Chemed Corp (CHE) 2025 Q3 法說會逐字稿

Good morning, and thank you for standing by. Welcome to the Chemed Corporation third quarter 2025 earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded.

早上好，感謝您的耐心等待。歡迎參加Chemed公司2025年第三季財報電話會議。（操作人員指示）請注意，今天的會議正在錄音。

I would now like to hand the conference over to your first speaker today, Holley Schmidt, Assistant Controller. Please go ahead.

現在我謹將會議交給今天的第一位發言人，助理財務總監霍莉·施密特女士。請繼續。

Good morning. Our conference call this morning will review the financial results for the third quarter of 2025 ended September 30, 2025. Before we begin, let me remind you that the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 apply to this conference call. During the course of this call, the company will make various remarks concerning management's expectations, predictions, plans and prospects that constitute forward-looking statements.

早安.今天早上的電話會議將回顧截至 2025 年 9 月 30 日的 2025 年第三季財務表現。在開始之前，請容我提醒各位，1995 年《私人證券訴訟改革法案》的安全港條款適用於本次電話會議。在本次電話會議期間，本公司將就管理層的預期、預測、計劃和前景發表各種評論，這些評論構成前瞻性陳述。

Actual results may differ materially from those projected by these forward-looking statements as a result of a variety of factors, including those identified in the company's news release of October 28 and in various other filings with the SEC. You are cautioned that any forward-looking statements reflect management's current view only and that the company undertakes no obligation to revise or update such statements in the future.

由於各種因素的影響，實際結果可能與這些前瞻性聲明所預測的結果有重大差異，這些因素包括本公司在 10 月 28 日的新聞稿和向美國證券交易委員會提交的各種其他文件中確定的因素。請注意，任何前瞻性陳述僅反映管理層目前的觀點，本公司不承擔將來修訂或更新此類陳述的義務。

In addition, management may also discuss non-GAAP operating performance results during today's call, including earnings before interest, taxes, depreciation and amortization or EBITDA and adjusted EBITDA. A reconciliation of these non-GAAP results is provided in the company's press release dated October 28, which is available on the company's website at chemed.com.

此外，管理階層也可能在今天的電話會議上討論非GAAP經營績效結果，包括息稅折舊攤提前利潤（EBITDA）和調整後EBITDA。本公司於 10 月 28 日發布的新聞稿中提供了這些非 GAAP 結果的調整表，該新聞稿可在公司網站 chemed.com 上查閱。

I would now like to introduce our speakers for today, Kevin McNamara, President and Chief Executive Officer of Chemed Corporation; Mike Witzeman, Chief Financial Officer of Chemed; and Joel Wherley, President and Chief Executive Officer of Chemed's VITAS Healthcare Corporation subsidiary.

現在我謹介紹我們今天的演講嘉賓：Chemed Corporation 總裁兼執行長 Kevin McNamara；Chemed 財務長 Mike Witzeman；以及 Chemed 旗下 VITAS Healthcare Corporation 子公司總裁兼執行長 Joel Wherley。

I will now turn the call over to Kevin McNamara.

現在我將把電話轉給凱文·麥克納馬拉。

Thank you, Holley. Good morning. Welcome to Chemed Corporation's third quarter 2025 conference call. I will begin with highlights for the quarter, then Mike and Joel will follow up with additional details. I will then open the call for questions.

謝謝你，霍莉。早安.歡迎參加Chemed公司2025年第三季業績電話會議。我將首先介紹本季度的亮點，然後Mike和Joel將補充更多細節。接下來我將開放提問環節。

Both operating units fell primarily in line with our expectations in the third quarter of 2025. VITAS continued to execute the strategies required to fully mitigate any potential Florida Medicare Cap billing limitation for the government's fiscal 2026 year.

2025年第三季度，兩個營運部門的業績基本上符合我們的預期。VITAS 繼續執行必要的策略，以完全緩解佛羅裡達州政府 2026 財政年度醫療保險上限計費限制可能帶來的任何影響。

Additions in VITAS during the quarter totaled 17,714, which equates to a 5.6% improvement from the same period of 2024. An important metric that we have been tracking related to Florida admissions is the percentage of total admissions that come from hospitals. Our analysis indicates that an appropriate balance for sustained long-term stability in the Florida patient base given the current mix of referral sources is between 42% and 45% of the total admissions should come from hospitals.

本季 VITAS 新增人數總計 17,714 人，較 2024 年同期成長 5.6%。我們一直在追蹤與佛羅裡達州入院人數相關的一個重要指標是，來自醫院的入院人數佔總入院人數的百分比。我們的分析表明，考慮到目前的轉診來源組合，為了保持佛羅裡達州患者群體的長期穩定，一個合適的平衡點是，來自醫院的患者佔總入院人數的 42% 到 45%。

During our community access program, this ratio dipped below the preferred range for a sustained period of time. In the third quarter of 2025, this ratio was 44.5%, which represents a high watermark during the post-pandemic period. The ratio has been above 42% for all of 2025. We previously estimated that the consolidated Florida program with 2025 Medicare Cap year with a $19 million billing limitation. We came in slightly better than that with a billing limitation of $18.9 million.

在我們的社區准入計劃期間，這一比例在一段時間內持續低於理想範圍。2025 年第三季度，這一比例為 44.5%，這是疫情後時期的一個高點。2025 年全年比例均高於 42%。我們先前估計，佛羅裡達州的綜合計劃在 2025 年 Medicare 上限年內，帳單限額為 1,900 萬美元。我們的最終結果略好一些，帳單限額為 1890 萬美元。

Management continues to believe there will be no Medicare Cap billing limitation related to our Florida program in 2026. As discussed above, the initiative to admit a higher percentage of hospital-based admissions has gained traction, and we anticipate that to continue. We have cleared all hurdles to opening our new Pinellas County location, which is now on track to open in early November. Our new program in Marion County, Florida, which opened in May of 2025 has grown to an ADC of 75 as of September 30, 2025. We project that it could double in size to an ADC of 150 by the end of 2026.

管理層仍然認為，到 2026 年，我們的佛羅裡達州計畫將不會受到醫療保險上限計費限制。如上文所述，提高醫院收治患者比例的措施已取得進展，我們預期這一趨勢將持續下去。我們已經清除了開設位於皮內拉斯縣新店的所有障礙，該店目前正按計劃於 11 月初開業。我們在佛羅裡達州馬里恩縣的新計畫於 2025 年 5 月啟動，截至 2025 年 9 月 30 日，平均每日住院人數已達 75 人。我們預計到 2026 年底，其規模可能會翻一番，達到 ADC 150。

Now let's turn to Roto-Rooter. Roto-Rooter revenue increased 1.1% in the third quarter of 2025 compared to the same period of 2024. Branch residential and commercial revenue were both encouraging with increases of 3.4% and 2.8%, respectively. Revenue from independent contractors continues to be disappointing, declining 4.7% in the third quarter of 2025.

現在讓我們來看看Roto-Rooter公司。2025 年第三季 Roto-Rooter 的營收比 2024 年同期成長了 1.1%。分行住宅和商業收入均表現令人鼓舞，分別成長了 3.4% 和 2.8%。獨立承包商的收入持續令人失望，2025 年第三季下降了 4.7%。

For the first time in several quarters, we saw strength in our residential plumbing revenue service line. Residential plumbing revenue increased 8.2% in the third quarter of 2025 compared to the same period of 2024. A multipronged campaign to target selected high revenue dollar plumbing services yielded positive results in the quarter.

幾個季度以來，我們的住宅管道服務收入首次出現強勁增長。2025 年第三季住宅管道營收比 2024 年同期成長 8.2%。本季度，一項針對特定高收入管道服務的多管齊下的行銷活動取得了積極成果。

The campaign included more targeted Internet focus on specific services, enhanced sales materials for the technicians in the field and more frequent close rate reporting to branch management related to the specific services. We are encouraged by the results of this campaign in the quarter.

活動包括更有針對性地利用網路推廣特定服務，加強對現場技術人員的銷售資料，以及更頻繁地向分公司管理層報告與特定服務相關的成交率。我們對本季此次活動的成果感到鼓舞。

Total leads were down 1.3% in the third quarter of 2025 compared to the same period of 2024. This is a nice improvement compared to the trajectory we saw in 2024 and earlier in 2025. As discussed in the past few quarters, the trend of increasing paid leads offset by declining natural leads continues.

2025 年第三季總銷售線索數量比 2024 年同期下降了 1.3%。與 2024 年和 2025 年初我們看到的軌跡相比，這是一個不錯的改進。正如過去幾季所討論的那樣，付費線索增加但自然線索減少的趨勢仍在繼續。

During the third quarter, paid leads increased 8.6% compared to the same quarter of 2024. The entire decline in leads is in the natural lead category. In my opinion, this trend is both a positive and a negative. While we are paying for more leads causing some margin pressure, we also believe this trend indicates a potential moderation of competition for leads from our most significant private equity competitors. We are monitoring these trends closely.

第三季度，付費線索比 2024 年同期成長了 8.6%。潛在客戶數量的全部下降都屬於自然線索類別。我認為，這種趨勢既有利也有弊。雖然我們為獲取更多潛在客戶付費，導致利潤率受到一定壓力，但我們也認為這一趨勢表明，來自我們最重要的私募股權競爭對手的潛在客戶競爭可能會有所緩和。我們正在密切關注這些趨勢。

As Mike will discuss further, Roto-Rooter margins continue to be below our long-term expectations. However, gross margin during the quarter was exactly in line with our guidance. The many operational initiatives discussed in past calls are having positive impacts. The shift from unpaid leads to paid leads was the main driver of the $3.6 million increase in SG&A costs in the quarter. This led to EBITDA and EBITDA margins to be slightly lower than our expectations for the quarter.

正如麥克將進一步討論的那樣，Roto-Rooter 的利潤率仍然低於我們的長期預期。然而，本季的毛利率完全符合我們的預期。過去幾次電話會議中討論的許多營運措施都產生了積極的影響。從非付費線索轉向付費線索是本季銷售、管理及行政費用增加 360 萬美元的主要原因。這導致本季 EBITDA 和 EBITDA 利潤率略低於我們的預期。

We are very encouraged with the performance of both businesses in the third quarter. VITAS is on track to ensure that the Florida Medicare Cap issue is behind us. While still below our long-term expectations, there are signs that the Roto-Rooter business has stabilized and is on the way to returning to a predictable, sustainable growth trajectory.

我們對兩家公司第三季的業績都非常滿意。VITAS 正在按計劃推進，以確保佛羅裡達州醫療保險上限問題徹底解決。雖然仍低於我們的長期預期，但有跡象表明 Roto-Rooter 的業務已經穩定下來，並且正在恢復到可預測、可持續的成長軌跡。

With that, I would like to turn this conference over to Mike.

接下來，我將把這次會議交給麥克。

Thanks, Kevin. VITAS net revenue was $407.7 million in the third quarter of 2025, which is an increase of 4.2% when compared to the prior year period. This revenue increase is comprised primarily of a 2.5% increase in days-of-care and a geographically weighted average Medicare reimbursement rate increase of approximately 4.1%.

謝謝你，凱文。VITAS 2025 年第三季淨收入為 4.077 億美元，比上年同期成長 4.2%。此次收入成長主要包括護理天數增加 2.5% 以及按地域加權平均計算的醫療保險報銷率增長約 4.1%。

The acuity mix shift negatively impacted revenue growth 121 basis points in the quarter when compared to the prior year revenue and level of care mix. The combination of Medicare Cap and other contra revenue changes negatively impacted revenue growth by approximately 124 basis points. The $6.1 million Medicare Cap billing limitation accrued in the third quarter of 2025 is comprised of $4.6 million for our Florida combined program and $1.5 million related to all other VITAS programs, mainly in California. We came in slightly better than our estimates for the quarter in both Florida and California.

與去年同期相比，護理水準組合的變化對本季營收成長產生了 121 個基點的負面影響。醫療保險上限和其他不利收入變化共同對收入成長產生了約 124 個基點的負面影響。2025 年第三季累積的 610 萬美元 Medicare 上限計費限制包括：佛羅裡達州綜合計劃的 460 萬美元，以及與所有其他 VITAS 計劃（主要在加利福尼亞州）相關的 150 萬美元。我們在佛羅裡達州和加利福尼亞州的季度業績都略好於預期。

Average revenue per patient day in the third quarter of 2025 was $205.08, which is 298 basis points above the prior year period. During the quarter, high acuity days-of-care were 2.3% of total days-of-care, a decline of 259 basis points when compared to the prior year quarter.

2025 年第三季每位患者每日平均收入為 205.08 美元，比去年同期高出 298 個基點。本季度，高危險照護天數佔總照護天數的 2.3%，與去年同期相比下降了 259 個基點。

Adjusted EBITDA excluding Medicare Cap totaled $70.4 million in the quarter, which is a decline of 3.8% when compared to the prior year period. Adjusted EBITDA margin in the quarter excluding Medicare Cap was 17.0%, which is 157 basis points below the prior year period. The lower EBITDA margin in the quarter reflects the impact of admitting more hospital-based short-stay patients. The EBITDA margin is within our expectations and guidance.

本季調整後的 EBITDA（不包括 Medicare Cap）總計 7,040 萬美元，與去年同期相比下降了 3.8%。不計入醫療保險上限，本季調整後的 EBITDA 利潤率為 17.0%，比去年同期下降了 157 個基點。本季較低的 EBITDA 利潤率反映了收治更多住院短期病人的影響。EBITDA利潤率符合我們的預期和指引。

Now let's turn to Roto-Rooter. Roto-Rooter branch residential revenue in the quarter totaled $150.9 million, an increase of 3.4% from the prior year period. This aggregate residential revenue change consisted of plumbing increasing 8.2%, excavation increasing 4.5% and water restoration increasing 6.8%, offset by a decline in drain cleaning of 2.6%.

現在讓我們來看看Roto-Rooter公司。本季 Roto-Rooter 分公司住宅收入總計 1.509 億美元，比去年同期成長 3.4%。住宅總收入變化包括管道工程成長 8.2%，挖掘工程成長 4.5%，水災修復工程成長 6.8%，但排水管道清理工程下降 2.6% 抵銷了這一成長。

Roto-Rooter branch commercial revenue in the quarter totaled $55 million, an increase of 2.8% from the prior year period. This aggregate commercial revenue change consisted of excavation increasing 10.2%, water restoration increasing 3.5% and drain cleaning revenue increasing 1.2%, offset by a decline in plumbing of 0.8%.

該季度 Roto-Rooter 分公司商業收入總計 5,500 萬美元，比上年同期成長 2.8%。商業總收入變化包括：挖掘業務成長 10.2%，水災修復業務成長 3.5%，排水管道清潔業務成長 1.2%，但管線工程收入下降 0.8% 抵銷了部分成長。

Revenue from our independent contractor declined 4.7% in the third quarter of 2025 as compared to the same period of 2024. Our independent contractors are generally smaller operations in middle-market cities. In many instances, based mainly on resourcing constraints, they have less effectively capitalized on the add-on service segment growth opportunities than our owned branch locations. We are actively working with the contractor group to help mitigate the issues in this segment of our business and get it back to a growth trajectory.

2025 年第三季度，我們獨立承包商的營收比 2024 年同期下降了 4.7%。我們的獨立承包商通常是中型城市中的小型企業。在許多情況下，主要由於資源限制，他們未能像我們自己的分支機構那樣有效地利用附加服務領域的成長機會。我們正在積極與承包商集團合作，以幫助緩解我們業務這一部分的問題，並使其恢復成長勢頭。

Adjusted EBITDA at Roto-Rooter in the third quarter of 2025 totaled $49.4 million, a decrease of 12.4% compared to the prior year quarter. Adjusted EBITDA margin in the quarter was 22.7%. The third quarter adjusted EBITDA margin represents a 351 basis point decline from the third quarter of 2024. The third quarter EBITDA margin is a 90 basis point improvement over the second quarter of 2025. While below our long-term expectations, Roto-Rooter's third quarter gross margins within our guidance range.

2025 年第三季 Roto-Rooter 的調整後 EBITDA 總計 4,940 萬美元，較上年同期下降 12.4%。本季調整後 EBITDA 利潤率為 22.7%。第三季調整後 EBITDA 利潤率較 2024 年第三季下降 351 個基點。第三季 EBITDA 利潤率比 2025 年第二季提高了 90 個基點。儘管低於我們的長期預期，但 Roto-Rooter 第三季的毛利率在我們預期的範圍內。

The many field-level initiatives discussed in prior quarters have begun to take hold. The paid versus natural lead generation shift discussed by Kevin drove the $3.6 million increase in SG&A costs and the resulting EBITDA margin pressure. This is the main reason for the slightly lower-than-expected EBITDA margin in the third quarter.

前幾個季度討論的許多實地舉措已經開始奏效。Kevin 所討論的付費與自然線索產生方式的轉變，導致了銷售、一般及行政費用增加 360 萬美元，並由此造成了 EBITDA 利潤率壓力。這是第三季 EBITDA 利潤率略低於預期的主要原因。

Management reiterates its previously issued guidance of $22 to $22.30 per share, excluding noncash expenses for stock options, tax benefits from stock option exercises, costs related to litigation and other discrete items. This guidance assumes that there will be no Medicare Cap related to our Florida combined program for the government fiscal year 2026, beginning on October 1, 2025.

管理層重申其先前發布的每股收益指引為 22 美元至 22.30 美元，不包括股票選擇權的非現金支出、股票選擇權行使的稅收優惠、與訴訟相關的成本和其他個別項目。本指南假設，對於 2026 財年（從 2025 年 10 月 1 日開始）的政府財政年度，我們的佛羅裡達州綜合計畫不會受到醫療保險上限的限制。

I will now turn this call over to Joel.

現在我將把通話交給喬爾。

Thanks, Mike. In the third quarter of 2025, our average daily census was 22,327 patients, an increase of 2.5%. In the quarter, hospital-directed admissions increased 10.4%. Home-based patient admissions increased 2.3%. Assisted living facility admissions increased 8.9%. And nursing home admissions declined 8.9% when compared to the prior year period.

謝謝你，麥克。2025 年第三季度，我們的平均每日住院人數為 22,327 名患者，成長了 2.5%。本季度，醫院直接入院人數增加了 10.4%。居家病人入院人數增加了 2.3%。輔助生活設施入住人數增加了 8.9%。與去年同期相比，養老院入住人數下降了 8.9%。

Our average length of stay in the quarter was 109.7 days. This compares to 102 days in the third quarter of 2024. The average length of stay in the second quarter of '25 was 137.1 days. Our median length of stay was 18 days in the third quarter of 2025, equal to the median in the third quarter of 2024. The median length of stay in the second quarter of 2025 was 20 days.

本季平均停留時間為 109.7 天。相比之下，2024 年第三季為 102 天。2025 年第二季的平均停留時間為 137.1 天。2025 年第三季度，我們的中位數住院時間為 18 天，與 2024 年第三季度的中位數住院時間相同。2025 年第二季的平均住院時間為 20 天。

It's important to remember that length of stay statistics are calculated based on discharged patients, not active patients. The return to a more normal length of stay metric in the third quarter is indicative of the success with our renewed focus on higher admissions from hospital as a preadmission location as previously discussed.

需要注意的是，住院時長統計數據是根據出院患者計算的，而不是根據在院患者計算的。第三季住院時長指標恢復正常，顯示我們之前討論過的，重新重視將醫院作為入院前場所的入院人數增加的做法取得了成功。

I'm excited about the opportunity to lead VITAS into its next chapter. The new CON in Pinellas County is a significant opportunity for VITAS. We will continue to put our best foot forward when applying for new CONs in the state of Florida. We will continue to focus on providing the best possible care to our patients and their families. That focus will be coupled with getting back to the basics of ensuring that we grow the business responsibly while effectively managing the Medicare Cap.

我很興奮有機會帶領 VITAS 進入下一個篇章。皮內拉斯縣的新 CON 對 VITAS 來說是一個重要的機會。我們將繼續全力以赴，爭取在佛羅裡達州獲得新的許可證。我們將繼續致力於為患者及其家屬提供最好的醫療服務。我們將把這一重點與回歸基本原則相結合，確保我們在有效管理醫療保險上限的同時，以負責任的方式發展業務。

With that, I'll turn the call back over to Kevin.

這樣，我就把電話轉回給凱文了。

Thank you, Joel. I will now open this teleconference to questions.

謝謝你，喬爾。現在我將開放本次電話會議，接受提問。

(Operator Instructions)

（操作說明）

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，加拿大皇家銀行資本市場。

Appreciate the reaffirmation and guidance with results in line with your expectations. But with the results in both segments falling a little bit below what the Street was modeling, we're getting a lot of questions about the elements that bridge us back to guidance in the fourth quarter. Can you kind of run through in each segment what you're seeing from a demand and cost trend perspective and even from a seasonal perspective that gives you confidence that we can kind of ramp back up to the guidance midpoint in fourth quarter?

感謝您的再次肯定和指導，結果符合您的預期。但由於這兩個業務部門的業績都略低於華爾街的預期，我們收到了許多第四季度業績如何才能恢復到預期水準的問題。您能否分別從需求和成本趨勢，甚至是季節性角度，逐一分析您觀察到的哪些因素讓您有信心在第四季度恢復到預期目標的中點？

Sure, Ben. I think the biggest sort of distinction is that there's a little more seasonality that we anticipate in the fourth quarter. And so when I looked at your -- how you progress the third and fourth quarter, and it was across all the analysts, it's not just you. But the third quarter was a little lower than our internal -- or a little higher than our internal expectations and the fourth quarter was a little lower. So all in all, where you ended up the year was exactly in line with where we end up the year. It's more of a seasonal thing.

當然可以，本。我認為最大的差異在於，我們預計第四季會有更多季節性因素的影響。所以，當我查看你對第三季和第四季的預測時，我發現所有分析師都持相同觀點，這不僅僅是你一個人的看法。但第三季略低於我們的內部預期——或者說略高於我們的內部預期，而第四季則略低於預期。總而言之，你們今年的最終結果和我們今年的最終結果完全一致。這比較是一種季節性現象。

The two -- when you break it down between VITAS and Roto-Rooter, VITAS' fourth quarter is always their best quarter. It's when the new rate increase goes in on October 1. Our margin spikes in the fourth quarter from that because our cost structure really hasn't changed from September, for instance, from September 30 to October 1. So we get a pretty nice bump in margin from that.

如果將 VITAS 和 Roto-Rooter 兩家公司進行比較，VITAS 的第四季總是其業績最好的季度。新的利率上調將於10月1日生效。從9月份到10月1日，我們的成本結構實際上並沒有發生變化，因此第四季的利潤率大幅上升。因此，我們的利潤率得到了相當可觀的提升。

From a Roto-Rooter perspective, they always do better in the fourth quarter and the first quarter. The fourth quarter, it's a weather impact. When it's colder, wetter, Roto-Rooter tends to get more jobs. So it's just a little bit of a change. And I would tell you that the difference is only a couple of million dollars, right, between each quarter. And so it's not -- I don't think there was a huge difference between what you had and what we had.

從 Roto-Rooter 的角度來看，他們在第四季和第一季的表現總是更好。第四季度，是天氣因素造成的。天氣越冷越潮濕，Roto-Rooter公司的業務量就越大。所以只是稍微改動了一下。我可以告訴你，每季之間的差額只有幾百萬美元，對吧。所以，我認為你們擁有的和我們擁有的之間並沒有太大的差別。

Right. But now we're giving you some specifics, Mike, some of the elements that we do expect to improve during the quarter compared to the third quarter.

正確的。但現在我們給你一些具體細節，麥克，一些我們預計在本季會比第三季有所改善的方面。

Sure, sure. So Roto-Rooter is probably the easier one where we talked about some of the things that we've been doing. We expect -- we've talked in the past about some of the issues that we've had from a cost perspective at Roto-Rooter with discounting in the field, with higher commission rates. That improved, as I mentioned in the prepared remarks.

當然，當然。所以，Roto-Rooter 可能是比較容易理解的，我們在那裡談到了我們一直在做的一些事情。我們預計——我們過去曾討論過 Roto-Rooter 在成本方面遇到的一些問題，例如現場折扣和更高的佣金率。正如我在準備好的演講稿中提到的，情況有所改善。

I think our sequential margin improved about 90 basis points, and we expect that to continue. So we're expecting some of the green shoots on the revenue side to continue but also to still improve margins as we go forward into the fourth quarter. And VITAS, I think, as steady as she goes in the fourth quarter from a margin and revenue perspective.

我認為我們的環比利潤率提高了約 90 個基點，我們預計這一趨勢還將繼續。因此，我們預計營收方面的一些復甦跡象將會持續，而且隨著我們進入第四季度，利潤率也將繼續提高。我認為，從利潤率和收入的角度來看，VITAS 在第四季度表現穩定。

Joel, anything with regard to areas where you see some comparative improvements from the third quarter to the fourth quarter by the results?

喬爾，從業績來看，你認為在哪些方面比第三季到第四季有所改善？

Yes. So -- and thanks for the questions, Ben. As we have talked about in the previous two quarters, we knew that we would have additional marginal compression specific to our shift in strategy away from community access and focusing more on hospitals as a preadmit driving a higher volume of shorter length of stay patients.

是的。那麼——謝謝你的提問，本。正如我們在前兩個季度所討論的那樣，我們知道，隨著我們策略的轉變，從社區准入轉向更多地關注醫院作為入院前階段，從而導致住院時間較短的患者數量增加，我們將面臨額外的邊際壓縮。

However, what we have done to offset that is institute additional efficiency gains internally with labor management, which we are really excited and have effectively put into place as well as going into the fourth quarter, as Mike indicated, is usually a good quarter for us. And as we manage that preadmit environment, and as I indicated earlier, back to a more reasonable length of stay, we're effectively managing the fixed costs associated with that.

然而，為了彌補這一點，我們已經在內部勞動力管理方面提高了效率，我們對此感到非常興奮，並且已經有效地實施了這些措施。此外，正如麥克所指出的，第四季通常是我們業績不錯的季度。正如我之前提到的，當我們管理好入院前的環境，並將住院時間縮短到更合理的程度時，我們就有效地控制了與之相關的固定成本。

And just to give you one specific, how this relates to the results for VITAS. As we mentioned in the third quarter, we shoot for between 42% and 45% is the ratio of hospital admissions. For the quarter, it was 44.5%. To the extent that, that were to moderate closer to 42%, you would expect to see longer stay patients, nonhospital admissions, would still be in a healthy range but it would yield more profitable patients.

舉個具體的例子，說說這與 VITAS 的結果有何關係。正如我們在第三季提到的，我們的目標是將住院率控制在 42% 到 45% 之間。本季為 44.5%。如果這一比例緩和到接近 42%，預計患者住院時間會更長，非住院入院人數仍將處於健康範圍內，但同時也會帶來更多盈利的患者。

So I mean, that expectation is that 44.5% is a high watermark during a period of extensive scrutiny on Medicare Cap. And just the moderation of that alone would cause the type of improvement we're talking quarter compared to quarter.

我的意思是，44.5% 的預期值是醫療保險上限受到廣泛審查期間的一個高點。僅僅降低這個數值就能帶來我們所謂的季度環比改善。

And if I could just do one follow-up here. Could you talk a little bit about your receivables? It looks like DSO is a little elevated. Just wanted to get your thoughts on how cash collections are progressing and if there's a timing issue there or kind of what we can expect from a cash collection perspective.

如果我能在這裡再補充一點的話。能簡單談談您的應收帳款狀況嗎？看起來DSO的位置稍微高了一些。想了解一下您對現金回收進度的看法，以及是否存在時間方面的問題，或者從現金回收的角度來看，我們可以期待些什麼。

That's just a timing issue, Ben. I think it's mainly at VITAS and it's mainly relating to Medicaid, as you might imagine, with all the other sand in the air from a government perspective, Medicaid has -- payments have slowed down, but it's not an indication of any deterioration in our collection efforts or ability to collect. It's just a timing issue.

這只是時間問題，本。我認為主要問題出在 VITAS，而且主要與 Medicaid 有關。正如你可能想像的那樣，從政府的角度來看，由於其他種種不確定因素，Medicaid 的付款速度有所放緩，但這並不意味著我們的收款工作或收款能力有所下降。這只是時間問題。

Brian Tanquilut, Jefferies.

Brian Tanquilut，傑富瑞集團。

So maybe just as I think about 2026 with where the Medicare rate shook out. I know you had previously provided some insights into how you were thinking about margins and growth rates for next year. So curious where that stands now and just broadly speaking, without giving guidance obviously, how you're thinking about the growth algorithm for 2026?

所以，也許就在我思考 2026 年醫療保險費率最終會是多少的時候。我知道您之前曾就明年的利潤率和成長率問題提供過一些見解。所以很好奇目前情況如何，而且就大致而言（當然不提供具體指導），您是如何看待 2026 年的成長演算法的？

Sure. I'll start and then Joel or Kevin can follow up. But we -- well, first, we're only at the beginning stages of our budget process, as I know you know. But I think the fourth quarter, particularly as it relates to Florida and the Medicare Cap, will really inform our decisions on how the operations are going to -- what's the strategy for 2026 and then how that relates to the financial statements.

當然。我先開始，然後喬爾或凱文可以跟進。但我們—首先，如您所知，我們目前仍處於預算編制過程的初期階段。但我認為第四季度，特別是與佛羅裡達州和醫療保險上限相關的第四季度，將真正影響我們對營運方式的決策——2026 年的策略是什麼，以及這與財務報表有何關係。

And the reason I say that is, generally speaking, Florida in the fourth quarter is when we generate essentially all of our cap liability in a year. And then we spend the next nine months overcoming that. And that's how it's operated. VITAS has operated since we started -- since we've owned them. We saw that, that number in the fourth quarter last year was a lot -- that liability in the fourth quarter was a lot higher than it has historically been. And so we had to moderate, as we've talked about a lot, to more hospital admissions.

我這麼說的原因是，一般來說，佛羅裡達州在第四季產生的資本負債基本上就是一年中的全部負債。然後，我們花了九個月的時間來克服這個問題。它就是這樣運作的。VITAS 自我們成立以來就一直在運作——自從我們擁有它們以來就一直在運作。我們看到，去年第四季的負債額非常高——第四季的負債額遠高於歷史平均。因此，正如我們多次討論的那樣，我們不得不控制住院人數。

To the extent -- and we believe this to be the trajectory we're on, but that number is much more moderate in the fourth quarter this year, that informs our ability, as Kevin mentioned before, to be able to start creeping back up the long-stay patients and improving both the revenue growth rate and the EBITDA margin.

就此而言——而且我們相信這就是我們正在走的軌跡，但今年第四季度的數字要溫和得多——正如凱文之前提到的那樣，這影響著我們能否開始逐步恢復長期住院患者的數量，並提高收入增長率和 EBITDA 利潤率。

Of course, that takes a little time as well as all patients on the first day are short-stay patients. So over time, we'll build a little more momentum in those long-stay categories to the extent we do it responsibly to make sure we don't have a cap problem.

當然，這需要一些時間，因為第一天的所有患者都是短期住院患者。因此，隨著時間的推移，我們將在這些長期住宿類別中建立起更大的發展勢頭，前提是我們以負責任的方式進行，以確保我們不會遇到配額限制問題。

But the fourth quarter is really going to inform 2026. If I had to say from a high-level perspective, again, a little bit of speculation, but I would say revenue in the 8 percent-ish range, margins at the 27.5% to 28% range is what we would think -- 17.5% to 18%, sorry, I was mixing that up. sorry, is what we would think off the top of our head. But again, we're putting the pen to paper now.

但第四季的情況將對 2026 年產生深遠影響。如果要從宏觀角度來看，這只是我的猜測，但我認為營收成長率會在 8% 左右，利潤率會在 27.5% 到 28% 之間——抱歉，我剛才記錯了，應該是 17.5% 到 18%。抱歉，這是我們初步的估計。但現在，我們又要開始動筆了。

Joel, anything with regard to - from an operating margin profitability that gives you renewed confidence for next year? And I know it's -- you're early in your budgeting process.

喬爾，關於營運利潤率方面，有什麼能讓你對明年重拾信心的嗎？我知道——你還處於預算編制的早期階段。

So thanks, Kevin. First, I would reiterate what Mike said. The fourth quarter is going to be a significant indicator as to the speed for which we can look at responsibly getting back to active census growth, especially within the Florida market.

謝謝你，凱文。首先，我想重申一下麥克所說的話。第四季將是一個重要的指標，它能反映出我們能否以負責任的速度恢復人口普查的正面成長，尤其是在佛羅裡達州市場。

We are very encouraged by the strategies we put in place, the steps that we have taken, the moderation of the average length of stay from a discharge perspective and all of the initiatives that we have put into place to mitigate any concerns going forward with cap, which then puts us in a position where we can be agile and responsibly get back focusing on census growth in those markets.

我們對我們採取的策略、已採取的措施、從出院角度來看平均住院時間的調整以及我們為減輕未來可能出現的入住率上限問題而採取的所有舉措都感到非常鼓舞，這使我們能夠靈活應對，並負責任地重新專注於這些市場的入住率增長。

I appreciate that. And maybe my follow-up, just to try to keep this to two questions. Kevin, you talked about the improvement that you're seeing in the competitive dynamics in Roto. So if you can speak to that. And then maybe as I go back to your comment about gross margin coming in, in mind, clearly, G&A is the area, the other lever there. So just wanted to hear your thoughts on improvement performance and opportunity on the G&A line as we think about both Roto and VITAS.

我很感激。或許我的後續問題是，盡量只提兩個問題。Kevin，你談到了你在Roto的競爭格局中看到的改善。如果您能談談這方面的話。然後，當我回到你關於毛利率的評論時，請記住，很明顯，一般及行政費用是另一個槓桿。所以，我想聽聽您對 G&A 線改進績效和機會的看法，因為我們同時在考慮 Roto 和 VITAS。

Okay. Well, let me -- let's have Mike start with the numbers on it, but I'll give you my overall perspective following that.

好的。好，先讓麥克從數據上講起，之後我再談談我的整體看法。

Yes, sure. The first question, Brian, is our total leads for the second quarter in a row were up almost -- were high single digits on a paid search basis. The entire deterioration in leads that we've seen is in unpaid search categories. Again, as we talked about that, that creates margin pressure because we're paying for more leads. But ultimately, we are not seeing the competitive pressures for those paid leads that we have in the past. And we find that to be encouraging.

當然可以。Brian，第一個問題是，我們連續第二季的總潛在客戶數量幾乎——按付費搜尋計算——增加了近10%。我們看到的潛在客戶數量下降全部發生在非付費搜尋類別中。正如我們之前討論過的，這會造成利潤壓力，因為我們需要為更多的潛在客戶付費。但歸根究底，我們並沒有看到過去那種付費線索的競爭壓力。我們認為這令人鼓舞。

The thing, I think, that gives us a little more confidence even in that is we've seen all other big players that -- in a lot of consumer service areas are also having trouble with unpaid. So it's not as if they're sort of targeting Roto-Rooter. All of the people who are willing to pay for leads are being forced to pay for more leads. And so that would include our private equity competitors and, as a result, we're very encouraged that we're getting the leads that maybe we hadn't been getting a year ago at this time.

我認為，讓我們更有信心的一點是，我們看到其他許多大型企業——在許多消費者服務領域——也面臨未付款的問題。所以他們並不是專門針對Roto-Rooter公司。所有願意付費購買潛在客戶資訊的人都被迫為更多的潛在客戶資訊付費。因此，這其中也包括我們的私募股權競爭對手，因此，我們非常鼓舞地看到，我們獲得了去年這個時候可能還沒有獲得的潛在客戶。

I'll give you an example. In the second quarter of last year, roto-Rooter paid more, spent more for Google advertising and all of the Internet. And we didn't -- and it was met by a competitive response. And the net result was everyone paid more, but there wasn't a change in the balance of leads. That's not what we're seeing now. We're seeing now as we spend more, we're getting more. And it's just up to us and basic economics to make sure that we maximize the utility of that spending.

我給你舉個例子。去年第二季度，Roto-Rooter 支付了更多費用，在Google廣告和整個網路上的支出也更多。而我們沒有——結果引發了激烈的競爭。最終結果是每個人都支付了更多費用，但銷售線索的平衡並沒有改變。但我們現在看到的並非如此。我們現在看到，我們花的錢越多，得到的也越多。接下來就看我們自己和基本的經濟學原理如何確保我們最大限度地發揮這筆支出的效用了。

Yes. And then as far as sort of margin, when we talk about gross margin being in line, they're in line with our expectations for the quarter. But they're not necessarily, as Kevin mentioned in his prepared remarks, they're not in line with our long-term expectations. There's work to do there still. But we recognized -- when we talk about it in the second quarter, we recognized it was a multi-quarter fix on some of those things, particularly some of the discounting in the field and commissions. So while the gross margins are in line with what we expected in the third quarter, there's still work to do there.

是的。至於利潤率方面，當我們談到毛利率是否達標時，它們符合我們對本季的預期。但正如凱文在事先準備好的演講稿中提到的那樣，它們並不一定符合我們的長期預期。那裡還有一些工作要做。但我們在第二季討論這個問題時意識到，有些問題需要幾個季度才能解決，特別是現場折扣和佣金方面的問題。因此，雖然第三季的毛利率符合我們的預期，但仍有許多工作要做。

Yes. And let me just say it. I'll make a subjective comment here. One of our biggest problems in getting margin on the calls we are getting is it's pricing discipline. And it's easier to have that pricing discipline when there's enough work to go around. And we're starting to see that as opposed to being down 10%, it's up 1%. So I mean, it's easier to have the discipline to not discount, to not -- to make sure we get a price that gives us our traditional margin. And again, it's the rising creek that more leads give you to provide that. And that's really -- it's subjective, but that's what we're really shooting for, for the improvement for 2026 in Roto-Rooter.

是的。讓我直說。我在這裡發表一些個人看法。我們在獲取選擇權保證金方面遇到的最大問題之一是定價紀律。當工作機會充足時，就更容易維持定價紀律。我們現在看到的情況是，與其說是下降 10%，不如說是上升了 1%。所以我的意思是，要保持自律，不要打折，確保我們能獲得傳統利潤率的價格，就容易多了。再一次，正是不斷上漲的溪流，帶來了更多的潛在客戶，讓你能夠提供這些。這其實是──這很主觀，但這正是我們努力的目標，也是 Roto-Rooter 在 2026 年進步的目標。

And then the last thing I would say, and this mirrors Kevin's remarks on the SG&A line. We're doing what we can to minimize the cost, but it's -- we want to make sure that we maximize the opportunities that are provided to us. And if it means spending a little more on paid search to provide the revenue growth that we think is appropriate, then we think that's a good investment. And we track revenue per lead cost and those sorts of things. So we track that pretty closely. And so we think it's the right use of money to drive top line to spend a little more on the paid marketing side.

最後我想說的是，這與凱文對銷售、管理及行政費用（SG&A）的評論不謀而合。我們正在盡一切努力降低成本，但我們希望確保最大限度地利用擺在我們面前的機會。如果這意味著需要在付費搜尋上多花一些錢，以實現我們認為合適的收入成長，那麼我們認為這是一項不錯的投資。我們會追蹤每個潛在客戶線索的成本和收入等數據。所以我們會密切注意這一點。因此，我們認為，為了提高營收，應該在付費行銷方面多投入一些資金。

And something we've -- it's not enough, but we have been talking about the operational aspects of Roto-Rooter and the internal metrics that is close rate at the call center, close rate in the field. A lot of those operational metrics remain very strong. So we feel that we're poised, if we get the calls, we should make more money from them.

還有一些事情——雖然還不夠，但我們一直在討論 Roto-Rooter 的營運方面以及內部指標，例如呼叫中心的成交率和現場的成交率。許多營運指標依然非常強勁。所以我們認為我們已經做好了準備，如果接到電話，我們應該可以從中賺到更多錢。

Joanna Gajuk, Bank of America.

Joanna Gajuk，美國銀行。

So maybe just to continue on the Roto-Rooter segment. So if I read this right, margins are under pressure because of the marketing costs, right? So how should we think about sustainable margins? I mean, it sounds like maybe that's a new kind of business model. You've got to pay more. So how should we think about -- I know you don't have specifics for next year, but say, over the medium term or longer term, how you think about margins in that business?

所以，或許我們可以繼續聊聊Roto-Rooter公司。所以如果我理解正確的話，利潤率會受到行銷成本的影響，對嗎？那我們該如何看待永續利潤率呢？我的意思是，這聽起來可能是一種新型的商業模式。你得付更多錢。那麼我們應該如何考慮——我知道您沒有明年的具體情況，但比如說，從中長期來看，您如何看待該業務的利潤率？

Sure. From a longer-term perspective, we think that the right margin -- and I'll get it right this time, Kevin. The margin at Roto-Rooter is 25% to 26% is the right EBITDA margin over the longer term. We're not quite there yet. We think that we should be able to absorb higher marketing costs because of the higher leads and the revenue that they generate.

當然。從長遠來看，我們認為合適的利潤率——這次我一定能做好，凱文。Roto-Rooter 的利潤率為 25% 至 26%，從長遠來看，這是合適的 EBITDA 利潤率。我們還沒完全達到目標。我們認為，由於潛在客戶數量增加以及由此帶來的收入成長，我們應該能夠承受更高的行銷成本。

And so there's no doubt that there's going to be continued pressure for the near term -- for certainly the foreseeable few quarters on marketing costs specifically. But we think that they are -- we're able to overcome them with other operational things we've talked about over the last few quarters.

因此毫無疑問，在短期內，尤其是未來幾個季度，行銷成本將持續面臨壓力。但我們認為，我們能夠透過過去幾季討論過的其他營運措施來克服這些問題。

Yes. Just let me tell you how it works in the real world. When calls are down, the service man goes out, makes a written estimate and it's all or nothing. Essentially, the customer says okay or no. And at that point, there's not another job on the board for that service man to go run to. You can see how he's inclined to say, Well, what will it take for me to do it? And that's the discounting. That's where you lose margin.

是的。讓我來告訴你現實世界是如何運作的。電話系統故障時，維修人員會上門，給予書面估價，要嘛全包，要嘛全不包。本質上，顧客會說「可以」或「不可以」。到了那個時候，已經沒有其他工作機會可以讓這位維修工去應徵了。你可以看出他傾向於說：“那麼，我需要做些什麼才能做到呢？”這就是折扣。這就是你損失利潤的地方。

And to the extent that we're able to get enough leads and get enough jobs on the board for those service men, you can see how that could have a dramatic effect on margin just by having that additional potential work. And it's like a multiplier effect. And again, we're not that far from getting back on an even keel with regard to leads. And when I say even keel, I mean something that's not down double digits. So that's the magic as far as paying a little bit more but still having strong margins.

如果我們能夠獲得足夠的客戶線索，並為這些服務人員安排足夠的工作，那麼僅僅因為有了這些額外的潛在工作，就能對利潤率產生巨大的影響。這就像是一種倍增效應。再說一遍，我們在領先優勢方面距離恢復正常水準已經不遠了。我說的「保持平穩」是指沒有出現兩位數的下滑。這就是其中的奧妙所在：只要多花一點錢，就能獲得可觀的利潤。

All or nothing. To the service man, if he cuts $70 off the job, that's at least something for his time. But again it's -- bad business drives out good business, and that's what we're always at war with.

要嘛全有，要嘛全無。對維修人員來說，如果他能從工作中減免 70 美元，那至少也是對他時間的補償。但事實依然如此——糟糕的商業行為會驅逐優秀的商業行為，而這正是我們一直在與之奮鬥的原因。

And we've put in some a little bit tighter controls around what the technicians are able to do at the door, a little bit higher level approval requirements and things like that. But a learned behavior like that doesn't change overnight. And that's why we knew this was going to be at least a couple of quarters to really fix this learned behavior in the field. And we're pleased with where it has progressed through the end of the third quarter.

我們對技術人員在門口可以進行的操作進行了一些更嚴格的控制，提高了審批要求等等。但這種後天養成的行為不會在一夜之間改變。所以我們知道，至少需要幾個季度的時間才能真正糾正這種在實際工作中養成的行為習慣。我們對第三季末的進展感到滿意。

Okay. Because like I say, if I look at year-to-date, adjusted EBITDA margin for the segment, about 23% or so. But I guess to get to your full year guidance, that just implies higher margin in fourth quarter. But you also alluded to the idea of like seasonality impact, right? So is that --

好的。因為就像我說的，如果我看一下該部門今年迄今為止的調整後 EBITDA 利潤率，大約是 23% 左右。但我認為，要實現全年業績預期，就意味著第四季利潤率會更高。但你也提到了季節性影響之類的因素，對吧？所以是這樣嗎？--

Yes, fourth quarter is always the highest.

是的，第四季總是最高的。

Always the higher margin. Okay. Because it kind of comes out to be like 25% or so to get to, call it, 24% for the year. So is that 24% like a good number to think about as we head into next year in terms of margins?

始終選擇利潤較高的方案。好的。因為這樣算下來，要達到全年 24%​​ 的目標，大概需要付出 25% 左右的努力。那麼，就利潤率而言，24% 這個數字在展望明年時是否值得我們參考呢？

I think we can do better than that next year. But again, we're working on the budgets now. But I think we should see some margin improvement certainly next year compared to '25.

我認為我們明年可以做得更好。但是，我們現在正在製定預算。但我認為，與 2025 年相比，明年利潤率肯定會有所提高。

And then when it comes to top line, right, so it's tracking, call it, 1% growth this year. So how should we think about it? Can this business kind of grow closer to mid-single digits? Is that still kind of on the table? And when would you think we should be able to see that kind of growth?

至於營收方面，今年預計成長1%。那我們該如何看待這個問題呢？這個業務能否達到接近中個位數的成長？這個方案還在考慮範圍嗎？你認為我們什麼時候才能看到這種成長？

I think we, again, are in the early stages of our budgeting process. I think we'll see better growth next year than we've seen this year, whether that's 3% to 5%, it's speculating at this point.

我認為，我們目前仍處於預算編制過程的早期階段。我認為明年我們將看到比今年更好的成長，無論是 3% 還是 5%，目前都只是猜測。

I would say that's probably going to be our budget. It's the way, it's -- put it that way that our budget will definitely start in that range as submitted to us, let's put it that way, and then we'll go to more.

我想這大概就是我們的預算了。就是這樣，這麼說吧，我們的預算肯定會從提交給我們的那個範圍開始，就這麼說吧，然後我們會增加更多。

Yes. And then with the green shoots we've seen in certain revenue categories, in the third quarter here, there could be upside to that. But we're monitoring day-to-day what's happening in the field. And we're going to put together a budget that we think is achievable but also realistic.

是的。而且，鑑於我們在第三季某些收入類別中看到的復甦跡象，這方面可能還有上升空間。但我們正在密切關注現場的日常情況。我們將制定一份我們認為既可行又切合實際的預算。

Okay. And switching to VITAS, right? So just to clarify first, so when you said you do not have too many liabilities in Florida under the cap. Is it because you just kind of based on the rate increase, you can tell that, hey, like the delta between the rates in Florida versus the cap increase is much smaller, so that's the reason for staying like no liability? Or are you in that statement, you also already assumed like some offsets from these new markets or other things?

好的。然後再換用VITAS，對吧？首先澄清一下，您之前說過您在佛羅裡達州的負債沒有太多，而且不超過上限。是因為你僅根據利率上漲情況就得出結論，例如佛羅裡達州的利率與上限漲幅之間的差距要小得多，所以才選擇不承擔責任嗎？或者，您在聲明中是否也已經考慮到了這些新市場或其他因素所帶來的一些抵銷效應？

Yes. So Joanna, it's not just based on the year-over-year reduction in the rate increase. It actually is because of our focus and strategy within the marketplace and what Kevin referenced at the beginning of the call, which is the overall percentage of our admissions coming from hospital preadmit environment which, as we know, has a tendency to drive a shorter length of stay patients.

是的。所以喬安娜，這不僅僅是基於利率逐年下降的幅度。實際上，這是因為我們在市場上的關注點和策略，以及凱文在電話會議開始時提到的，即我們來自醫院入院前環境的入院患者總比例，我們知道，這往往會導致患者住院時間縮短。

So what we saw was, last year in the Medicare Cap year for '25, we had multiple months where our overall percentage of hospital admissions dropped to a record low of our overall mix of admissions. That's what Kevin was referencing, that sweet spot being between 42%, 42.5% and 45%.

因此，我們看到，在 2025 年的 Medicare 上限年度，有好幾個月我們的住院總比例下降到我們整體入院人數佔總入院人數比例的歷史最低水平。這就是凱文所指的，最佳範圍在 42%、42.5% 和 45% 之間。

We are monitoring that on a regular basis. And as we indicated for the last quarter, we were at a high watermark of 44.5%. That's what gives us the confidence in knowing that we are in the right direction to mitigate any cap liability. Then with addition, on top of that, we have the Pinellas opening that we're excited about.

我們會定期監測此事。正如我們在上個季度所指出的那樣，我們達到了 44.5% 的高點。正是這一點讓我們有信心，我們正朝著正確的方向前進，以減輕任何上限責任。此外，我們也非常期待皮內拉斯縣的開幕。

Also don't forget, Joanna, the length of stay has really come back into line, which really indicates that the bubble of patients that we create -- the bubble of long-stay patients that we created in community access has been moderating as we expected as well.

喬安娜，別忘了，住院時間已經恢復正常，這確實表明，我們創造的患者群體——我們在社區准入中創造的長期住院患者群體——也正如我們預期的那樣正在逐漸縮小。

But Joel -- Joanna, you also pointed, there's no question that last year, the thing that pushed VITAS over the edge ultimately in one fell swoop,was the increase, the fact that the increase was 200 basis points higher than the rate that the Medicare Cap was going to be calculated on.

但喬爾——喬安娜，你也指出，毫無疑問，去年最終讓 VITAS 徹底失敗的原因是漲幅，漲幅比 Medicare Cap 的計算標準高出 200 個基點。

That means that alone was, in retrospect, too much to overcome, particularly in line with the issues Joel just spoke about. And then again, just to reiterate, the fact that we now have the rate increase for the nation and Florida, and it's what we have characterized from our perspective is kind of in a sweet spot. It's up but it's very doable.

這意味著，事後看來，光是這一點就足以克服太多困難，尤其考慮到喬爾剛才提到的那些問題。然後，再次重申一下，我們現在對全國和佛羅裡達州都提高了利率，從我們的角度來看，這正處於一個非常有利的階段。雖然還沒完成，但完全可行。

So what is that number, if you can share with us, versus the 200 delta in fiscal '25? What is it in '26?

那麼，如果您能與我們分享這個數字，它與 2025 財年的 200 差值相比是多少呢？'26年是什麼？

30 basis points to 40 basis points. The national average is around 2.6% or 2.7%. We've calculated our Florida average to be 3%. That equates to a $3 million or $4 million headwind, which is well within our ability to manage. That headwind last year was $22 million or $25 million.

30個基點至40個基點。全國平均約為 2.6% 或 2.7%。我們計算佛羅裡達州的平均值為 3%。這相當於 300 萬到 400 萬美元的逆風，這完全在我們能夠應付的範圍內。去年這股不利因素造成了 2,200 萬至 2,500 萬美元的損失。

All right. Exactly. Okay. Exactly, that's what I was looking for. And then so I guess, when it comes to these short stay patients, and it sounds like you're getting better -- you've got better traction and now I guess you're kind of maybe stopping that.

好的。確切地。好的。沒錯，這正是我要找的。所以，我想，對於這些短期住院的病人，聽起來你們的情況有所好轉——你們取得了更好的進展，現在我想你們可能正在逐漸停止這種做法。

Because at some point, you're going to talk about sort of like some pause, as in like there was more competition for these patients. So it sounds like in third quarter, like things have changed to the point where you're now also taking more of these longer stay patients. Is that the way to think about how you describe the situation?

因為在某種程度上，你會談到某種停頓，比如說，對這些病人的競爭更加激烈了。聽起來，到了第三季度，情況發生了變化，你們現在也接收了更多長期住院的病人。你是這樣看待和描述這種情況的嗎？

We definitely saw last year that -- as we said, VITAS knew at the beginning of the year that it's an uphill battle. And they've pulled various traditional levers that you would think would have the effect of getting more short-stay patients. That is more salespeople, more effort at the hospital level.

去年我們確實看到了這一點——正如我們所說，VITAS 在年初就知道這是一場艱苦的戰鬥。他們採取了各種傳統手段，你可能會認為這些手段會促使更多病人短期住院。這意味著需要更多的銷售人員，醫院層級也需要投入更多精力。

And one of the things we observed, it didn't have quite the effect that traditionally VITAS would have come to expect. And one aspect of that was pretty much everybody in Florida got this big increase. Not everybody -- I mean, impact, that is hospices do continuous care got that type of 200 basis point increase.

我們觀察到的一點是，它並沒有產生傳統 VITAS 所預期的效果。其中一個面向是，佛羅裡達州幾乎所有人的收入都大幅成長。並非所有機構——我的意思是，臨終關懷機構提供持續護理，都獲得了 200 個基點的增長。

But there were increases in Florida that the hospices that traditionally weren't that concerned with short stay patients became more concerned with them. And the real effect last year was just we pulled some levers that we expected to have some reaction. And given that environment, they didn't have quite the impact that we would have hoped. Those, for all the reasons we talked about, are kind of 2025 issues.

但佛羅裡達州的情況有所好轉，一些傳統上不太關注短期住院病人的臨終關懷機構開始更加關注這些病人。而去年真正的結果，只是我們採取了一些措施，我們預期會產生一些反應。鑑於當時的形勢，它們並沒有產生我們預期的影響。正如我們討論的那樣，這些問題都屬於 2025 年才會出現的問題。

2026 issues for VITAS is to get the hospital admissions, get the first-time Medicare admits, have a reasonable average length of stay. And given the reimbursement environment, we should be back to the position where we don't have the Medicare Cap limitation in Florida. It's just -- it's pretty simple. And maybe it's a lot of work to do those various components. But the conclusion from reasonable assumptions is pretty direct. Joel, anything to add just on that very general observation?

2026 年 VITAS 面臨的問題是：獲得醫院入院人數，獲得首次 Medicare 入院人數，以及達到合理的平均住院時長。鑑於目前的報銷環境，我們應該能夠回到佛羅裡達州不再受醫療保險上限限制的狀態。就是——就很簡單。或許完成這些不同的組成部分需要花費大量精力。但從合理的假設出發，結論非常直接。喬爾，關於你剛才那個非常籠統的觀察，還有什麼要補充的嗎？

No, I think you're spot on, Kevin. It was the combination of the census growth with the rate increase that just put us in a circumstance that was at a number where we couldn't get out from underneath it throughout the calendar -- throughout the Medicare Cap year.

不，我覺得你說得完全正確，凱文。人口成長和費率上漲的雙重影響，使我們陷入了一種困境，在整個醫療保險上限年度內，我們都無法擺脫這種困境。

And keep in mind, it's just one of those things. Even having said all that, no one likes a surprise $18.9 million hit. But that's still less than 2% of the -- I mean, it's still flying pretty darn close to what would have been arriving on fumes. We just didn't quite make it. We're within 2%. So it wasn't a big miss. It was a small miss. But it was -- the problem with it, it was the first time ever and it was a scary specter, a term that we hadn't really talked about in the past, that was Medicare Cap in Florida.

記住，這只是其中一件小事。即便如此，也沒有人喜歡意外獲得 1,890 萬美元的票房佳績。但這仍然不到 2%——我的意思是，它仍然非常接近勉強抵達時的水平。我們最終還是沒能成功。我們誤差在2%以內。所以這不算是什麼重大失誤。只是一個小小的失誤。但問題在於——這是有史以​​來第一次，而且是一個可怕的幽靈，一個我們過去從未真正談論過的術語，那就是佛羅裡達州的醫療保險上限。

And if I may follow up on the discussion on seasonality, right? So if I do the same exercise in VITAS in terms of just like how margins are tracking so far this year and what this impact was fourth quarter, so it sounds like margins, I guess, would need to go up year-over-year, like 50 bps or so to get to your prior, I guess, segment margin pre cap. But they've been down year-over-year.

我可以繼續討論季節性問題嗎？所以，如果我對 VITAS 做同樣的分析，看看今年到目前為止利潤率的走勢以及第四季度受到的影響，那麼利潤率似乎需要同比增長 50 個基點左右才能達到你之前的部門利潤率（未計入資本）。但與去年同期相比，他們的業績有所下降。

So I guess, what's going to be different? I guess, is this really the kind of the mix of patients you assume you're going to be having more of the tailwind from the long stay patients?

所以我想問，會有哪些不同呢？我想，你真的認為這種類型的病人組合能讓你更能受益於長期住院病人的幫助嗎？

No, I think it's the things we've talked about already. We get a bump from the rate increase, I think Joel has talked about some of the things they're doing at the SG&A level. If you notice, in the third quarter for VITAS, SG&A actually is down year-over-year. That's going to continue in the fourth quarter. So they're combining rate increases, a little better efficiencies as well as some specific targeted cost-cutting measures.

不，我覺得是我們已經討論過的那些事情。這次漲價為我們帶來了一些好處，我想喬爾已經談到了他們在銷售、管理及行政費用方面正在做的一些事情。如果您仔細觀察，您會發現 VITAS 第三季的銷售、一般及行政費用實際上比去年同期下降了。這種情況將在第四季繼續。因此，他們結合了提高費率、提高效率以及一些有針對性的成本削減措施。

Joanna, let me make one comment. And -- we don't give quarterly guidance. But I'd say, we reiterated guidance just yesterday. And Ben mentioned something earlier that as far as was basically wasn't aspirational to be shooting for midpoint of guidance.

喬安娜，請容許我補充一點。而且—我們不提供季度業績指引。但我想說，我們昨天才剛重申了相關指導。Ben 之前提到過，基本上不應該以指導方針的中點為目標。

And I'll just say at this point, no, I mean, we're shooting at the upper end of guidance. We don't think it's aspirational in any respect. And you're certainly right. Most of the questions have been along the lines of -- okay, so it is doable. It is -- that you are on course. And the answer is not only you are on course, we think that we're on the upper end of the course.

我只想說，不，我的意思是，我們的目標是達到指導方針的上限。我們認為它在任何方面都不具有啟發意義。你說的完全正確。大多數問題都類似於——好吧，所以這是可行的。也就是說──你正走在正確的道路上。答案不僅是你們走在正確的道路上，我們認為我們走在了正確的道路上。

And if I may, sorry, last question. But since you mentioned sequentially G&A down, but also the gross margin was actually up sequentially more than historically at third quarter versus Q2. Gross margin in VITAS will be higher. But this quarter it was like 220 basis points versus maybe like 100 or something in that range in the past. So is there something that you did this quarter?

如果可以的話，抱歉，最後一個問題。但既然你提到了 G&A 環比下降，但第三季的毛利率實際上比第二季環比增長幅度更大。VITAS的毛利率會更高。但本季這個數字達到了 220 個基點，而過去這個範圍的波動可能只有 100 個基點左右。那麼，你這季度做了些什麼嗎？

I don't think there's anything specific, Joanna. I think it's all the things that we've talked about with Joel talking about efficiencies that they've looked at. They looked program by program and are they properly staffed in Florida, and they made the adjustments when they needed to. So I don't think there's -- I wouldn't call there any specific initiatives or anything. I would call out directly other than they're looking program-by-program and managing costs appropriately.

喬安娜，我覺得沒什麼特別的。我認為這都是我們和喬爾討論過的關於提高效率的事情，也是他們一直在關注的問題。他們逐一進行審查，並檢查佛羅裡達州的人員是否充足，並在需要時進行調整。所以我覺得目前還沒有——我不會稱之為任何具體的舉措或措施。我本來想直接指出問題所在，但他們表示正在逐一進行審查，並適當地控製成本。

At this time, that does conclude the question-and-answer session. I would now like to turn it back to Kevin McNamara, CEO, for closing remarks.

至此，問答環節結束。現在我謹將發言權交還給執行長凱文·麥克納馬拉，請他作總結發言。

I just want to thank everyone for their attention to our quarterly report. I guess the next time you'll hear from us is mid-February where we'll both have the fourth quarter and our guidance for next year. Thank you.

我謹代表季度報告感謝大家的關注。我想下次你們會聽到我們的消息是在二月中旬，屆時我們會公佈第四季度業績以及我們對明年的業績展望。謝謝。

Thank you. And thank you for your participation in today's conference. This does conclude the program. You may now disconnect.

謝謝。感謝各位參加今天的會議。節目到此結束。您現在可以斷開連線了。