Q1 2023 Chemed Corporation Earnings Call
To ask a question at that time, Please press star one on your telephone.
As a reminder, today's call is being recorded I would now like turn the conference over your host Holly Schmidt Assistant controller, Ma'am you may begin.
Good morning, Our conference call. This morning will review the financial results for the first quarter of 2023 ended March 31, 2023 before we begin let me remind you that the safe Harbor provisions of the private Securities Litigation Reform Act of 1995 apply to this conference call.
During the course of this call the company will make various remarks concerning management's expectations predictions plans and prospects that constitute forward looking statements.
Actual results may differ materially from those projected by these forward looking statements as a result of a variety of factors, including those identified in the company's news release of April 26, and in various other filings with the SEC.
You are cautioned that any forward looking statements reflect management's current view only and that the company undertakes no obligation to revise or update such statements in the future and.
In addition management May also discuss non-GAAP operating performance results during today's call, including earnings before interest taxes, depreciation and amortization or EBITDA and adjusted EBITDA a.
A reconciliation of these non-GAAP results is provided in the Companys release.
Press release dated April 26, which is available on the company's website at Chemed Dot com.
I would now like to introduce our speakers for today, Kevin Mcnamara, President and Chief Executive Officer of Chemed Corporation Dave.
Williams Executive Vice President and Chief Financial Officer of Chemed, and Nick Westfall, President and Chief Executive Officer of Chemed, VITAS Healthcare Corporation subsidiary I will now turn the call over to Kevin Mcnamara.
Thank you colleagues.
Morning.
Welcome to Chemed Corporation's first quarter 2023 conference call I will begin with highlights for the quarter and David and Nick will follow up with additional operating detail I will then open up the call for questions.
Our first quarter 2023 operating results released last night continues to show a return to a more normalized growth in operating results post pandemic.
For VITAS normalization involves methodically increasing capacity by expanding our staff of licensed health care professionals in the first quarter of 2023, VITAS added 200 licensed professionals, 60% of which.
Our licensed nurses since we implemented our hiring and retention program in July 2022, VITAS expanded license staffing by 475 professionals, Nick will provide more detailed information on this issue later in the call.
Although we continue to see disruption in our referral patterns when compared to pre pandemic admissions. These disruptions continue to dissipate and reflect a methodical improvement in admissions and average daily census, and key pre admit patient locations.
Roto Rooter had a solid first quarter, increasing revenue seven 9% over the prior year revenue in the first quarter of 2023 exceeded our internal estimates with January 2023, being exceptionally strong March revenue was somewhat lighter than we anticipated, but still within normal patterns.
Overall demand for <unk> services in both commercial and residential segments continue at levels significantly above our prepaid demick demand. This was demonstrated with commercial revenue, increasing 41% and residential revenue expanding 73% when compared with the first quarter of 2019.
Roto Rooter continues to be well positioned and we anticipate continued expansion of market share by pressing our core competitive advantages in terms of brand awareness customer response time, $24 seven call centers and Internet presence.
With that I'd like to turn this teleconference over to David Thank.
Thank you Kevin.
<unk> net revenue was $310 million in the first quarter of 2023, which is an increase of three 8% when compared to our prior year period.
This revenue increase is comprised primarily of a 3% increase in days of care.
Geographically weighted average Medicare reimbursement rate increase of approximately two 9%.
Really offset by 200 basis points as a result of CMS re implementing the 2% sequestration cut that was suspended at the start of the pandemic in 2020.
Our acuity mix shift had minimal impact in the quarter when compared to the prior year revenue and level of care mix.
Our combination of Medicare cap and other contra revenue changes negatively impacted growth by about 10 basis points.
In the first quarter of 2023, VITAS accrued $2 $75 million and the Medicare cap billing limitations.
This compares to a $2 5 million Medicare cap billing limitation in the first quarter of 2022.
Of our 30 Medicare provider numbers 25 of these provider numbers have a trailing six month, Medicare cap cushion of 10% or greater.
One provider number has a cushion between 5% and 10% and one provider has a cushion between zero and 5%.
Three of our provider numbers do have a trailing six month billing limitation liability.
Our average revenue per patient per day in the first quarter of 2023 was $198 86.
Which is a 100 basis points above the prior year period.
Reimbursement for routine home care and high acuity care averaged $173 39.
$1042 <unk>, respectively.
During the quarter high acuity days of care was two 9% of total days of care essentially equal to the prior year quarter.
The first quarter 2023, gross margin, excluding Medicare cap and the hiring and retention bonus program was 22, 5%. This.
This is a 220 220 basis basis margin decline when compared to the first quarter of 2022.
<unk> adjusted EBITDA margin in the quarter, excluding Medicare cap was 15, 1%, which is a 234 basis points below the prior year period.
These margin declines are the result of CMS re implementing sequestration, which reduced our gross margin and EBITDA margin 200 basis points.
In addition, VITAS increased the licensed health care staff by 200 professionals in the first quarter of 'twenty three.
The net increase of 200 professionals higher throughout the first quarter is estimated to have negatively impacted gross margin and adjusted EBITDA margin by 50 basis points.
Roto Rooter generated quarterly revenue of $250 million in the first quarter of 2023, which is an increase of seven 9% compared to the prior year period.
Roto Rooter branch commercial revenue in the quarter totaled $59 $9 million, which is an increase of 10, 1% over the prior year.
This aggregate commercial revenue growth consisted of drain cleaning, increasing 4% plumbing, expanding 10, 7% excavation, increasing 26, 2% and water restoration expanding seven 4%.
Roto Rooter branch residential revenue in the quarter was $169 million, an increase of seven 5% over the prior year period that.
The components of this is aggregate residential growth rate of drain cleaning decreased two 9% plumbing, expanding three 6% excavation expanding three 9% and water restoration, increasing 27, 4%.
Roto Rooters gross margin in the quarter was 53, 1%, which is a 37 basis point increase when compared to the first quarter of 2022.
Adjusted EBITDA in the first quarter of 'twenty three totaled $71 8 million.
Which is an increase of 9% and the adjusted EBITDA margin in the quarter was 28, 8%, which is a 29 basis point expansion compared to the prior year.
I will now turn this call over to Nick Westfall, President and Chief Executive Officer of our VITAS healthcare business segments.
Thanks, David.
As we've mentioned in the past, we implemented targeted hiring and retention bonus program Abbvie toss effective July one of 2022.
This program is focused on licensing licensed nurses nurse managers home health aides and social workers. These onetime retention bonuses range from $2000 to $15000 per licensed health care professional.
The total 12 month forward looking cost of this program, including payroll taxes and government mandated overtime calculations is estimated at $40 million.
All retention bonus payments or individually cliff vested and paid out after the employee has successfully completed 12 additional months of continuous employment.
During the first quarter, we expanded this licensed health care professional staff by 200 employees, bringing total licensed health care staffing expansion attributed to this program to 475.
It is important to note. The majority of this increase in staffing as for licensed nurses, including admission nurses.
In the first quarter of 2023, our average daily census was 17830 patients an increase of 517 or 3% when compared to the prior year and an increase of 396 or two 3% sequentially.
The sequential monthly ADC growth within the fourth quarter of 2022, and the first quarter of 2023 is very encouraging given the timing lag of increased staffing following subsequent admissions and census expansion.
In the first quarter of 2023 VITAS is total admissions were 16179. This is a two 1% decline when compared to the first quarter of 2022, and a nine 1% sequential improvement when compared to the fourth quarter of 2022.
I am very encouraged by the last two quarters of sequential growth in emissions a primary driver for our admissions growth as a result of our increased capacity expansion derived from our hiring and retention program.
In the first quarter, our nursing home admissions increased six 6% and assisted facility admissions increased 10, 6%.
Hospital directed admissions declined four 9% and home based patient admissions declined two 9% in the quarter.
As compared to the fourth quarter of 2022, all pre admit segments improved.
With our nursing home admissions, increasing five 2% assisted facility admissions expanding 13% hospital directed emissions, increasing 8% and home based patient admission improving 10, 4% in the quarter.
Our average length of stay in the quarter was $99 nine days. This compares to $104 eight days in the first quarter of 2002 and $103 nine days in the fourth quarter of 2002. Our median length of stay was 15 days in the quarter and compares to 14 days in the first quarter of 'twenty, two and 16 days in the fourth quarter of 'twenty two.
To recap what our team has recently accomplished we have now generated three quarters of sequential growth in licensed health care workers two quarters of sequential growth in both admissions as well as ADC.
We have developed what I believe is a very sustainable path to building back our capacity in patient base to pre pandemic levels and beyond.
With that I'd like to turn this call back over to Kevin.
Mix.
And that was the appropriate time for considering questions.
Thank you Les.
Ladies and gentlemen, I'd like to ask a question. Please press star one on your Touchtone telephone again, if you'd like to ask a question. Please press star One line one moment for our first question.
Our first question comes from Joanna <unk> of Bank of America. Your line is open.
Hi, good morning, Thanks, so much for taking the question here, So first I guess.
Don.
Guidance.
This typically deal with the South, Florida, but can you talk about.
How the quarter.
Okay, ladies versus your internal expectations. I mean, you made a comment that was better on the resin side, but I guess, how would need us and then when you.
And how do you view the quarter on the.
Consolidated basis.
Yes, I'll take it on a macro basis, Joanna and then flip it to Kevin and Nick for more detail, but our internal estimates both roto rooter VITAS exceeded them. So we're very pleased on a macro basis with the quarter both in both segments.
And then what I would say is again.
Cash flow commentary.
On how the quarter came in.
VITAS we saw.
Continued improve.
Improvement and while there has been a key.
Aspect of.
What <unk> tried to do and that is adding more licensed health care professionals, we're adding those.
The expectation is that we wanted to add them faster than the.
Average daily census comes in for a couple of reasons for wanting to stay ahead of the power curve and we wanted to buildup.
<unk>.
For the end of the year.
Our retention program.
<unk>.
That's going well according to plan.
Roto Rooter capsule commentary I'd say.
Very strong early part of the quarter.
A little bit slower down little bit.
Those <unk>.
<unk> days.
We will slower the latter part of the quarter.
We get some questions.
Indicative of the economy slowing down some of the.
Some of the.
Activities that are less.
Emergency is that kicking in.
Maybe to a small extent.
<unk>.
It largely comes out of the.
For us.
Taking advantage of the opportunities with them.
Experienced management and we're still we're still suffering a little bit and road were from the fact that.
Yeah.
A lot of our managers have been hired away by.
Private equity for various service offerings, we've I think we've done a good job in closing the door on that but we're still suffering from some of the losses we had.
Good luck.
12 12 month.
Period preceding.
The recent quarter. So the capital commentary is overall good.
Some expenses at VITAS.
But we knew about.
Fueling dealing with the end of the relaxation of sequestration.
Adding the having the employees at Roto Rooter.
If a business and.
We want the phone to ring and Roto Rooter, and then we want to effectively respond to those phone calls.
<unk>.
That's a constant battle, so, but overall happy with results Vic anything bad.
VITAS is in just one level deeper when we think about the expansion of clinical capacity that <unk>.
Continues to be a result actually.
<unk>.
Performance, both from a hiring and turnover improvement, which is very encouraging on the emission side as I referenced on sequential admissions growth compared to the fourth quarter. Every segment was up high single digits to low single digits on a percentile basis and the resulting days of care expansion are coming in line a beating.
Some internal expectations so.
Really pleased with a lot of granular pieces that result in some of the metrics we report.
On that last point on improving capacity, adding the staff it sounds like you.
Going faster than you initially expected. So if you continue at this space right.
Does that change your view in terms of when you.
Expect to be back to coffee.
That census levels.
And I guess, what what's your latest view on that.
Well, let me start by saying, yes.
Yes generally.
It's a range.
To be very helpful.
Yes, it looks like a little bit sooner rather than later, but it's hard to be precise on that.
But it's not surprising that.
In this environment, if you have the staff.
We have a better shot at getting the patients.
So really we look at additives VITAS is internal metrics during the pandemic.
Worsening on a month by month basis.
<unk> inevitable, what was what was going to happen to the ADC.
We have.
Since we're on the other side of that.
It's almost this is inevitable.
On the improvement on ABC is.
So there is once you have the staff.
And we have not done we're not being coy, we havent precise calculations as far as when the.
When we're going to get back to that.
Lets say, our pre pandemic ADC level, but.
Yes.
We wanted to invest in an algorithm that problem, probably could come up with a pretty good estimate but that to what's used for that but that's one of the reasons why we the compare contrast, we mentioned about roto Rooter I mean, it's such a difference VITAS, we're fighting very hard to get back to where we were at the start of the pandemic and roto rooter.
Residential sales were up 73%.
From that period, so it's a tale of two cities and.
Sure.
Because people are making progress.
Progress.
Good solid pace.
Directionally, if we were to say.
Is it faster today than what we would've anticipated four or five months ago. Obviously I think that answer is yes, and the bottom line is if we can continue to win the war on talent, which is very thoughtful and we have the demand there for that talent to admit and care for patients, which we do.
It's just a question of trajectory right at this point so as long as we can continue to do that whether it's 200 a quarter, whether it's 250, whether it's $1 50.
We are right now.
Many of the markets in which we operate.
The teams are very being very successful in that and it has a compounding effect for existing staff and their level of satisfaction and what we're able to do for the for the community. So really really excited about the compounding morale and cultural impact that comes with that.
Thank you Sir.
The next filing.
Thank you.
Staff and highly trafficked.
To your point that you've seen this nice sequential growth.
And would you characterize it has also been happening faster than you guys.
For the full year and I guess prior comments, where it I'd expect more defensive come back second half of the year or so.
The percent growth year over year. This.
This quarter was it better than expected.
Or kind of.
Okay.
<unk> been thinking previously when it comes to the full year.
This is day, it's gone better than I expected as you remember when we develop the business plan. We conservatively estimated would add 25 net increase in licensed healthcare workers per month 75 per quarter, and obviously, we've been beating that.
All three quarters, we had the hiring and retention program almost tripled it what we did in Q1, so I guess, what we're trying to avoid but.
Having a line in the sand of when we get back to normal, but I'll stick my neck out a little bit and just say if the current rate of capacity expansion continues.
And running more like.
$50 75 increased licensed health care workers per month, 200, plus per quarter in 'twenty four we returned to our pre pandemic centers, but thats a big if the rate of expansion of capacity continues at the same pace.
Because.
Was it because of the lag will be at a pre pandemic license health care professional level months before.
The census level almost by definition, yes II.
And Thats, what straining our margins now as we have to build capacity before contributes to census, and then that census is negative margin until they have been in program for about 30 days or longer that incremental piece. So that's why we are having margin pressure today, because we're building back capacity, but that capacity as Joanne as you pointed out is getting.
To work pretty quick the subsequent quarter much faster than we first anticipated when we put this program in place in July of 'twenty two.
So nothing changes regarding timing expectations inside of the year related to that but really excited of getting off too.
Very fast start.
No no definitely.
Good traction there for sure.
On other topics.
On the <unk> side.
Medicare rates for the proposal that chemo calls only four 3% market basket update which has requested the floor for 2020.
So kind of what is what is your expectation there.
On the last call you said.
Yes.
You would assume should be some more closer to like 5%. So I think the Roswell that but is there a reason why you would think that the final leg of it will be.
Better similar to what happened last year or will it kind of back to maybe not as much of an improvement in Vietnam has to deal with that.
At 3% the market basket.
And what I would say Joanna as we talk to a number of shareholders and analysts we put a number out in the fourth quarter. What we think the minimum we should be given inflation within the hospital wage index basket and what the hospice industry is experiencing.
CMS has basically been caught using what I would call forecasted data that may be historically forecast and actual turns out to be pretty similar in terms of inflation by component, but with the spike in inflation that happened over the last 18 months.
It appears from our perspective that CMS uses forecasted data that is badly below actual inflation and they never true up from forecasted to actual inflation measurement is done by the Bureau of Labor statistics. So CMS has been caught lagging the increase and it really hasnt been noticed though.
Because our forecasted and actual have been running pretty low two 5% historically for what a decade plus now inflation is running through health care more significantly and CMS I think has been caught not passing through inflation and Thats why Medpac issued two separate report in March.
'twenty three and April 23, frankly.
<unk> out how badly flawed the market basket cms's utilizing because they are not accurately measuring appropriate inflation in health care models and it is a problem and we will do just fine.
We have scale. So we have leverage so we end up with the upper quartile of adjusted EBITDA gross margins most of the competitors in hospice are small not for profit hospices, many in rural markets, who lack the scale to.
Have really good margins, but to provide needed care, they're getting squeezed Joanna and if CMS does not fix this issue of not passing through appropriate inflation reimbursement increases.
<unk> for some of our small competitors will shrink and access to hospice in rural market, specifically will be limited.
So we are pointing out painfully.
MFS does not start approaching hospice in giving increases in inflation.
The smaller hospices will struggle.
<unk> go out of business.
Which is also just to add here, but no. We don't anticipate a significant change from the preliminary number at this point.
And.
Again it does.
This gives us our marching orders and.
We've tried to as the fourth quarter, we've tried to send the message out to.
Two.
And the market as far as what we're observing as far as the.
Inflation factor for the for hospice, but.
Again from them.
So I think some poor.
Structure with regard to the adjustment mechanism.
It comes out of the approximately two eight which is no one thinks that's what the inflation factor is.
Sure.
Waste market for hospitals and hospices.
The only other piece to highlight it is I think it is.
Better understood inside of DC now being openly advocated for and debated not only within the hospice segment, but just as importantly within the hospital segment and those trade Association since where we are.
Sure.
Against that hospital market Basket index as everybody knows.
This proposal.
Other things included in there.
Ron English surface.
Some questions there from CMS.
Our highest penalty for dose not submitting the quality data.
You bet.
<unk>.
Contacts how is the debt position there do you expect.
You have to look at some assets may be that would be fair to be acquired as they look to kind of to your point scale up and <unk>.
Got it.
Increased rebates and other things in the rack I guess.
Healthy position there.
Donna just to speak to that many of the things and I'll bucket it as program integrity.
We are in support of as well as the trade associations, who had made those joint recommendations on behalf of their membership to be proactive in the way in which the government could go thinking about helping the industry and supporting longstanding mission driven providers.
The issue is more abuse of expansion of licenses that are not providing care in local markets heavily concentrated in four states, including California.
So some of the pieces, they're talking about of expanding penalties to 4% et cetera.
Well don't happen to it first and foremost don't have applicability to VITAS, we conform and comply with everything on day, one and some of those providers.
That would be impacted by it wouldn't necessarily become acquisition targets because they are not submitting the data because they are not carrying for patients. Therefore, they have no real strategic value from an acquisition standpoint, there is a.
Some actions that can be taken to clean up optics of provider expansion that wouldn't impact.
Members inside of that community and I think thats really what a lot of those items are focused on not the fact that something is wrong with the benefit or that there is quality concerns around going back mission focused long standing providers that are actually providing care in the communities.
Thanks, Thanks for the call here.
Thank you.
Again, if you'd like to ask a question. Please press star one on your Touchtone telephone one moment. Please.
Our next question comes from the line of Ben Hendrix of RBC. Your line is open.
This gives us our marching orders and.
Thank you very much I was hoping you could give us your thoughts on the Medicare cap runway you had shifted your referral strategy in mid staffing shortages, which you noted could eventually press cap limitations any update on the cap trajectory overall now that hiring capacity is opening back up.
Yes.
Dan This is Dave Williams of course during the pandemic, we were actually stayed out of any significant cap problem, because although our admissions had dropped our revenue dropped as well and specifically a shift to less high acuity care as we are capacity constrained. So it's actually the drop in that high acuity.
Care.
That really gave us room under the Medicare cap billing limitation liability. So during the pandemic, we were actually just fine as many programs had actually expanded.
However, there is a limitation and we can't have length of stay go up indefinitely.
And that's why we were.
As we would've expected in our modeling we actually saw our average length of stay dropped below 100, what was it 90 999 nine and now at 15 median length of stay to that Thats kind of in our sweet spot, where historically pre pandemic average between 14 and 16, so thats a long winded way of saying is.
We've avoided any Medicare cap billing limitation with a drop in admissions because we added a drop in high acuity care now that we're back to admissions growing and actually now that we're back to slowly.
Increasing our presence in hospitals as the preeminent location of referrals, we should be back into expanding admission and once again being our continuing to be nicely below the billing limitations, but it would have been a problem. If we didn't start growing admissions with capacity expansion. That's what we've done now basically for three key.
Orders, so I think <unk>.
Medicare cap as a risk continues to dissipate, except in California, where we have exceptionally high reimbursement geographically, but then Medicare cap protection as a uniform rate throughout the country. So high reimbursement markets continued to run a bit of risk on Medicare cap billing on the other hand E.
With <unk> and the two programs were watching their very very profitable, we don't anticipate Medicare cap being a material issue certainly in 2023.
Well don't happen to it first and foremost don't have applicability to VITAS reconfirming comply with everything on day, one and some of those providers.
And just to reinforce I don't want to go back to sequential admissions growth in the hospital segment fourth quarter to first quarter was up 8%. So while we talk about it from a community access we still are servicing.
All of our key partners in the market, including the hospital segment.
To provide a data point.
Full agreement around.
Lack of shift lack of uncertainty that currently correct.
Great Thanks for that and clearly better than expected progress on the hiring front.
The change in your thoughts on how retention shakes out on those new hires and any chance that you could re up the retention program with more funding to address that.
So let me start by saying we'll be focusing.
<unk>.
We've been pretty clear that.
Again, if you'd like to ask a question. Please press star one on your Touchtone telephone one moment. Please.
The program was to address.
Our next question comes from a lot of Ben Hendrix of RBC. Your line is open.
Historical.
Historical but things that were happening for the first time in history.
Thank you very much I was hoping you could give us your thoughts on the Medicare cap runway you had shifted your referral strategy amid staffing shortages, which you noted could eventually press cap limitations any update on the cap trajectory overall now that hiring capacity is opening back up.
It was getting accountant, so I can say onetime events, but we do not anticipate.
Re instituting a different retention program.
A permanent.
Our view was it was for one moment in time and.
It would seem too.
Yes.
We've put it in we waited for an inflection point, we put the system in at that point it had.
This is Dave Williams of course during the pandemic, we were actually stayed out of any significant cap problem, because although our admissions had dropped our revenue dropped as well and specifically a shift to less high acuity care as we are capacity constrained so it's actually.
Great success, but it's.
I think.
Good point.
So it becomes self propagating.
Element that makes sense.
To the extent that you have more we have more staff everyone. Who's on your stat is happier and thinks that the company to do a better job and people are not wrapped around the axle. So.
Drop in that high acuity care.
That really gave us room under the Medicare cap billing limitation liability. So during the pandemic, we were actually just fine as many programs would actually expand it.
The extent that you have those forces working with you we do not anticipate continuing at now having said that I can't imagine any set of circumstances, where we've continue it.
However, there is a limitation and we can't have length of stay go up indefinitely.
And that's why we were.
As we would've expected in our modeling we actually saw our average length of stay dropped below 100, what was it 90 999 and now at 15 median length of stay to that kind of in our sweet spot, where historically pre pandemic average between 14 and 16, so thats a long winded way of saying is.
I don't want some Dr narrow to the point and say if there was some reason that.
Bundle says sensitive to reinstitute another program, we would do it but we don't see those as well.
We don't see those facts lining up it could be in the realm of possibility just a little more color with that Ben don't don't see that as a need while we talk about it on these calls that though it's a singular item driving at there is a large subset of well north of a dozen plus other complementary pieces.
Increasing our presence in hospitals as the pre admit location of referrals, we should be back into expanding admissions and once again been are continuing to be nicely below the billing limitations, but it would have been a problem. If we didn't start growing admissions with capacity expansion. That's what we've done now basically for three.
That also contribute to.
A lot of the metric improvement and obviously we track both.
<unk> turnover satisfaction on a bunch of different layers and all of those things are directionally, improving and so that tells me. The program itself has been very beneficial but in the same regard getting back to a lot of our more normalized pieces, but also making sure.
Quarters, So I think <unk>.
Medicare cap as a risk continues to dissipate, except in California, where we have exceptionally high reimbursement geographically, but then Medicare cap protection is a uniform rate throughout the country. So high reimbursement markets continued to run a bit of risk on Medicare cap billing on the other hand E.
Sure. There is sufficient time being spent recognizing rewarding celebrating employees highlighting the mission of why people join hospice, but also what makes <unk> special in that situation.
Is all the real compounding effect, that's helping these things.
In a substantial way and makes it sustainable and that's why I can use the word.
Confidently sustainable on a go forward basis.
And just to reinforce I don't want to go back to sequential admissions growth in the hospital pre admit segment fourth quarter to first quarter was up 8%. So while we talk about it from a community access we still are servicing.
Thanks for the comments guys.
Thank you I'm showing no further questions at this time I will turn the call back over to Kevin Mcnamara for any closing remarks.
Well I just wanted to think.
Everyone for their kind attention and.
We're very comfortable with the results.
To provide a data point.
Full agreement around.
We'll get back about three months from today and report on whats going on presently thank you.
Thank you ladies and gentlemen, this does conclude today's conference. Thank you all participating you may now disconnect have a great day.
The change in your thoughts on how retention shakes out on those new hires and any chance that you could re up their retention program with more funding to address that.
So let me start by saying that recovers.
The program was to address.
Historical.
That historical but things that were happening for the first time in history.
Getting accountant, so I can say one time events, but we do not anticipate.
Making a permanent.
Our view was it was for one moment in time and.
We've put it in we waited for an inflection point, we put the system in at that point, it's had great.
Great success, but it's.
I think.
Certain point.
So it becomes self propagating probably the element that makes sense.
To the extent that you have more we have more staff everyone. Who's on your staff is happier and thinks that the company to do a better job and people are not wrapped around the axle. So.
You have those forces working with you we do not anticipate continuing at now having said that I can't imagine any set of circumstances, where we've continue it I don't want to I don't want us some Dr narrow to the point and say if there was some reason that.
Bundle says sensitive to reinstitute another program, we would do it but we don't see those but we don't see those facts lining up it could be in the realm of possibility just a little more color with that Ben.
Don't see that as a need while we talk about it on these calls as though it's a singular item driving at there is a large subset of well north of a dozen plus other complementary pieces.
That also contribute to.
A lot of the metric improvement and obviously we track both.
Hiring turnover satisfaction on a bunch of different layers and all of those things are directionally, improving and so that tells me. The program itself has been very beneficial but in the same regard.
Getting back to a.
A lot of our more normalized pieces, but also making sure. There is sufficient time being spent recognizing rewarding celebrating employees highlighting the mission of why people join hospice, but also what makes <unk> special in that situation.
Is all the real compounding effect, that's that's helping these things.
In a substantial way and makes it sustainable that's why I can use the word.
Confidently sustainable on a go forward basis.
Thanks for the comments guys.
Thank you I'm.
Im showing no further questions at this time I'd like to turn the call back over to Kevin Mcnamara for any closing remarks.
Well I just wanted to thank everyone for their kind attention and where we are.
Very comfortable with the results and.
We'll get back about three months from today and report on whats going on presently thank you.
Thank you ladies and gentlemen, this does conclude today's conference. Thank you all participating you may now disconnect have a great day.