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Tenet Healthcare Corp.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 30 April 2026: press release. Guidance figures: 2 raised, 1 lowered, 26 kept. The quarter’s numbers.

Key takeaways

  • Net income and diluted EPS rose: Net income available to common shareholders was $702 million, or $8.01 per diluted share, against $406 million, or $4.27, a year earlier. Net operating revenues were $5,368 million, up 2.8%. Source
  • Adjusted diluted EPS up 10.6%: Adjusted diluted EPS was $4.82, up 10.6% from $4.36. Adjusted figures exclude the revenue from contract termination and related items, as reconciled in the release's tables. Source
  • Adjusted EBITDA flat, margin lower: Adjusted EBITDA was $1.162 billion versus $1.163 billion, with margin of 21.6% against 22.3%. Management cited same-facility revenue growth and expense control, offset by payer mix from lower exchange admissions. Source
  • Surgical revenue per case rose: Same-facility system-wide surgical net patient service revenue rose 5.3% as revenue per case rose 5.6% and cases fell 0.3%. Management attributed per-case growth to higher acuity and favorable service mix. Source
  • Revenue per admission fell 1.5%: Same-hospital revenue per adjusted admission declined 1.5%, mainly because a $40 million Medicaid supplemental benefit in the prior-year quarter did not recur. Source
  • Operating cash flow nearly doubled: Operating cash flow was $1.641 billion against $815 million. Working-capital inflows from inventories and other current assets ($407 million) and income taxes ($259 million) contributed. Source
  • Adjusted free cash flow up $300 million: Adjusted free cash flow was $978 million against $678 million, after capital spending of $180 million. Free cash flow was $1,461 million. Source
  • About $40 million non-recurring revenue: The company recognized an approximate $40 million favorable non-recurring pre-tax impact from previously deferred revenue. This impact is not reflected in same-hospital net patient service revenue. Source

“We delivered strong results in both the Ambulatory and Hospital segments in the first quarter of 2026, characterized by disciplined operations and strong free cash flow,”

Saum Sutaria, M.D., Chairman and Chief Executive Officer of Tenet

Guidance

AreaPeriodFigureAgainst last quarter
Net operating revenues (consolidated) SourceFY 2026$21,500 to $22,300Kept
Net income available to common shareholders SourceFY 2026$2,605 to $2,840Kept
Adjusted EBITDA (consolidated) SourceFY 2026$4,485 to $4,785Kept
Adjusted EBITDA margin SourceFY 202620.9% to 21.5%Kept
Diluted income per common share SourceFY 2026$29.94 to $32.64Raised from $29.60 to $32.27
Adjusted net income SourceFY 2026$1,425 to $1,625Kept
Adjusted diluted earnings per share SourceFY 2026$16.38 to $18.68Raised from $16.19 to $18.47
Equity in earnings of unconsolidated affiliates SourceFY 2026$265 to $275Kept
Depreciation and amortization SourceFY 2026$875 to $925Kept
Interest expense SourceFY 2026$800 to $810Kept
Income tax expense SourceFY 2026$985 to $1,060Kept
Net income available to noncontrolling interests SourceFY 2026$910 to $960Kept
Weighted average diluted common shares SourceFY 2026~87 millionLowered from ~88 million
Net cash provided by operating activities SourceFY 2026$3,640 to $4,090Kept
Adjusted net cash provided by operating activities SourceFY 2026$3,200 to $3,600Kept
Capital expenditures SourceFY 2026$700 to $800Kept
Free cash flow SourceFY 2026$2,940 to $3,290Kept
Adjusted free cash flow SourceFY 2026$2,500 to $2,800Kept
NCI cash distributions SourceFY 2026$900 to $970Kept
Ambulatory net operating revenues SourceFY 2026$5,500 to $5,700Kept
Ambulatory Adjusted EBITDA SourceFY 2026$2,130 to $2,230Kept
Ambulatory NCI SourceFY 2026$865 to $895Kept
Ambulatory Adjusted EBITDA less NCI SourceFY 2026$1,265 to $1,335Kept
Ambulatory same-facility system-wide revenues SourceFY 2026, versus prior yearUp 3.0% to 6.0%Kept
Hospital net operating revenues SourceFY 2026$16,000 to $16,600Kept
Hospital Adjusted EBITDA SourceFY 2026$2,355 to $2,555Kept
Hospital NCI SourceFY 2026$45 to $65Kept
Hospital inpatient admissions SourceFY 2026, versus prior yearUp 1.0% to 2.0%Kept
Hospital adjusted admissions SourceFY 2026, versus prior yearUp 1.0% to 2.0%Kept

What changed from last quarter

  • Guidance raised: Diluted income per common share guidance range was raised to $29.94 to $32.64 from $29.60 to $32.27. Source
  • Guidance raised: Adjusted diluted EPS guidance range was raised to $16.38 to $18.68 from $16.19 to $18.47. Source
  • Guidance lowered: Expected weighted average diluted share count was reduced to about 87 million from about 88 million. Source
  • New: First quarter 2026 included $413 million of revenue, or $314 million after-tax, from early conclusion of the CommonSpirit contract. The prior release anticipated this revenue for 2026. Source

Results and growth drivers

  • Net income and diluted EPS rose: Net income available to common shareholders was $702 million, or $8.01 per diluted share, against $406 million, or $4.27, a year earlier. Net operating revenues were $5,368 million, up 2.8%. Source
  • Adjusted diluted EPS up 10.6%: Adjusted diluted EPS was $4.82, up 10.6% from $4.36. Adjusted figures exclude the revenue from contract termination and related items, as reconciled in the release's tables. Source
  • Adjusted EBITDA flat, margin lower: Adjusted EBITDA was $1.162 billion versus $1.163 billion, with margin of 21.6% against 22.3%. Management cited same-facility revenue growth and expense control, offset by payer mix from lower exchange admissions. Source

Ambulatory segment

  • Surgical revenue per case rose: Same-facility system-wide surgical net patient service revenue rose 5.3% as revenue per case rose 5.6% and cases fell 0.3%. Management attributed per-case growth to higher acuity and favorable service mix. Source
  • Segment revenue up 10.6%: Ambulatory net operating revenues were $1,320 million, up 10.6%, reflecting same-facility growth, acquisitions and added service lines. Source
  • Segment Adjusted EBITDA up 6.1%: Ambulatory Adjusted EBITDA was $484 million, up 6.1% from $456 million, with margin of 36.7% against 38.2%. Same-facility growth, expense discipline and acquisitions contributed. Source
  • Surgical center portfolio size: At March 31, 2026, USPI held interests in 541 ambulatory surgery centers (407 consolidated) and 26 surgical hospitals (eight consolidated) across 37 states. Source

“We continue to support our physician partners to drive innovation in patient care as we execute on our high acuity strategy and grow our businesses both organically and inorganically.”

Saum Sutaria, M.D., Chairman and Chief Executive Officer of Tenet

Hospital segment

  • Hospital revenue nearly flat: Hospital net operating revenues were $4,048 million, up 0.5%. Management cited higher adjusted admissions, offset by payer mix from lower exchange admissions. Source
  • Revenue per admission fell 1.5%: Same-hospital revenue per adjusted admission declined 1.5%, mainly because a $40 million Medicaid supplemental benefit in the prior-year quarter did not recur. Source
  • Hospital Adjusted EBITDA down $29 million: Hospital Adjusted EBITDA was $678 million versus $707 million, with margin of 16.7% against 17.5%. Management cited the same dynamics as the consolidated results, partly offset by expense efficiencies. Source
  • Outpatient and ER visits declined: Same-hospital outpatient and emergency room visits both declined year over year, while same-hospital admissions were nearly flat. Source

Costs, margins and pricing

  • Supplies cost rose faster than revenue: Supplies expense rose 6.0% to $961 million, or 17.9% of net operating revenues, versus 17.4% a year earlier. Source
  • Salaries held near prior share: Salaries, wages and benefits rose 2.6% to $2,174 million, or 40.5% of revenue against 40.6%. Other operating expenses rose 2.9% to $1,122 million. Source
  • Operating income rose: Operating income was $1,296 million, or 24.1% of revenue, against $943 million, or 18.1%. The prior-year quarter included a $22 million net gain on facility sales. Source

Cash flow and balance sheet

  • Operating cash flow nearly doubled: Operating cash flow was $1.641 billion against $815 million. Working-capital inflows from inventories and other current assets ($407 million) and income taxes ($259 million) contributed. Source
  • Adjusted free cash flow up $300 million: Adjusted free cash flow was $978 million against $678 million, after capital spending of $180 million. Free cash flow was $1,461 million. Source
  • Net debt ratio slightly lower: Net debt to Adjusted EBITDA was 2.24x at March 31, 2026, against 2.25x at December 31, 2025. Source
  • Redeemable noncontrolling interests fell: Redeemable noncontrolling interests in consolidated subsidiaries were $2,137 million, against $2,956 million at December 31, 2025. Source

Capital and shareholder returns

  • Share repurchases of $318 million: The company repurchased 1.35 million shares of common stock for $318 million in the quarter, against $348 million a year earlier. Source
  • Capital spending by segment: Capital expenditures were $180 million, of which $148 million was in Hospital Operations and Services and $32 million in Ambulatory Care. Source

CommonSpirit and Conifer transaction

  • $540 million received in January: The $540 million CommonSpirit payment was satisfied on January 27, 2026 by offsetting the $540 million Conifer owed CommonSpirit, and it is added back in adjusted operating cash flow. Source
  • About $40 million non-recurring revenue: The company recognized an approximate $40 million favorable non-recurring pre-tax impact from previously deferred revenue. This impact is not reflected in same-hospital net patient service revenue. Source
  • Redemption reduced noncontrolling interest: The redemption reduced Tenet's redeemable noncontrolling interest by $846 million and increased additional paid-in capital by $306 million. Source

Full-year 2026 guidance

  • Adjusted EBITDA guidance held: Full-year 2026 Adjusted EBITDA guidance continues at $4.485 billion to $4.785 billion, with margin of 20.9% to 21.5%. Source
  • Diluted EPS guidance raised: Diluted income per common share guidance rose to $29.94 to $32.64, and adjusted diluted EPS guidance rose to $16.38 to $18.68. Source
  • Contract termination revenue excluded from revenue: Net operating revenues guidance excludes revenue from early contract conclusion, which the release reconciles at $1.65 billion for FY 2026. Source

Coming up, as management said on 30 April 2026

  • Remaining CommonSpirit installments: Remaining CommonSpirit payments of the $1.9 billion total are due in annual installments over the next three years. Source
  • Conifer support through 2026: Conifer will continue supporting CommonSpirit through the end of 2026 on financial terms consistent with the prior contract.

Figures management reported

FigureReported
Ambulatory same-facility system-wide net patient service revenues growth Source5.3%
Ambulatory same-facility system-wide surgical cases growth Source(0.3)%
Ambulatory same-facility system-wide net patient service revenue per case growth Source5.6%
Same-hospital admissions growth Source0.2%
Same-hospital outpatient visits growth Source(3.7)%
Same-hospital emergency room visits growth Source(3.2)%
Same-hospital surgeries growth Source(0.9)%
Same-hospital net patient service revenues Source$3,458 million

Risks management discussed

  • Regulatory: Prior-year Medicaid supplemental revenue benefits did not recur in the first quarter of 2026, which management cited as a comparison to the prior-year quarter. Source
  • Demand: Outpatient and emergency room visit volumes declined, which management presented alongside stable same-hospital admissions. Source
  • Demand: Lower exchange admissions led to unfavorable payer mix, which management cited as offsetting revenue growth in both segments. Source

Earlier plans management reported on

  • Not stated: Management stated that the FY 2026 Adjusted EBITDA range continues as previously given. Source
  • Not stated: Management stated confidence in executing its strategy and achieving its full-year 2026 expectations.
  • Not stated: The prior release stated Tenet would record about $1.65 billion of contract termination revenue, about $500 million of tax expense, and about $150 million of tax payments in 2026.

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.