Thomas J. Aaron
Thank you, Tim.
with which During bad third for from expenses increased expectations revenue and debt. was combination negatively million net was The our quarter, net rates, volumes, approximately Adjusted margin. combined along quarter, $XXX at increased third million down came EBITDA operating the impacted consolidated EBITDA of with in sequentially. a EBITDA the below our lower-than-expected $XXX payer lower revenue
quarter, quarter million while from versus reduced were million. revenues reimbursement reduced and an the caused On at Looking second approximately the net Waiver our Medicaid sequential incremental performance, aggregate. reductions third by reduction, our estimate Texas Program basis we of our hurricanes approximately EBITDA $XX the a Medicaid million expense $XX Florida in and approximately $XX HITECH
higher $XX expectations were Also, below from revenue sequentially. our in our expected, part in we the our than expenses million came operating and anticipated divestitures a As hurricanes. came net roughly drag our in
On a results revenues for the the we basis mentioned third or note adjusted third comparative net in a on items quarter, basis, On the X.X% details X.X%. of X.X% decreased quarter, a more exclude XXXX increase calculations Ross a for quarter on earlier. of revenues Now, adjusted call discussed volume as reminder, this net $XX following. the admissions. in comprised for is XXXX for admission decrease versus a and million This same-store
X.X%. Our declined inpatient admissions
Our ER visits down were X.X%.
Our surgeries were down X.X%.
quarter. drag on and admissions the Looking increased observation were days decreased at similar admissions, volumes our to OB our a second
bad XX.X% XX% and Consolidated debt quarter charity compared increased decreased adjusted XX increase. basis of revenue of outpatient basis revenue same-store, XXX-basis-point Our down a points; same-store revenues. Same-store self-pay, XX points; bad of of XXXX basis to for Consolidated and the points; XX XX to debt mix increase. which our decreased represents net increased third plus points; the XX before care expense managed basis for same-store points; points; net the XX.X% from down revenue same-store, XX.X% of XX increased for payer currently increased includes periods Medicare provision quarter down XX.X%, basis XXXX Advantage XX other, basis care XX points. third to uncompensated basis or Medicare XXX-basis-point shows basis Medicaid has points; from increased comparative plus self-pay three-month discounts care net the
discounts the Looking as divestitures of net in at of in that increase from have self-pay in part we of the bad care increases revenue. as revenue, this a volumes, and percentage quarter, experienced self-pay a uncompensated to of and co-pays much deductibles, patient our hospitals lower increases the hurricanes, prior debt percentage due an certain in
lower expected impacted as net net as from For expense points revenue and XXX consolidated on to a than points same-store. and revenue XX.X% before up lines Overall, was up basis bad percent expense debt a revenue. incremental debt net XX the the our third basis of was hurricanes our bad of a basis quarter, percent
basis XX of a the impact XX-basis-point net increased for third increased XXXX same-store as divested Hurricane lower expense basis which a XX the benefit offset approximately hospitals our by driven benefits items of of employee XXXX, quarter increase. Supplies salaries to operating expense percent For same-stores more XX in increase of quarter points and our points. revenues for revenue third higher points. for basis physician operating the The the as percentage than compared of same-stores cost. account and net expense, was
were of drove net costs as of activity. XXX our below pharmaceutical of costs. a the driven percent a of contract implant increase. net our the revenue of operating is which Other divestiture insurance quarter fees, specialist higher recent prior flat, medical number in year-to-date for higher While combination costs expenses costs by increased and corporate same-stores Despite Increases points. start are to a labor were as operating taxes, revenues basis third percentage XXXX, a divestitures, XXXX of
Looking if exclude margin our basis the performance, EBITDA higher. at divestitures, been the points would our impact third EBITDA and we quarter adjusted hurricanes XXX have from
our of X.X% particularly of in X.X% to noting worth vendor-related spend, year-to-date. designed quarter up terms a reduce working number that spend, It's around In our initiatives our same-store for were on we the total operating are and costs. and third operating expenses supplies operating
see XXXX. the fourth to $XXX quarter $XXX provided million for the progress by quarter compares in XXXX. expect cash of third million flows in This the operations to third flow, Switching and during to operations from quarter of some flows cash our We of cash XXXX. were
$XX approximately $XX impacted flow including was roughly working million; cash few XXXX, decreases, for of declined million For operations the by from million. items: and capital due $XX received a to timing changes, cash payments the $XXX cash million. cash were operations flows HITECH the cash first a reduction; compared flow $XXX from divestitures flows our nine months of other approximately year-over-year negatively provided Year-to-date million reduced by by payroll in to decrease
of was net $XXX for or CapEx, is net X.X% the Moving our X% $XXX year-to-date When XXXX spending $XXX net on Year-to-date, million hospitals. the our million CapEx focused lower revenue. or of targeted more compared of CapEx to million CapEx of to or previous years' X.X% due and limited core to XXXX third CapEx first CapEx the revenue higher-return is to through revenue, hospital comparing replacement our nine XXXX. quarter months of amounts,
as are orthopedics service CapEx around high-acuity relatively line other more and areas. we well points, additional towards addition, cardiology, build-outs access In allocating as
is XXXX. the our to debt, by over $X.X third Moving sheet have down since of of since million the debt million the had billion Also, million, year of $XXX approximately balance of the of we of at on XXXX, the from the and had end end which we maturities approximately approximately been beginning XX. billion the of $XX.X sheet, as of quarter, the reduced have current and start long-term $XXX $XXX September cash balance long-term
net as of billion terms is In and, that by expanded reduced EBITDA at $X for billion. That These be our have noting hospitals proceeds it's used Wayne maturities billion $X.X several And over to also we've will to lower margins. least the transactions on of noting and past our of signed debt net beyond for announcing letters billion $X billion. of hospitals, revenue. our for mid-single-digit worth we $X.X the primarily part long-term mentioned, accounting average, six intent accounting $X debt. program, revenue of sell our quarters, hospitals that we divestiture It's worth additional we of pursuing debt of are current close debt, long-term our divestiture recently nearly XX
coverage of We to times. ratio both is net the were an XX, terms of covenants, minimum X.X September increase times ratio on times XXXX, in December secured will XX, coverage end X.XX thereafter. which times ratio through is and compliance covenants leverage of ratio our XXXX, X X.XX and our of through X.XX senior interest XXXX, secured In times maximum with interest our bank leverage net with
no As until over of and XXXX, XX%, XX, secured on cushion our $X during XX%. our senior November cushion billion note our leverage our XXXX. capacity. secured accomplished of is on EBITDA net refinancings senior have on coverage maturities September we XXXX, ratio EBITDA today, of ratio is we have interest And Based
we most efficient move continue next Over manage capital assess Wayne? we'll way the our to months, the to structure forward. several as
