Total Revenue

$1.61 billion

19% growth Y/Y

Net Income Attributable

to Ardent Health

$114 million

Adjusted EBITDA⁽¹⁾

$183 million

213% growth Y/Y

Adjusted EBITDAR⁽¹⁾

$223 million

Adjusted Admissions

9.0% Growth Y/Y

Net Patient Service Revenue

per Adjusted Admission

9.5% Growth Y/Y

Recorded New Mexico State Directed Payment

Benefit of $94 million to Total Revenue;

$65 million to Adjusted EBITDA⁽¹⁾

Issuing Full-Year 2025 Guidance

Total Revenue: $6,200 - $6,450 million

Adjusted EBITDA⁽¹⁾: $575 - $615 million

Adjusted EBITDA and Adjusted EBITDAR are financial measures that have not been prepared in a manner that complies with U.S. generally accepted accounting principles ("GAAP"). See "Supplemental Non-GAAP Financial Information" for reconciliations of non-GAAP measures to their most comparable GAAP financial measures.

Strong Finish to 2024 – Introducing 2025 Guidance that Includes 19% Adjusted EBITDA Growth

• "We had a strong finish to 2024, highlighted by reported revenue growth of 19% and Adjusted EBITDA growth of well over 200% in the fourth quarter," stated Marty Bonick, President and Chief Executive Officer of Ardent Health. "For the full-year 2024, we grew revenue 10%, increased Adjusted EBITDA 58%, and expanded Adjusted EBITDA margins 260 basis points. Importantly, we achieved a key milestone when the New Mexico state directed payment program was retroactively approved in November 2024 for the period covering the second half of 2024."
• "In connection with the retroactive approval of the New Mexico state directed payment program, we recorded revenue of $94 million and Adjusted EBITDA of $65 million in the fourth quarter," continued Bonick. "Combined with our solid operational performance for the quarter, this resulted in 2024 revenue and Adjusted EBITDA well above our guidance ranges. Excluding that benefit, which was not included in previous guidance, Ardent Health delivered financial and operating performance that was consistent or favorable to our 2024 guidance."
• "Today, we are providing 2025 guidance that, at the midpoint, includes strong revenue and Adjusted EBITDA growth of 6% and 19%, respectively, and 100 basis points of Adjusted EBITDA margin expansion," said Bonick.
• "We enter 2025 with strong momentum and see encouraging operating environment tailwinds with early indications that volume growth will remain durable this year," added Bonick. "Among our 2025 strategic priorities, we are enhancing supply chain efficiencies, advancing service line optimization initiatives, and taking steps to execute on ambulatory growth as evidenced by our recently announced acquisition of 18 urgent care clinics. Additionally, as we assess organic and inorganic growth opportunities, we are operating from a position of balance sheet strength with over $550 million of cash and a lease-adjusted net leverage ratio of 2.9 times as of December 31, 2024."

Three Months Ended December 31,

(Unaudited)

2024

2023

% Change

Adjusted admissions

86,872

79,731

9.0

%

Admissions

40,300

36,133

11.5

%

Inpatient surgeries

9,108

8,376

8.7

%

Outpatient surgeries

24,296

23,044

5.4

%

Total surgeries

33,404

31,420

6.3

%

Emergency room visits

161,010

150,850

6.7

%

Net patient service revenue per adjusted admission

$

18,200

$

16,616

9.5

%

(Unaudited; dollars in millions, except per share amount)

Full Year 2025 Guidance

Total revenue

$6,200

—

$6,450

Net income attributable to Ardent Health Partners, Inc.

$245

—

$285

Adjusted EBITDA

$575

—

$615

Rent expense payable to REITs

$164

—

$164

Diluted earnings per share

$1.73

—

$2.01

Adjusted admissions growth

2.0%

—

3.0%

Net patient service revenue per adjusted admission growth

2.1%

—

4.4%

Capital expenditures

$215

—

$235

Lease-adjusted net leverage is defined as the Company's net debt as of December 31, 2024, plus 8x trailing twelve-month real estate investment trust ("REIT") rent expense as of the end of the fourth quarter of 2024, divided by trailing twelve-month Adjusted EBITDAR as of December 31, 2024.

To participate in the live teleconference:

United States Live:

1-888-596-4144

International Live:

1-646-968-2525

Access Code:

4437657

To listen to a replay of the teleconference, which will be available through March 13, 2025:

United States Replay:

1-800-770-2030

International Replay:

1-609-800-9909

Access Code:

4437657

Ardent Health Partners, Inc.

Consolidated Income Statements

(Unaudited; dollars in thousands, except per share amounts)

Three Months Ended December 31,

2024

2023

Amount

%

Amount

%

Total revenue

$

1,606,289

100.0

%

$

1,346,034

100.0

%

Expenses:

Salaries and benefits

653,966

40.7

%

598,123

44.4

%

Professional fees

286,299

17.8

%

265,159

19.7

%

Supplies

264,088

16.4

%

249,692

18.6

%

Rents and leases

27,326

1.7

%

24,214

1.8

%

Rents and leases, related party

37,816

2.4

%

36,966

2.7

%

Other operating expenses

141,368

8.8

%

109,711

8.1

%

Interest expense

13,528

0.8

%

18,451

1.4

%

Depreciation and amortization

37,854

2.4

%

35,982

2.7

%

Other non-operating gains

(23,202

)

(1.4

)%

(1,091

)

(0.1

)%

Total operating expenses

1,439,043

89.6

%

1,337,207

99.3

%

Income before income taxes

167,246

10.4

%

8,827

0.7

%

Income tax expense (benefit)

26,355

1.6

%

(1,954

)

(0.1

)%

Net income

140,891

8.8

%

10,781

0.8

%

Net income attributable to noncontrolling interests

26,687

1.7

%

14,934

1.1

%

Net income (loss) attributable to Ardent Health Partners, Inc.

$

114,204

7.1

%

$

(4,153

)

(0.3

)%

Net income (loss) per share:

Basic

$

0.82

$

(0.03

)

Diluted

$

0.81

$

(0.03

)

Weighted-average common shares outstanding:

Basic

140,044,699

126,115,301

Diluted

140,828,828

126,115,301

Ardent Health Partners, Inc.

Consolidated Income Statements

(Unaudited; dollars in thousands, except per share amounts)

Years Ended December 31,

2024

2023

Amount

%

Amount

%

Total revenue

$

5,966,072

100.0

%

$

5,409,483

100.0

%

Expenses:

Salaries and benefits

2,534,756

42.5

%

2,384,062

44.1

%

Professional fees

1,097,119

18.4

%

980,270

18.1

%

Supplies

1,033,122

17.3

%

993,405

18.4

%

Rents and leases

103,577

1.7

%

97,444

1.8

%

Rents and leases, related party

149,229

2.5

%

145,880

2.7

%

Other operating expenses

496,219

8.2

%

451,737

8.3

%

Government stimulus income

—

0.0

%

(8,463

)

(0.2

)%

Interest expense

65,578

1.1

%

74,305

1.4

%

Depreciation and amortization

146,288

2.5

%

140,842

2.6

%

Loss on extinguishment and modification of debt

3,388

0.1

%

—

0.0

%

Other non-operating gains

(26,264

)

(0.4

)%

(1,613

)

0.0

%

Total operating expenses

5,603,012

93.9

%

5,257,869

97.2

%

Income before income taxes

363,060

6.1

%

151,614

2.8

%

Income tax expense

63,352

1.1

%

22,637

0.4

%

Net income

299,708

5.0

%

128,977

2.4

%

Net income attributable to noncontrolling interests

89,365

1.5

%

75,073

1.4

%

Net income attributable to Ardent Health Partners, Inc.

$

210,343

3.5

%

$

53,904

1.0

%

Net income per share:

Basic

$

1.59

$

0.43

Diluted

$

1.58

$

0.43

Weighted-average common shares outstanding:

Basic

132,439,695

126,115,301

Diluted

132,744,577

126,115,301

Ardent Health Partners, Inc.

Consolidated Statements of Cash Flows

(Unaudited; in thousands)

Years Ended December 31,

2024

2023

Cash flows from operating activities:

Net income

$

299,708

$

128,977

Adjustments to reconcile net income to net cash provided by operating activities:

Depreciation and amortization

146,288

140,842

Other non-operating gains

(4,702

)

(45

)

Loss on extinguishment and modification of debt

2,158

—

Amortization of deferred financing costs and debt discounts

5,468

4,988

Deferred income taxes

24,044

3,996

Equity-based compensation

17,978

904

Loss (income) from non-consolidated affiliates

5,835

(1,653

)

Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:

Accounts receivable

40,001

(181,099

)

Inventories

(9,407

)

1,665

Prepaid expenses and other current assets

(136,009

)

(36,606

)

Accounts payable and other accrued expenses and liabilities

(103,860

)

136,824

Accrued salaries and benefits

27,524

22,905

Net cash provided by operating activities

315,026

221,698

Cash flows from investing activities:

Investment in acquisitions, net of cash acquired

(35,542

)

—

Purchases of property and equipment

(187,508

)

(137,408

)

Proceeds from divestitures

4,297

—

Other

(1,707

)

(575

)

Net cash used in investing activities

(220,460

)

(137,983

)

Cash flows from financing activities:

Proceeds from initial public offering, net of underwriting discounts and commissions

208,656

—

Proceeds from revolving line of credit

—

125,000

Proceeds from insurance financing arrangements

10,797

24,749

Proceeds from long-term debt

3,600

6,619

Payments of principal on revolving line of credit

—

(125,000

)

Payments of principal on insurance financing arrangements

(10,443

)

(22,877

)

Payments of principal on long-term debt

(108,371

)

(13,645

)

Debt issuance costs

(2,450

)

—

Payments of initial public offering costs

(9,534

)

—

Distributions to noncontrolling interests

(72,856

)

(63,875

)

Redemption of equity attributable to noncontrolling interests

—

(26,024

)

Other

5,243

(7,209

)

Net cash provided by (used in) financing activities

24,642

(102,262

)

Net increase (decrease) in cash and cash equivalents

119,208

(18,547

)

Cash and cash equivalents at beginning of year

437,577

456,124

Cash and cash equivalents at end of year

$

556,785

$

437,577

Supplemental Cash Flow Information:

Non-cash purchases of property and equipment

$

9,276

$

16,392

Offering costs not yet paid

$

330

$

—

Interest payments, net of capitalized interest

$

74,976

$

81,610

Income tax payments, net

$

41,603

$

19,433

Ardent Health Partners, Inc.

Consolidated Balance Sheets

(Unaudited; dollars in thousands, except per share amounts)

December 31,

2024 ⁽¹⁾

December 31,

2023 ⁽¹⁾

Assets

Current assets:

Cash and cash equivalents

$

556,785

$

437,577

Accounts receivable

743,031

775,452

Inventories

115,093

105,485

Prepaid expenses

113,749

77,281

Other current assets

304,093

222,290

Total current assets

1,832,751

1,618,085

Property and equipment, net

861,899

811,089

Operating lease right of use assets

248,040

260,003

Operating lease right of use assets, related party

929,106

941,150

Goodwill

852,084

844,704

Other intangible assets

76,930

76,930

Deferred income taxes

12,321

32,491

Other assets

142,969

147,106

Total assets

$

4,956,100

$

4,731,558

Liabilities and Equity

Current liabilities:

Current installments of long-term debt

$

9,234

$

18,605

Accounts payable

401,249

474,543

Accrued salaries and benefits

295,117

267,685

Other accrued expenses and liabilities

239,824

233,271

Total current liabilities

945,424

994,104

Long-term debt, less current installments

1,085,818

1,168,253

Long-term operating lease liability

221,443

235,241

Long-term operating lease liability, related party

919,313

932,090

Self-insured liabilities

227,048

243,552

Other long-term liabilities

34,697

76,002

Total liabilities

3,433,743

3,649,242

Redeemable noncontrolling interests

1,158

7,302

Equity:

Common units, no and unlimited units authorized as of December 31, 2024 and December 31, 2023, respectively; no and 484,922,828 units issued and outstanding as of December 31, 2024 and December 31, 2023, respectively

—

496,882

Preferred stock, par value $0.01 per share; 50,000,000 and no shares authorized as of December 31, 2024 and December 31, 2023, respectively; no shares issued and outstanding as of December 31, 2024 and 2023

—

—

Common stock, par value $0.01 per share; 750,000,000 and no shares authorized as of December 31, 2024 and December 31, 2023, respectively; 142,747,818 and no shares issued and outstanding as of December 31, 2024 and December 31, 2023, respectively

1,428

—

Additional paid-in capital

754,415

—

Accumulated other comprehensive income

9,737

18,561

Retained earnings

365,796

155,453

Equity attributable to Ardent Health Partners, Inc.

1,131,376

670,896

Noncontrolling interests

389,823

404,118

Total equity

1,521,199

1,075,014

Total liabilities and equity

$

4,956,100

$

4,731,558

As of December 31, 2024 and December 31, 2023, the consolidated balance sheet included total liabilities of consolidated variable interest entities of $306.4 million and $337.8 million, respectively. Refer to Note 2 of the Company's consolidated financial statements included in its Annual Report on Form 10-K for further discussion.

Ardent Health Partners, Inc.

Operating Statistics

(Unaudited)

Three Months Ended December 31,

Years Ended December 31,

2024

% Change

2023

2024

% Change

2023

Total revenue (in thousands)

$

1,606,289

19.3

%

$

1,346,034

$

5,966,072

10.3

%

$

5,409,483

Hospitals operated (at period end) ⁽¹⁾

30

(3.2

)%

31

30

(3.2

)%

31

Licensed beds (at period end) ⁽²⁾

4,281

(1.0

)%

4,323

4,281

(1.0

)%

4,323

Utilization of licensed beds ⁽³⁾

47

%

4.4

%

45

%

46

%

2.2

%

45

%

Admissions ⁽⁴⁾

40,300

11.5

%

36,133

157,295

7.1

%

146,887

Adjusted admissions ⁽⁵⁾

86,872

9.0

%

79,731

341,781

4.8

%

326,029

Inpatient surgeries ⁽⁶⁾

9,108

8.7

%

8,376

35,937

2.3

%

35,127

Outpatient surgeries ⁽⁷⁾

24,296

5.4

%

23,044

93,497

0.0

%

93,461

Total surgeries

33,404

6.3

%

31,420

129,434

0.7

%

128,588

Emergency room visits ⁽⁸⁾

161,010

6.7

%

150,850

636,222

4.5

%

609,010

Patient days ⁽⁹⁾

184,167

1.5

%

181,409

724,363

2.3

%

708,043

Total encounters ⁽¹⁰⁾

1,481,612

13.6

%

1,304,643

5,785,709

6.9

%

5,413,787

Average length of stay ⁽¹¹⁾

4.57

(9.0

)%

5.02

4.61

(4.4

)%

4.82

Net patient service revenue per adjusted admission ⁽¹²⁾

$

18,200

9.5

%

$

16,616

$

17,144

5.1

%

$

16,307

Hospitals operated (at period end). This metric represents the total number of hospitals operated by us at the end of the applicable period, irrespective of whether the hospital real estate is (i) owned by us, (ii) leased by us or (iii) held through a controlling interest in a JV. This metric includes the managed clinical operations of the hospital at UT Health North Campus in Tyler, Texas ("UT Health North Campus Tyler"), a hospital owned by The University of Texas Health Science Center at Tyler ("UTHSCT"), an affiliate of The University of Texas System. Since we only manage the clinical operations of UT Health North Campus Tyler, the financial results of such entity are not consolidated under Ardent Health Partners, Inc. On April 30, 2024, we closed UT Health East Texas Specialty Hospital, a long-term acute care hospital (the "LTAC Hospital") in Tyler, Texas. The LTAC Hospital's inventory and fixed assets were transferred or repurposed to be used by our other hospitals. The LTAC Hospital had 36 licensed patient beds and accounted for approximately $0.2 million and $1.7 million of total revenue and a pre-tax income (loss) of $0.4 million and $(0.7) million for the three months ended December 31, 2024 and 2023, respectively, and approximately $2.6 million and $9.7 million of total revenue and a pre-tax loss of $0.4 million and $1.2 million for the years ended December 31, 2024 and 2023, respectively.

Licensed beds (at period end). This metric represents the total number of beds for which the appropriate state agency licenses a facility, regardless of whether the beds are actually available for patient use.

Utilization of licensed beds. This metric represents a measure of the actual utilization of our inpatient facilities, computed by (i) dividing patient days by the number of days in each period, and (ii) further dividing that number by average licensed beds, which is calculated by dividing total licensed beds (at period end) by the number of days in the period, multiplied by the number of days in the period the licensed beds were in existence.

Admissions. This metric represents the number of patients admitted for inpatient treatment during the applicable period.

Adjusted admissions. This metric is used by management as a general measure of combined inpatient and outpatient volume. Adjusted admissions provides management with a key performance indicator that considers both inpatient and outpatient volumes by applying an inpatient volume measure (admissions) to a ratio of gross inpatient and outpatient revenue to gross inpatient revenue. Gross inpatient and outpatient revenue reflect gross inpatient and outpatient charges prior to estimated contractual adjustments, uninsured discounts, implicit price concessions, and other discounts. The calculation of adjusted admissions is summarized as follows:

Adjusted Admissions

=

Admissions

x

(Gross Inpatient Revenue + Gross Outpatient Revenue)

Gross Inpatient Revenue

(6)

Inpatient surgeries. This metric represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain management, c-sections, and certain diagnostic procedures are excluded from inpatient surgeries.

(7)

Outpatient surgeries. This metric represents the number of surgeries performed on patients who have not been admitted to our hospitals. Pain management, c-sections, and certain diagnostic procedures are excluded from outpatient surgeries.

(8)

Emergency room visits. This metric represents the total number of patients provided with emergency room treatment during the applicable period.

(9)

Patient days. This metric represents the total number of days of care provided to patients admitted to our hospitals during the applicable period.

(10)

Total encounters. This metric represents the total number of events where healthcare services are rendered resulting in a billable event during the applicable period. This includes both hospital and ambulatory patient interactions.

(11)

Average length of stay. This metric represents the average number of days admitted patients stay in our hospitals.

(12)

Net patient service revenue per adjusted admission. This metric represents net patient service revenue divided by adjusted admissions for the applicable period. Net patient service revenue reflects gross inpatient and outpatient charges less estimated contractual adjustments, uninsured discounts, implicit price concessions, and other discounts.

Ardent Health Partners, Inc.

Supplemental Non-GAAP Disclosures

(Unaudited; in thousands)

Three Months Ended December 31,

Years Ended December 31,

2024

2023

2024

2023

Net income

$

140,891

$

10,781

$

299,708

$

128,977

Adjusted EBITDA Addbacks:

Income tax expense (benefit)

26,355

(1,954

)

63,352

22,637

Interest expense

13,528

18,451

65,578

74,305

Depreciation and amortization

37,854

35,982

146,288

140,842

Noncontrolling interest earnings

(26,687

)

(14,934

)

(89,365

)

(75,073

)

Loss on extinguishment and modification of debt

—

—

3,388

—

Other non-operating gains ⁽¹⁾

(4,702

)

(1,091

)

(4,910

)

(1,613

)

Cybersecurity Incident (recoveries) expenses, net ⁽²⁾

(16,501

)

8,495

(21,477

)

8,495

Certain legal matters and related costs

2,000

—

2,000

—

Restructuring, exit and acquisition-related costs ⁽³⁾

1,057

2,080

12,751

13,553

Epic expenses ⁽⁴⁾

1,673

366

3,173

1,781

Equity-based compensation

9,105

181

17,978

904

(Income) loss from disposed operations

(1,980

)

5

9

(60

)

Adjusted EBITDA

$

182,593

$

58,362

$

498,473

$

314,748

(1)

Other non-operating gains include gains realized on certain non-recurring events or events that are non-operational in nature, including gains realized on certain asset divestitures.

(2)

Cybersecurity Incident (recoveries) expenses, net represent insurance recovery proceeds associated with the Cybersecurity Incident, net of incremental information technology and litigation costs.

(3)

Restructuring, exit and acquisition-related costs represent (i) enterprise restructuring costs, including severance costs related to work force reductions of $0.3 million and $1.8 million for the three months ended December 31, 2024 and 2023, respectively, and $10.4 million and $12.4 million for the years ended December 31, 2024 and 2023, respectively; (ii) penalties and costs incurred for terminating pre-existing contracts at acquired facilities of $0.2 million and $0.1 million for the three months ended December 31, 2024 and 2023, respectively, and $0.8 million and $0.7 million for the years ended December 31, 2024 and 2023, respectively; and (iii) third-party professional fees and expenses, salaries and benefits, and other internal expenses incurred in connection with potential and completed acquisitions of $0.6 million and $0.2 million for the three months ended December 31, 2024 and 2023, respectively, and $1.6 million and $0.5 million for the years ended December 31, 2024 and 2023, respectively.

(4)

Epic expenses consist of various costs incurred in connection with the implementation of Epic, our health information technology system. These costs included professional fees of $1.6 million and $0.4 million for the three months ended December 31, 2024 and 2023, respectively, and $3.1 million and $1.8 million for the years ended December 31, 2024 and 2023, respectively, and salaries and benefits of $0.1 million for the three months and year ended December 31, 2024. Epic expenses do not include the ongoing costs of the Epic system.

Ardent Health Partners, Inc.

Supplemental Non-GAAP Disclosures

(Unaudited; in thousands)

Three Months Ended

December 31, 2024

Year Ended

December 31, 2024

Net income

$

140,891

$

299,708

Adjusted EBITDAR Addbacks:

Income tax expense

26,355

63,352

Interest expense

13,528

65,578

Depreciation and amortization

37,854

146,288

Noncontrolling interest earnings

(26,687

)

(89,365

)

Loss on extinguishment and modification of debt

—

3,388

Other non-operating gains ⁽¹⁾

(4,702

)

(4,910

)

Cybersecurity Incident recoveries, net ⁽²⁾

(16,501

)

(21,477

)

Certain legal matters and related costs

2,000

2,000

Restructuring, exit and acquisition-related costs ⁽³⁾

1,057

12,751

Epic expenses ⁽⁴⁾

1,673

3,173

Equity-based compensation

9,105

17,978

(Income) loss from disposed operations

(1,980

)

9

Rent expense payable to REITs ⁽⁵⁾

40,618

160,444

Adjusted EBITDAR

$

223,211

$

658,917

(1)

Other non-operating gains include gains realized on certain non-recurring events or events that are non-operational in nature, including gains realized on certain asset divestitures.

(2)

Cybersecurity Incident recoveries, net represent insurance recovery proceeds associated with the Cybersecurity Incident, net of incremental information technology and litigation costs.

(3)

Restructuring, exit and acquisition-related costs represent (i) enterprise restructuring costs, including severance costs related to work force reductions of $0.3 million and $10.4 million for the three months ended and year ended December 31, 2024, respectively; (ii) penalties and costs incurred for terminating pre-existing contracts at acquired facilities of $0.2 million and $0.8 million for the three months ended and year ended December 31, 2024, respectively; and (iii) third-party professional fees and expenses, salaries and benefits, and other internal expenses incurred in connection with potential and completed acquisitions of $0.6 million and $1.6 million for the three months ended and year ended December 31, 2024, respectively.

(4)

(5)

Rent expense payable to REITs consists of rent expense of $37.8 million and $149.2 million related to the Ventas Master Lease and lease agreements associated with MOB Transactions with Ventas for the three months ended and year ended December 31, 2024, respectively, and rent expense of $2.8 million and $11.2 million related to a lease arrangement with MPT for the lease of Hackensack Meridian Mountainside Medical Center for the three months ended and year ended December 31, 2024, respectively.

Ardent Health Partners, Inc.

Supplemental Non-GAAP Disclosures

(Unaudited; in millions)

Guidance for the Full Year Ending

December 31, 2025

Low

High

Net income

$

342

$

386

Adjusted EBITDA Addbacks:

Income tax expense

91

101

Interest expense

63

59

Depreciation and amortization

146

143

Noncontrolling interest earnings

(97

)

(101

)

Cybersecurity Incident recoveries, net ⁽¹⁾

(21

)

(21

)

Restructuring, exit and acquisition-related costs

5

4

Epic expenses

6

4

Enterprise system conversion costs

2

2

Equity-based compensation

38

38

Adjusted EBITDA

$

575

$

615

Cybersecurity Incident recoveries, net represents insurance recovery proceeds associated with the Cybersecurity Incident, net of incremental information technology and litigation costs.