Tenet also posted adjusted EBITDA of $203 million in the quarter, down 15.4% year over year from $240 million in the prior year quarter. The results were adversely impacted by the continuing effects of the recession, including declining commercial enrollment and the deferral of elective procedures. Tenet also believes that the soft economy continued to challenge the volume growth and exerted pressure on the operating margin.. The Echo 13 that I reviewed had the Bali Hai fabric. It's very b