THC · Health care(services-general medical & surgical hospitals, nec) · 10 years of annual accounts filed with the SEC · latest fiscal year ended 2025-12-31
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Tenet Healthcare Corp reported revenue of $21.3 billion in fiscal 2025, after growing 0.1% a year over the previous 9 years. Its operating margin widened from 5.9% in 2016 to 16.5%. Of the $18.1 billion its operations generated over 10 years, 41.6% went back into the business and 22.4% to acquisitions; the share count fell 8.5%. On the accounting screens, it passes 5 of 7 Piotroski tests and its Altman Z'' of 2.24 is in the grey zone; none of the six cross-checks between its statements fires.
Revenue, fiscal 202521.3B+0.1% a year over 9 years
Operating margin16.5%gross margin —
Return on invested capital—
Free cash flow after stock pay2.4B11.4% of revenue
Net debt ÷ EBITDA—net debt —
Piotroski F-score5/7tests of improvement passed
Is it growing?
Revenue and the operating income it turns into. Growth that does not reach operating income is growth bought with margin.
RevenueOperating income
010.0B20.0B30.0B
2016Revenue 21.1BOperating income 1.2B
2017Revenue 20.6BOperating income 1.1B
2018Revenue 18.3BOperating income 1.6B
2019Revenue 18.5BOperating income 1.5B
2020Revenue 17.6BOperating income 2.0B
2021Revenue 19.5BOperating income 2.9B
2022Revenue 19.2BOperating income 2.3B
2023Revenue 20.6BOperating income 2.5B
2024Revenue 20.7BOperating income 6.0B
2025Revenue 21.3BOperating income 3.5B
2016201720182019202020212022202320242025
Compound growth a year
3 yrs
5 yrs
9 yrs
Revenue
+3.6%
+3.9%
+0.1%
Operating income
+14.6%
+12.0%
+12.2%
Net income
+33.2%
+25.2%
+33.5%
Earnings per share
+42.2%
+29.2%
+34.8%
Free cash flow per share
+112.5%
+0.6%
—
Shares
-6.3%
-3.1%
-1.0%
Falling shares are buybacks: each remaining share owns more of the company.
Does it earn more than its capital costs?
Margins say how much of each sale is kept; return on invested capital says how much the business earns on the money it needs to operate. Growth only creates value when that return is above the cost of the capital.
GrossOperatingNetFree cash flow
-10.0%0.0%10.0%20.0%30.0%
2016Operating 5.9%Net 0.8%Free cash flow -1.5%
2017Operating 5.4%Net -1.6%Free cash flow 2.4%
2018Operating 8.9%Net 2.5%Free cash flow 2.4%
2019Operating 8.3%Net 0.9%Free cash flow 3.0%
2020Operating 11.3%Net 4.4%Free cash flow 16.3%
2021Operating 14.7%Net 7.6%Free cash flow 4.7%
2022Operating 12.2%Net 5.2%Free cash flow 1.7%
2023Operating 12.2%Net 6.4%Free cash flow 7.9%
2024Operating 28.8%Net 19.7%Free cash flow 5.4%
2025Operating 16.5%Net 11.1%Free cash flow 11.9%
2016201720182019202020212022202320242025
Return on invested capital
Return on invested capitalCost of capital today · 10.2%
0.0%5.0%10.0%15.0%
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2016201720182019202020212022202320242025
Economic profit
Needs a cost of capital, which comes from the valuation below.
Return on equity
56.1%
Return on assets
8.0%
Asset turnover
0.72×
Is the profit cash, and where does the cash go?
Net income is an accounting opinion; free cash flow is what was left in the bank after investing. Stock-based pay does not leave the bank — shareholders pay it through dilution — so it is shown taken off as well.
Net incomeFree cash flowAfter stock-based pay
-2.0B02.0B4.0B6.0B
2016Net income 176.0MFree cash flow -317.0MAfter stock-based pay -385.0M
2017Net income -320.0MFree cash flow 493.0MAfter stock-based pay 434.0M
2018Net income 459.0MFree cash flow 432.0MAfter stock-based pay 386.0M
2019Net income 171.0MFree cash flow 563.0MAfter stock-based pay 521.0M
2020Net income 768.0MFree cash flow 2.9BAfter stock-based pay 2.8B
2021Net income 1.5BFree cash flow 910.0MAfter stock-based pay 854.0M
2022Net income 1.0BFree cash flow 321.0MAfter stock-based pay 265.0M
2023Net income 1.3BFree cash flow 1.6BAfter stock-based pay 1.6B
2024Net income 4.1BFree cash flow 1.1BAfter stock-based pay 1.0B
2025Net income 2.4BFree cash flow 2.5BAfter stock-based pay 2.4B
2016201720182019202020212022202320242025
Where 10 years of operating cash went, 2016–2025
18.1B generated by the business. Each band is its share of that total.
Reinvested in the business 42%7.5B
Acquisitions 22%4.0B
Dividends 0%0
Share buybacks 14%2.5B
Kept, or used to pay down debt 22%4.0B
Over the same years it paid 608.0M in stock. The share count fell 8.5%. 1.9B of the buybacks went beyond offsetting that dilution.
Per share
Earnings per shareFree cash flow per shareDividend per share
$-20.00$0.00$20.00$40.00$60.00
2016Earnings per share $1.77Free cash flow per share $-3.19
2017Earnings per share $-3.18Free cash flow per share $4.90
2018Earnings per share $4.42Free cash flow per share $4.16
2019Earnings per share $1.65Free cash flow per share $5.44
2020Earnings per share $7.23Free cash flow per share $26.98
2021Earnings per share $13.59Free cash flow per share $8.38
2022Earnings per share $9.06Free cash flow per share $2.90
2023Earnings per share $12.51Free cash flow per share $15.49
2024Earnings per share $41.52Free cash flow per share $11.40
2025Earnings per share $26.06Free cash flow per share $27.85
2016201720182019202020212022202320242025
Shares outstanding
Diluted shares
90.0M95.0M100.0M105.0M110.0M115.0M
2016Diluted shares 99.3M
2017Diluted shares 100.6M
2018Diluted shares 103.9M
2019Diluted shares 103.4M
2020Diluted shares 106.3M
2021Diluted shares 108.6M
2022Diluted shares 110.5M
2023Diluted shares 104.8M
2024Diluted shares 97.9M
2025Diluted shares 90.8M
2016201720182019202020212022202320242025
How strong is the balance sheet?
Debt is not bad in itself; debt the business cannot service in a bad year is. Net debt is debt minus cash, and below zero the company holds more cash than it owes.
Net debt ÷ EBITDA
—
Interest coverage
4× operating income ÷ interest
Current ratio
1.76 current assets ÷ current liabilities
Cash conversion cycle
— collects in 44d
Three classic screens of the accounts
Each asks a different question of the same statements — is it improving, does it look like a company heading for distress, do the accounts resemble ones that were manipulated. None is a verdict; each shows what moves it.
Piotroski F-score
Is the business improving? Nine yes-or-no tests, this year against last.
5of 7 tests passed
✓ProfitableReturn on assets above zeropassed
✓Cash from operationsOperating cash flow above zeropassed
✕Profitability improvedReturn on assets higher than a year beforefailed
✓Profit backed by cashOperating cash flow above net income (low accruals)passed
–Less long-term debtLong-term debt as a share of assets fell — not reportedno data
✕More liquidCurrent ratio higher than a year beforefailed
✓No new sharesShare count did not growpassed
–Better gross marginGross margin higher than a year before — not reportedno data
✓Sells more per assetAsset turnover higher than a year beforepassed
Where it misleads: it measures change, not level. An excellent business that stood still for a year scores low; a poor one recovering from a disaster scores high.
Altman Z''-score
Does the balance sheet look like those of companies that went bankrupt?
2.24grey zone
1.12.6
Working capital ÷ assets 0.11 × 6.56+0.75
Retained earnings ÷ assets 0.15 × 3.26+0.48
Operating income ÷ assets 0.12 × 6.72+0.79
Equity ÷ liabilities 0.20 × 1.05+0.21
Where it misleads: buybacks. A company that returns so much cash that its equity turns small or negative sinks the last two ratios without being anywhere near bankruptcy. Banks and insurers do not fit the model at all.
Beneish M-score
Do the accounts resemble those of companies that manipulated their earnings?
The accounts lack too many of the lines it needs.
Where the statements disagree
Cross-checks between the income statement, the balance sheet and the cash flow for the latest year, each with the benign reading and the worrying one.
None of the six cross-checks fires for the latest year: receivables and inventory move with revenue, profit turns into cash, investment keeps up with depreciation, the tax rate is ordinary and debt is moderate.
What is it worth, under which assumptions?
A company is worth the cash it will generate, brought back to today. This model projects revenue with growth that fades over the years, applies a free cash flow margin, and discounts the result at the cost of capital. Every assumption says where it came from, and all of them can be changed.
Value per share, with these assumptions$507.48discounted at 10.2% a year · 49% of it from after year 10
Type a share price on the left to ask the reverse questions: what growth, what margin or what discount rate that price implies.
What the value implies, in the usual multiples
At this model's value
Price ÷ earnings
19.5×
Enterprise value ÷ EBITDA
10.5×
Enterprise value ÷ revenue
2.2×
Free cash flow yield
5.3%
From cash flows to a value per share
10 years of cash flow, today23.4B
Everything after, today22.7B
The whole business46.1B
Minus net debt-0
What belongs to shareholders46.1B
Divided among 90.8M shares: <strong>$507.48</strong> each.
The projection next to its history
Reported free cash flow after stock pay, then the model's. A projection that looks nothing like the past needs a reason.
ReportedProjected
-2.0B02.0B4.0B6.0B
2016Reported -385.0M
2017Reported 434.0M
2018Reported 386.0M
2019Reported 521.0M
2020Reported 2.8B
2021Reported 854.0M
2022Reported 265.0M
2023Reported 1.6B
2024Reported 1.0B
2025Reported 2.4B
2026Projected 3.4B
2027Projected 3.5B
2028Projected 3.6B
2029Projected 3.8B
2030Projected 3.9B
2031Projected 4.0B
2032Projected 4.1B
2033Projected 4.2B
2034Projected 4.4B
2035Projected 4.5B
2016201820202022202420262028203020322034
Year by year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Revenue
22.2B
23.0B
23.9B
24.7B
25.5B
26.3B
27.1B
27.9B
28.6B
29.3B
Growth
4.0%
3.8%
3.7%
3.5%
3.3%
3.2%
3.0%
2.8%
2.7%
2.5%
Cash margin
15.2%
15.2%
15.2%
15.2%
15.2%
15.2%
15.2%
15.2%
15.2%
15.2%
Free cash flow
3.4B
3.5B
3.6B
3.8B
3.9B
4.0B
4.1B
4.2B
4.4B
4.5B
Worth today
3.1B
2.9B
2.7B
2.6B
2.4B
2.2B
2.1B
2.0B
1.8B
1.7B
If the least-known inputs move
Value per share as two inputs change at a time. Neighbouring cells that differ a lot are the conclusion: the value depends on numbers nobody knows to a point.
The discount rate and growth forever
discount ↓ · forever →
1.5%
2.0%
2.5%
3.0%
3.5%
9.2%
524
552
584
622
666
9.7%
491
516
543
575
612
10.2%
462
484
507
535
566
10.7%
437
455
476
500
526
11.2%
414
430
448
469
492
Year-one growth and the final margin
margin ↓ · growth →
0.0%
2.0%
4.0%
6.0%
8.0%
12.2%
368
399
432
467
506
13.7%
400
433
470
509
551
15.2%
431
468
507
550
596
16.8%
462
502
545
591
641
18.3%
494
537
583
633
687
All the inputs moving at once
5,000 valuations, each with growth, final margin, discount rate and growth forever drawn at random around the values on the left (spreads of 3.0%, 2.3%, 1.0% and 0.5%). Not a probability — the spreads are assumptions too — but an honest picture of how wide the answer is.
10th percentile$389.66
Median$508.69
90th percentile$681.16
$400.00$600.00$800.00
Half of the simulations land between <b>$440.62</b> and <b>$587.33</b>; one in ten below $389.66, one in ten above $681.16.
Does the long run make sense?
9.9×The terminal value prices the business in year 10 at 9.9 times that year's EBITDA.
Free growthIn year 10 free cash flow is at or above after-tax operating profit, yet the model grows 2.5% forever. Growth needs reinvestment; this assumes it comes for free, which flatters the terminal value.
49%of the value comes from after year 10. The more of it, the more the answer depends on the part nobody can see.
What lenders charge, after the tax saving on interest: 6.67% × (1 − 15.5%) = <strong>5.64%</strong>.
Weighted by how much of each the company uses (book value (no price given)): <strong>10.17%</strong>, the rate every future cash flow is discounted at.
What it has filed lately
The last twelve months at the SEC, most important first: annual and quarterly reports, events, large holders and insiders.
Every Form 4 filed in the last twelve months, read line by line: 6 filings by 5 people. Open-market purchases and sales are counted apart from awards, option exercises and shares withheld for taxes.
Bought on the open market—none in the period
Sold on the open market$12.9M7 sale(s) by 5 insider(s)
Under pre-arranged plans0%of the sales followed a 10b5-1 plan set months earlier
A Form 4 says what happened, when, how many shares and at what price. It does not say why: a sale can be diversification, a tax bill or a plan fixed months earlier, and an award is pay, not a purchase. Nothing here is a reason to buy or sell anything.
Which large funds report holding it
From the Form 13F of the 28 institutions followed on this site, as of the end of their last reported quarter. A 13F is filed up to 45 days later and shows only long positions in US-listed shares.
Accounts from the company's own SEC filings; lines some companies do not report are shown as a dash rather than estimated. The risk-free rate is the 10-year US Treasury yield. A DCF is a way of making assumptions explicit, not a forecast: it states what the company would be worth if the assumptions held. The scores are screens that point where to look, not verdicts. Nothing here is a recommendation to buy or sell.