In the fourth quarter of 2022, overall Chapter 11 distress remained essentially flat quarter-over-quarter and continued to trend well below both year-ago and historical benchmark levels. Real estate distress increased modestly from the prior quarter but remained significantly lower than long-term norms despite a slight uptick in filing share. Health care services distress declined sharply on both a quarterly and annual basis, moving closer to historical benchmarks as the share of health care filings continued to fall.