UNIVERSAL HEALTH SERVICES, INC. ANNOUNCES 2021 FOURTH QUARTER AND FULL YEAR FINANCIAL RESULTS, 2022 FULL YEAR EARNINGS GUIDANCE AND $1.4 BILLION INCREASE TO STOCK REPURCHASE PROGRAM
Universal Health Services reported a net income of $239.1 million or $3.00 per diluted share for Q4 2021, down from $308.7 million or $3.60 per diluted share in Q4 2020. Net revenues increased by 6.1% to $3.275 billion. For the full year 2021, net income was $991.6 million, or $11.82 per diluted share, on revenues of $12.642 billion, reflecting a 9.4% increase. The company expects 2022 revenues between $13.424 billion and $13.694 billion and adjusted EBITDA of $1.830 billion to $1.927 billion.
- Net revenues increased by 6.1% to $3.275 billion in Q4 2021.
- Net income for full year 2021 was $991.6 million, up from $944 million in 2020.
- Adjusted EPS for 2021 was $11.82, an increase from $11.12 in 2020.
- 2022 revenue guidance ranges from $13.424 billion to $13.694 billion.
- Q4 2021 net income down 22.5% compared to Q4 2020.
- Q4 2021 EBITDA decreased to $464.5 million from $557.2 million in Q4 2020.
- Net cash from operating activities dropped significantly to $884 million from $2.360 billion in 2020.
KING OF PRUSSIA, Pa., Feb. 24, 2022 /PRNewswire/ -- Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was
As reflected on the Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule"), our adjusted net income attributable to UHS during the fourth quarter of 2021 was
Included in our reported and adjusted net income attributable to UHS during the fourth quarter of 2021 was a net favorable after-tax impact of approximately
Included in our reported and adjusted net income attributable to UHS during the fourth quarter of 2020 were the following: (i) a favorable impact of approximately
As reflected on the Supplemental Schedule, included in our reported results during the fourth quarter of 2021, was a net aggregate favorable after-tax impact of
As reflected on the Supplemental Schedule, included in our reported results during the fourth quarter of 2020, was a net aggregate favorable after-tax impact of
As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization ("EBITDA net of NCI", NCI is net income attributable to noncontrolling interests), was
Consolidated Results of Operations, As Reported and As Adjusted – Twelve-month periods ended December 31, 2021 and 2020:
Reported net income attributable to UHS was
As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the twelve-month period ended December 31, 2021 was
Our reported and adjusted net income attributable to UHS during the twelve-month period ended December 31, 2021, included the following:
- a favorable after-tax impact of
$74.0 million , or $.88 per diluted share, resulting from approximately$97 million of revenues recorded during 2021 in connection with the Kentucky Medicaid Managed Care Hospital Rate Increase Program, covering the period of July 1, 2020 to December 31, 2021, as discussed below in Kentucky Hospital Rate Increase Program; - an unfavorable after-tax impact of approximately
$39.2 million , or $.47 per diluted share, resulting from a$52 million increase to our reserves for self-insured professional and general liability claims recorded during 2021 resulting from unfavorable trends experienced in connection with the number of asserted claims and reported incidents and estimates of losses for those claims, and; - an aggregate favorable after-tax impact of
$28.4 million , or $.34 per diluted share, resulting from approximately$38 million of aggregate commercial insurance proceeds received during 2021 in connection with: (i) the unfavorable economic impact resulting from the previously disclosed information technology incident that occurred during 2020 ($29 million aggregate proceeds received thus far representing partial recovery of the loss sustained), and; (ii) the COVID-19 pandemic (approximately$9 million of insurance proceeds received representing recovery of the policy maximum).
Our reported and adjusted net income attributable to UHS during the twelve-month period ended December 31, 2020, included the following: (i) a favorable impact of
As reflected on the Supplemental Schedule, included in our reported results during the twelve-month period ended December 31, 2021, were the following which, on a net aggregate basis, amounted to a de minimis amount: (i) an after-tax charge of
As reflected on the Supplemental Schedule, included in our reported results during the twelve-month period ended December 31, 2020, was a net aggregate unfavorable after-tax impact of
As calculated on the attached Supplemental Schedule, our EBITDA net of NCI, was
Acute Care Services – Three and twelve-month periods ended December 31, 2021 and 2020:
During the fourth quarter of 2021, at our acute care hospitals owned during both periods ("same facility basis"), adjusted admissions (adjusted for outpatient activity) increased by
At these facilities, excluding the CARES Act and other governmental stimulus revenues of approximately
During the twelve-month period ended December 31, 2021, at our acute care hospitals on a same facility basis, adjusted admissions increased by
Behavioral Health Care Services – Three and twelve-month periods ended December 31, 2021 and 2020:
During the fourth quarter of 2021, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by
At these facilities, excluding the CARES Act and other governmental stimulus revenues of approximately
During the twelve-month period ended December 31, 2021, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by
COVID-19
The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material effect on our operations and financial results since that time. The COVID-19 vaccination process commenced during the first quarter of 2021. Since that time through the second quarter of 2021, we had generally experienced a decline in COVID-19 patients as well as a corresponding recovery in non-COVID patient activity. However, during the third and fourth quarters of 2021, and continuing into the first quarter of 2022, our facilities have generally experienced an increase in COVID-19 patients resulting from the Delta and, more recently, the highly transmissible Omicron variants. Although booster doses for COVID-19 vaccinations began during the third quarter of 2021, and while we expect the administration of vaccines booster doses will assist in easing the number of COVID-19 patients, the pace at which this is likely to occur is very difficult to predict. Since the future volumes and severity of COVID-19 patients remain highly uncertain and subject to change, including potential increases in future COVID-19 patient volumes caused by new variants of the virus, as well as related pressures on staffing and wage rates, we are not able to fully quantify the impact that these factors will have on our future financial results. However, developments related to the COVID-19 pandemic could materially affect our financial performance during 2022.
Net Cash Provided by Operating Activities and Liquidity and Financing Transactions:
Net Cash Provided by Operating Activities:
For the twelve months ended December 31, 2021, our net cash provided by operating activities was
Liquidity and Financing Transactions:
As of December 31, 2021, we had
In connection with the various financing transactions completed during the third quarter of 2021, our results of operations for the twelve-month periods ended December 31, 2021, include a
Stock Repurchase Program and Increased Authorization:
On February 24, 2022, our Board of Directors authorized a
During the fourth quarter of 2021, pursuant to previous share repurchase authorizations, including a
As of December 31, 2021, prior to the above-mentioned increased authorization approved in February, 2022, we had an aggregate available repurchase authorization of
2022 Operating Results Forecast:
Reflected below is our 2022 guidance range for consolidated net revenues, earnings before interest, taxes, depreciation & amortization, and the impacts of other income/expense and net income attributable to noncontrolling interests ("Adjusted EBITDA net of NCI"), adjusted net income attributable to UHS per diluted share ("Adjusted EPS-diluted") and capital expenditures.
Adjusted EPS-diluted and Adjusted EBITDA net of NCI, are non-GAAP financial measures and should be examined in connection with net income determined in accordance with GAAP as presented in the consolidated financial statements and notes thereto in this report or in our filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2021. Please see the Supplemental Non-GAAP Disclosures - 2022 Operating Results Forecast schedule as included herein for additional information and a reconciliation to the financial forecasts as computed in accordance with GAAP.
For the Year Ended | ||
Low | High | |
Net revenues | ||
Adjusted EBITDA net of NCI | ||
Adjusted EPS-diluted | ||
Capital expenditures |
Our 2022 guidance contains a number of assumptions including, but not limited to, the following:
- The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material unfavorable effect on our operations and financial results since that time. The extent to which the COVID-19 pandemic and measures taken in response thereto impact our business, results of operations and financial condition will depend on numerous factors and future developments, most of which are beyond our control or ability to predict. The ultimate impact of the COVID-19 pandemic is highly uncertain and subject to change. We are not able to fully quantify the impact that these factors will have on our future financial results, but expect developments related to the COVID-19 pandemic to materially affect our financial performance in 2022 and may cause our 2022 actual operating results to differ materially from our 2022 operating results forecast. Please see additional disclosure above in COVID-19.
- The 2022 forecasted amounts exclude the impact of future items, if applicable, that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters including settlements, legal judgments and lawsuits, potential impacts of non-ordinary course acquisitions, divestitures, joint ventures or other strategic transactions, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, impairment of long-lived and intangible assets, other amounts that may be reflected in the current financial statements that relate to prior periods, and the impact of share repurchases that differ from our forecasted assumptions. It is also subject to certain conditions including those as set forth below in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures.
- Our net revenues are estimated to be approximately
$13.42 4 billion to$13.69 4 billion representing an increase of approximately6.2% to8.3% over our 2021 net revenues of approximately$12.64 2 billion. - Our Adjusted EBITDA net of NCI is estimated to be approximately
$1.83 0 billion to$1.92 7 billion as compared to our 2021 Adjusted EBITDA net of NCI of$1.90 0 billion. - Our Adjusted EPS-diluted range is estimated to be
$11.90 per diluted share to$12.90 per diluted share as compared to our adjusted net income attributable to UHS of$11.82 per diluted share for the year ended December 31, 2021, as calculated on the attached Supplemental Schedule.
Kentucky Hospital Rate Increase Program:
In early 2021, CMS approved the Kentucky Medicaid Managed Care Hospital Rate Increase Program ("HRIP") for SFY 2021, which covered the period of July 1, 2020 through June 30, 2021. In December 2021, CMS approved the HRIP program period for the period July 1, 2021 to December 31, 2021.
Included in our financial results for the three-month period ended December 31, 2021 is approximately
Programs such as HRIP require an annual state submission and approval by CMS. In December, 2021, CMS approved the program for the period of January 1, 2022 through December 31, 2022 at rates similar to the prior year. We estimate that our reimbursements pursuant to HRIP will approximate
Conference call information:
We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on February 25, 2022. The dial-in number is 1-877-648-7971.
A live broadcast of the conference call will be available on our website at www.uhs.com. Also, a replay of the call will be available following the conclusion of the live call and will be available for one full year.
General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures:
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2021 were approximately
Our operating philosophy is as effective today as it was upon the Company's founding in 1979, enabling us to provide compassionate care to our patients and their loved ones. Our strategy includes building or acquiring high quality hospitals in rapidly growing markets, investing in the people and equipment needed to allow each facility to thrive, and becoming the leading healthcare provider in each community we serve.
Headquartered in King of Prussia, PA, UHS has over 89,000 employees and through its subsidiaries operates 27 acute care hospitals, 335 behavioral health facilities, 40 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 39 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. In addition, UHS also has under construction, a new 170-bed acute care hospital located in Reno, Nevada, that is scheduled to be completed and opened during the first quarter of 2022. It acts as the advisor to Universal Health Realty Income Trust, a real estate investment trust (NYSE:UHT). For additional information visit www.uhs.com.
This press release contains forward-looking statements based on current management expectations. Numerous factors, including those disclosed herein, those related to the anticipated impact of COVID-19 on our operations and financial results, those related to healthcare industry trends and those detailed in our filings with the Securities and Exchange Commission (as set forth in Item 1A-Risk Factors and in Item 7-Forward-Looking Statements and Risk Factors in our Form 10-K for the year ended December 31, 2021), may cause the results to differ materially from those anticipated in the forward-looking statements. These statements are subject to risks and uncertainties and therefore actual results may differ materially. Readers should not place undue reliance on such forward-looking statements which reflect management's view 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. Many of the factors that could affect our future results are beyond our control or ability to predict, including the impact of the COVID-19 pandemic. Our future operations and financial results will likely be materially impacted by developments related to COVID-19 including, but not limited to, the potential impact on future COVID-19 patient volumes resulting from new variants of the virus, the length of time and severity of the spread of the pandemic; the volume of cancelled or rescheduled elective procedures and the volume of COVID-19 patients treated at our hospitals and other healthcare facilities; measures we are taking to respond to the COVID-19 pandemic; the impact of government and administrative regulation and stimulus on the hospital industry and potential retrospective adjustment in future periods of CARES Act and other grant income revenues recorded as revenues in prior periods; declining patient volumes and unfavorable changes in payer mix caused by deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients as the result of business closings and layoffs); potential disruptions to our clinical staffing and shortages and disruptions related to supplies required for our employees and patients; and potential increases to expenses related to staffing, supply chain or other expenditures; the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financing perspective; and changes in general economic conditions nationally and regionally in our markets resulting from the COVID-19 pandemic. We are not able to fully quantify the impact that these factors will have on our future financial results, but developments related to the COVID-19 pandemic could materially affect our financial performance during 2022.
We believe that adjusted net income attributable to UHS, adjusted net income attributable to UHS per diluted share, EBITDA net of NCI and Adjusted EBITDA net of NCI, which are non-GAAP financial measures ("GAAP" is Generally Accepted Accounting Principles in the United States of America), are helpful to our investors as measures of our operating performance. In addition, we believe that, when applicable, comparing and discussing our financial results based on these measures, as calculated, is helpful to our investors since it neutralizes the effect of material items impacting our net income attributable to UHS, such as, the impact of ASU 2016-09, unrealized gains/losses resulting from changes in the market value of shares of certain equity securities, and other potential material items that are nonrecurring or non-operational in nature including, but not limited to, impairments of long-lived and intangible assets, reserves for various matters including settlements, legal judgments and lawsuits, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. To obtain a complete understanding of our financial performance these measures should be examined in connection with net income attributable to UHS, as determined in accordance with GAAP, and as presented in the condensed consolidated financial statements and notes thereto in this report or in our other filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2021. Since the items included or excluded from these measures are significant components in understanding and assessing financial performance under GAAP, these measures should not be considered to be alternatives to net income as a measure of our operating performance or profitability. Since these measures, as presented, are not determined in accordance with GAAP and are thus susceptible to varying calculations, they may not be comparable to other similarly titled measures of other companies. Investors are encouraged to use GAAP measures when evaluating our financial performance.
Universal Health Services, Inc. | |||||||
Consolidated Statements of Income | |||||||
(in thousands, except per share amounts) | |||||||
(unaudited) | |||||||
Three months | Twelve months | ||||||
ended December 31, | ended December 31, | ||||||
2021 | 2020 | 2021 | 2020 | ||||
Net revenues | |||||||
Operating charges: | |||||||
Salaries, wages and benefits | 1,621,788 | 1,466,070 | 6,163,944 | 5,613,097 | |||
Other operating expenses | 802,279 | 690,560 | 3,035,869 | 2,672,762 | |||
Supplies expense | 374,157 | 351,324 | 1,427,134 | 1,288,132 | |||
Depreciation and amortization | 133,363 | 133,930 | 533,213 | 510,493 | |||
Lease and rental expense | 30,015 | 31,092 | 118,863 | 116,059 | |||
2,961,602 | 2,672,976 | 11,279,023 | 10,200,543 | ||||
Income from operations | 313,649 | 413,959 | 1,363,094 | 1,358,354 | |||
Interest expense, net | 19,217 | 19,886 | 83,672 | 106,285 | |||
Other (income) expense, net | (12,316) | (8,305) | (13,891) | (14) | |||
Income before income taxes | 306,748 | 402,378 | 1,293,313 | 1,252,083 | |||
Provision for income taxes | 72,837 | 94,644 | 305,681 | 299,293 | |||
Net income | 233,911 | 307,734 | 987,632 | 952,790 | |||
Less: Net income (loss) attributable to | |||||||
noncontrolling interests ("NCI") | (5,213) | (974) | (3,958) | 8,837 | |||
Net income attributable to UHS | |||||||
Basic earnings per share attributable to UHS (a) | |||||||
Diluted earnings per share attributable to UHS (a) |
Universal Health Services, Inc. | |||||||
Footnotes to Consolidated Statements of Income | |||||||
(in thousands, except per share amounts) | |||||||
(unaudited) | |||||||
Three months | Twelve months | ||||||
(a) Earnings per share calculation: | ended December 31, | ended December 31, | |||||
2021 | 2020 | 2021 | 2020 | ||||
Basic and diluted: | |||||||
Net income attributable to UHS | |||||||
Less: Net income attributable to unvested restricted share grants | (450) | (994) | (2,059) | (2,981) | |||
Net income attributable to UHS - basic and diluted | |||||||
Weighted average number of common shares - basic | 78,808 | 84,728 | 82,519 | 85,061 | |||
Basic earnings per share attributable to UHS: | |||||||
Weighted average number of common shares | 78,808 | 84,728 | 82,519 | 85,061 | |||
Add: Other share equivalents | 867 | 859 | 1,173 | 526 | |||
Weighted average number of common shares and equiv. - diluted | 79,675 | 85,587 | 83,692 | 85,587 | |||
Diluted earnings per share attributable to UHS: |
Universal Health Services, Inc. | |||||||
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule") | |||||||
For the Three Months ended December 31, 2021 and 2020 | |||||||
(in thousands, except per share amounts) | |||||||
(unaudited) | |||||||
Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization | |||||||
Three months ended | % Net | Three months ended | % Net | ||||
December 31, 2021 | revenues | December 31, 2020 | revenues | ||||
Net income attributable to UHS | |||||||
Depreciation and amortization | 133,363 | 133,930 | |||||
Interest expense, net | 19,217 | 19,886 | |||||
Provision for income taxes | 72,837 | 94,644 | |||||
EBITDA net of NCI | |||||||
Other (income) expense, net | (12,316) | (8,305) | |||||
Adjusted EBITDA net of NCI | |||||||
Net revenues | |||||||
Calculation of Adjusted Net Income Attributable to UHS | |||||||
Three months ended | Three months ended | ||||||
December 31, 2021 | December 31, 2020 | ||||||
Per | Per | ||||||
Amount | Diluted Share | Amount | Diluted Share | ||||
Net income attributable to UHS | |||||||
Plus/minus after-tax adjustments: | |||||||
Unrealized gain on equity securities | (4,119) | (0.05) | (3,880) | (0.05) | |||
Impact of ASU 2016-09 | 99 | - | 3,031 | 0.04 | |||
Subtotal adjustments | (4,020) | (0.05) | (849) | (0.01) | |||
Adjusted net income attributable to UHS |
Universal Health Services, Inc. | |||||||
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule") | |||||||
For the Twelve months ended December 31, 2021 and 2020 | |||||||
(in thousands, except per share amounts) | |||||||
(unaudited) | |||||||
Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization | |||||||
Twelve months ended | % Net | Twelve months ended | % Net | ||||
December 31, 2021 | revenues | December 31, 2020 | revenues | ||||
Net income attributable to UHS | |||||||
Depreciation and amortization | 533,213 | 510,493 | |||||
Interest expense, net | 83,672 | 106,285 | |||||
Provision for income taxes | 305,681 | 299,293 | |||||
EBITDA net of NCI | |||||||
Other (income) expense, net | (13,891) | (14) | |||||
Adjusted EBITDA net of NCI | |||||||
Net revenues | |||||||
Calculation of Adjusted Net Income Attributable to UHS | |||||||
Twelve months ended | Twelve months ended | ||||||
December 31, 2021 | December 31, 2020 | ||||||
Per | Per | ||||||
Amount | Diluted Share | Amount | Diluted Share | ||||
Net income attributable to UHS | |||||||
Plus/minus after-tax adjustments: | |||||||
Unrealized (gain) loss on equity securities | (10,374) | (0.12) | 3,313 | 0.04 | |||
Debt extinguishment costs | 12,884 | 0.15 | - | - | |||
Impact of ASU 2016-09 | (2,423) | (0.03) | 7,443 | 0.09 | |||
Subtotal adjustments | 87 | - | 10,756 | 0.13 | |||
Adjusted net income attributable to UHS |
Universal Health Services, Inc. | |||||||
Consolidated Statements of Comprehensive Income | |||||||
(in thousands) | |||||||
(unaudited) | |||||||
Three months | Twelve months | ||||||
ended December 31, | ended December 31, | ||||||
2021 | 2020 | 2021 | 2020 | ||||
Net income | |||||||
Other comprehensive income (loss): | |||||||
Minimum pension liability | 1,427 | 4,428 | 1,427 | 4,428 | |||
Foreign currency translation adjustment | 2,441 | 31,899 | (20,743) | 13,619 | |||
Other comprehensive income (loss) before tax | 3,868 | 36,327 | (19,316) | 18,047 | |||
Income tax expense (benefit) related to items of other comprehensive income (loss) | 471 | 2,728 | (1,487) | 1,820 | |||
Total other comprehensive income (loss), net of tax | 3,397 | 33,599 | (17,829) | 16,227 | |||
Comprehensive income | 237,308 | 341,333 | 969,803 | 969,017 | |||
Less: Comprehensive income (loss) attributable to noncontrolling interests | (5,213) | (974) | (3,958) | 8,837 | |||
Comprehensive income attributable to UHS |
Universal Health Services, Inc. | ||||||
Condensed Consolidated Balance Sheets | ||||||
(in thousands) | ||||||
(unaudited) | ||||||
December 31, | December 31, | |||||
2021 | 2020 | |||||
Assets | ||||||
Current assets: | ||||||
Cash and cash equivalents | $ | 115,301 | $ | 1,224,490 | ||
Accounts receivable, net | 1,746,635 | 1,728,928 | ||||
Supplies | 206,839 | 190,417 | ||||
Other current assets | 194,781 | 138,034 | ||||
Total current assets | 2,263,556 | 3,281,869 | ||||
Property and equipment | 10,770,702 | 9,885,888 | ||||
Less: accumulated depreciation | (4,896,427) | (4,512,764) | ||||
5,874,275 | 5,373,124 | |||||
Other assets: | ||||||
Goodwill | 3,962,624 | 3,882,715 | ||||
Deferred income taxes | 45,707 | 22,689 | ||||
Right of use assets-operating leases | 367,477 | 336,513 | ||||
Deferred charges | 6,525 | 4,985 | ||||
Other | 573,379 | 574,984 | ||||
Total Assets | $ | 13,093,543 | $ | 13,476,879 | ||
Liabilities and Stockholders' Equity | ||||||
Current liabilities: | ||||||
Current maturities of long-term debt | $ | 48,409 | $ | 331,998 | ||
Accounts payable and other liabilities | 1,860,490 | 1,668,671 | ||||
Medicare accelerated payments and deferred CARES Act and other grants | 6 | 376,151 | ||||
Operating lease liabilities | 64,484 | 59,796 | ||||
Federal and state taxes | 10,720 | 44,423 | ||||
Total current liabilities | 1,984,109 | 2,481,039 | ||||
Other noncurrent liabilities | 464,759 | 458,549 | ||||
Operating lease liabilities noncurrent | 304,624 | 278,303 | ||||
Medicare accelerated payments noncurrent | 0 | 322,617 | ||||
Long-term debt | 4,141,879 | 3,524,253 | ||||
Deferred income taxes | 0 | 5,582 | ||||
Redeemable noncontrolling interest | 5,119 | 4,569 | ||||
UHS common stockholders' equity | 6,089,664 | 6,317,146 | ||||
Noncontrolling interest | 103,389 | 84,821 | ||||
Total equity | 6,193,053 | 6,401,967 | ||||
Total Liabilities and Stockholders' Equity | $ | 13,093,543 | $ | 13,476,879 |
Universal Health Services, Inc. | |||
Consolidated Statements of Cash Flows | |||
(in thousands) | |||
(unaudited) | |||
Twelve months | |||
ended December 31, | |||
2021 | 2020 | ||
Cash Flows from Operating Activities: | |||
Net income | |||
Adjustments to reconcile net income to net | |||
cash provided by operating activities: | |||
Depreciation & amortization | 533,213 | 510,493 | |
(Gain) loss on sale of assets and businesses | (5,170) | 1,957 | |
Costs related to extinguishment of debt | 16,831 | 1,365 | |
Stock-based compensation expense | 73,686 | 65,837 | |
Provision for asset impairment | 14,391 | 0 | |
Changes in assets & liabilities, net of effects from | |||
acquisitions and dispositions: | |||
Accounts receivable | (8,873) | (145,901) | |
Accrued interest | 4,950 | (10,028) | |
Accrued and deferred income taxes | (54,030) | 9,593 | |
Other working capital accounts | 46,526 | 124,545 | |
Medicare accelerated payments and deferred CARES Act and other grants | (698,762) | 698,768 | |
Other assets and deferred charges | (39,337) | (4,555) | |
Other | (82,075) | 109,167 | |
Accrued insurance expense, net of commercial premiums paid | 186,215 | 159,223 | |
Payments made in settlement of self-insurance claims | (91,502) | (113,085) | |
Net cash provided by operating activities | 883,695 | 2,360,169 | |
Cash Flows from Investing Activities: | |||
Property and equipment additions | (855,659) | (731,307) | |
Proceeds received from sales of assets and businesses | 25,425 | 8,168 | |
Acquisition of businesses and property | (105,415) | (52,009) | |
Inflows (outflows) from foreign exchange contracts that hedge our net U.K. investment | 1,357 | (21,740) | |
Decrease (increase) in capital reserves of commercial insurance subsidiary | 100 | (100) | |
Costs incurred for purchase of information technology applications, net of refunds | 19,726 | (2,902) | |
Investment in, and advances to, joint ventures and other | 0 | (2,672) | |
Net cash used in investing activities | (914,466) | (802,562) | |
Cash Flows from Financing Activities: | |||
Repayments of long-term debt | (3,037,868) | (962,567) | |
Additional borrowings | 3,254,974 | 801,599 | |
Financing costs | (18,770) | (10,300) | |
Repurchase of common shares | (1,220,875) | (206,719) | |
Dividends paid | (65,896) | (17,344) | |
Issuance of common stock | 13,372 | 12,318 | |
Profit distributions to noncontrolling interests | (7,080) | (19,805) | |
Purchase of ownership interests by minority members | 13,193 | 17,959 | |
Net cash used in financing activities | (1,068,950) | (384,859) | |
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (499) | 739 | |
(Decrease) increase in cash, cash equivalents and restricted cash | (1,100,220) | 1,173,487 | |
Cash, cash equivalents and restricted cash, beginning of period | 1,279,154 | 105,667 | |
Cash, cash equivalents and restricted cash, end of period | |||
Supplemental Disclosures of Cash Flow Information: | |||
Interest paid | |||
Income taxes paid, net of refunds | |||
Noncash purchases of property and equipment |
Universal Health Services, Inc. | |||||||||
Supplemental Statistical Information | |||||||||
(unaudited) | |||||||||
% Change | % Change | ||||||||
3 Months ended | 12 Months ended | ||||||||
Same Facility: | 12/31/2021 | 12/31/2021 | |||||||
Acute Care Hospitals | |||||||||
Revenues (a) | |||||||||
Revenues-excludes governmental stimulus program revenues | |||||||||
Adjusted Admissions | |||||||||
Adjusted Patient Days | |||||||||
Revenue Per Adjusted Admission-excludes governmental stimulus program revenues | |||||||||
Revenue Per Adjusted Patient Day-excludes governmental stimulus program revenues | |||||||||
Behavioral Health Hospitals | |||||||||
Revenues (b) | |||||||||
Revenues-excludes governmental stimulus program revenues | |||||||||
Adjusted Admissions | |||||||||
Adjusted Patient Days | |||||||||
Revenue Per Adjusted Admission-excludes governmental stimulus program revenues | |||||||||
Revenue Per Adjusted Patient Day-excludes governmental stimulus program revenues | |||||||||
(a) Includes governmental stimulus program revenues of | |||||||||
(b) Includes governmental stimulus program revenues of | |||||||||
UHS Consolidated | Fourth Quarter Ended | Twelve months Ended | |||||||
12/31/2021 | 12/31/2020 | 12/31/2021 | 12/31/2020 | ||||||
Revenues | |||||||||
EBITDA net of NCI | |||||||||
EBITDA Margin net of NCI | |||||||||
Adjusted EBITDA net of NCI | |||||||||
Adjusted EBITDA Margin net of NCI | |||||||||
Cash Flow From Operations | |||||||||
Days Sales Outstanding | 49 | 50 | 50 | 55 | |||||
Capital Expenditures | |||||||||
Debt | |||||||||
UHS' Shareholders Equity | |||||||||
Debt / Total Capitalization | |||||||||
Debt / EBITDA net of NCI (1) | 2.19 | 2.07 | |||||||
Debt / Adjusted EBITDA net of NCI (1) | 2.21 | 2.07 | |||||||
Debt / Cash From Operations (1) | 4.74 | 1.63 | |||||||
Net Debt / EBITDA net of NCI (1) (2) | 2.19 | 1.45 | |||||||
Net Debt / Adjusted EBITDA net of NCI (1) (2) | 2.21 | 1.45 | |||||||
Net Debt / Cash From Operations (1) (2) | 4.74 | 1.14 | |||||||
(1) Latest 4 quarters. | |||||||||
(2) Debt, net of approximately |
Universal Health Services, Inc. | ||||||||||||||||
Acute Care Hospital Services | ||||||||||||||||
For the Three and Twelve months ended | ||||||||||||||||
December 31, 2021 and 2020 | ||||||||||||||||
(in thousands) | ||||||||||||||||
Same Facility Basis - Acute Care Hospital Services | ||||||||||||||||
Three months ended | Three months ended | Twelve months ended | Twelve months ended | |||||||||||||
December 31, 2021 | December 31, 2020 | December 31, 2021 | December 31, 2020 | |||||||||||||
Amount | % of Net | Amount | % of Net | Amount | % of Net | Amount | % of Net | |||||||||
Net revenues (a) | ||||||||||||||||
Operating charges: | ||||||||||||||||
Salaries, wages and benefits | 794,807 | 701,927 | 2,947,853 | 2,611,143 | ||||||||||||
Other operating expenses | 440,571 | 375,958 | 1,656,848 | 1,462,627 | ||||||||||||
Supplies expense | 317,142 | 299,376 | 1,218,969 | 1,081,154 | ||||||||||||
Depreciation and amortization | 81,153 | 83,321 | 327,774 | 318,077 | ||||||||||||
Lease and rental expense | 17,758 | 19,414 | 73,421 | 69,638 | ||||||||||||
Subtotal-operating expenses | 1,651,431 | 1,479,996 | 6,224,865 | 5,542,639 | ||||||||||||
Income from operations | 133,602 | 229,876 | 738,762 | 695,597 | ||||||||||||
Interest expense, net | 257 | 228 | 1,006 | 1,567 | ||||||||||||
Other (income) expense, net | 131 | - | - | 567 | - | - | ||||||||||
Income before income taxes | ||||||||||||||||
All Acute Care Hospital Services | ||||||||||||||||
Three months ended | Three months ended | Twelve months ended | Twelve months ended | |||||||||||||
December 31, 2021 | December 31, 2020 | December 31, 2021 | December 31, 2020 | |||||||||||||
Amount | % of Net | Amount | % of Net | Amount | % of Net | Amount | % of Net | |||||||||
Net revenues (a) | ||||||||||||||||
Operating charges: | ||||||||||||||||
Salaries, wages and benefits | 811,080 | 702,099 | 2,968,140 | 2,611,514 | ||||||||||||
Other operating expenses | 466,768 | 404,966 | 1,772,312 | 1,561,875 | ||||||||||||
Supplies expense | 322,010 | 299,383 | 1,224,664 | 1,081,159 | ||||||||||||
Depreciation and amortization | 83,046 | 83,368 | 331,508 | 318,124 | ||||||||||||
Lease and rental expense | 19,715 | 19,414 | 75,391 | 69,638 | ||||||||||||
Subtotal-operating expenses | 1,702,619 | 1,509,230 | 6,372,015 | 5,642,310 | ||||||||||||
Income from operations | 134,635 | 229,516 | 736,239 | 694,994 | ||||||||||||
Interest expense, net | 257 | 228 | 1,006 | 1,567 | ||||||||||||
Other (income) expense, net | 131 | - | - | 567 | - | - | ||||||||||
Income before income taxes |
(a) Includes governmental stimulus program revenues of |
We believe that providing our results on a "Same Facility" basis (which is a non-GAAP measure), which includes the operating results for facilities and businesses operated in both the current year and prior year periods, is helpful to our investors as a measure of our operating performance. Our Same Facility results also neutralize (if applicable), the effect of material items that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters, settlements, legal judgments and lawsuits, cost related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of long-lived and intangible assets and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. Our Same Facility basis results exclude from net revenues and other operating expenses, provider tax assessments incurred in each period. However, these provider tax assessments are included in net revenues and other operating expenses as reflected in the table under All Acute Care Hospital Services. The provider tax assessments had no impact on the income before income taxes as reflected on the above tables since the amounts offset between net revenues and other operating expenses. To obtain a complete understanding of our financial performance, the Same Facility results should be examined in connection with our net income as determined in accordance with GAAP and as presented herein and the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2021. |
The All Acute Care Hospital Services table summarizes the results of operations for all our acute care operations during the periods presented. These amounts include: (i) our acute care results on a same facility basis, as indicated above; (ii) the impact of provider tax assessments which increased net revenues and other operating expenses but had no impact on income before income taxes, and; (iii) certain other amounts including the results of facilities acquired or opened during the last twelve months. |
Universal Health Services, Inc. | ||||||||||||||||
Behavioral Health Care Services | ||||||||||||||||
For the Three and Twelve months ended | ||||||||||||||||
December 31, 2021 and 2020 | ||||||||||||||||
(in thousands) | ||||||||||||||||
Same Facility - Behavioral Health Care Services | ||||||||||||||||
Three months ended | Three months ended | Twelve months ended | Twelve months ended | |||||||||||||
December 31, 2021 | December 31, 2020 | December 31, 2021 | December 31, 2020 | |||||||||||||
Amount | % of Net | Amount | % of Net | Amount | % of Net | Amount | % of Net | |||||||||
Net revenues (a) | ||||||||||||||||
Operating charges: | ||||||||||||||||
Salaries, wages and benefits | 740,469 | 695,839 | 2,874,224 | 2,717,905 | ||||||||||||
Other operating expenses | 261,161 | 236,198 | 1,037,248 | 929,922 | ||||||||||||
Supplies expense | 52,081 | 50,681 | 203,516 | 204,442 | ||||||||||||
Depreciation and amortization | 45,377 | 45,660 | 182,303 | 175,537 | ||||||||||||
Lease and rental expense | 9,843 | 10,556 | 41,182 | 41,940 | ||||||||||||
Subtotal-operating expenses | 1,108,931 | 1,038,934 | 4,338,473 | 4,069,746 | ||||||||||||
Income from operations | 281,650 | 280,215 | 1,056,174 | 1,046,982 | ||||||||||||
Interest expense, net | 324 | 368 | 1,338 | 1,447 | ||||||||||||
Other (income) expense, net | (339) | (0.0)% | (1,277) | (0.1)% | 96 | 1,060 | ||||||||||
Income before income taxes | ||||||||||||||||
All Behavioral Health Care Services | ||||||||||||||||
Three months ended | Three months ended | Twelve months ended | Twelve months ended | |||||||||||||
December 31, 2021 | December 31, 2020 | December 31, 2021 | December 31, 2020 | |||||||||||||
Amount | % of Net | Amount | % of Net | Amount | % of Net | Amount | % of Net | |||||||||
Net revenues (a) | ||||||||||||||||
Operating charges: | ||||||||||||||||
Salaries, wages and benefits | 748,293 | 699,906 | 2,893,028 | 2,727,129 | ||||||||||||
Other operating expenses | 298,099 | 258,727 | 1,145,879 | 1,023,733 | ||||||||||||
Supplies expense | 52,567 | 50,850 | 204,840 | 204,711 | ||||||||||||
Depreciation and amortization | 46,891 | 47,931 | 187,761 | 182,012 | ||||||||||||
Lease and rental expense | 9,914 | 11,354 | 41,703 | 45,505 | ||||||||||||
Subtotal-operating expenses | 1,155,764 | 1,068,768 | 4,473,211 | 4,183,090 | ||||||||||||
Income from operations | 272,753 | 275,131 | 1,030,433 | 1,025,632 | ||||||||||||
Interest expense, net | 1,216 | 415 | 4,780 | 1,599 | ||||||||||||
Other (income) expense, net | (339) | (0.0)% | (1,561) | (0.1)% | 96 | 776 | ||||||||||
Income before income taxes |
(a) Includes governmental stimulus program revenues of |
We believe that providing our results on a "Same Facility" basis (which is a non-GAAP measure), which includes the operating results for facilities and businesses operated in both the current year and prior year periods, is helpful to our investors as a measure of our operating performance. Our Same Facility results also neutralize (if applicable), the effect of material items that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters, settlements, legal judgments, lawsuits and reserves established in connection with the government's investigation of our behavioral health care facilities, cost related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of long-lived and intangible assets and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. Our Same Facility basis results exclude from net revenues and other operating expenses, provider tax assessments incurred in each period. However, these provider tax assessments are included in net revenues and other operating expenses as reflected in the table under All Behavioral Health Care Services. The provider tax assessments had no impact on the income before income taxes as reflected on the above tables since the amounts offset between net revenues and other operating expenses. To obtain a complete understanding of our financial performance, the Same Facility results should be examined in connection with our net income as determined in accordance with GAAP and as presented herein and in the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2021. |
The All Behavioral Health Care Services table summarizes the results of operations for all our behavioral health care facilities during the periods presented. These amounts include: (i) our behavioral health results on a same facility basis, as indicated above; (ii) the impact of provider tax assessments which increased net revenues and other operating expenses but had no impact on income before income taxes, and; (iii) certain other amounts including the results of facilities acquired or opened during the last twelve months as well as the results of certain facilities that were closed or restructured during the past year. |
Universal Health Services, Inc. | ||||||||||||
Selected Hospital Statistics | ||||||||||||
For the Three Months ended | ||||||||||||
December 31, 2021 and 2020 | ||||||||||||
AS REPORTED: | ||||||||||||
ACUTE | BEHAVIORAL HEALTH | |||||||||||
12/31/21 | 12/31/20 | % change | 12/31/21 | 12/31/20 | % change | |||||||
Hospitals owned and leased | 27 | 26 | 335 | 334 | ||||||||
Average licensed beds | 6,654 | 6,476 | 24,154 | 23,859 | ||||||||
Average available beds | 6,482 | 6,304 | 24,054 | 23,759 | ||||||||
Patient days | 397,498 | 386,491 | 1,526,510 | 1,522,352 | ||||||||
Average daily census | 4,320.6 | 4,201.0 | 16,592.5 | 16,547.3 | ||||||||
Occupancy-licensed beds | - | |||||||||||
Occupancy-available beds | - | |||||||||||
Admissions | 77,352 | 72,877 | 111,132 | 109,514 | ||||||||
Length of stay | 5.1 | 5.3 | - | 13.4 | 13.4 | |||||||
Inpatient revenue | ||||||||||||
Outpatient revenue | 5,352,067 | 4,067,550 | 257,479 | 244,286 | ||||||||
Total patient revenue | 14,594,728 | 11,934,130 | 2,713,138 | 2,664,754 | ||||||||
Other revenue | 174,909 | 275,271 | - | 79,961 | 109,554 | - | ||||||
Gross hospital revenue | 14,769,637 | 12,209,401 | 2,793,099 | 2,774,308 | ||||||||
Total deductions | 12,932,383 | 10,470,655 | 1,364,582 | 1,430,409 | - | |||||||
Net hospital revenue | ||||||||||||
SAME FACILITY: | ||||||||||||
ACUTE | BEHAVIORAL HEALTH | |||||||||||
12/31/21 | 12/31/20 | % change | 12/31/21 | 12/31/20 | % change | |||||||
Hospitals owned and leased | 26 | 26 | 330 | 330 | ||||||||
Average licensed beds | 6,588 | 6,476 | 23,782 | 23,661 | ||||||||
Average available beds | 6,416 | 6,304 | 23,682 | 23,561 | ||||||||
Patient days | 394,045 | 386,491 | 1,512,830 | 1,512,397 | ||||||||
Average daily census | 4,283.1 | 4,201.0 | 16,443.8 | 16,439.1 | ||||||||
Occupancy-licensed beds | - | |||||||||||
Occupancy-available beds | - | |||||||||||
Admissions | 77,046 | 72,877 | 109,681 | 108,527 | ||||||||
Length of stay | 5.1 | 5.3 | - | 13.8 | 13.9 | - |
Universal Health Services, Inc. | ||||||||||||
Selected Hospital Statistics | ||||||||||||
For the Twelve months ended | ||||||||||||
December 31, 2021 and 2020 | ||||||||||||
AS REPORTED: | ||||||||||||
ACUTE | BEHAVIORAL HEALTH | |||||||||||
12/31/21 | 12/31/20 | % change | 12/31/21 | 12/31/20 | % change | |||||||
Hospitals owned and leased | 27 | 26 | 335 | 334 | ||||||||
Average licensed beds | 6,566 | 6,457 | 24,132 | 23,661 | ||||||||
Average available beds | 6,394 | 6,285 | 24,030 | 23,559 | ||||||||
Patient days | 1,568,639 | 1,458,321 | 6,162,780 | 6,142,823 | ||||||||
Average daily census | 4,297.6 | 3,984.5 | 16,884.3 | 16,783.7 | ||||||||
Occupancy-licensed beds | - | |||||||||||
Occupancy-available beds | - | |||||||||||
Admissions | 305,296 | 286,535 | 457,006 | 448,870 | ||||||||
Length of stay | 5.1 | 5.1 | 13.5 | 13.7 | - | |||||||
Inpatient revenue | ||||||||||||
Outpatient revenue | 20,633,921 | 16,272,520 | 1,013,547 | 963,799 | ||||||||
Total patient revenue | 57,156,076 | 46,834,613 | 10,940,948 | 10,682,733 | ||||||||
Other revenue | 659,136 | 788,694 | - | 269,435 | 332,766 | - | ||||||
Gross hospital revenue | 57,815,212 | 47,623,307 | 11,210,383 | 11,015,499 | ||||||||
Total deductions | 50,706,958 | 41,286,003 | 5,706,739 | 5,806,777 | - | |||||||
Net hospital revenue | ||||||||||||
SAME FACILITY: | ||||||||||||
ACUTE | BEHAVIORAL HEALTH | |||||||||||
12/31/21 | 12/31/20 | % change | 12/31/21 | 12/31/20 | % change | |||||||
Hospitals owned and leased | 26 | 26 | 330 | 330 | ||||||||
Average licensed beds | 6,543 | 6,457 | 23,740 | 23,477 | ||||||||
Average available beds | 6,371 | 6,285 | 23,638 | 23,375 | ||||||||
Patient days | 1,564,828 | 1,458,321 | 6,114,699 | 6,109,418 | ||||||||
Average daily census | 4,287.2 | 3,984.5 | 16,752.6 | 16,692.4 | ||||||||
Occupancy-licensed beds | - | |||||||||||
Occupancy-available beds | - | |||||||||||
Admissions | 304,955 | 286,535 | 451,493 | 445,737 | ||||||||
Length of stay | 5.1 | 5.1 | 13.5 | 13.7 | - |
Universal Health Services, Inc. | |||||||||
Supplemental Non-GAAP Disclosures | |||||||||
2022 Operating Results Forecast | |||||||||
(in thousands, except per share amounts) | |||||||||
Forecast For The Year Ending December 31, 2022 | |||||||||
% Net | % Net | ||||||||
Low | revenues | High | revenues | ||||||
Net revenues (a) | |||||||||
Adjusted net income attributable to UHS (a) (b) | |||||||||
Depreciation and amortization | 562,819 | 562,819 | |||||||
Interest expense | 124,941 | 124,941 | |||||||
Other (income) expense, net | (8,197) | (8,197) | |||||||
Provision for income taxes | 272,464 | 295,321 | |||||||
Adjusted EBITDA net of NCI (a) (c) | |||||||||
Adjusted net income attributable to UHS, per diluted share (a) (b) | |||||||||
Shares used in computing diluted earnings per share | 73,634 | 73,634 |
(a) The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material unfavorable effect on our operations and financial results. The extent to which the COVID-19 pandemic and measures taken in response thereto impact our business, results of operations and financial condition will depend on numerous factors and future developments, most of which are beyond our control or ability to predict. The ultimate impact of the COVID-19 pandemic is highly uncertain and subject to change. We are not able to fully quantify the impact that these factors will have on our future financial results, but expect developments related to the COVID-19 pandemic to materially affect our financial performance in 2022 and may cause our 2022 actual operating results to differ materially from our 2022 operating results forecast. |
(b) Adjusted net income attributable to UHS/per diluted share are non-GAAP financial measures. The 2022 forecasted amounts exclude the impact of future items, if applicable, that are nonrecurring or non-operational in nature including items such as pre-tax unrealized gains/losses resulting from changes in the market value of shares of certain equity securities, the impact of ASU 2016-09, and other potential material items including, but not limited to, reserves for various matters including settlements, legal judgments and lawsuits, potential impacts of non-ordinary course acquisitions, divestitures, joint ventures or other strategic transactions, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, impairment of long-lived and intangible assets, other amounts that may be reflected in the current financial statements that relate to prior periods, and the impact of share repurchases that differ from our forecasted assumptions. It is also subject to certain conditions including those as set forth below in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures. |
(c) Adjusted EBITDA net of NCI is a non-GAAP financial measure. To obtain a complete understanding of our financial performance, Adjusted EBITDA net of NCI should be examined in connection with net income determined in accordance with GAAP as presented in the consolidated financial statements and notes thereto in this report or in our filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2021. |
SOURCE Universal Health Services, Inc.
FAQ
What were Universal Health Services' earnings for Q4 2021?
How much did net revenues increase for UHS in Q4 2021?
What is the 2022 revenue guidance for UHS?