DALLAS--(BUSINESS WIRE)--Tenet Healthcare Corporation (NYSE: THC) reported net income from
continuing operations available to Tenet shareholders of $98 million in
the first quarter of 2018, compared to a $52 million net loss from
continuing operations in the first quarter of 2017. Adjusted EBITDA was
$665 million in the first quarter of 2018 compared to $527 million in
the first quarter of 2017.
“The actions we have taken to be a more efficient, agile and decisive
organization have resulted in stronger financial performance,” said
Ronald A. Rittenmeyer, executive chairman and CEO. “We are continuing
our focus on improving quality, growth and financial results and will be
exploring additional opportunities to enhance margins and shareholder
returns.”
Hospital Operations and Other Segment
Net operating revenues in the Hospital Operations and other segment were
$3.947 billion, down 4.1 percent from the first quarter of 2017,
primarily due to divestitures and a decline in health plan revenues.
On a same-hospital basis, net patient revenues after implicit price
concessions (as discussed below in the section titled “New Revenue
Recognition Accounting Rules and Uncompensated Care”) was $3.594
billion, up 6.7 percent from the first quarter of 2017. Adjusted
admissions were up 0.6 percent and revenue per adjusted admission was up
6.0 percent, with 190 basis points related to the California Provider
Fee and a benefit from increased acuity. Same-hospital revenue included
$64 million from the California Provider Fee Program in the first
quarter of 2018 compared to no revenue in the first quarter of 2017
since the 2017 program was not approved until December 2017.
Adjusted EBITDA in Tenet’s hospital segment was $402 million, an
increase of $93 million or 30.1 percent as compared to $309 million in
the first quarter of 2017. The $93 million increase in Adjusted EBITDA
in the hospital segment was primarily driven by: (i) a $64 million
increase in California Provider Fee revenue, (ii) a $12 million
favorable adjustment in Q1’18 to malpractice and workers’ compensation
expense related to an increase in the discount rate, (iii) strong cost
management within the company’s hospital operations and corporate
overhead functions, and (iv) increased acuity, which were partially
offset by divestiture activity.
Tenet’s health plan business recognized $6 million of revenue and a $1
million EBITDA loss in the first quarter of 2018 versus $65 million of
revenue and a $16 million loss in the first quarter of 2017. The revenue
and expenses associated with the Company’s health plan operations are
included in Tenet’s consolidated statements of operations; however, the
results are excluded from Adjusted EBITDA in both periods.
Selected operating expenses in the segment, defined as the sum of
salaries, wages and benefits, supplies and other operating expenses,
increased 2.7 percent on a per adjusted admission basis in the first
quarter of 2017.
Exchanges
Same-hospital exchange outpatient visits were 49,680 in the first
quarter of 2018, up 11.4 percent from the first quarter of 2017. Tenet’s
same-hospital exchange admissions were 4,677 in the first quarter of
2018, down 1.1 percent from the first quarter of 2017.
Ambulatory Care Segment
During the first quarter of 2018, the Ambulatory segment produced net
operating revenues of $498 million, representing an increase of 9.5
percent as compared to $455 million in the first quarter of 2017. In
addition, the Ambulatory segment generated Adjusted EBITDA of $165
million, up 7.8 percent from $153 million in the first quarter of 2017
and Adjusted EBITDA less facility-level noncontrolling interest was $109
million, up 9.0 percent from $100 million in the first quarter of 2017.
The results of many of the facilities in which the Ambulatory segment
has an investment are not consolidated by Tenet. To help analyze the
segment’s results of operations, management uses system-wide measures,
which include revenues and cases of both consolidated and unconsolidated
facilities. On a same-facility system-wide basis, revenue in the
Ambulatory segment increased 2.7 percent, with cases increasing 3.2
percent and revenue per case declining 0.5 percent. In the surgical
business, which represents the majority of the revenue in the Ambulatory
segment, same-facility system-wide revenue grew 2.3 percent, with cases
down 0.5 percent and revenue per case up 2.8 percent, reflecting growth
in higher-acuity surgical procedures. In the non-surgical business,
same-facility system-wide revenue grew 11.8 percent, with revenue per
case up 2.8 percent and cases up 8.7 percent, reflecting strong growth
in urgent care visits due in part to the elevated flu season.
Conifer Segment
During the first quarter of 2018, Conifer’s revenue increased 0.5
percent to $404 million, up from $402 million in the first quarter of
2017. Revenue from third party customers grew 4.5 percent to $254
million. Conifer’s revenue in the first quarter of 2018 included $10
million of contract termination fees related to one of Conifer’s
customers selling its hospital to a system that chose to insource
revenue cycle management.
Conifer generated $98 million of Adjusted EBITDA in the first quarter of
2018, up 50.8 percent from $65 million in the first quarter of 2017.
After normalizing for two items that increased Conifer’s Adjusted EBITDA
by $13 million in the first quarter of 2018, Adjusted EBITDA grew by 31
percent, primarily driven by improvements in Conifer’s cost structure.
The two items totaling $13 million were the aforementioned $10 million
contract termination fee and $3 million in customer incentive payments.
Net Income and Earnings Per Share
Tenet reported net income from continuing operations available to Tenet
shareholders of $98 million, or $0.95 per diluted share, in the first
quarter of 2018 compared to a net loss of $52 million, or $0.52 per
diluted share, in the first quarter of 2017.
As shown on Table #2, net income from continuing operations available to
Tenet shareholders of $98 million included: (i) $47 million of pre-tax
impairment and restructuring charges consisting of $19 million of
impairment charges primarily from the write-down of assets held for sale
in the Chicago area to their estimated fair value, $25 million of
restructuring charges primarily related to employee severance associated
with the Company’s cost reduction initiatives, and $3 million of
acquisition-related costs; (ii) a $110 million pre-tax gain on sales,
consolidation and deconsolidation of facilities, primarily related to a
$98 million pre-tax gain on the sale of MacNeal Hospital in the Chicago
area on March 1, 2018 and a $13 million pre-tax gain on the sales of our
minority interests in several Dallas-area hospitals; and (iii) an $8
million pre-tax loss from other items. These items collectively
increased pre-tax income by $55 million, after-tax income by $39 million
and diluted earnings per share by $0.38.
After adjusting for the items listed above and on Table #2, Tenet
produced Adjusted net income from continuing operations available to
Tenet shareholders of $59 million, or $0.57 per diluted share, during
the first quarter of 2018, as compared to an Adjusted net loss from
continuing operations attributable to Tenet shareholders of $27 million,
or $0.27 per diluted share, in the first quarter of 2017.
A reconciliation of GAAP net income (loss) available to Tenet
shareholders to Adjusted net income (loss) from continuing operations
and Adjusted diluted earnings (loss) per share from continuing
operations available to Tenet shareholders is contained in Table #2 at
the end of this release.
Cash Flow and Liquidity
Cash and cash equivalents were $974 million at March 31, 2018 compared
to $611 million at December 31, 2017. The Company had no outstanding
borrowings on its $1 billion credit line as of March 31, 2018. Accounts
receivable days outstanding from continuing operations were 54.3 at
March 31, 2018 compared to 55.8 at December 31, 2017.
Net cash provided by operating activities was $113 in the first quarter
of 2018, representing a $73 million decrease compared to $186 million in
the first quarter of 2017. After subtracting $143 million and $198
million of capital expenditures in the first quarters of 2018 and 2017,
respectively, Free Cash Flow was an outflow of $30 million in the first
quarter of 2018, a decline of $18 million compared to an outflow of $12
million in the first quarter of 2017. Adjusted Free Cash Flow was $4
million in the first quarter of 2018, representing a $6 million decrease
from $10 million in the first quarter of 2017. The year-over-year
declines in net cash provided by operating activities, free cash flow
and adjusted free cash flow were primarily due to an anticipated $82
million reduction in receipts related to the California Provider Fee
program.
Net cash provided by investing activities was $373 million in the first
quarter of 2018 compared to $189 million of net cash used in investing
activities in the first quarter of 2017. The 2018 period included $559
million of proceeds from the sales of facilities, long-term investments
and other assets, primarily from the sale of the Company’s two hospitals
in the Philadelphia area, MacNeal Hospital and the Company’s minority
interest in several Dallas-area hospitals.
Net cash used in financing activities was $123 million in the first
quarter of 2018 compared to $141 million of net cash used in financing
activities in the first quarter of 2017. The 2018 period included $50
million of debt retirement through open market purchases.
Reconciliations of net cash provided by operating activities to both
Free Cash Flow and Adjusted Free Cash Flow are contained in Table #3 at
the end of this release.
Outlook
The Company’s revised Outlook for 2018 includes:
-
Revenue of $17.9 billion to $18.3 billion,
-
Net income from continuing operations available to Tenet common
shareholders of $105 million to $180 million,
-
Adjusted EBITDA of $2.550 billion to $2.650 billion,
-
Net cash provided by operating activities of $1.245 billion to $1.550
billion,
-
Adjusted Free Cash Flow of $725 million to $925 million,
-
Diluted earnings per share from continuing operations available to
Tenet shareholders of $1.02 to $1.75, and
-
Adjusted diluted earnings per share from continuing operations
available to Tenet shareholders of $1.36 to $1.70.
The Company raised the midpoint of its previous 2018 Adjusted EBITDA
Outlook range by $50 million to reflect higher expectations for Conifer,
primarily as a result of the business achieving improvements in its cost
structure on a faster pace than previously anticipated.
The Outlook for 2018 assumes equity in earnings of unconsolidated
affiliates of $160 million to $170 million, net income attributable to
noncontrolling interests of $410 million to $430 million and an average
diluted share count of 103 million. The Outlook for net income
attributable to noncontrolling interests reflects a reduction in
noncontrolling interest expense as a result of Tenet increasing its
ownership in USPI from 80 percent to 95 percent, effective April 26,
2018, substantially offset by increased noncontrolling interest expense
at Conifer resulting from our increased expectations for Conifer’s net
income this year.
The Company’s Outlook for the second quarter of 2018 includes:
-
Revenue of $4.475 billion to $4.675 billion,
-
Net income from continuing operations available to Tenet shareholders
ranging from a loss of $5 million to income of $10 million,
-
Adjusted EBITDA of $605 million to $655 million,
-
Earnings per diluted share from continuing operations available to
Tenet shareholders ranging from a loss of $0.05 to earnings of $0.10,
and
-
Adjusted earnings per diluted share from continuing operations
available to Tenet shareholders ranging from $0.15 to $0.29.
The Outlook for the second quarter assumes equity in earnings of
unconsolidated affiliates of $35 million to $40 million, net income
attributable to noncontrolling interests of $95 million to $105 million,
and an average diluted share count of 102 million.
Additional details on Tenet’s Outlook for both the second quarter and
calendar year 2018 are available in Tables #4, #5 and #6 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
.
New Revenue Recognition Accounting Rules and Uncompensated Care
Effective January 1, 2018, Tenet adopted the Financial Accounting
Standards Board Accounting Standards Update (“ASU”) 2014-09, “Revenue
from Contracts with Customers (Topic 606)” (“ASU 2014-09”) using a
modified retrospective method of application. For our Hospital
Operations and other and Ambulatory Care segments, the adoption of ASU
2014-09 resulted in changes to our presentation for and disclosure of
revenue primarily related to uninsured or underinsured patients. Prior
to the adoption of ASU 2014-09, a significant portion of our provision
for doubtful accounts related to self-pay patients, as well as co-pays,
co-insurance amounts and deductibles owed to us by patients with
insurance. Under ASU 2014-09, the estimated uncollectable amounts due
from these patients are generally considered implicit price concessions
that are a direct reduction to net operating revenues, with a
corresponding material reduction in the amounts previously considered
provision for doubtful accounts. Since implicit price concessions are
essentially similar to provision for doubtful accounts, for
comparability purposes with the 2017 period implicit price concessions
in the 2018 quarter are compared to provision for doubtful accounts in
the 2017 quarter.
Tenet’s implicit price concessions in the first quarter of 2018 were
$347 million, representing a ratio of 6.9 percent of revenues before
these items compared to $383 million in the first quarter of 2017, or
7.4 percent of revenues. The decrease in this ratio was primarily
attributable to hospital divestitures, revenue growth in our Ambulatory
segment, and revenue from the California Provider Fee program revenue
being recorded in the first quarter of 2018.
Tenet’s uncompensated care costs, defined as the sum of implicit price
concessions, provision for doubtful accounts, charity care write-offs
and uninsured discounts, were $1.362 billion and $1.342 billion in the
first quarters of 2018 and 2017, respectively, including $1.015 billion
and $959 million, respectively, of charity care write-offs and uninsured
discounts that were offered through Tenet’s Compact with Uninsured
Patients. Uncompensated care in the first quarter of 2018 represented
22.5 percent of revenue before implicit price concessions, bad debts,
uninsured discounts and charity care write-offs, up from 21.8 percent in
the first quarter of 2017. Nearly all of Tenet’s uncompensated care is
associated with the Hospital Operations and other segment.
Uninsured plus charity admissions increased by 536 admissions, or 5.9
percent on a same-hospital basis in the first quarter of 2018 compared
to the first quarter of 2017. Uninsured plus charity outpatient visits
increased by 1,806 visits, or 1.6 percent, on a same-hospital basis.
Management’s Webcast Discussion of First Quarter Results
Tenet management will discuss the Company’s first quarter 2018 results
on a webcast scheduled for 10:00 a.m. Eastern Time (9:00 a.m. Central
Time) on May 1, 2018. Investors can access the webcast through the
Company’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-Q report for the three months ended March
31, 2018, which will be filed with the Securities and Exchange
Commission and posted on the Company’s website before the webcast.
This press release includes certain non-GAAP measures, such as Adjusted
EBITDA, Adjusted net income (loss) from continuing operations
attributable to Tenet shareholders, Adjusted diluted earnings (loss) per
share from continuing operations attributable to Tenet shareholders,
Free Cash Flow and Adjusted Free Cash Flow. Reconciliations of these
measures to the most comparable GAAP measure are contained in the tables
at the end of this release.
Tenet Healthcare Corporation is a diversified healthcare services
company with approximately 115,000 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 general acute care and
specialty hospitals, ambulatory surgery centers, urgent care centers and
other outpatient facilities in the United States and 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,” “estimate,” “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, 2017, and subsequent Form 10-Q filings and other
filings with the Securities and Exchange Commission.
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.
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|
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
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|
(Dollars in millions except per share amounts)
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|
Three Months Ended March 31,
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2018
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%
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2017
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%
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|
Change
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|
Net operating revenues:
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|
|
|
|
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Net operating revenues before provision for doubtful accounts
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$
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5,196
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Less: Provision for doubtful accounts
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|
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383
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Net operating revenues
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|
$
|
4,699
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|
|
100.0
|
%
|
|
4,813
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|
|
100.0
|
%
|
|
(2.4
|
)%
|
|
Equity in earnings of unconsolidated affiliates
|
|
25
|
|
|
0.5
|
%
|
|
29
|
|
|
0.6
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%
|
|
(13.8
|
)%
|
|
Operating expenses:
|
|
|
|
|
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|
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Salaries, wages and benefits
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2,227
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|
|
47.3
|
%
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|
2,380
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|
|
49.4
|
%
|
|
(6.4
|
)%
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|
Supplies
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|
774
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|
|
16.5
|
%
|
|
765
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|
|
15.9
|
%
|
|
1.2
|
%
|
|
Other operating expenses, net
|
|
1,060
|
|
|
22.6
|
%
|
|
1,187
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|
|
24.7
|
%
|
|
(10.7
|
)%
|
|
Electronic health record incentives
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|
(1
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)
|
|
—
|
%
|
|
(1
|
)
|
|
—
|
%
|
|
—
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%
|
|
Depreciation and amortization
|
|
204
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|
|
4.3
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%
|
|
221
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|
|
4.6
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%
|
|
|
|
Impairment and restructuring charges, and acquisition-related costs
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|
47
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|
|
1.0
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%
|
|
33
|
|
|
0.7
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%
|
|
|
|
Litigation and investigation costs
|
|
6
|
|
|
0.1
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%
|
|
5
|
|
|
0.1
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%
|
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
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|
(110
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)
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|
(2.3
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)%
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|
(15
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)
|
|
(0.3
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)%
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|
|
|
Operating income
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517
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|
|
11.0
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%
|
|
267
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|
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5.5
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%
|
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Interest expense
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|
(255
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)
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(258
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)
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Other non-operating expense, net
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|
(1
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)
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|
(5
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)
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Loss from early extinguishment of debt
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|
(1
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)
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|
|
—
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|
|
|
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Income from continuing operations, before income taxes
|
|
260
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|
|
|
|
4
|
|
|
|
|
|
|
Income tax benefit (expense)
|
|
(70
|
)
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|
|
33
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|
|
|
|
|
|
Income from continuing operations, before discontinued operations
|
|
190
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|
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37
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Discontinued operations:
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Income (loss) from operations
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|
1
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|
|
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|
(2
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)
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|
|
|
|
Income tax benefit (expense)
|
|
—
|
|
|
|
|
1
|
|
|
|
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|
Income (loss) from discontinued operations
|
|
1
|
|
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|
(1
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)
|
|
|
|
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|
Net income
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|
191
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|
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36
|
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Less: Net income attributable to noncontrolling interests
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92
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89
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Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
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99
|
|
|
|
|
$
|
(53
|
)
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|
|
|
|
Amounts available (attributable) to Tenet Healthcare Corporation
common shareholders
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|
|
|
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Income (loss) from continuing operations, net of tax
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|
$
|
98
|
|
|
|
|
$
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(52
|
)
|
|
|
|
|
|
Income (loss) from discontinued operations, net of tax
|
|
1
|
|
|
|
|
(1
|
)
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
99
|
|
|
|
|
$
|
(53
|
)
|
|
|
|
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
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Basic
|
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Continuing operations
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$
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0.97
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|
$
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(0.52
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)
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Discontinued operations
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0.01
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|
|
|
|
(0.01
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)
|
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|
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|
|
|
|
$
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0.98
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|
$
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(0.53
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)
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Diluted
|
|
|
|
|
|
|
|
|
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Continuing operations
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|
$
|
0.95
|
|
|
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$
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(0.52
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)
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|
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Discontinued operations
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|
0.01
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|
|
|
(0.01
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)
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|
$
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0.96
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|
|
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|
$
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(0.53
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)
|
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|
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|
|
Weighted average shares and dilutive securities outstanding (in
thousands):
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Basic
|
|
101,392
|
|
|
|
|
100,000
|
|
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Diluted*
|
|
102,656
|
|
|
|
|
100,000
|
|
|
|
|
|
|
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*
|
Had we generated income from continuing operations in the three
months ended March 31, 2017 the effect of employee stock options,
restricted stock units and deferred compensation units on the
diluted shares calculation would have been an increase of 848
thousand shares.
|
|
|
|
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|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
March 31,
|
|
|
December 31,
|
|
(Dollars in millions)
|
|
|
2018
|
|
|
2017
|
|
ASSETS
|
|
|
|
|
|
|
|
Current assets:
|
|
|
|
|
|
|
|
Cash and cash equivalents
|
|
|
$
|
974
|
|
|
|
$
|
611
|
|
|
Accounts receivable, less allowance for doubtful accounts
|
|
|
2,519
|
|
|
|
2,616
|
|
|
Inventories of supplies, at cost
|
|
|
294
|
|
|
|
289
|
|
|
Income tax receivable
|
|
|
20
|
|
|
|
5
|
|
|
Assets held for sale
|
|
|
599
|
|
|
|
1017
|
|
|
Other current assets
|
|
|
1,228
|
|
|
|
1,035
|
|
|
Total current assets
|
|
|
5,634
|
|
|
|
5,573
|
|
|
Investments and other assets
|
|
|
1,433
|
|
|
|
1,543
|
|
|
Deferred income taxes
|
|
|
383
|
|
|
|
455
|
|
|
Property and equipment, at cost, less accumulated depreciation and
amortization
|
|
|
6,906
|
|
|
|
7,030
|
|
|
Goodwill
|
|
|
7,036
|
|
|
|
7,018
|
|
|
Other intangible assets, at cost, less accumulated amortization
|
|
|
1,792
|
|
|
|
1,766
|
|
|
Total assets
|
|
|
$
|
23,184
|
|
|
|
$
|
23,385
|
|
|
|
|
|
|
|
|
|
|
LIABILITIES AND EQUITY
|
|
|
|
|
|
|
|
Current liabilities:
|
|
|
|
|
|
|
|
Current portion of long-term debt
|
|
|
$
|
666
|
|
|
|
$
|
146
|
|
|
Accounts payable
|
|
|
1,059
|
|
|
|
1,175
|
|
|
Accrued compensation and benefits
|
|
|
708
|
|
|
|
848
|
|
|
Professional and general liability reserves
|
|
|
222
|
|
|
|
200
|
|
|
Accrued interest payable
|
|
|
332
|
|
|
|
256
|
|
|
Liabilities held for sale
|
|
|
406
|
|
|
|
480
|
|
|
Other current liabilities
|
|
|
1,168
|
|
|
|
1,227
|
|
|
Total current liabilities
|
|
|
4,561
|
|
|
|
4,332
|
|
|
Long-term debt, net of current portion
|
|
|
14,223
|
|
|
|
14,791
|
|
|
Professional and general liability reserves
|
|
|
651
|
|
|
|
654
|
|
|
Defined benefit plan obligations
|
|
|
528
|
|
|
|
536
|
|
|
Deferred income taxes
|
|
|
36
|
|
|
|
36
|
|
|
Other long-term liabilities
|
|
|
627
|
|
|
|
631
|
|
|
Total liabilities
|
|
|
20,626
|
|
|
|
20,980
|
|
|
Commitments and contingencies
|
|
|
|
|
|
|
|
Redeemable noncontrolling interests in equity of consolidated
subsidiaries
|
|
|
1,942
|
|
|
|
1,866
|
|
|
Equity:
|
|
|
|
|
|
|
|
Shareholders’ equity:
|
|
|
|
|
|
|
|
Common stock
|
|
|
7
|
|
|
|
7
|
|
|
Additional paid-in capital
|
|
|
4,833
|
|
|
|
4,859
|
|
|
Accumulated other comprehensive loss
|
|
|
(239
|
)
|
|
|
(204
|
)
|
|
Accumulated deficit
|
|
|
(2,248
|
)
|
|
|
(2,390
|
)
|
|
Common stock in treasury, at cost
|
|
|
(2,418
|
)
|
|
|
(2,419
|
)
|
|
Total shareholders’ equity (deficit)
|
|
|
(65
|
)
|
|
|
(147
|
)
|
|
Noncontrolling interests
|
|
|
681
|
|
|
|
686
|
|
|
Total equity
|
|
|
616
|
|
|
|
539
|
|
|
Total liabilities and equity
|
|
|
$
|
23,184
|
|
|
|
$
|
23,385
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF CASH FLOW
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
(Dollars in millions)
|
|
|
March 31,
|
|
|
|
|
2018
|
|
|
2017
|
|
Net income
|
|
|
$
|
191
|
|
|
|
$
|
36
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities:
|
|
|
|
|
|
|
|
Depreciation and amortization
|
|
|
204
|
|
|
|
221
|
|
|
Provision for doubtful accounts
|
|
|
—
|
|
|
|
383
|
|
|
Deferred income tax expense (benefit)
|
|
|
70
|
|
|
|
—
|
|
|
Stock-based compensation expense
|
|
|
9
|
|
|
|
13
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
47
|
|
|
|
33
|
|
|
Litigation and investigation costs
|
|
|
6
|
|
|
|
5
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(110
|
)
|
|
|
(15
|
)
|
|
Loss from early extinguishment of debt
|
|
|
1
|
|
|
|
—
|
|
|
Equity in earnings of unconsolidated affiliates, net of
distributions received
|
|
|
9
|
|
|
|
4
|
|
|
Amortization of debt discount and debt issuance costs
|
|
|
11
|
|
|
|
11
|
|
|
Pre-tax loss (income) from discontinued operations
|
|
|
(1
|
)
|
|
|
2
|
|
|
Other items, net
|
|
|
(1
|
)
|
|
|
(2
|
)
|
|
Changes in cash from operating assets and liabilities:
|
|
|
|
|
|
|
|
Accounts receivable
|
|
|
(66
|
)
|
|
|
(446
|
)
|
|
Inventories and other current assets
|
|
|
(41
|
)
|
|
|
132
|
|
|
Income taxes
|
|
|
—
|
|
|
|
(34
|
)
|
|
Accounts payable, accrued expenses and other current liabilities
|
|
|
(183
|
)
|
|
|
(161
|
)
|
|
Other long-term liabilities
|
|
|
1
|
|
|
|
26
|
|
|
Payments for restructuring charges, acquisition-related costs,
and litigation costs and settlements
|
|
|
(33
|
)
|
|
|
(24
|
)
|
|
Net cash provided by (used in) operating activities from
discontinued operations, excluding income taxes
|
|
|
(1
|
)
|
|
|
2
|
|
|
Net cash provided by operating activities
|
|
|
113
|
|
|
|
186
|
|
|
Cash flows from investing activities:
|
|
|
|
|
|
|
|
Purchases of property and equipment — continuing operations
|
|
|
(143
|
)
|
|
|
(198
|
)
|
|
Purchases of businesses or joint venture interests, net of cash
acquired
|
|
|
(16
|
)
|
|
|
(6
|
)
|
|
Proceeds from sales of facilities and other assets
|
|
|
425
|
|
|
|
20
|
|
|
Proceeds from sales of marketable securities, long-term investments
and other assets
|
|
|
134
|
|
|
|
9
|
|
|
Purchases of equity investments
|
|
|
(30
|
)
|
|
|
(1
|
)
|
|
Other long-term assets
|
|
|
7
|
|
|
|
(12
|
)
|
|
Other items, net
|
|
|
(4
|
)
|
|
|
(1
|
)
|
|
Net cash provided by (used in) investing activities
|
|
|
373
|
|
|
|
(189
|
)
|
|
Cash flows from financing activities:
|
|
|
|
|
|
|
|
Repayments of borrowings under credit facility
|
|
|
—
|
|
|
|
—
|
|
|
Proceeds from borrowings under credit facility
|
|
|
—
|
|
|
|
—
|
|
|
Repayments of other borrowings
|
|
|
(91
|
)
|
|
|
(89
|
)
|
|
Proceeds from other borrowings
|
|
|
7
|
|
|
|
6
|
|
|
Debt issuance costs
|
|
|
—
|
|
|
|
(2
|
)
|
|
Distributions paid to noncontrolling interests
|
|
|
(64
|
)
|
|
|
(63
|
)
|
|
Proceeds from sale of noncontrolling interests
|
|
|
5
|
|
|
|
10
|
|
|
Purchases of noncontrolling interests
|
|
|
(9
|
)
|
|
|
—
|
|
|
Proceeds from exercise of stock options and employee stock purchase
plan
|
|
|
9
|
|
|
|
2
|
|
|
Other items, net
|
|
|
20
|
|
|
|
(5
|
)
|
|
Net cash used in financing activities
|
|
|
(123
|
)
|
|
|
(141
|
)
|
|
Net increase (decrease) in cash and cash equivalents
|
|
|
363
|
|
|
|
(144
|
)
|
|
Cash and cash equivalents at beginning of period
|
|
|
611
|
|
|
|
716
|
|
|
Cash and cash equivalents at end of period
|
|
|
$
|
974
|
|
|
|
$
|
572
|
|
|
Supplemental disclosures:
|
|
|
|
|
|
|
|
Interest paid, net of capitalized interest
|
|
|
$
|
(169
|
)
|
|
|
$
|
(130
|
)
|
|
Income tax refunds (payments), net
|
|
|
$
|
1
|
|
|
|
$
|
(1
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per adjusted patient day
|
|
|
Three Months Ended March 31,
|
|
|
and per adjusted patient admission amounts)
|
|
|
2018
|
|
|
2017
|
|
|
Change
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
|
69
|
|
|
|
76
|
|
|
|
(7
|
)
|
*
|
|
Total admissions
|
|
|
182,306
|
|
|
|
196,907
|
|
|
|
(7.4
|
)%
|
|
|
Adjusted patient admissions
|
|
|
320,868
|
|
|
|
347,150
|
|
|
|
(7.6
|
)%
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
|
172,490
|
|
|
|
186,648
|
|
|
|
(7.6
|
)%
|
|
|
Charity and uninsured admissions
|
|
|
9,816
|
|
|
|
10,259
|
|
|
|
(4.3
|
)%
|
|
|
Admissions through emergency department
|
|
|
125,076
|
|
|
|
126,473
|
|
|
|
(1.1
|
)%
|
|
|
Paying admissions as a percentage of total admissions
|
|
|
94.6
|
%
|
|
|
94.8
|
%
|
|
|
(0.2
|
)%
|
*
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
|
5.4
|
%
|
|
|
5.2
|
%
|
|
|
0.2
|
%
|
*
|
|
Emergency department admissions as a percentage of total admissions
|
|
|
68.6
|
%
|
|
|
64.2
|
%
|
|
|
4.4
|
%
|
*
|
|
Surgeries — inpatient
|
|
|
47,223
|
|
|
|
51,800
|
|
|
|
(8.8
|
)%
|
|
|
Surgeries — outpatient
|
|
|
63,008
|
|
|
|
69,604
|
|
|
|
(9.5
|
)%
|
|
|
Total surgeries
|
|
|
110,231
|
|
|
|
121,404
|
|
|
|
(9.2
|
)%
|
|
|
Patient days — total
|
|
|
858,648
|
|
|
|
923,339
|
|
|
|
(7.0
|
)%
|
|
|
Adjusted patient days
|
|
|
1,486,139
|
|
|
|
1,603,698
|
|
|
|
(7.3
|
)%
|
|
|
Average length of stay (days)
|
|
|
4.71
|
|
|
|
4.69
|
|
|
|
0.4
|
%
|
|
|
Licensed beds (at end of period)
|
|
|
18,457
|
|
|
|
20,439
|
|
|
|
(9.7
|
)%
|
|
|
Average licensed beds
|
|
|
18,685
|
|
|
|
20,440
|
|
|
|
(8.6
|
)%
|
|
|
Utilization of licensed beds
|
|
|
51.1
|
%
|
|
|
50.2
|
%
|
|
|
0.9
|
%
|
*
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
|
1,842,539
|
|
|
|
2,039,942
|
|
|
|
(9.7
|
)%
|
|
|
Paying visits (excludes charity and uninsured)
|
|
|
1,725,976
|
|
|
|
1,908,212
|
|
|
|
(9.6
|
)%
|
|
|
Charity and uninsured visits
|
|
|
116,563
|
|
|
|
131,730
|
|
|
|
(11.5
|
)%
|
|
|
Emergency department visits
|
|
|
697,001
|
|
|
|
733,051
|
|
|
|
(4.9
|
)%
|
|
|
Paying visits as a percentage of total visits
|
|
|
93.7
|
%
|
|
|
93.5
|
%
|
|
|
0.2
|
%
|
*
|
|
Charity and uninsured visits as a percentage of total visits
|
|
|
6.3
|
%
|
|
|
6.5
|
%
|
|
|
(0.2
|
)%
|
*
|
|
Total emergency department admissions and visits
|
|
|
822,077
|
|
|
|
859,524
|
|
|
|
(4.4
|
)%
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenues(3)
|
|
|
$
|
3,643
|
|
|
|
$
|
3,728
|
|
|
|
(2.3
|
)%
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenue(3) per adjusted patient admission
|
|
|
$
|
11,354
|
|
|
|
$
|
10,739
|
|
|
|
5.7
|
%
|
|
|
Net patient revenue(3) per adjusted patient day
|
|
|
$
|
2,451
|
|
|
|
$
|
2,325
|
|
|
|
5.4
|
%
|
|
|
Total selected operating expenses (salaries, wages and benefits,
supplies and other operating expenses) per adjusted patient admission(2)
|
|
|
$
|
10,561
|
|
|
|
$
|
10,288
|
|
|
|
2.7
|
%
|
|
|
Net Patient Revenues
(3)
from:
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
21.5
|
%
|
|
|
23.1
|
%
|
|
|
(1.6
|
)%
|
*
|
|
Medicaid
|
|
|
8.8
|
%
|
|
|
7.4
|
%
|
|
|
1.4
|
%
|
*
|
|
Managed care
|
|
|
65.0
|
%
|
|
|
65.2
|
%
|
|
|
(0.2
|
)%
|
*
|
|
Self-pay
|
|
|
1.0
|
%
|
|
|
0.3
|
%
|
|
|
0.7
|
%
|
*
|
|
Indemnity and other
|
|
|
3.7
|
%
|
|
|
4.0
|
%
|
|
|
(0.3
|
)%
|
*
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Represents the consolidated results of Tenet’s acute care hospitals
and related outpatient facilities included in the Hospital
Operations and other segment.
|
|
(2)
|
Excludes operating expenses from Tenet's health plans.
|
|
(3)
|
Less implicit price concessions and provision for doubtful accounts.
|
|
|
* This change is the difference between the 2018 and 2017 amounts
shown.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per adjusted patient day
|
|
|
Three Months Ended March 31,
|
|
|
and per adjusted patient admission amounts)
|
|
|
2018
|
|
|
2017
|
|
|
Change
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
|
69
|
|
|
|
69
|
|
|
|
—
|
|
*
|
|
Total admissions
|
|
|
179,208
|
|
|
|
178,725
|
|
|
|
0.3
|
%
|
|
|
Adjusted patient admissions
|
|
|
314,022
|
|
|
|
312,003
|
|
|
|
0.6
|
%
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
|
169,548
|
|
|
|
169,601
|
|
|
|
—
|
%
|
|
|
Charity and uninsured admissions
|
|
|
9,660
|
|
|
|
9,124
|
|
|
|
5.9
|
%
|
|
|
Admissions through emergency department
|
|
|
123,224
|
|
|
|
115,133
|
|
|
|
7.0
|
%
|
|
|
Paying admissions as a percentage of total admissions
|
|
|
94.6
|
%
|
|
|
94.9
|
%
|
|
|
(0.3
|
)%
|
*
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
|
5.4
|
%
|
|
|
5.1
|
%
|
|
|
0.3
|
%
|
*
|
|
Emergency department admissions as a percentage of total admissions
|
|
|
68.8
|
%
|
|
|
64.4
|
%
|
|
|
4.4
|
%
|
*
|
|
Surgeries — inpatient
|
|
|
46,575
|
|
|
|
47,539
|
|
|
|
(2.0
|
)%
|
|
|
Surgeries — outpatient
|
|
|
61,754
|
|
|
|
62,895
|
|
|
|
(1.8
|
)%
|
|
|
Total surgeries
|
|
|
108,329
|
|
|
|
110,434
|
|
|
|
(1.9
|
)%
|
|
|
Patient days — total
|
|
|
843,793
|
|
|
|
837,488
|
|
|
|
0.8
|
%
|
|
|
Adjusted patient days
|
|
|
1,453,447
|
|
|
|
1,440,173
|
|
|
|
0.9
|
%
|
|
|
Average length of stay (days)
|
|
|
4.71
|
|
|
|
4.69
|
|
|
|
0.4
|
%
|
|
|
Licensed beds (at end of period)
|
|
|
18,089
|
|
|
|
18,107
|
|
|
|
(0.1
|
)%
|
|
|
Average licensed beds
|
|
|
18,089
|
|
|
|
18,107
|
|
|
|
(0.1
|
)%
|
|
|
Utilization of licensed beds
|
|
|
51.8
|
%
|
|
|
51.4
|
%
|
|
|
0.4
|
%
|
*
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
|
1,798,885
|
|
|
|
1,817,295
|
|
|
|
(1.0
|
)%
|
|
|
Paying visits (excludes charity and uninsured)
|
|
|
1,684,875
|
|
|
|
1,705,091
|
|
|
|
(1.2
|
)%
|
|
|
Charity and uninsured visits
|
|
|
114,010
|
|
|
|
112,204
|
|
|
|
1.6
|
%
|
|
|
Emergency department visits
|
|
|
684,057
|
|
|
|
652,284
|
|
|
|
4.9
|
%
|
|
|
Paying visits as a percentage of total visits
|
|
|
93.7
|
%
|
|
|
93.8
|
%
|
|
|
(0.1
|
)%
|
*
|
|
Charity and uninsured visits as a percentage of total visits
|
|
|
6.3
|
%
|
|
|
6.2
|
%
|
|
|
0.1
|
%
|
*
|
|
Total emergency department admissions and visits
|
|
|
807,281
|
|
|
|
767,417
|
|
|
|
5.2
|
%
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenues(2)
|
|
|
$
|
3,594
|
|
|
|
$
|
3,368
|
|
|
|
6.7
|
%
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenue(2) per adjusted patient admission
|
|
|
$
|
11,445
|
|
|
|
$
|
10,796
|
|
|
|
6.0
|
%
|
|
|
Net patient revenue(2) per adjusted patient day
|
|
|
$
|
2,473
|
|
|
|
$
|
2,339
|
|
|
|
5.7
|
%
|
|
|
Net Patient Revenues
(2)
from:
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
21.3
|
%
|
|
|
23.5
|
%
|
|
|
(2.2
|
)%
|
*
|
|
Medicaid
|
|
|
8.8
|
%
|
|
|
7.0
|
%
|
|
|
1.8
|
%
|
*
|
|
Managed care
|
|
|
64.9
|
%
|
|
|
65.0
|
%
|
|
|
(0.1
|
)%
|
*
|
|
Self-pay
|
|
|
1.3
|
%
|
|
|
0.3
|
%
|
|
|
1.0
|
%
|
*
|
|
Indemnity and other
|
|
|
3.7
|
%
|
|
|
4.2
|
%
|
|
|
(0.5
|
)%
|
*
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Information for our Hospital Operations and other segment is
presented on a same-hospital basis, which includes the results of
our same 69 hospitals operated throughout the three months ended
March 31, 2018 and 2017, and associated outpatient facilities but
excludes the results of hospitals Tenet divested, since January 1,
2017.
|
|
(2)
|
Less implicit price concessions and provision for doubtful accounts.
|
|
|
* This change is the difference between the 2018 and 2017 amounts
shown.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
Three Months Ended
|
|
Year Ended
|
|
Three
Months
Ended
|
|
|
|
3/31/2017
|
|
6/30/2017
|
|
9/30/2017
|
|
12/31/2017
|
|
12/31/2017
|
|
3/31/2018
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues before provision for doubtful accounts
|
|
$
|
5,196
|
|
|
$
|
5,173
|
|
|
$
|
4,941
|
|
|
$
|
5,303
|
|
|
$
|
20,613
|
|
|
|
|
Less: Provision for doubtful accounts
|
|
383
|
|
|
371
|
|
|
355
|
|
|
325
|
|
|
1,434
|
|
|
|
|
Net operating revenues
|
|
4,813
|
|
|
4,802
|
|
|
4,586
|
|
|
4,978
|
|
|
19,179
|
|
|
$
|
4,699
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
29
|
|
|
28
|
|
|
38
|
|
|
49
|
|
|
144
|
|
|
25
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
2,380
|
|
|
2,346
|
|
|
2,264
|
|
|
2,284
|
|
|
9,274
|
|
|
2,227
|
|
|
Supplies
|
|
765
|
|
|
780
|
|
|
740
|
|
|
800
|
|
|
3,085
|
|
|
774
|
|
|
Other operating expenses, net
|
|
1,187
|
|
|
1,159
|
|
|
1,120
|
|
|
1,104
|
|
|
4,570
|
|
|
1,060
|
|
|
Electronic health record incentives
|
|
(1
|
)
|
|
(6
|
)
|
|
(1
|
)
|
|
(1
|
)
|
|
(9
|
)
|
|
(1
|
)
|
|
Depreciation and amortization
|
|
221
|
|
|
222
|
|
|
219
|
|
|
208
|
|
|
870
|
|
|
204
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
33
|
|
|
41
|
|
|
329
|
|
|
138
|
|
|
541
|
|
|
47
|
|
|
Litigation and investigation costs
|
|
5
|
|
|
1
|
|
|
6
|
|
|
11
|
|
|
23
|
|
|
6
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
(15
|
)
|
|
(23
|
)
|
|
(104
|
)
|
|
(2
|
)
|
|
(144
|
)
|
|
(110
|
)
|
|
Operating income
|
|
267
|
|
|
310
|
|
|
51
|
|
|
485
|
|
|
1,113
|
|
|
517
|
|
|
Interest expense
|
|
(258
|
)
|
|
(260
|
)
|
|
(257
|
)
|
|
(253
|
)
|
|
(1,028
|
)
|
|
(255
|
)
|
|
Other non-operating expense, net
|
|
(5
|
)
|
|
(5
|
)
|
|
(4
|
)
|
|
(8
|
)
|
|
(22
|
)
|
|
(1
|
)
|
|
Loss from early extinguishment of debt
|
|
—
|
|
|
(26
|
)
|
|
(138
|
)
|
|
—
|
|
|
(164
|
)
|
|
(1
|
)
|
|
Income (loss) from continuing operations, before income taxes
|
|
4
|
|
|
19
|
|
|
(348
|
)
|
|
224
|
|
|
(101
|
)
|
|
260
|
|
|
Income tax benefit (expense)
|
|
33
|
|
|
12
|
|
|
60
|
|
|
(324
|
)
|
|
(219
|
)
|
|
(70
|
)
|
|
Income (loss) from continuing operations, before
discontinued operations
|
|
37
|
|
|
31
|
|
|
(288
|
)
|
|
(100
|
)
|
|
(320
|
)
|
|
190
|
|
|
Discontinued operations:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income (loss) from operations
|
|
(2
|
)
|
|
2
|
|
|
(1
|
)
|
|
1
|
|
|
—
|
|
|
1
|
|
|
Income tax benefit (expense)
|
|
1
|
|
|
(1
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
Income (loss) from discontinued operations
|
|
(1
|
)
|
|
1
|
|
|
(1
|
)
|
|
1
|
|
|
—
|
|
|
1
|
|
|
Net income (loss)
|
|
36
|
|
|
32
|
|
|
(289
|
)
|
|
(99
|
)
|
|
(320
|
)
|
|
191
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
89
|
|
|
87
|
|
|
78
|
|
|
130
|
|
|
384
|
|
|
92
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(53
|
)
|
|
$
|
(55
|
)
|
|
$
|
(367
|
)
|
|
$
|
(229
|
)
|
|
$
|
(704
|
)
|
|
$
|
99
|
|
|
Amounts available (attributable) to Tenet Healthcare
Corporation common shareholders
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income (loss) from continuing operations, net of tax
|
|
$
|
(52
|
)
|
|
$
|
(56
|
)
|
|
$
|
(366
|
)
|
|
$
|
(230
|
)
|
|
$
|
(704
|
)
|
|
$
|
98
|
|
|
Income (loss) from discontinued operations, net of tax
|
|
(1
|
)
|
|
1
|
|
|
(1
|
)
|
|
1
|
|
|
—
|
|
|
1
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(53
|
)
|
|
$
|
(55
|
)
|
|
$
|
(367
|
)
|
|
$
|
(229
|
)
|
|
$
|
(704
|
)
|
|
$
|
99
|
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
(0.52
|
)
|
|
$
|
(0.56
|
)
|
|
$
|
(3.63
|
)
|
|
$
|
(2.28
|
)
|
|
$
|
(7.00
|
)
|
|
$
|
0.97
|
|
|
Discontinued operations
|
|
(0.01
|
)
|
|
0.01
|
|
|
(0.01
|
)
|
|
0.01
|
|
|
—
|
|
|
0.01
|
|
|
|
|
$
|
(0.53
|
)
|
|
$
|
(0.55
|
)
|
|
$
|
(3.64
|
)
|
|
$
|
(2.27
|
)
|
|
$
|
(7.00
|
)
|
|
$
|
0.98
|
|
|
Diluted
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
(0.52
|
)
|
|
$
|
(0.56
|
)
|
|
$
|
(3.63
|
)
|
|
$
|
(2.28
|
)
|
|
$
|
(7.00
|
)
|
|
$
|
0.95
|
|
|
Discontinued operations
|
|
(0.01
|
)
|
|
0.01
|
|
|
(0.01
|
)
|
|
0.01
|
|
|
—
|
|
|
0.01
|
|
|
|
|
$
|
(0.53
|
)
|
|
$
|
(0.55
|
)
|
|
$
|
(3.64
|
)
|
|
$
|
(2.27
|
)
|
|
$
|
(7.00
|
)
|
|
$
|
0.96
|
|
|
Weighted average shares and dilutive securities outstanding (in
thousands):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
100,000
|
|
|
100,612
|
|
|
100,812
|
|
|
100,945
|
|
|
100,592
|
|
|
101,392
|
|
|
Diluted
|
|
100,000
|
|
|
100,612
|
|
|
100,812
|
|
|
100,945
|
|
|
100,592
|
|
|
102,656
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1)
(Unaudited)
|
|
(Dollars in millions except per adjusted patient day and per
adjusted patient admission amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
Year Ended
|
|
Three
Months
Ended
|
|
|
3/31/2017
|
|
6/30/2017
|
|
9/30/2017
|
|
12/31/2017
|
|
12/31/2017
|
|
03/31/2018
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
76
|
|
|
76
|
|
|
73
|
|
|
72
|
|
|
72
|
|
|
69
|
|
|
Total admissions
|
|
196,907
|
|
|
190,394
|
|
|
185,389
|
|
|
186,185
|
|
|
758,875
|
|
|
182,306
|
|
|
Adjusted patient admissions
|
|
347,150
|
|
|
342,439
|
|
|
332,035
|
|
|
332,642
|
|
|
1,354,266
|
|
|
320,868
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
186,648
|
|
|
179,889
|
|
|
174,803
|
|
|
176,158
|
|
|
717,498
|
|
|
172,490
|
|
|
Charity and uninsured admissions
|
|
10,259
|
|
|
10,505
|
|
|
10,586
|
|
|
10,027
|
|
|
41,377
|
|
|
9,816
|
|
|
Admissions through emergency department
|
|
126,473
|
|
|
121,807
|
|
|
120,493
|
|
|
123,887
|
|
|
492,660
|
|
|
125,076
|
|
|
Paying admissions as a percentage of total admissions
|
|
94.8
|
%
|
|
94.5
|
%
|
|
94.3
|
%
|
|
94.6
|
%
|
|
94.5
|
%
|
|
94.6
|
%
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
5.2
|
%
|
|
5.5
|
%
|
|
5.7
|
%
|
|
5.4
|
%
|
|
5.5
|
%
|
|
5.4
|
%
|
|
Emergency department admissions as a percentage of total admissions
|
|
64.2
|
%
|
|
64.0
|
%
|
|
65.0
|
%
|
|
66.5
|
%
|
|
64.9
|
%
|
|
68.6
|
%
|
|
Surgeries — inpatient
|
|
51,800
|
|
|
52,083
|
|
|
50,939
|
|
|
50,292
|
|
|
205,114
|
|
|
47,223
|
|
|
Surgeries — outpatient
|
|
69,604
|
|
|
71,366
|
|
|
67,321
|
|
|
68,604
|
|
|
276,895
|
|
|
63,008
|
|
|
Total surgeries
|
|
121,404
|
|
|
123,449
|
|
|
118,260
|
|
|
118,896
|
|
|
482,009
|
|
|
110,231
|
|
|
Patient days — total
|
|
923,339
|
|
|
874,930
|
|
|
853,059
|
|
|
857,728
|
|
|
3,509,056
|
|
|
858,648
|
|
|
Adjusted patient days
|
|
1,603,698
|
|
|
1,552,302
|
|
|
1,502,831
|
|
|
1,505,130
|
|
|
6,163,961
|
|
|
1,486,139
|
|
|
Average length of stay (days)
|
|
4.69
|
|
|
4.60
|
|
|
4.60
|
|
|
4.61
|
|
|
4.62
|
|
|
4.71
|
|
|
Licensed beds (at end of period)
|
|
20,439
|
|
|
20,435
|
|
|
19,433
|
|
|
19,141
|
|
|
19,141
|
|
|
18,457
|
|
|
Average licensed beds
|
|
20,440
|
|
|
20,435
|
|
|
19,783
|
|
|
19,320
|
|
|
19,995
|
|
|
18,685
|
|
|
Utilization of licensed beds
|
|
50.2
|
%
|
|
47.0
|
%
|
|
46.9
|
%
|
|
48.3
|
%
|
|
48.1
|
%
|
|
51.1
|
%
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
2,039,942
|
|
|
1,981,848
|
|
|
1,867,471
|
|
|
1,901,864
|
|
|
7,791,125
|
|
|
1,842,539
|
|
|
Paying visits (excludes charity and uninsured)
|
|
1,908,212
|
|
|
1,849,697
|
|
|
1,741,815
|
|
|
1,777,790
|
|
|
7,277,514
|
|
|
1,725,976
|
|
|
Charity and uninsured visits
|
|
131,730
|
|
|
132,151
|
|
|
125,656
|
|
|
124,074
|
|
|
513,611
|
|
|
116,563
|
|
|
Emergency department visits
|
|
733,051
|
|
|
724,785
|
|
|
685,096
|
|
|
711,268
|
|
|
2,854,200
|
|
|
697,001
|
|
|
Paying visits as a percentage of total visits
|
|
93.5
|
%
|
|
93.3
|
%
|
|
93.3
|
%
|
|
93.5
|
%
|
|
93.4
|
%
|
|
93.7
|
%
|
|
Charity and uninsured visits as a percentage of total visits
|
|
6.5
|
%
|
|
6.7
|
%
|
|
6.7
|
%
|
|
6.5
|
%
|
|
6.6
|
%
|
|
6.3
|
%
|
|
Total emergency department admissions and visits
|
|
859,524
|
|
|
846,592
|
|
|
805,589
|
|
|
835,155
|
|
|
3,346,860
|
|
|
822,077
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenues(3)
|
|
$
|
3,728
|
|
|
$
|
3,719
|
|
|
$
|
3,522
|
|
|
$
|
3,860
|
|
|
$
|
14,829
|
|
|
$
|
3,643
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenue(3) per adjusted patient admission
|
|
$
|
10,739
|
|
|
$
|
10,860
|
|
|
$
|
10,607
|
|
|
$
|
11,604
|
|
|
$
|
10,950
|
|
|
$
|
11,354
|
|
|
Net patient revenue(3) per adjusted patient day
|
|
$
|
2,325
|
|
|
$
|
2,396
|
|
|
$
|
2,344
|
|
|
$
|
2,565
|
|
|
$
|
2,406
|
|
|
$
|
2,451
|
|
|
Total selected operating expenses (salaries, wages and benefits,
supplies and other operating expenses) per adjusted patient admission(2)
|
|
$
|
10,288
|
|
|
$
|
10,394
|
|
|
$
|
10,367
|
|
|
$
|
10,492
|
|
|
$
|
10,384
|
|
|
$
|
10,561
|
|
|
Net Patient Revenues
(3)
from:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
23.1
|
%
|
|
22.0
|
%
|
|
22.0
|
%
|
|
20.4
|
%
|
|
21.9
|
%
|
|
21.5
|
%
|
|
Medicaid
|
|
7.4
|
%
|
|
7.5
|
%
|
|
7.1
|
%
|
|
12.9
|
%
|
|
8.8
|
%
|
|
8.8
|
%
|
|
Managed care
|
|
65.2
|
%
|
|
65.9
|
%
|
|
66.1
|
%
|
|
61.5
|
%
|
|
64.6
|
%
|
|
65.0
|
%
|
|
Self-pay
|
|
0.3
|
%
|
|
0.5
|
%
|
|
0.3
|
%
|
|
1.3
|
%
|
|
0.6
|
%
|
|
1.0
|
%
|
|
Indemnity and other
|
|
4.0
|
%
|
|
4.1
|
%
|
|
4.5
|
%
|
|
3.9
|
%
|
|
4.1
|
%
|
|
3.7
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Represents the consolidated results of Tenet’s acute care hospitals
and related outpatient facilities included in the Hospital
Operations and other segment.
|
|
(2)
|
Excludes operating expenses from Tenet's health plans.
|
|
(3)
|
Less implicit price concessions and provision for doubtful accounts.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1)
(Unaudited)
|
|
(Dollars in millions except per adjusted patient day and per
adjusted patient admission amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
Year Ended
|
|
Three
Months
Ended
|
|
|
3/31/2017
|
|
6/30/2017
|
|
9/30/2017
|
|
12/31/2017
|
|
12/31/2017
|
|
3/31/2018
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
69
|
|
|
69
|
|
|
69
|
|
|
69
|
|
|
69
|
|
|
69
|
|
|
Total admissions
|
|
178,725
|
|
|
173,096
|
|
|
172,854
|
|
|
176,220
|
|
|
700,895
|
|
|
179,208
|
|
|
Adjusted patient admissions
|
|
312,003
|
|
|
308,046
|
|
|
307,115
|
|
|
312,281
|
|
|
1,239,445
|
|
|
314,022
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
169,601
|
|
|
163,657
|
|
|
162,815
|
|
|
166,453
|
|
|
662,526
|
|
|
169,548
|
|
|
Charity and uninsured admissions
|
|
9,124
|
|
|
9,439
|
|
|
10,039
|
|
|
9,767
|
|
|
38,369
|
|
|
9,660
|
|
|
Admissions through emergency department
|
|
115,133
|
|
|
110,834
|
|
|
112,554
|
|
|
117,155
|
|
|
455,676
|
|
|
123,224
|
|
|
Paying admissions as a percentage of total admissions
|
|
94.9
|
%
|
|
94.5
|
%
|
|
94.2
|
%
|
|
94.5
|
%
|
|
94.5
|
%
|
|
94.6
|
%
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
5.1
|
%
|
|
5.5
|
%
|
|
5.8
|
%
|
|
5.5
|
%
|
|
5.5
|
%
|
|
5.4
|
%
|
|
Emergency department admissions as a percentage of total admissions
|
|
64.4
|
%
|
|
64.0
|
%
|
|
65.1
|
%
|
|
66.5
|
%
|
|
65.0
|
%
|
|
68.8
|
%
|
|
Surgeries — inpatient
|
|
47,539
|
|
|
47,933
|
|
|
47,995
|
|
|
48,089
|
|
|
191,556
|
|
|
46,575
|
|
|
Surgeries — outpatient
|
|
62,895
|
|
|
64,401
|
|
|
62,244
|
|
|
64,202
|
|
|
253,742
|
|
|
61,754
|
|
|
Total surgeries
|
|
110,434
|
|
|
112,334
|
|
|
110,239
|
|
|
112,291
|
|
|
445,298
|
|
|
108,329
|
|
|
Patient days — total
|
|
837,488
|
|
|
795,533
|
|
|
792,268
|
|
|
808,903
|
|
|
3,234,192
|
|
|
843,793
|
|
|
Adjusted patient days
|
|
1,440,173
|
|
|
1,395,843
|
|
|
1,384,475
|
|
|
1,407,645
|
|
|
5,628,136
|
|
|
1,453,447
|
|
|
Average length of stay (days)
|
|
4.69
|
|
|
4.60
|
|
|
4.58
|
|
|
4.59
|
|
|
4.61
|
|
|
4.71
|
|
|
Licensed beds (at end of period)
|
|
18,107
|
|
|
18,123
|
|
|
18,149
|
|
|
18,089
|
|
|
18,089
|
|
|
18,089
|
|
|
Average licensed beds
|
|
18,107
|
|
|
18,123
|
|
|
18,150
|
|
|
18,113
|
|
|
18,123
|
|
|
18,089
|
|
|
Utilization of licensed beds
|
|
51.4
|
%
|
|
48.2
|
%
|
|
47.4
|
%
|
|
48.5
|
%
|
|
48.9
|
%
|
|
51.8
|
%
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
1,817,295
|
|
|
1,772,765
|
|
|
1,721,806
|
|
|
1,777,087
|
|
|
7,088,953
|
|
|
1,798,885
|
|
|
Paying visits (excludes charity and uninsured)
|
|
1,705,091
|
|
|
1,658,374
|
|
|
1,606,014
|
|
|
1,659,011
|
|
|
6,628,490
|
|
|
1,684,875
|
|
|
Charity and uninsured visits
|
|
112,204
|
|
|
114,391
|
|
|
115,792
|
|
|
118,076
|
|
|
460,463
|
|
|
114,010
|
|
|
Emergency department visits
|
|
652,284
|
|
|
647,233
|
|
|
628,868
|
|
|
661,111
|
|
|
2,589,496
|
|
|
684,057
|
|
|
Paying visits as a percentage of total visits
|
|
93.8
|
%
|
|
93.5
|
%
|
|
93.3
|
%
|
|
93.4
|
%
|
|
93.5
|
%
|
|
93.7
|
%
|
|
Charity and uninsured visits as a percentage of total visits
|
|
6.2
|
%
|
|
6.5
|
%
|
|
6.7
|
%
|
|
6.6
|
%
|
|
6.5
|
%
|
|
6.3
|
%
|
|
Total emergency department admissions and visits
|
|
767,417
|
|
|
758,067
|
|
|
741,422
|
|
|
778,266
|
|
|
3,045,172
|
|
|
807,281
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenues(2)
|
|
$
|
3,368
|
|
|
$
|
3,348
|
|
|
$
|
3,261
|
|
|
$
|
3,638
|
|
|
$
|
13,615
|
|
|
$
|
3,594
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient revenue(2) per adjusted patient admission
|
|
$
|
10,796
|
|
|
$
|
10,869
|
|
|
$
|
10,618
|
|
|
$
|
11,650
|
|
|
$
|
10,985
|
|
|
$
|
11,445
|
|
|
Net patient revenue(2) per adjusted patient day
|
|
$
|
2,339
|
|
|
$
|
2,399
|
|
|
$
|
2,355
|
|
|
$
|
2,584
|
|
|
$
|
2,419
|
|
|
$
|
2,473
|
|
|
Net Patient Revenues
(2)
from:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
23.5
|
%
|
|
22.3
|
%
|
|
21.9
|
%
|
|
20.3
|
%
|
|
22.0
|
%
|
|
21.3
|
%
|
|
Medicaid
|
|
7.0
|
%
|
|
7.1
|
%
|
|
6.8
|
%
|
|
13.1
|
%
|
|
8.6
|
%
|
|
8.8
|
%
|
|
Managed care
|
|
65.0
|
%
|
|
65.8
|
%
|
|
66.1
|
%
|
|
61.1
|
%
|
|
64.4
|
%
|
|
64.9
|
%
|
|
Self-pay
|
|
0.3
|
%
|
|
0.6
|
%
|
|
0.3
|
%
|
|
1.5
|
%
|
|
0.7
|
%
|
|
1.3
|
%
|
|
Indemnity and other
|
|
4.2
|
%
|
|
4.2
|
%
|
|
4.9
|
%
|
|
4.0
|
%
|
|
4.3
|
%
|
|
3.7
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Information for our Hospital Operations and other segment is
presented on a same-hospital basis, which includes the results of
our same 69 hospitals operated throughout the three months ended
March 31, 2018 and 2017, and associated outpatient facilities but
excludes the results of hospitals Tenet divested, since January 1,
2017.
|
|
(2)
|
Less implicit price concessions and provision for doubtful accounts.
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
SEGMENT REPORTING
(Unaudited)
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
March 31,
|
|
|
December 31,
|
|
|
|
|
2018
|
|
|
2017
|
|
Assets
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
|
$
|
16,271
|
|
|
|
$
|
16,466
|
|
|
Ambulatory Care
|
|
|
5,811
|
|
|
|
5,822
|
|
|
Conifer
|
|
|
1,102
|
|
|
|
1,097
|
|
|
Total
|
|
|
$
|
23,184
|
|
|
|
$
|
23,385
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
|
|
|
March 31,
|
|
|
|
|
2018
|
|
|
2017
|
|
Capital expenditures:
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
|
$
|
120
|
|
|
|
$
|
183
|
|
|
Ambulatory Care
|
|
|
15
|
|
|
|
11
|
|
|
Conifer
|
|
|
8
|
|
|
|
4
|
|
|
Total
|
|
|
$
|
143
|
|
|
|
$
|
198
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues:
|
|
|
|
|
|
|
|
Hospital Operations and other total prior to inter-segment
eliminations(1)
|
|
|
$
|
3,947
|
|
|
|
$
|
4,115
|
|
|
Ambulatory Care
|
|
|
498
|
|
|
|
455
|
|
|
Conifer
|
|
|
|
|
|
|
|
Tenet
|
|
|
150
|
|
|
|
159
|
|
|
Other customers
|
|
|
254
|
|
|
|
243
|
|
|
Total Conifer revenues
|
|
|
404
|
|
|
|
402
|
|
|
Inter-segment eliminations
|
|
|
(150
|
)
|
|
|
(159
|
)
|
|
Total
|
|
|
$
|
4,699
|
|
|
|
$
|
4,813
|
|
|
|
|
|
|
|
|
|
|
Equity in earnings of unconsolidated affiliates:
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
|
$
|
(2
|
)
|
|
|
$
|
2
|
|
|
Ambulatory Care
|
|
|
27
|
|
|
|
27
|
|
|
Total
|
|
|
$
|
25
|
|
|
|
$
|
29
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA:
|
|
|
|
|
|
|
|
Hospital Operations and other(2)
|
|
|
$
|
402
|
|
|
|
$
|
309
|
|
|
Ambulatory Care
|
|
|
165
|
|
|
|
153
|
|
|
Conifer
|
|
|
98
|
|
|
|
65
|
|
|
Total
|
|
|
$
|
665
|
|
|
|
$
|
527
|
|
|
|
|
|
|
|
|
|
|
Depreciation and amortization:
|
|
|
|
|
|
|
|
Hospital Operations and other
|
|
|
$
|
175
|
|
|
|
$
|
187
|
|
|
Ambulatory Care
|
|
|
17
|
|
|
|
22
|
|
|
Conifer
|
|
|
12
|
|
|
|
12
|
|
|
Total
|
|
|
$
|
204
|
|
|
|
$
|
221
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Hospital Operations and other revenues includes health plan revenues
of $6 million and $65 million for the three months ended March 31,
2018 and 2017, respectively.
|
|
(2)
|
Hospital Operations and other Adjusted EBITDA excludes health plan
losses of $(1) million and $(16) million for the three months ended
March 31, 2018 and 2017, respectively.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
STATEMENT OF OPERATIONS – AMBULATORY CARE SEGMENT
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
Three Months Ended March 31,
|
|
|
|
|
2018
|
|
|
2017
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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
|
|
|
|
|
|
|
|
|
$
|
462
|
|
|
|
$
|
475
|
|
|
Less: Provision for doubtful accounts
|
|
|
|
|
|
|
|
|
(7
|
)
|
|
|
(10
|
)
|
|
Net operating revenues
(1)
|
|
|
$
|
498
|
|
|
|
$
|
493
|
|
|
|
455
|
|
|
|
465
|
|
|
Equity in earnings of unconsolidated affiliates
(2)
|
|
|
27
|
|
|
|
—
|
|
|
|
27
|
|
|
|
—
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
162
|
|
|
|
120
|
|
|
|
150
|
|
|
|
114
|
|
|
Supplies
|
|
|
106
|
|
|
|
130
|
|
|
|
94
|
|
|
|
121
|
|
|
Other operating expenses, net
|
|
|
92
|
|
|
|
105
|
|
|
|
85
|
|
|
|
97
|
|
|
Depreciation and amortization
|
|
|
17
|
|
|
|
16
|
|
|
|
22
|
|
|
|
16
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
1
|
|
|
|
—
|
|
|
|
5
|
|
|
|
—
|
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(7
|
)
|
|
|
—
|
|
|
Operating income
|
|
|
148
|
|
|
|
122
|
|
|
|
133
|
|
|
|
117
|
|
|
Interest expense
|
|
|
(36
|
)
|
|
|
(5
|
)
|
|
|
(35
|
)
|
|
|
(6
|
)
|
|
Other
|
|
|
2
|
|
|
|
—
|
|
|
|
1
|
|
|
|
—
|
|
|
Net income from continuing operations, before income taxes
|
|
|
114
|
|
|
|
117
|
|
|
|
99
|
|
|
|
111
|
|
|
Income tax expense
|
|
|
(15
|
)
|
|
|
(2
|
)
|
|
|
(18
|
)
|
|
|
(2
|
)
|
|
Net income
|
|
|
99
|
|
|
|
$
|
115
|
|
|
|
81
|
|
|
|
$
|
109
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
64
|
|
|
|
|
|
|
66
|
|
|
|
|
|
Net income attributable to Tenet Healthcare Corporation common
shareholders
|
|
|
$
|
35
|
|
|
|
|
|
|
$
|
15
|
|
|
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
|
|
|
$
|
27
|
|
|
|
|
|
|
$
|
27
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
On a same-facility system-wide basis, net revenue in Tenet’s
Ambulatory Care segment increased 2.7% during the three months ended
March 31, 2018, with cases increasing 3.2% and revenue per case
decreasing 0.5%.
|
|
(2)
|
At March 31, 2018, 108 of the 338 facilities in the Company’s
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 230 facilities and account for
these investments as consolidated subsidiaries.
|
|
|
|
Non-GAAP Financial Measures
Adjusted EBITDA, a non-GAAP measure, 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, (2) net loss (income) attributable to noncontrolling
interests, (3) income (loss) from discontinued operations, (4) income
tax benefit (expense), (5) other non-operating income (expense), net,
(6) gain (loss) from early extinguishment of debt, (7) interest expense,
(8) litigation and investigation (costs) benefit, net of insurance
recoveries, (9) net gains (losses) on sales, consolidation and
deconsolidation of facilities, (10) impairment and restructuring charges
and acquisition-related costs, (11) depreciation and amortization and
(12) income (loss) from divested operations and closed businesses (i.e.,
the Company’s health plan businesses). Litigation and investigation
costs do not include ordinary course of business malpractice and other
litigation and related expense.
Adjusted net income (loss) from continuing operations attributable to
Tenet Healthcare Corporation common shareholders, a non-GAAP measure, is
defined by the Company as net income (loss) attributable to Tenet
Healthcare Corporation common shareholders before (1) impairment and
restructuring charges, and acquisition-related costs, (2) litigation and
investigation costs, (3) gains on sales, consolidation and
deconsolidation of facilities, (4) gain (loss) from early extinguishment
of debt, (5) income (loss) from divested operations and closed
businesses, (6) the associated impact of these five items on taxes and
noncontrolling interests, and (7) net income (loss) from discontinued
operations. Adjusted diluted earnings (loss) per share from continuing
operations, a non-GAAP term, is defined by the Company as Adjusted net
income (loss) from continuing operations attributable to Tenet
Healthcare Corporation common shareholders divided by the weighted
average primary or diluted shares outstanding in the reporting period.
Free Cash Flow, a non-GAAP measure, is defined by the Company as (1) net
cash provided by (used in) operating activities, less (2) purchases of
property and equipment from continuing operations.
Adjusted Free Cash Flow, a non-GAAP measure, is defined by the Company
as (1) Adjusted net cash provided by (used in) operating activities from
continuing operations, less (2) purchases of property and equipment from
continuing operations. Adjusted net cash provided by (used in) operating
activities, a non-GAAP measure, is defined by the Company as cash
provided by (used in) operating activities prior to (1) payments for
restructuring charges, acquisition-related costs and litigation costs
and settlements, and (2) net cash provided by (used in) operating
activities from discontinued operations.
The Company believes the foregoing non-GAAP measures are useful to
investors and analysts because they present additional information on
the Company’s financial performance. Investors, analysts, Company
management and the Company’s Board of Directors utilize these non-GAAP
measures, in addition to GAAP measures, to track the Company’s financial
and operating performance and compare the Company’s performance to its
peer companies, which utilize similar non-GAAP measures in their
presentations. The Human Resources Committee of the Company’s Board of
Directors also uses certain of these measures to evaluate management’s
performance for the purpose of determining incentive compensation.
Additional information regarding the purpose and utility of specific
non-GAAP measures used in this release is set forth below.
The Company believes that Adjusted EBITDA is a useful measure, in part,
because certain investors and analysts use both historical and projected
Adjusted EBITDA, in addition to other GAAP and non-GAAP measures, as
factors in determining the estimated fair value of shares of the
Company’s common stock. Company management also regularly reviews the
Adjusted EBITDA performance for each operating segment. The Company does
not use Adjusted EBITDA to measure liquidity, but instead to measure
operating performance.
We use, and we believe investors and analysts use, Free Cash Flow and
Adjusted Free Cash Flow as supplemental measures to analyze cash flows
generated from our operations because we believe it is useful to
investors in evaluating our ability to fund distributions paid to
noncontrolling interests, acquisitions, purchasing equity interests in
joint ventures or repaying debt.
These non-GAAP measures may not be comparable to similarly titled
measures reported by other companies. Because these measures exclude
many items that are included in our financial statements, they do not
provide a complete measure of our operating performance. For example,
the Company’s definitions of Free Cash Flow and Adjusted Free Cash Flow
do not include other important uses of cash including (1) cash used to
purchase businesses or joint venture interests, or (2) any items that
are classified as Cash Flows From Financing Activities on the Company’s
Consolidated Statement of Cash Flows, including items such as (i) cash
used to repay borrowings, (ii) distributions paid to noncontrolling
interests, or (iii) payments under the Put/Call Agreement for USPI
redeemable noncontrolling interest, which are recorded on the Statement
of Cash Flows as the purchase of noncontrolling interest. Accordingly,
investors are encouraged to use GAAP measures when evaluating the
Company’s financial performance.
A reconciliation of net income (loss) attributable to Tenet Healthcare
Corporation common shareholders, the most comparable GAAP measure, to
Adjusted EBITDA is set forth in Table #1 below for each quarter in 2017
and 2018. A reconciliation of net income (loss) attributable to Tenet
Healthcare Corporation common shareholders, the most comparable GAAP
measure, to Adjusted net income from continuing operations attributable
to Tenet Healthcare Corporation common shareholders is set forth in
Table #2 below for each quarter in 2017 and 2018. A reconciliation of
net cash provided by (used in) operating activities, the most comparable
GAAP measure, to Free Cash Flow and Adjusted Free Cash Flow is set forth
in Table #3 below for each quarter in 2017 and 2018.
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #1 – Reconciliation of Net Income Available (Loss
Attributable) to Tenet Healthcare Corporation Common Shareholders
to Adjusted EBITDA
(Unaudited)
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
2017
|
|
2018
|
|
|
|
|
1st Qtr
|
|
2nd Qtr
|
|
3rd Qtr
|
|
4th Qtr
|
|
Total
|
|
1st Qtr
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
|
$
|
(53
|
)
|
|
$
|
(55
|
)
|
|
$
|
(367
|
)
|
|
$
|
(229
|
)
|
|
$
|
(704
|
)
|
|
$
|
99
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
(89
|
)
|
|
(87
|
)
|
|
(78
|
)
|
|
(130
|
)
|
|
(384
|
)
|
|
(92
|
)
|
|
Income (loss) from discontinued operations, net of tax
|
|
|
(1
|
)
|
|
1
|
|
|
(1
|
)
|
|
1
|
|
|
—
|
|
|
1
|
|
|
Income (loss) from continuing operations
|
|
|
37
|
|
|
31
|
|
|
(288
|
)
|
|
(100
|
)
|
|
(320
|
)
|
|
190
|
|
|
Income tax benefit (expense)
|
|
|
33
|
|
|
12
|
|
|
60
|
|
|
(324
|
)
|
|
(219
|
)
|
|
(70
|
)
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
(26
|
)
|
|
(138
|
)
|
|
—
|
|
|
(164
|
)
|
|
(1
|
)
|
|
Other non-operating expense, net
|
|
|
(5
|
)
|
|
(5
|
)
|
|
(4
|
)
|
|
(8
|
)
|
|
(22
|
)
|
|
(1
|
)
|
|
Interest expense
|
|
|
(258
|
)
|
|
(260
|
)
|
|
(257
|
)
|
|
(253
|
)
|
|
(1,028
|
)
|
|
(255
|
)
|
|
Operating income
|
|
|
267
|
|
|
310
|
|
|
51
|
|
|
485
|
|
|
1,113
|
|
|
517
|
|
|
Litigation and investigation costs
|
|
|
(5
|
)
|
|
(1
|
)
|
|
(6
|
)
|
|
(11
|
)
|
|
(23
|
)
|
|
(6
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
15
|
|
|
23
|
|
|
104
|
|
|
2
|
|
|
144
|
|
|
110
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
(33
|
)
|
|
(41
|
)
|
|
(329
|
)
|
|
(138
|
)
|
|
(541
|
)
|
|
(47
|
)
|
|
Depreciation and amortization
|
|
|
(221
|
)
|
|
(222
|
)
|
|
(219
|
)
|
|
(208
|
)
|
|
(870
|
)
|
|
$
|
(204
|
)
|
|
Loss from divested and closed businesses
|
|
|
(16
|
)
|
|
(19
|
)
|
|
(6
|
)
|
|
—
|
|
|
(41
|
)
|
|
(1
|
)
|
|
Adjusted EBITDA
|
|
|
$
|
527
|
|
|
$
|
570
|
|
|
$
|
507
|
|
|
$
|
840
|
|
|
$
|
2,444
|
|
|
$
|
665
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues
|
|
|
$
|
4,813
|
|
|
$
|
4,802
|
|
|
$
|
4,586
|
|
|
$
|
4,978
|
|
|
$
|
19,179
|
|
|
$
|
4,699
|
|
|
Less: Net operating revenues from health plans
|
|
|
65
|
|
|
25
|
|
|
10
|
|
|
10
|
|
|
110
|
|
|
6
|
|
|
Adjusted net operating revenues
|
|
|
$
|
4,748
|
|
|
$
|
4,777
|
|
|
$
|
4,576
|
|
|
$
|
4,968
|
|
|
$
|
19,069
|
|
|
$
|
4,693
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders as a % of net operating revenues
|
|
|
(1.1
|
)%
|
|
(1.1
|
)%
|
|
(8.0
|
)%
|
|
(4.6
|
)%
|
|
(3.7
|
)%
|
|
2.1
|
%
|
|
Adjusted EBITDA as a % of adjusted net operating revenues
(Adjusted EBITDA margin)
|
|
|
11.1
|
%
|
|
11.9
|
%
|
|
11.1
|
%
|
|
16.9
|
%
|
|
12.8
|
%
|
|
14.2
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #2 – Reconciliation of Net Income Available (Loss
Attributable) to
Tenet Healthcare Corporation Common Shareholders to Adjusted
Net Income (Loss)
from Continuing Operations Attributable to Common Shareholders
(Unaudited)
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
|
2017
|
|
2018
|
|
|
|
|
1st Qtr
|
|
2nd Qtr
|
|
3rd Qtr
|
|
4th Qtr
|
|
Total
|
|
1st Qtr
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
|
$
|
(53
|
)
|
|
$
|
(55
|
)
|
|
$
|
(367
|
)
|
|
$
|
(229
|
)
|
|
$
|
(704
|
)
|
|
$
|
99
|
|
|
Net income (loss) from discontinued operations
|
|
|
(1
|
)
|
|
$
|
1
|
|
|
(1
|
)
|
|
1
|
|
|
—
|
|
|
1
|
|
|
Net income (loss) from continuing operations
|
|
|
(52
|
)
|
|
(56
|
)
|
|
(366
|
)
|
|
(230
|
)
|
|
(704
|
)
|
|
98
|
|
|
Less: Impairment and restructuring charges, and acquisition-related
costs(1)
|
|
|
(33
|
)
|
|
(41
|
)
|
|
(329
|
)
|
|
(138
|
)
|
|
(541
|
)
|
|
(47
|
)
|
|
Litigation and investigation costs
|
|
|
(5
|
)
|
|
(1
|
)
|
|
(6
|
)
|
|
(11
|
)
|
|
(23
|
)
|
|
(6
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities(2)
|
|
|
15
|
|
|
23
|
|
|
104
|
|
|
2
|
|
|
144
|
|
|
110
|
|
|
Loss from early extinguishment of debt(3)
|
|
|
—
|
|
|
(26
|
)
|
|
(138
|
)
|
|
—
|
|
|
(164
|
)
|
|
(1
|
)
|
|
Loss from divested and closed businesses
|
|
|
(16
|
)
|
|
(19
|
)
|
|
(6
|
)
|
|
—
|
|
|
(41
|
)
|
|
(1
|
)
|
|
Tax impact of above items
|
|
|
14
|
|
|
25
|
|
|
26
|
|
|
49
|
|
|
114
|
|
|
(16
|
)
|
|
Tax reform adjustment
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(252
|
)
|
|
(252
|
)
|
|
—
|
|
|
Noncontrolling interests impact of above items
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(23
|
)
|
|
(23
|
)
|
|
—
|
|
|
Adjusted net income (loss) from continuing operations
attributable to common shareholders
|
|
|
$
|
(27
|
)
|
|
$
|
(17
|
)
|
|
$
|
(17
|
)
|
|
$
|
143
|
|
|
$
|
82
|
|
|
$
|
59
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings (loss) per share
|
|
|
$
|
(0.52
|
)
|
|
$
|
(0.56
|
)
|
|
$
|
(3.63
|
)
|
|
$
|
(2.28
|
)
|
|
$
|
(7.00
|
)
|
|
$
|
0.95
|
|
|
Less: Impairment and restructuring charges, and acquisition-related
costs
|
|
|
(0.33
|
)
|
|
(0.41
|
)
|
|
(3.26
|
)
|
|
(1.35
|
)
|
|
(5.34
|
)
|
|
(0.46
|
)
|
|
Litigation and investigation costs
|
|
|
(0.05
|
)
|
|
(0.01
|
)
|
|
(0.06
|
)
|
|
(0.11
|
)
|
|
(0.23
|
)
|
|
(0.06
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
0.15
|
|
|
0.23
|
|
|
1.03
|
|
|
0.02
|
|
|
1.42
|
|
|
1.08
|
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
(0.26
|
)
|
|
(1.37
|
)
|
|
—
|
|
|
(1.62
|
)
|
|
(0.01
|
)
|
|
Loss from divested and closed businesses
|
|
|
(0.16
|
)
|
|
(0.19
|
)
|
|
(0.06
|
)
|
|
—
|
|
|
(0.40
|
)
|
|
(0.01
|
)
|
|
Tax impact of above items
|
|
|
0.14
|
|
|
0.25
|
|
|
0.26
|
|
|
0.48
|
|
|
1.12
|
|
|
(0.16
|
)
|
|
Tax reform adjustment
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(2.47
|
)
|
|
(2.49
|
)
|
|
—
|
|
|
Noncontrolling interests impact of above items
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(0.23
|
)
|
|
(0.23
|
)
|
|
—
|
|
|
Adjusted diluted earnings (loss) per share from continuing
operations
|
|
|
$
|
(0.27
|
)
|
|
$
|
(0.17
|
)
|
|
$
|
(0.17
|
)
|
|
$
|
1.40
|
|
|
$
|
0.81
|
|
|
$
|
0.57
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average basic shares outstanding
(in thousands)
|
|
|
100,000
|
|
|
100,612
|
|
|
100,812
|
|
|
100,945
|
|
|
100,592
|
|
|
101,392
|
|
|
Weighted average dilutive shares outstanding
(in thousands)
|
|
|
100,848
|
|
|
101,294
|
|
|
101,523
|
|
|
101,853
|
|
|
101,380
|
|
|
102,656
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Impairment and restructuring charges, and acquisition-related costs
of $47 million in the three months ended March 31, 2018 consists of
$19 million of impairment charges, primarily related to our
Chicago-area facilities, $25 million of restructuring charges and $3
million of acquisition-related costs.
|
|
(2)
|
Gain on sales, consolidation and deconsolidation of facilities of
$110 million in the three months ended March 31, 2018 was primarily
related to a gain on sale of MacNeal Hospital and its related
physician practices and related assets in Chicago area and the sales
of our minority interests in several Dallas-area hospitals.
|
|
(3)
|
Loss from early extinguishment of debt of $1 million in the three
months ended March 31, 2018 was related to the Company’s debt
redemptions.
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #3 – Reconciliations of Net Cash Provided By Operating
Activities to Free Cash Flow and Adjusted Free Cash Flow from
Continuing Operations
(Unaudited)
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
2017
|
|
2018
|
|
|
|
|
1st Qtr
|
|
2nd Qtr
|
|
3rd Qtr
|
|
4th Qtr
|
|
Total
|
|
1st Qtr
|
|
Net cash provided by operating activities
|
|
|
$
|
186
|
|
|
$
|
215
|
|
|
$
|
308
|
|
|
$
|
491
|
|
|
$
|
1,200
|
|
|
$
|
113
|
|
|
Purchases of property and equipment
|
|
|
(198
|
)
|
|
(150
|
)
|
|
(144
|
)
|
|
(215
|
)
|
|
(707
|
)
|
|
(143
|
)
|
|
Free cash flow
|
|
|
$
|
(12
|
)
|
|
$
|
65
|
|
|
$
|
164
|
|
|
$
|
276
|
|
|
$
|
493
|
|
|
$
|
(30
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by (used in) investing activities
|
|
|
$
|
(189
|
)
|
|
$
|
(119
|
)
|
|
$
|
535
|
|
|
$
|
(206
|
)
|
|
$
|
21
|
|
|
$
|
373
|
|
|
Net cash used in financing activities
|
|
|
$
|
(141
|
)
|
|
$
|
(193
|
)
|
|
$
|
(889
|
)
|
|
$
|
(103
|
)
|
|
$
|
(1,326
|
)
|
|
$
|
(123
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by operating activities
|
|
|
$
|
186
|
|
|
$
|
215
|
|
|
$
|
308
|
|
|
$
|
491
|
|
|
$
|
1,200
|
|
|
$
|
113
|
|
|
Less: payments for restructuring charges,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
acquisition-related costs, and litigation costs and settlements
|
|
|
(24
|
)
|
|
(38
|
)
|
|
(26
|
)
|
|
(37
|
)
|
|
(125
|
)
|
|
(33
|
)
|
|
Net cash provided by (used in) operating activities from
discontinued operations
|
|
|
2
|
|
|
(4
|
)
|
|
(1
|
)
|
|
(2
|
)
|
|
(5
|
)
|
|
(1
|
)
|
|
Adjusted net cash provided by operating activities from
continuing operations
|
|
|
208
|
|
|
257
|
|
|
335
|
|
|
530
|
|
|
1,330
|
|
|
147
|
|
|
Purchases of property and equipment
|
|
|
(198
|
)
|
|
(150
|
)
|
|
(144
|
)
|
|
(215
|
)
|
|
(707
|
)
|
|
(143
|
)
|
|
Adjusted free cash flow – continuing operations
|
|
|
$
|
10
|
|
|
$
|
107
|
|
|
$
|
191
|
|
|
$
|
315
|
|
|
$
|
623
|
|
|
$
|
4
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #4 – Reconciliation of Outlook Net Income (Loss)
Attributable to Tenet Healthcare Corporation Common Shareholders
to Outlook Adjusted EBITDA
(Unaudited)
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
Q2 2018
|
|
|
2018
|
|
|
|
|
Low
|
|
|
High
|
|
|
Low
|
|
|
High
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
|
$
|
(10
|
)
|
|
|
$
|
10
|
|
|
|
$
|
100
|
|
|
|
$
|
180
|
|
|
Less: Net income attributable to noncontrolling interests
|
|
|
(95
|
)
|
|
|
(105
|
)
|
|
|
(410
|
)
|
|
|
(430
|
)
|
|
Net loss from discontinued operations, net of tax
|
|
|
(5
|
)
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
—
|
|
|
Income tax expense
|
|
|
(45
|
)
|
|
|
(50
|
)
|
|
|
(205
|
)
|
|
|
(225
|
)
|
|
Interest expense
|
|
|
(250
|
)
|
|
|
(260
|
)
|
|
|
(1,000
|
)
|
|
|
(1,010
|
)
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
—
|
|
|
Other non-operating expense, net
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
(10
|
)
|
|
|
(15
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities(1)
|
|
|
—
|
|
|
|
—
|
|
|
|
110
|
|
|
|
110
|
|
|
Impairment and restructuring charges, acquisition-related costs, and
litigation costs and settlements(1)
|
|
|
(25
|
)
|
|
|
(15
|
)
|
|
|
(125
|
)
|
|
|
(75
|
)
|
|
Depreciation and amortization
|
|
|
(195
|
)
|
|
|
(205
|
)
|
|
|
(790
|
)
|
|
|
(810
|
)
|
|
Loss from divested and closed businesses
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
(10
|
)
|
|
|
(15
|
)
|
|
Adjusted EBITDA
|
|
|
$
|
605
|
|
|
|
$
|
655
|
|
|
|
$
|
2,550
|
|
|
|
$
|
2,650
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income (loss) from continuing operations
|
|
|
$
|
(5
|
)
|
|
|
$
|
10
|
|
|
|
$
|
105
|
|
|
|
$
|
180
|
|
|
Net operating revenues
|
|
|
$
|
4,475
|
|
|
|
$
|
4,675
|
|
|
|
$
|
17,900
|
|
|
|
$
|
18,300
|
|
|
Income (loss) from continuing operations as a % of operating
revenues
|
|
|
(0.1
|
)%
|
|
|
0.2
|
%
|
|
|
0.6
|
%
|
|
|
1.0
|
%
|
|
Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA
margin)
|
|
|
13.5
|
%
|
|
|
14.0
|
%
|
|
|
14.2
|
%
|
|
|
14.5
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
The Company has provided an estimate of restructuring charges and
related payments that it anticipates in 2018. The Company does not
generally forecast impairment charges, acquisition-related costs,
litigation costs and settlements, gains (losses) on sales, and
consolidation and deconsolidation of facilities because the Company
does not believe that it can forecast these items with sufficient
accuracy since some of these items are indeterminable at the time
the Company provides its financial Outlook.
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #5 – Reconciliation of Outlook Net Income (Loss)
Attributable to Tenet Healthcare Corporation Common Shareholders
to Outlook Adjusted Net Income (Loss) from Continuing Operations
Attributable to Common Shareholders
(Unaudited)
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
|
Q2 2018
|
|
|
2018
|
|
|
|
|
Low
|
|
|
High
|
|
|
Low
|
|
|
High
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
|
$
|
(10
|
)
|
|
|
$
|
10
|
|
|
|
$
|
100
|
|
|
|
$
|
180
|
|
|
Net loss from discontinued operations, net of tax
|
|
|
(5
|
)
|
|
|
$
|
—
|
|
|
|
(5
|
)
|
|
|
—
|
|
|
Net income (loss) from continuing operations
|
|
|
(5
|
)
|
|
|
10
|
|
|
|
105
|
|
|
|
180
|
|
|
Less: Impairment and restructuring charges, acquisition-related
costs,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
and litigation costs and settlements
|
|
|
(25
|
)
|
|
|
(15
|
)
|
|
|
(125
|
)
|
|
|
(75
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
—
|
|
|
|
—
|
|
|
|
110
|
|
|
|
110
|
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
—
|
|
|
Loss from divested and closed businesses
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
(10
|
)
|
|
|
(15
|
)
|
|
Tax impact of above items
|
|
|
5
|
|
|
|
—
|
|
|
|
(5
|
)
|
|
|
(15
|
)
|
|
Noncontrolling interests impact of above items
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
Adjusted net income (loss) from continuing operations available
(attributable) to common shareholders
|
|
|
$
|
15
|
|
|
|
$
|
30
|
|
|
|
$
|
140
|
|
|
|
$
|
175
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings (loss) per share
|
|
|
$
|
(0.05
|
)
|
|
|
$
|
0.10
|
|
|
|
$
|
1.02
|
|
|
|
$
|
1.75
|
|
|
Less: Impairment and restructuring charges, acquisition-related
costs,
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
and litigation costs and settlements
|
|
|
(0.25
|
)
|
|
|
(0.14
|
)
|
|
|
(1.21
|
)
|
|
|
(0.73
|
)
|
|
Gains on sales, consolidation and deconsolidation of facilities
|
|
|
—
|
|
|
|
—
|
|
|
|
1.07
|
|
|
|
1.07
|
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
|
—
|
|
|
|
(0.05
|
)
|
|
|
—
|
|
|
Loss from divested and closed businesses
|
|
|
—
|
|
|
|
(0.05
|
)
|
|
|
(0.10
|
)
|
|
|
(0.15
|
)
|
|
Tax impact of above items
|
|
|
0.05
|
|
|
|
—
|
|
|
|
(0.05
|
)
|
|
|
(0.14
|
)
|
|
Noncontrolling interests impact of above items
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
Adjusted diluted earnings (loss) per share from continuing
operations
|
|
|
$
|
0.15
|
|
|
|
$
|
0.29
|
|
|
|
$
|
1.36
|
|
|
|
$
|
1.70
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average basic shares outstanding (in thousands)
|
|
|
101,000
|
|
|
|
101,000
|
|
|
|
102,000
|
|
|
|
102,000
|
|
|
Weighted average dilutive shares outstanding (in thousands)
|
|
|
102,000
|
|
|
|
102,000
|
|
|
|
103,000
|
|
|
|
103,000
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #6 – Reconciliation of Outlook Net Cash Provided by
Operating Activities to Outlook Adjusted Free Cash Flow from
Continuing Operations
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
|
|
|
|
|
|
2018
|
|
|
|
|
|
|
|
|
|
Low
|
|
High
|
|
Net cash provided by operating activities
|
|
|
|
|
|
|
|
$
|
1,245
|
|
|
$
|
1,550
|
|
|
Less: Payments for restructuring charges, acquisition-related
|
|
|
|
|
|
|
|
|
|
|
|
|
|
costs and litigation costs and settlements(1)
|
|
|
|
|
|
|
|
(100
|
)
|
|
(50
|
)
|
|
Net cash used in operating activities from discontinued operations
|
|
|
|
|
|
|
|
(5
|
)
|
|
—
|
|
|
Adjusted net cash provided by operating activities – continuing
operations
|
|
|
|
|
|
|
|
1,350
|
|
|
1,600
|
|
|
Purchases of property and equipment – continuing operations
|
|
|
|
|
|
|
|
(625
|
)
|
|
(675
|
)
|
|
Adjusted free cash flow – continuing operations
(2)
|
|
|
|
|
|
|
|
$
|
725
|
|
|
$
|
925
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
The Company has provided an estimate of payments that it anticipates
in 2018 related to restructuring charges. The Company does not
generally forecast payments related to acquisition-related costs and
litigation costs and settlements because the Company does not
believe that it can forecast these items with sufficient accuracy
since some of these items may be indeterminable at the time the
Company provides its financial Outlook.
|
|
(2)
|
The Company's definition of Adjusted Free Cash Flow does not include
other important uses of cash including (1) cash used to purchase
businesses or joint venture interests, or (2) any items that are
classified as Cash Flows From Financing Activities on the Company's
Consolidated Statement of Cash Flows, including items such as (i)
cash used to repay borrowings, (ii) distributions paid to
noncontrolling interests, or (iii) payments under the Put/Call
Agreement for USPI redeemable noncontrolling interests, which are
recorded on the Statement of Cash Flows as the purchase of
noncontrolling interests.
|
