Tenet Reports 50% Increase in Adjusted EBITDA for Third Quarter

Tenet Healthcare Corporation (NYSE:THC) today reported Adjusted EBITDA, a non-GAAP term defined below, of $240 million for the third quarter ended Sept. 30, 2009, an increase of $80 million, or 50 percent, as compared to $160 million for the third quarter of 2008. On a same-hospital basis, Adjusted EBITDA was $236 million for the third quarter of 2009, an increase of $74 million, or 45.7 percent, as compared to $162 million in the third quarter of 2008. The net loss attributable to common shareholders for the third quarter of 2009 was $3 million, or $0.01 per share, compared to net income attributable to common shareholders of $104 million, or $0.22 per share, for the third quarter of 2008. Net income attributable to common shareholders in the third quarter of 2008 included pre-tax gains on sales of investments of $140 million.

“Our strategies drove a significant enhancement in earnings through the first three quarters of 2009, making this the second consecutive quarter in which we’ve generated year-over-year Adjusted EBITDA growth of 50 percent or better,” said Trevor Fetter, president and chief executive officer. “Adjusted free cash flow from continuing operations was also solid at $142 million. Strong revenue growth, excellent cost control, and robust growth in our outpatient business were more than sufficient to offset an adverse shift in payer mix. While the economy has had some effect year-to-date, it remains less than we would have expected in the context of rising unemployment levels in many of our markets. Given our strong year-to-date performance, we are raising our range for 2009 Adjusted EBITDA to $925 million to $975 million. Additionally, it is important to recognize the strong reception Tenet received from the capital markets this year as it successfully extended more than $2.3 billion of near-term debt maturities and raised fresh capital by accessing the preferred equity market. These actions reduced our leverage and created a much stronger and liquid balance sheet.”

Continuing Operations

Net loss attributable to common shareholders was $3 million in the third quarter of 2009, or $0.01 per share, including the following items with an aggregate, net unfavorable impact of $18 million after-tax, or $0.04 per share:

1. Loss from discontinued operations, net of tax, of $5 million, or $0.01 per share;

2. Favorable income tax adjustments of $3 million, or zero cents per share, primarily related to a decrease in the Company’s valuation allowance for deferred tax assets and other tax adjustments;

3. Loss from early extinguishment of debt of $16 million pre-tax, $10 million after-tax before the deferred tax valuation allowance, or $0.02 per share;

4. Litigation and investigation costs of $3 million pre-tax, $2 million after-tax before the deferred tax valuation allowance, or zero cents per share; and

5. Impairment of long lived-assets and goodwill, and restructuring charges of $7 million pre-tax, $4 million after-tax before the tax valuation allowance, or $0.01 per share.

Adjusted EBITDA

Adjusted EBITDA, a non-GAAP term defined below, was $240 million, or a margin of 10.6 percent of net operating revenues, in the third quarter of 2009. This represents an increase of $80 million, or 50 percent, from Adjusted EBITDA of $160 million in the third quarter of 2008, and a margin increase of 310 basis points as compared to an Adjusted EBITDA margin of 7.5 percent in the third quarter of 2008.

Same-hospital Adjusted EBITDA was $236 million in the third quarter of 2009, an increase of $74 million, or 45.7 percent, from the $162 million in the third quarter of 2008. The same-hospital Adjusted EBITDA margin increased by 290 basis points to 10.5 percent in the third quarter of 2009 compared to 7.6 percent in the third quarter of 2008. Same-hospital financial data excludes the results from one of the Company’s hospitals as discussed below.

Adjusted EBITDA is a non-GAAP term defined by the Company as net income (loss) attributable to common shareholders of Tenet Healthcare Corporation before: (1) the cumulative effect of changes in accounting principle, net of tax; (2) net income attributable to noncontrolling interests; (3) preferred stock dividends, (4) income (loss) from discontinued operations, net of tax; (5) income tax (expense) benefit; (6) net gains (losses) on sales of investments; (7) investment earnings (loss); (8) gain (loss) from early extinguishment of debt; (9) interest expense; (10) litigation and investigation (costs) benefit, net of insurance recoveries; (11) hurricane insurance recoveries, net of costs; (12) impairment of long-lived assets and goodwill and restructuring charges, net of insurance recoveries; (13) amortization; and (14) depreciation. A reconciliation of Adjusted EBITDA to net income (loss) attributable to Tenet Healthcare Corporation common shareholders is provided in Table #1 at the end of this release.

Same-Hospital Data

Same-hospital continuing operations data excludes Sierra Providence East Medical Center, in El Paso, which opened on May 21, 2008. Same-hospital continuing operations data is the primary form of tabular data presentation in the narrative sections of this document. There are currently 48 hospitals in same-hospital continuing operations. Sierra Providence East Medical Center will be added to our same-hospital reporting beginning in the first quarter of 2010.

Admissions, Patient Days and Surgeries


Admissions, Patient Days and Surgeries		Same-Hospital Continuing Operations
Admissions, Patient Days and Surgeries		Q3’09	Q3’08	Change (%)
Commercial Managed Care Admissions		33,204	34,759	(4.5)
Governmental Managed Care Admissions		29,539	27,065	9.1
Medicare Admissions		37,131	38,127	(2.6)
Medicaid Admissions		16,694	16,531	1.0
Uninsured Admissions		6,107	6,301	(3.1)
Charity Care Admissions		2,620	2,164	21.1
Other Admissions		3,357	3,578	(6.2)
Total Admissions		128,652	128,525	0.1
Paying Admissions (excludes Charity + Uninsured)		119,925	120,060	(0.1)
Charity Admissions + Uninsured Admissions		8,727	8,465	3.1
Admissions through Emergency Department		73,082	70,741	3.3
Commercial Managed Care Admits / Total Admits	(%)	25.8	27.0	(1.2) ^(a)
Emergency Department Admissions / Total Admits	(%)	56.8	55.0	1.8^(a)
Uninsured Admissions / Total Admissions	(%)	4.7	4.9	(0.2) ^(a)
Charity Admissions / Total Admissions	(%)	2.0	1.7	0.3 ^(a)
Surgeries – Inpatient		38,828	39,121	(0.7)
Surgeries – Outpatient		52,906	50,655	4.4
Surgeries – Total		91,734	89,776	2.2
Patient Days – Total		616,850	625,702	(1.4)
Adjusted Patient Days ^(b)		926,344	916,104	1.1
Patient Days – Commercial Managed Care		132,119	136,970	(3.5)
Average Length of Stay	(days)	4.8	4.9	(0.1) ^(a)
Adjusted Patient Admissions ^(b)		194,568	189,536	2.7
^(a) This change is the difference between the Q3’09 and Q3’08 amounts shown.
^(b) “Adjusted Patient Days / Admissions” represents actual patient days / admissions adjusted to include outpatient services by multiplying actual patient days / admissions by the sum of gross inpatient revenues and outpatient revenues and dividing the results by gross inpatient revenues.

Total admissions were relatively flat in the third quarter with an increase of 0.1 percent as compared to the third quarter of 2008. In the third quarter of 2008, total admissions had increased by 1.9 percent as compared to the third quarter of 2007, providing a strong prior-year comparative. Commercial managed care admissions declined by 4.5 percent, which compared favorably to the 5.7 percent decline in the second quarter of 2009.

The Company’s California Region and its Philadelphia Market each reported positive total admissions growth in the quarter. Tenet’s other regions reported admissions declines in the third quarter. Total surgery growth remained strong growing by 2.2 percent with outpatient surgeries growing by 4.4 percent but inpatient surgeries declining by 0.7 percent.

Flu related admissions were not a major factor in the quarter, adding 339 admissions to the third quarter of 2009 as compared to 17 flu related admissions in the third quarter of 2008, an increase of 322 admissions.

Outpatient Visits


Outpatient Visits		Same-Hospital Continuing Operations
Outpatient Visits		Q3’09	Q3’08	Change (%)
Commercial Managed Care OP Visits		351,592	351,594	-
Governmental Managed Care OP Visits		186,544	155,156	20.2
Medicare OP Visits		212,008	207,515	2.2
Medicaid OP Visits		75,936	68,103	11.5
Uninsured OP Visits		97,189	98,282	(1.1)
Charity Care OP Visits		7,135	5,320	34.1
Other OP Visits		52,685	52,028	1.3
Total OP Visits		983,089	937,998	4.8
Paying OP Visits (excludes Uninsured + Charity)		878,765	834,396	5.3
OP Surgery Visits		52,906	50,655	4.4
Emergency Department OP Visits		357,122	326,769	9.3
Charity + Uninsured OP Visits		104,324	103,602	0.7
Charity + Uninsured OP Visits / Total OP Visits	(%)	10.6	11.0	(0.4) ^(a)
Paying OP Visits / Total OP Visits		89.4	89.0	0.4 ^(a)
Commercial OP Visits / Total Visits	(%)	35.8	37.5	(1.7) ^(a)
^(a) This change is the difference between the Q3’09 and Q3’08 amounts shown.

Total same-hospital outpatient volume grew by 45,091 visits, or 4.8 percent, in the third quarter of 2009 compared to the third quarter of 2008. Tenet has now reported year-over-year growth in outpatient visits in six of the last seven quarters.

Changes in outpatient payer mix included growth in paying patients which rose to 89.4 percent of total outpatient visits, an increase of 40 basis points as compared to 89.0 percent in the third quarter of 2008, and a smaller contribution from commercial outpatient visits, which declined to 35.8 percent of total outpatient visits, a decline of 170 basis points as compared to 37.5 percent in the third quarter of 2008.

Newly opened or acquired facilities contributed 1,814 visits, net of the loss of visits from centers which were closed in the period following September 30, 2008. Excluding this net incremental volume from new facilities, organic growth in outpatient visits would have been an increase of 43,277 visits, or growth of 4.6 percent.

Outpatient surgeries also reported a strong quarter increasing by 4.4 percent. Outpatient surgeries grew by 3.5 percent in the second quarter of 2009. Outpatient imaging also continued its growth trend, increasing by 2.7 percent relative to the third quarter of 2008. Emergency Department outpatient visits increased by 30,353 visits, or 9.3 percent, in the third quarter of 2009 as compared to the third quarter of 2008. This increase in Emergency Department outpatient visits contributed 67 percent of the increase in total outpatient visits in the quarter.

Charity plus uninsured outpatient visits increased by 0.7 percent as compared to a decline rate of 3.4 percent in the second quarter of 2009.

Flu-related outpatient visits were 5,271 in the third quarter of 2009 as compared to 214 in the third quarter of 2008. This increase of 5,057 visits accounted for 11 percent of the total increase in outpatient visits of 45,091.

All of the Company’s regions exhibited growth in outpatient visits in the third quarter with the strongest growth coming from the Central and Florida Regions and the Philadelphia Market, each of which saw outpatient visit growth in excess of 8 percent. The Company’s California and Southern States Regions grew outpatient visits by more than one percent.

Revenues


Revenues ($ in millions)	Same-Hospital Continuing Operations
Revenues ($ in millions)	Q3’09	Q3’08	Change (%)
Net Operating Revenues	2,238	2,127	5.2
Net Patient Revenue from Commercial Managed Care	886	850	4.2
Revenues from the Uninsured	166	152	9.2

Revenue growth remained robust in the third quarter of 2009 with an increase of $111 million, or 5.2 percent, on a same-hospital basis. Favorable prior-year cost report adjustments contributed $11 million to net operating revenues in the third quarter of 2009 as compared to a contribution of $10 million in the third quarter of 2008. Excluding prior year cost report adjustments from both quarters, same-hospital revenues would have shown the same increase of 5.2 percent. Net operating revenues in the third quarter of 2009 include $6 million of revenue recognized by the Company’s Philadelphia Market related to calendar year 2008 that was approved for distribution to Tenet in the third quarter of 2009 by a Philadelphia HMO in which Tenet holds a minority interest.

Commercial managed care revenues grew by 4.2 percent on a same-hospital basis, a rate of growth significantly stronger than the 4.5 percent decline in commercial managed care admissions and the flat commercial managed care outpatient visits as compared to the third quarter of 2008.

Pricing


Pricing ($)	Same-Hospital Continuing Operations
Pricing ($)	Q3’09	Q3’08	Change (%)
Net Inpatient Revenue per Admission	11,286	10,885	3.7
Net Inpatient Revenue per Patient Day	2,354	2,236	5.3
Net Outpatient Revenue per Visit	711	692	2.7
Net Patient Revenue per Adjusted Patient Admission	11,055	10,805	2.3
Net Patient Revenue per Adjusted Patient Day	2,322	2,236	3.8
Managed Care: Net Inpatient Revenue per Admission	12,133	11,469	5.8
Managed Care: Net Outpatient Revenue per Visit	823	813	1.2

Pricing improvement was evident across all key metrics, primarily reflecting the improved terms of our commercial managed care contracts. The growth in net inpatient revenue per admission of 3.7 percent was adversely impacted by a mix shift, including a decline in commercial managed care admissions as a percent of total admissions to 25.8 percent in the third quarter of 2009 as compared to 27.0 percent of total admissions in the third quarter of 2008.

In a similar fashion, the 2.7 percent growth in outpatient revenue per visit was constrained by the decline of commercial outpatient visits as a percent of total outpatient visits to 35.8 percent in the third quarter of 2009 as compared to 37.5 percent of total outpatient visits in the third quarter of 2008.

Controllable Operating Expenses


Controllable Operating Expenses		Same-Hospital Continuing Operations
Controllable Operating Expenses		Q3’09	Q3’08	Change (%)
Salaries, Wages & Benefits	($mm)	945	937	0.9
Supplies	($mm)	386	375	2.9
Other Operating Expenses	($mm)	481	491	(2.0)
Total Controllable Operating Expenses	($mm)	1,812	1,803	0.5
Rent / Lease Expense ^(a)	($mm)	34	35	(2.9)
Unit Cost Statistics
Salaries, Wages & Benefits per Adjusted Patient Day	($)	1,020	1,023	(0.3)
Supplies per Adjusted Patient Day	($)	417	409	2.0
Other Operating Expenses per Adjusted Patient Day	($)	519	536	(3.2)
Total Controllable Operating Expenses per Adjusted Patient Day	($)	1,956	1,968	(0.6)
^(a) Included in Other Operating Expenses

Salaries, wages and benefits per adjusted patient day decreased by 0.3 percent in the third quarter of 2009 compared to the third quarter of 2008. This decrease is primarily due to a decline in full-time employee headcount, reduced contract labor expense, lower 401(k) match expense, and lower overtime costs. These cost efficiencies were partially offset by higher health benefits costs, and increased accruals for annual incentive compensation. Contract labor expense, which is included in salaries, wages and benefits, was $16 million in the third quarter of 2009, a decrease of $18 million, or 53 percent, compared to the third quarter of 2008. The third quarter of 2009 also included a $3 million favorable pension expense adjustment related to the termination of a fully funded and frozen retirement plan of a previously acquired company.

Supplies expense per adjusted patient day increased by 2.0 percent compared to the third quarter of 2008. The increase in supplies expense is primarily due to the increase in the number of surgeries which grew by 2.2 percent, and the increased utilization of high cost implants. A portion of the increase in supplies expense was offset by revenue growth related to payments we receive from certain payers.

Other operating expenses per adjusted patient day decreased by 3.2 percent compared to the third quarter of 2008. Contributing to this decrease was a $4 million, or 12.9 percent, decline in total hospital malpractice expense to $27 million, compared to $31 million in the third quarter of 2008. This decrease is primarily attributable to improved claims experience. Declines in consulting costs, utility costs and information systems implementation costs also had a favorable impact on other operating expenses. The favorable impact of these items was partially offset by increases in costs of contracted services and a reduction in information systems and business office costs allocable to discontinued operations.

Total controllable operating expenses, which is defined as salaries, wages & benefits, supplies, and other operating expenses, declined by 0.6 percent on a per adjusted patient day basis compared to the third quarter of 2008.

Provision for Doubtful Accounts


Bad Debt		Same-Hospital Continuing Operations
Bad Debt		Q3’09	Q3’08	Change (%)
Provision for Doubtful Accounts (“Bad Debt”)	($mm)	190	162	17.3
Bad Debt / Net Operating Revenues	(%)	8.5	7.6	0.9 ^(a)
Collection Rate from Self-Pay ^(b)		30.3	33.3	(3.0) ^(a)
Collection Rate from Managed Care Payers	(%)	97.8	97.9	(0.1) ^(a)
^(a) This change is the difference between the Q3’09 and Q3’08 amounts shown.
^(b) “Self-pay” accounts receivable are comprised of both uninsured and balance-after insurance receivables.

Bad debt expense increased by $28 million, or 17.3 percent, compared to the third quarter of 2008. The increase in bad debt expense was related to higher pricing, and decreased collection rates from self-pay accounts, partially offset by a decline in uninsured volumes and improved managed care accounts receivable aging categories.

The Company’s self-pay collection rate, which is the aggregate collection rate for uninsured and balance-after insurance accounts receivable, declined to approximately 30.3 percent in the third quarter of 2009 compared to 33.3 percent in the third quarter of 2008, and 30.8 percent in the second quarter of 2009.

The estimated direct and allocated costs (based on selected operating expenses, which include salaries, wages and benefits, supplies and other operating expenses) of caring for uninsured patients were $100 million and $93 million, respectively, for the third quarters of 2009 and 2008.

Accounts Receivable

Consolidated accounts receivable were approximately $1.195 billion at September 30, 2009 and $1.225 billion at June 30, 2009. Accounts receivable days outstanding from continuing operations were 47 days at September 30, 2009 compared to 48 days at June 30, 2009 and 50 days at December 31, 2008. This amount is calculated as accounts receivable from continuing operations divided by net revenue from continuing operations divided by the number of days in the quarter.

Cash Flow

Cash and cash equivalents were $731 million at September 30, 2009, a decrease of $27 million from $758 million at June 30, 2009.

Significant cash flow items in the three months ended September 30, 2009 included:

Payments of $383 million to purchase $376 million aggregate principal amount of our senior notes due in 2011, 2012, 2014, 2015 and 2031;
Net proceeds of $334 million from the issuance of 345,000 shares of 7.0% mandatory convertible preferred stock;
Interest payments of $100 million, including $4 million of payments that were accelerated and paid in the three months ended September 30, 2009 as a result of our repurchase of $308 million aggregate principal amount of our senior notes due in 2015 and $20 million of interest payments under an interest rate swap agreement that has the effect of converting our 7⅜% senior notes due 2013 from a fixed interest rate paid semi-annually to a variable interest rate paid monthly based on the one-month LIBOR plus a floating rate spread of approximately 5.46%;
$18 million received under the interest rate swap agreement discussed above;
Cash distributions of $3 million received related to the Company’s investment in the Reserve Yield Plus Fund, which are classified as investing activity cash flows;
Capital expenditures of $91 million;
$23 million in principal payments classified as operating cash outflows from continuing operations related to our 2006 civil settlement with the federal government;
$81 million in payments classified as operating cash outflows from continuing operations related to our 2009 settlement of wage and hour actions; and;
Income tax payments of $7 million.

Outlook for 2009

The Company is raising its 2009 outlook range for Adjusted EBITDA by $25 million to a new 2009 outlook range of $925 million to $975 million. The outlook for net income attributable to common shareholders for 2009 is in a range from $66 million to $130 million. A reconciliation of the Company’s outlook for 2009 Adjusted EBITDA to the outlook for net income attributable to common shareholders of Tenet Healthcare Corporation for the year ending Dec. 31, 2009 is provided in Table #3 below.

This favorable refinement to the 2009 outlook range reflects the Company’s stronger than anticipated results of operations in the third quarter.

Management’s Webcast Discussion of Third Quarter Results

Tenet management will discuss third quarter 2009 results on a webcast scheduled for 10:00 AM (ET) on Nov. 3, 2009. This webcast may be accessed through Tenet’s website at www.tenethealth.com/investors. A set of slides, which the Company will refer to on the call, will be posted to the Company’s website at approximately 7:30 AM (ET).

Tenet Healthcare Corporation is a health care services company whose subsidiaries and affiliates own and operate acute care hospitals, ambulatory surgery centers and diagnostic imaging centers. Tenet’s hospitals and related healthcare facilities are committed to providing high quality care to patients in the communities they serve. For more information, please visit www.tenethealth.com.

Some of the statements in this release may constitute forward-looking statements. Such forward-looking statements are based on our current expectations and could be affected by numerous factors and are subject to various risks and uncertainties discussed in our filings with the Securities and Exchange Commission, including our annual report on Form 10-K for the year ended Dec. 31, 2008, our quarterly reports on Form 10-Q, and periodic reports on Form 8-K. Do not rely on any forward-looking statement, as we cannot predict or control many of the factors that ultimately may affect our ability to achieve the results estimated. We make no promise to update any forward-looking statement, whether as a result of changes in underlying factors, new information, future events or otherwise.


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
(Unaudited)

(Dollars in millions except per share amounts)	Three Months Ended September 30,
	2009			%		2008			%		Change

Net operating revenues	$	2,262		100.0	%	$	2,140		100.0	%	5.7	%
Operating expenses:
Salaries, wages and benefits		(954	)	(42.2	%)		(943	)	(44.1	%)	1.2	%
Supplies		(389	)	(17.2	%)		(376	)	(17.6	%)	3.5	%
Provision for doubtful accounts		(193	)	(8.5	%)		(164	)	(7.7	%)	17.7	%
Other operating expenses, net		(486	)	(21.5	%)		(497	)	(23.1	%)	(2.2	%)
Depreciation		(85	)	(3.8	%)		(84	)	(3.9	%)	1.2	%
Amortization		(12	)	(0.5	%)		(10	)	(0.5	%)	20.0	%
Impairment of long-lived assets and goodwill, and restructuring charges		(7	)	(0.3	%)		(1	)	—
Litigation and investigation (costs) benefit, net of insurance recoveries		(3	)	(0.1	%)		5		0.2	%
Operating income		133		5.9	%		70		3.3	%
Interest expense		(112	)				(106	)
Loss from early extinguishment of debt		(16	)				—
Investment earnings		2					12
Net gain on sales of investments		—					140
Income from continuing operations, before income taxes		7					116
Income tax (expense) benefit		(3	)				4
Income from continuing operations, before discontinued operations		4					120
Discontinued operations:
Loss from operations		(2	)				(33	)
Impairment of long-lived assets and goodwill, and restructuring charges		(1	)				(21	)
Net losses on sales of facilities		—					(3	)
Litigation settlements, net of insurance recoveries		—					39
Income tax (expense) benefit		(2	)				4
Loss from discontinued operations		(5	)				(14	)
Net income (loss)		(1	)				106
Less: Preferred stock dividends		—					—
Less: Net income attributable to noncontrolling interests		2					2
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders	$	(3	)			$	104

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations	$	—				$	0.25
Discontinued operations		(0.01	)				(0.03	)
	$	(0.01	)			$	0.22

Diluted
Continuing operations	$	—				$	0.25
Discontinued operations		(0.01	)				(0.03	)
	$	(0.01	)			$	0.22
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		481,008					476,898
Diluted		498,084					480,789


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
(Unaudited)

(Dollars in millions except per share amounts)	Nine Months Ended September 30,
	2009			%		2008			%		Change

Net operating revenues	$	6,753		100.0	%	$	6,408		100.0	%	5.4	%
Operating expenses:
Salaries, wages and benefits		(2,868	)	(42.5	%)		(2,822	)	(44.0	%)	1.6	%
Supplies		(1,175	)	(17.4	%)		(1,126	)	(17.6	%)	4.4	%
Provision for doubtful accounts		(516	)	(7.6	%)		(462	)	(7.2	%)	11.7	%
Other operating expenses, net		(1,430	)	(21.2	%)		(1,459	)	(22.8	%)	(2.0	%)
Depreciation		(257	)	(3.8	%)		(249	)	(3.9	%)	3.2	%
Amortization		(34	)	(0.5	%)		(28	)	(0.4	%)	21.4	%
Impairment of long-lived assets and goodwill, and restructuring charges		(13	)	(0.2	%)		(4	)	(0.1	%)
Litigation and investigation costs, net of insurance recoveries		(13	)	(0.2	%)		(45	)	(0.7	%)
Operating income		447		6.6	%		213		3.3	%
Interest expense		(342	)				(312	)
Gain from early extinguishment of debt		97					—
Investment earnings (loss)		(1	)				21
Net gain on sales of investments		15					140
Income from continuing operations, before income taxes		216					62
Income tax (expense) benefit		(12	)				19
Income from continuing operations, before discontinued operations		204					81
Discontinued operations:
Loss from operations		(14	)				(25	)
Impairment of long-lived assets and goodwill, and restructuring charges		(16	)				(38	)
Net gains (losses) on sales of facilities		(2	)				5
Litigation settlements, net of insurance recoveries		—					39
Income tax expense		(4	)				(1	)
Loss from discontinued operations		(36	)				(20	)
Net income		168					61
Less: Preferred stock dividends		—					—
Less: Net income attributable to noncontrolling interests		8					3
Net income attributable to Tenet Healthcare Corporation common shareholders	$	160				$	58

Earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Basic
Continuing operations	$	0.41				$	0.16
Discontinued operations		(0.08	)				(0.04	)
	$	0.33				$	0.12
Diluted
Continuing operations	$	0.40				$	0.16
Discontinued operations		(0.07	)				(0.04	)
	$	0.33				$	0.12
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		479,942					476,091
Diluted		489,688					478,662


TENET HEALTHCARE CORPORATION
CONSOLIDATED BALANCE SHEET DATA
(Unaudited)

	September 30,			December 31,
(Dollars in Millions)	2009			2008
ASSETS
Current assets:
Cash and cash equivalents	$	731		$	507
Investments in Reserve Yield Plus Fund		3			14
Investments in marketable securities		16			2
Accounts receivable, less allowance for doubtful accounts		1,195			1,337
Inventories of supplies, at cost		153			161
Income tax receivable		—			6
Deferred income taxes		80			82
Assets held for sale		37			310
Other current assets		324			290
Total current assets		2,539			2,709
Investments and other assets		181			242
Property and equipment, at cost, less accumulated depreciation and amortization		4,172			4,291
Goodwill		607			609
Other intangible assets, at cost, less accumulated amortization		377			323
Total assets	$	7,876		$	8,174

LIABILITIES AND EQUITY
Current liabilities:
Current portion of long-term debt	$	2		$	2
Accounts payable		638			686
Accrued compensation and benefits		380			414
Professional and general liability reserves		114			127
Accrued interest payable		123			125
Accrued legal settlement costs		96			168
Other current liabilities		419			427
Total current liabilities		1,772			1,949
Long-term debt, net of current portion		4,267			4,778
Professional and general liability reserves		486			536
Accrued legal settlement costs		—			72
Other long-term liabilities		562			591
Deferred income taxes		116			101
Total liabilities		7,203			8,027
Commitments and contingencies
Equity:
Shareholders’ equity:
Preferred stock		334			—
Common stock		26			26
Additional paid-in capital		4,464			4,445
Accumulated other comprehensive loss		(27	)		(37	)
Accumulated deficit		(2,692	)		(2,852	)
Less common stock in treasury, at cost		(1,479	)		(1,479	)
Total shareholders’ equity		626			103
Noncontrolling interests		47			44
Total equity		673			147
Total liabilities and equity	$	7,876		$	8,174


TENET HEALTHCARE CORPORATION
CONSOLIDATED CASH FLOW DATA
(Unaudited)
(Dollars in Millions)	Nine Months Ended September 30,
	2009			2008
Net income	$	168		$	61
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		291			277
Provision for doubtful accounts		516			462
Net gain on sales of investments		(15	)		(140	)
Deferred income tax expense		17			11
Stock-based compensation expense		18			27
Impairment of long-lived assets and goodwill, and restructuring charges		13			4
Litigation and investigation costs, net of insurance recoveries		13			45
Net gain from early extinguishment of debt		(97	)		—
Fair market value adjustments related to interest rate swap and LIBOR cap agreements		(1	)		—
Proceeds from interest rate swap agreement		18			—
Pretax loss from discontinued operations		32			19
Other items, net		(2	)		(3	)
Changes in cash from changes in operating assets and liabilities:
Accounts receivable		(498	)		(478	)
Inventories and other current assets		(25	)		6
Income taxes		13			(32	)
Accounts payable, accrued expenses and other current liabilities		(37	)		(45	)
Other long-term liabilities		(6	)		(27	)
Payments against reserves for restructuring charges and litigation costs		(165	)		(79	)
Net cash provided by operating activities from discontinued operations, excluding income taxes		31			33
Net cash provided by operating activities		284			141
Cash flows from investing activities:
Purchases of property and equipment—Continuing operations		(216	)		(332	)
Purchases of property and equipment—Discontinued operations		(1	)		(16	)
Construction of new and replacement hospitals		(47	)		(65	)
Purchase of business		—			(92	)
Proceeds from sales of facilities and other assets – discontinued operations		221			160
Proceeds from sales of marketable securities, long-term investments and other assets		55			192
Proceeds from hospital authority bonds		49			8
Purchases of marketable securities		(17	)		(17	)
Distributions received from (reclassification of) investments in Reserve Yield Plus Fund		11			(48	)
Proceeds from cash surrender value or basis reduction of insurance policies		—			4
Other items, net		—			3
Net cash provided by (used in) investing activities		55			(203	)
Cash flows from financing activities:
Repayments of borrowings		(1,285	)		(1	)
Proceeds from borrowings		885			1
Deferred debt issuance costs		(47	)		(3	)
Proceeds from issuance of mandatory convertible preferred stock		334			—
Cash dividends on preferred stock		—			—
Contributions from noncontrolling interests		—			7
Distributions paid to noncontrolling interests		(5	)		(2	)
Other items, net		3			—
Net cash provided by (used in) financing activities		(115	)		2
Net increase (decrease) in cash and cash equivalents		224			(60	)
Cash and cash equivalents at beginning of period		507			572
Cash and cash equivalents at end of period	$	731		$	512
Supplemental disclosures:
Interest paid, net of capitalized interest	$	(340	)	$	(321	)
Income tax refunds (payments), net	$	15		$	(3	)


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS
(Unaudited)

(Dollars in millions except per patient day, per admission and per visit amounts)	Three Months Ended September 30,									Nine Months Ended September 30,
	2009			2008			Change			2009			2008			Change

Net inpatient revenues	$	1,452		$	1,399		3.8	%		$	4,380		$	4,254		3.0	%
Net outpatient revenues	$	699		$	649		7.7	%		$	2,050		$	1,914		7.1	%

Number of general hospitals (at end of period)		48			48		—		*		48			48		—		*
Licensed beds (at end of period)		13,309			13,256		0.4	%			13,309			13,256		0.4	%
Average licensed beds		13,309			13,261		0.4	%			13,303			13,276		0.2	%
Utilization of licensed beds		50.4	%		51.3	%	(0.9	%)	*		52.5	%		53.8	%	(1.3	%)	*
Patient days		616,850			625,702		(1.4	%)			1,908,053			1,955,366		(2.4	%)
Adjusted patient days		926,344			916,104		1.1	%			2,828,112			2,815,525		0.4	%
Net inpatient revenue per patient day	$	2,354		$	2,236		5.3	%		$	2,296		$	2,176		5.5	%
Admissions		128,652			128,525		0.1	%			391,362			393,378		(0.5	%)
Adjusted patient admissions		194,568			189,536		2.7	%			584,011			570,619		2.3	%
Net inpatient revenue per admission	$	11,286		$	10,885		3.7	%		$	11,192		$	10,814		3.5	%
Average length of stay (days)		4.8			4.9		(0.1	)	*		4.9			5.0		(0.1	)	*
Surgeries		91,734			89,776		2.2	%			272,385			266,719		2.1	%
Net outpatient revenue per visit	$	711		$	692		2.7	%		$	701		$	676		3.7	%
Outpatient visits		983,089			937,998		4.8	%			2,924,685			2,829,706		3.4	%

Sources of net patient revenue
Medicare		24.4	%		25.1	%	(0.7	%)	*		25.2	%		25.5	%	(0.3	%)	*
Medicaid		8.5	%		8.6	%	(0.1	%)	*		8.3	%		8.5	%	(0.2	%)	*
Managed care governmental		14.8	%		13.2	%	1.6	%	*		14.8	%		13.2	%	1.6	%	*
Managed care commercial		41.2	%		41.5	%	(0.3	%)	*		41.2	%		41.2	%	—		*
Indemnity, self-pay and other		11.1	%		11.6	%	(0.5	%)	*		10.5	%		11.6	%	(1.1	%)	*

* This change is the difference between the 2009 and 2008 amounts shown


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS
(Unaudited)

(Dollars in millions except per patient day, per admission and per visit amounts)	Three Months Ended September 30,									Nine Months Ended September 30,
	2009			2008			Change			2009			2008			Change

Net inpatient revenues	$	1,466		$	1,405		4.3	%		$	4,421		$	4,261		3.8	%
Net outpatient revenues	$	709		$	657		7.9	%		$	2,079		$	1,924		8.1	%

Number of general hospitals (at end of period)		49			49		—		*		49			49		—		*
Licensed beds (at end of period)		13,419			13,366		0.4	%			13,419			13,366		0.4	%
Average licensed beds		13,419			13,371		0.4	%			13,413			13,337		0.6	%
Utilization of licensed beds		50.4	%		51.0	%	(0.6	%)	*		52.6	%		53.6	%	(1.0	%)	*
Patient days		622,427			627,942		(0.9	%)			1,924,777			1,958,219		(1.7	%)
Adjusted patient days		935,375			920,430		1.6	%			2,854,688			2,821,176		1.2	%
Net inpatient revenue per patient day	$	2,355		$	2,237		5.3	%		$	2,297		$	2,176		5.6	%
Admissions		130,258			129,205		0.8	%			395,901			394,276		0.4	%
Adjusted patient admissions		197,164			190,843		3.3	%			591,223			572,398		3.3	%
Net inpatient revenue per admission	$	11,255		$	10,874		3.5	%		$	11,167		$	10,807		3.3	%
Average length of stay (days)		4.8			4.9		(0.1	)	*		4.9			5.0		(0.1	)	*
Surgeries		92,437			90,146		2.5	%			274,243			267,199		2.6	%
Net outpatient revenue per visit	$	712		$	695		2.4	%		$	702		$	678		3.5	%
Outpatient visits		995,968			945,569		5.3	%			2,962,755			2,839,708		4.3	%

Sources of net patient revenue
Medicare		24.4	%		25.1	%	(0.7	%)	*		25.1	%		25.5	%	(0.4	%)	*
Medicaid		8.5	%		8.6	%	(0.1	%)	*		8.3	%		8.5	%	(0.2	%)	*
Managed care governmental		14.8	%		13.3	%	1.5	%	*		14.8	%		13.1	%	1.7	%	*
Managed care commercial		41.2	%		41.6	%	(0.4	%)	*		41.2	%		41.2	%	—	%	*
Indemnity, self-pay and other		11.1	%		11.4	%	(0.3	%)	*		10.6	%		11.7	%	(1.1	%)	*

* This change is the difference between the 2009 and 2008 amounts shown


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
Fiscal 2009 by Calendar Quarter
(Unaudited)

(Dollars in millions except per share amounts)	Three Months Ended									Nine Months Ended
	3/31/09			6/30/09			9/30/09			9/30/09

Net operating revenues	$	2,262		$	2,229		$	2,262		$	6,753
Operating expenses:
Salaries, wages and benefits		(965	)		(949	)		(954	)		(2,868	)
Supplies		(391	)		(395	)		(389	)		(1,175	)
Provision for doubtful accounts		(156	)		(167	)		(193	)		(516	)
Other operating expenses, net		(472	)		(472	)		(486	)		(1,430	)
Depreciation		(85	)		(87	)		(85	)		(257	)
Amortization		(11	)		(11	)		(12	)		(34	)
Impairment of long-lived assets and goodwill, and restructuring charges		(5	)		(1	)		(7	)		(13	)
Litigation and investigation costs		(1	)		(9	)		(3	)		(13	)
Operating income		176			138			133			447
Interest expense		(110	)		(120	)		(112	)		(342	)
Gain (loss) from early extinguishment of debt		134			(21	)		(16	)		97
Investment earnings (loss)		2			(5	)		2			(1	)
Net gain on sales of investments		—			15			—			15
Income from continuing operations, before income taxes		202			7			7			216
Income tax expense		(5	)		(4	)		(3	)		(12	)
Income from continuing operations, before discontinued operations		197			3			4			204
Discontinued operations:
Loss from operations		(1	)		(11	)		(2	)		(14	)
Impairment of long-lived assets and goodwill, and restructuring charges		(9	)		(6	)		(1	)		(16	)
Net losses on sales of facilities		(2	)		—			—			(2	)
Income tax expense		(2	)		—			(2	)		(4	)
Loss from discontinued operations		(14	)		(17	)		(5	)		(36	)
Net income (loss)		183			(14	)		(1	)		168
Less: Preferred stock dividends		—			—			—			—
Less: Net income attributable to noncontrolling interests		5			1			2			8
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders	$	178		$	(15	)	$	(3	)	$	160

Diluted earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders
Continuing operations	$	0.40		$	0.01		$	—		$	0.40
Discontinued operations		(0.03	)		(0.04	)		(0.01	)		(0.07	)
	$	0.37		$	(0.03	)	$	(0.01	)	$	0.33
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		478,372			480,447			481,008			479,942
Diluted		479,512			488,244			498,084			489,688


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS
Fiscal 2009 by Calendar Quarter
(Unaudited)

(Dollars in millions except per patient day, per admission and per visit amounts)	Three Months Ended									Nine Months Ended
	3/31/09			6/30/09			9/30/09			9/30/09

Net inpatient revenues	$	1,501		$	1,427		$	1,452		$	4,380
Net outpatient revenues	$	659		$	692		$	699		$	2,050

Number of general hospitals (at end of period)		48			48			48			48
Licensed beds (at end of period)		13,305			13,309			13,309			13,309
Average licensed beds		13,299			13,301			13,309			13,303
Utilization of licensed beds		55.7	%		51.6	%		50.4	%		52.5	%
Patient days		667,078			624,125			616,850			1,908,053
Adjusted patient days		970,266			931,502			926,344			2,828,112
Net inpatient revenue per patient day	$	2,250		$	2,286		$	2,354		$	2,296
Admissions		133,892			128,818			128,652			391,362
Adjusted patient admissions		195,871			193,572			194,568			584,011
Net inpatient revenue per admission	$	11,211		$	11,078		$	11,286		$	11,192
Average length of stay (days)		5.0			4.9			4.8			4.9
Surgeries		89,076			91,575			91,734			272,385
Net outpatient revenue per visit	$	688		$	704		$	711		$	701
Outpatient visits		958,501			983,095			983,089			2,924,685

Sources of net patient revenue
Medicare		27.0	%		24.0	%		24.4	%		25.2	%
Medicaid		8.0	%		8.4	%		8.5	%		8.3	%
Managed care governmental		14.8	%		14.8	%		14.8	%		14.8	%
Managed care commercial		40.6	%		41.8	%		41.2	%		41.2	%
Indemnity, self-pay and other		9.6	%		11.0	%		11.1	%		10.5	%


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS
Fiscal 2009 by Calendar Quarter
(Unaudited)

(Dollars in millions except per patient day, per admission and per visit amounts)	Three Months Ended									Nine Months Ended
	3/31/09			6/30/09			9/30/09			9/30/09

Net inpatient revenues	$	1,514		$	1,441		$	1,466		$	4,421
Net outpatient revenues	$	668		$	702		$	709		$	2,079

Number of general hospitals (at end of period)		49			49			49			49
Licensed beds (at end of period)		13,415			13,419			13,419			13,419
Average licensed beds		13,409			13,411			13,419			13,413
Utilization of licensed beds		55.7	%		51.6	%		50.4	%		52.6	%
Patient days		672,636			629,714			622,427			1,924,777
Adjusted patient days		978,841			940,472			935,375			2,854,688
Net inpatient revenue per patient day	$	2,251		$	2,288		$	2,355		$	2,297
Admissions		135,335			130,308			130,258			395,901
Adjusted patient admissions		198,097			195,962			197,164			591,223
Net inpatient revenue per admission	$	11,187		$	11,058		$	11,255		$	11,167
Average length of stay (days)		5.0			4.8			4.8			4.9
Surgeries		89,640			92,166			92,437			274,243
Net outpatient revenue per visit	$	688		$	704		$	712		$	702
Outpatient visits		970,319			996,468			995,968			2,962,755

Sources of net patient revenue
Medicare		26.9	%		24.0	%		24.4	%		25.1	%
Medicaid		7.9	%		8.3	%		8.5	%		8.3	%
Managed care governmental		14.8	%		14.9	%		14.8	%		14.8	%
Managed care commercial		40.6	%		41.9	%		41.2	%		41.2	%
Indemnity, self-pay and other		9.8	%		10.9	%		11.1	%		10.6	%


TENET HEALTHCARE CORPORATION
CONSOLIDATED OPERATIONS DATA
Fiscal 2008 by Calendar Quarter
(Unaudited)

(Dollars in millions except per share amounts)	Three Months Ended												Year Ended
	3/31/08			6/30/08			9/30/08			12/31/08			12/31/08

Net operating revenues	$	2,156		$	2,112		$	2,140		$	2,177		$	8,585
Operating expenses:
Salaries, wages and benefits		(945	)		(934	)		(943	)		(957	)		(3,779	)
Supplies		(374	)		(376	)		(376	)		(385	)		(1,511	)
Provision for doubtful accounts		(145	)		(153	)		(164	)		(166	)		(628	)
Other operating expenses, net		(476	)		(486	)		(497	)		(469	)		(1,928	)
Depreciation		(81	)		(84	)		(84	)		(84	)		(333	)
Amortization		(9	)		(9	)		(10	)		(10	)		(38	)
Impairment of long-lived assets and goodwill, and restructuring charges		(1	)		(2	)		(1	)		(12	)		(16	)
Litigation and investigation (costs) benefit, net of insurance recoveries		(47	)		(3	)		5			4			(41	)
Operating income		78			65			70			98			311
Interest expense		(104	)		(102	)		(106	)		(106	)		(418	)
Investment earnings		5			4			12			1			22
Net gain (loss) on sales of investments		—			—			140			(1	)		139
Income (loss) from continuing operations, before income taxes		(21	)		(33	)		116			(8	)		54
Income tax (expense) benefit		(1	)		16			4			6			25
Income (loss) from continuing operations, before discontinued operations		(22	)		(17	)		120			(2	)		79
Discontinued operations:
Income (loss) from operations		4			4			(33	)		23			(2	)
Impairment of long-lived assets and goodwill, and restructuring charges		(10	)		(7	)		(21	)		(57	)		(95	)
Net gains (losses) on sales of facilities		—			8			(3	)		1			6
Litigation settlements, net of insurance recoveries		—			—			39			—			39
Income tax (expense) benefit		(2	)		(3	)		4			6			5
Income (loss) from discontinued operations		(8	)		2			(14	)		(27	)		(47	)
Net income (loss)		(30	)		(15	)		106			(29	)		32
Less: Net income attributable to noncontrolling interests		1			—			2			4			7
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders	$	(31	)	$	(15	)	$	104		$	(33	)	$	25
Diluted earnings (loss) per share attributable to Tenet Healthcare Corporation common shareholders:
Continuing operations	$	(0.05	)	$	(0.03	)	$	0.25		$	(0.01	)	$	0.15
Discontinued operations		(0.01	)		—			(0.03	)		(0.06	)		(0.10	)
	$	(0.06	)	$	(0.03	)	$	0.22		$	(0.07	)	$	0.05
Weighted average shares and dilutive securities outstanding (in thousands):
Basic		475,066			476,308			476,898			477,126			476,349
Diluted		475,066			476,308			480,789			477,126			478,606


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING SAME HOSPITALS
Fiscal 2008 by Calendar Quarter
(Unaudited)

(Dollars in millions except per patient day, per admission and per visit amounts)	Three Months Ended												Year Ended
	3/31/08			6/30/08			9/30/08			12/31/08			12/31/08

Net inpatient revenues	$	1,464		$	1,391		$	1,399		$	1,431		$	5,685
Net outpatient revenues	$	620		$	645		$	649		$	641		$	2,555

Number of general hospitals (at end of period)		48			48			48			48			48
Licensed beds (at end of period)		13,273			13,270			13,256			13,287			13,287
Average licensed beds		13,292			13,272			13,261			13,272			13,274
Utilization of licensed beds		57.0	%		53.1	%		51.3	%		51.7	%		53.2	%
Patient days		688,852			640,812			625,702			630,821			2,586,187
Adjusted patient days		971,476			927,945			916,104			918,560			3,734,085
Net inpatient revenue per patient day	$	2,125		$	2,171		$	2,236		$	2,268		$	2,198
Admissions		135,513			129,340			128,525			129,235			522,613
Adjusted patient admissions		192,387			188,696			189,536			189,357			759,976
Net inpatient revenue per admission	$	10,803		$	10,755		$	10,885		$	11,073		$	10,878
Average length of stay (days)		5.1			5.0			4.9			4.9			4.9
Surgeries		86,690			90,253			89,776			89,744			356,463
Net outpatient revenue per visit	$	652		$	686		$	692		$	694		$	681
Outpatient visits		951,195			940,513			937,998			923,317			3,753,023

Sources of net patient revenue
Medicare		26.3	%		25.1	%		25.1	%		25.6	%		25.5	%
Medicaid		8.4	%		8.4	%		8.6	%		8.2	%		8.4	%
Managed care governmental		13.2	%		13.0	%		13.2	%		13.9	%		13.3	%
Managed care commercial		40.2	%		41.9	%		41.5	%		41.9	%		41.4	%
Indemnity, self-pay and other		11.9	%		11.6	%		11.6	%		10.4	%		11.4	%


TENET HEALTHCARE CORPORATION
SELECTED STATISTICS – CONTINUING TOTAL HOSPITALS
Fiscal 2008 by Calendar Quarter
(Unaudited)

(Dollars in millions except per patient day, per admission and per visit amounts)	Three Months Ended												Year Ended
	3/31/08			6/30/08			9/30/08			12/31/08			12/31/08

Net inpatient revenues	$	1,464		$	1,392		$	1,405		$	1,439		$	5,700
Net outpatient revenues	$	620		$	647		$	657		$	648		$	2,572

Number of general hospitals (at end of period)		48			49			49			49			49
Licensed beds (at end of period)		13,273			13,380			13,366			13,397			13,397
Average licensed beds		13,292			13,345			13,371			13,382			13,347
Utilization of licensed beds		57.0	%		52.8	%		51.0	%		51.5	%		53.1	%
Patient days		688,852			641,425			627,942			634,421			2,592,640
Adjusted patient days		971,476			929,270			920,430			924,595			3,745,771
Net inpatient revenue per patient day	$	2,125		$	2,170		$	2,237		$	2,268		$	2,199
Admissions		135,513			129,558			129,205			130,265			524,541
Adjusted patient admissions		192,387			189,168			190,843			191,069			763,467
Net inpatient revenue per admission	$	10,803		$	10,744		$	10,874		$	11,047		$	10,867
Average length of stay (days)		5.1			5.0			4.9			4.9			4.9
Surgeries		86,690			90,363			90,146			90,166			357,365
Net outpatient revenue per visit	$	652		$	686		$	695		$	695		$	682
Outpatient visits		951,195			942,944			945,569			932,678			3,772,386

Sources of net patient revenue
Medicare		26.3	%		25.0	%		25.1	%		25.5	%		25.5	%
Medicaid		8.4	%		8.4	%		8.6	%		8.2	%		8.4	%
Managed care governmental		13.3	%		13.0	%		13.3	%		13.9	%		13.4	%
Managed care commercial		40.2	%		41.9	%		41.6	%		41.9	%		41.4	%
Indemnity, self-pay and other		11.8	%		11.7	%		11.4	%		10.5	%		11.3	%

(1) Reconciliation of Adjusted EBITDA

Adjusted EBITDA, a non-GAAP term, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common shareholders before (1) cumulative effect of changes in accounting principle, net of tax, (2) net income attributable to noncontrolling interests, (3) preferred stock dividends, (4) income (loss) from discontinued operations, net of tax, (5) income tax (expense) benefit, (6) net gain (loss) on sales of investments, (7) investment earnings (loss), (8) gain (loss) from early extinguishment of debt, (9) interest expense, (10) litigation and investigation (costs) benefit, net of insurance recoveries, (11) hurricane insurance recoveries, net of costs, (12) impairment of long-lived assets and goodwill and restructuring charges, net of insurance recoveries, (13) amortization, and (14) depreciation. The Company’s Adjusted EBITDA may not be comparable to EBITDA reported by other companies.

The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its financial statements, some of which are recurring or involve cash payments. The Company uses this information in its analysis of the performance of its business excluding items that it does not consider as relevant in the performance of its hospitals in continuing operations. Adjusted EBITDA is not a measure of liquidity, but is a measure of operating performance that management uses in its business as an alternative to net income (loss) attributable to Tenet Healthcare Corporation common shareholders. Because Adjusted EBITDA excludes many items that are included in our financial statements, it does not provide a complete measure of our operating performance. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance.

The reconciliation of net income (loss) attributable to Tenet Healthcare Corporation common shareholders, the most comparable GAAP term, to Adjusted EBITDA, is set forth in the first table below for the three and nine months ended September 30, 2009 and 2008.

(2) Adjusted Free Cash Flow

Adjusted Free Cash Flow, a non-GAAP term, is defined by the Company as cash provided by (used in) operating activities less income tax refunds (payments), payments against reserves for restructuring charges and litigation costs and settlements, operating cash flows from discontinued operations, capital expenditures in continuing operations, and new hospital construction expenditures. The Company believes the use of Adjusted Free Cash Flow is meaningful as the use of this financial measure provides the Company and the users of its financial statements with supplemental information about the impact on the Company’s cash flows from the items specified above. The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various items on its cash flows, some of which are recurring. The Company uses this information in its analysis of its cash flows excluding items that it does not consider relevant to the liquidity of its hospitals in continuing operations. Adjusted Free Cash Flow is a measure of liquidity that management uses in its business as an alternative to net cash provided by (used in) operating activities. Because Adjusted Free Cash Flow excludes many items that are included in our financial statements, it does not provide a complete measure of our liquidity. Accordingly, investors are encouraged to use GAAP measures when evaluating the Company’s financial performance or liquidity. The reconciliation of net cash provided by (used in) operating activities, the most comparable GAAP term, to Adjusted Free Cash Flow is set forth in the second table below for the three and nine months ended September 30, 2009 and 2008.


TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #1 - Reconciliation of Adjusted EBITDA to Net Income (Loss) Attributable to Tenet Healthcare Corporation Common Shareholders
(Unaudited)

	Three Months Ended September 30,						Nine Months Ended September 30,
(Dollars in millions)	2009			2008			2009			2008
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders	$	(3	)	$	104		$	160		$	58
Less: Net income attributable to noncontrolling interests		(2	)		(2	)		(8	)		(3	)
Preferred stock dividends		—			—			—			—
Income (loss) from discontinued operations, net of tax		(5	)		(14	)		(36	)		(20	)
Income (loss) from continuing operations		4			120			204			81
Income tax (expense) benefit		(3	)		4			(12	)		19
Investment earnings (loss)		2			12			(1	)		21
Gain (loss) from early extinguishment of debt		(16	)		—			97			—
Net gain on sales of investments		—			140			15			140
Interest expense		(112	)		(106	)		(342	)		(312	)
Operating income		133			70			447			213
Litigation and investigation (costs) benefit, net of insurance recoveries		(3	)		5			(13	)		(45	)
Impairment of long-lived assets and goodwill, and restructuring charges		(7	)		(1	)		(13	)		(4	)
Amortization		(12	)		(10	)		(34	)		(28	)
Depreciation		(85	)		(84	)		(257	)		(249	)
Adjusted EBITDA	$	240		$	160		$	764		$	539
Less: Adjusted EBITDA of hospital without full calendar year of operating results		4			(2	)		12			(10	)
Same-hospital Adjusted EBITDA	$	236		$	162		$	752		$	549

Net operating revenues	$	2,262		$	2,140		$	6,753		$	6,408
Less: Revenues of hospital without full calendar year of operating results		24			13			70			15
Same-hospital net operating revenues	$	2,238		$	2,127		$	6,683		$	6,393

Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin)		10.6	%		7.5	%		11.3	%		8.4	%
Adjusted same-hospital EBITDA as % of same-hospital net operating revenues (Adjusted same-hospital EBITDA margin)		10.5	%		7.6	%		11.3	%		8.6	%



Additional Supplemental Non-GAAP Disclosures
Table #2 - Reconciliation of Adjusted Free Cash Flow
(Unaudited)

(Dollars in millions)	Three Months Ended September 30,						Nine Months Ended September 30,
	2009			2008			2009			2008
Net cash provided by operating activities	$	120		$	151		$	284		$	141
Less:
Income tax refunds (payments), net		(7	)		—			15			(3	)
Payments against reserves for restructuring charges and litigation costs and settlements		(109	)		(23	)		(165	)		(79	)
Net cash provided by operating activities from discontinued operations		3			29			31			33
Adjusted net cash provided by operating activities – continuing operations		233			145			403			190
Purchases of property and equipment – continuing operations		(78	)		(100	)		(216	)		(332	)
Construction of new and replacement hospitals		(13	)		(9	)		(47	)		(65	)
Adjusted Free Cash Flow – continuing operations	$	142		$	36		$	140		$	(207	)

TENET HEALTHCARE CORPORATION
Additional Supplemental Non-GAAP Disclosures
Table #3 - Reconciliation of Outlook Adjusted EBITDA to Outlook Net Income Attributable to Tenet Healthcare Corporation Common Shareholders for Year Ending December 31, 2009
(Unaudited)

(Dollars in millions)	Low			High

Net income attributable to Tenet Healthcare Corporation common shareholders	$	66		$	130
Less:
Net income attributable to noncontrolling interests		(8	)		(13	)
Preferred stock dividends		(6	)		(6	)
Loss from discontinued operations, net of tax		(60	)		(40	)
Income from continuing operations		140			189
Income tax (expense) benefit		5			(5	)
Income from continuing operations, before income taxes		135			194
Net gain on sales of investments ^(a)		15			15
Interest expense, net		(460	)		(445	)
Net gain from early extinguishment of debt ^(a)		97			97
Operating income		483			527
Litigation and investigation costs		(25	)		(15	)
Impairment of long-lived assets and goodwill, and restructuring charges		(17	)		(13	)
Depreciation and amortization		(400	)		(420	)
Adjusted EBITDA	$	925		$	975

Net operating revenues	$	9,000		$	9,100
Adjusted EBITDA as % of net operating revenues (Adjusted EBITDA margin)		10.3	%		10.7	%

^(a)Management is not providing a forecast of these items for the remainder of 2009.


Additional Supplemental Non-GAAP Disclosures
Table #4 - Reconciliation of Outlook Adjusted EBITDA to Outlook Normalized Net Income Attributable to Tenet Healthcare Corporation Common Shareholders for Year Ending December 31, 2009
(Unaudited)

(Dollars in millions except per share amounts)	Low			High

Adjusted EBITDA (from Table # 3, above)	$	925		$	975

Depreciation and amortization		(400	)		(420	)
Interest expense, net		(460	)		(445	)
Normalized income from continuing operations before income taxes		65			110
Normalized income tax expense ^(a)		(24	)		(41	)
Normalized income from continuing operations		41			69
Preferred stock dividends		(6	)		(6	)
Net income attributable to noncontrolling interests		(8	)		(13	)
Normalized net income attributable to Tenet Healthcare Corporation common shareholders ^(a)	$	27		$	50

Weighted average shares outstanding (in millions)		492			492

Normalized earnings per share – continuing operations ^(a)	$	0.05		$	0.10

^(a) Uses normalized tax rate of 37.1 percent.


Table #5 - Reconciliation of Outlook Adjusted Free Cash Flow for the Year Ending December 31, 2009
(Unaudited)

(Dollars in millions)
	Low			High
Net cash provided by operating activities	$	253		$	343
Less:
Income tax refunds, net		15			25
Payments against reserves for restructuring charges and litigation costs		(195	)		(185	)
Net cash provided by operating activities from discontinued operations		28			38
Adjusted net cash provided by operating activities – continuing operations		405			465
Purchases of property and equipment – continuing operations		(345	)		(310	)
Construction of new and replacement hospitals		(80	)		(90	)
Adjusted Free Cash Flow – continuing operations	$	(20	)	$	65

Tenet Healthcare (THC)

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