0001193125-21-219158.txt : 20210720 0001193125-21-219158.hdr.sgml : 20210720 20210720080600 ACCESSION NUMBER: 0001193125-21-219158 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 15 CONFORMED PERIOD OF REPORT: 20210720 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Regulation FD Disclosure ITEM INFORMATION: Other Events ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20210720 DATE AS OF CHANGE: 20210720 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HCA Healthcare, Inc. CENTRAL INDEX KEY: 0000860730 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 273865930 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 211099513 BUSINESS ADDRESS: STREET 1: ONE PARK PLZ CITY: NASHVILLE STATE: TN ZIP: 37203 BUSINESS PHONE: 6153449551 MAIL ADDRESS: STREET 1: ONE PARK PLAZA CITY: NASHVILLE STATE: TN ZIP: 37203 FORMER COMPANY: FORMER CONFORMED NAME: HCA Holdings, Inc. DATE OF NAME CHANGE: 20101126 FORMER COMPANY: FORMER CONFORMED NAME: HCA INC/TN DATE OF NAME CHANGE: 20010627 FORMER COMPANY: FORMER CONFORMED NAME: HCA THE HEALTHCARE CO DATE OF NAME CHANGE: 20010419 8-K 1 d141111d8k.htm 8-K 8-K
false 0000860730 0000860730 2021-07-20 2021-07-20

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

PURSUANT TO SECTION 13 OR 15(d) OF THE

SECURITIES EXCHANGE ACT OF 1934

Date of Report (Date of earliest event reported): July 20, 2021

 

 

HCA HEALTHCARE, INC.

(Exact name of registrant as specified in its charter)

 

 

 

Delaware   001-11239   27-3865930

(State or other jurisdiction

of incorporation)

 

(Commission

File Number)

 

(IRS Employer

Identification No.)

One Park Plaza, Nashville,

Tennessee

  37203
(Address of principal executive offices)   (Zip Code)

Registrant’s telephone number, including area code: (615) 344-9551

Not Applicable

(Former name or former address, if changed since last report)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

 

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))

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each Class

  

Trading

Symbol(s)

  

Name of each exchange

on which registered

Common Stock, $.01 par value per share    HCA    New York Stock Exchange

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company     

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.     ☐

 

 

 


Item 2.02. Results of Operations and Financial Condition.

On July 20, 2021, HCA Healthcare, Inc. (the “Company”) issued a press release announcing, among other matters, its results of operations for the second quarter ended June 30, 2021, the text of which is set forth as Exhibit 99.1.

Item 7.01. Regulation FD Disclosure.

On July 20, 2021, the Company issued a press release announcing, among other matters, its results of operations for the second quarter ended June 30, 2021, the text of which is set forth as Exhibit 99.1.

Item 8.01. Other Events.

On July 20, 2021, the Company announced that its Board of Directors had declared a quarterly cash dividend of $0.48 per share of the Company’s common stock. The dividend will be paid on September 30, 2021 to stockholders of record at the close of business on September 16, 2021.

Item 9.01. Financial Statements and Exhibits.

 

(d)

Exhibits:

 

Exhibit 99.1    Press Release, dated July 20, 2021
Exhibit 104    Cover Page Interactive Data File (embedded within the Inline XBRL document).


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

HCA HEALTHCARE, INC.
 

/s/ William B. Rutherford

 

William B. Rutherford

Executive Vice President and Chief Financial Officer

Date: July 20, 2021

EX-99.1 2 d141111dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

 

LOGO

   LOGO

 

 

 

   FOR IMMEDIATE RELEASE

INVESTOR CONTACT:

   MEDIA CONTACT:

Mark Kimbrough

   Harlow Sumerford

615-344-2688

   615-344-1851

HCA Healthcare Reports Second Quarter 2021 Results;

Raises 2021 Guidance

Nashville, Tenn., July 20, 2021 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2021.

Key second quarter metrics (all percentage changes compare 2Q 2021 to 2Q 2020 unless otherwise noted):

 

 

Revenues totaled $14.435 billion

 

 

Net income attributable to HCA Healthcare, Inc. totaled $1.450 billion, or $4.36 per diluted share

 

 

Adjusted EBITDA totaled $3.219 billion

 

 

Cash flows from operating activities totaled $2.251 billion

 

 

Same facility admissions increased 17.5 percent and same facility equivalent admissions increased 26.8 percent

“With the effects of the pandemic moderating in the second quarter, we experienced a strong rebound in demand for healthcare services,” said Sam Hazen, Chief Executive Officer of HCA Healthcare. “We continue to invest aggressively in our strategic agenda, which is building greater clinical capabilities to serve our communities while also developing more comprehensive enterprise resources to support caregivers and differentiate our local networks.”

Revenues in the second quarter of 2021 increased to $14.435 billion, compared to $11.068 billion in the second quarter of 2020. Net income attributable to HCA Healthcare, Inc. totaled $1.450 billion, or $4.36 per diluted share, compared to $1.079 billion, or $3.16 per diluted share, in the second quarter of 2020. The second quarter of 2021 results include gains on sales of facilities of $8 million, or $0.02 per diluted share, and losses on retirement of debt of $12 million, or $0.03 per diluted share. The second quarter of 2020 results included losses on sales of facilities of $27 million, or $0.07 per diluted share. The Company recognized $822 million ($590 million net of tax), or $1.73 per diluted share, in government stimulus income during the second quarter of 2020 related to general distribution funds received from the provider relief fund established by the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act. During October 2020, the Company announced it would return, or repay early, its share of provider relief fund distributions of approximately $1.6 billion and approximately $4.4 billion in Medicare accelerated payments. In the third quarter of 2020, the Company reversed the $822 million of government stimulus income that it recognized during the second quarter of 2020.

 

1


For the second quarter of 2021, Adjusted EBITDA totaled $3.219 billion, compared to $2.666 billion in the second quarter of 2020, which included $822 million in government stimulus income. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions increased 17.5 percent and same facility equivalent admissions increased 26.8 percent in the second quarter of 2021, compared to the prior year period. Same facility emergency room visits increased 40.5 percent in the second quarter of 2021, compared to the prior year period. Same facility inpatient surgeries increased 15.0 percent while same facility outpatient surgeries increased 52.5 percent in the second quarter of 2021 compared to the same period of 2020. The second quarter of 2021 volume statistics show strong recoveries from the pandemic-related restrictions and policies that negatively affected patient volumes during the second quarter of 2020. Same facility revenue per equivalent admission increased 2.6 percent in the second quarter of 2021, compared to the second quarter of 2020.

Because of the decline in volumes in the second quarter of 2020 driven by the pandemic-related restrictions and policies, the Company believes a comparison of volume statistics to the comparable period in 2019 provides additional context to the improvement in operations during 2021. The following table provides a summary of statistical measures for the second quarter of 2021 compared to the same period in 2019 on a consolidated basis.

 

     Second Quarter  
     2021      2019      % Change  

Reported:

        

Admissions

     532,041        518,253        2.7

Equivalent Admissions

     916,212        903,419        1.4

Patient Days

     2,629,950        2,530,548        3.9

Equivalent Patient Days

     4,535,678        4,412,348        2.8

Inpatient Surgery Cases

     136,460        140,473        -2.9

Outpatient Surgery Cases

     262,107        253,441        3.4

Emergency Room Visits

     2,128,428        2,253,337        -5.5

Six Months Ended June 30, 2021

Revenues for the six months ended June 30, 2021 totaled $28.412 billion, compared to $23.929 billion in the same period of 2020. Net income attributable to HCA Healthcare, Inc. was $2.873 billion, or $8.50 per diluted share, compared to $1.660 billion, or $4.84 per diluted share, for the first six months of 2020. Results for the six months ended June 30, 2021 included gains on sales of facilities of $10 million, or $0.02 per diluted share, and losses on retirement of debt of $12 million, or $0.03 per diluted share. Results for the six months ended June 30, 2020 included government stimulus income of $822 million ($590 million net of tax), or $1.72 per diluted share, losses on sales of facilities of $20 million, or $0.06 per diluted share, and losses on retirement of debt of $295 million, or $0.66 per diluted share.

Balance Sheet and Cash Flows from Operations

As of June 30, 2021, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $1.120 billion, total debt of $32.572 billion, and total assets of $48.164 billion. During the second quarter of 2021, capital expenditures totaled $842 million, excluding acquisitions. Cash flows provided by operating activities in the second quarter totaled $2.251 billion, compared to $8.723 billion in the second quarter of 2020. The $8.723 billion of cash flow from operations for the second quarter of 2020 included the $822 million of government stimulus income and $4.999 billion of contract liabilities-deferred revenues, which were reversed during the third and fourth quarters of 2020.

 

2


During the second quarter of 2021, the Company repurchased 11.261 million shares of its common stock at a cost of $2.287 billion. The Company had $4.987 billion remaining under its repurchase authorization as of June 30, 2021. As of June 30, 2021, the Company had $5.620 billion of availability under its credit facilities.

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.48 per share on the Company’s common stock. The dividend will be paid on September 30, 2021 to stockholders of record at the close of business on September 16, 2021.

The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company’s financial condition and results of operations and contractual restrictions. Future dividends are expected to be funded by cash balances and future cash flows from operations.

2021 Revised Guidance

The 2021 guidance ranges for the year have been revised from our first quarter release and are as follows:

 

    

2021 Guidance Range

Revenues    $57.0 to $58.0 billion
Adjusted EBITDA    $12.10 to $12.50 billion
EPS (diluted)    $16.30 to $17.10 per diluted share
Capital Expenditures    Approximately $3.7 billion

The Company’s 2021 guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding the impact of the COVID-19 pandemic and related government legislation, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.

Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.

The Company’s guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company’s “Forward-Looking Statements.”

Earnings Conference Call

HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Daylight Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company’s Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx.

 

3


About the Company

As of June 30, 2021, HCA operated 187 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 states and the United Kingdom.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company’s financial guidance for the year ending December 31, 2021, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) developments related to COVID-19, including, without limitation, the length and severity of the pandemic and the spread of virus strains with new epidemiological characteristics; the volume of canceled or rescheduled procedures and the volume of COVID-19 patients cared for across our health systems; measures we are taking to respond to the COVID-19 pandemic; the impact and terms of government and administrative regulation and stimulus (including the Families First Coronavirus Response Act, the Coronavirus Aid, Relief and Economic Security (“CARES”) Act, the Paycheck Protection Program and Health Care Enhancement Act, the Consolidated Appropriations Act, 2021, the American Rescue Plan Act of 2021 and other enacted and potential future legislation); changes in revenues due to declining patient volumes, changes in payer mix and deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions; and the timing, availability and adoption of effective medical treatments and vaccines, (2) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financial perspective, (3) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”), including the effects of changes or court challenges to the Affordable Care Act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including proposals to expand coverage of federally-funded insurance programs as an alternative to private insurance or establish a single-payer system (such reforms often referred to as “Medicare for All”), and also including any such laws or governmental regulations which are adopted in response to the COVID-19 pandemic, (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions, and those required under the Pay-As-You-Go Act of 2010 (“PAYGO Act”) as a result of the federal budget deficit impact of the American Rescue Plan Act of 2021, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment

 

4


amounts for insured accounts, (6) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) the highly competitive nature of the health care business, (9) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (10) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (11) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (12) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) changes in general economic conditions nationally and regionally in our markets, including economic and business conditions (and the impact thereof on the economy, financial markets and banking industry) resulting from the COVID-19 pandemic, (16) the emergence of and effects related to other pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record (“EHR”) technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (25) changes in the U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2020 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

All references to “Company” and “HCA Healthcare” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

 

5


HCA Healthcare, Inc.  
Condensed Consolidated Comprehensive Income Statements  
Second Quarter  
(Dollars in millions, except per share amounts)  
     2021     2020  
     Amount     Ratio     Amount     Ratio  

Revenues

   $ 14,435       100.0   $ 11,068       100.0

Salaries and benefits

     6,385       44.2       5,330       48.2  

Supplies

     2,380       16.5       1,748       15.8  

Other operating expenses

     2,473       17.2       2,147       19.3  

Government stimulus income

                 (822     (7.4

Equity in earnings of affiliates

     (22     (0.2     (1      

Depreciation and amortization

     712       4.9       691       6.3  

Interest expense

     386       2.7       388       3.5  

Losses (gains) on sales of facilities

     (8     (0.1     27       0.2  

Losses on retirement of debt

     12       0.1              
  

 

 

   

 

 

   

 

 

   

 

 

 
     12,318       85.3       9,508       85.9  
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     2,117       14.7       1,560       14.1  

Provision for income taxes

     453       3.2       344       3.1  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     1,664       11.5       1,216       11.0  

Net income attributable to noncontrolling interests

     214       1.5       137       1.2  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc.

   $ 1,450       10.0     $ 1,079       9.8  
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted earnings per share

   $ 4.36       $ 3.16    

Shares used in computing diluted earnings per share (millions)

     332.613         341.599    

Comprehensive income attributable to HCA Healthcare, Inc.

   $ 1,466       $ 1,088    
  

 

 

     

 

 

   

 

6


HCA Healthcare, Inc.  
Condensed Consolidated Comprehensive Income Statements  
For the Six Months Ended June 30, 2021 and 2020  
(Dollars in millions, except per share amounts)  
     2021     2020  
     Amount     Ratio     Amount     Ratio  

Revenues

   $ 28,412       100.0   $ 23,929       100.0

Salaries and benefits

     12,686       44.6       11,448       47.8  

Supplies

     4,604       16.2       3,871       16.2  

Other operating expenses

     4,894       17.3       4,574       19.1  

Government stimulus income

                 (822     (3.4

Equity in earnings of affiliates

     (43     (0.2     (8      

Depreciation and amortization

     1,409       5.0       1,365       5.7  

Interest expense

     770       2.7       816       3.4  

Losses (gains) on sales of facilities

     (10           20       0.1  

Losses on retirement of debt

     12             295       1.2  
  

 

 

   

 

 

   

 

 

   

 

 

 
     24,322       85.6       21,559       90.1  
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     4,090       14.4       2,370       9.9  

Provision for income taxes

     846       3.0       456       1.9  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     3,244       11.4       1,914       8.0  

Net income attributable to noncontrolling interests

     371       1.3       254       1.1  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc.

   $ 2,873       10.1     $ 1,660       6.9  
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted earnings per share

   $ 8.50       $ 4.84    

Shares used in computing diluted earnings per share (millions)

     337.940         342.848    

Comprehensive income attributable to HCA Healthcare, Inc.

   $ 2,900       $ 1,558    
  

 

 

     

 

 

   

 

7


HCA Healthcare, Inc.  
Condensed Consolidated Balance Sheets  
(Dollars in millions)  
     June 30,     March 31,     December 31,  
     2021     2021     2020  

ASSETS

      

Current assets:

      

Cash and cash equivalents

   $ 1,120     $ 1,030     $ 1,793  

Accounts receivable

     7,636       7,424       7,051  

Inventories

     2,027       2,068       2,025  

Other

     1,692       1,514       1,464  
  

 

 

   

 

 

   

 

 

 
     12,475       12,036       12,333  

Property and equipment, at cost

     50,698       49,877       49,317  

Accumulated depreciation

     (27,227     (26,689     (26,118
  

 

 

   

 

 

   

 

 

 
     23,471       23,188       23,199  

Investments of insurance subsidiaries

     410       393       388  

Investments in and advances to affiliates

     382       427       422  

Goodwill and other intangible assets

     8,680       8,575       8,578  

Right-of-use operating lease assets

     2,118       2,083       2,024  

Other

     628       575       546  
  

 

 

   

 

 

   

 

 

 
   $ 48,164     $ 47,277     $ 47,490  
  

 

 

   

 

 

   

 

 

 

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current liabilities:

      

Accounts payable

   $ 3,531     $ 3,524     $ 3,535  

Accrued salaries

     1,896       1,767       1,720  

Other accrued expenses

     2,935       3,117       3,240  

Long-term debt due within one year

     253       234       209  
  

 

 

   

 

 

   

 

 

 
     8,615       8,642       8,704  

Long-term debt, less debt issuance costs and discounts of $255, $229 and $236

     32,319       30,838       30,795  

Professional liability risks

     1,585       1,553       1,486  

Right-of-use operating lease obligations

     1,767       1,730       1,673  

Income taxes and other liabilities

     2,088       2,032       1,940  

Stockholders’ equity:

      

Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc.

     (593     247       572  

Noncontrolling interests

     2,383       2,235       2,320  
  

 

 

   

 

 

   

 

 

 
     1,790       2,482       2,892  
  

 

 

   

 

 

   

 

 

 
   $ 48,164     $ 47,277     $ 47,490  
  

 

 

   

 

 

   

 

 

 

 

8


HCA Healthcare, Inc.  
Condensed Consolidated Statements of Cash Flows  
For the Six Months Ended June 30, 2021 and 2020  
(Dollars in millions)  
     2021     2020  

Cash flows from operating activities:

    

Net income

   $ 3,244     $ 1,914  

Adjustments to reconcile net income to net cash provided by operating activities:

    

Increase (decrease) in cash from operating assets and liabilities:

    

Accounts receivable

     (567     1,215  

Inventories and other assets

     (213     (57

Accounts payable and accrued expenses

     49       (336

Contract liabilities - deferred revenues

           4,999  

Depreciation and amortization

     1,409       1,365  

Income taxes

     2       472  

Losses (gains) on sales of facilities

     (10     20  

Losses on retirement of debt

     12       295  

Amortization of debt issuance costs and discounts

     14       14  

Share-based compensation

     226       148  

Other

     73       49  
  

 

 

   

 

 

 

Net cash provided by operating activities

     4,239       10,098  
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchase of property and equipment

     (1,496     (1,598

Acquisition of hospitals and health care entities

     (98     (346

Sales of hospitals and health care entities

     30       39  

Change in investments

     (12     (11

Other

     7       (37
  

 

 

   

 

 

 

Net cash used in investing activities

     (1,569     (1,953
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Issuances of long-term debt

     4,337       2,700  

Net change in revolving credit facilities

     800       (2,480

Repayment of long-term debt

     (3,731     (3,364

Distributions to noncontrolling interests

     (357     (199

Payment of debt issuance costs

     (32     (35

Payment of dividends

     (325     (153

Repurchase of common stock

     (3,814     (441

Other

     (224     (144
  

 

 

   

 

 

 

Net cash used in financing activities

     (3,346     (4,116
  

 

 

   

 

 

 

Effect of exchange rate changes on cash and cash equivalents

     3       (12
  

 

 

   

 

 

 

Change in cash and cash equivalents

     (673     4,017  

Cash and cash equivalents at beginning of period

     1,793       621  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 1,120     $ 4,638  
  

 

 

   

 

 

 

Interest payments

   $ 755     $ 854  

Income tax payments (refunds), net

   $ 844     $ (16

 

9


HCA Healthcare, Inc.  
Operating Statistics  
                 For the Six Months  
     Second Quarter     Ended June 30,  
     2021     2020     2021     2020  

Operations:

        

Number of Hospitals

     187       186       187       186  

Number of Freestanding Outpatient Surgery Centers*

     122       122       122       122  

Licensed Beds at End of Period

     49,693       49,403       49,693       49,403  

Weighted Average Beds in Service

     42,464       42,309       42,413       42,243  

Reported:

        

Admissions

     532,041       452,992       1,038,421       981,236  

% Change

     17.5       5.8  

Equivalent Admissions

     916,212       723,136       1,748,701       1,612,171  

% Change

     26.7       8.5  

Revenue per Equivalent Admission

   $ 15,756     $ 15,305     $ 16,248     $ 14,843  

% Change

     2.9       9.5  

Inpatient Revenue per Admission

   $ 16,144     $ 15,757     $ 16,606     $ 15,152  

% Change

     2.5       9.6  

Patient Days

     2,629,950       2,260,816       5,300,991       4,883,655  

% Change

     16.3       8.5  

Equivalent Patient Days

     4,535,678       3,609,607       8,926,869       8,023,845  

% Change

     25.7       11.3  

Inpatient Surgery Cases

     136,460       118,591       264,050       253,736  

% Change

     15.1       4.1  

Outpatient Surgery Cases

     262,107       170,911       493,335       397,230  

% Change

     53.4       24.2  

Emergency Room Visits

     2,128,428       1,516,116       3,970,206       3,780,823  

% Change

     40.4       5.0  

Outpatient Revenues as a

        

Percentage of Patient Revenues

     38.2     31.8     37.0     34.8

Average Length of Stay (days)

     4.943       4.991       5.105       4.977  

Occupancy (weighted average beds in service)

     68.1     58.7     69.1     63.5

Same Facility:

        

Admissions

     530,067       450,964       1,035,404       978,388  

% Change

     17.5       5.8  

Equivalent Admissions

     911,715       718,837       1,741,550       1,605,535  

% Change

     26.8       8.5  

Revenue per Equivalent Admission

   $ 15,683     $ 15,290     $ 16,193     $ 14,786  

% Change

     2.6       9.5  

Inpatient Revenue per Admission

   $ 16,168     $ 15,786     $ 16,626     $ 15,172  

% Change

     2.4       9.6  

Inpatient Surgery Cases

     136,027       118,293       263,608       253,011  

% Change

     15.0       4.2  

Outpatient Surgery Cases

     259,263       170,025       489,233       394,747  

% Change

     52.5       23.9  

Emergency Room Visits

     2,115,901       1,506,441       3,952,401       3,758,123  

% Change

     40.5       5.2  

 

*

Excludes freestanding endoscopy centers (21 centers at both June 30, 2021 and June 30, 2020).

 

10


HCA Healthcare, Inc.  
Supplemental Non-GAAP Disclosures  
Operating Results Summary  
(Dollars in millions, except per share amounts)  
                 For the Six Months  
     Second Quarter     Ended June 30,  
     2021     2020     2021     2020  

Revenues

   $ 14,435     $ 11,068     $ 28,412     $ 23,929  

Net income attributable to HCA Healthcare, Inc.

   $ 1,450     $ 1,079     $ 2,873     $ 1,660  

Losses (gains) on sales of facilities (net of tax)

     (6     24       (7     19  

Losses on retirement of debt (net of tax)

     9             9       227  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt (a)

     1,453       1,103       2,875       1,906  

Depreciation and amortization

     712       691       1,409       1,365  

Interest expense

     386       388       770       816  

Provision for income taxes

     454       347       846       525  

Net income attributable to noncontrolling interests

     214       137       371       254  
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA (a)

   $ 3,219     $ 2,666     $ 6,271     $ 4,866  
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA margin (a)

     22.3     24.1     22.1     20.3

Diluted earnings per share:

        

Net income attributable to HCA Healthcare, Inc.

   $ 4.36     $ 3.16     $ 8.50     $ 4.84  

Losses (gains) on sales of facilities

     (0.02     0.07       (0.02     0.06  

Losses on retirement of debt

     0.03             0.03       0.66  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt (a)

   $ 4.37     $ 3.23     $ 8.51     $ 5.56  
  

 

 

   

 

 

   

 

 

   

 

 

 

Shares used in computing diluted earnings per share (millions)

     332.613       341.599       337.940       342.848  

 

(a)

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles (“GAAP”). We believe net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that losses (gains) on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

 

11


HCA Healthcare, Inc.  
Supplemental Non-GAAP Disclosures  
2021 Operating Results Forecast  
(Dollars in millions, except per share amounts)  
     For the Year Ending  
     December 31, 2021  
     Low      High  

Revenues

   $ 57,000      $ 58,000  

Net income attributable to HCA Healthcare, Inc. (a)

   $ 5,350      $ 5,615  

Depreciation and amortization

     2,840        2,860  

Interest expense

     1,560        1,580  

Provision for income taxes

     1,625        1,695  

Net income attributable to noncontrolling interests

     725        750  
  

 

 

    

 

 

 

Adjusted EBITDA (a) (b)

   $ 12,100      $ 12,500  
  

 

 

    

 

 

 

Diluted earnings per share:

     

Net income attributable to HCA Healthcare, Inc.

   $ 16.30      $ 17.10  

Shares used in computing diluted earnings per share (millions)

     329.000        329.000  

The Company’s forecasted guidance range is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks.

 

(a)

The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets because the Company does not believe that it can forecast these items with sufficient accuracy.

 

(b)

Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles (“GAAP”). We believe Adjusted EBITDA is an important measure that supplements discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon Adjusted EBITDA as a primary measure to review and assess operating performance of its health care facilities and their management teams.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry.

Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

 

12

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MDL231M',B21N,,C+D,/0BL[2?"NBZ#(\FA:/I>G/)P[6EG'"6^I4#-%%.X&I &1112 __9 end XML 8 d141111d8k_htm.xml IDEA: XBRL DOCUMENT 0000860730 2021-07-20 2021-07-20 false 0000860730 8-K 2021-07-20 HCA HEALTHCARE, INC. DE 001-11239 27-3865930 One Park Plaza Nashville TN 37203 (615) 344-9551 false false false false Common Stock, $.01 par value per share HCA NYSE false XML 9 R1.htm IDEA: XBRL DOCUMENT v3.21.2
Document and Entity Information
Jul. 20, 2021
Cover [Abstract]  
Amendment Flag false
Entity Central Index Key 0000860730
Document Type 8-K
Document Period End Date Jul. 20, 2021
Entity Registrant Name HCA HEALTHCARE, INC.
Entity Incorporation State Country Code DE
Entity File Number 001-11239
Entity Tax Identification Number 27-3865930
Entity Address, Address Line One One Park Plaza
Entity Address, City or Town Nashville
Entity Address, State or Province TN
Entity Address, Postal Zip Code 37203
City Area Code (615)
Local Phone Number 344-9551
Written Communications false
Soliciting Material false
Pre Commencement Tender Offer false
Pre Commencement Issuer Tender Offer false
Security 12b Title Common Stock, $.01 par value per share
Trading Symbol HCA
Security Exchange Name NYSE
Entity Emerging Growth Company false
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