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8-K - 8-K - TENET HEALTHCARE CORPthc-201712318xkearningsrel.htm

Exhibit 99.1



tenet_logo.jpg
 
Tenet Reports Results for the Fourth Quarter Ended
December 31, 2017


l
Hospital segment same-hospital admissions increased 0.2%, adjusted admissions increased 1.3%, and revenue per adjusted admission increased 4.8%, resulting in same-hospital net patient revenue growth of 6.1%.
l
Ambulatory Care same-facility system-wide cases increased 4.6% and revenue per case increased 2.2%, resulting in revenue growth of 6.9%.
l
Conifer’s revenues decreased 2.0% with revenue from third parties flat year-over-year.
l
As a result of the Tax Cuts and Jobs Act, Tenet recorded a $252 million non-cash partial write-down of the Company’s deferred tax assets and a $22 million increase in noncontrolling interest expense, which lowered net income by $274 million in the fourth quarter. In addition, the Company recorded a $99 million after-tax charge, primarily related to the write-down of assets held for sale in Chicago and employee severance. As a result, Tenet reported a net loss from continuing operations attributable to Tenet shareholders of $230 million or $2.28 per diluted share in the fourth quarter. After adjusting for these items, which totaled $373 million or $3.68 per share, Tenet reported Adjusted diluted earnings per share from continuing operations of $1.40.
l
Adjusted EBITDA was $840 million in the fourth quarter, consisting of $538 million in the Hospital segment, $223 million in the Ambulatory segment and $79 million in the Conifer segment.
l
Net cash provided by operating activities in 2017 was $1.200 billion, a $642 million increase when compared to $558 million in 2016. Free Cash Flow was $493 million in 2017, an $810 million increase when compared to an outflow of $317 million in 2016. Adjusted Free Cash Flow was $623 million in 2017, a $243 million increase when compared to $380 million in 2016.
l
2018 Outlook has been increased to reflect net income from continuing operations attributable to Tenet common shareholders of $95 million to $105 million, Adjusted EBITDA of $2.500 billion to $2.600 billion, diluted earnings per share from continuing operations of $0.92 to $1.02 and Adjusted diluted earnings per share from continuing operations of $0.73 to $1.07.
DALLAS - February 26, 2018 - Tenet Healthcare Corporation (NYSE: THC) reported a net loss from continuing operations attributable to Tenet shareholders of $230 million in the fourth quarter of 2017 due to the items mentioned above, compared to a $79 million net loss from continuing operations in the fourth quarter of 2016. Adjusted EBITDA was $840 million in the fourth quarter of 2017 compared to $650 million in the fourth quarter of 2016.






“Our results for the fourth quarter were strong in each of our business segments,” said Ronald A. Rittenmeyer, executive chairman and CEO.  “Volume growth returned in our hospital and Ambulatory segments, cost controls were tight, and our financial results at USPI and Conifer were very strong.  Our cost control program is off to a great start and, when combined with improved financial performance in the fourth quarter, we are raising our Outlook for Adjusted EBITDA and Adjusted EPS for 2018.”

Hospital Operations and Other Segment

Net operating revenues in the Hospital Operations and other segment was $4.184 billion, up 3.4 percent from $4.046 billion in the fourth quarter of 2016; in order to improve comparability, these revenue figures exclude revenue generated by the Company’s health plans in both periods since the Company is exiting this business.

On a same-hospital basis, patient revenue was $4.126 billion, up 6.1 percent from $3.889 billion in the fourth quarter of 2016, with adjusted admissions up 1.3 percent and revenue per adjusted admission up 4.8 percent. The growth in revenue per adjusted admission was due to a $202 million increase in revenue from the California Provider Fee Program since the 2017 program was not approved until December 2017.

Adjusted EBITDA in Tenet’s hospital segment was $538 million, representing an increase of $143 million or 36.2 percent as compared to $395 million in the fourth quarter of 2016. The $143 million increase in Adjusted EBITDA in the hospital segment was primarily driven by: (i) $202 million increase in California Provider Fee revenue, with $267 million of revenue being under the program in the fourth quarter of 2017 compared to $65 million in the fourth quarter of 2016; (ii) $17 million unfavorable comparison due to the sale of the Company’s hospitals and related assets in Houston, effective August 1, 2017; (iii) $17 million of previously disclosed executive severance in the fourth quarter of 2017; and, (iv) an $8 million decline in electronic health record incentives.

Tenet’s health plan business was breakeven in the fourth quarter of 2017 versus a loss of $29 million on the EBITDA line in the fourth quarter of 2016. The revenue and expenses associated with the Company’s health plan operations are included in Tenet’s consolidated statements of operations; however, the results are excluded from Adjusted EBITDA in both periods.

Selected operating expenses in the segment, defined as the sum of salaries, wages and benefits, supplies and other operating expenses, increased 2.2 percent on a per adjusted admission basis in the fourth quarter of 2017.

Exchanges

Tenet’s same-hospital exchange admissions were 4,857 in the fourth quarter of 2017, up 0.2 percent from the fourth quarter of 2016. Same-hospital exchange outpatient visits were 51,451 in the fourth quarter of 2017, up 15.2 percent from the fourth quarter of 2016.


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Uncompensated Care

Tenet’s provision for doubtful accounts was $325 million in the fourth quarter of 2017, representing a ratio of 6.1 percent of revenues before bad debt, as compared to $354 million in the fourth quarter of 2016, or 6.9 percent of revenues before bad debt (excluding health plan revenues from both periods). The decrease in the bad debt ratio was primarily attributable to a $15 million decrease in same-hospital self-pay revenues, revenue growth in our Ambulatory segment, the sale of our Houston hospitals in 2017, and a full year of the California Provider Fee revenue being recorded in the fourth quarter of 2017.

Tenet’s uncompensated care costs, defined as the sum of the provision for doubtful accounts, charity care write-offs and uninsured discounts, were $1.361 billion and $1.332 billion in the fourth quarters of 2017 and 2016, respectively, including $1.036 billion and $978 million, respectively, of charity care write-offs and uninsured discounts that were offered through Tenet’s Compact with Uninsured Patients. Uncompensated care in the fourth quarter of 2017 represented 21.5 percent of revenue before bad debts, uninsured discounts and charity care write-offs, flat versus the fourth quarter of 2016. Nearly all of Tenet’s uncompensated care is associated with the Hospital Operations and other segment.

Uninsured plus charity admissions increased by 317 admissions, or 3.3 percent on a same-hospital basis in the fourth quarter of 2017 compared to the fourth quarter of 2016. Uninsured plus charity outpatient visits increased by 6,237 visits, or 5.6 percent, on a same-hospital basis.

Ambulatory Care Segment

During the fourth quarter of 2017, the Ambulatory segment produced net operating revenues of $545 million, representing an increase of 14.0 percent as compared to $478 million in the fourth quarter of 2016. In addition, the Ambulatory segment generated Adjusted EBITDA of $223 million, up 21.9 percent from $183 million in the fourth quarter of 2016 and Adjusted EBITDA less facility-level noncontrolling interest was $145 million, up 26.1 percent from $115 million in the fourth quarter of 2016.

The results of many of the facilities in which the Ambulatory segment has an investment are not consolidated by Tenet. To help analyze the segment’s results of operations, management uses system-wide measures, which include revenues and cases of both consolidated and unconsolidated facilities. On a same-facility system-wide basis, revenue in the Ambulatory segment increased 6.9 percent, with cases increasing 4.6 percent and revenue per case increasing 2.2 percent. The number of surgical days was the same in both periods and did not impact the year-over-year growth rates this quarter.

Conifer Segment

During the fourth quarter of 2017, Conifer’s revenue decreased 2.0 percent to $394 million, down from $402 million in the fourth quarter of 2016. Revenue from third party customers was flat at $239 million. Conifer generated $79 million of Adjusted EBITDA in the fourth quarter of 2017, up 9.7 percent from $72 million in the fourth quarter of 2016.

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Net Income and Earnings Per Share

Tenet reported a net loss from continuing operations attributable to Tenet shareholders of $230 million, or a loss of $2.28 per diluted share, in the fourth quarter of 2017 compared to a net loss of $79 million, or a loss of $0.79 per diluted share, in the fourth quarter of 2016.

As shown on Table #2, the net loss from continuing operations attributable to Tenet shareholders of approximately $230 million included: (i) a $252 million non-cash partial write-down of the Company’s deferred tax assets due to the reduction in the corporate federal income tax rate from 35 percent to 21 percent; (ii) a $138 million pre-tax impairment and restructuring charge consisting of $73 million from the write-down of assets held for sale in the Chicago-area to their estimated fair value, $42 million of restructuring charges primarily related to employee severance associated with the Company’s cost reduction initiatives, and $23 million of other impairment and restructuring charges; and, (iii) $9 million of other items.  These items collectively lowered pre-tax income by approximately $147 million and lowered after-tax income by approximately $350 million. In addition, there was a noncontrolling interest impact of $23 million substantially due to a non-cash reduction in the deferred tax liabilities of the Company’s Ambulatory segment. Collectively, these items lowered diluted earnings per share by approximately $3.68.

After adjusting for the items listed on Table #2, Tenet recorded Adjusted net income from continuing operations attributable to Tenet shareholders of $143 million, or $1.40 per diluted share, during the fourth quarter of 2017, as compared to Adjusted net income from continuing operations attributable to Tenet shareholders of $23 million, or $0.23 per diluted share, in the fourth quarter of 2016.

A reconciliation of GAAP net income (loss) attributable to Tenet shareholders to Adjusted net income (loss) from continuing operations and Adjusted diluted earnings (loss) per share from continuing operations attributable to Tenet shareholders is contained in Table #2 at the end of this release.

Cash Flow and Liquidity

Cash and cash equivalents were $611 million at December 31, 2017 compared to $429 million at September 30, 2017. The Company had no outstanding borrowings on its $1 billion credit line as of December 31, 2017. Accounts receivable days outstanding from continuing operations were 55.2 at December 31, 2017 compared to 55.6 at September 30, 2017 and 56.5 at December 31, 2016. The calculation of accounts receivable days outstanding from continuing operations: (i) includes the accounts receivable of the Company’s two hospitals in Philadelphia, the Company’s four hospitals in the Chicago-area, Des Peres Hospital in St. Louis, and the Aspen facilities in the United Kingdom, which have been classified in assets held for sale on the Condensed Consolidated Balance Sheet at December 31, 2017; (ii) excludes revenue from our former hospitals and related assets in Houston, which were divested on August 1, 2017, from the 2016 and 2017 periods; (iii) excludes health plan revenues from the 2016 and 2017 periods; and (iv) excludes California Provider Fee revenues from both 2016 and 2017.


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Net cash provided by operating activities in 2017 was $1.200 billion, representing a $642 million increase compared to $558 million in 2016. After subtracting $707 million and $875 million of capital expenditures in 2017 and 2016, respectively, Free Cash Flow was $493 million in 2017, an $810 million improvement compared to an outflow of $317 million in 2016. Adjusted Free Cash Flow was $623 million in 2017, representing a $243 million increase from $380 million in 2016.

Net cash provided by investing activities was $21 million in 2017 compared to $430 million of net cash used in investing activities in 2016. The 2017 period included $827 million of proceeds from the sales of facilities and other assets, primarily from the sale of the Company’s Houston-area hospitals effective August 1, 2017 for net pre-tax proceeds of approximately $750 million; the 2016 period included $573 million of proceeds from the sale of the Company’s hospitals and related outpatient facilities in Georgia.

Net cash used in financing activities was $1.326 billion in 2017 compared to $232 million of net cash provided by financing activities in 2016. The 2017 period included: (i) $729 million related to purchases of noncontrolling interests, primarily the Company’s purchase of an additional 23.7 percent of USPI, which increased Tenet’s ownership interest in the USPI joint venture to 80.0 percent; (ii) the refinancing activities that were completed in the second and third quarters of 2017; and (iii) the redemption of $250 million aggregate principal amount of Tenet’s 8.0 percent senior unsecured notes due 2020 on September 11, 2017.

Reconciliations of net cash provided by operating activities to both Free Cash Flow and Adjusted Free Cash Flow are contained in Table #3 at the end of this release.

Outlook

The Company’s revised Outlook for 2018 includes:

l
Revenue of $17.9 billion to $18.3 billion,
l
Net income from continuing operations attributable to Tenet common shareholders of $95 million to $105 million,
l
Adjusted EBITDA of $2.500 billion to $2.600 billion,
l
Net cash provided by operating activities of $1.245 billion to $1.450 billion,
l
Adjusted Free Cash Flow of $675 million to $875 million,
l
Diluted earnings per share from continuing operations attributable to Tenet shareholders ranging from $0.92 to $1.02, and
l
Adjusted diluted earnings per share from continuing operations attributable to Tenet shareholders of $0.73 to $1.07.
The Company raised the midpoint of its previous 2018 Adjusted EBITDA Outlook range $25 million to reflect: (i) higher expectations for Conifer; (ii) additional Medicaid DSH reimbursement since Medicaid DSH reimbursement cuts have been delayed in both federal fiscal years 2018 and 2019; (iii) greater than previously expected revenue from the California Provider Fee program in 2018; and (iv) a net reduction in estimated EBITDA from to-be-divested facilities in 2018.

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The Outlook for 2018 assumes equity in earnings of unconsolidated affiliates of $160 million to $170 million, net income attributable to noncontrolling interests of $415 million to $435 million and an average diluted share count of 103 million.

The Company’s Outlook for the first quarter of 2018 includes:

l
Revenue of $4.45 billion to $4.65 billion,
l
Net income from continuing operations attributable to Tenet shareholders of $50 million to $70 million,
l
Adjusted EBITDA of $580 million to $630 million,
l
Earnings per diluted share from continuing operations attributable to Tenet shareholders of $0.49 to $0.69, and
l
Adjusted earnings per diluted share from continuing operations attributable to Tenet shareholders ranging from a loss of $0.10 to earnings of $0.05.
 
The Outlook for the first quarter assumes equity in earnings of unconsolidated affiliates of approximately $30 million to $35 million, net income attributable to noncontrolling interests of $90 million to $100 million, and an average diluted share count of 102 million.

Additional details on Tenet’s Outlook for both the first quarter and calendar year 2018 are available in Tables #4 and #5 at the end of this press release and in an accompanying slide presentation that is accessible through the Company’s website at www.tenethealth.com/investors.

Management’s Webcast Discussion of Fourth Quarter Results

Tenet management will discuss the Company’s fourth quarter 2017 results on a webcast scheduled for 10:00 a.m. Eastern Time (9:00 a.m. Central Time) on February 27, 2018. Investors can access the webcast through the Company’s website at www.tenethealth.com/investors. A set of slides, which will be referred to on the conference call, is available on the Quarterly Results section of the Company’s website.

Additional information regarding Tenet’s quarterly results of operations is contained in its Form 10K report for the twelve months ended December 31, 2017, which will be filed with the Securities and Exchange Commission and posted on the Company’s website before the webcast.

This press release includes certain non-GAAP measures, such as Adjusted EBITDA, Adjusted net income (loss) from continuing operations attributable to Tenet shareholders, Adjusted diluted earnings (loss) per share from continuing operations attributable to Tenet shareholders, Free Cash Flow and Adjusted Free Cash Flow. Reconciliations of these measures to the most comparable GAAP measure are contained in the tables at the end of this release.

Tenet Healthcare Corporation is a diversified healthcare services company with 120,000 employees united around a common mission: to help people live happier, healthier lives.  Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the

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Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities in the United States and the United Kingdom. Tenet’s Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans. For more information, please visit www.tenethealth.com.

The terms "THC", "Tenet Healthcare Corporation", "the Company", "we", "us" or "our" refer to Tenet Healthcare Corporation or one or more of its subsidiaries or affiliates as applicable.

###
 
Investor Relations
Brendan Strong
469-893-6992
investorrelations@tenethealth.com
Corporate Communications
Lesley Bogdanow
469-893-2640 
mediarelations@tenethealth.com
 
This release contains “forward-looking statements” - that is, statements that relate to future, not past, events. In this context, forward-looking statements often address our expected future business and financial performance and financial condition, and often contain words such as “expect,” “assume,” “anticipate,” “estimate,” “intend,” “plan,” “believe,” “seek,” “see,” or “will.” Forward-looking statements by their nature address matters that are, to different degrees, uncertain. Particular uncertainties that could cause our actual results to be materially different than those expressed in our forward-looking statements include, but are not limited to, the factors disclosed under “Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the year ended December 31, 2017, and subsequent Form 10-Q filings and other filings with the Securities and Exchange Commission.

 
Tenet uses its Company website to provide important information to investors about the Company including the posting of important announcements regarding financial performance and corporate developments.

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TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)

 
 
 
 
 
 
 
 
 
 
 
(Dollars in millions except per share amounts)
 
Three Months Ended December 31,
 
 
2017
 
%
 
2016
 
%
 
Change
Net operating revenues:
 
 
 
 
 
 
 
 
 
 
Net operating revenues before provision for doubtful accounts
 
$
5,303

 
 
 
$
5,214

 
 
 
1.7
 %
Less: Provision for doubtful accounts
 
325

 
 
 
354

 
 
 
(8.2
)%
Net operating revenues
 
4,978

 
100.0
 %
 
4,860

 
100.0
 %
 
2.4
 %
Equity in earnings of unconsolidated affiliates
 
49

 
1.0
 %
 
46

 
0.9
 %
 
6.5
 %
Operating expenses:
 
 
 
 

 
 
 
 
 
 
Salaries, wages and benefits
 
2,284

 
45.9
 %
 
2,316

 
47.7
 %
 
(1.4
)%
Supplies
 
800

 
16.0
 %
 
773

 
15.9
 %
 
3.5
 %
Other operating expenses, net
 
1,104

 
22.2
 %
 
1,205

 
24.7
 %
 
(8.4
)%
Electronic health record incentives
 
(1
)
 
 %
 
(9
)
 
(0.2
)%
 
(88.9
)%
Depreciation and amortization
 
208

 
4.2
 %
 
218

 
4.5
 %
 
 
Impairment and restructuring charges, and acquisition-related costs
 
138

 
2.8
 %
 
121

 
2.5
 %
 
 
Litigation and investigation costs
 
11

 
0.2
 %
 
2

 
 %
 
 
Gains on sales, consolidation and deconsolidation of facilities
 
(2
)
 
 %
 
0

 
 %
 
 
Operating income
 
485

 
9.7
 %
 
280

 
5.8
 %
 
 
Interest expense
 
(253
)
 
 
 
(249
)
 
 
 
 
Other non-operating expense, net
 
(8
)
 
 
 
(2
)
 
 
 
 
Loss from early extinguishment of debt
 

 
 
 

 
 
 
 
Income from continuing operations, before income taxes
 
224

 
 
 
29

 
 
 
 
Income tax expense
 
(324
)
 
 
 
(6
)
 
 
 
 
Income (loss) from continuing operations, before discontinued operations
 
(100
)
 
 
 
23

 
 
 
 
Discontinued operations:
 
 
 
 
 
 
 
 
 
 
Income (loss) from operations
 
1

 
 
 
(1
)
 
 
 
 
Income tax benefit
 

 
 
 
1

 
 
 
 
Income (loss) from discontinued operations
 
1

 
 
 

 
 
 
 
Net income (loss)
 
(99
)
 
 
 
23

 
 
 
 
Less: Net income attributable to noncontrolling interests
 
130

 
 
 
102

 
 
 
 
Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(229
)
 
 
 
$
(79
)
 
 
 
 
Amounts attributable to Tenet Healthcare Corporation common shareholders
 
 
 
 
 
 
 
 
 
 
Loss from continuing operations, net of tax
 
$
(230
)
 
 
 
$
(79
)
 
 
 
 
Income (loss) from discontinued operations, net of tax
 
1

 
 
 

 
 
 
 
Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(229
)
 
 
 
$
(79
)
 
 
 
 
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders:
 
 
 
 
 
 
 
 
 
 
Basic
 
 
 
 
 
 
 
 
 
 
Continuing operations
 
$
(2.28
)
 
 
 
$
(0.79
)
 
 
 
 
Discontinued operations
 
0.01

 
 
 
0.00

 
 
 
 
 
 
$
(2.27
)
 
 
 
$
(0.79
)
 
 
 
 
Diluted
 
 
 
 
 
 
 
 
 
 
Continuing operations
 
$
(2.28
)
 
 
 
$
(0.79
)
 
 
 
 
Discontinued operations
 
0.01

 
 
 
0.00

 
 
 
 
 
 
$
(2.27
)
 
 
 
$
(0.79
)
 
 
 
 
Weighted average shares and dilutive securities outstanding (in thousands):
 
 
 
 
 
 
 
 
 
 
Basic
 
100,945

 
 
 
99,651

 
 
 
 
Diluted*
 
100,945

 
 
 
99,651

 
 
 
 


*Had we generated income from continuing operations in the three months ended December 31, 2017 and 2016 the effect of employee stock options, restricted stock units and deferred compensation units on the diluted shares calculation would have been an increase of 908 thousand and 1,277 thousand shares, respectively.

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TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)

 
 
 
 
 
 
 
 
 
 
 
(Dollars in millions except per share amounts)
 
Years Ended December 31,
 
 
2017
 
%
 
2016
 
%
 
Change
Net operating revenues:
 
 
 
 
 
 
 
 
 
 
Net operating revenues before provision for doubtful accounts
 
$
20,613

 
 
 
$
21,070

 
 
 
(2.2
)%
Less: Provision for doubtful accounts
 
1,434

 
 
 
1,449

 
 
 
(1.0
)%
Net operating revenues
 
19,179

 
100.0
 %
 
19,621

 
100.0
 %
 
(2.3
)%
Equity in earnings of unconsolidated affiliates
 
144

 
0.8
 %
 
131

 
0.7
 %
 
9.9
 %
Operating expenses:
 
 
 
 
 
 
 
 
 


Salaries, wages and benefits
 
9,274

 
48.4
 %
 
9,328

 
47.5
 %
 
(0.6
)%
Supplies
 
3,085

 
16.1
 %
 
3,124

 
15.9
 %
 
(1.2
)%
Other operating expenses, net
 
4,570

 
23.8
 %
 
4,891

 
25.0
 %
 
(6.6
)%
Electronic health record incentives
 
(9
)
 
0.0
 %
 
(32
)
 
(0.2
)%
 
(71.9
)%
Depreciation and amortization
 
870

 
4.5
 %
 
850

 
4.3
 %
 
 
Impairment and restructuring charges, and acquisition related costs
 
541

 
2.8
 %
 
202

 
1.1
 %
 
 
Litigation and investigation costs
 
23

 
0.1
 %
 
293

 
1.5
 %
 
 
Gains on sales, consolidation and deconsolidation of facilities
 
(144
)
 
(0.7
)%
 
(151
)
 
(0.8
)%
 
 
Operating income
 
1,113

 
5.8
 %
 
1,247

 
6.4
 %
 
 
Interest expense
 
(1,028
)
 
 
 
(979
)
 
 
 
 
Other non-operating expense, net
 
(22
)
 
 
 
(20
)
 
 
 
 
Loss from early extinguishment of debt
 
(164
)
 
 
 

 
 
 
 
Income (loss) from continuing operations, before income taxes
 
(101
)
 
 
 
248

 
 
 
 
Income tax expense
 
(219
)
 
 
 
(67
)
 
 
 
 
Income (loss) from continuing operations, before discontinued operations
 
(320
)
 
 
 
181

 
 
 
 
Discontinued operations:
 
 
 
 
 
 
 
 
 
 
Loss from operations
 

 
 
 
(6
)
 
 
 
 
Income tax benefit
 

 
 
 
1

 
 
 
 
Loss from discontinued operations
 

 
 
 
(5
)
 
 
 
 
Net income (loss)
 
(320
)
 
 
 
176

 
 
 
 
Less: Net income attributable to noncontrolling interests
 
384

 
 
 
368

 
 
 
 
Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(704
)
 
 
 
$
(192
)
 
 
 
 
Amounts attributable to Tenet Healthcare Corporation common shareholders
 
 
 
 
 
 
 
 
 
 
Loss from continuing operations, net of tax
 
$
(704
)
 
 
 
$
(187
)
 
 
 
 
Loss from discontinued operations, net of tax
 

 
 
 
(5
)
 
 
 
 
Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(704
)
 
 
 
$
(192
)
 
 
 
 
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders:
 
 
 
 
 
 
 
 
 
 
Basic
 
 
 
 
 
 
 
 
 
 
Continuing operations
 
$
(7.00
)
 
 
 
$
(1.88
)
 
 
 
 
Discontinued operations
 

 
 
 
(0.05
)
 
 
 
 
 
 
$
(7.00
)
 
 
 
$
(1.93
)
 
 
 
 
Diluted
 
 
 
 
 
 
 
 
 
 
Continuing operations
 
$
(7.00
)
 
 
 
$
(1.88
)
 
 
 
 
Discontinued operations
 

 
 
 
(0.05
)
 
 
 
 
 
 
$
(7.00
)
 
 
 
$
(1.93
)
 
 
 
 
Weighted average shares and dilutive securities outstanding (in thousands):
 
 
 
 
 
 
 
 
 
 
Basic
 
100,592

 
 
 
99,321

 
 
 
 
Diluted*
 
100,592

 
 
 
99,321

 
 
 
 


*Had we generated income from continuing operations in the twelve months ended December 31, 2017 and 2016, the effect of employee stock options, restricted stock units and deferred compensation units on the diluted shares calculation would have been an increase of 788 thousand and 1,421 thousand shares, respectively.



Page 9



TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
(Unaudited)

 
 
 
 
 
 
 
December 31,
 
December 31,
(Dollars in millions)
 
2017
 
2016
ASSETS
 
 
 
 
Current assets:
 
 
 
 
Cash and cash equivalents
 
$
611

 
$
716

Accounts receivable, less allowance for doubtful accounts
 
2,616

 
2,897

Inventories of supplies, at cost
 
289

 
326

Income tax receivable
 
5

 
4

Assets held for sale
 
1,017

 
29

Other current assets
 
1,035

 
1,285

Total current assets 
 
5,573

 
5,257

Investments and other assets
 
1,543

 
1,250

Deferred income taxes
 
455

 
871

Property and equipment, at cost, less accumulated depreciation and amortization
 
7,030

 
8,053

Goodwill
 
7,018

 
7,425

Other intangible assets, at cost, less accumulated amortization
 
1,766

 
1,845

Total assets 
 
$
23,385

 
$
24,701

 
 
 
 
 
LIABILITIES AND EQUITY
 
 
 
 
Current liabilities:
 
 
 
 
Current portion of long-term debt
 
$
146

 
$
191

Accounts payable
 
1,175

 
1,329

Accrued compensation and benefits
 
848

 
872

Professional and general liability reserves
 
200

 
181

Accrued interest payable
 
256

 
210

Liabilities held for sale
 
480

 
9

Other current liabilities
 
1,227

 
1,242

Total current liabilities 
 
4,332

 
4,034

Long-term debt, net of current portion
 
14,791

 
15,064

Professional and general liability reserves
 
654

 
613

Defined benefit plan obligations
 
536

 
626

Deferred income taxes
 
36

 
279

Other long-term liabilities
 
631

 
610

Total liabilities 
 
20,980

 
21,226

Commitments and contingencies
 
 
 
 
Redeemable noncontrolling interests in equity of consolidated subsidiaries
 
1,866

 
2,393

Equity:
 
 
 
 
Shareholders’ equity:
 
 
 
 
Common stock
 
7

 
7

Additional paid-in capital
 
4,859

 
4,827

Accumulated other comprehensive loss
 
(204
)
 
(258
)
Accumulated deficit
 
(2,390
)
 
(1,742
)
Common stock in treasury, at cost
 
(2,419
)
 
(2,417
)
Total shareholders’ equity (deficit)
 
(147
)
 
417

Noncontrolling interests 
 
686

 
665

Total equity
 
539

 
1,082

Total liabilities and equity 
 
$
23,385

 
$
24,701








Page 10



TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF CASH FLOW
(Unaudited)
 
 
Years Ended
(Dollars in millions)
 
December 31,
 
 
2017
 
2016
Net income (loss)
 
$
(320
)
 
$
176

Adjustments to reconcile net income (loss) to net cash provided by operating activities:
 
 

 
 
Depreciation and amortization
 
870

 
850

Provision for doubtful accounts
 
1,434

 
1,449

Deferred income tax expense
 
200

 
41

Stock-based compensation expense
 
59

 
68

Impairment and restructuring charges, and acquisition-related costs
 
541

 
202

Litigation and investigation costs
 
23

 
293

Gains on sales, consolidation and deconsolidation of facilities
 
(144
)
 
(151
)
Loss from early extinguishment of debt
 
164

 

Equity in earnings of unconsolidated affiliates, net of distributions received
 
(18
)
 
(13
)
Amortization of debt discount and debt issuance costs
 
44

 
41

Pre-tax loss from discontinued operations
 

 
6

Other items, net
 
(18
)
 
(1
)
Changes in cash from operating assets and liabilities:
 
 

 
 
Accounts receivable
 
(1,448
)
 
(1,604
)
Inventories and other current assets
 
(35
)
 
(83
)
Income taxes
 
(38
)
 
(8
)
Accounts payable, accrued expenses and other current liabilities
 
(10
)
 
(51
)
Other long-term liabilities
 
26

 
40

Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements
 
(125
)
 
(691
)
Net cash used in operating activities from discontinued operations, excluding income taxes
 
(5
)
 
(6
)
Net cash provided by operating activities
 
1,200

 
558

Cash flows from investing activities:
 
 

 
 
Purchases of property and equipment — continuing operations
 
(707
)
 
(875
)
Purchases of businesses or joint venture interests, net of cash acquired
 
(50
)
 
(117
)
Proceeds from sales of facilities and other assets
 
827

 
573

Proceeds from sales of marketable securities, long-term investments and other assets
 
36

 
62

Purchases of equity investments
 
(68
)
 
(39
)
Other long-term assets
 
(10
)
 
(31
)
Other items, net
 
(7
)
 
(3
)
Net cash provided by (used in) investing activities
 
21

 
(430
)
Cash flows from financing activities:
 
 

 
 
Repayments of borrowings under credit facility
 
(970
)
 
(1,895
)
Proceeds from borrowings under credit facility
 
970

 
1,895

Repayments of other borrowings
 
(4,139
)
 
(154
)
Proceeds from other borrowings
 
3,795

 
760

Debt issuance costs
 
(62
)
 
(12
)
Distributions paid to noncontrolling interests
 
(258
)
 
(218
)
Proceeds from sale of noncontrolling interests
 
31

 
22

Purchases of noncontrolling interests
 
(729
)
 
(186
)
Proceeds from exercise of stock options and employee stock purchase plan
 
7

 
4

Other items, net
 
29

 
16

Net cash provided by (used in) financing activities
 
(1,326
)
 
232

Net increase (decrease) in cash and cash equivalents
 
(105
)
 
360

Cash and cash equivalents at beginning of period
 
716

 
356

Cash and cash equivalents at end of period
 
$
611

 
$
716

Supplemental disclosures:
 
 

 
 
Interest paid, net of capitalized interest
 
$
(939
)
 
$
(932
)
Income tax payments, net
 
$
(56
)
 
$
(33
)

Page 11



TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1) 
(Unaudited)
(Dollars in millions except per patient day,
per admission, per adjusted admission and per visit amounts)
 
Three Months Ended December 31,
 
Years Ended December 31,
 
 
2017
 
2016
 
Change
 
2017
 
2016
 
Change
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Admissions, Patient Days and Surgeries
 
 
 
 
 
 
 
 
 
 
 
 
 
Number of hospitals (at end of period)
 
72

 
75

 
(3
)
*
72

 
75

 
(3
)
*
Total admissions
 
186,185

 
192,104

 
(3.1
)%
 
758,875

 
792,143

 
(4.2
)%
 
Adjusted patient admissions
 
332,642

 
338,929

 
(1.9
)%
 
1,354,266

 
1,389,768

 
(2.6
)%
 
Paying admissions (excludes charity and uninsured)
 
176,158

 
181,617

 
(3.0
)%
 
717,498

 
749,634

 
(4.3
)%
 
Charity and uninsured admissions
 
10,027

 
10,487

 
(4.4
)%
 
41,377

 
42,509

 
(2.7
)%
 
Admissions through emergency department
 
123,887

 
120,549

 
2.8
 %
 
492,660

 
499,335

 
(1.3
)%
 
Paying admissions as a percentage of total admissions
 
94.6
%
 
94.5
%
 
0.1
 %
*
94.5
%
 
94.6
%
 
(0.1
)%
*
Charity and uninsured admissions as a percentage of total admissions
 
5.4
%
 
5.5
%
 
(0.1
)%
*
5.5
%
 
5.4
%
 
0.1
 %
*
Emergency department admissions as a percentage of total admissions
 
66.5
%
 
62.8
%
 
3.7
 %
*
64.9
%
 
63.0
%
 
1.9
 %
*
Surgeries — inpatient
 
50,292

 
53,071

 
(5.2
)%
 
205,114

 
217,906

 
(5.9
)%
 
Surgeries — outpatient
 
68,604

 
73,678

 
(6.9
)%
 
276,895

 
298,974

 
(7.4
)%
 
Total surgeries
 
118,896

 
126,749

 
(6.2
)%
 
482,009

 
516,880

 
(6.7
)%
 
Patient days — total
 
857,728

 
888,185

 
(3.4
)%
 
3,509,056

 
3,690,335

 
(4.9
)%
 
Adjusted patient days
 
1,505,130

 
1,543,490

 
(2.5
)%
 
6,163,961

 
6,395,025

 
(3.6
)%
 
Average length of stay (days)
 
4.61

 
4.62

 
(0.2
)%
 
4.62

 
4.66

 
(0.9
)%
 
Licensed beds (at end of period)
 
19,141

 
20,354

 
(6.0
)%
 
19,141

 
20,354

 
(6.0
)%
 
Average licensed beds
 
19,320

 
20,326

 
(4.9
)%
 
19,995

 
20,651

 
(3.2
)%
 
Utilization of licensed beds
 
48.3
%
 
47.5
%
 
0.8
 %
*
48.1
%
 
48.8
%
 
(0.7
)%
*
Outpatient Visits
 
 
 
 
 
 
 
 
 
 
 
 
 
Total visits
 
1,901,864

 
1,950,549

 
(2.5
)%
 
7,791,125

 
8,144,473

 
(4.3
)%
 
Paying visits (excludes charity and uninsured)
 
1,777,790

 
1,834,844

 
(3.1
)%
 
7,277,514

 
7,577,799

 
(4.0
)%
 
Charity and uninsured visits
 
124,074

 
115,705

 
7.2
 %
 
513,611

 
566,674

 
(9.4
)%
 
Emergency department visits
 
711,268

 
701,100

 
1.5
 %
 
2,854,200

 
2,914,421

 
(2.1
)%
 
Paying visits as a percentage of total visits
 
93.5
%
 
94.1
%
 
(0.6
)%
*
93.4
%
 
93.0
%
 
0.4
 %
*
Charity and uninsured visits as a percentage of total visits
 
6.5
%
 
5.9
%
 
0.6
 %
*
6.6
%
 
7.0
%
 
(0.4
)%
*
Total emergency department admissions and visits
 
835,155

 
821,649

 
1.6
 %
 
3,346,860

 
3,413,756

 
(2.0
)%
 
Revenues
 
 
 
 
 
 
 
 
 
 
 
 
 
Net inpatient revenues
 
$
2,721

 
$
2,606

 
4.4
 %
 
$
10,319

 
$
10,619

 
(2.8
)%
 
Net outpatient revenues
 
$
1,450

 
$
1,457

 
(0.5
)%
 
$
5,869

 
$
5,848

 
0.4
 %
 
Total patient revenues
 
$
4,171

 
$
4,063

 
2.7
 %
 
$
16,188

 
$
16,467

 
(1.7
)%
 
Revenues on a Per Admission, Per Patient Day and Per Visit Basis
 
 
 
 
 
 
 
 
 
 
 
 
 
Net inpatient revenue per admission
 
$
14,614

 
$
13,566

 
7.7
 %
 
$
13,598

 
$
13,405

 
1.4
 %
 
Net inpatient revenue per patient day
 
$
3,172

 
$
2,934

 
8.1
 %
 
$
2,941

 
$
2,878

 
2.2
 %
 
Net outpatient revenue per visit
 
$
762

 
$
747

 
2.0
 %
 
$
753

 
$
718

 
4.9
 %
 
Net patient revenue per adjusted patient admission
 
$
12,539

 
$
11,988

 
4.6
 %
 
$
11,953

 
$
11,849

 
0.9
 %
 
Net patient revenue per adjusted patient day
 
$
2,771

 
$
2,632

 
5.3
 %
 
$
2,626

 
$
2,575

 
2.0
 %
 
Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission(2)
 
$
10,492

 
$
10,264

 
2.2
 %
 
$
10,384

 
$
10,176

 
2.0
 %
 
Net Patient Revenues from:
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
 
18.9
%
 
20.4
%
 
(1.5
)%
*
20.0
%
 
20.5
%
 
(0.5
)%
*
Medicaid
 
11.9
%
 
8.2
%
 
3.7
 %
*
8.1
%
 
8.2
%
 
(0.1
)%
*
Managed care
 
59.6
%
 
61.4
%
 
(1.8
)%
*
61.7
%
 
61.5
%
 
0.2
 %
*
Indemnity, self-pay and other
 
9.6
%
 
10.0
%
 
(0.4
)%
*
10.2
%
 
9.8
%
 
0.4
 %
*



(1) Represents the consolidated results of Tenet’s acute care hospitals and related outpatient facilities included in the Hospital Operations and other segment.
(2) Excludes operating expenses from Tenet's health plans.
* This change is the difference between the 2017 and 2016 amounts shown.

Page 12



TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1) 
(Unaudited)
(Dollars in millions except per patient day,
per admission, per adjusted admission and per visit amounts)
 
Three Months Ended December 31,
 
Years Ended December 31,
 
 
2017
 
2016
 
Change
 
2017
 
2016
 
Change
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Admissions, Patient Days and Surgeries
 
 
 
 
 
 
 
 
 
 
 
 
 
Number of hospitals (at end of period)
 
72

 
72

 

*
72

 
72

 

*
Total admissions
 
184,877

 
184,561

 
0.2
 %
 
738,528

 
753,673

 
(2.0
)%
 
Adjusted patient admissions
 
324,495

 
320,445

 
1.3
 %
 
1,294,913

 
1,310,962

 
(1.2
)%
 
Paying admissions (excludes charity and uninsured)
 
175,025

 
175,026

 
 %
 
699,613

 
715,198

 
(2.2
)%
 
Charity and uninsured admissions
 
9,852

 
9,535

 
3.3
 %
 
38,915

 
38,475

 
1.1
 %
 
Admissions through emergency department
 
123,102

 
116,374

 
5.8
 %
 
480,180

 
476,068

 
0.9
 %
 
Paying admissions as a percentage of total admissions
 
94.7
%
 
94.8
%
 
(0.1
)%
*
94.7
%
 
94.9
%
 
(0.2
)%
*
Charity and uninsured admissions as a percentage of total admissions
 
5.3
%
 
5.2
%
 
0.1
 %
*
5.3
%
 
5.1
%
 
0.2
 %
*
Emergency department admissions as a percentage of total admissions
 
66.6
%
 
63.1
%
 
3.5
 %
*
65.0
%
 
63.2
%
 
1.8
 %
*
Surgeries — inpatient
 
50,070

 
50,971

 
(1.8
)%
 
199,871

 
207,609

 
(3.7
)%
 
Surgeries — outpatient
 
68,432

 
71,129

 
(3.8
)%
 
271,228

 
286,761

 
(5.4
)%
 
Total surgeries
 
118,502

 
122,100

 
(2.9
)%
 
471,099

 
494,370

 
(4.7
)%
 
Patient days — total
 
853,217

 
857,118

 
(0.5
)%
 
3,423,934

 
3,515,087

 
(2.6
)%
 
Adjusted patient days
 
1,485,209

 
1,481,787

 
0.2
 %
 
5,964,002

 
6,080,456

 
(1.9
)%
 
Average length of stay (days)
 
4.62

 
4.64

 
(0.4
)%
 
4.64

 
4.66

 
(0.4
)%
 
Licensed beds (at end of period)
 
19,035

 
19,306

 
(1.4
)%
 
19,035

 
19,306

 
(1.4
)%
 
Average licensed beds
 
19,214

 
19,278

 
(0.3
)%
 
19,277

 
19,315

 
(0.2
)%
 
Utilization of licensed beds
 
48.3
%
 
48.3
%
 
 %
*
48.7
%
 
49.9
%
 
(1.2
)%
*
Outpatient Visits
 
 
 
 
 
 
 
 
 
 
 
 
 
Total visits
 
1,865,781

 
1,869,272

 
(0.2
)%
 
7,495,754

 
7,697,302

 
(2.6
)%
 
Paying visits (excludes charity and uninsured)
 
1,747,285

 
1,757,013

 
(0.6
)%
 
7,028,688

 
7,200,453

 
(2.4
)%
 
Charity and uninsured visits
 
118,496

 
112,259

 
5.6
 %
 
467,066

 
496,849

 
(6.0
)%
 
Emergency department visits
 
676,705

 
650,573

 
4.0
 %
 
2,664,448

 
2,689,519

 
(0.9
)%
 
Paying visits as a percentage of total visits
 
93.6
%
 
94.0
%
 
(0.4
)%
*
93.8
%
 
93.5
%
 
0.3
 %
*
Charity and uninsured visits as a percentage of total visits
 
6.4
%
 
6.0
%
 
0.4
 %
*
6.2
%
 
6.5
%
 
(0.3
)%
*
Total emergency department admissions and visits
 
799,807

 
766,947

 
4.3
 %
 
3,144,628

 
3,165,587

 
(0.7
)%
 
Revenues
 
 
 
 
 
 
 
 
 
 
 
 
 
Net inpatient revenues
 
$
2,695

 
$
2,518

 
7.0
 %
 
$
10,037

 
$
10,089

 
(0.5
)%
 
Net outpatient revenues
 
$
1,431

 
$
1,371

 
4.4
 %
 
$
5,626

 
$
5,452

 
3.2
 %
 
Total patient revenues
 
$
4,126

 
$
3,889

 
6.1
 %
 
$
15,663

 
$
15,541

 
0.8
 %
 
Revenues on a Per Admission, Per Patient Day and Per Visit Basis
 
 
 
 
 
 
 
 
 
 
 
 
 
Net inpatient revenue per admission
 
$
14,577

 
$
13,643

 
6.8
 %
 
$
13,591

 
$
13,386

 
1.5
 %
 
Net inpatient revenue per patient day
 
$
3,159

 
$
2,938

 
7.5
 %
 
$
2,931

 
$
2,870

 
2.1
 %
 
Net outpatient revenue per visit
 
$
767

 
$
733

 
4.6
 %
 
$
751

 
$
708

 
6.1
 %
 
Net patient revenue per adjusted patient admission
 
$
12,715

 
$
12,136

 
4.8
 %
 
$
12,096

 
$
11,855

 
2.0
 %
 
Net patient revenue per adjusted patient day
 
$
2,778

 
$
2,625

 
5.8
 %
 
$
2,626

 
$
2,556

 
2.7
 %
 
Net Patient Revenues from:
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicare
 
18.9
%
 
20.8
%
 
(1.9
)%
*
20.3
%
 
21.0
%
 
(0.7
)%
*
Medicaid
 
12.1
%
 
8.2
%
 
3.9
 %
*
8.1
%
 
8.2
%
 
(0.1
)%
*
Managed care
 
59.3
%
 
61.2
%
 
(1.9
)%
*
61.6
%
 
61.6
%
 
 %
*
Indemnity, self-pay and other
 
9.7
%
 
9.8
%
 
(0.1
)%
*
10.0
%
 
9.2
%
 
0.8
 %
*

(1) Information for our Hospital Operations and other segment is presented on a same-hospital basis, which includes the results of our same 72 hospitals operated throughout the twelve months ended December 31, 2017 and 2016, and associated outpatient facilities but excludes the results of hospitals that Tenet began operating, as well as hospitals Tenet divested, since January 1, 2016.
* This change is the difference between the 2017 and 2016 amounts shown.

Page 13



TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(Dollars in millions except per share amounts)
 
Three Months Ended
 
Year Ended
 
 
3/31/2017
 
6/30/2017
 
9/30/2017
 
12/31/2017
 
12/31/2017
Net operating revenues:
 
 
 
 
 
 
 
 
 
 
Net operating revenues before provision for doubtful accounts
 
$
5,196

 
$
5,173

 
$
4,941

 
$
5,303

 
$
20,613

Less: Provision for doubtful accounts
 
383

 
371

 
355

 
325

 
1,434

Net operating revenues
 
4,813

 
4,802

 
4,586

 
4,978

 
19,179

Equity in earnings of unconsolidated affiliates
 
29

 
28

 
38

 
49

 
144

Operating expenses:
 
 
 
 
 
 
 
 
 
 
Salaries, wages and benefits
 
2,380

 
2,346

 
2,264

 
2,284

 
9,274

Supplies
 
765

 
780

 
740

 
800

 
3,085

Other operating expenses, net
 
1,187

 
1,159

 
1,120

 
1,104

 
4,570

Electronic health record incentives
 
(1
)
 
(6
)
 
(1
)
 
(1
)
 
(9
)
Depreciation and amortization
 
221

 
222

 
219

 
208

 
870

Impairment and restructuring charges, and acquisition-related costs
 
33

 
41

 
329

 
138

 
541

Litigation and investigation costs
 
5

 
1

 
6

 
11

 
23

Gains on sales, consolidation and deconsolidation of facilities
 
(15
)
 
(23
)
 
(104
)
 
(2
)
 
(144
)
Operating income
 
267

 
310

 
51

 
485

 
1,113

Interest expense
 
(258
)
 
(260
)
 
(257
)
 
(253
)
 
(1,028
)
Other non-operating expense, net
 
(5
)
 
(5
)
 
(4
)
 
(8
)
 
(22
)
Loss from early extinguishment of debt
 

 
(26
)
 
(138
)
 

 
(164
)
Income (loss) from continuing operations, before income taxes
 
4

 
19

 
(348
)
 
224

 
(101
)
Income tax benefit (expense)
 
33

 
12

 
60

 
(324
)
 
(219
)
Income (loss) from continuing operations, before discontinued operations
 
37

 
31

 
(288
)
 
(100
)
 
(320
)
Discontinued operations:
 
 
 
 
 
 
 
 
 
 
Income (loss) from operations
 
(2
)
 
2

 
(1
)
 
1

 

Income tax benefit (expense)
 
1

 
(1
)
 

 

 

Income (loss) from discontinued operations
 
(1
)
 
1

 
(1
)
 
1

 

Net income (loss)
 
36

 
32

 
(289
)
 
(99
)
 
(320
)
Less: Net income attributable to noncontrolling interests
 
89

 
87

 
78

 
130

 
384

Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(53
)
 
$
(55
)
 
$
(367
)
 
$
(229
)
 
$
(704
)
Amounts attributable to Tenet Healthcare Corporation common shareholders
 
 
 
 
 
 
 
 
 
 
Loss from continuing operations, net of tax
 
$
(52
)
 
$
(56
)
 
$
(366
)
 
$
(230
)
 
$
(704
)
Income (loss) from discontinued operations, net of tax
 
(1
)
 
1

 
(1
)
 
1

 

Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(53
)
 
$
(55
)
 
$
(367
)
 
$
(229
)
 
$
(704
)
Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders:
 
 
 
 
 
 
 
 
 
 
Basic
 
 
 
 
 
 
 
 
 
 
Continuing operations
 
$
(0.52
)
 
$
(0.56
)
 
$
(3.63
)
 
$
(2.28
)
 
$
(7.00
)
Discontinued operations
 
(0.01
)
 
0.01

 
(0.01
)
 
0.01

 

 
 
$
(0.53
)
 
$
(0.55
)
 
$
(3.64
)
 
$
(2.27
)
 
$
(7.00
)
Diluted
 
 
 
 
 
 
 
 
 
 
Continuing operations
 
$
(0.52
)
 
$
(0.56
)
 
$
(3.63
)
 
$
(2.28
)
 
$
(7.00
)
Discontinued operations
 
(0.01
)
 
0.01

 
(0.01
)
 
0.01

 

 
 
$
(0.53
)
 
$
(0.55
)
 
$
(3.64
)
 
$
(2.27
)
 
$
(7.00
)
Weighted average shares and dilutive securities outstanding in thousands):
 
 
 
 
 
 
 
 
 
 
Basic
 
100,000

 
100,612

 
100,812

 
100,945

 
100,592

Diluted
 
100,000

 
100,612

 
100,812

 
100,945

 
100,592


Page 14



TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS(1) 
(Unaudited)
(Dollars in millions except per patient day,
per admission, per adjusted admission and
per visit amounts)
 
Three Months Ended
 
Year Ended
 
3/31/2017
 
6/30/2017
 
9/30/2017
 
12/31/2017
 
12/31/2017
 
 
 
 
 
 
 
 
 
 
 
Admissions, Patient Days and Surgeries
 
 
 
 
 
 
 
 
 
 
Number of hospitals (at end of period)
 
76

 
76

 
73

 
72

 
72

Total admissions
 
196,907

 
190,394

 
185,389

 
186,185

 
758,875

Adjusted patient admissions
 
347,150

 
342,439

 
332,035

 
332,642

 
1,354,266

Paying admissions (excludes charity and uninsured)
 
186,648

 
179,889

 
174,803

 
176,158

 
717,498

Charity and uninsured admissions
 
10,259

 
10,505

 
10,586

 
10,027

 
41,377

Admissions through emergency department
 
126,473

 
121,807

 
120,493

 
123,887

 
492,660

Paying admissions as a percentage of total admissions
 
94.8
%
 
94.5
%
 
94.3
%
 
94.6
%
 
94.5
%
Charity and uninsured admissions as a percentage of total admissions
 
5.2
%
 
5.5
%
 
5.7
%
 
5.4
%
 
5.5
%
Emergency department admissions as a percentage of total admissions
 
64.2
%
 
64.0
%
 
65.0
%
 
66.5
%
 
64.9
%
Surgeries — inpatient
 
51,800

 
52,083

 
50,939

 
50,292

 
205,114

Surgeries — outpatient
 
69,604

 
71,366

 
67,321

 
68,604

 
276,895

Total surgeries
 
121,404

 
123,449

 
118,260

 
118,896

 
482,009

Patient days — total
 
923,339

 
874,930

 
853,059

 
857,728

 
3,509,056

Adjusted patient days
 
1,603,698

 
1,552,302

 
1,502,831

 
1,505,130

 
6,163,961

Average length of stay (days)
 
4.69

 
4.60

 
4.60

 
4.61

 
4.62

Licensed beds (at end of period)
 
20,439

 
20,435

 
19,433

 
19,141

 
19,141

Average licensed beds
 
20,440

 
20,435

 
19,783

 
19,320

 
19,995

Utilization of licensed beds
 
50.2
%
 
47.0
%
 
46.9
%
 
48.3
%
 
48.1
%
Outpatient Visits
 
 
 
 
 
 
 
 
 
 
Total visits
 
2,039,942

 
1,981,848

 
1,867,471

 
1,901,864

 
7,791,125

Paying visits (excludes charity and uninsured)
 
1,908,212

 
1,849,697

 
1,741,815

 
1,777,790

 
7,277,514

Charity and uninsured visits
 
131,730

 
132,151

 
125,656

 
124,074

 
513,611

Emergency department visits
 
733,051

 
724,785

 
685,096

 
711,268

 
2,854,200

Paying visits as a percentage of total visits
 
93.5
%
 
93.3
%
 
93.3
%
 
93.5
%
 
93.4
%
Charity and uninsured visits as a percentage of total visits
 
6.5
%
 
6.7
%
 
6.7
%
 
6.5
%
 
6.6
%
Total emergency department admissions and visits
 
859,524

 
846,592

 
805,589

 
835,155

 
3,346,860

Revenues
 
 
 
 
 
 
 
 
 
 
Net inpatient revenues
 
$
2,609

 
$
2,555

 
$
2,434

 
$
2,721

 
$
10,319

Net outpatient revenues
 
$
1,482

 
$
1,511

 
$
1,426

 
$
1,450

 
$
5,869

Total patient revenues
 
$
4,091

 
$
4,066

 
$
3,860

 
$
4,171

 
$
16,188

Revenues on a Per Admission, Per Patient Day and Per Visit Basis
 
 
 
 
 
 
 
 
 
 
Net inpatient revenue per admission
 
$
13,250

 
$
13,420

 
$
13,129

 
$
14,614

 
$
13,598

Net inpatient revenue per patient day
 
$
2,826

 
$
2,920

 
$
2,853

 
$
3,172

 
$
2,941

Net outpatient revenue per visit
 
$
726

 
$
762

 
$
764

 
$
762

 
$
753

Net patient revenue per adjusted patient admission
 
$
11,785

 
$
11,874

 
$
11,625

 
$
12,539

 
$
11,953

Net patient revenue per adjusted patient day
 
$
2,551

 
$
2,619

 
$
2,568

 
$
2,771

 
$
2,626

Total selected operating expenses (salaries, wages and benefits, supplies and other operating expenses) per adjusted patient admission(2)
 
$
10,290

 
$
10,394

 
$
10,367

 
$
10,492

 
$
10,384

Net Patient Revenues from:
 
 
 
 
 
 
 
 
 
 
Medicare
 
21.0
%
 
20.1
%
 
20.0
%
 
18.9
%
 
20.0
%
Medicaid
 
6.7
%
 
6.9
%
 
6.5
%
 
11.9
%
 
8.1
%
Managed care
 
62.3
%
 
62.5
%
 
62.5
%
 
59.6
%
 
61.7
%
Indemnity, self-pay and other
 
10.0
%
 
10.5
%
 
11.0
%
 
9.6
%
 
10.2
%

(1)
Represents the consolidated results of Tenet’s acute care hospitals and related outpatient facilities included in the Hospital Operations and other segment.
(2)
Excludes operating expenses from Tenet's health plans.

Page 15



TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1) 
(Unaudited)
(Dollars in millions except per patient day,
per admission, per adjusted admission and
per visit amounts)
 
Three Months Ended
 
 
 
Year Ended
 
3/31/2017
 
6/30/2017
 
9/30/2017
 
12/31/2017
 
12/31/2017
 
 
 
 
 
 
 
 
 
 
 
Admissions, Patient Days and Surgeries
 
 
 
 
 
 
 
 
 
 
Number of hospitals (at end of period)
 
72

 
72

 
72

 
72

 
72

Total admissions
 
189,071

 
182,610

 
181,970

 
184,877

 
738,528

Adjusted patient admissions
 
326,533

 
323,064

 
320,821

 
324,495

 
1,294,913

Paying admissions (excludes charity and uninsured)
 
179,763

 
173,034

 
171,791

 
175,025

 
699,613

Charity and uninsured admissions
 
9,308

 
9,576

 
10,179

 
9,852

 
38,915

Admissions through emergency department
 
121,749

 
116,968

 
118,361

 
123,102

 
480,180

Paying admissions as a percentage of total admissions
 
95.1
%
 
94.8
%
 
94.4
%
 
94.7
%
 
94.7
%
Charity and uninsured admissions as a percentage of total admissions
 
4.9
%
 
5.2
%
 
5.6
%
 
5.3
%
 
5.3
%
Emergency department admissions as a percentage of total admissions
 
64.4
%
 
64.1
%
 
65.0
%
 
66.6
%
 
65.0
%
Surgeries — inpatient
 
49,735

 
49,992

 
50,074

 
50,070

 
199,871

Surgeries — outpatient
 
67,375

 
68,939

 
66,482

 
68,432

 
271,228

Total surgeries
 
117,110

 
118,931

 
116,556

 
118,502

 
471,099

Patient days — total
 
889,667

 
842,835

 
838,215

 
853,217

 
3,423,934

Adjusted patient days
 
1,527,316

 
1,485,211

 
1,466,266

 
1,485,209

 
5,964,002

Average length of stay (days)
 
4.71

 
4.62

 
4.61

 
4.62

 
4.64

Licensed beds (at end of period)
 
19,285

 
19,281

 
19,327

 
19,035

 
19,035

Average licensed beds
 
19,286

 
19,281

 
19,328

 
19,214

 
19,277

Utilization of licensed beds
 
51.3
%
 
48.0
%
 
47.1
%
 
48.3
%
 
48.7
%
Outpatient Visits
 
 
 
 
 
 
 
 
 
 
Total visits
 
1,937,168

 
1,879,210

 
1,813,595

 
1,865,781

 
7,495,754

Paying visits (excludes charity and uninsured)
 
1,821,837

 
1,763,098

 
1,696,468

 
1,747,285

 
7,028,688

Charity and uninsured visits
 
115,331

 
116,112

 
117,127

 
118,496

 
467,066

Emergency department visits
 
674,547

 
666,865

 
646,331

 
676,705

 
2,664,448

Paying visits as a percentage of total visits
 
94.0
%
 
93.8
%
 
93.5
%
 
93.6
%
 
93.8
%
Charity and uninsured visits as a percentage of total visits
 
6.0
%
 
6.2
%
 
6.5
%
 
6.4
%
 
6.2
%
Total emergency department admissions and visits
 
796,296

 
783,833

 
764,692

 
799,807

 
3,144,628

Revenues
 
 
 
 
 
 
 
 
 
 
Net inpatient revenues
 
$
2,505

 
$
2,446

 
$
2,391

 
$
2,695

 
$
10,037

Net outpatient revenues
 
$
1,390

 
$
1,419

 
$
1,386

 
$
1,431

 
$
5,626

Total patient revenues
 
$
3,895

 
$
3,865

 
$
3,777

 
$
4,126

 
$
15,663

Revenues on a Per Admission, Per Patient Day and Per Visit Basis
 
 
 
 
 
 
 
 
 
 
Net inpatient revenue per admission
 
$
13,249

 
$
13,395

 
$
13,140

 
$
14,577

 
$
13,591

Net inpatient revenue per patient day
 
$
2,816

 
$
2,902

 
$
2,852

 
$
3,159

 
$
2,931

Net outpatient revenue per visit
 
$
718

 
$
755

 
$
764

 
$
767

 
$
751

Net patient revenue per adjusted patient admission
 
$
11,928

 
$
11,964

 
$
11,773

 
$
12,715

 
$
12,096

Net patient revenue per adjusted patient day
 
$
2,550

 
$
2,602

 
$
2,576

 
$
2,778

 
$
2,626

Net Patient Revenues from:
 
 
 
 
 
 
 
 
 
 
Medicare
 
21.6
%
 
20.6
%
 
20.1
%
 
18.9
%
 
20.3
%
Medicaid
 
6.8
%
 
6.8
%
 
6.6
%
 
12.1
%
 
8.1
%
Managed care
 
62.2
%
 
62.6
%
 
62.3
%
 
59.3
%
 
61.6
%
Indemnity, self-pay and other
 
9.4
%
 
10.0
%
 
11.0
%
 
9.7
%
 
10.0
%

(1) Information for our Hospital Operations and other segment is presented on a same-hospital basis, which includes the results of our same 72 hospitals operated throughout the twelve months ended December 31, 2017 and 2016, and associated outpatient facilities but excludes the results of hospitals that Tenet began operating, as well as hospitals Tenet divested, since January 1, 2016.

Page 16



TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS(1) 
(Unaudited)
(Dollars in millions except per patient day, per
admission, per adjusted admission and per
visit amounts)
Three Months Ended
 
Year Ended
3/31/2016
 
6/30/2016
 
9/30/2016
 
12/31/2016
 
12/31/2016
 
 
 
 
 
 
 
 
 
 
Admissions, Patient Days and Surgeries
 
 
 
 
 
 
 
 
 
Number of hospitals (at end of period)
72

 
72

 
72

 
72

 
72

Total admissions
195,679

 
186,668

 
186,765

 
184,561

 
753,673

Adjusted patient admissions
335,006

 
327,551

 
327,960

 
320,445

 
1,310,962

Paying admissions (excludes charity and uninsured)
186,706

 
177,090

 
176,376

 
175,026

 
715,198

Charity and uninsured admissions
8,973

 
9,578

 
10,389

 
9,535

 
38,475

Admissions through emergency department
125,406

 
118,054

 
116,234

 
116,374

 
476,068

Paying admissions as a percentage of total admissions
95.4
%
 
94.9
%
 
94.4
%
 
94.8
%
 
94.9
%
Charity and uninsured admissions as a percentage of total admissions
4.6
%
 
5.1
%
 
5.6
%
 
5.2
%
 
5.1
%
Emergency department admissions as a percentage of total admissions
64.1
%
 
63.2
%
 
62.2
%
 
63.1
%
 
63.2
%
Surgeries - inpatient
51,719

 
52,363

 
52,556

 
50,971

 
207,609

Surgeries - outpatient
72,054

 
73,372

 
70,206

 
71,129

 
286,761

Total surgeries
123,773

 
125,735

 
122,762

 
122,100

 
494,370

Patient days - total
929,061

 
865,808

 
863,100

 
857,118

 
3,515,087

Adjusted patient days
1,579,483

 
1,510,969

 
1,508,217

 
1,481,787

 
6,080,456

Average length of stay (days)
4.75

 
4.64

 
4.62

 
4.64

 
4.66

Licensed beds (at end of period)
19,332

 
19,332

 
19,292

 
19,306

 
19,306

Average licensed beds
19,327

 
19,332

 
19,319

 
19,278

 
19,315

Utilization of licensed beds
53.4
%
 
49.2
%
 
48.6
%
 
48.3
%
 
49.9
%
Outpatient Visits
 
 
 
 
 
 
 
 
 
Total visits
1,969,133

 
1,945,124

 
1,913,773

 
1,869,272

 
7,697,302

Paying visits (excludes charity and uninsured)
1,841,053

 
1,819,407

 
1,782,980

 
1,757,013

 
7,200,453

Charity and uninsured visits
128,080

 
125,717

 
130,793

 
112,259

 
496,849

Emergency department visits
702,777

 
673,544

 
662,625

 
650,573

 
2,689,519

Paying visits as a percentage of total visits
93.5
%
 
93.5
%
 
93.2
%
 
94.0
%
 
93.5
%
Charity and uninsured visits as a percentage of total visits
6.5
%
 
6.5
%
 
6.8
%
 
6.0
%
 
6.5
%
Total emergency department admissions and visits
828,183

 
791,598

 
778,859

 
766,947

 
3,165,587

Revenues
 
 
 
 
 
 
 
 
 
Net inpatient revenues
$
2,568

 
$
2,470

 
$
2,533

 
$
2,518

 
$
10,089

Net outpatient revenues
$
1,370

 
$
1,377

 
$
1,334

 
$
1,371

 
$
5,452

Total patient revenues
$
3,938

 
$
3,847

 
$
3,867

 
$
3,889

 
$
15,541

Revenues on a Per Admission, Per Patient Day and Per Visit Basis
 
 
 
 
 
 
 
 
 
Net inpatient revenue per admission
$
13,124

 
$
13,232

 
$
13,562

 
$
13,643

 
$
13,386

Net inpatient revenue per patient day
$
2,764

 
$
2,853

 
$
2,935

 
$
2,938

 
$
2,870

Net outpatient revenue per visit
$
696

 
$
708

 
$
697

 
$
733

 
$
708

Net patient revenue per adjusted patient admission
$
11,755

 
$
11,745

 
$
11,791

 
$
12,136

 
$
11,855

Net patient revenue per adjusted patient day
$
2,493

 
$
2,546

 
$
2,564

 
$
2,625

 
$
2,556

Net Patient Revenues from:
 
 
 
 
 
 
 
 
 
Medicare
20.4
%
 
22.3
%
 
20.5
%
 
20.8
%
 
21.0
%
Medicaid
8.7
%
 
7.6
%
 
8.4
%
 
8.2
%
 
8.2
%
Managed care
61.7
%
 
59.5
%
 
64.3
%
 
61.2
%
 
61.6
%
Indemnity, self-pay and other
9.2
%
 
10.6
%
 
6.8
%
 
9.8
%
 
9.2
%

(1) Information for our Hospital Operations and other segment is presented on a same-hospital basis, which includes the results of our same 72 hospitals operated throughout the twelve months ended December 31, 2017 and 2016, and associated outpatient facilities but excludes the results of hospitals that Tenet began operating, as well as hospitals Tenet divested, since January 1, 2016.

Page 17



TENET HEALTHCARE CORPORATION
SEGMENT REPORTING
(Unaudited)

(Dollars in millions)
 
 
 
 
 
December 31,
 
December 31,
 
 
 
 
 
 
2017
 
2016
Assets
 
 
 
 
 
 
 
 
Hospital Operations and other
 
 
 
 
 
$
16,466

 
$
17,871

Ambulatory Care
 
 
 
 
 
5,822

 
5,722

Conifer
 
 
 
 
 
1,097

 
1,108

Total
 
 
 
 
 
$
23,385

 
$
24,701

 
 
 
 
 
 
 
 
 
 
 
Three Months Ended
 
Years Ended
 
 
December 31,
 
December 31,
 
 
2017
 
2016
 
2017
 
2016
Capital expenditures:
 
 
 
 
 
 
 
 
Hospital Operations and other
 
$
184

 
$
242

 
$
625

 
$
799

Ambulatory Care
 
23

 
9

 
60

 
51

Conifer
 
8

 
10

 
22

 
25

Total
 
$
215

 
$
261

 
$
707

 
$
875

 
 
 
 
 
 
 
 
 
Net operating revenues:
 
 
 
 
 
 
 
 
Hospital Operations and other total prior to inter-segment eliminations(1)
 
$
4,194

 
$
4,143

 
$
16,260

 
$
16,904

Ambulatory Care
 
545

 
478

 
1,940

 
1,797

Conifer
 
 
 
 
 
 
 
 
Tenet
 
155

 
163

 
618

 
651

Other clients
 
239

 
239

 
979

 
920

Total Conifer revenues
 
394

 
402

 
1,597

 
1,571

Inter-segment eliminations
 
(155
)
 
(163
)
 
(618
)
 
(651
)
Total
 
$
4,978

 
$
4,860

 
$
19,179

 
$
19,621

 
 
 
 
 
 
 
 
 
Equity in earnings of unconsolidated affiliates:
 
 
 
 
 
 
 
 
Hospital Operations and other
 
$

 
$
3

 
$
4

 
$
9

Ambulatory Care
 
49

 
43

 
140

 
122

Total
 
$
49

 
$
46

 
$
144

 
$
131

 
 
 
 
 
 
 
 
 
Adjusted EBITDA:
 
 
 
 
 
 
 
 
Hospital Operations and other(2)
 
$
538

 
$
395

 
$
1,462

 
$
1,586

Ambulatory Care
 
223

 
183

 
699

 
615

Conifer
 
79

 
72

 
283

 
277

Total
 
$
840

 
$
650

 
$
2,444

 
$
2,478

 
 
 
 
 
 
 
 
 
Depreciation and amortization:
 
 
 
 
 
 
 
 
Hospital Operations and other
 
$
176

 
$
184

 
$
736

 
$
709

Ambulatory Care
 
18

 
22

 
84

 
91

Conifer
 
14

 
12

 
50

 
50

Total
 
$
208

 
$
218

 
$
870

 
$
850

 
(1)
Hospital Operations and other revenues includes health plan revenues of $10 million and $110 million for the three and twelve months ended December 31, 2017, respectively and $97 million and $482 million for the three and twelve months ended December 31, 2016, respectively.
(2)
Hospital Operations and other Adjusted EBITDA excludes health plan EBITDA of less than one million and $(41) million for the three and twelve months ended December 31, 2017, respectively and $(29) million and $(37) million for the three and twelve months ended December 31, 2016, respectively.


Page 18



TENET HEALTHCARE CORPORATION
STATEMENT OF OPERATIONS – AMBULATORY CARE SEGMENT
(Unaudited)
 
 
 
 
 
 
 
 
 
(Dollars in millions)
 
Three Months Ended December 31,
 
 
2017
 
2016
 
 
 
 
 
 
 
 
 
 
 
Ambulatory Care as Reported Under GAAP
 
Unconsolidated Affiliates
 
Ambulatory Care as Reported Under GAAP
 
Unconsolidated Affiliates
Net operating revenues:
 
 
 
 
 
 
 
 
Net operating revenues before provision for doubtful accounts
 
$
556

 
$
625

 
$
487

 
$
582

Less: Provision for doubtful accounts
 
(11
)
 
(10
)
 
(9
)
 
(12
)
Net operating revenues(1)
 
545

 
615

 
478

 
570

Equity in earnings of unconsolidated affiliates(2)
 
49

 

 
43

 

Operating expenses:
 
 
 
 
 
 
 
 
Salaries, wages and benefits
 
165

 
131

 
157

 
124

Supplies
 
113

 
157

 
99

 
145

Other operating expenses, net
 
93

 
104

 
83

 
101

Electronic health record incentives
 

 

 
(1
)
 

Depreciation and amortization
 
18

 
16

 
22

 
17

Impairment and restructuring charges, and acquisition-related costs
 
4

 

 
17

 

(Gains) losses on sales, consolidation and deconsolidation of facilities
 
(2
)
 

 

 
4

Operating income
 
203

 
207

 
144

 
179

Interest expense
 
(36
)
 
(5
)
 
(35
)
 
(6
)
Other non-operating income (expense), net
 
1

 
(1
)
 
2

 

Income from continuing operations, before income taxes
 
168

 
201

 
111

 
173

Income tax benefit (expense)
 
73

 
(3
)
 
(17
)
 
(3
)
Net income
 
241

 
$
198

 
94

 
$
170

Less: Net income attributable to noncontrolling interests(3)
 
111

 
 
 
81

 
 
Net income attributable to Tenet Healthcare Corporation common shareholders
 
$
130

 
 
 
$
13

 
 
Equity in earnings of unconsolidated affiliates
 
 
 
$
49

 
 
 
$
43


(1)
On a same-facility system-wide basis, net revenue in Tenet’s Ambulatory Care segment increased 6.9% during the three months ended December 31, 2017, with cases increasing 4.6% and revenue per case increasing 2.2%.
(2)
At December 31, 2017, 106 of the 333 facilities in the Company’s Ambulatory segment were not consolidated based on the nature of the segment’s joint venture relationships with physicians and prominent healthcare systems. Although revenues of the segment’s unconsolidated facilities are not recorded as revenues by the Company, equity in earnings of unconsolidated affiliates is nonetheless a significant portion of the Company’s overall earnings. To help analyze results of operations, management also uses system-wide operating measures such as system-wide revenue growth, which includes revenues of both consolidated and unconsolidated facilities. We control our remaining 227 facilities and account for these investments as consolidated subsidiaries
(3)
During the three months ended December 31, 2017, the Company recorded $22 million of noncontrolling interests expense on a tax benefit of $109 million, as a result of the reduction in the corporate income tax rate from 35% to 21%.
 

Page 19



TENET HEALTHCARE CORPORATION
STATEMENT OF OPERATIONS – AMBULATORY CARE SEGMENT
(Unaudited)
 
 
 
 
 
 
 
 
 
(Dollars in millions)
 
Years Ended December 31,
 
 
2017
 
2016
 
 
 
 
 
 
 
 
 
 
 
Ambulatory Care as Reported Under GAAP
 
Unconsolidated Affiliates
 
Ambulatory Care as Reported Under GAAP
 
Unconsolidated Affiliates
Net operating revenues:
 
 
 
 
 
 
 
 
Net operating revenues before provision for doubtful accounts
 
$
1,978

 
$
2,117

 
$
1,833

 
$
2,073

Less: Provision for doubtful accounts
 
(38
)
 
(41
)
 
(36
)
 
(53
)
Net operating revenues(1)
 
1,940

 
2,076

 
1,797

 
2,020

Equity in earnings of unconsolidated affiliates(2)
 
140

 

 
122

 

Operating expenses:
 

 

 

 

Salaries, wages and benefits
 
623

 
483

 
594

 
477

Supplies
 
398

 
540

 
365

 
520

Other operating expenses, net
 
360

 
394

 
346

 
404

Electronic health record incentives
 

 

 
(1
)
 

Depreciation and amortization
 
84

 
65

 
91

 
68

Impairment and restructuring charges, and acquisition-related costs
 
74

 
1

 
26

 
1

(Gains) losses on sales, consolidation and deconsolidation of facilities
 
(9
)
 

 
(33
)
 
7

Operating income
 
550

 
593

 
531

 
543

Interest expense
 
(145
)
 
(22
)
 
(140
)
 
(24
)
Other non-operating income (expense), net
 
6

 
(1
)
 
2

 
6

Income from continuing operations, before income taxes
 
411

 
570

 
393

 
525

Income tax benefit (expense)
 
15

 
(9
)
 
(54
)
 
(8
)
Net Income
 
426

 
$
561

 
339

 
$
517

Less: Net income attributable to noncontrolling interests(3)
 
304

 
 
 
285

 
 
Net income attributable to Tenet Healthcare Corporation common shareholders
 
$
122

 
 
 
$
54

 
 
Equity in earnings of unconsolidated affiliates
 
 
 
$
140

 
 
 
$
122


(1)
On a same-facility system-wide basis, net revenue in Tenet’s Ambulatory Care segment increased 4.6% during the twelve months ended December 31, 2017, with cases increasing 0.6% and revenue per case increasing 3.9%.
(2)
At December 31, 2017, 106 of the 333 facilities in the Company’s Ambulatory segment were not consolidated based on the nature of the segment’s joint venture relationships with physicians and prominent healthcare systems. Although revenues of the segment’s unconsolidated facilities are not recorded as revenues by the Company, equity in earnings of unconsolidated affiliates is nonetheless a significant portion of the Company’s overall earnings. To help analyze results of operations, management also uses system-wide operating measures such as system-wide revenue growth, which includes revenues of both consolidated and unconsolidated facilities. We control our remaining 227 facilities and account for these investments as consolidated subsidiaries.
(3)
During the twelve months ended December 31, 2017, the Company recorded $22 million of noncontrolling interests expense on a tax benefit of $109 million, as a result of the reduction in the corporate income tax rate from 35% to 21%. During the twelve months ended December 31, 2016, the Company recorded $14 million of noncontrolling interests expense related to a $33 million gain on the consolidation of facilities (the gain is not included in Adjusted EBITDA) and an associated $7 million income tax benefit, net of $26 million of impairment and restructuring charges, and acquisition-related costs not included in Adjusted EBITDA.

Page 20




Non-GAAP Financial Measures
Adjusted EBITDA, a non-GAAP measure, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common shareholders before (1) the cumulative effect of changes in accounting principle, (2) net loss (income) attributable to noncontrolling interests, (3) income (loss) from discontinued operations, (4) income tax benefit (expense), (5) other non-operating income (expense), net, (6) gain (loss) from early extinguishment of debt, (7) interest expense, (8) litigation and investigation (costs) benefit, net of insurance recoveries, (9) net gains (losses) on sales, consolidation and deconsolidation of facilities, (10) impairment and restructuring charges and acquisition-related costs, (11) depreciation and amortization and (12) income (loss) from divested operations and closed businesses (i.e., the Company’s health plan businesses). Litigation and investigation costs do not include ordinary course of business malpractice and other litigation and related expense.
Adjusted net income (loss) from continuing operations attributable to Tenet Healthcare Corporation common shareholders, a non-GAAP measure, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common shareholders before (1) impairment and restructuring charges, and acquisition-related costs, (2) litigation and investigation costs, (3) gains on sales, consolidation and deconsolidation of facilities, (4) gain (loss) from early extinguishment of debt, (5) income (loss) from divested operations and closed businesses, (6) the associated impact of these five items on taxes and noncontrolling interests, and (7) income (loss) from discontinued operations. Adjusted diluted earnings (loss) per share from continuing operations, a non-GAAP term, is defined by the Company as Adjusted net income (loss) from continuing operations attributable to Tenet Healthcare Corporation common shareholders divided by the weighted average primary or diluted shares outstanding in the reporting period.
Free Cash Flow, a non-GAAP measure, is defined by the Company as (1) net cash provided by (used in) operating activities, less (2) purchases of property and equipment from continuing operations.
Adjusted Free Cash Flow, a non-GAAP measure, is defined by the Company as (1) Adjusted net cash provided by (used in) operating activities from continuing operations, less (2) purchases of property and equipment from continuing operations. Adjusted net cash provided by (used in) operating activities, a non-GAAP measure, is defined by the Company as cash provided by (used in) operating activities prior to (1) payments for restructuring charges, acquisition-related costs and litigation costs and settlements, and (2) net cash provided by (used in) operating activities from discontinued operations.
The Company believes the foregoing non-GAAP measures are useful to investors and analysts because they present additional information on the Company’s financial performance. Investors, analysts, Company management and the Company’s Board of Directors utilize these non-GAAP measures, in addition to GAAP measures, to track the Company’s financial and operating performance and compare the Company’s performance to its peer companies, which utilize similar non-GAAP measures in their presentations. The Human Resources Committee of the Company’s Board of Directors also uses certain of these measures to evaluate management’s performance for the purpose of determining incentive compensation. Additional information regarding the purpose and utility of specific non-GAAP measures used in this release is set forth below.
The Company believes that Adjusted EBITDA is a useful measure, in part, because certain investors and analysts use both historical and projected Adjusted EBITDA, in addition to other GAAP and non-GAAP measures, as factors in determining the estimated fair value of shares of the Company’s common stock. Company management also regularly reviews the Adjusted EBITDA performance for each operating segment. The Company does not use Adjusted EBITDA to measure liquidity, but instead to measure operating performance.
We use, and we believe investors and analysts use, Free Cash Flow and Adjusted Free Cash Flow as supplemental measures to analyze cash flows generated from our operations because we believe it is useful to investors in evaluating our ability to fund distributions paid to noncontrolling interests, acquisitions, purchasing equity interests in joint ventures or repaying debt.
These non-GAAP measures may not be comparable to similarly titled measures reported by other companies. Because these measures exclude many items that are included in our financial statements, they do not provide a complete measure of our operating performance. For example, the Company’s definitions of Free Cash Flow and Adjusted Free Cash Flow do not include other important uses of cash including (1) cash used to purchase businesses or joint venture interests, or (2) any items that are classified as Cash Flows From Financing Activities on the Company’s Consolidated Statement of Cash Flows, including items such as (i) cash used to repay borrowings, (ii) distributions paid to noncontrolling interests, or (iii) payments under the Put/Call Agreement for USPI redeemable noncontrolling interest, which are recorded on the Statement of Cash Flows as the purchase of noncontrolling interest. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance.
A reconciliation of Adjusted EBITDA to net income (loss) attributable to Tenet Healthcare Corporation common shareholders, the most comparable GAAP measure, is set forth in Table #1 below for the three and twelve months ended December 31, 2017 and 2016. A reconciliation of Adjusted net income from continuing operations attributable to Tenet Healthcare Corporation common shareholders to net income (loss) attributable to Tenet Healthcare Corporation common shareholders, the most comparable GAAP measure, is set forth in Table #2 below for the three and twelve months ended December 31, 2017 and 2016. A reconciliation of Free Cash Flow and Adjusted Free Cash Flow to net cash provided by (used in) operating activities, the most comparable GAAP measure, is set forth in Table #3 below for the three and twelve months ended December 31, 2017 and 2016.


Page 21



TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #1 – Reconciliation of Adjusted EBITDA to Net Loss
Attributable to Tenet Healthcare Corporation Common Shareholders
(Unaudited)
 
 
 
 
 
 
 
 
 
(Dollars in millions)
 
Three Months Ended
 
Years Ended
 
 
December 31,
 
December 31,
 
 
2017
 
2016
 
2017
 
2016
Net loss attributable to Tenet Healthcare Corporation common shareholders
 
$
(229
)
 
$
(79
)
 
$
(704
)
 
$
(192
)
Less: Net income attributable to noncontrolling interests
 
(130
)
 
(102
)
 
(384
)
 
(368
)
Income (loss) from discontinued operations, net of tax
 
1

 

 

 
(5
)
Income (loss) from continuing operations
 
(100
)
 
23

 
(320
)
 
181

Income tax expense
 
(324
)
 
(6
)
 
(219
)
 
(67
)
Loss from early extinguishment of debt
 

 

 
(164
)
 

Other non-operating expense, net
 
(8
)
 
(2
)
 
(22
)
 
(20
)
Interest expense
 
(253
)
 
(249
)
 
(1,028
)
 
(979
)
Operating income
 
485

 
280

 
1,113

 
1,247

Litigation and investigation costs
 
(11
)
 
(2
)
 
(23
)
 
(293
)
Gains on sales, consolidation and deconsolidation of facilities
 
2

 

 
144

 
151

Impairment and restructuring charges, and acquisition-related costs
 
(138
)
 
(121
)
 
(541
)
 
(202
)
Depreciation and amortization
 
(208
)
 
(218
)
 
(870
)
 
(850
)
Loss from divested and closed businesses
 

 
(29
)
 
(41
)
 
(37
)
Adjusted EBITDA
 
$
840

 
$
650

 
$
2,444

 
$
2,478

 
 
 
 
 
 
 
 
 
Net operating revenues
 
$
4,978

 
$
4,860

 
$
19,179

 
$
19,621

Less: Net operating revenues from health plans
 
10

 
97

 
110

 
482

Adjusted net operating revenues
 
$
4,968

 
$
4,763

 
$
19,069

 
$
19,139

 
 
 
 
 
 
 
 
 
Net loss attributable to Tenet Healthcare Corporation common shareholders as a % of net operating revenues
 
(4.6
)%
 
(1.6
)%
 
(3.7
)%
 
(1.0
)%
 
 
 
 
 
 
 
 
 
Adjusted EBITDA as % of adjusted net operating revenues (Adjusted EBITDA margin)
 
16.9
 %
 
13.6
 %
 
12.8
 %
 
12.9
 %









Page 22





TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #2 – Pre-Tax, After-Tax and Earnings (Loss) Per Share Impact of Certain Items
on Continuing Operations
(Unaudited)
 
 
 
 
 
 
 
 
 
 
 
Three Months Ended
 
Years Ended
(Dollars in millions except per share amounts)
 
December 31,
 
December 31,
 
 
2017
 
2016
 
2017
 
2016
Adjustments to calculate Adjusted Diluted EPS
 
Impairment and restructuring charges, and acquisition-related costs(1)
 
$
(138
)
 
$
(121
)
 
$
(541
)
 
$
(202
)
Litigation and investigation costs
 
(11
)
 
(2
)
 
(23
)
 
(293
)
Gain on sales, consolidation and deconsolidation of facilities(2)
 
2

 

 
144

 
151

Loss from early extinguishment of debt(3)
 

 

 
(164
)
 

Loss from divested and closed businesses
 

 
(28
)
 
(41
)
 
(39
)
Pre-tax impact
 
(147
)
 
(151
)
 
(625
)
 
(383
)
Tax impact of above items
 
49

 
44

 
114

 
81

Tax reform adjustment
 
(252
)
 

 
(252
)
 

Total after-tax impact
 
(350
)
 
(107
)
 
(763
)
 
(302
)
Noncontrolling interests impact(4)
 
(23
)
 
5

 
(23
)
 
(14
)
Total loss from items above
 
$
(373
)
 
$
(102
)
 
$
(786
)
 
$
(316
)
 
 
 
 
 
 
 
 
 
Net loss attributable to common shareholders
 
$
(229
)
 
$
(79
)
 
$
(704
)
 
$
(192
)
Less income (loss) from discontinued operations, net of tax
 
1

 

 

 
(5
)
Loss from continuing operations, net of tax
 
(230
)
 
(79
)
 
(704
)
 
(187
)
Loss from adjustments above
 
373

 
102

 
786

 
316

Adjusted net income from continuing operations attributable to common shareholders
 
$
143

 
$
23

 
$
82

 
$
129

 
 
 
 
 
 
 
 
 
Weighted average dilutive shares outstanding (in thousands)
 
101,853

 
100,928

 
101,380

 
100,742

Diluted loss per share from continuing operations
 
$
(2.28
)
 
$
(0.79
)
 
$
(7.00
)
 
$
(1.88
)
Adjusted diluted earnings per share from continuing operations
 
$
1.40

 
$
0.23

 
$
0.81

 
$
1.28







(1)
Impairment and restructuring charges, and acquisition-related costs of $541 million in the year ended December 31, 2017 were primarily related to the write-down of assets held for sale in Chicago, Philadelphia and the United Kingdom to their estimated fair value less the estimated costs to sell. 
(2)
Gain on sales, consolidation and deconsolidation of facilities of $144 million in the year ended December 31, 2017 was primarily related to a gain on sale of the Company’s former hospitals, physician practices and related assets in Houston, Texas.
(3)
Loss from early extinguishment of debt of $164 million in the year ended December 31, 2017 was related to the Company’s refinancing transactions and debt redemptions.
(4)
During the three months ended December 31, 2017, the Company recorded $22 million of noncontrolling interests expense on a tax benefit of $109 million, as a result of the reduction in the corporate income tax rate from 35% to 21%.



Page 23



TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #3 – Reconciliations of Free Cash Flow and Adjusted Free Cash Flow
(Unaudited)
 
 
 
 
 
 
 
 
 
 
 
Three Months Ended
 
Years Ended
(Dollars in millions)
 
December 31,
 
December 31,
 
 
2017
 
2016
 
2017
 
2016
Net cash provided by (used in) operating activities
 
$
491

 
$
(293
)
 
$
1,200

 
$
558

Purchases of property and equipment
 
(215
)
 
(261
)
 
(707
)
 
(875
)
Free cash flow
 
$
276

 
$
(554
)
 
$
493

 
$
(317
)
 
 
 
 
 
 
 
 
 
Net cash provided by (used in) investing activities
 
$
(206
)
 
$
(280
)
 
$
21

 
$
(430
)
Net cash provided by (used in) financing activities
 
$
(103
)
 
$
640

 
$
(1,326
)
 
$
232

 
 
 
 
 
 
 
 
 
Net cash provided by (used in) operating activities
 
$
491

 
$
(293
)
 
$
1,200

 
$
558

Less: Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements
 
(37
)
 
(559
)
 
(125
)
 
(691
)
Net cash used in operating activities from discontinued operations
 
(2
)
 
(7
)
 
(5
)
 
(6
)
Adjusted net cash provided by operating activities – continuing operations
 
530

 
273

 
1,330

 
1,255

Purchases of property and equipment – continuing operations
 
(215
)
 
(261
)
 
(707
)
 
(875
)
Adjusted free cash flow – continuing operations
 
$
315

 
$
12

 
$
623

 
$
380



Page 24



TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #4 – Reconciliation of Outlook Adjusted EBITDA to Outlook Net Income (Loss) Attributable to Tenet Healthcare Corporation Common Shareholders
(Unaudited)
 
 
 
 
 
 
 
 
 
(Dollars in millions, except per share amounts)
 
Q1 2018
 
2018
 
 
Low
 
High
 
Low
 
High
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders
 
$
45

 
$
70

 
$
90

 
$
105

Less: Net income attributable to noncontrolling interests
 
(90
)
 
(100
)
 
(415
)
 
(435
)
Loss from discontinued operations, net of tax
 
(5
)
 

 
(5
)
 

Income from continuing operations
 
140

 
170

 
510

 
540

Income tax expense
 
(75
)
 
(80
)
 
(215
)
 
(220
)
Income from continuing operations, before income taxes
 
215

 
250

 
725

 
760

Interest expense
 
(250
)
 
(260
)
 
(1,000
)
 
(1,010
)
Loss on early extinguishment of debt
 

 

 
(5
)
 

Other non-operating expense, net
 
(5
)
 
(5
)
 
(20
)
 
(25
)
Operating income
 
470

 
515

 
1,750

 
1,795

Gains on sales, consolidation and deconsolidation of facilities(1)
 
100

 
120

 
100

 
120

Impairment and restructuring charges, acquisition-related costs and litigation costs and settlements(1)
 
(15
)
 
(25
)
 
(50
)
 
(100
)
Depreciation and amortization
 
(195
)
 
(205
)
 
(790
)
 
(810
)
Loss from divested and closed businesses
 

 
(5
)
 
(10
)
 
(15
)
Adjusted EBITDA
 
$
580

 
$
630

 
$
2,500

 
$
2,600

Income from continuing operations
 
$
50

 
$
70

 
$
95

 
$
105

Income from continuing operations as a % of operating revenues
 
1.1
%
 
1.5
%
 
0.5
%
 
0.6
%
Net operating revenues
 
$
4,450

 
$
4,650

 
$
17,900

 
$
18,300

Adjusted EBITDA as % of adjusted net operating revenues (Adjusted EBITDA margin)
 
13.0
%
 
13.5
%
 
14.0
%
 
14.2
%
Adjusted EBITDA
 
$
580

 
$
630

 
$
2,500

 
$
2,600

Depreciation and amortization
 
(195
)
 
(205
)
 
(790
)
 
(810
)
Interest expense
 
(250
)
 
(260
)
 
(1,000
)
 
(1,010
)
Other non-operating expense, net
 
(5
)
 
(5
)
 
(20
)
 
(25
)
Adjusted income from continuing operations before income taxes
 
130

 
160

 
690

 
755

Income tax benefit (expense)
 
(50
)
 
(55
)
 
(200
)
 
(210
)
Adjusted income from continuing operations
 
80

 
105

 
490

 
545

Net income attributable to noncontrolling interests
 
(90
)
 
(100
)
 
(415
)
 
(435
)
Adjusted net income (loss) from continuing operations attributable to common shareholders
 
$
(10
)
 
$
5

 
$
75

 
$
110

Basic weighted average shares outstanding (in millions)
 
101

 
101

 
102

 
102

Fully diluted weighted average shares outstanding (in millions)
 
102

 
102

 
103

 
103

Diluted earnings per share from continuing operations
 
$
0.49

 
$
0.69

 
$
0.92

 
$
1.02

Adjusted diluted earnings (loss) per share from continuing operations
 
$
(0.10
)
 
$
0.05

 
$
0.73

 
$
1.07


(1)
The Company has provided an estimate of restructuring charges that it anticipates in 2018. The Company does not forecast impairment charges, acquisition-related costs and litigation costs and settlements, because the Company does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook. Gains on sales, consolidation and deconsolidation of facilities includes only an estimate for the MacNeal and Baylor joint venture restructuring transactions, which are currently expected to close in the first quarter of 2018.
    

Page 25



TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #5 – Reconciliation of Outlook Adjusted Free Cash Flow
for the Year Ending December 31, 2018
 
 
 
 
 
 
 
 
 
 
 
(Dollars in millions)
 
 
 
 
 
 
 
2018
 
 
 
 
 
 
 
 
Low
 
High
Net cash provided by operating activities
 
 
 
 
 
 
 
$
1,245

 
$
1,450

Less: Payments for restructuring charges, acquisition-related costs and litigation costs and settlements(1)
 
 
 
 
 
 
 
(50
)
 
(100
)
Net cash used in operating activities from discontinued operations
 
 
 
 
 
 
 
(5
)
 

Adjusted net cash provided by operating activities – continuing operations
 
 
 
 
 
 
 
1,300

 
1,550

Purchases of property and equipment – continuing operations
 
 
 
 
 
 
 
(625
)
 
(675
)
Adjusted free cash flow – continuing operations(2)
 
 
 
 
 
 
 
$
675

 
$
875

 
(1)
The Company has provided an estimate of payments that it anticipates in 2018 related to restructuring charges. The Company does not forecast payments related to acquisition-related costs and litigation costs and settlements because the Company does not believe that it can forecast these items with sufficient accuracy since some of these items may be indeterminable at the time the Company provides its financial Outlook.
(2)
The Company's definition of Adjusted Free Cash Flow does not include other important uses of cash including (1) cash used to purchase businesses or joint venture interests, or (2) any items that are classified as Cash Flows From Financing Activities on the Company's Consolidated Statement of Cash Flows, including items such as (i) cash used to repay borrowings, (ii) distributions paid to noncontrolling interests, or (iii) payments under the Put/Call Agreement for USPI redeemable noncontrolling interests, which are recorded on the Statement of Cash Flows as the purchase of noncontrolling interests.


Page 26