Financial Performance - For the three months ended March 31, 2025, the company reported total revenue of $1,353.2 million, a 2.4% increase compared to $1,321.2 million for the same period in 2024[78]. - Income from continuing operations, net of tax, was $74.7 million for the three months ended March 31, 2025, compared to $61.5 million for the same period in 2024, representing a 21% increase[78]. - Adjusted EBITDA for the three months ended March 31, 2025, was $151.4 million, down 8.6% from $165.8 million in the same period in 2024[78]. - Revenue for the three months ended March 31, 2025, was $1,353.2 million, a 2.4% increase from $1,321.2 million in the same period of 2024[108]. - Income from continuing operations before other income and expense decreased to $112.7 million in Q1 2025, down from $118.5 million in Q1 2024[108]. - Adjusted EBITDA for Q1 2025 was $151.4 million, with an Adjusted EBITDA margin of 11.2%, compared to $165.8 million and 12.5% in Q1 2024[108]. - Total operating expenses for Q1 2025 were $1,205.6 million, or 89.1% of revenue, compared to $1,169.2 million, or 88.5% of revenue in Q1 2024[112]. - Cost of services for Q1 2025 was $1,172.6 million, representing 86.7% of revenue, up from 84.8% in Q1 2024[112]. - General and administrative expenses decreased to $33.0 million, or 2.4% of revenue, from $48.4 million, or 3.7% of revenue in Q1 2024[112]. - Net income attributable to Select Medical Holdings Corporation was 4.2% in Q1 2025, down from 7.3% in Q1 2024[103]. Segment Performance - The critical illness recovery hospital segment generated revenue of $637.0 million, accounting for approximately 47% of total revenue, while the rehabilitation hospital and outpatient rehabilitation segments each contributed approximately 23%[73]. - The company experienced a 29.1% decrease in income from continuing operations before other income and expense in the critical illness recovery hospital segment compared to the previous year[79]. - The rehabilitation hospital segment saw a 15.7% increase in revenue, while the outpatient rehabilitation segment experienced a 1.4% increase[79]. - Critical illness recovery hospital revenue decreased by 2.9% to $637.0 million in Q1 2025, primarily due to a decrease in revenue per patient day from $2,219 to $2,179[109]. - Rehabilitation hospital revenue increased by 15.7% to $307.4 million in Q1 2025, with revenue per patient day rising 6.6% to $2,234[110]. - Outpatient rehabilitation revenue increased by 1.4% to $307.3 million in Q1 2025, driven by a 3.0% increase in revenue per visit to $102[111]. - Adjusted EBITDA for the Critical Illness Recovery Hospital Segment decreased to $86.6 million for the three months ended March 31, 2025, down from $115.9 million for the same period in 2024, resulting in a margin drop from 17.7% to 13.6%[114]. - Adjusted EBITDA for the Rehabilitation Hospital Segment increased by 14.7% to $70.4 million for the three months ended March 31, 2025, with a margin of 22.9%, slightly down from 23.1% in 2024[115]. - Adjusted EBITDA for the Outpatient Rehabilitation Segment was $24.3 million for the three months ended March 31, 2025, compared to $24.9 million in 2024, with a margin decrease from 8.2% to 7.9%[116]. Cash Flow and Capital Management - Net cash used in operating activities significantly improved to $(3.5) million for the three months ended March 31, 2025, compared to $(66.7) million in 2024, driven by a normalization of accounts receivable[125]. - Net working capital increased to $147.5 million at March 31, 2025, compared to $42.1 million at December 31, 2024, mainly due to higher accounts receivable[130]. - The company authorized a common stock repurchase program of up to $1.0 billion, with 649,804 shares repurchased at a cost of approximately $11.4 million during the three months ended March 31, 2025[132]. - As of March 31, 2025, the company had cash and cash equivalents of $53.2 million and $377.5 million of availability under its revolving facilities[134]. Market and Regulatory Environment - The company faces various risks, including changes in government reimbursement policies and shortages of qualified healthcare professionals, which could negatively impact revenue and profitability[68]. - Revenue from the Medicare program accounted for approximately 29% of the company's total revenue for both Q1 2025 and the year 2024[81]. - The standard federal rate for LTCH-PPS for fiscal year 2024 increased to $48,117 from $46,433 in fiscal year 2023, reflecting a market basket increase of 3.5%[86]. - The fixed-loss amount for high cost outlier cases under LTCH-PPS for fiscal year 2024 rose to $59,873, up from $38,518 in fiscal year 2023[86]. - The standard payment conversion factor for IRF-PPS for fiscal year 2024 was set at $18,541, an increase from $17,878 in fiscal year 2023[94]. - The outlier threshold amount for IRF-PPS decreased to $10,423 for fiscal year 2024 from $12,526 in fiscal year 2023[94]. - The proposed standard federal rate for LTCH-PPS for fiscal year 2026 is $50,729, an increase from $49,383 in fiscal year 2025[88]. - The proposed fixed-loss amount for high cost outlier cases under LTCH-PPS for fiscal year 2026 is $91,247, up from $77,048 in fiscal year 2025[88]. - The standard payment conversion factor for IRF-PPS for fiscal year 2026 is proposed to be $19,364, an increase from $18,907 in fiscal year 2025[96]. - CMS expects a 3% decrease in Medicare payments for physical and occupational therapy services in 2025[98]. - The criteria for outlier payment reconciliation were modified to a change in the LTCH's CCR of 20% or more, effective for cost reporting periods beginning on or after October 1, 2024[91]. Future Growth Strategies - The company plans to pursue new joint venture relationships and open new outpatient rehabilitation clinics to drive incremental growth[133].

Core Viewpoint - Select Medical Holdings Corporation reported a 2.4% increase in revenue for Q1 2025, alongside a significant rise in net income from continuing operations, indicating a positive financial trajectory despite challenges in certain segments [2][12]. Financial Performance - Revenue for Q1 2025 reached $1,353.2 million, up from $1,321.2 million in Q1 2024 [2]. - Income from continuing operations before other income and expense was $112.7 million, a decrease from $118.5 million year-over-year [2]. - Net income from continuing operations increased by 21.5% to $74.7 million compared to $61.5 million in the prior year [2]. - Adjusted EBITDA for Q1 2025 was $151.4 million, down from $165.8 million in Q1 2024 [2]. - Earnings per share from continuing operations rose by 33.3% to $0.44, compared to $0.33 in the same quarter last year [2]. Segment Performance - **Critical Illness Recovery Hospital Segment**: Revenue decreased by 2.9% to $637.0 million, with Adjusted EBITDA down 25.3% to $86.6 million [5][23]. - **Rehabilitation Hospital Segment**: Revenue increased by 15.7% to $307.4 million, with Adjusted EBITDA rising by 14.7% to $70.4 million [6][23]. - **Outpatient Rehabilitation Segment**: Revenue increased by 1.4% to $307.3 million, while Adjusted EBITDA slightly decreased to $24.3 million [7][24]. Company Overview - Select Medical operates 104 critical illness recovery hospitals, 35 rehabilitation hospitals, and 1,911 outpatient rehabilitation clinics across 40 states and the District of Columbia as of March 31, 2025 [4]. Dividend and Stock Repurchase - The Board of Directors declared a cash dividend of $0.0625 per share, payable on or about May 29, 2025 [8]. - A stock repurchase program was authorized for up to $1.0 billion, with 649,804 shares repurchased at a cost of approximately $11.4 million during Q1 2025 [10][11]. Business Outlook - For fiscal year 2025, Select Medical expects revenue between $5.3 billion and $5.5 billion, Adjusted EBITDA between $510 million and $530 million, and fully diluted earnings per share between $1.09 and $1.19 [12].

Financial Data and Key Metrics Changes - Revenue for Q4 2024 was $465 million, a 5.5% increase from $440.7 million in Q4 2023 [5] - Adjusted EBITDA rose to $77.5 million, up 13.6% from $68.3 million in the same quarter last year [5] - Net income was $22.8 million, with earnings per share at $0.17, slightly better than preliminary estimates but lower than the same quarter last year due to IPO recapitalization [6] - Adjusted EBITDA margin increased from 15.5% in Q4 2023 to 16.7% in Q4 2024 [5] Business Line Data and Key Metrics Changes - Occupational Health Center segment revenue was $437 million, a 5.4% increase year-over-year [11] - Workers' compensation revenue increased by 7% to $289.1 million, representing 66% of total center operating segment revenue [11][12] - Employer services revenue increased by 1.3% to $137.2 million, with visits per day declining by 4.8% [12] - On-site revenue grew by 7% to $17.1 million, with 10 new on-site centers expected to open soon [13] Market Data and Key Metrics Changes - Total patient visits per day were 46,800, a 2.1% decline year-over-year, driven by a 4.8% decrease in employer services visits [7][8] - Revenue per visit increased by 5.8% compared to the same quarter last year, driven by both workers' compensation and employer services [9] Company Strategy and Development Direction - The company aims to improve the health of America's workforce and continues to execute on strategic initiatives, including the acquisition of Nova Medical Centers [4][19] - The Nova acquisition, valued at $265 million, is expected to enhance the company's footprint and service offerings [19] - The company plans to continue its de novo strategy, with several new centers opening in 2025 [16][17] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about stabilizing hiring rates and improving employer services volumes in 2025 [8][50] - The company expects to generate approximately $2.1 billion in revenue for 2025, a 10.5% increase over 2024 [25] - Adjusted EBITDA for 2025 is projected to be between $410 million and $425 million, an 11% increase over 2024 [26] Other Important Information - The company declared a quarterly cash dividend of $0.0625 per share, payable on April 1, 2025 [15] - The net leverage ratio at the end of 2024 was 3.46x, with a target of approximately 3.0x within the next 18 to 24 months [15][23] Q&A Session Summary Question: Integration approach for Nova - Management highlighted their experience with similar integrations, emphasizing the overlapping infrastructure and support systems that will facilitate the process [33][35] Question: Deleveraging pathway post-Nova acquisition - The company plans to reduce net leverage to approximately 3.5x by the end of 2025, driven by cash flow generation and EBITDA growth [36][38] Question: Exposure to tariffs and impact on volumes - Management does not foresee significant headwinds from tariffs affecting employer clients at this time [45] Question: Economic drivers for guidance in 2025 - The guidance reflects a combination of improved employer services growth and stable trends in workers' compensation, influenced by broader economic conditions [48][50] Question: P&L considerations for Q4 performance - Management noted stable cost levels for services and G&A, with some seasonality in Q4 expenses [52][54] Question: Expected improvement in Employer Services - Management anticipates trends will improve, moving towards flat year-over-year growth and slight positive growth later in the year [60] Question: Rate updates for workers' compensation and employer services - Both categories are expected to see slightly elevated rates due to inflation, with a positive outlook for 2025 [62][64] Question: Long-term growth outlook - The company expects mid to high single-digit revenue growth driven by visit growth and rate increases, alongside M&A activities [65] Question: Development activities and new centers - The guidance includes planned openings for new centers and normal growth for on-site business, with no additional M&A included [67] Question: Government pay exposure - The company has minimal exposure to Medicare and Medicaid, with less than 1% of revenue from these sources [69]

Financial Data and Key Metrics Changes - The company reported a combined revenue increase of 8% in Q4 2024, with adjusted EBITDA growing by 4% from $111.8 million to $116 million [10] - For the full year, revenue from continuing operations grew by 7%, and adjusted EBITDA increased by 14%, reaching $510.4 million with a 9.8% adjusted EBITDA margin compared to 9.2% in 2023 [10][15] - The diluted loss per common share from continuing operations was $0.19 for Q4, compared to earnings of $0.12 in the same quarter last year [14] Business Line Data and Key Metrics Changes - The Critical Illness Recovery Hospital division saw a 6% increase in revenue and a 10% increase in adjusted EBITDA, with an adjusted EBITDA margin of 10.5% for Q4 [11] - The Inpatient Rehab Hospital division experienced a 13% revenue increase, but adjusted EBITDA declined by 6%, resulting in a margin of 21.2% [12] - The Outpatient Rehab division reported a 7% revenue increase and an 18% rise in adjusted EBITDA, with the adjusted EBITDA margin improving from 7.5% to 8.3% [13][14] Market Data and Key Metrics Changes - The company added 94 inpatient rehabilitation beds in Q4, with plans to add 481 additional beds in 2025 and 2026 [6][8] - The average daily census for the entire rehab division increased by 3%, while the occupancy rate was 81%, down from 85% in the prior year [12] Company Strategy and Development Direction - The company completed the spin-off of Concentra, focusing on its remaining three lines of business [3][4] - The company plans to open multiple new facilities, including a 45-bed rehab hospital in Temple, Texas, and a 63-bed rehab hospital in Ozark, Missouri, among others [7][8] - The company aims to optimize resources and serve targeted demographics through strategic closures and acquisitions in the outpatient division [9] Management Comments on Operating Environment and Future Outlook - Management noted that nursing agency rates have stabilized and utilization has returned to pre-COVID levels, with expectations for continued improvement in labor costs [11][17] - The company anticipates revenue for 2025 to be in the range of $5.4 billion to $5.6 billion, with adjusted EBITDA expected between $520 million and $540 million [22] - Management acknowledged confusion in the market regarding the impact of the Concentra spin-off on financial metrics [25][26] Other Important Information - The company refinanced $1.6 billion of outstanding debt, extending the maturity of its revolving credit facility to 2029 and increasing availability [4][5] - The company declared a cash dividend of $0.0625 per share payable on March 13, 2025 [16] Q&A Session Summary Question: Clarification on 2025 metrics - Analyst Justin Bowers inquired about revenue growth, EBITDA growth, and net leverage metrics for 2025, to which Martin Jackson confirmed the calculations and acknowledged market confusion regarding Concentra [25][26] Question: Development activity and startup costs - Bowers asked about the maturation of new facilities and associated startup costs, with Jackson indicating that the new beds would have a dampening effect on inpatient rehab margins for 2025 but expect significant growth in 2026 and 2027 [30][31] Question: Inpatient rehab margins and headwinds - Ben Hendrix questioned the lower margins in the inpatient rehab segment, with Robert Ortenzio explaining that hurricane impacts and startup losses contributed to the decrease [45][46] Question: 2025 outlook for IRF margins - Joanna Gajuk asked about the expected decline in IRF margins for 2025, with Jackson confirming that startup losses were the primary driver [50][51] Question: Outpatient rehab growth drivers - Gajuk also inquired about the expected growth in outpatient rehab EBITDA, with Jackson attributing it to increased rates from commercial contracts and improved clinical productivity [58][59]