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Press release from Business Wire

Tenet Reports Fourth Quarter Adjusted EBITDA of $336 Million, an Increase of 16.7%

<p class='bwalignc'> <i><b>7.3% Growth in Net Operating Revenues</b></i> </p> <p class='bwalignc'> <i><b>2.9% Increase in Adjusted Admissions</b></i> </p> <p class='bwalignc'> <i><b>7.5% Growth in Surgeries</b></i> </p>

Tuesday, February 26, 2013

Tenet Reports Fourth Quarter Adjusted EBITDA of $336 Million, an Increase of 16.7%07:30 EST Tuesday, February 26, 2013 DALLAS (Business Wire) -- Tenet Healthcare Corporation (NYSE:THC) today reported Adjusted EBITDA of $336 million for the fourth quarter ended December 31, 2012, an increase of $48 million, or 16.7 percent, as compared to Adjusted EBITDA of $288 million in the fourth quarter of 2011. Net income attributable to common shareholders in the quarter was $49 million, or $0.45 per share, compared to a loss of $76 million, or $0.70 per share, in the fourth quarter of 2011, which included an after-tax loss of $74 million due to the early extinguishment of debt, or $0.68 per share. Adjusted EBITDA for the year ended December 31, 2012 was $1.203 billion, an increase of $77 million, or 6.8 percent, as compared to Adjusted EBITDA of $1.126 billion in the year ended December 31, 2011. “The fourth quarter provided a strong finish to 2012, which became our ninth consecutive year of consistent earnings growth, with compound annual EBITDA growth of 15 percent,” said Trevor Fetter, president and chief executive officer. “Strong revenue growth and disciplined cost control were once again hallmarks of our financial performance. Net revenues grew by 7.3 percent reflecting strong volume increases and continued pricing strength. Our volume growth was one of the strongest in the investor-owned healthcare provider sector, and we recorded our ninth consecutive quarter of positive growth in adjusted admissions. Volume growth included another strong quarter of growth in outpatient surgeries which increased by 13.9 percent. Cost control was excellent with hospital operations restraining expense growth to just 1.9 percent per adjusted admission, and Conifer Health Solutions, Tenet's services business, reported another solid quarter contributing $31 million of Adjusted EBITDA.” Discussion of Results(Percentage changes compare Q4'12 to Q4'11, unless otherwise noted.) Adjusted admissions increased 2.9 percent in the fourth quarter led by strong growth in outpatient visits of 7.3 percent. Approximately 80 percent of the outpatient visit growth was organic. Total admissions were flat. Total emergency department visits increased 8.6 percent and emergency department admissions increased 1.7 percent. The sum of uninsured and charity admissions increased 1.1 percent. Bad debt expense as a percent of revenues was 7.9 percent, an increase of 20 basis points compared to 7.7 percent in the fourth quarter of 2011. The increase in bad debt expense was largely the result of the increase in uninsured patient volumes. Our self-pay collection rate was 28.9 percent in the fourth quarter of 2012, a 120 basis point improvement compared to 27.7 percent in the fourth quarter of 2011. Net operating revenues were $2.331 billion, an increase of $159 million, or 7.3 percent, compared to net operating revenues of $2.172 billion in the fourth quarter of 2011. Commercial managed care revenue increased 5.2 percent, which reflected a 7.1 percent and 7.6 percent increase in commercial managed care revenue per patient day and per outpatient visit, respectively. Total net patient revenue per adjusted admission was $11,866, an increase of 2.8 percent. This pricing increase primarily reflects improved terms in our contracts with commercial managed care payers, as well as higher Medicare reimbursement rates that became effective on October 1, partially offset by a softer payer mix. Selected operating expenses of our hospital operations, defined as the sum of salaries, wages and benefits, supplies and other operating expenses excluding the Company's Conifer services business, increased by only 1.9 percent on a per adjusted admission basis. This cost metric excludes Conifer since Conifer does not generate incremental volumes, which impacts the relationship of this aggregate cost metric to patient volumes. Supplies expense per adjusted admission declined 1.1 percent. Electronic health record incentives were $27 million in the fourth quarter of 2012 compared to $5 million in the fourth quarter of 2011 and are not a part of the definition of selected operating expenses. Cash and cash equivalents were $364 million at December 31, 2012 compared to $83 million at September 30, 2012. The Company had no outstanding balance on its bank line at December 31, 2012. Accounts receivable days improved by two days to 53 days down from 55 days at September 30, 2012. Approximately $57 million of aggregate revenues related to the California Provider Fee program and the Texas uncompensated care 1115 waiver program were recognized in Adjusted EBITDA in 2012, but were not yet received by year end. Outlook for Adjusted EBITDA in First Quarter and Full Year 2013 The Company confirms its previously announced Outlook for 2013 Adjusted EBITDA of $1.325 billion to $1.425 billion. The $1.375 billion mid-point of this Outlook range is slightly above the current consensus estimate. For the first quarter of 2013, the Outlook range for Adjusted EBITDA is $250 million to $290 million. This first quarter Outlook excludes any contribution related to the managed care portion of the 30 month California Provider Fee program, which is now expected to contribute $53 million to Adjusted EBITDA in our quarter ending June 30, 2013. Management's Webcast Discussion of Fourth Quarter Results Tenet management will discuss the Company's fourth quarter 2012 results on a 10:00 AM (ET) webcast on February 26, 2013. This webcast may be accessed through Tenet's website at www.tenethealth.com/investors. Additional information regarding Tenet's quarterly results of operations, including detailed tabular operational data, is contained in its Form 10-K report, which will be filed with the Securities and Exchange Commission and posted on the Tenet investor relations website before the webcast. This press release includes certain non-GAAP measures, such as Adjusted EBITDA. A reconciliation of non-GAAP measures included in this release is included in the financial tables at the end of this release. Tenet Healthcare Corporation, a leading health care services company, through its subsidiaries operates 49 hospitals, 117 outpatient centers and Conifer Health Solutions, a leader in business process solutions for health care providers that serves over 600 hospital and other clients nationwide. Tenet's hospitals and related health care facilities are committed to providing high quality care to patients in the communities they serve. For more information, please visit www.tenethealth.com. This document contains “forward-looking statements” – that is, statements relating 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,” “anticipate,” “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 the factors disclosed under “Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the year ended Dec. 31, 2012, our quarterly reports on Form 10-Q, periodic reports on Form 8-K and other filings with the Securities and Exchange Commission. The Company assumes no obligation to update forward-looking statements contained in this press release as a result of new information or future events or developments. Tenet uses its company web site to provide important information to investors about the company including the posting of important announcements regarding financial performance and corporate developments.   TENET HEALTHCARE CORPORATION CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) (Dollars in millions except per share amounts)   Three Months Ended December 31,2012   %   2011   %   Change   Net operating revenues: Net operating revenues before provision for doubtful accounts $ 2,531 $ 2,353 7.6 % Less: Provision for doubtful accounts   200     181   10.5 % Net operating revenues2,331100.0%2,172100.0%7.3%Operating expenses: Salaries, wages and benefits 1,091 46.8 % 1,014 46.7 % 7.6 % Supplies 388 16.6 % 381 17.5 % 1.8 % Other operating expenses, net 543 23.3 % 494 22.8 % 9.9 % Electronic health record incentives (27 ) (1.2 ) % (5 ) (0.2 ) % 440.0 % Depreciation and amortization 116 5.0 % 100 4.6 % 16.0 % Impairment of long-lived assets and goodwill, and restructuring charges, net 7 0.3 % 2 0.1 % Litigation and investigation costs   2   0.1 %   31   1.4 % Operating income2119.1%1557.1% Interest expense (109 ) (100 ) Loss from early extinguishment of debt (4 ) (117 ) Investment earnings (loss)   (1 )   —   Income (loss) from continuing operations, before income taxes97(62) Income tax benefit (expense)   (35 )   12   Income (loss) from continuing operations, before discontinued operations62(50)Discontinued operations: Loss from operations (9 ) (1 ) Impairment of long-lived assets and goodwill, and restructuring charges, net — (6 ) Litigation settlements, and investigation costs — (17 ) Income tax benefit   1     8   Loss from discontinued operations   (8)   (16)Net income (loss)54(66) Less: Preferred stock dividends — 6 Less: Net income attributable to noncontrolling interests Continuing operations 5 3 Discontinued operations   —     1   Net income (loss) attributable to Tenet Healthcare Corporation common shareholders$49   $(76)   Amounts attributable to Tenet Healthcare Corporation common shareholders Income (loss) from continuing operations, net of tax $ 57 $ (60 ) Loss from discontinued operations, net of tax   (8 )   (16 ) Net income (loss) attributable to Tenet Healthcare Corporation common shareholders$49   $(76)   Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholdersBasic Continuing operations $ 0.54 $ (0.55 ) Discontinued operations   (0.08 )   (0.15 ) $ 0.46   $ (0.70 ) Diluted Continuing operations $ 0.52 $ (0.55 ) Discontinued operations   (0.07 )   (0.15 ) $ 0.45   $ (0.70 ) Weighted average shares and dilutive securities outstanding (in thousands): Basic 105,961 108,114 Diluted 108,960 108,114   TENET HEALTHCARE CORPORATION CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) (Dollars in millions except per share amounts)Year Ended December 31,2012%2011%Change   Net operating revenues: Net operating revenues before provision for doubtful accounts $ 9,904 $ 9,371 5.7 % Less: Provision for doubtful accounts   785     717   9.5 % Net operating revenues9,119100.0%8,654100.0%5.4%Operating expenses: Salaries, wages and benefits 4,257 46.7 % 4,015 46.4 % 6.0 % Supplies 1,552 17.0 % 1,548 17.9 % 0.3 % Other operating expenses, net 2,147 23.5 % 2,020 23.4 % 6.3 % Electronic health record incentives (40 ) (0.4 ) % (55 ) (0.6 ) % (27.3 ) % Depreciation and amortization 430 4.7 % 398 4.6 % 8.0 % Impairment of long-lived assets and goodwill, and restructuring charges, net 19 0.2 % 20 0.2 % Litigation and investigation costs   5   0.1 %   55   0.6 % Operating income7498.2%6537.5% Interest expense (412 ) (375 ) Loss from early extinguishment of debt (4 ) (117 ) Investment earnings   1     3   Income from continuing operations, before income taxes334164 Income tax expense   (125 )   (61 ) Income from continuing operations, before discontinued operations209103Discontinued operations: Loss from operations (2 ) (18 ) Impairment of long-lived assets and goodwill, and restructuring charges, net (100 ) (6 ) Litigation and investigation costs — (17 ) Net gains on sales of facilities 1 — Income tax benefit   25     32   Loss from discontinued operations   (76)   (9)Net income13394 Less: Preferred stock dividends 11 24 Less: Net income (loss) attributable to noncontrolling interests Continuing operations 13 11 Discontinued operations   (32 )   1   Net income attributable to Tenet Healthcare Corporation common shareholders$141   $58     Amounts attributable to Tenet Healthcare Corporation common shareholders Income from continuing operations, net of tax $ 185 $ 68 Loss from discontinued operations, net of tax   (44 )   (10 ) Net income attributable to Tenet Healthcare Corporation common shareholders$141   $58     Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholdersBasic Continuing operations $ 1.77 $ 0.58 Discontinued operations   (0.42 )   (0.09 ) $ 1.35   $ 0.49   Diluted Continuing operations $ 1.70 $ 0.56 Discontinued operations   (0.40 )   (0.08 ) $ 1.30   $ 0.48   Weighted average shares and dilutive securities outstanding (in thousands): Basic 104,200 117,182 Diluted 108,926 121,295     TENET HEALTHCARE CORPORATION CONSOLIDATED BALANCE SHEETS (Unaudited)     December 31,   December 31,(Dollars in millions)20122011ASSETSCurrent assets: Cash and cash equivalents $ 364 $ 113 Accounts receivable, less allowance for doubtful accounts 1,345 1,278 Inventories of supplies, at cost 153 161 Income tax receivable 7 7 Current portion of deferred income taxes 354 418 Assets held for sale — 2 Other current assets   458     378   Total current assets2,6812,357 Investments and other assets 162 156 Deferred income taxes, net of current portion 342 374 Property and equipment, at cost, less accumulated depreciation and amortization 4,293 4,350 Goodwill 916 736 Other intangible assets, at cost, less accumulated amortization   650     489   Total assets$9,044   $8,462     LIABILITIES AND EQUITYCurrent liabilities: Current portion of long-term debt $ 94 $ 66 Accounts payable 722 760 Accrued compensation and benefits 415 376 Professional and general liability reserves 64 75 Accrued interest payable 125 112 Accrued legal settlement costs 8 64 Other current liabilities   335     362   Total current liabilities1,7631,815 Long-term debt, net of current portion 5,158 4,294 Professional and general liability reserves 292 337 Accrued legal settlement costs 2 2 Other long-term liabilities   595     506   Total liabilities7,8106,954 Commitments and contingencies Redeemable noncontrolling interests in equity of consolidated subsidiaries 16 16 Equity:Shareholders' equity: Preferred stock — 334 Common stock 7 7 Additional paid-in capital 4,471 4,427 Accumulated other comprehensive loss (68 ) (52 ) Accumulated deficit (1,288 ) (1,440 ) Common stock in treasury, at cost   (1,979 )   (1,853 ) Total shareholders' equity1,1431,423Noncontrolling interests   75     69   Total equity   1,218     1,492   Total liabilities and equity$9,044   $8,462       TENET HEALTHCARE CORPORATION CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) (Dollars in millions)   Year EndedDecember 31,2012   2011Net income$133$94Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization 430 398 Provision for doubtful accounts 785 717 Deferred income tax expense 92 81 Stock-based compensation expense 32 24 Impairment of long-lived assets and goodwill, and restructuring charges, net 19 20 Litigation and investigation costs 5 55 Loss from early extinguishment of debt 4 117 Amortization of debt discount and debt issuance costs 22 30 Pre-tax loss from discontinued operations 101 41 Other items, net (12 ) (13 ) Changes in cash from changes in operating assets and liabilities: Accounts receivable (868 ) (850 ) Inventories and other current assets (59 ) (35 ) Income taxes (5 ) (63 ) Accounts payable, accrued expenses and other current liabilities 9 (32 ) Other long-term liabilities 3 (5 ) Payments against reserves for restructuring charges and litigation costs and settlements(63)(44)Net cash used in operating activities from discontinued operations, excluding income taxes   (35)   (38)Net cash provided by operating activities593497Cash flows from investing activities: Purchases of property and equipment—continuing operations (506 ) (467 ) Purchases of property and equipment—discontinued operations (2 ) (8 ) Purchases of businesses or joint venture interests (211 ) (84 ) Proceeds from sales of facilities and other assets — discontinued operations 45 — Proceeds from sales of marketable securities, long-term investments and other assets 17 59 Other items, net   (5 )   (3 ) Net cash used in investing activities(662)(503)Cash flows from financing activities: Repayments of borrowings under credit facility (1,773 ) (365 ) Proceeds from borrowings under credit facility 1,693 445 Repayments of other borrowings (248 ) (843 ) Proceeds from other borrowings 1,092 900 Repurchases of preferred stock (292 ) — Deferred debt issuance costs (17 ) (21 ) Repurchases of common stock (126 ) (374 ) Cash dividends on preferred stock (14 ) (24 ) Distributions paid to noncontrolling interests (15 ) (10 ) Other items, net   20     6   Net cash provided by (used in) financing activities   320     (286) Net increase (decrease) in cash and cash equivalents 251 (292 ) Cash and cash equivalents at beginning of period   113     405   Cash and cash equivalents at end of period$364   $113   Supplemental disclosures: Interest paid, net of capitalized interest $ (376 ) $ (347 ) Proceeds from interest rate swap agreement $ — $ 30 Income tax payments, net $ (13 ) $ (10 )     TENET HEALTHCARE CORPORATION SELECTED STATISTICS – CONTINUING HOSPITALS (Unaudited)     (Dollars in millions except per patient day, per admission and per visit amounts)   Three Months Ended December 31,     Year Ended December 31,2012   2011   Change2012   2011   Change   Net inpatient revenues $ 1,544 $ 1,499 3.0 % $ 6,200 $ 6,028 2.9 %   Net outpatient revenues $ 821 $ 736 11.5 % $ 3,167 $ 2,928 8.2 %   Number of acute care hospitals (at end of period) 49 49 — * 49 49 — * Licensed beds (at end of period) 13,216 13,119 0.7 % 13,216 13,119 0.7 % Average licensed beds 13,216 13,119 0.7 % 13,187 13,115 0.5 % Utilization of licensed beds 47.7 % 48.9 % (1.2 ) % * 49.1 % 50.4 % (1.3 ) % * Patient days 580,426 589,848 (1.6 ) % 2,368,916 2,413,245 (1.8 ) % Adjusted patient days 915,584 902,762 1.4 % 3,693,828 3,673,447 0.6 % Net inpatient revenue per patient day $ 2,660 $ 2,541 4.7 % $ 2,617 $ 2,498 4.8 % Total admissions 125,290 125,347 — % 506,485 507,834 (0.3 ) % Adjusted patient admissions 199,304 193,631 2.9 % 796,874 780,026 2.2 % Net inpatient revenue per admission $ 12,323 $ 11,959 3.0 % $ 12,241 $ 11,870 3.1 % Average length of stay (days) 4.63 4.71 (1.7 )% 4.68 4.75 (1.5 ) % Total surgeries 98,045 91,200 7.5 % 380,955 362,286 5.2 % Outpatient visits 1,053,499 982,083 7.3 % 4,167,114 3,954,016 5.4 % Net outpatient revenue per visit $ 779 $ 749 4.0 % $ 760 $ 741 2.6 %   Sources of net patient revenues Medicare 22.4 % 23.1 % (0.7 ) % * 23.4 % 23.1 % 0.3 % * Medicaid 8.3 % 8.6 % (0.3 ) % * 8.4 % 9.0 % (0.6 ) % * Managed care 58.3 % 58.1 % 0.2 % * 57.4 % 57.2 % 0.2 % * Indemnity, self-pay and other 11.0 % 10.2 % 0.8 % * 10.8 % 10.7 % 0.1 % *     * This change is the difference between the 2012 and 2011 amounts shown     TENET HEALTHCARE CORPORATION CONSOLIDATED STATEMENTS OF OPERATIONS Fiscal 2012 by Calendar Quarter (Unaudited)   (Dollars in millions except per share amounts)   Three Months Ended   YearEnded03/31/12   06/30/12   09/30/12   12/31/1212/31/12   Net operating revenues: Net operating revenues before provision for doubtful accounts $ 2,491 $ 2,455 $ 2,427 $ 2,531 $ 9,904 Less: Provision for doubtful accounts   189     190     206     200     785   Net operating revenues2,3022,2652,2212,3319,119Operating expenses: Salaries, wages and benefits 1,062 1,054 1,050 1,091 4,257 Supplies 399 389 376 388 1,552 Other operating expenses, net 531 534 539 543 2,147 Electronic health record incentives — — (13 ) (27 ) (40 ) Depreciation and amortization 100 104 110 116 430 Impairment of long-lived assets and goodwill, and restructuring charges, net 3 3 6 7 19 Litigation and investigation costs   2     1     —     2     5   Operating income205180153211749 Interest expense (98 ) (102 ) (103 ) (109 ) (412 ) Loss from early extinguishment of debt — — — (4 ) (4 ) Investment earnings   1     —     1     (1 )   1   Income from continuing operations, before income taxes108785197334 Income tax expense   (42 )   (30 )   (18 )   (35 )   (125 ) Income from continuing operations, before discontinued operations66483362209Discontinued operations: Income from operations 2 1 4 (9 ) (2 ) Impairment of long-lived assets and goodwill, and restructuring charges, net   — (100 ) — — (100 ) Net gains (losses) on sales of facilities — 2 (1 ) — 1 Income tax benefit (expense)   (1 )   29     (4 )   1     25   Income (loss) from discontinued operations   1     (68)   (1)   (8)   (76)Net income (loss)67(20)3254133 Less: Preferred stock dividends 6 4 1 — 11 Less: Net income (loss) attributable to noncontrolling interests Continuing operations 3 2 3 5 13 Discontinued operations   —     (20 )   (12 )   —     (32 ) Net income (loss) attributable to Tenet Healthcare Corporation common shareholders$58   $(6)$40   $49   $141     Amounts attributable to Tenet Healthcare Corporation common shareholders Income from continuing operations, net of tax $ 57 $ 42 $ 30 $ 57 $ 185 Income (loss) from discontinued operations, net of tax   1     (48 )   10     (8 )   (44 ) Net income (loss) attributable to Tenet Healthcare Corporation common shareholders$58   $(6)$40   $49   $141     Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholdersBasic Continuing operations $ 0.55 $ 0.40 $ 0.29 $ 0.54 $ 1.77 Discontinued operations   0.01     (0.46 )   0.09     (0.08 )   (0.42 ) $ 0.56   $ (0.06 ) $ 0.38   $ 0.46   $ 1.35   Diluted Continuing operations $ 0.52 $ 0.39 $ 0.28 $ 0.52 $ 1.70 Discontinued operations   0.01     (0.45 )   0.09     (0.07 )   (0.40 ) $ 0.53   $ (0.06 ) $ 0.37   $ 0.45   $ 1.30   Weighted average shares and dilutive securities outstanding (in thousands): Basic 102,843 103,753 104,244 105,961 104,200 Diluted 121,218 106,927 107,311 108,960 108,926     TENET HEALTHCARE CORPORATION SELECTED STATISTICS – CONTINUING HOSPITALS (Unaudited)               Year(Dollars in millions except per patient day, per admission and per visit amounts)Three Months Ended   Ended03/31/12   06/30/1209/30/1212/31/1212/31/12   Net inpatient revenues $ 1,607 $ 1,548 $ 1,501 $ 1,544 $ 6,200 Net outpatient revenues $ 766 $ 791 $ 789 $ 821 $ 3,167   Number of acute care hospitals (at end of period) 49 49 49 49 49 Licensed beds (at end of period) 13,175 13,176 13,216 13,216 13,216 Average licensed beds 13,138 13,176 13,216 13,216 13,187 Utilization of licensed beds 51.6 % 49.2 % 47.8 % 47.7 % 49.1 % Patient days 617,459 590,437 580,594 580,426 2,368,916 Adjusted patient days 947,116 919,895 911,233 915,584 3,693,828 Net inpatient revenue per patient day $ 2,603 $ 2,622 $ 2,585 $ 2,660 $ 2,617 Total admissions 131,190 125,136 124,869 125,290 506,485 Adjusted patient admissions 202,860 196,932 197,778 199,304 796,874 Net inpatient revenue per admission $ 12,249 $ 12,371 $ 12,021 $ 12,323 $ 12,241 Average length of stay (days) 4.71 4.72 4.65 4.63 4.68 Total surgeries 93,228 95,422 94,260 98,045 380,955 Outpatient visits 1,031,611 1,046,768 1,035,236 1,053,499 4,167,114 Net outpatient revenue per visit $ 743 $ 756 $ 762 $ 779 $ 760   Sources of net patient revenues Medicare 26.5 % 22.7 % 22.1 % 22.4 % 23.4 % Medicaid 7.5 % 10.0 % 7.7 % 8.3 % 8.4 % Managed care 55.9 % 56.8 % 58.9 % 58.3 % 57.4 % Indemnity, self-pay and other 10.1 % 10.5 % 11.3 % 11.0 % 10.8 %     TENET HEALTHCARE CORPORATION CONSOLIDATED STATEMENTS OF OPERATIONS Fiscal 2011 by Calendar Quarter (Unaudited) (Dollars in millions except per share amounts)   Three Months Ended   Year Ended03/31/11   06/30/11   09/30/11   12/31/1112/31/11   Net operating revenues: Net operating revenues before provision for doubtful accounts $ 2,429 $ 2,300 $ 2,289 $ 2,353 $ 9,371 Less: Provision for doubtful accounts   179     168     189     181     717   Net operating revenues2,2502,1322,1002,1728,654Operating expenses: Salaries, wages and benefits 1,017 982 1,002 1,014 4,015 Supplies 396 392 379 381 1,548 Other operating expenses, net 491 508 527 494 2,020 Electronic health record incentives (25 ) (25 ) — (5 ) (55 ) Depreciation and amortization 98 100 100 100 398 Impairment of long-lived assets and goodwill, and restructuring charges, net 8 2 8 2 20 Litigation and investigation costs   11     8     5     31     55   Operating income25416579155653 Interest expense (118 ) (98 ) (59 ) (100 ) (375 ) Loss from early extinguishment of debt — — — (117 ) (117 ) Investment earnings   1     1     1     —     3   Income (loss) from continuing operations, before income taxes1376821(62)164 Income tax benefit (expense)   (50 )   (19 )   (4 )   12     (61 ) Income (loss) from continuing operations, before discontinued operations874917(50)103Discontinued operations: Loss from operations (10 ) (5 ) (2 ) (1 ) (18 ) Impairment of long-lived assets and goodwill, and restructuring charges, net — — — (6 ) (6 ) Litigation settlements, and investigation costs — — — (17 ) (17 ) Income tax benefit   5     19     —     8     32   Income (loss) from discontinued operations   (5)   14     (2)   (16)   (9)Net income (loss)826315(66)94 Less: Preferred stock dividends 6 6 6 6 24 Less: Net income (loss) attributable to noncontrolling interests Continuing operations 2 3 3 3 11 Discontinued operations   1     (1 )   —     1     1   Net income (loss) attributable to Tenet Healthcare Corporation common shareholders$73   $55   $6   $(76)$58     Amounts attributable to Tenet Healthcare Corporation common shareholders Income (loss) from continuing operations, net of tax $ 80 $ 40 $ 8 $ (60 ) $ 68 Income (loss) from discontinued operations, net of tax   (7 )   15     (2 )   (16 )   (10 ) Net income (loss) attributable to Tenet Healthcare Corporation common shareholders$73   $55   $6   $(76)$58     Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholdersBasic Continuing operations $ 0.66 $ 0.33 $ 0.07 $ (0.55 ) $ 0.58 Discontinued operations   (0.06 )   0.12     (0.02 )   (0.15 )   (0.09 ) $ 0.60   $ 0.45   $ 0.05   $ (0.70 ) $ 0.49   Diluted Continuing operations $ 0.61 $ 0.32 $ 0.07 $ (0.55 ) $ 0.56 Discontinued operations   (0.05 )   0.12     (0.02 )   (0.15 )   (0.08 ) $ 0.56   $ 0.44   $ 0.05   $ (0.70 ) $ 0.48   Weighted average shares and dilutive securities outstanding (in thousands): Basic 121,726 121,699 117,188 108,114 117,182 Diluted 141,295 125,937 120,908 108,114 121,295     TENET HEALTHCARE CORPORATION SELECTED STATISTICS – CONTINUING HOSPITALS (Unaudited)               (Dollars in millions except per patient day, per admission and per visit amounts)Three Months EndedYear Ended03/31/1106/30/1109/30/11   12/31/11   12/31/11   Net inpatient revenues $ 1,619 $ 1,466 $ 1,444 $ 1,499 $ 6,028 Net outpatient revenues $ 720 $ 738 $ 734 $ 736 $ 2,928   Number of acute care hospitals (at end of period) 49 49 49 49 49 Licensed beds (at end of period) 13,123 13,086 13,119 13,119 13,119 Average licensed beds 13,123 13,111 13,106 13,119 13,115 Utilization of licensed beds 53.8 % 50.0 % 49.1 % 48.9 % 50.4 % Patient days 635,463 595,986 591,948 589,848 2,413,245 Adjusted patient days 948,356 912,369 909,960 902,762 3,673,447 Net inpatient revenue per patient day $ 2,548 $ 2,460 $ 2,439 $ 2,541 $ 2,498 Total admissions 131,437 125,592 125,458 125,347 507,834 Adjusted patient admissions 197,459 193,971 194,965 193,631 780,026 Net inpatient revenue per admission $ 12,318 $ 11,673 $ 11,510 $ 11,959 $ 11,870 Average length of stay (days) 4.83 4.75 4.72 4.71 4.75 Total surgeries 87,507 91,005 92,574 91,200 362,286 Outpatient visits 990,411 994,204 987,318 982,083 3,954,016 Net outpatient revenue per visit $ 727 $ 742 $ 743 $ 749 $ 741   Sources of net patient revenue Medicare 23.2 % 23.5 % 22.5 % 23.1 % 23.1 % Medicaid 11.5 % 7.5 % 8.0 % 8.6 % 9.0 % Managed care 54.6 % 58.2 % 58.2 % 58.1 % 57.2 % Indemnity, self-pay and other 10.7 % 10.8 % 11.3 % 10.2 % 10.7 %     TENET HEALTHCARE CORPORATION SEGMENT REPORTING (Unaudited)     December 31,   December 31,   20122011Assets Hospital Operations and other $ 8,788 $ 8,389 Conifer   219     73   Total $ 9,007   $ 8,462     Three Months EndedDecember 31,Year EndedDecember 31,2012201120122011Capital expenditures: Hospital Operations and other $ 143 $ 172 $ 495 $ 461 Conifer   5     5     13     14   Total $ 148   $ 177   $ 508   $ 475     Net operating revenues: Hospital Operations and other $ 2,277 $ 2,150 $ 9,002 $ 8,575 Conifer Tenet 97 69 371 261 Other customers   54     22     117     79   2,428 2,241 9,490 8,915 Intercompany eliminations   (97 )   (69 )   (371 )   (261 ) Total $ 2,331   $ 2,172   $ 9,119   $ 8,654     Adjusted EBITDA: Hospital Operations and other $ 305 $ 271 $ 1,098 $ 1,083 Conifer   31     17     105     43   Total $ 336   $ 288   $ 1,203   $ 1,126     Depreciation and amortization: Hospital Operations and other $ 113 $ 97 $ 420 $ 389 Conifer   3     3     10     9   Total $ 116   $ 100   $ 430   $ 398     Adjusted EBITDA $ 336 $ 288 $ 1,203 $ 1,126 Depreciation and amortization (116 ) (100 ) (430 ) (398 ) Interest expense (109 ) (100 ) (412 ) (375 ) Loss from early extinguishment of debt (4 ) (117 ) (4 ) (117 ) Litigation and investigation costs (2 ) (31 ) (5 ) (55 ) Impairments of long-lived assets (7 ) (2 ) (19 ) (20 ) Investment earnings (loss)   (1 )   —     1     3   Income before income taxes $ 97   $ (62 ) $ 334   $ 164     Due to the fact that Conifer's revenues from providing services to Tenet's hospitals were based on estimated third-party billing terms in 2012 but not in 2011, the following supplemental table presents 2012 Adjusted EBITDA on a comparable basis to the prior year's presentation.     Three Months EndedDecember 31,Year EndedDecember 31,2012   20112012   2011Adjusted supplemental EBITDA: Hospital Operations and other $ 327 $ 271 $ 1,167 $ 1,083 Conifer   9   17   36   43 Total $ 336 $ 288 $ 1,203 $ 1,126   (1) Reconciliation of Adjusted EBITDA Adjusted EBITDA, a non-GAAP term, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common shareholders before (1) cumulative effect of changes in accounting principle, net of tax, (2) net income attributable to noncontrolling interests, (3) preferred stock dividends, (4) income (loss) from discontinued operations, net of tax, (5) income tax (expense) benefit, (6) investment earnings (loss), (7) gain (loss) from early extinguishment of debt, (8) net gain (loss) on sales of investments, (9) interest expense, (10) litigation and investigation (costs) benefit, net of insurance recoveries, (11) hurricane insurance recoveries, net of costs, (12) impairment of long-lived assets and goodwill and restructuring charges, net of insurance recoveries, and (13) depreciation and amortization. The Company's Adjusted EBITDA may not be comparable to EBITDA reported by other companies. The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its financial statements, some of which are recurring or involve cash payments. The Company uses this information in its analysis of the performance of its business excluding items that it does not consider as relevant in the performance of its hospitals in continuing operations. In addition, from time to time we use this measure to define certain performance targets under our compensation programs. Adjusted EBITDA is not a measure of liquidity, but is a measure of operating performance that management uses in its business as an alternative to net income (loss) attributable to Tenet Healthcare Corporation common shareholders. Because Adjusted EBITDA excludes many items that are included in our financial statements, it does not provide a complete measure of our operating performance. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company's financial performance. The reconciliation of net income (loss) attributable to Tenet Healthcare Corporation common shareholders, the most comparable GAAP term, to Adjusted EBITDA, is set forth in the first table below for the three and twelve months ended December 31, 2012 and 2011. (2) Adjusted Free Cash Flow Adjusted Free Cash Flow, a non-GAAP term, is defined by the Company as cash provided by (used in) operating activities less payments against reserves for restructuring charges and litigation costs, operating cashflows from discontinued operations, capital expenditures in continuing operations, and new hospital construction expenditures. The Company believes the use of Adjusted Free Cash Flow is meaningful as the use of this financial measure provides the Company and the users of its financial statements with supplemental information about the impact on the Company's cash flows from the items specified above. The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its cash flows, some of which are recurring. The Company uses this information in its analysis of its cash flows excluding items that it does not consider relevant to the liquidity of its hospitals in continuing operations. In addition, from time to time we use this measure to define certain performance targets under our compensation programs. Adjusted Free Cash Flow is a measure of liquidity that management uses in its business as an alternative to net cash provided by (used in) operating activities. Because Adjusted Free Cash Flow excludes many items that are included in our financial statements, it does not provide a complete measure of our liquidity. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company's financial performance or liquidity. The reconciliation of net cash provided by (used in) operating activities, the most comparable GAAP term, to Adjusted Free Cash Flow is set forth in the second table below for the three and twelve months ended December 31, 2012 and 2011.   TENET HEALTHCARE CORPORATION Additional Supplemental Non-GAAP Disclosures Table #1 - Reconciliation of Adjusted EBITDA to Net Income Attributable to Tenet HealthcareCorporation Common Shareholders (Unaudited)   (Dollars in millions)   Three Months EndedDecember 31,   Year EndedDecember 31,2012   20112012   2011 Net income (loss) attributable to Tenet Healthcare Corporation common shareholders $ 49 $ (76 ) $ 141 $ 58 Less: Net (income) loss attributable to noncontrolling interests (5 ) (4 ) 19 (12 ) Preferred stock dividends — (6 ) (11 ) (24 ) Loss from discontinued operations, net of tax   (8 )   (16 )   (76 )   (9 ) Income (loss) from continuing operations 62 (50 ) 209 103 Income tax (benefit) expense (35 ) 12 (125 ) (61 ) Investment earnings (loss) (1 ) 0 1 3 Loss from early extinguishment of debt (4 ) (117 ) (4 ) (117 ) Interest expense   (109 )   (100 )   (412 )   (375 ) Operating income 211 155 749 653 Litigation and investigation costs (2 ) (31 ) (5 ) (55 ) Impairment of long-lived assets and goodwill, and restructuring charges, net (7 ) (2 ) (19 ) (20 ) Depreciation and amortization   (116 )   (100 )   (430 )   (398 ) Adjusted EBITDA$336   $288   $1,203   $1,126     Net operating revenues$2,331   $2,172   $9,119   $8,654     Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin)14.4%13.3%13.2%13.0%     TENET HEALTHCARE CORPORATION Additional Supplemental Non-GAAP Disclosures Table #2 - Reconciliation of Adjusted Free Cash Flow (Unaudited)   (Dollars in millions)Three Months EndedDecember 31,Year EndedDecember 31,2012201120122011 Net cash provided by operating activities $ 256 $ 173 $ 593 $ 497 Less: Payments against reserves for restructuring charges and litigation costs (7 ) (17 ) (63 ) (44 ) Net cash used in operating activities from discontinued operations   (16 )   (4 )   (35 )   (38 ) Adjusted net cash provided by operating activities – continuing operations279194691579 Purchases of property and equipment – continuing operations   (148 )   (173 )   (506 )   (467 ) Adjusted free cash flow – continuing operations$131   $21   $185   $112         TENET HEALTHCARE CORPORATION Additional Supplemental Non-GAAP Disclosures Table #3 - Reconciliation of Outlook Adjusted EBITDA toOutlook Net Income Attributable to Tenet Healthcare Corporation Common Shareholdersfor the Year Ending December 31, 2013 (Unaudited)   (Dollars in millions)2013LowHigh Net income attributable to Tenet Healthcare Corporation common shareholders $ 118 $ 234 Less: Net (income) loss attributable to noncontrolling interests (25 ) (15 ) Loss from discontinued operations, net of tax   (5 )   0   Income from continuing operations $ 148 $ 249 Income tax expense (a)   (87 )   (146 ) Income from continuing operations, before income taxes $ 235 $ 395 Interest expense, net (415 ) (395 ) Loss from early extinguishment of debt   (185 )   (175 ) Operating income $ 835 $ 965 Depreciation and amortization   (490 )   (460 ) Adjusted EBITDA$1,325   $1,425     Net operating revenues$9,800   $10,100     Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin)13.5%14.1%   (a) Uses tax rate of 37% excluding unusual adjustments     TENET HEALTHCARE CORPORATION Additional Supplemental Non-GAAP Disclosures Table #4 - Reconciliation of Outlook Adjusted EBITDA toOutlook Normalized Income from Continuing Operationsfor the Year Ending December 31, 2013 (Unaudited)   (Dollars in millions except per share amounts)2013LowHighAdjusted EBITDA (from Table #3) $ 1,325 $ 1,425 Depreciation and amortization (490 ) (460 ) Interest expense, net   (415 )   (395 ) Normalized income from continuing operations before income taxes $ 420 $ 570 Income tax expense (a)   (155 )   (211 ) Normalized income from continuing operations $ 265 $ 359 Net (income) loss attributable to noncontrolling interests   (25 )   (15 ) Normalized net income attributable to common shareholders$240   $344     Fully Diluted weighted average share outstanding (in millions)104104   Normalized fully diluted earnings per share – continuing operations$2.31$3.31   (a) Uses tax rate of 37% excluding unusual adjustments     TENET HEALTHCARE CORPORATIONAdditional Supplemental Non-GAAP DisclosuresTable 5 - Reconciliation of Outlook Adjusted Free Cash Flowfor the Year Ending December 31, 2013 (Unaudited)   (Dollars in millions)   2013Low   High Net cash provided by operating activities $ 725 $ 845 Less: Payments against reserves for restructuring charges and litigation costs (20 ) (10 ) Net cash used in operating activities from discontinued operations   (30 )   (20 ) Adjusted net cash provided by operating activities – continuing operations$775$875 Purchases of property and equipment – continuing operations   (600 )   (550 ) Adjusted free cash flow – continuing operations$175   $325     Tenet Healthcare CorporationMedia:Rick Black, 469-893-2647Rick.Black@tenethealth.comorInvestors:Thomas Rice, 469-893-2522Thomas.Rice@tenethealth.com