NEW YORK (AP) — Health Management Associates Inc. reported a lower quarterly profit Friday that missed Wall Street expectations as the hospital operator saw revenue decline and costs climb.

The results came as the company, based in Naples, Fla., sought to fend off a push by a shareholder to replace its board of directors. Glenview Capital Management said it had support from Institutional Shareholder Services, a prominent proxy advisory firm, for its bid to elect eight nominees to the board.

HMA responded by saying it would support adding Glenview's nominees to its board and even making one of them chairman. But it wanted to keep two or three board members to ensure continuity and ensure an orderly transition, given its pending acquisition by another hospital operator.

For the three months ended June 30, the company said it earned $7.4 million, or 3 cents per share. That compares with $37 million, or 14 cents per share, a year ago.

Excluding the impact of one-time items, earnings from continuing operations were 7 cents per share.

Net revenue fell 5 percent to $1.46 billion.

Revenue per adjusted admission fell 2.7 percent at hospitals open at least a year. Surgeries decreased 2.2 percent and emergency room visits decreased 3.1 percent.

Its provision for doubtful accounts was $240.9 million, up from $214.6 million a year ago.

HMA has entered into an agreement to be acquired by fellow hospital operator Community Health Systems Inc. Community Health is making an additional payment for the deal depending on how some government investigations into HMA play out.

HMA has received subpoenas from the U. S. Department of Health and Human Services, Office of the Inspector General, regarding physician relationships and some emergency-room operations.

HMA runs 71 hospitals in 15 states, mostly in the Southeast and Texas.

Its shares were down 19 cents at $13.05.

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