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8-K - FORM 8-K - COMMUNITY HEALTH SYSTEMS INCg24966e8vk.htm
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99.1
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Investor Contact:
  W. Larry Cash
 
  Executive Vice President
 
  and Chief Financial Officer
 
  (615) 465-7000
COMMUNITY HEALTH SYSTEMS, INC. ANNOUNCES
THIRD QUARTER 2010 RESULTS WITH NET OPERATING REVENUES OF $3.3 BILLION
     FRANKLIN, TENN. (October 27, 2010) — Community Health Systems, Inc. (NYSE: CYH) today announced financial and operating results for the three and nine months ended September 30, 2010.
     Net operating revenues for the three months ended September 30, 2010, totaled $3.3 billion, a 5.4 percent increase compared with $3.1 billion for the same period in 2009. Income from continuing operations increased to $84.9 million for the three months ended September 30, 2010, compared with $75.4 million for the same period in 2009. Income from continuing operations attributable to Community Health Systems, Inc. common stockholders increased to $0.76 per share (diluted), on 92.5 million weighted-average shares outstanding for the three months ended September 30, 2010, compared with $0.65 per share (diluted), on 92.0 million weighted-average shares outstanding for the same period in 2009. Net income attributable to Community Health Systems, Inc. common stockholders increased 17.9 percent to $70.4 million, or $0.76 per share (diluted), for the three months ended September 30, 2010, compared with $59.7 million, or $0.65 per share (diluted), for the same period in 2009.
     Adjusted EBITDA for the three months ended September 30, 2010, was $441.5 million, compared with $417.8 million for the same period in 2009, representing a 5.7 percent increase. Adjusted EBITDA is EBITDA adjusted to exclude discontinued operations, gain/loss from early extinguishment of debt and net income attributable to noncontrolling interests. The Company uses adjusted EBITDA as a measure of liquidity. Net cash provided by operating activities for the three months ended September 30, 2010, was $356.6 million, compared with $356.4 million for the same period in 2009.
     The consolidated financial results for the three months ended September 30, 2010, reflect a 3.0 percent decrease in total admissions and a 0.2 percent decrease in total adjusted admissions compared with the same period in 2009. On a same-store basis, admissions decreased 3.6 percent and adjusted admissions decreased 1.3 percent, compared with the same period in 2009. On a same-store basis, net operating revenues increased 3.8 percent, compared with the same period in 2009.
     Net operating revenues for the nine months ended September 30, 2010, totaled $9.6 billion, a 6.3 percent increase compared with $9.0 billion for the same period in 2009. Income from continuing operations increased to $256.2 million for the nine months ended September 30, 2010, compared with $220.7 million for the same period in 2009. Income from continuing operations attributable to Community Health Systems, Inc. common stockholders increased to $2.26 per share (diluted), on 93.2 million weighted-average shares outstanding for the nine months ended September 30, 2010, compared with $1.94 per share (diluted), on 91.1 million weighted-average shares outstanding for the same period in 2009. Net income attributable to Community Health Systems, Inc. common stockholders increased 18.2 percent to $210.5 million, or $2.26 per share (diluted), for the nine months ended September 30, 2010, compared with $178.1 million, or $1.95 per share (diluted), for the same period in 2009.
     Adjusted EBITDA for the nine months ended September 30, 2010, was $1.3 billion, compared with $1.2 billion for the same period in 2009, representing a 6.5 percent increase. Net cash provided by operating activities for the nine months ended September 30, 2010, was $898.4 million, compared with $900.8 million for the same period of 2009.

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CYH Announces Third Quarter 2010 Results
Page 2
October 27, 2010
     The consolidated financial results for the nine months ended September 30, 2010, reflect a 0.5 percent decrease in total admissions and a 1.7 percent increase in total adjusted admissions compared with the same period in 2009. This increase was entirely due to acquisitions. On a same-store basis, admissions decreased 2.4 percent and adjusted admissions decreased 0.7 percent, compared with the same period in 2009. On a same-store basis, net operating revenues increased 3.6 percent, compared with the same period in 2009.
     Commenting on the results, Wayne T. Smith, chairman, president and chief executive officer of Community Health Systems, Inc., stated, “We are pleased with our solid financial performance for the third quarter of 2010, in what has continued to be a challenging economic environment. Our conservative operating strategy and strong focus on expense management have served us well. We continued to benefit from a consistent performance at the hospital level, as evidenced by favorable same-store revenue trends for the third quarter and year to date periods.”
     On October 1, 2010, the Company announced that certain of its subsidiaries acquired Forum Health, a system of hospitals and other healthcare providers based in Youngstown, Ohio. Forum Health’s operation includes two acute care hospitals: the 346-bed Trumbull Memorial Hospital in Warren, Ohio and the 398-bed Northside Medical Center in Youngstown, Ohio. Separately, on the same day, the Company announced the acquisition, by a subsidiary, of Bluefield Regional Medical Center, a 265-bed acute care hospital located in Bluefield, West Virginia.
     “Throughout 2010, we have continued to extend our market reach through selective acquisitions,” added Smith. “We have identified hospital facilities that meet our operating profile with the most opportunity for growth. We have a proven track record for the successful integration of these facilities with improved operating results. With the current healthcare regulatory climate, we believe there are significant opportunities for us to pursue additional acquisitions with a greater number of independent hospitals looking for established and operationally-focused partners. We can provide the experience and financial resources to support and keep these hospitals in the local community. We look forward to working together with each new hospital partner as we deliver on our commitment to deliver quality healthcare close to home.”
     Included on pages 13, 14 and 15 of this press release are tables setting forth the Company’s 2010 guidance and initial guidance for 2011. The 2010 guidance reaffirms the Company’s previous annual earnings guidance provided on July 28, 2010, as updated to reflect historical results through September 30, 2010, with certain changes to the assumptions used in connection with the guidance.
     Located in the Nashville, Tennessee, suburb of Franklin, Community Health Systems, Inc. is the largest publicly-traded hospital company in the United States and a leading operator of general acute care hospitals in non-urban and mid-size markets throughout the country. Through its subsidiaries, the Company currently owns, leases or operates 126 hospitals in 29 states with an aggregate of approximately 19,400 licensed beds. Its hospitals offer a broad range of inpatient and surgical services, outpatient treatment and skilled nursing care. In addition, through its subsidiary, Quorum Health Resources, LLC, the Company provides management and consulting services to over 150 independent non-affiliated general acute care hospitals located throughout the United States. Shares in Community Health Systems, Inc. are traded on the New York Stock Exchange under the symbol “CYH.”
     Community Health Systems, Inc. will hold a conference call to discuss this press release on Thursday, October 28, 2010, at 10:00 a.m. Central, 11:00 a.m. Eastern. Investors will have the opportunity to listen to a live internet broadcast of the conference call by clicking on the Investor Relations link of the Company’s website at www.chs.net, or at www.earnings.com. To listen to the live call, please go to the website at least fifteen minutes early to register, download and install any necessary audio software. For those who cannot listen to the live broadcast, a replay will be available shortly after the call and will continue through November 26, 2010. Copies of the Company’s Form 8-K (including this press release) and conference call slide show are available on the Company’s website at www.chs.net.

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CYH Announces Third Quarter 2010 Results
Page 3
October 27, 2010
     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 Community Health Systems, Inc. with the Securities and Exchange Commission, including the Company’s annual report on Form 10-K, current reports on Form 8-K and quarterly reports on Form 10-Q. These filings identify important risk factors and other uncertainties that could cause actual results to differ from those contained in the forward-looking statements. The Company undertakes no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

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CYH Announces Third Quarter 2010 Results
Page 4
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Financial Highlights (a)(b)

(in thousands, except per share amounts)
(Unaudited)
                                 
    Three Months Ended     Nine Months Ended  
    September 30,     September 30,  
    2010     2009     2010     2009  
Net operating revenues
  $ 3,252,055     $ 3,086,757     $ 9,583,801     $ 9,016,467  
Adjusted EBITDA (c)
  $ 441,473     $ 417,827     $ 1,317,882     $ 1,236,976  
Income from continuing operations (d)(e)(f)(g)
  $ 84,854     $ 75,361     $ 256,192     $ 220,679  
Net income attributable to Community Health Systems, Inc.
  $ 70,401     $ 59,712     $ 210,473     $ 178,062  
 
                               
Basic earnings per share attributable to Community
                               
Health Systems, Inc. common stockholders:
                               
Continuing operations
  $ 0.77     $ 0.66     $ 2.29     $ 1.96  
Discontinued operations
                      0.01  
 
                       
Net income
  $ 0.77     $ 0.66     $ 2.29     $ 1.97  
 
                       
 
Diluted earnings per share attributable to Community
                               
Health Systems, Inc. common stockholders:
                               
Continuing operations
  $ 0.76     $ 0.65     $ 2.26     $ 1.94  
Discontinued operations
                      0.01  
 
                       
Net income
  $ 0.76     $ 0.65     $ 2.26     $ 1.95  
 
                       
 
                               
Weighted-average number of shares outstanding (h):
                               
Basic
    91,485       90,923       92,036       90,424  
Diluted
    92,463       92,019       93,220       91,120  
 
                               
Net cash provided by operating activities
  $ 356,585     $ 356,353     $ 898,377     $ 900,760  
 
For footnotes, see pages 11 and 12.

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CYH Announces Third Quarter 2010 Results
Page 5
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Income (a)(b)

(in thousands, except per share amounts)
(Unaudited)
                                 
    Three Months Ended  
    September 30,  
    2010     2009  
            % of Net             % of Net  
            Operating             Operating  
    Amount     Revenue     Amount     Revenue  
Net operating revenues
  $ 3,252,055       100.0 %   $ 3,086,757       100.0 %
 
                       
Operating costs and expenses:
                               
Salaries and benefits
    1,303,389       40.1 %     1,239,147       40.1 %
Provision for bad debts
    403,077       12.4 %     378,357       12.3 %
Supplies
    443,113       13.6 %     428,120       13.9 %
Other operating expenses
    606,073       18.6 %     567,624       18.4 %
Rent
    64,465       2.0 %     62,683       2.0 %
Depreciation and amortization
    151,119       4.7 %     143,558       4.7 %
 
                       
Total operating costs and expenses
    2,971,236       91.4 %     2,819,489       91.4 %
 
                       
 
Income from operations (f)
    280,819       8.6 %     267,268       8.6 %
Interest expense, net
    164,011       5.0 %     161,823       5.2 %
Loss from early extinguishment of debt
          0.0 %     21       0.0 %
Equity in earnings of unconsolidated affiliates
    (9,535 )     -0.3 %     (7,001 )     -0.2 %
 
                       
Income from continuing operations before income taxes
    126,343       3.9 %     112,425       3.6 %
Provision for income taxes
    41,489       1.3 %     37,064       1.2 %
 
                       
Income from continuing operations (d)(f)(g)
    84,854       2.6 %     75,361       2.4 %
 
                       
 
Discontinued operations, net of taxes (b):
                               
Income from operations of hospitals sold and hospitals held for sale
          0.0 %           0.0 %
Income on sale of hospitals, net
          0.0 %           0.0 %
 
                       
Income from discontinued operations
          0.0 %           0.0 %
 
                       
Net income
    84,854       2.6 %     75,361       2.4 %
Less: Net income attributable to noncontrolling interests (a)
    14,453       0.4 %     15,649       0.5 %
 
                       
Net income attributable to Community Health Systems, Inc.
  $ 70,401       2.2 %   $ 59,712       1.9 %
 
                       
 
                               
Basic earnings per share attributable to Community Health Systems, Inc. common stockholders:
                               
Continuing operations
  $ 0.77             $ 0.66          
Discontinued operations
                           
 
                       
Net income
  $ 0.77             $ 0.66          
 
                           
 
                               
Diluted earnings per share attributable to Community Health Systems, Inc. common stockholders:
                               
Continuing operations
  $ 0.76             $ 0.65          
Discontinued operations
                           
 
                       
Net income
  $ 0.76             $ 0.65          
 
                           
 
Weighted-average number of shares outstanding (h):
                               
Basic
    91,485               90,923          
 
                           
Diluted
    92,463               92,019          
 
                           
 
For footnotes, see pages 11 and 12.
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CYH Announces Third Quarter 2010 Results
Page 6
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Income (a)(b)

(in thousands, except per share amounts)
(Unaudited)
                                 
    Nine Months Ended  
    September 30,  
    2010     2009  
            % of Net             % of Net  
            Operating             Operating  
    Amount     Revenue     Amount     Revenue  
Net operating revenues
  $ 9,583,801       100.0 %   $ 9,016,467       100.0 %
 
                       
 
                               
Operating costs and expenses:
                               
Salaries and benefits
    3,853,982       40.2 %     3,614,267       40.1 %
Provision for bad debts
    1,162,601       12.1 %     1,078,587       12.0 %
Supplies
    1,312,167       13.7 %     1,253,713       13.9 %
Other operating expenses
    1,778,153       18.6 %     1,680,414       18.7 %
Rent
    192,116       2.0 %     184,211       2.0 %
Depreciation and amortization
    452,179       4.7 %     421,566       4.7 %
 
                       
Total operating costs and expenses
    8,751,198       91.3 %     8,232,758       91.4 %
 
                       
 
                               
Income from operations (f)
    832,603       8.7 %     783,709       8.6 %
Interest expense, net
    486,308       5.0 %     487,209       5.3 %
Gain from early extinguishment of debt
          0.0 %     (2,385 )     0.0 %
Equity in earnings of unconsolidated affiliates
    (33,100 )     -0.3 %     (31,701 )     -0.4 %
 
                       
Income from continuing operations before income taxes
    379,395       4.0 %     330,586       3.7 %
Provision for income taxes
    123,203       1.3 %     109,907       1.2 %
 
                       
Income from continuing operations (d)(e)(f)(g)
    256,192       2.7 %     220,679       2.5 %
 
                       
 
                               
Discontinued operations, net of taxes (b):
                               
Income from operations of hospitals sold and hospitals held for sale (e)
          0.0 %     1,977       0.0 %
Loss on sale of hospitals, net
          0.0 %     (405 )     0.0 %
 
                       
Income from discontinued operations
          0.0 %     1,572       0.0 %
 
                       
Net income
    256,192       2.7 %     222,251       2.5 %
Less: Net income attributable to noncontrolling interests (a)
    45,719       0.5 %     44,189       0.5 %
 
                       
Net income attributable to Community Health Systems, Inc.
  $ 210,473       2.2 %   $ 178,062       2.0 %
 
                       
 
                               
Basic earnings per share attributable to Community Health Systems, Inc. common stockholders:
                               
Continuing operations
  $ 2.29             $ 1.96          
Discontinued operations
                  0.01          
 
                           
Net income
  $ 2.29             $ 1.97          
 
                           
 
                               
Diluted earnings per share attributable to Community Health Systems, Inc. common stockholders:
                               
Continuing operations
  $ 2.26             $ 1.94          
Discontinued operations
                  0.01          
 
                           
Net income
  $ 2.26             $ 1.95          
 
                           
 
                               
Weighted-average number of shares outstanding (h):
                               
Basic
    92,036               90,424          
 
                           
Diluted
    93,220               91,120          
 
                           
 
For footnotes, see pages 11 and 12.
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CYH Announces Third Quarter 2010 Results
Page 7
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Selected Operating Data (b)

($ in thousands)
(Unaudited)
                                                 
    For the Three Months Ended September 30,  
    Consolidated     Same-Store  
    2010     2009     % Change     2010     2009     % Change  
Number of hospitals (at end of period)
    123       122               122       122          
Licensed beds (at end of period)
    18,421       18,176               18,297       18,176          
Beds in service (at end of period)
    16,071       15,907               15,981       15,907          
Admissions
    169,775       175,107       -3.0 %     168,832       175,107       -3.6 %
Adjusted admissions
    327,048       327,837       -0.2 %     323,671       327,837       -1.3 %
Patient days
    714,576       730,676               711,026       730,676          
Average length of stay (days)
    4.2       4.2               4.2       4.2          
Occupancy rate (average beds in service)
    48.4 %     49.9 %             48.4 %     49.9 %        
Net operating revenues
  $ 3,252,055     $ 3,086,757       5.4 %   $ 3,204,902     $ 3,086,522       3.8 %
Net inpatient revenue as a % of total net operating revenues
    47.7 %     49.7 %             48.2 %     49.7 %        
Net outpatient revenue as a % of total net operating revenues
    49.9 %     48.0 %             49.6 %     48.0 %        
Income from operations (f)
  $ 280,819     $ 267,268       5.1 %   $ 288,090     $ 271,750       6.0 %
Income from operations as a % of net operating revenues
    8.6 %     8.6 %             9.0 %     8.8 %        
 
                                               
Depreciation and amortization
  $ 151,119     $ 143,558             $ 149,714     $ 143,558          
 
                                               
Equity in earnings of unconsolidated affiliates
  $ (9,535 )   $ (7,001 )           $ (9,535)   $ (6,961 )        
 
Liquidity Data:
                                               
Adjusted EBITDA (c)
  $ 441,473     $ 417,827       5.7 %                        
Adjusted EBITDA as a % of net operating revenues
    13.6 %     13.5 %                                
 
Net cash provided by operating activities
  $ 356,585     $ 356,353                                  
 
Net cash provided by operating activities as a % of net operating revenues
    11.0 %     11.5 %                                
 
                                               
 
For footnotes, see pages 11 and 12.
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CYH Announces Third Quarter 2010 Results
Page 8
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Selected Operating Data (b)

($ in thousands)
(Unaudited)
                                                 
    For the Nine Months Ended September 30,  
    Consolidated     Same-Store  
    2010     2009     % Change     2010     2009     % Change  
Number of hospitals (at end of period)
    123       122               122       122          
Licensed beds (at end of period)
    18,421       18,176               18,297       18,176          
Beds in service (at end of period)
    16,071       15,907               15,981       15,907          
Admissions
    518,270       520,921       -0.5 %     508,297       520,921       -2.4 %
Adjusted admissions
    974,716       958,674       1.7 %     952,264       958,674       -0.7 %
Patient days
    2,197,460       2,203,623               2,143,280       2,203,623          
Average length of stay (days)
    4.2       4.2               4.2       4.2          
Occupancy rate (average beds in service)
    50.3 %     51.6 %             50.1 %     51.6 %        
Net operating revenues
  $ 9,583,801     $ 9,016,467       6.3 %   $ 9,340,328     $ 9,015,153       3.6 %
Net inpatient revenue as a % of total net operating revenues
    49.0 %     50.0 %             49.4 %     50.0 %        
Net outpatient revenue as a % of total net operating revenues
    48.9 %     47.8 %             48.5 %     47.8 %        
Income from operations (f)
  $ 832,603     $ 783,709       6.2 %   $ 843,292     $ 795,075       6.1 %
Income from operations as a % of net operating revenues
    8.7 %     8.6 %             9.0 %     8.8 %        
 
Depreciation and amortization
  $ 452,179     $ 421,566             $ 442,169     $ 421,577          
 
Equity in earnings of unconsolidated affiliates
  $ (33,100 )   $ (31,701 )           $ (32,888 )   $ (31,589 )        
 
Liquidity Data:
                                               
Adjusted EBITDA (c)
  $ 1,317,882     $ 1,236,976       6.5 %                        
Adjusted EBITDA as a % of net operating revenues
    13.8 %     13.7 %                                
 
Net cash provided by operating activities
  $ 898,377     $ 900,760                                  
 
Net cash provided by operating activities as a % of net operating revenues
    9.4 %     10.0 %                                
 
For footnotes, see pages 11 and 12.
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CYH Announces Third Quarter 2010 Results
Page 9
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Balance Sheets (a)

(in thousands, except share data)
(Unaudited)
                 
    September 30,     December 31,  
    2010     2009  
ASSETS
               
Current assets
               
Cash and cash equivalents
  $ 567,749     $ 344,541  
Patient accounts receivable, net of allowance for doubtful accounts of $1,554,149 and $1,417,188 at September 30, 2010 and December 31, 2009, respectively
    1,651,406       1,617,903  
Supplies
    313,770       302,609  
Prepaid income taxes
    100,868       45,414  
Deferred income taxes
    78,621       80,714  
Prepaid expenses and taxes
    99,650       89,475  
Other current assets
    171,906       194,339  
 
           
Total current assets
    2,983,970       2,674,995  
 
           
Property and equipment
    8,135,499       7,787,256  
Less accumulated depreciation and amortization
    (1,991,929 )     (1,655,010 )
 
           
Property and equipment, net
    6,143,570       6,132,246  
 
           
Goodwill
    4,174,040       4,157,927  
 
           
Other assets, net
    1,117,913       1,056,304  
 
           
Total assets
  $ 14,419,493     $ 14,021,472  
 
           
 
               
LIABILITIES
               
Current liabilities
               
Current maturities of long-term debt
  $ 60,654     $ 66,470  
Accounts payable
    516,152       428,565  
Deferred income taxes
    28,522       28,397  
Accrued interest
    82,056       145,201  
Accrued liabilities
    892,620       789,163  
 
           
Total current liabilities
    1,580,004       1,457,796  
 
           
Long-term debt
    8,816,223       8,844,638  
 
           
Deferred income taxes
    474,748       475,812  
 
           
Other long-term liabilities
    1,038,229       858,952  
 
           
Total liabilities
    11,909,204       11,637,198  
 
           
 
               
Redeemable noncontrolling interests in equity of consolidated subsidiaries
    384,056       368,857  
 
           
 
               
EQUITY
               
Community Health Systems, Inc. stockholders’ equity
               
Preferred stock, $.01 par value per share, 100,000,000 shares authorized; none issued
           
Common stock, $.01 par value per share, 300,000,000 shares authorized; 93,715,461 shares issued and 92,740,092 shares outstanding at September 30, 2010, and 94,013,537 shares issued and 93,037,988 shares outstanding at December 31, 2009
    937       940  
Additional paid-in capital
    1,126,498       1,158,359  
Treasury stock, at cost, 975,549 shares at September 30, 2010 and December 31, 2009
    (6,678 )     (6,678 )
Accumulated other comprehensive loss
    (288,660 )     (221,385 )
Retained earnings
    1,229,872       1,019,399  
 
           
Total Community Health Systems, Inc. stockholders’ equity
    2,061,969       1,950,635  
Noncontrolling interests in equity of consolidated subsidiaries
    64,264       64,782  
 
           
Total equity
    2,126,233       2,015,417  
 
           
Total liabilities and equity
  $ 14,419,493     $ 14,021,472  
 
           
 
For footnotes, see pages 11 and 12.

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CYH Announces Third Quarter 2010 Results
Page 10
October 27, 2010
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Condensed Consolidated Statements of Cash Flows

(in thousands)
(Unaudited)
                 
    Nine Months Ended  
    September 30,  
    2010     2009  
Cash flows from operating activities
               
Net income
  $ 256,192     $ 222,251  
Adjustments to reconcile net income to net cash provided by operating activities:
               
Depreciation and amortization
    452,179       421,898  
Stock-based compensation expense
    29,899       35,121  
Loss on sale of hospitals and partnership interest, net
          405  
(Excess tax benefit) income tax payable increase relating to stock-based compensation
    (10,109 )     3,544  
Gain on early extinguishment of debt
          (2,385 )
Other non-cash expenses, net
    8,237       13,410  
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
               
Patient accounts receivable
    (25,579 )     (10,235 )
Supplies, prepaid expenses and other current assets
    4,755       18,278  
Accounts payable, accrued liabilities and income taxes
    172,687       194,955  
Other
    10,116       3,518  
 
           
Net cash provided by operating activities
    898,377       900,760  
 
           
 
               
Cash flows from investing activities
               
Acquisitions of facilities and other related equipment
    (67,541 )     (211,941 )
Purchases of property and equipment
    (381,853 )     (398,138 )
Proceeds from disposition of hospitals and other ancillary operations
          89,514  
Proceeds from sale of property and equipment
    2,845       2,521  
Increase in other non-operating assets
    (98,502 )     (111,476 )
 
           
Net cash used in investing activities
    (545,051 )     (629,520 )
 
           
 
               
Cash flows from financing activities
               
Proceeds from exercise of stock options
    53,839       9,952  
Excess tax benefit (income tax payable increase) relating to stock-based compensation
    10,109       (3,544 )
Deferred financing costs
          (82 )
Stock buy-back
    (107,932 )      
Proceeds from noncontrolling investors in joint ventures
    5,155       26,314  
Redemption of noncontrolling investments in joint ventures
    (2,467 )     (2,387 )
Distributions to noncontrolling investors in joint ventures
    (41,870 )     (43,744 )
Borrowings under credit agreement
          200,000  
Repayments of long-term indebtedness
    (46,952 )     (245,589 )
 
           
Net cash used in financing activities
    (130,118 )     (59,080 )
 
           
 
               
Net change in cash and cash equivalents
    223,208       212,160  
Cash and cash equivalents at beginning of period
    344,541       220,655  
 
           
Cash and cash equivalents at end of period
  $ 567,749     $ 432,815  
 
           

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CYH Announces Third Quarter 2010 Results
Page 11
October 27, 2010
Footnotes to Financial Statements
(a)   The following table provides information needed to calculate income per share which is adjusted for noncontrolling interests (in thousands).
                                 
    Three Months Ended     Nine Months Ended  
    September 30,     September 30,  
    2010     2009     2010     2009  
Income from continuing operations attributable to Community Health Systems, Inc. common stockholders:
                               
Income from continuing operations, net of taxes
  $ 84,854     $ 75,361     $ 256,192     $ 220,679  
Less: Income from continuing operations attributable to noncontrolling interests, net of taxes
    14,453       15,649       45,719       43,834  
 
                       
Income from continuing operations attributable to Community Health Systems, Inc. common stockholders — basic and diluted
  $ 70,401     $ 59,712     $ 210,473     $ 176,845  
 
                       
Income from discontinued operations attributable to Community Health Systems, Inc. common stockholders:
                               
Income from discontinued operations, net of taxes
  $     $     $     $ 1,572  
Less: Income from discontinued operations attributable to noncontrolling interests, net of taxes
                      355  
 
                       
Income from discontinued operations attributable to Community Health Systems, Inc. common stockholders — basic and diluted
  $     $     $     $ 1,217  
 
                       
(b)   Continuing operating results exclude discontinued operations for the nine months ended September 30, 2009.
 
(c)   EBITDA consists of net income attributable to Community Health Systems, Inc. before interest, income taxes, and depreciation and amortization. Adjusted EBITDA is EBITDA adjusted to exclude discontinued operations, gain/loss from early extinguishment of debt and net income attributable to noncontrolling interests. The Company has from time to time sold noncontrolling interests in certain of its subsidiaries or acquired subsidiaries with existing noncontrolling interest ownership positions. The Company believes that it is useful to present adjusted EBITDA because it excludes the portion of EBITDA attributable to these third party interests and clarifies for investors the Company’s portion of EBITDA generated by continuing operations. The Company uses adjusted EBITDA as a measure of liquidity. The Company has included this measure because it believes it provides investors with additional information about the Company’s ability to incur and service debt and make capital expenditures. Adjusted EBITDA is the basis for a key component in the determination of the Company’s compliance with some of the covenants under the Company’s senior secured credit facility, as well as to determine the interest rate and commitment fee payable under the senior secured credit facility.
 
    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.
 
Footnotes continued on the next page.

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CYH Announces Third Quarter 2010 Results
Page 12
October 27, 2010
Footnotes to Financial Statements (Continued)
    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     Nine Months Ended  
    September 30,     September 30,  
    2010     2009     2010     2009  
Adjusted EBITDA
  $ 441,473     $ 417,827     $ 1,317,882     $ 1,236,976  
Interest expense, net
    (164,011 )     (161,823 )     (486,308 )     (487,209 )
Provision for income taxes
    (41,489 )     (37,064 )     (123,203 )     (109,907 )
Income from operations of hospitals sold and hospitals held for sale, net of taxes
                      1,977  
Other non-cash expenses, net
    20,055       30,352       28,027       52,406  
Net changes in operating assets and liabilities, net of effects of acquisitions
    100,557       107,061       161,979       206,517  
 
                       
Net cash provided by operating activities
  $ 356,585     $ 356,353     $ 898,377     $ 900,760  
 
                       
(d)   Included in income from continuing operations for the nine months ended September 30, 2009, is a gain from early extinguishment of debt of $2.4 million with an after-tax impact of $1.5 million related to the repurchases on the open market and cancellation of $126.5 million of Senior Notes and the early payment of $110.4 million of term loans under the Company’s Credit Facility.
 
(e)   Included in discontinued operations for the nine months ended September 30, 2009 is Presbyterian Hospital of Denton (255 licensed beds) located in Denton, Texas, which was conveyed to the noncontrolling partner on March 31, 2009.
 
(f)   Included in income from operations and income from continuing operations for the three months and nine months ended September 30, 2010, are the following non-same-store charges:
    Pre-tax charges of $2.5 million and $4.3 million, respectively, related to acquisition costs; and
 
    Pre-tax charges of $1.9 million and $5.0 million, respectively, for system conversion costs.
(g)   Total consolidated net operating revenues and operating costs and expenses for the three months ended September 30, 2010, include approximately 50 basis points of net operating revenues and approximately 25 basis points of total operating costs and expenses, relating to the California Department of Health’s recently enacted “California Hospital Fee Program”, which had been anticipated in 2010. These amounts represent the eighteen month retroactive impact of the program from its inception date through September 30, 2010.
(h)   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     Nine Months Ended  
    September 30,     September 30,  
    2010     2009     2010     2009  
Weighted-average number of shares outstanding — basic
    91,485       90,923       92,036       90,424  
Add effect of dilutive securities:
                               
Stock awards and options
    978       1,096       1,184       696  
 
                       
Weighted-average number of shares outstanding — diluted
    92,463       92,019       93,220       91,120  
 
                       

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CYH Announces Third Quarter 2010 Results
Page 13
October 27, 2010
Regulation FD Disclosure
     The following tables set forth selected information concerning the Company’s projected consolidated operating results for the year ending December 31, 2010, and the initial projected consolidated operating results of the Company for the year ending December 31, 2011. These projections are based on the Company’s historical operating performance, current trends and other assumptions that the Company believes are reasonable at this time. The 2010 guidance reaffirms the Company’s previous annual earnings guidance for 2010 provided on July 28, 2010, as updated to reflect historical results through September 30, 2010, with certain changes to the assumptions used in connection with the guidance. See page 15 for a list of factors that could affect the future results of the Company or the healthcare industry generally.
     The following is provided as guidance to analysts and investors:
                         
    Updated 2010  
    Projection  
    Range  
Net operating revenues (in millions)
  $ 12,900     to   $ 13,200  
Adjusted EBITDA (in millions)
  $ 1,745     to   $ 1,775  
Income from continuing operations per share — diluted
  $ 2.93     to   $ 3.00  
Same hospitals annual admissions/adjusted admissions growth
    -1.0 %   to     1.0 %
Weighted-average diluted shares (in millions)
    92     to     93  
                         
    Initial 2011  
    Projection  
    Range *  
Net operating revenues (in millions)
  $ 13,900     to   $ 14,200  
Income from continuing operations per share — diluted
  $ 3.15     to   $ 3.35  
Acquisitions of new hospitals
    2     to     3  
 
*   Detail assumptions and additional guidance will be provided in February 2011 in conjunction with the Company’s year-end earnings release.
The following assumptions were used in developing the 2010 guidance provided above:
  Three acquisitions for 2010 representing a total of four acute hospitals have been completed and included.
  Projected 2010 same hospital annual admissions/adjusted admissions growth does not take into account service closures and other unusual events.
  Expressed as a percent of net operating revenues, the provision for bad debts is projected to be approximately 12.2% to 12.4% for 2010. These percentages may vary depending on changes in payor mix.
  Expressed as a percent of net operating revenues, depreciation and amortization is projected to be approximately 4.7% to 4.8% for 2010; however, this is a fixed cost and the percentages may vary as revenue varies. Excludes possible impact of any future fair-value adjustments to investments and hospital fixed asset impairments.
  2010 projection assumes an estimate of $0.03 to $0.05 per share (diluted) of acquisition costs that are required to be expensed.

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CYH Announces Third Quarter 2010 Results
Page 14
October 27, 2010
  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 2010 will remain relatively stable with the rates existing currently, particularly since the Company is a party to interest rate swap agreements (with original maturities of at least two years) resulting in total fixed debt including swaps being 93% of total debt. These swap agreements limit the effect of changes in interest rates. Based on these assumptions, expressed as a percentage of net operating revenues, interest expense is projected to be approximately 5.0% to 5.2% of net revenue guidance for 2010; however, these percentages will vary as revenue and interest rates vary. The 2010 and 2011 projections do not assume any changes to the financing terms of the Senior Secured Credit Facility or any new financing arrangements. The Company is currently exploring financing alternatives, including a possible amendment and partial extension of its existing Senior Secured Credit Facility.
 
  On September 16, 2010, having purchased substantially all of the stock authorized under the December 2009 program, 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. Through October 27, 2010, approximately 451,000 shares with a value of approximately $13.9 million were 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 0.4% for 2010.
  Expressed as a percentage of net operating revenues, net income attributable to noncontrolling interests is projected to be approximately 0.5% to 0.6% for 2010.
  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 2010. The income tax projection includes possible additional unrecognized tax benefits and tax revaluations that may be recognized prior to the end of 2010.
  Capital expenditures are projected as follows (in millions):
                         
    2010  
    Guidance  
Total
  $ 650     to   $ 750  
  Net cash provided by operating activities are projected as follows (in millions):
                         
    2010  
    Guidance  
Total
  $ 1,050     to   $ 1,100  
  The Company’s guidance does not take into account resolution of certain pending government investigations and lawsuits.

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CYH Announces Third Quarter 2010 Results
Page 15
October 27, 2010
     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 potential and recently-adopted 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;
 
    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 and Medicaid 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 and complete the sale of hospitals held for sale;
 
    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 and nine months ended September 30, 2010, are not necessarily indicative of the results that may be experienced for any such future period or for any future year, including the full year of 2010.
     The Company cautions that the projections for calendar year 2010 and the initial projections for calendar year 2011 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.
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