| Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 |
|---|---|---|---|---|---|---|---|---|---|---|---|
Cash flows from operating activities: | |||||||||||
Net income (loss) | |||||||||||
-590 | -704 | -2,396 | -1,626 | 259 | 203 | 217 | 346 | 277 | 348 | 306 | 252 |
Adjustments to reconcile net income (loss) to net cash provided by operating activities: | |||||||||||
Depreciation and amortization | |||||||||||
608 | 700 | 861 | 1,100 | 1,174 | 1,187 | 783 | 726 | 657 | 609 | 566 | 506 |
Deferred income taxes | |||||||||||
203 | -3 | -454 | -116 | 103 | 107 | 69 | 53 | 107 | 97 | 34 | 159 |
Government and other legal settlements and related costs | |||||||||||
51 | 11 | 9 | 16 | 4 | 101 | 102 | - | - | - | - | - |
Stock-based compensation expense | |||||||||||
10 | 13 | 24 | 46 | 59 | 54 | 38 | 41 | 42 | 38 | 44 | 52 |
Loss on sale, net | |||||||||||
- | - | - | - | -4 | - | - | - | -2 | - | -0 | - |
Impairment of hospitals sold or held for sale | |||||||||||
- | - | 6 | 8 | 5 | 50 | 5 | - | 47 | - | - | - |
Impairment and loss on sale of businesses, net | |||||||||||
138 | 668 | 2,123 | 1,919 | 68 | 41 | 12 | 10 | - | - | 12 | 5 |
Loss from early extinguishment of debt | |||||||||||
-54 | 31 | -40 | -30 | -16 | -73 | -1 | -115 | -66 | - | 2 | 2 |
Gain on sale of investments in unconsolidated affiliates | |||||||||||
- | - | - | 94 | - | - | - | - | - | - | - | - |
Loss (gain) on sale of hospitals and partnership interest, net | |||||||||||
- | - | - | - | - | - | - | - | - | - | - | 17 |
Excess tax benefit relating to stock-based compensation | |||||||||||
- | - | - | - | - | - | 7 | 4 | 5 | 10 | -3 | 1 |
Other non-cash expenses, net | |||||||||||
-182 | -38 | -35 | -31 | -47 | -13 | -61 | 33 | 28 | 12 | 22 | 3 |
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures: | |||||||||||
Patient accounts receivable | |||||||||||
-93 | -31 | -732 | 96 | 219 | 306 | 285 | 204 | 138 | 27 | -58 | 49 |
Supplies, prepaid expenses and other current assets | |||||||||||
-38 | -16 | 33 | -25 | 68 | -28 | 8 | 99 | 42 | 39 | 34 | 34 |
Accounts payable, accrued liabilities and income taxes | |||||||||||
-157 | -163 | -69 | -137 | -478 | 147 | 76 | 246 | 246 | 161 | 86 | 119 |
Payment of HMA legal settlement | |||||||||||
- | 266 | - | - | - | - | - | - | - | - | - | - |
Other | |||||||||||
245 | 36 | 105 | -31 | 53 | 83 | -25 | -17 | 27 | 2 | 22 | -62 |
Net cash provided by operating activities | |||||||||||
385 | 274 | 773 | 1,137 | 921 | 1,615 | 1,089 | 1,280 | 1,261 | 1,188 | 1,076 | 1,056 |
Cash flows from investing activities: | |||||||||||
Acquisitions of facilities and other related businesses | |||||||||||
13 | 26 | 6 | 123 | 57 | 3,091 | 44 | 322 | 415 | 248 | 263 | 161 |
Purchases of property and equipment | |||||||||||
438 | 527 | 564 | 744 | 953 | 853 | 614 | 769 | 776 | 667 | 576 | 692 |
Proceeds from disposition of hospitals and other ancillary operations | |||||||||||
604 | 405 | 1,692 | 143 | 155 | 88 | - | - | 173 | - | 89 | 365 |
Proceeds from sale of property and equipment | |||||||||||
3 | 8 | 7 | 15 | 15 | 50 | 7 | 6 | 11 | 8 | 4 | 13 |
Purchases of available-for-sale debt securities and equity securities | |||||||||||
80 | 78 | 125 | 505 | 162 | 263 | - | - | - | - | - | - |
Proceeds from sales of available-for-sale debt securities and equity securities | |||||||||||
92 | 114 | 208 | 464 | 156 | 229 | - | - | - | - | - | - |
Proceeds from sale of investments in unconsolidated affiliates | |||||||||||
- | - | - | 403 | - | - | - | - | - | - | - | - |
Distribution from Quorum Health Corporation | |||||||||||
- | - | - | 1,219 | - | - | - | - | - | - | - | - |
Increase in other investments | |||||||||||
170 | 141 | 143 | 242 | 205 | 511 | 340 | 298 | 188 | 137 | 120 | 190 |
Net cash (used in) provided by investing activities | |||||||||||
-2 | -245 | 1,069 | 630 | -1,051 | -4,351 | -991 | -1,383 | -1,195 | -1,044 | -867 | -665 |
Cash flows from financing activities: | |||||||||||
Proceeds from exercise of stock options | |||||||||||
- | - | - | - | 25 | 65 | 110 | 20 | 18 | 56 | 12 | 1 |
Repurchase of restricted stock shares for payroll tax withholding requirements | |||||||||||
1 | 1 | 5 | 6 | 20 | 11 | 15 | 9 | 13 | - | - | - |
Payment of special dividend to stockholders | |||||||||||
- | - | - | - | - | - | - | 23 | - | - | - | - |
Stock buy-back | |||||||||||
- | - | - | - | 159 | 9 | 27 | - | 85 | 113 | - | 90 |
Deferred financing costs and other debt-related costs | |||||||||||
46 | 96 | 66 | 26 | 30 | 276 | 13 | 141 | 19 | 13 | 0 | 3 |
Excess tax benefit relating to stock-based compensation | |||||||||||
- | - | - | - | - | - | 7 | 4 | 5 | 10 | -3 | 1 |
Proceeds from noncontrolling investors in joint ventures | |||||||||||
10 | 3 | 5 | - | 47 | 10 | - | 1 | 1 | 7 | 29 | 14 |
Redemption of noncontrolling investments in joint ventures | |||||||||||
11 | 31 | 6 | 19 | 36 | 158 | 9 | 44 | 13 | 7 | 7 | 77 |
Distributions to noncontrolling investors in joint ventures | |||||||||||
99 | 96 | 100 | 92 | 100 | 104 | 76 | 68 | 56 | 68 | 58 | 46 |
Proceeds from sale-lease back | |||||||||||
60 | - | - | - | - | - | - | - | - | - | - | - |
Proceeds from sale-lease back | |||||||||||
- | - | - | 159 | - | - | - | - | - | - | - | - |
Borrowings under credit agreements | |||||||||||
37 | 28 | 841 | 4,879 | 4,922 | 9,131 | 1,194 | 3,976 | 578 | - | 200 | - |
Issuance of long-term debt | |||||||||||
3,042 | 1,033 | 3,100 | - | - | 4,000 | - | 3,825 | 1,000 | - | - | - |
Proceeds from ABL facility | |||||||||||
202 | 797 | 105 | 107 | 206 | 204 | 338 | 350 | - | - | - | - |
Borrowings under credit agreement | |||||||||||
- | - | - | - | - | - | - | - | - | - | - | 131 |
Repayments of long-term indebtedness | |||||||||||
3,557 | 2,033 | 5,391 | 6,715 | 5,050 | 9,980 | 1,622 | 7,530 | 1,651 | 61 | 258 | 234 |
Net cash provided by (used in) financing activities | |||||||||||
-363 | -396 | -1,517 | -1,713 | -195 | 2,872 | -113 | 361 | -235 | -189 | -85 | -304 |
Net change in cash and cash equivalents | |||||||||||
20 | -367 | 325 | - | - | - | - | - | - | - | - | - |
Net change in cash and cash equivalents | |||||||||||
- | - | - | 54 | -325 | 136 | -15 | 258 | -169 | -45 | 123 | 87 |
Supplemental disclosure of cash flow information: | |||||||||||
Interest payments | |||||||||||
1,011 | 936 | 852 | 930 | 925 | 831 | 583 | 594 | 680 | 650 | 656 | 653 |
Income tax refunds (payments), net | |||||||||||
3 | 19 | -4 | 16 | 12 | -180 | 73 | 56 | 26 | 128 | 57 | -64 |