HCA Healthcare Reports Fourth Quarter 2021 Results and Provides 2022 Guidance
HCA Healthcare reported strong fourth-quarter results for 2021 with revenues of $15.064 billion, up from $14.293 billion year-over-year. Net income rose to $1.814 billion or $5.75 per diluted share, boosted by $563 million in facility sales gains. Notably, adjusted EBITDA reached $3.149 billion, slightly higher than the previous year. The company announced a new $8 billion share repurchase program and a quarterly dividend of $0.56 per share. For 2022, HCA estimates revenues between $60.0-$62.0 billion and net income between $5.550-$5.835 billion.
- Revenues in Q4 2021 increased by 5.4% to $15.064 billion compared to Q4 2020.
- Net income rose to $1.814 billion in Q4 2021, marking a 27.2% increase year-over-year.
- New share repurchase program authorized for up to $8 billion, enhancing shareholder value.
- Quarterly dividend announced at $0.56 per share, indicating confidence in financial health.
- 2022 guidance estimates revenues of $60.0-$62.0 billion and adjusted EBITDA of $12.55-$13.05 billion.
- Same facility inpatient surgeries declined by 1.2% in Q4 2021 compared to the prior year.
- High total debt of $34.579 billion could pose risks for future financial flexibility.
Company Increases Capital Spending, Authorizes Additional Share Repurchase Program and Increases Quarterly Dividend
Key fourth quarter metrics (all percentage changes compare 4Q 2021 to 4Q 2020 unless otherwise noted):
-
Revenues totaled
$15.06 4 billion -
Net income attributable to
HCA Healthcare, Inc. totaled , or$1.81 4 billion per diluted share$5.75 -
Adjusted EBITDA totaled
$3.14 9 billion -
Cash flows provided by operating activities totaled
$2.44 3 billion - Same facility admissions and same facility equivalent admissions increased 0.6 percent and 4.1 percent, respectively
“The Omicron surge started to influence our business in early December. Overall, our teams continued their tremendous response, and the effects of the pandemic’s ever-changing conditions were managed well as reflected in our fourth quarter financial results,” said
Revenues in the fourth quarter of 2021 increased to
For the fourth quarter of 2021, Adjusted EBITDA totaled
Same facility admissions and same facility equivalent admissions increased 0.6 percent and 4.1 percent, respectively, in the fourth quarter of 2021 compared to the prior year period. Same facility emergency room visits increased 19.6 percent in the fourth quarter of 2021, compared to the prior year period. Same facility inpatient surgeries declined 1.2 percent, and same facility outpatient surgeries increased 5.2 percent in the fourth quarter of 2021, compared to the same period of 2020. Same facility revenue per equivalent admission increased 2.2 percent in the fourth quarter of 2021, compared to the fourth quarter of 2020.
Year Ended
Revenues for the year ended
For 2021, Adjusted EBITDA totaled
Balance Sheet and Cash Flows from Operations
As of
During the fourth quarter of 2021, the Company repurchased 8.469 million shares of its common stock at a cost of
Share Repurchase Program
The
Dividend
The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company’s financial condition and results of operations and contractual restrictions. Future dividends are expected to be funded by cash balances and future cash flows from operations.
2022 Guidance
Today, the Company issued the following estimated guidance for 2022:
|
2022 |
||
Revenues |
|
||
Net Income Attributable to |
|
||
Adjusted EBITDA |
|
||
EPS (diluted) |
|
Capital expenditures for 2022, excluding acquisitions, are estimated to be approximately
The Company’s 2022 guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding the impact of the COVID-19 pandemic, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.
Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to
The Company’s guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company’s “Forward-Looking Statements.”
Annual Stockholders’ Meeting
The Company’s 2022 annual stockholders’ meeting will be held virtually on
Earnings Conference Call
About the Company
As of
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company’s financial guidance for the year ending
All references to “Company” and “HCA Healthcare” as used throughout this release refer to
Condensed Consolidated Comprehensive Income Statements | ||||||||||||||
Fourth Quarter | ||||||||||||||
(Dollars in millions, except per share amounts) | ||||||||||||||
2021 |
2020 |
|||||||||||||
Amount | Ratio | Amount | Ratio | |||||||||||
Revenues |
|
|
100.0 |
|
% |
|
|
100.0 |
% |
|||||
Salaries and benefits | 6,999 |
|
46.5 |
|
6,329 |
|
44.3 |
|||||||
Supplies | 2,414 |
|
16.0 |
|
2,370 |
|
16.6 |
|||||||
Other operating expenses | 2,537 |
|
16.8 |
|
2,482 |
|
17.3 |
|||||||
Equity in earnings of affiliates | (35 |
) |
(0.2 |
) |
(6 |
) |
- |
|||||||
Depreciation and amortization | 728 |
|
4.8 |
|
662 |
|
4.6 |
|||||||
Interest expense | 398 |
|
2.6 |
|
383 |
|
2.7 |
|||||||
Losses (gains) on sales of facilities | (563 |
) |
(3.7 |
) |
1 |
|
|
- |
||||||
12,478 |
|
82.8 |
|
12,221 |
|
|
85.5 |
|||||||
Income before income taxes | 2,586 |
|
17.2 |
|
2,072 |
|
14.5 |
|||||||
Provision for income taxes | 581 |
|
3.9 |
|
378 |
|
|
2.6 |
||||||
Net income | 2,005 |
|
13.3 |
|
1,694 |
|
11.9 |
|||||||
Net income attributable to noncontrolling interests | 191 |
|
1.3 |
|
268 |
|
|
1.9 |
||||||
Net income attributable to |
|
|
12.0 |
|
|
|
10.0 |
|||||||
Diluted earnings per share |
|
|
|
|
||||||||||
Shares used in computing diluted earnings per share (millions) | 315.418 |
|
345.374 |
|
||||||||||
Comprehensive income attributable to |
|
|
|
|
||||||||||
Condensed Consolidated Comprehensive Income Statements | ||||||||||||||
For the Years Ended |
||||||||||||||
(Dollars in millions, except per share amounts) | ||||||||||||||
2021 |
2020 |
|||||||||||||
Amount | Ratio | Amount | Ratio | |||||||||||
Revenues |
|
|
100.0 |
|
% |
|
|
100.0 |
|
% |
||||
Salaries and benefits | 26,779 |
|
45.6 |
|
23,874 |
|
46.3 |
|
||||||
Supplies | 9,481 |
|
16.1 |
|
8,369 |
|
16.2 |
|
||||||
Other operating expenses | 9,961 |
|
17.0 |
|
9,307 |
|
18.1 |
|
||||||
Equity in earnings of affiliates | (113 |
) |
(0.2 |
) |
(54 |
) |
(0.1 |
) |
||||||
Depreciation and amortization | 2,853 |
|
4.9 |
|
2,721 |
|
5.3 |
|
||||||
Interest expense | 1,566 |
|
2.7 |
|
1,584 |
|
3.1 |
|
||||||
Losses (gains) on sales of facilities | (1,620 |
) |
(2.8 |
) |
7 |
|
- |
|
||||||
Losses on retirement of debt | 12 |
|
- |
|
295 |
|
0.6 |
|
||||||
48,919 |
|
83.3 |
|
46,103 |
|
89.5 |
|
|||||||
Income before income taxes | 9,833 |
|
16.7 |
|
5,430 |
|
10.5 |
|
||||||
Provision for income taxes | 2,112 |
|
3.6 |
|
1,043 |
|
2.0 |
|
||||||
Net income | 7,721 |
|
13.1 |
|
4,387 |
|
8.5 |
|
||||||
Net income attributable to noncontrolling interests | 765 |
|
1.3 |
|
633 |
|
1.2 |
|
||||||
Net income attributable to |
|
|
11.8 |
|
|
|
7.3 |
|
||||||
Diluted earnings per share |
|
|
|
|
||||||||||
Shares used in computing diluted earnings per share (millions) | 328.752 |
|
343.605 |
|
||||||||||
Comprehensive income attributable to |
|
|
|
|
||||||||||
Condensed Consolidated Balance Sheets | |||||||||
(Dollars in millions) | |||||||||
2021 |
2021 |
2020 |
|||||||
ASSETS | |||||||||
Current assets: | |||||||||
Cash and cash equivalents |
|
|
|
|
|
|
|||
Accounts receivable | 8,095 |
|
8,433 |
|
7,051 |
|
|||
Inventories | 1,986 |
|
2,019 |
|
2,025 |
|
|||
Other | 2,010 |
|
1,769 |
|
1,464 |
|
|||
13,542 |
|
13,248 |
|
12,333 |
|
||||
Property and equipment, at cost | 51,350 |
|
50,695 |
|
49,317 |
|
|||
Accumulated depreciation | (27,287 |
) |
(27,148 |
) |
(26,118 |
) |
|||
24,063 |
|
23,547 |
|
23,199 |
|
||||
Investments of insurance subsidiaries | 438 |
|
418 |
|
388 |
|
|||
Investments in and advances to affiliates | 448 |
|
412 |
|
422 |
|
|||
9,540 |
|
9,153 |
|
8,578 |
|
||||
Right-of-use operating lease assets | 2,113 |
|
2,099 |
|
2,024 |
|
|||
Other | 598 |
|
685 |
|
546 |
|
|||
|
|
|
|
|
|
||||
LIABILITIES AND STOCKHOLDERS' EQUITY | |||||||||
Current liabilities: | |||||||||
Accounts payable |
|
|
|
|
|
|
|||
Accrued salaries | 1,912 |
|
2,134 |
|
1,720 |
|
|||
Other accrued expenses | 3,322 |
|
3,481 |
|
3,240 |
|
|||
Long-term debt due within one year | 237 |
|
250 |
|
209 |
|
|||
9,582 |
|
9,624 |
|
8,704 |
|
||||
Long-term debt, less debt issuance costs and discounts of |
34,342 |
|
32,049 |
|
30,795 |
|
|||
Professional liability risks | 1,514 |
|
1,522 |
|
1,486 |
|
|||
Right-of-use operating lease obligations | 1,755 |
|
1,742 |
|
1,673 |
|
|||
Income taxes and other liabilities | 2,060 |
|
2,800 |
|
1,940 |
|
|||
Stockholders' equity: | |||||||||
Stockholders' (deficit) equity attributable to |
(933 |
) |
(695 |
) |
572 |
|
|||
Noncontrolling interests | 2,422 |
|
2,520 |
|
2,320 |
|
|||
1,489 |
|
1,825 |
|
2,892 |
|
||||
|
|
|
|
|
|
||||
Condensed Consolidated Statements of Cash Flows | ||||||
For the Years Ended |
||||||
(Dollars in millions) | ||||||
2021 |
2020 |
|||||
Cash flows from operating activities: | ||||||
Net income |
|
|
|
|
||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||
Increase (decrease) in cash from operating assets and liabilities: | ||||||
Accounts receivable | (962 |
) |
327 |
|
||
Inventories and other assets | (540 |
) |
(304 |
) |
||
Accounts payable and accrued expenses | 999 |
|
1,255 |
|
||
Depreciation and amortization | 2,853 |
|
2,721 |
|
||
Income taxes | (70 |
) |
41 |
|
||
Losses (gains) on sales of facilities | (1,620 |
) |
7 |
|
||
Losses on retirement of debt | 12 |
|
295 |
|
||
Amortization of debt issuance costs and discounts | 27 |
|
30 |
|
||
Share-based compensation | 440 |
|
362 |
|
||
Other | 99 |
|
111 |
|
||
Net cash provided by operating activities | 8,959 |
|
9,232 |
|
||
Cash flows from investing activities: | ||||||
Purchase of property and equipment | (3,577 |
) |
(2,835 |
) |
||
Acquisition of hospitals and health care entities | (1,105 |
) |
(568 |
) |
||
Sales of hospitals and health care entities | 2,160 |
|
68 |
|
||
Change in investments | (117 |
) |
(20 |
) |
||
Other | (4 |
) |
(38 |
) |
||
Net cash used in investing activities | (2,643 |
) |
(3,393 |
) |
||
Cash flows from financing activities: | ||||||
Issuances of long-term debt | 4,344 |
|
2,700 |
|
||
Net change in revolving credit facilities | 2,780 |
|
(2,480 |
) |
||
Repayment of long-term debt | (3,869 |
) |
(3,437 |
) |
||
Distributions to noncontrolling interests | (749 |
) |
(626 |
) |
||
Payment of debt issuance costs | (38 |
) |
(35 |
) |
||
Payment of dividends | (624 |
) |
(153 |
) |
||
Repurchase of common stock | (8,215 |
) |
(441 |
) |
||
Other | (284 |
) |
(205 |
) |
||
Net cash used in financing activities | (6,655 |
) |
(4,677 |
) |
||
Effect of exchange rate changes on cash and cash equivalents | (3 |
) |
10 |
|
||
Change in cash and cash equivalents | (342 |
) |
1,172 |
|
||
Cash and cash equivalents at beginning of period | 1,793 |
|
621 |
|
||
Cash and cash equivalents at end of period |
|
|
|
|
||
Interest payments |
|
|
|
|
||
Income tax payments, net |
|
|
|
|
||
|
||||||||||||||||
Operating Statistics |
||||||||||||||||
For the Years | ||||||||||||||||
Fourth Quarter | Ended |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
Operations: | ||||||||||||||||
Number of Hospitals |
|
182 |
|
|
185 |
|
|
182 |
|
|
185 |
|
||||
Number of Freestanding Outpatient Surgery Centers* |
|
125 |
|
|
121 |
|
|
125 |
|
|
121 |
|
||||
Licensed Beds at End of Period |
|
48,803 |
|
|
49,265 |
|
|
48,803 |
|
|
49,265 |
|
||||
Weighted Average Beds in Service |
|
41,685 |
|
|
42,072 |
|
|
42,148 |
|
|
42,246 |
|
||||
Reported: | ||||||||||||||||
Admissions |
|
514,706 |
|
|
521,917 |
|
|
2,089,975 |
|
|
2,009,909 |
|
||||
% Change |
|
-1.4 |
% |
|
4.0 |
% |
||||||||||
Equivalent Admissions |
|
881,910 |
|
|
864,583 |
|
|
3,536,238 |
|
|
3,312,330 |
|
||||
% Change |
|
2.0 |
% |
|
6.8 |
% |
||||||||||
Revenue per Equivalent Admission | $ |
17,081 |
|
$ |
16,533 |
|
$ |
16,614 |
|
$ |
15,558 |
|
||||
% Change |
|
3.3 |
% |
|
6.8 |
% |
||||||||||
Inpatient Revenue per Admission | $ |
17,503 |
|
$ |
17,173 |
|
$ |
17,211 |
|
$ |
15,957 |
|
||||
% Change |
|
1.9 |
% |
|
7.9 |
% |
||||||||||
|
2,693,135 |
|
|
2,673,960 |
|
|
10,859,346 |
|
|
10,150,754 |
|
|||||
% Change |
|
0.7 |
% |
|
7.0 |
% |
||||||||||
Equivalent |
|
4,613,947 |
|
|
4,429,117 |
|
|
18,374,013 |
|
|
16,728,443 |
|
||||
% Change |
|
4.2 |
% |
|
9.8 |
% |
||||||||||
Inpatient Surgery Cases |
|
131,583 |
|
|
135,157 |
|
|
522,069 |
|
|
522,385 |
|
||||
% Change |
|
-2.6 |
% |
|
-0.1 |
% |
||||||||||
Outpatient Surgery Cases |
|
265,709 |
|
|
252,760 |
|
|
1,008,236 |
|
|
882,483 |
|
||||
% Change |
|
5.1 |
% |
|
14.2 |
% |
||||||||||
Emergency Room Visits |
|
2,166,959 |
|
|
1,855,823 |
|
|
8,475,345 |
|
|
7,450,307 |
|
||||
% Change |
|
16.8 |
% |
|
13.8 |
% |
||||||||||
Outpatient Revenues as a | ||||||||||||||||
Percentage of Patient Revenues . |
|
37.9 |
% |
|
35.3 |
% |
|
36.5 |
% |
|
35.1 |
% |
||||
Average Length of Stay (days) |
|
5.232 |
|
|
5.123 |
|
|
5.196 |
|
|
5.050 |
|
||||
Occupancy (weighted average beds in service) |
|
70.2 |
% |
|
69.1 |
% |
|
70.6 |
% |
|
65.6 |
% |
||||
Same Facility: | ||||||||||||||||
Admissions |
|
510,349 |
|
|
507,057 |
|
|
2,044,211 |
|
|
1,950,003 |
|
||||
% Change |
|
0.6 |
% |
|
4.8 |
% |
||||||||||
Equivalent Admissions |
|
871,676 |
|
|
837,658 |
|
|
3,448,584 |
|
|
3,203,855 |
|
||||
% Change |
|
4.1 |
% |
|
7.6 |
% |
||||||||||
Revenue per Equivalent Admission | $ |
16,997 |
|
$ |
16,623 |
|
$ |
16,623 |
|
$ |
15,642 |
|
||||
% Change |
|
2.2 |
% |
|
6.3 |
% |
||||||||||
Inpatient Revenue per Admission | $ |
17,479 |
|
$ |
17,260 |
|
$ |
17,256 |
|
$ |
16,068 |
|
||||
% Change |
|
1.3 |
% |
|
7.4 |
% |
||||||||||
Inpatient Surgery Cases |
|
130,772 |
|
|
132,382 |
|
|
513,049 |
|
|
511,017 |
|
||||
% Change |
|
-1.2 |
% |
|
0.4 |
% |
||||||||||
Outpatient Surgery Cases |
|
257,681 |
|
|
244,961 |
|
|
974,586 |
|
|
853,985 |
|
||||
% Change |
|
5.2 |
% |
|
14.1 |
% |
||||||||||
Emergency Room Visits |
|
2,134,956 |
|
|
1,784,870 |
|
|
8,224,617 |
|
|
7,142,579 |
|
||||
% Change |
|
19.6 |
% |
|
15.1 |
% |
||||||||||
* Excludes freestanding endoscopy centers (21 centers at both |
|
||||||||||||
Supplemental Non-GAAP Disclosures | ||||||||||||
Operating Results Summary | ||||||||||||
(Dollars in millions, except per share amounts) | ||||||||||||
For the Years | ||||||||||||
Fourth Quarter | Ended |
|||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||
Revenues |
|
|
|
|
|
|
|
|
||||
Net income attributable to |
|
|
|
|
|
|
|
|
||||
Losses (gains) on sales of facilities (net of tax) | (419 |
) |
- |
|
(1,214 |
) |
9 |
|
||||
Losses on retirement of debt (net of tax) | - |
|
- |
|
9 |
|
227 |
|
||||
Net income attributable to |
||||||||||||
of facilities and losses on retirement of debt (a) | 1,395 |
|
1,426 |
|
5,751 |
|
3,990 |
|
||||
Depreciation and amortization | 728 |
|
662 |
|
2,853 |
|
2,721 |
|
||||
Interest expense | 398 |
|
383 |
|
1,566 |
|
1,584 |
|
||||
Provision for income taxes | 437 |
|
379 |
|
1,709 |
|
1,109 |
|
||||
Net income attributable to noncontrolling interests | 191 |
|
268 |
|
765 |
|
633 |
|
||||
Adjusted EBITDA (a) |
|
|
|
|
|
|
|
|
||||
Adjusted EBITDA margin (a) | 20.9 |
% |
21.8 |
% |
21.5 |
% |
19.5 |
% |
||||
Diluted earnings per share: | ||||||||||||
Net income attributable to |
|
|
|
|
|
|
|
|
||||
Losses (gains) on sales of facilities | (1.33 |
) |
- |
|
(3.69 |
) |
0.02 |
|
||||
Losses on retirement of debt | - |
|
- |
|
0.03 |
|
0.66 |
|
||||
Net income attributable to |
||||||||||||
of facilities and losses on retirement of debt (a) |
|
|
|
|
|
|
|
|
||||
Shares used in computing diluted earnings per share (millions) | 315.418 |
|
345.374 |
|
328.752 |
|
343.605 |
|
(a) | Net income attributable to |
|||||||||||||||||
Management and investors review both the overall performance (including net income attributable to |
||||||||||||||||||
Net income attributable to |
Supplemental Non-GAAP Disclosures | ||||
2022 Operating Results Forecast | ||||
(Dollars in millions, except per share amounts) | ||||
For the Year Ending | ||||
Low | High | |||
Revenues |
|
|
||
Net income attributable to |
|
|
||
Depreciation and amortization | 2,980 |
3,020 |
||
Interest expense | 1,690 |
1,710 |
||
Provision for income taxes | 1,630 |
1,745 |
||
Net income attributable to noncontrolling interests | 700 |
740 |
||
Adjusted EBITDA (a) (b) |
|
|
||
Diluted earnings per share: | ||||
Net income attributable to |
|
|
||
Shares used in computing diluted earnings per share (millions) | 303.000 |
303.000 |
||
The Company's forecasted guidance range is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks. |
(a) | The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets because the Company does not believe that it can forecast these items with sufficient accuracy. | |||||||||||||
(b) | Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles ("GAAP"). We believe Adjusted EBITDA is an important measure that supplements discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon Adjusted EBITDA as a primary measure to review and assess operating performance of its health care facilities and their management teams. | |||||||||||||
Management and investors review both the overall performance (including net income attributable to |
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Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to |
View source version on businesswire.com: https://www.businesswire.com/news/home/20220127005298/en/
INVESTOR CONTACTS:
615-344-2688
MEDIA CONTACT:
615-344-1851
Source:
FAQ
What were HCA's fourth quarter 2021 revenues?
How did HCA's net income in Q4 2021 compare to Q4 2020?
What is HCA's plan for share repurchase in 2022?
When will HCA’s dividend be paid?