UHS Universal Health Services

Consolidated Results of Operations, As Reported and As Adjusted  – Three-month periods ended June 30, 2022 and 2021:

KING OF PRUSSIA, Pa., July 25, 2022 /PRNewswire/ -- Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was $164.1 million, or $2.20 per diluted share, during the second quarter of 2022, as compared to $325.0 million, or $3.79 per diluted share, during the second quarter of 2021. Net revenues increased by 3.9% to $3.323 billion during the second quarter of 2022 as compared to $3.198 billion during the second quarter of 2021.

As reflected on the Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule"), our adjusted net income attributable to UHS during the second quarter of 2022 was $163.9 million, or $2.20 per diluted share, as compared to $322.3 million, or $3.76 per diluted share, during the second quarter of 2021. 

Included in our reported and adjusted net income attributable to UHS during the three and six-month periods ended June 30, 2021 was a net favorable after-tax impact of approximately $29.8 million, or $.35 per diluted share, from the following: (i) a favorable after-tax impact of $42.3 million, or $.49 per diluted share, resulting from approximately $55 million of revenues recorded during the second quarter of 2021 in connection with the Kentucky Medicaid managed care hospital rate increase program (covering the period of July 1, 2020 to June 30, 2021); (ii) an unfavorable after-tax impact of approximately $27.2 million, or $.32 per diluted share, resulting from a $36 million increase to our reserves for self-insured professional and general liability claims, and; (iii) an aggregate favorable after-tax impact of $14.6 million, or $.17 per diluted share, resulting from commercial insurance proceeds of approximately $19 million received during the second quarter of 2021 in connection with a previously incurred information technology incident and the COVID-19 pandemic.     

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 $384.5 million during the second quarter of 2022, as compared to $581.8 million during the second quarter of 2021. Our adjusted earnings before interest, taxes, depreciation & amortization ("Adjusted EBITDA net of NCI"), which excludes the impact of other (income) expense, net, was $382.6 million during the second quarter of 2022, as compared to $572.7 million during the second quarter of 2021.

Consolidated Results of Operations, As Reported and As Adjusted  – Six-month periods ended June 30, 2022 and 2021:

Reported net income attributable to UHS was $318.0 million, or $4.22 per diluted share, during the first six months 2022, as compared to $534.1 million, or $6.22 per diluted share, during the first six months of 2021. Net revenues increased by 6.5% to $6.616 billion during the first six months of 2022 as compared to $6.211 billion during the comparable period of 2021.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the six-month period ended June 30, 2022 was $327.4 million, or $4.35 per diluted share, as compared to $532.4 million, or $6.20 per diluted share, during the six-month period ended June 30, 2021. 

As reflected on the Supplemental Schedule, included in our reported results during the first six months of 2022, was an unfavorable after-tax unrealized loss of $9.4 million, or $.13 per diluted share, ($12.3 million pre-tax which is included in "Other (income) expense, net"), resulting from a decrease in the market value of certain equity securities. 

As reflected on the Supplemental Schedule, included in our reported results during the six-month period ended June 30, 2021, was a net aggregate favorable after-tax impact of $1.7 million, or $.02 per diluted share, consisting of the following: (i) an after-tax unrealized loss of $0.5 million, or $.01 per diluted share, resulting from a decrease in the market value of certain marketable securities, and; (ii) a favorable after-tax impact of $2.2 million, or $.03 per diluted share, resulting from ASU 2016-09, "Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting" ("ASU 2016-09").

As calculated on the attached Supplemental Schedule, our EBITDA net of NCI was $752.9 million during the first six months of 2022, as compared to $1.008 billion during the first six months of 2021. Our Adjusted EBITDA net of NCI was $762.1 million during the first six months of 2022, as compared to $999.8 million during the first six months of 2021.

Acute Care Services – Three and six-month periods ended June 30, 2022 and 2021:

During the second quarter of 2022, at our acute care hospitals owned during both periods ("same facility basis"), adjusted admissions (adjusted for outpatient activity) decreased by 0.7% while adjusted patient days increased by 1.8%, as compared to the second quarter of 2021. At these facilities, during the second quarter of 2022, net revenue per adjusted admission increased by 2.5% while net revenue per adjusted patient day remained unchanged, as compared to the second quarter of 2021. Net revenues generated from our acute care services on a same facility basis increased by 3.3% during the second quarter of 2022, as compared to the second quarter of 2021. 

As previously disclosed in our update on operating results for the second quarter of 2022 and revision of 2022 full year guidance, as announced on June 30, 2022, our acute care hospitals experienced a significant decline in COVID-related patients during the second quarter of 2022, as compared to the first quarter of 2022. The decrease in COVID-related patient volumes during the second quarter of 2022 was not offset by an equivalent increase in non-COVID-related patients resulting in significant shortfalls in revenues and earnings as compared to our original forecasts the quarter. Although the decreased patient volumes at our acute care hospitals has relieved some of the staffing shortages and related cost escalations previously experienced at those facilities, recovery from the effects of the labor pressures has been occurring at a somewhat slower pace than expected. 

During the six-month period ended June 30, 2022, at our acute care hospitals on a same facility basis, adjusted admissions increased by 2.4% while adjusted patient days increased by 3.6%, as compared to the comparable six-month period of 2021. At these facilities, during the first six months of 2022, net revenue per adjusted admission increased by 2.9% while net revenue per adjusted patient day increased by 1.6%, as compared to the comparable six-month period of 2021. Net revenues generated from our acute care services on a same facility basis increased by 6.5% during the first six months of 2022, as compared to the comparable six-month period of 2021. 

Behavioral Health Care Services – Three and six-month periods ended June 30, 2022 and 2021:

During the second quarter of 2022, at behavioral health care facilities on a same facility basis, adjusted admissions decreased by 0.1% while adjusted patient days increased by 0.7%, as compared to the second quarter of 2021. At these facilities, during the second quarter of 2022, net revenue per adjusted admission increased by 2.6% and net revenue per adjusted patient day increased by 1.8%, as compared to the second quarter of 2021.  Net revenues generated from our behavioral health care services increased by 0.5% during the second quarter of 2022, as compared to the second quarter of 2021.

During the six-month period ended June 30, 2022, at behavioral health care facilities on a same facility basis, adjusted admissions decreased by 1.0% while adjusted patient days decreased by 0.3%, as compared to the comparable six-month period of 2021. At these facilities, during the first six months of 2022, net revenue per adjusted admission increased by 4.2% and net revenue per adjusted patient day increased by 3.4%, as compared to the comparable six-month period of 2021. Net revenues generated from our behavioral health care services increased by 2.1% during the first six months of 2022, as compared to the comparable period of 2021.

COVID-19 and Staffing Shortage

The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material effect on our operations and financial results since that time. The length and extent of the disruptions caused by the COVID‑19 pandemic are currently unknown; however, we expect such disruptions to continue during the remainder of 2022. Since the future volumes and severity of COVID-19 patients remain highly uncertain and subject to change, including potential increases in future COVID-19 patient volumes caused by new variants of the virus, as well as related pressures on staffing and wage rates, we are not able to fully quantify the impact that these factors will have on our future financial results.  However, developments related to the COVID-19 pandemic could continue to materially affect our financial performance during the remainder of 2022. 

The nationwide shortage of nurses and other clinical staff and support personnel has been a significant operating issue facing us and other healthcare providers. Like others in the healthcare industry, we continue to experience a shortage of nurses and other clinical staff and support personnel at our acute care and behavioral health care hospitals in many geographic areas. In some areas, the labor scarcity is putting a strain on our resources and staff, which has required us to utilize higher‑cost temporary labor and pay premiums above standard compensation for essential workers. This staffing shortage has required us to hire expensive temporary personnel and/or enhance wages and benefits to recruit and retain nurses and other clinical staff and support personnel. At certain facilities, particularly within our behavioral health care segment, we have been unable to fill all vacant positions and, consequently, have been required to limit patient volumes. These factors, which had a material unfavorable impact on our results of operations during the first six months of 2022, are expected to have an unfavorable material impact on our results of operations during the remainder of 2022.  

However, as previously disclosed on June 30, 2022, our revised operating results forecast for the balance of 2022 assumes that staffing vacancies and the corresponding premium pay expenditures will continue to sequentially decline in the second half of the year and that non-COVID patient volumes will incrementally improve, although both at a slower pace than our original forecast anticipated. We believe these assumptions will be bolstered by our continuing recruitment and retention initiatives, by changes to our historical patient care models, by other cost cutting measures and by aggressive contractual negotiations and renegotiations with our managed care payers. 

Net Cash Provided by Operating Activities and Liquidity:

Net Cash Provided by Operating Activities:

During the six-month period ended June 30, 2022, our net cash provided by operating activities was $478 million as compared to $119 million during the comparable six-month period of 2021.  The $359 million net increase in our net cash provided by operating activities during the first six months of 2022, as compared to the first six months of 2021, was due to: (i) a favorable change of $695 million resulting from the early return of Medicare accelerated payments which were received during 2020 and repaid during the first quarter of 2021, partially offset by; (ii) an unfavorable change of $199 million resulting from a decrease in net income plus depreciation and amortization expense, stock-based compensation expense, gain/loss on sales of assets and businesses, and provision for asset impairment; (iii) an unfavorable change of $102 million from other working capital accounts due primarily to the timing of disbursements for accrued expenses, accounts payable and accrued compensation, and; (iv) $35 million of other combined net unfavorable changes.    

Liquidity:

As of June 30, 2022, we had $1.056 billion of aggregate available borrowing capacity pursuant to our $1.2 billion revolving credit facility, net of outstanding borrowings and letters of credit.  In June, 2022, we entered into an amendment to our credit agreement which, among other things, added a new incremental tranche A term loan facility in the aggregate principal amount of $700 million. The net proceeds generated from the incremental tranche A term loan facility were used to repay a portion of the borrowings that were previously outstanding under our $1.2 billion revolving credit facility.     

Stock Repurchase Program:

As of December 31, 2021, we had an aggregate remaining repurchase authorization of approximately $358 million pursuant to our stock repurchase program. In February of 2022, our Board of Directors authorized a $1.4 billion increase to the program. As of June 30, 2022, we had an aggregate available repurchase authorization of $1.21 billion. 

Pursuant to the terms of our stock repurchase program, shares of our Class B Common Stock may be repurchased, from time to time as conditions allow, on the open market or in negotiated private transactions. During the second quarter of 2022, we have repurchased approximately 1.61 million shares at an aggregate cost of approximately $195.6 million (approximately $122 per share) pursuant to the program.  During the first six months of 2022, we have repurchased approximately 4.25 million shares at an aggregate cost of approximately $545.8 million (approximately $128 per share) pursuant to the program.

Conference call information:

We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on July 26, 2022.  A live webcast of the call will be available on our website at www.uhs.com. To participate via telephone, please register in advance by accessing this link.  Upon registration, all telephone participants will receive a confirmation email detailing how to join the conference call, including the dial-in number along with a unique passcode and registrant ID that can be used to access the call. A replay of the call will be available for one full year following the live call.

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

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2021 were approximately $12.6 billion. In 2022, UHS was again recognized as one of the World's Most Admired Companies by Fortune; ranked #297 on the Fortune 500; and in 2021, ranked #307 on Forbes' list of America's Largest Public Companies.

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 over 89,000 employees and through its subsidiaries operates 28 acute care hospitals, 333 behavioral health facilities, 41 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 39 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. It acts as the advisor to Universal Health Realty Income Trust, a real estate investment trust (NYSE:UHT).  For additional information visit www.uhs.com.

This press release contains forward-looking statements based on current management expectations.  Numerous factors, including those disclosed herein, those related to the anticipated impact of COVID-19 on our operations and financial results, those related to healthcare industry trends and those detailed in our filings with the Securities and Exchange Commission (as set forth in Item 2-Forward Looking Statements and Risk Factors in our Form 10-Q for the quarter ended March 31, 2022 and in Item 1A-Risk Factors and in Item 7-Forward-Looking Statements and Risk Factors in our Form 10-K for the year ended December 31, 2021), 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 the impact of the COVID-19 pandemic. Our future operations and financial results will likely be materially unfavorably impacted by developments related to COVID-19 including, but not limited to, the potential impact on future COVID-19 patient volumes resulting from new variants of the virus, the length of time and severity of the spread of the pandemic; the volume of cancelled or rescheduled elective procedures and the volume of COVID-19 patients treated at our hospitals and other healthcare facilities; measures we are taking to respond to the COVID-19 pandemic; the impact of government and administrative regulation and stimulus on the hospital industry and potential retrospective adjustment in future periods of CARES Act and other grant income revenues recorded as revenues in prior periods; declining patient volumes and unfavorable changes in payer mix caused by deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients as the result of business closings and layoffs); potential disruptions to our clinical staffing and shortages and disruptions related to supplies required for our employees and patients; potential increases to expenses and other costs related to staffing, supply chain, construction and medical equipment costs and other expenditures resulting from inflation; the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financing perspective; and changes in general economic conditions nationally and regionally in our markets resulting from the COVID-19 pandemic. In addition, please see the disclosure above in COVID-19 and Staffing Shortage, in connection with the nationwide shortage of nurses and other clinical staff and support personnel which has had, and is expected to continue to have, a material unfavorable impact on our results of operations.   

We believe that adjusted net income attributable to UHS, adjusted net income attributable to UHS per diluted share, EBITDA net of NCI and Adjusted EBITDA net of NCI, which are non-GAAP financial measures ("GAAP" is Generally Accepted Accounting Principles in the United States of America), are helpful to our investors as measures of our operating performance. In addition, we believe that, when applicable, comparing and discussing our financial results based on these measures, as calculated, is helpful to our investors since it neutralizes the effect of material items impacting our net income attributable to UHS, such as, changes in the market value of shares of certain equity securities and other potential material items that are nonrecurring or non-operational in nature including, but not limited to, impairments of goodwill and 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, 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 March 31, 2022 and our Report on Form 10-K for the year ended December 31, 2021. 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.