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Viking Therapeutics
Terns Pharmaceuticals

Universal Health Services Announces 2023 Third Quarter Financial Results

October 25, 2023 | Last Trade: US$180.11 4.31 2.45
  • Consolidated Results of Operations, As Reported and As Adjusted  – Three-month periods ended September 30, 2023 and 2022:

KING OF PRUSSIA, Pa., Oct. 25, 2023 /PRNewswire/ -- Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was $167.0 million, or $2.40 per diluted share, during the third quarter of 2023, as compared to $182.8 million, or $2.50 per diluted share, during the third quarter of 2022. Net revenues increased by 6.8% to $3.563 billion during the third quarter of 2023, as compared to $3.336 billion during the third quarter of 2022.

As reflected on the Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule"), our adjusted net income attributable to UHS during the third quarter of 2023 was $177.5 million, or $2.55 per diluted share, as compared to $185.8 million, or $2.54 per diluted share, during the third quarter of 2022.  As reflected on the Supplemental Schedule, included in our reported results were unrealized after-tax losses of $10.5 million, or $.15 per diluted share ($13.8 million pre-tax), during the third quarter of 2023, and $3.0 million, or $.04 per diluted share ($3.9 million pre-tax) during the third quarter of 2022. These unrealized losses, which are included in "Other (income) expense, net", resulted from decreases in the market value of certain equity securities. 

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization ("EBITDA net of NCI", NCI is net income attributable to noncontrolling interests), was $410.1 million during the third quarter of 2023, as compared to $421.7 million during the third quarter of 2022. Our adjusted earnings before interest, taxes, depreciation & amortization ("Adjusted EBITDA net of NCI"), which excludes the impact of other (income) expense, net, was $421.5 million during the third quarter of 2023, as compared to $427.8 million during the third quarter of 2022.

Consolidated Results of Operations, As Reported and As Adjusted  – Nine-month periods ended September 30, 2023 and 2022:

Reported net income attributable to UHS was $501.4 million, or $7.09 per diluted share, during the first nine months of 2023, as compared to $500.8 million, or $6.71 per diluted share, during the first nine months 2022. Net revenues increased by 6.3% to $10.578 billion during the first nine months of 2023, as compared to $9.952 billion during the comparable period of 2022.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the first nine months of 2023, was $524.5 million, or $7.42 per diluted share, as compared to $513.1 million, or $6.88 per diluted share, during the nine-month period ended September 30, 2022. 

As reflected on the Supplemental Schedule, included in our reported results were unrealized after-tax losses of $23.0 million, or $.33 per diluted share, ($30.1 million pre-tax) during the first nine months of 2023 and $12.4 million, or $.17 per diluted share, ($16.1 million pre-tax) during the first nine months of 2022. These unrealized losses, which are included in "Other (income) expense, net", resulted from decreases in the market value of certain equity securities. 

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization ("EBITDA net of NCI"), was $1.237 billion during the first nine months of 2023, as compared to $1.175 billion during the first nine months of 2022. Our adjusted earnings before interest, taxes, depreciation & amortization ("Adjusted EBITDA net of NCI"), which excludes the impact of other (income) expense, net, was $1.268 billion during the first nine months of 2023, as compared to $1.190 billion during the comparable period of 2022.

Acute Care Services – Three and nine-month periods ended September 30, 2023 and 2022:

During the third quarter of 2023, at our acute care hospitals owned during both periods ("same facility basis"), adjusted admissions (adjusted for outpatient activity) increased by 6.8% while adjusted patient days increased by 3.8%, as compared to the third quarter of 2022. At these facilities, during the third quarter of 2023, net revenue per adjusted admission increased by 0.4% while net revenue per adjusted patient day increased by 3.3%, as compared to the third quarter of 2022. Net revenues generated from our acute care services, on a same facility basis, increased by 7.5% during the third quarter of 2023, as compared to the third quarter of 2022.

 During the nine-month period ended September 30, 2023, at our acute care hospitals on a same facility basis, adjusted admissions increased by 8.3% while adjusted patient days increased by 4.8%, as compared to the first nine months of 2022. At these facilities, during the first nine months of 2023, net revenue per adjusted admission decreased by 2.0% while net revenue per adjusted patient day increased by 1.3%, as compared to the first nine months of 2022. Net revenues generated from our acute care services, on a same facility basis, increased by 6.9% during the first nine months of 2023, as compared to the comparable period of 2022.

Behavioral Health Care Services – Three and nine-month periods ended September 30, 2023 and 2022:

During the third quarter of 2023, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 0.8% while adjusted patient days increased by 1.1%, as compared to the third quarter of 2022. At these facilities, during the third quarter of 2023, net revenue per adjusted admission increased by 6.8% and net revenue per adjusted patient day increased by 6.5%, as compared to the third quarter of 2022. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 7.6% during the third quarter of 2023, as compared to the third quarter of 2022.

During the nine-month period ended September 30, 2023, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 3.8% while adjusted patient days increased by 2.4%, as compared to the first nine months of 2022. At these facilities, during the first nine months of 2023, net revenue per adjusted admission increased by 4.4% and net revenue per adjusted patient day increased by 5.9%, as compared to the first nine months of 2022. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 8.3% during the first nine months of 2023, as compared to the comparable period of 2022.

Net Cash Provided by Operating Activities and Liquidity:

Net Cash Provided by Operating Activities:

During the nine-month period ended September 30, 2023, our net cash provided by operating activities was $815 million as compared to $699 million during the first nine months of 2022. Included in the $117 million net increase in our net cash provided by operating activities was a favorable change of $109 million in other working capital accounts due primarily to the timing of disbursements for accrued compensation and accounts payable.

Liquidity:

As of September 30, 2023, we had $721 million of aggregate available borrowing capacity pursuant to our $1.2 billion revolving credit facility, net of outstanding borrowings and letters of credit.       

Stock Repurchase Program:

As of December 31, 2022, we had an aggregate remaining repurchase authorization of approximately $947 million pursuant to our stock repurchase program. Pursuant to the terms of our stock repurchase program, shares of our Class B Common Stock may be repurchased, from time to time as conditions allow, on the open market or in negotiated private transactions. 

During the third quarter of 2023, we have repurchased 1.32 million shares at an aggregate cost of approximately $175.1 million (approximately $133 per share) pursuant to the program. During the first nine months of 2023, we have repurchased approximately 2.73 million shares at an aggregate cost of approximately $367.2 million (approximately $135 per share) pursuant to the program.

As of September 30, 2023, we had an aggregate available repurchase authorization of approximately $580 million

Conference call information:

We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on October 26, 2023.  A live webcast of the call will be available on our website at www.uhs.com. To participate via telephone, please register in advance at this link

Upon registration, all telephone participants will receive a confirmation email detailing how to join the conference call, including the dial-in number along with a unique passcode and registrant ID that can be used to access the call. A replay of the call will be available for one full year following the live call.

General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2022 were approximately $13.4 billion. UHS ranked #311 on the Fortune 500; and #434 on Forbes' list of America's Largest Public Companies. UHS was again recognized as one of the World's Most Admired Companies by Fortune.  

Our operating philosophy is as effective today as it was upon the Company's founding in 1979, enabling us to provide compassionate care to our patients and their loved ones.  Our strategy includes building or acquiring high quality hospitals in rapidly growing markets, investing in the people and equipment needed to allow each facility to thrive, and becoming the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has approximately 93,800 employees and, through its subsidiaries, operates 27 inpatient acute care hospitals, 331 inpatient behavioral health facilities, 43 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 39 states, Washington, D.C., the United Kingdom and Puerto Rico. It acts as the advisor to Universal Health Realty Income Trust, a real estate investment trust (NYSE:UHT).  For additional information visit www.uhs.com.

This press release contains forward-looking statements based on current management expectations.  Numerous factors, including those disclosed herein, those related to the potential impact of COVID-19 on our operations and financial results, those related to healthcare industry trends and those detailed in our filings with the Securities and Exchange Commission (as set forth in Item 2-Forward Looking Statements and Risk Factors in our Form 10-Q for the quarter ended June 30, 2023 and in Item 1A-Risk Factors, and Item 7-Forward-Looking Statements and Risk Factors, in our Form 10-K for the year ended December 31, 2022), may cause the results to differ materially from those anticipated in the forward-looking statements.  These statements are subject to risks and uncertainties and therefore actual results may differ materially.  Readers should not place undue reliance on such forward-looking statements which reflect management's view 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. 

Many of the factors that could affect our future results are beyond our control or ability to predict, including, but not limited to:

  • The nationwide shortage of nurses and other clinical staff and support personnel has been a significant operating issue facing us and other healthcare providers. In some areas, the labor scarcity is putting a strain on our resources and staff, which has required us to utilize higher‑cost temporary labor and pay premiums above standard compensation for essential workers. These factors, which had a material unfavorable impact on our results of operations during 2022, could continue to have an unfavorable material impact on our results of operations for the foreseeable future.
  • The impact of the COVID-19 pandemic, which began in March, 2020, has had a material effect on our operations and financial results, at various times, since that time. We cannot predict if there will be future disruptions caused by the COVID‑19 pandemic.
  • A significant portion of our revenues are derived from federal and state government programs including the Medicare and Medicaid programs. Payments from these programs are subject to statutory and regulatory changes, administrative rulings, interpretations and determinations, requirements for utilization review, and federal and state funding restrictions. Changes to these programs, if adopted, could materially affect program payments which could materially impact our results of operations.
  • The increase in interest rates has substantially increased our borrowings costs and reduced our ability to access the capital markets on favorable terms. Additional increases in interest rates could have a significant unfavorable impact on our future results of operations and the resulting effect on the capital markets could adversely affect our ability to carry out our strategy.

We believe that adjusted net income attributable to UHS, adjusted net income attributable to UHS per diluted share, EBITDA net of NCI and Adjusted EBITDA net of NCI, which are non-GAAP financial measures ("GAAP" is Generally Accepted Accounting Principles in the United States of America), are helpful to our investors as measures of our operating performance. In addition, we believe that, when applicable, comparing and discussing our financial results based on these measures, as calculated, is helpful to our investors since it neutralizes the effect of material items impacting our net income attributable to UHS, such as, changes in the market value of shares of certain equity securities and other potential material items that are nonrecurring or non-operational in nature including, but not limited to, impairments of goodwill, long-lived and intangible assets, reserves for various matters including settlements, legal judgments and lawsuits, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, potential impacts of non-ordinary acquisitions, divestitures, joint ventures or other strategic transactions, and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. To obtain a complete understanding of our financial performance these measures should be examined in connection with net income attributable to UHS, as determined in accordance with GAAP, and as presented in the condensed consolidated financial statements and notes thereto in this report or in our other filings with the Securities and Exchange Commission including our Report on Form 10-Q for the quarter ended June 30, 2023 and our Report on Form 10-K for the year ended December 31, 2022. Since the items included or excluded from these measures are significant components in understanding and assessing financial performance under GAAP, these measures should not be considered to be alternatives to net income as a measure of our operating performance or profitability. Since these measures, as presented, are not determined in accordance with GAAP and are thus susceptible to varying calculations, they may not be comparable to other similarly titled measures of other companies. Investors are encouraged to use GAAP measures when evaluating our financial performance.

Universal Health Services, Inc.

Consolidated Statements of Income

(in thousands, except per share amounts)

(unaudited)

        
 

Three months

 

Nine months

 

ended September 30,

 

ended September 30,

 

2023

 

2022

 

2023

 

2022

        

Net revenues

$3,562,774

 

$3,336,027

 

$10,578,430

 

$9,952,390

        

Operating charges:

       

   Salaries, wages and benefits

1,784,870

 

1,677,431

 

5,308,476

 

5,061,173

   Other operating expenses

941,219

 

837,241

 

2,758,484

 

2,526,060

   Supplies expense

378,667

 

366,337

 

1,138,950

 

1,092,403

   Depreciation and amortization

137,195

 

145,874

 

422,560

 

433,508

   Lease and rental expense

35,466

 

33,264

 

105,775

 

97,075

 

3,277,417

 

3,060,147

 

9,734,245

 

9,210,219

        

Income from operations

285,357

 

275,880

 

844,185

 

742,171

        

Interest expense, net

53,378

 

35,653

 

153,085

 

83,002

Other (income) expense, net

11,472

 

6,015

 

31,797

 

15,244

        

Income before income taxes

220,507

 

234,212

 

659,303

 

643,925

        

Provision for income taxes

52,499

 

57,401

 

159,618

 

157,312

        

Net income

168,008

 

176,811

 

499,685

 

486,613

        

Less:  Net income (loss) attributable to

       

noncontrolling interests ("NCI")

1,019

 

(6,003)

 

(1,732)

 

(14,176)

        

Net income attributable to UHS

$166,989

 

$182,814

 

$501,417

 

$500,789

        
        
        
        
        
        

Basic earnings per share attributable to UHS (a)

$2.42

 

$2.52

 

$7.18

 

$6.78

        

Diluted earnings per share attributable to UHS (a)

$2.40

 

$2.50

 

$7.09

 

$6.71

Universal Health Services, Inc.

Footnotes to Consolidated Statements of Income

(in thousands, except per share amounts)

(unaudited)

        
 

Three months

 

Nine months

(a) Earnings per share calculation:

ended September 30,

 

ended September 30,

 

2023

 

2022

 

2023

 

2022

Basic and diluted:

       

Net income attributable to UHS

$166,989

 

$182,814

 

$501,417

 

$500,789

Less: Net income attributable to unvested restricted share grants

(52)

 

(179)

 

(242)

 

(592)

Net income attributable to UHS - basic and diluted

$166,937

 

$182,635

 

$501,175

 

$500,197

        

Weighted average number of common shares - basic

68,867

 

72,595

 

69,825

 

73,769

        

Basic earnings per share attributable to UHS:

$2.42

 

$2.52

 

$7.18

 

$6.78

        

Weighted average number of common shares

68,867

 

72,595

 

69,825

 

73,769

Add: Other share equivalents

757

 

465

 

825

 

743

Weighted average number of common shares and equiv. - diluted

69,624

 

73,060

 

70,650

 

74,512

        

Diluted earnings per share attributable to UHS:

$2.40

 

$2.50

 

$7.09

 

$6.71

Universal Health Services, Inc.

Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")

For the Three Months ended September 30, 2023 and 2022

(in thousands, except per share amounts)

(unaudited)

        
        
        

Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization
("EBITDA/Adjusted EBITDA net of NCI")

        
 

Three months ended

 

% Net

 

Three months ended

 

% Net

 

September 30, 2023

 

revenues

 

September 30, 2022

 

revenues

        

Net income attributable to UHS

$166,989

   

$182,814

  

   Depreciation and amortization

137,195

   

145,874

  

   Interest expense, net

53,378

   

35,653

  

   Provision for income taxes

52,499

   

57,401

  

EBITDA net of NCI

$410,061

 

11.5 %

 

$421,742

 

12.6 %

        

Other (income) expense, net

11,472

   

6,015

  

Adjusted EBITDA net of NCI

$421,533

 

11.8 %

 

$427,757

 

12.8 %

        

Net revenues

$3,562,774

   

$3,336,027

  
        
        
        
        
        

Calculation of Adjusted Net Income Attributable to UHS

        
 

Three months ended

 

Three months ended

 

September 30, 2023

 

September 30, 2022

   

Per

   

Per

 

Amount

 

Diluted Share

 

Amount

 

Diluted Share

        

Net income attributable to UHS

$166,989

 

$2.40

 

$182,814

 

$2.50

Plus/minus after-tax adjustments:

       

Unrealized loss on equity securities

10,528

 

0.15

 

2,974

 

0.04

Subtotal adjustments

10,528

 

0.15

 

2,974

 

0.04

Adjusted net income attributable to UHS

$177,517

 

$2.55

 

$185,788

 

$2.54

Universal Health Services, Inc.
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Nine Months ended September 30, 2023 and 2022
(in thousands, except per share amounts)
(unaudited)

 
 
 

Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization
("EBITDA/Adjusted EBITDA net of NCI")

        
 

Nine months ended

 

% Net

 

Nine months ended

 

% Net

 

September 30, 2023

 

revenues

 

September 30, 2022

 

revenues

        

Net income attributable to UHS

$501,417

   

$500,789

  

   Depreciation and amortization

422,560

   

433,508

  

   Interest expense, net

153,085

   

83,002

  

   Provision for income taxes

159,618

   

157,312

  

EBITDA net of NCI

$1,236,680

 

11.7 %

 

$1,174,611

 

11.8 %

        

Other (income) expense, net

31,797

   

15,244

  

Adjusted EBITDA net of NCI

$1,268,477

 

12.0 %

 

$1,189,855

 

12.0 %

        

Net revenues

$10,578,430

   

$9,952,390

  
        
        
        
        
        

Calculation of Adjusted Net Income Attributable to UHS

        
 

Nine months ended

 

Nine months ended

 

September 30, 2023

 

September 30, 2022

   

Per

   

Per

 

Amount

 

Diluted Share

 

Amount

 

Diluted Share

        

Net income attributable to UHS

$501,417

 

$7.09

 

$500,789

 

$6.71

Plus/minus after-tax adjustments:

       

Unrealized loss on equity securities

23,040

 

0.33

 

12,358

 

0.17

Subtotal adjustments

23,040

 

0.33

 

12,358

 

0.17

Adjusted net income attributable to UHS

$524,457

 

$7.42

 

$513,147

 

$6.88

Universal Health Services, Inc.

Condensed Consolidated Balance Sheets

(in thousands)

(unaudited)

       
   

September 30,

  

December 31,

   

2023

  

2022

Assets

      

Current assets:

      

    Cash and cash equivalents

 

$

80,768

 

$

102,818

    Accounts receivable, net

  

2,234,343

  

2,017,722

    Supplies

  

214,587

  

218,517

    Other current assets

  

223,303

  

198,283

          Total current assets

  

2,753,001

  

2,537,340

       

Property and equipment

  

11,610,188

  

11,085,852

Less: accumulated depreciation

  

(5,523,135)

  

(5,167,394)

   

6,087,053

  

5,918,458

       

Other assets:

      

    Goodwill

  

3,912,122

  

3,909,456

    Deferred income taxes

  

99,580

  

68,397

    Right of use assets-operating leases

  

443,924

  

454,650

    Deferred charges

  

7,062

  

6,264

    Other

  

570,728

  

599,623

Total Assets

 

$

13,873,470

 

$

13,494,188

       

Liabilities and Stockholders' Equity

      

Current liabilities:

      

    Current maturities of long-term debt

 

$

126,555

 

$

81,447

    Accounts payable and other liabilities

  

1,783,460

  

1,760,588

    Operating lease liabilities

  

72,655

  

67,776

    Federal and state taxes

  

7,145

  

4,608

          Total current liabilities

  

1,989,815

  

1,914,419

       

Other noncurrent liabilities

  

587,829

  

487,669

Operating lease liabilities noncurrent

  

388,550

  

395,522

Long-term debt

  

4,796,074

  

4,726,533

       

Redeemable noncontrolling interest

  

4,719

  

4,695

       

UHS common stockholders' equity

  

6,064,915

  

5,920,582

Noncontrolling interest

  

41,568

  

44,768

          Total equity

  

6,106,483

  

5,965,350

       

Total Liabilities and Stockholders' Equity

 

$

13,873,470

 

$

13,494,188

Universal Health Services, Inc.

Consolidated Statements of Cash Flows

(in thousands)

(unaudited)

 

Nine months

 

ended September 30,

 

2023

 

2022

    

Cash Flows from Operating Activities:

   

  Net income

$499,685

 

$486,613

  Adjustments to reconcile net income to net 

   

cash provided by operating activities:

   

Depreciation & amortization

422,560

 

433,508

(Gain) loss on sale of assets and businesses

(6,250)

 

584

Stock-based compensation expense

65,702

 

62,741

  Changes in assets & liabilities, net of effects from

   

acquisitions and dispositions:

   

   Accounts receivable

(193,108)

 

(155,142)

   Accrued interest

60

 

529

   Accrued and deferred income taxes 

(33,240)

 

(4,900)

   Other working capital accounts 

(65,062)

 

(173,903)

   Medicare accelerated payments and deferred CARES Act and other grants

1,764

 

2,921

   Other assets and deferred charges

48,985

 

22,219

   Other 

13,717

 

(23,358)

   Accrued insurance expense, net of commercial premiums paid

141,414

 

134,908

   Payments made in settlement of self-insurance claims

(80,861)

 

(88,001)

          Net cash provided by operating activities

815,366

 

698,719

    

Cash Flows from Investing Activities:

   

   Property and equipment additions

(536,665)

 

(569,555)

   Proceeds received from sales of assets and businesses

23,688

 

12,001

   Acquisition of businesses and property

(3,728)

 

(18,666)

   (Outflows) inflows from foreign exchange contracts that hedge our net U.K. investment

(7,723)

 

177,214

   Decrease in capital reserves of commercial insurance subsidiary 

0

 

100

          Net cash used in investing activities

(524,428)

 

(398,906)

    

Cash Flows from Financing Activities:

   

   Repayments of long-term debt

(54,009)

 

(194,115)

   Additional borrowings

165,000

 

705,321

   Financing costs

(308)

 

(2,541)

   Repurchase of common shares

(385,339)

 

(723,384)

   Dividends paid

(41,964)

 

(44,192)

   Issuance of common stock

9,841

 

10,399

   Profit distributions to noncontrolling interests

(5,258)

 

(5,426)

   (Purchase) sale of ownership interests by (from) minority members

408

 

(49,089)

          Net cash used in financing activities

(311,629)

 

(303,027)

    

   Effect of exchange rate changes on cash, cash equivalents and restricted cash

493

 

(10,339)

Decrease in cash, cash equivalents and restricted cash

(20,198)

 

(13,553)

Cash, cash equivalents and restricted cash, beginning of period

200,837

 

178,934

Cash, cash equivalents and restricted cash, end of period

$180,639

 

$165,381

    

Supplemental Disclosures of Cash Flow Information:

   

  Interest paid

$149,247

 

$78,992

    

  Income taxes paid, net of refunds

$191,189

 

$182,091

    

  Noncash purchases of property and equipment

$108,412

 

$97,264

Universal Health Services, Inc.

Supplemental Statistical Information

(unaudited)

          
          
       

 % Change 

 

 % Change 

       

3 Months ended

 

9 Months ended

Same Facility:

      

9/30/2023

 

9/30/2023

          

Acute Care Hospitals

         

Revenues

      

7.5 %

 

6.9 %

Adjusted Admissions

      

6.8 %

 

8.3 %

Adjusted Patient Days

      

3.8 %

 

4.8 %

Revenue Per Adjusted Admission

      

0.4 %

 

-2.0 %

Revenue Per Adjusted Patient Day

      

3.3 %

 

1.3 %

          

Behavioral Health Hospitals

         

Revenues

      

7.6 %

 

8.3 %

Adjusted Admissions

      

0.8 %

 

3.8 %

Adjusted Patient Days

      

1.1 %

 

2.4 %

Revenue Per Adjusted Admission

      

6.8 %

 

4.4 %

Revenue Per Adjusted Patient Day

      

6.5 %

 

5.9 %

          

UHS Consolidated

  

Third Quarter Ended

 

Nine Months Ended

   

9/30/2023

 

9/30/2022

 

9/30/2023

 

9/30/2022

          

Revenues

  

$3,562,774

 

$3,336,027

 

$10,578,430

 

$9,952,390

EBITDA net of NCI

  

$410,061

 

$421,742

 

$1,236,680

 

$1,174,611

EBITDA Margin net of NCI

  

11.5 %

 

12.6 %

 

11.7 %

 

11.8 %

Adjusted EBITDA net of NCI

  

$421,533

 

$427,757

 

$1,268,477

 

$1,189,855

Adjusted EBITDA Margin net of NCI

  

11.8 %

 

12.8 %

 

12.0 %

 

12.0 %

          

Cash Flow From Operations

  

$161,665

 

$220,672

 

$815,366

 

$698,719

Capital Expenditures  

  

$200,001

 

$161,593

 

$536,665

 

$569,555

Days Sales Outstanding

      

58

 

52

          
          

Debt 

      

$4,922,629

 

$4,704,663

UHS' Shareholders Equity

      

$6,064,915

 

$5,855,353

Debt / Total Capitalization

      

44.8 %

 

44.6 %

Debt / EBITDA net of NCI (1)

      

2.97

 

2.87

Debt / Adjusted EBITDA net of NCI (1)

     

2.83

 

2.87

Debt / Cash From Operations (1)

      

4.42

 

4.61

          

(1) Latest 4 quarters.

         

Universal Health Services, Inc.

  

Acute Care Hospital Services

  

For the Three and Nine Months ended

  

September 30, 2023 and 2022

  

(in thousands)

  
                   
                   

Same Facility Basis - Acute Care Hospital Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2023

 

September 30, 2022

 

September 30, 2023

 

September 30, 2022

  
  

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$1,965,856

 

100.0 %

 

$1,828,370

 

100.0 %

 

$5,808,205

 

100.0 %

 

$5,432,868

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

854,215

 

43.5 %

 

801,252

 

43.8 %

 

2,493,271

 

42.9 %

 

2,412,699

 

44.4 %

  

Other operating expenses

 

543,707

 

27.7 %

 

478,221

 

26.2 %

 

1,584,820

 

27.3 %

 

1,382,250

 

25.4 %

  

Supplies expense

 

324,226

 

16.5 %

 

302,162

 

16.5 %

 

964,228

 

16.6 %

 

904,547

 

16.6 %

  

Depreciation and amortization

 

86,583

 

4.4 %

 

92,830

 

5.1 %

 

265,021

 

4.6 %

 

274,574

 

5.1 %

  

Lease and rental expense

 

24,404

 

1.2 %

 

21,847

 

1.2 %

 

71,635

 

1.2 %

 

62,756

 

1.2 %

  

Subtotal-operating expenses

 

1,833,135

 

93.2 %

 

1,696,312

 

92.8 %

 

5,378,975

 

92.6 %

 

5,036,826

 

92.7 %

  

Income from operations

 

132,721

 

6.8 %

 

132,058

 

7.2 %

 

429,230

 

7.4 %

 

396,042

 

7.3 %

  

Interest expense, net

 

(778)

 

(0.0) %

 

234

 

0.0 %

 

(1,858)

 

(0.0) %

 

1,350

 

0.0 %

  

Other (income) expense, net

 

(1,045)

 

(0.1) %

 

384

 

0.0 %

 

5,168

 

0.1 %

 

806

 

0.0 %

  

Income before income taxes

 

$134,544

 

6.8 %

 

$131,440

 

7.2 %

 

$425,920

 

7.3 %

 

$393,886

 

7.3 %

  
                   
                   
                   

All Acute Care Hospital Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2023

 

September 30, 2022

 

September 30, 2023

 

September 30, 2022

  
  

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$2,017,288

 

100.0 %

 

$1,919,678

 

100.0 %

 

$5,993,899

 

100.0 %

 

$5,707,510

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

854,587

 

42.4 %

 

824,942

 

43.0 %

 

2,534,878

 

42.3 %

 

2,497,888

 

43.8 %

  

Other operating expenses

 

596,834

 

29.6 %

 

535,463

 

27.9 %

 

1,731,750

 

28.9 %

 

1,550,044

 

27.2 %

  

Supplies expense

 

323,475

 

16.0 %

 

311,404

 

16.2 %

 

979,185

 

16.3 %

 

935,559

 

16.4 %

  

Depreciation and amortization

 

86,535

 

4.3 %

 

96,020

 

5.0 %

 

274,165

 

4.6 %

 

285,558

 

5.0 %

  

Lease and rental expense

 

24,440

 

1.2 %

 

21,990

 

1.1 %

 

72,629

 

1.2 %

 

63,324

 

1.1 %

  

Subtotal-operating expenses

 

1,885,871

 

93.5 %

 

1,789,819

 

93.2 %

 

5,592,607

 

93.3 %

 

5,332,373

 

93.4 %

  

Income from operations

 

131,417

 

6.5 %

 

129,859

 

6.8 %

 

401,292

 

6.7 %

 

375,137

 

6.6 %

  

Interest expense, net

 

(778)

 

(0.0) %

 

234

 

0.0 %

 

(1,858)

 

(0.0) %

 

1,350

 

0.0 %

  

Other (income) expense, net

 

(211)

 

(0.0) %

 

384

 

0.0 %

 

6,921

 

0.1 %

 

806

 

0.0 %

  

Income before income taxes

 

$132,406

 

6.6 %

 

$129,241

 

6.7 %

 

$396,229

 

6.6 %

 

$372,981

 

6.5 %

  
                   
                   

We believe that providing our results on a "Same Facility" basis (which is a non-GAAP measure), which includes the operating results for facilities and businesses operated in both the current year and prior year periods, is helpful to our investors as a measure of our operating performance. Our Same Facility results also neutralize (if applicable), the effect of material items that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters, settlements, legal judgments and lawsuits, cost related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of goodwill, long-lived and intangible assets and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. Our Same Facility basis results exclude from net revenues and other operating expenses, provider tax assessments incurred in each period. However, these provider tax assessments are included in net revenues and other operating expenses as reflected in the table under All Acute Care Hospital Services. The provider tax assessments had no impact on the income before income taxes as reflected on the above tables since the amounts offset between net revenues and other operating expenses. To obtain a complete understanding of our financial performance, the Same Facility results should be examined in connection with our net income as determined in accordance with GAAP and as presented herein and the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2022 and Form 10-Q for the quarter ended June 30, 2023.

                   

The All Acute Care Hospital Services table summarizes the results of operations for all our acute care operations during the periods presented. These amounts include: (i) our acute care results on a same facility basis, as indicated above; (ii) the impact of provider tax assessments which increased net revenues and other operating expenses but had no impact on income before income taxes, and; (iii) certain other amounts including the results of facilities acquired or opened during the last twelve months.

Universal Health Services, Inc.

  

Behavioral Health Care Services

  

For the Three and Nine Months ended

  

September 30, 2023 and 2022

  

(in thousands)

  
                   
                   

Same Facility - Behavioral Health Care Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2023

 

September 30, 2022

 

September 30, 2023

 

September 30, 2022

  
  

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$1,513,354

 

100.0 %

 

$1,407,039

 

100.0 %

 

$4,490,078

 

100.0 %

 

$4,144,998

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

841,985

 

55.6 %

 

779,839

 

55.4 %

 

2,491,153

 

55.5 %

 

2,293,332

 

55.3 %

  

Other operating expenses

 

292,878

 

19.4 %

 

273,618

 

19.4 %

 

866,450

 

19.3 %

 

816,312

 

19.7 %

  

Supplies expense

 

55,102

 

3.6 %

 

55,466

 

3.9 %

 

161,205

 

3.6 %

 

157,457

 

3.8 %

  

Depreciation and amortization

 

47,484

 

3.1 %

 

46,487

 

3.3 %

 

139,039

 

3.1 %

 

137,249

 

3.3 %

  

Lease and rental expense

 

10,857

 

0.7 %

 

10,586

 

0.8 %

 

32,642

 

0.7 %

 

31,262

 

0.8 %

  

Subtotal-operating expenses

 

1,248,306

 

82.5 %

 

1,165,996

 

82.9 %

 

3,690,489

 

82.2 %

 

3,435,612

 

82.9 %

  

Income from operations

 

265,048

 

17.5 %

 

241,043

 

17.1 %

 

799,589

 

17.8 %

 

709,386

 

17.1 %

  

Interest expense, net

 

1,255

 

0.1 %

 

1,370

 

0.1 %

 

3,326

 

0.1 %

 

3,957

 

0.1 %

  

Other (income) expense, net

 

(985)

 

(0.1) %

 

(664)

 

(0.0) %

 

(2,294)

 

(0.1) %

 

(1,422)

 

(0.0) %

  

Income before income taxes

 

$264,778

 

17.5 %

 

$240,337

 

17.1 %

 

$798,557

 

17.8 %

 

$706,851

 

17.1 %

  
                   
                   
                   

All Behavioral Health Care Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2023

 

September 30, 2022

 

September 30, 2023

 

September 30, 2022

  
  

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$1,542,695

 

100.0 %

 

$1,434,828

 

100.0 %

 

$4,575,378

 

100.0 %

 

$4,235,215

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

844,244

 

54.7 %

 

782,909

 

54.6 %

 

2,498,338

 

54.6 %

 

2,310,761

 

54.6 %

  

Other operating expenses

 

322,208

 

20.9 %

 

300,406

 

20.9 %

 

949,958

 

20.8 %

 

898,655

 

21.2 %

  

Supplies expense

 

55,272

 

3.6 %

 

55,482

 

3.9 %

 

161,597

 

3.5 %

 

158,315

 

3.7 %

  

Depreciation and amortization

 

47,720

 

3.1 %

 

46,861

 

3.3 %

 

140,117

 

3.1 %

 

138,803

 

3.3 %

  

Lease and rental expense

 

10,911

 

0.7 %

 

11,010

 

0.8 %

 

32,834

 

0.7 %

 

32,803

 

0.8 %

  

Subtotal-operating expenses

 

1,280,355

 

83.0 %

 

1,196,668

 

83.4 %

 

3,782,844

 

82.7 %

 

3,539,337

 

83.6 %

  

Income from operations

 

262,340

 

17.0 %

 

238,160

 

16.6 %

 

792,534

 

17.3 %

 

695,878

 

16.4 %

  

Interest expense, net

 

1,252

 

0.1 %

 

1,375

 

0.1 %

 

3,456

 

0.1 %

 

4,106

 

0.1 %

  

Other (income) expense, net

 

(1,080)

 

(0.1) %

 

(1,164)

 

(0.1) %

 

(3,139)

 

(0.1) %

 

(1,922)

 

(0.0) %

  

Income before income taxes

 

$262,168

 

17.0 %

 

$237,949

 

16.6 %

 

$792,217

 

17.3 %

 

$693,694

 

16.4 %

  
                   
   

We believe that providing our results on a "Same Facility" basis (which is a non-GAAP measure), which includes the operating results for facilities and businesses operated in both the current year and prior year periods, is helpful to our investors as a measure of our operating performance. Our Same Facility results also neutralize (if applicable), the effect of material items that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters, settlements, legal judgments, lawsuits and reserves established in connection with the government's investigation of our behavioral health care facilities, cost related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of goodwill, long-lived and intangible assets and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. Our Same Facility basis results exclude from net revenues and other operating expenses, provider tax assessments incurred in each period. However, these provider tax assessments are included in net revenues and other operating expenses as reflected in the table under All Behavioral Health Care Services. The provider tax assessments had no impact on the income before income taxes as reflected on the above tables since the amounts offset between net revenues and other operating expenses. To obtain a complete understanding of our financial performance, the Same Facility results should be examined in connection with our net income as determined in accordance with GAAP and as presented herein and in the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2022 and Form 10-Q for the quarter ended June 30, 2023.

                   

The All Behavioral Health Care Services table summarizes the results of operations for all our behavioral health care facilities during the periods presented. These amounts include: (i) our behavioral health results on a same facility basis, as indicated above; (ii) the impact of provider tax assessments which increased net revenues and other operating expenses but had no impact on income before income taxes, and; (iii) certain other amounts including the results of facilities acquired or opened during the last twelve months as well as the results of certain facilities that were closed or restructured during the past year.

Universal Health Services, Inc.

Selected Hospital Statistics

For the Three Months ended

September 30, 2023 and 2022

             
             

AS REPORTED:

            
             
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

9/30/23

 

9/30/22

 

%  change

 

9/30/23

 

9/30/22

 

%  change

             

Hospitals owned and leased

 

27

 

28

 

-3.6 %

 

331

 

331

 

0.0 %

Average licensed beds

 

6,667

 

6,982

 

-4.5 %

 

24,194

 

24,222

 

-0.1 %

Average available beds

 

6,495

 

6,810

 

-4.6 %

 

24,094

 

24,122

 

-0.1 %

Patient days

 

384,348

 

386,341

 

-0.5 %

 

1,600,740

 

1,588,532

 

0.8 %

Average daily census

 

4,177.7

 

4,199.4

 

-0.5 %

 

17,399.3

 

17,266.7

 

0.8 %

Occupancy-licensed beds

 

62.7 %

 

60.1 %

 

4.2 %

 

71.9 %

 

71.3 %

 

0.9 %

Occupancy-available beds

 

64.3 %

 

61.7 %

 

4.3 %

 

72.2 %

 

71.6 %

 

0.9 %

Admissions

 

80,074

 

78,221

 

2.4 %

 

118,487

 

117,913

 

0.5 %

Length of stay

 

4.8

 

4.9

 

-2.8 %

 

13.5

 

13.4

 

0.8 %

             

Inpatient revenue

 

$10,916,060

 

$9,875,794

 

10.5 %

 

$2,703,478

 

$2,582,448

 

4.7 %

Outpatient revenue

 

7,480,353

 

6,379,324

 

17.3 %

 

259,060

 

248,167

 

4.4 %

Total patient revenue

 

18,396,413

 

16,255,118

 

13.2 %

 

2,962,538

 

2,830,615

 

4.7 %

Other revenue

 

251,985

 

215,179

 

17.1 %

 

81,149

 

67,228

 

20.7 %

Gross hospital revenue

 

18,648,398

 

16,470,297

 

13.2 %

 

3,043,687

 

2,897,843

 

5.0 %

Total deductions

 

16,631,110

 

14,550,619

 

14.3 %

 

1,500,992

 

1,463,015

 

2.6 %

Net hospital revenue 

 

$2,017,288

 

$1,919,678

 

5.1 %

 

$1,542,695

 

$1,434,828

 

7.5 %

             
             

SAME FACILITY:

            
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

9/30/23

 

9/30/22

 

%  change

 

9/30/23

 

9/30/22

 

%  change

             

Hospitals owned and leased

 

27

 

27

 

0.0 %

 

329

 

329

 

0.0 %

Average licensed beds

 

6,667

 

6,700

 

-0.5 %

 

23,983

 

24,077

 

-0.4 %

Average available beds

 

6,495

 

6,528

 

-0.5 %

 

23,883

 

23,977

 

-0.4 %

Patient days

 

384,348

 

372,480

 

3.2 %

 

1,589,806

 

1,577,358

 

0.8 %

Average daily census

 

4,177.7

 

4,048.7

 

3.2 %

 

17,280.5

 

17,145.2

 

0.8 %

Occupancy-licensed beds

 

62.7 %

 

60.4 %

 

3.7 %

 

72.1 %

 

71.2 %

 

1.2 %

Occupancy-available beds

 

64.3 %

 

62.0 %

 

3.7 %

 

72.4 %

 

71.5 %

 

1.2 %

Admissions

 

80,074

 

75,434

 

6.2 %

 

117,620

 

117,008

 

0.5 %

Length of stay

 

4.8

 

4.9

 

-2.8 %

 

13.5

 

13.5

 

0.3 %

Universal Health Services, Inc.

Selected Hospital Statistics

For the Nine Months ended

September 30, 2023 and 2022

             
             

AS REPORTED:

            
             
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

9/30/23

 

9/30/22

 

%  change

 

9/30/23

 

9/30/22

 

%  change

             

Hospitals owned and leased

 

27

 

28

 

-3.6 %

 

331

 

331

 

0.0 %

Average licensed beds

 

6,697

 

6,901

 

-3.0 %

 

24,203

 

24,269

 

-0.3 %

Average available beds

 

6,525

 

6,729

 

-3.0 %

 

24,103

 

24,169

 

-0.3 %

Patient days

 

1,172,957

 

1,168,248

 

0.4 %

 

4,761,887

 

4,669,598

 

2.0 %

Average daily census

 

4,296.5

 

4,279.3

 

0.4 %

 

17,442.8

 

17,104.8

 

2.0 %

Occupancy-licensed beds

 

64.2 %

 

62.0 %

 

3.5 %

 

72.1 %

 

70.5 %

 

2.3 %

Occupancy-available beds

 

65.8 %

 

63.6 %

 

3.5 %

 

72.4 %

 

70.8 %

 

2.3 %

Admissions

 

239,300

 

230,223

 

3.9 %

 

358,703

 

346,973

 

3.4 %

Length of stay

 

4.9

 

5.1

 

-3.4 %

 

13.3

 

13.5

 

-1.4 %

             

Inpatient revenue

 

$33,278,396

 

$29,821,756

 

11.6 %

 

$8,001,838

 

$7,580,475

 

5.6 %

Outpatient revenue

 

22,292,249

 

18,360,902

 

21.4 %

 

812,467

 

773,769

 

5.0 %

Total patient revenue

 

55,570,645

 

48,182,658

 

15.3 %

 

8,814,305

 

8,354,244

 

5.5 %

Other revenue

 

714,877

 

602,635

 

18.6 %

 

220,393

 

209,284

 

5.3 %

Gross hospital revenue

 

56,285,522

 

48,785,293

 

15.4 %

 

9,034,698

 

8,563,528

 

5.5 %

Total deductions

 

50,291,623

 

43,077,783

 

16.7 %

 

4,459,320

 

4,328,313

 

3.0 %

Net hospital revenue 

 

$5,993,899

 

$5,707,510

 

5.0 %

 

$4,575,378

 

$4,235,215

 

8.0 %

             
             

SAME FACILITY:

            
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

9/30/23

 

9/30/22

 

%  change

 

9/30/23

 

9/30/22

 

%  change

             

Hospitals owned and leased

 

27

 

27

 

0.0 %

 

329

 

329

 

0.0 %

Average licensed beds

 

6,581

 

6,619

 

-0.6 %

 

24,010

 

23,985

 

0.1 %

Average available beds

 

6,409

 

6,447

 

-0.6 %

 

23,910

 

23,885

 

0.1 %

Patient days

 

1,161,260

 

1,124,897

 

3.2 %

 

4,726,012

 

4,625,248

 

2.2 %

Average daily census

 

4,253.7

 

4,120.5

 

3.2 %

 

17,311.4

 

16,942.3

 

2.2 %

Occupancy-licensed beds

 

64.6 %

 

62.3 %

 

3.8 %

 

72.1 %

 

70.6 %

 

2.1 %

Occupancy-available beds

 

66.4 %

 

63.9 %

 

3.8 %

 

72.4 %

 

70.9 %

 

2.1 %

Admissions

 

236,911

 

221,868

 

6.8 %

 

355,419

 

343,014

 

3.6 %

Length of stay

 

4.9

 

5.1

 

-3.3 %

 

13.3

 

13.5

 

-1.4 %

Terns Pharmaceuticals

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