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HCA Reports Second Quarter 2019 Results

July 30, 2019 8:30 AM

Updates 2019 Guidance

NASHVILLE, Tenn.--(BUSINESS WIRE)-- HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2019.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20190730005393/en/

Key second quarter metrics (all percentage changes compare 2Q 2019 to 2Q 2018 unless otherwise noted):

Revenues in the second quarter of 2019 increased to $12.602 billion, compared to $11.529 billion in the second quarter of 2018. Net income attributable to HCA Healthcare, Inc. totaled $783 million, or $2.25 per diluted share, compared to $820 million, or $2.31 per diluted share, in the second quarter of 2018. Results for the second quarter of 2019 include gains on sales of facilities of $18 million, or $0.04 per diluted share. Second quarter of 2018 results included gains on sales of facilities of $9 million, or $0.02 per diluted share.

For the second quarter of 2019, Adjusted EBITDA totaled $2.293 billion, compared to $2.227 billion in the second quarter of 2018. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions increased 2.1 percent and same facility equivalent admissions increased 2.6 percent in the second quarter of 2019 compared to the prior year period. Same facility emergency room visits increased 3.0 percent in the second quarter of 2019, compared to the prior year period. Same facility inpatient surgeries declined 0.1 percent, while same facility outpatient surgeries increased 0.6 percent in the second quarter of 2019 compared to the same period of 2018. Same facility revenue per equivalent admission increased 1.7 percent in the second quarter of 2019 compared to the second quarter of 2018.

Salaries and benefits, supplies and other operating expenses totaled $10.317 billion, or 81.9 percent of revenues, in the second quarter of 2019, compared to $9.309 billion, or 80.8 percent of revenues, in the second quarter of 2018.

Six Months Ended June 30, 2019

Revenues for the six months ended June 30, 2019 totaled $25.119 billion compared to $22.952 billion in the same period of 2018. Net income attributable to HCA Healthcare, Inc. was $1.822 billion, or $5.22 per diluted share, compared to $1.964 billion, or $5.50 per diluted share, for the first six months of 2018. Results for the six months ended June 30, 2019 include gains on sales of facilities of $17 million, or $0.04 per diluted share. Results for the six months ended June 30, 2018 included gains on sales of facilities of $414 million, or $0.88 per diluted share.

Balance Sheet and Cash Flows from Operations

As of June 30, 2019, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $2.430 billion, total debt of $36.193 billion, and total assets of $45.449 billion. During the second quarter of 2019, capital expenditures totaled $964 million, excluding acquisitions. Cash flows provided by operating activities in the second quarter totaled $1.997 billion, compared to $1.582 billion in the second quarter of 2018.

During June 2019, we issued $5.000 billion aggregate principal amount of senior secured notes comprised of $2.000 billion aggregate principal amount of 4 1/8% senior secured notes due 2029, $1.000 billion aggregate principal amount of 5 1⁄8% senior secured notes due 2039 and $2.000 billion aggregate principal amount of 5 1⁄4% senior secured notes due 2049. During June 2019, we used the proceeds to temporarily reduce balances under our asset-based revolving credit facility.

During July 2019, we redeemed all $600 million outstanding aggregate principal amount of 4.25% senior secured notes due 2019, all $3.000 billion outstanding aggregate principal amount of 6.50% senior secured notes due 2020 and all $1.350 billion outstanding aggregate principal amount of 5.875% senior secured notes due 2022. Pretax losses on retirement of debt totaling $211 million for these redemptions will be recognized during the quarter ending September 30, 2019.

During the second quarter of 2019, the Company repurchased 1.928 million shares of its common stock at a cost of $242 million. For the six months ended June 30, 2019, the Company has repurchased 4.034 million shares at a cost of $520 million. The Company had $1.753 billion remaining under its existing repurchase authorization as of June 30, 2019.

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.40 per share on the Company’s common stock. The dividend will be paid on September 30, 2019 to stockholders of record at the close of business on September 3, 2019.

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.

2019 Guidance

The 2019 guidance ranges for the year are revised from our first quarter release and are as follows:

2019 Revised Guidance Range

Revenues

$50.5 to $51.5 billion

Adjusted EBITDA

$9.60 to $9.85 billion

EPS (diluted)

$10.25 to $10.65 per diluted share

Capital Expenditures

Approximately $3.7 billion

The Company’s 2019 guidance contains a number of assumptions, including:

Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.

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.”

Earnings Conference Call

HCA will host a conference call for investors at 9:00 a.m. Central Daylight Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed at: https://event.webcasts.com/starthere.jsp?ei=1234726&tp_key=fae8205a1b or through the Company’s Investor Relations web page at www.hcahealthcare.com.

About the Company

As of June 30, 2019, HCA operated 184 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 21 states and the United Kingdom.

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 December 31, 2019, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, (2) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Health Reform Law”), including the effects of court challenges to, any repeal of, or changes to, the Health Reform Law or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, (3) the effects related to the continued implementation of the sequestration spending reductions required under the Budget Control Act of 2011, and related legislation extending these reductions, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (4) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (5) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (6) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (7) the highly competitive nature of the health care business, (8) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (9) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (10) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (11) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (12) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (13) changes in accounting practices, (14) changes in general economic conditions nationally and regionally in our markets, (15) the emergence of and effects related to infectious diseases, (16) future divestitures which may result in charges and possible impairments of long-lived assets, (17) changes in business strategy or development plans, (18) delays in receiving payments for services provided, (19) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (20) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (21) the impact of potential cybersecurity incidents or security breaches, (22) our ongoing ability to demonstrate meaningful use of certified electronic health record technology, (23) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (24) the effects of the 2017 Tax Cuts and Jobs Act, including potential legislation or interpretive guidance that may be issued by federal and state taxing authorities or other standard-setting bodies, and (25) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2018 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

All references to “Company” and “HCA” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
Second Quarter
(Dollars in millions, except per share amounts)

2019

2018

Amount

Ratio

Amount

Ratio

Revenues

$12,602

100.0

%

$11,529

100.0

%

Salaries and benefits

5,837

46.3

5,274

45.8

Supplies

2,118

16.8

1,917

16.6

Other operating expenses

2,362

18.8

2,118

18.4

Equity in earnings of affiliates

(8

)

(0.1

)

(7

)

(0.1

)

Depreciation and amortization

636

5.0

562

4.9

Interest expense

477

3.8

436

3.8

Gains on sales of facilities

(18

)

(0.1

)

(9

)

(0.1

)

11,404

90.5

10,291

89.3

Income before income taxes

1,198

9.5

1,238

10.7

Provision for income taxes

271

2.1

272

2.3

Net income

927

7.4

966

8.4

Net income attributable to noncontrolling interests

144

1.2

146

1.3

Net income attributable to HCA Healthcare, Inc.

$783

6.2

$820

7.1

Diluted earnings per share

$2.25

$2.31

Shares used in computing diluted earnings per share (millions)

348.373

355.039

Comprehensive income attributable to HCA Healthcare, Inc.

$726

$756

HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
For the Six Months Ended June 30, 2019 and 2018
(Dollars in millions, except per share amounts)

2019

2018

Amount

Ratio

Amount

Ratio

Revenues

$25,119

100.0

%

$22,952

100.0

%

Salaries and benefits

11,484

45.7

10,563

46.0

Supplies

4,159

16.6

3,832

16.7

Other operating expenses

4,661

18.6

4,228

18.5

Equity in earnings of affiliates

(19

)

(0.1

)

(16

)

(0.1

)

Depreciation and amortization

1,255

5.0

1,115

4.8

Interest expense

938

3.7

867

3.8

Gains on sales of facilities

(17

)

(0.1

)

(414

)

(1.8

)

22,461

89.4

20,175

87.9

Income before income taxes

2,658

10.6

2,777

12.1

Provision for income taxes

550

2.2

529

2.3

Net income

2,108

8.4

2,248

9.8

Net income attributable to noncontrolling interests

286

1.1

284

1.2

Net income attributable to HCA Healthcare, Inc.

$1,822

7.3

$1,964

8.6

Diluted earnings per share

$5.22

$5.50

Shares used in computing diluted earnings per share (millions)

349.334

357.388

Comprehensive income attributable to HCA Healthcare, Inc.

$1,772

$1,981

HCA Healthcare, Inc.
Condensed Consolidated Balance Sheets
(Dollars in millions)
June 30, March 31, December 31,

2019

2019

2018

ASSETS
Current assets:
Cash and cash equivalents

$2,430

$531

$502

Accounts receivable

7,219

7,420

6,789

Inventories

1,826

1,778

1,732

Other

1,394

1,379

1,190

Total current assets

12,869

11,108

10,213

Property and equipment, at cost

45,369

44,583

42,965

Accumulated depreciation

(23,902

)

(23,455

)

(23,208

)

21,467

21,128

19,757

Investments of insurance subsidiaries

342

338

362

Investments in and advances to affiliates

247

246

232

Goodwill and other intangible assets

8,140

8,159

7,953

Right-of-use operating lease assets

1,787

1,812

-

Other

597

588

690

$45,449

$43,379

$39,207

LIABILITIES AND STOCKHOLDERS' DEFICIT
Current liabilities:
Accounts payable

$2,609

$2,693

$2,577

Accrued salaries

1,497

1,424

1,580

Other accrued expenses

2,782

2,618

2,624

Long-term debt due within one year

2,073

3,796

788

Total current liabilities

8,961

10,531

7,569

Long-term debt, less debt issuance costs and discounts of $252, $170 and $157

34,120

31,019

32,033

Professional liability risks

1,354

1,313

1,275

Right-of-use operating lease obligations

1,460

1,494

-

Income taxes and other liabilities

1,324

1,277

1,248

EQUITY (DEFICIT)
Stockholders' deficit attributable to HCA Healthcare, Inc.

(3,902

)

(4,354

)

(4,950

)

Noncontrolling interests

2,132

2,099

2,032

Total deficit

(1,770

)

(2,255

)

(2,918

)

$45,449

$43,379

$39,207

HCA Healthcare, Inc.
Consolidated Statements of Cash Flows
For the Six Months Ended June 30, 2019 and 2018
(Dollars in millions)

2019

2018

Cash flows from operating activities:
Net income

$2,108

$2,248

Adjustments to reconcile net income to net cash provided by operating activities:
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable

(174

)

(233

)

Inventories and other assets

(231

)

(200

)

Accounts payable and accrued expenses

(238

)

31

Depreciation and amortization

1,255

1,115

Income taxes

27

118

Gains on sales of facilities

(17

)

(414

)

Amortization of debt issuance costs and discounts

16

15

Share-based compensation

158

134

Other

67

51

Net cash provided by operating activities

2,971

2,865

Cash flows from investing activities:
Purchase of property and equipment

(1,745

)

(1,574

)

Acquisition of hospitals and health care entities

(1,504

)

(538

)

Disposition of hospitals and health care entities

41

799

Change in investments

59

23

Other

36

(25

)

Net cash used in investing activities

(3,113

)

(1,315

)

Cash flows from financing activities:
Issuance of long-term debt

6,451

-

Net change in revolving credit facilities

(3,040

)

210

Repayment of long-term debt

(98

)

(101

)

Distributions to noncontrolling interests

(247

)

(185

)

Payment of debt issuance costs

(63

)

(2

)

Payment of cash dividends

(278

)

(245

)

Repurchase of common stock

(520

)

(893

)

Other

(135

)

(192

)

Net cash provided by (used in) financing activities

2,070

(1,408

)

Effect of exchange rate changes on cash and cash equivalents

-

(6

)

Change in cash and cash equivalents

1,928

136

Cash and cash equivalents at beginning of period

502

732

Cash and cash equivalents at end of period

$2,430

$868

Interest payments

$910

$873

Income tax payments, net

$523

$411

HCA Healthcare, Inc.
Operating Statistics
For the Six Months
Second Quarter Ended June 30,

2019

2018

2019

2018

Operations:
Number of Hospitals

184

178

184

178

Number of Freestanding Outpatient Surgery Centers

125

122

125

122

Licensed Beds at End of Period

48,483

46,723

48,483

46,723

Weighted Average Licensed Beds

48,429

46,667

48,234

46,676

Reported:
Admissions

518,253

494,610

1,041,449

1,002,483

% Change

4.8%

3.9%

Equivalent Admissions

903,419

851,047

1,793,375

1,700,211

% Change

6.2%

5.5%

Revenue per Equivalent Admission

$

13,949

$

13,547

$

14,007

$

13,499

% Change

3.0%

3.8%

Inpatient Revenue per Admission

$

14,295

$

13,807

$

14,353

$

13,756

% Change

3.5%

4.3%

Patient Days

2,530,548

2,370,306

5,137,445

4,902,025

% Change

6.8%

4.8%

Equivalent Patient Days

4,412,348

4,080,800

8,846,680

8,313,834

% Change

8.1%

6.4%

Inpatient Surgery Cases

140,473

137,403

*

277,836

272,439

*
% Change

2.2%

2.0%

Outpatient Surgery Cases

253,441

246,013

*

494,287

478,496

*
% Change

3.0%

3.3%

Emergency Room Visits

2,253,337

2,148,338

4,540,777

4,450,450

% Change

4.9%

2.0%

Outpatient Revenues as a
Percentage of Patient Revenues

39.1%

38.6%

38.5%

37.9%

Average Length of Stay (days)

4.883

4.792

4.933

4.890

Occupancy

57.4%

55.8%

58.8%

58.0%

Same Facility:
Admissions

491,394

481,361

990,418

974,795

% Change

2.1%

1.6%

Equivalent Admissions

849,129

827,460

1,690,644

1,652,278

% Change

2.6%

2.3%

Revenue per Equivalent Admission

$

13,803

$

13,574

$

13,932

$

13,523

% Change

1.7%

3.0%

Inpatient Revenue per Admission

$

14,321

$

13,853

$

14,399

$

13,773

% Change

3.4%

4.5%

Inpatient Surgery Cases

132,815

132,963

263,088

263,283

% Change

-0.1%

-0.1%

Outpatient Surgery Cases

240,389

239,036

469,607

465,061

% Change

0.6%

1.0%

Emergency Room Visits

2,151,662

2,088,311

4,339,334

4,323,807

% Change

3.0%

0.4%

* Reclassifications between inpatient surgery cases and outpatient surgery cases for 2018 have been made to conform to the 2019 presentation.
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
Operating Results Summary
(Dollars in millions, except per share amounts)
For the Six Months
Second Quarter Ended June 30,

2019

2018

2019

2018

Revenues

$12,602

$11,529

$25,119

$22,952

Net income attributable to HCA Healthcare, Inc.

$783

$820

$1,822

$1,964

Gains on sales of facilities (net of tax)

(14

)

(8

)

(13

)

(313

)

Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities (a)

769

812

1,809

1,651

Depreciation and amortization

636

562

1,255

1,115

Interest expense

477

436

938

867

Provision for income taxes

267

271

546

428

Net income attributable to noncontrolling interests

144

146

286

284

Adjusted EBITDA (a)

$2,293

$2,227

$4,834

$4,345

Adjusted EBITDA margin (a)

18.2%

19.3%

19.2%

18.9%

Diluted earnings per share:
Net income attributable to HCA Healthcare, Inc.

$2.25

$2.31

$5.22

$5.50

Gains on sales of facilities

(0.04

)

(0.02

)

(0.04

)

(0.88

)

Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities (a)

$2.21

$2.29

$5.18

$4.62

Shares used in computing diluted earnings per share (millions)

348.373

355.039

349.334

357.388

______________

(a) Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles ("GAAP"). We believe net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities, and Adjusted EBITDA are important measures that supplement 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 net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities, and Adjusted EBITDA as the primary measures 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 HCA Healthcare, Inc., excluding gains on sales of facilities, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that gains on sales of facilities will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.
Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
2019 Operating Results Forecast
(Dollars in millions, except per share amounts)
For the Year Ending
December 31, 2019
Low High
Revenues

$50,500

$51,500

Net income attributable to HCA Healthcare, Inc. (a)

$3,580

$3,720

Depreciation and amortization

2,535

2,575

Interest expense

1,825

1,850

Provision for income taxes

1,070

1,115

Net income attributable to noncontrolling interests

590

590

Adjusted EBITDA (a) (b)

$9,600

$9,850

Diluted earnings per share:
Net income attributable to HCA Healthcare, Inc.

$10.25

$10.65

Shares used in computing diluted earnings per share (millions)

349.200

349.200

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 HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry.
Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

INVESTOR CONTACT:

Mark Kimbrough

615-344-2688

MEDIA CONTACT:

Ed Fishbough

615-344-2810

Source: HCA Healthcare, Inc.

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