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v2.4.0.8

Condensed Consolidated Statements of Cash Flows (USD $) In Thousands, unless otherwise specified | 9 Months Ended
--- | ---
Sep. 30, 2014 | Sep. 30, 2013
Cash Flows from Operating Activities: |  |
Net income | $ 414,504 | $ 420,837
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation & amortization | 277,506 | 248,648
Stock-based compensation expense | 22,713 | 20,072
Gains on sales of assets and businesses, net of losses | (7,837) | (2,973)
Write-off of deferred financing costs related to extinguishment of debt | 19,730 | 0
Changes in assets & liabilities, net of effects from acquisitions and dispositions: |  |
Accounts receivable | (98,193) | (99,261)
Accrued interest | 6,547 | 10,376
Accrued and deferred income taxes | (18,392) | 5,109
Other working capital accounts | 59,613 | 10,313
Other assets and deferred charges | 15,868 | 13,425
Other | (7,000) | 5,792
Accrued insurance expense, net of commercial premiums paid | 57,729 | (1,406)
Payments made in settlement of self-insurance claims | (53,234) | (55,009)
Net cash provided by operating activities | 689,554 | 575,923
Cash Flows from Investing Activities: |  |
Property and equipment additions, net of disposals | (309,361) | (279,751)
Proceeds received from sale of assets and businesses | 15,178 | 37,118
Cash paid/reserved related to acquisition of property and businesses | (402,405) | (1,320)
Costs incurred for purchase and implementation of electronic health records application | (11,204) | (42,353)
Net cash provided by (used in) investing activities | (707,792) | (286,306)
Cash Flows from Financing Activities: |  |
Reduction of long-term debt | (842,543) | (234,231)
Additional borrowings | 969,800 | 1,500
Financing costs | (13,413) | 0
Repurchase of common shares | (63,292) | (22,186)
Dividends paid | (19,794) | (14,706)
Issuance of common stock | 4,907 | 4,096
Excess income tax benefits related to stock-based compensation | 30,242 | 15,809
Profit distributions to noncontrolling interests | (25,074) | (51,248)
Net cash (used in) provided by financing activities | 40,833 | (300,966)
Effect of exchange rate changes on cash and cash equivalents | (122) | 0
Increase (decrease) in cash and cash equivalents | 22,473 | (11,349)
Cash and cash equivalents, beginning of period | 17,238 | 23,471
Cash and cash equivalents, end of period | 39,711 | 12,122
Supplemental Disclosures of Cash Flow Information: |  |
Interest paid, including early redemption premium and original issue discount write-off in 2014 | 98,670 | 88,430
Income taxes paid, net of refunds | $ 212,148 | $ 218,290

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- Definition The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4K -URI http://asc.fasb.org/extlink&oid=35736750&loc=SL4591552-111686 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 45 -Paragraph 19 -URI http://asc.fasb.org/extlink&oid=7656940&loc=SL4569616-111683 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (a),(c) -URI http://asc.fasb.org/extlink&oid=18733093&loc=SL4573702-111684 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4J -URI http://asc.fasb.org/extlink&oid=35736750&loc=SL4591551-111686 + Details
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- Definition The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3291-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 + Details
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- Definition Write-off of amounts previously capitalized as debt issuance cost in an extinguishment of debt. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 225 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.5-03.8) -URI http://asc.fasb.org/extlink&oid=26872669&loc=d3e20235-122688 + Details
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