Tenet Reports Results for the First Quarter Ended March 31, 2019

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.tenethealth.com/investors. A set of slides, which will be referred to on the conference call, will be 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 period ended March 31, 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 (THC) is a national diversified healthcare services company headquartered in Dallas, TX, 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.

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,” “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 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

(Unaudited)

 
(Dollars in millions except per share amounts) Three Months Ended March 31,
2019 % 2018 % Change
Net operating revenues $ 4,545 100.0 % 4,699 100.0 % (3.3 )%
Equity in earnings of unconsolidated affiliates 34 0.7 % 25 0.5 % 36.0 %
Operating expenses:
Salaries, wages and benefits 2,153 47.3 % 2,227 47.3 % (3.3 )%
Supplies 741 16.3 % 774 16.5 % (4.3 )%
Other operating expenses, net 1,074 23.6 % 1,060 22.6 % 1.3 %
Electronic health record incentives (1 ) — % (1 ) — % — %
Depreciation and amortization 208 4.6 % 204 4.3 %
Impairment and restructuring charges, and acquisition-related costs 19 0.4 % 47 1.0 %
Litigation and investigation costs 13 0.3 % 6 0.1 %
Net losses (gains) on sales, consolidation and deconsolidation of facilities   1   — %   (110 ) (2.3 )%
Operating income 371 8.2 % 517 11.0 %
Interest expense (251 ) (255 )
Other non-operating income (expense), net 1 (1 )
Loss from early extinguishment of debt   (47 )   (1 )
Income from continuing operations, before income taxes 74 260
Income tax expense   (17 )   (70 )
Income from continuing operations, before discontinued

operations

57 190
Discontinued operations:
Income from operations 10 1
Income tax expense   (2 )   —  
Income from discontinued operations   8     1  
Net income 65 191
Less: Net income available to noncontrolling interests   84     92  

Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders

 

$ (19 ) $ 99  

Amounts available (attributable) to Tenet Healthcare Corporation common shareholders

 

Income (loss) from continuing operations, net of tax $ (27 ) $ 98
Income from discontinued operations, net of tax   8     1  
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders $ (19 ) $ 99  
Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders:
Basic
Continuing operations $ (0.26 ) $ 0.97
Discontinued operations   0.08     0.01  
$ (0.18 ) $ 0.98  
Diluted
Continuing operations $ (0.26 ) $ 0.95
Discontinued operations   0.08     0.01  
$ (0.18 ) $ 0.96  

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

Basic 102,788 101,392
Diluted* 102,788 102,656
 

*Had we generated income from continuing operations available to common shareholders in the three months ended March 31, 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 1,753 thousand shares.

 
   

TENET HEALTHCARE CORPORATION

CONSOLIDATED BALANCE SHEETS

(Unaudited)

 
March 31, December 31,
(Dollars in millions) 2019 2018
ASSETS
Current assets:
Cash and cash equivalents $ 252 $ 411
Accounts receivable, less allowance for doubtful accounts 2,744 2,595
Inventories of supplies, at cost 308 305
Income tax receivable 17 21
Assets held for sale — 107
Other current assets   1,261     1,197  
Total current assets 4,582 4,636
Investments and other assets 2,331 1,456
Deferred income taxes 291 312
Property and equipment, at cost, less accumulated depreciation and amortization 6,996 6,993
Goodwill 7,283 7,281
Other intangible assets, at cost, less accumulated amortization   1,675     1,731  
Total assets $ 23,158   $ 22,409  
 
LIABILITIES AND EQUITY
Current liabilities:
Current portion of long-term debt $ 158 $ 182
Accounts payable 1,101 1,207
Accrued compensation and benefits 707 838
Professional and general liability reserves 224 216
Accrued interest payable 323 240
Liabilities held for sale — 43
Other current liabilities   1,212     1,131  
Total current liabilities 3,725 3,857
Long-term debt, net of current portion 14,814 14,644
Professional and general liability reserves 690 666
Defined benefit plan obligations 512 521
Deferred income taxes 36 36
Other long-term liabilities   1,268     578  
Total liabilities 21,045 20,302
Commitments and contingencies
Redeemable noncontrolling interests in equity of consolidated subsidiaries 1,439 1,420
Equity:
Shareholders’ equity:
Common stock 7 7
Additional paid-in capital 4,748 4,747
Accumulated other comprehensive loss (221 ) (223 )
Accumulated deficit (2,254 ) (2,236 )
Common stock in treasury, at cost   (2,414 )   (2,414 )
Total shareholders’ deficit (134 ) (119 )
Noncontrolling interests   808     806  
Total equity   674     687  
Total liabilities and equity $ 23,158   $ 22,409  
 
   

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF CASH FLOW

(Unaudited)

 
Three Months Ended
(Dollars in millions) March 31,
2019 2018
Net income $ 65 $ 191
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 208 204
Deferred income tax expense 19 70
Stock-based compensation expense 11 9
Impairment and restructuring charges, and acquisition-related costs 19 47
Litigation and investigation costs 13 6
Net losses (gains) on sales, consolidation and deconsolidation of facilities 1 (110 )
Loss from early extinguishment of debt 47 1
Equity in earnings of unconsolidated affiliates, net of distributions received 3 9
Amortization of debt discount and debt issuance costs 11 11
Pre-tax income from discontinued operations (10 ) (1 )
Other items, net (7 ) (1 )
Changes in cash from operating assets and liabilities:
Accounts receivable (158 ) (66 )
Inventories and other current assets (115 ) (41 )
Income taxes 9 —
Accounts payable, accrued expenses and other current liabilities (109 ) (183 )
Other long-term liabilities 37 1
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements (32 ) (33 )
Net cash used in operating activities from discontinued operations, excluding income taxes   (2 )   (1 )
Net cash provided by operating activities 10 113
Cash flows from investing activities:
Purchases of property and equipment — continuing operations (192 ) (143 )
Purchases of businesses or joint venture interests, net of cash acquired (2 ) (16 )
Proceeds from sales of facilities and other assets — continuing operations 41 425
Proceeds from sales of facilities and other assets — discontinued operations 17 —
Proceeds from sales of marketable securities, long-term investments and other assets 4 134
Purchases of equity investments (1 ) (30 )
Other long-term assets (2 ) 7
Other items, net   (4 )   (4 )
Net cash provided by (used in) investing activities (139 ) 373
Cash flows from financing activities:
Repayments of borrowings under credit facility (495 ) —
Proceeds from borrowings under credit facility 685 —
Repayments of other borrowings (1,620 ) (91 )
Proceeds from other borrowings 1,507 7
Debt issuance costs (18 ) —
Distributions paid to noncontrolling interests (74 ) (64 )
Proceeds from sales of noncontrolling interests 4 5
Purchases of noncontrolling interests (3 ) (9 )
Proceeds from exercise of stock options and employee stock purchase plan 1 9
Other items, net   (17 )   20  
Net cash used in financing activities   (30 )   (123 )
Net increase (decrease) in cash and cash equivalents (159 ) 363
Cash and cash equivalents at beginning of period   411     611  
Cash and cash equivalents at end of period $ 252   $ 974  
Supplemental disclosures:
Interest paid, net of capitalized interest $ (158 ) $ (169 )
Income tax refunds, net $ 9 $ 1
 
     

TENET HEALTHCARE CORPORATION

SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1)

(Unaudited)

 
(Dollars in millions except per adjusted patient day Three Months Ended March 31,
and per adjusted patient admission amounts) 2019 2018 Change
 
Admissions, Patient Days and Surgeries
Number of hospitals (at end of period) 65 69 (4 ) *
Total admissions 174,726 182,306 (4.2 )%
Adjusted patient admissions 308,133 320,868 (4.0 )%
Paying admissions (excludes charity and uninsured) 164,793 172,490 (4.5 )%
Charity and uninsured admissions 9,933 9,816 1.2 %
Admissions through emergency department 126,079 125,076 0.8 %
Paying admissions as a percentage of total admissions 94.3 % 94.6 % (0.3 )% *
Charity and uninsured admissions as a percentage of total admissions 5.7 % 5.4 % 0.3 % *
Emergency department admissions as a percentage of total admissions 72.2 % 68.6 % 3.6 % *
Surgeries — inpatient 44,795 47,223 (5.1 )%
Surgeries — outpatient 58,218 63,008 (7.6 )%
Total surgeries 103,013 110,231 (6.5 )%
Patient days — total 822,079 858,648 (4.3 )%
Adjusted patient days 1,420,170 1,486,139 (4.4 )%
Average length of stay (days) 4.70 4.71 (0.2 )%
Licensed beds (at end of period) 17,221 18,457 (6.7 )%
Average licensed beds 17,455 18,685 (6.6 )%
Utilization of licensed beds 52.3 % 51.1 % 1.2 % *
Outpatient Visits
Total visits 1,714,392 1,842,539 (7.0 )%
Paying visits (excludes charity and uninsured) 1,603,712 1,725,976 (7.1 )%
Charity and uninsured visits 110,680 116,563 (5.0 )%
Emergency department visits 657,449 697,001 (5.7 )%
Paying visits as a percentage of total visits 93.5 % 93.7 % (0.2 )% *
Charity and uninsured visits as a percentage of total visits 6.5 % 6.3 % 0.2 % *
Total emergency department admissions and visits 783,528 822,077 (4.7 )%
Revenues
Net patient service revenues(3) $ 3,582 $ 3,643 (1.7 )%
Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day
Net patient service revenue(3) per adjusted patient admission $ 11,625 $ 11,354 2.4 %
Net patient service revenue(3) per adjusted patient day $ 2,522 $ 2,451 2.9 %
Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission(2) $ 10,979 $ 10,561 4.0 %
Net patient service revenues(3) from:
Medicare 21.2 % 21.5 % (0.3 )% *
Medicaid 8.8 % 8.8 % — % *
Managed care 65.7 % 65.0 % 0.7 % *
Uninsured — % 1.0 % (1.0 )% *
Indemnity and other 4.3 % 3.7 % 0.6 % *
 

(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)

(Unaudited)

 
(Dollars in millions except per adjusted patient day Three Months Ended March 31,
and per adjusted patient admission amounts) 2019 2018 Change
 
Admissions, Patient Days and Surgeries
Number of hospitals (at end of period) 65 65 — *
Total admissions 173,470 173,684 (0.1 )%
Adjusted patient admissions 305,871 304,145 0.6 %
Paying admissions (excludes charity and uninsured) 163,632 164,239 (0.4 )%
Charity and uninsured admissions 9,838 9,445 4.2 %
Admissions through emergency department 125,228 119,957 4.4 %
Paying admissions as a percentage of total admissions 94.3 % 94.6 % (0.3 )% *
Charity and uninsured admissions as a percentage of total admissions 5.7 % 5.4 % 0.3 % *
Emergency department admissions as a percentage of total admissions 72.2 % 69.1 % 3.1 % *
Surgeries — inpatient 44,553 45,052 (1.1 )%
Surgeries — outpatient 57,896 59,720 (3.1 )%
Total surgeries 102,449 104,772 (2.2 )%
Patient days — total 815,329 817,000 (0.2 )%
Adjusted patient days 1,408,053 1,405,568 0.2 %
Average length of stay (days) 4.70 4.70 — %
Licensed beds (at end of period) 17,221 17,246 (0.1 )%
Average licensed beds 17,221 17,246 (0.1 )%
Utilization of licensed beds 52.6 % 52.6 % — % *
Outpatient Visits
Total visits 1,696,094 1,730,018 (2.0 )%
Paying visits (excludes charity and uninsured) 1,586,627 1,619,950 (2.1 )%
Charity and uninsured visits 109,467 110,068 (0.5 )%
Emergency department visits 651,852 663,722 (1.8 )%
Paying visits as a percentage of total visits 93.5 % 93.6 % (0.1 )% *
Charity and uninsured visits as a percentage of total visits 6.5 % 6.4 % 0.1 % *
Total emergency department admissions and visits 777,080 783,679 (0.8 )%
Revenues
Net patient service revenues(2) $ 3,559 $ 3,494 1.9 %
Revenues on a Per Adjusted Patient Admission and Per Adjusted Patient Day
Net patient service revenue(2) per adjusted patient admission $ 11,636 $ 11,488 1.3 %
Net patient service revenue(2) per adjusted patient day $ 2,528 $ 2,486 1.7 %
Net patient service revenues(2) from:
Medicare 21.0 % 20.9 % 0.1 % *
Medicaid 8.8 % 8.7 % 0.1 % *
Managed care 65.9 % 65.3 % 0.6 % *
Uninsured — % 1.3 % (1.3 )% *
Indemnity and other 4.3 % 3.8 % 0.5 % *
 

(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 three months ended March 31, 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.

 
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TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 
(Dollars in millions except per share amounts) Three Months Ended Year Ended Three Months Ended
3/31/2018 6/30/2018 9/30/2018 12/31/2018 12/31/2018 3/31/2019
Net operating revenues $ 4,699 $ 4,506 $ 4,489 $ 4,619 $ 18,313 $ 4,545
Equity in earnings of unconsolidated affiliates 25 39 33 53 150 34
Operating expenses:
Salaries, wages and benefits 2,227 2,135 2,116 2,156 8,634 2,153
Supplies 774 748 726 756 3,004 741
Other operating expenses, net 1,060 1,027 1,094 1,078 4,259 1,074
Electronic health record incentives (1 ) — — (2 ) (3 ) (1 )
Depreciation and amortization 204 194 204 200 802 208
Impairment and restructuring charges, and acquisition-related costs 47 30 46 86 209 19
Litigation and investigation costs 6 13 9 10 38 13

Net losses (gains) on sales, consolidation and deconsolidation of facilities

 

  (110 )   (8 )   7     (16 )   (127 )   1  
Operating income 517 406 320 404 1,647 371
Interest expense (255 ) (254 ) (249 ) (246 ) (1,004 ) (251 )
Other non-operating income (expense), net (1 ) (1 ) — (3 ) (5 ) 1
Gain (loss) from early extinguishment of debt   (1 )   (1 )   —     3     1     (47 )
Income from continuing operations, before income taxes 260 150 71 158 639 74
Income tax expense   (70 )   (44 )   (6 )   (56 )   (176 )   (17 )

Income from continuing operations, before discontinued operations

190 106 65 102 463 57
Discontinued operations:
Income (loss) from operations 1 2 — 1 4 10
Income tax benefit (expense)   —     —     —     (1 )   (1 )   (2 )
Income (loss) from discontinued operations   1     2     —     —     3     8  
Net income 191 108 65 102 466 65
Less: Net income available to noncontrolling interests   92     82     74     107     355     84  

Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders

$ 99   $ 26   $ (9 ) $ (5 ) $ 111   $ (19 )

Amounts available (attributable) to Tenet Healthcare Corporation common shareholders

Income (loss) from continuing operations, net of tax $ 98 $ 24 $ (9 ) $ (5 ) $ 108 $ (27 )
Income (loss) from discontinued operations, net of tax   1     2     —     —     3     8  

Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders

$ 99   $ 26   $ (9 ) $ (5 ) $ 111   $ (19 )

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 $