Select Medical Holdings Corp (SEM) 2024 Q2 法說會逐字稿

Good morning, and thank you for joining us today for Select Medical Holdings Corporation's earnings conference call to discuss the second-quarter 2024 results and the company's business outlook.

早安，感謝您今天參加 Select Medical Holdings Corporation 的收益電話會議，討論 2024 年第二季度業績和公司業務前景。

Speaking today are the company's Executive Chairman and Co-Founder, Robert Ortenzio; and the company's Senior Executive Vice President of Strategic Finance and Operations, Martin Jackson. Management will give you an overview of the quarter and then open the call for questions.

今天發言的是該公司的執行主席兼聯合創始人 Robert Ortenzio；以及公司策略財務和營運高級執行副總裁馬丁傑克遜 (Martin Jackson)。管理層將為您提供本季度的概述，然後開始提問。

Before we get started, we would like to remind you that this conference call may contain forward-looking statements regarding future events or the future financial performance of the company, including, without limitation, statements regarding operating results, growth opportunities, and other statements that refer to Select Medical's plans, expectations, strategies, intentions and beliefs.

在開始之前，我們想提醒您，本次電話會議可能包含有關未來事件或公司未來財務業績的前瞻性陳述，包括但不限於有關經營業績、成長機會的陳述以及其他有關未來事件的陳述。 Select Medical 的計劃、期望、策略、意圖和信念。

These forward-looking statements are based on the information available to management of Select Medical today, and the company assumes no obligation to update these statements as circumstances change.

這些前瞻性陳述是基於 Select Medical 管理層目前掌握的信息，公司不承擔隨著情況變化而更新這些陳述的義務。

At this time, I will turn the conference over to Mr. Robert Ortenzio.

這次我將把會議交給羅伯特·奧坦齊奧先生。

Thank you, operator. Good morning, everyone. Welcome to Select Medical's earnings call for second-quarter 2024. Before I address our second-quarter results, I wanted to highlight a few items. First, we successfully completed Concentra's initial public offering on July 26. The extraordinary efforts of many of our Concentra and Select colleagues throughout the process are greatly appreciated.

謝謝你，接線生。大家早安。歡迎參加 Select Medical 2024 年第二季財報電話會議。在介紹第二季業績之前，我想先強調一些事項。首先，我們在 7 月 26 日成功完成了 Concentra 的首次公開募股。我們非常感謝許多 Concentra 和 Select 同事在整個過程中所做的非凡努力。

Concentra issued 22,500,000 shares at an IPO share price of $23.50 and now trades under the symbol CON on the New York Stock Exchange. The underwriters of the IPO transaction have a 30-day option to purchase an additional 3,375,000 shares of Concentra common stock. Select Medical still owns 82.23% of Concentra's stock or 80.09% if the underwriters exercised their full allotment.

Concentra 發行了 22,500,000 股股票，IPO 股價為 23.50 美元，目前在紐約證券交易所交易，代號為 CON。此次 IPO 交易的承銷商擁有 30 天的選擇權，可以額外購買 3,375,000 股 Concentra 普通股。Select Medical 仍持有 Concentra 82.23% 的股票，如果承銷商行使全部配股，則持有 80.09%。

Select expects to distribute its remaining interest in Concentra to its shareholders within 12 months of the IPO as required by the private letter ruling from the IRS. In connection with the planned separation, Concentra entered into financing arrangements, which included a new senior credit facility, consisting of $850 million seven-year term loan; a $400 million five-year revolving facility, which was undrawn at closing; and $650 million of 6.875% senior notes due 2032.

Select 預計將按照美國國稅局私訊裁決的要求，在 IPO 後 12 個月內將其在 Concentra 的剩餘權益分配給股東。針對計劃中的分離，Concentra 達成了融資安排，其中包括一項新的高級信貸安排，其中包括 8.5 億美元的七年期定期貸款； 4億美元的五年循環貸款，在交易結束時尚未提取；以及 2032 年到期的 6.5 億美元、利率為 6.875% 的優先票據。

The majority of the net proceeds from the Concentra IPO-related debt transactions were used by Select to pay down debt. Concentra will be holding -- hosting their first conference call later this morning at 10:30 Eastern Time, where they will provide more detailed information regarding their performance and insight into their business.

Select 使用 Concentra IPO 相關債務交易的大部分淨收益來償還債務。Concentra 將於東部時間今天上午 10:30 舉行首次電話會議，屆時他們將提供有關其業績和業務洞察的更多詳細資訊。

On another positive note, US News & World Report recently issued its annual best hospitals list. I'm pleased to share with you that six Select Medical rehabilitation hospitals at 12 locations have been placed among the top in the nation for 2024-2025.

另一個積極的方面是，《美國新聞與世界報道》最近發布了年度最佳醫院名單。我很高興與您分享，12 個地點的 6 家精選醫療復健醫院已躋身 2024-2025 年全國前列。

They are at Number 4, Kessler Institute for Rehabilitation; Number 14, Banner Rehabilitation Hospital; Number 20, Baylor Scott & White Institute for Rehabilitation, Dallas; Number 23, California Rehabilitation Institute in Los Angeles; Number 24, Cleveland Clinic Rehabilitation Hospital; and Number 38, OhioHealth Rehabilitation Hospital in Columbus.

他們在 4 號凱斯勒康復研究所； 14號，橫幅復健醫院；第 20 號，貝勒·斯科特·懷特康復研究所，達拉斯；第23號，洛杉磯加州復健研究所； 24號，克利夫蘭診所復健醫院；以及哥倫布市的 38 號俄亥俄健康復健醫院。

This marks the 32nd consecutive year that Kessler Institute has been named among the nation's best hospitals for rehabilitation and the fourth year in a row for Baylor Scott & White, Dallas and OhioHealth. This recognition spotlights the commitment of each hospital providing the highest quality of care to patients and their families every day. It also demonstrates the dedication of every team member to our culture of delivering an exceptional patient experience.

這標誌著凱斯勒研究所連續 32 年被評為全國最佳復健醫院之一，也是 Baylor Scott & White、達拉斯和 OhioHealth 連續第四年被評為全美最佳復健醫院。這項認可凸顯了每家醫院每天為患者及其家人提供最高品質護理的承諾。它也體現了每個團隊成員對我們提供卓越患者體驗的文化的奉獻精神。

On the development front, we opened a new critical illness recovery hospital with a distinct part rehabilitation unit in Chicago with RUSH University system, adding 44 critical illness and 56 rehab beds on April 9. We are on target to open a 48-bed rehab hospital in Jacksonville, Florida later this year with our partner, UF Health Jacksonville.

在發展方面，我們與 RUSH 大學系統一起在芝加哥開設了一家新的危重病康復醫院，該醫院設有獨立的康復部門，於 4 月 9 日增加了 44 個危重病床位和 56 個康復床位。我們的目標是今年稍後與我們的合作夥伴 UF Health Jacksonville 在佛羅裡達州傑克遜維爾開設一家擁有 48 個床位的復健醫院。

The joint venture hospital and a hospital branded UF Health Rehabilitation Hospital North will be located in a new tower of UF Health. There are many other exciting development projects we have in the works for 2025 and 2026 in the inpatient rehabilitation division.

該合資醫院和一家名為 UF Health Rehabilitation Hospital North 的醫院將位於 UF Health 的一棟新大樓內。2025 年和 2026 年，我們在住院復健部門還有許多其他令人興奮的開發案。

To recap, in 2025, we're opening our fourth rehab hospital with Cleveland Clinic in Fairhill, our second hospital with UPMC in Central Pennsylvania, and our fourth rehab hospital as part of our joint venture with Banner in Tucson, Arizona.

回顧一下，到2025 年，我們將與克利夫蘭診所在Fairhill 合作開設第四家復健醫院，與UPMC 合作在賓州中部開設第二家醫院，並作為我們與Banner 合資企業的一部分在亞利桑那州圖森開設第四家復健醫院。

In 2026, we are planning to open a new 60-bed rehab hospital in Southern New Jersey, the Bacharach Institute for Rehab, in partnership with AtlantiCare and have scheduled to open a new freestanding 63-bed rehab hospital in Ozark, Missouri with CoxHealth system.

2026 年，我們計劃與AtlantiCare 合作，在新澤西州南部開設一家擁有60 個床位的新復健醫院—巴哈拉赫復健研究所，並計劃在密蘇裡州奧索卡開設一家配備CoxHealth 系統的新獨立復健醫院，擁有63 個床位。

Overall, we are very pleased with the development results and the pipeline for our specialty hospital divisions. Between the specific projects just mentioned, as well as some other smaller expansions in new distinct part units in existing hospitals, we plan to add 449 additional beds to our operations from the remainder of 2024 through 2026.

整體而言，我們對專科醫院部門的發展成果和管道感到非常滿意。在剛剛提到的具體項目以及現有醫院新的不同部分單元的其他一些較小規模的擴建中，我們計劃從 2024 年剩餘時間到 2026 年為我們的運營增加 449 張床位。

The additional beds consist of 423 rehab hospital beds, which includes 54 non-consolidating beds and 26 LTAC beds. There are also many other opportunities under evaluation that would further increase our Select Specialty Hospital footprint.

新增床位包括423張復健醫院床位，其中包括54張非鞏固床位和26張LTAC床位。還有許多其他機會正在評估中，這些機會將進一步擴大我們的精選專科醫院的足跡。

This quarter, our outpatient rehab division added 15 clinics via eight de novos and three acquisitions, a total of seven clinics. This is offset by the closure of five underperforming clinics and the fold-in of seven clinics into existing operations upon lease expiration. The pipeline for future growth remains strong, with 16 executed leases for de novo clinics scheduled to open later this year, along with one clinic acquisition in North Jersey.

本季度，我們的門診復健部門透過 8 次新建和 3 次收購增加了 15 家診所，總共 7 家診所。這被關閉五家表現不佳的診所以及租賃到期後將七家診所併入現有業務所抵消。未來的成長管道仍然強勁，計劃於今年稍後開業的 16 家新診所已執行租約，並在北澤西收購了一家診所。

Moving on to the second-quarter results, we continue 2024 with another strong quarter. The hospital divisions continued to exceed our expectations with the inpatient rehabilitation division returning double-digit growth in both revenue and adjusted EBITDA for the second straight quarter this year.

接下來是第二季業績，我們將在 2024 年繼續實現另一個強勁的季度。醫院部門持續超越我們的預期，住院復健部門今年連續第二季的收入和調整後 EBITDA 均達到兩位數成長。

Overall, our consolidated adjusted EBITDA grew 3% and revenue grew by 5% compared to Q2 of the prior year, with all four divisions exceeding prior-year revenue. For the quarter, total company adjusted EBITDA was $226.3 million compared to $219.5 million in the prior year. Our consolidated adjusted EBITDA margin was 12.9% for Q2 compared to 13.1% in the prior year.

總體而言，與去年第二季相比，我們的綜合調整後 EBITDA 成長了 3%，營收成長了 5%，所有四個部門的收入都超過了去年同期。本季度，公司調整後 EBITDA 總額為 2.263 億美元，去年同期為 2.195 億美元。第二季我們的綜合調整後 EBITDA 利潤率為 12.9%，而去年同期為 13.1%。

Our critical illness recovery hospital division continues to perform well with a 5% increase in revenue and a 10% increase in adjusted EBITDA compared to same quarter prior year. Critical illness incurred $3.6 million of startup losses related to new hospitals this quarter compared to $5.1 million in the same quarter prior year.

我們的重症復健醫院部門持續表現良好，與去年同期相比，收入成長了 5%，調整後 EBITDA 成長了 10%。本季與新醫院相關的重大疾病損失為 360 萬美元，而去年同期為 510 萬美元。

Current quarter startup losses primarily relate to the opening of RUSH Specialty hospital in April. And while our occupancy was slightly down from same quarter last year at 67%, down from 68%, our average daily census increased 1%. Our rate per day increased by 4%. Our adjusted EBITDA margin was 11.9% for the quarter compared to 11.4% in prior-year Q2.

本季啟動虧損主要與 RUSH 專科醫院 4 月開幕有關。雖然我們的入住率較去年同期的 68% 略有下降，為 67%，但我們的平均每日人口普查增加了 1%。我們每天的費率增加了 4%。本季調整後 EBITDA 利潤率為 11.9%，而去年第二季為 11.4%。

Critical illness experienced a 1% reduction in their salary, wage, and benefits to revenue ratio compared to prior-year Q2 with a 56.1% margin. Nursing agency utilization decreased 14%, and agency rates decreased by 4% compared to same quarter prior year. Orientation hours decreased 12% from prior year Q2. Nursing sign-on incentive bonuses decreased 18% from prior-year Q2.

與去年第二季相比，重症患者的薪資、薪資和福利與收入比下降了 1%，下降幅度為 56.1%。與去年同期相比，護理機構利用率下降 14%，代理費率下降 4%。迎新活動時間比去年第二季減少了 12%。護理師簽約激勵獎金比去年第二季下降 18%。

On the regulatory front, yesterday afternoon, CMS issued the final LTAC rules for fiscal year 2024, which will be effective October 1 of this year. The final rule includes a 2.6% increase in the federal base rate, which is higher than the proposed rule at 2.4%.

監管方面，昨天下午，CMS發布了2024財年LTAC最終規則，該規則將於今年10月1日生效。最終規則包括將聯邦基本利率提高 2.6%，高於擬議規則 2.4%。

The high-cost outlier threshold increased by $17,175 from $59,873 to $77,048, which was higher, and the increased outlier in the proposed rule of $15,524. The MS-LTC-DRG relative weight and expected length of stay were also updated in the final rule.

高成本異常值閾值從 59,873 美元增加到 77,048 美元，增加了 17,175 美元，擬議規則中的異常值增加了 15,524 美元。最終規則中也更新了 MS-LTC-DRG 相對權重和預期住院時間。

As previously mentioned, our inpatient rehab hospital division had a very strong quarter with 11% increase in revenue and 13% increase in adjusted EBITDA compared to Q2 prior year. Inpatient rehab incurred $3 million of startup losses this quarter, primarily related to the opening of RUSH Specialty Hospital unit in April compared to no startup losses in the prior year.

如前所述，我們的住院復健醫院部門的季度表現非常強勁，與去年第二季相比，營收成長了 11%，調整後 EBITDA 成長了 13%。住院復健中心本季產生了 300 萬美元的啟動虧損，主要與 4 月份 RUSH 專科醫院部門的開業有關，而前一年沒有啟動虧損。

Average daily census increased 7%, and our rate per patient day increased 5%. Our occupancy of 84% was consistent with prior year. The adjusted EBITDA margin for inpatient rehab was 23.1% for Q2, which was higher than the prior-year margin of 22.7%.

平均每日人口普查增加了 7%，每位患者每天的普查率增加了 5%。我們的入住率為 84%，與去年持平。第二季住院復健的調整後 EBITDA 利潤率為 23.1%，高於去年同期的 22.7%。

This week, CMS issued the final inpatient rehab rules for fiscal 2025, which were effective October 1. The final rule includes a 1.97% increase in standard federal payment rate, which is higher than the 1.79% included in the proposed rule. The high-cost outlier threshold increased $1,620, which is slightly less than the $1,735 increase in the proposed rule. The CMG relative weights and average length of stay values were also updated in the final rule.

本週，CMS 發布了 2025 財年住院康復的最終規則，該規則於 10 月 1 日生效。最終規則包括將標準聯邦支付率提高 1.97%，高於擬議規則中的 1.79%。高成本異常值閾值增加了 1,620 美元，略低於擬議規則中增加的 1,735 美元。最終規則中也更新了 CMG 相對權重和平均停留時間值。

Concentra experienced an increase of 2% in net revenues and 1% in adjusted EBITDA over prior-year same quarter. The increase in revenue was driven primarily by a 4% increase in rate, which was attributed to state fee schedule increases, along with a higher mix of workers' comp visit.

與去年同期相比，Concentra 的淨收入成長了 2%，調整後 EBITDA 成長了 1%。收入的增長主要是由於費率增加了 4%，這歸因於國家費用表的增加以及工人補償訪問的增加。

Consistent with the first quarter, Concentra's work comp volume remained strong with an increase of 2%. It was offset by a 4% decrease in employer-based visits, which were reimbursed at lower rates. Demand for employer-based visits have normalized compared to the COVID years, where we experienced a significant churn in labor force. We expect a decrease in employer-based visits to level off in the near future.

與第一季一致，Concentra 的工作量保持強勁，成長了 2%。但雇主探訪次數減少了 4%，且報銷費率較低，從而抵消了這種影響。與新冠疫情期間勞動力大幅流失相比，雇主探訪的需求已正常化。我們預計雇主訪問量的減少將在不久的將來趨於平穩。

Concentra's adjusted EBITDA margin was 21.3% for the quarter compared to 21.5% in the same quarter prior year. Outpatient rehab division experienced an increase of 4% in revenue with patient volumes increasing by 4% and net revenue per visit of $100, consistent with prior year. Our volume continues to maintain an upward trend, and net revenue per visit has stabilized with improvements in commercial managed care rates, offset by a decrease in our Medicare rates.

Concentra 本季調整後 EBITDA 利潤率為 21.3%，而去年同期為 21.5%。門診復健部門的收入增加了 4%，患者數量增加了 4%，每次就診的淨收入為 100 美元，與前一年一致。我們的業務量繼續保持上升趨勢，隨著商業管理護理費率的提高，每次就診的淨收入已經穩定，但被我們的醫療保險費率的下降所抵消。

The outpatient division's adjusted EBITDA decreased 12% compared to prior year, and the adjusted EBITDA margin went from 10.8% to 9.1%. Our outpatient team is focused on improving patient access, productivity, and staffing. Thus far in Q3, we have seen positive results when compared to prior-year Q3 performance. Earnings per share and adjusted earnings per share were $0.60 for the second quarter compared to $0.61 per share in the same quarter prior year.

門診部調整後 EBITDA 較前一年下降 12%，調整後 EBITDA 利潤率從 10.8% 上升至 9.1%。我們的門診團隊致力於改善患者就診、生產力和人員配置。到目前為止，與去年第三季的業績相比，我們在第三季看到了積極的成果。第二季每股收益和調整後每股收益為 0.60 美元，而去年同期為 0.61 美元。

In regard to our allocation and deployment of capital, our Board of Directors declared a cash dividend of $0.125, payable on August 30, to stockholders of record as of the close of business of August 14. This past quarter, we did not repurchase shares under our Board-authorized share repurchase program, and we continue to evaluate stock repurchases, reduction of debt, and development opportunities.

關於我們的資本分配和部署，我們的董事會宣佈於 8 月 30 日向截至 8 月 14 日收盤時在冊的股東派發 0.125 美元的現金股利。上個季度，我們沒有根據董事會授權的股票回購計畫回購股票，我們將繼續評估股票回購、減少債務和發展機會。

That concludes my prepared remarks. I'll turn it over to Marty Jackson for some additional financial details before we open the call up for questions.

我準備好的發言就到此結束。在我們開始提問之前，我會將其交給馬蒂傑克遜（Marty Jackson），以了解一些額外的財務細節。

Thanks, Bob. And good morning, everyone. I'll begin by providing additional detail on the progress we continue to make regarding labor costs within the critical illness recovery hospital division. Overall, our SWB as a percentage of revenue ratio was in line with our expectations at 56.1% this quarter, which is a decrease from 56.7% in Q2 of prior year.

謝謝，鮑伯。大家早安。首先，我將提供更多詳細信息，介紹我們在危重病復健醫院部門的勞動力成本方面繼續取得的進展。整體而言，本季我們的主觀幸福感佔營收比例為 56.1%，符合我們的預期，較去年第二季的 56.7% 有所下降。

In the second quarter of this year, we again saw a decrease in agency costs and utilization from prior-year Q2. Compared to Q2 '23, RN agency costs decreased by 16% and utilization decreased from 18% down to 16%. The agency rate for RNs also decreased by 4% from $77 to $74.

今年第二季度，我們再次看到代理成本和利用率較去年第二季度有所下降。與 23 年第二季相比，RN 代理成本下降了 16%，利用率從 18% 下降到 16%。註冊護士的代理費率也下降了 4%，從 77 美元降至 74 美元。

Nursing sign-on incentive bonuses decreased, as Bob had mentioned, by 18% from Q2 of prior year and 16% from the first quarter of this year. Finally, we also saw a decrease of 12% in our orientation hours for new hires. We are very pleased with the continued (technical difficulty) in regards to our labor costs.

正如鮑伯所提到的，護理師簽約激勵獎金比去年第二季下降了 18%，比今年第一季下降了 16%。最後，我們也發現新進員工入職培訓時間減少了 12%。我們對勞動成本方面持續存在的（技術困難）感到非常滿意。

Moving on to our financials, in Q2, equity in earnings of unconsolidated subsidiaries were $6.3 million. This compares to $10.5 million in the same quarter prior year. The decline in earnings was largely a result of the write-off of an impaired business we had a minority interest in. Net income attributable to non-controlling interest was $17.2 million. This compares to $13.6 million in the same quarter prior year. This increase is due to improved performance in our consolidated joint ventures.

轉向我們的財務數據，第二季度，未合併子公司的收益權益為 630 萬美元。相比之下，去年同期為 1,050 萬美元。收益下降主要是由於我們持有少數股權的受損業務被沖銷。歸屬於非控制權益的淨利為 1,720 萬美元。相比之下，去年同期為 1,360 萬美元。這一成長是由於我們合併的合資企業績效的改善。

Interest expense was $37.1 million in the second quarter. This compares to $49 million in the same quarter of prior year. The reduction in interest expense was principally due to the accelerated recognition of the gain of our interest rate hedge due to the prepayment of our term loan, which occurred in July as a result of the Concentra IPO.

第二季利息支出為 3,710 萬美元。相比之下，去年同期為 4,900 萬美元。利息支出的減少主要是由於我們因 Concentra IPO 於 7 月提前償還定期貸款而加速確認利率對沖收益。

At the end of the quarter, we had $3.6 billion of debt outstanding and $111.2 million of cash on the balance sheet. Our debt balance at the end of the quarter includes $2 billion in term loans, $345 million in revolving loans, $1.2 billion in 6.25% senior notes, and $63.4 million of other miscellaneous debt.

截至本季末，我們的資產負債表上有 36 億美元的未償債務和 1.112 億美元的現金。截至本季末，我們的債務餘額包括 20 億美元的定期貸款、3.45 億美元的循環貸款、12 億美元的 6.25% 優先票據以及 6,340 萬美元的其他雜項債務。

We ended the quarter with net leverage of our senior secured credit agreement of 4.13x. As of June 30, we had $367.4 million of availability on our revolving loans. The interest rate on the $2 billion of our term loans is capped at 1% SOFR plus 300 basis points through September 30, 2024.

本季結束時，我們的優先擔保信貸協議的淨槓桿率為 4.13 倍。截至 6 月 30 日，我們的循環貸款可用金額為 3.674 億美元。截至 2024 年 9 月 30 日，我們 20 億美元定期貸款的利率上限為 1% SOFR 加 300 個基點。

At the end of July, we utilized the proceeds from the IPO that Bob had mentioned and related debt transactions to pay off $300 million that was outstanding on our revolver with the remainder allocated to prepay $1.64 billion of our term loan. At the end of July, our consolidated debt balance, which includes Concentra, was approximately $3.1 billion with approximately $1.5 billion residing at Concentra and $1.6 billion at Select.

7 月底，我們利用鮑勃提到的 IPO 和相關債務交易的收益來償還我們的左輪手槍中未償還的 3 億美元，其餘部分用於預付我們的 16.4 億美元定期貸款。截至 7 月底，我們的合併債務餘額（包括 Concentra）約為 31 億美元，其中約 15 億美元位於 Concentra，16 億美元位於 Select。

Our consolidated net leverage is now approximately 3.5x, with Select leverage around 3.2x and Concentra approximately 3.8x. We expect to finish this year at approximately 3.2x to 3.3x leverage on a consolidated basis with Select slightly below 3x and Concentra at 3.5x to 3.6x levered.

我們的綜合淨槓桿率目前約為 3.5 倍，其中 Select 槓桿率約為 3.2 倍，Concentra 約為 3.8 倍。我們預計今年的合併槓桿率約為 3.2 倍至 3.3 倍，其中 Select 略低於 3 倍，Concentra 槓桿率為 3.5 倍至 3.6 倍。

For the second quarter, operating activities provided $278.2 million in cash flow. Our days sales outstanding or DSO was 56 days at June 30, 2024, compared to 52 days at June 30, 2023, and 58 days at March 31, 2024. The improvement compared to Q1 is attributable to the reduction in claims processing backlog that was impacted by the Change Healthcare cyber incident. We continue to see a reduction in our DSO in Q3 as we move on from the cyber incident.

第二季度，經營活動提供了 2.782 億美元的現金流。截至2024年6月30日，我們的應收帳款天數或DSO為56天，而2023年6月30日為52天，2024年3月31日為58天。與第一季相比的改善歸因於受 Change Healthcare 網路事件影響的索賠處理積壓工作的減少。隨著我們從網路事件中恢復過來，我們在第三季的 DSO 繼續減少。

Investing activities used $54.1 million of cash in the second quarter, primarily due to $55.5 million in purchases of property, equipment, and other assets, slightly offset by a sale of assets. Financing activities used $205.5 million of cash in the second quarter. We had $165 million in net payments on our revolving lines of credit, $16.3 million in dividends on our common stock, and $14.2 million in net payments on other debt.

第二季投資活動使用了 5,410 萬美元現金，主要是因為購買了 5,550 萬美元的財產、設備和其他資產，資產出售略有抵銷。第二季融資活動使用了 2.055 億美元現金。我們的循環信貸額度淨付款為 1.65 億美元，普通股股息為 1,630 萬美元，其他債務淨付款為 1,420 萬美元。

As stated previously, we did not repurchase any shares under our Board-authorized repurchase program this quarter. Last year, the Board approved a two-year extension of the share repurchase program, which remains in effect until December 31, 2025, unless further extended or earlier terminated by the Board.

如前所述，本季我們沒有根據董事會授權的回購計畫回購任何股票。去年，董事會批准將股票回購計畫延長兩年，該計畫有效期至 2025 年 12 月 31 日，除非董事會進一步延長或提前終止。

We are reaffirming our business outlook. For 2024, we expect revenues to be in the range of $6.9 billion to $7.1 billion, adjusted EBITDA to be in the range of $845 million to $885 million, fully diluted earnings per share to be in the range of $1.95 to $2.19, and adjusted earnings per share to be in the range of $1.96 to $2.20. Capital expenditures are expected to be in the range of $225 million to $275 million for 2024 with the majority of those dollars towards development.

我們重申我們的業務前景。2024 年，我們預計營收將在69 億至71 億美元之間，調整後EBITDA 將在8.45 億至8.85 億美元之間，完全稀釋每股收益將在1.95 至2.19 美元之間，調整後收益將在1.95 美元至2.19 美元之間每股價格在 1.96 美元至 2.20 美元之間。 2024 年資本支出預計在 2.25 億至 2.75 億美元之間，其中大部分用於開發。

This concludes our prepared remarks. And at this time, we would like to turn it back over to the operator to open the call up for questions.

我們準備好的演講到此結束。此時，我們想將其轉回給接線員以打開提問電話。

(Operator Instructions) Ben Hendrix, RBC Capital.

（操作員指令）Ben Hendrix，RBC Capital。

Thank you very much. I just wanted to get a little more information on the LTAC margin. I appreciate the comments about the startup costs in the quarter. So is there any other one-timers that would create -- that would explain that sequential phasing from 1Q to 2Q, whether they're seasonal aspects or anything one-time in that sequential decline? Thank you.

非常感謝。我只是想了解更多有關 LTAC 利潤率的資訊。我很欣賞有關本季啟動成本的評論。那麼，是否還有其他一次性因素可以解釋從第一季到第二季的連續階段，無論它們是季節性因素還是連續下降中的一次性因素？謝謝。

Yes, Ben. There was just -- I think we're only talking about a 1% drop of occupancy on a year-over-year basis, so it's relatively the same for us. I mean, the seasonality -- we didn't really see too much seasonality in there. If you're saying compared to Q1 versus Q2, we think it's really -- that's what we've been seeing during normal times. I mean, Q1 is always our highest quarter. Q2, we see a drop in census.

是的，本。我認為我們只是談論入住率同比下降 1%，所以對我們來說相對相同。我的意思是，季節性——我們並沒有真正看到太多的季節性。如果你說與第一季和第二季相比，我們認為這確實是我們在正常時期所看到的。我的意思是，第一季始終是我們業績最高的季度。第二季度，我們看到人口普查人數下降。

And the other thing I would add is, Q1 of this year was an extraordinary year in terms of volume. We just saw ICUs at our acute care hospital referral sources to be really just exceptionally high in Q1. So that explains the sequential -- your question on the sequential differences. We expect the second quarter to be less just in terms of the pulmonary volumes.

我要補充的另一件事是，就數量而言，今年第一季是非凡的一年。我們剛剛看到我們的急診醫院轉診來源中的 ICU 在第一季確實非常高。這就解釋了順序——你關於順序差異的問題。我們預計第二季的肺容量將減少。

Great. Thanks, guys. Appreciate it.

偉大的。謝謝，夥計們。欣賞它。

Thanks, Ben.

謝謝，本。

A.J. Rice, UBS.

A.J.賴斯，瑞銀。

Hi, everybody, maybe just a couple of questions. On the outpatient rehab business, obviously, the revenue -- the visits seem pretty standard, normal trend. I just wonder, on the margin side of that, it sounds like you're looking at some efficiencies, looking at things there.

大家好，也許只是幾個問題。顯然，就門診復健業務而言，收入——就診次數似乎相當標準，是正常趨勢。我只是想知道，在邊際方面，聽起來你正在考慮一些效率，看看那裡的事情。

Is it really a unique rate -- a little bit of rate lift to get back on the track where it's stable to improving margins? Or are there opportunities within the business to make adjustments that will drive that margin -- potential for margins to build an improvement over time?

這真的是獨特的利率嗎——稍微提高一點利率就能回到穩定提高利潤率的軌道上？或者企業內部是否有機會進行調整以提高利潤率——隨著時間的推移，利潤率有可能提高？

Yes, A.J. This is Marty. Certainly, rate would have a positive impact on margin, but that's not really the only thing. I mean, we've got to -- we've really kind of focused on a couple of areas. One is clinical efficiencies, meaning -- seeing -- therapists see -- the number of patients a therapist sees in a day. And then also, we are really focused on scheduling, making sure the scheduling is efficient.

是的，A.J.這是馬蒂。當然，利率會對利潤率產生正面影響，但這並不是唯一的因素。我的意思是，我們必須——我們確實專注於幾個領域。一是臨床效率，意思是──看到──治療師看到──治療師一天看到的病人數量。另外，我們非常注重調度，確保調度高效。

(Multiple speakers) Go ahead. I'm sorry.

（多名發言者）繼續。對不起。

We think that that will probably take us -- we've been working on this. We think that over the next two quarters in particular, starting off into the new year, we anticipate that some things that we're doing will help, such as some -- we're looking at scheduling modules that should help us improve our scheduling efficiency. And I think, really, when you take a look at the new year, we expect to see some real benefit.

我們認為這可能需要我們——我們一直在努力解決這個問題。我們認為，特別是在接下來的兩個季度，從新的一年開始，我們預計我們正在做的一些事情將會有所幫助，例如一些——我們正在研究調度模組，這應該有助於我們改進調度效率。我認為，真的，當你回顧新的一年時，我們期望看到一些真正的好處。

Okay. I appreciate all the comments about contract labor and bonus payments and everything. I guess when you peel all that back, maybe you said this, but I didn't hear it. The underlying wage rates you're seeing with your permanent -- or labor costs, however you want to describe it, with your permanent staff in the critical illness hospitals, I guess, is the main focus. What is that trending at now?

好的。我感謝所有關於合約工和獎金以及一切的評論。我想當你把所有這些都剝離開來時，也許你說過這樣的話，但我沒有聽到。我想，你所看到的長期員工的基本工資率——或者勞動力成本，無論你想如何描述它，以及危重病醫院的長期員工，都是主要關注點。現在的趨勢是什麼？

Yes. Right now, A.J., we're seeing that in the 3% to 3.5% range.

是的。A.J.，目前我們看到這一比例在 3% 到 3.5% 的範圍內。

Okay, so that's sort of back to pre-pandemic levels. Is that right?

好吧，這有點回到了大流行前的水平。是這樣嗎？

It really is.

確實如此。

Yes. Just the last question, trying to think through what's embedded in the guidance down to the EPS line, you mentioned that you've got a sort of reset on some of the protections you had on interest rates starting -- going into the fourth quarter.

是的。就最後一個問題而言，試圖思考每股盈餘線的指引中包含的內容，您提到從第四季度開始，您對利率的一些保護措施進行了某種重置。

Are you assuming in that guidance a step up in borrowing costs? I guess, what are you assuming for borrowing costs or interest expense in Q3 and Q4 in that guidance that you are sharing today?

您在該指引中是否假設借貸成本會上升？我想，在您今天分享的指南中，您對第三季和第四季的借貸成本或利息支出有何假設？

Yes, we are. We have included, in particular in the fourth quarter -- in essence, borrowing costs will go from the 300-basis-point spread plus 1%; SOFR, 4%. Today, SOFR is running in that 5.3% range. So that will certainly have a negative impact in the fourth quarter.

是的，我們是。我們已經包括，特別是在第四季度——實質上，借貸成本將從 300 個基點利差加 1% 開始； SOFR，4%。如今，SOFR 正在 5.3% 的範圍內運作。所以這肯定會對第四季產生負面影響。

Okay, all right. So that's roughly the order of magnitude of the impact on that particular tranche of debt. That makes sense. All right. Thanks a lot.

好吧，好吧。因此，這大致就是對該特定債務類別的影響的數量級。這是有道理的。好的。多謝。

Thank you, A.J.

謝謝你，A.J.

Thank you. I'm showing no further questions. So with that, I hand the call back over to management for any closing remarks.

謝謝。我沒有再提出任何問題。因此，我將電話轉回管理層以供結束語。

Thanks, operator. And just to remind that there is a Concentra call that will be at 10:30 Eastern today, so you'll get a lot more granularity on our Concentra division. With that, I'll end the call. Thank you.

謝謝，接線生。謹提醒您，今天東部時間 10:30 將召開 Concentra 電話會議，以便您能夠更詳細地了解我們的 Concentra 部門。說完，我就結束通話。謝謝。

Ladies and gentlemen, thank you for participating. This does conclude today's program, and you may now disconnect.

女士們、先生們，感謝您的參與。今天的節目到此結束，您現在可以斷開連線了。