Addus Homecare Corp (ADUS) 2024 Q4 法說會逐字稿

Hello and welcome to the Addus HomeCare's fourth quarter 2024 earnings conference call. (Operator Instructions) I would now like to hand the call to Dru Anderson, please go ahead.

您好，歡迎您參加 Addus HomeCare 2024 年第四季財報電話會議。(接線員指示) 現在我想將電話轉給 Dru Anderson，請繼續。

Thank you. Good morning and welcome to the Addus HomeCare fourth quarter 2024 earnings conference call. 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 by going to the company's website and reviewing yesterday's news release.

謝謝。早安，歡迎參加 Addus HomeCare 2024 年第四季財報電話會議。如果在今天的電話會議中討論了任何非 GAAP 財務指標，您也可以透過造訪公司網站並查看昨天的新聞稿，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 also contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including statements, among others, regarding Addus expected quarterly and annual financial performance for 2025 or beyond.

本次電話會議也可能包含《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 Addus 預計 2025 年或以後的季度和年度財務業績的陳述。

For this purpose, any statements made during this call that are not statements of historical fact may be deemed to be forward-looking statements. Without limiting the foregoing discussions of forecasts, estimates, targets, plans, beliefs, expectations, and the like are intended to identify forward-looking statements.

為此目的，本次電話會議中所做的任何非歷史事實陳述均可視為前瞻性陳述。在不限制前述預測、估計、目標、計劃、信念、期望等討論的情況下，旨在識別前瞻性陳述。

You are hereby caution that these statements may be affected by important factors, among others set forth in Addus filings with the Securities and Exchange Commission and in its fourth quarter, 2024 news release. Consequently, actual operations and results may differ materially from the results discussed in the forward-looking statements.

在此提醒您，這些聲明可能會受到重要因素的影響，其中包括 Addus 向美國證券交易委員會提交的文件以及 2024 年第四季新聞稿中所述的因素。因此，實際營運和結果可能與前瞻性陳述中討論的結果有重大差異。

The company undertakes no obligation to update any forward-looking statements, whether as a result of new information, future events, or otherwise. I will now turn the call over to the company's Chairman and Chief Executive Officer, Mr. Dirk Allison. Please go ahead, sir.

無論由於新資訊、未來事件或其他原因，本公司都不承擔更新任何前瞻性陳述的義務。現在我將把電話轉給公司董事長兼執行長 Dirk Allison 先生。先生，請繼續。

Thank you, Dru. Good morning and welcome to our 2024 fourth quarter earnings call. With me today our Brian Poff, our Chief Financial Officer, and Brad Bickham, our President and Chief Operating Officer. As we do on each of our quarterly calls, I will begin with a few overall comments, and then Brian will discuss the fourth quarter results in more detail.

謝謝你，德魯。早安，歡迎參加我們 2024 年第四季財報電話會議。今天和我一起的有我們的財務長 Brian Poff 和我們的總裁兼營運長 Brad Bickham。正如我們在每個季度電話會議上所做的那樣，我將首先發表一些總體評論，然後 Brian 將更詳細地討論第四季度的業績。

Following our comments, the three of us would be happy to respond to any questions. Before I discuss our earnings, which we announced yesterday, let me express some thoughts related to the potential Medicaid program changes being discussed by the new administration and Congress.

根據我們的評論，我們三人很樂意回答任何問題。在我討論我們昨天宣布的收益之前，請允許我表達一些與新政府和國會正在討論的醫療補助計劃潛在變化有關的想法。

It is well documented that the new administration is actively pursuing spending cuts across virtually all areas of federal spending. This includes healthcare service spending, although I note the President recently indicated that Medicare and Medicaid would not be touched as part of the cuts. Still, there are many proposals being floated, so I wanted to spend a few minutes sharing our view on some of these.

有充分證據表明，新政府正在積極削減幾乎所有聯邦支出領域。這包括醫療服務支出，儘管我注意到總統最近表示醫療保險和醫療補助不會受到削減。不過，仍有許多提案被提出，所以我想花幾分鐘就其中一些提案分享我們的看法。

As part of the congressional discussions concerning possible cuts to federal spending, the following have been listed among others, as potential areas to reduce federal spending on Medicaid. Per capita caps lowering of the FMAP floor, Medicaid FMAP penalty for covering undocumented immigrants with state-only money.

作為國會關於可能削減聯邦支出的討論的一部分，以下內容被列為可能削減聯邦醫療補助支出的領域。人均上限降低 FMAP 下限，使用州政府資金為無證移民提供醫療補助 FMAP 罰款。

Reverse or limit state directed Medicaid payments, Limit Medicaid provider taxes, repeal the American Rescue Plan FMAP state incentive. Medicaid work requirements and reversal of certain Biden administration rules such as nursing home staffing ratios and Medicaid access and enrollment rules.

撤銷或限制國家指導的醫療補助支付、限制醫療補助提供者稅、廢除美國救援計劃 FMAP 國家激勵措施。醫療補助工作要求以及拜登政府某些規則的撤銷，例如養老院人員配備比例以及醫療補助的准入和登記規則。

The aggregate federal savings of this list, if implemented, could be as high as $2.3 trillion over a 10-year period of time. However, it is believed that a number of these items on the list cannot be implemented concurrently.

如果實施，這份清單中的聯邦節省總額在 10 年內可能高達 2.3 兆美元。然而，人們認為清單中的許多項目無法同時實施。

Also, the most recent House of Representative budget resolution includes a health spending reduction of $880 billion over 10 years rather than the $2.3 trillion but provides no details regarding specific spending reductions.

此外，眾議院最新的預算決議包括在10年內削減8,800億美元（而非2.3兆美元）的醫療支出，但沒有提供有關具體支出削減的細節。

As you know, the population Addus serves is overwhelmingly older adults and people with disabilities, or in many cases, both. Most of the approaches that I just listed would not directly impact the population we serve, but there are a couple of items that I would like to address in more detail.

眾所周知，Addus 服務的人群絕大多數是老年人和殘疾人，或者在許多情況下兩者兼而有之。我剛才列出的大多數方法不會直接影響我們服務的人群，但有幾個問題我想更詳細地討論一下。

Per capita caps this idea discussed during the first Trump administration would set an annual upper limit on federal payments for Medicaid enrollee. Each state's total federal funding would be limited to the product of the number of enrollees times the cap per enrollees spending amount.

人均上限川普第一任政府期間討論的這個想法將對醫療補助參保者的聯邦支付設定年度上限。每個州的聯邦總資助金額將被限制為參保人數乘以每位參保者支出上限的乘積。

The payment spending caps could vary for the different Medicaid eligibility groups in each state. We understand that some proposals under discussion would only apply the spending caps to certain Medicaid eligible populations and not across the board.

各州不同醫療補助資格群的支付支出上限可能有所不同。我們了解到，正在討論的一些提案只會對某些符合醫療補助條件的人群實施支出上限，而不是對所有人群實施。

We believe our populations are less likely to be among the cap populations in those proposals. Lowering of the FMAP floor. Currently, the federal government reimburses states no less than 50% of the expenditures related to Medicaid.

我們認為，我們的人口不太可能屬於這些提案所限定的人口範圍。降低 FMAP 樓層。目前，聯邦政府向各州償還的醫療補助相關支出不低於50%。

Some states are paid a higher percentage based on the relative per capita income of the state, but all states receive no less than the 50% lower payment. Reducing the floor to the FMAP funding formula would impact a number of states with relatively higher earning population as they will receive less matching funds.

一些州根據該州的相對人均收入獲得更高的百分比，但所有州獲得的金額都不低於較低 50%。降低 FMAP 資助公式的下限將對一些收入人口相對較高的州產生影響，因為他們獲得的配對資金將減少。

According to a July 2024 report by the Paragon Institute, the only states we serve that could be impacted by the lowering or removal of the FMAP floor would be California and Washington. Which their combined Medicaid revenue represents approximately 2% of our total consolidated revenue.

根據 Paragon Institute 2024 年 7 月的報告，我們所服務的唯一可能受到降低或取消 FMAP 下限影響的州是加州和華盛頓州。他們的綜合醫療補助收入約占我們合併總收入的 2%。

While proposed changes to federal Medicaid funding could shift additional cost to the states, we are optimistic that there is sufficient bipartisan support for the services we provide to avoid significant reductions at the state level.

雖然對聯邦醫療補助資金的擬議修改可能會將額外的成本轉嫁給各州，但我們樂觀地認為，我們提供的服務將得到足夠的兩黨支持，以避免在州一級出現大幅削減。

I believe it is important to remember that the services we actually we offer reduce the overall cost to state Medicaid programs as the alternative is an increased frequency of Medicaid patients receiving more expensive institutional care.

我認為重要的是要記住，我們實際提供的服務降低了國家醫療補助計劃的總體成本，因為替代方案是增加醫療補助患者接受更昂貴的機構護理的頻率。

Obviously, we cannot predict which, if any, of these measures will be implemented or the net effect of any changes. However, we believe passage out of committee and then the house are both tall orders, and our government relations team believes passage in the Senate will be daunting even at this level of reduction.

顯然，我們無法預測這些措施中的哪些將會實施，也無法預測任何變化的淨效應。然而，我們認為，委員會通過該法案並在眾議院獲得通過都是一項艱鉅的任務，而我們的政府關係團隊認為，即使在這種削減水平下，參議院通過該法案仍將是一項艱鉅的任務。

In fact, the Senate is pursuing its own budget resolution that contemplates significantly lower spending cuts to Medicaid program again with unknown results. I want to be sure you understand our thinking concerning any potential Medicaid reductions.

事實上，參議院正在推行自己的預算決議，該決議再次考慮大幅削減醫療補助計劃的開支，但結果尚不清楚。我想確保你們了解我們對於任何潛在的醫療補助削減的想法。

Medicaid is a valuable state and federal lifeline to the extremely at-risk population that we serve, which, if cut, could lead to much higher total cost of care for both states and the federal government.

對於我們所服務的極度危險人群來說，醫療補助是一條寶貴的州和聯邦政府的生命線，如果被削減，可能會導致州和聯邦政府的總醫療成本大幅上升。

At Addus, we are focused on our strategy of expanding our services to this population as it relates to home care, which we believe remains valuable to both our states as well as Congress and this administration. We are encouraged by the bipartisan congressional comments opposing cuts to the Medicaid program.

在 Addus，我們專注於將我們的服務擴展到這一人群，因為它與家庭護理有關，我們相信這對我們各州以及國會和本屆政府都具有價值。國會兩黨一致反對削減醫療補助計劃的評論令我們感到鼓舞。

As we continue to work with our contacts in Washington, we believe that as low-cost provider to the elderly and disabled, we are in a good position to minimize any effect which may occur from the budget proposal as presented by the house.

隨著我們繼續與華盛頓的聯絡人合作，我們相信，作為老年人和殘疾人的低成本服務提供者，我們完全有能力將眾議院提出的預算提案可能產生的任何影響降至最低。

Now let me talk about the financial results we announced yesterday. Our total revenue for the fourth quarter of 2024 was $297.1 million an increase of 7.5% as compared to $276.4 million for the fourth quarter of 2023.

現在我來談談我們昨天公佈的財務結果。我們 2024 年第四季的總營收為 2.971 億美元，較 2023 年第四季的 2.764 億美元成長 7.5%。

This revenue growth resulted in adjusted earnings per share of $1.38 as compared to adjusted earnings per share for the fourth quarter of 2023 of $1.32 an increase of 4.6%. Our adjusted EBITDA was $37.8 million compared to $34.3 million for the fourth quarter of 2023, an increase of 10.3%.

這一營收成長導致調整後每股收益為 1.38 美元，而 2023 年第四季的調整後每股收益為 1.32 美元，成長了 4.6%。我們的調整後 EBITDA 為 3,780 萬美元，而 2023 年第四季為 3,430 萬美元，成長 10.3%。

This past year has been an exciting one for our company. We continue to be focused on our stated goal concerning growth and profitability as we demonstrated with the completion of our largest acquisition to date.

過去的一年對我們公司來說是令人興奮的一年。我們將繼續專注於我們關於成長和盈利的既定目標，正如我們迄今為止最大的收購的完成所證明的那樣。

For 2024, our total revenue was $1.2 billion including just one month of Gentiva personal care acquisition that closed on December 2, which is an increase of 9.1% as compared to the $1.1 billion for 2023.

2024 年，我們的總收入為 12 億美元，其中僅包括 12 月 2 日完成的 Gentiva 個人護理收購一個月的收入，與 2023 年的 11 億美元相比增長了 9.1%。

This revenue growth resulted in adjusted earnings per share of $5.26 as compared to adjusted earnings per share for 2023 of $4.58 an increase of 14.9%.

這一收入成長導致調整後每股收益為 5.26 美元，而 2023 年調整後每股收益為 4.58 美元，成長了 14.9%。

Our adjusted EBITDA for 2024 was $140.3 million as compared to $121 million for 2023, an increase of 15.9%. During 2024, we continued to experience consistent cash flows. As of the end of 2024, we had cash on hand of approximately $100 million.

我們 2024 年的調整後 EBITDA 為 1.403 億美元，而 2023 年為 1.21 億美元，成長 15.9%。2024 年，我們持續獲得穩定的現金流。截至 2024 年底，我們手頭上的現金約為 1 億美元。

Following the close of Gentiva PCS transaction on December 2, 2024, and borrowing of $233 million to fund this acquisition, the amount outstanding on our bank line of credit was approximately $223 million as of December 31, 2024.

繼 2024 年 12 月 2 日 Gentiva PCS 交易結束後，我們借入 2.33 億美元為此次收購提供資金，截至 2024 年 12 月 31 日，我們的銀行信用額度未償還金額約為 2.23 億美元。

We continue to have a conservative leveraged position at just under one times of adjusted EBITDA, allowing us the flexibility to continue to evaluate and pursue strategic acquisition opportunities. Let me share with you an update on Gentiva personal care transaction, which I mentioned closed this past December.

我們繼續保持保守的槓桿率，略低於調整後 EBITDA 的 1 倍，這使我們能夠靈活地繼續評估和尋求策略性收購機會。讓我與你們分享 Gentiva 個人護理交易的最新進展，我之前提到過該交易已於去年 12 月完成。

Following several months of joint planning with the Gentiva PCS team, we took over operations of this large PCS business with minimal disruption. Both teams did an excellent job of preparing for the December closing, understanding that Addus would need to provide most back-office services from day one.

經過與 Gentiva PCS 團隊數月的聯合規劃，我們以最小的干擾接管了這個大型 PCS 業務的營運。兩個團隊都為 12 月的收尾做好了出色的準備，他們明白 Addus 從第一天起就需要提供大部分後台服務。

While we normally have additional time following the closing of a transaction to transfer certain back-office systems, we did not have the runway in this case. However, with the detailed planning I just mentioned, we experienced a smooth process of moving this business into our Addus corporate structure.

雖然我們通常在交易結束後有額外的時間來轉移某些後台系統，但在這種情況下我們沒有足夠的時間。但是，有了剛才提到的詳細規劃，我們將這項業務轉移到 Addus 公司結構的過程非常順利。

Recently, I had the opportunity to spend the day with Brad and the leadership team from our acquired Gentiva operations. The focus of the day was to help orient this new leadership team with the systems and methods of the legacy at its operation.

最近，我有幸與布拉德以及我們收購的 Gentiva 業務的領導團隊一起度過了一天。當天的重點是幫助新的領導團隊熟悉其運作中的原始系統和方法。

I was encouraged by both the enthusiasm and deep experience that our new team brings to Addus. It gives me a great deal of confidence in our ability to continue to take care of the many new consumers we added as a result of this acquisition while also meeting the financial goals we developed during the due diligence and transition planning process.

我們的新團隊為 Addus 帶來的熱情和豐富經驗令我感到鼓舞。這讓我非常有信心，我們有能力繼續服務此次收購帶來的眾多新消費者，同時實現我們在盡職調查和過渡規劃過程中所製定的財務目標。

I want to officially welcome all of our Gentiva teammates to Addus. Before I discuss our labor and operations, let me talk about the corporate office leave write-off we included in our results announced yesterday.

我要正式歡迎所有 Gentiva 隊友來到 Addus。在我討論我們的勞動力和營運之前，讓我先談談我們昨天公佈的結果中包含的公司辦公室休假註銷。

Just prior to the 2020 pandemic, we had doubled the size of our corporate office footprint to support our corporate team and our potential future growth. After going remote for a number of weeks during the pandemic, our leadership team made the decision to utilize a modified remote work schedule for our Dallas team going forward as many companies have.

就在 2020 年疫情爆發之前，我們將公司辦公室的面積擴大了一倍，以支持我們的公司團隊和未來的潛在成長。在疫情期間遠距辦公數週後，我們的領導團隊決定像許多公司一樣，讓我們的達拉斯團隊今後採用修改後的遠距工作時間表。

In addition, we found that after an acquisition, we were better able to keep key leadership if we allowed certain new members of our team to remain in their current location as opposed to requiring them to relocate to Dallas.

此外，我們發現，收購後，如果我們允許團隊中的某些新成員留在當前位置而不是要求他們搬遷到達拉斯，我們就能更好地留住關鍵領導層。

With our company's operation being spread over 20 plus states, it has allowed leadership to be closer to our field operations. We've seen this change in approach worked extremely well for our corporate and operations staff. For this reason, we concluded there was excess space at our corporate office.

由於我們公司的業務遍布 20 多個州，因此領導層可以更接近我們的現場營運。我們已經看到這種方法的改變對我們的公司和營運員工非常有效。因此，我們得出結論，我們的公司辦公室有多餘的空間。

After researching the limited opportunities in the sublease market, we determined it made sense to take a one-time write-off of approximately $4.9 million in our fourth quarter of 2004 financial statements in order to accelerate the remaining cost related to this excess space.

在研究了轉租市場中有限的機會之後，我們認為有必要在 2004 年第四季的財務報表中一次性註銷約 490 萬美元，以加速償還與這些過剩空間相關的剩餘成本。

Now let me discuss certain areas of our operation. During the fourth quarter of 2024, we continued to experience solid caregiver hiring success, especially in our personal care segment. During the fourth quarter of 2024, we saw personal care hiring at 76 hires per day, up 2 hires per day when compared to the fourth quarter of 2023.

現在讓我討論一下我們營運的某些領域。在 2024 年第四季度，我們在護理人員招募方面繼續取得穩固的成功，尤其是在個人護理領域。2024 年第四季度，我們看到個人護理招募人數為每天 76 人，與 2023 年第四季相比，每天增加 2 人。

Please note that the hiring numbers exclude our New York operations, which we divested, as well as the release recently acquired GPS Gentiva PCS operation. Hiring is always more challenging in the fourth quarter of the year with both the Thanksgiving and Christmas holidays, so it is encouraging to see our hiring numbers remain in the mid 70s.

請注意，招聘人數不包括我們剝離的紐約業務，以及最近收購的 GPS Gentiva PCS 業務。由於感恩節和聖誕節假期，每年第四季的招募總是更具挑戰性，因此看到我們的招募人數保持在 70% 左右是令人鼓舞的。

In addition to our strong hiring numbers, we continued the momentum in starts per business day, which we have seen over the past few quarters.

除了強勁的招募人數外，我們還延續了過去幾個季度以來每個工作日的開工率的勢頭。

With respect to our clinical service line, as has been consistent over the past few quarters, we continue to see improvements in the overall clinical labor environment, although we do believe that for the foreseeable future, clinical hiring will remain more challenging and geographically variable than what we see in our PCS segment.

就我們的臨床服務線而言，與過去幾季的情況一樣，我們繼續看到整體臨床勞動力環境的改善，儘管我們確實相信，在可預見的未來，臨床招聘仍然將比我們在 PCS 部門看到的更具挑戰性和地理差異性。

As we have over the past few years, we continue to utilize the funding we received from the American Rescue Plan Act, or ARPA. During the fourth quarter of 2024, we received a small amount of additional ARPA funding while we utilized over $2.7 million leaving approximately $11 million remaining in accessible funds.

正如過去幾年一樣，我們繼續利用從美國救援計畫法案（ARPA）獲得的資金。在 2024 年第四季度，我們收到了少量額外的 ARPA 資金，同時我們使用了超過 270 萬美元，剩餘約 1,100 萬美元的可用資金。

These funds are continuing to be used to help the caregiver recruitment and retention efforts, as well as other opportunities to enhance our caregivers' experience and training. In our personal care segment, our services continue to receive favorable reimbursement support from many of the states in which we operate.

這些資金將繼續用於幫助護理人員的招募和保留工作，以及其他增強護理人員經驗和培訓的機會。在我們的個人護理領域，我們的服務繼續獲得我們經營所在的許多州的優惠報銷支援。

We are confident that personal care services continue to deliver real value to state Medicaid programs as well as our managed care partners through a reduction in the overall cost of care and, as we stated earlier, put us in a favorable position as various Medicaid changes are considered.

我們相信，個人護理服務將繼續透過降低整體護理成本為州醫療補助計劃以及我們的管理式醫療合作夥伴帶來真正的價值，並且如我們之前所說，在考慮各種醫療補助變化時，這將使我們處於有利地位。

On January 1, 2025, Illinois, our largest state for personal care services, enacted a 5.5% rate increase for personal care services, bringing the rate per hour to $29.63. We continue to appreciate the strong support that home and community-based services receive from the leadership of this state.

2025 年 1 月 1 日，我國個人照護服務規模最大的州伊利諾州將個人照護服務費率上調 5.5%，達到每小時 29.63 美元。我們繼續感謝本州領導階層對家庭和社區服務的大力支持。

Brian will give you more information on how we anticipate that this increase will possibly impact our personal care financial performance for 2025. Now let me discuss our same store revenue growth for the fourth quarter of 2024.

布萊恩將向您提供更多有關我們預計這一增長將如何影響我們 2025 年個人護理財務表現的信息。現在讓我討論一下我們 2024 年第四季的同店營收成長。

For our personal care segment, our same store revenue growth was 5.8% compared to the fourth quarter of 2023. During the fourth quarter of 2024, we saw personal care same store hours increase by 0.7% as compared to the same period in 2023.

就我們的個人護理部門而言，與 2023 年第四季相比，我們的同店收入成長了 5.8%。2024 年第四季度，我們發現個人護理同店營業時間與 2023 年同期相比增加了 0.7%。

We saw a slight impact to our same store hours growth due to continued Medicaid redeterminations, primarily in the northern part of Illinois. While this process has taken longer in Illinois, we believe this is nearing an end.

由於醫療補助計劃的持續重新確定，尤其是伊利諾伊州北部地區的重新確定，我們的同店營業時間增長受到了輕微影響。雖然這個過程在伊利諾伊州花費的時間更長，但我們相信它即將結束。

It is encouraging that we continue to see improvement in our percentage of hours served compared to authorized hours as we show nice improvement over the fourth quarter of 2023. This continued improvement, along with the completion of the Medicaid redetermination process, should help us as we focus on returning our same store of personal care hours growth rate to over 2%.

令人鼓舞的是，與授權工作時間相比，我們的服務工作時間百分比持續提高，因為我們在 2023 年第四季顯示出了良好的改善。這種持續的改善，加上醫療補助重新確定過程的完成，應該會幫助我們專注於將同店個人護理時間增長率恢復到 2% 以上。

Turning to our clinical operations, our hospice same store revenue increased 7.8% when compared to the fourth quarter of 2023. Our total average daily census increased to 3,472 for the quarter, up from 3,381 for the same period last year.

談到我們的臨床業務，與 2023 年第四季相比，我們的臨終關懷同店收入成長了 7.8%。本季度，我們平均每天的調查總數從去年同期的 3,381 人增加到 3,472 人。

Our same store average daily census increased 2.7% when compared to the same quarter last year. For the fourth quarter of 2024, our hospice medium length of stay was 26 days as compared to 31 days for the third quarter of 2024, as we saw an increase in the number of short lengths of stay patients in the fourth quarter.

與去年同期相比，我們的同店日均客流量增加了 2.7%。2024 年第四季度，我們的臨終關懷平均住院時間為 26 天，而 2024 年第三季度為 31 天，因為我們發現第四季度短期住院患者的數量有所增加。

Our stated target for this metric is mid to high 20s. Overall, while we are pleased by the improvement of our hospital segment this year, we have recently hired new operations and sales leadership to further accelerate improvement in this segment.

我們對此指標的既定目標是達到 20% 左右。總體而言，雖然我們對今年醫院部門的改善感到滿意，但我們最近聘請了新的營運和銷售領導層，以進一步加快該部門的改善。

We are in the final stages of an overall sales retaining retraining project, which will conclude this month, and we expect to drive continued volume improvements as the current year progresses. Our home health segment, same store revenue increased 1.6% when compared to the same quarter of 2023.

我們正處於整體銷售保留再培訓項目的最後階段，該項目將於本月結束，我們預計隨著今年的進展，銷售量將繼續增長。與 2023 年同期相比，我們的家庭保健部門同店收入成長了 1.6%。

We are pleased to see this segment of our business return to a positive same store revenue growth and anticipate this growth will continue in 2025.

我們很高興看到這項業務部門的同店收入恢復正成長，並預計這種成長將持續到 2025 年。

As we have previously discussed, our home health is an important partner to our hospice and personal care segments in the markets in which we have these overlapping services which allow us to provide our patients with the optimal care continuum to ensure our patients have the access to the right care at the right time.

正如我們之前所討論的，我們的家庭保健是臨終關懷和個人護理部門的重要合作夥伴，在這些市場中我們提供這些重疊的服務，這使我們能夠為患者提供最佳的護理連續性，以確保我們的患者能夠在正確的時間獲得正確的護理。

As demonstrated by the Gentiva personal care transaction. Acquisitions continue to be an important part of our growth strategy at Addus. Our targeted minimum annual revenue growth of 10% remains our gold even with the larger size of our revenue base.

正如Gentiva個人護理交易所所證明的那樣。收購仍然是 Addus 成長策略的重要組成部分。即使我們的收入基數擴大了，但我們設定的最低年收入成長率為 10%，這仍然是我們的黃金目標。

Specifically for home health opportunities, we continue to see more small transactions coming to market at this point in time. We feel this dynamic will continue until we know how CMS will handle annual home health rate rulemaking under the new administration, along with any visibility we can obtain regarding the potential revenue clawback.

具體來說，對於家庭保健機會，我們繼續看到更多小型交易在此時進入市場。我們認為這種動態將會持續下去，直到我們知道 CMS 在新政府領導下將如何處理年度家庭健康費率規則制定，以及我們可以獲得有關潛在收入追回的任何資訊。

We will, however, continue to look for those potential home health transactions that fit our strategy of adding clinical services in our existing personal care markets.

然而，我們將繼續尋找那些符合我們在現有個人護理市場中增加臨床服務的策略的潛在家庭保健交易。

Now that we have a strong presence in Texas, our team has started looking for both clinical and non-clinical acquisition opportunities in that state, which will allow us to start the process of statewide coverage in all three levels of home care. We are currently looking at certain smaller transactions which fit well with this strategy.

現在我們在德克薩斯州已經擁有強大的影響力，我們的團隊已經開始在該州尋找臨床和非臨床的收購機會，這將使我們能夠開始在全州範圍內覆蓋三個級別的家庭護理。我們目前正在研究一些適合這項策略的較小交易。

While there are indications of a number of larger clinical service acquisition opportunities potentially coming to market later in 2025, we remain committed to maintaining our conservative approach to pricing and overall due diligence, which we feel has proven to be advantageous for us over the past several quarters.

儘管有跡象表明，2025 年晚些時候可能會出現許多更大規模的臨床服務收購機會，但我們仍然致力於保持保守的定價和整體盡職調查方法，我們認為這在過去幾個季度已被證明對我們有利。

Before I turn the call over to Brian, I want to thank the Addis team for the care they are providing to our elderly and disabled consumers and patients. We all have come to understand that the majority of the elderly and disabled clients and patients want to receive care at home, which remains one of the safest and most cost-effective places to receive this care.

在我將電話轉給布萊恩之前，我想感謝亞的斯團隊為我們的老年和殘疾消費者和患者提供的護理。我們都已經了解到，大多數老年人和殘疾人客戶和患者都希望在家中接受護理，因為家仍然是接受此類護理最安全、最具成本效益的地方之一。

We believe this heightened awareness of the value of home-based care is favorable for our industry and will continue to be a growth opportunity for our company. We understand and appreciate that our operations and growth are dependent on both our dedicated caregivers and other employees who work so incredibly hard providing outstanding care and support to our clients, patients, and their families.

我們相信，對家庭護理價值的認識提高對我們的行業有利，並將繼續成為我們公司的成長機會。我們理解並感激，我們的營運和發展依賴於我們敬業的護理人員和其他員工，他們非常努力地為我們的客戶、患者及其家人提供出色的護理和支援。

With that, let me turn the call over to Brian.

說完這些，讓我把電話轉給布萊恩。

Thank you, Dirk, and good morning, everyone. Our fourth quarter financial results marked a strong finish to 2024 as we continue to deliver consistent profitable growth throughout the year. We achieved 7.5% top line growth and a 10.3% increase in adjusted EBITDA compared with the fourth quarter last year.

謝謝你，德克，大家早安。我們的第四季財務業績標誌著 2024 年的強勁收官，我們全年將繼續實現持續的獲利成長。與去年第四季相比，我們的營業收入成長了 7.5%，調整後 EBITDA 成長了 10.3%。

For the year, revenues were up 9.1% and adjust EBITDA increased 16% over 2023. Our personal care services segment was the key driver of our business with a solid 5.8% organic revenue growth rate over the same period last year.

全年營收成長 9.1%，調整後 EBITDA 較 2023 年成長 16%。我們的個人護理服務部門是我們業務的主要推動力，與去年同期相比，有機收入成長率穩定達到 5.8%。

This growth trend has consistently tracked well above our normal expected range of 3% to 5% this year. These results were supported by strong hiring trends and favorable rate support for personal care services in some of our larger markets.

這一成長趨勢一直遠高於我們今年 3% 至 5% 的正常預期範圍。這些結果得益於我們一些較大市場中強勁的招聘趨勢和對個人護理服務的優惠利率支持。

As a reminder, going forward, we will benefit from the statewide reimbursement increase in Illinois effective January 1, 2025, which will contribute approximately $23 million in annualized revenue with a margin in the low 20s consistent with the 77% rule in the state.

提醒一下，展望未來，我們將受益於伊利諾伊州自 2025 年 1 月 1 日起實施的全州報銷增加，這將帶來約 2,300 萬美元的年化收入，利潤率在 20% 出頭，與該州 77% 的規定一致。

The consolidated results for the fourth quarter included one month of the personal care operations of Gentiva acquired on December 2, 2024, and excluded the company's previous operations in the state of New York as a result of our agreement to divest these operations and exit the state.

第四季的綜合業績包括 2024 年 12 月 2 日收購的 Gentiva 個人護理業務的一個月業績，且不包括該公司先前在紐約州的業務，因為我們已同意剝離這些業務並退出該州。

However, during the fourth quarter, we did receive approximately $3.5 million in retroactive rate increases from the state of New York as a result of our previous reimbursement rate appeal. This revenue has been excluded from our adjusted results and same store metrics.

然而，在第四季度，由於我們先前的報銷率上訴，我們確實從紐約州收到了約 350 萬美元的追溯費率上調。此收入已從我們的調整後結果和同店指標中排除。

We saw a steady improvement in our hospice business in the fourth quarter, supported by the 2025 hospice reimbursement rate update effective October 1, 2024. We achieved 7.8% organic revenue growth and higher average daily census patient days and revenue per patient day compared with the fourth quarter last year.

在 2024 年 10 月 1 日生效的 2025 年臨終關懷報銷率更新的支持下，我們的臨終關懷業務在第四季度穩步改善。與去年第四季相比，我們實現了 7.8% 的有機收入成長，平均每日普查患者天數和每位患者日的收入都有所提高。

Hospice care accounted for 20.1% of our total revenue for the quarter. For our home health services, which is our smallest segment, accounting for 6.1% of our total revenue, we saw a return to positive organic revenue growth of 1.6% over the fourth quarter of last year. We believe home health continues to be complementary to our personal care and hospice services.

臨終關懷佔本季我們總收入的 20.1%。對於我們最小的部門家庭保健服務而言，它占我們總收入的 6.1％，我們看到去年第四季度的有機收入恢復增長 1.6％。我們相信家庭保健將繼續對我們的個人護理和臨終關懷服務起到補充作用。

In addition to organic growth, we have benefited from our recently acquired operations, and we remain focused on identifying additional acquisitions that will be accreted to our operations and support our ability to expand our market reach.

除了有機成長之外，我們還受益於最近收購的業務，我們仍然專注於尋找可以豐富我們業務並支持我們擴大市場範圍的其他收購。

The Gentiva acquisition was the largest in our history, adding approximately $280 million in annualized revenues and significantly expanding our market coverage.

Gentiva 收購是我們歷史上最大的收購，增加了約 2.8 億美元的年收入，並顯著擴大了我們的市場覆蓋範圍。

As we continue to look for acquisitions that align with our growth strategy, our primary objective is to find operations in markets where we can leverage our strong personal care presence and add clinical services so we can offer all three levels of home-based care.

隨著我們繼續尋找符合我們成長策略的收購，我們的主要目標是在能夠利用我們強大的個人護理業務並增加臨床服務的市場中尋找業務，以便我們能夠提供所有三個級別的家庭護理。

We also look for select opportunities to add new personal care markets where we can enter at scale. With the support of a strong balance sheet, even after the Gentiva acquisition, we are well positioned to execute our acquisition strategy.

我們也在尋找精選的機會來拓展新的個人護理市場，以便我們能夠大規模進入這些市場。在強勁資產負債表的支持下，即使在收購 Gentiva 之後，我們仍然能夠很好地執行我們的收購策略。

As Dirk noted, total net service revenues for the fourth quarter were $297.1 million or $293.7 million excluding the retroactive New York rate increase. The revenue breakdown, excluding New York is as follows. Personal care revenues were $216.9 million or 73.8% of revenue.

正如德克所指出的，第四季的總淨服務收入為 2.971 億美元，若不包括紐約追溯升息則為 2.937 億美元。除紐約以外的收入明細如下。個人護理收入為 2.169 億美元，佔收入的 73.8%。

Hospice care revenues were $59 million or 20.1% of revenue. And home health revenues for $17.8 million or 6.1% of revenue.

臨終關懷收入為 5,900 萬美元，佔收入的 20.1%。家庭保健收入為 1,780 萬美元，佔收入的 6.1%。

Sequentially, from the fourth quarter 2024 revenue of $293.7 million excluding New York, we expect the first quarter of 2025 to benefit from both the Illinois rate increase and two additional months of Gentiva revenue, partially offset by one less business day in personal care and some seasonal impact from the winter storms we experienced in certain of our markets.

連續，從 2024 年第四季度不包括紐約在內的 2.937 億美元收入來看，我們預計 2025 年第一季將受益於伊利諾伊州的費率上漲和 Gentiva 額外兩個月的收入，部分抵消了個人護理工作日減少一個和我們在某些​​市場經歷的冬季風暴帶來的一些季節性影響。

Other financial results for the fourth quarter of 2024 include the following. Excluding the impact of the retroactive New York rate increase, our gross margin percentage was 33.4%, essentially flat from the fourth quarter of 2023.

2024 年第四季的其他財務結果包括以下內容。排除紐約追溯升息的影響，我們的毛利率為 33.4%，與 2023 年第四季基本持平。

As expected, we saw a positive impact sequentially from the third quarter of 2024 from the Medicare hospice rate increase and the divestiture of our lower margin New York business.

正如預期的那樣，從 2024 年第三季開始，我們看到了醫療保險臨終關懷費率上漲以及利潤率較低的紐約業務剝離的積極影響。

Looking ahead to the first quarter of 2025, we expect our gross margin percentage to be negatively impacted by our annual merit increases and the normal annual reset of payroll taxes, as well as the mixed shift toward personal care from a full quarter of the Gentiva operations and the Illinois rate increase.

展望 2025 年第一季度，我們預計我們的毛利率百分比將受到年度績效加薪和工資稅的正常年度重置以及 Gentiva 業務整個季度向個人護理的混合轉變和伊利諾伊州利率上調的負面影響。

Cumulatively, we expect these items to contribute a decline sequentially in gross margin percentage of approximately 200 basis points compared to the fourth quarter of 2024, although we will see higher gross margin dollars with the first full quarter of the Gentiva operations and the Illinois statewide rate increase.

累計起來，我們預計這些項目將導致毛利率百分比與 2024 年第四季相比將比去年同期下降約 200 個基點，但隨著 Gentiva 業務的第一個完整季度和伊利諾伊州全州利率的上調，我們將看到更高的毛利率。

G&A expense was 24% of revenue compared with 22% of revenue for the fourth quarter a year ago, primarily as a result of higher acquisition expenses related to Gentiva, which included investment banking and professional fees of approximately $5.6 million.

一般及行政費用佔收入的 24%，而去年同期第四季為 22%，這主要由於與 Gentiva 相關的收購費用增加，其中包括約 560 萬美元的投資銀行和專業費用。

Adjust the G&A expenses for the fourth quarter of 2024 were 20.5%, a decrease from 20.6% in the comparable prior year quarter. As expected, we saw an increase sequentially from the third quarter in our adjusted G&A expense percentage as a result of the divestiture of the New York operations and their respective revenues no longer included in our financial results.

調整 2024 年第四季的 G&A 費用為 20.5%，低於去年同期的 20.6%。正如預期的那樣，由於紐約業務的剝離及其各自的收入不再包含在我們的財務結果中，我們的調整後 G&A 費用百分比較第三季度環比增加。

The company's adjusted EBITDA increased 10.3% to $37.8 million compared with $34.3 million a year ago. Adjusted EBITDA margin was 12.9%, an increase from 12.4% for the fourth quarter of 2024 and higher sequentially from 11.8% in the third quarter of 2024.

該公司調整後的 EBITDA 為 3,780 萬美元，較去年同期的 3,430 萬美元成長 10.3%。調整後的 EBITDA 利潤率為 12.9%，高於 2024 年第四季的 12.4%，且比 2024 年第三季的 11.8% 較上季成長。

As expected, the divestiture of our New York operations had a positive impact of approximately 90 basis points on our adjusted EBITDA margin percentage sequentially from the third quarter of 2024. Adjusted net income per diluted share was $1.38 compared with $1.32 for the fourth quarter of 2023.

正如預期的那樣，從 2024 年第三季開始，紐約業務的剝離對我們的調整後 EBITDA 利潤率百分比產生了約 90 個基點的積極影響。調整後每股攤薄淨利潤為 1.38 美元，而 2023 年第四季為 1.32 美元。

The adjusted per share results for the fourth quarter of 2024 exclude the following. Gain on sale of assets related to the New York divestiture of $0.15. The impact of the lease impairment of $0.20. The impact of the retroactive New York rate increase of $0.14. Acquisition expenses of $0.29 and non-cash stock-based compensation expense of $0.11.

2024 年第四季的調整後每股結果不包括以下內容。與紐約資產剝離相關的資產出售收益為 0.15 美元。租賃減損的影響為0.20美元。紐約利率追溯上調 0.14 美元的影響。收購費用為 0.29 美元，非現金股票薪酬費用為 0.11 美元。

The adjusted per share results for the fourth quarter of 2023 exclude the following. Impact of retroactive collecting bargaining agreements of $0.07, acquisition expenses of $0.07, and non-cash stock-based compensation expense of $0.12.

2023 年第四季的調整後每股結果不包括以下內容。追溯收取談判協議的影響為 0.07 美元、收購費用為 0.07 美元、非現金股票薪酬費用為 0.12 美元。

Our tax rate for the fourth quarter of 2024 was 25.5%, down sequentially from the third quarter as a result of our New York divestiture. As expected, for calendar 2025, we expect our tax rate to remain in the mid 20% range.

由於紐約業務的剝離，我們 2024 年第四季的稅率為 25.5%，季減第三季。正如預期的那樣，對於 2025 年，我們預計稅率將保持在 20% 的中間範圍內。

DSOs were 34.9 days at the end of the fourth quarter of 2024, excluding the Gentiva acquisition compared with 31.7 days at the end of the third quarter of 2024. We have continued to experience consistent cash collection from the majority of our payers.

截至 2024 年第四季末，不包括 Gentiva 收購，DSO 為 34.9 天，而 2024 年第三季末為 31.7 天。我們持續從大多數付款人穩定收取現金。

Our DSOs for the Illinois Department of Aging for the fourth quarter were a more normalized 40 days compared with 32.5 days at the end of the third quarter. Our net cash flow from operations was $10.4 million for the fourth quarter and $116.4 million for the full year 2024.

我們對伊利諾伊州老齡部門第四季度的 DSO 進行了更標準化的 40 天，而第三季末為 32.5 天。我們第四季的營運淨現金流為 1,040 萬美元，2024 年全年的營運淨現金流為 1.164 億美元。

As expected, we saw a lesser benefit from working capital changes in the fourth quarter sequentially from the third quarter. During the fourth quarter of 2024, we received $320,000 in ARPA funding, which we believe is our last currently scheduled disbursement.

正如預期的那樣，我們發現第四季度營運資本變化帶來的好處較第三季度減少。2024 年第四季度，我們收到了 32 萬美元的 ARPA 資金，我們認為這是我們目前安排的最後一筆支出。

We utilized approximately $2.7 million in ARPA funds during the fourth quarter, and we have approximately $11.2 million in funds remaining to be utilized. As of December 30, 2024, the company had cash of $98.9 million with capacity and availability under our revolving credit facility of $577.7 million and $346.6 million respectively.

我們在第四季度使用了大約 270 萬美元的 ARPA 資金，還有大約 1,120 萬美元的資金剩餘可供使用。截至 2024 年 12 月 30 日，該公司擁有現金 9,890 萬美元，循環信貸額度下的容量和可用性分別為 5.777 億美元和 3.466 億美元。

As previously disclosed during the fourth quarter, we entered into an amended and restated credit agreement to increase our revolving credit facility from $600 million to $650 million and extend the maturity date through July 2028.

正如第四季度所披露的那樣，我們簽署了一項修訂和重述的信貸協議，將我們的循環信貸額度從 6 億美元增加到 6.5 億美元，並將到期日延長至 2028 年 7 月。

With our consistently strong cash flow, we have already been able to make payments on a revolver subsequent to the Gentiva acquisition with a $10 million reduction in late December and an additional $10 million reduction to date in the first quarter of 2025.

憑藉我們持續強勁的現金流，我們已經能夠支付收購 Gentiva 後的循環信貸，12 月底減少了 1000 萬美元，2025 年第一季迄今又減少了 1000 萬美元。

We have a capital structure that supports our ability to continue to invest in our business and pursue our strategic growth initiatives, including acquisitions. We will continue to selectively pursue acquisitions in 2025, complement our organic growth in align with our strategy.

我們的資本結構支持我們繼續投資於我們的業務並實施包括收購在內的策略成長計劃的能力。我們將在 2025 年繼續有選擇地進行收購，根據我們的策略補充我們的有機成長。

At the same time, we expect to maintain our disciplined capital allocation strategy and continue to diligently manage our net leverage ratio through ongoing debt reduction. With the current net leverage of just under 1 time, we are well positioned as we head into 2025.

同時，我們希望保持嚴謹的資本配置策略，並透過持續減少債務繼續努力管理我們的淨槓桿率。目前的淨槓桿率略低於 1 倍，我們在邁向 2025 年時已做好了充分準備。

This concludes our prepared comments this morning, and thank you for being with us. I'll now ask the operator to please open the line for your questions.

今天上午我們的準備演講到此結束，感謝您的參與。現在請接線員開通熱線來回答您的問題。

Thank you. We will now begin the question-and-answer session. (Operator Instructions)

謝謝。我們現在開始問答環節。（操作員指令）

Today's first question comes from Joanna Gajuk with Bank of America. Please go ahead.

今天的第一個問題來自美國銀行的 Joanna Gajuk。請繼續。

Oh yes hi how are you? Thanks so much for taking the question here so I guess maybe first, on the quarter a couple of number of questions. In terms of the average revenue per hour in the quarter four, right, it was that sequential, so I assume that's the Gentiva deal, impact there.

噢是的你好嗎？非常感謝您在這裡回答這個問題，所以我想先問一下關於本季的幾個問題。就第四季度每小時的平均收入而言，它是連續的，所以我認為這是 Gentiva 交易的影響。

So, as we think about kind of the run rate including for fully Gentiva for three months, we're coming up with call it $25.25, $50 per hour, versus the legacy add of $28. So is it in the ballpark because, I understand that Texas. Our average hourly rate is much lower, so I just want to confirm kind of the math we're doing here.

因此，當我們考慮包括 Gentiva 三個月在內的全面運行率時，我們將其定為 25.25 美元，每小時 50 美元，而傳統的附加費為 28 美元。所以這是大致相同的，因為我了解德克薩斯州。我們的平均小時工資要低得多，所以我只是想確認一下我們在這裡做的計算。

Yeah, Joanna, I think that's right. Texas is a lower bill rate. We had one month in Q4. We'll have a full quarter in Q1, so I definitely wouldn't anticipate that to impact that and bring that just average per hour down. So the reimbursement rate in Texas is a little under $17 an hour, so it definitely is a little different from the files as we've talked about.

是的，喬安娜，我認為是對的。德州的費率較低。我們在第四季有一個月的時間。我們第一季會有完整的季度，所以我絕對不會預期這會對此產生影響，也不會導致每小時平均值下降。因此，德克薩斯州的報銷率略低於每小時 17 美元，所以它肯定與我們談論的文件有點不同。

Previously that we will see a little bit of offsets of that because we are getting the 5.5% increase in Illinois, which is our largest state. So net net there will be kind of a plus and minus there. So I would expect to see it probably slightly down as a result of that, but that's to be the kind of progression Q4 and Q1.

此前，我們會看到一些抵消，因為我們最大的州伊利諾伊州的增幅為 5.5%。因此，淨淨值會有一定的優點和缺點。因此我預計它可能會因此略有下降，但這將是第四季度和第一季的進展。

Okay thank you and another I guess number question here so in the quarter you said the organic. I guess volumes in in your personal covers. Did I get that right? Was it up, slightly? Could you, I guess remind me that number and I guess how does it compare versus your third quarter because I think in third quarter, the growth was maybe, comparable like 0.6% or something like that organic census.

好的，謝謝你，我想這裡還有一個數字問題，所以在本季度你所說的是有機的。我猜你的個人封面裡有捲數。我說得對嗎？是不是稍微漲了一點？您能否提醒我這個數字，以及與第三季相比如何，因為我認為第三季的成長率可能是 0.6% 左右，或是類似有機普查的數字。

Yeah, I think if you look at just personal care hours, quarter over quarter, we were up slightly, or year over year we're just under 1%, down slightly sequentially is basically flat. And if you look at just kind of volumes and PCS and Q4 and what impact is there, we've talked about the redeterminations.

是的，我認為如果只看個人護理時間，每個季度環比增長略有增加，同比則略有下降，環比基本持平。如果您只看數量、PCS 和 Q4 以及它們的影響，我們已經討論過重新確定的問題。

We saw a spike in discharges in October, started seeing that number decrease steadily through the Remainder of the fourth quarter and November and December, January again saw a little deceleration there and discharges. So, we believe that the redetermination process is largely done if not completely done.

我們發現 10 月排放量出現激增，然後在第四季度剩餘時間以及 11 月和 12 月，排放量開始穩定下降，1 月排放量又略有下降。因此，我們認為，重新確定過程即使沒有完全完成，基本上已經完成。

And we're starting to see admission volume start to tick up, at least we did in January. So optimistic that, when we look at just volume growth and PCS for 2025, we've talked about our long-term goal of 3% to 5% revenue increase. I think we'll be at kind of the high end of that range again.

我們開始看到入場人數開始上升，至少在一月是這樣的。我們非常樂觀，當我們只看 2025 年的銷售成長和 PCS 時，我們談到了營收成長 3% 至 5% 的長期目標。我認為我們將再次達到該範圍的高端。

Oh, I'm sorry, so you're talking about, for the full year 2025 to be towards the higher end.

哦，對不起，您說的是，2025 年全年的收入將接近較高水平。

Correct.

正確的。

Right, okay, and then because I guess, you alluded to like growing volumes, maybe 2%. So, I'm just trying to bridge, how you're going to get from what call it, a little bit less than 1%, I guess 2% because I want to say you also talk about previously about using your new scheduling up and I guess improving utilization, there.

好的，好的，然後因為我猜你提到了增長量，可能是 2%。所以，我只是想溝通一下，你將如何從所謂的略低於 1% 的水平，我猜是 2%，因為我想說，你之前也談到了使用新的調度，我想就是提高利用率。

And the average fill rate, so can you, kind of walk us through maybe, kind of the build, how you're going to get the 2% growth in organic volumes.

以及平均填充率，您能否向我們介紹如何實現 2% 的有機量成長。

Yeah, I mean, I think if you see one, we see that the redetermination process is largely done. So, we're not seeing the discharge rate is coming down to a more normalized level. We're also starting to see admission volumes tick up, which tells me that the referral sources are now, more focused on new clients rather than looking in redetermination.

是的，我的意思是，我認為如果你看到一個，我們就會看到重新確定過程基本上已經完成。因此，我們沒有看到放電率下降到更正常的水平。我們也開始看到入院人數逐漸增加，這顯示現在的推薦來源更著重於新客戶，而不是重新確定客戶。

So, I think I'll just on the volume side from the referral side. We're starting to see that number come up. As you point out, we have done a lot of things with our caregiver application. We're continuing to roll that out.

因此，我認為我只是從推薦方面來談數量方面。我們開始看到這個數字上升。正如您所指出的，我們已經針對護理人員應用程式做了很多事情。我們正在繼續推行這項措施。

It's fully rolled out in the state of Illinois where that we began to rollout in New Mexico, and, optimistic that we'll see some continued growth through that process, helping us with our service percentage.

我們首先在新墨西哥州推出了這項服務，隨後在伊利諾伊州全面推出，我們樂觀地認為，透過這個過程，我們將看到服務持續成長，從而幫助我們提高服務百分比。

So, I think optimistically, we're shooting for that 2% to 2.5% hours growth and I think Brian alluded to in his comments that, we saw a little bit of challenges volume wise, in Q1 related to weather, in January, that's kind of normal. It kind of depends on when a snowstorm hits. If it's a weekend, good. If it's a Monday, not so good.

因此，我樂觀地認為，我們的目標是實現 2% 至 2.5% 的小時數增長，我認為 Brian 在他的評論中提到，我們在第一季度看到了與天氣有關的一些數量挑戰，但在 1 月份，這很正常。這有點取決於暴風雪何時來臨。如果是周末就好了。如果是星期一，那就不太好了。

So, we saw a little bit of challenges there early in January, but again, January numbers look pretty good in spite of that.

因此，我們在 1 月初看到了一些挑戰，但儘管如此，1 月的數據看起來還是相當不錯的。

Thank you and if I may. Thank you for the for the comments at the start of the call around the potential, reforms which we don't know, what which items like is going to be finalized and you know you mentioned two of them, our interpretation was, there's, some support for the work requirements as well.

謝謝，如果可以的話。感謝您在電話會議開始時就潛在的改革所發表的評論，我們不知道哪些項目將最終確定，您提到了其中兩個，我們的解釋是，也對工作要求提供了一些支持。

So can you talk a little bit about, how that would, if at all impact your business if that was to happen, nationwide. Thank you.

那麼，您能否談談，如果這種情況在全國範圍內發生，將對您的業務產生什麼影響？謝謝。

Yeah, I mean, we just don't see any direct impact from that. If you think about the clients we serve, they're majority elderly in many cases also disabled, so, work requirement would have a negligible direct effect.

是的，我的意思是，我們只是沒有看到任何直接的影響。如果你想想我們服務的客戶，他們大多是老年人，很多時候也是殘疾人，所以，工作要求產生的直接影響可以忽略不計。

If anything, it might actually potentially add some caregivers availability to us. So we don't see any negative to our, kind of primary clients that we take care of.

如果有的話，它實際上可能會為我們增加一些護理人員的可用性。因此，我們認為這不會對我們所服務的主要客戶產生任何負面影響。

The next question comes from Brian Hendricks with RBC Capital Markets. Please go ahead.

下一個問題來自 RBC Capital Markets 的 Brian Hendricks。請繼續。

Hi, this is Mike Murray on for Brian. Thanks for taking my question. I wanted to drill down a little bit more into the Texas market. There's a sizable difference between healthcare minimum wage and the state minimum wage. You've obviously had a lot of success driving, volumes with rate.

大家好，我是 Mike Murray，代表 Brian 發言。感謝您回答我的問題。我想更深入地了解德克薩斯州市場。醫療保健最低工資和州最低工資之間存在相當大的差異。顯然，您在駕駛方面已經取得了很大成功，無論是數量還是速度。

Do you think you could outgrow your long-term personal care growth target of 3% to 5% given this delta and the attractive demographics in in Texas? Thanks.

考慮到這一差異以及德克薩斯州具有吸引力的人口統計數據，您是否認為您可以超越 3% 至 5% 的長期個人護理成長目標？謝謝。

Well, I think as you as as we have said many times, entering into the state of Texas was a a goal of ours for a long period of time due to the growth in the state. Both in just general population and the elderly growth.

嗯，我想正如我們多次說過的，由於德克薩斯州的發展，進入德克薩斯州是我們長期以來的目標。無論是一般人口或是老年人口的成長。

So, what we really believe will happen is it can allow us to remain near the top of that 3% to 5% at this point in time. Now whether or not we're able to exceed that due to the Texas market, we'll have to wait and see because we're still relatively new to it, but we do think it is very much a positive for our same store growth.

因此，我們真正相信的是，它可以讓我們目前保持 3% 到 5% 的峰值附近。現在，我們是否能夠憑藉德州市場超越這個目標，我們還需拭目以待，因為我們對這個市場還比較陌生，但我們確實認為這對我們的同店成長非常有利。

Thank you. I just have a quick follow up or a different question. So, hospice saw continued admission pressure, which led to sequential decline in census.

謝謝。我只是想快速跟進一下或問一個不同的問題。因此，臨終關懷機構的入院壓力持續存在，導致入院人數持續下降。

I appreciate that you're putting in a new operations and sales leadership in this segment, but I wanted to see if you could walk us through the drivers of the softness. Are you seeing lower admissions from certain referral sources? Are you seeing increased competition? Any color would be helpful. Thank you.

我很欣賞您為這一領域注入新的營運和銷售領導力，但我想看看您是否可以向我們介紹一下導致疲軟的因素。您是否發現某些轉診來源的入院率較低？您是否發現競爭加劇了？任何顏色都會有幫助。謝謝。

Yeah, on the admission volume, not overly concerned. We did, as we mentioned, we've, really revamped our sales and marketing team. We've been going through ongoing sales training that started up in Q4, actually by the tail end of Q3. We're wrapping that up or just wrapped it up this past week.

是的，關於入學人數，不是太擔心。正如我們所提到的，我們確實改組了我們的銷售和行銷團隊。我們一直在進行銷售培訓，培訓​​從第四季開始，實際上是在第三季末。我們正在結束這項工作，或者上週剛結束。

So, sales team has been fully retrained, we're, this new sales leadership. I feel optimistic and if you look at, really our January numbers were actually pretty strong from an admission standpoint. So not, real concern there, you do have in hospice, traditionally kind of pre-COVID, there was, a little bit of seasonality when you looked at admission volumes and ADC, Q4 tended to be kind of a, one of your tighter or more challenging.

因此，銷售團隊已經接受了全面的再培訓，我們是新的銷售領導。我感到很樂觀，如果你看一下，你會發現從入學角度來看，我們一月份的成績確實相當強勁。因此，這並不是真正的擔憂，在臨終關懷方面，傳統上在 COVID 之前，當您查看入院量和 ADC 時，會受到一點季節性的影響，第四季度往往是比較緊張或更具挑戰性的季度之一。

Quarters just because of the holidays, and then you come out of that, and you know your T1 looks up pretty good. So, optimistic that the changes that we made in the sales leadership will pay dividends for us in 2025 and that's when we look at kind of where we think we'll land, we've talked about, 5% to 7% as our target on the hospice side. I'm optimistic that we'll be towards the higher end there for 2025.

只是因為假期而出現了一個季度，然後你走出了那個季度，你知道你的 T1 看起來相當不錯。因此，我們樂觀地認為，我們在銷售領導層方面所做的改變將在 2025 年為我們帶來紅利，而那時我們將考慮我們的目標，我們已經討論過，臨終關懷方面的目標為 5% 到 7%。我樂觀地認為，到 2025 年，我們將達到更高的目標。

Awesome thank you so much.

太棒了，非常感謝。

The next question comes from Brian Tanquilut with Jefferies. Please go ahead.

下一個問題來自 Jefferies 的 Brian Tanquilut。請繼續。

Hey, good morning. Maybe Dirk, just to follow up on the questions on policy, as we think about the potential for changes to the FMAP. How are you thinking about how that could impact you given number one, the geographic footprints that you have and then maybe the flip side of this, any case studies that you can point to where in states.

嘿，早安。也許 Dirk，只是為了跟進政策問題，因為我們正在考慮 FMAP 變化的可能性。您如何看待這會對您產生什麼影響？首先，考慮到您所擁有的地理足跡；然後，也許還有另一方面，您可以指出各州的案例研究。

Where maybe they've block granted Medicaid, kind of like what have the states done in terms of adapting to that maybe using more home health and, just measures like that that you can point us so that we can frame how to think about, your exposure to Medicaid risk if Congress changes the program. Thanks.

他們可能已經批准了醫療補助，有點像各州在適應這一點方面所做的那樣，也許使用更多的家庭保健等措施，你可以指出我們，以便我們可以構思如何思考，如果國會改變該計劃，你將面臨什麼樣的醫療補助風險。謝謝。

Yeah, well, if there's a reduction in FMAP or quite honestly FMAP or block grants, we believe and have consistently believed and stated that Addus is in the right place in the Medicare environment. We are the company; we're the low-cost provider. We're in the home. We're not in the institutions.

是的，如果 FMAP 或整體撥款減少，我們相信並且一直相信並表示 Addus 在醫療保險環境中處於正確的位置。我們是公司；我們是低成本供應商。我們在家裡。我們不在機構內。

We have demonstrated over the last four or five years with our value-based care approach in two or three of our markets that we're able to lower the cost to the state or to the particular Medicaid payer in that market, whether it be a fewer e room visit.

過去四、五年來，我們已經在兩三個市場中運用基於價值的醫療護理方法，證明我們能夠降低該市場中州政府或特定醫療補助支付方的成本，無論是較少的電子病房就診次數。

Whether it be readmits to hospitals, trying to keep patients out of the hospitals, and quite frankly, as you're aware, we're much less expensive for our general population base if we're able to keep them in their home as opposed to them ending up in a nursing facility, which is going to have to be paid at that higher cost. By the state.

無論是重新入院，還是試圖讓患者遠離醫院，坦白說，如你所知，如果我們能夠將患者留在家中，而不是最終將他們送入護理機構，那麼對於我們普通民眾而言，花費就會少得多，而護理機構的費用則會更高。由國家決定。

So again, we're watching all of the issues I mentioned earlier as it relates to Medicaid. We've been working very closely with our state and federal lobbyists as to what may happen, but at this point, we're pretty positive on the fact that whatever change may or may not happen through Medicaid, Addus is in the right place, and we believe we'll be able to handle those changes.

因此，我們再次關注我之前提到的與醫療補助相關的所有問題。我們一直在與州和聯邦遊說者密切合作，以了解可能發生的事情，但目前，我們非常樂觀地認為，無論醫療補助計劃可能發生或不發生任何變化，Addus 都處於正確的位置，我們相信我們能夠處理這些變化。

No, I appreciate that. And then maybe just as a follow up to Joanna's question on volumes are we right in thinking that you're still, there's still supply demand imbalance here and that you're not filling essentially every order so as you ramp up hiring that, we should see some volume growth that gets at least that 2% number that you mentioned is that is that the right way to frame that?

不，我很感激。然後也許只是作為對 Joanna 關於銷量問題的跟進，我們是否正確地認為您這裡仍然存在供需失衡，並且您基本上沒有完成每個訂單，所以當您加大招聘力度時，我們應該看到銷量增長至少達到您提到的 2%，這是正確的表達方式嗎？

Yeah, I think, in most of our markets, we have that imbalance and so there is just there is an opportunity to the extent that we're better able to leverage our existing workforce to give them more hours, which is, really where a lot of our focus is on now.

是的，我認為，在我們的大多數市場中，都存在這種不平衡，因此，我們就有機會更好地利用現有勞動力，讓他們有更多工作時間，而這實際上是我們現在關注的重點。

I think we're in a pretty good spot hiring and where I really want to see our teams do better is actually Getting more hours out of our existing workforce it's a lower cost way to do business. It also should help with turnover rates because that's really the number one reason why caregivers leave us is, ironically that they can't get all the hours that they want.

我認為我們在招募方面處於一個相當不錯的位置，我真正希望看到我們的團隊做得更好的實際上是從我們現有的勞動力中獲得更多的工作時間，這是一種成本更低的經營方式。這也應該有助於降低離職率，因為諷刺的是，這確實是護理人員離開我們的首要原因，因為他們無法獲得他們想要的所有工作時間。

And so that's where we're really focusing our attention, and I think there's opportunity to help us get to that 2%, 2.5% hours growth consistently.

所以這就是我們真正關注的重點，我認為這有機會幫助我們持續實現 2%、2.5% 的小時數成長。

Awesome thanks Brad.

太棒了，謝謝布拉德。

The next question is from Tao Zhu with Macquarie. Please go ahead.

下一個問題來自麥格理的陶鑄。請繼續。

Hey, good morning. Thank you for taking my question. Just to follow up on Medicaid, thinking about the mechanics here, if the 2025 budget contains certain cuts to the federal share of Medicaid dollars, when do you think that will hit your state reimbursement? Is it a later 2025 event or more of a 2026 event?

嘿，早安。感謝您回答我的問題。只是為了跟進醫療補助計劃，思考這裡的機制，如果 2025 年預算對醫療補助計劃的聯邦份額進行一定程度的削減，您認為何時會影響您的州報銷？它是 2025 年稍後發生的事件，還是 2026 年發生的事件？

And I think you also mentioned that state lawmakers could step in to soften the blow, given the value proposition. Curious, what are the discussions there today.

我想您也提到，考慮到價值主張，州立法者可以介入以減輕打擊。好奇，今天那裡討論的是什麼。

Yeah, I think as far as when it would hit, I don't think it would affect 2025 at all. It would be years after that that I think anything that might be changed with Medicaid would come into effect.

是的，我認為就其何時發生而言，我認為它根本不會影響 2025 年。我認為，醫療補助計劃的任何變更可能還要過幾年才會生效。

Yeah, I think, a lot of states are currently in their budget process and so, I agree with Dirk. I think really if you if you saw pressure on state budgets, it's probably more of a 2026 item than a 2025 item for them.

是的，我認為很多州目前正處於預算過程中，因此我同意德克的觀點。我認為，如果你真的看到州預算面臨壓力，那麼對他們來說，這可能更多的是 2026 年的問題，而不是 2025 年的問題。

Got it. Thanks for the clarity. So, Brian, you talked about the expected 200 basis point, margin decline from the fourth quarter to the first quarter. How much of that is attributed to Gentiva? I'm wondering what the margin profile is today and how much cost synergies you can extract following the system, integrations that you have.

知道了。謝謝你的澄清。布萊恩，您談到了預計利潤率從第四季度到第一季將下降 200 個基點。其中有多少歸功於 Gentiva？我想知道今天的利潤狀況如何，以及按照你們現有的系統和整合，你們可以提取多少成本綜效。

Yeah, I think if you think about it, how, with Gentiva, Texas being the largest piece of that, their gross margins are kind of in that low 20s.

是的，我想如果你仔細想想，你會發現，由於德州的 Gentiva 是其中最大的一塊，所以他們的毛利率大概在 20% 以下。

So that's definitely going to be impactful as part of the mix with additional two months, we typically are going to see, the normal every year annual reset of payroll taxes and merits and those kinds of things, are probably, a little over 100 basis points for us just sequentially, so it's probably just under 100 basis points, it's probably just a mixed shift overall.

因此，這肯定會對額外兩個月產生影響，我們通常會看到，每年正常的工資稅和福利等年度重置可能對我們來說只是連續的 100 個基點多一點，所以它可能略低於 100 個基點，總體來說可能只是混合轉變。

Got you. And lastly, if I may, the hospice revenue per patient day grew 5.6% year on year, which is higher than the Medicare rate increase in October. What, what's, contributing to that strengthening rate in hospice?

明白了。最後，如果可以的話，每位病人每天的臨終關懷收入同比增長了 5.6％，高於 10 月份的醫療保險費率增長。什麼因素導致了臨終關懷率的提高？

Yeah, I think in the quarter, so we got the hospice rate increase, which is obviously the larger component there. Outside of that, we had probably just a little bit of mixed shift, and we also had, I think, a positive impact in the quarter from the implicit price concession in hospice. They performed very well, and I think that was the other difference in what you saw year over year in Q4.

是的，我認為在本季度，我們的臨終關懷率有所增加，這顯然是其中較大的組成部分。除此之外，我們可能只是有一些混合轉變，而且我認為，臨終關懷領域的隱性價格優惠也對本季產生了積極影響。他們的表現非常出色，我認為這就是第四季度與去年同期相比的另一個不同之處。

Great. Thank you.

偉大的。謝謝。

The next question comes from Andrew Mark with Buckley's. Please go ahead.

下一個問題來自 Buckley 的 Andrew Mark。請繼續。

Good morning. This is Evan on for Andrew. How is the integration of Gentiva progressing? Is there any timeline you can share to achieve mature EBITDA margins? And does this acquisition impact free cash flow conversion and the pace of deals for 2025? Thanks.

早安.這是埃文 (Evan) 代替安德魯 (Andrew)。Gentiva 的整合進度如何？能分享一下實現成熟 EBITDA 利潤率的時間表嗎？此次收購是否會影響自由現金流轉換和 2025 年的交易節奏？謝謝。

Yeah, I'll start with just talking about the pace of integration. As Dirk mentioned, this is not our typical integration, even though it was our largest transaction to date, there were a lot more functions we took over day one, the biggest of which was really payroll and benefits, and hats off to the team, both internally at the sports center and then also.

是的，我首先要談談整合的速度。正如德克所提到的，這不是我們典型的整合，儘管這是我們迄今為止最大的交易，但我們在第一天接管了很多職能，其中最大的職能實際上是工資和福利，我們向團隊致敬，包括體育中心內部以及其他方面。

Looking at the Gentiva team, they did a remarkable job in making that happen and go very smooth, surprisingly smooth, process on that, integration. Really, if you look at just kind of pace of integration, we're steadily kind of working through, the other items, not as heavy of a lift as the payroll and benefits, the probably the biggest one that will be out there is converting their billing and scheduling system.

看看 Gentiva 團隊，他們做了出色的工作，使這一目標得以實現，並且整合過程進行得非常順利，出奇的順利。真的，如果你只看整合的速度，我們正在穩定地處理其他項目，這些項目並不像工資和福利那麼繁重，可能最大的項目是轉換他們的計費和排程系統。

We're waiting till we get home care homebase that we've been working with over the past several years developing a new product this personal care focus, before we roll that out to the Gentiva team.

我們正在等待家庭護理基地的落成，過去幾年來我們一直與該基地合作開發一款以個人護理為重點的新產品，然後再將其推廣給 Gentiva 團隊。

So that's probably more like a, an 18-month time frame, before they come on the docket, they'll be kind of back and loaded, on that process. So, that's probably the biggest remaining integration item, but again it's pretty far off in the future.

因此，這可能更像是一個 18 個月的時間框架，在他們進入審理程序之前，他們會回到這個流程並做好準備。所以，這可能是剩下的最大的整合項目，但是它仍然距離未來相當遙遠。

Yeah, it is real quick on the cash flow, so I think, out of the gate early on I think we've had a pretty good transition as far as billing practices and over into our system. So, like Brad mentioned, we, we've not changed their billing systems, a lot of that's going to remain pretty static, so no real impact there. I think conversion on cash flow is going to remain pretty consistent.

是的，現金流確實非常快，所以我認為，從一開始我們就認為，就計費實踐和系統而言，我們已經有了相當好的過渡。因此，就像布拉德提到的那樣，我們沒有改變他們的計費系統，其中許多系統將保持相當靜態，所以不會產生實際影響。我認為現金流轉換將保持相當穩定。

A couple of little things as we kind of move through some of the enrollment changes, but nothing, material. So, I think we're actually very pleased with how that's progressed for the first, 2.5 months of the acquisition.

在我們進行一些招生變更的過程中，發生了一些小事，但並不是什麼實質的事情。所以我認為，我們對收購後前 2.5 個月的進展感到非常滿意。

And just a quick follow up on Gentiva, the $5.6 million in investment banking professional fees during the quarter. Was that included in the $7 million worth of acquisition expenses? Thanks.

簡單說一下 Gentiva，本季的投資銀行專業費用為 560 萬美元。這筆費用包含在 700 萬美元的收購費用中嗎？謝謝。

That that is included in that $7 million. So those are the larger components of why it was $7 million during the quarter and all in acquisition costs.

這已經包含在 700 萬美元中了。所以這些就是導致本季營收為 700 萬美元且全部為收購成本的主要原因。

Thanks for the call.

感謝您的來電。

The next question is from Scott Fidel with Stephens. Please go ahead.

下一個問題來自史蒂芬斯的斯科特·菲德爾。請繼續。

Hi, thanks. Good morning. First question, just wanted to pick up, Dirk, on some of the comments you had made around, still wanting to prioritize, pursuing, acquisition opportunities where there's scaled, personal care, assets, still out there.

嗨，謝謝。早安.第一個問題，德克，我只是想回答你剛才提到的一些評論，你仍然希望優先考慮和追求有規模的個人護理資產的收購機會。

Can you maybe, can the team maybe give us, some flavor on sort of, that pipeline and. Terms of, how many, you know those types of properties, maybe out there as an opportunity, for M&A, and then from a timing perspective, I know you're recommitting, to your core M&A strategy with all the comments that you've made, today and in the press release last night, from a timing perspective though, would you want to see ultimately how.

您能否，團隊能否為我們介紹一下該管道的一些情況？就數量而言，您知道這些類型的資產有多少，也許可以作為併購的機會，然後從時間角度來看，我知道您會重新致力於您的核心併購策略，從您今天和昨晚的新聞發布會上發表的所有評論來看，從時間角度來看，您想看看最終會如何。

I guess the sort of the legislative, process does play out in Washington just to get visibility on, ultimately if there are changes to Medicaid reimbursement. How those could flow through, or would you if an opportunity strikes, I guess ahead of that, would you pursue that, still while I guess the legislative sausage making is still playing out in Washington.

我想，華盛頓的立法程序最終只是為了讓人們了解醫療補助報銷是否會改變。這些將如何進行，或者，如果機會來臨，我想在此之前，你會追求它嗎，而我猜立法香腸製作仍在華盛頓進行。

Yeah, I think the legislative potential changes on Medicaid. We believe, as I said earlier, we'll be able to handle those as a company because of our position in the market. So, we are not changing our strategy or potential timing on deals based on that.

是的，我認為醫療補助的立法可能會改變。我們相信，正如我之前所說，憑藉我們在市場中的地位，我們將有能力作為一家公司來處理這些問題。因此，我們不會因此改變我們的策略或交易的潛在時機。

Now, obviously we'll stay aware of that. We'll continue to look at what that might be, but we are in the process now of looking at opportunities that could further our not only our personal care strengthens in various states but also so adding all three levels of care in markets out there that might be available to us.

現在，我們顯然會意識到這一點。我們將繼續研究這可能是什麼，但我們現在正在尋找機會，不僅可以進一步加強我們在各州的個人護理，還可以增加我們可能在市場上提供的所有三個級別的護理。

And so as far as the number of things we're seeing, there's a number of smaller deals out there. I think that's what you're going to see probably for the majority of 2025. I do think. Based on some of the recent discussions we've had, there are some larger transactions coming out potentially at the end towards the end of 2025.

就我們所看到的數量而言，有許多規模較小的交易。我認為這可能是 2025 年大部分時間都會看到的情況。我確實認為。根據我們最近的一些討論，2025 年底可能會出現一些更大的交易。

Some of those are in the clinical care area where, pricing may be difficult for us, but it is something we will continue to look at. So, I think overall I would say our strategic goal with our development, our acquisitions meeting our 10% target is still in effect today, and the potential changes from the Medicaid, any Medicaid changes are not a concern of ours today.

其中一些屬於臨床護理領域，定價對我們來說可能很困難，但我們會繼續關注。所以，我認為總的來說，我們的發展策略目標、我們的收購達到 10% 的目標今天仍然有效，而醫療補助的潛在變化、任何醫療補助變化都不是今天我們關心的問題。

Okay, got it. And then as a follow up question, just wanted to go back to margins and Brian, appreciate, some of the color on sequential, good guys and bad guys on margin for the first quarter.

好的，明白了。然後作為後續問題，我只想回到利潤率問題，布萊恩，請欣賞第一季利潤率連續、好人和壞人的一些細節。

So, it might be helpful to just maybe to expand it out, in terms of your thinking for the full year, and anything you'd want to call out as we think about modeling, either from a positive, or negative perspective in terms of.

因此，就您對全年的思考而言，以及在我們考慮建模時您想要指出的任何事情（無論是從積極還是消極的角度），也許將其擴展開來都會有所幫助。

Sort of, I guess, the integration of Gentiva does that provide sort of a ramping dynamic on margins to some degree, improvements in hospice, same store growth that that Brad had mentioned, normal seasonal factors just thought, anything you could throw at us, to help, sort of provide more details on how you see margins sort of playing out over the rest of the year and then even from a year over year perspective in 2025 versus 2024. Thanks.

我想，Gentiva 的整合在某種程度上會為利潤率帶來某種程度的提升，臨終關懷的改善，布拉德提到的同店增長，正常的季節性因素，以及您可以向我們提供的任何信息，以幫助我們提供更多細節，說明您如何看待利潤率在今年剩餘時間內的表現，甚至從 2025 年與 2024 年的同比角度來看。謝謝。

Yes, and I'll preface it just thinking about the business that we have today. Obviously, any additional, acquisitions, particularly in the clinical services space is going to change that mix a little bit, but that put to the side.

是的，首先我先考慮一下我們今天的業務。顯然，任何額外的收購，特別是在臨床服務領域的收購都會稍微改變這種組合，但這一點可以放在一邊。

I think our normal seasonality that we expect as we kind of look at gross margins down to EBITDA Q1 is always our low water mark with payroll tax resets and merits and everything like along those lines. We usually see a little bit of lift into Q2.

我認為，當我們將毛利率降至 EBITDA Q1 時，我們預期的正常季節性始終是我們的低水位線，包括工資稅重置和優點以及類似的東西。我們通常會看到第二季出現小幅上漲。

I think it's typically been, historically 30-40 basis points and the Q2 improvement, Q2 to Q3 usually pretty flat, nothing really kind of moving the needle there and then Q4 is usually our best quarter of the year. We get our hospice rate increase then, which is, today about 20% of our business, but we also kind of get some additional relief on some of those payroll tax caps, in Q4 as well.

我認為，從歷史上看，通常情況是，第二季度的改善幅度為 30-40 個基點，而第二季度到第三季度通常相當持平，沒有什麼真正意義上的推動作用，而第四季度通常是我們一年中最好的季度。我們的臨終關懷費率當時有所增加，目前約占我們業務的 20%，但在第四季度，我們也獲得了一些工資稅上限的額外減免。

So, it's kind of a, step up kind of through the year than what we typically historically have seen and what we would expect this year again in the absence of any further acquisitions which might change the mix slightly.

因此，這是一種全年的進步，比我們通常歷史上看到的以及我們今年的預期要高，因為沒有任何進一步的收購可能會稍微改變組合。

Great. What I'm going to trying to sneak one more in here if I could just, appreciate the update just on the debt pay down, Brian, is there any type of placeholder, I know obviously this could be contingent on M&A, but you know if we're thinking about, sort of utilizing free cash flow and to pay down debt, any type of marker you'd want to give us on maybe what you know for 2025 could be a sort of a good bogey for full year debt pay down.

偉大的。我想在這裡再偷偷問一句，如果可以的話，請欣賞關於債務償還的最新消息，布萊恩，是否有任何類型的佔位符，我知道這顯然可能取決於併購，但你知道，如果我們考慮利用自由現金流來償還債務，你想給我們提供任何類型的標記，也許你知道 2025 年可能成為全年債務償還的一個很好的預兆。

Yeah, if you think about just, kind of our typical conversion rate from operating cash flow, we usually see that kind of in that, mid 70s of GAAP, but as if you think about, projections for this year, that would anticipate us being in kind of that $115 million, $120 million and free cash flow for this year.

是的，如果您想一想，我們典型的營運現金流轉換率，我們通常會看到這種轉換率在 GAAP 的 75% 左右，但如果您想一想今年的預測，預計今年我們的自由現金流將達到 1.15 億美元、1.2 億美元。

So, in the absence of M&A and working cap changes, a lot of that would be, targeted for debt repayment. Again, there could be some timing differences quarter to quarter, but that would be kind of how we would see it for the full year so you can kind of break that down and do have to kind of see, what the potential is there.

因此，在沒有併購和營運資本變化的情況下，許多資金將用於償還債務。同樣，每個季度之間可能會存在一些時間差異，但這差不多就是我們對全年的看法，因此你可以對其進行分解，看看其中存在哪些潛力。

So, coming out of the year at $220 million in debt, I mentioned we've already paid down $10 million this quarter on the revolver, but obviously opportunities to continue to lighten that load through cash flow in the absence of M&A, but again our preference and our focus is on, continuing to utilize our balance sheet on the M&A front.

因此，今年的債務為 2.2 億美元，我提到我們本季已經償還了 1000 萬美元的循環信貸，但顯然在沒有併購的情況下，我們有機會繼續透過現金流減輕這一負擔，但我們的偏好和重點是繼續在併購方面利用我們的資產負債表。

Okay great thank you.

好的，非常感謝。

The next question will come from Jared Halls of William Blair. Please go ahead.

下一個問題來自 William Blair 的 Jared Halls。請繼續。

Hey, good morning, thanks for taking the questions and appreciate all the color thus far, maybe just on the policy environment, I'm wondering with the backdrop of let's call it trying to drive more efficiency in payments.

嘿，早上好，感謝您回答這些問題，並感謝迄今為止的所有細節，也許只是在政策環境方面，我想知道在我們稱之為試圖提高支付效率的背景下。

Do you think that can catalyze an acceleration of value-based or accountable care type reimbursement models from, for home care, looking at your state managed care partners just curious if you see any kind of incremental lift from that.

您是否認為這可以加速基於價值或負責任的護理類型報銷模式的發展，對於家庭護理而言，看看您所在州管理的護理合作夥伴，我只是好奇您是否看到任何形式的增量提升。

Well, I think it certainly could I mean, certainly as the federal government's looking at efficiencies throughout the various departments, states may look at that also. And for us, that's one of the reasons why we feel like it puts us in a great position with our value-based care approach over the last 4 or 5 years.

嗯，我認為當然可以，我的意思是，當聯邦政府審查各部門的效率時，各州也可能會審查這一點。對我們來說，這就是為什麼我們覺得過去四、五年來，我們基於價值的照護方法讓我們處於良好地位的原因之一。

As I mentioned earlier, we have demonstrated that through our abilities we've been able to work with either the states or with the managed Medicaid providers to reduce their cost. And again, if you're talking about an environment where you're really looking at efficiencies and how do you get rid of waste.

正如我之前提到的，我們已經證明，透過我們的能力，我們能夠與各州或受管理的醫療補助提供者合作，以降低他們的成本。再說了，如果您談論的環境真正關注的是效率以及如何消除浪費。

That is the way you can do it is in a low-cost environment, if we can make sure that we're able to do what we do in a value-based approach to reduce cost overall, that should be very valuable to our state partners.

這就是在低成本環境下實現這一目標的方法，如果我們能夠確保以基於價值的方式開展工作以降低總體成本，那麼這對我們的國家合作夥伴來說應該是非常有價值的。

Got it that that makes a lot of sense, and then maybe just one more follow up here on the labor environment. I think you alluded to, expecting the clinical, labor environment to remain more challenging relative to PCS.

我明白了，這很有道理，然後也許我們再來跟進一下勞動環境。我想您曾提到，預計臨床和勞動環境相對於 PCS 來說仍然更具挑戰性。

Just wanted to unpack that a little further in terms of what specifically you're seeing. Is that largely just reflective of the rate environment and making it hard to sort of pay the wages that you need to pay? Is there any other competitive dynamics that you're seeing from other players in the space, in terms of attracting and retaining talent? Thanks.

只是想根據您所看到的具體情況進一步解釋一下。這是否很大程度上只是反映了利率環境並使得支付您需要支付的工資變得困難？在吸引和留住人才方面，您是否看到該領域其他參與者有其他競爭態勢？謝謝。

No, I mean, I think it's really just looking at the, and it's been well documented that there is a shortage, and that shortage is continuing to build on clinical staff. When you look at nurses, in particular, so it's really looking at just competition with, institutional providers who may be able to pay in a position to pay a higher wage.

不，我的意思是，我認為這只是看一下，而且有充分的證據表明存在短缺，並且臨床工作人員的短缺繼續增加。特別是當你看護士時，它實際上只是與可能有能力支付更高工資的機構提供者競爭。

The nice thing that we're able to offer to nurses is one flexibility and that opportunity to have kind of a one-on-one care with patients and some nurses will are more than happy to kind of sacrifice. Little extra money they might make working a shift at a hospital to have that one-on-one opportunity and greater scheduling flexibility honestly working for us.

我們能夠為護理人員提供的福利是一種靈活性和與病人進行一對一護理的機會，有些護理人員非常樂意做出這種犧牲。他們可能會透過在醫院輪班工作賺取一點額外的錢來獲得一對一的機會和更大的時間安排靈活性，誠實地為我們工作。

But it's just a dynamic that I think the healthcare industry will be facing, for the foreseeable future versus on the personal care side, we feel like we're in a pretty good spot there from a labor standpoint.

但我認為這只是醫療保健產業將面臨的一個動態，在可預見的未來，與個人照護方面相比，我們覺得從勞動力的角度來看我們處於相當有利的位置。

Okay, great. Thank you.

好的，太好了。謝謝。

As a reminder to ask a question, you may press then one. The next question today comes from Matthew Gilmore with KeyBanc. Please go ahead.

為了提醒您提問，您可以按「一」。今天的下一個問題來自 KeyBanc 的 Matthew Gilmore。請繼續。

Hey guys, I've just got one question left, but it's got two parts for the improvement in the percent of hours for service and personal care that Dirk mentioned. I believe you made some system and process improvements that are helping to drive that metric, but the first part is can you just give us a sense for how much room there is to go there.

嘿夥計們，我只剩下一個問題了，但它分為兩部分，分別針對 Dirk 提到的服務和個人護理時間百分比的提高。我相信你們做了一些系統和流程改進，有助於推動這個指標，但第一部分是，你能否讓我們了解還有多少發展空間。

And then the second part is as the redetermination impact fades, does the penetration and number of hours just naturally come down because you're using your labor capacity for new patients, or is this improvement in penetration purely additive to your growth?

然後第二部分是，隨著重新確定的影響逐漸消退，滲透率和小時數是否會因為您將勞動力用於新患者而自然下降，或者這種滲透率的提高是否純粹對您的增長有幫助？

Yeah, I think, if you look at the things that we're doing, from our caregiver application to help caregivers actually kind of have greater visibility on when they're, if they're scheduled to, essentially kind of come up short against the authorized hours and it allows them the flexibility to work with their client to schedule those hours to make those up. I think there is, we have further room to grow in that respect.

是的，我認為，如果你看看我們正在做的事情，從我們的護理人員應用程式到幫助護理人員實際上更清楚地了解他們何時安排工作，是否基本上沒有達到授權的工作時間，並且它允許他們靈活地與他們的客戶合作來安排這些時間來彌補這些不足。我認為是的，在這方面我們還有進一步成長的空間。

I mean, I've been very pleased with the buy-in. From caregivers who have actually, downloaded the app and are actively using it, that was one of my big concerns was, if you build it, will they come, and I think we've made it useful to them as a tool, and they see the value in it.

我的意思是，我對這次買入感到非常滿意。從那些實際上已經下載並積極使用該應用程式的護理人員那裡，我最大的擔憂之一是，如果你開發了它，他們會來嗎？我認為我們已經讓它成為一個對他們有用的工具，他們看到了它的價值。

So, I think there's continues to be opportunity to increase our service percentage, which that's the number of hours we serve against the authorization. And when you look at that, I mean, I think that is actually additive to our growth because those are hours otherwise, we probably wouldn't have scheduled you'd like to think our service coordinators would be kind of, all, monitoring that closely.

因此，我認為我們仍然有機會提高服務百分比，也就是我們根據授權提供的服務的小時數。當你看到這一點時，我的意思是，我認為這實際上對我們的成長有幫助，因為否則，我們可能不會安排這些時間，你會認為我們的服務協調員會如此密切地監控。

But I think having the caregivers actually have that visibility will actually allow us to greater leverage our existing workforce and increase that service percentage, which is capturing hours we otherwise wouldn't Serve.

但我認為，讓護理人員真正具有這種可見性，實際上可以讓我們更好地利用現有勞動力，並提高服務百分比，也就是節省我們原本不會提供服務的時間。

That's great. Thanks, Brad.

那太棒了。謝謝，布拉德。

The next question comes from Constantine Davis with Citizens. Please go ahead.

下一個問題來自公民頻道的康斯坦丁·戴維斯。請繼續。

Hi, thanks. Just a couple of quick ones, I guess first just I just wanted to be sure I heard you right, but it sounded like Dirk in your prepared remarks you see some continued PCS sort of M&A opportunities in Texas, and I just wonder if you could expand on that just given you're already the largest provider there and obviously you know the relative rate and margin differential in that in that state.

嗨，謝謝。我只想快速問幾個問題，首先，我只是想確保我聽對了，但聽起來德克，在你準備好的發言中，你看到德克薩斯州繼續存在一些 PCS 類型的併購機會，我只是想知道你是否可以詳細說明一下，因為你已經是那裡最大的供應商，而且顯然你知道該州的相對利率和利潤差異。

Yeah, well, first off, Texas is a profitable state. Even with the lower hourly rate just due to the rate we pay caregivers, we still have a nice margin in that state. And talking about the size, we are the largest, but even the TOP4 providers are less than 20% of the market.

是的，首先，德克薩斯州是一個盈利的州。即使由於我們支付給護理人員的費率較低，每小時的費率也較低，但在該州我們仍然有不錯的利潤。就規模而言，我們是最大的，但即使是前四名供應商的市佔率也不到20％。

We're about 5% of the market, so we still have a lot of opportunity to grow our coverage across the state, and it's something that when we looked at the Gentiva transaction, we knew it was going to be an added benefit to the company.

我們的市佔率約為 5%，因此我們仍有許多機會擴大我們在全州的覆蓋範圍，當我們審視 Gentiva 交易時，我們就知道這將為公司帶來額外的好處。

So once that actually was completed and we've got them on board, our development team is now actively looking at other opportunities in all three levels of care in the state and certainly personal care is part of that focus that we're looking at.

因此，一旦這項工作真正完成，並得到他們的支持，我們的開發團隊就會積極尋找該州所有三個級別的護理中的其他機會，當然個人護理是我們關注的重點之一。

And do you guys have any visibility into sort of process for rate lift in Texas? Just wondering if you can talk about the dialogue there and anything that might happen either this year or next.

你們對德州提高利率的流程有什麼了解嗎？只是想知道您是否可以談談那裡的對話以及今年或明年可能發生的任何事情。

Yeah, I mean, I think if you look at the rate in taxes and possibilities there is a, there's discussions right now with the legislative session, the legislature is in session. There is a proposal to increase funding for personal care services. So, we're monitoring that closely.

是的，我的意思是，我認為如果你看看稅率和可能性，現在立法會議正在討論，立法機關正在開會。有一項提案要求增加個人護理服務的資金。所以，我們正在密切監視。

Not a lot of clarity there yet other than we think that we feel pretty good there might be some upside, but don't really have it quantified right now at this point. Still a lot of work to be done in the legislature.

目前還沒有太多明確的訊息，只是我們感覺很好，可能存在一些好處，但目前還沒有真正量化。立法機關還有很多工作要做。

Great. And then, just one housekeeping on the on the corporate office lease, is there any lease expense savings tied to that in 2025?

偉大的。然後，僅對公司辦公室租賃進行一次內部管理，到 2025 年是否會節省租賃費用？

No, it should be flat on. So, we've actually had a kind of a full rate sublet for the last couple of years since COVID that's expiring. That's kind of what, put us in position to go ahead and accelerate and do the impairment, so there shouldn't be any impact on the PNL side.

不，應該是平放的。因此，自新冠疫情爆發以來，過去幾年我們實際上一直有一種全價轉租，但這種轉租即將到期。這就是讓我們能夠繼續加速並進行減損的原因，因此這不應該對 PNL 方面產生任何影響。

Thank you.

謝謝。

The next question comes from Ryan Langston with TD Cowen. Please go ahead.

下一個問題來自 TD Cowen 的 Ryan Langston。請繼續。

Thanks for squeezing me in just a couple quick ones, I think you said there was some storm impact maybe in the first quarter. Can you help us maybe think about the quantification of that and then just wondering, is there any impact in the first quarter we should think about from this elevated flu season that we're seeing either from employees' ability for hours or just hours that you're booking with your clients? Thanks.

感謝您抽出時間快速問幾個問題，我認為您說過第一季可能受到了風暴的影響。您能否幫助我們思考一下這個問題的量化，然後想一想，我們是否應該考慮這個流感季節的延長對第一季度的影響，無論是從員工的工作時間能力還是從您與客戶預約的時間能力來看？謝謝。

Yeah, storm impact. I mean, I think if you if you think it seems like an eternity ago, but it was early January, we had some pretty significant storms that rolled through snow and ice hitting us in some areas that don't handle it as well.

是的，風暴影響。我的意思是，如果你覺得這似乎是很久以前的事了，但那是在一月初，我們遭遇了一些相當嚴重的風暴，風暴席捲了冰雪，襲擊了一些無法很好應對的地區。

So, we saw some negative impact there, and certainly if on the personal care side, we get paid for hours served and if we missed the visit, we TRY to reschedule, but there's certainly some challenges there.

因此，我們看到了一些負面影響，當然，如果在個人護理方面，我們會根據服務的時間獲得報酬，如果我們錯過了訪問，我們會嘗試重新安排，但這肯定會帶來一些挑戰。

So, there was a little impact in January, but overall, I feel pretty good about, where we and in February going into March, on the personal care side, from the flu season, anecdotally, there's certainly a lot of people have been out of the office, sick, but haven't heard, really any major impact there.

因此，一月份確實受到了一點影響，但總體而言，我感覺還不錯，在二月到三月，就個人護理方面而言，由於流感季節的原因，據傳聞，肯定有很多人生病了而沒有去辦公室，但並沒有聽說有什麼重大影響。

And again, I think we've gotten accustomed to kind of working through those types of issues, when you think about it seems like a lifetime ago with COVID and everything else, and we were able to weather those events pretty well.

而且，我想我們已經習慣了解決這些類型的問題，當你想起來，這似乎是一輩子以前的事了，還有新冠疫情和其他事情，我們能夠很好地度過這些事件。

Okay, just last one, PCS turnover. I maybe I missed it if I did, sorry, but can you remind us where you're running actually on turnover in that, division, and I guess we can't either any different, just in terms of that side of the business.

好的，只剩下最後一個了，PCS 營業額。我可能沒注意，抱歉，您能否提醒我們該部門的實際營業額情況，我想就業務的這一方面而言，我們也不會有任何不同。

Thanks. Yeah, I mean, we run around 50%, 55%, which is a little, better than the industry average, and again, I think some of the things that we're doing, we're optimistic that we'll be able to reduce that number, further.

謝謝。是的，我的意思是，我們的運行率在 50% 到 55% 左右，這比行業平均水平要好一點，而且我認為，透過我們正在做的一些事情，我們樂觀地認為我們將能夠進一步降低這個數字。

Yeah, with respect to Gentiva, I think, don't have their number. In front of me, but don't see any differences in their workforce than ours, so their turnover rate probably consistent.

是的，關於 Gentiva，我認為沒有他們的電話號碼。在我面前，但沒有看到他們的勞動力與我們的勞動力有任何差異，所以他們的流動率可能一致。

That being said, they do have a lot of preferred workers, so probably 70% of their Texas workforce is preferred workers, and you typically see a lower turnover rate there.

話雖如此，他們確實有很多優先員工，所以他們在德克薩斯州的勞動力中可能有 70% 是優先員工，而且你通常會看到那裡的離職率較低。

At this time, there are no further questions. I would like to turn the call back over to Dirk Allison for closing remarks.

目前，沒有其他問題。我想將電話轉回給 Dirk Allison 來做最後發言。

Thank you, operator. We want to thank each of you for taking time to join us today on our earnings call. I hope you all have a great week. Goodbye.

謝謝您，接線生。我們想感謝你們每個人今天抽出時間參加我們的收益電話會議。祝大家有個愉快的一周。再見。

The conference has now concluded. Thank you for participating. 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。