Before we begin, if you do not already have a copy, the fourth quarter earnings release, supplemental information, and related Form 8-K filed with the SEC are available on our website at encompasshealth.com. On page two of the supplemental information, you will find the safe harbor statements, which are also set forth in greater detail on the last page of the earnings release. During the call, we'll make forward-looking statements such as guidance and growth projections, which are subject to risks and uncertainties, many of which are beyond our control. You are cautioned not to place undue reliance on the estimates, projections, guidance, and other forward-looking information presented, which are based on current estimates of future events and speak only as of today.

Our 2025 revenue increased 10.5%, driven by 6% discharge growth and pricing growth, benefiting from patient mix and patient outcome quality. 2025 EBITDA grew 14.9% as we gained operating leverage and exercised disciplined expense management. Our full year discharge to community rate was 84.6%, discharge to acute care was 8.6%, and discharge to SNF rate was 6.1%. We will continue investing in capacity additions as the underlying growth in the target demographic remains at approximately 4%, and the demand-supply gap of licensed IRF beds continues to widen.

The presence of these models notwithstanding, with the exception of 2020, for obvious reasons, we have recorded positive total and same-store discharge growth every year. Regulatory change is a constant in our business, and we have a long track record of successfully adapting and continuing to grow as the underlying demand for IRF services continues to grow. Our expectation for continued growth is reflected in our initial 2026 guidance. I'll now turn it over to Doug to provide some additional details on Q4 and the specifics of our 2026 guidance.

What went well
  • Q4 revenue rose 9.9% to $1.5 billion and adjusted EBITDA increased 15.9% to $335.6 million (5.3% discharge growth, 4.1% higher net revenue per discharge).
  • Full-year 2025 revenue grew 10.5% (on 6% discharge growth) and adjusted EBITDA grew 14.9%.
  • Premium labor spend fell more than $21 million for the full year; Q4 premium labor of $23.8 million and contract labor at 1.1% of FTEs were the lowest since Q1 2021.
  • Q4 adjusted free cash flow rose 23.6% to $235.4 million, bringing the 2025 total to $818 million (+18.5%).
  • Added 517 beds in 2025 (390 via eight new hospitals, 127 via bed additions); four of the eight new hospitals contributed positive adjusted EBITDA in Q4.
  • Returned $158 million via buybacks and $71 million in dividends, ended the year at 1.9x net leverage, and extended/expanded the Palantir agreement; issued initial 2026 guidance of $6.365-6.465 billion revenue, $1.34-1.38 billion EBITDA, and $5.81-6.10 adjusted EPS.
What went wrong
  • Benefits expense per FTE rose 2.9% as the company anniversaried a prior-year increase in group medical claims.
  • Management flagged regulatory overhang from the extension of RCD into Texas and California and the new TEAM episodic-payment model beginning January 1, 2026 (89 hospitals in initial TEAM markets).
  • Net reopening and ramp-up costs were $2.9 million in Q4 and $13.9 million for the full year.

More on Encompass Health Corp

Reported 2026-02-06 · figures from the Encompass Health Corp Q4 2025 earnings call.

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