The company spent $450 million on capital expenditures in the first six months of 2024, including equipment, renovations, and new projects. The company expects to spend $400-$550 million more in the remainder of the year.

Behavioral health care facilities in the U.K. generated net revenues of $213 million and $190 million during the three-month periods ended June 30, 2024 and 2023, respectively.

A new Medicaid managed care directed payment program in Washington, D.C. could become effective for the period of October 1, 2024 through September 30, 2025, with potential subsequent annual programs. If approved in its current form, the company estimates its aggregate net benefit from this program will approximate $85 million.

On a Same Facility basis during the three-month period ended June 30, 2024, as compared to the comparable quarter of 2023, the increase to salaries, wages and benefits expense moderated to $20 million, or 2.3%. The company attributes this to a reduction in premium pay and a restructuring at certain acute care hospitals.

The company continues to manage its debt levels and capital structure, with total debt as a percentage of total capitalization at approximately 41% as of June 30, 2024.

The company receives substantial reimbursement from multiple states in connection with various supplemental Medicaid payment programs. The company has also been actively pursuing new programs to increase revenue.

A jury returned a verdict for compensatory damages of $60 million and punitive damages of $475 million against The Pavilion Behavioral Health System, an indirect subsidiary of the Company. If the resolution of the Pavilion matter exhausts all or a significant portion of the remaining commercial insurance coverage available, our future results of operations and capital resources could be materially adversely impacted.

The healthcare industry is labor intensive and salaries, wages and benefits are subject to inflationary pressures, as are supplies expense and other operating expenses. We cannot predict future inflationary increases, which if significant, could have a material unfavorable impact on our future results of operations.

The increase in interest rates during the past few years has increased our interest expense significantly increasing our expenses and reducing our free cash flow and our ability to access the capital markets on favorable terms.

The company faces competition from other healthcare providers in certain markets. Technological and pharmaceutical improvements that increase the cost of providing, or reduce the demand for healthcare.

The company's ability to attract and retain qualified personnel, nurses, physicians and other healthcare professionals and the impact on our labor and related expenses resulting from a shortage of nurses, physicians and other healthcare professionals.

If successful, future cyberattacks could have a material adverse effect on our business. Any costs that we incur as a result of a data security incident or breach, including costs to update our security protocols to mitigate such an incident or breach could be significant.

The company is implementing various productivity enhancement programs and cost reduction initiatives including team-based patient care initiatives designed to optimize the level of patient care services provided by licensed nurses/clinicians.

The company is working to reduce clinical variation in connection with the utilization of medical supplies, and; various other efforts to increase productivity and/or reduce costs including investments in new information technology applications.

Supplies expense increased $4 million, or 1.2%, during the second quarter of 2024, as compared to the comparable quarter of 2023. As a percentage of net revenues, supplies expense decreased to 15.8% during the three-month period ended June 30, 2024, as compared to 16.6% during the second quarter of 2023.

The company is investing in new information technology applications to increase productivity and/or reduce costs.

During the three-month period ended June 30, 2024, the company has repurchased 373,249 shares at an aggregate cost of approximately $70.0 million pursuant to the terms of our stock repurchase program.

During the quarter ended June 30, 2024, we declared and paid dividends of $.20 per share.

The company expects to spend approximately $850 million to $1 billion on capital expenditures which includes expenditures for capital equipment, construction of new facilities, and renovations and expansions at existing hospitals.

A member of our Board of Directors and member of the Executive Committee and Finance Committee is a partner in Norton Rose Fulbright US LLP, a law firm engaged by us for a variety of legal services.

We operate in a highly regulated and litigious industry which subjects us to various claims and lawsuits in the ordinary course of business as well as regulatory proceedings and government investigations.

The laws and regulations governing the healthcare industry are complex covering, among other things, government healthcare participation requirements, licensure, certification and accreditation, privacy of patient information, reimbursement for patient services as well as fraud and abuse compliance.

An increasing number of legislative initiatives have been passed into law that may result in major changes in the health care delivery system on a national or state level.