Community Health Systems, Inc. Announces First Quarter 2021 Results

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Community Health Systems, Inc. (CYH) reported Q1 2021 net operating revenues of $3.013 billion, a 0.4% decrease from Q1 2020. The company faced a net loss of $(64) million or $(0.51) per diluted share, contrasting with a net income of $18 million or $0.15 per share in the previous year. Adjusted EBITDA was $495 million, boosted by $82 million from pandemic relief funds. Admissions declined 14.0% year-over-year, while same-store revenues rose 9.8%. The company also experienced a $71 million pre-tax loss from debt extinguishment. A conference call is scheduled for April 29, 2021.

Positive

Adjusted EBITDA increased to $495 million, up from $309 million in Q1 2020.
The company received approximately $82 million in pandemic relief funds, positively impacting adjusted EBITDA.
Same-store net operating revenues increased by 9.8%, indicating effective management amidst challenges.

Negative

Net loss attributable to common stockholders was $(64) million, compared to net income of $18 million in Q1 2020.
Admissions decreased by 14.0% year-over-year, indicating potential operational challenges.
The company recognized a $71 million pre-tax loss from early extinguishment of debt.

04/28/2021 - 04:15 PM

Community Health Systems, Inc. (NYSE: CYH) (the “Company”) today announced financial and operating results for the three months ended March 31, 2021.

The following highlights the financial and operating results for the three months ended March 31, 2021.

Net operating revenues totaled $3.013 billion.
Net loss attributable to Community Health Systems, Inc. common stockholders was $(64) million, or $(0.51) per share (diluted), compared with net income of $18 million, or $0.15 per share (diluted), for the same period in 2020. Excluding the adjusting items as presented in the table in footnote (e) on page 14, net income attributable to Community Health Systems, Inc. common stockholders was $0.36 per share (diluted), compared to net loss of $(1.59) per share (diluted) for the same period in 2020.
Adjusted EBITDA was $495 million, including $82 million of pandemic relief funds, compared with $309 million for the same period in 2020.
Net cash provided by operating activities was $101 million, which included repayments of Medicare accelerated payments in the amount of approximately $18 million. Net cash provided by operating activities was $57 million for the same period in 2020.
On a same-store basis, admissions decreased 4.9 percent and adjusted admissions decreased 7.2 percent, compared with the same period in 2020.

Net operating revenues for the three months ended March 31, 2021, totaled $3.013 billion, a 0.4 percent decrease compared with $3.025 billion for the same period in 2020.

Net loss attributable to Community Health Systems, Inc. common stockholders was $(64) million, or $(0.51) per share (diluted), for the three months ended March 31, 2021, compared with net income of $18 million, or $0.15 per share (diluted), for the same period in 2020. Excluding the adjusting items as presented in the table in footnote (e) on page 14, net income attributable to Community Health Systems, Inc. common stockholders was $0.36 per share (diluted) for the three months ended March 31, 2021, compared to net loss of $(1.59) per share (diluted) for the same period in 2020. Payments received by the Company through the Public Health and Social Services Emergency Fund (the “PHSSEF”) and state and local pandemic relief programs, as more specifically described below, had a positive impact on net income attributable to Community Health Systems, Inc. common stockholders (both on a consolidated and adjusted basis) of approximately $62 million, or $0.54 on a per share (diluted) basis, for the three months ended March 31, 2021. Weighted-average shares outstanding (diluted) were 126 million and 114 million for the three months ended March 31, 2021 and 2020, respectively.

Adjusted EBITDA for the three months ended March 31, 2021, was $495 million compared with $309 million for the same period in 2020. Payments received by the Company through the PHSSEF and state and local pandemic relief programs had a positive impact on Adjusted EBITDA of approximately $82 million for the three months ended March 31, 2021.

The consolidated operating results for the three months ended March 31, 2021, reflect a 14.0 percent decrease in admissions and a 15.8 percent decrease in adjusted admissions, compared with the same period in 2020. On a same-store basis, admissions decreased 4.9 percent and adjusted admissions decreased 7.2 percent for the three months ended March 31, 2021, compared with the same period in 2020. On a same-store basis, net operating revenues increased 9.8 percent for the three months ended March 31, 2021, compared with the same period in 2020, primarily reflecting COVID-19 pandemic-induced changes in the mix of services provided and payor mix compared to the prior period.

Commenting on the results, Tim L. Hingtgen, chief executive officer of Community Health Systems, Inc., said, “Our strong operational and financial performance in the first quarter of 2021 reflects our ability to manage through the challenges of the COVID pandemic while also advancing strategic initiatives that strengthen our organization and produce real-time, positive results. Our market leadership teams continue to adjust their operating models as COVID cases fluctuate, by managing shifts in volumes, revenue, and expenses to achieve the best possible results. At the same time, we are making targeted capital investments and leveraging enterprise-wide programs to ensure our services are both accessible to consumers and facilitate growth over time. As always, we are grateful for our front-line clinicians and other caregivers who continue to provide safe, quality, compassionate care in the most extraordinary of circumstances.”

Financing Transactions:

The Company recognized a net, pre-tax loss from early extinguishment of debt of approximately $71 million for the three months ended March 31, 2021, as a result of the following financing transactions:

Redemption of the remaining principal amount of the 6¼% Senior Secured Notes due 2023 of approximately $95 million using cash on hand.
Completion of a private offering of $1.775 billion aggregate principal amount of 6⅞% Junior-Priority Secured Notes due 2029 on February 2, 2021. The proceeds of this offering, together with cash on hand, were used to redeem the remaining principal amount of the 9⅞% Junior-Priority Secured Notes due 2023 of approximately $1.769 billion and to pay related fees and expenses.
Completion of a private offering of $1.095 billion aggregate principal amount of 4¾% Senior Secured Notes due 2031 on February 9, 2021. The proceeds of the offering, together with cash on hand, were used to redeem the remaining principal amount of the 8⅝% Senior Secured Notes due 2024 of approximately $1.033 billion and to pay related fees and expenses.
Redemption of the remaining principal amount of the 6⅞% Senior Notes due 2022 of approximately $126 million using cash on hand.

COVID – 19 Pandemic:

COVID-19, a disease caused by a novel strain of coronavirus, materially affected the Company’s results of operations during 2020, and continued to affect the Company’s results of operations during the three months ended March 31, 2021. Federal and state governments have passed legislation, promulgated regulations and taken other administrative actions intended to assist healthcare providers in providing care to COVID-19 and other patients during the public health emergency. Sources of relief include the CARES Act, which was enacted on March 27, 2020, the Paycheck Protection Program and Health Care Enhancement Act (the “PPPHCE Act”), which was enacted on April 24, 2020, the Consolidated Appropriations Act, 2021 (the “CAA”), which was enacted on December 27, 2020, and the American Rescue Plan Act of 2021 (the “ARPA”), which was enacted on March 11, 2021. Together, these stimulus laws authorize over $178 billion in funding to be distributed to hospitals and other healthcare providers through the PHSSEF. In addition to the relief funding, the CARES Act provided for an expansion of the Medicare Accelerated and Advance Payment Program. Various state and local programs also exist to provide relief, either independently or through distribution of monies received via the CARES Act and other enacted federal legislation. The Company has been a beneficiary of these stimulus monies.

Through March 31, 2021, the Company received approximately $708 million in payments through the PHSSEF and various state and local programs on a cumulative basis since their enactment of which approximately $705 million was received during the year ended December 31, 2020, and the balance of which was received during the three months ended March 31, 2021. PHSSEF payments are intended to compensate healthcare providers for lost revenues and incremental expenses, as defined by the U.S. Department of Health and Human Services (“HHS”), incurred in response to the COVID-19 pandemic and are not required to be repaid provided that recipients attest to and comply with certain terms and conditions, including limitations on balance billing and not using funds received from the PHSSEF to reimburse eligible expenses or lost revenues, as defined by HHS, that other sources have or may be obligated to reimburse.

The Company recognized approximately $82 million of the PHSSEF and various state and local program payments eligible to be claimed as a reduction in operating costs and expenses during the three months ended March 31, 2021. During the three months ended March 31, 2021, the Company’s estimate of the amount of payments received through the PHSSEF or state and local programs for which the Company is reasonably assured of meeting the underlying terms and conditions was updated based on, among other things, expenses incurred in the period that are attributable to the coronavirus, the Company’s results of operations during such period as compared to the Company’s 2020 budget for the same period in the prior year and the allocation of targeted distribution payments to various subsidiaries. Amounts received through the PHSSEF or state and local programs that have not been recognized as a reduction to operating costs and expenses and otherwise have not been refunded to HHS or state and local agencies as of March 31, 2021, are reflected within accrued liabilities-other in the condensed consolidated balance sheet. Such unrecognized amounts may either be returned to HHS in one or more future periods when a procedure for doing so is established by HHS or may be recognized as a reduction in operating costs and expenses in future periods if the underlying conditions for recognition are reasonably assured of having been met.

HHS’ interpretation of the underlying terms and conditions of such PHSSEF payments, including auditing and reporting requirements, continues to evolve. Additional guidance or new and amended interpretations of existing guidance on the terms and conditions of such PHSSEF payments may result in the Company’s inability to recognize certain PHSSEF payments, changes in the estimate of amounts recognized, or the derecognition of amounts previously recognized, which (in any such case) may be material.

Medicare accelerated payments of approximately $1.2 billion were received during April 2020. No additional Medicare accelerated payments have been received by the Company since such time, including during the three months ended March 31, 2021, and approximately $18 million and $77 million of amounts previously received were repaid to the Centers for Medicare & Medicaid Services (“CMS”) or assumed by buyers related to hospitals the Company divested during the three months ended March 31, 2021, and year ended December 31, 2020, respectively. The Company does not expect to receive additional Medicare accelerated payments. Payments under the Medicare Accelerated and Advance Payment Program are advances that must be repaid. Providers are required to repay accelerated payments beginning one year after the payment was issued. After such one-year period, Medicare payments owed to providers will be recouped according to the repayment terms. The repayment terms specify that for the first 11 months after repayment begins, repayment will occur through an automatic recoupment of 25% of Medicare payments otherwise owed to the provider during such time. At the end of the eleven-month period, recoupment will increase to 50% for six months. At the end of the six months (or 29 months from the receipt of the initial accelerated payment), Medicare will issue a letter for full repayment of any remaining balance, as applicable. In such event, if payment is not received within 30 days, interest will accrue at the rate of 4% per annum from the date the letter was issued and will be assessed for each full 30-day period that the balance remains unpaid. Recoupments by CMS of Medicare accelerated payments previously received by the Company began in April 2021, pursuant to the aforementioned payment terms. As of March 31, 2021, approximately $546 million of Medicare accelerated payments are reflected within accrued liabilities-other in the condensed consolidated balance sheet while the remaining approximately $517 million are included within other long-term liabilities. In April 2021, CMS began recouping Medicare accelerated payments previously received by the Company.

The PHSSEF payments received to date as noted above and payments which the Company may receive in the future under the CARES Act and other stimulus legislation have been and may continue to be beneficial in partially mitigating the impact of the COVID-19 pandemic on the Company’s results of operations and financial position. Additionally, the federal government may consider additional stimulus and relief efforts, but the Company is unable to predict whether additional stimulus measures will be enacted or their impact, if any. The Company is unable to assess the extent to which anticipated ongoing negative impacts on the Company arising from the COVID-19 pandemic will be offset by benefits which the Company may recognize or receive in the future under the CARES Act and other enacted stimulus legislation or any future stimulus measures.

Divestitures and hospital closures:

The Company completed the divestiture of three hospitals on January 1, 2021, (in respect of which the Company received proceeds at a preliminary closing on December 31, 2020), one hospital on February 1, 2021, and one hospital on April 1, 2021. While the Company’s formal portfolio rationalization program concluded as of December 31, 2020 (inclusive of definitive agreements entered into in 2020 for the sales of hospitals which have been completed in 2021), the Company continues to receive interest from potential acquirers for certain of its hospitals, and may, from time to time, consider selling additional hospitals if the Company considers any such dispositions to be in its best interests.

Financial and statistical data for 2020 and 2021 presented in this press release includes the operating results of divested or closed hospitals for the periods prior to the consummation of the respective divestiture or hospital closing. Same-store operating results exclude the results of a hospital opened in 2020 and the hospitals divested or closed in 2020 and 2021.

Information About Non-GAAP Financial Measures

This press release presents Adjusted EBITDA, a non-GAAP financial measure, which is EBITDA adjusted to add back net income attributable to noncontrolling interests and to exclude loss (gain) from early extinguishment of debt, impairment and (gain) loss on sale of businesses, (income) expense related to government and other legal settlements and related costs, expense incurred in the fourth quarter of 2020 related to the settlement of certain professional liability claims for which the third-party insurers’ obligation to insure the Company against the underlying loss is being litigated, expense related to employee termination benefits and other restructuring charges, expense from settlement and fair value adjustments on the CVR agreement liability related to the Health Management Associates, Inc. (“HMA”) legal proceedings and related legal expenses, the impact of changes in estimate to increase the professional liability claims accrual recorded during the second quarter of 2019 (which estimate was further revised in the third quarter of 2019 based on updated actuarial analysis) with respect to claims incurred in 2016 and prior years and expense related to the valuation allowance recorded in the second quarter of 2019 to reserve the outstanding balance of a promissory note received from the buyer in connection with the sale of two of the Company’s hospitals in 2017, as well as income from a reduction of the valuation allowance on the outstanding balance of a promissory note from the buyer of another hospital. For information regarding why the Company believes Adjusted EBITDA provides useful information to investors, and for a reconciliation of Adjusted EBITDA to net (loss) income attributable to Community Health Systems, Inc. stockholders, see footnote (c) to the Financial Highlights, Financial Statements and Selected Operating Data below.

Additionally, this press release presents adjusted net income (loss) attributable to Community Health Systems, Inc. common stockholders per share (diluted), a non-GAAP financial measure, to reflect the impact on net (loss) income attributable to Community Health Systems, Inc. common stockholders per share (diluted) from the selected items used in the calculation of Adjusted EBITDA. For information regarding why the Company believes this non-GAAP financial measure provides useful information to investors, and for a reconciliation of this non-GAAP financial measure to net income (loss) attributable to Community Health Systems, Inc. common stockholders per share (diluted), see footnote (e) to the Financial Highlights, Financial Statements and Selected Operating Data below.

The non-GAAP financial measures set forth above are not measurements of financial performance under U.S. GAAP, and should not be considered in isolation or as a substitute for any financial measure calculated in accordance with U.S. GAAP. Additionally, the calculation of these non-GAAP financial measures may not be comparable to similarly titled measures presented by other companies.

Included on pages 15, 16, 17 and 18 of this press release are tables setting forth the Company’s 2021 annual earnings guidance. The 2021 guidance is based on the Company’s historical operating performance, current trends and other assumptions that the Company believes are reasonable at this time as more specifically discussed below.

Community Health Systems, Inc. is one of the largest publicly traded hospital companies in the United States and a leading operator of general acute care hospitals in communities across the country. The Company, through its subsidiaries, owns, leases or operates 84 affiliated hospitals in 16 states with an aggregate of approximately 13,000 licensed beds.

The Company’s headquarters are located in Franklin, Tennessee, a suburb south of Nashville. Shares in Community Health Systems, Inc. are traded on the New York Stock Exchange under the symbol “CYH.” More information about the Company can be found on its website at www.chs.net.

Community Health Systems, Inc. will hold a conference call on Thursday, April 29, 2021, at 10:00 a.m. Central, 11:00 a.m. Eastern, to review financial and operating results for the first quarter ended March 31, 2021. Investors will have the opportunity to listen to a live internet broadcast of the conference call by clicking on the Investor Relations link of the Company’s website at www.chs.net. To listen to the live call, please go to the website at least fifteen minutes early to register, download and install any necessary audio software. For those who cannot listen to the live broadcast, a replay will be available shortly after the call and will continue to be available for approximately 30 days. Copies of this press release and conference call slide show, as well as the Company’s Current Report on Form 8-K (including this press release), will be available on the Company’s website at www.chs.net.


COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
Financial Highlights (a)(b)
(In millions, except per share amounts)
(Unaudited)


	Three Months Ended
	March 31,
	2021			2020

Net operating revenues	$	3,013		$	3,025
Net (loss) income (f), (g)		(35	)		34
Net (loss) income attributable to Community Health
Systems, Inc. stockholders		(64	)		18
Adjusted EBITDA (c)		495			309
Net cash provided by operating activities		101			57

(Loss) earnings per share attributable to Community
Health Systems, Inc. common stockholders:
Basic (f), (g)	$	(0.51	)	$	0.15
Diluted (e), (f), (g)		(0.51	)		0.15

Weighted-average number of shares outstanding (d):
Basic		126			114
Diluted		126			114
____ For footnotes, see pages 12, 13 and 14.

COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES

Condensed Consolidated Statements of (Loss) Income (a)(b)

(In millions, except per share amounts)

(Unaudited)

Three Months Ended March 31,

2021

2020

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