NASHVILLE, Tenn., Nov 05, 2009 /PRNewswire-FirstCall via COMTEX/ ----HCA Inc. today announced financial and operating results for its third quarter ended September 30, 2009.

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Third Quarter Summary:

   --  Revenues increased 7.6 percent to $7.533 billion from $7.002 billion in
   the third quarter of 2008.
   --  Net income attributable to HCA Inc. totaled $196 million, compared to
   $86 million in the prior year's third quarter.
   --  Adjusted EBITDA totaled $1.273 billion, compared to $1.053 billion in
   the third quarter of 2008.
   --  Provision for doubtful accounts totaled $910 million, compared to $819
   million in the prior year.
   --  Interest expense increased to $510 million from $497 million in the
   prior year's third quarter.
   --  Same facility equivalent admissions increased 4.8 percent, while same
   facility admissions increased 2.7 percent in the third quarter compared
   to the same period last year.
   --  Same facility revenue per equivalent admission increased 2.8 percent.
   Revenue per equivalent patient day, on a same facility basis, increased
   4.6 percent.
   --  Total surgeries, on a same facility basis, increased 1.2 percent from
   the prior year's third quarter.
   
   --  Same facility emergency department visits increased 11.1% compared to
   the third quarter of 2008.
   
   

Driven by strong inpatient, outpatient and emergency department volumes, HCA's revenues for the third quarter totaled $7.533 billion, compared to $7.002 billion in the third quarter of 2008. Net income attributable to HCA Inc. for the third quarter of 2009 totaled $196 million, compared to $86 million in the prior year's third quarter. Adjusted EBITDA in the quarter totaled $1.273 billion, compared to $1.053 billion in the previous year's third quarter. A table describing adjusted EBITDA and reconciling net income attributable to HCA Inc. to adjusted EBITDA for these periods is included in this release. Results for the third quarter of 2009 include impairments of long-lived assets of $3 million. Third quarter 2008 results include a $44 million charge for impairments of long-lived assets and gains on sales of facilities of $50 million.

The provision for doubtful accounts increased to $910 million, or 12.1 percent of revenues, in the third quarter of 2009 from $819 million, or 11.7 percent of revenues, in the third quarter of 2008. Charity care and uninsured discounts totaled $1.288 billion in the third quarter of 2009 compared to $920 million in the third quarter of 2008. Same facility uninsured admissions increased 8.2 percent in the third quarter of 2009 compared to the prior year's third quarter. Same facility uninsured admissions comprised 7.0 percent of total admissions in the third quarter of 2009 compared to 6.6 percent in the third quarter of 2008.

During the third quarter of 2009, salaries and benefits, supply expense and other operating expenses totaled $5.403 billion compared to $5.171 billion in the third quarter of 2008. These expenses, as a percent of revenues, declined 2.2% in the third quarter of 2009 compared to the third quarter of 2008.

Interest expense increased to $510 million in the third quarter of 2009, compared to $497 million in the same period of 2008.

Same facility admissions increased 2.7 percent and same facility equivalent admissions increased 4.8 percent in the third quarter of 2009 compared to the prior year's third quarter. Same facility inpatient surgeries increased 1.9 percent and same facility outpatient surgeries increased 0.8 percent in the third quarter. Same facility revenue per equivalent admission increased 2.8 percent in the third quarter of 2009 compared to the third quarter of 2008.

Revenues for the nine months ended September 30, 2009 totaled $22.447 billion compared to $21.109 billion for the same period of 2008. Net income attributable to HCA Inc. was $838 million for the nine months ended September 30, 2009 compared to $397 million in the same period of the prior year. Adjusted EBITDA totaled $4.129 billion for the first nine months of 2009 compared to $3.337 billion for the same period of 2008. Results for the nine months ended September 30, 2009 include losses on sales of facilities of $8 million and impairments of long-lived assets of $16 million compared to gains on sales of facilities of $90 million and impairments of long-lived assets of $53 million in the first nine months of 2008.

Cash flows from operating activities increased $900 million, from $1.415 billion for the nine months ended September 30, 2008 to $2.315 billion for the nine months ended September 30, 2009. The increase was due primarily to the $513 million increase in net income and $347 million improvement from changes in operating assets and liabilities and the provision for doubtful accounts.

As of September 30, 2009, HCA's balance sheet reflected cash and cash equivalents of $443 million, total debt of $25.914 billion, and total assets of $24.120 billion. During the third quarter of 2009, capital expenditures totaled $296 million, excluding acquisitions. For the nine months ended September 30, 2009, capital expenditures totaled $915 million, excluding acquisitions.

During 2009, HCA issued $3.060 billion aggregate principal amount of first and second lien notes. The net proceeds from the debt issuances were used to repay outstanding indebtedness under the Company's senior secured term loan facilities.

As of September 30, 2009, HCA operated 163 hospitals and 105 freestanding surgery centers (including eight hospitals and eight freestanding surgery centers operated through equity method joint ventures).

Earnings Conference Call

HCA will host a conference call for investors at 9:00 a.m. Central Time today. A live audio broadcast of the call via webcast will also be available to investors. The broadcast will be available on a replay basis beginning this afternoon. The webcast can be accessed at: http://www.videonewswire.com/event.asp?id=63265 or through the Company's Investor Relations web page, www.hcahealthcare.com.

Cautionary Statement about Preliminary Results and Other Forward-Looking Information

This press release contains forward-looking statements based on current management expectations. Those forward-looking statements include all statements other than those made solely with respect to historical fact. Numerous risks, uncertainties and other factors may cause actual results to differ materially from those expressed in any forward-looking statements. These factors include, but are not limited to, (1) the ability to recognize the benefits of the Recapitalization, (2) the impact of the substantial indebtedness incurred to finance the Recapitalization and the ability to refinance such indebtedness on acceptable terms, (3) the possible enactment of federal or state health care reform and changes in federal, state or local laws or regulations affecting the health care industry, (4) increases, particularly in the current economic downturn, in the amount and risk of collectibility of uninsured accounts and deductibles and copayment amounts for insured accounts, (5) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (6) possible changes in the Medicare, Medicaid and other state programs, including Medicaid supplemental payments pursuant to upper payment limit ("UPL") programs, that may impact reimbursements to health care providers and insurers, (7) the highly competitive nature of the health care business, (8) changes in revenue mix, including potential declines in the population covered under managed care agreements due to the current economic downturn and the ability to enter into and renew managed care provider agreements on acceptable terms, (9) the efforts of insurers, health care providers and others to contain health care costs, (10) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (11) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (12) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (13) changes in accounting practices, (14) changes in general economic conditions nationally and regionally in our markets, (15) future divestitures which may result in charges, (16) changes in business strategy or development plans, (17) delays in receiving payments for services provided, (18) the outcome of pending and any future tax audits, appeals and litigation associated with our tax positions, (19) potential liabilities and other claims that may be asserted against us, and (20) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2008 and 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.

   
   HCA Inc.
   Condensed Consolidated Income Statements
   Third Quarter
   (Dollars in millions)
   
   
   2009             2008
   --------------   --------------
   Amount   Ratio   Amount   Ratio
   ------   -----   ------   -----
   
   Revenues                               $7,533   100.0%  $7,002   100.0%
   
   Salaries and benefits                   3,013    40.0    2,883    41.2
   Supplies                                1,206    16.0    1,141    16.3
   Other operating expenses                1,184    15.7    1,147    16.4
   Provision for doubtful accounts           910    12.1      819    11.7
   Equity in earnings of affiliates          (53)   (0.7)     (41)   (0.6)
   Depreciation and amortization             354     4.7      350     5.0
   Interest expense                          510     6.8      497     7.1
   Gains on sales of facilities                -       -      (50)   (0.7)
   Impairment of long-lived assets             3       -       44     0.6
   ---     ---      ---     ---
   7,127    94.6    6,790    97.0
   -----    ----    -----    ----
   
   Income before income taxes                406     5.4      212     3.0
   
   Provision for income taxes                132     1.8       76     1.1
   ---     ---      ---     ---
   
   Net income                                274     3.6      136     1.9
   
   Net income attributable to
   noncontrolling interests                  78     1.0       50     0.7
   ---     ---      ---     ---
   
   Net income attributable to HCA Inc.   $196     2.6      $86     1.2
   ====     ===      ===     ===
   
   

   
   HCA Inc.
   Condensed Consolidated Income Statements
   For the Nine Months Ended September 30, 2009 and 2008
   (Dollars in millions)
   
   
   2009               2008
   ---------------     --------------
   Amount    Ratio     Amount   Ratio
   ------    -----     ------   -----
   
   Revenues                            $22,447   100.0%   $21,109   100.0%
   
   Salaries and benefits                 8,880    39.6      8,563    40.6
   Supplies                              3,627    16.2      3,463    16.4
   Other operating expenses              3,410    15.1      3,396    16.1
   Provision for doubtful accounts       2,583    11.5      2,520    11.9
   Equity in earnings of affiliates       (182)   (0.8)      (170)   (0.8)
   Depreciation and amortization         1,067     4.8      1,062     5.0
   Interest expense                      1,487     6.6      1,521     7.2
   Losses (gains) on sales of
   facilities                               8       -        (90)   (0.4)
   Impairment of long-lived assets          16     0.1         53     0.3
   ---     ---        ---     ---
   
   20,896    93.1     20,318    96.3
   ------    ----     ------    ----
   
   Income before income taxes            1,551     6.9        791     3.7
   
   Provision for income taxes              480     2.1        233     1.1
   ---     ---        ---     ---
   
   Net income                            1,071     4.8        558     2.6
   
   Net income attributable to
   noncontrolling interests               233     1.1        161     0.7
   ---     ---        ---     ---
   
   Net income attributable to
   HCA Inc.                           $838     3.7       $397     1.9
   ====     ===       ====     ===
   
   

   
   HCA Inc.
   Supplemental Operating Results Summary
   (Dollars in millions)
   
   For the Nine Months
   Third Quarter     Ended September 30,
   --------------   --------------------
   2009      2008      2009      2008
   ----      ----      ----      ----
   
   Revenues                           $7,533    $7,002   $22,447   $21,109
   
   Net income attributable to
   HCA Inc.                            $196       $86      $838      $397
   Losses (gains) on sales of
   facilities (net of tax)             -       (29)        5       (53)
   Impairment of long-lived
   assets (net of tax)                 2        28        10        34
   ---       ---       ---       ---
   Net income attributable to
   HCA Inc., excluding losses
   (gains) on sales of facilities
   and impairment of long-lived assets  198        85       853       378
   Depreciation and amortization      354       350     1,067     1,062
   Interest expense                   510       497     1,487     1,521
   Provision for income taxes         133        71       489       215
   Net income attributable to
   noncontrolling interests           78        50       233       161
   ---       ---       ---       ---
   
   
   Adjusted EBITDA (a)             $1,273    $1,053    $4,129    $3,337
   ======    ======    ======    ======
   
   (a)  Net income attributable to HCA Inc., excluding losses (gains) on
   sales of facilities and impairment of long-lived assets and
   adjusted EBITDA are non-GAAP financial measures.  We believe that
   net income attributable to HCA Inc., excluding losses (gains) on
   sales of facilities and impairment of long-lived assets and
   adjusted EBITDA are important measures that supplement discussions
   and analysis of our results of operations.  We believe that it is
   useful to investors to provide disclosures of our results of
   operations on the same basis as that used by management.
   Management relies upon net income attributable to HCA Inc.,
   excluding losses (gains) on sales of facilities and impairment of
   long-lived assets and adjusted EBITDA as the primary measures to
   review and assess operating performance of its hospital facilities
   and their management teams.
   
   Management and investors review both the overall performance
   (including; net income attributable to HCA Inc., excluding losses
   (gains) on sales of facilities and impairment of long-lived assets
   and GAAP net income attributable to HCA 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
   impairments of long-lived assets 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 Inc., excluding losses (gains) on
   sales of facilities and impairment of long-lived assets and
   adjusted EBITDA are not measures of financial performance under
   accounting principles generally accepted in the United States, and
   should not be considered as alternatives to net income attributable
   to HCA 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 Inc., excluding
   losses (gains) on sales of facilities and impairment of long-lived
   assets and adjusted EBITDA are not measurements determined in
   accordance with generally accepted accounting principles and are
   susceptible to varying calculations, net income attributable to HCA
   Inc., excluding losses (gains) on sales of facilities and
   impairment of long-lived assets and adjusted EBITDA, as presented,
   may not be comparable to other similarly titled measures presented
   by other companies.
   
   

   
   HCA Inc.
   Condensed Consolidated Balance Sheets
   (Dollars in millions)
   
   
   Sept. 30, June 30, Dec. 31,
   2009      2009      2008
   ----      ----      ----
   ASSETS
   Current assets:
   Cash and cash equivalents                   $443      $450      $465
   Accounts receivable, less allowance for
   doubtful accounts                         3,499     3,680     3,780
   Inventories                                  745       730       737
   Deferred income taxes                      1,099     1,032       914
   Other                                        515       556       405
   ---       ---       ---
   Total current assets                    6,301     6,448     6,301
   
   Property and equipment, at cost              24,389    24,185    23,714
   Accumulated depreciation                    (13,038)  (12,752)  (12,185)
   -------   -------   -------
   11,351    11,433    11,529
   
   Investments of insurance subsidiary           1,371     1,322     1,422
   Investments in and advances to affiliates       855       854       842
   Goodwill                                      2,596     2,594     2,580
   Deferred loan costs                             436       444       458
   Other                                         1,210     1,146     1,148
   -----     -----     -----
   
   $24,120   $24,241   $24,280
   =======   =======   =======
   
   
   LIABILITIES AND STOCKHOLDERS' DEFICIT
   Current liabilities:
   Accounts payable                          $1,199    $1,206    $1,370
   Accrued salaries                             954       876       854
   Other accrued expenses                     1,316     1,119     1,282
   Long-term debt due within one year           635       194       404
   ---       ---       ---
   Total current liabilities                4,104     3,395     3,910
   
   Long-term debt                               25,279    26,351    26,585
   Professional liability risks                  1,097     1,108     1,108
   Income taxes and other liabilities            1,782     1,713     1,782
   -----     -----     -----
   Total liabilities                      32,262    32,567    33,385
   
   Equity securities with contingent
   redemption rights                              147       155       155
   
   EQUITY (DEFICIT)
   HCA Inc. stockholders' deficit               (9,279)   (9,486)  (10,255)
   Noncontrolling interests                        990      1,005      995
   ---      -----      ---
   Total deficit                          (8,298)    (8,481)  (9,260)
   ------     ------   ------
   
   $24,120   $24,241   $24,280
   =======   =======   =======
   
   

   
   HCA Inc.
   Condensed Consolidated Statements of Cash Flows
   For the Nine Months Ended September 30, 2009 and 2008
   (Dollars in millions)
   
   
   2009      2008
   ----      ----
   
   Cash flows from operating activities:
   Net income                                          $1,071      $558
   Adjustments to reconcile net income to net cash
   provided by operating activities:
   Change in operating assets and liabilities       (2,136)   (2,420)
   Provision for doubtful accounts                   2,583     2,520
   Depreciation and amortization                     1,067     1,062
   Income taxes                                       (485)     (379)
   Losses (gains) on sales of facilities                 8       (90)
   Impairment of long-lived assets                      16        53
   Amortization of deferred loan costs                  60        59
   Pay-in-kind interest                                 58         -
   Share-based compensation                             21        25
   Other                                                52        27
   ---       ---
   
   Net cash provided by operating activities      2,315     1,415
   -----     -----
   
   Cash flows from investing activities:
   Purchase of property and equipment                    (915)   (1,115)
   Acquisition of hospitals and health care
   entities                                              (42)      (76)
   Disposition of hospitals and health care entities       39       185
   Change in investments                                  113        30
   Other                                                   (2)        4
   ---       ---
   
   Net cash used in investing activities           (807)     (972)
   ----      -----
   Cash flows from financing activities:
   Issuance of long-term debt                           2,979         4
   Net change in revolving bank credit facility        (1,125)      530
   Repayment of long-term debt                         (3,050)     (775)
   Distributions to noncontrolling interests             (254)     (141)
   Payment of  debt issuance costs                        (68)        -
   Other                                                  (12)      (10)
   ---       ---
   
   Net cash used in financing activities         (1,530)     (392)
   ------      ----
   
   Change in cash and cash equivalents                       (22)       51
   Cash and cash equivalents at beginning of period          465       393
   ---       ---
   
   Cash and cash equivalents at end of period               $443      $444
   ====      ====
   
   Interest payments                                      $1,154    $1,380
   Income tax payments, net of refunds                      $965      $612
   
   

   
   HCA Inc.
   Operating Statistics
   
   For the Nine Months
   Third Quarter     Ended September 30,
   --------------   --------------------
   2009      2008      2009      2008
   ----      ----      ----      ----
   Consolidating Hospitals:
   ------------------------
   
   Number of Hospitals                155       158       155       158
   Weighted Average Licensed Beds  38,829    38,390    38,819    38,405
   Licensed Beds at End of Period  38,829    38,386    38,829    38,386
   
   Reported:
   Admissions                     387,600   377,400 1,171,200 1,161,700
   % Change                        2.7%                0.8%
   Equivalent Admissions          615,100   587,400 1,835,200 1,776,300
   % Change                        4.7%                3.3%
   Revenue per Equivalent
   Admission                     $12,245   $11,922   $12,231   $11,884
   % Change                        2.7%                2.9%
   Inpatient Revenue per
   Admission                     $11,833   $11,224   $11,625   $11,203
   % Change                        5.4%                3.8%
   
   Patient Days                 1,848,000 1,833,700 5,673,600 5,745,900
   Equivalent Patient Days      2,934,100 2,854,700 8,890,500 8,785,600
   
   Inpatient Surgery Cases        125,300   121,400   372,300   371,800
   % Change                        3.2%                0.1%
   Outpatient Surgery Cases       199,100   196,500   593,700   595,500
   % Change                        1.3%               -0.3%
   
   Emergency Room Visits        1,441,200 1,303,100 4,198,900 3,969,500
   % Change                       10.6%                5.8%
   
   Outpatient Revenues as a
   Percentage of Patient
   Revenues                         38.1%     38.5%     38.3%     37.3%
   
   Average Length of Stay             4.8       4.9       4.8       4.9
   
   Occupancy                         51.7%     51.9%     53.5%     54.6%
   Equivalent Occupancy              82.1%     80.8%     83.8%     83.5%
   
   Same Facility:
   Admissions                     380,300   370,400 1,150,100 1,136,600
   % Change                        2.7%                1.2%
   Equivalent Admissions          602,800   575,200 1,799,900 1,734,400
   % Change                        4.8%                3.8%
   Revenue per Equivalent
   Admission                     $12,262   $11,929   $12,230   $11,900
   % Change                        2.8%                2.8%
   Inpatient Revenue per
   Admission                     $11,894   $11,276   $11,668   $11,246
   % Change                        5.5%                3.8%
   
   Inpatient Surgery Cases        123,300   121,000   367,100   364,600
   % Change                        1.9%                0.7%
   Outpatient Surgery Cases       196,100   194,600   585,700   586,300
   % Change                        0.8%               -0.1%
   
   Emergency Room Visits        1,404,000 1,263,900 4,093,700 3,848,400
   % Change                       11.1%                6.4%
   
   Number of Consolidating and
   Nonconsolidating (Equity Joint
   Ventures) Hospitals:
   
   Consolidating                      155       158       155       158
   Nonconsolidating (Equity
   Joint Ventures)                     8         8         8         8
   ---       ---       ---       ---
   
   Total Number of Hospitals          163       166       163       166
   ===       ===       ===       ===
   
   

SOURCE HCA Inc.

www.hcahealthcare.com
   

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