A.J. Rice : Okay. All right. And maybe just a follow-up, I’ll take a stab at this one. I know you’re not going to give formal ’24 guidance until you report fourth quarter or at least around the first of the year. But you talked about labor inflation moderating some of the things around volume and de novos, what, in your mind, are the puts and takes we should keep in mind as we’re trying to develop forecast in any areas of particular variability, as you sit right now and think about next year?
Doug Coltharp: I think you’ve hit on the keys, which is, one, we look at volume growth heading into next year. Obviously, we’ll be up against challenging comps given the good discharge growth we’ve had this year. But we’re going to benefit from the continued maturation of 25 de novos that were added from 21 through the end of ’23 and the addition of 150 beds to existing hospitals. And we do anticipate that moderating labor inflation will occur as we anniversary the 6% increase in SW, FTE, we’re anticipating for ’23. Those are going to be the primary drivers.
Operator: We’ll take our next question from Brian Tanquilut with Jefferies.
Brian Tanquilut : Congrats on the quarter. Doug, I guess my first question, as I think about your revised guidance for the year and what you’ve reported so far in the first 3 quarters. The Q4 kind of like is a little different from typical seasonality in terms of contribution to the year. So just curious, is there anything we should be thinking about in terms of what that like sequential decline or flattening that imply on the guide for Q4.
Doug Coltharp: Yes. So as we move into Q4, we’re obviously benefiting from the price increase, not surprisingly because we have really kind of established normalized seasonal flows. We would expect discharges from Q3 to Q4 to be kind of relatively flat in that range. So you’re not getting a pickup there sequentially. You’re consuming a pretty good chunk of the pricing increase, the merit increase, which was a little over 3%. And then we’re also anticipating that you’ll see somewhat of an increase, which is not atypical. It was a little bit of an anomaly in Q4 last year and the length of stay. And then just kind of some regular way increases in supplies and OOE, some of which is attributable to seasonality. So not a lot to call out there. And again, it’s — you had a very strong Q3. So it’s not surprising that we’re kind of calling the ball here for Q4.
Brian Tanquilut : Okay. That makes sense. And then, Mark, maybe as I think about your comments in the release on — or in the slide deck on pricing on the commercial side. How should we be thinking about commercial price trend — share price strategy we look at 2024?
Mark Tarr: We continue to work on payers, as we’ve done in past quarters with the MA contract negotiations we’ve had. As we move more contracts towards CMG, you’re starting to see less of the differential between the fee-for-service Medicare and MA plans. I think it was down to 3% or 4% differential this last quarter. So we continue to make progress there. And I think you expect to see that going forward.
Doug Coltharp: Yes, Brian, the other thing you got to call out as you think about the movement from Q3 to Q4 is the impact of the 2023 de novos. As we discussed in our comments earlier, we had a really strong quarter in Q3 where those actually contributed $900,000 in EBITDA. But we’re still anticipating that the preopening and ramp-up costs for the full year will be in that $10 million to $12 million range, which implies a $3.5 million to $5.5 million, swing the other way in Q4.
Operator: [Operator Instructions] Our next question comes from Pito Chickering with Deutsche Bank.
Kieran Ryan : You’ve got Kieran Ryan on for Pito. You mentioned that the hip and knee patients continue to present at a pretty good rate in 3Q, and I know you called out some strong ortho demand in the second quarter. So I guess, just could you just comment on if that strength in ortho continued into 3Q, and if there’s any other specialties you want to call out, whether that’s neuro stroke or anything like that?
Mark Tarr: We continue to see growth in our stroke program. I think as I noted in my comments around the orthopedic, we’re just kind of getting back to normalized flow that we had seen prior to the pandemic. So it’s not an area that is growing off of a very large base, but we have placed a huge focus over the past several years in growing our stroke program. We’ve seen nice gains on that. We’ve seen nice gains and other neuro and continue to focus on those categories.
Doug Coltharp: Again, these are some smaller categories, but brain injury was up 8.6%. Cardiac was up 2.4%, so a little bit lower there. Major multiple trauma up 10.4%. This was a quarter again, and we discussed this more in Q2, where the strength of our discharge growth was across patient categories and across — very broad-based across geographies as well, which is encouraging to us.
Kieran Ryan : Awesome. And then just a quick follow-up. Would you be able to give an update on our turnover. I think you were running at 22% year-to-date after 2Q. It sounded like maybe a little bit more sequential improvement there or…
Mark Tarr: Our most recent quarter and most recent trend on a month basis — that 22%, 23% turnover rate continued what we have seen progress on. We’ve put a lot of focus on is the turnover within 1 year of hiring of the RMs, and that’s an area that we knew we could see improvement on. We’ve seen improvement on that. We’ve put a lot of focus on the orientation and onboarding of our nurses, which we think will help us longer term and continuing to hold or decrease that turnover rate.
Doug Coltharp: It’s important to note as well, we tend to focus on the nursing, but our therapist turnover on a year-to-date basis at the end of the third quarter was less than 8%.
Operator: Our next question will come from Matt Larew with William Blair.
Matt Larew : A follow-up a bit on the patient mix question, but obviously, it was another strong quarter on the MA side, as it has been really for the last several quarters in particular. And so similar to Kieran’s question, any particular patient categories or already trends to call out on the MA side?
Doug Coltharp: No. So if we look in aggregate at MA, for the quarter, total MA discharges were up approximately 13%. That takes us to just other — under 18% on a year-to-date basis. And importantly, when you look in the same store for MA, it was 11% for Q3 and just under 15% on a year-to-date basis, continue to see very good growth in MA for stroke patients, but 1 of the things that we’ve highlighted with regard to this overall discharge growth in MA is our value proposition now seems to be resonating with those MA plans across the broader patient spectrum. So we’re seeing the broadening of the acuity there as well.
Matt Larew : Okay. And then just a follow-up on the hospital that you pulled forward from [24% to 23%]. What really allowed you to accelerate that opening process? Is this related to the prefabrication that you’ve been doing? Or is this more of a licensing or staffing issue? And depending on what it is, can you apply this to the extensive pipeline you have in place right now?
