Risk Factors Update Summary

• Changes in federal and state healthcare regulations were added, impacting our ability to implement strategies.
• Uncertainty surrounding the implementation of new regulations and legislation may impact agreements and operations.
• Increase in the number of U.S. dialysis patients from 400 to 800.
• Potential changes in payment structures and regulations could affect our joint ventures and international operations.
• Proposed regulations limiting payments to dialysis providers could adversely affect financial condition and cash flow.
• Reduction in the credit agreement from up to $1.5 billion to $1 billion.
• Implementation of cost-saving initiatives is crucial to offset challenging conditions and maintain growth.
• Potential impact from increased union organizing activities on wages, benefits, and business disruptions.
• Transition from LIBOR to SOFR as the benchmark rate for borrowing.
• Increased labor costs due to ongoing labor market challenges and legislative changes may impact expenses.