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8-K - FORM 8-K - HEALTH MANAGEMENT ASSOCIATES, INCd8k.htm

Exhibit 99.1

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PRESS RELEASE

FOR IMMEDIATE RELEASE

 

    Contact:        John C. Merriwether
       Vice President of Financial Relations
       Health Management Associates, Inc.
       (239) 598-3131

Health Management 1st Quarter 2011 Diluted EPS from Continuing Operations

Increases 16% to $0.22 and Net Revenue Increases 13% to $1.43 Billion

NAPLES, FLORIDA (April 25, 2011) Health Management Associates, Inc. (NYSE: HMA) today announced its consolidated financial results for the first quarter ended March 31, 2011.

Key metrics from continuing operations for the first quarter (all percentage changes compare the first quarter of 2011 to the first quarter of 2010 unless otherwise noted) include:

 

   

Diluted earnings per share (“EPS”) increased 15.8% to $0.22;

 

   

Revenue increased 12.7% to $1,433.6 million;

 

   

Income from continuing operations increased 16.4% to $62.7 million;

 

   

Adjusted EBITDA increased 9.3% to $214.4 million;

 

   

Admissions increased 4.2% while adjusted admissions increased 8.3%;

 

   

Same hospital net revenue increased 4.8% to $1,333.0 million;

 

   

Same hospital Adjusted EBITDA increased 6.3% to $243.4 million, resulting in a 30 basis point improvement in margin, to 18.3%;

 

   

Same hospital surgeries increased 0.5%; and

 

   

Same hospital admissions and adjusted admissions declined 3.9% and 0.3%, respectively.

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Health Management Associates, Inc. / Page 2

 

The tables accompanying this press release include a reconciliation of consolidated net income to all presentations of Adjusted EBITDA (which is not a GAAP measure) contained in this press release. Those tables also contain disclaimers and other important information regarding how Health Management defines and uses Adjusted EBITDA.

For continuing operations at hospitals operated by Health Management for one year or more, referred to as same hospital continuing operations, net revenue increased $61.2 million or 4.8% to $1,333.0 million compared to the prior year’s first quarter. Adjusted EBITDA from same hospital continuing operations grew 6.3% to $243.4 million, representing 18.3% of net revenue, as compared to $229.0 million and 18.0% of net revenue for the same quarter a year ago. A 0.5% increase in same hospital surgeries contributed to this net revenue and Adjusted EBITDA growth. Admissions from same hospital continuing operations in the first quarter were affected by declines in uninsured admissions and weather-related disruptions to a greater degree than during the same period a year ago, contributing to a 3.9% decline, while same hospital adjusted admissions were essentially flat, at -0.3%, compared to the prior year’s first quarter.

“We are very pleased to report another great quarter,” said Gary D. Newsome, Health Management’s President and Chief Executive Officer. “We will continue to focus on the initiatives we believe continue to significantly contribute to our outstanding results, including cost discipline, emergency room operations, physician recruitment and market service development. We believe our catalyst for growth continues to be our acquisition and partnership opportunities, as evidenced by our recent announcement to partner with the existing physician owners at Tri-Lakes Medical Center in Batesville, Mississippi. We plan to continue our disciplined approach to hospital acquisitions and joint ventures.”

Health Management’s provision for doubtful accounts, or bad debt expense, was $172.8 million, or 12.1% of net revenue, for the first quarter compared to $156.9 million, or 12.3% of net revenue, for the same quarter a year ago.

 

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Health Management Associates, Inc. / Page 3

 

Uninsured self-pay patient discounts for the first quarter were $226.8 million, compared to $179.6 million for the same quarter a year ago. Charity/indigent care write-offs for the quarter were $21.4 million, compared to $20.8 million for the same quarter a year ago. The sum of uninsured discounts, charity/indigent write-offs and bad debt expense, as a percent of the sum of net revenue, uninsured discounts and charity/indigent write-offs (which Health Management refers to as the Uncompensated Patient Care Percentage) was 25.0% for the first quarter, compared to 24.3% for the first quarter a year ago, and 25.1% for the fourth quarter ended December 31, 2010. Health Management believes that its Uncompensated Patient Care Percentage provides key information regarding the aggregate level of patient care for which it does not receive remuneration.

Cash flow from continuing operating activities for the first quarter ended March 31, 2011 was $116.8 million, after cash interest and cash tax payments aggregating $43.4 million. Health Management’s total leverage ratio and interest coverage ratio were 4.03 and 3.52, respectively, at March 31, 2011. These ratios are well within the requirements of Health Management’s credit facilities.

Health Management is increasing its diluted EPS objective range for fiscal year 2011 to be between $0.74 and $0.78 from between $0.72 and $0.76, and Health Management expects 2011 same hospital admissions growth to be between -1% and 1%. These objective ranges do not include any benefit from potential 2011 acquisitions.

As previously announced on April 20, 2011, a subsidiary of Health Management signed a definitive agreement to partner with the current physician owners of the 112-bed Tri-Lakes Medical Center, located in Batesville, Mississippi. Under the joint venture, Health Management will acquire a controlling interest in Tri-Lakes Medical Center and manage its operations. The transaction is expected to be completed by June 1, 2011.

 

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Health Management Associates, Inc. / Page 4

 

“We believe that our disciplined approach to controlling costs and the successful implementation of our operational initiatives will continue to result in improvement of our operating results in 2011 and that our first quarter results validate our approach. Likewise, we anticipate another successful year of hospital acquisitions in 2011, and we believe our recent Tri-Lakes Medical Center partnership announcement is indicative of an active pipeline of attractive acquisition and partnership opportunities,” added Newsome. “Health Management is about enabling America’s best local health care. We plan to continue investing in innovation in 2011 as we see opportunities to expand our existing hospitals’ scope and breadth of services, while at the same time we expect to continue to be an attractive strategic partner for hospitals in search of operational expertise with the best cultural fit. We believe we remain the only pure-player in the non-urban sector.”

Health Management’s executive team will hold a conference call and webcast to discuss the contents of this press release and Health Management’s consolidated financial results for the first quarter ended March 31, 2011 on Tuesday, April 26, 2011 at 11:00 a.m. EDT. Investors are invited to access the webcast via Health Management’s website at www.HMA.com or via www.streetevents.com. Alternatively, investors may join the conference call by dialing 877-476-3476.

Health Management will archive a copy of the audio webcast of the conference call, along with any related information that Health Management may be required to provide pursuant to Securities and Exchange Commission rules, on its website under the heading “Investor Relations,” for a period of 60 days following the conference call.

Health Management enables America’s best local health care by providing the people, processes, capital and expertise necessary for its hospital and physician partners to fulfill their local missions of delivering superior health care services.

 

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Health Management Associates, Inc. / Page 5

 

Upon completion of the previously announced transaction to partner with the existing physician owners of Tri-Lakes Medical Center, Health Management, through its subsidiaries, will operate 60 hospitals, with approximately 9,000 licensed beds, in non-urban communities located throughout the United States. All references to “HMA”, “Health Management,” the “Company”, “we”, “us” or “our” used in this release refer to Health Management Associates, Inc. and its affiliates.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements are subject to risks, uncertainties and assumptions and are identified by words such as “expects,” “estimates,” “projects,” “anticipates,” “believes,” “plans”, “could” and other similar words. All statements addressing operating performance, events or developments that Health Management Associates, Inc. expects or anticipates will occur in the future, including but not limited to projections of revenue, income or loss, capital expenditures, earnings per share, debt structure, bad debt expense, capital structure, repayment of indebtedness, other financial items and operating statistics, statements regarding the plans and objectives of management for future operations, innovations, or market service development, statements regarding acquisitions, joint ventures, divestitures and other proposed or contemplated transactions (including but not limited to statements regarding the potential for future acquisitions and perceived benefits of acquisitions), statements of future economic performance, statements regarding the effects and/or interpretations of recently enacted or future health care laws and regulations, statements of the assumptions underlying or relating to any of the foregoing statements, and other statements which are other than statements of historical fact, are considered to be “forward-looking statements.

Because they are forward-looking, such statements should be evaluated in light of important risk factors and uncertainties. These risk factors and uncertainties are more fully described in Health Management Associates, Inc.’s most recent Annual Report on Form 10-K, under the heading entitled “Risk Factors.” Should one or more of these risks or uncertainties materialize, or should any of Health Management Associates, Inc.’s underlying assumptions prove incorrect, actual results could vary materially from those currently anticipated. In addition, undue reliance should not be placed on Health Management Associates, Inc.’s forward-looking statements. Except as required by law, Health Management Associates, Inc. disclaims any obligation to update or publicly announce any revisions to any of the forward-looking statements contained in this press release.

 

(financial tables follow)

 

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HEALTH MANAGEMENT ASSOCIATES, INC.

CONSOLIDATED STATEMENTS OF INCOME

(unaudited, in thousands, except per share amounts)

 

     Three Months Ended
March 31,
 
     2011     2010  

Net revenue

   $ 1,433,641      $ 1,271,744   

Operating expenses:

    

Salaries and benefits

     571,393        502,575   

Supplies

     195,003        179,170   

Provision for doubtful accounts

     172,802        156,905   

Depreciation and amortization

     65,372        61,217   

Rent expense

     36,018        29,733   

Other operating expenses

     243,996        207,187   
                

Total operating expenses

     1,284,584        1,136,787   
                

Income from operations

     149,057        134,957   

Other income (expense):

    

Gains on sales of assets, net

     60        1,195   

Interest and other income, net

     134        1,271   

Interest expense

     (51,037     (53,574
                

Income from continuing operations before income taxes

     98,214        83,849   

Provision for income taxes

     (35,504     (29,983
                

Income from continuing operations

     62,710        53,866   

Loss from discontinued operations, net of income taxes

     (598     (447
                

Consolidated net income

     62,112        53,419   

Net income attributable to noncontrolling interests

     (6,588     (6,479
                

Net income attributable to Health Management Associates, Inc.

   $ 55,524      $ 46,940   
                

Earnings per share attributable to Heath Management

    

Associates, Inc. common stockholders:

    

Basic and Diluted:

    

Continuing operations

   $ 0.22      $ 0.19   

Discontinued operations

     —          —     
                

Net income

   $ 0.22      $ 0.19   
                

Weighted average number of shares outstanding:

    

Basic

     250,038        247,555   
                

Diluted

     253,727        249,867   
                

Net income attributable to Health Management Associates, Inc.

    

Income from continuing operations, net of income taxes

   $ 56,122      $ 47,387   

Loss from discontinued operations, net of income taxes

     (598     (447
                

Net income attributable to Health Management Associates, Inc.

   $ 55,524      $ 46,940   
                

 

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HEALTH MANAGEMENT ASSOCIATES, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

(unaudited, in thousands)

 

     Three Months Ended
March 31,
 
     2011     2010  

Cash flows from operating activities:

    

Consolidated net income

   $ 62,112      $ 53,419   

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

    

Depreciation and amortization

     67,040        62,900   

Provision for doubtful accounts

     172,802        156,905   

Stock-based compensation expense

     6,483        4,467   

Gains on sales of assets, net

     (60     (1,195

Losses (gains) on sales of available-for-sale securities

     203        (932

Deferred income tax expense

     11,695        2,665   

Changes in assets and liabilities of continuing operations:

    

Accounts receivable

     (236,412     (243,620

Supplies, prepaid expenses and other current assets

     (5,526     (7,683

Prepaid and recoverable income taxes

     22,479        26,052   

Deferred charges and other long-term assets

     (4,430     (3,706

Accounts payable, accrued expenses and other liabilities

     22,739        30,548   

Equity compensation excess income tax benefits

     (2,897     (1,100

Loss from discontinued operations, net of income taxes

     598        447   
                

Net cash provided by continuing operating activities

     116,826        79,167   
                

Cash flows from investing activities:

    

Acquisitions and other

     (3,696     (10,959

Additions to property, plant and equipment

     (47,463     (32,712

Proceeds from sales of assets and insurance recoveries

     137        2,142   

Purchases of available-for-sale securities

     (240,538     (80,130

Proceeds from sales of available-for-sale securities

     165,952        45,000   

Decrease in restricted funds

     5,696        6,078   
                

Net cash used in continuing investing activities

     (119,912     (70,581
                

Cash flows from financing activities:

    

Principal payments on debt and capital lease obligations

     (9,018     (9,445

Proceeds from exercises of stock options

     5,557        3,561   

Cash received from noncontrolling shareholders

     —          2,547   

Cash payments to noncontrolling shareholders

     (4,546     (5,407

Equity compensation excess income tax benefits

     2,897        1,100   
                

Net cash used in continuing financing activities

     (5,110     (7,644
                

Net increase (decrease) in cash and cash equivalents before discontinued operations

     (8,196     942   

Net increases (decreases) in cash and cash equivalents from discontinued operations:

    

Operating activities

     2,180        483   

Investing activities

     —          (186
                

Net increase (decrease) in cash and cash equivalents

     (6,016     1,239   

Cash and cash equivalents at beginning of the period

     101,812        106,018   
                

Cash and cash equivalents at end of the period

   $ 95,796      $ 107,257   
                

 

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HEALTH MANAGEMENT ASSOCIATES, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS AND STATISTICS

 

(unaudited, in thousands)    March 31,
2011
     December 31,
2010
 

Assets

     

Current assets:

     

Cash and cash equivalents

   $ 95,796       $ 101,812   

Available-for-sale securities

     131,874         57,327   

Accounts receivable, net

     808,950         759,131   

Other current assets

     255,054         269,808   

Assets held for sale

     4,994         4,994   

Property, plant and equipment, net

     2,677,986         2,664,641   

Restricted funds

     47,668         51,067   

Other assets

     1,022,186         1,001,305   
                 

Total assets

   $ 5,044,508       $ 4,910,085   
                 

Liabilities and Stockholders’ Equity

     

Current liabilities

   $ 580,334       $ 555,630   

Deferred income taxes

     184,056         157,177   

Other long-term liabilities

     688,968         680,073   

Long-term debt

     2,977,100         2,983,719   

Stockholders’ equity

     614,050         533,486   
                 

Total liabilities and stockholders’ equity

   $ 5,044,508       $ 4,910,085   
                 

 

     Three Months Ended March 31,  
     2011     2010     % Change  

Continuing Operations

      

Occupancy

     48.3     49.1  

Patient days

     381,195        362,393        5.2

Admissions

     88,343        84,766        4.2

Adjusted admissions

     159,642        147,365        8.3

Average length of stay

     4.3        4.3     

Surgeries

     82,897        78,126        6.1

Emergency room visits

     393,148        343,256        14.5

Net revenue (in thousands)

   $ 1,433,641      $ 1,271,744        12.7

Net revenue per adjusted admission

   $ 8,980      $ 8,630        4.1

Total inpatient revenue percentage

     50.3     51.9  

Total outpatient revenue percentage

     49.7     48.1  

Same Hospitals

      

Occupancy

     47.3     49.1  

Patient days

     349,607        362,393        -3.5

Admissions

     81,460        84,766        -3.9

Adjusted admissions

     146,899        147,365        -0.3

Average length of stay

     4.3        4.3     

Surgeries

     78,527        78,126        0.5

Emergency room visits

     360,256        343,256        5.0

Net revenue (in thousands)

   $ 1,332,971      $ 1,271,744        4.8

Net revenue per adjusted admission

   $ 9,074      $ 8,630        5.1

Total inpatient revenue percentage

     50.6     51.9  

Total outpatient revenue percentage

     49.4     48.1  

 

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HEALTH MANAGEMENT ASSOCIATES, INC.

SUPPLEMENTAL CONSOLIDATED STATEMENTS OF INCOME INFORMATION

(unaudited, in thousands)

 

     Three Months Ended
March 31,
 
     2011     2010  

Net revenue

   $ 1,433,641      $ 1,271,744   

Less acquisitions

     100,670        —     
                

Same hospital net revenue

   $ 1,332,971      $ 1,271,744   
                

Consolidated net income

   $ 62,112      $ 53,419   

Adjustments:

    

Loss from discontinued operations, net of income taxes

     598        447   

Provision for income taxes

     35,504        29,983   

Gains on sales of assets, net

     (60     (1,195

Interest and other income, net

     (134     (1,271

Interest expense

     51,037        53,574   

Depreciation and amortization

     65,372        61,217   
                

Adjusted EBITDA (a)

     214,429        196,174   

Adjustment for acquisitions, corporate and other

     28,940        32,842   
                

Same hospital operating Adjusted EBITDA (a)

   $ 243,369      $ 229,016   
                

Same hospital operating Adjusted EBITDA margins =

    

Same hospital operating Adjusted EBITDA / Same hospital net revenue (a)

     18.3     18.0
                

 

(a) Adjusted EBITDA is defined as consolidated net income before discontinued operations, net gains on sales of assets, net interest and other income, interest expense, income taxes, and depreciation and amortization. Adjusted EBITDA margin is defined as Adjusted EBITDA divided by net revenue. Adjusted EBITDA is not a measure determined in accordance with generally accepted accounting principles in the United States, commonly known as GAAP. Nevertheless, Health Management believes that providing non-GAAP information such as Adjusted EBITDA is important for investors and other readers of Health Management’s financial statements, as it is commonly used as an analytical indicator within the health care industry and Health Management’s debt facilities contain covenants that use Adjusted EBITDA in their calculations. Because Adjusted EBITDA is a non-GAAP measure and is thus susceptible to varying calculations, Adjusted EBITDA, as presented, may not be directly comparable to other similarly titled measures used by other companies.

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