8-K

UNIVERSAL HEALTH SERVICES INC (UHS)

8-K 2022-02-24 For: 2022-02-24
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): February 24, 2022

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 February 24, 2022, 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 February 24, 2022.
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 February 24, 2022.
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><br>Chief Financial Officer

Date: February 24, 2022

uhs-ex991_8.htm

Exhibit 99.1

FOR IMMEDIATE RELEASE

February 24, 2022

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

UNIVERSAL HEALTH SERVICES, INC.

ANNOUNCES 2021 FOURTH QUARTER AND FULL YEAR FINANCIAL RESULTS,

2022 FULL YEAR EARNINGS GUIDANCE AND $1.4 BILLION INCREASE TO STOCK REPURCHASE PROGRAM

Consolidated Results of Operations, As Reported and As Adjusted  – Three-month periods ended December 31, 2021 and 2020:

KING OF PRUSSIA, PA – Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was $239.1 million, or $3.00 per diluted share, during the fourth quarter of 2021, as compared to $308.7 million, or $3.60 per diluted share, during the fourth quarter of 2020. Net revenues increased by 6.1% to $3.275 billion during the fourth quarter of 2021 as compared to $3.087 billion during the fourth quarter of 2020.

As reflected on the Schedule of Non-GAAP Supplemental Information (“Supplemental Schedule”), our adjusted net income attributable to UHS during the fourth quarter of 2021 was $235.1 million, or $2.95 per diluted share, as compared to $307.9 million, or $3.59 per diluted share, during the fourth quarter of 2020.

Included in our reported and adjusted net income attributable to UHS during the fourth quarter of 2021 was a net favorable after-tax impact of approximately $26.2 million, or $.33 per diluted share, resulting from approximately $34 million of revenues recorded during the fourth quarter in connection with the Kentucky Medicaid Managed Care Hospital Rate Increase Program, covering the period of July 1, 2021 to December 31, 2021, as discussed below in Kentucky Hospital Rate Increase Program;

Included in our reported and adjusted net income attributable to UHS during the fourth quarter of 2020 were the following: (i) a favorable impact of approximately $151.4 million, or $1.76 per diluted share, resulting from the recording of approximately $200 million of grant revenues from various governmental stimulus programs, most notably the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), and; (ii) an unfavorable estimated impact of $42.1 million ($55 million pre-tax), or $.49 per diluted share, resulting from the information technology incident that occurred in September, 2020.

As reflected on the Supplemental Schedule, included in our reported results during the fourth quarter of 2021, was a net aggregate favorable after-tax impact of $4.0 million, or $.05 per diluted share, consisting primarily of an after-tax unrealized gain of $4.1 million, or $.05 per diluted share, ($5.4 million pre-tax which is included in “Other (income) expense, net”), resulting from an increase in the market value of certain equity securities.

As reflected on the Supplemental Schedule, included in our reported results during the fourth quarter of 2020, was a net aggregate favorable after-tax impact of $849,000, or $.01 per diluted share, consisting of the following: (i) an after-tax unrealized gain of $3.9 million, or $.05 per diluted share, resulting from an increase in the market value certain equity securities, and; (ii) a unfavorable after-tax impact of $3.0 million, or $.04 per diluted share, resulting from ASU 2016-09, “Compensation – Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting” (“ASU 2016-09”).

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization (“EBITDA net of NCI”, NCI is net income attributable to noncontrolling interests), was $464.5 million during the fourth quarter of 2021, as compared to $557.2 million during the fourth quarter of 2020. Our adjusted earnings before interest, taxes, depreciation & amortization (“Adjusted EBITDA net of NCI”), which excludes the impact of other (income) expense, net, was $452.2 million during the fourth quarter of 2021 as compared to $548.9 million during the fourth quarter of 2020.

Consolidated Results of Operations, As Reported and As Adjusted  – Twelve-month periods ended December 31, 2021 and 2020:

Reported net income attributable to UHS was $991.6 million, or $11.82 per diluted share, during the full year of 2021, as compared to $944.0 million, or $10.99 per diluted share, during the 2020 full year. Net revenues increased by 9.4% to $12.642 billion during 2021 as compared to $11.559 billion during 2020.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the twelve-month period ended December 31, 2021 was $991.7 million, or $11.82 per diluted share, as compared to $954.7 million, or $11.12 per diluted share, during the full year of 2020.

Our reported and adjusted net income attributable to UHS during the twelve-month period ended December 31, 2021, included the following:

a favorable after-tax impact of $74.0 million, or $.88 per diluted share, resulting from approximately $97 million of revenues recorded during 2021 in connection with the Kentucky Medicaid Managed Care Hospital Rate Increase Program, covering the period of July 1, 2020 to December 31, 2021, as discussed below in Kentucky Hospital Rate Increase Program;
an unfavorable after-tax impact of approximately $39.2 million, or $.47 per diluted share, resulting from a $52 million increase to our reserves for self-insured professional and general liability claims recorded during 2021 resulting from unfavorable trends experienced in connection with the number of asserted claims and reported incidents and estimates of losses for those claims, and;
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an aggregate favorable after-tax impact of $28.4 million, or $.34 per diluted share, resulting from approximately $38 million of aggregate commercial insurance proceeds received during 2021 in connection with: (i) the unfavorable economic impact resulting from the previously disclosed information technology incident that occurred during 2020 ($29 million aggregate proceeds received thus far representing partial recovery of the loss sustained), and; (ii) the COVID-19 pandemic (approximately $9 million of insurance proceeds received representing recovery of the policy maximum).
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Our reported and adjusted net income attributable to UHS during the twelve-month period ended December 31, 2020, included the following: (i) a favorable impact of $308.6 million, or $3.61 per diluted share, resulting from the recording of grant revenues of approximately $413 million from various governmental stimulus programs, most notably the CARES Act; (ii) an unfavorable estimated impact of $51.3 million ($67 million pre-tax), or $.60 per diluted share, resulting from the information technology incident that occurred in September, 2020, and; (iii) a favorable impact of $21.4 million, or $0.25 per diluted share, resulting from $28 million of net revenues recorded in connection with the California Medicaid supplemental payment program related to our acute care hospitals.

As reflected on the Supplemental Schedule, included in our reported results during the twelve-month period ended December 31, 2021, were the following which, on a net aggregate basis, amounted to a de minimis amount: (i) an after-tax charge of $12.9 million, or $.15 per diluted share, ($16.8 million pre-tax which is included in “Other (income) expense, net”) recorded in connection with the costs related to extinguishment of debt resulting from various financing transactions completed during the third quarter of 2021; (ii) an after-tax unrealized gain of $10.4 million, or $.12 per diluted share, ($13.6 million pre-tax which is included in “Other

(income) expense, net”) resulting from an increase in the market value of shares of certain equity securities, and; (iii) a favorable after-tax impact of $2.4 million, or $.03 per diluted share, resulting from ASU 2016-09.

As reflected on the Supplemental Schedule, included in our reported results during the twelve-month period ended December 31, 2020, was a net aggregate unfavorable after-tax impact of $10.8 million, or $.13 per diluted share, consisting of the following: (i) an after-tax unrealized loss of $3.3 million, or $.04 per diluted share, resulting from a decrease in the market value of shares of certain equity securities, and; (ii) an unfavorable after-tax impact of $7.4 million, or $.09 per diluted share, resulting from ASU 2016-09.

As calculated on the attached Supplemental Schedule, our EBITDA net of NCI, was $1.914 billion during the twelve-month period ended December 31, 2021, as compared to $1.860 billion during the full year of 2020. Our Adjusted EBITDA net of NCI, which excludes the impact of other (income) expense, net, was $1.900 billion during the twelve-month period ended December 31, 2021, as compared to $1.860 billion during the full year of 2020.

Acute Care Services – Three and twelve-month periods ended December 31, 2021 and 2020:

During the fourth quarter of 2021, at our acute care hospitals owned during both periods (“same facility basis”), adjusted admissions (adjusted for outpatient activity) increased by 8.9% and adjusted patient days increased by 5.0%, as compared to the fourth quarter of 2020.

At these facilities, excluding the CARES Act and other governmental stimulus revenues of approximately $155 million recorded during the fourth quarter of 2020, net revenue per adjusted admission increased by 3.7% while net revenue per adjusted patient day increased by 7.5% during the fourth quarter of 2021, as compared to the fourth quarter of 2020.  During the fourth quarter of 2021, as compared to the fourth quarter of 2020, net revenues generated from our acute care services on a same facility basis increased by 4.4% including the CARES Act and other governmental stimulus revenues recorded during the fourth quarter of 2020, and increased by 14.8% excluding the CARES Act and other governmental stimulus revenues recorded during the fourth quarter of 2020.

During the twelve-month period ended December 31, 2021, at our acute care hospitals on a same facility basis, adjusted admissions increased by 7.7% and adjusted patient days increased by 8.6%, as compared to the full year of 2020.  At these facilities, excluding the CARES Act and other governmental stimulus revenues of approximately $316 million recorded during the full year of 2020, net revenue per adjusted admission increased by 8.6% while net revenue per adjusted patient day increased by 7.7% during the full year of 2021, as compared to 2020. During the full year of 2021, as compared to 2020, net revenues generated from our acute care services on a same facility basis increased by 11.6% including the CARES Act and other governmental stimulus revenues recorded during the full year of 2020 and increased by 17.6% excluding the CARES Act and other governmental stimulus revenues recorded during 2020.

Behavioral Health Care Services – Three and twelve-month periods ended December 31, 2021 and 2020:

During the fourth quarter of 2021, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 1.5% and adjusted patient days increased 0.5%, as compared to the fourth quarter of 2020.

At these facilities, excluding the CARES Act and other governmental stimulus revenues of approximately $45 million recorded during the fourth quarter of 2020, net revenue per adjusted admission increased by 7.8% while net revenue per adjusted patient day increased by 8.9% during the fourth quarter of 2021, as compared to the fourth quarter of 2020.  During the fourth quarter of 2021, as compared to the fourth quarter of 2020, net revenues generated from our behavioral health care services on a same facility basis increased by 5.4% including the CARES Act and other governmental stimulus revenues recorded during the fourth quarter of 2020, and increased by 9.2% excluding the CARES Act and other governmental stimulus revenues recorded during the fourth quarter of 2020.

During the twelve-month period ended December 31, 2021, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 1.6% and adjusted patient days increased by 0.4%, as compared to the full year of 2020. At these facilities, excluding the CARES Act and other governmental stimulus revenues of approximately $97 million recorded during the full year of 2020, net revenue per adjusted admission increased by 5.4% while net revenue per adjusted patient day increased by 6.7% during the full year of 2021, as compared to the full year of 2020.  During the year ended December 31, 2021, as compared to the full year of 2020, net revenues generated from our behavioral health care services on a same facility basis increased by 5.4% including the CARES Act and other governmental stimulus revenues recorded during the full year of 2020, and increased by 7.5% excluding the CARES Act and other governmental stimulus revenues recorded during the year ended December 31, 2020.

COVID-19

The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material effect on our operations and financial results since that time. The COVID-19 vaccination process commenced during the first quarter of 2021. Since that time through the second quarter of 2021, we had generally experienced a decline in COVID-19 patients as well as a corresponding recovery in non-COVID patient activity.  However, during the third and fourth quarters of 2021, and continuing into the first quarter of 2022, our facilities have generally experienced an increase in COVID-19 patients resulting from the Delta and, more recently, the highly transmissible Omicron variants. Although booster doses for COVID-19 vaccinations began during the third quarter of 2021, and while we expect the administration of vaccines booster doses will assist in easing the number of COVID-19 patients, the pace at which this is likely to occur is very difficult to predict. Since the future volumes and severity of COVID-19 patients remain highly uncertain and subject to change, including potential increases in future COVID-19 patient volumes caused by new variants of the virus, as well as related pressures on staffing and wage rates, we are not able to fully quantify the impact that these factors will have on our future financial results.  However, developments related to the COVID-19 pandemic could materially affect our financial performance during 2022.

Net Cash Provided by Operating Activities and Liquidity and Financing Transactions:

Net Cash Provided by Operating Activities:

For the twelve months ended December 31, 2021, our net cash provided by operating activities was $884 million as compared to $2.360 billion during the full year of 2020.  The $1.476 billion net decrease in our cash provided by operating activities during the year ended December 31, 2021, as compared to full year of 2020, was due to: (i) an unfavorable change of $1.398 billion resulting primarily from the early return of the $695 million of Medicare accelerated payments which were repaid during the first quarter of 2021, as compared to a favorable change of $699 million experienced during 2020 resulting primarily from receipt of the Medicare accelerated payments; (ii) an unfavorable change of approximately $262 million due to the following, as provided for by the CARES Act: (1) a $178 million favorable impact experienced during 2020 resulting from the payment deferral of the employer’s share of Social Security taxes, and; (2) an $84 million unfavorable impact experienced during 2021 resulting from the payment of the first of two installments to remit the deferred amount (the $94 million remaining payment deferral will be remitted during 2022); (iii) a favorable change of $137 million in accounts receivable due, in part, to the unfavorable impact experienced during 2020, and corresponding favorable impact experienced during 2021, resulting from the coding, billing and collection delays experienced during the fourth quarter of 2020 resulting from the information technology incident that occurred in September, 2020; (iv) a favorable change of $88 million resulting from an increase in net income plus depreciation and amortization expense, stock-based compensation expense, gain/loss on sales of assets and businesses, costs related to extinguishment of debt and provision for asset impairment; (v) an unfavorable change of $64 million in accrued and deferred income taxes; (vi) a favorable change of $49 million in accrued insurance expense, net of commercial premiums paid, and; (vii) $26 million of other combined net unfavorable changes.

Liquidity and Financing Transactions:

As of December 31, 2021, we had $854 million of aggregate available borrowing capacity pursuant to our $1.2 billion revolving credit facility, net of outstanding letters of credit.

In connection with the various financing transactions completed during the third quarter of 2021, our results of operations for the twelve-month periods ended December 31, 2021, include a $16.8 million pre-tax charge incurred for costs related to the extinguishment of debt. This pre-tax charge consisted of the following: (i) $6.8 million incurred to write-off unamortized deferred charges on the extinguished debt, and; (ii) a $10 million make-whole premium paid on the early redemption of the $400 million, 5.00% senior secured notes.

Stock Repurchase Program and Increased Authorization:

On February 24, 2022, our Board of Directors authorized a $1.4 billion increase to our stock repurchase program. Pursuant to this 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 fourth quarter of 2021, pursuant to previous share repurchase authorizations, including a $1.0 billion increase to the program approved by our Board of Directors in July, 2021, we have repurchased approximately 3.43 million shares at an aggregate cost of approximately $432.3 million (approximately $126 per share).  For the year ended December 31, 2021, we have repurchased approximately 8.41 million shares at an aggregate cost of approximately $1.201 billion (approximately $143 per share).

As of December 31, 2021, prior to the above-mentioned increased authorization approved in February, 2022, we had an aggregate available repurchase authorization of $358.2 million.  In January and February of 2022, we have repurchased an additional 2.30 million shares at an aggregate cost of approximately $299.1 million (approximately $130 per share).  As of February 24, 2022, including the above-mentioned $1.4 billion increased authorization, we have an aggregate available repurchase authorization of approximately $1.46 billion.

2022 Operating Results Forecast:

Reflected below is our 2022 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”), adjusted net income attributable to UHS per diluted share (“Adjusted EPS-diluted”) and capital expenditures.

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, 2021. Please see the Supplemental Non-GAAP Disclosures - 2022 Operating Results Forecast schedule as included herein for additional information and a reconciliation to the financial forecasts as computed in accordance with GAAP.

For the Year Ended

December 31, 2022

Low High
Net revenues $13.424 billion $13.694 billion
Adjusted EBITDA net of NCI $1.830 billion $1.927 billion
Adjusted EPS-diluted $11.90 per share $12.90 per share
Capital expenditures $950 million $1.100 billion

Our 2022 guidance contains a number of assumptions including, but not limited to, the following:

The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material unfavorable effect on our operations and financial results since that time. The
extent to which the COVID-19 pandemic and measures taken in response thereto impact our business, results of operations and financial condition will depend on numerous factors and future developments, most of which are beyond our control or ability to predict. The ultimate impact of the COVID-19 pandemic is highly uncertain and subject to change. We are not able to fully quantify the impact that these factors will have on our future financial results, but expect developments related to the COVID-19 pandemic to materially affect our financial performance in 2022 and may cause our 2022 actual operating results to differ materially from our 2022 operating results forecast. Please see additional disclosure above in COVID-19.
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The 2022 forecasted amounts exclude the impact of future items, if applicable, that are nonrecurring or non-operational in nature including items such as, 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, impairment of 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 below in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures.
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Our net revenues are estimated to be approximately $13.424 billion to $13.694 billion representing an increase of approximately 6.2% to 8.3% over our 2021 net revenues of approximately $12.642 billion.
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Our Adjusted EBITDA net of NCI is estimated to be approximately $1.830 billion to $1.927 billion as compared to our 2021 Adjusted EBITDA net of NCI of $1.900 billion.
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Our Adjusted EPS-diluted range is estimated to be $11.90 per diluted share to $12.90 per diluted share as compared to our adjusted net income attributable to UHS of $11.82 per diluted share for the year ended December 31, 2021, as calculated on the attached Supplemental Schedule.
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Kentucky Hospital Rate Increase Program:

In early 2021, CMS approved the Kentucky Medicaid Managed Care Hospital Rate Increase Program (“HRIP”) for SFY 2021, which covered the period of July 1, 2020 through June 30, 2021. In December 2021, CMS approved the HRIP program period for the period July 1, 2021 to December 31, 2021.

Included in our financial results for the three-month period ended December 31, 2021 is approximately $34 million of HRIP reimbursement covering the six-month period of July 1, 2021 through December 31, 2021.  Included in our financial results for the full year of 2021 was approximately $97 million of HRIP reimbursement covering the eighteen-month period of July 1, 2020 through December 31, 2021.

Programs such as HRIP require an annual state submission and approval by CMS. In December, 2021, CMS approved the program for the period of January 1, 2022 through December 31, 2022 at rates similar to the prior year. We estimate that our reimbursements pursuant to HRIP will approximate $58 million during the year ended December 31, 2022.

Conference call information:

We will hold a conference call for investors and analysts at 9:00 a.m. eastern time on February 25, 2022. The dial-in number is 1-877-648-7971.

A live broadcast of the conference call will be available on our website at www.uhs.com.  Also, a replay of the call will be available following the conclusion of the live call and will be available for one full year.

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

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2021 were approximately $12.6 billion. In 2022, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and in 2021 the Company ranked #270 on the Fortune 500 and #307 on Forbes’ list of America’s Largest Public Companies.

Our operating philosophy is as effective today as it was upon the Company’s founding in 1979, enabling us to provide compassionate care to our patients and their loved ones.  Our strategy includes building or acquiring high quality hospitals in rapidly growing markets, investing in the people and equipment needed to allow each facility to thrive, and becoming the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has over 89,000 employees and through its subsidiaries operates 27 acute care hospitals, 335 behavioral health facilities, 40 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 39 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. In addition, UHS also has under construction, a new 170-bed acute care hospital located in Reno, Nevada, that is scheduled to be completed and opened during the first quarter of 2022. It acts as the advisor to Universal Health Realty Income Trust, a real estate investment trust (NYSE:UHT).  For additional information visit www.uhs.com.

This press release contains forward-looking statements based on current management expectations.  Numerous factors, including those disclosed herein, those related to the anticipated impact of COVID-19 on our operations and financial results, those related to healthcare industry trends and those detailed in our filings with the Securities and Exchange Commission (as set forth in Item 1A-Risk Factors and in Item 7-Forward-Looking Statements and Risk Factors in our Form 10-K for the year ended December 31, 2021), may cause the results to differ materially from those anticipated in the forward-looking statements.  These statements are subject to risks and uncertainties and therefore actual results may differ materially.  Readers should not place undue reliance on such forward-looking statements which reflect management’s view only as of the date hereof.  We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.  Many of the factors that could affect our future results are beyond our control or ability to predict, including the impact of the COVID-19 pandemic. Our future operations and financial results will likely be materially impacted by developments related to COVID-19 including, but not limited to, the potential impact on future COVID-19 patient volumes resulting from new variants of the virus, the length of time and severity of the spread of the pandemic; the volume of cancelled or rescheduled elective procedures and the volume of COVID-19 patients treated at our hospitals and other healthcare facilities; measures we are taking to respond to the COVID-19 pandemic; the impact of government and administrative regulation and stimulus on the hospital industry and potential retrospective adjustment in future periods of CARES Act and other grant income revenues recorded as revenues in prior periods; declining patient volumes and unfavorable changes in payer mix caused by deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients as the result of business closings and layoffs); potential disruptions to our clinical staffing and shortages and disruptions related to supplies required for our employees and patients; and potential increases to expenses related to staffing, supply chain or other expenditures; the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financing perspective; and changes in general economic conditions nationally and regionally in our markets resulting from the COVID-19 pandemic. We are not able to fully quantify the impact that these factors will have on our future financial results, but developments related to the COVID-19 pandemic could materially affect our financial performance during 2022.

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, the impact of ASU 2016-09, unrealized gains/losses resulting from 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 long-lived and intangible assets, reserves for various matters including settlements, legal judgments and lawsuits, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. To obtain a complete understanding of our financial performance these measures should be examined in connection with net income attributable to UHS, as determined in accordance with GAAP, and as presented in the condensed consolidated financial statements and notes thereto in this report or in our other filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2021. Since the items included or excluded from these measures are significant components in understanding and assessing financial performance under GAAP, these measures should not be considered to be alternatives to net income as a measure of our operating performance or profitability. Since these measures, as presented, are not determined in accordance with GAAP and are thus susceptible to varying calculations, they may not be comparable to other similarly titled measures of other companies. Investors are encouraged to use GAAP measures when evaluating our financial performance.

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Universal Health Services, Inc.
Consolidated Statements of Income
(in thousands, except per share amounts)
(unaudited)
Three months Twelve months
ended December 31, ended December 31,
2021 2020 2021 2020
Net revenues $ 3,275,251 3,086,935 $ 12,642,117 11,558,897
Operating charges:
Salaries, wages and benefits 1,621,788 1,466,070 6,163,944 5,613,097
Other operating expenses 802,279 690,560 3,035,869 2,672,762
Supplies expense 374,157 351,324 1,427,134 1,288,132
Depreciation and amortization 133,363 133,930 533,213 510,493
Lease and rental expense 30,015 31,092 118,863 116,059
2,961,602 2,672,976 11,279,023 10,200,543
Income from operations 313,649 413,959 1,363,094 1,358,354
Interest expense, net 19,217 19,886 83,672 106,285
Other (income) expense, net (12,316 ) (8,305 ) (13,891 ) (14 )
Income before income taxes 306,748 402,378 1,293,313 1,252,083
Provision for income taxes 72,837 94,644 305,681 299,293
Net income 233,911 307,734 987,632 952,790
Less:  Net income (loss) attributable to noncontrolling interests ("NCI") (5,213 ) (974 ) (3,958 ) 8,837
Net income attributable to UHS $ 239,124 $ 308,708 $ 991,590 $ 943,953
Basic earnings per share attributable to UHS (a) $ 3.03 $ 3.63 $ 11.99 $ 11.06
Diluted earnings per share attributable to UHS (a) $ 3.00 $ 3.60 $ 11.82 $ 10.99
Universal Health Services, Inc.
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Footnotes to Consolidated Statements of Income
(in thousands, except per share amounts)
(unaudited)
Three months Twelve months
ended December 31, ended December 31,
2021 2020 2021 2020
(a) Earnings per share calculation:
Basic and diluted:
Net income attributable to UHS $ 239,124 $ 308,708 $ 991,590 $ 943,953
Less: Net income attributable to unvested restricted share grants (450 ) (994 ) (2,059 ) (2,981 )
Net income attributable to UHS - basic and diluted $ 238,674 $ 307,714 $ 989,531 $ 940,972
Weighted average number of common shares - basic 78,808 84,728 82,519 85,061
Basic earnings per share attributable to UHS: $ 3.03 $ 3.63 $ 11.99 $ 11.06
Weighted average number of common shares 78,808 84,728 82,519 85,061
Add: Other share equivalents 867 859 1,173 526
Weighted average number of common shares and equiv. - diluted 79,675 85,587 83,692 85,587
Diluted earnings per share attributable to UHS: $ 3.00 $ 3.60 $ 11.82 $ 10.99
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- ---
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Three Months ended December 31, 2021 and 2020
(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
December 31, 2021 revenues December 31, 2020 revenues
Net income attributable to UHS $ 239,124 $ 308,708
Depreciation and amortization 133,363 133,930
Interest expense, net 19,217 19,886
Provision for income taxes 72,837 94,644
EBITDA net of NCI $ 464,541 14.2 % $ 557,168 18.0 %
Other (income) expense, net (12,316 ) (8,305 )
Adjusted EBITDA net of NCI $ 452,225 13.8 % $ 548,863 17.8 %
Net revenues $ 3,275,251 $ 3,086,935
Calculation of Adjusted Net Income Attributable to UHS
Three months ended Three months ended
December 31, 2021 December 31, 2020
Per Per
Amount Diluted Share Amount Diluted Share
Net income attributable to UHS $ 239,124 $ 3.00 $ 308,708 $ 3.60
Plus/minus after-tax adjustments:
Unrealized gain on equity securities (4,119 ) (0.05 ) (3,880 ) (0.05 )
Impact of ASU 2016-09 99 - 3,031 0.04
Subtotal adjustments (4,020 ) (0.05 ) (849 ) (0.01 )
Adjusted net income attributable to UHS $ 235,104 $ 2.95 $ 307,859 $ 3.59
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- ---
Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule")
For the Twelve Months ended December 31, 2021 and 2020
(in thousands, except per share amounts)
(unaudited)
Calculation of Earnings/Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization ("EBITDA/Adjusted EBITDA net of NCI")
Twelve months ended % Net Twelve months ended % Net
December 31, 2021 revenues December 31, 2020 revenues
Net income attributable to UHS $ 991,590 $ 943,953
Depreciation and amortization 533,213 510,493
Interest expense, net 83,672 106,285
Provision for income taxes 305,681 299,293
EBITDA net of NCI $ 1,914,156 15.1 % $ 1,860,024 16.1 %
Other (income) expense, net (13,891 ) (14 )
Adjusted EBITDA net of NCI $ 1,900,265 15.0 % $ 1,860,010 16.1 %
Net revenues $ 12,642,117 $ 11,558,897
Calculation of Adjusted Net Income Attributable to UHS
Twelve months ended Twelve months ended
December 31, 2021 December 31, 2020
Per Per
Amount Diluted Share Amount Diluted Share
Net income attributable to UHS $ 991,590 $ 11.82 $ 943,953 $ 10.99
Plus/minus after-tax adjustments:
Unrealized (gain) loss on equity securities (10,374 ) (0.12 ) 3,313 0.04
Debt extinguishment costs 12,884 0.15 - -
Impact of ASU 2016-09 (2,423 ) (0.03 ) 7,443 0.09
Subtotal adjustments 87 - 10,756 0.13
Adjusted net income attributable to UHS $ 991,677 $ 11.82 $ 954,709 $ 11.12
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- ---
Consolidated Statements of Comprehensive Income
(in thousands)
(unaudited)
Three months Twelve months
ended December 31, ended December 31,
2021 2020 2021 2020
Net income $ 233,911 $ 307,734 $ 987,632 $ 952,790
Other comprehensive income (loss):
Minimum pension liability 1,427 4,428 1,427 4,428
Foreign currency translation adjustment 2,441 31,899 (20,743 ) 13,619
Other comprehensive income (loss)  before tax 3,868 36,327 (19,316 ) 18,047
Income tax expense (benefit) related to items of other comprehensive income (loss) 471 2,728 (1,487 ) 1,820
Total other comprehensive income (loss), net of tax 3,397 33,599 (17,829 ) 16,227
Comprehensive income 237,308 341,333 969,803 969,017
Less: Comprehensive income attributable to noncontrolling interests (5,213 ) (974 ) (3,958 ) 8,837
Comprehensive income attributable to UHS $ 242,521 $ 342,307 $ 973,761 $ 960,180
Universal Health Services, Inc.
--- --- --- --- --- --- ---
Condensed Consolidated Balance Sheets
(in thousands)
(unaudited)
December 31, December 31,
2021 2020
Assets
Current assets:
Cash and cash equivalents $ 115,301 $ 1,224,490
Accounts receivable, net 1,746,635 1,728,928
Supplies 206,839 190,417
Other current assets 194,781 138,034
Total current assets 2,263,556 3,281,869
Property and equipment 10,770,702 9,885,888
Less: accumulated depreciation (4,896,427 ) (4,512,764 )
5,874,275 5,373,124
Other assets:
Goodwill 3,962,624 3,882,715
Deferred income taxes 45,707 22,689
Right of use assets-operating leases 367,477 336,513
Deferred charges 6,525 4,985
Other 573,379 574,984
Total Assets $ 13,093,543 $ 13,476,879
Liabilities and Stockholders' Equity
Current liabilities:
Current maturities of long-term debt $ 48,409 $ 331,998
Accounts payable and other liabilities 1,860,490 1,668,671
Medicare accelerated payments and deferred CARES Act and other grants 6 376,151
Operating lease liabilities 64,484 59,796
Federal and state taxes 10,720 44,423
Total current liabilities 1,984,109 2,481,039
Other noncurrent liabilities 464,759 458,549
Operating lease liabilities noncurrent 304,624 278,303
Medicare accelerated payments noncurrent 0 322,617
Long-term debt 4,141,879 3,524,253
Deferred income taxes 0 5,582
Redeemable noncontrolling interest 5,119 4,569
UHS common stockholders' equity 6,089,664 6,317,146
Noncontrolling interest 103,389 84,821
Total equity 6,193,053 6,401,967
Total Liabilities and Stockholders' Equity $ 13,093,543 $ 13,476,879
Universal Health Services, Inc.
--- --- --- --- --- --- ---
Consolidated Statements of Cash Flows
(in thousands)
(unaudited)
Twelve months
ended December 31,
2021 2020
Cash Flows from Operating Activities:
Net income $ 987,632 $ 952,790
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization 533,213 510,493
(Gain) loss on sale of assets and businesses (5,170 ) 1,957
Costs related to extinguishment of debt 16,831 1,365
Stock-based compensation expense 73,686 65,837
Provision for asset impairment 14,391 0
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable (8,873 ) (145,901 )
Accrued interest 4,950 (10,028 )
Accrued and deferred income taxes (54,030 ) 9,593
Other working capital accounts 46,526 124,545
Medicare accelerated payments and deferred CARES Act and other grants (698,762 ) 698,768
Other assets and deferred charges (39,337 ) (4,555 )
Other (82,075 ) 109,167
Accrued insurance expense, net of commercial premiums paid 186,215 159,223
Payments made in settlement of self-insurance claims (91,502 ) (113,085 )
Net cash provided by operating activities 883,695 2,360,169
Cash Flows from Investing Activities:
Property and equipment additions (855,659 ) (731,307 )
Proceeds received from sales of assets and businesses 25,425 8,168
Acquisition of businesses and property (105,415 ) (52,009 )
Inflows (outflows) from foreign exchange contracts that hedge our net U.K. investment 1,357 (21,740 )
Decrease (increase) in capital reserves of commercial insurance subsidiary 100 (100 )
Costs incurred for purchase of information technology applications, net of refunds 19,726 (2,902 )
Investment in, and advances to, joint venture and other 0 (2,672 )
Net cash used in investing activities (914,466 ) (802,562 )
Cash Flows from Financing Activities:
Repayments of long-term debt (3,037,868 ) (962,567 )
Additional borrowings 3,254,974 801,599
Financing costs (18,770 ) (10,300 )
Repurchase of common shares (1,220,875 ) (206,719 )
Dividends paid (65,896 ) (17,344 )
Issuance of common stock 13,372 12,318
Profit distributions to noncontrolling interests (7,080 ) (19,805 )
Purchase of ownership interests by minority member 13,193 17,959
Net cash used in financing activities (1,068,950 ) (384,859 )
Effect of exchange rate changes on cash, cash equivalents and restricted cash (499 ) 739
(Decrease) increase in cash, cash equivalents and restricted cash (1,100,220 ) 1,173,487
Cash, cash equivalents and restricted cash, beginning of period 1,279,154 105,667
Cash, cash equivalents and restricted cash, end of period $ 178,934 $ 1,279,154
Supplemental Disclosures of Cash Flow Information:
Interest paid $ 75,607 $ 112,598
Income taxes paid, net of refunds $ 362,978 $ 286,247
Noncash purchases of property and equipment $ 167,234 $ 74,854
Universal Health Services, Inc.
--- --- --- ---
Supplemental Statistical Information
(unaudited)
% Change % Change
Same Facility: Quarter ended 12 months ended
12/31/2021 12/31/2021
Acute Care Services
Revenues (a) 4.4% 11.6%
Revenues-excludes governmental stimulus revenues 14.8% 17.6%
Adjusted Admissions 8.9% 7.7%
Adjusted Patient Days 5.0% 8.6%
Revenue Per Adjusted Admission-excludes governmental stimulus revenues 3.7% 8.6%
Revenue Per Adjusted Patient Day-excludes governmental stimulus revenues 7.5% 7.7%
Behavioral Health Care Services
Revenues (b) 5.4% 5.4%
Revenues-excludes governmental stimulus revenues 9.2% 7.5%
Adjusted Admissions 1.5% 1.6%
Adjusted Patient Days 0.5% 0.4%
Revenue Per Adjusted Admission-excludes governmental stimulus revenues 7.8% 5.4%
Revenue Per Adjusted Patient Day-excludes governmental stimulus revenues 8.9% 6.7%
(a) Includes governmental stimulus program revenues of 155 million and 316 million recorded in the three and twelve-months periods ended December 31, 2020, respectively.
(b) Includes governmental stimulus program revenues of 45 million and 97 million recorded in the three and twelve-months periods ended December 31, 2020, respectively.
UHS Consolidated Twelve months ended
12/31/2020 12/31/2021 12/31/2020
Revenues $3,086,935 $12,642,117 $11,558,897
EBITDA net of NCI $557,168 $1,914,156 $1,860,024
EBITDA Margin net of NCI 18.0% 15.1% 16.1%
Adjusted EBITDA net of NCI $548,863 $1,900,265 $1,860,010
Adjusted EBITDA Margin net of NCI 17.8% 15.0% 16.1%
Cash Flow From Operations $142,012 $883,695 $2,360,169
Days Sales Outstanding 50 50 55
Capital Expenditures $184,651 $855,659 $731,307
Debt $4,190,288 $3,856,251
UHS' Shareholders Equity $6,089,664 $6,317,146
Debt / Total Capitalization 40.8% 37.9%
Debt / EBITDA net of NCI (1) 2.19 2.07
Debt / Adjusted EBITDA net of NCI (1) 2.21 2.07
Debt / Cash From Operations (1) 4.74 1.63
Net Debt / EBITDA net of NCI (1) (2) 2.19 1.45
Net Debt / Adjusted EBITDA net of NCI (1) (2) 2.21 1.45
Net Debt / Cash From Operations (1) (2) 4.74 1.14
(1) Latest 4 quarters
(2) Debt, net of approximately 1.2 billion of short-term cash investments as of December 31, 2020.

All values are in US Dollars.

Universal Health Services, Inc.

Acute Care Hospital Services

For the Three and Twelve Months ended

December 31, 2021 and 2020

(in thousands)

Same Facility Basis - Acute Care Hospital Services
Three months ended Twelve months ended Twelve months ended
December 31, 2020 December 31, 2021 December 31, 2020
% of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues
Net revenues (a) 1,785,033 100.0 % $ 1,709,872 100.0 % $ 6,963,627 100.0 % 6,238,236 100.0 %
Operating charges:
Salaries, wages and benefits 794,807 44.5 % 701,927 41.1 % 2,947,853 42.3 % 2,611,143 41.9 %
Other operating expenses 440,571 24.7 % 375,958 22.0 % 1,656,848 23.8 % 1,462,627 23.4 %
Supplies expense 317,142 17.8 % 299,376 17.5 % 1,218,969 17.5 % 1,081,154 17.3 %
Depreciation and amortization 81,153 4.5 % 83,321 4.9 % 327,774 4.7 % 318,077 5.1 %
Lease and rental expense 17,758 1.0 % 19,414 1.1 % 73,421 1.1 % 69,638 1.1 %
Subtotal-operating expenses 1,651,431 92.5 % 1,479,996 86.6 % 6,224,865 89.4 % 5,542,639 88.8 %
Income from operations 133,602 7.5 % 229,876 13.4 % 738,762 10.6 % 695,597 11.2 %
Interest expense, net 257 0.0 % 228 0.0 % 1,006 0.0 % 1,567 0.0 %
Other (income) expense, net 131 0.0 % - - 567 0.0 % - -
Income before income taxes 133,214 7.5 % $ 229,648 13.4 % $ 737,189 10.6 % $ 694,030 11.1 %
All Acute Care Hospital Services
Three months ended Twelve months ended Twelve months ended
December 31, 2020 December 31, 2021 December 31, 2020
% of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues
Net revenues (a) 1,837,254 100.0 % $ 1,738,746 100.0 % $ 7,108,254 100.0 % 6,337,304 100.0 %
Operating charges:
Salaries, wages and benefits 811,080 44.1 % 702,099 40.4 % 2,968,140 41.8 % 2,611,514 41.2 %
Other operating expenses 466,768 25.4 % 404,966 23.3 % 1,772,312 24.9 % 1,561,875 24.6 %
Supplies expense 322,010 17.5 % 299,383 17.2 % 1,224,664 17.2 % 1,081,159 17.1 %
Depreciation and amortization 83,046 4.5 % 83,368 4.8 % 331,508 4.7 % 318,124 5.0 %
Lease and rental expense 19,715 1.1 % 19,414 1.1 % 75,391 1.1 % 69,638 1.1 %
Subtotal-operating expenses 1,702,619 92.7 % 1,509,230 86.8 % 6,372,015 89.6 % 5,642,310 89.0 %
Income from operations 134,635 7.3 % 229,516 13.2 % 736,239 10.4 % 694,994 11.0 %
Interest expense, net 257 0.0 % 228 0.0 % 1,006 0.0 % 1,567 0.0 %
Other (income) expense, net 131 0 - - 567 0 - -
Income before income taxes 134,247 7.3 % $ 229,288 13.2 % $ 734,666 10.3 % $ 693,427 10.9 %
(a) Includes governmental stimulus program revenues of 155 million and 316 million recorded in the three and twelve-months periods ended December 31, 2020, respectively.

All values are in US Dollars.

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 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, 2021.

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 Twelve Months ended

December 31, 2021 and 2020

(in thousands)

Same Facility - Behavioral Health Care Services
Three months ended Twelve months ended Twelve months ended
December 31, 2020 December 31, 2021 December 31, 2020
% of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues
Net revenues (a) 1,390,581 100.0 % 1,319,149 100.0 % $ 5,394,647 100.0 % 5,116,728 100.0 %
Operating charges:
Salaries, wages and benefits 740,469 53.2 % 695,839 52.7 % 2,874,224 53.3 % 2,717,905 53.1 %
Other operating expenses 261,161 18.8 % 236,198 17.9 % 1,037,248 19.2 % 929,922 18.2 %
Supplies expense 52,081 3.7 % 50,681 3.8 % 203,516 3.8 % 204,442 4.0 %
Depreciation and amortization 45,377 3.3 % 45,660 3.5 % 182,303 3.4 % 175,537 3.4 %
Lease and rental expense 9,843 0.7 % 10,556 0.8 % 41,182 0.8 % 41,940 0.8 %
Subtotal-operating expenses 1,108,931 79.7 % 1,038,934 78.8 % 4,338,473 80.4 % 4,069,746 79.5 %
Income from operations 281,650 20.3 % 280,215 21.2 % 1,056,174 19.6 % 1,046,982 20.5 %
Interest expense, net 324 0.0 % 368 0.0 % 1,338 0.0 % 1,447 0.0 %
Other (income) expense, net (339 ) (0.0 )% (1,277 ) (0.1 )% 96 0.0 % 1,060 0.0 %
Income before income taxes 281,665 20.3 % $ 281,124 21.3 % $ 1,054,740 19.6 % $ 1,044,475 20.4 %
All Behavioral Health Care Services
Three months ended Twelve months ended Twelve months ended
December 31, 2020 December 31, 2021 December 31, 2020
% of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues Amount % of Net<br><br><br>Revenues
Net revenues (a) 1,428,517 100.0 % 1,343,899 100.0 % $ 5,503,644 100.0 % 5,208,722 100.0 %
Operating charges:
Salaries, wages and benefits 748,293 52.4 % 699,906 52.1 % 2,893,028 52.6 % 2,727,129 52.4 %
Other operating expenses 298,099 20.9 % 258,727 19.3 % 1,145,879 20.8 % 1,023,733 19.7 %
Supplies expense 52,567 3.7 % 50,850 3.8 % 204,840 3.7 % 204,711 3.9 %
Depreciation and amortization 46,891 3.3 % 47,931 3.6 % 187,761 3.4 % 182,012 3.5 %
Lease and rental expense 9,914 0.7 % 11,354 0.8 % 41,703 0.8 % 45,505 0.9 %
Subtotal-operating expenses 1,155,764 80.9 % 1,068,768 79.5 % 4,473,211 81.3 % 4,183,090 80.3 %
Income from operations 272,753 19.1 % 275,131 20.5 % 1,030,433 18.7 % 1,025,632 19.7 %
Interest expense, net 1,216 0.1 % 415 0.0 % 4,780 0.1 % 1,599 0.0 %
Other (income) expense, net (339 ) (0.0 )% (1,561 ) (0.1 )% 96 0.0 % 776 0.0 %
Income before income taxes 271,876 19.0 % $ 276,277 20.6 % $ 1,025,557 18.6 % $ 1,023,257 19.6 %
(a) Includes governmental stimulus program revenues of 45 million and 97 million recorded in the three and twelve-months periods ended December 31, 2020, respectively.

All values are in US Dollars.

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 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, 2021.

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
December 31, 2021 and 2020
AS REPORTED:
ACUTE BEHAVIORAL HEALTH
12/31/21 12/31/20 % change 12/31/21 12/31/20 % change
Hospitals owned and leased 27 26 3.8 % 335 334 0.3 %
Average licensed beds 6,654 6,476 2.7 % 24,154 23,859 1.2 %
Average available beds 6,482 6,304 2.8 % 24,054 23,759 1.2 %
Patient days 397,498 386,491 2.8 % 1,526,510 1,522,352 0.3 %
Average daily census 4,320.6 4,201.0 2.8 % 16,592.5 16,547.3 0.3 %
Occupancy-licensed beds 64.9 % 64.9 % 0.1 % 68.7 % 69.4 % -1.0 %
Occupancy-available beds 66.7 % 66.6 % 0.1 % 69.0 % 69.6 % -0.9 %
Admissions 77,352 72,877 6.1 % 111,132 109,514 1.5 %
Length of stay 5.1 5.3 -3.0 % 13.4 13.4 0.0 %
Inpatient revenue $ 9,242,661 $ 7,866,580 17.5 % $ 2,455,659 $ 2,420,468 1.5 %
Outpatient revenue 5,352,067 4,067,550 31.6 % 257,479 244,286 5.4 %
Total patient revenue 14,594,728 11,934,130 22.3 % 2,713,138 2,664,754 1.8 %
Other revenue 174,909 275,271 -36.5 % 79,961 109,554 -27.0 %
Gross hospital revenue 14,769,637 12,209,401 21.0 % 2,793,099 2,774,308 0.7 %
Total deductions 12,932,383 10,470,655 23.5 % 1,364,582 1,430,409 -4.6 %
Net hospital revenue $ 1,837,254 $ 1,738,746 5.7 % $ 1,428,517 $ 1,343,899 6.3 %
SAME FACILITY:
ACUTE BEHAVIORAL HEALTH
12/31/21 12/31/20 % change 12/31/21 12/31/20 % change
Hospitals owned and leased 26 26 0.0 % 330 330 0.0 %
Average licensed beds 6,588 6,476 1.7 % 23,782 23,661 0.5 %
Average available beds 6,416 6,304 1.8 % 23,682 23,561 0.5 %
Patient days 394,045 386,491 2.0 % 1,512,830 1,512,397 0.0 %
Average daily census 4,283.1 4,201.0 2.0 % 16,443.8 16,439.1 0.0 %
Occupancy-licensed beds 65.0 % 64.9 % 0.2 % 69.1 % 69.5 % -0.5 %
Occupancy-available beds 66.8 % 66.6 % 0.2 % 69.4 % 69.8 % -0.5 %
Admissions 77,046 72,877 5.7 % 109,681 108,527 1.1 %
Length of stay 5.1 5.3 -3.6 % 13.8 13.9 -1.0 %
Universal Health Services, Inc.
--- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ---
Selected Hospital Statistics
For the Twelve months ended
December 31, 2021 and 2020
AS REPORTED:
ACUTE BEHAVIORAL HEALTH
12/31/21 12/31/20 % change 12/31/21 12/31/20 % change
Hospitals owned and leased 27 26 3.8 % 335 334 0.3 %
Average licensed beds 6,566 6,457 1.7 % 24,132 23,661 2.0 %
Average available beds 6,394 6,285 1.7 % 24,030 23,559 2.0 %
Patient days 1,568,639 1,458,321 7.6 % 6,162,780 6,142,823 0.3 %
Average daily census 4,297.6 3,984.5 7.9 % 16,884.3 16,783.7 0.6 %
Occupancy-licensed beds 65.5 % 61.7 % 6.1 % 70.0 % 70.9 % -1.3 %
Occupancy-available beds 67.2 % 63.4 % 6.0 % 70.3 % 71.2 % -1.3 %
Admissions 305,296 286,535 6.5 % 457,006 448,870 1.8 %
Length of stay 5.1 5.1 0.7 % 13.5 13.7 -1.6 %
Inpatient revenue $ 36,522,155 $ 30,562,093 19.5 % $ 9,927,401 $ 9,718,934 2.1 %
Outpatient revenue 20,633,921 16,272,520 26.8 % 1,013,547 963,799 5.2 %
Total patient revenue 57,156,076 46,834,613 22.0 % 10,940,948 10,682,733 2.4 %
Other revenue 659,136 788,694 -16.4 % 269,435 332,766 -19.0 %
Gross hospital revenue 57,815,212 47,623,307 21.4 % 11,210,383 11,015,499 1.8 %
Total deductions 50,706,958 41,286,003 22.8 % 5,706,739 5,806,777 -1.7 %
Net hospital revenue $ 7,108,254 $ 6,337,304 12.2 % $ 5,503,644 $ 5,208,722 5.7 %
SAME FACILITY:
ACUTE BEHAVIORAL HEALTH
12/31/21 12/31/20 % change 12/31/21 12/31/20 % change
Hospitals owned and leased 26 26 0.0 % 330 330 0.0 %
Average licensed beds 6,543 6,457 1.3 % 23,740 23,477 1.1 %
Average available beds 6,371 6,285 1.4 % 23,638 23,375 1.1 %
Patient days 1,564,828 1,458,321 7.3 % 6,114,699 6,109,418 0.1 %
Average daily census 4,287.2 3,984.5 7.6 % 16,752.6 16,692.4 0.4 %
Occupancy-licensed beds 65.5 % 61.7 % 6.2 % 70.6 % 71.1 % -0.8 %
Occupancy-available beds 67.3 % 63.4 % 6.1 % 70.9 % 71.4 % -0.8 %
Admissions 304,955 286,535 6.4 % 451,493 445,737 1.3 %
Length of stay 5.1 5.1 0.8 % 13.5 13.7 -1.2 %
Universal Health Services, Inc.
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Supplemental Non-GAAP Disclosures
2022 Operating Results Forecast
(in thousands, except per share amounts)
Forecast For The Year Ending December 31, 2022
% Net % Net
Low revenues High revenues
Net revenues (a) $ 13,424,000 $ 13,694,000
Adjusted net income attributable to UHS (a) (b) $ 878,145 $ 951,813
Depreciation and amortization 562,819 562,819
Interest expense 124,941 124,941
Other (income) expense, net (8,197 ) (8,197 )
Provision for income taxes 272,464 295,321
Adjusted EBITDA net of NCI (a) (c) $ 1,830,172 13.6 % $ 1,926,697 14.1 %
Adjusted net income attributable to UHS, per diluted share (a) (b) $ 11.90 $ 12.90
Shares used in computing diluted earnings per share 73,634 73,634
(a) The impact of the COVID-19 pandemic, which began during the second half of March, 2020, has had a material unfavorable effect on our operations and financial results. The extent to which the COVID-19 pandemic and measures taken in response thereto impact our business, results of operations and financial condition will depend on numerous factors and future developments, most of which are beyond our control or ability to predict. The ultimate impact of the COVID-19 pandemic is highly uncertain and subject to change. We are not able to fully quantify the impact that these factors will have on our future financial results, but expect developments related to the COVID-19 pandemic to materially affect our financial performance in 2022 and may cause our 2022 actual operating results to differ materially from our 2022 operating results forecast.
(b) Adjusted net income attributable to UHS/per diluted share are non-GAAP financial measures.  The 2022 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, the impact of ASU 2016-09, 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, impairment of 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 below in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures.
(c) 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, 2021.