Recent Updates
Recently added Catalysts
CYH

CYH Announces Third Quarter 2023 Results

Key Takeaway: Exhibit Number 99.1 Investor Contact: Kevin Hammons President and Chief Financial Officer (615) 465-7000 COMMUNITY HEALTH SYSTEMS, INC. ANNOUNCES THIRD QUARTER ENDED SEPTEMBER 30, 2023 RESULTS FRANKLIN, Tenn. (October 25, 2023) Community Health Systems, Inc. (NYSE: CYH) (

Full Press Release Details

Exhibit Number
99.1
Investor Contact: Kevin Hammons
President and
Chief Financial Officer
(615) 465-7000
COMMUNITY HEALTH SYSTEMS, INC. ANNOUNCES THIRD QUARTER
ENDED SEPTEMBER 30, 2023 RESULTS
FRANKLIN, Tenn. (October 25, 2023) Community Health Systems, Inc. (NYSE: CYH) (the Company ) today announced financial and operating results for the three and nine months ended September 30, 2023.
The following highlights the financial and operating results for the three months ended September 30, 2023.
-Net operating revenues totaled $3.086 billion.
-Net loss attributable to Community Health Systems, Inc. stockholders was $(91) million, or $(0.69) per share (diluted), compared to $(42) million, or $(0.32) per share (diluted), for the same period in 2022. Excluding the adjusting items as presented in the table in footnote (e) on page 15, net loss attributable to Community Health Systems, Inc. stockholders was $(0.33) per share (diluted), compared to $(0.52) per share (diluted) for the same period in 2022.
-Adjusted EBITDA was $360 million.
-Net cash provided by operating activities was $29 million for the three months ended September 30, 2023, compared to $137 million for the same period in 2022.
-On a same-store basis, admissions increased 3.7 percent and adjusted admissions increased 4.2 percent, compared to the same period in 2022.
Commenting on the results, Tim L. Hingtgen, chief executive officer of Community Health Systems, Inc., said, Strong volume growth in admissions, adjusted admissions, ER visits and clinic appointments during the quarter reflect successful execution of many of our key strategies, including investments in service lines, physician recruitment, capacity optimization programs, and the maturity of our transfer center services. Our local management teams are focused on ensuring access to health services for their communities and our healthcare workers continue to deliver high-quality care for their patients.
Three Months Ended September 30, 2023
Net operating revenues for the three months ended September 30, 2023, totaled $3.086 billion, a 2.0 percent increase compared to $3.025 billion for the same period in 2022. On a same-store basis, net operating revenues increased 5.1 percent for the three months ended September 30, 2023, compared to the same period in 2022. Net operating revenues for the three months ended September 30, 2023, reflect a 0.5 percent increase in admissions and a 0.4 percent increase in adjusted admissions, compared to the same period in 2022. On a same-store basis, admissions increased 3.7 percent and adjusted admissions increased 4.2 percent for the three months ended September 30, 2023, compared to the same period in 2022.
CYH Announces Third Quarter 2023 Results
Net loss attributable to Community Health Systems, Inc. stockholders was $(91) million, or $(0.69) per share (diluted), for the three months ended September 30, 2023, compared to $(42) million, or $(0.32) per share (diluted), for the same period in 2022. Excluding the adjusting items as presented in the table in footnote (e) on page 15, net loss attributable to Community Health Systems, Inc. stockholders was $(0.33) per share (diluted) for the three months ended September 30, 2023, compared to $(0.52) per share (diluted) for the same period in 2022. During the three months ended September 30, 2023, pandemic relief funds did not materially impact net loss attributable to Community Health Systems, Inc. stockholders. During the three months ended September 30, 2022, pandemic relief funds had a positive impact on net loss attributable to Community Health Systems, Inc. stockholders (both on a consolidated and adjusted basis) of approximately $84 million, or $0.65 on a per share (diluted) basis.
Adjusted EBITDA for the three months ended September 30, 2023, was $360 million compared to $400 million for the same period in 2022. During the three months ended September 30, 2023, pandemic relief funds did not materially impact Adjusted EBITDA. During the three months ended September 30, 2022, pandemic relief funds had a positive impact on Adjusted EBITDA of approximately $115 million.
The increase in net loss attributable to Community Health Systems, Inc. stockholders and the decrease in Adjusted EBITDA for the three months ended September 30, 2023, compared to the same period in 2022, is primarily due to unfavorable changes in payor mix, a reduction in pandemic relief funds recognized, higher costs for supplemental reimbursement programs, and increased rates for outsourced medical specialists, partially offset by stronger inpatient volumes and reduced expense for contract labor.
Nine months Ended September 30, 2023
Net operating revenues for the nine months ended September 30, 2023, totaled $9.308 billion, a 2.6 percent increase compared to $9.069 billion for the same period in 2022. On a same-store basis, net operating revenues increased 5.3 percent for the nine months ended September 30, 2023, compared to the same period in 2022. Net operating revenues for the nine months ended September 30, 2023, reflect a 0.9 percent increase in admissions and a 2.4 percent increase in adjusted admissions, compared to the same period in 2022. On a same-store basis, admissions increased 4.4 percent and adjusted admissions increased 6.1 percent for the nine months ended September 30, 2023, compared to the same period in 2022.
Net loss attributable to Community Health Systems, Inc. stockholders was $(180) million, or $(1.38) per share (diluted), for the nine months ended September 30, 2023, compared to $(369) million, or $(2.86) per share (diluted), for the same period in 2022. Excluding the adjusting items as presented in the table in footnote (e) on page 15, net loss attributable to Community Health Systems, Inc. stockholders was $(0.98) per share (diluted) for the nine months ended September 30, 2023, compared to $(2.92) per share (diluted) for the same period in 2022. During the nine months ended September 30, 2023, pandemic relief funds did not materially impact net loss attributable to Community Health Systems, Inc. stockholders. During the nine months ended September 30, 2022, pandemic relief funds had a positive impact on net loss attributable to Community Health Systems, Inc. stockholders (both on a consolidated and adjusted basis) of approximately $125 million, or $0.97 on a per share (diluted) basis.
Adjusted EBITDA for the nine months ended September 30, 2023, was $1.068 billion compared to $1.062 billion for the same period in 2022. During the nine months ended September 30, 2023, pandemic relief funds did not materially impact Adjusted EBITDA. During the nine months ended September 30, 2022, pandemic relief funds had a positive impact on Adjusted EBITDA of approximately $171 million.
The decrease in net loss attributable to Community Health Systems, Inc. stockholders and the increase in Adjusted EBITDA for the nine months ended September 30, 2023, compared to the same period in 2022, is primarily due to stronger inpatient and outpatient volumes, increased reimbursement rates, higher acuity, an increase in non-patient revenue, and reduced expense for contract labor, partially offset by unfavorable changes in payor mix, a reduction in pandemic relief funds recognized, increased salaries and benefits expense, higher costs for professional liability insurance, and increased rates for outsourced medical specialists.
CYH Announces Third Quarter 2023 Results
During 2023, through the date of this press release, the Company has completed the divestiture of three hospitals and the sale of a majority interest in another hospital. On January 1, 2023, the Company completed the divestiture of one hospital (in respect of which the Company received proceeds at a preliminary closing on December 31, 2022). On April 1, 2023, the Company completed the divestiture of one hospital (in respect of which the Company received proceeds at a preliminary closing on March 31, 2023). On July 1, 2023, the Company completed the divestiture of one hospital (in respect of which the Company received proceeds at a preliminary closing on June 30, 2023). On September 1, 2023, the Company completed the sale of a majority interest in one hospital. Financial and statistical data for 2023 and 2022 presented in this press release includes the operating results of divested or closed businesses for the periods prior to the consummation of the respective divestiture or closure. Same-store operating results and statistical information include operating results of businesses operated in the comparable current year and prior year periods and exclude businesses divested or closed in 2022 and the nine months ended September 30, 2023.
Information About Non-GAAP Financial Measures
This press release presents Adjusted EBITDA, a non-GAAP financial measure, which is EBITDA adjusted to add back net income attributable to noncontrolling interests and to exclude loss (gain) from early extinguishment of debt, impairment and (gain) loss on sale of businesses, expense related to the Business Transformation Costs (as defined in footnote (c) to the Financial Highlights, Financial Statements and Selected Operating Data below), gain on sale of equity interests in Macon Healthcare, LLC, expense related to government and other legal matters and related costs, income during the fourth quarter of 2021 associated with the settlement of litigation for the recovery of amounts of certain professional liability claims settled in 2020 covered by third-party insurance policies, expense related to employee termination benefits and other restructuring charges, the impact of a change in estimate to increase the professional liability claims accrual recorded during the fourth quarter of 2022 with respect to claims incurred in prior years related to divested locations and the gain on sale by HealthTrust Purchasing Group, L.P. ( HealthTrust ) of a majority interest in CoreTrust Holdings, LLC ( CoreTrust ) completed during the fourth quarter of 2022. For information regarding why the Company believes Adjusted EBITDA provides useful information to investors, and for a reconciliation of Adjusted EBITDA to net loss attributable to Community Health Systems, Inc. stockholders, see footnote (c) to the Financial Highlights, Financial Statements and Selected Operating Data below.
Additionally, this press release presents adjusted net loss attributable to Community Health Systems, Inc. stockholders per share (diluted), a non-GAAP financial measure, to reflect the impact on net loss attributable to Community Health Systems, Inc. stockholders per share (diluted) from the selected items used in the calculation of Adjusted EBITDA. For information regarding why the Company believes this non-GAAP financial measure provides useful information to investors, and for a reconciliation of this non-GAAP financial measure to net loss attributable to Community Health Systems, Inc. stockholders per share (diluted), see footnote (e) to the Financial Highlights, Financial Statements and Selected Operating Data below.
The non-GAAP financial measures set forth above are not measurements of financial performance under U.S. GAAP, and should not be considered in isolation or as a substitute for any financial measure calculated in accordance with U.S. GAAP. Additionally, the calculation of these non-GAAP financial measures may not be comparable to similarly titled measures disclosed by other companies.
CYH Announces Third Quarter 2023 Results
Included on pages 16, 17, 18, 19 and 20 of this press release are tables setting forth the Company's 2023 updated annual earnings guidance. The 2023 guidance is based on the Company's historical operating performance, current trends and other assumptions the Company believes are reasonable at this time as more specifically discussed below.
About Community Health Systems, Inc.
Community Health Systems, Inc. is one of the nation's largest healthcare companies. The Company's affiliates are leading providers of healthcare services, developing and operating healthcare delivery systems in 43 distinct markets across 15 states. As of October 25, 2023, the Company's subsidiaries own or lease 76 affiliated hospitals with over 12,000 beds and operate more than 1,000 sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.
The Company's headquarters are located in Franklin, Tennessee, a suburb south of Nashville. Shares in Community Health Systems, Inc. are traded on the New York Stock Exchange under the symbol CYH. More information about the Company can be found on its website at www.chs.net.
Community Health Systems, Inc. will hold a conference call on Thursday, October 26, 2023, at 10:00 a.m. Central, 11:00 a.m. Eastern, to review financial and operating results for the third quarter ended September 30, 2023. Investors will have the opportunity to listen to a live internet broadcast of the conference call by clicking on the Investor Relations link of the Company's website at www.chs.net. For those who cannot listen to the live broadcast, a replay will be available shortly after the call and will continue to be available for approximately 30 days. Copies of this press release and conference call slide show, as well as the Company's Current Report on Form 8-K (including this press release), will be available on the Company's website at www.chs.net.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Financial Highlights (a)(b)
(In millions, except per share amounts)
Three Months Ended Nine Months Ended
September 30, September 30,
2023 2022 2023 2022
Net operating revenues $ 3,086 $ 3,025 $ 9,308 $ 9,069
Net (loss) income (f) (52 ) - (70 ) (267 )
Net loss attributable to Community Health Systems,
Inc. stockholders (91 ) (42 ) (180 ) (369 )
Adjusted EBITDA (c) 360 400 1,068 1,062
Net cash provided by operating activities 29 137 120 291
Loss per share attributable to Community Health
Systems, Inc. stockholders:
Basic (f) $ (0.69 ) $ (0.32 ) $ (1.38 ) $ (2.86 )
Diluted (e), (f) (0.69 ) (0.32 ) (1.38 ) (2.86 )
Weighted-average number of shares outstanding (d):
Basic 131 129 130 129
Diluted 131 129 130 129
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Loss (a)(b)
(In millions, except per share amounts)
Three Months Ended September 30,
2023 2022
% of Net % of Net
Operating Operating
Amount Revenues Amount Revenues
Net operating revenues $ 3,086 100.0 % $ 3,025 100.0 %
Operating costs and expenses:
Salaries and benefits 1,338 43.4 % 1,352 44.7 %
Supplies 489 15.8 % 492 16.3 %
Other operating expenses 853 27.7 % 828 27.4 %
Lease cost and rent 79 2.6 % 80 2.6 %
Pandemic relief funds - - % (115 ) (3.8 ) %
Depreciation and amortization 128 4.1 % 137 4.5 %
Impairment and (gain) loss on sale of businesses, net (f) 26 0.8 % 47 1.6 %
Total operating costs and expenses 2,913 94.4 % 2,821 93.3 %
Income from operations (f) 173 5.6 % 204 6.7 %
Interest expense, net 208 6.8 % 217 7.2 %
Loss (gain) from early extinguishment of debt - - % (78 ) (2.6 ) %
Equity in earnings of unconsolidated affiliates (2 ) (0.1 ) % (5 ) (0.2 ) %
(Loss) income before income taxes (33 ) (1.1 ) % 70 2.3 %
Provision for income taxes 19 0.6 % 70 2.3 %
Net (loss) income (f) (52 ) (1.7 ) % - - %
Less: Net income attributable to noncontrolling interests 39 1.2 % 42 1.4 %
Net loss attributable to Community Health Systems,
Inc. stockholders $ (91 ) (2.9 ) % $ (42 ) (1.4 ) %
Loss per share attributable to Community
Health Systems, Inc. stockholders:
Basic (f) $ (0.69 ) $ (0.32 )
Diluted (e), (f) $ (0.69 ) $ (0.32 )
Weighted-average number of shares outstanding (d):
Basic 131 129
Diluted 131 129
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Loss (a)(b)
(In millions, except per share amounts)
Nine Months Ended September 30,
2023 2022
% of Net % of Net
Operating Operating
Amount Revenues Amount Revenues
Net operating revenues $ 9,308 100.0 % $ 9,069 100.0 %
Operating costs and expenses:
Salaries and benefits 4,040 43.4 % 3,972 43.8 %
Supplies 1,499 16.1 % 1,477 16.3 %
Other operating expenses 2,524 27.1 % 2,511 27.7 %
Lease cost and rent 240 2.6 % 236 2.6 %
Pandemic relief funds - - % (171 ) (1.9 ) %
Depreciation and amortization 384 4.1 % 398 4.4 %
Impairment and (gain) loss on sale of businesses, net (f) (9 ) (0.1 ) % 54 0.6 %
Total operating costs and expenses 8,678 93.2 % 8,477 93.5 %
Income from operations (f) 630 6.8 % 592 6.5 %
Interest expense, net 621 6.7 % 652 7.1 %
Loss (gain) from early extinguishment of debt - - % (73 ) (0.8 ) %
Equity in earnings of unconsolidated affiliates (5 ) (0.1 ) % (11 ) (0.1 ) %
Income before income taxes 14 0.2 % 24 0.3 %
Provision for income taxes 84 1.0 % 291 3.2 %
Net loss (f) (70 ) (0.8 ) % (267 ) (2.9 ) %
Less: Net income attributable to noncontrolling interests 110 1.1 % 102 1.2 %
Net loss attributable to Community Health Systems,
Inc. stockholders $ (180 ) (1.9 ) % $ (369 ) (4.1 ) %
Loss per share attributable to Community
Health Systems, Inc. stockholders:
Basic (f) $ (1.38 ) $ (2.86 )
Diluted (e), (f) $ (1.38 ) $ (2.86 )
Weighted-average number of shares outstanding (d):
Basic 130 129
Diluted 130 129
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Comprehensive Loss
Three Months Ended Nine Months Ended
September 30, September 30,
2023 2022 2023 2022
Net (loss) income $ (52 ) $ - $ (70 ) $ (267 )
Other comprehensive (loss) income, net of income taxes:
Net change in fair value of available-for-sale debt securities, net of tax (3 ) (6 ) (1 ) (20 )
Amortization and recognition of unrecognized pension cost components, net of tax - - - 1
Other comprehensive loss (3 ) (6 ) (1 ) (19 )
Comprehensive loss (55 ) (6 ) (71 ) (286 )
Less: Comprehensive income attributable to noncontrolling interests 39 42 110 102
Comprehensive loss attributable to Community Health
Systems, Inc. stockholders $ (94 ) $ (48 ) $ (181 ) $ (388 )
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Selected Operating Data (a)
(Dollars in millions)
Three Months Ended September 30,
Consolidated Same-Store
2023 2022 % Change 2023 2022 % Change
Number of hospitals (at end of period) 76 81 76 76
Licensed beds (at end of period) 12,494 13,309 12,494 12,443
Beds in service (at end of period) 10,621 11,559 10,621 10,712
Admissions 109,043 108,509 0.5 % 108,872 104,954 3.7 %
Adjusted admissions 249,988 248,950 0.4 % 249,743 239,721 4.2 %
Patient days 459,838 497,034 474,268 480,535
Average length of stay (days) 4.3 4.6 4.4 4.6
Occupancy rate (average beds in service) 46.8 % 46.7 % 48.4 % 48.7 %
Net operating revenues $ 3,086 $ 3,025 2.0 % $ 3,081 $ 2,931 5.1 %
Net inpatient revenues as a % of net operating
revenues 46.5 % 46.3 % 46.5 % 46.4 %
Net outpatient revenues as a % of net operating
revenues 53.5 % 53.7 % 53.5 % 53.6 %
Income from operations (f) $ 173 $ 204 -15.2 %
Income from operations as a % of net operating revenues 5.6 % 6.7 %
Depreciation and amortization $ 128 $ 137
Equity in earnings of unconsolidated affiliates $ (2 ) $ (5 )
Net loss attributable to Community Health Systems, Inc. stockholders $ (91 ) $ (42 ) -116.7 %
Net loss attributable to Community Health Systems, Inc. stockholders as a % of net operating revenues -2.9 % -1.4 %
Adjusted EBITDA (c) $ 360 $ 400 -10.0 %
Adjusted EBITDA as a % of net operating revenues 11.7 % 13.2 %
Net cash provided by operating activities $ 29 $ 137 -78.8 %
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Selected Operating Data (a)
(Dollars in millions)
Nine Months Ended September 30,
Consolidated Same-Store
2023 2022 % Change 2023 2022 % Change
Number of hospitals (at end of period) 76 81 76 76
Licensed beds (at end of period) 12,494 13,309 12,494 12,443
Beds in service (at end of period) 10,621 11,559 10,621 10,712
Admissions 327,466 324,681 0.9 % 323,679 309,921 4.4 %
Adjusted admissions 745,207 727,677 2.4 % 736,684 694,024 6.1 %
Patient days 1,453,905 1,546,477 1,449,317 1,478,304
Average length of stay (days) 4.5 4.8 4.5 4.7
Occupancy rate (average beds in service) 49.3 % 49.0 % 49.9 % 50.6 %
Net operating revenues $ 9,308 $ 9,069 2.6 % $ 9,210 $ 8,750 5.3 %
Net inpatient revenues as a % of net operating
revenues 46.9 % 46.9 % 46.8 % 47.0 %
Net outpatient revenues as a % of net operating
revenues 53.1 % 53.1 % 53.2 % 53.0 %
Income from operations (f) $ 630 $ 592 6.4 %
Income from operations as a % of net operating revenues 6.8 % 6.5 %
Depreciation and amortization $ 384 $ 398
Equity in earnings of unconsolidated affiliates $ (5 ) $ (11 )
Net loss attributable to Community
Health Systems, Inc. stockholders $ (180 ) $ (369 ) 51.2 %
Net loss attributable to Community
Health Systems, Inc. stockholders as a %
of net operating revenues -1.9 % -4.1 %
Adjusted EBITDA (c) $ 1,068 $ 1,062 0.6 %
Adjusted EBITDA as a % of net operating revenues 11.5 % 11.7 %
Net cash provided by operating activities $ 120 $ 291 -58.8 %
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Balance Sheets
(In millions, except share data)
September 30, 2023 December 31, 2022
ASSETS
Current assets
Cash and cash equivalents $ 91 $ 118
Patient accounts receivable 2,160 2,040
Supplies 325 353
Prepaid income taxes 98 99
Prepaid expenses and taxes 249 237
Other current assets 325 235
Total current assets 3,248 3,082
Property and equipment 9,367 9,639
Less accumulated depreciation and amortization (4,207 ) (4,274 )
Property and equipment, net 5,160 5,365
Goodwill 3,943 4,166
Deferred income taxes 49 49
Other asset, net 2,274 2,007
Total assets $ 14,674 $ 14,669
LIABILITIES AND STOCKHOLDERS' DEFICIT
Current liabilities
Current maturities of long-term debt $ 22 $ 21
Current operating lease liabilities 121 148
Accounts payable 837 773
Accrued liabilities:
Employee compensation 513 637
Accrued interest 184 189
Other 472 418
Total current liabilities 2,149 2,186
Long-term debt (g) 11,820 11,614
Deferred income taxes 344 354
Long-term operating lease liabilities 560 605
Other long-term liabilities 694 644
Total liabilities 15,567 15,403
Redeemable noncontrolling interests in equity of consolidated subsidiaries 329 541
STOCKHOLDERS ' DEFICIT
Community Health Systems, Inc. stockholders' deficit:
Preferred stock, $.01 par value per share, 100,000,000 shares authorized; none issued - -
Common stock, $.01 par value per share, 300,000,000 shares authorized; 136,772,094
shares issued and outstanding at September 30, 2023, and 134,703,717 shares
issued and outstanding at December 31, 2022 1 1
Additional paid-in capital 2,170 2,084
Accumulated other comprehensive loss (23 ) (21 )
Accumulated deficit (3,611 ) (3,431 )
Total Community Health Systems, Inc. stockholders' deficit (1,463 ) (1,367 )
Noncontrolling interests in equity of consolidated subsidiaries 241 92
Total stockholders ' deficit (1,222 ) (1,275 )
Total liabilities and stockholders ' deficit $ 14,674 $ 14,669
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Cash Flows
Nine Months Ended September 30,
2023 2022
Cash flows from operating activities
Net loss $ (70 ) $ (267 )
Adjustments to reconcile net loss to net cash provided by
operating activities:
Depreciation and amortization 384 398
Deferred income taxes 22 290
Stock-based compensation expense 16 14
Impairment and (gain) loss on sale of businesses, net (f) (9 ) 54
Loss (gain) from early extinguishment of debt - (73 )
Other non-cash expenses, net 132 140
Changes in operating assets and liabilities, net of effects of
acquisitions and divestitures:
Patient accounts receivable (119 ) 93
Supplies, prepaid expenses and other current assets (100 ) (94 )
Accounts payable, accrued liabilities and income taxes (69 ) (90 )
Other (67 ) (174 )
Net cash provided by operating activities 120 291
Cash flows from investing activities
Acquisitions of facilities and other related businesses (35 ) (9 )
Purchases of property and equipment (357 ) (284 )
Proceeds from disposition of hospitals and other ancillary operations 123 3
Proceeds from sale of property and equipment 27 30
Purchases of available-for-sale debt securities and equity securities (126 ) (73 )
Proceeds from sales of available-for-sale debt securities and equity securities 221 62
Distribution of CoreTrust proceeds - 121
Purchases of investments in unconsolidated affiliates (8 ) (18 )
Increase in other investments (51 ) (39 )
Net cash used in investing activities (206 ) (207 )
Cash flows from financing activities
Repurchase of restricted stock shares for payroll tax withholding requirements (4 ) (8 )
Deferred financing costs and other debt-related costs - (73 )
Proceeds from noncontrolling investors in joint ventures 4 10
Redemption of noncontrolling investments in joint ventures (1 ) (2 )
Distributions to noncontrolling investors in joint ventures (108 ) (105 )
Other borrowings 30 35
Issuance of long-term debt - 1,535
Proceeds from ABL Facility 2,290 -
Repayments of long-term indebtedness (2,152 ) (1,683 )
Net cash provided by (used in) financing activities 59 (291 )
Net change in cash and cash equivalents (27 ) (207 )
Cash and cash equivalents at beginning of period 118 507
Cash and cash equivalents at end of period $ 91 $ 300
For footnotes, see pages 13, 14 and 15.
CYH Announces Third Quarter 2023 Results
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data
(a)Both financial and statistical results include the operating results of divested or closed businesses for the periods prior to the consummation of the respective divestiture or closing. Same-store operating results and statistical information include operating results of businesses operated in the comparable current year and prior year periods and exclude businesses divested or closed in 2022 and the nine months ended September 30, 2023. There were no discontinued operations reported for 2023 and 2022.
(b)The following table provides information needed to calculate loss per share, which is adjusted for income attributable to noncontrolling interests (in millions):
Three Months Ended Nine Months Ended
September 30, September 30,
2023 2022 2023 2022
Net loss attributable to Community Health Systems, Inc. stockholders:
Net (loss) income $ (52 ) $ - $ (70 ) $ (267 )
Less: Income attributable to noncontrolling interests, net of taxes 39 42 110 102
Net loss attributable to Community Health Systems, Inc.
stockholders basic and diluted $ (91 ) $ (42 ) $ (180 ) $ (369 )
(c)EBITDA is a non-GAAP financial measure which consists of net loss attributable to Community Health Systems, Inc. before interest, income taxes, and depreciation and amortization. Adjusted EBITDA, also a non-GAAP financial measure, is EBITDA adjusted to add back net income attributable to noncontrolling interests and to exclude loss (gain) from early extinguishment of debt, impairment and (gain) loss on sale of businesses, expense from third-party consulting costs associated with significant process and systems redesign across multiple functions (the Business Transformation Costs ) as part of the Company's previously disclosed multi-year initiative to modernize and consolidate technology platforms and associated processes, gain on sale of equity interests in Macon Healthcare, LLC, expense related to government and other legal matters and related costs, income during the fourth quarter of 2021 associated with the settlement of litigation for the recovery of amounts of certain professional liability claims settled in 2020 covered by third-party insurance policies, expense related to employee termination benefits and other restructuring charges, the impact of a change in estimate to increase the professional liability claims accrual recorded during the fourth quarter of 2022 with respect to claims incurred in prior years related to divested locations and the gain on sale by HealthTrust of a majority interest in CoreTrust completed during the fourth quarter of 2022. The Company has from time to time sold noncontrolling interests in certain of its subsidiaries or acquired subsidiaries with existing noncontrolling interest ownership positions. The Company believes that it is useful to present Adjusted EBITDA because it adds back the portion of EBITDA attributable to these third-party interests. The Company reports Adjusted EBITDA as a measure of financial performance. Adjusted EBITDA is a key measure used by management to assess the operating performance of the Company's hospital operations and to make decisions on the allocation of resources. Adjusted EBITDA is also used to evaluate the performance of the Company's executive management team and is one of the primary metrics used in connection with determining short-term cash incentive compensation and the achievement of vesting criteria with respect to performance-based equity awards. In addition, management utilizes Adjusted EBITDA in assessing the Company's consolidated results of operations and operational performance and in comparing the Company's results of operations between periods.
CYH Announces Third Quarter 2023 Results
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data (Continued)
The Company believes it is useful to provide investors and other users of the Company's financial statements this performance measure to align with how management assesses the Company's results of operations. Adjusted EBITDA also is comparable to a similar metric called Consolidated EBITDA, as defined in the Company's asset-based loan facility (the ABL Facility ) and the Company's existing note indentures, which is a key component in the determination of the Company's compliance with certain covenants under the ABL Facility and such note indentures (including the Company's ability to service debt and incur capital expenditures), and is used to determine the interest rate and commitment fee payable under the ABL Facility (although Adjusted EBITDA does not include all of the adjustments described in the ABL Facility). Adjusted EBITDA includes the Adjusted EBITDA attributable to hospitals that were divested during the course of such year, but in each case solely to the extent relating to the period prior to the consummation of the applicable divestiture.
Adjusted EBITDA is not a measurement of financial performance under U.S. GAAP. It should not be considered in isolation or as a substitute for net income, operating income, or any other performance measure calculated in accordance with U.S. GAAP. The items excluded from Adjusted EBITDA are significant components in understanding and evaluating financial performance. The Company believes such adjustments are appropriate as the magnitude and frequency of such items can vary significantly and are not related to the assessment of normal operating performance. Additionally, this calculation of Adjusted EBITDA may not be comparable to similarly titled measures disclosed by other companies.
The following table reflects the reconciliation of Adjusted EBITDA, as defined, to net loss attributable to Community Health Systems, Inc. stockholders as derived directly from the condensed consolidated financial statements (in millions):
Three Months Ended Nine Months Ended
September 30, September 30,
2023 2022 2023 2022
Net loss attributable to Community Health
Systems, Inc. stockholders $ (91 ) $ (42 ) $ (180 ) $ (369 )
Adjustments:
Provision for income taxes 19 70 84 291
Depreciation and amortization 128 137 384 398
Net income attributable to noncontrolling interests 39 42 110 102
Interest expense, net 208 217 621 652
Loss (gain) from early extinguishment of debt - (78 ) - (73 )
Impairment and (gain) loss on sale of businesses, net 26 47 (9 ) 54
Expense from government and other legal matters and related costs 24 5 33 5
Expense from business transformation costs 6 - 13 -
Expense related to employee termination benefits and other restructuring charges 1 2 12 2
Adjusted EBITDA $ 360 $ 400 $ 1,068 $ 1,062
(d)The following table sets forth components reconciling the basic weighted-average number of shares to the diluted weighted-average number of shares (in millions):
Three Months Ended Nine Months Ended
September 30, September 30,
2023 2022 2023 2022
Weighted-average number of shares outstanding - basic 131 129 130 129
Add effect of dilutive securities:
Stock awards and options - - - -
Weighted-average number of shares outstanding - diluted 131 129 130 129
CYH Announces Third Quarter 2023 Results
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data (Continued)
The Company generated a net loss attributable to Community Health Systems, Inc. stockholders for each of the three and nine-month periods ended September 30, 2023 and 2022, so the effect of dilutive securities is not considered because their effect would be antidilutive. If the Company had generated net income, the effect of stock awards and options on the diluted shares calculation would have been an increase of 224,178 shares and 565,641 shares during the three months ended September 30, 2023 and 2022, respectively, and 298,184 shares and 1,305,604 shares during the nine months ended September 30, 2023 and 2022, respectively.
(e)The following supplemental table reconciles net loss attributable to Community Health Systems, Inc. stockholders, as reported, on a per share (diluted) basis, to net loss attributable to Community Health Systems, Inc. stockholders per share (diluted) with the adjustments described herein (total per share amounts may not add due to rounding). The Company believes that the presentation of non-GAAP adjusted net loss attributable to Community Health Systems, Inc. stockholders per share (diluted) presents useful information to investors by highlighting the impact on net loss attributable to Community Health Systems, Inc. stockholders per share (diluted) of selected items used in calculating Adjusted EBITDA which may not reflect the Company's underlying operating performance and assisting in comparing the Company's results of operations between periods.
Three Months Ended Nine Months Ended
September 30, September 30,
2023 2022 2023 2022
Net loss per share (diluted), as reported $ (0.69 ) $ (0.32 ) $ (1.38 ) $ (2.86 )
Adjustments:
Loss (gain) from early extinguishment of debt - (0.53 ) - (0.42 )
Impairment and (gain) loss on sale of businesses, net 0.18 0.28 0.05 0.33
Expense from government and other legal matters and related costs 0.14 0.03 0.20 0.03
Expense from business transformation costs 0.04 - 0.08 -
Expense related to employee termination benefits and other restructuring charges 0.01 0.01 0.07 0.01
Net loss per share (diluted), excluding adjustments $ (0.33 ) $ (0.52 ) $ (0.98 ) $ (2.92 )
Last updated: Oct 25, 2023