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HCA Reports Second Quarter 2018 Results

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HCA Healthcare, Inc. (NYSE:HCA) today announced financial and operating
results for the second quarter ended June 30, 2018.

This press release features multimedia. View the full release here:
https://www.businesswire.com/news/home/20180725005115/en/

Key second quarter metrics (all percentage changes compare 2Q
2018 to 2Q 2017 unless noted):

  • Revenues increased 7.4 percent to $11.529 billion
  • Net income attributable to HCA Healthcare, Inc. totaled $820
    million, or $2.31 per diluted share
  • Adjusted EBITDA totaled $2.227 billion, an increase of 6.6 percent
  • Cash flows from operations totaled $1.582 billion
  • Same facility equivalent admissions increased 2.8 percent while
    same facility admissions increased 2.7 percent
  • Same facility revenue per equivalent admission increased 3.6 percent

Revenues in the second quarter increased to $11.529 billion, compared to
$10.733 billion in the second quarter of 2017. Net income attributable
to HCA Healthcare, Inc. totaled $820 million, or $2.31 per diluted
share, compared to $657 million, or $1.75 per diluted share, in the
second quarter of 2017. The second quarter 2018 results include gains on
sales of facilities of $9 million, or $0.02 per diluted share. The
Company recognized a tax benefit of $121 million, or $0.34 per diluted
share, on net income attributable to HCA Healthcare, Inc., excluding
gains on sales of facilities, for the second quarter of 2018, due to a
reduction in its effective tax rate related to the impact of the Tax
Cuts and Jobs Act. Adjusted EBITDA totaled $2.227 billion compared to
$2.090 billion in the second quarter of 2017. Adjusted EBITDA is a
non-GAAP financial measure. A table reconciling net income attributable
to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions for the second quarter of 2018 increased 2.7
percent, while same facility equivalent admissions increased 2.8 percent
compared to the prior year period. Same facility emergency room visits
for the second quarter of 2018 declined 0.8 percent from the prior
year's second quarter. Same facility inpatient surgeries increased 1.7
percent, while same facility outpatient surgeries increased 2.6 percent
compared to the second quarter of 2017.

During the second quarter of 2018, salaries and benefits, supplies and
other operating expenses totaled $9.309 billion, or 80.8 percent of
revenues, compared to $8.656 billion, or 80.6 percent of revenues, in
the second quarter of 2017. On a same-facility basis, salaries and
benefits, supplies and other operating expenses totaled $8.571 billion,
or 77.8 percent of revenues, during for the second quarter of 2018,
compared to $8.150 billion, or 78.7 percent of revenues, on a
same-facility basis for the same period of 2017.

Six Months Ended June 30, 2018

Revenues for the six months ended June 30, 2018 totaled $22.952 billion
compared to $21.356 billion in the same period of 2017. Net income
attributable to HCA Healthcare, Inc. was $1.964 billion, or $5.50 per
diluted share, compared to $1.316 billion, or $3.48 per diluted share,
for the first six months of 2017. Results for the six months ended June
30, 2018 include gains on sales of facilities of $414 million, or $0.88
per diluted share. The Company also recognized a tax benefit of $192
million, or $0.54 per diluted share, on net income attributable to HCA
Healthcare, Inc., excluding gains on sales of facilities, for the six
months ended June 30, 2018, due to a reduction in its effective tax rate
related to the impact of the Tax Cuts and Jobs Act. Results for the six
months ended June 30, 2018 also include a $96 million tax benefit, or
$0.27 per diluted share, compared to $76 million, or $0.20 per diluted
share, for the same period of 2017, related to the recording of excess
tax benefits for employee equity award settlements.

Balance Sheet and Cash Flows from Operations

As of June 30, 2018, HCA Healthcare, Inc.'s balance sheet reflected cash
and cash equivalents of $868 million, total debt of $33.192 billion, and
total assets of $37.742 billion. During the second quarter of 2018,
capital expenditures totaled $880 million, excluding acquisitions. Cash
flows provided by operating activities in the quarter totaled $1.582
billion compared to $1.404 billion in the second quarter of 2017.

As of June 30, 2018, HCA's leverage ratio as measured by Total
Debt/Adjusted EBITDA was 3.91x, compared to 4.02x as of December 31,
2017.

During the second quarter of 2018, the Company repurchased 4.670 million
shares of its common stock at a cost of $470 million, and during the six
months ended June 30, 2018, repurchased 9.040 million shares of its
common stock at a cost of $893 million. The Company had $910 million
remaining under its existing repurchase authorization as of June 30,
2018.

As of June 30, 2018, HCA operated 178 hospitals and approximately 1,800
sites of care, including surgery centers, freestanding emergency rooms,
urgent care centers and physician clinics, in 20 states and the United
Kingdom.

Dividend

HCA today announced that its Board of Directors declared a quarterly
cash dividend of $0.35 per share on the Company's common stock. The
dividend will be paid on September 28, 2018 to stockholders of record at
the close of business on September 4, 2018.

The declaration and payment of any future dividend will be subject to
the discretion of the Board of Directors and will depend on a variety of
factors, including the Company's financial condition and results of
operations and contractual restrictions. Future dividends are expected
to be funded by cash balances and future cash flows from operations.

2018 Guidance

The 2018 guidance ranges for the year have been revised from our fourth
quarter 2017 and first quarter 2018 releases and are as follows:

       

2018 Updated Guidance Range

Revenues $45.5 to $46.5 billion
Adjusted EBITDA $8.65 to $8.85 billion
EPS (diluted) $9.00 to $9.40 per diluted share
Capital Expenditures Approximately $3.5 billion
 

The Company's 2018 guidance contains a number of assumptions, including:

  • 2018 guidance for EPS (diluted) includes an estimated $110 million
    income tax benefit, or $0.31 per diluted share, for excess tax
    benefits related to employee equity award settlements recorded as a
    component of the provision for income taxes. The timing and amounts
    related to employee equity award settlements are difficult to project
    and may vary from this estimate.
  • 2018 guidance reflects the sale of the Company's Oklahoma facilities
    which closed February 1, 2018. These facilities had annual revenues of
    approximately $1 billion and Adjusted EBITDA of approximately $180
    million in 2017.
  • 2018 guidance includes an estimated impact of $1.25 earnings per
    diluted share related to the Tax Cuts and Jobs Act.
  • 2018 guidance excludes any acquisitions that have not been completed
    as of June 30, 2018.
  • 2018 guidance excludes any hurricane insurance recoveries the Company
    may receive.
  • 2018 guidance excludes any changes in our estimates of the impact of
    the Tax Cuts and Jobs Act on our deferred tax assets and liabilities.
  • 2018 guidance excludes the impact of items such as, but not limited
    to, gains or losses on sales of facilities, losses on retirement of
    debt, legal claim costs and impairments of long-lived assets.

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

The Company's guidance is based on current plans and expectations and is
subject to a number of known and unknown uncertainties and risks,
including those set forth below in the Company's "Forward-Looking
Statements."

Earnings Conference Call

HCA will host a conference call for investors at 9:00 a.m. Central
Daylight Time today. All interested investors are invited to access a
live audio broadcast of the call via webcast. The broadcast also will be
available on a replay basis beginning this afternoon. The webcast can be
accessed at: https://event.webcasts.com/starthere.jsp?ei=1160373&tp_key=8102f3251b
or through the Company's Investor Relations web page, www.hcahealthcare.com.

Forward-Looking Statements

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

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

 
HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
Second Quarter
(Dollars in millions, except per share amounts)
                 
 
 
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  
 
Diluted earnings per share $ 2.31 $ 1.75
 
Cash dividends declared per share $ 0.35 $ -
 
Shares used in computing diluted earnings per share (millions) 355.039 375.338
 
Comprehensive income attributable to HCA Healthcare, Inc. $ 756   $ 684  
 
 
HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
For the Six Months Ended June 30, 2018 and 2017
(Dollars in millions, except per share amounts)
                 
 
 
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 )     -  
 
  20,175       87.9     19,130       89.6  
 
Income before income taxes 2,777 12.1 2,226 10.4
 
Provision for income taxes   529       2.3     654       3.0  
 
Net income 2,248 9.8 1,572 7.4
 
Net income attributable to noncontrolling interests   284       1.2     256       1.2  
 
Net income attributable to HCA Healthcare, Inc. $ 1,964       8.6   $ 1,316       6.2  
 
Diluted earnings per share $ 5.50 $ 3.48
 
Cash dividends declared per share $ 0.70 $ -
 
Shares used in computing diluted earnings per share (millions) 357.388 377.647
 
Comprehensive income attributable to HCA Healthcare, Inc. $ 1,981   $ 1,361  
 
 
HCA Healthcare, Inc.
Condensed Consolidated Balance Sheets
(Dollars in millions)
                   
 
 
June 30, March 31, December 31,
2018 2018 2017
 
ASSETS
Current assets:
Cash and cash equivalents $ 868 $ 1,086 $ 732
Accounts receivable 6,592 6,332 6,501
Inventories 1,636 1,677 1,573
Other   1,298     1,296     1,171  
Total current assets 10,394 10,391 9,977
 
Property and equipment, at cost 41,142 40,308 40,084
Accumulated depreciation   (22,598 )   (22,184 )   (22,189 )
18,544 18,124 17,895
 
Investments of insurance subsidiaries 414 417 418
Investments in and advances to affiliates 234 231 199
Goodwill and other intangible assets 7,459 7,471 7,394
Other   697     665     710  
 
$ 37,742   $ 37,299   $ 36,593  
 
 
 
LIABILITIES AND STOCKHOLDERS' DEFICIT
Current liabilities:
Accounts payable $ 2,457 $ 2,538 $ 2,606
Accrued salaries 1,315 1,238 1,369
Other accrued expenses 2,161 2,005 1,983
Long-term debt due within one year   1,692     1,697     200  
Total current liabilities 7,625 7,478 6,158
 
Long-term debt, less net debt issuance costs of $151, $158 and $164 31,500 31,594 32,858
Professional liability risks 1,283 1,244 1,198
Income taxes and other liabilities 1,459 1,417 1,374
 
EQUITY (DEFICIT)
Stockholders' deficit attributable to HCA Healthcare, Inc. (5,989 ) (6,244 ) (6,806 )
Noncontrolling interests   1,864     1,810     1,811  
Total deficit   (4,125 )   (4,434 )   (4,995 )
$ 37,742   $ 37,299   $ 36,593  
 
 
HCA Healthcare, Inc.
Consolidated Statements of Cash Flows
For the Six Months Ended June 30, 2018 and 2017
(Dollars in millions)
                 
 
 
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  
 
Net cash provided by operating activities   2,865     2,684  
 
 
Cash flows from investing activities:
Purchase of property and equipment (1,574 ) (1,304 )
Acquisition of hospitals and health care entities (538 ) (295 )
Disposition of hospitals and health care entities 799 14
Change in investments 23 (11 )
Other   (25 )   5  
 
Net cash used in investing activities   (1,315 )   (1,591 )
 
 
Cash flows from financing activities:
Issuance of long-term debt - 1,502
Net change in revolving 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 ) -
Repurchase of common stock (893 ) (966 )
Other   (192 )   (42 )
 
Net cash used in financing activities   (1,408 )   (1,034 )
 
Effect of exchange rate changes on cash and cash equivalents   (6 )   -  
 
Change in cash and cash equivalents 136 59
Cash and cash equivalents at beginning of period   732     646  
 
 
Cash and cash equivalents at end of period $ 868   $ 705  
 
 
Interest payments $ 873 $ 834
Income tax payments, net $ 411 $ 387
 
 
HCA Healthcare, Inc.
Operating Statistics
                       
 
For the Six Months
Second Quarter Ended June 30,

2018

2017

2018

2017

 
Operations:
Number of Hospitals 178 172 178 172
Number of Freestanding Outpatient Surgery Centers 122 119 122 119
Licensed Beds at End of Period 46,723 44,727 46,723 44,727
Weighted Average Licensed Beds 46,667 44,605 46,676 44,484
 
Reported:
Admissions 494,610 473,174 1,002,483 958,935

    % Change

4.5 % 4.5 %
Equivalent Admissions 851,047 809,367 1,700,211 1,621,559

    % Change

5.1 % 4.9 %
Revenue per Equivalent Admission $ 13,547 $ 13,262 $ 13,499 $ 13,170

    % Change

2.1 % 2.5 %
Inpatient Revenue per Admission $ 13,807 $ 13,779 $ 13,756 $ 13,458

    % Change

0.2 % 2.2 %
 
Patient Days 2,370,306 2,307,086 4,902,025 4,710,019

    % Change

2.7 % 4.1 %
Equivalent Patient Days 4,080,800 3,946,938 8,313,834 7,964,642

    % Change

3.4 % 4.4 %
 
Inpatient Surgery Cases 139,049 134,553 275,699 267,894

    % Change

3.3 % 2.9 %
Outpatient Surgery Cases 244,367 234,215 475,236 460,130

    % Change

4.3 % 3.3 %
 
Emergency Room Visits 2,148,338 2,116,123 4,450,450 4,279,261

    % Change

1.5 % 4.0 %
 
Outpatient Revenues as a
Percentage of Patient Revenues 38.6 % 37.3 % 37.9 % 37.7 %
 
Average Length of Stay (days) 4.792 4.876 4.890 4.912
 
Occupancy 55.8 % 56.8 % 58.0 % 58.5 %
 
Same Facility:
Admissions 470,606 458,142 952,898 930,009

    % Change

2.7 % 2.5 %
Equivalent Admissions 806,148 783,881 1,610,398 1,573,575

    % Change

2.8 % 2.3 %
Revenue per Equivalent Admission $ 13,673 $ 13,198 $ 13,605 $ 13,110

    % Change

3.6 % 3.8 %
Inpatient Revenue per Admission $ 13,942 $ 13,681 $ 13,840 $ 13,377

    % Change

1.9 % 3.5 %
 
Inpatient Surgery Cases 132,026 129,761 261,536 258,864

    % Change

1.7 % 1.0 %
Outpatient Surgery Cases 232,835 227,004 452,756 447,979

    % Change

2.6 % 1.1 %
 
Emergency Room Visits 2,031,040 2,047,463 4,205,288 4,149,001

    % Change

-0.8 % 1.4 %
 
 
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
Operating Results Summary
(Dollars in millions, except per share amounts)
                               
 
For the Six Months
Second Quarter Ended June 30,

2018

2017

2018

2017

 
Revenues $ 11,529 $ 10,733 $ 22,952 $ 21,356
 
Net income attributable to HCA Healthcare, Inc. $ 820 $ 657 $ 1,964 $ 1,316
Gains on sales of facilities (net of tax)   (8 )   (1 )   (313 )   (2 )
Net income attributable to HCA Healthcare, Inc., excluding gains on
sales of facilities (a)
812 656 1,651 1,314
Depreciation and amortization 562 521 1,115 1,042
Interest expense 436 411 867 830
Provision for income taxes 271 364 428 653
Net income attributable to noncontrolling interests   146     138     284     256  
 
Adjusted EBITDA (a) $ 2,227   $ 2,090   $ 4,345   $ 4,095  
 
Adjusted EBITDA margin (a) 19.3 % 19.5 % 18.9 % 19.2 %
 
Diluted earnings per share:
Net income attributable to HCA Healthcare, Inc. $ 2.31 $ 1.75 $ 5.50 $ 3.48
Gains on sales of facilities   (0.02 )   -     (0.88 )   -  
Net income attributable to HCA Healthcare, Inc., excluding gains on
sales of facilities (a)
$ 2.29   $ 1.75   $ 4.62   $ 3.48  
 
Shares used in computing diluted earnings per share (millions) 355.039 375.338 357.388 377.647
 
       
 
(a) Net income attributable to HCA Healthcare, Inc., excluding gains on
sales of facilities, and Adjusted EBITDA should not be considered as
measures of financial performance under generally accepted
accounting principles ("GAAP"). We believe net income attributable
to HCA Healthcare, Inc., excluding gains on sales of facilities, and
Adjusted EBITDA are important measures that supplement discussions
and analysis of our results of operations. We believe it is useful
to investors to provide disclosures of our results of operations on
the same basis used by management. Management relies upon net income
attributable to HCA Healthcare, Inc., excluding gains on sales of
facilities, and Adjusted EBITDA as the primary measures to review
and assess operating performance of its health care facilities and
their management teams.
 
Management and investors review both the overall performance
(including net income attributable to HCA Healthcare, Inc.,
excluding gains on sales of facilities, and GAAP net income
attributable to HCA Healthcare, Inc.) and operating performance
(Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and
the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are
utilized by management and investors to compare our current
operating results with the corresponding periods during the previous
year and to compare our operating results with other companies in
the health care industry. It is reasonable to expect that gains on
sales of facilities will occur in future periods, but the amounts
recognized can vary significantly from period to period, do not
directly relate to the ongoing operations of our health care
facilities and complicate period comparisons of our results of
operations and operations comparisons with other health care
companies.
 
Net income attributable to HCA Healthcare, Inc., excluding gains on
sales of facilities, and Adjusted EBITDA are not measures of
financial performance under GAAP, and should not be considered as
alternatives to net income attributable to HCA Healthcare, Inc. as a
measure of operating performance or cash flows from operating,
investing and financing activities as a measure of liquidity.
Because net income attributable to HCA Healthcare, Inc., excluding
gains on sales of facilities, and Adjusted EBITDA are not
measurements determined in accordance with GAAP and are susceptible
to varying calculations, net income attributable to HCA Healthcare,
Inc., excluding gains on sales of facilities, and Adjusted EBITDA,
as presented, may not be comparable to other similarly titled
measures presented by other companies.
 
 
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
2018 Operating Results Forecast
(Dollars in millions, except per share amounts)
                       
 
For the Year Ending
December 31, 2018

Low

High

 
Revenues $45,500 $46,500
 
Net income attributable to HCA Healthcare, Inc. (a) $3,180 $3,325
Depreciation and amortization 2,250 2,250
Interest expense 1,775 1,775
Provision for income taxes 895 925
Net income attributable to noncontrolling interests 550 575
 
Adjusted EBITDA (a) (b) $8,650 $8,850
 
Diluted earnings per share:
Net income attributable to HCA Healthcare, Inc. $9.00 $9.40
 
Shares used in computing diluted earnings per share (millions) 353.600 353.600
 

The Company's forecasted guidance range is based on current
plans and expectations and is subject to a number of known and
unknown uncertainties and risks.

       
 
(a) The Company does not forecast the impact of items such as, but not
limited to, losses (gains) on sales of facilities, losses on
retirement of debt, legal claim costs (benefits) and impairments of
long-lived assets because the Company does not believe that it can
forecast these items with sufficient accuracy.
 
(b) Adjusted EBITDA should not be considered a measure of financial
performance under generally accepted accounting principles ("GAAP").
We believe Adjusted EBITDA is an important measure that supplements
discussions and analysis of our results of operations. We believe it
is useful to investors to provide disclosures of our results of
operations on the same basis used by management. Management relies
upon Adjusted EBITDA as a primary measure to review and assess
operating performance of its health care facilities and their
management teams.
 
Management and investors review both the overall performance
(including net income attributable to HCA Healthcare, Inc.) and
operating performance (Adjusted EBITDA) of our health care
facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted
EBITDA divided by revenues) are utilized by management and investors
to compare our current operating results with the corresponding
periods during the previous year and to compare our operating
results with other companies in the health care industry.
 
Adjusted EBITDA is not a measure of financial performance under GAAP
and should not be considered as an alternative to net income
attributable to HCA Healthcare, Inc. as a measure of operating
performance or cash flows from operating, investing and financing
activities as a measure of liquidity. Because Adjusted EBITDA is not
a measurement determined in accordance with GAAP and is susceptible
to varying calculations, Adjusted EBITDA, as presented, may not be
comparable to other similarly titled measures presented by other
companies.
 

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