Ardent Health, Inc.
For the period ended Sep 30, 2025. Filed Nov 14, 2025.
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Sep 30, 2025 · Filed Nov 14, 2025
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Notes to Condensed Consolidated Financial Statements
September 30, 2025
(Unaudited)
- Description of the Business and Basis of Presentation
Reporting Entity
Ardent Health, Inc. was initially formed in 2015 as a Delaware limited liability company. On July 17, 2024, Ardent Health
Partners, LLC converted from a Delaware limited liability company into a Delaware corporationin connection with its initial
public offering and changed its name to Ardent Health Partners, Inc. Effective June 3, 2025, Ardent Health Partners, Inc.
changed its name to Ardent Health, Inc. Ardent Health, Inc. is a holding company that has affiliates that operate acute care
hospitals and other healthcare facilities and employ physicians. The terms “Ardent,” the “Company,” “we,” “our” and “us,”
as used in these notes to the unaudited condensed consolidated financial statements, refer to Ardent Health, Inc. and its
affiliates and on or prior to July 16, 2024, Ardent Health Partners, LLC and its affiliates, unless stated otherwise or indicated
by context. The term “affiliates” includes direct and indirect subsidiaries of Ardent and partnerships and joint ventures in
which such subsidiaries are equity owners. At September 30, 2025, the Company operated 30 acute care hospitals insix
states, includingtwo rehabilitation hospitals andtwo surgical hospitals.
Basis of Presentation
The financial statements include the unaudited condensed consolidated balance sheets, income statements, comprehensive
(loss) income statements, statements of cash flows and statements of changes in equity of the Company and its affiliates,
which are controlled by the Company through the Company’s direct or indirect ownership of a majority equity interest and
rights granted to the Company through certain variable interests. All intercompany balances and transactions have been
eliminated in consolidation. In the opinion of management, all adjustments, which consist of normal recurring adjustments,
and disclosures considered necessary for a fair presentation have been included.
Certain information and disclosures normally included in annual financial statements presented in accordance with U.S.
generally accepted accounting principles (“GAAP”) have been omitted in these interim financial statements pursuant to rules
and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, these unaudited condensed consolidated
financial statements and related notes should be read in conjunction with the Company's audited consolidated financial
statements and notes thereto included in the Company's Annual Report on Form 10-K for the year ended December 31, 2024
(the“Annual Report”).
Initial Public Offering and Corporate Conversion
On July 19, 2024, the Company completed an initial public offering of 12,000,000 shares of its common stock at a public
offering price of$16.00 per share (the "IPO") for aggregate gross proceeds of$192.0 million and net proceeds of
approximately$181.4 million, after deducting underwriting discounts and commissions of approximately$10.6 million. The
Company provided the underwriters with an option to purchase up to an additional 1,800,000 shares of common stock of the
Company, which was fully exercised by the underwriters, and, on July 30, 2024, the Company issued 1,800,000 additional
shares of common stock at$16.00 per share for additional net proceeds of approximately$27.2 million, after deducting
underwriting discounts and commissions of approximately$1.6 million. The Company’s common stock is listed on the New
York Stock Exchange under the symbol “ARDT”.
On July 17, 2024, in connection with the IPO and immediately prior to the effectiveness of the Company's Registration
Statement on Form S-1, the Company converted from a Delaware limited liability company into a Delaware corporation by
means of a statutory conversion (the “Corporate Conversion”) and changed its name to Ardent Health Partners, Inc. As a
result of the Corporate Conversion, the outstanding limited liability company membership units and vested profits interest
units were converted into 120,937,099 shares of common stock and outstanding unvested profits interest units were converted
into 2,848,027 shares of restricted common stock. Immediately following the Corporate Conversion, ALH Holdings, LLC, a
subsidiary of Ventas, Inc. ("Ventas"), a common unit holder that beneficially owned a percentage of the Company’s
outstanding membership interests and maintained a seat on the Company’s board of managers, making Ventas a related party,
contributed all of its outstanding common stock in AHP Health Partners, Inc. ("AHP Health Partners"), a direct subsidiary of
the Company, to Ardent Health Partners, Inc. in exchange for 5,178,202 shares of common stock of Ardent Health Partners,
Inc. (the "ALH Contribution"). As a result of the ALH Contribution, AHP Health Partners became a wholly-owned
subsidiary of Ardent Health Partners, Inc. The Corporate Conversion and the ALH Contribution have been retrospectively
applied to prior periods herein for the purposes of calculating basic and diluted net income per share. The Company’s
certificate of incorporation authorizes 750,000,000 shares of common stock and 50,000,000 shares of preferred stock, each
with a$0.01 par value per share.
General and Administrative Costs
The majority of the Company’s expenses are "cost of revenue" items. Costs that could be classified as general and
administrative by the Company include its corporate office costs and centralized corporate services such as human resources,
information technology, and finance, which were$36.5 million and$33.7 million for the three months ended September 30,
2025 and 2024, respectively, and$104.0 million and$95.7 million for thenine months ended September 30, 2025 and 2024,
- Summary of Significant Accounting Policies
Recent Accounting Pronouncements Not Yet Adopted
In December 2023, the Financial Accounting Standards Board (the"FASB") issued Accounting Standards Update ("ASU")
2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures("ASU 2023-09"), which requires a public
business entity to disclose specific categories in its annual effective tax rate reconciliation and provide disaggregated
information about significant reconciling items by jurisdiction and by nature. ASU 2023-09 also requires entities to disclose
their income tax payments (net of refunds) to international, federal, and state and local jurisdictions and includes several other
changes to income tax disclosure requirements. This standard is effective for annual periods beginning after December 15,
2024, and requires prospective application with the option to apply it retrospectively. The adoption of this guidance will not
affect the Company’s consolidated results of operations, financial position or cash flows. The Company is currently
evaluating the standard to determine its impact on the Company’s disclosures.
In November 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses("ASU 2024-03"), which
requires the disclosure of certain disaggregated expenses within the notes to the financial statements. ASU 2024-03 is
effective for annual periods beginning after December 15, 2026, and interim reporting periods within fiscal years beginning
after December 15, 2027. Adoption of ASU 2024-03 can either be applied prospectively to consolidated financial statements
issued for reporting periods after the effective date of this standard or retrospectively to any or all prior periods presented in
the consolidated financial statements. Early adoption is also permitted. The Company is currently evaluating the standard to
determine its impact on the Company’s disclosures.
In September 2025, the FASB issued ASU 2025-06, Intangibles - Goodwill and Other - Internal-Use Software (Topic 350):
Targeted Improvements to the Accounting for Internal-Use Software("ASU 2025-06"), which modernizes the current
internal-use software accounting guidance by removing all references to software project development stages. Under ASU
2025-06, an entity begins capitalizing software costs when (i) management has implicitly or explicitly authorized and
committed to funding a computer software project and (ii) it is probable the project will be completed and the software will
be used to perform the function intended (referred to as the“probable-to-complete recognition threshold”). This ASU is
effective for annual reporting periods beginning after December 15, 2027, and interim periods within those annual reporting
periods, with early adoption permitted. The Company is currently evaluating this new standard, but does not expect it to have
a significant impact on its financial statement presentation or results of operations.
Variable Interest Entities
GAAP requires variable interest entities ("VIEs") to be consolidated if an entity’s interest in the VIE is a controlling financial
interest in accordance with Accounting Standards Codification ("ASC") 810, Consolidation("ASC 810"). Under the variable
interest model, a controlling financial interest is determined based on which entity, if any, has (i) the power to direct the
activities of the VIE that most significantly impact the VIE’s economic performance and (ii) the obligation to absorb the
losses, or the right to receive the benefits, from the VIE that could potentially be significant to the VIE.
The Company performs ongoing reassessments of whether changes in the facts and circumstances regarding the Company’s
involvement with a VIE could cause the Company’s consolidation conclusion to change. The consolidation status of the VIEs
with which the Company is involved may change as a result of such reassessments. Changes in consolidation status are
applied prospectively.
The Company, through its wholly-owned subsidiaries, owns majority interests in certain limited liability companies
("LLCs"), with each LLC owning and operating one or more hospitals. The noncontrolling interest is typically owned by a
not-for-profit medical system, university, academic medical center or foundation or combination thereof (individually or
collectively referred to as "minority member"). The employees that work for the LLC and the related hospital(s) are
employees of the Company, and the Company manages the day-to-day operations of the LLC and the hospital(s) pursuant to
a management services agreement ("MSA").
The LLCs are VIEs due to their structure as LLCs and the control that resides with the Company through the MSA. The
Company consolidates each of these LLCs as it is considered the primary beneficiary due to the MSA providing the
Company the right to direct the day-to-day operating and capital activities of the LLC and the respective hospital(s) that most
significantly impact the LLC’s economic performance. Additionally, the Company would absorb a majority of the entity’s
expected losses, receive a majority of the entity’s expected residual returns, or both, as a result of its majority ownership,
contractual or other financial interests in the entity. The MSAs are subject to termination only by mutual agreement of the
Company and minority member, except in the case of gross negligence, fraud or bankruptcy of the Company, in which case
the minority member can force termination of the MSA.
All of the Company’s VIEs meet the definition of a business, and the Company holds a majority of their issued voting equity
interests. Their assets are not required to be used only for the settlement of VIE obligations as the Company has the ability to
direct the use of the VIE assets through its joint venture and cash management agreements.
The governance rights of the minority members are restricted to those that protect their financial interests and do not preclude
consolidation of the LLCs. The rights of minority members generally are limited to such items as the right to approve the
issuance of new ownership interests, calls for additional cash contributions, the acquisition or divestiture of significant assets
and the incurrence of debt in excess of levels not expected to be incurred in the normal course of business.
As of September 30, 2025 and December 31, 2024, nine of the Company’s hospitals were owned and operated through LLCs
that have been determined to be VIEs and were consolidated by the Company. Consolidated assets at September 30, 2025 and
December 31, 2024 included total assets of VIEs equal to$1.3 billion. The Company’s VIEs do not have creditors that have
recourse to the Company. As the structure and nature of business are very similar for each of the LLCs, they are discussed
and presented herein on a combined basis.
The total liabilities of VIEs included in the Company’s unaudited condensed consolidated balance sheets are shown below (in
thousands):
| September 30, 2025 | December 31, 2024 | |
|---|---|---|
| Current liabilities: | ||
| Current installments of long-term debt | $2,949 | $2,266 |
| Accounts payable | 87,862 | 89,428 |
| Accrued salaries and benefits | 35,256 | 37,713 |
| Other accrued expenses and liabilities | 56,059 | 45,250 |
| Total current liabilities | 182,126 | 174,657 |
| Long-term debt, less current installments | 10,829 | 8,192 |
| Long-term operating lease liability | 101,880 | 108,897 |
| Long-term operating lease liability, related party | 9,342 | 9,423 |
| Self-insured liabilities | 680 | 676 |
| Other long-term liabilities | 4,107 | 4,595 |
| Total liabilities | $308,964 | $306,440 |
Income from operations before income taxes attributable to VIEs was$75.7 million and$68.6 million for the three months
ended September 30, 2025 and 2024, respectively, and$206.3 million and$207.0 million for thenine months ended
Accounting Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and judgments
that affect the amounts reported in the unaudited condensed consolidated financial statements and accompanying notes. On
an ongoing basis, the Company evaluates its estimates. The Company bases its estimates on historical experience and on
various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for
making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual
results may differ from these estimates.
Revenue Recognition
Overview
The Company’s revenue generally relates to contracts with patients in which its performance obligations are to provide
healthcare services to the patients. Revenue is recorded during the period the Company’s obligations to provide healthcare
services are satisfied. Revenue for performance obligations satisfied over time is recognized based on charges incurred in
relation to total expected charges. The Company’s performance obligations for inpatient services are generally satisfied over
periods that average approximately five days. The Company’s performance obligations for outpatient services are generally
satisfied over a period of less than one day. As the Company’s performance obligations relate to contracts with a duration of
one year or less, the Company elected the optional exemption under ASC Topic 606, Revenue from Contracts with
Customers, and, therefore, is not required to disclose the transaction price for the remaining performance obligations at the
end of the reporting period or when the Company expects to recognize revenue. Additionally, the Company is not required to
adjust the consideration for the existence of a significant financing component when the period between the transfer of the
services and the payment for such services is one year or less.
Change in Accounting Estimate
During the three months ended September 30, 2025, a change in accounting estimate resulting from a modification to the
technique used to estimate the collectability of accounts receivable and new information provided by recently completed
hindsight evaluations of historical collection trends resulted in a decrease in revenue of$42.6 million. During the three
months ended September 30, 2025, the Company implemented a new revenue accounting system that provided management
with additional information to more precisely estimate the collectability of accounts receivable, particularly with respect to
more timely consideration of payor denial and payment trends. The detailed information provided by the new system during
the three months ended September 30, 2025, along with the Company's recently completed analysis of historical collection
trends, indicated the current collection estimate differed from historical collection estimates thereby resulting in a change in
accounting estimate in accordance with ASC 250-10, Accounting Changes and Error Corrections, to be accounted for during
the three months ended September 30, 2025 (the period of change).
Contractual Adjustments, Discounts and Cost Report Settlements
Contractual relationships with patients, in most cases, involve a third party payor (Medicare, Medicaid and managed care
health plans), and the transaction prices for services provided are dependent upon the terms provided by (Medicare and
Medicaid) or negotiated with (managed care health plans) the third party payors. The payment arrangements with third party
payors for the services provided to the related patients typically specify payments at amounts less than the Company’s
standard charges.
The Company’s revenue is based upon the estimated amounts the Company expects to be entitled to receive from patients
and third party payors. Estimates of contractual adjustments under managed care insurance plans are based upon the
estimated contractual reimbursement percentage. Revenue related to uninsured patients and copayment and deductible
amounts for patients who have healthcare coverage may have discounts applied (uninsured discounts and other discounts).
The Company also records estimated implicit price concessions (based primarily on historical collection experience) related
to uninsured accounts to record self-pay revenue at the estimated amounts expected to be collected.
Medicare and Medicaid regulations and various managed care contracts, under which the discounts from the Company’s
standard charges must be calculated, are complex and are subject to interpretation and adjustment. The Company estimates
contractual adjustments on a payor-specific basis based on its interpretation of the applicable regulations or contract terms.
However, the necessity of the services authorized and provided, and resulting reimbursements, are often subject to
interpretation. These interpretations may result in payments that differ from the Company’s estimates. Additionally, updated
regulations and contract renegotiations occur frequently, necessitating continual review and assessment of the estimates by
management.
Laws and regulations governing Medicare and Medicaid programs are complex and subject to interpretation and adjustment.
Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final
settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as
the"cost report" filing and settlement process). Settlements under reimbursement agreements with third party payors are
estimated and recorded in the period in which the related services are rendered and are adjusted in future periods as final
settlements are determined. Final determination of amounts earned under the Medicare, Medicaid and other third party payor
programs often occurs in subsequent years because of audits by the programs, rights of appeal, and the application of
technical provisions. Settlements are considered in the recognition of net patient service revenue on an estimated basis in the
period the related services are rendered, and such amounts are subsequently adjusted in future periods as adjustments become
known or as years are no longer subject to such audits and reviews. Differences between original estimates and subsequent
revisions, including final settlements, are included in the results of operations of the period in which the revisions are made.
These adjustments resulted inan increase to net patient service revenue of$4.5 million and$4.9 million for the three months
ended September 30, 2025 and 2024, respectively, andan increase to net patient service revenue of$13.7 million and$4.9
million for thenine months ended September 30, 2025 and 2024, respectively.
At September 30, 2025 and December 31, 2024, the Company’s settlements under reimbursement agreements with third
party payors were a net payable of$7.6 million and a net receivable of$1.9 million, respectively, of which a receivable of
$30.9 million and$42.6 million, respectively, was included in other current assets and a payable of$38.5 million and
$40.7 million, respectively, was included in other accrued expenses and liabilities in the unaudited condensed consolidated
balance sheets.
Final determination of amounts earned under prospective payment and other reimbursement activities is subject to review by
appropriate governmental authorities or their agents. In the opinion of the Company’s management, adequate provision has
been made for any adjustments that may result from such reviews.
Subsequent adjustments that are determined to be the result of an adverse change in the patient’s or the payor’s ability to pay
are recognized as bad debt expense. Bad debt expense for thethree and nine months ended September 30, 2025 and 2024 was
not material to the Company.
Payor Mix
The Company’s total revenue is presented in the following table (dollars in thousands):
| Three Months Ended September 30, · Nine Months Ended September 30, | ||||||||
|---|---|---|---|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |||||
| Amount | % of Total Revenue | Amount | % of Total Revenue | Amount | % of Total Revenue | Amount | % of Total Revenue | |
| Medicare | $599,491 | 38.0% | $561,491 | 38.7% | $1,838,885 | 38.9% | $1,709,137 | 39.3% |
| Medicaid | 154,120 | 9.8% | 148,448 | 10.2% | 463,196 | 9.9% | 460,060 | 10.6% |
| Other managed care | 701,279 | 44.5% | 627,112 | 43.3% | 2,070,484 | 43.9% | 1,874,705 | 43.0% |
| Self-pay and other | 86,307 | 5.4% | 79,390 | 5.5% | 259,390 | 5.5% | 234,522 | 5.2% |
| Net patient service revenue | $1,541,197 | 97.7% | $1,416,441 | 97.7% | $4,631,955 | 98.2% | $4,278,424 | 98.1% |
| Other revenue | 35,549 | 2.3% | 33,376 | 2.3% | 87,305 | 1.8% | 81,359 | 1.9% |
| Total revenue | $1,576,746 | 100.0% | $1,449,817 | 100.0% | $4,719,260 | 100.0% | $4,359,783 | 100.0% |
Charity Care
The Company provides care without charge to certain patients who qualify under the local charity care policy of the hospital
where the patient receives services. The Company estimates that its costs of care provided under its charity care programs
approximated$6.4 million and$8.2 million for the three months ended September 30, 2025 and 2024, respectively, and
$50.2 million and$41.8 million for thenine months ended September 30, 2025 and 2024, respectively. The Company does
not report a charity care patient’s charges in revenue as it is the Company’s policy not to pursue collection of amounts related
to these patients, and therefore contracts with these patients do not exist.
The Company’s management estimates its costs of care provided under its charity care programs utilizing a calculated ratio of
costs to gross charges multiplied by the Company’s gross charity care charges provided. The Company’s gross charity care
charges include only services provided to patients who are unable to pay and qualify under the Company’s local charity care
policies. To the extent the Company receives reimbursement through the various governmental assistance programs in which
it participates to subsidize its care of indigent patients, the Company does not include these patients’ charges in its cost of
care provided under its charity care program.
Market Risks
The Company’s revenue is subject to potential regulatory and economic changes in certain states where the Company
generates significant revenue. The following is an analysis by state of revenue as a percentage of the Company’s total
revenue for those states in which the Company generates significant revenue:
| Three Months Ended September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Oklahoma | 23.8% | 24.7% | 23.6% | 24.8% |
| New Mexico | 17.0% | 13.7% | 17.1% | 14.6% |
| Texas | 35.3% | 37.4% | 35.8% | 36.4% |
| New Jersey | 10.3% | 10.1% | 10.2% | 10.2% |
| Other | 13.6% | 14.1% | 13.3% | 14.0% |
| Total | 100.0% | 100.0% | 100.0% | 100.0% |
Supplemental Programs
Several of the Company’s facilities participate in supplemental Medicaid reimbursement programs to offset a portion of the
costs associated with providing care to Medicaid patients. These programs are funded with a combination of state and federal
resources and may be in the form of payments, such as upper payment limit payments, that are intended to address the
difference between traditional Medicaid fee-for-service payments and Medicare reimbursement rates, or payments under
other programs that vary by state under Section 1115 waivers. Additionally, many states have implemented directed payment
programs to direct certain Medicaid managed care plan expenditures. In most cases, these programs are authorized by the
Centers for Medicare & Medicaid Services ("CMS")for a specified period of time and subject to periodic extension or re-
approval. Many of the states in which we receive supplemental Medicaid payments have adopted assessments or taxes levied
on healthcare providers to fund the non-federal portion of Medicaid programs. These payment programs are currently under
the review ofcertain government agencies. Additionally, some states have requested modifications to their existing
supplemental payment programs during the annual renewal process with CMS.
The Company recognizes revenue and related expenses under these programs in the period in which amounts are estimable
and payment is reasonably assured. Reimbursements under these programs are included within total revenue, and assessments
and other program-related costs are included within other operating expenses in the Company's unaudited condensed
consolidated income statements.
Acquisitions
Acquisitions are accounted for using the acquisition method of accounting prescribed by ASC 805, Business Combinations,
and the results of operations are included in the unaudited condensed consolidated income statement from the respective
dates of acquisition. The purchase price of these transactions is allocated to the assets acquired and liabilities assumed based
upon their respective fair values at the date of acquisition and can be subject to change up to 12 months subsequent to the
acquisition date due to settling amounts related to purchased working capital and final determination of fair value estimates.
The Company is required to allocate the purchase price of acquired businesses to identifiable assets acquired and liabilities
assumed and, if applicable, noncontrolling interests based on their fair values. The Company records the excess of the
purchase price allocation over those fair values as goodwill.
On January 1, 2025, the Company completed the acquisitions of certain assets and operationsof 18 urgent care clinics in New
Mexico and Oklahoma for a combined purchase price of $27.5 million. The consideration transferred on December 31, 2024,
consisted solely of cash. Upon closing of the acquisitions, approximately$4.1 million was placed into escrow to cover
potential working capital adjustments and to secure certain indemnification obligations pursuant to the terms of the purchase
agreements. This escrow amount is included in the total purchase consideration of$27.5 million. Most of the combined
purchase price for assets and operations acquired was recorded as goodwill with an immaterial portion allocated to
identifiable assets acquired and liabilities assumed. The fair values of assets and liabilities recorded as of September 30, 2025
related to these acquisitions are provisional and will be finalized at the close of the measurement period.
Fair Value of Financial Instruments
Cash and cash equivalents, accounts receivable, inventories, prepaid expenses, other current assets, accounts payable, accrued
salaries and benefits, accrued interest and other accrued expenses and current liabilities (other than those pertaining to lease
liabilities) are reflected in the accompanying unaudited condensed consolidated financial statements at amounts that
approximate fair value because of the short-term nature of these instruments. The fair value of the Company’s revolving
credit facility also approximates its carrying value as it bears interest at current market rates. Refer to Note 5, Interest Rate
Swap Agreements, for discussion of the fair value measurement of the Company’s derivative instruments.
The carrying amounts and fair values of the Company’s senior secured term loan facility and its 5.75% Senior Notes due
2029 (the"5.75% Senior Notes") were as follows (in thousands):
| Carrying Amount | Fair Value | |||
|---|---|---|---|---|
| September 30, 2025 | December 31, 2024 | September 30, 2025 | December 31, 2024 | |
| Senior secured term loan facility | $772,256 | $773,772 | $773,221 | $779,575 |
| 5.75% Senior Notes | $299,664 | $299,596 | $294,045 | $289,110 |
The estimated fair values of the Company’s senior secured term loan facility and the 5.75% Senior Notes were based upon
quoted market prices at that date and are categorized as Level 2 within the fair value hierarchy.
Noncontrolling Interests
The financial statements include the financial position and results of operations of hospital and healthcare operations in which
the Company owned less than 100% of the equity interests, but maintained a controlling interest during the presented periods.
Earnings or losses attributable to the noncontrolling interests are presented separately in the consolidated income statements.
In accordance with ASC 810, holders of noncontrolling interests are considered to be equity holders in the consolidated
company, pursuant to which noncontrolling interests are classified as part of equity, unless the noncontrolling interests are
redeemable. Certain redemptive features associated with the noncontrolling interests for The University of Kansas Health
System – St. Francis Campus ("St. Francis") could require the Company to deliver cash if the redemptive features are
exercised. These redemptive features could be exercised upon, among other things, the Company’s exclusion or suspension
from participation in any federal or state government healthcare payor program. Therefore, the noncontrolling interests
balance for St. Francis is classified outside the permanent equity section of the Company’s unaudited condensed consolidated
balance sheets.
The redeemable noncontrolling interests related to St. Francis at September 30, 2025 and December 31,2024 have not been
subsequently measured at fair value since the acquisition date in 2017. The noncontrolling interests are not currently
redeemable and it is not probable that the noncontrolling interests will become redeemable as the possibility of the Company
being excluded or suspended from participation in any federal or state government healthcare payor program is remote.
Earnings Per Share
Basic netincome (loss) per share is computed by dividing netincome (loss) available to common stockholders by the
weighted-average common shares outstanding during the period. Diluted netincome (loss) per share takes into account the
potential dilution that could occur if securities or other contracts to issue shares, such as unvested restricted stock units, were
exercised and converted into shares. Diluted netincome (loss) per share is computed by dividing netincome (loss) available
to common stockholders by the weighted-average common shares outstanding during the period, increased by the number of
additional shares that would have been outstanding if the potential shares had been issued and were dilutive.
- Related Party Transactions
Effective August 4, 2015, Ventas acquired ownership of the Company’s real estate in exchange for a$1.4 billion payment
from Ventas and the Company’s agreement to lease the acquired real estate back from Ventas (the “Ventas Master Lease”).
The Ventas Master Lease is a 20-year master lease agreement (with a renewal option for an additional 10 years) with certain
subsidiaries of Ventas, pursuant to which the Company currently leases 10 of the Company’s hospitals. The Ventas Master
Lease includes an annual rent escalator equal to the lesser of four times the Consumer Price Index or 2.5%. In accordance
with ASC 842, Leases, variable lease payments are excluded from the Company’s minimum rental payments used to
determine the right-of-use assets and lease obligations and are recognized as expense when incurred. The Ventas Master
Lease includes a number of operating and financial restrictions on the Company. Management believes the Company was in
compliance with all financial covenants as of September 30, 2025.
The Company recorded rent expense related to the Ventas Master Lease and other lease agreements with Ventas for certain
medical office buildings of$38.1 million and$37.2 million for the three months ended September 30, 2025 and 2024,
respectively, and$114.0 million and$111.4 million for thenine months ended September 30, 2025 and 2024, respectively.
- Long-Term Debt and Financing Matters
Long-term debt consists of the following (in thousands):
| September 30, 2025 | December 31, 2024 | |
|---|---|---|
| Senior secured term loan facility | $772,256 | $773,772 |
| 5.75% Senior Notes | 299,664 | 299,596 |
| Finance leases | 25,993 | 20,907 |
| Other debt | 20,410 | 15,672 |
| Deferred financing costs | (11,958) | (14,895) |
| Total debt | 1,106,365 | 1,095,052 |
| Less current maturities | (19,342) | (9,234) |
| Long-term debt, less current maturities | $1,087,023 | $1,085,818 |
As of September 30, 2025 and December 31,2024, the senior secured term loan facility reflected an original issue discount
("OID") of$5.2 million and$3.7 million, respectively. As of September 30, 2025 and December 31,2024, the 5.75% Senior
Notes balance reflected an OID of$0.3 million and$0.4 million, respectively.
Senior Secured Credit Facilities
On August 24, 2021, the Company entered into a credit agreement (the "Term Loan B Credit Agreement") for itssenior
secured term loan facility (the "Term Loan B Facility"), which provided funding up to a principal amount of$900.0 million
with aseven-year maturity. Principal under the Term Loan B Facility was due in consecutive equal quarterly installments of
0.25% of the initial$900.0 million principal amount as of the execution of the credit agreement (subject to certain reductions
from time to time as a result of the application of prepayments), with the remaining balance due upon maturity of the Term
Loan B Facility. The proceeds from the Term Loan B Facility were used to prepay in full the Company's then-outstanding
$825.0 million senior secured term loan facility, including any accrued and unpaid interest, fees and other expenses related to
the transaction. On June 8, 2023, the Company amended the Term Loan B Credit Agreement to replace the London Interbank
Offered Rate ("LIBOR") with the Term Secured Overnight Financing Rate ("SOFR") and Daily Simple SOFR (each as
defined in the amended Term Loan B Credit Agreement) as the reference interest rate. On June 26, 2024, the Company used
cash on hand to prepay$100.0 million of the$877.5 million outstanding principal on the Term Loan B Facility, which
prepaid all remaining required quarterly principal payments; no modification was made to the Term Loan B Credit
Agreement as a result of this prepayment. Effective July 19, 2024, pursuant to the terms of the Term Loan B Credit
Agreement and as a result of the IPO, the applicable margin was automatically reduced by 25 basis points to 3.25% over
Term SOFR and 2.25% over the base rate. On September 18, 2024, the Company executed an amendment to reprice its Term
Loan B Credit Agreement. The repricing reduced the applicable interest rate by 50 basis points from Term SOFR plus 3.25%
to Term SOFR plus 2.75% and from the base rate plus 2.25% to the base rate plus 1.75%, and it eliminated the credit spread
adjustment. No modifications were made to the maturity of the loans as a result of the repricing, and all other terms of the
Term Loan B Credit Agreement were substantially unchanged. On September 18, 2025, the Company executed an
amendment to refinance the outstanding term loans under its Term Loan B Credit Agreement. The amendment (i) reduced the
applicable interest rate by 50 basis points from Term SOFR plus 2.75% to Term SOFR plus 2.25% and from the base rate
plus 1.75% to the base rate plus 1.25%, (ii) extended the maturity date to September 18, 2032, (iii) increased the baskets for
certain fixed dollar negative covenants and (iv) reestablished principal payments under the amended Term Loan B Facility,
which are due in consecutive equal quarterly installments of 0.25% of the refinanced$777.5 million principal amount
beginning on December 31, 2025 (subject to certain reductions from time to time as a result of the application of
prepayments), with the remaining balance due upon the new maturity date in September 2032.
Effective July 8, 2021, the Company entered into an amended and restated senior credit agreement for its$225.0 million
senior secured asset-based revolving credit facility (the "ABL Credit Agreement"). The ABL Credit Agreement consisted of a
$225.0 million senior secured asset-based revolving credit facility with afive-year maturity. On April 21, 2023, the Company
amended the ABL Credit Agreement to replace LIBOR with the Term SOFR and Daily Simple SOFR (each as defined in the
amended ABL Credit Agreement) as the reference interest rate. On June 26, 2024, the Company amended the ABL Credit
Agreement to increase the revolving commitment to$325.0 million and extend its maturity date to June 26, 2029. On
September 18, 2025, the Company further amended the ABL Credit Agreement to align its covenants to those in the amended
Term Loan B Credit Agreement.
The Term Loan B Credit Agreement and ABL Credit Agreement contain a number of customary affirmative and negative
covenants that limit or restrict the ability of the Company and its subsidiaries to (subject, in each case, to a number of
important exceptions, thresholds and qualifications as set forth in the Term Loan B Credit Agreement and ABL Credit
Agreement):
incur additional indebtedness (including guarantee obligations);
incur liens;
make certain investments;
make certain dispositions and engage in certain sale / leaseback transactions;
make certain payments or other distributions; and
engage in certain transactions with affiliates.
In addition, the ABL Credit Agreement contains a springing financial covenant that requires the maintenance, after failure to
maintain a specified minimum amount of availability to borrow under the senior secured asset-based revolving credit facility,
of a minimum fixed charge coverage ratio of 1.00 to 1.00, as determined at the end of each fiscal quarter. Management
believes that, as of September 30, 2025, the Company maintained more than the minimum amount of availability under the
senior secured asset-based revolving credit facility and, therefore, the minimum fixed charge ratio described herein was not
applicable.
Borrowings under the Term Loan B Facility bear interest at a rate per annum equal to, at the Company’s option, either (i) a
base rate (the "base rate") determined by reference to the highest of (a) the federal funds effective rate plus 0.50%, (b) the rate
last quoted by Bank of America as the "Prime Rate" in the United States for U.S. dollar loans, and (c) Term SOFR applicable
for an interest period of one month (not to be less than 0.50% per annum), plus 1.00% per annum, in each case, plus an
applicable margin, or (ii) Term SOFR (not to be less than 0.50% per annum) for the interest period selected, in each case,
plus an applicable margin. The current applicable margin under the Term Loan B Credit Agreement is equal to 1.25% for
base rate borrowings and 2.25% for Term SOFR borrowings.
The$325.0 million senior secured asset-based revolving credit facility is comprised of two tranches: (1) a$275.0 million
non-UT Health East Texas borrowers’ tranche and (2) a$50.0 million UT Health East Texas borrowers’ tranche available to
the Company’s East Texas Health System, LLC subsidiary (collectively referred to as the "ABL Facilities"). At the election
of the borrowers under the applicable ABL Facility loan, the interest rate per annum applicable to loans under the ABL
Facilities is based on a fluctuating rate of interest determined by reference to either (i) the base rate determined by reference
to the highest of (A) the federal funds effective rate plus 0.50%, (B) the rate last quoted by The Wall Street Journal as the
"Prime Rate" in the United States for U.S. dollar loans from time to time, and (C) Term SOFR (as adjusted for any applicable
statutory reserve rate) applicable for an interest period of one month, plus 1.00% per annum, in each case, plus an applicable
margin, or (ii) the higher of Term SOFR or 0.00% per annum for the interest period selected, in each case, plus an applicable
margin. The applicable margin is determined based on the percentage of the average daily availability of the ABL Facilities.
The applicable margin for the non-UT Health East Texas ABL Facility loan ranges from 0.5% to 1.0% for base rate
borrowings and 1.5% to 2.0% for Term SOFR borrowings. The applicable margin for the UT Health East Texas ABL Facility
loan ranges from 1.5% to 2.0% for base rate borrowings and 2.5% to 3.0% for Term SOFR borrowings.
The Term Loan B Facility and ABL Facilities are collectively referred to herein as the "Senior Secured Credit Facilities."
The Senior Secured Credit Facilities are guaranteed by the Company and certain of the Company’s subsidiaries. Guarantees
of the Company’s subsidiaries that are tenants under the Ventas Master Lease ("Tenants") are limited to (i) the Term Loan B
Facility and (ii) the obligations of the loan parties under the ABL Facilities (excluding any obligations of the entities that
constitute the UT Health East Texas system). In addition, the guarantees of the Tenants with respect to the indebtedness
incurred under both the Term Loan B Facility and ABL Facilities are subject to an aggregate dollar cap amount.
The non-UT Health East Texas ABL Facility is secured by first priority liens over substantially all of the Company’s and
each guarantor’s accounts and other receivables, chattel paper, deposit accounts and securities accounts, general intangibles,
instruments, investment property, commercial tort claims and letters of credit relating to the foregoing, along with books,
records and documents, and proceeds thereof, subject to certain exceptions (the "ABL Priority Collateral"), and a second
priority lien over substantially all of the Company’s and each guarantor’s other assets (including all of the capital stock of the
domestic guarantors), subject to certain exceptions (the "Term Priority Collateral"). The obligations of the UT Health East
Texas ABL Facility and obligations in excess of the maximum aggregate dollar cap amount permitted to be guaranteed by the
Tenants under the Term Loan B Facility and ABL Facilities, in each case, are not secured by the assets of the subsidiaries that
are also Tenants.
The Term Loan B Facility is secured by a first priority lien on the Term Priority Collateral and a second priority lien on the
ABL Priority Collateral. Certain excluded assets are not included in the Term Priority Collateral or the ABL Priority
Collateral. The obligations in excess of the maximum aggregate dollar cap amount permitted to be guaranteed by the Tenants
under the Term Loan B Facility and ABL Facilities, in each case, are not secured by the assets of the subsidiaries that are also
Tenants.
Subject to certain exceptions (including with regard to the ABL Priority Collateral), thresholds and reinvestment rights, the
Term Loan B Facility is subject to mandatory prepayments with respect to:
net cash proceeds of issuances of debt by AHP Health Partners or any of its restricted subsidiaries that are not
permitted by the Term Loan B Facility;
subject to certain thresholds, reinvestment permissions and carve-outs,100% (with step-downs to 50% and 0%,
based upon achievement of specified senior secured net leverage ratio levels) of net cash proceeds of certain asset
sales;
subject to certain thresholds, reinvestment permissions and carve-outs,100% (with step-downs to 50% and 0%,
based upon achievement of specified senior secured net leverage ratio levels) of net cash proceeds of certain
insurance and condemnation events;
50% (with step-downs to 25% and 0%, based upon achievement of specified senior secured net leverage ratio levels)
of annual excess cash flow, net of certain voluntary prepayments of secured indebtedness, of AHP Health Partners
and its subsidiaries commencing with the fiscal year ending December 31, 2022; and
net cash proceeds received in connection with any exercise of the purchase option of the loans by Ventas under the
Relative Rights Agreement.
5.75% Senior Notes due 2029
On July 8, 2021, AHP Health Partners (the"Issuer") issued the 5.75% Senior Notes, which mature on July 15, 2029, pursuant
to an indenture (the"2029 Notes Indenture"). The 2029 Notes Indenture provides that the 5.75% Senior Notes are general
senior unsecured obligations of the Issuer and are unconditionally guaranteed on a senior unsecured basisby the Company
and certain subsidiaries of the Issuer. In addition, the guarantees of the Tenants are subject to an aggregate dollar cap amount.
The 5.75% Senior Notes are subordinate to the Senior Secured Credit Facilities.
The 5.75% Senior Notes bear interest at a rate of 5.75% per annum, which is payable semi-annually, in cash in arrears, on
January 15 and July 15 of each year.
The Issuermay redeem the 5.75% Senior Notes, in whole or in part, at any time and from time to time, at the redemption
prices set forth below, plus accrued and unpaid interest, if any, to the redemption date, subject to compliance with certain
conditions:
| Date (if redeemed during the 12 month period beginning on July 15 of the years indicated below) | Percentage |
|---|---|
| 2025 | 101.438% |
| 2026 and thereafter | 100.000% |
If the Issuer experiences certain change of control events, the Issuer must offer to repurchase all of the 5.75% Senior Notes
(unless otherwise redeemed) at a price equal to 101% of the principal amount thereof, plus accrued and unpaid interest, if
any, to the repurchase date. If the Issuer sells certain assets and does not reinvest the net proceeds or repay senior debt in
compliance with the 2029 Notes Indenture, it must offer to repurchase the 5.75% Senior Notes at 100% of the principal
amount thereof, plus accrued and unpaid interest, if any, to the repurchase date.
Future Installments
Future installments of long-term debt at September 30, 2025, excluding unamortized discounts and unamortized deferred
financing costs, are as follows (in thousands):
| 2025 (remaining three months) | $7,744 |
| 2026 | 23,467 |
| 2027 | 15,127 |
| 2028 | 12,552 |
| 2029 | 311,567 |
| Thereafter | 753,447 |
| Total | $1,123,904 |
- Interest Rate Swap Agreements
Market risks relating to the Company’s operations result primarily from changes in interest rates. The Company’s exposure to
interest rate risk results from the entry into financial debt instruments that arose from transactions entered into during the
normal course of business. As part of an overall risk management program, the Company evaluates and manages exposure to
changes in interest rates on an ongoing basis. The Company has no intention of entering into financial derivative contracts,
other than to hedge a specific financial risk. To mitigate the Company’s exposure to fluctuations in interest rates, the
Company uses pay-fixed interest rate swaps, generally designated as cash flow hedges of interest payments on floating rate
borrowings. Pay-fixed swaps effectively convert floating-rate borrowings to fixed-rate borrowings. Unrealized gains or losses
from the designated cash flow hedges and related tax effects are deferred in accumulated other comprehensive income
("AOCI") and recognized in earnings as the interest payments occur. Hedges and derivative financial instruments may
continue to be used in the future in order to manage interest rate exposure.
The Company has entered into interest rate swap agreements to manage its exposure to fluctuations in interest rates. The
valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow
analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives,
including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied
volatilities. The Company has determined the inputs used to value its derivatives fall within Level 2 of the fair value
hierarchy.
On October 8, 2021, the Company executed interest rate swap agreements (the"October 2021 Agreements") with Barclays
Bank PLC and Bank of America, N.A. as counterparties, with initial notional amounts totaling$529.0 million and an
effective date of August 31, 2023 and expiring June 30, 2026. The notional amounts decline over time until expiration. Under
the October 2021 Agreements, the Company was required to make monthly fixed rate payments at annual rates ranging from
1.53% to 1.55%, and the counterparties were obligated to make monthly floating rate payments to the Company based on
one-month LIBOR, each subject to a floor of 0.50%. Effective August 31, 2023, the Company amended the October 2021
Agreements to adjust the fixed rates and replace the LIBOR floating interest rate options with Term SOFR floating rate
options. Under the amended October 2021 Agreements, the Company is required to make monthly fixed rate payments at
annual rates ranging from 1.47% to 1.48%, and the counterparties are obligated to make monthly floating rate payments to
the Company based on one-month Term SOFR, each subject to a floor of 0.39%. As of September 30, 2025, the notional
amounts under the October 2021 Agreements were$398.4 million.
On February 5, 2025, the Company executed new interest rate swap agreements (the "February 2025 Agreements") with
Truist Bank and Royal Bank of Canada, as counterparties, with an effective date of June 30, 2025 and expiring June 26, 2029.
As of the effective date, the notional amounts totaled$0.6 million, and will accrete up to$400.4 million by June 30, 2026,
when the October 2021 Agreements expire. Under the February 2025 Agreements, the Company is required to make monthly
fixed payments at annual rates ranging from 3.97% to 3.98% and the counterparties are required to make monthly floating
rate payments to the Company based on one-month Term SOFR, each subject to a floor of 0.50%. As of September 30, 2025,
the notional amounts under the February 2025 Agreements were$2.0 million.
The Company accounts for its interest rate swap agreements in accordance with ASC 815, Derivatives and Hedging. The
October 2021 Agreements and February 2025 Agreements are designated as cash flow hedges and recorded at fair value on
the Company’s unaudited condensed consolidated balance sheets with changes in fair value included in AOCI as a
component of equity and reclassified into interest expense in the same periods during which the hedge transactions affect
earnings.
The Company performs assessments of effectiveness for its cash flow hedges on a quarterly basis to confirm that the hedges
continue to meet the highly effective criteria required to continue applying cash flow hedge accounting. During thenine
months ended September 30, 2025 and the year ended December 31, 2024, these hedges were highly effective. Accordingly,
no unrealized gain or loss related to these hedges was reflected in the accompanying unaudited condensed consolidated
income statements, and the change in fair value was included in AOCI as a component of equity. Realized gains and losses
during the periods have been reclassified from AOCI to interest expense.
The following table presents the effects of derivatives in cash flow hedging relationships on the Company’s AOCI and
earnings (in thousands):
| Three Months Ended September 30, · Nine Months Ended September 30, | ||||||||
|---|---|---|---|---|---|---|---|---|
| Classification · 2025 · 2024 · 2025 · 2024 | ||||||||
| Unrealized (loss) income recognized | AOCI | $(110) | $(5,062) | $(8,056) | $3,077 | |||
| Reclassification from AOCI into earnings | Interest expense, net | (2,919) | (5,118) | (8,684) | (15,357) | |||
| Net change in AOCI | $(3,029) | $(10,180) | $(16,740) | $(12,280) | ||||
In the 12 months following September 30, 2025, the Company estimates that an additional$3.9 million will be reclassified as
a reduction to interest expense.
As of September 30, 2025 and December 31, 2024, the fair value of the Company’s interest rate swap agreements reflected a
net liability balance of$3.6 million and anet asset balance of$13.2 million, respectively. The following table presents the
fair value of the Company’s interest rate swap agreements as recorded in the unaudited condensed consolidated balance
sheets (in thousands):
| Classification | September 30, 2025 | December 31, 2024 |
|---|---|---|
| Assets: | ||
| Other current assets | $4,879 | $9,914 |
| Other assets | — | 3,264 |
| Total interest rate swap assets | 4,879 | 13,178 |
| Liabilities: | ||
| Other accrued expenses and liabilities | 971 | — |
| Other long-term liabilities | 7,470 | — |
| Total interest rate swap liabilities | 8,441 | — |
| Fair value of interest rate swap agreements | $(3,562) | $13,178 |
- Income Taxes
On July 4, 2025, the One Big Beautiful Bill Act ("OBBBA") was enacted, resulting in changes to the U.S. federal tax law.
Under ASC 740, Income Taxes, the effect of tax law changes are required to be recognized in the reporting period of
enactment, which is the three months ended September 30, 2025. Provisions of the OBBBA that will impact the Company
include (i) the return to the EBITDA formula used to calculate the business interest expense limitation under Internal
Revenue Code ("IRC") Section 163(j) and (ii) the allowance of 100% bonus depreciation for qualifying property placed in
service after January 19, 2025. The provisions of the OBBBA will reduce the Company's current tax liability, but are not
expected to have a material impact on the Company's current year tax expense.
The Company’s income tax provision was a benefit of$3.4 million, which equates to an effective tax rate of 154.8%, and
expense of$11.1 million, which equates to aneffective tax rate of 19.4%, for the three months ended September 30, 2025 and
2024, respectively. The increase in the effective tax rate was due to an increase in noncontrolling interest earnings as a
percentage of pre-tax income (loss). The Company’s income tax provision was an expense of$38.1 million, which equates to
an effective tax rate of 19.6%, and$37.0 million, which equates to an effective tax rate of 18.9%, for thenine months ended
The Company follows the provisions of ASC 740, Income Taxes, regarding unrecognized tax benefits. At September 30,
2025 and December 31,2024, the Company hadno accrual for unrecognized tax benefits.
As of September 30, 2025, the Company had no ongoing or pending federal examinations for prior years. The Company has
outstanding federal income tax refund claims for the 2016 and 2018 tax years. At September 30, 2025, the refund claims
totaled$10.0 million and were included in other current assets on the Company’sunaudited condensed consolidated balance
sheet. These refund claims are subject to ongoing Joint Committee on Taxation reviews, as well as a statute waiver through
December 31, 2026 that has been agreed to for the years 2016 through 2018. At September 30, 2025, interest income
receivable related to the refund claim totaled $1.9 million, which was included in other current assets. During thenine months
ended September 30, 2025, the Company accrued$1.1 million of interest income related to the refund claim, which was
included in the Company's income tax expense. The Company’s tax years from 2021 through 2024 remain open to
examination by federal and state taxing authorities.
- Self-Insured Liabilities
The liabilities for professional, general, workers’ compensation and occupational injury liability risks are based on actuarially
determined estimates. Liabilities for professional, general, workers’ compensation and occupational injury liability risks
represent the estimated ultimate cost of all reported and unreported losses incurred through the respective balance sheet dates.
The Company provides an accrual for actuarially determined claims reported but not paid and estimates of claims incurred
but not reported.
Professional and General Liability
The total costs for professional and general liability losses are based on the Company’s premiums and retention costs, and
were$64.2 million and$15.6 million for the three months ended September 30, 2025 and 2024, respectively, and$105.5
million and$50.5 million for thenine months ended September 30, 2025 and 2024, respectively. The Company experienced
an increase in its expense for professional and general liability insurance during the three andnine months ended September
30, 2025 primarily as a result of recording an accrual for loss contingencies associated with adverse claim developments in its
New Mexico market as described further in Note 9, Commitments and Contingencies.
Workers' Compensation and Occupational Injury Liability
The total costs for workers’ compensation liability insurance are based on the Company’s premiums and retention costs, and
were$2.4 million for each of the three months ended September 30, 2025 and 2024, and$2.9 million and$5.7 million for
thenine months ended September 30, 2025 and 2024, respectively.
- Employee Benefit Plans
Defined Contribution Plan
The Company maintains defined contribution retirement plans that cover its eligible employees. The Company incurred total
costs related to the retirement plans of$12.5 million and$11.2 million for the three months ended September 30, 2025 and
2024, respectively, and$40.3 million and$36.2 million for thenine months ended September 30, 2025 and 2024,
Employee Health Plan
The Company maintains a self-insured medical and dental plan for substantially all of its employees. The Company's reserve
for employee health costs includes amounts for reported claims, which are accrued upon occurrence, as well as a provision
for incurred but not reported claims, which areestimated based on an average lag time and experience. Accruals are based on
the estimated ultimate cost of settlement, including claim settlement expenses.
The total costs of employee health coverage were$49.7 million and$47.2 million for the three months ended September 30,
2025 and 2024, respectively, and$139.7 million and$133.9 million for thenine months ended September 30, 2025 and 2024,
- Commitments and Contingencies
Professional Liability Claims
In connection with the Company’s periodic review of its professional liability accrual, with input from its third-party actuary,
management considered the increasingly hostile medical malpractice environment, recent increases in settlement payments,
and individual accruals for unresolved prior period claims. The emergence of adverse prior period claim developments,
particularly with respect to the Company’s New Mexico market, combined with increased social inflationary pressures,
resulted in an increase in the Company’s professional liability reserves of$47.2 million as of September 30, 2025. The
increase in the Company’s professional liability reserves was primarily attributable to recent settlements and ongoing
litigation arising from a single provider who was employed between 2019 and 2022. Management considers the impact of
recent claim developments, actuarial inputs, advice of legal counsel, and other information pertinent to the matter to accrue
an estimate for contingent liabilities when losses are both probable and reasonably estimable.
Litigation and Regulatory Matters
From time to time, claims and suits arise in the ordinary course of the Company’s business. The Company has been, is
currently, and may in the future be subject to claims, lawsuits, qui tam actions, civil investigative demands, subpoenas,
investigations, audits and other inquiries related to its operations. In certain of these actions, plaintiffs request punitive or
other damages against the Company that may not be covered by insurance. These claims, lawsuits, and proceedings are in
various stages of adjudication or investigation and involve a wide variety of claims and potential outcomes. Depending on
whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution
could have a material adverse effect on the Company’s results of operations, financial position or liquidity.
The Company records accruals for such contingencies to the extent that the Company concludes it is probable that a liability
has been incurred and the amount of the loss can be reasonably estimated. Apart from ongoing litigation associated with
unresolved professional liability claims as described above, management does not believe that the Company is party to any
proceeding that, either individually or in the aggregate, could have a material adverse effect on its business, financial
condition, results of operations or liquidity. However, in light of the inherent uncertainties involved, it is possible that the
settlement of these unresolved claims could have a material adverse impact on the Company’s future results of operations,
financial position, or liquidity.
In November 2023, the Company determined that a ransomware cybersecurity incident had impacted and disrupted a number
of the Company’s operational and information technology systems (the "Cybersecurity Incident"). During this time, the
Company’s hospitals remained operational and continued to deliver patient care utilizing established downtime procedures.
The Company immediately suspended user access to impacted information technology applications, executed cybersecurity
protection protocols, and took steps to restrict further unauthorized activity. Additionally, because of the time taken to contain
and remediate the Cybersecurity Incident, online electronic billing systems were not functioning at their full capacities and
certain billing, reimbursement and payment functions were delayed, which had an adverse impact on the Company’s results
of operations and cash flows for 2023 and the first quarter of 2024.
As a result of the Cybersecurity Incident, three putative class actions were filed against the Company in the U.S. District
Court for the Middle District of Tennessee: Burke v. AHS Medical Holdings LLC, No. 3:23-cv-01308; Redd v. AHS Medical
Holdings, LLC, No. 3:23-cv-01342; and Epperson v. AHS Management Company, Inc., No. 3:24-cv-00396. These cases
were consolidated by the District Court on April 24, 2024, under the caption Hodge v. AHS Management Company, Inc., No.
3:23-cv-01308 (M.D. Tenn.). The complaint for the consolidated class action, filed on behalf of approximately 38,000
individuals who alleged their personal information and protected health information were affected by the Cybersecurity
Incident, generally asserted state common law claims of negligence, breach of implied contract, unjust enrichment, breach of
fiduciary duty, and invasion of privacy with respect to how the Company managed sensitive data. On October 4, 2024, the
Company executed a settlement agreement to resolve the consolidated class action litigation. On October 9, 2024, the District
Court preliminarily approved the settlement. Plaintiffs filed a Motion for Final Approval of the Settlement ("Motion for Final
Approval"), which the Company did not oppose. Following a hearing on the Motion for Final Approval that was conducted
on August 1, 2025, the Court ordered class counsel, the settlement administrator and the Company to implement the agreed
upon settlement of the consolidated case. Pursuant to the settlement, the Company will make settlement payments, the total of
which will not have a material impact on the Company’s results of operations, financial position orliquidity. Upon entry of
the Final Order, the clerk was ordered to close the case.
During thenine months ended September 30, 2025, the Company received$21.5 million of business insurance recovery
proceeds related to the Cybersecurity Incident, all of which was included in other non-operating gains on the Company's
condensed consolidated income statement. No business insurance recovery proceeds related to the Cybersecurity Incident
were received during the three months ended September 30, 2025.
Acquisitions
The Company has acquired, and plans to continue to acquire, businesses with prior operating histories. Acquired companies
may have unknown or contingent liabilities, including liabilities for failure to comply with healthcare laws and regulations,
such as billing and reimbursement, fraud and abuse and anti-kickback laws. The Company has from time to time identified
certain past practices of acquired companies that do not conform to its standards. Although the Company institutes policies
designed to conform such practices to its standards following completion of acquisitions, there can be no assurance that the
Company will not become liable for the past activities of these acquired facilities that may later be asserted to be improper by
private plaintiffs or government agencies. Although the Company generally seeks to obtain indemnification from prospective
sellers covering such matters, there can be no assurance that any such matter will be covered by indemnification or, if
covered, that such indemnification will be adequate to cover potential losses and fines.
- Segments
The Company hasone reportable segment, which is healthcare services. The healthcare services segment generates revenues
by delivering care to its customers, or patients, through its integrated network of hospitals, ambulatory facilities, and
physician practices. The Company's Chief Operating Decision Maker ("CODM") is its President and Chief Executive Officer,
who regularly reviews financial operating results on a consolidated basis for purposes of allocating resources and evaluating
financial performance. The Company’s CODM manages the operations on a consolidated basis to make decisions about
overall company resource allocation and to assess overall company performance.
The CODM’s assessment of segment performance and allocation of segment resources is based on consolidated net income
attributable to Ardent Health, Inc. The CODM uses this consolidated profitability measure to monitor budget versus actual
results, compare Company profitability period-over-period and make capital investment decisions.
The following table presents the composition of consolidated net(loss) income attributable to Ardent Health, Inc. for the
healthcare services segment, including significant expenses that are regularly provided to and reviewed by the CODM (in
thousands):
| Three Months Ended September 30, · Nine Months Ended September 30, | ||||
|---|---|---|---|---|
| 2025 · 2024 · 2025 · 2024 | ||||
| Total revenue | $1,576,746 | $1,449,817 | $4,719,260 | $4,359,783 |
| Less: | ||||
| Employee salaries and benefits | 652,993 | 610,724 | 1,932,237 | 1,802,053 |
| Contract labor | 23,969 | 24,499 | 74,074 | 78,737 |
| Supplies | 275,881 | 251,862 | 805,375 | 769,034 |
| Medical professional fees | 121,901 | 101,004 | 338,103 | 295,295 |
| Contract services | 183,182 | 173,219 | 544,849 | 515,525 |
| Other segment items (1) | 342,298 | 262,187 | 933,767 | 803,000 |
| Net (loss) income attributable to Ardent Health, Inc. | $(23,478) | $26,322 | $90,855 | $96,139 |
| (1) | Other segment items included in net (loss) income attributable to Ardent Health, Inc. for each of the periods presented primarily consists of rent expense, interest expense, depreciation and amortization, income tax (benefit) expense, other operating expenses, loss on extinguishment and modification of debt, other non-operating losses (gains) and net income attributable to noncontrolling interests. | |||
The measure of segment assets is reported on the unaudited condensed consolidated balance sheets as total consolidated
assets. The accounting policies for the segment are consistent with the consolidated accounting policies provided in Note 2.
As of September 30, 2025 and December 31, 2024, all of the Company’s long-lived assets were located in the United States,
and for thethree and nine months ended September 30, 2025 and 2024, all revenue was earned in the United States.
- Earnings Per Share
Basic netincome (loss) per share is computed by dividing netincome (loss) attributable to common stockholders by the
weighted-average number of common shares outstanding. Diluted netincome (loss) per share is computed by dividing net
income (loss) attributable to common stockholders by the weighted-average number of common shares outstanding plus the
dilutive effect of outstanding securities, and such dilutive effect is computed using the treasury stock method.
The following table sets forth the computation of basic and diluted net(loss) income per share (in thousands, except share
and per share amounts):
| Three Months Ended September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Basic: | ||||
| Net (loss) income attributable to common stockholders | $(23,478) | $26,322 | $90,855 | $96,139 |
| Weighted-average number of common shares | 141,226,862 | 137,107,595 | 140,569,409 | 129,877,510 |
| Net (loss) income per common share | $(0.17) | $0.19 | $0.65 | $0.74 |
| Diluted: | ||||
| Net (loss) income attributable to common stockholders | $(23,478) | $26,322 | $90,855 | $96,139 |
| Weighted-average number of common shares | 141,226,862 | 137,542,995 | 141,242,065 | 130,022,643 |
| Net (loss) income per common share | $(0.17) | $0.19 | $0.64 | $0.74 |
The following table sets forth the components of the denominator for the computation of basic and diluted net(loss) income
per share for net(loss) income attributable to Ardent Health, Inc. stockholders:
| Three Months Ended September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Weighted-average number of common shares - basic | 141,226,862 | 137,107,595 | 140,569,409 | 129,877,510 |
| Effect of dilutive securities(1) | — | 435,400 | 672,656 | 145,133 |
| Weighted-average number of common shares - diluted | 141,226,862 | 137,542,995 | 141,242,065 | 130,022,643 |
(1)The effect of dilutive securities does not reflect weighted-average potential common shares from restricted stock and restricted stock units of
3,034,583 and 379,437 for thethree months ended September 30, 2025 and 2024, respectively, and 1,439,373 and 126,479 for thenine months ended
September 30, 2025 and 2024, respectively, because their effect was antidilutive as calculated under the treasury stock method.
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.