☒ | QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
2019 Large accelerated filer2018 Voting common stock, $.01 par value HCA New York Stock Exchange and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 ofRegulationand post such files). Yes (Do not check if a smaller reporting company) 20182019 346,046,000
Page of Form 10-Q | ||||||||
Part I. | Financial Information | |||||||
| Financial | |||||||
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Item 3. | 43 | |||||||
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Item 4. | 43 | |||||||
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Part II. | Other Information | |||||||
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Item 1. | 43 | |||||||
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Item | 44 | |||||||
Item 2. | ||||||||
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Item 6. | 45 | |||||||
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2018
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Revenues | $ | 11,529 | $ | 10,733 | $ | 22,952 | $ | 21,356 | ||||||||
Salaries and benefits | 5,274 | 4,896 | 10,563 | 9,797 | ||||||||||||
Supplies | 1,917 | 1,795 | 3,832 | 3,592 | ||||||||||||
Other operating expenses | 2,118 | 1,965 | 4,228 | 3,895 | ||||||||||||
Equity in earnings of affiliates | (7 | ) | (13 | ) | (16 | ) | (23 | ) | ||||||||
Depreciation and amortization | 562 | 521 | 1,115 | 1,042 | ||||||||||||
Interest expense | 436 | 411 | 867 | 830 | ||||||||||||
Gains on sales of facilities | (9 | ) | (2 | ) | (414 | ) | (3 | ) | ||||||||
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10,291 | 9,573 | 20,175 | 19,130 | |||||||||||||
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Income before income taxes | 1,238 | 1,160 | 2,777 | 2,226 | ||||||||||||
Provision for income taxes | 272 | 365 | 529 | 654 | ||||||||||||
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Net income | 966 | 795 | 2,248 | 1,572 | ||||||||||||
Net income attributable to noncontrolling interests | 146 | 138 | 284 | 256 | ||||||||||||
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Net income attributable to HCA Healthcare, Inc. | $ | 820 | $ | 657 | $ | 1,964 | $ | 1,316 | ||||||||
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Per share data: | ||||||||||||||||
Basic earnings | $ | 2.35 | $ | 1.79 | $ | 5.62 | $ | 3.58 | ||||||||
Diluted earnings | $ | 2.31 | $ | 1.75 | $ | 5.50 | $ | 3.48 | ||||||||
Cash dividends declared | $ | 0.35 | $ | — | $ | 0.70 | $ | — | ||||||||
Shares used in earnings per share calculations (in millions): | ||||||||||||||||
Basic | 348.615 | 365.847 | 349.726 | 368.056 | ||||||||||||
Diluted | 355.039 | 375.338 | 357.388 | 377.647 |
See
Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Revenues | $ | 12,602 | $ | 11,529 | $ | 25,119 | $ | 22,952 | ||||||||
Salaries and benefits | 5,837 | 5,274 | 11,484 | 10,563 | ||||||||||||
Supplies | 2,118 | 1,917 | 4,159 | 3,832 | ||||||||||||
Other operating expenses | 2,362 | 2,118 | 4,661 | 4,228 | ||||||||||||
Equity in earnings of affiliates | (8 | ) | (7 | ) | (19 | ) | (16 | ) | ||||||||
Depreciation and amortization | 636 | 562 | 1,255 | 1,115 | ||||||||||||
Interest expense | 477 | 436 | 938 | 867 | ||||||||||||
Gains on sales of facilities | (18 | ) | (9 | ) | (17 | ) | (414 | ) | ||||||||
11,404 | 10,291 | 22,461 | 20,175 | |||||||||||||
Income before income taxes | 1,198 | 1,238 | 2,658 | 2,777 | ||||||||||||
Provision for income taxes | 271 | 272 | 550 | 529 | ||||||||||||
Net income | 927 | 966 | 2,108 | 2,248 | ||||||||||||
Net income attributable to noncontrolling interests | 144 | 146 | 286 | 284 | ||||||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 783 | $ | 820 | $ | 1,822 | $ | 1,964 | ||||||||
Per share data: | ||||||||||||||||
Basic earnings | $ | 2.29 | $ | 2.35 | $ | 5.32 | $ | 5.62 | ||||||||
Diluted earnings | $ | 2.25 | $ | 2.31 | $ | 5.22 | $ | 5.50 | ||||||||
Shares used in earnings per share calculations (in millions): | ||||||||||||||||
Basic | 342.170 | 348.615 | 342.513 | 349.726 | ||||||||||||
Diluted | 348.373 | 355.039 | 349.334 | 357.388 |
2018
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Net income | $ | 966 | $ | 795 | $ | 2,248 | $ | 1,572 | ||||||||
Other comprehensive income (loss) before taxes: | ||||||||||||||||
Foreign currency translation | (76 | ) | 45 | (22 | ) | 55 | ||||||||||
Unrealized (losses) gains onavailable-for-sale securities | (1 | ) | 2 | (6 | ) | 5 | ||||||||||
Defined benefit plans | — | — | — | — | ||||||||||||
Pension costs included in salaries and benefits | 5 | 4 | 10 | 9 | ||||||||||||
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5 | 4 | 10 | 9 | |||||||||||||
Change in fair value of derivative financial instruments | 15 | (11 | ) | 50 | (8 | ) | ||||||||||
Interest (benefits) costs included in interest expense | (2 | ) | 6 | (2 | ) | 13 | ||||||||||
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13 | (5 | ) | 48 | 5 | ||||||||||||
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Other comprehensive (loss) income before taxes | (59 | ) | 46 | 30 | 74 | |||||||||||
Income taxes related to other comprehensive income items | 5 | 19 | 13 | 29 | ||||||||||||
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Other comprehensive (loss) income | (64 | ) | 27 | 17 | 45 | |||||||||||
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Comprehensive income | 902 | 822 | 2,265 | 1,617 | ||||||||||||
Comprehensive income attributable to noncontrolling interests | 146 | 138 | 284 | 256 | ||||||||||||
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Comprehensive income attributable to HCA Healthcare, Inc. | $ | 756 | $ | 684 | $ | 1,981 | $ | 1,361 | ||||||||
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Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Net income | $ | 927 | $ | 966 | $ | 2,108 | $ | 2,248 | ||||||||
Other comprehensive income (loss) before taxes: | ||||||||||||||||
Foreign currency translation | (38 | ) | (76 | ) | (18 | ) | (22 | ) | ||||||||
Unrealized gains (losses) on available-for-sale securities | 6 | (1 | ) | 14 | (6 | ) | ||||||||||
Defined benefit plans | — | — | — | — | ||||||||||||
Pension costs included in salaries and benefits | 4 | 5 | 7 | 10 | ||||||||||||
4 | 5 | 7 | 10 | |||||||||||||
Change in fair value of derivative financial instruments | (34 | ) | 15 | (52 | ) | 50 | ||||||||||
Interest benefits included in interest expense | (6 | ) | (2 | ) | (11 | ) | (2 | ) | ||||||||
(40 | ) | 13 | (63 | ) | 48 | |||||||||||
Other comprehensive (loss) income before taxes | (68 | ) | (59 | ) | (60 | ) | 30 | |||||||||
Income taxes (benefits) related to other comprehensive income items | (11 | ) | 5 | (10 | ) | 13 | ||||||||||
Other comprehensive (loss) income | (57 | ) | (64 | ) | (50 | ) | 17 | |||||||||
Comprehensive income | 870 | 902 | 2,058 | 2,265 | ||||||||||||
Comprehensive income attributable to noncontrolling interests | 144 | 146 | 286 | 284 | ||||||||||||
Comprehensive income attributable to HCA Healthcare, Inc. | $ | 726 | $ | 756 | $ | 1,772 | $ | 1,981 | ||||||||
June 30, 2018 | December 31, 2017 | |||||||
ASSETS | ||||||||
Current assets: | ||||||||
Cash and cash equivalents | $ | 868 | $ | 732 | ||||
Accounts receivable | 6,592 | 6,501 | ||||||
Inventories | 1,636 | 1,573 | ||||||
Other | 1,298 | 1,171 | ||||||
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10,394 | 9,977 | |||||||
Property and equipment, at cost | 41,142 | 40,084 | ||||||
Accumulated depreciation | (22,598 | ) | (22,189 | ) | ||||
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18,544 | 17,895 | |||||||
Investments of insurance subsidiaries | 414 | 418 | ||||||
Investments in and advances to affiliates | 234 | 199 | ||||||
Goodwill and other intangible assets | 7,459 | 7,394 | ||||||
Other | 697 | 710 | ||||||
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$ | 37,742 | $ | 36,593 | |||||
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LIABILITIES AND STOCKHOLDERS’ DEFICIT | ||||||||
Current liabilities: | ||||||||
Accounts payable | $ | 2,457 | $ | 2,606 | ||||
Accrued salaries | 1,315 | 1,369 | ||||||
Other accrued expenses | 2,161 | 1,983 | ||||||
Long-term debt due within one year | 1,692 | 200 | ||||||
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7,625 | 6,158 | |||||||
Long-term debt, less net debt issuance costs of $151 and $164 | 31,500 | 32,858 | ||||||
Professional liability risks | 1,283 | 1,198 | ||||||
Income taxes and other liabilities | 1,459 | 1,374 | ||||||
Stockholders’ deficit: | ||||||||
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 346,760,200 shares in 2018 and 350,091,600 shares in 2017 | 3 | 4 | ||||||
Accumulated other comprehensive loss | (261 | ) | (278 | ) | ||||
Retained deficit | (5,731 | ) | (6,532 | ) | ||||
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Stockholders’ deficit attributable to HCA Healthcare, Inc. | (5,989 | ) | (6,806 | ) | ||||
Noncontrolling interests | 1,864 | 1,811 | ||||||
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(4,125 | ) | (4,995 | ) | |||||
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$ | 37,742 | $ | 36,593 | |||||
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June 30, 2019 | December 31, 2018 | |||||||
ASSETS | ||||||||
Current assets: | ||||||||
Cash and cash equivalents | $ | 2,430 | $ | 502 | ||||
Accounts receivable | 7,219 | 6,789 | ||||||
Inventories | 1,826 | 1,732 | ||||||
Other | 1,394 | 1,190 | ||||||
12,869 | 10,213 | |||||||
Property and equipment, at cost | 45,369 | 42,965 | ||||||
Accumulated depreciation | (23,902 | ) | (23,208 | ) | ||||
21,467 | 19,757 | |||||||
Investments of insurance subsidiaries | 342 | 362 | ||||||
Investments in and advances to affiliates | 247 | 232 | ||||||
Goodwill and other intangible assets | 8,140 | 7,953 | ||||||
Right-of-use operating lease assets | 1,787 | — | ||||||
Other | 597 | 690 | ||||||
$ | 45,449 | $ | 39,207 | |||||
LIABILITIES AND STOCKHOLDERS’ DEFICIT | ||||||||
Current liabilities: | ||||||||
Accounts payable | $ | 2,609 | $ | 2,577 | ||||
Accrued salaries | 1,497 | 1,580 | ||||||
Other accrued expenses | 2,782 | 2,624 | ||||||
Long-term debt due within one year | 2,073 | 788 | ||||||
8,961 | 7,569 | |||||||
Long-term debt, less debt issuance costs and discountsof $252 and $157 | 34,120 | 32,033 | ||||||
Professional liability risks | 1,354 | 1,275 | ||||||
Right-of-use operating lease obligations | 1,460 | — | ||||||
Income taxes and other liabilities | 1,324 | 1,248 | ||||||
Stockholders’ deficit: | ||||||||
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 341,516,800 shares in 2019 and 342,895,200 shares in 2018 | 3 | 3 | ||||||
Accumulated other comprehensive loss | (431 | ) | (381 | ) | ||||
Retained deficit | (3,474 | ) | (4,572 | ) | ||||
Stockholders’ deficit attributable to HCA Healthcare, Inc. | (3,902 | ) | (4,950 | ) | ||||
Noncontrolling interests | 2,132 | 2,032 | ||||||
(1,770 | ) | (2,918 | ) | |||||
$ | 45,449 | $ | 39,207 | |||||
Equity (Deficit) Attributable to HCA Healthcare, Inc. | Equity Attributable to Noncontrolling Interests | Total | |||||||||||||||||||||||||||
Common Stock | Capital in Excess of Par Value | Accumulated Other Comprehensive Loss | Retained Deficit | ||||||||||||||||||||||||||
Shares (in millions) | Par Value | ||||||||||||||||||||||||||||
Balances, December 31, 2017 | 350.092 | $ | 4 | $ | — | $ | (278 | ) | $ | (6,532 | ) | $ | 1,811 | $ | (4,995 | ) | |||||||||||||
Comprehensive income | 81 | 1,144 | 138 | 1,363 | |||||||||||||||||||||||||
Repurchase of common stock | (4.370 | ) | 114 | (537 | ) | (423 | ) | ||||||||||||||||||||||
Share-based benefit plans | 5.265 | (114 | ) | (114 | ) | ||||||||||||||||||||||||
Cash dividends declared ($0.35 per share) | (126 | ) | (126 | ) | |||||||||||||||||||||||||
Distributions | (92 | ) | (92 | ) | |||||||||||||||||||||||||
Other | (47 | ) | (47 | ) | |||||||||||||||||||||||||
Balances, March 31, 2018 | 350.987 | 4 | — | (197 | ) | (6,051 | ) | 1,810 | (4,434 | ) | |||||||||||||||||||
Comprehensive income | (64 | ) | 820 | 146 | 902 | ||||||||||||||||||||||||
Repurchase of common stock | (4.670 | ) | (1 | ) | (93 | ) | (376 | ) | (470 | ) | |||||||||||||||||||
Share-based benefit plans | 0.443 | 96 | 96 | ||||||||||||||||||||||||||
Cash dividends declared ($0.35 per share) | (124 | ) | (124 | ) | |||||||||||||||||||||||||
Distributions | (93 | ) | (93 | ) | |||||||||||||||||||||||||
Other | (3 | ) | 1 | (2 | ) | ||||||||||||||||||||||||
Balances, June 30, 2018 | 346.760 | 3 | — | (261 | ) | (5,731 | ) | 1,864 | (4,125 | ) | |||||||||||||||||||
Comprehensive income | (5 | ) | 759 | 137 | 891 | ||||||||||||||||||||||||
Repurchase of common stock | (2.518 | ) | (55 | ) | (247 | ) | (302 | ) | |||||||||||||||||||||
Share-based benefit plans | 0.844 | 54 | 54 | ||||||||||||||||||||||||||
Cash dividends declared ($0.35 per share) | (123 | ) | (123 | ) | |||||||||||||||||||||||||
Distributions | (130 | ) | (130 | ) | |||||||||||||||||||||||||
Other | 1 | 4 | 5 | ||||||||||||||||||||||||||
Balances, September 30, 2018 | 345.086 | 3 | — | (266 | ) | (5,342 | ) | 1,875 | (3,730 | ) | |||||||||||||||||||
Comprehensive income | (20 | ) | 1,064 | 181 | 1,225 | ||||||||||||||||||||||||
Repurchase of common stock | (2.512 | ) | (69 | ) | (266 | ) | (335 | ) | |||||||||||||||||||||
Share-based benefit plans | 0.321 | 79 | 79 | ||||||||||||||||||||||||||
Cash dividends declared ($0.35 per share) | (123 | ) | (123 | ) | |||||||||||||||||||||||||
Distributions | (126 | ) | (126 | ) | |||||||||||||||||||||||||
Other | (10 | ) | (95 | ) | 95 | 102 | 92 | ||||||||||||||||||||||
Balances, December 31, 2018 | 342.895 | 3 | — | (381 | ) | (4,572 | ) | 2,032 | (2,918 | ) | |||||||||||||||||||
Comprehensive income | 7 | 1,039 | 142 | 1,188 | |||||||||||||||||||||||||
Repurchase of common stock | (2.106 | ) | 32 | (310 | ) | (278 | ) | ||||||||||||||||||||||
Share-based benefit plans | 2.242 | (29 | ) | (29 | ) | ||||||||||||||||||||||||
Cash dividends declared ($0.40 per share) | (140 | ) | (140 | ) | |||||||||||||||||||||||||
Distributions | (136 | ) | (136 | ) | |||||||||||||||||||||||||
Other | (3 | ) | 61 | 58 | |||||||||||||||||||||||||
Balances, March 31, 2019 | 343.031 | 3 | — | (374 | ) | (3,983 | ) | 2,099 | (2,255 | ) | |||||||||||||||||||
Comprehensive income | (57 | ) | 783 | 144 | 870 | ||||||||||||||||||||||||
Repurchase of common stock | (1.928 | ) | (107 | ) | (135 | ) | (242 | ) | |||||||||||||||||||||
Share-based benefit plans | 0.414 | 118 | 118 | ||||||||||||||||||||||||||
Cash dividends declared ($0.40 per share) | (139 | ) | (139 | ) | |||||||||||||||||||||||||
Distributions | (111 | ) | (111 | ) | |||||||||||||||||||||||||
Other | (11 | ) | (11 | ) | |||||||||||||||||||||||||
Balances, June 30, 2019 | 341.517 | $ | 3 | $ | — | $ | (431 | ) | $ | (3,474 | ) | $ | 2,132 | $ | (1,770 | ) | |||||||||||||
2018
2018 | 2017 | |||||||
Cash flows from operating activities: | ||||||||
Net income | $ | 2,248 | $ | 1,572 | ||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
Increase (decrease) in cash from operating assets and liabilities: | ||||||||
Accounts receivable | (233 | ) | 81 | |||||
Inventories and other assets | (200 | ) | (178 | ) | ||||
Accounts payable and accrued expenses | 31 | (298 | ) | |||||
Depreciation and amortization | 1,115 | 1,042 | ||||||
Income taxes | 118 | 267 | ||||||
Gains on sales of facilities | (414 | ) | (3 | ) | ||||
Amortization of debt issuance costs | 15 | 16 | ||||||
Share-based compensation | 134 | 140 | ||||||
Other | 51 | 45 | ||||||
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Net cash provided by operating activities | 2,865 | 2,684 | ||||||
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Cash flows from investing activities: | ||||||||
Purchase of property and equipment | (1,574 | ) | (1,304 | ) | ||||
Acquisition of hospitals and health care entities | (538 | ) | (295 | ) | ||||
Disposal of hospitals and health care entities | 799 | 14 | ||||||
Change in investments | 23 | (11 | ) | |||||
Other | (25 | ) | 5 | |||||
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Net cash used in investing activities | (1,315 | ) | (1,591 | ) | ||||
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Cash flows from financing activities: | ||||||||
Issuances of long-term debt | — | 1,502 | ||||||
Net change in revolving bank credit facilities | 210 | (1,160 | ) | |||||
Repayment of long-term debt | (101 | ) | (95 | ) | ||||
Distributions to noncontrolling interests | (185 | ) | (248 | ) | ||||
Payment of debt issuance costs | (2 | ) | (25 | ) | ||||
Payment of cash dividends | (245 | ) | — | |||||
Repurchases of common stock | (893 | ) | (966 | ) | ||||
Other | (192 | ) | (42 | ) | ||||
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Net cash used in financing activities | (1,408 | ) | (1,034 | ) | ||||
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Effect of exchange rate changes on cash and cash equivalents | (6 | ) | — | |||||
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Change in cash and cash equivalents | 136 | 59 | ||||||
Cash and cash equivalents at beginning of period | 732 | 646 | ||||||
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Cash and cash equivalents at end of period | $ | 868 | $ | 705 | ||||
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Interest payments | $ | 873 | $ | 834 | ||||
Income tax payments, net | $ | 411 | $ | 387 |
See
2019 | 2018 | |||||||
Cash flows from operating activities: | ||||||||
Net income | $ | 2,108 | $ | 2,248 | ||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
Increase (decrease) in cash from operating assets and liabilities: | ||||||||
Accounts receivable | (174 | ) | (233 | ) | ||||
Inventories and other assets | (231 | ) | (200 | ) | ||||
Accounts payable and accrued expenses | (238 | ) | 31 | |||||
Depreciation and amortization | 1,255 | 1,115 | ||||||
Income taxes | 27 | 118 | ||||||
Gains on sales of facilities | (17 | ) | (414 | ) | ||||
Amortization of debt issuance costs and discounts | 16 | 15 | ||||||
Share-based compensation | 158 | 134 | ||||||
Other | 67 | 51 | ||||||
Net cash provided by operating activities | 2,971 | 2,865 | ||||||
Cash flows from investing activities: | ||||||||
Purchase of property and equipment | (1,745 | ) | (1,574 | ) | ||||
Acquisition of hospitals and health care entities | (1,504 | ) | (538 | ) | ||||
Disposal of hospitals and health care entities | 41 | 799 | ||||||
Change in investments | 59 | 23 | ||||||
Other | 36 | (25 | ) | |||||
Net cash used in investing activities | (3,113 | ) | (1,315 | ) | ||||
Cash flows from financing activities: | ||||||||
Issuances of long-term debt | 6,451 | — | ||||||
Net change in revolving bank credit facilities | (3,040 | ) | 210 | |||||
Repayment of long-term debt | (98 | ) | (101 | ) | ||||
Distributions to noncontrolling interests | (247 | ) | (185 | ) | ||||
Payment of debt issuance costs | (63 | ) | (2 | ) | ||||
Payment of cash dividends | (278 | ) | (245 | ) | ||||
Repurchases of common stock | (520 | ) | (893 | ) | ||||
Other | (135 | ) | (192 | ) | ||||
Net cash provided by (used in) financing activities | 2,070 | (1,408 | ) | |||||
Effect of exchange rate changes on cash and cash equivalents | — | (6 | ) | |||||
Change in cash and cash equivalents | 1,928 | 136 | ||||||
Cash and cash equivalents at beginning of period | 502 | 732 | ||||||
Cash and cash equivalents at end of period | $ | 2,430 | $ | 868 | ||||
Interest payments | $ | 910 | $ | 873 | ||||
Income tax payments, net | $ | 523 | $ | 411 |
2018.
In May 2014, the Financial Accounting Standards Board (“FASB”) issued a new standard related to revenue recognition. We adopted the new standard effective January 1, 2018, using the full retrospective method. The adoption of the new standard did not have an impact on our recognition of net revenues for any periods prior to adoption. The most significant impact of adopting the new standard is to the presentation of our consolidated income statements, where we no longer present the “Provision for doubtful accounts” as a separate line item and our “Revenues” are presented net of estimated implicit price concession revenue deductions. We also have eliminated the related presentation of “allowances for doubtful accounts” on our consolidated balance sheets as a result of the adoption of the new standard.
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)
Revenues (continued)
insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted
Quarter | ||||||||||||||||
2018 | Ratio | 2017 | Ratio | |||||||||||||
Medicare | $ | 2,425 | 21.0 | % | $ | 2,272 | 21.2 | % | ||||||||
Managed Medicare | 1,345 | 11.7 | 1,158 | 10.8 | ||||||||||||
Medicaid | 357 | 3.1 | 376 | 3.5 | ||||||||||||
Managed Medicaid | 586 | 5.1 | 527 | 4.9 | ||||||||||||
Managed care and insurers | 5,993 | 51.9 | 5,729 | 53.4 | ||||||||||||
International (managed care and insurers) | 295 | 2.6 | 269 | 2.5 | ||||||||||||
Other | 528 | 4.6 | 402 | 3.7 | ||||||||||||
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Revenues | $ | 11,529 | 100.0 | % | $ | 10,733 | 100.0 | % | ||||||||
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Six Months | ||||||||||||||||
2018 | Ratio | 2017 | Ratio | |||||||||||||
Medicare | $ | 4,949 | 21.6 | % | $ | 4,633 | 21.7 | % | ||||||||
Managed Medicare | 2,744 | 12.0 | 2,341 | 11.0 | ||||||||||||
Medicaid | 638 | 2.8 | 670 | 3.1 | ||||||||||||
Managed Medicaid | 1,147 | 5.0 | 1,116 | 5.2 | ||||||||||||
Managed care and insurers | 12,055 | 52.5 | 11,352 | 53.2 | ||||||||||||
International (managed care and insurers) | 600 | 2.6 | 538 | 2.5 | ||||||||||||
Other | 819 | 3.5 | 706 | 3.3 | ||||||||||||
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| |||||||||
Revenues | $ | 22,952 | 100.0 | % | $ | 21,356 | 100.0 | % | ||||||||
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Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material
Quarter | ||||||||||||||||
2019 | Ratio | 2018 | Ratio | |||||||||||||
Medicare | $ | 2,635 | 20.9 | % | $ | 2,425 | 21.0 | % | ||||||||
Managed Medicare | 1,595 | 12.7 | 1,345 | 11.7 | ||||||||||||
Medicaid | 416 | 3.3 | 357 | 3.1 | ||||||||||||
Managed Medicaid | 554 | 4.4 | 586 | 5.1 | ||||||||||||
Managed care and insurers | 6,425 | 50.9 | 5,993 | 51.9 | ||||||||||||
International (managed care and insurers) | 284 | 2.3 | 295 | 2.6 | ||||||||||||
Other | 693 | 5.5 | 528 | 4.6 | ||||||||||||
Revenues | $ | 12,602 | 100.0 | % | $ | 11,529 | 100.0 | % | ||||||||
Six Months | ||||||||||||||||
2019 | Ratio | 2018 | Ratio | |||||||||||||
Medicare | $ | 5,405 | 21.5 | % | $ | 4,949 | 21.6 | % | ||||||||
Managed Medicare | 3,184 | 12.7 | 2,744 | 12.0 | ||||||||||||
Medicaid | 763 | 3.0 | 638 | 2.8 | ||||||||||||
Managed Medicaid | 1,167 | 4.6 | 1,147 | 5.0 | ||||||||||||
Managed care and insurers | 12,851 | 51.1 | 12,055 | 52.5 | ||||||||||||
International (managed care and insurers) | 581 | 2.3 | 600 | 2.6 | ||||||||||||
Other | 1,168 | 4.8 | 819 | 3.5 | ||||||||||||
Revenues | $ | 25,119 | 100.0 | % | $ | 22,952 | 100.0 | % | ||||||||
amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process).
The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Prior to November 2017, patients treated at hospitals fornon-elective care, who have income at or below 200% of the federal poverty level, were eligible for charity care. During November 2017, we expanded our charity policy to include patients who have income above 200%, but at or below 400%, of the federal poverty level and we will limit the patient responsibility amounts for these patients to a percentage of their annual household income, computed on a sliding scale based upon their annual income and the applicable percentage of the federal poverty level. The federal poverty level is established by the federal government and is based on income and family size. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. In implementing the uninsured discount policy, we may first attempt to provide assistance to uninsured patients to help determine whether they may qualify for Medicaid, other federal or state assistance, or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.
The collection of outstanding receivables for Medicare, Medicaid, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients. Estimated implicit price concessions are recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed.
The estimates for implicit price concessions are based upon management’s assessment of historical writeoffs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical writeoffs and collections at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. We believe our quarterly updates to the estimated implicit price concession amounts at each of our hospital facilities provide reasonable estimates of our revenues and valuations of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material adjustments to the valuations of our accounts receivable orperiod-to-period comparisons of our results of operations. At June 30, 2018 and December 31, 2017, estimated implicit price concessions of $5.736 billion and $5.488 billion, respectively, had been recorded as reductions to our accounts receivable balances to enable us to record our revenues and accounts receivable at the estimated amounts we expect to collect.
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)
Revenues (continued)
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) | $ | 9,871 | $ | 9,177 | $ | 19,738 | $ | 18,326 | ||||||||
Cost-to-charges ratio (patient care costs as percentage of gross patient charges) | 12.6 | % | 13.0 | % | 12.5 | % | 12.9 | % | ||||||||
Total uncompensated care | $ | 6,486 | $ | 5,721 | $ | 12,738 | $ | 11,048 | ||||||||
Multiply by thecost-to-charges ratio | 12.6 | % | 13.0 | % | 12.5 | % | 12.9 | % | ||||||||
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Estimated cost of total uncompensated care | $ | 817 | $ | 743 | $ | 1,592 | $ | 1,425 | ||||||||
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Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) | $ | 10,953 | $ | 9,871 | $ | 21,559 | $ | 19,738 | ||||||||
Cost-to-charges ratio (patient care costs as percentage of gross patient charges) | 12.2 | % | 12.6 | % | 12.0 | % | 12.5 | % | ||||||||
Total uncompensated care | $ | 7,695 | $ | 6,486 | $ | 14,780 | $ | 12,738 | ||||||||
Multiply by the cost-to-charges ratio | 12.2 | % | 12.6 | % | 12.0 | % | 12.5 | % | ||||||||
Estimated cost of total uncompensated care | $ | 938 | $ | 817 | $ | 1,774 | $ | 1,592 | ||||||||
Recent Pronouncements
In February 2016, the FASB issued Accounting Standards Update2016-02,Leases (“ASU2016-02”), which requires lessees to recognize assets and liabilities for most leases. ASU2016-02 is effective for public business entities for annual and interim periods beginning after December 15, 2018. Early adoption is permitted. We are continuing to evaluate the provisions of ASU2016-02 (and related developments) to determine how our financial statements will be affected, and we believe the primary effect of adopting the new standard will be to recordright-of-use assets and obligations for our leases currently classified as operating leases.
investments. During the six months ended June 30, 2018, we received proceeds of $758 million and recognized a net pretax gain of $372 million related to the sale of the two hospital facilities in our Oklahoma market. During the
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 2 — ACQUISITIONS AND DISPOSITIONS (continued)
six months ended June 30, 2018, we also received
As we complete our analysis of the Tax Act, we may make adjustments to the provisional amounts and record additional amounts for those federal, state, and foreign tax assets and liabilities for which we were unable to make reasonable estimates as of June 30, 2018. Any adjustments or additional amounts recorded may materially impact our provision for income taxes and effective tax rate in the periods in which they are made.
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 4 — EARNINGS PER SHARE (continued)
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 820 | $ | 657 | $ | 1,964 | $ | 1,316 | ||||||||
Weighted average common shares outstanding | 348.615 | 365.847 | 349.726 | 368.056 | ||||||||||||
Effect of dilutive incremental shares | 6.424 | 9.491 | 7.662 | 9.591 | ||||||||||||
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Shares used for diluted earnings per share | 355.039 | 375.338 | 357.388 | 377.647 | ||||||||||||
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Earnings per share: | ||||||||||||||||
Basic earnings | $ | 2.35 | $ | 1.79 | $ | 5.62 | $ | 3.58 | ||||||||
Diluted earnings | $ | 2.31 | $ | 1.75 | $ | 5.50 | $ | 3.48 |
Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 783 | $ | 820 | $ | 1,822 | $ | 1,964 | ||||||||
Weighted average common shares outstanding | 342.170 | 348.615 | 342.513 | 349.726 | ||||||||||||
Effect of dilutive incremental shares | 6.203 | 6.424 | 6.821 | 7.662 | ||||||||||||
Shares used for diluted earnings per share | 348.373 | 355.039 | 349.334 | 357.388 | ||||||||||||
Earnings per share: | ||||||||||||||||
Basic earnings | $ | 2.29 | $ | 2.35 | $ | 5.32 | $ | 5.62 | ||||||||
Diluted earnings | $ | 2.25 | $ | 2.31 | $ | 5.22 | $ | 5.50 |
June 30, 2018 | ||||||||||||||||
Amortized Cost | Unrealized Amounts | Fair Value | ||||||||||||||
Gains | Losses | |||||||||||||||
Debt securities | $ | 337 | $ | 5 | $ | (1 | ) | $ | 341 | |||||||
Money market funds and other | 118 | — | — | 118 | ||||||||||||
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$ | 455 | $ | 5 | $ | (1 | ) | 459 | |||||||||
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Amounts classified as current assets | (45 | ) | ||||||||||||||
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Investment carrying value | $ | 414 | ||||||||||||||
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December 31, 2017 | ||||||||||||||||
Amortized Cost | Unrealized Amounts | Fair Value | ||||||||||||||
Gains | Losses | |||||||||||||||
Debt securities | $ | 361 | $ | 10 | $ | — | $ | 371 | ||||||||
Money market funds and other | 101 | — | — | 101 | ||||||||||||
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$ | 462 | $ | 10 | $ | — | 472 | ||||||||||
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Amounts classified as current assets | (54 | ) | ||||||||||||||
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Investment carrying value | $ | 418 | ||||||||||||||
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June 30, 2019 | |||||||||||||||||
Amortized Cost | Unrealized Amounts | Fair Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities | $ | 334 | $ | 17 | $ | — | $ | 351 | |||||||||
Money market funds and other | 104 | — | — | 104 | |||||||||||||
$ | 438 | $ | 17 | $ | — | 455 | |||||||||||
Amounts classified as current assets | (113 | ) | |||||||||||||||
Investment carrying value | $ | 342 | |||||||||||||||
December 31, 2018 | |||||||||||||||||
Amortized Cost | Unrealized Amounts | Fair Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities | $ | 338 | $ | 5 | $ | (2 | ) | $ | 341 | ||||||||
Money market funds and other | 68 | — | — | 68 | |||||||||||||
$ | 406 | $ | 5 | $ | (2 | ) | 409 | ||||||||||
Amounts classified as current assets | (47 | ) | |||||||||||||||
Investment carrying value | $ | 362 | |||||||||||||||
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)
Amortized Cost | Fair Value | |||||||
Due in one year or less | $ | 24 | $ | 25 | ||||
Due after one year through five years | 50 | 50 | ||||||
Due after five years through ten years | 218 | 221 | ||||||
Due after ten years | 45 | 45 | ||||||
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$ | 337 | $ | 341 | |||||
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Amortized Cost | Fair Value | |||||||
Due in one year or less | $ | 3 | $ | 3 | ||||
Due after one year through five years | 74 | 77 | ||||||
Due after five years through ten years | 192 | 203 | ||||||
Due after ten years | 65 | 68 | ||||||
$ | 334 | $ | 351 | |||||
Notional Amount | Maturity Date | Fair Value | ||||||||||
Pay-fixed interest rate swaps | $ | 2,000 | December 2021 | $ | 83 | |||||||
Pay-fixed interest rate swaps | 500 | December 2022 | 15 |
Notional Amount | Maturity Date | Fair Value | ||||||||||
Pay-fixed interest rate swaps | $ | 2,000 | December 2021 | $ | 7 | |||||||
Pay-fixed interest rate swaps | 500 | December 2022 | (7 | ) |
Derivatives in Cash Flow Hedging Relationships | Amount of Gain Recognized in OCI on Derivatives, Net of Tax | Location of Gain Reclassified from Accumulated OCI into Operations | Amount of Gain Reclassified from Accumulated OCI into Operations | |||||||||
Interest rate swaps | $ | 39 | Interest expense | $ | 2 |
Derivatives in Cash Flow Hedging Relationships | Amount of Loss Recognized in OCI on Derivatives, Net of Tax | Location of Gain Reclassified from Accumulated OCI into Operations | Amount of Gain Reclassified from Accumulated OCI into Operations | |||||||||
Interest rate swaps | $ | 40 | Interest expense | $ | 11 |
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)
June 30, 2018 | ||||||||||||||||
Fair Value Measurements Using | ||||||||||||||||
Fair Value | Quoted Prices in Active Markets for Identical Assets (Level 1) | Significant Other Observable Inputs (Level 2) | Significant Unobservable Inputs (Level 3) | |||||||||||||
Assets: | ||||||||||||||||
Investments of insurance subsidiaries: | ||||||||||||||||
Debt securities | $ | 341 | $ | — | $ | 341 | $ | — | ||||||||
Money market funds and other | 118 | 118 | — | — | ||||||||||||
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Investments of insurance subsidiaries | 459 | 118 | 341 | — | ||||||||||||
Less amounts classified as current assets | (45 | ) | (45 | ) | — | — | ||||||||||
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$ | 414 | 73 | $ | 341 | $ | — | ||||||||||
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Interest rate swaps (Other) | $ | 98 | $ | — | $ | 98 | $ | — | ||||||||
December 31, 2017 | ||||||||||||||||
Fair Value Measurements Using | ||||||||||||||||
Fair Value | Quoted Prices in Active Markets for Identical Assets (Level 1) | Significant Other Observable Inputs (Level 2) | Significant Unobservable Inputs (Level 3) | |||||||||||||
Assets: | ||||||||||||||||
Investments of insurance subsidiaries: | ||||||||||||||||
Debt securities | $ | 371 | $ | — | $ | 371 | $ | — | ||||||||
Money market funds and other | 101 | 101 | — | — | ||||||||||||
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Investments of insurance subsidiaries | 472 | 101 | 371 | — | ||||||||||||
Less amounts classified as current assets | (54 | ) | (54 | ) | — | — | ||||||||||
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$ | 418 | $ | 47 | $ | 371 | $ | — | |||||||||
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Interest rate swaps (Other) | $ | 50 | $ | — | $ | 50 | $ | — |
June 30, 2019 | ||||||||||||||||
Fair Value Measurements Using | ||||||||||||||||
Fair Value | Quoted Prices in Active Markets for Identical Assets (Level 1) | Significant Other Observable Inputs (Level 2) | Significant Unobservable Inputs (Level 3) | |||||||||||||
Investments of insurance subsidiaries: | ||||||||||||||||
Debt securities | $ | 351 | $ | — | $ | 351 | $ | — | ||||||||
Money market funds and other | 104 | 104 | — | — | ||||||||||||
Investments of insurance subsidiaries | 455 | 104 | 351 | — | ||||||||||||
Less amounts classified as current assets | (113 | ) | (103 | ) | (10 | ) | — | |||||||||
$ | 342 | 1 | $ | 341 | $ | — | ||||||||||
December 31, 2018 | ||||||||||||||||
Fair Value Measurements Using | ||||||||||||||||
Fair Value | Quoted Prices in Active Markets for Identical Assets (Level 1) | Significant Other Observable Inputs (Level 2) | Significant Unobservable Inputs (Level 3) | |||||||||||||
Investments of insurance subsidiaries: | ||||||||||||||||
Debt securities | $ | 341 | $ | — | $ | 341 | $ | — | ||||||||
Money market funds and other | 68 | 68 | — | — | ||||||||||||
Investments of insurance subsidiaries | 409 | 68 | 341 | — | ||||||||||||
Less amounts classified as current assets | (47 | ) | (47 | ) | — | — | ||||||||||
$ | 362 | $ | 21 | $ | 341 | $ | — | |||||||||
Interest rate swaps (Other) | $ | 63 | $ | — | $ | 63 | $ | — |
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
June 30, 2018 | December 31, 2017 | |||||||
Senior secured asset-based revolving credit facility (effective interest rate of 3.6%) | $ | 3,750 | $ | 3,680 | ||||
Senior secured revolving credit facility (effective interest rate of 3.6%) | 140 | — | ||||||
Senior secured term loan facilities (effective interest rate of 3.5%) | 3,849 | 3,891 | ||||||
Senior secured notes (effective interest rate of 5.4%) | 15,300 | 15,300 | ||||||
Other senior secured debt (effective interest rate of 5.8%) | 552 | 599 | ||||||
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Senior secured debt | 23,591 | 23,470 | ||||||
Senior unsecured notes (effective interest rate of 6.4%) | 9,752 | 9,752 | ||||||
Net debt issuance costs | (151 | ) | (164 | ) | ||||
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Total debt (average life of 6.4 years, rates averaging 5.3%) | 33,192 | 33,058 | ||||||
Less amounts due within one year | 1,692 | 200 | ||||||
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$ | 31,500 | $ | 32,858 | |||||
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June 30, 2019 | December 31, 2018 | |||||||
Senior secured asset-based revolving credit facility | $ | — | $ | 3,040 | ||||
Senior secured revolving credit facility | — | — | ||||||
Senior secured term loan facilities (effective interest rate of 3.6%) | 3,752 | 3,801 | ||||||
Senior secured notes (effective interest rate of 5.4%) | 18,800 | 13,800 | ||||||
Other senior secured debt (effective interest rate of 5.5%) | 641 | 585 | ||||||
Senior secured debt | 23,193 | 21,226 | ||||||
Senior unsecured notes (effective interest rate of 6.3%) | 13,252 | 11,752 | ||||||
Debt issuance costs and discounts | (252 | ) | (157 | ) | ||||
Total debt (average life of 8.2 years, rates averaging 5.5%) | 36,193 | 32,821 | ||||||
Less amounts due within one year | 2,073 | 788 | ||||||
$ | 34,120 | $ | 32,033 | |||||
Balance Sheet Classification | June 30, 2019 | |||||||
Assets: | ||||||||
Operating leases | Right-of-use operating lease assets | $ | 1,787 | |||||
Finance leases | Property and equipment | 598 | ||||||
Total lease assets | $ | 2,385 | ||||||
Liabilities: | ||||||||
Current: | ||||||||
Operating leases | Other accrued expenses | $ | 339 | |||||
Finance leases | Long-term debt due within one year | 90 | ||||||
Noncurrent: | ||||||||
Operating leases | Right-of-use operating lease obligations | 1,460 | ||||||
Finance leases | Long-term debt | 447 | ||||||
Total lease liabilities | $ | 2,336 | ||||||
Weighted-average remaining term: | ||||||||
Operating leases | 11.5 years | |||||||
Finance leases | 9.9 years | |||||||
Weighted-average discount rate: | ||||||||
Operating leases(1) | 5.5 | % | ||||||
Finance leases | 6.2 | % |
(1) | Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019. |
2019 | ||||||||
Quarter | Six Months | |||||||
Finance lease expense: | ||||||||
Amortization of leased assets | $ | 20 | $ | 37 | ||||
Interest on lease liabilities | 9 | 15 | ||||||
Operating leases(2) | 99 | 193 | ||||||
Short-term lease expense(2) | 75 | 153 | ||||||
Variable lease expense(2) | 35 | 74 | ||||||
$ | 238 | $ | 472 | |||||
(2) | Expenses are included in “other operating expenses” in our condensed consolidated income statements. |
2019 | ||||
Cash paid for amounts included in the measurement of lease liabilities: | ||||
Operating cash flows for operating leases | $ | 267 | ||
Operating cash flows for finance leases | 15 | |||
Financing cash flows for finance leases | 37 |
Operating Leases | Finance Leases | |||||||
Year 1 | $ | 400 | $ | 115 | ||||
Year 2 | 375 | 102 | ||||||
Year 3 | 282 | 99 | ||||||
Year 4 | 223 | 62 | ||||||
Year 5 | 174 | 60 | ||||||
Thereafter | 1,210 | 293 | ||||||
Total minimum lease payments | 2,664 | 731 | ||||||
Less: amount of lease payments representing interest | (865 | ) | (194 | ) | ||||
Present value of future minimum lease payments | 1,799 | 537 | ||||||
Less: current obligations under leases | (339 | ) | (90 | ) | ||||
Long-term lease obligations | $ | 1,460 | $ | 447 | ||||
The changes in stockholders’ deficit, including changes in stockholders’ deficit attributableSHARE REPURCHASES TRANSACTIONS AND OTHER COMPREHENSIVE LOSS
Equity (Deficit) Attributable to HCA Healthcare, Inc. | ||||||||||||||||||||||||
Common Stock | Accumulated Other Comprehensive Loss | Retained Deficit | Equity Attributable to Noncontrolling Interests | Total | ||||||||||||||||||||
Shares | Par Value | |||||||||||||||||||||||
Balances at December 31, 2017 | 350.092 | $ | 4 | $ | (278 | ) | $ | (6,532 | ) | $ | 1,811 | $ | (4,995 | ) | ||||||||||
Comprehensive income | — | — | 17 | 1,964 | 284 | 2,265 | ||||||||||||||||||
Repurchase of common stock | (9.040 | ) | (1 | ) | — | (892 | ) | — | (893 | ) | ||||||||||||||
Dividends and distributions | — | — | — | (250 | ) | (185 | ) | (435 | ) | |||||||||||||||
Share-based benefit plans | 5.708 | — | — | (18 | ) | — | (18 | ) | ||||||||||||||||
Dispositions of entities with noncontrolling interests | — | — | — | — | (53 | ) | (53 | ) | ||||||||||||||||
Other | — | — | — | (3 | ) | 7 | 4 | |||||||||||||||||
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Balances at June 30, 2018 | 346.760 | $ | 3 | $ | (261 | ) | $ | (5,731 | ) | $ | 1,864 | $ | (4,125 | ) | ||||||||||
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$2 billion of our outstanding common stock. During the six months ended June 30, 2018,2019, we repurchased 9.0404.034 million shares of our common stock at an average price of $98.73$128.88 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during October 2017.2017 (which was completed during 2019) and the $2.0 billion share repurchase program authorized during January 2019. At June 30, 2018,2019, we had $910 million$1.753 billion of repurchase authorization available under the October 2017January 2019 authorization.
Unrealized Gains on Available- for-Sale Securities | Foreign Currency Translation Adjustments | Defined Benefit Plans | Change in Fair Value of Derivative Instruments | Total | ||||||||||||||||
Balances at December 31, 2017 | $ | 7 | $ | (149 | ) | $ | (168 | ) | $ | 32 | $ | (278 | ) | |||||||
Unrealized losses onavailable-for-sale securities, net of $1 income tax benefit | (5 | ) | — | — | — | (5 | ) | |||||||||||||
Foreign currency translation adjustments | — | (22 | ) | — | — | (22 | ) | |||||||||||||
Change in fair value of derivative instruments, net of $11 of income taxes | — | — | — | 39 | 39 | |||||||||||||||
Expense (income) reclassified into operations from other comprehensive income, net of $3 income tax benefit and $- income taxes, respectively | — | — | 7 | (2 | ) | 5 | ||||||||||||||
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|
|
|
| |||||||||||
Balances at June 30, 2018 | $ | 2 | $ | (171 | ) | $ | (161 | ) | $ | 69 | $ | (261 | ) | |||||||
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|
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|
|
|
|
|
|
|
Unrealized Gains on Available- for-Sale Securities | Foreign Currency Translation Adjustments | Defined Benefit Plans | Change in Fair Value of Derivative Instruments | Total | ||||||||||||||||
Balances at December 31, 2018 | $ | 3 | $ | (283 | ) | $ | (148 | ) | $ | 47 | $ | (381 | ) | |||||||
Unrealized gains on available-for-sale securities, net of $3 of income taxes | 11 | — | — | — | 11 | |||||||||||||||
Foreign currency translation adjustments, net of $1 income tax benefit | — | (17 | ) | — | — | (17 | ) | |||||||||||||
Change in fair value of derivative instruments, net of $12 income tax benefits | — | — | — | (40 | ) | (40 | ) | |||||||||||||
Expense (income) reclassified into operations from other comprehensive income, net of $2 income tax benefits and $2 of income taxes, respectively | — | — | 5 | (9 | ) | (4 | ) | |||||||||||||
Balances at June 30, 2019 | $ | 14 | $ | (300 | ) | $ | (143 | ) | $ | (2 | ) | $ | (431 | ) | ||||||
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)
Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Tennessee and Texas. We also operate
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Revenues: | ||||||||||||||||
National Group | $ | 5,609 | $ | 5,160 | $ | 11,177 | $ | 10,308 | ||||||||
American Group | 5,390 | 5,093 | 10,717 | 10,088 | ||||||||||||
Corporate and other | 530 | 480 | 1,058 | 960 | ||||||||||||
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| |||||||||
$ | 11,529 | $ | 10,733 | $ | 22,952 | $ | 21,356 | |||||||||
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| |||||||||
Equity in earnings of affiliates: | ||||||||||||||||
National Group | $ | (2 | ) | $ | (4 | ) | $ | (4 | ) | $ | (9 | ) | ||||
American Group | (10 | ) | (10 | ) | (19 | ) | (18 | ) | ||||||||
Corporate and other | 5 | 1 | 7 | 4 | ||||||||||||
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| |||||||||
$ | (7 | ) | $ | (13 | ) | $ | (16 | ) | $ | (23 | ) | |||||
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| |||||||||
Adjusted segment EBITDA: | ||||||||||||||||
National Group | $ | 1,284 | $ | 1,162 | $ | 2,466 | $ | 2,293 | ||||||||
American Group | 1,147 | 1,040 | 2,178 | 2,047 | ||||||||||||
Corporate and other | (204 | ) | (112 | ) | (299 | ) | (245 | ) | ||||||||
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| |||||||||
$ | 2,227 | $ | 2,090 | $ | 4,345 | $ | 4,095 | |||||||||
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| |||||||||
Depreciation and amortization: | ||||||||||||||||
National Group | $ | 232 | $ | 217 | $ | 457 | $ | 431 | ||||||||
American Group | 255 | 238 | 507 | 476 | ||||||||||||
Corporate and other | 75 | 66 | 151 | 135 | ||||||||||||
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| |||||||||
$ | 562 | $ | 521 | $ | 1,115 | $ | 1,042 | |||||||||
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| |||||||||
Adjusted segment EBITDA | $ | 2,227 | $ | 2,090 | $ | 4,345 | $ | 4,095 | ||||||||
Depreciation and amortization | 562 | 521 | 1,115 | 1,042 | ||||||||||||
Interest expense | 436 | 411 | 867 | 830 | ||||||||||||
Gains on sales of facilities | (9 | ) | (2 | ) | (414 | ) | (3 | ) | ||||||||
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| |||||||||
Income before income taxes | $ | 1,238 | $ | 1,160 | $ | 2,777 | $ | 2,226 | ||||||||
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Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Revenues: | ||||||||||||||||
National Group | $ | 6,444 | $ | 5,609 | $ | 12,761 | $ | 11,177 | ||||||||
American Group | 5,626 | 5,390 | 11,221 | 10,717 | ||||||||||||
Corporate and other | 532 | 530 | 1,137 | 1,058 | ||||||||||||
$ | 12,602 | $ | 11,529 | $ | 25,119 | $ | 22,952 | |||||||||
Equity in earnings of affiliates: | ||||||||||||||||
National Group | $ | (3 | ) | $ | (2 | ) | $ | (5 | ) | $ | (4 | ) | ||||
American Group | (11 | ) | (10 | ) | (22 | ) | (19 | ) | ||||||||
Corporate and other | 6 | 5 | 8 | 7 | ||||||||||||
$ | (8 | ) | $ | (7 | ) | $ | (19 | ) | $ | (16 | ) | |||||
Adjusted segment EBITDA: | ||||||||||||||||
National Group | $ | 1,364 | $ | 1,284 | $ | 2,818 | $ | 2,466 | ||||||||
American Group | 1,117 | 1,147 | 2,258 | 2,178 | ||||||||||||
Corporate and other | (188 | ) | (204 | ) | (242 | ) | (299 | ) | ||||||||
$ | 2,293 | $ | 2,227 | $ | 4,834 | $ | 4,345 | |||||||||
Depreciation and amortization: | ||||||||||||||||
National Group | $ | 283 | $ | 232 | $ | 548 | $ | 457 | ||||||||
American Group | 270 | 255 | 551 | 507 | ||||||||||||
Corporate and other | 83 | 75 | 156 | 151 | ||||||||||||
$ | 636 | $ | 562 | $ | 1,255 | $ | 1,115 | |||||||||
Adjusted segment EBITDA | $ | 2,293 | $ | 2,227 | $ | 4,834 | $ | 4,345 | ||||||||
Depreciation and amortization | 636 | 562 | 1,255 | 1,115 | ||||||||||||
Interest expense | 477 | 436 | 938 | 867 | ||||||||||||
Gains on sales of facilities | (18 | ) | (9 | ) | (17 | ) | (414 | ) | ||||||||
Income before income taxes | $ | 1,198 | $ | 1,238 | $ | 2,658 | $ | 2,777 | ||||||||
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
During December 2012,
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 7,129 | $ | 5,473 | $ | — | $ | 12,602 | ||||||||||||
Salaries and benefits | — | — | 3,199 | 2,638 | — | 5,837 | ||||||||||||||||||
Supplies | — | — | 1,189 | 929 | — | 2,118 | ||||||||||||||||||
Other operating expenses | 1 | — | 1,157 | 1,204 | — | 2,362 | ||||||||||||||||||
Equity in earnings of affiliates | (822 | ) | — | (1 | ) | (7 | ) | 822 | (8 | ) | ||||||||||||||
Depreciation and amortization | — | — | 354 | 282 | — | 636 | ||||||||||||||||||
Interest expense (income) | 16 | 1,010 | (511 | ) | (38 | ) | — | 477 | ||||||||||||||||
Gains on sales of facilities | — | — | (8 | ) | (10 | ) | — | (18 | ) | |||||||||||||||
Management fees | — | — | (205 | ) | 205 | — | — | |||||||||||||||||
(805 | ) | 1,010 | 5,174 | 5,203 | 822 | 11,404 | ||||||||||||||||||
Income (loss) before income taxes | 805 | (1,010 | ) | 1,955 | 270 | (822 | ) | 1,198 | ||||||||||||||||
Provision (benefit) for income taxes | 22 | (235 | ) | 450 | 34 | — | 271 | |||||||||||||||||
Net income (loss) | 783 | (775 | ) | 1,505 | 236 | (822 | ) | 927 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 21 | 123 | — | 144 | ||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 783 | $ | (775 | ) | $ | 1,484 | $ | 113 | $ | (822 | ) | $ | 783 | ||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 726 | $ | (806 | ) | $ | 1,487 | $ | 84 | $ | (765 | ) | $ | 726 | ||||||||||
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 6,774 | $ | 4,755 | $ | — | $ | 11,529 | ||||||||||||
Salaries and benefits | — | — | 3,025 | 2,249 | — | 5,274 | ||||||||||||||||||
Supplies | — | — | 1,127 | 790 | — | 1,917 | ||||||||||||||||||
Other operating expenses | 4 | — | 1,122 | 992 | — | 2,118 | ||||||||||||||||||
Equity in earnings of affiliates | (852 | ) | — | (1 | ) | (6 | ) | 852 | (7 | ) | ||||||||||||||
Depreciation and amortization | — | — | 329 | 233 | — | 562 | ||||||||||||||||||
Interest expense | 16 | 867 | (389 | ) | (58 | ) | — | 436 | ||||||||||||||||
Losses (gains) on sales of facilities | — | — | 23 | (32 | ) | — | (9 | ) | ||||||||||||||||
Management fees | — | — | (157 | ) | 157 | — | — | |||||||||||||||||
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| |||||||||||||
(832 | ) | 867 | 5,079 | 4,325 | 852 | 10,291 | ||||||||||||||||||
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| |||||||||||||
Income (loss) before income taxes | 832 | (867 | ) | 1,695 | 430 | (852 | ) | 1,238 | ||||||||||||||||
Provision (benefit) for income taxes | 12 | (201 | ) | 389 | 72 | — | 272 | |||||||||||||||||
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| |||||||||||||
Net income (loss) | 820 | (666 | ) | 1,306 | 358 | (852 | ) | 966 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 22 | 124 | — | 146 | ||||||||||||||||||
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| |||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 820 | $ | (666 | ) | $ | 1,284 | $ | 234 | $ | (852 | ) | $ | 820 | ||||||||||
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| |||||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 756 | $ | (656 | ) | $ | 1,287 | $ | 157 | $ | (788 | ) | $ | 756 | ||||||||||
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|
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 6,774 | $ | 4,755 | $ | — | $ | 11,529 | ||||||||||||
Salaries and benefits | — | — | 3,025 | 2,249 | — | 5,274 | ||||||||||||||||||
Supplies | — | — | 1,127 | 790 | — | 1,917 | ||||||||||||||||||
Other operating expenses | 4 | — | 1,122 | 992 | — | 2,118 | ||||||||||||||||||
Equity in earnings of affiliates | (852 | ) | — | (1 | ) | (6 | ) | 852 | (7 | ) | ||||||||||||||
Depreciation and amortization | — | — | 329 | 233 | — | 562 | ||||||||||||||||||
Interest expense (income) | 16 | 867 | (389 | ) | (58 | ) | — | 436 | ||||||||||||||||
Losses (gains) on sales of facilities | — | — | 23 | (32 | ) | — | (9 | ) | ||||||||||||||||
Management fees | — | — | (157 | ) | 157 | — | — | |||||||||||||||||
(832 | ) | 867 | 5,079 | 4,325 | 852 | 10,291 | ||||||||||||||||||
Income (loss) before income taxes | 832 | (867 | ) | 1,695 | 430 | (852 | ) | 1,238 | ||||||||||||||||
Provision (benefit) for income taxes | 12 | (201 | ) | 389 | 72 | — | 272 | |||||||||||||||||
Net income (loss) | 820 | (666 | ) | 1,306 | 358 | (852 | ) | 966 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 22 | 124 | — | 146 | ||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 820 | $ | (666 | ) | $ | 1,284 | $ | 234 | $ | (852 | ) | $ | 820 | ||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 756 | $ | (656 | ) | $ | 1,287 | $ | 157 | $ | (788 | ) | $ | 756 | ||||||||||
2019
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors (as adjusted) | Subsidiary Non- Guarantors (as adjusted) | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 6,369 | $ | 4,364 | $ | — | $ | 10,733 | ||||||||||||
Salaries and benefits | — | — | 2,870 | 2,026 | — | 4,896 | ||||||||||||||||||
Supplies | — | — | 1,055 | 740 | — | 1,795 | ||||||||||||||||||
Other operating expenses | 4 | — | 1,064 | 897 | — | 1,965 | ||||||||||||||||||
Equity in earnings of affiliates | (658 | ) | — | (1 | ) | (12 | ) | 658 | (13 | ) | ||||||||||||||
Depreciation and amortization | — | — | 302 | 219 | — | 521 | ||||||||||||||||||
Interest expense | 16 | 755 | (315 | ) | (45 | ) | — | 411 | ||||||||||||||||
Losses (gains) on sales of facilities | — | — | (4 | ) | 2 | — | (2 | ) | ||||||||||||||||
Management fees | — | — | (160 | ) | 160 | — | — | |||||||||||||||||
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| |||||||||||||
(638 | ) | 755 | 4,811 | 3,987 | 658 | 9,573 | ||||||||||||||||||
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|
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| |||||||||||||
Income (loss) before income taxes | 638 | (755 | ) | 1,558 | 377 | (658 | ) | 1,160 | ||||||||||||||||
Provision (benefit) for income taxes | (19 | ) | (279 | ) | 565 | 98 | — | 365 | ||||||||||||||||
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| |||||||||||||
Net income (loss) | 657 | (476 | ) | 993 | 279 | (658 | ) | 795 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 27 | 111 | — | 138 | ||||||||||||||||||
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| |||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 657 | $ | (476 | ) | $ | 966 | $ | 168 | $ | (658 | ) | $ | 657 | ||||||||||
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Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 684 | $ | (480 | ) | $ | 969 | $ | 196 | $ | (685 | ) | $ | 684 | ||||||||||
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HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 14,353 | $ | 10,766 | $ | — | $ | 25,119 | ||||||||||||
Salaries and benefits | — | — | 6,336 | 5,148 | — | 11,484 | ||||||||||||||||||
Supplies | — | — | 2,366 | 1,793 | — | 4,159 | ||||||||||||||||||
Other operating expenses | 3 | — | 2,303 | 2,355 | — | 4,661 | ||||||||||||||||||
Equity in earnings of affiliates | (1,848 | ) | — | (3 | ) | (16 | ) | 1,848 | (19 | ) | ||||||||||||||
Depreciation and amortization | — | — | 709 | 546 | — | 1,255 | ||||||||||||||||||
Interest expense (income) | 32 | 2,005 | (984 | ) | (115 | ) | — | 938 | ||||||||||||||||
Gains on sales of facilities | — | — | (7 | ) | (10 | ) | — | (17 | ) | |||||||||||||||
Management fees | — | — | (376 | ) | 376 | — | — | |||||||||||||||||
(1,813 | ) | 2,005 | 10,344 | 10,077 | 1,848 | 22,461 | ||||||||||||||||||
Income (loss) before income taxes | 1,813 | (2,005 | ) | 4,009 | 689 | (1,848 | ) | 2,658 | ||||||||||||||||
Provision (benefit) for income taxes | (9 | ) | (466 | ) | 922 | 103 | — | 550 | ||||||||||||||||
Net income (loss) | 1,822 | (1,539 | ) | 3,087 | 586 | (1,848 | ) | 2,108 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 41 | 245 | — | 286 | ||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 1,822 | $ | (1,539 | ) | $ | 3,046 | $ | 341 | $ | (1,848 | ) | $ | 1,822 | ||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 1,772 | $ | (1,588 | ) | $ | 3,051 | $ | 335 | $ | (1,798 | ) | $ | 1,772 | ||||||||||
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 13,550 | $ | 9,402 | $ | — | $ | 22,952 | ||||||||||||
Salaries and benefits | — | — | 6,094 | 4,469 | — | 10,563 | ||||||||||||||||||
Supplies | — | — | 2,268 | 1,564 | — | 3,832 | ||||||||||||||||||
Other operating expenses | 5 | — | 2,250 | 1,973 | — | 4,228 | ||||||||||||||||||
Equity in earnings of affiliates | (1,942 | ) | — | (3 | ) | (13 | ) | 1,942 | (16 | ) | ||||||||||||||
Depreciation and amortization | — | — | 652 | 463 | — | 1,115 | ||||||||||||||||||
Interest expense | 32 | 1,704 | (756 | ) | (113 | ) | — | 867 | ||||||||||||||||
Gains on sales of facilities | — | — | (372 | ) | (42 | ) | — | (414 | ) | |||||||||||||||
Management fees | — | — | (315 | ) | 315 | — | — | |||||||||||||||||
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| �� |
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(1,905 | ) | 1,704 | 9,818 | 8,616 | 1,942 | 20,175 | ||||||||||||||||||
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| |||||||||||||
Income (loss) before income taxes | 1,905 | (1,704 | ) | 3,732 | 786 | (1,942 | ) | 2,777 | ||||||||||||||||
Provision (benefit) for income taxes | (59 | ) | (396 | ) | 856 | 128 | — | 529 | ||||||||||||||||
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| |||||||||||||
Net income (loss) | 1,964 | (1,308 | ) | 2,876 | 658 | (1,942 | ) | 2,248 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 50 | 234 | — | 284 | ||||||||||||||||||
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| |||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 1,964 | $ | (1,308 | ) | $ | 2,826 | $ | 424 | $ | (1,942 | ) | $ | 1,964 | ||||||||||
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| |||||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 1,981 | $ | (1,271 | ) | $ | 2,833 | $ | 397 | $ | (1,959 | ) | $ | 1,981 | ||||||||||
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HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 13,550 | $ | 9,402 | $ | — | $ | 22,952 | ||||||||||||
Salaries and benefits | — | — | 6,094 | 4,469 | — | 10,563 | ||||||||||||||||||
Supplies | — | — | 2,268 | 1,564 | — | 3,832 | ||||||||||||||||||
Other operating expenses | 5 | — | 2,250 | 1,973 | — | 4,228 | ||||||||||||||||||
Equity in earnings of affiliates | (1,942 | ) | — | (3 | ) | (13 | ) | 1,942 | (16 | ) | ||||||||||||||
Depreciation and amortization | — | — | 652 | 463 | — | 1,115 | ||||||||||||||||||
Interest expense (income) | 32 | 1,704 | (756 | ) | (113 | ) | — | 867 | ||||||||||||||||
Gains on sales of facilities | — | — | (372 | ) | (42 | ) | — | (414 | ) | |||||||||||||||
Management fees | — | — | (315 | ) | 315 | — | — | |||||||||||||||||
(1,905 | ) | 1,704 | 9,818 | 8,616 | 1,942 | 20,175 | ||||||||||||||||||
Income (loss) before income taxes | 1,905 | (1,704 | ) | 3,732 | 786 | (1,942 | ) | 2,777 | ||||||||||||||||
Provision (benefit) for income taxes | (59 | ) | (396 | ) | 856 | 128 | — | 529 | ||||||||||||||||
Net income (loss) | 1,964 | (1,308 | ) | 2,876 | 658 | (1,942 | ) | 2,248 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 50 | 234 | — | 284 | ||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc. | $ | 1,964 | $ | (1,308 | ) | $ | 2,826 | $ | 424 | $ | (1,942 | ) | $ | 1,964 | ||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 1,981 | $ | (1,271 | ) | $ | 2,833 | $ | 397 | $ | (1,959 | ) | $ | 1,981 | ||||||||||
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
ASSETS | ||||||||||||||||||||||||
Current assets: | ||||||||||||||||||||||||
Cash and cash equivalents | $ | 300 | $ | — | $ | 1,700 | $ | 430 | $ | — | $ | 2,430 | ||||||||||||
Accounts receivable | — | — | 4,004 | 3,215 | — | 7,219 | ||||||||||||||||||
Inventories | — | — | 1,194 | 632 | — | 1,826 | ||||||||||||||||||
Other | — | — | 756 | 638 | — | 1,394 | ||||||||||||||||||
300 | — | 7,654 | 4,915 | — | 12,869 | |||||||||||||||||||
Property and equipment, net | — | — | 12,749 | 8,718 | — | 21,467 | ||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 342 | — | 342 | ||||||||||||||||||
Investments in and advances to affiliates | 34,964 | — | 29 | 218 | (34,964 | ) | 247 | |||||||||||||||||
Goodwill and other intangible assets | — | — | 5,725 | 2,415 | — | 8,140 | ||||||||||||||||||
Right-of-use operating lease assets | — | — | 436 | 1,351 | — | 1,787 | ||||||||||||||||||
Other | 462 | — | 21 | 114 | — | 597 | ||||||||||||||||||
$ | 35,726 | $ | — | $ | 26,614 | $ | 18,073 | $ | (34,964 | ) | $ | 45,449 | ||||||||||||
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | ||||||||||||||||||||||||
Current liabilities: | ||||||||||||||||||||||||
Accounts payable | $ | — | $ | — | $ | 1,754 | $ | 855 | $ | — | $ | 2,609 | ||||||||||||
Accrued salaries | — | — | 908 | 589 | — | 1,497 | ||||||||||||||||||
Other accrued expenses | 67 | 441 | 896 | 1,378 | — | 2,782 | ||||||||||||||||||
Long-term debt due within one year | — | 1,976 | 53 | 44 | — | 2,073 | ||||||||||||||||||
67 | 2,417 | 3,611 | 2,866 | — | 8,961 | |||||||||||||||||||
Long-term debt, net | 997 | 32,579 | 224 | 320 | — | 34,120 | ||||||||||||||||||
Intercompany balances | 37,985 | (8,618 | ) | (29,356 | ) | (11 | ) | — | — | |||||||||||||||
Professional liability risks | — | — | — | 1,354 | — | 1,354 | ||||||||||||||||||
Right-of-use operating lease obligations | — | — | 331 | 1,129 | — | 1,460 | ||||||||||||||||||
Income taxes and other liabilities | 579 | — | 232 | 513 | — | 1,324 | ||||||||||||||||||
39,628 | 26,378 | (24,958 | ) | 6,171 | — | 47,219 | ||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. | (3,902 | ) | (26,378 | ) | 51,488 | 9,854 | (34,964 | ) | (3,902 | ) | ||||||||||||||
Noncontrolling interests | — | — | 84 | 2,048 | — | 2,132 | ||||||||||||||||||
(3,902 | ) | (26,378 | ) | 51,572 | 11,902 | (34,964 | ) | (1,770 | ) | |||||||||||||||
$ | 35,726 | $ | — | $ | 26,614 | $ | 18,073 | $ | (34,964 | ) | $ | 45,449 | ||||||||||||
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
ASSETS | ||||||||||||||||||||||||
Current assets: | ||||||||||||||||||||||||
Cash and cash equivalents | $ | — | $ | — | $ | 174 | $ | 328 | $ | — | $ | 502 | ||||||||||||
Accounts receivable | — | — | 3,964 | 2,825 | — | 6,789 | ||||||||||||||||||
Inventories | — | — | 1,178 | 554 | — | 1,732 | ||||||||||||||||||
Other | — | — | 669 | 521 | — | 1,190 | ||||||||||||||||||
— | — | 5,985 | 4,228 | — | 10,213 | |||||||||||||||||||
Property and equipment, net | — | — | 12,450 | 7,307 | — | 19,757 | ||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 362 | — | 362 | ||||||||||||||||||
Investments in and advances to affiliates | 33,166 | — | 29 | 203 | (33,166 | ) | 232 | |||||||||||||||||
Goodwill and other intangible assets | — | — | 5,724 | 2,229 | — | 7,953 | ||||||||||||||||||
Other | 478 | 64 | 35 | 113 | — | 690 | ||||||||||||||||||
$ | 33,644 | $ | 64 | $ | 24,223 | $ | 14,442 | $ | (33,166 | ) | $ | 39,207 | ||||||||||||
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | ||||||||||||||||||||||||
Current liabilities: | ||||||||||||||||||||||||
Accounts payable | $ | — | $ | — | $ | 1,721 | $ | 856 | $ | — | $ | 2,577 | ||||||||||||
Accrued salaries | — | — | 998 | 582 | — | 1,580 | ||||||||||||||||||
Other accrued expenses | 142 | 403 | 905 | 1,174 | — | 2,624 | ||||||||||||||||||
Long-term debt due within one year | — | 696 | 55 | 37 | — | 788 | ||||||||||||||||||
142 | 1,099 | 3,679 | 2,649 | — | 7,569 | |||||||||||||||||||
Long-term debt, net | 996 | 30,544 | 212 | 281 | — | 32,033 | ||||||||||||||||||
Intercompany balances | 36,951 | (6,789 | ) | (28,415 | ) | (1,747 | ) | — | — | |||||||||||||||
Professional liability risks | — | — | — | 1,275 | — | 1,275 | ||||||||||||||||||
Income taxes and other liabilities | 505 | — | 223 | 520 | — | 1,248 | ||||||||||||||||||
38,594 | 24,854 | (24,301 | ) | 2,978 | — | 42,125 | ||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. | (4,950 | ) | (24,790 | ) | 48,437 | 9,519 | (33,166 | ) | (4,950 | ) | ||||||||||||||
Noncontrolling interests | — | — | 87 | 1,945 | — | 2,032 | ||||||||||||||||||
(4,950 | ) | (24,790 | ) | 48,524 | 11,464 | (33,166 | ) | (2,918 | ) | |||||||||||||||
$ | 33,644 | $ | 64 | $ | 24,223 | $ | 14,442 | $ | (33,166 | ) | $ | 39,207 | ||||||||||||
OF CASH FLOWS
2019
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors (as adjusted) | Subsidiary Non- Guarantors (as adjusted) | Eliminations | Condensed Consolidated | |||||||||||||||||||
Revenues | $ | — | $ | — | $ | 12,705 | $ | 8,651 | $ | — | $ | 21,356 | ||||||||||||
Salaries and benefits | — | — | 5,774 | 4,023 | — | 9,797 | ||||||||||||||||||
Supplies | — | — | 2,130 | 1,462 | — | 3,592 | ||||||||||||||||||
Other operating expenses | 5 | — | 2,114 | 1,776 | — | 3,895 | ||||||||||||||||||
Equity in earnings of affiliates | (1,266 | ) | — | (3 | ) | (20 | ) | 1,266 | (23 | ) | ||||||||||||||
Depreciation and amortization | — | — | 612 | 430 | — | 1,042 | ||||||||||||||||||
Interest expense | 32 | 1,488 | (605 | ) | (85 | ) | — | 830 | ||||||||||||||||
Gains on sales of facilities | — | — | (3 | ) | — | — | (3 | ) | ||||||||||||||||
Management fees | — | — | (320 | ) | 320 | — | — | |||||||||||||||||
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(1,229 | ) | 1,488 | 9,699 | 7,906 | 1,266 | 19,130 | ||||||||||||||||||
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Income (loss) before income taxes | 1,229 | (1,488 | ) | 3,006 | 745 | (1,266 | ) | 2,226 | ||||||||||||||||
Provision (benefit) for income taxes | (87 | ) | (549 | ) | 1,091 | 199 | — | 654 | ||||||||||||||||
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Net income (loss) | 1,316 | (939 | ) | 1,915 | 546 | (1,266 | ) | 1,572 | ||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 50 | 206 | — | 256 | ||||||||||||||||||
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Net income (loss) attributable to HCA Healthcare, Inc. | $ | 1,316 | $ | (939 | ) | $ | 1,865 | $ | 340 | $ | (1,266 | ) | $ | 1,316 | ||||||||||
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Comprehensive income (loss) attributable to HCA Healthcare, Inc. | $ | 1,361 | $ | (936 | ) | $ | 1,871 | $ | 376 | $ | (1,311 | ) | $ | 1,361 | ||||||||||
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HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Cash flows from operating activities: | ||||||||||||||||||||||||
Net income (loss) | $ | 1,822 | $ | (1,539 | ) | $ | 3,087 | $ | 586 | $ | (1,848 | ) | $ | 2,108 | ||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||||||||||||||||||||||
Changes in operating assets and liabilities | — | 40 | (305 | ) | (378 | ) | — | (643 | ) | |||||||||||||||
Depreciation and amortization | — | — | 709 | 546 | — | 1,255 | ||||||||||||||||||
Income taxes | 27 | — | — | — | — | 27 | ||||||||||||||||||
Gains on sales of facilities | — | — | (7 | ) | (10 | ) | — | (17 | ) | |||||||||||||||
Amortization of debt issuance costs and discounts | — | 16 | — | — | — | 16 | ||||||||||||||||||
Share-based compensation | — | — | 158 | — | — | 158 | ||||||||||||||||||
Equity in earnings of affiliates | (1,848 | ) | — | — | — | 1,848 | — | |||||||||||||||||
Other | 54 | — | 14 | (1 | ) | — | 67 | |||||||||||||||||
Net cash provided by (used in) operating activities | 55 | (1,483 | ) | 3,656 | 743 | — | 2,971 | |||||||||||||||||
Cash flows from investing activities: | ||||||||||||||||||||||||
Purchase of property and equipment | — | — | (953 | ) | (792 | ) | — | (1,745 | ) | |||||||||||||||
Acquisition of hospitals and health care entities | — | — | (35 | ) | (1,469 | ) | — | (1,504 | ) | |||||||||||||||
Disposition of hospitals and health care entities | — | — | 30 | 11 | — | 41 | ||||||||||||||||||
Change in investments | — | — | 14 | 45 | — | 59 | ||||||||||||||||||
Other | — | — | (9 | ) | 45 | — | 36 | |||||||||||||||||
Net cash used in investing activities | — | — | (953 | ) | (2,160 | ) | — | (3,113 | ) | |||||||||||||||
Cash flows from financing activities: | ||||||||||||||||||||||||
Issuance of long-term debt | — | 6,451 | — | — | — | 6,451 | ||||||||||||||||||
Net change in revolving credit facilities | — | (3,040 | ) | — | — | — | (3,040 | ) | ||||||||||||||||
Repayment of long-term debt | — | (47 | ) | (31 | ) | (20 | ) | — | (98 | ) | ||||||||||||||
Distributions to noncontrolling interests | — | — | (44 | ) | (203 | ) | — | (247 | ) | |||||||||||||||
Payment of debt issuance costs | — | (63 | ) | — | — | — | (63 | ) | ||||||||||||||||
Payment of cash dividends | (278 | ) | — | — | — | — | (278 | ) | ||||||||||||||||
Repurchases of common stock | (520 | ) | — | — | — | — | (520 | ) | ||||||||||||||||
Changes in intercompany balances with affiliates, net | 1,165 | (1,818 | ) | (1,102 | ) | 1,755 | — | — | ||||||||||||||||
Other | (122 | ) | — | — | (13 | ) | — | (135 | ) | |||||||||||||||
Net cash provided by (used in) financing activities | 245 | 1,483 | (1,177 | ) | 1,519 | — | 2,070 | |||||||||||||||||
Change in cash and cash equivalents | 300 | — | 1,526 | 102 | — | 1,928 | ||||||||||||||||||
Cash and cash equivalents at beginning of period | — | — | 174 | 328 | — | 502 | ||||||||||||||||||
Cash and cash equivalents at end of period | $ | 300 | $ | — | $ | 1,700 | $ | 430 | $ | — | $ | 2,430 | ||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET
JUNE 30, 2018
(Dollars in millions)
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
ASSETS | ||||||||||||||||||||||||
Current assets: | ||||||||||||||||||||||||
Cash and cash equivalents | $ | — | $ | — | $ | 197 | $ | 671 | $ | — | $ | 868 | ||||||||||||
Accounts receivable | — | — | 3,873 | 2,719 | — | 6,592 | ||||||||||||||||||
Inventories | — | — | 1,093 | 543 | — | 1,636 | ||||||||||||||||||
Other | — | — | 743 | 555 | — | �� | 1,298 | |||||||||||||||||
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| |||||||||||||
— | — | 5,906 | 4,488 | — | 10,394 | |||||||||||||||||||
Property and equipment, net | — | — | 11,842 | 6,702 | — | 18,544 | ||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 414 | — | 414 | ||||||||||||||||||
Investments in and advances to affiliates | 31,540 | — | 28 | 206 | (31,540 | ) | 234 | |||||||||||||||||
Goodwill and other intangible assets | — | — | 5,429 | 2,030 | — | 7,459 | ||||||||||||||||||
Other | 450 | 98 | 29 | 120 | — | 697 | ||||||||||||||||||
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$ | 31,990 | $ | 98 | $ | 23,234 | $ | 13,960 | $ | (31,540 | ) | $ | 37,742 | ||||||||||||
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LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | ||||||||||||||||||||||||
Current liabilities: | ||||||||||||||||||||||||
Accounts payable | $ | 1 | $ | — | $ | 1,683 | $ | 773 | $ | — | $ | 2,457 | ||||||||||||
Accrued salaries | — | — | 836 | 479 | — | 1,315 | ||||||||||||||||||
Other accrued expenses | 101 | 382 | 670 | 1,008 | — | 2,161 | ||||||||||||||||||
Long-term debt due within one year | — | 1,597 | 61 | 34 | — | 1,692 | ||||||||||||||||||
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102 | 1,979 | 3,250 | 2,294 | — | 7,625 | |||||||||||||||||||
Long-term debt, net | 995 | 30,048 | 282 | 175 | — | 31,500 | ||||||||||||||||||
Intercompany balances | 36,325 | (8,608 | ) | (26,352 | ) | (1,365 | ) | — | — | |||||||||||||||
Professional liability risks | — | — | — | 1,283 | — | 1,283 | ||||||||||||||||||
Income taxes and other liabilities | 557 | — | 388 | 514 | — | 1,459 | ||||||||||||||||||
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37,979 | 23,419 | (22,432) | 2,901 | — | 41,867 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. | (5,989 | ) | (23,321 | ) | 45,588 | 9,273 | (31,540 | ) | (5,989 | ) | ||||||||||||||
Noncontrolling interests | — | — | 78 | 1,786 | — | 1,864 | ||||||||||||||||||
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(5,989 | ) | (23,321 | ) | 45,666 | 11,059 | (31,540 | ) | (4,125 | ) | |||||||||||||||
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$ | 31,990 | $ | 98 | $ | 23,234 | $ | 13,960 | $ | (31,540 | ) | $ | 37,742 | ||||||||||||
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HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATING BALANCE SHEET
DECEMBER 31, 2017
(Dollars in millions)
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
ASSETS | ||||||||||||||||||||||||
Current assets: | ||||||||||||||||||||||||
Cash and cash equivalents | $ | 1 | $ | — | $ | 112 | $ | 619 | $ | — | $ | 732 | ||||||||||||
Accounts receivable | — | — | 3,693 | 2,808 | — | 6,501 | ||||||||||||||||||
Inventories | — | — | 1,030 | 543 | — | 1,573 | ||||||||||||||||||
Other | — | — | 663 | 508 | — | 1,171 | ||||||||||||||||||
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1 | — | 5,498 | 4,478 | — | 9,977 | |||||||||||||||||||
Property and equipment, net | — | — | 11,110 | 6,785 | — | 17,895 | ||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 418 | — | 418 | ||||||||||||||||||
Investments in and advances to affiliates | 29,581 | — | 22 | 177 | (29,581 | ) | 199 | |||||||||||||||||
Goodwill and other intangible assets | — | — | 4,893 | 2,501 | — | 7,394 | ||||||||||||||||||
Other | 510 | 50 | 47 | 103 | — | 710 | ||||||||||||||||||
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$ | 30,092 | $ | 50 | $ | 21,570 | $ | 14,462 | $ | (29,581 | ) | $ | 36,593 | ||||||||||||
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LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | ||||||||||||||||||||||||
Current liabilities: | ||||||||||||||||||||||||
Accounts payable | $ | — | $ | — | $ | 1,793 | $ | 813 | $ | — | $ | 2,606 | ||||||||||||
Accrued salaries | — | — | 862 | 507 | — | 1,369 | ||||||||||||||||||
Other accrued expenses | 29 | 378 | 536 | 1,040 | — | 1,983 | ||||||||||||||||||
Long-term debt due within one year | — | 97 | 64 | 39 | — | 200 | ||||||||||||||||||
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29 | 475 | 3,255 | 2,399 | — | 6,158 | |||||||||||||||||||
Long-term debt, net | 995 | 31,367 | 307 | 189 | — | 32,858 | ||||||||||||||||||
Intercompany balances | 35,322 | (9,742 | ) | (25,228 | ) | (352 | ) | — | — | |||||||||||||||
Professional liability risks | — | — | — | 1,198 | — | 1,198 | ||||||||||||||||||
Income taxes and other liabilities | 552 | — | 357 | 465 | — | 1,374 | ||||||||||||||||||
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36,898 | 22,100 | (21,309 | ) | 3,899 | — | 41,588 | ||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. | (6,806 | ) | (22,050 | ) | 42,755 | 8,876 | (29,581 | ) | (6,806 | ) | ||||||||||||||
Noncontrolling interests | — | — | 124 | 1,687 | — | 1,811 | ||||||||||||||||||
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(6,806 | ) | (22,050 | ) | 42,879 | 10,563 | (29,581 | ) | (4,995 | ) | |||||||||||||||
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$ | 30,092 | $ | 50 | $ | 21,570 | $ | 14,462 | $ | (29,581 | ) | $ | 36,593 | ||||||||||||
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HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)
HCA HEALTHCARE, INC.
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Cash flows from operating activities: | ||||||||||||||||||||||||
Net income (loss) | $ | 1,964 | $ | (1,308 | ) | $ | 2,876 | $ | 658 | $ | (1,942 | ) | $ | 2,248 | ||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||||||||||||||||||||||
Changes in operating assets and liabilities | — | 2 | (352 | ) | (52 | ) | — | (402 | ) | |||||||||||||||
Depreciation and amortization | — | — | 652 | 463 | — | 1,115 | ||||||||||||||||||
Income taxes | 118 | — | — | — | — | 118 | ||||||||||||||||||
Gains on sales of facilities | — | — | (372 | ) | (42 | ) | — | (414 | ) | |||||||||||||||
Amortization of debt issuance costs | — | 15 | — | — | — | 15 | ||||||||||||||||||
Share-based compensation | — | — | 134 | — | — | 134 | ||||||||||||||||||
Equity in earnings of affiliates | (1,942 | ) | — | — | — | 1,942 | — | |||||||||||||||||
Other | 43 | — | — | 8 | — | 51 | ||||||||||||||||||
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| |||||||||||||
Net cash provided by (used in) operating activities | 183 | (1,291 | ) | 2,938 | 1,035 | — | 2,865 | |||||||||||||||||
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Cash flows from investing activities: | ||||||||||||||||||||||||
Purchase of property and equipment | — | — | (900 | ) | (674 | ) | — | (1,574 | ) | |||||||||||||||
Acquisition of hospitals and health care entities | — | — | (438 | ) | (100 | ) | — | (538 | ) | |||||||||||||||
Disposition of hospitals and health care entities | — | — | 767 | 32 | — | 799 | ||||||||||||||||||
Change in investments | — | — | 17 | 6 | — | 23 | ||||||||||||||||||
Other | — | — | (30 | ) | 5 | — | (25 | ) | ||||||||||||||||
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Net cash used in investing activities | — | — | (584 | ) | (731 | ) | — | (1,315 | ) | |||||||||||||||
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Cash flows from financing activities: | ||||||||||||||||||||||||
Net change in revolving credit facilities | — | 210 | — | — | — | 210 | ||||||||||||||||||
Repayment of long-term debt | — | (41 | ) | (38 | ) | (22 | ) | — | (101 | ) | ||||||||||||||
Distributions to noncontrolling interests | — | — | (43 | ) | (142 | ) | — | (185 | ) | |||||||||||||||
Payment of debt issuance costs | — | (2 | ) | — | — | — | (2 | ) | ||||||||||||||||
Payment of cash dividends | (245 | ) | — | — | — | — | (245 | ) | ||||||||||||||||
Repurchases of common stock | (893 | ) | — | — | — | — | (893 | ) | ||||||||||||||||
Changes in intercompany balances with affiliates, net | 1,150 | 1,124 | (2,188 | ) | (86 | ) | — | — | ||||||||||||||||
Other | (196 | ) | — | — | 4 | — | (192 | ) | ||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Net cash (used in) provided by financing activities | (184 | ) | 1,291 | (2,269 | ) | (246 | ) | — | (1,408 | ) | ||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Effect on exchange rate changes on cash and cash equivalents | — | — | — | (6 | ) | — | (6 | ) | ||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Change in cash and cash equivalents | (1 | ) | — | 85 | 52 | — | 136 | |||||||||||||||||
Cash and cash equivalents at beginning of period | 1 | — | 112 | 619 | — | 732 | ||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 197 | $ | 671 | $ | — | $ | 868 | ||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors | Subsidiary Non- Guarantors | Eliminations | Condensed Consolidated | |||||||||||||||||||
Cash flows from operating activities: | ||||||||||||||||||||||||
Net income (loss) | $ | 1,964 | $ | (1,308 | ) | $ | 2,876 | $ | 658 | $ | (1,942 | ) | $ | 2,248 | ||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||||||||||||||||||||||
Changes in operating assets and liabilities | — | 2 | (352 | ) | (52 | ) | — | (402 | ) | |||||||||||||||
Depreciation and amortization | — | — | 652 | 463 | — | 1,115 | ||||||||||||||||||
Income taxes | 118 | — | — | — | — | 118 | ||||||||||||||||||
Gains on sales of facilities | — | — | (372 | ) | (42 | ) | — | (414 | ) | |||||||||||||||
Amortization of debt issuance costs and discounts | — | 15 | — | — | — | 15 | ||||||||||||||||||
Share-based compensation | — | — | 134 | — | — | 134 | ||||||||||||||||||
Equity in earnings of affiliates | (1,942 | ) | — | — | — | 1,942 | — | |||||||||||||||||
Other | 43 | — | — | 8 | — | 51 | ||||||||||||||||||
Net cash provided by (used in) operating activities | 183 | (1,291 | ) | 2,938 | 1,035 | — | 2,865 | |||||||||||||||||
Cash flows from investing activities: | ||||||||||||||||||||||||
Purchase of property and equipment | — | — | (900 | ) | (674 | ) | — | (1,574 | ) | |||||||||||||||
Acquisition of hospitals and health care entities | — | — | (438 | ) | (100 | ) | — | (538 | ) | |||||||||||||||
Disposition of hospitals and health care entities | — | — | 767 | 32 | — | 799 | ||||||||||||||||||
Change in investments | — | — | 17 | 6 | — | 23 | ||||||||||||||||||
Other | — | — | (30 | ) | 5 | — | (25 | ) | ||||||||||||||||
Net cash used in investing activities | — | — | (584 | ) | (731 | ) | — | (1,315 | ) | |||||||||||||||
Cash flows from financing activities: | ||||||||||||||||||||||||
Net change in revolving credit facilities | — | 210 | — | — | — | 210 | ||||||||||||||||||
Repayment of long-term debt | — | (41 | ) | (38 | ) | (22 | ) | — | (101 | ) | ||||||||||||||
Distributions to noncontrolling interests | — | — | (43 | ) | (142 | ) | — | (185 | ) | |||||||||||||||
Payment of debt issuance costs | — | (2 | ) | — | — | — | (2 | ) | ||||||||||||||||
Payment of cash dividends | (245 | ) | — | — | — | — | (245 | ) | ||||||||||||||||
Repurchases of common stock | (893 | ) | — | — | — | — | (893 | ) | ||||||||||||||||
Changes in intercompany balances with affiliates, net | 1,150 | 1,124 | (2,188 | ) | (86 | ) | — | — | ||||||||||||||||
Other | (196 | ) | — | — | 4 | — | (192 | ) | ||||||||||||||||
Net cash (used in) provided by financing activities | (184 | ) | 1,291 | (2,269 | ) | (246 | ) | — | (1,408 | ) | ||||||||||||||
Effect on exchange rate changes on cash and cash equivalents | — | — | — | (6 | ) | — | (6 | ) | ||||||||||||||||
Change in cash and cash equivalents | (1 | ) | — | 85 | 52 | — | 136 | |||||||||||||||||
Cash and cash equivalents at beginning of period | 1 | — | 112 | 619 | — | 732 | ||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 197 | $ | 671 | $ | — | $ | 868 | ||||||||||||
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS
FOR THE SIX MONTHS ENDED JUNE 30, 2017
(Dollars in millions)
HCA Healthcare, Inc. Issuer | HCA Inc. Issuer | Subsidiary Guarantors (as adjusted) | Subsidiary Non- Guarantors (as adjusted) | Eliminations | Condensed Consolidated | |||||||||||||||||||
Cash flows from operating activities: | ||||||||||||||||||||||||
Net income (loss) | $ | 1,316 | $ | (939 | ) | $ | 1,915 | $ | 546 | $ | (1,266 | ) | $ | 1,572 | ||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||||||||||||||||||||||
Changes in operating assets and liabilities | 1 | (189 | ) | (196 | ) | (11 | ) | — | (395 | ) | ||||||||||||||
Depreciation and amortization | — | — | 612 | 430 | — | 1,042 | ||||||||||||||||||
Income taxes | 267 | — | — | — | — | 267 | ||||||||||||||||||
Gains on sales of facilities | — | — | (3 | ) | — | — | (3 | ) | ||||||||||||||||
Amortization of debt issuance costs | — | 16 | — | — | — | 16 | ||||||||||||||||||
Share-based compensation | — | — | 140 | — | — | 140 | ||||||||||||||||||
Equity in earnings of affiliates | (1,266 | ) | — | — | — | 1,266 | — | |||||||||||||||||
Other | 39 | — | 1 | 5 | — | 45 | ||||||||||||||||||
|
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|
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|
|
|
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|
|
|
| |||||||||||||
Net cash provided by (used in) operating activities | 357 | (1,112 | ) | 2,469 | 970 | — | 2,684 | |||||||||||||||||
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|
|
|
|
|
|
|
|
|
| |||||||||||||
Cash flows from investing activities: | ||||||||||||||||||||||||
Purchase of property and equipment | — | — | (729 | ) | (575 | ) | — | (1,304 | ) | |||||||||||||||
Acquisition of hospitals and health care entities | — | — | (6 | ) | (289 | ) | — | (295 | ) | |||||||||||||||
Disposition of hospitals and health care entities | — | — | 10 | 4 | — | 14 | ||||||||||||||||||
Change in investments | — | — | — | (11 | ) | — | (11 | ) | ||||||||||||||||
Other | — | — | 2 | 3 | — | 5 | ||||||||||||||||||
|
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|
|
|
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|
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|
|
|
| |||||||||||||
Net cash used in investing activities | — | — | (723 | ) | (868 | ) | — | (1,591 | ) | |||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Cash flows from financing activities: | ||||||||||||||||||||||||
Issuance of long-term debt | — | 1,500 | — | 2 | — | 1,502 | ||||||||||||||||||
Net change in revolving credit facilities | — | (1,160 | ) | — | — | — | (1,160 | ) | ||||||||||||||||
Repayment of long-term debt | — | (42 | ) | (33 | ) | (20 | ) | — | (95 | ) | ||||||||||||||
Distributions to noncontrolling interests | — | — | (79 | ) | (169 | ) | — | (248 | ) | |||||||||||||||
Payment of debt issuance costs | — | (25 | ) | — | — | — | (25 | ) | ||||||||||||||||
Repurchases of common stock | (966 | ) | — | — | — | — | (966 | ) | ||||||||||||||||
Changes in intercompany balances with affiliates, net | 671 | 839 | (1,589 | ) | 79 | — | — | |||||||||||||||||
Other | (62 | ) | — | — | 20 | — | (42 | ) | ||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Net cash (used in) provided by financing activities | (357 | ) | 1,112 | (1,701 | ) | (88 | ) | — | (1,034 | ) | ||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||
Change in cash and cash equivalents | — | — | 45 | 14 | — | 59 | ||||||||||||||||||
Cash and cash equivalents at beginning of period | — | — | 113 | 533 | — | 646 | ||||||||||||||||||
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|
|
|
|
| |||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 158 | $ | 547 | $ | — | $ | 705 | ||||||||||||
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HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)
The above supplemental condensed consolidating financial information for the quarter and six months ended June 30, 2017 has been adjusted to properly record the impact
changes in interpretations, assumptions and expectations regardingthe effects of the 2017 Tax Cuts and Jobs Act (the “Tax Act”), including additionalpotential legislation or interpretive guidance that may be issued by federal and state taxing authorities or other standard-setting bodies, and (25) other risk factors described in our annual report onForm20172018 and our other filings with the Securities and Exchange Commission. As a consequence, current plans, anticipated actions and future financial position and results of operations may differ from those expressed in any forward-looking statements made by or on behalf of HCA. You are cautioned not to unduly rely on such forward-looking statements when evaluating the information presented in this report, which forward-looking statements reflect management’s views only as of the date of this report. We undertake no obligation to revise or update any forward-looking statements, whether as a result of new information, future events or otherwise.
2018.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted
Quarter | ||||||||||||||||
2018 | Ratio | 2017 | Ratio | |||||||||||||
Medicare | $ | 2,425 | 21.0 | % | $ | 2,272 | 21.2 | % | ||||||||
Managed Medicare | 1,345 | 11.7 | 1,158 | 10.8 | ||||||||||||
Medicaid | 357 | 3.1 | 376 | 3.5 | ||||||||||||
Managed Medicaid | 586 | 5.1 | 527 | 4.9 | ||||||||||||
Managed care and insurers | 5,993 | 51.9 | 5,729 | 53.4 | ||||||||||||
International (managed care and insurers) | 295 | 2.6 | 269 | 2.5 | ||||||||||||
Other | 528 | 4.6 | 402 | 3.7 | ||||||||||||
|
|
|
|
|
|
|
| |||||||||
Revenues | $ | 11,529 | 100.0 | % | $ | 10,733 | 100.0 | % | ||||||||
|
|
|
|
|
|
|
|
Six Months | ||||||||||||||||
2018 | Ratio | 2017 | Ratio | |||||||||||||
Medicare | $ | 4,949 | 21.6 | % | $ | 4,633 | 21.7 | % | ||||||||
Managed Medicare | 2,744 | 12.0 | 2,341 | 11.0 | ||||||||||||
Medicaid | 638 | 2.8 | 670 | 3.1 | ||||||||||||
Managed Medicaid | 1,147 | 5.0 | 1,116 | 5.2 | ||||||||||||
Managed care and insurers | 12,055 | 52.5 | 11,352 | 53.2 | ||||||||||||
International (managed care and insurers) | 600 | 2.6 | 538 | 2.5 | ||||||||||||
Other | 819 | 3.5 | 706 | 3.3 | ||||||||||||
|
|
|
|
|
|
|
| |||||||||
Revenues | $ | 22,952 | 100.0 | % | $ | 21,356 | 100.0 | % | ||||||||
|
|
|
|
|
|
|
|
Quarter | ||||||||||||||||
2019 | Ratio | 2018 | Ratio | |||||||||||||
Medicare | $ | 2,635 | 20.9 | % | $ | 2,425 | 21.0 | % | ||||||||
Managed Medicare | 1,595 | 12.7 | 1,345 | 11.7 | ||||||||||||
Medicaid | 416 | 3.3 | 357 | 3.1 | ||||||||||||
Managed Medicaid | 554 | 4.4 | 586 | 5.1 | ||||||||||||
Managed care and insurers | 6,425 | 50.9 | 5,993 | 51.9 | ||||||||||||
International (managed care and insurers) | 284 | 2.3 | 295 | 2.6 | ||||||||||||
Other | 693 | 5.5 | 528 | 4.6 | ||||||||||||
Revenues | $ | 12,602 | 100.0 | % | $ | 11,529 | 100.0 | % | ||||||||
Six Months | ||||||||||||||||
2019 | Ratio | 2018 | Ratio | |||||||||||||
Medicare | $ | 5,405 | 21.5 | % | $ | 4,949 | 21.6 | % | ||||||||
Managed Medicare | 3,184 | 12.7 | 2,744 | 12.0 | ||||||||||||
Medicaid | 763 | 3.0 | 638 | 2.8 | ||||||||||||
Managed Medicaid | 1,167 | 4.6 | 1,147 | 5.0 | ||||||||||||
Managed care and insurers | 12,851 | 51.1 | 12,055 | 52.5 | ||||||||||||
International (managed care and insurers) | 581 | 2.3 | 600 | 2.6 | ||||||||||||
Other | 1,168 | 4.8 | 819 | 3.5 | ||||||||||||
Revenues | $ | 25,119 | 100.0 | % | $ | 22,952 | 100.0 | % | ||||||||
2018.
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) | $ | 9,871 | $ | 9,177 | $ | 19,738 | $ | 18,326 | ||||||||
Cost-to-charges ratio (patient care costs as percentage of gross patient charges) | 12.6 | % | 13.0 | % | 12.5 | % | 12.9 | % | ||||||||
Total uncompensated care | $ | 6,486 | $ | 5,721 | $ | 12,738 | $ | 11,048 | ||||||||
Multiply by thecost-to-charges ratio | 12.6 | % | 13.0 | % | 12.5 | % | 12.9 | % | ||||||||
|
|
|
|
|
|
|
| |||||||||
Estimated cost of total uncompensated care | $ | 817 | $ | 743 | $ | 1,592 | $ | 1,425 | ||||||||
|
|
|
|
|
|
|
|
Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) | $ | 10,953 | $ | 9,871 | $ | 21,559 | $ | 19,738 | ||||||||
Cost-to-charges ratio (patient care costs as percentage of gross patient charges) | 12.2 | % | 12.6 | % | 12.0 | % | 12.5 | % | ||||||||
Total uncompensated care | $ | 7,695 | $ | 6,486 | $ | 14,780 | $ | 12,738 | ||||||||
Multiply by the cost-to-charges ratio | 12.2 | % | 12.6 | % | 12.0 | % | 12.5 | % | ||||||||
Estimated cost of total uncompensated care | $ | 938 | $ | 817 | $ | 1,774 | $ | 1,592 | ||||||||
2018.
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Medicare | 29 | % | 30 | % | 30 | % | 31 | % | ||||||||
Managed Medicare | 18 | 16 | 18 | 16 | ||||||||||||
Medicaid | 5 | 5 | 5 | 5 | ||||||||||||
Managed Medicaid | 12 | 12 | 12 | 12 | ||||||||||||
Managed care and insurers | 28 | 29 | 27 | 28 | ||||||||||||
Uninsured | 8 | 8 | 8 | 8 | ||||||||||||
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| |||||||||
100 | % | 100 | % | 100 | % | 100 | % | |||||||||
|
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|
|
|
|
|
|
Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Medicare | 29 | % | 29 | % | 29 | % | 30 | % | ||||||||
Managed Medicare | 18 | 18 | 19 | 18 | ||||||||||||
Medicaid | 5 | 5 | 5 | 5 | ||||||||||||
Managed Medicaid | 12 | 12 | 12 | 12 | ||||||||||||
Managed care and insurers | 27 | 28 | 27 | 27 | ||||||||||||
Uninsured | 9 | 8 | 8 | 8 | ||||||||||||
100 | % | 100 | % | 100 | % | 100 | % | |||||||||
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
Quarter | Six Months | |||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||
Medicare | 28 | % | 28 | % | 29 | % | 29 | % | ||||||||
Managed Medicare | 13 | 13 | 14 | 13 | ||||||||||||
Medicaid | 5 | 6 | 4 | 5 | ||||||||||||
Managed Medicaid | 5 | 5 | 5 | 5 | ||||||||||||
Managed care and insurers | 49 | 48 | 48 | 48 | ||||||||||||
|
|
|
|
|
|
|
| |||||||||
100 | % | 100 | % | 100 | % | 100 | % | |||||||||
|
|
|
|
|
|
|
|
Quarter | Six Months | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Medicare | 28 | % | 28 | % | 29 | % | 29 | % | ||||||||
Managed Medicare | 15 | 13 | 14 | 14 | ||||||||||||
Medicaid | 5 | 5 | 4 | 4 | ||||||||||||
Managed Medicaid | 5 | 5 | 5 | 5 | ||||||||||||
Managed care and insurers | 47 | 49 | 48 | 48 | ||||||||||||
100 | % | 100 | % | 100 | % | 100 | % | |||||||||
2019.
Quarter | ||||||||||||||||
2018 | 2017 | |||||||||||||||
Amount | Ratio | Amount | Ratio | |||||||||||||
Revenues | $ | 11,529 | 100.0 | $ | 10,733 | 100.0 | ||||||||||
Salaries and benefits | 5,274 | 45.8 | 4,896 | 45.6 | ||||||||||||
Supplies | 1,917 | 16.6 | 1,795 | 16.7 | ||||||||||||
Other operating expenses | 2,118 | 18.4 | 1,965 | 18.3 | ||||||||||||
Equity in earnings of affiliates | (7 | ) | (0.1 | ) | (13 | ) | (0.1 | ) | ||||||||
Depreciation and amortization | 562 | 4.9 | 521 | 4.9 | ||||||||||||
Interest expense | 436 | 3.8 | 411 | 3.8 | ||||||||||||
Gains on sales of facilities | (9 | ) | (0.1 | ) | (2 | ) | — | |||||||||
|
|
|
|
|
|
|
| |||||||||
10,291 | 89.3 | 9,573 | 89.2 | |||||||||||||
|
|
|
|
|
|
|
| |||||||||
Income before income taxes | 1,238 | 10.7 | 1,160 | 10.8 | ||||||||||||
Provision for income taxes | 272 | 2.3 | 365 | 3.4 | ||||||||||||
|
|
|
|
|
|
|
| |||||||||
Net income | 966 | 8.4 | 795 | 7.4 | ||||||||||||
Net income attributable to noncontrolling interests | 146 | 1.3 | 138 | 1.3 | ||||||||||||
|
|
|
|
|
|
|
| |||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 820 | 7.1 | $ | 657 | 6.1 | ||||||||||
|
|
|
|
|
|
|
| |||||||||
% changes from prior year: | ||||||||||||||||
Revenues | 7.4 | % | 4.0 | % | ||||||||||||
Income before income taxes | 6.6 | 2.5 | ||||||||||||||
Net income attributable to HCA Healthcare, Inc. | 24.9 | (0.2 | ) | |||||||||||||
Admissions(a) | 4.5 | 1.3 | ||||||||||||||
Equivalent admissions(b) | 5.1 | 2.1 | ||||||||||||||
Revenue per equivalent admission | 2.1 | 1.9 | ||||||||||||||
Same facility % changes from prior year(c): | ||||||||||||||||
Revenues | 6.5 | 3.4 | ||||||||||||||
Admissions(a) | 2.7 | 0.8 | ||||||||||||||
Equivalent admissions(b) | 2.8 | 1.3 | ||||||||||||||
Revenue per equivalent admission | 3.6 | 2.0 |
Quarter | ||||||||||||||||
2019 | 2018 | |||||||||||||||
Amount | Ratio | Amount | Ratio | |||||||||||||
Revenues | $ | 12,602 | 100.0 | $ | 11,529 | 100.0 | ||||||||||
Salaries and benefits | 5,837 | 46.3 | 5,274 | 45.8 | ||||||||||||
Supplies | 2,118 | 16.8 | 1,917 | 16.6 | ||||||||||||
Other operating expenses | 2,362 | 18.8 | 2,118 | 18.4 | ||||||||||||
Equity in earnings of affiliates | (8 | ) | (0.1 | ) | (7 | ) | (0.1 | ) | ||||||||
Depreciation and amortization | 636 | 5.0 | 562 | 4.9 | ||||||||||||
Interest expense | 477 | 3.8 | 436 | 3.8 | ||||||||||||
Gains on sales of facilities | (18 | ) | (0.1 | ) | (9 | ) | (0.1 | ) | ||||||||
11,404 | 90.5 | 10,291 | 89.3 | |||||||||||||
Income before income taxes | 1,198 | 9.5 | 1,238 | 10.7 | ||||||||||||
Provision for income taxes | 271 | 2.1 | 272 | 2.3 | ||||||||||||
Net income | 927 | 7.4 | 966 | 8.4 | ||||||||||||
Net income attributable to noncontrolling interests | 144 | 1.2 | 146 | 1.3 | ||||||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 783 | 6.2 | $ | 820 | 7.1 | ||||||||||
% changes from prior year: | ||||||||||||||||
Revenues | 9.3 | % | 7.4 | % | ||||||||||||
Income before income taxes | (3.2 | ) | 6.6 | |||||||||||||
Net income attributable to HCA Healthcare, Inc. | (4.5 | ) | 24.9 | |||||||||||||
Admissions(a) | 4.8 | 4.5 | ||||||||||||||
Equivalent admissions(b) | 6.2 | 5.1 | ||||||||||||||
Revenue per equivalent admission | 3.0 | 2.1 | ||||||||||||||
Same facility % changes from prior year(c): | ||||||||||||||||
Revenues | 4.3 | 6.5 | ||||||||||||||
Admissions(a) | 2.1 | 2.7 | ||||||||||||||
Equivalent admissions(b) | 2.6 | 2.8 | ||||||||||||||
Revenue per equivalent admission | 1.7 | 3.6 |
Six Months | ||||||||||||||||
2018 | 2017 | |||||||||||||||
Amount | Ratio | Amount | Ratio | |||||||||||||
Revenues | $ | 22,952 | 100.0 | $ | 21,356 | 100.0 | ||||||||||
Salaries and benefits | 10,563 | 46.0 | 9,797 | 45.9 | ||||||||||||
Supplies | 3,832 | 16.7 | 3,592 | 16.8 | ||||||||||||
Other operating expenses | 4,228 | 18.5 | 3,895 | 18.2 | ||||||||||||
Equity in earnings of affiliates | (16 | ) | (0.1 | ) | (23 | ) | (0.1 | ) | ||||||||
Depreciation and amortization | 1,115 | 4.8 | 1,042 | 4.9 | ||||||||||||
Interest expense | 867 | 3.8 | 830 | 3.9 | ||||||||||||
Gains on sales of facilities | (414 | ) | (1.8 | ) | (3 | ) | — | |||||||||
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| |||||||||
20,175 | 87.9 | 19,130 | 89.6 | |||||||||||||
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| |||||||||
Income before income taxes | 2,777 | 12.1 | 2,226 | 10.4 | ||||||||||||
Provision for income taxes | 529 | 2.3 | 654 | 3.0 | ||||||||||||
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| |||||||||
Net income | 2,248 | 9.8 | 1,572 | 7.4 | ||||||||||||
Net income attributable to noncontrolling interests | 284 | 1.2 | 256 | 1.2 | ||||||||||||
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| |||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 1,964 | 8.6 | $ | 1,316 | 6.2 | ||||||||||
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| |||||||||
% changes from prior year: | ||||||||||||||||
Revenues | 7.5 | % | 3.8 | % | ||||||||||||
Income before income taxes | 24.7 | — | ||||||||||||||
Net income attributable to HCA Healthcare, Inc. | 49.3 | (2.7 | ) | |||||||||||||
Admissions(a) | 4.5 | 1.3 | ||||||||||||||
Equivalent admissions(b) | 4.9 | 1.9 | ||||||||||||||
Revenue per equivalent admission | 2.5 | 1.8 | ||||||||||||||
Same facility % changes from prior year(c): | ||||||||||||||||
Revenues | 6.2 | 3.3 | ||||||||||||||
Admissions(a) | 2.5 | 1.0 | ||||||||||||||
Equivalent admissions(b) | 2.3 | 1.5 | ||||||||||||||
Revenue per equivalent admission | 3.8 | 1.8 |
Six Months | ||||||||||||||||
2019 | 2018 | |||||||||||||||
Amount | Ratio | Amount | Ratio | |||||||||||||
Revenues | $ | 25,119 | 100.0 | $ | 22,952 | 100.0 | ||||||||||
Salaries and benefits | 11,484 | 45.7 | 10,563 | 46.0 | ||||||||||||
Supplies | 4,159 | 16.6 | 3,832 | 16.7 | ||||||||||||
Other operating expenses | 4,661 | 18.6 | 4,228 | 18.5 | ||||||||||||
Equity in earnings of affiliates | (19 | ) | (0.1 | ) | (16 | ) | (0.1 | ) | ||||||||
Depreciation and amortization | 1,255 | 5.0 | 1,115 | 4.8 | ||||||||||||
Interest expense | 938 | 3.7 | 867 | 3.8 | ||||||||||||
Gains on sales of facilities | (17 | ) | (0.1 | ) | (414 | ) | (1.8 | ) | ||||||||
22,461 | 89.4 | 20,175 | 87.9 | |||||||||||||
Income before income taxes | 2,658 | 10.6 | 2,777 | 12.1 | ||||||||||||
Provision for income taxes | 550 | 2.2 | 529 | 2.3 | ||||||||||||
Net income | 2,108 | 8.4 | 2,248 | 9.8 | ||||||||||||
Net income attributable to noncontrolling interests | 286 | 1.1 | 284 | 1.2 | ||||||||||||
Net income attributable to HCA Healthcare, Inc. | $ | 1,822 | 7.3 | $ | 1,964 | 8.6 | ||||||||||
% changes from prior year: | ||||||||||||||||
Revenues | 9.4 | % | 7.5 | % | ||||||||||||
Income before income taxes | (4.3 | ) | 24.7 | |||||||||||||
Net income attributable to HCA Healthcare, Inc. | (7.2 | ) | 49.3 | |||||||||||||
Admissions(a) | 3.9 | 4.5 | ||||||||||||||
Equivalent admissions(b) | 5.5 | 4.9 | ||||||||||||||
Revenue per equivalent admission | 3.8 | 2.5 | ||||||||||||||
Same facility % changes from prior year(c): | ||||||||||||||||
Revenues | 5.4 | 6.2 | ||||||||||||||
Admissions(a) | 1.6 | 2.5 | ||||||||||||||
Equivalent admissions(b) | 2.3 | 2.3 | ||||||||||||||
Revenue per equivalent admission | 3.0 | 3.8 |
(a) | Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume. |
(b) | Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume. |
(c) | Same facility information excludes the operations of hospitals and their related facilities which were either acquired or divested during the current and prior period. |
2018
2018.
2018.
2018.
2019.
2018
2018.
2018.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Six Months Ended June 30, 2018 and 2017 (continued)
2019 compared to the first six months of 2017.2018. Supply costs per equivalent admission increased 3.5%2.9% for medical devices, 7.6% for pharmacy supplies and 4.7%0.9% for general medical and surgical items and declined 7.8% for pharmacy supplies in the first six months of 20182019 compared to the first six months of 2017.
2018.
respectively.
2019.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Liquidity and Capital Resources (continued)
interest payments and net tax payments in the first six months of 2019 and 2018 and 2017 were $1.284$1.433 billion and $1.221$1.284 billion, respectively. Working capital totaled $2.769$3.908 billion at June 30, 20182019 and $3.819$2.644 billion at December 31, 2017. The decline in working capital of $1.050 billion is primarily related to an increase in long-term debt due within one year of $1.492 billion.
2018.
2018.
During March 2018, we also entered into an additional joinder agreement to refinance a portionnotes due 2020 and all $1.350 billion outstanding aggregate principal amount of our existing senior securedterm B-9 loan credit facility maturing on March 18, 2023 and pay related fees and expenses with a new approximately $1.166 billion senior securedterm B-11 loan credit facility maturing on March 18, 2023. The5.875% senior secured termB-11 loan credit facilitynotes due 2022. Pretax losses on retirement of debt totaling $211 million for these redemptions will bear interest at LIBOR plus an applicable margin of 1.75% or a base rate plus an applicable margin of 0.75%, compared to applicable margins of 2.00% and 1.00%, respectively, underbe recognized during the senior secured termB-9 loan credit facility.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Liquidity and Capital Resources (continued)
With respect to our interest-bearing liabilities, approximately $5.240 billion of long-term debt at June 30, 2018 was subject to variable rates of interest, while the remaining balance in long-term debt of $27.952 billion at June 30, 2018 was subject to fixed rates of interest.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Liquidity and Capital Resources (continued)
Market Risk (continued)
facilities bear interest at a rate equal to an applicable margin plus, at our option, either (a) a base rate determined by reference to the higher of (1) the federal funds rate plus 0.50% andor (2) the prime rate of Bank of America or (b) a LIBOR rate for the currency of such borrowing for the relevant interest period. The applicable margin for borrowings under the senior secured credit facilities may fluctuate according to a leverage ratio. The average effective interest rate for our long-term debt was 5.5% and 5.3% each for the six months ended June 30, 2019 and 2018, and 2017.
respectively.
2019 | 2018 | |||||||
Number of hospitals in operation at: | ||||||||
March 31 | 185 | 178 | ||||||
June 30 | 184 | 178 | ||||||
September 30 | 179 | |||||||
December 31 | 179 | |||||||
Number of freestanding outpatient surgical centers in operation at: | ||||||||
March 31 | 124 | 120 | ||||||
June 30 | 125 | 122 | ||||||
September 30 | 122 | |||||||
December 31 | 123 | |||||||
Licensed hospital beds at(a): | ||||||||
March 31 | 48,455 | 46,745 | ||||||
June 30 | 48,483 | 46,723 | ||||||
September 30 | 47,060 | |||||||
December 31 | 47,199 | |||||||
Weighted average licensed beds(b): | ||||||||
Quarter: | ||||||||
First | 48,036 | 46,686 | ||||||
Second | 48,429 | 46,667 | ||||||
Third | 46,909 | |||||||
Fourth | 47,159 | |||||||
Year | 46,857 | |||||||
Average daily census(c): | ||||||||
Quarter: | ||||||||
First | 28,966 | 28,130 | ||||||
Second | 27,808 | 26,047 | ||||||
Third | 25,991 | |||||||
Fourth | 26,510 | |||||||
Year | 26,663 | |||||||
Admissions(d): | ||||||||
Quarter: | ||||||||
First | 523,196 | 507,873 | ||||||
Second | 518,253 | 494,610 | ||||||
Third | 497,899 | |||||||
Fourth | 503,371 | |||||||
Year | 2,003,753 |
2018 | 2017 | |||||||
Number of hospitals in operation at: | ||||||||
March 31 | 178 | 171 | ||||||
June 30 | 178 | 172 | ||||||
September 30 | 177 | |||||||
December 31 | 179 | |||||||
Number of freestanding outpatient surgical centers in operation at: | ||||||||
March 31 | 120 | 118 | ||||||
June 30 | 122 | 119 | ||||||
September 30 | 119 | |||||||
December 31 | 120 | |||||||
Licensed hospital beds at(a): | ||||||||
March 31 | 46,745 | 44,374 | ||||||
June 30 | 46,723 | 44,727 | ||||||
September 30 | 46,250 | |||||||
December 31 | 46,738 | |||||||
Weighted average licensed beds(b): | ||||||||
Quarter: | ||||||||
First | 46,686 | 44,362 | ||||||
Second | 46,667 | 44,605 | ||||||
Third | 45,887 | |||||||
Fourth | 46,636 | |||||||
Year | 45,380 | |||||||
Average daily census(c): | ||||||||
Quarter: | ||||||||
First | 28,130 | 26,699 | ||||||
Second | 26,047 | 25,353 | ||||||
Third | 25,653 | |||||||
Fourth | 26,304 | |||||||
Year | 26,000 | |||||||
Admissions(d): | ||||||||
Quarter: | ||||||||
First | 507,873 | 485,761 | ||||||
Second | 494,610 | 473,174 | ||||||
Third | 482,557 | |||||||
Fourth | 495,121 | |||||||
Year | 1,936,613 | |||||||
Equivalent admissions(e): | ||||||||
Quarter: | ||||||||
First | 849,164 | 812,192 | ||||||
Second | 851,047 | 809,367 | ||||||
Third | 818,887 | |||||||
Fourth | 845,986 | |||||||
Year | 3,286,432 |
2019 | 2018 | |||||||
Equivalent admissions(e): | ||||||||
Quarter: | ||||||||
First | 889,956 | 849,164 | ||||||
Second | 903,419 | 851,047 | ||||||
Third | 854,940 | |||||||
Fourth | 865,255 | |||||||
Year | 3,420,406 | |||||||
Average length of stay (days)(f): | ||||||||
Quarter: | ||||||||
First | 5.0 | 5.0 | ||||||
Second | 4.9 | 4.8 | ||||||
Third | 4.8 | |||||||
Fourth | 4.8 | |||||||
Emergency room visits(g): | ||||||||
Quarter: | ||||||||
First | 2,287,440 | 2,302,112 | ||||||
Second | 2,253,337 | 2,148,338 | ||||||
Third | 2,139,375 | |||||||
Fourth | 2,174,606 | |||||||
Year | 8,764,431 | |||||||
Outpatient surgeries(h)*: | ||||||||
Quarter: | ||||||||
First | 240,846 | 232,483 | ||||||
Second | 253,441 | 246,013 | ||||||
Third | 236,801 | |||||||
Fourth | 256,240 | |||||||
Year | 971,537 | |||||||
Inpatient surgeries(i)*: | ||||||||
Quarter: | ||||||||
First | 137,363 | 135,036 | ||||||
Second | 140,473 | 137,403 | ||||||
Third | 137,156 | |||||||
Fourth | 138,625 | |||||||
Year | 548,220 | |||||||
Days revenues in accounts receivable(j): | ||||||||
Quarter: | ||||||||
First | 53 | 50 | ||||||
Second | 52 | 52 | ||||||
Third | �� | 52 | ||||||
Fourth | 51 |
2018 | 2017 | |||||||
Average length of stay (days)(f): | ||||||||
Quarter: | ||||||||
First | 5.0 | 4.9 | ||||||
Second | 4.8 | 4.9 | ||||||
Third | 4.9 | |||||||
Fourth | 4.9 | |||||||
Emergency room visits(g): | ||||||||
Quarter: | ||||||||
First | 2,302,112 | 2,163,138 | ||||||
Second | 2,148,338 | 2,116,123 | ||||||
Third | 2,130,460 | |||||||
Fourth | 2,214,416 | |||||||
Year | 8,624,137 | |||||||
Outpatient surgeries(h): | ||||||||
Quarter: | ||||||||
First | 230,869 | 225,915 | ||||||
Second | 244,367 | 234,215 | ||||||
Third | 224,252 | |||||||
Fourth | 250,925 | |||||||
Year | 935,307 | |||||||
Inpatient surgeries(i): | ||||||||
Quarter: | ||||||||
First | 136,650 | 133,341 | ||||||
Second | 139,049 | 134,553 | ||||||
Third | 137,187 | |||||||
Fourth | 141,147 | |||||||
Year | 546,228 | |||||||
Days revenues in accounts receivable(j): | ||||||||
Quarter: | ||||||||
First | 50 | 48 | ||||||
Second | 52 | 49 | ||||||
Third | 51 | |||||||
Fourth | 52 | |||||||
Outpatient revenues as a % of patient revenues(k): | ||||||||
Quarter: | ||||||||
First | 37 | % | 38 | % | ||||
Second | 39 | % | 37 | % | ||||
Third | 38 | % | ||||||
Fourth | 39 | % | ||||||
Year | 38 | % |
2019 | 2018 | |||||||
Outpatient revenues as a % of patient revenues(k): | ||||||||
Quarter: | ||||||||
First | 38 | % | 37 | % | ||||
Second | 39 | % | 39 | % | ||||
Third | 39 | % | ||||||
Fourth | 38 | % | ||||||
Year | 38 | % |
(a) | Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency. |
(b) | Represents the average number of licensed beds, weighted based on periods owned. |
(c) | Represents the average number of patients in our hospital beds each day. |
(d) | Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume. |
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Operating Data (continued)
(e) | Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume resulting in a general measure of combined inpatient and outpatient volume. |
(f) | Represents the average number of days admitted patients stay in our hospitals. |
(g) | Represents the number of patients treated in our emergency rooms. |
(h) | Represents the number of surgeries performed on patients who were not admitted to our hospitals. Pain management and endoscopy procedures are not included in outpatient surgeries. Reclassifications between inpatient surgery cases and outpatient surgery cases for 2018 have been made to conform to the 2019 presentation. |
(i) | Represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain management and endoscopy procedures are not included in inpatient surgeries. Reclassifications between inpatient surgery cases and outpatient surgery cases for 2018 have been made to conform to the 2019 presentation. |
(j) | Revenues per day is calculated by dividing revenues for the quarter by the days in the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the quarter divided by revenues per day. |
(k) | Represents the percentage of patient revenues related to patients who are not admitted to our hospitals. |
* | Reclassifications between inpatient surgery cases and outpatient surgery cases for the first, second and third quarters of 2018 have been made to conform to the 2019 presentation. |
2019.
Period | Total Number of Shares Purchased | Average Price Paid per Share | Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs | Approximate Dollar Value of Shares That May Yet Be Purchased Under Publicly Announced Plans or Programs | ||||||||||||
April 1, 2018 through April 30, 2018 | 1,742,373 | $ | 97.04 | 1,742,373 | $ | 1,210 | ||||||||||
May 1, 2018 through May 31, 2018 | 1,674,941 | $ | 100.55 | 1,674,941 | $ | 1,042 | ||||||||||
June 1, 2018 through June 30, 2018 | 1,252,160 | $ | 105.40 | 1,252,160 | $ | 910 | ||||||||||
|
|
|
| |||||||||||||
Total for second quarter 2018 | 4,669,474 | $ | 100.54 | 4,669,474 | $ | 910 | ||||||||||
|
|
|
|
Period | Total Number of Shares Purchased | Average Price Paid per Share | Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs | Approximate Dollar Value of Shares That May Yet Be Purchased Under Publicly Announced Plans or Programs | ||||||||||||
April 1, 2019 through April 30, 2019 | 745,636 | $ | 124.81 | 745,636 | $ | 1,902 | ||||||||||
May 1, 2019 through May 31, 2019 | 555,252 | $ | 124.33 | 555,252 | $ | 1,833 | ||||||||||
June 1, 2019 through June 30, 2019 | 627,269 | $ | 127.54 | 627,269 | $ | 1,753 | ||||||||||
Total for second quarter 2019 | 1,928,157 | $ | 125.56 | 1,928,157 | $ | 1,753 | ||||||||||
| ||||||
3.1 | — | |||||
3.2 | — | |||||
4.1 | — | |||||
4.2 | — | |||||
4.3 | — | |||||
4.4 | — | |||||
4.5 | — | |||||
4.6 | — | |||||
4.7 | — | |||||
10.1 | — | |||||
31.1 | — | |||||
| ||||||
31.2 | — | |||||
| ||||||
32 | — | |||||
| ||||||
101 | — | The following financial information from our quarterly report onForm 10-Q for the quarters and six months ended June 30, | ||||
104 | — | The cover page from the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2019, formatted in Inline XBRL (included in Exhibit 101). |
* | Management compensatory plan or arrangement |
HCA Healthcare, Inc. | ||
| ||
By: | / William B. | |
William B. Rutherford | ||
Executive Vice President and Chief Financial Officer |
2, 2019