DALLAS--(BUSINESS WIRE)--Tenet Healthcare Corporation (NYSE: THC) reported a net loss from
continuing operations attributable to Tenet common shareholders of $27
million in the first quarter of 2019 compared to net income of $98
million in the first quarter of 2018. Adjusted EBITDA was $613 million
in the first quarter of 2019 above the midpoint of the Company’s Outlook
range of $575 million to $625 million.
Ronald A. Rittenmeyer, Executive Chairman and CEO, said, “We had a solid
start to the year, building on the many positive changes we made across
the enterprise in 2018. These changes include the continued addition of
new leadership as well as an infusion of fresh thinking, which are
helping to transform our approach to operations and overall enterprise
culture. In the first quarter, we continued to make progress in each of
our business segments through rigorous implementation of our
strategic initiatives, and we were pleased with our performance,
both operationally and financially. As we move through the year, we
remain focused on revenue growth and expense management to sharpen
operations and our competitive position.”
Results for the Quarter Ended March 31, 2019
Adjusted EBITDA was $613 million in the first quarter of 2019 compared
to $665 million in the first quarter of 2018. The decline was primarily
attributable to: (i) a $38 million increase in malpractice expense; (ii)
$11 million of losses generated by a risk-based contracting business in
California in the first quarter of 2019; (iii) $7 million due to the
divestiture of Aspen Healthcare, the Company’s former operations in the
United Kingdom; and (iv) $10 million of contract termination fees
received by Conifer in the first quarter of 2018 which did not occur
again in the first quarter of 2019. These four items were substantially
anticipated in the Company’s Outlook range provided in February.
Hospital Operations and Other Segment
Net operating revenues in the Hospital Operations and other segment were
$3.862 billion in the first quarter of 2019, down 2.2 percent from the
first quarter of 2018. The decline in revenue was due to hospital
divestitures, partially offset by same-hospital revenue growth.
On a same-hospital basis, net patient service revenues were $3.559
billion in the first quarter of 2019, up 1.9 percent from the first
quarter of 2018. Admissions declined 0.1 percent on a same-hospital
basis, adjusted admissions increased 0.6 percent and revenue per
adjusted admission increased 1.3 percent. A decline in flu cases lowered
admissions and adjusted admissions by 80 basis points and 60 basis
points, respectively.
Adjusted EBITDA in Tenet’s hospital segment was $337 million in the
first quarter of 2019 compared to $402 million in the first quarter of
2018. The $65 million decline was primarily due to a $38 million
increase in malpractice expense (comprised of a $21 million increase to
settle various claims and $17 million of discount rate adjustments), $11
million of losses generated by a risk-based contracting business in
California in the first quarter of 2019 and a stronger flu season in the
first quarter of 2018.
Selected operating expenses in the Hospital Operations and other segment
increased 4.0 percent on a per adjusted admission basis in the first
quarter of 2019 and increased 2.5 percent excluding the $38 million
increase in malpractice expense as well as the $11 million of losses
generated by a risk-based contracting business in California. Selected
operating expenses include salaries, wages and benefits, supplies and
other operating expenses and exclude the costs of the Company’s health
plan businesses. Salaries, wages and benefits increased 2.8 percent per
adjusted admission in the first quarter of 2019 and supply expense
remained substantially the same. Other operating expenses increased 9.4
percent per adjusted admission in the first quarter of 2019 and
increased 3.6 percent per adjusted admission excluding the increase in
malpractice expense and risk-based contracting losses in California
mentioned above.
Ambulatory Care Segment
The Ambulatory Care segment produced net operating revenues of $480
million in the first quarter of 2019, a decrease of 3.6 percent compared
to $498 million in the first quarter of 2018. The decline in revenue was
due to the divestiture of Aspen Healthcare in the third quarter of 2018.
Aspen generated $49 million of revenue and $7 million of Adjusted EBITDA
and Adjusted EBITDA less facility-level noncontrolling interest in the
first quarter of 2018. After normalizing for the divestiture of Aspen,
the Ambulatory Care segment generated Adjusted EBITDA of $177 million in
the first quarter of 2019, up 12.0 percent from $158 million in the
first quarter of 2018 and Adjusted EBITDA less facility-level
noncontrolling interest was $112 million, up 9.8 percent from $102
million in the first quarter of 2018.
The results of many of the facilities in which the Ambulatory Care
segment has an investment are not consolidated by Tenet (of the 334
facilities at March 31, 2019, the results of 108 were accounted for
under the equity method for unconsolidated affiliates). 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 Care segment increased 4.2 percent in the first
quarter of 2019, with cases increasing 0.9 percent and revenue per case
increasing 3.3 percent. In the surgical business, which represents the
majority of the revenue in the Ambulatory segment, same-facility
system-wide revenue grew 4.2 percent in the first quarter of 2019, with
cases up 2.8 percent and revenue per case up 1.4 percent.
Conifer Segment
During the first quarter of 2019, Conifer’s revenue declined 13.6
percent to $349 million, primarily due to client attrition following
divestitures by Tenet and other customers, down from $404 million in the
first quarter of 2018. Revenue from third party customers declined 20.1
percent to $203 million in the first quarter of 2019. The year-over-year
revenue and EBITDA comparisons were also impacted by $10 million of
contract termination fees received by Conifer in the first quarter of
2018, which did not occur again in the first quarter of 2019.
Conifer generated $99 million of Adjusted EBITDA in the first quarter of
2019, up 1.0 percent from $98 million in the first quarter of 2018 and
up 12.5 percent after adjusting for the $10 million of contract
termination fees in the first quarter of 2018. Adjusted EBITDA margins
increased 410 basis points to 28.4 percent, reflecting the ongoing
improvement in Conifer’s cost structure.
Net Income and Earnings Per Share
Tenet reported a net loss from continuing operations attributable to
Tenet common shareholders of $27 million, or $0.26 per diluted share, in
the first quarter of 2019 compared to net income of $98 million, or
$0.95 per diluted share, in the first quarter of 2018. The net loss in
the first quarter of 2019 included a $47 million pre-tax loss from the
early extinguishment of debt; net income in the first quarter of 2018
included $110 million of pre-tax gains on sales, consolidation and
deconsolidation of facilities, primarily comprised of a $98 million gain
from the sale of MacNeal Hospital and other operations affiliated with
the hospital and a gain of $13 million from the sales of the Company’s
minority interests in four North Texas hospitals.
After adjusting for the items listed on Table #2, Tenet produced
Adjusted net income from continuing operations available to Tenet common
shareholders of $56 million, or $0.54 per diluted share, in the first
quarter of 2019, compared to $59 million, or $0.57 per diluted share, in
the first quarter of 2018.
A reconciliation of GAAP net income available (loss attributable) to
Tenet common shareholders to Adjusted net income available (loss
attributable) from continuing operations and Adjusted diluted earnings
(loss) per share from continuing operations is contained in Table #2 at
the end of this release.
Cash Flow and Liquidity
Cash and cash equivalents were $252 million at March 31, 2019 compared
to $411 million at December 31, 2018. The Company had $190 million of
outstanding borrowings on its $1 billion credit line as of March 31,
2019. Accounts receivable days outstanding from continuing operations
were 58.6 at March 31, 2019 compared to 56.5 at December 31, 2018.
Net cash provided by operating activities was $10 million in the first
quarter of 2019, representing a $103 million decrease compared to $113
million in the first quarter of 2018. After subtracting $192 million and
$143 million of capital expenditures in the first quarters of 2019 and
2018, respectively, Free Cash Flow was an outflow of $182 million in the
first quarter of 2019, a decrease of $152 million compared to an outflow
of $30 million in the first quarter of 2018. Adjusted Free Cash Flow was
an outflow of $148 million in the first quarter of 2019, representing a
$152 million decrease from an inflow of $4 million in the first quarter
of 2018.
Net cash used in investing activities was $139 million in the first
quarter of 2019 compared to $373 million of net cash provided by
investing activities in the first quarter of 2018. Results in the first
quarter of 2019 included $62 million of proceeds from the sales of
facilities, long-term investments and other assets compared to $559
million in the first quarter of 2018.
Net cash used in financing activities was $30 million in the first
quarter of 2019 compared to $123 million used in the first quarter of
2018.
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 Outlook for 2019 includes:
-
Revenue of $18.0 billion to $18.4 billion,
-
Net income from continuing operations available to Tenet common
shareholders of $17 million to $117 million,
-
Adjusted EBITDA of $2.650 billion to $2.750 billion,
-
Net cash provided by operating activities of $1.070 billion to $1.375
billion,
-
Adjusted Free Cash Flow of $600 million to $800 million,
-
Diluted earnings per share from continuing operations of $0.16 to
$1.10, and
-
Adjusted diluted earnings per share from continuing operations of
$2.08 to $2.59.
The Outlook for 2019 assumes equity in earnings of unconsolidated
affiliates of $180 million to $190 million, depreciation and
amortization expense of $805 million to $825 million, interest expense
of $985 million to $995 million, net income available to noncontrolling
interests of $425 million to $445 million and an average diluted share
count of 106 million.
The Company’s Outlook for the second quarter of 2019 includes:
-
Revenue of $4.400 billion to $4.700 billion,
-
Net income available (loss attributable) from continuing operations to
Tenet common shareholders ranging from a loss of $5 million to income
of $40 million,
-
Adjusted EBITDA of $625 million to $675 million,
-
Diluted earnings (loss) per share from continuing operations ranging
from a loss of $0.05 per share to earnings of $0.38 per share, and
-
Adjusted diluted earnings per share from continuing operations ranging
from $0.29 to $0.63.
The Outlook for the second quarter assumes equity in earnings of
unconsolidated affiliates of $40 million to $45 million, depreciation
and amortization expense of $200 million to $210 million, interest
expense of $240 million to $250 million, net income available to
noncontrolling interests of $100 million to $110 million, and an average
diluted share count of 104 million.
Additional details on Tenet’s Outlook for both the second quarter and
calendar year 2019 are available in Tables #4, #5 and #6 at the end of
this press release and in an accompanying slide presentation that will
be accessible through the Company’s website at www.tenethealth.com/investors.
Management’s Webcast Discussion of First
Quarter Results
Tenet management will discuss the Company’s first quarter 2019 results
on a webcast scheduled for 9:00 a.m. Eastern Time (8:00 a.m. Central
Time) on April 30, 2019. 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, will
be 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 period ended March 31,
2019, which will be filed with the Securities and Exchange Commission
and posted on the Company’s website.
This press release includes certain non-GAAP measures, such as Adjusted
EBITDA, Adjusted net income available (loss attributable) from
continuing operations to Tenet common shareholders, Adjusted diluted
earnings (loss) per share from continuing operations, Free Cash Flow and
Adjusted Free Cash Flow. Reconciliations of these measures to the most
comparable GAAP measures are contained in the tables at the end of this
release.
Tenet Healthcare Corporation (NYSE: THC) is a national diversified
healthcare services company headquartered in Dallas, TX, with 110,000
employees. Through an expansive care network that includes United
Surgical Partners International, we operate 65 hospitals and
approximately 500 other healthcare facilities, including surgical
hospitals, ambulatory surgery centers, urgent care and imaging centers
and other outpatient facilities. We also operate Conifer Health
Solutions, which provides revenue cycle management and value-based care
services to hospitals, health systems, physician practices, employers
and other customers. At the center of everything we do is a commitment
to deliver the right care, in the right place, at the right time, and to
continually improve and advance the healthcare delivery system in the
markets we serve. 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,” “anticipate,” “assume,” “believe,” “budget,”
“estimate,” “forecast,” “intend,” “plan,” “predict,” “project,” “seek,”
“see,” “target,” 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, 2018, 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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2019
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%
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2018
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%
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|
Change
|
|
Net operating revenues
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$
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4,545
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|
|
100.0
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%
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|
|
4,699
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|
|
100.0
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%
|
|
(3.3
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)%
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|
Equity in earnings of unconsolidated affiliates
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|
|
34
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|
|
0.7
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%
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|
|
25
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|
|
0.5
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%
|
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36.0
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%
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|
Operating expenses:
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Salaries, wages and benefits
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2,153
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47.3
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%
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|
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2,227
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|
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47.3
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%
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(3.3
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)%
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|
Supplies
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|
|
741
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|
|
16.3
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%
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|
|
774
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|
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16.5
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%
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|
(4.3
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)%
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|
Other operating expenses, net
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1,074
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|
|
23.6
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%
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|
|
1,060
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|
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22.6
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%
|
|
1.3
|
%
|
|
Electronic health record incentives
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|
(1
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)
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|
—
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%
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|
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(1
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)
|
|
—
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%
|
|
—
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%
|
|
Depreciation and amortization
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|
|
208
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|
|
4.6
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%
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|
|
204
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|
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4.3
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%
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|
|
|
Impairment and restructuring charges, and acquisition-related costs
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19
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0.4
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%
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47
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|
|
1.0
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%
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|
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|
Litigation and investigation costs
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|
|
13
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|
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0.3
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%
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|
|
6
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|
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0.1
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%
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|
|
|
Net losses (gains) on sales, consolidation and deconsolidation of
facilities
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|
1
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|
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—
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%
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|
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(110
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)
|
|
(2.3
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)%
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|
|
|
Operating income
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|
|
371
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|
|
8.2
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%
|
|
|
517
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|
|
11.0
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%
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|
|
|
Interest expense
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|
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(251
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)
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(255
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)
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|
Other non-operating income (expense), net
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1
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(1
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)
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Loss from early extinguishment of debt
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(47
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)
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(1
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)
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Income from continuing operations, before income taxes
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74
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|
|
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|
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260
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|
|
|
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Income tax expense
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|
|
(17
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)
|
|
|
|
|
(70
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)
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|
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|
|
Income from continuing operations, before discontinued
operations
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|
|
57
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|
|
|
|
|
190
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|
|
|
|
|
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Discontinued operations:
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Income from operations
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10
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|
1
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|
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Income tax expense
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(2
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)
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|
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—
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Income from discontinued operations
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|
8
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|
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|
1
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|
|
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Net income
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65
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|
|
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|
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191
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|
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Less: Net income available to noncontrolling interests
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84
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92
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|
|
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|
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Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
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|
$
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(19
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)
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|
$
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99
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|
|
|
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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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|
$
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(27
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)
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|
|
|
$
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98
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|
|
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Income from discontinued operations, net of tax
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|
|
8
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|
|
|
|
|
1
|
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(19
|
)
|
|
|
|
$
|
99
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|
|
|
|
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
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|
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Basic
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|
|
|
|
|
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Continuing operations
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$
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(0.26
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)
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$
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0.97
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Discontinued operations
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0.08
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0.01
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|
|
|
|
|
|
|
$
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(0.18
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)
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|
$
|
0.98
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Diluted
|
|
|
|
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Continuing operations
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|
$
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(0.26
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)
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|
|
$
|
0.95
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|
|
|
|
|
|
Discontinued operations
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0.08
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|
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0.01
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$
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(0.18
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)
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|
$
|
0.96
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Weighted average shares and dilutive securities outstanding (in
thousands):
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Basic
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|
102,788
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|
101,392
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|
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Diluted*
|
|
|
102,788
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|
|
|
|
|
102,656
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*Had we generated income from continuing operations available to
common shareholders in the three months ended March 31, 2019 the
effect of employee stock options, restricted stock units and
deferred compensation units on the diluted shares calculation
would have been an increase of 1,753 thousand shares.
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|
|
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|
TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
(Unaudited)
|
|
|
|
|
|
|
|
|
|
March 31,
|
|
December 31,
|
|
(Dollars in millions)
|
|
2019
|
|
2018
|
|
ASSETS
|
|
|
|
|
|
Current assets:
|
|
|
|
|
|
Cash and cash equivalents
|
|
$
|
252
|
|
|
$
|
411
|
|
|
Accounts receivable, less allowance for doubtful accounts
|
|
|
2,744
|
|
|
|
2,595
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|
|
Inventories of supplies, at cost
|
|
|
308
|
|
|
|
305
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|
|
Income tax receivable
|
|
|
17
|
|
|
|
21
|
|
|
Assets held for sale
|
|
|
—
|
|
|
|
107
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|
|
Other current assets
|
|
|
1,261
|
|
|
|
1,197
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|
|
Total current assets
|
|
|
4,582
|
|
|
|
4,636
|
|
|
Investments and other assets
|
|
|
2,331
|
|
|
|
1,456
|
|
|
Deferred income taxes
|
|
|
291
|
|
|
|
312
|
|
|
Property and equipment, at cost, less accumulated depreciation and
amortization
|
|
|
6,996
|
|
|
|
6,993
|
|
|
Goodwill
|
|
|
7,283
|
|
|
|
7,281
|
|
|
Other intangible assets, at cost, less accumulated amortization
|
|
|
1,675
|
|
|
|
1,731
|
|
|
Total assets
|
|
$
|
23,158
|
|
|
$
|
22,409
|
|
|
|
|
|
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|
|
LIABILITIES AND EQUITY
|
|
|
|
|
|
Current liabilities:
|
|
|
|
|
|
Current portion of long-term debt
|
|
$
|
158
|
|
|
$
|
182
|
|
|
Accounts payable
|
|
|
1,101
|
|
|
|
1,207
|
|
|
Accrued compensation and benefits
|
|
|
707
|
|
|
|
838
|
|
|
Professional and general liability reserves
|
|
|
224
|
|
|
|
216
|
|
|
Accrued interest payable
|
|
|
323
|
|
|
|
240
|
|
|
Liabilities held for sale
|
|
|
—
|
|
|
|
43
|
|
|
Other current liabilities
|
|
|
1,212
|
|
|
|
1,131
|
|
|
Total current liabilities
|
|
|
3,725
|
|
|
|
3,857
|
|
|
Long-term debt, net of current portion
|
|
|
14,814
|
|
|
|
14,644
|
|
|
Professional and general liability reserves
|
|
|
690
|
|
|
|
666
|
|
|
Defined benefit plan obligations
|
|
|
512
|
|
|
|
521
|
|
|
Deferred income taxes
|
|
|
36
|
|
|
|
36
|
|
|
Other long-term liabilities
|
|
|
1,268
|
|
|
|
578
|
|
|
Total liabilities
|
|
|
21,045
|
|
|
|
20,302
|
|
|
Commitments and contingencies
|
|
|
|
|
|
Redeemable noncontrolling interests in equity of consolidated
subsidiaries
|
|
|
1,439
|
|
|
|
1,420
|
|
|
Equity:
|
|
|
|
|
|
Shareholders’ equity:
|
|
|
|
|
|
Common stock
|
|
|
7
|
|
|
|
7
|
|
|
Additional paid-in capital
|
|
|
4,748
|
|
|
|
4,747
|
|
|
Accumulated other comprehensive loss
|
|
|
(221
|
)
|
|
|
(223
|
)
|
|
Accumulated deficit
|
|
|
(2,254
|
)
|
|
|
(2,236
|
)
|
|
Common stock in treasury, at cost
|
|
|
(2,414
|
)
|
|
|
(2,414
|
)
|
|
Total shareholders’ deficit
|
|
|
(134
|
)
|
|
|
(119
|
)
|
|
Noncontrolling interests
|
|
|
808
|
|
|
|
806
|
|
|
Total equity
|
|
|
674
|
|
|
|
687
|
|
|
Total liabilities and equity
|
|
$
|
23,158
|
|
|
$
|
22,409
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF CASH FLOW
(Unaudited)
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
(Dollars in millions)
|
|
March 31,
|
|
|
|
2019
|
|
2018
|
|
Net income
|
|
$
|
65
|
|
|
$
|
191
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities:
|
|
|
|
|
|
Depreciation and amortization
|
|
|
208
|
|
|
|
204
|
|
|
Deferred income tax expense
|
|
|
19
|
|
|
|
70
|
|
|
Stock-based compensation expense
|
|
|
11
|
|
|
|
9
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
19
|
|
|
|
47
|
|
|
Litigation and investigation costs
|
|
|
13
|
|
|
|
6
|
|
|
Net losses (gains) on sales, consolidation and deconsolidation of
facilities
|
|
|
1
|
|
|
|
(110
|
)
|
|
Loss from early extinguishment of debt
|
|
|
47
|
|
|
|
1
|
|
|
Equity in earnings of unconsolidated affiliates, net of
distributions received
|
|
|
3
|
|
|
|
9
|
|
|
Amortization of debt discount and debt issuance costs
|
|
|
11
|
|
|
|
11
|
|
|
Pre-tax income from discontinued operations
|
|
|
(10
|
)
|
|
|
(1
|
)
|
|
Other items, net
|
|
|
(7
|
)
|
|
|
(1
|
)
|
|
Changes in cash from operating assets and liabilities:
|
|
|
|
|
|
Accounts receivable
|
|
|
(158
|
)
|
|
|
(66
|
)
|
|
Inventories and other current assets
|
|
|
(115
|
)
|
|
|
(41
|
)
|
|
Income taxes
|
|
|
9
|
|
|
|
—
|
|
|
Accounts payable, accrued expenses and other current liabilities
|
|
|
(109
|
)
|
|
|
(183
|
)
|
|
Other long-term liabilities
|
|
|
37
|
|
|
|
1
|
|
|
Payments for restructuring charges, acquisition-related costs,
and litigation costs and settlements
|
|
|
(32
|
)
|
|
|
(33
|
)
|
|
Net cash used in operating activities from discontinued
operations, excluding income taxes
|
|
|
(2
|
)
|
|
|
(1
|
)
|
|
Net cash provided by operating activities
|
|
|
10
|
|
|
|
113
|
|
|
Cash flows from investing activities:
|
|
|
|
|
|
Purchases of property and equipment — continuing operations
|
|
|
(192
|
)
|
|
|
(143
|
)
|
|
Purchases of businesses or joint venture interests, net of cash
acquired
|
|
|
(2
|
)
|
|
|
(16
|
)
|
|
Proceeds from sales of facilities and other assets — continuing
operations
|
|
|
41
|
|
|
|
425
|
|
|
Proceeds from sales of facilities and other assets — discontinued
operations
|
|
|
17
|
|
|
|
—
|
|
|
Proceeds from sales of marketable securities, long-term investments
and other assets
|
|
|
4
|
|
|
|
134
|
|
|
Purchases of equity investments
|
|
|
(1
|
)
|
|
|
(30
|
)
|
|
Other long-term assets
|
|
|
(2
|
)
|
|
|
7
|
|
|
Other items, net
|
|
|
(4
|
)
|
|
|
(4
|
)
|
|
Net cash provided by (used in) investing activities
|
|
|
(139
|
)
|
|
|
373
|
|
|
Cash flows from financing activities:
|
|
|
|
|
|
Repayments of borrowings under credit facility
|
|
|
(495
|
)
|
|
|
—
|
|
|
Proceeds from borrowings under credit facility
|
|
|
685
|
|
|
|
—
|
|
|
Repayments of other borrowings
|
|
|
(1,620
|
)
|
|
|
(91
|
)
|
|
Proceeds from other borrowings
|
|
|
1,507
|
|
|
|
7
|
|
|
Debt issuance costs
|
|
|
(18
|
)
|
|
|
—
|
|
|
Distributions paid to noncontrolling interests
|
|
|
(74
|
)
|
|
|
(64
|
)
|
|
Proceeds from sales of noncontrolling interests
|
|
|
4
|
|
|
|
5
|
|
|
Purchases of noncontrolling interests
|
|
|
(3
|
)
|
|
|
(9
|
)
|
|
Proceeds from exercise of stock options and employee stock purchase
plan
|
|
|
1
|
|
|
|
9
|
|
|
Other items, net
|
|
|
(17
|
)
|
|
|
20
|
|
|
Net cash used in financing activities
|
|
|
(30
|
)
|
|
|
(123
|
)
|
|
Net increase (decrease) in cash and cash equivalents
|
|
|
(159
|
)
|
|
|
363
|
|
|
Cash and cash equivalents at beginning of period
|
|
|
411
|
|
|
|
611
|
|
|
Cash and cash equivalents at end of period
|
|
$
|
252
|
|
|
$
|
974
|
|
|
Supplemental disclosures:
|
|
|
|
|
|
Interest paid, net of capitalized interest
|
|
$
|
(158
|
)
|
|
$
|
(169
|
)
|
|
Income tax refunds, net
|
|
$
|
9
|
|
|
$
|
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)
|
|
2019
|
|
2018
|
|
Change
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
65
|
|
|
69
|
|
|
(4
|
)
|
*
|
|
Total admissions
|
|
174,726
|
|
|
182,306
|
|
|
(4.2
|
)%
|
|
|
Adjusted patient admissions
|
|
308,133
|
|
|
320,868
|
|
|
(4.0
|
)%
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
164,793
|
|
|
172,490
|
|
|
(4.5
|
)%
|
|
|
Charity and uninsured admissions
|
|
9,933
|
|
|
9,816
|
|
|
1.2
|
%
|
|
|
Admissions through emergency department
|
|
126,079
|
|
|
125,076
|
|
|
0.8
|
%
|
|
|
Paying admissions as a percentage of total admissions
|
|
94.3
|
%
|
|
94.6
|
%
|
|
(0.3
|
)%
|
*
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
5.7
|
%
|
|
5.4
|
%
|
|
0.3
|
%
|
*
|
|
Emergency department admissions as a percentage of total admissions
|
|
72.2
|
%
|
|
68.6
|
%
|
|
3.6
|
%
|
*
|
|
Surgeries — inpatient
|
|
44,795
|
|
|
47,223
|
|
|
(5.1
|
)%
|
|
|
Surgeries — outpatient
|
|
58,218
|
|
|
63,008
|
|
|
(7.6
|
)%
|
|
|
Total surgeries
|
|
103,013
|
|
|
110,231
|
|
|
(6.5
|
)%
|
|
|
Patient days — total
|
|
822,079
|
|
|
858,648
|
|
|
(4.3
|
)%
|
|
|
Adjusted patient days
|
|
1,420,170
|
|
|
1,486,139
|
|
|
(4.4
|
)%
|
|
|
Average length of stay (days)
|
|
4.70
|
|
|
4.71
|
|
|
(0.2
|
)%
|
|
|
Licensed beds (at end of period)
|
|
17,221
|
|
|
18,457
|
|
|
(6.7
|
)%
|
|
|
Average licensed beds
|
|
17,455
|
|
|
18,685
|
|
|
(6.6
|
)%
|
|
|
Utilization of licensed beds
|
|
52.3
|
%
|
|
51.1
|
%
|
|
1.2
|
%
|
*
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
Total visits
|
|
1,714,392
|
|
|
1,842,539
|
|
|
(7.0
|
)%
|
|
|
Paying visits (excludes charity and uninsured)
|
|
1,603,712
|
|
|
1,725,976
|
|
|
(7.1
|
)%
|
|
|
Charity and uninsured visits
|
|
110,680
|
|
|
116,563
|
|
|
(5.0
|
)%
|
|
|
Emergency department visits
|
|
657,449
|
|
|
697,001
|
|
|
(5.7
|
)%
|
|
|
Paying visits as a percentage of total visits
|
|
93.5
|
%
|
|
93.7
|
%
|
|
(0.2
|
)%
|
*
|
|
Charity and uninsured visits as a percentage of total visits
|
|
6.5
|
%
|
|
6.3
|
%
|
|
0.2
|
%
|
*
|
|
Total emergency department admissions and visits
|
|
783,528
|
|
|
822,077
|
|
|
(4.7
|
)%
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
Net patient service revenues(3)
|
|
$
|
3,582
|
|
|
$
|
3,643
|
|
|
(1.7
|
)%
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
Net patient service revenue(3) per adjusted patient
admission
|
|
$
|
11,625
|
|
|
$
|
11,354
|
|
|
2.4
|
%
|
|
|
Net patient service revenue(3) per adjusted patient day
|
|
$
|
2,522
|
|
|
$
|
2,451
|
|
|
2.9
|
%
|
|
|
Total selected operating expenses (salaries, wages and
benefits, supplies and other operating expenses) per adjusted
patient admission(2)
|
|
$
|
10,979
|
|
|
$
|
10,561
|
|
|
4.0
|
%
|
|
|
Net patient service revenues
(3)
from:
|
|
|
|
|
|
|
|
|
Medicare
|
|
21.2
|
%
|
|
21.5
|
%
|
|
(0.3
|
)%
|
*
|
|
Medicaid
|
|
8.8
|
%
|
|
8.8
|
%
|
|
—
|
%
|
*
|
|
Managed care
|
|
65.7
|
%
|
|
65.0
|
%
|
|
0.7
|
%
|
*
|
|
Uninsured
|
|
—
|
%
|
|
1.0
|
%
|
|
(1.0
|
)%
|
*
|
|
Indemnity and other
|
|
4.3
|
%
|
|
3.7
|
%
|
|
0.6
|
%
|
*
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(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.
|
|
* This change is the difference between the 2019 and 2018 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)
|
|
2019
|
|
2018
|
|
Change
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
65
|
|
|
65
|
|
|
—
|
|
*
|
|
Total admissions
|
|
173,470
|
|
|
173,684
|
|
|
(0.1
|
)%
|
|
|
Adjusted patient admissions
|
|
305,871
|
|
|
304,145
|
|
|
0.6
|
%
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
163,632
|
|
|
164,239
|
|
|
(0.4
|
)%
|
|
|
Charity and uninsured admissions
|
|
9,838
|
|
|
9,445
|
|
|
4.2
|
%
|
|
|
Admissions through emergency department
|
|
125,228
|
|
|
119,957
|
|
|
4.4
|
%
|
|
|
Paying admissions as a percentage of total admissions
|
|
94.3
|
%
|
|
94.6
|
%
|
|
(0.3
|
)%
|
*
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
5.7
|
%
|
|
5.4
|
%
|
|
0.3
|
%
|
*
|
|
Emergency department admissions as a percentage of total admissions
|
|
72.2
|
%
|
|
69.1
|
%
|
|
3.1
|
%
|
*
|
|
Surgeries — inpatient
|
|
44,553
|
|
|
45,052
|
|
|
(1.1
|
)%
|
|
|
Surgeries — outpatient
|
|
57,896
|
|
|
59,720
|
|
|
(3.1
|
)%
|
|
|
Total surgeries
|
|
102,449
|
|
|
104,772
|
|
|
(2.2
|
)%
|
|
|
Patient days — total
|
|
815,329
|
|
|
817,000
|
|
|
(0.2
|
)%
|
|
|
Adjusted patient days
|
|
1,408,053
|
|
|
1,405,568
|
|
|
0.2
|
%
|
|
|
Average length of stay (days)
|
|
4.70
|
|
|
4.70
|
|
|
—
|
%
|
|
|
Licensed beds (at end of period)
|
|
17,221
|
|
|
17,246
|
|
|
(0.1
|
)%
|
|
|
Average licensed beds
|
|
17,221
|
|
|
17,246
|
|
|
(0.1
|
)%
|
|
|
Utilization of licensed beds
|
|
52.6
|
%
|
|
52.6
|
%
|
|
—
|
%
|
*
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
1,696,094
|
|
|
1,730,018
|
|
|
(2.0
|
)%
|
|
|
Paying visits (excludes charity and uninsured)
|
|
1,586,627
|
|
|
1,619,950
|
|
|
(2.1
|
)%
|
|
|
Charity and uninsured visits
|
|
109,467
|
|
|
110,068
|
|
|
(0.5
|
)%
|
|
|
Emergency department visits
|
|
651,852
|
|
|
663,722
|
|
|
(1.8
|
)%
|
|
|
Paying visits as a percentage of total visits
|
|
93.5
|
%
|
|
93.6
|
%
|
|
(0.1
|
)%
|
*
|
|
Charity and uninsured visits as a percentage of total visits
|
|
6.5
|
%
|
|
6.4
|
%
|
|
0.1
|
%
|
*
|
|
Total emergency department admissions and visits
|
|
777,080
|
|
|
783,679
|
|
|
(0.8
|
)%
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
Net patient service revenues(2)
|
|
$
|
3,559
|
|
|
$
|
3,494
|
|
|
1.9
|
%
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
Net patient service revenue(2) per adjusted patient
admission
|
|
$
|
11,636
|
|
|
$
|
11,488
|
|
|
1.3
|
%
|
|
|
Net patient service revenue(2) per adjusted patient day
|
|
$
|
2,528
|
|
|
$
|
2,486
|
|
|
1.7
|
%
|
|
|
Net patient service revenues
(2)
from:
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
21.0
|
%
|
|
20.9
|
%
|
|
0.1
|
%
|
*
|
|
Medicaid
|
|
8.8
|
%
|
|
8.7
|
%
|
|
0.1
|
%
|
*
|
|
Managed care
|
|
65.9
|
%
|
|
65.3
|
%
|
|
0.6
|
%
|
*
|
|
Uninsured
|
|
—
|
%
|
|
1.3
|
%
|
|
(1.3
|
)%
|
*
|
|
Indemnity and other
|
|
4.3
|
%
|
|
3.8
|
%
|
|
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 65 hospitals operated throughout the three months ended
March 31, 2019 and 2018 and associated outpatient facilities, but
excludes the results of hospitals Tenet divested since
January 1, 2018.
|
|
(2) Less implicit price concessions.
|
|
* This change is the difference between the 2019 and 2018 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
|
|
|
|
3/31/2018
|
|
6/30/2018
|
|
9/30/2018
|
|
12/31/2018
|
|
12/31/2018
|
|
3/31/2019
|
|
Net operating revenues
|
|
$
|
4,699
|
|
|
$
|
4,506
|
|
|
$
|
4,489
|
|
|
$
|
4,619
|
|
|
$
|
18,313
|
|
|
$
|
4,545
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
25
|
|
|
|
39
|
|
|
|
33
|
|
|
|
53
|
|
|
|
150
|
|
|
|
34
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
2,227
|
|
|
|
2,135
|
|
|
|
2,116
|
|
|
|
2,156
|
|
|
|
8,634
|
|
|
|
2,153
|
|
|
Supplies
|
|
|
774
|
|
|
|
748
|
|
|
|
726
|
|
|
|
756
|
|
|
|
3,004
|
|
|
|
741
|
|
|
Other operating expenses, net
|
|
|
1,060
|
|
|
|
1,027
|
|
|
|
1,094
|
|
|
|
1,078
|
|
|
|
4,259
|
|
|
|
1,074
|
|
|
Electronic health record incentives
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
—
|
|
|
|
(2
|
)
|
|
|
(3
|
)
|
|
|
(1
|
)
|
|
Depreciation and amortization
|
|
|
204
|
|
|
|
194
|
|
|
|
204
|
|
|
|
200
|
|
|
|
802
|
|
|
|
208
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
47
|
|
|
|
30
|
|
|
|
46
|
|
|
|
86
|
|
|
|
209
|
|
|
|
19
|
|
|
Litigation and investigation costs
|
|
|
6
|
|
|
|
13
|
|
|
|
9
|
|
|
|
10
|
|
|
|
38
|
|
|
|
13
|
|
|
Net losses (gains) on sales, consolidation and deconsolidation of
facilities
|
|
|
(110
|
)
|
|
|
(8
|
)
|
|
|
7
|
|
|
|
(16
|
)
|
|
|
(127
|
)
|
|
|
1
|
|
|
Operating income
|
|
|
517
|
|
|
|
406
|
|
|
|
320
|
|
|
|
404
|
|
|
|
1,647
|
|
|
|
371
|
|
|
Interest expense
|
|
|
(255
|
)
|
|
|
(254
|
)
|
|
|
(249
|
)
|
|
|
(246
|
)
|
|
|
(1,004
|
)
|
|
|
(251
|
)
|
|
Other non-operating income (expense), net
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(3
|
)
|
|
|
(5
|
)
|
|
|
1
|
|
|
Gain (loss) from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
3
|
|
|
|
1
|
|
|
|
(47
|
)
|
|
Income from continuing operations, before income taxes
|
|
|
260
|
|
|
|
150
|
|
|
|
71
|
|
|
|
158
|
|
|
|
639
|
|
|
|
74
|
|
|
Income tax expense
|
|
|
(70
|
)
|
|
|
(44
|
)
|
|
|
(6
|
)
|
|
|
(56
|
)
|
|
|
(176
|
)
|
|
|
(17
|
)
|
|
Income from continuing operations, before discontinued
operations
|
|
|
190
|
|
|
|
106
|
|
|
|
65
|
|
|
|
102
|
|
|
|
463
|
|
|
|
57
|
|
|
Discontinued operations:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income (loss) from operations
|
|
|
1
|
|
|
|
2
|
|
|
|
—
|
|
|
|
1
|
|
|
|
4
|
|
|
|
10
|
|
|
Income tax benefit (expense)
|
|
|
—
|
|
|
|
—
|
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
(2
|
)
|
|
Income (loss) from discontinued operations
|
|
|
1
|
|
|
|
2
|
|
|
|
—
|
|
|
|
—
|
|
|
|
3
|
|
|
|
8
|
|
|
Net income
|
|
|
191
|
|
|
|
108
|
|
|
|
65
|
|
|
|
102
|
|
|
|
466
|
|
|
|
65
|
|
|
Less: Net income available to noncontrolling interests
|
|
|
92
|
|
|
|
82
|
|
|
|
74
|
|
|
|
107
|
|
|
|
355
|
|
|
|
84
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
99
|
|
|
$
|
26
|
|
|
$
|
(9
|
)
|
|
$
|
(5
|
)
|
|
$
|
111
|
|
|
$
|
(19
|
)
|
|
Amounts available (attributable) to Tenet Healthcare
Corporation common shareholders
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income (loss) from continuing operations, net of tax
|
|
$
|
98
|
|
|
$
|
24
|
|
|
$
|
(9
|
)
|
|
$
|
(5
|
)
|
|
$
|
108
|
|
|
$
|
(27
|
)
|
|
Income (loss) from discontinued operations, net of tax
|
|
|
1
|
|
|
|
2
|
|
|
|
—
|
|
|
|
—
|
|
|
|
3
|
|
|
|
8
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
99
|
|
|
$
|
26
|
|
|
$
|
(9
|
)
|
|
$
|
(5
|
)
|
|
$
|
111
|
|
|
$
|
(19
|
)
|
|
Earnings (loss) per share available (attributable) to Tenet
Healthcare Corporation common shareholders:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
0.97
|
|
|
$
|
0.23
|
|
|
$
|
(0.09
|
)
|
|
$
|
(0.05
|
)
|
|
$
|
1.06
|
|
|
$
|
(0.26
|
)
|
|
Discontinued operations
|
|
|
0.01
|
|
|
|
0.02
|
|
|
|
—
|
|
|
$
|
—
|
|
|
|
0.03
|
|
|
|
0.08
|
|
|
|
|
$
|
0.98
|
|
|
$
|
0.25
|
|
|
$
|
(0.09
|
)
|
|
$
|
(0.05
|
)
|
|
$
|
1.09
|
|
|
$
|
(0.18
|
)
|
|
Diluted
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Continuing operations
|
|
$
|
0.95
|
|
|
$
|
0.23
|
|
|
$
|
(0.09
|
)
|
|
$
|
(0.05
|
)
|
|
$
|
1.04
|
|
|
$
|
(0.26
|
)
|
|
Discontinued operations
|
|
|
0.01
|
|
|
|
0.02
|
|
|
|
0.00
|
|
|
|
0.00
|
|
|
|
0.03
|
|
|
|
0.08
|
|
|
|
|
$
|
0.96
|
|
|
$
|
0.25
|
|
|
$
|
(0.09
|
)
|
|
$
|
(0.05
|
)
|
|
$
|
1.07
|
|
|
$
|
(0.18
|
)
|
|
Weighted average shares and dilutive securities outstanding (in
thousands):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
|
101,392
|
|
|
|
102,147
|
|
|
|
102,402
|
|
|
|
102,501
|
|
|
|
102,110
|
|
|
|
102,788
|
|
|
Diluted
|
|
|
102,656
|
|
|
|
104,177
|
|
|
|
102,402
|
|
|
|
102,501
|
|
|
|
103,881
|
|
|
|
102,788
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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
|
|
|
3/31/2018
|
|
6/30/2018
|
|
9/30/2018
|
|
12/31/2018
|
|
12/31/2018
|
|
3/31/2019
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
|
69
|
|
|
|
68
|
|
|
|
68
|
|
|
|
68
|
|
|
|
68
|
|
|
|
65
|
|
|
Total admissions
|
|
|
182,306
|
|
|
|
168,453
|
|
|
|
168,201
|
|
|
|
170,407
|
|
|
|
689,367
|
|
|
|
174,726
|
|
|
Adjusted patient admissions
|
|
|
320,868
|
|
|
|
306,063
|
|
|
|
306,197
|
|
|
|
308,113
|
|
|
|
1,241,241
|
|
|
|
308,133
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
|
172,490
|
|
|
|
158,216
|
|
|
|
157,193
|
|
|
|
160,172
|
|
|
|
648,071
|
|
|
|
164,793
|
|
|
Charity and uninsured admissions
|
|
|
9,816
|
|
|
|
10,237
|
|
|
|
11,008
|
|
|
|
10,235
|
|
|
|
41,296
|
|
|
|
9,933
|
|
|
Admissions through emergency department
|
|
|
125,076
|
|
|
|
115,036
|
|
|
|
116,727
|
|
|
|
120,012
|
|
|
|
476,851
|
|
|
|
126,079
|
|
|
Paying admissions as a percentage of total admissions
|
|
|
94.6
|
%
|
|
|
93.9
|
%
|
|
|
93.5
|
%
|
|
|
94.0
|
%
|
|
|
94.0
|
%
|
|
|
94.3
|
%
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
|
5.4
|
%
|
|
|
6.1
|
%
|
|
|
6.5
|
%
|
|
|
6.0
|
%
|
|
|
6.0
|
%
|
|
|
5.7
|
%
|
|
Emergency department admissions as a percentage of total admissions
|
|
|
68.6
|
%
|
|
|
68.3
|
%
|
|
|
69.4
|
%
|
|
|
70.4
|
%
|
|
|
69.2
|
%
|
|
|
72.2
|
%
|
|
Surgeries — inpatient
|
|
|
47,223
|
|
|
|
46,274
|
|
|
|
45,626
|
|
|
|
45,897
|
|
|
|
185,020
|
|
|
|
44,795
|
|
|
Surgeries — outpatient
|
|
|
63,008
|
|
|
|
63,805
|
|
|
|
61,468
|
|
|
|
62,638
|
|
|
|
250,919
|
|
|
|
58,218
|
|
|
Total surgeries
|
|
|
110,231
|
|
|
|
110,079
|
|
|
|
107,094
|
|
|
|
108,535
|
|
|
|
435,939
|
|
|
|
103,013
|
|
|
Patient days — total
|
|
|
858,648
|
|
|
|
766,519
|
|
|
|
761,920
|
|
|
|
779,728
|
|
|
|
3,166,815
|
|
|
|
822,079
|
|
|
Adjusted patient days
|
|
|
1,486,139
|
|
|
|
1,373,480
|
|
|
|
1,365,662
|
|
|
|
1,383,372
|
|
|
|
5,608,653
|
|
|
|
1,420,170
|
|
|
Average length of stay (days)
|
|
|
4.71
|
|
|
|
4.55
|
|
|
|
4.53
|
|
|
|
4.58
|
|
|
|
4.59
|
|
|
|
4.70
|
|
|
Licensed beds (at end of period)
|
|
|
18,457
|
|
|
|
18,314
|
|
|
|
18,302
|
|
|
|
17,937
|
|
|
|
17,937
|
|
|
|
17,221
|
|
|
Average licensed beds
|
|
|
18,685
|
|
|
|
18,362
|
|
|
|
18,302
|
|
|
|
17,935
|
|
|
|
18,321
|
|
|
|
17,455
|
|
|
Utilization of licensed beds
|
|
|
51.1
|
%
|
|
|
45.9
|
%
|
|
|
45.3
|
%
|
|
|
47.3
|
%
|
|
|
47.4
|
%
|
|
|
52.3
|
%
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
|
1,842,539
|
|
|
|
1,749,847
|
|
|
|
1,722,292
|
|
|
|
1,734,523
|
|
|
|
7,049,201
|
|
|
|
1,714,392
|
|
|
Paying visits (excludes charity and uninsured)
|
|
|
1,725,976
|
|
|
|
1,633,372
|
|
|
|
1,607,184
|
|
|
|
1,617,970
|
|
|
|
6,584,502
|
|
|
|
1,603,712
|
|
|
Charity and uninsured visits
|
|
|
116,563
|
|
|
|
116,475
|
|
|
|
115,108
|
|
|
|
116,553
|
|
|
|
464,699
|
|
|
|
110,680
|
|
|
Emergency department visits
|
|
|
697,001
|
|
|
|
643,036
|
|
|
|
638,248
|
|
|
|
649,544
|
|
|
|
2,627,829
|
|
|
|
657,449
|
|
|
Paying visits as a percentage of total visits
|
|
|
93.7
|
%
|
|
|
93.3
|
%
|
|
|
93.3
|
%
|
|
|
93.3
|
%
|
|
|
93.4
|
%
|
|
|
93.5
|
%
|
|
Charity and uninsured visits as a percentage of total visits
|
|
|
6.3
|
%
|
|
|
6.7
|
%
|
|
|
6.7
|
%
|
|
|
6.7
|
%
|
|
|
6.6
|
%
|
|
|
6.5
|
%
|
|
Total emergency department admissions and visits
|
|
|
822,077
|
|
|
|
758,072
|
|
|
|
754,975
|
|
|
|
769,556
|
|
|
|
3,104,680
|
|
|
|
783,528
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient service revenues(3)
|
|
$
|
3,643
|
|
|
$
|
3,443
|
|
|
$
|
3,434
|
|
|
$
|
3,561
|
|
|
$
|
14,081
|
|
|
$
|
3,582
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient service revenue(3) per adjusted patient
admission
|
|
$
|
11,354
|
|
|
$
|
11,249
|
|
|
$
|
11,215
|
|
|
$
|
11,557
|
|
|
$
|
11,344
|
|
|
$
|
11,625
|
|
|
Net patient service revenue(3) per adjusted patient day
|
|
$
|
2,451
|
|
|
$
|
2,507
|
|
|
$
|
2,515
|
|
|
$
|
2,574
|
|
|
$
|
2,511
|
|
|
$
|
2,522
|
|
|
Total selected operating expenses (salaries, wages and
benefits, supplies and other operating expenses) per adjusted
patient admission(2)
|
|
$
|
10,561
|
|
|
$
|
10,619
|
|
|
$
|
10,771
|
|
|
$
|
10,861
|
|
|
$
|
10,701
|
|
|
$
|
10,979
|
|
|
Net patient service revenues
(3)
from:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
21.5
|
%
|
|
|
20.4
|
%
|
|
|
19.8
|
%
|
|
|
20.1
|
%
|
|
|
20.5
|
%
|
|
|
21.2
|
%
|
|
Medicaid
|
|
|
8.8
|
%
|
|
|
9.1
|
%
|
|
|
9.8
|
%
|
|
|
9.1
|
%
|
|
|
9.2
|
%
|
|
|
8.8
|
%
|
|
Managed care
|
|
|
65.0
|
%
|
|
|
66.0
|
%
|
|
|
64.9
|
%
|
|
|
65.8
|
%
|
|
|
65.4
|
%
|
|
|
65.7
|
%
|
|
Uninsured
|
|
|
1.0
|
%
|
|
|
0.2
|
%
|
|
|
0.9
|
%
|
|
|
0.5
|
%
|
|
|
0.7
|
%
|
|
|
—
|
%
|
|
Indemnity and other
|
|
|
3.7
|
%
|
|
|
4.3
|
%
|
|
|
4.6
|
%
|
|
|
4.5
|
%
|
|
|
4.2
|
%
|
|
|
4.3
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(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.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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
|
|
|
3/31/2018
|
|
6/30/2018
|
|
9/30/2018
|
|
12/31/2018
|
|
12/31/2018
|
|
3/31/2019
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions, Patient Days and Surgeries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of hospitals (at end of period)
|
|
|
65
|
|
|
|
65
|
|
|
|
65
|
|
|
|
65
|
|
|
|
65
|
|
|
|
65
|
|
|
Total admissions
|
|
|
173,684
|
|
|
|
163,903
|
|
|
|
164,075
|
|
|
|
166,458
|
|
|
|
668,120
|
|
|
|
173,470
|
|
|
Adjusted patient admissions
|
|
|
304,145
|
|
|
|
297,460
|
|
|
|
298,221
|
|
|
|
300,562
|
|
|
|
1,200,388
|
|
|
|
305,871
|
|
|
Paying admissions (excludes charity and uninsured)
|
|
|
164,239
|
|
|
|
153,816
|
|
|
|
153,227
|
|
|
|
156,392
|
|
|
|
627,674
|
|
|
|
163,632
|
|
|
Charity and uninsured admissions
|
|
|
9,445
|
|
|
|
10,087
|
|
|
|
10,848
|
|
|
|
10,066
|
|
|
|
40,446
|
|
|
|
9,838
|
|
|
Admissions through emergency department
|
|
|
119,957
|
|
|
|
111,902
|
|
|
|
113,833
|
|
|
|
117,229
|
|
|
|
462,921
|
|
|
|
125,228
|
|
|
Paying admissions as a percentage of total admissions
|
|
|
94.6
|
%
|
|
|
93.8
|
%
|
|
|
93.4
|
%
|
|
|
94.0
|
%
|
|
|
93.9
|
%
|
|
|
94.3
|
%
|
|
Charity and uninsured admissions as a percentage of total admissions
|
|
|
5.4
|
%
|
|
|
6.2
|
%
|
|
|
6.6
|
%
|
|
|
6.0
|
%
|
|
|
6.1
|
%
|
|
|
5.7
|
%
|
|
Emergency department admissions as a percentage of total admissions
|
|
|
69.1
|
%
|
|
|
68.3
|
%
|
|
|
69.4
|
%
|
|
|
70.4
|
%
|
|
|
69.3
|
%
|
|
|
72.2
|
%
|
|
Surgeries — inpatient
|
|
|
45,052
|
|
|
|
45,191
|
|
|
|
44,783
|
|
|
|
45,012
|
|
|
|
180,038
|
|
|
|
44,553
|
|
|
Surgeries — outpatient
|
|
|
59,720
|
|
|
|
62,205
|
|
|
|
60,080
|
|
|
|
61,151
|
|
|
|
243,156
|
|
|
|
57,896
|
|
|
Total surgeries
|
|
|
104,772
|
|
|
|
107,396
|
|
|
|
104,863
|
|
|
|
106,163
|
|
|
|
423,194
|
|
|
|
102,449
|
|
|
Patient days — total
|
|
|
817,000
|
|
|
|
743,442
|
|
|
|
740,870
|
|
|
|
758,359
|
|
|
|
3,059,671
|
|
|
|
815,329
|
|
|
Adjusted patient days
|
|
|
1,405,568
|
|
|
|
1,329,915
|
|
|
|
1,325,229
|
|
|
|
1,342,745
|
|
|
|
5,403,457
|
|
|
|
1,408,053
|
|
|
Average length of stay (days)
|
|
|
4.70
|
|
|
|
4.54
|
|
|
|
4.52
|
|
|
|
4.56
|
|
|
|
4.58
|
|
|
|
4.70
|
|
|
Licensed beds (at end of period)
|
|
|
17,246
|
|
|
|
17,246
|
|
|
|
17,234
|
|
|
|
17,237
|
|
|
|
17,237
|
|
|
|
17,221
|
|
|
Average licensed beds
|
|
|
17,246
|
|
|
|
17,246
|
|
|
|
17,234
|
|
|
|
17,235
|
|
|
|
17,240
|
|
|
|
17,221
|
|
|
Utilization of licensed beds
|
|
|
52.6
|
%
|
|
|
47.4
|
%
|
|
|
46.7
|
%
|
|
|
47.8
|
%
|
|
|
48.6
|
%
|
|
|
52.6
|
%
|
|
Outpatient Visits
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total visits
|
|
|
1,730,018
|
|
|
|
1,683,879
|
|
|
|
1,658,292
|
|
|
|
1,670,272
|
|
|
|
6,742,461
|
|
|
|
1,696,094
|
|
|
Paying visits (excludes charity and uninsured)
|
|
|
1,619,950
|
|
|
|
1,571,574
|
|
|
|
1,547,384
|
|
|
|
1,558,357
|
|
|
|
6,297,265
|
|
|
|
1,586,627
|
|
|
Charity and uninsured visits
|
|
|
110,068
|
|
|
|
112,305
|
|
|
|
110,908
|
|
|
|
111,915
|
|
|
|
445,196
|
|
|
|
109,467
|
|
|
Emergency department visits
|
|
|
663,722
|
|
|
|
622,898
|
|
|
|
617,925
|
|
|
|
630,557
|
|
|
|
2,535,102
|
|
|
|
651,852
|
|
|
Paying visits as a percentage of total visits
|
|
|
93.6
|
%
|
|
|
93.3
|
%
|
|
|
93.3
|
%
|
|
|
93.3
|
%
|
|
|
93.4
|
%
|
|
|
93.5
|
%
|
|
Charity and uninsured visits as a percentage of total visits
|
|
|
6.4
|
%
|
|
|
6.7
|
%
|
|
|
6.7
|
%
|
|
|
6.7
|
%
|
|
|
6.6
|
%
|
|
|
6.5
|
%
|
|
Total emergency department admissions and visits
|
|
|
783,679
|
|
|
|
734,800
|
|
|
|
731,758
|
|
|
|
747,786
|
|
|
|
2,998,023
|
|
|
|
777,080
|
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient service revenues(2)
|
|
$
|
3,494
|
|
|
$
|
3,358
|
|
|
$
|
3,369
|
|
|
$
|
3,492
|
|
|
$
|
13,713
|
|
|
$
|
3,559
|
|
|
Revenues on a Per Adjusted Patient Admission and Per Adjusted
Patient Day
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net patient service revenue(2) per adjusted patient
admission
|
|
$
|
11,488
|
|
|
$
|
11,289
|
|
|
$
|
11,297
|
|
|
$
|
11,618
|
|
|
$
|
11,424
|
|
|
$
|
11,636
|
|
|
Net patient service revenue(2) per adjusted patient day
|
|
$
|
2,486
|
|
|
$
|
2,525
|
|
|
$
|
2,542
|
|
|
$
|
2,601
|
|
|
$
|
2,538
|
|
|
$
|
2,528
|
|
|
Net patient service revenues
(2)
from:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare
|
|
|
20.9
|
%
|
|
|
20.1
|
%
|
|
|
19.5
|
%
|
|
|
19.8
|
%
|
|
|
20.1
|
%
|
|
|
21.0
|
%
|
|
Medicaid
|
|
|
8.7
|
%
|
|
|
8.9
|
%
|
|
|
9.8
|
%
|
|
|
9.1
|
%
|
|
|
9.1
|
%
|
|
|
8.8
|
%
|
|
Managed care
|
|
|
65.3
|
%
|
|
|
66.4
|
%
|
|
|
65.2
|
%
|
|
|
66.1
|
%
|
|
|
65.8
|
%
|
|
|
65.9
|
%
|
|
Uninsured
|
|
|
1.3
|
%
|
|
|
0.2
|
%
|
|
|
0.9
|
%
|
|
|
0.5
|
%
|
|
|
0.7
|
%
|
|
|
—
|
%
|
|
Indemnity and other
|
|
|
3.8
|
%
|
|
|
4.4
|
%
|
|
|
4.6
|
%
|
|
|
4.5
|
%
|
|
|
4.3
|
%
|
|
|
4.3
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1) Information for our Hospital Operations and other segment is
presented on a same-hospital basis, which includes the results of
our same 65 hospitals operated throughout the three months ended
March 31, 2019 and 2018 and associated outpatient facilities, but
excludes the results of hospitals Tenet divested since
January 1, 2018.
|
|
(2) Less implicit price concessions.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
SEGMENT REPORTING
(Unaudited)
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
March 31,
|
|
December 31,
|
|
|
|
2019
|
|
2018
|
|
Assets
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
16,070
|
|
|
$
|
15,684
|
|
|
Ambulatory Care
|
|
|
6,014
|
|
|
|
5,711
|
|
|
Conifer
|
|
|
1,074
|
|
|
|
1,014
|
|
|
Total
|
|
$
|
23,158
|
|
|
$
|
22,409
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended
|
|
|
|
March 31,
|
|
|
|
2019
|
|
2018
|
|
Capital expenditures:
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
170
|
|
|
$
|
120
|
|
|
Ambulatory Care
|
|
|
20
|
|
|
|
15
|
|
|
Conifer
|
|
|
2
|
|
|
|
8
|
|
|
Total
|
|
$
|
192
|
|
|
$
|
143
|
|
|
|
|
|
|
|
|
Net operating revenues:
|
|
|
|
|
|
Hospital Operations and other total prior to inter-segment
eliminations(1)
|
|
$
|
3,862
|
|
|
$
|
3,947
|
|
|
Ambulatory Care
|
|
|
480
|
|
|
|
498
|
|
|
Conifer
|
|
|
|
|
|
Tenet
|
|
|
146
|
|
|
|
150
|
|
|
Other customers
|
|
|
203
|
|
|
|
254
|
|
|
Total Conifer revenues
|
|
|
349
|
|
|
|
404
|
|
|
Inter-segment eliminations
|
|
|
(146
|
)
|
|
|
(150
|
)
|
|
Total
|
|
$
|
4,545
|
|
|
$
|
4,699
|
|
|
|
|
|
|
|
|
Equity in earnings of unconsolidated affiliates:
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
3
|
|
|
$
|
(2
|
)
|
|
Ambulatory Care
|
|
|
31
|
|
|
|
27
|
|
|
Total
|
|
$
|
34
|
|
|
$
|
25
|
|
|
|
|
|
|
|
|
Adjusted EBITDA:
|
|
|
|
|
|
Hospital Operations and other(2)
|
|
$
|
337
|
|
|
$
|
402
|
|
|
Ambulatory Care
|
|
|
177
|
|
|
|
165
|
|
|
Conifer
|
|
|
99
|
|
|
|
98
|
|
|
Total
|
|
$
|
613
|
|
|
$
|
665
|
|
|
|
|
|
|
|
|
Depreciation and amortization:
|
|
|
|
|
|
Hospital Operations and other
|
|
$
|
179
|
|
|
$
|
175
|
|
|
Ambulatory Care
|
|
|
18
|
|
|
|
17
|
|
|
Conifer
|
|
|
11
|
|
|
|
12
|
|
|
Total
|
|
$
|
208
|
|
|
$
|
204
|
|
|
|
|
|
|
|
|
|
|
|
|
(1) Hospital Operations and other revenues includes health plan
revenues of less than $1 million and $6 million for the three
months ended March 31, 2019 and 2018, respectively.
|
|
(2) Hospital Operations and other Adjusted EBITDA excludes health
plan EBITDA of $(1) million for both the three months ended
March 31, 2019 and 2018.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
STATEMENTS OF OPERATIONS – AMBULATORY CARE SEGMENT
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
Three Months Ended March 31,
|
|
|
|
2019
|
|
2018
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ambulatory Care as Reported Under GAAP
|
|
Unconsolidated Affiliates
|
|
Ambulatory Care as Reported Under GAAP
|
|
Unconsolidated Affiliates
|
|
Net operating revenues
(1)
|
|
$
|
480
|
|
|
$
|
568
|
|
|
$
|
498
|
|
|
$
|
493
|
|
|
Equity in earnings of unconsolidated affiliates
(2)
|
|
|
31
|
|
|
|
—
|
|
|
|
27
|
|
|
|
—
|
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
Salaries, wages and benefits
|
|
|
153
|
|
|
|
147
|
|
|
|
162
|
|
|
|
120
|
|
|
Supplies
|
|
|
99
|
|
|
|
149
|
|
|
|
106
|
|
|
|
130
|
|
|
Other operating expenses, net
|
|
|
82
|
|
|
|
126
|
|
|
|
92
|
|
|
|
105
|
|
|
Depreciation and amortization
|
|
|
18
|
|
|
|
20
|
|
|
|
17
|
|
|
|
16
|
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
3
|
|
|
|
—
|
|
|
|
1
|
|
|
|
—
|
|
|
Net gains on sales, consolidation and deconsolidation of facilities
|
|
|
(5
|
)
|
|
|
(26
|
)
|
|
|
(1
|
)
|
|
|
—
|
|
|
Operating income
|
|
|
161
|
|
|
|
152
|
|
|
|
148
|
|
|
|
122
|
|
|
Interest expense
|
|
|
(31
|
)
|
|
|
(7
|
)
|
|
|
(36
|
)
|
|
|
(5
|
)
|
|
Other
|
|
|
3
|
|
|
|
6
|
|
|
|
2
|
|
|
|
—
|
|
|
Net income from continuing operations, before income taxes
|
|
|
133
|
|
|
|
151
|
|
|
|
114
|
|
|
|
117
|
|
|
Income tax expense
|
|
|
(15
|
)
|
|
|
(2
|
)
|
|
|
(15
|
)
|
|
|
(2
|
)
|
|
Net income
|
|
|
118
|
|
|
$
|
149
|
|
|
|
99
|
|
|
$
|
115
|
|
|
Less: Net income available to noncontrolling interests
|
|
|
68
|
|
|
|
|
|
64
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
50
|
|
|
|
|
$
|
35
|
|
|
|
|
Equity in earnings of unconsolidated affiliates
|
|
|
|
$
|
31
|
|
|
|
|
$
|
27
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1) On a same-facility system-wide basis, net revenue in Tenet’s
Ambulatory Care segment increased 4.2% during the three months
ended March 31, 2019, with cases increasing 0.9% and revenue per
case increasing 3.3%.
|
|
(2) At March 31, 2019, 108 of the 334 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 226 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 available (loss attributable) to Tenet Healthcare Corporation
common shareholders before (1) the cumulative effect of changes in
accounting principle, (2) net loss attributable (income available) to
noncontrolling interests, (3) income (loss) from discontinued
operations, (4) income tax benefit (expense), (5) gain (loss) from early
extinguishment of debt, (6) other non-operating income (expense), net,
(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 available (loss attributable) from continuing
operations to Tenet Healthcare Corporation common shareholders, a
non-GAAP measure, is defined by the Company as net income available
(loss attributable) to Tenet Healthcare Corporation common shareholders
before (1) net income (loss) from discontinued operations,
(2) impairment and restructuring charges, and acquisition-related costs,
(3) litigation and investigation costs, (4) net gains (losses) on sales,
consolidation and deconsolidation of facilities, (5) gain (loss) from
early extinguishment of debt, (6) income (loss) from divested operations
and closed businesses, and (7) the associated impact of these items on
taxes and noncontrolling interests. Adjusted diluted earnings (loss) per
share from continuing operations, a non-GAAP term, is defined by the
Company as Adjusted net income available (loss attributable) from
continuing operations 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 available (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 2018 and 2019. A reconciliation of net income available (loss
attributable) to Tenet Healthcare Corporation common shareholders, the
most comparable GAAP measure, to Adjusted net income available (loss
attributable) from continuing operations to Tenet Healthcare Corporation
common shareholders is set forth in Table #2 below for each quarter in
2018 and 2019. A reconciliation of net cash provided by 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 2018 and 2019.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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)
|
|
2018
|
|
2019
|
|
|
|
1st Qtr
|
|
2nd Qtr
|
|
3rd Qtr
|
|
4th Qtr
|
|
Total
|
|
1st Qtr
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
99
|
|
|
$
|
26
|
|
|
$
|
(9
|
)
|
|
$
|
(5
|
)
|
|
$
|
111
|
|
|
$
|
(19
|
)
|
|
Less: Net income available to noncontrolling interests
|
|
|
(92
|
)
|
|
|
(82
|
)
|
|
|
(74
|
)
|
|
|
(107
|
)
|
|
|
(355
|
)
|
|
|
(84
|
)
|
|
Income from discontinued operations, net of tax
|
|
|
1
|
|
|
|
2
|
|
|
|
—
|
|
|
|
—
|
|
|
|
3
|
|
|
|
8
|
|
|
Income from continuing operations
|
|
|
190
|
|
|
|
106
|
|
|
|
65
|
|
|
|
102
|
|
|
|
463
|
|
|
|
57
|
|
|
Income tax expense
|
|
|
(70
|
)
|
|
|
(44
|
)
|
|
|
(6
|
)
|
|
|
(56
|
)
|
|
|
(176
|
)
|
|
|
(17
|
)
|
|
Gain (loss) from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
3
|
|
|
|
1
|
|
|
|
(47
|
)
|
|
Other non-operating income (expense), net
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
(3
|
)
|
|
|
(5
|
)
|
|
|
1
|
|
|
Interest expense
|
|
|
(255
|
)
|
|
|
(254
|
)
|
|
|
(249
|
)
|
|
|
(246
|
)
|
|
|
(1,004
|
)
|
|
|
(251
|
)
|
|
Operating income
|
|
|
517
|
|
|
|
406
|
|
|
|
320
|
|
|
|
404
|
|
|
|
1,647
|
|
|
|
371
|
|
|
Litigation and investigation costs
|
|
|
(6
|
)
|
|
|
(13
|
)
|
|
|
(9
|
)
|
|
|
(10
|
)
|
|
|
(38
|
)
|
|
|
(13
|
)
|
|
Net gains (losses) on sales, consolidation and deconsolidation of
facilities
|
|
|
110
|
|
|
|
8
|
|
|
|
(7
|
)
|
|
|
16
|
|
|
|
127
|
|
|
|
(1
|
)
|
|
Impairment and restructuring charges, and acquisition-related costs
|
|
|
(47
|
)
|
|
|
(30
|
)
|
|
|
(46
|
)
|
|
|
(86
|
)
|
|
|
(209
|
)
|
|
|
(19
|
)
|
|
Depreciation and amortization
|
|
|
(204
|
)
|
|
|
(194
|
)
|
|
|
(204
|
)
|
|
|
(200
|
)
|
|
|
(802
|
)
|
|
|
(208
|
)
|
|
Income (loss) from divested and closed businesses
|
|
|
(1
|
)
|
|
|
1
|
|
|
|
9
|
|
|
|
—
|
|
|
|
9
|
|
|
|
(1
|
)
|
|
Adjusted EBITDA
|
|
$
|
665
|
|
|
$
|
634
|
|
|
$
|
577
|
|
|
$
|
684
|
|
|
$
|
2,560
|
|
|
$
|
613
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues
|
|
$
|
4,699
|
|
|
$
|
4,506
|
|
|
$
|
4,489
|
|
|
$
|
4,619
|
|
|
$
|
18,313
|
|
|
$
|
4,545
|
|
|
Less: Net operating revenues from health plans
|
|
|
6
|
|
|
|
—
|
|
|
|
8
|
|
|
|
—
|
|
|
|
14
|
|
|
|
—
|
|
|
Adjusted net operating revenues
|
|
$
|
4,693
|
|
|
$
|
4,506
|
|
|
$
|
4,481
|
|
|
$
|
4,619
|
|
|
$
|
18,299
|
|
|
$
|
4,545
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders as a % of net operating revenues
|
|
|
2.1
|
%
|
|
|
0.6
|
%
|
|
|
(0.2
|
)%
|
|
|
(0.1
|
)%
|
|
|
0.6
|
%
|
|
|
(0.4
|
)%
|
|
Adjusted EBITDA as a % of adjusted net operating revenues
(Adjusted EBITDA margin)
|
|
|
14.2
|
%
|
|
|
14.1
|
%
|
|
|
12.9
|
%
|
|
|
14.8
|
%
|
|
|
14.0
|
%
|
|
|
13.5
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #2 – Reconciliations of Net Income Available (Loss
Attributable) to
Tenet Healthcare Corporation Common Shareholders to Adjusted
Net Income Available from Continuing Operations to Common
Shareholders
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
2018
|
|
2019
|
|
|
|
1st Qtr
|
|
2nd Qtr
|
|
3rd Qtr
|
|
4th Qtr
|
|
Total
|
|
1st Qtr
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
99
|
|
|
$
|
26
|
|
|
$
|
(9
|
)
|
|
$
|
(5
|
)
|
|
$
|
111
|
|
|
$
|
(19
|
)
|
|
Net income from discontinued operations
|
|
|
1
|
|
|
$
|
2
|
|
|
|
—
|
|
|
|
—
|
|
|
|
3
|
|
|
|
8
|
|
|
Net income (loss) from continuing operations
|
|
|
98
|
|
|
|
24
|
|
|
|
(9
|
)
|
|
|
(5
|
)
|
|
|
108
|
|
|
|
(27
|
)
|
|
Less: Impairment and restructuring charges, and
acquisition-related costs
|
|
|
(47
|
)
|
|
|
(30
|
)
|
|
|
(46
|
)
|
|
|
(86
|
)
|
|
|
(209
|
)
|
|
|
(19
|
)
|
|
Litigation and investigation costs
|
|
|
(6
|
)
|
|
|
(13
|
)
|
|
|
(9
|
)
|
|
|
(10
|
)
|
|
|
(38
|
)
|
|
|
(13
|
)
|
|
Net gains (losses) on sales, consolidation and deconsolidation of
facilities
|
|
|
110
|
|
|
|
8
|
|
|
|
(7
|
)
|
|
|
16
|
|
|
|
127
|
|
|
|
(1
|
)
|
|
Gain (loss) from early extinguishment of debt
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
—
|
|
|
|
3
|
|
|
|
1
|
|
|
|
(47
|
)
|
|
Income (loss) from divested and closed businesses
|
|
|
(1
|
)
|
|
|
1
|
|
|
|
9
|
|
|
|
—
|
|
|
|
9
|
|
|
|
(1
|
)
|
|
Tax impact of above items
|
|
|
(16
|
)
|
|
|
8
|
|
|
|
14
|
|
|
|
19
|
|
|
|
25
|
|
|
|
(2
|
)
|
|
Adjusted net income available from continuing operations to
common shareholders
|
|
$
|
59
|
|
|
$
|
51
|
|
|
$
|
30
|
|
|
$
|
53
|
|
|
$
|
193
|
|
|
$
|
56
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings (loss) per share from continuing operations
|
|
$
|
0.95
|
|
|
$
|
0.23
|
|
|
$
|
(0.09
|
)
|
|
$
|
(0.05
|
)
|
|
$
|
1.04
|
|
|
$
|
(0.26
|
)
|
|
Less: Impairment and restructuring charges, and
acquisition-related costs
|
|
|
(0.46
|
)
|
|
|
(0.29
|
)
|
|
|
(0.44
|
)
|
|
|
(0.83
|
)
|
|
|
(2.01
|
)
|
|
|
(0.18
|
)
|
|
Litigation and investigation costs
|
|
|
(0.06
|
)
|
|
|
(0.12
|
)
|
|
|
(0.09
|
)
|
|
|
(0.10
|
)
|
|
|
(0.37
|
)
|
|
|
(0.12
|
)
|
|
Net gains (losses) on sales, consolidation and deconsolidation of
facilities
|
|
|
1.08
|
|
|
|
0.07
|
|
|
|
(0.07
|
)
|
|
|
0.15
|
|
|
|
1.22
|
|
|
|
(0.01
|
)
|
|
Gain (loss) from early extinguishment of debt
|
|
|
(0.01
|
)
|
|
|
(0.01
|
)
|
|
|
—
|
|
|
|
0.03
|
|
|
|
0.01
|
|
|
|
(0.45
|
)
|
|
Income (loss) from divested and closed businesses
|
|
|
(0.01
|
)
|
|
|
0.01
|
|
|
|
0.09
|
|
|
|
—
|
|
|
|
0.09
|
|
|
|
(0.01
|
)
|
|
Tax impact of above items
|
|
|
(0.16
|
)
|
|
|
0.08
|
|
|
|
0.13
|
|
|
|
0.18
|
|
|
|
0.24
|
|
|
|
(0.02
|
)
|
|
Adjusted diluted earnings per share from continuing operations
|
|
$
|
0.57
|
|
|
$
|
0.49
|
|
|
$
|
0.29
|
|
|
$
|
0.51
|
|
|
$
|
1.86
|
|
|
$
|
0.54
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average basic shares outstanding (in thousands)
|
|
|
101,392
|
|
|
|
102,147
|
|
|
|
102,402
|
|
|
|
102,501
|
|
|
|
102,110
|
|
|
|
102,788
|
|
|
Weighted average dilutive shares outstanding (in thousands)
|
|
|
102,656
|
|
|
|
104,177
|
|
|
|
104,575
|
|
|
|
104,118
|
|
|
|
103,881
|
|
|
|
104,541
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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)
|
|
2018
|
|
2019
|
|
|
|
1st Qtr
|
|
2nd Qtr
|
|
3rd Qtr
|
|
4th Qtr
|
|
Total
|
|
1st Qtr
|
|
Net cash provided by operating activities
|
|
$
|
113
|
|
|
$
|
348
|
|
|
$
|
338
|
|
|
$
|
250
|
|
|
$
|
1,049
|
|
|
$
|
10
|
|
|
Purchases of property and equipment
|
|
|
(143
|
)
|
|
|
(125
|
)
|
|
|
(136
|
)
|
|
|
(213
|
)
|
|
|
(617
|
)
|
|
|
(192
|
)
|
|
Free cash flow
|
|
$
|
(30
|
)
|
|
$
|
223
|
|
|
$
|
202
|
|
|
$
|
37
|
|
|
$
|
432
|
|
|
$
|
(182
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by (used in) investing activities
|
|
$
|
373
|
|
|
$
|
(148
|
)
|
|
$
|
(105
|
)
|
|
$
|
(235
|
)
|
|
$
|
(115
|
)
|
|
$
|
(139
|
)
|
|
Net cash used in financing activities
|
|
$
|
(123
|
)
|
|
$
|
(771
|
)
|
|
$
|
(136
|
)
|
|
$
|
(104
|
)
|
|
$
|
(1,134
|
)
|
|
$
|
(30
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by operating activities
|
|
$
|
113
|
|
|
$
|
348
|
|
|
$
|
338
|
|
|
$
|
250
|
|
|
$
|
1,049
|
|
|
$
|
10
|
|
|
Less: Payments for restructuring charges, acquisition-related
costs, and litigation costs and settlements
|
|
|
(33
|
)
|
|
|
(30
|
)
|
|
|
(50
|
)
|
|
|
(50
|
)
|
|
|
(163
|
)
|
|
|
(32
|
)
|
|
Net cash used in operating activities from discontinued operations
|
|
|
(1
|
)
|
|
|
(2
|
)
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
(5
|
)
|
|
|
(2
|
)
|
|
Adjusted net cash provided by operating activities from
continuing operations
|
|
|
147
|
|
|
|
380
|
|
|
|
389
|
|
|
|
301
|
|
|
|
1,217
|
|
|
|
44
|
|
|
Purchases of property and equipment
|
|
|
(143
|
)
|
|
|
(125
|
)
|
|
|
(136
|
)
|
|
|
(213
|
)
|
|
|
(617
|
)
|
|
|
(192
|
)
|
|
Adjusted free cash flow – continuing operations
|
|
$
|
4
|
|
|
$
|
255
|
|
|
$
|
253
|
|
|
$
|
88
|
|
|
$
|
600
|
|
|
$
|
(148
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #4 – Reconciliation of Outlook Net Income Available (Loss
Attributable) to Tenet Healthcare Corporation Common Shareholders
to Outlook Adjusted EBITDA
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions)
|
|
Q2 2019
|
|
2019
|
|
|
|
Low
|
|
High
|
|
Low
|
|
High
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(10
|
)
|
|
$
|
40
|
|
|
$
|
17
|
|
|
$
|
122
|
|
|
Less: Net income available to noncontrolling interests
|
|
|
(100
|
)
|
|
|
(110
|
)
|
|
|
(425
|
)
|
|
|
(445
|
)
|
|
Net income (loss) from discontinued operations, net of tax
|
|
|
(5
|
)
|
|
|
—
|
|
|
|
—
|
|
|
|
5
|
|
|
Income tax expense
|
|
|
(30
|
)
|
|
|
(40
|
)
|
|
|
(165
|
)
|
|
|
(185
|
)
|
|
Interest expense
|
|
|
(250
|
)
|
|
|
(240
|
)
|
|
|
(995
|
)
|
|
|
(985
|
)
|
|
Loss from early extinguishment of debt(1)
|
|
|
—
|
|
|
|
—
|
|
|
|
(47
|
)
|
|
|
(47
|
)
|
|
Other non-operating expense, net
|
|
|
(5
|
)
|
|
|
(5
|
)
|
|
|
(10
|
)
|
|
|
(15
|
)
|
|
Net gains (losses) on sales, consolidation and deconsolidation of
facilities(1)
|
|
|
—
|
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
Impairment and restructuring charges, acquisition-related costs, and
litigation costs and settlements(2)
|
|
|
(40
|
)
|
|
|
(30
|
)
|
|
|
(175
|
)
|
|
|
(125
|
)
|
|
Depreciation and amortization
|
|
|
(200
|
)
|
|
|
(210
|
)
|
|
|
(805
|
)
|
|
|
(825
|
)
|
|
Income (loss) from divested and closed businesses
|
|
|
(5
|
)
|
|
|
—
|
|
|
|
(10
|
)
|
|
|
(5
|
)
|
|
Adjusted EBITDA
|
|
$
|
625
|
|
|
$
|
675
|
|
|
$
|
2,650
|
|
|
$
|
2,750
|
|
|
|
|
|
|
|
|
|
|
|
|
Income (loss) from continuing operations
|
|
$
|
(5
|
)
|
|
$
|
40
|
|
|
$
|
17
|
|
|
$
|
117
|
|
|
Net operating revenues
|
|
$
|
4,400
|
|
|
$
|
4,700
|
|
|
$
|
18,000
|
|
|
$
|
18,400
|
|
|
Income (loss) from continuing operations as a % of operating
revenues
|
|
|
(0.1
|
)%
|
|
|
0.9
|
%
|
|
|
0.1
|
%
|
|
|
0.6
|
%
|
|
Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA
margin)
|
|
|
14.2
|
%
|
|
|
14.4
|
%
|
|
|
14.7
|
%
|
|
|
14.9
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)The Company does not generally forecast losses from the early
extinguishment of debt or net gains (losses) on sales,
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. The
figures shown represent the Company's actual year-to-date results
for these items.
|
|
(2) The Company has provided an estimate of restructuring charges
and related payments that it anticipates in 2019. The figures
shown represent the Company's estimate for restructuring charges
plus the actual year-to-date results for impairment charges,
acquisition-related costs, and litigation costs and settlements.
The Company does not generally forecast impairment charges,
acquisition-related costs, litigation costs and settlements
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 – Reconciliations of Outlook Net Income Available
(Loss Attributable) to Tenet Healthcare Corporation Common
Shareholders to Outlook Adjusted Net Income Available from
Continuing Operations to Common Shareholders
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
(Dollars in millions except per share amounts)
|
|
Q2 2019
|
|
2019
|
|
|
|
Low
|
|
High
|
|
Low
|
|
High
|
|
Net income available (loss attributable) to Tenet Healthcare
Corporation common shareholders
|
|
$
|
(10
|
)
|
|
$
|
40
|
|
|
$
|
17
|
|
|
$
|
122
|
|
|
Net income (loss) from discontinued operations, net of tax
|
|
|
(5
|
)
|
|
|
—
|
|
|
|
—
|
|
|
|
5
|
|
|
Net income (loss) from continuing operations
|
|
|
(5
|
)
|
|
|
40
|
|
|
|
17
|
|
|
|
117
|
|
|
Less: Impairment and restructuring charges, acquisition-related
costs, and litigation costs and settlements
|
|
|
(40
|
)
|
|
|
(30
|
)
|
|
|
(175
|
)
|
|
|
(125
|
)
|
|
Net gains (losses) on sales, consolidation and deconsolidation of
facilities
|
|
|
—
|
|
|
|
—
|
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
|
—
|
|
|
|
(47
|
)
|
|
|
(47
|
)
|
|
Income (loss) from divested and closed businesses
|
|
|
(5
|
)
|
|
|
—
|
|
|
|
(10
|
)
|
|
|
(5
|
)
|
|
Tax impact of above items
|
|
|
10
|
|
|
|
5
|
|
|
|
30
|
|
|
|
20
|
|
|
Adjusted net income available from continuing operations to
common shareholders
|
|
$
|
30
|
|
|
$
|
65
|
|
|
$
|
220
|
|
|
$
|
275
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings (loss) per share from continuing operations
|
|
$
|
(0.05
|
)
|
|
$
|
0.38
|
|
|
$
|
0.16
|
|
|
$
|
1.10
|
|
|
Less: Impairment and restructuring charges, acquisition-related
costs, and litigation costs and settlements
|
|
|
(0.38
|
)
|
|
|
(0.29
|
)
|
|
|
(1.65
|
)
|
|
|
(1.18
|
)
|
|
Net gains (losses) on sales, consolidation and deconsolidation of
facilities
|
|
|
—
|
|
|
|
—
|
|
|
|
(0.01
|
)
|
|
|
(0.01
|
)
|
|
Loss from early extinguishment of debt
|
|
|
—
|
|
|
|
—
|
|
|
|
(0.44
|
)
|
|
|
(0.44
|
)
|
|
Income (loss) from divested and closed businesses
|
|
|
(0.05
|
)
|
|
|
—
|
|
|
|
(0.09
|
)
|
|
|
(0.05
|
)
|
|
Tax impact of above items
|
|
|
0.10
|
|
|
|
0.05
|
|
|
|
0.27
|
|
|
|
0.19
|
|
|
Adjusted diluted earnings per share from continuing operations
|
|
$
|
0.29
|
|
|
$
|
0.63
|
|
|
$
|
2.08
|
|
|
$
|
2.59
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average basic shares outstanding (in thousands)
|
|
|
103,000
|
|
|
|
103,000
|
|
|
|
104,000
|
|
|
|
104,000
|
|
|
Weighted average dilutive shares outstanding (in thousands)
|
|
|
104,000
|
|
|
|
104,000
|
|
|
|
106,000
|
|
|
|
106,000
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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)
|
|
2019
|
|
|
|
Low
|
|
High
|
|
Net cash provided by operating activities
|
|
$
|
1,070
|
|
|
$
|
1,375
|
|
|
Less: Payments for restructuring charges, acquisition-related
costs and litigation costs and settlements(1)
|
|
|
(175
|
)
|
|
|
(125
|
)
|
|
Net cash used in operating activities from discontinued operations
|
|
|
(5
|
)
|
|
|
—
|
|
|
Adjusted net cash provided by operating activities – continuing
operations
|
|
|
1,250
|
|
|
|
1,500
|
|
|
Purchases of property and equipment – continuing operations
|
|
|
(650
|
)
|
|
|
(700
|
)
|
|
Adjusted free cash flow – continuing operations
(2)
|
|
$
|
600
|
|
|
$
|
800
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)The Company has provided an estimate of payments that it
anticipates in 2019 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.
|
|
|
|
|
|
|
|
|
|
|