Hospital operator Tenet Healthcare Corp. (THC), which has been under scrutiny for its billing practices, Tuesday said its fourth-quarter loss widened to $2 billion on various charges.

Tenet Healthcare (search), which has not reported a quarterly net profit since the first quarter of 2003, said its admissions trends, a key profit driver, were improving.

"Same-hospital admissions declined 3.8 percent in the fourth quarter of 2004 versus the fourth quarter of 2003, but have been essentially flat so far in 2005," Reynold Jennings, chief operating officer, said in a statement.

But analysts said Tenet's future remains unclear.

"Operationally, it is still a big turnaround. I don't think we're anywhere near normalized operating results," said Darren Lehrich, analyst at Piper Jaffray, noting that Tenet still faces potential costs from asset sales, litigation and inquiries into its billing practices.

Dallas-based Tenet reported a fourth-quarter net loss of $2.02 billion, or $4.33 per share, compared with a loss of $954 million, or $2.05 per share, a year earlier.

Excluding discontinued operations and the charges from litigation, restructuring costs and writing down assets, Tenet reported a loss of 6 cents per share.

Analysts had expected a loss in a range of 2 cents to 16 cents per share, with an average loss estimate of 9 cents, according to Reuters Estimates.

"I believe all the elements of Tenet's restructuring with the exception of a legal resolution are now in place," company President and Chief Executive Trevor Fetter said on a conference call with investors.

Tenet has been under regulatory scrutiny since late 2002 for how it billed Medicare for treating the sickest patients.

The company has also changed its practices for treating uninsured patients and billing Medicare for complex and expensive cases, known as "outlier" patients. Tenet has also replaced top executives, divested hospitals, and refinanced debt.

Joseph Chiarelli, an analyst at Oppenheimer who rates Tenet "buy," said the company is meeting the expectations it set in December. "It's a little early now to see where the progression is for (2005), but they are on the right track," he said.

Chiarelli said Tenet's move to raise cash, a figure that is expected to grow to $1.3 billion from $900 million over the next month after a tax refund, could lead to a settlement with the federal government over Medicare billing.

The company said if it is able to achieve industry-average admissions growth it should have a positive impact on its future results. If the negative admissions trends of 2004 continue, Tenet said it will not meet its current objectives for operating performance in 2005.

The company said it expects net operating revenue in 2005 to be flat to slightly increased, compared with $9.9 billion in 2004. It expects to achieve market level managed care price increases in the mid-to high single digits.

Tenet's stock rose 16 cents to $11.20 in afternoon trade on the New York Stock Exchange. Tenet's stock, which had traded at more than $50 in October 2002, has traded between $13.42 and $9.15 over the past 52 weeks.