Tenet Reports Fourth Quarter 2010 Results

Feb 25, 2011 8:20am

Earnings of $0.14 per diluted share in Q4’10, compared to $0.04 in Q4’09

Company Confirms 2011 Outlook

DALLAS--(BUSINESS WIRE)-- Tenet Healthcare Corporation (NYSE:THC):

Fourth Quarter 2010 Key Metrics

Net income attributable to common shareholders of $74 million in Q4’10, compared to $21 million in Q4’09, an increase of 252 percent
Adjusted EBITDA of $281 million in Q4’10, compared to $218 million in Q4’09, an increase of 28.9 percent
Adjusted EBITDA margin of 12.2 percent in Q4’10, compared to 9.6 percent in Q4’09, an increase of 260 basis points

2010 Key Metrics

Net income attributable to common shareholders of $1.119 billion in 2010, compared to $181 million in 2009 (2010 net income included the recognition of $1.043 billion of tax benefits)
Earnings of $2.04 per diluted share in 2010, compared to $0.37 per diluted share in 2009
Adjusted EBITDA of $1.050 billion in 2010, compared to $982 million in 2009, an increase of 6.9 percent
Adjusted EBITDA margin of 11.4 percent in 2010, compared to 10.9 percent in 2009, an increase of 50 basis points

Subsequent Events in Q1’11

California Provider Fee Program received CMS final approval on January 18, 2011
- $64 million will be recorded in net revenue in Q1’11

Tenet Healthcare Corporation (NYSE:THC) today reported adjusted EBITDA of $281 million for the fourth quarter ended December 31, 2010, an increase of $63 million, or 28.9 percent, compared to $218 million for the fourth quarter of 2009. Net income attributable to common shareholders for the fourth quarter of 2010 was $74 million, or $0.14 per diluted share, compared to $21 million, or $0.04 per diluted share, for the fourth quarter of 2009.

“Our volume trends showed significant improvement in November and December compared to the first ten months of the year. Those strengthening trends have continued into January and February 2011. In the fourth quarter of 2010 we achieved a 3.2 percent increase in paying outpatient visits compared to 2009’s fourth quarter. Strong pricing growth and continued excellent cost performance also contributed to a solid quarter. Our full year 2010 adjusted EBITDA of $1.05 billion is the highest in seven years, and the seventh consecutive year of EBITDA growth. Our adjusted EBITDA margin of 12.2 percent in the fourth quarter is the highest fourth quarter margin we’ve reported in seven years, and our full year 2010 margin of 11.4 percent is the highest in seven years,” said Trevor Fetter, president and chief executive officer. “We are reconfirming our 2011 outlook for adjusted EBITDA in a range of $1.150 billion to $1.250 billion and we are introducing our 2011 outlook for net cash provided by operating activities in the range of $570 million to $740 million.”

Discussion of Results (Percentage changes compare Q4’10 to Q4’09, unless otherwise noted.)

Admissions and paying admissions declined by 2.0 percent and 2.2 percent, respectively. These declines were smaller than the respective declines of 3.5 percent and 3.9 percent in the sequential third quarter of 2010. Outpatient visits and paying outpatient visits increased by 2.9 and 3.2 percent, respectively compared to the fourth quarter of 2009. Adjusted admissions increased by 0.4 percent compared to the fourth quarter of 2009.

Net operating revenues were $2.301 billion, an increase of $40 million, or 1.8 percent, compared to net operating revenues of $2.261 billion in the fourth quarter of 2009. Net patient revenues per adjusted patient day increased by 2.4 percent.

Total controllable operating expenses decreased by $33 million, or 1.8 percent. This decrease included a favorable variance in malpractice expense. Total controllable costs per adjusted patient day declined by twenty dollars, or 1.0 percent. Controllable operating expenses is defined as the sum of salaries, wages and benefits, supplies, and other operating expenses.

Bad debt expense increased to $191 million from $181 million in the fourth quarter of 2009, an increase of $10 million, or 5.5 percent. The ratio of bad debt expense to net operating revenues rose to 8.3 percent, compared to 8.0 percent in the fourth quarter of 2009, an increase of 30 basis points. The sum of uninsured and charity admissions were flat in the fourth quarter, compared to the fourth quarter of 2009.

Adjusted net cash provided by operating activities was $180 million in the fourth quarter of 2010 compared to $159 million in the fourth quarter of 2009, an increase of $21 million, or 13.2 percent. Adjusted free cash flow used in continuing operations was $16 million in the fourth quarter of 2010 compared to a use of $33 million in the fourth quarter of 2009, a favorable change of $17 million. This was primarily the result of a decrease in tax payments, partially offset by an increase in working capital. Net cash provided by operating activities was $175 million in the fourth quarter of 2010 compared to $141 million in the fourth quarter of 2009, an increase of $34 million, or 24.1 percent. Cash and cash equivalents were $405 million at December 31, 2010, an increase of $7 million from September 30, 2010. In addition to the above items, the increase in cash includes the receipt of $50 million from the sale of certain medical office buildings and the use of $21 million to purchase eleven outpatient centers.

Management’s Webcast Discussion of Fourth Quarter Results

Tenet management will discuss fourth quarter 2010 results on a webcast scheduled for 9:00 AM (ET) on February 25, 2011. This webcast may be accessed through Tenet’s website at www.tenethealth.com/investors. A set of slides, to which management intends to refer on the call, will be posted to the Company’s website at approximately 7:30 AM (ET).

Additional information regarding Tenet’s quarterly results of operations, including detailed tabular operational data, is contained in its Form 10-K report, which will be filed with the Securities and Exchange Commission and posted on the Tenet investor relations website before today’s webcast. This press release includes certain non-GAAP measures, such as Adjusted EBITDA and Adjusted Free Cash Flow. A reconciliation of these financial measures and the most directly comparable GAAP measure is included in the financial tables at the end of this release.

Tenet Healthcare Corporation is a health care services company whose subsidiaries and affiliates own and operate acute care hospitals, ambulatory surgery centers and diagnostic imaging centers. Tenet’s hospitals and related healthcare facilities are committed to providing high quality care to patients in the communities they serve. For more information, please visit www.tenethealth.com.

Some of the statements in this release may constitute forward-looking statements. Such forward-looking statements are based on our current expectations and could be affected by numerous factors and are subject to various risks and uncertainties discussed in our filings with the Securities and Exchange Commission, including our annual report on Form 10-K for the year ended Dec. 31, 2010, our quarterly reports on Form 10-Q, and periodic reports on Form 8-K. Do not rely on any forward-looking statement, as we cannot predict or control many of the factors that ultimately may affect our ability to achieve the results estimated. We make no promise to update any forward-looking statement, whether as a result of changes in underlying factors, new information, future events or otherwise.

Tenet uses its company web site to provide important information to investors about the company including the posting of important announcements regarding financial performance and corporate developments.


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
(Unaudited)

(Dollars in millions except per share amounts)	Three Months Ended December 31,
	2010			%		2009			%		Change

Net operating revenues	$	2,301		100.0	%	$	2,261		100.0	%	1.8	%
Operating expenses:
Salaries, wages and benefits		967		42.0	%		989		43.7	%	(2.2	)%
Supplies		394		17.1	%		394		17.4	%	—	%
Provision for doubtful accounts		191		8.3	%		181		8.0	%	5.5	%
Other operating expenses, net		468		20.3	%		479		21.3	%	(2.3	)%
Depreciation and amortization		101		4.4	%		95		4.2	%	6.3	%
Impairment of long-lived assets and goodwill, and restructuring charges		9		0.4	%		14		0.6	%
Litigation and investigation costs		6		0.3	%		18		0.8	%
Operating income		165		7.2	%		91		4.0	%
Interest expense		(101	)				(103	)
Loss from early extinguishment of debt		(2	)				—
Investment earnings		—					1
Income (loss) from continuing operations, before income taxes		62					(11	)
Income tax benefit (expense)		(2	)				35
Income from continuing operations, before discontinued operations		60					24
Discontinued operations:
Income from operations		15					4
Impairment of long-lived assets and goodwill, and restructuring charges, net		—					4
Net gain on sales of facilities		—					1
Income tax benefit (expense)		7					(4	)
Income from discontinued operations		22					5
Net income		82					29
Less: Preferred stock dividends		6					6
Less: Net income attributable to noncontrolling interests		2					2
Net income attributable to Tenet Healthcare Corporation common shareholders	$	74				$	21

Amounts attributable to Tenet Healthcare Corporation common shareholders
Income from continuing operations, net of tax	$	52				$	16
Income from discontinued operations, net of tax		22					5
Net income attributable to Tenet Healthcare Corporation common shareholders	$	74				$	21

Earnings per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations	$	0.11				$	0.03
Discontinued operations		0.04					0.01
	$	0.15				$	0.04
Diluted
Continuing operations	$	0.10				$	0.03
Discontinued operations		0.04					0.01
	$	0.14				$	0.04
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		485,549					481,131
Diluted		561,921					500,577


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
(Unaudited)

(Dollars in millions except per share amounts)	Year Ended December 31,
	2010			%		2009			%		Change

Net operating revenues	$	9,205		100.0	%	$	9,014		100.0	%	2.1	%
Operating expenses:
Salaries, wages and benefits		3,900		42.4	%		3,857		42.8	%	1.1	%
Supplies		1,577		17.1	%		1,569		17.4	%	0.5	%
Provision for doubtful accounts		740		8.0	%		697		7.7	%	6.2	%
Other operating expenses, net		1,938		21.1	%		1,909		21.2	%	1.5	%
Depreciation and amortization		394		4.3	%		386		4.3	%	2.1	%
Impairment of long-lived assets and goodwill, and restructuring charges		10		0.1	%		27		0.3	%
Litigation and investigation costs		12		0.1	%		31		0.3	%
Operating income		634		6.9	%		538		6.0	%
Interest expense		(424	)				(445	)
Gain (loss) from early extinguishment of debt		(57	)				97
Investment earnings		5					—
Net gain on sales of investments		—					15
Income from continuing operations, before income taxes		158					205
Income tax benefit		977					23
Income from continuing operations, before discontinued operations		1,135					228
Discontinued operations:
Income (loss) from operations		11					(10	)
Impairment of long-lived assets and goodwill, and restructuring charges, net		(1	)				(12	)
Net losses on sales of facilities		—					(1	)
Income tax benefit (expense)		7					(8	)
Income (loss) from discontinued operations		17					(31	)
Net income		1,152					197
Less: Preferred stock dividends		24					6
Less: Net income attributable to noncontrolling interests		9					10
Net income attributable to Tenet Healthcare Corporation common shareholders	$	1,119				$	181

Amounts attributable to Tenet Healthcare Corporation common shareholders
Income from continuing operations, net of tax	$	1,102				$	212
Income (loss) from discontinued operations, net of tax		17					(31	)
Net income attributable to Tenet Healthcare Corporation common shareholders	$	1,119				$	181

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations	$	2.28				$	0.44
Discontinued operations		0.03					(0.06	)
	$	2.31				$	0.38
Diluted
Continuing operations	$	2.01				$	0.43
Discontinued operations		0.03					(0.06	)
	$	2.04				$	0.37
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		484,321					480,240
Diluted		560,631					507,277


TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEET DATA
(Unaudited)

	December 31,			December 31,
(Dollars in millions)	2010			2009
ASSETS
Current assets:
Cash and cash equivalents	$	405		$	690
Investments in Reserve Yield Plus Fund		1			2
Investments in marketable securities		—			11
Accounts receivable, less allowance for doubtful accounts		1,143			1,158
Inventories of supplies, at cost		156			153
Income tax receivable		22			35
Current portion of deferred income taxes		282			108
Assets held for sale		14			29
Other current assets		288			286
Total current assets		2,311			2,472
Investments and other assets		164			182
Deferred income taxes, net of current portion		627			—
Property and equipment, at cost, less accumulated depreciation and amortization		4,304			4,313
Goodwill		652			607
Other intangible assets, at cost, less accumulated amortization		442			379
Total assets	$	8,500		$	7,953

LIABILITIES AND EQUITY
Current liabilities:
Current portion of long-term debt	$	67		$	2
Accounts payable		720			739
Accrued compensation and benefits		363			370
Professional and general liability reserves		84			106
Accrued interest payable		115			127
Accrued legal settlement costs		8			76
Other current liabilities		368			363
Total current liabilities		1,725			1,783
Long-term debt, net of current portion		3,997			4,272
Professional and general liability reserves		383			466
Accrued legal settlement costs		22			19
Other long-term liabilities		554			568
Deferred income taxes		—			148
Total liabilities		6,681			7,256
Commitments and contingencies
Equity:
Shareholders’ equity:
Preferred stock		334			334
Common stock		27			27
Additional paid-in capital		4,449			4,461
Accumulated other comprehensive loss		(43	)		(32	)
Accumulated deficit		(1,522	)		(2,665	)
Less common stock in treasury, at cost		(1,479	)		(1,479	)
Total shareholders’ equity		1,766			646
Noncontrolling interests		53			51
Total equity		1,819			697
Total liabilities and equity	$	8,500		$	7,953


TENET HEALTHCARE CORPORATION
CONSOLIDATED CASH FLOW DATA
(Unaudited)

(Dollars in millions)	Year Ended December 31,
	2010			2009
Net income	$	1,152		$	197
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		394			386
Provision for doubtful accounts		740			697
Net gain on sales of investments		—			(15	)
Deferred income tax (benefit) expense		(952	)		20
Stock-based compensation expense		22			23
Impairment of long-lived assets and goodwill, and restructuring charges		10			27
Fair market value adjustments related to interest rate swap and LIBOR cap agreements		3			(1	)
Litigation and investigation costs		12			31
Loss (gain) from early extinguishment of debt		57			(97	)
Amortization of debt discount and issue costs		31			27
Pretax (gain) loss from discontinued operations		(10	)		23
Other items, net		(4	)		6
Changes in cash from changes in operating assets and liabilities:
Accounts receivable		(744	)		(646	)
Inventories and other current assets		(17	)		(22	)
Income taxes		3			(78	)
Accounts payable, accrued expenses and other current liabilities		(84	)		12
Other long-term liabilities		(58	)		(13	)
Payments against reserves for restructuring charges and litigation costs		(83	)		(192	)
Net cash provided by operating activities from discontinued operations, excluding income taxes		—			40
Net cash provided by operating activities		472			425
Cash flows from investing activities:
Purchases of property and equipment—continuing operations		(450	)		(397	)
Purchases of property and equipment—discontinued operations		(13	)		(1	)
Construction of new and replacement hospitals		(13	)		(58	)
Purchases of businesses or joint venture interest		(65	)		—
Proceeds from sales of facilities and other assets – discontinued operations		19			221
Proceeds from sales of marketable securities, long-term investments and other assets		84			67
Proceeds from hospital authority bonds		—			49
Purchases of marketable securities		—			(17	)
Distributions received from investments in Reserve Yield Plus Fund		1			12
Release of escrow funds		15			—
Other items, net		2			(1	)
Net cash used in investing activities		(420	)		(125	)
Cash flows from financing activities:
Repayments of borrowings		(886	)		(1,291	)
Proceeds from borrowings		601			885
Deferred debt issuance costs		(27	)		(46	)
Proceeds from issuance of mandatory convertible preferred stock		—			334
Cash dividends on preferred stock		(24	)		—
Distributions paid to noncontrolling interests		(8	)		(7	)
Other items, net		7			8
Net cash used in financing activities		(337	)		(117	)
Net increase (decrease) in cash and cash equivalents		(285	)		183
Cash and cash equivalents at beginning of period		690			507
Cash and cash equivalents at end of period	$	405		$	690
Supplemental disclosures:
Interest paid, net of capitalized interest	$	(402	)	$	(439	)
Proceeds from interest rate swap agreement	$	—		$	39
Income tax (payments) refunds, net	$	34		$	(43	)


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING HOSPITALS
(Unaudited)

(Dollars in millions except per patient day, per
admission and per visit amounts)	Three Months Ended December 31,									Year Ended December 31,
	2010			2009			Change			2010			2009			Change

Net inpatient revenues	$	1,477		$	1,481		(0.3	)%		$	5,929		$	5,902		0.5	%
Net outpatient revenues	$	730		$	691		5.6	%		$	2,903		$	2,770		4.8	%

Number of general hospitals (at end of period)		49			49		—		*		49			49		—		*
Licensed beds (at end of period)		13,428			13,436		(0.1	)%			13,428			13,436		(0.1	)%
Average licensed beds		13,429			13,436		(0.1	)%			13,430			13,419		0.1	%
Utilization of licensed beds		49.3	%		50.8	%	(1.5	)%	*		50.4	%		52.1	%	(1.7	)%	*
Patient days		608,890			628,438		(3.1	)%			2,473,017			2,553,215		(3.1	)%
Adjusted patient days		923,219			930,542		(0.8	)%			3,723,702			3,785,230		(1.6	)%
Net inpatient revenue per patient day	$	2,426		$	2,357		2.9	%		$	2,397		$	2,312		3.7	%
Admissions		126,977			129,631		(2.0	)%			512,972			525,532		(2.4	)%
Adjusted patient admissions		194,098			193,279		0.4	%			778,505			784,502		(0.8	)%
Net inpatient revenue per admission	$	11,632		$	11,425		1.8	%		$	11,558		$	11,231		2.9	%
Average length of stay (days)		4.8			4.8		—		*		4.8			4.9		(0.1	)	*
Surgeries		89,859			90,470		(0.7	)%			360,206			364,713		(1.2	)%
Net outpatient revenue per visit	$	730		$	711		2.7	%		$	741		$	704		5.3	%
Outpatient visits		999,827			971,741		2.9	%			3,917,758			3,934,496		(0.4	)%

Sources of net patient revenue
Medicare		23.5	%		24.7	%	(1.2	)%	*		23.9	%		25.0	%	(1.1	)%	*
Medicaid		8.6	%		7.5	%	1.1	%	*		8.7	%		8.1	%	0.6	%	*
Managed care		56.9	%		56.2	%	0.7	%	*		56.5	%		56.1	%	0.4	%	*
Indemnity, self-pay and other		11.0	%		11.6	%	(0.6	)%	*		10.9	%		10.8	%	0.1	%	*

* This change is the difference between the 2010 and 2009 amounts shown


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
Fiscal 2010 by Calendar Quarter
(Unaudited)

													Year
(Dollars in millions except per share amounts)	Three Months Ended												Ended
	3/31/10			6/30/10			9/30/10			12/31/10			12/31/10

Net operating revenues	$	2,339		$	2,303		$	2,262		$	2,301		$	9,205
Operating expenses:
Salaries, wages and benefits		987			969			977			967			3,900
Supplies		398			395			390			394			1,577
Provision for doubtful accounts		189			173			187			191			740
Other operating expenses, net		467			498			505			468			1,938
Depreciation and amortization		95			97			101			101			394
Impairment of long-lived assets and goodwill, and restructuring charges		—			(2	)		3			9			10
Litigation and investigation costs		2			2			2			6			12
Operating income		201			171			97			165			634
Interest expense		(109	)		(107	)		(107	)		(101	)		(424	)
Loss from early extinguishment of debt		—			—			(55	)		(2	)		(57	)
Investment earnings		1			1			3			—			5
Income (loss) from continuing operations, before income taxes		93			65			(62	)		62			158
Income tax (expense) benefit		(3	)		(20	)		1,002			(2	)		977
Income from continuing operations, before discontinued operations		90			45			940			60			1,135
Discontinued operations:
Income (loss) from operations		5			(5	)		(4	)		15			11
Impairment of long-lived assets and goodwill, and restructuring charges, net		1			(3	)		1			—			(1	)
Income tax (expense) benefit		(1	)		(2	)		3			7			7
Income (loss) from discontinued operations		5			(10	)		—			22			17
Net income		95			35			940			82			1,152
Less: Preferred stock dividends		6			6			6			6			24
Less: Net income attributable to noncontrolling interests		1			4			2			2			9
Net income attributable to Tenet Healthcare Corporation common shareholders	$	88		$	25		$	932		$	74		$	1,119

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations	$	0.17		$	0.07		$	1.92		$	0.11		$	2.28
Discontinued operations		0.01			(0.02	)		—			0.04			0.03
	$	0.18		$	0.05		$	1.92		$	0.15		$	2.31
Diluted
Continuing operations	$	0.16		$	0.07		$	1.68		$	0.10		$	2.01
Discontinued operations		0.01			(0.02	)		—			0.04			0.03
	$	0.17		$	0.05		$	1.68		$	0.14		$	2.04
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		481,917			484,610			485,210			485,549			484,321
Diluted		559,228			502,549			559,850			561,921			560,631


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING HOSPITALS
Fiscal 2010 by Calendar Quarter
(Unaudited)

(Dollars in millions except per patient day, per													Year
admission and per visit amounts)	Three Months Ended												Ended
	3/31/10			6/30/10			9/30/10			12/31/10			12/31/10

Net inpatient revenues	$	1,544		$	1,478		$	1,430		$	1,477		$	5,929
Net outpatient revenues	$	706		$	733		$	734		$	730		$	2,903

Number of general hospitals (at end of period)		49			49			49			49			49
Licensed beds (at end of period)		13,430			13,420			13,430			13,428			13,428
Average licensed beds		13,431			13,435			13,423			13,429			13,430
Utilization of licensed beds		54.0	%		50.3	%		48.3	%		49.3	%		50.4	%
Patient days		652,952			614,365			596,810			608,890			2,473,017
Adjusted patient days		958,248			929,186			913,049			923,219			3,723,702
Net inpatient revenue per patient day	$	2,365		$	2,406		$	2,396		$	2,426		$	2,397
Admissions		132,599			127,751			125,645			126,977			512,972
Adjusted patient admissions		195,909			194,828			193,670			194,098			778,505
Net inpatient revenue per admission	$	11,644		$	11,569		$	11,381		$	11,632		$	11,558
Average length of stay (days)		4.9			4.8			4.7			4.8			4.8
Surgeries		87,998			91,285			91,064			89,859			360,206
Net outpatient revenue per visit	$	741		$	741		$	752		$	730		$	741
Outpatient visits		952,915			988,706			976,310			999,827			3,917,758

Sources of net patient revenue
Medicare		25.1	%		23.2	%		23.7	%		23.5	%		23.9	%
Medicaid		8.7	%		9.3	%		8.0	%		8.6	%		8.7	%
Managed care		55.3	%		56.5	%		57.0	%		56.9	%		56.5	%
Indemnity, self-pay and other		10.9	%		11.0	%		11.3	%		11.0	%		10.9	%

(1) Reconciliation of Adjusted EBITDA

Adjusted EBITDA, a non-GAAP term, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common shareholders before (1) cumulative effect of changes in accounting principle, net of tax, (2) net income attributable to noncontrolling interests, (3) preferred stock dividends, (4) income (loss) from discontinued operations, net of tax, (5) income tax (expense) benefit, (6) investment earnings (loss), (7) gain (loss) from early extinguishment of debt, (8) net gain (loss) on sales of investments, (9) interest expense, (10) litigation and investigation (costs) benefit, net of insurance recoveries, (11) hurricane insurance recoveries, net of costs, (12) impairment of long-lived assets and goodwill and restructuring charges, net of insurance recoveries, and (13) depreciation and amortization. The Company’s Adjusted EBITDA may not be comparable to EBITDA reported by other companies.

The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its financial statements, some of which are recurring or involve cash payments. The Company uses this information in its analysis of the performance of its business excluding items that it does not consider as relevant in the performance of its hospitals in continuing operations. Adjusted EBITDA is not a measure of liquidity, but is a measure of operating performance that management uses in its business as an alternative to net income (loss) attributable to Tenet Healthcare Corporation common shareholders. Because Adjusted EBITDA excludes many items that are included in our financial statements, it does not provide a complete measure of our operating performance. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance.

The reconciliation of net income (loss) attributable to Tenet Healthcare Corporation common shareholders, the most comparable GAAP term, to Adjusted EBITDA, is set forth in the first table below for the three and twelve months ended December 31, 2010 and 2009.

(2) Adjusted Free Cash Flow

Adjusted Free Cash Flow, a non-GAAP term, is defined by the Company as cash provided by (used in) operating activities less payments against reserves for restructuring charges and litigation costs, operating cash flows from discontinued operations, capital expenditures in continuing operations, and new hospital construction expenditures. The Company believes the use of Adjusted Free Cash Flow is meaningful as the use of this financial measure provides the Company and the users of its financial statements with supplemental information about the impact on the Company’s cash flows from the items specified above. The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its cash flows, some of which are recurring. The Company uses this information in its analysis of its cash flows excluding items that it does not consider relevant to the liquidity of its hospitals in continuing operations. Adjusted Free Cash Flow is a measure of liquidity that management uses in its business as an alternative to net cash provided by (used in) operating activities. Because Adjusted Free Cash Flow excludes many items that are included in our financial statements, it does not provide a complete measure of our liquidity. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance or liquidity. The reconciliation of net cash provided by (used in) operating activities, the most comparable GAAP term, to Adjusted Free Cash Flow is set forth in the second table below for the three and twelve months ended December 31, 2010 and 2009.


TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #1 - Reconciliation of Adjusted EBITDA to Net Income Attributable to Tenet Healthcare Corporation Common Shareholders
(Unaudited)

(Dollars in millions)	Three Months Ended December 31,						Year Ended December 31,
	2010			2009			2010			2009
Net income attributable to Tenet Healthcare Corporation common shareholders	$	74		$	21		$	1,119		$	181
Less: Net income attributable to noncontrolling interests		(2	)		(2	)		(9	)		(10	)
Preferred stock dividends		(6	)		(6	)		(24	)		(6	)
Income (loss) from discontinued operations, net of tax		22			5			17			(31	)
Income from continuing operations		60			24			1,135			228
Income tax (expense) benefit		(2	)		35			977			23
Investment earnings		—			1			5			—
Gain (loss) from early extinguishment of debt		(2	)		—			(57	)		97
Net gain on sales of investments		—			—			—			15
Interest expense		(101	)		(103	)		(424	)		(445	)
Operating income		165			91			634			538
Litigation and investigation costs		(6	)		(18	)		(12	)		(31	)
Impairment of long-lived assets and goodwill, and restructuring charges		(9	)		(14	)		(10	)		(27	)
Depreciation and amortization		(101	)		(95	)		(394	)		(386	)
Adjusted EBITDA	$	281		$	218		$	1,050		$	982

Net operating revenues	$	2,301		$	2,261		$	9,205		$	9,014

Adjusted EBITDA as % of net operating revenues
(Adjusted EBITDA margin)		12.2	%		9.6	%		11.4	%		10.9	%


Additional Supplemental Non-GAAP Disclosures
Table #2 Reconciliation of Adjusted Free Cash Flow
(Unaudited)

(Dollars in millions)	Three Months Ended December 31,						Year Ended December 31,
	2010			2009			2010			2009
Net cash provided by operating activities	$	175		$	141		$	472		$	425
Less:
Payments against reserves for restructuring charges and litigation costs		(7	)		(27	)		(83	)		(192	)
Net cash provided by operating activities from discontinued operations		2			9			—			40
Adjusted net cash provided by operating activities – continuing operations		180			159			555			577
Purchases of property and equipment – continuing operations		(196	)		(181	)		(450	)		(397	)
Construction of new and replacement hospitals		—			(11	)		(13	)		(58	)
Adjusted Free Cash Flow – continuing operations	$	(16	)	$	(33	)	$	92		$	122


TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #3 - Reconciliation of Outlook Adjusted EBITDA to Outlook Net Income Attributable to Tenet Healthcare Corporation Common Shareholders for Year Ending December 31, 2011
(Unaudited)

(Dollars in millions)	Low			High

Net income attributable to Tenet Healthcare Corporation common shareholders	$	165		$	239
Less:
Net income attributable to noncontrolling interests		(15	)		(10	)
Preferred stock dividends		(24	)		(24	)
Loss from discontinued operations, net of tax		0			0
Income from continuing operations		204			273
Income tax expense		(136	)		(182	)
Income from continuing operations, before income taxes		340			455
Interest expense, net		(415	)		(395	)
Operating income		755			850
Litigation and investigation costs ^(a)		0			0
Impairment of long-lived assets and goodwill, and restructuring charges		(5	)		0
Depreciation and amortization		(390	)		(400	)
Adjusted EBITDA	$	1,150		$	1,250

Net operating revenues	$	9,700		$	9,900
Adjusted EBITDA as % of net operating revenues
(Adjusted EBITDA margin)		11.9	%		12.6	%

^(a) Company has not forecasted for 2011 unincurred costs related to litigation and investigations.


Additional Supplemental Non-GAAP Disclosures
Table #4 - Reconciliation of Outlook Adjusted EBITDA to Outlook Normalized Net Income Attributable to Tenet Healthcare Corporation Common Shareholders for Year Ending December 31, 2011
(Unaudited)

(Dollars in millions except per share amounts)	Low			High

Adjusted EBITDA (from Table # 3, above)	$	1,150		$	1,250

Depreciation and amortization		(390	)		(400	)
Interest expense, net		(415	)		(395	)
Normalized income from continuing operations before income taxes		345			455
Normalized income tax expense ^(a)		(138	)		(182	)
Normalized income from continuing operations		207			273
Preferred stock dividends		(24	)		(24	)
Net income attributable to noncontrolling interests		(15	)		(10	)
Normalized net income attributable to Tenet Healthcare Corporation common shareholders ^(a)	$	168		$	239

Weighted average shares outstanding (in millions) ^(b)		507			566

Normalized earnings per share – continuing operations ^(a)	$	0.33		$	0.46

^(a) Uses normalized tax rate of 40 percent.
^(b) The high end of the range includes an additional 59 million shares as our mandatory convertible
preferred stock is dilutive at this level of earnings.


Additional Supplemental Non-GAAP Disclosures
Table #5 Reconciliation of Outlook Adjusted Free Cash Flow for the Year Ending December 31, 2011
(Unaudited)

(Dollars in millions)
	Low			High
Net cash provided by operating activities	$	570		$	740
Less:
Payments against reserves for restructuring charges and litigation costs ^(a)		(30	)		(20	)
Net cash used in operating activities from discontinued operations		(25	)		(5	)
Adjusted net cash provided by operating activities – continuing operations		625			765
Purchases of property and equipment – continuing operations		(475	)		(525	)
Adjusted Free Cash Flow – continuing operations	$	150		$	240

^(a) Company has not forecasted for 2011 unincurred payments related to litigation and investigations.

CONTACT:

Tenet Healthcare Corporation
Media:
Rick Black, 469-893-2647
[email protected]
or
Investors:
Thomas Rice, 469-893-2522
[email protected]

KEYWORDS: United States North America Texas

INDUSTRY KEYWORDS: Health Hospitals

MEDIA:

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