HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating
results for the fourth quarter ended December 31, 2017.
Key fourth quarter metrics (all percentage changes compare 4Q
2017 to 4Q 2016 unless otherwise noted):
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Revenues totaled $11.562 billion, an increase of 8.6 percent
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Net income attributable to HCA Healthcare, Inc. totaled $474
million, or $1.30 per diluted share
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Adjusted EBITDA totaled $2.362 billion, an increase of 7.1 percent
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Cash flows from operating activities totaled $1.734 billion,
compared to $1.699 billion in the prior year’s fourth quarter
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Same facility equivalent admissions increased 2.3 percent, while
same facility admissions increased 1.4 percent
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Same facility revenue per equivalent admission increased 3.5 percent
Revenues in the fourth quarter totaled $11.562 billion, compared to
$10.641 billion in the fourth quarter of 2016. Net income attributable
to HCA Healthcare, Inc. totaled $474 million, or $1.30 per diluted
share, compared to $920 million, or $2.39 per diluted share, in the
fourth quarter of 2016. Results for the fourth quarter of 2017 include a
non-cash increase in the Company’s provision for income taxes of $301
million, or $0.83 per diluted share, related to the estimated impact of
the Tax Cuts and Jobs Act on our deferred tax assets and liabilities.
This estimate may be refined as further information becomes available.
During the fourth quarter of 2016, the Company recognized gains on sales
of facilities of $15 million, or $0.04 per diluted share, and legal
claim benefits of $279 million, or $0.46 per diluted share. The Company
recognized a tax benefit of $2 million, or $0.01 per diluted share, in
the fourth quarter of 2017 compared to a $33 million tax benefit, or
$0.09 per diluted share, in the fourth quarter of 2016 for excess tax
benefits related to employee equity award settlements recorded as a
component of the provision for income taxes.
Adjusted EBITDA for the fourth quarter of 2017 increased 7.1 percent to
$2.362 billion from $2.206 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 Healthcare, Inc. to Adjusted EBITDA is included in this release.
Fourth quarter revenue growth was primarily driven by an increase of 2.3
percent in same facility equivalent admissions and an increase of 3.5
percent in same facility revenue per equivalent admission compared to
the fourth quarter of 2016. Same facility admissions increased 1.4
percent in the fourth quarter of 2017 compared to the prior year period
while same facility emergency room visits increased 3.4 percent in the
fourth quarter of 2017 compared to the prior year period.
During the fourth quarter of 2017, same facility inpatient surgeries
increased 0.6 percent while same facility outpatient surgeries increased
0.8 percent compared to the prior year period.
The Company’s same facility operating expense per equivalent admission
increased 3.3 percent from the prior year’s fourth quarter. During the
fourth quarter of 2017, salaries and benefits, supplies and other
operating expenses totaled $9.209 billion, or 79.7 percent of revenues,
compared to $8.445 billion, or 79.4 percent of revenues, in the fourth
quarter of 2016.
Year Ended December 31, 2017
Revenues for the year ended December 31, 2017 totaled $43.614 billion
compared to $41.490 billion for 2016. Net income attributable to HCA
Healthcare, Inc. for 2017 was $2.216 billion, or $5.95 per diluted
share, compared to $2.890 billion, or $7.30 per diluted share, for the
year ended December 31, 2016. Results for the year ended December 31,
2017 include a non-cash increase in the Company’s provision for income
taxes of $301 million, or $0.81 per diluted share, related to the
estimated impact of the Tax Cuts and Jobs Act on our deferred tax assets
and liabilities. This estimate may be refined as further information
becomes available. Results for the year ended December 31, 2017 also
include gains on sales of facilities of $8 million, or $0.01 per diluted
share, and losses on retirement of debt of $39 million, or $0.06 per
diluted share.
In 2017, the Company incurred additional expenses and experienced losses
of revenues estimated at approximately $140 million, or $0.24 per
diluted share, associated with Hurricanes Harvey and Irma’s impact on
our Corpus Christi, Houston, Florida, Georgia and South Carolina
facilities. This amount is prior to any insurance recoveries which the
Company may receive.
The Company recognized an $82 million, or $0.22 per diluted share, tax
benefit in 2017 compared to a $162 million tax benefit, or $0.41 per
diluted share, during 2016 for excess tax benefits related to employee
equity award settlements recorded as a component of the provision for
income taxes. For 2016, the Company also recognized a reduction in the
provision for income taxes of $51 million, or $0.13 per diluted share,
resulting from the completion of the IRS examination of HCA’s 2011 and
2012 federal income tax returns. Results for 2016 also included gains on
sales of facilities of $23 million, or $0.05 per diluted share, and
legal claims benefits of $246 million, or $0.39 per diluted share.
Adjusted EBITDA for 2017 increased to $8.233 billion compared to $8.218
billion in 2016.
Balance Sheet and Cash Flow
As of December 31, 2017, HCA Healthcare, Inc.’s balance sheet reflected
cash and cash equivalents of $732 million, total debt of $33.058
billion, and total assets of $36.593 billion. During the fourth quarter
of 2017, capital expenditures totaled $982 million, excluding
acquisitions. The Company repurchased 7.2 million shares of its common
stock at a cost of $576 million in the fourth quarter and had $1.802
billion remaining on its $2 billion October 2017 authorization as of
December 31, 2017. For 2017, the Company repurchased 25.1 million shares
of its common stock at a cost of $2.051 billion. At December 31, 2017,
the Company had 350.092 million shares outstanding compared to 370.536
million shares outstanding as of December 31, 2016. Net cash provided by
operating activities in the fourth quarter of 2017 totaled $1.734
billion compared to $1.699 billion in the prior year’s fourth quarter.
Today, the Company is also announcing a planned increase in its 3-year
capital expenditures program to pursue growth opportunities in its
existing markets. The updated capital investment program is expected to
approximate $10.5 billion over the next three years, up from the
previous 3-year spend of approximately $8.2 billion.
As of December 31, 2017, HCA operated 179 hospitals and 120 freestanding
surgery centers and numerous other healthcare facilities.
Dividend
HCA today announced that its Board of Directors declared a quarterly
cash dividend of $0.35 per share on the Company’s common stock. The
dividend will be paid on March 30, 2018 to stockholders of record at the
close of business on March 1, 2018.
“The initiation of a quarterly dividend demonstrates our confidence in
the financial strength of our Company and the cash flow it generates,”
stated R. Milton Johnson, Chairman and Chief Executive Officer of HCA.
“We believe our cash flow from operations will allow us to continue to
invest in our existing markets, and pursue acquisition opportunities,
while also returning capital to stockholders. The announcement today
reinforces our commitment to delivering value to stockholders while
investing for future growth.”
The declaration and payment of any future dividend will be subject to
the discretion of the Board of Directors and will depend on a variety of
factors, including the Company’s financial condition and results of
operations and contractual restrictions. Future dividends are expected
to be funded by cash balances and future cash flows from operations.
2018 Guidance
Today, HCA issued the following estimated guidance for 2018:
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2018 Guidance Range
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Revenues
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$45.0 to $46.0 billion
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Adjusted EBITDA
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$8.45 to $8.75 billion
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EPS (diluted)
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$8.50 to $9.00 per diluted share
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Capital Expenditures
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Approximately $3.5 billion
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The Company’s 2018 guidance contains a number of assumptions, including:
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2018 guidance for EPS (diluted) includes an estimated $50 million
income tax benefit, or $0.14 per diluted share, for excess tax
benefits related to employee equity award settlements recorded as a
component of the provision for income taxes. The timing and amounts
related to employee equity award settlements are difficult to project
and may vary from this estimate.
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2018 guidance assumes the sale of the Company’s Oklahoma facilities
closing during the first quarter. These facilities had annual revenues
of approximately $1 billion and Adjusted EBITDA of approximately $180
million in 2017.
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2018 guidance includes an estimated impact of $1.35 earnings per
diluted share related to the Tax Cuts and Jobs Act.
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2018 guidance excludes any acquisitions that have not been completed.
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2018 guidance excludes any hurricane insurance recoveries the Company
may receive.
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2018 guidance excludes any changes in our estimates of the impact of
the Tax Cuts and Jobs Act on our deferred tax assets and liabilities.
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2018 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.
Adjusted EBITDA is a non-GAAP financial measure. A table reconciling
forecasted net income attributable to HCA Healthcare, Inc. to forecasted
Adjusted EBITDA is included in this release.
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 2018 annual stockholders’ meeting will be held in
Nashville, Tennessee on April 26, 2018 at 2:00 p.m. local time for
stockholders of record as of March 7, 2018.
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=1160368&tp_key=22f9dbc8eb
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 the Company’s
financial guidance for the year ending December 31, 2018, as well as
other statements that do not relate solely to historical or current
facts. Forward-looking statements can be identified by the use of words
like “may,” “believe,” “will,” “expect,” “project,” “estimate,”
“anticipate,” “plan,” “initiative” or “continue.” These forward-looking
statements are based on our current plans and expectations and are
subject to a number of known and unknown uncertainties and risks, many
of which are beyond our control, which could significantly affect
current plans and expectations and our future financial position and
results of operations. These factors include, but are not limited to,
(1) the impact of our substantial indebtedness and the ability to
refinance such indebtedness on acceptable terms, (2) the impact of the
Patient Protection and Affordable Care Act, as amended by the Health
Care and Education Reconciliation Act (collectively, the “Health Reform
Law”), including the effects of any repeal of, or changes to, the Health
Reform Law or changes to its implementation, the possible enactment of
additional federal or state health care reforms and possible changes to
other federal, state or local laws or regulations affecting the health
care industry, (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 and the size
of the uninsured or underinsured population (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) the impact of potential cybersecurity
incidents or security breaches, (22) our ongoing ability to demonstrate
meaningful use of certified electronic health record technology, (23)
the impact of natural disasters, such as hurricanes and floods, or
similar events beyond the Company’s control, (24) changes in
interpretations, assumptions, and expectations regarding the Tax Cuts
and Jobs Act, including additional guidance that may be issued by
federal and state taxing authorities, and (25) other risk factors
described in our annual report on Form 10-K for the year ended December
31, 2016 and our other filings with the Securities and Exchange
Commission. Many of the factors that will determine our future results
are beyond our ability to control or predict. In light of the
significant uncertainties inherent in the forward-looking statements
contained herein, readers should not place undue reliance on
forward-looking statements, which reflect management’s views only as of
the date hereof. We undertake no obligation to revise or update any
forward-looking statements, or to make any other forward-looking
statements, whether as a result of new information, future events or
otherwise.
All references to “Company” and “HCA” as used throughout this release
refer to HCA Healthcare, Inc. and its affiliates.
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HCA Healthcare, Inc.
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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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2017
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2016
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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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$12,497
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$11,506
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Provision for doubtful accounts
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935
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865
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Revenues
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11,562
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100.0
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%
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10,641
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100.0
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%
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Salaries and benefits
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5,181
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44.8
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4,764
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44.8
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Supplies
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1,947
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16.8
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1,802
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16.9
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Other operating expenses
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2,081
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18.1
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1,879
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17.7
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Equity in earnings of affiliates
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(9)
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(0.1)
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(10)
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(0.1)
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Depreciation and amortization
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550
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4.8
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503
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4.6
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Interest expense
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433
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3.7
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432
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4.1
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Losses (gains) on sales of facilities
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2
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-
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(15)
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(0.1)
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Legal claim benefits
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-
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-
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(279)
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(2.6)
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10,185
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88.1
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9,076
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85.3
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Income before income taxes
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1,377
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11.9
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1,565
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14.7
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Provision for income taxes
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736
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6.4
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480
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4.5
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Net income
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641
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5.5
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1,085
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10.2
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Net income attributable to noncontrolling interests
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167
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1.4
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165
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1.6
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Net income attributable to HCA Healthcare, Inc.
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$474
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4.1
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$920
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8.6
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Diluted earnings per share
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$1.30
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$2.39
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Shares used in computing diluted earnings per share (millions)
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363.943
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384.747
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Comprehensive income attributable to HCA Healthcare, Inc.
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$464
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$923
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HCA Healthcare, Inc.
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Condensed Consolidated Comprehensive Income Statements
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For the Years Ended December 31, 2017 and 2016
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(Dollars in millions, except per share amounts)
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2017
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2016
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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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$47,653
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$44,747
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Provision for doubtful accounts
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4,039
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3,257
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Revenues
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43,614
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100.0
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%
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41,490
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100.0
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%
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Salaries and benefits
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20,059
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46.0
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18,897
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45.5
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Supplies
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7,316
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16.8
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6,933
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16.7
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Other operating expenses
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8,051
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18.4
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7,496
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18.1
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Equity in earnings of affiliates
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(45)
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(0.1)
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(54)
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(0.1)
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Depreciation and amortization
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2,131
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|
4.9
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1,966
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4.8
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Interest expense
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1,690
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3.9
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|
1,707
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4.1
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Gains on sales of facilities
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(8)
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-
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(23)
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(0.1)
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Lossses on retirement of debt
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39
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0.1
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4
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-
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Legal claim benefits
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-
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-
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(246)
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(0.6)
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39,233
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|
90.0
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36,680
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88.4
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|
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|
|
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Income before income taxes
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4,381
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10.0
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4,810
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11.6
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Provision for income taxes
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1,638
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3.7
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|
1,378
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3.3
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Net income
|
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2,743
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|
6.3
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|
3,432
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8.3
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|
|
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Net income attributable to noncontrolling interests
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|
|
527
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1.2
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|
542
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1.3
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Net income attributable to HCA Healthcare, Inc.
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$2,216
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5.1
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$2,890
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7.0
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Diluted earnings per share
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$5.95
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$7.30
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Shares used in computing diluted earnings per share (millions)
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372.221
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395.851
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|
|
|
|
|
|
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|
|
Comprehensive income attributable to HCA Healthcare, Inc.
|
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|
$2,276
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|
|
|
|
$2,817
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HCA Healthcare, Inc.
|
|
Condensed Consolidated Balance Sheets
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(Dollars in millions)
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31,
|
|
|
September 30,
|
|
|
December 31,
|
|
|
|
|
|
|
|
|
|
|
|
|
2017
|
|
|
2017
|
|
|
2016
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
ASSETS
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Current assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents
|
|
|
|
|
|
|
$732
|
|
|
$718
|
|
|
$646
|
|
Accounts receivable, less allowance for doubtful accounts of
$5,488, $5,416 and $4,988
|
|
|
|
|
|
|
6,501
|
|
|
5,980
|
|
|
5,826
|
|
Inventories
|
|
|
|
|
|
|
1,573
|
|
|
1,546
|
|
|
1,503
|
|
Other
|
|
|
|
|
|
|
|
1,171
|
|
|
1,204
|
|
|
1,111
|
|
Total current assets
|
|
|
|
|
|
|
9,977
|
|
|
9,448
|
|
|
9,086
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Property and equipment, at cost
|
|
|
|
|
|
|
40,084
|
|
|
39,262
|
|
|
37,055
|
|
Accumulated depreciation
|
|
|
|
|
|
|
(22,189)
|
|
|
(21,933)
|
|
|
(20,703)
|
|
|
|
|
|
|
|
|
|
|
|
|
17,895
|
|
|
17,329
|
|
|
16,352
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Investments of insurance subsidiaries
|
|
|
|
|
|
418
|
|
|
368
|
|
|
336
|
|
Investments in and advances to affiliates
|
|
|
|
|
|
199
|
|
|
201
|
|
|
206
|
|
Goodwill and other intangible assets
|
|
|
|
|
|
7,394
|
|
|
7,357
|
|
|
6,704
|
|
Other
|
|
|
|
|
|
|
|
710
|
|
|
1,028
|
|
|
1,074
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$36,593
|
|
|
$35,731
|
|
|
$33,758
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
LIABILITIES AND STOCKHOLDERS' DEFICIT
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Current liabilities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Accounts payable
|
|
|
|
|
|
|
$2,606
|
|
|
$2,314
|
|
|
$2,318
|
|
Accrued salaries
|
|
|
|
|
|
|
1,369
|
|
|
1,312
|
|
|
1,265
|
|
Other accrued expenses
|
|
|
|
|
|
|
1,983
|
|
|
1,783
|
|
|
2,035
|
|
Long-term debt due within one year
|
|
|
|
|
|
200
|
|
|
202
|
|
|
216
|
|
Total current liabilities
|
|
|
|
|
|
|
6,158
|
|
|
5,611
|
|
|
5,834
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Long-term debt, less net debt issuance costs of $164, $171 and $170
|
|
|
|
32,858
|
|
|
32,751
|
|
|
31,160
|
|
Professional liability risks
|
|
|
|
|
|
|
1,198
|
|
|
1,179
|
|
|
1,148
|
|
Income taxes and other liabilities
|
|
|
|
|
|
|
1,374
|
|
|
1,256
|
|
|
1,249
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
EQUITY (DEFICIT)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Stockholders' deficit attributable to HCA Healthcare, Inc.
|
|
|
|
|
(6,806)
|
|
|
(6,780)
|
|
|
(7,302)
|
|
Noncontrolling interests
|
|
|
|
|
|
|
1,811
|
|
|
1,714
|
|
|
1,669
|
|
Total deficit
|
|
|
|
|
|
|
|
(4,995)
|
|
|
(5,066)
|
|
|
(5,633)
|
|
|
|
|
|
|
|
|
|
|
|
|
$36,593
|
|
|
$35,731
|
|
|
$33,758
|
|
|
|
HCA Healthcare, Inc.
|
|
Consolidated Statements of Cash Flows
|
|
For the Years Ended December 31, 2017 and 2016
|
|
(Dollars in millions)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2017
|
|
2016
|
|
|
|
|
|
|
|
|
|
Cash flows from operating activities:
|
|
|
|
|
|
|
|
Net income
|
|
|
$2,743
|
|
$3,432
|
|
Adjustments to reconcile net income to net cash provided by
operating activities:
|
|
|
|
|
|
|
Increase (decrease) in cash from operating assets and liabilities:
|
|
|
|
|
|
|
Accounts receivable
|
|
|
(4,640)
|
|
(3,247)
|
|
Provision for doubtful accounts
|
|
4,039
|
|
3,257
|
|
Accounts receivable, net
|
|
|
(601)
|
|
10
|
|
Inventories and other assets
|
|
|
(69)
|
|
(112)
|
|
Accounts payable and accrued expenses
|
|
374
|
|
144
|
|
Depreciation and amortization
|
|
|
2,131
|
|
1,966
|
|
Income taxes
|
|
|
433
|
|
123
|
|
Gains on sales of facilities
|
|
|
(8)
|
|
(23)
|
|
Losses on retirement of debt
|
|
|
39
|
|
4
|
|
Legal claim benefits
|
|
-
|
|
(246)
|
|
Amortization of debt issuance costs
|
|
31
|
|
34
|
|
Share-based compensation
|
|
|
270
|
|
251
|
|
Other
|
|
|
83
|
|
70
|
|
|
|
|
|
|
|
|
|
Net cash provided by operating activities
|
|
5,426
|
|
5,653
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from investing activities:
|
|
|
|
|
|
|
|
Purchase of property and equipment
|
|
(3,015)
|
|
(2,760)
|
|
Acquisition of hospitals and health care entities
|
|
(1,212)
|
|
(576)
|
|
Disposition of hospitals and health care entities
|
|
25
|
|
26
|
|
Change in investments
|
|
(73)
|
|
64
|
|
Other
|
|
|
(4)
|
|
6
|
|
|
|
|
|
|
|
|
|
Net cash used in investing activities
|
|
(4,279)
|
|
(3,240)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from financing activities:
|
|
|
|
|
|
|
|
Issuance of long-term debt
|
|
1,502
|
|
5,400
|
|
Net change in revolving credit facilities
|
|
760
|
|
(110)
|
|
Repayment of long-term debt
|
|
(753)
|
|
(4,475)
|
|
Distributions to noncontrolling interests
|
|
(448)
|
|
(434)
|
|
Payment of debt issuance costs
|
|
(26)
|
|
(40)
|
|
Repurchase of common stock
|
|
(2,051)
|
|
(2,751)
|
|
Other
|
|
|
(45)
|
|
(98)
|
|
|
|
|
|
|
|
|
|
Net cash used in financing activities
|
|
(1,061)
|
|
(2,508)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Change in cash and cash equivalents
|
|
86
|
|
(95)
|
|
Cash and cash equivalents at beginning of period
|
|
646
|
|
741
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents at end of period
|
|
$732
|
|
$646
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Interest payments
|
|
|
$1,700
|
|
$1,666
|
|
Income tax payments, net
|
|
|
$1,205
|
|
$1,255
|
|
|
|
HCA Healthcare, Inc.
|
|
Operating Statistics
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Years
|
|
|
|
|
|
|
|
Fourth Quarter
|
|
|
Ended December 31,
|
|
|
|
|
|
|
|
|
2017
|
|
|
|
|
2016
|
|
|
|
|
2017
|
|
|
|
|
2016
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operations:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of Hospitals
|
|
|
|
179
|
|
|
|
|
170
|
|
|
|
|
179
|
|
|
|
|
170
|
|
|
Number of Freestanding Outpatient Surgery Centers
|
|
|
|
120
|
|
|
|
|
118
|
|
|
|
|
120
|
|
|
|
|
118
|
|
|
Licensed Beds at End of Period
|
|
|
|
46,738
|
|
|
|
|
44,290
|
|
|
|
|
46,738
|
|
|
|
|
44,290
|
|
|
Weighted Average Licensed Beds
|
|
|
|
46,636
|
|
|
|
|
44,274
|
|
|
|
|
45,380
|
|
|
|
|
44,077
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Reported:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions
|
|
|
|
495,121
|
|
|
|
|
475,281
|
|
|
|
|
1,936,613
|
|
|
|
|
1,891,831
|
|
|
% Change
|
|
|
|
4.2
|
%
|
|
|
|
|
|
|
2.4
|
%
|
|
|
|
|
Equivalent Admissions
|
|
|
|
845,986
|
|
|
|
|
801,799
|
|
|
|
|
3,286,432
|
|
|
|
|
3,191,519
|
|
|
% Change
|
|
|
|
5.5
|
%
|
|
|
|
|
|
|
3.0
|
%
|
|
|
|
|
Revenue per Equivalent Admission
|
|
|
$
|
13,666
|
|
|
|
$
|
13,272
|
|
|
|
$
|
13,271
|
|
|
|
$
|
13,000
|
|
|
% Change
|
|
|
|
3.0
|
%
|
|
|
|
|
|
|
2.1
|
%
|
|
|
|
|
Inpatient Revenue per Admission
|
|
|
$
|
13,886
|
|
|
|
$
|
13,339
|
|
|
|
$
|
13,571
|
|
|
|
$
|
13,100
|
|
|
% Change
|
|
|
|
4.1
|
%
|
|
|
|
|
|
|
3.6
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Patient Days
|
|
|
|
2,420,007
|
|
|
|
|
2,308,865
|
|
|
|
|
9,490,138
|
|
|
|
|
9,274,384
|
|
|
% Change
|
|
|
|
4.8
|
%
|
|
|
|
|
|
|
2.3
|
%
|
|
|
|
|
Equivalent Patient Days
|
|
|
|
4,135,032
|
|
|
|
|
3,895,055
|
|
|
|
|
16,104,764
|
|
|
|
|
15,645,886
|
|
|
% Change
|
|
|
|
6.2
|
%
|
|
|
|
|
|
|
2.9
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Inpatient Surgery Cases
|
|
|
|
141,147
|
|
|
|
|
136,385
|
|
|
|
|
546,228
|
|
|
|
|
537,306
|
|
|
% Change
|
|
|
|
3.5
|
%
|
|
|
|
|
|
|
1.7
|
%
|
|
|
|
|
Outpatient Surgery Cases
|
|
|
|
250,925
|
|
|
|
|
242,095
|
|
|
|
|
935,307
|
|
|
|
|
932,213
|
|
|
% Change
|
|
|
|
3.6
|
%
|
|
|
|
|
|
|
0.3
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Emergency Room Visits
|
|
|
|
2,214,416
|
|
|
|
|
2,074,074
|
|
|
|
|
8,624,137
|
|
|
|
|
8,378,340
|
|
|
% Change
|
|
|
|
6.8
|
%
|
|
|
|
|
|
|
2.9
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Outpatient Revenues as a
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Percentage of Patient Revenues
|
|
|
|
38.7
|
%
|
|
|
|
38.5
|
%
|
|
|
|
37.8
|
%
|
|
|
|
38.3
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Average Length of Stay (days)
|
|
|
|
4.888
|
|
|
|
|
4.858
|
|
|
|
|
4.900
|
|
|
|
|
4.902
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Occupancy
|
|
|
|
56.4
|
%
|
|
|
|
56.7
|
%
|
|
|
|
57.3
|
%
|
|
|
|
57.5
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Same Facility:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Admissions
|
|
|
|
476,571
|
|
|
|
|
469,964
|
|
|
|
|
1,890,144
|
|
|
|
|
1,869,581
|
|
|
% Change
|
|
|
|
1.4
|
%
|
|
|
|
|
|
|
1.1
|
%
|
|
|
|
|
Equivalent Admissions
|
|
|
|
810,171
|
|
|
|
|
791,889
|
|
|
|
|
3,198,124
|
|
|
|
|
3,150,244
|
|
|
% Change
|
|
|
|
2.3
|
%
|
|
|
|
|
|
|
1.5
|
%
|
|
|
|
|
Revenue per Equivalent Admission
|
|
|
$
|
13,777
|
|
|
|
$
|
13,311
|
|
|
|
$
|
13,340
|
|
|
|
$
|
13,049
|
|
|
% Change
|
|
|
|
3.5
|
%
|
|
|
|
|
|
|
2.2
|
%
|
|
|
|
|
Inpatient Revenue per Admission
|
|
|
$
|
14,012
|
|
|
|
$
|
13,397
|
|
|
|
$
|
13,661
|
|
|
|
$
|
13,168
|
|
|
% Change
|
|
|
|
4.6
|
%
|
|
|
|
|
|
|
3.7
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Inpatient Surgery Cases
|
|
|
|
135,807
|
|
|
|
|
135,009
|
|
|
|
|
533,825
|
|
|
|
|
532,448
|
|
|
% Change
|
|
|
|
0.6
|
%
|
|
|
|
|
|
|
0.3
|
%
|
|
|
|
|
Outpatient Surgery Cases
|
|
|
|
241,446
|
|
|
|
|
239,583
|
|
|
|
|
912,936
|
|
|
|
|
924,895
|
|
|
% Change
|
|
|
|
0.8
|
%
|
|
|
|
|
|
|
-1.3
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Emergency Room Visits
|
|
|
|
2,113,380
|
|
|
|
|
2,044,086
|
|
|
|
|
8,368,279
|
|
|
|
|
8,256,499
|
|
|
% Change
|
|
|
|
3.4
|
%
|
|
|
|
|
|
|
1.4
|
%
|
|
|
|
|
|
|
HCA Healthcare, Inc.
|
|
Supplemental Non-GAAP Disclosures
|
|
Operating Results Summary
|
|
(Dollars in millions, except per share amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Years
|
|
|
|
|
|
|
|
|
|
|
|
|
Fourth Quarter
|
|
|
Ended December 31,
|
|
|
|
|
|
|
|
|
|
|
|
|
2017
|
|
|
2016
|
|
|
2017
|
|
|
2016
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Revenues
|
|
|
$11,562
|
|
|
$10,641
|
|
|
$43,614
|
|
|
$41,490
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Healthcare, Inc.
|
|
$474
|
|
|
$920
|
|
|
$2,216
|
|
|
$2,890
|
|
|
Losses (gains) on sales of facilities (net of tax)
|
|
|
1
|
|
|
(15)
|
|
|
(5)
|
|
|
(19)
|
|
|
Losses on retirement of debt (net of tax)
|
|
|
-
|
|
|
-
|
|
|
25
|
|
|
2
|
|
|
Legal claim benefits (net of tax)
|
|
|
|
-
|
|
|
(176)
|
|
|
-
|
|
|
(155)
|
|
Net income attributable to HCA Healthcare, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim benefits (a)
|
|
475
|
|
|
729
|
|
|
2,236
|
|
|
2,718
|
|
|
Depreciation and amortization
|
|
|
|
550
|
|
|
503
|
|
|
2,131
|
|
|
1,966
|
|
|
Interest expense
|
|
|
|
433
|
|
|
432
|
|
|
1,690
|
|
|
1,707
|
|
|
Provision for income taxes
|
|
|
|
737
|
|
|
377
|
|
|
1,649
|
|
|
1,285
|
|
|
Net income attributable to noncontrolling interests
|
|
167
|
|
|
165
|
|
|
527
|
|
|
542
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA (a)
|
|
|
|
$2,362
|
|
|
$2,206
|
|
|
$8,233
|
|
|
$8,218
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA margin (a)
|
|
|
|
20.4%
|
|
|
20.7%
|
|
|
18.9%
|
|
|
19.8%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings per share:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Healthcare, Inc.
|
|
$1.30
|
|
|
$2.39
|
|
|
$5.95
|
|
|
$7.30
|
|
|
Losses (gains) on sales of facilities
|
|
|
-
|
|
|
(0.04)
|
|
|
(0.01)
|
|
|
(0.05)
|
|
|
Losses on retirement of debt
|
|
|
|
-
|
|
|
-
|
|
|
0.06
|
|
|
0.01
|
|
|
Legal claim benefits
|
|
|
|
-
|
|
|
(0.46)
|
|
|
-
|
|
|
(0.39)
|
|
|
|
Net income attributable to HCA Healthcare, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim benefits(a)
|
|
$1.30
|
|
|
$1.89
|
|
|
$6.00
|
|
|
$6.87
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Shares used in computing diluted earnings per share (millions)
|
|
363.943
|
|
|
384.747
|
|
|
372.221
|
|
|
395.851
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(a)
|
Net income attributable to HCA Healthcare, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim benefits, and Adjusted EBITDA should not be considered
as measures of financial performance under generally accepted
accounting principles ("GAAP"). We believe net income attributable
to HCA Healthcare, Inc., excluding losses (gains) on sales of
facilities, losses on retirement of debt and legal claim benefits,
and Adjusted EBITDA are important measures that supplement
discussions and analysis of our results of operations. We believe it
is useful to investors to provide disclosures of our results of
operations on the same basis used by management. Management relies
upon net income attributable to HCA Healthcare, Inc., excluding
losses (gains) on sales of facilities, losses on retirement of debt
and legal claim benefits, and Adjusted EBITDA as the primary
measures to review and assess operating performance of its health
care facilities and their management teams.
|
|
|
|
|
|
Management and investors review both the overall performance
(including net income attributable to HCA Healthcare, Inc.,
excluding losses (gains) on sales of facilities, losses on
retirement of debt and legal claim benefits, and GAAP net income
attributable to HCA Healthcare, Inc.) and operating performance
(Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and
the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are
utilized by management and investors to compare our current
operating results with the corresponding periods during the previous
year and to compare our operating results with other companies in
the health care industry. It is reasonable to expect that losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim benefits will occur in future periods, but the amounts
recognized can vary significantly from period to period, do not
directly relate to the ongoing operations of our health care
facilities and complicate period comparisons of our results of
operations and operations comparisons with other health care
companies.
|
|
|
|
|
|
Net income attributable to HCA Healthcare, Inc., excluding losses
(gains) on sales of facilities, losses on retirement of debt and
legal claim benefits, and Adjusted EBITDA are not measures of
financial performance under GAAP, and should not be considered as
alternatives to net income attributable to HCA Healthcare, Inc. as a
measure of operating performance or cash flows from operating,
investing and financing activities as a measure of liquidity.
Because net income attributable to HCA Healthcare, Inc., excluding
losses (gains) on sales of facilities, losses on retirement of debt
and legal claim benefits, and Adjusted EBITDA are not measurements
determined in accordance with GAAP and are susceptible to varying
calculations, net income attributable to HCA Healthcare, Inc.,
excluding losses (gains) on sales of facilities, losses on
retirement of debt and legal claim benefits, and Adjusted EBITDA, as
presented, may not be comparable to other similarly titled measures
presented by other companies.
|
|
|
|
HCA Healthcare, Inc.
|
|
Supplemental Non-GAAP Disclosures
|
|
2018 Operating Results Forecast
|
|
(Dollars in millions, except per share amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Year Ending
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31, 2018
|
|
|
|
|
|
|
|
|
|
|
|
|
Low
|
|
High
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Revenues
|
|
|
|
$45,000
|
|
$46,000
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Healthcare, Inc. (a)
|
|
|
$3,020
|
|
$3,200
|
|
|
Depreciation and amortization
|
|
|
|
2,200
|
|
2,200
|
|
|
Interest expense
|
|
|
|
1,775
|
|
1,775
|
|
|
Provision for income taxes
|
|
|
|
955
|
|
1,075
|
|
|
Net income attributable to noncontrolling interests
|
|
|
500
|
|
500
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA (a) (b)
|
|
|
|
$8,450
|
|
$8,750
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted earnings per share:
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to HCA Healthcare, Inc.
|
|
|
$8.50
|
|
$9.00
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Shares used in computing diluted earnings per share (millions)
|
|
|
355.300
|
|
355.300
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The Company's forecasted guidance range is based on current plans
and expectations and is subject to a number of known and unknown
uncertainties and risks.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(a)
|
The Company does not forecast the impact of items such as, but not
limited to, losses (gains) on sales of facilities, losses on
retirement of debt, legal claim costs (benefits) and impairments of
long-lived assets because the Company does not believe that it can
forecast these items with sufficient accuracy.
|
|
|
|
|
(b)
|
Adjusted EBITDA should not be considered a measure of financial
performance under generally accepted accounting principles ("GAAP").
We believe Adjusted EBITDA is an important measure that supplements
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 Adjusted EBITDA as a primary measure to review and assess
operating performance of its health care facilities and their
management teams.
|
|
|
|
|
|
Management and investors review both the overall performance
(including net income attributable to HCA Healthcare, Inc.) 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.
|
|
|
|
|
|
Adjusted EBITDA is not a measure of financial performance under GAAP
and should not be considered as an alternative to net income
attributable to HCA Healthcare, Inc. as a measure of operating
performance or cash flows from operating, investing and financing
activities as a measure of liquidity. Because Adjusted EBITDA is not
a measurement determined in accordance with GAAP and is susceptible
to varying calculations, Adjusted EBITDA, as presented, may not be
comparable to other similarly titled measures presented by other
companies.
|
HCA Healthcare, Inc.
Investor Contact:
Mark Kimbrough, 615-344-2688
or
Media Contact:
Ed Fishbough, 615-344-2810