Universal Health Realty Income Trust (UHT) 2012 Q1 法說會逐字稿

Good morning. My name is Christine and I will be your conference operator. At this time, I would like to welcome everyone to the UHS first-quarter earnings conference call. (Operator Instructions). Thank you. I will now turn the conference over to Mr. Steve Filton, CFO.

早安.我叫克莉絲汀，我將擔任您的會議接線生。此時此刻，我謹歡迎大家參加 UHS 第一季財報電話會議。 （操作員說明）。謝謝。我現在將會議交給財務長 Steve Filton 先生。

Thank you and good morning. Alan Miller, our CEO, is also joining us this morning. Welcome to this review of Universal Health Services' results for the first quarter ended March 31, 2012.

謝謝你，早安。我們的執行長艾倫米勒 (Alan Miller) 今天早上也將加入我們。歡迎閱讀全民健康服務截至 2012 年 3 月 31 日第一季業績回顧。

During this conference call, Alan and I will be using words such as believes, expects, anticipates, estimates, and similar words that represent forecasts, projections, and forward-looking statements. For anyone not familiar with the risks and uncertainties inherent in these forward-looking statements, I recommend a careful reading of the section on risk factors and forward-looking statements and risk factors in our Form 10-K for the year ended December 31, 2011.

在這次電話會議中，艾倫和我將使用諸如相信、期望、預期、估計等詞語以及代表預測、預測和前瞻性陳述的類似詞語。對於任何不熟悉這些前瞻性陳述固有的風險和不確定性的人，我建議仔細閱讀我們截至 2011 年 12 月 31 日的 10-K 表格中有關風險因素和前瞻性陳述以及風險因素的部分。

We'd like to highlight just a couple of developments and business trends before opening the call up to questions.

在開始提問之前，我們想強調一些進展和業務趨勢。

As discussed in our press release last night, the Company recorded net income attributable to UHS per diluted share of $1.31 for the quarter. After adjusting for the prior-year impact of several reimbursement items recorded during the quarter, our adjusted net income attributable to UHS per diluted share for the quarter ended March 31, 2012, was $1.13.

正如我們昨晚的新聞稿中所討論的，該公司本季稀釋後每股 UHS 淨利潤為 1.31 美元。在本季度記錄的多項報銷項目對上一年的影響進行調整後，截至 2012 年 3 月 31 日的季度，我們調整後歸屬於 UHS 攤薄每股的淨利潤為 1.13 美元。

On a same-facility basis, revenues in our behavioral health division increased 5.3% during the first quarter of 2012. We note that the PSI facilities are included in our same-store data for the entire quarter.

在同一個設施基礎上，我們的行為健康部門的收入在 2012 年第一季成長了 5.3%。

Adjusted admissions and patient days to our behavioral health facilities owned for more than a year increased 9.2% and 2.8%, respectively, during the first quarter. Revenue per adjusted patient day rose 2.4% during the first quarter of 2012 over the comparable prior-year quarter.

第一季度，我們擁有一年多的行為健康設施的調整後入院人數和患者天數分別增加了 9.2% 和 2.8%。 2012 年第一季調整後每個患者日的收入比去年同期增加了 2.4%。

Operating margins for our behavioral health hospitals owned for more than a year increased to 26.8% during the quarter ended March 31, 2012, as compared to 26.5% during the comparable prior-year period.

截至 2012 年 3 月 31 日的季度，我們擁有一年以上的行為健康醫院的營業利潤率增至 26.8%，而去年同期為 26.5%。

On a same-facility basis in our acute care division, revenues increased 0.8% during the first quarter of 2012. The increase resulted primarily from a 1.6% increase in adjusted admissions to our hospitals owned for more than a year. The relatively muted revenue growth reflects a difficult comparison to the prior-year quarter when our net revenues were favorably impacted by positive changes in payer mix, especially stabilization in uninsured volumes.

在我們的急診護理部門的相同設施基礎上，2012 年第一季度的收入增長了 0.8%。相對疲軟的收入成長反映了與去年同期相比的困難，當時我們的淨收入受到付款人結構積極變化的有利影響，特別是未投保數量的穩定。

On a same-facility basis, operating margins for our acute hospitals decreased to 18.6% during the first quarter of 2012 from 20.5% during the first quarter of 2011. We also note that there are no EHR-related revenues included in our quarterly financial statements.

在相同設施的基礎上，我們急診醫院的營業利潤率從2011 年第一季的20.5% 下降到2012 年第一季的18.6%。的收入。

Our acute care hospitals provided charity care and uninsured discounts based on charges at established rates amounting to $315 million and $223 million during the three-month period ended March 31, 2012, and 2011. As a percentage of acute care net revenues, bad debts, charity, care expense, and the uninsured discount in this year's first quarter were at levels higher than those experienced during the first quarter of 2011.

在截至 2012 年 3 月 31 日和 2011 年的三個月期間，我們的急診醫院按照既定費率提供慈善護理和無保險折扣，費用分別為 3.15 億美元和 2.23 億美元。慈善、護理費用和無保險折扣的水平高於2011 年第一季的水平。

However, due primarily to the increase in behavioral health revenues and the very low levels of bad debt and uninsured discounts in that business, our overall percentage of bad debts, charity care, and uninsured discounts were lower than those experienced during the first quarter of 2011.

然而，主要由於行為健康收入的增加以及該業務中壞帳和無保險折扣的水平非常低，我們的壞帳、慈善護理和無保險折扣的總體百分比低於 2011 年第一季的水平。

Our cash from operating activities was approximately $134 million during the first quarter of 2012, as compared to $183 million in the first quarter of 2011. Our Accounts Receivable days outstanding increased to 56 days during the first quarter of 2012, primarily due to a lack of Medicaid payments from the state of Illinois and a lack of disproportionate share payments from Texas, as well as the rural floor settlement recorded as a receivable during the quarter.

2012 年第一季度，我們來自經營活動的現金約為1.34 億美元，而2011 年第一季為1.83 億美元。是由於缺乏伊利諾伊州的醫療補助付款和德克薩斯州沒有不成比例的份額付款，以及農村基層結算在本季度記錄為應收帳款。

At March 31, 2012, our ratio of debt to total capitalization was 59.6%.

截至2012年3月31日，我們的債務佔總資本的比率為59.6%。

We spent $93 million on capital expenditures during the first quarter. Included in our capital expenditures were the construction costs related to the ongoing construction of a new acute care hospital in Temecula, California, and a new bed tower at our Wellington facility in Florida.

第一季我們的資本支出為 9,300 萬美元。我們的資本支出包括與正在加州特曼庫拉建造一座新的急診醫院以及在佛羅裡達州惠靈頓工廠建造一座新床塔相關的建設成本。

Effective in the first quarter of 2012, we have completed all of the divestitures required by the FTC as part of the PSI acquisition.

自 2012 年第一季起，我們已完成 FTC 要求的所有資產剝離（作為 PSI 收購的一部分）。

Alan and I would be pleased to answer your questions at this time.

艾倫和我很高興此時回答您的問題。

(Operator Instructions). Adam Feinstein, Barclays Capital.

（操作員說明）。亞當·范斯坦，巴克萊資本。

Hi, good morning. This is Brian Sekino on behalf of Adam this morning. Just wanted to know if you could provide us with some details in Vegas on some of the mix shift that you saw in acute care versus the strong Q1 of 2011. If you could provide us with some details on how the mix shifted, if that was really the bolus of the mix shift in the quarter.

嗨，早安。我是布萊恩·塞基諾 (Brian Sekino)，今天早上代表 Adam。只是想知道您是否可以在維加斯向我們提供一些關於您在急診護理領域看到的一些混合變化與2011 年強勁第一季度相比的一些細節。詳細信息，如果是的話確實是本季度混合變化的重點。

Sure, Brian. I mean, I think that in talking about the comparison, the sort of anomaly was in the first quarter of last year.

當然，布萊恩。我的意思是，我認為在談論比較時，這種異常現像出現在去年第一季。

For those of you who recall, we talked a great deal in Q1 of 2011 about the fact that rather dramatically unemployment rates had declined in the Vegas market from like 15% at the end of 2010 to 12% in the first quarter of 2011, and we saw benefit from that in our business almost immediately. We saw a reduction in uninsured volumes in the first quarter of 2011 that had an extremely favorable effect on our results and our revenues per admission, etc.

你們還記得嗎，我們在 2011 年第一季談了很多關於拉斯維加斯市場失業率大幅下降的事實，從 2010 年底的 15% 左右下降到 2011 年第一季的 12%，並且我們幾乎立即就看到了我們的業務從中受益。 2011 年第一季度，我們看到未投保人數有所減少，這對我們的業績和每次入場收入等產生了極其有利的影響。

As 2011 progressed, the payor mix sort of regressed back to kind of a normal mean, if you will, both in the Vegas market and I think in the portfolio in general. And most of those trends continued into the first quarter of 2011 -- excuse me, into the first quarter of 2012.

隨著 2011 年的進展，如果你願意的話，無論是在維加斯市場還是在整個投資組合中，付款人組合都回歸到了正常水平。其中大部分趨勢一直持續到 2011 年第一季——對不起，一直持續到 2012 年第一季。

And those trends are, again, the same as we've talked about the last few quarters. Commercial volumes are down, Medicare volumes are down, really the only volumes that are up are Medicaid, which is actually managed Medicaid, and, to some degree, our uninsured volumes. That's particularly true in some of our more economically troubled markets like Vegas and south Texas. But it's generally true through the portfolio.

這些趨勢與我們過去幾季討論的趨勢相同。商業銷售下降，醫療保險銷售量下降，實際上唯一上升的是醫療補助（實際上是由醫療補助管理），以及在某種程度上，我們的未投保銷售量。在拉斯維加斯和德克薩斯州南部等一些經濟陷入困境的市場尤其如此。但從投資組合來看，這通常是正確的。

And that's what made the comparison so difficult from an acute care perspective in Q1.

這就是從第一季急診護理角度進行比較變得如此困難的原因。

Okay, and then, just a question on the behavioral side. It looks like adjusted admissions were up very strong and adjusted patient days were up, but there was a gap in the growth. Is there a shift in more acute versus RTC, or is there also some length-of-stay pressures from the Medicaid payors as well?

好的，然後是行為上的問題。看起來調整後的入院人數成長非常強勁，調整後的患者天數也有所增加，但成長有差距。與 RTC 相比，是否存在更嚴重的轉變，或者是否也存在來自醫療補助付款人的一些居留期限壓力？

Brian, again, it's a continuing trend where we're seeing compression in our length of stay, not anything new, but also not something that seems to be decelerating yet at this point.

布萊恩，再說一次，這是一個持續的趨勢，我們看到停留時間的壓縮，這不是什麼新鮮事，但目前似乎還沒有減速。

It is primarily focused in the residential business. Length of stay is down on both sides of our behavioral business, but primarily on the residential side. And it is mostly, I think, a function of Medicaid and managed Medicaid payors intentionally, obviously, trying to get their patients out of the residential facilities sooner than previously.

它主要專注於住宅業務。我們的行為業務雙方的停留時間都在下降，但主要是住宅方面。我認為，這主要是醫療補助的一項功能，顯然，管理醫療補助付款人是為了讓病人比以前更快離開住院設施。

Tom Gallucci, Lazard Capital.

湯姆·加魯奇，拉扎德資本。

Good morning. Thanks for the detail, Steve. I guess just on volumes, over and above mix, on absolute utilization, did you see anything that was new or different as you looked inside the details of the numbers that indicate that anything is better or worse than maybe where the trends had been in recent quarters or more stabilization?

早安.謝謝你的詳細信息，史蒂夫。我想只是在數量上，在混合上，在絕對利用率上，當你查看數字的細節時，你是否看到了任何新的或不同的東西，這些細節表明任何事情都比最近的趨勢更好或更差季度或更穩定？

You know, the growth in volumes at 1.6% growth in adjusted admissions, same-store admissions, you know, we thought seemed to be much as expected and a reasonable number.

你知道，調整後的入場人數、同店入場人數增加了 1.6%，我們認為這似乎符合預期，也是一個合理的數字。

I think, Tom, we're more focused on the fact that when the economy begins to improve in a number of our markets, but in particularly some of our larger markets, that we're well positioned to benefit from that and we're waiting patiently for that to happen. Obviously, this has been an extended recession, and it's been particularly extended, again, in some of our most important markets, so that's really what we're keeping our eye on, most importantly.

湯姆，我認為，我們更關注這樣一個事實：當我們的一些市場，特別是一些較大的市場的經濟開始改善時，我們就處於有利地位，可以從中受益，而且我們耐心等待這件事的發生。顯然，這是一場長期的衰退，而且在我們一些最重要的市場中，衰退的時間特別長，所以這才是我們真正關注的，最重要的。

Okay, so not seeing things worse, but it doesn't sound like -- you're still waiting for things to get a little bit better.

好吧，所以沒有看到事情變得更糟，但這聽起來不像——你仍在等待事情變得更好。

On the cash flow, you mentioned some of the state collections, I guess, in particular. Was there anything else that you can talk about on collections or rates? Still pretty consistent relative to -- well, outside, I guess, of the states that you mentioned?

關於現金流，我想你特別提到了一些國家收藏。關於收藏或費率還有什麼可以談的嗎？相對於——嗯，我猜，除了你提到的那些州之外，仍然相當一致？

I think from a rate perspective, there's nothing significant going on, either from our government payors or our private payors.

我認為從利率的角度來看，無論是我們的政府付款人還是私人付款人都沒有發生任何重大事件。

The biggest collection issue, which we discussed last quarter as well, is almost a complete lack of payments from Illinois Medicaid, although payments did resume again this past week. So we view that as an encouraging sign.

我們上季也討論過的最大收款問題是伊利諾州醫療補助幾乎完全沒有付款，儘管上週確實再次恢復了付款。因此，我們認為這是一個令人鼓舞的跡象。

And we believe the Texas Medicaid disproportionate share payments, which were not made in Q1, we're actually expecting at least a portion of those payments to be made either today or Monday. So we're hoping to get a little bit of easing of that pressure.

我們認為，德州醫療補助計劃不成比例地支付了第一季未支付的費用，我們實際上預計至少其中一部分將在今天或週一支付。因此，我們希望能夠稍微緩解這種壓力。

Okay, then as Illinois has resumed, do they sort of have a catch-up, or how fast do you expect to make up what you haven't been paid in the past?

好的，那麼隨著伊利諾伊州的恢復，他們是否有趕上，或者您希望多快彌補您過去未收到的工資？

I wish I could precisely answer that question, Tom. The state is not terribly helpful in letting folks know what their plan is, although they certainly have taken the position consistently that they intend to pay all the outstanding receivables.

我希望我能準確地回答這個問題，湯姆。國家並沒有多大幫助讓人們知道他們的計劃是什麼，儘管他們確實一貫採取的立場是他們打算支付所有未償還的應收帳款。

So that's our expectation, and obviously that's the way we've reflected it in our financials. But there is no plan that the state has issued as to when the timing of those payments will take place.

這就是我們的預期，顯然這也是我們在財務數據中反映這一預期的方式。但該州尚未發布關於何時支付這些款項的計劃。

Okay, thanks, Steve.

好的，謝謝，史蒂夫。

Darren Lehrich, Deutsche Bank.

達倫·萊里奇，德意志銀行。

Thanks. Good morning, everybody. A couple of things here. I guess, first, I wanted to just start with capital deployment. It does look like you held a little back in the quarter on share repurchase. And I guess I'd be curious just to know if you're preserving capital for any particular reason at the moment, and to the extent that ties into what you're seeing in the acquisition pipeline, how we should be thinking about that and how maybe that has changed over the last six months or so as you think about deploying capital?

謝謝。大家早安。這裡有幾件事。我想，首先，我想從資本部署開始。看起來您在本季的股票回購方面確實有所推遲。我想我很好奇，只是想知道您目前是否出於任何特定原因保留資本，以及在某種程度上與您在收購渠道中看到的情況有關，我們應該如何考慮這一點以及當您考慮部署資本時，在過去六個月左右的時間裡，情況可能發生了怎樣的變化？

Darren, I don't think there's anything terribly new this quarter. As I think we've probably said pretty consistently over the course of the last few quarters, we are mostly focused on generating cash and repaying debt as effectively as we can.

達倫，我認為本季沒有什麼特別新的東西。正如我認為我們在過去幾季中一直在說的那樣，我們主要專注於盡可能有效地產生現金和償還債務。

We are entertaining other opportunities, both internal and external, to deploy capital. If we discover or are able to take advantage of opportunities that we find really compelling, we're prepared to do so. But again, I'll make the point that in our minds they're going to have to be pretty compelling.

我們正在抓住其他內部和外部的機會來部署資本。如果我們發現或能夠利用我們認為真正有吸引力的機會，我們就準備好這樣做。但我要再次指出，在我們看來，它們必須非常引人注目。

Okay, and then, you know, I guess just with the Knapp deal looking like it's sort of off the table for now, is there anything else that looks more imminent in the pipeline, just on the acute side? I would love to get a comment or two there about what kinds of things you're evaluating.

好吧，然後，你知道，我猜納普交易目前看起來有點不可能，還有其他看起來更迫在眉睫的事情嗎？我很想就您正在評估的事物類型發表一兩則評論。

Yes, so as we discussed last quarter, the Knapp deal that we had previously announced has lapsed, largely because the seller has been unable to meet all their obligations and are involved in some litigation at the moment.

是的，正如我們上季度討論的那樣，我們之前宣布的納普交易已經失效，很大程度上是因為賣方無法履行所有義務，並且目前正捲入一些訴訟。

So you're right. We've put that off to the side, as is our practice, Darren. I don't think we're going to make any specific comments about opportunities on either side of the business. Again, just suffice it to say that we're continuing to look.

所以你是對的。我們已經把它放在一邊了，就像我們的做法一樣，達倫。我認為我們不會對業務雙方的機會做出任何具體評論。再說一次，只要說我們正在繼續尋找就足夠了。

And we're continuing to pursue internal opportunities as well. I mentioned in my remarks that we're building new hospitals -- or new acute capacity in California and Florida, and we certainly continue to explore those opportunities as well.

我們也將繼續尋求內部機會。我在演講中提到，我們正在加州和佛羅裡達州建立新醫院或新的急救能力，當然也會繼續探索這些機會。

Right, okay. And then, just as you look at the acute business, obviously the comp was the big factor here. Is there any way to help us think about how things progressed over the course of the quarter? And can you just comment a little bit about how you see that comp impacting Q2? I know it was still pretty strong throughout the first half last year, but how should we be thinking about that?

對了，好吧。然後，就像你看到這個嚴峻的業務一樣，顯然薪酬是這裡的重要因素。有什麼方法可以幫助我們思考本季的進展嗎？您能否簡單評論一下您如何看待該競爭對第二季的影響？我知道去年上半年它仍然相當強勁，但我們應該如何考慮這一點？

As far as the progression goes, Darren, I would say that both volumes and payor mix probably strengthened a little bit as the quarter went on, although in fairness, I don't -- I'm not exactly sure how or what to read into that.

就進展而言，達倫，我想說，隨著本季度的繼續，交易量和付款人組合可能都會有所加強，儘管公平地說，我沒有——我不太確定如何閱讀或閱讀什麼內容進入那個。

You're absolutely right. I mean, our expectations that we set a couple of months ago when we gave guidance for 2012 was that acute-care revenue growth would be fairly modest in 2012 in the kind of 2.5% to 3% range.

你是絕對正確的。我的意思是，幾個月前我們在給出 2012 年指導時所設定的預期是，2012 年急診收入增長將相當溫和，在 2.5% 至 3% 的範圍內。

Part of that thinking was that we knew that in the first half of the year the comparisons would be difficult, so even though we didn't get into specifics, and won't do that today, either, I think the notion was we would be somewhat lower than the 2.5% to 3% the first half of the year and so a little bit higher in the back half of the year as the comparisons got easier. And that's still our view.

這個想法的一部分是，我們知道在今年上半年進行比較會很困難，所以即使我們沒有討論具體細節，而且今天也不會這樣做，我認為我們的想法是我們會略低於上半年的2.5 % 至3%，因此下半年會略高一些，因為比較變得更容易。這仍然是我們的觀點。

I should make the point that I think the first quarter played out very consistent with our internal expectations, certainly from an overall basis, but from a pricing perspective, we were, I think, a little disappointed with the level of acute-care pricing, but don't view it at all as out of line with our full-year guidance.

我應該指出的是，我認為第一季的表現與我們的內部預期非常一致，當然從整體來看，但從定價的角度來看，我認為我們對急診護理的定價水平有點失望，但不要認為它與我們的全年指導不符。

Ralph Giacobbe, Credit Suisse.

拉爾夫·賈科布，瑞士信貸。

Thanks. Good morning. Just, Steve, going back to what you just said in terms of the pricing number, you know, down 0.8 on the acute-care side, obviously impacted by the mix. But I was just wondering on the pure pricing side, maybe you could remind us what rates you're getting from managed care, if it's sort of in line with what you've historically gotten or a little bit lower. And maybe even on the Medicaid side, maybe tell us what the pure price decline was in the first quarter.

謝謝。早安.只是，史蒂夫，回到你剛才所說的定價數字，你知道，急性護理方面下降了 0.8，顯然受到了組合的影響。但我只是想知道純粹的定價方面，也許您可以提醒我們您從管理式醫療中獲得的費率是多少，是否與您歷史上獲得的費率一致或稍微低一些。也許甚至在醫療補助方面，也許可以告訴我們第一季的純粹價格下降是多少。

I think from a rate perspective, Ralph, we continue to get commercial rate increases in the 5% to 7% range that we have talked about for some time.

拉爾夫，我認為從費率的角度來看，我們繼續將商業費率提高到 5% 至 7% 的範圍，這一點我們已經討論了一段時間了。

Our Medicare declines, as we've been saying since July of last year, are in sort of the 3%, 4% range, and I think what's driving -- as I tried to outline before, what's driving the pressure on acute-care pricing is not rates from a particular payor, but the mix of business, and that mix continues to shift from our better-paying commercial and Medicare patients to our weaker-paying Medicaid and, frankly, nonpaying patients.

正如我們自去年7 月以來一直在說的那樣，我們的醫療保險下降了3%、4% 的範圍，我認為是什麼在推動——正如我之前試圖概述的那樣，是什麼在推動急症護理的壓力定價不是來自特定付款人的費率，而是業務組合，而這種組合繼續從支付較高的商業和醫療保險患者轉向支付較弱的醫療補助以及坦率地說，不付費的患者。

That trend has been in place for a while now, and that's -- the fact that that trend was interrupted in the first quarter of 2011, last year, and we're seeing it sort of just -- it resumed in the back half of 2011 into 2012, that's really what's driving that very difficult comparison in Q1.

這種趨勢已經存在了一段時間了，事實上，這種趨勢在 2011 年第一季、去年就被中斷了，我們看到它在 2011 年下半年又恢復了。確實是導致第一季進行非常困難的比較的原因。

Okay, that's fair. Maybe you can give us, in terms of your managed-care contracts, do you have what percentage is done for 2012 versus 2013?

好吧，這很公平。也許您可以告訴我們，就您的管理式醫療合約而言，2012 年與 2013 年相比，您完成的百分比是多少？

I would say at this point, we've probably got somewhere between two-thirds and three-quarters of our 2012 contracts done and may be a quarter to a third of our 2013 contracts.

我想說，目前我們可能已經完成了 2012 年合約的三分之二到四分之三，也可能完成了 2013 年合約的四分之一到三分之一。

Okay, and then, just going back to the behavioral side, your conversation earlier around the decline in length of stay, is this something we should think about that is going to comp out shortly or is there just a lot more days to come out as more -- as we get more of a shift to managed Medicaid?

好的，然後，回到行為方面，您之前關於停留時間縮短的談話，是我們應該考慮的事情，很快就會解決，還是還有很多天才能出現更多——當我們更多地轉向管理醫療補助時？

I'm not sure, Ralph, that we can answer that question with great confidence. There's pressure on length of stay. It has been existing now for some time.

拉爾夫，我不確定我們是否可以充滿信心地回答這個問題。停留時間有壓力。它已經存在了一段時間了。

I think it is largely a function of state Medicaid programs or their contractor managed Medicaid providers who are attempting to address budgetary concerns and drive costs down by reducing length of stay.

我認為這很大程度上是州醫療補助計劃或其承包商管理的醫療補助提供者的功能，他們試圖透過減少住院時間來解決預算問題並降低成本。

As we expect with Medicaid rates, we think that pressure will ease a little bit in this next budgetary cycle beginning this summer, but I suspect that we may not see length-of-stay compression completely stabilize at that point. It may still continue to trend downward.

正如我們對醫療補助費率的預期，我們認為壓力將在今年夏天開始的下一個預算週期中有所緩解，但我懷疑屆時我們可能不會看到住院時間壓縮完全穩定。可能仍會持續呈下降趨勢。

A.J. Rice, UBS.

A.J.賴斯，瑞銀。

Hi, everybody. A couple of questions, if I could ask. On the acute side, the year-to-year margin trend down 190 basis points. I assume that you would say that that's mostly due to the topline pressure, but I did want to at least ask. Is there anything on labor or supply that's worth calling out that you saw in the quarter that was particularly noteworthy, absent just the natural effect of the pressure on the topline?

大家好。如果我可以問的話，有幾個問題。從嚴重的角度來看，利潤率年減了 190 個基點。我想你會說這主要是由於頂線壓力，但我確實想至少問一下。除了壓力對營收的自然影響之外，您在本季看到的勞動力或供應方面是否有任何值得特別關注的事情？

No, A.J., I think that we would attribute the margin decline almost exclusively to the topline pressure.

不，A.J.，我認為我們將利潤率下降幾乎完全歸因於營收壓力。

Okay. You didn't recognize any HITECH revenue in the -- or incentive payments in the quarter. You did collect, it looks like, $17 million in cash. Do you have an updated estimate or what is your thought on how much you would likely collect in cash this year? And any thought on time -- updated thought on timing of recognition?

好的。您沒有確認本季度的任何 HITECH 收入或獎勵付款。看起來你確實收到了 1700 萬美元現金。您有最新的估計嗎？關於時間的任何想法——關於認可時間的最新想法？

I think, you know, I would just kind of reiterate what we talked about from a free cash flow perspective last year -- excuse me, at our 2012 guidance, and that is we expect to generate free cash flow in the $400 million to $500 million range. And again, much like our operating income guidance, I don't think we have any changes to that.

我想，你知道，我只是想重申一下我們去年從自由現金流角度討論的內容——請原諒，在我們 2012 年的指導中，我們預計將產生 4 億至 500 美元的自由現金流萬範圍。再說一次，就像我們的營業收入指導一樣，我認為我們對此沒有任何改變。

Okay, and then, just finally, on the Medicare proposed rule, any comment or thought or reaction to that relative to what you were thinking?

好的，最後，關於醫療保險提議的規則，與您的想法相關的任何評論、想法或反應？

I don't know what others have said, but I think we probably reacted by thinking that the update was maybe 100 to 150 basis points lower than we expected, mostly because of a higher-than-expected coding adjustment and a higher threshold on the outliers.

我不知道其他人怎麼說，但我認為我們的反應可能是認為更新可能比我們預期的低 100 到 150 個基點，主要是因為高於預期的編碼調整和更高的閾值異常值。

I'm not smart enough to predict how the final rule will look. Obviously, the industry will lobby hard for some relief on both those issues.

我不夠聰明，無法預測最終規則會是什麼樣子。顯然，該行業將努力遊說以緩解這兩個問題。

Right, sure. Okay, all right, thanks for the update.

對，當然。好的，好的，謝謝您的更新。

A.J., you guys did very well in the draft. You got a first rounder in Jim Forbes.

A.J.，你們在選秀中表現得非常好。你在吉姆福布斯 (Jim Forbes) 中獲得了第一輪選秀權。

Thanks, thanks. Thanks, Al.

謝謝，謝謝。謝謝，艾爾。

Gary Lieberman, Wells Fargo.

加里‧利伯曼，富國銀行。

Good morning. Thanks for taking my question. Behavioral continues to be very strong. Is it possible for you to parse out how much of that is organic, how much of that is continuing to benefit from the synergies on the Psych Solutions assets?

早安.感謝您提出我的問題。行為仍然非常強烈。您能否分析其中有多少是有機的，有多少是繼續受益於心理解決方案資產的綜效？

I don't know that I can do it precisely, Gary. I will tell you that we continue to improve the margin on the PSI assets or the PSI portfolio, and I think our view is that there is still a benefit to be -- continuing benefit to be had.

我不知道我能否準確地做到這一點，加里。我會告訴你，我們將繼續提高 PSI 資產或 PSI 投資組合的利潤率，我認為我們的觀點是，仍然有一個好處——持續的好處。

So, we're generally positive about behavioral performance for two reasons. I mean, one is we view the revenue growth in that business as very solid and strong. We've been growing at above 5% for 2.5 years now in the teeth, obviously, of a very severe recession, and so we feel real good about the underlying demand in that business.

因此，我們通常對行為表現持正面態度，原因有二。我的意思是，一是我們認為該業務的收入成長非常穩固且強勁。顯然，在非常嚴重的衰退中，我們已經連續 2.5 年以 5% 以上的速度成長，因此我們對該業務的潛在需求感到非常滿意。

And then, we still feel, as I said, that there are opportunities, that we've talked about in many cases before, to continue to drive slightly higher margins in the PSI portfolio.

然後，正如我所說，我們仍然認為有機會繼續推動 PSI 投資組合的利潤率略高，正如我們之前在許多情況下討論過的那樣。

And so, the total compared to when you first purchased the assets, the total expectation is higher, lower, the same, in terms of the total synergies that you'll be able to get out of it?

因此，與您第一次購買資產時相比，就您能夠從中獲得的總協同效應而言，總期望是更高、更低還是相同？

I mean, in terms of the margin improvement, which we pegged all along at sort of 50 to 100 basis points cumulatively, I'd say we feel fairly confident we'll come in at the high end of that number.

我的意思是，就利潤率改善而言，我們一直將利潤率累積固定在 50 到 100 個基點，我想說，我們相當有信心達到該數字的高端。

Okay, great. Thanks a lot.

好的，太好了。多謝。

Gary Taylor, Citigroup.

加里泰勒，花旗集團。

Just had two questions. Steve, is this the first quarter that PSI is fully in the same store or was that last quarter?

只是有兩個問題。史蒂夫，這是 PSI 完全進入同一家商店的第一季還是上季？

No, it's the first quarter where we have a full quarter comparison.

不，這是我們進行完整季度比較的第一季。

Okay, so that's what I thought. So, you'd been running on kind of the legacy UHS north of 6% revenue growth for some time, and this number is 5.3%. Did I miss any comment in terms of have you parsed out at all PSI versus legacy UHS, or is the length-of-stay issue kind of impacting both of the assets?

好吧，我就是這麼想的。因此，一段時間以來，你一直依靠傳統的 UHS 收入成長超過 6%，而這個數字是 5.3%。我是否錯過了有關您是否已解析所有 PSI 與傳統 UHS 的任何評論，或者停留時間問題是否會影響這兩種資產？

I think that the length-of-stay issue is affecting the residential assets primarily, again in both portfolios.

我認為，居住時間問題主要影響住宅資產，在這兩個投資組合中也是如此。

I will say, and I don't know that you were getting to this question with your -- or getting to this point with your question, but having the PSI facilities in for a full quarter of comparison, we get a little bit of a drag from their [Heinz] facilities in Virginia. Those were facilities that were somewhat of a problem for PSI. They were troubled facilities at the time PSI owned them, and quite frankly remain so for us.

我會說，我不知道你是否會用你的問題來解決這個問題，或者用你的問題來解決這個問題，但是通過 PSI 設施進行整個季度的比較，我們得到了一點從他們在弗吉尼亞州的[亨氏]工廠拖出來。這些設施對 PSI 來說有些問題。在 PSI 擁有它們時，它們是問題設施，坦白說，對我們來說仍然如此。

So including [that], we closed down one of the three campuses that we operate there. That clearly drove revenue down in the quarter in an effort to sort of right that ship and get the quality issues in line for future growth, which I think we feel well poised to do. But it was a bit of a drag in the quarter and the mechanics of having PSI in the same-store comparison contributed to that.

因此，我們關閉了在那裡運營的三個校區之一。這顯然導致了本季度的收入下降，以努力解決問題並解決品質問題以適應未來的成長，我認為我們已經準備好了。但這在本季有點拖累，而 PSI 參與同店比較的機制也促成了這一點。

Okay, yes, that is what I was after. I presume you're not going to want to break those out separately anymore, but I was just wondering if the slightly slower revenue growth was the impact of PSI coming into the quarter, and it sounds like it was.

好吧，是的，這就是我所追求的。我想您不會再將它們分開，但我只是想知道收入成長稍微放緩是否是 PSI 進入本季度的影響，聽起來確實如此。

Would you agree -- I mean, does Leap Year have a positive benefit for the behavioral book?

你同意嗎——我的意思是，閏年對行為書有正面的好處嗎？

You know, I've always been a believer that Leap Year doesn't have much of an effect either way. It affects the cosmetic metrics a little bit. You've got an extra, obviously, day of both admissions and patient days, but you also have an extra day of salary expense, and so I don't think it makes a whole lot of difference.

你知道，我一直相信閏年不會產生太大影響。它會稍微影響外觀指標。顯然，你有額外一天的入院日和住院日，但你也有額外一天的工資費用，所以我認為這沒有太大區別。

Okay, and my last question may be more for Alan. I'd be interested -- I was reading the other day about this $1.5 billion Union Village development in Las Vegas that's supposed to have four hospitals, and just wondering if you guys had a view if that's kind of still a pipe dream at this stage, or if at any point that geographically that would possibly create any threat to you if they eventually get these hospitals built. Any thoughts around that?

好吧，我的最後一個問題可能更多是針對艾倫的。我很感興趣——前幾天我讀到了有關拉斯維加斯聯合村耗資15 億美元的開發項目的消息，該開發項目應該有四家醫院，只是想知道你們是否有看法，在現階段這是否仍然是一個白日夢，或者如果他們最終建成這些醫院，在任何地理位置上都可能對您構成任何威脅。對此有什麼想法嗎？

I'll take that one, Gary. So that big development, which is in the southeast part of Las Vegas, or in Henderson, has been on the boards for many, many years. It sounds like it's a little bit closer to reality, perhaps, than it has been.

我要那個，加里。因此，位於拉斯維加斯東南部或亨德森的大型開發項目已經列入董事會很多很多年了。聽起來也許比以前更接近現實了。

From a hospital perspective, I think the developers went to Catholic Healthcare West because they clearly have historically dominated that quadrant of the market. What we have heard, and I don't mean it in any way to be definitive, is that the -- whether or not Catholic Healthcare West will build or what they will build as part of that development is very much still uncertain at this point.

從醫院的角度來看，我認為開發人員選擇了 Catholic Healthcare West，因為他們顯然在歷史上主導了市場的象限。我們所聽到的，我並不是說以任何方式是確定的，是 - 天主教醫療保健西部是否會建設或他們將建設什麼作為該開發的一部分，目前仍然非常不確定。

So no, I think from our perspective, that is not a quadrant of the city that we have ever competed terribly robustly in, and I don't think that's changing anytime soon.

所以，不，我認為從我們的角度來看，這不是我們曾經激烈競爭的城市象限，而且我認為這種情況不會很快改變。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Okay, thank you. I wasn't -- it wasn't clear to me whether you answered this in response to A.J.'s question, but as far as the EPS guidance that you're giving, are you reaffirming that, kind of ex the Medicare boost?

好的，謝謝。我不是——我不清楚你是否回答了 A.J. 的問題，但就你給出的 EPS 指導而言，你是否重申了這一點，有點像醫療保險的提振？

Yes, our practice, I think, always is if we don't say anything, we're not changing anything, but yes, we would reconfirm our year-end guidance.

是的，我認為，我們的做法始終是，如果我們不說什麼，我們就不會改變任何事情，但是，是的，我們會重新確認我們的年終指導。

Okay. And then, the Medicare boost would be on top of that, the one-time items discussed this quarter would be on top of that?

好的。然後，醫療保險的提振將是最重要的，本季討論的一次性項目將是最重要的？

Right, I mean, we're excluding that from our guidance, just like we excluded them during the quarter.

是的，我的意思是，我們將其排除在我們的指導之外，就像我們在本季排除它們一樣。

All right, perfect. And I guess maybe the answer was in response to Gary's question, but I would have thought that the same-store behavioral revenue growth would have been a little bit stronger, even with Leap Year. Is it really just for that one facility or is there anything else? I guess, how much was closing down that one campus to your same-store metrics?

好吧，完美。我想答案可能是為了回答加里的問題，但我以為即使是閏年，同店行為收入成長也會更強一些。真的只是為了那一項設施還是還有其他什麼？我猜想，根據同店指標，關閉園區的成本是多少？

I don't know the precise impact, but that was probably the biggest impact, Kevin. We closed a facility in Missouri, a residential facility, in a process to convert it to acute-care beds. That had, again, a slightly negative impact in the quarter, although obviously we think an ongoing, more positive impact. We continue to work on some regulatory issues in Illinois that I think long term should have a positive impact.

我不知道確切的影響，但這可能是最大的影響，凱文。我們關閉了密蘇裡州的一個住宅設施，並將其改造成急診床位。這再次對本季產生了輕微的負面影響，儘管我們顯然認為會產生持續的、更積極的影響。我們繼續致力於解決伊利諾伊州的一些監管問題，我認為從長遠來看，這些問題應該會產生積極的影響。

But I don't know that any of those had real needle-moving impacts.

但我不知道其中任何一個都會產生真正的重大影響。

And then, as far as Vegas goes, I guess we're kind of seeing some modest economic improvement in Vegas. I mean, how -- in your experience, how long is there between a change in the underlying economic metrics in a market before that starts to really flow through to the numbers because it sounds like it's not showing up yet, but when would you start to expect that to show up?

然後，就維加斯而言，我想我們會看到維加斯的經濟略有改善。我的意思是，根據您的經驗，市場基本經濟指標的變化之間需要多長時間才能開始真正體現在數字上，因為聽起來還沒有出現，但您什麼時候開始？

I think that historically, Kevin, our view is is there's usually something like a two- to four-quarter lag before our business, the hospital business, starts to really get the impact of underlying economic metrics, particularly changes in unemployment.

凱文，我認為從歷史上看，我們的觀點是，在我們的業務（醫院業務）開始真正受到基本經濟指標（尤其是失業率變化）的影響之前，通常會有兩到四個季度的滯後。

It's why we were so surprised a year ago that we seemed to get an almost kind of real-time immediate benefit from a decline in unemployment in that market, and why we frankly at the time didn't think that was necessarily going to be sustainable.

這就是為什麼我們一年前如此驚訝，因為我們似乎從該市場的失業率下降中獲得了近乎實時的即時收益，以及為什麼我們當時坦率地認為這不一定是可持續的。

But to your point, I think that some of the news coming out of the Vegas market over the last few months has been encouraging. We're certainly encouraged by it, and we would hope that by the end of this year we'd start to see some of that benefit in our business.

但就你的觀點而言，我認為過去幾個月來自維加斯市場的一些消息令人鼓舞。我們當然對此感到鼓舞，我們希望到今年年底，我們能夠開始在我們的業務中看到一些好處。

Todd Corsair, UBS.

托德·海盜，瑞銀集團。

Thanks. I was just wondering if you guys could comment on your outlook for allocating free cash flow. As someone earlier pointed out, only a couple million dollars spent on share purchase during the quarter, and I think per your 10-K, you are expecting a pretty significant amount of cash flow.

謝謝。我只是想知道你們是否可以對分配自由現金流的前景發表評論。正如之前有人指出的那樣，本季度僅花費了幾百萬美元購買股票，而且我認為根據您的 10-K，您預計會有相當大量的現金流。

So, really just interested in sort of hearing where you stand in terms of the balance sheet at this point. Do you want to -- are you guys prioritizing moving back toward investment grade or might we expect a more balanced allocation of free cash flow, perhaps with a little more towards the equity in terms of stock repurchase going forward?

所以，我真的只是想聽聽你目前的資產負債表狀況。你們是否想——你們是否優先考慮回到投資級別，或者我們是否期望自由現金流的分配更加平衡，也許在未來的股票回購方面更多地轉向股權？

Todd, I think that Darren asked a similar question before and I'd just very quickly reiterate that absent compelling opportunities on the M&A front, we're largely dedicating our free cash flow to debt repayment, but are exploring these opportunities. And if compelling ones arise, we will be prepared to take advantage of them.

托德，我認為達倫之前問過類似的問題，我只是很快重申，在併購方面缺乏引人注目的機會，我們主要將自由現金流用於償還債務，但正在探索這些機會。如果出現令人信服的問題，我們將準備好利用它們。

But outside of M&A, stock repurchase is a far lower priority than debt reduction?

但在併購之外，股票回購的優先順序遠低於債務削減？

You know, I think all the priorities sort of have to be considered at the same time, and so I think that if there is a lack of compelling M&A opportunities, we might have a different point of view about free cash flow -- I mean, excuse me, about share purchase, but I don't think we can kind of answer the opportunity in a vacuum. We are exploring all those alternatives at the same time.

你知道，我認為所有優先事項都必須同時考慮，所以我認為如果缺乏引人注目的併購機會，我們可能會對自由現金流有不同的看法 - 我的意思是對不起，關於股票購買，但我認為我們不能在真空中回答這個機會。我們正在同時探索所有這些替代方案。

That's very helpful, thanks. And lastly, could you just refresh us on what remaining capacity you have under existing authorization?

這非常有幫助，謝謝。最後，能否向我們介紹一下您在現有授權下的剩餘產能？

I think our existing authorization is fairly thin, but I don't think that is a determinant factor. If we think it's appropriate to move forward, we certainly, I think, can expand that authorization without a great deal of difficulty.

我認為我們現有的授權相當薄弱，但我不認為這是一個決定性因素。如果我們認為繼續前進是適當的，我認為我們當然可以毫無困難地擴大授權。

No obstacle there. Okay. Thanks very much for your time.

那裡沒有障礙。好的。非常感謝您抽出時間。

(Operator Instructions). Whit Mayo, Robert W. Baird.

（操作員說明）。惠特·梅奧，羅伯特·W·貝爾德。

Hey, thanks, just a couple final questions. Steve, is it still your expectation that the Medicare rule for behavioral will be a notice and will probably avoid the formal rule-making session? And does that really mean anything to you, one way or the other?

嘿，謝謝，最後還有幾個問題。史蒂夫，您是否仍然期望醫療保險行為規則將成為一個通知，並且可能會避免正式的規則制定會議？這對你來說真的意味著什麼嗎？

Whit, I think that the question has been put to us quite differently over the course of the last few months, and that is, were we expecting major changes to the psych BPS regulations? And we said no, we expected that the action of CMS would likely either just be the regular market basket update or some minor tweaks of the system. That remains our expectation.

惠特，我認為在過去幾個月裡，我們向我們提出的問題完全不同，也就是說，我們是否期望心理 BPS 法規會發生重大變化？我們說不，我們預期 CMS 的行動可能只是定期的購物籃更新或對系統進行一些細微的調整。這仍然是我們的期望。

It strikes me -- you know more about this than I do, but it strikes me that the investors and the investing public are coming around to that point of view. We've had that point of view for some months now.

令我震驚的是——你對這一點的了解比我多，但令我震驚的是投資者和投資公眾正在接受這一觀點。幾個月來我們一直抱持這種觀點。

I'd agree. And maybe one other question. Several of your peers are feeling the pinch on salaries and other expenses from employment costs, income guarantees, whatever physician strategy they have, and it's really never been central to sort of what you guys view as core to your strategy. Just wanted to confirm that nothing has really changed one way or the other as you think about sort of realigning interests with physicians?

我同意。也許還有另一個問題。你們的一些同行感受到了工資和其他費用的壓力，這些支出來自就業成本、收入保障、無論他們採取什麼醫生策略，而這實際上從來都不是你們所認為的策略核心的核心。只是想確認一下，當您考慮與醫生重新調整利益時，沒有任何事情真正改變？

I think, just to be clear, we certainly believe, as I think most of our peers do, that physician integration is a critical piece of a strategy moving forward.

我認為，需要澄清的是，我們當然相信，正如我認為我們的大多數同行所做的那樣，醫生整合是前進策略的關鍵部分。

I think, as you've described it and I think fairly described it, we may not be as enthusiastic about the idea that the only way to address the physician integration issue is through employment and acquisition. We're pursuing kind of a whole array of alternatives, including critical integration, etc., and will continue to do so, in large part because we recognize, I think as you've alluded to in your comments, that the purchase of physician practices and the employment of physicians often results in negative consequences like increased costs, etc., that if we can, we'd prefer to avoid.

我認為，正如您所描述的那樣，而且我認為描述得很公正，我們可能不會那麼熱衷於解決醫生整合問題的唯一方法是透過就業和收購的想法。我們正在尋求一系列替代方案，包括關鍵整合等，並將繼續這樣做，很大程度上是因為我們認識到，我認為正如您在評論中提到的那樣，購買醫生醫生的實踐和僱用通常會導致負面後果，例如成本增加等，如果可以的話，我們寧願避免。

But we very much view physician integration as a market-by-market issue, and as I said, we don't have a one-solution-fits-all approach to it, but we are very conscious of the fact that providers over the years have had very negative experiences in many cases with the economics of physician employment and acquisition, and so we're very cautious about it.

但我們非常認為醫生整合是一個逐個市場的問題，正如我所說，我們沒有萬能的解決方案，但我們非常意識到這樣一個事實：多年來，在醫生僱用和招聘的經濟學方面，我們在許多情況下都有非常負面的經歷，因此我們對此非常謹慎。

Yes, and maybe shifting gears just to HITECH and maybe a longer-term question, but do you have any internal thoughts as you look out to stage two in the requirements. I know it's a little over the horizon, but I guess I'm sort of curious what's on the top of mind with your IT department right now?

是的，也許只是轉向 HITECH，也許是一個長期問題，但是當您關注需求的第二階段時，您有任何內部想法嗎？我知道這有點超出預期，但我想我有點好奇您的 IT 部門現在最關心的是什麼？

I'm not exactly sure what you're asking, Whit. If you're asking, do we think we can comply with the stage two requirements, I think the answer is yes.

我不太確定你在問什麼，惠特。如果你問我們是否可以遵守第二階段的要求，我想答案是可以的。

Our EHR implementation, which is still in relatively early stages, but we've got probably a quarter of our hospitals implemented at this point, we're feeling pretty good about the way it's going. You know, we're not yet there in terms of meeting the meaningful-use requirements, but we expect to be there and are feeling generally positive about the process.

我們的電子病歷實施仍處於相對較早的階段，但目前我們可能已經有四分之一的醫院實施了，我們對進展感覺非常好。您知道，我們尚未滿足有意義的使用要求，但我們希望能夠實現這一目標，並且對這一過程總體感到積極。

I guess I was just sort of asking whether or not you felt that there were going to have to be more, additional internal resources committed to get to stage two and three, and maybe a corollary to that being the cost associated with it. I guess, few of us have a great idea for sort of what it looks into stage two and three at this point.

我想我只是想問您是否認為必須投入更多額外的內部資源才能進入第二階段和第三階段，也許隨之而來的就是與之相關的成本。我想，目前我們中很少人對第二階段和第三階段的內容有什麼好點子。

Okay, I understand the question better. I think that our -- at this point, our overall estimates of what the EHR will -- EHR implementation will cost us have not changed, but in fairness, I think your question points to a good point or makes a good point.

好吧，我更明白這個問題了。我認為，我們——目前，我們對電子病歷實施的總體估計——電子病歷實施將給我們帶來的成本沒有改變，但公平地說，我認為你的問題指出了一個很好的觀點，或者提出了一個很好的觀點。

It is a changing process. Every time we do an implementation, we sort of rethink our approach, etc. So it's certainly not impossible that at some point down the road, we come back and revise our estimates of cost or whatever. But at the moment, I think we're comfortable with what we put out there.

這是一個改變的過程。每次我們進行實施時，我們都會重新思考我們的方法等。但目前，我認為我們對我們所發布的內容感到滿意。

Got it. And one last one, sorry to slip this in. I may have missed it. But did you give any colors on surgical growth and maybe sort of what you're seeing with the birth rate and maybe acuity in the quarter?

知道了。最後一件事，很抱歉把它塞進去。但是，您是否對手術生長情況以及您在本季度的出生率和敏銳度方面看到的情況進行了任何說明？

Yes, acuity has not really changed for us. We've not had any significant changes in acuity.

是的，我們的敏銳度並沒有真正改變。我們的敏銳度沒有任何重大變化。

I think birth rate remains as it has been for the last few years, down a little bit, and from surgical perspective, I think our overall surgeries were probably down a percent or two for the quarter, with inpatient surgeries being down a little bit more and outpatient surgeries being a little bit better than that.

我認為出生率仍與過去幾年一樣，略有下降，從手術角度來看，我認為本季度我們的整體手術量可能下降了一兩個百分點，住院手術量下降更多門診手術比這要好一點。

Great. Very helpful, thanks.

偉大的。非常有幫助，謝謝。

Adam Feinstein, Barclays.

亞當范斯坦，巴克萊銀行。

Thank you. I know we asked one previously, so I will be brief here. But just wanted to just maybe ask, you guys have done a great job of investing CapEx over the years in some of these bigger projects. Just thought maybe it would be helpful just to give a quick update on some of the bigger projects in recent years, maybe just talk about how those have ramped up. And as you think about doing future projects, just wanted to get a quick update on some of the larger ones in recent years, like Texoma and Palmdale and Wellington coming up.

謝謝。我知道我們之前問過一個問題，所以我在這裡簡單介紹一下。但只是想問一下，多年來，你們在一些較大項目的資本支出投資方面做得非常出色。只是想也許快速更新近年來一些較大的項目會有所幫助，也許只是談論這些項目是如何發展的。當您考慮未來的專案時，只想快速了解近年來一些較大專案的最新情況，例如即將推出的 Texoma、Palmdale 和威靈頓。

Sure, so the three big acute-care projects that we've completed in the last year are a new hospital; a replacement facility in the acquired Texoma market, which is north of Dallas; a replacement facility for our Lancaster hospital in Palmdale, California; and then, a significant new tower for Summerlin in Las Vegas.

當然，我們去年完成的三個大型急診護理計畫是一棟新醫院；位於達拉斯北部收購的 Texoma 市場的替代設施；位於加州帕姆代爾的蘭開斯特醫院的替代設施；然後是拉斯維加斯薩默林的一座重要的新塔。

Obviously, although this wasn't contemplated when we undertook those three projects, that were all frankly begun around the same time, they were all begun right in -- well, frankly, before the recession and opened in the middle of the recession. So I think we've said a number of times that all three of those projects have been somewhat slower to ramp up than our original expectations.

顯然，儘管我們在開展這三個項目時沒有考慮到這一點，但坦率地說，這三個項目都是在同一時間開始的，坦率地說，它們都是在經濟衰退之前開始的，並在經濟衰退中期開始的。因此，我認為我們已經多次說過，所有這三個項目的進展速度都比我們最初的預期要慢一些。

On the other hand, I don't think that our fundamental view of any of those projects has fundamentally changed from when we undertook them. We think that they will all be ultimately (technical difficulty) and helpful to our earnings.

另一方面，我認為我們對這些項目的基本看法與我們開展這些項目時相比並沒有發生根本性的改變。我們認為它們最終都會（技術難度）對我們的收入有所幫助。

Texoma is probably the one that's had the most success so far. It's a market that's probably has had the least sort of economic drag. Southern California and Las Vegas have had more of an economic drag, so the Summerlin and Palmdale projects have been a little bit slower.

Texoma 可能是迄今為止最成功的公司。這個市場可能受到的經濟拖累最小。南加州和拉斯維加斯的經濟拖累更大，因此薩默林和帕姆代爾計畫的進度要慢一些。

In terms of the new projects that we have going, the new hospital in Temecula, California, is part of our Riverside County network where we have got three existing hospitals. There's data out there that shows that Temecula is sort of the largest metropolitan area without a hospital in the U.S., so we think that there is a tremendous unmet demand there that we're hoping to serve.

就我們正在進行的新項目而言，位於加州特曼庫拉的新醫院是我們河濱縣網路的一部分，我們現有三家醫院。有數據顯示，特曼庫拉是美國最大的沒有醫院的大都會區，因此我們認為，我們希望滿足那裡巨大的未滿足需求。

And then, our Wellington Hospital on the east coast of Florida has been a hospital that has been extremely successful for us, particularly over the last five or seven years, and we're just trying to take advantage of the fact that we've had some capacity constraints there. And so, we'll have that bed tower open by the end of this year.

然後，我們位於佛羅裡達州東海岸的惠靈頓醫院對我們來說是一家非常成功的醫院，特別是在過去的五到七年裡，我們只是想利用這樣一個事實：那裡有一些容量限制。因此，我們將在今年年底前開放該床塔。

Frank Morgan, RBC Capital Markets.

弗蘭克摩根，加拿大皇家銀行資本市場。

Good morning. I hopped on late, so I apologize here if you've already asked this. But did you talk about, Steve, the uninsured admit rates, either the growth in it or the mix as a percentage of total admits that were uninsured?

早安.我遲到了，所以如果您已經問過這個問題，我在此表示歉意。但是，史蒂夫，你有沒有談論過未投保的錄取率，無論是增長還是未投保的錄取率佔未投保錄取總數的百分比？

Frank, I think what we've said is that basically the trend we're seeing in our acute-care business is lower commercial and Medicare admits and higher managed Medicaid and self-pay admits, and that is a trend that, frankly, has probably been present now for a good three, maybe four quarters.

弗蘭克，我認為我們所說的是，基本上我們在急診護理業務中看到的趨勢是較低的商業性和醫療保險承認以及更高管理的醫療補助和自費承認，坦率地說，這種趨勢已經現在可能已經存在了三個，也許四個季度了。

There are no further questions at this time.

目前沒有其他問題。

Okay, we thank everybody. We know everybody has a busy morning and we look forward to speaking with you again next quarter.

好的，我們謝謝大家。我們知道每個人早上都很忙碌，我們期待下個季度再次與您交談。

Thank you, again, for participating in today's conference call. You may now disconnect.

再次感謝您參加今天的電話會議。您現在可以斷開連線。