Encompass Health Corp (EHC) 2025 Q2 法說會逐字稿

Good morning, everyone, and welcome to Encompass Health's Second Quarter 2025 Earnings Conference Call. (Operator Instructions)

大家早安，歡迎參加 Encompass Health 2025 年第二季財報電話會議。（操作員指示）

Today's conference call is being recorded. If you have any objections, you may disconnect at this time. I will now turn the call over to Mark Miller, Encompass Health's Chief Investment Relations Officer.

今天的電話會議正在錄音。如果您有任何異議，您可以立即斷開連接。現在我將把電話轉給 Encompass Health 的首席投資關係長 Mark Miller。

Thank you, operator, and good morning, everyone. Thank you for joining Encompass Health's Second Quarter 2025 Earnings Call. Before we begin, if you do not already have a copy, the second quarter earnings release, supplemental information and related Form 8-K filed with the SEC are available on our website at encompasshealth.com. On page 2 of the supplemental information, you will find the Safe Harbor statements, which are also set forth in greater detail on the last page of the earnings release.

謝謝接線員，大家早安。感謝您參加 Encompass Health 2025 年第二季財報電話會議。在我們開始之前，如果您還沒有副本，您可以在我們的網站 (encompasshealth.com) 上找到第二季財報、補充資訊以及提交給美國證券交易委員會 (SEC) 的相關 8-K 表格。在補充資料的第二頁，您可以找到安全港聲明，財報的最後一頁也對這些聲明進行了更詳細的說明。

During the call, we will make forward-looking statements such as guidance and growth projections, which are subject to risks and uncertainties, many of which are beyond our control. Certain risks and uncertainties, like those relating to regulatory developments as well as volume, bad debt and cost trends that could actually -- that could cause actual results to differ materially from our projections, estimates and expectations are discussed in the company's SEC filings, including the earnings release and related Form 8-K, the Form 10-K for the year ended December 31, 2024, the Form 10-Q for the quarter ended March 31, 2025, and the Form 10-Q for the quarter ended June 30, 2025, when filed. We encourage you to read them.

在電話會議中，我們將做出前瞻性陳述，例如指導和成長預測，這些陳述受風險和不確定性的影響，其中許多是我們無法控制的。某些風險和不確定因素，例如與監管發展以及交易量、壞帳和成本趨勢有關的風險和不確定因素，實際上可能導致實際結果與我們的預測、估計和預期存在重大差異，這些因素在該公司的 SEC 文件中進行了討論，包括收益報告和相關的 8-K 表、截至 2024 年 12 月 31 日的年度截至 10-K 2025 年 6 月 30 日的季度 10-Q 表。我們鼓勵您閱讀它們。

You are cautioned not to place undue reliance on the estimates, projections, guidance and other forward-looking information presented, which are based on current estimates of future events and speak only as of today. We do not undertake a duty to update these forward-looking statements. Our supplemental information and discussion on this call will include certain non-GAAP financial measures, for such measures, reconciliations to the most directly comparable GAAP measure is available at the end of the supplemental information at the end of the earnings release and as part of the Form 8-K filed yesterday with the SEC, all of which are available on our website.

請注意不要過度依賴所提供的估計、預測、指導和其他前瞻性信息，這些信息基於對未來事件的當前估計，並且僅代表截至今天的情況。我們不承擔更新這些前瞻性陳述的義務。我們在本次電話會議上的補充資訊和討論將包括某些非 GAAP 財務指標，對於此類指標，與最直接可比的 GAAP 指標的對帳可在收益報告末尾的補充資訊末尾找到，也可以作為昨天向美國證券交易委員會提交的 8-K 表格的一部分找到，所有這些都可以在我們的網站上找到。

I would like to remind everyone that we will adhere to the one question and one follow-up question rule to allow everyone to submit a question. If you have additional questions, please feel free to put yourself back in the queue. With that, I'll turn the call over to President and Chief Executive Officer, Mark Tarr.

我想提醒大家，我們將遵守一個問題和一個後續問題的規則，讓每個人都提交一個問題。如果您還有其他問題，請隨時回到佇列。說完這些，我將把電話轉給總裁兼執行長馬克塔爾 (Mark Tarr)。

Mark, thank you, and good morning, everyone. Our discharge growth in the second quarter facilitated an increase of 12% in revenue and 17.2% in adjusted EBITDA. Total discharges for Q2 increased 7.2%, including 4.7% in same-store. Our discharge growth was again broad-based across geographies, payers and patient type. Our focus remains on successfully treating patients with complex medical conditions.

馬克，謝謝你，大家早安。我們第二季的排放量成長推動了營收成長 12%，調整後 EBITDA 成長 17.2%。第二季總出院人數增加 7.2%，其中同店出院人數增加 4.7%。我們的出院人數增長再次廣泛地跨越了地理、付款人和患者類型。我們的重點仍然是成功治療患有複雜疾病的患者。

Neurological conditions and stroke for which we have extensive clinical expertise, grew 12% and 6.7%, respectively, in the quarter. Our dedicated and highly competent clinical teams continue to deliver outstanding patient outcomes. Our Q2 discharge community rate was our discharge to acute rate was 8.5% and our discharge to SNF rate was 5.8%. Our performance on each of these quality metrics is favorable compared to the industry average.

我們擁有豐富臨床專業知識的神經系統疾病和中風病例在本季分別增加了 12% 和 6.7%。我們敬業且高素質的臨床團隊不斷為患者帶來卓越的治療效果。我們的 Q2 出院社區率為我們的急性出院率為 8.5%，我們的 SNF 出院率為 5.8%。與行業平均值相比，我們在每個品質指標上的表現都是良好的。

In Q2, we opened a new 60-bed hospital in Fort Myers, Florida. We also added 26 beds to an existing hospital. In July, we opened a new 50-bed hospital in Daytona Beach, Florida and added 20 beds to an existing hospital. Over the balance of the year, we plan to open 5 additional hospitals, 4 for de novos with a total of 190 beds and a 50-bed freestanding satellite hospital and add another 30 to 50 beds to existing hospitals.

第二季度，我們在佛羅裡達州邁爾斯堡開設了一家擁有 60 張床位的新醫院。我們也為現有醫院增加了26張病床。7 月，我們在佛羅裡達州代托納比奇開設了一家擁有 50 張床位的新醫院，並在現有醫院中增加了 20 張床位。在今年餘下的時間裡，我們計劃再開設 5 家醫院，其中 4 家為新發醫院，共有 190 張床位，還有一家擁有 50 張床位的獨立衛星醫院，並在現有醫院中再增加 30 至 50 張床位。

Due in large part to our Q2 results, we are again increasing our 2025 guidance. The demand for inpatient rehabilitation services remains considerably underserved, and continues to grow as the US population ages. The Medicare beneficiary population is the fastest-growing segment of the US population.

很大程度上由於我們第二季的業績，我們再次提高了 2025 年的預期。住院復健服務的需求仍然嚴重不足，並且隨著美國人口老化而持續增長。醫療保險受益人群是美國人口中成長最快的族群。

It is estimated that by 2030, 1 in 5 Americans more than 70 million people will be aged 65 or older. The 65-or-older population has been growing consistently at a CAGR of approximately 3%. The average age of our Medicare beneficiary patient is 77 years old, and the aged 75-plus population is growing at approximately 4%, yet the supply of licensed IRF beds in the USas increased only nominally.

據估計，到2030年，每5個美國人中就有1個（超過7,000萬人）年齡在65歲或以上。65歲或以上人口一直以約3%的複合年增長率持續成長。我們的醫療保險受益患者的平均年齡為 77 歲，75 歲以上的老年人口增長率約為 4%，但美國獲得許可的 IRF 床位供應量僅名義上增加。

As a result, the demand for treatment of complex medical conditions such as stroke, necessitating earth care intensity is significantly underserved. We treat more patients with IRF appropriate conditions than any other provider. This allows us to develop and refine best-in-class clinical protocols which are then extrapolated across our hospitals via our continuous best practice initiatives. The identification, development and implementation of these clinical protocols is enhanced by our state-of-the-art information systems, including our IRF specific electronic medical record.

因此，對中風等複雜疾病的治療需求，以及對地球照護強度的要求，明顯得不到滿足。我們治療的患有 IRF 適當病症的患者比任何其他醫療服務提供者都多。這使我們能夠開發和完善一流的臨床方案，然後透過我們持續的最佳實踐計劃將其推廣到我們的醫院。我們最先進的資訊系統（包括 IRF 特定的電子病歷）增強了這些臨床協議的識別、開發和實施。

In addition to our strong performance on discharge community rate, we outperform industry averages on many quality, patient safety and patient satisfaction measures, including patients' mobility at discharge their ability to care for themselves at discharge, medication management, pressure ulcers or pressure injuries that are new or worsened and patient Net Promoter Score. Referring hospitals know they can reliably spend complex patients to our hospitals for post-acute services. Our attractiveness as a partner to acute care hospitals is further evidenced by the fact that 67 of our 169 hospitals are operated as joint ventures.

除了在出院社區率方面表現強勁之外，我們在許多品質、病人安全和病人滿意度指標上也優於行業平均水平，包括病人出院時的活動能力、出院時的自我照護能力、藥物管理、新發或惡化的壓瘡或壓力損傷以及病人淨推薦值。轉診醫院知道他們可以可靠地將病情複雜的患者送到我們的醫院接受急性後期治療。我們作為急診醫院合作夥伴的吸引力進一步體現在我們擁有 169 家醫院，其中 67 家是以合資企業形式運作的。

Finally, on August 1, 2025, CMS released the 2026 IRF final rule. This included a net market basket update of 2.6% and which we estimate would result in approximately 2.7% increase in net revenue per discharge for our Medicare patients beginning October 1, 2025, and based on our current patient mix.

最終，CMS 於 2025 年 8 月 1 日發布了 2026 年 IRF 最終規則。這包括 2.6% 的淨市場籃子更新，根據我們目前的患者組合，我們估計從 2025 年 10 月 1 日開始，這將導致我們的醫療保險患者每次出院的淨收入增加約 2.7%。

With that, I'll turn it over to Doug.

說完這些，我就把話題交給道格。

Thank you, Mark, and good morning, everyone. Revenue for the second quarter increased 12% to $1.46 billion and adjusted EBITDA increased 17.2% to $308.6 million. The revenue increase was comprised of 7.2% discharge growth a 4.2% increase in net revenue per discharge. Q2 net revenue per discharge benefited from a decrease of 90 basis points in bad debt expense to 2%. Recall that Q2 '24 bad debt expense included reserves associated with significant increase in prepayment claims reviews under TPE.

謝謝你，馬克，大家早安。第二季營收成長 12% 至 14.6 億美元，調整後 EBITDA 成長 17.2% 至 3.086 億美元。收入成長包括排放量成長 7.2% 和每次排放量淨收入成長 4.2%。第二季每筆出院淨收入受惠於壞帳費用下降 90 個基點至 2%。回想一下，24 年第二季的壞帳費用包括與 TPE 下預付款索賠審查大幅增加相關的準備金。

Q2 FWB per FTE increased 4%.

第二季每 FTE 的 FWB 增加了 4%。

Salaries and wages per FTE, excluding contract labor and sign-on and ship bonuses increased 3.4%. Contract labor and sign-on and shipped bonuses declined by $4.9 million or 15.1%. Contract labor FTEs represented 1.3% of total FTEs. Q2 benefit expense per FTE increased by 18%, and benefits expense growth continues to be driven by an increase in the frequency of high dollar medical claims. We expect group medical expense growth to moderate in the second half of the year as we anniversary the increase we experienced in 2024.

不包括合約工、簽約獎金和船舶獎金在內的每全職員工薪資和薪水增加了 3.4%。合約工、簽約獎金和運送獎金減少了 490 萬美元，降幅為 15.1%。合約工全職當量佔全職當量總數的 1.3%。第二季每位全職員工的福利支出增加了 18%，高額醫療理賠頻率的增加持續推動福利支出的成長。我們預計，隨著 2024 年經歷的成長週年紀念，團體醫療費用成長將在下半年放緩。

Net preopening and ramp-up costs were $4 million in Q2, taking the first half totaled to $6.1 million. We expect these costs for the full year to be in a range of $18 million to $22 million. Q2 adjusted free cash flow increased 30.5% to approximately $186 million, bringing year-to-date adjusted free cash flow to approximately $408 million a 31.7% increase from the first half of 2024. On the basis of our strong Q2 performance and the tax benefit of additional bonus depreciation resulting from recent legislation, we now expect 2025 adjusted free cash flow of $705 million to $795 million favorable.

第二季淨開業前和擴張成本為 400 萬美元，上半年總計 610 萬美元。我們預計全年成本將在 1800 萬美元至 2200 萬美元之間。第二季調整後的自由現金流成長 30.5% 至約 1.86 億美元，使年初至今調整後的自由現金流達到約 4.08 億美元，較 2024 年上半年成長 31.7%。基於我們強勁的第二季業績以及最近立法帶來的額外獎金折舊稅收優惠，我們現在預計 2025 年調整後的自由現金流將達到 7.05 億美元至 7.95 億美元。

Our leverage and liquidity remain very favorable. Net leverage at quarter end was 2x. We ended the quarter with approximately $100 million in unrestricted cash and in excess of $950 million available on our $1 billion revolving credit facility. During the second quarter, we repurchased approximately 232,000 shares of our common stock for $24.7 million. We recently announced an increase in our quarterly dividend next payable in October to $0.19 per share.

我們的槓桿率和流動性仍然非常有利。季度末的淨槓桿率為 2 倍。截至本季末，我們擁有約 1 億美元的非限制性現金，以及超過 9.5 億美元的 10 億美元循環信貸額度。第二季度，我們以 2,470 萬美元回購了約 232,000 股普通股。我們最近宣布將 10 月支付的季度股息提高至每股 0.19 美元。

As can be seen on Page 13 of our supplemental materials, we have again increased our anticipated growth CapEx estimate for 2025. You will recall that following Q1, we raised our estimated 2025 spend by $15 million to $20 million to pull forward a number of bed expansions in response to our increasing occupancy rates. We are now further increasing our 2025 estimated spend on bed expansion by $25 million, predominantly related to our recently announced CON approval for a freestanding hospital in Cleveland, Tennessee, which we intend to operate as a satellite of an existing hospital.

正如我們補充資料第 13 頁所示，我們再次提高了 2025 年預期成長資本支出估計值。您會記得，在第一季之後，我們將預計 2025 年的支出提高了 1500 萬美元至 2000 萬美元，以提前擴建一些床位，以應對不斷上升的入住率。我們現在進一步將 2025 年的床位擴建預計支出增加 2500 萬美元，這主要與我們最近宣布的 CON 批准在田納西州克利夫蘭建立一家獨立醫院有關，我們打算將其作為現有醫院的衛星醫院來運作。

Production of this fully prefabricated hospital will commence shortly. We also added $5 million to our anticipated 2025 de novo spend as we have elected to accelerate the land purchase of a future period de novo.

這座完全預製的醫院的生產即將開始。由於我們選擇加快未來一段時間的土地購買，我們還在預計的 2025 年 de novo 支出中增加了 500 萬美元。

Moving on to guidance. We are raising our 2025 guidance as follows: net operating revenue of $5.88 billion to $5.98 billion, adjusted EBITDA of $1.22 billion to $1.25 billion and adjusted earnings per share of $5.12 to $5.34. The key considerations underlying our guidance can be found on Page 11 of the supplemental slides.

繼續指導。我們將2025年業績指引上調如下：淨營業收入從58.8億美元上調至59.8億美元，調整後息稅折舊攤銷前利潤（EBITDA）從12.2億美元上調至12.5億美元，調整後每股收益從5.12美元上調至5.34美元。我們業績指引所依據的關鍵考量因素請參考第11頁的補充投影片。

And with that, we'll now open the lines for questions.

現在，我們開始回答問題。

(Operator Instructions)

（操作員指示）

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Good morning, Andrew.

早安，安德魯。

Hi. Good morning. Occupancy rates have increased more than 200 basis points year-over-year through the first half of the year. I think some of that has benefited from a shift to single bed rooms. But if you just look purely at your single bedroom facilities, like where is mature occupancy? And what levels are you comfortable operating at? Thanks.

你好。早安.今年上半年，入住率年增超過200個基點。我認為，部分原因是由於改用單人床房而受益。但是，如果您只單純地看單臥室設施，那麼成熟的入住率在哪裡呢？您覺得在哪些層面上操作比較方便？謝謝。

Yes. So it varies pretty widely across the portfolio, really depending on the maturity of the hospital itself. First, to begin and give some of the specifics, the numbers that you're looking at, Andrew. At the end of 2020, 41% of the beds in our portfolio were private. At the end of the second quarter, we were at 56%.

是的。因此，整個投資組合的差異很大，實際上取決於醫院本身的成熟度。首先，請給出一些具體細節，即您正在查看的數字，安德魯。截至 2020 年底，我們投資組合中 41% 的床位為私人床位。截至第二季末，我們的佔比已達 ​​56%。

To your point, occupancy in Q2 was 76.6%, and that's up 210 basis points over the second quarter of last year. When we're looking at an all private room facility, when the occupancy starts to stabilize north of 80%, we start putting it on a list -- we put it on a list and start thinking about a future period bed expansion.

正如您所說，第二季的入住率為 76.6%，比去年第二季上升了 210 個基點。當我們考慮一個全私人房間設施時，當入住率開始穩定在 80% 以上時，我們就開始把它列入清單 - 我們把它列入清單並開始考慮未來床位的擴展。

Now the capacity in those facilities can run into the mid- to high 90s because you're not facing issues of gender or germ compatibility. It's lower than that for the hospitals that are still semiprivate rooms. Recall, as we move into the back half of the year, based on the opening schedule that Mark highlighted during his comments, you're going to see a little bit of a downward pressure on the occupancy because we've got that new capacity coming on board.

現在這些設施的容量可以達到 90% 左右，因為您不再面臨性別或細菌相容性問題。對於仍為半私人房間的醫院來說，這個數字要低。回想一下，隨著我們進入下半年，根據馬克在評論中強調的開業時間表，你會看到入住率略有下降的壓力，因為我們有新的容量加入。

Great. And maybe just as a follow-up, there was some discussion of quality ratings in previous CMS rate proposals, but I don't think any of that has moved forward yet. Just curious to get your thoughts on those initiatives, what would you be willing to -- whether you support that and where you think you stand if those quality initiatives ultimately came to play. Thanks.

偉大的。也許只是作為後續行動，在之前的 CMS 費率提案中有一些關於品質評級的討論，但我認為這些都還沒有任何進展。我只是好奇地想知道您對這些舉措的看法，您願意做什麼——您是否支持這些舉措，以及如果這些品質舉措最終發揮作用，您認為自己的立場是什麼。謝謝。

Yes. Andrew, it's Mark. So the quality initiatives, any change in those did not get included in the final rule. They did take out some of the ones around COVID that were COVID specific. When we work with our trade associations, we are fine with looking at and including various quality measurements and think that we would do extremely well on that. We just want to make sure as an industry that we all agree on what those would be and how they would be measured.

是的。安德魯，我是馬克。因此，品質舉措及其中的任何變更都沒有被納入最終規則。他們確實刪除了一些與 COVID 相關的、特定於 COVID 的內容。當我們與行業協會合作時，我們樂於研究和納入各種品質測量，並認為我們在這方面做得非常好。我們只是想確保作為一個行業，我們都同意這些是什麼以及如何衡量它們。

Great. Thank you.

偉大的。謝謝。

Matthew Gillmor, KeyBanc.

馬修‧吉爾摩 (Matthew Gillmor)，KeyBanc。

Hey. Thanks. Good morning.

嘿。謝謝。早安.

I just wanted to do a quick follow-up on Andrew's question around quality. Can you just remind us how you share your quality results with different stakeholders? I guess I was thinking referral sources and JV partners. And are there any particular areas of quality that are sort of most relevant or important to those stakeholders?

我只是想快速跟進一下安德魯關於品質的問題。您能否提醒我們您如何與不同的利害關係人分享您的品質成果？我想我當時考慮的是推薦來源和合資夥伴。是否存在與這些利害關係人最相關或最重要的特定品質領域？

Yes. So we work closely with Joint Commission. And a matter of fact, they do our Medicare validation surveys for all of our new start-up de novos. And relative to outcome metrics, the ones that we really focus on and share, although with our joint ventures, we can go as deep as they want to, but the ones we're really focused on are discharge community, discharge to acute, discharge to SNF. And then we always include the patient satisfaction measurement with the Net Promoter Score.

是的。因此我們與聯合委員會密切合作。事實上，他們為我們所有的新創公司進行了醫療保險驗證調查。相對於結果指標，我們真正關注和分享的是，儘管透過我們的合資企業，我們可以盡可能深入地了解他們，但我們真正關注的是出院社區、出院至急性病、出院至 SNF。然後，我們總是將患者滿意度測量與淨建議值結合。

Those have all been prioritized by Medicare in the past. I think they are a good representation of the functionality of the patients at the time of discharge. And as you heard me in my prepared remarks, those are the ones that we do extremely well in. We do well in others. There are 16 measurements as part of the CMS care compare.

過去，這些都是醫療保險優先考慮的。我認為它們很好地體現了患者出院時的功能。正如你們在我準備好的發言中所聽到的，這些是我們做得非常出色的領域。我們在其他方面做得很好。CMS 護理比較包含 16 項測量。

But we're very proud of our outcomes and have been so for many years and continue to improve our outcomes. As a matter of fact, if you look at the discharge community as well as to acute, those were all the highest we've had in recent quarters. So we're very proud of our quality and make it a priority.

但我們對我們的成果感到非常自豪，多年來一直如此，並將繼續改善我們的成果。事實上，如果你看看出院社區以及急性病患者，這些都是我們最近幾季以來的最高水準。因此，我們對我們的品質感到非常自豪，並將其作為優先事項。

In addition to the acute care hospitals, obviously, another important constituency are the physicians who refer patients to us and many oversee the care of those patients when they come into our facility. And they tend to be very data-driven. And so we share with them a lot of the patient improvement scores that Mark cited in his comments earlier today. So we're looking at the gains that they have in functional capabilities and the ability to care for themselves and so forth. And again, that's all -- those are very numerically driven scores that physicians like to see and that they really study very hard.

除了急診醫院之外，顯然，另一個重要的組成部分是將患者轉診給我們的醫生，許多醫生負責監督進入我們醫院的患者護理。而且他們往往非常依賴數據。因此，我們與他們分享了馬克今天早些時候在評論中引用的許多患者改善分數。因此，我們正在觀察他們在功能能力、自我照顧能力等方面的進步。再說一遍，這就是全部——這些都是醫生喜歡看到的、而且他們確實非常努力研究的數字分數。

Great, I appreciate that.

太好了，我很感激。

And then I wanted to ask a follow-up on payer mix. It seems like the Medicare fee-for-service mix was pretty stable this quarter, but maybe managed care ticked up a little bit. And I noticed you increased the -- I think, your managed care pricing assumption. I was curious if there's a story around that to tell or what's driving that trend or perhaps it's just within kind of normal variation of what you'd expect.

然後我想問一下有關付款人組合的後續問題。本季醫療保險按服務收費組合似乎相當穩定，但管理式醫療可能略有上漲。我注意到您增加了—我認為，您的管理式醫療定價假設。我很好奇這其中是否有一個故事，或者是什麼推動了這一趨勢，或者也許這只是你所期望的正常變化。

There actually is a bit of a story there, and that has to do specifically with the VA Community Care Network contract. And so we have been seeing -- and that, again, is administered by 2 companies in the US One is a division of Optum and the other is Tri-West. More of our hospitals fall under the administration of Optum. When I say it's administered by those companies, it is on behalf of the VA.

這裡面其實有一點故事，具體與 VA 社區護理網絡合約有關。我們看到，這又是由美國的兩家公司管理的，一家是 Optum 的一個部門，另一家是 Tri-West。我們的更多醫院都歸 Optum 管理。當我說它由這些公司管理時，它是代表 VA 的。

But unlike Medicare Advantage, the VA is still the party that is making authorization decisions regarding patients that are referred to that network. So over the last three years, we've seen growth in that line of business that's been in the mid-teens. and it now comprises almost 18% of our overall managed care business. And importantly, it pays at the Medicare CMG. So that has been a driver of the growth in the managed care and also the improved pricing.

但與醫療保險優勢計劃不同的是，退伍軍人事務部仍然是對轉診到​​該網路的患者做出授權決定的一方。因此，在過去三年中，我們看到該業務線的成長速度達到了十五六倍，現在它占我們整體管理式醫療業務的近 18%。重要的是，它由 Medicare CMG 支付。因此，這成為管理式醫療成長和定價改善的驅動力。

Great, thank you.

太好了，謝謝。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Hey. Good morning, guys. Nice quarter.

嘿。大家早安。不錯的季度。

Looking at the EBITDA in the first half of the year for the back half of the year, can you sort of bridge to us sort of what the implied guidance is, how we should be thinking about start-up losses in the back half of the year, changes to employee per occupied bed in the back half of the year or any other changes as we bridge the first half of the year and the back half of the year?

透過查看上半年的 EBITDA 和下半年的 EBITDA，您能否向我們解釋一下隱含的指導是什麼，我們應該如何考慮下半年的啟動損失、下半年每張床位員工人數的變化，或者在連接上半年和下半年時出現的任何其他變化？

Yes, absolutely. And so as we move into the back half of the year, we do expect to incur the lion's share of the preopening and ramp-up costs. Again, if you're at the midpoint of the $18 million to $22 million for the year and you subtract out the $6 million in the first half, you're looking at about a $14 million number. We ran at a 2% bad debt number for the first half of the year. We hope that continues.

是的，絕對是。因此，隨著我們進入下半年，我們確實預計將承擔大部分開業前和開業初期的成本。再說一次，如果你處於全年 1800 萬美元到 2200 萬美元的中間值，並減去上半年的 600 萬美元，你會看到大約 1400 萬美元的數字。今年上半年我們的壞帳率為 2%。我們希望這種情況能夠持續下去。

But in our guidance assumptions, we've assumed that there is some resumption of TPE activity, which would cause that number to go higher.

但在我們的指導假設中，我們假設 TPE 活動有所恢復，這將導致該數字上升。

So pick your point for the second half of the year between 2% and 2.5%, you'd see an increase there. It's a smaller number, but we had favorable insurance adjustments of about $4 million in the first half of the year. We're not necessarily anticipating that those would continue. Even though it was down on a year-over-year basis, the net EBITDA impact from provider taxes was about $7 million. There's no guarantee that, that continues in the second half of the year.

因此，選擇下半年的點位在 2% 到 2.5% 之間，你會看到那裡的成長。雖然這個數字較小，但今年上半年我們的保險調整額度約為 400 萬美元。我們不一定預期這種情況會持續下去。儘管與去年同期相比有所下降，但供應商稅對淨 EBITDA 的影響仍約為 700 萬美元。沒有人能保證這種情況會在今年下半年持續下去。

And then the item that you suggested is we ran at a 3.34 EPOB in the first half of the year. We expect that to be closer to 3.40, particularly given the new capacity coming on board in the second half of the year. Going the other way is the Q4 pricing update, at least a portion of which will be offset by our annual merit cycle. I think those are most of the pieces, Pito. I hope that was responsive to your question.

然後，您建議的項目是，我們在今年上半年的運行速度為 3.34 EPOB。我們預計該比率將接近 3.40，特別是考慮到下半年新產能的投入。另一種情況是第四季度的定價更新，其中至少一部分將被我們的年度績效週期所抵消。我認為這些就是大部分作品，Pito。我希望這能回答你的問題。

Yes. That's perfect.

是的。那很完美。

Can you -- in the script, you talked about it, but what was the premium labor in the first quarter versus second quarter sort of sequentially? Just looking at the contract employees, they're basically flat sequentially. And I'm wondering if you saw a reduction overtime as you brought on more employees in the second quarter. And then any other comments you have on the ease of hiring today versus turnover on the full-time employees? Thanks.

你能嗎 - 在腳本中，你談到了這一點，但第一季度與第二季度的優質勞動力數量依次是多少？僅從合約工來看，他們的數量基本上是連續持平的。我想知道，隨著第二季員工數量的增加，加班時間是否減少。那麼，您對當今招募的便利性與全職員工的流動率還有其他評論嗎？謝謝。

Yes. So sign-on and shift bonus from Q1 to Q2 in Q1, it was $12.2 million. It was $10.9 million in Q2. In terms of the shift bonus component, it was $10.7 million in Q1 and $8.4 million in -- so nice improvement there. With regard to contract labor, we went from 16.4% in Q1, up just slightly to 16.7% in Q2. Contract labor FTEs, I think you actually hit this number, moved slightly from 375 to 379.

是的。因此，第一季從第一季到第二季的簽約獎金和輪班獎金為 1,220 萬美元。第二季為 1,090 萬美元。就輪班獎金部分而言，第一季為 1070 萬美元，第二季為 840 萬美元——因此取得了不錯的進步。就合約工而言，我們從第一季的 16.4% 略微上升至第二季的 16.7%。合約工 FTE，我認為你實際上達到了這個數字，從 375 略微上升到 379。

Peter, I'm going to ask Pat Tuer to weigh in on what he's seeing in terms of labor. He and the operations team have been working real hard, specifically on the recruitment and the retention, as we've mentioned in past calls.

彼得，我要請帕特‧圖爾談談他對勞動力的看法。正如我們在過去的電話會議中提到的那樣，他和營運團隊一直在努力工作，特別是在招募和留住人才方面。

Thanks, Mark. So we continue to see strong hiring. You may recall, a few years ago, we centralized our talent acquisition function. So we have 83 full-time employees that do nothing but focus on bringing people into our organization, and that encompasses both recruiters as well as the recruitment and marketing function. So we continue to see net hires up.

謝謝，馬克。因此，我們繼續看到強勁的招募勢頭。您可能還記得，幾年前，我們集中了人才招募職能。因此，我們有 83 名全職員工，他們的工作就是專注於為我們的組織招募人才，這包括招募人員以及招募和行銷職能。因此，我們繼續看到淨僱用人數上升。

We had 71 net hires in Q2, which is another strong quarter for us. And from a turnover perspective, we are hovering around pre-pandemic levels, just at 21%. That's up slightly from Q1, but it is well below the turnover rates that we saw during the pandemic. And our local teams are focused on making sure that the employees in their markets are paid competitively.

我們在第二季淨聘用了 71 名員工，這對我們來說又是一個表現強勁的季度。從營業額角度來看，我們徘徊在疫情前的水平，僅為 21%。這比第一季略有上升，但遠低於疫情期間的營業額率。我們的本地團隊致力於確保其市場的員工獲得有競爭力的薪酬。

We've also created a number of career ladders, and we're focused on enrolling as many folks that qualify for those into those ladders. We have shown if we can get an employee, a nurse specifically on the clinical ladder, they're turning over about 1/4 of the rate of our non-laddered nurses. So the other 2 things I'll point out is from a retention standpoint, we've put some effort in the workflow analysis just to make sure that we're reducing the burden on our clinical employees and making their workday as efficient as possible. And then another benefit of the centralized talent acquisition function is that with that recruitment function being centralized, our local HR folks have been able to focus more heavily on the engagement side, which has also helped retention.

我們還創建了許多職業階梯，並致力於招募盡可能多的符合條件的人才加入這些階梯。我們已經證明，如果我們能招募一名員工，特別是一名臨床護士，他們的離職率將達到非臨床護士的 1/4。因此，我要指出的另外兩件事是，從保留的角度來看，我們在工作流程分析方面付出了一些努力，只是為了確保減輕臨床員工的負擔並使他們的工作盡可能高效。集中人才招募功能的另一個好處是，隨著招募功能的集中，我們當地的人力資源人員能夠更加專注於參與方面，這也有助於留住人才。

A few of those turnover numbers were specific to nursing, which obviously has been a huge focus for us, too. But I mean we are also focused on therapy openings and making sure we retain our therapists as well. So I feel like we're making some continued progress here in what continues to be a challenging market out there.

其中一些營業額數字與護理有關，這顯然也是我們關注的重點。但我的意思是，我們也專注於治療機會，並確保我們也能留住我們的治療師。因此，我覺得我們在持續充滿挑戰的市場中取得了一些持續的進展。

Great. Thanks so much, guys.

偉大的。非常感謝大家。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

Hey, guys. Maybe just a follow-up on the hiring efforts. I was just thinking that we never talked about the physiatrist market, only nurses and therapists. How does that market look like today? And maybe talk about how you find bringing doctors into new markets?

嘿，大家好。也許只是招募工作的後續跟進。我只是在想，我們從來沒有談論過物理治療師市場，只談論過護士和治療師。如今這個市場狀況如何？也許可以談談您如何將醫生帶入新市場？

Hey, Whit. I'm going to ask Pat to deal on that. I will say before he gets some specifics, we have a team of physician recruiters here at Encompass, and that is somewhat centralized, but we've also had to use market and regional recruiters as well. I would say that overall, the pysiatry market is challenging, but has been fairly stable over the last two to three years. But I'll let Pat give you some specifics.

嘿，惠特。我要請帕特來處理這件事。在他了解具體細節之前，我想說，我們在 Encompass 有一個醫生招募團隊，這個團隊比較集中，但我們也必須使用市場和區域招募人員。我想說，總體而言，修甲市場充滿挑戰，但在過去兩三年中一直相當穩定。但我會讓帕特給你一些具體細節。

Thanks, Whit. So just a couple of specifics. We -- so from market to market, this can vary, but I would say the supply has stabilized, as Mark has alluded. In a number of our markets, we partner with or have established residency programs with universities that have helped from a recruitment perspective. And then we also have a strong component of internal medicine physicians that also have worked to become rehab physicians in markets that may be challenging to get a PM&R physician.

謝謝，惠特。僅介紹幾個具體細節。我們——因此，從市場到市場，這可能會有所不同，但我想說供應已經穩定下來，正如馬克所暗示的那樣。在我們的許多市場中，我們與大學合作或建立了居住計劃，從招募的角度提供了幫助。此外，我們還擁有大量內科醫生，他們也努力成為復健醫生，而這些市場可能很難找到 PM&R 醫生。

So I would say we're -- we have been able to fill all the needs that we currently have. And as Mark alluded, we have a pretty strong recruitment team that focuses solely on this.

所以我想說我們已經能夠滿足我們目前的所有需求。正如馬克所暗示的，我們擁有一支非常強大的招募團隊，專注於此。

It remains challenged. I will say over the last decade, we've seen a pleasant trend in what used to be 10 years ago, a lot of physiatrists primarily wanted to do outpatient and in some cases, pain management. And then we've seen a nice trend in the last couple of years where these physiatrists are very interested in inpatient setting and treating complex patients. So that's been a nice little push as we've gone out to recruit doctors.

它仍然面臨挑戰。我想說的是，在過去的十年裡，我們看到了一個令人欣喜的趨勢，與十年前相比，許多物理治療師主要想做門診，在某些情況下，還想做疼痛管理。過去幾年我們看到了一個很好的趨勢，這些物理治療師對住院環境和治療複雜患者非常感興趣。因此，當我們出去招募醫生時，這是一個很好的推動。

Okay. My follow-up is, I'm looking at my model here, and it's got leverage now below 2x now. And are we not at a floor where you should look to maybe hold it steady and take that excess capital and prioritize larger buybacks? I appreciate the increase in the growth CapEx, but it seems like you can probably balance both. Thanks.

好的。我的後續行動是，我正在查看我的模型，現在它的槓桿率低於 2 倍。我們是否還沒有到達一個最低點，你應該考慮保持穩定，利用過剩資本，優先進行更大規模的回購？我很欣賞成長資本支出的增加，但似乎你可能可以平衡兩者。謝謝。

Yes. The short answer is yes. So again, as we think about capital allocation, the top priority is going to continue to be towards capacity expansions. And as we noted in our comments, we have increased this year the allotment to both bed expansions and to de novos. We expect it to be at an elevated level for the next several years given the opportunity that exists to meet some of that rising demand.

是的。簡短的回答是肯定的。因此，當我們考慮資本配置時，首要任務仍然是產能擴張。正如我們在評論中指出的那樣，今年我們增加了床位擴建和新生床位的分配。考慮到有機會滿足部分不斷增長的需求，我們預計未來幾年這一水平將處於較高水平。

We do get a benefit both this year, it's almost $50 million, and we'll have an ongoing benefit related to bonus depreciation. So even as we increase our capital expenditures, we're getting a favorable cash flow from the tax benefit also. And so the likely place to go is going to be with more share repurchase activity.

我們今年確實獲得了福利，接近 5000 萬美元，而且我們還將獲得與獎金折舊相關的持續福利。因此，即使我們增加資本支出，我們也能從稅收優惠中獲得有利的現金流。因此，可能的做法是進行更多的股票回購活動。

Okay, great. Thanks.

好的，太好了。謝謝。

Joanna Gajuk, Bank of America.

美國銀行的喬安娜‧加朱克 (Joanna Gajuk)。

Hey. Good morning. Thanks. Hey, hi. Thanks for taking the question.

嘿。早安.謝謝。嘿，你好。感謝您回答這個問題。

So I guess maybe first, I guess, the follow-up on the last, I guess, discussion around the capital deployment priorities such is there likely more share repo. Any considerations around acquisitions? I think I've asked you this before. It sounds like you believe when it comes to your core business, the inpatient we have, you believe de novos and bed additions still we prefer those because of the returns over deals. But any consideration around looking outside of the inpatient rehab? I just want to ask just in case. Thank you.

所以我想也許首先，我想，最後的後續討論是圍繞資本部署優先事項，例如是否可能有更多的股票回購。對於收購有什麼考量嗎？我想我以前問過你這個問題。聽起來您認為，當涉及到您的核心業務，即我們擁有的住院病人時，您認為新病人和床位增加仍然讓我們更喜歡這些，因為回報比交易更多。但有沒有考慮過住院復健以外的其他治療？我只是想以防萬一問一下。謝謝。

Right now, we have not identified any particular service lines or capabilities that are important to our key constituencies that we don't currently provide. And so there are no adjacencies that are on our radar screen to move into. We would consider those only to the extent some of those key constituencies, whether it was referral sources or payers came to us and said, you could be meaningfully more valuable to us as a partner if in addition to IRF services, you could do this additional thing. And that has not arisen in any of our discussions yet. With regard to acquisitions within the IRF space, we continue to use the model as part of our business development effort where we will acquire a unit in an existing hospital and have it folded into a new de novo as a market entrant strategy.

目前，我們還沒有確定任何對我們的主要客戶很重要但我們目前沒有提供的特定服務線或能力。因此，我們的雷達螢幕上不存在可供進入的鄰接區域。我們只會在某些關鍵選區（無論是推薦來源還是付款人）來找我們並說，如果除了 IRF 服務之外，您還可以做這件額外的事情，那麼作為合作夥伴，您對我們來說會更有價值。但在我們的任何討論中還沒有出現這種情況。對於 IRF 領域內的收購，我們將繼續使用該模型作為我們業務發展工作的一部分，我們將收購現有醫院的一個部門，並將其納入新的 de novo 作為市場進入策略。

That will continue to be an arrow that we have in our quiver. As we've mentioned before, there are some portfolios of freestanding IRFs that are out there predominantly sponsored by private equity. Some of those have experienced attractive growth and have some favorable operating characteristics. As those become available, we would probably evaluate those, but it's a pretty high bar to surpass the returns that we're getting from our de novo activity. So the real focus of our cash flow and our capital allocation in terms of capacity expansion is going to be -- is going to remain on our own de novo activity and then bed expansions at existing hospitals.

這將繼續是我們箭筒裡的一支箭。正如我們之前提到的，有一些獨立的 IRF 投資組合主要由私募股權贊助。其中一些企業經歷了可觀的成長，並具有一些良好的經營特徵。當這些變得可用時，我們可能會對其進行評估，但要超越我們從新活動中獲得的回報，這是一個相當高的標準。因此，就產能擴張而言，我們的現金流量和資本配置的真正重點將是——繼續專注於我們自己的新業務活動，然後是現有醫院的床位擴張。

Thanks for that. And my question about the same-store volumes were up very nicely in the quarter. Can you talk about, I guess, the metrics by specialty? Sometimes you give us these metrics. So just curious about whether there's any outlier or every kind of categories going similarly? Thank you.

謝謝。我的問題是關於本季同店銷售額大幅成長。能談談依專業劃分的指標嗎？有時您會向我們提供這些指標。所以只是好奇是否有任何異常值或每種類別都有類似的情況？謝謝。

Yes. So we can provide you with some of that. So if we look -- and Mark hit on some of these numbers in his comments in the quarter, neurological was very strong, up 12.5%. We saw another good quarter of stroke growth. That was up 6.7%.

是的。因此我們可以為您提供其中的一些。因此，如果我們看一下——馬克在本季度的評論中提到了其中一些數字，神經系統疾病表現非常強勁，增長了 12.5%。我們又看到中風病例成長良好。這一數字上漲了 6.7%。

Brain injury is a smaller, but still a significant category. That was up over 12%. So good growth in a lot of those areas where we focused in terms of being able to treat more medically complex, higher acuity patients. That's been a portion of our differentiation strategy for more than a decade now.

腦損傷雖然較小，但仍是一個重要的類別。這一數字上漲了 12% 以上。因此，在我們關注的許多領域都取得了良好的成長，能夠治療醫學上更複雜、病情更嚴重的患者。十多年來，這一直是我們差異化策略的一部分。

Great. I appreciate it. Thank you.

偉大的。我很感激。謝謝。

Ann Hynes, Mizuho Securities.

安‧海因斯 (Ann Hynes)，瑞穗證券。

Good morning. Thank you.

早安.謝謝。

I know there is a few CON states that might relax the CONs, maybe North Carolina, South Carolina and Tennessee. Can you just give us the update on the status of those and maybe how you view de novo activity in those states once the CONs are lifted? Thanks.

我知道有幾個 CON 州可能會放寬 CON，可能是北卡羅來納州、南卡羅來納州和田納西州。您能否向我們介紹一下這些情況的最新情況，以及一旦 CON 解除，您如何看待這些州的 de novo 活動？謝謝。

Yes, we have a presence, as you know, in South Carolina, up to and all around the Charlotte marketplace that their CON will subside January 1, 2027. There is a lot of discussions among many within the decision-makers in the state of North Carolina. We have one hospital now in the state of North Carolina in Winston-Salem and believe that, that state with its growth and its demographics and its shortage of rehab beds would be a state that would look not dissimilar to what Florida had looked for us in terms of our ability to be a first mover in the state and have a significant number of attractive markets in which to pursue.

是的，如您所知，我們在南卡羅來納州直至夏洛特市場及其周邊地區都有業務，他們的 CON 將於 2027 年 1 月 1 日消退。北卡羅來納州的決策者對此進行了大量討論。我們現在在北卡羅來納州溫斯頓塞勒姆有一家醫院，並相信，鑑於該州的發展、人口結構和康復床位的短缺，該州與我們在該州尋找的類似，因為我們有能力成為該州的先行者，並且擁有大量有吸引力的市場可供開拓。

Perfect. And then on -- a big theme is this quarter with the payers is just increased coding and maybe more of the use of AI with documentation. How is Encompass using AI to code and document better? Thanks.

完美的。然後——本季度的一個重要主題是付款人只是增加了編碼，並且可能更多地使用帶有文件的人工智慧。Encompass 如何利用 AI 來更好地編碼和記錄？謝謝。

Yes. So we've mentioned previously, we do have a partnership with Palantir and what we're really looking to do is utilize AI, and Pat mentioned this in some of his remarks earlier, to reduce the administrative burden on our staff and also just to improve the consistency with which we're presenting information.

是的。我們之前提到過，我們確實與 Palantir 有合作關係，我們真正想要做的是利用人工智慧，Pat 在之前的一些評論中也提到過這一點，以減輕我們員工的行政負擔，並提高我們呈現資訊的一致性。

It also allows us, for instance, when we get a medical record on a patient who is transferring to us from an acute care hospital it is voluminous. And it's very taxing on our staff to have to come through that record and make sure that we're pulling forward the most pertinent information into our own documentation and AI can really facilitate that process.

例如，當我們獲得從急診醫院轉院給我們的患者的醫療記錄時，它也允許我們進行大量的醫療記錄。我們的員工必須仔細查看這些記錄，確保將最相關的資訊納入我們自己的文件中，這是一項非常繁重的工作，而人工智慧可以真正促進這一過程。

Now nothing that we're doing with AI is overriding individual clinical judgment. We make sure that there is a stringent manual review of these processes as well. But it is a tool that ultimately we think can reduce administrative burden, improve accuracy and in so doing, also increase the job satisfaction of our staff.

現在，我們利用人工智慧所做的一切都不會凌駕於個人臨床判斷之上。我們確保對這些流程進行嚴格的人工審查。但我們認為，它最終可以減輕行政負擔，提高準確性，從而提高員工的工作滿意度。

And one specific application of that has been used by our nurse liaison to go out and do patient evaluations, which can take a lot of time and many of these patients don't turn into admissions. So I mean, anything we can do to help these nurse liaisons become more efficient, and we've done that working with Palantir as they use their iPad to do the assessment and all the documentation around that.

我們的護理聯絡員使用其中的一個特定應用來外出對患者進行評估，這可能花費大量時間，並且許多患者無法入院。所以我的意思是，我們可以做任何事情來幫助這些護理聯絡員提高效率，我們已經與 Palantir 合作完成了這項工作，他們使用 iPad 進行評估並記錄所有相關內容。

And we've been able to reduce the time for documentation of that assessment by 20 minutes, which you start multiplying that out by all the liaisons that we have and the patients that are being evaluated, and you can see a significant gain in efficiency. And it's also a job satisfaction plus for those liaisons. But that's just one specific application of how we're applying AI and the use of working specifically with Palantir and Oracle in some cases.

我們已經能夠將評估記錄的時間減少 20 分鐘，如果你將這個時間乘以我們所有的聯絡員和正在評估的患者，你會發現效率顯著提高。對這些聯絡員來說，這也是一種工作滿意度的加分項。但這只是我們應用人工智慧的一個具體應用，以及在某些情況下與 Palantir 和 Oracle 合作的用途。

And ultimately, it inures to the benefit of both the acute care hospital as the referral source and the patient. It allows us to be more responsive and respond faster, which has the potential to free up that bed in the acute care hospital. It also means that if we can make a faster decision and the patient comes into our facility, they're going to start their therapy regime earlier, which has substantial clinical benefits.

最終，它將使作為轉診來源的急診醫院和病人雙方受益。它使我們能夠更迅速地做出反應，從而有可能釋放急診醫院的床位。這也意味著，如果我們能夠更快地做出決定，而患者來到我們的機構，他們將更早開始治療方案，這將帶來巨大的臨床益處。

Ann, I was just going to add -- this is Pat. We also use predictive analytics and modeling to help us with our fall risk model. So since 2020, when we implemented this model, our fall rate has improved by 30%. And that model looks at 50 different clinical elements, consolidates those into a risk score and informs our clinicians of the patients that enhanced fall risk. And then the other is on acute care transfers.

安，我只是想補充一下——這是帕特。我們也使用預測分析和建模來幫助我們建立跌倒風險模型。因此，自 2020 年我們實施該模型以來，我們的跌倒率已經改善了 30%。該模型研究了 50 種不同的臨床因素，將它們整合成風險評分，並告知我們的臨床醫生哪些患者的跌倒風險較高。另一個是關於急性護理轉移。

Back in 2015, we developed a REACT model, which continues to be refined, and that has led to a rate improvement of 24% since 2020. So two other examples of where we're using predictive analytics within our systems to help improve quality in the clinical process.

早在 2015 年，我們就開發了 REACT 模型，該模型不斷完善，自 2020 年以來，該模型已將利率提高了 24%。另外兩個例子是我們在系統中使用預測分析來幫助提高臨床過程的品質。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Hi, everybody. Just on the managed care contracting, any it out from a couple of other questions. Anything with the pressure that they're experiencing changes in the dynamics, terms, discussion and rate updates you're seeing?

大家好。僅就管理式醫療承包而言，還有其他幾個問題。您看到他們在動態、條款、討論和費率更新方面經歷的變化有什麼壓力嗎？

AJ, you were a little bit garbled there. I think the question was specifically around managed care contracting.

AJ，你那裡有點混亂。我認為這個問題具體是關於管理式醫療合約的。

As we go through some of the renewals, are we seeing anything that is significantly different from recent historical? I mentioned earlier because it's contained within the managed care bucket for us on payer mix, the impact of the VA work in the community care network that has been very favorable, and that's led to the higher-than-anticipated price increase there. Also good growth because it's been increasing the last two-plus years at a growth rate in the mid-teens.

當我們經歷一些更新時，我們是否看到了與近期歷史有顯著不同的東西？我之前提到過，因為它包含在我們管理的醫療支付方組合中，VA 工作對社區護理網絡的影響非常有利，這導致了那裡的價格上漲高於預期。這也是良好的成長，因為過去兩年多來，它的成長率一直維持在十五六成左右。

Other than that, I'd say it's been fairly standard in terms of annual price increases kind of in that 2.5% to 3% range and volume growth is not all that significant.

除此之外，我認為年度價格上漲幅度在 2.5% 到 3% 之間是相當標準的，而銷售成長並不是那麼顯著。

Okay. And then another one, you're pacing on de novo new deals, partnerships, et cetera, has been very steady, if not improving -- increasing a little bit. But I always want to be aware of the pipeline and what you're seeing out there. Have the discussion with acute care partners and potentials on JVs and things like that? Is there any change in that or in the depth of the potential backlog that you see? Anything to call out there?

好的。另外，你在新交易、合作夥伴關係等方面的步伐一直非常穩定，即使沒有改善，也只是略有增加。但我總是想了解管道以及你在那裡看到的東西。是否與急性照護夥伴和潛在合作夥伴討論過合資企業等事宜？您認為這種情況或潛在積壓的深度有什麼變化嗎？有什麼要喊出來的嗎？

No. We included in the supplemental slides, the development activity that has been announced, and there are 18 projects, including those that have already opened up this year. Consistent with what we've said before, we maintain an active dialogue or an active pipeline of right at about 50 projects, and it's stayed pretty steady at about that level. So I feel good about the visibility to continue at this level of growth for the next several years.

不。我們在補充幻燈片中列出了已經宣布的開發活動，共有 18 個項目，包括今年已經開放的項目。與我們之前所說的一致，我們保持著大約 50 個項目的積極對話或活躍管道，並且一直保持在這個水平上。因此，我對未來幾年繼續保持這一成長水平的前景充滿信心。

I think one thing that's notable on this development list is the fact that we're growing not only in states where we already have a presence like such as Pennsylvania or Georgia, but we also have some new states that we're entering, and we'll open up our first hospital in Danbury, Connecticut here in Q3. And then we'll also be in the outer years, we'll be looking at adding hospital in Utah and another out in Nevada. So we're looking at where we have market density as well as some opportunities to open up in new states.

我認為這個發展清單上值得注意的一件事是，我們不僅在賓夕法尼亞州或療養院等我們已經有業務的州發展，而且我們還在進入一些新的州，我們將在第三季度在康涅狄格州丹伯里開設第一家醫院。然後，我們還將在未來幾年考慮在猶他州和內華達州增設醫院。因此，我們正在尋找市場密度以及在新州開拓市場的機會。

Okay, great, thanks so much.

好的，太好了，非常感謝。

Jared Haase, William Blair.

賈里德·哈斯、威廉·布萊爾。

Hey. Good morning. Thanks for taking the questions.

嘿。早安.感謝您回答這些問題。

Maybe I'll ask one around the benefits expense. And I think you said that was up 18% in the period. A couple of quick ones. One, just can you remind us the split in total SWB spend between wages and benefit costs? And then I assume much of that growth is driven by kind of specialty pharmaceuticals, but just wanted to confirm that.

也許我會問一下福利費用。我認為您說過，這段期間內成長了 18%。幾個簡單的。第一，您能否提醒我們 SWB 總支出中薪資和福利成本的分配情況？然後我認為大部分增長是由特種藥品推動的，但我只是想確認這一點。

And then I guess with that being the case, assuming things like specialty pharmaceuticals are a big driver, it doesn't seem like that's going away anytime soon. So I'm wondering if there's anything incremental to sort of your strategy to manage benefits expense going forward?

然後我想，在這種情況下，假設特種藥品等是一個很大的驅動力，那麼這種趨勢似乎不會很快消失。所以我想知道，您是否有針對未來管理福利費用的策略進行一些改進？

Yes. So a lot to unpack there. So in response to the first question, total benefits runs at about 10.5% of the total SWB line, right between 10.5% and 11%, even with the recent increases that we've seen. The double-digit increases that we've been seeing for the last year have been driven predominantly by an increased frequency of high dollar claims, which we typically classify as an individual claim of over $100,000. Some of that is due to overall inflation in the health care system.

是的。那裡有很多東西需要打開。因此，回答第一個問題，即使我們看到最近有所增加，總福利仍約佔總 SWB 線的 10.5%，介於 10.5% 和 11% 之間。去年我們看到的兩位數成長主要是由於高額索賠頻率的增加，我們通常將其歸類為超過 10 萬美元的個人索賠。部分原因是醫療保健系統的整體通貨膨脹。

So those patients, even if they're experiencing a malady similar to what they had previously, whereas the cost of treatment may have been less than $100,000, it's over $100,000. It's not really been driven by the specialty pharma with one exception that I'll go through in a minute.

因此，即使這些患者所患的疾病與以前類似，治療費用可能低於 10 萬美元，甚至超過 10 萬美元。它實際上並不是由專業製藥公司推動的，但有一個例外，我稍後會講到。

And so I think when a lot of folks think of specialty pharma, you're thinking of things like the GLP-1s and then also some of the other notable drugs that we see out there like KEYTRUDA and so forth. And what we've seen there is that the rate of increase in terms of our spend on those drugs has been relatively modest, kind of in the mid-single-digit increase, and that's because rebates have kept pace with the increased spend on those drugs. Where we are seeing the impact of specialty drugs is with some of the cancer treatments. And that gets picked up in the medical claims versus the pharma claims because those are administered on an inpatient basis.

因此，我認為，當許多人想到專科製藥時，他們會想到 GLP-1 之類的藥物，以及我們看到的其他一些著名藥物，如 KEYTRUDA 等等。我們看到，我們在這些藥物上的支出成長率相對溫和，大概在個位數的中等水平，這是因為回扣與這些藥物上的支出成長保持了同步。我們看到了特種藥物對某些癌症治療的影響。這在醫療索賠與藥品索賠中被提及，因為這些索賠是在住院基礎上進行的。

Got it. That -- that's really helpful color. I appreciate all that.

知道了。那——那確實是有用的顏色。我對此表示感謝。

And then maybe just as a quick follow-up, I'll ask on free cash flow. A nice quarter. I think it was up about 31%. If I look at the revised guidance, I think it implies about 9% or so for the full year, 9% growth. I think you kind of clarified some of the bridging items in the second half and sort of the timing of the capital investment. But maybe the question, if I think longer term, any guardrails or parameters you would frame in terms of how we should think about free cash flow growth going forward, either in terms of a total annual growth rate or conversion relative to EBITDA?

然後也許只是作為一個快速的後續問題，我會問自由現金流。一個美好的季度。我認為它上漲了約 31%。如果我看一下修訂後的指引，我認為這意味著全年成長率約為 9% 左右。我認為您已經澄清了下半年的一些過渡項目以及資本投資的時機。但也許問題是，如果我從長遠角度考慮，您會制定什麼護欄或參數來引導我們思考未來的自由現金流成長，無論是從年度成長率還是相對於 EBITDA 的轉換率來看？

Yes. I think it's going to be relatively similar. So I think that CapEx is going to be roughly similar over the next several years. Obviously, we would anticipate further growth in EBITDA. And as we mentioned earlier, we've gotten a benefit this year and would expect to see a benefit over the next several years as well from the change in the tax legislation regarding bonus depreciation. And so that should enhance the flow-through.

是的。我認為它會比較相似。所以我認為未來幾年的資本支出將大致相同。顯然，我們預計 EBITDA 將進一步成長。正如我們之前提到的，我們今年已經從獎金折舊稅法的變化中獲得了好處，並且預計未來幾年我們也將從中受益。這樣可以增強流通。

Okay, that's perfect. I'll hop back in queue. Thank you.

好的，太完美了。我會重新回到隊列中。謝謝。

Brian Tanquilut, Jefferies.

布萊恩·坦奎魯特（Brian Tanquilut），傑富瑞集團。

Good morning. Congrats on the quarter. Maybe just a question, Doug. As I think about tariffs and I know you're expanding your CapEx budget for the year. Are you seeing any changes there that we need to be thinking about as we think through 2026 budgeting for CapEx and construction costs?

早安.恭喜本季取得佳績。也許只是一個問題，道格。當我考慮關稅時，我知道您正在擴大今年的資本支出預算。當我們考慮 2026 年資本支出和建設成本預算時，您是否看到了我們需要考慮的任何變化？

Not yet. Obviously, there's still a whole lot that is in flux. We've talked previously about how we source our materials. We don't have a lot of exposure, for instance, to concrete, which is predominantly sourced out of Mexico, given the building composition. From a steel perspective, a lot of the steel that we use is recycled steel that we're able to procure in the US

還沒有。顯然，仍有許多事情處於變化之中。我們之前討論過我們如何取得材料。例如，考慮到建築的組成，我們對混凝土的接觸並不多，混凝土主要來自墨西哥。從鋼鐵角度來看，我們使用的鋼材許多都是在美國採購的再生鋼

So thus far, we haven't seen a pronounced impact from tariffs on construction cost inflation, but it's obviously something that remains in flux for everybody who's out there, and we continue to keep an eye on.

因此到目前為止，我們還沒有看到關稅對建築成本通膨產生明顯影響，但對於每個人來說，這顯然仍是一個不斷變化的問題，我們將繼續關注。

I appreciate that. And then maybe, Mark, I appreciate all the comments on the quality and the discussions you're having with the JV partners. Maybe curious if you can share with us any feedback or any discussions since July that you or your staff and your team have had with the referral partners.

我很感激。那麼，馬克，也許我很欣賞所有關於品質的評論以及你與合資夥伴的討論。您可能很好奇，您是否可以與我們分享自 7 月以來您或您的員工和團隊與推薦合作夥伴之間的任何回饋或討論。

Yes. So Brian, we were very transparent and reached out to our partners. We are aware that -- this article may come out. We didn't know when it's going to come out. We didn't know what it was going to say, but we reached out to all of our partners and said this may be out there. We have always been transparent with our partners relative to our quality outcomes or anything that might be out in terms of changes in regulations or otherwise.

是的。所以布萊恩，我們非常透明並與我們的合作夥伴進行了聯繫。我們知道——這篇文章可能會發表。我們不知道它什麼時候會問世。我們不知道它會說什麼，但我們聯繫了我們所有的合作夥伴並告訴他們這可能會出現。我們始終對我們的合作夥伴保持透明，包括我們的品質成果或任何可能出現的法規變更或其他方面的問題。

But I think that our partners certainly are referring physicians, are referring hospitals and the patients themselves recognize our quality. And as it leads to the outcomes that we can get relative to return back to the community or the Net Promoter Score or their likelihood or low likelihood of being readmitted back to the acute care hospitals, and that's what they appreciate. We think it's -- the article that took 0.001% of our total discharges for that time period reviewed in the article and tried to use that to cast what we would consider to be a mischaracterization across our quality was disappointing.

但我認為我們的合作夥伴肯定是轉診醫生、轉診醫院，而且病人自己也認可我們的品質。因為這會導致我們可以獲得相對於回報社區或淨推薦值或他們再次回到急診醫院的可能性或低可能性的結果，這就是他們所欣賞的。我們認為——這篇文章只佔了我們在文章中回顧的那個時間段內總排放量的 0.001%，並試圖用它來描述我們認為對我們的品質的錯誤描述，這是令人失望的。

Yes. Really helpful commentary. Thank you, Mark.

是的。真的很有幫助的評論。謝謝你，馬克。

(Operator Instructions)

（操作員指示）

Raj Kumar, Stephens.

拉吉·庫馬爾，史蒂芬斯。

Good morning. Just kind of looking at this is 12 straight quarters of same-store discharge growth above 4%. Maybe kind of just balancing insights from upstream acute care hospital providers and how they're seeing moderating volume growth to more normalized levels. And then also kind of a tougher comp backdrop for Encompass. How do you see same-store growth in the back half? And then there's a lot of new facilities coming online in the back half as well. So maybe kind of providing a framing of growth relative to that 6% to 8% target in the back half between same-store and new store?

早安.從某種程度上來看，這是連續 12 個季度同店銷售額成長率超過 4%。也許只是平衡上游急診醫院提供者的見解以及他們如何將業務量成長緩和到更正常的水平。這對 Encompass 來說也是一種更嚴峻的競爭背景。您如何看待下半年同店成長？下半年還會有許多新設施上線。那麼，也許可以提供一個相對於同店和新店下半年 6% 到 8% 目標的成長框架？

I think you've hit on the right factors, which is you're going to have more capacity coming on board in the second half, which will help in terms of new store growth. But some of that capacity is coming on very late in the year. So it's not going to impact this year as much as it will benefit next year in terms of new store growth. From a same-store perspective, you're absolutely right. It's great. We've had 12 consecutive quarters north of 4%. That has raised the bar in terms of the comp that we're up against.

我認為你已經找到了正確的因素，那就是下半年你將有更多的產能投入，這將有助於新店的成長。但部分產能在今年底才會開始投入使用。因此，就新店成長而言，它對今年的影響不會太大，但對明年將有利。從同店角度來看，您說得完全正確。這很棒。我們已經連續 12 個季度的成長率超過 4%。這提高了我們所面臨的競爭標準。

As it relates to what you may be seeing upstream at the acute care hospitals, just a reminder that although it feels like because we get in excess of 90% of our referrals from acute care hospitals that there ought to be a high correlation between our volumes and acute care hospitals, but it does not exist. And it does not exist because only less than 5% of the patients being discharged from acute care hospitals in the US wind up going to the IRF setting. And that portion of their volume because it relates to nondiscretionary illnesses that ultimately qualify for treatment in an IRF are not very volatile. So the volatility that the acute care hospitals see that we do not is predominantly around discretionary treatments.

這與您可能在急診醫院上游看到的情況有關，只是提醒一下，雖然感覺上因為我們從急診醫院獲得了超過 90% 的轉診，所以我們的數量和急診醫院之間應該存在高度相關性，但事實並非如此。但這種情況並不存在，因為在美國，只有不到 5% 從急診醫院出院的病人最終會進入 IRF 環境。由於這部分交易量與最終符合 IRF 治療條件的非自由裁量疾病有關，因此波動性不是很大。因此，急診醫院看到而我們沒有看到的波動主要集中在自由裁量治療方面。

Thank you for the call. Got it. And then maybe just separately on a smaller portion of the business, outpatient visits was up nicely sequentially, although still down year-over-year and then pricing has been going up drastically in that business as well. So maybe what was that driver of growth? Was it kind of like a onetime surprise like we saw on like fee-for-service and inpatient side in the first quarter or is there something being strategically done to maybe stabilize that business since pricing has been kind of accommodated?

謝謝您的來電。知道了。然後，也許只是單獨就業務的較小部分而言，門診就診量環比大幅上升，儘管同比仍有所下降，但該業務的價格也大幅上漲。那麼，成長的動力究竟是什麼呢？這是否像我們在第一季看到的按服務收費和住院治療那樣只是一次性的意外，還是說，由於定價已經得到某種程度的調整，因此正在採取某種戰略措施來穩定該業務？

So is your question more -- yes, is your question more about outpatient revenue or outpatient volume because the outpatient revenue increase is largely attributable to the increase in Medicaid supplemental payments. That category is outpatient and other, if you're looking at page 5 of our supplemental slides.

所以你的問題更多的是——是的，你的問題更多的是關於門診收入還是門診收入，因為門診收入的增加很大程度上歸因於醫療補助補充支付的增加。如果您正在查看我們的補充投影片的第 5 頁，則該類別是門診和其他類別。

Yes, I was more referring to just volumes was kind of up 8% quarter-over-quarter, which is seems much more higher than how it has been historically between 1Q and 2Q.

是的，我更多的是指交易量環比增長了 8%，這似乎比第一季和第二季之間的歷史水平要高得多。

Thanks, Raj. This is Pat. So outpatient, we only have a small number of locations, and we have intentionally lowered that footprint over time, including the closure of 3 outpatient facilities within the last year. So I would just say that the operations that we still have running have a good book of business.

謝謝，拉傑。這是帕特。因此，對於門診部來說，我們只有少數幾個地點，並且我們有意隨著時間的推移減少了這一範圍，包括在去年關閉了 3 家門診設施。因此，我只想說，我們仍在運作的業務有著良好的業績。

They're well known in their communities, and they often are specialized from an outpatient therapy perspective that draws volume in. So I wouldn't say that it is a nationwide intentional strategy, but a very market-specific strategy with the teams that have outpatient in their communities.

他們在社區中很有名，通常專門從事門診治療，吸引了大量患者。因此，我不會說這是一項全國性的有意策略，而是針對社區內有門診病人的團隊的非常針對市場的策略。

Thank you very much.

非常感謝。

Thank you. And it does appear that we have no further questions at this time. I'd be happy to return the call to Mark Miller for any closing comments.

謝謝。目前看來我們沒有其他問題。我很樂意回電給馬克·米勒，詢問他的任何結束語。

Thank you, operator. If anyone has additional questions, please call me at 205-970-5860. Thank you again for joining today's call.

謝謝您，接線生。如果有人還有其他問題，請撥打 205-970-5860 與我聯絡。再次感謝您參加今天的電話會議。

Thank you. This does conclude today's conference. You may now disconnect your lines, and everyone, have a great day.

謝謝。今天的會議到此結束。現在您可以斷開您的線路了，祝大家有美好的一天。