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Ardent Health Reports Third Quarter 2025 Results

Ardent Health, Inc. (NYSE: ARDT) ("Ardent Health" or the "Company"), a leading provider of healthcare in growing mid-sized urban communities across the U.S., today announced results for the quarter ended September 30, 2025.

Third Quarter 2025 Operating and Financial Summary

All comparisons are versus the same prior year period. See the footnotes to the Operating Statistics table of this press release for definitions of the metrics below and a full list of key operating metrics.

Total Revenue

$1.58 billion

8.8% growth Y/Y

Net Loss Attributable

to Ardent Health

$23 million

Adjusted EBITDA(1)

$143 million

46.3% growth Y/Y

Adjusted EBITDAR(1)

$184 million

Admissions

5.8% growth Y/Y

Adjusted Admissions

2.9% growth Y/Y

Net Patient Service Revenue

per Adjusted Admission

5.8% growth Y/Y

Revising 2025 Adjusted EBITDA(1) Guidance

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

Revising Adjusted EBITDA(1): $530 - $555 million

(1)

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" and reconciliations of non-GAAP measures to their most comparable GAAP financial measures contained later in this press release.

Third Quarter 2025 Results Commentary

  • "Our third quarter results reflect a continuation of the strong demand trends we saw in the first half of 2025," stated Marty Bonick, President and Chief Executive Officer of Ardent Health. “Admissions grew 5.8%, adjusted admissions increased 2.9% (near the high end of our 2025 guidance of 2-3%), and total surgeries turned positive for the first time this year, rising 1.4%. Additionally, revenue and adjusted EBITDA increased 9% and 46%, respectively, and year-to-date adjusted EBITDA through the third quarter grew 30%. Ardent generated strong operating cash flow of $154 million in 3Q25 compared to $90 million in 3Q24."
  • "While we continue to execute on our strategic priorities, certain industry headwinds are persisting more than anticipated," added Bonick. "We expected Professional Fee expense growth to moderate this year to the upper-single digit range. First half 2025 results were consistent with that, but Professional Fee growth accelerated to 11% in the third quarter. Additionally, payor denials were more pronounced in the third quarter. These dynamics drove a shortfall to our third quarter adjusted EBITDA projections and we expect fourth quarter earnings to be below our original targets. As a result, we are updating 2025 adjusted EBITDA guidance to $530 - $555 million."
  • "As part of our IMPACT program, we are taking deliberate, measurable actions to mitigate these industry pressures," continued Bonick. "The company has already undertaken a workforce optimization program and renegotiated key contracts, including with certain payors and agency labor that will start to benefit earnings in the fourth quarter. We have also launched focused initiatives in precision staffing, supply chain discipline, and OR excellence."
  • "We remain confident in our ability to deliver long-term shareholder value while effectively managing near-term challenges,” stated Bonick. “Our updated 2025 guidance implies revenue and adjusted EBITDA growth of 6% and 9%, respectively, and we are generating significant cash flow. Over the longer-term, Ardent is well positioned to continue growing adjusted EBITDA and expanding margins driven by key pillars including: durable demand, operational efficiencies captured by our IMPACT program, and capital deployment supported by our strong balance sheet with over $600 million of cash and net leverage of 2.5x."

 

Financial Performance Summary

For the third quarter of 2025:

  • Total revenue grew 8.8% year-over-year to $1,577 million. The growth in total revenue resulted primarily from a 2.9% increase in adjusted admissions and 5.8% growth in net patient service revenue per adjusted admission year-over-year. Excluding the impact of a $43 million reduction to revenue resulting from a change in accounting estimate, as discussed below, total revenue grew 11.7% year-over-year.
  • Net loss attributable to Ardent Health was $23 million, or $0.17 per diluted share, compared to net income attributable to Ardent Health of $26 million, or $0.19 per diluted share, in the third quarter of 2024.
  • Adjusted EBITDA increased 46.3% year-over-year to $143 million.

Two non-recurring items impacted reported third quarter 2025 financial results:

  • During the third quarter, 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 $43 million. During the quarter, 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 $43 million adjustment is reflected in total revenue for the quarter but excluded from adjusted EBITDA.
  • During the third quarter, the Company recorded an increase to its professional liability reserves as part of its periodic review of professional liability claims, with input from its third-party actuary. The increase in reserves included an adjustment of $54 million attributable to the emergence of adverse prior period claim developments with respect to recent settlements and ongoing litigation arising from a limited set of claims between 2019 and 2022 in New Mexico for a single provider who the Company no longer employs, as well as consideration of broader industry trends, including social inflationary pressures. The $54 million adjustment attributable to New Mexico is excluded from adjusted EBITDA.

Operating Performance Summary

The following table provides a summary of certain key operating metrics for the third quarter of 2025 compared to the same prior year period. See the footnotes to the Operating Statistics table of this press release for definitions of the metrics below and a full list of key operating metrics.

 

Three Months Ended September 30,

(Unaudited)

 

2025

 

 

2024

 

% Change

Adjusted admissions

 

89,328

 

 

86,833

 

2.9

%

Admissions

 

41,862

 

 

39,568

 

5.8

%

Inpatient surgeries

 

9,732

 

 

8,871

 

9.7

%

Outpatient surgeries

 

22,813

 

 

23,220

 

(1.8

%)

Total surgeries

 

32,545

 

 

32,091

 

1.4

%

Emergency room visits

 

161,198

 

 

161,343

 

(0.1

%)

Net patient service revenue per adjusted admission

$

17,252

 

$

16,312

 

5.8

%

  • Admissions for the third quarter of 2025 increased 5.8% year-over-year, driven by strong inpatient surgery growth.
  • Surgeries for the third quarter of 2025 increased 1.4% year-over-year, a modest improvement from declines of 0.7% and 0.2% in the first and second quarters of 2025, respectively. The total surgery year-over-year increase of 1.4% in the third quarter of 2025 reflected inpatient surgery growth of 9.7% and an outpatient surgery decline of 1.8%.

Balance Sheet, Cash Flow & Liquidity Update

As of September 30, 2025, the Company had total cash and cash equivalents of $609 million and total debt of $1.1 billion. The Company’s net leverage ratio as of September 30, 2025 was 1.0x, as calculated under the Company's credit agreements, and its lease-adjusted net leverage ratio1 was 2.5x, an improvement from 2.7x as of June 30, 2025. At the end of the third quarter, the Company’s available liquidity was $904 million.

During the third quarter of 2025, net cash provided by operating activities was $154 million, compared to $90 million in the same prior year period.

________________________________

1

Lease-adjusted net leverage ratio is defined as the Company's net debt as of September 30, 2025, plus 8x trailing twelve-month real estate investment trust ("REIT") rent expense as of the end of the third quarter of 2025, divided by trailing twelve-month Adjusted EBITDAR as of September 30, 2025.

2025 Financial Guidance

The Company is reaffirming its full-year 2025 revenue guidance, which at the midpoint is an increase of 6% from 2024.

The Company now expects full-year 2025 adjusted EBITDA of $530 - $555 million, which at the midpoint is an increase of 9% from 2024. The updated guidance primarily reflects higher Professional Fee expenses and a higher level of payor denials for the second half of 2025. The accounts receivable and professional liability reserve adjustments were not a factor in revising adjusted EBITDA guidance.

All guidance is current as of the time provided and is subject to change.

 

Full Year 2025 Guidance

(Dollars in millions, except per share amount)

Previous Guidance

 

New Guidance

Total revenue

$6,200

$6,450

 

$6,200

$6,450

Net income attributable to Ardent Health, Inc.

$245

$285

 

$121

$146

Adjusted EBITDA

$575

$615

 

$530

$555

Rent expense payable to REITs

$164

$164

 

$164

$164

Diluted earnings per share

$1.73

$2.01

 

$0.85

$1.03

Adjusted admissions growth

2.0%

3.0%

 

2.0%

3.0%

Net patient service revenue per adjusted admission growth

2.1%

4.4%

 

2.1%

4.4%

Capital expenditures

$215

$235

 

$215

$235

The Company’s guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks, including those set forth below under the heading "Forward-Looking Statements." The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets. The Company does not believe that it can forecast these items with sufficient accuracy because of the inherent difficulty of forecasting the timing or amount of various items that have not yet occurred and are out of the Company’s control or cannot be reasonably predicted.

Third Quarter 2025 Results Conference Call

The Company will host a conference call to discuss its third quarter financial results on November 13, 2025, at 9:00 a.m. Eastern Time. A webcast of the conference call will be available in the Investor Relations section of the Company’s corporate website at https://ir.ardenthealth.com. To listen to a live broadcast, go to the site at least 15 minutes prior to the scheduled start time in order to register, download, and install any necessary audio software.

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 November 27, 2025:

United States Replay:

1-800-770-2030

International Replay:

1-609-800-9909

Access Code:

4437657

About Ardent Health

Ardent Health (NYSE: ARDT) is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, the Company delivers care through a system of 30 acute care hospitals and approximately 280 sites of care with over 1,900 employed and affiliated providers across six states. For more information, please visit ardenthealth.com.

Supplemental Non-GAAP Financial Information

We have included certain non-GAAP financial measures in this press release, including Adjusted EBITDA, Adjusted EBITDA margin, and Adjusted EBITDAR. We define these terms as follows:

  • Adjusted EBITDA and Adjusted EBITDA Margin. Adjusted EBITDA is defined as net income plus (i) provision for income taxes, (ii) interest expense and (iii) depreciation and amortization expense (or EBITDA), as adjusted to deduct noncontrolling interest earnings, and excludes the effects of loss on extinguishment and modification of debt; other non-operating losses (gains); recoveries from the cybersecurity incident in November 2023 (the "Cybersecurity Incident"), net of incremental information technology and litigation costs; restructuring, exit and acquisition-related costs; change in accounting estimate; New Mexico professional liability accrual; expenses incurred in connection with the implementation of our integrated health information technology system provided by Epic Systems; equity-based compensation expense; and (income) loss from disposed operations. Adjusted EBITDA margin is defined as Adjusted EBITDA divided by total revenue.



    Adjusted EBITDA and Adjusted EBITDA margin are non-GAAP performance measures used by our management and external users of our financial statements, such as investors, analysts, lenders, rating agencies and other interested parties, to evaluate companies in our industry. Adjusted EBITDA and Adjusted EBITDA margin are performance measures that are not prepared in accordance with GAAP and are presented in this press release because our management considers them important analytical indicators commonly used within the healthcare industry to evaluate financial performance and allocate resources. Further, our management believes that Adjusted EBITDA and Adjusted EBITDA margin are useful financial metrics to assess our operating performance from period to period by excluding certain material non-cash items and unusual or non-recurring items that we do not expect to continue in the future and certain other adjustments we believe are not reflective of our ongoing operations and our performance.



    Because not all companies use identical calculations, our presentation of Adjusted EBITDA and Adjusted EBITDA margin may not be comparable to other similarly titled measures of other companies. While we believe these are useful supplemental performance measures for investors and other users of our financial information, you should not consider Adjusted EBITDA and Adjusted EBITDA margin in isolation or as a substitute for net income or any other items calculated in accordance with GAAP. Adjusted EBITDA and Adjusted EBITDA margin have inherent material limitations as performance measures, because they add back certain expenses to net income, resulting in those expenses not being taken into account in the performance measures. We have borrowed money, so interest expense is a necessary element of our costs. Because we have material capital and intangible assets, depreciation and amortization expense are necessary elements of our costs. Likewise, the payment of taxes is a necessary element of our operations. Because Adjusted EBITDA and Adjusted EBITDA margin exclude these and other items, they have material limitations as measures of our performance.

  • Adjusted EBITDAR. Adjusted EBITDAR is defined as Adjusted EBITDA further adjusted to add back rent expense payable to REITs, which consists of rent expense pursuant to the master lease agreement (the "Ventas Master Lease") with Ventas, Inc. ("Ventas"), lease agreements associated with the MOB Transactions (defined below) and a lease arrangement with Medical Properties Trust, Inc. ("MPT") for the Hackensack Meridian Mountainside Medical Center.



    Adjusted EBITDAR is a commonly used non-GAAP valuation measure used by our management, research analysts, investors and other interested parties to evaluate and compare the enterprise value of different companies in our industry. Adjusted EBITDAR excludes: (1) certain material noncash items and unusual or non-recurring items that we do not expect to continue in the future; (2) certain other adjustments that do not impact our enterprise value; and (3) rent expense payable to our REITs. We operate 30 acute care hospitals, 12 of which we lease from two REITs, Ventas and MPT, pursuant to long-term lease agreements. Additionally, during 2022, we completed the sale of 18 medical office buildings to Ventas in exchange for $204.0 million and concurrently entered into agreements to lease the real estate back from Ventas over a 12-year initial term with eight options to renew for additional five-year terms (the "MOB Transactions"). Our management views the long-term lease agreements with Ventas and MPT, as well as the MOB Transactions, as more like financing arrangements than true operating leases, with the rent payable to such REITs being similar to interest expense. As a result, our capital structure is different than many of our competitors, especially those whose real estate portfolio is predominately owned and not leased. Excluding the rent payable to such REITs allows investors to compare our enterprise value to those of other healthcare companies without regard to differences in capital structures, leasing arrangements and geographic markets, which can vary significantly among companies. Our management also uses Adjusted EBITDAR as one measure in determining the value of prospective acquisitions or divestitures. Finally, financial covenants in certain of our lease agreements, including the Ventas Master Lease, use Adjusted EBITDAR as a measure of compliance. Adjusted EBITDAR does not reflect our cash requirements for leasing commitments. As such, our presentation of Adjusted EBITDAR should not be construed as a performance or liquidity measure.



    Because not all companies use identical calculations, our presentation of Adjusted EBITDAR may not be comparable to other similarly titled measures of other companies. While we believe this is a useful supplemental valuation measure for investors and other users of our financial information, you should not consider Adjusted EBITDAR in isolation or as a substitute for net income or any other items calculated in accordance with GAAP. Adjusted EBITDAR has inherent material limitations as a valuation measure, because it adds back certain expenses to net income, resulting in those expenses not being taken into account in the valuation measure. The payment of taxes and rent is a necessary element of our valuation. Because Adjusted EBITDAR excludes these and other items, it has material limitations as a measure of our valuation.

Forward-Looking Statements

This press release contains "forward-looking statements" as that term is defined in the U.S. federal securities laws. These forward-looking statements include, but are not limited to, statements other than statements of historical facts, including, among others, statements relating to our future financial performance, our business prospects and strategy, anticipated financial position, liquidity and capital needs, the industry in which we operate and other similar matters. Words such as "anticipates," "expects," "intends," "plans," "predicts," "believes," "seeks," "estimates," "could," "would," "will," "may," "can," "continue," "potential," "should" and the negative of these terms or other comparable terminology often identify forward-looking statements. These forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties that could cause actual results to differ materially from the results contemplated by the forward-looking statements. Factors, risks, and uncertainties that could cause actual outcomes and results to be materially different from those contemplated include, among others: (1) general economic and business conditions, both nationally and in the regions in which we operate, including the impact of challenging macroeconomic conditions and inflationary pressures, current geopolitical instability, and impacts from the imposition of, or changes in, tariffs, as well as the potential impact on us of the federal government shutdown or other uncertain political, financial, credit and capital conditions; (2) possible reductions or other changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs or state directed payments, that could have an adverse effect on our revenues and business; (3) reduction in the reimbursement rates paid by commercial payors, increased reimbursement denials or payment delays by commercial payors, our inability to retain and negotiate favorable contracts with private third party payors, or an increasing volume of uninsured or underinsured patients; (4) effects of changes in healthcare policy or legislation, including the One Big Beautiful Bill Act (the "OBBBA") and any other reforms that have or may be undertaken by the current presidential administration, and legal and regulatory restrictions on our hospitals that have physician owners; (5) the ability to achieve operating and financial targets, develop and execute mitigation plans to offset to the extent possible impacts from the OBBBA, the scheduled expiration of temporary enhanced subsidies for individuals eligible to purchase insurance coverage through health insurance marketplaces and imposition of tariffs, attain expected levels of patient volumes and revenues, and control the costs of providing services; (6) security threats, catastrophic events and other disruptions affecting our, our service providers’ or our joint venture ("JV") partners’ information technology and related systems, which have adversely affected, and could in the future adversely affect, our relationships with patients and business partners and subject us to legal claims and liabilities, reputational harm and business disruption and adversely affect our financial condition; (7) the highly competitive nature of the healthcare industry and continued industry trends towards clinical transparency and value-based purchasing may impact our competitive position; (8) inability to recruit and retain quality physicians, as well as increasing cost to contract with hospital-based physicians; (9) changes to physician utilization practices and treatment methodologies and other factors outside our control that impact demand for medical services and may reduce our revenues and ability to grow profitability; (10) the effects related to the sequestration spending reductions pursuant to both the Budget Control Act of 2011 and the Pay-As-You-Go Act of 2010 and the potential for future deficit reduction legislation; (11) continued industry trends toward value-based purchasing, third party payor consolidation and care coordination among healthcare providers; (12) inability to successfully complete acquisitions or strategic JVs or inability to realize all of the anticipated benefits; (13) liabilities because of professional liability and other claims brought against our hospitals, physician practices, outpatient facilities or other business operations; (14) exposure to certain risks and uncertainties by the JVs through which we conduct a significant portion of our operations, including anticipated synergies of past acquisitions and the risk that transactions may not receive necessary government clearances; (15) failure to obtain drugs and medical supplies at favorable prices or sufficient volumes; (16) operational, legal and financial risks associated with outsourcing functions to third parties; (17) our facilities are heavily concentrated in Texas and Oklahoma, which makes us sensitive to regulatory, economic and competitive conditions and changes in those states; (18) negative impact of severe weather, climate change, and other factors beyond our control, which could restrict patient access to care or cause one or more facilities to close temporarily or permanently; (19) risks related to the Master Lease with Ventas ("Ventas Master Lease") and its restrictions and limitations on our business; (20) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms; (21) our failure to comply with complex laws and regulations applicable to the healthcare industry or to adjust our operations in response to changing laws and regulations; (22) the impact of governmental claims or governmental investigations, payor audits and litigation brought against our hospitals, physician practices, outpatient facilities or other business operations; (23) actual or perceived failures to comply with applicable data protection, privacy and security laws, regulations, standards and other requirements; (24) the impact of a deterioration of public health conditions associated with a future pandemic, epidemic or outbreak of infectious disease; (25) inability to or delay in building, acquiring, selling, renovating or expanding our healthcare facilities; (26) failure to comply with federal and state laws relating to Medicare and Medicaid enrollment, permit, licensing and accreditation requirements; (27) the results of our efforts to use technology, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience; (28) our status as a controlled company; (29) conflicts of interest between our controlling stockholder and other holders of our common stock; and (30) other risk factors described in our filings with the Securities and Exchange Commission.

Many of the important factors that will determine these results are beyond our ability to control or predict. You are cautioned not to put undue reliance on any forward-looking statements, which speak only as of the date of this press release. Except as otherwise required by law, we do not assume any obligation to publicly update or release any revisions to these forward-looking statements to reflect events or circumstances after the date of this news release or to reflect the occurrence of unanticipated events. All references to "Company," "Ardent Health," "Ardent," "we," "our" and "us" as used throughout this release refer to Ardent Health, Inc. and its affiliates, unless stated otherwise or indicated by context.

Ardent Health, Inc.

Condensed Consolidated Income Statements

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

 

 

Three Months Ended September 30,

 

2025

 

2024

 

Amount

 

%

 

Amount

 

%

Total revenue

$

1,576,746

 

 

100.0

%

 

$

1,449,817

 

 

100.0

%

Expenses:

 

 

 

 

 

 

 

Salaries and benefits

 

676,962

 

 

42.9

%

 

 

635,223

 

 

43.8

%

Professional fees

 

305,083

 

 

19.3

%

 

 

274,223

 

 

18.9

%

Supplies

 

275,881

 

 

17.5

%

 

 

251,862

 

 

17.4

%

Rents and leases

 

26,386

 

 

1.7

%

 

 

26,410

 

 

1.8

%

Rents and leases, related party

 

38,106

 

 

2.4

%

 

 

37,249

 

 

2.6

%

Other operating expenses

 

198,714

 

 

12.6

%

 

 

117,700

 

 

8.2

%

Interest expense

 

13,914

 

 

0.9

%

 

 

14,629

 

 

1.0

%

Depreciation and amortization

 

39,156

 

 

2.5

%

 

 

36,771

 

 

2.5

%

Loss on extinguishment and modification of debt

 

7,344

 

 

0.5

%

 

 

1,898

 

 

0.1

%

Other non-operating gains

 

(2,597

)

 

(0.2

)%

 

 

(2,807

)

 

(0.2

)%

Total operating expenses

 

1,578,949

 

 

100.1

%

 

 

1,392,750

 

 

96.1

%

(Loss) income before income taxes

 

(2,203

)

 

(0.1

)%

 

 

57,067

 

 

3.9

%

Income tax (benefit) expense

 

(3,410

)

 

(0.2

)%

 

 

11,062

 

 

0.7

%

Net income

 

1,207

 

 

0.1

%

 

 

46,005

 

 

3.2

%

Net income attributable to noncontrolling interests

 

24,685

 

 

1.6

%

 

 

19,683

 

 

1.4

%

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

$

(23,478

)

 

(1.5

)%

 

$

26,322

 

 

1.8

%

 

 

 

 

 

 

 

 

Net (loss) income per share:

 

 

 

 

 

 

 

Basic

$

(0.17

)

 

 

 

$

0.19

 

 

 

Diluted

$

(0.17

)

 

 

 

$

0.19

 

 

 

Weighted-average common shares outstanding:

 

 

 

 

 

 

 

Basic

 

141,226,862

 

 

 

 

 

137,107,595

 

 

 

Diluted

 

141,226,862

 

 

 

 

 

137,542,995

 

 

 

Ardent Health, Inc.

Condensed Consolidated Income Statements

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

 

 

Nine Months Ended September 30,

 

2025

 

2024

 

Amount

 

%

 

Amount

 

%

Total revenue

$

4,719,260

 

 

100.0

%

 

$

4,359,783

 

 

100.0

%

Expenses:

 

 

 

 

 

 

 

Salaries and benefits

 

2,006,311

 

 

42.5

%

 

 

1,880,790

 

 

43.1

%

Professional fees

 

882,952

 

 

18.7

%

 

 

810,820

 

 

18.6

%

Supplies

 

805,375

 

 

17.1

%

 

 

769,034

 

 

17.6

%

Rents and leases

 

81,972

 

 

1.7

%

 

 

76,251

 

 

1.7

%

Rents and leases, related party

 

113,975

 

 

2.4

%

 

 

111,413

 

 

2.6

%

Other operating expenses

 

493,179

 

 

10.5

%

 

 

354,851

 

 

8.2

%

Interest expense

 

42,819

 

 

0.9

%

 

 

52,050

 

 

1.2

%

Depreciation and amortization

 

114,666

 

 

2.4

%

 

 

108,434

 

 

2.5

%

Loss on extinguishment and modification of debt

 

7,344

 

 

0.2

%

 

 

3,388

 

 

0.1

%

Other non-operating gains

 

(23,320

)

 

(0.5

)%

 

 

(3,062

)

 

(0.1

)%

Total operating expenses

 

4,525,273

 

 

95.9

%

 

 

4,163,969

 

 

95.5

%

Income before income taxes

 

193,987

 

 

4.1

%

 

 

195,814

 

 

4.5

%

Income tax expense

 

38,114

 

 

0.8

%

 

 

36,997

 

 

0.9

%

Net income

 

155,873

 

 

3.3

%

 

 

158,817

 

 

3.6

%

Net income attributable to noncontrolling interests

 

65,018

 

 

1.4

%

 

 

62,678

 

 

1.4

%

Net income attributable to Ardent Health, Inc.

$

90,855

 

 

1.9

%

 

$

96,139

 

 

2.2

%

 

 

 

 

 

 

 

 

Net income per share:

 

 

 

 

 

 

 

Basic

$

0.65

 

 

 

 

$

0.74

 

 

 

Diluted

$

0.64

 

 

 

 

$

0.74

 

 

 

Weighted-average common shares outstanding:

 

 

 

 

 

 

 

Basic

 

140,569,409

 

 

 

 

 

129,877,510

 

 

 

Diluted

 

141,242,065

 

 

 

 

 

130,022,643

 

 

 

Ardent Health, Inc.

Condensed Consolidated Statements of Cash Flows

(Unaudited; in thousands)

 

 

Nine Months Ended

September 30,

 

 

2025

 

 

 

2024

 

Cash flows from operating activities:

 

 

 

Net income

$

155,873

 

 

$

158,817

 

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

 

 

 

Depreciation and amortization

 

114,666

 

 

 

108,434

 

Other non-operating losses

 

1,275

 

 

 

 

Loss on extinguishment and modification of debt

 

515

 

 

 

2,158

 

Amortization of deferred financing costs and debt discounts

 

3,568

 

 

 

4,235

 

Deferred income taxes

 

14,884

 

 

 

1,690

 

Equity-based compensation

 

30,183

 

 

 

8,873

 

(Income) loss from non-consolidated affiliates

 

(1,409

)

 

 

2,160

 

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

 

 

 

Accounts receivable

 

16,594

 

 

 

77,284

 

Inventories

 

(6,308

)

 

 

(2,545

)

Prepaid expenses and other current assets

 

(47,361

)

 

 

(21,189

)

Accounts payable and other accrued expenses and liabilities

 

(15,716

)

 

 

(132,031

)

Accrued salaries and benefits

 

(19,689

)

 

 

(12,429

)

Net cash provided by operating activities

 

247,075

 

 

 

195,457

 

Cash flows from investing activities:

 

 

 

Investment in acquisitions, net of cash acquired

 

 

 

 

(8,044

)

Purchases of property and equipment

 

(127,909

)

 

 

(106,234

)

Other

 

(92

)

 

 

(738

)

Net cash used in investing activities

 

(128,001

)

 

 

(115,016

)

Cash flows from financing activities:

 

 

 

Proceeds from insurance financing arrangements

 

15,607

 

 

 

10,797

 

Proceeds from long-term debt

 

 

 

 

3,600

 

Payments of principal on insurance financing arrangements

 

(10,751

)

 

 

(7,370

)

Payments of principal on long-term debt

 

(4,506

)

 

 

(106,335

)

Debt issuance costs

 

(2,573

)

 

 

(2,450

)

Payments of initial public offering costs

 

 

 

 

(8,636

)

Distributions to noncontrolling interests

 

(62,366

)

 

 

(53,138

)

Other

 

(1,829

)

 

 

 

Net cash (used in) provided by financing activities

 

(66,418

)

 

 

45,124

 

Net increase in cash and cash equivalents

 

52,656

 

 

 

125,565

 

Cash and cash equivalents at beginning of period

 

556,785

 

 

 

437,577

 

Cash and cash equivalents at end of period

$

609,441

 

 

$

563,142

 

 

Supplemental Cash Flow Information:

Non-cash purchases of property and equipment

$

13,509

 

 

$

5,546

Offering costs not yet paid

$

 

 

$

898

Ardent Health, Inc.

Condensed Consolidated Balance Sheets

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

 

 

September 30,

2025 (1)

 

December 31,

2024 (1)

Assets

 

 

 

Current assets:

 

 

 

Cash and cash equivalents

$

609,441

 

 

$

556,785

Accounts receivable

 

729,414

 

 

 

743,031

Inventories

 

121,594

 

 

 

115,093

Prepaid expenses

 

130,882

 

 

 

113,749

Other current assets

 

366,129

 

 

 

304,093

Total current assets

 

1,957,460

 

 

 

1,832,751

Property and equipment, net

 

887,984

 

 

 

861,899

Operating lease right of use assets

 

292,206

 

 

 

248,040

Operating lease right of use assets, related party

 

919,124

 

 

 

929,106

Goodwill

 

877,509

 

 

 

852,084

Other intangible assets

 

90,090

 

 

 

76,930

Deferred income taxes

 

18,406

 

 

 

12,321

Other assets

 

111,594

 

 

 

142,969

Total assets

$

5,154,373

 

 

$

4,956,100

 

 

 

 

Liabilities and Equity

 

 

 

Current liabilities:

 

 

 

Current installments of long-term debt

$

19,342

 

 

$

9,234

Accounts payable

 

381,853

 

 

 

401,249

Accrued salaries and benefits

 

275,607

 

 

 

295,117

Other accrued expenses and liabilities

 

266,352

 

 

 

239,824

Total current liabilities

 

943,154

 

 

 

945,424

Long-term debt, less current installments

 

1,087,023

 

 

 

1,085,818

Long-term operating lease liability

 

260,748

 

 

 

221,443

Long-term operating lease liability, related party

 

908,482

 

 

 

919,313

Self-insured liabilities

 

260,621

 

 

 

227,048

Other long-term liabilities

 

62,498

 

 

 

34,697

Total liabilities

 

3,522,526

 

 

 

3,433,743

 

 

 

 

Redeemable noncontrolling interests

 

(1,489

)

 

 

1,158

Equity:

 

 

 

Preferred stock, par value $0.01 per share; 50,000,000 shares authorized; no shares issued and outstanding

 

 

 

 

Common stock, par value $0.01 per share; 750,000,000 shares authorized; 143,169,831 shares issued and outstanding as of September 30, 2025 and 142,747,818 shares issued and outstanding as of December 31, 2024

 

1,432

 

 

 

1,428

Additional paid-in capital

 

782,765

 

 

 

754,415

Accumulated other comprehensive (loss) income

 

(2,634

)

 

 

9,737

Retained earnings

 

456,651

 

 

 

365,796

Equity attributable to Ardent Health, Inc.

 

1,238,214

 

 

 

1,131,376

Noncontrolling interests

 

395,122

 

 

 

389,823

Total equity

 

1,633,336

 

 

 

1,521,199

Total liabilities and equity

$

5,154,373

 

 

$

4,956,100

(1)

As of September 30, 2025 and December 31, 2024, the unaudited condensed consolidated balance sheet included total liabilities of consolidated variable interest entities of $309.0 million and $306.4 million, respectively. Refer to Note 2 of the Company's unaudited condensed consolidated financial statements included in its Quarterly Report on Form 10-Q for the three and nine months ended September 30, 2025 for further discussion.

Ardent Health, Inc.

Operating Statistics

(Unaudited)

 

 

Three Months Ended September 30,

 

Nine Months Ended September 30,

 

 

2025

 

 

% Change

 

 

2024

 

 

 

2025

 

 

% Change

 

 

2024

 

Total revenue (in thousands)

$

1,576,746

 

 

8.8

%

 

$

1,449,817

 

 

$

4,719,260

 

 

8.2

%

 

$

4,359,783

 

Hospitals operated (at period end) (1)

 

30

 

 

0.0

%

 

 

30

 

 

 

30

 

 

0.0

%

 

 

30

 

Licensed beds (at period end) (2)

 

4,281

 

 

(0.1

)%

 

 

4,287

 

 

 

4,281

 

 

(0.1

)%

 

 

4,287

 

Utilization of licensed beds (3)

 

49

%

 

6.5

%

 

 

46

%

 

 

50

%

 

8.7

%

 

 

46

%

Admissions (4)

 

41,862

 

 

5.8

%

 

 

39,568

 

 

 

124,786

 

 

6.7

%

 

 

116,995

 

Adjusted admissions (5)

 

89,328

 

 

2.9

%

 

 

86,833

 

 

 

261,031

 

 

2.4

%

 

 

254,909

 

Inpatient surgeries (6)

 

9,732

 

 

9.7

%

 

 

8,871

 

 

 

28,822

 

 

7.4

%

 

 

26,829

 

Outpatient surgeries (7)

 

22,813

 

 

(1.8

)%

 

 

23,220

 

 

 

67,385

 

 

(2.6

)%

 

 

69,201

 

Total surgeries

 

32,545

 

 

1.4

%

 

 

32,091

 

 

 

96,207

 

 

0.2

%

 

 

96,030

 

Emergency room visits (8)

 

161,198

 

 

(0.1

)%

 

 

161,343

 

 

 

479,069

 

 

0.8

%

 

 

475,212

 

Patient days (9)

 

193,558

 

 

6.3

%

 

 

182,023

 

 

 

584,510

 

 

8.2

%

 

 

540,196

 

Total encounters (10)

 

1,577,281

 

 

6.4

%

 

 

1,482,655

 

 

 

4,519,815

 

 

5.0

%

 

 

4,304,097

 

Average length of stay (11)

 

4.62

 

 

0.4

%

 

 

4.60

 

 

 

4.68

 

 

1.3

%

 

 

4.62

 

Net patient service revenue per adjusted admission (12)

$

17,252

 

 

5.8

%

 

$

16,312

 

 

$

17,745

 

 

5.7

%

 

$

16,784

 

(1)

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, Inc.

 

 

 

On April 30, 2024, we closed UT Health East Texas Specialty Hospital, a long-term acute care hospital with 36 licensed patient beds (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.

 

 

(2)

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.

 

(3)

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.

 

(4)

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

 

(5)

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, Inc.

Supplemental Non-GAAP Disclosures

(Unaudited; in thousands)

 

 

Three Months Ended

September 30,

 

Nine Months Ended

September 30,

 

 

2025

 

 

 

2024

 

 

 

2025

 

 

 

2024

 

Net income

$

1,207

 

 

$

46,005

 

 

$

155,873

 

 

$

158,817

 

Adjusted EBITDA Addbacks:

 

 

 

 

 

 

 

Income tax (benefit) expense

 

(3,410

)

 

 

11,062

 

 

 

38,114

 

 

 

36,997

 

Interest expense

 

13,914

 

 

 

14,629

 

 

 

42,819

 

 

 

52,050

 

Depreciation and amortization

 

39,156

 

 

 

36,771

 

 

 

114,666

 

 

 

108,434

 

Noncontrolling interest earnings

 

(24,685

)

 

 

(19,683

)

 

 

(65,018

)

 

 

(62,678

)

Loss on extinguishment and modification of debt

 

7,344

 

 

 

1,490

 

 

 

7,344

 

 

 

3,388

 

Other non-operating losses (gains) (1)

 

353

 

 

 

47

 

 

 

1,130

 

 

 

(208

)

Cybersecurity Incident recoveries, net (2)

 

(2,950

)

 

 

(4,976

)

 

 

(22,655

)

 

 

(4,976

)

Restructuring, exit and acquisition-related costs (3)

 

3,040

 

 

 

3,796

 

 

 

7,944

 

 

 

11,694

 

Change in accounting estimate (4)

 

43,298

 

 

 

 

 

 

43,298

 

 

 

 

New Mexico professional liability accrual (5)

 

54,468

 

 

 

 

 

 

54,468

 

 

 

 

Epic expenses (6)

 

1,620

 

 

 

485

 

 

 

2,904

 

 

 

1,500

 

Equity-based compensation

 

9,674

 

 

 

8,135

 

 

 

30,183

 

 

 

8,873

 

(Income) loss from disposed operations

 

(11

)

 

 

3

 

 

 

22

 

 

 

1,989

 

Adjusted EBITDA

$

143,018

 

 

$

97,764

 

 

$

411,092

 

 

$

315,880

 

Total revenue

$

1,576,746

 

 

$

1,449,817

 

 

$

4,719,260

 

 

$

4,359,783

 

Adjusted EBITDA margin

 

9.1

%

 

 

6.7

%

 

 

8.7

%

 

 

7.2

%

(1)

Other non-operating losses (gains)include losses and gains realized on certain non-recurring events or events that are non-operational in nature.

 

(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 $2.7 million and $3.2 million for the three months ended September 30, 2025 and 2024, respectively, and $6.0 million and $10.1 million for the nine months ended September 30, 2025 and 2024, respectively, (ii) penalties and costs incurred for terminating pre-existing contracts at acquired facilities of $0.2 million for the three months ended September 30, 2024, and $0.4 million and $0.6 million for the nine months ended September 30, 2025 and 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 $0.3 million and $0.4 million for the three months ended September 30, 2025 and 2024, respectively, and $1.5 million and $1.0 million for the nine months ended September 30, 2025 and 2024, respectively.

 

(4)

Change in accounting estimate reflects the reduction in total revenue of $42.6 million and its $0.7 million impact on noncontrolling interest earnings as a result of a change in its accounting estimate of the collectability of accounts receivable as further described above.

 

(5)

During the three and nine months ended September 30, 2025, we recorded an increase in our professional liability reserves of $47.2 million. This adjustment included an increase of $54.5 million for adverse prior-period claim developments in New Mexico primarily attributable to recent claim settlements and ongoing litigation arising from the actions of a single provider who was employed between 2019 and 2022 and as further described above.

 

(6)

Epic expenses consist of various costs incurred in connection with the implementation of Epic, our health information technology system. These costs included (i) professional fees of $0.2 million and $0.5 million for the three months ended September 30, 2025 and 2024, respectively, and $1.5 million for each of the nine months ended September 30, 2025 and 2024, (ii) salaries and benefits of $1.3 million for each of the three and nine months ended September 30, 2025, and (iii) other expenses related to one-time training and onboarding support costs of $0.1 million for each of the three and nine months ended September 30, 2025. Epic expenses do not include ongoing operating costs of the Epic system.

Ardent Health, Inc.

Supplemental Non-GAAP Disclosures

(Unaudited; in thousands)

 

 

Three Months

Ended

September 30,

2025

 

Nine Months

Ended

September 30,

2025

Net income

$

1,207

 

 

$

155,873

 

Adjusted EBITDAR Addbacks:

 

 

 

Income tax expense

 

(3,410

)

 

 

38,114

 

Interest expense

 

13,914

 

 

 

42,819

 

Depreciation and amortization

 

39,156

 

 

 

114,666

 

Noncontrolling interest earnings

 

(24,685

)

 

 

(65,018

)

Loss on extinguishment and modification of debt

 

7,344

 

 

 

7,344

 

Other non-operating losses (1)

 

353

 

 

 

1,130

 

Cybersecurity Incident recoveries, net (2)

 

(2,950

)

 

 

(22,655

)

Restructuring, exit and acquisition-related costs (3)

 

3,040

 

 

 

7,944

 

Change in accounting estimate (4)

 

43,298

 

 

 

43,298

 

New Mexico professional liability accrual (5)

 

54,468

 

 

 

54,468

 

Epic expenses (6)

 

1,620

 

 

 

2,904

 

Equity-based compensation

 

9,674

 

 

 

30,183

 

(Income) loss from disposed operations

 

(11

)

 

 

22

 

Rent expense payable to REITs (7)

 

40,961

 

 

 

122,522

 

Adjusted EBITDAR

$

183,979

 

 

$

533,614

 

(1)

Other non-operating losses include losses realized on certain non-recurring events or events that are non-operational in nature.

 

(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 $2.7 million and $6.0 million for the three and nine months ended September 30, 2025, respectively, (ii) penalties and costs incurred for terminating pre-existing contracts at acquired facilities of $0.4 million for the nine months ended September 30, 2025, and (iii) third-party professional fees and expenses, salaries and benefits, and other internal expenses incurred in connection with potential and completed acquisitions of $0.3 million and $1.5 million for the three and nine months ended September 30, 2025, respectively..

 

(4)

Change in accounting estimate reflects the reduction in total revenue of $42.6 million and its $0.7 million impact on noncontrolling interest earnings as a result of a change in its accounting estimate of the collectability of accounts receivable as further described above.

 

(5)

During the three and nine months ended September 30, 2025, we recorded an increase in our professional liability reserves of $47.2 million. This adjustment included an increase of $54.5 million for adverse prior-period claim developments in New Mexico primarily attributable to recent claim settlements and ongoing litigation arising from the actions of a single provider who was employed between 2019 and 2022 and as further described above.

 

(6)

Epic expenses consist of various costs incurred in connection with the implementation of Epic, our health information technology system. These costs included (i) professional fees of $0.2 million and $1.5 million for the three and nine months ended September 30, 2025, respectively, (ii) salaries and benefits of $1.3 million for each of the three and nine months ended September 30, 2025, and (iii) other expenses related to one-time training and onboarding support costs of $0.1 million for each of the three and nine months ended September 30, 2025. Epic expenses do not include ongoing operating costs of the Epic system.

 

(7)

Rent expense payable to REITs for the three and nine months ended September 30, 2025 consists of rent expense of $38.1 million and $114.0 million, respectively, related to the Ventas Master Lease and other lease agreements with Ventas for medical office buildings and rent expense of $2.9 million and $8.5 million, respectively, related to a lease arrangement with MPT for the lease of Hackensack Meridian Mountainside Medical Center.

Ardent Health, Inc.

Supplemental Non-GAAP Disclosures

(Unaudited; in millions)

 

 

Guidance for the Full Year Ending 

December 31, 2025

 

Low

 

High

Net income

$

207

 

 

$

234

 

Adjusted EBITDA Addbacks:

 

 

 

Income tax expense

 

51

 

 

 

58

 

Interest expense

 

58

 

 

 

56

 

Depreciation and amortization

 

156

 

 

 

153

 

Noncontrolling interest earnings

 

(86

)

 

 

(88

)

Loss on extinguishment and modification of debt

 

7

 

 

 

7

 

Other non-operating gains

 

1

 

 

 

1

 

Cybersecurity Incident recoveries, net (1)

 

(23

)

 

 

(23

)

Restructuring, exit and acquisition-related costs

 

14

 

 

 

13

 

Change in accounting estimate (2)

 

43

 

 

 

43

 

New Mexico professional liability accrual (3)

 

54

 

 

 

54

 

Epic expenses

 

4

 

 

 

4

 

Enterprise system conversion costs

 

3

 

 

 

3

 

Equity-based compensation

 

41

 

 

 

40

 

Adjusted EBITDA

$

530

 

 

$

555

 

(1)

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

 

(2)

Change in accounting estimate reflects the reduction in total revenue of $42.6 million and its $0.7 million impact on noncontrolling interest earnings as a result of a change in its accounting estimate of the collectability of accounts receivable as further described above.

 

(3)

During the three and nine months ended September 30, 2025, we recorded an increase in our professional liability reserves of $47.2 million. This adjustment included an increase of $54.5 million for adverse prior-period claim developments in New Mexico primarily attributable to recent claim settlements and ongoing litigation arising from the actions of a single provider who was employed between 2019 and 2022 and as further described above.

 

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