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8-K - FORM 8-K - HCA Healthcare, Inc.d887683d8k.htm

Exhibit 99.1

 

LOGO   LOGO

 

 

 

  FOR IMMEDIATE RELEASE
INVESTOR CONTACT:   MEDIA CONTACT:
Mark Kimbrough   Harlow Sumerford
615-344-2688   615-344-1851

HCA Healthcare Reports Second Quarter 2020 Results

Nashville, Tenn., July 22, 2020 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2020.

Key second quarter metrics (all percentage changes compare 2Q 2020 to 2Q 2019 unless otherwise noted):

 

   

Revenues totaled $11.068 billion

 

   

Net income attributable to HCA Healthcare, Inc. totaled $1.079 billion, or $3.16 per diluted share

 

   

Adjusted EBITDA totaled $2.666 billion

 

   

Cash flows from operating activities totaled $8.723 billion

 

   

Same facility admissions declined 12.8 percent and same facility equivalent admissions declined 20.1 percent

“Throughout this remarkably challenging pandemic, I am reminded daily of what an incredible and resilient organization we have,” said Sam Hazen, Chief Executive Officer of HCA Healthcare. “I see our colleagues and physicians working every day to do the right thing for others, and I want to thank them for their dedication to our patients and the tremendous sacrifices they, and their families, are making in the midst of this global health crisis.”

“With our continued focus on our patients and the well-being of our colleagues and physicians, we can be proud of our accomplishments. I am confident that we are well positioned for long-term success and to continue the remarkable legacy that is HCA Healthcare,” stated Hazen.

Revenues in the second quarter of 2020 declined to $11.068 billion from $12.602 billion in the second quarter of 2019. Net income attributable to HCA Healthcare, Inc. totaled $1.079 billion, or $3.16 per diluted share, compared to $783 million, or $2.25 per diluted share, in the second quarter of 2019. The Company recognized $822 million ($590 million net of tax), or $1.73 per diluted share, in government stimulus income during the second quarter of 2020 related to general distribution funds received from the provider relief fund established by the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act. The Company recorded losses on sales of facilities of $27 million, or $0.07 per diluted share, during the second quarter of 2020 and gains on sales of facilities of $18 million, or $0.04 per diluted share, during the second quarter of 2019.

 

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For the second quarter of 2020, Adjusted EBITDA totaled $2.666 billion, compared to $2.293 billion in the second quarter of 2019. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions declined 12.8 percent while same facility equivalent admissions declined 20.1 percent in the second quarter of 2020, compared to the prior year period. Same facility emergency room visits declined 32.9 percent in the second quarter of 2020, compared to the prior year period. Same facility inpatient surgeries declined 15.7 percent, while same facility outpatient surgeries declined 32.6 percent in the second quarter of 2020, compared to the same period of 2019. Same facility revenue per equivalent admission increased 10.0 percent in the second quarter of 2020, compared to the second quarter of 2019. Patient volumes across most service lines were significantly impacted in April due to state and local policies implemented to contain the spread of COVID-19 and preserve personal protective equipment. Patient volumes gradually improved in May and June as states began to re-open and allow for non-emergent procedures.

Six Months Ended June 30, 2020

Revenues for the six months ended June 30, 2020 totaled $23.929 billion, compared to $25.119 billion in the same period of 2019. Net income attributable to HCA Healthcare, Inc. was $1.660 billion, or $4.84 per diluted share, compared to $1.822 billion, or $5.22 per diluted share, for the first six months of 2019. Results for the six months ended June 30, 2020 include government stimulus income of $822 million ($590 million net of tax), or $1.72 per diluted share, losses on sales of facilities of $20 million, or $0.06 per diluted share, and losses on retirement of debt of $295 million, or $0.66 per diluted share. Results for the six months ended June 30, 2019 included gains on sales of facilities of $17 million, or $0.04 per diluted share.

Balance Sheet and Cash Flows from Operations

As of June 30, 2020, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $4.638 billion, total debt of $30.942 billion, and total assets of $48.709 billion. During the second quarter of 2020, capital expenditures totaled $745 million, excluding acquisitions. Cash flows provided by operating activities in the second quarter totaled $8.723 billion, compared to $1.997 billion in the second quarter of 2019. Cash flows from operations for the second quarter included $4.4 billion of accelerated Medicare payments and $1.4 billion of provider relief fund distributions provided for in the CARES Act, of which $4.999 billion remains deferred on the balance sheet at June 30, 2020.

As of June 30, 2020, the Company had $7.718 billion of availability under its credit facilities.

Earnings Conference Call

HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Daylight Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company’s Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx.

 

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About the Company

As of June 30, 2020, HCA operated 186 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 21 states and the United Kingdom.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company’s capital allocation, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) developments related to COVID-19, including, without limitation, related to the length and severity of the pandemic; the volume of canceled or rescheduled procedures and the volume of COVID-19 patients cared for across our health systems; measures we are taking to respond to the COVID-19 pandemic; the impact of government and administrative regulation and stimulus (including the CARES Act, the Paycheck Protection Program and Health Care Enhancement Act and other enacted legislation); changes in revenues due to declining patient volumes, changes in payor mix and deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions and supply shortages and disruptions; and the timing and availability of effective medical treatments and vaccines, (2) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financial perspective, (3) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”), including the effects of court challenges to, any repeal of, or changes to, the Affordable Care Act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including single-payer proposals (often referred to as “Medicare for All”), and also including any such laws or governmental regulations which are adopted in response to the COVID-19 pandemic, (4) the effects related to the continued implementation of the sequestration spending reductions required under the Budget Control Act of 2011, and related legislation extending these reductions, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or

 

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underinsured population, (8) the highly competitive nature of the health care business, (9) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (10) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (11) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (12) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) changes in general economic conditions nationally and regionally in our markets, including economic and business conditions resulting from the COVID-19 pandemic, (16) the emergence of and effects related to other pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record (“EHR”) technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (25) changes in the U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2019 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

All references to “Company” and “HCA” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

 

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HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

Second Quarter

(Dollars in millions, except per share amounts)

 

     2020     2019  
     Amount     Ratio     Amount     Ratio  

Revenues

   $ 11,068       100.0   $ 12,602       100.0

Salaries and benefits

     5,330       48.2       5,837       46.3  

Supplies

     1,748       15.8       2,118       16.8  

Other operating expenses

     2,147       19.3       2,362       18.8  

Government stimulus income

     (822     (7.4     —           —      

Equity in earnings of affiliates

     (1     —           (8     (0.1

Depreciation and amortization

     691       6.3       636       5.0  

Interest expense

     388       3.5       477       3.8  

Losses (gains) on sales of facilities

     27       0.2       (18     (0.1
  

 

 

   

 

 

   

 

 

   

 

 

 
     9,508       85.9       11,404       90.5  
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     1,560       14.1       1,198       9.5  

Provision for income taxes

     344       3.1       271       2.1  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     1,216       11.0       927       7.4  

Net income attributable to noncontrolling interests

     137       1.2       144       1.2  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc.

   $ 1,079       9.8     $ 783       6.2  
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted earnings per share

   $ 3.16       $ 2.25    

Shares used in computing diluted earnings per share (millions)

     341.599         348.373    

Comprehensive income attributable to HCA Healthcare, Inc.

   $ 1,088       $ 726    
  

 

 

     

 

 

   

 

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HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

For the Six Months Ended June 30, 2020 and 2019

(Dollars in millions, except per share amounts)

 

     2020     2019  
     Amount     Ratio     Amount     Ratio  

Revenues

   $ 23,929       100.0   $ 25,119       100.0

Salaries and benefits

     11,448       47.8       11,484       45.7  

Supplies

     3,871       16.2       4,159       16.6  

Other operating expenses

     4,574       19.1       4,661       18.6  

Government stimulus income

     (822     (3.4     —         —    

Equity in earnings of affiliates

     (8     —         (19     (0.1

Depreciation and amortization

     1,365       5.7       1,255       5.0  

Interest expense

     816       3.4       938       3.7  

Losses (gains) on sales of facilities

     20       0.1       (17     (0.1

Losses on retirement of debt

     295       1.2       —         —    
  

 

 

   

 

 

   

 

 

   

 

 

 
     21,559       90.1       22,461       89.4  
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     2,370       9.9       2,658       10.6  

Provision for income taxes

     456       1.9       550       2.2  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     1,914       8.0       2,108       8.4  

Net income attributable to noncontrolling interests

     254       1.1       286       1.1  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc.

   $ 1,660       6.9     $ 1,822       7.3  
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted earnings per share

   $ 4.84       $ 5.22    

Shares used in computing diluted earnings per share (millions)

     342.848         349.334    

Comprehensive income attributable to HCA Healthcare, Inc.

   $ 1,558       $ 1,772    
  

 

 

     

 

 

   

 

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HCA Healthcare, Inc.

Condensed Consolidated Balance Sheets

(Dollars in millions)

 

     June 30,     March 31,     December 31,  
     2020     2020     2019  

ASSETS

      

Current assets:

      

Cash and cash equivalents

   $ 4,638     $ 731     $ 621  

Accounts receivable

     6,139       6,890       7,380  

Inventories

     1,834       1,953       1,849  

Other

     1,420       1,442       1,346  
  

 

 

   

 

 

   

 

 

 

Total current assets

     14,031       11,016       11,196  

Property and equipment, at cost

     48,484       47,861       47,235  

Accumulated depreciation

     (25,413     (24,876     (24,520
  

 

 

   

 

 

   

 

 

 
     23,071       22,985       22,715  

Investments of insurance subsidiaries

     364       325       315  

Investments in and advances to affiliates

     275       238       249  

Goodwill and other intangible assets

     8,578       8,587       8,269  

Right-of-use operating lease assets

     1,863       1,828       1,834  

Other

     527       442       480  
  

 

 

   

 

 

   

 

 

 
   $ 48,709     $ 45,421     $ 45,058  
  

 

 

   

 

 

   

 

 

 

LIABILITIES AND STOCKHOLDERS’ DEFICIT

      

Current liabilities:

      

Accounts payable

   $ 2,882     $ 2,750     $ 2,905  

Accrued salaries

     1,631       1,560       1,775  

Other accrued expenses

     3,181       2,547       2,932  

Contract liabilities - deferred revenues

     4,999       —         —    

Long-term debt due within one year

     163       162       145  
  

 

 

   

 

 

   

 

 

 

Total current liabilities

     12,856       7,019       7,757  

Long-term debt, less debt issuance costs and discounts of $252, $258 and $239

     30,779       34,699       33,577  

Professional liability risks

     1,485       1,432       1,370  

Right-of-use operating lease obligations

     1,531       1,497       1,499  

Income taxes and other liabilities

     1,490       1,477       1,420  

EQUITY (DEFICIT)

      

Stockholders’ deficit attributable to HCA Healthcare, Inc.

     (1,786     (2,962     (2,808

Noncontrolling interests

     2,354       2,259       2,243  
  

 

 

   

 

 

   

 

 

 

Total equity (deficit)

     568       (703     (565
  

 

 

   

 

 

   

 

 

 
   $ 48,709     $ 45,421     $ 45,058  
  

 

 

   

 

 

   

 

 

 

 

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HCA Healthcare, Inc.

Consolidated Statements of Cash Flows

For the Six Months Ended June 30, 2020 and 2019

(Dollars in millions)

 

     2020     2019  

Cash flows from operating activities:

    

Net income

   $ 1,914     $ 2,108  

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

    

Increase (decrease) in cash from operating assets and liabilities:

    

Accounts receivable

     1,215       (174

Inventories and other assets

     (57     (231

Accounts payable and accrued expenses

     (336     (238

Contract liabilities - deferred revenues

     4,999       —    

Depreciation and amortization

     1,365       1,255  

Income taxes

     472       27  

Losses (gains) on sales of facilities

     20       (17

Losses on retirement of debt

     295       —    

Amortization of debt issuance costs and discounts

     14       16  

Share-based compensation

     148       158  

Other

     49       67  
  

 

 

   

 

 

 

Net cash provided by operating activities

     10,098       2,971  
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchase of property and equipment

     (1,598     (1,745

Acquisition of hospitals and health care entities

     (346     (1,504

Sales of hospitals and health care entities

     39       41  

Change in investments

     (11     59  

Other

     (37     36  
  

 

 

   

 

 

 

Net cash used in investing activities

     (1,953     (3,113
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Issuances of long-term debt

     2,700       6,451  

Net change in revolving bank credit facilities

     (2,480     (3,040

Repayment of long-term debt

     (3,364     (98

Distributions to noncontrolling interests

     (199     (247

Payment of debt issuance costs

     (35     (63

Payment of dividends

     (153     (278

Repurchases of common stock

     (441     (520

Other

     (144     (135
  

 

 

   

 

 

 

Net cash (used in) provided by financing activities

     (4,116     2,070  
  

 

 

   

 

 

 

Effect of exchange rate changes on cash and cash equivalents

     (12     —    
  

 

 

   

 

 

 

Change in cash and cash equivalents

     4,017       1,928  

Cash and cash equivalents at beginning of period

     621       502  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 4,638     $ 2,430  
  

 

 

   

 

 

 

Interest payments

   $ 854     $ 910  

Income tax (refunds) payments, net

   $ (16   $ 523  

 

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HCA Healthcare, Inc.

Operating Statistics

 

                 For the Six Months  
     Second Quarter     Ended June 30,  
     2020     2019     2020     2019  

Operations:

        

Number of Hospitals

     186       184       186       184  

Number of Freestanding Outpatient Surgery Centers

     122       125       122       125  

Licensed Beds at End of Period

     49,403       48,483       49,403       48,483  

Weighted Average Licensed Beds

     49,358       48,429       49,259       48,234  

Reported:

        

Admissions

     452,992       518,253       981,236       1,041,449  

% Change

     -12.6       -5.8  

Equivalent Admissions

     723,136       903,419       1,612,171       1,793,375  

% Change

     -20.0       -10.1  

Revenue per Equivalent Admission

   $ 15,305     $ 13,949     $ 14,843     $ 14,007  

% Change

     9.7       6.0  

Inpatient Revenue per Admission

   $ 15,757     $ 14,291     $ 15,152     $ 14,350  

% Change

     10.3       5.6  

Patient Days

     2,260,816       2,530,548       4,883,655       5,137,445  

% Change

     -10.7       -4.9  

Equivalent Patient Days

     3,609,607       4,412,348       8,023,845       8,846,680  

% Change

     -18.2       -9.3  

Inpatient Surgery Cases

     118,591       140,473       253,736       277,836  

% Change

     -15.6       -8.7  

Outpatient Surgery Cases

     170,911       253,441       397,230       494,287  

% Change

     -32.6       -19.6  

Emergency Room Visits

     1,516,116       2,253,337       3,780,823       4,540,777  

% Change

     -32.7       -16.7  

Outpatient Revenues as a Percentage of Patient Revenues

     31.8     39.1     34.8     38.5

Average Length of Stay (days)

     4.991       4.883       4.977       4.933  

Occupancy

     50.3     57.4     54.5     58.8

Same Facility:

        

Admissions

     439,990       504,436       955,751       1,016,253  

% Change

     -12.8       -6.0  

Equivalent Admissions

     698,704       874,692       1,563,609       1,741,858  

% Change

     -20.1       -10.2  

Revenue per Equivalent Admission

   $ 15,171     $ 13,794     $ 14,646     $ 13,907  

% Change

     10.0       5.3  

Inpatient Revenue per Admission

   $ 15,774     $ 14,319     $ 15,146     $ 14,383  

% Change

     10.2       5.3  

Inpatient Surgery Cases

     115,192       136,651       246,536       270,529  

% Change

     -15.7       -8.9  

Outpatient Surgery Cases

     165,058       244,782       384,336       477,970  

% Change

     -32.6       -19.6  

Emergency Room Visits

     1,480,229       2,207,396       3,700,457       4,451,252  

% Change

     -32.9       -16.9  

 

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HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

Operating Results Summary

(Dollars in millions, except per share amounts)

 

                 For the Six Months  
     Second Quarter     Ended June 30,  
     2020     2019     2020     2019  

Revenues

   $ 11,068     $ 12,602     $ 23,929     $ 25,119  

Net income attributable to HCA Healthcare, Inc.

   $ 1,079     $ 783     $ 1,660     $ 1,822  

Losses (gains) on sales of facilities (net of tax)

     24       (14     19       (13

Losses on retirement of debt (net of tax)

     —         —         227       —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt (a)

     1,103       769       1,906       1,809  

Depreciation and amortization

     691       636       1,365       1,255  

Interest expense

     388       477       816       938  

Provision for income taxes

     347       267       525       546  

Net income attributable to noncontrolling interests

     137       144       254       286  
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA (a)

   $ 2,666     $ 2,293     $ 4,866     $ 4,834  
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA margin (a)

     24.1     18.2     20.3     19.2

Diluted earnings per share:

        

Net income attributable to HCA Healthcare, Inc.

   $ 3.16     $ 2.25     $ 4.84     $ 5.22  

Losses (gains) on sales of facilities

     0.07       (0.04     0.06       (0.04

Losses on retirement of debt

     —         —         0.66       —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt (a)

   $ 3.23     $ 2.21     $ 5.56     $ 5.18  
  

 

 

   

 

 

   

 

 

   

 

 

 

Shares used in computing diluted earnings per share (millions)

     341.599       348.373       342.848       349.334  

 

(a)

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles (“GAAP”). We believe net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that losses (gains) on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

 

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