EX-99.1 2 thc-20241231ex991earningsr.htm EX-99.1 Document

Exhibit 99.1
tenethealthrgba.jpg

Tenet Reports Strong Fourth Quarter and FY 2024 Results;
Provides 2025 Financial Outlook
•Net income available to common shareholders in fourth quarter 2024 was $318 million, or $3.32 per diluted share

•Adjusted diluted earnings per share1 was $3.44 in fourth quarter 2024

•Consolidated Adjusted EBITDA1 in fourth quarter 2024 was $1.048 billion, which represents an Adjusted EBITDA margin of 20.7%

•Fourth quarter 2024 Ambulatory Care Adjusted EBITDA of $530 million increased 14.2% over fourth quarter 2023

•FY 2025 Adjusted EBITDA Outlook is expected to be in the range of $3.975 billion to $4.175 billion



DALLAS — February 12, 2025 — Tenet Healthcare Corporation (Tenet) (NYSE: THC) today announced its results for the quarter ended December 31, 2024.

"2024 was an outstanding year for Tenet characterized by robust revenue growth, efficient operations, high levels of patient satisfaction and clinical quality, and a portfolio transformation that drove substantial balance sheet deleveraging," said Saum Sutaria, M.D., Chairman and Chief Executive Officer of Tenet. "Our focused strategy, disciplined operating management, and the strong demand for acute care and ambulatory surgical services provide us with momentum as we begin the year and confidence to achieve our full year 2025 expectations."








Page 1

Tenet’s results for fourth quarter 2024 versus fourth quarter 2023 are as follows:

Three Months Ended December 31,Years Ended December 31,
($ in millions, except per share results)2024202320242023
Net operating revenues
$5,072
$5,379
$20,665
$20,548
Net income available to Tenet common shareholders
$318
$244
$3,200
$611
Net income available to Tenet common shareholders per diluted share
$3.32
$2.30
$32.70
$5.71
Adjusted EBITDA1
$1,048
$1,012
$3,995
$3,541
Adjusted diluted earnings per share1
$3.44$2.68$11.88$6.98

•Net operating revenues in fourth quarter 2024 were $5.072 billion, versus $5.379 billion in fourth quarter 2023, reflecting the impact of the divestiture of fourteen hospitals in 2024, partially offset by strong same facility revenue growth, favorable payer mix, and acquisitions of ambulatory surgical centers.

•Net income available to the Company’s common shareholders in the fourth quarter 2024 was $318 million, or $3.32 per diluted share, versus $244 million, or $2.30 per diluted share, in fourth quarter 2023.

•Net income available to the Company's common shareholders in 2024 was $3.2 billion, or $32.70 per diluted share, versus $611 million, or $5.71 in 2023. 2024 results included a pre-tax gain of $2.916 billion ($2.143 billion after-tax, or $21.89 per diluted share) primarily associated with the hospital divestitures.

•Adjusted EBITDA1 in fourth quarter 2024 was $1.048 billion compared to $1.012 billion in fourth quarter 2023, reflecting strong same-hospital admissions growth, strong ambulatory net revenue per case growth, favorable payer mix, and increased Medicaid supplemental revenues in Michigan, partially offset by the impact of hospital divestitures. Fourth quarter 2023 results included $52 million of revenue associated with Medicaid supplemental revenue program adjustments in California and Texas.



Page 2

Balance Sheet and Cash Flows

•Cash flows provided by operating activities for the year ended December 31, 2024 were $2.047 billion versus $2.374 billion for the year ended December 31, 2023. Cash flows provided by operating activities for the year ended December 31, 2024 included $855 million of income taxes paid associated with gains on sale of hospitals and related operations.

•The Company produced free cash flow1 of $1.116 billion for the year ended December 31, 2024 versus $1.623 billion for the year ended December 31, 2023.

•In the year ended December 31, 2024, the Company repurchased 5,596,573 shares of common stock for $672 million.

•The Company’s ratio of net debt to Adjusted EBITDA1 was 2.54x at December 31, 2024 compared to 3.89x at December 31, 2023.








Page 3

Ambulatory Care (Ambulatory) Segment

Tenet’s Ambulatory business segment is comprised of the operations of United Surgical Partners International (USPI). As of December 31, 2024, USPI had interests in 518 ambulatory surgery centers (375 consolidated) and 25 surgical hospitals (seven consolidated) in 37 states.

Three Months Ended December 31,Years Ended December 31,
Ambulatory segment results ($ in millions)2024202320242023
Revenues
Net operating revenues$1,259$1,077
$4,534
$3,865
Same-facility system-wide net patient service revenues2
$2,183$2,010$7,664$7,109
Volume Changes versus the Prior-Year Period
Same-facility system-wide surgical cases2
0.1 %3.9 %0.3 %5.6 %
Same-facility system-wide surgical cases on same-business day basis2
(1.5)%3.9 %(0.5)%6.0 %
Adjusted EBITDA, Margins and NCI
Adjusted EBITDA
$530
$464
$1,810
$1,544
Adjusted EBITDA margin
42.1%
43.1%
39.9%
39.9%
Adjusted EBITDA less NCI
$317
$280
$1,096
$958

•Fourth quarter 2024 net operating revenues increased 16.9% compared to fourth quarter 2023 driven by strong net revenue per case growth, acquisitions of facilities, and increased service lines.

•Surgical business same-facility system-wide net patient service revenues increased 8.6% in fourth quarter 2024 compared to fourth quarter 2023, with cases up 0.1% and net revenue per case up 8.5%. Net revenue per case growth was driven by higher acuity associated with favorable case mix as well as favorable payer mix.

•Fourth quarter 2024 Adjusted EBITDA increased 14.2% compared to fourth quarter 2023, due to strong net revenue per case growth, disciplined expense management, and contributions from acquisitions.






Page 4

Hospital Operations and Services (Hospital) Segment
Tenet’s Hospital business segment is primarily comprised of acute care and specialty hospitals, imaging centers, ancillary outpatient facilities, micro-hospitals and physician practices. It also provides comprehensive end-to-end and focused point services, including hospital and physician revenue cycle management, patient communications and engagement support and value-based care solutions.

Three Months Ended December 31,Years Ended December 31,
Hospital segment results ($ in millions)
2024202320242023
Revenues
Net operating revenues
$3,813$4,302
$16,131
$16,683
Same-hospital net patient service revenues3
$3,218
$3,104
$12,829
$11,968
Same-Hospital Volume Changes versus the Prior-Year Period
Admissions
5.0%
1.0%
4.7%
2.2%
Adjusted admissions4
3.1%
0.1%
2.5%
2.5%
Outpatient visits (including outpatient ER visits)
0.4%
(2.2)%
0.3%
(1.3)%
Emergency Room visits (inpatient and outpatient)
(2.4)%
(3.3)%
0.9%
0.1%
Hospital surgeries
0.2%
0.8%
0.6%
0.6%
Adjusted EBITDA
Adjusted EBITDA
$518
$548
$2,185
$1,997
Adjusted EBITDA margin
13.6%
12.7%
13.5%
12.0%

•Fourth quarter 2024 net operating revenues declined 11.4% from fourth quarter 2023 primarily due to the impact of hospital divestitures in 2024, partially offset by strong same hospital admissions growth, favorable payer mix, and improved pricing yield.

•Same-hospital net patient service revenue per adjusted admission increased 0.6% year-over-year for fourth quarter 2024 primarily due to improved pricing yield, favorable payer mix, and our focus on growing higher acuity services, partially offset by net unfavorable Medicaid supplemental revenue program adjustments relative to fourth quarter 2023.

•Adjusted EBITDA in fourth quarter 2024 was $518 million compared to $548 million in fourth quarter 2023, reflecting strong same-hospital admissions growth and revenue per adjusted admission, favorable payer mix, and increased supplemental revenues in Michigan, offset by the impact of hospital divestitures and the favorable Medicaid supplemental revenue program adjustments of $52 million in fourth quarter 2023.




Page 5

2025 Outlook1

Tenet’s Outlook for full year 2025 (consolidated and by segment) follows.

CONSOLIDATED ($ in millions, except per share amounts)
FY 2025 Outlook
Net operating revenues
$20,600 to $21,000
Net income available to Tenet common stockholders
$1,040 to $1,185
Adjusted EBITDA
$3,975 to $4,175
Adjusted EBITDA margin
19.3% to 19.9%
Diluted income per common share
$10.95 to $12.47
Adjusted net income
$1,115 to $1,220
Adjusted diluted earnings per share
$11.74 to $12.84
Equity in earnings of unconsolidated affiliates$265 to $275
Depreciation and amortization
$805 to $835
Interest expense
$795 to $805
Income tax expense5
$420 to $465
Net income available to NCI
$910 to $960
Weighted average diluted common shares
~95 million
Net cash provided by operating activities
$2,500 to $2,850
Adjusted net cash provided by operating activities
$2,600 to $2,900
Capital expenditures
$700 to $800
Free cash flow
$1,800 to $2,050
Adjusted free cash flow
$1,900 to $2,100
NCI cash distributions$750 to $800
















Page 6

Ambulatory Segment ($ in millions)
FY 2025 Outlook
Net operating revenues$4,850 to $5,000
Adjusted EBITDA$1,915 to $1,985
NCI$760 to $790
Adjusted EBITDA less NCI$1,155 to $1,195
Changes versus prior year6:
Same-facility system-wide revenueUp 3.0% to 6.0%

Hospital Segment ($ in millions)
FY 2025 Outlook
Net operating revenues$15,750 to $16,000
Adjusted EBITDA$2,060 to $2,190
NCI$150 to $170
Changes versus prior year6:
Inpatient admissionsUp 2.0% to 3.0%
Adjusted admissionsUp 2.0% to 3.0%




Management’s Webcast Discussion of Results
Tenet management will discuss the Company’s fourth quarter 2024 results in a webcast scheduled for 10:00 a.m. Eastern Time (9:00 a.m. Central Time) on February 12, 2025. Investors can access the webcast through the Company’s website at www.tenethealth.com/investors.

The slide presentation associated with the webcast referenced above, a copy of this earnings press release, and a related supplemental financial disclosures document will be available on the Company’s Investor Relations website on February 12, 2025.



Page 7

Cautionary Statement
This release contains “forward-looking statements” - that is, statements that relate to future, not past, events. In this context, forward-looking statements often address the Company’s expected future business and financial performance and financial condition, and often contain words such as “expect,” “anticipate,” “assume,” “believe,” “budget,” “estimate,” “forecast,” “intend,” “plan,” “predict,” “project,” “seek,” “see,” “target,” or “will.” Forward-looking statements by their nature address matters that are, to different degrees, uncertain. Particular uncertainties that could cause the Company’s actual results to be materially different than those expressed in the Company’s forward-looking statements include, but are not limited to the factors disclosed under “Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the year ended December 31, 2023 and other filings with the Securities and Exchange Commission.

Footnotes
1.Tables and discussions throughout this earnings release include certain financial measures, including those related to our first quarter and full year 2025 Outlook, that are not in accordance with accounting principles generally accepted in the United States of America (GAAP). Reconciliations of GAAP measures to the Adjusted (non-GAAP) measures used are detailed in Tables #1-6 included at the end of this earnings release. Management’s reasoning for the use of these non-GAAP measures and descriptions of the various non-GAAP measures are included in the Non-GAAP Financial Measures section of this earnings release.
2.Same-facility system-wide revenues and statistical information include the results of the facilities in which the Ambulatory segment has an investment that are not consolidated by Tenet. To help analyze the segment’s results of operations, management uses system-wide measures, which include revenues and cases of both consolidated and unconsolidated facilities.
3.For 2024, same-hospital revenues and statistical data include those for hospitals and hospital-affiliated outpatient centers operated by the Company’s Hospital segment continuously from January 1, 2023 through December 31, 2024. Amounts associated with physician practices are excluded.
4.Adjusted admissions represent actual patient admissions adjusted to include outpatient services provided by facilities in our Hospital segment by multiplying actual patient admissions by the sum of gross inpatient revenues and outpatient revenues, then dividing that result by gross inpatient revenues.
5.Income tax expense is calculated by multiplying 24% (the federal corporate tax rate of 21% plus an estimate of state taxes) by the sum of: pretax income less GAAP facility level NCI expense plus permanent differences, and non-deductible interest expense.
6.Change versus prior year is presented on a same-facility system-wide basis for USPI Ambulatory surgical cases and on a same-hospital basis for hospital statistics.



Page 8

About Tenet Healthcare
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates ambulatory surgery centers and surgical hospitals. We also operate a national portfolio of acute care and specialty hospitals, other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve. For more information, please visit www.tenethealth.com.

Contact Information
Investor ContactMedia Contact
Will McDowellRobert Dyer
469-893-2387469-893-2640
william.mcdowell@tenethealth.com
mediarelations@tenethealth.com



Page 9

Non-GAAP Financial Measures
The Company believes the non-GAAP measures described below are useful to investors and analysts because they present additional information on the Company’s financial performance. Investors, analysts, Company management and the Company’s Board of Directors utilize these non-GAAP measures, in addition to GAAP measures, to track the Company’s financial and operating performance and compare the Company’s performance to its peer companies, which use similar non-GAAP financial measures in their presentations and earnings releases. The Human Resources Committee of the Company’s Board of Directors also uses certain of these measures to evaluate management’s performance for the purpose of determining incentive compensation. Additional information regarding the purpose and utility of specific non-GAAP measures used in this release is set forth below.
•Adjusted EBITDA is defined by the Company as net income available (loss attributable) to Tenet common shareholders before (1) the cumulative effect of changes in accounting principles, (2) net loss attributable (income available) to noncontrolling interests, (3) income (loss) from discontinued operations, net of tax, (4) income tax benefit (expense), (5) gain (loss) from early extinguishment of debt, (6) other non-operating income (expense), net, (7) interest expense, (8) litigation and investigation benefit (costs), net of insurance recoveries, (9) net gains (losses) on sales, consolidation and deconsolidation of facilities, (10) impairment and restructuring charges and acquisition-related costs, (11) depreciation and amortization and (12) income (loss) from divested and closed businesses (i.e., health plan businesses). Litigation and investigation costs excluded do not include ordinary course of business malpractice and other litigation and related expenses.
•Adjusted diluted earnings (loss) per share is defined by the Company as Adjusted net income available (loss attributable) to Tenet common shareholders, divided by the weighted average diluted shares outstanding in the reporting period.
•Adjusted net income available (loss attributable) to Tenet common shareholders is defined by the Company as net income available (loss attributable) to Tenet common shareholders before (1) income (loss) from discontinued operations, net of tax, (2) gain (loss) from early extinguishment of debt, (3) litigation and investigation benefit (costs), net of insurance recoveries, (4) net gains (losses) on sales, consolidation and deconsolidation of facilities, (5) impairment and restructuring charges and acquisition-related costs, (6) income (loss) from divested and closed businesses (i.e., health plan businesses) and (7) the associated impact of these items on taxes and noncontrolling interests. Litigation and investigation costs excluded do not include ordinary course of business malpractice and other litigation and related expenses.
•Free Cash Flow is defined by the Company as (1) net cash provided by (used in) operating activities, less (2) purchases of property and equipment.
•Adjusted Free Cash Flow is defined by the Company as (1) Adjusted net cash provided by (used in) operating activities, less (2) purchases of property and equipment.
•Adjusted net cash provided by (used in) operating activities is defined by the Company as cash provided by (used in) operating activities prior to (1) payments for restructuring charges, acquisition-related costs and litigation costs and settlements, and (2) net cash provided by (used in) operating activities from discontinued operations.
The Company believes that Adjusted EBITDA is a useful measure, in part, because certain investors and analysts use both historical and projected Adjusted EBITDA, in addition to other GAAP and non-GAAP measures, as factors in determining the estimated fair value of shares of the Company’s common stock. Company management also regularly reviews the Adjusted EBITDA performance for each operating segment. The Company does not use Adjusted EBITDA to measure liquidity, but instead to measure operating performance.
The Company uses, and believes investors use, Free Cash Flow and Adjusted Free Cash Flow as supplemental non-GAAP measures to analyze cash flows generated from the Company’s operations. The Company believes these measures are useful to investors in evaluating its ability to fund distributions paid to noncontrolling interests or for acquisitions, purchasing equity interests in joint ventures or repaying debt.
These non-GAAP measures may not be comparable to similarly titled measures reported by other companies. Because these measures exclude many items that are included in the Company’s financial statements, they do not provide a complete measure of the Company’s operating performance. For example, the Company’s definitions of Free Cash Flow and Adjusted Free Cash Flow do not include other important uses of cash including (1) cash used to purchase businesses or joint venture interests, or (2) any items that are classified as Cash Flows from Financing Activities on the Company’s Consolidated Statement of Cash Flows, including items such as (i) cash used to repay borrowings, or (ii) distributions paid to noncontrolling interests. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance.
See corresponding reconciliations of the non-GAAP financial measures referred to above to the most comparable GAAP financial measures in Tables #1 - 6 below.


Page 10

Tenet Healthcare Corporation
Financial Statements and Reconciliations
Fourth Quarter Earnings Release
Table of Contents

Page 11


    
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(Dollars in millions, except per share amounts)Three Months Ended December 31,
2024%2023%Change
Net operating revenues$5,072 100.0 %$5,379 100.0 %(5.7)%
Grant income1 — %2 — %(50.0)%
Equity in earnings of unconsolidated affiliates78 1.5 %73 1.4 %6.8 %
Operating expenses:  
Salaries, wages and benefits2,094 41.3 %2,315 43.0 %(9.5)%
Supplies930 18.3 %931 17.3 %(0.1)%
Other operating expenses, net1,079 21.3 %1,196 22.2 %(9.8)%
Depreciation and amortization193 3.8 %216 4.0 %
Impairment and restructuring charges, and acquisition-related costs27 0.5 %53 1.0 %
Litigation and investigation costs17 0.3 %19 0.4 %
Net gains on sales, consolidation and deconsolidation of facilities(10)(0.2)%(11)(0.2)%
Operating income821 16.2 %735 13.7 %
Interest expense(203)(227)
Other non-operating income, net37 11 
Income before income taxes655 519 
Income tax expense(83)(63)
Net income572 456 
Less: Net income available to noncontrolling interests254 212 
Net income available to Tenet Healthcare Corporation common shareholders$318 $244 
Earnings per share available to Tenet Healthcare Corporation common shareholders:
Basic$3.34 $2.42 
Diluted$3.32 $2.30 
Weighted average shares and dilutive securities outstanding (in thousands):
Basic95,102 100,956
Diluted95,882 104,167


Page 12

    
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(Dollars in millions, except per share amounts)Years Ended December 31,
2024%2023%Change
Net operating revenues$20,665 100.0 %$20,548 100.0 %0.6 %
Grant income10 — %16 0.1 %(37.5)%
Equity in earnings of unconsolidated affiliates260 1.3 %228 1.1 %14.0 %
Operating expenses:  
Salaries, wages and benefits8,801 42.6 %9,146 44.5 %(3.8)%
Supplies3,647 17.6 %3,590 17.5 %1.6 %
Other operating expenses, net4,492 21.7 %4,515 22.0 %(0.5)%
Depreciation and amortization818 4.0 %870 4.2 %
Impairment and restructuring charges, and acquisition-related costs102 0.5 %137 0.7 %
Litigation and investigation costs35 0.2 %47 0.2 %
Net gains on sales, consolidation and deconsolidation of facilities(2,916)(14.1)%(23)(0.1)%
Operating income5,956 28.8 %2,510 12.2 %
Interest expense(826)(901)
Other non-operating income, net126 19 
Loss from early extinguishment of debt(8)(11)
Income before income taxes5,248 1,617 
Income tax expense(1,184)(306)
Net income4,064 1,311 
Less: Net income available to noncontrolling interests864 700 
Net income available to Tenet Healthcare Corporation common shareholders$3,200 $611 
Earnings per share available to Tenet Healthcare Corporation common shareholders:
Basic$33.02 $6.01 
Diluted$32.70 $5.71 
Weighted average shares and dilutive securities outstanding (in thousands):
Basic96,904 101,639
Diluted97,881 104,800


Page 13

    
TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEETS
(Unaudited)
(Dollars in millions)December 31,December 31,
20242023
ASSETS
Current assets:
Cash and cash equivalents$3,019 $1,228 
Accounts receivable2,536 2,914 
Inventories of supplies, at cost346 411 
Assets held for sale21 775 
Other current assets1,760 1,839 
Total current assets
7,682 7,167 
Investments and other assets3,037 3,157 
Deferred income taxes80 77 
Property and equipment, at cost, less accumulated depreciation and amortization6,049 6,236 
Goodwill10,691 10,307 
Other intangible assets, at cost, less accumulated amortization1,397 1,368 
Total assets
$28,936 $28,312 
LIABILITIES AND EQUITY
Current liabilities:
Current portion of long-term debt$92 $120 
Accounts payable1,294 1,408 
Accrued compensation and benefits899 930 
Professional and general liability reserves238 254 
Accrued interest payable149 200 
Liabilities held for sale13 69 
Income tax payable18 23 
Other current liabilities1,607 1,756 
Total current liabilities
4,310 4,760 
Long-term debt, net of current portion13,081 14,882 
Professional and general liability reserves900 792 
Defined benefit plan obligations298 335 
Deferred income taxes227 326 
Other long-term liabilities1,573 1,709 
Total liabilities
20,389 22,804 
Commitments and contingencies
Redeemable noncontrolling interests in equity of consolidated subsidiaries2,727 2,391 
Equity:  
Shareholders’ equity:  
Common stock8 8 
Additional paid-in capital4,873 4,834 
Accumulated other comprehensive loss(180)(181)
Retained earnings (accumulated deficit)3,008 (192)
Common stock in treasury, at cost(3,538)(2,861)
Total shareholders’ equity4,171 1,608 
Noncontrolling interests
1,649 1,509 
Total equity 5,820 3,117 
Total liabilities and equity
$28,936 $28,312 






Page 14

    
TENET HEALTHCARE CORPORATION
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
(Dollars in millions)Years Ended
December 31,
20242023
Net income$4,064 $1,311 
Adjustments to reconcile net income to net cash provided by operating activities:  
Depreciation and amortization818 870 
Deferred income tax expense (benefit)(103)52 
Stock-based compensation expense67 66 
Impairment and restructuring charges, and acquisition-related costs102 137 
Litigation and investigation costs35 47 
Net gains on sales, consolidation and deconsolidation of facilities(2,916)(23)
Loss from early extinguishment of debt8 11 
Equity in earnings of unconsolidated affiliates, net of distributions received(29)(13)
Amortization of debt discount and debt issuance costs26 32 
Net gains from the sale of investments and long-lived assets(4)(29)
Other items, net(4)(4)
Changes in cash from operating assets and liabilities:  
Accounts receivable245 (29)
Inventories and other current assets(86)(139)
Income taxes16 10 
Accounts payable, accrued expenses and other current liabilities(30)215 
Other long-term liabilities(9)14 
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements(153)(154)
Net cash provided by operating activities2,047 2,374 
Cash flows from investing activities:  
Purchases of property and equipment(931)(751)
Purchases of businesses or joint venture interests, net of cash acquired(571)(224)
Proceeds from sales of facilities and other assets4,981 71 
Proceeds from sales of marketable securities and long-term investments63 50 
Purchases of marketable securities and long-term investments(94)(104)
Other items, net(19)(11)
Net cash provided by (used in) investing activities3,429 (969)
Cash flows from financing activities:  
Repayments of borrowings(2,243)(1,542)
Proceeds from borrowings23 1,370 
Repurchases of common stock(672)(200)
Debt issuance costs— (16)
Distributions paid to noncontrolling interests(681)(594)
Proceeds from the sale of noncontrolling interests23 43 
Purchases of noncontrolling interests(200)(167)
Advances from managed care payers342 — 
Repayments of advances from managed care payers(310)— 
Other items, net33 71 
Net cash used in financing activities(3,685)(1,035)
Net increase in cash and cash equivalents1,791 370 
Cash and cash equivalents at beginning of period1,228 858 
Cash and cash equivalents at end of period$3,019 $1,228 
Supplemental disclosures:  
Interest paid, net of capitalized interest$(851)$(882)
Income tax payments, net$(1,271)$(243)


Page 15

    
TENET HEALTHCARE CORPORATION
SEGMENT REPORTING
(Unaudited)
Three Months EndedYears Ended
December 31,December 31,
(Dollars in millions)2024202320242023
Net operating revenues:     
Ambulatory Care$1,259 $1,077 $4,534 $3,865 
Hospital Operations and Services3,813 4,302 16,131 16,683 
Total$5,072 $5,379 $20,665 $20,548 
Equity in earnings of unconsolidated affiliates:    
Ambulatory Care$75 $69 $250 $218 
Hospital Operations and Services3 4 10 10 
Total$78 $73 $260 $228 
Adjusted EBITDA:    
Ambulatory Care$530 $464 $1,810 $1,544 
Hospital Operations and Services518 548 2,185 1,997 
Total$1,048 $1,012 $3,995 $3,541 
Adjusted EBITDA margins:
Ambulatory Care42.1 %43.1 %39.9 %39.9 %
Hospital Operations and Services13.6 %12.7 %13.5 %12.0 %
Total20.7 %18.8 %19.3 %17.2 %
Capital expenditures:
Ambulatory Care$21 $22 $86 $80 
Hospital Operations and Services309 186 845 671 
Total$330 $208 $931 $751 


Page 16

    
TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #1 – Reconciliations of Net Income Available to Tenet Healthcare Corporation Common Shareholders to Adjusted Net Income Available to Common Shareholders
(Unaudited)
Three Months EndedYears Ended
December 31,December 31,
(Dollars in millions, except per share amounts)2024202320242023
Net income available to Tenet Healthcare Corporation common shareholders$318 $244 $3,200 $611 
Less:
Impairment and restructuring charges, and acquisition-related costs
  (27)(53)(102)(137)
Litigation and investigation costs(17)(19)(35)(47)
Net gains on sales, consolidation and deconsolidation of facilities10 11 2,916 23 
Loss from early extinguishment of debt— — (8)(11)
Tax and noncontrolling interests impact of above items 22 22 (733)39 
Adjusted net income available to common shareholders$330 $283 $1,162 $744 
Diluted earnings per share$3.32 $2.30 $32.70 $5.71 
Less:
Impairment and restructuring charges, and acquisition-related costs
(0.28)(0.51)(1.04)(1.31)
Litigation and investigation costs(0.18)(0.18)(0.36)(0.45)
Net gains on sales, consolidation and deconsolidation of facilities0.11 0.10 29.79 0.22 
Loss from early extinguishment of debt— — (0.08)(0.10)
Tax and noncontrolling interests impact of above items0.23 0.21 (7.49)0.37 
Adjusted diluted earnings per share$3.44 $2.68 $11.88 $6.98 
Weighted average basic shares outstanding (in thousands)95,102 100,956 96,904 101,639 
Weighted average dilutive shares outstanding (in thousands)95,882 104,167 97,881 104,800 


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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #2 – Reconciliations of Net Income Available to Tenet Healthcare Corporation Common Shareholders to Adjusted EBITDA
(Unaudited)
Three Months EndedYears Ended
December 31,December 31,
(Dollars in millions)2024202320242023
Net income available to Tenet Healthcare Corporation common shareholders$318 $244 $3,200 $611 
Less:
Net income available to noncontrolling interests(254)(212)(864)(700)
Net income572 456 4,064 1,311 
Income tax expense(83)(63)(1,184)(306)
Loss from early extinguishment of debt— — (8)(11)
Other non-operating income, net37 11 126 19 
Interest expense(203)(227)(826)(901)
Operating income821 735 5,956 2,510 
Litigation and investigation costs(17)(19)(35)(47)
Net gains on sales, consolidation and deconsolidation of facilities10 11 2,916 23 
Impairment and restructuring charges, and acquisition-related costs(27)(53)(102)(137)
Depreciation and amortization(193)(216)(818)(870)
Adjusted EBITDA$1,048 $1,012 $3,995 $3,541 
Net operating revenues$5,072 $5,379 $20,665 $20,548 
Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues6.3 %4.5 %15.5 %3.0 %
Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin)20.7 %18.8 %19.3 %17.2 %



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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #3 – Reconciliations of Net Cash Provided by (Used in) Operating Activities to
Free Cash Flow and Adjusted Free Cash Flow
(Unaudited)
2024
(Dollars in millions)Q4YTD
Net cash provided by (used in) operating activities$(331)$2,047 
Purchases of property and equipment(330)(931)
Free cash flow$(661)$1,116 
Net cash provided by (used in) investing activities$(372)$3,429 
Net cash used in financing activities$(372)$(3,685)
Net cash provided by (used in) operating activities$(331)$2,047 
Less:
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements(34)(153)
Adjusted net cash provided by (used in) operating activities(297)2,200 
Purchases of property and equipment(330)(931)
Adjusted free cash flow$(627)$1,269 
2023
(Dollars in millions)Q4YTD
Net cash provided by operating activities$824 $2,374 
Purchases of property and equipment(208)(751)
Free cash flow$616 $1,623 
Net cash used in investing activities$(333)$(969)
Net cash used in financing activities$(317)$(1,035)
Net cash provided by operating activities$824 $2,374 
Less:
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements(49)(154)
Adjusted net cash provided by operating activities873 2,528 
Purchases of property and equipment(208)(751)
Adjusted free cash flow$665 $1,777 


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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #4 – Reconciliations of Outlook Net Income Available to Tenet Healthcare Corporation Common Shareholders to Outlook Adjusted Net Income Available to Common Shareholders
(Unaudited)
FY 2025
(Dollars in millions, except per share amounts)LowHigh
Net income available to Tenet Healthcare Corporation common shareholders$1,040 $1,185 
Less:
Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1)
(100)(50)
Tax and noncontrolling interests impact of above items25 15 
Adjusted net income available to common shareholders$1,115 $1,220 
Diluted earnings per share$10.95 $12.47 
Less:
Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements
(1.05)(0.53)
Tax and noncontrolling interests impact of above items0.26 0.16 
Adjusted diluted earnings per share$11.74 $12.84 
Weighted average basic shares outstanding (in thousands)94,000 94,000 
Weighted average dilutive shares outstanding (in thousands)95,000 95,000 
(1) The figures shown represent the Company's estimate for restructuring charges. The Company does not generally forecast impairment charges, acquisition-related costs, and litigation costs and settlements because it does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook.
    






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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #5 – Reconciliations of Outlook Net Income Available to Tenet Healthcare Corporation Common Shareholders to Outlook Adjusted EBITDA
(Unaudited)
FY 2025
(Dollars in millions)LowHigh
Net income available to Tenet Healthcare Corporation common shareholders$1,040 $1,185 
Less:
Net income available to noncontrolling interests(910)(960)
Income tax expense(420)(465)
Interest expense(805)(795)
Other non-operating income, net105 115 
Impairment and restructuring charges, acquisition-related costs, and litigation costs and settlements(1)
(100)(50)
Depreciation and amortization(805)(835)
Adjusted EBITDA$3,975 $4,175 
Net income available to Tenet Healthcare Corporation common shareholders$1,040 $1,185 
Net operating revenues$20,600 $21,000 
Net income available to Tenet Healthcare Corporation common shareholders as a % of net operating revenues5.0 %5.6 %
Adjusted EBITDA as a % of net operating revenues (Adjusted EBITDA margin)19.3 %19.9 %
(1) The figures shown represent the Company's estimate for restructuring charges. The Company does not generally forecast impairment charges, acquisition-related costs, and litigation costs and settlements because it does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook.



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TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP disclosures
Table #6 – Reconciliations of Outlook Net Cash Provided by Operating Activities
to Outlook Free Cash Flow and Outlook Adjusted Free Cash Flow
(Unaudited)
FY 2025
(Dollars in millions)LowHigh
Net cash provided by operating activities$2,500 $2,850 
Purchases of property and equipment(700)(800)
Free cash flow$1,800 $2,050 
Net cash provided by operating activities$2,500 $2,850 
Less:
Payments for restructuring charges, acquisition-related costs and litigation costs and settlements(1)
(100)(50)
Adjusted net cash provided by operating activities
2,600 2,900 
Purchases of property and equipment(700)(800)
Adjusted free cash flow(2)
$1,900 $2,100 
(1) The figures shown represent the Company's estimate for restructuring payments. The Company does not generally forecast payments for acquisition-related costs, and litigation costs and settlements because it does not believe that it can forecast these items with sufficient accuracy since some of these items are indeterminable at the time the Company provides its financial Outlook.
(2) The Company’s definition of Adjusted Free Cash Flow does not include other important uses of cash including (1) cash used to purchase businesses or joint venture interests, or (2) any items that are classified as Cash Flows From Financing Activities on the Company’s Consolidated Statement of Cash Flows, including items such as (i) cash used to repay borrowings, and (ii) distributions paid to noncontrolling interests.


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