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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2020
Sep. 30, 2019
Cash flows from operating activities:    
Net income $ 257.1 $ 355.6
Loss from discontinued operations, net of tax 0.0 0.6
Adjustments to reconcile net income to net cash provided by operating activities—    
Depreciation and amortization 180.7 160.3
Loss on early extinguishment of debt 0.0 2.3
Stock-based compensation 25.3 87.0
Deferred tax (benefit) expense (5.7) 20.8
Gain on consolidation of Yuma Rehabilitation Hospital 0.0 (19.2)
Other, net 15.5 2.3
Change in assets and liabilities, net of acquisitions—    
Accounts receivable (71.8) (37.8)
Other assets 17.3 (11.1)
Accounts payable 10.3 (4.2)
Accrued payroll 86.7 (21.0)
Accrued interest payable (0.2) 7.4
Other liabilities (90.0) (118.7)
Net cash used in operating activities of discontinued operations (0.2) (4.6)
Total adjustments 167.9 63.5
Net cash provided by operating activities 425.0 419.7
Cash flows from investing activities:    
Acquisitions of businesses, net of cash acquired (1.1) (231.2)
Purchases of property and equipment (256.2) (259.9)
Additions to capitalized software costs (5.7) (9.2)
Other, net (1.8) (11.4)
Net cash used in investing activities (264.8) (511.7)
Cash flows from financing activities:    
Proceeds from bond issuance 592.5 1,000.0
Principal payments on debt, including pre-payments (14.7) (115.8)
Borrowings on revolving credit facility 330.0 525.0
Payments on revolving credit facility (375.0) (555.0)
Principal payments under finance lease obligations (16.7) (14.2)
Debt issuance costs (13.5) (15.2)
Taxes paid on behalf of employees for shares withheld (15.7) (16.2)
Dividends paid on common stock (84.3) (81.3)
Distributions paid to noncontrolling interests of consolidated affiliates (52.9) (57.6)
Repurchases of common stock, including fees and expenses (4.9) (45.9)
Purchase of equity interests in consolidated affiliates (162.3) (162.9)
Other, net 25.8 11.4
Net cash provided by financing activities 208.3 472.3
Increase in cash, cash equivalents, and restricted cash 368.5 380.3
Cash, cash equivalents, and restricted cash at beginning of period 159.6 133.5
Cash, cash equivalents, and restricted cash at end of period 528.1 513.8
Reconciliation of Cash, Cash Equivalents, and Restricted Cash    
Cash and cash equivalents at beginning of period 94.8 69.2
Restricted cash at beginning of period 57.4 59.0
Restricted cash included in other long-term assets at beginning of period 7.4 5.3
Cash, cash equivalents, and restricted cash at beginning of period 159.6 133.5
Cash and cash equivalents at end of period 450.0 422.0
Restricted cash at end of period 57.2 66.8
Restricted cash included in other long-term assets at end of period 20.9 25.0
Cash, cash equivalents, and restricted cash at end of period 528.1 513.8
Supplemental schedule of noncash financing activity:    
Adoption of ASC 842 $ 0.0 $ 349.4