| Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cash flows from operating activities | ||||||||||||
Net Income (Loss) Attributable to Parent | ||||||||||||
2,707 | 1,683 | 2,448 | 614 | 1,276 | 1,147 | 1,231 | 1,222 | 1,419 | 1,099 | 1,040 | 647 | 833 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||||||
Gain (Loss) on Disposition of Business | ||||||||||||
0 | -786 | 0 | 0 | 270 | 0 | 0 | - | - | - | - | - | - |
Debt Securities, Available-for-sale, Realized Gain (Loss) | ||||||||||||
62 | 90 | 14 | 96 | 146 | 20 | 22 | 33 | 11 | 6 | 20 | -79 | 11 |
Equity in net earnings | ||||||||||||
14 | 11 | 0 | 0 | - | - | - | - | - | - | - | - | - |
Stock-based compensation | ||||||||||||
163 | 137 | 157 | 115 | 109 | 98 | 92 | 82 | 67 | 63 | 66 | 55 | 42 |
Depreciation | ||||||||||||
505 | 444 | 410 | 388 | 354 | 328 | 309 | 338 | 303 | 263 | 250 | 220 | 184 |
Amortization | ||||||||||||
70 | 90 | 75 | 77 | 93 | 121 | 117 | - | - | - | - | - | - |
(Gain) loss on sale of property and equipment, net | ||||||||||||
- | - | - | - | - | - | - | - | - | - | - | 0 | 13 |
Benefit for deferred income taxes | ||||||||||||
-162 | -194 | -132 | 71 | 2 | 64 | -42 | 80 | -22 | 199 | 27 | 22 | 32 |
Provision for doubtful accounts | ||||||||||||
- | - | - | 39 | 61 | 32 | 37 | -26 | 31 | 19 | 19 | 5 | 28 |
Changes in operating assets and liabilities, net of effect of businesses acquired and dispositions: | ||||||||||||
Receivables | ||||||||||||
32 | 164 | -426 | 158 | 180 | 264 | 251 | -326 | 106 | 46 | 60 | 152 | -60 |
Other assets | ||||||||||||
-118 | 484 | 582 | -426 | 872 | 952 | 330 | 253 | 183 | -81 | -113 | 100 | -105 |
Benefits payable | ||||||||||||
1,142 | 252 | 105 | -413 | 501 | 582 | 109 | -41 | 256 | 247 | 17 | 412 | 245 |
Other liabilities | ||||||||||||
471 | -676 | 641 | 937 | -129 | 413 | 313 | 300 | 194 | 722 | 14 | -170 | -317 |
Unearned revenues | ||||||||||||
-36 | -95 | 98 | -84 | 3 | 155 | -24 | -43 | 26 | -46 | -9 | -10 | 64 |
Other | ||||||||||||
90 | 107 | 155 | -162 | -70 | -42 | -93 | -79 | -61 | -45 | -19 | -18 | -34 |
Net cash provided by operating activities | ||||||||||||
5,284 | 2,173 | 4,051 | 1,936 | 868 | 1,618 | 1,716 | 1,923 | 2,079 | 2,242 | 1,422 | 982 | 1,224 |
Acquisitions, net of cash acquired | ||||||||||||
0 | 354 | 31 | 7 | 38 | 18 | 187 | 1,235 | 226 | 833 | 12 | 422 | 493 |
Purchase of equity method investment in Kindred at Home | ||||||||||||
0 | 1,095 | 0 | 0 | - | - | - | - | - | - | - | - | - |
Cash transferred in sale of business | ||||||||||||
0 | 805 | 0 | 0 | - | - | - | - | - | - | - | - | - |
Proceeds from sale of business | ||||||||||||
- | - | - | - | 1,061 | 72 | 34 | 0 | 0 | - | - | - | - |
Purchases of property and equipment | ||||||||||||
736 | 612 | 524 | 527 | 523 | 528 | 441 | 410 | 346 | 222 | 185 | 261 | 239 |
Proceeds from sales of property and equipment | ||||||||||||
- | - | - | - | 1 | 0 | 4 | 0 | 10 | 0 | 1 | 0 | 26 |
Purchases of investment securities | ||||||||||||
6,361 | 4,687 | 6,265 | 6,566 | 6,739 | 2,883 | 3,261 | 3,221 | 3,678 | 4,589 | 7,197 | 5,681 | 3,488 |
Maturities of investment securities | ||||||||||||
1,733 | 972 | 1,111 | 1,426 | 1,065 | 885 | 1,077 | 1,497 | 1,623 | 1,821 | 1,271 | 498 | 1,387 |
Proceeds from sales of investment securities | ||||||||||||
4,086 | 3,494 | 2,768 | 4,312 | 5,493 | 2,409 | 1,592 | 1,404 | 1,259 | 2,012 | 3,951 | 4,496 | 1,670 |
Change in securities lending collateral | ||||||||||||
- | - | - | - | - | - | - | - | - | - | -312 | -871 | -709 |
Net cash (used in) provided by investing activities | ||||||||||||
-1,278 | -3,087 | -2,941 | -1,362 | 320 | -63 | -1,182 | -1,965 | -1,358 | -1,811 | -1,859 | -498 | -1,845 |
Receipts from contract deposits, net | ||||||||||||
-623 | -640 | 1,823 | 1,093 | -296 | -919 | -150 | -397 | -378 | -237 | - | - | - |
Proceeds from issuance of senior notes, net | ||||||||||||
987 | 0 | 1,779 | 0 | 0 | 1,733 | 0 | 990 | 0 | 0 | - | 749 | 0 |
Repayments of Short-term Debt | ||||||||||||
- | - | - | 0 | - | - | - | - | - | - | - | - | - |
Excess tax benefit from stock-based compensation | ||||||||||||
- | - | - | - | 15 | 12 | 8 | 22 | 15 | 2 | 5 | 9 | 37 |
(Repayments) proceeds from issuance of commercial paper, net | ||||||||||||
-360 | 485 | -153 | -2 | 298 | 0 | 0 | - | - | - | - | - | - |
Proceeds from term loan | ||||||||||||
0 | 1,000 | 0 | 0 | - | - | - | - | - | - | - | - | - |
Receipts from CMS contract deposits | ||||||||||||
- | - | - | - | - | - | - | - | - | - | 2,354 | 2,761 | 2,866 |
Withdrawals from CMS contract deposits | ||||||||||||
- | - | - | - | - | - | - | - | - | - | 1,861 | 2,572 | 3,051 |
Borrowings under credit agreement | ||||||||||||
- | - | - | - | - | - | - | - | - | - | - | 1,175 | 1,685 |
Repayments under credit agreement | ||||||||||||
- | - | - | - | - | - | - | - | - | - | 250 | 1,725 | 1,335 |
Debt issue costs | ||||||||||||
- | - | - | - | - | - | - | - | - | - | - | 6 | 0 |
Proceeds from swap termination | ||||||||||||
- | - | - | - | - | - | - | - | - | - | - | -93 | 0 |
Change in securities lending payable | ||||||||||||
- | - | - | - | - | - | - | - | - | - | -312 | -898 | 709 |
Change in book overdraft | ||||||||||||
54 | 30 | -71 | -89 | -33 | -69 | 79 | 18 | -103 | 35 | 150 | -44 | -24 |
Repayment of term loan | ||||||||||||
650 | 350 | 0 | - | - | - | - | - | - | - | - | - | - |
Repayments of Long-term Debt | ||||||||||||
400 | 0 | 800 | 0 | 0 | 500 | 0 | 36 | 0 | 0 | - | - | - |
Common stock repurchases | ||||||||||||
1,070 | 1,090 | 3,365 | 104 | 385 | 872 | 531 | 518 | 541 | 108 | 23 | 106 | 27 |
Dividends paid | ||||||||||||
291 | 265 | 220 | 177 | 172 | 172 | 168 | 165 | 82 | 0 | 0 | - | - |
Proceeds from stock option exercises and other, net | ||||||||||||
58 | 45 | 62 | 11 | 21 | 29 | 60 | 57 | 72 | -63 | 17 | 10 | 61 |
Net cash provided by financing activities | ||||||||||||
-2,295 | -785 | -945 | 732 | -552 | -758 | -702 | -29 | -1,017 | -371 | 80 | -554 | 921 |
Increase in cash and cash equivalents | ||||||||||||
1,711 | -1,699 | 165 | 1,306 | 636 | 797 | -168 | -71 | -296 | 60 | -357 | -70 | 300 |
Supplemental cash flow disclosures: | ||||||||||||
Interest payments | ||||||||||||
212 | 195 | 216 | 185 | 187 | 143 | 146 | 110 | 114 | 112 | 113 | 73 | 67 |
Income tax payments, net | ||||||||||||
518 | 631 | 1,498 | 916 | 1,179 | 1,030 | 734 | 745 | 874 | 785 | 627 | 347 | 443 |
Details of businesses acquired in purchase transactions: | ||||||||||||
Fair value of assets acquired, net of cash acquired | ||||||||||||
28 | 392 | 31 | 7 | 38 | 18 | 196 | 1,535 | 266 | 1,044 | 12 | 772 | 1,315 |
Less: Fair value of liabilities assumed | ||||||||||||
28 | 38 | 0 | 0 | 0 | 0 | 9 | 300 | 40 | 211 | 0 | -349 | -821 |
Payments to Acquire Businesses, Net of Cash Acquired | ||||||||||||
0 | 354 | 31 | 7 | 38 | 18 | 187 | 1,235 | 226 | 833 | 12 | 422 | 493 |