Community Health Systems, Inc. Announces Fourth Quarter 2011 Results with Net Operating Revenues of $3.4 Billion
Net operating revenues for the three months ended
Adjusted EBITDA for the three months ended
The consolidated financial results for the three months ended
Net operating revenues for the year ended
Adjusted EBITDA was
The consolidated financial results for the year ended
Commenting on the results,
On
On
“We were very pleased to meet our acquisition goals for 2011 as we continued to expand our portfolio of hospitals,” added Smith. “Our strategy has always been focused on identifying hospital facilities that meet our operating profile and offer the most opportunity for growth. With the current healthcare regulatory climate, we believe there are significant opportunities for additional suitable acquisitions in 2012. We have the ability to leverage our proven track record for the successful integration of these hospitals with improved operating results and enhanced services. More importantly, we have a favorable reputation as a trusted partner in each of the communities we serve. As we look ahead to the coming year, we will continue to seek to deliver value to both our community partners and our shareholders.”
Included on pages 13, 14 and 15 of this press release are tables setting forth the Company’s 2012 annual earnings guidance. The 2012 guidance is based on the Company’s historical operating performance, current trends and other assumptions that the Company believes are reasonable at this time.
Located in the
Forward-Looking Statements
Statements contained in this news release regarding expected operating results, acquisition transactions or divestitures and other events are forward-looking statements that involve risk and uncertainties. Actual future events or results may differ materially from these statements. Readers are referred to the documents filed by
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(Unaudited) |
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| Three Months Ended | Year Ended | |||||||||||||||
| December 31, | ||||||||||||||||
| 2011 | 2010 | 2011 | 2010 | |||||||||||||
| Net operating revenues (c) | $ | 3,442,514 | $ | 3,314,193 | $ | 13,626,168 | $ | 12,623,274 | ||||||||
| Adjusted EBITDA (d) | 463,767 | 451,089 | 1,836,650 | 1,761,484 | ||||||||||||
| Income from continuing operations (e)(f)(g) | 55,615 | 94,468 | 335,894 | 355,213 | ||||||||||||
| Net income attributable to |
$ | 30,931 | $ | 69,510 | $ | 201,948 | $ | 279,983 | ||||||||
|
Basic earnings (loss) per share attributable to |
||||||||||||||||
| Continuing operations (e)(f)(g) | $ | 0.38 | $ | 0.79 | $ | 2.89 | $ | 3.13 | ||||||||
| Discontinued operations (h) | (0.03 | ) | (0.02 | ) | (0.65 | ) | (0.07 | ) | ||||||||
| Net income | $ | 0.35 | $ | 0.77 | $ | 2.24 | $ | 3.05 | ||||||||
|
Diluted earnings (loss) per share attributable to |
||||||||||||||||
| Continuing operations (e)(f)(g) | $ | 0.38 | $ | 0.78 | $ | 2.87 | $ | 3.08 | ||||||||
| Discontinued operations (h) | (0.03 | ) | (0.02 | ) | (0.64 | ) | (0.07 | ) | ||||||||
| Net income | $ | 0.35 | $ | 0.76 | $ | 2.23 | $ | 3.01 | ||||||||
| Weighted-average number of shares outstanding (i): | ||||||||||||||||
| Basic | 88,345 | 90,422 | 89,967 | 91,719 | ||||||||||||
| Diluted | 88,914 | 91,779 | 90,666 | 92,946 | ||||||||||||
| Net cash provided by operating activities | $ | 441,673 | $ | 290,353 | $ | 1,261,908 | $ | 1,188,730 | ||||||||
|
_____ For footnotes, see pages 11 and 12. |
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||||||||||||||
| Three Months Ended December 31, | ||||||||||||||
| 2011 | 2010 | |||||||||||||
| Amount |
% of Net |
Amount |
% of Net |
|||||||||||
| Net operating revenues (c) | $ | 3,442,514 | 100.0 | % | $ | 3,314,193 | 100.0 | % | ||||||
| Operating costs and expenses: | ||||||||||||||
| Salaries and benefits | 1,421,310 | 41.3 | % | 1,348,424 | 40.7 | % | ||||||||
| Provision for bad debts | 436,689 | 12.7 | % | 409,837 | 12.4 | % | ||||||||
| Supplies | 467,864 | 13.6 | % | 450,963 | 13.6 | % | ||||||||
| Other operating expenses | 622,501 | 18.0 | % | 602,833 | 18.2 | % | ||||||||
| Electronic health records incentive reimbursement (c) | (23,170 | ) | -0.7 | % | - | 0.0 | % | |||||||
| Rent | 64,699 | 1.9 | % | 63,382 | 1.9 | % | ||||||||
| Depreciation and amortization | 171,628 | 5.0 | % | 154,026 | 4.6 | % | ||||||||
| Total operating costs and expenses | 3,161,521 | 91.8 | % | 3,029,465 | 91.4 | % | ||||||||
| Income from operations (e)(g) | 280,993 | 8.2 | % | 284,728 | 8.6 | % | ||||||||
| Interest expense, net | 158,482 | 4.6 | % | 164,543 | 5.0 | % | ||||||||
| Loss on early extinguishment of debt | 66,019 | 1.9 | % | - | 0.0 | % | ||||||||
| Equity in earnings of unconsolidated affiliates | (11,146 | ) | -0.3 | % | (12,335 | ) | -0.4 | % | ||||||
|
Income from continuing operations before income taxes |
67,638 | 2.0 | % | 132,520 | 4.0 | % | ||||||||
| Provision for income taxes | 12,023 | 0.4 | % | 38,052 | 1.1 | % | ||||||||
| Income from continuing operations (e)(g) | 55,615 | 1.6 | % | 94,468 | 2.9 | % | ||||||||
| Discontinued operations, net of taxes (h): | ||||||||||||||
| Loss from operations of entities sold | (3,223 | ) | -0.1 | % | (2,219 | ) | -0.1 | % | ||||||
| Gain on sale | 728 | 0.0 | % | - | 0.0 | % | ||||||||
| Loss from discontinued operations, net of taxes | (2,495 | ) | -0.1 | % | (2,219 | ) | -0.1 | % | ||||||
| Net income | 53,120 | 1.5 | % | 92,249 | 2.8 | % | ||||||||
| Less: Net income attributable to noncontrolling interests | 22,189 | 0.6 | % | 22,739 | 0.7 | % | ||||||||
| Net income attributable to |
$ | 30,931 | 0.9 | % | $ | 69,510 | 2.1 | % | ||||||
|
Basic earnings (loss) per share attributable to |
||||||||||||||
| Continuing operations (e)(g) | $ | 0.38 | $ | 0.79 | </td> | |||||||||
| Discontinued operations | (0.03 | ) | (0.02 | ) | ||||||||||
| Net income | $ | 0.35 | $ | 0.77 | ||||||||||
|
Diluted earnings (loss) per share attributable to |
||||||||||||||
| Continuing operations (e)(g) | $ | 0.38 | $ | 0.78 | ||||||||||
| Discontinued operations | (0.03 | ) | (0.02 | ) | ||||||||||
| Net income | $ | 0.35 | $ | 0.76 | ||||||||||
|
Weighted-average number of shares outstanding (i): |
||||||||||||||
| Basic | 88,345 | 90,422 | ||||||||||||
| Diluted | 88,914 | 91,779 | ||||||||||||
|
_____ For footnotes, see pages 11 and 12. |
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||||||||||||||
| Year Ended December 31, | ||||||||||||||
| 2011 | 2010 | |||||||||||||
| Amount |
% of Net |
Amount |
% of Net |
|||||||||||
| Net operating revenues (c) | $ | 13,626,168 | 100.0 | % | $ | 12,623,274 | 100.0 | % | ||||||
| Operating costs and expenses: | ||||||||||||||
| Salaries and benefits | 5,577,925 | 40.9 | % | 5,093,767 | 40.3 | % | ||||||||
| Provision for bad debts | 1,719,956 | 12.6 | % | 1,530,852 | 12.1 | % | ||||||||
| Supplies | 1,834,106 | 13.5 | % | 1,738,088 | 13.8 | % | ||||||||
| Other operating expenses | 2,515,638 | 18.5 | % | 2,296,063 | 18.2 | % | ||||||||
| Electronic health records incentive reimbursement (c) | (63,397 | ) | -0.5 | % | - | 0.0 | % | |||||||
| Rent | 254,781 | 1.9 | % | 248,463 | 2.0 | % | ||||||||
| Depreciation and amortization | 652,674 | 4.8 | % | 594,997 | 4.7 | % | ||||||||
| Total operating costs and expenses | 12,491,683 | 91.7 | % | 11,502,230 | 91.1 | % | ||||||||
| Income from operations (e)(g) | 1,134,485 | 8.3 | % | 1,121,044 | 8.9 | % | ||||||||
| Interest expense, net | 644,410 | 4.7 | % | 647,593 | 5.2 | % | ||||||||
| Loss on early extinguishment of debt | 66,019 | 0.5 | % | - | 0.0 | % | ||||||||
| Equity in earnings of unconsolidated affiliates | (49,491 | ) | -0.4 | % | (45,443 | ) | -0.4 | % | ||||||
|
Income from continuing operations before income taxes |
473,547 | 3.5 | % | 518,894 | 4.1 | % | ||||||||
| Provision for income taxes (f) | 137,653 | 1.0 | % | 163,681 | 1.3 | % | ||||||||
| Income from continuing operations (e)(f)(g) | 335,894 | 2.5 | % | 355,213 | 2.8 | % | ||||||||
|
Discontinued operations, net of taxes (h): Loss from operations of entities sold |
(7,769 | ) | -0.1 | % | (6,772 | ) | -0.1 | % | ||||||
| Impairment of hospitals sold | (47,930 | ) | -0.4 | % | - | 0.0 | % | |||||||
| Loss on sale, net | (2,572 | ) | -0.0 | % | - | 0.0 | % | |||||||
| Loss from discontinued operations, net of taxes | (58,271 | ) | -0.5 | % | (6,772 | ) | -0.1 | % | ||||||
| Net income | 277,623 | 2.0 | % | 348,441 | 2.7 | % | ||||||||
| Less: Net income attributable to noncontrolling interests | 75,675 | 0.5 | % | 68,458 | 0.5 | % | ||||||||
| Net income attributable to |
$ | 201,948 | 1.5 | % | $ | 279,983 | 2.2 | % | ||||||
|
Basic earnings (loss) per share attributable to |
||||||||||||||
| Continuing operations (e)(f)(g) | $ | 2.89 | $ | 3.13 | ||||||||||
| Discontinued operations | (0.65 | ) | (0.07 | ) | ||||||||||
| Net income | $ | 2.24 | $ | 3.05 | ||||||||||
|
Diluted earnings (loss) per share attributable to |
||||||||||||||
| Continuing operations (e)(f)(g) | $ | 2.87 | $ | 3.08 | ||||||||||
| Discontinued operations | (0.64 | ) | (0.07 | ) | ||||||||||
| Net income | $ | 2.23 | $ | 3.01 | ||||||||||
|
Weighted-average number of shares outstanding (i): |
||||||||||||||
| Basic | 89,967 | 91,719 | ||||||||||||
| Diluted | 90,666 | 92,946 | ||||||||||||
| </td> | ||||||||||||||
|
_____ For footnotes, see pages 11 and 12. |
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||||||||||||||||||||||
| For the Three Months Ended |
||||||||||||||||||||||
| Consolidated | Same-Store | |||||||||||||||||||||
| 2011 | 2010 | % Change | 2011 | 2010 | % Change | |||||||||||||||||
| Number of hospitals (at end of period) | 131 | 127 | 127 | 127 | ||||||||||||||||||
| Licensed beds (at end of period) | 19,695 | 19,004 | 18,992 | 19,004 | ||||||||||||||||||
| Beds in service (at end of period) | 16,832 | 16,264 | 16,207 | 16,264 | ||||||||||||||||||
| Admissions | 165,542 | 171,510 | -3.5 | % | 160,008 | 171,510 | -6.7 | % | ||||||||||||||
| Adjusted admissions | 331,720 | 325,957 | 1.8 | % | 321,502 | 325,957 | -1.4 | % | ||||||||||||||
| Patient days | 732,430 | 737,642 | 701,213 | 737,642 | ||||||||||||||||||
| Average length of stay (days) | 4.4 | 4.3 | 4.4 | 4.3 | ||||||||||||||||||
| Occupancy rate (average beds in service) | 47.3 | % | 49.3 | % | 47.1 | % | 49.3 | % | ||||||||||||||
| Net operating revenues | $ | 3,442,514 | 3,314,193 | 3.9 | % | $ | 3,351,302 | $ | 3,310,799 | 1.2 | % | |||||||||||
|
Net inpatient revenues as a % of total net operating revenues |
44.5 | % | 49.2 | % | 44.2 | % | 49.3 | % | ||||||||||||||
|
Net outpatient revenues as a % of total net operating revenues |
53.5 | % | 48.4 | % | 53.7 | % | 48.5 | % | ||||||||||||||
| Income from operations | $ | 280,993 | $ | 284,728 | -1.3 | % | $ | 298,275 | $ | 288,151 | 3.5 | % | ||||||||||
|
Income from operations as a % of net operating revenues |
8.2 | % | 8.6 | % | 8.9 | % | 8.7 | % | ||||||||||||||
| Depreciation and amortization | $ | 171,628 | $ | 154,026 | $ | 167,283 | $ | 154,026 | ||||||||||||||
| Equity in earnings of unconsolidated affiliates | $ | (11,146 | ) | $ | (12,335 | ) | $ | (11,161 | ) | $ | (12,335 | ) | ||||||||||
| Liquidity Data: | ||||||||||||||||||||||
| Adjusted EBITDA (d) | $ | 463,767 | $ | 451,089 | 2.8 | % | ||||||||||||||||
|
Adjusted EBITDA as a % of net operating revenues |
13.5 | % | 13.6 | % | ||||||||||||||||||
| Net cash provided by operating activities | $ | 441,673 | $ | 290,353 | ||||||||||||||||||
|
Net cash provided by operating activities as a % of net operating revenues |
12.8 | % | 8.8 | % | ||||||||||||||||||
|
_____ For footnotes, see pages 11 and 12. |
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|
||||||||||||||||||||||
| For the Year Ended |
||||||||||||||||||||||
| Consolidated | Same-Store | |||||||||||||||||||||
| 2011 | 2010 | % Change | 2011 | 2010 | % Change | |||||||||||||||||
| Number of hospitals (at end of period) | 131 | 127 | 127 | 127 | ||||||||||||||||||
| Licensed beds (at end of period) | 19,695 | 19,004 | 18,992 | 19,004 | ||||||||||||||||||
| Beds in service (at end of period) | 16,832 | 16,264 | 16,207 | 16,264 | ||||||||||||||||||
| Admissions | 675,050 | 678,284 | -0.5 | % | 640,302 | 678,284 | -5.6 | % | ||||||||||||||
| Adjusted admissions | 1,330,988 | 1,277,235 | 4.2 | % | 1,267,860 | 1,277,235 | -0.7 | % | ||||||||||||||
| Patient days | 2,970,044 | 2,891,699 | 2,806,139 | 2,891,699 | ||||||||||||||||||
| Average length of stay (days) | 4.4 | 4.3 | 4.4 | 4.3 | ||||||||||||||||||
| Occupancy rate (average beds in service) | 49.1 | % | 50.2 | % | 48.9 | % | 50.2 | % | ||||||||||||||
| Net operating revenues | $ | 13,626,168 | $ | 12,623,274 | 7.9 | % | $ | 13,083,230 | $ | 12,618,026 | 3.7 | % | ||||||||||
|
Net inpatient revenues as a % of total net operating revenues |
46.1 | % | 49.3 | % | 45.7 | % | 49.3 | % | ||||||||||||||
|
Net outpatient revenues as a % of total net operating revenues |
51.9 | % | 48.5 | % | 52.3 | % | 48.5 | % | ||||||||||||||
| Income from operations | $ | 1,134,485 | $ | 1,121,044 | 1.2 | % | $ | 1,188,176 | $ | 1,131,850 | 5.0 | % | ||||||||||
|
Income from operations as a % of net operating revenues |
8.3 | % | 8.9 | % | 9.1 | % | 9.0 | % | ||||||||||||||
| Depreciation and amortization | $ | 652,674 | $ | 594,997 | $ | 633,417 | $ | 594,997 | ||||||||||||||
|
Equity in earnings of unconsolidated affiliates |
$ | (49,491 | ) | $ | (45,443 | ) | $ | (49,507 | ) | $ | (45,380 | ) | ||||||||||
| Liquidity Data: | ||||||||||||||||||||||
| Adjusted EBITDA (d) | $ | 1,836,650 | $ | 1,761,484 | 4.3 | % | ||||||||||||||||
|
Adjusted EBITDA as a % of net operating revenues |
13.5 | % | 14.0 | % | ||||||||||||||||||
| Net cash provided by operating activities | $ | 1,261,908 | $ | 1,188,730 | ||||||||||||||||||
|
Net cash provided by operating activities as a % of net operating revenues |
9.3 | % | 9.4 | % | ||||||||||||||||||
|
_____ For footnotes, see pages 11 and 12. |
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|||||||||
| December 31, | |||||||||
| 2011 | 2010 | ||||||||
| ASSETS | |||||||||
| Current assets | |||||||||
| Cash and cash equivalents | $ | 129,865 | $ | 299,169 | |||||
|
Patient accounts receivable, net of allowance for doubtful accounts of |
1,834,167 | 1,714,542 | |||||||
| Supplies | 346,611 | 329,114 | |||||||
| Prepaid income taxes | 101,389 | 118,464 | |||||||
| Deferred income taxes | 89,797 | 115,819 | |||||||
| Prepaid expenses and taxes | 112,613 | 100,754 | |||||||
| Other current assets | 231,647 | 193,331 | |||||||
| Total current assets | 2,846,089 | 2,871,193 | |||||||
| Property and equipment | 9,369,528 | 8,383,122 | |||||||
| Less accumulated depreciation and amortization | (2,513,552 | ) | (2,058,685 | ) | |||||
| Property and equipment, net | 6,855,976 | 6,324,437 | |||||||
| Goodwill | 4,264,845 | 4,150,247 | |||||||
| Other assets, net | 1,241,930 | 1,352,246 | |||||||
| Total assets | $ | 15,208,840 | $ | 14,698,123 | |||||
| LIABILITIES | |||||||||
| Current liabilities | |||||||||
| Current maturities of long-term debt | $ | 63,706 | $ | 63,139 | |||||
| Accounts payable | 748,997 | 526,338 | |||||||
| Deferred income taxes | - | 8,882 | |||||||
| Accrued interest | 110,121 | 146,415 | |||||||
| Accrued liabilities | 988,315 | 897,266 | |||||||
| Total current liabilities | 1,911,139 | 1,642,040 | |||||||
| Long-term debt | 8,782,798 | 8,808,382 | |||||||
| Deferred income taxes | 704,725 | 608,177 | |||||||
| Other long-term liabilities | 949,990 | 1,001,675 | |||||||
| Total liabilities | 12,348,652 | 12,060,274 | |||||||
| Redeemable noncontrolling interests in equity of consolidated subsidiaries | 395,743 | 387,472 | |||||||
| EQUITY | |||||||||
|
Preferred stock, |
- | - | |||||||
|
Common stock, |
915 | 936 | |||||||
| Additional paid-in capital | 1,086,008 | 1,126,751 | |||||||
|
Treasury stock, at cost, 975,549 shares at |
(6,678 | ) | (6,678 | ) | |||||
| Accumulated other comprehensive loss | (184,479 | ) | (230,927 | ) | |||||
| Retained earnings | 1,501,330 | 1,299,382 | |||||||
| Total |
2,397,096 | 2,189,464 | |||||||
| Noncontrolling interests in equity of consolidated subsidiaries | 67,349 | 60,913 | |||||||
| Total equity | 2,464,445 | 2,250,377 | |||||||
| Total liabilities and equity | $ | 15,208,840 | $ | 14,698,123 | |||||
|
_____ For footnotes, see pages 11 and 12. |
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|||||||||
| Year Ended | |||||||||
| December 31, | |||||||||
| 2011 | 2010 | ||||||||
| Cash flows from operating activities | |||||||||
| Net income | $ | 277,623 | $ | 348,441||||||
|
Adjustments to reconcile net income to net cash provided by operating activities: |
|
|
|||||||
| Depreciation and amortization |
657,665 |
609,839 |
|||||||
| Deferred income taxes | 107,032 | 97,370 | |||||||
| Stock-based compensation expense | 42,542 | 38,779 | |||||||
| Loss on sale, net | 2,572 | - | |||||||
| Impairment of hospitals sold | 47,930 | - | |||||||
| Loss on early extinguishment of debt | 66,019 | - | |||||||
| Excess tax benefit relating to stock-based compensation | (5,290 | ) | (10,219 | ) | |||||
| Other non-cash expenses, net | 28,716 | 12,503 | |||||||
|
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures: |
|||||||||
| Patient accounts receivable | (138,332 | ) | (27,049 | ) | |||||
| Supplies, prepaid expenses and other current assets | (42,858 | ) | (39,904 | ) | |||||
| Accounts payable, accrued liabilities and income taxes | 246,110 | 161,952 | |||||||
| Other | (27,821 | ) | (2,982 | ) | |||||
| Net cash provided by operating activities | 1,261,908 | 1,188,730 | |||||||
| Cash flows from investing activities | |||||||||
| Acquisitions of facilities and other related equipment | (415,360 | ) | (248,251 | ) | |||||
| Purchases of property and equipment | (776,713 | ) | (667,378 | ) | |||||
| Proceeds from disposition of hospitals and other ancillary operations | 173,387 | - | |||||||
| Proceeds from sale of property and equipment | 11,160 | 8,401 | |||||||
| Increase in other investments | (188,249 | ) | (137,082 | ) | |||||
| Net cash used in investing activities | (1,195,775 | ) | (1,044,310 | ) | |||||
| Cash flows from financing activities | |||||||||
| Proceeds from exercise of stock options | 18,910 | 56,916 | |||||||
| Cancellation of restricted stock in satisfaction of withholding tax requirements | (13,311 | ) | - | ||||||
| Deferred financing costs | (19,352 | ) | (13,260 | ) | |||||
| Excess tax benefit relating to stock-based compensation | 5,290 | 10,219 | |||||||
| Stock buy-back | (85,790 | ) | (113,961 | ) | |||||
| Proceeds from noncontrolling investors in joint ventures | 1,229 | 7,201 | |||||||
| Redemption of noncontrolling investments in joint ventures | (13,022 | ) | (7,318 | ) | |||||
| Distributions to noncontrolling investors in joint ventures | (56,094 | ) | (68,113 | ) | |||||
| Borrowings under credit agreement | 578,236 | - | |||||||
| Issuance of long-term debt | 1,000,000 | - | |||||||
| Repayments of long-term indebtedness | (1,651,533 | ) | (61,476 | ) | |||||
| Net cash used in financing activities | (235,437 | ) | (189,792 | ) | |||||
| Net change in cash and cash equivalents | (169,304 | ) | (45,372 | ) | |||||
| Cash and cash equivalents at beginning of period | 299,169 | 344,541 | |||||||
| Cash and cash equivalents at end of period | $ | 129,865 | $ | 299,169 | |||||
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data
(a) The following table provides information needed to calculate income per share which is adjusted for income attributable to noncontrolling interests (in thousands).
| Three Months Ended | Year Ended | |||||||||||||||
| December 31, | ||||||||||||||||
| 2011 | 2010 | 2011 | 2010 | |||||||||||||
|
Income from continuing operations attributable to |
||||||||||||||||
| Income from continuing operations, net of taxes | $ | 55,615 | $ | 94,468 | $ | 335,894 | $ | 355,213 | ||||||||
|
Less: Income from continuing operations attributable to noncontrolling interests, net of taxes |
22,189 | 22,761 | 75,675 | 68,577 | ||||||||||||
|
Income from continuing operations attributable to |
$ | 33,426 | $ | 71,707 | $ | 260,219 | $ | 286,636 | ||||||||
|
Loss from discontinued operations attributable to |
||||||||||||||||
| Loss from discontinued operations, net of taxes | $ | (2,495 | ) | $ | (2,219 | ) | $ | (58,271 | ) | $ | (6,772 | ) | ||||
|
Less: Loss from discontinued operations attributable to noncontrolling interests, net of taxes |
- | (22 | ) | - | (119 | ) | ||||||||||
|
Loss from discontinued operations attributable to |
$ | (2,495 | ) | $ | (2,197 | ) | $ | (58,271 | ) | $ | (6,653 | ) | ||||
(b) Continuing operating results exclude discontinued operations for the three months and years ended
(c) Health Information Technology (HITECH) electronic health records incentive reimbursement was previously reflected as revenue for the three months ended
(d) EBITDA consists of net income attributable to
Adjusted EBITDA is not a measurement of financial performance or liquidity under U.S. GAAP. It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with U.S. GAAP. The items excluded from adjusted EBITDA are significant components in understanding and evaluating financial performance and liquidity. This calculation of adjusted EBITDA may not be comparable to similarly titled measures reported by other companies.
The following table reconciles adjusted EBITDA, as defined, to net cash provided by operating activities as derived directly from the condensed consolidated financial statements (in thousands):
| Three Months Ended | Year Ended | |||||||||||||||
| December 31, | ||||||||||||||||
| 2011 | 2010 | 2011 | 2010 | |||||||||||||
| Adjusted EBITDA | $ | 463,767 | $ | 451,089 | $ | 1,836,650 | $ | 1,761,484 | ||||||||
| Interest expense, net | (158,482 | ) | (164,543 | ) | (644,410 | ) | (647,593 | ) | ||||||||
| Provision for income taxes | (12,023 | ) | (38,052 | ) | (137,653 | ) | (163,681 | ) | ||||||||
| Loss from operations of entities sold, net of taxes | (3,223 | ) | (2,219 | ) | (7,769 | ) | (6,772 | ) | ||||||||
| Other non-cash expenses, net | 24,837 | 16,670 | </td> | 70,959 | 55,905 | |||||||||||
|
Net changes in operating assets and liabilities, net of effects of acquisitions |
126,797 | 27,408 | 144,131 | 189,387 | ||||||||||||
| Net cash provided by operating activities | $ | 441,673 | $ | 290,353 | $ | 1,261,908 | $ | 1,188,730 | ||||||||
(e) Included in non-same-store income from operations and income from continuing operations for the three months and year ended December 31, 2011, are pre-tax legal and other costs of
(f) The provision for income taxes for the year ended
(g) Also included in income from continuing operations for the three months and year ended
(h) Included in discontinued operations for the three months and year ended
- Effective
February 1, 2011 , the Company soldWillamette Community Medical Group, LLC , which is a physician clinic operating asOregon Medical Group , located inSpringfield, Oregon , with a carrying amount of net assets, including an allocation of reporting unit goodwill, of$19.7 million , toOregon Healthcare Resources, LLC , for$14.6 million in cash. - Effective
September 1, 2011 , two hospitals, one inTulsa, Oklahoma , and one inClaremore, Oklahoma , were sold. The after-tax loss on sale was approximately$38.7 million . - Effective
October 22, 2011 , the Company sold its partnership interests in the limited partnership that operatesCleveland Regional Medical Center (107 licensed beds) located inCleveland, Texas . The after-tax loss on sale was approximately$8.5 million .
(i) The following table sets forth components reconciling the basic weighted-average number of shares to the diluted weighted-average number of shares (in thousands):
| Three Months Ended | Year Ended | |||||||
| December 31, | ||||||||
| 2011 | 2010 | 2011 | 2010 | |||||
|
Weighted-average number of shares outstanding - basic |
88,345 | 90,422 | 89,967 | 91,719 | ||||
| Add effect of dilutive securities: | ||||||||
| Stock awards and options | 569 | 1,357 | 699 | 1,227 | ||||
|
Weighted-average number of shares outstanding - diluted |
88,914 | 91,779 | 90,666 | 92,946 | ||||
(j) Total per share amounts may not add due to rounding.
Regulation FD Disclosure
The following tables set forth selected information concerning the Company’s projected consolidated operating results for the year ending
The following is provided as guidance to analysts and investors:
| Restated | |||||||||||||||
| 2012 |
2011 Actual | ||||||||||||||
| Net operating revenues less provision for bad debt (in millions) * | $ | 12,700 | to | $ | 13,100 | $ | 11,906 | ||||||||
| Adjusted EBITDA (in millions) | $ | 1,910 | to | $ | 1,950 | $ | 1,837 | ||||||||
| Income from continuing operations per share - diluted | $ | 3.45 | to | $ | 3.70 | $ | 3.33 |
** |
|||||||
| Same-store hospital annual adjusted admissions growth | -0.5 | % | to | 1.5 | % | -0.7 | % | ||||||||
| Weighted-average diluted shares (in millions) | 90 | to | 91 | 91 | |||||||||||
| Income from continuing operations per share-diluted | |||||||||||||||
| 1st Quarter ending |
$ | 0.84 | to | $ | 0.90 | ||||||||||
| __________ | |||||||||||||||
|
* Any reference to net operating revenues means net operating revenues less provision for bad debt. |
|||||||||||||||
|
** Excludes loss on early extinguishment of debt. |
|||||||||||||||
The following assumptions were used in developing the 2012 guidance provided above:
- Effective
January 1, 2012 , the Company adopted Accounting Standards Update 2011-07, which requires the provision for bad debts expense associated with patient service revenue to be presented as an offset to the patient service revenue line item in the statement of operations. 2012 projection range and restated 2011 actual net operating revenues are presented net of projected and actual provision for bad debts, respectively. - Health Information Technology (HITECH) electronic health records incentive reimbursement was previously reflected as revenue and has been reclassified as a reduction to operating expense for the year ended
December 31, 2011 , complying with the recently changed recognition rules preferred by theSEC . Under the gain contingency model preferred by theSEC , the aggregate amount of incentive reimbursement recognized over the life of the program will not be impacted, but recognition of incentive reimbursement could be delayed in some cases up to one year after receipt of the incentive payments. Expressed as a percent of net operating revenues, electronic health records incentive reimbursement for 2012 is projected to be approximately 0.6% to 0.8%. Electronic health records related total costs and expenses for 2012 expressed as a percentage of net operating revenues, are projected to be approximately 0.3% to 0.5%, including depreciation and amortization expressed as a percentage of net operating revenues of approximately 0.2% to 0.3%. The projections related to HITECH incentive reimbursement and the related costs are based on the assumption that approximately one-third of our hospitals will be Stage 1 compliant bySeptember 30, 2012 . Delays in compliance until later in 2012 may defer recognition of the incentive reimbursement into future years without reducing the aggregate incentive we receive under this program. Accelerating compliance of additional hospitals during 2012 may result in additional expenses being incurred but may not accelerate the recognition of the incentive reimbursement into 2012. - 2012 projection includes four to five assumed hospital acquisitions after
December 31, 2011 , including those previously announced but not yet closed. - Projected 2012 same-store hospital annual adjusted admissions growth does not take into account service closures and other unusual events.
- Expressed as a percentage of net operating revenues, depreciation and amortization is projected to be approximately 5.6% to 5.8% for 2012; however, this is a fixed cost and the percentages may vary as revenue varies. Such amounts exclude the possible impact of any future fair-value adjustments to investments and hospital fixed asset impairments.
- 2012 projection includes an estimate of
$0.04 to $0.06 per share (diluted) of acquisition costs that are required to be expensed. - The Company’s 2012 projection range includes approximately 15 basis points of net revenue for legal expense and other expenses expected to be incurred related to the Tenet lawsuit, governmental investigations, and shareholder lawsuits. The Company’s 2012 projection does not take into account resolution of government investigations, Tenet-related lawsuits, and other significant lawsuits not resolved at
February 21, 2012 . - For the purpose of providing interest expense guidance, the Company assumes that the borrowing rate under the Company’s
$7.2 billion Senior Secured Credit Facility for 2012 will remain relatively stable with the rates existing currently, particularly since the Company is a party to interest rate swap agreements. Total fixed debt including swaps is expected to average approximately 72% to 77% of total debt. These swap agreements limit the effect of changes in interest rates. Based on these assumptions and the Company’s planned first quarter 2012 accounts receivable securitization, expressed as a percentage of net operating revenues, interest expense is projected to be approximately 4.7% to 4.9% for 2012; however, these percentages will vary as revenue and interest rates vary. The 2012 projection does not assume any significant changes to the financing terms of the Senior Secured Credit Facility or any significant new financing arrangements, not announced prior toFebruary 21, 2012 . - On
December 14, 2011 , the Company adopted a new open market repurchase program for up to four million shares of the Company’s common stock, not to exceed$100 million in purchases. The new repurchase program will conclude at the earliest of three years, when the maximum number of shares has been repurchased, or when the maximum dollar amount has been reached. ThroughFebruary 21, 2012 , no shares have been purchased and retired under this repurchase plan. - Expressed as a percentage of net operating revenues, equity in earnings of unconsolidated affiliates is projected to be approximately 0.3% to 0.5% for 2012.
- Expressed as a percentage of net operating revenues, net income attributable to noncontrolling interests is projected to be approximately 0.5% to 0.7% for 2012.
- Expressed as a percentage of income from continuing operations before income taxes, provision for income tax is projected to be approximately 31.0% to 33.0% for 2012.
- Capital expenditures are projected as follows (in millions):
| 2012
Guidance |
|||||||||
| Total | $ | 800 | to | $ | 900 | ||||
- Net cash provided by operating activities are projected as follows (in millions):
| 2012
Guidance |
|||||||||
| Total | $ | 1,200 | to | $ | 1,300 | ||||
The projections set forth in this report constitute forward-looking statements within the meaning of Section 27A of the Securities Act, Section 21E of the Exchange Act and the Private Securities Litigation Reform Act of 1995. Although the Company believes that these forward-looking statements are based on reasonable assumptions, these assumptions are inherently subject to significant economic and competitive uncertainties and contingencies, which are difficult or impossible to predict accurately and are beyond the control of the Company. Accordingly, the Company cannot give any assurance that its expectations will in fact occur and cautions that actual results may differ materially from those in the forward-looking statements. A number of factors could affect the future results of the Company or the healthcare industry generally and could cause the Company’s expected results to differ materially from those expressed in this filing.
These factors include, among other things:
- general economic and business conditions, both nationally and in the regions in which we operate;
- implementation and effect of adopted and potential federal and state healthcare legislation;
- risks associated with our substantial indebtedness, leverage, and debt service obligations;
- demographic changes;
- changes in, or the failure to comply with, governmental regulations;
- potential adverse impact of known and unknown government investigations, audits, and Federal and State False Claims Act litigation and other legal proceedings;
- our ability, where appropriate, to enter into and maintain managed care provider arrangements and the terms of these arrangements;
- changes in, or the failure to comply with, managed care provider contracts could result in disputes and changes in reimbursement that could be applied retroactively;
- changes in inpatient or outpatient
Medicare andMedicaid payment levels; - increases in the amount and risk of collectability of patient accounts receivable;
- increases in wages as a result of inflation or competition for highly technical positions and rising supply costs due to market pressure from pharmaceutical companies and new product releases;
- liabilities and other claims asserted against us, including self-insured malpractice claims;
- competition;
- our ability to attract and retain, without significant employment costs, qualified personnel, key management, physicians, nurses and other health care workers;
- trends toward treatment of patients in less acute or specialty healthcare settings, including ambulatory surgery centers or specialty hospitals;
- changes in medical or other technology;
- changes in U.S. generally accepted accounting principles;
- the availability and terms of capital to fund additional acquisitions or replacement facilities;
- our ability to successfully acquire additional hospitals or complete divestitures;
- our ability to successfully integrate any acquired hospitals or to recognize expected synergies from such acquisitions;
- our ability to obtain adequate levels of general and professional liability insurance;
- timeliness of reimbursement payments received under government programs; and
- the other risk factors set forth in our public filings with the
Securities and Exchange Commission .
The consolidated operating results for the three months and year ended
The Company cautions that the projections for calendar year 2012 set forth in this press release are given as of the date hereof based on currently available information. The Company is not undertaking any obligation to update these projections as conditions change or other information becomes available.
Investor Contact:
W. Larry Cash, 615-465-7000
Executive Vice President and Chief Financial Officer
Source:
| Copyright: | Copyright Business Wire 2012 |
| Wordcount: | 6798 |



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