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HCA · HCA Healthcare, Inc.

50 filings

10-Q

HCA 10-Q Quarterly Reports

HCA Healthcare, Inc. - 50 quarterly reports

Filing record · 2016–202610-K1110-Q328-K144

HCA filed 11 annual reports (10-K), 32 quarterly reports (10-Q) and 144 current reports (8-K) between 2016 and 2026.

  1. Material agreement8-K · Jun ’17Jun ’17
  2. Material agreement8-K · Oct ’19Oct ’19
  3. Leadership change8-K · Oct ’21Oct ’21
  4. Leadership change8-K · Jul ’25Jul ’25
  1. 2026-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2026

    HCA Healthcare's second quarter of 2026 showed solid top-line growth, with revenues rising 8.7% year over year to $20.230 billion and net income attributable to HCA of $1.699 billion, or $7.62 per diluted share, versus $6.83 a year earlier. A large part of the revenue gain is non-recurring in nature: the quarter includes $1.372 billion of incremental revenue and $829 million of other operating expenses tied to the Florida state directed payment program, of which roughly $980 million of revenue and $557 million of expense relate to periods before 2026. Management also cited about $400 million of incremental net benefit from Medicaid supplemental payment programs. Excluding these items, underlying growth in revenue per equivalent admission and volumes was more modest, and the quarter's operating margin pressure from other operating expenses (24.9% of revenue versus 20.4%) is substantially tied to the same program. Cash generation weakened sharply. Operating cash flow fell to $2.335 billion in the quarter from $4.210 billion, driven by about $1.4 billion of unfavorable working capital changes, mainly higher accounts receivable linked to Medicaid directed payment programs, and a $594 million increase in income taxes paid. For the first half, operating cash flow was $4.349 billion versus $5.861 billion. Uninsured admissions rose 23.3% in the quarter, reflecting the expiration of enhanced Exchange premium tax credits at the end of 2025, and accounts receivable grew to $12.281 billion. Days revenue in receivables rose to 55 from 51 a year earlier. Balance sheet and capital allocation remain active. Total debt reached $49.718 billion, up from $46.492 billion at year-end, as the company issued $3.0 billion of senior notes and relied on commercial paper, which stood at $3.890 billion. The company repurchased $3.635 billion of stock in the first half and 4.75 million shares in the second quarter, leaving $7.210 billion of authorization available. Stockholders' deficit widened to $(3.209) billion including noncontrolling interests. Management reports that the Medicaid directed payment and provider tax changes under the 2025 Federal Budget Act remain a key uncertainty, and management is projecting 2026 capital expenditures of $5.0 to $5.5 billion.

    Jul 28, 2026
  2. 2026-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2026

    HCA Healthcare's first quarter 2026 revenue rose 4.3% to $19.109 billion, driven by a 3.1% increase in revenue per equivalent admission and a 1.1% rise in equivalent admissions. Diluted EPS increased 10.9% to $7.15, but this was largely a function of a roughly 9% reduction in diluted share count (226.7 million versus 249.4 million) from ongoing buybacks. Net income attributable to HCA grew only 0.6% to $1.620 billion, and pre-tax income fell 1.7% to $2.287 billion as interest expense rose 6.8% to $584 million and depreciation and amortization rose 8.1%. The lower effective tax rate (21.0% versus 23.8%) was supported by a $103 million tax benefit from employee equity award settlements, which flatters the current quarter's earnings quality. The filing highlights a payer-mix shift that investors should monitor. Managed care and insurer revenue as a share of total revenue fell to 47.5% from 49.4%, reflecting the expiration of enhanced Exchange premium tax credits at the end of 2025. Uninsured admissions rose 15.6% on a consolidated basis, and charity care rose to $5.513 billion from $3.644 billion. Estimated uncompensated care costs increased to $1.252 billion from $1.055 billion. Respiratory-related admissions fell 42% against a weak seasonal comparison, which weighed on volumes. Outpatient surgeries declined 2.7%. Balance sheet and liquidity require attention. Total debt was $48.0 billion, and short-term debt and current maturities climbed to $8.5 billion, including $3.65 billion of commercial paper. Working capital was negative $3.2 billion, although management states that excluding commercial paper it would have been positive $444 million and that the company can refinance commercial paper under its senior unsecured credit facility. Operating cash flow improved to $2.014 billion from $1.651 billion, but capital expenditures of $1.119 billion and share repurchases of $1.571 billion were funded in part by net borrowings of $1.4 billion. Stockholders' deficit widened to $(2.978) billion. Management reiterated 2026 capital expenditure guidance of $5.0 to $5.5 billion and declared a $0.78 quarterly dividend.

    Apr 29, 2026
  3. 2025-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2025

    HCA Healthcare's third-quarter 2025 results were strong on the top and bottom lines. Revenues rose 9.6% to $19.161 billion (same-facility revenues up 9.2%), driven by a 6.1% increase in revenue per equivalent admission and a 3.2% increase in equivalent admissions. Net income attributable to HCA rose 29.4% to $1.643 billion, or $6.96 per diluted share, versus $4.88 a year earlier. Part of the margin improvement came from lower salaries and benefits as a share of revenue (43.6% vs. 45.0%) and a 23.9% effective tax rate. Management attributed the revenue-per-admission gain partly to higher state supplemental Medicaid revenue from newly approved programs, a source of revenue the filing flags as exposed to federal policy changes. Cash flow and capital allocation were the main focus of the nine-month period. Operating cash flow rose to $10.277 billion from $7.955 billion, but this was helped by a $1.259 billion decline in income taxes paid, related to an IRS deferral for Tennessee-based taxpayers until Q4 2025. Management spent $7.509 billion on share repurchases (21.3 million shares at an average of $352.40) and $3.455 billion on capital expenditures, against planned 2025 capex of about $5.0 billion. Cash fell to $997 million, and working capital turned negative at $(2.611) billion. Total debt rose to $44.511 billion, with $6.110 billion due within one year, including $1.910 billion of commercial paper. Shareholders' deficit widened to $(2.159) billion. The filing also flags policy risks for 2026. The One Big Beautiful Bill Act is expected to reduce Medicaid spending and coverage, and sequestration could cut Medicare reimbursement by up to 4% in early 2026 absent congressional action. Medicaid DSH reductions of $8.0 billion per year began October 1, 2025, and the expiration of enhanced ACA premium tax credits after December 31, 2025 could raise uninsured volumes. Management states that cash flows and its credit facilities should be sufficient for liquidity needs.

    Oct 30, 2025
  4. 2025-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2025

    HCA Healthcare's second quarter 2025 results show continued top-line and earnings growth. Revenues rose 6.4% year over year to $18.605 billion, driven by a 3.9% increase in revenue per equivalent admission and a 2.3% increase in equivalent admissions. Net income attributable to HCA rose 13.1% to $1.653 billion, or $6.83 per diluted share, versus $5.53 a year earlier, helped by a 0.2-point-lower salaries and benefits ratio and a lower effective tax rate (24.1% vs. 27.4%). Adjusted segment EBITDA across the three groups reached $4.201 billion for the quarter, up from $3.805 billion. Share count reduction from buybacks (diluted shares down about 8.7% year over year) amplified per-share gains. Management also repurchased $5.011 billion of stock in the first half of 2025 while maintaining a 2025 capex plan of about $5.0 billion. Balance sheet and liquidity require closer attention. Total debt rose to $44.483 billion from $43.031 billion at year-end 2024, and working capital turned negative at $376 million, largely due to $5.104 billion of debt due within one year and $1.778 billion of commercial paper, a new program established in June 2025. Cash fell to $939 million. Stockholders' deficit attributable to HCA widened to $(4.394) billion, reflecting heavy buybacks that exceed retained earnings growth. Management highlighted that the July 4, 2025 One Big Beautiful Bill Act (OBBBA) is expected to reduce Medicaid coverage and federal spending over time, and that supplemental payment programs and enhanced ACA premium tax credits face expiration or restructuring risk. Management has not quantified the financial impact of these policy changes, so these remain the principal forward-looking uncertainties for investors. Operating cash flow improved substantially to $5.861 billion in the first half of 2025 from $4.440 billion, but about $853 million of the increase reflects a deferral of Tennessee estimated tax payments to the fourth quarter of 2025, which is a timing benefit rather than recurring earnings power. Investors should separate these timing effects from underlying cash generation.

    Aug 4, 2025
  5. 2025-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2025

    HCA Healthcare's first quarter 2025 results showed solid top-line growth and earnings expansion. Revenues rose 5.7% to $18.321 billion from $17.339 billion, driven by a 3.1% increase in equivalent admissions and a 2.5% increase in revenue per equivalent admission. Net income attributable to HCA rose 1.2% to $1.610 billion, or $6.45 per diluted share, versus $5.93 a year earlier. The comparison is flattered by the prior-year quarter, which included $201 million of facility sale gains ($0.57 per diluted share), so underlying earnings growth was stronger than the headline suggests. Pretax income increased 3.5%, and diluted share count fell about 7% (249.4 million vs. 268.0 million) due to heavy buybacks, which helped per-share results. Cash generation weakened meaningfully. Operating cash flow fell $818 million to $1.651 billion, driven by a $1.157 billion negative swing in working capital, with accounts receivable rising to $11.1 billion and days revenue in receivables at 54. Capital spending was $991 million, and HCA repurchased $2.5 billion of stock in the quarter, funded in part by new borrowings. Total debt increased to $44.6 billion, though the company refinanced its 2025 maturities and terminated several secured facilities in favor of an $8 billion unsecured revolver, with $7.8 billion available at quarter-end. Stockholders' deficit widened to $(438) million, a result of buybacks exceeding retained earnings, which is typical for a leveraged repurchaser but worth monitoring. Management flagged several risks going forward, including possible restructuring or elimination of state Medicaid supplemental payment programs, expiration of enhanced ACA premium tax credits at the end of 2025, rising uninsured volumes in Texas and Florida, and inflation in other operating expenses. Planned 2025 capex of $5.0 to $5.2 billion and the $8.3 billion remaining buyback authorization signal continued capital deployment.

    May 1, 2025
  6. 2024-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2024

    HCA Healthcare's third quarter 2024 results showed strong top-line and earnings growth. Revenues rose 7.9% year over year to $17.487 billion, driven by a 5.0% increase in equivalent admissions and a 2.8% increase in revenue per equivalent admission. Net income attributable to HCA rose 17.7% to $1.270 billion, or $4.88 per diluted share (versus $3.91). Income before taxes grew 17.0% to $1.906 billion, with salaries and benefits falling to 45.0% of revenue from 46.6%, helped by a 17.8% decline in contract labor. Offsetting this, supplies, other operating expenses and interest expense were higher as a share of revenue or in absolute terms, and the quarter absorbed about $50 million (about $0.15 per diluted share) of Hurricane Helene costs. For the first nine months, revenues increased 9.8% to $52.318 billion and diluted EPS reached $16.37, up from $13.07. Operating cash flow improved to $7.955 billion from $6.757 billion, while capital expenditures held near $3.6 billion with about $5 billion planned for 2024. Share repurchases were significant at $4.342 billion year to date, and the company retired about 13 million shares, reducing the share count by roughly 6% year over year. Management expects Hurricane Helene and Hurricane Milton to cost $200 million to $300 million ($0.60 to $0.90 per diluted share) in the fourth quarter, before any insurance recoveries. Balance sheet leverage rose modestly. Total debt reached $42.965 billion, up from $39.593 billion at year-end 2023, following $7.5 billion of new senior notes issued in 2024 to refinance the asset-based revolver and fund the maturity of $2.0 billion of 2024 notes. Stockholders' deficit attributable to HCA widened to $(2.182) billion, a function of the buybacks and dividends exceeding retained earnings. Liquidity remains solid, with $7.986 billion available under senior secured credit facilities and $2.888 billion of cash. The company also disclosed that its Florida and Texas hospitals represent 59% of admissions and 51% of revenue, concentrating exposure in two states.

    Oct 31, 2024
  7. 2024-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2024

    HCA Healthcare's second quarter 2024 results showed continued top-line momentum. Revenues rose 10.3% year over year to $17.492 billion, driven by a 6.0% increase in equivalent admissions and a 4.1% increase in revenue per equivalent admission. Net income attributable to HCA grew 22.5% to $1.461 billion, and diluted EPS rose to $5.53 from $4.29. Results were helped by a $12 million gain on facility sales in the quarter, while the six-month period included a larger $213 million gain, primarily from the sale of a California hospital. Operating margin pressure is visible in the cost lines: other operating expenses rose to 20.7% of revenue from 19.2%, driven by professional fees and state provider fees, while salaries and benefits improved to 43.9% of revenue from 45.9%, helped by a 25.7% decline in contract labor. Cash generation and balance sheet items warrant attention. Operating cash flow for the quarter fell $504 million year over year to $1.971 billion, mainly because of a $824 million negative swing in working capital, chiefly higher accounts receivable and lower accounts payable. Total debt rose to $40.880 billion, and the current portion of long-term debt jumped to $4.574 billion, which pushed working capital down to $872 million from $2.272 billion at year-end 2023. HCA issued $4.5 billion of senior notes in February 2024 and repaid a $2.0 billion maturity in March. Capital spending remains heavy, with planned 2024 capex of $5.1 to $5.3 billion. Management also returned significant capital to shareholders, repurchasing $2.547 billion of stock in the first half and declaring a $0.66 quarterly dividend, while shares outstanding fell to 259.2 million from 265.5 million at year-end 2023. Overall, the filing reflects strong earnings growth supported by volume gains and labor cost relief, offset by rising non-labor costs, weaker working capital conversion, and a larger debt load. Investors would likely focus on whether accounts receivable trends normalize and whether the company can sustain margin improvement while funding elevated capital spending and buybacks.

    Jul 29, 2024
  8. 2024-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2024

    HCA Healthcare's first quarter 2024 results showed strong top-line and earnings growth. Revenues rose 11.2% to $17.339 billion from $15.591 billion, driven by a 7.1% increase in equivalent admissions and a 3.9% rise in revenue per equivalent admission (same facility revenues up 8.8%). Net income attributable to HCA Healthcare rose 16.7% to $1.591 billion, or $5.93 per diluted share, versus $4.85 a year earlier. The quarter was helped by a $201 million pretax gain on sales of facilities (primarily a California hospital sale, worth $0.57 per diluted share), while the prior-year quarter included a $145 million one-time revenue benefit from resolving disputed payer claims. Excluding these items, underlying growth was still solid, though operating cost pressure was evident: other operating expenses rose to 20.9% of revenues from 18.7%, driven by professional fees and state provider fees, while salaries and benefits improved to 44.4% of revenues from 45.4%. Cash generation and capital allocation were robust. Operating cash flow increased to $2.469 billion from $1.803 billion, helped by working capital changes. HCA issued $4.5 billion of senior notes in February 2024 and used proceeds to repay its asset-based revolver, then repaid $2.0 billion of 2024 maturities. Total debt was $40.191 billion at quarter end, and the company repurchased 3.894 million shares for about $1.18 billion. Management reiterated planned 2024 capital expenditures of $5.1 to $5.3 billion and declared a $0.66 quarterly dividend. Investors should weigh the high leverage and rising debt-service costs, with interest expense up 6.9% to $512 million, against the strong volume growth, favorable pricing, and disciplined capital returns.

    May 2, 2024
  9. 2023-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2023

    HCA Healthcare's third quarter 2023 10-Q shows continued top-line growth driven mainly by pricing and volume, but margin pressure and rising leverage-related costs are weighing on profitability. Revenue rose 8.3% year over year to $16.213 billion in the quarter, with revenue per equivalent admission up 3.6% and equivalent admissions up 4.5%. Net income attributable to HCA fell 4.9% to $1.079 billion, and diluted EPS held flat at $3.91 because of a 5% reduction in diluted share count from buybacks. Nine-month revenue grew 6.5% to $47.665 billion, while pretax income rose only 1.6%, reflecting higher other operating expenses (19.5% of revenue versus 18.6%), including directed payment program costs, and higher interest expense of $1.447 billion versus $1.288 billion. Balance sheet and cash flow trends warrant attention. Total debt was $39.346 billion at September 30, 2023, and the company describes itself as highly leveraged. Operating cash flow for the nine months rose to $6.757 billion, but capital expenditures of $3.585 billion, buybacks of $2.901 billion, dividends and noncontrolling distributions left cash essentially flat at $891 million. Management plans roughly $4.7 billion of capex for 2023 and has $6.455 billion of revolver availability. Shareholder returns have been funded in part by new borrowing, and the company's own financing activity shows net debt additions of about $1.1 billion year to date. Investors should also note a $105 million pretax loss from a hospital-based physician staffing joint venture in Q3, a July 2023 data security incident referenced in the forward-looking statements, and an ongoing qui tam False Claims Act lawsuit related to the Texas Medicaid program in Harris County. Management reports no material changes to risk factors versus the 2022 10-K, and the uncertain outcome of supplemental payment program reviews remains a key policy risk given Medicaid and Medicare exposure.

    Oct 26, 2023
  10. 2023-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2023

    HCA Healthcare's second quarter 2023 results showed continued top-line growth and solid profitability. Revenues rose 7.0% year over year to $15.861 billion, driven by a 4.0% increase in equivalent admissions and a 2.9% increase in revenue per equivalent admission. Same facility revenues grew 6.2%. Net income attributable to HCA was $1.193 billion, or $4.29 per diluted share, up from $3.90 a year earlier, helped by lower share count after buybacks (diluted shares fell to 278.2 million from 296.1 million). Adjusted segment EBITDA was $3.056 billion, roughly flat with the prior year's $3.042 billion, and operating margin pressure came mainly from other operating expenses, which rose to 19.2% of revenue from 18.3%, led by a 70 basis point increase in professional fees. Cash generation improved meaningfully. Operating cash flow for the first half of 2023 was $4.278 billion, up 44% from $2.975 billion, largely from working capital improvement, particularly lower accounts receivable. Capital spending increased to $2.438 billion for the first half, and management plans roughly $4.7 billion of capital expenditures for 2023. HCA continues to carry heavy leverage, with total debt of $38.932 billion, and interest expense rose 14.5% to $964 million for the six months as the average effective rate climbed to 5.0%. The company issued $3.25 billion of senior notes in May 2023 to repay its asset-based revolver, extending maturities into 2028, 2033 and 2053. Investors should also note the July 2023 data security incident, which HCA says may involve information for about 11 million patients. It contains no clinical or financial account data, and management does not expect a material impact, though multiple class action lawsuits have been filed. Other items to monitor include the qui tam lawsuit tied to the Texas Medicaid program, ongoing IRS examinations, and continued uncertainty around state supplemental payment programs.

    Aug 2, 2023
  11. 2023-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2023

    HCA Healthcare's first quarter 2023 results (quarter ended March 31, 2023) show continued top-line growth and improved profitability versus the prior year. Revenues rose 4.3% to $15.591 billion, driven by a 6.7% increase in equivalent admissions partly offset by a 2.2% decline in revenue per equivalent admission. Net income attributable to HCA rose 7.1% to $1.363 billion, and diluted EPS grew to $4.85 from $4.14, aided by a 8.8% reduction in diluted share count following aggressive buybacks. Adjusted segment EBITDA increased roughly 7.7% to $3.172 billion, and operating cash flow improved to $1.803 billion from $1.345 billion. Note that the first quarter 2023 results include a $145 million one-time benefit from resolving disputed prior-year claims with a commercial payer, which flatters the period. The balance sheet and capital structure warrant attention. Total debt stood at $38.856 billion, and $2.378 billion of long-term debt came due within one year, up sharply from $370 million at year-end 2022, which reduced working capital to $2.513 billion. Interest expense rose 17% to $479 million as the average effective interest rate increased to 5.0% from 4.6%. Management highlighted $5.509 billion of variable-rate debt, with a hypothetical 1% rate increase implying roughly $55 million in annualized pretax earnings reduction. Stockholders' equity moved to a small positive $232 million (including noncontrolling interests), from a deficit of $73 million at year-end, reflecting buybacks and distributions offset by earnings. Capital allocation remained shareholder-focused but heavy. HCA repurchased $846 million of stock in the quarter, paid $175 million in dividends, and distributed $187 million to noncontrolling interests, while capital expenditures reached $1.197 billion against a 2023 plan of approximately $4.6 billion. Management also noted a pending qui tam lawsuit related to the Texas Medicaid Program in Harris County, and the company continues to face scrutiny of supplemental payment programs that could affect future revenues. Liquidity is supported by $3.795 billion of available revolver capacity, and management believes operating cash flow and credit access are sufficient for the foreseeable future.

    Apr 27, 2023
  12. 2022-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2022

    HCA Healthcare's Q3 2022 10-Q shows a quarter of softer top-line results and sharply lower earnings versus a year earlier, which was inflated by large facility-sale gains. Revenue fell 2.0% to $14.971 billion, and net income attributable to HCA declined 50% to $1.134 billion ($3.91 diluted EPS), compared with $2.269 billion ($7.00) in Q3 2021. The comparison is distorted by a $1.047 billion pretax gain on hospital sales in Q3 2021; excluding that, the underlying decline is smaller but operating margins still compressed. Salaries and benefits were 46.1% of revenue and other operating expenses rose to 19.1% of revenue from 16.6%, reflecting inflation, directed payment program costs and professional fees. Same facility revenue fell 1.3% as revenue per equivalent admission declined 3.5%, partly because of much higher COVID-19 volume in the prior-year period (12.7% of same facility admissions versus 5.2% this year). Capital allocation remained aggressive. HCA repurchased $5.481 billion of stock over the nine months and paid $497 million in dividends, while total debt rose to $37.71 billion, up from $34.58 billion at year-end 2021. The company issued $6.0 billion of senior secured notes in March 2022 and used proceeds to repay revolvers and retire 2023 maturities. An S&P investment-grade rating allowed the release of subsidiary guarantees and collateral on the senior secured notes, which are now effectively unsecured. Planned 2022 capital expenditures are about $4.2 billion, and nine-month operating cash flow was $5.995 billion, down $521 million year over year. Management states that cash flows and credit facilities should cover liquidity needs for at least 12 months. For investors, the key tensions are margin pressure from labor and supply inflation, reliance on continued buybacks funded partly by debt, and the reduced one-time gains from divestitures. Leverage is high, with a hypothetical 1% rate increase implying roughly $40 million of annualized pretax earnings reduction. The company also faces an unresolved qui tam False Claims Act lawsuit related to the Texas Medicaid Program in Harris County, though management believes its participation complied with program requirements.

    Nov 1, 2022
  13. 2022-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2022

    HCA Healthcare's second-quarter 2022 results show continued top-line growth but meaningful margin and earnings pressure. Revenues rose 2.7% to $14.820 billion (same facility +4.0%), driven by a 4.2% increase in revenue per equivalent admission, while equivalent admissions fell 1.5%. Net income attributable to HCA fell 20.3% to $1.155 billion, and diluted EPS declined to $3.90 from $4.36. The decline reflects salaries and benefits rising to 45.8% of revenues (from 44.2%), with management citing inflation and continued premium-rate labor use, and other operating expenses rising to 18.3% of revenues (from 17.2%). Same facility salaries and benefits per full-time equivalent rose 5.9%. Admissions declined 3.2% on a consolidated basis, while emergency department visits rose 4.5%. Capital allocation and the balance sheet were significant themes. HCA repurchased $4.783 billion of stock in the first six months of 2022 and retained $3.803 billion of authorization under the January 2022 program. Total debt rose to $38.903 billion at June 30, 2022, from $34.579 billion at year-end 2021, following a $6.0 billion senior secured notes issuance in March. Stockholders' deficit attributable to HCA widened to $(3.680) billion. Cash flow from operations fell 29.8% for the six months to $2.975 billion, largely due to working capital outflows, including a $344 million deferred payroll tax payment. Capital expenditures reached $1.941 billion in the first half, with full-year 2022 planned at about $4.2 billion. In May 2022, S&P issued an investment grade rating, which allowed the release of subsidiary guarantees and collateral on the senior secured notes. For investors, the central questions are whether labor and supply cost inflation can be offset by pricing, whether volume recovery continues, and how the company balances aggressive buybacks against rising leverage. Interest expense increased 9.1% to $434 million in the quarter, and a hypothetical 1% rise in interest rates would reduce annualized pretax earnings by about $51 million. Management believes operating cash flow, credit facility availability and debt market access will cover liquidity needs for the next 12 months.

    Aug 1, 2022
  14. 2022-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2022

    HCA Healthcare's first-quarter 2022 results show top-line growth with pressure on margins and a heavier debt load. Revenues rose 6.9% to $14.945 billion (same-facility up 7.8%), driven by a 3.6% increase in revenue per equivalent admission and a 3.2% increase in equivalent admissions. Net income attributable to HCA fell 10.6% to $1.273 billion, though diluted EPS was flat at $4.14 because the share count dropped sharply through buybacks (diluted shares 307.4 million vs. 343.3 million a year earlier). Pretax income declined 8.1% to $1.814 billion, and salaries and benefits rose to 46.4% of revenue from 45.1%, reflecting premium-rate labor usage and wage pressure. The quarter also included a $244 million Texas directed payment benefit in revenues, partly offset by $90 million of related provider tax expense in other operating expenses, so underlying results are somewhat less favorable than the headline figures suggest. Cash generation weakened. Operating cash flow fell to $1.345 billion from $1.988 billion, mainly due to a $344 million payment of deferred 2020 payroll taxes and a $121 million decline in net income excluding facility gains. Capital expenditures rose to $861 million, and management plans about $4.2 billion for 2022. Debt rose to $37.7 billion from $34.6 billion after HCA issued $6.0 billion of senior secured notes in March 2022 and used proceeds to pay down revolver borrowings. Long-term debt is largely fixed-rate, with an average effective rate of 4.6%, and HCA plans to redeem $2.5 billion of 2023 notes in April 2022, which is expected to produce about $80 million in pretax debt-retirement losses in the second quarter. Shareholder returns remain substantial: the company repurchased 8.4 million shares for $2.1 billion in the quarter and has $6.5 billion of authorization remaining, and it declared a $0.56 quarterly dividend. Investors should weigh the strong volume recovery and aggressive capital return against rising leverage, higher labor and supply costs, and dependence on Texas and Florida supplemental payment programs, which are under review by state agencies and CMS. A qui tam False Claims Act lawsuit tied to the Harris County Medicaid program remains pending, and management cannot yet estimate its effect.

    May 3, 2022
  15. 2021-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2021

    HCA Healthcare's Q3 2021 results were driven by strong top-line growth and a large one-time gain. Revenue rose 14.8% to $15.276 billion from $13.311 billion, with consolidated equivalent admissions up 8.4% and revenue per equivalent admission up 5.9%. Net income attributable to HCA was $2.269 billion, or $7.00 per diluted share, versus $668 million ($1.95) a year earlier. That figure includes a $1.047 billion pretax gain on facility sales ($2.43 per diluted share), mainly from the sale of four Georgia hospitals, so underlying profitability grew less dramatically. Excluding the gain, the margin picture was mixed: salaries and benefits rose to 46.4% of revenue from 45.8%, driven by premium labor costs during the COVID-19 surge, and supply costs rose to 16.1% of revenue, with pharmacy supplies up 24%. Cash generation and leverage deserve investor attention. Operating cash flow fell $440 million in the quarter to $2.277 billion, reflecting a $797 million working-capital drag, mainly from higher accounts receivable. Nine-month operating cash flow was $6.516 billion, down from $12.815 billion, though the prior year included a $6.1 billion CARES Act stimulus liability. Total debt stood at $32.299 billion, and management describes HCA as highly leveraged. Capital allocation was aggressive: the company repurchased $6.143 billion of stock in the first nine months, including 9.6 million shares in Q3, leaving $2.658 billion of authorization. Shareholders' deficit attributable to HCA was $(695) million at quarter end, versus positive equity of $572 million at year-end 2020, reflecting buybacks. The filing also flags operating and regulatory considerations. Inpatient surgeries declined 5.3% as capacity was diverted to COVID-19 patients, while emergency department visits rose 28.9%. Texas and Florida hold 91 hospitals and generated 57% of admissions. Medicaid supplemental payment programs in Texas and other states are under review, and management cannot estimate their financial impact. A qui tam lawsuit tied to the Texas Medicaid program in Harris County is ongoing, and an IRS examination of 2016–2018 returns remains open. Management states that operating cash flow, credit facilities, and debt market access are sufficient for the next 12 months.

    Nov 1, 2021
  16. 2021-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2021

    HCA Healthcare's second quarter 2021 results showed a sharp rebound in patient activity as COVID-19 restrictions eased. Revenues rose 30.4% year over year to $14.435 billion, with equivalent admissions up 26.7% and revenue per equivalent admission up 2.9%. Net income attributable to HCA was $1.450 billion, or $4.36 per diluted share, versus $1.079 billion ($3.16) a year earlier. The comparison is distorted by the prior-year quarter, which included $822 million of CARES Act government stimulus income. Excluding that item, underlying profitability still improved meaningfully, with income before taxes up 35.7% and adjusted segment EBITDA rising from $2.666 billion to $3.219 billion. Cost pressures were visible. Salaries and benefits fell to 44.2% of revenue from 48.2%, but same-facility labor rate increases averaged 7.8%, and supply costs per equivalent admission rose 7.4% as surgical volumes rebounded. Cash flow from operations fell to $2.251 billion in the quarter from $8.723 billion, largely because the prior year included $4.999 billion of Medicare accelerated payment deferrals and the stimulus income. For the first six months, operating cash flow was $4.239 billion versus $10.098 billion. Capital allocation was aggressive. HCA repurchased 11.26 million shares in the quarter at an average of $203.06, and 19.74 million shares year to date for roughly $3.8 billion in cash. Total debt rose to $32.572 billion after a $2.35 billion senior secured note issuance and a refinancing of term loans. The company remains highly leveraged, with $4.987 billion of buyback authorization remaining and a quarterly dividend of $0.48 declared for September 2021.

    Aug 2, 2021
  17. 2021-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2021

    HCA Healthcare's first quarter 2021 results showed strong top-line and profitability growth despite a sharp decline in patient volumes. Revenues rose 8.7% to $13.977 billion from $12.861 billion, driven by a 16.1% increase in revenue per equivalent admission, which more than offset a 6.4% decline in equivalent admissions. Net income attributable to HCA rose 145% to $1.423 billion, or $4.14 per diluted share, versus $581 million ($1.69) a year earlier. The comparison is flattered by $295 million in debt-retirement losses in Q1 2020, so the underlying improvement is smaller than the headline figures suggest. Management attributed the higher revenue per admission to favorable payer mix, higher acuity, and reimbursement under the Families First Coronavirus Response Act for uninsured COVID-19 patients, which reclassified them as insured admissions. Those COVID-related benefits are unlikely to recur at the same scale, so investors should be cautious about extrapolating this pricing trend. Cost discipline and cash generation were also important. Salaries and benefits fell to 45.1% of revenue from 47.6%, and other operating expenses fell to 17.4% from 18.9%, while supply costs per equivalent admission rose 11.9%. Operating cash flow increased 45% to $1.988 billion, although working capital absorbed $311 million, mainly from higher accounts receivable. Capital expenditures were $654 million, with $3.7 billion planned for 2021. Management also repurchased $1.527 billion of stock, completing a $2 billion program, and retains $7.274 billion of remaining authorization. Balance sheet leverage remains substantial. Total debt was $31.072 billion at March 31, 2021, against cash of $1.030 billion, and interest expense declined to $384 million from $428 million as the company refinanced high-cost debt. The company reported working capital of $3.394 billion and stated that operating cash flow and credit facility availability are sufficient for the next 12 months. The filing also discloses an ongoing qui tam False Claims Act lawsuit related to Texas Medicaid uncompensated-care pool funding in Harris County, which management says it is vigorously defending.

    Apr 30, 2021
  18. 2020-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2020

    HCA Healthcare's Q3 2020 10-Q shows a quarter with revenue up 4.9% to $13.311 billion and net income attributable to HCA of $668 million ($1.95 diluted EPS), versus $612 million ($1.76) a year earlier. The headline numbers are distorted by accounting for COVID-19 government aid. In Q2 the company recognized $822 million of Provider Relief Fund income, and in Q3 it reversed that amount after HHS changed the rules on what providers can retain. Excluding the reversal, the quarter's results look meaningfully stronger, helped by a 15.3% increase in revenue per equivalent admission that offset a 9.1% decline in equivalent admissions. Emergency room visits fell 20.1% and surgeries fell 6.7%, so underlying volumes remain pressured even as acuity and reimbursement per case rose. The balance sheet changed sharply because of the CARES Act. Cash rose to $6.588 billion from $621 million at year-end 2019, but this is largely offset by a $6.123 billion government stimulus refund liability. On October 8, 2020, HCA announced it will repay about $1.6 billion of Provider Relief Fund distributions and about $4.4 billion of accelerated Medicare payments. Year-to-date operating cash flow of $12.815 billion is therefore inflated, and the company said it would fall to about $6.815 billion excluding these funds. Total debt was $30.964 billion at quarter-end, down from $33.722 billion, and the company suspended its share repurchases and quarterly dividend. For investors, the key questions are how quickly volumes recover, whether the repayment of government funds drains cash as expected, and how much of the reported earnings strength is repeatable. The company's own disclosures leave these open, and it notes that COVID-19 remains a significant uncertainty heading into the end of 2020.

    Oct 29, 2020
  19. 2020-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2020

    HCA Healthcare's Q2 2020 results reflected a sharp COVID-19 hit to elective volumes, partly offset by federal relief. Consolidated revenues fell 12.2% year over year to $11.068 billion, driven by a 20.0% decline in equivalent admissions, with surgeries down 26.5% and emergency department visits down 32.7%. Revenue per equivalent admission rose 9.7%, and salaries and benefits rose to 48.2% of revenue from 46.3%. Reported net income attributable to HCA was $1.079 billion, or $3.16 per diluted share, up from $2.25 a year earlier. That figure is flattered by $822 million of CARES Act Provider Relief Fund "government stimulus income" ($1.73 per diluted share) and $60 million of employee retention payroll tax credits, so underlying operating performance was materially weaker than the headline EPS suggests. Cash generation and liquidity improved markedly. Operating cash flow for the first six months rose to $10.098 billion from $2.971 billion, largely because of $4.999 billion of unapplied accelerated Medicare payments and unrecognized relief distributions recorded as contract liabilities (deferred revenue). These amounts are not free cash: accelerated Medicare advances must be repaid or recouped, and the Provider Relief Fund distributions are conditional on attestation and compliance. Cash rose to $4.638 billion, and total debt declined to $30.942 billion after HCA issued $2.7 billion of 3.50% notes due 2030 and redeemed $3 billion of higher-coupon notes, recording a $295 million pretax loss on retirement. HCA suspended its share repurchases and quarterly dividend, reduced capex to an expected $2.8 to $3.0 billion, and reported $7.718 billion of available senior secured credit facility capacity. The filing flags significant risks going forward. Florida and Texas, which account for 56% of admissions and 49% of revenues, are described as recent COVID-19 "hot spots", and management states it cannot estimate the length or severity of the pandemic's impact. Equity also reflects a stockholders' deficit, now a small positive $568 million total (including noncontrolling interests) after prior deficits, and HCA remains highly leveraged. Investors should view the Q2 earnings as heavily boosted by one-time relief, with the sustainability of volume recovery and the ultimate treatment of conditional government funds as the key open questions.

    Jul 30, 2020
  20. 2020-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2020

    HCA Healthcare's first-quarter 2020 results were hit by the COVID-19 pandemic, which disrupted patient volumes in the last two weeks of March. Revenue rose 2.7% year over year to $12.861 billion, and admissions grew 1.0%, but surgeries fell 4.4% and emergency room visits fell 1.0%. Net income attributable to HCA fell 44.1% to $581 million, or $1.69 per diluted share, versus $2.97 a year earlier. The decline was driven by a $295 million loss on early debt retirement ($0.66 per diluted share), salaries and benefits rising to 47.6% of revenue from 45.1%, and a higher uninsured patient mix, with uninsured admissions up 6.9%. Cash generation was stronger than earnings suggest. Operating cash flow rose to $1.375 billion from $974 million, mainly from collecting receivables, and accounts receivable fell to $6.89 billion. Management responded defensively: it suspended share repurchases and the quarterly dividend, cut capital expenditures, and drew on a new $2 billion 364-day term loan (undrawn at quarter-end). Total debt was $34.861 billion, and the company is highly leveraged. Stockholders' deficit widened to $(703) million. Subsequent events were material to liquidity. HCA requested accelerated Medicare payments and received about $4.3 billion in April 2020, along with about $900 million from the CARES Act Provider Relief Fund, which management expects to recognize as revenue in the second quarter. Management says cash flow, credit facilities, and debt market access will be sufficient for the next 12 months, but it also states it cannot estimate the length or severity of the pandemic's impact, so earnings visibility remains low.

    May 6, 2020
  21. 2019-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2019

    HCA Healthcare's Q3 2019 10-Q shows revenue growth remaining strong but earnings under pressure. Revenues rose 10.9% to $12.694 billion for the quarter (9.9% for the nine months to $37.813 billion), driven by a 7.5% increase in equivalent admissions and a 3.1% rise in revenue per equivalent admission. Same-facility revenue grew a more modest 6.3% in the quarter. However, net income attributable to HCA fell 19.3% to $612 million ($1.76 diluted EPS vs. $2.15 a year earlier), largely because of an $211 million pretax loss on debt retirement from July 2019 bond redemptions, the absence of 2018's large hospital-sale gains, and higher interest and depreciation costs. Nine-month diluted EPS was $6.98 versus $7.65. Cash generation and balance sheet activity were the main stories of the period. Operating cash flow rose to $5.097 billion for the nine months (from $4.586 billion), while capital expenditures of $2.884 billion and acquisitions of $1.592 billion (including a seven-hospital North Carolina system) pushed investing outflows to $4.375 billion. HCA raised $6.45 billion in new debt and refinanced several senior secured notes, bringing total debt to $34.245 billion. The company continues to carry a stockholders' deficit of $1.447 billion, a structural feature of its leveraged recapitalization history rather than a near-term liquidity signal, and management states that operating cash flow, available credit facilities and debt market access are sufficient for the next 12 months. Investors should also note several risk items: a qui tam False Claims Act lawsuit related to the Texas Medicaid Program in Harris County, uncertainty around Texas and other state supplemental Medicaid payment programs, an open IRS examination of 2016 and 2017 tax returns, and an uncompensated care ratio that rose to 38.4% of revenues and uncompensated care in the quarter. Share repurchases of $759 million year-to-date and a $0.40 quarterly dividend show continued capital return despite the high leverage.

    Nov 1, 2019
  22. 2019-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2019

    HCA Healthcare's Q2 2019 10-Q shows continued top-line growth but flat-to-lower profitability and a sharply higher debt load. Revenue rose 9.3% to $12.602 billion for the quarter and 9.4% to $25.119 billion for the six months, driven by a 6.2% increase in equivalent admissions and a 3.0% increase in revenue per equivalent admission. Same facility revenue grew a more modest 4.3% for the quarter. However, net income attributable to HCA fell 4.5% to $783 million ($2.25 diluted EPS vs. $2.31) in the quarter and 7.2% to $1.822 billion ($5.22 vs. $5.50) for the half-year. The year-over-year declines were largely due to the absence of the prior-year $414 million gain on the Oklahoma hospital sales, higher interest expense, and higher depreciation from acquisitions and capital spending. Operating expenses rose faster than revenue, with salaries and benefits at 46.3% of revenue in Q2 versus 45.8% a year earlier. The balance sheet and capital structure changed significantly. Total debt reached $36.193 billion at June 30, 2019, up from $32.821 billion at year-end 2018, after HCA issued $1.5 billion of unsecured notes in January and $5.0 billion of secured notes in June to fund a seven-hospital North Carolina acquisition and to refinance the asset-based revolver. In July, HCA redeemed roughly $4.95 billion of higher-coupon secured notes, which will produce a $211 million pretax loss in Q3 2019. Stockholders' deficit narrowed to $(1.770) billion from $(2.918) billion, driven mainly by retained earnings growth. Operating cash flow was $2.971 billion for the first half, up modestly, and management expects 2019 capital expenditures of about $3.7 billion excluding acquisitions. The filing also flags several risks. HCA disclosed a qui tam (whistleblower) lawsuit tied to the Texas Medicaid Section 1115 waiver program in Harris County, which was unsealed on May 21, 2019 and in which neither the federal nor state government intervened. Uninsured admissions rose 5.1% in the quarter on a same-facility basis, and total uncompensated care reached 37.9% of revenue plus uncompensated care, up from 36.0%. Management also noted that state supplemental Medicaid payment programs are under review, which could reduce future revenue, and that the IRS has opened an examination of the 2016 and 2017 returns. Management believes existing cash flows, credit facilities, and debt market access are sufficient for the next 12 months.

    Aug 2, 2019
  23. 2019-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2019

    HCA Healthcare's first quarter 2019 10-Q shows continued top-line growth but lower bottom-line earnings versus the prior year, which was flattered by a $405 million pretax gain on the sale of Oklahoma hospitals. Revenues rose 9.6% to $12.517 billion, driven by a 4.6% increase in revenue per equivalent admission and a 4.8% increase in equivalent admissions. Same facility revenues grew 6.3%. Net income attributable to HCA fell 9.2% to $1.039 billion, and diluted EPS declined to $2.97 from $3.18. Excluding the prior-year gain on facility sales, the earnings decline is smaller than the headline figures suggest, though income before taxes still fell 5.2%, and salaries, supplies and other operating expenses were broadly in line with revenue growth. Interest expense rose to $461 million on higher average debt of $34.0 billion. Balance sheet and cash flow trends warrant attention. Operating cash flow fell 24% to $974 million, reflecting a $428 million 401(k) Company match payment and $709 million of negative working capital changes. Accounts receivable rose to $7.42 billion, with days revenues in accounts receivable up to 53 from 50 a year earlier. HCA spent $1.474 billion on acquisitions, primarily a seven-hospital North Carolina health system, funded largely by $1.5 billion of new senior unsecured notes. Total debt reached $34.8 billion, and the company remains in a stockholders' deficit of $2.255 billion, a consequence of past recapitalization and buybacks rather than an operating-loss signal. Management repurchased 2.1 million shares for $278 million and declared a $0.40 quarterly dividend, and it expects 2019 capital expenditures of about $3.7 billion. Risk items for investors include exposure to government programs, with Texas Medicaid supplemental payments of $108 million in the quarter and ongoing state reviews of supplemental programs that could reduce payments. A DOJ inquiry into Texas Medicaid's Harris County program and a new IRS examination of 2016-2017 returns are also disclosed. Management states that liquidity is adequate for the next 12 months, and the company's disclosure controls were concluded to be effective.

    May 3, 2019
  24. 2018-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2018

    HCA Healthcare's third quarter 2018 results showed strong top-line and earnings growth. Revenues rose 7.1% to $11.451 billion from $10.696 billion, and same facility revenues grew 7.4%, driven by a 2.5% increase in revenue per equivalent admission and a 4.4% increase in equivalent admissions. Net income attributable to HCA rose to $759 million, or $2.15 per diluted share, versus $426 million, or $1.15, a year earlier. The comparison is flattered by a $132 million tax benefit ($0.37 per diluted share) from the 2017 Tax Cuts and Jobs Act and a $70 million reduction in professional liability provisions, partly offset by lower reported losses on debt retirement and lower hurricane-related costs in the prior year. Cash flow from operations for the nine months reached $4.586 billion, up from $3.692 billion, and the company returned capital through $1.195 billion of share repurchases and $366 million of dividends. The balance sheet remains highly leveraged. Total debt was $33.107 billion at September 30, 2018, against a stockholders' deficit of $3.730 billion, and interest expense rose to $442 million for the quarter. Management highlighted that it issued $2.0 billion of senior notes in August 2018 and used the proceeds to redeem $1.5 billion of 3.75% secured notes due 2019, which lowers near-term refinancing risk. Uninsured volumes continued to rise, with same facility uninsured admissions up 8.8% in the quarter, and total uncompensated care reached 37.2% of revenues plus uncompensated care. Investors should weigh the strong operating momentum against this rising uninsured mix, the sensitivity to Medicaid supplemental payment programs (Texas supplemental payments were $101 million in the quarter), and the largely one-time nature of the tax and actuarial benefits.

    Nov 6, 2018
  25. 2018-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2018

    HCA Healthcare's second-quarter 2018 Form 10-Q (filed August 3, 2018) shows continued top-line momentum alongside a large one-time boost to earnings. Revenues rose 7.4% to $11.529 billion for the quarter and 7.5% to $22.952 billion for the six months, driven by 2.1% growth in revenue per equivalent admission and 5.1% growth in equivalent admissions. Same facility revenues grew 6.5% in the quarter. Net income attributable to HCA rose 24.9% to $820 million ($2.31 per diluted share) for the quarter, but the quarter included only a $9 million gain on facility sales and a roughly $0.34 per diluted share tax benefit from the 2017 Tax Cuts and Jobs Act. For the six months, net income attributable to HCA was $1.964 billion ($5.50 per diluted share), inflated by $414 million of pretax gains, primarily from the sale of two Oklahoma hospitals, and a $0.54 per share tax benefit. Underlying operating trends were mixed. Salaries and benefits rose to 45.8% of revenue in the quarter from 45.6%, and same facility labor rate increases averaged 3.4%. Uncompensated care rose to 36.0% of revenue plus uncompensated care in the quarter from 34.8%, and same facility uninsured admissions grew 7.8%. Interest expense increased to $436 million as total debt reached $33.2 billion, and the company remains highly leveraged. Operating cash flow was $2.865 billion for the six months, while capital expenditures of $1.574 billion and share repurchases of $893 million were funded in part by disposal proceeds and new borrowings. The company also began paying a quarterly dividend of $0.35 per share and held $910 million of remaining buyback authorization. For investors, the key questions are how much of the earnings improvement is recurring versus driven by tax reform and asset sales, and whether rising uninsured volumes and labor costs will pressure margins over time. Management expects 2018 capital expenditures of about $3.5 billion and states that operating cash flow, credit facility availability and debt market access will meet liquidity needs for the next 12 months.

    Aug 3, 2018
  26. 2018-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2018

    HCA Healthcare's first quarter 2018 results showed strong top-line and earnings growth, though a large portion of net income came from one-time items. Revenues rose 7.5% to $11.423 billion from $10.623 billion, with same facility revenues up 5.8%, driven by a 2.9% increase in revenue per equivalent admission and a 4.6% increase in equivalent admissions. Net income attributable to HCA rose 73.5% to $1.144 billion, or $3.18 per diluted share, versus $1.74 a year earlier. However, results include $405 million in pretax gains on sales of facilities (mainly the sale of two Oklahoma hospitals, worth $0.85 per diluted share) and a $0.20 per share tax benefit from the 2017 Tax Cuts and Jobs Act, so underlying growth is more modest than headline figures suggest. Same facility admissions grew 2.2%, while uninsured admissions rose 10.1%, a trend that points to rising uncompensated care, which reached 35.4% of revenues plus uncompensated care versus 33.4% a year earlier. Balance sheet and cash flow metrics are mixed. Operating cash flow was $1.300 billion, up modestly from $1.280 billion. Total debt was $33.291 billion, and interest expense rose to $431 million from $419 million. Working capital declined to $2.913 billion from $3.819 billion, largely because $1.497 billion of long-term debt became due within one year, a figure that management says reflects refinancing activity. HCA continued shareholder returns, repurchasing 4.37 million shares for $423 million and paying a $0.35 quarterly dividend, its first in the comparison period. Management expects 2018 capital expenditures of about $3.5 billion and says cash flows and available credit will meet liquidity needs over the next 12 months. The company remains highly leveraged, with a stockholders' deficit of $4.434 billion. Investors should monitor the sustainability of volume and pricing growth, the uninsured trend, and the risk to Medicaid supplemental payment programs, especially in Texas, which generated $98 million in the quarter. Future results will also depend on the outcome of ongoing Tax Act adjustments, which management says could materially affect the provision for income taxes.

    May 8, 2018
  27. 2017-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2017

    HCA Healthcare's Q3 2017 10-Q shows a quarter of solid top-line growth overshadowed by margin pressure and lower earnings. Revenues rose 4.2% to $10.696 billion, but net income attributable to HCA fell 31% to $426 million ($1.15 diluted EPS vs. $1.59). The main drag was the provision for doubtful accounts, which jumped $431 million to $1.271 billion as uninsured volumes surged (uninsured revenue up $513 million in the quarter). Management also cited about $140 million (roughly $0.24 per diluted share) of hurricane Harvey and Irma impacts and a roughly $50 million unfavorable Texas Medicaid Waiver settlement. Salaries and benefits rose to 47.5% of revenue from 46.1%, and other operating expenses rose to 19.4% from 18.5%. Balance sheet and cash flow trends are mixed. Total debt rose to $32.953 billion, and the company issued $1.5 billion of 5.5% senior secured notes due 2047 while funding acquisitions ($1.142 billion in the first nine months, up from $468 million). Operating cash flow fell to $3.692 billion for the nine months from $3.954 billion. HCA still repurchased $1.475 billion of stock in the nine months, reducing diluted shares to 369.8 million for the quarter from 389.6 million a year earlier, and the board authorized a new $2 billion buyback in October 2017. The company remains highly leveraged, with a stockholders' deficit of $5.066 billion. For investors, the key questions are whether the uninsured trend and the rising provision for doubtful accounts are structural or temporary, whether labor cost growth can be contained, and how the company balances buybacks against heavy capital spending (about $3.0 billion expected in 2017) and acquisitions with a highly leveraged capital structure.

    Nov 7, 2017
  28. 2017-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2017

    HCA Healthcare's Q2 2017 results show continued top-line growth alongside rising pressure from uninsured patients. Revenues rose 4.0% to $10.733 billion for the quarter (6.5% growth before the provision for doubtful accounts), and six-month revenues rose 3.8% to $21.356 billion. However, net income attributable to HCA fell slightly to $657 million in the quarter (flat versus $658 million a year earlier) and to $1.316 billion for six months (down 2.7%). Diluted EPS rose to $1.75 from $1.65 for the quarter, but that gain was driven mainly by a 5.8% reduction in diluted share count from aggressive buybacks, not by earnings growth. The provision for doubtful accounts jumped to $1.073 billion from $762 million, and management's combined measure of uninsured costs (provision, charity care and uninsured discounts) reached 34.8% of the relevant revenue base versus 32.5% a year ago. Balance sheet and cash flow data point to a highly leveraged capital structure. Total debt was $31.661 billion at June 30, 2017, and stockholders' deficit attributable to HCA stood at $(6.792) billion. Operating cash flow was $2.684 billion for six months, roughly flat year over year, with working capital headwinds and lower interest and tax payments offsetting. Capital expenditures excluding acquisitions were $1.304 billion in the first half, with full-year 2017 guidance of approximately $2.9 billion. Management repurchased 11.525 million shares for $966 million in the first half and retains $887 million of authorization. In June 2017 the company issued $1.5 billion of 5.5% senior secured notes due 2047 and amended its ABL facility to $3.75 billion, extending maturity to 2022, with proceeds earmarked partly for pending hospital acquisitions and redemption of $500 million of 8% notes. For investors, the central questions are whether the uninsured trend (driven by Affordable Care Act exchange enrollment and high-deductible plans) can be managed, whether same-facility volume growth of 1.3% in the quarter can keep pace with rising labor and supply costs, and how the Health Reform Law, Texas Medicaid waiver renewal and state supplemental payment programs could change reimbursement. The filing does not quantify these risks, and management says they remain uncertain.

    Aug 4, 2017
  29. 2017-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2017

    HCA Healthcare's first quarter 2017 results show modest top-line growth with pressure on profitability. Revenues rose 3.5% to $10.623 billion from $10.260 billion, driven by a 1.7% increase in revenue per equivalent admission and a 1.8% rise in equivalent admissions. Net income attributable to HCA fell 5.0% to $659 million, and diluted EPS rose to $1.74 from $1.69, helped by a 7.4% reduction in diluted share count (379.98 million vs. 410.58 million) following aggressive buybacks. Income before taxes declined 2.7%, and the effective tax rate rose to 30.4% from 29.1%, partly offset by $67 million of excess tax benefits from equity award settlements. Operating pressure is visible in the cost lines. Salaries and benefits rose to 46.1% of revenues from 45.8%, supply costs rose to 16.9% from 16.7%, and other operating expenses rose to 18.2% from 18.1%. Adjusted segment EBITDA was essentially flat at $2.005 billion versus $2.003 billion. Uninsured exposure is a key watch item: charity care and uninsured discounts rose $131 million and $384 million year over year, and the combined provision, discounts and charity care ratio worsened to 33.4% from 32.1%. Operating cash flow declined 8.5% to $1.280 billion, mainly from working capital and taxes. The balance sheet remains highly leveraged, with total debt of $31.514 billion and a stockholders' deficit of $5.357 billion. Liquidity is adequate, with $2.139 billion available under senior secured credit facilities at March 31, 2017. HCA repurchased 5.121 million shares for $424 million, leaving $1.429 billion of authorization, and agreed to buy six hospitals for roughly $950 million, expected to close in the second and third quarters of 2017. Management expects 2017 capital expenditures of about $2.9 billion.

    May 9, 2017
  30. 2016-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2016

    HCA Holdings' third quarter 2016 results showed continued top-line growth and strong earnings expansion, driven by a sharp decline in the provision for doubtful accounts and a one-time tax benefit. Revenues rose 4.2% to $10.270 billion, with revenue per equivalent admission up 2.7% and equivalent admissions up 1.5%. Net income attributable to HCA Holdings climbed 37.7% to $618 million, or $1.59 per diluted share, versus $1.05 a year earlier. However, roughly $0.16 of diluted EPS came from tax benefits ($51 million related to the IRS resolution for 2011-2012 and $11 million from ASU 2016-09 adoption), and the quarter also included legal claim costs of $11 million tied to the Health Midwest litigation. Beneath the headline numbers, the uninsured mix remains a key watch item. The provision for doubtful accounts fell $318 million year over year, but uninsured discounts rose $531 million and charity care rose $117 million, so the combined uninsured-related revenue deductions and provision as a percentage of revenue were 33.7% versus 33.1% a year ago. Revenue before provision for doubtful accounts grew only 0.9% in the quarter, indicating that the reported revenue gains depend heavily on lower bad-debt charges rather than gross revenue growth. Operating cash flow for the quarter was $1.206 billion, up $105 million. The balance sheet remains highly leveraged, with total debt of $31.441 billion and stockholders' deficit of $6.163 billion. The company repurchased $2.213 billion of stock in the first nine months of 2016 and has $390 million remaining under its $3 billion authorization. Management expects 2016 capital expenditures of about $2.7 billion. A subsequent event disclosed in the filing is an agreement to transfer Oklahoma hospital operations to an affiliate of the University Hospitals Authority and Trust for $750 million, expected to close in the first half of 2017.

    Nov 3, 2016
  31. 2016-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2016

    HCA Holdings' second quarter 2016 10-Q shows a company growing revenue and earnings while its balance sheet remains highly leveraged. Revenues rose 4.3% to $10.319 billion, driven by a 2.4% increase in revenue per equivalent admission and a 1.9% increase in equivalent admissions. Net income attributable to HCA Holdings grew 29.8% to $658 million, or $1.65 per diluted share, versus $1.18 a year earlier. Part of that gain reflects a $44 million tax benefit from the early adoption of ASU 2016-09, which contributed $0.11 per diluted share, and the prior-year quarter included a $125 million debt retirement loss that did not recur. Underlying operating trends were mixed. The provision for doubtful accounts fell $273 million to $762 million, largely because uninsured discounts and charity care rose sharply ($667 million and $205 million, respectively), so the company is shifting how uninsured patient revenue is recognized rather than simply collecting more cash. Salaries and benefits, supplies, and other operating expenses were stable as a share of revenue, though other operating expenses rose to 18.0% of revenue from 17.7%. Operating cash flow for the six months was $2.748 billion, up from $2.075 billion. HCA spent $1.858 billion repurchasing stock in the first half and $1.172 billion on capital expenditures, while acquisitions rose to $430 million. The balance sheet carries significant risk. Total debt was $31.452 billion at June 30, 2016, against stockholders' deficit of $6.498 billion, and HCA reports that it is highly leveraged. Two items warrant monitoring: the Health Midwest litigation, with $458 million accrued and an appeal pending, and the UK Competition and Markets Authority's final London divestiture decision, expected in the third quarter of 2016. Management believes operating cash flow, credit facility availability, and debt market access will cover liquidity needs for the next 12 months.

    Aug 4, 2016
  32. 2016-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2016

    HCA Healthcare, Inc. (HCA) reported its first quarter 2016 results, demonstrating solid revenue and net income growth. Total revenues increased by 6.0% to $10.26 billion compared to the prior year's first quarter, driven by a 2.2% increase in revenue per equivalent admission and a 3.7% rise in equivalent admissions. Net income attributable to HCA Holdings, Inc. saw a significant increase of 17.3% to $694 million, or $1.69 per diluted share, up from $591 million, or $1.36 per diluted share, in the first quarter of 2015. This growth was bolstered by operational improvements and a favorable tax benefit related to the early adoption of a new accounting standard. The company experienced increased patient volumes across various service lines, including admissions, outpatient surgeries, and emergency department visits, indicating strong demand for its services. Despite a notable increase in the provision for doubtful accounts and self-pay revenue deductions, which reflects the ongoing challenges in collectibility from uninsured patients, HCA managed to improve its profitability. The company also actively engaged in capital allocation, repurchasing approximately $621 million of its common stock during the quarter, underscoring management's confidence in its financial health and commitment to shareholder returns.

    May 6, 2016
  33. 2015-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2015

    HCA Holdings' third quarter 2015 results show top-line growth alongside weaker bottom-line earnings. Revenues rose 6.9% to $9.856 billion, driven by a 4.8% increase in equivalent admissions and a 2.0% gain in revenue per equivalent admission. Same facility revenues grew 5.5%. However, net income attributable to HCA Holdings fell 13.4% to $449 million, and diluted EPS declined to $1.05 from $1.16. The earnings decline reflects a $400 million increase in the provision for doubtful accounts, which rose to $1.158 billion, and $77 million of legal claim costs tied to the Health Midwest litigation. Adding uninsured discounts and charity care, the combined uninsured-related revenue deductions and provisions reached 33.1% of the relevant revenue base, up from 29.8% a year earlier. This is the key issue for investors: growth in uninsured volumes, linked to Affordable Care Act exchange and Medicaid expansion dynamics, is pressuring collections and margins. Cash generation remained solid. Operating cash flow for the nine months rose to $3.176 billion from $2.821 billion, and HCA spent $1.386 billion repurchasing common stock. The company also announced a new $3 billion share repurchase authorization on October 26, 2015, after the quarter end. Total debt stood at $29.752 billion, and the average effective interest rate on long-term debt fell to 5.5% in the quarter from 6.0% a year earlier, which reduced interest expense to $411 million. Management expects 2015 capital expenditures of about $2.4 billion and EHR incentive income of $46 million to $50 million for the year. Legal and regulatory exposure remains significant. The Health Midwest judgment carries an accrued liability of $382 million, and the securities class action against HCA is likely to proceed to trial in 2016. The UK Competition and Markets Authority matter also remains open, with a decision expected in early 2016. The company disclosed no material changes to risk factors from its 2014 Form 10-K.

    Oct 29, 2015
  34. 2015-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2015

    HCA Healthcare, Inc. reported strong financial performance for the second quarter and the first six months of 2015, demonstrating robust revenue growth and increased net income compared to the prior year. Revenues saw a significant increase of 7.2% year-over-year for the quarter, driven by a rise in equivalent admissions and revenue per equivalent admission. This top-line growth translated into improved profitability, with net income attributable to HCA Holdings, Inc. rising by 4.9% for the quarter and a substantial 32.3% for the six-month period. The company also continued its focus on capital allocation through significant share repurchases. While operating expenses, particularly salaries and benefits and supplies, increased, they were managed effectively relative to revenue growth. The company also highlighted its strong liquidity position, supported by operational cash flows and available credit facilities, enabling continued investment in capital expenditures. Despite facing ongoing challenges in the healthcare industry, including regulatory changes and the complexities of reimbursement, HCA Healthcare has shown resilience and a capacity for growth. Investors should note the company's strategic debt management, ongoing share repurchase programs, and commitment to operational efficiency as key indicators of its financial health and future prospects.

    Aug 5, 2015
  35. 2015-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2015

    HCA Healthcare, Inc. reported strong first-quarter 2015 results, demonstrating significant top-line growth and improved profitability compared to the prior year. Total revenues increased by 9.5% year-over-year, driven by a combination of increased patient volumes and slight improvements in revenue per equivalent admission. This revenue growth translated into a substantial increase in net income, which more than doubled from the first quarter of 2014, largely due to operational efficiencies and a favorable swing in income tax benefits. The company's operational performance was robust, with solid growth in admissions, equivalent admissions, and surgical volumes across both consolidated and same-facility metrics. A notable trend highlighted is the significant decline in uninsured patient admissions and the corresponding reduction in the provision for doubtful accounts, which management attributes to increased health coverage through insurance exchanges and Medicaid expansion programs. This positive trend contributed to improved operating margins. Financially, HCA Healthcare managed its debt effectively, with a slight decrease in overall interest expense due to lower average interest rates, despite a notable increase in long-term debt due within one year. The company also continued its share repurchase program, returning capital to shareholders. Overall, the first quarter of 2015 signals a period of strong operational execution and financial recovery for HCA Healthcare.

    May 5, 2015
  36. 2014-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2014

    HCA Holdings' third quarter 2014 results showed strong top-line and earnings growth. Revenues rose 9.0% to $9.220 billion from $8.456 billion, with same facility revenues up 8.1%, driven by a 3.3% increase in revenue per equivalent admission and a 5.5% increase in equivalent admissions. Net income attributable to HCA Holdings was $518 million, or $1.16 per diluted share, versus $365 million, or $0.79, a year earlier. The quarter was helped by two favorable changes in estimates that netted to a $26 million revenue increase: a $94 million Medicare RAC settlement accrual ($0.13 per diluted share) and a $68 million reduction to Texas Medicaid Waiver revenues ($0.09 per diluted share). Importantly, the Texas Medicaid waiver reduction was followed on October 1, 2014 by a CMS deferral of the federal portion of certain indigent care payments, and management expects to stop recognizing some of those revenues, a forward-looking risk to watch. Credit and balance sheet trends were mixed but improving. Uninsured admissions fell 14.8% on a same facility basis, and the provision for doubtful accounts declined $197 million year over year, which management attributes to coverage gains from health insurance exchanges and Medicaid expansion. Total debt was $28.470 billion at September 30, 2014, and the company remains highly leveraged, with stockholders' deficit of $6.0 billion. Management refinanced aggressively during 2014, issuing $3.5 billion in March and an additional $2.0 billion in October, and it expects a $108 million pretax loss on the November redemption of $1.4 billion of 7 1/4% notes. Cash flow from operations rose to $2.821 billion for the first nine months, and the board authorized a $1.0 billion share repurchase program in October 2014 after repurchasing 14.6 million shares for $750 million in May. Key legal overhangs include a securities class action in which the court certified a class on September 22, 2014, an ongoing DOJ review of implantable cardio-defibrillator billing, a Health Midwest capital commitment lawsuit with an accrued legal claim cost of $78 million in the first quarter, and a UK Competition and Markets Authority order requiring divestiture of certain London or Wellington hospitals, which HCA is appealing. Management expects Q4 2014 EHR incentive income of $110 million to $130 million for the full year, and it projects 2014 capital expenditures of about $2.2 billion.

    Nov 4, 2014
  37. 2014-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2014

    HCA Holdings' second quarter 2014 results showed solid top-line growth and improved earnings, though the quarter was flattered by a one-time Texas Medicaid item and dented by a debt refinancing charge. Revenues rose 9.2% to $9.230 billion, and same facility revenues rose 7.7%, driven by a 5.4% increase in revenue per equivalent admission. Net income attributable to HCA Holdings grew 14.3% to $483 million, or $1.07 per diluted share. Results include a $142 million ($0.20 per diluted share) Medicaid benefit tied to Texas indigent care reimbursements for the program year ended September 30, 2013, and a $226 million ($0.32 per diluted share) loss on debt retirement. Excluding these items, underlying performance was more modest than the headline figures suggest. The key operating trend is improving credit quality in the patient base. The provision for doubtful accounts fell $295 million year over year to $728 million, and the combined uninsured burden (provision, charity care and uninsured discounts) fell to 29.0% of the relevant revenue base from 31.2%. Management attributes this to previously uninsured patients gaining coverage through the health insurance exchanges and Medicaid expansion, with same facility uninsured admissions down 14.7%. Operating efficiency was mixed: salaries and benefits and supplies both improved as a percentage of revenue, while other operating expenses held flat at 17.8%. Balance sheet and capital allocation were active during the quarter. HCA issued $3.5 billion of secured notes in March, used the proceeds to redeem $2.75 billion of higher-coupon notes in April, and repurchased 14.6 million shares for $750 million in May. Total debt stood at $28.988 billion, and the company remains highly leveraged with a stockholders' deficit of $6.588 billion. Lower average interest rates reduced interest expense to $427 million in the quarter from $462 million. Investors should weigh the strong cash generation and improving volume and payer trends against the sizable leverage, the Health Midwest and ICD-related legal exposures, and the UK competition remedy still under appeal.

    Aug 5, 2014
  38. 2014-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2014

    HCA Holdings, Inc. reported its first quarter 2014 financial results, showing a slight increase in net income attributable to HCA Holdings, Inc. to $347 million ($0.76 per diluted share) from $344 million ($0.74 per diluted share) in the prior year's quarter. Total revenues grew by 4.6% to $8.832 billion. The company experienced revenue growth driven by an increase in revenue per equivalent admission, despite a slight decrease in equivalent admissions. Operational highlights include a notable increase in the provision for doubtful accounts and associated uninsured discounts, indicating pressure from patients with less insurance coverage. The company also recorded significant legal claim costs related to the Health Midwest litigation. Financially, HCA managed its debt by issuing new notes and repaying existing ones, demonstrating active capital management. The company maintains a strong liquidity position with substantial credit facilities available. However, the company faces ongoing legal and regulatory scrutiny, including investigations into billing practices and a recent adverse ruling in the UK regarding competition in the private healthcare market, for which an appeal is planned. Investors should monitor the impact of healthcare reform, evolving reimbursement policies, and the resolution of ongoing legal matters.

    May 6, 2014
  39. 2013-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2013

    HCA Holdings' third quarter 2013 results showed modest top-line growth alongside pressure on the bottom line. Revenues rose 4.9% to $8.456 billion from $8.062 billion, driven by a 3.9% increase in revenue per equivalent admission and a 0.9% rise in equivalent admissions. However, net income attributable to HCA Holdings grew only 1.5% to $365 million ($0.79 diluted EPS vs. $0.78), and nine-month net income fell 12.3% to $1.132 billion ($2.44 diluted EPS vs. $2.81), largely because the prior-year period benefited from a $170 million pretax Medicare revenue adjustment and because the provision for doubtful accounts continues to climb. Uninsured discounts and charity care are expanding, with the combined provision, uninsured discounts and charity care equal to 31.7% of adjusted revenue in the quarter versus 30.5% a year earlier. Electronic health record incentive income fell to $75 million from $131 million, and interest expense rose to $458 million as average debt reached $28.2 billion. Cash flow and balance sheet items point to a company still heavily leveraged. Operating cash flow for the nine months declined to $2.454 billion from $2.912 billion, reflecting lower net income and an adverse working capital swing of $330 million. Total debt was $28.377 billion at September 30, 2013, and the stockholders' deficit improved to $(7.044) billion from $(8.341) billion. Capital expenditures are guided to about $2.0 billion for 2013. Management expects liquidity to be sufficient for the next 12 months, supported by operating cash flow and $2.3 billion of available revolver capacity. Subsequent to quarter end, on November 1, 2013, Bain Capital and KKR sold 30 million shares in a secondary offering. HCA concurrently repurchased about $500 million of stock from the selling stockholders at $46.92 per share. Because HCA is no longer a controlled company, it must appoint a majority-independent board within one year. Ongoing legal exposures include a DOJ review of implantable cardioverter-defibrillator billing, a Missouri judgment in the Health Midwest litigation of at least $162 million (plus about $12 million in fees), and securities and derivative litigation tied to the 2011 IPO.

    Nov 6, 2013
  40. 2013-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2013

    HCA Holdings' second quarter 2013 results show modest top-line growth with flat-to-lower earnings quality versus the prior year. Revenues rose 4.2% to $8.450 billion (from $8.112 billion), driven by a 3.0% increase in revenue per equivalent admission and a 1.1% rise in equivalent admissions. Net income attributable to HCA Holdings grew 8.1% to $423 million, or $0.91 per diluted share, versus $0.85 a year earlier. However, the six-month picture is weaker: net income attributable to HCA fell 17.7% to $767 million ($1.66 per diluted share vs. $2.03), largely because the first half of 2012 included a $170 million pretax benefit from Medicare revenue adjustments (about $0.22 per share) that did not recur. The key watch items for investors are uninsured and bad-debt dynamics and cash generation. The provision for doubtful accounts remained large at $1.023 billion in the quarter, but uninsured discounts rose $398 million year over year, and the combined provision, uninsured discounts and charity care burden reached 31.2% of the relevant revenue base versus 29.5% a year earlier. Operating cash flow fell sharply, to $814 million in the quarter from $1.460 billion, and to $1.554 billion for the six months from $2.257 billion, reflecting working capital drag and higher income tax payments. Accounts receivable rose to $4.915 billion, and the company reported a 52-day revenue-in-receivables metric alongside 34% of receivables over 180 days old. Balance sheet leverage remains very high. Total debt was $28.2 billion at June 30, 2013, with stockholders' deficit attributable to HCA of $(8.823) billion, though the deficit narrowed from $(9.660) billion at year-end 2012 as retained earnings improved. Interest expense rose to $462 million in the quarter, and management expects 2013 capital expenditures of approximately $2.0 billion. Legal and regulatory overhangs include the Health Midwest judgment (at least $162 million, with an ongoing court-supervised accounting), DOJ reviews related to implantable cardio-defibrillators and interventional cardiology, and securities class action litigation tied to the 2011 IPO, which was partially dismissed in May 2013. Management also disclosed that CEO Richard Bracken will retire as CEO and remain as Chairman through 2014.

    Aug 7, 2013
  41. 2013-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2013

    HCA Healthcare, Inc. reported its first quarter 2013 financial results, showing a slight increase in revenue to $8.44 billion, up from $8.405 billion in the prior year's first quarter. However, net income attributable to HCA Holdings, Inc. saw a significant decrease, falling to $344 million ($0.74 per diluted share) compared to $540 million ($1.18 per diluted share) in the first quarter of 2012. This decline was influenced by several factors, including a loss on debt retirement and sale of facilities in the current quarter, and beneficial Medicare revenue adjustments in the prior year. Operational metrics showed mixed results, with a slight increase in consolidated admissions but a decrease in both inpatient and outpatient surgeries. The company experienced an increase in its provision for doubtful accounts and uninsured discounts, reflecting challenges in patient collections. Despite the lower net income, the company's liquidity remains a focus, with substantial debt levels and ongoing capital expenditure plans. Investors should monitor the company's ability to manage its debt and navigate the evolving healthcare regulatory landscape.

    May 7, 2013
  42. 2012-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2012

    HCA Holdings, Inc. reported third-quarter 2012 revenues of $8.062 billion, up from $7.258 billion in the third quarter of 2011, and net income attributable to HCA Holdings, Inc. of $360 million, or $0.78 per diluted share, compared to $61 million, or $0.11 per diluted share, a year earlier. The quarter's results include net gains on sales of facilities of $7 million, and the year-earlier quarter included losses on retirement of debt of $406 million. Revenue growth was driven primarily by a 2.5% increase in revenue per equivalent admission and an 8.3% increase in equivalent admissions, with the consolidation of the HCA-HealthONE LLC venture contributing to the consolidated increase. On a same facility basis, revenues rose 3.3%. Interest expense fell to $446 million from $519 million, reflecting a lower average effective interest rate. For the first nine months of 2012, net income attributable to HCA Holdings, Inc. was $1.291 billion, or $2.81 per diluted share. The filing states that two Medicare adjustments, a Rural Floor Provision Settlement and SSI ratio changes, added $170 million to income before income taxes, or $0.22 per diluted share. The provision for doubtful accounts rose to $2.666 billion from $2.164 billion, and the company's uninsured-related adjustments remained a notable pressure point. Total debt was $26.933 billion at September 30, 2012, and the company describes itself as highly leveraged. Cash flow from operating activities was $2.912 billion for the nine months. Subsequent to quarter end, the Board declared a distribution of $2.50 per share, or approximately $1.2 billion in the aggregate, expected to be paid on November 16, 2012, funded by existing senior secured credit facilities. In October 2012, the company issued $2.500 billion of notes and replaced its $2.000 billion revolving credit facility. The filing also discloses ongoing government investigations related to implantable cardio-defibrillators and interventional cardiology, and pending securities class action litigation tied to the 2011 initial public offering.

    Nov 6, 2012
  43. 2012-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended May 30, 2012

    HCA Healthcare, Inc. (HCA) reported strong financial performance for the second quarter and first six months of 2012, demonstrating significant year-over-year growth in revenues and net income. Revenues increased by 11.9% in the second quarter and 12.7% for the six-month period, driven by higher patient volumes and revenue per equivalent admission. Net income attributable to HCA Holdings, Inc. saw a substantial increase of 70.3% in the second quarter and 98.4% for the first six months, reflecting improved operational efficiency and favorable revenue trends. The company's operating expenses also saw an increase, primarily in salaries, benefits, and supplies, in line with revenue growth. However, cost control measures appear to be effective, as the company managed to improve its profit margins. HCA also highlighted positive cash flow generation from operations, providing flexibility for investments and debt management. The company continues to invest in its facilities and appears well-positioned to navigate the evolving healthcare landscape, including the impact of healthcare reform.

    Aug 6, 2012
  44. 2012-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2012

    HCA Healthcare, Inc. reported strong financial performance for the first quarter of 2012, with revenues increasing by 13.5% to $8.4 billion compared to the same period in 2011. This growth was driven by a 11.4% increase in equivalent admissions and a 1.9% rise in revenue per equivalent admission, partly bolstered by the full consolidation of the HCA-HealthONE LLC venture. Net income attributable to HCA Holdings, Inc. significantly improved, reaching $540 million ($1.18 per diluted share) from $240 million ($0.52 per diluted share) in the prior year. This improvement was aided by substantial Medicare revenue adjustments totaling $188 million, though partially offset by a retroactive reduction of $83 million. The company also benefited from a decrease in interest expense by $91 million due to a lower average effective interest rate on its debt. However, cash flows from operations saw a decline primarily due to changes in working capital. HCA Healthcare continues to manage its significant debt load and is actively engaged in capital allocation, including a $971 million distribution to stockholders declared in February 2012. The company maintains a positive outlook, anticipating continued revenue growth and managing operational costs, while also addressing ongoing legal and regulatory matters.

    May 9, 2012
  45. 2011-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2011

    HCA Holdings' third-quarter 2011 10-Q shows a quarter dominated by balance-sheet restructuring rather than operating momentum. Net income attributable to HCA Holdings fell 75% to $61 million ($0.11 diluted EPS) from $243 million ($0.55) a year earlier, driven primarily by a $406 million pretax loss on retirement of debt tied to refinancing the second lien toggle and second lien notes with $5.0 billion of new notes. Revenues rose 5.5% to $7.310 billion, with consolidated admissions up 4.8% and same-facility admissions up 3.2%, but same-facility revenue per equivalent admission declined 0.1% due to a shift toward less acute medical cases. The provision for doubtful accounts (now presented as a deduction from revenue under ASU 2011-07) rose modestly, and the combined uninsured discount, charity care and bad debt burden reached 28.3% of related revenues versus 26.4% a year ago, a key pressure point. Operationally, operating cash flow for the nine months was flat at $2.546 billion, but third-quarter operating cash flow fell $376 million to $880 million on working capital changes. Capital spending rose sharply to $1.170 billion for the nine months (versus $860 million), with 2011 capex guided to about $1.6 billion. Total debt stood at $26.596 billion at quarter-end, and the company is highly leveraged, though the IPO proceeds ($2.506 billion) and the $1.503 billion repurchase of 80.8 million shares from Bank of America affiliates reshaped the capital structure. Subsequent to quarter-end, HCA acquired the remaining ~40% of HCA-HealthONE for $1.450 billion, which management expects to be immediately accretive, and it issued $500 million of 8.00% notes due 2018 to help fund it. Investors should also note several new legal and tax overhangs: a securities class action under Section 11 of the Securities Act tied to the March 2011 IPO registration statement, a DOJ review of implantable cardio-defibrillator billing at 95 hospitals, and ongoing IRS disputes for 2002 through 2006 tax years. Legislative pressure on Medicare and Medicaid reimbursement, including Florida and Texas Medicaid cuts estimated at roughly $35 million and $20 million to $60 million respectively, is also highlighted as a risk to future revenue growth.

    Nov 9, 2011
  46. 2011-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2011

    HCA Holdings, Inc. (HCA) reported second-quarter 2011 net income attributable to HCA Holdings of $229 million, or $0.43 per diluted share, down from $293 million, or $0.67 per diluted share, in the prior-year quarter. Revenues rose 4.0% to $8.063 billion, with same facility revenues up 2.4%, driven by a 3.4% increase in equivalent admissions and only 0.5% growth in revenue per equivalent admission. The earnings decline reflects a $75 million loss on retirement of debt in the quarter, higher salaries and benefits (41.2% of revenues vs. 39.6%), higher other operating expenses, and an effective tax rate of 39.1% versus 31.8% a year earlier, partly offset by a lower provision for doubtful accounts (9.6% of revenues vs. 10.2%). Management noted a shift in service mix toward less acute medical cases, which led to lower-than-anticipated revenue growth. The most significant balance sheet development is the March 2011 IPO, which raised $2.506 billion in net proceeds used to pay down revolving credit facilities. Total debt fell to $25.320 billion from $28.225 billion at year-end 2010, and interest expense declined modestly to $520 million in the quarter. The company's stockholders' deficit narrowed to $(7.534) billion, and operating cash flow increased to $748 million in the quarter from $436 million, mainly due to lower income tax payments. Subsequent to quarter-end, HCA announced a $5.000 billion note issuance on August 1, 2011, intended to refinance higher-cost second lien notes, with an expected pretax debt retirement charge of about $396 million, and an agreement to repurchase the Colorado Health Foundation's interest in HCA-HealthONE for $1.45 billion. Investors should weigh the company's continued high leverage (debt of about 7.7x... with average effective rate of 8.2% on long-term debt) against its improving liquidity after the IPO, the uncertain outcome of pending IRS disputes, the Health Reform Law and Budget Control Act's potential effects on Medicare and Medicaid reimbursement, and an open Department of Justice review of implantable cardio-defibrillator billing across 95 hospitals.

    Aug 5, 2011
  47. 2011-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2011

    HCA Holdings, Inc. reported first-quarter 2011 results in its first 10-Q following its March 2011 initial public offering and holding company reorganization. Revenues rose 6.8% to $8.055 billion, driven by a 2.9% increase in revenue per equivalent admission and a 3.7% increase in equivalent admissions. However, net income attributable to HCA Holdings fell 38.2% to $240 million ($0.52 diluted EPS) from $388 million ($0.89), primarily due to a $181 million pretax charge to terminate the sponsor management agreement. Excluding that charge and the small facility-sale loss, earnings would have been lower only modestly, but the quarter was also affected by a sharp rise in the provision for doubtful accounts (8.1% of revenue vs. 7.5%) and an effective tax rate of 43.3% that included a $29 million unrecognized tax benefit adjustment. The IPO raised $2.506 billion in net proceeds from 87.7 million primary shares at $30.00, and HCA used roughly $2.5 billion to repay revolving credit borrowings, cutting total debt to $25.366 billion from $28.225 billion at year-end 2010. Stockholders' deficit improved substantially to $(7.788) billion from $(10.794) billion. Interest expense rose to $533 million on a higher average debt balance, although the average effective interest rate eased to 7.9%. Operating cash flow increased to $918 million, aided by working capital and income tax refunds. Key risks flagged in the filing include a Department of Justice review of implantable cardio-defibrillator billing at 87 hospitals that could lead to False Claims Act claims, the ongoing IRS dispute over HCA Inc.'s 2005-2006 returns, the New Hampshire Portsmouth Regional Hospital litigation, and increasing uninsured and self-pay pressures. Management also expects $290-340 million of 2011 Medicare and Medicaid EHR incentive revenue, mostly recognized in the fourth quarter, and the company announced redemptions of $1.1 billion of second lien notes expected to produce a roughly $75 million pretax extinguishment charge.

    May 11, 2011
  48. 2010-Q3

    HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2010

    HCA Inc.'s Q3 2010 10-Q shows a company still carrying heavy leverage from its 2006 sponsor-led recapitalization, but with improving operating momentum. Revenue rose 1.5% to $7.647 billion in the quarter and 2.2% to $22.947 billion for the nine months. Net income attributable to HCA Inc. grew 24.3% to $243 million for the quarter and 10.3% to $924 million for the nine months. Diluted EPS was $2.49 for the quarter and $9.55 for the nine months, though these figures reflect a much smaller equity base than a conventional public company because of the recapitalization and large cash distributions. The headline uncertainty is the quality of revenue. The provision for doubtful accounts fell sharply, from $910 million to $721 million in the quarter, largely because HCA increased uninsured discounts in August 2009. That change lowered reported revenue growth and shifted the mix of uninsured costs. Combined uninsured discounts, charity care and bad-debt provisions reached $7.088 billion for the nine months, up from $6.169 billion. Cash revenue growth of 4.6% in the quarter is therefore a better gauge of underlying trends than headline revenue growth. Balance sheet and cash flow points matter most for equity investors. Total debt was $26.079 billion at September 30, 2010, and stockholders' deficit was $9.242 billion. The company paid $2.251 billion in distributions to stockholders in the first nine months, funded largely with borrowings, and management said it contemplated an approximately $2 billion distribution in the fourth quarter of 2010 tied to a planned holding-company restructuring. An IPO was also in process, with proceeds intended partly to repay debt. Operating cash flow of $2.611 billion was up $296 million year over year, but interest expense of $1.571 billion consumed a large share of operating earnings.

    Nov 9, 2010
  49. 2010-Q2

    HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2010

    HCA Inc. reported second-quarter 2010 net income attributable to HCA Inc. of $293 million, up from $282 million a year earlier, on revenues of $7.756 billion (up 3.7%). Six-month net income attributable to HCA Inc. rose 6.0% to $681 million. Growth was constrained by a sharp rise in uninsured self-pay deductions: uninsured discounts jumped to $1.072 billion in the quarter from $605 million, following an August 2009 increase in discount percentages. This lowered the provision for doubtful accounts to $788 million (10.2% of revenues, versus 11.6%), which flatters reported bad debt expense while reducing top-line revenue. Management emphasizes cash revenues (revenues less provision for doubtful accounts), which grew 5.3%, as a better gauge of underlying performance. Operating cash flow was $450 million in the quarter, down $209 million year over year, mainly from working capital changes. The balance sheet remains highly leveraged. Total debt was $26.8 billion at June 30, 2010, against a stockholders' deficit of $9.5 billion. In the first half of 2010, the company paid $2.251 billion in distributions to stockholders, funded largely with borrowings, and refinanced term loans with lower-coupon first lien notes. Interest expense rose to $530 million in the quarter, and the company's Form S-1 for a proposed IPO (filed May 7, 2010) signals intent to use proceeds to repay existing debt. Key risks include ongoing IRS disputes over tax allowances for doubtful accounts, a New Hampshire Foundation lawsuit with a potential remedy phase in May 2011, and regulatory exposure under the Health Reform Law, which reduces Medicare and Medicaid DSH payments. For investors, the story is one of steady volume and pricing growth partly masked by rising uninsured care, a high-leverage capital structure shaped by the 2006 recapitalization, and a dependence on capital market access to refinance and manage debt maturities.

    Aug 11, 2010
  50. 2010-Q1

    HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2010

    HCA Inc.'s first-quarter 2010 10-Q shows modest top-line growth and solid earnings, but the report is dominated by the balance-sheet effects of its 2006 leveraged buyout. Revenues rose 1.5% to $7.544 billion, and net income attributable to HCA Inc. increased 8.1% to $388 million from $360 million. Income before taxes grew 10.6%, helped by a sharp 37% drop in the provision for doubtful accounts to $564 million (7.5% of revenues, versus 10.9% a year earlier). That decline is largely a presentation effect: uninsured discounts rose $418 million after HCA raised its uninsured discount percentages in August 2009, so reported revenue growth was held back. Cash revenues, which exclude the provision for doubtful accounts, rose 5.4%, a better gauge of underlying growth. Admissions grew 0.7% and same-facility admissions 0.9%, while outpatient surgeries fell 1.9%. The balance sheet is the central concern for investors. Total debt reached $26.855 billion, up from $25.670 billion at year-end, and interest expense rose 9.6% to $516 million as the average effective rate climbed from 7.1% to 8.0%. The company paid a $1.751 billion cash distribution to stockholders in February 2010, funded largely by new senior secured borrowings, and declared a further $500 million distribution in May 2010. As a result, stockholders' deficit widened to $10.313 billion attributable to HCA Inc. (total deficit of $9.298 billion including noncontrolling interests). Operating cash flow improved to $901 million, but this was boosted by a net income tax refund of $71 million. Management states liquidity is sufficient for the next twelve months. Regulatory and legal risks are also significant. The Health Reform Law, enacted March 2010, is expected to expand coverage substantially, but it also brings material Medicare and Medicaid reductions, including Medicare DSH cuts and market-basket reductions, and management says it cannot predict the net effect. Roughly 40% of 2009 revenues came from Medicare and Medicaid, and about half of licensed beds are in Texas and Florida. Open IRS disputes and a New Hampshire hospital transfer lawsuit remain unresolved. Management does not expect these matters to be material.

    May 7, 2010