8-K

UNIVERSAL HEALTH SERVICES INC (UHS)

8-K 2023-07-26 For: 2023-07-25
View Original
Added on April 04, 2026

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): July 25, 2023

UNIVERSAL HEALTH SERVICES, INC.

(Exact name of registrant as specified in its charter)

Delaware 1-10765 23-2077891
(State or other jurisdiction of (Commission (I.R.S. Employer
Incorporation or Organization) File Number) Identification No.)

UNIVERSAL CORPORATE CENTER

367 SOUTH GULPH ROAD

KING OF PRUSSIA, Pennsylvania 19406

(Address of principal executive office) (Zip Code)

Registrant’s telephone number, including area code (610) 768-3300

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 (see General Instructions A.2. below):

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
Class B Common Stock UHS 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 July 25, 2023, Universal Health Services, Inc. issued the press release attached hereto as Exhibit 99.1.

Item 9.01 Financial Statements and Exhibits

(d) Exhibits.

99.1 Universal Health Services, Inc., press release, dated July 25, 2023.
104 Cover Page Interactive Data File (embedded within the Inline XBRL document).

Exhibit Index

Exhibit No. Exhibit
99.1 Universal Health Services, Inc., press release, dated July 25, 2023.
104 Cover Page Interactive Data File (embedded within the Inline XBRL document).

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.

Universal Health Services, Inc.
By: /s/ Steve Filton
Name: Steve Filton
Title: Executive Vice President and<br><br>Chief Financial Officer

Date: July 26, 2023

EX-99.1

Exhibit 99.1

FOR IMMEDIATE RELEASE

July 25, 2023

CONTACT: Steve Filton
Chief Financial Officer
610-768-3300

UNIVERSAL HEALTH SERVICES, INC.

ANNOUNCES 2023 SECOND QUARTER FINANCIAL RESULTS

Consolidated Results of Operations, As Reported and As Adjusted – Three-month periods ended June 30, 2023 and 2022:

KING OF PRUSSIA, PA – Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was $171.3 million, or $2.42 per diluted share, during the second quarter of 2023, as compared to $164.1 million, or $2.20 per diluted share, during the second quarter of 2022. Net revenues increased by 6.8% to $3.548 billion during the second quarter of 2023, as compared to $3.323 billion during the second quarter of 2022.

As reflected on the Schedule of Non-GAAP Supplemental Information (“Supplemental Schedule”), our adjusted net income attributable to UHS during the second quarter of 2023 was $179.4 million, or $2.53 per diluted share, as compared to $163.9 million, or $2.20 per diluted share, during the second quarter of 2022. As reflected on the Supplemental Schedule, included in our reported results was an unrealized after-tax loss of $8.1 million, or $.11 per diluted share, ($10.5 million pre-tax) during the second quarter of 2023. The unrealized loss, which is included in “Other (income) expense, net”, resulted from a decrease in the market value of certain equity securities.

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization (“EBITDA net of NCI”, NCI is net income attributable to noncontrolling interests), was $419.3 million during the second quarter of 2023, as compared to $384.5 million during the second quarter of 2022. Our adjusted earnings before interest, taxes, depreciation & amortization (“Adjusted EBITDA net of NCI”), which excludes the impact of other (income) expense, net, was $425.9 million during the second quarter of 2023, as compared to $382.6 million during the second quarter of 2022.

Consolidated Results of Operations, As Reported and As Adjusted – Six-month periods ended June 30, 2023 and 2022:

Reported net income attributable to UHS was $334.4 million, or $4.70 per diluted share, during the first six months of 2023, as compared to $318.0 million, or $4.22 per diluted share, during the first six months 2022. Net revenues increased by 6.0% to $7.016 billion during the first six months of 2023, as compared to $6.616 billion during the comparable period of 2022.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the first six months of 2023, was $346.9 million, or $4.87 per diluted share, as compared to $327.4 million, or $4.35 per diluted share, during the six-month period ended June 30, 2022.

As reflected on the Supplemental Schedule, included in our reported results were unrealized after-tax losses of $12.5 million, or $.17 per diluted share, ($16.3 million pre-tax) during the first six months of 2023 and $9.4 million, or $.13 per diluted share, ($12.3 million pre-tax) during the first six months of 2022. These unrealized losses, which are included in “Other (income) expense, net”, resulted from decreases in the market value of certain equity securities.

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization (“EBITDA net of NCI”), was $826.6 million during the first six months of 2023, as compared to $752.9 million during the first six months of 2022. Our adjusted earnings before interest, taxes, depreciation & amortization (“Adjusted EBITDA net of NCI”), which excludes the impact of other (income) expense, net, was

$846.9 million during the first six months of 2023, as compared to $762.1 million during the comparable period of 2022.

Acute Care Services – Three and six-month periods ended June 30, 2023 and 2022:

During the second quarter of 2023, at our acute care hospitals owned during both periods (“same facility basis”), adjusted admissions (adjusted for outpatient activity) increased by 7.7% while adjusted patient days increased by 6.9%, as compared to the second quarter of 2022. At these facilities, during the second quarter of 2023, net revenue per adjusted admission increased by 1.3% while net revenue per adjusted patient day increased by 2.0%, as compared to the second quarter of 2022. Net revenues generated from our acute care services, on a same facility basis, increased by 9.7% during the second quarter of 2023, as compared to the second quarter of 2022.

During the six-month period ended June 30, 2023, at our acute care hospitals on a same facility basis, adjusted admissions increased by 9.1% while adjusted patient days increased by 5.2%, as compared to the first six months of 2022. At these facilities, during the first six months of 2023, net revenue per adjusted admission decreased by 3.3% while net revenue per adjusted patient day increased by 0.3%, as compared to the first six months of 2022. Net revenues generated from our acute care services, on a same facility basis, increased by 6.6% during the first six months of 2023, as compared to the comparable period of 2022.

Behavioral Health Care Services – Three and six-month periods ended June 30, 2023 and 2022:

During the second quarter of 2023, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 3.3% while adjusted patient days increased by 1.5%, as compared to the second quarter of 2022. At these facilities, during the second quarter of 2023, net revenue per adjusted admission increased by 4.4% and net revenue per adjusted patient day increased by 6.2%, as compared to the second quarter of 2022. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 7.8% during the second quarter of 2023, as compared to the second quarter of 2022.

During the six-month period ended June 30, 2023, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 5.4% while adjusted patient days increased by 3.1%, as compared to the first six months of 2022. At these facilities, during the first six months of 2023, net revenue per adjusted admission increased by 3.3% and net revenue per adjusted patient day increased by 5.6%, as compared to the first six months of 2022. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 8.7% during the first six months of 2023, as compared to the comparable period of 2022.

Net Cash Provided by Operating Activities and Liquidity:

Net Cash Provided by Operating Activities:

During the six-month period ended June 30, 2023, our net cash provided by operating activities was $654 million as compared to $478 million during the first six months of 2022. Included in the $176 million net increase in our net cash provided by operating activities was a favorable change of $119 million in other working capital accounts due primarily to the timing of disbursements for accrued compensation and accounts payable.

Liquidity:

As of June 30, 2023, we had $946 million of aggregate available borrowing capacity pursuant to our $1.2 billion revolving credit facility, net of outstanding borrowings and letters of credit.

Stock Repurchase Program:

As of December 31, 2022, we had an aggregate remaining repurchase authorization of approximately $947 million pursuant to our stock repurchase program. 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 2023, we have repurchased 758,578 shares at an aggregate cost of approximately $113.4 million (approximately $150 per share) pursuant to the program. During the first six

months of 2023, we have repurchased approximately 1.4 million shares at an aggregate cost of approximately $192.1 million (approximately $136 per share) pursuant to the program.

As of June 30, 2023, we had an aggregate available repurchase authorization of approximately $755 million.

Revised 2023 Operating Results Forecasts:

Based upon the operating trends and financial results experienced during the first six months of 2023, as indicated on the Revised Forecast table below, we are increasing the lower end of our guidance range for consolidated net revenues, earnings before interest, taxes, depreciation & amortization, and the impacts of other income/expense and net income attributable to noncontrolling interests (“Adjusted EBITDA, net of NCI”), and adjusted net income attributable to UHS per diluted share (“Adjusted EPS-diluted”) for the year ended December 31, 2023. The higher end of the 2023 guidance range for these metrics is remaining substantially unchanged.

The tables below include our revised 2023 operating results forecasts for the year ended December 31, 2023, as well as our original 2023 operating results forecast which was previously disclosed on February 27, 2023.

Revised Forecast Original Forecast
For the Year Ended For the Year Ended
December 31, 2023 December 31, 2023
Low High Low High
Net revenues $14.130 billion $14.330 billion $14.044 billion $14.314 billion
Adjusted EBITDA, net of NCI $1.696 billion $1.756 billion $1.662 billion $1.753 billion
Adjusted EPS – diluted $9.85 per share $10.50 per share $9.50 per share $10.50 per share

Adjusted EPS-diluted and Adjusted EBITDA net of NCI, are non-GAAP financial measures and should be examined in connection with net income determined in accordance with GAAP as presented in the consolidated financial statements and notes thereto in this report or in our filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2022 and our Form 10-Q for the quarter ended March 31, 2023. Please see the schedule of Supplemental Non-GAAP Disclosures - 2023 Revised Operating Results Forecast, as included herein for additional information and a reconciliation to the financial forecasts as computed in accordance with GAAP. In addition, the 2023 revised forecasted amounts exclude the impact of certain future items, if applicable, including those as outlined below in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures.

Conference call information:

We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on July 26, 2023. A live webcast of the call will be available on our website at www.uhs.com. To participate via telephone, please register in advance at this link.

Upon registration, all telephone participants will receive a confirmation email detailing how to join the conference call, including the dial-in number along with a unique passcode and registrant ID that can be used to access the call. A replay of the call will be available for one full year following the live call.

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

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2022 were approximately $13.4 billion. UHS ranked #311 on the Fortune 500; and #434 on Forbes’ list of America’s Largest Public Companies. UHS was again recognized as one of the World’s Most Admired Companies by Fortune.

Our operating philosophy is as effective today as it was upon the Company’s founding in 1979, enabling us to provide compassionate care to our patients and their loved ones. Our strategy includes building or

acquiring high quality hospitals in rapidly growing markets, investing in the people and equipment needed to allow each facility to thrive, and becoming the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has approximately 93,800 employees and, through its subsidiaries, operates 27 inpatient acute care hospitals, 331 inpatient behavioral health facilities, 42 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 39 states, Washington, D.C., the United Kingdom and Puerto Rico. It acts as the advisor to Universal Health Realty Income Trust, a real estate investment trust (NYSE:UHT). For additional information visit www.uhs.com.

This press release contains forward-looking statements based on current management expectations. Numerous factors, including those disclosed herein, those related to the potential 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, 2023 and in Item 1A-Risk Factors, and Item 7-Forward-Looking Statements and Risk Factors, in our Form 10-K for the year ended December 31, 2022), may cause the results to differ materially from those anticipated in the forward-looking statements. These statements are subject to risks and uncertainties and therefore actual results may differ materially. Readers should not place undue reliance on such forward-looking statements which reflect management’s view only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

Many of the factors that could affect our future results are beyond our control or ability to predict, including, but not limited to:

• The nationwide shortage of nurses and other clinical staff and support personnel has been a significant operating issue facing us and other healthcare providers. 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. These factors, which had a material unfavorable impact on our results of operations during 2022, could continue to have an unfavorable material impact on our results of operations for the foreseeable future.

• The impact of the COVID-19 pandemic, which began in March, 2020, has had a material effect on our operations and financial results, at various times, since that time. We cannot predict if there will be future disruptions caused by the COVID‑19 pandemic.

• A significant portion of our revenues are derived from federal and state government programs including the Medicare and Medicaid programs. Payments from these programs are subject to statutory and regulatory changes, administrative rulings, interpretations and determinations, requirements for utilization review, and federal and state funding restrictions. Changes to these programs, if adopted, could materially affect program payments which could materially impact our results of operations.

• The increase in interest rates has substantially increased our borrowings costs and reduced our ability to access the capital markets on favorable terms. Additional increases in interest rates could have a significant unfavorable impact on our future results of operations and the resulting effect on the capital markets could adversely affect our ability to carry out our strategy.

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, long-lived and intangible assets, reserves for various matters including settlements, legal judgments and lawsuits, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, potential impacts of non-ordinary

acquisitions, divestitures, joint ventures or other strategic transactions, and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. To obtain a complete understanding of our financial performance these measures should be examined in connection with net income attributable to UHS, as determined in accordance with GAAP, and as presented in the condensed consolidated financial statements and notes thereto in this report or in our other filings with the Securities and Exchange Commission including our Report on Form 10-Q for the quarter ended March 31, 2023 and our Report on Form 10-K for the year ended December 31, 2022. 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.

(more)

Universal Health Services, Inc.
Consolidated Statements of Income
(in thousands, except per share amounts)
(unaudited)
Three months Six months
ended June 30, ended June 30,
2023 2022 2023 2022
Net revenues $ 3,548,138 3,323,407 $ 7,015,656 6,616,363
Operating charges:
Salaries, wages and benefits 1,770,271 1,691,472 3,523,606 3,383,742
Other operating expenses 938,314 867,885 1,817,265 1,688,819
Supplies expense 380,294 354,993 760,283 726,066
Depreciation and amortization 143,744 143,850 285,365 287,634
Lease and rental expense 35,387 31,773 70,309 63,811
3,268,010 3,089,973 6,456,828 6,150,072
Income from operations 280,128 233,434 558,828 466,291
Interest expense, net 48,831 25,676 99,707 47,349
Other (income) expense, net 6,602 (1,972 ) 20,325 9,229
Income before income taxes 224,695 209,730 438,796 409,713
Provision for income taxes 55,393 50,949 107,119 99,911
Net income 169,302 158,781 331,677 309,802
Less: Net income (loss) attributable to noncontrolling interests ("NCI") (2,011 ) (5,281 ) (2,751 ) (8,173 )
Net income attributable to UHS $ 171,313 $ 164,062 $ 334,428 $ 317,975
Basic earnings per share attributable to UHS (a) $ 2.44 $ 2.22 $ 4.75 $ 4.27
Diluted earnings per share attributable to UHS (a) $ 2.42 $ 2.20 $ 4.70 $ 4.22
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- ---
Footnotes to Consolidated Statements of Income
(in thousands, except per share amounts)
(unaudited)
Three months Six months
ended June 30, ended June 30,
2023 2022 2023 2022
(a) Earnings per share calculation:
Basic and diluted:
Net income attributable to UHS $ 171,313 $ 164,062 $ 334,428 $ 317,975
Less: Net income attributable to unvested restricted share grants (61 ) (164 ) (190 ) (413 )
Net income attributable to UHS - basic and diluted $ 171,252 $ 163,898 $ 334,238 $ 317,562
Weighted average number of common shares - basic 70,073 73,682 70,304 74,356
Basic earnings per share attributable to UHS: $ 2.44 $ 2.22 $ 4.75 $ 4.27
Weighted average number of common shares 70,073 73,682 70,304 74,356
Add: Other share equivalents 766 753 859 882
Weighted average number of common shares and equiv. - diluted 70,839 74,435 71,163 75,238
Diluted earnings per share attributable to UHS: $ 2.42 $ 2.20 $ 4.70 $ 4.22
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- ---
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Three Months ended June 30, 2023 and 2022
(in thousands, except per share amounts)
(unaudited)
Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization ("EBITDA/Adjusted EBITDA net of NCI")
Three months ended % Net Three months ended % Net
June 30, 2023 revenues June 30, 2022 revenues
Net income attributable to UHS $ 171,313 $ 164,062
Depreciation and amortization 143,744 143,850
Interest expense, net 48,831 25,676
Provision for income taxes 55,393 50,949
EBITDA net of NCI $ 419,281 11.8 % $ 384,537 11.6 %
Other (income) expense, net 6,602 (1,972 )
Adjusted EBITDA net of NCI $ 425,883 12.0 % $ 382,565 11.5 %
Net revenues $ 3,548,138 $ 3,323,407
Calculation of Adjusted Net Income Attributable to UHS
Three months ended Three months ended
June 30, 2023 June 30, 2022
Per Per
Amount Diluted Share Amount Diluted Share
Net income attributable to UHS $ 171,313 $ 2.42 $ 164,062 $ 2.20
Plus/minus after-tax adjustments:
Unrealized loss (gain) on equity securities 8,051 0.11 (153 ) -
Subtotal adjustments 8,051 0.11 (153 ) -
Adjusted net income attributable to UHS $ 179,364 $ 2.53 $ 163,909 $ 2.20
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- ---
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Six Months ended June 30, 2023 and 2022
(in thousands, except per share amounts)
(unaudited)
Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization ("EBITDA/Adjusted EBITDA net of NCI")
Six months ended % Net Six months ended % Net
June 30, 2023 revenues June 30, 2022 revenues
Net income attributable to UHS $ 334,428 $ 317,975
Depreciation and amortization 285,365 287,634
Interest expense, net 99,707 47,349
Provision for income taxes 107,119 99,911
EBITDA net of NCI $ 826,619 11.8 % $ 752,869 11.4 %
Other (income) expense, net 20,325 9,229
Adjusted EBITDA net of NCI $ 846,944 12.1 % $ 762,098 11.5 %
Net revenues $ 7,015,656 $ 6,616,363
Calculation of Adjusted Net Income Attributable to UHS
Six months ended Six months ended
June 30, 2023 June 30, 2022
Per Per
Amount Diluted Share Amount Diluted Share
Net income attributable to UHS $ 334,428 $ 4.70 $ 317,975 $ 4.22
Plus/minus after-tax adjustments:
Unrealized loss on equity securities 12,512 0.17 9,384 0.13
Subtotal adjustments 12,512 0.17 9,384 0.13
Adjusted net income attributable to UHS $ 346,940 $ 4.87 $ 327,359 $ 4.35
Universal Health Services, Inc.
--- --- --- --- --- --- ---
Condensed Consolidated Balance Sheets
(in thousands)
(unaudited)
June 30, December 31,
2023 2022
Assets
Current assets:
Cash and cash equivalents $ 79,451 $ 102,818
Accounts receivable, net 2,103,478 2,017,722
Supplies 215,380 218,517
Other current assets 226,405 198,283
Total current assets 2,624,714 2,537,340
Property and equipment 11,441,608 11,085,852
Less: accumulated depreciation (5,413,892 ) (5,167,394 )
6,027,716 5,918,458
Other assets:
Goodwill 3,929,722 3,909,456
Deferred income taxes 109,773 68,397
Right of use assets-operating leases 446,618 454,650
Deferred charges 5,858 6,264
Other 587,908 599,623
Total Assets $ 13,732,309 $ 13,494,188
Liabilities and Stockholders' Equity
Current liabilities:
Current maturities of long-term debt $ 111,357 $ 81,447
Accounts payable and other liabilities 1,843,379 1,760,588
Operating lease liabilities 73,649 67,776
Federal and state taxes 6,962 4,608
Total current liabilities 2,035,347 1,914,419
Other noncurrent liabilities 571,206 487,669
Operating lease liabilities noncurrent 387,709 395,522
Long-term debt 4,605,075 4,726,533
Redeemable noncontrolling interest 4,213 4,695
UHS common stockholders' equity 6,087,182 5,920,582
Noncontrolling interest 41,577 44,768
Total equity 6,128,759 5,965,350
Total Liabilities and Stockholders' Equity $ 13,732,309 $ 13,494,188
Universal Health Services, Inc.
--- --- --- --- --- --- ---
Consolidated Statements of Cash Flows
(in thousands)
(unaudited)
Six months
ended June 30,
2023 2022
Cash Flows from Operating Activities:
Net income $ 331,677 $ 309,802
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization 285,365 287,634
(Gain) loss on sale of assets and businesses (6,250 ) 1,084
Stock-based compensation expense 43,062 41,640
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable (82,078 ) (89,729 )
Accrued interest (107 ) 1,329
Accrued and deferred income taxes (32,695 ) (34,260 )
Other working capital accounts 20,216 (98,811 )
Medicare accelerated payments and deferred CARES Act and other grants 2,741 5,339
Other assets and deferred charges 32,746 30,278
Other 15,471 (15,763 )
Accrued insurance expense, net of commercial premiums paid 95,157 97,570
Payments made in settlement of self-insurance claims (51,604 ) (58,066 )
Net cash provided by operating activities 653,701 478,047
Cash Flows from Investing Activities:
Property and equipment additions (336,664 ) (407,962 )
Proceeds received from sales of assets and businesses 23,688 10,232
Acquisition of businesses and property (3,728 ) (12,485 )
(Outflows) inflows from foreign exchange contracts that hedge our net U.K. investment (31,305 ) 84,535
Decrease in capital reserves of commercial insurance subsidiary 0 100
Net cash used in investing activities (348,009 ) (325,580 )
Cash Flows from Financing Activities:
Repayments of long-term debt (93,557 ) (226,854 )
Additional borrowings 0 700,000
Financing costs (293 ) (2,387 )
Repurchase of common shares (209,756 ) (565,182 )
Dividends paid (28,263 ) (29,641 )
Issuance of common stock 6,598 6,661
Profit distributions to noncontrolling interests (4,735 ) (5,323 )
Sale of ownership interests from minority members 407 (1,307 )
Net cash used in financing activities (329,599 ) (124,033 )
Effect of exchange rate changes on cash, cash equivalents and restricted cash 2,377 (5,457 )
Increase (decrease) in cash, cash equivalents and restricted cash (21,530 ) 22,977
Cash, cash equivalents and restricted cash, beginning of period 200,837 178,934
Cash, cash equivalents and restricted cash, end of period $ 179,307 $ 201,911
Supplemental Disclosures of Cash Flow Information:
Interest paid $ 97,297 $ 43,796
Income taxes paid, net of refunds $ 133,840 $ 145,448
Noncash purchases of property and equipment $ 100,461 $ 112,420
Universal Health Services, Inc.
--- --- --- --- ---
Supplemental Statistical Information
(unaudited)
% Change % Change
Same Facility: Three Months ended Six Months ended
6/30/2023 6/30/2023
Acute Care Services
Revenues 9.7% 6.6%
Adjusted Admissions 7.7% 9.1%
Adjusted Patient Days 6.9% 5.2%
Revenue Per Adjusted Admission 1.3% -3.3%
Revenue Per Adjusted Patient Day 2.0% 0.3%
Behavioral Health Care Services
Revenues 7.8% 8.7%
Adjusted Admissions 3.3% 5.4%
Adjusted Patient Days 1.5% 3.1%
Revenue Per Adjusted Admission 4.4% 3.3%
Revenue Per Adjusted Patient Day 6.2% 5.6%
UHS Consolidated Second quarter ended Six months ended
6/30/2023 6/30/2022 6/30/2023 6/30/2022
Revenues $3,548,138 $3,323,407 $7,015,656 $6,616,363
EBITDA net of NCI $419,281 $384,537 $826,619 $752,869
EBITDA Margin net of NCI 11.8% 11.6% 11.8% 11.4%
Adjusted EBITDA net of NCI $425,883 $382,565 $846,944 $762,098
Adjusted EBITDA Margin net of NCI 12.0% 11.5% 12.1% 11.5%
Cash Flow From Operations $362,948 $32,614 $653,701 $478,047
Days Sales Outstanding 54 50 54 50
Capital Expenditures $167,912 $207,960 $336,664 $407,962
Debt $4,716,432 $4,665,409
UHS' Shareholders Equity $6,087,182 $5,814,660
Debt / Total Capitalization 43.7% 44.5%
Debt / EBITDA net of NCI (1) 2.83 2.81
Debt / Adjusted EBITDA net of NCI (1) 2.70 2.81
Debt / Cash From Operations (1) 4.03 3.76
(1) Latest 4 quarters.

Universal Health Services, Inc.

Acute Care Hospital Services

For the Three and Six Months ended

June 30, 2023 and 2022

(in thousands)

Same Facility Basis - Acute Care Hospital Services
Three months ended Three months ended Six months ended Six months ended
June 30, 2023 June 30, 2022 June 30, 2023 June 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 1,953,269 100.0 % $ 1,779,801 100.0 % $ 3,842,349 100.0 % $ 3,604,498 100.0 %
Operating charges:
Salaries, wages and benefits 828,503 42.4 % 799,804 44.9 % 1,639,056 42.7 % 1,611,447 44.7 %
Other operating expenses 548,713 28.1 % 469,560 26.4 % 1,041,113 27.1 % 904,030 25.1 %
Supplies expense 323,746 16.6 % 292,303 16.4 % 640,002 16.7 % 602,385 16.7 %
Depreciation and amortization 91,511 4.7 % 89,980 5.1 % 178,438 4.6 % 181,744 5.0 %
Lease and rental expense 23,639 1.2 % 20,204 1.1 % 47,231 1.2 % 40,909 1.1 %
Subtotal-operating expenses 1,816,112 93.0 % 1,671,851 93.9 % 3,545,840 92.3 % 3,340,515 92.7 %
Income from operations 137,157 7.0 % 107,950 6.1 % 296,509 7.7 % 263,983 7.3 %
Interest expense, net (503 ) (0.0 )% 478 0.0 % (1,080 ) (0.0 )% 1,116 0.0 %
Other (income) expense, net - - 221 0.0 % 6,213 0.2 % 422 0.0 %
Income before income taxes $ 137,660 7.0 % $ 107,251 6.0 % $ 291,376 7.6 % $ 262,445 7.3 %
All Acute Care Hospital Services
Three months ended Three months ended Six months ended Six months ended
June 30, 2023 June 30, 2022 June 30, 2023 June 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 2,003,079 100.0 % $ 1,875,516 100.0 % $ 3,976,611 100.0 % $ 3,787,832 100.0 %
Operating charges:
Salaries, wages and benefits 836,331 41.8 % 829,040 44.2 % 1,680,291 42.3 % 1,672,946 44.2 %
Other operating expenses 590,616 29.5 % 532,504 28.4 % 1,134,916 28.5 % 1,014,582 26.8 %
Supplies expense 327,650 16.4 % 302,728 16.1 % 655,710 16.5 % 624,155 16.5 %
Depreciation and amortization 94,304 4.7 % 95,004 5.1 % 187,630 4.7 % 189,538 5.0 %
Lease and rental expense 24,035 1.2 % 20,482 1.1 % 48,189 1.2 % 41,334 1.1 %
Subtotal-operating expenses 1,872,936 93.5 % 1,779,758 94.9 % 3,706,736 93.2 % 3,542,555 93.5 %
Income from operations 130,143 6.5 % 95,758 5.1 % 269,875 6.8 % 245,277 6.5 %
Interest expense, net (503 ) (0.0 )% 478 0.0 % (1,080 ) (0.0 )% 1,116 0.0 %
Other (income) expense, net 119 0.0 % 221 0.0 % 7,132 0.2 % 422 0.0 %
Income before income taxes $ 130,527 6.5 % $ 95,059 5.1 % $ 263,823 6.6 % $ 243,739 6.4 %

We believe that providing our results on a “Same Facility” basis (which is a non-GAAP measure), which includes the operating results for facilities and businesses operated in both the current year and prior year periods, is helpful to our investors as a measure of our operating performance. Our Same Facility results also neutralize (if applicable), the effect of material items that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters, settlements, legal judgments and lawsuits, cost related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of goodwill, long-lived and intangible assets and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. Our Same Facility basis results exclude from net revenues and other operating expenses, provider tax assessments incurred in each period. However, these provider tax assessments are included in net revenues and other operating expenses as reflected in the table under All Acute Care Hospital Services. The provider tax assessments had no impact on the income before income taxes as reflected on the above tables since the amounts offset between net revenues and other operating expenses. To obtain a complete understanding of our financial performance, the Same Facility results should be examined in connection with our net income as determined in accordance with GAAP and as presented herein and the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2022 and Form 10-Q for the quarter ended March 31, 2023.

The All Acute Care Hospital Services table summarizes the results of operations for all our acute care operations during the periods presented. These amounts include: (i) our acute care results on a same facility basis, as indicated above; (ii) the impact of provider tax assessments which increased net revenues and other operating expenses but had no impact on income before income taxes, and; (iii) certain other amounts including the results of facilities acquired or opened during the last twelve months.

Universal Health Services, Inc.

Behavioral Health Care Services

For the Three and Six Months ended

June 30, 2023 and 2022

(in thousands)

Same Facility - Behavioral Health Care Services
Three months ended Three months ended Six months ended Six months ended
June 30, 2023 June 30, 2022 June 30, 2023 June 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 1,517,005 100.0 % $ 1,407,147 100.0 % $ 2,976,724 100.0 % $ 2,737,959 100.0 %
Operating charges:
Salaries, wages and benefits 843,222 55.6 % 767,333 54.5 % 1,649,168 55.4 % 1,513,493 55.3 %
Other operating expenses 296,203 19.5 % 274,146 19.5 % 573,572 19.3 % 542,694 19.8 %
Supplies expense 53,773 3.5 % 52,373 3.7 % 106,103 3.6 % 101,991 3.7 %
Depreciation and amortization 46,554 3.1 % 45,280 3.2 % 91,555 3.1 % 90,762 3.3 %
Lease and rental expense 11,203 0.7 % 10,415 0.7 % 21,785 0.7 % 20,676 0.8 %
Subtotal-operating expenses 1,250,955 82.5 % 1,149,547 81.7 % 2,442,183 82.0 % 2,269,616 82.9 %
Income from operations 266,050 17.5 % 257,600 18.3 % 534,541 18.0 % 468,343 17.1 %
Interest expense, net 993 0.1 % 1,360 0.1 % 2,071 0.1 % 2,587 0.1 %
Other (income) expense, net (733 ) (0.0 )% (643 ) (0.0 )% (1,309 ) (0.0 )% (758 ) (0.0 )%
Income before income taxes $ 265,790 17.5 % $ 256,883 18.3 % $ 533,779 17.9 % $ 466,514 17.0 %
All Behavioral Health Care Services
Three months ended Three months ended Six months ended Six months ended
June 30, 2023 June 30, 2022 June 30, 2023 June 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 1,542,194 100.0 % $ 1,433,920 100.0 % $ 3,032,683 100.0 % $ 2,800,387 100.0 %
Operating charges:
Salaries, wages and benefits 844,308 54.7 % 773,966 54.0 % 1,654,094 54.5 % 1,527,852 54.6 %
Other operating expenses 322,518 20.9 % 299,782 20.9 % 627,750 20.7 % 598,249 21.4 %
Supplies expense 53,837 3.5 % 52,655 3.7 % 106,325 3.5 % 102,832 3.7 %
Depreciation and amortization 46,778 3.0 % 45,863 3.2 % 92,397 3.0 % 91,942 3.3 %
Lease and rental expense 11,255 0.7 % 10,973 0.8 % 21,923 0.7 % 21,793 0.8 %
Subtotal-operating expenses 1,278,696 82.9 % 1,183,239 82.5 % 2,502,489 82.5 % 2,342,668 83.7 %
Income from operations 263,498 17.1 % 250,681 17.5 % 530,194 17.5 % 457,719 16.3 %
Interest expense, net 993 0.1 % 1,366 0.1 % 2,204 0.1 % 2,731 0.1 %
Other (income) expense, net (1,188 ) (0.1 )% (643 ) (0.0 )% (2,059 ) (0.1 )% (758 ) (0.0 )%
Income before income taxes $ 263,693 17.1 % $ 249,958 17.4 % $ 530,049 17.5 % $ 455,746 16.3 %

We believe that providing our results on a “Same Facility” basis (which is a non-GAAP measure), which includes the operating results for facilities and businesses operated in both the current year and prior year periods, is helpful to our investors as a measure of our operating performance. Our Same Facility results also neutralize (if applicable), the effect of material items that are nonrecurring or non-operational in nature including items such as, but not limited to, reserves for various matters, settlements, legal judgments, lawsuits and reserves established in connection with the government's investigation of our behavioral health care facilities, cost related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of goodwill, long-lived and intangible assets and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. Our Same Facility basis results exclude from net revenues and other operating expenses, provider tax assessments incurred in each period. However, these provider tax assessments are included in net revenues and other operating expenses as reflected in the table under All Behavioral Health Care Services. The provider tax assessments had no impact on the income before income taxes as reflected on the above tables since the amounts offset between net revenues and other operating expenses. To obtain a complete understanding of our financial performance, the Same Facility results should be examined in connection with our net income as determined in accordance with GAAP and as presented herein and in the condensed consolidated financial statements and notes thereto as contained in our Form 10-K for the year ended December 31, 2022 and Form 10-Q for the quarter ended March 31, 2023.

The All Behavioral Health Care Services table summarizes the results of operations for all our behavioral health care facilities during the periods presented. These amounts include: (i) our behavioral health results on a same facility basis, as indicated above; (ii) the impact of provider tax assessments which increased net revenues and other operating expenses but had no impact on income before income taxes, and; (iii) certain other amounts including the results of facilities acquired or opened during the last twelve months as well as the results of certain facilities that were closed or restructured during the past year.

Universal Health Services, Inc.
Selected Hospital Statistics
For the Three Months Ended
June 30, 2023 and 2022
AS REPORTED:
ACUTE BEHAVIORAL HEALTH
06/30/23 06/30/22 % change 06/30/23 06/30/22 % change
Hospitals owned and leased 27 28 -3.6 % 331 333 -0.6 %
Average licensed beds 6,624 6,971 -5.0 % 24,189 24,340 -0.6 %
Average available beds 6,452 6,799 -5.1 % 24,089 24,240 -0.6 %
Patient days 384,373 375,955 2.2 % 1,588,575 1,574,715 0.9 %
Average daily census 4,223.8 4,131.4 2.2 % 17,456.9 17,304.6 0.9 %
Occupancy-licensed beds 63.8 % 59.3 % 7.6 % 72.2 % 71.1 % 1.5 %
Occupancy-available beds 65.5 % 60.8 % 7.7 % 72.5 % 71.4 % 1.5 %
Admissions 79,100 76,713 3.1 % 119,656 116,627 2.6 %
Length of stay 4.9 4.9 -0.8 % 13.3 13.4 -0.9 %
Inpatient revenue $ 10,960,845 $ 9,706,731 12.9 % $ 2,670,370 $ 2,561,553 4.2 %
Outpatient revenue 7,515,780 6,206,039 21.1 % 281,036 268,489 4.7 %
Total patient revenue 18,476,625 15,912,770 16.1 % 2,951,406 2,830,042 4.3 %
Other revenue 240,899 202,975 18.7 % 73,926 75,359 -1.9 %
Gross hospital revenue 18,717,524 16,115,745 16.1 % 3,025,332 2,905,401 4.1 %
Total deductions 16,714,445 14,240,229 17.4 % 1,483,138 1,471,481 0.8 %
Net hospital revenue $ 2,003,079 $ 1,875,516 6.8 % $ 1,542,194 $ 1,433,920 7.6 %
SAME FACILITY:
ACUTE BEHAVIORAL HEALTH
06/30/23 06/30/22 % change 06/30/23 06/30/22 % change
Hospitals owned and leased 27 27 0.0 % 330 330 0.0 %
Average licensed beds 6,624 6,689 -1.0 % 24,063 23,991 0.3 %
Average available beds 6,452 6,517 -1.0 % 23,963 23,891 0.3 %
Patient days 384,373 362,044 6.2 % 1,578,277 1,559,048 1.2 %
Average daily census 4,223.8 3,978.5 6.2 % 17,343.7 17,132.4 1.2 %
Occupancy-licensed beds 63.8 % 59.5 % 7.2 % 72.1 % 71.4 % 0.9 %
Occupancy-available beds 65.5 % 61.0 % 7.2 % 72.4 % 71.7 % 0.9 %
Admissions 79,100 73,927 7.0 % 118,778 115,271 3.0 %
Length of stay 4.9 4.9 -0.8 % 13.3 13.5 -1.8 %
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ---
Selected Hospital Statistics
For the Six Months Ended
June 30, 2023 and 2022
AS REPORTED:
ACUTE BEHAVIORAL HEALTH
06/30/23 06/30/22 % change 06/30/23 06/30/22 % change
Hospitals owned and leased 27 28 -3.6 % 331 333 -0.6 %
Average licensed beds 6,711 6,860 -2.2 % 24,210 24,291 -0.3 %
Average available beds 6,539 6,688 -2.2 % 24,110 24,191 -0.3 %
Patient days 788,626 781,907 0.9 % 3,161,147 3,081,066 2.6 %
Average daily census 4,357.0 4,319.9 0.9 % 17,464.9 17,022.5 2.6 %
Occupancy-licensed beds 64.9 % 63.0 % 3.1 % 72.1 % 70.1 % 2.9 %
Occupancy-available beds 66.6 % 64.6 % 3.2 % 72.4 % 70.4 % 2.9 %
Admissions 159,226 152,002 4.8 % 240,216 229,060 4.9 %
Length of stay 5.0 5.1 -3.7 % 13.2 13.5 -2.2 %
Inpatient revenue $ 22,362,336 $ 19,945,962 12.1 % $ 5,298,360 $ 4,998,027 6.0 %
Outpatient revenue 14,811,896 11,981,578 23.6 % 553,407 525,602 5.3 %
Total patient revenue 37,174,232 31,927,540 16.4 % 5,851,767 5,523,629 5.9 %
Other revenue 462,892 387,456 19.5 % 139,244 142,056 -2.0 %
Gross hospital revenue 37,637,124 32,314,996 16.5 % 5,991,011 5,665,685 5.7 %
Total deductions 33,660,513 28,527,164 18.0 % 2,958,328 2,865,298 3.2 %
Net hospital revenue $ 3,976,611 $ 3,787,832 5.0 % $ 3,032,683 $ 2,800,387 8.3 %
SAME FACILITY:
ACUTE BEHAVIORAL HEALTH
06/30/23 06/30/22 % change 06/30/23 06/30/22 % change
Hospitals owned and leased 27 27 0.0 % 330 330 0.0 %
Average licensed beds 6,538 6,578 -0.6 % 24,024 23,939 0.4 %
Average available beds 6,366 6,406 -0.6 % 23,924 23,839 0.4 %
Patient days 776,943 752,308 3.3 % 3,136,187 3,047,895 2.9 %
Average daily census 4,292.5 4,156.4 3.3 % 17,327.0 16,839.2 2.9 %
Occupancy-licensed beds 65.7 % 63.2 % 3.9 % 72.1 % 70.3 % 2.5 %
Occupancy-available beds 67.4 % 64.9 % 3.9 % 72.4 % 70.6 % 2.5 %
Admissions 156,837 146,434 7.1 % 237,799 226,006 5.2 %
Length of stay 5.0 5.1 -3.6 % 13.2 13.5 -2.2 %
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- ---
Supplemental Non-GAAP Disclosures
2023 Revised Operating Results Forecast
(in thousands, except per share amounts)
Forecast For The Year Ending December 31, 2023
% Net % Net
Low revenues High revenues
Net revenues $ 14,130,000 $ 14,330,000
Adjusted net income attributable to UHS (a) $ 693,483 $ 739,143
Depreciation and amortization 584,725 584,725
Interest expense 198,996 198,996
Other (income) expense, net 1,353 1,353
Provision for income taxes 217,796 232,136
Adjusted EBITDA net of NCI (b) $ 1,696,353 12.0 % $ 1,756,353 12.3 %
Adjusted net income attributable to UHS, per diluted share (a) $ 9.85 $ 10.50
Shares used in computing diluted earnings per share 70,332 70,332
(a) Adjusted net income attributable to UHS/per diluted share are non-GAAP financial measures. The 2023 forecasted amounts exclude the impact of future items, if applicable, that are nonrecurring or non-operational in nature including items such as pre-tax unrealized gains/losses resulting from changes in the market value of shares of certain equity securities, and other potential material items including, but not limited to, reserves for various matters including settlements, legal judgments and lawsuits, potential impacts of non-ordinary course acquisitions, divestitures, joint ventures or other strategic transactions, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, impairments of goodwill, long-lived and intangible assets, other amounts that may be reflected in the current financial statements that relate to prior periods, and the impact of share repurchases that differ from our forecasted assumptions. It is also subject to certain conditions including those as set forth in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures.
(b) Adjusted EBITDA net of NCI is a non-GAAP financial measure. To obtain a complete understanding of our financial performance, Adjusted EBITDA net of NCI should be examined in connection with net income determined in accordance with GAAP as presented in the consolidated financial statements and notes thereto in this report or in our filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2022 and our Report Form 10-Q for the quarter ended March 31, 2023.