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Supplemental Condensed Consolidating Financial Information (Details 2) (USD $)
In Thousands
9 Months Ended
Sep. 30, 2011
Sep. 30, 2010
Sep. 30, 2011
Parent Guarantor [Member]
Sep. 30, 2010
Parent Guarantor [Member]
Sep. 30, 2011
Issuer [Member]
Sep. 30, 2010
Issuer [Member]
Sep. 30, 2011
Other Guarantors [Member]
Sep. 30, 2010
Other Guarantors [Member]
Sep. 30, 2011
Non-Guarantors [Member]
Sep. 30, 2010
Non-Guarantors [Member]
Sep. 30, 2010
Eliminations [Member]
Sep. 30, 2011
Eliminations [Member]
Dec. 31, 2010
Eliminations [Member]
Cash flows from operating activities:             
Net cash (used in) provided by operating activities$ 820,235$ 898,377$ (23,970)$ (150,750)$ (120,269)$ (101,498)$ 595,670$ 804,039$ 368,804$ 346,586   
Cash flows from investing activities:             
Acquisitions of facilities and other related equipment(209,451)(67,541)    (163,397)(39,140)(46,054)(28,401)   
Purchases of property and equipment(532,845)(381,853)    (295,298)(211,023)(237,547)(170,830)   
Proceeds from disposition of hospitals and other ancillary operations172,578       172,578    
Proceeds from sale of property and equipment9,2512,845    1,2692,3987,982447   
Increase in other non-operating assets(130,980)(98,502)    (90,009)(64,177)(40,971)(34,325)   
Net cash used in investing activities(691,447)(545,051)    (547,435)(311,942)(144,012)(233,109)   
Cash flows from financing activities:             
Proceeds from exercise of stock options18,88053,83918,88053,839         
Deferred financing costs(100)   (100)        
Excess tax benefit relating to stock-based compensation4,61610,1094,61610,109         
Stock buy-back(85,790)(107,932)(85,790)(107,932)         
Proceeds from noncontrolling investors in joint ventures1,2295,155      1,2295,155   
Redemption of noncontrolling investments in joint ventures(4,784)(2,467)      (4,784)(2,467)   
Distributions to noncontrolling investors in joint ventures(49,928)(41,870)      (49,928)(41,870)   
Changes in intercompany balances with affiliates, net  86,264194,734157,854134,102(90,312)(246,860)(153,806)(81,976)   
Borrowings under credit agreement83,000   83,000        
Repayments of long-term indebtedness(128,768)(46,952)  (120,485)(32,604)(7,222)(12,788)(1,061)(1,560)   
Net cash used in financing activities(161,645)(130,118)23,970150,750120,269101,498(97,534)(259,648)(208,350)(122,718)   
Net change in cash and cash equivalents(32,857)223,208    (49,299)232,44916,442(9,241)   
Cash and cash equivalents at beginning of period299,169344,5410000212,992238,70986,177105,832000
Cash and cash equivalents at end of period$ 266,312$ 567,749$ 0$ 0$ 0$ 0$ 163,693$ 471,158$ 102,619$ 96,591$ 0$ 0$ 0