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8-K - CURRENT REPORT OF MATERIAL EVENTS OR CORPORATE CHANGES - TENET HEALTHCARE CORPa13-18001_18k.htm

Exhibit 99.1

 

GRAPHIC

 

Tenet Reports $336 Million of Adjusted EBITDA for Second Quarter

16.7% Increase in Adjusted EBITDA

6.9% Increase in Net Operating Revenues

Acquisition of Vanguard Health Systems Expected to Close by Year-End

 

DALLAS — August 6, 2013 — Tenet Healthcare Corporation (NYSE:THC) today reported its results for the second quarter ended June 30, 2013, which included the following:

 

·            Adjusted EBITDA of $336 million for the second quarter ended June 30, 2013, an increase of $48 million, or 16.7 percent, as compared to Adjusted EBITDA of $288 million in the second quarter of 2012.

·            Income from continuing operations, excluding impairments, restructuring charges, acquisition-related costs, litigation and investigation costs, the loss on early extinguishment of debt, and other tax adjustments, was $69 million after-tax, or $0.66 per diluted share, in the second quarter of 2013.  In the second quarter of 2012, income from continuing operations was $44 million after-tax, or $0.41 per diluted share, excluding litigation and investigation costs, impairments, and restructuring charges.

 

“Tenet drove a 16.7 percent increase in Adjusted EBITDA through outstanding cost control and revenue growth,” said Trevor Fetter, president and chief executive officer. “We grew both outpatient visits and emergency department volumes in the quarter, and we doubled revenues in our Conifer services business. We are revising our Outlook for 2013 Adjusted EBITDA to growth of 4 to 8 percent reflecting softer than anticipated inpatient volumes. Planning for the integration of our Vanguard Health Systems acquisition is proceeding smoothly, and we expect to close the transaction before the end of this year.”

 

Discussion of Results   (Percentage changes compare Q2’13 to Q2’12, unless otherwise noted.)

 

Adjusted admissions declined 0.7 percent in the second quarter reflecting a 2.5 percent increase in outpatient visits and a 3.5 percent decline in inpatient admissions. Outpatient visit growth was 39 percent organic. Emergency department visits increased 2.9 percent, and surgeries increased by 13.9 percent.

 

Net operating revenues were $2.422 billion, an increase of $157 million, or 6.9 percent, compared to net operating revenues of $2.265 billion in the second quarter of 2012. Total net patient revenue per adjusted admission was $12,208, an increase of 2.7 percent. These pricing increases primarily reflect improved terms in our contracts with commercial managed care payers. Commercial managed care revenue increased 4.7 percent per admission, 6.3 percent per patient day, and 6.9 percent per outpatient visit. Net operating revenues in the second quarter of 2013 included $19 million of additional revenues from the California Provider Fee 30-month Program compared to the second quarter of 2012.

 

Selected operating expenses of our hospital operations, defined as the sum of salaries, wages and benefits, supplies and other operating expenses excluding the Company’s Conifer services business, increased by 2.4 percent on a per adjusted admission basis. Excluding the incremental expenses related to increased physician employment, this growth was 0.9 percent. Supplies expense per adjusted admission was approximately flat, increasing by only 0.2 percent. Electronic health records incentives were $34 million in the second quarter of 2013 and were zero in the second quarter of 2012. These incentives are not a part of the definition of selected operating expenses.

 

Bad debt expense increased by $17 million to $207 million in the second quarter of 2013 compared to last year’s second quarter. Bad debt expense as a percent of revenues was 7.9 percent, an increase of 20 basis points, compared to 7.7 percent in the second quarter of 2012. The increase in bad debt expense was primarily attributable to a $15 million increase in uninsured revenues. Our self-pay collection rate improved to 28.7 percent in the second quarter of 2013 compared to 28.5 percent in the second quarter of 2012.

 

Conifer reported a 12 percent increase in Adjusted EBITDA to $28 million as compared to $25 million in the second quarter of 2012. Conifer’s revenues increased by $111 million to $219 million in this year’s second

 



 

quarter. The growth in both revenues and Adjusted EBITDA reflects the implementation of Catholic Health Initiatives (“CHI”) revenue cycle operations and other new business.

 

Net loss attributable to common shareholders in the second quarter of 2013 was $50 million after-tax, or $0.49 per share, compared to a net loss of $6 million after-tax, or $0.06 per diluted share, in the second quarter of 2012.

 

Cash and cash equivalents were $90 million at June 30, 2013 compared to $95 million at March 31, 2013. The Company had a $33 million balance on its bank line at June 30, 2013. Accounts receivable days improved to 51 days, down from 52 days at March 31, 2013, and 53 days at December 31, 2012.

 

In the second quarter Tenet invested an additional $92 million to repurchase approximately 1.998 million shares.  Under the current Board authorized repurchase program of $500 million, the Company has invested $292 million in the last three quarters to repurchase 7.859 million shares. Since 2011, Tenet has invested $984 million to repurchase almost 30 percent, or 40.893 million shares, including its convertible preferred stock, at a weighted average price of $24.06 per share.

 

Outlook for Adjusted EBITDA

 

Based on inpatient volumes in the first half of 2013, which were significantly softer than initially projected, the Company’s new Outlook range for 2013 Adjusted EBITDA is $1.250 billion to $1.300 billion. The mid-point of this Outlook range represents growth of 6 percent compared to the $1.203 billion reported in 2012. This Outlook excludes the impact of the acquisition of Vanguard Health Systems (“Vanguard”), which is expected to close prior to year-end 2013.

 

The Outlook for the second half, exclusive of the expected contribution from Vanguard, is expected to be in a range of $640 to $690 million, representing growth of approximately 9 percent compared to Adjusted EBITDA in the first half of $610 million. The Outlook range for the Company’s third quarter Adjusted EBITDA is $275 million to $325 million. The third quarter is expected to be the last quarter reported before closing the Vanguard acquisition.

 

Management’s Webcast Discussion of Second Quarter Results

 

Tenet management will discuss the Company’s second quarter 2013 results on a 10:00 a.m. (ET) webcast on August 6, 2013. This webcast may be accessed through Tenet’s website at www.tenethealth.com/investors.

 

Additional information regarding Tenet’s quarterly results of operations, including detailed tabular operational data, is contained in its Form 10-Q report, which will be filed with the Securities and Exchange Commission and posted on the Tenet investor relations website before the webcast. This press release includes certain non-GAAP measures, such as Adjusted EBITDA. A reconciliation of Adjusted EBITDA to net income attributable to Tenet common shareholders is included in the financial tables at the end of this release.

 

About Tenet

 

Tenet Healthcare Corporation, a leading health care services company, through its subsidiaries operates 49 hospitals, 129 outpatient centers and Conifer Health Solutions, a leader in business process solutions for health care providers serving more than 600 hospital and other clients nationwide. Tenet’s hospitals and related health care facilities are committed to providing high quality care to patients in the communities they serve. For more information, please visit www.tenethealth.com.

 

# # #

 

Media:   Steven Campanini (469) 893-2640

Investors:   Thomas Rice (469) 893-2522

Steven.Campanini@tenethealth.com

Thomas.Rice@tenethealth.com

 

2



 

This document 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,” “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 occurrence of any event, change or other circumstances that could give rise to the termination of our merger agreement with Vanguard Health Systems, Inc. (“Vanguard”); the failure to satisfy conditions to completion of the proposed merger, including receipt of regulatory approvals; changes in the business or operating prospects of Vanguard; and the other factors disclosed under “Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the year ended December 31, 2012, and in our quarterly reports on Form 10-Q, periodic reports on Form 8-K and other filings with the Securities and Exchange Commission. The information contained in this release is as of the date hereof. The Company assumes no obligation to update forward-looking statements contained in this release as a result of new information or future events or developments.

 

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.

 

3



 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 

 

 

Three Months Ended June 30,

 

(Dollars in millions except per share amounts)

 

2013

 

%

 

2012

 

%

 

Change

 

Net operating revenues:

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues before provision for doubtful accounts

 

$

2,629

 

 

 

$

2,455

 

 

 

7.1

%

Less: Provision for doubtful accounts

 

207

 

 

 

190

 

 

 

8.9

%

Net operating revenues

 

2,422

 

100.0

%

2,265

 

100.0

%

6.9

%

Operating expenses:

 

 

 

 

 

 

 

 

 

 

 

Salaries, wages and benefits

 

1,166

 

48.1

%

1,054

 

46.5

%

10.6

%

Supplies

 

387

 

16.0

%

389

 

17.2

%

(0.5

)%

Other operating expenses, net

 

567

 

23.4

%

534

 

23.7

%

6.2

%

Electronic health record incentives

 

(34

)

(1.4

)%

 

%

100.0

%

Depreciation and amortization

 

121

 

5.0

%

104

 

4.6

%

16.3

%

Impairment and restructuring charges, and acquisition-related costs

 

11

 

0.5

%

3

 

0.1

%

 

 

Litigation and investigation costs

 

2

 

0.1

%

1

 

%

 

 

Operating income

 

202

 

8.3

%

180

 

7.9

%

 

 

Interest expense

 

(98

)

 

 

(102

)

 

 

 

 

Loss from early extinguishment of debt

 

(171

)

 

 

 

 

 

 

 

Investment earnings

 

1

 

 

 

 

 

 

 

 

Income (loss) from continuing operations, before income taxes

 

(66

)

 

 

78

 

 

 

 

 

Income tax benefit (expense)

 

20

 

 

 

(30

)

 

 

 

 

Income (loss) from continuing operations, before discontinued operations

 

(46

)

 

 

48

 

 

 

 

 

Discontinued operations:

 

 

 

 

 

 

 

 

 

 

 

Income from operations

 

6

 

 

 

1

 

 

 

 

 

Impairment of long-lived assets and goodwill, and restructuring charges, net

 

 

 

 

(100

)

 

 

 

 

Net gains on sales of facilities

 

 

 

 

2

 

 

 

 

 

Income tax benefit (expense)

 

(3

)

 

 

29

 

 

 

 

 

Income (loss) from discontinued operations

 

3

 

 

 

(68

)

 

 

 

 

Net Loss

 

(43

)

 

 

(20

)

 

 

 

 

Less: Preferred stock dividends

 

 

 

 

4

 

 

 

 

 

Less: Net income (loss) attributable to noncontrolling interests

 

 

 

 

 

 

 

 

 

 

 

Continuing operations

 

7

 

 

 

2

 

 

 

 

 

Discontinued operations

 

 

 

 

(20

)

 

 

 

 

Loss attributable to Tenet Healthcare Corporation common shareholders

 

$

(50

)

 

 

$

(6

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Amounts attributable to Tenet Healthcare Corporation common shareholders

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from continuing operations, net of tax

 

$

(53

)

 

 

$

42

 

 

 

 

 

Income (loss) from discontinued operations, net of tax

 

3

 

 

 

(48

)

 

 

 

 

Loss attributable to Tenet Healthcare Corporation common shareholders

 

$

(50

)

 

 

$

(6

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders

 

 

 

 

 

 

 

 

 

 

 

Basic

 

 

 

 

 

 

 

 

 

 

 

Continuing operations

 

$

(0.52

)

 

 

$

0.40

 

 

 

 

 

Discontinued operations

 

0.03

 

 

 

(0.46

)

 

 

 

 

 

 

$

(0.49

)

 

 

$

(0.06

)

 

 

 

 

Diluted

 

 

 

 

 

 

 

 

 

 

 

Continuing operations

 

$

(0.52

)

 

 

$

0.39

 

 

 

 

 

Discontinued operations

 

0.03

 

 

 

(0.45

)

 

 

 

 

 

 

$

(0.49

)

 

 

$

(0.06

)

 

 

 

 

Weighted average shares and dilutive securities outstanding (in thousands):

 

 

 

 

 

 

 

 

 

 

 

Basic

 

103,010

 

 

 

103,753

 

 

 

 

 

Diluted

 

103,010

 

 

 

106,927

 

 

 

 

 

 

4



 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 

 

 

Six Months Ended June 30,

 

(Dollars in millions except per share amounts)

 

2013

 

%

 

2012

 

%

 

Change

 

Net operating revenues:

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues before provision for doubtful accounts

 

$

5,223

 

 

 

$

4,946

 

 

 

5.6

%

Less: Provision for doubtful accounts

 

414

 

 

 

379

 

 

 

9.2

%

Net operating revenues

 

4,809

 

100.0

%

4,567

 

100.0

%

5.3

%

Operating expenses:

 

 

 

 

 

 

 

 

 

 

 

Salaries, wages and benefits

 

2,327

 

48.4

%

2,116

 

46.3

%

10.0

%

Supplies

 

771

 

16.0

%

788

 

17.3

%

(2.2

)%

Other operating expenses, net

 

1,135

 

23.6

%

1,065

 

23.3

%

6.6

%

Electronic health record incentives

 

(34

)

(0.7

)%

 

%

100.0

%

Depreciation and amortization

 

235

 

4.9

%

204

 

4.5

%

15.2

%

Impairment and restructuring charges, and acquisition-related costs

 

25

 

0.5

%

6

 

0.1

%

 

 

Litigation and investigation costs

 

2

 

0.1

%

3

 

0.1

%

 

 

Operating income

 

348

 

7.2

%

385

 

8.4

%

 

 

Interest expense

 

(201

)

 

 

(200

)

 

 

 

 

Loss from early extinguishment of debt

 

(348

)

 

 

 

 

 

 

 

Investment earnings

 

1

 

 

 

1

 

 

 

 

 

Income (loss) from continuing operations, before income taxes

 

(200

)

 

 

186

 

 

 

 

 

Income tax benefit (expense)

 

73

 

 

 

(72

)

 

 

 

 

Income (loss) from continuing operations, before discontinued operations

 

(127

)

 

 

114

 

 

 

 

 

Discontinued operations:

 

 

 

 

 

 

 

 

 

 

 

Income from operations

 

3

 

 

 

3

 

 

 

 

 

Impairment of long-lived assets and goodwill, and restructuring charges, net

 

0

 

 

 

(100

)

 

 

 

 

Net gains on sales of facilities

 

0

 

 

 

2

 

 

 

 

 

Income tax benefit (expense)

 

(2

)

 

 

28

 

 

 

 

 

Income (loss) from discontinued operations

 

1

 

 

 

(67

)

 

 

 

 

Net income (loss)

 

(126

)

 

 

47

 

 

 

 

 

Less: Preferred stock dividends

 

 

 

 

10

 

 

 

 

 

Less: Net income (loss) attributable to noncontrolling interests

 

 

 

 

 

 

 

 

 

 

 

Continuing operations

 

12

 

 

 

5

 

 

 

 

 

Discontinued operations

 

 

 

 

(20

)

 

 

 

 

Net income (loss) attributable to Tenet Healthcare Corporation common shareholders

 

$

(138

)

 

 

$

52

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Amounts attributable to Tenet Healthcare Corporation common shareholders

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from continuing operations, net of tax

 

$

(139

)

 

 

$

99

 

 

 

 

 

Income (loss) from discontinued operations, net of tax

 

1

 

 

 

(47

)

 

 

 

 

Net income (loss) attributable to Tenet Healthcare Corporation common shareholders

 

$

(138

)

 

 

$

52

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders

 

 

 

 

 

 

 

 

 

 

 

Basic

 

 

 

 

 

 

 

 

 

 

 

Continuing operations

 

$

(1.34

)

 

 

$

0.96

 

 

 

 

 

Discontinued operations

 

0.01

 

 

 

(0.46

)

 

 

 

 

 

 

$

(1.33

)

 

 

$

0.50

 

 

 

 

 

Diluted

 

 

 

 

 

 

 

 

 

 

 

Continuing operations

 

$

(1.34

)

 

 

$

0.93

 

 

 

 

 

Discontinued operations

 

0.01

 

 

 

(0.44

)

 

 

 

 

 

 

$

(1.33

)

 

 

$

0.49

 

 

 

 

 

Weighted average shares and dilutive securities outstanding (in thousands):

 

 

 

 

 

 

 

 

 

 

 

Basic

 

103,557

 

 

 

103,298

 

 

 

 

 

Diluted

 

103,557

 

 

 

108,680

 

 

 

 

 

 

5



 

TENET HEALTHCARE CORPORATION

CONSOLIDATED BALANCE SHEETS

(Unaudited)

 

 

 

June 30,

 

December 31,

 

(Dollars in millions)

 

2013

 

2012

 

ASSETS

 

 

 

 

 

Current assets:

 

 

 

 

 

Cash and cash equivalents

 

$

90

 

$

364

 

Accounts receivable, less allowance for doubtful accounts

 

1,369

 

1,345

 

Inventories of supplies, at cost

 

153

 

153

 

Income tax receivable

 

12

 

7

 

Current portion of deferred income taxes

 

350

 

354

 

Other current assets

 

600

 

458

 

Total current assets

 

2,574

 

2,681

 

Investments and other assets

 

166

 

162

 

Deferred income taxes, net of current portion

 

420

 

342

 

Property and equipment, at cost, less accumulated depreciation and amortization

 

4,326

 

4,293

 

Goodwill

 

970

 

916

 

Other intangible assets, at cost, less accumulated amortization

 

700

 

650

 

Total assets

 

$

9,156

 

$

9,044

 

 

 

 

 

 

 

LIABILITIES AND EQUITY

 

 

 

 

 

Current liabilities:

 

 

 

 

 

Current portion of long-term debt

 

$

71

 

$

94

 

Accounts payable

 

587

 

722

 

Accrued compensation and benefits

 

402

 

415

 

Professional and general liability reserves

 

84

 

64

 

Accrued interest payable

 

91

 

125

 

Other current liabilities

 

423

 

343

 

Total current liabilities

 

1,658

 

1,763

 

Long-term debt, net of current portion

 

5,564

 

5,158

 

Professional and general liability reserves

 

265

 

292

 

Other long-term liabilities

 

608

 

597

 

Total liabilities

 

8,095

 

7,810

 

Commitments and contingencies

 

 

 

 

 

Redeemable noncontrolling interests in equity of consolidated subsidiaries

 

80

 

16

 

Equity:

 

 

 

 

 

Shareholders’ equity:

 

 

 

 

 

Common stock

 

7

 

7

 

Additional paid-in capital

 

4,552

 

4,471

 

Accumulated other comprehensive loss

 

(68

)

(68

)

Accumulated deficit

 

(1,426

)

(1,288

)

Common stock in treasury, at cost

 

(2,170

)

(1,979

)

Total shareholders’ equity

 

895

 

1,143

 

Noncontrolling interests

 

86

 

75

 

Total equity

 

981

 

1,218

 

Total liabilities and equity

 

$

9,156

 

$

9,044

 

 

6



 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited)

 

 

 

Six Months Ended
June 30,

 

(Dollars in millions)

 

2013

 

2012

 

Net income (loss)

 

$

(126

)

$

47

 

Adjustments to reconcile net income (loss) to net cash provided by operating activities:

 

 

 

 

 

Depreciation and amortization

 

235

 

204

 

Provision for doubtful accounts

 

414

 

379

 

Deferred income tax expense (benefit)

 

(76

)

37

 

Stock-based compensation expense

 

19

 

17

 

Impairment and restructuring charges, and acquisition-related costs

 

25

 

6

 

Litigation and investigation costs

 

2

 

3

 

Loss from early extinguishment of debt

 

348

 

 

Amortization of debt discount and debt issuance costs

 

9

 

11

 

Pre-tax (income) loss from discontinued operations

 

(3

)

95

 

Other items, net

 

(18

)

(4

)

Changes in cash from operating assets and liabilities:

 

 

 

 

 

Accounts receivable

 

(445

)

(450

)

Inventories and other current assets

 

(166

)

(116

)

Income taxes

 

(4

)

(5

)

Accounts payable, accrued expenses and other current liabilities

 

(65

)

23

 

Other long-term liabilities

 

5

 

26

 

Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements

 

(19

)

(50

)

Net cash used in operating activities from discontinued operations, excluding income taxes

 

(7

)

(22

)

Net cash provided by operating activities

 

128

 

201

 

Cash flows from investing activities:

 

 

 

 

 

Purchases of property and equipment — continuing operations

 

(256

)

(251

)

Purchases of property and equipment — discontinued operations

 

 

(1

)

Purchases of businesses or joint venture interests

 

(16

)

(13

)

Proceeds from sales of facilities and other assets — discontinued operations

 

1

 

10

 

Proceeds from sales of marketable securities, long-term investments and other assets

 

3

 

5

 

Other long-term assets

 

6

 

(3

)

Other items, net

 

2

 

5

 

Net cash used in investing activities

 

(260

)

(248

)

Cash flows from financing activities:

 

 

 

 

 

Repayments of borrowings under credit facility

 

(620

)

(973

)

Proceeds from borrowings under credit facility

 

653

 

1,093

 

Repayments of other borrowings

 

(1,967

)

(67

)

Proceeds from other borrowings

 

1,907

 

292

 

Repurchases of preferred stock

 

 

(292

)

Deferred debt issuance costs

 

(30

)

(2

)

Repurchases of common stock

 

(192

)

(26

)

Cash dividends on preferred stock

 

 

(12

)

Distributions paid to noncontrolling interests

 

(10

)

(6

)

Contributions from noncontrolling interests

 

98

 

2

 

Proceeds from exercise of stock options

 

21

 

4

 

Other items, net

 

(2

)

3

 

Net cash provided by (used in) financing activities

 

(142

)

16

 

Net decrease in cash and cash equivalents

 

(274

)

(31

)

Cash and cash equivalents at beginning of period

 

364

 

113

 

Cash and cash equivalents at end of period

 

$

90

 

$

82

 

Supplemental disclosures:

 

 

 

 

 

Interest paid, net of capitalized interest

 

$

(226

)

$

(181

)

Income tax payments, net

 

$

(8

)

$

(11

)

 

7



 

TENET HEALTHCARE CORPORATION

SELECTED STATISTICS — CONTINUING HOSPITALS

(Unaudited)

 

(Dollars in millions except per patient day, per

 

Three Months Ended June 30,

 

Six Months Ended June 30,

 

admission and per visit amounts)

 

2013

 

2012

 

Change

 

2013

 

2012

 

Change

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net inpatient revenues

 

$

1,542

 

$

1,548

 

(0.4

)%

$

3,078

 

$

3,155

 

(2.4

)%

Net outpatient revenues

 

$

844

 

$

791

 

6.7

%

$

1,657

 

$

1,557

 

6.4

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of acute care hospitals (at end of period)

 

49

 

49

 

*

49

 

49

 

*

Licensed beds (at end of period)

 

13,180

 

13,176

 

%

13,180

 

13,176

 

%

Average licensed beds

 

13,180

 

13,176

 

%

13,180

 

13,157

 

0.2

%

Utilization of licensed beds

 

47.3

%

49.2

%

(1.9

)%*

49.1

%

50.4

%

(1.3

)%*

Patient days — total

 

567,390

 

590,437

 

(3.9

)%

1,170,675

 

1,207,896

 

(3.1

)%

Adjusted patient days

 

909,720

 

919,718

 

(1.1

)%

1,849,560

 

1,866,872

 

(0.9

)%

Net inpatient revenue per patient day

 

$

2,718

 

$

2,622

 

3.7

%

$

2,629

 

$

2,612

 

0.7

%

Total admissions

 

120,722

 

125,136

 

(3.5

)%

246,651

 

256,326

 

(3.8

)%

Adjusted patient admissions

 

195,440

 

196,831

 

(0.7

)%

393,105

 

399,630

 

(1.6

)%

Net inpatient revenue per admission

 

$

12,773

 

$

12,371

 

3.2

%

$

12,479

 

$

12,309

 

1.4

%

Average length of stay (days)

 

4.70

 

4.72

 

(0.4

)%

4.75

 

4.71

 

0.8

%

Total surgeries

 

108,669

 

95,422

 

13.9

%

210,082

 

188,650

 

11.4

%

Outpatient visits

 

1,072,712

 

1,046,768

 

2.5

%

2,127,501

 

2,078,379

 

2.4

%

Net outpatient revenue per visit

 

$

787

 

$

756

 

4.1

%

$

779

 

$

749

 

4.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net Patient Revenues from:

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare

 

21.0

%

22.7

%

(1.7

)%*

22.0

%

24.6

%

(2.6

)%*

Medicaid

 

9.9

%

10.0

%

(0.1

)%*

9.0

%

8.7

%

0.3

%*

Managed care

 

58.1

%

56.8

%

1.3

%*

58.0

%

56.3

%

1.7

%*

Indemnity, self-pay and other

 

11.0

%

10.5

%

0.5

%*

11.0

%

10.4

%

0.6

%*

 


* This change is the difference between the 2013 and 2012 amounts shown

 

8



 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

Fiscal 2013 Calendar Quarter

(Unaudited)

 

 

 

Three Months Ended

 

Six Months
Ended

 

(Dollars in millions except per share amounts)

 

03/31/13

 

06/30/13

 

06/30/13

 

 

 

 

 

 

 

 

 

Net operating revenues:

 

 

 

 

 

 

 

Net operating revenues before provision for doubtful accounts

 

$

2,594

 

$

2,629

 

$

5,223

 

Less: Provision for doubtful accounts

 

207

 

207

 

414

 

Net operating revenues

 

2,387

 

2,422

 

4,809

 

Operating expenses:

 

 

 

 

 

 

 

Salaries, wages and benefits

 

1,161

 

1,166

 

2,327

 

Supplies

 

384

 

387

 

771

 

Other operating expenses, net

 

568

 

567

 

1,135

 

Electronic health record incentives

 

 

(34

)

(34

)

Depreciation and amortization

 

114

 

121

 

235

 

Impairment and restructuring charges, and acquisition-related costs

 

14

 

11

 

25

 

Litigation and investigation costs

 

 

2

 

2

 

Operating income

 

146

 

202

 

348

 

Interest expense

 

(103

)

(98

)

(201

)

Loss from early extinguishment of debt

 

(177

)

(171

)

(348

)

Investment earnings

 

 

1

 

1

 

Loss from continuing operations, before income taxes

 

(134

)

(66

)

(200

)

Income tax benefit

 

53

 

20

 

73

 

Loss from continuing operations, before discontinued operations

 

(81

)

(46

)

(127

)

Discontinued operations:

 

 

 

 

 

 

 

Income (loss) from operations

 

(3

)

6

 

3

 

Income tax benefit (expense)

 

1

 

(3

)

(2

)

Income (loss) from discontinued operations

 

(2

)

3

 

1

 

Net loss

 

(83

)

(43

)

(126

)

Less: Net income attributable to noncontrolling interests

 

 

 

 

 

 

 

Continuing operations

 

5

 

7

 

12

 

Net loss attributable to Tenet Healthcare Corporation common shareholders

 

$

(88

)

$

(50

)

$

(138

)

Amounts attributable to Tenet Healthcare Corporation common shareholders

 

 

 

 

 

 

 

Loss from continuing operations, net of tax

 

$

(86

)

$

(53

)

$

(139

)

Income (loss) from discontinued operations, net of tax

 

(2

)

3

 

1

 

Net loss attributable to Tenet Healthcare Corporation common shareholders

 

$

(88

)

$

(50

)

$

(138

)

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders

 

 

 

 

 

 

 

Basic

 

 

 

 

 

 

 

Continuing operations

 

$

(0.83

)

$

(0.52

)

$

(1.34

)

Discontinued operations

 

(0.02

)

0.03

 

0.01

 

 

 

$

(0.85

)

$

(0.49

)

$

(1.33

)

Diluted

 

 

 

 

 

 

 

Continuing operations

 

$

(0.83

)

$

(0.52

)

$

(1.34

)

Discontinued operations

 

(0.02

)

0.03

 

0.01

 

 

 

$

(0.85

)

$

(0.49

)

$

(1.33

)

Weighted average shares and dilutive securities outstanding (in thousands):

 

 

 

 

 

 

 

Basic

 

104,103

 

103,010

 

103,557

 

Diluted

 

104,103

 

103,010

 

103,557

 

 

9



 

TENET HEALTHCARE CORPORATION

SELECTED STATISTICS — CONTINUING HOSPITALS

(Unaudited)

 

 

 

Three Months Ended

 

Six Months
Ended

 

(Dollars in millions except per patient day, per admission and per visit amounts)

 

03/31/13

 

06/30/13

 

06/30/13

 

 

 

 

 

 

 

 

 

Net inpatient revenues

 

$

1,536

 

$

1,542

 

$

3,078

 

Net outpatient revenues

 

$

813

 

$

844

 

$

1,657

 

 

 

 

 

 

 

 

 

Number of acute care hospitals (at end of period)

 

49

 

49

 

49

 

Licensed beds (at end of period)

 

13,180

 

13,180

 

13,180

 

Average licensed beds

 

13,180

 

13,180

 

13,180

 

Utilization of licensed beds

 

50.9

%

47.3

%

49.1

%

Patient days — total

 

603,285

 

567,390

 

1,170,675

 

Adjusted patient days

 

939,840

 

909,720

 

1,849,560

 

Net inpatient revenue per patient day

 

$

2,546

 

$

2,718

 

$

2,629

 

Total admissions

 

125,929

 

120,722

 

246,651

 

Adjusted patient admissions

 

197,665

 

195,440

 

393,105

 

Net inpatient revenue per admission

 

$

12,197

 

$

12,773

 

$

12,479

 

Average length of stay (days)

 

4.79

 

4.70

 

4.75

 

Total surgeries

 

101,413

 

108,669

 

210,082

 

Outpatient visits

 

1,054,789

 

1,072,712

 

2,127,501

 

Net outpatient revenue per visit

 

$

771

 

$

787

 

$

779

 

 

 

 

 

 

 

 

 

Net Patient Revenues from:

 

 

 

 

 

 

 

Medicare

 

23.0

%

21.0

%

22.0

%

Medicaid

 

8.0

%

9.9

%

9.0

%

Managed care

 

57.9

%

58.1

%

58.0

%

Indemnity, self-pay and other

 

11.1

%

11.0

%

11.0

%

 

10



 

TENET HEALTHCARE CORPORATION

SEGMENT REPORTING

(Unaudited)

 

 

 

June 30,

 

December 31,

 

 

 

2013

 

2012

 

Assets

 

 

 

 

 

Hospital Operations and other

 

$

8,889

 

$

8,825

 

Conifer

 

267

 

219

 

Total

 

$

9,156

 

$

9,044

 

 

 

 

Three Months Ended
June 30,

 

Six Months Ended
June 30,

 

 

 

2013

 

2012

 

2013

 

2012

 

Capital expenditures:

 

 

 

 

 

 

 

 

 

Hospital Operations and other

 

$

117

 

$

114

 

$

248

 

$

247

 

Conifer

 

6

 

2

 

8

 

5

 

Total

 

$

123

 

$

116

 

$

256

 

$

252

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues:

 

 

 

 

 

 

 

 

 

Hospital Operations and other

 

$

2,297

 

$

2,247

 

$

4,565

 

$

4,532

 

Conifer

 

 

 

 

 

 

 

 

 

Tenet

 

94

 

90

 

186

 

180

 

Other customers

 

125

 

18

 

244

 

35

 

 

 

2,516

 

2,355

 

4,995

 

4,747

 

Intercompany eliminations

 

(94

)

(90

)

(186

)

(180

)

Total

 

$

2,422

 

$

2,265

 

$

4,809

 

$

4,567

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA:

 

 

 

 

 

 

 

 

 

Hospital Operations and other

 

$

308

 

$

263

 

$

550

 

$

548

 

Conifer

 

28

 

25

 

60

 

50

 

Total

 

$

336

 

$

288

 

$

610

 

$

598

 

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization:

 

 

 

 

 

 

 

 

 

Hospital Operations and other

 

$

115

 

$

101

 

$

225

 

$

199

 

Conifer

 

6

 

3

 

10

 

5

 

Total

 

$

121

 

$

104

 

$

235

 

$

204

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA

 

$

336

 

$

288

 

$

610

 

$

598

 

Depreciation and amortization

 

(121

)

(104

)

(235

)

(204

)

Impairments and restructuring charges, and acquisition-related costs

 

(11

)

(3

)

(25

)

(6

)

Litigation and investigation costs

 

(2

)

(1

)

(2

)

(3

)

Interest expense

 

(98

)

(102

)

(201

)

(200

)

Loss from early extinguishment of debt

 

(171

)

 

(348

)

 

Investment earnings

 

1

 

 

1

 

1

 

Income (loss) before income taxes

 

$

(66

)

$

78

 

$

(200

)

$

186

 

 

11



 

(1) Reconciliation of Adjusted EBITDA

 

Adjusted EBITDA, a non-GAAP term, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common shareholders before (1) the cumulative effect of changes in accounting principle, net of tax; (2) net loss (income) attributable to noncontrolling interests; (3) preferred stock dividends; (4) income (loss) from discontinued operations, net of tax; (5) income tax benefit (expense); (6) investment earnings (loss); (7) gain (loss) from early extinguishment of debt; (8) net gain (loss) on sales of investments; (9) interest expense; (10) litigation and investigation benefit (costs), net of insurance recoveries; (11) hurricane insurance recoveries, net of costs; (12) impairment and restructuring charges and acquisition-related costs; and (13) depreciation and amortization. The Company’s Adjusted EBITDA may not be comparable to EBITDA reported by other companies.

 

The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its financial statements, some of which are recurring or involve cash payments. The Company uses this information in its analysis of the performance of its business excluding items that it does not consider as relevant in the performance of its hospitals in continuing operations. In addition, from time to time we use this measure to define certain performance targets under our compensation programs. Adjusted EBITDA is not a measure of liquidity, but is a measure of operating performance that management uses in its business as an alternative to net income (loss) attributable to Tenet Healthcare Corporation common shareholders. Because Adjusted EBITDA excludes many items that are included in our financial statements, it does not provide a complete measure of our operating performance. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance.

 

The reconciliation of net income (loss) attributable to Tenet Healthcare Corporation common shareholders, the most comparable GAAP term, to Adjusted EBITDA, is set forth in the first table below for the three and six months ended June 30, 2013 and 2012.

 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP Disclosures

Table #1 - Reconciliation of Adjusted EBITDA to Net Income Attributable to Tenet Healthcare Corporation Common Shareholders

(Unaudited)

 

 

 

Three Months Ended
June 30,

 

Six Months Ended
June 30,

 

(Dollars in millions)

 

2013

 

2012

 

2013

 

2012

 

Net income (loss) attributable to Tenet Healthcare Corporation common shareholders

 

$

(50

)

$

(6

)

$

(138

)

$

52

 

Less: Net (income) loss attributable to noncontrolling interests

 

(7

)

18

 

(12

)

15

 

Preferred stock dividends

 

 

(4

)

 

(10

)

Income (loss) from discontinued operations, net of tax

 

3

 

(68

)

1

 

(67

)

Income (loss) from continuing operations

 

(46

)

48

 

(127

)

114

 

Income tax (expense) benefit

 

20

 

(30

)

73

 

(72

)

Investment earnings

 

1

 

 

1

 

1

 

Loss from early extinguishment of debt

 

(171

)

 

(348

)

 

Interest expense

 

(98

)

(102

)

(201

)

(200

)

Operating income

 

202

 

180

 

348

 

385

 

Litigation and investigation costs

 

(2

)

(1

)

(2

)

(3

)

Impairment and restructuring charges, and acquisition-related costs

 

(11

)

(3

)

(25

)

(6

)

Depreciation and amortization

 

(121

)

(104

)

(235

)

(204

)

Adjusted EBITDA

 

$

336

 

$

288

 

$

610

 

$

598

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues

 

$

2,422

 

$

2,265

 

$

4,809

 

$

4,567

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin)

 

13.9

%

12.7

%

12.7

%

13.1

%

 

12



 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP Disclosures

Table #2 - Reconciliation of Adjusted Free Cash Flow

(Unaudited)

 

 

 

Six Months Ended
June 30,

 

(Dollars in millions)

 

2013

 

2012

 

Net cash provided by operating activities

 

$

128

 

$

201

 

Less:

 

 

 

 

 

Payments for restructuring charges, acquisition-related costs and litigation costs and settlements

 

(19

)

(50

)

Net cash used in operating activities from discontinued operations

 

(7

)

(22

)

Adjusted net cash provided by operating activities — continuing operations

 

154

 

273

 

Purchases of property and equipment — continuing operations

 

(256

)

(251

)

Adjusted free cash flow — continuing operations

 

$

(102

)

$

22

 

 

Table #3 - Reconciliation of Outlook Adjusted EBITDA to

Outlook Net Income Attributable to Tenet Healthcare Corporation Common Shareholders

for the Year Ending December 31, 2013

(Unaudited)

 

 

 

2013

 

(Dollars in millions)

 

Low

 

High

 

Net income (loss) attributable to Tenet Healthcare Corporation common shareholders

 

$

(43

)

$

29

 

Less:

 

 

 

 

 

Net (income) loss attributable to noncontrolling interests

 

(25

)

(15

)

Loss from discontinued operations, net of tax

 

(5

)

0

 

Income (loss) from continuing operations

 

$

(13

)

$

44

 

Income tax expense (benefit) (a)

 

7

 

(26

)

Income (loss) from continuing operations, before income taxes

 

$

(20

)

$

70

 

Loss from early extinguishment of debt

 

(348

)

(348

)

Interest expense, net

 

(400

)

(380

)

Operating income

 

$

728

 

$

798

 

Impairment and restructuring charges, acquisition-related costs and litigation costs(b)

 

(27

)

(27

)

Depreciation and amortization

 

(495

)

(475

)

Adjusted EBITDA

 

$

1,250

 

$

1,300

 

Net operating revenues

 

$

9,700

 

$

9,900

 

 

 

 

 

 

 

Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin)

 

12.9

%

13.1

%

 


(a)        Uses tax rate of 37% excluding unusual adjustments

(b)       Company does not forecast impairment and restructuring charges, acquisition-related costs and litigation costs

 

13



 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP Disclosures

Table #4 - Reconciliation of Outlook Adjusted EBITDA to

Outlook Normalized Income from Continuing Operations

for the Year Ending December 31, 2013

(Unaudited)

 

 

 

Q3 2013

 

2013

 

(Dollars in millions except per share amounts)

 

Low

 

High

 

Low

 

High

 

Adjusted EBITDA

 

$

275

 

$

325

 

$

1,250

 

$

1,300

 

Depreciation and amortization

 

(130

)

(120

)

(495

)

(475

)

Interest expense, net

 

(100

)

(90

)

(400

)

(380

)

Normalized income from continuing operations before income taxes

 

$

45

 

$

115

 

$

355

 

$

445

 

Income tax expense (a)

 

(17

)

(43

)

(131

)

(165

)

Normalized income from continuing operations

 

$

28

 

$

72

 

$

224

 

$

280

 

Net (income) loss attributable to noncontrolling interests

 

(7

)

(5

)

(25

)

(15

)

Normalized net income attributable to common shareholders

 

$

21

 

$

67

 

$

199

 

$

265

 

 

 

 

 

 

 

 

 

 

 

Fully diluted weighted average share outstanding (in millions)

 

103

 

103

 

104

 

104

 

 

 

 

 

 

 

 

 

 

 

Normalized fully diluted earnings per share — continuing operations

 

$

0.20

 

$

0.65

 

$

1.91

 

$

2.55

 

 


(a) Uses tax rate of 37% excluding unusual adjustments

 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP Disclosures

Table #5 - Reconciliation of Outlook Adjusted Free Cash Flow

for the Year Ending December 31, 2013

(Unaudited)

 

 

 

2013

 

(Dollars in millions)

 

Low

 

High

 

Net cash provided by operating activities

 

$

 625

 

$

 745

 

Less:

 

 

 

 

 

Payments for restructuring charges, acquisition-related costs and litigation costs and settlements

 

(30

)

(20

)

Net cash used in operating activities from discontinued operations

 

(20

)

(10

)

Adjusted net cash provided by operating activities — continuing operations

 

$

675

 

$

775

 

Purchases of property and equipment — continuing operations

 

(600

)

(550

)

Adjusted free cash flow — continuing operations

 

$

75

 

$

225

 

 

14