Started with our next presentation today. First off, thank you for joining us here in person. And for those of you who are joining us via webcast, my name is Joe Noyons. I'm with Three Part Advisors. Up next, we have one of our investor relations clients, U.S. Physical Therapy, traded on the New York Stock Exchange under the symbol USPH. U.S. Physical Therapy is a leading operator of PT clinics in the U.S., operating over 750 clinics in over 40 or in 43 states. And they're also a leading provider of industrial injury prevention. And with us today is the CFO, Carey Hendrickson.
Thanks, Joe.
Thank you. Good afternoon. I know I'm the first thing right after lunch, right? So, you know, it's a nice cold room, so we should be able to stay awake, I think. Definitely cold. I'm cold up here. Yeah, exactly. I know. Yeah. And shout out to Joe. Joe and Three Part Advisors do an excellent job for us. Joe just took me on a great trip to Boston to meet a whole bunch of new investors. And he just does a terrific job. So thank you, Joe, for that. And thanks to Three Part, for sure.
I am here today to talk about U.S. Physical Therapy. I'm the CFO. I've been with U.S. Physical Therapy since November of 2020, so four years, almost exactly just past the four-year mark. We have a management team that's been in place for a long time.
Our CEO, Chris Reading, has been the CEO since 2004. And he has really engineered this growth story of USPH through the years, through the past 20 years. We've grown significantly, both through acquisitions and de novos. We've also entered a new business in the industrial injury prevention business that was just a fledgling business when we bought and made our first acquisition in that in 2017. And now it's becoming a much more significant piece of our business. So we'll talk about that some of today as we go through the presentation.
Of course, disclaimers, forward-looking statements, all that stuff, right? This is kind of a nice snapshot of USPH. We have 752 clinics across the United States. They're in 43 states. I'll show you where those states are in a few minutes. We have a diversified payer mix on the PT side.
86% of our revenue comes from the physical therapy business, and then 14% from this other business that I'll talk about called industrial injury prevention services. So that's kind of who we are at the top level. We have attractive market dynamics that I'll talk about. And there's a lot of it's a very fragmented space. There's lots of room for consolidation in this space. And then we have a proven business model. I'll talk to you about that. The real key there is a partnership model that we have. And that's really what has made this company work so well for so many years. And then from a financial position, we have a very strong financial position. Our balance sheet, it's very clean. We have one $150 million term loan that we've amortized down to $142 million now.
We have $117 million of cash, so net debt of only $25 million. Our EBITDA guidance for this year is $80 million-$85 million. So it's like 0.3 leverage ratio. We did use some cash just last month, though, to pay for an acquisition in New York. So it's probably about 1.2 our leverage ratio now. And very, very manageable. And we're going to keep it that way. I mean, we'll make acquisitions, but we generate a lot of cash. So we're able to make a lot of the acquisitions with cash from operations generated, as well as using we'll use debt as we need to.
So we'll talk about a lot of that as we go forward. But here are the 752 clinics that we have in 43 states. You can see the three largest states for us. The two largest are Texas, which has 86, and Tennessee.
They're in the middle of the eastern side of the country. It has 86 as well. We also have a significant presence in Michigan with 55 clinics there. We have 44 clinics in Virginia, 40 in Oregon. We just made an acquisition at the end of last month, end of October in New York, and added 50 clinics in New York. That's the first time we entered into the state of New York.
We have a good presence across a number of states across the United States. It is a large and growing market opportunity. It's an addressable market of about $40 billion expected to be in 2025. It's a big market there. Favorable demographics. Look, everything is. It's a tailwind for us on the demographic side. We have an aging population. The more that you age, the more you need physical therapy.
And I'm living testament to that myself, needing physical therapy for my lower back earlier this year. We're a physically active population and obese population as well. And all those things lend itself to physical therapy. And we're going to have a nice growing demand into the foreseeable future for physical therapy. And then I'd also say there's healthcare delivery is shifting towards a lower cost, high quality providers, and that's physical therapy.
I mean, a lot of doctors recommend physical therapy to be done to avoid more costly surgeries and more difficult surgeries to recover from. And it's a very effective way to manage your illness and your injuries. And then consolidation is something that is naturally occurring because the operating environment is just a little more challenging for physical therapists today than it was five to 10 years ago. You've had Medicare rate reductions.
You've had increases in inflationary cost. It's a more regulated environment than it used to be. I mean, there's a lot of things like that that lend itself to scale and to being part of something that's larger and not being. It's more difficult to be out on your own. So it's certainly been a good aggregating space for us. The competitive landscape, as just mentioned, it's highly fragmented. There are more than 37,000 clinics across the United States. The largest player in the space is Select Medical.
They have 1,920 clinics. That's what, maybe 5% of the overall base. ATI is the other public player. They have 870, and we have 752 clinics. So the three of us combined have less than 10% of the overall market, and there's a few other larger private groups that are supported by PE firms, Confluent, Athletico.
There's a few of them out there that have a similar number of about 600, maybe 700 clinics or so. But altogether, even all the large guys together maybe have 20% of the space. So there's still a lot out there to be consolidated. And honestly, within this space, we're the only ones doing the consolidating. We're the only strategic player out there doing it because ATI, their strategy is more about de novos. And also, they're in a very precarious debt position.
So they don't have any capacity to do any acquisitions. Select Medical has just kind of had this 1,920 clinics forever. They're not really expanding. They're just running the clinics they have. They're not buying in the physical therapy space. And the other private guys in the space, they also have leverage concerns. So they're not out making acquisitions.
So we're really the only one that's consolidating in the space. And if, like for larger groups, where there may be 35, 40, 50 clinics that may be in an auction situation, it's us against PE firms. We're the only strategic in the space. And in that case, the owners always want to go with us. And so we have an edge in that regard. If they have PE money already in them, the PE guys may win those because they can pay more. But it's kind of a mix there. But it is a little more challenging in an auction situation at times.
Let me go first to this partnership model because I think this is key. And then I'll go back to the growth. I just wanted to talk about the partnership model because this is what's really made us successful.
If you look at the bottom set of bullets here talking about the strategic acquisitions structured as partnerships, we have a partnership model. And that really causes our interest to be aligned with our partners. We typically go in and buy 70%-80% of a partner group. And they keep ownership 20%-30%. The original founders do. And in that case, we pay them a multiple upfront, whatever that multiple is that we've determined is the right price for that group. We pay them a multiple of their EBITDA for that 70% portion. And so they still own 30%.
And we say, "We'll pay you the same multiple on the back end. So grow your business while you're with us, open de novos, make tuck-in acquisitions, grow your existing business so that that back-end payment can be as big as possible." So we're aligned on the back end and trying to grow for the long term. And then we're also making monthly cash distributions to those partners. So at the end of every month, we look at the cash in the bank account, and we split it 70/30. So they're incented for the short term and for the long term.
And that partnership model is what has really made this business hum for as long as it has. It's very different than the peers that I was talking about earlier. They typically own 100% of the clinics that they operate. And they have employees who are running those clinics. And it's just a different mindset.
Just a different mindset when you have partners who are so engaged and invested in the business. So let me go back and talk about our growth strategy then. We really encourage our partners to grow through de novos. And we typically have maybe 30 to 35 of those that start per year in de novos. And de novo is a new clinic.
It's just like a new box that you're opening up. And so different than some of the companies do, what most do is they have someone at corporate who's saying, "Hey, this looks like a good corner that needs some PT. It's a growing market. Let's start it there. And let's put an employee in place to kind of run this new clinic." All of our de novos are under the auspices of an existing partnership.
So it's someone who's already in the market, who already knows the market, who already has referral relationships established in that market. They just see an opportunity in a new area of town that's growing to expand. And so they start a new clinic in that area. And it's under the watchful eye of this partner, who again has a vested interest in both the long-term and the short-term success of this de novo. So it's someone feet on the ground, a watchful eye.
They've been grooming someone within their group to run that clinic. So all of our de novos, they just work. They all work. In other situations for de novos, you kind of have a lot of dry holes, some that work and some that don't. In ours, they all work because they're under the watchful eye of that partner.
And then we also encourage our partners to maximize their existing facilities, grow patient volumes, continue to reach out, and strengthen your referral base. And then on our side, we're working to improve their net rates. And let's just stop and talk a second about net rates while we're here. Net rate is really critical. We have had some challenges with net rate because CMS has given Medicare rate we've had Medicare rate cuts for four years in a row now.
And we'll have one more year, we think one more year in 2025. And so that has kind of caused for 2021 to 2022, our net rate went down a little bit. 2022 to 2023, it was kind of even. We really put a lot of effort against contract negotiations beginning at the end of, excuse me, at the end of 2022, first part of 2023.
And we've made a lot of progress in that. And so now we're really seeing the fruits of those efforts. In 2024, in the Q3 , our net rate was up 3.2% over the previous year. And if you exclude Medicare, it was up 4%. So we're seeing really nice increases now. And if we can keep that and get Medicare going the right direction, which, knock on wood, we believe that will be in 2026 when that will begin to go the right direction from a they will have reached the end of their cuts. They will have things balanced to where they want them. And then we'll begin to move in a positive direction forward.
That will be a really good inflection point for us and for the company, for net rates, and I think for our stock as well when we get on the other side of that. So that's kind of where we are from a net rate standpoint, seeing really good growth in that now. And we expect to continue to see that going forward. And then we're augmenting that growth through strategic acquisitions. I mentioned we just made an acquisition in New York last week. Acquisition strength. We've made more than 50 acquisitions since 2005. They range in size from three clinics to 52 clinics. The one last week in New York was 50 clinics that we added. It's an outstanding operation. They're primarily in Long Island.
And I like them not only for their contribution they have today, but for where they're going to go because they have a lot of growth expected in those markets. And they expect to continue to expand. They had five clinics in 2017, and they've grown to 50 clinics now in 2024. And they want to continue to grow at that kind of rate as they go forward. So that'll be a good grower for us, we expect. But acquisitions are something we just do. It's just a part of our DNA.
We make acquisitions every year. And you can expect us to continue to do that. We make acquisitions on both the physical therapy side and the industrial injury prevention side. We like both businesses very well. They have similar margins. Margins in the PT business are between 18% and 20%.
On the industrial injury prevention business, it's actually low 20s, like 22%-23% margins. So really good margins in both businesses. You'll see us expand in both. And then here's this example of the new clinics we've opened since November 1 of 2023. We've actually added 85 clinics since that point in time. And these are some of the brands and names of ones we've added since that time. Our revenue mix, I talked about how PT is 86% of our business. Industrial injury prevention is 14%. Within that 86%, that PT, we have a good diversified payer mix. 47% of our business comes from commercial payers. 33% is Medicare. 10% is workers' comp. 3% or so is Medicaid. And then 7% is other, which is basically self-pay and some auto insurance. It's kind of a long tail.
Like if there's an injury, an accident, then we get paid for the physical therapy associated with that. And then there are different rates that we get paid for these different segments. So the commercial segment, our overall rate in the Q3 , just for example, was $105.75 per visit. But commercial was about $104. Medicare, that 33% piece, was about $93. Workers' comp, which is that 10% pie, was $140. So we've been renegotiating rates and trying to get higher rates.
We've also been increasing workers' comp as a percent of our overall mix because of the high rate of that business. So it had dipped to about 9% of our business a couple of years ago. And now we've got it up to about 10.5% of our business. And that's meaningful because of the much higher rate of the workers' compensation business.
So we feel good about the progress we're making here. And it's a really nice mix. This is just an example of the real growth drivers for the physical therapy side of the business. Obviously, we're growing a number of clinics because of de novos, as well as acquisitions.
Our number of clinics are growing on an average CAGR of 4%. Our daily patient visits per clinic, which is the real kind of same-store measure of volume, has been growing at a CAGR of 3% over the last 10, 12 years. It's just consistent growth. The one dip you see there was the COVID year where we dipped down a little bit in that year and then bounced right back up. Actually, by September of 2020 in that year, we were back to normal volumes. So it's a very resilient business. And it's because physical therapy works.
It's very, very resilient. So then you can see the number of patient visits, as you would expect, has increased at a CAGR of about 7%. So it's a really nice volume story, really nice volume growth. And then we get the net rate growth on top of that. Our margins have declined some over the last couple of years. They were in the low 20s. And now they've been down near 20% the last couple of years. That's because of labor inflation. We have had some labor inflation. And that's something that we're addressing directly. And we've seen some improvement in margin. In the Q3 of 2024, our margin was 18.9%. And if you look back at the Q3 of 2023, it was 18.0%. So we've seen some improvement in that margin.
We just got that because we had 3.2% growth in our net rate in the third quarter of 2024, plus volume growth on top of that, which brought mature clinic growth to about 5.6% in revenue. Our total operating costs grew at 2.2%. Labor was up 3.5% on a per-visit basis. Our overall total operating costs were up 2.2%. We got some leverage. We're able to increase that margin in the Q3 of 2024 versus the Q3 of 2023. I think you'll see that continue as we go forward. That's certainly our expectation. Industrial injury prevention. Let me just tell you a little bit about what this business is. This is where we have someone on site at large manufacturers, at warehouses, that is providing consultative advice on safety and repetitive motion jobs.
We're making sure if someone has a repetitive motion job at a manufacturing client, they're doing that job in a way that won't get them injured. We also are walking around and making sure people are lifting properly. We provide safety seminars. We're walking the floor just to make sure people are doing their job in a safe manner.
And it's about a three-to-one return. It saves them on workers' compensation costs. So it's about a three-to-one return what it costs for our services versus what they save in workers' compensation costs. It's very effective. We have large clients, large Fortune 500 clients for the most part. We have large auto manufacturers like Toyota, Kia, Hyundai, Honda. We have Delta Air Lines, Hankook Tires. We have also big warehouses like Costco. We have someone at about 500 of the Costcos across the nation.
They want us to be at every single one. They have about 585 in the nation now. They want us to be at every one of those because it's such an effective use of their dollars, and their employees love it. Their employees like the fact that we're investing in them, that they're being invested in, and so it's positive for them too, and so this is a really good growing business for us. It's been growing organically. The top line has been growing between 12%-14% annually, and EBITDA is growing at that rate also, and kind of a mid-teens kind of organic growth rate year to year.
This is a great business, and we're also making acquisitions in that space, so if you looked at our Q3 this year, our organic growth rate was about 12% of revenue, about 13% in EBITDA.
But including the acquisition, it was about 30% growth in both revenue and EBITDA in the Q3 . So really, really good growth story here. And it's a really good business. It's a nice I like it also because it's diversification away from the payer reimbursement model. It's I'm not having to deal with Medicare and CMS and all those kinds of things. Although I think Dr. Oz is going to solve all the CMS problems. So we're good. Why not, right? Why not? But anyway, it's a really good business. And we're glad to have kind of added this back in. When we started this, got into this in 2017, it was maybe $5 million of revenue and $1 million of EBITDA. And today it's $90 million in revenue and about $20 million in EBITDA.
It's been a really nice grower for us, and we think it's going to continue to grow. It has really good margins too. You'll see we had a big increase in revenue from 2021 to 2022. That's because we made a significant acquisition at the end of 2021. That's where that growth came in the revenue. The two businesses were a little different. You see the margin that came down to it still. It was like in the mid-20s, and it came down to about 20%-21%, about 21%. That's the margin dynamics of the two separate engines that we have for this industrial injury prevention business were different. The one we bought had more auto manufacturers, and those margins tend to be lower. Their margin overall was about 16% or 17%.
So when you added that to the 25% margin that we had on the other piece of the business, it makes it about 21%. So that's why you see that margin decrease because really it's growing. It was 20.7% in 2022. You can see 21% in 2023. If you look in the box above there, you can see that a year-to-date gross margin is at 21.4%. So that margin is growing again in 2024. The margin in the Q3 , by the way, was 22.2%. So it keeps growing. Strong balance sheet. I talked about the balance sheet initially when we talked. It's very, very strong. At this point in time, this is through September 30, we had $117 million of cash. The acquisition of the New York acquisition we made, we used about $75 million of that cash.
That leaves us about what, $42 million or so of cash there left. We have about $25 million or $30 million of that that we keep for working capital. So maybe $15 million or $20 million left still for acquisition. We do have another acquisition we expect to close before the end of the year. That'll probably take a good chunk of that $15 million-$20 million. Next year, we'll be using our revolver. That rate is. It's a very good rate. It's SOFR plus about 185 basis points. It's still a good rate. We have great relationships with our banks, the ability to get cash whenever we need it. We're in a really good position from that regard. Acquisitions. That's what we're going to use the cash primarily for. Acquisitions. We do pay a dividend.
It's at an annual yield of $1.76, $1.76 that we pay out on that per share. It's like a between we try to keep that between 1.5% and 2% yield just to have a nice extra for investors, and we've grown that year each year, year over year since we instituted the dividend back in 2010 or so, so that's great. We're also going to allocate to de novos, like I said, but de novos do not require much capital. De novos for us, it costs somewhere around $150,000 to start up a new operation.
They just need some equipment inside and then leasehold improvements, so there's not a lot of expenditure there. But if you say you're going to do 30 of those a year and you've got $250,000, that's what, $6 million I mean, $125,000, $150,000, it's maybe $6 million we spend a year on de novos.
So not a big expenditure there. And we generate a lot more cash than that. So that's kind of an overview of the company. This is the executive team. As I talked about, Chris Reading has been our CEO since 2004. I've been there since 2020. The rest of the team has been there quite some time, Eric, Graham, and Rick. They've been in the PT business for a number of years and have known Chris and/or worked with him at other places in their past lives. And just a dynamic team to work with. I enjoy working with them every day. And they do a great job. And they know the business really, really well. So it's a good, stable, steady management team as well. And so that's it. That's a summary.
This is a summary of our investment highlights. We've talked about it. We're publicly traded pure-play PT.
There's only two places you can get that. One is with us and one is with ATI. I would advise you to steer toward us on that. Let me just say that. I'd advise you to steer toward us in that equation. We have a proven business model, significant scale with a national footprint, large and growing demographics, very favorable demographics as we go forward, strong cash flow, strong balance sheet, and attractive dividend yield. So that's who we are in a nutshell. I appreciate your time and listening today. I'll open the floor. If anybody has any questions, I'm happy to answer them. Yes, sir. The trend in reimbursement. So I talked about this a little bit, but let's take Medicare out of the equation, and then I'll talk about Medicare.
But we've had really so at the beginning of 2022, we took a different approach to our contracting group. Honestly, it started reporting to me then, and I just said, "Our time to just take a fresh look," right? And so we take a fresh look. We didn't have the proper resources allocated to contracting and credentialing. And they were spending a lot of their time because we do so many acquisitions. And each acquisition, you have to bring all those contracts over from the old company onto our new company.
And so there's a lot of negotiation, a lot of that has to happen in that space. And they were spending so much time on acquisitions, they didn't have enough time to be really working on the large payers that we needed them to be putting the effort against from a contracting standpoint.
So we kind of reallocated resources, have some dedicated resources that just work on acquisitions. And then we have our real big heavy hitters who are great at contract negotiation, working on all of our large contracts all the time. And so we've seen really good progress. Since that time, we've been seeing increases of 3%-5% per quarter, year over year in our payer reimbursement rates, absent Medicare. And with Medicare, like in the Q2 and Q3 , there were pretty similar results.
We had about 3.2% growth in everything, including Medicare, about 4% growth in reimbursement rates, excluding Medicare. We have Medicare. I think I talked about this during the presentation, but I've talked about a lot of stuff today in different meetings. But we've had four years of Medicare rate reductions. We think we have one more in 2025.
And then after that, we believe they'll return to normal historical patterns, which has been a small increase year to year in Medicare. And if we can get there with the other work that we've done on the contracting side, I think we're going to be in a really, really good place. Yeah. Yes.
Could you say more about the valuation?
Sure. Yeah. So the multiples haven't changed much over the past few years. It depends on the size of the clinic group and some of the operating model dynamics of the particular acquisitions. But usually, we pay between 6x and 9x EBITDA for those acquisitions. The one we just did in New York had 50 clinics. So it was a much larger group than we normally buy. And it had a very different growth profile. So we paid more for that.
We actually paid 12.75 x EBITDA for that group, but I do a very rigorous discounted cash flow model on every single one of our acquisitions. Our weighted average cost of capital is about 9%, and I expect at least something like a mid-teens growth internal rate of return on our acquisitions because I definitely want that spread to be pretty sizable. Because of the growth profile of the acquisition, it made it where the 12.75 x was very reasonable for the asset that we're buying. As I mentioned, they've been growing at a rapid rate. We expect them to continue to grow at that, and a lot of times, you get a CIM from an acquisition candidate, and they've been, their EBITDA has been down, down, down, down. Then all of a sudden, it goes like this.
When they're going to and they think, "Oh, yeah, there's oh, yeah, sure. Now that we're going to get you guys are going to take us over, we're going to grow like crazy." Well, this one has a trend line that was already like this, and so we could project forward, yes, we think that trend line will continue. So we feel really good about the growth there. Love the team, fantastic management team that has proven they can do it. So we're really excited about that opportunity. Yes, sir.
Can you comment a little further on your industrial injury prevention business, how attractive it is?
Yeah.
Well, let's say automation limits your [audio-distortion]
Yeah. Yeah. I think in some, I mean, maybe on certain manufacturing clients, there could be some where automation would affect it.
When I think about Costco, I don't think that's going to be the case, and clients like Costco. But I understand the question. But I would say this, there's still a lot of business out there. I mean, there's an enormous potential with this group and unreached, untapped potential right now within this. So I think there's plenty of room for continued expansion and growth in that industrial injury prevention business. I really do. I think so. Than the potential. That's right. I think so. Yes. Yes, sir.
[aud io-distortion]
Yeah. Well, there's nothing with Medicare that's complete. CMS doesn't. We have no say in it whatsoever. So there's no leverage there.
The reason why I have confidence in them to stop in 2025 is because back when they initially as we went into 2021, and they were going to make all of the cuts at one time, they were going to reduce. So what happened was back in that timeframe, primary care physicians were no longer taking Medicare patients. And so in order for them to take Medicare patients, CMS had to pay primary care physicians more. So they wanted to increase primary care physicians actually by 14%. And in order to do that, they're on the Physician Fee Schedule with us.
Any doctor that you go into see in an office setting is on this Physician Fee Schedule. And that Physician Fee Schedule, the dollars in that bucket for physician fees only changes a small percentage from year to year, maybe 1% or 1% - 2% in that bucket.
So that bucket is just moving like this. So when you want to make a 14% increase to primary care physicians, you got to cut everybody else in order to make that happen. So that was what they wanted to do initially. And our cut was supposed to be 9%. We were supposed to receive a 9% reduction. Congress came in and said, "You can't do that all at once like that." So we've been taking this cut over the course of a few years. After the reduction in 2025, we'll be a little bit north of that 9%. So that's why we feel like this is the end of it because we will have reached the rebalancing stage, that rebalancing point where they wanted to be initially when they did this when they did the reduction.
So we feel pretty confident that when we get to 2025, after that, things are going to return to normal. That's what gives me confidence here. Yes, sir.
Do you have any statistics on [audio distortion]
In what regard? And our volume in our clinics and.
[audio distortion] 8:00 A.M. to 5:00 P.M., 40 hours a week. [audio distortion] whatever you call them. So that's 400 hours. Of those 400 hours, potential hours, how many of them are you booked?
Yeah. We're [audio distortion] . So we have a really tight scheduling matrix that we use. And we have to use it's with physical therapists, physical therapy assistants, and techs.
And we are trying to balance the work out between them all to make sure we get maximum payment and that we use them efficiently throughout that whole time because PTAs get paid less for Medicare than PTs do. They get paid about 15% less. We get paid 15% less if they do it. So you got to balance all of that out on your scheduling. And we run really high capacity. We want our clinicians to see between 11 and 12 patients per day. And those that aren't at that level, those are the ones where we've got the excess utilization that we can increase. And we're working with them to get them up to that level of 11 to 12.
11 to 12 is a good number where they are seeing they're busy and they're seeing a lot of patients in a day, but it doesn't lead to burnout. You also don't want them to burn out and leave the industry or go someplace else where they don't have to work quite so hard. So it's a balance there. I would say our volume, which is somewhere around 30 visits per clinic per day, with the existing staff we have is towards the upper ends of that limit. I think we could go a little higher than that if we just had the same group of employees we have today. We could go a little north of 31, maybe even to 32 if it was fully 100% utilized capacity. But beyond that, we're going to need to add new clinicians.
We're going to have to add clinicians to grow that volume even greater than that. That's what we're working hard at is adding clinicians. Some of the problems that some of our competitors have had and one of the public peers I just spoke about that's having significant issues, you have to look at those situations and begin conversations with some of the PTs at those places and encourage them to perhaps come to a place that's a little more stable. I'm trying to be nice in my comment there. For us, it's not. It's not. It's not. Our attrition rate is about 20%. It's about that would say, on average, someone stays with us five years. Obviously, some stay with us a lot longer than that.
And then we have some younger people who may just be there a year or two and then move to the next opportunity. When they're younger, they move around a little bit more. The industry average is 30%, and we're at about 20%. So we do a good job of keeping employees. But it has, over the last couple of years, taken us a little bit longer to replace the employees when we use them because it's a pretty tight market for PTs. So I think my time's up. Thank you all so much for your attention today and for your questions. I really appreciate it. Have a good afternoon.