Vanguard Reports Second Quarter Results
NASHVILLE, TN–(Marketwire – Feb 8, 2010) – Vanguard Health Systems, Inc. (”Vanguard”)
today voiced formula for the second entertain finished Dec 31, 2009.
Total revenues for the entertain finished Dec 31, 2009 were $843.6 million,
an enlarge of $51.0 million or 6.4% from the before to to year quarter. Patient
service revenues and illness devise reward revenues increasing $16.9 million
and $34.1 million, respectively, from the before to to year quarter. The increase
in studious use revenues was essentially attributable to a 2.9% increase
in sum practiced discharges and a 0.3% diminution in studious income per
total practiced liberate during the stream year entertain compared to the
prior year quarter. The diminution in studious income per sum adjusted
discharge during the stream year entertain was due to the doing of
an uninsured bonus process in the Phoenix and San Antonio hospitals
effective Jul 1, 2009, identical to the module implemented in the Illinois
hospitals on Apr 1, 2009, and a shift to the Medicaid tentative process at
these same hospitals as formerly disclosed. Absent these process changes,
patient income per sum practiced liberate would have increasing by 5.2%
during the stream year entertain compared to the before to to year quarter. The
increase in illness devise reward revenues was essentially attributable to a
20.5% enlarge in normal membership in Phoenix Health Plan (PHP) during
the stream year entertain compared to the before to to year quarter. Economic
conditions in Arizona have resulted in an enlarge in the series of
individuals authorised for coverage underneath the Arizona Health Care Cost
Containment System (AHCCCS) during the stream year entertain ensuing in
more enrollees in PHP.
For the entertain finished Dec 31, 2008, Vanguard had a detriment from
continuing operations of $20.0 million compared to income from continuing
operations of $10.9 million during the before to to year entertain primarily
resulting from the $43.1 million ($31.8 million, net of taxes) goodwill
impairment detriment associated to the dual Chicago hospitals during the current
year quarter, as formerly disclosed. Many comparisons of particular cost
and responsibility apparatus as a commission of sum revenues during the stream year
quarter were impacted by the poignant expansion in illness devise premium
revenues and the uninsured bonus and Medicaid tentative process changes. A
table describing the stroke of adjustments to sure losses and revenues
and associated ratios for the strident caring services shred and to certain
statistical measures is enclosed in this press recover in the attached
Supplemental Operating Measures Adjusted for Comparative Analysis. Health
plan claims responsibility as a commission of illness devise reward revenues
increased to 80.5% during the stream year entertain compared to 79.0% during
the before to to year entertain essentially due to changes to enrollee healing costs
and enrollee demographic brew at PHP.
During the entertain finished Dec 31, 2009, net detriment attributable to
Vanguard Health Systems, Inc. stockholders was $20.7 million compared to
$10.1 million net income attributable to Vanguard Health Systems, Inc.
stockholders during the before to to year quarter.
Adjusted EBITDA was $83.8 million for the entertain finished Dec 31, 2009,
an enlarge of $5.3 million or 6.8% from the before to to year quarter. A
reconciliation of Adjusted EBITDA to net income (loss) attributable to
Vanguard Health Systems, Inc. stockholders as dynamic in suitability with
generally supposed accounting beliefs for the buliding finished December
31, 2008 and 2009 is enclosed in the trustworthy supplemental financial
information.
The combined handling formula for the entertain finished Dec 31, 2009
reflect a 1.0% enlarge in discharges and a 2.9% enlarge in sum adjusted
discharges compared to the before to to year quarter. Outpatient surgeries and
emergency room visits increasing 0.6% and 9.2%, respectively, during the
current year entertain compared to the before to to year quarter. Inpatient
surgeries during the stream year entertain were prosaic compared to the prior
year quarter.
Total revenues for the 6 months finished Dec 31, 2009 were $1,667.0
million, an enlarge of $155.4 million or 10.3% from the before to to year period.
Patient use revenues and illness devise reward revenues increasing $37.7
million and $117.7 million, respectively, from the before to to year period.
Patient use revenues for the stream year duration were positively
impacted by a 2.8% enlarge in sum practiced discharges and a 0.4%
increase in studious income per practiced sum liberate compared to the
prior year period. Absent the formerly discussed uninsured bonus and
Medicaid tentative process changes, studious income per practiced total
discharge would have increasing 5.6% during the stream year duration compared
to the before to to year period. Health devise reward revenues increasing 39.4%
during the stream year duration essentially due to the poignant enrollment
increase for PHP’s brand brand brand brand brand brand brand new stipulate with AHCCCS which went in to outcome on
October 1, 2008, as formerly discussed.
For the 6 months finished Dec 31, 2009, Vanguard had a detriment from
continuing operations of $17.4 million compared to income from continuing
operations of $11.7 million during the before to to year period, primarily
resulting from the organization to help the poor spoil detriment famous during the current
year duration as described on top of and as formerly publicly disclosed. Many
comparisons of particular price and responsibility apparatus as a commission of total
revenues during the stream year duration were impacted by the significant
growth in illness devise reward revenues and the uninsured bonus and
Medicaid tentative process changes formerly discussed. The Supplemental
Operating Measures Adjusted for Comparative Analysis list enclosed later
in this press recover sets onward the stroke of the uninsured bonus and
Medicaid tentative process changes to sure losses and revenues and
related ratios of the strident caring services shred and to certain
statistical measures. Health devise claims responsibility as a commission of health
plan reward revenues increasing to 79.6% during the stream year period
compared to 76.2% during the before to to year duration as a outcome of changes to
capitation rates, enrollee healing costs and enrollee demographic brew under
PHP’s brand brand brand brand brand brand brand new stipulate with AHCCCS which went in to outcome on Oct 1, 2008.
During the 6 months finished Dec 31, 2009, net detriment attributable to
Vanguard Health Systems, Inc. stockholders was $19.2 million compared to
$11.0 million net income attributable to Vanguard Health Systems, Inc.
stockholders during the before to to year period.
Adjusted EBITDA was $152.5 million for the 6 months finished Dec 31,
2009, an enlarge of $10.8 million or 7.6% from the before to to year period. A
reconciliation of Adjusted EBITDA to income (loss) attributable to Vanguard
Health Systems, Inc. stockholders as dynamic in suitability with
generally supposed accounting beliefs for the six-month durations ended
December 31, 2008 and 2009 is enclosed in the trustworthy supplemental
financial information.
The combined handling formula for the 6 months finished Dec 31,
2009 simulate a 2.8% enlarge in sum practiced discharges compared to the
prior year period, whilst discharges were prosaic duration over period. Inpatient
surgeries and outpatient surgeries increasing 0.1% and 1.4%, respectively,
while puncture room visits increasing 7.2% during the stream year period
compared to the before to to year period.
Cash flows from handling activities were $149.6 million for the 6 months
ended Dec 31, 2009, a $4.6 million diminution from the before to to year
period. Net days in accounts receivable was 46 days, 45 days and 50 days as
of Dec 31, 2009, Jun 30, 2009 and Dec 31, 2008, respectively.
Vanguard will host a discussion call for investors at 11:00 am EST on
February 9, 2010. All meddlesome investors have been invited to entrance a live
audio promote of the call, around webcast. The live webcast can be accessed
on the home page of Vanguard’s Web site at www.vanguardhealth.com by
clicking on “Second Quarter Webcast” or at
http://visualwebcaster.com/event.asp?id=65311. If you have been incompetent to
participate during the live webcast, the call will be permitted on a replay
basis on Vanguard’s Web site www.vanguardhealth.com. To entrance the replay,
click on the Latest News couple on the Investor Relations page of
www.vanguardhealth.com. The replay will be permitted around this couple for one
year.
Vanguard owns and operates fifteen strident caring hospitals and complementary
facilities and services in Chicago, Illinois; Phoenix, Arizona; San
Antonio, Texas; and Massachusetts. Vanguard’s devise is to develop
locally branded, extensive healthcare smoothness networks in urban
markets. Vanguard will aspire to acquisitions where there have been opportunities to
partner with heading smoothness systems in brand brand brand brand brand brand brand new civic markets. Upon acquiring
a trickery or network of facilities, Vanguard implements vital and
operational alleviation initiatives together with expanding services,
strengthening relations with physicians and managed caring organizations,
recruiting brand brand brand brand brand brand brand new physicians and upgrading report systems and other
capital equipment. These strategies urge peculiarity and network coverage in
a price in outcome and permitted demeanour for the communities we serve.
This press recover contains forward-looking statements inside of the meaning
of the sovereign bonds laws, which have been dictated to be lonesome by the
safe harbors combined thereby. These forward-looking statements embody all
statements which have been not chronological statements of actuality and those statements
regarding Vanguard’s intent, idea or expectations. Do not rely on any
forward-looking statements as such statements have been theme to numerous
factors, risks and uncertainties which could equates to Vanguard’s actual
outcomes, results, opening or achievements to be materially different
from those projected. These factors, risks and uncertainties include, among
others, Vanguard’s tall grade of precedence and seductiveness rate risk;
Vanguard’s capability to catch almost some-more debt; handling and
financial restrictions in Vanguard’s debt agreements; Vanguard’s capability to
generate money to use the debt; intensity guilt associated to
disclosures of relations in in between physicians and Vanguard’s hospitals;
Vanguard’s capability to grow the commercial operation and successfully exercise its
business strategies; Vanguard’s capability to successfully confederate any
future acquisitions; the intensity which acquisitions could be costly,
unsuccessful or theme Vanguard to astonishing liabilities; post-payment
claims reviews by bureaucratic agencies which could outcome in additional
costs to Vanguard; conflicts of seductiveness which might movement as a outcome of
Vanguard’s carry out by a small series of stockholders; the highly
competitive inlet of the healthcare business; bureaucratic law of
the attention together with Medicare and Medicaid payment levels; changes
in Federal, state or internal law inspiring the healthcare industry;
the probable dramatization of Federal or state healthcare reform; pressures to
contain costs by managed caring organizations and alternative insurers and
Vanguard’s capability to come to conditions excusable conditions with these third party
payers; the capability to capture and keep competent supervision and
personnel, together with physicians and nurses; claims and authorised actions
relating to veteran liabilities or alternative matters; the impacts of
weakened mercantile conditions and flighty collateral markets on Vanguard’s
results of operations, monetary on all sides and money flows; Vanguard’s
failure to sufficient raise the comforts with technologically advanced
equipment could adversely start the revenues and marketplace position;
Vanguard’s bearing to the increasing amounts of and pick up risks
associated with uninsured accounts and the co-pay and deductible portions
of insured accounts; Vanguard’s capability to say or enlarge patient
membership and carry out costs of the managed healthcare plans; the
geographic thoroughness of Vanguard’s operations; the technological and
pharmaceutical improvements which enlarge the price of on condition which healthcare
services or revoke the direct for such services; the timeliness of
reimbursement payments perceived underneath supervision programs; the potential
adverse stroke of well known and different supervision investigations; and those
factors, risks and uncertainties minute in Vanguard’s filings from time
to time with the Securities and Exchange Commission, including, among
others, Vanguard’s Annual Reports on Form 10-K and the Quarterly Reports on
Form 10-Q.
Although Vanguard believes which the assumptions underlying the
forward-looking statements contained in this press recover have been reasonable,
any of these assumptions could infer to be inaccurate, and, therefore,
there can be no declaration which the forward-looking statements enclosed in
this press recover will infer to be accurate. In light of the significant
uncertainties fundamental in the forward-looking statements enclosed herein,
you should not courtesy the inclusion of such report as a representation
by Vanguard which the objectives and skeleton expected by the
forward-looking statements will start or be achieved, or if any of them do,
what stroke they will have on Vanguard’s formula of operations and
financial condition. Vanguard undertakes no requisite to publicly release
any revisions to any forward-looking statements contained herein to reflect
events and resources occurring after the date hereof or to simulate the
occurrence of amazing events.
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Operations (Unaudited)
(In millions)
Three months ended
Dec 31,
-------------------------------------
2008
(as adjusted) 2009
-------- -------- -------- --------
Patient use revenues $ 614.4 77.5% $ 631.3 74.8%
Premium revenues 178.2 22.5 212.3 25.2
-------- -------- -------- --------
Total revenues 792.6 100.0 843.6 100.0
Costs and Expenses:
Salaries and benefits (includes
batch remuneration of $0.8 and
$1.0, respectively) 302.7 38.2 324.5 38.5
Health devise claims responsibility 140.7 17.8 170.8 20.2
Supplies 112.8 14.2 114.8 13.6
Provision for puzzled accounts 48.3 6.1 35.0 4.1
Purchased services 40.3 5.1 44.7 5.3
Non-income taxes 10.9 1.4 10.7 1.3
Rents and leases 10.3 1.3 11.2 1.3
Other handling losses 48.9 6.1 49.1 5.8
Depreciation and amortization 32.1 4.1 34.3 4.1
Interest, net 28.6 3.6 27.5 3.3
Impairment detriment -- 0.0 43.1 5.1
Other 1.0 0.1 1.5 0.2
-------- -------- -------- --------
Total costs and losses 776.6 98.0 867.2 102.8
-------- -------- -------- --------
Income (loss) from continuing
operations before to to income taxes 16.0 2.0 (23.6) (2.8)
Income taxation good (expense) (5.1) (0.6) 3.6 0.4
-------- -------- -------- --------
Income (loss) from continuing
operations 10.9 1.4 (20.0) (2.4)
Income (loss) from discontinued
operations, net of taxes (0.1) 0.0 0.1 0.0
-------- -------- -------- --------
Net income (loss) 10.8 1.4 (19.9) (2.4)
Less: Net income attributable to
non-controlling interests (0.7) (0.1) (0.8) (0.1)
-------- -------- -------- --------
Net income (loss) attributable to
Vanguard Health Systems, Inc.
stockholders $ 10.1 1.3% $ (20.7) (2.5)%
======== ========
Amounts attributable to Vanguard
Health Systems, Inc.
stockholders:
Income (loss) from continuing
operations, net of taxes $ 10.2 1.3% $ (20.8) (2.5)%
Income (loss) from discontinued
operations, net of taxes (0.1) 0.0 0.1 0.0
-------- -------- -------- --------
Net income (loss) attributable to
Vanguard Health Systems, Inc.
stockholders $ 10.1 1.3% $ (20.7) (2.5)%
======== ========
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Operations (Unaudited)
(In millions)
Six months ended
Dec 31,
-------------------------------------
2008
(as adjusted) 2009
-------- -------- ------- --------
Patient use revenues $1,212.7 80.2% $1,250.4 75.0%
Premium revenues 298.9 19.8 416.6 25.0
-------- -------- -------- --------
Total revenues 1,511.6 100.0 1,667.0 100.0
Costs and Expenses:
Salaries and benefits (includes
batch remuneration of $2.2 and
$2.9, respectively) 595.3 39.4 638.9 38.3
Health devise claims responsibility 227.7 15.1 331.8 19.9
Supplies 224.6 14.8 225.8 13.5
Provision for puzzled accounts 102.9 6.8 72.2 4.3
Purchased services 81.7 5.4 92.3 5.5
Non-income taxes 19.0 1.3 24.9 1.5
Rents and leases 21.5 1.4 22.3 1.3
Other handling losses 99.4 6.6 109.2 6.6
Depreciation and amortization 64.4 4.3 68.3 4.1
Interest, net 57.3 3.8 54.7 3.3
Impairment detriment -- 0.0 43.1 2.6
Other 0.8 0.0 2.6 0.2
-------- -------- -------- --------
Total costs and losses 1,494.6 98.9 1,686.1 101.1
-------- -------- -------- --------
Income (loss) from continuing
operations before to to income taxes 17.0 1.1 (19.1) (1.1)
Income taxation good (expense) (5.3) (0.4) 1.7 0.1
-------- -------- -------- --------
Income (loss) from continuing
operations 11.7 0.7 (17.4) (1.0)
Income (loss) from discontinued
operations, net of taxes 0.9 0.1 (0.1) 0.0
-------- -------- -------- --------
Net income (loss) 12.6 0.8 (17.5) (1.0)
Less: Net income attributable to
non-controlling interests (1.6) (0.1) (1.7) (0.1)
-------- -------- -------- --------
Net income (loss) attributable to
Vanguard Health Systems, Inc.
stockholders $ 11.0 0.7% $ (19.2) (1.1)%
======== ========
Amounts attributable to Vanguard
Health Systems, Inc.
stockholders:
Income (loss) from continuing
operations, net of taxes $ 10.1 0.6% $ (19.1) (1.1)%
Income (loss) from discontinued
operations, net of taxes 0.9 0.1 (0.1) 0.0
-------- -------- -------- --------
Net income (loss) attributable to
Vanguard Health Systems, Inc.
stockholders $ 11.0 0.7% $ (19.2) (1.1)%
======== ========
VANGUARD HEALTH SYSTEMS, INC.
Supplemental Financial Information (Unaudited)
Reconciliation of Adjusted EBITDA to Net Income (Loss) Attributable to
Vanguard Health Systems, Inc. Stockholders
(In millions)
Three months finished Six months ended
Dec 31, Dec 31,
2008 2009 2008 2009
-------- -------- -------- --------
Net income (loss) attributable
to Vanguard Health Systems,
Inc. stockholders $ 10.1 $ (20.7) $ 11.0 $ (19.2)
Interest, net 28.6 27.5 57.3 54.7
Income taxation responsibility (benefit) 5.1 (3.6) 5.3 (1.7)
Depreciation and amortization 32.1 34.3 64.4 68.3
Non-controlling interests 0.7 0.8 1.6 1.7
Loss (gain) on ordering of resources - 0.4 (2.1) 0.4
Equity process income (0.3) (0.3) (0.3) (0.5)
Stock remuneration 0.8 1.0 2.2 2.9
Monitoring fees and losses 1.3 1.4 2.6 2.7
Realized land detriment on
investments -- -- 0.6 --
Impairment detriment -- 43.1 -- 43.1
Discontinued operations, net of
taxes 0.1 (0.1) (0.9) 0.1
-------- -------- -------- --------
Adjusted EBITDA (a) $ 78.5 $ 83.8 $ 141.7 $ 152.5
======== ======== ======== ========
(a) Adjusted EBITDA is discernible as income before to to seductiveness responsibility (net of
seductiveness income), income taxes, debasement and amortization,
non-controlling interests, benefit or detriment on the ordering of assets,
equity process income, batch compensation, monitoring fees and expenses,
satisfied land detriment on investments, spoil loss, debt
extinguishment costs and dropped operations, net of taxes.
Adjusted EBITDA is not dictated as a surrogate for net income (loss)
attributable to Vanguard Health Systems, Inc. stockholders, operating
money flows or alternative money upsurge matter interpretation dynamic in accordance
with accounting beliefs in all supposed in the United States. Due
to varying methods of calculation, Adjusted EBITDA as presented might not
be allied to likewise patrician measures of alternative companies.
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Balance Sheets
(In millions)
(Unaudited)
Jun 30, Dec 31,
2009 2009
--------- ---------
ASSETS
Current assets:
Cash and money equivalents $ 308.2 $ 358.0
Restricted money 1.9 21.9
Accounts receivable, net of stipend for doubtful
accounts of $121.5 and $69.9 at Jun 30, 2009 and
Dec 31, 2009, respectively 275.3 288.6
Inventories 48.3 50.1
Deferred income taxes 29.6 13.2
Prepaid losses and alternative stream resources 68.4 61.4
--------- ---------
Total stream resources 731.7 793.2
Property, plant and equipment, net 1,174.1 1,164.3
Goodwill 692.1 649.1
Intangible assets, net 54.6 50.6
Deferred income taxes 38.0 60.7
Investments in auction rate bonds 21.6 21.6
Other resources 19.0 20.1
--------- ---------
Total resources $ 2,731.1 $ 2,759.6
========= =========
LIABILITIES AND EQUITY
Current liabilities:
Accounts on credit $ 127.9 $ 148.5
Accrued salaries and benefits 133.9 121.5
Accrued illness devise claims 117.6 136.0
Accrued seductiveness 13.2 19.2
Other accrued losses and stream liabilities 79.5 79.1
Current maturities of long-term debt 8.0 8.0
--------- ---------
Total stream liabilities 480.1 512.3
Professional and ubiquitous guilt and workers
remuneration pot 76.7 83.0
Other liabilities 34.9 36.6
Long-term debt, rebate stream maturities 1,543.6 1,545.6
Commitments and contingencies
Equity:
Vanguard Health Systems, Inc. stockholders' equity:
Common batch -- --
Additional paid-in collateral 651.3 654.2
Accumulated alternative extensive detriment (6.8) (4.1)
Retained necessity (56.7) (75.9)
--------- ---------
Total Vanguard Health Systems, Inc.
stockholders' equity 587.8 574.2
Non-controlling interests 8.0 7.9
--------- ---------
Total equity 595.8 582.1
--------- ---------
Total liabilities and equity $ 2,731.1 $ 2,759.6
========= =========
VANGUARD HEALTH SYSTEMS, INC.
Condensed Consolidated Statements of Cash Flows (Unaudited)
(In millions)
Six months ended
Dec 31,
--------------------
2008
(as adjusted) 2009
--------- ---------
Operating activities:
Net income (loss) $ 12.6 $ (17.5)
Adjustments to determine net income (loss) to net
money supposing by handling activities:
Loss (income) from dropped operations,
net of taxes (0.9) 0.1
Depreciation and amortization 64.4 68.3
Provision for puzzled accounts 102.9 72.2
Deferred income taxes 1.6 (7.7)
Amortization of loan costs 2.6 2.9
Accretion of principal on comparison bonus records 10.6 5.8
Loss (gain) on sale of resources (2.1) 0.4
Stock remuneration 2.2 2.9
Non-cash satisfied land detriment on investments 0.6 --
Impairment detriment -- 43.1
Changes in handling resources and liabilities:
Accounts receivable (103.6) (85.5)
Inventories (1.3) (1.8)
Prepaid losses and alternative stream resources 2.1 5.2
Accounts on credit 4.4 20.6
Accrued losses and alternative liabilities 57.2 40.7
--------- ---------
Net money supposing by handling activities -
stability operations 153.3 149.7
Net money supposing by (used in) handling activities -
dropped operations 0.9 (0.1)
--------- ---------
Net money supposing by handling activities 154.2 149.6
Investing activities:
Capital expenditures (54.7) (68.4)
Acquisitions (3.6) (1.5)
Proceeds from item dispositions 4.0 1.4
Increase in limited money -- (20.0)
Other (0.3) (0.3)
--------- ---------
Net money used in investing activities (54.6) (88.8)
Financing activities:
Payments of long-term debt (3.9) (3.8)
Payments associated to derivative instrument with
financing component -- (5.4)
Distributions paid to non-controlling interests (2.7) (1.8)
--------- ---------
Net money used in financing activities (6.6) (11.0)
--------- ---------
Net enlarge in money and money equivalents 93.0 49.8
Cash and money equivalents, commencement of duration 141.6 308.2
--------- ---------
Cash and money equivalents, finish of duration $ 234.6 $ 358.0
========= =========
Net money paid for seductiveness $ 45.1 $ 41.9
========= =========
Net money paid (received) for income taxes $ 1.0 $ (13.2)
========= =========
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited)
(In millions)
Three Months Ended Dec 31, 2008
---------------------------------------------------
Acute % of % of
Care Reve- Health Reve- Elimi- Consol-
Services nues Plans nues nations idated
------- ----- ------- ----- ------- -------
Patient service
revenues(1) $ 622.2 100.0 % $ -- 0.0 % $ (7.8) $ 614.4
Premium revenues - 0.0 % 178.2 100.0 % -- 178.2
------- ----- ------- ----- ------- -------
Total revenues 622.2 100.0 % 178.2 100.0 % (7.8) 792.6
Salaries and
benefits (excludes
batch compensation) 294.6 47.4 % 7.3 4.1 % -- 301.9
Health devise responsibility - 0.0 % 148.5 83.3 % (7.8) 140.7
Supplies 112.7 18.1 % 0.1 0.0 % -- 112.8
Provision for
puzzled accounts 48.3 7.8 % - 0.0 % -- 48.3
Other operating
losses 101.0 16.2 % 9.4 5.3 % -- 110.4
------- ----- ------- ----- ------- -------
Total operating
losses 556.6 89.5 % 165.3 92.7 % (7.8) 714.1
------- ----- ------- ----- ------- -------
Segment EBITDA(2) 65.6 10.5 % 12.9 7.3 % -- 78.5
Less:
Interest, net 28.9 4.7 % (0.3) (0.2)% -- 28.6
Depreciation and
amortization 31.1 5.0 % 1.0 0.6 % -- 32.1
Equity process income (0.3) (0.1)% -- 0.0 % -- (0.3)
Stock remuneration 0.8 0.1 % -- 0.0 % -- 0.8
Monitoring fees and
losses 1.3 0.2 % -- 0.0 % -- 1.3
------- ----- ------- ----- ------- -------
Income from
continuing
operations before
income taxes $ 3.8 0.6 % $ 12.2 6.9 % $ -- $ 16.0
======= ===== ======= ===== ======= =======
(1) Vanguard eliminates in converging those studious use revenues
warranted by the hospitals and associated healthcare comforts attributable
to services supposing to enrollees in the illness skeleton and also
eliminates the analogous healing claims losses incurred by its
illness skeleton for those services.
(2) Segment EBITDA is discernible as income (loss) from stability operations
before to to income taxes rebate seductiveness responsibility (net of seductiveness income),
debasement and amortization, equity process income, stock
compensation, benefit or detriment on ordering of assets, monitoring fees and
expenses, satisfied land detriment on investments, spoil detriment and
debt extinguishment costs. Management uses Segment EBITDA to measure
opening for Vanguard's segments and to rise vital objectives
and handling skeleton for those segments. Segment EBITDA eliminates the
disproportionate outcome of non-cash debasement of discernible resources and
amortization of unsubstantial assets, most of which formula from
acquisitions accounted for underneath the squeeze process of accounting.
Segment EBITDA additionally eliminates the goods of changes in seductiveness rates
which supervision believes describe to ubiquitous trends in tellurian capital
markets, but have been not indispensably demonstrative of the operating
opening of Vanguard's segments. Management believes which Segment
EBITDA provides utilitarian report about the monetary opening of
Vanguard's segments to investors, lenders, monetary analysts and
rating agencies. Additionally, supervision believes which investors and
lenders perspective Segment EBITDA as an critical cause in creation investment
decisions and assessing the worth of Vanguard. Segment EBITDA is not a
surrogate for net income, handling money flows or alternative money flow
matter interpretation dynamic in suitability with accounting principles
in all supposed in the United States. Segment EBITDA, as presented,
might not be allied to likewise patrician measures of alternative companies.
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) - Continued
(In millions)
Three Months Ended Dec 31, 2009
---------------------------------------------------
Acute % of % of
Care Reve- Health Reve- Elimi- Consol-
Services nues Plans nues nations idated
------- ----- ------- ----- ------- -------
Patient service
revenues(1) $ 641.7 100.0 % $ -- 0.0 % $ (10.4) $ 631.3
Premium revenues -- 0.0 % 212.3 100.0 % - 212.3
------- ----- ------- ----- ------- -------
Total revenues 641.7 100.0 % 212.3 100.0 % (10.4) 843.6
Salaries and
benefits (excludes
batch compensation) 315.2 49.1 % 8.3 3.9 % -- 323.5
Health devise claims
responsibility -- 0.0 % 181.2 85.4 % (10.4) 170.8
Supplies 114.7 17.9 % 0.1 0.0 % -- 114.8
Provision for doubtful
accounts 35.0 5.4 % - 0.0 % -- 35.0
Other operating
losses 107.7 16.8 % 8.0 3.8 % -- 115.7
------- ----- ------- ----- ------- -------
Total operating
losses 572.6 89.2 % 197.6 93.1 % (10.4) 759.8
------- ----- ------- ----- ------- -------
Segment EBITDA(2) 69.1 10.8 % 14.7 6.9 % -- 83.8
Less:
Interest, net 27.6 4.3 % (0.1) (0.1)% -- 27.5
Depreciation and
amortization 33.1 5.2 % 1.2 0.6 % -- 34.3
Equity process income (0.3) (0.1)% -- 0.0 % -- (0.3)
Stock remuneration 1.0 0.2 % -- 0.0 % -- 1.0
Loss on ordering of
resources 0.4 0.1 % -- 0.0 % -- 0.4
Monitoring fees and
losses 1.4 0.2 % -- 0.0 % -- 1.4
Impairment detriment 43.1 6.7 % -- 0.0 % -- 43.1
------- ----- ------- ----- ------- -------
Income (loss) from
stability operations
before to to income taxes $ (37.2) (5.8)% $ 13.6 6.4 % $ -- $ (23.6)
======= ===== ======= ===== ======= =======
(1) Vanguard eliminates in converging those studious use revenues
warranted by the hospitals and associated healthcare comforts attributable
to services supposing to enrollees in the illness skeleton and also
eliminates the analogous healing claims losses incurred by its
illness skeleton for those services.
(2) Segment EBITDA is discernible as income (loss) from stability operations
before to to income taxes rebate seductiveness responsibility (net of seductiveness income),
debasement and amortization, equity process income, stock
compensation, benefit or detriment on ordering of assets, monitoring fees and
expenses, satisfied land detriment on investments, spoil detriment and
debt extinguishment costs. Management uses Segment EBITDA to measure
opening for Vanguard's segments and to rise vital objectives
and handling skeleton for those segments. Segment EBITDA eliminates the
disproportionate outcome of non-cash debasement of discernible resources and
amortization of unsubstantial assets, most of which formula from
acquisitions accounted for underneath the squeeze process of accounting.
Segment EBITDA additionally eliminates the goods of changes in seductiveness rates
which supervision believes describe to ubiquitous trends in tellurian capital
markets, but have been not indispensably demonstrative of the operating
opening of Vanguard's segments. Management believes which Segment
EBITDA provides utilitarian report about the monetary opening of
Vanguard's segments to investors, lenders, monetary analysts and
rating agencies. Additionally, supervision believes which investors and
lenders perspective Segment EBITDA as an critical cause in creation investment
decisions and assessing the worth of Vanguard. Segment EBITDA is not a
surrogate for net income, handling money flows or alternative money flow
matter interpretation dynamic in suitability with accounting principles
in all supposed in the United States. Segment EBITDA, as presented,
might not be allied to likewise patrician measures of alternative companies.
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) - Continued
(In millions)
Six Months Ended Dec 31, 2008
---------------------------------------------------------
Acute % of % of
Care Reve- Health Reve- Elimi- Consol-
Services nues Plans nues nations idated
-------- ----- -------- ----- ------- --------
Patient service
revenues(1) $1,230.0 100.0 % $ -- 0.0 % $ (17.3) $1,212.7
Premium
revenues -- 0.0 % 298.9 100.0 % - 298.9
-------- ----- -------- ----- ------- --------
Total
revenues 1,230.0 100.0 % 298.9 100.0 % (17.3) 1,511.6
Salaries and
benefits
(excludes stock
compensation) 578.6 47.0 % 14.5 4.8 % -- 593.1
Health plan
responsibility -- 0.0 % 245.0 82.0 % (17.3) 227.7
Supplies 224.4 18.3 % 0.2 0.1 % -- 224.6
Provision for
doubtful
accounts 102.9 8.4 % -- 0.0 % -- 102.9
Other operating
losses 204.3 16.6 % 17.3 5.8 % -- 221.6
-------- ----- -------- ----- ------- --------
Total
operating
losses 1,110.2 90.3 % 277.0 92.7 % (17.3) 1,369.9
-------- ----- -------- ----- ------- --------
Segment
EBITDA(2) 119.8 9.7 % 21.9 7.3 % -- 141.7
Less:
Interest, net 58.4 4.7 % (1.1) (0.4)% -- 57.3
Depreciation
and
amortization 62.4 5.1 % 2.0 0.7 % -- 64.4
Equity method
income (0.3) (0.1)% -- 0.0 % -- (0.3)
Stock
remuneration 2.2 0.2 % -- 0.0 % -- 2.2
Gain on
ordering of
resources (2.1) (0.2)% -- 0.0 % -- (2.1)
Monitoring fees
and losses 2.6 0.2 % -- 0.0 % -- 2.6
Realized
land loss
on investments 0.6 0.1 % -- 0.0 % -- 0.6
-------- ----- -------- ----- ------- --------
Income (loss)
from
continuing
operations
before to to income
taxes $ (4.0) (0.3)% $ 21.0 7.0 % $ -- $ 17.0
======== ===== ======== ===== ======= ========
(1) Vanguard eliminates in converging those studious use revenues
warranted by the hospitals and associated healthcare comforts attributable
to services supposing to enrollees in the illness skeleton and also
eliminates the analogous healing claims losses incurred by its
illness skeleton for those services.
(2) Segment EBITDA is discernible as income (loss) from stability operations
before to to income taxes rebate seductiveness responsibility (net of seductiveness income),
debasement and amortization, equity process income, stock
compensation, benefit or detriment on ordering of assets, monitoring fees and
expenses, satisfied land detriment on investments, spoil detriment and
debt extinguishment costs. Management uses Segment EBITDA to measure
opening for Vanguard's segments and to rise strategic
objectives and handling skeleton for those segments. Segment EBITDA
eliminates the disproportionate outcome of non-cash debasement of tangible
resources and amortization of unsubstantial assets, most of which results
from acquisitions accounted for underneath the squeeze process of
accounting. Segment EBITDA additionally eliminates the goods of changes in
seductiveness rates which supervision believes describe to ubiquitous trends in
tellurian collateral markets, but have been not indispensably demonstrative of the
handling opening of Vanguard's segments. Management believes that
Segment EBITDA provides utilitarian report about the financial
opening of Vanguard's segments to investors, lenders, financial
analysts and rating agencies. Additionally, supervision believes that
investors and lenders perspective Segment EBITDA as an critical cause in
creation investment decisions and assessing the worth of Vanguard.
Segment EBITDA is not a surrogate for net income, handling money flows
or alternative money upsurge matter interpretation dynamic in suitability with
accounting beliefs in all supposed in the United States. Segment
EBITDA, as presented, might not be allied to likewise titled
measures of alternative companies.
VANGUARD HEALTH SYSTEMS, INC.
Segment Information (Unaudited) - Continued
(In millions)
Six Months Ended Dec 31, 2009
---------------------------------------------------------
Acute % of % of
Care Reve- Health Reve- Elimi- Consol-
Services nues Plans nues nations idated
-------- ----- -------- ----- ------- --------
Patient service
revenues(1) $1,271.4 100.0 % $ -- 0.0 % $ (21.0) $1,250.4
Premium revenues -- 0.0 % 416.6 100.0 % -- 416.6
-------- ----- -------- ----- ------- --------
Total
revenues 1,271.4 100.0 % 416.6 100.0 % (21.0) 1,667.0
Salaries and
benefits
(excludes
stock
compensation) 619.2 48.7 % 16.8 4.1 % -- 636.0
Health plan
claims responsibility -- 0.0 % 352.8 84.7 % (21.0) 331.8
Supplies 225.7 17.7 % 0.1 0.0 % -- 225.8
Provision for
puzzled accounts 72.2 5.7 % -- 0.0 % -- 72.2
Other operating
losses 230.9 18.2 % 17.8 4.3 % -- 248.7
-------- ----- -------- ----- ------- --------
Total
operating
losses 1,148.0 90.3 % 387.5 93.1 % (21.0) 1,514.5
-------- ----- -------- ----- ------- --------
Segment
EBITDA(2) 123.4 9.7 % 29.1 6.9 % -- 152.5
Less:
Interest, net 55.0 4.3 % (0.3) (0.1)% -- 54.7
Depreciation
and
amortization 66.1 5.2 % 2.2 0.5 % -- 68.3
Equity method
income (0.5) (0.1)% -- 0.0 % -- (0.5)
Stock
remuneration 2.9 0.2 % -- 0.0 % -- 2.9
Gain on disposal
of resources 0.4 0.1 % -- 0.0 % -- 0.4
Monitoring fees
and losses 2.7 0.2 % -- 0.0 % -- 2.7
Realized holding
detriment on
investments -- 0.0 % -- 0.0 % -- --
Impairment detriment 43.1 3.4 % -- 0.0 % -- 43.1
-------- ----- -------- ----- ------- --------
Income (loss)
from
continuing
operations
before to to income
taxes $ (46.3) (3.6)% $ 27.2 6.5 % $ -- $ (19.1)
======== ===== ======== ===== ======= ========
(1) Vanguard eliminates in converging those studious use revenues
warranted by the hospitals and associated healthcare comforts attributable
to services supposing to enrollees in the illness skeleton and also
eliminates the analogous healing claims losses incurred by its
illness skeleton for those services.
(2) Segment EBITDA is discernible as income (loss) from stability operations
before to to income taxes les seductiveness responsibility (net of seductiveness income),
debasement and amortization, equity process income, stock
compensation, benefit or detriment on ordering of assets, monitoring fees and
expenses, satisfied land detriment on investments, spoil detriment and
debt extinguishment costs. Management uses Segment EBITDA to measure
opening for Vanguard's segments and to rise vital objectives
and handling skeleton for those segments. Segment EBITDA eliminates the
disproportionate outcome of non-cash debasement of discernible resources and
amortization of unsubstantial assets, most of which formula from
acquisitions accounted for underneath the squeeze process of accounting.
Segment EBITDA additionally eliminates the goods of changes in seductiveness rates
which supervision believes describe to ubiquitous trends in tellurian capital
markets, but have been not indispensably demonstrative of the operating
opening of Vanguard's segments. Management believes which Segment
EBITDA provides utilitarian report about the monetary opening of
Vanguard's segments to investors, lenders, monetary analysts and
rating agencies. Additionally, supervision believes which investors and
lenders perspective Segment EBITDA as an critical cause in creation investment
decisions and assessing the worth of Vanguard. Segment EBITDA is not a
surrogate for net income, handling money flows or alternative money flow
matter interpretation dynamic in suitability with accounting principles
in all supposed in the United States. Segment EBITDA, as presented,
might not be allied to likewise patrician measures of alternative companies.
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited)
Three months
ended
Dec 31
---------------- %
2008 2009 Change
------- ------- -------
Number of hospitals at finish of duration fifteen 15
Licensed beds at finish of duration 4,135 4,135
Discharges 41,604 42,037 1.0 %
Adjusted discharges 70,939 72,990 2.9 %
Adjusted discharges-hospitals 67,377 69,022 2.4 %
Average length of stay 4.23 4.19 (0.9)%
Patient days 175,944 176,233 0.2 %
Adjusted studious days 300,003 306,000 2.0 %
Adjusted studious days-hospitals 284,937 289,364 1.6 %
Patient income per practiced liberate $ 8,495 $ 8,470 (0.3)%
Patient income per adjusted
discharge-hospitals $ 8,626 $ 8,533 (1.1)%
Inpatient surgeries 9,384 9,380 0.0 %
Outpatient surgeries 19,026 19,143 0.6 %
Emergency room visits 142,671 155,818 9.2 %
Charity caring and uninsured discounts as a
percent of strident caring services segment
revenues (prior to these discounts) 3.5% 10.2%
Provision for puzzled accounts as a percent
of strident caring services shred revenues
(prior to gift and uninsured discounts) 7.5% 4.9%
Net studious income payer mix:
Medicare 25.9% 26.1%
Medicaid 7.1% 6.7%
Managed Medicare 14.2% 15.1%
Managed Medicaid 8.9% 9.3%
Managed caring 35.3% 35.0%
Commercial 0.9% 1.1%
Self compensate 7.7% 6.7%
------- -------
Total 100.0% 100.0%
======= =======
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited)
Six months
ended
Dec 31,
---------------- %
2008 2009 Change
------- ------- -------
Number of hospitals at finish of duration fifteen 15
Licensed beds at finish of duration 4,135 4,135
Discharges 83,885 83,920 0.0 %
Adjusted discharges 143,261 147,213 2.8 %
Adjusted discharges-hospitals 136,044 139,126 2.3 %
Average length of stay 4.22 4.15 (1.7)%
Patient days 354,058 348,199 (1.7)%
Adjusted studious days 604,668 610,811 1.0 %
Adjusted studious days-hospitals 574,207 577,260 0.5 %
Patient income per practiced liberate $ 8,284 $ 8,314 0.4 %
Patient income per adjusted
discharge-hospitals $ 8,449 $ 8,384 (0.8)%
Inpatient surgeries 18,862 18,888 0.1 %
Outpatient surgeries 37,926 38,460 1.4 %
Emergency room visits 289,853 310,727 7.2 %
Charity caring and uninsured discounts as a
percent of strident caring services segment
revenues (prior to these discounts) 3.8% 10.9%
Provision for puzzled accounts as a percent
of strident caring services shred revenues
(prior to gift and uninsured discounts) 8.0% 5.1%
Net studious income payer mix:
Medicare 25.8% 25.3%
Medicaid 7.3% 7.2%
Managed Medicare 13.8% 14.8%
Managed Medicaid 9.2% 9.9%
Managed caring 34.8% 35.0%
Commercial 1.0% 1.0%
Self compensate 8.1% 6.8%
------- -------
Total 100.0% 100.0%
======= =======
VANGUARD HEALTH SYSTEMS, INC.
Supplemental Operating Measures Adjusted for Comparative Analysis
For the 3 months finished Dec 31, 2009
(dollars in millions, solely for statistical measures)
(Unaudited)
%
of Segment Revenues
-------------------
Impact of Non-GAAP
Policy Changes as
------------------ GAAP- adjusted
GAAP- Uninsured Medicaid Non-GAAP basement (4)
basement Discounts Pending Adjusted ------------ -----
Amounts(1) (2) (3) Amounts(4) 2009 2008 2009
------- --------- -------- -------- ----- ----- -----
Acute care
services
segment:
Total
revenues(5) $ 641.7 $ 37.8 $ (3.9) $ 675.6 100.0% 100.0% 100.0%
Salaries and
benefits(8) $ 316.2 $ - $ - $ 316.2 49.3% 47.5% 46.8%
Supplies $ 114.7 $ - $ - $ 114.7 17.9% 18.1% 17.0%
Provision
for
doubtful
accounts $ 35.0 $ 37.8 $ (4.3) $ 68.5 5.4% 7.8% 10.1%
Other
operating
losses $ 107.7 $ - $ - $ 107.7 16.8% 16.2% 16.0%
Total
operating
losses $ 573.6 $ 37.8 $ (4.3) $ 607.1 89.4% 89.6% 89.9%
%
of Segment Revenues
Prior to Charity and
Uninsured Discounts
-------------------
Impact of Non-GAAP
Policy Changes as
----------------- Non-GAAP GAAP- adjusted
GAAP- Uninsured Medicaid Adjusted basement (4)
basement Discounts Pending Amounts ------------- -----
Amounts(1) (2) (3) (4) 2009 2008 2009
------- ------- -------- -------- ----- ----- -----
Uncompensated
care(6) $ 107.6 $ (14.1) $ (4.3) $ 89.2 15.1% 11.0% 12.8%
Total
revenues,
before to to to
charity(7) $ 662.4 $ 37.8 $ (3.9) $ 696.3
Impact of Policy
Changes Current
Statistical ---------------- Statisical Prior Year
Measure, Uninsured Medicaid Measure, Year Change,
as Discounts Pending as Statistical as
reported (2) (3) practiced Measure adjusted
------- --------- ------ ---------- ------- ---------
Vanguard
consolidated:
Patient
revenue
per total
adjusted
liberate $ 8,470 $ 518 $ (53) $ 8,935 $ 8,495 5.2 %
Self-pay
discharges 1,999 - (578) 1,421 1,220 16.5 %
Medicaid
discharges 3,672 - 578 4,250 4,313 (1.5)%
VANGUARD HEALTH SYSTEMS, INC.
Supplemental Operating Measures Adjusted for Comparative Analysis
For the 6 months finished Dec 31, 2009
(dollars in millions, solely for statistical measures)
(Unaudited)
%
of Segment Revenues
-------------------
Impact of Non-GAAP
Policy Changes as
------------------ GAAP- adjusted
GAAP- Uninsured Medicaid Non-GAAP basement (4)
basement Discounts Pending Adjusted ------------ -----
Amounts(1) (2) (3) Amounts(4) 2009 2008 2009
------- --------- -------- -------- ----- ----- -----
Acute care
services
segment:
Total
revenues
(5) $1,271.4 $ 74.2 $ (10.7) $1,334.9 100.0% 100.0% 100.0%
Salaries
and
benefits
(8) $ 622.1 $ - $ - $ 622.1 48.9% 47.2% 46.6%
Supplies $ 225.7 $ - $ - $ 225.7 17.7% 18.3% 16.9%
Provision
for
doubtful
accounts $ 72.2 $ 74.2 $ (14.0) $ 132.4 5.7% 8.4% 9.9%
Other
operating
losses $ 230.9 $ - $ - $ 230.9 18.2% 16.6% 17.3%
Total
operating
losses $1,150.9 $ 74.2 $ (14.0) $1,211.1 90.5% 90.5% 90.7%
%
of Segment Revenues
Prior to Charity and
Uninsured Discounts
-------------------
Impact of Non-GAAP
Policy Changes as
----------------- Non-GAAP GAAP- adjusted
GAAP- Uninsured Medicaid Adjusted basement (4)
basement Discounts Pending Amounts ------------ -----
Amounts(1) (2) (3) (4) 2009 2008 2009
------- ------- -------- -------- ----- ----- -----
Acute care
services
segment:
Uncompen-
sated
care(6) $ 228.3 $ (38.7) $ (14.0) $ 175.6 16.0% 11.8% 12.7%
Total
revenues,
before to to to
charity(7) $1,314.6 $ 74.2 $ (10.7) $1,378.1
Impact of Policy
Changes Current
Statistical ------------------ Statisical Prior Year
Measure, Uninsured Medicaid Measure, Year Change,
as Discounts Pending as Statistical as
reported (2) (3) practiced Measure adjusted
------- --------- ------- ---------- -------- ---------
Vanguard
consolidated:
Patient
revenue
per total
adjusted
liberate $ 8,314 $ 504 $ (72) $ 8,746 $ 8,284 5.6 %
Self-pay
discharges 4,257 - (1,425) 2,832 2,635 7.5 %
Medicaid
discharges 7,264 - 1,425 8,689 8,764 (0.9)%
(1) Amounts reflected in or components of amounts reflected in the segment
report tables enclosed in this release. These amounts have been based
on revenues or losses dynamic in suitability with accounting
beliefs in all supposed in the United States.
(2) Includes the stroke of the uninsured bonus process implemented for
Vanguard's Illinois hospitals in outcome Apr 1, 2009 and for its
Phoenix and San Antonio hospitals in outcome Jul 1, 2009. Under this
policy, Vanguard relates an uninsured bonus (calculated as a
customary commission of sum revenues) at the time of studious billing
and includes this bonus as a rebate to revenues. This uninsured
bonus module relates to patients reception sanatorium services who
have no word coverage and do not differently encounter Vanguard's charity
caring guidelines. Vanguard available a sum of $51.9 million of
uninsured discounts associated to the strident caring services shred during
the 3 months finished Dec 31, 2009, $37.8 million of which
associated to non-Medicaid tentative accounts which marked down revenues as a
outcome of implementing this policy. Vanguard available a sum of $112.9
million of uninsured discounts associated to the strident caring services
shred during the 6 months finished Dec 31, 2009, $74.2 million of
which associated to non-Medicaid tentative accounts which marked down revenues as
a outcome of implementing this policy.
(3) Includes the stroke of Vanguard's accounting process shift for
accounts tentative Medicaid qualification. Prior to the doing of
the brand brand brand brand brand brand brand new uninsured bonus policy, Vanguard personal accounts pending
Medicaid gift as Medicaid revenues (and Medicaid discharges)
and available a contractual bonus for these accounts formed on the
normal Medicaid payment rate for any specific state until
gift was confirmed. Vanguard implemented a brand brand brand brand brand brand brand new Medicaid
tentative process for those hospitals which have implemented the uninsured
bonus process whereby Medicaid tentative accounts have been personal as
self-pay revenues (and self-pay discharges) with an uninsured discount
applied. The shift of these accounts is theme to Vanguard's
stipend for puzzled accounts policy. For those accounts that
subsequently validate for Medicaid coverage, the uninsured bonus is
topsy-turvy and the comment is reclassified to Medicaid revenues (and
Medicaid discharges) with the suitable contractual bonus applied.
The disproportion in in between the state-specific Medicaid contractual
discounts underneath the before process and the uninsured discount
commission practical to Medicaid tentative accounts underneath the brand brand brand brand brand brand brand new policy
increasing sum revenues by $3.9 million and $10.7 million for the
3 months and 6 months finished Dec 31, 2009, respectively.
The sustenance for puzzled accounts available for Medicaid pending
accounts, after the uninsured discounts were applied, were $4.3 million
and $14.0 million for the 3 months and 6 months finished December
31, 2009, respectively.
(4) Revenues, sure losses and those losses as a commission of
revenues for the strident caring services shred for the 3 months and
6 months finished Dec 31, 2009 have been practiced to concede for
analogous dimensions on a basement unchanging with the 3 months and
6 months finished Dec 31, 2008 (before doing of the
uninsured bonus process or the shift to the Medicaid pending
policy). Management believes these non-GAAP measures will provide
investors, analysts and ubiquitous users of this monetary report an
in outcome equates to to review the handling formula of Vanguard's acute
caring services shred for the stream year durations to those of the
before to to year periods. However, these non-GAAP handling measures have been not
meant to reinstate GAAP-basis revenues, losses or losses as a
commission of revenues as handling opening indicators for the
strident caring services segment.
(5) Total revenues for the strident caring services shred paint revenues
before to to to the rejecting in converging of revenues warranted by
Vanguard's hospitals for services supposing to enrollees in Vanguard's
owned illness plans.
(6) Uncompensated caring is discernible as the sum of uninsured discounts,
gift deductions and the sustenance for puzzled accounts.
(7) Represents sum revenues for the strident caring services shred plus
gift deductions.
(8) Includes batch compensation.
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