Tenet Reports Strong Fourth Quarter and FY 2024 Results; Provides 2025 Financial Outlook

Tenet Reports Strong Fourth Quarter and FY 2024 Results; Provides 2025 Financial Outlook

  • Net income available to common shareholders in fourth quarter 2024 was $318 million, or $3.32 per diluted share
  • Adjusted diluted earnings per share1 was $3.44 in fourth quarter 2024
  • Consolidated Adjusted EBITDA1 in fourth quarter 2024 was $1.048 billion, which represents an Adjusted EBITDA margin of 20.7%
  • Fourth quarter 2024 Ambulatory Care Adjusted EBITDA of $530 million increased 14.2% over fourth quarter 2023
  • FY 2025 Adjusted EBITDA Outlook is expected to be in the range of $3.975 billion to $4.175 billion

DALLAS–(BUSINESS WIRE)–
Tenet Healthcare Corporation (Tenet) (NYSE: THC) today announced its results for the quarter ended December 31, 2024.

“2024 was an outstanding year for Tenet characterized by robust revenue growth, efficient operations, high levels of patient satisfaction and clinical quality, and a portfolio transformation that drove substantial balance sheet deleveraging,” said Saum Sutaria, M.D., Chairman and Chief Executive Officer of Tenet. “Our focused strategy, disciplined operating management, and the strong demand for acute care and ambulatory surgical services provide us with momentum as we begin the year and confidence to achieve our full year 2025 expectations.”

Tenet’s results for fourth quarter 2024 versus fourth quarter 2023 are as follows:

 

Three Months Ended December 31,

Years Ended December 31,

($ in millions, except per share results)

2024

2023

2024

2023

Net operating revenues

$5,072

$5,379

$20,665

$20,548

Net income available to Tenet common shareholders

$318

$244

$3,200

$611

Net income available to Tenet common shareholders per diluted share

$3.32

$2.30

$32.70

$5.71

Adjusted EBITDA1

$1,048

$1,012

$3,995

$3,541

Adjusted diluted earnings per share1

$3.44

$2.68

$11.88

$6.98

  • Net operating revenues in fourth quarter 2024 were $5.072 billion, versus $5.379 billion in fourth quarter 2023, reflecting the impact of the divestiture of fourteen hospitals in 2024, partially offset by strong same facility revenue growth, favorable payer mix, and acquisitions of ambulatory surgical centers.

  • Net income available to the Company’s common shareholders in the fourth quarter 2024 was $318 million, or $3.32 per diluted share, versus $244 million, or $2.30 per diluted share, in fourth quarter 2023.

  • Net income available to the Company’s common shareholders in 2024 was $3.2 billion, or $32.70 per diluted share, versus $611 million, or $5.71 in 2023. 2024 results included a pre-tax gain of $2.916 billion ($2.143 billion after-tax, or $21.89 per diluted share) primarily associated with the hospital divestitures.

  • Adjusted EBITDA1 in fourth quarter 2024 was $1.048 billion compared to $1.012 billion in fourth quarter 2023, reflecting strong same-hospital admissions growth, strong ambulatory net revenue per case growth, favorable payer mix, and increased Medicaid supplemental revenues in Michigan, partially offset by the impact of hospital divestitures. Fourth quarter 2023 results included $52 million of revenue associated with Medicaid supplemental revenue program adjustments in California and Texas.

Balance Sheet and Cash Flows

  • Cash flows provided by operating activities for the year ended December 31, 2024 were $2.047 billion versus $2.374 billion for the year ended December 31, 2023. Cash flows provided by operating activities for the year ended December 31, 2024 included $855 million of income taxes paid associated with gains on sale of hospitals and related operations.

  • The Company produced free cash flow1 of $1.116 billion for the year ended December 31, 2024 versus $1.623 billion for the year ended December 31, 2023.

  • In the year ended December 31, 2024, the Company repurchased 5,596,573 shares of common stock for $672 million.

  • The Company’s ratio of net debt to Adjusted EBITDA1 was 2.54x at December 31, 2024 compared to 3.89x at December 31, 2023.

Ambulatory Care (Ambulatory) Segment

Tenet’s Ambulatory business segment is comprised of the operations of United Surgical Partners International (USPI). As of December 31, 2024, USPI had interests in 518 ambulatory surgery centers (375 consolidated) and 25 surgical hospitals (seven consolidated) in 37 states.

 

Three Months Ended December 31,

Years Ended December 31,

Ambulatory segment results ($ in millions)

2024

2023

2024

2023

Revenues

 

 

 

 

Net operating revenues

$1,259

$1,077

$4,534

$3,865

Same-facility system-wide net patient service revenues2

$2,183

$2,010

$7,664

$7,109

Volume Changes versus the Prior-Year Period

 

 

 

 

Same-facility system-wide surgical cases2

0.1%

3.9%

0.3 %

5.6%

Same-facility system-wide surgical cases on same-business day basis2

(1.5)%

3.9%

(0.5)%

6.0%

Adjusted EBITDA, Margins and NCI

 

 

 

 

Adjusted EBITDA

$530

$464

$1,810

$1,544

Adjusted EBITDA margin

42.1%

43.1%

39.9%

39.9%

Adjusted EBITDA less NCI

$317

$280

$1,096

$958

  • Fourth quarter 2024 net operating revenues increased 16.9% compared to fourth quarter 2023 driven by strong net revenue per case growth, acquisitions of facilities, and increased service lines.

  • Surgical business same-facility system-wide net patient service revenues increased 8.6% in fourth quarter 2024 compared to fourth quarter 2023, with cases up 0.1% and net revenue per case up 8.5%. Net revenue per case growth was driven by higher acuity associated with favorable case mix as well as favorable payer mix.

  • Fourth quarter 2024 Adjusted EBITDA increased 14.2% compared to fourth quarter 2023, due to strong net revenue per case growth, disciplined expense management, and contributions from acquisitions.

Hospital Operations and Services (Hospital) Segment

Tenet’s Hospital business segment is primarily comprised of acute care and specialty hospitals, imaging centers, ancillary outpatient facilities, micro-hospitals and physician practices. It also provides comprehensive end-to-end and focused point services, including hospital and physician revenue cycle management, patient communications and engagement support and value-based care solutions.

 

Three Months Ended December 31,

Years Ended December 31,

Hospital segment results($ in millions)

2024

2023

2024

2023

Revenues

 

 

 

 

Net operating revenues

$3,813

$4,302

$16,131

$16,683

Same-hospital net patient service revenues3

$3,218

$3,104

$12,829

$11,968

Same-Hospital Volume Changes versus the Prior-Year Period

 

 

 

 

Admissions

5.0%

1.0%

4.7%

2.2%

Adjusted admissions4

3.1%

0.1%

2.5%

2.5%

Outpatient visits (including outpatient ER visits)

0.4%

(2.2)%

0.3%

(1.3)%

Emergency Room visits (inpatient and outpatient)

(2.4)%

(3.3)%

0.9%

0.1%

Hospital surgeries

0.2%

0.8%

0.6%

0.6%

Adjusted EBITDA

 

 

 

 

Adjusted EBITDA

$518

$548

$2,185

$1,997

Adjusted EBITDA margin

13.6%

12.7%

13.5%

12.0%

  • Fourth quarter 2024 net operating revenues declined 11.4% from fourth quarter 2023 primarily due to the impact of hospital divestitures in 2024, partially offset by strong same hospital admissions growth, favorable payer mix, and improved pricing yield.

  • Same-hospital net patient service revenue per adjusted admission increased 0.6% year-over-year for fourth quarter 2024 primarily due to improved pricing yield, favorable payer mix, and our focus on growing higher acuity services, partially offset by net unfavorable Medicaid supplemental revenue program adjustments relative to fourth quarter 2023.

  • Adjusted EBITDA in fourth quarter 2024 was $518 million compared to $548 million in fourth quarter 2023, reflecting strong same-hospital admissions growth and revenue per adjusted admission, favorable payer mix, and increased supplemental revenues in Michigan, offset by the impact of hospital divestitures and the favorable Medicaid supplemental revenue program adjustments of $52 million in fourth quarter 2023.

2025 Outlook1

Tenet’s Outlook for full year 2025 (consolidated and by segment) follows.

CONSOLIDATED ($ in millions, except per share amounts)

FY 2025 Outlook

Net operating revenues

$20,600 to $21,000

Net income available to Tenet common stockholders

$1,040 to $1,185

Adjusted EBITDA

$3,975 to $4,175

Adjusted EBITDA margin

19.3% to 19.9%

Diluted income per common share

$10.95 to $12.47

Adjusted net income

$1,115 to $1,220

Adjusted diluted earnings per share

$11.74 to $12.84

Equity in earnings of unconsolidated affiliates

$265 to $275

Depreciation and amortization

$805 to $835

Interest expense

$795 to $805

Income tax expense5

$420 to $465

Net income available to NCI

$910 to $960

Weighted average diluted common shares

~95 million

Net cash provided by operating activities

$2,500 to $2,850

Adjusted net cash provided by operating activities

$2,600 to $2,900

Capital expenditures

$700 to $800

Free cash flow

$1,800 to $2,050

Adjusted free cash flow

$1,900 to $2,100

NCI cash distributions

$750 to $800

Ambulatory Segment($ in millions)

FY 2025 Outlook

Net operating revenues

$4,850 to $5,000

Adjusted EBITDA

$1,915 to $1,985

NCI

$760 to $790

Adjusted EBITDA less NCI

$1,155 to $1,195

Changes versus prior year6:

 

Same-facility system-wide revenue

Up 3.0% to 6.0%

 
 

Hospital Segment ($ in millions)

FY 2025 Outlook

Net operating revenues

$15,750 to $16,000

Adjusted EBITDA

$2,060 to $2,190

NCI

$150 to $170

Changes versus prior year6:

 

Inpatient admissions

Up 2.0% to 3.0%

Adjusted admissions

Up 2.0% to 3.0%

Management’s Webcast Discussion of Results

Tenet management will discuss the Company’s fourth quarter 2024 results in a webcast scheduled for 10:00 a.m. Eastern Time (9:00 a.m. Central Time) on February 12, 2025. Investors can access the webcast through the Company’s website at www.tenethealth.com/investors.

The slide presentation associated with the webcast referenced above, a copy of this earnings press release, and a related supplemental financial disclosures document will be available on the Company’s Investor Relations website on February 12, 2025.

Cautionary Statement

This release contains “forward-looking statements” – that is, statements that relate to future, not past, events. In this context, forward-looking statements often address the Company’s expected future business and financial performance and financial condition, and often contain words such as “expect,” “anticipate,” “assume,” “believe,” “budget,” “estimate,” “forecast,” “intend,” “plan,” “predict,” “project,” “seek,” “see,” “target,” or “will.” Forward-looking statements by their nature address matters that are, to different degrees, uncertain. Particular uncertainties that could cause the Company’s actual results to be materially different than those expressed in the Company’s forward-looking statements include, but are not limited to the factors disclosed under “Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the year ended December 31, 2023 and other filings with the Securities and Exchange Commission.

Footnotes

  1. Tables and discussions throughout this earnings release include certain financial measures, including those related to our first quarter and full year 2025 Outlook, that are not in accordance with accounting principles generally accepted in the United States of America (GAAP). Reconciliations of GAAP measures to the Adjusted (non-GAAP) measures used are detailed in Tables #1-6 included at the end of this earnings release. Management’s reasoning for the use of these non-GAAP measures and descriptions of the various non-GAAP measures are included in the Non-GAAP Financial Measures section of this earnings release.

  2. Same-facility system-wide revenues and statistical information include the results of the facilities in which the Ambulatory segment has an investment that are not consolidated by Tenet. To help analyze the segment’s results of operations, management uses system-wide measures, which include revenues and cases of both consolidated and unconsolidated facilities.

  3. For 2024, same-hospital revenues and statistical data include those for hospitals and hospital-affiliated outpatient centers operated by the Company’s Hospital segment continuously from January 1, 2023 through December 31, 2024. Amounts associated with physician practices are excluded.

  4. Adjusted admissions represent actual patient admissions adjusted to include outpatient services provided by facilities in our Hospital segment by multiplying actual patient admissions by the sum of gross inpatient revenues and outpatient revenues, then dividing that result by gross inpatient revenues.

  5. Income tax expense is calculated by multiplying 24% (the federal corporate tax rate of 21% plus an estimate of state taxes) by the sum of: pretax income less GAAP facility level NCI expense plus permanent differences, and non-deductible interest expense.

  6. Change versus prior year is presented on a same-facility system-wide basis for USPI Ambulatory surgical cases and on a same-hospital basis for hospital statistics.

About Tenet Healthcare

Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates ambulatory surgery centers and surgical hospitals. We also operate a national portfolio of acute care and specialty hospitals, other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve. For more information, please visit www.tenethealth.com.

Non-GAAP Financial Measures

The Company believes the non-GAAP measures described below are useful to investors and analysts because they present additional information on the Company’s financial performance. Investors, analysts, Company management and the Company’s Board of Directors utilize these non-GAAP measures, in addition to GAAP measures, to track the Company’s financial and operating performance and compare the Company’s performance to its peer companies, which use similar non-GAAP financial measures in their presentations and earnings releases. The Human Resources Committee of the Company’s Board of Directors also uses certain of these measures to evaluate management’s performance for the purpose of determining incentive compensation. Additional information regarding the purpose and utility of specific non-GAAP measures used in this release is set forth below.

  • Adjusted EBITDA is defined by the Company as net income available (loss attributable) to Tenet common shareholders before (1) the cumulative effect of changes in accounting principles, (2) net loss attributable (income available) to noncontrolling interests, (3) income (loss) from discontinued operations, net of tax, (4) income tax benefit (expense), (5) gain (loss) from early extinguishment of debt, (6) other non-operating income (expense), net, (7) interest expense, (8) litigation and investigation benefit (costs), net of insurance recoveries, (9) net gains (losses) on sales, consolidation and deconsolidation of facilities, (10) impairment and restructuring charges and acquisition-related costs, (11) depreciation and amortization and (12) income (loss) from divested and closed businesses (i.e., health plan businesses). Litigation and investigation costs excluded do not include ordinary course of business malpractice and other litigation and related expenses.

  • Adjusted diluted earnings (loss) per share is defined by the Company as Adjusted net income available (loss attributable) to Tenet common shareholders, divided by the weighted average diluted shares outstanding in the reporting period.

  • Adjusted net income available (loss attributable) to Tenet common shareholders is defined by the Company as net income available (loss attributable) to Tenet common shareholders before (1) income (loss) from discontinued operations, net of tax, (2) gain (loss) from early extinguishment of debt, (3) litigation and investigation benefit (costs), net of insurance recoveries, (4) net gains (losses) on sales, consolidation and deconsolidation of facilities, (5) impairment and restructuring charges and acquisition-related costs, (6) income (loss) from divested and closed businesses (i.e., health plan businesses) and (7) the associated impact of these items on taxes and noncontrolling interests. Litigation and investigation costs excluded do not include ordinary course of business malpractice and other litigation and related expenses.

  • Free Cash Flow is defined by the Company as (1) net cash provided by (used in) operating activities, less (2) purchases of property and equipment.

  • Adjusted Free Cash Flowis defined by the Company as (1) Adjusted net cash provided by (used in) operating activities, less (2) purchases of property and equipment.

  • Adjusted net cash provided by (used in) operating activities is defined by the Company as cash provided by (used in) operating activities prior to (1) payments for restructuring charges, acquisition-related costs and litigation costs and settlements, and (2) net cash provided by (used in) operating activities from discontinued operations.

The Company believes that Adjusted EBITDA is a useful measure, in part, because certain investors and analysts use both historical and projected Adjusted EBITDA, in addition to other GAAP and non-GAAP measures, as factors in determining the estimated fair value of shares of the Company’s common stock. Company management also regularly reviews the Adjusted EBITDA performance for each operating segment. The Company does not use Adjusted EBITDA to measure liquidity, but instead to measure operating performance.

The Company uses, and believes investors use, Free Cash Flow and Adjusted Free Cash Flow as supplemental non-GAAP measures to analyze cash flows generated from the Company’s operations. The Company believes these measures are useful to investors in evaluating its ability to fund distributions paid to noncontrolling interests or for acquisitions, purchasing equity interests in joint ventures or repaying debt.

These non-GAAP measures may not be comparable to similarly titled measures reported by other companies. Because these measures exclude many items that are included in the Company’s financial statements, they do not provide a complete measure of the Company’s operating performance. For example, the Company’s definitions of Free Cash Flow and Adjusted Free Cash Flow do not include other important uses of cash including (1) cash used to purchase businesses or joint venture interests, or (2) any items that are classified as Cash Flows from Financing Activities on the Company’s Consolidated Statement of Cash Flows, including items such as (i) cash used to repay borrowings, or (ii) distributions paid to noncontrolling interests. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance.

See corresponding reconciliations of the non-GAAP financial measures referred to above to the most comparable GAAP financial measures in Tables #1 – 6 below. 

Tenet Healthcare Corporation

Financial Statements and Reconciliations

Fourth Quarter Earnings Release

 

Table of Contents

 

Description

Page

Consolidated Statements of Operations

12

Consolidated Balance Sheets

14

Consolidated Statements of Cash Flows

15

Segment Reporting

17

Table #1 – Reconciliations of Net Income to Adjusted Net Income

18

Table #2 – Reconciliations of Net Income to Adjusted EBITDA

19

Table #3 – Reconciliations of Net Cash Provided by (Used in) Operating Activities to Free Cash Flow and Adjusted Free Cash Flow

20

Table #4 – Reconciliations of Outlook Net Income to Outlook Adjusted Net Income

21

Table #5 – Reconciliations of Outlook Net Income to Outlook Adjusted EBITDA

22

Table #6 – Reconciliations of Outlook Net Cash Provided by Operating Activities to Outlook Free Cash Flow and Outlook Adjusted Free Cash Flow

23

 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 

(Dollars in millions, except per share amounts)

 

Three Months Ended December 31,

 

2024

 

%

 

2023

 

%

 

Change

Net operating revenues

 

$

5,072

 

 

100.0

%

 

$

5,379

 

 

100.0

%

 

(5.7

)%

Grant income

 

 

1

 

 

%

 

 

2

 

 

%

 

(50.0

)%

Equity in earnings of unconsolidated affiliates

 

 

78

 

 

1.5

%

 

 

73

 

 

1.4

%

 

6.8

%

Operating expenses:

 

 

 

 

 

 

 

 

 

 

Salaries, wages and benefits

 

 

2,094

 

 

41.3

%

 

 

2,315

 

 

43.0

%

 

(9.5

)%

Supplies

 

 

930

 

 

18.3

%

 

 

931

 

 

17.3

%

 

(0.1

)%

Other operating expenses, net

 

 

1,079

 

 

21.3

%

 

 

1,196

 

 

22.2

%

 

(9.8

)%

Depreciation and amortization

 

 

193

 

 

3.8

%

 

 

216

 

 

4.0

%

 

 

Impairment and restructuring charges, and acquisition-related costs

 

 

27

 

 

0.5

%

 

 

53

 

 

1.0

%

 

 

Litigation and investigation costs

 

 

17

 

 

0.3

%

 

 

19

 

 

0.4

%

 

 

Net gains on sales, consolidation and deconsolidation of facilities

 

 

(10

)

 

(0.2

)%

 

 

(11

)

 

(0.2

)%

 

 

Operating income

 

 

821

 

 

16.2

%

 

 

735

 

 

13.7

%

 

 

Interest expense

 

 

(203

)

 

 

 

 

(227

)

 

 

 

 

Other non-operating income, net

 

 

37

 

 

 

 

 

11

 

 

 

 

 

Income before income taxes

 

 

655

 

 

 

 

 

519

 

 

 

 

 

Income tax expense

 

 

(83

)

 

 

 

 

(63

)

 

 

 

 

Net income

 

 

572

 

 

 

 

 

456

 

 

 

 

 

Less: Net income available to noncontrolling interests

 

 

254

 

 

 

 

 

212

 

 

 

 

 

Net income available to Tenet Healthcare Corporation common shareholders

 

$

318

 

 

 

 

$

244

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share available to Tenet Healthcare Corporation common shareholders:

 

 

 

 

 

 

 

 

 

 

Basic

 

$

3.34

 

 

 

 

$

2.42

 

 

 

 

 

Diluted

 

$

3.32

 

 

 

 

$

2.30

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average shares and dilutive securities outstanding (in thousands):

 

 

 

 

 

 

 

 

 

 

Basic

 

 

95,102

 

 

 

 

 

100,956

 

 

 

 

 

Diluted

 

 

95,882

 

 

 

 

 

104,167

 

 

 

 

 

 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 

(Dollars in millions, except per share amounts)

 

Years Ended December 31,

 

2024

 

%

 

2023

 

%

 

Change

Net operating revenues

 

$

20,665

 

 

100.0

%

 

$

20,548

 

 

100.0

%

 

0.6

%

Grant income

 

 

10

 

 

%

 

 

16

 

 

0.1

%

 

(37.5

)%

Equity in earnings of unconsolidated affiliates

 

 

260

 

 

1.3

%

 

 

228

 

 

1.1

%

 

14.0

%

Operating expenses:

 

 

 

 

 

 

 

 

 

 

Salaries, wages and benefits

 

 

8,801

 

 

42.6

%

 

 

9,146

 

 

44.5

%

 

(3.8

)%

Supplies

 

 

3,647

 

 

17.6

%

 

 

3,590

 

 

17.5

%

 

1.6

%

Other operating expenses, net

 

 

4,492

 

 

21.7

%

 

 

4,515

 

 

22.0

%

 

(0.5

)%

Depreciation and amortization

 

 

818

 

 

4.0

%

 

 

870

 

 

4.2

%

 

 

Impairment and restructuring charges, and acquisition-related costs

 

 

102

 

 

0.5

%

 

 

137

 

 

0.7

%

 

 

Litigation and investigation costs

 

 

35

 

 

0.2

%

 

 

47

 

 

0.2

%

 

 

Net gains on sales, consolidation and deconsolidation of facilities

 

 

(2,916

)

 

(14.1

)%

 

 

(23

)

 

(0.1

)%

 

 

Operating income

 

 

5,956

 

 

28.8

%

 

 

2,510

 

 

12.2

%

 

 

Interest expense

 

 

(826

)

 

 

 

 

(901

)

 

 

 

 

Other non-operating income, net

 

 

126

 

 

 

 

 

19

 

 

 

 

 

Loss from early extinguishment of debt

 

 

(8

)

 

 

 

 

(11

)

 

 

 

 

Income before income taxes

 

 

5,248

 

 

 

 

 

1,617

 

 

 

 

 

Income tax expense

 

 

(1,184

)

 

 

 

 

(306

)

 

 

 

 

Net income

 

 

4,064

 

 

 

 

 

1,311

 

 

 

 

 

Less: Net income available to noncontrolling interests

 

 

864

 

 

 

 

 

700

 

 

 

 

 

Net income available to Tenet Healthcare Corporation common shareholders

 

$

3,200

 

 

 

 

$

611

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share available to Tenet Healthcare Corporation common shareholders:

 

 

 

 

 

 

 

 

 

 

Basic

 

$

33.02

 

 

 

 

$

6.01

 

 

 

 

 

Diluted

 

$

32.70

 

 

 

 

$

5.71

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average shares and dilutive securities outstanding (in thousands):

 

 

 

 

 

 

 

 

 

 

Basic

 

 

96,904

 

 

 

 

 

101,639

 

 

 

 

 

Diluted

 

 

97,881

 

 

 

 

 

104,800

 

 

 

 

 

 

TENET HEALTHCARE CORPORATION

CONSOLIDATED BALANCE SHEETS

(Unaudited)

 

(Dollars in millions)

 

December 31,

 

December 31,

 

2024

 

2023

ASSETS

 

 

 

 

Current assets:

 

 

 

 

Cash and cash equivalents

 

$

3,019

 

 

$

1,228

 

Accounts receivable

 

 

2,536

 

 

 

2,914

 

Inventories of supplies, at cost

 

 

346

 

 

 

411

 

Assets held for sale

 

 

21

 

 

 

775

 

Other current assets

 

 

1,760

 

 

 

1,839

 

Total current assets

 

 

7,682

 

 

 

7,167

 

Investments and other assets

 

 

3,037

 

 

 

3,157

 

Deferred income taxes

 

 

80

 

 

 

77

 

Property and equipment, at cost, less accumulated depreciation and amortization

 

 

6,049

 

 

 

6,236

 

Goodwill

 

 

10,691

 

 

 

10,307

 

Other intangible assets, at cost, less accumulated amortization

 

 

1,397

 

 

 

1,368

 

Total assets

 

$

28,936

 

 

$

28,312

 

 

 

 

 

 

LIABILITIES AND EQUITY

 

 

 

 

Current liabilities:

 

 

 

 

Current portion of long-term debt

 

$

92

 

 

$

120

 

Accounts payable

 

 

1,294

 

 

 

1,408

 

Accrued compensation and benefits

 

 

899

 

 

 

930

 

Professional and general liability reserves

 

 

238

 

 

 

254

 

Accrued interest payable

 

 

149

 

 

 

200

 

Liabilities held for sale

 

 

13

 

 

 

69

 

Income tax payable

 

 

18

 

 

 

23

 

Other current liabilities

 

 

1,607

 

 

 

1,756

 

Total current liabilities

 

 

4,310

 

 

 

4,760

 

Long-term debt, net of current portion

 

 

13,081

 

 

 

14,882

 

Professional and general liability reserves

 

 

900

 

 

 

792

 

Defined benefit plan obligations

 

 

298

 

 

 

335

 

Deferred income taxes

 

 

227

 

 

 

326

 

Other long-term liabilities

 

 

1,573

 

 

 

1,709

 

Total liabilities

 

 

20,389

 

 

 

22,804

 

Commitments and contingencies

 

 

 

 

Redeemable noncontrolling interests in equity of consolidated subsidiaries

 

 

2,727

 

 

 

2,391

 

Equity:

 

 

 

 

Shareholders’ equity:

 

 

 

 

Common stock

 

 

8

 

 

 

8

 

Additional paid-in capital

 

 

4,873

 

 

 

4,834

 

Accumulated other comprehensive loss

 

 

(180

)

 

 

(181

)

Retained earnings (accumulated deficit)

 

 

3,008

 

 

 

(192

)

Common stock in treasury, at cost

 

 

(3,538

)

 

 

(2,861

)

Total shareholders’ equity

 

 

4,171

 

 

 

1,608

 

Noncontrolling interests

 

 

1,649

 

 

 

1,509

 

Total equity

 

 

5,820

 

 

 

3,117

 

Total liabilities and equity

 

$

28,936

 

 

$

28,312

 

 

TENET HEALTHCARE CORPORATION

CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited)

 

(Dollars in millions)

 

Years Ended

 

December 31,

 

2024

 

2023

Net income

 

$

4,064

 

 

$

1,311

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

Depreciation and amortization

 

 

818

 

 

 

870

 

Deferred income tax expense (benefit)

 

 

(103

)

 

 

52

 

Stock-based compensation expense

 

 

67

 

 

 

66

 

Impairment and restructuring charges, and acquisition-related costs

 

 

102

 

 

 

137

 

Litigation and investigation costs

 

 

35

 

 

 

47

 

Net gains on sales, consolidation and deconsolidation of facilities

 

 

(2,916

)

 

 

(23

)

Loss from early extinguishment of debt

 

 

8

 

 

 

11

 

Equity in earnings of unconsolidated affiliates, net of distributions received

 

 

(29

)

 

 

(13

)

Amortization of debt discount and debt issuance costs

 

 

26

 

 

 

32

 

Net gains from the sale of investments and long-lived assets

 

 

(4

)

 

 

(29

)

Other items, net

 

 

(4

)

 

 

(4

)

Changes in cash from operating assets and liabilities:

 

 

 

 

Accounts receivable

 

 

245

 

 

 

(29

)

Inventories and other current assets

 

 

(86

)

 

 

(139

)

Income taxes

 

 

16

 

 

 

10

 

Accounts payable, accrued expenses and other current liabilities

 

 

(30

)

 

 

215

 

Other long-term liabilities

 

 

(9

)

 

 

14

 

Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements

 

 

(153

)

 

 

(154

)

Net cash provided by operating activities

 

 

2,047

 

 

 

2,374

 

Cash flows from investing activities:

 

 

 

 

Purchases of property and equipment

 

 

(931

)

 

 

(751

)

Purchases of businesses or joint venture interests, net of cash acquired

 

 

(571

)

 

 

(224

)

Proceeds from sales of facilities and other assets

 

 

4,981

 

 

 

71

 

Proceeds from sales of marketable securities and long-term investments

 

 

63

 

 

 

50

 

Purchases of marketable securities and long-term investments

 

 

(94

)

 

 

(104

)

Other items, net

 

 

(19

)

 

 

(11

)

Net cash provided by (used in) investing activities

 

 

3,429

 

 

 

(969

)

Cash flows from financing activities:

 

 

 

 

Repayments of borrowings

 

 

(2,243

)

 

 

(1,542

)

Proceeds from borrowings

 

 

23

 

 

 

1,370

 

Repurchases of common stock

 

 

(672

)

 

 

(200

)

Debt issuance costs

 

 

 

 

 

(16

)

Distributions paid to noncontrolling interests

 

 

(681

)

 

 

(594

)

Proceeds from the sale of noncontrolling interests

 

 

23

 

 

 

43

 

Purchases of noncontrolling interests

 

 

(200

)

 

 

(167

)

Advances from managed care payers

 

 

342

 

 

 

 

Repayments of advances from managed care payers

 

 

(310

)

 

 

 

Other items, net

 

 

33

 

 

 

71

 

Net cash used in financing activities

 

 

(3,685

)

 

 

(1,035

)

Net increase in cash and cash equivalents

 

 

1,791

 

 

 

370

 

Cash and cash equivalents at beginning of period

 

 

1,228

 

 

 

858

 

Cash and cash equivalents at end of period

 

$

3,019

 

 

$

1,228

 

Supplemental disclosures:

 

 

 

 

Interest paid, net of capitalized interest

 

$

(851

)

 

$

(882

)

Income tax payments, net

 

$

(1,271

)

 

$

(243

)

 

TENET HEALTHCARE CORPORATION

SEGMENT REPORTING

(Unaudited)

 

 

 

Three Months Ended

 

Years Ended

 

 

December 31,

 

December 31,

(Dollars in millions)

 

2024

 

2023

 

2024

 

2023

Net operating revenues:

 

 

 

 

 

 

 

 

Ambulatory Care

 

$

1,259

 

 

$

1,077

 

 

$

4,534

 

 

$

3,865

 

Hospital Operations and Services

 

 

3,813

 

 

 

4,302

 

 

 

16,131

 

 

 

16,683

 

Total

 

$

5,072

 

 

$

5,379

 

 

$

20,665

 

 

$

20,548

 

 

 

 

 

 

 

 

 

 

Equity in earnings of unconsolidated affiliates:

 

 

 

 

 

 

 

 

Ambulatory Care

 

$

75

 

 

$

69

 

 

$

250

 

 

$

218

 

Hospital Operations and Services

 

 

3

 

 

 

4

 

 

 

10

 

 

 

10

 

Total

 

$

78

 

 

$

73

 

 

$

260

 

 

$

228

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA:

 

 

 

 

 

 

 

 

Ambulatory Care

 

$

530

 

 

$

464

 

 

$

1,810

 

 

$

1,544

 

Hospital Operations and Services

 

 

518

 

 

 

548

 

 

 

2,185

 

 

 

1,997

 

Total

 

$

1,048

 

 

$

1,012

 

 

$

3,995

 

 

$

3,541

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA margins:

 

 

 

 

 

 

 

 

Ambulatory Care

 

 

42.1

%

 

 

43.1

%

 

 

39.9

%

 

 

39.9

%

Hospital Operations and Services

 

 

13.6

%

 

 

12.7

%

 

 

13.5

%

 

 

12.0

%

Total

 

 

20.7

%

 

 

18.8

%

 

 

19.3

%

 

 

17.2

%

 

 

 

 

 

 

 

 

 

Capital expenditures:

 

 

 

 

 

 

 

 

Ambulatory Care

 

$

21

 

 

$

22

 

 

$

86

 

 

$

80

 

Hospital Operations and Services

 

 

309

 

 

 

186

 

 

 

845

 

 

 

671

 

Total

 

$

330

 

 

$

208

 

 

$

931

 

 

$

751

 

 

 

 

 

 

 

 

 

 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP disclosures

Table #1 – Reconciliations of Net Income Available to Tenet Healthcare Corporation Common Shareholders to Adjusted Net Income Available to Common Shareholders

(Unaudited)

 

 

 

Three Months Ended

 

Years Ended

 

 

December 31,

 

December 31,

(Dollars in millions, except per share amounts)

 

2024

 

2023

 

2024

 

2023

Net income available to Tenet Healthcare Corporation common shareholders

 

$

318

 

 

$

244

 

 

$

3,200

 

 

$

611

 

Less:

 

 

 

 

 

 

 

 

Impairment and restructuring charges, and acquisition-related costs

 

 

(27

)

 

 

(53

)

 

 

(102

)

 

 

(137

)

Litigation and investigation costs

 

 

(17

)

 

 

(19

)

 

 

(35

)

 

 

(47

)

Net gains on sales, consolidation and deconsolidation of facilities

 

 

10

 

 

 

11

 

 

 

2,916

 

 

 

23

 

Loss from early extinguishment of debt

 

 

 

 

 

 

 

 

(8

)

 

 

(11

)

Tax and noncontrolling interests impact of above items

 

 

22

 

 

 

22

 

 

 

(733

)

 

 

39

 

Adjusted net income available to common shareholders

 

$

330

 

 

$

283

 

 

$

1,162

 

 

$

744

 

 

 

 

 

 

 

 

 

 

Diluted earnings per share

 

$

3.32

 

 

$

2.30

 

 

$

32.70

 

 

$

5.71

 

Less:

 

 

 

 

 

 

 

 

Impairment and restructuring charges, and acquisition-related costs

 

 

(0.28

)

 

 

(0.51

)

 

 

(1.04

)

 

 

(1.31

)

Litigation and investigation costs

 

 

(0.18

)

 

 

(0.18

)

 

 

(0.36

)

 

 

(0.45

)

Net gains on sales, consolidation and deconsolidation of facilities

 

 

0.11

 

 

 

0.10

 

 

 

29.79

 

 

 

0.22

 

Loss from early extinguishment of debt

 

 

 

 

 

 

 

 

(0.08

)

 

 

(0.10

)

Tax and noncontrolling interests impact of above items

 

 

0.23

 

 

 

0.21

 

 

 

(7.49

)

 

 

0.37

 

Adjusted diluted earnings per share

 

$

3.44

 

 

$

2.68

 

 

$

11.88

 

 

$

6.98

 

 

 

 

 

 

 

 

 

 

Weighted average basic shares outstanding (in thousands)

 

 

95,102

 

 

 

100,956

 

 

 

96,904

 

 

 

101,639

 

Weighted average dilutive shares outstanding (in thousands)

 

 

95,882

 

 

 

104,167

 

 

 

97,881

 

 

 

104,800

 

 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP disclosures

Table #2 – Reconciliations of Net Income Available to Tenet Healthcare Corporation Common Shareholders to Adjusted EBITDA

(Unaudited)

 

 

 

Three Months Ended

 

Years Ended

 

 

December 31,

 

December 31,

(Dollars in millions)

 

2024

 

2023

 

2024

 

2023

Net income available to Tenet Healthcare Corporation common shareholders

 

$

318

 

 

$

244

 

 

$

3,200

 

 

$

611

 

Less:

 

 

 

 

 

 

 

 

Net income available to noncontrolling interests

 

 

(254

)

 

 

(212

)

 

 

(864

)

 

 

(700

)

Net income

 

 

572

 

 

 

456

 

 

 

4,064

 

 

 

1,311

 

Income tax expense

 

 

(83

)

 

 

(63

)

 

 

(1,184

)

 

 

(306

)

Loss from early extinguishment of debt

 

 

 

 

 

 

 

 

(8

)

 

 

(11

)

Other non-operating income, net

 

 

37

 

 

 

11

 

 

 

126

 

 

 

19

 

Interest expense

 

 

(203

)

 

 

(227

)

 

 

(826

)

 

 

(901

)

Operating income

 

 

821

 

 

 

735

 

 

 

5,956

 

 

 

2,510

 

Litigation and investigation costs

 

 

(17

)

 

 

(19

)

 

 

(35

)

 

 

(47

)

Net gains on sales, consolidation and deconsolidation of facilities

 

 

10

 

 

 

11

 

 

 

2,916

 

 

 

23

 

Impairment and restructuring charges, and acquisition-related costs

 

 

(27

)

 

 

(53

)

 

 

(102

)

 

 

(137

)

Depreciation and amortization

 

 

(193

)

 

 

(216

)

 

 

(818

)

 

 

(870

)

Adjusted EBITDA

 

$

1,048

 

 

$

1,012

 

 

$

3,995

 

 

$

3,541

 

 

 

 

 

 

 

 

 

 

Net operating revenues

 

$

5,072

 

 

$

5,379

 

 

$

20,665

 

 

$

20,548

 

 

 

 

 

 

 

 

 

 

Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues

 

 

6.3

%

 

 

4.5

%

 

 

15.5

%

 

 

3.0

%

 

 

 

 

 

 

 

 

 

Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin)

 

 

20.7

%

 

 

18.8

%

 

 

19.3

%

 

 

17.2

%

 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP disclosures

Table #3 – Reconciliations of Net Cash Provided by (Used in) Operating Activities to

Free Cash Flow and Adjusted Free Cash Flow

(Unaudited)

 

 

 

2024

(Dollars in millions)

 

Q4

 

YTD

Net cash provided by (used in) operating activities

 

$

(331

)

 

$

2,047

 

Purchases of property and equipment

 

 

(330

)

 

 

(931

)

Free cash flow

 

$

(661

)

 

$

1,116

 

 

 

 

 

 

Net cash provided by (used in) investing activities

 

$

(372

)

 

$

3,429

 

Net cash used in financing activities

 

$

(372

)

 

$

(3,685

)

 

 

 

 

 

Net cash provided by (used in) operating activities

 

$

(331

)

 

$

2,047

 

Less:

 

 

 

 

Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements

 

 

(34

)

 

 

(153

)

Adjusted net cash provided by (used in) operating activities

 

 

(297

)

 

 

2,200

 

Purchases of property and equipment

 

 

(330

)

 

 

(931

)

Adjusted free cash flow

 

$

(627

)

 

$

1,269

 

 

 

 

2023

(Dollars in millions)

 

Q4

 

YTD

Net cash provided by operating activities

 

$

824

 

 

$

2,374

 

Purchases of property and equipment

 

 

(208

)

 

 

(751

)

Free cash flow

 

$

616

 

 

$

1,623

 

 

 

 

 

 

Net cash used in investing activities

 

$

(333

)

 

$

(969

)

Net cash used in financing activities

 

$

(317

)

 

$

(1,035

)

 

 

 

 

 

Net cash provided by operating activities

 

$

824

 

 

$

2,374

 

Less:

 

 

 

 

Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements

 

 

(49

)

 

 

(154

)

Adjusted net cash provided by operating activities

 

 

873

 

 

 

2,528

 

Purchases of property and equipment

 

 

(208

)

 

 

(751

)

Adjusted free cash flow

 

$

665

 

 

$

1,777

 

 

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP disclosures

Table #4 – Reconciliations of Outlook Net Income Available to Tenet Healthcare Corporation Common Shareholders to Outlook Adjusted Net Income Available to Common Shareholders

(Unaudited)

 

 

 

 

FY 2025

(Dollars in millions, except per share amounts)

 

 

Low

 

High

Net income available to Tenet Healthcare Corporation common shareholders

 

 

$

1,040

 

 

$

1,185

 

Less:

 

 

 

 

 

Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1)

 

 

 

(100

)

 

 

(50

)

Tax and noncontrolling interests impact of above items

 

 

 

25

 

 

 

15

 

Adjusted net income available to common shareholders

 

 

$

1,115

 

 

$

1,220

 

 

 

 

 

 

 

Diluted earnings per share

 

 

$

10.95

 

 

$

12.47

 

Less:

 

 

 

 

 

Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements

 

 

 

(1.05

)

 

 

(0.53

)

Tax and noncontrolling interests impact of above items

 

 

 

0.26

 

 

 

0.16

 

Adjusted diluted earnings per share

 

 

$

11.74

 

 

$

12.84

 

 

 

 

 

 

 

Weighted average basic shares outstanding (in thousands)

 

 

 

94,000

 

 

 

94,000

 

Weighted average dilutive shares outstanding (in thousands)

 

 

 

95,000

 

 

 

95,000

 

(1)

The figures shown represent the Company’s estimate for restructuring charges. The Company does not generally forecast impairment charges, acquisition-related costs, and litigation costs and settlements because it does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook.

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP disclosures

Table #5 – Reconciliations of Outlook Net Income Available to Tenet Healthcare Corporation Common Shareholders to Outlook Adjusted EBITDA

(Unaudited)

 

 

 

 

FY 2025

(Dollars in millions)

 

 

Low

 

High

Net income available to Tenet Healthcare Corporation common shareholders

 

 

$

1,040

 

 

$

1,185

 

Less:

 

 

 

 

 

Net income available to noncontrolling interests

 

 

 

(910

)

 

 

(960

)

Income tax expense

 

 

 

(420

)

 

 

(465

)

Interest expense

 

 

 

(805

)

 

 

(795

)

Other non-operating income, net

 

 

 

105

 

 

 

115

 

Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1)

 

 

 

(100

)

 

 

(50

)

Depreciation and amortization

 

 

 

(805

)

 

 

(835

)

Adjusted EBITDA

 

 

$

3,975

 

 

$

4,175

 

 

 

 

 

 

 

Net income available to Tenet Healthcare Corporation common shareholders

 

 

$

1,040

 

 

$

1,185

 

Net operating revenues

 

 

$

20,600

 

 

$

21,000

 

Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues

 

 

 

5.0

%

 

 

5.6

%

Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin)

 

 

 

19.3

%

 

 

19.9

%

(1)

The figures shown represent the Company’s estimate for restructuring charges. The Company does not generally forecast impairment charges, acquisition-related costs, and litigation costs and settlements because it does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook.

TENET HEALTHCARE CORPORATION

Additional Supplemental Non-GAAP disclosures

Table #6 – Reconciliations of Outlook Net Cash Provided by Operating Activities

to Outlook Free Cash Flow and Outlook Adjusted Free Cash Flow

(Unaudited)

 

 

 

FY 2025

(Dollars in millions)

 

Low

 

High

Net cash provided by operating activities

 

$

2,500

 

 

$

2,850

 

Purchases of property and equipment

 

 

(700

)

 

 

(800

)

Free cash flow

 

$

1,800

 

 

$

2,050

 

 

 

 

 

 

Net cash provided by operating activities

 

$

2,500

 

 

$

2,850

 

Less:

 

 

 

 

Payments for restructuring charges, acquisition-related costs and litigation costs and settlements(1)

 

 

(100

)

 

 

(50

)

Adjusted net cash provided by operating activities

 

 

2,600

 

 

 

2,900

 

Purchases of property and equipment

 

 

(700

)

 

 

(800

)

Adjusted free cash flow(2)

 

$

1,900

 

 

$

2,100

 

(1)

The figures shown represent the Company’s estimate for restructuring payments. The Company does not generally forecast payments for acquisition-related costs, and litigation costs and settlements because it does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook.

(2)

The Company’s definition of Adjusted Free Cash Flow does not include other important uses of cash including (1) cash used to purchase businesses or joint venture interests, or (2) any items that are classified as Cash Flows From Financing Activities on the Company’s Consolidated Statement of Cash Flows, including items such as (i) cash used to repay borrowings, and (ii) distributions paid to noncontrolling interests.

 

Investor Contact

Will McDowell

469-893-2387

[email protected]

Media Contact

Robert Dyer

469-893-2640

[email protected]

KEYWORDS: Texas United States North America

INDUSTRY KEYWORDS: Hospitals Health Practice Management

MEDIA:

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