Pain keeps spreading in the hospital sector.

Two weeks after industry giant HCA ( HCA) first warned of a third-quarter shortfall, other hospital operators continue to limp forward with weak results of their own. Health Management Associates ( HMA) will soon break a strong record of meeting -- and often beating -- Wall Street expectations, according to a preannouncement issued Thursday night. Meanwhile, Universal Health ( UHS) has now managed to deliver its third earnings miss in a year.

Both companies weathered a severe spike in bad debt from the uninsured, a chronic industry problem that was only exacerbated by the Gulf Coast hurricanes.

HMA expects to report fourth-quarter profits of 35 cents a share, 2 cents shy of the consensus estimate. The hurricanes caused only part of that shortfall, with insurance recoveries from past storms more than offsetting their impact. Weak patient volumes, coupled with higher provisions for doubtful accounts, hurt the company more.

During the latest quarter, HMA saw same-hospital admissions inch up just 0.4%, even as uninsured admissions kept rocketing.

"HMA continues to be challenged by an increasingly uninsured patient mix," wrote Bear Stearns analyst Jason Gurda, who has a market-weight rating on the stock. "Based on some initial data from the company, we estimate that uninsured admissions increased approximately 10% during the September quarter. ... Two of HMA's markets -- Florida and Texas -- continue to see material uninsured growth, and the impact of the hurricanes only makes these trends worse."

All told, 7.5% of the patients treated by HMA hospitals last quarter lacked health insurance coverage. That figure is up from 6.9% one year ago. As a result, HMA found itself increasing its provision for doubtful accounts to 8.2% of total revenue -- compared with 7.5% a year earlier -- and writing off more business up front as charity and indigent care.

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