(State of Incorporation) | (Commission File Number) | (IRS Employer Identification Number) |
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) | |||||
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) | |||||
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) | |||||
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) |
Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||||||||
Item 2.02. | Results of Operations and Financial Condition. |
Item 9.01. | Financial Statements and Exhibits. |
Exhibit No. | Description | |||||||
99.1 | ||||||||
104 | Cover Page Interactive Data File (embedded within the inline XBRL document) |
TENET HEALTHCARE CORPORATION | ||||||||
Date: October 20, 2021 | By: | /s/ R. SCOTT RAMSEY | ||||||
R. Scott Ramsey | ||||||||
Senior Vice President, Controller |
($ in millions, except per share results) | Q3’21 | Q3’20 | YTD Q3’21 | YTD Q3’20 | ||||||||||
Net income available (loss attributable) to Tenet common shareholders from continuing operations | $448 | $(197) | $665 | $(15) | ||||||||||
Net income available (loss attributable) to Tenet common shareholders from continuing operations per diluted share | $4.12 | $(1.87) | $6.13 | $(0.14) | ||||||||||
Adjusted EBITDA excluding grant income | $851 | $621 | $2,401 | $1,415 | ||||||||||
Adjusted EBITDA | $855 | $551 | $2,466 | $1,868 | ||||||||||
Adjusted diluted earnings per share from continuing operations | $1.99 | $0.64 | $4.88 | $3.17 | ||||||||||
The table above as well as tables and discussions throughout this earnings release include certain financial measures that are not in accordance with accounting principles generally accepted in the United States of America (GAAP). Reconciliations of GAAP measures to the Adjusted (non-GAAP) measures used are detailed in Tables #1-3 included at the end of this earnings release. Management’s reasoning for the use of these non-GAAP measures and descriptions of the various non-GAAP measures are included in the Non-GAAP Financial Measures section of this earnings release. |
Hospital segment results ($ in millions) | Q3’21 | Q3’20 | YTD Q3’21 | YTD Q3’20 | ||||||||||
Revenues | ||||||||||||||
Net operating revenues | $4,030 | $3,803 | $12,072 | $10,725 | ||||||||||
Grant income | $2 | ($57) | $30 | $417 | ||||||||||
Same-hospital net patient service revenues (a) | $3,599 | $3,246 | $10,498 | $9,170 | ||||||||||
Same-Hospital Volume Changes versus the Prior-Year Period (a) | ||||||||||||||
Admissions | 2.6 | % | (11.0) | % | 1.1 | % | (12.0) | % | ||||||
Adjusted admissions (b) | 4.4 | % | (15.0) | % | 3.2 | % | (15.6) | % | ||||||
Outpatient visits (including outpatient ER visits) | 15.3 | % | (19.2) | % | 18.1 | % | (23.1) | % | ||||||
Emergency Room visits (inpatient and outpatient) | 25.0 | % | (22.3) | % | 6.5 | % | (19.6) | % | ||||||
Hospital surgeries | 1.0 | % | (10.0) | % | 8.8 | % | (15.6) | % | ||||||
Adjusted EBITDA | ||||||||||||||
Adjusted EBITDA excluding grant income | $494 | $297 | $1,349 | $657 | ||||||||||
Adjusted EBITDA | $496 | $240 | $1,379 | $1,074 |
Ambulatory segment results ($ in millions) | Q3’21 | Q3’20 | YTD Q3’21 | YTD Q3’20 | ||||||||||
Revenues | ||||||||||||||
Net operating revenues | $666 | $565 | $1,976 | $1,423 | ||||||||||
Grant income excluding equity earnings impact | $1 | ($9) | $23 | $28 | ||||||||||
Grant income in equity earnings | $1 | ($4) | $12 | $8 | ||||||||||
Same-facility system-wide net patient service revenues (c) | $1,344 | $1,290 | $3,871 | $3,298 | ||||||||||
Volume Changes versus the Prior-Year Period | ||||||||||||||
Same-facility system-wide surgical cases (c)(d) | 6.8 | % | (5.9) | % | 20.4 | % | (18.8) | % | ||||||
Same-facility system-wide surgical cases on same-business day basis (c)(d) | 6.8 | % | (5.9) | % | 21.0 | % | (19.3) | % | ||||||
Adjusted EBITDA and NCI | ||||||||||||||
Adjusted EBITDA excluding grant income | $272 | $228 | $791 | $502 | ||||||||||
Adjusted EBITDA | $274 | $215 | $826 | $538 | ||||||||||
Adjusted EBITDA less facility-level NCI excluding grant income | $178 | $146 | $514 | $324 | ||||||||||
Adjusted EBITDA less facility-level NCI | $178 | $138 | $534 | $344 | ||||||||||
Adjusted EBITDA less total NCI excluding grant income (d) | $173 | $143 | $501 | $319 | ||||||||||
Adjusted EBITDA less total NCI (d) | $173 | $135 | $520 | $338 |
Conifer segment results ($ in millions) | Q3’21 | Q3’20 | YTD Q3’21 | YTD Q3’20 | ||||||||||
Net operating revenues | $314 | $325 | $943 | $962 | ||||||||||
Adjusted EBITDA | $85 | $96 | $261 | $256 |
($ in millions) | September 30, 2021 | June 30, 2021 | March 31, 2021 | December 31, 2020 | ||||||||||
Cash and cash equivalents | $2,292 | $2,194 | $2,141 | $2,446 | ||||||||||
Accounts receivable days outstanding | 56.4 | 55.2 | 55.8 | 55.6 | ||||||||||
Line-of-credit borrowings outstanding | — | — | — | — | ||||||||||
Ratio of net debt plus Medicare advances liability to Adjusted EBITDA (e) | 3.47 | 4.17 | 4.37 | 4.70 |
($ in millions) | Q3’21 | Q3’20 | YTD Q3’21 | YTD Q3’20 | ||||||||||
Net cash provided by operating activities | $432 | $593 | $1,211 | $2,961 | ||||||||||
Capital expenditures | $(111) | $(86) | $(354) | $(374) | ||||||||||
Free cash flow | $321 | $507 | $857 | $2,587 | ||||||||||
Adjusted free cash flow | $353 | $646 | $974 | $2,840 | ||||||||||
Net cash provided by (used in) investing activities | $997 | $(117) | $802 | $(406) | ||||||||||
Net cash provided by (used in) financing activities | $(1,331) | $(690) | $(2,167) | $483 |
CONSOLIDATED ($ in millions except per share amounts) | FY 2021 Outlook | Q4'21 Outlook | |||||||||
Net operating revenues | $19,500 to $19,800 | $4,871 to $5,171 | |||||||||
Net income from continuing operations available to Tenet common stockholders | $773 to $818 | $108 to $153 | |||||||||
Adjusted EBITDA | $3,275 to $3,325 | $809 to $859 | |||||||||
Adjusted EBITDA margin | ~16.8% | ~16.6% | |||||||||
Diluted income per common share from continuing operations | $7.09 to $7.50 | $0.99 to $1.40 | |||||||||
Adjusted net income from continuing operations | $670 to $695 | $141 to $166 | |||||||||
Adjusted diluted earnings per share from continuing operations | $6.15 to $6.38 | $1.29 to $1.52 | |||||||||
Equity in earnings of unconsolidated affiliates | $200 to $220 | $45 to $55 | |||||||||
Depreciation and amortization | $860 to $870 | $206 to $216 | |||||||||
Interest expense | $915 to $925 | $213 to $223 | |||||||||
Net income available to NCI | $565 to $585 | $173 to $193 | |||||||||
Weighted average diluted common shares | ~109 million | ~109 million | |||||||||
NCI cash distributions | $450 to $470 | ||||||||||
Effective tax rate (f) | ~18% | ||||||||||
Net cash provided by operating activities | $1,165 to $1,435 | ||||||||||
Adjusted net cash provided by operating activities | $1,325 to $1,575 | ||||||||||
Capital expenditures | $675 to $725 | ||||||||||
Adjusted free cash flow | $650 to $850 |
Hospital Segment ($ in millions) | FY 2021 Outlook | |||||||
Net operating revenues | $16,015 to $16,245 | |||||||
Adjusted EBITDA | $1,720 to $1,740 | |||||||
NCI | $35 to $40 | |||||||
Changes versus FY 2020 (g): | ||||||||
Inpatient admissions | Up 1% to 2% | |||||||
Outpatient visits | Up 15% to 18% | |||||||
Adjusted admissions | Up 3% to 4% | |||||||
Ambulatory Segment ($ in millions) | FY 2021 Outlook | |||||||
Net operating revenues | $2,700 to $2,750 | |||||||
Adjusted EBITDA | $1,205 to $1,225 | |||||||
Total NCI (Facility level and Baylor University Medical Center) | $470 to $480 | |||||||
Adjusted EBITDA less total NCI | $735 to $745 | |||||||
Changes versus FY 2020 (g): | ||||||||
Surgical cases volumes | Up 16% to 18% | |||||||
Net revenues per surgical case | (2.5%) to Flat |
Conifer Segment ($ in millions) | FY 2021 Outlook | |||||||
Net operating revenues | $1,275 to $1,295 | |||||||
Adjusted EBITDA | $350 to $360 | |||||||
NCI | $60 to $65 | |||||||
Investor Contact | Media Contact | |||||||
Regina Nethery | Lesley Bogdanow | |||||||
469-893-2387 | 469-893-2640 | |||||||
regina.nethery@tenethealth.com | mediarelations@tenethealth.com |
Description | Page | ||||
(Dollars in millions except per share amounts) | Three Months Ended September 30, | |||||||||||||||||||||||||||||||
2021 | % | 2020 | % | Change | ||||||||||||||||||||||||||||
Net operating revenues | $ | 4,894 | 100.0 | % | $ | 4,557 | 100.0 | % | 7.4 | % | ||||||||||||||||||||||
Grant income | 3 | 0.1 | % | (66) | (1.4) | % | 104.5 | % | ||||||||||||||||||||||||
Equity in earnings of unconsolidated affiliates | 45 | 0.9 | % | 44 | 1.0 | % | 2.3 | % | ||||||||||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||||||||||
Salaries, wages and benefits | 2,209 | 45.1 | % | 2,142 | 47.1 | % | 3.1 | % | ||||||||||||||||||||||||
Supplies | 827 | 16.9 | % | 784 | 17.2 | % | 5.5 | % | ||||||||||||||||||||||||
Other operating expenses, net | 1,051 | 21.5 | % | 1,058 | 23.2 | % | (0.7) | % | ||||||||||||||||||||||||
Depreciation and amortization | 209 | 4.3 | % | 215 | 4.7 | % | ||||||||||||||||||||||||||
Impairment and restructuring charges, and acquisition-related costs | 15 | 0.3 | % | 57 | 1.3 | % | ||||||||||||||||||||||||||
Litigation and investigation costs | 29 | 0.6 | % | 9 | 0.2 | % | ||||||||||||||||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | (412) | (8.4) | % | (1) | — | % | ||||||||||||||||||||||||||
Operating income | 1,014 | 20.7 | % | 271 | 5.9 | % | ||||||||||||||||||||||||||
Interest expense | (227) | (263) | ||||||||||||||||||||||||||||||
Other non-operating income, net | 7 | — | ||||||||||||||||||||||||||||||
Loss from early extinguishment of debt | (20) | (312) | ||||||||||||||||||||||||||||||
Income (loss) from continuing operations, before income taxes | 774 | (304) | ||||||||||||||||||||||||||||||
Income tax benefit (expense) | (197) | 197 | ||||||||||||||||||||||||||||||
Income (loss) from continuing operations, before discontinued operations | 577 | (107) | ||||||||||||||||||||||||||||||
Discontinued operations: | ||||||||||||||||||||||||||||||||
Income from operations | 1 | 1 | ||||||||||||||||||||||||||||||
Income from discontinued operations | 1 | 1 | ||||||||||||||||||||||||||||||
Net income (loss) | 578 | (106) | ||||||||||||||||||||||||||||||
Less: Net income available to noncontrolling interests | 129 | 90 | ||||||||||||||||||||||||||||||
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | 449 | $ | (196) | ||||||||||||||||||||||||||||
Amounts available (attributable) to Tenet Healthcare Corporation common shareholders | ||||||||||||||||||||||||||||||||
Income (loss) from continuing operations, net of tax | $ | 448 | $ | (197) | ||||||||||||||||||||||||||||
Income from discontinued operations, net of tax | 1 | 1 | ||||||||||||||||||||||||||||||
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | 449 | $ | (196) | ||||||||||||||||||||||||||||
Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||||||||||||||
Basic | ||||||||||||||||||||||||||||||||
Continuing operations | $ | 4.18 | $ | (1.87) | ||||||||||||||||||||||||||||
Discontinued operations | 0.01 | 0.01 | ||||||||||||||||||||||||||||||
$ | 4.19 | $ | (1.86) | |||||||||||||||||||||||||||||
Diluted | ||||||||||||||||||||||||||||||||
Continuing operations | $ | 4.12 | $ | (1.87) | ||||||||||||||||||||||||||||
Discontinued operations | 0.01 | 0.01 | ||||||||||||||||||||||||||||||
$ | 4.13 | $ | (1.86) | |||||||||||||||||||||||||||||
Weighted average shares and dilutive securities outstanding (in thousands): | ||||||||||||||||||||||||||||||||
Basic | 107,050 | 105,263 | ||||||||||||||||||||||||||||||
Diluted | 108,761 | 105,263 |
(Dollars in millions except per share amounts) | Nine Months Ended September 30, | |||||||||||||||||||||||||||||||
2021 | % | 2020 | % | Change | ||||||||||||||||||||||||||||
Net operating revenues | $ | 14,629 | 100.0 | % | $ | 12,725 | 100.0 | % | 15.0 | % | ||||||||||||||||||||||
Grant income | 53 | 0.4 | % | 445 | 3.5 | % | (88.1) | % | ||||||||||||||||||||||||
Equity in earnings of unconsolidated affiliates | 141 | 1.0 | % | 103 | 0.8 | % | 36.9 | % | ||||||||||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||||||||||
Salaries, wages and benefits | 6,690 | 45.8 | % | 6,193 | 48.6 | % | 8.0 | % | ||||||||||||||||||||||||
Supplies | 2,490 | 17.0 | % | 2,158 | 17.0 | % | 15.4 | % | ||||||||||||||||||||||||
Other operating expenses, net | 3,177 | 21.7 | % | 3,054 | 24.0 | % | 4.0 | % | ||||||||||||||||||||||||
Depreciation and amortization | 654 | 4.5 | % | 624 | 4.9 | % | ||||||||||||||||||||||||||
Impairment and restructuring charges, and acquisition-related costs | 55 | 0.4 | % | 166 | 1.3 | % | ||||||||||||||||||||||||||
Litigation and investigation costs | 64 | 0.4 | % | 13 | 0.1 | % | ||||||||||||||||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | (427) | (2.9) | % | (4) | — | % | ||||||||||||||||||||||||||
Operating income | 2,120 | 14.5 | % | 1,069 | 8.4 | % | ||||||||||||||||||||||||||
Interest expense | (702) | (761) | ||||||||||||||||||||||||||||||
Other non-operating income, net | 16 | 3 | ||||||||||||||||||||||||||||||
Loss from early extinguishment of debt | (74) | (316) | ||||||||||||||||||||||||||||||
Income (loss) from continuing operations, before income taxes | 1,360 | (5) | ||||||||||||||||||||||||||||||
Income tax benefit (expense) | (303) | 227 | ||||||||||||||||||||||||||||||
Income from continuing operations, before discontinued operations | 1,057 | 222 | ||||||||||||||||||||||||||||||
Discontinued operations: | ||||||||||||||||||||||||||||||||
Income from operations | — | — | ||||||||||||||||||||||||||||||
Income from discontinued operations | — | — | ||||||||||||||||||||||||||||||
Net income | 1,057 | 222 | ||||||||||||||||||||||||||||||
Less: Net income available to noncontrolling interests | 392 | 237 | ||||||||||||||||||||||||||||||
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | 665 | $ | (15) | ||||||||||||||||||||||||||||
Amounts available (attributable) to Tenet Healthcare Corporation common shareholders | ||||||||||||||||||||||||||||||||
Income (loss) from continuing operations, net of tax | $ | 665 | $ | (15) | ||||||||||||||||||||||||||||
Income (loss) from discontinued operations, net of tax | — | — | ||||||||||||||||||||||||||||||
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders | $ | 665 | $ | (15) | ||||||||||||||||||||||||||||
Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||||||||||||||
Basic | ||||||||||||||||||||||||||||||||
Continuing operations | $ | 6.23 | $ | (0.14) | ||||||||||||||||||||||||||||
Discontinued operations | — | — | ||||||||||||||||||||||||||||||
$ | 6.23 | $ | (0.14) | |||||||||||||||||||||||||||||
Diluted | ||||||||||||||||||||||||||||||||
Continuing operations | $ | 6.13 | $ | (0.14) | ||||||||||||||||||||||||||||
Discontinued operations | — | — | ||||||||||||||||||||||||||||||
$ | 6.13 | $ | (0.14) | |||||||||||||||||||||||||||||
Weighted average shares and dilutive securities outstanding (in thousands): | ||||||||||||||||||||||||||||||||
Basic | 106,727 | 104,803 | ||||||||||||||||||||||||||||||
Diluted | 108,465 | 104,803 |
September 30, | December 31, | |||||||||||||
(Dollars in millions) | 2021 | 2020 | ||||||||||||
ASSETS | ||||||||||||||
Current assets: | ||||||||||||||
Cash and cash equivalents | $ | 2,292 | $ | 2,446 | ||||||||||
Accounts receivable | 2,742 | 2,690 | ||||||||||||
Inventories of supplies, at cost | 376 | 368 | ||||||||||||
Assets held for sale | — | 140 | ||||||||||||
Other current assets | 1,495 | 1,503 | ||||||||||||
Total current assets | 6,905 | 7,147 | ||||||||||||
Investments and other assets | 2,564 | 2,534 | ||||||||||||
Deferred income taxes | 140 | 325 | ||||||||||||
Property and equipment, at cost, less accumulated depreciation and amortization | 6,162 | 6,692 | ||||||||||||
Goodwill | 8,662 | 8,808 | ||||||||||||
Other intangible assets, at cost, less accumulated amortization | 1,480 | 1,600 | ||||||||||||
Total assets | $ | 25,913 | $ | 27,106 | ||||||||||
LIABILITIES AND EQUITY | ||||||||||||||
Current liabilities: | ||||||||||||||
Current portion of long-term debt | $ | 125 | $ | 145 | ||||||||||
Accounts payable | 1,100 | 1,207 | ||||||||||||
Accrued compensation and benefits | 1,071 | 942 | ||||||||||||
Professional and general liability reserves | 268 | 243 | ||||||||||||
Accrued interest payable | 262 | 248 | ||||||||||||
Liabilities held for sale | — | 70 | ||||||||||||
Contract liabilities | 1,218 | 659 | ||||||||||||
Other current liabilities | 1,335 | 1,333 | ||||||||||||
Total current liabilities | 5,379 | 4,847 | ||||||||||||
Long-term debt, net of current portion | 14,009 | 15,574 | ||||||||||||
Professional and general liability reserves | 762 | 735 | ||||||||||||
Defined benefit plan obligations | 444 | 497 | ||||||||||||
Deferred income taxes | 29 | 29 | ||||||||||||
Contract liabilities - long-term | 15 | 918 | ||||||||||||
Other long-term liabilities | 1,592 | 1,617 | ||||||||||||
Total liabilities | 22,230 | 24,217 | ||||||||||||
Commitments and contingencies | ||||||||||||||
Redeemable noncontrolling interests in equity of consolidated subsidiaries | 2,048 | 1,952 | ||||||||||||
Equity: | ||||||||||||||
Shareholders’ equity: | ||||||||||||||
Common stock | 8 | 7 | ||||||||||||
Additional paid-in capital | 4,862 | 4,844 | ||||||||||||
Accumulated other comprehensive loss | (274) | (281) | ||||||||||||
Accumulated deficit | (1,463) | (2,128) | ||||||||||||
Common stock in treasury, at cost | (2,411) | (2,414) | ||||||||||||
Total shareholders’ equity | 722 | 28 | ||||||||||||
Noncontrolling interests | 913 | 909 | ||||||||||||
Total equity | 1,635 | 937 | ||||||||||||
Total liabilities and equity | $ | 25,913 | $ | 27,106 |
Nine Months Ended | ||||||||||||||
(Dollars in millions) | September 30, | |||||||||||||
2021 | 2020 | |||||||||||||
Net income | $ | 1,057 | $ | 222 | ||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||||||||
Depreciation and amortization | 654 | 624 | ||||||||||||
Deferred income tax expense (benefit) | 183 | (246) | ||||||||||||
Stock-based compensation expense | 43 | 38 | ||||||||||||
Impairment and restructuring charges, and acquisition-related costs | 55 | 166 | ||||||||||||
Litigation and investigation costs | 64 | 13 | ||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | (427) | (4) | ||||||||||||
Loss from early extinguishment of debt | 74 | 316 | ||||||||||||
Equity in earnings of unconsolidated affiliates, net of distributions received | 10 | (11) | ||||||||||||
Amortization of debt discount and debt issuance costs | 25 | 30 | ||||||||||||
Pre-tax loss from discontinued operations | — | — | ||||||||||||
Other items, net | (23) | (4) | ||||||||||||
Changes in cash from operating assets and liabilities: | ||||||||||||||
Accounts receivable | (202) | 280 | ||||||||||||
Inventories and other current assets | (111) | 30 | ||||||||||||
Income taxes | 67 | 9 | ||||||||||||
Accounts payable, accrued expenses, contract liabilities and other current liabilities | (149) | 1,546 | ||||||||||||
Other long-term liabilities | 8 | 205 | ||||||||||||
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (116) | (252) | ||||||||||||
Net cash used in operating activities from discontinued operations, excluding income taxes | (1) | (1) | ||||||||||||
Net cash provided by operating activities | 1,211 | 2,961 | ||||||||||||
Cash flows from investing activities: | ||||||||||||||
Purchases of property and equipment | (354) | (374) | ||||||||||||
Purchases of businesses or joint venture interests, net of cash acquired | (64) | (61) | ||||||||||||
Proceeds from sales of facilities and other assets | 1,235 | 13 | ||||||||||||
Proceeds from sales of marketable securities, long-term investments and other assets | 18 | 44 | ||||||||||||
Purchases of marketable securities and equity investments | (23) | (41) | ||||||||||||
Other items, net | (10) | 13 | ||||||||||||
Net cash provided by (used in) investing activities | 802 | (406) | ||||||||||||
Cash flows from financing activities: | ||||||||||||||
Repayments of borrowings under credit facility | — | (740) | ||||||||||||
Proceeds from borrowings under credit facility | — | 740 | ||||||||||||
Repayments of other borrowings | (3,183) | (3,244) | ||||||||||||
Proceeds from other borrowings | 1,413 | 3,815 | ||||||||||||
Debt issuance costs | (15) | (48) | ||||||||||||
Distributions paid to noncontrolling interests | (316) | (184) | ||||||||||||
Proceeds from sale of noncontrolling interests | 14 | 7 | ||||||||||||
Purchases of noncontrolling interests | (19) | (34) | ||||||||||||
Proceeds from shares issued under stock-based compensation plans, net of taxes paid related to net share settlement | 11 | 13 | ||||||||||||
Medicare advances and grants received by unconsolidated affiliates, net of recoupment | (8) | 150 | ||||||||||||
Other items, net | (64) | 8 | ||||||||||||
Net cash provided by (used in) financing activities | (2,167) | 483 | ||||||||||||
Net increase (decrease) in cash and cash equivalents | (154) | 3,038 | ||||||||||||
Cash and cash equivalents at beginning of period | 2,446 | 262 | ||||||||||||
Cash and cash equivalents at end of period | $ | 2,292 | $ | 3,300 | ||||||||||
Supplemental disclosures: | ||||||||||||||
Interest paid, net of capitalized interest | $ | (664) | $ | (757) | ||||||||||
Income tax payments, net | $ | (54) | $ | (10) |
Three Months Ended | Nine Months Ended | |||||||||||||||||||||||||
(Dollars in millions) | September 30, | September 30, | ||||||||||||||||||||||||
2021 | 2020 | 2021 | 2020 | |||||||||||||||||||||||
Net operating revenues (1) : | ||||||||||||||||||||||||||
Hospital Operations and other (prior to inter-segment eliminations) | $ | 4,030 | $ | 3,803 | $ | 12,072 | $ | 10,725 | ||||||||||||||||||
Ambulatory Care | 666 | 565 | 1,976 | 1,423 | ||||||||||||||||||||||
Conifer | ||||||||||||||||||||||||||
Tenet | 116 | 136 | 362 | 385 | ||||||||||||||||||||||
Other clients | 198 | 189 | 581 | 577 | ||||||||||||||||||||||
Total Conifer revenues | 314 | 325 | 943 | 962 | ||||||||||||||||||||||
Inter-segment eliminations | (116) | (136) | (362) | (385) | ||||||||||||||||||||||
Total | $ | 4,894 | $ | 4,557 | $ | 14,629 | $ | 12,725 | ||||||||||||||||||
Equity in earnings of unconsolidated affiliates: | ||||||||||||||||||||||||||
Hospital Operations and other | $ | 2 | $ | 3 | $ | 11 | $ | 1 | ||||||||||||||||||
Ambulatory Care | 43 | 41 | 130 | 102 | ||||||||||||||||||||||
Total | $ | 45 | $ | 44 | $ | 141 | $ | 103 | ||||||||||||||||||
Adjusted EBITDA (including grant income): | ||||||||||||||||||||||||||
Hospital Operations and other | $ | 496 | $ | 240 | $ | 1,379 | $ | 1,074 | ||||||||||||||||||
Ambulatory Care | 274 | 215 | 826 | 538 | ||||||||||||||||||||||
Conifer | 85 | 96 | 261 | 256 | ||||||||||||||||||||||
Total | $ | 855 | $ | 551 | $ | 2,466 | $ | 1,868 | ||||||||||||||||||
Adjusted EBITDA margins (including grant income): | ||||||||||||||||||||||||||
Hospital Operations and other | 12.3 | % | 6.3 | % | 11.4 | % | 10.0 | % | ||||||||||||||||||
Ambulatory Care | 41.1 | % | 38.1 | % | 41.8 | % | 37.8 | % | ||||||||||||||||||
Conifer | 27.1 | % | 29.5 | % | 27.7 | % | 26.6 | % | ||||||||||||||||||
Total | 17.5 | % | 12.1 | % | 16.9 | % | 14.7 | % | ||||||||||||||||||
Adjusted EBITDA margins (excluding grant income): | ||||||||||||||||||||||||||
Hospital Operations and other | 12.3 | % | 7.8 | % | 11.2 | % | 6.1 | % | ||||||||||||||||||
Ambulatory Care | 40.8 | % | 40.4 | % | 40.0 | % | 35.3 | % | ||||||||||||||||||
Conifer | 27.1 | % | 29.5 | % | 27.7 | % | 26.6 | % | ||||||||||||||||||
Total | 17.4 | % | 13.6 | % | 16.4 | % | 11.1 | % | ||||||||||||||||||
Capital expenditures: | ||||||||||||||||||||||||||
Hospital Operations and other | $ | 95 | $ | 71 | $ | 295 | $ | 328 | ||||||||||||||||||
Ambulatory Care | 14 | 11 | 49 | 32 | ||||||||||||||||||||||
Conifer | 2 | 4 | 10 | 14 | ||||||||||||||||||||||
Total | $ | 111 | $ | 86 | $ | 354 | $ | 374 | ||||||||||||||||||
(1) Net operating revenues include the impact of implicit price concessions and bad debts | ||||||||||||||||||||||||||
(Dollars in millions except per share amounts) | 2021 | |||||||||||||
Q3 | YTD | |||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders | $ | 449 | $ | 665 | ||||||||||
Net income from discontinued operations | 1 | — | ||||||||||||
Net income from continuing operations | 448 | 665 | ||||||||||||
Less: Impairment and restructuring charges, and acquisition-related costs | (15) | (55) | ||||||||||||
Litigation and investigation costs | (29) | (64) | ||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | 412 | 427 | ||||||||||||
Loss from early extinguishment of debt | (20) | (74) | ||||||||||||
Tax impact of above items | (116) | (98) | ||||||||||||
Adjusted net income available from continuing operations to common shareholders | $ | 216 | $ | 529 | ||||||||||
Diluted earnings per share from continuing operations | $ | 4.12 | $ | 6.13 | ||||||||||
Less: Impairment and restructuring charges, and acquisition-related costs | (0.14) | (0.51) | ||||||||||||
Litigation and investigation costs | (0.27) | (0.59) | ||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | 3.79 | 3.94 | ||||||||||||
Loss from early extinguishment of debt | (0.18) | (0.68) | ||||||||||||
Tax impact of above items | (1.07) | (0.91) | ||||||||||||
Adjusted diluted earnings per share from continuing operations | $ | 1.99 | $ | 4.88 | ||||||||||
Weighted average basic shares outstanding (in thousands) | 107,050 | 106,727 | ||||||||||||
Weighted average dilutive shares outstanding (in thousands) | 108,761 | 108,465 |
(Dollars in millions except per share amounts) | 2020 | |||||||||||||
Q3 | YTD | |||||||||||||
Net loss attributable to Tenet Healthcare Corporation common shareholders | $ | (196) | $ | (15) | ||||||||||
Net income from discontinued operations | 1 | — | ||||||||||||
Net loss from continuing operations | (197) | (15) | ||||||||||||
Less: Impairment and restructuring charges, and acquisition-related costs | (57) | (166) | ||||||||||||
Litigation and investigation costs | (9) | (13) | ||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | 1 | 4 | ||||||||||||
Loss from early extinguishment of debt | (312) | (316) | ||||||||||||
Tax impact of above items | 112 | 140 | ||||||||||||
Adjusted net income available from continuing operations to common shareholders | $ | 68 | $ | 336 | ||||||||||
Diluted loss per share from continuing operations | $ | (1.87) | $ | (0.14) | ||||||||||
Less: Impairment and restructuring charges, and acquisition-related costs | (0.54) | (1.57) | ||||||||||||
Litigation and investigation costs | (0.08) | (0.12) | ||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | 0.01 | 0.04 | ||||||||||||
Loss from early extinguishment of debt | (2.93) | (2.98) | ||||||||||||
Tax impact of above items | 1.05 | 1.32 | ||||||||||||
Adjusted diluted earnings per share from continuing operations | $ | 0.64 | $ | 3.17 | ||||||||||
Weighted average basic shares outstanding (in thousands) | 105,263 | 104,803 | ||||||||||||
Weighted average dilutive shares outstanding (in thousands) | 106,503 | 105,938 | ||||||||||||
(Dollars in millions) | 2021 | |||||||||||||
Q3 | YTD | |||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders | $ | 449 | $ | 665 | ||||||||||
Less: Net income available to noncontrolling interests | (129) | (392) | ||||||||||||
Income from discontinued operations, net of tax | 1 | — | ||||||||||||
Income from continuing operations | 577 | 1,057 | ||||||||||||
Income tax expense | (197) | (303) | ||||||||||||
Loss from early extinguishment of debt | (20) | (74) | ||||||||||||
Other non-operating income, net | 7 | 16 | ||||||||||||
Interest expense | (227) | (702) | ||||||||||||
Operating income | 1,014 | 2,120 | ||||||||||||
Litigation and investigation costs | (29) | (64) | ||||||||||||
Net gain on sales, consolidation and deconsolidation of facilities | 412 | 427 | ||||||||||||
Impairment and restructuring charges, and acquisition-related costs | (15) | (55) | ||||||||||||
Depreciation and amortization | (209) | (654) | ||||||||||||
Adjusted EBITDA | $ | 855 | $ | 2,466 | ||||||||||
Net operating revenues | $ | 4,894 | $ | 14,629 | ||||||||||
Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues | 9.2 | % | 4.5 | % | ||||||||||
Adjusted EBITDA as a % of Net operating revenues (Adjusted EBITDA margin) | 17.5 | % | 16.9 | % | ||||||||||
(Dollars in millions) | 2020 | |||||||||||||
Q3 | YTD | |||||||||||||
Net loss attributable to Tenet Healthcare Corporation common shareholders | $ | (196) | $ | (15) | ||||||||||
Less: Net income available to noncontrolling interests | (90) | (237) | ||||||||||||
Income from discontinued operations, net of tax | 1 | — | ||||||||||||
(Loss) income from continuing operations | (107) | 222 | ||||||||||||
Income tax benefit | 197 | 227 | ||||||||||||
Loss from early extinguishment of debt | (312) | (316) | ||||||||||||
Other non-operating income, net | — | 3 | ||||||||||||
Interest expense | (263) | (761) | ||||||||||||
Operating income | 271 | 1,069 | ||||||||||||
Litigation and investigation costs | (9) | (13) | ||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | 1 | 4 | ||||||||||||
Impairment and restructuring charges, and acquisition-related costs | (57) | (166) | ||||||||||||
Depreciation and amortization | (215) | (624) | ||||||||||||
Adjusted EBITDA | $ | 551 | $ | 1,868 | ||||||||||
Net operating revenues | $ | 4,557 | $ | 12,725 | ||||||||||
Net loss attributable to Tenet Healthcare Corporation common shareholders as a % of net operating revenues | (4.3) | % | (0.1) | % | ||||||||||
Adjusted EBITDA as a % of Net operating revenues (Adjusted EBITDA margin) | 12.1 | % | 14.7 | % |
(Dollars in millions) | 2021 | |||||||||||||
Q3 | YTD | |||||||||||||
Net cash provided by operating activities | $ | 432 | $ | 1,211 | ||||||||||
Purchases of property and equipment | (111) | (354) | ||||||||||||
Free cash flow | $ | 321 | $ | 857 | ||||||||||
Net cash provided by investing activities | $ | 997 | $ | 802 | ||||||||||
Net cash used in financing activities | $ | (1,331) | $ | (2,167) | ||||||||||
Net cash provided by operating activities | $ | 432 | $ | 1,211 | ||||||||||
Less: Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (31) | (116) | ||||||||||||
Net cash used in operating activities from discontinued operations | (1) | (1) | ||||||||||||
Adjusted net cash provided by operating activities from continuing operations | 464 | 1,328 | ||||||||||||
Purchases of property and equipment | (111) | (354) | ||||||||||||
Adjusted free cash flow – continuing operations | $ | 353 | $ | 974 |
(Dollars in millions) | 2020 | |||||||||||||
Q3 | YTD | |||||||||||||
Net cash provided by operating activities | $ | 593 | $ | 2,961 | ||||||||||
Purchases of property and equipment | (86) | (374) | ||||||||||||
Free cash flow | $ | 507 | $ | 2,587 | ||||||||||
Net cash used in investing activities | $ | (117) | $ | (406) | ||||||||||
Net cash (used in) provided by financing activities | $ | (690) | $ | 483 | ||||||||||
Net cash provided by operating activities | $ | 593 | $ | 2,961 | ||||||||||
Less: Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (138) | (252) | ||||||||||||
Net cash used in operating activities from discontinued operations | (1) | (1) | ||||||||||||
Adjusted net cash provided by operating activities from continuing operations | 732 | 3,214 | ||||||||||||
Purchases of property and equipment | (86) | (374) | ||||||||||||
Adjusted free cash flow – continuing operations | $ | 646 | $ | 2,840 |
(Dollars in millions) | Q4’21 | FY 2021 | ||||||||||||||||||||||||
Low | High | Low | High | |||||||||||||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders | $ | 108 | $ | 153 | $ | 773 | $ | 818 | ||||||||||||||||||
Less: Net income available to noncontrolling interests | (173) | (193) | (565) | (585) | ||||||||||||||||||||||
Income tax expense | (52) | (67) | (355) | (370) | ||||||||||||||||||||||
Interest expense | (223) | (213) | (925) | (915) | ||||||||||||||||||||||
Loss from early extinguishment of debt(1) | — | — | (74) | (74) | ||||||||||||||||||||||
Other non-operating income (expense), net | (1) | 4 | 15 | 20 | ||||||||||||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | — | — | 427 | 427 | ||||||||||||||||||||||
Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(2) | (41) | (21) | (160) | (140) | ||||||||||||||||||||||
Depreciation and amortization | (206) | (216) | (860) | (870) | ||||||||||||||||||||||
Loss from divested and closed businesses (i.e., health plan businesses) | (5) | — | (5) | — | ||||||||||||||||||||||
Adjusted EBITDA | $ | 809 | $ | 859 | $ | 3,275 | $ | 3,325 | ||||||||||||||||||
Net operating revenues | $ | 4,871 | $ | 5,171 | $ | 19,500 | $ | 19,800 | ||||||||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders as a % of operating revenues | 2.2 | % | 3.0 | % | 4.0 | % | 4.1 | % | ||||||||||||||||||
Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin) | 16.6 | % | 16.6 | % | 16.8 | % | 16.8 | % |
(Dollars in millions except per share amounts) | Q4’21 | FY 2021 | ||||||||||||||||||||||||
Low | High | Low | High | |||||||||||||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders | $ | 108 | $ | 153 | $ | 773 | $ | 818 | ||||||||||||||||||
Net income from discontinued operations, net of tax | — | — | — | — | ||||||||||||||||||||||
Net income from continuing operations | 108 | 153 | 773 | 818 | ||||||||||||||||||||||
Less: Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1) | (41) | (21) | (160) | (140) | ||||||||||||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | — | — | 427 | 427 | ||||||||||||||||||||||
Loss from early extinguishment of debt(2) | — | — | (74) | (74) | ||||||||||||||||||||||
Loss from divested and closed businesses (i.e., health plan businesses) | (5) | — | (5) | — | ||||||||||||||||||||||
Tax impact of above items | 13 | 8 | (85) | (90) | ||||||||||||||||||||||
Noncontrolling interests impact of above items | — | — | — | — | ||||||||||||||||||||||
Adjusted net income available from continuing operations to common shareholders | $ | 141 | $ | 166 | $ | 670 | $ | 695 | ||||||||||||||||||
Diluted earnings per share from continuing operations | $ | 0.99 | $ | 1.40 | $ | 7.09 | $ | 7.50 | ||||||||||||||||||
Less: Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements | (0.38) | (0.19) | (1.47) | (1.29) | ||||||||||||||||||||||
Net gains on sales, consolidation and deconsolidation of facilities | — | — | 3.92 | 3.92 | ||||||||||||||||||||||
Loss from early extinguishment of debt | — | — | (0.68) | (0.68) | ||||||||||||||||||||||
Loss from divested and closed businesses (i.e., health plan businesses) | (0.05) | — | (0.05) | — | ||||||||||||||||||||||
Tax impact of above items | 0.12 | 0.07 | (0.78) | (0.83) | ||||||||||||||||||||||
Noncontrolling interests impact of above items | — | — | — | — | ||||||||||||||||||||||
Adjusted diluted earnings per share from continuing operations | $ | 1.29 | $ | 1.52 | $ | 6.15 | $ | 6.38 | ||||||||||||||||||
Weighted average basic shares outstanding (in thousands) | 107,000 | 107,000 | 107,000 | 107,000 | ||||||||||||||||||||||
Weighted average dilutive shares outstanding (in thousands) | 109,000 | 109,000 | 109,000 | 109,000 |
(Dollars in millions) | FY 2021 | |||||||||||||||||||||||||||||||
Low | High | |||||||||||||||||||||||||||||||
Net cash provided by operating activities | $ | 1,165 | $ | 1,435 | ||||||||||||||||||||||||||||
Purchases of property and equipment – continuing operations | (675) | (725) | ||||||||||||||||||||||||||||||
Free cash flow – continuing operations | $ | 490 | $ | 710 | ||||||||||||||||||||||||||||
Net cash provided by operating activities | $ | 1,165 | $ | 1,435 | ||||||||||||||||||||||||||||
Less: Payments for restructuring charges, acquisition-related costs and litigation costs and settlements(1) | (160) | (140) | ||||||||||||||||||||||||||||||
Adjusted net cash provided by operating activities – continuing operations | 1,325 | 1,575 | ||||||||||||||||||||||||||||||
Purchases of property and equipment – continuing operations | (675) | (725) | ||||||||||||||||||||||||||||||
Adjusted free cash flow – continuing operations(2) | $ | 650 | $ | 850 |
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