Ladies and gentlemen, welcome to Sienna Senior Living Inc's Q1 2023 conference call. Today's call is hosted by Nitin Jain, President and Chief Executive Officer, and David Hung, Chief Financial Officer of Sienna Senior Living Inc. Please be aware that certain statements or information discussed today are forward-looking and actual results could differ materially. The company does not undertake to update any forward-looking statement or information. Please refer to the forward-looking information and risk factor sections in the company's public filing, including its most recent MD&A and AIF for more information. You will also find a more fulsome discussion of the company's results in its MD&A and financial statements for the period, which are posted on SEDAR and can be found on the company's website, siennaliving.ca. Today's call is being recorded and a replay will be available.
Instructions for accessing the call are posted on the company's website. The details are provided in the company's news release. The company has posted slides which accompany the host's remarks on the company website under Events and Presentations. With that, I will now turn the call over to Mr. Jain. Please go ahead, Mr. Jain.
Thank you, Cheryl, and good morning, everyone, and thank you for joining us on our call today. We have many reasons to be optimistic. As we move further into 2023, our retirement segment is showing strong year-over-year growth, our long-term care operations continue to stabilize, and our cost management strategy is showing early signs of success. In addition, we are strengthening our ability to recruit and retain team members and have reduced our reliance on temporary agency staffing. With respect to operating results, strong demand for our retirement residences supported an 11% year-over-year increase in our Same Property NOI in the first quarter. Occupancy growth in combination with rate increases supported a double-digit increase in our retirement segment. We'll continue to capitalize on the growing demand for seniors living and leverage our Aspira brand and signature programs to generate strong interest in our retirement residences.
Q1 resident move-ins remained consistent and supported occupancy growth despite the typical seasonal trend of higher winter move-outs, primarily to long-term care. Average same-property occupancy was 88.2% in Q1, up 300 basis point year-over-year. In our acquisition portfolio, average occupancy increased by 350 basis point to 85.7% since we acquired 12 residences in Ontario and Saskatchewan in May of 2022. For the full year, we expect occupancy to reach approximately 90% in our same property portfolio and exceed 87% in our acquisition portfolio in 2023. Our long-term care operations saw a steady increase in retirement and resident admissions, with most communities returning to occupancy levels at or above 97% by the end of the first quarter, making them eligible for full funding.
Most remaining pandemic-related restrictions have now been lifted, and there is a real sense of optimism among team members, residents, and their families. The lifting of restrictions also contributed to our strong results. Same Property NOI in a long-term care segment increased by 9% in the Q1 compared to prior year. Demand for long-term care beds is higher than ever. Over the next 10 years, demand for long-term care is expected to increase by nearly 40%. At the end of March, the Ontario Ministry of Long-Term Care announced a funding increase for long-term care providers, providing a 2% increase in the other accommodation funding per diem. Other accommodations covers everything from housekeeping, building and property operations and maintenance, as well as dietary services. For the long-term viability of the sector, it is crucial that funding reflects the impact of inflation.
Together with other sector participants, we'll therefore continue to work with the government to address this funding shortfall. Moving to slide seven. Among the major improvements during first quarter was our reduced aid reliance on agency staffing to full staffing gaps. We reduced the number of agencies we are working with from over 100 to less than 20 and negotiated improved contract terms, such as enforcing a minimum filled rate threshold while reducing rates by approximately 15%. You will start seeing the impact of this improvement in the second quarter. Year-over-year, we were able to reduce overall agency costs by 35% in the first quarter and by 29% since fourth quarter 2022. Through a combination of an improving operating environment, fewer stat holidays compared to Q4, and a focus on filling vacancies with permanent team members rather than temporary agency staff.
The need for agency staffing will always exist, but to a much lesser extent. In recent years, many healthcare workers across the sector left their permanent jobs to work for agencies, which had a significant negative impact on team members' morale and resident satisfaction. We will continue to pursue all avenues to lessen our reliance on agency staff. We have been working on a number of initiatives to deal with the ongoing staffing shortages. As part of our talent acquisition strategy, we have improved our onboarding process and have further intensified our campus recruitment. We have placed approximately 900 students at our residence in the first quarter alone and hope to hire many of them once they graduate. We also ramped up the placement of temporary foreign workers, and we continue to employ Ukrainian refugees. In addition, we invested in an automated centralized scheduling and call-out system.
The system helps to fill staffing gaps with our own team members before shifts go to agency staff. It also provides tighter control on overtime and offers insight into future staffing needs. To date, the system has been rolled out across all of our long-term care communities, and plans to roll it across our retirement residences are underway. Moving to development. At Sienna, our focus of owning a diversified portfolio of private paid retirement residences and public funded long-term care communities is reflected in our development initiatives. Our current retirement project in Niagara Falls is scheduled to be completed in the fourth quarter 2023. The estimated total capital investment for 100% of the joint venture with Reichmann Seniors Housing is approximately CAD 55 million. Pre-leasing indicators for the 150-suite retirement residences have been strong.
In addition, we have started construction at our campus of care project in Brantford, where we are replacing 120 Class C long-term care beds with 160 Class A beds and adding 147 retirement suites. The estimated total development cost for this project is approximately CAD 140 million, for which we will receive approximately CAD 3.3 million of construction funding annually over 25 years for the long-term care portion. The estimated development yield for this project is around 8%. We also continue with construction at our redevelopment project in North Bay, where we're replacing 148 Class C beds with 160 Class A beds.
The total development cost for this project, which has an approximate 7.5% development yield, is close to CAD 80 million, for which we will receive CAD 3.3 million of construction funding annually for 25 years. Once these three projects are complete and operational, they are expected to lower Sienna's AFFO payout ratio by mid to high single digits. With that, I'll turn it over to David Hung for an update on our operating and financial results.
Thank you, Nitin, and good morning, everyone. I will start on slide 11 for financial results. In Q1 2023, total adjusted revenues increased by 14.5% year-over-year to CAD 199.6 million. This increase was largely due to occupancy and rental rate growth and additional revenue from the 12 properties we acquired in Q2 2022 in our retirement segment, as well as flow-through funding for increased direct resident care and funding received in relation to wage enhancements in our LTC segment. Total net operating income increased by 13% to CAD 36.3 million this quarter compared to Q1 2022, mainly due to a CAD 3.9 million increase in Same Property NOI in the retirement segment, as well as additional NOI from the 12 retirement properties we acquired in Q2 of last year.
Our retirement Same Property NOI increased by 11% to CAD 15.3 million in Q1 2023 compared to last year, primarily as a result of strong year-over-year occupancy and rate increases, partially offset by higher labor and food costs, increased maintenance, and utilities expenses. A successful leasing strategy and solid demand in key markets supported strong year-over-year occupancy growth in our Same Property portfolio. Same Property NOI in our long-term care segment increased by 9.1% to CAD 19.3 million in Q1 2023 due to a more stabilized operating environment in addition to retroactive funding for expenses incurred in prior years. At the end of March, we received additional information from the Ontario government with respect to the funding of third and fourth beds that have been permanently closed in our older Class C homes.
The government will continue to fully fund the other accommodation per diems until March 31st, 2025 for these beds. At the same time, there will be a gradual funding reduction for the nursing and personal care per diems over the next two years. Cost pressures and high inflation have impacted our operating margins in both our retirement and long-term care segments for some time. Many of our recent initiatives have been focused on cost management, early signs of their positive impact are reflected in our results. Moving to slide 12. During Q1 2023, Operating Funds from Operations increased by 14.3% to CAD 18.4 million compared to last year, primarily due to higher NOI and lower general and administrative costs offset by higher interest expense.
OFFO per share increased by 5.9% to CAD 0.253 in Q1, 2023. Adjusted Funds from Operations increased by 10.6% to CAD 18.2 million compared to last year. The increase was due to higher OFFO offset by higher maintenance costs and a decrease in construction funding income. AFFO per share increased by 2.5% to CAD 0.249 in Q1, 2023. The AFFO payout ratio was 94% in Q1, 2023, a 230 basis point improvement compared to 96.3% a year ago.
With respect to our debt metrics, we lowered debt to annualized Adjusted EBITDA to 8.4x in Q1 2023 from 8.7x in Q1 2022, and increased our liquidity to CAD 308 million as at March 31, 2023. In addition, we paid down CAD 9 million of our revolving credit facility during the quarter using lower cost mortgage financing with CMHC. We ended Q1 2023 with a debt to gross book value of 44.5% and a CAD 1.1 billion of unencumbered assets, which positions us well to execute on our upcoming financing initiatives. We expect to refinance the majority of our 2023 debt maturities with CMHC mortgages at attractive rates. I will now turn the call back to Nitin for his closing remarks.
Thank you, David. We are proud of the progress we have made so far this year. Our ongoing initiatives to generate strong occupancy and rate increases, coupled with a significant reduction in agency staffing costs, are reflected in our results. We also made some efficiencies at our corporate office, which is expected to result in an annual G&A savings of approximately CAD 3 million. As we look ahead, long-term fundamentals in Canadian senior living are stronger than ever, and we see significant growth potential in our business over the next several years. We're actively working on a number of initiatives which may contribute to a significant expansion of our net operating income. The first one, through occupancy growth and retirement as we continue on a path towards reaching stabilized same-property occupancy of 92.5%.
This represents a 430 basis point increase from a Q1 occupancy of 88.2%. Second, we expect to generate incremental NOI from the contributions of our acquisitions in the past year, as well as our retirement project in Niagara Falls, which is expected to have a 7.5% development yield. Third, through the elimination of net pandemic expenses and agency cost, which were CAD 8.2 million in 2022. We plan to do this by being laser-focused on managing agency cost while working with governments to ensure that operators are fully funded for all costs of resident care. Fourth, through catch-up funding from Ontario government to address funding shortfalls as a result of inflation in recent years. Each percentage point increase in other accommodation funding represents an annual additional CAD 1.2 million of funding.
We believe that all of these initiatives could have a considerable impact on the value of our business and should help us to grow our NOI, OFFO, and improve our AFFO payout ratio in the coming years. Our success depends on a team that is fully aligned with Sienna's purpose, vision, and values. It was a key reason for the implementation of a company-wide employee share ownership program and for redefining our purpose, vision, and values. Every day, we see amazing examples of the team members who are putting our purpose of cultivating happiness in daily life into action. Team members such as Shanna, who's a recreation therapist in BC who helped a resident learn to read and ultimately helped them find happiness by becoming more socially connected to the broader community.
Danielle, a resident engagement manager who supports a pen pal program at our Kensington Place Retirement Residence in Toronto, which has now over 30 student volunteers writing letters to our residents. Danielle is already planning a year-end prom style get-together with residents and the students. Our team members from support service in our homes who have been preparing and delivering meals for seniors in the community as part of our Sienna Sunday Supper program. I'm so incredibly proud of our team, and I'm confident that together with our 12,000 team members, we will continue to deliver on our purpose. On behalf of everyone at Sienna, I want to thank all of you on this call for your continued support. We are now pleased to answer any questions you may have.
To ask a question, please press star one on your telephone keypad. If you would like to withdraw your question, again, press star one. Your first question is from Jonathan Kelcher of TD Securities. Please go ahead. Your line is open.
Thanks. Good morning.
Good morning, Jonathan.
First question, just on the 2% OA increase. Obviously, you guys are disappointed with that, and I know the industry is working with the government to try and rectify that. If you're successful on that, when would that hit? Then the question really is there a chance for an increase this year, or is that something that we kinda have to wait for April 1st next year?
Sure, Jonathan. You know, in the past, we have been used to being funding increases once a year. Over the last three years, government has been, for most, in most programs, been quite proactive and really reacting to the needs of the time. BC, for example, we had a funding catch-up of 9% last year, and there, you know, the funding we find in BC is quite substantial, you know, pretty close to inflation. In Ontario, you know, even the 2% funding was not appropriate. You know, we were very pleased to see the funding on third and fourth rooms, the funding on CFS.
We continue to feel optimistic that we will get a in-year funding increase because that goes to the heart of the development of thousands of beds that needs to be redeveloped in Ontario.
Okay. That's helpful. On the third and fourth beds and the funding for that, you guys have 350 beds. How many of those would be in homes that you plan to redevelop over the next couple of years?
Yeah. In North Bay and in Brantford, there would be about 50 of the beds out of the 350 that would be redeveloped.
Okay. Yeah, that's your current developments. What about, I'm sure you guys have a list of, what's up next?
That's correct. You know, really the way we are prioritizing these projects, Jonathan, I would say maybe in multiple folds. First is obviously, the first one for us is operational viability. Some of the homes which are much older, for example, if they're more complex, operational needs, that will go first, followed by the third or fourth rooms. Then there's a reality of there are some municipalities which are easier to work with others. You know, obviously the timing of that would dictate that. The third and fourth rooms is definitely part of our equation.
Okay. That's it for me. I'll turn it back. Thanks.
Thank you.
Your next question is from Himanshu Gupta of Scotiabank. Please go ahead. Your line is open.
Thank you and good morning. Just sticking to third and fourth beds and, you know, the other accommodation funding will continue until March 2025. Is it fair to say that minimal to no impact on these homes until then?
That's correct, Himanshu. We don't expect any impact because the OA funding will continue to 2025. We wouldn't expect any impact until that point.
Okay, that's good. overall Long-Term Care NOI, do you still expect 2023 NOI to be similar to last year? I mean, as mentioned by you in the on the last call, is there now upside to this number given the retroactive funding which you received?
Himanshu, it's a bit too early to tell. You know, as we talked about, like, we are seeing stabilization across the portfolio. You know, the coming off restrictions, the catch-up pandemic funding, getting to nearly all of our homes, speaking 97% or above. We are trending positively, but I think it's a bit early to commit to a different number at this stage.
Okay. Would you say that Q1 was ahead of your expectations at CCNOI?
I wouldn't really... you know, I don't want to get into, you know, internal expectations versus what's there. I would say, you know, we are pleased to see, you know, it's been difficult few years, and we're finally seeing, you know, a bit of a positive trend on it.
Okay. Fair to say that. Fair to hear that. Just switching to retirement homes now. Rental rate growth, has that accelerated? I mean, would you say that?
No, it's been pretty consistent. you know, In U.S., the rental rates have been around 8%-10%. In Canada, I think it's been around half of that. We still are not caught up in inflation, so there's definitely the intent to continue on that journey. We don't see rates accelerating, but we think the rental growth rate should be that 4%-5% that we have seen previously.
Listen, the 4%-5%, is it happening across the board or is it mostly on homes which are 85% or 90% occupied? Hello? Okay.
This is the operator. Please remain on the line.
It's Nitin and David. Can you hear us okay, Cheryl ?
You are coming through loud and clear.
Okay, perfect. Apologies for that, Himanshu. Sorry. we were just answering your question. The 4% and 5% rental increase, I would say in U.S. we are seeing much bigger increases. I think your question around is it across, it really is an average, but it's pretty consistent across.
There are no further questions at this time. This concludes today's conference call. Thank you for your participation. You may now disconnect.