Community Health Systems, Inc. Announces Fourth Quarter and Year Ended December 31, 2022 Results and 2023 Guidance
Community Health Systems (NYSE: CYH) reported its Q4 and full-year results for 2022, highlighting net revenues of $3.142 billion, down 2.8% YoY, and a net income of $414 million, or $3.18 per diluted share, compared to $178 million, or $1.34 per share in Q4 2021. Excluding adjustments, net income was $1.50 per share, up from $1.15. Adjusted EBITDA for Q4 was $404 million, marking a 25.2% decline YoY. For the full year, total revenues reached $12.211 billion, a decrease of 1.3%, with a net income of $46 million or $0.35 per diluted share, significantly down from $230 million or $1.76 in 2021. The company is optimistic for 2023, expecting improved operational performance.
- Net income for Q4 2022 was $414 million, a significant increase from $178 million in Q4 2021.
- Earnings per share (diluted) for Q4 increased to $3.18 from $1.34 YoY.
- Same-store admissions increased by 4.4% in Q4 compared to the same period in 2021.
- The company extinguished approximately $378 million in notes during Q4 2022, resulting in a pre-tax gain of $180 million.
- Net operating revenues for Q4 2022 decreased by 2.8% YoY, indicating declining performance.
- Adjusted EBITDA dropped by 25.2% compared to Q4 2021, from $540 million to $404 million.
- Full-year net income fell significantly to $46 million in 2022 from $230 million in 2021.
- Higher salaries and benefits expenses due to wage inflation increased operating costs during 2022.
The following highlights the financial and operating results for the three months ended
-
Net operating revenues totaled
.$3.14 2 billion -
Net income attributable to
Community Health Systems, Inc. stockholders was , or$414 million per share (diluted), compared to$3.18 , or$178 million per share (diluted), for the same period in 2021. Excluding the adjusting items as presented in the table in footnote (e) on page 16, net income attributable to$1.34 Community Health Systems, Inc. stockholders was per share (diluted), compared to$1.50 per share (diluted) for the same period in 2021.$1.15 -
Adjusted EBITDA was
, including$404 million of pandemic relief funds.$2 million -
Net cash provided by operating activities was
for the three months ended$9 million December 31, 2022 , which included payment of approximately of 2020 social security taxes deferred pursuant to the CARES Act, compared to net cash used in operating activities of$73 million , which included repayments of Medicare accelerated payments in the amount of$531 million , for the same period in 2021.$814 million -
Approximately
principal amount of notes outstanding were extinguished during the three months ended$378 million December 31, 2022 . - On a same-store basis, admissions increased 4.4 percent and adjusted admissions increased 8.2 percent, compared to the same period in 2021.
Commenting on the results,
Three Months Ended
Net operating revenues for the three months ended
Net income attributable to
Adjusted EBITDA for the three months ended
The increase in net income attributable to
Year Ended
Net operating revenues for the year ended
Net income attributable to
Adjusted EBITDA for the year ended
The decrease in net income attributable to
Note Repurchases
During the three months ended
Pandemic Relief Funds
The Company received pandemic relief fund payments through various federal, state and local programs of approximately
Other
Certain of the Company’s facilities in
During the three months ended
Same-store operating results exclude businesses divested in 2021 and 2022, businesses closed in 2022 and one de novo hospital that opened in 2022.
Effective
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, gain on sale of equity interests in
The non-GAAP financial measures set forth above are not measurements of financial performance under
Included on pages 17, 18, 19, 20 and 21 of this press release are tables setting forth the Company’s 2023 annual earnings guidance. The 2023 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.
The Company’s headquarters are located in
Financial Highlights (a)(b) | |||||||||||||
(In millions, except per share amounts) | |||||||||||||
(Unaudited) | |||||||||||||
Three Months Ended | Year Ended | ||||||||||||
2022 |
2021 |
2022 |
2021 |
||||||||||
Net operating revenues | $ | 3,142 |
$ | 3,233 |
|
$ | 12,211 |
$ | 12,368 |
|
|||
Net income (f) | 446 |
223 |
|
179 |
368 |
|
|||||||
Net income attributable to |
414 |
178 |
|
46 |
230 |
|
|||||||
Adjusted EBITDA (c) | 404 |
540 |
|
1,466 |
1,969 |
|
|||||||
Net cash provided by (used in) operating activities | 9 |
(531 |
) |
300 |
(131 |
) |
|||||||
Earnings per share attributable to Community |
|||||||||||||
Basic (f) | $ | 3.21 |
$ | 1.40 |
|
$ | 0.35 |
$ | 1.82 |
|
|||
Diluted (e), (f) | 3.18 |
1.34 |
|
0.35 |
1.76 |
|
|||||||
Weighted-average number of shares outstanding (d): | |||||||||||||
Basic | 129 |
127 |
|
129 |
127 |
|
|||||||
Diluted | 130 |
133 |
|
130 |
131 |
|
|||||||
______ |
|||||||||||||
For footnotes, see pages 14, 15 and 16. |
Condensed Consolidated Statements of Income (a)(b) | |||||||||||||||
(In millions, except per share amounts) | |||||||||||||||
(Unaudited) | |||||||||||||||
Three Months Ended |
|||||||||||||||
2022 |
2021 |
||||||||||||||
% of Net | % of Net | ||||||||||||||
Operating | Operating | ||||||||||||||
Amount | Revenues | Amount | Revenues | ||||||||||||
Net operating revenues | $ | 3,142 |
|
100.0 |
|
% |
$ | 3,233 |
|
100.0 |
|
% |
|||
Operating costs and expenses: | |||||||||||||||
Salaries and benefits | 1,357 |
|
43.2 |
|
% |
1,337 |
|
41.4 |
|
% |
|||||
Supplies | 498 |
|
15.8 |
|
% |
521 |
|
16.1 |
|
% |
|||||
Other operating expenses | 826 |
|
26.4 |
|
% |
789 |
|
24.3 |
|
% |
|||||
Lease cost and rent | 82 |
|
2.6 |
|
% |
77 |
|
2.4 |
|
% |
|||||
Pandemic relief funds | (2 |
) |
(0.1 |
) |
% |
(46 |
) |
(1.4 |
) |
% |
|||||
Depreciation and amortization | 136 |
|
4.3 |
|
% |
131 |
|
4.1 |
|
% |
|||||
Impairment and (gain) loss on sale of businesses, net (f) | 17 |
|
0.5 |
|
% |
- |
|
- |
|
% |
|||||
Total operating costs and expenses | 2,914 |
|
92.7 |
|
% |
2,809 |
|
86.9 |
|
% |
|||||
Income from operations (f) | 228 |
|
7.3 |
|
% |
424 |
|
13.1 |
|
% |
|||||
Interest expense, net | 205 |
|
6.6 |
|
% |
220 |
|
6.8 |
|
% |
|||||
Gain from early extinguishment of debt | (180 |
) |
(5.7 |
) |
% |
- |
|
- |
|
% |
|||||
Gain on sale of equity interests in |
- |
|
- |
|
% |
(13 |
) |
(0.4 |
) |
% |
|||||
Gain from CoreTrust transaction | (119 |
) |
(3.8 |
) |
% |
- |
|
- |
|
% |
|||||
Equity in earnings of unconsolidated affiliates | (3 |
) |
(0.1 |
) |
% |
(4 |
) |
(0.1 |
) |
% |
|||||
Income before income taxes | 325 |
|
10.3 |
|
% |
221 |
|
6.8 |
|
% |
|||||
Benefit from income taxes | (121 |
) |
(3.9 |
) |
% |
(2 |
) |
(0.1 |
) |
% |
|||||
Net income (f) | 446 |
|
14.2 |
|
% |
223 |
|
6.9 |
|
% |
|||||
Less: Net income attributable to noncontrolling interests | 32 |
|
1.0 |
|
% |
45 |
|
1.4 |
|
% |
|||||
Net income attributable to |
$ | 414 |
|
13.2 |
|
% |
$ | 178 |
|
5.5 |
|
% |
|||
Earnings per share attributable to Community |
|||||||||||||||
Basic (f) | $ | 3.21 |
|
$ | 1.40 |
|
|||||||||
Diluted (e), (f) | $ | 3.18 |
|
$ | 1.34 |
|
|||||||||
Weighted-average number of shares outstanding (d): | |||||||||||||||
Basic | 129 |
|
127 |
|
|||||||||||
Diluted | 130 |
|
133 |
|
|||||||||||
_____ |
116 |
|
|||||||||||||
For footnotes, see pages 14, 15 and 16. |
Condensed Consolidated Statements of Income (a)(b) | |||||||||||||||
(In millions, except per share amounts) | |||||||||||||||
(Unaudited) | |||||||||||||||
Year Ended |
|||||||||||||||
2022 |
2021 |
||||||||||||||
% of Net | % of Net | ||||||||||||||
Operating | Operating | ||||||||||||||
Amount | Revenues | Amount | Revenues | ||||||||||||
Net operating revenues | $ | 12,211 |
|
100.0 |
|
% |
$ | 12,368 |
|
100.0 |
|
% |
|||
Operating costs and expenses: | |||||||||||||||
Salaries and benefits | 5,330 |
|
43.6 |
|
% |
5,242 |
|
42.4 |
|
% |
|||||
Supplies | 1,975 |
|
16.2 |
|
% |
2,042 |
|
16.5 |
|
% |
|||||
Other operating expenses | 3,336 |
|
27.3 |
|
% |
2,958 |
|
23.9 |
|
% |
|||||
Lease cost and rent | 317 |
|
2.6 |
|
% |
308 |
|
2.5 |
|
% |
|||||
Pandemic relief funds | (173 |
) |
(1.4 |
) |
% |
(148 |
) |
(1.2 |
) |
% |
|||||
Depreciation and amortization | 534 |
|
4.4 |
|
% |
540 |
|
4.4 |
|
% |
|||||
Impairment and (gain) loss on sale of businesses, net (f) | 71 |
|
0.6 |
|
% |
24 |
|
0.2 |
|
% |
|||||
Total operating costs and expenses | 11,390 |
|
93.3 |
|
% |
10,966 |
|
88.7 |
|
% |
|||||
Income from operations (f) | 821 |
|
6.7 |
|
% |
1,402 |
|
11.3 |
|
% |
|||||
Interest expense, net | 858 |
|
7.0 |
|
% |
885 |
|
7.2 |
|
% |
|||||
(Gain) loss from early extinguishment of debt | (253 |
) |
(2.1 |
) |
% |
79 |
|
0.6 |
|
% |
|||||
Gain on sale of equity interests in |
- |
|
- |
|
% |
(39 |
) |
(0.3 |
) |
% |
|||||
Gain from CoreTrust transaction | (119 |
) |
(1.0 |
) |
% |
- |
|
- |
|
% |
|||||
Equity in earnings of unconsolidated affiliates | (14 |
) |
(0.1 |
) |
% |
(22 |
) |
(0.2 |
) |
% |
|||||
Income before income taxes | 349 |
|
2.9 |
|
% |
499 |
|
4.0 |
|
% |
|||||
Provision for income taxes | 170 |
|
1.4 |
|
% |
131 |
|
1.0 |
|
% |
|||||
Net income (f) | 179 |
|
1.5 |
|
% |
368 |
|
3.0 |
|
% |
|||||
Less: Net income attributable to noncontrolling interests | 133 |
|
1.1 |
|
% |
138 |
|
1.1 |
|
% |
|||||
Net income attributable to |
$ | 46 |
|
0.4 |
|
% |
$ | 230 |
|
1.9 |
|
% |
|||
Earnings per share attributable to Community |
|||||||||||||||
Basic (f) | $ | 0.35 |
|
$ | 1.82 |
|
|||||||||
Diluted (e), (f) | $ | 0.35 |
|
$ | 1.76 |
|
|||||||||
Weighted-average number of shares outstanding (d): | |||||||||||||||
Basic | 129 |
|
127 |
|
|||||||||||
Diluted | 130 |
|
131 |
|
|||||||||||
_____ |
|||||||||||||||
For footnotes, see pages 14, 15 and 16. |
Condensed Consolidated Statements of Comprehensive Income | ||||||||||||||
(In millions) | ||||||||||||||
(Unaudited) | ||||||||||||||
Three Months Ended | Year Ended | |||||||||||||
2022 |
2021 |
2022 |
2021 |
|||||||||||
Net income | $ | 446 |
$ | 223 |
|
$ | 179 |
|
$ | 368 |
|
|||
Other comprehensive income (loss), net of income taxes: | ||||||||||||||
Net change in fair value of available-for-sale debt securities, net of tax | 2 |
(1 |
) |
(17 |
) |
(5 |
) |
|||||||
Amortization and recognition of unrecognized pension cost components, net of tax | 10 |
1 |
|
10 |
|
3 |
|
|||||||
Other comprehensive income (loss) | 12 |
- |
|
(7 |
) |
(2 |
) |
|||||||
Comprehensive income | 458 |
223 |
|
172 |
|
366 |
|
|||||||
Less: Comprehensive income attributable to noncontrolling interests | 32 |
45 |
|
133 |
|
138 |
|
|||||||
Comprehensive income attributable to |
$ | 426 |
$ | 178 |
|
$ | 39 |
|
$ | 228 |
|
|||
_____ |
||||||||||||||
For footnotes, see pages 14, 15 and 16. |
Selected Operating Data (a) | |||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||
(Unaudited) | |||||||||||||||||||||
Three Months Ended |
|||||||||||||||||||||
Consolidated | Same-Store | ||||||||||||||||||||
2022 |
2021 |
% Change |
2022 |
2021 |
% Change |
||||||||||||||||
Number of hospitals (at end of period) |
|
80 |
|
|
83 |
|
|
79 |
|
|
79 |
|
|||||||||
Licensed beds (at end of period) |
|
12,832 |
|
|
13,289 |
|
|
12,780 |
|
|
12,796 |
|
|||||||||
Beds in service (at end of period) |
|
10,936 |
|
|
11,629 |
|
|
10,884 |
|
|
11,136 |
|
|||||||||
Admissions |
|
110,084 |
|
|
107,998 |
|
1.9 |
% |
|
108,699 |
|
|
104,087 |
|
4.4 |
% |
|||||
Adjusted admissions |
|
248,072 |
|
|
235,801 |
|
5.2 |
% |
|
243,522 |
|
|
225,120 |
|
8.2 |
% |
|||||
Patient days |
|
506,387 |
|
|
547,724 |
|
|
504,109 |
|
|
532,561 |
|
|||||||||
Average length of stay (days) |
|
4.6 |
|
|
5.1 |
|
|
4.6 |
|
|
5.1 |
|
|||||||||
Occupancy rate (average beds in service) |
|
50.0 |
% |
|
51.5 |
% |
|
50.0 |
% |
|
52.3 |
% |
|||||||||
Net operating revenues | $ |
3,142 |
|
$ |
3,233 |
|
-2.8 |
% |
$ |
3,123 |
|
$ |
3,163 |
|
-1.3 |
% |
|||||
Net inpatient revenues as a % of net operating revenues |
|
46.3 |
% |
|
48.7 |
% |
|
46.4 |
% |
|
48.8 |
% |
|||||||||
Net outpatient revenues as a % of net operating revenues |
|
53.7 |
% |
|
51.3 |
% |
|
53.6 |
% |
|
51.2 |
% |
|||||||||
Income from operations (f) | $ |
228 |
|
$ |
424 |
|
-46.2 |
% |
|||||||||||||
Income from operations as a % of net operating revenues |
|
7.3 |
% |
|
13.1 |
% |
|||||||||||||||
Depreciation and amortization | $ |
136 |
|
$ |
131 |
|
|||||||||||||||
Equity in earnings of unconsolidated affiliates | $ |
(3 |
) |
$ |
(4 |
) |
|||||||||||||||
Net income attributable to |
$ |
414 |
|
$ |
178 |
|
132.6 |
% |
|||||||||||||
Net income attributable to |
|
13.2 |
% |
|
5.5 |
% |
|||||||||||||||
Adjusted EBITDA (c) | $ |
404 |
|
$ |
540 |
|
-25.2 |
% |
|||||||||||||
Adjusted EBITDA as a % of net operating revenues |
|
12.9 |
% |
|
16.7 |
% |
|||||||||||||||
Net cash provided by (used in) operating activities | $ |
9 |
|
$ |
(531 |
) |
101.7 |
% |
|||||||||||||
____ |
|||||||||||||||||||||
For footnotes, see pages 14, 15 and 16. |
Selected Operating Data (a) | |||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||
(Unaudited) | |||||||||||||||||||||
Year Ended |
|||||||||||||||||||||
Consolidated | Same-Store | ||||||||||||||||||||
2022 |
2021 |
% Change |
2022 |
2021 |
% Change |
||||||||||||||||
Number of hospitals (at end of period) |
|
80 |
|
|
83 |
|
|
79 |
|
|
79 |
|
|||||||||
Licensed beds (at end of period) |
|
12,832 |
|
|
13,289 |
|
|
12,780 |
|
|
12,796 |
|
|||||||||
Beds in service (at end of period) |
|
10,936 |
|
|
11,629 |
|
|
10,884 |
|
|
11,136 |
|
|||||||||
Admissions |
|
434,765 |
|
|
442,445 |
|
-1.7 |
% |
|
423,907 |
|
|
421,961 |
|
0.5 |
% |
|||||
Adjusted admissions |
|
975,737 |
|
|
950,717 |
|
2.6 |
% |
|
942,743 |
|
|
897,781 |
|
5.0 |
% |
|||||
Patient days |
|
2,052,864 |
|
|
2,190,405 |
|
|
2,014,822 |
|
|
2,107,599 |
|
|||||||||
Average length of stay (days) |
|
4.7 |
|
|
5.0 |
|
|
4.8 |
|
|
5.0 |
|
|||||||||
Occupancy rate (average beds in service) |
|
49.2 |
% |
|
51.1 |
% |
|
50.0 |
% |
|
51.7 |
% |
|||||||||
Net operating revenues | $ |
12,211 |
|
$ |
12,368 |
|
-1.3 |
% |
$ |
12,038 |
|
$ |
12,065 |
|
-0.2 |
% |
|||||
Net inpatient revenues as a % of net operating revenues |
|
46.8 |
% |
|
48.3 |
% |
|
46.8 |
% |
|
48.3 |
% |
|||||||||
Net outpatient revenues as a % of net operating revenues |
|
53.2 |
% |
|
51.7 |
% |
|
53.2 |
% |
|
51.7 |
% |
|||||||||
Income from operations (f) | $ |
821 |
|
$ |
1,402 |
|
-41.4 |
% |
|||||||||||||
Income from operations as a % of net operating revenues |
|
6.7 |
% |
|
11.3 |
% |
|||||||||||||||
Depreciation and amortization | $ |
534 |
|
$ |
540 |
|
|||||||||||||||
Equity in earnings of unconsolidated affiliates | $ |
(14 |
) |
$ |
(22 |
) |
|||||||||||||||
Net income attributable to |
$ |
46 |
|
$ |
230 |
|
-80.0 |
% |
|||||||||||||
Net income attributable to |
|
0.4 |
% |
|
1.9 |
% |
|||||||||||||||
Adjusted EBITDA (c) | $ |
1,466 |
|
$ |
1,969 |
|
-25.5 |
% |
|||||||||||||
Adjusted EBITDA as a % of net operating revenues |
|
12.0 |
% |
|
15.9 |
% |
|||||||||||||||
Net cash provided by (used in) operating activities | $ |
300 |
|
$ |
(131 |
) |
329.0 |
% |
|||||||||||||
____ |
|||||||||||||||||||||
For footnotes, see pages 14, 15 and 16. |
Condensed Consolidated Balance Sheets | ||||||||
(In millions, except share data) | ||||||||
(Unaudited) | ||||||||
ASSETS | ||||||||
Current assets | ||||||||
Cash and cash equivalents | $ | 118 |
|
$ | 507 |
|
||
Patient accounts receivable | 2,040 |
|
2,062 |
|
||||
Supplies | 353 |
|
355 |
|
||||
Prepaid income taxes | 99 |
|
94 |
|
||||
Prepaid expenses and taxes | 237 |
|
192 |
|
||||
Other current assets | 235 |
|
269 |
|
||||
Total current assets | 3,082 |
|
3,479 |
|
||||
Property and equipment: | ||||||||
Land and improvements | 497 |
|
534 |
|
||||
Buildings and improvements | 6,038 |
|
6,050 |
|
||||
Equipment and fixtures | 3,104 |
|
3,173 |
|
||||
Property and equipment | 9,639 |
|
9,757 |
|
||||
Less accumulated depreciation and amortization | (4,274 |
) |
(4,204 |
) |
||||
Property and equipment, net | 5,365 |
|
5,553 |
|
||||
4,166 |
|
4,219 |
|
|||||
Deferred income taxes | 49 |
|
53 |
|
||||
Other assets, net of accumulated amortization of |
2,007 |
|
1,913 |
|
||||
Total assets | $ | 14,669 |
|
$ | 15,217 |
|
||
LIABILITIES AND STOCKHOLDERS’ DEFICIT | ||||||||
Current liabilities | ||||||||
Current maturities of long-term debt | $ | 21 |
|
$ | 31 |
|
||
Current operating lease liabilities | 148 |
|
147 |
|
||||
Accounts payable | 773 |
|
830 |
|
||||
Accrued liabilities: | ||||||||
Employee compensation | 637 |
|
655 |
|
||||
Accrued interest | 189 |
|
225 |
|
||||
Other | 418 |
|
476 |
|
||||
Total current liabilities | 2,186 |
|
2,364 |
|
||||
Long-term debt (g) | 11,614 |
|
12,109 |
|
||||
Deferred income taxes | 354 |
|
192 |
|
||||
Long-term operating lease liabilities | 605 |
|
535 |
|
||||
Other long-term liabilities | 644 |
|
827 |
|
||||
Total liabilities | 15,403 |
|
16,027 |
|
||||
Redeemable noncontrolling interests in equity of consolidated subsidiaries | 541 |
|
480 |
|
||||
STOCKHOLDERS’ DEFICIT | ||||||||
Preferred stock, |
- |
|
- |
|
||||
Common stock, |
1 |
|
1 |
|
||||
Additional paid-in capital | 2,084 |
|
2,118 |
|
||||
Accumulated other comprehensive loss | (21 |
) |
(14 |
) |
||||
Accumulated deficit | (3,431 |
) |
(3,477 |
) |
||||
(1,367 |
) |
(1,372 |
) |
|||||
Noncontrolling interests in equity of consolidated subsidiaries | 92 |
|
82 |
|
||||
Total stockholders’ deficit | (1,275 |
) |
(1,290 |
) |
||||
Total liabilities and stockholders’ deficit | $ | 14,669 |
|
$ | 15,217 |
|
||
____ |
||||||||
For footnotes, see pages 14, 15 and 16. |
Condensed Consolidated Statements of Cash Flows | |||||||
(In millions) | |||||||
(Unaudited) | |||||||
Year Ended |
|||||||
2022 |
2021 |
||||||
Cash flows from operating activities | |||||||
Net income | $ | 179 |
|
$ | 368 |
|
|
Adjustments to reconcile net income to net cash provided by (used in) operating activities: | |||||||
Depreciation and amortization | 534 |
|
540 |
|
|||
Deferred income taxes | 165 |
|
170 |
|
|||
Stock-based compensation expense | 20 |
|
25 |
|
|||
Impairment and (gain) loss on sale of businesses, net (f) | 71 |
|
24 |
|
|||
(Gain) loss from early extinguishment of debt | (253 |
) |
79 |
|
|||
Gain on sale of equity interests in |
- |
|
(39 |
) |
|||
Gain from CoreTrust transaction | (119 |
) |
- |
|
|||
Other non-cash expenses, net | 182 |
|
78 |
|
|||
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures: | |||||||
Patient accounts receivable | 22 |
|
(136 |
) |
|||
Supplies, prepaid expenses and other current assets | (128 |
) |
1 |
|
|||
Repayment/derecognition of Medicare accelerated payments | - |
|
(1,081 |
) |
|||
Accounts payable, accrued liabilities and income taxes | (158 |
) |
16 |
|
|||
Other | (215 |
) |
(176 |
) |
|||
Net cash provided by (used in) operating activities | 300 |
|
(131 |
) |
|||
Cash flows from investing activities | |||||||
Acquisitions of facilities and other related businesses | (9 |
) |
(3 |
) |
|||
Purchases of property and equipment | (415 |
) |
(469 |
) |
|||
Proceeds from disposition of hospitals and other ancillary operations | 89 |
|
17 |
|
|||
Proceeds from sale of property and equipment | 38 |
|
10 |
|
|||
Purchases of available-for-sale debt securities and equity securities | (114 |
) |
(171 |
) |
|||
Proceeds from sales of available-for-sale debt securities and equity securities | 110 |
|
102 |
|
|||
Purchases of investments in unconsolidated affiliates | (19 |
) |
(7 |
) |
|||
Proceeds from sale of equity interests in |
- |
|
110 |
|
|||
Distribution of CoreTrust proceeds | 121 |
|
- |
|
|||
Increase in other investments | (60 |
) |
(113 |
) |
|||
Net cash used in investing activities | (259 |
) |
(524 |
) |
|||
Cash flows from financing activities | |||||||
Repurchase of restricted stock shares for payroll tax withholding requirements | (8 |
) |
(5 |
) |
|||
Deferred financing costs and other debt-related costs | (74 |
) |
(313 |
) |
|||
Proceeds from noncontrolling investors in joint ventures | 13 |
|
- |
|
|||
Redemption of noncontrolling investments in joint ventures | (5 |
) |
(19 |
) |
|||
Distributions to noncontrolling investors in joint ventures | (125 |
) |
(121 |
) |
|||
Other borrowings | 48 |
|
60 |
|
|||
Issuance of long-term debt | 1,535 |
|
4,310 |
|
|||
Proceeds from ABL facility | 542 |
|
- |
|
|||
Repayments of long-term indebtedness | (2,356 |
) |
(4,426 |
) |
|||
Net cash used in financing activities | (430 |
) |
(514 |
) |
|||
Net change in cash and cash equivalents | (389 |
) |
(1,169 |
) |
|||
Cash and cash equivalents at beginning of period | 507 |
|
1,676 |
|
|||
Cash and cash equivalents at end of period | $ | 118 |
|
$ | 507 |
|
|
_____ |
|||||||
For footnotes, see pages 14, 15 and 16. |
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data |
||
|
||
(a) | Both financial and statistical results include the operating results of divested or closed businesses for the periods prior to the consummation of the respective divestiture or closing. Same-store operating results and statistical information exclude businesses divested in 2021 and 2022, businesses closed in 2022 and one hospital opened in 2022. There were no discontinued operations reported for 2022 and 2021. |
|
|
||
(b) | The following table provides information needed to calculate earnings per share, which is adjusted for income attributable to noncontrolling interests (in millions): |
Three Months Ended | Year Ended | ||||||||||
2022 |
2021 |
2022 |
2021 |
||||||||
Net income attributable to |
|||||||||||
Net income | $ | 446 |
$ | 223 |
$ | 179 |
$ | 368 |
|||
Less: Income attributable to noncontrolling interests, net of taxes | 32 |
45 |
133 |
138 |
|||||||
Net income attributable to |
$ | 414 |
$ | 178 |
$ | 46 |
$ | 230 |
(c) |
EBITDA is a non-GAAP financial measure which consists of net income attributable to |
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data (Continued) |
|
Adjusted EBITDA is not a measurement of financial performance under |
|
The following table reflects the reconciliation of Adjusted EBITDA, as defined, to net income attributable to |
Three Months Ended | Year Ended | ||||||||||||||
2022 |
2021 |
2022 |
2021 |
||||||||||||
Net income attributable to |
$ | 414 |
|
$ | 178 |
|
$ | 46 |
|
$ | 230 |
|
|||
Adjustments: | |||||||||||||||
(Benefit from) provision for income taxes | (121 |
) |
(2 |
) |
170 |
|
131 |
|
|||||||
Depreciation and amortization | 136 |
|
131 |
|
534 |
|
540 |
|
|||||||
Net income attributable to noncontrolling interests | 32 |
|
45 |
|
133 |
|
138 |
|
|||||||
Interest expense, net | 205 |
|
220 |
|
858 |
|
885 |
|
|||||||
(Gain) loss from early extinguishment of debt | (180 |
) |
- |
|
(253 |
) |
79 |
|
|||||||
Impairment and (gain) loss on sale of businesses, net | 17 |
|
- |
|
71 |
|
24 |
|
|||||||
Gain from CoreTrust transaction | (119 |
) |
- |
|
(119 |
) |
- |
|
|||||||
Gain on sale of equity interests in |
- |
|
(13 |
) |
- |
|
(39 |
) |
|||||||
Expense from government and other legal matters and related costs | - |
|
- |
|
5 |
|
- |
|
|||||||
(Income) expense from the settlement of professional liability claims for which the third-party insurers' obligation to insure the Company for the underlying loss has been settled | - |
|
(19 |
) |
- |
|
(19 |
) |
|||||||
Expense related to employee termination benefits and other restructuring charges | 5 |
|
- |
|
6 |
|
- |
|
|||||||
Change in estimate for professional claims liability related to divested locations | 15 |
|
- |
|
15 |
|
- |
|
|||||||
Adjusted EBITDA | $ | 404 |
|
$ | 540 |
|
$ | 1,466 |
|
$ | 1,969 |
|
(d) | The following table sets forth components reconciling the basic weighted-average number of shares to the diluted weighted-average number of shares (in millions): |
Three Months Ended | Year Ended | ||||||
2022 |
|
2021 |
2022 |
2021 |
|||
Weighted-average number of shares outstanding - basic | 129 |
127 |
129 |
127 |
|||
Add effect of dilutive securities: | |||||||
Stock awards and options | 1 |
6 |
1 |
4 |
|||
Weighted-average number of shares outstanding - diluted | 130 |
133 |
130 |
131 |
During the three months and year ended |
Footnotes to Financial Highlights, Financial Statements and Selected Operating Data (Continued) |
||
|
||
(e) |
The following supplemental table reconciles net income attributable to |
|
Three Months Ended | Year Ended | |||||||||||||
|
|||||||||||||||
|
2022 |
|
2021 |
|
2022 |
|
2021 |
||||||||
Net income per share (diluted), as reported | $ |
3.18 |
|
$ |
1.34 |
|
$ |
0.35 |
|
$ |
1.76 |
|
|||
Adjustments: | |||||||||||||||
(Gain) loss from early extinguishment of debt |
|
(1.18 |
) |
|
- |
|
|
(1.60 |
) |
|
0.89 |
|
|||
Impairment and (gain) loss on sale of businesses, net |
|
0.10 |
|
|
- |
|
|
0.42 |
|
|
0.15 |
|
|||
Gain from CoreTrust transaction |
|
(0.71 |
) |
|
- |
|
|
(0.71 |
) |
|
- |
|
|||
Gain on sale of equity interests in |
|
- |
|
|
(0.08 |
) |
|
- |
|
|
(0.24 |
) |
|||
Expense from government and other legal matters and related costs |
|
- |
|
|
- |
|
|
0.03 |
|
|
- |
|
|||
(Income) expense from the settlement of professional liability claims for which the third-party insurers' obligation to insure the Company for the underlying loss has been settled |
|
- |
|
|
(0.11 |
) |
|
- |
|
|
(0.11 |
) |
|||
Expense related to employee termination benefits and other restructuring charges |
|
0.03 |
|
|
- |
|
|
0.04 |
|
|
- |
|
|||
Change in estimate for professional claims liability related to divested locations |
|
0.09 |
|
|
- |
|
|
0.09 |
|
|
- |
|
|||
Net income (loss) per share (diluted), excluding adjustments | $ |
1.50 |
|
$ |
1.15 |
|
$ |
(1.38 |
) |
$ |
2.45 |
|
(f) |
Both income from operations and net income included a net non-cash expense of |
|
|
||
(g) |
The maximum aggregate principal amount under the ABL Facility is |
Regulation FD Disclosure |
|
Set forth below is selected information concerning the Company’s projected consolidated operating results for the year ending |
|
The following is provided as guidance to analysts and investors: |
2023 |
|||||||||
Net operating revenues (in millions) | $ | 12,200 |
|
to | $ | 12,600 |
|
||
Adjusted EBITDA (in millions) | $ | 1,475 |
|
to | $ | 1,625 |
|
||
Net loss per share - diluted | $ | (0.65 |
) |
to | $ | (0.05 |
) |
||
Weighted-average diluted shares (in millions) | 130.0 |
|
to | 131.0 |
|
The following assumptions were used in developing the 2023 guidance provided above:
-
The Company’s projections exclude the following:
- Effect of debt refinancing activities, including gains and losses from early extinguishment of debt;
- Impairment of goodwill and long-lived assets;
- Previously recorded pandemic relief funds and the potential recognition of additional pandemic relief funds;
- The impact of any potential future divestitures;
- Gains or losses from the sales of businesses;
- Employee termination benefits and restructuring costs;
- Resolution of government investigations or other significant legal settlements;
- Costs incurred in connection with divestitures; and
- Other significant gains or losses that neither relate to the ordinary course of business nor reflect the Company’s underlying business performance.
Other assumptions used in the above guidance:
-
Expressed as a percentage of net operating revenues, depreciation and amortization of approximately
4.2% for 2023. Additionally, this is a fixed cost and the percentages may vary based on changes in net operating revenues. Such amounts exclude the possible impact of any future hospital fixed asset impairments. -
Interest expense is estimated to be between
and$815 million while cash paid for interest, which excludes the amortization of deferred financing costs, is expected to be$835 million to$760 million . Total fixed rate debt is expected to average approximately$780 million 100% of total debt during 2023. -
Expressed as a percentage of net operating revenues, net income attributable to noncontrolling interests of approximately
1.1% to1.2% for 2023. -
Expressed as a percentage of net operating revenues, provision for income taxes of approximately
0.8% to0.9% for 2023.
A reconciliation of the Company’s projected 2023 Adjusted EBITDA, a forward-looking non-GAAP financial measure, to the Company’s projected net loss attributable to
Year Ending | |||||||
Low | High | ||||||
Net loss attributable to |
$ | (84 |
) |
$ | (6 |
) |
|
Adjustments: | |||||||
Depreciation and amortization | 510 |
|
530 |
|
|||
Interest expense, net | 815 |
|
835 |
|
|||
Provision for income taxes | 99 |
|
116 |
|
|||
Net income attributable to noncontrolling interests | 135 |
|
150 |
|
|||
Adjusted EBITDA (1) | $ | 1,475 |
|
$ | 1,625 |
|
(1) |
The Company does not include in this reconciliation the impact of certain items not included in the Company’s forecast set forth above that would be included in a reconciliation of historical net income (loss) attributable to |
- Capital expenditures are projected as follows (in millions):
2023 |
||||||||
Guidance | ||||||||
Total |
$ |
450 |
to | $ |
500 |
|||
- Net cash provided by operating activities are projected as follows (in millions):
2023 |
||||||||
Guidance | ||||||||
Total |
$ |
675 |
to | $ |
825 |
- Diluted weighted-average shares outstanding are projected to be approximately 130 million to 131 million for 2023.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995 that involve risk and uncertainties. All statements in this press release other than statements of historical fact, including statements regarding projections, expected operating results, and other events that depend upon or refer to future events or conditions or that include words such as “expects,” “anticipates,” “intends,” “plans,” “believes,” “estimates,” “thinks,” and similar expressions, are forward-looking statements. Although the Company believes that these forward-looking statements are based on reasonable assumptions, these assumptions are inherently subject to significant economic and competitive uncertainties and contingencies, which are difficult or impossible to predict accurately and may be beyond the control of the Company. Accordingly, the Company cannot give any assurance that its expectations will in fact occur and cautions that actual results may differ materially from those in the forward-looking statements. A number of factors could affect the future results of the Company or the healthcare industry generally and could cause the Company’s expected results to differ materially from those expressed in this press release.
These factors include, among other things:
- general economic and business conditions, both nationally and in the regions in which we operate, including the current negative macroeconomic conditions, ongoing inflationary pressures that have significantly increased and may continue to significantly increase our expenses, the current high interest rate environment, ongoing challenging labor market conditions and labor shortages, and supply chain shortages and disruptions, as well as the current and/or potential future adverse impact of such economic conditions and other factors on our net operating revenues (including our service mix, revenue mix, payor mix and/or patient volumes) and our ability to collect outstanding receivables;
- developments related to COVID-19, including, without limitation, related to the length and severity of the pandemic; the volume of canceled or rescheduled procedures; and the spread of potentially more contagious and/or virulent forms of the virus, including variants of the virus for which currently available vaccines, treatments and tests may not be effective or authorized;
- uncertainty regarding the magnitude and timing of any future payments or benefits we may receive or realize under the Coronavirus Aid, Relief and Economic Security Act, the Paycheck Protection Program and Health Care Enhancement Act, the Consolidated Appropriations Act, 2021, the American Rescue Plan Act of 2021 and any other future stimulus or relief measures related to COVID-19;
- the impact of current or future federal and state health reform initiatives, including the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (the “Affordable Care Act”), and the potential for changes to the Affordable Care Act, its implementation or its interpretation (including through executive orders and court challenges);
- the extent to and manner in which states support increases, decreases or changes in Medicaid programs, implement health insurance exchanges or alter the provision of healthcare to state residents through legislation, regulation or otherwise;
- the future and long-term viability of health insurance exchanges and potential changes to the beneficiary enrollment process;
- risks associated with our substantial indebtedness, leverage and debt service obligations, including our ability to refinance such indebtedness on acceptable terms or to incur additional indebtedness, and our ability to remain in compliance with debt covenants;
- demographic changes;
- changes in, or the failure to comply with, federal, state or local laws or governmental regulations affecting our business;
- potential adverse impact of known and unknown legal, regulatory and governmental proceedings and other loss contingencies, including governmental investigations and audits, and federal and state false claims act litigation;
- our ability, where appropriate, to enter into and maintain provider arrangements with payors and the terms of these arrangements, which may be further affected by the increasing consolidation of health insurers and managed care companies and vertical integration efforts involving payors and healthcare providers;
- changes in, or the failure to comply with, contract terms with payors and changes in reimbursement policies or rates paid by federal or state healthcare programs or commercial payors;
-
any security breaches, cyber-attacks, loss of data, other cybersecurity threats or incidents, and any actual or perceived failures to comply with legal requirements governing the privacy and security of health information or other regulated, sensitive or confidential information, or legal requirements regarding data privacy or data protection, and the impact of the security breach announced by us on
February 13, 2023 , including legal, reputational, and financial risks associated with this security breach, the results of our ongoing investigation of this security breach, any potential regulatory inquiries and/or litigation to which we may become subject in connection with this security breach, and the extent of remediation and other additional costs that may be incurred by us in connection with this security breach; - any potential impairments in the carrying value of goodwill, other intangible assets, or other long-lived assets, or changes in the useful lives of other intangible assets;
- changes in inpatient or outpatient Medicare and Medicaid payment levels and methodologies;
- the effects related to the implementation of the sequestration spending reductions pursuant to both the Budget Control Act of 2011 and the Pay-As-You-Go Act of 2010 and the potential for future deficit reduction legislation;
- increases in the amount and risk of collectability of patient accounts receivable, including decreases in collectability which may result from, among other things, self-pay growth and difficulties in recovering payments for which patients are responsible, including co-pays and deductibles;
- the efforts of insurers, healthcare providers, large employer groups and others to contain healthcare costs, including the trend toward value-based purchasing;
- the impact of competitive labor market conditions and the shortage of nurses, including in connection with our ability to hire and retain qualified nurses, physicians, other medical personnel and key management, and increased labor expenses as a result of such competitive labor market conditions, inflation and competition for such positions;
- any failure to obtain medical supplies or pharmaceuticals at favorable prices;
- liabilities and other claims asserted against us, including self-insured professional liability claims;
- competition;
- trends toward treatment of patients in less acute or specialty healthcare settings, including ambulatory surgery centers or specialty hospitals or via telehealth;
- changes in medical or other technology;
-
changes in
U.S. GAAP; - the availability and terms of capital to fund any additional acquisitions or replacement facilities or other capital expenditures;
- our ability to successfully make acquisitions or complete divestitures, our ability to complete any such acquisitions or divestitures on desired terms or at all, the timing of the completion of any such acquisitions or divestitures, and our ability to realize the intended benefits from any such acquisitions or divestitures;
- the impact that changes in our relationships with joint venture or syndication partners could have on effectively operating our hospitals or ancillary services or in advancing strategic opportunities;
- our ability to successfully integrate any acquired hospitals and/or outpatient facilities, or to recognize expected synergies from acquisitions;
- the impact of severe weather conditions and climate change, as well as the timing and amount of insurance recoveries in relation to severe weather events;
- our ability to obtain adequate levels of insurance, including cyber, general liability, professional liability, and directors and officers liability insurance;
- timeliness of reimbursement payments received under government programs;
- effects related to pandemics, epidemics, or outbreaks of infectious diseases, including the coronavirus causing the disease known as COVID-19;
- any failure to comply with our obligations under license or technology agreements;
- challenging economic conditions in non-urban communities in which we operate;
- the concentration of our revenue in a small number of states;
- our ability to realize anticipated cost savings and other benefits from our current strategic and operational cost savings initiatives;
- any changes in or interpretations of income tax laws and regulations; and
-
the risk factors set forth in our Annual Report on Form 10-K for the year ended
December 31, 2021 , filed with theSecurities and Exchange Commission (the “SEC”) onFebruary 17, 2022 and other filings filed with theSEC .
The consolidated operating results for the three months and year ended
View source version on businesswire.com: https://www.businesswire.com/news/home/20230215005760/en/
President and Chief Financial Officer
(615) 465-7000
Source:
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