Revenue Growth and Same-Facility Improvement
Reported Q1 revenue of $828.8 million, a 7.6% increase year-over-year. Same-facility revenue grew 7.3% YoY, driven by a 5.6% increase in revenue per patient day and a 1.6% increase in patient days.
Strong Acute and RTC Performance
Acute segment revenue grew 14.2% YoY and RTC grew 6.3% YoY, with acute growth driven by increased patient volumes and new facility ramp contributions.
Adjusted EBITDA Outperformance
Q1 adjusted EBITDA was $144.2 million, up 7.5% YoY and $7.2 million above the high end of Q1 guidance. Same-facility adjusted EBITDA for Q1 was $199.5 million.
Raised Full-Year Profitability Guidance
Full-year adjusted EBITDA range was increased from $575M–$610M to $580M–$615M (a $5M midpoint raise). Adjusted EPS guidance was raised from $1.30–$1.55 to $1.35–$1.60.
Operational Execution and Cost Efficiency
Management implemented organizational restructures, reduced corporate headcount, and realized better-than-planned cost efficiencies at corporate and facility levels; start-up losses were $12M in Q1, $2M better than forecast.
Bed and JV Development Progress
Added 82 beds in Q1; on track to add 400–600 beds in 2026. Opened a JV with Tufts (24 beds open today, ability to serve 144 when fully licensed) and expects additional JV facility openings in Q2 (Orlando Health and a 96-bed facility in Iowa).
Balance Sheet and Liquidity
As of March 31, 2026, cash and equivalents were $158 million with ~$565 million available on a $1 billion revolver. Net leverage was ~3.9x adjusted EBITDA at quarter end; management expects year-end leverage in the 3.9x–4.2x range.
Improved Workforce Metrics and Quality Focus
Staff retention improved for the eighth consecutive quarter. Management emphasized clinical quality, outcome measurement expansion, strengthened referral relationships, and use of technology (including pilots of AI) to improve operations and revenue cycle.
Cash Flow Improvement vs Prior Year
Operating cash flow of $62 million and CapEx of $77 million produced free cash flow of negative $15 million in Q1, an improvement of $148 million compared to Q1 2025. Management continues to expect positive free cash flow for 2026.
Q2 Provided Guidance for Clarity
Management provided Q2 guidance: revenue $835M–$850M, adjusted EBITDA $142M–$152M, and adjusted EPS $0.30–$0.40 to account for timing differences in supplemental payments year-over-year.