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Condensed Consolidating financial statements (Tables)
9 Months Ended
Sep. 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 September 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Patient services revenues
 
$

 
$
1,761,235

 
$
1,087,531

 
$
(67,597
)
 
$
2,781,169

Provision for uncollectible accounts
 

 
(2,728
)
 
(1,249
)
 

 
(3,977
)
Net patient service revenues
 

 
1,758,507

 
1,086,282

 
(67,597
)
 
2,777,192

Other revenues
 
204,183

 
140,956

 
83,860

 
(302,113
)
 
126,886

Total net revenues
 
204,183

 
1,899,463

 
1,170,142

 
(369,710
)
 
2,904,078

Operating expenses
 
11,046

 
1,823,752

 
1,060,654

 
(369,710
)
 
2,525,742

Operating income
 
193,137

 
75,711

 
109,488

 

 
378,336

Debt expense
 
(110,712
)
 
(43,535
)
 
(14,206
)
 
58,622

 
(109,831
)
Other income, net
 
51,150

 
2,994

 
9,758

 
(58,622
)
 
5,280

Income tax expense
 
33,364

 
28,320

 
3,570

 

 
65,254

Equity earnings in subsidiaries
 
43,059

 
123,186

 

 
(166,245
)
 

Net income from continuing operations
 
143,270

 
130,036

 
101,470

 
(166,245
)
 
208,531

Net loss from discontinued operations, net of tax
 

 

 
(6,843
)
 

 
(6,843
)
Net income
 
143,270

 
130,036

 
94,627

 
(166,245
)
 
201,688

Less: Net income attributable to noncontrolling interests
 

 

 

 
(58,418
)
 
(58,418
)
Net income attributable to DaVita Inc.
 
$
143,270

 
$
130,036

 
$
94,627

 
$
(224,663
)
 
$
143,270

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

 
$
1,699,109

 
$
1,028,548

 
$
(56,956
)
 
$
2,670,701

Provision for uncollectible accounts
 

 
(9,246
)
 
(2,731
)
 

 
(11,977
)
Net patient service revenues
 

 
1,689,863

 
1,025,817

 
(56,956
)
 
2,658,724

Other revenues
 
207,968

 
127,269

 
136,448

 
(283,079
)
 
188,606

Total net revenues
 
207,968

 
1,817,132

 
1,162,265

 
(340,035
)
 
2,847,330

Operating expenses and charges
 
205,324

 
1,649,128

 
1,043,875

 
(340,035
)
 
2,558,292

Operating income
 
2,644

 
168,004

 
118,390

 

 
289,038

Debt expense
 
(127,353
)
 
(50,254
)
 
(10,570
)
 
62,250

 
(125,927
)
Other income, net
 
106,148

 
603

 
7,719

 
(110,463
)
 
4,007

Income tax (benefit) expense
 
(3,536
)
 
43,583

 
12,000

 

 
52,047

Equity earnings in subsidiaries
 
(121,771
)
 
60,448

 

 
61,323

 

Net (loss) income from continuing operations
 
(136,796
)
 
135,218

 
103,539

 
13,110

 
115,071

Net loss from discontinued operations, net of tax
 

 

 
(259,952
)
 
48,213

 
(211,739
)
Net (loss) income
 
(136,796
)
 
135,218

 
(156,413
)
 
61,323

 
(96,668
)
Less: Net income attributable to noncontrolling interests
 

 

 

 
(40,128
)
 
(40,128
)
Net (loss) income attributable to DaVita Inc.
 
$
(136,796
)
 
$
135,218

 
$
(156,413
)
 
$
21,195

 
$
(136,796
)


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

 
$
5,181,017

 
$
3,164,726

 
$
(195,357
)
 
$
8,150,386

Provision for uncollectible accounts
 

 
(13,530
)
 
(6,159
)
 

 
(19,689
)
Net patient service revenues
 

 
5,167,487

 
3,158,567

 
(195,357
)
 
8,130,697

Other revenues
 
600,318

 
438,058

 
130,345

 
(809,523
)
 
359,198

Total net revenues
 
600,318

 
5,605,545

 
3,288,912

 
(1,004,880
)
 
8,489,895

Operating expenses and charges
 
315,169

 
5,106,307

 
2,892,570

 
(1,004,880
)
 
7,309,166

Operating income
 
285,149

 
499,238

 
396,342

 

 
1,180,729

Debt expense
 
(389,203
)
 
(145,110
)
 
(39,807
)
 
188,944

 
(385,176
)
Other income, net
 
263,407

 
4,332

 
31,800

 
(281,676
)
 
17,863

Income tax expense
 
41,017

 
122,633

 
34,288

 

 
197,938

Equity earnings in subsidiaries
 
447,774

 
318,431

 

 
(766,205
)
 

Net income from continuing operations
 
566,110

 
554,258

 
354,047

 
(858,937
)
 
615,478

Net income from discontinued operations, net of tax
 

 

 
10,122

 
92,732

 
102,854

Net income
 
566,110

 
554,258

 
364,169

 
(766,205
)
 
718,332

Less: Net income attributable to noncontrolling interests
 

 

 

 
(152,222
)
 
(152,222
)
Net income attributable to DaVita Inc.
 
$
566,110

 
$
554,258

 
$
364,169

 
$
(918,427
)
 
$
566,110

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

 
$
5,100,487

 
$
3,039,056

 
$
(159,365
)
 
$
7,980,178

Provision for uncollectible accounts
 

 
(26,430
)
 
(9,408
)
 

 
(35,838
)
Net patient service revenues
 

 
5,074,057

 
3,029,648

 
(159,365
)
 
7,944,340

Other revenues
 
608,850

 
355,055

 
512,025

 
(836,543
)
 
639,387

Total net revenues
 
608,850

 
5,429,112

 
3,541,673

 
(995,908
)
 
8,583,727

Operating expenses and charges
 
484,329

 
4,949,070

 
3,008,320

 
(995,908
)
 
7,445,811

Operating income
 
124,521

 
480,042

 
533,353

 

 
1,137,916

Debt expense
 
(362,501
)
 
(151,373
)
 
(30,660
)
 
185,399

 
(359,135
)
Other income, net
 
315,573

 
2,864

 
20,981

 
(328,835
)
 
10,583

Income tax expense
 
24,108

 
112,193

 
70,351

 

 
206,652

Equity earnings in subsidiaries
 
255,681

 
328,042

 

 
(583,723
)
 

Net income from continuing operations
 
309,166

 
547,382

 
453,323

 
(727,159
)
 
582,712

Net loss from discontinued operations, net of tax
 

 

 
(291,265
)
 
143,436

 
(147,829
)
Net income
 
309,166

 
547,382

 
162,058

 
(583,723
)
 
434,883

Less: Net income attributable to noncontrolling interests
 

 

 

 
(125,717
)
 
(125,717
)
Net income attributable to DaVita Inc.
 
$
309,166

 
$
547,382

 
$
162,058

 
$
(709,440
)
 
$
309,166



Condensed Consolidating Statements of Income
For the nine months ended September 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Patient service operating revenues
 
$
8,150,386

 
$

 
$

 
$
8,150,386

Provision for uncollectible accounts
 
(19,689
)
 

 

 
(19,689
)
Net patient service operating revenues
 
8,130,697

 

 

 
8,130,697

Other revenues
 
359,198

 

 

 
359,198

Total net operating revenues
 
8,489,895

 

 

 
8,489,895

Operating expenses
 
7,309,166

 

 

 
7,309,166

Operating income
 
1,180,729

 

 

 
1,180,729

Debt expense
 
(385,176
)
 

 

 
(385,176
)
Other income
 
17,863

 

 

 
17,863

Income tax expense
 
197,938

 

 

 
197,938

Net income from continuing operations
 
615,478

 

 

 
615,478

Net income from discontinued operations, net of tax
 
102,854

 
12,706

 
249

 
89,899

Net income
 
718,332

 
12,706

 
249

 
705,377

Less: Net income attributable to noncontrolling interests
 
(152,222
)
 
(1,255
)
 

 
(150,967
)
Net income attributable to DaVita Inc.
 
$
566,110

 
$
11,451

 
$
249

 
$
554,410


(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 September 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
143,270

 
$
130,036

 
$
94,627

 
$
(166,245
)
 
$
201,688

Other comprehensive income (loss)
 
509

 

 
(44,502
)
 

 
(43,993
)
Total comprehensive income
 
143,779

 
130,036

 
50,125

 
(166,245
)
 
157,695

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(58,418
)
 
(58,418
)
Comprehensive income attributable to DaVita Inc.
 
$
143,779

 
$
130,036

 
$
50,125

 
$
(224,663
)
 
$
99,277

For the three months ended September 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net (loss) income
 
$
(136,796
)
 
$
135,218

 
$
(156,413
)
 
$
61,323

 
$
(96,668
)
Other comprehensive income (loss)
 
1,643

 

 
(8,827
)
 

 
(7,184
)
Total comprehensive (loss) income
 
(135,153
)
 
135,218

 
(165,240
)
 
61,323

 
(103,852
)
Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(40,128
)
 
(40,128
)
Comprehensive (loss) income attributable to DaVita Inc.
 
$
(135,153
)
 
$
135,218

 
$
(165,240
)
 
$
21,195

 
$
(143,980
)

For the nine months ended September 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
566,110

 
$
554,258

 
$
364,169

 
$
(766,205
)
 
$
718,332

Other comprehensive income (loss)
 
3,110

 

 
(45,790
)
 

 
(42,680
)
Total comprehensive income
 
569,220

 
554,258

 
318,379

 
(766,205
)
 
675,652

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(152,222
)
 
(152,222
)
Comprehensive income attributable to DaVita Inc.
 
$
569,220

 
$
554,258

 
$
318,379

 
$
(918,427
)
 
$
523,430

For the nine months ended September 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Net income
 
$
309,166

 
$
547,382

 
$
162,058

 
$
(583,723
)
 
$
434,883

Other comprehensive income (loss)
 
5,499

 

 
(39,475
)
 

 
(33,976
)
Total comprehensive income
 
314,665

 
547,382

 
122,583

 
(583,723
)
 
400,907

Less: Comprehensive income attributable to noncontrolling interest
 

 

 

 
(125,717
)
 
(125,717
)
Comprehensive income attributable to DaVita Inc.
 
$
314,665

 
$
547,382

 
$
122,583

 
$
(709,440
)
 
$
275,190


Condensed Consolidating Statements of Comprehensive Income
For the nine months ended September 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Net income
 
$
718,332

 
$
12,706

 
$
249

 
$
705,377

Other comprehensive income
 
(42,680
)
 

 

 
(42,680
)
Total comprehensive income
 
675,652

 
12,706

 
249

 
662,697

Less: Comprehensive income attributable to the noncontrolling
interests
 
(152,222
)
 
(1,255
)
 

 
(150,967
)
Comprehensive income attributable to DaVita Inc.
 
$
523,430

 
$
11,451

 
$
249

 
$
511,730

 
 
(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets
Condensed Consolidating Balance Sheets
As of September 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash and cash equivalents
 
$
831,514

 
$
213,635

 
$
208,107

 
$

 
$
1,253,256

Restricted cash and equivalents
 

 
14,444

 
89,441

 

 
103,885

Accounts receivable, net
 

 
1,221,169

 
680,056

 

 
1,901,225

Other current assets
 
161,548

 
455,616

 
123,188

 

 
740,352

Total current assets
 
993,062

 
1,904,864

 
1,100,792

 

 
3,998,718

Property and equipment, net
 
515,952

 
1,576,140

 
1,327,146

 

 
3,419,238

Operating lease right-of-use assets
 
103,621

 
1,592,472

 
1,085,195

 

 
2,781,288

Intangible assets, net
 
85

 
34,493

 
83,088

 

 
117,666

Investments in and advances to affiliates, net
 
10,465,104

 
7,110,581

 
3,074,784

 
(20,650,469
)
 

Other long-term assets and investments
 
96,953

 
91,115

 
181,193

 

 
369,261

Goodwill
 

 
4,818,001

 
1,947,658

 

 
6,765,659

Total assets
 
$
12,174,777

 
$
17,127,666

 
$
8,799,856

 
$
(20,650,469
)
 
$
17,451,830

Current liabilities
 
$
313,934

 
$
1,233,054

 
$
659,652

 
$

 
$
2,206,640

Intercompany liabilities, net
 
922,571

 
3,074,785

 
2,572,810

 
(6,570,166
)
 

Long-term operating leases liabilities
 
131,743

 
1,508,343

 
1,042,039

 

 
2,682,125

Long-term debt and other long-term liabilities
 
7,746,653

 
664,470

 
343,360

 

 
8,754,483

Noncontrolling interests subject to put provisions
 
741,300

 

 

 
554,759

 
1,296,059

Total DaVita Inc. shareholders' equity
 
2,318,576

 
10,647,014

 
3,433,289

 
(14,080,303
)
 
2,318,576

Noncontrolling interests not subject to put
provisions
 

 

 
748,706

 
(554,759
)
 
193,947

Total equity
 
2,318,576

 
10,647,014

 
4,181,995

 
(14,635,062
)
 
2,512,523

Total liabilities and equity
 
$
12,174,777

 
$
17,127,666

 
$
8,799,856

 
$
(20,650,469
)
 
$
17,451,830


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

 
$
1,232

 
$
261,153

 
$

 
$
323,038

Restricted cash and equivalents
 
1,005

 
12,048

 
79,329

 

 
92,382

Accounts receivable, net
 

 
1,204,122

 
654,486

 

 
1,858,608

Other current assets
 
37,185

 
565,974

 
157,407

 

 
760,566

Current assets held for sale
 

 

 
5,389,565

 

 
5,389,565

Total current assets
 
98,843

 
1,783,376

 
6,541,940

 

 
8,424,159

Property and equipment, net
 
491,462

 
1,584,321

 
1,317,886

 

 
3,393,669

Intangible assets, net
 
153

 
42,896

 
75,797

 

 
118,846

Investments in and advances to affiliates, net
 
13,522,198

 
6,196,801

 
2,498,545

 
(22,217,544
)
 

Other long-term assets and investments
 
53,385

 
90,037

 
188,196

 

 
331,618

Goodwill
 

 
4,806,939

 
2,035,021

 

 
6,841,960

Total assets
 
$
14,166,041

 
$
14,504,370

 
$
12,657,385

 
$
(22,217,544
)
 
$
19,110,252

Current liabilities
 
$
1,945,943

 
$
1,217,526

 
$
483,933

 
$

 
$
3,647,402

Current liabilities held for sale
 

 

 
1,243,759

 

 
1,243,759

Intercompany liabilities, net
 

 
2,498,545

 
6,161,292

 
(8,659,837
)
 

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

 
687,443

 
580,028

 

 
9,186,052

Noncontrolling interests subject to put provisions
 
598,075

 

 

 
526,566

 
1,124,641

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

 
10,100,856

 
3,456,851

 
(13,557,707
)
 
3,703,442

Noncontrolling interests not subject to put
provisions
 

 

 
731,522

 
(526,566
)
 
204,956

Total equity
 
3,703,442

 
10,100,856

 
4,188,373

 
(14,084,273
)
 
3,908,398

Total liabilities and equity
 
$
14,166,041

 
$
14,504,370

 
$
12,657,385

 
$
(22,217,544
)
 
$
19,110,252

Condensed Consolidating Balance Sheets
As of September 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Cash and cash equivalents
 
$
1,253,256

 
$

 
$

 
$
1,253,256

Restricted cash and equivalents
 
103,885

 

 

 
103,885

Accounts receivable, net
 
1,901,225

 

 

 
1,901,225

Other current assets
 
740,352

 

 

 
740,352

Total current assets
 
3,998,718

 

 

 
3,998,718

Property and equipment, net
 
3,419,238

 

 

 
3,419,238

Operating lease right-of-use assets
 
2,781,288

 

 

 
2,781,288

Amortizable intangibles, net
 
117,666

 

 

 
117,666

Other long-term assets
 
369,261

 

 

 
369,261

Goodwill
 
6,765,659

 

 

 
6,765,659

Total assets
 
$
17,451,830

 
$

 
$

 
$
17,451,830

Current liabilities
 
$
2,206,640

 
$

 
$

 
$
2,206,640

Long-term operating leases liabilities
 
2,682,125

 

 

 
2,682,125

Long-term debt and other long-term liabilities
 
8,754,483

 

 

 
8,754,483

Noncontrolling interests subject to put provisions
 
1,296,059

 

 

 
1,296,059

Total DaVita Inc. shareholders’ equity
 
2,318,576

 

 

 
2,318,576

Noncontrolling interests not subject to put provisions
 
193,947

 

 

 
193,947

Shareholders’ equity
 
2,512,523

 

 

 
2,512,523

Total liabilities and shareholder’s equity
 
$
17,451,830

 
$

 
$

 
$
17,451,830

 
 
(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 nine months ended September 30, 2019
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash flows provided by operating activities:
 
 
 
 
 
 
 
 
 
 
Net income
 
$
566,110

 
$
554,258

 
$
364,169

 
$
(766,205
)
 
$
718,332

Changes in operating assets and liabilities and non-cash
items included in net income
 
(336,223
)
 
(74,600
)
 
318,111

 
766,205

 
673,493

Net cash provided by operating activities
 
229,887

 
479,658

 
682,280

 

 
1,391,825

Cash flows provided by (used in) investing activities:
 
 

 
 

 
 

 
 

 
 

Additions of property and equipment
 
(106,476
)
 
(218,839
)
 
(221,868
)
 

 
(547,183
)
Acquisitions
 

 
(11,832
)
 
(65,516
)
 

 
(77,348
)
Proceeds (purchases) from asset and business sales
 
3,824,516

 
(244
)
 
39,347

 

 
3,863,619

purchases from investment sales and other items, net
 
(94,322
)
 
(7,474
)
 
(3,267
)
 

 
(105,063
)
Net cash provided by (used in) investing activities
 
3,623,718

 
(238,389
)
 
(251,304
)
 

 
3,134,025

Cash flows used in financing activities:
 
 

 
 

 
 

 
 

 
 

Long-term debt and related financing costs, net
 
(2,028,954
)
 
(8,025
)
 
(13,033
)
 

 
(2,050,012
)
Intercompany borrowings (payments)
 
785,450

 
(14,854
)
 
(770,596
)
 

 

Other items
 
(1,840,245
)
 
(3,591
)
 
(109,916
)
 

 
(1,953,752
)
Net cash used in financing activities
 
(3,083,749
)
 
(26,470
)
 
(893,545
)
 

 
(4,003,764
)
Effect of exchange rate changes on cash, cash
equivalents and restricted cash
 

 

 
(4,178
)
 

 
(4,178
)
Net increase (decrease) in cash, cash equivalents and
restricted cash
 
769,856

 
214,799

 
(466,747
)
 

 
517,908

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
 
769,856

 
214,799

 
(42,934
)
 

 
941,721

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

 
13,280

 
340,482

 

 
415,420

Cash, cash equivalents and restricted cash of continuing
operations at end of the period
 
$
831,514

 
$
228,079

 
$
297,548

 
$

 
$
1,357,141


 
For the nine months ended September 30, 2018
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
Cash flows provided by operating activities:
 
 
 
 
 
 
 
 
 
 
Net income
 
$
309,166

 
$
547,382

 
$
162,058

 
$
(583,723
)
 
$
434,883

Changes in operating assets and liabilities and non-cash
items included in net income
 
(235,558
)
 
(104,179
)
 
703,379

 
583,723

 
947,365

Net cash provided by operating activities
 
73,608

 
443,203

 
865,437

 

 
1,382,248

Cash flows used in investing activities:
 
 

 
 

 
 

 
 

 
 

Additions of property and equipment
 
(124,585
)
 
(296,028
)
 
(285,046
)
 

 
(705,659
)
Acquisitions
 

 
(5,646
)
 
(107,880
)
 

 
(113,526
)
Proceeds from asset and business sales
 

 
55,035

 
80,233

 

 
135,268

Proceeds (purchases) from investment sales and other items, net
 
32,345

 
(2,295
)
 
(7,452
)
 

 
22,598

Net cash used in investing activities
 
(92,240
)
 
(248,934
)
 
(320,145
)
 

 
(661,319
)
Cash flows provided by (used in) financing activities:
 
 

 
 

 
 

 
 

 
 

Long-term debt and related financing costs, net
 
866,537

 
(8,601
)
 
(12,100
)
 

 
845,836

Intercompany borrowings (payments)
 
454,410

 
(174,148
)
 
(280,262
)
 

 

Other items
 
(1,154,921
)
 
(18,713
)
 
(95,541
)
 

 
(1,269,175
)
Net cash provided by (used in) financing activities
 
166,026

 
(201,462
)
 
(387,903
)
 

 
(423,339
)
Effect of exchange rate changes on cash, cash
equivalents and restricted cash
 

 

 
(5,790
)
 

 
(5,790
)
Net increase (decrease) in cash, cash equivalents and restricted cash
 
147,394

 
(7,193
)
 
151,599

 

 
291,800

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

 

 
270,565

 

 
270,565

Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations
 
147,394

 
(7,193
)
 
(118,966
)
 

 
21,235

Cash, cash equivalents and restricted cash of continuing
operations at beginning of the year
 
150,307

 
19,963

 
348,650

 

 
518,920

Cash, cash equivalents and restricted cash of continuing
operations at end of the period
 
$
297,701

 
$
12,770

 
$
229,684

 
$

 
$
540,155


Condensed Consolidating Statements of Cash Flows
For the nine months ended September 30, 2019
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
Cash flows from operating activities:
 
 
 
 
 
 
 
 
Net income
 
$
718,332

 
$
12,706

 
$
249

 
$
705,377

Changes in operating and intercompany assets and liabilities and
non-cash items included in net income
 
673,493

 
(4,607
)
 
(249
)
 
678,349

Net cash provided by operating activities
 
1,391,825

 
8,099

 

 
1,383,726

Cash flows from investing activities:
 
 

 
 

 
 

 
 

Additions of property and equipment
 
(547,183
)
 
(846
)
 

 
(546,337
)
Acquisitions
 
(77,348
)
 

 

 
(77,348
)
Proceeds from asset and business sales
 
3,863,619

 

 

 
3,863,619

Investments and other items
 
(105,063
)
 
(1,882
)
 

 
(103,181
)
Net cash provided by (used in) investing activities
 
3,134,025

 
(2,728
)
 

 
3,136,753

Cash flows from financing activities:
 
 

 
 

 
 

 
 

Long-term debt
 
(2,050,012
)
 

 

 
(2,050,012
)
Intercompany
 

 
(247,175
)
 

 
247,175

Other items
 
(1,953,752
)
 

 

 
(1,953,752
)
Net cash used in financing activities
 
(4,003,764
)
 
(247,175
)
 

 
(3,756,589
)
Effect of exchange rate changes on cash, cash equivalents and
restricted cash
 
(4,178
)
 

 

 
(4,178
)
Net increase (decrease) in cash, cash equivalents and restricted cash
 
517,908

 
(241,804
)
 

 
759,712

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
 
941,721

 

 

 
941,721

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
 
$
1,357,141

 
$

 
$

 
$
1,357,141

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