NASHVILLE, Tenn. (AP) -- HCA Holdings Inc., the largest U.S. hospital chain, said Monday that admissions growth slowed down during the first quarter.
The company said its growth slowed as outpatient volumes were lower than expected and inpatient admissions also fell compared to last year. It said most of that weakness occurred in the second half of the three-month period. The company also expects to take about $33 million, or 5 cents per share, in charges related to losses on facility sales and the retirement of debt.
HCA had 162 hospitals and 112 free-standing surgery centers at the end of 2012. It is the second hospital chain to announce weak first-quarter results. Health Management Associates Inc., which runs non-urban hospitals mostly located in the Southeast, said last week that admissions didn't live up to its expectations and observation stays had increased. It also said more patients were having difficulty paying their bills because of a variety of factors.
HCA said revenue edged up to $8.44 billion from $8.41 billion a year ago. Adjusted earnings before interest, taxes, depreciation and amortization fell 14 percent to $1.57 billion.
Analysts expected revenue of $8.63 billion and EBITDA of $1.66 billion, according to FactSet.
Shares of HCA fell 4.2 percent to $36.72 Monday as part of a broader market sell-off, and the stock fell another $1.72, or 4.7 percent, to $35 in after-hours trading.
HCA said adjusted admissions at hospitals opened at least a year fell 0.7 percent. The first quarter of 2012 included an extra day because of the leap year, and excluding that extra day, adjusted admissions at hospitals open at least a year rose 0.4 percent. At those hospitals inpatient surgeries fell 2.6 percent, outpatient surgeries fell 4.3 percent, and emergency room visits increased 3.8 percent.
Revenue per equivalent admission at those locations grew 0.8 percent.
Admissions at hospitals open at least a year are considered an important measurement of the company's performance. The measurement excludes results from locations that opened, closed, or were sold or acquired within the last year. Adjusted admissions includes both inpatient admissions and outpatient procedures.
HCA said it began cutting costs to respond to lower volumes, but it did not provide specifics.
The company said it is backing its full-year guidance, which calls for adjusted earnings per share of $3 to $3.30 and $33.5 billion to $34.5 billion in revenue. Analysts expect $3.18 per share and $34.11 billion in revenue, on average.
HCA Holdings is scheduled to report its quarterly results in early May.