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Vanguard Reports Third Quarter Results
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Income Statements (Unaudited)
(In millions)
Three months ended
March 31,
----------------------------------
2008 2009
----------------------------------
Patient service revenues $ 607.9 83.8% $ 676.1 78.8%
Premium revenues 117.7 16.2 181.9 21.2
----------------------------------
Total revenues 725.6 100.0 858.0 100.0
Costs and Expenses:
Salaries and benefits (includes stock
compensation of $0.9 and $1.2,
respectively) 297.9 41.1 328.4 38.3
Supplies 112.9 15.5 115.3 13.4
Medical claims expense 84.9 11.7 143.0 16.7
Provision for doubtful accounts 53.1 7.3 52.5 6.1
Purchased services 39.6 5.4 43.3 5.0
Rents and leases 10.7 1.5 11.0 1.3
Other operating expenses 52.3 7.2 79.5 9.3
Depreciation and amortization 31.6 4.4 31.6 3.7
Interest, net 29.4 4.1 27.2 3.2
Other 2.2 0.3 1.9 0.2
----------------------------------
Total costs and expenses 714.6 98.5 833.7 97.2
----------------------------------
Income from continuing operations
before income taxes 11.0 1.5 24.3 2.8
Income tax expense 3.5 0.5 8.2 0.9
----------------------------------
Income from continuing operations 7.5 1.0 16.1 1.9
Loss from discontinued operations, net
of taxes (1.0) (0.1) (0.3) (0.1)
----------------------------------
Net income $ 6.5 0.9% $ 15.8 1.8%
======= =======
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Income Statements (Unaudited)
(In millions)
Nine months ended
March 31,
------------------------------------------
2008 2009
------------------------------------------
Patient service revenues $ 1,740.4 83.9% $ 1,888.8 79.7%
Premium revenues 333.7 16.1 480.8 20.3
------------------------------------------
Total revenues 2,074.1 100.0 2,369.6 100.0
Costs and Expenses:
Salaries and benefits
(includes stock
compensation
of $1.9 and
$3.4, respectively) 851.6 41.1 923.7 39.0
Supplies 323.2 15.6 339.9 14.3
Medical claims expense 242.9 11.7 370.7 15.6
Provision for doubtful
accounts 156.2 7.5 155.4 6.6
Purchased services 111.7 5.4 125.0 5.3
Rents and leases 30.7 1.5 32.5 1.3
Other operating expenses 159.6 7.7 197.9 8.4
Depreciation and amortization 96.8 4.7 96.0 4.0
Interest, net 93.4 4.5 84.5 3.6
Other 7.6 0.3 4.3 0.2
------------------------------------------
Total costs and expenses 2,073.7 100.0 2,329.9 98.3
------------------------------------------
Income from continuing
operations before income taxes 0.4 0.0 39.7 1.7
Income tax expense - 0.0 13.5 0.6
------------------------------------------
Income from continuing
operations 0.4 0.0 26.2 1.1
Income (loss) from discontinued
operations, net of taxes (0.3) 0.0 0.6 0.0
------------------------------------------
Net income $ 0.1 0.0% $ 26.8 1.1%
========= ==========
VANGUARD HEALTH SYSTEMS, INC.
Supplemental Financial Information (Unaudited)
Reconciliation of Adjusted EBITDA to Net Income
(In millions)
Three months Nine months
ended March 31, ended March 31,
---------------- ----------------
2008 2009 2008 2009
------- ------- ------- -------
Net income $ 6.5 $ 15.8 $ 0.1 $ 26.8
Interest, net 29.4 27.2 93.4 84.5
Income tax expense 3.5 8.2 - 13.5
Depreciation and amortization 31.6 31.6 96.8 96.0
Minority interests 0.6 0.7 2.3 2.3
Loss (gain) on disposal of assets 0.6 - 0.8 (2.1)
Equity method income (0.3) (0.1) (0.5) (0.4)
Stock compensation 0.9 1.2 1.9 3.4
Monitoring fees and expenses 1.3 1.3 5.0 3.9
Realized holding loss on investments - - - 0.6
Discontinued operations, net of taxes 1.0 0.3 0.3 (0.6)
------- ------- ------- -------
Adjusted EBITDA (a) $ 75.1 $ 86.2 $ 200.1 $ 227.9
======= ======= ======= =======
(a) Adjusted EBITDA is defined as income before interest expense (net of
interest income), income taxes, depreciation and amortization, minority
interests, gain or loss on the disposal of assets, equity method
income, stock compensation, monitoring fees and expenses, realized
holding loss on investments and discontinued operations, net of taxes.
Adjusted EBITDA is not intended as a substitute for net income,
operating cash flows or other cash flow statement data determined in
accordance with accounting principles generally accepted in the United
States. Due to varying methods of calculation, Adjusted EBITDA as
presented may not be comparable to similarly titled measures of other
companies.
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Balance Sheets
(In millions)
(Unaudited)
June 30, March 31,
2008 2009
ASSETS ----------- -----------
Current assets:
Cash and cash equivalents $ 141.6 $ 292.2
Restricted cash 2.1 2.0
Marketable securities 26.3 -
Accounts receivable, net of allowance for
uncollectible accounts of approximately $117.7
and $119.8 at June 30, 2008 and March 31, 2009,
respectively 300.4 319.9
Inventories 49.2 49.5
Prepaid expenses and other current assets 80.3 90.0
----------- -----------
Total current assets 599.9 753.6
Property, plant and equipment, net 1,174.0 1,159.6
Goodwill 689.2 691.7
Intangible assets, net 61.4 57.7
Investments in and advances to affiliates 6.0 5.4
Investments in auction rate securities - 24.2
Other assets 51.8 50.8
----------- -----------
Total assets $ 2,582.3 $ 2,743.0
=========== ===========
LIABILITIES AND STOCKHOLDERS? EQUITY
Current liabilities:
Accounts payable $ 162.8 $ 170.1
Accrued salaries and benefits 97.4 106.8
Accrued health claims 51.1 97.9
Accrued interest 13.2 26.1
Other accrued expenses and current liabilities 49.6 95.5
Current maturities of long-term debt 8.0 8.0
----------- -----------
Total current liabilities 382.1 504.4
Minority interests in equity of consolidated
entities 9.1 7.9
Other liabilities 97.0 105.0
Long-term debt, less current maturities 1,529.5 1,539.8
Commitments and contingencies
Stockholders? equity:
Common Stock - -
Additional paid-in capital 647.1 650.4
Accumulated other comprehensive income (loss) 2.8 (6.0)
Retained deficit (85.3) (58.5)
----------- -----------
Total liabilities and stockholders? equity $ 2,582.3 $ 2,743.0
=========== ===========
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Cash Flows (Unaudited)
(In millions)
Nine months
ended March 31,
----------------
2008 2009
------- -------
Operating activities:
Net income $ 0.1 $ 26.8
Adjustments to reconcile net income to net cash from
operating activities:
Loss (income) from discontinued operations 0.3 (0.6)
Depreciation and amortization 96.8 96.0
Provision for doubtful accounts 156.2 155.4
Deferred income taxes (3.3) (1.0)
Amortization of loan costs 3.6 4.0
Accretion of principal on senior discount notes 14.4 16.0
Loss (gain) on disposal of assets 0.8 (2.1)
Stock compensation 1.9 3.4
Realized holding loss on investments - 0.6
Changes in operating assets and liabilities, net of
effects of acquisitionsand dispositions:
Accounts receivable (193.60) (174.5)
Inventories (2.4) (0.3)
Prepaid expenses and other current assets (1.1) 4.9
Accounts payable 22.1 7.2
Accrued expenses and other liabilities 27.6 111.0
------- -------
Net cash provided by operating activities - continuing
operations 123.4 246.8
Net cash provided by operating activities - discontinued
operations 2.0 0.6
------- -------
Net cash provided by operating activities 125.4 247.4
Investing activities:
Capital expenditures (80.9) (87.3)
Acquisitions (0.2) (3.7)
Purchases of short-term investments (90.0) -
Sales of short-term investments 60.0 -
Other 0.7 0.2
------- -------
Net cash used in investing activities - continuing
operations (110.4) (90.8)
Net cash provided by investing activities - discontinued
operations 2.8 -
------- -------
Net cash used in investing activities (107.6) (90.8)
Financing activities:
Payments of long-term debt (5.9) (5.8)
Proceeds from stock option exercises 0.2 -
Payments to retire stock and stock options (0.2) (0.2)
------- -------
Net cash used in financing activities (5.9) (6.0)
------- -------
Net increase in cash and cash equivalents 11.9 150.6
Cash and cash equivalents, beginning of period 120.1 141.6
------- -------
Cash and cash equivalents, end of period $ 132.0 $ 292.2
======= =======
Net cash paid for interest $ 63.5 $ 53.1
======= =======
Net cash paid for income taxes $ 0.6 $ 4.2
======= =======
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited)
(In millions)
Three Months Ended March 31, 2008
---------------------------------------------------------
Acute
Care % of Health % of Elimi- Conso-
Services Revenues Plans Revenues nations lidated
-------- -------- ------- -------- ------- -------
Patient service
revenues(1) $ 616.2 100.0 % $ - 0.0 % $ (8.3) $ 607.9
Premium revenues - 0.0 % 117.7 100.0 % - 117.7
-------- -------- ------- -------- ------- -------
Total
revenues 616.2 100.0 % 117.7 100.0 % (8.3) 725.6
Salaries and
benefits
(excludes stock
compensation) 292.9 47.5 % 4.1 3.5 % - 297.0
Supplies 113.1 18.4 % (0.2) (0.2)% - 112.9
Medical claims
expense - 0.0 % 93.2 79.2 % (8.3) 84.9
Provision for
doubtful
accounts 53.1 8.6 % - 0.0 % - 53.1
Other operating
expenses 95.5 15.5 % 7.1 6.0 % - 102.6
-------- -------- ------- -------- ------- -------
Total
operating
expenses 554.6 90.0 % 104.2 88.5 % (8.3) 650.5
-------- -------- ------- -------- ------- -------
Segment
EBITDA(2) 61.6 10.0 % 13.5 11.5 % - 75.1
Less:
Interest, net 30.2 4.9 % (0.8) (0.7)% - 29.4
Depreciation
and
amortization 30.6 5.0 % 1.0 0.9 % - 31.6
Minority
interest 0.6 0.1 % - 0.0 % - 0.6
Equity method
income (0.3) 0.0 % - 0.0 % - (0.3)
Stock
compensation 0.9 0.1 % - 0.0 % - 0.9
Loss on
disposal of
assets 0.6 0.1 % - 0.0 % - 0.6
Monitoring
fees and
expenses 1.3 0.2 % - 0.0 % - 1.3
-------- -------- ------- -------- ------- -------
Income
(loss) from
continuing
operations
before
income
taxes $ (2.3) (0.4)% $ 13.3 11.3 % $ - $ 11.0
======== ======== ======= ======== ======= =======
(1) Vanguard eliminates in consolidation those patient service revenues
earned by its hospitals and related healthcare facilities attributable
to services provided to enrollees in its health plans and also
eliminates the corresponding medical claims expenses incurred by its
health plans for those services.
(2) Segment EBITDA is defined as income before interest expense (net of
interest income), income taxes, depreciation and amortization, minority
interests, equity method income, stock compensation, gain or loss on
disposal of assets, monitoring fees and expenses, realized holding loss
on investments and discontinued operations, net of taxes. Management
uses Segment EBITDA to measure performance for Vanguard's segments and
to develop strategic objectives and operating plans for those segments.
Segment EBITDA eliminates the uneven effect of non-cash depreciation of
tangible assets and amortization of intangible assets, much of which
results from acquisitions accounted for under the purchase method of
accounting. Segment EBITDA also eliminates the effects of changes in
interest rates that management believes relate to general trends in
global capital markets, but are not necessarily indicative of the
operating performance of Vanguard's segments. Management believes that
Segment EBITDA provides useful information about the financial
performance of Vanguard's segments to investors, lenders, financial
analysts and rating agencies. Additionally, management believes that
investors and lenders view Segment EBITDA as an important factor in
making investment decisions and assessing the value of Vanguard.
Segment EBITDA is not a substitute for net income, operating cash flows
or other cash flow statement data determined in accordance with
accounting principles generally accepted in the United States.
Segment EBITDA, as presented, may not be comparable to similarly
titled measures of other companies.
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) - Continued
(In millions)
Three Months Ended March 31, 2009
------------------------------------------------------
Acute
Care % of Health % of Elimi- Consoli-
Services Revenues Plans Revenues nations lidated
-------- ------- --------- ------- ------- -------
Patient service
revenues(1) $ 683.8 100.0% $ - 0.0% $ (7.7) $ 676.1
Premium revenues - 0.0% 181.9 100.0% - 181.9
-------- ------- --------- ------- ------- -------
Total revenues 683.8 100.0% 181.9 100.0% (7.7) 858.0
Salaries and
benefits
(excludes
stock
compensation) 319.0 46.7% 8.2 4.5% - 327.2
Supplies 115.3 16.8% - 0.0% - 115.3
Medical claims
expense - 0.0% 150.7 82.9% (7.7) 143.0
Provision for
doubtful accounts 52.5 7.7% - 0.0% - 52.5
Other operating
expenses 124.3 18.2% 9.5 5.2% - 133.8
-------- ------- --------- ------- ------- -------
Total operating
expenses 611.1 89.4% 168.4 92.6% (7.7) 771.8
-------- ------- --------- ------- ------- -------
Segment
EBITDA(2) 72.7 10.6% 13.5 7.4% - 86.2
Less:
Interest, net 26.9 3.9% 0.3 0.2% - 27.2
Depreciation and
amortization 30.6 4.5% 1.0 0.5% - 31.6
Minority
interests 0.7 0.1% - 0.0% - 0.7
Equity method
income (0.1) 0.0% - 0.0% - (0.1)
Stock
compensation 1.2 0.2% - 0.0% - 1.2
Monitoring fees
and expenses 1.3 0.2% - 0.0% - 1.3
-------- ------- --------- ------- ------- -------
Income from
continuing
operations
before income
taxes $ 12.1 1.7% $ 12.2 6.7% $ - $ 24.3
======== ======= ========= ======= ======= =======
(1) Vanguard eliminates in consolidation those patient service revenues
earned by its hospitals and related healthcare facilities attributable
to services provided to enrollees in its health plans and also
eliminates the corresponding medical claims expenses incurred by its
health plans for those services.
(2) Segment EBITDA is defined as income before interest expense (net of
interest income), income taxes, depreciation and amortization, minority
interests, equity method income, stock compensation, gain or loss on
disposal of assets, monitoring fees and expenses, realized holding loss
on investments and discontinued operations, net of taxes. Management
uses Segment EBITDA to measure performance for Vanguard's segments and
to develop strategic objectives and operating plans for those segments.
Segment EBITDA eliminates the uneven effect of non-cash depreciation of
tangible assets and amortization of intangible assets, much of which
results from acquisitions accounted for under the purchase method of
accounting. Segment EBITDA also eliminates the effects of changes in
interest rates that management believes relate to general trends in
global capital markets, but are not necessarily indicative of the
operating performance of Vanguard's segments. Management believes that
Segment EBITDA provides useful information about the financial
performance of Vanguard's segments to investors, lenders, financial
analysts and rating agencies. Additionally, management believes that
investors and lenders view Segment EBITDA as an important factor in
making investment decisions and assessing the value of Vanguard.
Segment EBITDA is not a substitute for net income, operating cash flows
or other cash flow statement data determined in accordance with
accounting principles generally accepted in the United States.
Segment EBITDA, as presented, may not be comparable to similarly
titled measures of other companies.
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) - Continued
(In millions)
Nine Months Ended March 31, 2008
-------------------------------------------------------------
Acute
Care % of Health % of
Services Revenues Plans Revenues Eliminations Consolidated
--------- -------- ------- -------- ----------- -----------
Patient
service
revenues(1) $ 1,763.9 100.0% $ - 0.0% $ (23.5) $ 1,740.4
Premium
revenues - 0.0% 333.7 100.0% - 333.7
--------- -------- ------- -------- ----------- -----------
Total
revenues 1,763.9 100.0% 333.7 100.0% (23.5) 2,074.1
Salaries and
benefits
(excludes
stock
compensation) 837.9 47.5% 11.8 3.5% - 849.7
Supplies 323.1 18.3% 0.1 0.0% - 323.2
Medical
claims
expense - 0.0% 266.4 79.9% (23.5) 242.9
Provision for
doubtful
accounts 156.2 8.8% - 0.0% - 156.2
Other
operating
expenses 280.0 15.9% 22.0 6.6% - 302.0
--------- -------- ------- -------- ----------- -----------
Total
operating
expenses 1,597.2 90.5% 300.3 90.0% (23.5) 1,874.0
--------- -------- ------- -------- ----------- -----------
Segment
EBITDA(2) 166.7 9.5% 33.4 10.0% - 200.1
Less:
Interest,
net 97.4 5.5% (4.0) (1.2)% - 93.4
Depreciation
and
amortization 93.6 5.3% 3.2 1.0% - 96.8
Minority
interest 2.3 0.1% - 0.0% - 2.3
Equity
method
income (0.5) 0.0% - 0.0% - (0.5)
Stock
compensation 1.9 0.1% - 0.0% - 1.9
Loss on
disposal
of assets 0.8 0.1% - 0.0% - 0.8
Monitoring
fees and
expenses 5.0 0.3% - 0.0% - 5.0
--------- -------- ------- -------- ----------- -----------
Income
(loss)
from
continuing
operations
before
income
taxes $ (33.8) (1.9)% $ 34.2 10.2% $ - $ 0.4
========= ===== ======= ===== =========== ===========
(1) Vanguard eliminates in consolidation those patient service revenues
earned by its hospitals and related healthcare facilities attributable
to services provided to enrollees in its health plans and also
eliminates the corresponding medical claims expenses incurred by its
health plans for those services.
(2) Segment EBITDA is defined as income before interest expense (net of
interest income), income taxes, depreciation and amortization,
minority interests, equity method income, stock compensation, gain or
loss on disposal of assets, monitoring fees and expenses, realized
holding loss on investments and discontinued operations, net of
taxes. Management uses Segment EBITDA to measure performance for
Vanguard's segments and to develop strategic objectives and operating
plans for those segments. Segment EBITDA eliminates the uneven
effect of non-cash depreciation of tangible assets and amortization
of intangible assets, much of which results from acquisitions
accounted for under the purchase method of accounting. Segment
EBITDA also eliminates the effects of changes in interest rates that
management believes relate to general trends in global capital
markets, but are not necessarily indicative of the operating
performance of Vanguard's segments. Management believes that Segment
EBITDA provides useful information about the financial performance
of Vanguard's segments to investors, lenders, financial analysts
and rating agencies. Additionally, management believes that
investors and lenders view Segment EBITDA as an important factor
in making investment decisions and assessing the value of Vanguard.
Segment EBITDA is not a substitute for net income, operating cash
flows or other cash flow statement data determined in accordance with
accounting principles generally accepted in the United States.
Segment EBITDA, as presented, may not be comparable to similarly
titled measures of other companies.
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) - Continued
(In millions)
Nine Months Ended March 31, 2009
-------------------------------------------------------------
Acute
Care % of Health % of
Services Revenues Plans Revenues Eliminations Consolidated
--------- -------- ------- -------- ----------- -----------
Patient service
revenues(1) $1,913.8 100.0% $ - 0.0% $ (25.0) $ 1,888.8
Premium
revenues - 0.0% 480.8 100.0% - 480.8
--------- -------- ------- -------- ----------- -----------
Total
revenues 1,913.8 100.0% 480.8 100.0% (25.0) 2,369.6
Salaries and
benefits
(excludes
stock
compensation) 897.6 46.9% 22.7 4.7% - 920.3
Supplies 339.7 17.8% 0.2 0.1% - 339.9
Medical claims
expense - 0.0% 395.7 82.3% (25.0) 370.7
Provision for
doubtful
accounts 155.4 8.1% - 0.0% - 155.4
Other operating
expenses 328.6 17.2% 26.8 5.6% - 355.4
--------- -------- ------- -------- ----------- -----------
Total
operating
expenses 1,721.3 90.0% 445.4 92.7% (25.0) 2,141.7
--------- -------- ------- -------- ----------- -----------
Segment
EBITDA(2) 192.5 10.0% 35.4 7.3% - 227.9
Less:
Interest, net 85.3 4.5% (0.8) (0.2)% - 84.5
Depreciation
and
amortization 93.0 4.8% 3.0 0.6% - 96.0
Minority
interest 2.3 0.1% - 0.0% - 2.3
Equity method
income (0.4) (0.1)% - 0.0% - (0.4)
Stock
compensation 3.4 0.2% - 0.0% - 3.4
Gain on
disposal of
assets (2.1) (0.1)% - 0.0% - (2.1)
Monitoring
fees and
expenses 3.9 0.2% - 0.0% - 3.9
Realized
holding loss
on
investments 0.6 0.1% - 0.0% - 0.6
--------- -------- ------- -------- ----------- -----------
Income from
continuing
operations
before
income
taxes $ 6.5 0.3% $ 33.2 6.9% $ - $ 39.7
======== ===== ====== ===== =========== ===========
(1) Vanguard eliminates in consolidation those patient service revenues
earned by its hospitals and related healthcare facilities attributable
to services provided to enrollees in its health plans and also
eliminates the corresponding medical claims expenses incurred by its
health plans for those services.
(2) Segment EBITDA is defined as income before interest expense (net of
interest income), income taxes, depreciation and amortization, minority
interests, equity method income, stock compensation, gain or loss on
disposal of assets, monitoring fees and expenses, realized holding
loss on investments and discontinued operations, net of taxes.
Management uses Segment EBITDA to measure performance for Vanguard's
segments and to develop strategic objectives and operating plans for
those segments. Segment EBITDA eliminates the uneven effect of
non-cash depreciation of tangible assets and amortization of
intangible assets, much of which results from acquisitions accounted
for under the purchase method of accounting. Segment EBITDA also
eliminates the effects of changes in interest rates that management
believes relate to general trends in global capital markets, but are
not necessarily indicative of the operating performance of
Vanguard's segments. Management believes that Segment EBITDA
provides useful information about the financial performance of
Vanguard's segments to investors, lenders, financial analysts and
rating agencies. Additionally, management believes that investors
and lenders view Segment EBITDA as an important factor in making
investment decisions and assessing the value of Vanguard. Segment
EBITDA is not a substitute for net income, operating cash flows or
other cash flow statement data determined in accordance with
accounting principles generally accepted in the United States.
Segment EBITDA, as presented, may not be comparable to similarly
titled measures of other companies.
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited)
Three months
ended March 31,
----------------
%
2008 2009 Change
------- ------- -------
Number of hospitals at end of period 15 15
Licensed beds at end of period 4,140 4,135
Discharges 43,838 42,595 (2.8)%
Total adjusted discharges 72,094 73,221 1.6 %
Adjusted discharges-hospitals 68,467 69,460 1.5 %
Average length of stay 4.46 4.29 (3.8)%
Patient days 195,317 182,872 (6.4)%
Patient revenue per total adjusted discharge $ 8,262 $ 9,054 9.6 %
Patient revenue per adjusted discharge-hospitals $ 8,317 $ 8,997 8.2 %
Inpatient surgeries 9,366 9,578 2.3 %
Outpatient surgeries 18,321 18,931 3.3 %
Emergency room visits 153,186 156,940 2.5 %
Charity care as a percent of patient
service revenues 3.9% 3.2%
Provision for doubtful accounts as a percent
of patient service revenues 8.7% 7.8%
Net patient revenue payer mix:
Medicare 26.5% 24.7%
Medicaid 6.6% 9.0%
Managed Medicare 14.7% 14.0%
Managed Medicaid 7.4% 8.2%
Managed care 35.5% 35.6%
Commercial 1.0% 0.7%
Self pay 8.3% 7.8%
------- -------
Total 100.0% 100.0%
======= =======
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics - Continued
(Unaudited)
Nine months
ended March 31,
----------------
%
2008 2009 Change
------- ------- -------
Number of hospitals at end of period 15 15
Licensed beds at end of period 4,140 4,135
Discharges 127,171 126,480 (0.5)%
Total adjusted discharges 212,688 216,489 1.8 %
Adjusted discharges-hospitals 201,844 205,510 1.8 %
Average length of stay 4.35 4.25 (2.3)%
Patient days 553,662 536,930 (3.0)%
Patient revenue per total adjusted discharge $ 8,020 $ 8,544 6.5 %
Patient revenue per adjusted discharge-hospitals $ 8,080 $ 8,634 6.9 %
Inpatient surgeries 27,767 28,440 2.4 %
Outpatient surgeries 54,535 56,857 4.3 %
Emergency room visits 443,407 446,793 0.8 %
Charity care as a percent of patient
service revenues 3.6% 3.7%
Provision for doubtful accounts as a percent
of patient service revenues 9.0% 8.2%
Net patient revenue payer mix:
Medicare 26.1% 25.4%
Medicaid 7.7% 7.9%
Managed Medicare 14.0% 13.9%
Managed Medicaid 7.5% 8.8%
Managed care 34.9% 35.1%
Commercial 1.1% 0.9%
Self pay 8.7% 8.0%
------- -------
Total 100.0% 100.0%
======= =======
Contact: Vanguard Health Systems, Inc. Aaron Broad, Director Investor Relations (615) 665-6131
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