Full Press Release Details
Tenet Reports Results for the Third Quarter
Ended September 30, 2016
DALLAS October 31, 2016 Tenet Healthcare Corporation (NYSE:THC) reported a net loss from continuing operations of $9 million in the
third quarter of 2016, a $19 million improvement when compared to a $28 million net loss from continuing operations in the third quarter of 2015. Adjusted EBITDA was $570 million in the third quarter of 2016, an increase of $4 million, or 0.7
percent, compared to $566 million in the third quarter of 2015.
Our focus on high-acuity service lines continues to drive growth in our hospitals
and contributed to the 5.3% increase in same-hospital patient revenues this quarter. Adjusted EBITDA in our hospital segment increased by a similar amount after adjusting for acquisitions, divestitures and electronic health record
incentives, said Trevor Fetter, chairman and chief executive officer. Conifer and USPI delivered another outstanding quarter, and our three business segments continue to work together to enhance our long-term growth.
Hospital Operations and Other Segment
Net operating revenue in the Hospital Operations and other segment was $4.162 billion, down 0.4 percent from $4.179 billion in the third quarter of 2015 due to
hospitals that have been divested since that time. On a same-hospital basis, patient revenue increased to $3.768 billion, up 5.3 percent from $3.577 billion in the third quarter of 2015. The increase was driven by a 1.4 percent increase in adjusted
patient admissions and a 3.9 percent increase in net patient revenue per adjusted admission.
Adjusted EBITDA in Tenet s hospital segment was $334
million, representing a decline of 12.8 percent as compared to $383 million in the third quarter of 2015. The decline was primarily driven by divestitures in 2015 and 2016 and an expected decrease in electronic health record incentives, and was
partially offset by acquisitions in 2015. In addition, Tenet s health plan business lowered EBITDA in the segment by approximately $5 million.
hospital segment selected operating expenses, defined as the sum of salaries, wages and benefits, supplies and other operating expenses, increased 3.1 percent on a per adjusted admission basis in the quarter. Approximately one-third of the increase
was attributable to an increase in expense at Tenet s health plans, which was substantially offset by an increase in health plan revenues as a result of additional covered lives in 2016.
Tenet s same-hospital exchange admissions
were 5,465 in the third quarter of 2016, up 16.9 percent from the third quarter of 2015. Same-hospital exchange outpatient visits were 51,015, up 32.0 percent from the third quarter of 2015.
Tenet s provision for doubtful
accounts was $367 million in the third quarter of 2016, representing a ratio of 7.0 percent of revenues before bad debt, as compared to $371 million in the third quarter of 2015, or 7.3 percent of revenues before bad debt. Tenet s uncompensated
care costs, defined as the sum of the provision for doubtful accounts, charity care write-offs and uninsured discounts, was $1.318 billion and $1.303 billion in the third quarters of 2016 and 2015, respectively, including $951 million and $932
million, respectively, of charity care write-offs and uninsured discounts that were offered through Tenet s Compact with Uninsured Patients. Uncompensated care represented 21.4 percent of revenue before bad debts, uninsured discounts and
charity care write-offs in the third quarter of 2016, down from 21.7 percent in the third quarter of 2015. Nearly all of Tenet s uncompensated care is associated with the Hospital Operations and other segment.
Uninsured plus charity admissions increased by 985 admissions, or 10.5 percent on a same-hospital basis in the third quarter of 2016 compared to the third
quarter of 2015. Uninsured plus charity outpatient visits decreased by 3,733 visits, or 2.8 percent, on a same-hospital basis.
Ambulatory Care Segment
During the third quarter of 2016, the Ambulatory segment produced net operating revenue of $448 million, representing an increase of 36.2 percent as compared
to $329 million in the third quarter of 2015. In addition, the Ambulatory segment generated Adjusted EBITDA of $157 million, up 28.7 percent from $122 million in the third quarter of 2015
The results of many of the facilities in which the Ambulatory segment has an investment are not consolidated by Tenet. 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 segment increased 9.7 percent, with
cases increasing 4.0 percent and revenue per case increasing 5.5 percent.
During the third quarter of 2016, Conifer s revenue increased 14.7 percent to $398 million, up from $347 million in the third quarter of 2015, and
Conifer s revenue from third party customers increased by 29.9 percent to $239 million. Conifer generated $79 million of Adjusted EBITDA in the third quarter of 2016, up 29.5 percent from $61 million in the third quarter of 2015. Conifer s
results for the third quarter of 2016 included $9 million of annual customer incentives. These incentives may be achieved again in future years, but will not recur at these levels in the fourth quarter of 2016.
Net Income and Earnings Per Share
Tenet reported a net
loss from continuing operations of $9 million, or $0.09 per share, in the third quarter of 2016 compared to a net loss of $28 million, or $0.28 per share, in the third quarter of 2015.
After adjusting for certain items which are listed on Table #2, Tenet generated Adjusted net income from continuing operations of $16 million, or $0.16 per
diluted share, during the third quarter of 2016, as compared to Adjusted net income from continuing operations of $30 million, or $0.29 per diluted share, in the third quarter of 2015.
A reconciliation of GAAP net income available (loss attributable) to Tenet Healthcare Corporation common shareholders to Adjusted net income from continuing
operations and Adjusted diluted earnings per share from continuing operations is contained in Table #2 at the end of this release.
Cash Flow and Liquidity
Cash and cash equivalents were $649 million at September 30, 2016 compared to $656 million at June 30, 2016. The Company had no outstanding
borrowings on its $1 billion credit line as of September 30, 2016. Accounts receivable days outstanding were 52.9 at September 30, 2016 compared to 51.1 at June 30, 2016 and 49.5 at December 31, 2015.
Net cash provided by operating activities in the nine months ended September 30, 2016 was $851 million, representing a $16 million improvement compared
to $835 million in the comparable period in 2015. After subtracting $614 million and $566 million of capital expenditures in the nine months ended September 30, 2016 and September 30, 2015, respectively, Free Cash Flow was $237 million in
the nine months ended September 30, 2016, representing a $32 million decline compared to $269 million in the comparable period in 2015. Adjusted Free Cash Flow was $368 million in the nine months ended September 30, 2016, representing a
$76 million decline from $444 million in the comparable period in 2015.
Net cash used in investing activities was $150 million in the nine months ended
September 30, 2016 compared to $1.272 billion of net cash used in investing activities in the comparable period in 2015. Net cash used in financing activities was $408 million in the nine months ended September 30, 2016 compared to $694
million of net cash provided by financing activities in the comparable period in 2015.
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 2016 includes:
The Outlook for calendar
year 2016 assumes equity in earnings of unconsolidated affiliates of $120 million to $130 million, electronic health record incentives of $30 million to $35 million, net income attributable to noncontrolling interests of $340 million to $360 million
(excluding an additional $19 million of noncontrolling interests recorded by USPI in the first nine months of 2016 related to gains on consolidation) and an average diluted share count of 101 million.
The Company s Outlook for the fourth quarter of 2016 includes:
The Outlook for the fourth
quarter assumes equity in earnings of unconsolidated affiliates of approximately $40 million, electronic health record incentives of approximately $10 million, net income attributable to noncontrolling interests of $94 million to $114 million and an
average diluted share count of 102 million.
Additional details on Tenet s Outlook for both the fourth quarter and calendar year 2016 are available
in Tables 4 and 5 at the end of this press release and in an accompanying slide presentation that is accessible through the Company s website at www.tenethealth.com/investors.
Management s Webcast Discussion of Third Quarter Results
Tenet management will discuss the Company s third quarter 2016 results on a webcast scheduled for 10:00 a.m. EDT (9:00 a.m. CDT) on November 1, 2016.
Investors can access the webcast through Tenet s website at www.tenethealth.com/investors. A set of slides, which will be referred to on the conference call, is available on the Quarterly Results section of the Company s website.
Additional information regarding Tenet s quarterly results of operations is contained in its Form 10-Q report for the three months ended
September 30, 2016, which will be filed with the Securities and Exchange Commission and posted on the Tenet website before the webcast. This press release includes certain non-GAAP measures, such as Adjusted EBITDA, Adjusted net income from
continuing operations, Adjusted diluted earnings per share from continuing operations, Free Cash Flow and Adjusted Free Cash Flow. Reconciliations of these measures to the most comparable GAAP measure are contained in the tables at the end of this
Tenet Healthcare Corporation is a diversified healthcare services company with 130,000 employees united around a common mission: to help people
live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates 79 general acute care hospitals, 20 short-stay surgical hospitals and approximately
470 outpatient centers in the United States, as well as nine facilities in the United Kingdom. Tenet s Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health
systems, integrated delivery networks, physician groups, self-insured organizations and health plans. For more information, please visit www.tenethealth.com.
The terms THC , Tenet Healthcare Corporation , the Company , we ,
us or our refer to Tenet Healthcare Corporation or one or more of its subsidiaries or affiliates as applicable.
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, assume, anticipate,
intend, plan, believe, seek, see, or will. Forward-looking statements by their nature address matters that are, to different degrees, uncertain. Particular uncertainties that
could cause our actual results to be materially different than those expressed in our forward-looking statements include, but are not limited to, the factors disclosed under Forward-Looking Statements and Risk Factors in our
Form 10-K for the year ended December 31, 2015, Form 10-Q for the quarterly period ended September 30, 2016 and other filings with the Securities and Exchange Commission. Among other things, these factors include adverse regulatory
developments, government investigations or litigation.
Tenet uses its Company website to provide important information to investors
about the Company including the posting of important announcements regarding financial performance and corporate developments.
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
| (Dollars in millions except per share amounts) | Three Months Ended September 30, | |||||||||||||||||||
| 2016 | % | 2015 | % | Change | ||||||||||||||||
| Net operating revenues: | ||||||||||||||||||||
| Net operating revenues before provision for doubtful accounts | $ | 5,216 | $ | 5,063 | 3.0 | % | ||||||||||||||
| Less: Provision for doubtful accounts | 367 | 371 | (1.1 | )% | ||||||||||||||||
| Net operating revenues | 4,849 | 100.0 | % | 4,692 | 100.0 | % | 3.3 | % | ||||||||||||
| Equity in earnings of unconsolidated affiliates | 31 | 0.6 | % | 28 | 0.6 | % | 10.7 | % | ||||||||||||
| Operating expenses: | ||||||||||||||||||||
| Salaries, wages and benefits | 2,314 | 47.7 | % | 2,258 | 48.2 | % | 2.5 | % | ||||||||||||
| Supplies | 767 | 15.8 | % | 752 | 16.0 | % | 2.0 | % | ||||||||||||
| Other operating expenses, net | 1,231 | 25.4 | % | 1,151 | 24.5 | % | 7.0 | % | ||||||||||||
| Electronic health record incentives | (2 | ) | % | (7 | ) | (0.1 | )% | (71.4 | )% | |||||||||||
| Depreciation and amortization | 205 | 4.2 | % | 185 | 3.9 | % | ||||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 31 | 0.6 | % | 44 | 0.9 | % | ||||||||||||||
| Litigation and investigation costs | 4 | 0.1 | % | 50 | 1.1 | % | ||||||||||||||
| Gains on sales, consolidation and deconsolidation of facilities | (3 | ) | (0.1 | )% | % | |||||||||||||||
| Operating income | 333 | 6.9 | % | 287 | 6.1 | % | ||||||||||||||
| Interest expense | (243 | ) | (248 | ) | ||||||||||||||||
| Investment earnings (losses) | (1 | ) | 1 | |||||||||||||||||
| Net income from continuing operations, before income taxes | 89 | 40 | ||||||||||||||||||
| Income tax expense | (10 | ) | (11 | ) | ||||||||||||||||
| Net income from continuing operations, before discontinued operations | 79 | 29 | ||||||||||||||||||
| Discontinued operations: | ||||||||||||||||||||
| Income (loss) from operations | 2 | (1 | ) | |||||||||||||||||
| Income tax expense | (1 | ) | ||||||||||||||||||
| Net income (loss) from discontinued operations | 1 | (1 | ) | |||||||||||||||||
| Net income | 80 | 28 | ||||||||||||||||||
| Less: Net income attributable to noncontrolling interests | 88 | 57 | ||||||||||||||||||
| Net loss attributable to Tenet Healthcare Corporation common shareholders | $ | (8 | ) | $ | (29 | ) | ||||||||||||||
| Amounts available (attributable) to Tenet Healthcare Corporation common shareholders | ||||||||||||||||||||
| Net loss from continuing operations, net of tax | $ | (9 | ) | $ | (28 | ) | ||||||||||||||
| Net income (loss) from discontinued operations, net of tax | 1 | (1 | ) | |||||||||||||||||
| Net loss attributable to Tenet Healthcare Corporation common shareholders | $ | (8 | ) | $ | (29 | ) | ||||||||||||||
| Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||
| Basic | ||||||||||||||||||||
| Continuing operations | $ | (0.09 | ) | $ | (0.28 | ) | ||||||||||||||
| Discontinued operations | 0.01 | (0.01 | ) | |||||||||||||||||
| $ | (0.08 | ) | $ | (0.29 | ) | |||||||||||||||
| Diluted | ||||||||||||||||||||
| Continuing operations | $ | (0.09 | ) | $ | (0.28 | ) | ||||||||||||||
| Discontinued operations | 0.01 | (0.01 | ) | |||||||||||||||||
| $ | (0.08 | ) | $ | (0.29 | ) | |||||||||||||||
| Weighted average shares and dilutive securities outstanding (in thousands): | ||||||||||||||||||||
| Basic | 99,523 | 99,537 | ||||||||||||||||||
| Diluted* | 99,523 | 99,537 |
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
| (Dollars in millions except per share amounts) | Nine Months Ended September 30, | |||||||||||||||||||
| 2016 | % | 2015 | % | Change | ||||||||||||||||
| Net operating revenues: | ||||||||||||||||||||
| Net operating revenues before provision for doubtful accounts | $ | 15,856 | $ | 14,694 | 7.9 | % | ||||||||||||||
| Less: Provision for doubtful accounts | 1,095 | 1,086 | 0.8 | % | ||||||||||||||||
| Net operating revenues | 14,761 | 100.0 | % | 13,608 | 100.0 | % | 8.5 | % | ||||||||||||
| Equity in earnings of unconsolidated affiliates | 85 | 0.6 | % | 48 | 0.4 | % | 77.1 | % | ||||||||||||
| Operating expenses: | ||||||||||||||||||||
| Salaries, wages and benefits | 7,032 | 47.6 | % | 6,568 | 48.3 | % | 7.1 | % | ||||||||||||
| Supplies | 2,351 | 15.9 | % | 2,146 | 15.8 | % | 9.6 | % | ||||||||||||
| Other operating expenses, net | 3,686 | 25.0 | % | 3,325 | 24.4 | % | 10.9 | % | ||||||||||||
| Electronic health record incentives | (23 | ) | (0.2 | )% | (46 | ) | (0.3 | )% | (50.0 | )% | ||||||||||
| Depreciation and amortization | 632 | 4.3 | % | 589 | 4.3 | % | ||||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 81 | 0.6 | % | 266 | 2.0 | % | ||||||||||||||
| Litigation and investigation costs | 291 | 2.0 | % | 67 | 0.5 | % | ||||||||||||||
| Gains on sales, consolidation and deconsolidation of facilities | (151 | ) | (1.0 | )% | % | |||||||||||||||
| Operating income | 947 | 6.4 | % | 741 | 5.4 | % | ||||||||||||||
| Interest expense | (730 | ) | (664 | ) | ||||||||||||||||
| Investment earnings (losses) | 2 | |||||||||||||||||||
| Net income from continuing operations, before income taxes | 219 | 77 | ||||||||||||||||||
| Income tax expense | (61 | ) | ||||||||||||||||||
| Net income from continuing operations, before discontinued operations | 158 | 77 | ||||||||||||||||||
| Discontinued operations: | ||||||||||||||||||||
| Loss from operations | (5 | ) | (1 | ) | ||||||||||||||||
| Income tax expense | ||||||||||||||||||||
| Net loss from discontinued operations | (5 | ) | (1 | ) | ||||||||||||||||
| Net income | 153 | 76 | ||||||||||||||||||
| Less: Net income attributable to noncontrolling interests | 266 | 119 | ||||||||||||||||||
| Net loss attributable to Tenet Healthcare Corporation common shareholders | $ | (113 | ) | $ | (43 | ) | ||||||||||||||
| Amounts attributable to Tenet Healthcare Corporation common shareholders | ||||||||||||||||||||
| Net loss from continuing operations, net of tax | $ | (108 | ) | $ | (42 | ) | ||||||||||||||
| Net loss from discontinued operations, net of tax | (5 | ) | (1 | ) | ||||||||||||||||
| Net loss attributable to Tenet Healthcare Corporation common shareholders | $ | (113 | ) | $ | (43 | ) | ||||||||||||||
| Net loss per share attributable to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||
| Basic | ||||||||||||||||||||
| Continuing operations | $ | (1.09 | ) | $ | (0.42 | ) | ||||||||||||||
| Discontinued operations | (0.05 | ) | (0.01 | ) | ||||||||||||||||
| $ | (1.14 | ) | $ | (0.43 | ) | |||||||||||||||
| Diluted | ||||||||||||||||||||
| Continuing operations | $ | (1.09 | ) | $ | (0.42 | ) | ||||||||||||||
| Discontinued operations | (0.05 | ) | (0.01 | ) | ||||||||||||||||
| $ | (1.14 | ) | $ | (0.43 | ) | |||||||||||||||
| Weighted average shares and dilutive securities outstanding (in thousands): | ||||||||||||||||||||
| Basic | 99,210 | 99,160 | ||||||||||||||||||
| Diluted* | 99,210 | 99,160 |
TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
| September 30, | December 31, | |||||||
| (Dollars in millions) | 2016 | 2015 | ||||||
| ASSETS | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 649 | $ | 356 | ||||
| Accounts receivable, less allowance for doubtful accounts | 2,786 | 2,704 | ||||||
| Inventories of supplies, at cost | 322 | 309 | ||||||
| Income tax receivable | 11 | 7 | ||||||
| Assets held for sale | 17 | 550 | ||||||
| Other current assets | 1,331 | 1,245 | ||||||
| Total current assets | 5,116 | 5,171 | ||||||
| Investments and other assets | 1,324 | 1,175 | ||||||
| Deferred income taxes | 840 | 776 | ||||||
| Property and equipment, at cost, less accumulated depreciation and amortization | 7,965 | 7,915 | ||||||
| Goodwill | 7,376 | 6,970 | ||||||
| Other intangible assets, at cost, less accumulated amortization | 1,853 | 1,675 | ||||||
| Total assets | $ | 24,474 | $ | 23,682 | ||||
| LIABILITIES AND EQUITY | ||||||||
| Current liabilities: | ||||||||
| Current portion of long-term debt | $ | 184 | $ | 127 | ||||
| Accounts payable | 1,228 | 1,380 | ||||||
| Accrued compensation and benefits | 809 | 880 | ||||||
| Professional and general liability reserves | 185 | 177 | ||||||
| Accrued interest payable | 308 | 205 | ||||||
| Liabilities held for sale | 13 | 101 | ||||||
| Accrued legal settlement costs | 527 | 294 | ||||||
| Other current liabilities | 1,293 | 1,144 | ||||||
| Total current liabilities | 4,547 | 4,308 | ||||||
| Long-term debt, net of current portion | 14,323 | 14,383 | ||||||
| Professional and general liability reserves | 620 | 578 | ||||||
| Defined benefit plan obligations | 586 | 595 | ||||||
| Deferred income taxes | 320 | 37 | ||||||
| Other long-term liabilities | 606 | 557 | ||||||
| Total liabilities | 21,002 | 20,458 | ||||||
| Commitments and contingencies | ||||||||
| Redeemable noncontrolling interests in equity of consolidated subsidiaries | 2,307 | 2,266 | ||||||
| Equity: | ||||||||
| Shareholders equity: | ||||||||
| Common stock | 7 | 7 | ||||||
| Additional paid-in capital | 4,801 | 4,815 | ||||||
| Accumulated other comprehensive loss | (200 | ) | (164 | ) | ||||
| Accumulated deficit | (1,663 | ) | (1,550 | ) | ||||
| Common stock in treasury, at cost | (2,417 | ) | (2,417 | ) | ||||
| Total shareholders equity | 528 | 691 | ||||||
| Noncontrolling interests | 637 | 267 | ||||||
| Total equity | 1,165 | 958 | ||||||
| Total liabilities and equity | $ | 24,474 | $ | 23,682 |
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF CASH FLOW
| Nine Months Ended | ||||||||
| (Dollars in millions) | September 30, | |||||||
| 2016 | 2015 | |||||||
| Net Income | $ | 153 | $ | 76 | ||||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
| Depreciation and amortization | 632 | 589 | ||||||
| Provision for doubtful accounts | 1,095 | 1,086 | ||||||
| Deferred income tax expense (benefit) | 32 | (10 | ) | |||||
| Stock-based compensation expense | 51 | 50 | ||||||
| Impairment and restructuring charges, and acquisition-related costs | 81 | 266 | ||||||
| Litigation and investigation costs | 291 | 67 | ||||||
| Gains on sales, consolidation and deconsolidation of facilities | (151 | ) | ||||||
| Equity in earnings of unconsolidated affiliates, net of distributions received | 2 | (48 | ) | |||||
| Amortization of debt discount and debt issuance costs | 33 | 32 | ||||||
| Pre-tax loss from discontinued operations | 5 | 1 | ||||||
| Other items, net | (3 | ) | 22 | |||||
| Changes in cash from operating assets and liabilities: | ||||||||
| Accounts receivable | (1,156 | ) | (1,124 | ) | ||||
| Inventories and other current assets | (95 | ) | (62 | ) | ||||
| Income taxes | (1 | ) | (5 | ) | ||||
| Accounts payable, accrued expenses and other current liabilities | (35 | ) | 39 | |||||
| Other long-term liabilities | 48 | 31 | ||||||
| Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (132 | ) | (157 | ) | ||||
| Net cash provided by (used in) operating activities from discontinued operations, excluding income taxes | 1 | (18 | ) | |||||
| Net cash provided by operating activities | 851 | 835 | ||||||
| Cash flows from investing activities: | ||||||||
| Purchases of property and equipment continuing operations | (614 | ) | (566 | ) | ||||
| Purchases of businesses or joint venture interests, net of cash acquired | (96 | ) | (720 | ) | ||||
| Proceeds from sales of facilities and other assets | 573 | 28 | ||||||
| Proceeds from sales of marketable securities, long-term investments and other assets | 36 | 18 | ||||||
| Purchases of equity investments | (37 | ) | (18 | ) | ||||
| Other long-term assets | (15 | ) | (6 | ) | ||||
| Other items, net | 3 | (8 | ) | |||||
| Net cash used in investing activities | (150 | ) | (1,272 | ) | ||||
| Cash flows from financing activities: | ||||||||
| Repayments of borrowings under credit facility | (1,195 | ) | (1,880 | ) | ||||
| Proceeds from borrowings under credit facility | 1,195 | 1,770 | ||||||
| Repayments of other borrowings | (112 | ) | (2,011 | ) | ||||
| Proceeds from other borrowings | 4 | 3,208 | ||||||
| Debt issuance costs | (1 | ) | (76 | ) | ||||
| Distributions paid to noncontrolling interests | (151 | ) | (65 | ) | ||||
| Proceeds from sale of noncontrolling interests | 19 | 4 | ||||||
| Purchase of noncontrolling interests | (180 | ) | (254 | ) | ||||
| Proceeds from exercise of stock options | 4 | 15 | ||||||
| Other items, net | 9 | (17 | ) | |||||
| Net cash provided by (used in) financing activities | (408 | ) | 694 | |||||
| Net increase in cash and cash equivalents | 293 | 257 | ||||||
| Cash and cash equivalents at beginning of period | 356 | 193 | ||||||
| Cash and cash equivalents at end of period | $ | 649 | $ | 450 | ||||
| Supplemental disclosures: | ||||||||
| Interest paid, net of capitalized interest | $ | (596 | ) | $ | (519 | ) | ||
| Income tax payments, net | $ | (33 | ) | $ | (6 | ) |
TENET HEALTHCARE CORPORATION
SELECTED STATISTICS CONTINUING TOTAL HOSPITALS(1)
| (Dollars in millions except per patient day, | ||||||||||||||||||||||||
| per admission, per adjusted admission | Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||||||||||||||
| and per visit amounts) | 2016 | 2015 | Change | 2016 | 2015 | Change | ||||||||||||||||||
| Admissions, Patient Days and Surgeries | ||||||||||||||||||||||||
| Number of hospitals (at end of period) | 75 | 83 | (8 | ) * | 75 | 83 | (8 | ) * | ||||||||||||||||
| Total admissions | 194,342 | 201,870 | (3.7 | )% | 600,039 | 612,111 | (2.0 | )% | ||||||||||||||||
| Adjusted patient admissions | 345,207 | 352,352 | (2.0 | )% | 1,050,839 | 1,050,594 | % | |||||||||||||||||
| Paying admissions (excludes charity and uninsured) | 183,042 | 190,548 | (3.9 | )% | 568,017 | 579,304 | (1.9 | )% | ||||||||||||||||
| Charity and uninsured admissions | 11,300 | 11,322 | (0.2 | )% | 32,022 | 32,807 | (2.4 | )% | ||||||||||||||||
| Admissions through emergency department | 120,447 | 126,050 | (4.4 | )% | 378,786 | 388,164 | (2.4 | )% | ||||||||||||||||
| Paying admissions as a percentage of total admissions | 94.2 | % | 94.4 | % | (0.2 | )% * | 94.7 | % | 94.6 | % | 0.1 | % * | ||||||||||||
| Charity and uninsured admissions as a percentage of total admissions | 5.8 | % | 5.6 | % | 0.2 | % * | 5.3 | % | 5.4 | % | (0.1 | )% * | ||||||||||||
| Emergency department admissions as a percentage of total admissions | 62.0 | % | 62.4 | % | (0.4 | )% * | 63.1 | % | 63.4 | % | (0.3 | )% * | ||||||||||||
| Surgeries inpatient | 54,701 | 55,977 | (2.3 | )% | 164,835 | 164,969 | (0.1 | )% | ||||||||||||||||
| Surgeries outpatient | 72,646 | 73,960 | (1.8 | )% | 225,296 | 213,894 | 5.3 | % | ||||||||||||||||
| Total surgeries | 127,346 | 129,937 | (2.0 | )% | 390,131 | 378,863 | 3.0 | % | ||||||||||||||||
| Patient days total | 894,323 | 927,964 | (3.6 | )% | 2,802,150 | 2,833,716 | (1.1 | )% | ||||||||||||||||
| Adjusted patient days | 1,567,894 | 1,601,494 | (2.1 | )% | 4,851,535 | 4,809,669 | 0.9 | % | ||||||||||||||||
| Average length of stay (days) | 4.60 | 4.60 | % | 4.67 | 4.63 | 0.9 | % | |||||||||||||||||
| Licensed beds (at end of period) | 20,340 | 21,527 | (5.5 | )% | 20,340 | 21,527 | (5.5 | )% | ||||||||||||||||
| Average licensed beds | 20,367 | 21,122 | (3.6 | )% | 20,757 | 20,924 | (0.8 | )% | ||||||||||||||||
| Utilization of licensed beds | 47.7 | % | 47.8 | % | (0.1 | )% * | 49.3 | % | 49.6 | % | (0.3 | )% * | ||||||||||||
| Outpatient Visits | ||||||||||||||||||||||||
| Total visits | 2,009,019 | 2,076,524 | (3.3 | )% | 6,193,924 | 6,134,134 | 1.0 | % | ||||||||||||||||
| Paying visits (excludes charity and uninsured) | 1,862,046 | 1,904,467 | (2.2 | )% | 5,742,955 | 5,645,246 | 1.7 | % | ||||||||||||||||
| Charity and uninsured visits | 146,973 | 172,057 | (14.6 | )% | 450,969 | 488,888 | (7.8 | )% | ||||||||||||||||
| Emergency department visits | 707,713 | 747,993 | (5.4 | )% | 2,213,321 | 2,232,477 | (0.9 | )% | ||||||||||||||||
| Paying visits as a percentage of total visits | 92.7 | % | 91.7 | % | 1.0 | % * | 92.7 | % | 92.0 | % | 0.7 | % * | ||||||||||||
| Charity and uninsured visits as a percentage of total visits | 7.3 | % | 8.3 | % | (1.0 | )% * | 7.3 | % | 8.0 | % | (0.7 | )% * | ||||||||||||
| Revenues | ||||||||||||||||||||||||
| Net inpatient revenues | $ | 2,644 | $ | 2,603 | 1.6 | % | $ | 8,013 | $ | 7,917 | 1.2 | % | ||||||||||||
| Net outpatient revenues | $ | 1,417 | $ | 1,515 | (6.5 | )% | $ | 4,391 | $ | 4,411 | (0.5 | )% | ||||||||||||
| Revenues on a Per Admission, Per Patient Day and Per Visit Basis | ||||||||||||||||||||||||
| Net inpatient revenue per admission | $ | 13,605 | $ | 12,894 | 5.5 | % | $ | 13,354 | $ | 12,934 | 3.2 | % | ||||||||||||
| Net inpatient revenue per patient day | $ | 2,956 | $ | 2,805 | 5.4 | % | $ | 2,860 | $ | 2,794 | 2.4 | % | ||||||||||||
| Net outpatient revenue per visit | $ | 705 | $ | 730 | (3.4 | )% | $ | 709 | $ | 719 | (1.4 | )% | ||||||||||||
| Net patient revenue per adjusted patient admission | $ | 11,764 | $ | 11,688 | 0.7 | % | $ | 11,804 | $ | 11,734 | 0.6 | % | ||||||||||||
| Net patient revenue per adjusted patient day | $ | 2,590 | $ | 2,571 | 0.7 | % | $ | 2,557 | $ | 2,563 | (0.2 | )% | ||||||||||||
| Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission | $ | 10,666 | $ | 10,348 | 3.1 | % | $ | 10,621 | $ | 10,315 | 3.0 | % | ||||||||||||
| Net Patient Revenues from: | ||||||||||||||||||||||||
| Medicare | 19.9 | % | 19.8 | % | 0.1 | % * | 20.5 | % | 20.8 | % | (0.3 | )% * | ||||||||||||
| Medicaid | 8.4 | % | 8.8 | % | (0.4 | )% * | 8.2 | % | 8.9 | % | (0.7 | )% * | ||||||||||||
| Managed care | 64.0 | % | 61.1 | % | 2.9 | % * | 61.5 | % | 60.2 | % | 1.3 | % * | ||||||||||||
| Indemnity, self-pay and other | 7.7 | % | 10.3 | % | (2.6 | )% * | 9.8 | % | 10.1 | % | (0.3 | )% * |
TENET HEALTHCARE CORPORATION