Companies / Tenet Healthcare

Tenet Healthcare THC

Services-General Medical & Surgical Hospitals, NEC · Balance sheet at Sep 30, 2026 · $ in millions

Next 12 Months: Starting Case
$ in millionsLast 12 MonthsNext Quarter (4Q26E)vs. 4Q25ANext 12 MonthsChange
Revenue$22,154$5,6622.4%$22,2890.6%
Adj. EBITDA$6,559$1,31512.6%$5,088(22.4%)
Free Cash Flow$3,328$72597.4%$2,740(17.7%)
Net Debt, end of period$10,569$9,844$7,829(25.9%)
Net Debt / Adj. EBITDA1.6x1.5x1.5x-0.1x
Total Liquidity, end of period$4,574$5,299$7,31459.9%
The credit over the next year

Tenet is now two businesses: USPI, a fast growing ambulatory surgery chain that earned about 40% of third quarter 2026 Adjusted EBITDA, and 51 acute care hospitals whose margin rose to 19.2% on volume growth and tight labor cost. Over the next year the credit turns on whether hospital pricing per adjusted admission keeps up as exchange enrollment falls after the enhanced ACA subsidies ended and as the 2025 federal reconciliation law starts to cap Medicaid supplemental payments in 2027, whether salaries per adjusted admission stay near $8,300 to $8,700, and whether USPI keeps adding cases and revenue per case through acquisitions and higher acuity. Cash flow also gets a lift from the first $453mm CommonSpirit note payment in January 2027, while Conifer revenue from CommonSpirit ends after October 2026; net leverage was 2.11x at September 30, 2026 with no secured notes left due before 2028.

  • Leverage falls from 1.6x to 1.5x over the next four quarters on the starting case.
  • Free cash flow of $2.74bn is projected over the next year, with no itemised debt due in that time.
  • Net debt shrinks from $10.57bn to $7.83bn.
  • Liquidity a year out is $7.31bn, against $4.57bn today.
  • Company guidance for fiscal 2026: adjusted EBITDA of $5.05bn to $5.20bn on its own definition, free cash flow of $2.83bn to $3.13bn.

Built from the inputs on the Projections tab of the model; change them there. A starting case from history, not a forecast.

Capital Structure
Cap StructureAmt Out.Mkt PriceYieldLev. ThroughView
Unrestricted Cash$2,674.0
4.625% Senior Secured First Lien Notes due 2028600.099.2%*5.16%0.1xBullish
4.250% Senior Secured First Lien Notes due 20291,400.097.4%*5.37%0.3xBullish
6.125% Senior Secured First Lien Notes due 20302,000.0100.7%*4.66%0.6xNeutral
4.375% Senior Secured First Lien Notes due 20301,450.096.9%*5.37%0.8xBullish
Senior Secured ABL Revolving Credit Facility (2025 Credit Agreement)0.0100.0%N/a0.8xBullish
6.750% Senior Secured First Lien Notes due 20311,350.0102.2%*5.68%1.0xNeutral
5.500% Senior Secured First Lien Notes due 20321,500.098.6%*5.77%1.3xBullish
Finance leases, mortgages and other notes679.0100.0%N/a1.4xBullish
6.125% Senior Notes due 20281,250.0100.1%*5.92%1.6xNeutral
6.875% Senior Notes due 2031362.0106.2%*5.45%1.6xBullish
6.000% Senior Notes due 2033750.0100.2%*5.96%1.7xBullish
6.250% Senior Notes due 20342,000.0100.0%6.25%2.0xBullish
Total Debt$13,243.02.0x
Net Debt$10,569.01.6x
Last Twelve Months
Revenue$22,154
Implied Costs(15,595)
Adj. EBITDA$6,559
(-) Interest Expense(830)
(-) Capex(910)
Memo: FCF$3,328
Total Liquidity$4,574.0