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continued to test the nerves of its daring shareholder corps Monday, predicting a wider-than-expected fourth-quarter loss, a billion-dollar writedown and another weak year in 2005.

The hospital operator sees a fourth-quarter operating loss that exceeds the loss of 8 cents a share it posted in the third quarter, citing reduced patient volume, bad debt from uninsured patients, higher labor and supply costs, and less profitable managed-care contracts.

Analysts surveyed by Thomson First Call were expecting Tenet to lose 4 cents a share in the fourth quarter.

In addition, Tenet plans to book charges in the quarter that cover its estimate of long-lived asset and goodwill impairment that "could exceed $1 billion as a result of its current financial trends, preliminary budgets and outlook.

"The company, which had $1.3 billion of cash at Sept. 30, said it expects to have a similar amount at Dec. 31, 2004, after funding in the fourth quarter the repurchase of approximately $100 million of notes due in 2006 and 2007 and completing various hospital sales as previously announced," Tenet said.

Tenet recently marked the second anniversary of a series of hospital and insurance scandals that cut is market value by 75% and long ago rendered its stock a flyer for deep-value investors. Those investors have themselves faced a series of gut-checks in recent months as the company's larger problem became industry hardships like escalating costs and debt-collection challenges.

For 2005, Tenet warned Monday that earnings from continuing operations are not expected to exceed breakeven, and could show little or no improvement from "recent performance." Meanwhile, the company plans another round of cost-reduction initiatives that will be phased in throughout the year.

"While we anticipate a very challenging 2005, we are developing an aggressive internal operating plan to maximize performance within the reality of our current operating environment," Tenet said. "In addition to precise execution of this plan, we need a return to sustained increases in volumes. For volumes to recover, however, we need to substantially resolve our open litigation and investigation matters."

"Cost discipline is a core element of our near-term operating strategy, but there is a limit on how far we can prudently cut costs," the company added. "Going forward, we are confident that significant additional margin improvement is possible. However, it will only come as we achieve higher volumes and capture the operating leverage inherent in hospital operations."

Tenet shares fell 93 cents, or 8%, to $11.11 in premarket trading Monday.