Top-Line and Profitability Growth
Q1 revenue increased 9% year-over-year to $1.59 billion; adjusted EBITDA rose 11.2% to $348.8 million. Company raised 2026 guidance to net operating revenue of $6.375B–$6.470B, adjusted EBITDA $1.35B–$1.38B, and adjusted EPS $5.89–$6.11.
Strong Discharge and Pricing Trends
Total discharges grew 4.3% (1.6% same-store), and net revenue per discharge increased 3.7%, driven by patient mix and a favorable Medicare SSI adjustment.
Outstanding Clinical Outcomes and Quality Metrics
Discharge-to-community improved 50 basis points to 84.5%; discharge-to-acute improved 30 bps to 8.6%; discharge-to-SNF improved 20 bps to 6.2% — all above industry averages.
Workforce Stability and Lower Premium Labor
Annualized RN turnover improved to 17.8% from 20.2% (lowest since at least 2012); therapist turnover improved to 6.4% from 7.8%. These improvements helped drive a 9.4% decline in premium labor spend versus Q1 2025 and contract labor FTEs fell to 1.2% of total FTEs (down 10 bps).
Capacity Expansion and Development Pipeline
Opened a new 49-bed hospital in Irmo, SC and added 44 beds to existing hospitals in Q1; plan to open 7 more hospitals (≈340 beds) and add 100–150 incremental beds in 2026. Pipeline beyond 2026: 11 hospitals / 520 beds; developing small-format hospital strategy with at least one expected in 2027.
Strong Cash Generation and Capital Allocation
Q1 adjusted free cash flow of $194 million. Repurchased ~708,000 shares for $71.6 million in Q1; paid and declared $0.19 per share dividends. Net leverage at quarter end was a modest 1.9x, supporting ongoing buybacks and growth CapEx.
Operational Efficiency and Digital/Analytics Initiatives
SWB per FTE increased 3.7%; investments in clinical career ladders and Palantir-enabled market/real-estate, revenue cycle and documentation productivity initiatives expected to drive more efficient clinical and administrative workflows.
Potential Favorable Medicare Pricing Update
CMS 2027 IRF proposed rule included a net market basket update of 2.4%, which the company estimates could yield a ~2.4% pricing increase for Medicare patients beginning Oct 1, 2026 (pending final rule).