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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Millions
3 Months Ended
Mar. 31, 2019
Mar. 31, 2018
Cash flows from operating activities:    
Net loss $ (101.0) $ (6.0)
Adjustments to reconcile net loss to net cash provided by operating activities:    
Depreciation and amortization 153.0 181.0
Government and other legal settlements and related costs 5.0 5.0
Stock-based compensation expense 3.0 4.0
Impairment and (gain) loss on sale of businesses, net 38.0 28.0
Loss from early extinguishment of debt 31.0 4.0
Other non-cash expenses, net 36.0 12.0
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:    
Patient accounts receivable (10.0) (66.0)
Supplies, prepaid expenses and other current assets 14.0 (21.0)
Accounts payable, accrued liabilities and income taxes 23.0 (33.0)
Other (59.0) (2.0)
Net cash provided by operating activities 133.0 106.0
Cash flows from investing activities:    
Acquisitions of facilities and other related businesses (4.0) (8.0)
Purchases of property and equipment (121.0) (170.0)
Proceeds from disposition of hospitals and other ancillary operations 161.0 11.0
Proceeds from sale of property and equipment   3.0
Purchases of available-for-sale securities and equity securities (15.0) (19.0)
Proceeds from sales of available-for-sale securities and equity securities 32.0 34.0
Increase in other investments (34.0) (28.0)
Net cash provided by (used in) investing activities 19.0 (177.0)
Cash flows from financing activities:    
Repurchase of restricted stock shares for payroll tax withholding requirements (1.0) (1.0)
Deferred financing costs and other debt-related costs (25.0) (11.0)
Proceeds from noncontrolling investors in joint ventures 1.0  
Redemption of noncontrolling investments in joint ventures (1.0) (3.0)
Distributions to noncontrolling investors in joint ventures (27.0) (23.0)
Borrowings under credit agreements 12.0 10.0
Issuance of long-term debt 1,840.0  
Proceeds from ABL facility 25.0 49.0
Repayments of long-term indebtedness (1,895.0) (89.0)
Net cash used in financing activities (71.0) (68.0)
Net change in cash and cash equivalents 81.0 (139.0)
Cash and cash equivalents at beginning of period 196.0 563.0
Cash and cash equivalents at end of period 277.0 424.0
Supplemental disclosure of cash flow information:    
Interest payments (189.0) (212.0)
Income tax refunds (payments), net