0001193125-24-018748.txt : 20240130 0001193125-24-018748.hdr.sgml : 20240130 20240130080100 ACCESSION NUMBER: 0001193125-24-018748 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 16 CONFORMED PERIOD OF REPORT: 20240124 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Departure of Directors or Certain Officers; Election of Directors; Appointment of Certain Officers: Compensatory Arrangements of Certain Officers ITEM INFORMATION: Regulation FD Disclosure ITEM INFORMATION: Other Events ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20240130 DATE AS OF CHANGE: 20240130 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HCA Healthcare, Inc. CENTRAL INDEX KEY: 0000860730 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 273865930 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 24575908 BUSINESS ADDRESS: STREET 1: ONE PARK PLZ CITY: NASHVILLE STATE: TN ZIP: 37203 BUSINESS PHONE: 6153449551 MAIL ADDRESS: STREET 1: ONE PARK PLAZA CITY: NASHVILLE STATE: TN ZIP: 37203 FORMER COMPANY: FORMER CONFORMED NAME: HCA Holdings, Inc. DATE OF NAME CHANGE: 20101126 FORMER COMPANY: FORMER CONFORMED NAME: HCA INC/TN DATE OF NAME CHANGE: 20010627 FORMER COMPANY: FORMER CONFORMED NAME: HCA THE HEALTHCARE CO DATE OF NAME CHANGE: 20010419 8-K 1 d734797d8k.htm FORM 8-K Form 8-K
false 0000860730 0000860730 2024-01-24 2024-01-24

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

PURSUANT TO SECTION 13 OR 15(d)

OF THE SECURITIES EXCHANGE ACT OF 1934

Date of Report (Date of earliest event reported): January 30, 2024 (January 24, 2024)

 

 

HCA Healthcare, Inc.

(Exact Name of Registrant as Specified in its Charter)

 

 

 

Delaware   001-11239   27-3865930

(State or Other Jurisdiction

of Incorporation)

  

(Commission

File Number)

  

(I.R.S. Employer

Identification No.)

 

One Park Plaza, Nashville,

Tennessee

   37203
(Address of Principal Executive Offices)   (Zip Code)

(615) 344-9551

(Registrant’s Telephone Number, including Area Code)

Not Applicable

(Former Name or Former Address, if Changed Since Last Report)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

☐

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

☐

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

☐

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

☐

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each Class

  

Trading
Symbol(s)

  

Name of each exchange

on which registered

Common Stock, $.01 par value per share   HCA   New York Stock Exchange

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company  ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐

 

 

 

Item 2.02.

Results of Operations and Financial Condition.

On January 30, 2024, HCA Healthcare, Inc. (the “Company”) issued a press release announcing, among other matters, its results of operations for the fourth quarter and year ended December 31, 2023, the text of which is set forth as Exhibit 99.1.

 

Item 5.02.

Departure of Directors or Certain Officers; Election of Directors; Appointment of Certain Officers; Compensatory Arrangements of Certain Officers.

Retirement of William B. Rutherford as Executive Vice President and Chief Financial Officer of the Company

On January 24, 2024, William B. Rutherford notified the Company of his intent to retire from his position as Executive Vice President and Chief Financial Officer, effective May 1, 2024.

A copy of the press release issued by the Company relating to Mr. Rutherford’s retirement is attached hereto as Exhibit 99.1 and incorporated herein by reference.

Appointment of Michael A. Marks as Executive Vice President and Chief Financial Officer of the Company

In conjunction with Mr. Rutherford’s retirement, on January 30, 2024, the Company announced that Michael A. Marks, age 54, will succeed Mr. Rutherford as Executive Vice President and Chief Financial Officer, effective May 1, 2024. Mr. Marks joined HCA Healthcare in 1996 and has served as Senior Vice President — Finance since January 1, 2023. Mr. Marks previously served as Vice President — Financial Operations Support from March 2021 to December 2022. Prior to that time, he served as CFO of the National Group from December 2008 to February 2021 and CFO of the West Florida Division from January 2006 to November 2008.

Beginning on the effective date of Mr. Marks’ appointment, the Compensation Committee (the “Committee”) of the Board of Directors of the Company has approved a base salary of $900,000 for Mr. Marks. In addition, in connection with his appointment, the Committee determined to grant Mr. Marks a long-term equity incentive award with a total target grant date value of $2,000,000 (the “Equity Award”), with fifty percent (50%) of the target award in the form of stock appreciation rights which vest over four years and the other fifty percent (50%) of the target award in the form of performance share units which vest upon achievement of a cumulative three year earnings per share goal, in each case, in accordance with the terms and conditions of the award agreements and the 2020 Stock Incentive Plan for Key Employees of HCA Healthcare, Inc. and its Affiliates. The Equity Award is anticipated to be granted on or about May 1, 2024. Other than with respect to the foregoing, Mr. Marks is not a party to any material plan, contract or arrangement with the Company other than the HCA Supplemental Executive Retirement Plan and other plans and arrangements generally available to all Executive Vice President-level officers of the Company and as disclosed in the Company’s definitive proxy statement on Schedule 14A filed with the U.S. Securities and Exchange Commission on March 10, 2023.

There is no arrangement or understanding between Mr. Marks and any other person pursuant to which Mr. Marks was appointed. There are no family relationships, as defined in Item 401 of Regulation S-K, between Mr. Marks and any of the Company’s executive officers or directors or persons nominated or chosen to become a director or executive officer. There are no transactions in which Mr. Marks has an interest requiring disclosure under Item 404(a) of Regulation S-K.

A copy of the press release issued by the Company relating to Mr. Marks’ appointment as the Company’s Executive Vice President and Chief Financial Officer is attached hereto as Exhibit 99.1 and incorporated herein by reference.

 

Item 7.01.

Regulation FD Disclosure.

On January 30, 2024, the Company issued a press release announcing, among other matters, its results of operations for the fourth quarter and year ended December 31, 2023 as well as the matters discussed in Item 5.02, the text of which is set forth as Exhibit 99.1.

Item 8.01.

Other Events.

On January 30, 2024, the Company announced that its Board of Directors had authorized an additional share repurchase program for up to $6 billion of the Company’s outstanding common stock. Repurchases will be made in accordance with applicable securities laws from time to time in the open market, through privately negotiated transactions, or otherwise.

On January 30, 2024, the Company also announced that its Board of Directors had declared a quarterly cash dividend of $0.66 per share of the Company’s common stock. The dividend will be paid on March 29, 2024 to stockholders of record at the close of business on March 15, 2024.

 

Item 9.01.

Financial Statements and Exhibits.

(d) Exhibits:

 

Exhibit 99.1    Press Release, dated January 30, 2024.
Exhibit 104    Cover Page Interactive Data File (embedded within the Inline XBRL document)

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

HCA HEALTHCARE, INC.

/s/ John M. Franck II

John M. Franck II
Vice President – Legal & Corporate Secretary

Date: January 30, 2024

EX-99.1 2 d734797dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

 

LOGO

 

   FOR IMMEDIATE RELEASE
INVESTOR CONTACT:   

MEDIA CONTACT:

Frank Morgan   

Harlow Sumerford

615-344-2688   

615-344-1851

HCA HEALTHCARE REPORTS FOURTH QUARTER 2023 RESULTS

AND PROVIDES 2024 GUIDANCE

BILL RUTHERFORD TO RETIRE AND MIKE MARKS TO BECOME CFO

Nashville, Tenn., January 30, 2024 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the fourth quarter ended December 31, 2023.

Key fourth quarter metrics (all percentage changes compare 4Q 2023 to 4Q 2022 unless otherwise noted):

 

  ●  

Revenues totaled $17.303 billion

  ●  

Net income attributable to HCA Healthcare, Inc. totaled $1.607 billion, or $5.93 per diluted share

  ●  

Adjusted EBITDA totaled $3.618 billion

  ●  

Cash flows from operating activities totaled $2.674 billion

  ●  

Same facility admissions increased 3.1 percent while same facility equivalent admissions increased 3.9 percent

“In the quarter, we experienced strong demand for services across our diversified portfolio of markets, facilities, and service lines. This growth coupled with improved cost trends drove solid financial performance in the fourth quarter. Once again, our people have delivered positive outcomes for our patients, the communities we serve, and our other stakeholders. I want to thank them for their hard work and everything they do for our company,” said Sam Hazen, Chief Executive Officer of HCA Healthcare.

Revenues in the fourth quarter of 2023 totaled $17.303 billion, compared to $15.497 billion in the fourth quarter of 2022. Net income attributable to HCA Healthcare, Inc. totaled $1.607 billion, or $5.93 per diluted share, compared to $2.081 billion, or $7.28 per diluted share, in the fourth quarter of 2022. Results for the fourth quarter of 2023 include gains on sales of facilities of $7 million, or $0.03 per diluted share. Results for the fourth quarter of 2022 include gains on sales of facilities of $1.326 billion, or $2.64 per diluted share, related to sales of our controlling interests in certain healthcare entities.

 

1

For the fourth quarter of 2023, Adjusted EBITDA totaled $3.618 billion, compared to $3.179 billion in the fourth quarter of 2022. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions increased 3.1 percent while same facility equivalent admissions increased 3.9 percent in the fourth quarter of 2023, compared to the prior year period. Same facility emergency room visits increased 2.1 percent in the fourth quarter of 2023, compared to the prior year period. Same facility inpatient surgeries increased 1.0 percent, and same facility outpatient surgeries increased 0.7 percent in the fourth quarter of 2023, compared to the same period of 2022. Same facility revenue per equivalent admission increased 6.9 percent in the fourth quarter of 2023, compared to the fourth quarter of 2022.

Year Ended December 31, 2023

Revenues for the year ended December 31, 2023 totaled $64.968 billion, compared to $60.233 billion for the year ended December 31, 2022. Net income attributable to HCA Healthcare, Inc. was $5.242 billion, or $18.97 per diluted share, for the year ended December 31, 2023 compared to $5.643 billion, or $19.15 per diluted share, for the year ended December 31, 2022. Results for the year ended December 31, 2023 include losses on sales of facilities of $5 million, or $0.04 per diluted share. Results for the year ended December 31, 2022 include gains on sales of facilities of $1.301 billion, or $2.46 per diluted share, and losses on retirement of debt of $78 million, or $0.20 per diluted share.

For 2023, Adjusted EBITDA totaled $12.726 billion, compared to $12.067 billion in 2022. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Balance Sheet and Cash Flows from Operations

As of December 31, 2023, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $935 million, total debt of $39.593 billion, and total assets of $56.211 billion. During the fourth quarter of 2023, capital expenditures totaled $1.159 billion, excluding acquisitions. Cash flows provided by operating activities in the fourth quarter of 2023 totaled $2.674 billion, compared to $2.527 billion in the fourth quarter of 2022.

During the fourth quarter of 2023, the Company repurchased 3.647 million shares of its common stock at a cost of $910 million. The Company had $775 million remaining under its repurchase authorization as of December 31, 2023. As of December 31, 2023, the Company had $6.107 billion of availability under its credit facilities.

Share Repurchase Program

The HCA Healthcare, Inc. Board of Directors has authorized an additional share repurchase program for up to $6 billion of the Company’s outstanding common stock. Repurchases will be made in accordance with applicable securities laws and may be made at management’s discretion from time to time in the open market, through privately negotiated transactions, or otherwise. The repurchase program has no time limit and may be suspended for periods or discontinued at any time.

 

2

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.66 per share on the Company’s common stock. The dividend will be paid on March 29, 2024 to stockholders of record at the close of business on March 15, 2024.

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

2024 Guidance

Today, the Company issued the following estimated guidance for 2024:

 

      2024 Guidance Range  

Revenues

   

 $67.75 to $70.25 billion

Net Income Attributable to HCA Healthcare, Inc.

   

 $5.20 to $5.60 billion

Adjusted EBITDA

   

 $12.85 to $13.55 billion

EPS (diluted)

   

 $19.70 to $21.20 per diluted share

Capital expenditures for 2024, excluding acquisitions, are estimated to be in the range of $5.1 to $5.3 billion.

The Company’s 2024 guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding patient volumes and payor mix as well as general economic conditions, including inflation, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.

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

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

CFO Announcement

HCA Healthcare is also announcing today that Bill Rutherford has decided to retire as Executive Vice President and Chief Financial Officer (“CFO”) after a 34-year career with the company. Mike Marks, HCA Healthcare’s current Senior Vice President, Finance, will succeed Mr. Rutherford as Executive Vice President and CFO, effective May 1, 2024.

“Bill has announced his plan to retire from HCA after 34 years with the company,” said Sam Hazen, Chief Executive Officer of HCA Healthcare. “Bill has had a tremendous impact during his ten years as CFO. The impressive operating results and shareholder returns achieved throughout his tenure are a testament to his leadership and disciplined approach to driving profitable growth. Without question, Bill’s legacy will endure.”

 

3

“Bill has also developed an incredibly high-performing finance team, including Mike, who is an accomplished finance professional and respected leader. I am thrilled for Mike to take on the CFO role and couldn’t be more confident in his ability to continue to advance our company’s success,” said Hazen. “I want to thank Bill for his many contributions to HCA and congratulate him on his upcoming retirement. I also want to welcome Mike as the new CFO,” said Hazen. “Mike has worked closely with Bill, the senior team, and myself. He will be an exceptional CFO as we continue to deliver on our commitment to the care and improvement of human life while keeping our financial foundation strong.”

Mr. Marks joined HCA Healthcare in 1996 and has held a number of positions in accounting and finance, including Senior Vice President — Finance, Vice President — Financial Operations Support, CFO of the National Group and CFO of the West Florida Division.

Annual Stockholders’ Meeting

The Company’s 2024 annual stockholders’ meeting will be held virtually on April 25, 2024 at 2:00 p.m. Central Time for stockholders of record as of February 26, 2024.

Earnings Conference Call

HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company’s Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx.

About the Company

As of December 31, 2023, HCA operated 186 hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 states and the United Kingdom.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company’s financial guidance for the year ending December 31, 2024, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) changes in or related to general economic conditions nationally and regionally in our markets, including inflation and economic and business conditions (and the impact thereof on the economy, financial markets and banking industry); changes in revenues due to declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions (including as a result of geopolitical disruptions); and the impact of potential federal government shutdowns, (2) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (3) the impact of current and future federal

 

4

and state health reform initiatives and possible changes to other federal, state or local laws and regulations affecting the health care industry, including, but not limited to, proposals to expand coverage of federally-funded insurance programs as an alternative to private insurance or establish a single-payer system (such reforms often referred to as “Medicare for All”), (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions and those required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of the American Rescue Plan Act of 2021, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, attain expected levels of patient volumes and revenues, and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) personnel-related capacity constraints, increases in wages and the ability to attract, utilize and retain qualified management and other personnel, including affiliated physicians, nurses and medical and technical support personnel, (9) the highly competitive nature of the health care business, (10) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (11) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (12) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) the emergence of and effects related to pandemics, epidemics and outbreaks of infectious diseases or other public health crises, including but not limited to developments related to COVID-19, (16) future divestitures which may result in charges and possible impairments of long-lived assets, (17) changes in business strategy or development plans, (18) delays in receiving payments for services provided, (19) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (20) the impact of known and unknown government investigations, litigation and other claims that may be made against us, (21) the impact of actual and potential cybersecurity incidents or security breaches, including the data security incident disclosed in July 2023, (22) our ongoing ability to demonstrate meaningful use of certified electronic health record technology and the impact of interoperability requirements, (23) the impact of natural disasters, such as hurricanes and floods, physical risks from climate change or similar events beyond our control, (24) changes in U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, (25) the results of our efforts to use technology and resilience initiatives to drive efficiencies, better outcomes and an enhanced patient experience, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2022 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to “Company,” “HCA” and “HCA Healthcare” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

 

5

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

Fourth Quarter

Unaudited

(Dollars in millions, except per share amounts)

 

     2023     2022  
  

 

 

    

 

 

  
     Amount      Ratio     Amount      Ratio  

Revenues

      $17,303         100.0   %      $15,497         100.0   % 

Salaries and benefits

      7,570         43.7        7,055         45.5   

Supplies

      2,584         14.9        2,429         15.7   

Other operating expenses

      3,559         20.7        2,850         18.4   

Equity in earnings of affiliates

      (28)        (0.2)       (16)        (0.1)  

Depreciation and amortization

      789         4.5        750         4.9   

Interest expense

      491         2.8        453         2.9   

Gains on sales of facilities

      (7)        -        (1,326)        (8.6)  
  

 

 

    

 

 

  
     14,958         86.4        12,195         78.7   
  

 

 

    

 

 

  

Income before income taxes

      2,345         13.6        3,302         21.3   

Provision for income taxes

      484         2.8        656         4.2   
  

 

 

    

 

 

  

Net income

      1,861         10.8        2,646         17.1   

Net income attributable to noncontrolling interests

      254         1.5        565         3.7   
  

 

 

    

 

 

  

Net income attributable to HCA Healthcare, Inc.

      $1,607         9.3        $2,081         13.4   
  

 

 

    

 

 

  

Diluted earnings per share

      $5.93           $7.28      

Shares used in computing diluted earnings per share (millions)

      271.186           285.663      

Comprehensive income attributable to HCA Healthcare, Inc.

      $1,673           $2,183      
  

 

 

       

 

 

     

 

6

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

For the Years Ended December 31, 2023 and 2022

Unaudited

(Dollars in millions, except per share amounts)

 

     2023     2022  
  

 

 

    

 

 

  
     Amount      Ratio     Amount      Ratio  

Revenues

      $64,968         100.0   %      $60,233         100.0   % 

Salaries and benefits

      29,487         45.4        27,685         46.0   

Supplies

      9,902         15.2        9,371         15.6   

Other operating expenses

      12,875         19.8        11,155         18.5   

Equity in earnings of affiliates

      (22)        -        (45)        (0.1)  

Depreciation and amortization

      3,077         4.7        2,969         5.0   

Interest expense

      1,938         3.0        1,741         2.9   

Losses (gains) on sales of facilities

      5         -        (1,301)        (2.2)  

Losses on retirement of debt

      -         -        78         0.1   
  

 

 

    

 

 

  
     57,262         88.1        51,653         85.8   
  

 

 

    

 

 

  

Income before income taxes

      7,706         11.9        8,580         14.2   

Provision for income taxes

      1,615         2.5        1,746         2.9   
  

 

 

    

 

 

  

Net income

      6,091         9.4        6,834         11.3   

Net income attributable to noncontrolling interests

      849         1.3        1,191         1.9   
  

 

 

    

 

 

  

Net income attributable to HCA Healthcare, Inc.

      $5,242         8.1        $5,643         9.4   
  

 

 

    

 

 

  

Diluted earnings per share

      $18.97           $19.15      

Shares used in computing diluted earnings per share (millions)

      276.412           294.666      

Comprehensive income attributable to HCA Healthcare, Inc.

      $5,307           $5,557      
  

 

 

       

 

 

     

 

7

HCA Healthcare, Inc.

Condensed Consolidated Balance Sheets

Unaudited

(Dollars in millions)

 

     December 31,   September 30,   December 31,
     2023   2023   2022

ASSETS

       

Current assets:

       

Cash and cash equivalents

      $935       $891       $908  

Accounts receivable

      9,958       9,182       8,891  

Inventories

      2,021       2,030       2,068  

Other

      2,013       2,191       1,776  
  

 

 

 

  

 

 

 

  

 

 

 

     14,927       14,294       13,643  

Property and equipment, at cost

      58,548       57,772       54,757  

Accumulated depreciation

      (30,833 )      (30,655 )      (29,182 ) 
  

 

 

 

  

 

 

 

  

 

 

 

     27,715       27,117       25,575  

Investments of insurance subsidiaries

      477       382       381  

Investments in and advances to affiliates

      756       739       823  

Goodwill and other intangible assets

      9,945       9,778       9,653  

Right-of-use operating lease assets

      2,207       2,079       2,065  

Other

      184       200       298  
  

 

 

 

  

 

 

 

  

 

 

 

     $56,211       $54,589       $52,438  
  

 

 

 

  

 

 

 

  

 

 

 

LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT)

       

Current liabilities:

       

Accounts payable

      $4,233       $4,139       $4,239  

Accrued salaries

      2,127       1,912       1,712  

Other accrued expenses

      3,871       3,803       3,581  

Long-term debt due within one year

      2,424       2,553       370  
  

 

 

 

  

 

 

 

  

 

 

 

     12,655       12,407       9,902  

Long-term debt, less debt issuance costs and discounts of $333, $341 and $301

      37,169       36,793       37,714  

Professional liability risks

      1,557       1,590       1,528  

Right-of-use operating lease obligations

      1,903       1,776       1,752  

Income taxes and other liabilities

      1,867       1,666       1,615  

Stockholders’ equity (deficit):

       

Stockholders’ deficit attributable to HCA Healthcare, Inc.

      (1,774 )      (2,477 )      (2,767 ) 

Noncontrolling interests

      2,834       2,834       2,694  
  

 

 

 

  

 

 

 

  

 

 

 

     1,060       357       (73 ) 
  

 

 

 

  

 

 

 

  

 

 

 

     $56,211       $54,589       $52,438  
  

 

 

 

  

 

 

 

  

 

 

 

 

8

HCA Healthcare, Inc.

Condensed Consolidated Statements of Cash Flows

For the Years Ended December 31, 2023 and 2022

Unaudited

(Dollars in millions)

 

     2023   2022

Cash flows from operating activities:

     

Net income

      $6,091       $6,834  

Adjustments to reconcile net income to net cash provided by operating activities:

     

Increase (decrease) in cash from operating assets and liabilities:

     

Accounts receivable

      (935 )      (797 ) 

Inventories and other assets

      (126 )      (59 ) 

Accounts payable and accrued expenses

      604       (296 ) 

Depreciation and amortization

      3,077       2,969  

Income taxes

      229       571  

Losses (gains) on sales of facilities

      5       (1,301 ) 

Losses on retirement of debt

      -       78  

Amortization of debt issuance costs and discounts

      35       29  

Share-based compensation

      262       341  

Other

      189       153  
  

 

 

 

  

 

 

 

Net cash provided by operating activities

      9,431       8,522  
  

 

 

 

  

 

 

 

Cash flows from investing activities:

     

Purchase of property and equipment

      (4,744 )      (4,395 ) 

Acquisition of hospitals and health care entities

      (635 )      (224 ) 

Sales of hospitals and health care entities

      193       1,237  

Change in investments

      (112 )      14  

Other

      (19 )      (21 ) 
  

 

 

 

  

 

 

 

Net cash used in investing activities

       (5,317 )       (3,389 ) 
  

 

 

 

  

 

 

 

Cash flows from financing activities:

     

Issuances of long-term debt

      3,224       5,997  

Net change in revolving credit facilities

      (1,020 )      120  

Repayment of long-term debt

      (909 )      (2,830 ) 

Distributions to noncontrolling interests

      (640 )      (1,025 ) 

Payment of debt issuance costs

      (31 )      (53 ) 

Payment of dividends

      (661 )      (653 ) 

Repurchase of common stock

      (3,811 )      (7,000 ) 

Other

      (246 )      (212 ) 
  

 

 

 

  

 

 

 

Net cash used in financing activities

      (4,094 )      (5,656 ) 
  

 

 

 

  

 

 

 

Effect of exchange rate changes on cash and cash equivalents

      7       (20 ) 
  

 

 

 

  

 

 

 

Change in cash and cash equivalents

      27       (543 ) 

Cash and cash equivalents at beginning of period

      908       1,451  
  

 

 

 

  

 

 

 

Cash and cash equivalents at end of period

      $935       $908  
  

 

 

 

  

 

 

 

Interest payments

      $1,892       $1,662  

Income tax payments, net

      $1,386       $1,175  

 

9

HCA Healthcare, Inc.

Operating Statistics

 

     Fourth Quarter     For the Years
Ended December 31,		  
    

2023

    

2022

    

2023

    

2022

  

Operations:

         

Number of Hospitals

      186       182       186       182  

Number of Freestanding Outpatient Surgery Centers*

      124       126       124       126  

Licensed Beds at End of Period

      49,588       49,281       49,588       49,281  

Weighted Average Beds in Service

      42,072       42,119       41,873       41,982  

Reported:

         

Admissions

      544,554       530,298       2,130,728       2,075,459  

% Change

      2.7 %        2.7 %   

Equivalent Admissions

      974,561       931,990       3,788,434       3,611,299  

% Change

      4.6 %        4.9 %   

Revenue per Equivalent Admission

    $ 17,755     $ 16,628     $ 17,149     $ 16,679  

% Change

      6.8 %        2.8 %   

Inpatient Revenue per Admission

    $ 18,992     $ 17,634     $ 18,201     $ 17,361  

% Change

      7.7 %        4.8 %   

Patient Days

      2,674,331       2,648,683       10,483,236       10,504,145  

% Change

      1.0 %        -0.2 %   

Equivalent Patient Days

      4,786,197       4,655,841       18,639,194       18,277,212  

% Change

      2.8 %        2.0 %   

Inpatient Surgery Cases

      132,417       131,840       528,845       522,151  

% Change

      0.4 %        1.3 %   

Outpatient Surgery Cases

      270,286       265,610       1,044,415       1,023,239  

% Change

      1.8 %        2.1 %   

Emergency Room Visits

      2,452,395       2,412,781       9,342,783       8,971,951  

% Change

      1.6 %        4.1 %   

Outpatient Revenues as a

         

Percentage of Patient Revenues

      38.4 %      37.5 %      38.3 %      37.6 % 

Average Length of Stay (days)

      4.911       4.995       4.920       5.061  

Occupancy**

      72.5 %      72.0 %      72.3 %      72.1 % 

Same Facility:

         

Admissions

      542,628       526,259       2,127,112       2,059,561  

% Change

      3.1 %        3.3 %   

Equivalent Admissions

      959,366       923,585       3,750,098       3,577,457  

% Change

      3.9 %        4.8 %   

Revenue per Equivalent Admission

    $ 17,672     $ 16,533     $ 17,080     $ 16,637  

% Change

      6.9 %        2.7 %   

Inpatient Revenue per Admission

    $ 19,025     $ 17,530     $ 18,210     $ 17,313  

% Change

      8.5 %        5.2 %   

Inpatient Surgery Cases

      132,056       130,804       528,085       517,898  

% Change

      1.0 %        2.0 %   

Outpatient Surgery Cases

      263,398       261,685       1,026,639       1,002,076  

% Change

      0.7 %        2.5 %   

Emergency Room Visits

      2,445,405       2,395,650       9,328,741       8,907,055  

% Change

      2.1 %        4.7 %   

 

*

Excludes freestanding endoscopy centers (24 centers at December 31, 2023 and 21 centers at December 31, 2022).

**

Reflects the rate of occupancy (patient days and observations) based on weighted average beds in service.

 

10

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

Operating Results Summary

(Dollars in millions, except per share amounts)

 

             For the Years
     Fourth Quarter   Ended December 31,
     2023   2022   2023    2022
Revenues      $17,303       $15,497       $64,968        $60,233  

Net income attributable to HCA Healthcare, Inc.

      $1,607       $2,081       $5,242        $5,643  

Losses (gains) on sales of facilities (net of tax)

      (9 )      (755 )      12        (727 ) 

Losses on retirement of debt (net of tax)

      -       -       -        60  
  

 

 

 

  

 

 

 

  

 

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities
and losses on retirement of debt (a)

      1,598       1,326       5,254        4,976  

Depreciation and amortization

      789       750       3,077        2,969  

Interest expense

      491       453       1,938        1,741  

Provision for income taxes

      486       422       1,608        1,527  

Net income attributable to noncontrolling interests (b)

      254       228       849        854  
  

 

 

 

  

 

 

 

  

 

 

 

   

 

 

 

Adjusted EBITDA (a)

      $3,618       $3,179       $12,726        $12,067  
  

 

 

 

  

 

 

 

  

 

 

 

   

 

 

 

Adjusted EBITDA margin (a)

      20.9%       20.5%       19.6%        20.0%  
Diluted earnings per share:          

Net income attributable to HCA Healthcare, Inc.

      $5.93       $7.28       $18.97        $19.15  

Losses (gains) on sales of facilities

      (0.03 )      (2.64 )      0.04        (2.46 ) 

Losses on retirement of debt

      -       -       -        0.20  
  

 

 

 

  

 

 

 

  

 

 

 

   

 

 

 

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities
and losses on retirement of debt (a)

      $5.90       $4.64       $19.01        $16.89  
  

 

 

 

  

 

 

 

  

 

 

 

   

 

 

 

Shares used in computing diluted earnings per share (millions)

      271.186       285.663       276.412        294.666  

 

 

(a)

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles (“GAAP”). We believe net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that losses (gains) on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

 

(b)

The 2022 amounts are net of noncontrolling interests related to gains on sales of facilities.

 

11

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

2024 Operating Results Forecast

(Dollars in millions, except per share amounts)

 

     For the Year Ending
      December 31, 2024 
    

Low

   

High

Revenues

      $67,750        $70,250  

Net income attributable to HCA Healthcare, Inc. (a)

      $5,200        $5,600  

Depreciation and amortization

      3,200        3,270  

Interest expense

      1,985        2,040  

Provision for income taxes

      1,615        1,740  

Net income attributable to noncontrolling interests

      850        900  
  

 

 

 

   

 

 

 

Adjusted EBITDA (a) (b)

      $12,850        $13,550  
  

 

 

 

   

 

 

 

Diluted earnings per share:

      

Net income attributable to HCA Healthcare, Inc.

      $19.70        $21.20  

Shares used in computing diluted earnings per share (millions)

      264.000        264.000  

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

 

 

 

(a)

The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets because the Company does not believe that it can forecast these items with sufficient accuracy.

 

(b)

Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles (“GAAP”). We believe Adjusted EBITDA is an important measure that supplements discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon Adjusted EBITDA as a primary measure to review and assess operating performance of its health care facilities and their management teams.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA is utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry.

Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

 

12

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Document and Entity Information
Jan. 24, 2024
Cover [Abstract]  
Amendment Flag false
Entity Central Index Key 0000860730
Document Type 8-K
Document Period End Date Jan. 24, 2024
Entity Registrant Name HCA Healthcare, Inc.
Entity Incorporation State Country Code DE
Entity File Number 001-11239
Entity Tax Identification Number 27-3865930
Entity Address, Address Line One One Park Plaza
Entity Address, City or Town Nashville
Entity Address, State or Province TN
Entity Address, Postal Zip Code 37203
City Area Code (615)
Local Phone Number 344-9551
Written Communications false
Soliciting Material false
Pre Commencement Tender Offer false
Pre Commencement Issuer Tender Offer false
Security 12b Title Common Stock, $.01 par value per share
Trading Symbol HCA
Security Exchange Name NYSE
Entity Emerging Growth Company false
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