DALLAS--(BUSINESS WIRE)--Tenet Healthcare Corporation (NYSE:THC) reported Adjusted EBITDA of $613
million for the fourth quarter of 2015, a decrease of $33 million, or
5.1 percent, compared to $646 million in the fourth quarter of 2014.
After normalizing for timing differences related to the California
Provider Fee program, Adjusted EBITDA increased $91 million or 17.4
percent.
“We delivered Adjusted EBITDA at the midpoint of our Outlook for the
fourth quarter and are on a path to deliver strong growth in Adjusted
EBITDA and improved Adjusted Free Cash Flow in 2016,” said Trevor
Fetter, chairman and chief executive officer. “Similar to our results in
the third quarter, we experienced pressure on lower acuity inpatient
hospital admissions and continued to drive increases in higher-acuity
admissions. Our Conifer Health Solutions and United Surgical Partners
subsidiaries performed well, with Conifer meeting our expectations and
USPI delivering stronger-than-expected results in the fourth quarter.”
Hospital Operations and Other Segment
Results for the fourth quarter of 2015 were impacted by the timing of
revenue related to the California Provider Fee program as discussed
further below.
During the fourth quarter of 2015, net operating revenue in the hospital
operations and other segment increased 5.0 percent to $4.423 billion, up
from $4.213 billion in the fourth quarter of 2014. On a same-hospital
basis, net patient revenue increased 0.7 percent to $3.992 billion, up
from $3.966 billion in the fourth quarter of 2014. The increase was
driven by a 0.3 percent increase in adjusted patient admissions and a
0.3 percent increase in net patient revenue per adjusted admission.
The increases in both same-hospital revenue and same-hospital revenue
per adjusted admission in the fourth quarter of 2015 were negatively
impacted by timing differences related to the California Provider Fee
program. On a same-hospital basis, during both calendar year 2014 and
the fourth quarter of 2014, the hospital segment recorded $150 million
of revenue related to the California Provider Fee program, of which
approximately $112 million was related to the first nine months of 2014
since the program was not approved until the fourth quarter of 2014.
During 2015, Tenet recorded $166 million of revenue related to the
California Provider Fee program on a same-hospital basis, including $42
million in the fourth quarter of 2015. After adjusting for the
approximately $112 million of out-of-period revenue related to the
California Provider Fee program in the fourth quarter of 2014,
same-hospital net patient revenue per adjusted admission increased 3.2
percent in the fourth quarter of 2015.
During 2015, net operating revenue in the hospital operations and other
segment increased 8.0 percent to $16.928 billion, up from $15.681
billion in 2014. On a same-hospital basis, net patient revenue increased
5.5 percent to $15.709 billion, up from $14.886 billion in 2014. The
increase was driven by a 2.4 percent increase in adjusted patient
admissions and a 3.1 percent increase in net patient revenue per
adjusted admission.
Fourth quarter Adjusted EBITDA in Tenet’s hospital segment was $394
million, representing a decline of 28.8 percent as compared to $553
million in the fourth quarter of 2014. During both calendar year 2014
and the fourth quarter of 2014, the hospital segment recorded $165
million of revenue related to the California Provider Fee program, of
which, $124 million was related to the first nine months of 2014 since
the program was not approved until the fourth quarter of 2014. During
calendar year 2015 and the fourth quarter of 2015, the hospital segment
recorded $188 million and $49 million, respectively, of revenue related
to the California Provider Fee program. After adjusting for timing
differences related to the California Provider Fee, Adjusted EBITDA in
the hospital segment during the fourth quarter of 2015 decreased 8.2
percent to $394 million.
During 2015, Adjusted EBITDA in the hospital segment increased 0.1
percent to $1.653 billion, up from $1.651 billion in 2014.
Total hospital selected operating expenses, defined as the sum of
salaries, wages and benefits, supplies and other operating expenses,
increased 1.4 percent per adjusted admission in the quarter. The company
continued to deliver improvements in contract labor expense, with a 9.4
percent decline in same hospital contract labor per adjusted admission
in the fourth quarter.
Medicaid and Exchanges
Uninsured plus charity admissions declined by 187 admissions, or 1.8
percent on a same hospital basis in the fourth quarter of 2015. Medicaid
admissions decreased by 703 admissions, or 1.3 percent in the fourth
quarter. Same-hospital uninsured plus charity outpatient visits declined
by 5,135 visits, or 3.2 percent, and Medicaid outpatient visits
increased by 4,105 visits, or 0.7 percent in the fourth quarter.
In Tenet’s six Medicaid expansion states, same-hospital uninsured plus
charity admissions declined by 187 admissions, or 11.1 percent, and
Medicaid admissions increased by 287 admissions, or 1.0 percent in the
fourth quarter of 2015. Uninsured plus charity outpatient visits
decreased by 1,615 visits, or 3.5 percent, and Medicaid outpatient
visits grew by 2,946 visits, or 0.8 percent in the fourth quarter. The
six states are comprised of five states that expanded Medicaid in 2014
(Arizona, California, Illinois, Massachusetts and Michigan) and one
state that expanded Medicaid in 2015 (Pennsylvania).
Tenet’s same-hospital exchange admissions were 4,734 in the fourth
quarter of 2015, up 27.0 percent from the fourth quarter of 2014.
Same-hospital exchange outpatient visits were 44,616 in the fourth
quarter of 2015, up 45.6 percent from the fourth quarter of 2014.
Uncompensated Care
Tenet’s bad debt expense ratio was 7.2 percent of revenues before bad
debt in the fourth quarter of 2015, down from 7.4 percent in the fourth
quarter of 2014. Including $1.029 billion and $920 million of charity
care write-offs and uninsured discounts that were offered through
Tenet’s Compact with Uninsured Patients in the fourth quarters of 2015
and 2014, respectively, Tenet’s uncompensated care was $1.420 billion
and $1.275 billion, respectively, in these periods. As a percentage of
adjusted revenue, uncompensated care represented 22.0 percent of
adjusted revenue in the fourth quarter of 2015, down from 22.2 percent
in the fourth quarter of 2014. Nearly all of Tenet’s uncompensated care
is associated with the hospital segment.
Ambulatory Segment
The results of many of the facilities in which the Ambulatory segment
has an investment are not consolidated by Tenet or USPI. To help analyze
results of operations, management uses system-wide measures which
include revenues and cases of both consolidated and unconsolidated
facilities. Tenet’s acquisition of a majority interest in USPI and all
of Aspen on June 16, 2015 makes the year-over-year comparisons less
meaningful. In order to improve comparability, Tenet is presenting the
results for the ambulatory segment on a pro forma basis, including the
results of USPI and Aspen in each comparable period.
During the fourth quarter of 2015, on a pro forma basis, the ambulatory
segment delivered net operating revenue of $397 million, representing an
increase of 28.9 percent as compared to $308 million in the fourth
quarter of 2014. During 2015, on a pro forma basis, the ambulatory
segment delivered net operating revenue of $1.343 billion, representing
an increase of 17.8 percent as compared to $1.140 billion of revenue in
2014.
On a pro forma same-facility system-wide basis in the fourth quarter of
2015, revenue in the ambulatory segment increased 12.5 percent, with
cases increasing 6.9 percent and revenue per case increasing 5.2 percent.
During the fourth quarter of 2015, on a pro forma basis, Tenet’s
ambulatory segment delivered Adjusted EBITDA of $158 million, up 17.9
percent from $134 million in the fourth quarter of 2014. After
subtracting $48 million and $33 million of net income attributable to
noncontrolling interests in the fourth quarters of 2015 and 2014,
respectively, and prior to subtracting additional noncontrolling
interest related to Welsh Carson’s and other pre-existing USPI
shareholders 49.9 percent ownership interest in the USPI joint venture,
Adjusted EBITDA less NCI increased 8.9 percent to $110 million in the
fourth quarter of 2015, up from $101 million in the fourth quarter of
2014. After subtracting $69 million and $49 million of Adjusted net
income attributable to noncontrolling interests in the fourth quarters
of 2015 and 2014, respectively, Adjusted EBITDA less NCI increased 4.7
percent to $89 million in the fourth quarter of 2015, up from $85
million in the fourth quarter of 2014. The Adjusted net income
attributable to noncontrolling interests in the fourth quarter of 2015
excludes $16 million of net income attributable to noncontrolling
interests recorded during the quarter related to $32 million of gains on
the consolidation and deconsolidation of certain businesses.
During 2015, on a pro forma basis, the ambulatory segment delivered
Adjusted EBITDA of $489 million, up 14.5 percent from $427 million in
2014. After subtracting $137 million and $112 million of net income
attributable to noncontrolling interests in 2015 and 2014, respectively,
and prior to subtracting additional noncontrolling interest related to
Welsh Carson’s and other pre-existing USPI shareholders 49.9 percent
ownership interest in the USPI joint venture, Adjusted EBITDA less NCI
increased 11.7 percent to $352 million in 2015, up from $315 million in
2014. After subtracting $206 million and $150 million of net income
attributable to noncontrolling interests in 2015 and 2014, respectively,
Adjusted EBITDA less NCI increased 2.2 percent to $283 million in 2015,
up from $277 million in 2014. After adjusting for the additional $16
million of net income attributable to noncontrolling interests that was
recorded in the fourth quarter of 2015, Adjusted EBITDA Less NCI in the
ambulatory segment increased 7.9 percent in 2015.
Conifer Segment
During the fourth quarter of 2015, Conifer’s revenue increased 17.4
percent to $384 million, up from $327 million. Conifer’s revenue
increased 18.4 percent during 2015 to $1.413 billion, up from $1.193
billion in 2014. Excluding revenue from Tenet, Conifer’s revenue from
other third party customers increased by 27.2 percent to $206 million in
the fourth quarter of 2015 and by 24.1 percent to $747 million in 2015.
In the fourth quarter of 2015, Conifer generated $61 million of Adjusted
EBITDA, down 4.7 percent versus $64 million in the fourth quarter of
2014. During 2015, Conifer delivered Adjusted EBITDA of $265 million, up
30.5 percent from $203 million in 2014.
Net Income and Earnings Per Diluted Share
During the fourth quarter of 2015, Tenet generated Adjusted net income
from continuing operations of $35 million, or $0.35 per diluted share.
This excludes $135 million, or $1.36 per diluted share, in after-tax
items such as impairment charges, restructuring charges,
acquisition-related costs, litigation and investigation costs, the loss
from the early extinguishment of debt, and gains on sales, consolidation
and deconsolidation of facilities. During the fourth quarter of 2014,
the company generated adjusted net income from continuing operations of
$104 million, or $1.03 per diluted share, excluding the comparable items
that totaled $43 million after-tax, or $0.42 per diluted share.
During 2015, Tenet generated Adjusted net income from continuing
operations of $208 million, or $2.05 per diluted share. This excludes
$350 million, or $3.48 per diluted share, in after-tax items such as
impairment charges, restructuring charges, acquisition-related costs,
litigation and investigation costs, the loss from the early
extinguishment of debt, and gains on sales, consolidation and
deconsolidation of facilities. During 2014, the company generated
adjusted net income from continuing operations of $145 million, or $1.45
per diluted share, excluding the comparable items that totaled $111
million after-tax, or $1.11 per diluted share.
On a GAAP basis in the fourth quarter of 2015, including the results of
both continuing and discontinued operations, Tenet reported a net loss
attributable to common shareholders of $97 million, or $0.98 per diluted
share, compared to net income of $61 million, or $0.61 per diluted
share, in the fourth quarter of 2014. On a GAAP basis in 2015, including
the results of both continuing and discontinued operations, Tenet
reported a net loss attributable to common shareholders of $140 million,
or $1.41 per diluted share, compared to net income of $12 million, or
$0.12 per diluted share, in 2014.
Cash Flow and Liquidity
Cash and cash equivalents were $356 million at December 31, 2015
compared to $193 million at December 31, 2014. Tenet’s cash and debt
balances as of December 31, 2015 reflect the cash proceeds that the
company received from the sale of two hospitals in North Carolina, the
sale of a majority position in four hospitals in Dallas, and the related
changes that these transactions had on Tenet’s balance sheet. The
company ended 2015 with no outstanding borrowings on its $1 billion
credit line.
Accounts receivable days outstanding were 49.5 at December 31, 2015,
representing no change from September 30, 2015 or December 31, 2014.
Adjusted net cash provided by operating activities in 2015 was $1.247
billion, representing a 42.0 percent increase compared to $878 million
in 2014. After subtracting $842 million and $933 million of capital
expenditures in 2015 and 2014, respectively, Adjusted Free Cash Flow was
$405 million in 2015, up from an outflow of $55 million in 2014.
Tenet repurchased $40 million of stock during the fourth quarter. As of
December 31, 2015, the company had $460 million of remaining
authorization under the previously announced $500 million share
repurchase program. The repurchase program will expire on December 31,
2016 and may be suspended for periods or discontinued at any time.
Increase in Litigation Reserves
In the three months ended December 31, 2015, the Company increased its
aggregate reserve for the Clinica de la Mama criminal investigation and
civil litigation from $20 million to $238 million to reflect an offer it
made in February 2016 to resolve the matter. This amount is reflected in
the consolidated balance sheet as of December 31, 2015 as accrued legal
settlement costs. The $218 million reserve increase lowered net income
by approximately $184 million or $1.86 per diluted share during the
fourth quarter of 2015. As previously disclosed, the Company commenced
discussions in January 2016 with the U.S. Department of Justice and the
State of Georgia regarding potential resolution of these matters. For
additional information, see Note 15 to the Consolidated Financial
Statements included in the Company’s Form 10-K for the year ended
December 31, 2015.
Outlook
During 2016, Tenet expects to deliver revenue of $18.8 billion to $19.2
billion, Adjusted EBITDA of $2.4 billion to $2.5 billion, and Adjusted
earnings per diluted share of $1.18 to $2.25. The Outlook for EPS in
calendar year 2016 assumes net income attributable to noncontrolling
interests of $310 million to $330 million and an average diluted share
count of 102 million.
During 2016, Tenet expects to deliver Adjusted Free Cash Flow of $400
million to $600 million, compared to $405 million in 2015, and
anticipates additional improvement in Adjusted Free Cash Flow in 2017.
The Outlook for Adjusted Free Cash Flow in 2016 is based on an Outlook
of $1.300 billion to $1.450 billion of Adjusted Net Cash Provided by
Operating Activities less $850 million to $900 million of capital
expenditures. In addition, the company anticipates making cash
distributions to noncontrolling interests of $220 million to $240
million in 2016.
During the first quarter of 2016, Tenet expects to deliver revenue of
$4.7 billion to $4.9 billion, Adjusted EBITDA of $550 million to $600
million and Adjusted earnings per diluted share of $0.05 to $0.54
assuming an average diluted share count of 101 million.
Additional details on Tenet’s Outlook for both the first quarter and
calendar year 2016 are available in Tables 3, 4 and 5 at the end of this
press release and in an accompanying slide presentation that is
accessible through the company’s website at www.tenethealth.com/investors.
Management’s Webcast Discussion of Fourth Quarter Results
Tenet management will discuss the Company’s fourth quarter 2015 results
on a webcast scheduled for 10:00 a.m. EST (9:00 a.m. CST) on February
23, 2016. Investors can access the webcast through Tenet’s website at www.tenethealth.com/investors.
A set of slides, which will be referred to on the conference call, is
available on the Quarterly Results section of the Company’s website.
Additional information regarding Tenet’s quarterly results of operations
is contained in its Form 10-K report for the year ended December 31,
2015, which will be filed with the Securities and Exchange Commission
and posted on the Tenet website before the webcast. This press release
includes certain non-GAAP measures, such as Adjusted EBITDA. A
reconciliation of Adjusted EBITDA to net income attributable to Tenet
common shareholders is included in the financial tables at the end of
this release.
Tenet Healthcare Corporation is a diversified healthcare services
company with more than 130,000 employees united around a common mission:
to help people live happier, healthier lives. Through its subsidiaries,
partnerships and joint ventures, including United Surgical Partners
International, the company operates 84 general acute care hospitals, 20
short-stay surgical hospitals and over 470 outpatient centers in the
United States, as well as nine facilities in the United Kingdom. Tenet’s
Conifer Health Solutions subsidiary provides technology-enabled
performance improvement and health management solutions to hospitals,
health systems, integrated delivery networks, physician groups,
self-insured organizations and health plans. For more information,
please visit www.tenethealth.com.
The terms "THC," "Tenet Healthcare Corporation," "the company," "we,"
"us" or "our" refer to Tenet Healthcare Corporation or one or more of
its subsidiaries or affiliates as applicable.
This release contains “forward-looking statements” – that is, statements
that relate to future, not past, events. In this context,
forward-looking statements often address our expected future business
and financial performance and financial condition, and often contain
words such as “expect,” “assume,” “anticipate,” “intend,” “plan,”
“believe,” “seek,” “see,” or “will.” Forward-looking statements by their
nature address matters that are, to different degrees, uncertain.
Particular uncertainties that could cause our actual results to be
materially different than those expressed in our forward-looking
statements include, but are not limited to, the factors disclosed under
“Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the
year ended December 31, 2015 and other filings with the Securities and
Exchange Commission. Among other things, these factors include adverse
regulatory developments, government investigations or litigation,
including any significant monetary resolution or other undesirable
consequences of the Clinica de la Mama qui tam action and criminal
investigation described in Note 15 to the Consolidated Financial
Statements included in our Form 10-K for the year ended December 31,
2015. The terms of a final resolution, if any, of the Clinica de la Mama
matter may require us to pay significant fines and penalties and give
rise to other costs or adverse consequences that materially exceed the
reserve we have established and could have a material adverse effect on
our business, financial condition, results of operations or cash flows.
Tenet uses its company website to provide important information to
investors about the company including the posting of important
announcements regarding financial performance and corporate developments.
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
CONSOLIDATED STATEMENTS OF OPERATIONS
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
Three Months Ended December 31,
|
|
|
|
|
2015
|
|
|
%
|
|
|
|
2014
|
|
|
%
|
|
|
Change
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues before provision for doubtful accounts
|
|
$
|
5,417
|
|
|
|
|
$
|
4,821
|
|
|
|
|
12.4
|
%
|
|
Less: Provision for doubtful accounts
|
|
|
391
|
|
|
|
|
|
356
|
|
|
|
|
9.8
|
%
|
|
Net operating revenues
|
|
|
5,026
|
|
|
100.0
|
%
|
|
|
4,465
|
|
|
100.0
|
%
|
|
12.6
|
%
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
51
|
|
|
1.0
|
%
|
|
|
3
|
|
|
0.1
|
%
|
|
1,600.0
|
%
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
2,443
|
|
|
48.6
|
%
|
|
|
2,118
|
|
|
47.5
|
%
|
|
15.3
|
%
|
|
Supplies
|
|
|
817
|
|
|
16.3
|
%
|
|
|
688
|
|
|
15.4
|
%
|
|
18.8
|
%
|
|
Other operating expenses, net
|
|
|
1,230
|
|
|
24.5
|
%
|
|
|
1,048
|
|
|
23.5
|
%
|
|
17.4
|
%
|
|
Electronic health record incentives
|
|
|
(26
|
)
|
|
(0.5
|
)%
|
|
|
(32
|
)
|
|
(0.7
|
)%
|
|
(18.8
|
)%
|
|
Depreciation and amortization
|
|
|
208
|
|
|
4.1
|
%
|
|
|
240
|
|
|
5.4
|
%
|
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
52
|
|
|
1.0
|
%
|
|
|
63
|
|
|
1.4
|
%
|
|
|
|
Litigation and investigation costs
|
|
|
224
|
|
|
4.5
|
%
|
|
|
6
|
|
|
0.1
|
%
|
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(186
|
)
|
|
(3.7
|
)%
|
|
|
—
|
|
|
|
|
|
|
Operating income
|
|
|
315
|
|
|
6.3
|
%
|
|
|
337
|
|
|
7.5
|
%
|
|
|
|
Interest expense
|
|
|
(248
|
)
|
|
|
|
|
(196
|
)
|
|
|
|
|
|
Loss from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
|
|
—
|
|
|
|
|
|
|
Investment earnings
|
|
|
1
|
|
|
|
|
|
—
|
|
|
|
|
|
|
Net income from continuing operations, before income taxes
|
|
|
67
|
|
|
|
|
|
141
|
|
|
|
|
|
|
Income tax expense
|
|
|
(68
|
)
|
|
|
|
|
(60
|
)
|
|
|
|
|
|
Net income (loss) from continuing operations, before discontinued
operations
|
|
|
(1
|
)
|
|
|
|
|
81
|
|
|
|
|
|
|
Discontinued operations:
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(1
|
)
|
|
|
|
|
—
|
|
|
|
|
|
|
Litigation and investigation costs
|
|
|
5
|
|
|
|
|
|
—
|
|
|
|
|
|
|
Income tax expense
|
|
|
(1
|
)
|
|
|
|
|
—
|
|
|
|
|
|
|
Net income from discontinued operations
|
|
|
3
|
|
|
|
|
|
—
|
|
|
|
|
|
|
Net income
|
|
|
2
|
|
|
|
|
|
81
|
|
|
|
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
99
|
|
|
|
|
|
20
|
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(97
|
)
|
|
|
|
$
|
61
|
|
|
|
|
|
|
Amounts available (attributable) to Tenet Healthcare Corporation
common shareholders
|
|
|
|
|
|
|
|
|
|
|
|
Net income (loss) from continuing operations, net of tax
|
|
$
|
(100
|
)
|
|
|
|
$
|
61
|
|
|
|
|
|
|
Net income from discontinued operations, net of tax
|
|
|
3
|
|
|
|
|
|
—
|
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(97
|
)
|
|
|
|
$
|
61
|
|
|
|
|
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
$
|
(1.01
|
)
|
|
|
|
$
|
0.62
|
|
|
|
|
|
|
Continuing operations
|
|
|
0.03
|
|
|
|
|
|
—
|
|
|
|
|
|
|
|
|
$
|
(0.98
|
)
|
|
|
|
$
|
0.62
|
|
|
|
|
|
|
Diluted
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
(1.01
|
)
|
|
|
|
$
|
0.61
|
|
|
|
|
|
|
Discontinued operations
|
|
|
0.03
|
|
|
|
|
|
—
|
|
|
|
|
|
|
|
|
$
|
(0.98
|
)
|
|
|
|
$
|
0.61
|
|
|
|
|
|
|
Weighted average shares and dilutive securities outstanding (in
thousands):
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
99,188
|
|
|
|
|
|
98,331
|
|
|
|
|
|
|
Diluted*
|
|
|
99,188
|
|
|
|
|
|
101,279
|
|
|
|
|
|
*Had we generated income from continuing operations in the three months
ended December 31, 2015 the effect of employee stock options, restricted
stock units and deferred compensation units on the diluted shares
calculation would have been an increase of 2,173 shares.
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
CONSOLIDATED STATEMENTS OF OPERATIONS
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
Years Ended December 31,
|
|
|
|
|
2015
|
|
|
%
|
|
|
|
2014
|
|
|
%
|
|
|
Change
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues before provision for doubtful accounts
|
|
$
|
20,111
|
|
|
|
|
$
|
17,908
|
|
|
|
|
12.3
|
%
|
|
Less: Provision for doubtful accounts
|
|
|
1,477
|
|
|
|
|
|
1,305
|
|
|
|
|
13.2
|
%
|
|
Net operating revenues
|
|
|
18,634
|
|
|
100.0
|
%
|
|
|
16,603
|
|
|
100.0
|
%
|
|
12.2
|
%
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
99
|
|
|
0.5
|
%
|
|
|
12
|
|
|
0.1
|
%
|
|
725.0
|
%
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
9,011
|
|
|
48.4
|
%
|
|
|
8,023
|
|
|
48.3
|
%
|
|
12.3
|
%
|
|
Supplies
|
|
|
2,963
|
|
|
15.9
|
%
|
|
|
2,630
|
|
|
15.8
|
%
|
|
12.7
|
%
|
|
Other operating expenses, net
|
|
|
4,555
|
|
|
24.4
|
%
|
|
|
4,114
|
|
|
24.8
|
%
|
|
10.7
|
%
|
|
Electronic health record incentives
|
|
|
(72
|
)
|
|
(0.4
|
)%
|
|
|
(104
|
)
|
|
(0.6
|
)%
|
|
(30.8
|
)%
|
|
Depreciation and amortization
|
|
|
797
|
|
|
4.3
|
%
|
|
|
849
|
|
|
5.1
|
%
|
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
318
|
|
|
1.7
|
%
|
|
|
153
|
|
|
0.9
|
%
|
|
|
|
Litigation and investigation costs
|
|
|
291
|
|
|
1.6
|
%
|
|
|
25
|
|
|
0.2
|
%
|
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(186
|
)
|
|
(1.0
|
)%
|
|
|
—
|
|
|
—
|
%
|
|
|
|
Operating income
|
|
|
1,056
|
|
|
5.7
|
%
|
|
|
925
|
|
|
5.6
|
%
|
|
|
|
Interest expense
|
|
|
(912
|
)
|
|
|
|
|
(754
|
)
|
|
|
|
|
|
Loss from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
|
|
(24
|
)
|
|
|
|
|
|
Investment earnings
|
|
|
1
|
|
|
|
|
|
—
|
|
|
|
|
|
|
Net income from continuing operations, before income taxes
|
|
|
144
|
|
|
|
|
|
147
|
|
|
|
|
|
|
Income tax expense
|
|
|
(68
|
)
|
|
|
|
|
(49
|
)
|
|
|
|
|
|
Net income from continuing operations, before discontinued
operations
|
|
|
76
|
|
|
|
|
|
98
|
|
|
|
|
|
|
Discontinued operations:
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(5
|
)
|
|
|
|
|
(17
|
)
|
|
|
|
|
|
Litigation and investigation costs
|
|
|
8
|
|
|
|
|
|
(18
|
)
|
|
|
|
|
|
Income tax benefit (expense)
|
|
|
(1
|
)
|
|
|
|
|
13
|
|
|
|
|
|
|
Net income (loss) from discontinued operations
|
|
|
2
|
|
|
|
|
|
(22
|
)
|
|
|
|
|
|
Net income
|
|
|
78
|
|
|
|
|
|
76
|
|
|
|
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
218
|
|
|
|
|
|
64
|
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(140
|
)
|
|
|
|
$
|
12
|
|
|
|
|
|
|
Amounts available (attributable) to Tenet Healthcare Corporation
common shareholders
|
|
|
|
|
|
|
|
|
|
|
|
Net income (loss) from continuing operations, net of tax
|
|
$
|
(142
|
)
|
|
|
|
$
|
34
|
|
|
|
|
|
|
Net income (loss) from discontinued operations, net of tax
|
|
|
2
|
|
|
|
|
|
(22
|
)
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(140
|
)
|
|
|
|
$
|
12
|
|
|
|
|
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
(1.43
|
)
|
|
|
|
$
|
0.35
|
|
|
|
|
|
|
Discontinued operations
|
|
|
0.02
|
|
|
|
|
|
(0.23
|
)
|
|
|
|
|
|
|
|
$
|
(1.41
|
)
|
|
|
|
$
|
0.12
|
|
|
|
|
|
|
Diluted
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
(1.43
|
)
|
|
|
|
$
|
0.34
|
|
|
|
|
|
|
Discontinued operations
|
|
|
0.02
|
|
|
|
|
|
(0.22
|
)
|
|
|
|
|
|
|
|
$
|
(1.41
|
)
|
|
|
|
$
|
0.12
|
|
|
|
|
|
|
Weighted average shares and dilutive securities outstanding (in
thousands):
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
99,167
|
|
|
|
|
|
97,801
|
|
|
|
|
|
|
Diluted*
|
|
|
99,167
|
|
|
|
|
|
100,287
|
|
|
|
|
|
*Had we generated income from continuing operations in the twelve months
ended December 31, 2015 the effect of employee stock options, restricted
stock units and deferred compensation units on the diluted shares
calculation would have been an increase of 2,380 shares.
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
CONSOLIDATED BALANCE SHEETS
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31,
|
|
December 31,
|
|
(Dollars in millions)
|
|
|
2015
|
|
|
|
2014
|
|
|
ASSETS
|
|
|
|
|
|
Current assets:
|
|
|
|
|
|
Cash and cash equivalents
|
|
$
|
356
|
|
|
$
|
193
|
|
|
Accounts receivable, less allowance for doubtful accounts
|
|
|
2,704
|
|
|
|
2,404
|
|
|
Inventories of supplies, at cost
|
|
|
309
|
|
|
|
276
|
|
|
Income tax receivable
|
|
|
7
|
|
|
|
2
|
|
|
Assets held for sale
|
|
|
550
|
|
|
|
2
|
|
|
Other current assets
|
|
|
1,245
|
|
|
|
1,093
|
|
|
Total current assets
|
|
|
5,171
|
|
|
|
3,970
|
|
|
Investments and other assets
|
|
|
1,175
|
|
|
|
384
|
|
|
Deferred income taxes
|
|
|
776
|
|
|
|
863
|
|
|
Property and equipment, at cost, less accumulated depreciation and
amortization
|
|
|
7,915
|
|
|
|
7,733
|
|
|
Goodwill
|
|
|
6,970
|
|
|
|
3,913
|
|
|
Other intangible assets, at cost, less accumulated amortization
|
|
|
1,675
|
|
|
|
1,088
|
|
|
Total assets
|
|
$
|
23,682
|
|
|
$
|
17,951
|
|
|
|
|
|
|
|
|
LIABILITIES AND EQUITY
|
|
|
|
|
|
Current liabilities:
|
|
|
|
|
|
Current portion of long-term debt
|
|
$
|
127
|
|
|
$
|
112
|
|
|
Accounts payable
|
|
|
1,380
|
|
|
|
1,179
|
|
|
Accrued compensation and benefits
|
|
|
880
|
|
|
|
852
|
|
|
Professional and general liability reserves
|
|
|
177
|
|
|
|
189
|
|
|
Accrued interest payable
|
|
|
205
|
|
|
|
194
|
|
|
Liabilities held for sale
|
|
|
101
|
|
|
|
—
|
|
|
Accrued legal settlement costs
|
|
|
294
|
|
|
|
45
|
|
|
Other current liabilities
|
|
|
1,144
|
|
|
|
1,006
|
|
|
Total current liabilities
|
|
|
4,308
|
|
|
|
3,577
|
|
|
Long-term debt, net of current portion
|
|
|
14,383
|
|
|
|
11,505
|
|
|
Professional and general liability reserves
|
|
|
578
|
|
|
|
492
|
|
|
Defined benefit plan obligations
|
|
|
595
|
|
|
|
633
|
|
|
Other long-term liabilities
|
|
|
594
|
|
|
|
558
|
|
|
Total liabilities
|
|
|
20,458
|
|
|
|
16,765
|
|
|
Commitments and contingencies
|
|
|
|
|
|
Redeemable noncontrolling interests in equity of consolidated
subsidiaries
|
|
|
2,266
|
|
|
|
401
|
|
|
Equity:
|
|
|
|
|
|
Shareholders’ equity:
|
|
|
|
|
|
Common stock
|
|
|
7
|
|
|
|
7
|
|
|
Additional paid-in capital
|
|
|
4,815
|
|
|
|
4,614
|
|
|
Accumulated other comprehensive loss
|
|
|
(164
|
)
|
|
|
(182
|
)
|
|
Accumulated deficit
|
|
|
(1,550
|
)
|
|
|
(1,410
|
)
|
|
Common stock in treasury, at cost
|
|
|
(2,417
|
)
|
|
|
(2,378
|
)
|
|
Total shareholders’ equity
|
|
|
691
|
|
|
|
651
|
|
|
Noncontrolling interests
|
|
|
267
|
|
|
|
134
|
|
|
Total equity
|
|
|
958
|
|
|
|
785
|
|
|
Total liabilities and equity
|
|
$
|
23,682
|
|
|
$
|
17,951
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
CONSOLIDATED STATEMENTS OF CASH FLOW
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Years Ended
|
|
(Dollars in millions)
|
|
December 31,
|
|
|
|
|
2015
|
|
|
|
2014
|
|
|
Net Income
|
|
$
|
78
|
|
|
$
|
76
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities:
|
|
|
|
|
|
Depreciation and amortization
|
|
|
797
|
|
|
|
849
|
|
|
Provision for doubtful accounts
|
|
|
1,477
|
|
|
|
1,305
|
|
|
Deferred income tax expense
|
|
|
42
|
|
|
|
30
|
|
|
Stock-based compensation expense
|
|
|
69
|
|
|
|
51
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
318
|
|
|
|
153
|
|
|
Litigation and investigation costs
|
|
|
291
|
|
|
|
25
|
|
|
Loss from early extinguishment of debt
|
|
|
1
|
|
|
|
24
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(186
|
)
|
|
|
—
|
|
|
Undistributed earnings from affiliates
|
|
|
(99
|
)
|
|
|
(10
|
)
|
|
Amortization of debt discount and debt issuance costs
|
|
|
41
|
|
|
|
28
|
|
|
Pre-tax loss (income) from discontinued operations
|
|
|
(3
|
)
|
|
|
35
|
|
|
Other items, net
|
|
|
59
|
|
|
|
(30
|
)
|
|
Changes in cash from operating assets and liabilities:
|
|
|
|
|
|
Accounts receivable
|
|
|
(1,632
|
)
|
|
|
(1,896
|
)
|
|
Inventories and other current assets
|
|
|
(130
|
)
|
|
|
(314
|
)
|
|
Income taxes
|
|
|
18
|
|
|
|
3
|
|
|
Accounts payable, accrued expenses and other current liabilities
|
|
|
68
|
|
|
|
505
|
|
|
Other long-term liabilities
|
|
|
38
|
|
|
|
44
|
|
|
Payments for restructuring charges, acquisition-related costs,
and litigation costs and settlements
|
|
|
(200
|
)
|
|
|
(168
|
)
|
|
Net cash used in operating activities from discontinued
operations, excluding income taxes
|
|
|
(21
|
)
|
|
|
(23
|
)
|
|
Net cash provided by operating activities
|
|
|
1,026
|
|
|
|
687
|
|
|
Cash flows from investing activities:
|
|
|
|
|
|
Purchases of property and equipment — continuing operations
|
|
|
(842
|
)
|
|
|
(933
|
)
|
|
Purchases of businesses or joint venture interests, net of cash
acquired
|
|
|
(940
|
)
|
|
|
(428
|
)
|
|
Proceeds from sales of facilities and other assets
|
|
|
549
|
|
|
|
6
|
|
|
Proceeds from sales of marketable securities, long-term investments
and other assets
|
|
|
60
|
|
|
|
13
|
|
|
Purchases of equity investments
|
|
|
(134
|
)
|
|
|
(12
|
)
|
|
Other long-term assets
|
|
|
(4
|
)
|
|
|
31
|
|
|
Other items, net
|
|
|
(6
|
)
|
|
|
1
|
|
|
Net cash used in investing activities
|
|
|
(1,317
|
)
|
|
|
(1,322
|
)
|
|
Cash flows from financing activities:
|
|
|
|
|
|
Repayments of borrowings under credit facility
|
|
|
(2,815
|
)
|
|
|
(2,430
|
)
|
|
Proceeds from borrowings under credit facility
|
|
|
2,595
|
|
|
|
2,245
|
|
|
Repayments of other borrowings
|
|
|
(2,049
|
)
|
|
|
(683
|
)
|
|
Proceeds from other borrowings
|
|
|
3,158
|
|
|
|
1,608
|
|
|
Repurchases of common stock
|
|
|
(40
|
)
|
|
|
—
|
|
|
Debt issuance costs
|
|
|
(80
|
)
|
|
|
(27
|
)
|
|
Distributions paid to noncontrolling interests
|
|
|
(110
|
)
|
|
|
(45
|
)
|
|
Contributions from noncontrolling interests
|
|
|
4
|
|
|
|
18
|
|
|
Purchase of noncontrolling interests
|
|
|
(254
|
)
|
|
|
—
|
|
|
Proceeds from exercise of stock options
|
|
|
15
|
|
|
|
26
|
|
|
Other items, net
|
|
|
30
|
|
|
|
3
|
|
|
Net cash provided by financing activities
|
|
|
454
|
|
|
|
715
|
|
|
Net increase in cash and cash equivalents
|
|
|
163
|
|
|
|
80
|
|
|
Cash and cash equivalents at beginning of period
|
|
|
193
|
|
|
|
113
|
|
|
Cash and cash equivalents at end of period
|
|
$
|
356
|
|
|
$
|
193
|
|
|
Supplemental disclosures:
|
|
|
|
|
|
Interest paid, net of capitalized interest
|
|
$
|
(859
|
)
|
|
$
|
(726
|
)
|
|
Income tax payments, net
|
|
$
|
(7
|
)
|
|
$
|
(8
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1)
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per patient day,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
per admission, per adjusted admission
|
|
Three Months Ended December 31,
|
|
Years Ended December 31,
|
|
|
and per visit amounts)
|
|
|
2015
|
|
|
|
2014(2)
|
|
|
Change
|
|
|
2015(2)
|
|
|
|
2014(2)
|
|
|
Change
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net inpatient revenues
|
|
$
|
2,736
|
|
|
$
|
2,719
|
|
|
0.6
|
%
|
|
$
|
10,652
|
|
|
$
|
10,015
|
|
|
6.4
|
%
|
|
|
Net outpatient revenues
|
|
$
|
1,616
|
|
|
$
|
1,448
|
|
|
11.6
|
%
|
|
$
|
6,027
|
|
|
$
|
5,449
|
|
|
10.6
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of acute care hospitals (at end of period)
|
|
|
86
|
|
|
|
80
|
|
|
6
|
|
*
|
|
86
|
|
|
|
80
|
|
|
—
|
|
*
|
|
Licensed beds (at end of period)
|
|
|
22,525
|
|
|
|
20,814
|
|
|
8.2
|
%
|
|
|
22,525
|
|
|
|
20,814
|
|
|
8.2
|
%
|
|
|
Average licensed beds
|
|
|
22,549
|
|
|
|
20,805
|
|
|
8.4
|
%
|
|
|
21,092
|
|
|
|
20,531
|
|
|
2.7
|
%
|
|
|
Utilization of licensed beds
|
|
|
47.4
|
%
|
|
|
49.0
|
%
|
|
(1.6
|
)%
|
*
|
|
49.6
|
%
|
|
|
49.3
|
%
|
|
0.3
|
%
|
*
|
|
Patient days - total
|
|
|
983,856
|
|
|
|
937,803
|
|
|
4.9
|
%
|
|
|
3,817,572
|
|
|
|
3,695,288
|
|
|
3.3
|
%
|
|
|
Adjusted patient days
|
|
|
1,710,620
|
|
|
|
1,578,854
|
|
|
8.3
|
%
|
|
|
6,520,289
|
|
|
|
6,203,383
|
|
|
5.1
|
%
|
|
|
Net inpatient revenue per patient day
|
|
$
|
2,781
|
|
|
$
|
2,899
|
|
|
(4.1
|
)%
|
|
$
|
2,790
|
|
|
$
|
2,710
|
|
|
3.0
|
%
|
|
|
Total admissions
|
|
|
211,991
|
|
|
|
202,337
|
|
|
4.8
|
%
|
|
|
824,102
|
|
|
|
791,165
|
|
|
4.2
|
%
|
|
|
Adjusted patient admissions
|
|
|
371,994
|
|
|
|
344,857
|
|
|
7.9
|
%
|
|
|
1,422,588
|
|
|
|
1,343,511
|
|
|
5.9
|
%
|
|
|
Charity and uninsured admissions
|
|
|
11,529
|
|
|
|
11,232
|
|
|
2.6
|
%
|
|
|
44,336
|
|
|
|
45,679
|
|
|
(2.9
|
)%
|
|
|
Net inpatient revenue per admission
|
|
$
|
12,906
|
|
|
$
|
13,438
|
|
|
(4.0
|
)%
|
|
$
|
12,926
|
|
|
$
|
12,659
|
|
|
2.1
|
%
|
|
|
Average length of stay (days)
|
|
|
4.64
|
|
|
|
4.63
|
|
|
0.2
|
%
|
|
|
4.63
|
|
|
|
4.67
|
|
|
(0.9
|
)%
|
|
|
Total surgeries
|
|
|
138,264
|
|
|
|
128,050
|
|
|
8.0
|
%
|
|
|
517,127
|
|
|
|
495,980
|
|
|
4.3
|
%
|
|
|
Admissions through emergency department
|
|
|
133,108
|
|
|
|
127,361
|
|
|
4.5
|
%
|
|
|
521,272
|
|
|
|
495,195
|
|
|
5.3
|
%
|
|
|
Emergency department visits
|
|
|
778,148
|
|
|
|
737,680
|
|
|
5.5
|
%
|
|
|
3,010,625
|
|
|
|
2,824,526
|
|
|
6.6
|
%
|
|
|
Total emergency department admissions and visits
|
|
|
911,256
|
|
|
|
865,041
|
|
|
5.3
|
%
|
|
|
3,531,897
|
|
|
|
3,319,721
|
|
|
6.4
|
%
|
|
|
Outpatient visits
|
|
|
2,198,005
|
|
|
|
1,995,237
|
|
|
10.2
|
%
|
|
|
8,332,139
|
|
|
|
7,720,886
|
|
|
7.9
|
%
|
|
|
Charity and uninsured outpatient visits
|
|
|
173,280
|
|
|
|
165,365
|
|
|
4.8
|
%
|
|
|
662,168
|
|
|
|
660,924
|
|
|
0.2
|
%
|
|
|
Net outpatient revenue per visit
|
|
$
|
735
|
|
|
$
|
726
|
|
|
1.2
|
%
|
|
$
|
723
|
|
|
$
|
706
|
|
|
2.4
|
%
|
|
|
Net patient revenue per adjusted patient admission
|
|
$
|
11,699
|
|
|
$
|
12,083
|
|
|
(3.2
|
)%
|
|
$
|
11,724
|
|
|
$
|
11,510
|
|
|
1.9
|
%
|
|
|
Net patient revenue per adjusted patient day
|
|
$
|
2,544
|
|
|
$
|
2,639
|
|
|
(3.6
|
)%
|
|
$
|
2,558
|
|
|
$
|
2,493
|
|
|
2.6
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net Patient Revenues from:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
19.3
|
%
|
|
|
21.1
|
%
|
|
(1.8
|
)%
|
*
|
|
20.4
|
%
|
|
|
22.0
|
%
|
|
(1.6
|
)%
|
*
|
|
Medicaid
|
|
|
8.2
|
%
|
|
|
11.3
|
%
|
|
(3.1
|
)%
|
*
|
|
8.7
|
%
|
|
|
9.6
|
%
|
|
(0.9
|
)%
|
*
|
|
Managed care
|
|
|
61.6
|
%
|
|
|
57.5
|
%
|
|
4.1
|
%
|
*
|
|
60.6
|
%
|
|
|
58.4
|
%
|
|
2.2
|
%
|
*
|
|
Indemnity, self-pay and other
|
|
|
10.9
|
%
|
|
|
10.1
|
%
|
|
0.8
|
%
|
*
|
|
10.3
|
%
|
|
|
10.0
|
%
|
|
0.3
|
%
|
*
|
|
(1)
|
|
Represents the results of Tenet’s Hospital Operations and other
segment.
|
|
(2)
|
|
The results for 2014 and the quarter ended March 31, 2015 have been
restated to exclude the results of the surgery and imaging centers
that Tenet contributed to the joint venture with United Surgical
Partners International. The results for these surgery and imaging
centers are now reported in Tenet’s Ambulatory Care segment.
|
|
|
|
* This change is the difference between the 2015 and 2014 amounts
shown.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1)
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per patient day,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
per admission, per adjusted admission
|
|
Three Months Ended December 31,
|
|
|
Years Ended December 31,
|
|
|
and per visit amounts)
|
|
|
2015
|
|
|
|
2014(2)
|
|
|
Change
|
|
|
|
2015(2)
|
|
|
|
2014(2)
|
|
|
Change
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net inpatient revenues
|
|
$
|
2,546
|
|
|
$
|
2,591
|
|
|
(1.7
|
)%
|
|
|
$
|
10,079
|
|
|
$
|
9,615
|
|
|
4.8
|
%
|
|
|
Net outpatient revenues
|
|
$
|
1,446
|
|
|
$
|
1,375
|
|
|
5.2
|
%
|
|
|
$
|
5,630
|
|
|
$
|
5,271
|
|
|
6.8
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of acute care hospitals (at end of period)
|
|
|
75
|
|
|
|
75
|
|
|
—
|
|
*
|
|
|
75
|
|
|
|
75
|
|
|
—
|
|
*
|
|
Licensed beds (at end of period)
|
|
|
19,882
|
|
|
|
19,984
|
|
|
(0.5
|
)%
|
|
|
|
19,882
|
|
|
|
19,984
|
|
|
(0.5
|
)%
|
|
|
Average licensed beds
|
|
|
19,906
|
|
|
|
19,975
|
|
|
(0.3
|
)%
|
|
|
|
19,969
|
|
|
|
19,905
|
|
|
0.3
|
%
|
|
|
Utilization of licensed beds
|
|
|
47.8
|
%
|
|
|
48.9
|
%
|
|
(1.1
|
)%
|
*
|
|
|
49.0
|
%
|
|
|
49.1
|
%
|
|
(0.1
|
)%
|
*
|
|
Patient days - total
|
|
|
875,226
|
|
|
|
898,353
|
|
|
(2.6
|
)%
|
|
|
|
3,573,155
|
|
|
|
3,566,694
|
|
|
0.2
|
%
|
|
|
Adjusted patient days
|
|
|
1,508,868
|
|
|
|
1,512,531
|
|
|
(0.2
|
)%
|
|
|
|
6,083,749
|
|
|
|
5,993,861
|
|
|
1.5
|
%
|
|
|
Net inpatient revenue per patient day
|
|
$
|
2,909
|
|
|
$
|
2,884
|
|
|
0.9
|
%
|
|
|
$
|
2,821
|
|
|
$
|
2,696
|
|
|
4.6
|
%
|
|
|
Total admissions
|
|
|
190,642
|
|
|
|
194,169
|
|
|
(1.8
|
)%
|
|
|
|
774,480
|
|
|
|
765,951
|
|
|
1.1
|
%
|
|
|
Adjusted patient admissions
|
|
|
332,037
|
|
|
|
330,884
|
|
|
0.3
|
%
|
|
|
|
1,333,227
|
|
|
|
1,301,936
|
|
|
2.4
|
%
|
|
|
Charity and uninsured admissions
|
|
|
10,386
|
|
|
|
10,573
|
|
|
(1.8
|
)%
|
|
|
|
41,325
|
|
|
|
43,496
|
|
|
(5.0
|
)%
|
|
|
Net inpatient revenue per admission
|
|
$
|
13,355
|
|
|
$
|
13,344
|
|
|
0.1
|
%
|
|
|
$
|
13,014
|
|
|
$
|
12,553
|
|
|
3.7
|
%
|
|
|
Average length of stay (days)
|
|
|
4.59
|
|
|
|
4.63
|
|
|
(0.9
|
)%
|
|
|
|
4.61
|
|
|
|
4.66
|
|
|
(1.1
|
)%
|
|
|
Total surgeries
|
|
|
123,761
|
|
|
|
123,854
|
|
|
(0.1
|
)%
|
|
|
|
487,953
|
|
|
|
482,633
|
|
|
1.1
|
%
|
|
|
Admissions through emergency department
|
|
|
119,814
|
|
|
|
122,089
|
|
|
(1.9
|
)%
|
|
|
|
489,401
|
|
|
|
479,805
|
|
|
2.0
|
%
|
|
|
Emergency department visits
|
|
|
700,837
|
|
|
|
703,265
|
|
|
(0.3
|
)%
|
|
|
|
2,816,943
|
|
|
|
2,738,233
|
|
|
2.9
|
%
|
|
|
Total emergency department admissions and visits
|
|
|
820,651
|
|
|
|
825,354
|
|
|
(0.6
|
)%
|
|
|
|
3,306,344
|
|
|
|
3,218,038
|
|
|
2.7
|
%
|
|
|
Outpatient visits
|
|
|
1,974,943
|
|
|
|
1,917,935
|
|
|
3.0
|
%
|
|
|
|
7,831,785
|
|
|
|
7,496,243
|
|
|
4.5
|
%
|
|
|
Charity and uninsured outpatient visits
|
|
|
153,357
|
|
|
|
158,492
|
|
|
(3.2
|
)%
|
|
|
|
618,571
|
|
|
|
636,712
|
|
|
(2.8
|
)%
|
|
|
Net outpatient revenue per visit
|
|
$
|
732
|
|
|
$
|
717
|
|
|
2.1
|
%
|
|
|
$
|
719
|
|
|
$
|
703
|
|
|
2.3
|
%
|
|
|
Net patient revenue per adjusted patient admission
|
|
$
|
12,023
|
|
|
$
|
11,986
|
|
|
0.3
|
%
|
|
|
$
|
11,783
|
|
|
$
|
11,434
|
|
|
3.1
|
%
|
|
|
Net patient revenue per adjusted patient day
|
|
$
|
2,646
|
|
|
$
|
2,622
|
|
|
0.9
|
%
|
|
|
$
|
2,582
|
|
|
$
|
2,484
|
|
|
3.9
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net Patient Revenues from:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
19.6
|
%
|
|
|
20.7
|
%
|
|
(1.1
|
)%
|
*
|
|
|
19.6
|
%
|
|
|
21.7
|
%
|
|
(2.1
|
)%
|
*
|
|
Medicaid
|
|
|
8.3
|
%
|
|
|
11.1
|
%
|
|
(2.8
|
)%
|
*
|
|
|
8.3
|
%
|
|
|
9.4
|
%
|
|
(1.1
|
)%
|
*
|
|
Managed care
|
|
|
61.6
|
%
|
|
|
58.3
|
%
|
|
3.3
|
%
|
*
|
|
|
61.6
|
%
|
|
|
59.0
|
%
|
|
2.6
|
%
|
*
|
|
Indemnity, self-pay and other
|
|
|
10.5
|
%
|
|
|
9.9
|
%
|
|
0.6
|
%
|
*
|
|
|
10.5
|
%
|
|
|
9.9
|
%
|
|
0.6
|
%
|
*
|
|
(1)
|
|
Represents the results of Tenet’s Hospital Operations and other
segment.
|
|
(2)
|
|
The results for 2014 and the quarter ended March 31, 2015 have been
restated to exclude the results of the surgery and imaging centers
that Tenet contributed to the joint venture with United Surgical
Partners International. The results for these surgery and imaging
centers are now reported in Tenet’s Ambulatory Care segment.
|
|
|
|
* This change is the difference between the 2015 and 2014 amounts
shown.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
CONSOLIDATED STATEMENTS OF OPERATIONS
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
Three Months Ended
|
|
Year Ended
|
|
|
|
|
03/31/15
|
|
|
|
6/30/2015
|
|
|
|
9/30/2015
|
|
|
|
12/31/2015
|
|
|
|
12/31/2015
|
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues before provision for doubtful accounts
|
|
$
|
4,787
|
|
|
$
|
4,844
|
|
|
$
|
5,063
|
|
|
$
|
5,417
|
|
|
$
|
20,111
|
|
|
Less: Provision for doubtful accounts
|
|
|
363
|
|
|
|
352
|
|
|
|
371
|
|
|
|
391
|
|
|
|
1,477
|
|
|
Net operating revenues
|
|
|
4,424
|
|
|
|
4,492
|
|
|
|
4,692
|
|
|
|
5,026
|
|
|
|
18,634
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
4
|
|
|
|
16
|
|
|
|
28
|
|
|
|
51
|
|
|
|
99
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
2,125
|
|
|
|
2,185
|
|
|
|
2,258
|
|
|
|
2,443
|
|
|
|
9,011
|
|
|
Supplies
|
|
|
687
|
|
|
|
707
|
|
|
|
752
|
|
|
|
817
|
|
|
|
2,963
|
|
|
Other operating expenses, net
|
|
|
1,093
|
|
|
|
1,081
|
|
|
|
1,151
|
|
|
|
1,230
|
|
|
|
4,555
|
|
|
Electronic health record incentives
|
|
|
(6
|
)
|
|
|
(33
|
)
|
|
|
(7
|
)
|
|
|
(26
|
)
|
|
|
(72
|
)
|
|
Depreciation and amortization
|
|
|
207
|
|
|
|
197
|
|
|
|
185
|
|
|
|
208
|
|
|
|
797
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
29
|
|
|
|
193
|
|
|
|
44
|
|
|
|
52
|
|
|
|
318
|
|
|
Litigation and investigation costs
|
|
|
3
|
|
|
|
14
|
|
|
|
50
|
|
|
|
224
|
|
|
|
291
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
|
(186
|
)
|
|
|
(186
|
)
|
|
Operating income
|
|
|
290
|
|
|
|
164
|
|
|
|
287
|
|
|
|
315
|
|
|
|
1,056
|
|
|
Interest expense
|
|
|
(199
|
)
|
|
|
(217
|
)
|
|
|
(248
|
)
|
|
|
(248
|
)
|
|
|
(912
|
)
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
Investment earnings (loss)
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
1
|
|
|
|
1
|
|
|
|
1
|
|
|
Net income (loss) from continuing operations, before income taxes
|
|
|
91
|
|
|
|
(54
|
)
|
|
|
40
|
|
|
|
67
|
|
|
|
144
|
|
|
Income tax benefit (expense)
|
|
|
(16
|
)
|
|
|
27
|
|
|
|
(11
|
)
|
|
|
(68
|
)
|
|
|
(68
|
)
|
|
Net income (loss) from continuing operations, before discontinued
operations
|
|
|
75
|
|
|
|
(27
|
)
|
|
|
29
|
|
|
|
(1
|
)
|
|
|
76
|
|
|
Discontinued operations:
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(1
|
)
|
|
|
(2
|
)
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
(5
|
)
|
|
Litigation and investigation costs
|
|
|
3
|
|
|
|
—
|
|
|
|
—
|
|
|
|
5
|
|
|
|
8
|
|
|
Income tax benefit (expense)
|
|
|
(1
|
)
|
|
|
1
|
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
Net income (loss) from discontinued operations
|
|
|
1
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
3
|
|
|
|
2
|
|
|
Net income (loss)
|
|
|
76
|
|
|
|
(28
|
)
|
|
|
28
|
|
|
|
2
|
|
|
|
78
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
29
|
|
|
|
33
|
|
|
|
57
|
|
|
|
99
|
|
|
|
218
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
47
|
|
|
$
|
(61
|
)
|
|
$
|
(29
|
)
|
|
$
|
(97
|
)
|
|
$
|
(140
|
)
|
|
Amounts available (attributable) to Tenet Healthcare Corporation
common shareholders
|
|
|
|
|
|
|
|
|
|
|
|
Net income (loss) from continuing operations, net of tax
|
|
$
|
46
|
|
|
$
|
(60
|
)
|
|
$
|
(28
|
)
|
|
$
|
(100
|
)
|
|
$
|
(142
|
)
|
|
Net income (loss) from discontinued operations, net of tax
|
|
|
1
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
3
|
|
|
|
2
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
47
|
|
|
$
|
(61
|
)
|
|
$
|
(29
|
)
|
|
$
|
(97
|
)
|
|
$
|
(140
|
)
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
0.47
|
|
|
$
|
(0.60
|
)
|
|
$
|
(0.28
|
)
|
|
$
|
(1.01
|
)
|
|
$
|
(1.43
|
)
|
|
Discontinued operations
|
|
|
0.01
|
|
|
|
(0.01
|
)
|
|
|
(0.01
|
)
|
|
|
0.03
|
|
|
|
0.02
|
|
|
|
|
$
|
0.48
|
|
|
$
|
(0.61
|
)
|
|
$
|
(0.29
|
)
|
|
$
|
(0.98
|
)
|
|
$
|
(1.41
|
)
|
|
Diluted
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
0.46
|
|
|
$
|
(0.60
|
)
|
|
$
|
(0.28
|
)
|
|
$
|
(1.01
|
)
|
|
$
|
(1.43
|
)
|
|
Discontinued operations
|
|
|
0.01
|
|
|
|
(0.01
|
)
|
|
|
(0.01
|
)
|
|
|
0.03
|
|
|
|
0.02
|
|
|
|
|
$
|
0.47
|
|
|
$
|
(0.61
|
)
|
|
$
|
(0.29
|
)
|
|
$
|
(0.98
|
)
|
|
$
|
(1.41
|
)
|
|
Weighted average shares and dilutive securities outstanding (in
thousands):
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
98,699
|
|
|
|
99,244
|
|
|
|
99,537
|
|
|
|
99,188
|
|
|
|
99,167
|
|
|
Diluted
|
|
|
100,872
|
|
|
|
99,244
|
|
|
|
99,537
|
|
|
|
99,188
|
|
|
|
99,167
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1)
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per patient day,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
per admission, per adjusted admission
|
|
Three Months Ended
|
|
Year Ended
|
|
and per visit amounts)
|
|
03/31/15(2)
|
|
|
06/30/15
|
|
|
9/30/2015
|
|
|
12/31/2015
|
|
|
|
12/31/2015
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net inpatient revenues
|
|
$2,691
|
|
|
$2,622
|
|
|
$2,603
|
|
|
$2,736
|
|
|
$
|
10,652
|
|
|
Net outpatient revenues
|
|
$1,412
|
|
|
$1,484
|
|
|
$1,515
|
|
|
$1,616
|
|
|
$
|
6,027
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of acute care hospitals (at end of period)
|
|
80
|
|
|
80
|
|
|
83
|
|
|
86
|
|
|
|
86
|
|
|
Licensed beds (at end of period)
|
|
20,826
|
|
|
20,826
|
|
|
21,527
|
|
|
22,525
|
|
|
|
22,525
|
|
|
Average licensed beds
|
|
20,823
|
|
|
20,826
|
|
|
21,122
|
|
|
22,549
|
|
|
|
21,092
|
|
|
Utilization of licensed beds
|
|
52.1
|
%
|
|
49.1
|
%
|
|
47.8
|
%
|
|
47.4
|
%
|
|
|
49.6
|
%
|
|
Patient days - total
|
|
975,912
|
|
|
929,840
|
|
|
927,964
|
|
|
983,856
|
|
|
|
3,817,572
|
|
|
Adjusted patient days
|
|
1,618,516
|
|
|
1,589,659
|
|
|
1,601,494
|
|
|
1,710,620
|
|
|
|
6,520,289
|
|
|
Net inpatient revenue per patient day
|
|
$2,756
|
|
|
$2,821
|
|
|
$2,805
|
|
|
$2,781
|
|
|
$
|
2,790
|
|
|
Total admissions
|
|
208,333
|
|
|
201,908
|
|
|
201,870
|
|
|
211,991
|
|
|
|
824,102
|
|
|
Adjusted patient admissions
|
|
349,097
|
|
|
349,145
|
|
|
352,352
|
|
|
371,994
|
|
|
|
1,422,588
|
|
|
Charity and uninsured admissions
|
|
10,950
|
|
|
10,535
|
|
|
11,322
|
|
|
11,529
|
|
|
|
44,336
|
|
|
Net inpatient revenue per admission
|
|
$12,912
|
|
|
$12,991
|
|
|
$12,894
|
|
|
$12,906
|
|
|
$
|
12,926
|
|
|
Average length of stay (days)
|
|
4.68
|
|
|
4.61
|
|
|
4.60
|
|
|
4.64
|
|
|
|
4.63
|
|
|
Total surgeries
|
|
121,403
|
|
|
127,523
|
|
|
129,937
|
|
|
138,264
|
|
|
|
517,127
|
|
|
Admissions through emergency department
|
|
133,544
|
|
|
128,570
|
|
|
126,050
|
|
|
133,108
|
|
|
|
521,272
|
|
|
Emergency department visits
|
|
741,533
|
|
|
742,951
|
|
|
747,993
|
|
|
778,148
|
|
|
|
3,010,625
|
|
|
Total emergency department admissions and visits
|
|
875,077
|
|
|
871,521
|
|
|
874,043
|
|
|
911,256
|
|
|
|
3,531,897
|
|
|
Outpatient visits
|
|
1,994,573
|
|
|
2,063,037
|
|
|
2,076,524
|
|
|
2,198,005
|
|
|
|
8,332,139
|
|
|
Charity and uninsured outpatient visits
|
|
157,197
|
|
|
159,634
|
|
|
172,057
|
|
|
173,280
|
|
|
|
662,168
|
|
|
Net outpatient revenue per visit
|
|
$708
|
|
|
$719
|
|
|
$730
|
|
|
$735
|
|
|
$
|
723
|
|
|
Net patient revenue per adjusted patient admission
|
|
$11,750
|
|
|
$11,764
|
|
|
$11,688
|
|
|
$11,699
|
|
|
$
|
11,724
|
|
|
Net patient revenue per adjusted patient day
|
|
$2,534
|
|
|
$2,584
|
|
|
$2,571
|
|
|
$2,544
|
|
|
$
|
2,558
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net Patient Revenues from:
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
21.9
|
%
|
|
20.7
|
%
|
|
19.8
|
%
|
|
19.3
|
%
|
|
|
20.4
|
%
|
|
Medicaid
|
|
9.4
|
%
|
|
8.5
|
%
|
|
8.8
|
%
|
|
8.2
|
%
|
|
|
8.7
|
%
|
|
Managed care
|
|
58.6
|
%
|
|
60.8
|
%
|
|
61.1
|
%
|
|
61.6
|
%
|
|
|
60.6
|
%
|
|
Indemnity, self-pay and other
|
|
10.2
|
%
|
|
10.0
|
%
|
|
10.3
|
%
|
|
10.9
|
%
|
|
|
10.3
|
%
|
|
(1)
|
|
Represents the results of Tenet’s Hospital Operations and other
segment.
|
|
(2)
|
|
The results for the quarter ended March 31, 2015 have been restated
to exclude the results of the surgery and imaging centers that Tenet
contributed to the joint venture with United Surgical Partners
International. The results for these surgery and imaging centers are
now reported in Tenet’s Ambulatory Care segment.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1)
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per patient day,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
per admission, per adjusted admission
|
|
Three Months Ended
|
|
Year Ended
|
|
and per visit amounts)
|
|
03/31/15(2)
|
|
|
06/30/15
|
|
|
9/30/2015
|
|
|
|
12/31/2015
|
|
|
|
12/31/2015
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net inpatient revenues
|
|
$2,568
|
|
|
$2,493
|
|
|
$2,472
|
|
|
$
|
2,546
|
|
|
$
|
10,079
|
|
|
Net outpatient revenues
|
|
$1,350
|
|
|
$1,407
|
|
|
$1,427
|
|
|
$
|
1,446
|
|
|
$
|
5,630
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of acute care hospitals (at end of period)
|
|
75
|
|
|
75
|
|
|
75
|
|
|
|
75
|
|
|
|
75
|
|
|
Licensed beds (at end of period)
|
|
19,996
|
|
|
19,996
|
|
|
19,953
|
|
|
|
19,882
|
|
|
|
19,882
|
|
|
Average licensed beds
|
|
19,993
|
|
|
19,996
|
|
|
19,985
|
|
|
|
19,906
|
|
|
|
19,969
|
|
|
Utilization of licensed beds
|
|
51.9
|
%
|
|
48.9
|
%
|
|
47.6
|
%
|
|
|
47.8
|
%
|
|
|
49.0
|
%
|
|
Patient days - total
|
|
934,521
|
|
|
888,952
|
|
|
874,456
|
|
|
|
875,226
|
|
|
|
3,573,155
|
|
|
Adjusted patient days
|
|
1,550,217
|
|
|
1,520,937
|
|
|
1,503,727
|
|
|
|
1,508,868
|
|
|
|
6,083,749
|
|
|
Net inpatient revenue per patient day
|
|
$2,748
|
|
|
$2,804
|
|
|
$2,827
|
|
|
$
|
2,909
|
|
|
$
|
2,821
|
|
|
Total admissions
|
|
199,460
|
|
|
193,324
|
|
|
191,054
|
|
|
|
190,642
|
|
|
|
774,480
|
|
|
Adjusted patient admissions
|
|
334,218
|
|
|
334,451
|
|
|
332,521
|
|
|
|
332,037
|
|
|
|
1,333,227
|
|
|
Charity and uninsured admissions
|
|
10,291
|
|
|
9,947
|
|
|
10,701
|
|
|
|
10,386
|
|
|
|
41,325
|
|
|
Net inpatient revenue per admission
|
|
$12,875
|
|
|
$12,895
|
|
|
$12,939
|
|
|
$
|
13,355
|
|
|
$
|
13,014
|
|
|
Average length of stay (days)
|
|
4.69
|
|
|
4.60
|
|
|
4.58
|
|
|
|
4.59
|
|
|
|
4.61
|
|
|
Total surgeries
|
|
117,412
|
|
|
123,015
|
|
|
123,765
|
|
|
|
123,761
|
|
|
|
487,953
|
|
|
Admissions through emergency department
|
|
127,497
|
|
|
122,826
|
|
|
119,264
|
|
|
|
119,814
|
|
|
|
489,401
|
|
|
Emergency department visits
|
|
706,433
|
|
|
707,425
|
|
|
702,248
|
|
|
|
700,837
|
|
|
|
2,816,943
|
|
|
Total emergency department admissions and visits
|
|
833,930
|
|
|
830,251
|
|
|
821,512
|
|
|
|
820,651
|
|
|
|
3,306,344
|
|
|
Outpatient visits
|
|
1,912,749
|
|
|
1,980,927
|
|
|
1,963,166
|
|
|
|
1,974,943
|
|
|
|
7,831,785
|
|
|
Charity and uninsured outpatient visits
|
|
150,324
|
|
|
152,449
|
|
|
162,441
|
|
|
|
153,357
|
|
|
|
618,571
|
|
|
Net outpatient revenue per visit
|
|
$706
|
|
|
$710
|
|
|
$727
|
|
|
$
|
732
|
|
|
$
|
719
|
|
|
Net patient revenue per adjusted patient admission
|
|
$11,723
|
|
|
$11,661
|
|
|
$11,726
|
|
|
$
|
12,023
|
|
|
$
|
11,783
|
|
|
Net patient revenue per adjusted patient day
|
|
$2,527
|
|
|
$2,564
|
|
|
$2,593
|
|
|
$
|
2,646
|
|
|
$
|
2,582
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net Patient Revenues from:
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
21.6
|
%
|
|
20.4
|
%
|
|
20.0
|
%
|
|
|
19.6
|
%
|
|
|
19.6
|
%
|
|
Medicaid
|
|
9.2
|
%
|
|
8.2
|
%
|
|
8.6
|
%
|
|
|
8.3
|
%
|
|
|
8.3
|
%
|
|
Managed care
|
|
59.2
|
%
|
|
61.6
|
%
|
|
61.5
|
%
|
|
|
61.6
|
%
|
|
|
61.6
|
%
|
|
Indemnity, self-pay and other
|
|
10.0
|
%
|
|
9.8
|
%
|
|
9.9
|
%
|
|
|
10.5
|
%
|
|
|
10.5
|
%
|
|
(1)
|
|
Represents the results of Tenet’s Hospital Operations and other
segment.
|
|
(2)
|
|
The results for the quarter ended March 31, 2015 have been restated
to exclude the results of the surgery and imaging centers that Tenet
contributed to the joint venture with United Surgical Partners
International. The results for these surgery and imaging centers are
now reported in Tenet’s Ambulatory Care segment.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
SELECTED STATISTICS – CONTINUING SAME HOSPITALS((1))
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per patient day,
|
|
|
|
|
|
|
|
|
|
|
|
per admission, per adjusted admission
|
|
Three Months Ended
|
|
Year Ended
|
|
and per visit amounts)
|
|
|
03/31/14
|
|
|
|
06/30/14
|
|
|
|
9/30/2014
|
|
|
|
12/31/2014
|
|
|
|
12/31/2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net inpatient revenues
|
|
$
|
2,364
|
|
|
$
|
2,324
|
|
|
$
|
2,336
|
|
|
$
|
2,591
|
|
|
$
|
9,615
|
|
|
Net outpatient revenues
|
|
$
|
1,250
|
|
|
$
|
1,323
|
|
|
$
|
1,323
|
|
|
$
|
1,375
|
|
|
$
|
5,271
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of acute care hospitals (at end of period)
|
|
|
75
|
|
|
|
75
|
|
|
|
75
|
|
|
|
75
|
|
|
|
75
|
|
|
Licensed beds (at end of period)
|
|
|
19,832
|
|
|
|
19,932
|
|
|
|
19,932
|
|
|
|
19,984
|
|
|
|
19,984
|
|
|
Average licensed beds
|
|
|
19,832
|
|
|
|
19,881
|
|
|
|
19,932
|
|
|
|
19,975
|
|
|
|
19,905
|
|
|
Utilization of licensed beds
|
|
|
50.7
|
%
|
|
|
48.7
|
%
|
|
|
48.2
|
%
|
|
|
48.9
|
%
|
|
|
49.1
|
%
|
|
Patient days - total
|
|
|
904,400
|
|
|
|
880,198
|
|
|
|
883,743
|
|
|
|
898,353
|
|
|
|
3,566,694
|
|
|
Adjusted patient days
|
|
|
1,485,264
|
|
|
|
1,496,763
|
|
|
|
1,499,303
|
|
|
|
1,512,531
|
|
|
|
5,993,861
|
|
|
Net inpatient revenue per patient day
|
|
$
|
2,614
|
|
|
$
|
2,640
|
|
|
$
|
2,643
|
|
|
$
|
2,884
|
|
|
$
|
2,696
|
|
|
Total admissions
|
|
|
190,021
|
|
|
|
189,642
|
|
|
|
192,119
|
|
|
|
194,169
|
|
|
|
765,951
|
|
|
Adjusted patient admissions
|
|
|
315,397
|
|
|
|
325,810
|
|
|
|
329,845
|
|
|
|
330,884
|
|
|
|
1,301,936
|
|
|
Charity and uninsured admissions
|
|
|
12,094
|
|
|
|
10,510
|
|
|
|
10,319
|
|
|
|
10,573
|
|
|
|
43,496
|
|
|
Net inpatient revenue per admission
|
|
$
|
12,441
|
|
|
$
|
12,255
|
|
|
$
|
12,159
|
|
|
$
|
13,344
|
|
|
$
|
12,553
|
|
|
Average length of stay (days)
|
|
|
4.76
|
|
|
|
4.64
|
|
|
|
4.60
|
|
|
|
4.63
|
|
|
|
4.66
|
|
|
Total surgeries
|
|
|
115,391
|
|
|
|
120,778
|
|
|
|
122,610
|
|
|
|
123,854
|
|
|
|
482,633
|
|
|
Admissions through emergency department
|
|
|
120,160
|
|
|
|
119,269
|
|
|
|
118,287
|
|
|
|
122,089
|
|
|
|
479,805
|
|
|
Emergency department visits
|
|
|
655,714
|
|
|
|
689,083
|
|
|
|
690,171
|
|
|
|
703,265
|
|
|
|
2,738,233
|
|
|
Total emergency department admissions and visits
|
|
|
775,874
|
|
|
|
808,352
|
|
|
|
808,458
|
|
|
|
825,354
|
|
|
|
3,218,038
|
|
|
Outpatient visits
|
|
|
1,787,262
|
|
|
|
1,887,541
|
|
|
|
1,903,505
|
|
|
|
1,917,935
|
|
|
|
7,496,243
|
|
|
Charity and uninsured outpatient visits
|
|
|
158,356
|
|
|
|
161,773
|
|
|
|
158,091
|
|
|
|
158,492
|
|
|
|
636,712
|
|
|
Net outpatient revenue per visit
|
|
$
|
699
|
|
|
$
|
701
|
|
|
$
|
695
|
|
|
$
|
717
|
|
|
$
|
703
|
|
|
Net patient revenue per adjusted patient admission
|
|
$
|
11,459
|
|
|
$
|
11,194
|
|
|
$
|
11,093
|
|
|
$
|
11,986
|
|
|
$
|
11,434
|
|
|
Net patient revenue per adjusted patient day
|
|
$
|
2,433
|
|
|
$
|
2,437
|
|
|
$
|
2,440
|
|
|
$
|
2,622
|
|
|
$
|
2,484
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net Patient Revenues from:
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
22.4
|
%
|
|
|
22.4
|
%
|
|
|
21.2
|
%
|
|
|
20.7
|
%
|
|
|
21.7
|
%
|
|
Medicaid
|
|
|
7.7
|
%
|
|
|
9.9
|
%
|
|
|
8.7
|
%
|
|
|
11.1
|
%
|
|
|
9.4
|
%
|
|
Managed care
|
|
|
58.2
|
%
|
|
|
58.4
|
%
|
|
|
61.1
|
%
|
|
|
58.3
|
%
|
|
|
59.0
|
%
|
|
Indemnity, self-pay and other
|
|
|
11.7
|
%
|
|
|
9.3
|
%
|
|
|
9.1
|
%
|
|
|
9.9
|
%
|
|
|
9.9
|
%
|
|
(1)
|
|
Represents the results of Tenet’s Hospital Operations and other
segment. The results for 2014 have been restated to exclude the
results of the surgery and imaging centers that Tenet contributed to
the joint venture with United Surgical Partners International. The
results for these surgery and imaging centers are now reported in
Tenet’s Ambulatory Care segment.
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
SEGMENT REPORTING
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31,
|
|
December 31,
|
|
|
|
|
|
|
|
|
2015
|
|
|
|
2014
|
|
|
Assets
|
|
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
|
|
|
|
$
|
17,353
|
|
|
$
|
16,810
|
|
|
Ambulatory Care
|
|
|
|
|
|
|
5,159
|
|
|
|
212
|
|
|
Conifer
|
|
|
|
|
|
|
1,170
|
|
|
|
929
|
|
|
Total
|
|
|
|
|
|
$
|
23,682
|
|
|
$
|
17,951
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
Years Ended
|
|
|
|
December 31,
|
|
December 31,
|
|
|
|
|
2015
|
|
|
|
2014
|
|
|
|
2015
|
|
|
|
2014
|
|
|
Capital expenditures:
|
|
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
250
|
|
|
$
|
188
|
|
|
$
|
786
|
|
|
$
|
899
|
|
|
Ambulatory Care
|
|
|
14
|
|
|
|
3
|
|
|
|
28
|
|
|
|
9
|
|
|
Conifer
|
|
|
12
|
|
|
|
8
|
|
|
|
28
|
|
|
|
25
|
|
|
Total
|
|
$
|
276
|
|
|
$
|
199
|
|
|
$
|
842
|
|
|
$
|
933
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
4,423
|
|
|
$
|
4,213
|
|
|
$
|
16,928
|
|
|
$
|
15,681
|
|
|
Ambulatory Care
|
|
|
397
|
|
|
|
90
|
|
|
|
959
|
|
|
|
320
|
|
|
Conifer
|
|
|
|
|
|
|
|
|
|
Tenet
|
|
|
178
|
|
|
|
165
|
|
|
|
666
|
|
|
|
591
|
|
|
Other customers
|
|
|
206
|
|
|
|
162
|
|
|
|
747
|
|
|
|
602
|
|
|
Total Conifer revenues
|
|
|
384
|
|
|
|
327
|
|
|
|
1,413
|
|
|
|
1,193
|
|
|
Intercompany eliminations
|
|
|
(178
|
)
|
|
|
(165
|
)
|
|
|
(666
|
)
|
|
|
(591
|
)
|
|
Total
|
|
$
|
5,026
|
|
|
$
|
4,465
|
|
|
$
|
18,634
|
|
|
$
|
16,603
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA:
|
|
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
394
|
|
|
$
|
553
|
|
|
$
|
1,653
|
|
|
$
|
1,651
|
|
|
Ambulatory Care
|
|
|
158
|
|
|
|
29
|
|
|
|
358
|
|
|
|
98
|
|
|
Conifer
|
|
|
61
|
|
|
|
64
|
|
|
|
265
|
|
|
|
203
|
|
|
Total
|
|
$
|
613
|
|
|
$
|
646
|
|
|
$
|
2,276
|
|
|
$
|
1,952
|
|
|
|
|
|
|
|
|
|
|
|
|
Depreciation and amortization:
|
|
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
177
|
|
|
$
|
227
|
|
|
$
|
702
|
|
|
$
|
810
|
|
|
Ambulatory Care
|
|
|
18
|
|
|
|
3
|
|
|
|
46
|
|
|
|
14
|
|
|
Conifer
|
|
|
13
|
|
|
|
10
|
|
|
|
49
|
|
|
|
25
|
|
|
Total
|
|
$
|
208
|
|
|
$
|
240
|
|
|
$
|
797
|
|
|
$
|
849
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA
|
|
$
|
613
|
|
|
$
|
646
|
|
|
$
|
2,276
|
|
|
$
|
1,952
|
|
|
Depreciation and amortization
|
|
|
(208
|
)
|
|
|
(240
|
)
|
|
|
(797
|
)
|
|
|
(849
|
)
|
|
Impairments and restructuring charges, and acquisition-related costs
|
|
|
(52
|
)
|
|
|
(63
|
)
|
|
|
(318
|
)
|
|
|
(153
|
)
|
|
Litigation and investigation costs
|
|
|
(224
|
)
|
|
|
(6
|
)
|
|
|
(291
|
)
|
|
|
(25
|
)
|
|
Interest expense
|
|
|
(248
|
)
|
|
|
(196
|
)
|
|
|
(912
|
)
|
|
|
(754
|
)
|
|
Loss from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(24
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
186
|
|
|
|
—
|
|
|
|
186
|
|
|
|
—
|
|
|
Investment Earnings
|
|
|
1
|
|
|
|
—
|
|
|
|
1
|
|
|
|
—
|
|
|
Income from continuing operations before income taxes
|
|
$
|
67
|
|
|
$
|
141
|
|
|
$
|
144
|
|
|
$
|
147
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
STATEMENT OF OPERATIONS – AMBULATORY CARE SEGMENT
|
|
INCLUDING PRO FORMA USPI AND ASPEN FOR ALL PERIODS
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended December 31,
|
|
|
|
2015
|
|
|
2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ambulatory
Care as
Reported
Under
GAAP
|
|
Unconsolidated
Affiliates
|
|
Ambulatory
Care as
Reported
Under
GAAP
|
|
Unconsolidated
Affiliates
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
Net operating revenues before provision for doubtful accounts
|
|
$
|
404
|
|
|
$
|
637
|
|
|
$
|
313
|
|
|
$
|
587
|
|
|
Less: Provision for doubtful accounts
|
|
|
(7
|
)
|
|
|
(13
|
)
|
|
|
(5
|
)
|
|
|
(14
|
)
|
|
Net operating revenues(1)
|
|
|
397
|
|
|
|
624
|
|
|
|
308
|
|
|
|
573
|
|
|
Equity in earnings of unconsolidated affiliates(2)
|
|
|
47
|
|
|
|
—
|
|
|
|
43
|
|
|
|
—
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
130
|
|
|
|
135
|
|
|
|
97
|
|
|
|
130
|
|
|
Supplies
|
|
|
79
|
|
|
|
148
|
|
|
|
57
|
|
|
|
142
|
|
|
Other operating expenses, net
|
|
|
78
|
|
|
|
111
|
|
|
|
65
|
|
|
|
106
|
|
|
Electronic health record incentives
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(2
|
)
|
|
|
—
|
|
|
Depreciation and amortization
|
|
|
18
|
|
|
|
20
|
|
|
|
14
|
|
|
|
20
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
3
|
|
|
|
(2
|
)
|
|
|
7
|
|
|
|
—
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(32
|
)
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
Operating income
|
|
|
169
|
|
|
|
212
|
|
|
|
113
|
|
|
|
175
|
|
|
Interest expense
|
|
|
(35
|
)
|
|
|
(7
|
)
|
|
|
(31
|
)
|
|
|
(7
|
)
|
|
Net income from continuing operations, before income taxes
|
|
|
134
|
|
|
|
205
|
|
|
|
82
|
|
|
|
168
|
|
|
Income tax expense
|
|
|
(16
|
)
|
|
|
(3
|
)
|
|
|
(19
|
)
|
|
|
(2
|
)
|
|
Net income
|
|
|
118
|
|
|
$
|
202
|
|
|
|
63
|
|
|
$
|
166
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
85
|
|
|
|
|
|
49
|
|
|
|
|
Net income attributable to Tenet Healthcare Corporation common
shareholders
|
|
$
|
33
|
|
|
|
|
$
|
14
|
|
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
|
$
|
47
|
|
|
|
|
$
|
43
|
|
|
(1)
|
|
On a same-facility system-wide basis, net revenue in Tenet’s
Ambulatory Care segment increased 12.5% during the three months
ended December 31, 2015, with cases increasing 6.9% and revenue per
case increasing 5.2%.
|
|
(2)
|
|
At December 31, 2015, 139 of the 333 facilities in the Company’s
newly formed Ambulatory segment were not consolidated based on the
nature of the segment’s joint venture relationships with physicians
and prominent healthcare systems. Although revenues of the segment’s
unconsolidated facilities are not recorded as revenues by the
Company, equity in earnings of unconsolidated affiliates is
nonetheless a significant portion of the Company’s overall earnings.
To help analyze results of operations, management also uses
system-wide operating measures such as system-wide revenue growth,
which includes revenues of both consolidated and unconsolidated
facilities. We control our remaining 194 facilities and account for
these investments as consolidated subsidiaries.
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
STATEMENT OF OPERATIONS – AMBULATORY CARE SEGMENT
|
|
INCLUDING PRO FORMA USPI AND ASPEN FOR ALL PERIODS
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Years Ended December 31,
|
|
|
|
2015
|
|
|
2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ambulatory
Care as
Reported
Under
GAAP
|
|
Unconsolidated
Affiliates
|
|
Ambulatory
Care as
Reported
Under
GAAP
|
|
Unconsolidated
Affiliates
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
Net operating revenues before provision for doubtful accounts
|
|
$
|
1,366
|
|
|
$
|
2,213
|
|
|
$
|
1,156
|
|
|
$
|
1,967
|
|
|
Less: Provision for doubtful accounts
|
|
|
(23
|
)
|
|
|
(53
|
)
|
|
|
(16
|
)
|
|
|
(48
|
)
|
|
Net operating revenues(1)
|
|
|
1,343
|
|
|
|
2,160
|
|
|
|
1,140
|
|
|
|
1,919
|
|
|
Equity in earnings of unconsolidated affiliates(2)
|
|
|
126
|
|
|
|
—
|
|
|
|
116
|
|
|
|
—
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
438
|
|
|
|
514
|
|
|
|
368
|
|
|
|
463
|
|
|
Supplies
|
|
|
253
|
|
|
|
542
|
|
|
|
203
|
|
|
|
478
|
|
|
Other operating expenses, net
|
|
|
290
|
|
|
|
448
|
|
|
|
260
|
|
|
|
397
|
|
|
Electronic health record incentives
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(2
|
)
|
|
|
—
|
|
|
Depreciation and amortization
|
|
|
64
|
|
|
|
80
|
|
|
|
56
|
|
|
|
76
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
5
|
|
|
|
1
|
|
|
|
9
|
|
|
|
(6
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(32
|
)
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
Operating income
|
|
|
452
|
|
|
|
575
|
|
|
|
362
|
|
|
|
511
|
|
|
Interest expense
|
|
|
(137
|
)
|
|
|
(28
|
)
|
|
|
(123
|
)
|
|
|
(28
|
)
|
|
Other
|
|
|
—
|
|
|
|
(2
|
)
|
|
|
—
|
|
|
|
1
|
|
|
Net income from continuing operations, before income taxes
|
|
|
315
|
|
|
|
545
|
|
|
|
239
|
|
|
|
484
|
|
|
Income tax expense
|
|
|
(52
|
)
|
|
|
(8
|
)
|
|
|
(49
|
)
|
|
|
(8
|
)
|
|
Net Income
|
|
|
263
|
|
|
$
|
537
|
|
|
|
190
|
|
|
$
|
476
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
206
|
|
|
|
|
|
150
|
|
|
|
|
Net income attributable to Tenet Healthcare Corporation common
shareholders
|
|
$
|
57
|
|
|
|
|
$
|
40
|
|
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
|
$
|
126
|
|
|
|
|
$
|
116
|
|
|
(1)
|
|
On a pro forma same-facility system-wide basis, net revenue in
Tenet’s Ambulatory Care segment increased 11.7% during the twelve
months ended December 31, 2015, with cases increasing 7.9% and
revenue per case increasing 3.6%.
|
|
(2)
|
|
At December 31, 2015, 139 of the 333 facilities in the Company’s
newly formed Ambulatory segment were not consolidated based on the
nature of the segment’s joint venture relationships with physicians
and prominent healthcare systems. Although revenues of the segment’s
unconsolidated facilities are not recorded as revenues by the
Company, equity in earnings of unconsolidated affiliates is
nonetheless a significant portion of the Company’s overall earnings.
To help analyze results of operations, management also uses
system-wide operating measures such as system-wide revenue growth,
which includes revenues of both consolidated and unconsolidated
facilities. We control our remaining 194 facilities and account for
these investments as consolidated subsidiaries.
|
|
|
|
|
(1) Reconciliation of Adjusted EBITDA
Adjusted EBITDA, a non-GAAP term, is defined by the Company as net
income (loss) attributable to Tenet Healthcare Corporation common
shareholders before (1) the cumulative effect of changes in accounting
principle, net of tax; (2) net loss (income) attributable to
noncontrolling interests; (3) preferred stock dividends; (4) income
(loss) from discontinued operations, net of tax; (5) income tax benefit
(expense); (6) investment earnings (loss); (7) gain (loss) from early
extinguishment of debt; (8) net gain (loss) on sales of investments; (9)
interest expense; (10) litigation and investigation benefit (costs), net
of insurance recoveries; (11) hurricane insurance recoveries, net of
costs; (12) net gains (losses) on sales, consolidation and
deconsolidation of facilities: (13) impairment and restructuring charges
and acquisition-related costs; and (14) depreciation and amortization.
The Company’s Adjusted EBITDA may not be comparable to EBITDA reported
by other companies.
The Company provides this information as a supplement to GAAP
information to assist itself and investors in understanding the impact
of various items on its financial statements, some of which are
recurring or involve cash payments. The Company uses this information in
its analysis of the performance of its business excluding items that it
does not consider as relevant in the performance of its hospitals in
continuing operations. In addition, from time to time we use this
measure to define certain performance targets under our compensation
programs. Adjusted EBITDA is not a measure of liquidity, but is a
measure of operating performance that management uses in its business as
an alternative to net income (loss) attributable to Tenet Healthcare
Corporation common shareholders. Because Adjusted EBITDA excludes many
items that are included in our financial statements, it does not provide
a complete measure of our operating performance. Accordingly, investors
are encouraged to use GAAP measures when evaluating the Company’s
financial performance.
The reconciliation of net income (loss) attributable to Tenet Healthcare
Corporation common shareholders, the most comparable GAAP term, to
Adjusted EBITDA, is set forth in the first table below for the three and
twelve months ended December 31, 2015 and 2014.
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
Additional Supplemental Non-GAAP disclosures
|
|
Table #1 – Reconciliation of Adjusted EBITDA to Net Loss
Attributable to
|
|
Tenet Healthcare Corporation Common Shares
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
Years Ended
|
|
|
|
December 31,
|
|
December 31,
|
|
|
|
|
2015
|
|
|
|
2014
|
|
|
|
2015
|
|
|
|
2014
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(97
|
)
|
|
$
|
61
|
|
|
$
|
(140
|
)
|
|
$
|
12
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
(99
|
)
|
|
|
(20
|
)
|
|
|
(218
|
)
|
|
|
(64
|
)
|
|
Net income (loss) from discontinued operations, net of tax
|
|
|
3
|
|
|
|
—
|
|
|
|
2
|
|
|
|
(22
|
)
|
|
Income from continuing operations
|
|
|
(1
|
)
|
|
|
81
|
|
|
|
76
|
|
|
|
98
|
|
|
Income tax expense
|
|
|
(68
|
)
|
|
|
(60
|
)
|
|
|
(68
|
)
|
|
|
(49
|
)
|
|
Investment earnings
|
|
|
1
|
|
|
|
—
|
|
|
|
1
|
|
|
|
—
|
|
|
Loss from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(24
|
)
|
|
Interest expense
|
|
|
(248
|
)
|
|
|
(196
|
)
|
|
|
(912
|
)
|
|
|
(754
|
)
|
|
Operating income
|
|
|
315
|
|
|
|
337
|
|
|
|
1,056
|
|
|
|
925
|
|
|
Litigation and investigation costs
|
|
|
(224
|
)
|
|
|
(6
|
)
|
|
|
(291
|
)
|
|
|
(25
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
186
|
|
|
|
—
|
|
|
|
186
|
|
|
|
—
|
|
|
Impairment and restructuring charges, acquisition-related costs and
litigation costs and settlements
|
|
|
(52
|
)
|
|
|
(63
|
)
|
|
|
(318
|
)
|
|
|
(153
|
)
|
|
Depreciation and amortization
|
|
|
(208
|
)
|
|
|
(240
|
)
|
|
|
(797
|
)
|
|
|
(849
|
)
|
|
Adjusted EBITDA
|
|
$
|
613
|
|
|
$
|
646
|
|
|
$
|
2,276
|
|
|
$
|
1,952
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues
|
|
$
|
5,026
|
|
|
$
|
4,465
|
|
|
$
|
18,634
|
|
|
$
|
16,603
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA
margin)
|
|
|
12.2
|
%
|
|
|
14.5
|
%
|
|
|
12.2
|
%
|
|
|
11.8
|
%
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
Additional Supplemental Non-GAAP disclosures
|
|
Table #2 – Reconciliation of Adjusted Free Cash Flow
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
Years Ended
|
|
(Dollars in millions)
|
|
December 31,
|
|
December 31,
|
|
|
|
|
2015
|
|
|
|
2014
|
|
|
|
2015
|
|
|
|
2014
|
|
|
Net cash provided by operating activities
|
|
$
|
191
|
|
|
$
|
219
|
|
|
$
|
1,026
|
|
|
$
|
687
|
|
|
Less:
|
|
|
|
|
|
|
|
|
|
Payments for restructuring charges, acquisition-related costs, and
litigation costs and settlements
|
|
|
(43
|
)
|
|
|
(53
|
)
|
|
|
(200
|
)
|
|
|
(168
|
)
|
|
Net cash used in operating activities from discontinued operations
|
|
|
(3
|
)
|
|
|
(7
|
)
|
|
|
(21
|
)
|
|
|
(23
|
)
|
|
Adjusted net cash provided by operating activities – continuing
operations
|
|
|
237
|
|
|
|
279
|
|
|
|
1,247
|
|
|
|
878
|
|
|
Purchases of property and equipment – continuing operations
|
|
|
(276
|
)
|
|
|
(199
|
)
|
|
|
(842
|
)
|
|
|
(933
|
)
|
|
Adjusted free cash flow – continuing operations
|
|
$
|
(39
|
)
|
|
$
|
80
|
|
|
$
|
405
|
|
|
$
|
(55
|
)
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
Additional Supplemental Non-GAAP disclosures
|
|
Table #3 – Reconciliation of Outlook Adjusted EBITDA to
|
|
Outlook Net Income Attributable to Tenet Healthcare Corporation
Common Shareholders
|
|
for the Year Ending December 31, 2016
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
Q1 2016
|
|
2016
|
|
|
|
|
Low
|
|
High
|
|
Low
|
|
High
|
|
Net income attributable to Tenet Healthcare Corporation common
shareholders
|
|
$
|
3
|
|
|
$
|
55
|
|
|
$
|
115
|
|
|
$
|
230
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
(70
|
)
|
|
|
(60
|
)
|
|
|
(330
|
)
|
|
|
(310
|
)
|
|
Net Loss from discontinued operations, net of tax
|
|
|
(2
|
)
|
|
|
-
|
|
|
|
(5
|
)
|
|
|
-
|
|
|
Income from continuing operations
|
|
|
75
|
|
|
|
115
|
|
|
|
450
|
|
|
|
540
|
|
|
Income tax expense
|
|
|
(10
|
)
|
|
|
(50
|
)
|
|
|
(130
|
)
|
|
|
(200
|
)
|
|
Income from continuing operations, before income taxes
|
|
|
85
|
|
|
|
165
|
|
|
|
580
|
|
|
|
740
|
|
|
Interest expense, net
|
|
|
(245
|
)
|
|
|
(235
|
)
|
|
|
(970
|
)
|
|
|
(950
|
)
|
|
Operating income
|
|
|
330
|
|
|
|
400
|
|
|
|
1,550
|
|
|
|
1,690
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
Impairment and restructuring charges, acquisition-related costs
|
|
|
|
|
|
|
|
|
|
and litigation costs and settlements(a)
|
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
Depreciation and amortization
|
|
|
(220
|
)
|
|
|
(200
|
)
|
|
|
(850
|
)
|
|
|
(810
|
)
|
|
Adjusted EBITDA
|
|
$
|
550
|
|
|
$
|
600
|
|
|
$
|
2,400
|
|
|
$
|
2,500
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues
|
|
$
|
4,700
|
|
|
$
|
4,900
|
|
|
$
|
18,800
|
|
|
$
|
19,200
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA
margin)
|
|
|
11.7
|
%
|
|
|
12.2
|
%
|
|
|
12.8
|
%
|
|
|
13.0
|
%
|
|
(a)
|
|
Company does not forecast impairment and restructuring charges,
acquisition-related costs, litigation costs and settlements, and
gains on sales, consolidation and deconsolidation of facilities.
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
Additional Supplemental Non-GAAP disclosures
|
|
Table #4 – Reconciliation of Outlook Adjusted EBITDA to
|
|
Outlook Normalized Income from Continuing Operations
|
|
for the Year Ending December 31, 2016
|
|
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
Q1 2016
|
|
2016
|
|
|
|
|
Low
|
|
High
|
|
Low
|
|
High
|
|
Adjusted EBITDA
|
|
$
|
550
|
|
|
$
|
600
|
|
|
$
|
2,400
|
|
|
$
|
2,500
|
|
|
Depreciation and amortization
|
|
|
(220
|
)
|
|
|
(200
|
)
|
|
|
(850
|
)
|
|
|
(810
|
)
|
|
Interest expense
|
|
|
(245
|
)
|
|
|
(235
|
)
|
|
|
(970
|
)
|
|
|
(950
|
)
|
|
Normalized income from continuing operations before income taxes
|
|
|
85
|
|
|
|
165
|
|
|
|
580
|
|
|
|
740
|
|
|
Income tax expense
|
|
|
(10
|
)
|
|
|
(50
|
)
|
|
|
(130
|
)
|
|
|
(200
|
)
|
|
Normalized income from continuing operations
|
|
|
75
|
|
|
|
115
|
|
|
|
450
|
|
|
|
540
|
|
|
Net income attributable to noncontrolling interests
|
|
|
(70
|
)
|
|
|
(60
|
)
|
|
|
(330
|
)
|
|
|
(310
|
)
|
|
Normalized net income attributable to common shares
|
|
$
|
5
|
|
|
$
|
55
|
|
|
$
|
120
|
|
|
$
|
230
|
|
|
|
|
|
|
|
|
|
|
|
|
Fully diluted weighted average share outstanding (in millions)
|
|
|
101
|
|
|
|
101
|
|
|
|
102
|
|
|
|
102
|
|
|
|
|
|
|
|
|
|
|
|
|
Normalized fully diluted earnings per share – continuing
operations
|
|
$
|
0.05
|
|
|
$
|
0.54
|
|
|
$
|
1.18
|
|
|
$
|
2.25
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
|
|
Additional Supplemental Non-GAAP disclosures
|
|
Table #5 – Reconciliation of Outlook Adjusted Free Cash Flow
|
|
for the Year Ending December 31, 2016
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
|
|
|
|
|
2016
|
|
|
|
|
|
|
|
|
|
|
Low
|
|
High
|
|
Net cash provided by operating activities
|
|
|
|
|
|
|
|
$
|
1,275
|
|
|
$
|
1,435
|
|
|
Less:
|
|
|
|
|
|
|
|
|
|
|
|
Payments for restructuring charges, acquisition-related costs and
litigation costs and settlements(a)
|
|
|
|
|
|
|
|
|
-
|
|
|
|
-
|
|
|
Net cash used in operating activities from discontinued operations
|
|
|
|
|
|
|
|
|
(25
|
)
|
|
|
(15
|
)
|
|
Adjusted net cash provided by operating activities – continuing
operations
|
|
|
|
|
|
|
|
$
|
1,300
|
|
|
$
|
1,450
|
|
|
Purchases of property and equipment – continuing operations
|
|
|
|
|
|
|
|
|
(900
|
)
|
|
|
(850
|
)
|
|
Adjusted free cash flow – continuing operations
|
|
|
|
|
|
|
|
$
|
400
|
|
|
$
|
600
|
|
(a) Company does not forecast impairment and restructuring
charges, acquisition-related costs, and litigation costs and settlements.
