Operating cash flow reached $196.7M in 2026Q2 against net income of $16.9M (OCF/NI of 11.6x), but FCF swung from -$88.3M in 2026Q1 to $158.1M in 2026Q2, highlighting working capital-driven volatility.
Ardent Health Inc. (ARDT) cash flow statement — 7-year operating, investing & financing cash flows
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'18 | Dec'17 | Dec'16 |
|---|
| Cash from Operations | 510.14M | 470.51M | 315.03M | 221.7M | -38.36M | 159.59M | 119.47M | 85.78M |
| Operating CF Margin % | - | 7.44% | 5.28% | 4.1% | -0.75% | 3.83% | 3.98% | 4.07% |
| Operating CF Growth % | 74.74% | 49.36% | 42.1% | 677.96% | -124.04% | 33.58% | 39.28% | - |
| Net Income | 78.23M | 230.13M | 299.71M | 128.98M | 265.37M | -143.02M | -35.65M | 14.6M |
| Depreciation & Amortization | 164.52M | 155.7M | 146.29M | 140.84M | 138.17M | 143.19M | 109.53M | 71.51M |
| Stock-Based Compensation | 25.99M | 39.29M | 17.98M | 904K | 611K | 0 | 0 | 0 |
| Deferred Taxes | 20.68M | 43.59M | 24.04M | 4M | 46.12M | -7.82M | 49.7M | -12.71M |
| Other Non-Cash Items | 55.37M | 5.13M | 8.76M | 3.29M | -478.89M | 152.7M | 45.83M | 43.08M |
| Working Capital Changes | 99.61M | -3.34M | -181.75M | -56.31M | -9.74M | 14.54M | -49.94M | -30.71M |
| Change in Receivables | 63.57M | 59.16M | 40M | -181.1M | -17.18M | -9.05M | -63.82M | -17.72M |
| Change in Inventory | 2.54M | -3.15M | -9.41M | 1.67M | 4.67M | -1.03M | -3.61M | 56K |
| Change in Payables | 52.25M | 62.06M | -103.86M | 136.82M | 14.42M | 37.15M | 41.3M | -9.28M |
| Cash from Investing | -211.94M | -214.23M | -220.46M | -137.98M | 46.58M | -482.14M | -966.93M | -64.83M |
| Capital Expenditures | -209.56M | -211.9M | -187.51M | -137.41M | -151.11M | -160.66M | -121.53M | -80.5M |
| CapEx % of Revenue | 3.27% | 3.35% | 3.14% | 2.54% | 2.95% | 3.86% | 4.05% | 3.82% |
| Acquisitions | -2.5M | -2.5M | -31.25M | 0 | 206.37M | -349.83M | -857.55M | -2.5M |
| Investments | - | - | - | - | - | - | - | - |
| Other Investing | 127K | 179K | -1.71M | -575K | -8.69M | 28.35M | 12.16M | 18.17M |
| Cash from Financing | -115.96M | -103.47M | 24.64M | -102.26M | -270.33M | 353.22M | 826.81M | -25.89M |
| Debt Issued (Net) | -20.22M | -7.99M | -104.77M | -7.03M | -16.41M | 252.63M | 718.51M | -5.67M |
| Equity Issued (Net) | -13.03M | 0 | 208.66M | 0 | 0 | 99.12M | 143.94M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | -174.81M | 0 | 0 | 0 |
| Share Repurchases | -13.03M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | -82.71M | -95.48M | -79.24M | -95.24M | -79.11M | 1.47M | -35.64M | -20.22M |
| Net Change in Cash | 183.85M | 152.82M | 119.21M | -18.55M | -262.11M | -12.3M | -20.65M | -4.95M |
| Free Cash Flow | 300.57M | 258.61M | 127.52M | 84.29M | -189.47M | -1.07M | -2.06M | 3.62M |
| FCF Margin % | 4.69% | 4.09% | 2.14% | 1.56% | -3.69% | -0.03% | -0.07% | 0.17% |
| FCF Growth % | 171.82% | 102.8% | 51.28% | 144.49% | -17590.57% | 48.06% | -156.96% | - |
| FCF per Share | 2.10 | 1.83 | 0.96 | 0.59 | -1.32 | -0.01 | -0.01 | 0.03 |
| FCF Conversion (FCF/Net Income) | 3.84x | 3.46x | 1.50x | 4.41x | -0.20x | -1.12x | -3.35x | 5.87x |
| Interest Paid | 0 | 0 | 74.98M | 81.61M | 90.85M | 86.54M | 64.63M | 26.01M |
| Taxes Paid | 0 | 0 | 41.6M | 19.43M | 55.82M | 5.55M | 2.37M | 23.62M |
Quick answers to the most common questions about buying ARDT stock.
Ardent Health Inc. (ARDT) generated $470.5M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Ardent Health Inc. (ARDT) generated $258.6M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Ardent Health Inc. (ARDT) spent $211.9M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
Key Metrics
Top Statement Risk
Working capital volatility and EPS miss
Metrics are mathematically derived from official filings.
Cash Conversion Swings on Working Capital
In 2026Q2, ARDT's operating cash flow reached $196.7M against net income of $16.9M, an OCF/NI ratio of 11.6x, per reported financials, highlighting the impact of working capital swings on cash conversion.
The OCF/NI ratio of 11.6x in 2026Q2 is extreme, driven by a $107.5M positive working capital change, which contrasts sharply with the -1.5x ratio in 2026Q1 when working capital consumed $160.1M. This volatility suggests that earnings quality is heavily influenced by timing of receivables and payables, not just operational performance. Investors should monitor whether these swings reflect sustainable improvements in collections or merely quarter-end timing effects.
FCF Volatility Masks Underlying Stability
Free cash flow swung from -$88.3M in 2026Q1 to $158.1M in 2026Q2, with FCF margin improving to 9.7% from -5.5%, based on reported figures, indicating high quarter-to-quarter variability despite stable revenue.
The FCF trajectory is erratic, with positive quarters in 2025Q2-Q4 and 2026Q2, but negative in 2025Q1 and 2026Q1, reflecting the working capital swings. The average FCF margin over the last four quarters is approximately 4.4%, which is below the peer FCF margin of 7.7% for HCA, suggesting ARDT's cash generation is less efficient. This volatility may indicate that the company's cash flow is not yet a reliable indicator of underlying profitability, warranting a longer-term view.
Capital Intensity Remains Moderate
CapEx as a percentage of revenue averaged 3.0% over the last four quarters, per financial statements, with 2025Q4 peaking at 5.2%, indicating a moderate reinvestment rate relative to peers like HCA's 7.7% FCF margin.
ARDT's capital intensity is relatively low, with CapEx/Revenue ranging from 1.5% to 5.2% over the past ten quarters, suggesting a focus on maintenance rather than aggressive expansion. The 2025Q4 spike to 5.2% may reflect a one-time investment, but the overall trend is stable. This moderate capex supports the company's ability to generate positive FCF, but it may also limit growth potential if the company needs to invest more to maintain its regional density moat.
Working Capital Drives Cash Flow Swings
Working capital changes ranged from -$160.1M in 2026Q1 to +$107.5M in 2026Q2, as reported in cash flow statements, causing significant quarterly cash flow volatility and obscuring underlying operational trends.
The working capital swings are the primary driver of the erratic operating cash flow, with negative changes in 2025Q1, 2025Q2, 2024Q4, and 2026Q1, and positive changes in other quarters. This pattern suggests that ARDT's collections and payables management are not smooth, possibly due to the lumpy nature of supplemental reimbursements and payer mix shifts. Investors should monitor whether the company can stabilize these swings, as they currently mask the true cash-generating ability of the business.
Capital Deployment Focused on Buybacks
In 2026Q2, ARDT repurchased $13.0M of shares, the only buyback in the last ten quarters, while paying no dividends, according to cash flow data, indicating a nascent capital return program.
The company has not paid dividends and only recently initiated a modest share repurchase, suggesting a conservative capital deployment strategy. The $13.0M buyback in 2026Q2 is small relative to the $158.1M FCF generated that quarter, implying management may be prioritizing balance sheet flexibility or future investments. Given the private equity heritage, investors should watch for potential increases in capital returns if cash generation stabilizes.
Cumulative Earnings vs Cash Gap
Over the last ten quarters, cumulative net income was $402.0M while operating cash flow totaled $897.9M, per reported data, a gap of $495.9M, indicating that cash generation has far exceeded reported earnings.
The cumulative OCF exceeds net income by a wide margin, largely due to non-cash charges like D&A and favorable working capital changes. This divergence suggests that earnings are understating the company's cash-generating ability, which may be a positive signal for valuation. However, the volatility in working capital means this gap is not consistent, and investors should not extrapolate the cumulative trend into future quarters without understanding the drivers.
What the Cash Flow Statement Obscures
ARDT's cash flow statement obscures the impact of stock-based compensation, which totaled $8.0M in 2026Q2, and the lumpy nature of supplemental reimbursements, potentially overstating the sustainability of operating cash flow.
While SBC is added back to operating cash flow, it represents a real economic cost to shareholders, and the $8.0M in 2026Q2 is not trivial relative to net income of $16.9M. Additionally, the working capital swings may be influenced by the timing of state supplemental payments, which are not separately disclosed and can distort quarterly comparisons. Investors should adjust for these items to assess the true recurring cash generation, as the reported OCF may not be fully repeatable.