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swung to a first-quarter profit of $70 million thanks mostly to adjustments to previously booked tax and insurance assets. Earnings from continuing operations were slightly better than expected, although the hospital operator continued to see lower revenue and admissions.

Tenet earned $70 million, or 15 cents a share, in the quarter, compared with a loss of $4 million, or 1 cent a share, a year ago. Continuing earnings were $15 million, or 3 cents a share, in the latest quarter, down from $20 million, or 4 cents a share, a year ago, but better than the 2-cent loss forecast by Thomson First Call.

Discontinued earnings in the latest quarter included a $20 million favorable adjustment to a tax allowance for deferred tax assets; a $28 million favorable adjustment to an insurance recovery; and a $9 million favorable adjustment to cost settlements.

First-quarter revenue fell 3.5% to $2.41 billion, about $50 million shy of forecasts. Tenet's overall admissions fell 6.7% from a year ago to 166,426 in the first quarter, while uninsured admissions rose 0.2% to 6,240. On a same-hospital basis, admissions fell 3.3% while uninsured admissions rose 0.1%.

The company said about 27% of the decline in same-hospital admissions was attributable to the loss of admissions from closed businesses. In commercial managed care, same-hospital admissions fell 5.3% from a year ago, while managed Medicare and Medicaid admissions rose 5.8%.

Some of the decline in admissions was made up with better pricing, as Tenet's same-hospital net inpatient revenue per admission was $10,151 in the quarter, up from $9,596. Its bad debt provision also fell to $138 million, or 5.7% of revenue, from $167 million, or 6.7% of revenue.

"We improved our pricing and maintained tight control of costs while reducing our bad debt expense in the first quarter, which contributed to positive earnings," Tenet said. "But we continue to struggle with declining patient volumes in a number of our hospitals, and rebuilding those volumes is our top priority."