Exhibit 99.1
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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 |
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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.
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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 | | | | | |
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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 | | | | | |
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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 | |
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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 | ) |
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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
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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