There's no doubt that Community Health Systems (CYH -0.99%) is having a great start to 2020. The hospital stock was up more than 60% year to date entering this week.

Community Health Systems announced its 2019 fourth-quarter and full-year results after the market closed on Wednesday. And that great start to 2020 is getting even better. Here are the highlights from the company's Q4 update.

Female health care provider and female patient.

Image source: Getty Images.

By the numbers

Did Community Health Systems report tremendous revenue growth in Q4? Actually, no. The company's revenue fell 5% year over year to $3.29 billion. However, this result easily topped the average analysts' Q4 revenue estimate of $3.18 billion.

Community Health's bottom line also deteriorated in the fourth quarter. The company announced a net loss in Q4 of $373 million, or $3.27 per share, based on generally accepted accounting principles (GAAP). In the prior-year period, Community Health posted a GAAP net loss of $328 million, or $2.91 per share. 

However, the picture looked much better on a non-GAAP basis. Community Health reported adjusted earnings per share in Q4 of $0.40. This reflected a significant improvement from the adjusted net loss of $0.42 in the prior-year period. It also handily blew away the consensus Wall Street estimate of an adjusted net loss of $0.46 per share in Q4.

Behind the numbers

Community Health Systems' year-over-year revenue decline wasn't concerning at all. The company sold 12 hospitals during 2019. This obviously impacted the top line and caused admissions to decline by 9.9% year over year.

What really matters, though, is how the hospitals that Community Health retained performed. Adjusted same-store admissions increased 1.8% over the prior-year period in Q4. Also, net operating revenue on a same-store basis rose 3.7% year over year.

The company's worsening GAAP net loss in Q4 stemmed largely from higher income taxes. However, Community Health's non-GAAP earnings in the quarter included big adjustments for a change in tax valuation allowance, impairment and loss on the sale of businesses, and expenses from government and other legal settlements. These adjustments enabled the hospital operator to beat Wall Street's expectations.

Looking ahead

Community Health Systems projects sales of $12.4 million to $12.8 million for full-year 2020. The company expects a GAAP net loss per share of between $1.30 and $0.60. This full-year guidance includes the impact of divestitures that have already been completed and those that are expected to close this year.

"As we enter 2020, we expect to deliver incremental growth, driven by a combination of continued same-store net revenue performance and execution across our strategic margin improvement programs," CEO Wayne T. Smith said. One factor that could impact many healthcare stocks in 2020, though, including Community Health Systems, is the U.S. presidential election. The outcome of the election could significantly alter the future prospects for Community Health.