All right, we're gonna go ahead and get started. My pleasure to have the team from Acadia today. We've got Chris Hunter and Heather Dixon, and Patrick is in the front row. Welcome. So I thought I might just get into it. If anyone has any questions throughout this, let's keep this as interactive as possible and raise your hand, and we'll try to get to everyone's questions. But obviously, there's been a lot of discussion lately around, like, how you stepped into the second quarter, Heather, with volumes. You provided some, I think, clarifying comments. Maybe if you just wanna refresh everyone's view here on the room and to the trajectory of the volumes as you're thinking about the progression of the second quarter. Sure. Happy to. You're right. On the earnings call, we talked about experiencing a period of softness towards the end of the first quarter, which we think was in large part due to the impact of the timing of Easter and spring break this year versus other years, and I think that's pretty similar to what others in our space have experienced as well. But what gives us confidence in the acceleration of volume throughout the rest of the year is two things I would point to. The first is we expect that what we experienced was transitory in March, and we're pleased with our year-over-year admissions growth and the way since it has been rebuilding since that time. So we expect that softness is largely behind us at that point, at this point. Second, I'll just remind you what we've said in regards to second quarter. We said that we expect our year-over-year, same-store patient day growth will be at least in line with what we saw for Q1, if not better. And then maybe lastly, I'll just point to the benefit from the ramp of bed additions. We've talked quite a bit about bed additions and de novos that we've put in place over the last several quarters, but maybe if we just talk about that a little bit more. You recall we added over 1,000 new beds in the past 18 months, and 400 of those were in the second half of last year alone. So of course, we'll be seeing an increasing benefit from those bed additions in the second half of this year as compared to the first half of this year, as those just continue to ramp. And then, of course, you all know we're adding around 1,200 beds for this year, and we will see some incremental benefit from those beds coming online in the second half of the year. We've mentioned before that those are largely weighted to the back half of the year. Right. So of the 1,200 this year, how many are in the third and the fourth quarter? I know timing is always a factor on when they all open. Yeah. The significant majority- Yeah ... is in the second half of the year- Sure ... and it's hard to pinpoint exactly which quarter because of, you know, the way that construction works, but significant majority are in the second half and weighted towards the back end of that. Okay. There's also been some noise, in addition to volumes, just around, like, maybe consensus estimates. Some analysts have been cutting numbers, so I didn't know if there's anything that you'd like to just go ahead and address, Heather. Yeah. Maybe let's just talk about a couple of things. First, let me just reiterate, feel really good about the census build and admissions growth since Q1. So just wanna make sure that's really clear. Second, we are, as I just mentioned, expecting some growth and some increment from those bed additions. And maybe just to click a little deeper into the bed additions and put some quantification around it, just go back through the math. Over the last 18 months, roughly 1,000 new beds and then 400 in the second half of last year. Those are ramping very nicely, and we think those are gonna be a pretty good contributor to EBITDA for the second half. If I just try to put some quantification around that, we would expect from the bed additions that are coming online in the second half of the year alone, that would contribute at least $10 million of incremental EBITDA in the second half versus what we saw in the first half of the year. So just to dive in on that and maybe just a couple more things to add to why we feel really good about the back half of the year. Medicaid revenue, we've mentioned before, the vast majority of the Medicaid revenue renews. Those contracts renew in the second half of the year, usually July first or October first dates. So if you just think about the sequential cadence of EBITDA, that would contribute to... Those rate updates would contribute to improved EBITDA in the second half of the year versus the first half of the year. So that's part of what we have built into our expectations. And then, you know, finally, you're right, I do think, the street may have mismodeled the cadence of EBITDA, at the start of the year, and, you know, that's frankly a place that we could have done a better job of giving you some indication there whenever we gave our initial outlook. But, given the pace of the bed additions and how we expect EBITDA to ramp for all those reasons I just mentioned, we would expect for 2024, the weighting of EBITDA in the second half versus the first half to be slightly more towards the second half of the year than what we've experienced in the past years. Okay. It's a little bit more. And then, you know, finally, I think what you're seeing is model changes, and people are beginning to reflect that in their models, and I think consensus is starting to capture that cadence now. Okay, so a couple of things to unpack in there. You normally get rate updates from states in the second half. That's, that's a recurring. Would there be any difference in the rate of growth that you would expect to get from states this year versus prior years? No. Okay. So then if I look at, like, what you normally earn in, I'm talking out loud, normally earn in the first half versus the second half, I would then add maybe $10 million of incremental EBITDA on top of normal seasonality. Is that a fair way- For the bed additions, for sure. Okay. Yes. Okay. At least. All right. All right, I think I got that. Remind me the number of beds that you've got targeted for 2025 at this point. Roughly in line with 2024. Yeah. For sure. I think the one difference to point out, just, Whit, as you're thinking about, how those increments will contribute in 2024 and then continue for 2025, we accelerated the number of bed additions to existing facilities in 2024 versus what we've historically done. Right. We went from roughly 300 to at least 400, so that's gonna have a growing impact to the back half of 2024 as well. Yeah. Whit, for 2025, I would just take you back to our Investor Day in late 2022, where we kind of laid out the progression, particularly with the- Yeah ... visibility that we have into the JVs. You know, we've guided to, you know, over $1,100 in 2024 and 2025. I think we'll do $1,200 this year. Yep. You know, fully expect to, and I would say, you know, 2025 continues to be in line. Got it. Okay. One of the things that stood out in the first quarter to me was the growth in the number of closures. In any given year, you're shutting down programs and facilities that are either not performing or you don't wanna spend the time, and maybe it's a distraction, doesn't really matter, but certainly things have elevated to increase a bit around closures. Is there any consistent themes around how you're approaching this in terms of internal discipline, or, you know, how do I interpret the growth that we're seeing in closures? Well, maybe I'll start, and I'll talk about some of the magnitude and the growth that you're pointing to. Over the past four quarters, we've closed four underperforming facilities, and those, there were three of those in just the last two quarters, and so you're right, a little bit of an elevated pace. And just to quantify that a little bit from a year-over-year perspective, that's roughly $12 million-$15 million per quarter for the first- Right ... and second quarter related to those, and you can see that in the same-store revenue comps. I do think that there's been a little bit of confusion about those contributions from a modeling perspective, so I'll try and maybe give a little bit of clarity, and then we talk about the reasons for them. But just to start with, there's generally no EBITDA impact to speak of from those closures. That's typically a large driving factor to why we're closing them. So just talking about revenue, if you look back over the past few years, roughly the run rate was about $5 million a quarter from closed facilities. In the past years, and of course, I just mentioned it, it's at a much higher level, sort of currently, and that's just because some of the optimization of the portfolio that we've done. I don't expect that to continue. We wouldn't expect that elevated level to continue, and we think that would normalize back down to what we've seen- Great ... as a traditional rate. But, you know, I'm sure Chris would say the same thing. Yeah. Yeah, I mean, this is deliberate in terms of what you guys have been doing internally. Yeah. This is what- I just think this is, you know, continued portfolio optimization. It's something we'll continue to evaluate, but I think as Heather said, we don't have, you know, an expectation at this level that we, you know, just saw going forward. And, you know, we obviously wanna make sure that our facilities are performing and that there's a sustainable path, and so we'll continue to look at that on a regular evaluation, but it's just normal portfolio optimization, is the way I'd capture it. Not to put you on the spot about this, as I'm just thinking about some of the other internal changes. New COO, I didn't know if there's, Yep ... any comments, thoughts you'd care to share with the audience? Yeah. John Hollingsworth has been, you know, in this industry for 30 years and has decided to retire, and we're really pleased to have an internal replacement, Dr. Nasser Khan, who we brought in to lead our CTC business, who has really done a fantastic job of reigniting growth within that business, also leading the company through Medicaid redetermination last year. He's on the Board of NABH. Just a really proven operator, who not only brings a very strong track record from when he was at Shields before that entity was sold to Walgreens, but also spent some time at DaVita with just very strong, you know, a very strong growth track record. And I think just the way that he has come into CTC through Medicaid redetermination, put a number of things in place that have enabled us to reduce our employee turnover in that line of business, but also to see, you know, really strong clinical outcomes, as well as, you know, very strong patient retention and reducing the wait times, which is a big driver of growth in that business because patients just do not want to come in and wait at a facility. So, Nasser's done a phenomenal job of attracting in talent. John and Nasser are already working very closely together. I think we have the benefit of continuing to see John. He'll be a consultant through the end of the year, still a significant shareholder, and, you know, is doing a great job and just working through the transition. So we're really excited about what Nasser is gonna bring. Good. One of the frequent questions we get is around just, the enterprise-wide pricing and trying to—you know, drill down into kind of a core pricing. You obviously get a benefit of having the revenue from the CTC business. It depends, like, which one of your service lines might be growing faster or slower than others can have. Is there just a simple rule of thumb, Heather, that you look at and say, "If our same-store revenue per patient day is X, it's normally inflated by, you know, a point from CTC?"... And then lately, it's been driven, you know, acute's been driving it. I guess where we're trying to go is I get a lot of questions on, like, what's kind of the normalized core pricing that we should think about, you know, moving forward? Yeah. I would say you hit on the first piece that I would point out. So when you look at the revenue per day growth, you're right, CTC does contribute to that calculation without any patient days, and CTC, as you know, has been growing at a really nice pace. So if you back out just the impact for Q1 of CTC growth, that's about 100 basis points off of that growth rate. And then if you recall, we mentioned a one-time payment that we received in Q1 of about $7 million, and we get those from time to time. If they're large, we'll call them out specifically, as we did in Q1. If you back that out, that's about another 100 basis points, and so that gets us down to what I would think of as our sort of baseline growth rate of about 5%. Okay. Chris, can we just spend a second? I wanna think about 2023. It was a year of heavy investment- Mm-hmm. People, processes, technology. There's a lot that's gone on in terms of investing in the organization that a lot of investors don't see. Maybe if you just- Mm ... step back and talk about some of the processes that you undertook last year to modernize the organization, you know, where, I mean, we all know about the EMR, but maybe- Yeah some of the less obvious areas. Yeah, I think, you know, we're a company that has 260 facilities that has really grown through acquisitions. So as you would expect, there has been a lot of variation that we've seen facility to facility. But I think we've done some very focused work going in and looking at: How can we leverage technology to take out some of the variation? But I think we've also done a really good job of making investments in patient quality, and I think, you know, our remote patient monitoring software that we put in place, that we now have in place at all of our acute facilities, we've seen tremendous outcomes from those in terms of just being able to monitor our acute patients consistently. We've also put some technology in place with respect to patient safety that we're rolling out in all of our acute facilities through the end of this year. And, you know, we've done that across really all of our lines of business. I mean, our CTC business has some of the highest CARF quality scores in the entire industry. And, you know, we're continuing to do that on the EMR front as well. I mean, obviously, the EMR is quite an installation. It takes a little bit longer, so it will go, you know, well into next year in getting those facilities up. I think those are representative of some of the things we're doing on the technology side, and then just, you know, on the clinical versus non-clinical, I think, we have been very consistent in looking at staffing ratios for our, you know, HR team that's in the facilities in the field, our IT team. Even looking at the way that we train our clinicians or new employees that are coming into the organization, there was a lot of variation around how that is done. Our Chief Nursing Officer led an effort to routinize the way that we train our staff, and it has led to significant improvement in our retention. So I just think that, you know, we're, we're still in the early innings of this journey and working- Right ... through how do we address the variation, but I think the early proof points have been very encouraging, and we've got, you know, quite a ways to continue to go. Okay. So sounds like you've done a lot of work on the identification of variability, and now it's the- Yes ... heavy work in front of you to start standardizing all of that, but still an opportunity. Can we spend a minute on labor, just sort of how you feel about, where you are on the labor agenda, your hiring, where you think you could do a little bit better, maybe, you know, each one of the different businesses? Sure, I'll start. I mean, we clearly saw, you know, the high-water mark of base wage inflation in the fourth quarter of 2022, where we were over 8%, and we had talked at this time last year of our expectation to consistently bring that down under 5%, which is where we did end the year and certainly where we ended the first quarter as well. So we've put a number of strategies in place, particularly on the employee engagement front, that I think have been instrumental in helping that to happen. I would say, you know, I pointed out the really strong improvements that Nasser put in place in the CTC business. I think when you have 260 different facilities, the career laddering and our ability to demonstrate to our staff that there is career progression outside of just that individual facility where they're currently working across the entire company. And so that career laddering, clearly making investments in things like tuition reimbursement, putting the training in place, all those things consistently have really helped us bring down turnover. But anything you would add just overall? I would just maybe talk about the pace of deceleration- Mm-hmm ... has been significant over the last several quarters. You guys know we hit the high-water mark in Q4 2022, over 8%. Brought that down over 300 basis points in the period of about 12 months. So, significant concentration on what we're doing from a process perspective to manage those. That process hasn't changed internally, so we're still very focused on them, and as you know, we came down below 5% in Q4 last year. That's continued for the last couple of quarters, and we would expect for that to continue. So feel good about it, but not taking our eye off of it. Okay. One of the other efforts, Chris, that you went through last year is identifying, you know, larger core markets where you've got a number of different services, whether it's acute RTC- Yeah. CTC, now maybe outpatient, maybe some PHP, IOP. Where are you in terms of putting an effort away to, around, you know, integrating some of those? I know it's- Yeah Gonna be different market by market, but might be helpful to hear just sort of like where you are in the review of that. Yeah, it's a great question. I would say we're still in the very early innings. I mean, I think it starts with having the right IT investments in place so that we're able to capture data and share data between lines of business. I think we're doing. We've been very intentional around cross-selling. We know that somebody that comes to one of our specialty facilities and admits, 70% of the time will also have an underlying OUD diagnosis, and so that interplay between the lines of business is something that we've been really intentional about. I think that you mentioned the outpatient side. You know, I think the partial hospitalization programs, as well as the intensive outpatient programs that we have in place, clinically, there's majority of our patients indicate that there is an opportunity for post-discharge for some PHP/IOP programming. And so we've been very intentional in the past year of adding those programs. We added over 40 to existing markets last year. We've added another 15 programs this year, and I just think that outpatient component is gonna play a central role in integrating, you know, the, the various lines of business. But I would still say that we're, you know, we're very early in working through that, and we do think that there will be value to unlock, you know, given the presence and the, the concentration that or the, the focus that we have in, in various markets. But, you know, we're still still very early. It's something that, you know, Nasser clearly will be spending time on. Yeah, there's a lot of really interesting data around IOP services and looking at- Yes states that have expanded it and the significant percentage of certain populations that are, you know, receiving treatment there. On the topic of outpatient, CMS came out, or CMMI came out earlier this year with their first sort of behavioral program to attempt to integrate primary care and behavioral health services, CTC, IOP, outpatient, all of that sits really well in the design of the program. I think as CMS, you know, thinks about the direction that it's gonna go. I know it's early, you know? Yeah. There's a lot to... What, what have you learned? Where do you think Acadia can play a role inside this? Well, I think overall, we love the idea of an integrated behavioral health model. I mean, obviously, a big part of our strategy is joint ventures, working very closely with these health systems, and the integration between physical and mental health. I think for this program specifically, we're still waiting to see some of the details from CMS. I mean, I think some of the specific things that we're looking at are: What will the care model look like? What will the funding model look like? What geographic participation do they have in mind? Overall, there seems to be a real focus on outpatient- Right ... which we think will be exciting for our CTC business and certainly, you know, on the PHP/IOP front. But I just think overall, we just need to see details of the program, but it's something that we're, you know, optimistic about and would certainly like to participate in if, you know, if, you know, when the details come forth, you know, it makes sense. Any other things happening at the state level? And we'll periodically, I'll get into a rabbit hole down on reading about waiver plans and whatnot, and State of New York passed a really big or had a—CMS approved a very large one, and a significant portion of, like, $6 billion-$7 billion is going to mental health. Is there anything else that's on your radar screen, just at the state level? And maybe the corollary to this is just sort of like all the DPP funding, too, which is- Yeah ... you know, continuing to accelerate. You know, I'll take this state question. Heather, maybe you want to speak to, to DPP, but I think, you know, the 1115 waivers is clearly something that we continue to watch. I think going, you know, all the way back to the 1960s, you know, there is broad consensus that a lot of these rules have just been out of step with modern clinical practice. So the 1115 waivers are set up in a way to help address some of the reimbursement challenges for inpatient psychiatric care for Medicaid- Right ... patients. So, you know, we're tracking that very closely. Most states have now put these 1115 waivers in place in some forms. A few that we've seen opting in more recently are the states of Missouri and Wisconsin, where, you know, we have presence. So, you know, we applaud that and are clearly continuing to watch that closely. So I think that's what I would point out on the state side, but you want to say anything on DPP? Yeah, sure. So DPP, we, you know, we watch closely, and we have, you know, people that are dedicated to focusing on that and advocating on our behalf. We typically anticipate some of those. There are, you know, many, many states that have sort of a recurring theme of DPP payments, and that's just part of what we consider our normal reimbursement, and that's built into our guidance and, and our expectations every year. But to the extent there are the larger DPP payments, we won't build those into guidance. We'll call them out if we know about them ahead of time or, or certainly when we receive them, as we did in Q1 with the $7 million and $10 million expected for the full year. Any of the others that are sort of out there, and I know there's a lot of conversation about those, are not, you know, built into the guidance for the larger amounts. Got it. Makes sense. Any updated views on redeterminations? I feel like we're kind of, like, at the tail end of when we would expect to see, you know, any impact, although United's scaring everyone right, right now about it. Just any other update? Overall, no, no update for us. You know, we've previously messaged that we expect that our patients will have kind of moving through the redetermination process by middle of this year, and that continues to be consistent. So, you know, we've had really strong track record of those patients that actually have lost coverage, being able to re-enroll them, and, you know, overall, I think we feel very good about where we are. Heather, do you have an idea or an estimation within a range of what percentage of your admissions are coming from patients covered under exchange plans? I would say it's a very, very low percentage. Those would, from a payer mix for us, those would fall under the commercial bucket whenever you look at our payer mix, disclosures. But that's largely situated in CTC, and that was a product of, you know, some patients did, you know, come off of Medicaid. Most of those patients, sort of were back onto Medicaid within 30 days. We were able to get them back on coverage, but there was a portion of them that moved into commercial, and then a portion of that commercial that was exchange based, but very, very small numbers, from our perspective. So if the hospitals are sizing sort of on the low end, I'm just talking out loud, like maybe 4%-7% of their admissions, I'm just intuitively thinking that EMTALA ER, like, you're gonna probably pull more of the volume in there. So intuitively, it would make sense that you would be less than the acute care hospitals. Doesn't that make- Significantly, yes. Yeah. Okay, so it could just be a few points to maybe not significant at all. Thinking of CTCs, we've got the Physician Fee Schedule that should come out in the next month or so, and, you know, we all comb through it to see the language around how they're thinking about rates and reimbursement going forward, and it's been generally favorable, I think. When you read what they've written, we're not prepared to make any substantive changes to the CTC payment model or unbundle it or look at redoing the bundle. We're concerned about it being a substance use crisis. I mean, any expectation that we could see any larger changes this year? Not from my perspective. Yeah. We're not expecting any significant changes or really anything of note, as a result of that. Okay. Where do we stand with the whole MOTA legislation? Yeah, I think, I'll make it a bigger question. What are any other, like, regulatory, legislative areas that you're focused on right now that you don't hear us ask you enough about? I mean, I think that, you know, overall, the-- we talked about the CMMI program and the 1115 waivers. I mean, I think, you know, that's clearly been an area of focus. You know, on MOTA, which is a question that we get a lot, we're not seeing that legislation progress, and I just wanna re-echo that, you know, we continue to be highly focused on improving access to OUD across the country. We just think that this legislation, in terms of the way that it was proposed, there-- it imposes a number of barriers, around lack of insurance coverage, prior auth, restrictive zoning. I mean, there are just some challenges to it overall, but we're really trying to work through some of the things that we believe can augment the, you know, the legislation overall and, you know, continue to work with, you know, all of our partners to, to kind of move things along on that end. It has not progressed outside of the, you know, the Senate and in the House, and so I think we're really turning our attention to: What can we be doing as the largest pure-play behavioral health company to improve access and to work with states, you know, as well as the federal government, to get more access where it's needed? Okay. Maybe last one here, just capital priorities, how you're thinking about maybe share repurchase at current levels, how you're thinking about preserving dry powder for any opportunistic acquisitions. Haven't looked at your debt stack in a while to see if there's anything that you need to address, which I don't think you do. But next 12 months, how do you think about sources and uses of cash? Yeah, I'll start, and you can jump in. Sure. So to start with the last piece, from a debt stack perspective, we will be sort of looking at refreshing that in the next 12 months for sure, just as a part of normal course of business. We are constantly evaluating the best use and the best returns on capital, and we look at all of the growth pathways that we have, and we focus on those that have the highest and best return of capital. We wanna make sure we're focused on preserving, you know, capital for M&A that makes sense for us as well. But it's certainly something that we talk about on a regular basis. I would just add, I mean, we're in an attractive position that there are so many ways for us to deploy capital that are attractive, and there's constant trade-offs and, you know, we are looking at where can we get the highest return, and we're always gonna do the best thing for shareholders. Well, good. Well, with that, guys, I think we're out of time. Thank you for joining us today. Thank you. Thank you.