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CONSOLIDATED AND COMBINED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Cash flows from operating activities:      
Net income (loss) $ (345,197) $ 4,735 $ 7,353
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:      
Depreciation and amortization 117,288 128,001 127,593
Non-cash interest expense 2,496 0 0
Provision for (benefit from) deferred income taxes (56,339) 2,542 5,007
Stock-based compensation expense 7,441 0 0
Impairment of long-lived assets and goodwill 291,870 13,000 1,000
Loss on sale of hospitals, net 2,150 0 0
Changes in reserves for self-insurance claims, net of payments 27,994 0 0
Changes in reserves for legal, professional and settlement costs, net of payments 3,651 0 0
Other non-cash expense (income), net (575) 380 495
Changes in operating assets and liabilities, net of acquisitions and divestitures:      
Patient accounts receivable, net 10,205 (16,639) (38,744)
Due from and due to third-party payors, net 7,005 (18,198) (47,626)
Inventories, prepaid expenses and other current assets 1,457 8,000 (7,194)
Accounts payable and accrued liabilities 20,760 (78,944) 3,422
Long-term assets and liabilities, net (9,120) 12 (8,262)
Net cash provided by operating activities 81,086 42,889 43,044
Cash flows from investing activities:      
Capital expenditures for property and equipment (79,920) (59,455) (69,066)
Capital expenditures for software (7,269) (8,845) (61,054)
Acquisitions, net of cash acquired (785) (8,019) (141,994)
Proceeds from the sale of hospitals 13,746 0 0
Proceeds from asset sales 1,082 3,114 258
Other investing activities 0 (5,387) (242)
Net cash used in investing activities (73,146) (78,592) (272,098)
Cash flows from financing activities:      
Borrowings of long-term debt 1,256,281 372 110
Repayments of long-term debt (15,222) (1,563) (1,631)
Increase in Due to Parent, net 24,796 262,775 111,686
Increase (decrease) in receivables facility, net 0 (224,774) 122,064
Payments of debt issuance costs (29,146) 0 0
Cash paid to Parent related to the Spin-off (1,217,336) 0 0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares (13) 0 0
Cash distributions to noncontrolling investors (2,850) (1,623) (1,489)
Purchases of shares from noncontrolling investors (101) (937) 0
Net cash provided by financing activities 16,409 34,250 230,740
Net change in cash and cash equivalents 24,349 (1,453) 1,686
Cash and cash equivalents at beginning of period 1,106 2,559 873
Cash and cash equivalents at end of period 25,455 1,106 2,559
Supplemental cash flow information:      
Interest payments, net 90,909 98,290 92,926
Income tax payments, net of refunds (after the Spin-off) 0 0 0
Non-cash purchases of property and equipment under capital lease obligations $ 6,579 $ 15,488 $ 2,407