Company Quick10K Filing
Tenet Healthcare
Price22.73 EPS1
Shares104 P/E19
MCap2,354 P/FCF3
Net Debt14,544 EBIT936
TEV16,898 TEV/EBIT18
TTM 2019-09-30, in MM, except price, ratios
10-Q 2020-03-31 Filed 2020-05-04
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10-Q 2019-09-30 Filed 2019-11-04
10-Q 2019-06-30 Filed 2019-08-05
10-Q 2019-03-31 Filed 2019-04-29
10-K 2018-12-31 Filed 2019-02-25
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10-K 2009-12-31 Filed 2010-02-23
8-K 2020-06-16
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8-K 2020-03-19
8-K 2020-02-26
8-K 2020-02-24
8-K 2020-01-14
8-K 2019-12-12
8-K 2019-11-06
8-K 2019-11-04
8-K 2019-09-12
8-K 2019-08-26
8-K 2019-08-16
8-K 2019-08-12
8-K 2019-08-12
8-K 2019-08-05
8-K 2019-07-24
8-K 2019-06-19
8-K 2019-06-01
8-K 2019-05-02
8-K 2019-04-29
8-K 2019-02-27
8-K 2019-02-25
8-K 2019-02-05
8-K 2019-01-28
8-K 2019-01-22
8-K 2019-01-22
8-K 2019-01-03
8-K 2018-11-27
8-K 2018-11-05
8-K 2018-08-17
8-K 2018-08-06
8-K 2018-06-28
8-K 2018-05-25
8-K 2018-05-03
8-K 2018-04-30
8-K 2018-03-23
8-K 2018-03-05
8-K 2018-02-26
8-K 2018-01-21
8-K 2018-01-11
8-K 2018-01-08

THC 10Q Quarterly Report

Part I. Financial Information
Item 1. Financial Statements
Note 1. Basis of Presentation
Note 2. Accounts Receivable
Note 3. Contract Balances
Note 4. Assets and Liabilities Held for Sale
Note 5. Impairment and Restructuring Charges, and Acquisition - Related Costs
Note 6. Long - Term Debt
Note 7. Guarantees
Note 8. Employee Benefit Plans
Note 9. Equity
Note 10. Net Operating Revenues
Note 11. Property and Professional and General Liability Insurance
Note 12. Claims and Lawsuits
Note 13. Redeemable Noncontrolling Interests in Equity of Consolidated Subsidiaries
Note 14. Income Taxes
Note 15. Earnings (Loss) per Common Share
Note 16. Fair Value Measurements
Note 17. Acquisitions
Note 18. Segment Information
Note 19. Subsequent Events
Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations
Item 3. Quantitative and Qualitative Disclosures About Market Risk
Item 4. Controls and Procedures
Part II. Other Information
Item 1. Legal Proceedings
Item 1A. Risk Factors
Item 6. Exhibits
EX-10.D thc-20200331ex10e.htm
EX-18 thc-20200331ex18.htm
EX-31.A thc-20200331ex31a.htm
EX-31.B thc-20200331ex31b.htm
EX-32 thc-20200331ex32.htm

Tenet Healthcare Earnings 2020-03-31

Balance SheetIncome StatementCash Flow
2519149402012201420172020
Assets, Equity
4.73.72.71.80.8-0.22016201720182020
Rev, G Profit, Net Income
1.50.90.2-0.4-1.1-1.72012201420172020
Ops, Inv, Fin

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
 
Form 10-Q
 
Quarterly report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 for the quarterly period ended March 31, 2020
 
OR
Transition report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 for the transition period from               to               
 
Commission File Number 1-7293
 
_________________________________________
 
TENET HEALTHCARE CORPORATION
(Exact name of Registrant as specified in its charter)
 
_________________________________________

Nevada
95-2557091
(State of Incorporation)
(IRS Employer Identification No.)

14201 Dallas Parkway
Dallas, TX 75254
(Address of principal executive offices, including zip code)
 
(469893-2200
(Registrant’s telephone number, including area code)
_________________________________________
Securities registered pursuant to Section 12(b) of the Act:
Title of each class
 
Trading symbol
 
Name of each exchange on which registered
Common stock,
$0.05 par value
 
THC
 
New York Stock Exchange
6.875% Senior Notes due 2031
 
THC31
 
New York Stock Exchange

Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months, and (2) has been subject to such filing requirements for the past 90 days.   Yes x No ¨
 
Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months.   Yes x No ¨
 
Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company (each as defined in Exchange Act Rule 12b-2).
Large accelerated filer
x
 
 
Accelerated filer
¨
Non-accelerated filer
¨
 
 
 
 
 
 
 
 
 
 
Smaller reporting company
 
 
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. ¨
 
Indicate by check mark whether the Registrant is a shell company (as defined in Exchange Act Rule 12b-2).   Yes  No x

At April 30, 2020, there were 104,715,188 shares of the Registrant’s common stock outstanding.
 



TENET HEALTHCARE CORPORATION
TABLE OF CONTENTS


i


PART I. FINANCIAL INFORMATION
ITEM 1. FINANCIAL STATEMENTS

TENET HEALTHCARE CORPORATION AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
Dollars in Millions
(Unaudited)
 
 
March 31,
 
December 31,
 
 
2020
 
2019
ASSETS
 
 
 
 
Current assets:
 
 
 
 
Cash and cash equivalents
 
$
613

 
$
262

Accounts receivable
 
2,722

 
2,743

Inventories of supplies, at cost
 
324

 
310

Income tax receivable
 
18

 
10

Assets held for sale
 
394

 
387

Other current assets
 
1,317

 
1,369

Total current assets 
 
5,388

 
5,081

Investments and other assets
 
2,467

 
2,369

Deferred income taxes
 
263

 
183

Property and equipment, at cost, less accumulated depreciation and amortization
($5,622 at March 31, 2020 and $5,498 at December 31, 2019)
 
6,786

 
6,878

Goodwill
 
7,308

 
7,252

Other intangible assets, at cost, less accumulated amortization
($1,130 at March 31, 2020 and $1,092 at December 31, 2019)
 
1,611

 
1,602

Total assets 
 
$
23,823

 
$
23,365

LIABILITIES AND EQUITY
 
 

 
 

Current liabilities:
 
 

 
 

Current portion of long-term debt
 
$
165

 
$
171

Accounts payable
 
1,079

 
1,204

Accrued compensation and benefits
 
788

 
877

Professional and general liability reserves
 
279

 
330

Accrued interest payable
 
306

 
245

Liabilities held for sale
 
49

 
44

Other current liabilities
 
1,429

 
1,334

Total current liabilities 
 
4,095

 
4,205

Long-term debt, net of current portion
 
15,082

 
14,580

Professional and general liability reserves
 
638

 
635

Defined benefit plan obligations
 
547

 
560

Deferred income taxes
 
27

 
27

Other long-term liabilities
 
1,405

 
1,415

Total liabilities 
 
21,794

 
21,422

Commitments and contingencies
 


 


Redeemable noncontrolling interests in equity of consolidated subsidiaries
 
1,526

 
1,506

Equity:
 
 

 
 

Shareholders’ equity:
 
 

 
 

Common stock, $0.05 par value; authorized 262,500,000 shares; 152,870,875 shares issued at March 31, 2020 and 152,540,815 shares issued at December 31, 2019
 
7

 
7

Additional paid-in capital
 
4,739

 
4,760

Accumulated other comprehensive loss
 
(256
)
 
(257
)
Accumulated deficit
 
(2,434
)
 
(2,513
)
Common stock in treasury, at cost, 48,342,502 shares at March 31, 2020 and 48,344,195 shares at December 31, 2019
 
(2,414
)
 
(2,414
)
Total shareholders’ deficit
 
(358
)
 
(417
)
Noncontrolling interests 
 
861

 
854

Total equity 
 
503

 
437

Total liabilities and equity 
 
$
23,823

 
$
23,365


See accompanying Notes to Condensed Consolidated Financial Statements.



TENET HEALTHCARE CORPORATION AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
Dollars in Millions, Except Per-Share Amounts
(Unaudited) 
 
 
Three Months Ended March 31,
 
 
2020
 
2019
Net operating revenues 
 
$
4,520

 
$
4,545

Equity in earnings of unconsolidated affiliates
 
28

 
34

Operating expenses:
 
 

 
 

Salaries, wages and benefits
 
2,187

 
2,151

Supplies
 
763

 
741

Other operating expenses, net
 
1,013

 
1,065

Depreciation and amortization
 
203

 
208

Impairment and restructuring charges, and acquisition-related costs
 
55

 
19

Litigation and investigation costs
 
2

 
13

Net losses (gains) on sales, consolidation and deconsolidation of facilities
 
(2
)
 
1

Operating income 
 
327

 
381

Interest expense
 
(243
)
 
(251
)
Other non-operating income, net
 
1

 
1

Loss from early extinguishment of debt
 

 
(47
)
Income from continuing operations, before income taxes 
 
85

 
84

Income tax benefit (expense)
 
75

 
(20
)
Income from continuing operations, before discontinued operations 
 
160

 
64

Discontinued operations:
 
 

 
 

Income (loss) from operations
 
(1
)
 
10

Income tax expense
 

 
(2
)
Income (loss) from discontinued operations 
 
(1
)
 
8

Net income
 
159

 
72

Less: Net income available to noncontrolling interests
 
66

 
84

Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders 
 
$
93

 
$
(12
)
Amounts available (attributable) to Tenet Healthcare Corporation common shareholders
 
 

 
 

Income (loss) from continuing operations, net of tax
 
$
94

 
$
(20
)
Income (loss) from discontinued operations, net of tax
 
(1
)
 
8

Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders
 
$
93

 
$
(12
)
Earnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders:
 
 

 
 

Basic
 
 

 
 

Continuing operations
 
$
0.90

 
$
(0.19
)
Discontinued operations
 
(0.01
)
 
0.08

 
 
$
0.89

 
$
(0.11
)
Diluted
 
 

 
 

Continuing operations
 
$
0.89

 
$
(0.19
)
Discontinued operations
 
(0.01
)
 
0.08

 
 
$
0.88

 
$
(0.11
)
Weighted average shares and dilutive securities outstanding (in thousands):
 
 

 
 

Basic
 
104,353

 
102,788

Diluted
 
105,733

 
102,788


See accompanying Notes to Condensed Consolidated Financial Statements.


2


TENET HEALTHCARE CORPORATION AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OTHER COMPREHENSIVE INCOME
Dollars in Millions
(Unaudited)
 
 
 
Three Months Ended
March 31,
 
 
2020
 
2019
Net income
 
$
159

 
$
72

Other comprehensive income:
 
 
 
 
Amortization of net actuarial loss included in other non-operating expense, net
 
2

 
3

Unrealized gains (losses) on debt securities held as available-for-sale
 
1

 

Other comprehensive income before income taxes
 
3

 
3

Income tax expense related to items of other comprehensive income
 
(2
)
 
(1
)
Total other comprehensive income, net of tax
 
1

 
2

Comprehensive net income
 
160

 
74

Less: Comprehensive income attributable to noncontrolling interests
 
66

 
84

Comprehensive income available (loss attributable) to Tenet Healthcare Corporation common shareholders
 
$
94

 
$
(10
)

See accompanying Notes to Condensed Consolidated Financial Statements.


3


TENET HEALTHCARE CORPORATION AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
Dollars in Millions
(Unaudited)
 
 
Three Months Ended
March 31,
 
 
2020
 
2019
Net income
 
$
159

 
$
72

Adjustments to reconcile net income to net cash provided by operating activities:
 
 
 
 
Depreciation and amortization
 
203

 
208

Deferred income tax (benefit) expense
 
(79
)
 
22

Stock-based compensation expense
 
13

 
11

Impairment and restructuring charges, and acquisition-related costs
 
55

 
19

Litigation and investigation costs
 
2

 
13

Net losses (gains) on sales, consolidation and deconsolidation of facilities
 
(2
)
 
1

Loss from early extinguishment of debt
 

 
47

Equity in earnings of unconsolidated affiliates, net of distributions received
 
(11
)
 
3

Amortization of debt discount and debt issuance costs
 
10

 
11

Pre-tax loss (income) from discontinued operations
 
1

 
(10
)
Other items, net
 
2

 
(7
)
Changes in cash from operating assets and liabilities:
 
 

 
 

Accounts receivable
 
14

 
(158
)
Inventories and other current assets
 
23

 
(115
)
Income taxes
 
2

 
9

Accounts payable, accrued expenses and other current liabilities
 
(144
)
 
(119
)
Other long-term liabilities
 
(51
)
 
37

Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements
 
(68
)
 
(32
)
Net cash used in operating activities from discontinued operations, excluding income taxes
 

 
(2
)
Net cash provided by operating activities
 
129

 
10

Cash flows from investing activities:
 
 

 
 

Purchases of property and equipment — continuing operations
 
(182
)
 
(192
)
Purchases of businesses or joint venture interests, net of cash acquired
 
(55
)
 
(2
)
Proceeds from sales of facilities and other assets — continuing operations
 
11

 
41

Proceeds from sales of facilities and other assets — discontinued operations
 

 
17

Proceeds from sales of marketable securities, long-term investments and other assets
 
10

 
4

Purchases of marketable securities and equity investments
 
(4
)
 
(4
)
Other long-term assets
 
(2
)
 
(2
)
Other items, net
 
18

 
(1
)
Net cash used in investing activities
 
(204
)
 
(139
)
Cash flows from financing activities:
 
 

 
 

Repayments of borrowings under credit facility
 
(240
)
 
(495
)
Proceeds from borrowings under credit facility
 
740

 
685

Repayments of other borrowings
 
(48
)
 
(1,620
)
Proceeds from other borrowings
 
7

 
1,507

Debt issuance costs
 
(1
)
 
(18
)
Distributions paid to noncontrolling interests
 
(76
)
 
(74
)
Proceeds from sale of noncontrolling interests
 
2

 
4

Purchases of noncontrolling interests
 

 
(3
)
Proceeds from exercise of stock options and employee stock purchase plan
 
2

 
1

Other items, net
 
40

 
(17
)
Net cash provided by (used in) financing activities
 
426

 
(30
)
Net increase (decrease) in cash and cash equivalents
 
351

 
(159
)
Cash and cash equivalents at beginning of period
 
262

 
411

Cash and cash equivalents at end of period
 
$
613

 
$
252

Supplemental disclosures:
 
 

 
 

Interest paid, net of capitalized interest
 
$
(172
)
 
$
(158
)
Income tax (payments) refunds, net
 
$
(3
)
 
$
9

 
See accompanying Notes to Condensed Consolidated Financial Statements.


4


TENET HEALTHCARE CORPORATION
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS 

NOTE 1. BASIS OF PRESENTATION
 
Description of Business and Basis of Presentation
 
Tenet Healthcare Corporation (together with our subsidiaries, referred to herein as “Tenet,” “we” or “us”) is a diversified healthcare services company headquartered in Dallas, Texas. Through an expansive care network that includes USPI Holding Company, Inc. (“USPI”), at March 31, 2020, we operated 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers, and other care sites and clinics. We also operate Conifer Health Solutions, LLC through our Conifer Holdings, Inc. (“Conifer”) subsidiary, which provides revenue cycle management and value-based care services to hospitals, healthcare systems, physician practices, employers and other customers.
 
This quarterly report supplements our Annual Report on Form 10-K for the year ended December 31, 2019 (“Annual Report”). As permitted by the Securities and Exchange Commission for interim reporting, we have omitted certain notes and disclosures that substantially duplicate those in our Annual Report. For further information, refer to the audited Consolidated Financial Statements and notes included in our Annual Report. Unless otherwise indicated, all financial and statistical data included in these notes to our Condensed Consolidated Financial Statements relate to our continuing operations, with dollar amounts expressed in millions (except per-share amounts).

Effective January 1, 2020, we adopted the Financial Accounting Standards Board (“FASB”) Accounting Standards Update (“ASU”) 2016-13, “Financial Instruments—Credit Losses (Topic 326) Measurement of Credit Losses on Financial Instruments” (“ASU 2016-13”) using the modified retrospective transition approach as of the period of adoption. Upon adoption of ASU 2016-13 on January 1, 2020, we recorded a cumulative effect adjustment to increase accumulated deficit by $14 million.

Certain prior-year amounts have been reclassified to conform to the current year presentation. In the accompanying Condensed Consolidated Statements of Operations, electronic health record incentives have been reclassified to other operating expenses, net, as they are no longer significant enough to present separately. In the accompanying Condensed Consolidated Statements of Cash Flows, purchases of marketable securities have been reclassified from other items, net within cash flows from investing activities to purchases of marketable securities and equity investments. Additionally, our financial statements and corresponding footnotes for prior periods have been recast to reflect retrospective application of the change in accounting principle discussed in the Professional and General Liability Reserves section of this note.

Although the Condensed Consolidated Financial Statements and related notes within this document are unaudited, we believe all adjustments considered necessary for a fair presentation have been included and are of a normal recurring nature. In preparing our financial statements in conformity with accounting principles generally accepted in the United States (“GAAP”), we are required to make estimates and assumptions that affect the amounts reported in our Condensed Consolidated Financial Statements and these accompanying notes. We regularly evaluate the accounting policies and estimates we use. In general, we base the estimates on historical experience and on assumptions that we believe to be reasonable given the particular circumstances in which we operate. Actual results may vary from those estimates. Financial and statistical information we report to other regulatory agencies may be prepared on a basis other than GAAP or using different assumptions or reporting periods and, therefore, may vary from amounts presented herein. Although we make every effort to ensure that the information we report to those agencies is accurate, complete and consistent with applicable reporting guidelines, we cannot be responsible for the accuracy of the information they make available to the public.
 
Operating results for the three month period ended March 31, 2020 are not necessarily indicative of the results that may be expected for the full year. Reasons for this include, but are not limited to: the impact of the novel coronavirus pandemic on our operations, business, financial condition and cash flows; overall revenue and cost trends, particularly the timing and magnitude of price changes; fluctuations in contractual allowances and cost report settlements and valuation allowances; managed care contract negotiations, settlements or terminations and payer consolidations; trends in patient accounts receivable collectability and associated implicit price concessions; fluctuations in interest rates; levels of malpractice insurance expense and settlement trends; impairment of long-lived assets and goodwill; restructuring charges; losses, costs and insurance recoveries related to natural disasters and other weather-related occurrences; litigation and investigation costs; acquisitions and dispositions of facilities and other assets; gains (losses) on sales, consolidation and deconsolidation of facilities; income tax rates and deferred tax asset valuation allowance activity; changes in estimates of accruals for annual incentive compensation; the timing and amounts of stock option and restricted stock unit grants to employees and directors; gains (losses) from early

5


extinguishment of debt; and changes in occupancy levels and patient volumes. Factors that affect service mix, revenue mix, patient volumes and, thereby, the results of operations at our hospitals and related healthcare facilities include, but are not limited to: changes in federal, state and local healthcare and business regulations, including mandated closures and other operating restrictions; the business environment, economic conditions and demographics of local communities in which we operate; the number of uninsured and underinsured individuals in local communities treated at our hospitals; disease hotspots and seasonal cycles of illness; climate and weather conditions; physician recruitment, satisfaction, retention and attrition; advances in technology and treatments that reduce length of stay; local healthcare competitors; utilization pressure by managed care organizations, as well as managed care contract negotiations or terminations; hospital performance data on quality measures and patient satisfaction, as well as standard charges for services; any unfavorable publicity about us, or our joint venture partners, that impacts our relationships with physicians and patients; and changing consumer behavior, including with respect to the timing of elective procedures. These considerations apply to year-to-year comparisons as well.

Professional and General Liability Reserves

We accrue for estimated professional and general liability claims when they are probable and can be reasonably estimated. The accrual, which includes an estimate for incurred but not reported claims, is updated each quarter based on a model of projected payments using case-specific facts and circumstances and our historical loss reporting, development and settlement patterns. To the extent that subsequent claims information varies from our estimates, the liability is adjusted in the period such information becomes available. Malpractice expense is presented within other operating expenses in the accompanying Condensed Consolidated Statements of Operations.

In the three months ended March 31, 2020, we changed our method of accounting for our estimated professional and general liability claims. Under the new method of accounting, the liabilities are reported on an undiscounted basis whereas, previously, the liabilities were reported on a discounted basis. We believe that the undiscounted presentation is preferable because it simplifies the accounting for the liabilities, thereby increasing understandability of our financial results and financial condition, is consistent with the manner in which management evaluates our business, and results in an accounting method and financial statement presentation that is consistent with our key peers.

Accordingly, our financial statements and corresponding footnotes for the respective prior periods have been recast to reflect retrospective application of the change in accounting principle. We recorded the cumulative effect for the change in accounting principle as an increase of $44 million to accumulated deficit as of January 1, 2017. This change increased our accumulated deficit by $46 million, $56 million and $63 million at December 31, 2019, March 31, 2019 and December 31, 2018, respectively.
The following tables present the effects of the change in accounting principle to our financial statements:

Condensed Consolidated Balance Sheets:
 
 
Prior to Change in Accounting Principle
 
Effect of Change in Accounting Principle
 
As Reported
At March 31, 2020:
 
 
 
 
 
 
Deferred income taxes
 
$
259

 
$
4

 
$
263

Professional and general liability reserves
 
$
622

 
$
16

 
$
638

Other long-term liabilities
 
$
1,402

 
$
3

 
$
1,405

Accumulated deficit
 
$
(2,419
)
 
$
(15
)
 
$
(2,434
)
 
 
As Reported
 
Effect of Change in Accounting Principle
 
As Adjusted
At December 31, 2019:
 
 
 
 
 
 
Deferred income taxes
 
$
169

 
$
14

 
$
183

Professional and general liability reserves
 
$
585

 
$
50

 
$
635

Other long-term liabilities
 
$
1,405

 
$
10

 
$
1,415

Accumulated deficit
 
$
(2,467
)
 
$
(46
)
 
$
(2,513
)


6


Condensed Consolidated Statements of Operations (in millions, except for per-share amounts):
 
 
Prior to Change in Accounting Principle
 
Effect of Change in Accounting Principle
 
As Reported
Three months ended March 31, 2020:
 
 
 
 
 
 
Salaries, wages and benefits
 
$
2,194

 
$
(7
)
 
$
2,187

Other operating expenses, net
 
$
1,047

 
$
(34
)
 
$
1,013

Operating income 
 
$
286

 
$
41

 
$
327

Income tax benefit
 
$
85

 
$
(10
)
 
$
75

Net income
 
$
128

 
$
31

 
$
159

Net income from continuing operations available to Tenet Healthcare Corporation common shareholders
 
$
63

 
$
31

 
$
94

Earnings per share available to Tenet Healthcare Corporation common shareholders from continuing operations:
 
 
 
 
 
 
Basic
 
$
0.60

 
$
0.30

 
$
0.90

Diluted
 
$
0.60

 
$
0.29

 
$
0.89


 
 
As Reported
 
Effect of Change in Accounting Principle
 
As Adjusted
 Three months ended March 31, 2019:
 
 
 
 
 
 
Salaries, wages and benefits
 
$
2,153

 
$
(2
)
 
$
2,151

Other operating expenses, net
 
$
1,073

 
$
(8
)
 
$
1,065

Operating income 
 
$
371

 
$
10

 
$
381

Income tax expense
 
$
(17
)
 
$
(3
)
 
$
(20
)
Net income
 
$
65

 
$
7

 
$
72

Net loss from continuing operations attributable to Tenet Healthcare Corporation common shareholders
 
$
(27
)
 
$
7

 
$
(20
)
Loss per share attributable to Tenet Healthcare Corporation common shareholders from continuing operations:
 
 
 
 
 
 
Basic
 
$
(0.26
)
 
$
0.07

 
$
(0.19
)
Diluted
 
$
(0.26
)
 
$
0.07

 
$
(0.19
)

Condensed Consolidated Statements of Cash Flows:
 
 
Prior to Change in Accounting Principle
 
Effect of Change in Accounting Principle
 
As Reported
Three months ended March 31, 2020:
 
 
 
 
 
 
Net income
 
$
128

 
$
31

 
$
159

Deferred income tax benefit
 
$
(89
)
 
$
10

 
$
(79
)
Accounts payable, accrued expenses and other current liabilities
 
$
(103
)
 
$
(41
)
 
$
(144
)
Net cash provided by operating activities
 
$
129

 
$

 
$
129


 
 
As Reported
 
Effect of Change in Accounting Principle
 
As Adjusted
 Three months ended March 31, 2019:
 
 
 
 
 
 
Net income
 
$
65

 
$
7

 
$
72

Deferred income tax expense
 
$
19

 
$
3

 
$
22

Accounts payable, accrued expenses and other current liabilities
 
$
(109
)
 
$
(10
)
 
$
(119
)
Net cash provided by operating activities
 
$
10

 
$

 
$
10


Net Operating Revenues

We recognize net operating revenues in the period in which we satisfy our performance obligations under contracts by transferring services to our customers. Net operating revenues are recognized in the amounts we expect to be entitled to, which are the transaction prices allocated for the distinct services. Net operating revenues for our Hospital Operations and other

7


(“Hospital Operations”) and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, managed care and other health plans, as well as certain uninsured patients under our Compact with Uninsured Patients (“Compact”) and other uninsured discount and charity programs. Net operating revenues for our Conifer segment primarily consist of revenues from providing revenue cycle management services to healthcare systems, as well as individual hospitals, physician practices, self-insured organizations, health plans and other entities.

Net Patient Service Revenues—We report net patient service revenues at the amounts that reflect the consideration we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payers (including managed care payers and government programs) and others, and they include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews and investigations. Generally, we bill our patients and third-party payers several days after the services are performed or shortly after discharge. Revenues are recognized as performance obligations are satisfied.

Conifer Revenues—Our Conifer segment recognizes revenue from its contracts when Conifer’s performance obligations are satisfied, which is generally as services are rendered. Revenue is recognized in an amount that reflects the consideration to which Conifer expects to be entitled.

Cash and Cash Equivalents
 
We treat highly liquid investments with original maturities of three months or less as cash equivalents. Cash and cash equivalents were $613 million and $262 million at March 31, 2020 and December 31, 2019, respectively. At March 31, 2020 and December 31, 2019, our book overdrafts were $225 million and $246 million, respectively, which were classified as accounts payable.
 
At March 31, 2020 and December 31, 2019, $152 million and $176 million, respectively, of total cash and cash equivalents in the accompanying Condensed Consolidated Balance Sheets were intended for the operations of our captive insurance subsidiaries, and $2 million for both periods of total cash and cash equivalents in the accompanying Condensed Consolidated Balance Sheets were intended for the operations of our health plan-related businesses.
 
Also at March 31, 2020 and December 31, 2019, we had $65 million and $136 million, respectively, of property and equipment purchases accrued for items received but not yet paid. Of these amounts, $49 million and $119 million, respectively, were included in accounts payable.

During the three months ended March 31, 2020 and 2019, we recorded non-cancellable finance leases of $15 million and $36 million, respectively, and non-cancellable operating leases of $54 million and $28 million, respectively.
 
Other Intangible Assets
 
The following tables provide information regarding other intangible assets, which are included in the accompanying Condensed Consolidated Balance Sheets at March 31, 2020 and December 31, 2019: 
 
 
Gross
Carrying
Amount
 
Accumulated
Amortization
 
Net Book
Value
At March 31, 2020:
 
 
 
 
 
 
Capitalized software costs
 
$
1,657

 
$
(948
)
 
$
709

Trade names
 
102

 

 
102

Contracts
 
877

 
(98
)
 
779

Other
 
105

 
(84
)
 
21

Total
 
$
2,741

 
$
(1,130
)
 
$
1,611

 
 
Gross
Carrying
Amount
 
Accumulated
Amortization
 
 Net Book
Value
At December 31, 2019:
 
 
 
 
 
 
Capitalized software costs
 
$
1,616

 
$
(912
)
 
$
704

Trade names
 
102

 

 
102

Contracts
 
869

 
(94
)
 
775

Other
 
107

 
(