A Miami, Fla.-based group of dissident shareholders on Monday issued a report contending that Tenet Healthcare Corp. will not likely survive in its present form.

The report - titled "Tenet's Death Rattle" - from Tenet Shareholder Committee LLC says that because of the healthcare provider's "rapidly deteriorating cash position and potential multi-billion liabilities, we do not see how Tenet can survive as it is currently structured."

Committee Chairman M. Lee Pearce, MD, added that it "seems to us that the more likely outcome is a reorganization of Tenet into several separate regional companies, perhaps as many as four."

The shareholder report comes two weeks after Tenet announced it would sell 27 hospitals - including 19 facilities in California -- as part of a major restructuring to focus foster long-term growth. Tenet said it would focus its financial and management resources on 69 acute care hospitals in 13 states, including 17 remaining facilities in California.

The shareholder report contends that:

• Operations at the 27 hospitals to be sold will likely deteriorate rapidly, as is often the case in the hospital industry following announcement of a pending sale. This will likely cause a further drain on Tenet's cash flow;
  
  
• Even with the planned sale of the 27 hospitals, substantial asset sales will be required to support the company's existing $4 billion in debt and payments resulting from government investigations, malpractice lawsuits, and other liabilities associated with the $17 billion loss of shareholder value over the last 15 months; and
  
  
• Tenet's total liabilities arising from federal and state investigations of outlier overpayments, Medicare upcoding, physician relocation practices, as well as medical malpractice lawsuits, shareholder lawsuits and other allegations to be at least $3 billion.