Strong Revenue and EBITDA Growth
Full-year 2025 revenue increased 10.5%; Q4 revenue rose 9.9% to $1.5B. Full-year adjusted EBITDA grew 14.9%, and Q4 adjusted EBITDA increased 15.9% to $335.6M.
Robust Free Cash Flow and Capital Deployment
Full-year adjusted free cash flow was $818M (up 18.5% year-over-year); Q4 adjusted free cash flow was $235.4M (up 23.6%). Management funded $736M of capex, $158M in share repurchases and returned $71M in cash dividends while keeping long-term debt essentially flat.
Volume Growth and Patient Mix
2025 discharge growth was 6% (Q4 discharge growth 5.3%). Net revenue per discharge increased 4.1% in Q4 (including a $2.7M managed care settlement). Management highlighted favorable fee-for-service growth and broad-based growth across diagnosis categories (brain injury +8.7%, cardiac +5.1%, neuro +4.5%, major trauma +5%, stroke +3.8%).
Quality and Outcomes
Strong quality metrics: full-year discharge-to-community 84.6%, discharge-to-acute-care 8.6%, discharge-to-SNF 6.1% — each favorable versus industry averages. Management reported record patient outcome scores and patient satisfaction for 2025.
Labor Cost Improvement and Workforce Progress
Premium labor spend declined by more than $21M year-over-year in 2025; Q4 premium labor costs fell $5.8M to $23.8M (lowest since Q1 2021). Contract labor FTEs at 1.1% of total FTEs (lowest since Q1 2021). SWB per FTE up 2.1% in Q4; nursing turnover 20.2% and therapy turnover 7.8% for the year; company added ~300 net RNs same-store in 2025.
Capacity Expansion and Strategic Growth
Added 517 beds in 2025 (390 via 8 new hospitals and 127 by adding beds to existing hospitals). Plan to add a new modality of 24-bed small-format hospitals beginning in 2027 to support a hub-and-spoke strategy and expand market density.
Technology and Operational Enhancements
Completed ERP conversion to Oracle Fusion (October) and expanded Palantir relationship to streamline admission documentation and enhance claim-denial responses, with expectations to expand analytics to CRM, revenue cycle and clinical staffing.
Prudent Balance Sheet and 2026 Guidance
Year-end net financial leverage 1.9x (provides flexibility). 2026 guidance: net operating revenue $6.365B–$6.465B, adjusted EBITDA $1.34B–$1.38B, adjusted EPS $5.81–$6.10.