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CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2017
Sep. 30, 2016
Cash flows from operating activities:    
Net income $ 489,876 $ 844,812
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 593,527 531,475
Goodwill and asset impairment charges 701,523 253,000
Stock-based compensation expense 28,478 29,817
Deferred income taxes (132,781) 48,778
Equity investment income, net 19,071 16,825
Gain on changes in ownership interests, net (23,402) (404,165)
Other non-cash charges 41,709 9,163
Changes in operating assets and liabilities, other than from acquisitions and divestitures:    
Accounts receivable (146,024) (85,660)
Inventories 14,272 (13,045)
Other receivables and other current assets (47,173) (1,616)
Other long-term assets (13,831) 31,081
Accounts payable 18,595 (45,507)
Accrued compensation and benefits (60,063) 79,289
Other current liabilities 39,445 119,549
Income taxes 22,669 79,592
Other long-term liabilities 18,648 (12,126)
Net cash provided by operating activities 1,564,539 1,481,262
Cash flows from investing activities:    
Additions of property and equipment (639,829) (575,243)
Acquisitions (726,538) (497,331)
Proceeds from asset and business sales 92,529 18,991
Purchase of investments available for sale (9,882) (9,041)
Purchase of investments held-to-maturity (225,166) (976,411)
Proceeds from sale of investments available for sale 5,822 8,636
Proceeds from investments held-to-maturity 398,765 743,941
Purchase of intangible assets 0 (75)
Purchase of equity investments (3,014) (11,629)
Proceeds from sale of equity investments 0 40,920
Distributions received on equity investments 80 0
Net cash used in investing activities (1,107,233) (1,257,242)
Cash flows from financing activities:    
Borrowings 38,160,821 39,102,302
Payments on long-term debt and other financing costs (38,269,284) (39,201,204)
Purchase of treasury stock (321,411) (620,898)
Distributions to noncontrolling interests (165,463) (145,072)
Stock award exercises and other share issuances, net 15,781 18,515
Contributions from noncontrolling interests 51,156 35,524
Purchase of noncontrolling interests (1,432) (9,727)
Other 0 12,584
Net cash used in financing activities (529,832) (807,976)
Effect of exchange rate changes on cash and cash equivalents 5,449 (1,664)
Net decrease in cash and cash equivalents (67,077) (585,620)
Cash and cash equivalents at beginning of period 913,187 1,499,116
Cash and cash equivalents at end of period $ 846,110 $ 913,496