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CHS Posts $328M Loss for Q4, Revenues Rise by Nearly $400M

By Jack O'Brien  
   February 20, 2019

Another rough quarter marked an end to a challenging 2018 for the for-profit rural hospital operator.

For the second quarter in a row, Community Health Systems (CHS) posted a net loss of more than $325 million, this time despite an increase in operating revenues, according to the company's earnings report released Wednesday afternoon.

CHS posted a net loss attributable to shareholders of $328 million in Q4 2018, down from a net loss of more than $2 billion during Q4 2017, while recording net operating revenues of $3.5 billion, an increase of nearly $400 million year-over-year. 

For the full year, CHS recorded operating revenues of $14.2 billion, down from $15.3 billion in 2017, and a net loss of $788 million, less than a third of the $2.5 billion loss in the year prior.

Related: CHS Records $325M Loss in Q3, Revenues Decline by Nearly 6%

In Q4, the Franklin, Tennessee-based for-profit hospital operator did manage to significantly reduce its net losses per share down to $2.91 per share, whereas a year ago it was a loss of $17.98 per share.

This trend held true for the full year as well, with the company showing a net loss per share of $6.99 in 2018 as compared to $22 per share in 2017.

The financial results come as CHS continues to divest its hospitals in an effort to reduce its debts, finishing 2018 with 12 less hospitals than it began with.

Related: CHS to Sell 4 Hospitals, Exit South Carolina

C-suite perspective:

“Our fourth quarter marked a strong finish to the year," Wayne T. Smith, chairman and CEO of CHS, said in a statement. "During 2018, our market leaders made significant progress across areas such as our patient safety and connectivity, competitive position in core markets, and operational efficiency. These strategic investments and our solid execution drove enhanced same store performance during 2018. In 2019, we believe that we have a number of opportunities to further leverage these strategic initiatives to drive incremental growth, and achieve additional progress as we further strengthen our core portfolio and reduce our debt.”

CHS also posted an adjusted EBITDA of $419 million in Q4, up $10 million year-over-year, though its full year adjusted EBITDA declined by $61 million from 2017.  

Related: Financial Woes Threaten Closures for 1-in-5 Rural Hospitals

Admissions continue to be a troublesome spot for CHS, as adjusted admissions fell 15% year-over-year and patient days dropped 15.3% over the same period of time. 


  • CHS finished 2018 with $274 million in net cash provided by operating activities, down from $773 million at the end of 2017.
  • As a result of reducing its hospital ownership, CHS' licensed bed count at the end of 2018 totalled 18,227 beds, down from 20,850 beds in 2017. 
  • The provider's net cash used in operating activities reached $165 million in Q4 2018, up from $156 million during Q4 2017.

For complete financial information, review CHS' filing with the Securities and Exchange Commission.

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


In the previous quarter, the system suffered a $325 million loss as revenues declined by 6%.

Q4 2018 was actually an improvement over a $2 billion net loss recorded in Q4 2017.

CHS' adjusted EBITDA was $419 million, a $10 million improvement year-over-year.

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