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Amneal Pharmaceuticals

Universal Health Services Announces 2024 Third Quarter Financial Results

October 24, 2024 | Last Trade: US$196.66 0.86 -0.44
  • Consolidated Results of Operations, As Reported and As Adjusted  – Three-month periods ended September 30, 2024 and 2023:

KING OF PRUSSIA, Penn., Oct. 24, 2024 /PRNewswire/ -- Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was $258.7 million, or $3.80 per diluted share, during the third quarter of 2024, as compared to $167.0 million, or $2.40 per diluted share, during the third quarter of 2023. Net revenues increased by 11.2% to $3.963 billion during the third quarter of 2024, as compared to $3.563 billion during the third quarter of 2023.

As reflected on the Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule"), our adjusted net income attributable to UHS during the third quarter of 2024 was $252.5 million, or $3.71 per diluted share, as compared to $177.5 million, or $2.55 per diluted share, during the third quarter of 2023. 

As reflected on the Supplemental Schedule, included in our reported results during the third quarter of 2024 were: (i) an unrealized after-tax gain of $2.3 million, or $.03 per diluted share ($3.0 million pre-tax), resulting from an increase in the market value of certain equity securities (included in "Other (income) expense, net"), and; (ii) a favorable net after-tax impact of $3.9 million, or $.06 per diluted share, resulting from the net tax benefit recorded pursuant to "ASU 2016-09", Compensation – Stock Compensation: Improvements to Employee Share-Based Payment Accounting, net of the impact of executive compensation limitations pursuant to IRC section 162(m).   

As reflected on the Supplemental Schedule, included in our reported results during the third quarter of 2023, was an after-tax loss of $10.5 million, or $.15 per diluted share ($13.8 million pre-tax), resulting from a decrease 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 $528.6 million, or 13.3% of net revenues, during the third quarter of 2024, as compared to $410.1 million, or 11.5% of net revenues, during the third quarter of 2023. Our adjusted earnings before interest, taxes, depreciation & amortization ("Adjusted EBITDA net of NCI"), which excludes the impact of other (income) expense, net, was $526.5 million, or 13.3% of net revenues, during the third quarter of 2024, as compared to $421.5 million, or 11.8% of net revenues, during the third quarter of 2023.

Consolidated Results of Operations, As Reported and As Adjusted  – Nine-month periods ended September 30, 2024 and 2023

Reported net income attributable to UHS was $809.7 million, or $11.88 per diluted share, during the first nine months of 2024, as compared to $501.4 million, or $7.09 per diluted share, during the first nine months 2023. Net revenues increased by 10.7% to $11.714 billion during the first nine months of 2024, as compared to $10.578 billion during the comparable period of 2023.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the first nine months of 2024 was $798.2 million, or $11.71 per diluted share, as compared to $524.5 million, or $7.42 per diluted share, during the comparable period of 2023. 

As reflected on the Supplemental Schedule, included in our reported results during the first nine months of 2024 were: (i) an unrealized after-tax loss of $4.0 million, or $.06 per diluted share ($5.3 million pre-tax), resulting from a decrease in the market value of certain equity securities (included in "Other (income) expense, net"), and; (ii) a favorable net after-tax impact of $15.5 million, or $.23 per diluted share, resulting from the above-mentioned net tax benefit recorded in connection with ASU 2016-09, net of the impact of executive compensation limitations pursuant to IRC section 162(m).     

As reflected on the Supplemental Schedule, our reported results during the first nine months of 2023, included an unrealized after-tax loss of $23.0 million, or $.33 per diluted share, ($30.1 million pre-tax) resulting from a decrease in the market value of certain equity securities.   

As calculated on the attached Supplemental Schedule, our EBITDA net of NCI, was $1.628 billion, or 13.9% of net revenues, during the first nine months of 2024, as compared to $1.237 billion, or 11.7% of net revenues, during the first nine months of 2023. Our Adjusted EBITDA net of NCI, which excludes the impact of other (income) expense, net, was $1.631 billion, or 13.9% of net revenues, during the first nine months of 2024, as compared to $1.268 billion, or 12.0% of net revenues, during the comparable period of 2023.

Acute Care Services – Three and nine-month periods ended September 30, 2024 and 2023

During the third quarter of 2024, at our acute care hospitals owned during both periods ("same facility basis"), adjusted admissions (adjusted for outpatient activity) increased by 1.5% while adjusted patient days increased by 2.0%, as compared to the third quarter of 2023. At these facilities, during the third quarter of 2024, net revenue per adjusted admission increased by 7.0% while net revenue per adjusted patient day increased by 6.5%, as compared to the third quarter of 2023. Net revenues generated from our acute care services, on a same facility basis, increased by 9.2% during the third quarter of 2024, as compared to the third quarter of 2023.

During the nine-month period ended September 30, 2024, at our acute care hospitals on a same facility basis, adjusted admissions increased by 3.1% while adjusted patient days increased by 2.3%, as compared to the first nine months of 2023. At these facilities, during the first nine months of 2024, net revenue per adjusted admission increased by 5.0% while net revenue per adjusted patient day increased by 5.8%, as compared to the first nine months of 2023. Net revenues generated from our acute care services, on a same facility basis, increased by 8.5% during the first nine months of 2024, as compared to the comparable period of 2023.

Behavioral Health Care Services – Three and nine-month periods ended September 30, 2024 and 2023

During the third quarter of 2024, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 2.2% while adjusted patient days increased by 1.8%, as compared to the third quarter of 2023. At these facilities, during the third quarter of 2024, net revenue per adjusted admission increased by 8.0% and net revenue per adjusted patient day increased by 8.5%, as compared to the third quarter of 2023. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 10.5% during the third quarter of 2024, as compared to the third quarter of 2023.

During the nine-month period ended September 30, 2024, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 0.3% while adjusted patient days increased by 1.7%, as compared to the first nine months of 2023. At these facilities, during the first nine months of 2024, net revenue per adjusted admission increased by 10.1% and net revenue per adjusted patient day increased by 8.7%, as compared to the first nine months of 2023. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 10.6% during the first nine months of 2024, as compared to the comparable period of 2023.

Net Cash Provided by Operating Activities and Liquidity

Net Cash Provided by Operating Activities:

During the nine-month period ended September 30, 2024, our net cash provided by operating activities was $1.409 billion as compared to $815 million during the first nine months of 2023. The $593 million net increase in our net cash provided by operating activities consisted of: (i) a favorable change of $353 million resulting from an increase in net income plus/minus depreciation and amortization expense, stock-based compensation expense, gains on sales of assets and businesses and costs related to extinguishment of debt; (ii) a favorable change of $205 million in accounts receivable; (iii) a favorable change of $66 million in other working capital accounts; (iv) an unfavorable change of $55 million in other assets and deferred charges, and; (v) $24 million of other combined net favorable changes.     

Liquidity:

As previously disclosed on Form 8-K on October 1, 2024, in September, 2024, we completed the following financing transactions:

  • public offering of $500 million aggregate principal amount of 4.625% senior secured notes due in 2029;
  • public offering of $500 million aggregate principal amount of 5.050% senior secured notes due in 2034;
  • amended our credit agreement to:
    • extend the maturity date to September, 2029 (from August, 2026 previously),
    • increase the revolving credit facility to $1.3 billion (from $1.2 billion previously), and;
    • reduce the outstanding borrowings pursuant the tranche A term loan facility by approximately $1.0 billion, to $1.2 billion, utilizing the proceeds generated from the issuance of the above-mentioned senior secured notes due in 2029 and 2034.

As of September 30, 2024, we had $1.01 billion of aggregate available borrowing capacity pursuant to our $1.3 billion revolving credit facility, net of outstanding borrowings and letters of credit.       

Stock Repurchase Program:

In July, 2024, our Board of Directors authorized a $1.0 billion increase to our stock repurchase program. Pursuant to this 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 2024, we have repurchased 658,000 shares at an aggregate cost of approximately $153.9 million (approximately $234 per share) pursuant to the program. During the first nine months of 2024, we have repurchased 1.731 million shares at an aggregate cost of approximately $348.9 million (approximately $202 per share) pursuant to the program.

As of September 30, 2024, we had an aggregate available repurchase authorization of approximately $1.074 billion.

Conference call information:

We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on October 25, 2024.  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. (the "Company") has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2023 were $14.282 billion. UHS ranked #299 on the Fortune 500; and #399 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 96,700 employees and, through its subsidiaries, operates 27 inpatient acute care hospitals, 334 inpatient behavioral health facilities, 49 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 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, 2024 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, 2023), 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:  

  • 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.
  • The outcome of known and unknown litigation, liabilities and other claims asserted against us and/or our subsidiaries, including, but not limited to, the matters related to Cumberland Hospital for Children and Adolescents, located in New Kent, Virginia, as previously disclosed on Form 8-K on September 30, 2024, and the matter related to the Pavilion Behavioral Health System, located in Champaign, Illinois, as previously disclosed on Forms 8-K on April 1, 2024, September 30, 2024 and October 11, 2024, and Forms 10-Q for the quarterly periods ended March 31, 2024 and June 30, 2024. Although we can make no assurances regarding the ultimate outcome of these matters, or what damages will ultimately be awarded, the final resolution of these matters could have a material adverse effect on the Company.

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, the impact of ASU 2016-09 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, 2024 and our Report on Form 10-K for the year ended December 31, 2023. 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,

 

2024

 

2023

 

2024

 

2023

        

Net revenues

$3,963,027

 

$3,562,774

 

$11,714,213

 

$10,578,430

        

Operating charges:

       

   Salaries, wages and benefits

1,912,308

 

1,784,870

 

5,611,304

 

5,308,476

   Other operating expenses

1,090,197

 

941,219

 

3,165,483

 

2,758,484

   Supplies expense

390,250

 

378,667

 

1,181,886

 

1,138,950

   Depreciation and amortization

149,567

 

137,195

 

438,050

 

422,560

   Lease and rental expense

36,540

 

35,466

 

108,165

 

105,775

 

3,578,862

 

3,277,417

 

10,504,888

 

9,734,245

        

Income from operations

384,165

 

285,357

 

1,209,325

 

844,185

        

Interest expense, net

44,660

 

53,378

 

146,385

 

153,085

Other (income) expense, net

(2,028)

 

11,472

 

3,315

 

31,797

        

Income before income taxes

341,533

 

220,507

 

1,059,625

 

659,303

        

Provision for income taxes

75,623

 

52,499

 

233,563

 

159,618

        

Net income

265,910

 

168,008

 

826,062

 

499,685

        

Less:  Net income (loss) attributable to

       

noncontrolling interests ("NCI")

7,196

 

1,019

 

16,362

 

(1,732)

        

Net income attributable to UHS

$258,714

 

$166,989

 

$809,700

 

$501,417

        
        
        

Basic earnings per share attributable to UHS (a)

$3.89

 

$2.42

 

$12.11

 

$7.18

        

Diluted earnings per share attributable to UHS (a)

$3.80

 

$2.40

 

$11.88

 

$7.09

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,

 

2024

 

2023

 

2024

 

2023

Basic and diluted:

       

Net income attributable to UHS

$258,714

 

$166,989

 

$809,700

 

$501,417

Less: Net income attributable to unvested restricted share grants

0

 

(52)

 

(50)

 

(242)

Net income attributable to UHS - basic and diluted

$258,714

 

$166,937

 

$809,650

 

$501,175

        

Weighted average number of common shares - basic

66,537

 

68,867

 

66,873

 

69,825

        

Basic earnings per share attributable to UHS:

$3.89

 

$2.42

 

$12.11

 

$7.18

        

Weighted average number of common shares

66,537

 

68,867

 

66,873

 

69,825

Add: Other share equivalents

1,571

 

757

 

1,297

 

825

Weighted average number of common shares and equiv. - diluted

68,108

 

69,624

 

68,170

 

70,650

        

Diluted earnings per share attributable to UHS:

$3.80

 

$2.40

 

$11.88

 

$7.09

Universal Health Services, Inc.

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

For the Three Months ended September 30, 2024 and 2023

(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, 2024

 

revenues

 

September 30, 2023

 

revenues

        

Net income attributable to UHS

$258,714

   

$166,989

  

   Depreciation and amortization

149,567

   

137,195

  

   Interest expense, net

44,660

   

53,378

  

   Provision for income taxes

75,623

   

52,499

  

EBITDA net of NCI

$528,564

 

13.3 %

 

$410,061

 

11.5 %

        

Other (income) expense, net

(2,028)

   

11,472

  

Adjusted EBITDA net of NCI

$526,536

 

13.3 %

 

$421,533

 

11.8 %

        

Net revenues

$3,963,027

   

$3,562,774

  
        
        
        
        
        

Calculation of Adjusted Net Income Attributable to UHS

        
 

Three months ended

 

Three months ended

 

September 30, 2024

 

September 30, 2023

   

Per

   

Per

 

Amount

 

Diluted Share

 

Amount

 

Diluted Share

        

Net income attributable to UHS

$258,714

 

$3.80

 

$166,989

 

$2.40

Plus/minus after-tax adjustments:

       

Unrealized (gain) loss on equity securities

(2,275)

 

(0.03)

 

10,528

 

0.15

Impact of ASU 2016-09, net

(3,928)

 

(0.06)

 

-

 

-

Subtotal adjustments

(6,203)

 

(0.09)

 

10,528

 

0.15

Adjusted net income attributable to UHS

$252,511

 

$3.71

 

$177,517

 

$2.55

Universal Health Services, Inc.

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

For the Nine Months ended September 30, 2024 and 2023

(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, 2024

 

revenues

 

September 30, 2023

 

revenues

        

Net income attributable to UHS

$809,700

   

$501,417

  

   Depreciation and amortization

438,050

   

422,560

  

   Interest expense, net

146,385

   

153,085

  

   Provision for income taxes

233,563

   

159,618

  

EBITDA net of NCI

$1,627,698

 

13.9 %

 

$1,236,680

 

11.7 %

        

Other (income) expense, net

3,315

   

31,797

  

Adjusted EBITDA net of NCI

$1,631,013

 

13.9 %

 

$1,268,477

 

12.0 %

        

Net revenues

$11,714,213

   

$10,578,430

  
        
        
        
        
        

Calculation of Adjusted Net Income Attributable to UHS

        
 

Nine months ended

 

Nine months ended

 

September 30, 2024

 

September 30, 2023

   

Per

   

Per

 

Amount

 

Diluted Share

 

Amount

 

Diluted Share

        

Net income attributable to UHS

$809,700

 

$11.88

 

$501,417

 

$7.09

Plus/minus after-tax adjustments:

       

Unrealized loss on equity securities

4,038

 

0.06

 

23,040

 

0.33

Impact of ASU 2016-09, net

(15,540)

 

(0.23)

 

-

 

-

Subtotal adjustments

(11,502)

 

(0.17)

 

23,040

 

0.33

Adjusted net income attributable to UHS

$798,198

 

$11.71

 

$524,457

 

$7.42

Universal Health Services, Inc.

Condensed Consolidated Balance Sheets

(in thousands)

(unaudited)

       
   

September 30,

  

December 31,

   

2024

  

2023

Assets

      

Current assets:

      

    Cash and cash equivalents

 

$

106,077

 

$

119,439

    Accounts receivable, net

  

2,214,268

  

2,238,265

    Supplies

  

220,062

  

216,988

    Other current assets

  

261,549

  

236,658

          Total current assets

  

2,801,956

  

2,811,350

       

Property and equipment

  

12,448,230

  

11,777,047

Less: accumulated depreciation

  

(6,005,664)

  

(5,652,518)

   

6,442,566

  

6,124,529

       

Other assets:

      

    Goodwill

  

3,965,492

  

3,932,407

    Deferred income taxes

  

121,904

  

85,626

    Right of use assets-operating leases

  

421,441

  

433,962

    Deferred charges

  

9,705

  

6,974

    Other

  

590,784

  

572,754

Total Assets

 

$

14,353,848

 

$

13,967,602

       

Liabilities and Stockholders' Equity

      

Current liabilities:

      

    Current maturities of long-term debt

 

$

38,351

 

$

126,686

    Accounts payable and other liabilities

  

1,896,234

  

1,813,015

    Operating lease liabilities

  

72,801

  

71,600

    Federal and state taxes

  

3,802

  

2,046

          Total current liabilities

  

2,011,188

  

2,013,347

       

Other noncurrent liabilities

  

660,247

  

584,007

Operating lease liabilities noncurrent

  

377,644

  

382,559

Long-term debt

  

4,618,060

  

4,785,783

       

Redeemable noncontrolling interest

  

5,623

  

5,191

       

UHS common stockholders' equity

  

6,605,696

  

6,149,001

Noncontrolling interest

  

75,390

  

47,714

          Total equity

  

6,681,086

  

6,196,715

       

Total Liabilities and Stockholders' Equity

 

$

14,353,848

 

$

13,967,602

Universal Health Services, Inc.

Consolidated Statements of Cash Flows

(in thousands)

(unaudited)

 

Nine months

 

ended September 30,

 

2024

 

2023

    

Cash Flows from Operating Activities:

   

  Net income

$826,062

 

$499,685

  Adjustments to reconcile net income to net 

   

cash provided by operating activities:

   

Depreciation & amortization

438,050

 

422,560

Gains on sale of assets and businesses

(5,124)

 

(6,250)

Costs related to extinguishment of debt

3,158

 

0

Stock-based compensation expense

72,727

 

65,702

  Changes in assets & liabilities, net of effects from

   

acquisitions and dispositions:

   

   Accounts receivable

11,703

 

(193,108)

   Accrued interest

(1,762)

 

60

   Accrued and deferred income taxes 

(10,949)

 

(33,240)

   Other working capital accounts 

1,329

 

(65,062)

   Medicare accelerated payments and deferred CARES Act and other grants

0

 

1,764

   Other assets and deferred charges

(5,621)

 

48,985

   Other 

25,732

 

13,717

   Accrued insurance expense, net of commercial premiums paid

175,104

 

141,414

   Payments made in settlement of self-insurance claims

(121,745)

 

(80,861)

          Net cash provided by operating activities

1,408,664

 

815,366

    

Cash Flows from Investing Activities:

   

   Property and equipment additions

(697,865)

 

(536,665)

   Proceeds received from sales of assets and businesses

30,219

 

23,688

   Acquisition of businesses and property

0

 

(3,728)

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

(35,667)

 

(7,723)

   Decrease in capital reserves of commercial insurance subsidiary 

197

 

0

          Net cash used in investing activities

(703,116)

 

(524,428)

    

Cash Flows from Financing Activities:

   

   Repayments of long-term debt

(2,471,515)

 

(54,009)

   Additional borrowings

2,210,248

 

165,000

   Financing costs

(9,992)

 

(308)

   Repurchase of common shares

(420,588)

 

(385,339)

   Dividends paid

(40,302)

 

(41,964)

   Issuance of common stock

10,864

 

9,841

   Profit distributions to noncontrolling interests

(5,791)

 

(5,258)

   Sale of ownership interests to minority members

8,959

 

408

          Net cash used in financing activities

(718,117)

 

(311,629)

    

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

2,696

 

493

Increase (decrease) in cash, cash equivalents and restricted cash

(9,873)

 

(20,198)

Cash, cash equivalents and restricted cash, beginning of period

214,470

 

200,837

Cash, cash equivalents and restricted cash, end of period

$204,597

 

$180,639

    

Supplemental Disclosures of Cash Flow Information:

   

  Interest paid

$144,378

 

$149,247

    

  Income taxes paid, net of refunds

$236,975

 

$191,189

    

  Noncash purchases of property and equipment

$87,333

 

$108,412

Universal Health Services, Inc.

Supplemental Statistical Information

(unaudited)

          
          
       

 % Change 

 

 % Change 

       

3 Months ended

 

9 Months ended

Same Facility:

      

9/30/2024

 

9/30/2024

          

Acute Care Hospitals

         

Revenues

      

9.2 %

 

8.5 %

Adjusted Admissions

      

1.5 %

 

3.1 %

Adjusted Patient Days

      

2.0 %

 

2.3 %

Revenue Per Adjusted Admission

      

7.0 %

 

5.0 %

Revenue Per Adjusted Patient Day

      

6.5 %

 

5.8 %

          

Behavioral Health Hospitals

         

Revenues

      

10.5 %

 

10.6 %

Adjusted Admissions

      

2.2 %

 

0.3 %

Adjusted Patient Days

      

1.8 %

 

1.7 %

Revenue Per Adjusted Admission

      

8.0 %

 

10.1 %

Revenue Per Adjusted Patient Day

      

8.5 %

 

8.7 %

          

UHS Consolidated

  

Third Quarter Ended

 

Nine Months Ended

   

9/30/2024

 

9/30/2023

 

9/30/2024

 

9/30/2023

          

Revenues

  

$3,963,027

 

$3,562,774

 

$11,714,213

 

$10,578,430

EBITDA net of NCI

  

$528,564

 

$410,061

 

$1,627,698

 

$1,236,680

EBITDA Margin net of NCI

  

13.3 %

 

11.5 %

 

13.9 %

 

11.7 %

Adjusted EBITDA net of NCI

  

$526,536

 

$421,533

 

$1,631,013

 

$1,268,477

Adjusted EBITDA Margin net of NCI

  

13.3 %

 

11.8 %

 

13.9 %

 

12.0 %

          

Cash Flow From Operations

  

$332,977

 

$161,665

 

$1,408,664

 

$815,366

Capital Expenditures  

  

$247,932

 

$200,001

 

$697,865

 

$536,665

Days Sales Outstanding

      

52

 

58

          
          

Debt 

      

$4,656,411

 

$4,922,629

UHS' Shareholders Equity

      

$6,605,696

 

$6,064,915

Debt / Total Capitalization

      

41.3 %

 

44.8 %

Debt / EBITDA net of NCI (1)

      

2.21

 

2.97

Debt / Adjusted EBITDA net of NCI (1)

     

2.21

 

2.83

Debt / Cash From Operations (1)

      

2.50

 

4.42

          

(1) Latest 4 quarters.

         

Universal Health Services, Inc.

  

Acute Care Hospital Services

  

For the Three and Nine months ended

  

September 30, 2024 and 2023

  

(in thousands)

  

(unaudited)

  
                   

Same Facility Basis - Acute Care Hospital Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2024

 

September 30, 2023

 

September 30, 2024

 

September 30, 2023

  
  

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$2,147,732

 

100.0 %

 

$1,965,985

 

100.0 %

 

$6,355,078

 

100.0 %

 

$5,858,015

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

893,436

 

41.6 %

 

854,284

 

43.5 %

 

2,609,544

 

41.1 %

 

2,517,163

 

43.0 %

  

Other operating expenses

 

598,840

 

27.9 %

 

543,584

 

27.6 %

 

1,754,999

 

27.6 %

 

1,604,084

 

27.4 %

  

Supplies expense

 

332,799

 

15.5 %

 

323,580

 

16.5 %

 

1,011,602

 

15.9 %

 

976,712

 

16.7 %

  

Depreciation and amortization

 

93,752

 

4.4 %

 

86,437

 

4.4 %

 

278,062

 

4.4 %

 

273,646

 

4.7 %

  

Lease and rental expense

 

24,202

 

1.1 %

 

24,443

 

1.2 %

 

72,308

 

1.1 %

 

72,459

 

1.2 %

  

Subtotal-operating expenses

 

1,943,029

 

90.5 %

 

1,832,328

 

93.2 %

 

5,726,515

 

90.1 %

 

5,444,064

 

92.9 %

  

Income from operations

 

204,703

 

9.5 %

 

133,657

 

6.8 %

 

628,563

 

9.9 %

 

413,951

 

7.1 %

  

Interest expense, net 

 

1,077

 

0.1 %

 

(778)

 

(0.0) %

 

3,363

 

0.1 %

 

(1,858)

 

(0.0) %

  

Other (income) expense, net 

 

(590)

 

(0.0) %

 

(490)

 

0.0 %

 

(1,348)

 

(0.0) %

 

5,723

 

0.1 %

  

Income before income taxes

 

$204,216

 

9.5 %

 

$134,925

 

6.9 %

 

$626,548

 

9.9 %

 

$410,086

 

7.0 %

  
                   
                   
                   

All Acute Care Hospital Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2024

 

September 30, 2023

 

September 30, 2024

 

September 30, 2023

  
  

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$2,245,517

 

100.0 %

 

$2,017,288

 

100.0 %

 

$6,604,007

 

100.0 %

 

$5,993,899

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

894,551

 

39.8 %

 

854,587

 

42.4 %

 

2,612,118

 

39.6 %

 

2,534,878

 

42.3 %

  

Other operating expenses

 

699,316

 

31.1 %

 

596,834

 

29.6 %

 

2,009,231

 

30.4 %

 

1,731,750

 

28.9 %

  

Supplies expense

 

332,772

 

14.8 %

 

323,475

 

16.0 %

 

1,011,460

 

15.3 %

 

979,185

 

16.3 %

  

Depreciation and amortization

 

94,522

 

4.2 %

 

86,535

 

4.3 %

 

279,048

 

4.2 %

 

274,165

 

4.6 %

  

Lease and rental expense

 

24,490

 

1.1 %

 

24,440

 

1.2 %

 

72,638

 

1.1 %

 

72,629

 

1.2 %

  

Subtotal-operating expenses

 

2,045,651

 

91.1 %

 

1,885,871

 

93.5 %

 

5,984,495

 

90.6 %

 

5,592,607

 

93.3 %

  

Income from operations

 

199,866

 

8.9 %

 

131,417

 

6.5 %

 

619,512

 

9.4 %

 

401,292

 

6.7 %

  

Interest expense, net 

 

1,077

 

0.0 %

 

(778)

 

(0.0) %

 

3,363

 

0.1 %

 

(1,858)

 

(0.0) %

  

Other (income) expense, net 

 

(527)

 

(0.0) %

 

(211)

 

(0.0) %

 

(354)

 

(0.0) %

 

6,921

 

0.1 %

  

Income before income taxes

 

$199,316

 

8.9 %

 

$132,406

 

6.6 %

 

$616,503

 

9.3 %

 

$396,229

 

6.6 %

  
                   
                   

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, 2023 and our Form 10-Q for the quarter ended June 30, 2024 .

                   

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, 2024 and 2023

  

(in thousands)

  

(unaudited)

  
                   

Same Facility - Behavioral Health Care Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2024

 

September 30, 2023

 

September 30, 2024

 

September 30, 2023

  
  

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$1,672,453

 

100.0 %

 

$1,514,017

 

100.0 %

 

$4,972,612

 

100.0 %

 

$4,494,791

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

916,435

 

54.8 %

 

842,683

 

55.7 %

 

2,679,938

 

53.9 %

 

2,494,850

 

55.5 %

  

Other operating expenses

 

313,402

 

18.7 %

 

294,788

 

19.5 %

 

934,107

 

18.8 %

 

869,771

 

19.4 %

  

Supplies expense

 

57,723

 

3.5 %

 

55,112

 

3.6 %

 

171,594

 

3.5 %

 

161,371

 

3.6 %

  

Depreciation and amortization

 

52,075

 

3.1 %

 

47,472

 

3.1 %

 

149,094

 

3.0 %

 

139,358

 

3.1 %

  

Lease and rental expense

 

11,806

 

0.7 %

 

10,883

 

0.7 %

 

34,908

 

0.7 %

 

32,684

 

0.7 %

  

Subtotal-operating expenses

 

1,351,441

 

80.8 %

 

1,250,938

 

82.6 %

 

3,969,641

 

79.8 %

 

3,698,034

 

82.3 %

  

Income from operations

 

321,012

 

19.2 %

 

263,079

 

17.4 %

 

1,002,971

 

20.2 %

 

796,757

 

17.7 %

  

Interest expense, net 

 

1,041

 

0.1 %

 

1,252

 

0.1 %

 

3,076

 

0.1 %

 

3,455

 

0.1 %

  

Other (income) expense, net 

 

(794)

 

(0.0) %

 

(985)

 

(0.1) %

 

(2,341)

 

(0.0) %

 

(2,294)

 

(0.1) %

  

Income before income taxes

 

$320,765

 

19.2 %

 

$262,812

 

17.4 %

 

$1,002,236

 

20.2 %

 

$795,596

 

17.7 %

  
                   
                   
                   

All Behavioral Health Care Services

                  
                   
  

Three months ended

 

Three months ended

 

Nine months ended

 

Nine months ended

  
  

September 30, 2024

 

September 30, 2023

 

September 30, 2024

 

September 30, 2023

  
  

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

 

Amount

 

% of Net
Revenues

 

Amount

 

% of Net
Revenues 

  

Net revenues

 

$1,714,914

 

100.0 %

 

$1,542,695

 

100.0 %

 

$5,102,290

 

100.0 %

 

$4,575,378

 

100.0 %

  

Operating charges:

                  

Salaries, wages and benefits

 

919,301

 

53.6 %

 

844,244

 

54.7 %

 

2,690,118

 

52.7 %

 

2,498,338

 

54.6 %

  

Other operating expenses

 

354,331

 

20.7 %

 

322,208

 

20.9 %

 

1,054,007

 

20.7 %

 

949,958

 

20.8 %

  

Supplies expense

 

57,830

 

3.4 %

 

55,272

 

3.6 %

 

172,031

 

3.4 %

 

161,597

 

3.5 %

  

Depreciation and amortization

 

52,452

 

3.1 %

 

47,720

 

3.1 %

 

150,949

 

3.0 %

 

140,117

 

3.1 %

  

Lease and rental expense

 

11,956

 

0.7 %

 

10,911

 

0.7 %

 

35,235

 

0.7 %

 

32,834

 

0.7 %

  

Subtotal-operating expenses

 

1,395,870

 

81.4 %

 

1,280,355

 

83.0 %

 

4,102,340

 

80.4 %

 

3,782,844

 

82.7 %

  

Income from operations

 

319,044

 

18.6 %

 

262,340

 

17.0 %

 

999,950

 

19.6 %

 

792,534

 

17.3 %

  

Interest expense, net 

 

1,041

 

0.1 %

 

1,252

 

0.1 %

 

3,076

 

0.1 %

 

3,456

 

0.1 %

  

Other (income) expense, net 

 

(861)

 

(0.1) %

 

(1,080)

 

(0.1) %

 

(2,408)

 

(0.0) %

 

(3,139)

 

(0.1) %

  

Income before income taxes

 

$318,864

 

18.6 %

 

$262,168

 

17.0 %

 

$999,282

 

19.6 %

 

$792,217

 

17.3 %

  
                   
   

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 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 the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2023 and our Form 10-Q for the quarter ended June 30, 2024.

                   

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. 

Universal Health Services, Inc.

Selected Hospital Statistics

For the Three Months ended

September 30, 2024 and 2023

(unaudited)

             

AS REPORTED:

            
             
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

09/30/24

 

09/30/23

 

%  change

 

09/30/24

 

09/30/23

 

%  change

             

Hospitals owned and leased

 

27

 

27

 

0.0 %

 

334

 

331

 

0.9 %

Average licensed beds

 

6,657

 

6,667

 

-0.1 %

 

24,446

 

24,194

 

1.0 %

Average available beds

 

6,485

 

6,495

 

-0.2 %

 

24,346

 

24,094

 

1.0 %

Patient days

 

393,521

 

384,348

 

2.4 %

 

1,630,369

 

1,600,740

 

1.9 %

Average daily census

 

4,277.4

 

4,177.7

 

2.4 %

 

17,721.4

 

17,399.3

 

1.9 %

Occupancy-licensed beds

 

64.3 %

 

62.7 %

 

2.5 %

 

72.5 %

 

71.9 %

 

0.8 %

Occupancy-available beds

 

66.0 %

 

64.3 %

 

2.5 %

 

72.8 %

 

72.2 %

 

0.8 %

Admissions

 

81,731

 

80,074

 

2.1 %

 

121,421

 

118,487

 

2.5 %

Length of stay

 

4.8

 

4.8

 

0.3 %

 

13.4

 

13.5

 

-0.6 %

             

Inpatient revenue

 

$12,277,563

 

$10,916,060

 

12.5 %

 

$2,835,301

 

$2,703,478

 

4.9 %

Outpatient revenue

 

8,573,270

 

7,480,353

 

14.6 %

 

268,182

 

259,060

 

3.5 %

Total patient revenue

 

20,850,833

 

18,396,413

 

13.3 %

 

3,103,483

 

2,962,538

 

4.8 %

Other revenue

 

266,822

 

251,985

 

5.9 %

 

84,770

 

81,149

 

4.5 %

Gross revenue

 

21,117,655

 

18,648,398

 

13.2 %

 

3,188,253

 

3,043,687

 

4.7 %

Total deductions

 

18,872,138

 

16,631,110

 

13.5 %

 

1,473,339

 

1,500,992

 

-1.8 %

Net revenue 

 

$2,245,517

 

$2,017,288

 

11.3 %

 

$1,714,914

 

$1,542,695

 

11.2 %

             
             

SAME FACILITY:

            
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

09/30/24

 

09/30/23

 

%  change

 

09/30/24

 

09/30/23

 

%  change

             

Hospitals owned and leased

 

27

 

27

 

0.0 %

 

333

 

333

 

0.0 %

Average licensed beds

 

6,657

 

6,667

 

-0.1 %

 

24,277

 

24,012

 

1.1 %

Average available beds

 

6,485

 

6,495

 

-0.2 %

 

24,177

 

23,912

 

1.1 %

Patient days

 

393,521

 

384,348

 

2.4 %

 

1,618,344

 

1,586,108

 

2.0 %

Average daily census

 

4,277.4

 

4,177.7

 

2.4 %

 

17,590.7

 

17,240.3

 

2.0 %

Occupancy-licensed beds

 

64.3 %

 

62.7 %

 

2.5 %

 

72.5 %

 

71.8 %

 

0.9 %

Occupancy-available beds

 

66.0 %

 

64.3 %

 

2.5 %

 

72.8 %

 

72.1 %

 

0.9 %

Admissions

 

81,731

 

80,074

 

2.1 %

 

120,515

 

117,635

 

2.4 %

Length of stay

 

4.8

 

4.8

 

0.3 %

 

13.4

 

13.5

 

-0.4 %

Universal Health Services, Inc.

Selected Hospital Statistics

For the Nine Months ended

September 30, 2024 and 2023

(unaudited)

             

AS REPORTED:

            
             
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

09/30/24

 

09/30/23

 

%  change

 

09/30/24

 

09/30/23

 

%  change

             

Hospitals owned and leased

 

27

 

27

 

0.0 %

 

334

 

331

 

0.9 %

Average licensed beds

 

6,657

 

6,697

 

-0.6 %

 

24,413

 

24,203

 

0.9 %

Average available beds

 

6,485

 

6,525

 

-0.6 %

 

24,313

 

24,103

 

0.9 %

Patient days

 

1,199,271

 

1,172,957

 

2.2 %

 

4,858,431

 

4,761,887

 

2.0 %

Average daily census

 

4,376.9

 

4,296.5

 

1.9 %

 

17,731.5

 

17,442.8

 

1.7 %

Occupancy-licensed beds

 

65.7 %

 

64.2 %

 

2.5 %

 

72.6 %

 

72.1 %

 

0.8 %

Occupancy-available beds

 

67.5 %

 

65.8 %

 

2.5 %

 

72.9 %

 

72.4 %

 

0.8 %

Admissions

 

247,170

 

239,300

 

3.3 %

 

361,149

 

358,703

 

0.7 %

Length of stay

 

4.9

 

4.9

 

0.0 %

 

13.5

 

13.3

 

1.7 %

             

Inpatient revenue

 

$37,522,395

 

$33,278,396

 

12.8 %

 

$8,375,470

 

$8,001,838

 

4.7 %

Outpatient revenue

 

25,553,451

 

22,292,249

 

14.6 %

 

833,260

 

812,467

 

2.6 %

Total patient revenue

 

63,075,846

 

55,570,645

 

13.5 %

 

9,208,730

 

8,814,305

 

4.5 %

Other revenue

 

747,424

 

714,877

 

4.6 %

 

247,182

 

220,393

 

12.2 %

Gross revenue

 

63,823,270

 

56,285,522

 

13.4 %

 

9,455,912

 

9,034,698

 

4.7 %

Total deductions

 

57,219,263

 

50,291,623

 

13.8 %

 

4,353,622

 

4,459,320

 

-2.4 %

Net revenue 

 

$6,604,007

 

$5,993,899

 

10.2 %

 

$5,102,290

 

$4,575,378

 

11.5 %

             
             

SAME FACILITY:

            
             
  

ACUTE

 

BEHAVIORAL HEALTH

  

09/30/24

 

09/30/23

 

%  change

 

09/30/24

 

09/30/23

 

%  change

             

Hospitals owned and leased

 

27

 

27

 

0.0 %

 

333

 

333

 

0.0 %

Average licensed beds

 

6,657

 

6,634

 

0.3 %

 

24,189

 

24,060

 

0.5 %

Average available beds

 

6,485

 

6,462

 

0.4 %

 

24,089

 

23,960

 

0.5 %

Patient days

 

1,199,271

 

1,166,693

 

2.8 %

 

4,819,550

 

4,726,531

 

2.0 %

Average daily census

 

4,376.9

 

4,273.6

 

2.4 %

 

17,589.6

 

17,313.3

 

1.6 %

Occupancy-licensed beds

 

65.7 %

 

64.4 %

 

2.1 %

 

72.7 %

 

72.0 %

 

1.1 %

Occupancy-available beds

 

67.5 %

 

66.1 %

 

2.1 %

 

73.0 %

 

72.3 %

 

1.1 %

Admissions

 

247,170

 

238,237

 

3.7 %

 

358,114

 

356,028

 

0.6 %

Length of stay

 

4.9

 

4.9

 

0.0 %

 

13.5

 

13.3

 

1.5 %

Terns Pharmaceuticals

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