Legal And Regulatory RiskOngoing Department of Justice investigation is generating substantial legal expenses and higher reserves, creating balance-sheet risk and pressuring free cash flow.
Liability And Insurance CostsHigher malpractice and general liability reserves and increased insurance costs have forced downward revisions to adjusted EBITDA guidance, reducing earnings visibility and making free cash flow recovery more challenging.
Medicaid Payor PressurePressure from Medicaid managed care and state limits on out-of-state Medicaid treatment is reducing authorized patient days and volumes, weighing on revenue at impacted facilities.