8-K

UNIVERSAL HEALTH SERVICES INC (UHS)

8-K 2023-10-26 For: 2023-10-25
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): October 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 October 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 October 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 October 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: October 26, 2023

EX-99.1

Exhibit 99.1

FOR IMMEDIATE RELEASE

October 25, 2023

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

UNIVERSAL HEALTH SERVICES, INC.

ANNOUNCES 2023 THIRD QUARTER FINANCIAL RESULTS

Consolidated Results of Operations, As Reported and As Adjusted – Three-month periods ended September 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 $167.0 million, or $2.40 per diluted share, during the third quarter of 2023, as compared to $182.8 million, or $2.50 per diluted share, during the third quarter of 2022. Net revenues increased by 6.8% to $3.563 billion during the third quarter of 2023, as compared to $3.336 billion during the third quarter of 2022.

As reflected on the Schedule of Non-GAAP Supplemental Information (“Supplemental Schedule”), our adjusted net income attributable to UHS during the third quarter of 2023 was $177.5 million, or $2.55 per diluted share, as compared to $185.8 million, or $2.54 per diluted share, during the third quarter of 2022. As reflected on the Supplemental Schedule, included in our reported results were unrealized after-tax losses of $10.5 million, or $.15 per diluted share ($13.8 million pre-tax), during the third quarter of 2023, and $3.0 million, or $.04 per diluted share ($3.9 million pre-tax) during the third quarter 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”, NCI is net income attributable to noncontrolling interests), was $410.1 million during the third quarter of 2023, as compared to $421.7 million during the third 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 $421.5 million during the third quarter of 2023, as compared to $427.8 million during the third quarter of 2022.

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

Reported net income attributable to UHS was $501.4 million, or $7.09 per diluted share, during the first nine months of 2023, as compared to $500.8 million, or $6.71 per diluted share, during the first nine months 2022. Net revenues increased by 6.3% to $10.578 billion during the first nine months of 2023, as compared to $9.952 billion during the comparable period of 2022.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the first nine months of 2023, was $524.5 million, or $7.42 per diluted share, as compared to $513.1 million, or $6.88 per diluted share, during the nine-month period ended September 30, 2022.

As reflected on the Supplemental Schedule, included in our reported results were unrealized after-tax losses of $23.0 million, or $.33 per diluted share, ($30.1 million pre-tax) during the first nine months of 2023 and $12.4 million, or $.17 per diluted share, ($16.1 million pre-tax) during the first nine 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 $1.237 billion during the first nine months of 2023, as compared to $1.175 billion during the first nine 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

$1.268 billion during the first nine months of 2023, as compared to $1.190 billion during the comparable period of 2022.

Acute Care Services – Three and nine-month periods ended September 30, 2023 and 2022:

During the third quarter of 2023, at our acute care hospitals owned during both periods (“same facility basis”), adjusted admissions (adjusted for outpatient activity) increased by 6.8% while adjusted patient days increased by 3.8%, as compared to the third quarter of 2022. At these facilities, during the third quarter of 2023, net revenue per adjusted admission increased by 0.4% while net revenue per adjusted patient day increased by 3.3%, as compared to the third quarter of 2022. Net revenues generated from our acute care services, on a same facility basis, increased by 7.5% during the third quarter of 2023, as compared to the third quarter of 2022.

During the nine-month period ended September 30, 2023, at our acute care hospitals on a same facility basis, adjusted admissions increased by 8.3% while adjusted patient days increased by 4.8%, as compared to the first nine months of 2022. At these facilities, during the first nine months of 2023, net revenue per adjusted admission decreased by 2.0% while net revenue per adjusted patient day increased by 1.3%, as compared to the first nine months of 2022. Net revenues generated from our acute care services, on a same facility basis, increased by 6.9% during the first nine months of 2023, as compared to the comparable period of 2022.

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

During the third quarter of 2023, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 0.8% while adjusted patient days increased by 1.1%, as compared to the third quarter of 2022. At these facilities, during the third quarter of 2023, net revenue per adjusted admission increased by 6.8% and net revenue per adjusted patient day increased by 6.5%, as compared to the third quarter of 2022. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 7.6% during the third quarter of 2023, as compared to the third quarter of 2022.

During the nine-month period ended September 30, 2023, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 3.8% while adjusted patient days increased by 2.4%, as compared to the first nine months of 2022. At these facilities, during the first nine months of 2023, net revenue per adjusted admission increased by 4.4% and net revenue per adjusted patient day increased by 5.9%, as compared to the first nine months of 2022. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 8.3% during the first nine 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 nine-month period ended September 30, 2023, our net cash provided by operating activities was $815 million as compared to $699 million during the first nine months of 2022. Included in the $117 million net increase in our net cash provided by operating activities was a favorable change of $109 million in other working capital accounts due primarily to the timing of disbursements for accrued compensation and accounts payable.

Liquidity:

As of September 30, 2023, we had $721 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 third quarter of 2023, we have repurchased 1.32 million shares at an aggregate cost of approximately $175.1 million (approximately $133 per share) pursuant to the program. During the first nine months of 2023, we have repurchased approximately 2.73 million shares at an aggregate cost of approximately $367.2 million (approximately $135 per share) pursuant to the program.

As of September 30, 2023, we had an aggregate available repurchase authorization of approximately $580 million.

Conference call information:

We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on October 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, 43 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 June 30, 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 June 30, 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 Nine months
ended September 30, ended September 30,
2023 2022 2023 2022
Net revenues $ 3,562,774 3,336,027 $ 10,578,430 9,952,390
Operating charges:
Salaries, wages and benefits 1,784,870 1,677,431 5,308,476 5,061,173
Other operating expenses 941,219 837,241 2,758,484 2,526,060
Supplies expense 378,667 366,337 1,138,950 1,092,403
Depreciation and amortization 137,195 145,874 422,560 433,508
Lease and rental expense 35,466 33,264 105,775 97,075
3,277,417 3,060,147 9,734,245 9,210,219
Income from operations 285,357 275,880 844,185 742,171
Interest expense, net 53,378 35,653 153,085 83,002
Other (income) expense, net 11,472 6,015 31,797 15,244
Income before income taxes 220,507 234,212 659,303 643,925
Provision for income taxes 52,499 57,401 159,618 157,312
Net income 168,008 176,811 499,685 486,613
Less: Net income (loss) attributable to noncontrolling interests ("NCI") 1,019 (6,003 ) (1,732 ) (14,176 )
Net income attributable to UHS $ 166,989 $ 182,814 $ 501,417 $ 500,789
Basic earnings per share attributable to UHS (a) $ 2.42 $ 2.52 $ 7.18 $ 6.78
Diluted earnings per share attributable to UHS (a) $ 2.40 $ 2.50 $ 7.09 $ 6.71
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- ---
Footnotes to Consolidated Statements of Income
(in thousands, except per share amounts)
(unaudited)
Three months Nine months
ended September 30, ended September 30,
2023 2022 2023 2022
(a) Earnings per share calculation:
Basic and diluted:
Net income attributable to UHS $ 166,989 $ 182,814 $ 501,417 $ 500,789
Less: Net income attributable to unvested restricted share grants (52 ) (179 ) (242 ) (592 )
Net income attributable to UHS - basic and diluted $ 166,937 $ 182,635 $ 501,175 $ 500,197
Weighted average number of common shares - basic 68,867 72,595 69,825 73,769
Basic earnings per share attributable to UHS: $ 2.42 $ 2.52 $ 7.18 $ 6.78
Weighted average number of common shares 68,867 72,595 69,825 73,769
Add: Other share equivalents 757 465 825 743
Weighted average number of common shares and equiv. - diluted 69,624 73,060 70,650 74,512
Diluted earnings per share attributable to UHS: $ 2.40 $ 2.50 $ 7.09 $ 6.71
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- ---
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Three Months ended September 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
September 30, 2023 revenues September 30, 2022 revenues
Net income attributable to UHS $ 166,989 $ 182,814
Depreciation and amortization 137,195 145,874
Interest expense, net 53,378 35,653
Provision for income taxes 52,499 57,401
EBITDA net of NCI $ 410,061 11.5 % $ 421,742 12.6 %
Other (income) expense, net 11,472 6,015
Adjusted EBITDA net of NCI $ 421,533 11.8 % $ 427,757 12.8 %
Net revenues $ 3,562,774 $ 3,336,027
Calculation of Adjusted Net Income Attributable to UHS
Three months ended Three months ended
September 30, 2023 September 30, 2022
Per Per
Amount Diluted Share Amount Diluted Share
Net income attributable to UHS $ 166,989 $ 2.40 $ 182,814 $ 2.50
Plus/minus after-tax adjustments:
Unrealized loss on equity securities 10,528 0.15 2,974 0.04
Subtotal adjustments 10,528 0.15 2,974 0.04
Adjusted net income attributable to UHS $ 177,517 $ 2.55 $ 185,788 $ 2.54
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- ---
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Nine Months ended September 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")
Nine months ended % Net Nine months ended % Net
September 30, 2023 revenues September 30, 2022 revenues
Net income attributable to UHS $ 501,417 $ 500,789
Depreciation and amortization 422,560 433,508
Interest expense, net 153,085 83,002
Provision for income taxes 159,618 157,312
EBITDA net of NCI $ 1,236,680 11.7 % $ 1,174,611 11.8 %
Other (income) expense, net 31,797 15,244
Adjusted EBITDA net of NCI $ 1,268,477 12.0 % $ 1,189,855 12.0 %
Net revenues $ 10,578,430 $ 9,952,390
Calculation of Adjusted Net Income Attributable to UHS
Nine months ended Nine months ended
September 30, 2023 September 30, 2022
Per Per
Amount Diluted Share Amount Diluted Share
Net income attributable to UHS $ 501,417 $ 7.09 $ 500,789 $ 6.71
Plus/minus after-tax adjustments:
Unrealized loss on equity securities 23,040 0.33 12,358 0.17
Subtotal adjustments 23,040 0.33 12,358 0.17
Adjusted net income attributable to UHS $ 524,457 $ 7.42 $ 513,147 $ 6.88
Universal Health Services, Inc.
--- --- --- --- --- --- ---
Condensed Consolidated Balance Sheets
(in thousands)
(unaudited)
September 30, December 31,
2023 2022
Assets
Current assets:
Cash and cash equivalents $ 80,768 $ 102,818
Accounts receivable, net 2,234,343 2,017,722
Supplies 214,587 218,517
Other current assets 223,303 198,283
Total current assets 2,753,001 2,537,340
Property and equipment 11,610,188 11,085,852
Less: accumulated depreciation (5,523,135 ) (5,167,394 )
6,087,053 5,918,458
Other assets:
Goodwill 3,912,122 3,909,456
Deferred income taxes 99,580 68,397
Right of use assets-operating leases 443,924 454,650
Deferred charges 7,062 6,264
Other 570,728 599,623
Total Assets $ 13,873,470 $ 13,494,188
Liabilities and Stockholders' Equity
Current liabilities:
Current maturities of long-term debt $ 126,555 $ 81,447
Accounts payable and other liabilities 1,783,460 1,760,588
Operating lease liabilities 72,655 67,776
Federal and state taxes 7,145 4,608
Total current liabilities 1,989,815 1,914,419
Other noncurrent liabilities 587,829 487,669
Operating lease liabilities noncurrent 388,550 395,522
Long-term debt 4,796,074 4,726,533
Redeemable noncontrolling interest 4,719 4,695
UHS common stockholders' equity 6,064,915 5,920,582
Noncontrolling interest 41,568 44,768
Total equity 6,106,483 5,965,350
Total Liabilities and Stockholders' Equity $ 13,873,470 $ 13,494,188
Universal Health Services, Inc.
--- --- --- --- --- --- ---
Consolidated Statements of Cash Flows
(in thousands)
(unaudited)
Nine months
ended September 30,
2023 2022
Cash Flows from Operating Activities:
Net income $ 499,685 $ 486,613
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization 422,560 433,508
(Gain) loss on sale of assets and businesses (6,250 ) 584
Stock-based compensation expense 65,702 62,741
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable (193,108 ) (155,142 )
Accrued interest 60 529
Accrued and deferred income taxes (33,240 ) (4,900 )
Other working capital accounts (65,062 ) (173,903 )
Medicare accelerated payments and deferred CARES Act and other grants 1,764 2,921
Other assets and deferred charges 48,985 22,219
Other 13,717 (23,358 )
Accrued insurance expense, net of commercial premiums paid 141,414 134,908
Payments made in settlement of self-insurance claims (80,861 ) (88,001 )
Net cash provided by operating activities 815,366 698,719
Cash Flows from Investing Activities:
Property and equipment additions (536,665 ) (569,555 )
Proceeds received from sales of assets and businesses 23,688 12,001
Acquisition of businesses and property (3,728 ) (18,666 )
(Outflows) inflows from foreign exchange contracts that hedge our net U.K. investment (7,723 ) 177,214
Decrease in capital reserves of commercial insurance subsidiary 0 100
Net cash used in investing activities (524,428 ) (398,906 )
Cash Flows from Financing Activities:
Repayments of long-term debt (54,009 ) (194,115 )
Additional borrowings 165,000 705,321
Financing costs (308 ) (2,541 )
Repurchase of common shares (385,339 ) (723,384 )
Dividends paid (41,964 ) (44,192 )
Issuance of common stock 9,841 10,399
Profit distributions to noncontrolling interests (5,258 ) (5,426 )
(Purchase) sale of ownership interests by (from) minority members 408 (49,089 )
Net cash used in financing activities (311,629 ) (303,027 )
Effect of exchange rate changes on cash, cash equivalents and restricted cash 493 (10,339 )
Decrease in cash, cash equivalents and restricted cash (20,198 ) (13,553 )
Cash, cash equivalents and restricted cash, beginning of period 200,837 178,934
Cash, cash equivalents and restricted cash, end of period $ 180,639 $ 165,381
Supplemental Disclosures of Cash Flow Information:
Interest paid $ 149,247 $ 78,992
Income taxes paid, net of refunds $ 191,189 $ 182,091
Noncash purchases of property and equipment $ 108,412 $ 97,264
Universal Health Services, Inc.
--- --- --- --- ---
Supplemental Statistical Information
(unaudited)
% Change % Change
Same Facility: Three Months ended Nine Months ended
9/30/2023 9/30/2023
Acute Care Services
Revenues 7.5% 6.9%
Adjusted Admissions 6.8% 8.3%
Adjusted Patient Days 3.8% 4.8%
Revenue Per Adjusted Admission 0.4% -2.0%
Revenue Per Adjusted Patient Day 3.3% 1.3%
Behavioral Health Care Services
Revenues 7.6% 8.3%
Adjusted Admissions 0.8% 3.8%
Adjusted Patient Days 1.1% 2.4%
Revenue Per Adjusted Admission 6.8% 4.4%
Revenue Per Adjusted Patient Day 6.5% 5.9%
UHS Consolidated Third quarter ended Nine months ended
9/30/2023 9/30/2022 9/30/2023 9/30/2022
Revenues $3,562,774 $3,336,027 $10,578,430 $9,952,390
EBITDA net of NCI $410,061 $421,742 $1,236,680 $1,174,611
EBITDA Margin net of NCI 11.5% 12.6% 11.7% 11.8%
Adjusted EBITDA net of NCI $421,533 $427,757 $1,268,477 $1,189,855
Adjusted EBITDA Margin net of NCI 11.8% 12.8% 12.0% 12.0%
Cash Flow From Operations $161,665 $220,672 $815,366 $698,719
Capital Expenditures $200,001 $161,593 $536,665 $569,555
Days Sales Outstanding 58 52
Debt $4,922,629 $4,704,663
UHS' Shareholders Equity $6,064,915 $5,855,353
Debt / Total Capitalization 44.8% 44.6%
Debt / EBITDA net of NCI (1) 2.97 2.87
Debt / Adjusted EBITDA net of NCI (1) 2.83 2.87
Debt / Cash From Operations (1) 4.42 4.61
(1) Latest 4 quarters.

Universal Health Services, Inc.

Acute Care Hospital Services

For the Three and Nine Months ended

September 30, 2023 and 2022

(in thousands)

Same Facility Basis - Acute Care Hospital Services
Three months ended Three months ended Nine months ended Nine months ended
September 30, 2023 September 30, 2022 September 30, 2023 September 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 1,965,856 100.0 % $ 1,828,370 100.0 % $ 5,808,205 100.0 % $ 5,432,868 100.0 %
Operating charges:
Salaries, wages and benefits 854,215 43.5 % 801,252 43.8 % 2,493,271 42.9 % 2,412,699 44.4 %
Other operating expenses 543,707 27.7 % 478,221 26.2 % 1,584,820 27.3 % 1,382,250 25.4 %
Supplies expense 324,226 16.5 % 302,162 16.5 % 964,228 16.6 % 904,547 16.6 %
Depreciation and amortization 86,583 4.4 % 92,830 5.1 % 265,021 4.6 % 274,574 5.1 %
Lease and rental expense 24,404 1.2 % 21,847 1.2 % 71,635 1.2 % 62,756 1.2 %
Subtotal-operating expenses 1,833,135 93.2 % 1,696,312 92.8 % 5,378,975 92.6 % 5,036,826 92.7 %
Income from operations 132,721 6.8 % 132,058 7.2 % 429,230 7.4 % 396,042 7.3 %
Interest expense, net (778 ) (0.0 )% 234 0.0 % (1,858 ) (0.0 )% 1,350 0.0 %
Other (income) expense, net (1,045 ) (0.1 )% 384 0.0 % 5,168 0.1 % 806 0.0 %
Income before income taxes $ 134,544 6.8 % $ 131,440 7.2 % $ 425,920 7.3 % $ 393,886 7.3 %
All Acute Care Hospital Services
Three months ended Three months ended Nine months ended Nine months ended
September 30, 2023 September 30, 2022 September 30, 2023 September 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 2,017,288 100.0 % $ 1,919,678 100.0 % $ 5,993,899 100.0 % $ 5,707,510 100.0 %
Operating charges:
Salaries, wages and benefits 854,587 42.4 % 824,942 43.0 % 2,534,878 42.3 % 2,497,888 43.8 %
Other operating expenses 596,834 29.6 % 535,463 27.9 % 1,731,750 28.9 % 1,550,044 27.2 %
Supplies expense 323,475 16.0 % 311,404 16.2 % 979,185 16.3 % 935,559 16.4 %
Depreciation and amortization 86,535 4.3 % 96,020 5.0 % 274,165 4.6 % 285,558 5.0 %
Lease and rental expense 24,440 1.2 % 21,990 1.1 % 72,629 1.2 % 63,324 1.1 %
Subtotal-operating expenses 1,885,871 93.5 % 1,789,819 93.2 % 5,592,607 93.3 % 5,332,373 93.4 %
Income from operations 131,417 6.5 % 129,859 6.8 % 401,292 6.7 % 375,137 6.6 %
Interest expense, net (778 ) (0.0 )% 234 0.0 % (1,858 ) (0.0 )% 1,350 0.0 %
Other (income) expense, net (211 ) (0.0 )% 384 0.0 % 6,921 0.1 % 806 0.0 %
Income before income taxes $ 132,406 6.6 % $ 129,241 6.7 % $ 396,229 6.6 % $ 372,981 6.5 %

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 June 30, 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 Nine Months ended

September 30, 2023 and 2022

(in thousands)

Same Facility - Behavioral Health Care Services
Three months ended Three months ended Nine months ended Nine months ended
September 30, 2023 September 30, 2022 September 30, 2023 September 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 1,513,354 100.0 % $ 1,407,039 100.0 % $ 4,490,078 100.0 % $ 4,144,998 100.0 %
Operating charges:
Salaries, wages and benefits 841,985 55.6 % 779,839 55.4 % 2,491,153 55.5 % 2,293,332 55.3 %
Other operating expenses 292,878 19.4 % 273,618 19.4 % 866,450 19.3 % 816,312 19.7 %
Supplies expense 55,102 3.6 % 55,466 3.9 % 161,205 3.6 % 157,457 3.8 %
Depreciation and amortization 47,484 3.1 % 46,487 3.3 % 139,039 3.1 % 137,249 3.3 %
Lease and rental expense 10,857 0.7 % 10,586 0.8 % 32,642 0.7 % 31,262 0.8 %
Subtotal-operating expenses 1,248,306 82.5 % 1,165,996 82.9 % 3,690,489 82.2 % 3,435,612 82.9 %
Income from operations 265,048 17.5 % 241,043 17.1 % 799,589 17.8 % 709,386 17.1 %
Interest expense, net 1,255 0.1 % 1,370 0.1 % 3,326 0.1 % 3,957 0.1 %
Other (income) expense, net (985 ) (0.1 )% (664 ) (0.0 )% (2,294 ) (0.1 )% (1,422 ) (0.0 )%
Income before income taxes $ 264,778 17.5 % $ 240,337 17.1 % $ 798,557 17.8 % $ 706,851 17.1 %
All Behavioral Health Care Services
Three months ended Three months ended Nine months ended Nine months ended
September 30, 2023 September 30, 2022 September 30, 2023 September 30, 2022
Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues Amount % of Net<br>Revenues
Net revenues $ 1,542,695 100.0 % $ 1,434,828 100.0 % $ 4,575,378 100.0 % $ 4,235,215 100.0 %
Operating charges:
Salaries, wages and benefits 844,244 54.7 % 782,909 54.6 % 2,498,338 54.6 % 2,310,761 54.6 %
Other operating expenses 322,208 20.9 % 300,406 20.9 % 949,958 20.8 % 898,655 21.2 %
Supplies expense 55,272 3.6 % 55,482 3.9 % 161,597 3.5 % 158,315 3.7 %
Depreciation and amortization 47,720 3.1 % 46,861 3.3 % 140,117 3.1 % 138,803 3.3 %
Lease and rental expense 10,911 0.7 % 11,010 0.8 % 32,834 0.7 % 32,803 0.8 %
Subtotal-operating expenses 1,280,355 83.0 % 1,196,668 83.4 % 3,782,844 82.7 % 3,539,337 83.6 %
Income from operations 262,340 17.0 % 238,160 16.6 % 792,534 17.3 % 695,878 16.4 %
Interest expense, net 1,252 0.1 % 1,375 0.1 % 3,456 0.1 % 4,106 0.1 %
Other (income) expense, net (1,080 ) (0.1 )% (1,164 ) (0.1 )% (3,139 ) (0.1 )% (1,922 ) (0.0 )%
Income before income taxes $ 262,168 17.0 % $ 237,949 16.6 % $ 792,217 17.3 % $ 693,694 16.4 %

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, 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 June 30, 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
September 30, 2023 and 2022
AS REPORTED:
ACUTE BEHAVIORAL HEALTH
09/30/23 09/30/22 % change 09/30/23 09/30/22 % change
Hospitals owned and leased 27 28 -3.6 % 331 331 0.0 %
Average licensed beds 6,667 6,982 -4.5 % 24,194 24,222 -0.1 %
Average available beds 6,495 6,810 -4.6 % 24,094 24,122 -0.1 %
Patient days 384,348 386,341 -0.5 % 1,600,740 1,588,532 0.8 %
Average daily census 4,177.7 4,199.4 -0.5 % 17,399.3 17,266.7 0.8 %
Occupancy-licensed beds 62.7 % 60.1 % 4.2 % 71.9 % 71.3 % 0.9 %
Occupancy-available beds 64.3 % 61.7 % 4.3 % 72.2 % 71.6 % 0.9 %
Admissions 80,074 78,221 2.4 % 118,487 117,913 0.5 %
Length of stay 4.8 4.9 -2.8 % 13.5 13.4 0.8 %
Inpatient revenue $ 10,916,060 $ 9,875,794 10.5 % $ 2,703,478 $ 2,582,448 4.7 %
Outpatient revenue 7,480,353 6,379,324 17.3 % 259,060 248,167 4.4 %
Total patient revenue 18,396,413 16,255,118 13.2 % 2,962,538 2,830,615 4.7 %
Other revenue 251,985 215,179 17.1 % 81,149 67,228 20.7 %
Gross hospital revenue 18,648,398 16,470,297 13.2 % 3,043,687 2,897,843 5.0 %
Total deductions 16,631,110 14,550,619 14.3 % 1,500,992 1,463,015 2.6 %
Net hospital revenue $ 2,017,288 $ 1,919,678 5.1 % $ 1,542,695 $ 1,434,828 7.5 %
SAME FACILITY:
ACUTE BEHAVIORAL HEALTH
09/30/23 09/30/22 % change 09/30/23 09/30/22 % change
Hospitals owned and leased 27 27 0.0 % 329 329 0.0 %
Average licensed beds 6,667 6,700 -0.5 % 23,983 24,077 -0.4 %
Average available beds 6,495 6,528 -0.5 % 23,883 23,977 -0.4 %
Patient days 384,348 372,480 3.2 % 1,589,806 1,577,358 0.8 %
Average daily census 4,177.7 4,048.7 3.2 % 17,280.5 17,145.2 0.8 %
Occupancy-licensed beds 62.7 % 60.4 % 3.7 % 72.1 % 71.2 % 1.2 %
Occupancy-available beds 64.3 % 62.0 % 3.7 % 72.4 % 71.5 % 1.2 %
Admissions 80,074 75,434 6.2 % 117,620 117,008 0.5 %
Length of stay 4.8 4.9 -2.8 % 13.5 13.5 0.3 %
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ---
Selected Hospital Statistics
For the Nine Months Ended
September 30, 2023 and 2022
AS REPORTED:
ACUTE BEHAVIORAL HEALTH
09/30/23 09/30/22 % change 09/30/23 09/30/22 % change
Hospitals owned and leased 27 28 -3.6 % 331 331 0.0 %
Average licensed beds 6,697 6,901 -3.0 % 24,203 24,269 -0.3 %
Average available beds 6,525 6,729 -3.0 % 24,103 24,169 -0.3 %
Patient days 1,172,957 1,168,248 0.4 % 4,761,887 4,669,598 2.0 %
Average daily census 4,296.5 4,279.3 0.4 % 17,442.8 17,104.8 2.0 %
Occupancy-licensed beds 64.2 % 62.0 % 3.5 % 72.1 % 70.5 % 2.3 %
Occupancy-available beds 65.8 % 63.6 % 3.5 % 72.4 % 70.8 % 2.3 %
Admissions 239,300 230,223 3.9 % 358,703 346,973 3.4 %
Length of stay 4.9 5.1 -3.4 % 13.3 13.5 -1.4 %
Inpatient revenue $ 33,278,396 $ 29,821,756 11.6 % $ 8,001,838 $ 7,580,475 5.6 %
Outpatient revenue 22,292,249 18,360,902 21.4 % 812,467 773,769 5.0 %
Total patient revenue 55,570,645 48,182,658 15.3 % 8,814,305 8,354,244 5.5 %
Other revenue 714,877 602,635 18.6 % 220,393 209,284 5.3 %
Gross hospital revenue 56,285,522 48,785,293 15.4 % 9,034,698 8,563,528 5.5 %
Total deductions 50,291,623 43,077,783 16.7 % 4,459,320 4,328,313 3.0 %
Net hospital revenue $ 5,993,899 $ 5,707,510 5.0 % $ 4,575,378 $ 4,235,215 8.0 %
SAME FACILITY:
ACUTE BEHAVIORAL HEALTH
09/30/23 09/30/22 % change 09/30/23 09/30/22 % change
Hospitals owned and leased 27 27 0.0 % 329 329 0.0 %
Average licensed beds 6,581 6,619 -0.6 % 24,010 23,985 0.1 %
Average available beds 6,409 6,447 -0.6 % 23,910 23,885 0.1 %
Patient days 1,161,260 1,124,897 3.2 % 4,726,012 4,625,248 2.2 %
Average daily census 4,253.7 4,120.5 3.2 % 17,311.4 16,942.3 2.2 %
Occupancy-licensed beds 64.6 % 62.3 % 3.8 % 72.1 % 70.6 % 2.1 %
Occupancy-available beds 66.4 % 63.9 % 3.8 % 72.4 % 70.9 % 2.1 %
Admissions 236,911 221,868 6.8 % 355,419 343,014 3.6 %
Length of stay 4.9 5.1 -3.3 % 13.3 13.5 -1.4 %