Encompass Health Corp (EHC) 2025 Q3 法說會逐字稿

Good morning, everyone, and welcome to Encompass Health's third quarter 2021 earnings conference call. (Operator Instructions) Today's conference call is being recorded. If you have any objections, you may disconnect at this time.

各位早安，歡迎參加 Encompass Health 2021 年第三季財報電話會議。（操作員指示）今天的電話會議正在錄音。如果您有任何異議，可以立即斷開連接。

I will now turn the call over to Mark Miller, Encompass Health's Chief Investor Relations Officer.

現在我將把電話交給 Encompass Health 的首席投資者關係長 Mark Miller。

Thank you, operator, and good morning, everyone. Thank you for joining Encompass Health's third quarter 2025 earnings call. Before we begin, if you do not already have a copy, the third 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 年第三季財報電話會議。在開始之前，如果您還沒有相關文件，第三季收益報告、補充資訊以及向美國證券交易委員會 (SEC) 提交的相關 8-K 表格均可在我們的網站 encompasshealth.com 上找到。補充資料第 2 頁包含安全港聲明，收益報告最後一頁也對此進行了更詳細的闡述。

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 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 quarters ended March 31, 2025, June 30, 2025, and September 30, 2025 when filed. We encourage you to read them.

在電話會議中，我們將發表一些前瞻性聲明，例如業績指引和成長預測，這些聲明存在風險和不確定性，其中許多風險和不確定性是我們無法控制的。某些風險和不確定性，例如與監管發展以及銷售、壞帳和成本趨勢相關的風險和不確定性，可能會導致實際結果與我們的預測、估計和預期存在重大差異，這些風險和不確定性已在公司提交給美國證券交易委員會的文件中進行了討論，包括盈利報告和相關的 8-K 表格、截至 2024 年 12 月 31 日止 3112 月 2024 年 12 月 31 日止年的表格 31K日、2025 年 6 月 30 日及 2025 年 9 月 30 日止季度的 10-Q 表格（提交時）。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.

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，並且僅代表截至今日的情況。我們不承擔更新這些前瞻性陳述的義務。

Our supplemental information and discussion on this call will include certain non-GAAP financial measures. For such measures, reconciliation 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. 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.

本次電話會議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，與最直接可比較的 GAAP 指標的調節表可在收益發布末尾的補充資訊中找到，也可在昨天向美國證券交易委員會提交的 8-K 表格中找到，所有這些都可以在我們的網站上找到。我想提醒大家，我們將遵守每個問題和一個後續問題的規則，以便每個人都能提交問題。如果您還有其他問題，請隨時重新排隊。

With that, I'll turn the call over to President and Chief Executive Officer, Mark Tarr.

接下來，我將把電話交給總裁兼執行長馬克·塔爾。

Thank you, Mark, and good morning, everyone. Revenue in Q3 increased 9.4% and adjusted EBITDA grew 11.4%, contributing to year-to-date revenue growth of 10.6% and adjusted EBITDA growth of 14.5%. On largely to our Q3 results, we have again increased our 2025 guidance Doug will cover the details of the quarter and guidance in his comments. Our dedicated and highly competent clinical teams continue to deliver outstanding patient outcomes. Our Q3 discharge community rate was 84.6%.

謝謝你，馬克，大家早安。第三季營收成長 9.4%，調整後 EBITDA 成長 11.4%，使得今年迄今的營收成長了 10.6%，調整後 EBITDA 成長了 14.5%。接下來主要談談我們的第三季業績，我們又提高了 2025 年的業績預期。 Doug 將在他的評論中詳細介紹本季業績和業績預期。我們敬業且能力卓越的臨床團隊持續為患者帶來優異的治療效果。第三季社區出院率達 84.6%。

Our discharge to cut rate was 8.6%, and our discharge to SNF rate was 6%. Our performance on each of these quality metrics exceeds the industry average. Our high-quality patient care was again recognized by Newsweek in Statista to name Encompass Health, America's most awarded leader in inpatient habilitation for the sixth consecutive years.

我們的出院轉入護理機構的比例為 8.6%，出院轉入專業護理機構的比例為 6%。我們在每項品質指標上的表現都超過了行業平均。我們高品質的病患照護再次獲得《新聞週刊》在 Statista 的認可，連續第六年將 Encompass Health 評為美國住院復健領域獲獎最多的領導者。

We continue to invest in our clinical staff by providing professional growth and development opportunities, such as our career lighter programs. These programs contribute to our continued favorable turnover rates. Q3 '25 annualized RN turnover, of 20.2% and annualized service turnover of 7.8% are consistent with last year's very favorable trends. In Q3, we opened three new hospitals a 40-bed hospital in Danbury, Connecticut, our first in that state, a 50-bed hospital in Daytona Beach, Florida and a 50-bed hospital in Wildwood Florida or The Villages. We also added 39 beds to existing hospitals.

我們持續投資於我們的臨床員工，為他們提供專業成長和發展機會，例如我們的職業輕鬆計劃。這些項目有助於我們維持良好的員工流動率。2025 年第三季註冊護理師年化流動率為 20.2%，服務人員年化流動率為 7.8%，與去年非常有利的趨勢一致。第三季度，我們開設了三家新醫院：一家是位於康乃狄克州丹伯里的 40 張床位醫院（這是我們在州內的第一家醫院），一家是位於康乃狄克州丹伯里的 40 張床位醫院（這是我們在該州的第一家醫院），一家是位於佛羅裡達州代托納海灘的 50 張床位醫院，還有一家是位於佛羅裡達州懷爾德伍德（又稱「村莊」）的 50 張床位醫院。我們也為現有醫院增加了 39 張床位。

Earlier this month, we opened a 50-bed hospital in St. Petersburg, Florida. We expect to open 2 additional 50 bed hospitals in Q4, one in Amarillo, Texas; and the other in Layforce, Florida and add approximately 37 beds to existing hospitals. The demand for inpatient rehabilitation services remains considerably underserved and continues to grow as the US population ages.

本月初，我們在佛羅裡達州聖彼得堡開設了一家擁有 50 張床位的醫院。我們預計在第四季度開設兩家新的 50 床位醫院，一家位於德克薩斯州阿馬裡洛，另一家位於佛羅裡達州萊福斯，並為現有醫院增加約 37 張床位。美國住院復健服務的需求仍然嚴重不足，隨著美國人口老化，這項需求仍在增加。

The Medicare beneficiary population is the fastest-growing segment of the US population. It is estimated that by 2030, one in five 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%.

美國聯邦醫療保險受益人群是美國人口成長最快的族群。據估計，到 2030 年，五分之一的美國人（超過 7,000 萬人）將年滿 65 歲或以上。65 歲及以上人口一直以約 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 歲以上的人口以約 4% 的速度成長。

Yet the supply of licensed IRF beds in the US has increased only nominally. As a result, the demand for treatment of the complex medical conditions such as stroke necessitating earth care intensity remain significantly underserved. We are responding to this unmet need by continuing to open new hospitals and add beds to existing hospitals. We have again increased our expected bed addition growth.

然而，美國獲得許可的復健床位供應量僅略有增加。因此，對於中風等需要高強度醫療照護的複雜疾病的治療需求仍然嚴重不足。我們正在透過不斷開設新醫院和增加現有醫院的床位來應對這項未被滿足的需求。我們再次提高了預期新增床位數。

We now expect to add approximately 127 beds to existing hospitals in 2025 approximately 150 to 200 in both 2026 and 2027. Our pipeline of announced new hospitals with opening dates beyond 2025 and currently consists of 14 hospitals with 690 beds. With an active pipeline, more than 40 projects, additional hospital locations will soon join this list. To this point, last week, we received CON approval to build a 40-bed hospital in Clarksville, Tennessee.

我們現在預計，到 2025 年將在現有醫院增加約 127 張床位，到 2026 年和 2027 年將分別增加約 150 至 200 張床位。我們已宣布的新醫院項目計劃於 2025 年以後開業，目前共有 14 家醫院，690 張床位。目前已有超過 40 個項目正在積極籌備中，未來將有更多醫院選址加入這一行列。截至上週，我們已獲得在田納西州克拉克斯維爾建造一家擁有 40 個床位的醫院的 CON 批准。

On October 3, we converted our ERP system to Oracle Fusion. Our team worked tirelessly and diligently for more than 18 months to accomplish this challenging feat. We experienced no significant disruptions to our operations from the conversion -- although like any other project of this magnitude, there remain bugs to be resolved and refinements to be made.

10月3日，我們將ERP系統升級為Oracle Fusion。我們的團隊歷經 18 個月的不懈努力和辛勤工作，才完成了這項艱鉅的任務。轉換過程並未對我們的營運造成重大干擾——儘管像任何其他如此規模的專案一樣，仍然存在一些漏洞需要解決，還有一些改進需要進行。

Now I'll turn it over to Doug.

現在我把麥克風交給道格。

Thank you, Mark, and good morning, everyone. Revenue growth of 9.4% in Q3 was driven primarily by a 5% increase in total discharges and a 3.3% increase in net revenue for discharge. As we have previously stated, quarterly fluctuations in discharge volume growth and the composition of that growth between same and new store is a normal expectation of our business model. Volume growth in any particular quarter is influenced by factors such as the prior year period comp, the timing of capacity additions in the current and prior year and the calendar. For example, the day of the week in which the quarter ends and the timing of any holidays.

謝謝你，馬克，大家早安。第三季營收成長 9.4%，主要得益於出院總數成長 5% 和出院淨收入成長 3.3%。正如我們之前所述，季度出貨量成長的波動以及同店和新店之間成長組成的波動是我們商業模式的正常預期。任何特定季度的銷售成長都會受到多種因素的影響，例如去年同期比較基數、本年度和上年度產能增加的時間以及日曆年。例如，季度結束的星期幾以及任何假日的具體時間。

Specific to Q3, Discharge growth comp from Q3 '24 is a very strong 8.8%. Q3 '24 same-store discharge growth of 6.8% and is our highest since Q2 '21 when we were normalizing from COVID. As for the timing of capacity additions in comparison to Q3 '25 Q4 same-store growth benefited from a significantly higher number of de novo beds transitioning from new store to same-store as well as a higher number of bed additions to existing hospitals in the immediately preceding quarters. Additionally, this year, we consolidated 2 satellite locations, comprising 72 beds in Cincinnati, Ohio in Sewickley, Pennsylvania into their host hospitals. This was primarily attributable to lease expirations and allows for market rationalization.

具體到第三季度，與 2024 年第三季相比，出貨量成長非常強勁，達到 8.8%。2024 年第三季同店銷售額成長 6.8%，是自 2021 年第二季以來的最高水平，當時我們正在從新冠疫情中恢復過來。至於新增容量的時間，與 2025 年第三季相比，第四季同店成長得益於從新店轉移到同店的新增床位數量顯著增加，以及前幾季現有醫院新增床位數量的增加。此外，今年我們將位於俄亥俄州辛辛那提和賓夕法尼亞州塞威克利的兩個衛星地點（共 72 床）合併到其所屬醫院。這主要是由於租約到期造成的，也使得市場趨於合理化。

Ultimately, we expect to transition much of the volume in these closed units to the remaining hospitals. And in the case of Cincinnati, we are adding beds to accommodate this expectation. Nonetheless, these consolidations had a negative impact of approximately 35 basis points on Q3 and total and same-store discharge growth.

最終，我們預計將這些已關閉病房的大部分病人轉移到其他醫院。就辛辛那提而言，我們正在增加床位以滿足這一預期。儘管如此，這些合併對第三季總銷售額和同店銷售額成長產生了約 35 個基點的負面影響。

As Mark stated, the market for IRF services is growing and underserved. Reflective of this market opportunity, we are again increasing our estimated annual bed additions to existing hospitals through 2027. We have increased the estimated bed additions to existing hospitals for 2025 from approximately 110 to approximately 127. And for each of 2026 and 2027 from approximately 120 to now 150 to 200. Taken together with our new hospitals, capacity expansions now total approximately 517 beds in 2025, 540 to 590 beds in 2026 450 to 500 beds in 2027.

正如馬克所說，IRF 服務的市場正在成長，但服務不足。鑑於這一市場機遇，我們再次提高了到 2027 年現有醫院每年新增床位數的預估數量。我們已將 2025 年現有醫院預計新增床位數量從約 110 張增加到約 127 張。2026 年和 2027 年，每年的數值都從大約 120 增加到現在的 150 到 200。加上我們新建的醫院，到 2025 年，床位總數將增加約 517 張；到 2026 年，床位總數將增加 540 至 590 張；到 2027 年，床位總數將增加 450 至 500 張。

Q3 '25 adjusted EBITDA increased 11.4% and to $300.1 million. The quarter included $10.8 million of net provider tax revenue an increase of $7.7 million from Q3 '24, owing largely to retroactive payments related to newly initiated programs in Tennessee and West Virginia. This increase in net provider tax revenue was partially offset by a $1.6 million increase in noncontrolling interest expense associated with higher net provider tax revenues at joint venture hospitals. Q3 '25 adjusted EBITDA also included a $1.3 million retroactive property tax assessment associated with one of our California hospitals and approximately $3 million in accelerated supply purchases in anticipation of the October Fusion ERP conversion.

2025 年第三季調整後 EBITDA 成長 11.4%，達到 3.001 億美元。本季淨供應商稅收收入為 1,080 萬美元，比 2024 年第三季增加了 770 萬美元，這主要歸功於與田納西州和西維吉尼亞州新啟動的項目相關的追溯付款。合資醫院淨供應商稅收收入的增加，導致少數股東權益支出增加 160 萬美元，部分抵消了淨供應商稅收的增加。2025 年第三季調整後的 EBITDA 還包括與我們加州一家醫院相關的 130 萬美元追溯性房產稅評估，以及為迎接 10 月份 Fusion ERP 系統轉換而加速採購的約 300 萬美元供應品。

Q3 per FTE increased 2.6%. Premium labor costs comprised of contract labor and sign-on and ship bonuses declined $5.6 million from Q3 $24 million to $27 million. Benefits expense per FTE increased 1.9% as we anniversaried the large increase in group medical claims experienced in Q3 last year. EPOB of 3.42% for the quarter was driven in part by the timing of capacity additions. Q3 adjusted free cash flow decreased 8.2% and to $174.2 million, primarily due to a $55.8 million increase in working capital, which included accelerated payments of accounts payable in preparation for the October Fusion conversion.

第三季每位全職員工成長2.6%。包括合約工、簽約獎金和出貨獎金在內的高級勞動成本從第三季的 2,400 萬美元下降到 2,700 萬美元，減少了 560 萬美元。由於去年第三季團體醫療理賠大幅增加，每位全職員工的福利支出增加了 1.9%。本季 EPOB 為 3.42%，部分原因是產能擴張的時機。第三季調整後自由現金流下降 8.2% 至 1.742 億美元，主要原因是營運資金增加 5,580 萬美元，其中包括為 10 月份的 Fusion 轉換而加速支付應付帳款。

We expect accounts payable balances to normalize during Q4. On a year-to-date basis, Free cash flow increased 16.5% to $582.5 million. We have increased our full year adjusted free cash flow estimate to $730 million to $810 million. During Q3, we repurchased approximately 221,000 shares of our common stock for approximately $25 million, bringing the year-to-date total to approximately $82 million. We also declared a cash dividend of $0.19 per share, which was paid earlier this month.

我們預計應付帳款餘額將在第四季恢復正常。今年迄今為止，自由現金流成長了 16.5%，達到 5.825 億美元。我們將全年調整後自由現金流預期上調至 7.3 億美元至 8.1 億美元。第三季度，我們回購了約 22.1 萬股普通股，耗資約 2,500 萬美元，使今年迄今的回購總額達到約 8,200 萬美元。我們也宣布派發每股 0.19 美元的現金股息，該股息已於本月初支付。

Our leverage and liquidity remain well positioned. Net leverage at quarter end was 2 times. And in September, we retired the remaining $100 million balance of our 2025 5.75% senior notes. As Mark stated, we have again raised our 2025 guidance. We now assume net operating revenue of $5.905 billion to $5.955 billion, adjusted EBITDA of $1.235 billion to $1.255 billion and adjusted earnings per share of $5.22 to $5.37. The key considerations underlying our guidance can be found on page 11 of the supplemental slides.

我們的槓桿率和流動性狀況依然良好。季末淨槓桿率為 2 倍。9 月份，我們償還了剩餘的 1 億美元 2025 年到期的 5.75% 優先票據。正如馬克所說，我們再次提高了2025年的業績預期。我們現在預計淨營業收入為 59.05 億美元至 59.55 億美元，調整後 EBITDA 為 12.35 億美元至 12.55 億美元，調整後每股收益為 5.22 美元至 5.37 美元。我們做出此預測的關鍵考慮因素可在補充投影片的第 11 頁找到。

And with that, we'll open the lines for Q&A.

接下來，我們將開放問答環節。

(Operator Instructions)

（操作說明）

Joanna Gajuk, Bank of America.

Joanna Gajuk，美國銀行。

So I guess maybe first on the discussion around, I guess, accelerated bed additions and de novos too, which is clearly the volume seem to be the issue, I guess, or where questions are in terms of just slowdown this quarter, but obviously, you kind of explained a couple of things. But let's talk about the future, right? So how should we think about this accelerated bed addition plans impacting your volume growth going forward? And I guess to that point, your 6% to 8% sort of long-term growth algo, can you talk about -- I know you don't give any specifics for '26, but kind of how should we think about it into next year?

所以我想首先討論的是加速床位增加和新建項目，顯然，數量似乎是問題所在，或者說，問題在於本季度增速放緩，但顯然，您已經解釋了一些事情。但我們還是來談談未來吧？那麼，我們該如何看待這種加速增加床位的計畫對你們未來業務量成長的影響呢？我想說的是，關於您提出的 6% 到 8% 的長期成長演算法，您能談談嗎——我知道您沒有給出 2026 年的具體數據，但我們應該如何看待明年的情況？

Yes. So I think the fact that for the second time this year, we're increasing bed expansions and now doing it for a multiyear period is really a validation of our business model and strategy. It reflects the fact that our de novos have been performing well and are justifying bed expansions as they mature. It also reflects what we've been saying about the unmet need for IRF services really across the country and our unique position to be able to step in and add capacity.

是的。所以我認為，今年我們第二次增加床位擴建，而這次將持續多年，這確實是對我們商業模式和策略的驗證。這反映出我們的新種植園表現良好，並且隨著種植園的成熟，需要擴大種植床位。這也反映了我們一直以來所說的，全國各地對 IRF 服務的需求尚未得到滿足，而我們擁有獨特的優勢，能夠介入並增加服務能力。

We've also talked in the past that bed additions to existing hospitals offer the highest return on invested capital we have. So that's a favorable component as well. And I think all of you have observed as we have, that our occupancy has been steadily rising over the last couple of years. So this is in response to that demand that we're seeing at existing facilities.

我們過去也討論過，在現有醫院增加床位是投資報酬率最高的措施。所以這也是一個有利因素。我想大家都和我們一樣注意到，過去幾年我們的入住率一直在穩定上升。這是為了回應我們在現有設施中看到的這種需求。

We continue to be very optimistic about the market that is in front of us, the total addressable market. This suggests that on a go-forward basis, we're going to be more heavily weighted in the past than we have been towards bed additions in terms of total capacity expansions. But it's going to be continued utilization of both of those arrows in our quiver, maintaining the de novo program and then the increased bed expansions that we outlined for at least the next three years.

我們對眼前的市場，也就是潛在市場總量，仍保持著非常樂觀的態度。這表明，從長遠來看，在總容量擴張方面，我們將比以往更加重視增加床位。但是，我們將繼續利用我們手中的這兩支箭，維持全新的項目，並繼續推進我們概述的床位擴展計劃，至少在未來三年內如此。

Joanne, you may recall from past calls where we've mentioned that one of the areas we're prioritizing where we add beds is to help give a higher complement of private beds to those hospitals that have a high percentage of semiprivate rooms. So that too has helped with our overall occupancy.

喬安妮，你可能還記得我們之前的通話中提到過，我們優先增加床位的地區之一是幫助那些半私人病房比例較高的醫院增加私人病床的數量。所以這也有助於提高我們的整體入住率。

I think it's important to note, too, that these aren't just numbers that we have specifically identified projects and the number of beds at each one of those hospitals supporting those increased ranges for bed additions over the next three years.

我認為同樣重要的是要指出，這些數字不僅僅是我們已經明確確定的項目以及每家醫院在未來三年內支持床位增加的床位數量。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Not surprising, I'm asking a similar question there. But I guess sitting back here and looking at sort of the next couple of years here, what percent of -- I guess, what level of CapEx as a percent of revenue should we be modeling in order to keep your discharge growth in that 6% to 8% range? Just as are you scaling up bed additions to sort of get to the proper levels of occupancy for more durable growth?

不出所料，我在那裡也問了類似的問題。但我想，回顧未來幾年，為了維持出貨量成長在 6% 到 8% 的範圍內，我們應該將資本支出佔收入的百分比設定為多少？就像您逐步增加床位，以達到合適的入住率，從而實現更持久的成長一樣？

Yes. So growth CapEx this year at the midpoint of the estimate is about $580 million. we're increasing the number of bed expansions and holding the number of anticipated de novos relatively constant from year-to-year. So you figure at the midpoint of the range at 175, you're up about 50 beds in each of the next two years and the average cost per bed on a bed addition is roughly $800,000. That would be the increment to the 580,000 that you might pencil in.

是的。因此，今年成長資本支出以預估中位數計算約為 5.8 億美元。我們將增加床位擴建數量，並保持預計新建床位數量逐年相對穩定。所以，以中間值 175 計算，未來兩年每年大約增加 50 張床位，每增加一張床位的平均成本約為 80 萬美元。那將是你在預估的 58 萬基礎上增加的金額。

Okay. Great. And then a question on occupancy. In order to maximize margins but still maintain growth, what is the target occupancy before you expand beds at the facility? And how quickly can you expand capacity at those facilities? And any color on what percent of your facilities today are at max occupancy and a headwind for growth?

好的。偉大的。然後是關於入住率的問題。為了在保持成長的同時實現利潤最大化，在擴建床位之前，該設施的目標入住率是多少？這些設施的產能擴張速度有多快？能否提供一些關於目前貴公司設施入住率達到飽和、成長面臨阻力的百分比數據？

Yes. So there's a lot of it depends on there, as we've talked about before, in terms of when you're hitting what might be considered a peak occupancy, the composition between private and semi-private beds that Mark mentioned earlier goes a long way towards that determination. We've been steadily moving the percentage of our overall portfolio that is comprised of private beds. At the end of Q3, it was up again to 57%. And again, that compares favorably to 41% at the end of 2020. Generally speaking, whether it's semi-private or private, a hospital starts to hit our radar screen for potential bed expansion after it crosses 80% of sustained occupancy.

是的。所以，正如我們之前討論過的，這很大程度上取決於何時達到入住率高峰，而馬克之前提到的私人床位和半私人床位的組成在很大程度上決定了這一點。我們一直在穩步提高私人床位在我們整體投資組合中所佔的比例。第三季末，比例再次上升至 57%。而且，這一數字比 2020 年底的 41% 有了顯著提高。一般來說，無論是半私立醫院或私立醫院，當其持續入住率超過 80% 時，我們就會開始關注該醫院是否有擴建床位的可能性。

Within an all private room hospital because you're not facing issues of gender or germ compatibility, you can run into the mid-90% and do that very efficiently. With semi private, you're probably going to peak out just south of 90%. In terms of ability to add beds, it depends on the physical configuration of the plant and then really whether or not you're in a CON state or not. I will note that even for our hospitals in CON states, in almost every instance that we can think of, the process for adding beds to an existing hospital is much shorter and less complicated than it is for getting a CON for a new hospital.

在全是單人病房的醫院裡，由於不存在性別或細菌相容性問題，感染率可以達到 90% 以上，而且效率很高。在半私密模式下，你的最高使用率可能略低於 90%。至於能否增加床位，這取決於工廠的物理結構，以及你是否處於 CON 狀態。我要指出的是，即使對於我們位於已獲得 CON 認證的州的醫院而言，在我們能想到的幾乎所有情況下，向現有醫院增加床位的流程都比為新醫院獲得 CON 認證的流程要短得多、簡單得多。

When I mentioned the physical plant for the building, we have some older legacy hospitals that just cannot be expanded anymore. We have the ability to address capacity needs in those markets by adding a freestanding satellite. You've seen us do that effectively a number of places in our portfolio. We are also in the design process and something that we're going to be talking a lot more in the future, which is what we call a small format hospital, which will be a smaller version of a freestanding unit that can be used for bed expansion opportunities and market diversification. And that would be roughly a 24-bed unit built on, say, 2 to 2.5 acres of land. It's a very efficient plant.

當我提到大樓的五金設施時，我們有一些老舊的醫院已經無法再擴建了。我們可以透過增加一顆獨立衛星來滿足這些市場的容量需求。在我們的投資組合中，您已經看到我們有效地運用了這種方法。我們目前也處於設計階段，未來我們將更多地談論我們稱之為小型醫院的概念，它將是獨立單元的縮小版，可用於床位擴充和市場多元化。那大概就是一個建在 2 到 2.5 英畝土地上的 24 個床位單位。它是一種非常有效率的植物。

Again, we expect to be talking more about that in the future. In most cases, where we do have the ability to add beds to an existing hospital, it can happen pretty quickly, meaning from the point of ideation to it working its way through the design and construction time line, it's certainly less than 24 months, and it may be closer to 18 months.

我們預計未來還會就此話題進行更多討論。在大多數情況下，如果我們有能力為現有醫院增加床位，那麼這個過程可以非常迅速，這意味著從構思到完成設計和建造，肯定不到 24 個月，可能接近 18 個月。

Ann Hynes, Mizuho Securities.

安海恩斯，瑞穗證券。

I know your stock is down a little bit on today's earnings. Did expectations come in line with your estimates? Did anything surprise you in the quarter versus what you initially thought? And then secondly, maybe if you can give an update just on the Washington outlook and there's anything that the company is watching closely.

我知道你們的股票因為今天的財報而略有下跌。實際結果是否與您的預估相符？本季有哪些事情與你最初的預期相比，讓你感到驚訝？其次，您能否簡要介紹華盛頓的局勢，以及公司正在密切關注的任何事情？

I would say no surprises in the quarter other than the retro payment from Tennessee and West Virginia on the net provider taxes and maybe the California property assessment. Those were kind of in the queue, but we weren't sure when they would come through. Otherwise, I would say just kind of scanning down the P&L that everything was pretty much in line with our expectation. Had another quarter of really good labor management, both in terms of controlling the spend, seeing a year-to-year decrease in the premium labor spend, felt really good.

我覺得本季除了田納西州和西維吉尼亞州補繳淨供應商稅款以及加州房產評估之外，不會有什麼意外。那些東西算是排在後面了，但我們不確定什麼時候才能到貨。否則，我只想說，粗略瀏覽損益表，一切基本上都符合我們的預期。又一個季度勞動力管理做得非常好，無論是在控制支出方面，還是在看到高薪勞動力支出同比下降方面，都感覺非常好。

We had been anticipating, but until it gets there, you don't know that we would see a nice decrease in the inflation rate on the benefits because of what we experienced in the second half of last year. And it was nice to see yet another quarter where bad debt was at the low end of our expectations. TPE activity did resume at a modest level in Q3.

我們一直在期待著，但直到它真正發生之前，你都無法確定由於去年下半年的經歷，福利通膨率是否會大幅下降。令人欣慰的是，壞帳率又一個季度低於我們的預期。第三季TPE活動以適度水準恢復。

But again, nothing that caused any alarm and our performance under RCD remains very strong in the latest cycle. So again, aside from maybe the timing and the magnitude of the out-of-period provider tax revenue, nothing that was a surprise. Mark, do you want to give?

但再次強調，沒有出現任何令人擔憂的情況，我們在RCD下的最新週期表現依然非常強勁。所以，除了非正常期間供應商稅收收入的時間和數額可能有些出人意料之外，沒有其他意外。馬克，你想捐款嗎？

Yes. And relative to your question around Washington, in spite of Washington being closed down in a lot of areas, we remain active there. We are not seeing anything near term that is of concern. It was -- it's our understanding that CMS was called back to the office this week. So hopefully, things go back to a normal flow there, but we're just not overly concerned about anything that we see right now on the horizon.

是的。至於你問到的關於華盛頓的問題，儘管華盛頓很多地區都已關閉，但我們仍然在那裡開展活動。我們目前沒有看到任何近期內需要擔憂的事情。據我們了解，CMS本週被召回辦公室。所以希望那裡的情況能恢復正常，但我們對目前看來即將發生的事情並不太擔心。

And this is Pat. Just a quick expansion on the labor comment. There's a lot to be proud of here. Both our centralized TA team and our operators have done a great job -- we posted our best same-store net hiring quarter since Q3 of 2023. Turnover is back down to pre-pandemic levels and contract labor shift and sign-on bonus are at their lowest level since Q1 of 2021.

這位是帕特。關於勞工問題，我再補充一點。這裡有很多值得驕傲的地方。我們的集中式人才招募團隊和營運團隊都做得非常出色——我們取得了自 2023 年第三季以來最好的同店淨招募季度業績。人員流動率已回落至疫情前水平，合約工輪班和簽約獎金均處於 2021 年第一季以來的最低水平。

Matthew Gilmore, KeyBanc.

Matthew Gilmore，KeyBanc。

I thought I might ask about payer mix. I think there was some favorability in the first half with traditional Medicare and VA. It seems like that may be normalized in the third quarter with moderation in pricing. Just curious if you could give some comments on how payer mix evolved in the third quarter compared to the first half.

我想問一下關於付款方構成的問題。我認為上半年傳統醫療保險和退伍軍人事務部（VA）的受保人比較多。第三季價格趨於穩定，這種情況似乎會有所改善。我很好奇您能否就第三季與上半年相比，支付方組成的變化情況發表一些看法。

Yes. So in terms of payer mix, if we just look at the growth rates by payer in Q3, relatively comparable between Medicare and Medicare Advantage, both were up -- or Medicare was up 4.4%. This is total discharge growth. Medicare Advantage was up 4.8%. Managed care saw another nice increase, 9.2%.

是的。因此，就支付方組成而言，如果我們只看第三季度各支付方的成長率，Medicare 和 Medicare Advantage 之間的成長率相對接近，兩者都在上升——或者說 Medicare 上升了 4.4%。這是總排放量成長量。聯邦醫療保險優勢計劃 (Medicare Advantage) 的成長率為 4.8%。醫療管理產業又迎來了一個可觀的成長，達到 9.2%。

I'll remind you that, that includes the volume that we're getting under the VA Community Care network, and that continued to see another nice increase in the quarter. That was up -- and again, it's off of a relatively small base, but that was up almost 26% on a year-over-year basis, and that pays at the Medicare CMG rate. That contract now comprises about 18% of our total managed care volume. In terms of elsewhere in the payer mix, Medicaid was up about 3.5%. So overall, we feel like the growth across the payers was pretty well balanced.

我提醒各位，這其中也包括我們在 VA 社區醫療網絡下獲得的醫療量，而該網絡在本季度繼續保持了良好的增長勢頭。雖然基數相對較小，但同比上漲了近 26%，而且以 Medicare CMG 費率計算，這是可以接受的。該合約目前約占我們醫療管理總業務量的 18%。就其他支付方組成而言，醫療補助成長了約 3.5%。所以總的來說，我們認為各支付方的成長情況相當均衡。

That's great. And then, Doug, I thought I might see if you could provide some comments on headwinds and tailwinds for 2026. I know you're not providing specific guidance, but anything to call out just from a modeling perspective as we're thinking about next year?

那太棒了。然後，道格，我想請你談談對 2026 年的順風和逆風的看法。我知道您沒有提供具體指導，但從建模的角度來看，在考慮明年的事情時，您有什麼需要特別指出的嗎？

I don't know that a lot comes immediately to mind other than I think net provider taxes will continue to be a bit of a wildcard. But again, if you look at the progress that we've made through the course of the year on premium labor, I think that sets us up well going into 2026. Again, the level of capacity expansion overall is going to be up somewhat next year. My guess is because we're going to be at roughly the same level on de novo activity that ramp-up costs and start-up costs will be comparable next year to what they are this year. It could be a little bit of fluctuation in bad debt, but things seem to have settled in there.

除了我認為淨供應商稅將繼續成為一個不確定因素之外，我一時想不出太多其他的事情。但是，如果你看看我們今年在優質勞動力方面取得的進展，我認為這將為我們進入 2026 年奠定良好的基礎。明年整體產能擴張水準還會略有提升。我的猜測是，由於明年的新建項目數量將大致與今年持平，因此啟動成本和開工成本將與今年相當。壞帳可能會有些波動，但目前情況似乎已經穩定下來了。

So Matt, we're currently in the budgeting process for 2026, but I'm not aware of anything at this point that I would call out as a significant headwind or tailwind. And look, a continuation in this environment would not be a bad thing.

所以，馬特，我們目前正在進行 2026 年的預算編制工作，但就目前而言，我還沒有發現任何可以稱之為重大不利因素或有利因素的情況。而且，繼續在這種環境下發展並非壞事。

Whit Mayo, Leerink Partners.

Whit Mayo，Leerink Partners。

Maybe just back to volumes for a second. You quantified the satellite consolidation. I think that was 35 basis points. Doug, any way to put numbers around the timing of beds, the calendar? I think 4th of July might have been on a Friday. There are some other factors there. I mean the comp is the comp, it is what it is. Just wondering if just -- there's any way to put a framework around maybe just quantifying what some of those other factors might mean optically for the same-store discharges.

或許我們先回到音量的問題。你對衛星整合進行了量化分析。我認為那是35個基點。道格，有沒有辦法把床位使用時間具體化，例如記在日曆上？我記得7月4日好像是星期五。還有其他一些因素。我的意思是，比賽就是比賽，它就是這樣。我只是想知道——有沒有辦法建立一個框架，量化其他一些因素對同店銷售額在視覺上可能產生的影響。

You can kind of walk yourself in circles a little bit in trying to do that. It was a little bit of an odd cadence to the quarter. If we compare it to last year, the toughest comp that we were actually up against was the month of July, and yet we did pretty well in July. The quarter -- volume in the quarter was kind of a U-shape. July was solid. We reached the nadir in August and then recovered nicely in September.

這樣做的話，你可能會有點原地打轉。這季度節奏有點奇怪。如果與去年相比，我們實際面臨的最嚴峻的競爭是在七月份，但我們七月份的表現相當不錯。本季－本季的交易量呈U形。七月表現穩健。我們在8月份跌至谷底，然後在9月份很好地恢復了。

And so I don't know that we can point to any specifics. We've got kind of the same dynamic with more holidays as we look at Q4. And so I think overall, the dynamics with regard to the impact of the capacity expansions in the satellites for Q4 set up a lot like Q3 with an extra dynamic around the timing of holidays. And it's a bit of a wildcard. So we can look, for instance, at the month of October, and it ends tomorrow on a Friday that happens to be Halloween.

所以，我不知道我們能否指出任何具體細節。展望第四季度，隨著假期增多，我們也會面臨類似的動態。因此，我認為總體而言，第四季衛星容量擴張的影響動態與第三季非常相似，只是假期時間表增加了一些額外的動態因素。這有點像個變數。例如，我們可以看看十月份，它明天就結束了，明天是星期五，而星期五恰好是萬聖節。

Is that a positive or a negative? I don't know. It's a factor, though. Likewise, Thanksgiving this year is two days short of the latest it can fall. It falls on Thursday to 27. Again, that's going to have an impact, but it could be a positive or a negative. So it's, again, difficult to be too specific about those things.

這是好事還是壞事？我不知道。但這確實是一個因素。同樣，今年的感恩節比它最晚的日期還早兩天。週四將降至27歲。這肯定會產生影響，但影響可能是正面的，也可能是負面的。所以，再次強調，很難對這些事情給予非常具體的說明。

We look again and I think we're not measuring this -- we're not managing this business quarter-to-quarter. And we said all along that there were going to be fluctuations based on the factors that I identified in my script. We set out a target to have a discharge CAGR between 2023 and 2027, total discharges of somewhere in the 6% to 8%. We're almost three years through that five-year target, and we're 75%. And we've increased the number of capacity additions that we're going to have in future periods. So obviously, we feel very good about the prospects of the business.

我們再次審視，我認為我們沒有衡量這一點——我們沒有按季度管理這項業務。我們一直都說過，根據我在劇本中確定的因素，價格會有波動。我們設定了一個目標，即 2023 年至 2027 年期間的排放量複合年增長率達到 6% 至 8%。五年目標已經過去近三年了，我們完成了 75%。我們已經增加了未來幾個時期將要新增的產能數量。顯然，我們對公司的前景非常樂觀。

Whit, there weren't really -- if you look at our actual program mix, when we mentioned payer mix earlier, program mix, we weren't anything that really stood out. We continue to see progress made and continued absolute case growth for strokes, other neuro continues to be strong. So there wasn't anything that really kind of stood out from a volume standpoint that would tie back to our program mix.

惠特，其實並沒有什麼特別突出的地方——如果你看看我們實際的項目組合，就像我們之前提到的支付方組合和項目組合一樣，我們並沒有什麼真正突出的地方。我們看到中風病例持續成長，其他神經系統疾病病例也持續強勁成長。所以從音量上看，並沒有什麼特別突出的歌曲能與我們的節目組合聯繫起來。

And I think that's important to note. Obviously, we analyze the volume and the trends there in a lot of different ways. We didn't see anything looking at the third quarter results that said we need to make a course correction. Other than in the normal course of business where we do recognize that some markets outperformed others and we'd like to see a rise in tide lift all boats.

我認為這一點很重要。顯然，我們會從很多不同的角度分析那裡的交易量和趨勢。從第三季業績來看，我們沒有發現任何需要調整方向的跡象。除了正常的商業活動之外，我們也意識到有些市場表現優於其他市場，我們希望看到整體市場上漲帶動所有市場繁榮。

Yes, I can kind of tell your brain into a pretzel, trying to figure this out. My second question is really just an update on the review choice demo and how your experience has evolved this year versus your expectations?

是的，我可以告訴你，為了弄清楚這件事，你的大腦都快被攪成麻花了。我的第二個問題其實只是想了解評測選擇演示的最新情況，以及您今年的體驗與您的預期相比發生了哪些變化？

So every month, since the end of the first quarter, we run with all seven of our hospitals in the state of Alabama having affirmation rates north of 90%. Cycle 3 ended in June. And because of our performance early in that cycle, we did not clear the 90% affirmation rate for all of began on July 1. And since cycle 4 began, all seven of our hospitals have been north of the target 90% affirmation rate. It remains a situation where we have to stay very hands on with regard to Palmetto.

因此，自第一季末以來，每個月我們在阿拉巴馬州的七家醫院的確認率都超過 90%。第三輪週期於六月結束。由於我們在該週期早期的表現，我們沒有達到 7 月 1 日開始的整個週期 90% 的確認率。自第四週期開始以來，我們所有七家醫院的確認率都超過了 90% 的目標值。對於帕爾梅托公司，我們仍然需要密切關注其發展狀況。

And as much as we can through a government shutdown, we're also staying very much in touch with CMS to ensure that we are being treated fairly and appropriately throughout this process. So we continue to have to apply more administrative resources to this and should be necessary. But generally speaking, the program is running much better than it was during the course of cycle 2 and cycle 3.

在政府停擺期間，我們盡最大努力與CMS保持密切聯繫，以確保我們在整個過程中得到公平和適當的對待。因此，我們仍需投入更多行政資源，而且這樣做也是必要的。但總的來說，該計劃的運作情況比第二週期和第三週期好得多。

Andrew Mok, Barclays.

Andrew Mok，巴克萊銀行。

Given all the de novos and supply-demand factors, we don't usually hear much about closures or consolidations in the space. So I was hoping you can speak a little bit to that dynamic. Was this truly a unique event -- or does this happen with more regularity and is only getting called out given the extra attention to volumes in the quarter?

考慮到所有新成立的公司和供需因素，我們通常不會聽到該領域出現倒閉或合併的消息。所以我希望您能談談這種動態。這真的是一起獨特的事件嗎？還是說這種情況其實經常發生，只是因為本季交易量受到特別關注才被注意到？

Andrew, this is Pat. Both of those are unique situations where the -- where we were renting space from hospital or location closed. So one-off events, a very small percentage of our portfolio and not anticipating any additional activity in the future.

安德魯，這位是帕特。這兩種情況都很特殊，因為我們租用的空間所在的醫院或場所關閉了。因此，這些活動只是一次性事件，在我們投資組合中所佔比例很小，而且預計未來不會有任何額外的活動。

Great. And maybe a question on the Medicare landscape more broadly. It's undergoing some pretty big changes, whether there's a slowdown in Medicare Advantage growth next year or greater than normal churn across the national payers. Just curious how you're thinking about that and any implications for your business?

偉大的。或許還可以問一個關於聯邦醫療保險（Medicare）整體情況的問題。它正在經歷一些相當大的變化，無論是明年 Medicare Advantage 的增長放緩，還是全國支付方的人員更替比正常情況更大。我很好奇您對此有何看法，以及這對您的業務有何影響？

I think -- and again, it's reflected in some of the discharge growth rates by payer that I reviewed earlier. But what we like is that we do well across the payer spectrum. Obviously, our primary areas of focus are with Medicare fee-for-service and Medicare Advantage. If Medicare Advantage growth is slowing that means that the greater opportunity is within fee-for-service, and that actually pays at a slightly higher rate, and we do better with regard to conversion rates, the percentage of admits to referrals.

我認為——而且，這一點也反映在我之前審查的一些按支付方劃分的出院增長率中。但我們喜歡的是，我們在各種支付方群體中都表現出色。顯然，我們的主要關注領域是聯邦醫療保險按服務收費計劃和聯邦醫療保險優勢計劃。如果 Medicare Advantage 的成長正在放緩，這意味著更大的機會在於按服務收費，而且這種收費方式的支付速度實際上略高，我們在轉換率（即入院轉診的百分比）方面做得更好。

So that's not a bad dynamic for us. Conversely, if Medicare managed growth resumes, what we've demonstrated, particularly over the last four years that we can effectively play in that sandbox as well. So in terms of how we're planning for 2026, a more global shift between Medicare Advantage and Medicare fee-for-service is not going to impact how we plan the business.

所以這對我們來說並非壞事。反之，如果 Medicare 管理的成長恢復，我們已經證明，尤其是在過去四年裡，我們也可以有效地參與其中。因此，就我們 2026 年的規劃而言，Medicare Advantage 和 Medicare 按服務收費模式之間更廣泛的全球性轉變不會影響我們的業務規劃。

Andrew, this is Pat. Just some additional context. So when we look at strokes, about half of them in the country are going to skilled nursing facilities. And that's including in markets that we currently operate in. So we see continued upside there. The same story plays out with brain injury, which is just a huge patient population that we have the opportunity to serve.

安德魯，這位是帕特。補充一些背景資訊。所以，當我們觀察中風病例時，會發現全國大約有一半的中風患者最終會被送到專業護理機構。這其中也包括我們目前營運的市場。所以我們看到這方面仍有上漲空間。腦損傷患者的情況也類似，我們有機會為龐大的腦損傷患者群體提供服務。

And then while it's not fee-for-service Medicare, that VA dynamic that Doug talked about before, it's a small in size, but it grew 25.6%. And that -- this was the first quarter where we have really put some scaled attention to it. And we had originally, when this opportunity came out, we weren't sure how to size it. We thought it was proximity to a VA. And when we look across our portfolio of what we were currently pooling, we had hospitals that were 250 miles away from a VA that we're growing double-digit percentage point.

雖然它不是按服務收費的醫療保險，但正如道格之前提到的，退伍軍人事務部（VA）的這種模式規模很小，卻增長了 25.6%。而這——這是我們第一個真正大規模關注此事的季度。最初，當這個機會出現時，我們並不確定如何評估它的規模。我們當時以為是因為離退伍軍人事務部近。當我們審視我們目前正在整合的投資組合時，我們發現有些醫院距離退伍軍人事務部 (VA) 250 英里，但我們的業務成長速度卻達到了兩位數百分比。

So we looked at hospitals like that and what they were doing from a process perspective, created a tool kit, scaled that up, and Q3 is really the first time that we have implemented that. So I see upside in these areas in 2026.

因此，我們研究了像這樣的醫院以及它們從流程角度所做的工作，創建了一個工具包，並擴大了規模，而第三季度是我們真正第一次實施該工具包。所以我認為這些領域在2026年會有上漲空間。

AJ Rice, UBS.

AJ Rice，瑞銀集團。

Just to maybe think about -- we obviously talked a lot about the development and program and so forth. I wonder if you could comment on your pipeline, and you sort of hit on this trajectory of 6 to 10 a year, averaging about 8% and you sort of got that pipeline baked for the next three years, it looks like. Is there any pressure that people want to move faster than you're able to accommodate them in terms of potential partners out there? What's the competitive landscape to other people? Are they on basically the same time frame that are competing against you for those joint ventures? Any thoughts on that?

或許可以思考一下——我們顯然談了很多關於發展和計劃等等方面的內容。我想知道您能否談談您的產品線，您似乎已經達到了每年 6 到 10 個產品的產量，平均增長率約為 8%，而且看起來您已經為未來三年的產品線做好了準備。是否有這樣的壓力：人們希望盡快找到合適的合作夥伴，而你卻無法滿足他們的需求？在其他人眼中，競爭格局如何？在合資專案競標中，與你競爭的競爭對手的時間框架是否基本相同？對此有什麼看法？

Yes. So I'll go back to a couple of things that Mark mentioned in his comments. One is we've got 14 projects that were announced and underway as at the end of Q3. Since then, we've already added another project with the awarding of another COM in the state of Tennessee. That's within a total active pipeline, meaning more than just exploratory conversations of 40 projects. And we feel good about being able to operate least the midpoint of that 6% to 10% target range. What could change that and move us up in the near term? We've talked before about the potential for CON restrictions to be a key states, namely North Carolina.

是的。所以，我再回到馬克在評論中提到的一些事情。一是截至第三季末，我們有 14 個專案已經宣布並正在進行中。從那以後，我們又增加了一個項目，在田納西州獲得了另一個 COM 認證。這還不包括其他 40 個正在進行的項目，這意味著不僅僅是探索性的對話。我們感覺能夠至少達到 6% 到 10% 目標範圍的中點。什麼因素能夠改變這種局面，使我們在短期內取得進步？我們之前討論過 CON 限制可能會成為關鍵州，特別是北卡羅來納州的問題。

In terms of pressure from any other parties, I think you specifically cited potential joint venture partners to move more quickly. It tends to be the opposite, which is we can move much more quickly than our partners just because of the experience we have both in operating as a joint venture and the way that we have streamlined our design and construction process. So that is not an issue. With regard to competition, we've got a number of parties out there, namely Select Medical and HCA, who have publicly stated plans to increase the number of beds they're adding. They have different models than we do, and the market remains incredibly underserved. So we don't see that in any way crowding this out.

至於來自其他方面的壓力，我認為你特別提到了潛在的合資夥伴，希望他們加快步伐。情況往往恰恰相反，由於我們在合資經營方面累積了豐富的經驗，並且簡化了設計和施工流程，我們的行動速度往往比合作夥伴快得多。所以這不是問題。就競爭而言，目前有不少公司，特別是 Select Medical 和 HCA，它們都已公開表示計劃增加床位數。他們的模式與我們不同，而且市場仍然嚴重缺乏服務。所以我們認為這不會以任何方式擠佔其他方面的優勢。

And as we've mentioned previously, Part of the reason that in spite of the very attractive market opportunity that's out there, you don't see more competition coming in is the barriers to entry in this business are really high. It is capital intensive. It is clinically complex. It is heavily regulated. All of those things make it very difficult for somebody who's not really well-capitalized and experienced to step into the breach.

正如我們之前提到的，儘管市場機會非常誘人，但你卻看不到更多競爭者進入這個行業，部分原因是這個行業的進入門檻真的很高。它屬於資本密集型產業。臨床上很複雜。它受到嚴格監管。所有這些因素都使得資金和經驗不足的人很難填補這一空白。

AJ, the fact that we've done a lot of new development over the last x number of years, and we have the resources internally. Well, that's the real estate or our design and construction team and we can move with a high priority on first mover advantages, speed to market. I think we've shown that over and over again. Relative to your question around joint venture partners, as Doug noted, does vary from partner to partner. But if you look at a partner like what we have with Dimont in the State of Georgia, I mean, we collectively have both systems have really prioritized post-acute and rehabilitation in particular.

AJ，事實上，在過去的幾年裡，我們進行了許多新的開發，而且我們內部也擁有資源。嗯，這就是我們的房地產或設計和施工團隊，我們可以優先考慮先發優勢和快速上市。我認為我們已經一次又一次地證明了這一點。關於你提出的合資夥伴的問題，正如 Doug 指出的那樣，情況因合作夥伴而異。但如果你看看像我們在喬治亞州的 Dimont 這樣的合作夥伴，我的意思是，我們兩個系統都非常重視急性後期護理和復健。

We now have seven hospitals with that partnership because we moved at a brisk pace to make sure we were taking advantage of the opportunities in the various marketplaces they serve. So we think we're very well aligned with our partnership opportunities out there.

現在我們已經與七家醫院建立了合作關係，因為我們迅速採取行動，確保我們能夠抓住各個醫院所在市場提供的機會。所以我們認為我們與現有的合作夥伴機會非常契合。

On your -- at one point, when we had met during the summer, you had said that you may be looking at expanding your prefab capability that there were some geographic constraints on it. Where does that stand at this point? And what might that do for you if that -- if you are able to open that up to a broader geography?

在你——我們夏天見面的時候，你曾說過你可能正在考慮擴大預製件產能，但那方面存在一些地域限制。目前情況如何？如果能夠將視野拓展到更廣闊的地域，這對你來說會有什麼好處呢？

Yes. So what A.J. is referencing specifically is right now, there are some geographical limitations on where we could utilize specifically full prefabrication of hospitals, and that relates to transportation loans right now the way that we are using food construction for larger projects is we're essentially building modules. And those modules are loaded on the flatbed trucks and transported to the site. And we are using predominantly trucks because the modules are too wide to effectively utilize rail.

是的。所以 A.J. 具體指的是，目前我們在哪些地方可以完全使用預製醫院方面存在一些地域限制，這與交通貸款有關。目前，我們使用食品建築進行大型專案的方式是，我們基本上是在建造模組。這些模組被裝載到平闆卡車上，然後運送到現場。我們主要使用卡車運輸，因為模組太寬，無法有效利用鐵路運輸。

So we are looking at two things. One is, can we change the configuration of the module so they can fit on rail which is a more cost-effective mode of transportation and could increase the geography to which the replicable or do we need a second manufacturing site that would be close to those geographies, or there's a version of modular construction on prefab that is called panelized construction. So if you think about taking a cardboard box and folding it from where it's open, that changes the overall dimensions of that particular module, and it can potentially fit on rail. So there are a number of things underway that I would state are very much still in the evaluation stage.

所以我們主要關注兩件事。一是，我們能否改變模組的配置，使其能夠裝在鐵路上運輸，這是一種更具成本效益的運輸方式，並且可以擴大可複製的地理範圍；二是我們需要第二個製造基地，靠近這些地理區域；三是有一種預製模組化建築，稱為板式建築。所以，如果你想像一下把一個紙箱從開口處折疊起來，就會改變這個特定模組的整體尺寸，使其有可能安裝在軌道上。因此，目前有許多項目正在進行中，但我認為這些項目仍處於評估階段。

I will say that the other thing that is changing is a dynamic, and this is more empirical or not anecdotal than it is completely empirical right now, is that we are seeing that increasingly for our type of construction, whereas we used to compare conventional to full prefab. There's really not much happening. There's no pure conventional anymore. Almost all conventional construction, certainly all that we're using at least uses componentized prefab construction, meaning the incorporation of prefab bathrooms or headwalls or both. So it's a bit of a hybrid model.

我想說，另一件正在發生變化的事情是動態的，而且這更多的是一種經驗性的，或者說不是軼事性的，而不是完全的經驗性的，那就是我們看到，在我們這種類型的建築中，這種情況越來越普遍，而我們過去常常將傳統建築與完全預製建築進行比較。沒什麼大事發生。已經不存在純粹的傳統觀念了。幾乎所有傳統建築，至少我們目前使用的所有建築，都採用組件式預製建築，這意味著採用預製浴室或床頭牆，或兩者都採用。所以它有點像是一種混合模式。

And if that has become the norm, the cost differential has stayed relatively constant between the two, which has been significant. But the construction time line, which had a significant advantage for full prefab is decreasing. And so the that's a dynamic we need to keep an eye on. favorable dynamic.

如果這種情況已成為常態，那麼兩者之間的成本差異將保持相對穩定，而這種差異是顯著的。但全預製構件的施工時間優勢正在減弱。所以，這是我們需要密切關注的動態，一種有利的動態。

Brian Tanquilut, Jefferies.

Brian Tanquilut，傑富瑞集團。

Maybe, Doug, as I think about the salaries line, as a percentage of revenue, it looked pretty good this quarter. But tying it back to your comments on just some of the ramp. Just curious, how are you thinking about labor and then maybe EPOB, where that eventually optimizes once all the ramping of capacity happens?

道格，或許吧，我仔細想想薪資支出佔收入的百分比，這季度看起來還不錯。但回到你對部分坡道的評論。我只是好奇，您是如何考慮勞動成本以及最終的EPOB（員工年收入）的？這些成本最終會在產能全面提升後達到最優。

Yes. So I'm going to ask first for Pat to comment on EPOB and then I'll talk maybe a little bit about just other trends within.

是的。所以我首先要請 Pat 對 EPOB 發表一下看法，然後我可能會稍微談談其中的其他趨勢。

Thanks Doug. Brian, this is Pat. One of the comments on the quarter for EPOB, Part of it is related to the timing components of de novo activity. But the other piece ties back to the hiring that we've done in Q3. We had $162 million net RMs hired for the quarter.

謝謝你，道格。布萊恩，這是派特。EPOB季度評論之一，部分內容與新業務活動的時序要素有關。但另一部分則與我們在第三季進行的招募有關。本季我們淨聘用了價值 1.62 億美元的區域經理。

Outside of our ends, we had a really robust hiring quarter. And those are people that are currently in some form of orientation or presetting right now that is pushing EPOB up that will normalize in the future. And if retention stays where it is to the benefit of other buckets like premium pay.

除我們自身部門外，我們本季的招募情況非常強勁。這些人目前處於某種形式的定向或預設狀態，這推高了 EPOB，而 EPOB 將在未來恢復正常。如果員工留任率保持不變，那麼其他福利項目（例如加班費）也將受益。

Brian, as we've stated in the past, that $3.4 million number on EPOB, that's where we feel the right number. I mean if you -- there might be times when you have a volume increase, you might see the dropped down a little bit, but on an ongoing basis, we feel that's the right number to make sure that we are efficient. But yes, we are also responding to the staff and the ability to retain staff it's critically important. So that $3.4 million would be a number that we really try to work towards.

Brian，正如我們之前所說，EPOB 上的 340 萬美元這個數字，我們認為是正確的數字。我的意思是，如果——有時銷量會增加，銷量可能會略微下降，但從長遠來看，我們認為這是確保我們高效運營的合適數字。但是，是的，我們也在關注員工，而留住員工的能力至關重要。所以，340萬美元將是我們努力的目標。

So in terms of labor trends and combining what Pat and Mark have offered on EPOB, we think that we've made great progress and more of the progress that we anticipated on reducing premium labor spend in 2025. And if we can hold that relatively steady on a nominal dollar basis moving into 2026, that would certainly be a positive even as volume grows, I think our assumption is that our core underlying SWB per FTE inflation is probably going to stabilize at least for the near term, somewhere around 3% to 3.25%. The benefits piece, which is about 10.5% of the total SWB line, predominantly because of group medical, which is 75% benefits, excluding payroll taxes is likely to have an inflation factor in 2026 in the high single digits.

因此，就勞動力趨勢而言，結合 Pat 和 Mark 在 EPOB 方面提出的建議，我們認為我們在降低 2025 年的額外勞動力支出方面取得了巨大進展，並且比我們預期的進展更多。如果到 2026 年，我們能夠以名義美元為基礎保持相對穩定，即使交易量增長，這當然也是一個積極的信號。我認為，我們的假設是，我們的核心基礎 SWB 每 FTE 通膨率至少在短期內可能會穩定下來，在 3% 到 3.25% 左右。福利部分約佔總福利支出的 10.5%，主要原因是團體醫療保險，而團體醫療保險佔福利的 75%（不包括工資稅），預計到 2026 年，其通貨膨脹率將達到個位數高點。

Just to clarify that 162 net RMs hired was the same-store number as well.

需要澄清的是，淨增聘的 162 名區域經理也是同一家門市的數量。

Got it. And then maybe, Doug, just quickly on the ERP rollout. Just curious what you can share with us in terms of, number one, what you're seeing so far? And then number two, what kinds of efficiency gains should we expect on the P&L at some point and kind of like the time line in terms of achieving those targets?

知道了。然後，Doug，或許可以簡單談談ERP系統的上線狀況。我很好奇，就目前來看，您能和我們分享一下您的觀察結果嗎？其次，我們應該預期在某個時候損益表上會獲得哪些效率提升？以及實現這些目標的具體時間表是什麼？

So the good news is we threw the switch on October 3 and the lights didn't go out, right? But -- and this was a very comprehensive ERP conversion across all finance and accounting functions across supply chain, which is a big deal for us and across all HR functions. The overwhelming majority of modules within that work from the get-go smoothly and efficiently and as we had hoped. But as is the case with every one of these items, there are bugs that need to be fixed and refinements that need to be made. That's why you see the $3 million in incremental post implementation expenses that we've added to this year.

好消息是，我們在 10 月 3 日啟動了開關，燈沒有熄滅，對吧？但是——這是一次非常全面的 ERP 系統轉換，涵蓋了整個供應鏈的所有財務和會計職能，這對我們來說意義重大，對所有人力資源職能部門也是如此。絕大多數模組從一開始就運行流暢高效，正如我們所希望的那樣。但與所有這些項目一樣，它也存在一些需要修復的錯誤和需要改進的地方。這就是為什麼你會看到我們今年增加了 300 萬美元的實施後額外支出。

We, in anticipating that this would be the case asked our implementation consult, we did this back in the summer to continue to devote those same resources to us for a period of time post implementation to help us work through these things in the real term. And those -- we're nothing items off the list on a daily basis. As we stated from the get-go, unlike a lot of other ERPs that were driven because of inefficiencies or inconsistencies in the legacy system. That was not necessarily the case here. Again, many times the driver for an ERP conversion is a company that has grown through acquisitions and has not converted every one of their various business units over to a single unit. That wasn't applicable for us.

我們預料到這種情況，因此在夏季時就要求我們的實施顧問繼續投入同樣的資源，以便在實施後的一段時間內幫助我們實際解決這些問題。而這些──我們每天都會把這些事情從待辦事項清單中剔除。正如我們從一開始就聲明的那樣，與其他許多因遺留系統效率低下或不一致而驅動的 ERP 系統不同。但這裡的情況未必如此。再次強調，許多時候推動 ERP 系統轉換的原因是公司透過收購不斷發展壯大，但尚未將其各個業務部門全部合併為一個單一的部門。那對我們來說並不適用。

We were on a single operating system. Everybody was basically on PeopleSoft products, and we were operating efficiently. I say that because ultimately, we do believe that there will be enhanced efficiencies and workflows from the full implementation of Fusion. But it's not something that was done for a specific ROI. And therefore, we're not looking to quantify a specific impact on our P&L.

我們當時使用的是單一作業系統。基本上所有人都在使用 PeopleSoft 產品，我們的營運效率很高。我這麼說是因為我們最終相信，Fusion 的全面實施將提高效率並優化工作流程。但這並非為了追求特定的投資報酬率而採取的措施。因此，我們並不打算量化對損益表的具體影響。

Brian, this is Mark. I mentioned it in my script, but I do want to give a call out our teams here in Birmingham as well as our teams down in the hospitals as part of this conversion. They've worked day and night plus the weekends to make sure that this execution was near flawless and not just any organization can do this in the manner they did. I'm really proud of what they've done.

布萊恩，這是馬克。我在稿子裡提到了，但我想特別感謝我們在伯明罕的團隊以及在醫院的團隊，感謝他們參與這次轉型。他們日夜兼程，週末也加班加點，確保這次執行近乎完美，而且不是什麼組織都能像他們那樣做到這一點。我為他們所取得的成就感到非常自豪。

Jared Haase, William Blair.

賈里德·哈斯，威廉·布萊爾。

All the details thus far. I'll ask another one on sort of the backdrop or outlook for Medicare Advantage. And I'm curious, we've heard a lot about the plans sort of talking about them moving members from more flexible PPO products towards these HMOs. And I'm curious when you see kind of that shift in mix towards more of a managed care product like that. Does that have any impact on Encompass either from kind of a preauthorization perspective or maybe your ability to be a part of those, call it, narrow or tighter networks?

目前為止的所有細節。我再問一個關於聯邦醫療保險優勢計劃的背景或前景的問題。我很好奇，我們聽說了很多關於這些計劃的討論，例如將會員從更靈活的 PPO 產品轉移到這些 HMO 產品。我很想知道，您何時會看到這種組合轉向更像管理式醫療產品的方向。這是否會對 Encompass 產生任何影響，無論是從預授權的角度來看，還是從您加入那些所謂的狹窄或更嚴格的網路的能力來看？

Jared, this is Pat. We have not seen much change in the MA side on the pre-op perspective and don't anticipate changes as we head into 2026. As Doug said, we have a lot of success on the prior of perspective. And as we navigate the layers of appeal, but it's still a grind every day dealing with those plans, but our teams are persistent and advocating for the patients in those markets that deserve our level of care.

Jared，這位是Pat。從術前角度來看，MA方面並沒有太大變化，預計到2026年也不會改變。正如道格所說，我們在先驗視角方面取得了巨大的成功。儘管我們努力應對各種上訴程序，但每天處理這些計劃仍然是一件非常辛苦的事情，不過我們的團隊堅持不懈，為那些應該得到我們這種水平護理的市場中的患者爭取權益。

Okay. Great. That's helpful. And then maybe just a follow-up on occupancy. When we think about the influence of your, I guess, 2025 capacity investments maturing, and then the additions that you have planned for next year, any nuances we should keep in mind from, I guess, a cadence perspective next year on the occupancy rate? Or should we sort of pencil that in staying relatively constant in the mid-70s range?

好的。偉大的。那很有幫助。然後或許可以跟進一下入住率狀況。當我們考慮您2025年產能投資到期以及您計劃明年新增產能的影響時，從節奏角度來看，明年入住率方面有哪些細微差別需要注意？或者我們應該暫定將其保持在 70 多度的範圍內？

Yes. I think just maybe thinking initially about the Q4, Q1 dynamic. So remember, we had our highest ever occupancy level in Q1 of last year. And then as you look maybe to Q3 and Q4 of this year, we're adding a lot of our bulk capacity, meaning the de novos coming online late in the year. So we had an opening that occurred very late in September. And then we've got one each in October, November and December. So those are all still going to be very much in ramp mode as we move into the first quarter of next year.

是的。我覺得最初可能只是在考慮第四季和第一季之間的動態關係。所以請記住，去年第一季我們的入住率達到了歷史最高水準。然後，展望今年第三季和第四季度，我們將增加大量散裝產能，這意味著新建案將在今年稍後上線。所以我們在九月下旬出現了一個職缺。然後，十月、十一月和十二月各有一場。因此，進入明年第一季度，這些項目仍將處於快速成長階段。

So it wouldn't -- and I haven't put a pen to the paper yet. But I wouldn't surprise me if you saw some downward pressure in terms of the year-over-year comparison in occupancy rates in the first quarter of next year. Of course, all of that can change depending on the intensity of a flu season. I guess you got to throw COVID into the mix and all that other kind of stuff. And anyway, there will be period-to-period fluctuations as a result of the timing of capacity additions, but our overall occupancy rates remain on an upward trajectory.

所以不會——而且我還沒動筆寫下來。但如果明年第一季入住率比去年同期出現一些下行壓力，我不會感到驚訝。當然，所有這些都可能根據流感季節的嚴重程度而改變。我想你得把新冠疫情以及其他種種因素都考慮進去。而且，由於新增容量的時間安排，入住率會不時出現波動，但我們的整體入住率仍呈現上升趨勢。

Jared, in our supplemental slides on slide 17, we have the development activity and when the hospitals will come on in 2026. So just draw your attention to that.

Jared，在我們的補充投影片第 17 頁中，我們介紹了開發活動以及醫院將於 2026 年投入使用的情況。所以，請注意這一點。

(Operator Instructions)

（操作說明）

Raj Kumar.

拉傑·庫馬爾。

Maybe just kind of, on the kind of satellite consolidation. And maybe I missed the comment, but what's kind of embedded from a year-on-year standpoint in 4Q? In terms of the growth headwind? And then maybe just one on the kind of potential impacts from the negative headlines that came out earlier in the 3Q. Do you kind of see any changes to referral patterns as a result of that? Or was it kind of business as usual?

或許只是某種程度上，關於衛星整合。或許我錯過了這篇評論，但從年比角度來看，第四季有哪些比較突出的因素呢？就成長逆風而言？然後，或許可以談談第三季早些時候出現的負面新聞可能帶來的影響。你認為這是否對轉診模式造成了任何影響？還是一切照舊？

I'll take your -- I'll answer the last question first. This is Mark. We've not seen any impact among our referral patterns. As we stated on last quarter's call, we were very proactive in terms of communicating with our joint venture partners, with our referral sources and they're all aware of our quality, and we share that openly. So we've not seen any negative fallout from that article.

我先回答最後一個問題。這是馬克。我們的轉診模式沒有受到任何影響。正如我們在上個季度電話會議上所說，我們在與合資夥伴、推薦來源溝通方面非常積極主動，他們都知道我們的質量，我們也公開分享了這一點。所以，我們還沒有看到那篇文章有任何負面影響。

With regard to the Q4 potential headwind from the two satellite closures, again, we estimated that at 35 basis points even before we add the beds in Cincinnati, we should start seeing a resumption of -- or consolidation of some of that volume into the remaining hospitals in that market. So I would say it will probably be a little bit less, maybe 25 to 30 basis points in Q4.

關於第四季度兩家衛星醫院關閉可能帶來的不利影響，我們再次估計，即使在辛辛那提增加床位之前，35 個基點的波動也會導致部分業務量恢復或整合到該市場剩餘的醫院中。所以我認為第四季可能會略微減少一些，也許減少 25 到 30 個基點。

Got it. And then as my follow-up, just kind of thinking about the preopening and start-up costs, $11 million year-to-date, I think roughly $7 million from the low end of what's embedded for this year. So maybe kind of helping us think about from the three hospitals that are opening in 4Q, how much of that was realized in the third quarter? And it seems like you have like a back half weighted pipeline next year as well from an opening standpoint. So maybe what's kind of being assumed in 4Q spend related to the first half hospitals in '26?

知道了。然後，作為我的後續考慮，我只是想了解一下開業前的準備和啟動成本，今年迄今為止已經花費了 1100 萬美元，我認為今年預算中最低的 700 萬美元左右。那麼，或許我們可以思考一下，在第四季開業的三家醫院中，有多少是在第三季實現的？從開局來看，你們明年的後半段賽程似乎也比較緊湊。那麼，2026 年上半年醫院相關的第四季支出可能有哪些假設呢？

Yes. So it's going to be on kind of a rolling basis. So the estimate for the year is 18% to 22%. You're at 11% through three quarters probably pegging the midpoint of that range is not a bad place to be in terms of the Q4 estimate. Most of that is going to be related to the openings that occur in Q4, a portion is applicable to the early openings in 2026, probably a good proxy for where we might land with regard to number is something in the same range that we asked for the full year this year. And two, when you get to the latter stages of 2026, that is going to include some expenses related to '27 openings.

是的。所以這會是一個滾動進行的過程。因此，今年的預期成長率為 18% 至 22%。前三個季度完成 11%，如果能達到這個範圍的中點，對於第四季的預測來說應該不算太糟。其中大部分與第四季度的開業有關，一部分適用於 2026 年的早期開業，我們最終的數字可能與我們今年全年要求的數字大致相同。第二，到了 2026 年後期，這將包括一些與 2027 年開業相關的費用。

At this time, there are no additional questions. I'd like to turn the program over to Mark Miller for any closing remarks.

目前沒有其他問題。我謹將節目交給馬克‧米勒，請他作總結發言。

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

謝謝接線生。如果還有其他問題，請致電 205-970-5860 與我聯絡。再次感謝您參加今天的電話會議。

Thank you for your participation. This does conclude today's program. You may disconnect at any time.

感謝您的參與。今天的節目到此結束。您可以隨時斷開連線。