Insurance Technology Industry News

TMCNet:  Tenet Reports Fourth Quarter Adjusted EBITDA of $336 Million, an Increase of 16.7%

[February 26, 2013]

Tenet Reports Fourth Quarter Adjusted EBITDA of $336 Million, an Increase of 16.7%

DALLAS --(Business Wire)--

Tenet Healthcare Corporation (NYSE:THC) today reported Adjusted EBITDA of $336 million for the fourth quarter ended December 31, 2012, an increase of $48 million, or 16.7 percent, as compared to Adjusted EBITDA of $288 million in the fourth quarter of 2011. Net income attributable to common shareholders in the quarter was $49 million, or $0.45 per share, compared to a loss of $76 million, or $0.70 per share, in the fourth quarter of 2011, which included an after-tax loss of $74 million due to the early extinguishment of debt, or $0.68 per share. Adjusted EBITDA for the year ended December 31, 2012 was $1.203 billion, an increase of $77 million, or 6.8 percent, as compared to Adjusted EBITDA of $1.126 billion in the year ended December 31, 2011.

"The fourth quarter provided a strong finish to 2012, which became our ninth consecutive year of consistent earnings growth, with compound annual EBITDA growth of 15 percent," said Trevor Fetter, president and chief executive officer. "Strong revenue growth and disciplined cost control were once again hallmarks of our financial performance. Net revenues grew by 7.3 percent reflecting strong volume increases and continued pricing strength. Our volume growth was one of the strongest in the investor-owned healthcare provider sector, and we recorded our ninth consecutive quarter of positive growth in adjusted admissions. Volume growth included another strong quarter of growth in outpatient surgeries which increased by 13.9 percent. Cost control was excellent with hospital operations restraining expense growth to just 1.9 percent per adjusted admission, and Conifer Health Solutions, Tenet's services business, reported another solid quarter contributing $31 million of Adjusted EBITDA."

Discussion of Results (Percentage changes compare Q4'12 to Q4'11, unless otherwise noted.)

Adjusted admissions increased 2.9 percent in the fourth quarter led by strong growth in outpatient visits of 7.3 percent. Approximately 80 percent of the outpatient visit growth was organic. Total admissions were flat. Total emergency department visits increased 8.6 percent and emergency department admissions increased 1.7 percent. The sum of uninsured and charity admissions increased 1.1 percent.

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 fourth quarter of 2011. The increase in bad debt expense was largely the result of the increase in uninsured patient volumes. Our self-pay collection rate was 28.9 percent in the fourth quarter of 2012, a 120 basis point improvement compared to 27.7 percent in the fourth quarter of 2011.

Net operating revenues were $2.331 billion, an increase of $159 million, or 7.3 percent, compared to net operating revenues of $2.172 billion in the fourth quarter of 2011. Commercial managed care revenue increased 5.2 percent, which reflected a 7.1 percent and 7.6 percent increase in commercial managed care revenue per patient day and per outpatient visit, respectively.

Total net patient revenue per adjusted admission was $11,866, an increase of 2.8 percent. This pricing increase primarily reflects improved terms in our contracts with commercial managed care payers, as well as higher Medicare reimbursement rates that became effective on October 1, partially offset by a softer payer mix.

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 only 1.9 percent on a per adjusted admission basis. This cost metric excludes Conifer since Conifer does not generate incremental volumes, which impacts the relationship of this aggregate cost metric to patient volumes. Supplies expense per adjusted admission declined 1.1 percent. Electronic health record incentives were $27 million in the fourth quarter of 2012 compared to $5 million in the fourth quarter of 2011 and are not a part of the definition of selected operating expenses.

Cash and cash equivalents were $364 million at December 31, 2012 compared to $83 million at September 30, 2012. The Company had no outstanding balance on its bank line at December 31, 2012. Accounts receivable days improved by two days to 53 days down from 55 days at September 30, 2012. Approximately $57 million of aggregate revenues related to the California Provider Fee program and the Texas uncompensated care 1115 waiver program were recognized in Adjusted EBITDA in 2012, but were not yet received by year end.

Outlook for Adjusted EBITDA in First Quarter and Full Year 2013

The Company confirms its previously announced Outlook for 2013 Adjusted EBITDA of $1.325 billion to $1.425 billion. The $1.375 billion mid-point of this Outlook range is slightly above the current consensus estimate. For the first quarter of 2013, the Outlook range for Adjusted EBITDA is $250 million to $290 million. This first quarter Outlook excludes any contribution related to the managed care portion of the 30 month California Provider Fee program, which is now expected to contribute $53 million to Adjusted EBITDA in our quarter ending June 30, 2013.

Management's Webcast Discussion of Fourth Quarter Results

Tenet management will discuss the Company's fourth quarter 2012 results on a 10:00 AM (ET) webcast on February 26, 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-K 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 non-GAAP measures included in this release is included in the financial tables at the end of this release.

Tenet Healthcare Corporation, a leading health care services company, through its subsidiaries operates 49 hospitals, 117 outpatient centers and Conifer Health Solutions, a leader in business process solutions for health care providers that serves over 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.

This document contains "forward-looking statements" - that is, statements relating 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 the factors disclosed under "Forward-Looking Statements" and "Risk Factors" in our Form 10-K for the year ended Dec. 31, 2012, our quarterly reports on Form 10-Q, periodic reports on Form 8-K and other filings with the Securities and Exchange Commission. The Company assumes no obligation to update forward-looking statements contained in this press release as a result of new information or future events or developments.

Tenet uses its company web site to provide important information to investors about the company including the posting of important announcements regarding financial performance and corporate developments.



 
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(Dollars in millions except per share amounts)   Three Months Ended December 31,
2012   %   2011   %   Change
 
Net operating revenues:
Net operating revenues before provision for doubtful accounts $ 2,531 $ 2,353 7.6 %
Less: Provision for doubtful accounts   200     181   10.5 %
Net operating revenues 2,331 100.0 % 2,172 100.0 % 7.3 %
Operating expenses:
Salaries, wages and benefits 1,091 46.8 % 1,014 46.7 % 7.6 %
Supplies 388 16.6 % 381 17.5 % 1.8 %
Other operating expenses, net 543 23.3 % 494 22.8 % 9.9 %
Electronic health record incentives (27 ) (1.2 ) % (5 ) (0.2 ) % 440.0 %
Depreciation and amortization 116 5.0 % 100 4.6 % 16.0 %
Impairment of long-lived assets and goodwill, and restructuring charges, net 7 0.3 % 2 0.1 %
Litigation and investigation costs   2   0.1 %   31   1.4 %
Operating income 211 9.1 % 155 7.1 %
Interest expense (109 ) (100 )
Loss from early extinguishment of debt (4 ) (117 )
Investment earnings (loss)   (1 )   -  
Income (loss) from continuing operations, before income taxes 97 (62 )
Income tax benefit (expense)   (35 )   12  

Income (loss) from continuing operations, before discontinued operations

62 (50 )
Discontinued operations:
Loss from operations (9 ) (1 )
Impairment of long-lived assets and goodwill, and restructuring charges, net - (6 )
Litigation settlements, and investigation costs - (17 )
Income tax benefit   1     8  
Loss from discontinued operations   (8 )   (16 )
Net income (loss) 54 (66 )
Less: Preferred stock dividends - 6
Less: Net income attributable to noncontrolling interests
Continuing operations 5 3
Discontinued operations   -     1  
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 49   $ (76 )
 
Amounts attributable to Tenet Healthcare Corporation common shareholders
Income (loss) from continuing operations, net of tax $ 57 $ (60 )
Loss from discontinued operations, net of tax   (8 )   (16 )
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 49   $ (76 )
 
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations $ 0.54 $ (0.55 )
Discontinued operations   (0.08 )   (0.15 )
$ 0.46   $ (0.70 )
Diluted
Continuing operations $ 0.52 $ (0.55 )
Discontinued operations   (0.07 )   (0.15 )
$ 0.45   $ (0.70 )

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

Basic 105,961 108,114
Diluted 108,960 108,114
 
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(Dollars in millions except per share amounts) Year Ended December 31,
2012 % 2011 % Change
 
Net operating revenues:
Net operating revenues before provision for doubtful accounts $ 9,904 $ 9,371 5.7 %
Less: Provision for doubtful accounts   785     717   9.5 %
Net operating revenues 9,119 100.0 % 8,654 100.0 % 5.4 %
Operating expenses:
Salaries, wages and benefits 4,257 46.7 % 4,015 46.4 % 6.0 %
Supplies 1,552 17.0 % 1,548 17.9 % 0.3 %
Other operating expenses, net 2,147 23.5 % 2,020 23.4 % 6.3 %
Electronic health record incentives (40 ) (0.4 ) % (55 ) (0.6 ) % (27.3 ) %
Depreciation and amortization 430 4.7 % 398 4.6 % 8.0 %
Impairment of long-lived assets and goodwill, and restructuring charges, net 19 0.2 % 20 0.2 %
Litigation and investigation costs   5   0.1 %   55   0.6 %
Operating income 749 8.2 % 653 7.5 %
Interest expense (412 ) (375 )
Loss from early extinguishment of debt (4 ) (117 )
Investment earnings   1     3  
Income from continuing operations, before income taxes 334 164
Income tax expense   (125 )   (61 )

Income from continuing operations, before discontinued operations

209 103
Discontinued operations:
Loss from operations (2 ) (18 )

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

(100 ) (6 )
Litigation and investigation costs - (17 )
Net gains on sales of facilities 1 -
Income tax benefit   25     32  
Loss from discontinued operations   (76 )   (9 )
Net income 133 94
Less: Preferred stock dividends 11 24
Less: Net income (loss) attributable to noncontrolling interests
Continuing operations 13 11
Discontinued operations   (32 )   1  
Net income attributable to Tenet Healthcare Corporation common shareholders $ 141   $ 58  
 
Amounts attributable to Tenet Healthcare Corporation common shareholders
Income from continuing operations, net of tax $ 185 $ 68
Loss from discontinued operations, net of tax   (44 )   (10 )
Net income attributable to Tenet Healthcare Corporation common shareholders $ 141   $ 58  
 
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations $ 1.77 $ 0.58
Discontinued operations   (0.42 )   (0.09 )
$ 1.35   $ 0.49  
Diluted
Continuing operations $ 1.70 $ 0.56
Discontinued operations   (0.40 )   (0.08 )
$ 1.30   $ 0.48  

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

Basic 104,200 117,182
Diluted 108,926 121,295
 
 
TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
(Unaudited)
 
  December 31,   December 31,
(Dollars in millions) 2012 2011
ASSETS
Current assets:
Cash and cash equivalents $ 364 $ 113
Accounts receivable, less allowance for doubtful accounts 1,345 1,278
Inventories of supplies, at cost 153 161
Income tax receivable 7 7
Current portion of deferred income taxes 354 418
Assets held for sale - 2
Other current assets   458     378  
Total current assets 2,681 2,357
Investments and other assets 162 156
Deferred income taxes, net of current portion 342 374
Property and equipment, at cost, less accumulated depreciation and amortization 4,293 4,350
Goodwill 916 736
Other intangible assets, at cost, less accumulated amortization   650     489  
Total assets $ 9,044   $ 8,462  
 
LIABILITIES AND EQUITY
Current liabilities:
Current portion of long-term debt $ 94 $ 66
Accounts payable 722 760
Accrued compensation and benefits 415 376
Professional and general liability reserves 64 75
Accrued interest payable 125 112
Accrued legal settlement costs 8 64
Other current liabilities   335     362  
Total current liabilities 1,763 1,815
Long-term debt, net of current portion 5,158 4,294
Professional and general liability reserves 292 337
Accrued legal settlement costs 2 2
Other long-term liabilities   595     506  
Total liabilities 7,810 6,954
Commitments and contingencies
Redeemable noncontrolling interests in equity of consolidated subsidiaries 16 16
Equity:
Shareholders' equity:
Preferred stock - 334
Common stock 7 7
Additional paid-in capital 4,471 4,427
Accumulated other comprehensive loss (68 ) (52 )
Accumulated deficit (1,288 ) (1,440 )
Common stock in treasury, at cost   (1,979 )   (1,853 )
Total shareholders' equity 1,143 1,423
Noncontrolling interests   75     69  
Total equity   1,218     1,492  
Total liabilities and equity $ 9,044   $ 8,462  
 
 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
(Dollars in millions)  

Year Ended
December 31,

2012   2011
Net income $ 133 $ 94
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 430 398
Provision for doubtful accounts 785 717
Deferred income tax expense 92 81
Stock-based compensation expense 32 24
Impairment of long-lived assets and goodwill, and restructuring charges, net 19 20
Litigation and investigation costs 5 55
Loss from early extinguishment of debt 4 117
Amortization of debt discount and debt issuance costs 22 30
Pre-tax loss from discontinued operations 101 41
Other items, net (12 ) (13 )
Changes in cash from changes in operating assets and liabilities:
Accounts receivable (868 ) (850 )
Inventories and other current assets (59 ) (35 )
Income taxes (5 ) (63 )
Accounts payable, accrued expenses and other current liabilities 9 (32 )
Other long-term liabilities 3 (5 )
Payments against reserves for restructuring charges and litigation costs and settlements (63 ) (44 )
Net cash used in operating activities from discontinued operations, excluding income taxes   (35 )   (38 )
Net cash provided by operating activities 593 497
Cash flows from investing activities:
Purchases of property and equipment-continuing operations (506 ) (467 )
Purchases of property and equipment-discontinued operations (2 ) (8 )
Purchases of businesses or joint venture interests (211 ) (84 )
Proceeds from sales of facilities and other assets - discontinued operations 45 -
Proceeds from sales of marketable securities, long-term investments and other assets 17 59
Other items, net   (5 )   (3 )
Net cash used in investing activities (662 ) (503 )
Cash flows from financing activities:
Repayments of borrowings under credit facility (1,773 ) (365 )
Proceeds from borrowings under credit facility 1,693 445
Repayments of other borrowings (248 ) (843 )
Proceeds from other borrowings 1,092 900
Repurchases of preferred stock (292 ) -
Deferred debt issuance costs (17 ) (21 )
Repurchases of common stock (126 ) (374 )
Cash dividends on preferred stock (14 ) (24 )
Distributions paid to noncontrolling interests (15 ) (10 )
Other items, net   20     6  
Net cash provided by (used in) financing activities   320     (286 )
Net increase (decrease) in cash and cash equivalents 251 (292 )
Cash and cash equivalents at beginning of period   113     405  
Cash and cash equivalents at end of period $ 364   $ 113  
Supplemental disclosures:
Interest paid, net of capitalized interest $ (376 ) $ (347 )
Proceeds from interest rate swap agreement $ - $ 30
Income tax payments, net $ (13 ) $ (10 )
 
 

TENET HEALTHCARE CORPORATION

SELECTED STATISTICS - CONTINUING HOSPITALS
(Unaudited)
 

 

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

  Three Months Ended December 31,     Year Ended December 31,
2012   2011   Change 2012   2011   Change
 
Net inpatient revenues $ 1,544 $ 1,499 3.0 % $ 6,200 $ 6,028 2.9 %  
Net outpatient revenues $ 821 $ 736 11.5 % $ 3,167 $ 2,928 8.2 %
 
Number of acute care hospitals (at end of period) 49 49 - * 49 49 - *
Licensed beds (at end of period) 13,216 13,119 0.7 % 13,216 13,119 0.7 %
Average licensed beds 13,216 13,119 0.7 % 13,187 13,115 0.5 %
Utilization of licensed beds 47.7 % 48.9 % (1.2 ) % * 49.1 % 50.4 % (1.3 ) % *
Patient days 580,426 589,848 (1.6 ) % 2,368,916 2,413,245 (1.8 ) %
Adjusted patient days 915,584 902,762 1.4 % 3,693,828 3,673,447 0.6 %
Net inpatient revenue per patient day $ 2,660 $ 2,541 4.7 % $ 2,617 $ 2,498 4.8 %
Total admissions 125,290 125,347 - % 506,485 507,834 (0.3 ) %
Adjusted patient admissions 199,304 193,631 2.9 % 796,874 780,026 2.2 %
Net inpatient revenue per admission $ 12,323 $ 11,959 3.0 % $ 12,241 $ 11,870 3.1 %
Average length of stay (days) 4.63 4.71 (1.7 )% 4.68 4.75 (1.5 ) %
Total surgeries 98,045 91,200 7.5 % 380,955 362,286 5.2 %
Outpatient visits 1,053,499 982,083 7.3 % 4,167,114 3,954,016 5.4 %
Net outpatient revenue per visit $ 779 $ 749 4.0 % $ 760 $ 741 2.6 %
 
Sources of net patient revenues
Medicare 22.4 % 23.1 % (0.7 ) % * 23.4 % 23.1 % 0.3 % *
Medicaid 8.3 % 8.6 % (0.3 ) % * 8.4 % 9.0 % (0.6 ) % *
Managed care 58.3 % 58.1 % 0.2 % * 57.4 % 57.2 % 0.2 % *
Indemnity, self-pay and other 11.0 % 10.2 % 0.8 % * 10.8 % 10.7 % 0.1 % *
 
 
* This change is the difference between the 2012 and 2011 amounts shown
 
 
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
Fiscal 2012 by Calendar Quarter
(Unaudited)
 
(Dollars in millions except per share amounts)   Three Months Ended  

Year
Ended

03/31/12   06/30/12   09/30/12   12/31/12 12/31/12
 
Net operating revenues:
Net operating revenues before provision for doubtful accounts $ 2,491 $ 2,455 $ 2,427 $ 2,531 $ 9,904
Less: Provision for doubtful accounts   189     190     206     200     785  
Net operating revenues 2,302 2,265 2,221 2,331 9,119
Operating expenses:
Salaries, wages and benefits 1,062 1,054 1,050 1,091 4,257
Supplies 399 389 376 388 1,552
Other operating expenses, net 531 534 539 543 2,147
Electronic health record incentives - - (13 ) (27 ) (40 )
Depreciation and amortization 100 104 110 116 430

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

3 3 6 7 19
Litigation and investigation costs   2     1     -     2     5  
Operating income 205 180 153 211 749
Interest expense (98 ) (102 ) (103 ) (109 ) (412 )
Loss from early extinguishment of debt - - - (4 ) (4 )
Investment earnings   1     -     1     (1 )   1  
Income from continuing operations, before income taxes 108 78 51 97 334
Income tax expense   (42 )   (30 )   (18 )   (35 )   (125 )
Income from continuing operations, before discontinued operations 66 48 33 62 209
Discontinued operations:
Income from operations 2 1 4 (9 ) (2 )

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

 

- (100 ) - - (100 )
Net gains (losses) on sales of facilities - 2 (1 ) - 1
Income tax benefit (expense)   (1 )   29     (4 )   1     25  
Income (loss) from discontinued operations   1     (68 )   (1 )   (8 )   (76 )
Net income (loss) 67 (20 ) 32 54 133
Less: Preferred stock dividends 6 4 1 - 11

Less: Net income (loss) attributable to noncontrolling interests

Continuing operations 3 2 3 5 13
Discontinued operations   -     (20 )   (12 )   -     (32 )
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 58   $ (6 ) $ 40   $ 49   $ 141  
 
Amounts attributable to Tenet Healthcare Corporation common shareholders
Income from continuing operations, net of tax $ 57 $ 42 $ 30 $ 57 $ 185
Income (loss) from discontinued operations, net of tax   1     (48 )   10     (8 )   (44 )
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 58   $ (6 ) $ 40   $ 49   $ 141  
 
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations $ 0.55 $ 0.40 $ 0.29 $ 0.54 $ 1.77
Discontinued operations   0.01     (0.46 )   0.09     (0.08 )   (0.42 )
$ 0.56   $ (0.06 ) $ 0.38   $ 0.46   $ 1.35  
Diluted
Continuing operations $ 0.52 $ 0.39 $ 0.28 $ 0.52 $ 1.70
Discontinued operations   0.01     (0.45 )   0.09     (0.07 )   (0.40 )
$ 0.53   $ (0.06 ) $ 0.37   $ 0.45   $ 1.30  

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

Basic 102,843 103,753 104,244 105,961 104,200
Diluted 121,218 106,927 107,311 108,960 108,926
 
 

TENET HEALTHCARE CORPORATION

SELECTED STATISTICS - CONTINUING HOSPITALS
(Unaudited)
           

 

Year

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

Three Months Ended

 

Ended

03/31/12   06/30/12 09/30/12 12/31/12 12/31/12
 
Net inpatient revenues

$

1,607

$ 1,548 $ 1,501 $ 1,544 $ 6,200
Net outpatient revenues

$

766

$ 791 $ 789 $ 821 $ 3,167
 
Number of acute care hospitals (at end of period) 49 49 49 49 49
Licensed beds (at end of period) 13,175 13,176 13,216 13,216 13,216
Average licensed beds 13,138 13,176 13,216 13,216 13,187
Utilization of licensed beds 51.6 % 49.2 % 47.8 % 47.7 % 49.1 %
Patient days 617,459 590,437 580,594 580,426 2,368,916
Adjusted patient days 947,116 919,895 911,233 915,584 3,693,828
Net inpatient revenue per patient day

$

2,603

$ 2,622 $ 2,585 $ 2,660 $ 2,617
Total admissions 131,190 125,136 124,869 125,290 506,485
Adjusted patient admissions 202,860 196,932 197,778 199,304 796,874
Net inpatient revenue per admission

$

12,249

$ 12,371 $ 12,021 $ 12,323 $ 12,241
Average length of stay (days) 4.71 4.72 4.65 4.63 4.68
Total surgeries 93,228 95,422 94,260 98,045 380,955
Outpatient visits 1,031,611 1,046,768 1,035,236 1,053,499 4,167,114
Net outpatient revenue per visit

$

743

$ 756 $ 762 $ 779 $ 760
 
Sources of net patient revenues
Medicare 26.5 % 22.7 % 22.1 % 22.4 % 23.4 %
Medicaid 7.5 % 10.0 % 7.7 % 8.3 % 8.4 %
Managed care 55.9 % 56.8 % 58.9 % 58.3 % 57.4 %
Indemnity, self-pay and other 10.1 % 10.5 % 11.3 % 11.0 % 10.8 %
 
 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

Fiscal 2011 by Calendar Quarter

(Unaudited)

(Dollars in millions except per share amounts)   Three Months Ended   Year Ended
03/31/11   06/30/11   09/30/11   12/31/11 12/31/11
 
Net operating revenues:
Net operating revenues before provision for doubtful accounts $ 2,429 $ 2,300 $ 2,289 $ 2,353 $ 9,371
Less: Provision for doubtful accounts   179     168     189     181     717  
Net operating revenues 2,250 2,132 2,100 2,172 8,654
Operating expenses:
Salaries, wages and benefits 1,017 982 1,002 1,014 4,015
Supplies 396 392 379 381 1,548
Other operating expenses, net 491 508 527 494 2,020
Electronic health record incentives (25 ) (25 ) - (5 ) (55 )
Depreciation and amortization 98 100 100 100 398
Impairment of long-lived assets and goodwill, and restructuring charges, net 8 2 8 2 20
Litigation and investigation costs   11     8     5     31     55  
Operating income 254 165 79 155 653
Interest expense (118 ) (98 ) (59 ) (100 ) (375 )
Loss from early extinguishment of debt - - - (117 ) (117 )
Investment earnings   1     1     1     -     3  

Income (loss) from continuing operations, before income taxes

137 68 21 (62 ) 164
Income tax benefit (expense)   (50 )   (19 )   (4 )   12     (61 )

Income (loss) from continuing operations, before discontinued operations

87 49 17 (50 ) 103
Discontinued operations:
Loss from operations (10 ) (5 ) (2 ) (1 ) (18 )
Impairment of long-lived assets and goodwill, and restructuring charges, net - - - (6 ) (6 )
Litigation settlements, and investigation costs - - - (17 ) (17 )
Income tax benefit   5     19     -     8     32  
Income (loss) from discontinued operations   (5 )   14     (2 )   (16 )   (9 )
Net income (loss) 82 63 15 (66 ) 94
Less: Preferred stock dividends 6 6 6 6 24
Less: Net income (loss) attributable to noncontrolling interests
Continuing operations 2 3 3 3 11
Discontinued operations   1     (1 )   -     1     1  
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 73   $ 55   $ 6   $ (76 ) $ 58  
 
Amounts attributable to Tenet Healthcare Corporation common shareholders
Income (loss) from continuing operations, net of tax $ 80 $ 40 $ 8 $ (60 ) $ 68
Income (loss) from discontinued operations, net of tax   (7 )   15     (2 )   (16 )   (10 )
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 73   $ 55   $ 6   $ (76 ) $ 58  
 
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations $ 0.66 $ 0.33 $ 0.07 $ (0.55 ) $ 0.58
Discontinued operations   (0.06 )   0.12     (0.02 )   (0.15 )   (0.09 )
$ 0.60   $ 0.45   $ 0.05   $ (0.70 ) $ 0.49  
Diluted
Continuing operations $ 0.61 $ 0.32 $ 0.07 $ (0.55 ) $ 0.56
Discontinued operations   (0.05 )   0.12     (0.02 )   (0.15 )   (0.08 )
$ 0.56   $ 0.44   $ 0.05   $ (0.70 ) $ 0.48  

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

Basic 121,726 121,699 117,188 108,114 117,182
Diluted 141,295 125,937 120,908 108,114 121,295
 
 
TENET HEALTHCARE CORPORATION

SELECTED STATISTICS - CONTINUING HOSPITALS

(Unaudited)

           

 

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

Three Months Ended Year Ended
03/31/11 06/30/11 09/30/11   12/31/11   12/31/11
 
Net inpatient revenues $ 1,619 $ 1,466 $ 1,444 $ 1,499 $ 6,028
Net outpatient revenues $ 720 $ 738 $ 734 $ 736 $ 2,928
 
Number of acute care hospitals (at end of period) 49 49 49 49 49
Licensed beds (at end of period) 13,123 13,086 13,119 13,119 13,119
Average licensed beds 13,123 13,111 13,106 13,119 13,115
Utilization of licensed beds 53.8 % 50.0 % 49.1 % 48.9 % 50.4 %
Patient days 635,463 595,986 591,948 589,848 2,413,245
Adjusted patient days 948,356 912,369 909,960 902,762 3,673,447
Net inpatient revenue per patient day $ 2,548 $ 2,460 $ 2,439 $ 2,541 $ 2,498
Total admissions 131,437 125,592 125,458 125,347 507,834
Adjusted patient admissions 197,459 193,971 194,965 193,631 780,026
Net inpatient revenue per admission $ 12,318 $ 11,673 $ 11,510 $ 11,959 $ 11,870
Average length of stay (days) 4.83 4.75 4.72 4.71 4.75
Total surgeries 87,507 91,005 92,574 91,200 362,286
Outpatient visits 990,411 994,204 987,318 982,083 3,954,016
Net outpatient revenue per visit $ 727 $ 742 $ 743 $ 749 $ 741
 
Sources of net patient revenue
Medicare 23.2 % 23.5 % 22.5 % 23.1 % 23.1 %
Medicaid 11.5 % 7.5 % 8.0 % 8.6 % 9.0 %
Managed care 54.6 % 58.2 % 58.2 % 58.1 % 57.2 %
Indemnity, self-pay and other 10.7 % 10.8 % 11.3 % 10.2 % 10.7 %
 
 
TENET HEALTHCARE CORPORATION

SEGMENT REPORTING

(Unaudited)

   
December 31,   December 31,
  2012 2011
Assets
Hospital Operations and other $ 8,788 $ 8,389
Conifer   219     73  
Total $ 9,007   $ 8,462  
 

Three Months Ended
December 31,

Year Ended
December 31,

2012 2011 2012 2011
Capital expenditures:
Hospital Operations and other $ 143 $ 172 $ 495 $ 461
Conifer   5     5     13     14  
Total $ 148   $ 177   $ 508   $ 475  
 
Net operating revenues:
Hospital Operations and other $ 2,277 $ 2,150 $ 9,002 $ 8,575
Conifer
Tenet 97 69 371 261
Other customers   54     22     117     79  
2,428 2,241 9,490 8,915
Intercompany eliminations   (97 )   (69 )   (371 )   (261 )
Total $ 2,331   $ 2,172   $ 9,119   $ 8,654  
 
Adjusted EBITDA:
Hospital Operations and other $ 305 $ 271 $ 1,098 $ 1,083
Conifer   31     17     105     43  
Total $ 336   $ 288   $ 1,203   $ 1,126  
 
Depreciation and amortization:
Hospital Operations and other $ 113 $ 97 $ 420 $ 389
Conifer   3     3     10     9  
Total $ 116   $ 100   $ 430   $ 398  
 
Adjusted EBITDA $ 336 $ 288 $ 1,203 $ 1,126
Depreciation and amortization (116 )

(100

)

(430 ) (398 )
Interest expense (109 ) (100 ) (412 ) (375 )
Loss from early extinguishment of debt (4 ) (117 ) (4 ) (117 )
Litigation and investigation costs (2 ) (31 ) (5 ) (55 )
Impairments of long-lived assets (7 ) (2 ) (19 ) (20 )
Investment earnings (loss)   (1 )   -     1     3  
Income before income taxes $ 97   $ (62 ) $ 334   $ 164  
 

Due to the fact that Conifer's revenues from providing services to Tenet's hospitals were based on estimated third-party billing terms in 2012 but not in 2011, the following supplemental table presents 2012 Adjusted EBITDA on a comparable basis to the prior year's presentation.

   

Three Months Ended
December 31,

Year Ended
December 31,

2012   2011 2012   2011
Adjusted supplemental EBITDA:
Hospital Operations and other $ 327 $ 271 $ 1,167 $ 1,083
Conifer   9   17   36   43
Total $ 336 $ 288 $ 1,203 $ 1,126
 

(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) cumulative effect of changes in accounting principle, net of tax, (2) net income attributable to noncontrolling interests, (3) preferred stock dividends, (4) income (loss) from discontinued operations, net of tax, (5) income tax (expense) benefit, (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 (costs) benefit, net of insurance recoveries, (11) hurricane insurance recoveries, net of costs, (12) impairment of long-lived assets and goodwill and restructuring charges, net of insurance recoveries, 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 twelve months ended December 31, 2012 and 2011.

(2) Adjusted Free Cash Flow

Adjusted Free Cash Flow, a non-GAAP term, is defined by the Company as cash provided by (used in) operating activities less payments against reserves for restructuring charges and litigation costs, operating cashflows from discontinued operations, capital expenditures in continuing operations, and new hospital construction expenditures. The Company believes the use of Adjusted Free Cash Flow is meaningful as the use of this financial measure provides the Company and the users of its financial statements with supplemental information about the impact on the Company's cash flows from the items specified above. 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 cash flows, some of which are recurring. The Company uses this information in its analysis of its cash flows excluding items that it does not consider relevant to the liquidity 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 Free Cash Flow is a measure of liquidity that management uses in its business as an alternative to net cash provided by (used in) operating activities. Because Adjusted Free Cash Flow excludes many items that are included in our financial statements, it does not provide a complete measure of our liquidity. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company's financial performance or liquidity. The reconciliation of net cash provided by (used in) operating activities, the most comparable GAAP term, to Adjusted Free Cash Flow is set forth in the second table below for the three and twelve months ended December 31, 2012 and 2011.

 
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)
 
(Dollars in millions)   Three Months Ended
December 31,
  Year Ended
December 31,
2012   2011 2012   2011
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 49 $ (76 ) $ 141 $ 58
Less: Net (income) loss attributable to noncontrolling interests (5 ) (4 ) 19 (12 )
Preferred stock dividends - (6 ) (11 ) (24 )
Loss from discontinued operations, net of tax   (8 )   (16 )   (76 )   (9 )
Income (loss) from continuing operations 62 (50 ) 209 103
Income tax (benefit) expense (35 ) 12 (125 ) (61 )
Investment earnings (loss) (1 ) 0 1 3
Loss from early extinguishment of debt (4 ) (117 ) (4 ) (117 )
Interest expense   (109 )   (100 )   (412 )   (375 )
Operating income 211 155 749 653
Litigation and investigation costs (2 ) (31 ) (5 ) (55 )
Impairment of long-lived assets and goodwill, and restructuring charges, net (7 ) (2 ) (19 ) (20 )
Depreciation and amortization   (116 )   (100 )   (430 )   (398 )
Adjusted EBITDA $ 336   $ 288   $ 1,203   $ 1,126  
 
Net operating revenues $ 2,331   $ 2,172   $ 9,119   $ 8,654  
 
Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin) 14.4 % 13.3 % 13.2 % 13.0 %
 
 
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #2 - Reconciliation of Adjusted Free Cash Flow
(Unaudited)
 
(Dollars in millions) Three Months Ended
December 31,
Year Ended
December 31,
2012 2011 2012 2011
Net cash provided by operating activities $ 256 $ 173 $ 593 $ 497
Less: Payments against reserves for restructuring charges and litigation costs (7 ) (17 ) (63 ) (44 )
Net cash used in operating activities from discontinued operations   (16 )   (4 )   (35 )   (38 )
Adjusted net cash provided by operating activities - continuing operations 279 194 691 579
Purchases of property and equipment - continuing operations   (148 )   (173 )   (506 )   (467 )
Adjusted free cash flow - continuing operations $ 131   $ 21   $ 185   $ 112  
 
   
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
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)
 
(Dollars in millions) 2013
Low High
Net income attributable to Tenet Healthcare Corporation common shareholders $ 118 $ 234

Less:

Net (income) loss attributable to noncontrolling interests

(25 ) (15 )
Loss from discontinued operations, net of tax   (5 )   0  
Income from continuing operations $ 148 $ 249
Income tax expense (a)   (87 )   (146 )
Income from continuing operations, before income taxes $ 235 $ 395
Interest expense, net (415 ) (395 )
Loss from early extinguishment of debt   (185 )   (175 )
Operating income $ 835 $ 965
Depreciation and amortization   (490 )   (460 )
Adjusted EBITDA $ 1,325   $ 1,425  
 
Net operating revenues $ 9,800   $ 10,100  
 
Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin) 13.5 % 14.1 %
 
(a) Uses tax rate of 37% excluding unusual adjustments
 
 
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)
 
(Dollars in millions except per share amounts) 2013
Low High
Adjusted EBITDA (from Table #3) $ 1,325 $ 1,425

Depreciation and amortization

(490 ) (460 )
Interest expense, net   (415 )   (395 )
Normalized income from continuing operations before income taxes $ 420 $ 570
Income tax expense (a)   (155 )   (211 )

Normalized income from continuing operations

$ 265 $ 359
Net (income) loss attributable to noncontrolling interests   (25 )   (15 )
Normalized net income attributable to common shareholders $ 240   $ 344  
 
Fully Diluted weighted average share outstanding (in millions) 104 104
 
Normalized fully diluted earnings per share - continuing operations $ 2.31 $ 3.31
 
(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)
 
(Dollars in millions)   2013
Low   High
Net cash provided by operating activities $ 725 $ 845

Less:

Payments against reserves for restructuring charges and litigation costs

(20 ) (10 )
Net cash used in operating activities from discontinued operations   (30 )   (20 )
Adjusted net cash provided by operating activities - continuing operations $ 775 $ 875
Purchases of property and equipment - continuing operations   (600 )   (550 )
Adjusted free cash flow - continuing operations $ 175   $ 325  
 


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