Greetings. Welcome to the Amedisys Q4 2021 earnings conference call. At this time, all participants are in a listen-only mode. A question-and-answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note this conference is being recorded. I will now turn the conference over to your host, Nick Muscato, SVP of Finance. Thank you. You may begin. Thank you, operator, and welcome to the Amedisys Investor Conference Call to discuss the results of the Q4 and year-ended December 31st, 2021. A copy of our press release, supplemental slides, and related Form 8-K filing with the SEC are available on the investor relations page of our website. Speaking on today's call from Amedisys will be Paul Kusserow, Chairman and Chief Executive Officer, Chris Gerard, President and Chief Operating Officer, and Scott Ginn, Executive Vice President and Chief Financial Officer. Also joining us is Dave Kemmerly, Chief Legal and Government Affairs Officer. Before we get started with our call, I would like to remind everyone that statements made on this conference call today may constitute forward-looking statements and are protected under the safe harbor of the Private Securities Litigation Reform Act. These forward-looking statements are based on information available to Amedisys today. The company assumes no obligations to update information provided on this call to reflect subsequent events other than as required under applicable securities laws. These forward-looking statements may involve a number of risks and uncertainties, which may cause the company's results or actual outcomes to differ materially from such statements. These risks and uncertainties include factors detailed in our SEC filings, including our Forms 10-K, 10-Q, and 8-K. In addition, as required by SEC Regulation G, a reconciliation of any non-GAAP measure mentioned during our call today to the most comparable GAAP measure will also be available in our Forms 10-K, 10-Q, and 8-K. Thank you. Now I'll turn the call over to Amedisys Chairman and CEO, Paul Kusserow. Thanks, Nick, and welcome to the Amedisys Q4 and year-end 2021 earnings call. We have a lot to discuss on today's call, but as this will be my last earnings call, before we dive in, I first want to thank and acknowledge Nick Muscato for all of his fine work on these calls over the years. He has taken us to a new level, and I'm very appreciative of what he has done for me and Amedisys. I would also like to express my sincere appreciation for all of the 21,000 Amedisys employees, whether you are at a patient's bedside or support those providing the industry's best-in-class care. At Amedisys, we put quality before everything, and the unwavering dedication of all of our employees has been delivering great patient care, and this dedication to quality continues to be my greatest point of pride and largest source of inspiration. I humbly thank you for all that you do. 2021 was a topsy-turvy year unlike any other. Before I turn it over to Chris and Scott, I'd like to highlight a few of the many successes we've had during the year. Though CMS has frozen the publicly reported home health stars metrics, we never let our foot off the gas on quality. We never will. It's simply in our DNA. In 2021, we continued to make strides. Using industry data and internal benchmarks, we proved that once again, Amedisys is second to none in home health quality. You can't deliver great care without great caregivers, and we have made human capital a passion, recruitment and turnover a science, and focused hard and creatively on building and retaining our incredibly important clinical staff. I want to thank and acknowledge Sharon Brunecz and her team for putting us at the vanguard by constantly reminding us it's all about our people. As healthcare labor markets become more challenged nationwide, Amedisys was able to drive our clinical turnover down an additional 9% from 2020 to 2021. Additionally, to fuel our present and future growth, we increased our recruitment numbers by driving a 27% increase in recruited headcount. Recruitment, retention, and turnover are continuously our biggest initiatives, as having enough clinical capacity to serve our patients in our fast-growing industries has never been more paramount. Demand is not gonna be the issue. Supply is, and we are improving our capabilities here every day. While still facing many challenges brought upon by COVID in both home health and hospice, in 2021, we still grew our EBITDA 10%, and we grew our EBITDA margin 40 basis points while delivering $189 million in cash flow from operations. We beat Q4 during the peak of Omicron. We took our cash flow, and we invested in the inorganic growth of our business, resulting in the acquisition of four CLNs, VNA, Evolution, and changed the game with our acquisition of Contessa. By acquiring Contessa, we took a meaningful step in differentiating ourselves as more than just a home health and hospice company. The leader in its space, Contessa builds risk-bearing, tech-enabled hospital at home, SNF at home, and capitated palliative platforms. It has become our platform for future innovation and new models for care delivered in the home. We further continued to think outside the box and challenge our thinking by investing in connectRN, an innovative solution for recruiting nurses and for engaging with our current clinical workforce differently. In the coming weeks, you'll hear of other investments that continue to push us to innovate and differentiate in this constantly evolving market. Finally, and yet most importantly, we delivered the highest quality care, performing more than 11.5 million visits for more than 445,000 patients in 2021. Among the backdrop of COVID-19 disruption and its impact on all of healthcare, 2021 is a year I'm exceptionally proud of. The lead-in quote to our 2022 strategic plan was a quote from the ancient Greek philosopher Heraclitus, you can't step into the same river twice. Amedisys enters 2022 as a new, expanded, and complete organization, well poised for continued growth and even further differentiation in our expanding solutions for the home. With that, I'll turn it over to President and COO and incoming CEO, Chris Gerard, to run us through the operational updates. Chris? Thanks, Paul. Now let's dive into our Q4 and full year Home Health segment performance. For the quarter, Home Health grew total admissions and total volume by 2%. For the year, Home Health grew same-store total admissions by 6% and total volume by 5%. Elective procedures as a percentage of our total episodes increased from 7% in Q3 to nearly 8% in Q4. Much of the increase quarter-over-quarter was in the H1 of Q4, where we actually saw electives reach pre-pandemic levels of greater than 8.5%-9%. However, as the Omicron variant set in, we exited the year back in the 6.5% range. We are beginning to see improvements in this percentage, but we're not yet back to the pre-Omicron levels. For the quarter, we performed 13.7 visits per episode, down 0.1 visits sequentially and down 0.3 visits year over year. On clinical mix, in Q4, we achieved 49% LPN utilization and 53% PTA utilization. We have made tremendous progress in our clinical mix throughout 2021 and believe that there is still additional room for optimization of our LPN utilization percentage as well as some additional improvement in our PTA utilization. Lastly, the final 2022 home health payment rule has been released, and I'm pleased to say that we will be receiving slightly over a 3% rate update. Now, moving on to hospice. For the quarter, hospice same store admits were down 1% over a 15% Q4 2020 comp, and ADC was down 4%. For the year, same store admits grew 2% and ADC was down 4%. We again made good progress on hiring hospice BD FTEs, ending the quarter with 533. We had previously stated a desire to exit 2021 with 550 hospice BD FTEs. However, we had some planned consolidations and closures during Q4, which impacted our hiring trajectory. Nonetheless, we ended 2021 with 48 additional BD FTEs versus our 2020 exit rate, and we look for increased productivity from these new reps as well as our senior staff to drive continued admit growth as we move forward. Hospice ADC remained pressured in Q4 as we continue to see a trend of patients coming on to service much later in the dying process and not realizing the full value of the benefit. Our hospice discharge average length of stay fell to 90.3 days in Q4 from 94.5 days in Q3. The median length of stay dropped to 22.7 days from 24.3 days. These decreases were driven by an increased percentage of deaths on census. The increase of deaths on census is materially impactful to the hospice segment performance as a 1% change in discharge rate is equivalent to approximately 130 ADC, which over the quarter would have added approximately $2 million to the bottom line. As we look back at 2021 as a whole, our deaths as a percentage current pre-COVID time frames, again, having a material impact on the ability to consistently grow ADC in the near term. Though predicting behavior is more art than science, we do think that the increased death rate is a short-term issue and over time will return to normal. Whenever behavior returns to pre-COVID normal and patients access healthcare like they did pre-pandemic, we will see an ADC increase, and as we continue to hire and retain our BD staff and grow admissions, ADC growth will follow. In summary, 2021 was the year that saw both home health and hospice continue to be impacted by COVID-19 issues and their subsequent shakeout. Many of the challenges presented in our current operating environment are out of our control, but they have forced us to think differently, become more efficient, innovative, and set us up to be even more successful organizations as those challenges dissipate. I am tremendously proud of what we've accomplished and the care we have delivered during these very challenging and unpredictable times. Now, I'd like to discuss Contessa's performance for the quarter. Our high acuity segment, Contessa, which offers home-based recovery solutions for patients in need of acute-level care, continued positive momentum in Q4. Total admissions were 520 since the closing of the acquisition last August. Clinical management of patients admitted onto Contessa's program continues to be a strength, evidenced by favorable MLR performance relative to expectations, as well as strong quality and satisfaction metrics. From the financial perspective, during Q4, three JVs reached profitability, which proves that this model continues to be efficient and scalable in different types of markets. We are also excited to announce that through Contessa, we closed another joint venture partnership with a multi-hospital health system in Penn State Health. This Penn State Health joint venture, which is an extension of our existing partnership with Highmark Health, is another example of the demand and appeal that high-value health systems have for Contessa's home-based acute services. Program operations for this market are expected to go live in Q2 2022. Additionally, Contessa continues to add payer sources for its high acuity clinical models. In the coming months, we expect a number of new health plan contracts for the hospital at home and SNF at home models, increasing total addressable patients. We continue to remain encouraged by Contessa's robust pipeline of additional health system opportunities. Furthermore, this year we've had strong performance through scaling of existing markets, increased penetration of our newer clinical models, additional value-based contracts, and an increasing number of partnerships that reach market-level profitability. Amedisys continues to focus on integration efforts with Contessa related to nurse staffing strategies for the high acuity programs. Contessa has historically relied on third-party home nursing providers in select markets where Contessa's hospital partners do not have capabilities to provide home nursing. Nurse capacity constraints in those markets have resulted in Contessa not being able to admit all patients referred to the program. Amedisys and Contessa have begun implementation of a strategy to in-source nursing requirements instead of continuing reliance on third-party providers in the majority of the markets in which Contessa operates. While meaningful progress has been made in several markets to increase ADC capacity, i.e., Tennessee and Arizona, the integration efforts are taking longer in select existing markets, such as New York and pending markets in Hershey, Pennsylvania, and Tacoma, Washington. We are very pleased with the high acuity segment's performance and are excited about the new opportunities and capabilities Contessa has brought to our organization. The combination of Amedisys and Contessa has created a truly differentiated in-home care platform, and I'm very excited by all the opportunities ahead of us in 2022. With that, I'll turn it over to Scott, who will take us through a more detailed review of our financial performance for the quarter and our projections for 2022. Scott? Thanks, Chris. For the Q4 of 2021, on a GAAP basis, we delivered net income of $1.04 per diluted share on $559 million in revenue, a revenue increase of $9 million or 2% compared to 2020. For the quarter, our results were impacted by income or expense items adjusting our GAAP results that we have characterized as non-core, temporary, or one time in nature. Slide 15 of our supplemental slides provides detail regarding these items and the income statement line items each adjustment impacts. For the full year of 2022, on an adjusted basis, revenue grew $136 million or 7% to $2.2 billion. EBITDA increased $26 million or 10% to $300 million. EBITDA as a percentage of revenue increased 40 basis points to 13.6%, and EPS decreased $0.16 to $5.95. Keep in mind that prior year includes the Q3 EPS benefit of $0.72 resulting from executive stock option exercises. The suspension of sequestration added $36 million to our revenue and gross margin for the year, which is up $13 million over prior year. For the Q4 on an adjusted basis, our results were as follows. Revenue grew $9 million or 2% to $559 million. EBITDA decreased $13 million or 17% to $65 million. Excluding the acquisition of Contessa, the EBITDA decline was $8 million. EBITDA as a percentage of revenue decreased 260 basis points to 11.6%. Excluding Contessa, EBITDA as a percentage of revenue declined 160 basis points to 12.6%. EPS decreased $0.31 or 21% to $1.18 per share. Contessa drove $0.13 of the decline. Now turning to our Q4 adjusted segment performance. Keep in mind, segment-level EBITDA is pre-corporate allocation. In home health, revenue was $337 million, up $8 million or 2% compared to prior year. Revenue per episode was up $45 or 1.5%. The increase in revenue per episode is the result of 1.9% increase in reimbursement, partially offset by a change in our case mix. Our visits are down 0.3 visits per episode. Our implementation of Medalogix Care has led to a reduction of two visits since Q1 2020. Improvement in our revenue per episode and lower visits added 130 basis points to gross margin, but was offset by an increase in cost per visit, resulting in a gross margin decrease of 40 basis points. The increase in cost per visit was driven by planned wage increases, an increase in new hire pay, clinician bonuses, wage inflation, and health insurance. G&A increased approximately $4 million, mainly driven by raises, increases in care center administrative staff, travel and training, partially offset by lower incentive comp. Segment EBITDA was $63 million, with an EBITDA margin of 19%, which is down from 20% in 2020. Our 1.5% increase in revenue per episode and the decrease in visits per episode were not enough to overcome labor pressures. Sequentially, segment EBITDA was down $5 million on a seasonality-driven increase in health insurance of $3 million and an increase in cost per visit, which was driven by a full quarter of raises, new hire pay, and clinician training. Now turning to our hospice segment results. For the Q4, revenue was $205 million, up $1 million over prior year. Net revenue per day was up 5%, driven by a 2% hospice rate increase that went into effect October 1st, 2021, and reductions in our CAP liability. Hospice cost per day increased $8.78, primarily due to fixed costs associated with salaried employees on a lower census, planned raises, wage inflation, health insurance costs, higher utilization of contractors, and higher visits performed by hourly employees, as prior year was impacted by access restrictions due to COVID. As we've detailed in previous quarters, we have maintained our clinical staffing levels similar to prior year despite a year-over-year decline in census. EBITDA was $41 million, down approximately $12 million. G&A increased $6 million due to planned wage increases, additional business development resources, higher recruiting fees, and higher travel costs. Sequentially, admissions increased 4%, with ADC remaining relatively flat due to higher discharge rates, which is typical as Q4 historically has the highest discharge rates of the year. Segment EBITDA decreased $625,000 as the rate increase effective 10/1 and positive CAP adjustments were offset by a full quarter of annual raises as well as additional bonuses and raises to increase employee retention, higher contract utilization, and higher health insurance costs. Turning to our total general and administrative expenses. On an adjusted basis, total G&A was $183 million, or 32.8% of total revenue, up 120 basis points, mainly due to the Contessa acquisition, which added $6 million in additional G&A. The remaining $3 million of the year-over-year increase is due to raises, additional resources to support growth, higher travel and training spend, and higher health insurance costs, partially offset by lower incentive compensation costs. Excluding Contessa, our G&A as a percentage of revenue increased 20 basis points over prior year. Sequentially, G&A is up $7 million, of which $2 million is due to the addition of Contessa. The rest of the sequential increase is due to higher health insurance costs, an increase in staffing, primarily BD resources, and severance. For the quarter, we generated $5 million in cash flow from operations, which includes $27 million in repayment to deferred payroll taxes. For the year, we generated $189 million in cash flow from operations. Our net leverage ratio at the end of the quarter was 1.3x, inclusive of the funding of the Contessa acquisition. Turning to M&A. In November, we announced a new hospital at home JV partnership with Penn State Health. As Chris noted, we've been very pleased with the accelerated pace of incoming partnership requests at Contessa since we closed the deal. We also recently announced the signing of the Evolution Health deal, which will add 15 care centers to our Texas, Oklahoma, and Ohio footprint. Though Evolution is very much a turnaround, we're excited about the opportunity to increase our density and believe the longer-term growth and profitability outlook for the asset is compelling. Finally, just yesterday, we announced the signing of Assisted Care Home Health, adding two locations in the CON state of North Carolina. I am very pleased with our M&A efforts and excited about the opportunities within our pipeline. As you can see on page six of our supplemental slide deck, we're initiating our guidance ranges for 2022. As we've said, 2022 is very much a setup year for 2023. Our guidance ranges are as follows: adjusted revenue of $2.33 billion-$2.365 billion, adjusted EBITDA of $275 million-$285 million, and adjusted EPS of $5.23-$5.45 on an estimated 33.2 million shares outstanding. There are several key factors impacting our 2022 guidance outlined on slide 18 of our supplemental slides. These items include rate updates of 3.2% in home health and 2% in hospice, which are partially offset by the expiration of sequestration suspension. As a reminder, sequestration suspension remains at the full 2% for the Q1 and 1% for the Q2. The net impact of reimbursement is expected to be approximately a positive $25 million. Higher than normal wage increases as a result of increased labor cost pressures. Keep in mind, our H1 of 2022 results are impacted by raises given in August 2021. An incentive comp headwind of $16 million over 2021 as incentive compensation expense reflected our performing below plan targets. Continued incremental investments in the business of approximately $8 million, which includes $5 million in additional de novo spend, $3 million in investments focused on workforce optimization, automation, and the rollout of Medalogix Muse product in our hospice business. Our investments in Contessa will reduce EBITDA $17 million over prior year, which is $6 million higher than originally anticipated due to a significant ramp in business development opportunities and our desire to enter the palliative care at home business. The impact of COVID-19 on our volumes in January and February of 2022 was approximately $7 million. Due to an increase of clinicians on quarantine during the first part of the year, we had volume misses of 2,300 admits in research and home health, and misses of 200 admits in hospice. Though the number of clinicians on quarantine spiked with the rapid spread of Omicron, we have seen a significant decline in the number of clinicians on quarantine at this point. At our peak in mid-January, we had the highest percentage of clinicians on quarantine since the beginning of the pandemic at approximately 7%, whereas today the percentage is closer to 2%. Further, we continue to see some Medicare Advantage plans moving away from PDGM reimbursement to per visit arrangements through utilization of benefit managers. When this happens, there is a short-term reimbursement impact. That said, our M&A partners continue to recognize the value of home health for their members, and that is materializing itself in the openness to tie quality to outcomes. Though the 2022 impact will be between $10 million-$14 million, we will continue to mitigate this impact via our workforce optimization initiatives by leveraging, by delivering the best outcomes and utilizing the Medalogix suite of products. The combination of these initiatives and improvements in per visit reimbursement rates will result in better margin in this business than in recent past. Our effective tax rate assumption for 2021 is approximately 27%, with an estimated cash tax rate of approximately 19%. Though M&A is not contemplated in our 2022 guidance, we do expect to continue to acquire both home health and hospice assets this year, and we expect cash flow from operations to be between $180 million-$200 million. Some additional items to keep in mind related to our performance in Q4 2021 compared to Q1 of 2022. The first of these items are seasonality in nature. The impact of the ADC hospice decline, combined with two lesser calendar days, is estimated to impact revenues by approximately $4 million. The benefit of lower health costs related to seasonality of claims of approximately $10 million and an increase in payroll taxes of approximately $3 million. Some new items for 2022 are a $2 million sequential decrease in EBITDA due to Contessa, an increase of $5 million due to 2022 incentive compensation. Keep in mind, 2021 was impacted by performance coming in below plan metrics. This ends our prepared remarks. Operator, please open the line for questions. Thank you. At this time, we will be conducting a question-and-answer session. If you'd like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you'd like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. Please limit to one question and one follow-up. Our first question comes from the line of Brian Tanquilut with Jefferies. Please proceed with your question. Hey, good morning, guys. Good morning. Hey, Scott, really appreciate all the color you gave on the guidance. Just wanted to ask maybe for you and Chris, you know, how should we be thinking about your confidence in that guidance range? Maybe Chris, more directly to you know, as you take over the CEO spot coming up here, you know, what's your thinking on guidance philosophy and, you know, how are you thinking about your approach to the business, you know, being the new CEO? Any strategic things that we need to be thinking about as you step into the role? Yeah, I'll start and turn it over to Chris. Brian, I'm very confident in what we laid out there. Certainly, we wouldn't have, from a clarity perspective, not having, you know, January, which is our first full month view impacted by Omicron, that would have made our lives a little easier and everyone's lives a little easier. From a vision into the future, we feel good about it. We feel strong. We think we've left some room within our performance numbers that we laid out to outperform, which is what we always wanna do. You know, we've got the same pressures moving in. I think the biggest things to keep an eye on are hospice length of stay, which is the one item that's somewhat out of our control, and we'll be keeping an eye on. We've got a lot of plans out there. We've proven that when we laid out plans before and we can get in front of some things, we'll get great results. I feel very confident in it, Brian. Hey, Brian, it's Chris. Yeah, appreciate the question. You know, I've been part of doing, you know, giving guidance since we resumed guidance a few years back. You know, a lot of the same inputs are happening today that's happened over time. I think that, you know, given what we've experienced over the last two years with the pandemic particularly, and just how, you know, you can't predict everything, you know, we just spend a lot of time looking at all the inputs and handicapping those as we come up with kinda, you know, what we put out there as a number. Obviously, you know, wouldn't put anything out there I didn't feel confident that we were gonna be able to achieve and hopefully overachieve. I feel like, you know, that's what we're putting out for 2022. Again, handicapping some things like labor pressures, wage inflation, length of stay, as Scott mentioned, on the hospice side. In terms of financials, I think one thing around innovation that you're gonna see, and that is actually more of the same, but what we've been doing quietly over time is, you know, investing and partnering alongside other companies out there. Here in the back half of the year, sequestration suspension goes to zero. The opportunities are strong, the pipeline's strong. The M&A team is excellent. They've done a great job, and they'll continue to deliver. I think those things open up from a valuation perspective. You know, we're still kinda looking at and focusing on home health right now, kind of at 12x-14x valuation. We think through synergies and getting them through our operations, we're gonna get those at closer to a 10x at the year three marker. Feel great about it. I felt, you know, beginning of last year, I felt great, too. Things kinda slowed up a bit for all of us, but a lot of line of sight and inroads out there. It's a healthy pipeline, and I would think we're gonna get some more incomings in the back half of the year. Awesome. Paul, congrats on the upcoming retirement. Thanks. Appreciate it, Brian. Thanks. Our next question comes from the line of Matt Larew with William Blair. Please proceed with your question. Hey, Matt. I wanted to first ask about Contessa, and just wanted to sort of bridge the gap between, you know, I think just the revenue profile that's maybe a bit light on what you've been expecting versus some of the partnership activity and your commentary that is as bullish as you were anticipating. Maybe just help us understand that, and you know, you mentioned that staffing has been somewhat of a limiting issue. I'm curious sort of what the true demand has been in terms of- We've got some of those issues. I think it was probably over 300 admits that we probably missed the opportunity. I think that's one issue. The second issue on the revenue difference is that this hospital to home through the Medicare waiver program, we've gotten a lot of that business, and that's really the lower revenue kind of per episode, if you wanna use that label on it, than a typical risk-based. So, that's some of the differential, and yeah, our commentary is certainly more bullish than the top line number. We certainly have a lot of line of sight into what we think this thing can do and feel bullish about 2022. I'd say most of that is what I described is why revenue's a little off at this point. Matt, just, you know, as the team wanted to get me out of the office, they sent me on the road with Contessa, and I've been out with Travis Messina, CEO, calling on a bunch of clients. Just to reemphasize Scott's point, the appetite and the pipe there is quite extraordinary. I think we're very excited. I think the other exciting thing is the types of discussions have changed from pure hospital-at-home to other types of, you know, risk-based palliative, SNF at home, as well as potential partnerships, potential JVs. I couldn't be more excited about the choice we made with Contessa. Got it. A quick follow-up on that one. Just, Scott, you laid out sort of the EBIT impact for the year, but could you maybe give some sense for what the exit, EBIT, drag might be relative to, early on in the year? Yeah, I mean, that's not what I can do for you. I think somewhat around probably, you know, from a revenue perspective, I'd say that drops at about 25% in the H1, about 75% in the H2. We think the H2 EBITDA is probably about 40% of the drag for the year. You know, I think we're optimistic. Maybe we've got some things that can potentially change that. Right now, that's our view we wanna go with. Okay. Got it. Then just a question about hospice guidance at 13% same store. Clearly last year had the issues in terms of BD turnover and, you know, clearly have a bigger sales force now. But what is the level of confidence in terms of building up to that 13% number? And maybe what has the trend been like year to date that's probably helped you know, start to build towards that? Hey, Matt. You know, I feel very confident in the number that we put out. We brought 46 additional BD FTEs into this year versus last year. Turnover is trending in a good direction as well, which is suggesting that our reps are kinda growing into longer tenured buckets where productivity also increases as well. The productivity of our reps today is as expected, so no surprises there. I will say, Q1, the one impact in Q1 was really around the quarantines and Omicron really peaking in mid-January. We call out that we lost about maybe 200 hospice admissions in the quarter, which is kinda having an early impact. Since the quarantines have come down and Omicron has subsided, we've seen volumes come back up very nicely. I'm encouraged by, you know, kind of what we're gonna be able to produce from a hospice organic growth perspective this year. You know, the one caveat is that there's still a lot of unpredictability and inconsistency in the discharge median length of stay as well as discharge rates. You know, as that moves around, then that's having a little bit of a drag on the ADC growth. Hey, Matt, just a quick follow-up on Contessa and that missing revenue to not leave anything out. There was also an anticipated in 2021 acquisition deal that would get closed. It's a home health asset that was within that, and it's kinda just looking to use that deferral differently within the Contessa asset. It was supposed to close, got held up in regulatory issues, so that was part of the delay as well. We expect to get that closed this year. Okay. Thanks, everyone. Thanks, Matt. Our next question comes from the line of Justin Bowers with Deutsche Bank. Please proceed with your question. Hey, Justin. Hey, Paul, and good morning, everyone. Very apt choice of music. Congrats on the transition. It's been quite a run. Just a quick follow-up on Matt's question with Contessa. What's kind of the visibility in the revenue that you have kind of, I guess, in backlog or in the guidance for 2022? Just on hospice, I know that you know a lot of the discharge rate is out of your control, but has there been any shift or you know the way that you guys are attacking different referral sources? You know, have you seen any changes this quarter in terms of accessibility to some of the senior living and SNF referral sources? Yeah. Yeah, on upGrad, Contessa, I mean, we feel good about what's out there. I think there is some back-end loaded pieces. You can see we're on track, probably ahead of track, I would say, on the signing of JV deals, feel great about that. You can see, as I mentioned, we're front-loading some G&A costs to do that. I think the development that's changed, as always, when we looked at this asset, we wanted and had the opportunity to build off on a palliative asset as well, the palliative program. That's probably moving along faster than we thought, I think there's a potential upside in those numbers. We're working on some deals and hope to get those across the finish line, which could certainly help that number as well. That's something to look forward to, on Contessa. Yeah. Hey, Justin, on the hospice question, I'd say no, there's not really any, you know, notable shift in referral source or segment where patients are coming from, with the one exception is there is a direct correlation of a spike in the pandemic. Even when we saw Delta last fall, as well as we saw Omicron early this year, and hospitals' beds were full, we also saw a one or two percentage point tick up in our actual hospital referral volume or mix of our admissions. Then that would also drive down length of stay a little bit. But we've seen even as Omicron has kind of settled out, it's back down to normal. In terms of what we can do is, you know, we always are doing account optimization. We're looking to utilize claims data to identify where we're getting business from, where we're not getting business from, and where there's opportunities. We assign that to our reps to be able to go out and, you know, establish relationships and build upon that. There's probably gonna be more science around that, you know, related to just kind of the length of stay opportunities that are out there in terms of kind of our targeted accounts. The last question around facility access. It's pretty open for us now. We do have, you know. Again, I think that comes and goes with the pandemic, you know, kind of waves. Right now, we're seeing that we're not having access issues, you know, in our markets today. Got it. Appreciate the questions, and congrats, Chris. Thanks, Justin. Our next question comes from the line of A.J. Rice with Credit Suisse. Please proceed with your question. Hey, A.J. Best wishes, Paul, in the future. Let me just ask on the labor and benefit assumptions around 2022. I know in your slide deck, I think it's page 18, you have a 2%-3% assumption around salaries, and then it says 11% growth in benefits, and it looks like 8% of that is attributable to headcount. Is that headcount. Is there any reason to think that that's not also something we should think about on the wages, even if the apples to apples increase is 2%-3%, there's as much as an 8% increase in headcount that you're anticipating? Also on that 2%-3%, if you break that down, I'm assuming that's the consolidated number. Is it materially different in hospice versus home health? Yeah. I'd say not really the way we built that, A.J. You know, that's kinda what we said we're gonna get for our normal raise pipeline. There's other inflation embedded in there just from an exit rate perspective that's really not called out. There's also probably another $14-$15 million-ish that we've got in there kind of for bonus type retention payments that you're not really seeing. That's reflective in that number. I'd say it's across both lines. I'd say the hospice is a little different because you're seeing material increases in cost per day lines because of our lower ADC. We're down roughly 560 ADC year-over-year, and we have only 37 less commissions. As we said before, we've kept those staffing levels at a higher level, so you'll see that cost per day as that ADC expands, kinda correct itself, but still be up because of other inflation pressures. On the, I think the easiest way to think about, and there's a couple of ways, of course, to look at it, but on the cost per visit line, as we've got it modeled, we've got our model, and our cost per visit from 2021 to 2022 being up almost about 5%. That's gonna be reflective of everything going on. It's health insurance, what's happening around labor pressures. Also has contractors within that number, which we're expecting to pull that down. The overall inflation number, as you can see, would be much bigger. That's only half the story. The other half is our plans around what we're gonna do with VPE. We believe we can take those down. We think for every kind of a shift in a quarter of a point in visits, you're gonna offset about 2% inflation. As I've laid out those numbers and what's built in our expectations is a cost per episode increase of roughly 3%. You can see there's some offset planning, and we'll pull that back down, and that's on top of we're getting roughly a 3% rate increase year-over-year. That's kinda how I slice that up, A.J., if that's helpful. Yeah, that's great. Maybe just as a follow-up, ask about, you know, any latest thoughts on the discussions with CMS and Washington generally about PDGM, about what you're expecting for the rate proposal that'll come out in the summer for next year or any other initiatives that you're tracking closely. Yeah. We've got Dave Kemmerly, our resident Washington expert here, so. Yeah, AJ, thanks for your question. You know, as you know, last year in the proposed and final rule, CMS shared a methodology that if employed, would have resulted in additional cut for behavior changes under the new PDGM payment system. However, to its credit, CMS, they realized that COVID and the continuation of the PHE had an impact on the data, and that continued claims analysis was needed. I think since that time, we've seen multiple waves of COVID, come and go. We've seen the continuation of the PHE, significant workforce issues, continued growing demand, and lack of capacity for home health that one would think would necessitate further analysis without instituting additional cuts. CMS also stated, it was open to receiving input on additional methodologies and approaches to determining budget neutrality. With that being said, you know, our team and the industry are fully prepared and are preparing to respond to whatever CMS may put in the proposed rule this summer. But I would say this, I'd remind you that historically, proposed cuts are typically blunted to some appreciable degree in the final rules. Also a reminder that as we sit here today, we expect about a 3.35% market basket update in that rule. And that could increase because that market basket update is calculated also has Q3 and Q4 projected forecasted wage inflation in it. By the time the rule comes out, there should be some Q3 and Q4 2021 actual wage inflation in there. Expect a nice market basket update. We expect CMS to be very reasonable and reasoned in their approach to any particular, any additional behavioral cuts, if at all. Lastly, I'd say this, I mean, we will urge CMS and our friends in Congress that, you know, any PHE or COVID impacted year is not a good baseline year to determine anything. They should probably delay any changes until we have kind of a clean year. I think we'll spend a lot of effort on this. The industry collectively will spend a lot on it. Our peers are spending a lot on it. I think there'll be a lot of attention and a lot of very deep analysis. I feel confident on it, A.J., that there'll be, you know, still be a good outcome here. You heard it right here, A.J. CMS- Yeah. is gonna be reasonable. We're excited. Okay. All right. Thanks a lot. Our next question comes from the line of Sarah James with Barclays. Please proceed with your question. Hi, Sarah. Hi, and, congratulations on your retirement. Churn went up to Thank you. 21.5. The first three quarters of the year, it was 18.3. I'm wondering if this level is sustained so far in 2022. And then on the nurse churn, you guys broke that out for the full year, at 26.8%. I would like to get a sense of how it looked exiting the year or early in 2022. Thanks. Yeah. Hey, Sarah, it's Chris. For turnover for us, you know, throughout 2021, you know, we stated that we improved our nursing turnover 9%. We also, you know, discussed after our Q3 earnings call, you know, kind of the impact Delta was having on staffing as well as, you know, this migration to travel nurses and the rates that were being paid. We were, you know, we were a little bit of a victim of that as well. We had, you know, our nursing turnover in Q4 was in line with our expectations, but ticked up slightly in Q4 over Q3. Coming out of the gates this year is looking really strong for us, with just a couple of pockets in very specific geographies that we still are having some challenges, you know, to being able to stabilize around. A lot of that also is correlated to kind of the wave, the Omicron and the stress, you know, associated with us getting up to almost 7% of our clinicians on quarantine at one point in time in January. It was a lot of volume coming into those same markets, and I think that created a little bit of churn. Right now, I feel good that we will continue to drive down our nursing turnover. That's a big focus for us around clinical capacity and keeping our own is our best and most impactful lever for us to pull. You know, we're strong on culture and making sure that this is a good place to work. You know, we have a lot of it, you know, a lot of initiatives around that, a lot of focus around that, and I feel good that we'll drive down turnover even further this year. Great. Just a qualitative comment, Sarah, is that we find when there's high quality, which we are the highest quality out there, it correlates to lower turnover. The more we become a really good place for people to work and deliver excellent care, the more people wanna stay with us. It's also helped, as I mentioned in my comments on recruitment. Our recruitment has been fantastic, and a lot of that is because we stand so strongly for quality. Got it. Follow-up question on this is, as you think about the staffing constraint that you guys have talked about and the growth for Contessa expansion into palliative and SNF alternatives, how do you think about the areas of shortage compared to each other? Is this more of a limiting factor from personal caregivers, or is it still mainly the nurses and clinicians that are putting you in a position to turn away admits? It's nursing, nurses and clinicians. You know, on both the Contessa side as well as on the home health and hospice side, registered nurses are typically the ones that are initiating the care that we're providing. That's the gating factor of whether or not we can admit the patient is whether or not we have the clinical staff to be able to take care of them. It starts with having the nurse to be able to do the admission. You know, for us, that is why workforce optimization is critical. We need to also continue to focus on using lower licensed, skilled caregivers, you know, where appropriate, so that we can continue to expand the capacity of our nurses. On the Contessa side, you know, we find that the nurses are out there and in, and the shortage that we're looking at is not, you know, it's not huge, but it's really kind of, you know, educating the local market about this type of a job. It is acute care in the home, which is not very well known out there. I think that as hospital at home continues to grow in recognition out there, then I think we will find more critical care nurses wanting to migrate from the hospital setting where they're burned out to something that's still high acute care, you know, services, but in the home. I'm optimistic that we'll be able to catch up to the demand there. Yeah, let me just emphasize what Chris said. I think he's exactly right, and that's what we've seen in the marketplace. We've actually are looking for people who are getting quite burned out in hospitals, who have hospital skills to transfer and do that in a less intensive, difficult place in the home. So that once people hear that message, it's a very attractive message for the hospital type of nurses that we need to recruit to do hospital in the home and palliative in the home and SNF in the home. Thank you. Thanks. Appreciate it. Our next question comes from the line of Ben Hendrix with RBC Capital. Please proceed with your question. Hey, thanks, everybody. All right, Ben. Hey, how's it going? Congrats to Paul and Chris. All right. Thank you. Appreciate it. Just turning back to Justin's question with regard to hospice ADC, given that your admission volume, referral mix, and diagnosis mix are essentially in line with normal patterns, can you help us understand what's driving these late admissions to hospice care and the medium length of stay headwinds? I guess I'm trying to get my head around how that volatility normalizes and how that might play out in terms of timing. Thanks. Yeah. Thanks, Ben. I'll take that. This is Chris. You know, we think that the key driver here is just basically disruption in the normal kind of accessing healthcare. If you think about during the pandemic over the last 2.5 years, number one, you know, lockdowns happening, you know, throughout the country at multiple stages, waves of the pandemic coming on, access to doctor's offices going to virtual environment versus in-office environment, and people also having, you know, a fear of even getting out and going to the doctor. You know, what we feel like really is happening is, you know, people that are somewhat or, you know, potentially hospice appropriate are delaying getting just their typical checkups or diagnostic testing, and diseases are being kind of identified later in the process, which means they've had more impact on the patients. If you think about just the journey to hospice, it starts with kind of a diagnosis that would suggest, you know, life expectancy of six months or less. You know, people when they first get that news will typically aggressively try to fight that, you know, whatever means they can. Then at some point when they accept, you know, end of life care as their treatment, then they move on to hospice. We think that they're getting diagnosed later. We think that they're, you know, then trying to, you know, kind of, you know, fight whatever it is. Then at the time that they're coming onto hospice is they're just closer to passing than they have been in a normal, you know, kind of a normal environment. Prior to 2020, when the pandemic first began, it was relatively predictable. Your discharge rate and your median length of stay is pretty consistent based on, you know, your segment mix. What we've seen is it's just been. It's been pretty erratic, consistently erratic, if that's a phrase, you know, ever since then, and it continues so far in 2022. Thank you. Thank you. As a reminder, we ask that you please limit to one question and one follow-up. Our next question comes from the line of Joanna Gajuk with Bank of America. Please proceed with your question. Hey, Joanna. Yes. Hi, thanks. Hi, how are you? Yes. I guess one question. Great. On the front of the discussion on labor. You mentioned the pretty good hiring momentum is a 27% increase in recruit headcount. Do you have? I don't know, maybe you haven't said, but a net hiring number, in a sense, you know, just trying to assess how much you increased your clinical staff pool last year. Yeah, we don't. I don't have a net hiring count right in front of me, but Joanna, I'd be happy to kind of follow up with you and kind of get that out there. You know, we do know from our clinical capacity, we have expanded our clinical workforce throughout last year and rolling into this year, have seen positive momentum as well. We don't have it quantified to the number of actual clinicians, you know, net you know, new nurses or new clinicians, you know, less turnover. It's net positive. I just don't have the number. Yeah, I think in my comments, we talked about gross hiring increase of 27%. Yeah. On the net side, we're clearly in the positive area. Yeah. We don't have that number. I think also remember that what we've seen in certain cases is some of those folks that we've hired moving into PRN, and we're working very hard to, particularly with the connectRN tools and these other things, to really start to increase our efficiencies with the PRN pool, and utilizing new technologies and new techniques and new incentives. We keep at that top-line level, and we keep driving our turnover down. Obviously, we're gonna keep more and more people. All right. Thank you so much. I guess I'll yield to the next person who wants to ask a question because we only have a few minutes left. Thanks so much. Thank you, Joanna. Appreciate it. Our next question comes from the line of Matt Borsch with BMO Capital Markets. Please proceed with your question. Hey, Matt. Well, hey, how are you? Good. I'll start out by thanking Joanna too. Let me just ask a question. I know you've gotten a lot of versions of this. Looking at the constraints on clinical labor, if you project forward to a year or a year and a half from now, and let's assume we're really well past any variants of COVID, how do you think the labor force is gonna compare in a year and a half to what you had in 2018, 2019? How many residual headwinds do you think you'll still be dealing with and you know what things will you have done by then to offset them? Yeah, I think that's a great way to state the question, Matt. For us, I mean, this is all we're about, and this is what we're focused on, you know, day in and day out. We do feel like, you know, if you think out a year or two away, and assuming there's no really kinda, you know, new variants and things that are gonna be driving, you know, different types of demand, you know, we feel like this migration of the nurse to the traveling nurse role and the wages that they're able to get for doing that, I think that settles out. I think it's new and, you know, it's a new scene for these nurses, and I think they kinda like it, and they're getting paid very well. Obviously, that's related to the demand from the hospitals. You know, if that settles out to where there's less of that and less competition and nurses wanna get back to where they have a stable job and they know what they're gonna be expected to do and know where they're gonna be staying, you know, and living, I think that's gonna create, you know, better kinda stability for us. For us, you know, increasing our clinical capacity is on several fronts. It's one, making sure we're using our clinicians at the right level of their license. We have opportunities in hospice and still further opportunities in home health, where we're using registered nurses, and we could be appropriately using LPNs and LVNs that will create additional capacity for us. We're also seeing tools that are helping us get smarter with how we're using our clinicians. Medalogix Care was a, you know, a great one to point to in how it's helped us optimize our visits per episode, so that we're not providing unnecessary visits for the patients that are not any value add to the patients. We're now utilizing Medalogix Muse on the hospice side to get smarter with our clinical capacity there. What I think you'll see is you're gonna see better efficiencies within how you're utilizing your existing staff. I still think that it'll be challenging to hire enough and net enough new staff to fully meet the demand when you think about the demand that's moving into the home and what was accelerated with the pandemic. I think technology will also be utilized more in terms of you know providing virtual visits and telehealth visits and things like that to offset the you know lack of you know kind of access to nurses if that's appropriate. I think that there's gonna be consolidation within the industry also that's gonna allow those that are high quality, very stable, solvent providers out there to really start to amass, you know, clinicians, to be able to, you know, take more market share as well. I think it will be a shakeout, you know, within the industry. I think the ones that are, you know, really prepared for that and taking it serious, we've been working on this for two years. This is all we focus on right now in terms of, you know, when we think about our headwinds for the next five years. So those that solve for it, I think will be in good shape. I still think there'll be more demand than supply. Those that don't, I think are gonna be very, very challenged. A quick coda to Chris's very good response. We talked yesterday, Matt, about the McKinsey report, which, you know, again, if it's a quarter right, we'll take it, where, you know, the 25% of healthcare can be shifted into the home. You know, meaning it'll turn into a $270 billion industry or something like that. I think we believe that the demand is definitely gonna be there to drive care into the home, that it's gonna be increasing and that the game is gonna be how do we attract and retain and make as productive the people that can do these types of things in the home. We get it. We've seen it. We've been prepping for it for two, three years. I'd say we're way ahead of everyone else in terms of how we think about it. That's all. That's great. I'm good for now. Thank you. Thanks, Matt. Thanks, Matt. Our next question comes from the line of Andrew Mok with UBS. Please proceed with your question. Hi. Hi, and congrats again to Paul. Best wishes. You will be missed. Wanted to clarify a few comments in response to A.J.'s question on the salaries increasing only 2%-3%. For the $16 million of incentive comp in 2022, can you confirm that that's related to clinician bonuses? It was unclear to me whether that's included in the cost of service line or whether that's gonna be included in SWB in the G&A line. Yeah. The $16 million is not the clinician line. That's just on the G&A line. That's incentive comp plan reset for 2022. I think there's been some thoughts that maybe that's some catch up from 2021. It's not. It's just our new plan. We start accruing as if we're gonna achieve plan, which is at 100%. That's all G&A line. I think, and we could have laid this out better as I look at it now and understand some of the confusion. What we've laid out in our guidance t houghts are the 2%-3% is just general what we think in our wage raise pool. There's also numbers we put in for additional bonus retention that's just locked into our numbers that we're using to guide to the year. That's why I kinda went back to the example. If you look at our cost per visit, it's up roughly in our modeling about 5% over prior year, which is gonna include all the noise in cost per visit. That certainly would include the health going up. It would include contractor, which is gonna be roughly a plus 10% type, 10%-14% type of additional rate we're estimating this year. That's being reduced by the fact we believe we're gonna bring contractor utilization down. A lot of things going on in the episode, we can offset at least 2% of that for every 0.25 reduction in a visit. Got it. The retention bonuses are flowing through the cost of service line. Yes, they are. Yes. They're just not in what we laid out on that. Right. Got it. 2%. Okay. How we Just a quick follow-up on the investment in connectRN. It's only a $5 million investment so far. Is that an area of focus that you'd like to invest further? And what kind of impact or return are you expecting from that investment? Thanks. Yeah, Andrew, this is Nick. Doubt we'll make any more equity investments into that asset. But where we are going to invest is kind of our time and attention to help, you know, partner with them to develop a home health specific solution, and hospice specific solution. You know, historically, that company was born on, you know, servicing the staffing needs of the SNF industry. As they've looked to expand verticals, I think it was a very timely and very nice partnership. They've been wonderful partners as far as helping us think through how to gigify our, you know, home health and hospice workforce. So we're spending a lot of time developing that asset for kind of home health and hospice specific operations. Probably won't be any further equity investment in there. From a return perspective, you know, if you think about our PRN workforce, you know, that's relatively, from a visits perspective, relatively unproductive. If we're able to, you know, incentivize them and engage with our clinicians in a different way to give them kinda shift-based work or gig-based work, that really takes off a lot of pressure from, you know, the hiring and retention side of the house. These people are already trained, you know, on home care, home-based, you know, already onboarded, already credentialed. It can really be a nice lever to pull from a productivity perspective. You know, the ROI is on a $5 million investment, the ROI on getting an additional visit, you know, out of that PRN workforce is substantial. Yeah, just one last point. I know we're over, but this is, you know, and Nick's been leading this, so I give him lots of credit and as well as the team. The fact that we're making investments in people that are forging way out in front, forging new territory in areas that we know strategically are very important is really important for us as an organization culturally to always look ahead and partner with those change people out there so that we don't get surprised by it. We're part of the change, not acting and reacting to the change. I think that's something unique here. My guess is you're gonna see more of these. Thank you. Our next question comes from the line of Scott Fidel with Stephens. Please proceed with your question. Hey, Scott. Hey, everyone. Thanks. Echo the congrats to Paul and Chris. My question, just I'll try to package it into one, is, first, just, any guidance or thoughts just on the EBITDA split when thinking about the H1 versus the H2 in 2022. Then the follow-up part would just be, you know, on Contessa and, you know, I know it's early here in 2022, but just given the importance of modeling this in the out years, you know, any initial guideposts that you'd wanna give us just in how you're thinking about that revenue trending out, you know, into 2023 from that $56 million, you know, outlook that you've provided for us in 2022. Thanks. Thanks, Scott. You know, I'd say from a revenue perspective, you can certainly go back and look at our historical patterns. Unfortunately, they've been a little bit disrupted here in 2020 and 2021. You know, we're looking, I would say, somewhere in that 47%-48% load in the H1 of the year. From an EBITDA perspective, I think you're gonna see, as I had in my prepared comments, we got some pressure coming from Q4 to Q1, normal seasonality hit earlier than anticipated. You know, we're just talking right now. We think, and that's really around that palliative asset. We believe that's gonna expand earlier than we thought. More to come. DeWitt? All right. We're at the end. We saved the best for last. There you go. Thanks for holding on. No, I gotta get better at the star one thing. Can we just go back. There you go. Can we just go back for a second to the comments that you were making about MA? I think, Scott, you said that this year we're gonna see some of our plans transition from something that resembles PDGM to a per visit. You referenced this maybe being a short-term headwind. I'm just trying to understand really what's going on here. It sounded like you referenced something around maybe home health benefit managers. Can you sort of just unpack this a little bit and help us sort of understand it? I mean, I think there's a couple things going on. One is, you know, we've seen this. If you go back probably a couple years ago, we had a major player go from home CMS reimbursement down to a per-visit method. I think just systematically, I don't think a lot of them are big fans of it. We do still have some out there and some that are still gonna stay on that. I think as those historically move forward, you'll probably see a greater move to just paying us per visit. That's my commentary around that. The good news is the early indications of the if you go convert our PDGM-type revenue per visit to, from a PDGM revenue per episode to a revenue per visit number, we feel like some of the contracts we're negotiating are in a good ballpark going down to that. They're still not gonna be at 100% of the Medicare rate. That's a little differential there. The comment just around benefit managers is we see that, you talk about the different players out there as they use that puts really just more pressure on the utilization side of our services. If you think about from the per- visit, we're just selling per- visit as we go out there and send a clinician in. You know, that's not really anything new for us. We do that on the CMS side from reimbursement perspective on our Medicare business. That's not necessarily a bad thing as long as we like the rate, because that just means it frees up capacity to send somewhere else if we see that and can use that from a rate perspective to really manage that business a bit. Just something we have that we've known has been out in front of us, but feel good about where our Medicare, our managed care team is from negotiating rates, and they're gonna continue to push that. We think they see the quality aspects of our business. I think some of this labor tightness will help us from a leverage perspective. We'll continue to use that. I think that'll bridge us up to a nice 2023 as we get through the haircut from moving to a PDGM reimbursement to a per- visit. Yeah. A last comment. It's hard to drive utilization management when there's increasing scarcity of the asset you're trying to negotiate with. Again, when you have our quality and you have our ability to recruit and retain, you know, we think that increasingly that's gonna move more into leverage to the providers versus the conveners and the plans. Got it. Just one last follow-up on this is, as you look at your MA book today, that's what we wanna call it, how much is still PDGM-like reimbursement? How much is per- visit? Maybe where was it a year ago? Maybe you don't wanna guess as to where it's gonna go, but I guess I'm just trying to think about how that book has transitioned over time. Today, our PDGM-like book is 12.7% of our home health revenue, and per- visit is 19.1%. I don't have a year ago, but I would say it was probably closer to maybe, you know, probably closer to half, you know, split 50/50 between the two, and just moving more to the per- visit side. I think that over time, actually, I think you're gonna see new types of models come out of payment that may not fit squarely into either one of these buckets, things like case rate and things like that could, you know, be actually an opportunity for us to want to take more of that business and actually do it at a better margin than we're getting today. I think the catalyst is gonna be the labor pressure that the industry is facing that's not gonna go away anytime soon. It's gonna make it more and more challenging for these plans to get their members access to care in the home, which is gonna drive up their total cost of care. I think we're running into a spot here now where there's gonna be some leverage and some, you know, some genuine desire from both sides of the table to come to something that makes more sense. And, and- As we're thinking about this strategically, this is very interesting to us because we have Contessa, which takes risk. We are driving utilization management to a science with the Medalogix piece. We have high quality, so we know what sort of product we're delivering with incredible accuracy. We're clearly moving to a place where we can bet on ourselves. By doing that, we can go to the plans and say, "You don't need utilization management when we can do all that for you. Yeah. Just to be clear, so I don't confuse anybody because I use a different terminology, but if you look at page six on our slide, we got our revenue sources, and you can see what we're referring to, that PDGM-like reimbursement, we refer to as private episodic. Private payers that pay us episodic, and you can see the split on page six for those who wanna go back and take a look at it. Thank you. Ladies and gentlemen, we have reached the end of the question and answer session. I will now turn the call over to Chairman and CEO, Paul Kusserow, for closing remarks. All right. Thank you very much, Alex, and thanks to everyone who joined us on our call today. I would also like to again thank all our caregivers who delivered yet another great quarter and year of results. I'd finally like to thank all of you on the phone and the webcast for your interest in Amedisys. As this is my last earnings call as CEO, as I am moving to the role of Chairman, I'd just like to say how proud, honored, and humbled I am to have served and led this organization for the past seven and a half years. It's been a life-changing journey to serve our patients and employees. I believe the best time to transition leadership is when an organization has a clear idea of where it's going and a great strategy to get there, when it's at its peak strength, hitting on all cylinders, looking at problems and executing hard to make them opportunities. The team we have built is second to none and knows how to move our strategy to completion. I'm leaving you all in the very capable hands of Chris Gerard, who's one of the best operators I've ever seen. It is an exciting time to be at Amedisys. Care in the home is the right space. We're the highest quality asset, and I truly believe that the company we have built will lead, innovate, and change how healthcare is delivered in the future. As you can tell, I'm beyond excited to continue to watch this story play out, albeit I'll be cheering on everyone from the stands. Please take care. Thanks for taking this journey with us, and buckle up. The best is yet to come. Godspeed, Amedisys. Thank you. This concludes today's conference, and you may disconnect your lines at this time. Thank you for your participation, and have a wonderful day.