Provides 2016 Guidance
HCA Holdings, Inc. (NYSE: HCA) today announced financial and operating
results for the fourth quarter ended December 31, 2015.
Key fourth quarter metrics (all percentage changes compare 4Q
2015 to 4Q 2014 unless noted):
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Revenues totaled $10.249 billion, an increase of 6.4 percent
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Net income attributable to HCA Holdings, Inc. totaled $582 million, or
$1.40 per diluted share, compared to $527 million, or $1.19 per
diluted share, in the fourth quarter of 2014
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Adjusted EBITDA totaled $2.131 billion, an increase of 8.9 percent
-
Cash flows from operating activities totaled $1.558 billion, compared
to $1.627 billion in the prior year’s fourth quarter
-
Same facility equivalent admissions increased 2.9 percent, while same
facility admissions increased 1.6 percent
-
Same facility revenue per equivalent admission increased 2.6 percent
Revenues in the fourth quarter totaled $10.249 billion, compared to
$9.636 billion in the fourth quarter of 2014. Fourth quarter 2014
results included a $68 million increase in Medicaid revenues related to
the reversal of the Texas Medicaid Waiver Program adjustment to reduce
revenues that was recorded in the third quarter of 2014.
Net income attributable to HCA Holdings, Inc. totaled $582 million, or
$1.40 per diluted share, compared to $527 million, or $1.19 per diluted
share, in the fourth quarter of 2014. Results for the fourth quarter of
2015 include losses on sales of facilities of $7 million, or $0.01 per
diluted share, losses on retirement of debt of $10 million, or $0.02 per
diluted share, and legal claim costs of $172 million, or $0.26 per
diluted share. Results for the fourth quarter of 2014 included gains on
sales of facilities of $9 million, or $0.01 per diluted share, and
losses on retirement of debt of $109 million, or $0.15 per diluted share.
Adjusted EBITDA for the fourth quarter of 2015 increased 8.9 percent to
$2.131 billion compared to $1.956 billion in the prior year period.
Adjusted EBITDA is a non-GAAP financial measure. A table providing
supplemental information on Adjusted EBITDA and reconciling net income
attributable to HCA Holdings, Inc. to Adjusted EBITDA is included in
this release.
Fourth quarter revenue growth was driven by solid volume and higher
revenue per equivalent admission, as same facility case mix, or acuity,
increased 2.1 percent compared to the prior year. Same facility
equivalent admissions increased 2.9 percent while same facility
admissions increased 1.6 percent in the fourth quarter of 2015 compared
to the fourth quarter of 2014. Same facility emergency room visits
increased 3.6 percent in the fourth quarter of 2015 compared to the
prior year period.
Same facility revenue per equivalent admission increased 2.6 percent in
the fourth quarter of 2015. During the fourth quarter same facility
inpatient surgeries increased 1.5 percent while same facility outpatient
surgeries increased 2.2 percent compared to the prior year period.
The Company’s same facility operating expense per equivalent admission,
excluding electronic health record (“EHR”) and equity income, increased
1.2 percent from the prior year’s fourth quarter. During the fourth
quarter of 2015, salaries and benefits, supplies and other operating
expenses totaled $8.127 billion, or 79.3 percent of revenues, compared
to $7.719 billion, or 80.1 percent of revenues, in the fourth quarter of
2014.
Twelve Months Ended December 31, 2015
Revenues for the year ended December 31, 2015 totaled $39.678 billion
compared to $36.918 billion for 2014. Net income attributable to HCA
Holdings, Inc. for 2015 was $2.129 billion, or $4.99 per diluted share,
compared to $1.875 billion, or $4.16 per diluted share, for the year
ended December 31, 2014. Results for the year ended December 31, 2015
include losses on retirement of debt of $135 million, or $0.20 per
diluted share, and legal claims costs of $249 million, or $0.37 per
diluted share. Results for 2014 included gains on sales of facilities of
$29 million, or $0.04 per diluted share, losses on retirement of debt of
$335 million, or $0.47 per diluted share, and legal claim costs of $78
million, or $0.11 per diluted share. Adjusted EBITDA for 2015 increased
to $7.915 billion compared to $7.428 billion in 2014.
Balance Sheet and Cash Flow
As of December 31, 2015, HCA Holdings, Inc.’s balance sheet reflected
cash and cash equivalents of $741 million, total debt of $30.488
billion, and total assets of $32.744 billion. During the fourth quarter
of 2015, capital expenditures totaled $804 million, excluding
acquisitions. During the fourth quarter of 2015, the Company repurchased
approximately 14.362 million shares of its common stock, at a cost of
$1.011 billion. The Company had approximately $2.603 billion remaining
under its $3 billion repurchase authorization at year end. The Company
had approximately 398.739 and 420.478 million shares outstanding as of
December 31, 2015 and 2014, respectively. Net cash provided by operating
activities in the fourth quarter of 2015 totaled $1.558 billion compared
to $1.627 billion in the prior year’s fourth quarter.
As of December 31, 2015, HCA operated 168 hospitals and 116 freestanding
surgery centers.
2016 Guidance
Today, HCA issued the following estimated guidance for 2016:
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2016 Guidance Range
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Revenues
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$41.5 to $42.5 billion
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Adjusted EBITDA
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$8.15 to $8.45 billion
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Adjusted EPS (diluted)
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$6.00 to $6.45 per diluted share
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Capital Expenditures
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Approximately $2.7 billion
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The Company’s 2016 guidance contains a number of assumptions, including:
-
EHR incentive income of approximately $6 million compared to EHR
incentive income of $47 million in 2015; and
-
2016 guidance excludes the impact of items such as, but not limited
to, gains or losses on sales of facilities, losses on retirement of
debt, legal claim costs and impairments of long-lived assets.
The Company’s guidance is based on current plans and expectations and is
subject to a number of known and unknown uncertainties and risks,
including those set forth below in the Company’s “Forward-Looking
Statements.”
The Company’s 2016 annual stockholders’ meeting will be held in
Nashville, Tennessee on April 28, 2016 at 2:00 p.m. local time for
stockholders of record as of March 4, 2016.
Earnings Conference Call
HCA will host a conference call for investors at 9:00 a.m. Central
Standard 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 at: https://event.webcasts.com/starthere.jsp?ei=1080621
or through the Company’s Investor Relations web page at www.hcahealthcare.com.
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 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) the impact of our substantial indebtedness and
the ability to refinance such indebtedness on acceptable terms, (2) the
effects related to the implementation of the Patient Protection and
Affordable Care Act, as amended by the Health Care and Education
Reconciliation Act (collectively, the “Health Reform Law”), possible
delays in or complications related to implementation of the Health
Reform Law, court challenges, the possible enactment of additional
federal or state health care reforms and possible changes to the Health
Reform Law and other federal, state or local laws or regulations
affecting the health care industry, (3) the effects related to the
continued implementation of the sequestration spending reductions
required under the Budget Control Act of 2011 (the “BCA”), 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, (4) increases in the amount and risk of collectability of
uninsured accounts and deductibles and copayment amounts for insured
accounts, (5) the ability to achieve operating and financial targets,
and attain expected levels of patient volumes and control the costs of
providing services, (6) possible changes in Medicare, Medicaid and other
state programs, including Medicaid upper payment limit programs or
waiver programs, that may impact reimbursements to health care providers
and insurers, (7) the highly competitive nature of the health care
business, (8) changes in service mix, revenue mix and surgical volumes,
including potential declines in the population covered under managed
care agreements, the ability to enter into and renew managed care
provider agreements on acceptable terms and the impact of consumer
driven health plans and physician utilization trends and practices, (9)
the efforts of insurers, health care providers and others to contain
health care costs, (10) the outcome of our continuing efforts to
monitor, maintain and comply with appropriate laws, regulations,
policies and procedures, (11) increases in wages and the ability to
attract and retain qualified management and personnel, including
affiliated physicians, nurses and medical and technical support
personnel, (12) the availability and terms of capital to fund the
expansion of our business and improvements to our existing facilities,
(13) changes in accounting practices, (14) changes in general economic
conditions nationally and regionally in our markets, (15) the emergence
and effects related to infectious diseases; (16) future divestitures
which may result in charges and possible impairments of long-lived
assets, (17) changes in business strategy or development plans, (18)
delays in receiving payments for services provided, (19) the outcome of
pending and any future tax audits, disputes and litigation associated
with our tax positions, (20) potential adverse impact of known and
unknown government investigations, litigation and other claims that may
be made against us, (21) our ongoing ability to demonstrate meaningful
use of certified electronic health record technology, and (22) other
risk factors described in our annual report on Form 10-K for the year
ended December 31, 2014 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 Holdings, Inc. and its affiliates.
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HCA Holdings, Inc.
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Condensed Consolidated Comprehensive Income Statements
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Fourth Quarter
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(Dollars in millions, except per share amounts)
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2015
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2014
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Amount
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Ratio
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Amount
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Ratio
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Revenues before provision for doubtful accounts
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$
|
11,323
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|
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$
|
10,468
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Provision for doubtful accounts
|
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|
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1,074
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|
|
|
|
|
|
832
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|
|
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Revenues
|
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|
10,249
|
|
|
|
100.0
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%
|
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|
|
9,636
|
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|
|
100.0
|
%
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|
|
|
|
|
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Salaries and benefits
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4,606
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44.9
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|
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4,282
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44.4
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Supplies
|
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|
|
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1,686
|
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16.4
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|
|
|
|
1,659
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|
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17.2
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Other operating expenses
|
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|
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1,835
|
|
|
|
18.0
|
|
|
|
|
1,778
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|
|
18.5
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|
Electronic health record incentive income
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(1
|
)
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-
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(28
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)
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(0.3
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)
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Equity in earnings of affiliates
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|
(8
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)
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(0.1
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)
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|
|
(11
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)
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|
(0.1
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)
|
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Depreciation and amortization
|
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|
480
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|
|
|
4.6
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|
|
|
459
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4.7
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|
Interest expense
|
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|
|
410
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|
|
4.0
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|
|
|
429
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|
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4.5
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Losses (gains) on sales of facilities
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|
7
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|
0.1
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|
|
|
(9
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)
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(0.1
|
)
|
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Losses on retirement of debt
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|
10
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0.1
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|
|
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|
109
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|
1.1
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Legal claim costs
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172
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|
1.7
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|
-
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-
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|
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|
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|
|
|
|
|
|
9,197
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|
|
|
89.7
|
|
|
|
|
8,668
|
|
|
|
89.9
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|
|
|
|
|
|
|
|
|
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|
|
|
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Income before income taxes
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|
|
1,052
|
|
|
|
10.3
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|
|
|
|
968
|
|
|
|
10.1
|
|
|
|
|
|
|
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|
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|
|
|
|
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|
Provision for income taxes
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|
|
314
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|
|
|
3.1
|
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|
|
|
292
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|
|
3.1
|
|
|
|
|
|
|
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|
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|
|
|
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Net income
|
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|
|
|
738
|
|
|
|
7.2
|
|
|
|
|
676
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|
7.0
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to noncontrolling interests
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|
|
|
156
|
|
|
|
1.5
|
|
|
|
|
149
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|
|
|
1.5
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Holdings, Inc.
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|
$
|
582
|
|
|
|
5.7
|
|
|
|
$
|
527
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|
|
|
5.5
|
|
|
|
|
|
|
|
|
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|
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|
|
|
|
|
|
Diluted earnings per share
|
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|
|
$
|
1.40
|
|
|
|
|
|
|
$
|
1.19
|
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|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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Shares used in computing diluted earnings per share (millions)
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|
|
415.918
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|
443.866
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|
|
|
|
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|
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Comprehensive income attributable to HCA Holdings, Inc.
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|
$
|
626
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|
|
|
|
|
|
$
|
410
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HCA Holdings, Inc.
|
|
Condensed Consolidated Comprehensive Income Statements
|
|
For the Years Ended December 31, 2015 and 2014
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(Dollars in millions, except per share amounts)
|
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|
|
|
|
|
|
|
|
2015
|
|
|
2014
|
|
|
|
|
|
Amount
|
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Ratio
|
|
|
Amount
|
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Ratio
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
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|
Revenues before provision for doubtful accounts
|
|
|
|
$
|
43,591
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|
|
|
|
|
|
$
|
40,087
|
|
|
|
|
|
Provision for doubtful accounts
|
|
|
|
|
3,913
|
|
|
|
|
|
|
|
3,169
|
|
|
|
|
|
Revenues
|
|
|
|
|
39,678
|
|
|
|
100.0
|
%
|
|
|
|
36,918
|
|
|
|
100.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Salaries and benefits
|
|
|
|
|
18,115
|
|
|
|
45.7
|
|
|
|
|
16,641
|
|
|
|
45.1
|
|
|
Supplies
|
|
|
|
|
6,638
|
|
|
|
16.7
|
|
|
|
|
6,262
|
|
|
|
17.0
|
|
|
Other operating expenses
|
|
|
|
|
7,103
|
|
|
|
17.9
|
|
|
|
|
6,755
|
|
|
|
18.2
|
|
|
Electronic health record incentive income
|
|
|
|
|
(47
|
)
|
|
|
(0.1
|
)
|
|
|
|
(125
|
)
|
|
|
(0.3
|
)
|
|
Equity in earnings of affiliates
|
|
|
|
|
(46
|
)
|
|
|
(0.1
|
)
|
|
|
|
(43
|
)
|
|
|
(0.1
|
)
|
|
Depreciation and amortization
|
|
|
|
|
1,904
|
|
|
|
4.8
|
|
|
|
|
1,820
|
|
|
|
5.0
|
|
|
Interest expense
|
|
|
|
|
1,665
|
|
|
|
4.2
|
|
|
|
|
1,743
|
|
|
|
4.7
|
|
|
Losses (gains) on sales of facilities
|
|
|
|
|
5
|
|
|
|
-
|
|
|
|
|
(29
|
)
|
|
|
(0.1
|
)
|
|
Losses on retirement of debt
|
|
|
|
|
135
|
|
|
|
0.3
|
|
|
|
|
335
|
|
|
|
0.9
|
|
|
Legal claim costs
|
|
|
|
|
249
|
|
|
|
0.6
|
|
|
|
|
78
|
|
|
|
0.2
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
35,721
|
|
|
|
90.0
|
|
|
|
|
33,437
|
|
|
|
90.6
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income before income taxes
|
|
|
|
|
3,957
|
|
|
|
10.0
|
|
|
|
|
3,481
|
|
|
|
9.4
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Provision for income taxes
|
|
|
|
|
1,261
|
|
|
|
3.2
|
|
|
|
|
1,108
|
|
|
|
3.0
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
|
|
|
2,696
|
|
|
|
6.8
|
|
|
|
|
2,373
|
|
|
|
6.4
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to noncontrolling interests
|
|
|
|
|
567
|
|
|
|
1.4
|
|
|
|
|
498
|
|
|
|
1.3
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Holdings, Inc.
|
|
|
|
$
|
2,129
|
|
|
|
5.4
|
|
|
|
$
|
1,875
|
|
|
|
5.1
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings per share
|
|
|
|
$
|
4.99
|
|
|
|
|
|
|
$
|
4.16
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Shares used in computing diluted earnings per share (millions)
|
|
|
|
|
426.721
|
|
|
|
|
|
|
|
450.352
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Comprehensive income attributable to HCA Holdings, Inc.
|
|
|
|
$
|
2,187
|
|
|
|
|
|
|
$
|
1,809
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HCA Holdings, Inc.
|
|
Supplemental Non-GAAP Disclosures
|
|
Operating Results Summary
|
|
(Dollars in millions, except per share amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Years
|
|
|
|
|
|
|
Fourth Quarter
|
|
Ended December 31,
|
|
|
|
|
|
|
2015
|
|
2014
|
|
2015
|
|
2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Revenues
|
|
$
|
10,249
|
|
$
|
9,636
|
|
|
$
|
39,678
|
|
$
|
36,918
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Holdings, Inc.
|
|
$
|
582
|
|
$
|
527
|
|
|
$
|
2,129
|
|
$
|
1,875
|
|
|
|
Losses (gains) on sales of facilities (net of tax)
|
|
|
4
|
|
|
(7
|
)
|
|
|
3
|
|
|
(18
|
)
|
|
|
Losses on retirement of debt (net of tax)
|
|
|
7
|
|
|
68
|
|
|
|
86
|
|
|
211
|
|
|
|
Legal claim costs (net of tax)
|
|
|
108
|
|
|
-
|
|
|
|
157
|
|
|
49
|
|
|
Net income attributable to HCA Holdings, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim costs (a)
|
|
|
701
|
|
|
588
|
|
|
|
2,375
|
|
|
2,117
|
|
|
|
Depreciation and amortization
|
|
|
480
|
|
|
459
|
|
|
|
1,904
|
|
|
1,820
|
|
|
|
Interest expense
|
|
|
410
|
|
|
429
|
|
|
|
1,665
|
|
|
1,743
|
|
|
|
Provision for income taxes
|
|
|
384
|
|
|
331
|
|
|
|
1,404
|
|
|
1,250
|
|
|
|
Net income attributable to noncontrolling interests
|
|
|
156
|
|
|
149
|
|
|
|
567
|
|
|
498
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA (a)
|
|
$
|
2,131
|
|
$
|
1,956
|
|
|
$
|
7,915
|
|
$
|
7,428
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings per share:
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Holdings, Inc.
|
|
$
|
1.40
|
|
$
|
1.19
|
|
|
$
|
4.99
|
|
$
|
4.16
|
|
|
|
Losses (gains) on sales of facilities
|
|
|
0.01
|
|
|
(0.01
|
)
|
|
|
-
|
|
|
(0.04
|
)
|
|
|
Losses on retirement of debt
|
|
|
0.02
|
|
|
0.15
|
|
|
|
0.20
|
|
|
0.47
|
|
|
|
Legal claim costs
|
|
|
0.26
|
|
|
-
|
|
|
|
0.37
|
|
|
0.11
|
|
|
|
|
Net income attributable to HCA Holdings, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim costs(a)
|
|
$
|
1.69
|
|
$
|
1.33
|
|
|
$
|
5.56
|
|
$
|
4.70
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Shares used in computing diluted earnings per share (millions)
|
|
|
415.918
|
|
|
443.866
|
|
|
|
426.721
|
|
|
450.352
|
|
|
|
|
|
|
|
|
|
|
|
(a)
|
Net income attributable to HCA Holdings, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim costs, 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 Holdings, Inc., excluding losses (gains) on sales of
facilities, losses on retirement of debt and legal claim costs, 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 Holdings, Inc., excluding losses (gains) on
sales of facilities, losses on retirement of debt and legal claim
costs, 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 Holdings, Inc., excluding
losses (gains) on sales of facilities, losses on retirement of debt
and legal claim costs, and GAAP net income attributable to HCA
Holdings, 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, losses on retirement of debt and legal claim
costs 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 Holdings, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim costs, and Adjusted EBITDA are not measures of financial
performance under GAAP, and should not be considered as alternatives
to net income attributable to HCA Holdings, 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 Holdings, Inc., excluding losses (gains) on
sales of facilities, losses on retirement of debt and legal claim
costs, and Adjusted EBITDA are not measurements determined in
accordance with GAAP and are susceptible to varying calculations,
net income attributable to HCA Holdings, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim costs, and Adjusted EBITDA, as presented, may not be
comparable to other similarly titled measures presented by other
companies.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HCA Holdings, Inc.
|
|
Condensed Consolidated Balance Sheets
|
|
(Dollars in millions)
|
|
|
|
|
|
|
|
|
December 31,
|
|
|
September 30,
|
|
|
December 31,
|
|
|
|
|
2015
|
|
|
2015
|
|
|
2014
|
|
|
|
|
|
|
|
|
|
|
|
|
ASSETS
|
|
|
|
|
|
|
|
|
|
|
Current assets:
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents
|
|
|
$
|
741
|
|
|
|
$
|
588
|
|
|
|
$
|
566
|
|
|
Accounts receivable, less allowance for doubtful accounts of
$5,326, $5,111 and $5,011
|
|
|
|
5,889
|
|
|
|
|
5,827
|
|
|
|
|
5,694
|
|
|
Inventories
|
|
|
|
1,439
|
|
|
|
|
1,379
|
|
|
|
|
1,279
|
|
|
Deferred income taxes
|
|
|
|
-
|
|
|
|
|
412
|
|
|
|
|
366
|
|
|
Other
|
|
|
|
1,163
|
|
|
|
|
1,015
|
|
|
|
|
1,025
|
|
|
Total current assets
|
|
|
|
9,232
|
|
|
|
|
9,221
|
|
|
|
|
8,930
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Property and equipment, at cost
|
|
|
|
34,614
|
|
|
|
|
34,207
|
|
|
|
|
32,980
|
|
|
Accumulated depreciation
|
|
|
|
(19,600
|
)
|
|
|
|
(19,503
|
)
|
|
|
|
(18,625
|
)
|
|
|
|
|
|
15,014
|
|
|
|
|
14,704
|
|
|
|
|
14,355
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Investments of insurance subsidiaries
|
|
|
|
432
|
|
|
|
|
409
|
|
|
|
|
494
|
|
|
Investments in and advances to affiliates
|
|
|
|
178
|
|
|
|
|
186
|
|
|
|
|
165
|
|
|
Goodwill and other intangible assets
|
|
|
|
6,731
|
|
|
|
|
6,540
|
|
|
|
|
6,416
|
|
|
Other
|
|
|
|
1,157
|
|
|
|
|
836
|
|
|
|
|
620
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
32,744
|
|
|
|
$
|
31,896
|
|
|
|
$
|
30,980
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
LIABILITIES AND STOCKHOLDERS' DEFICIT
|
|
|
|
|
|
|
|
|
|
|
Current liabilities:
|
|
|
|
|
|
|
|
|
|
|
Accounts payable
|
|
|
$
|
2,170
|
|
|
|
$
|
1,877
|
|
|
|
$
|
2,035
|
|
|
Accrued salaries
|
|
|
|
1,233
|
|
|
|
|
1,358
|
|
|
|
|
1,370
|
|
|
Other accrued expenses
|
|
|
|
1,880
|
|
|
|
|
1,701
|
|
|
|
|
1,737
|
|
|
Long-term debt due within one year
|
|
|
|
233
|
|
|
|
|
1,377
|
|
|
|
|
338
|
|
|
Total current liabilities
|
|
|
|
5,516
|
|
|
|
|
6,313
|
|
|
|
|
5,480
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Long-term debt, less net debt issuance costs of $167, $160 and $219
|
|
|
|
30,255
|
|
|
|
|
28,375
|
|
|
|
|
29,088
|
|
|
Professional liability risks
|
|
|
|
1,115
|
|
|
|
|
1,117
|
|
|
|
|
1,078
|
|
|
Income taxes and other liabilities
|
|
|
|
1,904
|
|
|
|
|
1,903
|
|
|
|
|
1,832
|
|
|
|
|
|
|
|
|
|
|
|
|
|
EQUITY (DEFICIT)
|
|
|
|
|
|
|
|
|
|
|
Stockholders' deficit attributable to HCA Holdings, Inc.
|
|
|
|
(7,599
|
)
|
|
|
|
(7,294
|
)
|
|
|
|
(7,894
|
)
|
|
Noncontrolling interests
|
|
|
|
1,553
|
|
|
|
|
1,482
|
|
|
|
|
1,396
|
|
|
Total deficit
|
|
|
|
(6,046
|
)
|
|
|
|
(5,812
|
)
|
|
|
|
(6,498
|
)
|
|
|
|
|
$
|
32,744
|
|
|
|
$
|
31,896
|
|
|
|
$
|
30,980
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HCA Holdings, Inc.
|
|
Consolidated Statements of Cash Flows
|
|
For the Years Ended December 31, 2015 and 2014
|
|
(Dollars in millions)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2015
|
|
|
2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from operating activities:
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
|
|
$
|
2,696
|
|
|
|
$
|
2,373
|
|
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities:
|
|
|
|
|
|
|
|
|
|
|
|
Increase (decrease) in cash from operating assets and liabilities:
|
|
|
|
|
|
|
|
|
|
|
|
|
Accounts receivable
|
|
|
|
|
(4,114
|
)
|
|
|
|
(3,645
|
)
|
|
|
|
|
|
Provision for doubtful accounts
|
|
|
|
|
3,913
|
|
|
|
|
3,169
|
|
|
|
|
|
|
Accounts receivable, net
|
|
|
|
|
(201
|
)
|
|
|
|
(476
|
)
|
|
|
|
|
|
Inventories and other assets
|
|
|
|
|
(314
|
)
|
|
|
|
(232
|
)
|
|
|
|
|
|
Accounts payable and accrued expenses
|
|
|
|
|
192
|
|
|
|
|
444
|
|
|
|
|
|
Depreciation and amortization
|
|
|
|
|
1,904
|
|
|
|
|
1,820
|
|
|
|
|
|
Income taxes
|
|
|
|
|
(160
|
)
|
|
|
|
(83
|
)
|
|
|
|
|
Losses (gains) on sales of facilities
|
|
|
|
|
5
|
|
|
|
|
(29
|
)
|
|
|
|
|
Losses on retirement of debt
|
|
|
|
|
135
|
|
|
|
|
335
|
|
|
|
|
|
Legal claim costs
|
|
|
|
|
149
|
|
|
|
|
78
|
|
|
|
|
|
Amortization of debt issuance costs
|
|
|
|
|
35
|
|
|
|
|
42
|
|
|
|
|
|
Share-based compensation
|
|
|
|
|
239
|
|
|
|
|
163
|
|
|
|
|
|
Other
|
|
|
|
|
54
|
|
|
|
|
13
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by operating activities
|
|
|
|
|
4,734
|
|
|
|
|
4,448
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from investing activities:
|
|
|
|
|
|
|
|
|
|
|
Purchase of property and equipment
|
|
|
|
|
(2,375
|
)
|
|
|
|
(2,176
|
)
|
|
|
|
Acquisition of hospitals and health care entities
|
|
|
|
|
(351
|
)
|
|
|
|
(766
|
)
|
|
|
|
Disposition of hospitals and health care entities
|
|
|
|
|
73
|
|
|
|
|
51
|
|
|
|
|
Change in investments
|
|
|
|
|
63
|
|
|
|
|
(37
|
)
|
|
|
|
Other
|
|
|
|
|
7
|
|
|
|
|
10
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash used in investing activities
|
|
|
|
|
(2,583
|
)
|
|
|
|
(2,918
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from financing activities:
|
|
|
|
|
|
|
|
|
|
|
Issuance of long-term debt
|
|
|
|
|
5,548
|
|
|
|
|
5,502
|
|
|
|
|
Net change in revolving credit facilities
|
|
|
|
|
150
|
|
|
|
|
440
|
|
|
|
|
Repayment of long-term debt
|
|
|
|
|
(4,920
|
)
|
|
|
|
(5,164
|
)
|
|
|
|
Distributions to noncontrolling interests
|
|
|
|
|
(495
|
)
|
|
|
|
(442
|
)
|
|
|
|
Payment of debt issuance costs
|
|
|
|
|
(50
|
)
|
|
|
|
(73
|
)
|
|
|
|
Repurchase of common stock
|
|
|
|
|
(2,397
|
)
|
|
|
|
(1,750
|
)
|
|
|
|
Income tax benefits
|
|
|
|
|
235
|
|
|
|
|
134
|
|
|
|
|
Other
|
|
|
|
|
(47
|
)
|
|
|
|
(25
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash used in financing activities
|
|
|
|
|
(1,976
|
)
|
|
|
|
(1,378
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Change in cash and cash equivalents
|
|
|
|
|
175
|
|
|
|
|
152
|
|
|
Cash and cash equivalents at beginning of period
|
|
|
|
|
566
|
|
|
|
|
414
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents at end of period
|
|
|
|
$
|
741
|
|
|
|
$
|
566
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Interest payments
|
|
|
|
$
|
1,650
|
|
|
|
$
|
1,758
|
|
|
Income tax payments, net
|
|
|
|
$
|
1,186
|
|
|
|
$
|
1,057
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HCA Holdings, Inc.
|
|
Operating Statistics
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Years
|
|
|
|
|
|
|
Fourth Quarter
|
|
|
Ended December 31,
|
|
|
|
|
|
|
2015
|
|
|
2014
|
|
|
2015
|
|
|
2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operations:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of Hospitals
|
|
|
|
|
168
|
|
|
|
|
166
|
|
|
|
|
168
|
|
|
|
|
166
|
|
|
|
Number of Freestanding Outpatient Surgery Centers
|
|
|
|
|
116
|
|
|
|
|
113
|
|
|
|
|
116
|
|
|
|
|
113
|
|
|
|
Licensed Beds at End of Period
|
|
|
|
|
43,771
|
|
|
|
|
43,356
|
|
|
|
|
43,771
|
|
|
|
|
43,356
|
|
|
|
Weighted Average Licensed Beds
|
|
|
|
|
43,705
|
|
|
|
|
43,321
|
|
|
|
|
43,620
|
|
|
|
|
43,132
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Reported:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions
|
|
|
|
|
467,300
|
|
|
|
|
458,000
|
|
|
|
|
1,868,800
|
|
|
|
|
1,795,300
|
|
|
|
% Change
|
|
|
|
|
2.0
|
%
|
|
|
|
|
|
|
4.1
|
%
|
|
|
|
|
|
Equivalent Admissions
|
|
|
|
|
787,800
|
|
|
|
|
760,200
|
|
|
|
|
3,122,700
|
|
|
|
|
2,958,700
|
|
|
|
% Change
|
|
|
|
|
3.6
|
%
|
|
|
|
|
|
|
5.5
|
%
|
|
|
|
|
|
Revenue per Equivalent Admission
|
|
|
|
$
|
13,010
|
|
|
|
$
|
12,676
|
|
|
|
$
|
12,706
|
|
|
|
$
|
12,478
|
|
|
|
% Change
|
|
|
|
|
2.6
|
%
|
|
|
|
|
|
|
1.8
|
%
|
|
|
|
|
|
Inpatient Revenue per Admission
|
|
|
|
$
|
12,634
|
|
|
|
$
|
12,461
|
|
|
|
$
|
12,407
|
|
|
|
$
|
12,327
|
|
|
|
% Change
|
|
|
|
|
1.4
|
%
|
|
|
|
|
|
|
0.6
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Patient Days
|
|
|
|
|
2,283,800
|
|
|
|
|
2,216,700
|
|
|
|
|
9,155,700
|
|
|
|
|
8,699,800
|
|
|
|
% Change
|
|
|
|
|
3.0
|
%
|
|
|
|
|
|
|
5.2
|
%
|
|
|
|
|
|
Equivalent Patient Days
|
|
|
|
|
3,850,500
|
|
|
|
|
3,679,000
|
|
|
|
|
15,299,100
|
|
|
|
|
14,337,200
|
|
|
|
% Change
|
|
|
|
|
4.7
|
%
|
|
|
|
|
|
|
6.7
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Inpatient Surgery Cases
|
|
|
|
|
134,000
|
|
|
|
|
132,600
|
|
|
|
|
529,900
|
|
|
|
|
518,900
|
|
|
|
% Change
|
|
|
|
|
1.1
|
%
|
|
|
|
|
|
|
2.1
|
%
|
|
|
|
|
|
Outpatient Surgery Cases
|
|
|
|
|
240,200
|
|
|
|
|
233,400
|
|
|
|
|
909,400
|
|
|
|
|
891,600
|
|
|
|
% Change
|
|
|
|
|
2.9
|
%
|
|
|
|
|
|
|
2.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Emergency Room Visits
|
|
|
|
|
2,037,700
|
|
|
|
|
1,949,200
|
|
|
|
|
8,050,200
|
|
|
|
|
7,450,700
|
|
|
|
% Change
|
|
|
|
|
4.5
|
%
|
|
|
|
|
|
|
8.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Outpatient Revenues as a Percentage of Patient Revenues
|
|
|
|
|
40.5
|
%
|
|
|
|
38.9
|
%
|
|
|
|
39.6
|
%
|
|
|
|
38.1
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Average Length of Stay
|
|
|
|
|
4.9
|
|
|
|
|
4.8
|
|
|
|
|
4.9
|
|
|
|
|
4.8
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Occupancy
|
|
|
|
|
56.8
|
%
|
|
|
|
55.6
|
%
|
|
|
|
57.5
|
%
|
|
|
|
55.3
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Same Facility:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions
|
|
|
|
|
461,900
|
|
|
|
|
454,700
|
|
|
|
|
1,847,300
|
|
|
|
|
1,786,000
|
|
|
|
% Change
|
|
|
|
|
1.6
|
%
|
|
|
|
|
|
|
3.4
|
%
|
|
|
|
|
|
Equivalent Admissions
|
|
|
|
|
775,000
|
|
|
|
|
753,000
|
|
|
|
|
3,075,700
|
|
|
|
|
2,939,700
|
|
|
|
% Change
|
|
|
|
|
2.9
|
%
|
|
|
|
|
|
|
4.6
|
%
|
|
|
|
|
|
Revenue per Equivalent Admission
|
|
|
|
$
|
12,998
|
|
|
|
$
|
12,666
|
|
|
|
$
|
12,695
|
|
|
|
$
|
12,479
|
|
|
|
% Change
|
|
|
|
|
2.6
|
%
|
|
|
|
|
|
|
1.7
|
%
|
|
|
|
|
|
Inpatient Revenue per Admission
|
|
|
|
$
|
12,675
|
|
|
|
$
|
12,482
|
|
|
|
$
|
12,449
|
|
|
|
$
|
12,340
|
|
|
|
% Change
|
|
|
|
|
1.5
|
%
|
|
|
|
|
|
|
0.9
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Inpatient Surgery Cases
|
|
|
|
|
132,800
|
|
|
|
|
130,900
|
|
|
|
|
524,200
|
|
|
|
|
513,400
|
|
|
|
% Change
|
|
|
|
|
1.5
|
%
|
|
|
|
|
|
|
2.1
|
%
|
|
|
|
|
|
Outpatient Surgery Cases
|
|
|
|
|
234,100
|
|
|
|
|
229,000
|
|
|
|
|
890,300
|
|
|
|
|
876,300
|
|
|
|
% Change
|
|
|
|
|
2.2
|
%
|
|
|
|
|
|
|
1.6
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Emergency Room Visits
|
|
|
|
|
1,999,500
|
|
|
|
|
1,929,800
|
|
|
|
|
7,912,800
|
|
|
|
|
7,392,300
|
|
|
|
% Change
|
|
|
|
|
3.6
|
%
|
|
|
|
|
|
|
7.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|

HCA Holdings, Inc.
Investor Contact:
Mark Kimbrough, 615-344-2688
or
Media Contact:
Ed Fishbough, 615-344-2810