| Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 |
|---|---|---|---|---|---|---|---|---|---|---|---|
Net income | |||||||||||
154,000 | 466,000 | -320,000 | 176,000 | 78,000 | 76,000 | -104,000 | 133,000 | 94,000 | 1,152,000 | 197,000 | 32,000 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||||||
Depreciation, Depletion and Amortization | |||||||||||
850,000 | 802,000 | 870,000 | 850,000 | 797,000 | 849,000 | 545,000 | 430,000 | 398,000 | 380,000 | 373,000 | 371,000 |
Provision for doubtful accounts | |||||||||||
- | - | 1,434,000 | 1,449,000 | 1,477,000 | 1,305,000 | 972,000 | 785,000 | 717,000 | 727,000 | 684,000 | 628,000 |
Net gain on sales of investments | |||||||||||
- | - | - | - | - | - | - | - | - | - | 15,000 | 139,000 |
Deferred income tax (benefit) expense | |||||||||||
137,000 | 150,000 | 200,000 | 41,000 | 42,000 | 30,000 | -67,000 | 92,000 | 81,000 | -952,000 | 20,000 | -14,000 |
Stock-based compensation expense | |||||||||||
42,000 | 46,000 | 59,000 | 68,000 | 69,000 | 51,000 | 36,000 | 32,000 | 24,000 | 22,000 | 23,000 | 33,000 |
Restructuring Settlement Impairment Provisions and Acquisition Cost | |||||||||||
185,000 | 209,000 | 541,000 | 202,000 | 318,000 | 153,000 | 103,000 | 19,000 | 20,000 | 10,000 | 27,000 | 16,000 |
Gain (Loss) Related to Litigation Settlement | |||||||||||
-141,000 | -38,000 | -23,000 | -293,000 | -291,000 | -25,000 | -31,000 | -5,000 | -55,000 | -12,000 | -31,000 | -41,000 |
Net Gain on Sale, Consolidation, And Deconsolidation Of Facilities | |||||||||||
-15,000 | 127,000 | 144,000 | 151,000 | 186,000 | - | - | - | - | - | - | - |
Gain (Loss) on Extinguishment of Debt | |||||||||||
-227,000 | 1,000 | -164,000 | 0 | -1,000 | -24,000 | -348,000 | -4,000 | -117,000 | -57,000 | 97,000 | 0 |
Equity in earnings of unconsolidated affiliates, net of distributions received | |||||||||||
32,000 | 12,000 | 18,000 | 13,000 | 99,000 | 10,000 | 13,000 | - | - | - | - | - |
Fair market value adjustments related to interest rate swap and LIBOR cap agreements | |||||||||||
- | - | - | - | - | - | - | - | - | -3,000 | 1,000 | 0 |
Amortization of debt discount and debt issuance costs | |||||||||||
35,000 | 45,000 | 44,000 | 41,000 | 41,000 | 28,000 | 19,000 | 22,000 | 30,000 | 31,000 | 27,000 | 15,000 |
Pre-tax loss (income) from discontinued operations | |||||||||||
15,000 | 4,000 | 0 | -6,000 | 3,000 | -35,000 | -7,000 | -101,000 | -41,000 | 10,000 | -9,000 | -52,000 |
Other items, net | |||||||||||
15,000 | 21,000 | 18,000 | 1,000 | -59,000 | 30,000 | 20,000 | 12,000 | 13,000 | 5,000 | -6,000 | -11,000 |
Changes in cash from operating assets and liabilities: | |||||||||||
Accounts receivable | |||||||||||
247,000 | 134,000 | 1,448,000 | 1,604,000 | 1,632,000 | 1,896,000 | 987,000 | 868,000 | 850,000 | 731,000 | 635,000 | 647,000 |
Inventories and other current assets | |||||||||||
94,000 | -17,000 | 35,000 | 83,000 | 130,000 | 314,000 | 203,000 | 59,000 | 35,000 | 15,000 | 24,000 | 1,000 |
Income taxes | |||||||||||
-8,000 | 3,000 | 38,000 | 8,000 | -18,000 | -3,000 | - | 5,000 | 63,000 | -3,000 | 78,000 | 20,000 |
Accounts payable, accrued expenses and other current liabilities | |||||||||||
36,000 | -152,000 | -10,000 | -51,000 | 68,000 | 505,000 | 38,000 | 9,000 | -32,000 | -87,000 | 15,000 | -29,000 |
Other long-term liabilities | |||||||||||
3,000 | -102,000 | 26,000 | 40,000 | 38,000 | 44,000 | 13,000 | 3,000 | -5,000 | -58,000 | -13,000 | -37,000 |
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements | |||||||||||
192,000 | 163,000 | 125,000 | 691,000 | 200,000 | 168,000 | 114,000 | 63,000 | 44,000 | 83,000 | 192,000 | 100,000 |
Net cash used in operating activities from discontinued operations, excluding income taxes | |||||||||||
-5,000 | -5,000 | -5,000 | -6,000 | -21,000 | -23,000 | -15,000 | -35,000 | -38,000 | 16,000 | 68,000 | 18,000 |
Net Cash Provided by (Used in) Operating Activities | |||||||||||
1,233,000 | 1,049,000 | 1,200,000 | 558,000 | 1,026,000 | 687,000 | 589,000 | 593,000 | 497,000 | 472,000 | 425,000 | 208,000 |
Cash flows from investing activities: | |||||||||||
Purchases of property and equipment — continuing operations | |||||||||||
670,000 | 617,000 | 707,000 | 875,000 | 842,000 | 933,000 | 691,000 | 506,000 | 467,000 | 433,000 | 387,000 | 452,000 |
Construction of new and replacement hospitals | |||||||||||
- | - | - | - | - | - | - | - | - | 13,000 | 58,000 | 75,000 |
Purchases of property and equipment - discontinued operations | |||||||||||
- | - | - | - | - | - | - | 2,000 | 8,000 | 30,000 | 11,000 | 20,000 |
Purchases of businesses or joint venture interests, net of cash acquired | |||||||||||
25,000 | 113,000 | 50,000 | 117,000 | 940,000 | 428,000 | 1,515,000 | 211,000 | 84,000 | 65,000 | 0 | 92,000 |
Proceeds from sales of facilities and other assets — continuing operations | |||||||||||
63,000 | 543,000 | 827,000 | 573,000 | 549,000 | 6,000 | 20,000 | 45,000 | 0 | 19,000 | 221,000 | 160,000 |
Proceeds from sales of facilities and other assets — discontinued operations | |||||||||||
17,000 | 0 | 0 | - | - | - | - | - | - | - | - | - |
Proceeds from sales of marketable securities, long-term investments and other assets | |||||||||||
82,000 | 199,000 | 36,000 | 62,000 | 60,000 | 52,000 | 12,000 | 17,000 | 59,000 | 84,000 | 67,000 | 224,000 |
Purchases of marketable securities and equity investments | |||||||||||
62,000 | 148,000 | 81,000 | 39,000 | 134,000 | 12,000 | 1,000 | - | - | - | - | - |
Other long-term assets | |||||||||||
24,000 | -15,000 | 10,000 | 31,000 | 4,000 | 8,000 | -8,000 | 9,000 | 2,000 | - | - | - |
Purchases of marketable securities | |||||||||||
- | - | - | - | - | - | - | - | - | - | 17,000 | 26,000 |
Distributions received from investments in Reserve Yield Plus Fund | |||||||||||
- | - | - | - | - | - | - | - | - | - | 12,000 | -14,000 |
Proceeds from hospital authority bonds | |||||||||||
- | - | - | - | - | - | - | - | - | - | 49,000 | 8,000 |
Proceeds from cash surrender value or basis reduction of insurance policies | |||||||||||
- | - | - | - | - | - | - | - | - | - | - | 11,000 |
Release of escrow funds | |||||||||||
- | - | - | - | - | - | - | - | - | -15,000 | 0 | 0 |
Other items, net | |||||||||||
0 | -6,000 | -6,000 | 3,000 | 6,000 | -1,000 | -3,000 | -4,000 | 1,000 | -3,000 | 1,000 | -2,000 |
Net cash used in investing activities | |||||||||||
-619,000 | -115,000 | 21,000 | -430,000 | -1,317,000 | -1,322,000 | -2,164,000 | -662,000 | -503,000 | -420,000 | -125,000 | -274,000 |
Cash flows from financing activities: | |||||||||||
Repayments of borrowings under credit facility | |||||||||||
2,640,000 | 950,000 | 970,000 | 1,895,000 | 2,815,000 | 2,430,000 | 1,286,000 | 1,773,000 | 365,000 | 0 | 0 | - |
Proceeds from borrowings under credit facility | |||||||||||
2,640,000 | 950,000 | 970,000 | 1,895,000 | 2,595,000 | 2,245,000 | 1,691,000 | 1,693,000 | 445,000 | 0 | 0 | - |
Repayments of other borrowings | |||||||||||
6,131,000 | 312,000 | 4,139,000 | 154,000 | 2,049,000 | 683,000 | 5,133,000 | 248,000 | 843,000 | 886,000 | 1,291,000 | 2,000 |
Proceeds from other borrowings | |||||||||||
5,719,000 | 23,000 | 3,795,000 | 760,000 | 3,158,000 | 1,608,000 | 6,507,000 | 1,092,000 | 900,000 | 601,000 | 885,000 | 1,000 |
Repurchases of preferred stock | |||||||||||
- | - | - | - | - | - | - | 292,000 | 0 | 0 | - | - |
Repurchases of common stock | |||||||||||
- | - | - | - | 40,000 | - | 400,000 | 126,000 | 374,000 | 0 | 0 | - |
Proceeds from issuance of mandatory convertible preferred stock | |||||||||||
- | - | - | - | - | - | - | - | - | - | 334,000 | 0 |
Cash dividends on preferred stock | |||||||||||
- | - | - | - | - | - | - | 14,000 | 24,000 | 24,000 | 0 | 0 |
Debt issuance costs | |||||||||||
70,000 | 0 | 62,000 | 12,000 | 80,000 | 27,000 | 154,000 | 17,000 | 21,000 | 27,000 | 46,000 | 3,000 |
Distributions paid to noncontrolling interests | |||||||||||
307,000 | 288,000 | 258,000 | 218,000 | 110,000 | 45,000 | 27,000 | 15,000 | 10,000 | 8,000 | 7,000 | 3,000 |
Proceeds from sale of noncontrolling interests | |||||||||||
21,000 | 20,000 | 31,000 | 22,000 | 11,000 | - | - | - | - | - | - | - |
Purchases of noncontrolling interests | |||||||||||
11,000 | 647,000 | 729,000 | 186,000 | 268,000 | - | - | - | - | - | - | - |
Proceeds from exercise of stock options and employee stock purchase plan | |||||||||||
12,000 | 16,000 | 7,000 | 4,000 | 15,000 | 26,000 | 22,000 | 11,000 | 3,000 | - | - | - |
Contributions from noncontrolling interests | |||||||||||
- | - | - | - | - | - | 99,000 | 3,000 | 0 | - | - | - |
Other items, net | |||||||||||
4,000 | 54,000 | 29,000 | 16,000 | 37,000 | 21,000 | 5,000 | 6,000 | 3,000 | 7,000 | 8,000 | 8,000 |
Net cash provided by (used in) financing activities | |||||||||||
-763,000 | -1,134,000 | -1,326,000 | 232,000 | 454,000 | 715,000 | 1,324,000 | 320,000 | -286,000 | -337,000 | -117,000 | 1,000 |
Net increase (decrease) in cash and cash equivalents | |||||||||||
-149,000 | -200,000 | -105,000 | 360,000 | 163,000 | 80,000 | -251,000 | 251,000 | -292,000 | -285,000 | 183,000 | -65,000 |
Supplemental disclosures: | |||||||||||
Interest paid, net of capitalized interest | |||||||||||
946,000 | 976,000 | 939,000 | 932,000 | 859,000 | 726,000 | 426,000 | 376,000 | -347,000 | -402,000 | -439,000 | 391,000 |
Proceeds from interest rate swap agreement | |||||||||||
- | - | - | - | - | - | - | - | 30,000 | 0 | 39,000 | 0 |
Income tax (payments) refunds, net | |||||||||||
12,000 | 25,000 | 56,000 | 33,000 | 7,000 | 8,000 | -6,000 | -13,000 | -10,000 | 34,000 | -43,000 | -4,000 |