Question-and-Answer Session
Operator
Thank you. (Operator Instructions). And we'll go first to Bill Bonello at Wachovia.
Bill Bonello - Wachovia
Good morning, guys. Just a couple of follow-up questions. On the Q1 guidance how that you've been impact are the losses at the new hospitals?
Rich Lechleiter
Hey, Bill good morning this is Rich. As you know we opened up some hospitals late in '06, and we opened four in 2007, and put the [India] replacement in place at the end of the year. The EBITDAR drag in Q1 is about $2 million or $3 million. And one of the things we're excited about in terms of looking forward at the end of the year particularly is the turnaround or the flip as those things start to mature and reach there potential, particularly with respect to commercial admissions and start to actually contribute to the EBITDAR growth, probably starting in the Q4.
Bill Bonello - Wachovia
Okay. And as you think about that, is that sort of turnaround time based on what prior experience with other new hospitals you've opened?
Paul Diaz
Yeah. Bill just to add a little more color. Depending on when a hospital opens, it can take 12 to 18 to 24 months before we sort of hit stride. We've opened six new hospitals in the last 14 months, and so to Rich's point, we've got a great track record performance in our hospital development over the years and we are very excited about the opportunities later this year and going into next year as these hospitals grow and stabilize. But there could be great variability which is what you see and towards the Q1 guidance in terms of how those hospitals might or might not hit stride.
Bill Bonello - Wachovia
Sure, okay. And then just a second question about Q1. The prior period adjustments that you recognized, how does that happen? I mean it sounds like you went through the year, you recognized prior period adjustments, a huge amount in 2007, then you reset the bar at Q1, how do those actually get realized? Why we sort of start over at the beginning of the year as opposed to the actuaries being able to say, well based on what we have seen over the last six months, here's how we adjust our estimate.
Rich Lechleiter
Hey Bill, let me take a shot at that. As most of you know we go through an full actuarial process using two different firms each quarter to try to deal with the issues that I think you are talking about. Let me give you an example of kind of how the numbers roll by quarter in terms of this process.
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