{
  "docId": "019dd923-622b-71dc-a6dc-0b4b29bc87ea",
  "docSlug": "ad16f67f6f75",
  "documentTitle": "Health Management Associates (HMA)",
  "authorId": "12_Glenview",
  "authorName": "Larry Robbins",
  "documentKindSlug": "activist-deck",
  "documentKindLabel": "Activist deck",
  "sourceTypeSlug": "activist_investor",
  "sourceTypeLabel": "Activist investor",
  "presentationDate": "2013-07-01 00:00:00",
  "orientation": "landscape",
  "aspectRatio": 1.2941177,
  "pageNumber": 27,
  "pageCount": 54,
  "prevPage": 26,
  "nextPage": 28,
  "slideType": "expose_contradiction",
  "function": "expose_contradiction",
  "density": "overcrowded",
  "nDataPoints": 12,
  "notes": "Uses a split-screen comparison to juxtapose management claims against operational reality.",
  "elementsJson": [
    "headline_text",
    "bullet_list",
    "data_table",
    "paragraph",
    "footnote"
  ],
  "metadataConfidence": 1,
  "imagePath": null,
  "slideHref": "/slides/019dd923-622b-71dc-a6dc-0b4b29bc87ea/27",
  "deckHref": "/decks/019dd923-622b-71dc-a6dc-0b4b29bc87ea",
  "deckJsonHref": "/decks/019dd923-622b-71dc-a6dc-0b4b29bc87ea.json",
  "deckAnchorHref": "/decks/019dd923-622b-71dc-a6dc-0b4b29bc87ea#slide-27",
  "components": [
    {
      "bbox": null,
      "kind": "callout",
      "text": "At least ~$600m of $1.2B spent since January 2010 was on hospitals that were non-strategic, located outside HMA’s core geographic footprint",
      "attrs": null,
      "subkind": null,
      "toolName": "Visual emphasis",
      "toolSlug": "visual-emphasis",
      "confidence": null,
      "componentId": "019dd953-25b3-7229-bef4-c9aa2493bc1c",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.1,
        "w": 0.4,
        "x": 0.53,
        "y": 0.27
      },
      "kind": "list",
      "text": "The Board recently hired outside advisors to help focus its M&A strategy, citing the discontinuity of prior acquisitions and their prior focus on just buying \"boxes\" without geographic density and strategic focus.",
      "attrs": null,
      "subkind": "bullet",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "7ed05049-be0d-49b1-9516-aa3034a7b489",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.08,
        "w": 0.4,
        "x": 0.08,
        "y": 0.25
      },
      "kind": "list",
      "text": "Management's model is to purchase hospitals at double-digit multiples of current EBITDA. Their goal: Improve operations to where the final purchase price is approximately 5x EBITDA in year 5.",
      "attrs": null,
      "subkind": "bullet",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "929d0ee0-2fa8-4745-b076-5a5496df1393",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.05,
        "w": 0.4,
        "x": 0.53,
        "y": 0.48
      },
      "kind": "list",
      "text": "This quarter, HMA management called out inferior performance at newly acquired hospitals.",
      "attrs": null,
      "subkind": "bullet",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "fdf75dab-e16d-4d34-b892-6022bbe73402",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.05,
        "w": 0.3,
        "x": 0.15,
        "y": 0.17
      },
      "kind": "paragraph",
      "text": "HMA claims to have targeted EBITDA growth through M&A...",
      "attrs": null,
      "subkind": "paragraph",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "2b41295d-bf4e-4475-bf52-f99deed8f69f",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.05,
        "w": 0.3,
        "x": 0.6,
        "y": 0.17
      },
      "kind": "paragraph",
      "text": "...but their poor track record is reflected in HMA's stock price",
      "attrs": null,
      "subkind": "paragraph",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "abaa072a-28d3-4a32-bac8-ee5854b83aa6",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.1,
        "w": 0.38,
        "x": 0.55,
        "y": 0.54
      },
      "kind": "quote",
      "text": "\"Increases in uninsured outpatient and emergency room volumes, and decreases in the collection of deductibles and co-pays impacted bad debt expense, particularly at hospitals recently acquired\"—HMA 1Q13 pre-release announcement, April 2013",
      "attrs": null,
      "subkind": "pull-quote",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "a7f2f111-cb53-47b7-bfa8-9c51e80598ba",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.08,
        "w": 0.38,
        "x": 0.55,
        "y": 0.38
      },
      "kind": "quote",
      "text": "\"It's more about the demographics and the out migration and the location and being nonurban that drive our decision-making\"—HMA CFO, July 24, 2012 Earnings Call",
      "attrs": null,
      "subkind": "pull-quote",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "b135da54-2bd0-4d13-9533-946d78e0dcda",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": null,
      "kind": "quote",
      "text": "\"It's more about the demographics and the out migration and the location and being nonurban that drive our decision-making\" — HMA CFO, July 24, 2012 Earnings Call; \"Increases in uninsured outpatient and emergency room volumes, and decreases in the collection of deductibles and co-pays impacted bad debt expense, particularly at hospitals recently acquired\" — HMA 1Q13 pre-release announcement, April 2013",
      "attrs": null,
      "subkind": null,
      "toolName": "Authority citation",
      "toolSlug": "authority-citation",
      "confidence": null,
      "componentId": "019dd953-25b3-7229-bef4-cf515ddcb43c",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.05,
        "w": 0.45,
        "x": 0.06,
        "y": 0.88
      },
      "kind": "source-note",
      "text": "1. Estimate based on Morgan Stanley equity research estimates. 2. HMA previously had 2 hospitals in Oklahoma and 3 in Tennessee.",
      "attrs": null,
      "subkind": null,
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "a0d2c25b-80d6-4d4e-a7ff-833c54abfac3",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.45,
        "w": 0.42,
        "x": 0.08,
        "y": 0.35
      },
      "kind": "table",
      "text": "Transaction Date, Acquisition, State, Assets, Transaction Price",
      "attrs": null,
      "subkind": "data",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "7c41ad7c-d004-4269-8be4-bab7fc3cd1c5",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.03,
        "w": 0.45,
        "x": 0.06,
        "y": 0.09
      },
      "kind": "title",
      "text": "THE BOARD HAS WEAK STRATEGIC VISION",
      "attrs": null,
      "subkind": "headline",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "bffc1fa2-7b24-47ab-ab93-ed83aa373b3b",
      "frameworkName": null,
      "frameworkSlug": null
    }
  ],
  "metrics": [],
  "tools": [],
  "frameworks": [
    {
      "name": "before-after-framing",
      "slug": null,
      "matchId": "0a50f371-dcbf-47f7-bbc5-69654b42a902",
      "evidence": "Juxtaposition of stated strategy vs. actual performance outcomes",
      "confidence": 0.9
    }
  ],
  "arcBeats": [
    {
      "to": 35,
      "from": 6,
      "beatId": "aefe9b7f-8290-44ea-8ca4-6cdc1d4ec4b4",
      "arcName": "Problem-Agitate-Solution",
      "arcSlug": "problem-agitate-solution",
      "beatName": "Agitate",
      "beatSlug": "problem-agitate-solution-agitate-make-it-worse",
      "evidence": "The document agitates the issues, highlighting the consequences of the current board and management's actions, including multiple investigations, inconsistent financial management, and misaligned executive incentive compensation.",
      "position": 1,
      "confidence": 0.8,
      "parentBeatName": "Development",
      "parentBeatSlug": "development"
    }
  ],
  "loops": [
    {
      "to": 30,
      "from": 26,
      "name": "Cost Of Inaction",
      "slug": "27-cost-of-inaction",
      "bestFor": "Urgent budget requests, compliance, risk mitigation",
      "matchId": "e5a4e996-1771-4d6e-9f26-c159287c44da",
      "evidence": "The document highlights the cost of inaction, including the failure to create shareholder value and the consequences of the current board and management's actions.",
      "position": 2,
      "objective": "To highlight the cost of inaction",
      "structure": "The Status Quo -> The Hidden Costs Accumulating -> The Future State of Inaction -> The Tipping Point",
      "confidence": 0.7,
      "description": "Quantify what happens if the audience does nothing"
    }
  ],
  "imagePathAlt": null,
  "thumbSrc": null,
  "thumbSrcAlt": null,
  "locked": true
}