Acadia Healthcare Company Inc (ACHC) 2024 Q4 法說會逐字稿

Hello and welcome to the Acadia Healthcare fourth quarter 2024 earnings conference calls. (Operator Instructions) As a reminder, this conference is being recorded. I would now like to hand the call to Patrick Feeley. Please go ahead.

您好，歡迎參加 Acadia Healthcare 2024 年第四季財報電話會議。（操作員指示）提醒一下，本次會議正在錄音。現在我想把電話交給派崔克·菲利。請繼續。

Thank you, and good morning. Yesterday after the market closed, we issued a press release announcing our fourth quarter 2024 financial results. This press release can be found in the investor relations section of the acadiahealthcare.com website. Here with me today to discuss the results are Chris Hunter, Chief Executive Officer; and Heather Dixon, Chief Financial Officer.

謝謝，早安。昨天收盤後，我們發布了一份新聞稿，宣布了我們的 2024 年第四季財務表現。新聞稿可在 acadiahealthcare.com 網站的投資者關係部分找到。今天與我一起討論結果的有執行長 Chris Hunter；以及財務長 Heather Dixon。

To the extent any non-GAAP financial measure is discussed in today's call, you will also find a reconciliation of that measure to the most directly comparable financial measure calculated according to GAAP in the press release that is posted on our website.

如果今天的電話會議中討論了任何非 GAAP 財務指標，您也可以在我們網站上發布的新聞稿中找到該指標與根據 GAAP 計算的最直接可比較財務指標的對帳。

This conference call may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Including statements, among others regarding Acadia's expected quarterly and annual financial performance for 2024 and beyond.

本次電話會議可能包含《1995 年私人證券訴訟改革法》所定義的前瞻性陳述。其中包括有關阿卡迪亞 2024 年及以後預期季度和年度財務業績的聲明。

These statements may be affected by the important factors, among others set forth in the Acadia filings with the Securities and Exchange Commission and in the company's fourth quarter news release, and consequently actual operations and results may differ materially from the results discussed in the forward-looking statements.

這些聲明可能受到 Acadia 向美國證券交易委員會提交的文件和公司第四季度新聞稿中列出的重要因素的影響，因此實際營運和結果可能與前瞻性聲明中討論的結果存在重大差異。

At this time, I would like to turn the conference call over to Chris.

現在，我想將電話會議轉給克里斯。

Thank you, Patrick, and good morning everyone. Thank you for being with us for Acadia's fourth quarter 2024 conference call. For the fourth quarter, we reported solid financial and operating results, capping off another year of growth and progress for Acadia. Total revenue increased 4.2% over the prior year's fourth quarter to $774 million. For the full year we delivered over $3.1 billion in revenue, a 7.7% increase over 2023.

謝謝你，派崔克，大家早安。感謝您參加 Acadia 2024 年第四季電話會議。第四季度，我們報告了穩健的財務和營運業績，為阿卡迪亞又一年的成長和進步畫上了句號。總營收比去年同期第四季成長 4.2%，達到 7.74 億美元。全年我們實現了超過 31 億美元的收入，比 2023 年成長 7.7%。

Same facility patient days grew 3.2% in the fourth quarter and remained stable between 3% and 4% in each month throughout the quarter, excluding the impact of a handful of underperforming facilities, same facility growth would have been above 5% in the quarter.

第四季度同一機構的患者天數增加了 3.2%，整個季度每個月都穩定在 3% 至 4% 之間，若排除少數表現不佳的機構的影響，本季度同一機構的成長率將超過 5%。

We also benefited from a more stable labor environment in 2024 supported by our initiatives centered around recruitment, retention, and employee engagement, and a strong focus on training in our local markets. Working together with our facility operators has helped us attract and maintain talent in a competitive market.

我們也受惠於 2024 年更穩定的勞動力環境，這得益於我們以招募、留任和員工敬業度為中心的舉措以及對當地市場培訓的高度重視。與我們的設施營運商合作幫助我們在競爭激烈的市場中吸引和留住人才。

I'd like to now take a moment to reflect on what drives us forward as an organization and why I remain as confident as ever in our strategy. At our core, we are a company dedicated to transforming the lives of patients, families, and those in the communities we serve for the better.

現在，我想花點時間思考一下是什麼推動我們組織前進，以及為什麼我對我們的策略一如既往地充滿信心。從本質上講，我們是一家致力於改善患者、家庭以及我們服務所在社區居民生活的公司。

Our facilities treat many of the most complex high acuity cases and fill a critical gap in the continuum of care for evidence-based specialized behavioral healthcare.

我們的設施可以治療許多最複雜的高敏銳度病例，並填補了循證專門行為醫療保健護理過程中的關鍵空白。

What sets us apart is our unwavering commitment to putting patient needs first, setting a high bar for care standards and compliance and prioritizing quality. We back up this commitment by investing heavily in technologies to enhance safety and people and processes to support effective patient care delivery.

我們的獨特之處在於我們始終堅持將患者的需求放在第一位，為護理標準和合規性設定高標準，並優先考慮品質。為了履行這項承諾，我們投入大量資金來提高技術安全性，並投入大量資金來提供人員和流程以支持有效的病患照護。

We believe we have led the industry in adopting the latest technology and evidence-based practices and attracting the most skilled practitioners in the field.

我們相信，我們在採用最新技術和循證實踐以及吸引該領域最熟練的從業者方面已經處於行業領先地位。

Helping us to deliver safe quality care with positive clinical outcomes and patient satisfaction scores, for example, we are going above and beyond what's required of behavioral health care facilities by investing in electronic medical records which reduce medication errors, improve care coordination, support quality, and ensure the consistent delivery of evidence-based care.

例如，透過投資電子病歷來減少用藥錯誤、改善護理協調、支持品質並確保始終如一地提供循證護理，我們可以幫助我們提供安全優質的護理，並獲得積極的臨床結果和患者滿意度評分，從而超越行為健康護理機構的要求。

We have added patient monitoring devices across Acadia's acute facilities which enhance patient safety and mitigate incident risk. We believe we lead the industry in performance metrics and the use of this technology, underscoring our confidence that the care delivered at Acadia sets the standard for other providers. We have also implemented wearable safety devices for staff that enables improved response times in mitigation of potential risk.

我們在阿卡迪亞的急診設施中增加了病人監護設備，以增強病人安全並降低事故風險。我們相信，我們在性能指標和這項技術的使用方面處於行業領先地位，這突顯了我們對阿卡迪亞提供的護理為其他提供者樹立標準的信心。我們還為員工配備了穿戴式安全設備，以縮短回應時間，降低潛在風險。

Our ability to use data has continued to advance significantly. Our integrated quality dashboard now provides real-time visibility into over 50 distinct safety, patient experience, and regulatory compliance related key performance indicators. This gives facility leadership real-time insight into performance across our hospitals, creating a culture of accountability for quality.

我們使用數據的能力持續顯著提高。我們整合的品質儀表板現在可以即時查看超過 50 個不同的安全性、病患體驗和法規遵循相關的關鍵績效指標。這讓機構領導層能夠即時了解我們所有醫院的績效，從而形成一種對品質負責的文化。

As CEO of Acadia, I continue to remain highly focused on these initiatives, and we will continue to prioritize them and expand them when necessary. I strongly believe this patient-centered approach is driving superior outcomes and patient experience and also unlocking operational effectiveness across the organization.

作為阿卡迪亞的首席執行官，我將繼續高度關注這些舉措，我們將繼續優先考慮這些舉措，並在必要時擴大它們。我堅信這種以患者為中心的方法將帶來卓越的治療結果和患者體驗，同時也能提高整個組織的運作效率。

Before I turn it over to Heather to dive deeper into the financial discussion, I'd like to provide a progress update on our growth strategy. We completed construction on approximately 1,300 beds in 2024, including approximately 1,100 completed during the fourth quarter. 776 of these new beds became operational during 2024, including the opening of four new acute inpatient hospitals.

在我將主題轉交給 Heather 深入討論財務問題之前，我想先介紹一下我們的成長策略的進展。我們在 2024 年完成了約 1,300 張床位的建設，其中第四季度完成了約 1,100 張床位。其中 776 張新床位將於 2024 年投入運營，其中包括四家新的急性住院醫院的開幕。

In the fourth quarter, 577 newly constructed beds became operational, including 233 beds to existing facilities and 344 beds from new facilities. In the first two months of 2025, we have added an additional 313 license beds. Joint venture partnerships continue to be an important part of our growth strategy.

第四季度，577張新建床位投入運營，包括現有設施中的233張床位和新設施中的344張床位。2025年前兩個月，我們又增加了313張許可證床位。合資夥伴關係仍然是我們成長策略的重要組成部分。

We are fortunate that a growing number of well-respected health systems are choosing to partner with Acadia to better serve patients by bridging the gap between physical and behavioral healthcare. During the fourth quarter, we opened our 144 bed joint venture hospital with Intermountain Health in Denver, Colorado.

我們很幸運，越來越多受人尊敬的醫療系統選擇與阿卡迪亞合作，透過彌合身體和行為醫療保健之間的差距來更好地服務患者。第四季度，我們與 Intermountain Health 在科羅拉多州丹佛開設了擁有 144 張床位的合資醫院。

We also recently opened our 192-bed joint venture hospital in partnership with Henry Ford Health in Detroit. Looking forward, we have a solid pipeline of potential opportunities to work with other leading providers and attractive markets and expect to add between 800 and 1,000 total beds this year.

我們最近也與底特律的亨利福特醫療中心合作開設了擁有 192 張床位的合資醫院。展望未來，我們擁有大量與其他領先供應商和具有吸引力的市場合作的潛在機會，預計今年將增加 800 至 1,000 張床位。

We are proud of this progress, which would not have been possible without the efforts of the over 25,000 dedicated employees, clinicians, and healthcare professionals who work at Acadia.

我們為這一進步感到自豪，如果沒有阿卡迪亞 25,000 多名敬業的員工、臨床醫生和醫療保健專業人員的努力，這項進步是不可能實現的。

As communities across the United States continue to face an unprecedented mental health and addiction crisis with rising rates of depression, anxiety, substance use disorders, and suicide, Acadia continues to be committed to expanding access and providing the specialized care and treatment that's so desperately needed. As we look to 2025 and beyond, we remain confident in our strategy and goals we have set for ourselves.

隨著美國各地社區繼續面臨前所未有的心理健康和成癮危機，憂鬱、焦慮、物質使用障礙和自殺率不斷上升，阿卡迪亞繼續致力於擴大治療機會並提供急需的專門護理和治療。展望2025年及以後，我們對自己所訂定的策略和目標依然充滿信心。

At this time, I will now turn the call over to Heather to discuss our financial results for the quarter.

現在，我將把電話轉給希瑟，討論本季的財務表現。

Thanks, Chris, and good morning everyone. Our fourth quarter of financial performance reflects consistent growth trends across our diversified portfolio of behavioral health service lines. We reported $774 million in revenue for the quarter, representing an increase of 4.2% over the fourth quarter of last year.

謝謝，克里斯，大家早安。我們第四季的財務表現反映了我們多元化行為健康服務系列的一致成長趨勢。我們報告本季營收為 7.74 億美元，比去年第四季成長 4.2%。

Same facility revenue grew 4.7% compared with the fourth quarter of 2023, which included patient day growth of 3.2% and an increase in revenue per patient day of 1.4%. As Chris mentioned, same facility patient day growth stabilized in the 3% to 4% range for each month in the quarter.

與 2023 年第四季相比，同一設施收入成長了 4.7%，其中包括患者日成長 3.2%，每位患者日收入成長 1.4%。正如克里斯所提到的，本季每個月同一機構的病人日成長率都穩定在 3% 到 4% 的範圍內。

Our revenue per patient day growth moderated versus the third quarter primarily due to the timing of supplemental payments. Absent the impact of timing, pricing trends remained stable as payers continued to place a high degree of emphasis on the behavioral health needs of their members.

我們的每位患者每天的收入成長與第三季相比有所放緩，這主要是由於補充支付的時間表。不受時間影響，定價趨勢保持穩定，因為付款人繼續高度重視其會員的行為健康需求。

Adjusted EBITDA for the fourth quarter of 2024 was $153.1 million. Adjusted EBITDA margin was 19.8% compared with 22.8% for the same quarter last year. On the same facility basis, adjusted EBITDA was $196.4 million and adjusted EBITDA margin was 25.7% in the fourth quarter of this year and 28.4% for the prior year's fourth quarter.

2024 年第四季調整後 EBITDA 為 1.531 億美元。調整後 EBITDA 利潤率為 19.8%，去年同期為 22.8%。以相同設施計算，今年第四季調整後的 EBITDA 為 1.964 億美元，調整後的 EBITDA 利潤率為 25.7%，去年同期為 28.4%。

During the fourth quarter of 2024, we recorded a $14 million increase to our reserves for self-insured professional and general liability claims.

2024 年第四季度，我們的自保專業和一般責任索賠準備金增加了 1,400 萬美元。

This adjustment is related to years prior to 2024 and is largely a result of the unfavorable trends experienced by the broader industry in recent years.

此次調整與 2024 年之前的年份有關，主要是由於近年來整個行業經歷的不利趨勢所致。

Startup losses related to new facilities were $11.2 million in the fourth quarter of 2024, a $6 million year over year increase relative to the fourth quarter of 2023, and a $4 million dollar increase sequentially over the third quarter, a reflection of the step up in the number of newly-constructed facilities.

2024 年第四季與新設施相關的啟動損失為 1,120 萬美元，與 2023 年第四季相比增加 600 萬美元，與第三季相比增加 400 萬美元，這反映了新建設施數量的增加。

These quarterly results also reflect a $7 million revenue impact and a $5 million EBITDA impact due to the decision to close the facility in the fourth quarter as a part of our ongoing portfolio management efforts.

這些季度業績也反映了 700 萬美元的收入影響和 500 萬美元的 EBITDA 影響，這是由於我們決定在第四季度關閉該工廠作為我們持續投資組合管理工作的一部分。

Adjusted income attributable to Acadia stockholders per diluted share was $0.64 for the fourth quarter of 2024 and $0.85 for the prior year period, excluding the income from the provider relief fund in the fourth quarter of 2023.

2024 年第四季歸屬於 Acadia 股東的調整後每股攤薄收益為 0.64 美元，去年同期為 0.85 美元，不包括 2023 年第四季來自供應商救濟基金的收入。

Consistent with previous periods, adjustments to income for the fourth quarter of 2024 include transaction, legal, and other costs, loss on impairment, and provision for income taxes.

與前期一致，2024 年第四季的收入調整包括交易、法律和其他成本、減損損失和所得稅準備金。

We continued to maintain a strong financial position throughout 2024, providing us with the ability to make the right strategic investments to enhance our operations and support our growth strategy. As of December 31, 2024, we had $76.3 million in cash and cash equivalents and $226.5 million available under our $600 million dollar revolving credit facility with a net leverage ratio of approximately 2.7.

我們在 2024 年繼續保持強勁的財務狀況，這使我們能夠進行正確的策略投資，以增強我們的營運並支持我們的成長策略。截至 2024 年 12 月 31 日，我們擁有 7,630 萬美元的現金和現金等價物，6 億美元循環信貸額度下可用資金為 2.265 億美元，淨槓桿率約為 2.7。

Moving on to our outlook for 2025, as noted in our press release, we are providing full year guidance as follows. Revenue is expected to be in the range of $3.3 billion to $3.4 billion. Adjusted EBITDA is expected to be in the range of $675 million to $725 million. Adjusted earnings per share is expected to be in the range of $2.50 to $2.80. We expect operating cash flows to be in the range of $460 million to $510 million. We expect capital spending to be in the range of $630 million to $690 million. This includes approximately $525 million to $575 million in expansion spending related to the construction of new beds.

談到我們對 2025 年的展望，正如我們在新聞稿中所述，我們提供全年指引如下。預計收入在 33 億美元至 34 億美元之間。調整後的 EBITDA 預計在 6.75 億美元至 7.25 億美元之間。調整後每股收益預計在 2.50 美元至 2.80 美元之間。我們預計營運現金流在 4.6 億美元至 5.1 億美元之間。我們預計資本支出在 6.3 億美元至 6.9 億美元之間。其中包括約 5.25 億至 5.75 億美元的用於建設新床位的擴建支出。

Our full-year guidance includes same facility patient day growth and the low to mid-single digits, as Chris mentioned, we continue to focus on improving volume at a handful of underperforming facilities. However, our outlook does not assume a material improvement in the performance of this group. Were we to see a more material improvement sooner that would represent potential upside to our guidance range.

我們的全年指引包括同一設施的患者日增長和低至中等個位數，正如克里斯所提到的，我們將繼續專注於提高少數表現不佳的設施的數量。然而，我們的展望並不認為該集團的業績會有實質改善。如果我們能夠更快地看到更實質的改善，這將代表我們的指導範圍有潛在的上升空間。

As a result, full-year guidance therefore assumes an approximate $20 million EBITDA headwind from this small group of facilities. Our full year guidance assumes same facility revenue per patient day growth and the low-single digits.

因此，全年指引假設這一小部分設施將帶來約 2000 萬美元的 EBITDA 逆風。我們的全年指導假設是每位病人每天的設施收入將增長且保持在低個位數。

This includes a net year over year change in Medicaid supplemental payments in the range of flat to a $15 million dollar increase. This contemplates a range of outcomes related to the new Tennessee program, which the company expects to recognize subsequent to the first quarter of 2025.

這包括醫療補助補充支付的淨同比變化，範圍從持平到增加 1500 萬美元。這考慮了與新田納西州計劃相關的一系列結果，該公司預計這些結果將在 2025 年第一季之後實現。

I would also remind you that as called out throughout the last year, 2024 EBITDA included approximately $10 million in non-recurring supplemental payments.

我還要提醒您，正如去年全年所呼籲的那樣，2024 年 EBITDA 包含約 1000 萬美元的非經常性補充付款。

Full-year guidance includes $50 million to $55 million in total startup losses related to newly-opened facilities. This represents a year over year increase in startup costs of approximately $25 million as compared to 2024, a reflection of the significant increase in the pace of bed growth as well as the timing of new facility openings.

全年預期包括與新開設設施相關的 5,000 萬至 5,500 萬美元的總啟動損失。與 2024 年相比，這意味著啟動成本年增約 2,500 萬美元，反映了床位成長速度和新設施開放時間的顯著增加。

Full-year guidance also includes a year over year increase in professional liability expense of approximately $10 million. This increase is related to recent trends experienced across the industry, including higher reinsurance costs, and we believe reflects a more conservative position.

全年指引還包括專業責任費用年增約 1000 萬美元。這一成長與整個產業近期的趨勢有關，包括更高的再保險成本，我們認為這反映了更保守的立場。

I would also point out that 2024 consolidated results included approximately $60 million of revenue and $5 million of EBITDA from facilities that were subsequently exited, or a 200 basis point and 70-basis point headwind to 2025 revenue and EBITDA growth respectively.

我還要指出的是，2024 年綜合業績包括隨後退出的設施帶來的約 6000 萬美元收入和 500 萬美元 EBITDA，這分別對 2025 年收入和 EBITDA 增長造成 200 個基點和 70 個基點的阻力。

We also issued financial guidance for the first quarter of 2025 as follows. Revenue in the range of $765 million to $775 million and adjusted EBITDA in the range of $130 million to $135 million.

我們也發布了 2025 年第一季的財務指導，如下所示。營收在 7.65 億美元至 7.75 億美元之間，調整後 EBITDA 在 1.3 億美元至 1.35 億美元之間。

First quarter guidance includes the following assumptions. Given the large number of beds open towards the end of 2024 and anticipated in early 2025, startup losses are expected to be disproportionately weighted towards the first half of the year.

第一季的指引包括以下假設。鑑於 2024 年底和 2025 年初預計將有大量床位開放，預計新創公司損失將主要集中在上半年。

First quarter startup losses are expected to be approximately $20 million representing an increase of approximately $15 million over the first quarter of 2024.

預計第一季新創公司損失約 2,000 萬美元，比 2024 年第一季增加約 1,500 萬美元。

First quarter guidance assumes a net decrease in Medicaid supplemental payments of approximately $10 million to $15 million.

第一季的指引假設醫療補助補充支付淨減少約 1,000 萬美元至 1,500 萬美元。

As a reminder, 2024 first quarter results included $7 million in non-recurring supplemental payments.

提醒一下，2024 年第一季的業績包括 700 萬美元的非經常性補充付款。

I would also note that first quarter 2024 consolidated results included approximately $25 million of revenue from facilities that were subsequently closed, representing a 300-basis-point headwind to first quarter growth. Facility closures are expected to be a headwind to year over year EBITDA growth of approximately $5 million in the first quarter.

我還要指出的是，2024 年第一季的綜合業績包括隨後關閉的設施產生的約 2,500 萬美元收入，這對第一季的成長造成了 300 個基點的阻力。預計工廠關閉將對第一季約 500 萬美元的 EBITDA 年成長造成阻力。

Finally, for modeling purposes, I would remind you that last year's first quarter had one extra day compared to this year's first quarter. As always, the company's guidance does not reflect the impact of any future acquisitions, divestitures, transaction, legal, and other costs, or non-recurring settlements expense.

最後，為了建模的目的，我要提醒你，去年第一季比今年第一季多了一天。與往常一樣，該公司的指引並未反映任何未來收購、資產剝離、交易、法律和其他成本或非經常性結算費用的影響。

Before we move on to Q&A, I would like to talk briefly about the outlook beyond 2025 and the significant tailwinds for this business over the next few years. We materially accelerated the pace of new bed growth in 2024, and we expect to add another 800 to 1,000 beds in 2025.

在我們進入問答環節之前，我想先簡單談談 2025 年以後的前景以及未來幾年這項業務的重大推動因素。我們在 2024 年大幅加快了新增床位成長速度，預計 2025 年將再增加 800 至 1,000 張床位。

This means we will have roughly 1,600 to 1,800 new beds that we expect to go from generating startup losses to a positive EBITDA contribution over the course of 2026 and beyond. At the same time, startup losses from new facilities are expected to decline beyond 2025.

這意味著我們將擁有大約 1,600 到 1,800 張新床位，我們預計在 2026 年及以後，這些床位將從產生的啟動損失轉為正的 EBITDA 貢獻。同時，預計2025年後新廠的啟動損失將會下降。

Therefore, we see an inflection point in earnings growth in 2026 and expect 2026 EBITDA growth to be towards the high end of the long-term outlook range provided with our press release yesterday.

因此，我們預計 2026 年獲利成長將出現拐點，並預計 2026 年 EBITDA 成長將達到我們昨天新聞稿中所述的長期展望範圍的高端。

We anticipate the benefit of accelerating EBITDA growth combined with the decline in capital spending will drive the company towards meaningful free cash flow generation.

我們預計，EBITDA 成長加速加上資本支出下降將推動公司實現有意義的自由現金流產生。

As a reminder, a little over $100 million of our annual CapEx is related to maintenance and IT spending, or about 2% to 3% of revenue, with the remainder going towards the construction of new beds and CTC facilities. As such, we anticipate a material reduction in capital expenditures relative to our current quarterly run rate later this year. And again in 2026, as the pace of bed construction moderates from the recent highs.

提醒一下，我們每年的資本支出中略高於 1 億美元與維護和 IT 支出有關，約佔收入的 2% 到 3%，其餘部分用於建造新的床位和 CTC 設施。因此，我們預計今年稍後的資本支出將相對於目前的季度運行率大幅減少。2026 年，床位建設速度將再次從近期的高點放緩。

Over the three years beginning 2026, we expect revenue growth of 7% to 9% and EBITDA growth of 8% to 10%. We have excellent visibility into this level of growth as we moderate the pace of our bed additions to 600 to 800 beds per year, still well above our historical pace of annual bed growth.

從 2026 年開始的三年內，我們預期營收成長 7% 至 9%，EBITDA 成長 8% 至 10%。由於我們將增加床位的速度控制在每年 600 到 800 張床位，因此我們對這一增長水平有著很好的了解，這仍然遠高於我們歷史上年度床位增長速度。

Moderating the pace of bed growth will allow us to unlock more of the embedded EBITDA and free cash flow generating power of the record setting beds added throughout 2024 and 2025. Going forward, we believe the pace of investment and new bed growth strikes the right balance between investment and the growth of the business and the generation of free cash flow.

減緩床位成長速度將使我們能夠釋放 2024 年和 2025 年新增創紀錄床位所帶來的更多內含 EBITDA 和自由現金流生成能力。展望未來，我們相信投資步伐和新床位成長將在投資與業務成長和自由現金流的產生之間取得適當的平衡。

In summary, we believe we can continue to invest to meet growing demand and drive a healthy pace of top and bottom line growth while returning to free cash flow positive by the end of 2026.

總而言之，我們相信我們可以繼續投資以滿足不斷增長的需求並推動健康的營收和利潤成長，同時到 2026 年底恢復自由現金流為正。

We believe this more balanced approach to growth and free cash flow generation will also provide the company increased flexibility going forward when it comes to capital deployment.

我們相信，這種更平衡的成長和自由現金流產生方式也將為公司未來的資本部署提供更大的靈活性。

Finally, as noted in our press release, our Board of Directors has authorized a new $300 million share repurchase program. Repurchases will be made in accordance with applicable securities laws and are subject to market conditions and other factors.

最後，正如我們的新聞稿中所述，我們的董事會已批准一項新的 3 億美元股票回購計畫。回購將根據適用的證券法進行，並受市場條件和其他因素的影響。

With that operator, we are ready to open the call for questions.

有了這個接線員，我們就可以開始回答問題了。

Thank you. We will now begin the question and answer session.

謝謝。我們現在開始問答環節。

(Operator Instructions) Whit Mayo, Leerink Partners.

（操作員指示）Whit Mayo，Leerink Partners。

Hey, thanks. Maybe Heather to follow up on that last comment. Obviously you have a lot of capital commitment this year. Guidance implies that you're burning maybe $180 million of cash. The interest expenses up presumably might include some incremental debt. To fund the growth. So one of their financing plans this year, and can you give us an idea on preliminary sources and uses of cash next year? Like how much exactly will the growth CapEx and IT spending be down in 2026?

嘿，謝謝。也許希瑟會跟進最後一則評論。顯然，今年你們有很多資本投入。指導意見暗示你可能要燒掉 1.8 億美元現金。利息支出可能包括一些增量債務。為成長提供資金。那麼他們今年的融資計畫之一是什麼？您能否向我們介紹明年的現金初步來源和用途？例如，2026 年資本支出和 IT 支出成長究竟會下降多少？

Hi, thanks for the question. Yeah, just to give you a little bit of information in regards to the financing option that you mentioned, if you look in our 10-K, you will see a disclosure included regarding the refinancing that we are just about to wrap up it mentions that we have refinanced the existing bank facilities and also that we will be upsizing our revolver to about $1 billion. So that is contemplated in in what's disclosed in the 10-K and there should be more coming about that shortly.

你好，謝謝你的提問。是的，我只是想向您提供一些有關您提到的融資選擇的信息，如果您查看我們的 10-K 報表，您會看到其中包含有關我們即將完成的再融資的披露，其中提到我們已經對現有銀行設施進行了再融資，並且我們將把我們的循環信貸額度增加到約 10 億美元。這是在 10-K 文件中披露的內容中考慮到的，並且很快就會有更多相關內容。

In terms of free cash flow and how we think about that, we have messaged and you would have seen in our disclosures that came out in the press release that we expect to see cash flow be back to cash flow positive by the end of 2026, and that is largely a result of a couple of things.

關於自由現金流以及我們對此的看法，我們已經傳達了訊息，您會在我們新聞稿中披露的內容中看到，我們預計到 2026 年底現金流將恢復為正值，這主要是由於幾件事造成的。

The first would be the EBITDA contribution that we expect to see beginning in 2026. And that is as the result with a couple of things. One, the contribution from the new beds that we have been adding, those should start to really generate nice EBITDA in 2026. And two, the cessation of the elevated level of costs associated with the pre-opening of those facilities. So those two things in confluence should generate operating cash flows at a nice rate.

第一個是我們預計將從 2026 年開始看到的 EBITDA 貢獻。這就是一些事情的結果。首先，我們不斷增加的新床位的貢獻應該會在 2026 年開始真正產生不錯的 EBITDA。二是停止與這些設施預開放相關的高成本。因此，這兩件事結合在一起應該會以不錯的速度產生營運現金流。

In addition, you'll see that CapEx will come down as well. The high-water mark for CapEx sort of came to the end of '24 and will continue with that rate in the beginning of '25 as we continue to have that high pace of beds opening. But that should moderate and then start to decline in the back half of '25 and then continue to decline in 2026.

此外，您還會發現資本支出也會下降。資本支出的最高水位大約在 24 年底達到，並將在 25 年初繼續保持這一速度，因為我們將繼續保持較高的床位開放速度。但這趨勢應該會逐漸緩和，在 2025 年下半年開始下降，並在 2026 年持續下降。

Is there a number that you can share within a range for how much the CapEx is going to decline next year?

您能告訴我明年資本支出會下降多少嗎？

You know it's -- I don't want to provide guidance on 2026 at this point, but we would expect the run rate of CapEx to come down materially over '25 and then again in 2026. I mean, maybe ballpark around $100 million.

你知道這是——我現在不想提供關於 2026 年的指導，但我們預計資本支出的運行率將在 25 年大幅下降，然後在 2026 年再次下降。我的意思是，大概在 1 億美元左右。

Okay. And then the follow up here, just the first quarter guide implies that you're going to earn, I think, like 18% of the full year, which is certainly a question that we're getting. Can you just maybe help us think through a bridge from the from the first quarter to the full year? I mean, there should be more supplemental dollars in the back half, fewer startup losses. Maybe an expectation the growth is better. Just any numbers around that to frame kind of the walk forward would be helpful. Thanks.

好的。然後接下來的問題是，光是第一季的指南就意味著你將獲得全年收入的 18%，這當然是我們正在考慮的問題。您能否幫助我們思考如何從第一季到全年實現這一目標？我的意思是，下半年應該有更多的補充資金，減少啟動損失。也許預期成長會更好。只要圍繞這一框架制定的任何數字都可以提供幫助。謝謝。

Yeah, let me take that and hopefully I'll hit all the pieces that you were looking at. So you can see in the first quarter and certainly the full year guidance that the first quarter is expected to contribute less to the full year than what we would see in a typical year. But we would also anticipate the second quarter is likely to be less than typical as the percentage of the full year as well due to similar timing factors looking year over year.

是的，讓我來接手，希望我能擊中你所看到的所有部分。因此，您可以在第一季以及全年指引中看到，預計第一季對全年的貢獻將低於我們在典型年份所看到的。但我們也預計，第二季的銷售額佔全年銷售額的百分比可能低於正常水平，因為與去年同期相比，時間因素類似。

That's largely driven by a couple of things, the first, the startup costs that we've been talking about, and then also the timing of supplemental payments.

這主要由幾個因素決定，首先是我們一直在談論的啟動成本，然後是補充支付的時間。

Yeah, we expect the first quarter to be the high water mark for startup losses, with about $20 million in total startup losses for the quarter out of the $50 million to $55 million that we're guiding to for the full year. So think about roughly 35% to 40% of the full-year startup costs landing in the first quarter alone. And startup costs are expected to taper down over the course of the year. So the second quarter is also likely to be elevated.

是的，我們預計第一季新創公司虧損將達到最高點，本季新創企業總虧損約為 2,000 萬美元，而我們預計全年新創企業虧損總額為 5,000 萬至 5,500 萬美元。想想看，光是在第一季度，全年的啟動成本就佔了大約 35% 到 40%。預計啟動成本將在今年內逐漸下降。因此第二季的產量也可能會上升。

But again, that depends on the timing of several factors which are hard to predict with any precision. The other swing factor I would mention is related to the quarterly cadence for supplemental payments, the net supplemental payments, including the associated taxes, and those can be lumpy and as hard to predict with precision. But what our guidance assumes is that first quarter supplemental payments will be down about $10 million to $15 million year over year, but they will be up for the full year. So I would suggest for modeling purposes, you assume second quarter net supplemental payments are down year over year as well.

但同樣，這取決於幾個難以準確預測的因素的時間。我要提到的另一個影響因素與補充支付的季度節奏、淨補充支付（包括相關稅款）有關，這些因素可能會不穩定，難以準確預測。但我們的指導假設是，第一季的補充支付將年減約 1,000 萬至 1,500 萬美元，但全年將會增加。因此，我建議，出於建模目的，假設第二季的淨補充支付也較去年同期下降。

Yeah thanks.

是的，謝謝。

Brian Tanquilut, Jefferies.

傑富瑞 (Jefferies) 的 Brian Tanquilut。

Hey, good morning. Maybe Heather, just to drill down into some of the comments you made on the long, longer term growth algorithm or growth outlook. Just curious, I mean, as we think about 10% bet ads the past few years in a soft comp in 2025. And I know you said high end of the range, in '26. So shouldn't that be higher than that 8% to 10% range, number one, and how should we be thinking about the margin and pricing assumptions that you have post-2025?

嘿，早安。也許希瑟，只是想深入探討你對長期成長演算法或成長前景所做的一些評論。只是好奇，我的意思是，我們想想過去幾年 10% 的賭注廣告在 2025 年的軟補償中。我知道您說過，高端是 26 年。那麼，首先，這不應該高於 8% 到 10% 的範圍嗎？我們應該如何考慮 2025 年後的利潤和定價假設？

Yeah, hi, thanks for the question. I'll just maybe start by reiterating a couple of things, the revenue growth at 7% to 9% for those several years beginning and, beginning after this year. And EBITDA growth of 8% to 10%. So to your question about how should we feel about margin and margin expansion just to point out the delta and those two numbers that we've headlined.

是的，你好，謝謝你的提問。我首先想重申幾件事，從今年開始以及今年以後的幾年裡，收入成長率將保持在 7% 到 9% 之間。EBITDA成長8%至10%。因此，對於您關於我們應該如何看待利潤率和利潤率擴張的問題，我們只需指出增量和我們所討論的兩個數字。

And I'll just point out one more thing.We would expect 2026 to be at the high end of that range, based on all the things that I just talked to in response to Whit's question a little bit more granularity. We'd expect volume growth to be in the mid-single digit range on average. And that pulls in the beds that we're adding, of course. And to answer that question that you asked. But as we said in the past, we'd expect average rates to normalize back towards the historical low to mid-single digit range at some point in the future, and our long-term outlook assumes we see rate growth in that area.

我只想指出一點，根據我剛才在回答 Whit 的問題時談到的所有細節，我們預計 2026 年將處於該範圍的高端。我們預期銷量成長率平均在個位數的中等水準。當然，這會吸引我們增加床位。並回答您提出的問題。但正如我們過去所說的那樣，我們預計未來某個時候平均利率將回到歷史低點至中等個位數的正常水平，並且我們的長期展望假設我們會看到利率在該區域增長。

That doesn't mean that we won't have years when we outperform. As I mentioned, 2026, we're going to be at the high end of that range, but our base case assumes that we see a more normalized growth rate and that's a prudent approach and leaves room, for conservatism and for us to outpace that.

但這並不代表我們不會擁有表現優異的年份。正如我所提到的，到 2026 年，我們將處於該範圍的高端，但我們的基本情況假設我們看到更正常化的成長率，這是一種審慎的做法，為保守主義和我們超越這一目標留下了空間。

Maybe just stepping back a little bit higher level, that was a lot of granular detail. I just want to say a couple of things about the long term guide. Nothing has changed with how we're thinking about the opportunity here, the strategy that we have in terms of meeting that significant unmet demand is the same. We'll continue to expand capacity and we'll continue to meet that need. But what we're doing today is taking a more balanced approach, and that's balancing CapEx bed growth and free cash flow. We can still add beds at a much faster rate than the company has historically done and drive top and bottom line growth at the same time.

也許只要退後一點點，就可以看到更高層次的許多細節。我只想說幾件關於長期指南的事情。我們對這機會的看法沒有任何改變，我們在滿足這項尚未滿足的巨大需求方面的策略也是一樣的。我們將繼續擴大產能並繼續滿足這項需求。但我們今天採取的是更平衡的方法，即平衡資本支出床位成長和自由現金流。我們仍然可以以比公司過去更快的速度增加床位，同時推動營收和利潤的成長。

To be clear, our growth strategy remains primarily focused on deploying capital efficiently towards growth and expanding the footprint of the business to meet those needs. And I'm not suggesting any sort of shift away from that with this long-term guide.

需要明確的是，我們的成長策略仍然主要集中在有效地部署資本以實現成長，並擴大業務範圍以滿足這些需求。而且我並不建議透過這份長期指南來改變這一點。

But we also recognize the opportunity to moderate the pace of spending, smooth out the bed growth a bit, and then unlock more of the free cash flow power embedded in the business as these beds continue to ramp, as we've been talking about. And that's going to give us the ability to be more opportunistic from a capital allocation perspective.

但我們也意​​識到，有機會減緩支出的速度，稍微平滑一下床位的成長，然後隨著這些床位的不斷增加，釋放出更多的業務中蘊含的自由現金流力量，正如我們一直在談論的那樣。從資本配置的角度來看，這將使我們更有能力抓住機會。

So that's a reflection, this refreshed look is a reflection, as we look back and look forward and making sure that we are being appropriately prudent when we're building our assumptions and putting targets in the market. So maybe just to summarize, I've said a lot, it's really a combination of those two things. I would add that we have a high level of confidence in this growth outlook and our visibility is supported by the significant embedded EBITDA power from the thousands of beds that we've been adding.

所以這是一種反思，這種更新的視角是一種反思，當我們回顧過去並展望未來時，確保我們在建立假設和設定市場目標時採取適當謹慎的態度。所以也許只是總結一下，我已經說了很多，它實際上是這兩件事的結合。我想補充一點，我們對這一成長前景充滿信心，而且我們新增的數千張床位所帶來的巨大內含 EBITDA 實力也為我們的可見性提供了支持。

I appreciate that. And my follow up as I think about Q1, there's a lot of chatter about whether it's the fire issues in California or snowstorms.

我很感激。當我思考第一季的問題時，我發現有很多關於加州火災問題還是暴風雪的討論。

Just curious what you're seeing in terms of that and then kind of like if you can share the same sort of assumptions that you've made into the Q1 guide? Just out of curiosity. Thanks.

只是好奇您對此有何看法，然後您是否可以分享您在 Q1 指南中做出的相同假設？只是出於好奇。謝謝。

Why don't I just maybe give you a little bit of the color on the bridge in general just to address that and then any sort of knock-on questions here just for clarity. So for Q1, I'll start with startup costs. I mentioned this, but I'll just reiterate in terms of Q1 specifically here to be complete, we expect about $15 million in higher startup costs versus the first quarter of 2024, and we expect that to be to the high water mark for the year.

我為什麼不先給你介紹一下大橋的大致情況，先解決這個問題，然後再在這裡回答任何相關的問題，以便清楚了解情況。因此對於第一季度，我將從啟動成本開始。我提到過這一點，但我只想重申一下，就第一季而言，我們預計啟動成本將比 2024 年第一季增加約 1500 萬美元，我們預計這將是今年的最高水位。

In terms of supplemental payment, the first quarter will be down around $10 million to $15 million year over year due to timing, and recall that we had $7 million in out of period payments in the first quarter last year.

在補充付款方面，由於時間原因，第一季的補充付款將比去年同期減少約 1,000 萬至 1,500 萬美元，回想一下，去年第一季我們的期外付款為 700 萬美元。

We mentioned in our press release that we had a facility closure right at the beginning of Q1, that's about a $5 million dollar drag to Q1 for 2025. And then, come to your point on volume, our '25 outlook does not assume a material improvement on those handful of facilities that we've previously talked about. It's difficult for us to put an estimate on the timing for the turnaround of a small group of facilities. And so we believe it's more prudent just to take a conservative approach when we're setting guidance.

我們在新聞稿中提到，我們在第一季初關閉了一家工廠，這將對 2025 年第一季造成約 500 萬美元的損失。然後，談到您對數量的觀點，我們的 25 年展望並不假設我們之前談到的少數設施會有實質的改善。我們很難估計一小部分設施的恢復時間。因此，我們認為，在製定指導時採取保守的做法是更謹慎的做法。

So 2025, as a result of that assumes roughly a $20 million dollar EBITDA headwind for the full year from that handful of underperforming facilities.

因此，到 2025 年，預計全年少數表現不佳的設施將為 EBITDA 帶來約 2,000 萬美元的阻力。

And just directly to your question, that's not specifically related to fires or any of the other events.

直接回答您的問題，這與火災或任何其他事件沒有具體關係。

There, there's, normal seasonality with weather, of course, always in Q1, but nothing that I would call out here. It's just focused on those few facilities. One point on that, the year over year headwind would be spread over the first three quarters of the year, just as a reminder because the fourth quarter would already have been impacted in 2024. And so we should see a tailwind as we comp over the fourth quarter of ‘24 results. So that's a total of 20 in the year, but really, distributed to the first three quarters and then, starting in Q1.

當然，天氣有正常的季節性，總是在第一季度，但我在這裡沒有什麼可說的。它只是專注於那幾個設施。需要提醒的是，年比逆風將蔓延至今年前三個季度，因為第四季在 2024 年就已經受到影響。因此，當我們比較 2024 年第四季的業績時，我們應該會看到順風。所以今年總共有 20 個，但實際上分佈在前三個季度，然後從第一季開始。

One last thing that that we haven't talked about that I'll just mention for completeness as I'm going through the bridge for Q1 is professional liability expense. We -- you would have seen that we took a charge in Q4 and we're also assuming in the guidance for 2025 an incremental $10 million year over year for the full year so obviously there's going to be a piece of that in one as well. That's just a reflection of what we believe is a more conservative approach to reserve claims this year.

最後還有一件事我們還沒談過，在討論第一季的情況時，為了完整性我只想提一下，那就是專業責任費用。我們——您可能已經看到，我們在第四季度收取了費用，我們還假設在 2025 年的指引中，全年費用將同比增加 1000 萬美元，因此顯然其中也會有一部分。這只是反映了我們認為今年對準備金索賠採取了更保守的態度。

Awesome. Thank you.

驚人的。謝謝。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Thanks. Hi everyone. So in Q4, I think the revenue, per day moderated, growth to 1.7% and then 3.6% in Q3, which is more like what it was for the full year and you're calling out low-single digit pricing, growth for ‘25. I'm just trying to understand.

謝謝。大家好。因此，我認為在第四季度，每日收入成長放緩至 1.7%，然後在第三季度成長 3.6%，這更接近全年的水平，而你所說的 25 年定價成長率為低個位數。我只是想了解一下。

I know there's some moving parts and maybe that's impacting it more than is a parent. But is that something you're seeing rates come down on the Medicaid side, on the commercial side, or otherwise or rate growth rather moderate, or are you just giving yourself the leeway that it could moderate?

我知道其中存在一些變動因素，也許其影響比父母更大。但是，您是否看到醫療補助、商業或其他方面的費率下降，或者費率增長相當溫和，或者您只是給自己留有緩和的餘地？

Yeah, hi AJ, thanks for the question. Maybe I'll just go through a little bit of detail on the rate and what we're thinking about when we go through guidance.

是的，你好，AJ，謝謝你的提問。也許我會稍微詳細地介紹利率以及我們在製定指導時所考慮的問題。

First, I just want to, I know I've said it a couple of times, but I think it bears saying again, the ‘25 guidance assumes supplemental payments will be flat to up $15 million for this year. So the '25 guidance essentially assumes we'll get a little less of a tailwind relative to the years past.

首先，我知道我已經說過幾次了，但我認為值得再說一遍，'25 指導假設今年的補充支付將持平至 1500 萬美元。因此，2025 年的指引基本上假設我們面臨的順風相對於過去幾年會稍微弱一些。

The timing and the magnitude of those payments, can be very difficult to predict. And if that improves then we have more visibility or timing shifts then we will see upside and that could be, it's a positive swing factor for us in the reported revenue per day.

這些付款的時間和金額可能很難預測。如果情況有所改善，那麼我們就會有更高的可見度或時間變化，那麼我們就會看到上行空間，這可能是我們報告的每日收入的一個正面波動因素。

And the second thing I would say is given the noise on the policy front we just believe it's prudent at this early point in the year, incorporate a more conservative approach in our thinking about rate updates given the broader environment.

我想說的第二件事是，考慮到政策方面的噪音，我們認為在今年年初這個階段採取謹慎的態度，在更廣泛的環境下，在考慮利率更新時採取更為保守的方法。

There's nothing specific on the horizon that we're seeing is concerning, but we have taken a slightly more cautious approach as we think about 2025, given the level of uncertainty on the policy front.

目前我們看到的前景沒有什麼值得擔憂的具體情況，但考慮到政策上的不確定性，我們對 2025 年採取了更為謹慎的態度。

If this level of conservatism proves unnecessary, then great growth could wind up closer to the mid-single digit range. And it may finally just to round it out from an overall rate perspective, we're assuming the commercial rate environment remains stable.

如果事實證明這種程度的保守是不必要的，那麼巨大的成長最終可能會接近中等個位數的範圍。最終，從整體利率角度來看，我們假設商業利率環境保持穩定。

Okay, and then for my follow up. Looking at the different margin dynamics, I know again there's a lot of moving parts. I think fourth quarter you're 19.8%. That gave you the full year EBITDA margin about 22.5%. I think for the last five years prior to that you've been more like 23.3%. If I look at -- peel away what you're saying about liability and those cluster of facilities that are underperforming. What are you assuming in '25 that your core portfolio does in margin stable? Is it down?

好的，然後我的後續問題。透過觀察不同的利潤動態，我再次了解到其中有許多變動因素。我認為第四季你的成長率是 19.8%。這使得全年 EBITDA 利潤率達到約 22.5%。我認為在此之前的五年裡你的比例大概是 23.3%。如果我看一下——剝離你所說的責任和那些表現不佳的設施群。您假設在 25 年您的核心投資組合的利潤率會保持穩定嗎？掉下來了嗎？

And if I look at the implied growth, going out a couple years, I think you sort of back of the envelope get to about 21.5% for '28, which is below the five year prior. Are you thinking that you can't that the margin of the last five years is probably higher than you're going to see for quite a while? So essence of it, what's the assumption for the underlying portfolio actually the call out for '25 and is the assumption that that the margin of the last five years is a couple 100 basis points higher than what you're likely to get to even a couple of years from now?

如果我看一下隱含的成長率，那麼展望未來幾年，我想 28 年的成長率大約是 21.5%，低於五年前的水準。您是否認為，過去五年的利潤率可能比相當長一段時間內的利潤率還要高？所以它的本質是，對於基礎投資組合的實際假設是‘25’，並且假設過去五年的利潤率比幾年後可能獲得的利潤率高出幾百個基點？

Okay, AJ, let me try to answer that. So I would point to a couple of things at a very high level. Let me just talk about a couple of things. You talk about Q4 '24, and the impact full year and then moving into '25. What do we expect and pointing to specifically that margin compression.

好的，AJ，讓我試著回答這個問題。因此我想從非常高的層面指出幾件事。讓我只談幾件事。您談論的是 24 年第四季以及對全年和 25 年的影響。我們期望什麼，具體指出利潤率壓縮。

Q4 margin compression was very specifically a result of two things. That was the additional reserve for the professional liability reserve and the closure of liability in the quarter. So that's what drove that and obviously it impacted the full year as well.

Q4 利潤率壓縮具體是因為兩件事造成的。這是專業責任準備金和本季責任結清的額外準備金。這就是推動這一事件發生的原因，而且顯然也影響了全年業績。

As we think about '25, I would just point out to a couple of things I won't belabor these. But we've got the startup costs and we have the continuation of the professional liability expense that we are assuming a higher rate for 2025. That's about $10 million over 2024. And then when we look at volume, we're not expecting a material improvement, as I said, in those few facilities. And we're just trying to be prudent and take a conservative approach when we set the guidance, and that is giving us about a $20 million dollar headwind to EBITDA for 2025.

當我們思考'25時，我只想指出幾件事，我不會詳細闡述這些。但我們已經有了啟動成本，而且還有持續的專業責任費用，我們假設 2025 年的費率會更高。這相當於 2024 年的 1000 萬美元。然後，當我們從產量來看時，正如我所說，我們並不期望這幾個設施會有實質的改善。我們在製定指導方針時只是試圖謹慎並採取保守的方法，這將給我們 2025 年的 EBITDA 帶來約 2000 萬美元的阻力。

If those items that I'm calling out improve, then we will have upside and we will have a tailwind as we move through the year. But we just felt it was better to be more cautious at this point to your question of what's the underlying business look like from a margin perspective, we see that as stable. It's just these few things that we're calling out specifically on top. But the underlying business we see is continuing to be stable in the range that we've seen historically.

如果我提到的那些項目得到改善，那麼我們就會有上行空間，並且在今年會有順風。但我們只是覺得，在回答你關於從利潤率角度來看基礎業務是什麼樣子的問題時，最好現在更加謹慎，我們認為這是穩定的。這正是我們特別要強調的幾件事。但我們看到基礎業務繼續保持穩定在歷史範圍內。

Okay, alright, thank you.

好的，好的，謝謝你。

Ben Hendrix, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Ben Hendrix。

Hey, thank you very much. Last quarter, you talked a lot about depressed referral activity on the back of some difficult press headlines last year.

嘿，非常感謝。上個季度，您多次談到由於去年一些負面新聞頭條而導致的推薦活動低迷。

Can you give us an update on how your referral activity has progressed across your various service lines into 2025? And then how should that impact the pacing we should expect through the year of your low- to mid-single digit, same sort of volume growth that you've put into guidance? Thanks.

您能否向我們介紹一下 2025 年您在各個服務線上的推薦活動進度？那麼，這對我們預期全年的低到中等個位數的銷售速度有何影響，銷售成長是否與你所指導的相同？謝謝。

Hey, thanks, Ben. This is Chris. Why don't I start and maybe Heather can add some commentary as well, I would say just on the referral source front that we just continue to be very engaged with outreach to our external stakeholders, including all these key referral sources and other important partners. We have been very intentional about consistent outreach.

嘿，謝謝，本。這是克里斯。我先開始吧，希瑟也許也可以補充一些評論，我想說，僅在推薦來源方面，我們就會繼續積極地與外部利益相關者聯繫，包括所有這些關鍵推薦來源和其他重要合作夥伴。我們一直非常注重持續的外展活動。

Really to correct any of the misunderstandings that were created from the media reporting and as we've consistently emphasized for them the quality of the care that we provide, the substantial investments that we're making, and safety and compliance and quality over the last two years that we continue to make, we think that that is resonating. We have put particular focus on ensuring that our most important referral sources do understand. The facts and we've, clearly put some commentary on our website that I think has a lot of detail that has been very well received.

實際上，為了糾正媒體報導造成的任何誤解，正如我們一直向他們強調的那樣，我們提供的護理品質、我們所做的大量投資以及我們在過去兩年中繼續在安全性、合規性和品質方面所做的努力，我們認為這引起了共鳴。我們特別注重確保我們最重要的推薦來源確實理解。事實是，我們在網站上明確發表了一些評論，我認為這些評論非常詳細，並且受到了熱烈歡迎。

And so when you just look across our entire facility base, the referral issue continues to be less and less of a challenge, and it allows us to focus on the smaller number of facilities that Heather referenced are still performing below our expectation, right now. So Heather, anything you would add? .

因此，當您縱觀我們整個設施基礎時，轉診問題的挑戰就越來越小，這使我們能夠專注於 Heather 提到的目前表現仍低於我們預期的少數設施。那麼 Heather，您還有什麼要補充嗎？。

Just maybe to double down on a couple of things there, Chris. We talked about, back in January that the majority of the headwinds were coming from a handful of facilities and that began in Q4, as Chris mentioned, we are just continuing to work through the process and turning around the small group of facilities.

克里斯，也許需要加倍努力做幾件事。我們早在 1 月就討論過，大部分阻力來自少數幾家工廠，而且這種情況從第四季度開始出現，正如 Chris 提到的那樣，我們只是在繼續推進這一進程，扭轉一小部分工廠的經營狀況。

But you know, I would just note as well that, in the portfolio of this size in any period we're going to have some that overperform and some that underperform. And we spent the last several months just really getting to understand the referral pattern issue and mitigate it where appropriate. And we're at a point now where if you look across our entire book of business, we feel good that referrals are not a widespread issue.

但你知道，我還要指出的是，在任何時期，這種規模的投資組合中都會有一些表現優異的資產，也有一些表現不佳的資產。我們花了幾個月的時間才真正了解推薦模式問題，並在適當的情況下緩解它。現在，如果你回顧我們整個業務，你會發現，推薦並不是一個普遍存在的問題，這一點讓我們感到欣慰。

But as I noticed, we're focused on the small number of facilities that are performing below our expectations.

但正如我注意到的，我們關注的是少數表現低於我們預期的設施。

Thank you.

謝謝。

John Ransom, Raymond James.

約翰·蘭塞姆、雷蒙·詹姆斯。

Hey good morning, if we look out to '26 and beyond the mix of bed ads, it's crept up in terms of de novos versus facility ads. What does that look like in the out years?

嘿，早安，如果我們展望 26 年以及床位廣告組合之外，就會發現從頭到尾的廣告與設施廣告的比例有所上升。未來幾年狀況會如何？

Hi, John, good morning. As we look out in the out years, I think we'll con we'll continue to be focused on de novos, some of those JV partners just based on the pipeline that we have as well, but I would say de novo facilities heavily focused in the acute space.

嗨，約翰，早安。展望未來幾年，我認為我們將繼續專注於 de novos，其中一些合資夥伴也只是基於我們擁有的管道，但我想說 de novo 設施主要集中在急性領域。

So our math is that, the construction costs have gone up probably a third or so since the plan was laid out by the old management team in '21. So unless the returns have improved, it looks like to us like the EBITDA returns are in the maybe 10% range. But I just didn't know is there a rethinking of the de novo math and do all these projects still make sense in kind of light of the current environment.

因此，我們的計算是，自1921年舊管理團隊制定計畫以來，建造成本可能已經上漲了三分之一左右。因此，除非回報率提高，否則在我們看來，EBITDA 回報率可能在 10% 左右。但我只是不知道是否需要重新思考從頭數學，而所有這些項目在當前環境下是否仍然有意義。

So no, I don't think there's anything there to talk about in terms of the profitability or sort of the returns expectations for those facilities. I mean, it's clear that we have multiple options of how to deploy capital and we apply a very rigorous approach that that we've talked about many times before. We are constantly looking at those returns we're making sure that we have our models updated for the right information and we continue to see the benefit from those hospitals, those de novos that we're adding. And we have seen nice returns over the last several years. We've seen rate improvement and we've seen that really contribute to volume and I think we will we'll see that in a big way in 2026 whenever we see that happening.

所以，我認為就這些設施的獲利能力或回報預期而言，沒有什麼可談的。我的意思是，很明顯我們在如何部署資本方面有多種選擇，而且我們採用了一種非常嚴格的方法，我們之前已經多次談論過這一點。我們不斷關注這些回報，確保我們的模型更新正確的訊息，並繼續看到這些醫院、這些新增患者帶來的好處。過去幾年來我們已經看到了良好的回報。我們已經看到了利率的提高，也看到了這確實對交易量做出了貢獻，我認為，我們將在 2026 年看到這種情況大規模發生。

So whenever we see the cost of construction, the construction rates going up in some pockets, that's what we feel confident about the rate growth that has kept up with that construction cost at the same time. So from a returns perspective, we still feel good about those returns.

因此，每當我們看到建築成本、建築費率在某些地方上漲時，我們就對費率的成長與建築成本保持同步充滿信心。因此，從回報的角度來看，我們仍然對這些回報感到滿意。

Okay, thank you. And just two more quick ones for me, the MIT business slowed a bit in the quarter, we're, seeing mid-single digit growth. Number one, and then number two, just going back to the question on referral patterns and underperforming facilities are the ones that are left are these mostly in the markets that were the subject of the media scrutiny or are there other markets? Thank you.

好的，謝謝。對我來說，再快速說兩個，本季 MIT 業務有所放緩，我們看到了中等個位數的成長。第一，然後是第二，回到關於轉診模式和表現不佳的設施的問題，剩下的問題是，這些主要是在媒體審查的市場中，還是還有其他市場？謝謝。

So that business, as you will recall, has grown substantially over the past 12, 18 months, maybe even 24 months, and that is that experienced great growth. The growth rates we have expected would come down just as a comp over the prior years because of that significant growth, there is.

所以，正如大家所記得的，該業務在過去 12、18 個月，甚至 24 個月都實現了大幅增長，這可以說是巨大的增長。由於顯著的成長，我們預計成長率與前幾年相比會有所下降。

A lot of strength in that business. We continue to see record volumes associated with that business. So there's nothing I would point to apart from just the normal, growth pattern as we talk over some periods of significant growth. We still see that as a strong business and we think about it as a mid-single digit grower for future periods.

這項業務實力雄厚。我們繼續看到與該業務相關的創紀錄交易量。因此，當我們談論一些顯著增長時期時，除了正常的成長模式之外，我沒有什麼可指出的。我們仍然認為這是一項強勁的業務，我們認為未來一段時間內它將保持中等個位數的成長。

Okay, thank you.

好的，謝謝。

Matthew Gilmore, KeyBanc.

馬修·吉爾摩，KeyBanc。

Hey, thanks for the question. So for the underperforming facilities that you've called out, can you maybe just give us a sense for, what you're doing on the ground to improve the results there?

嘿，謝謝你的提問。那麼，對於您所指出的表現不佳的設施，您能否告訴我們，您們正在採取哪些實際措施來改善那裡的表現？

Yeah, thanks, Matt. I would start with health care is local, so for us it really starts with a comprehensive review of the competitive landscape. We look really closely at the programming at that individual facility. And then you know as we really dig in and make an assessment on you know a specific facility we're going to look at a number of very specific factors.

是的，謝謝，馬特。我想說的是，醫療保健是本地化的，所以對我們來說，這實際上始於對競爭格局的全面審查。我們非常仔細地研究了該單一設施的編程情況。然後你知道，當我們真正深入研究並對特定設施進行評估時，我們會考慮許多非常具體的因素。

So one would be -- we'll look at the business development function we'll look at the current funnel, we'll look at the referral sources, identify any gaps in coverage, and, clearly work with the team, on a plan there. We're going to look really closely at admissions and that can include.

因此，一方面我們會研究業務發展功能，研究目前的管道，研究推薦來源，找出覆蓋範圍內的差距，並與團隊合作制定計畫。我們將非常仔細地審查招生情況，其中包括：

Inquiries it can you know look at deflections and what's going on there we're going to do an assessment of the leadership team, not only the quality of the team but also any staffing needs and gaps related to that team.

透過詢問，您可以了解偏差以及那裡發生的事情，我們將對領導團隊進行評估，不僅評估團隊的質量，還評估與該團隊相關的任何人員需求和差距。

We'll look at technology. We've obviously invested heavily, but we want to ensure that there's, adherence and, really strong adoption. Of the platforms that we've put in place from the remote monitoring technology to the EMR to the patient safety, and specifically the comprehensive quality dashboards that we've put in place as well. So we want to make sure that that is also in place.

我們將關注技術。我們顯然已經投入了巨資，但我們希望確保人們能夠堅持並真正採用。我們已經建立了遠端監控技術、電子病歷 (EMR) 和病人安全等平台，特別是我們已經建立的綜合品質儀表板。因此，我們希望確保這一點也得以落實。

And then the final thing I would say is maybe just the physical plant we would even look at are there any facility improvements that would be an impediment. So it's a comprehensive suite of things that we're looking at working very closely with our operational leadership and getting very granular on the ground level.

最後我想說的是，也許我們只會關注實體工廠，看看是否有任何設施改進會成為障礙。所以這是一套全面的措施，我們正在與我們的營運領導層密切合作，並在基層進行細緻的研究。

Got it. And then as a follow up, should we think about the drag from those facilities assuming there's no improvement over the over the near term. But that'd be a 2% drag kind of consistent with what you saw in the fourth quarter?

知道了。然後作為後續問題，我們是否應該考慮這些設施帶來的拖累，假設短期內沒有改善。但這將是 2% 的拖累，與您在第四季度看到的情況一致嗎？

Yeah, that's about the right ballpark now. Okay, thank you.

是的，現在這就是正確的估計。好的，謝謝。

Scott Fidel, Stephens.

史考特菲德爾、史蒂芬斯。

Oh, hi. Thanks. Good morning. First question, just, wanted to get your update around. I know that you had talked about in the last few quarters that it ultimately you saw sort of the volumes start to moderate a bit. That you would have flexibility to potentially flex down some of the labor you know staffing related costs.

哦，你好。謝謝。早安.第一個問題，我只是想了解您的最新情況。我知道您在過去幾個季度中談過，最終您會看到交易量開始有所緩和。您可以靈活地降低部分與人員配置相關的成本。

The full year guidance does assume a bit lower of a volume frame, around it, so just curious sort of how are you guys thinking about that option, or lever, doesn't seem like you have much embedded into the guidance around that. But was hoping to get your sort of breakdown of some of the, options you have around flexing down cost potentially?

全年指引確實假設了較低的交易量框架，所以只是好奇你們是如何看待這個選項或槓桿的，似乎你們並沒有在指引中嵌入太多內容。但您是否希望對降低成本方面可能採取的一些選擇進行細分？

Yeah, hi, thanks for the question. That that's a good question. If you recall in Q4 when we brought the guide down related to the pressure that we were seeing, we brought the EBITDA guide down disproportionately higher than the revenue guide. And that implied about a $15 million EBITDA headwind for Q4 of '24.

是的，你好，謝謝你的提問。這是個好問題。如果您還記得，在第四季度，我們因看到的壓力而下調了預期，當時我們將 EBITDA 預期下修得比收入預期高得多。這意味著 24 年第四季的 EBITDA 將面臨約 1500 萬美元的阻力。

As we think about 2025, we are anticipating for that same small group of facilities about $20 million of a headwind built into $25 million. So to your question of have we started to focus on cost levers and right sizing the cost structure? Yes. Because $15 million for one quarter alone versus $20 million for the full year is factoring in the cost measures that we are taking and the things that we're doing in relation to those facilities.

當我們展望 2025 年時，我們預計同一組設施將面臨約 2000 萬美元的逆風，總成本為 2500 萬美元。那麼，對於您的問題，我們是否已經開始關注成本槓桿和正確確定成本結構？是的。因為僅一個季度的成本就為 1500 萬美元，而全年的成本為 2000 萬美元，這考慮到了我們正在採取的成本措施以及與這些設施相關的工作。

Just as a reminder, we have not built in any upside expectations from a volume perspective for that handful of facilities for the year. But if those facilities were to begin to turn around and the volume.

需要提醒的是，從數量角度來看，我們並沒有對今年的這些設施抱持任何上行預期。但如果這些設施開始扭轉局面，數量就會增加。

Improves, that would of course be upside and a tailwind for us as we move throughout the year. But at this point, because the timing is hard to predict on those facilities or any facility that we're working on we thought it was more prudent to take a cautious approach.

改善，這當然會為我們全年的發展帶來好處和順風。但在這一點上，由於這些設施或我們正在建造的任何設施的時機都很難預測，因此我們認為採取謹慎的態度是更明智的做法。

Okay. And then as my follow up, I wanted to know whether, as you've announced, or the board announced that the $300 million dollar expansion of the buyback program, whether there's any type of, methodical, inputs or sort of framing that you're going to be approaching this around. In terms of sort of, like a maximum leverage target that you'd be willing to go to fund buybacks as compared to comparing against the current valuation and pressure in the stock and then on that front.

好的。然後作為我的後續問題，我想知道，正如您或董事會宣布的，將回購計劃擴大 3 億美元，是否有任何類型、有條不紊的投入或框架可以幫助您解決這個問題。就某種程度而言，例如您願意為回購提供資金的最大槓桿目標，與股票的當前估值和壓力進行比較。

Maybe if you want to just give us some clarity around. What you're thinking would be the maximum leverage, given the increase in the revolver. You know that you have accessible to fund, some of the negative free cash flow in the projects that you have until you get to '26 where FTF is expected to improve?

也許你只是想給我們一些澄清。考慮到左輪手槍的威力增加，您所想的就是最大槓桿率。您是否知道，在 2026 年之前，您可以獲得資金來彌補專案中的部分負自由現金流，而到 2026 年，FTF 預計會有所改善？

Thanks Scott. This is Chris. I'll go ahead and start and see if Heather wants to add anything, I would just start by saying, I mean, we have this authorization that's been approved by the Board in place and it was clearly deliberately put in place to utilize and we're planning to do so.

謝謝斯科特。這是克里斯。我先開始講，看看 Heather 是否想補充任何內容，我首先要說的是，我們已獲得董事會批准的授權，顯然這是特意設立的，我們正計劃這樣做。

We're not going to comment on any specific timeline, but I think right now from a leverage standpoint and Heather can chime in. We would expect to naturally de-lever as dog grows over the next few years, and we talked about anticipating an inflection point with respect to free cash flow in '26. And so what would you add from there?

我們不會對任何具體的時間表發表評論，但我認為現在從槓桿的角度來看，希瑟可以加入討論。我們預計，隨著未來幾年狗的成長，槓桿率會自然降低，我們也談到了預計26年自由現金流將出現拐點。那您想補充什麼呢？

I mean that's the exact point that I would add, if we think about to your point of effectively when and how would we fund. And think about actually being in the market in terms of leverage. We have a comfortable leverage ratio, and we are expecting that to come down naturally to Chris's point. We've talked about '26 being a significant growth year for us from an EBITDA perspective, and that will naturally bring that leverage back down.

我的意思是，如果我們思考您提到的何時以及如何有效地提供資金，這就是我要補充的觀點。並從槓桿的角度來思考實際市場狀況。我們擁有舒適的槓桿率，我們預計它會自然下降至克里斯所指出的水平。我們說過，從 EBITDA 的角度來看，26 年對我們來說是重要的成長年，這自然會降低槓桿。

And then we think even beyond that if you think about the CapEx reductions that's going to bring that leverage down as well. And so given that we would be comfortable looking at, taking up leverage in order to fund what we need to do from a share repurchase perspective just given the cash flow power in the business, we'd see comfort there.

然後我們認為，如果你考慮資本支出的減少，這也會降低槓桿率。因此，考慮到我們願意考慮利用槓桿來為股票回購所需的活動提供資金，考慮到公司業務的現金流實力，我們會感到安心。

Okay, thank you.

好的，謝謝。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Hi, good morning. Obviously, a lot of attention on state directed payments lately. I think you can appreciate that investors want to understand the risk to get comfortable, around that area of concern. So can you disclose your total exposure to State-directed payments for us for 2024?

嗨，早安。顯然，最近人們對國家指導支付給予了極大關注。我想你可以理解，投資人希望了解所關注領域的風險，以便安心應對。那麼您能否向我們揭露 2024 年國家指示支付的總風險敞口？

Yeah, sure. Hi Andrew, good morning, would be happy to. So the total gross supplemental payments, would be less than $200 million. And that's of course before the provider taxes that we pay into those programs.

是的，當然。嗨，安德魯，早上好，我很樂意。因此，補充支付總額將少於 2 億美元。當然，這還不包括我們為這些項目支付的提供者稅。

Okay, so about 2/3 of that is a good ballpark to think about in terms of net benefit?

好的，那麼從淨收益的角度來看，大約 2/3 是一個不錯的大概數字嗎？

I just I wouldn't expect ours to be any different than that for the rest of the industry. That's a pretty good ballpark.

我只是不希望我們與業內其他人有任何不同。那是一個非常好的球場。

Understood. And then I'm still struggling to understand how there could be such a significant drop off in revenue per patient day from mid- to low-single digits, mid-single digits to low single digits. Especially when I think about fiscal year '25 rates carrying into the first half of calendar year '25 and state supplementals being up overall, it seems like you're kind of pointing to state supplementals being the area of conservatism.

明白了。然後，我仍然很難理解為什麼每位病人每天的收入會從中個位數下降到低個位數，再從中個位數下降到低個位數。尤其是當我想到 25 財年的稅率將延續到 25 日曆年上半年，而且州補貼總體上有所上漲時，您似乎在指出州補貼是保守主義的領域。

But that seems to go against the philosophy of booking six quarters of Tennessee. So if state directed payments are up overall, it feels like there's a moderation on either core rate or CTC revenue. Is there anything you can share that might help reconcile these comments?

但這似乎違背了預訂田納西州四分之六的理念。因此，如果國家指導支付總體上有所增加，那麼感覺核心利率或 CTC 收入就會有所緩和。您能分享什麼來幫助調和這些評論嗎？

Yeah, let me head on a couple of things. The first we've talked about, supplemental payments that in prior years they've been a nice tailwind for us and that it will be less of a tailwind certainly compared to the relative, recent years.

是的，讓我談幾件事。首先，我們談到了補充付款，在前幾年，它們對我們來說是一個很好的順風，但是與最近幾年相比，它的順風作用肯定會減弱。

The second thing that I will just reiterate is that we feel that there is -- that it's the right thing to do to just be prudent at this point in the year just given.

我要重申的第二件事是，我們認為，在一年中的這個時候，採取謹慎的態度是正確的做法。

Everything that, the noise that we're seeing, we feel like it's better to take a conservative approach and, certainly there will be upside there if our conservative approach is sort of proven wrong. And then just directly to your question regarding CPC, that's service line delivered. Above trend growth obviously in '23 and early '24. And that was a tailwind of about 100 basis points to our growth in the early part of 2024 from a rate perspective. And that's just naturally is the growth rate moderate over the prior year comp, we would see that become less of a tailwind.

我們看到的所有噪音都讓我們覺得最好採取保守的方法，而且，如果我們的保守方法被證明是錯的，那麼肯定會有好處。然後直接回答你關於 CPC 的問題，這是提供的服務線。23年和24年初的成長明顯高於趨勢。從利率角度來看，這對我們 2024 年初的成長來說是約 100 個基點的順風。這很自然地表明，與上年相比，成長率有所放緩，我們會看到，這種順風勢頭減弱了。

In '25, we wouldn't expect that service line to be a material swing factor in either direction. It's just not the tailwind that we had early in 2024.

在'25年，我們預期服務線不會成為任何一個方向的重大波動因素。這只不過不是我們在 2024 年初所擁有的順風。

Thank you. This concludes our question and answer session. I would now like to turn the call back over to Mr. Hunter for closing remarks.

謝謝。我們的問答環節到此結束。現在我想將演講時間轉回給亨特先生，請他作最後發言。

Thank you. In closing, I want to again thank our committed facility leaders, clinicians, and over 25,000 dedicated employees across the country who have continued to work tirelessly to meet the needs of patients in a safe and effective manner. We have a strong foundation and a proven strategy for driving growth and delivering greater value to both the patients we serve and our shareholders.

謝謝。最後，我要再次感謝我們盡職盡責的機構領導、臨床醫生以及全國 25,000 多名敬業的員工，他們一直不懈地工作，以安全有效的方式滿足患者的需求。我們擁有堅實的基礎和行之有效的策略，可以推動成長並為我們服務的患者和股東創造更大的價值。

Thank you for being with us this morning and for your interest in Acadia. Have a great day.

感謝您今天上午與我們在一起並感謝您對阿卡迪亞的關注。祝你有美好的一天。

The conference has now concluded. Thank you for your participation. You may now disconnect your lines.

會議現已結束。感謝您的參與。現在您可以斷開線路了。