.9 million net operating loss carryforwards available as at 
December 31, 2019 (2018 – $5.7 million), which expire in the years 2036 through 2039, and capital loss carryforwards of 
$41.7 million (2018 – $42.1 million) which have not been tax benefited and are available indefinitely to apply against future 
capital gains.  

Deferred tax assets recognized as at December 31, 2019, were $12.7 million (2018 – $9.7 million). Net deferred tax 
liabilities decreased in 2019 to $1.5 million from $1.6 million at December 31, 2018.  

Recognized Deferred Tax Assets and Liabilities  

Net deferred tax liabilities comprise the following:  

Property and equipment 
Intangible assets 
Other assets 
Deferred financing costs 
Financial assets at fair value 
Self-insurance reserves 
Indemnification provisions 
Employee benefit accruals 
Operating loss carryforwards 
Deferred revenue 
Decommissioning provision 
Other 
Set-off of tax 
Deferred tax liabilities, net 

Assets 
 5,928 
 74 
 – 
 63 
 212 
 250 
 681 
 9,672 
 3,445 
 3,287 
 2,525 
 1,119 
 (14,508) 
 12,748 

Liabilities 
 21,700 
 5,237 
 394 
 914 
 422 
 – 
 – 
 – 
 – 
 27 
 – 
 66 
 (14,508) 
 14,252 

2019  
Net  
 15,772  
 5,163  
 394  
 851  
 210  
 (250)  
 (681)  
 (9,672)  
 (3,445)  
 (3,260)  
 (2,525)  
 (1,053)  
 –  
 1,504  

Assets 
 6,410 
 73 
 – 
 67 
 – 
 254 
 2,357 
 9,599 
 1,519 
 3,348 
 2,482 
 1,335 
 (17,699) 
 9,745 

Liabilities 
 20,339 
 5,933 
 683 
 1,379 
 545 
 – 
 – 
 – 
 – 
 48 
 – 
 115 
 (17,699) 
 11,343 

2018 
Net 
 13,929 
 5,860 
 683 
 1,312 
 545 
 (254) 
 (2,357) 
 (9,599) 
 (1,519) 
 (3,300) 
 (2,482) 
 (1,220) 
 – 
 1,598 

Deferred income taxes are provided for temporary differences between the carrying values of assets and liabilities and their 
respective tax values as well as available tax loss carryforwards. Management believes it is more likely than not that the 
Company’s corporate subsidiaries will realize the benefits of these deductible differences. 

The significant components of deferred income tax assets and liabilities and the movement in these balances during the year 
were as follows: 

  Recognized in 

Property and equipment 
Other assets 
Deferred financing costs 
Financial assets at fair value 
Self-insurance reserves 
Indemnification provisions 
Intangible assets 
Employee benefit accruals 
Operating loss carryforwards 
Deferred revenue 
Decommissioning provision 
Other 
Deferred tax liabilities, net 

Balance 

Other  Recognized in 
January 1,  Recognized in  Comprehensive  Discontinued 
Operations 
 – 
 – 
 – 
 – 
 – 
 1,314  
 – 
 – 
 – 
 – 
 – 
 – 
 1,314  

2019  Net Earnings 
 1,843  
 (285) 
 (461) 
 (335) 
 4  
 288  
 (697) 
 303  
 (1,926) 
 40  
 (43) 
 167  
 (1,102) 

Income/Other 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 (376) 
 – 
 – 
 – 
 – 
 (376) 

 13,929  
 683  
 1,312  
 545  
 (254) 
 (2,357) 
 5,860  
 (9,599) 
 (1,519) 
 (3,300) 
 (2,482) 
 (1,220) 
 1,598  

Change in 

Balance 
Foreign  December 31, 
2019 
 15,772  
 394  
 851  
 210  
 (250) 
 (681) 
 5,163  
 (9,672) 
 (3,445) 
 (3,260) 
 (2,525) 
 (1,053) 
 1,504  

Exchange 
 – 
 (4) 
 – 
 – 
 – 
 74  
 – 
 – 
 – 
 – 
 – 
 – 
 70  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

34 

 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

  Recognized in 

Property and equipment 
Other assets 
Deferred financing costs 
Financial assets at fair value 
Self-insurance reserves 
Indemnification provisions 
Intangible assets 
Employee benefit accruals 
Operating loss carryforwards 
Deferred revenue 
Decommissioning provision 
Other 
Deferred tax liabilities, net 

Balance 

Other  Recognized in 
January 1,  Recognized in  Comprehensive  Discontinued 
Operations 
 – 
 – 
 – 
 – 
 – 
 5,830  
 – 
 – 
 – 
 – 
 – 
 – 
 5,830  

2018  Net Earnings 
 (6,121) 
 (217) 
 1,678  
 (363) 
 22  
 232  
 428  
 548  
 403  
 1,038  
 (234) 
 (1,308) 
 (3,894) 

Income/Other 
 – 
 – 
 (86) 
 – 
 – 
 – 
 – 
 (134) 
 – 
 – 
 – 
 – 
 (220) 

 20,050  
 963  
 (280) 
 908  
 (276) 
 (7,939) 
 5,432  
 (10,013) 
 (1,922) 
 (4,338) 
 (2,248) 
 88  
 425  

Change in 

Balance 
Foreign  December 31, 
2018 
 13,929  
 683  
 1,312  
 545  
 (254) 
 (2,357) 
 5,860  
 (9,599) 
 (1,519) 
 (3,300) 
 (2,482) 
 (1,220) 
 1,598  

Exchange 
 – 
 (63) 
 – 
 – 
 – 
 (480) 
 – 
 – 
 – 
 – 
 – 
 – 
 (543) 

23. COMMITMENTS AND CONTINGENCIES 

Property and Equipment Commitments 

The Company has outstanding commitments of $0.6 million at December 31, 2019, in connection with retirement 
communities under development in Ontario. 

Legal Proceedings and Regulatory Actions  

The Company and its consolidated subsidiaries are defendants in various actions and proceedings that are brought against 
them from time to time in connection with their operations.  

As previously disclosed, in April 2018, the Company was served with a statement of claim alleging negligence by the 
Company in the operation of its long-term care homes and its provision of care to residents and seeking $150.0 million in 
damages. The claim sought an order certifying the claim as a class action pursuant to the Class Proceedings Act (Ontario). 
By order of the Ontario Superior Court of Justice the class proceeding was discontinued on October 25, 2018. Following 
the discontinuance, the plaintiff who commenced the class proceeding still has the option to pursue a claim on her own 
behalf while others may also do so separately on their own behalf. Since July 2019, certain individual plaintiffs have served 
the Company with statements of claim alleging negligence by the Company in the operation of certain of its long-term care 
homes and its provision of care to certain residents. The Company intends to defend itself against any and all such 
individual claims and does not believe the outcome on any or all such claims would have a material adverse impact on its 
business, results of operations or financial condition and in any event believes that any potential liability would be resolved 
within the limits of its insurance coverage. 

On September 19, 2018, the Company was served with a statement of claim seeking an order certifying the claim as a class 
action pursuant to the Class Proceedings Act (Ontario). The claim alleges that the Company failed to properly apply certain 
required medical equipment sterilization protocols at one or more of its home health care clinics and seeks $20.0 million in 
damages. The Company does not believe that the lawsuit or the damages sought have merit. The Company intends to 
vigorously defend itself against the claim and does not believe the outcome will have a material adverse impact on its 
business, results of operations or financial condition and in any event believes that any potential liability would be resolved 
within the limits of its insurance coverage.  

The provision of health care services is subject to complex government regulations. Every effort is made by the Company 
to prevent deficiencies in the quality of patient care through quality assurance strategies and to remedy any such 
deficiencies cited by government inspections within the applicable prescribed period of time. The Company accrues for 
costs that may result from investigations, or any possible related litigation, to the extent that an outflow of funds is probable 
and a reliable estimate of the amount of the associated costs can be made. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

35 

 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
Notes to Consolidated Financial Statements  

24. EMPLOYEE BENEFITS 

Retirement compensation arrangements are maintained for certain employee groups as described below.  

Defined Benefit Plans 

The Company has pension arrangements for certain of its executives, which include a registered defined benefit pension 
plan, as well as a supplementary plan that provide pension benefits in excess of statutory limits. Both of these plans have 
been closed to new entrants for several years. The plans are exposed to various risks, including longevity risk, currency 
risk, interest rate risk and market risks. 

The different types of defined benefit plans of the Company are listed below.  

Funded 
Defined Benefit Plan 
2018 
 5,066  
 7,666  
 (2,600)  

2019 
 5,325 
 8,137 
 (2,812) 

Unfunded Supplementary 
Defined Benefit Plan  
2018  
 –  
 33,523  
 (33,523)  

2019 
 – 
 33,678 
 (33,678) 

2019 
 5,325 
 41,815 
 (36,490) 

Total 
2018 
 5,066 
 41,189 
 (36,123) 

Fair value of plan assets 
Present value of obligations 
Deficit 

FUNDING 

As required by law, the registered defined benefit pension plan benefits are funded through a trust, and the Company is 
responsible for meeting the statutory obligations for funding this plan. The funding requirement for past service is 
determined based on separate actuarial valuations for funding purposes, which are completed every three years. The last 
actuarial review was performed effective October 1, 2018 and completed in early 2019. 

The supplementary plan is unfunded and pension benefits are secured through a letter of credit that is renewed annually. 
The Company does not set aside assets for this plan and the benefit payments are funded from our cash from operations. 

DEFINED BENEFIT OBLIGATIONS 

Present Value of Defined Benefit Obligations 
Accrued benefit obligations 

Balance at beginning of year 
Current service cost 
Benefits paid 
Interest costs 
Actuarial losses 
Balance at end of year 

Plan assets 

Fair value at beginning of year 
Employer contributions 
Actual return on plan assets 
Interest income on plan assets 
Benefits paid 
Fair value at end of year 
Defined benefit obligations 

2019 

2018 

 41,189 
 98 
 (2,614) 
 1,399 
 1,743 
 41,815 

 5,066 
 159 
 321 
 172 
 (393) 
 5,325 
 36,490 

 42,081 
 104 
 (2,680) 
 1,330 
 354 
 41,189 

 5,443 
 88 
 (241) 
 172 
 (396) 
 5,066 
 36,123 

The expected contribution to the supplementary plan for the coming year is approximately $3.4 million. 

Current accrued liabilities 
Other long-term liabilities (Note 13) 
Accrued benefit liability at end of year 

2019 
 3,881 
 32,609 
 36,490 

2018 
 2,637 
 33,486 
 36,123 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

36 

 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
Notes to Consolidated Financial Statements  

EFFECT OF CHANGES TO DEFINED BENEFIT OBLIGATIONS 

Expense Recognized in Net Earnings 
Annual benefit plan expense 

Current service cost 
Interest costs 

Plan benefit expense recognized in the year - included in operating expenses and   

administrative costs 

Actuarial Losses Recognized in Other Comprehensive Income 
Amount accumulated in accumulated deficit at January 1 
Actuarial loss arising from changes in liability experience and assumption changes 
Return on assets 
Income tax recovery on actuarial losses 
Amount recognized in accumulated deficit at December 31 

PLAN ASSETS 

Equities 
Fixed income securities 
Real estate / commercial mortgage 

ACTUARIAL ASSUMPTIONS 

Discount rate for year-end accrued obligation 
Discount rate for period expense 
Rate of compensation increase 
Income Tax Act limit increase 
Average remaining service years of active employees 

2019 

2018 

 98 
 1,227 

 104 
 1,158 

 1,325 

 1,262 

 (10,236) 
 (1,740) 
 321 
 376 
 (11,279) 

 (9,863) 
 (266) 
 (241) 
 134 
 (10,236) 

2019 
 47% 
 33% 
 20% 
 100% 

2019 
 3.00% 
 3.50% 
 – 
 3.00% 
 2 

2018 
 42% 
 38% 
 20% 
 100% 

2018 
 3.50% 
 3.25% 
 2.00% 
 3.00% 
 2 

The present value of the pension obligations depends on a number of factors that are determined on an actuarial basis using 
a number of assumptions. The assumptions used in determining the net cost (income) for pensions include the discount rate. 
Any changes in these assumptions will impact the carrying amount of pension obligations.  

The Company determines the appropriate discount rate at the end of each year. This is the interest rate that should be used 
to determine the present value of estimated future cash outflows expected to be required to settle the pension obligations. In 
determining the appropriate discount rate, the Company considers the interest rates of high-quality corporate bonds that are 
denominated in the currency in which the benefits will be paid, and those that have terms to maturity approximating the 
terms of the related pension liability.  

Changes to the following actuarial assumptions, while holding the other assumptions constant, would have affected the 
defined benefit obligation and related expense for 2019 by the amounts shown below.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

37 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
Notes to Consolidated Financial Statements  

Discount rate 

1% increase 
1% decrease 

Rate of compensation increase* 

1% increase 
1% decrease 

Mortality rate 

10% increase 
10% decrease 

Increase (Decrease) in 
Benefit Obligation 

Increase (Decrease) in 
Net Earnings 

 (3,602) 
 4,255 

 – 
 – 

 (811) 
 917 

 (204) 
 263 

 – 
 – 

 24 
 (28) 

* No impact as actual salary rates are used in valuation for 2019 

Defined Contribution Plans 

The Company maintains registered savings and defined contribution plans and matches up to 120% of the employees’ 
contributions according to seniority, subject to a maximum based on the salary of the plan participants. Contributions 
expensed by Canada in 2019 and 2018 were $17.1 million and $16.7 million, respectively. 

25.  MANAGEMENT OF RISKS AND FINANCIAL INSTRUMENTS  

(a) Management of Risks 

LIQUIDITY RISK 

Liquidity risk is the risk that the Company will encounter difficulty in meeting its contractual obligations. The Company 
manages our liquidity risk through the use of budgets and forecasts. Cash requirements are monitored regularly based on 
actual financial results and actual cash flows to ensure that there are sufficient resources to meet operational requirements. 
In addition, since there is a risk that current borrowings and long-term debt may not be refinanced or may not be refinanced 
on as favourable terms or with interest rates as favourable as those of the existing debt, the Company attempts to 
appropriately structure the timing of contractual long-term debt renewal obligations and exposures.  

The following are the contractual maturities of financial liabilities, including estimated interest payments: 

As at December 31, 2019 
Convertible debentures 
CMHC mortgages 
Non-CMHC mortgages 
Construction loans 
Lease liabilities 
Accounts payable and accrued 
Income taxes payable 

Carrying 
Amount 
 120,675 
 128,878 
 164,349 
 64,601 
 86,208 
 136,922 
 1,606 
 703,239 

Contractual 
Cash Flows 
 161,288 
 152,981 
 212,800 
 66,026 
 111,521 
 136,922 
 1,606 
 843,144 

Less than 
1 Year 
 6,325 
 38,652 
 33,128 
 66,026 
 15,236 
 136,922 
 1,606 
 297,895 

1-2 Years 
 6,325 
 14,472 
 10,820 
 – 
 15,652 
 – 
 – 
 47,269 

2-5 Years 
 18,975 
 45,167 
 86,533 
 – 
 40,625 
 – 
 – 
 191,300 

More than 
5 Years 
 129,663 
 54,690 
 82,319 
 – 
 40,008 
 – 
 – 
 306,680 

The gross outflows presented above represent the contractual undiscounted cash flows.  

In addition to cash generated from its operations and cash on hand, the Company has available undrawn credit facilities 
totalling $70.0 million (2018 – $69.1 million). 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

38 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

CREDIT RISK 

Credit risk is the risk that one party to a financial instrument will cause a financial loss for the Company by failing to 
discharge its obligation. The nature and maximum exposure to credit risk as at December 31 was: 

Cash and short-term investments 
Restricted cash 
Accounts receivables, net of allowance  
Investments held for self-insured liabilities  
Government note receivables  

Cash and Short-term Investments 

Carrying Amount 
2018 
2019 
 65,893 
 94,457 
 2,290 
 2,441 
 50,570 
 50,382 
 67,938 
 27,562 
 53,341 
 47,854 
 240,032 
 222,696 

The majority of our cash and short-term investments are held with highly rated financial institutions in Canada.  

Restricted Cash 

The restricted cash is cash held mainly on account of lender capital reserves with no credit risk. 

Accounts Receivables, Net of Allowance 

The Company periodically evaluates the adequacy of its provision for receivable impairment by conducting a specific 
account review of amounts in excess of predefined target amounts and aging thresholds. Allowances for uncollectibility are 
considered based upon the evaluation of the circumstances for each of these specific accounts. In addition, the Company 
has established percentages for provision for receivable impairment that are based upon historical collection trends for each 
payor type and age of the receivables. Accounts receivable that are specifically estimated to be uncollectible, based upon 
the above process, are fully reserved for in the provision for receivable impairment until they are written off or collected.  

Receivables from government agencies represent the only concentrated group of accounts receivable for the Company 
which is primarily from provincial government agencies. Management does not believe there is any credit risk associated 
with these government agencies other than possible funding delays. Accounts receivable other than from government 
agencies consist of private individuals that are subject to different economic conditions, none of which represents any 
concentrated credit risk to the Company. 

The maximum exposure to credit risk for accounts receivable at the reporting date is the carrying value of each class of 
receivable. 

Trade receivables 
Other receivables 

2019  
 38,633  
 11,749  
 50,382  

2018 
 39,894 
 10,676 
 50,570 

As at December 31, 2019, receivables from government agencies represented approximately 80% of the total receivables 
(2018 – 85%). Management continuously monitors reports from trade associations or notes from provincial or federal 
agencies that announce possible delays that are rare to occur and usually associated with changes of fiscal intermediaries or 
changes in information technology or forms.  

Receivables, other than those from government agencies, consist of receivables from various payors and do not represent 
any concentrated credit risks to the Company. There is no significant exposure to any single party.  

As at December 31, 2019, the Company had trade receivables of $38.6 million (2018 – $39.9 million). All the receivables 
were fully performing and collectible in the amounts outlined above.  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

39 

  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

The aging analysis of these trade receivables is as follows: 

Current 
Between 30 and 90 days 
Over 90 days 
Less: provision for receivable impairment 

Movements on the Company’s provision for receivable impairment are as follows:  

At January 1 
Increase in provision for receivable impairment 
Receivables written off as uncollectible 
At December 31 

2019 
 24,538 
 12,704 
 3,553 
 (2,162) 
 38,633 

2018 
 28,889 
 10,122 
 2,479 
 (1,596) 
 39,894 

2019 
 1,596 
 1,941 
 (1,375) 
 2,162 

2018 
 1,597 
 2,910 
 (2,911) 
 1,596 

Any change in provision for receivables impairment has been included in operating expenses in net earnings. In general, 
amounts charged to the provision for impairment of trade receivables are written off when there is no expectation of 
recovering additional cash. 

Investments Held for Self-insured Liabilities 

The Company’s investments held for self-insured liabilities include investments in corporate or government fixed-rate 
bonds with ratings above a rating of AAA- along with U.S. treasuries. The majority of these investments are investment 
grade. Cash held for self-insured liabilities are with high-quality financial institutions. The Company limits the amount of 
exposure to any one institution.  

Notes, Mortgages and Amounts Receivable 

Included in notes, mortgages and amounts receivable were $47.9 million (2018 – $53.3 million) of discounted amounts 
receivable due from government agencies. These represent amounts funded by the Ontario government for a portion of 
LTC home construction costs over a 20-year or 25-year period (Note 10). The Company does not believe there is any credit 
exposure for these amounts due from government agencies. 

CURRENCY RISK 

Currency risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate because of changes 
in foreign exchange rates. Cross-border transactions are subject to exchange rate fluctuations that may result in realized 
gains or losses as and when payments are made.  

As a result of the U.S. Sale Transaction, our exposure to foreign currency risk has been significantly reduced. The 
following table outlines the net asset exposure to both the U.S. continuing operations and other items retained from the U.S. 
Sale Transaction as at December 31, 2019. 

Assets 

Current assets 
Investments held for self-insured liabilities 

Liabilities 

Current liabilities 
Indemnification provisions 
Non-current liabilities 

Net asset exposure 

US$ 

 16,962 
 21,218 

 3,955 
 5,717 
 6,663 
 21,845 

2019 
C$ 

 22,032 
 27,562 

 5,137 
 7,426 
 8,655 
 28,376 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

40 

  
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
Notes to Consolidated Financial Statements  

Net Earnings Sensitivity Analysis  

Prior to the U.S. Sale Transaction, the majority of the Company’s operations were conducted in the United States.  As at 
December 31, 2019, U.S. operations have no revenue from continuing operations (2018 – less than 1%).  

Every one cent strengthening of the Canadian dollar against the U.S. dollar in 2019 would favourably impact net earnings 
by $0.1 million and OCI by $0.1 million. This analysis assumes that all other variables, in particular the interest rates, 
remain constant. 

INTEREST RATE RISK 

Interest rate risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate because of 
changes in market interest rates. 

To mitigate interest rate risk, the Company’s long-term care debt portfolio includes fixed-rate debt and variable-rate debt 
with interest rate swaps in place.  At December 31, 2019, construction loans of $64.6 million are variable-rate debt, which 
do not have interest rate swaps in place.  The Company’s credit facility, and future borrowings, may be at variable rates 
which would expose the Company to the risk of interest rate volatility (Note 12). 

Although the majority of the Company’s long-term debt is effectively at fixed rates, there can be no assurance that as debt 
matures, renewal rates will not significantly impact future income and cash flow. The Company does not account for any 
fixed-rate liabilities at FVTPL; consequently, changes in interest rates have no impact on our fixed-rate debt and therefore, 
would not impact net earnings. 

Below is the interest rate profile of our interest-bearing financial instruments, which reflects the impact of the interest rate 
swaps:  

Fixed-rate instruments: 
Long-term debt (1) 

Total liability in fixed-rate instruments 
Variable-rate instruments: 
Long-term debt (1) 

(1) Includes current portion and excludes netting of deferred financing costs. 

Fair Value Sensitivity Analysis for Variable-rate Instruments 

Carrying Amount 
2018 

2019 

 500,110 
 500,110 

 64,601 
 64,601 

 484,520 
 484,520 

 52,866 
 52,866 

All long-term debt with variable rates are classified as other financial liabilities, which are measured at amortized cost using 
the effective interest method of amortization; therefore, changes in interest rates would not affect OCI or net earnings with 
respect to variable-rate debt. As at December 31, 2019, long-term debt with variable rates represented 11.4% of total debt 
(2018 – 9.8%). The value of the interest rate swaps is subject to fluctuations in interest rates, changes in fair value of these 
swaps are recognized in net earnings. 

Cash Flow Sensitivity Analysis for Variable-rate Instruments 

An increase of 100 basis points in interest rates would have decreased net earnings by $0.5 million and a decrease of 
100 basis points in interest rates would have increased net earnings by $0.5 million. This analysis assumes that all other 
variables, in particular foreign currency rates, remains constant, and excludes variable interest rate debt that is locked in 
through interest rate swaps. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

41 

 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
Notes to Consolidated Financial Statements  

(b) Fair values of Financial Instruments  

As at December 31, 2019 
Financial assets: 

Cash and short-term investments 
Restricted cash 
Invested assets (1) 
Accounts receivable 
Interest rate swaps 
Amounts receivable and other assets (2) (3) 
Investments held for self-insured liabilities 

Financial liabilities: 

Accounts payable 
Interest rate swaps 
Long-term debt excluding convertible debentures (3) (4) 
Convertible debentures 

As at December 31, 2018 
Financial assets: 

Cash and short-term investments 
Restricted cash 
Invested assets (1) 
Accounts receivable 
Interest rate swaps 
Amounts receivable and other assets (2) (3) 
Investments held for self-insured liabilities 

Financial liabilities: 

Accounts payable 
Interest rate swaps 
Long-term debt excluding convertible debentures (3) (4) 
Convertible debentures 

(1) Included in other assets. 
(2) Includes primarily amounts receivable from government. 
(3) Includes current portion. 
(4) Excludes netting of deferred financing costs. 

BASIS FOR DETERMINING FAIR VALUES 

Amortized 
Cost 

Fair Value 
through Profit 
and Loss 

Total 
Carrying 
Amount 

 94,457  
 2,441  
 354  
 50,382 
 – 
 47,854  
 6,316 
 201,804 

 18,021  
 – 
 444,036  
 120,675  
 582,732  

 – 
 – 
 – 
 – 
 1,480  
 – 
 21,246 
 22,726 

 – 
 702  
 – 
 – 
 702  

Amortized 
Cost 

Fair Value 
through Profit 
and Loss 

 65,893  
 2,290  
 442  
 50,570  
 – 
 53,341  
 2,242  
 174,778  

 6,239  
 – 
 417,611  
 119,775  
 543,625  

 – 
 – 
 – 
 – 
 2,556  
 – 
 65,696  
 68,252  

 – 
 523  
 – 
 – 
 523  

 94,457  
 2,441  
 354  
 50,382 
 1,480  
 47,854  
 27,562  
 224,530 

 18,021  
 702  
 444,036  
 120,675  
 583,434  

Total 
Carrying 
Amount 

 65,893  
 2,290  
 442  
 50,570  
 2,556  
 53,341  
 67,938  
 243,030  

 6,239  
 523  
 417,611  
 119,775  
 544,148  

Fair 
Value 
Hierarchy 

Level 2 

Level 2 
Level 2 
Level 1 

Level 2 
Level 1 

Fair 
Value 
Hierarchy 

Level 2 

Level 2 
Level 2 
Level 1 

Level 2 
Level 1 

Fair 
Value 

 94,471  
 2,441  
 354  
 50,382 
 1,480  
 51,950  
 27,562  
 228,640 

 18,021  
 702  
 450,382  
 132,585  
 601,690  

Fair 
Value 

 65,907  
 2,290  
 442  
 50,570  
 2,556  
 55,142  
 67,938  
 244,845  

 6,239  
 523  
 444,092  
 125,551  
 576,405  

The following summarizes the significant methods and assumptions used in estimating the fair values of financial 
instruments reflected in the previous table. 

Fair values for investments designated as FVTPL are based on quoted market prices. Accounts receivable are recorded at 
amortized cost. The carrying values of accounts receivable approximate fair values due to their short-term maturities, with 
the exception of the amounts receivable due from the government of Ontario, which are valued at discounted future cash 
flows using current applicable rates for similar instruments of comparable maturity and credit quality (Note 10). The fair 
values of convertible debentures are based on the closing price of the publicly traded convertible debentures on each 
reporting date, and the fair values of mortgages and other debt are estimated based on discounted future cash flows using 
discount rates that reflect current market conditions for instruments with similar terms and risks. 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

42 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
Notes to Consolidated Financial Statements  

FAIR VALUE HIERARCHY 

The Company uses a fair value hierarchy to categorize the type of valuation techniques from which fair values are derived: 
Level 1 – use of quoted market prices; Level 2 – internal models using observable market information as inputs; and Level 
3 – internal models without observable market information as inputs.  

The fair value hierarchy for the fair values of financial instruments where carrying value is not a reasonable approximation 
of fair value, are indicated above.  

26.  CAPITAL MANAGEMENT 

The Company accesses the capital markets periodically to fund acquisitions, growth capital expenditures and certain other 
expenditures. The Company monitors the capital markets to assess the conditions for changes in capital and the cost of such 
capital relative to the return on any acquisitions or growth capital projects. Funds raised in the capital markets that are not 
deployed in acquisitions or growth projects are held in high-quality investments with surplus cash held in secure 
institutions. The Company manages the cash position and prepare monthly cash flow projections over the remaining and 
future fiscal periods, and the Company continuously monitors the level, nature and maturity dates of debt and level of 
leverage and interest coverage ratios to ensure our compliance with debt covenants. The Company provides information to 
the Board on a regular basis in order to carefully evaluate any significant cash flow decisions.  

Capital Structure 

The Company defines its capital structure to include long-term debt, net of cash and short-term investments, and share 
capital. 

Current portion of long-term debt (1) 
Long-term debt (1) 
Total debt 
Less: cash and short-term investments 
Net debt 
Share capital 

(1) Net of financing costs. 

2019 

2018 

 133,771 

 74,626 

 422,535 
 556,306 
 (94,457) 
 461,849 
 498,116 
 959,965 

 454,344 
 528,970 
 (65,893) 
 463,077 
 492,064 
 955,141 

27.  RELATED PARTY TRANSACTIONS 

Transactions with Key Management Personnel 

As previously disclosed, the Company’s former President and Chief Executive Officer stepped down from his position on 
October 22, 2018. In connection therewith, the Company recorded a charge of $1.7 million in the three months ended 
September 30, 2018, representing a cash payment of $2.9 million reflected below as part of post-employment benefits, 
partially offset by the reversal of $1.2 million in respect of forfeited PSUs. 

Compensation of Key Management Personnel 

The remuneration of directors and other key management personnel of the Company was as follows:  

Salaries and short-term benefits 
Post-employment benefits 
Share-based compensation 

2019 
 2,636 
 – 
 1,231 
 3,867 

2018 
 3,318 
 2,917 
 (106) 
 6,129 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

43 

 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements  

28.  SEGMENTED INFORMATION  

The Company reports the following segments: i) long-term care; ii) retirement living; iii) home health care; iv) contract 
services, consulting and group purchasing as “other Canadian operations”; and v) the Canadian corporate functions and any 
intersegment eliminations as “corporate Canada”.  The continuing U.S. operations consist of the Captive.  

The long-term care segment represents the 58 long-term care homes that the Company owns and operates in Canada. The 
retirement living segment includes seven acquired retirement communities and four constructed retirement communities. 
The retirement communities provide accommodation and services to private-pay residents at rates set by the Company 
based on the services provided and market conditions. Through our wholly owned subsidiary ParaMed, ParaMed’s home 
health care operations provide complex nursing care, occupational, physical and speech therapy, and assistance with daily 
activities to accommodate those living at home.  

The Company’s other Canadian operations are composed of its contract services, consulting and group purchasing 
divisions. Through our Extendicare Assist division, the Company provides contract services and consulting to third parties; 
and through our SGP Purchasing Partner Network division, the Company offers cost-effective purchasing contracts to other 
senior care providers for food, capital equipment, furnishings, cleaning and nursing supplies, and office products. 

The Company continues to group its former and remaining U.S. operations as one segment.  The Captive’s expense 
incurred for self-insured liabilities related to the Company’s U.S. general and professional liability risks up to the date of 
the U.S. Sale Transaction as well as the disposed U.S. businesses are presented as discontinued operations; while the 
Captive’s costs to administer and manage the settlement of the remaining claims are reported as continuing operations 
within the U.S. segment. 

(in thousands of Canadian dollars) 
CONTINUING OPERATIONS 
Revenue 
Operating expenses 
Net operating income 
Administrative costs  
Earnings (loss) before depreciation, 
amortization, and other expense 

Depreciation and amortization 
Other expense 
Earnings (loss) before net finance costs 

Net interest costs 
Foreign exchange and fair value 

adjustments 

Net finance costs (income) 
Earnings before income taxes 
Income tax expense (recovery) 
Current  
Deferred 
Total income tax expense 
Earnings from continuing operations 

DISCONTINUED OPERATIONS 
Earnings from discontinued operations, net 

of income taxes 

Net earnings 

Long-term 
Care 

Retirement 
Living 

Home 
Health Care 

Other 
Canadian 
Operations 

Corporate 
Canada 

Total 
Canada 

Total 
U.S. 

2019 

Total 

 643,785  
 566,375  
 77,410  

 41,276  
 29,844  
 11,432  

 422,995  
 391,646  
 31,349  

 23,894  
 10,635  
 13,259  

 – 
 – 
 – 
 41,151  

 1,131,950  
 998,500  
 133,450  
 41,151  

 – 
 – 
 – 
 1,188  

 1,131,950  
 998,500  
 133,450  
 42,339  

 39,590  
 2,404  

 26,240  

 2,081  
 28,321  

 8,287  
 (1,102) 
 7,185  

 92,299  
 39,590  
 2,404  
 50,305  
 26,240  

 2,081  
 28,321  
 21,984  

 8,287  
 (1,102) 
 7,185  
 14,799  

 (1,188) 
 – 
 – 
 (1,188) 
 648  

 (4,088) 
 (3,440) 
 2,252  

 – 
 – 
 – 
 2,252  

 91,111  
 39,590  
 2,404  
 49,117  
 26,888  

 (2,007) 
 24,881  
 24,236  

 8,287  
 (1,102) 
 7,185  
 17,051  

 – 

 – 

 11,579  

 11,579  

 14,799  

 13,831  

 28,630  

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

44 

 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
Notes to Consolidated Financial Statements  

(in thousands of Canadian dollars) 
CONTINUING OPERATIONS 
Revenue 
Operating expenses 
Net operating income 
Administrative costs  
Earnings (loss) before depreciation, 
amortization, and other expense 

Depreciation and amortization 
Other expense 
Earnings (loss) before net finance costs 

 i

Net interest costs 
Foreign exchange and fair value 

adjustments 
Net finance costs 
Earnings (loss) before income taxes 
Income tax expense (recovery) 
Current  
Deferred 
Total income tax expense 
Earnings (loss) from continuing 

operations 

DISCONTINUED OPERATIONS 
Loss from discontinued operations, net of 

income taxes 

Net earnings  

Long-term 
Care 

Retirement 
Living 

Home 
Health Care 

Other 
Canadian 
Operations 

Corporate 
Canada 

Total 
Canada 

Total 
U.S. 

 632,533  
 559,489  
 73,044  
 –  

 33,412  
 24,430  
 8,982  
 –  

 431,343  
 393,354  
 37,989  
 –  

 22,291  
 8,750  
 13,541  
 –  

 23  
 –  
 23  
 38,570  

 1,119,602  
 986,023  
 133,579  
 38,570  

 35,270  
 20,195  

 25,073  

 (149) 
 24,924  

 8,129  
 (3,894) 
 4,235  

 95,009  
 35,270  
 20,195  
 39,544  
 25,073  

 (149) 
 24,924  
 14,620  

 8,129  
 (3,894) 
 4,235  

 405  
 –  
 405  
 1,176  

 (771) 
 –  
 –  
 (771) 
 1,628  

 (98) 
 1,530  
 (2,301) 

 –  
 –  
 –  

2018 

Total 

 1,120,007  
 986,023  
 133,984  
 39,746  

 94,238  
 35,270  
 20,195  
 38,773  
 26,701  

 (247) 
 26,454  
 12,319  

 8,129  
 (3,894) 
 4,235  

 10,385  

 (2,301) 

 8,084  

 –  

 –  

 23,654  

 10,385  

 21,353  

 23,654  

 31,738  

29.  SIGNIFICANT SUBSIDIARIES 

The following is a list of the significant subsidiaries as at December 31, 2019, all of which are 100% directly or indirectly 
owned by the Company.  

Extendicare (Canada) Inc. 
ParaMed Inc. 
Harvest Retirement Community Inc. 
Stonebridge Crossing Retirement Community Inc. 
Empire Crossing Retirement Community Inc. 
Yorkton Crossing Retirement Community Inc. 
West Park Crossing Retirement Community Inc. 
Bolton Mills Retirement Community Inc. 
Douglas Crossing Retirement Community Inc. 
Lynde Creek Manor Retirement Community Inc. 
9994165 Canada Inc. 
Riverbend Crossing Retirement Community Inc. 
Cedar Crossing Retirement Community Inc. 
Laurier Indemnity Company, Ltd. 

Jurisdiction of Incorporation 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Canada 
Bermuda 

Extendicare Inc. – 2019 Annual Consolidated Financial Statements 

45 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
STOCK EXCHANGE LISTING

Toronto Stock Exchange
Symbols:
Common Shares – EXE
2025 Convertible Debt (5.0%) – EXE.DB.C

TRANSFER AGENT

Computershare Trust Company of Canada 
Tel: (800) 564-6253 Fax: (866) 249-7775 
email: service@computershare.com 
www.computershare.com

PUBLISHED INFORMATION

Additional information about Extendicare, including this  
report, is available for viewing or printing on its website,  
in addition to news releases, quarterly reports and  
other filings with the securities commissions.  
Printed copies are available upon request.

VISIT EXTENDICARE’S WEBSITE AT WWW.EXTENDICARE.COM

 
3000 Steeles Avenue East, Suite 103, Markham, Ontario, Canada L3R 4T9 
T 905.470.4000  F 905.470.5588  www.extendicare.com