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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Cash flows from operating activities:    
Net loss $ (244) $ (405)
Adjustments to reconcile net loss to net cash provided by operating activities:    
Depreciation and amortization 456 531
Government and other legal settlements and related costs 25 9
Stock-based compensation expense 8 10
Impairment and (gain) loss on sale of businesses, net 70 314
Loss (gain) from early extinguishment of debt 31 (32)
Other non-cash expenses, net 140 25
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:    
Patient accounts receivable 82 38
Supplies, prepaid expenses and other current assets 40 14
Accounts payable, accrued liabilities and income taxes (315) (47)
Other (102) (17)
Net cash provided by operating activities 191 440
Cash flows from investing activities:    
Acquisitions of facilities and other related businesses (13) (21)
Purchases of property and equipment (322) (413)
Proceeds from disposition of hospitals and other ancillary operations 363 228
Proceeds from sale of property and equipment 1 7
Purchases of available-for-sale securities and equity securities (58) (50)
Proceeds from sales of available-for-sale securities and equity securities 72 75
Increase in other investments (146) (76)
Net cash used in investing activities (103) (250)
Cash flows from financing activities:    
Repurchase of restricted stock shares for payroll tax withholding requirements (1) (1)
Deferred financing costs and other debt-related costs (28) (93)
Proceeds from noncontrolling investors in joint ventures 10 2
Redemption of noncontrolling investments in joint ventures (6) (27)
Distributions to noncontrolling investors in joint ventures (78) (74)
Proceeds from sale-lease back 56  
Borrowings under credit agreements 26 24
Issuance of long-term debt 2,489 1,033
Proceeds from ABL facility 25 587
Repayments of long-term indebtedness (2,620) (1,869)
Net cash used in financing activities (127) (418)
Net change in cash and cash equivalents (39) (228)
Cash and cash equivalents at beginning of period 196 563
Cash and cash equivalents at end of period 157 335
Supplemental disclosure of cash flow information:    
Interest payments (810) (637)
Income tax refunds (payments), net $ 3 $ 17