Universal Health Services (UHS) Annual Cash Flow Statement

Cash Flow Summary

Universal Health Services (UHS) annual cash flow statement covering fiscal 2017 through 2022, as reported to the SEC.

Universal Health Services generated $996.02M in cash from operations in fiscal 2022, up 12.7% from $883.7M in fiscal 2021.
That is 1.5 times its reported net income of $656.98M.
After spending $734M on property and equipment additions, free cash flow was $262.02M.
Investing activities used $647.3M and financing activities used $318.4M. Overall, cash went up $21.9M.
Universal Health Services spent $832.92M buying back its own shares and paid $58.45M in dividends.

Net cash provided by operating activities has shrunk 4.4% a year on average since fiscal 2017, from $1.25B to $996.02M.

A cash flow statement shows the cash that actually came in and went out, split between running the business, investing and financing.

Figures in USD thousands

						Dec'22	Dec'21	Dec'20	Dec'19	Dec'18	Dec'17
Cash Flows from Operating Activities:
Net income
656,982	987,632	952,790	827,543	797,883	771,312	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net income						656,982	987,632	952,790	827,543	797,883	771,312	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization
581,861	533,213	510,493	490,392	453,076	447,883	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Depreciation & amortization						581,861	533,213	510,493	490,392	453,076	447,883	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Gain) loss on sale of assets and businesses
-584	5,170	-1,957	7,540	2,513	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Gain) loss on sale of assets and businesses						-584	5,170	-1,957	7,540	2,513	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Costs related to extinguishment of debt
-	16,831	1,365	-	2,727	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Costs related to extinguishment of debt						-	16,831	1,365	-	2,727	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Stock-based compensation expense
85,400	73,700	65,800	69,400	66,600	56,700	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Stock-based compensation expense						85,400	73,700	65,800	69,400	66,600	56,700	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Provision for asset impairment
57,550	14,391	-	97,631	49,310	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Provision for asset impairment						57,550	14,391	-	97,631	49,310	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Provision for settlements
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Provision for settlements						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable
258,338	8,873	145,901	42,056	42,239	24,719	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts receivable						258,338	8,873	145,901	42,056	42,239	24,719	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Construction management and other receivable
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Construction management and other receivable						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued interest
-1,835	-4,950	10,028	-209	4,478	-705	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued interest						-1,835	-4,950	10,028	-209	4,478	-705	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued and deferred income taxes
29,510	54,030	-9,593	25,194	54,052	6,405	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued and deferred income taxes						29,510	54,030	-9,593	25,194	54,052	6,405	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other working capital accounts
146,692	-46,526	-124,545	-39,664	-24,696	15,165	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other working capital accounts						146,692	-46,526	-124,545	-39,664	-24,696	15,165	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Medicare accelerated payments and deferred CARES Act and other grants
-2,391	698,762	-698,768	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Medicare accelerated payments and deferred CARES Act and other grants						-2,391	698,762	-698,768	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other assets and deferred charges
-19,918	39,337	4,555	27,205	31,429	27,936	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other assets and deferred charges						-19,918	39,337	4,555	27,205	31,429	27,936	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other
-8,676	-82,075	109,167	7,703	-1,536	21,769	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other						-8,676	-82,075	109,167	7,703	-1,536	21,769	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess income tax benefits related to stock-based compensation
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess income tax benefits related to stock-based compensation						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued insurance expense, net of commercial premiums paid
174,723	186,215	159,223	105,672	92,863	102,595	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued insurance expense, net of commercial premiums paid						174,723	186,215	159,223	105,672	92,863	102,595	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments made in settlement of self-insurance claims
141,983	91,502	113,085	97,781	76,147	79,192	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments made in settlement of self-insurance claims						141,983	91,502	113,085	97,781	76,147	79,192	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash provided by operating activities
996,023	883,695	2,360,169	1,438,469	1,274,742	1,247,585	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash provided by operating activities						996,023	883,695	2,360,169	1,438,469	1,274,742	1,247,585	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash Flows from Investing Activities:
Property and equipment additions
734,001	855,659	731,307	634,095	664,962	557,506	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Property and equipment additions						734,001	855,659	731,307	634,095	664,962	557,506	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds received from sales of assets and businesses
12,001	25,425	8,168	9,450	13,502	108	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds received from sales of assets and businesses						12,001	25,425	8,168	9,450	13,502	108	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Acquisition of businesses and property
20,309	105,415	52,009	8,005	110,464	22,878	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Acquisition of businesses and property						20,309	105,415	52,009	8,005	110,464	22,878	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Outflows) inflows from foreign exchange contracts that hedge our net U.K. investment
-94,913	-1,357	21,740	19,763	-66,151	64,333	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Outflows) inflows from foreign exchange contracts that hedge our net U.K. investment						-94,913	-1,357	21,740	19,763	-66,151	64,333	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Costs incurred for purchase and implementation of information technology applications
-	-19,726	2,902	21,418	36,243	29,047	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Costs incurred for purchase and implementation of information technology applications						-	-19,726	2,902	21,418	36,243	29,047	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Decrease in capital reserves of commercial insurance subsidiary
-100	-100	100	-	-100	3,100	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Decrease in capital reserves of commercial insurance subsidiary						-100	-100	100	-	-100	3,100	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in, and advances to, joint ventures and other
-	-	2,672	14,579	15,331	7,976	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in, and advances to, joint ventures and other						-	-	2,672	14,579	15,331	7,976	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Return of Deposit on terminated purchase agreement
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Return of Deposit on terminated purchase agreement						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Settlement proceeds received related to prior year acquisition, net of expenses
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Settlement proceeds received related to prior year acquisition, net of expenses						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in joint-venture
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in joint-venture						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in investing activities
-647,296	-914,466	-802,562	-688,410	-747,247	-684,732	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in investing activities						-647,296	-914,466	-802,562	-688,410	-747,247	-684,732	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash Flows from Financing Activities:
Repayments of long-term debt
89,367	3,037,868	962,567	57,142	830,496	143,106	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Repayments of long-term debt						89,367	3,037,868	962,567	57,142	830,496	143,106	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Additional borrowings, net
705,321	3,254,974	801,599	39,220	791,247	41,100	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Additional borrowings, net						705,321	3,254,974	801,599	39,220	791,247	41,100	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Acquisition of noncontrolling interests in majority owned businesses
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Acquisition of noncontrolling interests in majority owned businesses						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Financing costs
3,164	18,770	10,300	-	13,787	76	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Financing costs						3,164	18,770	10,300	-	13,787	76	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Repurchase of common shares
832,918	1,220,875	206,719	770,504	397,425	364,401	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Repurchase of common shares						832,918	1,220,875	206,719	770,504	397,425	364,401	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Dividends paid
58,449	65,896	17,344	53,003	37,342	38,211	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Dividends paid						58,449	65,896	17,344	53,003	37,342	38,211	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Issuance of common stock
14,068	13,372	12,318	10,806	10,196	10,254	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Issuance of common stock						14,068	13,372	12,318	10,806	10,196	10,254	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess income tax benefits related to stock based compensation
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess income tax benefits related to stock based compensation						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Profit distributions to noncontrolling interests
5,391	7,080	19,805	15,859	14,595	24,713	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Profit distributions to noncontrolling interests						5,391	7,080	19,805	15,859	14,595	24,713	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds received from sale/leaseback of real property
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds received from sale/leaseback of real property						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from sale of noncontrolling interests in majority owned business
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from sale of noncontrolling interests in majority owned business						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase of ownership interests by minority member
-	-	-	1,446	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase of ownership interests by minority member						-	-	-	1,446	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase (sale) of ownership interests by (from) minority members
-48,500	13,193	17,959	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase (sale) of ownership interests by (from) minority members						-48,500	13,193	17,959	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in financing activities
-318,400	-1,068,950	-384,859	-845,036	-492,202	-519,153	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in financing activities						-318,400	-1,068,950	-384,859	-845,036	-492,202	-519,153	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Effect of exchange rate changes on cash, cash equivalents and restricted cash
-8,424	-499	739	959	-2,905	1,647	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Effect of exchange rate changes on cash, cash equivalents and restricted cash						-8,424	-499	739	959	-2,905	1,647	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Decrease) increase in cash, cash equivalents and restricted cash
21,903	-1,100,220	1,173,487	-94,018	32,388	45,347	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Decrease) increase in cash, cash equivalents and restricted cash						21,903	-1,100,220	1,173,487	-94,018	32,388	45,347	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Supplemental Disclosures of Cash Flow Information:
Interest paid
120,136	75,607	112,598	157,406	150,293	135,533	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Interest paid						120,136	75,607	112,598	157,406	150,293	135,533	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income taxes paid, net of refunds
250,759	362,978	286,247	260,622	293,837	370,855	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income taxes paid, net of refunds						250,759	362,978	286,247	260,622	293,837	370,855	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Noncash purchases of property and equipment
72,064	167,234	74,854	63,514	77,674	82,496	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Noncash purchases of property and equipment						72,064	167,234	74,854	63,514	77,674	82,496	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Right-of-use assets obtained in exchange for lease obligations
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Right-of-use assets obtained in exchange for lease obligations						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx