HCA Reports Fourth Quarter 2012 Results
Provides 2013 Guidance
Key fourth quarter metrics (all percentage changes compare 4Q 2012 to 4Q 2011 unless noted):
- Revenues increased 8.5 percent to $8.434 billion
- Net income attributable to HCA Holdings, Inc. totaled $314 million, or $0.68 per diluted share (includes pretax legal claim costs of $175 million, or $0.24 per diluted share)
- Adjusted EBITDA declined 2.0 percent to $1.606 billion
- Cash flow from operations totaled $1.263 billion
- Same facility equivalent admissions increased 5.0 percent while same facility admissions increased 4.3 percent
- Same facility emergency room visits increased 12.7 percent
- Same facility revenue per equivalent admission increased 0.5 percent
"We are pleased with our operating performance in the fourth quarter. Many of our key operating metrics met our expectations reflecting the strength of our delivery networks," stated Richard M. Bracken, Chairman and CEO.
Fourth quarter 2012 revenues increased to $8.434 billion compared to $7.769 billion in the prior year's fourth quarter. Revenue growth was primarily driven by increased patient utilization at the Company's facilities and the financial consolidation (effective November 1, 2011) of our HealthONE joint venture. On a consolidated basis, equivalent admissions increased 7.1 percent, while admissions increased 6.0 percent compared to the prior year period.
Patient volume trends in the fourth quarter were strong, and same facility equivalent admissions increased 5.0 percent. Same facility admissions increased 4.3 percent and same facility emergency room visits increased 12.7 percent in the fourth quarter compared to the prior year period.
On January 24, 2013, a Missouri judge ruled in favor of a nonprofit health foundation in a lawsuit against HCA. In the case, the plaintiff alleged that HCA did not make the full level of capital expenditures and uncompensated care agreed to in connection with its purchase of hospitals from Health Midwest in 2003. HCA recorded $175 million of legal claim costs in the fourth quarter of 2012 related to this ruling; however, the Company plans to appeal the ruling.
Net income attributable to HCA Holdings, Inc. totaled $314 million, or $0.68 per diluted share, compared to $1.935 billion, or $4.25 per diluted share, in the fourth quarter of 2011. Results for the fourth quarter of 2012 include pretax legal claim costs of $175 million, or $0.24 per diluted share, and pretax gains on sales of facilities of $11 million, or $0.01 per diluted share. Results for the fourth quarter of 2011 include a pretax gain on the acquisition of a controlling interest in an equity investment of $1.522 billion, or $3.13 per diluted share, and pretax gains on sales of facilities of $145 million, or $0.18 per diluted share. The Company's effective tax rate in the fourth quarter of 2011 was favorably impacted by the majority of the gain associated with the acquisition of the controlling interest in the equity investment being nontaxable.
For the fourth quarter of 2012, Adjusted EBITDA totaled $1.606 billion, compared to $1.639 billion in the previous year. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Holdings, Inc. to Adjusted EBITDA is included in this release.
Year Ended December 31, 2012
Revenues for the year ended December 31, 2012 totaled $33.013 billion compared to $29.682 billion in 2011. Net income attributable to HCA Holdings, Inc. in 2012 was $1.605 billion, or $3.49 per diluted share, compared to $2.465 billion, or $4.97 per diluted share, in 2011. Results for the year ended December 31, 2012 include a net favorable Medicare settlement of $188 million to revenues, $170 million to Adjusted EBITDA and $0.22 per diluted share and pretax legal claim costs of $175 million, or $0.24 per diluted share. Results also include pretax gains on sales of facilities of $15 million, or $0.02 per diluted share. Results for the year ended December 31, 2011 include a pretax gain on the acquisition of a controlling interest in an equity investment of $1.522 billion, or $2.87 per diluted share, pretax gains on sales of facilities of $142 million, or $0.16 per diluted share, pretax losses on the retirement of debt of $481 million, or $0.61 per diluted share, and a pretax charge for termination of management agreement of $181 million, or $0.30 per diluted share. Adjusted EBITDA for 2012 totaled $6.531 billion compared to $6.061 billion in 2011.
Balance Sheet and Cash Flow
As of December 31, 2012, HCA Holdings, Inc.'s balance sheet reflected cash and cash equivalents of $705 million, total debt of $28.930 billion, and total assets of $28.075 billion. During the fourth quarter, capital expenditures totaled $594 million, excluding acquisitions, compared to $509 million in the previous year's fourth quarter. HCA's debt-to-Adjusted EBITDA ratio at December 31, 2012 was 4.4x compared to 4.5x at December 31, 2011. Net cash provided by operating activities totaled $1.263 billion compared to $1.387 billion in the fourth quarter of 2011.
Today, HCA issued the following estimated guidance for 2013:
|Revenues||$33.50 to $34.50 billion|
|Adjusted EBITDA||$6.25 to $6.50 billion|
|Adjusted EPS (diluted)||$3.00 to $3.30|
|Capital Expenditures||Approximately $2 billion|
This guidance range excludes the impact of items, if applicable, that are non-operational in nature including items such as, but not limited to, gains or losses on sales of facilities and businesses, gains or losses on early debt retirement and impairments of long-lived assets. The guidance includes estimated EHR incentive income assumptions in a range of $200-$225 million and EHR expenses in a range of $110-$130 million. This guidance is also subject to certain conditions including those as set forth below in the Company's "Cautionary Statement about Preliminary Results and Other Forward-Looking Information".
The Company's annual shareholders' meeting will be held in Nashville, Tennessee on April 24, 2013 at 2:00 p.m. local time for shareholders of record as of March 1, 2013.
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=1012822 or through the Company's Investor Relations web page at www.hcahealthcare.com.
Cautionary Statement about Preliminary Results and Other Forward-Looking Information
This press release contains forward-looking statements based on current management expectations. Those forward-looking statements include all statements other than those made solely with respect to historical fact and are subject to finalization of the Company's fourth quarter and year-end financial and accounting procedures. Numerous risks, uncertainties and other factors may cause actual results to differ materially from those expressed in any forward-looking statements. These factors include, but are not limited to, (1) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, (2) the effects related to the enactment and implementation of the Budget Control Act of 2011 and the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act (collectively, the "Health Reform Law"), the possible enactment of additional federal or state health care reforms and possible changes to the Health Reform Law and other federal, state or local laws or regulations affecting the health care industry, (3) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (4) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (5) possible changes in the 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, (6) the highly competitive nature of the health care business, (7) 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, (8) the efforts of insurers, health care providers and others to contain health care costs, (9) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (10) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (11) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (12) changes in accounting practices, (13) changes in general economic conditions nationally and regionally in our markets, (14) future divestitures which may result in charges and possible impairments of long-lived assets, (15) changes in business strategy or development plans, (16) delays in receiving payments for services provided, (17) the outcome of pending and any future tax audits, appeals and litigation associated with our tax positions, (18) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (19) our ongoing ability to demonstrate meaningful use of certified electronic health record technology and recognize income for the related Medicare or Medicaid incentive payments, and (20) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2011 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management's views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.
All references to "Company" and "HCA" as used throughout this release refer to HCA Holdings, Inc. and its affiliates.
|HCA Holdings, Inc.|
|Condensed Consolidated Comprehensive Income Statements|
|(Dollars in millions, except per share amounts)|
|Revenues before provision for doubtful accounts||$||9,538||$||8,429|
|Provision for doubtful accounts||1,104||660|
|Salaries and benefits||3,865||45.8||3,492||44.9|
|Other operating expenses||1,552||18.4||1,453||18.7|
|Electronic health record incentive income||(80||)||(0.9||)||(120||)||(1.5||)|
|Equity in earnings of affiliates||(10||)||(0.1||)||(41||)||(0.5||)|
|Depreciation and amortization||425||4.9||387||5.0|
|Gains on sales of facilities||(11||)||(0.1||)||(145||)||(1.9||)|
|Legal claim costs||175||2.1||-||-|
|Gain on acquisition of controlling interest in equity investment||-||-||(1,522||)||(19.6||)|
|Income before income taxes||555||6.6||2,454||31.6|
|Provision for income taxes||128||1.5||412||5.3|
|Net income attributable to noncontrolling interests||113||1.4||107||1.4|
|Net income attributable to HCA Holdings, Inc.||$||314||3.7||$||1,935||24.9|
|Diluted earnings per share||$||0.68||$||4.25|
|Shares used in computing diluted earnings per share (000)||461,131||455,460|
|Comprehensive income attributable to HCA Holdings, Inc.||$||297||$||1,919|