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Supplemental Data (Tables)
6 Months Ended
Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Condensed Consolidating Statements of Operations
Condensed Consolidating Statements of Operations
For the three months ended June 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Patient services revenues
 
$

 
$
1,781,066

 
$
1,014,869

 
$
(61,870
)
 
$
2,734,065

Provision for uncollectible accounts
 

 
(7,246
)
 
(3,003
)
 

 
(10,249
)
Net patient service revenues
 

 
1,773,820

 
1,011,866

 
(61,870
)
 
2,723,816

Other revenues
 
207,299

 
115,226

 
37,035

 
(240,671
)
 
118,889

Total net revenues
 
207,299

 
1,889,046

 
1,048,901

 
(302,541
)
 
2,842,705

Operating expenses
 
160,464

 
1,673,331

 
849,565

 
(302,541
)
 
2,380,819

Operating income
 
46,835

 
215,715

 
199,336

 

 
461,886

Debt expense
 
(144,896
)
 
(52,762
)
 
(11,217
)
 
65,049

 
(143,826
)
Other income, net
 
102,059

 
2,716

 
8,958

 
(108,090
)
 
5,643

Income tax expense
 
627

 
63,930

 
11,381

 

 
75,938

Equity earnings in subsidiaries
 
270,180

 
168,441

 

 
(438,621
)
 

Net income from continuing operations
 
273,551

 
270,180

 
185,696

 
(481,662
)
 
247,765

Net income from discontinued operations, net of tax
 

 

 
36,351

 
43,041

 
79,392

Net income
 
273,551

 
270,180

 
222,047

 
(438,621
)
 
327,157

Less: Net income attributable to noncontrolling interests
 

 

 

 
(53,606
)
 
(53,606
)
Net income attributable to DaVita Inc.
 
$
273,551

 
$
270,180

 
$
222,047

 
$
(492,227
)
 
$
273,551

For the three months ended June 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Patient service revenues
 
$

 
$
1,831,545

 
$
936,646

 
$
(49,788
)
 
$
2,718,403

Provision for uncollectible accounts
 

 
(27,159
)
 
(22,247
)
 

 
(49,406
)
Net patient service revenues
 

 
1,804,386

 
914,399

 
(49,788
)
 
2,668,997

Other revenues
 
205,317

 
214,266

 
43,137

 
(244,764
)
 
217,956

Total net revenues
 
205,317

 
2,018,652

 
957,536

 
(294,552
)
 
2,886,953

Operating expenses and charges
 
145,649

 
1,850,377

 
747,287

 
(294,552
)
 
2,448,761

Operating income
 
59,668

 
168,275

 
210,249

 

 
438,192

Debt expense
 
(120,814
)
 
(52,363
)
 
(9,274
)
 
62,759

 
(119,692
)
Other income, net
 
105,344

 
2,856

 
4,440

 
(110,646
)
 
1,994

Income tax expense
 
13,257

 
40,019

 
30,592

 

 
83,868

Equity earnings in subsidiaries
 
236,335

 
157,586

 

 
(393,921
)
 

Net income from continuing operations
 
267,276

 
236,335

 
174,823

 
(441,808
)
 
236,626

Net income from discontinued operations, net of tax
 

 

 
21,809

 
47,887

 
69,696

Net income
 
267,276

 
236,335

 
196,632

 
(393,921
)
 
306,322

Less: Net income attributable to noncontrolling interests
 

 

 

 
(39,046
)
 
(39,046
)
Net income attributable to DaVita Inc.
 
$
267,276

 
$
236,335

 
$
196,632

 
$
(432,967
)
 
$
267,276



For the six months ended June 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Patient services revenues
 
$

 
$
3,558,312

 
$
1,933,473

 
$
(122,568
)
 
$
5,369,217

Provision for uncollectible accounts
 

 
(11,216
)
 
(4,496
)
 

 
(15,712
)
Net patient service revenues
 

 
3,547,096

 
1,928,977

 
(122,568
)
 
5,353,505

Other revenues
 
396,135

 
226,367

 
72,654

 
(462,844
)
 
232,312

Total net revenues
 
396,135

 
3,773,463

 
2,001,631

 
(585,412
)
 
5,585,817

Operating expenses and charges
 
304,123

 
3,333,784

 
1,730,929

 
(585,412
)
 
4,783,424

Operating income
 
92,012

 
439,679

 
270,702

 

 
802,393

Debt expense
 
(278,491
)
 
(105,241
)
 
(21,936
)
 
130,323

 
(275,345
)
Other income, net
 
212,257

 
5,312

 
18,069

 
(223,055
)
 
12,583

Income tax expense
 
7,653

 
110,474

 
14,557

 

 
132,684

Equity earnings in subsidiaries
 
404,715

 
175,439

 

 
(580,154
)
 

Net income from continuing operations
 
422,840

 
404,715

 
252,278

 
(672,886
)
 
406,947

Net income from discontinued operations, net of tax
 

 

 
16,965

 
92,732

 
109,697

Net income
 
422,840

 
404,715

 
269,243

 
(580,154
)
 
516,644

Less: Net income attributable to noncontrolling interests
 

 

 

 
(93,804
)
 
(93,804
)
Net income attributable to DaVita Inc.
 
$
422,840

 
$
404,715

 
$
269,243

 
$
(673,958
)
 
$
422,840

For the six months ended June 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Patient services revenues
 
$

 
$
3,621,733

 
$
1,785,047

 
$
(97,303
)
 
$
5,309,477

Provision for uncollectible accounts
 

 
(17,531
)
 
(6,330
)
 

 
(23,861
)
Net patient service revenues
 

 
3,604,202

 
1,778,717

 
(97,303
)
 
5,285,616

Other revenues
 
400,882

 
419,226

 
114,070

 
(483,397
)
 
450,781

Total net revenues
 
400,882

 
4,023,428

 
1,892,787

 
(580,700
)
 
5,736,397

Operating expenses and charges
 
279,005

 
3,641,471

 
1,547,743

 
(580,700
)
 
4,887,519

Operating income
 
121,877

 
381,957

 
345,044

 

 
848,878

Debt expense
 
(235,148
)
 
(104,560
)
 
(16,649
)
 
123,149

 
(233,208
)
Other income, net
 
209,425

 
5,379

 
10,144

 
(218,372
)
 
6,576

Income tax expense
 
27,644

 
88,962

 
37,999

 

 
154,605

Equity earnings in subsidiaries
 
377,452

 
183,638

 

 
(561,090
)
 

Net income from continuing operations
 
445,962

 
377,452

 
300,540

 
(656,313
)
 
467,641

Net (loss) income from discontinued operations,
 net of tax
 

 

 
(31,313
)
 
95,223

 
63,910

Net income
 
445,962

 
377,452

 
269,227

 
(561,090
)
 
531,551

Less: Net income attributable to noncontrolling interests
 

 

 

 
(85,589
)
 
(85,589
)
Net income attributable to DaVita Inc.
 
$
445,962

 
$
377,452

 
$
269,227

 
$
(646,679
)
 
$
445,962



Condensed Consolidating Statements of Income
For the six months ended June 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Patient service operating revenues
 
$
5,369,217

 
$

 
$

 
$
5,369,217

Provision for uncollectible accounts
 
(15,712
)
 

 

 
(15,712
)
Net patient service operating revenues
 
5,353,505

 

 

 
5,353,505

Other revenues
 
232,312

 

 

 
232,312

Total net operating revenues
 
5,585,817

 

 

 
5,585,817

Operating expenses
 
4,783,424

 

 

 
4,783,424

Operating income
 
802,393

 

 

 
802,393

Debt expense
 
(275,345
)
 

 

 
(275,345
)
Other income
 
12,583

 

 

 
12,583

Income tax expense
 
132,684

 

 

 
132,684

Net income from continuing operations
 
406,947

 

 

 
406,947

Net income from discontinued operations, net of tax
 
109,697

 
12,706

 
249

 
96,742

Net income
 
516,644

 
12,706

 
249

 
503,689

Less: Net income attributable to noncontrolling interests
 
(93,804
)
 
(1,255
)
 

 
(92,549
)
Net income attributable to DaVita Inc.
 
$
422,840

 
$
11,451

 
$
249

 
$
411,140


(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income
Condensed Consolidating Statements of Comprehensive Income
For the three months ended June 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
273,551

 
$
270,180

 
$
222,047

 
$
(438,621
)
 
$
327,157

Other comprehensive income
 
1,575

 

 
12,365

 

 
13,940

Total comprehensive income
 
275,126

 
270,180

 
234,412

 
(438,621
)
 
341,097

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(53,606
)
 
(53,606
)
Comprehensive income attributable to DaVita Inc.
 
$
275,126

 
$
270,180

 
$
234,412

 
$
(492,227
)
 
$
287,491

For the three months ended June 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
267,276

 
$
236,335

 
$
196,632

 
$
(393,921
)
 
$
306,322

Other comprehensive income (loss)
 
1,269

 

 
(50,529
)
 

 
(49,260
)
Total comprehensive income
 
268,545

 
236,335

 
146,103

 
(393,921
)
 
257,062

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(39,046
)
 
(39,046
)
Comprehensive income attributable to DaVita Inc.
 
$
268,545

 
$
236,335

 
$
146,103

 
$
(432,967
)
 
$
218,016


For the six months ended June 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
422,840

 
$
404,715

 
$
269,243

 
$
(580,154
)
 
$
516,644

Other comprehensive income (loss)
 
2,601

 

 
(1,288
)
 

 
1,313

Total comprehensive income
 
425,441

 
404,715

 
267,955

 
(580,154
)
 
517,957

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(93,804
)
 
(93,804
)
Comprehensive income attributable to DaVita Inc.
 
$
425,441

 
$
404,715

 
$
267,955

 
$
(673,958
)
 
$
424,153

For the six months ended June 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
445,962

 
$
377,452

 
$
269,227

 
$
(561,090
)
 
$
531,551

Other comprehensive income (loss)
 
3,856

 

 
(30,648
)
 

 
(26,792
)
Total comprehensive income
 
449,818

 
377,452

 
238,579

 
(561,090
)
 
504,759

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(85,589
)
 
(85,589
)
Comprehensive income attributable to DaVita Inc.
 
$
449,818

 
$
377,452

 
$
238,579

 
$
(646,679
)
 
$
419,170


Condensed Consolidating Statements of Comprehensive Income
For the six months ended June 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Net income
 
$
516,644

 
$
12,706

 
$
249

 
$
503,689

Other comprehensive income
 
1,313

 

 

 
1,313

Total comprehensive income
 
517,957

 
12,706

 
249

 
505,002

Less: Comprehensive income attributable to the noncontrolling
interests
 
(93,804
)
 
(1,255
)
 

 
(92,549
)
Comprehensive income attributable to DaVita Inc.
 
$
424,153

 
$
11,451

 
$
249

 
$
412,453

 
 
(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets
Condensed Consolidating Balance Sheets
As of June 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash and cash equivalents
 
$
3,374,887

 
$

 
$
200,751

 
$

 
$
3,575,638

Restricted cash and equivalents
 
1,007

 
12,181

 
93,584

 

 
106,772

Accounts receivable, net
 

 
1,352,844

 
657,957

 

 
2,010,801

Other current assets
 
37,185

 
545,881

 
114,352

 

 
697,418

Total current assets
 
3,413,079

 
1,910,906

 
1,066,644

 

 
6,390,629

Property and equipment, net
 
501,219

 
1,613,193

 
1,290,903

 

 
3,405,315

Operating lease right-of-use assets
 
105,137

 
1,636,360

 
1,049,388

 

 
2,790,885

Intangible assets, net
 
107

 
37,272

 
83,195

 

 
120,574

Investments in subsidiaries
 
11,304,840

 
3,184,913

 

 
(14,489,753
)
 

Intercompany receivables
 

 
1,563,270

 
1,483,874

 
(3,047,144
)
 

Other long-term assets and investments
 
80,491

 
81,567

 
196,113

 

 
358,171

Goodwill
 

 
4,821,054

 
2,044,332

 

 
6,865,386

Total assets
 
$
15,404,873

 
$
14,848,535

 
$
7,214,449

 
$
(17,536,897
)
 
$
19,930,960

Current liabilities
 
$
3,767,482

 
$
1,348,798

 
$
590,664

 
$

 
$
5,706,944

Intercompany payables
 
1,710,121

 

 
1,337,023

 
(3,047,144
)
 

Long-term operating leases liabilities
 
133,349

 
1,550,461

 
1,005,439

 

 
2,689,249

Long-term debt and other long-term liabilities
 
5,103,876

 
644,436

 
357,653

 

 
6,105,965

Noncontrolling interests subject to put provisions
 
640,747

 

 

 
544,986

 
1,185,733

Total DaVita Inc. shareholders' equity
 
4,049,298

 
11,304,840

 
3,184,913

 
(14,489,753
)
 
4,049,298

Noncontrolling interests not subject to put
provisions
 

 

 
738,757

 
(544,986
)
 
193,771

Total equity
 
4,049,298

 
11,304,840

 
3,923,670

 
(15,034,739
)
 
4,243,069

Total liabilities and equity
 
$
15,404,873

 
$
14,848,535

 
$
7,214,449

 
$
(17,536,897
)
 
$
19,930,960


As of December 31, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash and cash equivalents
 
$
60,653

 
$

 
$
262,385

 
$

 
$
323,038

Restricted cash and equivalents
 
1,005

 
12,048

 
79,329

 

 
92,382

Accounts receivable, net
 

 
1,264,290

 
594,318

 

 
1,858,608

Other current assets
 
37,185

 
601,318

 
122,063

 

 
760,566

Current assets held for sale
 

 

 
5,389,565

 

 
5,389,565

Total current assets
 
98,843

 
1,877,656

 
6,447,660

 

 
8,424,159

Property and equipment, net
 
491,462

 
1,624,835

 
1,277,372

 

 
3,393,669

Intangible assets, net
 
153

 
42,933

 
75,760

 

 
118,846

Investments in subsidiaries
 
10,102,750

 
3,371,450

 

 
(13,474,200
)
 

Intercompany receivables
 
3,419,448

 
259,573

 
1,788,043

 
(5,467,064
)
 

Other long-term assets and investments
 
53,385

 
80,537

 
197,696

 

 
331,618

Goodwill
 

 
4,812,365

 
2,029,595

 

 
6,841,960

Total assets
 
$
14,166,041

 
$
12,069,349

 
$
11,816,126

 
$
(18,941,264
)
 
$
19,110,252

Current liabilities
 
$
1,945,943

 
$
1,251,534

 
$
449,925

 
$

 
$
3,647,402

Current liabilities held for sale
 

 

 
1,243,759

 

 
1,243,759

Intercompany payables
 

 

 
5,467,064

 
(5,467,064
)
 

Long-term debt and other long-term liabilities
 
7,918,581

 
715,065

 
552,406

 

 
9,186,052

Noncontrolling interests subject to put provisions
 
598,075

 

 

 
526,566

 
1,124,641

Total DaVita Inc. shareholders' equity
 
3,703,442

 
10,102,750

 
3,371,450

 
(13,474,200
)
 
3,703,442

Noncontrolling interests not subject to put
provisions
 

 

 
731,522

 
(526,566
)
 
204,956

Total equity
 
3,703,442

 
10,102,750

 
4,102,972

 
(14,000,766
)
 
3,908,398

Total liabilities and equity
 
$
14,166,041

 
$
12,069,349

 
$
11,816,126

 
$
(18,941,264
)
 
$
19,110,252

Condensed Consolidating Balance Sheets
As of June 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Cash and cash equivalents
 
$
3,575,638

 
$

 
$

 
$
3,575,638

Restricted cash and equivalents
 
106,772

 

 

 
106,772

Accounts receivable, net
 
2,010,801

 

 

 
2,010,801

Other current assets
 
697,418

 

 

 
697,418

Total current assets
 
6,390,629

 

 

 
6,390,629

Property and equipment, net
 
3,405,315

 

 

 
3,405,315

Operating lease right-of-use assets
 
2,790,885

 

 

 
2,790,885

Amortizable intangibles, net
 
120,574

 

 

 
120,574

Other long-term assets
 
358,171

 

 

 
358,171

Goodwill
 
6,865,386

 

 

 
6,865,386

Total assets
 
$
19,930,960

 
$

 
$

 
$
19,930,960

Current liabilities
 
$
5,706,944

 
$

 
$

 
$
5,706,944

Long-term operating leases liabilities
 
2,689,249

 

 

 
2,689,249

Long-term debt and other long-term liabilities
 
6,105,965

 

 

 
6,105,965

Noncontrolling interests subject to put provisions
 
1,185,733

 

 

 
1,185,733

Total DaVita Inc. shareholders’ equity
 
4,049,298

 

 

 
4,049,298

Noncontrolling interests not subject to put provisions
 
193,771

 

 

 
193,771

Shareholders’ equity
 
4,243,069

 

 

 
4,243,069

Total liabilities and shareholder’s equity
 
$
19,930,960

 
$

 
$

 
$
19,930,960

 
 
(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows
Condensed Consolidating Statements of Cash Flows
For the six months ended June 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash flows from operating activities:
 
 
 
 
 
 
 
 
 
 
Net income
 
$
422,840

 
$
404,715

 
$
269,243

 
$
(580,154
)
 
$
516,644

Changes in operating assets and liabilities and non-cash
items included in net income
 
(292,988
)
 
(210,545
)
 
157,850

 
580,154

 
234,471

Net cash provided by operating activities
 
129,852

 
194,170

 
427,093

 

 
751,115

Cash flows from investing activities:
 
 

 
 

 
 

 
 

 
 

Additions of property and equipment
 
(63,037
)
 
(174,483
)
 
(136,398
)
 

 
(373,918
)
Acquisitions
 

 
(8,975
)
 
(56,995
)
 

 
(65,970
)
Proceeds from asset and business sales
 
3,824,509

 
33

 
26,839

 

 
3,851,381

Proceeds (purchases) from investment sales and other items, net
 
729

 
(6,560
)
 
(2,970
)
 

 
(8,801
)
Net cash provided by (used in) investing activities
 
3,762,201

 
(189,985
)
 
(169,524
)
 

 
3,402,692

Cash flows from financing activities:
 
 

 
 

 
 

 
 

 
 

Long-term debt and related financing costs, net
 
(1,152,510
)
 
(5,270
)
 
(6,329
)
 

 
(1,164,109
)
Intercompany borrowing (payments)
 
656,704

 
1,218

 
(657,922
)
 

 

Other items
 
(82,011
)
 

 
(64,433
)
 

 
(146,444
)
Net cash used in financing activities
 
(577,817
)
 
(4,052
)
 
(728,684
)
 

 
(1,310,553
)
Effect of exchange rate changes on cash, cash
equivalents and restricted cash
 

 

 
(77
)
 

 
(77
)
Net increase (decrease) in cash, cash equivalents and
restricted cash
 
3,314,236

 
133

 
(471,192
)
 

 
2,843,177

Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations
 

 

 
(423,813
)
 

 
(423,813
)
Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations
 
3,314,236

 
133

 
(47,379
)
 

 
3,266,990

Cash, cash equivalents and restricted cash of continuing
operations at beginning of the year
 
61,658

 
12,048

 
341,714

 

 
415,420

Cash, cash equivalents and restricted cash of continuing
operations at end of the period
 
$
3,375,894

 
$
12,181

 
$
294,335

 
$

 
$
3,682,410


 
For the six months ended June 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash flows from operating activities:
 
 
 
 
 
 
 
 
 
 
Net income
 
$
445,962

 
$
377,452

 
$
269,227

 
$
(561,090
)
 
$
531,551

Changes in operating assets and liabilities and non-cash
items included in net income
 
(361,134
)
 
31,554

 
161,514

 
561,090

 
393,024

Net cash provided by operating activities
 
84,828

 
409,006

 
430,741

 

 
924,575

Cash flows from investing activities:
 
 

 
 

 
 

 
 

 
 

Additions of property and equipment
 
(77,169
)
 
(216,103
)
 
(180,705
)
 

 
(473,977
)
Acquisitions
 

 
(6,916
)
 
(82,549
)
 

 
(89,465
)
Proceeds from asset and business sales
 

 
28,546

 
87,695

 

 
116,241

Proceeds (purchases) from investment sales and other items, net
 
32,415

 
(7,232
)
 
(2,046
)
 

 
23,137

Net cash used in investing activities
 
(44,754
)
 
(201,705
)
 
(177,605
)
 

 
(424,064
)
Cash flows from financing activities:
 
 

 
 

 
 

 
 

 
 

Long-term debt and related financing costs, net
 
584,500

 
(4,398
)
 
(6,121
)
 

 
573,981

Intercompany borrowing (payments)
 
224,359

 
(187,712
)
 
(36,647
)
 

 

Other items
 
(804,245
)
 
(13,208
)
 
(62,437
)
 

 
(879,890
)
Net cash provided by (used in) financing activities
 
4,614

 
(205,318
)
 
(105,205
)
 

 
(305,909
)
Effect of exchange rate changes on cash, cash
equivalents and restricted cash
 

 

 
(3,473
)
 

 
(3,473
)
Net increase in cash, cash equivalents and restricted cash
 
44,688

 
1,983

 
144,458

 

 
191,129

Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations
 

 

 
229,901

 

 
229,901

Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations
 
44,688

 
1,983

 
(85,443
)
 

 
(38,772
)
Cash, cash equivalents and restricted cash of continuing
operations at beginning of the year
 
150,307

 
9,384

 
359,229

 

 
518,920

Cash, cash equivalents and restricted cash of continuing
operations at end of the period
 
$
194,995

 
$
11,367

 
$
273,786

 
$

 
$
480,148


Condensed Consolidating Statements of Cash Flows
For the six months ended June 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Cash flows from operating activities:
 
 
 
 
 
 
 
 
Net income
 
$
516,644

 
$
12,706

 
$
249

 
$
503,689

Changes in operating and intercompany assets and liabilities and
non-cash items included in net income
 
234,471

 
(4,607
)
 
(249
)
 
239,327

Net cash provided by operating activities
 
751,115

 
8,099

 

 
743,016

Cash flows from investing activities:
 
 

 
 

 
 

 
 

Additions of property and equipment
 
(373,918
)
 
(846
)
 

 
(373,072
)
Acquisitions
 
(65,970
)
 

 

 
(65,970
)
Proceeds from asset and business sales
 
3,851,381

 

 

 
3,851,381

Investments and other items
 
(8,801
)
 
(1,882
)
 

 
(6,919
)
Net cash provided by (used in) investing activities
 
3,402,692

 
(2,728
)
 

 
3,405,420

Cash flows from financing activities:
 
 

 
 

 
 

 
 

Long-term debt
 
(1,164,109
)
 

 

 
(1,164,109
)
Intercompany
 

 
(247,175
)
 

 
247,175

Other items
 
(146,444
)
 

 

 
(146,444
)
Net cash used in financing activities
 
(1,310,553
)
 
(247,175
)
 

 
(1,063,378
)
Effect of exchange rate changes on cash, cash equivalents and
restricted cash
 
(77
)
 

 

 
(77
)
Net increase (decrease) in cash, cash equivalents and restricted cash
 
2,843,177

 
(241,804
)
 

 
3,084,981

Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations
 
(423,813
)
 
(241,804
)
 

 
(182,009
)
Net increase in cash, cash equivalents and restricted cash from continuing operations
 
3,266,990

 

 

 
3,266,990

Cash, cash equivalents and restricted cash of continuing operations
at beginning of the year
 
415,420

 

 

 
415,420

Cash, cash equivalents and restricted cash of continuing operations
at end of the period
 
$
3,682,410

 
$

 
$

 
$
3,682,410

 
(1)
After elimination of the unrestricted subsidiaries and the physician groups.