Tenet Reports Strongest Volume Growth in Four Years for Quarter Ended June 30, 2008
* Reuters is not responsible for the content in this press release.
Highlights:
-- 1.9 percent increase in same-hospital admissions
-- 0.4 percent growth in same-hospital paying outpatient visits
-- 2.3 percent growth in same-hospital surgeries
-- 7.5 percent increase in same-hospital commercial managed care
revenues
-- $171 million in same-hospital adjusted EBITDA, an increase of
9.6 percent
-- $42 million in adjusted free cash flow from continuing
operations
-- $102 million in capital expenditures in continuing operations
-- $352 million in cash and equivalents at June 30, 2008, up $74
million from March 31, 2008
DALLAS--(Business Wire)--
Tenet Healthcare Corporation (NYSE:THC) today reported a net loss
of $15 million, or $0.03 per share, for its second quarter of 2008,
compared to a net loss of $30 million, or $0.06 per share, for its
second quarter of 2007. Adjusted EBITDA, defined below, for the second
quarter of 2008 was $163 million, an increase of 4.5 percent, as
compared to $156 million for the second quarter of 2007. Adjusted
EBITDA for the second quarter of 2008 excluded $12 million of EBITDA
from USC University Hospital, which was moved to discontinued
operations, and two other hospitals that were divested during the
quarter. The exclusion of USC University Hospital from continuing
operations and the impact of a $16 million adverse prior year cost
report adjustment related to a pending CMS decision in connection with
GME FTE limits and related reimbursement at one of our hospitals
reduced continuing operations earnings per share by $0.03 per share.
"I am very pleased with our core, same-hospital growth in
admissions as well as the increase in outpatient visits by paying
patients," said Trevor Fetter, president and chief executive officer.
"Not only is this the best performance we've had in the last four
years, it continues an improving trend and demonstrates the increasing
effectiveness of our strategies around quality, targeted service
lines, and physician relationships."
"Same-hospital commercial managed care admissions were up 1.3
percent in the eight service lines representing the primary focus of
our Targeted Growth Initiative," said Stephen L. Newman, M.D., chief
operating officer. "This growth was aided by net expansion of our
active medical staff, which grew by 354 physicians in the second
quarter, including 119 physicians at our new hospital in El Paso. We
expect the increasing number of physicians on the medical staffs of
our hospitals will prove to be a robust leading indicator of our
ability to sustain our positive trend in volumes. Pricing increases
were also strong in the quarter, with same-hospital net operating
revenues from commercial payers growing by 7.5 percent."
"We produced $42 million in adjusted free cash flow from
continuing operations in the quarter," said Biggs C. Porter, chief
financial officer. "We are substantively unchanged in our outlook for
2008, adjusting it only for the reclassification of USC to
discontinued operations. We are also maintaining our $1 billion 2009
objective for adjusted EBITDA despite the sales of USC, our interest
in Broadlane, and other assets. These asset dispositions have an
offsetting positive impact on shareholder value resulting from the
reduction in net debt."
Adjusted EBITDA
Adjusted EBITDA, defined below, was $163 million, or a margin of
7.6 percent of net operating revenues, in the second quarter of 2008.
This represents an increase of $7 million, or 4.5 percent, from $156
million in the second quarter of 2007, and a margin decline of 20
basis points as compared to an adjusted EBITDA margin of 7.8 percent
in the second quarter of 2007. Adjusted EBITDA was $379 million for
the first six months of 2008 as compared to $337 million for the first
six months of 2007, an increase of $42 million, or 12.5 percent.
Same-hospital adjusted EBITDA, defined below, was $171 million in
the second quarter of 2008, an increase of $15 million, or 9.6
percent, from the $156 million in the second quarter of 2007.
Same-hospital adjusted EBITDA margin increased by 30 basis points to
8.1 percent in the second quarter of 2008 as compared to a
same-hospital adjusted EBITDA margin of 7.8 percent in the second
quarter of 2007.
The two leased hospitals that remain in continuing operations but
whose leases will not be renewed reported breakeven adjusted EBITDA in
both the second quarters of 2008 and 2007. The results from these two
hospitals have been excluded from the calculation of adjusted EBITDA
as well as same-hospital adjusted EBITDA. These two hospitals are our
Irvine Regional Hospital and Medical Center and Community Hospital of
Los Gatos. The leases on these hospitals expire in February and May
2009, respectively. The results from these two hospitals will be
excluded from the calculation of adjusted EBITDA in future quarters as
well.
Adjusted EBITDA is a non-GAAP term defined by the Company as net
income (loss) before: (1) the cumulative effect of changes in
accounting principle, net of tax; (2) income (loss) from discontinued
operations, net of tax; (3) income (loss) from leased hospitals whose
leases will not be renewed; (4) income tax (expense) benefit; (5) net
gains (losses) on sales of investments; (6) minority interests; (7)
investment earnings; (8) interest expense; (9) litigation and
investigation (costs) benefit; (10) hurricane insurance recoveries,
net of costs; (11) impairment of long-lived assets and goodwill and
restructuring charges, net of insurance recoveries; (12) amortization;
and (13) depreciation. A reconciliation of net income (loss) to
"adjusted EBITDA" is provided in Table #1 at the end of this release.
Same-Hospital Data
Same-hospital data excludes the impact of two hospitals: (1)
Coastal Carolina Medical Center, which we acquired on June 30, 2007;
and (2) Sierra Providence East Medical Center, in El Paso, which
opened on May 21, 2008. Same-hospital data is the primary form of
tabular data presentation in the narrative sections of this document.
Total-hospital data, including the contribution of Coastal
Carolina Medical Center and Sierra Providence East Medical Center, is
provided in the tabular presentation of data at the end of this
document. As a result of this approach, certain amounts in the
narrative section of this document will not tie to amounts in the
condensed consolidated statement of operations.
At June 30, 2008, there were 52 hospitals in total-hospital
continuing operations, a net decline of two hospitals from the 54
hospitals reported in total-hospital continuing operations at March
31, 2008. This change reflects the addition of Sierra Providence East
Medical Center in El Paso, the sale of two hospitals, Garden Grove
Hospital and Medical Center and San Dimas Community Hospital, both in
California, and their reclassification into discontinued operations,
and the reclassification of USC University Hospital into discontinued
operations as a result of the anticipated divestiture of this
hospital.
Continuing operations, both total-hospital and same-hospital,
include the results from Irvine Regional Hospital and Medical Center
and Community Hospital of Los Gatos. We previously announced our
intent not to renew those leases. These two hospitals will remain in
continuing operations until their respective leases expire.
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*T
Admissions, Patient Days and Surgeries
----------------------------------------------------------------------
Admissions, Patient Days and Same-Hospital
Surgeries Continuing Operations
----------------------------
Q2'08 Q2'07 Change (%)
---------------------------------------- ------- ------- ----------
Commercial Managed Care
Admissions 37,381 38,229 (2.2)
---------------------------------------- ------- ------- ----------
Governmental Managed Care
Admissions 27,685 23,864 16.0
---------------------------------------- ------- ------- ----------
Medicare Admissions 40,600 40,991 (1.0)
---------------------------------------- ------- ------- ----------
Medicaid Admissions 15,867 16,252 (2.4)
---------------------------------------- ------- ------- ----------
Uninsured Admissions 5,979 5,724 4.5
---------------------------------------- ------- ------- ----------
Charity Care Admissions 2,497 2,479 0.7
---------------------------------------- ------- ------- ----------
Other Admissions 3,439 3,389 1.5
---------------------------------------- ------- ------- ----------
Total Admissions 133,448 130,928 1.9
---------------------------------------- ------- ------- ----------
Admissions excluding Charity +
Uninsured 124,972 122,725 1.8
---------------------------------------- ------- ------- ----------
Charity Admissions + Uninsured
Admissions 8,476 8,203 3.3
---------------------------------------- ------- ------- ----------
Admissions through Emergency
Department 74,025 72,143 2.6
---------------------------------------- ------- ------- ----------
Commercial Managed Care Admits /
Total Admits (%) 28.0 29.2 (1.2) (a)
---------------------------------------- ------- ------- ----------
Emergency Department Admissions /
Total Admits (%) 55.5 55.1 0.4 (a)
---------------------------------------- ------- ------- ----------
Uninsured Admissions / Total
Admissions (%) 4.5 4.4 0.1 (a)
---------------------------------------- ------- ------- ----------
Charity Admissions / Total
Admissions (%) 1.9 1.9 - (a)
---------------------------------------- ------- ------- ----------
Surgeries - Inpatient 40,267 39,901 0.9
---------------------------------------- ------- ------- ----------
Surgeries - Outpatient 53,386 51,613 3.4
---------------------------------------- ------- ------- ----------
Surgeries - Total 93,653 91,514 2.3
---------------------------------------- ------- ------- ----------
Patient Days - Total 657,451 649,207 1.3
---------------------------------------- ------- ------- ----------
Adjusted Patient Days (b) 949,829 930,147 2.1
---------------------------------------- ------- ------- ----------
Patient Days - Commercial Managed
Care 148,419 153,096 (3.1)
---------------------------------------- ------- ------- ----------
Average Length of Stay (days) 4.9 5.0 (0.1) (a)
---------------------------------------- ------- ------- ----------
Adjusted Patient Admissions (b) 194,104 188,775 2.8
----------------------------------------------------------------------
(a) This change is the difference between the Q2'08 and Q2'07
amounts shown
(b) "Adjusted Patient Days / Admissions" represents actual patient
days / admissions adjusted to include outpatient services by
multiplying actual patient days / admissions by the sum of gross
inpatient revenues and outpatient revenues and dividing the
results by gross inpatient revenues.
----------------------------------------------------------------------
*T
All regions achieved admissions growth of 2.5 percent, or better,
with the exception of our Southern States Region, which experienced an
admissions decline of 1.4 percent in the second quarter of 2008.
Florida's admissions growth was particularly strong with admissions
increasing by 3.0 percent. Growth was also strong in Philadelphia with
admissions increasing by 5.1 percent in the second quarter.
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*T
Outpatient Visits
----------------------------------------------------------------------
Outpatient Visits Same-Hospital
Continuing Operations
----------------------------
Q2'08 Q2'07 Change (%)
---------------------------------------- ------- ------- ----------
Total OP Visits 959,839 962,420 (0.3)
---------------------------------------- ------- ------- ----------
Uninsured OP Visits 100,733 104,486 (3.6)
---------------------------------------- ------- ------- ----------
Uninsured OP Visits / Total OP
Visits (%) 10.5 10.9 (0.4) (a)
---------------------------------------- ------- ------- ----------
Charity Care OP Visits 4,857 6,886 (29.5)
---------------------------------------- ------- ------- ----------
Charity Care OP Visits / Total OP
Visits (%) 0.5 0.7 (0.2) (a)
---------------------------------------- ------- ------- ----------
OP Visits excluding Charity and
Uninsured 854,249 851,048 0.4
---------------------------------------- ------- ------- ----------
OP Surgery Visits 53,386 51,613 3.4
---------------------------------------- ------- ------- ----------
Commercial Managed Care OP Visits 359,823 366,512 (1.8)
---------------------------------------- ------- ------- ----------
Commercial OP Visits / Total Visits (%) 37.5 38.1 (0.6) (a)
----------------------------------------------------------------------
(a) This change is the difference between the Q2'08 and Q2'07
amounts shown
----------------------------------------------------------------------
*T
Excluding uninsured and charity outpatient visits, outpatient
visits increased by 0.4 percent in the second quarter of 2008 as
compared to the second quarter of 2007. Our growth in outpatient
visits continues to be adversely impacted by increasing competition
from physician-owned entities providing outpatient services.
Approximately half the large 29.5 percent decline in charity visits is
attributable to the recent expansion of a county government clinic
near one of our hospitals.
Imaging visits declined by 7,361, or 3.1 percent, more than fully
accounting for the total decline of 2,581 outpatient visits. This was
largely the result of volume losses to a growing number of competing
retail imaging centers.
The 3.4 percent increase in outpatient surgery volume included a
28 percent increase in volumes at our freestanding ambulatory surgery
centers.
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*T
Revenues
----------------------------------------------------------------------
Revenues Same-Hospital
($ in millions) Continuing Operations
------------------------
Q2'08 Q2'07 Change (%)
-------------------------------------------- ----- ----- ----------
Net Operating Revenues 2,175 2,054 5.9
-------------------------------------------- ----- ----- ----------
Net Patient Revenue from Commercial
Managed Care 886 824 7.5
-------------------------------------------- ----- ----- ----------
Revenues from the Uninsured 159 156 1.9
-------------------------------------------- ----- ----- ----------
Charity Care Gross Charges (a) 145 150 (3.3)
-------------------------------------------- ----- ----- ----------
Provision for Doubtful Accounts ("Bad
Debt") 153 142 7.7
-------------------------------------------- ----- ----- ----------
Uncompensated Care (b) 298 292 2.1
-------------------------------------------- ----- ----- ----------
Uncompensated Care / (Net Operating
Revenues plus Charity Care Gross
Charges) (b) (%) 12.8 13.2 (0.4) (c)
----------------------------------------------------------------------
(a) Charity Care Gross Charges are not included in Net Operating
Revenues
(b) "Uncompensated Care" is a non-GAAP measure defined as Charity
Care Gross Charges plus Provision for Doubtful Accounts
(c) This change is the difference between the Q2'08 and Q2'07
amounts shown
----------------------------------------------------------------------
*T
Net operating revenues for the second quarter of 2008 were
adversely impacted by a $22 million change in prior year cost report
and valuation allowance adjustments resulting from the net impact of
unfavorable cost report adjustments of $9 million in the second
quarter of 2008 compared to favorable cost report adjustments of $13
million in the second quarter of 2007. The principal reason for the
net negative cost report adjustments in the second quarter of 2008 was
a $16 million adverse adjustment related to a pending CMS decision in
connection with GME FTE limits and related reimbursement at one of our
hospitals. We are pursuing a reversal of CMS's position on this
matter. Excluding these cost report adjustments from both quarters,
same-hospital net operating revenues would have increased by $143
million, or 7.0 percent, from the second quarter of 2007 to the second
quarter of 2008.
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*T
Pricing
----------------------------------------------------------------------
Pricing Same-Hospital
($) Continuing Operations
--------------------------
Q2'08 Q2'07 Change (%)
------------------------------------------ ------ ------ ----------
Net Inpatient Revenue per Admission 10,753 10,502 2.4
------------------------------------------ ------ ------ ----------
Net Inpatient Revenue per Patient Day 2,183 2,118 3.1
------------------------------------------ ------ ------ ----------
Net Outpatient Revenue per Visit 694 635 9.3
------------------------------------------ ------ ------ ----------
Net Patient Revenue per Adjusted Patient
Admission 10,824 10,520 2.9
------------------------------------------ ------ ------ ----------
Net Patient Revenue per Adjusted Patient
Day 2,212 2,135 3.6
------------------------------------------ ------ ------ ----------
Managed Care: Net Inpatient Revenue per
Admission 11,414 10,805 5.6
------------------------------------------ ------ ------ ----------
Managed Care: Net Outpatient Revenue per
Visit 810 742 9.2
----------------------------------------------------------------------
*T
Pricing improvement was evident across all key metrics, primarily
reflecting the improved terms of our commercial managed care
contracts. Inpatient pricing in the second quarter of 2008 was
adversely affected by the $16 million adverse adjustment that, as
described above, is related to a pending CMS decision in connection
with GME FTE limits and related reimbursement at one of our hospitals.
Outpatient pricing outpaced the growth in inpatient pricing due to
an improving mix of procedures performed in our outpatient facilities.
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*T
Controllable Operating Expenses
----------------------------------------------------------------------
Controllable Operating Expenses Same-Hospital
Continuing Operations
------------------------
Q2'08 Q2'07 Change (%)
-------------------------------------------- ----- ----- ----------
Salaries, Wages & Benefits ($mm) 959 913 5.0
-------------------------------------------- ----- ----- ----------
Supplies ($mm) 390 359 8.6
-------------------------------------------- ----- ----- ----------
Other Operating Expenses ($mm) 502 484 3.7
-------------------------------------------- ----- ----- ----------
Total Controllable Operating
Expenses ($mm) 1,851 1,756 5.4
-------------------------------------------- ----- ----- ----------
Rent / Lease Expense (a) ($mm) 38 38 -
-------------------------------------------- ----- ----- ----------
Unit Cost Statistics
-------------------------------------------- ----- ----- ----------
Salaries, Wages & Benefits per
Adjusted Patient Day ($) 1,010 982 2.9
-------------------------------------------- ----- ----- ----------
Supplies per Adjusted Patient Day ($) 411 386 6.5
-------------------------------------------- ----- ----- ----------
Other Operating Expenses per Adjusted
Patient Day ($) 528 520 1.5
-------------------------------------------- ----- ----- ----------
Total Controllable Operating Expenses
per Adjusted Patient Day ($) 1,949 1,888 3.2
----------------------------------------------------------------------
(a) Included in Other Operating Expenses
----------------------------------------------------------------------
*T
On a per adjusted patient day basis, the 3.2 percent increase in
controllable operating expenses is within our outlook of 3.0 to 3.5
percent for 2008.
On a per adjusted patient day basis, salaries, wages and benefits
increased 2.9 percent in the second quarter of 2008 as compared to the
second quarter of 2007. This increase is primarily due to merit
increases for our employees, increased annual incentive compensation
costs and increased health benefits costs, partially offset by a
decline in full-time employee headcount and contract labor expense,
and improved workers' compensation loss experience.
Supplies expense per adjusted patient day increased by 6.5 percent
in the second quarter of 2008 as compared to the second quarter of
2007. The increase in supplies expense is primarily due to the
increased number of surgeries as well as higher costs for implants and
pacemakers, reflecting both technology improvements and inflationary
price increases. The increase in supplies expense was partially offset
by lower cardiovascular and pharmaceutical supply costs, resulting
from a decline in cardiovascular procedures and our initiatives to use
more cost-effective pharmaceuticals. The increase in supplies expense
is offset by revenue growth, including pass-through payments we
receive from certain payers.
"Other Operating Expenses" per adjusted patient day increased by
1.5 percent in the second quarter of 2008 as compared to the second
quarter of 2007. The increase is primarily due to the higher physician
fees and contracted services, partially offset by lower information
systems implementation costs, lower malpractice expense, and increased
volume levels. Growth in our patient volumes reduces other operating
expenses on a per adjusted patient day basis as a result of fixed
costs in this expense category that do not fluctuate with changes in
our patient volumes such as utilities, property taxes, rent, certain
information technology costs and certain contracted services.
The "Other Operating Expenses" line item includes malpractice
expense which was $39 million in the second quarter of 2008 compared
to $45 million in the second quarter of 2007. This decrease is
primarily attributable to improved claims experience partially offset
by $3 million of incremental expenses related to a lower interest rate
environment that increased the discounted present value of projected
future liabilities.
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*T
Provision for Doubtful Accounts
----------------------------------------------------------------------
Bad Debt Same-Hospital
Continuing Operations
------------------------
Q2'08 Q2'07 Change (%)
-------------------------------------------- ----- ----- ----------
Provision for Doubtful Accounts ("Bad
Debt") ($mm) 153 142 7.7
-------------------------------------------- ----- ----- ----------
Bad Debt / Net Operating Revenues (%) 7.0 6.9 0.1 (a)
-------------------------------------------- ----- ----- ----------
Collection Rate from Self-Pay (%) 36 35 1.0 (a)
-------------------------------------------- ----- ----- ----------
Collection Rate from Managed Care
Payers (%) 98 98 - (a)
----------------------------------------------------------------------
(a) This change is the difference between the Q2'08 and Q2'07
amounts shown
----------------------------------------------------------------------
*T
Our provision for doubtful accounts increased primarily due to
higher uninsured revenues, pricing increases and improved charge
capture in our emergency departments. The adverse impact from these
pressures on our bad debt expense were partially mitigated by higher
collections at point-of-service and improved collection trends
primarily related to self-pay accounts.
Accounts Receivable
Consolidated accounts receivable were $1.450 billion at June 30,
2008, and $1.468 billion at March 31, 2008. Accounts receivable days
outstanding from continuing operations were 53 days at June 30, 2008,
flat compared to March 31, 2008 and December 31, 2007.
Cash Flow
Cash and cash equivalents were $352 million at June 30, 2008, an
increase of $74 million from $278 million at March 31, 2008. Adjusted
Free Cash Flow, defined below, was positive $39 million in the second
quarter of 2008 compared to negative $6 million in the second quarter
of 2007.
Adjusted Free Cash Flow, a non-GAAP term, is defined by the
Company as cash flows provided by (used in) operating activities less
capital expenditures in continuing operations, new and replacement
hospital construction expenditures, income tax refunds (payments), net
cash provided by operating activities from discontinued operations,
cash flows from hospitals whose leases will not be renewed, and
payments against reserves for restructuring charges and litigation
costs and settlements. The reconciliation of net cash provided by
(used in) operating activities, the most comparable GAAP term, to
Adjusted Free Cash Flow is provided in Table #2 at the end of this
release.
Significant cash receipts and disbursements in the second quarter
of 2008 included:
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*T
(1) $60 million in proceeds from the sale of facilities and other
assets related to discontinued operations;
(2) Capital expenditures of $110 million, consisting of $102 million
in continuing operations and $8 million in discontinued
operations;
(3) $70 million in interest payments;
(4) $22 million in principal payments (excluding interest of $2
million) related to the Company's 2006 civil settlement with the
federal government;
(5) Net income tax payments of $4 million; and,
(6) $3 million payment to acquire a surgery center now affiliated with
the Company's John F. Kennedy Memorial Hospital in California.
*T
Net cash provided by operating activities was $123 million in the
second quarter of 2008 as compared to $285 million in the second
quarter of 2007, a decline of $162 million. Factors contributing to
the decline in cash provided by operating activities in the second
quarter of 2008 compared to the second quarter of 2007 include the
following:
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*T
(1) Net income tax refunds of $169 million were received in the second
quarter of 2007 compared to payments of $4 million in the second
quarter of 2008;
(2) Payments of $24 million ($22 million in principal and $2 million
in interest) in the second quarter of 2008 related to our 2006
civil settlement with the federal government. No payments related
to this settlement were required in the second quarter of 2007;
and,
(3) $31 million of additional cash flows related to enhanced
management of our accounts payable.
*T
Outlook for 2008 and 2009
Tenet's outlook for 2008 is substantively unchanged. However, we
are updating the range of our 2008 adjusted EBITDA outlook for
continuing operations only for the reclassification of the earnings of
USC University Hospital to discontinued operations. Accordingly, the
underlying performance of the hospitals in continuing operations is
expected to remain the same as was reflected in the prior expressed
outlook for 2008 adjusted EBITDA of $775 million to $850 million.
After reflecting the reclassification of USC, the revised 2008 outlook
for adjusted EBITDA for continuing operations is $750 million to $825
million, and the range for net loss is $120 million to $20 million.
There is a parallel change in the 2008 outlook for adjusted cash flow
from operations from the prior range of $400 million to $500 million
to the revised 2008 outlook range of $375 million to $475 million.
Tenet is maintaining its 2009 objective of $1 billion in adjusted
EBITDA and approximately breakeven adjusted free cash flow.
A reconciliation of outlook adjusted EBITDA to net loss for the
year ending December 31, 2008 is provided in Table #3; and a
reconciliation of outlook adjusted net cash provided by operating
activities, and outlook adjusted free cash flow from continuing
operations to outlook net cash provided by operating activities for
the year ending December 31, 2008 is provided in Table #4 at the end
of this document.
Management's Webcast Discussion of Second Quarter Results
Tenet management will discuss second quarter 2008 results on a
webcast scheduled to begin at 9:30 AM (ET) on August 5, 2008. This
webcast may be accessed through Tenet website at www.tenethealth.com.
A set of slides which may be referred to during management's remarks
will be posted to the Company's website at approximately 7:30 AM (ET).
Tenet Healthcare Corporation, through its subsidiaries, owns and
operates acute care hospitals and related ancillary health care
businesses, which include ambulatory surgery centers and diagnostic
imaging centers. Tenet is committed to providing high quality care to
patients in the communities we serve. Tenet can be found on the World
Wide Web at www.tenethealth.com.
Some of the statements in this release may constitute
forward-looking statements. Such forward-looking statements are based
on our current expectations and could be affected by numerous factors
and are subject to various risks and uncertainties discussed
in our filings with the Securities and Exchange Commission,
including our annual report on Form 10-K for the year ended Dec. 31,
2007, our quarterly reports on Form 10-Q, and periodic reports on Form
8-K. Do not rely on any forward-looking statement, as we cannot
predict or control many of the factors that ultimately may affect our
ability to achieve the results estimated. We make no promise to update
any forward-looking statement, whether as a result of changes in
underlying factors, new information, future events or otherwise.
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*T
TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
(Unaudited)
(Dollars in millions except
per share amounts) Three Months Ended June 30,
------------------------------------------
2008 % 2007 % Change
--------- ------- --------- ------- ------
Net operating revenues $ 2,184 100.0% $ 2,054 100.0% 6.3%
Operating expenses:
Salaries, wages and
benefits (967) (44.3%) (913) (44.4%) 5.9%
Supplies (392) (17.9%) (359) (17.5%) 9.2%
Provision for doubtful
accounts (154) (7.1%) (142) (6.9%) 8.5%
Other operating
expenses, net (508) (23.3%) (484) (23.6%) 5.0%
Depreciation (85) (3.9%) (77) (3.7%) 10.4%
Amortization (10) (0.4%) (8) (0.4%) 25.0%
Impairment of long-lived
assets and goodwill,
and restructuring
charges (2) (0.1%) (8) (0.4%)
Litigation and
investigation (costs)
benefit (3) (0.1%) 1 --%
--------- ------- --------- -------
Operating income 63 2.9% 64 3.1%
Interest expense (102) (105)
Investment earnings 4 15
Minority interests -- (1)
--------- ---------
Loss from continuing
operations, before income
taxes (35) (27)
Income tax benefit 16 3
--------- ---------
Loss from continuing
operations, before
discontinued operations (19) (24)
Discontinued operations:
Income (loss) from
operations 6 (4)
Impairment of long-lived
assets and goodwill,
and restructuring
charges (7) (3)
Net gain on sales of
facilities 8 2
Income tax expense (3) (1)
--------- ---------
Income (loss) from
discontinued operations,
net of tax 4 (6)
--------- ---------
Net loss $ (15) $ (30)
========= =========
Earnings (loss) per share
Basic and diluted:
Continuing operations $ (0.04) $ (0.05)
Discontinued
operations 0.01 (0.01)
--------- ---------
$ (0.03) $ (0.06)
========= =========
Weighted average shares and
dilutive securities
outstanding (in
thousands): 476,308 473,212
*T
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*T
TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
(Unaudited)
(Dollars in millions except
per share amounts) Six Months Ended June 30,
------------------------------------------
2008 % 2007 % Change
--------- ------- --------- ------- ------
Net operating revenues $ 4,419 100.0% $ 4,155 100.0% 6.4%
Operating expenses:
Salaries, wages and
benefits (1,947) (44.1%) (1,853) (44.6%) 5.1%
Supplies (780) (17.7%) (726) (17.5%) 7.4%
Provision for doubtful
accounts (302) (6.8%) (276) (6.6%) 9.4%
Other operating
expenses, net (1,005) (22.7%) (959) (23.1%) 4.8%
Depreciation (168) (3.8%) (154) (3.7%) 9.1%
Amortization (19) (0.4%) (16) (0.4%) 18.8%
Impairment of long-lived
assets and goodwill,
and restructuring
charges (3) (0.1%) (11) (0.2%)
Litigation and
investigation (costs)
benefit (50) (1.1%) 2 --
--------- ------- --------- -------
Operating income 145 3.3% 162 3.9%
Interest expense (206) (210)
Investment earnings 9 26
Minority interests (1) (3)
--------- ---------
Loss from continuing
operations, before income
taxes (53) (25)
Income tax benefit 14 94
--------- ---------
Income (loss) from
continuing operations,
before discontinued
operations (39) 69
Discontinued operations:
Income (loss) from
operations 6 (26)
Impairment of long-lived
assets and goodwill,
and restructuring
charges (17) (12)
Net gain on sales of
facilities 8 1
Income tax (expense)
benefit (4) 13
--------- ---------
Loss from discontinued
operations, net of tax (7) (24)
--------- ---------
Net income (loss) $ (46) $ 45
========= =========
Earnings (loss) per share
Basic and diluted:
Continuing operations $ (0.09) $ 0.14
Discontinued
operations (0.01) (0.05)
--------- ---------
$ (0.10) $ 0.09
========= =========
Weighted average shares and
dilutive securities
outstanding (in
thousands): 475,687 474,514
*T
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*T
TENET HEALTHCARE CORPORATION
BALANCE SHEET DATA
(Unaudited)
June 30, December 31,
(Dollars in millions) 2008 2007
-------- ------------
ASSETS
Current assets:
Cash and cash equivalents $ 352 $ 572
Investments in marketable debt securities 8 20
Accounts receivable, less allowance for
doubtful accounts 1,450 1,385
Inventories of supplies, at cost 170 183
Income tax receivable 29 7
Deferred income taxes 118 87
Assets held for sale 385 51
Other current assets 266 255
-------- ------------
Total current assets 2,778 2,560
Investments and other assets 271 288
Property and equipment, at cost, less
accumulated depreciation and amortization 4,274 4,645
Goodwill 610 607
Other intangible assets, at cost, less
accumulated amortization 310 293
-------- ------------
Total assets $ 8,243 $ 8,393
======== ============
LIABILITIES AND SHAREHOLDERS' EQUITY
Current liabilities:
Current portion of long-term debt $ 2 $ 1
Accounts payable 643 780
Accrued compensation and benefits 338 393
Professional and general liability reserves 150 161
Accrued interest payable 125 126
Accrued legal settlement costs 167 119
Other current liabilities 548 468
-------- ------------
Total current liabilities 1,973 2,048
Long-term debt, net of current portion 4,775 4,771
Professional and general liability reserves 547 555
Accrued legal settlement costs 118 163
Other long-term liabilities and minority
interests 654 683
Deferred income taxes 147 119
-------- ------------
Total liabilities 8,214 8,339
Commitments and contingencies
Shareholders' equity:
Common stock 26 26
Additional paid-in capital 4,431 4,412
Accumulated other comprehensive loss (26) (28)
Accumulated deficit (2,923) (2,877)
Less common stock in treasury, at cost (1,479) (1,479)
-------- ------------
Total shareholders' equity 29 54
-------- ------------
Total liabilities and shareholders' equity $ 8,243 $ 8,393
======== ============
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TENET HEALTHCARE CORPORATION
CASH FLOW DATA
(Unaudited)
Six Months Ended
(Dollars in millions) June 30,
----------------
2008 2007
-------- -------
Net income (loss) $ (46) $ 45
Adjustments to reconcile net income (loss) to net
cash from operating activities:
Depreciation and amortization 187 170
Provision for doubtful accounts 302 276
Deferred income tax expense 16 1
Stock-based compensation expense 20 21
Impairment of long-lived assets and goodwill, and
restructuring charges 3 11
Litigation and investigation costs (benefit) 50 (2)
Pre-tax loss from discontinued operations 3 37
Other items, net (3) (12)
Changes in cash from changes in operating assets and
liabilities:
Accounts receivable (360) (299)
Inventories and other current assets 15 5
Income taxes (29) 60
Accounts payable, accrued expenses and other
current liabilities (89) (200)
Other long-term liabilities (25) 15
Payments against reserves for restructuring charges
and litigation costs and settlements (56) (28)
Net cash provided by operating activities from
discontinued operations, excluding income taxes 2 31
-------- -------
Net cash provided by (used in) operating
activities (10) 131
Cash flows from investing activities:
Purchases of property and equipment:
Continuing operations (233) (217)
Discontinued operations (10) (18)
Construction of new and replacement hospitals (56) (27)
Purchase of business (3) (36)
Proceeds from sales of facilities and other assets
- discontinued operations 83 53
Proceeds from sales of marketable securities,
long-term investments and other assets 14 442
Purchases of marketable securities (8) (434)
Other items, net 2 (4)
-------- -------
Net cash used in investing activities (211) (241)
Cash flows from financing activities:
Repayments of borrowings (1) --
Other items, net 2 1
-------- -------
Net cash provided by financing activities 1 1
-------- -------
Net decrease in cash and cash equivalents (220) (109)
Cash and cash equivalents at beginning of period 572 784
-------- -------
Cash and cash equivalents at end of period $ 352 $ 675
======== =======
Supplemental disclosures:
Interest paid, net of capitalized interest $ (195) $ (191)
Income tax (payments) refunds, net $ (3) $ 168
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TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING SAME HOSPITALS
(Unaudited)
(Dollars in millions except per
patient day, per admission and per
visit amounts) Three Months Ended June 30,
------------------------------
2008 2007 Change
----------- ----------- ------
Net inpatient revenues $ 1,435 $ 1,375 4.4%
Net outpatient revenues $ 666 $ 611 9.0%
Number of general hospitals (at end
of period) 50 50 -- (a)
Licensed beds (at end of period) 13,713 13,736 (0.2%)
Average licensed beds 13,715 13,746 (0.2%)
Utilization of licensed beds 52.7% 51.9% 0.8% (a)
Patient days 657,451 649,207 1.3%
Adjusted patient days 949,829 930,147 2.1%
Net inpatient revenue per patient
day $ 2,183 $ 2,118 3.1%
Admissions 133,448 130,928 1.9%
Adjusted patient admissions 194,104 188,775 2.8%
Net inpatient revenue per admission $ 10,753 $ 10,502 2.4%
Average length of stay (days) 4.9 5.0 (0.1%)(a)
Surgeries 93,653 91,514 2.3%
Net outpatient revenue per visit $ 694 $ 635 9.3%
Outpatient visits 959,839 962,420 (0.3%)
Sources of net patient revenue
Medicare 24.8% 25.0% (0.2%)(a)
Medicaid 8.2% 9.3% (1.1%)(a)
Managed care governmental 13.2% 11.3% 1.9% (a)
Managed care commercial 42.2% 41.5% 0.7% (a)
Indemnity, self-pay and other 11.6% 12.9% (1.3%)(a)
(Dollars in millions except per
patient day, per admission and per
visit amounts) Six Months Ended June 30,
------------------------------
2008 2007 Change
----------- ----------- ------
Net inpatient revenues $ 2,949 $ 2,801 5.3%
Net outpatient revenues $ 1,309 $ 1,209 8.3%
Number of general hospitals (at end
of period) 50 50 -- (a)
Licensed beds (at end of period) 13,713 13,736 (0.2%)
Average licensed beds 13,725 13,742 (0.1%)
Utilization of licensed beds 54.7% 54.3% 0.4% (a)
Patient days 1,366,298 1,349,698 1.2%
Adjusted patient days 1,947,225 1,908,454 2.0%
Net inpatient revenue per patient
day $ 2,158 $ 2,075 4.0%
Admissions 273,703 270,001 1.4%
Adjusted patient admissions 392,589 384,030 2.2%
Net inpatient revenue per admission $ 10,774 $ 10,374 3.9%
Average length of stay (days) 5.0 5.0 -- (a)
Surgeries 183,925 183,299 0.3%
Net outpatient revenue per visit $ 678 $ 622 9.0%
Outpatient visits 1,931,709 1,943,714 (0.6%)
Sources of net patient revenue
Medicare 25.4% 26.2% (0.8%)(a)
Medicaid 8.3% 8.2% 0.1% (a)
Managed care governmental 13.4% 12.0% 1.4% (a)
Managed care commercial 41.3% 41.4% (0.1%)(a)
Indemnity, self-pay and other 11.6% 12.2% (0.6%)(a)
(a) This change is the difference between the 2008 and 2007 amounts
shown
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TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING TOTAL HOSPITALS
(Unaudited)
(Dollars in millions except per
patient day, per admission and per
visit amounts) Three Months Ended June 30,
------------------------------
2008 2007 Change
----------- ----------- ------
Net inpatient revenues $ 1,439 $ 1,375 4.7%
Net outpatient revenues $ 670 $ 611 9.7%
Number of general hospitals (at end
of period) 52 51 1 (a)
Licensed beds (at end of period) 13,864 13,777 0.6%
Average licensed beds 13,829 13,760 0.5%
Utilization of licensed beds 52.4% 51.8% 0.6% (a)
Patient days 659,534 649,207 1.6%
Adjusted patient days 955,538 930,147 2.7%
Net inpatient revenue per patient
day $ 2,182 $ 2,118 3.0%
Admissions 133,983 130,928 2.3%
Adjusted patient admissions 195,522 188,775 3.6%
Net inpatient revenue per admission $ 10,740 $ 10,502 2.3%
Average length of stay (days) 4.9 5.0 (0.1) (a)
Surgeries 93,970 91,514 2.7%
Net outpatient revenue per visit $ 689 $ 635 8.5%
Outpatient visits 972,261 962,420 1.0%
Sources of net patient revenue
Medicare 24.8% 25.0% (0.2%)(a)
Medicaid 8.2% 9.3% (1.1%)(a)
Managed care governmental 13.2% 11.3% 1.9% (a)
Managed care commercial 42.1% 41.5% 0.6% (a)
Indemnity, self-pay and other 11.7% 12.9% (1.2%)(a)
(Dollars in millions except per
patient day, per admission and per
visit amounts) Six Months Ended June 30,
------------------------------
2008 2007 Change
----------- ----------- ------
Net inpatient revenues $ 2,955 $ 2,801 5.5%
Net outpatient revenues $ 1,316 $ 1,209 8.9%
Number of general hospitals (at end
of period) 52 51 1 (a)
Licensed beds (at end of period) 13,864 13,777 0.6%
Average licensed beds 13,803 13,749 0.4%
Utilization of licensed beds 54.5% 54.2% 0.3% (a)
Patient days 1,369,843 1,349,698 1.5%
Adjusted patient days 1,957,182 1,908,454 2.6%
Net inpatient revenue per patient
day $ 2,157 $ 2,075 4.0%
Admissions 274,580 270,001 1.7%
Adjusted patient admissions 395,000 384,030 2.9%
Net inpatient revenue per admission $ 10,762 $ 10,374 3.7%
Average length of stay (days) 5.0 5.0 -- (a)
Surgeries 184,483 183,299 0.6%
Net outpatient revenue per visit $ 674 $ 622 8.4%
Outpatient visits 1,953,945 1,943,714 0.5%
Sources of net patient revenue
Medicare 25.4% 26.2% (0.8%)(a)
Medicaid 8.3% 8.2% 0.1% (a)
Managed care governmental 13.3% 12.0% 1.3% (a)
Managed care commercial 41.3% 41.4% (0.1%)(a)
Indemnity, self-pay and other 11.7% 12.2% (0.5%)(a)
(a) This change is the difference between the 2008 and 2007 amounts
shown
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TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
Calendar Year 2008 by Quarter
(Unaudited)
(Dollars in millions except per Six Months
share amounts) Three Months Ended Ended
-------------------
3/31/08 6/30/08 6/30/08
--------- --------- ----------
Net operating revenues $ 2,235 $ 2,184 $ 4,419
Operating expenses:
Salaries, wages and benefits (980) (967) (1,947)
Supplies (388) (392) (780)
Provision for doubtful accounts (148) (154) (302)
Other operating expenses, net (497) (508) (1,005)
Depreciation (83) (85) (168)
Amortization (9) (10) (19)
Impairment of long-lived assets
and goodwill, and restructuring
charges (1) (2) (3)
Litigation and investigation
(costs) benefit (47) (3) (50)
--------- --------- ----------
Operating income 82 63 145
Interest expense (104) (102) (206)
Investment earnings 5 4 9
Minority interests (1) -- (1)
--------- --------- ----------
Loss from continuing operations,
before income taxes (18) (35) (53)
Income tax (expense) benefit (2) 16 14
--------- --------- ----------
Loss from continuing operations,
before discontinued operations (20) (19) (39)
Discontinued operations:
Income from operations -- 6 6
Impairment of long-lived assets
and goodwill, and restructuring
charges (10) (7) (17)
Net gain on sales of facilities -- 8 8
Income tax expense (1) (3) (4)
--------- --------- ----------
Income (loss) from discontinued
operations, net of tax (11) 4 (7)
--------- --------- ----------
Net loss $ (31) $ (15) $ (46)
========= ========= ==========
Earnings (loss) per share
Basic and diluted:
Continuing operations $ (0.04) $ (0.04) $ (0.09)
Discontinued operations (0.02) 0.01 (0.01)
--------- --------- ----------
$ (0.06) $ (0.03) $ (0.10)
========= ========= ==========
Weighted average shares and dilutive
securities outstanding (in
thousands): 475,066 476,308 475,687
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TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING SAME HOSPITALS
Calendar Year 2008 by Quarter
(Unaudited)
(Dollars in millions except per
patient day, per admission and per Six Months
visit amounts) Three Months Ended Ended
-------------------
3/31/08 6/30/08 6/30/08
--------- --------- -----------
Net inpatient revenues $ 1,514 $ 1,435 $ 2,949
Net outpatient revenues $ 643 $ 666 $ 1,309
Number of general hospitals (at end
of period) 50 50 50
Licensed beds (at end of period) 13,716 13,713 13,713
Average licensed beds 13,735 13,715 13,725
Utilization of licensed beds 56.7% 52.7% 54.7%
Patient days 708,847 657,451 1,366,298
Adjusted patient days 997,396 949,829 1,947,225
Net inpatient revenue per patient
day $ 2,136 $ 2,183 $ 2,158
Admissions 140,255 133,448 273,703
Adjusted patient admissions 198,485 194,104 392,589
Net inpatient revenue per admission $ 10,795 $ 10,753 $ 10,774
Average length of stay (days) 5.1 4.9 5.0
Surgeries 90,272 93,653 183,925
Net outpatient revenue per visit $ 662 $ 694 $ 678
Outpatient visits 971,870 959,839 1,931,709
Sources of net patient revenue
Medicare 26.0% 24.8% 25.4%
Medicaid 8.3% 8.2% 8.3%
Managed care governmental 13.5% 13.2% 13.4%
Managed care commercial 40.5% 42.2% 41.3%
Indemnity, self-pay and other 11.7% 11.6% 11.6%
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TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
Calendar Year 2007 by Quarter
(Unaudited)
(Dollars in
millions except
per share amounts) Three Months Ended Year Ended
---------------------------------------
3/31/07 6/30/07 9/30/07 12/31/07 12/31/07
--------- --------- --------- --------- ----------
Net operating
revenues $ 2,101 $ 2,054 $ 2,093 $ 2,127 $ 8,375
Operating expenses:
Salaries, wages
and benefits (940) (913) (930) (971) (3,754)
Supplies (367) (359) (356) (375) (1,457)
Provision for
doubtful
accounts (134) (142) (158) (133) (567)
Other operating
expenses, net (475) (484) (483) (492) (1,934)
Depreciation (77) (77) (78) (80) (312)
Amortization (8) (8) (7) (8) (31)
Impairment of
long-lived
assets and
goodwill, and
restructuring
charges (3) (8) (13) (35) (59)
Hurricane
insurance
recoveries, net
of costs -- -- -- 3 3
Litigation and
investigation
(costs) benefit 1 1 (3) (12) (13)
--------- --------- --------- --------- ----------
Operating income 98 64 65 24 251
Interest expense (105) (105) (105) (104) (419)
Investment earnings 11 15 10 11 47
Minority interests (2) (1) (1) -- (4)
--------- --------- --------- --------- ----------
Income (loss) from
continuing
operations, before
income taxes 2 (27) (31) (69) (125)
Income tax
(expense) benefit 91 3 (10) (20) 64
--------- --------- --------- --------- ----------
Income (loss) from
continuing
operations, before
discontinued
operations 93 (24) (41) (89) (61)
Discontinued
operations:
Income (loss)
from operations (22) (4) (5) 28 (3)
Impairment of
long-lived
assets and
goodwill, and
restructuring
charges (9) (3) (6) (13) (31)
Net gain (loss)
on sales of
facilities (1) 2 (5) (4) (8)
Income tax
(expense)
benefit 14 (1) (2) 3 14
--------- --------- --------- --------- ----------
Income (loss) from
discontinued
operations, net of
tax (18) (6) (18) 14 (28)
--------- --------- --------- --------- ----------
Net income (loss) $ 75 $ (30) $ (59) $ (75) $ (89)
========= ========= ========= ========= ==========
Earnings (loss) per
share
Basic and
diluted:
Continuing
operations $ 0.20 $ (0.05) $ (0.08) $ (0.19) $ (0.13)
Discontinued
operations (0.04) (0.01) (0.04) 0.03 (0.06)
--------- --------- --------- --------- ----------
$ 0.16 $ (0.06) $ (0.12) $ (0.16) $ (0.19)
========= ========= ========= ========= ==========
Weighted average
shares and
dilutive
securities
outstanding (in
thousands): 474,326 473,212 473,984 474,286 473,405
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TENET HEALTHCARE CORPORATION
SELECTED STATISTICS - CONTINUING SAME HOSPITALS
Calendar Year 2007 by Quarter
(Unaudited)
(Dollars in
millions except
per patient day,
per admission and
per visit
amounts) Three Months Ended Year Ended
---------------------------------------
3/31/07 6/30/07 9/30/07 12/31/07 12/31/07
--------- --------- --------- --------- -----------
Net inpatient
revenues $ 1,426 $ 1,375 $ 1,395 $ 1,427 $ 5,623
Net outpatient
revenues $ 598 $ 611 $ 617 $ 619 $ 2,445
Number of general
hospitals (at end
of period) 50 50 50 50 50
Licensed beds (at
end of period) 13,743 13,736 13,743 13,773 13,773
Average licensed
beds 13,736 13,746 13,743 13,773 13,750
Utilization of
licensed beds 56.7% 51.9% 50.9% 51.8% 52.8%
Patient days 700,491 649,207 643,501 655,790 2,648,989
Adjusted patient
days 978,307 930,147 922,970 934,607 3,766,031
Net inpatient
revenue per
patient day $ 2,036 $ 2,118 $ 2,168 $ 2,176 $ 2,123
Admissions 139,073 130,928 130,909 134,088 534,998
Adjusted patient
admissions 195,255 188,775 189,094 192,463 765,587
Net inpatient
revenue per
admission $ 10,254 $ 10,502 $ 10,656 $ 10,642 $ 10,510
Average length of
stay (days) 5.0 5.0 4.9 4.9 5.0
Surgeries 91,785 91,514 92,489 91,567 367,355
Net outpatient
revenue per visit $ 609 $ 635 $ 650 $ 652 $ 636
Outpatient visits 981,294 962,420 949,485 948,865 3,842,064
Sources of net
patient revenue
Medicare 27.3% 25.0% 25.1% 25.4% 25.7%
Medicaid 7.1% 9.3% 9.3% 8.7% 8.6%
Managed care
governmental 12.7% 11.3% 11.5% 12.9% 12.1%
Managed care
commercial 41.3% 41.5% 41.8% 41.3% 41.5%
Indemnity,
self-pay and
other 11.6% 12.9% 12.3% 11.7% 12.1%
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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
(1) Reconciliation of Adjusted EBITDA
Adjusted EBITDA, a non-GAAP term, is defined by the Company as net
income (loss) before (1) cumulative effect of change in
accounting principle, net of tax, (2) income (loss) from
discontinued operations, net of tax, (3) income (loss) from
leased hospitals whose leases will not be renewed, (4) income tax
(expense) benefit, (5) net gains (losses) on sales of investments
(6) minority interests, (7) investment earnings, (8) interest
expense, (9) litigation and investigation (costs) benefit, (10)
hurricane insurance recoveries, net of costs, (11) impairment of
long-lived assets and goodwill and restructuring charges, (12)
amortization, and (13) depreciation. The Company's adjusted
EBITDA may not be comparable to EBITDA reported by other
companies.
The Company provides this information as a supplement to GAAP
information to assist itself and investors in understanding the
impact of various items on its financial statements, some of
which are recurring or involve cash payments. The Company uses
this information in its analysis of the performance of its
business excluding items that it does not consider as relevant in
the performance of its hospitals in continuing operations.
Adjusted EBITDA is not a measure of liquidity, but is a measure
of operating performance that management uses in its business as
an alternative to net income (loss). Because Adjusted EBITDA
excludes many items that are included in our financial
statements, it does not provide a complete measure of our
operating performance. Accordingly, investors are encouraged to
use GAAP measures when evaluating the Company's financial
performance.
The reconciliation of net income (loss), the most comparable GAAP
term, to Adjusted EBITDA, is set forth in the first table below
for the three and six months ended June 30, 2008 and 2007.
(2) Adjusted Free Cash Flow
Adjusted Free Cash Flow, a non-GAAP term, is defined by the
Company as cash flows provided by (used in) operating activities
less capital expenditures in continuing operations; new and
replacement hospital construction expenditures; income tax
refunds (payments), net; net cash provided by operating
activities from discontinued operations; adjusted free cash flow
from leased hospitals whose leases will not be renewed; and
payments against reserves for restructuring charges and
litigation costs and settlements. The Company believes the use of
Adjusted Free Cash Flow is meaningful, as the use of this
financial measure provides the Company and the users of its
financial statements with supplemental information about the
impact on the Company's cash flows from the items specified
above. The Company provides this information as a supplement to
GAAP information to assist itself and investors in understanding
the impact of various items on its cash flows, some of which are
recurring. The Company uses this information in its analysis of
its cash flows excluding items that it does not consider relevant
to the liquidity of its hospitals in continuing operations going
forward. Adjusted Free Cash Flow is a measure of liquidity that
management uses in its business as an alternative to net cash
provided by (used in) operating activities. Because Adjusted Free
Cash Flow excludes many items that are included in our financial
statements, it does not provide a complete measure of our
liquidity. Accordingly, investors are encouraged to use GAAP
measures when evaluating the Company's financial performance or
liquidity. The reconciliation of net cash provided by (used in)
operating activities, the most comparable GAAP term, to Adjusted
Free Cash Flow is set forth in the second table below for the
three and six months ended June 30, 2008 and 2007.
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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #1 - Reconciliation of Adjusted EBITDA
(Unaudited)
(Dollars in millions) Three Months Six Months
Ended Ended
June 30, June 30,
--------------- ---------------
2008 2007 2008 2007
------- ------- ------- -------
Net income (loss) $ (15) $ (30) $ (46) $ 45
Less: Income (loss) from discontinued
operations, net of tax 4 (6) (7) (24)
------- ------- ------- -------
Income (loss) from continuing
operations (19) (24) (39) 69
Income tax benefit 16 3 14 94
Minority interests -- (1) (1) (3)
Investment earnings 4 15 9 26
Interest expense (102) (105) (206) (210)
------- ------- ------- -------
Operating income 63 64 145 162
Litigation and investigation
(costs) benefit (3) 1 (50) 2
Impairment of long-lived assets
and goodwill and restructuring
charges (2) (8) (3) (11)
Amortization (10) (8) (19) (16)
Depreciation (85) (77) (168) (154)
------- ------- ------- -------
Adjusted EBITDA - continuing
operations 163 156 385 341
Less: Income from hospitals whose
leases will not be renewed -- -- 6 4
------- ------- ------- -------
Adjusted EBITDA $ 163 $ 156 $ 379 $ 337
======= ======= ======= =======
Net operating revenues $2,184 $2,054 $4,419 $4,155
Less: Net operating revenues from
hospitals whose leases will not be
renewed 51 52 109 105
------- ------- ------- -------
Adjusted net operating revenues $2,133 $2,002 $4,310 $4,050
======= ======= ======= =======
Adjusted EBITDA as % of adjusted net
operating revenues (Adjusted EBITDA
margin) 7.6% 7.8% 8.8% 8.3%
Additional Supplemental Non-GAAP Disclosures
Table #2 - Reconciliation of Adjusted Free Cash Flow
(Unaudited)
(Dollars in millions) Three Months Six Months
Ended Ended
June 30, June 30,
--------------- ---------------
2008 2007 2008 2007
------- ------- ------- -------
Net cash provided by (used in)
operating activities $ 123 $ 285 $ (10) $ 131
Less: Income tax (payments) refunds,
net (4) 169 (3) 168
Payments against reserves for
restructuring charges and
litigation costs and
settlements (28) (20) (56) (28)
Net cash provided by operating
activities from discontinued
operations 11 5 2 31
------- ------- ------- -------
Adjusted net cash provided by (used
in) operating activities - continuing
operations 144 131 47 (40)
Purchases of property and
equipment - continuing
operations (75) (122) (233) (217)
Construction of new and
replacement hospitals (27) (16) (56) (27)
------- ------- ------- -------
Adjusted free cash flow - continuing
operations 42 (7) (242) (284)
Less free cash flow from
hospitals whose leases will not
be renewed 3 (1) 3 --
------- ------- ------- -------
Adjusted free cash flow $ 39 $ (6) $ (245) $ (284)
======= ======= ======= =======
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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #3 - Reconciliation of Outlook Adjusted EBITDA to
Outlook Net Loss for Year Ending December 31, 2008
(Unaudited)
(Dollars in millions) Low High
------- -------
Net loss $ (120) $ (20)
Less: Loss from discontinued operations, net of tax (25) -
------- -------
Loss from continuing operations (95) (20)
Income tax benefit 5 5
------- -------
Income (loss) from continuing operations, before
income taxes (100) (25)
Interest expense, net (400) (400)
------- -------
Operating income 300 375
Litigation and investigation costs (50) (50)
Depreciation and amortization (400) (400)
------- -------
Adjusted EBITDA $ 750 $ 825
======= =======
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Table #4 - Reconciliation of Outlook Adjusted Free Cash Flow
for the Year Ending December 31, 2008
(Unaudited)
(Dollars in millions)
Low High
------- -------
Net cash provided by operating activities $ 175 $ 300
Less: Income tax payments, net (45) (45)
Payments against reserves for restructuring
charges and litigation costs and settlements (100) (100)
Net cash used in operating activities from
discontinued operations (55) (30)
------- -------
Adjusted net cash provided by operating activities -
continuing operations 375 475
Purchases of property and equipment - continuing
operations (508) (558)
Construction of new and replacement hospitals (82) (82)
------- -------
Adjusted free cash flow - continuing operations $ (215) $ (165)
======= =======
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Tenet Healthcare Corporation
Media:
David Matthews, 469-893-2640
David.Matthews@tenethealth.com
or
Investors:
Thomas Rice, 469,893-2522
Thomas.Rice@tenethealth.com
Copyright Business Wire 2008
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