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HCA Healthcare Reports First Quarter 2021 Results

April, 22, 2021

Revises 2021 Guidance

HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the first quarter ended March 31, 2021.

Key first quarter metrics (all percentage changes compare 1Q 2021 to 1Q 2020 unless otherwise noted):

  • Revenues totaled $13.977 billion
  • Net income attributable to HCA Healthcare, Inc. totaled $1.423 billion, or $4.14 per diluted share
  • Adjusted EBITDA totaled $3.052 billion
  • Cash flows from operating activities totaled $1.988 billion
  • Same facility admissions declined 4.2 percent and same facility equivalent admissions declined 6.5 percent

“The first quarter is yet another period where the disciplined operating culture and strong execution by our teams were on display. I want to thank our 275,000 colleagues and 50,000 physicians for their tremendous work. We could not have performed at this level without their unwavering commitment to our patients and the communities they serve,” said Sam Hazen, Chief Executive Officer of HCA Healthcare. “As we continue to resource and execute on our strategic agenda, we will remain true to our mission of improving lives and delivering on the responsibilities we have to our stakeholders.”

Revenues in the first quarter of 2021 increased to $13.977billion, compared to $12.861 billion in the first quarter of 2020. Net income attributable to HCA Healthcare, Inc. totaled $1.423 billion, or $4.14 per diluted share, compared to $581 million, or $1.69 per diluted share, in the first quarter of 2020. Results for the first quarter of 2020 included losses on retirement of debt of $295 million, or $0.66 per diluted share, and gains on sales of facilities of $7 million, or $0.02 per diluted share.

For the first quarter of 2021, Adjusted EBITDA totaled $3.052 billion, compared to $2.200 billion in the first quarter of 2020. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions declined 4.2 percent and same facility equivalent admissions declined 6.5 percent in the first quarter of 2021, compared to the prior year period. Same facility emergency room visits declined 18.4 percent in the first quarter of 2021, compared to the prior year period. Same facility inpatient surgeries declined 5.4 percent while same facility outpatient surgeries increased 2.3 percent in the first quarter of 2021 compared to the same period of 2020. Same facility revenue per equivalent admission increased 16.6 percent in the first quarter of 2021, compared to the first quarter of 2020, due to increases in acuity of patients treated and favorable payer mix.

Balance Sheet and Cash Flows from Operations

As of March 31, 2021, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $1.030 billion, total debt of $31.072 billion, and total assets of $47.277 billion. During the first quarter of 2021, capital expenditures totaled $654 million, excluding acquisitions. Cash flows provided by operating activities in the first quarter totaled $1.988 billion, compared to $1.375 billion in the first quarter of 2020.

During the first quarter of 2021, the Company repurchased 8.477 million shares of its common stock at a cost of $1.527 billion. The Company had $7.274 billion remaining under its repurchase authorization as of March 31, 2021. As of March 31, 2021, the Company had $5.590 billion of availability under its credit facilities.

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.48 per share on the Company’s common stock. The dividend will be paid on June 30, 2021 to stockholders of record at the close of business on June 16, 2021.

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.

2021 Revised Guidance

The 2021 guidance ranges for the year have been revised from our fourth quarter release and are as follows:

 

2021 Guidance Range

Revenues

$54.0 to $55.5 billion

Adjusted EBITDA

$10.85 to $11.35 billion

EPS (diluted)

$13.30 to $14.30 per diluted share

Capital Expenditures

Approximately $3.7 billion

The Company’s 2021 guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding the impact of the COVID-19 pandemic and related government legislation, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment 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.”

Annual Stockholders’ Meeting

The Company’s 2021 annual stockholders’ meeting will be held virtually on April 28, 2021 at 2:00 p.m. Central Daylight Time for stockholders of record as of March 8, 2021.

Earnings Conference Call

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

About the Company

As of March 31, 2021, HCA operated 186 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 states and the United Kingdom.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company’s financial guidance for the year ending December 31, 2021, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) developments related to COVID-19, including, without limitation, the length and severity of the pandemic; the volume of canceled or rescheduled procedures and the volume of COVID-19 patients cared for across our health systems; measures we are taking to respond to the COVID-19 pandemic; the impact and terms of government and administrative regulation and stimulus (including the Families First Coronavirus Response Act, the Coronavirus Aid, Relief and Economic Security (“CARES”) Act, the Paycheck Protection Program and Health Care Enhancement Act, the Consolidated Appropriations Act, 2021, the American Rescue Plan Act of 2021 and other enacted and potential future legislation); changes in revenues due to declining patient volumes, changes in payer mix and deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions; and the timing and availability of effective medical treatments and vaccines, (2) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financial perspective, (3) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”), including the effects of court challenges to, any repeal of, or changes to, the Affordable Care Act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including proposals to expand coverage of federally-funded insurance programs as an alternative to private insurance or establish a single-payer system (such reforms often referred to as “Medicare for All”), and also including any such laws or governmental regulations which are adopted in response to the COVID-19 pandemic, (4) the effects related to the continued implementation of the sequestration spending reductions required under the Budget Control Act of 2011, and related legislation extending these reductions, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) the highly competitive nature of the health care business, (9) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (10) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (11) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (12) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) changes in general economic conditions nationally and regionally in our markets, including economic and business conditions (and the impact thereof on the economy, financial markets and banking industry) resulting from the COVID-19 pandemic, (16) the emergence of and effects related to other pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record (“EHR”) technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (25) changes in the U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2020 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 Healthcare” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
First Quarter
(Dollars in millions, except per share amounts)
       
       
       

2021

 

2020

Amount

 

Ratio

 

Amount

 

Ratio

       
Revenues

$

13,977

 

 

100.0

%

 

$

12,861

 

 

100.0

%

       
Salaries and benefits

 

6,301

 

 

45.1

 

 

 

6,118

 

 

47.6

 

Supplies

 

2,224

 

 

15.9

 

 

 

2,123

 

 

16.5

 

Other operating expenses

 

2,421

 

 

17.4

 

 

 

2,427

 

 

18.9

 

Equity in earnings of affiliates

 

(21

)

 

(0.2

)

 

 

(7

)

 

(0.1

)

Depreciation and amortization

 

697

 

 

5.0

 

 

 

674

 

 

5.3

 

Interest expense

 

384

 

 

2.7

 

 

 

428

 

 

3.3

 

Gains on sales of facilities

 

(2

)

 

-

 

 

 

(7

)

 

(0.1

)

Losses on retirement of debt

 

-

 

 

-

 

 

 

295

 

 

2.3

 

       

 

12,004

 

 

85.9

 

 

 

12,051

 

 

93.7

 

       
Income before income taxes

 

1,973

 

 

14.1

 

 

 

810

 

 

6.3

 

       
Provision for income taxes

 

393

 

 

2.8

 

 

 

112

 

 

0.9

 

       
Net income

 

1,580

 

 

11.3

 

 

 

698

 

 

5.4

 

       
Net income attributable to noncontrolling interests

 

157

 

 

1.1

 

 

 

117

 

 

0.9

 

       
Net income attributable to HCA Healthcare, Inc.

$

1,423

 

 

10.2

 

 

$

581

 

 

4.5

 

       
Diluted earnings per share

$

4.14

 

   

$

1.69

 

 
       
Shares used in computing diluted earnings per share (millions)

 

343.321

 

   

 

344.096

 

 
       
Comprehensive income attributable to HCA Healthcare, Inc.

$

1,434

 

   

$

470

 

 
HCA Healthcare, Inc.
Condensed Consolidated Balance Sheets
(Dollars in millions)
 
 
 

March 31,

 

December 31,

 

2021

 

 

 

2020

 

 
ASSETS
Current assets:
Cash and cash equivalents

$

1,030

 

$

1,793

 

Accounts receivable

 

7,424

 

 

7,051

 

Inventories

 

2,068

 

 

2,025

 

Other

 

1,514

 

 

1,464

 

 

12,036

 

 

12,333

 

 
Property and equipment, at cost

 

49,877

 

 

49,317

 

Accumulated depreciation

 

(26,689

)

 

(26,118

)

 

23,188

 

 

23,199

 

 
Investments of insurance subsidiaries

 

393

 

 

388

 

Investments in and advances to affiliates

 

427

 

 

422

 

Goodwill and other intangible assets

 

8,575

 

 

8,578

 

Right-of-use operating lease assets

 

2,083

 

 

2,024

 

Other

 

575

 

 

546

 

 

$

47,277

 

$

47,490

 

 
 
 
LIABILITIES AND STOCKHOLDERS' EQUITY
Current liabilities:
Accounts payable

$

3,524

 

$

3,535

 

Accrued salaries

 

1,767

 

 

1,720

 

Other accrued expenses

 

3,117

 

 

3,240

 

Long-term debt due within one year

 

234

 

 

209

 

 

8,642

 

 

8,704

 

 
Long-term debt, less debt issuance costs and discounts of $229 and $236

 

30,838

 

 

30,795

 

Professional liability risks

 

1,553

 

 

1,486

 

Right-of-use operating lease obligations

 

1,730

 

 

1,673

 

Income taxes and other liabilities

 

2,032

 

 

1,940

 

 
Stockholders' equity:
Stockholders' equity attributable to HCA Healthcare, Inc.

 

247

 

 

572

 

Noncontrolling interests

 

2,235

 

 

2,320

 

 

2,482

 

 

2,892

 

$

47,277

 

$

47,490

 

 
HCA Healthcare, Inc.
Condensed Consolidated Statements of Cash Flows
First Quarter
(Dollars in millions)
 
 
 

 

2021

 

 

2020

 

 
Cash flows from operating activities:
Net income

$

1,580

 

$

698

 

Adjustments to reconcile net income to net cash provided by operating activities:
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable

 

(371

)

 

464

 

Inventories and other assets

 

(85

)

 

(196

)

Accounts payable and accrued expenses

 

(371

)

 

(784

)

Depreciation and amortization

 

697

 

 

674

 

Income taxes

 

406

 

 

121

 

Gains on sales of facilities

 

(2

)

 

(7

)

Losses on retirement of debt

 

-

 

 

295

 

Amortization of debt issuance costs and discounts

 

8

 

 

7

 

Share-based compensation

 

97

 

 

82

 

Other

 

29

 

 

21

 

 
Net cash provided by operating activities

 

1,988

 

 

1,375

 

 
 
Cash flows from investing activities:
Purchase of property and equipment

 

(654

)

 

(853

)

Acquisition of hospitals and health care entities

 

(22

)

 

(328

)

Sales of hospitals and health care entities

 

20

 

 

35

 

Change in investments

 

(2

)

 

(1

)

Other

 

9

 

 

2

 

 
Net cash used in investing activities

 

(649

)

 

(1,145

)

 
 
Cash flows from financing activities:
Issuances of long-term debt

 

-

 

 

2,700

 

Net change in revolving credit facilities

 

80

 

 

1,440

 

Repayment of long-term debt

 

(47

)

 

(3,327

)

Distributions to noncontrolling interests

 

(234

)

 

(154

)

Payment of debt issuance costs

 

-

 

 

(34

)

Payment of dividends

 

(169

)

 

(152

)

Repurchase of common stock

 

(1,527

)

 

(441

)

Other

 

(207

)

 

(141

)

 
Net cash used in financing activities

 

(2,104

)

 

(109

)

 
Effect of exchange rate changes on cash and cash equivalents

 

2

 

 

(11

)

 
Change in cash and cash equivalents

 

(763

)

 

110

 

Cash and cash equivalents at beginning of period

 

1,793

 

 

621

 

 
 
Cash and cash equivalents at end of period

$

1,030

 

$

731

 

 
 
Interest payments

$

375

 

$

468

 

Income tax refunds, net

$

(13

)

$

(9

)

 
HCA Healthcare, Inc.
Operating Statistics
 
 
 
First Quarter

 

2021

 

 

 

2020

 

 

 
Operations:
Number of Hospitals

 

186

 

 

 

186

 

Number of Freestanding Outpatient Surgery Centers*

 

121

 

 

 

123

 

Licensed Beds at End of Period

 

49,561

 

 

 

49,357

 

Weighted Average Beds in Service

 

42,363

 

 

 

42,177

 

 

 

 

Reported:

 

 

 

Admissions

 

506,380

 

 

 

528,244

 

% Change

 

-4.1

%

 

 

Equivalent Admissions

 

832,489

 

 

 

889,035

 

% Change

 

-6.4

%

 

 

Revenue per Equivalent Admission

$

16,789

 

 

$

14,466

 

% Change

 

16.1

%

 

 

Inpatient Revenue per Admission

$

17,090

 

 

$

14,632

 

% Change

 

16.8

%

 

 

 

 

 

Patient Days

 

2,671,041

 

 

 

2,622,839

 

% Change

 

1.8

%

 

 

Equivalent Patient Days

 

4,391,191

 

 

 

4,414,238

 

% Change

 

-0.5

%

 

 

 

 

 

Inpatient Surgery Cases

 

127,590

 

 

 

135,145

 

% Change

 

-5.6

%

 

 

Outpatient Surgery Cases

 

231,228

 

 

 

226,319

 

% Change

 

2.2

%

 

 

 

 

 

Emergency Room Visits

 

1,841,778

 

 

 

2,264,707

 

% Change

 

-18.7

%

 

 

 

 

 

Outpatient Revenues as a

 

 

 

Percentage of Patient Revenues

 

35.8

%

 

 

37.3

%

 

 

 

Average Length of Stay (days)

 

5.275

 

 

 

4.965

 

 

 

 

Occupancy (weighted average beds in service)

 

70.1

%

 

 

68.3

%

 

 

 

Same Facility:

 

 

 

Admissions

 

505,338

 

 

 

527,424

 

% Change

 

-4.2

%

 

 

Equivalent Admissions

 

829,765

 

 

 

887,127

 

% Change

 

-6.5

%

 

 

Revenue per Equivalent Admission

$

16,755

 

 

$

14,372

 

% Change

 

16.6

%

 

 

Inpatient Revenue per Admission

$

17,106

 

 

$

14,637

 

% Change

 

16.9

%

 

 

 

 

 

Inpatient Surgery Cases

 

127,460

 

 

 

134,718

 

% Change

 

-5.4

%

 

 

Outpatient Surgery Cases

 

229,837

 

 

 

224,722

 

% Change

 

2.3

%

 

 

 

 

 

Emergency Room Visits

 

1,836,500

 

 

 

2,251,682

 

% Change

 

-18.4

%

 

 

 
 
* Excludes freestanding endoscopy centers (21 centers at both March 31, 2021 and March 31, 2020).
 
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
Operating Results Summary
(Dollars in millions, except per share amounts)
 
 
 

First Quarter

 

2021

 

 

 

2020

 

 
Revenues

$

13,977

 

$

12,861

 

 
Net income attributable to HCA Healthcare, Inc.

$

1,423

 

$

581

 

Gains on sales of facilities (net of tax)

 

(1

)

 

(5

)

Losses on retirement of debt (net of tax)

 

-

 

 

227

 

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

 

1,422

 

 

803

 

Depreciation and amortization

 

697

 

 

674

 

Interest expense

 

384

 

 

428

 

Provision for income taxes

 

392

 

 

178

 

Net income attributable to noncontrolling interests

 

157

 

 

117

 

 
Adjusted EBITDA (a)

$

3,052

 

$

2,200

 

 
Adjusted EBITDA margin (a)

 

21.8

%

 

17.1

%

 
Diluted earnings per share:
Net income attributable to HCA Healthcare, Inc.

$

4.14

 

$

1.69

 

Gains on sales of facilities

 

-

 

 

(0.02

)

Losses on retirement of debt

 

-

 

 

0.66

 

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

$

4.14

 

$

2.33

 

 
Shares used in computing diluted earnings per share (millions)

 

343.321

 

 

344.096

 

(a)

  Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles ("GAAP"). We believe net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.
 
  Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that gains on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.
 
  Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
2021 Operating Results Forecast
(Dollars in millions, except per share amounts)
   
   
For the Year Ending
December 31, 2021
Low   High
   
Revenues

$

54,000

 

$

55,500

   
Net income attributable to HCA Healthcare, Inc. (a)

$

4,395

 

$

4,725

Depreciation and amortization

 

2,870

 

 

2,900

Interest expense

 

1,600

 

 

1,620

Provision for income taxes

 

1,350

 

 

1,450

Net income attributable to noncontrolling interests

 

635

 

 

655

   
Adjusted EBITDA (a) (b)

$

10,850

 

$

11,350

   
Diluted earnings per share:  
Net income attributable to HCA Healthcare, Inc.

$

13.30

 

$

14.30

   
Shares used in computing diluted earnings per share (millions)

 

330.000

 

 

330.000

   
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.

 

INVESTOR CONTACT:
Mark Kimbrough
615-344-2688

MEDIA CONTACT:
Harlow Sumerford
615-344-1851

Source: HCA Healthcare

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