Financial Performance - In Q4, revenue increased by 9.9% to $1.5 billion, and adjusted EBITDA rose by 15.9% to $335.6 million, driven by 5.3% discharge growth and a 4.1% increase in net revenue per discharge [1][5] - For the full year 2025, revenue grew by 10.5%, with EBITDA increasing by 14.9%, supported by operating leverage and disciplined expense management [3][5] - Adjusted free cash flow for the full year was $818 million, reflecting an 18.5% increase [9] Labor and Operational Efficiency - Premium labor costs decreased significantly, down more than $21 million year-over-year in 2025, with Q4 premium labor at $23.8 million, the lowest since Q1 2021 [2][5][7] - The company added approximately 300 same-store registered nurses (RNs) during 2025, contributing to improved operational efficiency [7] Capacity Expansion and Growth Strategy - Management plans to add 517 beds in 2025 through new hospitals and expansions, with ongoing investments expected to meet a growing target demographic [12] - A new 24-bed small-format hospital prototype is set to launch in 2027 as part of a hub-and-spoke strategy [13] 2026 Guidance - For 2026, management guided net revenue of $6.365–6.465 billion, adjusted EBITDA of $1.34–1.38 billion, and adjusted EPS of $5.81–6.10, with a leverage target of approximately 1.83x [4][18] Regulatory and Payer Dynamics - The company reported a 93% affirmation rate for its Alabama hospitals under the RCD model, indicating effective engagement with CMS [16] - Management expressed concerns about challenges with a national Medicare Advantage payer, which affected conversion rates despite referral growth [20]