Full Press Release Details
Tenet Reports Results for the Second Quarter Ended June 30, 2019
DALLAS - Aug. 5, 2019 - Tenet Healthcare Corporation (NYSE: THC) reported net income from continuing operations attributable to Tenet common shareholders of $15 million in the second quarter of 2019 compared to net income of $24 million in the second quarter of 2018. Adjusted EBITDA was $657 million in the second quarter of 2019 above the midpoint of the Company's Outlook range of $625 million to $675 million.
Ronald A. Rittenmeyer, Executive Chairman and CEO, said, "We delivered another strong quarter which included a very meaningful improvement in volume growth in our hospital portfolio, continued volume and earnings growth at USPI and strong financial results at Conifer. We are continuing to take appropriate actions to improve our cost structure and our focus on improving volume growth is showing results."
Results for the Quarter Ended June 30, 2019
Tenet reported net income from continuing operations attributable to Tenet common shareholders of $15 million, or $0.14 per diluted share, in the second quarter of 2019 compared to net income of $24 million, or $0.23 per diluted share, in the second quarter of 2018.
After adjusting for the items listed on Table #2, Tenet produced Adjusted net income from continuing operations available to Tenet common shareholders of $59 million, or $0.56 per diluted share, in the second quarter of 2019, compared to $51 million, or $0.49 per diluted share, in the second quarter of 2018.
Adjusted EBITDA was $657 million in the second quarter of 2019 compared to $634 million in the second quarter of 2018, an increase of 3.6 percent. Results in the second quarter of 2019 included $13 million of additional expense in the Hospital Operations and other segment due to a decline in the treasury rate utilized to discount our actuarial liabilities compared to a $4 million benefit in the second quarter of 2018.
Reconciliations of GAAP net income available (loss attributable) to Tenet common shareholders to Adjusted net income available (loss attributable) from continuing operations, Adjusted diluted earnings (loss) per share from continuing operations and Adjusted EBITDA are contained in Tables #1 and #2 at the end of this release.
Hospital Operations and Other Segment
Net operating revenues in the Hospital Operations and other segment were $3.827 billion in the second quarter of 2019, up 2.5 percent from the second quarter of 2018. The increase in revenue was primarily due to revenue growth on a same-hospital basis, partially offset by hospital divestitures.
On a same-hospital basis, net patient service revenues were $3.547 billion in the second quarter of 2019, up 5.7 percent from the second quarter of 2018. Admissions increased 3.3 percent on a same-hospital basis, adjusted admissions increased 2.2 percent and revenue per adjusted admission increased 3.4 percent.
Adjusted EBITDA in Tenet's hospital segment was $347 million in the second quarter of 2019 compared to $345 million in the second quarter of 2018.
Selected operating expenses in the Hospital Operations and other segment increased 3.5 percent on a per adjusted admission basis in the second quarter of 2019. Selected operating expenses include salaries, wages and benefits, supplies and other operating expenses and exclude the costs of the Company's health plan businesses. Salaries, wages and benefits increased 3.4 percent per adjusted admission in the second quarter of 2019, supply expense increased 1.2 percent and other operating expenses increased 5.3 percent.
Ambulatory Care Segment
The Ambulatory Care segment produced net operating revenues of $524 million in the second quarter of 2019, a decrease of 1.3 percent compared to $531 million in the second quarter of 2018. The decline in revenue was due to the divestiture of Aspen Healthcare, the Company's former business in the U.K. that was sold in the third quarter of 2018. Aspen generated $47 million of revenue and $7 million of Adjusted EBITDA and Adjusted EBITDA less facility-level noncontrolling interest in the second quarter of 2018. After normalizing for the divestiture of Aspen, the Ambulatory Care segment generated Adjusted EBITDA of $207 million in the second quarter of 2019, up 8.4 percent from $191 million in the second quarter of 2018 and Adjusted EBITDA less facility-level noncontrolling interest was $132 million, up 9.1 percent from $121 million in the second quarter of 2018.
The results of many of the facilities in which the Ambulatory Care segment has an investment are not consolidated by Tenet (of the 344 facilities at June 30, 2019, the results of 112 were accounted for under the equity method for unconsolidated affiliates). To help analyze the segment's results of operations, management uses system-wide measures, which include revenues and cases of both consolidated and unconsolidated facilities. On a same-facility system-wide basis, revenue in the Ambulatory Care segment increased 5.3 percent in the second quarter of 2019, with cases increasing 3.2 percent and revenue per case increasing 2.0 percent. In the surgical business, which represents the majority of the revenue in the Ambulatory segment, same-facility system-wide revenue grew 5.2 percent in the second quarter of 2019, with cases up 2.6 percent and revenue per case up 2.5 percent.
Conifer generated $103 million of Adjusted EBITDA in the second quarter of 2019, up 13.2 percent from $91 million in the second quarter of 2018. Adjusted EBITDA margins increased 540 basis points to 29.0 percent, reflecting ongoing improvements in Conifer's cost structure as well as $13 million of annual service performance incentive revenues from customers that were recognized in the second quarter of 2019.
During the second quarter of 2019, Conifer's revenue declined 8.0 percent to $355 million, from $386 million in the second quarter of 2018, primarily due to client attrition following divestitures by Tenet and other customers. Revenue from third-party customers declined 13.6 percent to $209 million in the second quarter of 2019.
Results for the Six Months Ended June 30, 2019
Tenet reported a net loss from continuing operations attributable to Tenet common shareholders of $12 million, or $0.12 per diluted share, in the first half of 2019 compared to net income of $122 million, or $1.18 per diluted share, in the first half of 2018. The 2019 period included a $47 million pre-tax loss from the extinguishment of debt or $0.45 per diluted share. The 2018 period included a $118 million pre-tax gain, or $1.15 per diluted share, from the sales, consolidation and deconsolidation of facilities.
After adjusting for the items listed on Table #2, Tenet produced Adjusted net income from continuing operations available to Tenet common shareholders of $115 million, or $1.10 per diluted share, in the first half of 2019, compared to $110 million, or $1.06 per diluted share, in the first half of 2018.
Adjusted EBITDA was $1.270 billion in the first half of 2019 compared to $1.299 billion in the first half of 2018, a decline of $29 million or 2.2 percent. The decline was primarily attributable to: (i) a $37 million year-over-year increase in expense due to a decline in the treasury rate used to discount the Company's actuarial liabilities; (ii) $15 million of lower earnings related to a risk-based contracting business in California; and, (iii) the divestiture of Aspen Healthcare, which generated $14 million of Adjusted EBITDA in the first half of 2018.
Hospital Operations and Other Segment
Net operating revenues in the Hospital Operations and other segment were $7.689 billion in the first half of 2019, essentially flat with the first half of 2018.
On a same-hospital basis, net patient service revenues were $7.104 billion in the first half of 2019, up 3.7 percent from the first half of 2018. Admissions increased 1.6 percent on a same-hospital basis in the first half of 2019, adjusted admissions increased 1.4 percent and revenue per adjusted admission increased 2.3 percent.
Adjusted EBITDA in Tenet's hospital segment was $684 million in the first half of 2019 compared to $747 million in the first half of 2018. The $63 million decline was primarily due to: (i) a $37 million year-over-year increase in expense due to a decline in the treasury rate used to discount the Company's actuarial liabilities; and, (ii) $15 million of lower earnings related to a risk-based contracting business in California.
Selected operating expenses in the Hospital Operations and other segment increased 3.7 percent on a per adjusted admission basis in the first half of 2019. Selected operating expenses include salaries, wages and benefits, supplies and other operating expenses and exclude the costs of the Company's health plan businesses. Salaries, wages and benefits increased 3.1 percent per adjusted admission in the first half of 2019, supply expense increased 0.6 percent and other operating expenses increased 7.3 percent.
Ambulatory Care Segment
The Ambulatory Care segment produced net operating revenues of $1.004 billion in the first half of 2019, a decrease of 2.4 percent compared to $1.029 billion in the first half of 2018. The decline in revenue was due to the divestiture of Aspen Healthcare, the Company's former business in the U.K. that was sold in the third quarter of 2018. Aspen generated $96 million of revenue and $14 million of Adjusted EBITDA and Adjusted EBITDA less facility-level noncontrolling interest in the first half of 2018. After normalizing for the divestiture of Aspen, the Ambulatory Care segment generated Adjusted EBITDA of $384 million in the first half of 2019, up 10.0 percent from $349 million in the first half of 2018 and Adjusted EBITDA less facility-level noncontrolling interest was $244 million, up 9.4 percent from $223 million in the first half of 2018.
On a same-facility system-wide basis, revenue in the Ambulatory Care segment increased 4.8 percent in the first half of 2019, with cases increasing 2.1 percent and revenue per case increasing 2.7 percent. In the surgical business, which represents the majority of the revenue in the Ambulatory segment, same-facility system-wide revenue grew 4.7 percent in the first half of 2019, with cases up 2.7 percent and revenue per case up 2.0 percent.
Conifer generated $202 million of Adjusted EBITDA in the first half of 2019, up 6.9 percent from $189 million in the first half of 2018. Adjusted EBITDA margins increased 480 basis points to 28.7 percent, reflecting ongoing improvements in Conifer's cost structure.
During the first half of 2019, Conifer's revenue declined 10.9 percent to $704 million, from $790 million in the first half of 2018 primarily due to client attrition following divestitures by Tenet and other customers. Revenue from third-party customers declined 16.9 percent to $412 million in the first half of 2019.
Cash Flow and Liquidity
Cash and cash equivalents were $249 million at June 30, 2019 compared to $252 million at March 31, 2019. The Company had $190 million of outstanding borrowings on its $1 billion credit line as of June 30, 2019. Accounts receivable days outstanding from continuing operations were 58.4 at June 30, 2019 compared to 58.6 at March 31, 2019.
Net cash provided by operating activities was $294 million in the first half of 2019, representing a $167 million decrease compared to $461 million in the first half of 2018. After subtracting $336 million and $268 million of capital expenditures in the first half of 2019 and 2018, respectively, Free Cash Flow was an outflow of $42 million in the first half of 2019, a decrease of $235 million compared to Free Cash Flow of $193 million in the first half of 2018. Adjusted Free Cash Flow was $43 million in the first half of 2019, representing a $216 million decrease from $259 million of Adjusted Free Cash Flow in the first half of 2018.
Net cash used in investing activities was $303 million in the first half of 2019 compared to $225 million of net cash provided by investing activities in the first half of 2018. Results in the first half of 2019 included $66 million of proceeds from the sales of facilities, long-term investments and other assets compared to $624 million in the first half of 2018.
Net cash used in financing activities was $153 million in the first half of 2019 compared to $894 million used in the first half of 2018 when the Company invested $630 million in cash to increase its ownership in USPI from 80% to 95%.
Reconciliations of net cash provided by operating activities to both Free Cash Flow and Adjusted Free Cash Flow are contained in Table #3 at the end of this release.
The Company's Outlook for 2019 includes:
The Outlook for 2019 assumes California Provider Fee revenues of approximately $260 million, equity in earnings of unconsolidated affiliates of $180 million to $190 million, depreciation and amortization expense of $820 million to $840 million, interest expense of $985 million to $995 million, net income available to noncontrolling interests of $410 million to $430 million and an average diluted share count of 106 million.
The Company's Outlook for the third quarter of 2019 includes:
The Outlook for the third quarter assumes California Provider Fee revenues of approximately $65 million, equity in earnings of unconsolidated affiliates of $40 million to $45 million, depreciation and amortization expense of $200 million to $210 million, interest expense of $240 million to $250 million, net income available to noncontrolling interests of $95 million to $105 million, and an average diluted share count of 106 million.
Additional details on Tenet's Outlook for both the third quarter and calendar year 2019 are available in Tables #4, #5 and #6 at the end of this press release and in an accompanying slide presentation that will be accessible through the Company's website at www.tenethealth.com/investors.
Management's Webcast Discussion of Second Quarter Results
Tenet management will discuss the Company's second quarter 2019 results on a webcast scheduled for 10:00 a.m. Eastern Time (9:00 a.m. Central Time) on August 6, 2019. Investors can access the webcast through the Company's website at www.tenethealth.com/investors. A set of slides, which will be referred to on the conference call, will be available on the Company's website.
Additional information regarding Tenet's quarterly results of operations is contained in its Form 10-Q report for the period ended June 30, 2019, which will be filed with the Securities and Exchange Commission and posted on the Company's website.
This press release includes certain non-GAAP measures, such as Adjusted EBITDA, Adjusted net income available (loss attributable) from continuing operations to Tenet common shareholders, Adjusted diluted earnings (loss) per share from continuing operations, Free Cash Flow and Adjusted Free Cash Flow. Reconciliations of these measures to the most comparable GAAP measures are contained in the tables at the end of this release.
Tenet Healthcare Corporation (NYSE: THC) is a national diversified healthcare services company headquartered in Dallas with 110,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 500 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other outpatient facilities. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other customers. At the center of everything we do is a commitment to deliver the right care, in the right place, at the right time, and to continually improve and advance the healthcare delivery system in the markets we serve. For more information, please visit www.tenethealth.com.
This release 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," "assume," "believe," "budget," "estimate," "forecast," "intend," "plan," "predict," "project," "seek," "see," "target," 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 factors disclosed under "Forward-Looking Statements" and "Risk Factors" in our Form 10-K for the year ended December 31, 2018, and subsequent Form 10-Q filings and other filings with the Securities and Exchange Commission.
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
| (Dollars in millions except per share amounts) | Three Months Ended June 30, | ||||||||||||||||
| 2019 | % | 2018 | % | Change | |||||||||||||
| Net operating revenues | $ | 4,560 | 100.0 | % | $ | 4,506 | 100.0 | % | 1.2 | % | |||||||
| Equity in earnings of unconsolidated affiliates | 42 | 0.9 | % | 39 | 0.9 | % | 7.7 | % | |||||||||
| Operating expenses: | |||||||||||||||||
| Salaries, wages and benefits | 2,148 | 47.1 | % | 2,135 | 47.4 | % | 0.6 | % | |||||||||
| Supplies | 753 | 16.5 | % | 748 | 16.6 | % | 0.7 | % | |||||||||
| Other operating expenses, net | 1,044 | 22.9 | % | 1,027 | 22.8 | % | 1.7 | % | |||||||||
| Electronic health record incentives | - | - | % | - | - | % | - | % | |||||||||
| Depreciation and amortization | 214 | 4.7 | % | 194 | 4.3 | % | |||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 36 | 0.8 | % | 30 | 0.7 | % | |||||||||||
| Litigation and investigation costs | 18 | 0.4 | % | 13 | 0.3 | % | |||||||||||
| Net losses (gains) on sales, consolidation and deconsolidation of facilities | 1 | - | % | (8 | ) | (0.2 | )% | ||||||||||
| Operating income | 388 | 8.5 | % | 406 | 9.0 | % | |||||||||||
| Interest expense | (247 | ) | (254 | ) | |||||||||||||
| Other non-operating expense, net | (1 | ) | (1 | ) | |||||||||||||
| Loss from early extinguishment of debt | - | (1 | ) | ||||||||||||||
| Income from continuing operations, before income taxes | 140 | 150 | |||||||||||||||
| Income tax expense | (30 | ) | (44 | ) | |||||||||||||
| Income from continuing operations, before discontinued operations | 110 | 106 | |||||||||||||||
| Discontinued operations: | |||||||||||||||||
| Income from operations | 2 | 2 | |||||||||||||||
| Income tax expense | - | - | |||||||||||||||
| Income from discontinued operations | 2 | 2 | |||||||||||||||
| Net income | 112 | 108 | |||||||||||||||
| Less: Net income available to noncontrolling interests | 95 | 82 | |||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 17 | $ | 26 | |||||||||||||
| Amounts available to Tenet Healthcare Corporation common shareholders | |||||||||||||||||
| Income from continuing operations, net of tax | $ | 15 | $ | 24 | |||||||||||||
| Income from discontinued operations, net of tax | 2 | 2 | |||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 17 | $ | 26 | |||||||||||||
| Earnings per share available to Tenet Healthcare Corporation common shareholders: | |||||||||||||||||
| Basic | |||||||||||||||||
| Continuing operations | $ | 0.15 | $ | 0.23 | |||||||||||||
| Discontinued operations | 0.02 | 0.02 | |||||||||||||||
| $ | 0.17 | $ | 0.25 | ||||||||||||||
| Diluted | |||||||||||||||||
| Continuing operations | $ | 0.14 | $ | 0.23 | |||||||||||||
| Discontinued operations | 0.02 | 0.02 | |||||||||||||||
| $ | 0.16 | $ | 0.25 | ||||||||||||||
| Weighted average shares and dilutive securities outstanding (in thousands): | |||||||||||||||||
| Basic | 103,198 | 102,147 | |||||||||||||||
| Diluted* | 104,629 | 104,177 |
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
| (Dollars in millions except per share amounts) | Six Months Ended June 30, | ||||||||||||||||
| 2019 | % | 2018 | % | Change | |||||||||||||
| Net operating revenues | $ | 9,105 | 100.0 | % | $ | 9,205 | 100.0 | % | (1.1 | )% | |||||||
| Equity in earnings of unconsolidated affiliates | 76 | 0.8 | % | 64 | 0.7 | % | 18.8 | % | |||||||||
| Operating expenses: | |||||||||||||||||
| Salaries, wages and benefits | 4,301 | 47.3 | % | 4,362 | 47.5 | % | (1.4 | )% | |||||||||
| Supplies | 1,494 | 16.4 | % | 1,522 | 16.5 | % | (1.8 | )% | |||||||||
| Other operating expenses, net | 2,118 | 23.3 | % | 2,087 | 22.7 | % | 1.5 | % | |||||||||
| Electronic health record incentives | (1 | ) | - | % | (1 | ) | - | % | - | % | |||||||
| Depreciation and amortization | 422 | 4.6 | % | 398 | 4.3 | % | |||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 55 | 0.6 | % | 77 | 0.8 | % | |||||||||||
| Litigation and investigation costs | 31 | 0.3 | % | 19 | 0.2 | % | |||||||||||
| Net losses (gains) on sales, consolidation and deconsolidation of facilities | 2 | - | % | (118 | ) | (1.3 | )% | ||||||||||
| Operating income | 759 | 8.3 | % | 923 | 10.0 | % | |||||||||||
| Interest expense | (498 | ) | (509 | ) | |||||||||||||
| Other non-operating expense, net | - | (2 | ) | ||||||||||||||
| Loss from early extinguishment of debt | (47 | ) | (2 | ) | |||||||||||||
| Income from continuing operations, before income taxes | 214 | 410 | |||||||||||||||
| Income tax expense | (47 | ) | (114 | ) | |||||||||||||
| Income from continuing operations, before discontinued operations | 167 | 296 | |||||||||||||||
| Discontinued operations: | |||||||||||||||||
| Income from operations | 12 | 3 | |||||||||||||||
| Income tax expense | (2 | ) | - | ||||||||||||||
| Income from discontinued operations | 10 | 3 | |||||||||||||||
| Net income | 177 | 299 | |||||||||||||||
| Less: Net income available to noncontrolling interests | 179 | 174 | |||||||||||||||
| Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | (2 | ) | $ | 125 | ||||||||||||
| Amounts available (attributable) to Tenet Healthcare Corporation common shareholders | |||||||||||||||||
| Income (loss) from continuing operations, net of tax | $ | (12 | ) | $ | 122 | ||||||||||||
| Income from discontinued operations, net of tax | 10 | 3 | |||||||||||||||
| Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | (2 | ) | $ | 125 | ||||||||||||
| Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | |||||||||||||||||
| Basic | |||||||||||||||||
| Continuing operations | $ | (0.12 | ) | $ | 1.20 | ||||||||||||
| Discontinued operations | 0.10 | 0.03 | |||||||||||||||
| $ | (0.02 | ) | $ | 1.23 | |||||||||||||
| Diluted | |||||||||||||||||
| Continuing operations | $ | (0.12 | ) | $ | 1.18 | ||||||||||||
| Discontinued operations | 0.10 | 0.03 | |||||||||||||||
| $ | (0.02 | ) | $ | 1.21 | |||||||||||||
| Weighted average shares and dilutive securities outstanding (in thousands): | |||||||||||||||||
| Basic | 102,993 | 101,770 | |||||||||||||||
| Diluted* | 102,993 | 103,416 |
*Had we generated income from continuing operations available to common shareholders in the six months ended June 30, 2019 the effect of employee stock options, restricted stock units and deferred compensation units on the diluted shares calculation would have been an increase of 1,592 thousand shares.
TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
| June 30, | December 31, | |||||||
| (Dollars in millions) | 2019 | 2018 | ||||||
| ASSETS | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 249 | $ | 411 | ||||
| Accounts receivable | 2,734 | 2,595 | ||||||
| Inventories of supplies, at cost | 309 | 305 | ||||||
| Income tax receivable | 19 | 21 | ||||||
| Assets held for sale | - | 107 | ||||||
| Other current assets | 1,393 | 1,197 | ||||||
| Total current assets | 4,704 | 4,636 | ||||||
| Investments and other assets | 2,297 | 1,456 | ||||||
| Deferred income taxes | 268 | 312 | ||||||
| Property and equipment, at cost, less accumulated depreciation and amortization | 6,995 | 6,993 | ||||||
| Goodwill | 7,298 | 7,281 | ||||||
| Other intangible assets, at cost, less accumulated amortization | 1,645 | 1,731 | ||||||
| Total assets | $ | 23,207 | $ | 22,409 | ||||
| LIABILITIES AND EQUITY | ||||||||
| Current liabilities: | ||||||||
| Current portion of long-term debt | $ | 664 | $ | 182 | ||||
| Accounts payable | 1,088 | 1,207 | ||||||
| Accrued compensation and benefits | 720 | 838 | ||||||
| Professional and general liability reserves | 228 | 216 | ||||||
| Accrued interest payable | 233 | 240 | ||||||
| Liabilities held for sale | - | 43 | ||||||
| Other current liabilities | 1,217 | 1,131 | ||||||
| Total current liabilities | 4,150 | 3,857 | ||||||
| Long-term debt, net of current portion | 14,312 | 14,644 | ||||||
| Professional and general liability reserves | 669 | 666 | ||||||
| Defined benefit plan obligations | 507 | 521 | ||||||
| Deferred income taxes | 36 | 36 | ||||||
| Other long-term liabilities | 1,354 | 578 | ||||||
| Total liabilities | 21,028 | 20,302 | ||||||
| Commitments and contingencies | ||||||||
| Redeemable noncontrolling interests in equity of consolidated subsidiaries | 1,462 | 1,420 | ||||||
| Equity: | ||||||||
| Shareholders' equity: | ||||||||
| Common stock | 7 | 7 | ||||||
| Additional paid-in capital | 4,755 | 4,747 | ||||||
| Accumulated other comprehensive loss | (219) | (223) | ||||||
| Accumulated deficit | (2,237) | (2,236) | ||||||
| Common stock in treasury, at cost | (2,414) | (2,414) | ||||||
| Total shareholders' deficit | (108) | (119) | ||||||
| Noncontrolling interests | 825 | 806 | ||||||
| Total equity | 717 | 687 | ||||||
| Total liabilities and equity | $ | 23,207 | $ | 22,409 |
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF CASH FLOWS
| Six Months Ended | ||||||||
| (Dollars in millions) | June 30, | |||||||
| 2019 | 2018 | |||||||
| Net income | $ | 177 | $ | 299 | ||||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
| Depreciation and amortization | 422 | 398 | ||||||
| Deferred income tax expense | 42 | 108 | ||||||
| Stock-based compensation expense | 23 | 20 | ||||||
| Impairment and restructuring charges, and acquisition-related costs | 55 | 77 | ||||||
| Litigation and investigation costs | 31 | 19 | ||||||
| Net losses (gains) on sales, consolidation and deconsolidation of facilities | 2 | (118 | ) | |||||
| Loss from early extinguishment of debt | 47 | 2 | ||||||
| Equity in earnings of unconsolidated affiliates, net of distributions received | (2 | ) | 10 | |||||
| Amortization of debt discount and debt issuance costs | 21 | 22 | ||||||
| Pre-tax income from discontinued operations | (12 | ) | (3 | ) | ||||
| Other items, net | (10 | ) | (1 | ) | ||||
| Changes in cash from operating assets and liabilities: | ||||||||
| Accounts receivable | (138 | ) | (13 | ) | ||||
| Inventories and other current assets | (64 | ) | 144 | |||||
| Income taxes | (2 | ) | (18 | ) | ||||
| Accounts payable, accrued expenses and other current liabilities | (217 | ) | (371 | ) | ||||
| Other long-term liabilities | 4 | (48 | ) | |||||
| Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (80 | ) | (63 | ) | ||||
| Net cash used in operating activities from discontinued operations, excluding income taxes | (5 | ) | (3 | ) | ||||
| Net cash provided by operating activities | 294 | 461 | ||||||
| Cash flows from investing activities: | ||||||||
| Purchases of property and equipment - continuing operations | (336 | ) | (268 | ) | ||||
| Purchases of businesses or joint venture interests, net of cash acquired | (13 | ) | (89 | ) | ||||
| Proceeds from sales of facilities and other assets - continuing operations | 40 | 481 | ||||||
| Proceeds from sales of facilities and other assets - discontinued operations | 17 | - | ||||||
| Proceeds from sales of marketable securities, long-term investments and other assets | 9 | 143 | ||||||
| Purchases of equity investments | (9 | ) | (37 | ) | ||||
| Other long-term assets | (4 | ) | 3 | |||||
| Other items, net | (7 | ) | (8 | ) | ||||
| Net cash provided by (used in) investing activities | (303 | ) | 225 | |||||
| Cash flows from financing activities: | ||||||||
| Repayments of borrowings under credit facility | (1,095 | ) | (360 | ) | ||||
| Proceeds from borrowings under credit facility | 1,285 | 360 | ||||||
| Repayments of other borrowings | (1,668 | ) | (161 | ) | ||||
| Proceeds from other borrowings | 1,516 | 14 | ||||||
| Debt issuance costs | (18 | ) | - | |||||
| Distributions paid to noncontrolling interests | (144 | ) | (140 | ) | ||||
| Proceeds from sales of noncontrolling interests | 9 | 7 | ||||||
| Purchases of noncontrolling interests | (6 | ) | (642 | ) | ||||
| Proceeds from exercise of stock options and employee stock purchase plan | 3 | 14 | ||||||
| Other items, net | (35 | ) | 14 | |||||
| Net cash used in financing activities | (153 | ) | (894 | ) | ||||
| Net decrease in cash and cash equivalents | (162 | ) | (208 | ) | ||||
| Cash and cash equivalents at beginning of period | 411 | 611 | ||||||
| Cash and cash equivalents at end of period | $ | 249 | $ | 403 | ||||
| Supplemental disclosures: | ||||||||
| Interest paid, net of capitalized interest | $ | (484 | ) | $ | (501 | ) | ||
| Income tax payments, net | $ | (13 | ) | $ | (21 | ) |
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING TOTAL HOSPITALS(1)
| (Dollars in millions except per adjusted patient day | Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||||
| and per adjusted patient admission amounts) | 2019 | 2018 | Change | 2019 | 2018 | Change | |||||||||||||||||
| Admissions, Patient Days and Surgeries | |||||||||||||||||||||||
| Number of hospitals (at end of period) | 65 | 68 | (3 | ) | * | 65 | 68 | (3 | ) | * | |||||||||||||
| Total admissions | 169,352 | 168,453 | 0.5 | % | 344,078 | 350,759 | (1.9 | )% | |||||||||||||||
| Adjusted patient admissions | 304,066 | 306,063 | (0.7 | )% | 612,199 | 626,931 | (2.3 | )% | |||||||||||||||
| Paying admissions (excludes charity and uninsured) | 159,128 | 158,216 | 0.6 | % | 323,921 | 330,706 | (2.1 | )% | |||||||||||||||
| Charity and uninsured admissions | 10,224 | 10,237 | (0.1 | )% | 20,157 | 20,053 | 0.5 | % | |||||||||||||||
| Admissions through emergency department | 121,088 | 115,036 | 5.3 | % | 247,167 | 240,112 | 2.9 | % | |||||||||||||||
| Paying admissions as a percentage of total admissions | 94.0 | % | 93.9 | % | 0.1 | % | * | 94.1 | % | 94.3 | % | (0.2 | )% | * | |||||||||
| Charity and uninsured admissions as a percentage of total admissions | 6.0 | % | 6.1 | % | (0.1 | )% | * | 5.9 | % | 5.7 | % | 0.2 | % | * | |||||||||
| Emergency department admissions as a percentage of total admissions | 71.5 | % | 68.3 | % | 3.2 | % | * | 71.8 | % | 68.5 | % | 3.3 | % | * | |||||||||
| Surgeries - inpatient | 44,641 | 46,274 | (3.5 | )% | 89,436 | 93,497 | (4.3 | )% | |||||||||||||||
| Surgeries - outpatient | 60,936 | 63,805 | (4.5 | )% | 119,154 | 126,813 | (6.0 | )% | |||||||||||||||
| Total surgeries | 105,577 | 110,079 | (4.1 | )% | 208,590 | 220,310 | (5.3 | )% | |||||||||||||||
| Patient days - total | 787,582 | 766,519 | 2.7 | % | 1,609,661 | 1,625,167 | (1.0 | )% | |||||||||||||||
| Adjusted patient days | 1,387,929 | 1,373,480 | 1.1 | % | 2,808,099 | 2,859,619 | (1.8 | )% | |||||||||||||||
| Average length of stay (days) | 4.65 | 4.55 | 2.2 | % | 4.68 | 4.63 | 1.1 | % | |||||||||||||||
| Licensed beds (at end of period) | 17,221 | 18,314 | (6.0 | )% | 17,221 | 18,314 | (6.0 | )% | |||||||||||||||
| Average licensed beds | 17,221 | 18,362 | (6.2 | )% | 17,338 | 18,523 | (6.4 | )% | |||||||||||||||
| Utilization of licensed beds | 50.3 | % | 45.9 | % | 4.4 | % | * | 51.3 | % | 48.5 | % | 2.8 | % | * | |||||||||
| Outpatient Visits | |||||||||||||||||||||||
| Total visits | 1,693,805 | 1,749,847 | (3.2 | )% | 3,408,197 | 3,592,386 | (5.1 | )% | |||||||||||||||
| Paying visits (excludes charity and uninsured) | 1,581,530 | 1,633,372 | (3.2 | )% | 3,185,242 | 3,359,348 | (5.2 | )% | |||||||||||||||
| Charity and uninsured visits | 112,275 | 116,475 | (3.6 | )% | 222,955 | 233,038 | (4.3 | )% | |||||||||||||||
| Emergency department visits | 637,107 | 643,036 | (0.9 | )% | 1,294,556 | 1,340,037 | (3.4 | )% | |||||||||||||||
| Paying visits as a percentage of total visits | 93.4 | % | 93.3 | % | 0.1 | % | * | 93.5 | % | 93.5 | % | - | % | * | |||||||||
| Charity and uninsured visits as a percentage of total visits | 6.6 | % | 6.7 | % | (0.1 | )% | * | 6.5 | % | 6.5 | % | - | % | * | |||||||||
| Total emergency department admissions and visits | 758,195 | 758,072 | - | % | 1,541,723 | 1,580,149 | (2.4 | )% | |||||||||||||||
| Revenues | |||||||||||||||||||||||
| Net patient service revenues (3) | $ | 3,547 | $ | 3,443 | 3.0 | % | $ | 7,129 | $ | 7,086 | 0.6 | % | |||||||||||
| Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day | |||||||||||||||||||||||
| Net patient service revenue (3) per adjusted patient admission | $ | 11,665 | $ | 11,249 | 3.7 | % | $ | 11,645 | $ | 11,303 | 3.0 | % | |||||||||||
| Net patient service revenue (3) per adjusted patient day | $ | 2,556 | $ | 2,507 | 2.0 | % | $ | 2,539 | $ | 2,478 | 2.5 | % | |||||||||||
| Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission (2) | $ | 10,988 | $ | 10,619 | 3.5 | % | $ | 10,983 | $ | 10,590 | 3.7 | % | |||||||||||
| Net patient service revenues (3) from: | |||||||||||||||||||||||
| Medicare | 20.3 | % | 20.4 | % | (0.1 | )% | * | 20.7 | % | 20.9 | % | (0.2 | )% | * | |||||||||
| Medicaid | 8.9 | % | 9.1 | % | (0.2 | )% | * | 8.9 | % | 9.0 | % | (0.1 | )% | * | |||||||||
| Managed care | 65.7 | % | 66.0 | % | (0.3 | )% | * | 65.7 | % | 65.5 | % | 0.2 | % | * | |||||||||
| Uninsured | 0.3 | % | 0.2 | % | 0.1 | % | * | 0.2 | % | 0.6 | % | (0.4 | )% | * | |||||||||
| Indemnity and other | 4.8 | % | 4.3 | % | 0.5 | % | * | 4.5 | % | 4.0 | % | 0.5 | % | * |
(1) Represents the consolidated results of Tenet's acute care hospitals and related outpatient facilities included in the Hospital Operations and other segment.
(2) Excludes operating expenses from Tenet's health plans.
(3) Less implicit price concessions.
* This change is the difference between the 2019 and 2018 amounts shown.
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING SAME HOSPITALS(1)
| (Dollars in millions except per adjusted patient day | Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||||
| and per adjusted patient admission amounts) | 2019 | 2018 | Change | 2019 | 2018 | Change | |||||||||||||||||
| Admissions, Patient Days and Surgeries | |||||||||||||||||||||||
| Number of hospitals (at end of period) | 65 | 65 | - | 65 | 65 | - | * | ||||||||||||||||
| Total admissions | 169,352 | 163,903 | 3.3 | % | 342,822 | 337,587 | 1.6 | % | |||||||||||||||
| Adjusted patient admissions | 304,066 | 297,460 | 2.2 | % | 609,937 | 601,605 | 1.4 | % | |||||||||||||||
| Paying admissions (excludes charity and uninsured) | 159,129 | 153,816 | 3.5 | % | 322,761 | 318,055 | 1.5 | % | |||||||||||||||
| Charity and uninsured admissions | 10,223 | 10,087 | 1.3 | % | 20,061 | 19,532 | 2.7 | % | |||||||||||||||
| Admissions through emergency department | 121,088 | 111,902 | 8.2 | % | 246,316 | 231,859 | 6.2 | % | |||||||||||||||
| Paying admissions as a percentage of total admissions | 94.0 | % | 93.8 | % | 0.2 | % | 94.1 | % | 94.2 | % | (0.1 | )% | * | ||||||||||
| Charity and uninsured admissions as a percentage of total admissions | 6.0 | % | 6.2 | % | (0.2 | )% | 5.9 | % | 5.8 | % | 0.1 | % | * | ||||||||||
| Emergency department admissions as a percentage of total admissions | 71.5 | % | 68.3 | % | 3.2 | % | 71.8 | % | 68.7 | % | 3.1 | % | * | ||||||||||
| Surgeries - inpatient | 44,641 | 45,191 | (1.2 | )% | 89,194 | 90,243 | (1.2 | )% | |||||||||||||||
| Surgeries - outpatient | 60,936 | 62,205 | (2.0 | )% | 118,832 | 121,925 | (2.5 | )% | |||||||||||||||
| Total surgeries | 105,577 | 107,396 | (1.7 | )% | 208,026 | 212,168 | (2.0 | )% | |||||||||||||||
| Patient days - total | 787,582 | 743,442 | 5.9 | % | 1,602,911 | 1,560,442 | 2.7 | % | |||||||||||||||
| Adjusted patient days | 1,387,929 | 1,329,915 | 4.4 | % | 2,795,982 | 2,735,483 | 2.2 | % | |||||||||||||||
| Average length of stay (days) | 4.65 | 4.54 | 2.4 | % | 4.68 | 4.62 | 1.3 | % | |||||||||||||||
| Licensed beds (at end of period) | 17,221 | 17,246 | (0.1 | )% | 17,221 | 17,246 | (0.1 | )% | |||||||||||||||
| Average licensed beds | 17,221 | 17,246 | (0.1 | )% | 17,221 | 17,246 | (0.1 | )% | |||||||||||||||
| Utilization of licensed beds | 50.3 | % | 47.4 | % | 2.9 | % | 51.4 | % | 50.0 | % | 1.4 | % | * | ||||||||||
| Outpatient Visits | |||||||||||||||||||||||
| Total visits | 1,693,805 | 1,673,056 | 1.2 | % | 3,380,669 | 3,389,952 | (0.3 | )% | |||||||||||||||
| Paying visits (excludes charity and uninsured) | 1,581,555 | 1,560,950 | 1.3 | % | 3,159,190 | 3,168,144 | (0.3 | )% | |||||||||||||||
| Charity and uninsured visits | 112,250 | 112,106 | 0.1 | % | 221,479 | 221,808 | (0.1 | )% | |||||||||||||||
| Emergency department visits | 637,107 | 622,898 | 2.3 | % | 1,288,959 | 1,286,620 | 0.2 | % | |||||||||||||||
| Paying visits as a percentage of total visits | 93.4 | % | 93.3 | % | 0.1 | % | 93.4 | % | 93.5 | % | (0.1 | )% | * | ||||||||||
| Charity and uninsured visits as a percentage of total visits | 6.6 | % | 6.7 | % | (0.1 | )% | 6.6 | % | 6.5 | % | 0.1 | % | * | ||||||||||
| Total emergency department admissions and visits | 758,195 | 734,800 | 3.2 | % | 1,535,275 | 1,518,479 | 2.8 | % | |||||||||||||||
| Revenues | |||||||||||||||||||||||
| Net patient service revenues (2) | $ | 3,547 | $ | 3,357 | 5.7 | % | $ | 7,104 | $ | 6,850 | 3.7 | % | |||||||||||
| Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day | |||||||||||||||||||||||
| Net patient service revenue (2) per adjusted patient admission | $ | 11,665 | $ | 11,286 | 3.4 | % | $ | 11,647 | $ | 11,386 | 2.3 | % | |||||||||||
| Net patient service revenue (2) per adjusted patient day | $ | 2,556 | $ | 2,524 | 1.3 | % | $ | 2,541 | $ | 2,504 | 1.5 | % | |||||||||||
| Net patient service revenues (2) from: | |||||||||||||||||||||||
| Medicare | 20.3 | % | 20.1 | % | 0.2 | % | 20.6 | % | 20.5 | % | 0.1 | % | * | ||||||||||
| Medicaid | 8.9 | % | 8.9 | % | - | % | 8.9 | % | 8.8 | % | 0.1 | % | * | ||||||||||
| Managed care | 65.7 | % | 66.4 | % | (0.7 | )% | 65.8 | % | 65.8 | % | - | % | * | ||||||||||
| Uninsured | 0.3 | % | 0.2 | % | 0.1 | % | 0.2 | % | 0.8 | % | (0.6 | )% | * | ||||||||||
| Indemnity and other | 4.8 | % | 4.4 | % | 0.4 | % | 4.5 | % | 4.1 | % | 0.4 | % | * |
(1) Information for our Hospital Operations and other segment is presented on a same-hospital basis, which includes the results of our same 65 hospitals operated throughout the six months ended June 30, 2019 and 2018 and associated outpatient facilities, but excludes the results of hospitals Tenet divested since January 1, 2018.
(2) Less implicit price concessions.
* This change is the difference between the 2019 and 2018 amounts shown.
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
| (Dollars in millions except per share amounts) | Three Months Ended | Six Months Ended | ||||||||||
| 3/31/2019 | 6/30/2019 | 6/30/2019 | ||||||||||
| Net operating revenues | $ | 4,545 | $ | 4,560 | $ | 9,105 | ||||||
| Equity in earnings of unconsolidated affiliates | 34 | 42 | 76 | |||||||||
| Operating expenses: | ||||||||||||
| Salaries, wages and benefits | 2,153 | 2,148 | 4,301 | |||||||||
| Supplies | 741 | 753 | 1,494 | |||||||||
| Other operating expenses, net | 1,074 | 1,044 | 2,118 | |||||||||
| Electronic health record incentives | (1 | ) | - | (1 | ) | |||||||
| Depreciation and amortization | 208 | 214 | 422 | |||||||||
| Impairment and restructuring charges, and acquisition-related costs | 19 | 36 | 55 | |||||||||
| Litigation and investigation costs | 13 | 18 | 31 | |||||||||
| Net losses on sales, consolidation and deconsolidation of facilities | 1 | 1 | 2 | |||||||||
| Operating income | 371 | 388 | 759 | |||||||||
| Interest expense | (251 | ) | (247 | ) | (498 | ) | ||||||
| Other non-operating income (expense), net | 1 | (1 | ) | - | ||||||||
| Loss from early extinguishment of debt | (47 | ) | - | (47 | ) | |||||||
| Income from continuing operations, before income taxes | 74 | 140 | 214 | |||||||||
| Income tax expense | (17 | ) | (30 | ) | (47 | ) | ||||||
| Income from continuing operations, before discontinued operations | 57 | 110 | 167 | |||||||||
| Discontinued operations: | ||||||||||||
| Income from operations | 10 | 2 | 12 | |||||||||
| Income tax expense | (2 | ) | - | (2 | ) | |||||||
| Income from discontinued operations | 8 | 2 | 10 | |||||||||
| Net income | 65 | 112 | 177 | |||||||||
| Less: Net income available to noncontrolling interests | 84 | 95 | 179 | |||||||||
| Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | (19 | ) | $ | 17 | $ | (2 | ) | ||||
| Amounts available (attributable) to Tenet Healthcare Corporation common shareholders | ||||||||||||
| Income (loss) from continuing operations, net of tax | $ | (27 | ) | $ | 15 | $ | (12 | ) | ||||
| Income from discontinued operations, net of tax | 8 | 2 | 10 | |||||||||
| Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | (19 | ) | $ | 17 | $ | (2 | ) | ||||
| Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||
| Basic | ||||||||||||
| Continuing operations | $ | (0.26 | ) | $ | 0.15 | $ | (0.12 | ) | ||||
| Discontinued operations | 0.08 | 0.02 | 0.10 | |||||||||
| $ | (0.18 | ) | $ | 0.17 | $ | (0.02 | ) | |||||
| Diluted | ||||||||||||
| Continuing operations | $ | (0.26 | ) | $ | 0.14 | $ | (0.12 | ) | ||||
| Discontinued operations | 0.08 | 0.02 | 0.10 | |||||||||
| $ | (0.18 | ) | $ | 0.16 | $ | (0.02 | ) | |||||
| Weighted average shares and dilutive securities outstanding (in thousands): | ||||||||||||
| Basic | 102,788 | 103,198 | 102,993 | |||||||||
| Diluted | 102,788 | 104,629 | 102,993 |
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
| (Dollars in millions except per share amounts) | Three Months Ended | Year Ended | ||||||||||||||||||
| 3/31/2018 | 6/30/2018 | 9/30/2018 | 12/31/2018 | 12/31/2018 | ||||||||||||||||
| Net operating revenues | $ | 4,699 | $ | 4,506 | $ | 4,489 | $ | 4,619 | $ | 18,313 | ||||||||||
| Equity in earnings of unconsolidated affiliates | 25 | 39 | 33 | 53 | 150 | |||||||||||||||
| Operating expenses: | ||||||||||||||||||||
| Salaries, wages and benefits | 2,227 | 2,135 | 2,116 | 2,156 | 8,634 | |||||||||||||||
| Supplies | 774 | 748 | 726 | 756 | 3,004 | |||||||||||||||
| Other operating expenses, net | 1,060 | 1,027 | 1,094 | 1,078 | 4,259 | |||||||||||||||
| Electronic health record incentives | (1 | ) | - | - | (2 | ) | (3 | ) | ||||||||||||
| Depreciation and amortization | 204 | 194 | 204 | 200 | 802 | |||||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 47 | 30 | 46 | 86 | 209 | |||||||||||||||
| Litigation and investigation costs | 6 | 13 | 9 | 10 | 38 | |||||||||||||||
| Net losses (gains) on sales, consolidation and deconsolidation of facilities | (110 | ) | (8 | ) | 7 | (16 | ) | (127 | ) | |||||||||||
| Operating income | 517 | 406 | 320 | 404 | 1,647 | |||||||||||||||
| Interest expense | (255 | ) | (254 | ) | (249 | ) | (246 | ) | (1,004 | ) | ||||||||||
| Other non-operating expense, net | (1 | ) | (1 | ) | - | (3 | ) | (5 | ) | |||||||||||
| Gain (loss) from early extinguishment of debt | (1 | ) | (1 | ) | - | 3 | 1 | |||||||||||||
| Income from continuing operations, before income taxes | 260 | 150 | 71 | 158 | 639 | |||||||||||||||
| Income tax expense | (70 | ) | (44 | ) | (6 | ) | (56 | ) | (176 | ) | ||||||||||
| Income from continuing operations, before discontinued operations | 190 | 106 | 65 | 102 | 463 | |||||||||||||||
| Discontinued operations: | ||||||||||||||||||||
| Income from operations | 1 | 2 | - | 1 | 4 | |||||||||||||||
| Income tax expense | - | - | - | (1 | ) | (1 | ) | |||||||||||||
| Income from discontinued operations | 1 | 2 | - | - | 3 | |||||||||||||||
| Net income | 191 | 108 | 65 | 102 | 466 | |||||||||||||||
| Less: Net income available to noncontrolling interests | 92 | 82 | 74 | 107 | 355 | |||||||||||||||
| Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | 99 | $ | 26 | $ | (9 | ) | $ | (5 | ) | $ | 111 | ||||||||
| Amounts available (attributable) to Tenet Healthcare Corporation common shareholders | ||||||||||||||||||||
| Income (loss) from continuing operations, net of tax | $ | 98 | $ | 24 | $ | (9 | ) | $ | (5 | ) | $ | 108 | ||||||||
| Income from discontinued operations, net of tax | 1 | 2 | - | - | 3 | |||||||||||||||
| Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | 99 | $ | 26 | $ | (9 | ) | $ | (5 | ) | $ | 111 | ||||||||
| Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||
| Basic | ||||||||||||||||||||
| Continuing operations | $ | 0.97 | $ | 0.23 | $ | (0.09 | ) | $ | (0.05 | ) | $ | 1.06 | ||||||||
| Discontinued operations | 0.01 | 0.02 | - | - | 0.03 | |||||||||||||||
| $ | 0.98 | $ | 0.25 | $ | (0.09 | ) | $ | (0.05 | ) | $ | 1.09 | |||||||||
| Diluted | ||||||||||||||||||||
| Continuing operations | $ | 0.95 | $ | 0.23 | $ | (0.09 | ) | $ | (0.05 | ) | $ | 1.04 | ||||||||
| Discontinued operations | 0.01 | 0.02 | - | - | 0.03 | |||||||||||||||
| $ | 0.96 | $ | 0.25 | $ | (0.09 | ) | $ | (0.05 | ) | $ | 1.07 | |||||||||
| Weighted average shares and dilutive securities outstanding (in thousands): | ||||||||||||||||||||
| Basic | 101,392 | 102,147 | 102,402 | 102,501 | 102,110 | |||||||||||||||
| Diluted | 102,656 | 104,177 | 102,402 | 102,501 | 103,881 |
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING TOTAL HOSPITALS(1)
| (Dollars in millions except per adjusted patient day and per adjusted patient admission amounts) | ||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||
| 3/31/2019 | 6/30/2019 | 06/30/2019 | ||||||||||
| Admissions, Patient Days and Surgeries | ||||||||||||
| Number of hospitals (at end of period) | 65 | 65 | 65 | |||||||||
| Total admissions | 174,726 | 169,352 | 344,078 | |||||||||
| Adjusted patient admissions | 308,133 | 304,066 | 612,199 | |||||||||
| Paying admissions (excludes charity and uninsured) | 164,793 | 159,128 | 323,921 | |||||||||
| Charity and uninsured admissions | 9,933 | 10,224 | 20,157 | |||||||||
| Admissions through emergency department | 126,079 | 121,088 | 247,167 | |||||||||
| Paying admissions as a percentage of total admissions | 94.3 | % | 94.0 | % | 94.1 | % | ||||||
| Charity and uninsured admissions as a percentage of total admissions | 5.7 | % | 6.0 | % | 5.9 | % | ||||||
| Emergency department admissions as a percentage of total admissions | 72.2 | % | 71.5 | % | 71.8 | % | ||||||
| Surgeries - inpatient | 44,795 | 44,641 | 89,436 | |||||||||
| Surgeries - outpatient | 58,218 | 60,936 | 119,154 | |||||||||
| Total surgeries | 103,013 | 105,577 | 208,590 | |||||||||
| Patient days - total | 822,079 | 787,582 | 1,609,661 | |||||||||
| Adjusted patient days | 1,420,170 | 1,387,929 | 2,808,099 | |||||||||
| Average length of stay (days) | 4.70 | 4.65 | 4.68 | |||||||||
| Licensed beds (at end of period) | 17,221 | 17,221 | 17,221 | |||||||||
| Average licensed beds | 17,455 | 17,221 | 17,338 | |||||||||
| Utilization of licensed beds | 52.3 | % | 50.3 | % | 51.3 | % | ||||||
| Outpatient Visits | ||||||||||||
| Total visits | 1,714,392 | 1,693,805 | 3,408,197 | |||||||||
| Paying visits (excludes charity and uninsured) | 1,603,712 | 1,581,530 | 3,185,242 | |||||||||
| Charity and uninsured visits | 110,680 | 112,275 | 222,955 | |||||||||
| Emergency department visits | 657,449 | 637,107 | 1,294,556 | |||||||||
| Paying visits as a percentage of total visits | 93.5 | % | 93.4 | % | 93.5 | % | ||||||
| Charity and uninsured visits as a percentage of total visits | 6.5 | % | 6.6 | % | 6.5 | % | ||||||
| Total emergency department admissions and visits | 783,528 | 758,195 | 1,541,723 | |||||||||
| Revenues | ||||||||||||
| Net patient service revenues (3) | $ | 3,582 | $ | 3,547 | $ | 7,129 | ||||||
| Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day | ||||||||||||
| Net patient service revenue (3) per adjusted patient admission | $ | 11,625 | $ | 11,665 | $ | 11,645 | ||||||
| Net patient service revenue (3) per adjusted patient day | $ | 2,522 | $ | 2,556 | $ | 2,539 | ||||||
| Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission (2) | $ | 10,979 | $ | 10,988 | $ | 10,983 | ||||||
| Net patient service revenues (3) from: | ||||||||||||
| Medicare | 21.2 | % | 20.3 | % | 20.7 | % | ||||||
| Medicaid | 8.8 | % | 8.9 | % | 8.9 | % | ||||||
| Managed care | 65.7 | % | 65.7 | % | 65.7 | % | ||||||
| Uninsured | - | % | 0.3 | % | 0.2 | % | ||||||
| Indemnity and other | 4.3 | % | 4.8 | % | 4.5 | % |
(3) Less implicit price concessions.
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING TOTAL HOSPITALS(1)
| (Dollars in millions except per adjusted patient day and per adjusted patient admission amounts) | ||||||||||||||||||||
| Three Months Ended | Year Ended | |||||||||||||||||||
| 3/31/2018 | 6/30/2018 | 9/30/2018 | 12/31/2018 | 12/31/2018 | ||||||||||||||||
| Admissions, Patient Days and Surgeries | ||||||||||||||||||||
| Number of hospitals (at end of period) | 69 | 68 | 68 | 68 | 68 | |||||||||||||||
| Total admissions | 182,306 | 168,453 | 168,201 | 170,407 | 689,367 | |||||||||||||||
| Adjusted patient admissions | 320,868 | 306,063 | 306,197 | 308,113 | 1,241,241 | |||||||||||||||
| Paying admissions (excludes charity and uninsured) | 172,490 | 158,216 | 157,193 | 160,172 | 648,071 | |||||||||||||||
| Charity and uninsured admissions | 9,816 | 10,237 | 11,008 | 10,235 | 41,296 | |||||||||||||||
| Admissions through emergency department | 125,076 | 115,036 | 116,727 | 120,012 | 476,851 | |||||||||||||||
| Paying admissions as a percentage of total admissions | 94.6 | % | 93.9 | % | 93.5 | % | 94.0 | % | 94.0 | % | ||||||||||
| Charity and uninsured admissions as a percentage of total admissions | 5.4 | % | 6.1 | % | 6.5 | % | 6.0 | % | 6.0 | % | ||||||||||
| Emergency department admissions as a percentage of total admissions | 68.6 | % | 68.3 | % | 69.4 | % | 70.4 | % | 69.2 | % | ||||||||||
| Surgeries - inpatient | 47,223 | 46,274 | 45,626 | 45,897 | 185,020 | |||||||||||||||
| Surgeries - outpatient | 63,008 | 63,805 | 61,468 | 62,638 | 250,919 | |||||||||||||||
| Total surgeries | 110,231 | 110,079 | 107,094 | 108,535 | 435,939 | |||||||||||||||
| Patient days - total | 858,648 | 766,519 | 761,920 | 779,728 | 3,166,815 | |||||||||||||||
| Adjusted patient days | 1,486,139 | 1,373,480 | 1,365,662 | 1,383,372 | 5,608,653 | |||||||||||||||
| Average length of stay (days) | 4.71 | 4.55 | 4.53 | 4.58 | 4.59 | |||||||||||||||
| Licensed beds (at end of period) | 18,457 | 18,314 | 18,302 | 17,937 | 17,937 | |||||||||||||||
| Average licensed beds | 18,685 | 18,362 | 18,302 | 17,935 | 18,321 | |||||||||||||||
| Utilization of licensed beds | 51.1 | % | 45.9 | % | 45.3 | % | 47.3 | % | 47.4 | % | ||||||||||
| Outpatient Visits | ||||||||||||||||||||
| Total visits | 1,842,539 | 1,749,847 | 1,722,292 | 1,734,523 | 7,049,201 | |||||||||||||||
| Paying visits (excludes charity and uninsured) | 1,725,976 | 1,633,372 | 1,607,184 | 1,617,970 | 6,584,502 | |||||||||||||||
| Charity and uninsured visits | 116,563 | 116,475 | 115,108 | 116,553 | 464,699 | |||||||||||||||
| Emergency department visits | 697,001 | 643,036 | 638,248 | 649,544 | 2,627,829 | |||||||||||||||
| Paying visits as a percentage of total visits | 93.7 | % | 93.3 | % | 93.3 | % | 93.3 | % | 93.4 | % | ||||||||||
| Charity and uninsured visits as a percentage of total visits | 6.3 | % | 6.7 | % | 6.7 | % | 6.7 | % | 6.6 | % | ||||||||||
| Total emergency department admissions and visits | 822,077 | 758,072 | 754,975 | 769,556 | 3,104,680 | |||||||||||||||
| Revenues | ||||||||||||||||||||
| Net patient service revenues (3) | $ | 3,643 | $ | 3,443 | $ | 3,434 | $ | 3,561 | $ | 14,081 | ||||||||||
| Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day | ||||||||||||||||||||
| Net patient service revenue (3) per adjusted patient admission | $ | 11,354 | $ | 11,249 | $ | 11,215 | $ | 11,557 | $ | 11,344 | ||||||||||
| Net patient service revenue (3) per adjusted patient day | $ | 2,451 | $ | 2,507 | $ | 2,515 | $ | 2,574 | $ | 2,511 | ||||||||||
| Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission (2) | $ | 10,561 | $ | 10,619 | $ | 10,771 | $ | 10,861 | $ | 10,701 | ||||||||||
| Net patient service revenues (3) from: | ||||||||||||||||||||
| Medicare | 21.5 | % | 20.4 | % | 19.8 | % | 20.1 | % | 20.5 | % | ||||||||||
| Medicaid | 8.8 | % | 9.1 | % | 9.8 | % | 9.1 | % | 9.2 | % | ||||||||||
| Managed care | 65.0 | % | 66.0 | % | 64.9 | % | 65.8 | % | 65.4 | % | ||||||||||
| Uninsured | 1.0 | % | 0.2 | % | 0.9 | % | 0.5 | % | 0.7 | % | ||||||||||
| Indemnity and other | 3.7 | % | 4.3 | % | 4.6 | % | 4.5 | % | 4.2 | % |
(3) Less implicit price concessions.
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING SAME HOSPITALS(1)
| (Dollars in millions except per adjusted patient day and per adjusted patient admission amounts) | ||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||
| 3/31/2019 | 6/30/2019 | 6/30/2019 | ||||||||||
| Admissions, Patient Days and Surgeries | ||||||||||||
| Number of hospitals (at end of period) | 65 | 65 | 65 | |||||||||
| Total admissions | 173,470 | 169,352 | 342,822 | |||||||||
| Adjusted patient admissions | 305,871 | 304,066 | 609,937 | |||||||||
| Paying admissions (excludes charity and uninsured) | 163,632 | 159,129 | 322,761 | |||||||||
| Charity and uninsured admissions | 9,838 | 10,223 | 20,061 | |||||||||
| Admissions through emergency department | 125,228 | 121,088 | 246,316 | |||||||||
| Paying admissions as a percentage of total admissions | 94.3 | % | 94.0 | % | 94.1 | % | ||||||
| Charity and uninsured admissions as a percentage of total admissions | 5.7 | % | 6.0 | % | 5.9 | % | ||||||
| Emergency department admissions as a percentage of total admissions | 72.2 | % | 71.5 | % | 71.8 | % | ||||||
| Surgeries - inpatient | 44,553 | 44,641 | 89,194 | |||||||||
| Surgeries - outpatient | 57,896 | 60,936 | 118,832 | |||||||||
| Total surgeries | 102,449 | 105,577 | 208,026 | |||||||||
| Patient days - total | 815,329 | 787,582 | 1,602,911 | |||||||||
| Adjusted patient days | 1,408,053 | 1,387,929 | 2,795,982 | |||||||||
| Average length of stay (days) | 4.70 | 4.65 | 4.68 | |||||||||
| Licensed beds (at end of period) | 17,221 | 17,221 | 17,221 | |||||||||
| Average licensed beds | 17,221 | 17,221 | 17,221 | |||||||||
| Utilization of licensed beds | 52.6 | % | 50.3 | % | 51.4 | % | ||||||
| Outpatient Visits | ||||||||||||
| Total visits | 1,686,864 | 1,693,805 | 3,380,669 | |||||||||
| Paying visits (excludes charity and uninsured) | 1,577,635 | 1,581,555 | 3,159,190 | |||||||||
| Charity and uninsured visits | 109,229 | 112,250 | 221,479 | |||||||||
| Emergency department visits | 651,852 | 637,107 | 1,288,959 | |||||||||
| Paying visits as a percentage of total visits | 93.5 | % | 93.4 | % | 93.4 | % | ||||||
| Charity and uninsured visits as a percentage of total visits | 6.5 | % | 6.6 | % | 6.6 | % | ||||||
| Total emergency department admissions and visits | 777,080 | 758,195 | 1,535,275 | |||||||||
| Revenues | ||||||||||||
| Net patient service revenues (2) | $ | 3,557 | $ | 3,547 | $ | 7,104 | ||||||
| Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day | ||||||||||||
| Net patient service revenue (2) per adjusted patient admission | $ | 11,629 | $ | 11,665 | $ | 11,647 | ||||||
| Net patient service revenue (2) per adjusted patient day | $ | 2,526 | $ | 2,556 | $ | 2,541 | ||||||
| Net patient service revenues (2) from: | ||||||||||||
| Medicare | 21.0 | % | 20.3 | % | 20.6 | % | ||||||
| Medicaid | 8.8 | % | 8.9 | % | 8.9 | % | ||||||
| Managed care | 65.9 | % | 65.7 | % | 65.8 | % | ||||||
| Uninsured | - | % | 0.3 | % | 0.2 | % | ||||||
| Indemnity and other | 4.3 | % | 4.8 | % | 4.5 | % |
(1) Information for our Hospital Operations and other segment is presented on a same-hospital basis, which includes the results of our same 65 hospitals operated throughout the six months ended June 30, 2019 and 2018 and associated outpatient facilities, but excludes the results of hospitals Tenet divested since January 1, 2018.
(2) Less implicit price concessions.
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING SAME HOSPITALS(1)
| (Dollars in millions except per adjusted patient day and per adjusted patient admission amounts) | ||||||||||||||||||||
| Three Months Ended | Year Ended | |||||||||||||||||||
| 3/31/2018 | 6/30/2018 | 9/30/2018 | 12/31/2018 | 12/31/2018 | ||||||||||||||||
| Admissions, Patient Days and Surgeries | ||||||||||||||||||||
| Number of hospitals (at end of period) | 65 | 65 | 65 | 65 | 65 | |||||||||||||||
| Total admissions | 173,684 | 163,903 | 164,075 | 166,458 | 668,120 | |||||||||||||||
| Adjusted patient admissions | 304,145 | 297,460 | 298,221 | 300,562 | 1,200,388 | |||||||||||||||
| Paying admissions (excludes charity and uninsured) | 164,239 | 153,816 | 153,227 | 156,392 | 627,674 | |||||||||||||||
| Charity and uninsured admissions | 9,445 | 10,087 | 10,848 | 10,066 | 40,446 | |||||||||||||||
| Admissions through emergency department | 119,957 | 111,902 | 113,833 | 117,229 | 462,921 | |||||||||||||||
| Paying admissions as a percentage of total admissions | 94.6 | % | 93.8 | % | 93.4 | % | 94.0 | % | 93.9 | % | ||||||||||
| Charity and uninsured admissions as a percentage of total admissions | 5.4 | % | 6.2 | % | 6.6 | % | 6.0 | % | 6.1 | % | ||||||||||
| Emergency department admissions as a percentage of total admissions | 69.1 | % | 68.3 | % | 69.4 | % | 70.4 | % | 69.3 | % | ||||||||||
| Surgeries - inpatient | 45,052 | 45,191 | 44,783 | 45,012 | 180,038 | |||||||||||||||
| Surgeries - outpatient | 59,720 | 62,205 | 60,080 | 61,151 | 243,156 | |||||||||||||||
| Total surgeries | 104,772 | 107,396 | 104,863 | 106,163 | 423,194 | |||||||||||||||
| Patient days - total | 817,000 | 743,442 | 740,870 | 758,359 | 3,059,671 | |||||||||||||||
| Adjusted patient days | 1,405,568 | 1,329,915 | 1,325,229 | 1,342,745 | 5,403,457 | |||||||||||||||
| Average length of stay (days) | 4.70 | 4.54 | 4.52 | 4.56 | 4.58 | |||||||||||||||
| Licensed beds (at end of period) | 17,246 | 17,246 | 17,234 | 17,237 | 17,237 | |||||||||||||||
| Average licensed beds | 17,246 | 17,246 | 17,234 | 17,235 | 17,240 | |||||||||||||||
| Utilization of licensed beds | 52.6 | % | 47.4 | % | 46.7 | % | 47.8 | % | 48.6 | % | ||||||||||
| Outpatient Visits | ||||||||||||||||||||
| Total visits | 1,716,896 | 1,673,056 | 1,647,013 | 1,658,541 | 6,695,506 | |||||||||||||||
| Paying visits (excludes charity and uninsured) | 1,607,194 | 1,560,950 | 1,536,247 | 1,547,018 | 6,251,409 | |||||||||||||||
| Charity and uninsured visits | 109,702 | 112,106 | 110,766 | 111,523 | 444,097 | |||||||||||||||
| Emergency department visits | 663,722 | 622,898 | 617,925 | 630,557 | 2,535,102 | |||||||||||||||
| Paying visits as a percentage of total visits | 93.6 | % | 93.3 | % | 93.3 | % | 93.3 | % | 93.4 | % | ||||||||||
| Charity and uninsured visits as a percentage of total visits | 6.4 | % | 6.7 | % | 6.7 | % | 6.7 | % | 6.6 | % | ||||||||||
| Total emergency department admissions and visits | 783,679 | 734,800 | 731,758 | 747,786 | 2,998,023 | |||||||||||||||
| Revenues | ||||||||||||||||||||
| Net patient service revenues (2) | $ | 3,493 | $ | 3,357 | $ | 3,367 | $ | 3,490 | $ | 13,707 | ||||||||||
| Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day | ||||||||||||||||||||
| Net patient service revenue (2) per adjusted patient admission | $ | 11,485 | $ | 11,286 | $ | 11,290 | $ | 11,612 | $ | 11,419 | ||||||||||
| Net patient service revenue (2) per adjusted patient day | $ | 2,485 | $ | 2,524 | $ | 2,541 | $ | 2,599 | $ | 2,537 | ||||||||||
| Net patient service revenues (2) from: | ||||||||||||||||||||
| Medicare | 20.9 | % | 20.1 | % | 19.5 | % | 19.8 | % | 20.1 | % | ||||||||||
| Medicaid | 8.7 | % | 8.9 | % | 9.8 | % | 9.1 | % | 9.1 | % | ||||||||||
| Managed care | 65.3 | % | 66.4 | % | 65.2 | % | 66.1 | % | 65.8 | % | ||||||||||
| Uninsured | 1.3 | % | 0.2 | % | 0.9 | % | 0.5 | % | 0.7 | % | ||||||||||
| Indemnity and other | 3.8 | % | 4.4 | % | 4.6 | % | 4.5 | % | 4.3 | % |
(1) Information for our Hospital Operations and other segment is presented on a same-hospital basis, which includes the results of our same 65 hospitals operated throughout the six months ended June 30, 2019 and 2018 and associated outpatient facilities, but excludes the results of hospitals Tenet divested since January 1, 2018.
(2) Less implicit price concessions.
TENET HEALTHCARE CORPORATION