Community Health Systems, Inc. (NYSE:CYH) Q3 2023 Earnings Call Transcript

Kevin Hammons: Yeah. I think that’s right, Tim. I just want to maybe reiterate, although we saw that decline in surgery sequentially, it was positive over prior year. Second quarter was also a very strong surgical quarter for us. And with the continued sequential improvement in both admissions and adjusted admissions, we still saw continued growth with the only softness being in surgeries that we kind of saw in the third quarter, but we are attributing that to just kind of normal seasonality, and we expect that to pick back up in the fourth quarter.

Tim Hingtgen: I think the last comment I’ll make just to kind of, I guess, support our confidence in the surgery growth opportunities across the portfolio. And we are exceeding the pre-COVID baseline. Certainly, I think that bodes well for us and the acuity of our surgical business, the inpatient business is growing as we invest in provide a recruitment in the specialist that drive that. And then the last thing I’ll add is, the new, I guess, I’ll say, input to our surgical growth opportunities, with more capacity, we are seeing record transfer center volumes as well. We are up sequentially and over prior year, I believe, by 7% and 8%. So again, still great demand out there for us as we open up capacity and invest in the right service lines and providers.

Operator: The next question is from Stephen Baxter with Wells Fargo. Please go ahead.

Stephen Baxter: [Technical difficulty]

Operator: Mr. Baxter, we’re having trouble hearing you. Is your phone muted or you have a good connection?

Stephen Baxter: Yeah. Sorry about that, I think problem on my end –

Operator: Thank you.

Stephen Baxter: Hope it resolved. Yeah. So I just wanted to ask a couple of, I think, in a related question, just to make sure I’m tracking correctly. We had the quarter a little bit below, but generally right in line with where our model was. I think you’re pretty close to consensus as well for EBITDA in the quarter. So I would love to just hear a little bit more about understanding the guidance revision at this point and what that reflects? And then just to make sure I’m tracking the seasonality comments correctly, it sounds like as best I can tell, that you’re suggesting you saw something closer to normal seasonality in the third quarter and thought that you might see something a little bit less than that. But I just want to clarify that that’s the case and not that you saw seasonality excess of typical levels in the third quarter? Thank you.

Kevin Hammons: Sure. And I’ll start with some comments on our guidance. So our guidance update around EBITDA really just wanted to reflect kind of that where we are year-to-date. We started off the year with a very soft first quarter. Now that we’re through the third quarter, and only have – we caught some of that miss back, I think, in the second quarter, we kind of came in line with the expectations on the third quarter, but did not have outsized performance that really clawed back much of the miss in the first quarter. So the update is really reflective of just our year-to-date results. If you think about what the implied fourth quarter is now from our updated guidance, it’s still – at the midpoint, $407 million of EBITDA, $3.142 billion of net revenue, that would be our highest EBITDA quarter of the year.

As we had expected, it’s a 13% margin at the midpoint implied which is the highest margin quarter of the year. So I still think reflects continued growth and reflects again where we are coming out of the third quarter and just an update with only one quarter to go in the year. In terms of seasonality for Q3, I think it’s really just kind of the normal seasonality that we had experienced kind of pre-pandemic in terms of kind of patient behavior and physician behavior around vacations and so forth. What I would just, again, maybe point out is, I think we stepped over some of that with continued growth, particularly in the outpatient side and then with some cost management. So we did not experience maybe the normal pressure on EBITDA sequentially that we had historically from that seasonality, but in terms of kind of volume of business and type of business and patient behavior, it was a much more seasonal quarter than we – more so than we anticipated at the beginning of the year when we thought growth may be a little more straight line throughout the year and recovered from the pandemic.