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8-K - FORM 8-K - VANGUARD HEALTH SYSTEMS INC | c11955e8vk.htm |
EX-99.2 - EXHIBIT 99.2 - VANGUARD HEALTH SYSTEMS INC | c11955exv99w2.htm |
EX-99.3 - EXHIBIT 99.3 - VANGUARD HEALTH SYSTEMS INC | c11955exv99w3.htm |
EXHIBIT 99.1
Vanguard Reports Second Quarter Results
NASHVILLE, Tenn. February 7, 2011 Vanguard Health Systems, Inc.
(Vanguard) today announced results for the second quarter ended December 31,
2010.
Total revenues for the quarter ended December 31, 2010 were $960.6 million, an
increase of $120.1 million or 14.3% from the prior year quarter. Patient
service revenues increased $120.6 million from the prior year quarter. Health
plan premium revenues decreased $0.5 million or 0.2% from the prior year
quarter. Patient service revenues were positively impacted by Vanguards August
1, 2010 acquisition of West Suburban Medical Center and Westlake Hospital and
its acquisition of Arizona Heart Hospital on October 1, 2010. Same hospital
patient service revenues increased $25.2 million or 4.0% during the quarter
ended December 31, 2010 compared to the prior year quarter.
Vanguard reported a loss from continuing operations of $1.9 million for the
quarter ended December 31, 2010 compared to $19.1 million during the prior year
quarter. During the quarter ended December 31, 2010, Vanguards net loss
attributable to Vanguard Health Systems, Inc. stockholders was $5.0 million
compared to $20.7 million during the prior year quarter. The prior year quarter
amount included a $43.1 million impairment loss compared to $0.9 million
impairment loss during the current year quarter. The provision for doubtful
accounts as a percentage of patient service revenues increased to 6.8% during
the quarter ended December 31, 2010 compared to 5.6% during the prior year
quarter. Total uncompensated care as a percentage of acute care services
segment revenues (prior to charity and uninsured revenue deductions) was 16.5%
during the quarter ended December 31, 2010 compared to 15.1% during the prior
year quarter.
Adjusted EBITDA for the quarter ended December 31, 2010 was $86.4 million, a
2.5% increase compared to the prior year quarter. A reconciliation of Adjusted
EBITDA to net loss attributable to Vanguard Health Systems, Inc. stockholders
as determined in accordance with generally accepted accounting principles for
the quarters ended December 31, 2009 and 2010 is included in the attached
supplemental financial information.
The consolidated operating results for the quarter ended December 31, 2010
reflect an 11.3% increase in discharges and a 14.6% increase in adjusted
discharges compared to the prior year quarter. On a same hospital basis,
discharges decreased 0.4% and adjusted discharges increased 2.8% during the
current year quarter compared to the prior year quarter. For the quarter ended
December 31, 2010, same hospital emergency room visits increased 2.7%, while
same hospital inpatient surgeries and outpatient surgeries decreased 8.1% and
6.4%, respectively, compared to the prior year quarter. We continue to be
impacted by weak consumer demand for elective surgeries and also have
experienced continuing declines in deliveries quarter over quarter. On a same
hospital basis, patient revenues per adjusted discharge increased 1.1% during
the current year quarter compared to the prior year quarter.
Total revenues for the six months ended December 31, 2010 were $1,874.5
million, an increase of $214.1 million or 12.9% from the prior year period.
Patient service revenues increased $198.3 million from the prior year period.
Health plan premium revenues increased $15.8 million or 3.8% from the prior
year period. Our Phoenix Health Plan had higher enrollment for the six months
ended December 31, 2010 compared to the prior year period. Patient service
revenues were positively impacted by the previously mentioned acquisitions
during the six months ended December 31, 2010. Same hospital patient service
revenues increased $57.0 million or 4.6% during the six months ended December
31, 2010 compared to the prior year period primarily due to a 2.5% increase in
same hospital adjusted discharges and a 2.1% increase in same hospital patient
revenue per adjusted discharge.
Vanguard reported income from continuing operations of $0.2 million for the six
months ended December 31, 2010 compared to a $16.1 million loss from continuing
operations during the prior year period. During the six months ended December
31, 2010, Vanguards net loss attributable to Vanguard Health Systems, Inc.
stockholders was $3.8 million compared to $19.2 million during the prior year
period. The provision for doubtful accounts as a percentage of patient service
revenues increased to 7.1% during the six months ended December 31, 2010
compared to 5.8% during the prior year period. Total uncompensated care as a
percentage of acute care services segment revenues (prior to charity and
uninsured revenue deductions) was 17.0% during the six months ended December
31, 2010 compared to 16.0% during the prior year period.
Adjusted EBITDA for the six months ended December 31, 2010 was $164.1 million,
a 7.1% increase compared to the prior year period. A reconciliation of Adjusted
EBITDA to net loss attributable to Vanguard Health Systems, Inc. stockholders
as determined in accordance with generally accepted accounting principles for
the six months ended December 31, 2009 and 2010 is included in the attached
supplemental financial information.
The consolidated operating results for the six months ended December 31, 2010
reflect an 9.4% increase in discharges and a 12.0% increase in adjusted
discharges compared to the prior year period. On a same hospital basis,
discharges were flat and adjusted discharges increased 2.5% during the current
year period compared to the prior year period. For the six months ended
December 31, 2010, same hospital emergency room visits increased 3.3%, while
same hospital inpatient surgeries and outpatient surgeries decreased 6.0% and
5.7%, respectively, compared to the prior year period.
Cash flows from operating activities were $127.1 million for the six months
ended December 31, 2010, a decrease of $22.5 million from the prior year
period. This decrease was primarily due to a $40.6 million increase in net cash
paid for interest and income taxes during the current year period compared to
the prior year period. Cash interest payments were higher as a result of
Vanguards comprehensive refinancing completed in January 2010 and the
additional senior notes issued in July 2010.
As previously announced, effective January 1, 2011, Vanguard acquired Detroit
Medical Center (DMC), which owns and operates eight hospitals in and around
Detroit, Michigan with 1,734 licensed beds. Under the purchase agreement,
Vanguard acquired all of DMCs assets (other than donor restricted and certain
other assets) and assumed all of its liabilities (other than its outstanding
bonds and certain other liabilities). The cash purchase price was $368.1
million and was funded with cash on hand.
On January 26, 2011, Vanguard or its wholly-owned subsidiaries issued an
aggregate principal amount of $350.0 million 7.750% senior notes due 2019 and
$749.2 million ($444.7 million of gross cash proceeds) 10.375% senior discount
notes due 2016, each in a private placement. Vanguard will pay cash interest on
the senior notes on February 1 and August 1 of each year, beginning on August
1, 2011. No cash interest will accrue on the senior discount notes, but they
will accrete at a rate of 10.375% per annum, compounded semi-annually on
February 1 and August 1 of each year, such that the initial accreted value of
$595.08 of $1,000 stated principal amount will equal the principal amount at
maturity on February 1, 2016. Vanguard used the proceeds from the senior
discount notes offering to pay a dividend to its equity holders and will use
the proceeds from the senior notes offering for general corporate purposes,
including acquisitions.
Vanguard will host a conference call for investors at 11:00 am EST on February
8, 2011. All interested investors are invited to access a live audio broadcast
of the call, via webcast. The live webcast can be accessed on the home page of
Vanguards Web site at www.vanguardhealth.com by clicking on Second Quarter
Webcast or at http://visualwebcaster.com/event.asp?id=75754. If you are unable
to participate during the live webcast, the call will be available on a replay
basis on Vanguards Web site www.vanguardhealth.com. To access the replay,
click on the Latest News link on the Investor Relations page of
www.vanguardhealth.com. The replay will be available via this link for one
year.
Vanguard owns and operates 26 acute care and specialty hospitals and
complementary facilities and services in Chicago, Illinois; Phoenix, Arizona;
San Antonio, Texas; Detroit, Michigan and Massachusetts. Vanguards strategy is
to develop locally branded, comprehensive healthcare delivery networks in urban
markets. Vanguard will pursue acquisitions where there are opportunities to
partner with leading delivery systems in new urban markets or to increase its
presence in existing markets. Upon acquiring a facility or network of
facilities, Vanguard implements strategic and operational improvement
initiatives including expanding services, strengthening relationships with
physicians and managed care organizations, recruiting new physicians and
upgrading information systems and other capital equipment. These strategies
improve quality and network coverage in a cost effective and accessible manner
for the communities Vanguard serves.
This press release contains forward-looking statements within the meaning of
the federal securities laws which are intended to be covered by the safe
harbors created thereby. Forward-looking statements are those statements that
are based upon managements current plans and expectations as opposed to
historical and current facts and are often identified in this release by use of
words including but not limited to may, believe, will, project,
expect, estimate, anticipate, and plan. These statements are based upon
estimates and assumptions made by Vanguards management that, although believed
to be reasonable, are subject to numerous factors, risks and uncertainties that
could cause actual outcomes and results to be materially different from those
projected. These factors, risks and uncertainties include, among others,
Vanguards high degree of leverage and interest rate risk; Vanguards ability
to incur substantially more debt; operating and financial restrictions in
Vanguards debt agreements; Vanguards ability to generate cash necessary to
service Vanguards debt; weakened economic conditions and volatile capital
markets; post-payment claims reviews by governmental agencies; Vanguards
ability to successfully implement Vanguards business strategies; Vanguards
ability to successfully integrate the acquisition of substantially all of the
assets of The Detroit Medical Center, Westlake Hospital and West Suburban
Medical Center and future acquisitions; conflicts of interest that may arise as
a result of Vanguards control by a small number of stockholders; the highly
competitive nature of the healthcare industry; governmental regulation of the
industry, including Medicare and Medicaid reimbursement levels; pressures to
contain costs by managed care organizations and other insurers and Vanguards
ability to negotiate acceptable terms with these third party payers; Vanguards
ability to attract and retain qualified management and healthcare
professionals, including physicians and nurses; potential federal or state
reform of healthcare, implementation of existing reform legislation and
potential modifications to such legislation; future governmental
investigations; Vanguards ability to adequately enhance its facilities with
technologically advanced equipment; the availability of capital to fund
Vanguards corporate growth strategy; potential lawsuits or other claims
asserted against Vanguard; Vanguards ability to maintain or increase patient
membership and control costs of its managed healthcare plans; changes in
general economic conditions; Vanguards exposure to the increased amounts of
and collection risks associated with uninsured accounts and the co-pay and
deductible portions of insured accounts; dependence on Vanguards senior
management team and local management personnel; volatility of professional and
general liability insurance for Vanguard and the physicians who practice at its
hospitals and increases in the quantity and severity of professional liability
claims; Vanguards ability to maintain and increase patient volumes and control
the costs of providing services, including salaries and benefits, supplies and
bad debts; increased costs from further government regulation of healthcare and
Vanguards failure to comply, or allegations of Vanguards failure to comply,
with applicable laws and regulations; the geographic concentration of
Vanguards operations; technological and pharmaceutical improvements that
increase the cost of providing, or reduce the demand for, healthcare services
and shift demand for inpatient services to outpatient settings; a failure of
Vanguards information systems would adversely impact its ability to manage its
operations; costs and compliance risks associated with Section 404 of the
Sarbanes-Oxley Act of 2002; material non-cash charges to earnings from
impairment of goodwill associated with declines in the fair market values of
Vanguards reporting units; volatility of materials and labor costs for
potential construction projects that may be necessary for future growth; and
those factors, risks and uncertainties detailed in Vanguards filings from time
to time with the Securities and Exchange Commission, including, among others,
Vanguards Annual Reports on Form 10-K, its Quarterly Reports on Form 10-Q and
its Current Report on Form 8-K dated January 19, 2011.
Although Vanguard believes that the assumptions underlying the forward-looking
statements contained in this press release are reasonable, any of these
assumptions could prove to be inaccurate, and, therefore, there can be no
assurance that the forward-looking statements included in this press release
will prove to be accurate. In light of the significant uncertainties inherent
in the forward-looking statements included herein, you should not regard the
inclusion of such information as a representation by Vanguard that its
objectives and plans anticipated by the forward-looking statements will occur
or be achieved, or if any of them do, what impact they will have on Vanguards
results of operations and financial condition. Vanguard undertakes no
obligation to publicly release any revisions to any forward-looking statements
contained herein to reflect events and circumstances occurring after the date
hereof or to reflect the occurrence of unanticipated events.
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Operations (Unaudited)
(In millions)
Condensed Consolidated Statements of Operations (Unaudited)
(In millions)
Quarter ended December 31, | ||||||||||||||||
2009 | 2010 | |||||||||||||||
Patient service revenues |
$ | 628.2 | 74.7 | % | $ | 748.8 | 78.0 | % | ||||||||
Premium revenues |
212.3 | 25.3 | 211.8 | 22.0 | ||||||||||||
Total revenues |
840.5 | 100.0 | 960.6 | 100.0 | ||||||||||||
Costs and expenses: |
||||||||||||||||
Salaries and benefits (includes stock
compensation of $1.0 and $1.7, respectively) |
$ | 322.9 | 38.4 | 375.5 | 39.1 | |||||||||||
Health plan claims expense |
170.8 | 20.3 | 164.8 | 17.2 | ||||||||||||
Supplies |
114.6 | 13.6 | 133.5 | 13.9 | ||||||||||||
Provision for doubtful accounts |
35.0 | 4.2 | 51.2 | 5.3 | ||||||||||||
Purchased services |
43.8 | 5.2 | 62.5 | 6.5 | ||||||||||||
Non-income taxes |
10.7 | 1.3 | 17.0 | 1.8 | ||||||||||||
Rents and leases |
11.0 | 1.3 | 11.7 | 1.2 | ||||||||||||
Other operating expenses |
48.4 | 5.8 | 59.7 | 6.2 | ||||||||||||
Depreciation and amortization |
34.0 | 4.0 | 38.6 | 4.0 | ||||||||||||
Interest, net |
27.6 | 3.3 | 35.1 | 3.7 | ||||||||||||
Impairment loss |
43.1 | 5.1 | 0.9 | 0.1 | ||||||||||||
Other |
1.5 | 0.2 | 2.3 | 0.2 | ||||||||||||
Total costs and expenses |
863.4 | 102.7 | 952.8 | 99.2 | ||||||||||||
Income (loss) from continuing operations
before income taxes |
(22.9 | ) | (2.7 | ) | 7.8 | 0.8 | ||||||||||
Income tax benefit (expense) |
3.8 | 0.5 | (9.7 | ) | (1.0 | ) | ||||||||||
Loss from continuing operations |
(19.1 | ) | (2.3 | ) | (1.9 | ) | (0.2 | ) | ||||||||
Loss from discontinued operations, net of taxes |
(0.8 | ) | (0.1 | ) | (2.3 | ) | (0.2 | ) | ||||||||
Net loss |
(19.9 | ) | (2.4 | ) | (4.2 | ) | (0.4 | ) | ||||||||
Less: Net income attributable to non-controlling interests |
(0.8 | ) | (0.1 | ) | (0.8 | ) | (0.1 | ) | ||||||||
Net loss attributable to Vanguard
Health Systems, Inc. stockholders |
$ | (20.7 | ) | (2.5 | )% | $ | (5.0 | ) | (0.5 | )% | ||||||
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Operations (Unaudited)
(In millions)
Condensed Consolidated Statements of Operations (Unaudited)
(In millions)
Six months ended December 31, | ||||||||||||||||
2009 | 2010 | |||||||||||||||
Patient service revenues |
$ | 1,243.8 | 74.9 | % | $ | 1,442.1 | 76.9 | % | ||||||||
Premium revenues |
416.6 | 25.1 | 432.4 | 23.1 | ||||||||||||
Total revenues |
1,660.4 | 100.0 | 1,874.5 | 100.0 | ||||||||||||
Costs and expenses: |
||||||||||||||||
Salaries and benefits (includes stock
compensation of $2.9 and $2.9, respectively) |
$ | 635.6 | 38.3 | 730.3 | 39.0 | |||||||||||
Health plan claims expense |
331.8 | 20.0 | 338.9 | 18.1 | ||||||||||||
Supplies |
225.4 | 13.6 | 254.5 | 13.6 | ||||||||||||
Provision for doubtful accounts |
72.2 | 4.3 | 103.0 | 5.5 | ||||||||||||
Purchased services |
90.5 | 5.5 | 113.5 | 6.1 | ||||||||||||
Non-income taxes |
24.9 | 1.5 | 33.2 | 1.8 | ||||||||||||
Rents and leases |
21.9 | 1.3 | 22.7 | 1.2 | ||||||||||||
Other operating expenses |
107.8 | 6.5 | 117.2 | 6.3 | ||||||||||||
Depreciation and amortization |
67.6 | 4.1 | 75.8 | 4.0 | ||||||||||||
Interest, net |
54.8 | 3.3 | 69.9 | 3.7 | ||||||||||||
Impairment loss |
43.1 | 2.6 | 0.9 | | ||||||||||||
Other |
2.6 | 0.2 | 7.1 | 0.4 | ||||||||||||
Total costs and expenses |
1,678.2 | 101.1 | 1,867.0 | 99.6 | ||||||||||||
Income (loss) from continuing operations
before income taxes |
(17.8 | ) | (1.1 | ) | 7.5 | 0.4 | ||||||||||
Income tax benefit (expense) |
1.7 | 0.1 | (7.3 | ) | (0.4 | ) | ||||||||||
Income (loss) from continuing operations |
(16.1 | ) | (1.0 | ) | 0.2 | | ||||||||||
Loss from discontinued operations, net of taxes |
(1.4 | ) | (0.1 | ) | (2.2 | ) | (0.1 | ) | ||||||||
Net loss |
(17.5 | ) | (1.1 | ) | (2.0 | ) | (0.1 | ) | ||||||||
Less: Net income attributable to non-controlling interests |
(1.7 | ) | (0.1 | ) | (1.8 | ) | (0.1 | ) | ||||||||
Net loss attributable to Vanguard
Health Systems, Inc. stockholders |
$ | (19.2 | ) | (1.2 | )% | $ | (3.8 | ) | (0.2 | )% | ||||||
Vanguard Health Systems, Inc.
Supplemental Financial Information (Unaudited)
Reconciliation of Adjusted EBITDA to Net Loss Attributable to Vanguard Health Systems, Inc. Stockholders
Supplemental Financial Information (Unaudited)
Reconciliation of Adjusted EBITDA to Net Loss Attributable to Vanguard Health Systems, Inc. Stockholders
(In millions)
Quarter ended | Six months ended | |||||||||||||||
December 31, | December 31, | |||||||||||||||
2009 | 2010 | 2009 | 2010 | |||||||||||||
Net loss attributable to Vanguard Health
Systems, Inc. stockholders |
$ | (20.7 | ) | $ | (5.0 | ) | $ | (19.2 | ) | $ | (3.8 | ) | ||||
Interest, net |
27.6 | 35.1 | 54.8 | 69.9 | ||||||||||||
Income tax expense (benefit) |
(3.8 | ) | 9.7 | (1.7 | ) | 7.3 | ||||||||||
Depreciation and amortization |
34.0 | 38.6 | 67.6 | 75.8 | ||||||||||||
Non-controlling interests |
0.8 | 0.8 | 1.7 | 1.8 | ||||||||||||
Loss on disposal of assets |
0.4 | 0.1 | 0.4 | 0.1 | ||||||||||||
Equity method income |
(0.3 | ) | (0.3 | ) | (0.5 | ) | (0.6 | ) | ||||||||
Stock compensation |
1.0 | 1.7 | 2.9 | 2.9 | ||||||||||||
Monitoring fees and expenses |
1.4 | 1.1 | 2.7 | 2.5 | ||||||||||||
Realized and unrealized losses on investments |
| 0.1 | | 0.1 | ||||||||||||
Acquisition related expenses |
| 1.3 | | 5.0 | ||||||||||||
Impairment loss |
43.1 | 0.9 | 43.1 | 0.9 | ||||||||||||
Discontinued operations, net of taxes |
0.8 | 2.3 | 1.4 | 2.2 | ||||||||||||
Adjusted EBITDA (1) |
$ | 84.3 | $ | 86.4 | $ | 153.2 | $ | 164.1 | ||||||||
(1) | Adjusted EBITDA is defined as income (loss) before interest expense (net of interest income), income taxes, depreciation and amortization, non-controlling interests, gain or loss on disposal of assets, equity method income, stock compensation, monitoring fees and expenses, realized and unrealized gains or losses on investments, acquisition related expenses, debt extinguishment costs, impairment losses, pension expense and discontinued operations, net of taxes. Adjusted EBITDA is not intended as a substitute for net income (loss) attributable to Vanguard Health Systems, Inc. stockholders, operating cash flows or other cash flow data determined in accordance with accounting principles generally accepted in the United States. Due to varying methods of calculation, Adjusted EBITDA as presented may not be comparable to similarly titled measures of other companies. |
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Balance Sheets
(In millions)
Condensed Consolidated Balance Sheets
(In millions)
(Unaudited) | ||||||||
June 30, | December 31, | |||||||
2010 | 2010 | |||||||
ASSETS |
||||||||
Current assets: |
||||||||
Cash and cash equivalents |
$ | 257.6 | $ | 58.3 | ||||
Restricted cash |
2.3 | 3.0 | ||||||
Accounts receivable, net of allowance for doubtful accounts of
approximately $75.6 and $87.2, respectively |
270.4 | 321.5 | ||||||
Inventories |
49.6 | 56.6 | ||||||
Deferred tax assets |
21.9 | 18.1 | ||||||
Prepaid expenses and other current assets |
119.2 | 83.5 | ||||||
Total current assets |
721.0 | 541.0 | ||||||
Property, plant and equipment, net of accumulated depreciation |
1,203.8 | 1,264.5 | ||||||
Goodwill |
649.1 | 650.2 | ||||||
Intangible assets, net of accumulated amortization |
66.0 | 67.7 | ||||||
Deferred tax assets, noncurrent |
50.0 | 48.2 | ||||||
Investments in auction rate securities |
19.8 | 15.7 | ||||||
Deposit for acquisition |
| 368.1 | ||||||
Other assets |
19.9 | 19.9 | ||||||
Total assets |
$ | 2,729.6 | $ | 2,975.3 | ||||
LIABILITIES AND EQUITY |
||||||||
Current liabilities: |
||||||||
Accounts payable |
$ | 194.8 | $ | 187.3 | ||||
Accrued salaries and benefits |
144.9 | 148.7 | ||||||
Accrued health plan claims and settlements |
149.8 | 157.3 | ||||||
Accrued interest |
41.4 | 40.5 | ||||||
Other accrued expenses and current liabilities |
76.9 | 89.4 | ||||||
Current maturities of long-term debt and capital leases |
8.2 | 8.3 | ||||||
Total current liabilities |
616.0 | 631.5 | ||||||
Professional and general liability and workers compensation reserves |
83.6 | 93.8 | ||||||
Other liabilities |
31.6 | 35.4 | ||||||
Long-term debt and capital leases, less current maturities |
1,743.8 | 1,959.2 | ||||||
Commitments and contingencies |
||||||||
Equity: |
||||||||
Vanguard Health Systems, Inc. stockholders equity: |
||||||||
Common stock |
| | ||||||
Additional paid-in capital |
354.9 | 357.8 | ||||||
Accumulated other comprehensive loss |
(2.5 | ) | (0.6 | ) | ||||
Retained deficit |
(105.9 | ) | (109.7 | ) | ||||
Total Vanguard Health Systems, Inc. stockholders equity |
246.5 | 247.5 | ||||||
Non-controlling interests |
8.1 | 7.9 | ||||||
Total equity |
254.6 | 255.4 | ||||||
Total liabilities and equity |
$ | 2,729.6 | $ | 2,975.3 | ||||
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Cash Flows (Unaudited)
(In millions)
Condensed Consolidated Statements of Cash Flows (Unaudited)
(In millions)
Six months ended | ||||||||
December 31, | ||||||||
2009 | 2010 | |||||||
Operating activities: |
||||||||
Net loss |
$ | (17.5 | ) | $ | (2.0 | ) | ||
Adjustments to reconcile net loss to net cash provided by operating activities: |
||||||||
Loss from discontinued operations |
1.4 | 2.2 | ||||||
Depreciation and amortization |
67.6 | 75.8 | ||||||
Provision for doubtful accounts |
72.2 | 103.0 | ||||||
Amortization of loan costs and accretion of principal on notes |
8.7 | 3.9 | ||||||
Loss on disposal of assets |
0.4 | 0.1 | ||||||
Stock compensation |
2.9 | 2.9 | ||||||
Deferred income taxes |
(7.7 | ) | 5.7 | |||||
Acquisition related expenses |
| 5.0 | ||||||
Impairment loss |
43.1 | 0.9 | ||||||
Realized loss on investments |
| 0.1 | ||||||
Changes in operating assets and liabilities, net of the impact of acquisitions: |
||||||||
Accounts receivable |
(85.5 | ) | (139.5 | ) | ||||
Inventories |
(1.8 | ) | (1.0 | ) | ||||
Prepaid expenses and other current assets |
5.2 | 32.9 | ||||||
Accounts payable |
20.6 | (11.2 | ) | |||||
Accrued expenses and other liabilities |
41.4 | 50.5 | ||||||
Net cash provided by operating activities continuing operations |
151.0 | 129.3 | ||||||
Net cash used in operating activities discontinued operations |
(1.4 | ) | (2.2 | ) | ||||
Net cash provided by operating activities |
149.6 | 127.1 | ||||||
Investing activities: |
||||||||
Acquisitions and related expenses |
(1.5 | ) | (457.9 | ) | ||||
Capital expenditures |
(68.4 | ) | (79.4 | ) | ||||
Proceeds from asset dispositions |
1.4 | 0.1 | ||||||
Increase in restricted cash |
(20.0 | ) | | |||||
Other |
(0.3 | ) | 5.9 | |||||
Net cash used in investing activities continuing operations |
(88.8 | ) | (531.3 | ) | ||||
Net cash used in investing activities |
(88.8 | ) | (531.3 | ) | ||||
Financing activities: |
||||||||
Payments of long-term debt and capital leases |
(3.8 | ) | (4.1 | ) | ||||
Proceeds from debt borrowings |
| 216.6 | ||||||
Payments related to derivative instrument with financing element |
(5.4 | ) | | |||||
Payments of refinancing costs and fees |
| (5.6 | ) | |||||
Distributions paid to non-controlling interests and other |
(1.8 | ) | (2.0 | ) | ||||
Net cash provided by (used in) financing activities |
(11.0 | ) | 204.9 | |||||
Net increase (decrease) in cash and cash equivalents |
49.8 | (199.3 | ) | |||||
Cash and cash equivalents, beginning of year |
308.2 | 257.6 | ||||||
Cash and cash equivalents, end of year |
$ | 358.0 | $ | 58.3 | ||||
Net cash paid for interest |
$ | 41.9 | $ | 69.6 | ||||
Net cash received for income taxes |
$ | (13.2 | ) | $ | (0.3 | ) | ||
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited)
(In millions)
Segment Information (Unaudited)
(In millions)
Quarter ended December 31, 2009 | ||||||||||||||||||||||||
Acute | ||||||||||||||||||||||||
Care | % of | Health | % of | |||||||||||||||||||||
Services | Revenues | Plans | Revenues | Eliminations | Consolidated | |||||||||||||||||||
Patient service revenues(1) |
$ | 638.6 | 100.0 | % | $ | | | % | $ | (10.4 | ) | $ | 628.2 | |||||||||||
Premium revenues |
| | 212.3 | 100.0 | | 212.3 | ||||||||||||||||||
Total revenues |
638.6 | 100.0 | 212.3 | 100.0 | (10.4 | ) | 840.5 | |||||||||||||||||
Salaries and benefits
(excludes stock
compensation) |
313.6 | 49.1 | 8.3 | 3.9 | | 321.9 | ||||||||||||||||||
Health plan claims
expense(1) |
| | 181.2 | 85.4 | (10.4 | ) | 170.8 | |||||||||||||||||
Supplies |
114.5 | 17.9 | 0.1 | | | 114.6 | ||||||||||||||||||
Provision for doubtful
accounts |
35.0 | 5.5 | | | | 35.0 | ||||||||||||||||||
Other operating expenses |
105.9 | 16.6 | 8.0 | 3.8 | | 113.9 | ||||||||||||||||||
Total operating expenses |
569.0 | 89.1 | 197.6 | 93.1 | (10.4 | ) | 756.2 | |||||||||||||||||
Segment EBITDA(2) |
69.6 | 10.9 | 14.7 | 6.9 | | 84.3 | ||||||||||||||||||
Less: |
||||||||||||||||||||||||
Interest, net |
27.7 | 4.3 | (0.1 | ) | (0.0 | ) | | 27.6 | ||||||||||||||||
Depreciation and
amortization |
32.8 | 5.1 | 1.2 | 0.6 | | 34.0 | ||||||||||||||||||
Equity method income |
(0.3 | ) | (0.0 | ) | | | | (0.3 | ) | |||||||||||||||
Stock compensation |
1.0 | 0.2 | | | | 1.0 | ||||||||||||||||||
Loss on disposal of assets |
0.4 | 0.1 | | | | 0.4 | ||||||||||||||||||
Monitoring fees and
expenses |
1.4 | 0.2 | | | | 1.4 | ||||||||||||||||||
Impairment loss |
43.1 | 6.7 | | | | 43.1 | ||||||||||||||||||
Income (loss) from
continuing operations
before income taxes |
$ | (36.5 | ) | (5.7 | )% | $ | 13.6 | 6.4 | % | $ | | $ | (22.9 | ) | ||||||||||
(1) | Vanguard eliminates in consolidation those patient service revenues earned by its healthcare facilities attributable to services provided to enrollees in its owned health plans and eliminates the corresponding medical claims expenses incurred by the health plans for those services. | |
(2) | Segment EBITDA is defined as income (loss) from continuing operations before income taxes less interest expense (net of interest income), depreciation and amortization, equity method income, stock compensation, gain or loss on disposal of assets, realized and unrealized gains or losses on investments, monitoring fees and expenses, acquisition related expenses, debt extinguishment costs, pension expense and impairment losses. Management uses Segment EBITDA to measure performance for Vanguards segments and to develop strategic objectives and operating plans for those segments. Segment EBITDA eliminates the uneven effect of non-cash depreciation of tangible assets and amortization of intangible assets, much of which results from acquisitions accounted for under the purchase method of accounting. Segment EBITDA also eliminates the effects of changes in interest rates which management believes relate to general trends in global capital markets, but are not necessarily indicative of the operating performance of Vanguards segments. Management believes that Segment EBITDA provides useful information about the financial performance of Vanguards segments to investors, lenders, financial analysts and rating agencies. Additionally, management believes that investors and lenders view Segment EBITDA as an important factor in making investment decisions assessing the value of Vanguard. Segment EBITDA is not a substitute for net income (loss), operating cash flows or other cash flow statement data determined in accordance with accounting principles generally accepted in the United States. Segment EBITDA, as presented, may not be comparable to similar measures of other companies. |
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) (continued)
(In millions)
Segment Information (Unaudited) (continued)
(In millions)
Quarter ended December 31, 2010 | ||||||||||||||||||||||||
Acute | ||||||||||||||||||||||||
Care | % of | Health | % of | |||||||||||||||||||||
Services | Revenues | Plans | Revenues | Eliminations | Consolidated | |||||||||||||||||||
Patient service revenues(1) |
$ | 759.8 | 100.0 | % | $ | | | % | $ | (11.0 | ) | $ | 748.8 | |||||||||||
Premium revenues |
| | 211.8 | 100.0 | | 211.8 | ||||||||||||||||||
Total revenues |
759.8 | 100.0 | 211.8 | 100.0 | (11.0 | ) | 960.6 | |||||||||||||||||
Salaries and benefits
(excludes stock
compensation) |
365.5 | 48.1 | 8.3 | 3.9 | | 373.8 | ||||||||||||||||||
Health plan claims
expense(1) |
| | 175.8 | 83.0 | (11.0 | ) | 164.8 | |||||||||||||||||
Supplies |
133.4 | 17.6 | 0.1 | | | 133.5 | ||||||||||||||||||
Provision for doubtful
accounts |
51.2 | 6.7 | | | | 51.2 | ||||||||||||||||||
Other operating expenses |
140.7 | 18.5 | 10.2 | 4.8 | | 150.9 | ||||||||||||||||||
Total operating expenses |
690.8 | 90.9 | 194.4 | 91.8 | (11.0 | ) | 874.2 | |||||||||||||||||
Segment EBITDA(2) |
69.0 | 9.1 | 17.4 | 8.2 | | 86.4 | ||||||||||||||||||
Less: |
||||||||||||||||||||||||
Interest, net |
36.0 | 4.7 | (0.9 | ) | (0.4 | ) | | 35.1 | ||||||||||||||||
Depreciation and
amortization |
37.5 | 4.9 | 1.1 | 0.5 | | 38.6 | ||||||||||||||||||
Equity method income |
(0.3 | ) | (0.0 | ) | | | | (0.3 | ) | |||||||||||||||
Stock compensation |
1.7 | 0.2 | | | | 1.7 | ||||||||||||||||||
Loss on disposal of assets |
0.1 | | | | | 0.1 | ||||||||||||||||||
Monitoring fees and
expenses |
1.1 | 0.1 | | | | 1.1 | ||||||||||||||||||
Realized loss on
investments |
0.1 | | | | | 0.1 | ||||||||||||||||||
Acquisition related
expenses |
1.3 | 0.2 | | | | 1.3 | ||||||||||||||||||
Impairment loss |
0.9 | 0.1 | | | | 0.9 | ||||||||||||||||||
Income (loss) from
continuing operations
before income taxes |
$ | (9.4 | ) | (1.2 | )% | $ | 17.2 | 8.1 | % | $ | | $ | 7.8 | |||||||||||
(1) | Vanguard eliminates in consolidation those patient service revenues earned by its healthcare facilities attributable to services provided to enrollees in its owned health plans and eliminates the corresponding medical claims expenses incurred by the health plans for those services. | |
(2) | Segment EBITDA is defined as income (loss) from continuing operations before income taxes less interest expense (net of interest income), depreciation and amortization, equity method income, stock compensation, gain or loss on disposal of assets, realized or unrealized gains or losses on investments, monitoring fees and expenses, acquisition related expenses, debt extinguishment costs, pension expense and impairment losses. Management uses Segment EBITDA to measure performance for Vanguards segments and to develop strategic objectives and operating plans for those segments. Segment EBITDA eliminates the uneven effect of non-cash depreciation of tangible assets and amortization of intangible assets, much of which results from acquisitions accounted for under the purchase method of accounting. Segment EBITDA also eliminates the effects of changes in interest rates which management believes relate to general trends in global capital markets, but are not necessarily indicative of the operating performance of Vanguards segments. Management believes that Segment EBITDA provides useful information about the financial performance of Vanguards segments to investors, lenders, financial analysts and rating agencies. Additionally, management believes that investors and lenders view Segment EBITDA as an important factor in making investment decisions assessing the value of Vanguard. Segment EBITDA is not a substitute for net income (loss), operating cash flows or other cash flow statement data determined in accordance with accounting principles generally accepted in the United States. Segment EBITDA, as presented, may not be comparable to similar measures of other companies. |
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) (continued)
(In millions)
Segment Information (Unaudited) (continued)
(In millions)
Six months ended December 31, 2009 | ||||||||||||||||||||||||
Acute | ||||||||||||||||||||||||
Care | % of | Health | % of | |||||||||||||||||||||
Services | Revenues | Plans | Revenues | Eliminations | Consolidated | |||||||||||||||||||
Patient service revenues(1) |
$ | 1,264.8 | 100.0 | % | $ | | | % | $ | (21.0 | ) | $ | 1,243.8 | |||||||||||
Premium revenues |
| | 416.6 | 100.0 | | 416.6 | ||||||||||||||||||
Total revenues |
1,264.8 | 100.0 | 416.6 | 100.0 | (21.0 | ) | 1,660.4 | |||||||||||||||||
Salaries and benefits
(excludes stock
compensation) |
615.9 | 48.7 | 16.8 | 4.0 | | 632.7 | ||||||||||||||||||
Health plan claims
expense(1) |
| | 352.8 | 84.7 | (21.0 | ) | 331.8 | |||||||||||||||||
Supplies |
225.3 | 17.8 | 0.1 | | | 225.4 | ||||||||||||||||||
Provision for doubtful
accounts |
72.2 | 5.7 | | | | 72.2 | ||||||||||||||||||
Other operating expenses |
227.3 | 18.0 | 17.8 | 4.3 | | 245.1 | ||||||||||||||||||
Total operating expenses |
1,140.7 | 90.2 | 387.5 | 93.0 | (21.0 | ) | 1,507.2 | |||||||||||||||||
Segment EBITDA(2) |
124.1 | 9.8 | 29.1 | 7.0 | | 153.2 | ||||||||||||||||||
Less: |
||||||||||||||||||||||||
Interest, net |
55.1 | 4.4 | (0.3 | ) | (0.1 | ) | | 54.8 | ||||||||||||||||
Depreciation and
amortization |
65.4 | 5.2 | 2.2 | 0.5 | | 67.6 | ||||||||||||||||||
Equity method income |
(0.5 | ) | (0.0 | ) | | | | (0.5 | ) | |||||||||||||||
Stock compensation |
2.9 | 0.2 | | | | 2.9 | ||||||||||||||||||
Loss on disposal of assets |
0.4 | | | | | 0.4 | ||||||||||||||||||
Monitoring fees and
expenses |
2.7 | 0.2 | | | | 2.7 | ||||||||||||||||||
Impairment loss |
43.1 | 3.4 | | | | 43.1 | ||||||||||||||||||
Income (loss) from
continuing operations
before income taxes |
$ | (45.0 | ) | (3.6 | )% | $ | 27.2 | 6.5 | % | $ | | $ | (17.8 | ) | ||||||||||
(1) | Vanguard eliminates in consolidation those patient service revenues earned by its healthcare facilities attributable to services provided to enrollees in its owned health plans and eliminates the corresponding medical claims expenses incurred by the health plans for those services. | |
(2) | Segment EBITDA is defined as income (loss) from continuing operations before income taxes less interest expense (net of interest income), depreciation and amortization, equity method income, stock compensation, gain or loss on disposal of assets, realized or unrealized gains or losses on investments, monitoring fees and expenses, acquisition related expenses, debt extinguishment costs, pension expense and impairment losses. Management uses Segment EBITDA to measure performance for Vanguards segments and to develop strategic objectives and operating plans for those segments. Segment EBITDA eliminates the uneven effect of non-cash depreciation of tangible assets and amortization of intangible assets, much of which results from acquisitions accounted for under the purchase method of accounting. Segment EBITDA also eliminates the effects of changes in interest rates which management believes relate to general trends in global capital markets, but are not necessarily indicative of the operating performance of Vanguards segments. Management believes that Segment EBITDA provides useful information about the financial performance of Vanguards segments to investors, lenders, financial analysts and rating agencies. Additionally, management believes that investors and lenders view Segment EBITDA as an important factor in making investment decisions assessing the value of Vanguard. Segment EBITDA is not a substitute for net income (loss), operating cash flows or other cash flow statement data determined in accordance with accounting principles generally accepted in the United States. Segment EBITDA, as presented, may not be comparable to similar measures of other companies. |
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) (continued)
(In millions)
Segment Information (Unaudited) (continued)
(In millions)
Six months ended December 31, 2010 | ||||||||||||||||||||||||
Acute | ||||||||||||||||||||||||
Care | % of | Health | % of | |||||||||||||||||||||
Services | Revenues | Plans | Revenues | Eliminations | Consolidated | |||||||||||||||||||
Patient service revenues(1) |
$ | 1,463.9 | 100.0 | % | $ | | | % | $ | (21.8 | ) | $ | 1,442.1 | |||||||||||
Premium revenues |
| | 432.4 | 100.0 | | 432.4 | ||||||||||||||||||
Total revenues |
1,463.9 | 100.0 | 432.4 | 100.0 | (21.8 | ) | 1,874.5 | |||||||||||||||||
Salaries and benefits
(excludes stock
compensation) |
710.9 | 48.6 | 16.5 | 3.8 | | 727.4 | ||||||||||||||||||
Health plan claims expense(1) |
| | 360.7 | 83.4 | (21.8 | ) | 338.9 | |||||||||||||||||
Supplies |
254.4 | 17.4 | 0.1 | | | 254.5 | ||||||||||||||||||
Provision for doubtful
accounts |
103.0 | 7.0 | | | | 103.0 | ||||||||||||||||||
Other operating expenses |
265.9 | 18.2 | 20.7 | 4.8 | | 286.6 | ||||||||||||||||||
Total operating expenses |
1,334.2 | 91.1 | 398.0 | 92.0 | (21.8 | ) | 1,710.4 | |||||||||||||||||
Segment EBITDA(2) |
129.7 | 8.9 | 34.4 | 8.0 | | 164.1 | ||||||||||||||||||
Less: |
||||||||||||||||||||||||
Interest, net |
71.1 | 4.9 | (1.2 | ) | (0.3 | ) | | 69.9 | ||||||||||||||||
Depreciation and
amortization |
73.6 | 5.0 | 2.2 | 0.5 | | 75.8 | ||||||||||||||||||
Equity method income |
(0.6 | ) | (0.0 | ) | | | | (0.6 | ) | |||||||||||||||
Stock compensation |
2.9 | 0.2 | | | | 2.9 | ||||||||||||||||||
Loss on disposal of assets |
0.1 | | | | | 0.1 | ||||||||||||||||||
Monitoring fees and
expenses |
2.5 | 0.2 | | | | 2.5 | ||||||||||||||||||
Realized loss on investments |
0.1 | | | | | 0.1 | ||||||||||||||||||
Acquisition related expenses |
5.0 | 0.3 | | | | 5.0 | ||||||||||||||||||
Impairment loss |
0.9 | 0.1 | | | | 0.9 | ||||||||||||||||||
Income (loss) from
continuing operations
before income taxes |
$ | (25.9 | ) | (1.8 | )% | $ | 33.4 | 7.7 | % | $ | | $ | 7.5 | |||||||||||
(1) | Vanguard eliminates in consolidation those patient service revenues earned by its healthcare facilities attributable to services provided to enrollees in its owned health plans and eliminates the corresponding medical claims expenses incurred by the health plans for those services. | |
(2) | Segment EBITDA is defined as income (loss) from continuing operations before income taxes less interest expense (net of interest income), depreciation and amortization, equity method income, stock compensation, gain or loss on disposal of assets, realized or unrealized gains or losses on investments, monitoring fees and expenses, acquisition related expenses, debt extinguishment costs, pension expense and impairment losses. Management uses Segment EBITDA to measure performance for Vanguards segments and to develop strategic objectives and operating plans for those segments. Segment EBITDA eliminates the uneven effect of non-cash depreciation of tangible assets and amortization of intangible assets, much of which results from acquisitions accounted for under the purchase method of accounting. Segment EBITDA also eliminates the effects of changes in interest rates which management believes relate to general trends in global capital markets, but are not necessarily indicative of the operating performance of Vanguards segments. Management believes that Segment EBITDA provides useful information about the financial performance of Vanguards segments to investors, lenders, financial analysts and rating agencies. Additionally, management believes that investors and lenders view Segment EBITDA as an important factor in making investment decisions assessing the value of Vanguard. Segment EBITDA is not a substitute for net income (loss), operating cash flows or other cash flow statement data determined in accordance with accounting principles generally accepted in the United States. Segment EBITDA, as presented, may not be comparable to similar measures of other companies. |
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited)
Selected Operating Statistics
(Unaudited)
Quarter ended | ||||||||||||
December 31, | ||||||||||||
CONSOLIDATED: | 2009 | 2010 | % Change | |||||||||
Number of hospitals at end of period |
15 | 18 | ||||||||||
Licensed beds at end of period |
4,135 | 4,534 | ||||||||||
Discharges |
42,037 | 46,803 | 11.3 | % | ||||||||
Adjusted discharges |
72,725 | 83,330 | 14.6 | |||||||||
Adjusted discharges hospitals |
69,022 | 78,948 | 14.4 | |||||||||
Average length of stay |
4.19 | 4.19 | | |||||||||
Patient days |
176,233 | 195,929 | 11.2 | |||||||||
Adjusted patient days |
304,887 | 348,841 | 14.4 | |||||||||
Adjusted patient days hospitals |
289,364 | 330,497 | 14.2 | |||||||||
Patient revenue per adjusted discharge |
$ | 8,458 | $ | 8,765 | 3.6 | |||||||
Patient revenue per adjusted discharge hospitals |
$ | 8,533 | $ | 8,836 | 3.6 | |||||||
Inpatient surgeries |
9,380 | 9,826 | 4.8 | |||||||||
Outpatient surgeries |
19,143 | 19,488 | 1.8 | |||||||||
Emergency room visits |
155,818 | 178,198 | 14.4 | % | ||||||||
Charity care and uninsured discounts as a percent of acute care
segment revenues (prior to these discounts) |
10.2 | % | 10.5 | % | ||||||||
Provision for doubtful accounts as a percent of acute care services
segment revenues (prior to charity and uninsured discounts) |
4.9 | % | 6.0 | % | ||||||||
Net patient revenue payer mix: |
||||||||||||
Medicare |
26.2 | % | 25.8 | % | ||||||||
Medicaid |
6.7 | 8.5 | ||||||||||
Managed Medicare |
15.1 | 14.3 | ||||||||||
Managed Medicaid |
9.2 | 8.5 | ||||||||||
Managed care |
35.0 | 33.8 | ||||||||||
Commercial |
1.1 | 1.1 | ||||||||||
Self pay |
6.7 | 8.0 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
Discharges by payer: |
||||||||||||
Medicare |
27.6 | % | 28.2 | % | ||||||||
Medicaid |
8.7 | 10.6 | ||||||||||
Managed Medicare |
16.1 | 16.2 | ||||||||||
Managed Medicaid |
15.6 | 14.4 | ||||||||||
Managed care |
26.8 | 24.8 | ||||||||||
Commercial |
0.4 | 0.5 | ||||||||||
Self pay |
4.8 | 5.3 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited) (continued)
Selected Operating Statistics
(Unaudited) (continued)
Six Months Ended | ||||||||||||
December 31, | ||||||||||||
CONSOLIDATED: | 2009 | 2010 | % Change | |||||||||
Number of hospitals at end of period |
15 | 18 | ||||||||||
Licensed beds at end of period |
4,135 | 4,534 | ||||||||||
Discharges |
83,918 | 91,780 | 9.4 | % | ||||||||
Adjusted discharges |
146,651 | 164,176 | 12.0 | |||||||||
Adjusted discharges hospitals |
139,123 | 155,618 | 11.9 | |||||||||
Average length of stay |
4.15 | 4.17 | 0.5 | |||||||||
Patient days |
348,205 | 382,377 | 9.8 | |||||||||
Adjusted patient days |
608,506 | 683,996 | 12.4 | |||||||||
Adjusted patient days hospitals |
577,270 | 648,343 | 12.3 | |||||||||
Patient revenue per adjusted discharge |
$ | 8,302 | $ | 8,580 | 3.3 | |||||||
Patient revenue per adjusted discharge hospitals |
$ | 8,384 | $ | 8,638 | 3.0 | |||||||
Inpatient surgeries |
18,888 | 19,583 | 3.7 | |||||||||
Outpatient surgeries |
38,460 | 38,891 | 1.1 | |||||||||
Emergency room visits |
310,727 | 351,363 | 13.1 | % | ||||||||
Charity care and uninsured discounts as a percent of acute care
segment revenues (prior to these discounts) |
10.9 | % | 10.7 | % | ||||||||
Provision for doubtful accounts as a percent of acute care services
segment revenues (prior to charity and uninsured discounts) |
5.1 | % | 6.3 | % | ||||||||
Net patient revenue payer mix: |
||||||||||||
Medicare |
25.3 | % | 25.6 | % | ||||||||
Medicaid |
7.2 | 8.0 | ||||||||||
Managed Medicare |
14.9 | 14.5 | ||||||||||
Managed Medicaid |
9.8 | 9.0 | ||||||||||
Managed care |
34.9 | 33.9 | ||||||||||
Commercial |
1.1 | 1.1 | ||||||||||
Self pay |
6.8 | 7.9 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
Discharges by payer: |
||||||||||||
Medicare |
27.1 | % | 27.9 | % | ||||||||
Medicaid |
8.7 | 10.4 | ||||||||||
Managed Medicare |
16.0 | 15.7 | ||||||||||
Managed Medicaid |
15.4 | 14.7 | ||||||||||
Managed care |
27.3 | 25.3 | ||||||||||
Commercial |
0.4 | 0.5 | ||||||||||
Self pay |
5.1 | 5.5 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited) (continued)
Selected Operating Statistics
(Unaudited) (continued)
Quarter ended | ||||||||||||
December 31, | ||||||||||||
SAME HOSPITAL (1): | 2009 | 2010 | % Change | |||||||||
Number of hospitals at end of period |
15 | 15 | ||||||||||
Licensed beds at end of period |
4,135 | 4,017 | ||||||||||
Patient service revenues (in millions) |
$ | 628.2 | $ | 653.4 | 4.0 | % | ||||||
Discharges |
42,037 | 41,864 | (0.4 | ) | ||||||||
Adjusted discharges |
72,725 | 74,754 | 2.8 | |||||||||
Adjusted discharges hospitals |
69,022 | 70,808 | 2.6 | |||||||||
Average length of stay |
4.19 | 4.14 | (1.2 | ) | ||||||||
Patient days |
176,233 | 173,497 | (1.6 | ) | ||||||||
Adjusted patient days |
304,887 | 309,803 | 1.6 | |||||||||
Adjusted patient days hospitals |
289,364 | 293,449 | 1.4 | |||||||||
Patient revenue per adjusted discharge |
$ | 8,458 | $ | 8,552 | 1.1 | |||||||
Patient revenue per adjusted discharge hospitals |
$ | 8,533 | $ | 8,656 | 1.4 | |||||||
Inpatient surgeries |
9,380 | 8,618 | (8.1 | ) | ||||||||
Outpatient surgeries |
19,143 | 17,910 | (6.4 | ) | ||||||||
Emergency room visits |
155,818 | 160,055 | 2.7 | % | ||||||||
Charity care and uninsured discounts as a percent of acute
care services segment revenues (prior to these discounts) |
10.2 | % | 10.8 | % | ||||||||
Provision for doubtful accounts as a percent of acute care
services
segment revenues (prior to charity and uninsured discounts) |
4.9 | % | 6.1 | % | ||||||||
Net patient revenue payer mix: |
||||||||||||
Medicare |
26.2 | % | 25.6 | % | ||||||||
Medicaid |
6.7 | 7.1 | ||||||||||
Managed Medicare |
15.1 | 15.2 | ||||||||||
Managed Medicaid |
9.2 | 9.2 | ||||||||||
Managed care |
35.0 | 34.7 | ||||||||||
Commercial |
1.1 | 1.1 | ||||||||||
Self pay |
6.7 | 7.1 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
Discharges by payer: |
||||||||||||
Medicare |
27.6 | % | 27.6 | % | ||||||||
Medicaid |
8.7 | 8.6 | ||||||||||
Managed Medicare |
16.1 | 17.5 | ||||||||||
Managed Medicaid |
15.6 | 15.5 | ||||||||||
Managed care |
26.8 | 25.6 | ||||||||||
Commercial |
0.4 | 0.5 | ||||||||||
Self pay |
4.8 | 4.7 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
(1) | Same hospital results exclude those facilities that were not part of Vanguard for the full quarters of both years. |
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited) (continued)
Selected Operating Statistics
(Unaudited) (continued)
Six Months Ended | ||||||||||||
December 31, | ||||||||||||
SAME HOSPITAL (1): | 2009 | 2010 | % Change | |||||||||
Number of hospitals at end of period |
15 | 15 | ||||||||||
Licensed beds at end of period |
4,135 | 4,017 | ||||||||||
Patient service revenues (in millions) |
$ | 1,243.8 | $ | 1,300.8 | 4.6 | % | ||||||
Discharges |
83,918 | 83,869 | (0.1 | ) | ||||||||
Adjusted discharges |
146,651 | 150,342 | 2.5 | |||||||||
Adjusted discharges hospitals |
139,123 | 142,376 | 2.3 | |||||||||
Average length of stay |
4.15 | 4.13 | (0.5 | ) | ||||||||
Patient days |
348,205 | 346,473 | (0.5 | ) | ||||||||
Adjusted patient days |
608,506 | 621,081 | 2.1 | |||||||||
Adjusted patient days hospitals |
577,270 | 588,173 | 1.9 | |||||||||
Patient revenue per adjusted discharge |
$ | 8,302 | $ | 8,473 | 2.1 | |||||||
Patient revenue per adjusted discharge hospitals |
$ | 8,384 | $ | 8,554 | 2.0 | |||||||
Inpatient surgeries |
18,888 | 17,746 | (6.0 | ) | ||||||||
Outpatient surgeries |
38,460 | 36,253 | (5.7 | ) | ||||||||
Emergency room visits |
310,727 | 320,935 | 3.3 | % | ||||||||
Charity care and uninsured discounts as a percent of acute
care services segment revenues (prior to these discounts) |
10.9 | % | 10.8 | % | ||||||||
Provision for doubtful accounts as a percent of acute care
services
segment revenues (prior to charity and uninsured discounts) |
5.1 | % | 6.1 | % | ||||||||
Net patient revenue payer mix: |
||||||||||||
Medicare |
25.3 | % | 25.1 | % | ||||||||
Medicaid |
7.2 | 7.2 | ||||||||||
Managed Medicare |
14.9 | 15.1 | ||||||||||
Managed Medicaid |
9.8 | 9.5 | ||||||||||
Managed care |
34.9 | 35.0 | ||||||||||
Commercial |
1.1 | 1.0 | ||||||||||
Self pay |
6.8 | 7.1 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
Discharges by payer: |
||||||||||||
Medicare |
27.1 | % | 27.4 | % | ||||||||
Medicaid |
8.7 | 8.7 | ||||||||||
Managed Medicare |
16.0 | 16.8 | ||||||||||
Managed Medicaid |
15.4 | 15.6 | ||||||||||
Managed care |
27.3 | 26.0 | ||||||||||
Commercial |
0.4 | 0.4 | ||||||||||
Self pay |
5.1 | 5.1 | ||||||||||
Total |
100.0 | % | 100.0 | % | ||||||||
(1) | Same hospital results exclude those facilities that were not part of Vanguard for the full six-month periods of both years. |
Contact:
|
Vanguard Health Systems, Inc. Gary Willis Senior Vice President and Chief Accounting Officer (615) 665-6098 |