Nevada |
1-7293 | 95-2557091 | ||||||||||||
| (State of Incorporation) | (Commission File Number) | (IRS Employer Identification Number) |
||||||||||||
☐ |
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) |
||||
☐ |
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) | ||||
☐ |
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) | ||||
☐ |
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) | ||||
| Title of each class | Trading Symbol(s) |
Name of each exchange on which registered |
||||||||||||
| Common stock, $0.05 par value | THC | NYSE | ||||||||||||
| 6.875% Senior Notes due 2031 | THC31 | NYSE | ||||||||||||
| Item 2.02. | Results of Operations and Financial Condition. | ||||
| Item 9.01. | Financial Statements and Exhibits. | ||||
| Exhibit No. | Description | |||||||
| 99.1 | ||||||||
| 104 | Cover Page Interactive Data File (embedded within the inline XBRL document) | |||||||
| TENET HEALTHCARE CORPORATION | ||||||||
| Date: February 9, 2023 | By: | /s/ R. SCOTT RAMSEY | ||||||
| R. Scott Ramsey | ||||||||
| Senior Vice President, Controller | ||||||||

Three Months Ended December 31, |
Twelve Months Ended December 31, |
|||||||||||||
($ in millions, except per share results) |
2022 | 2021 | 2022 | 2021 | ||||||||||
Net operating revenues |
$4,990 |
$4,856 |
$19,174 |
$19,485 |
||||||||||
Net income available to Tenet common shareholders from continuing operations |
$102 |
$250 |
$410 |
$915 |
||||||||||
Net income available to Tenet common shareholders from continuing operations per diluted share |
$0.92 |
$2.30 |
$3.78 |
$8.43 |
||||||||||
Adjusted EBITDA1 excluding grant income |
$857 |
$877 |
$3,275 |
$3,278 |
||||||||||
Adjusted EBITDA1 |
$897 |
$1,017 |
$3,469 |
$3,483 |
||||||||||
Adjusted diluted earnings per share from continuing operations1 |
$1.96 |
$2.70 |
$6.80 |
$7.58 |
||||||||||
| Three Months Ended December 31, | Twelve Months Ended December 31, |
|||||||||||||
Ambulatory segment results ($ in millions) |
2022 | 2021 | 2022 | 2021 | ||||||||||
Revenues |
||||||||||||||
Net operating revenues |
$933 |
$742 |
$3,248 |
$2,718 |
||||||||||
Same-facility system-wide net patient service revenues2 |
$1,763 | $1,712 | $6,241 | $5,968 | ||||||||||
Volume Changes versus the Prior-Year Period |
||||||||||||||
Same-facility system-wide surgical cases2 |
0.7% |
4.4% |
2.0% |
15.6% |
||||||||||
Same-facility system-wide surgical cases on same-business day basis2 |
0.7% |
6.1% |
1.6% |
16.6% |
||||||||||
Adjusted EBITDA, Margins and Noncontrolling Interest (NCI) |
||||||||||||||
Adjusted EBITDA excluding grant income |
$407 |
$343 |
$1,323 |
$1,134 |
||||||||||
| Adjusted EBITDA | $407 |
$371 |
$1,327 |
$1,197 |
||||||||||
Adjusted EBITDA margin excluding grant income |
43.6% |
46.2% |
40.7% |
41.7% |
||||||||||
Adjusted EBITDA margin |
43.6% |
50.0% |
40.9% |
44.0% |
||||||||||
Adjusted EBITDA less facility-level NCI excluding grant income |
$262 |
$220 |
$865 |
$734 |
||||||||||
| Adjusted EBITDA less facility-level NCI | $262 |
$236 |
$867 |
$770 |
||||||||||
Adjusted EBITDA less total NCI excluding grant income |
$262 |
$214 |
$856 |
$715 |
||||||||||
| Adjusted EBITDA less total NCI | $262 |
$229 |
$858 |
$749 |
||||||||||
Three Months Ended December 31, |
Twelve Months Ended December 31, |
|||||||||||||
Hospital segment results ($ in millions) |
2022 | 2021 | 2022 | 2021 | ||||||||||
Revenues |
||||||||||||||
Net operating revenues (prior to inter-segment eliminations) |
$3,840 |
$3,910 |
$15,061 |
$15,982 |
||||||||||
Grant income |
$40 |
$112 |
$190 |
$142 |
||||||||||
Same-hospital net patient service revenues3 |
$3,486 |
$3,545 |
$13,703 |
$14,043 |
||||||||||
Same-Hospital Volume Changes versus the Prior-Year Period |
||||||||||||||
Admissions |
0.5% |
(3.9)% |
(4.5)% |
(0.1)% |
||||||||||
Adjusted admissions4 |
2.9% |
—% |
(1.2)% |
2.4% |
||||||||||
Outpatient visits (including outpatient ER visits) |
(2.8)% |
8.8% |
(4.8)% |
15.7% |
||||||||||
Emergency Room visits (inpatient and outpatient) |
7.7% |
16.3% |
4.8% |
8.9% |
||||||||||
Hospital surgeries |
(2.5)% |
(1.4)% |
(3.7)% |
6.1% |
||||||||||
| Adjusted EBITDA | ||||||||||||||
| Adjusted EBITDA excluding grant income | $360 |
$440 |
$1,587 |
$1,789 |
||||||||||
Adjusted EBITDA |
$400 |
$552 |
$1,777 |
$1,931 |
||||||||||
| Adjusted EBITDA margin excluding grant income | 9.4% |
11.3% |
10.5% |
11.2% |
||||||||||
Adjusted EBITDA margin |
10.4% |
14.1% |
11.8% |
12.1% |
||||||||||
Three Months Ended December 31, |
Twelve Months Ended December 31, |
|||||||||||||
Conifer segment results ($ in millions) |
2022 | 2021 | 2022 | 2021 | ||||||||||
Net operating revenues |
$326 |
$324 |
$1,316 |
$1,267 |
||||||||||
Adjusted EBITDA |
$90 |
$94 |
$365 |
$355 |
||||||||||
Adjusted EBITDA margin |
27.6% |
29.0% |
27.7% |
28.0% |
||||||||||
CONSOLIDATED ($ in millions, except per share amounts) |
FY 2023 Outlook |
First Quarter
2023 Outlook
|
|||||||||
| Net operating revenues | $19,700 to $20,100 |
$4,700 to $4,900 |
|||||||||
Income from continuing operations available to Tenet common stockholders |
$420 to $585 |
$90 to $125 |
|||||||||
| Adjusted EBITDA | $3,160 to $3,360 |
$750 to $800 |
|||||||||
| Adjusted EBITDA margin | 16.0% to 16.7% |
16.0% to 16.3% |
|||||||||
| Diluted income per common share from continuing operations | $3.89 to $5.43 |
$0.82 to $1.14 |
|||||||||
| Adjusted net income from continuing operations | $505 to $630 |
$110 to $135 |
|||||||||
| Adjusted diluted earnings per share from continuing operations | $4.68 to $5.85 |
$1.00 to $1.23 |
|||||||||
| Equity in earnings of unconsolidated affiliates | $200 to $220 | $35 to $45 | |||||||||
| Depreciation and amortization | $850 to $875 |
$210 to $220 |
|||||||||
| Interest expense | $870 to $880 |
$215 to $225 |
|||||||||
Income tax expense5 |
$270 to $300 |
$60 to $70 |
|||||||||
| Net income available to NCI | $620 to $670 |
$135 to $155 |
|||||||||
| Weighted average diluted common shares | ~107 million |
~107 million |
|||||||||
| NCI cash distributions | $540 to $580 | ||||||||||
| Net cash provided by operating activities | $1,700 to $2,000 |
||||||||||
| Adjusted net cash provided by operating activities | $1,825 to $2,075 |
||||||||||
| Capital expenditures | $625 to $675 |
||||||||||
| Free cash flow | $1,075 to $1,325 |
||||||||||
| Adjusted free cash flow – continuing operations | $1,200 to $1,400 |
||||||||||
Ambulatory Segment ($ in millions) |
FY 2023 Outlook |
|||||||
| Net operating revenues | $3,550 to $3,650 | |||||||
| Adjusted EBITDA | $1,415 to $1,475 | |||||||
| Total NCI (Facility level) | $510 to $540 | |||||||
| Adjusted EBITDA less total NCI | $905 to $935 | |||||||
Changes versus prior year6: |
||||||||
| Surgical cases volumes | Up 2.0% to 3.0% | |||||||
| Net revenues per surgical case | Up 2.0% to 3.0% | |||||||
Hospital Segment ($ in millions) |
FY 2023 Outlook |
|||||||
| Net operating revenues (prior to inter-segment eliminations) | $15,315 to $15,565 | |||||||
| Adjusted EBITDA | $1,415 to $1,545 | |||||||
| NCI | $20 to $35 | |||||||
Changes versus prior year6: |
||||||||
| Inpatient admissions | Up 1.0% to 3.0% | |||||||
| Adjusted admissions | Up 2.0% to 4.0% | |||||||
Conifer Segment ($ in millions) |
FY 2023 Outlook |
|||||||
| Net operating revenues | $1,285 to $1,335 | |||||||
| Adjusted EBITDA | $330 to $340 | |||||||
| NCI | $90 to $95 | |||||||
| Investor Contact | Media Contact |
|||||||
| Will McDowell | Robert Dyer | |||||||
| 469-893-2387 | 469-893-2640 | |||||||
| william.mcdowell@tenethealth.com | mediarelations@tenethealth.com |
|||||||
| (Dollars in millions, except per share amounts) | Three Months Ended December 31, | |||||||||||||||||||||||||||||||
| 2022 | % | 2021 | % | Change | ||||||||||||||||||||||||||||
| Net operating revenues | $ | 4,990 | 100.0 | % | $ | 4,856 | 100.0 | % | 2.8 | % | ||||||||||||||||||||||
| Grant income | 40 | 0.8 | % | 138 | 2.8 | % | (71.0) | % | ||||||||||||||||||||||||
| Equity in earnings of unconsolidated affiliates | 65 | 1.3 | % | 77 | 1.6 | % | (15.6) | % | ||||||||||||||||||||||||
| Operating expenses: | ||||||||||||||||||||||||||||||||
| Salaries, wages and benefits | 2,306 | 46.2 | % | 2,188 | 45.0 | % | 5.4 | % | ||||||||||||||||||||||||
| Supplies | 860 | 17.2 | % | 838 | 17.3 | % | 2.6 | % | ||||||||||||||||||||||||
| Other operating expenses, net | 1,032 | 20.7 | % | 1,029 | 21.2 | % | 0.3 | % | ||||||||||||||||||||||||
| Depreciation and amortization | 213 | 4.3 | % | 201 | 4.1 | % | ||||||||||||||||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 129 | 2.6 | % | 30 | 0.6 | % | ||||||||||||||||||||||||||
| Litigation and investigation costs | 20 | 0.4 | % | 52 | 1.1 | % | ||||||||||||||||||||||||||
| Net gains on sales, consolidation and deconsolidation of facilities | (1) | — | % | (18) | (0.4) | % | ||||||||||||||||||||||||||
| Operating income | 536 | 10.7 | % | 751 | 15.5 | % | ||||||||||||||||||||||||||
| Interest expense | (219) | (221) | ||||||||||||||||||||||||||||||
| Other non-operating income (loss), net | 4 | (2) | ||||||||||||||||||||||||||||||
| Income from continuing operations, before income taxes | 321 | 528 | ||||||||||||||||||||||||||||||
| Income tax expense | (47) | (108) | ||||||||||||||||||||||||||||||
| Income from continuing operations, before discontinued operations | 274 | 420 | ||||||||||||||||||||||||||||||
| Discontinued operations: | ||||||||||||||||||||||||||||||||
| Loss from operations | — | (1) | ||||||||||||||||||||||||||||||
| Loss from discontinued operations | — | (1) | ||||||||||||||||||||||||||||||
| Net income | 274 | 419 | ||||||||||||||||||||||||||||||
| Less: Net income available to noncontrolling interests | 172 | 170 | ||||||||||||||||||||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders |
$ | 102 | $ | 249 | ||||||||||||||||||||||||||||
Amounts available to Tenet Healthcare Corporation common shareholders |
||||||||||||||||||||||||||||||||
| Income from continuing operations, net of tax | $ | 102 | $ | 250 | ||||||||||||||||||||||||||||
| Loss from discontinued operations, net of tax | — | (1) | ||||||||||||||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 102 | $ | 249 | ||||||||||||||||||||||||||||
| Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||||||||||||||
| Basic | ||||||||||||||||||||||||||||||||
| Continuing operations | $ | 0.98 | $ | 2.33 | ||||||||||||||||||||||||||||
| Discontinued operations | — | (0.01) | ||||||||||||||||||||||||||||||
| $ | 0.98 | $ | 2.32 | |||||||||||||||||||||||||||||
| Diluted | ||||||||||||||||||||||||||||||||
| Continuing operations | $ | 0.92 | $ | 2.30 | ||||||||||||||||||||||||||||
| Discontinued operations | — | (0.01) | ||||||||||||||||||||||||||||||
| $ | 0.92 | $ | 2.29 | |||||||||||||||||||||||||||||
| Weighted average shares and dilutive securities outstanding (in thousands): |
||||||||||||||||||||||||||||||||
| Basic | 104,519 | 107,150 | ||||||||||||||||||||||||||||||
| Diluted | 106,368 | 108,890 | ||||||||||||||||||||||||||||||
| (Dollars in millions, except per share amounts) | Twelve Months Ended December 31, | |||||||||||||||||||||||||||||||
| 2022 | % | 2021 | % | Change | ||||||||||||||||||||||||||||
| Net operating revenues | $ | 19,174 | 100.0 | % | $ | 19,485 | 100.0 | % | (1.6) | % | ||||||||||||||||||||||
| Grant income | 194 | 1.0 | % | 191 | 1.0 | % | 1.6 | % | ||||||||||||||||||||||||
| Equity in earnings of unconsolidated affiliates | 216 | 1.1 | % | 218 | 1.1 | % | (0.9) | % | ||||||||||||||||||||||||
| Operating expenses: | ||||||||||||||||||||||||||||||||
| Salaries, wages and benefits | 8,844 | 46.1 | % | 8,878 | 45.6 | % | (0.4) | % | ||||||||||||||||||||||||
| Supplies | 3,273 | 17.0 | % | 3,328 | 17.1 | % | (1.7) | % | ||||||||||||||||||||||||
| Other operating expenses, net | 3,998 | 20.8 | % | 4,206 | 21.6 | % | (4.9) | % | ||||||||||||||||||||||||
| Depreciation and amortization | 841 | 4.4 | % | 855 | 4.4 | % | ||||||||||||||||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 226 | 1.2 | % | 85 | 0.4 | % | ||||||||||||||||||||||||||
| Litigation and investigation costs | 70 | 0.4 | % | 116 | 0.6 | % | ||||||||||||||||||||||||||
| Net gains on sales, consolidation and deconsolidation of facilities | (1) | — | % | (445) | (2.3) | % | ||||||||||||||||||||||||||
| Operating income | 2,333 | 12.2 | % | 2,871 | 14.7 | % | ||||||||||||||||||||||||||
| Interest expense | (890) | (923) | ||||||||||||||||||||||||||||||
| Other non-operating income, net | 10 | 14 | ||||||||||||||||||||||||||||||
| Loss from early extinguishment of debt | (109) | (74) | ||||||||||||||||||||||||||||||
| Income from continuing operations, before income taxes | 1,344 | 1,888 | ||||||||||||||||||||||||||||||
| Income tax expense | (344) | (411) | ||||||||||||||||||||||||||||||
| Income from continuing operations, before discontinued operations | 1,000 | 1,477 | ||||||||||||||||||||||||||||||
| Discontinued operations: | ||||||||||||||||||||||||||||||||
| Income (loss) from operations | 1 | (1) | ||||||||||||||||||||||||||||||
| Income (loss) from discontinued operations | 1 | (1) | ||||||||||||||||||||||||||||||
| Net income | 1,001 | 1,476 | ||||||||||||||||||||||||||||||
| Less: Net income available to noncontrolling interests | 590 | 562 | ||||||||||||||||||||||||||||||
Net income available to Tenet Healthcare Corporation common shareholders |
$ | 411 | $ | 914 | ||||||||||||||||||||||||||||
Amounts available to Tenet Healthcare Corporation common shareholders |
||||||||||||||||||||||||||||||||
| Income from continuing operations, net of tax | $ | 410 | $ | 915 | ||||||||||||||||||||||||||||
| Income (loss) from discontinued operations, net of tax | 1 | (1) | ||||||||||||||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 411 | $ | 914 | ||||||||||||||||||||||||||||
| Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders: | ||||||||||||||||||||||||||||||||
| Basic | ||||||||||||||||||||||||||||||||
| Continuing operations | $ | 3.83 | $ | 8.56 | ||||||||||||||||||||||||||||
| Discontinued operations | 0.01 | (0.01) | ||||||||||||||||||||||||||||||
| $ | 3.84 | $ | 8.55 | |||||||||||||||||||||||||||||
| Diluted | ||||||||||||||||||||||||||||||||
| Continuing operations | $ | 3.78 | $ | 8.43 | ||||||||||||||||||||||||||||
| Discontinued operations | 0.01 | (0.01) | ||||||||||||||||||||||||||||||
| $ | 3.79 | $ | 8.42 | |||||||||||||||||||||||||||||
|
Weighted average shares and dilutive securities outstanding
(in thousands):
|
||||||||||||||||||||||||||||||||
| Basic | 106,929 | 106,833 | ||||||||||||||||||||||||||||||
| Diluted | 110,516 | 108,571 | ||||||||||||||||||||||||||||||
| December 31, | December 31, | |||||||||||||
| (Dollars in millions) | 2022 | 2021 | ||||||||||||
| ASSETS | ||||||||||||||
| Current assets: | ||||||||||||||
| Cash and cash equivalents | $ | 858 | $ | 2,364 | ||||||||||
| Accounts receivable | 2,943 | 2,770 | ||||||||||||
| Inventories of supplies, at cost | 405 | 384 | ||||||||||||
| Other current assets | 1,775 | 1,557 | ||||||||||||
Total current assets |
5,981 | 7,075 | ||||||||||||
| Investments and other assets | 3,147 | 3,254 | ||||||||||||
| Deferred income taxes | 19 | 65 | ||||||||||||
Property and equipment, at cost, less accumulated depreciation and amortization |
6,462 | 6,427 | ||||||||||||
| Goodwill | 10,123 | 9,261 | ||||||||||||
Other intangible assets, at cost, less accumulated amortization |
1,424 | 1,497 | ||||||||||||
Total assets |
$ | 27,156 | $ | 27,579 | ||||||||||
| LIABILITIES AND EQUITY | ||||||||||||||
| Current liabilities: | ||||||||||||||
| Current portion of long-term debt | $ | 145 | $ | 135 | ||||||||||
| Accounts payable | 1,504 | 1,300 | ||||||||||||
| Accrued compensation and benefits | 778 | 896 | ||||||||||||
| Professional and general liability reserves | 255 | 254 | ||||||||||||
| Accrued interest payable | 213 | 203 | ||||||||||||
| Contract liabilities | 110 | 959 | ||||||||||||
| Other current liabilities | 1,471 | 1,362 | ||||||||||||
Total current liabilities |
4,476 | 5,109 | ||||||||||||
| Long-term debt, net of current portion | 14,934 | 15,511 | ||||||||||||
| Professional and general liability reserves | 790 | 791 | ||||||||||||
| Defined benefit plan obligations | 331 | 421 | ||||||||||||
| Deferred income taxes | 217 | 36 | ||||||||||||
| Contract liabilities – long-term | 13 | 15 | ||||||||||||
| Other long-term liabilities | 1,787 | 1,439 | ||||||||||||
Total liabilities |
22,548 | 23,322 | ||||||||||||
| Commitments and contingencies | ||||||||||||||
Redeemable noncontrolling interests in equity of consolidated subsidiaries |
2,149 | 2,203 | ||||||||||||
| Equity: | ||||||||||||||
| Shareholders’ equity: | ||||||||||||||
| Common stock | 8 | 8 | ||||||||||||
| Additional paid-in capital | 4,778 | 4,877 | ||||||||||||
| Accumulated other comprehensive loss | (181) | (233) | ||||||||||||
| Accumulated deficit | (803) | (1,214) | ||||||||||||
| Common stock in treasury, at cost | (2,660) | (2,410) | ||||||||||||
| Total shareholders’ equity | 1,142 | 1,028 | ||||||||||||
Noncontrolling interests |
1,317 | 1,026 | ||||||||||||
Total equity |
2,459 | 2,054 | ||||||||||||
Total liabilities and equity |
$ | 27,156 | $ | 27,579 | ||||||||||
| Twelve Months Ended | ||||||||||||||
| (Dollars in millions) | December 31, | |||||||||||||
| 2022 | 2021 | |||||||||||||
| Net income | $ | 1,001 | $ | 1,476 | ||||||||||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||||||||
| Depreciation and amortization | 841 | 855 | ||||||||||||
| Deferred income tax expense | 209 | 250 | ||||||||||||
| Stock-based compensation expense | 56 | 56 | ||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | 226 | 85 | ||||||||||||
| Litigation and investigation costs | 70 | 116 | ||||||||||||
| Net gains on sales, consolidation and deconsolidation of facilities | (1) | (445) | ||||||||||||
| Loss from early extinguishment of debt | 109 | 74 | ||||||||||||
| Equity in earnings of unconsolidated affiliates, net of distributions received | 2 | (10) | ||||||||||||
| Amortization of debt discount and debt issuance costs | 33 | 33 | ||||||||||||
| Pre-tax (income) loss from discontinued operations | (1) | 1 | ||||||||||||
| Net gains from the sale of investments and long-lived assets | (117) | (23) | ||||||||||||
| Other items, net | 13 | (10) | ||||||||||||
| Changes in cash from operating assets and liabilities: | ||||||||||||||
| Accounts receivable | (140) | (197) | ||||||||||||
| Inventories and other current assets | (64) | (52) | ||||||||||||
| Income taxes | (26) | 68 | ||||||||||||
| Accounts payable, accrued expenses, contract liabilities and other current liabilities | (898) | (584) | ||||||||||||
| Other long-term liabilities | (15) | 28 | ||||||||||||
| Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (214) | (153) | ||||||||||||
| Net cash used in operating activities from discontinued operations, excluding income taxes | (1) | — | ||||||||||||
| Net cash provided by operating activities | 1,083 | 1,568 | ||||||||||||
| Cash flows from investing activities: | ||||||||||||||
| Purchases of property and equipment | (762) | (658) | ||||||||||||
| Purchases of businesses or joint venture interests, net of cash acquired | (234) | (1,220) | ||||||||||||
| Proceeds from sales of facilities and other assets | 210 | 1,248 | ||||||||||||
| Proceeds from sales of marketable securities, long-term investments and other assets | 76 | 31 | ||||||||||||
| Purchases of marketable securities and equity investments | (92) | (108) | ||||||||||||
| Other items, net | (6) | (7) | ||||||||||||
| Net cash used in investing activities | (808) | (714) | ||||||||||||
| Cash flows from financing activities: | ||||||||||||||
| Repayments of borrowings | (2,851) | (3,221) | ||||||||||||
| Proceeds from borrowings | 2,023 | 2,872 | ||||||||||||
| Repurchases of common stock | (250) | — | ||||||||||||
| Debt issuance costs | (24) | (31) | ||||||||||||
| Distributions paid to noncontrolling interests | (560) | (423) | ||||||||||||
| Proceeds from the sale of noncontrolling interests | 27 | 25 | ||||||||||||
| Purchases of noncontrolling interests | (100) | (27) | ||||||||||||
| Medicare advances and grants received by unconsolidated affiliates, net of recoupment | — | (67) | ||||||||||||
| Other items, net | (46) | (64) | ||||||||||||
| Net cash used in financing activities | (1,781) | (936) | ||||||||||||
| Net decrease in cash and cash equivalents | (1,506) | (82) | ||||||||||||
| Cash and cash equivalents at beginning of period | 2,364 | 2,446 | ||||||||||||
| Cash and cash equivalents at end of period | $ | 858 | $ | 2,364 | ||||||||||
| Supplemental disclosures: | ||||||||||||||
| Interest paid, net of capitalized interest | $ | (848) | $ | (937) | ||||||||||
| Income tax payments, net | $ | (161) | $ | (92) | ||||||||||
| Three Months Ended | Twelve Months Ended | |||||||||||||||||||||||||
| (Dollars in millions) | December 31, | December 31, | ||||||||||||||||||||||||
| 2022 | 2021 | 2022 | 2021 | |||||||||||||||||||||||
Net operating revenues (1) : |
||||||||||||||||||||||||||
| Ambulatory Care | $ | 933 | $ | 742 | $ | 3,248 | $ | 2,718 | ||||||||||||||||||
| Hospital Operations and other (prior to inter-segment eliminations) | 3,840 | 3,910 | 15,061 | 15,982 | ||||||||||||||||||||||
| Conifer | ||||||||||||||||||||||||||
| Tenet | 109 | 120 | 451 | 482 | ||||||||||||||||||||||
| Other clients | 217 | 204 | 865 | 785 | ||||||||||||||||||||||
| Total Conifer revenues | 326 | 324 | 1,316 | 1,267 | ||||||||||||||||||||||
| Inter-segment eliminations | (109) | (120) | (451) | (482) | ||||||||||||||||||||||
| Total | $ | 4,990 | $ | 4,856 | $ | 19,174 | $ | 19,485 | ||||||||||||||||||
| Equity in earnings of unconsolidated affiliates: | ||||||||||||||||||||||||||
| Ambulatory Care | $ | 63 | $ | 63 | $ | 206 | $ | 193 | ||||||||||||||||||
| Hospital Operations and other | 2 | 14 | 10 | 25 | ||||||||||||||||||||||
| Total | $ | 65 | $ | 77 | $ | 216 | $ | 218 | ||||||||||||||||||
| Adjusted EBITDA (including grant income): | ||||||||||||||||||||||||||
| Ambulatory Care | $ | 407 | $ | 371 | $ | 1,327 | $ | 1,197 | ||||||||||||||||||
| Hospital Operations and other | 400 | 552 | 1,777 | 1,931 | ||||||||||||||||||||||
| Conifer | 90 | 94 | 365 | 355 | ||||||||||||||||||||||
| Total | $ | 897 | $ | 1,017 | $ | 3,469 | $ | 3,483 | ||||||||||||||||||
| Adjusted EBITDA margins (including grant income): | ||||||||||||||||||||||||||
| Ambulatory Care | 43.6 | % | 50.0 | % | 40.9 | % | 44.0 | % | ||||||||||||||||||
| Hospital Operations and other | 10.4 | % | 14.1 | % | 11.8 | % | 12.1 | % | ||||||||||||||||||
| Conifer | 27.6 | % | 29.0 | % | 27.7 | % | 28.0 | % | ||||||||||||||||||
| Total | 18.0 | % | 20.9 | % | 18.1 | % | 17.9 | % | ||||||||||||||||||
| Adjusted EBITDA margins (excluding grant income): | ||||||||||||||||||||||||||
| Ambulatory Care | 43.6 | % | 46.2 | % | 40.7 | % | 41.7 | % | ||||||||||||||||||
| Hospital Operations and other | 9.4 | % | 11.3 | % | 10.5 | % | 11.2 | % | ||||||||||||||||||
| Conifer | 27.6 | % | 29.0 | % | 27.7 | % | 28.0 | % | ||||||||||||||||||
| Total | 17.2 | % | 18.1 | % | 17.1 | % | 16.8 | % | ||||||||||||||||||
| Capital expenditures: | ||||||||||||||||||||||||||
| Ambulatory Care | $ | 17 | $ | 17 | $ | 75 | $ | 66 | ||||||||||||||||||
| Hospital Operations and other | 263 | 283 | 668 | 578 | ||||||||||||||||||||||
| Conifer | 10 | 4 | 19 | 14 | ||||||||||||||||||||||
| Total | $ | 290 | $ | 304 | $ | 762 | $ | 658 | ||||||||||||||||||
| (1) Net operating revenues include the impact of implicit price concessions and bad debts | ||||||||||||||||||||||||||
| (Dollars in millions, except per share amounts) | Three Months Ended | Twelve Months Ended | ||||||||||||||||||||||||
| December 31, | December 31, | |||||||||||||||||||||||||
| 2022 | 2021 | 2022 | 2021 | |||||||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 102 | $ | 249 | $ | 411 | $ | 914 | ||||||||||||||||||
| Net (loss) income from discontinued operations | — | (1) | 1 | (1) | ||||||||||||||||||||||
| Net income from continuing operations | 102 | 250 | 410 | 915 | ||||||||||||||||||||||
|
Less: Impairment and restructuring charges, and acquisition-related
costs
|
(129) | (30) | (226) | (85) | ||||||||||||||||||||||
| Litigation and investigation costs | (20) | (52) | (70) | (116) | ||||||||||||||||||||||
| Net gains on sales, consolidation and deconsolidation of facilities | 1 | 18 | 1 | 445 | ||||||||||||||||||||||
| Loss from early extinguishment of debt | — | — | (109) | (74) | ||||||||||||||||||||||
| Loss from divested and closed businesses | — | (1) | — | (1) | ||||||||||||||||||||||
| Tax and noncontrolling interests impact of above items | 37 | 21 | 70 | (77) | ||||||||||||||||||||||
| Adjusted net income available from continuing operations to common shareholders | $ | 213 | $ | 294 | $ | 744 | $ | 823 | ||||||||||||||||||
| Diluted earnings per share from continuing operations | $ | 0.92 | $ | 2.30 | $ | 3.78 | $ | 8.43 | ||||||||||||||||||
| Less: Impairment and restructuring charges, and acquisition-related costs
|
(1.21) | (0.27) | (2.04) | (0.78) | ||||||||||||||||||||||
| Litigation and investigation costs | (0.19) | (0.48) | (0.63) | (1.07) | ||||||||||||||||||||||
| Net gains on sales, consolidation and deconsolidation of facilities | 0.01 | 0.17 | 0.01 | 4.10 | ||||||||||||||||||||||
| Loss from early extinguishment of debt | — | — | (0.99) | (0.68) | ||||||||||||||||||||||
| Loss from divested and closed businesses | — | (0.01) | — | (0.01) | ||||||||||||||||||||||
| Tax and noncontrolling interests impact of above items | 0.35 | 0.19 | 0.63 | (0.71) | ||||||||||||||||||||||
| Adjusted diluted earnings per share from continuing operations | $ | 1.96 | $ | 2.70 | $ | 6.80 | $ | 7.58 | ||||||||||||||||||
| Weighted average basic shares outstanding (in thousands) | 104,519 | 107,150 | 106,929 | 106,833 | ||||||||||||||||||||||
| Weighted average dilutive shares outstanding (in thousands) | 106,368 | 108,890 | 110,516 | 108,571 | ||||||||||||||||||||||
| (Dollars in millions) | Three Months Ended | Twelve Months Ended | ||||||||||||||||||||||||
| December 31, | December 31, | |||||||||||||||||||||||||
| 2022 | 2021 | 2022 | 2021 | |||||||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 102 | $ | 249 | $ | 411 | $ | 914 | ||||||||||||||||||
| Less: Net income available to noncontrolling interests | (172) | (170) | (590) | (562) | ||||||||||||||||||||||
| (Loss) income from discontinued operations, net of tax | — | (1) | 1 | (1) | ||||||||||||||||||||||
| Income from continuing operations | 274 | 420 | 1,000 | 1,477 | ||||||||||||||||||||||
| Income tax expense | (47) | (108) | (344) | (411) | ||||||||||||||||||||||
| Loss from early extinguishment of debt | — | — | (109) | (74) | ||||||||||||||||||||||
| Other non-operating income (loss), net | 4 | (2) | 10 | 14 | ||||||||||||||||||||||
| Interest expense | (219) | (221) | (890) | (923) | ||||||||||||||||||||||
| Operating income | 536 | 751 | 2,333 | 2,871 | ||||||||||||||||||||||
| Litigation and investigation costs | (20) | (52) | (70) | (116) | ||||||||||||||||||||||
| Net gains on sales, consolidation and deconsolidation of facilities | 1 | 18 | 1 | 445 | ||||||||||||||||||||||
| Impairment and restructuring charges, and acquisition-related costs | (129) | (30) | (226) | (85) | ||||||||||||||||||||||
| Depreciation and amortization | (213) | (201) | (841) | (855) | ||||||||||||||||||||||
| Loss from divested and closed businesses | — | (1) | — | (1) | ||||||||||||||||||||||
| Adjusted EBITDA | $ | 897 | $ | 1,017 | $ | 3,469 | $ | 3,483 | ||||||||||||||||||
| Net operating revenues | $ | 4,990 | $ | 4,856 | $ | 19,174 | $ | 19,485 | ||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues | 2.0 | % | 5.1 | % | 2.1 | % | 4.7 | % | ||||||||||||||||||
| Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin) | 18.0 | % | 20.9 | % | 18.1 | % | 17.9 | % | ||||||||||||||||||
| (Dollars in millions) | 2022 | |||||||||||||
| Q4 | Full Year | |||||||||||||
| Net cash provided by operating activities | $ | 421 | $ | 1,083 | ||||||||||
| Purchases of property and equipment | (290) | (762) | ||||||||||||
| Free cash flow | 131 | 321 | ||||||||||||
| Add back: Medicare Advance Repayments | — | 880 | ||||||||||||
| Payroll Tax Deferral Payments | 128 | 128 | ||||||||||||
| Free cash flow, excluding repayment of Medicare Advances and Deferred Payroll Tax Payments | $ | 259 | $ | 1,329 | ||||||||||
| Net cash used in investing activities | $ | (306) | $ | (808) | ||||||||||
| Net cash used in financing activities | $ | (465) | $ | (1,781) | ||||||||||
| Net cash provided by operating activities | $ | 421 | $ | 1,083 | ||||||||||
| Less: Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (57) | (214) | ||||||||||||
| Net cash used in operating activities from discontinued operations | — | (1) | ||||||||||||
| Adjusted net cash provided by operating activities from continuing operations | 478 | 1,298 | ||||||||||||
| Purchases of property and equipment | (290) | (762) | ||||||||||||
| Adjusted free cash flow – continuing operations | 188 | 536 | ||||||||||||
| Add back: Medicare Advance Repayments | — | 880 | ||||||||||||
| Payroll Tax Deferral Payments | 128 | 128 | ||||||||||||
| Adjusted free cash flow – continuing operations, excluding repayments of Medicare Advances and Deferred Payroll Tax Payments | $ | 316 | $ | 1,544 | ||||||||||
| (Dollars in millions) | 2021 | |||||||||||||
| Q4 | Full Year | |||||||||||||
| Net cash provided by operating activities | $ | 357 | $ | 1,568 | ||||||||||
| Purchases of property and equipment | (304) | (658) | ||||||||||||
| Free cash flow | 53 | 910 | ||||||||||||
| Add back: Medicare Advance Repayments | 186 | 512 | ||||||||||||
| Payroll Tax Deferral Payments | 128 | 128 | ||||||||||||
| Free cash flow, excluding repayment of Medicare Advances and Deferred Payroll Tax Payments | $ | 367 | $ | 1,550 | ||||||||||
| Net cash used in investing activities | $ | (1,516) | $ | (714) | ||||||||||
| Net cash provided by (used in) financing activities | $ | 1,231 | $ | (936) | ||||||||||
| Net cash provided by operating activities | $ | 357 | $ | 1,568 | ||||||||||
| Less: Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | (37) | (153) | ||||||||||||
| Net cash provided by operating activities from discontinued operations | 1 | — | ||||||||||||
| Adjusted net cash provided by operating activities from continuing operations | 393 | 1,721 | ||||||||||||
| Purchases of property and equipment | (304) | (658) | ||||||||||||
| Adjusted free cash flow – continuing operations | 89 | 1,063 | ||||||||||||
| Add back: Medicare Advance Repayments | 186 | 512 | ||||||||||||
| Payroll Tax Deferral Payments | 128 | 128 | ||||||||||||
| Adjusted free cash flow – continuing operations, excluding repayments of Medicare Advances and Deferred Payroll Tax Payments | $ | 403 | $ | 1,703 | ||||||||||
| (Dollars in millions, except per share amounts) | First Quarter 2023 |
FY 2023 | ||||||||||||||||||||||||
| Low | High | Low | High | |||||||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 90 | $ | 125 | $ | 420 | $ | 585 | ||||||||||||||||||
| Net income from continuing operations | 90 | 125 | 420 | 585 | ||||||||||||||||||||||
Less: Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1) |
(25) | (15) | (100) | (50) | ||||||||||||||||||||||
Tax impact of above items |
5 | 5 | 15 | 5 | ||||||||||||||||||||||
| Adjusted net income available from continuing operations to common shareholders | $ | 110 | $ | 135 | $ | 505 | $ | 630 | ||||||||||||||||||
| Diluted earnings per share from continuing operations | $ | 0.82 | $ | 1.14 | $ | 3.89 | $ | 5.43 | ||||||||||||||||||
| Less: Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements | (0.23) | (0.14) | (0.93) | (0.47) | ||||||||||||||||||||||
Tax impact of above items |
0.05 | 0.05 | 0.14 | 0.05 | ||||||||||||||||||||||
| Adjusted diluted earnings per share from continuing operations | $ | 1.00 | $ | 1.23 | $ | 4.68 | $ | 5.85 | ||||||||||||||||||
| Weighted average basic shares outstanding (in thousands) | 103,000 | 103,000 | 103,000 | 103,000 | ||||||||||||||||||||||
| Weighted average dilutive shares outstanding (in thousands) | 107,000 | 107,000 | 107,000 | 107,000 | ||||||||||||||||||||||
| (Dollars in millions) | First Quarter 2023 |
FY 2023 | ||||||||||||||||||||||||
| Low | High | Low | High | |||||||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders | $ | 90 | $ | 125 | $ | 420 | $ | 585 | ||||||||||||||||||
| Less: Net income available to noncontrolling interests | (135) | (155) | (620) | (670) | ||||||||||||||||||||||
Income tax expense |
(60) | (70) | (270) | (300) | ||||||||||||||||||||||
Interest expense |
(225) | (215) | (880) | (870) | ||||||||||||||||||||||
| Other non-operating expense, net | (5) | — | (20) | (10) | ||||||||||||||||||||||
Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1) |
(25) | (15) | (100) | (50) | ||||||||||||||||||||||
Depreciation and amortization |
(210) | (220) | (850) | (875) | ||||||||||||||||||||||
| Adjusted EBITDA | $ | 750 | $ | 800 | $ | 3,160 | $ | 3,360 | ||||||||||||||||||
| Income from continuing operations | $ | 90 | $ | 125 | $ | 420 | $ | 585 | ||||||||||||||||||
| Net operating revenues | $ | 4,700 | $ | 4,900 | $ | 19,700 | $ | 20,100 | ||||||||||||||||||
| Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues | 1.9 | % | 2.6 | % | 2.1 | % | 2.9 | % | ||||||||||||||||||
| Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin) | 16.0 | % | 16.3 | % | 16.0 | % | 16.7 | % | ||||||||||||||||||
| (Dollars in millions) | FY 2023 | |||||||||||||||||||||||||||||||
| Low | High | |||||||||||||||||||||||||||||||
| Net cash provided by operating activities | $ | 1,700 | $ | 2,000 | ||||||||||||||||||||||||||||
| Purchases of property and equipment – continuing operations | (625) | (675) | ||||||||||||||||||||||||||||||
| Free cash flow – continuing operations | $ | 1,075 | $ | 1,325 | ||||||||||||||||||||||||||||
| Net cash provided by operating activities | $ | 1,700 | $ | 2,000 | ||||||||||||||||||||||||||||
Less: Payments for restructuring charges, acquisition-related costs and litigation costs and settlements(1) |
(125) | (75) | ||||||||||||||||||||||||||||||
Adjusted net cash provided by operating activities – continuing operations |
1,825 | 2,075 | ||||||||||||||||||||||||||||||
| Purchases of property and equipment – continuing operations | (625) | (675) | ||||||||||||||||||||||||||||||
Adjusted free cash flow – continuing operations(2) |
$ | 1,200 | $ | 1,400 | ||||||||||||||||||||||||||||