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Condensed Consolidating financial statements (Tables)
6 Months Ended
Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Condensed Consolidating Statements of Operations
Condensed Consolidating Statements of Operations
 
 
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Three Months Ended June 30, 2018
 
 
 
 
 
Patient services 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

 
192,356

 

 
(428,691
)
 

Net income from continuing operations
 
267,276

 
271,105

 
174,823

 
(476,578
)
 
236,626

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

 
(34,770
)
 
56,579

 
47,887

 
69,696

Net income
 
267,276

 
236,335

 
231,402

 
(428,691
)
 
306,322

Less: Net income attributable to noncontrolling interests
 

 

 

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

 
$
236,335

 
$
231,402

 
$
(467,737
)
 
$
267,276


 
 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Three Months Ended June 30, 2017
 
DaVita Inc.
 
 
 
 
Patient service revenues
 
$

 
$
1,654,430

 
$
879,780

 
$
(39,601
)
 
$
2,494,609

Provision for uncollectible accounts
 

 
(72,845
)
 
(36,755
)
 

 
(109,600
)
Net patient service revenues
 

 
1,581,585

 
843,025

 
(39,601
)
 
2,385,009

Other revenues
 
193,585

 
305,319

 
15,835

 
(200,349
)
 
314,390

Total net revenues
 
193,585

 
1,886,904

 
858,860

 
(239,950
)
 
2,699,399

Operating expenses
 
138,104

 
1,682,483

 
727,566

 
(239,950
)
 
2,308,203

Operating income
 
55,481

 
204,421

 
131,294

 

 
391,196

Debt expense
 
(106,159
)
 
(48,117
)
 
(13,038
)
 
59,380

 
(107,934
)
Other income
 
102,299

 
1,369

 
5,997

 
(104,867
)
 
4,798

Income tax expense
 
20,528

 
71,299

 
10,088

 

 
101,915

Equity earnings in subsidiaries
 
95,908

 
85,549

 

 
(181,457
)
 

Net income from continuing operations
 
127,001

 
171,923

 
114,165

 
(226,944
)
 
186,145

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

 
(76,015
)
 
6,008

 
45,487

 
(24,520
)
Net income
 
127,001

 
95,908

 
120,173

 
(181,457
)
 
161,625

Less: Net income attributable to noncontrolling interests
 

 

 

 
(34,624
)
 
(34,624
)
Net income attributable to DaVita Inc.
 
$
127,001

 
$
95,908

 
$
120,173

 
$
(216,081
)
 
$
127,001



 
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Six Months Ended June 30, 2018
 
 
 
 
 
Patient service 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
 
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
 
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

 
258,851

 

 
(636,303
)
 

Net income from continuing operations
 
445,962

 
452,665

 
300,540

 
(731,526
)
 
467,641

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

 
(75,213
)
 
43,900

 
95,223

 
63,910

Net income
 
445,962

 
377,452

 
344,440

 
(636,303
)
 
531,551

Less: Net income attributable to noncontrolling interests
 

 

 

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

 
$
377,452

 
$
344,440

 
$
(721,892
)
 
$
445,962


 
 
DaVita Inc.
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Six Months Ended June 30, 2017
 
 
 
 
 
Patient service revenues
 
$

 
$
3,185,156

 
$
1,809,011

 
$
(76,772
)
 
$
4,917,395

Provision for uncollectible accounts
 

 
(133,898
)
 
(82,760
)
 

 
(216,658
)
Net patient service revenues
 

 
3,051,258

 
1,726,251

 
(76,772
)
 
4,700,737

Other revenues
 
414,971

 
610,937

 
31,925

 
(427,920
)
 
629,913

Total net revenues
 
414,971

 
3,662,195

 
1,758,176

 
(504,692
)
 
5,330,650

Operating expenses
 
270,014

 
2,891,303

 
1,406,901

 
(504,692
)
 
4,063,526

Operating income
 
144,957

 
770,892

 
351,275

 

 
1,267,124

Debt expense
 
(208,823
)
 
(95,760
)
 
(25,270
)
 
117,522

 
(212,331
)
Other income
 
202,636

 
4,172

 
9,583

 
(207,607
)
 
8,784

Income tax expense
 
54,481

 
307,165

 
21,934

 

 
383,580

Equity earnings in subsidiaries
 
490,409

 
248,165

 

 
(738,574
)
 

Net income from continuing operations
 
574,698

 
620,304

 
313,654

 
(828,659
)
 
679,997

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

 
(129,895
)
 
21,723

 
90,085

 
(18,087
)
Net income
 
574,698

 
490,409

 
335,377

 
(738,574
)
 
661,910

Less: Net income attributable to noncontrolling interests
 

 

 

 
(87,212
)
 
(87,212
)
Net income attributable to DaVita Inc.
 
$
574,698

 
$
490,409

 
$
335,377

 
$
(825,786
)
 
$
574,698




Condensed Consolidating Statements of Income
 
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
For The Six Months Ended June 30, 2018
 
 
 
 
Patient service operating revenues
 
$
5,309,477

 
$

 
$

 
$
5,309,477

Provision for uncollectible accounts
 
(23,861
)
 

 

 
(23,861
)
Net patient service operating revenues
 
5,285,616

 

 

 
5,285,616

Other revenues
 
450,781

 

 

 
450,781

Total net operating revenues
 
5,736,397

 

 

 
5,736,397

Operating expenses
 
4,887,519

 

 

 
4,887,519

Operating income
 
848,878

 

 

 
848,878

Debt expense, including refinancing charges
 
(233,208
)
 

 

 
(233,208
)
Other income
 
6,576

 

 

 
6,576

Income tax expense
 
154,605

 

 

 
154,605

Net income from continuing operations
 
467,641

 

 

 
467,641

Net income from discontinued operations, net of tax
 
63,910

 
16,466

 
323

 
47,121

Net income
 
531,551

 
16,466

 
323

 
514,762

Less: Net income attributable to noncontrolling interests
 
(85,589
)
 
(8,544
)
 

 
(77,045
)
Net income attributable to DaVita Inc.
 
$
445,962

 
$
7,922

 
$
323

 
$
437,717


(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income
Condensed Consolidating Statements of Comprehensive Income
 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Three Months Ended June 30, 2018
 
DaVita Inc.
 
 
 
 
Net income
 
$
267,276

 
$
236,335

 
$
231,402

 
$
(428,691
)
 
$
306,322

Other comprehensive income (loss)
 
1,269

 

 
(50,529
)
 

 
(49,260
)
Total comprehensive income
 
268,545

 
236,335

 
180,873

 
(428,691
)
 
257,062

Less: Comprehensive income attributable to
noncontrolling interest
 

 

 

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

 
$
236,335

 
$
180,873

 
$
(467,737
)
 
$
218,016

 
 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Three Months Ended June 30, 2017
 
DaVita Inc.
 
 
 
 
Net income
 
$
127,001

 
$
95,908

 
$
120,173

 
$
(181,457
)
 
$
161,625

Other comprehensive income
 
436

 

 
49,142

 

 
49,578

Total comprehensive income
 
127,437

 
95,908

 
169,315

 
(181,457
)
 
211,203

Less: Comprehensive income attributable to the
noncontrolling interests
 

 

 

 
(34,624
)
 
(34,624
)
Comprehensive income attributable to DaVita Inc.
 
$
127,437

 
$
95,908

 
$
169,315

 
$
(216,081
)
 
$
176,579

 
 

Condensed Consolidating Statements of Comprehensive Income
 
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
For The Six Months Ended June 30, 2018
 
 
 
 
Net income
 
$
531,551

 
$
16,466

 
$
323

 
$
514,762

Other comprehensive loss
 
(26,792
)
 

 

 
(26,792
)
Total comprehensive income
 
504,759

 
16,466

 
323

 
487,970

Less: Comprehensive income attributable to the noncontrolling
interests
 
(85,589
)
 
(8,544
)
 

 
(77,045
)
Comprehensive income attributable to DaVita Inc.
 
$
419,170

 
$
7,922

 
$
323

 
$
410,925

 
 
(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets
Condensed Consolidating Balance Sheets
 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
As of June 30, 2018
 
DaVita Inc.
 
 
 
 
Cash and cash equivalents
 
$
193,991

 
$

 
$
195,273

 
$

 
$
389,264

Restricted cash and equivalents
 
1,004

 
11,367

 
78,513

 

 
90,884

Accounts receivable, net
 

 
1,274,067

 
568,041

 

 
1,842,108

Other current assets
 
37,185

 
547,928

 
124,912

 

 
710,025

Current assets held for sale
 

 
5,101,853

 
951,228

 

 
6,053,081

Total current assets
 
232,180

 
6,935,215

 
1,917,967

 

 
9,085,362

Property and equipment, net
 
441,159

 
1,553,931

 
1,234,008

 

 
3,229,098

Intangible assets, net
 
199

 
46,491

 
53,565

 

 
100,255

Investments in subsidiaries
 
10,304,847

 
3,163,787

 

 
(13,468,634
)
 

Intercompany receivables
 
3,579,186

 

 
1,386,117

 
(4,965,303
)
 

Other long-term assets and investments
 
54,077

 
68,922

 
219,291

 

 
342,290

Goodwill
 

 
4,767,041

 
1,911,518

 

 
6,678,559

Total assets
 
$
14,611,648

 
$
16,535,387

 
$
6,722,466

 
$
(18,433,937
)
 
$
19,435,564

Current liabilities
 
$
1,831,526

 
$
1,219,455

 
$
461,433

 
$

 
$
3,512,414

Current liabilities held for sale
 

 
734,745

 
536,619

 

 
1,271,364

Intercompany payables
 

 
3,548,086

 
1,417,217

 
(4,965,303
)
 

Long-term debt and other long-term liabilities
 
7,897,430

 
728,254

 
494,437

 

 
9,120,121

Noncontrolling interests subject to put provisions
 
603,508

 

 

 
443,650

 
1,047,158

Total DaVita Inc. shareholders' equity
 
4,279,184

 
10,304,847

 
3,163,787

 
(13,468,634
)
 
4,279,184

Noncontrolling interests not subject to put
provisions
 

 

 
648,973

 
(443,650
)
 
205,323

Total equity
 
4,279,184

 
10,304,847

 
3,812,760

 
(13,912,284
)
 
4,484,507

Total liabilities and equity
 
$
14,611,648

 
$
16,535,387

 
$
6,722,466

 
$
(18,433,937
)
 
$
19,435,564


 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
As of December 31, 2017
 
DaVita Inc.
 
 
 
 
Cash and cash equivalents
 
$
149,305

 
$

 
$
358,929

 
$

 
$
508,234

Restricted cash and equivalents
 
1,002

 
9,384

 
300

 

 
10,686

Accounts receivable, net
 

 
1,208,715

 
506,035

 

 
1,714,750

Other current assets
 
67,025

 
595,066

 
86,955

 

 
749,046

Current assets held for sale
 

 
4,992,067

 
769,575

 

 
5,761,642

Total current assets
 
217,332

 
6,805,232

 
1,721,794

 

 
8,744,358

Property and equipment, net
 
408,010

 
1,560,390

 
1,180,813

 

 
3,149,213

Intangible assets, net
 
250

 
50,971

 
62,606

 

 
113,827

Investments in subsidiaries
 
10,009,874

 
3,085,722

 

 
(13,095,596
)
 

Intercompany receivables
 
3,677,947

 

 
1,313,213

 
(4,991,160
)
 

Other long-term assets and investments
 
47,297

 
68,344

 
214,875

 

 
330,516

Goodwill
 

 
4,732,320

 
1,877,959

 

 
6,610,279

Total assets
 
$
14,360,710

 
$
16,302,979

 
$
6,371,260

 
$
(18,086,756
)
 
$
18,948,193

Current liabilities
 
$
238,706

 
$
1,181,139

 
$
436,262

 
$

 
$
1,856,107

Current liabilities held for sale
 

 
739,294

 
445,776

 

 
1,185,070

Intercompany payables
 

 
3,690,042

 
1,301,118

 
(4,991,160
)
 

Long-term debt and other long-term liabilities
 
8,857,373

 
682,630

 
469,587

 

 
10,009,590

Noncontrolling interests subject to put provisions
 
574,602

 

 

 
436,758

 
1,011,360

Total DaVita Inc. shareholders' equity
 
4,690,029

 
10,009,874

 
3,085,722

 
(13,095,596
)
 
4,690,029

Noncontrolling interests not subject to put
provisions
 

 

 
632,795

 
(436,758
)
 
196,037

Total equity
 
4,690,029

 
10,009,874

 
3,718,517

 
(13,532,354
)
 
4,886,066

Total liabilities and equity
 
$
14,360,710

 
$
16,302,979

 
$
6,371,260

 
$
(18,086,756
)
 
$
18,948,193

Condensed Consolidating Balance Sheets
 
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
As of June 30, 2018
 
 
 
 
Cash and cash equivalents
 
$
389,264

 
$

 
$

 
$
389,264

Restricted cash and equivalents
 
90,884

 

 

 
90,884

Accounts receivable, net
 
1,842,108

 

 

 
1,842,108

Other current assets
 
710,025

 

 

 
710,025

Current assets held for sale
 
6,053,081

 
524,595

 
3,056

 
5,525,430

Total current assets
 
9,085,362

 
524,595

 
3,056

 
8,557,711

Property and equipment, net
 
3,229,098

 

 

 
3,229,098

Amortizable intangibles, net
 
100,255

 

 

 
100,255

Other long-term assets
 
342,290

 

 

 
342,290

Goodwill
 
6,678,559

 

 

 
6,678,559

Total assets
 
$
19,435,564

 
$
524,595

 
$
3,056

 
$
18,907,913

Current liabilities
 
$
3,512,414

 
$

 
$

 
$
3,512,414

Current liabilities held for sale
 
1,271,364

 
334,091

 

 
937,273

Payables to parent
 

 
56,761

 
3,056

 
(59,817
)
Long-term debt and other long-term liabilities
 
9,120,121

 

 

 
9,120,121

Noncontrolling interests subject to put provisions
 
1,047,158

 

 

 
1,047,158

Total DaVita Inc. shareholders’ equity
 
4,279,184

 
133,743

 

 
4,145,441

Noncontrolling interests not subject to put provisions
 
205,323

 

 

 
205,323

Shareholders’ equity
 
4,484,507

 
133,743

 

 
4,350,764

Total liabilities and shareholder’s equity
 
$
19,435,564

 
$
524,595

 
$
3,056

 
$
18,907,913

 
 
(1)
After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows
Condensed Consolidating Statements of Cash Flows
 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Six Months Ended June 30, 2018
 
DaVita Inc.
 
 
 
 
Cash flows from operating activities:
 
 
 
 
 
 
 
 
 
 
Net income
 
$
445,962

 
$
377,452

 
$
344,440

 
$
(636,303
)
 
$
531,551

Changes in operating assets and liabilities and non-cash
items included in net income
 
(361,991
)
 
26,502

 
92,210

 
636,303

 
393,024

Net cash provided by operating activities
 
83,971

 
403,954

 
436,650

 

 
924,575

Cash flows from investing activities:
 
 

 
 

 
 

 
 

 
 

Additions of property and equipment
 
(77,169
)
 
(258,471
)
 
(138,337
)
 

 
(473,977
)
Acquisitions
 

 
(8,195
)
 
(81,270
)
 

 
(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

 
(8,257
)
 
(1,021
)
 

 
23,137

Net cash used in investing activities
 
(44,754
)
 
(246,377
)
 
(132,933
)
 

 
(424,064
)
Cash flows from financing activities:
 
 

 
 

 
 

 
 

 
 

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

 
(5,429
)
 
(5,090
)
 

 
573,981

Intercompany borrowing (payments)
 
225,216

 
(130,553
)
 
(94,663
)
 

 

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

 
(879,890
)
Net cash provided by (used in) financing activities
 
5,471

 
(149,190
)
 
(162,190
)
 

 
(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

 
8,387

 
138,054

 

 
191,129

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

 
6,404

 
223,497

 

 
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


 
 
 
 
 
Guarantor
subsidiaries
 
Non-
Guarantor
subsidiaries
 
Consolidating
adjustments
 
Consolidated
total
For The Six Months Ended June 30, 2017
 
DaVita Inc.
 
 
 
 
Cash flows from operating activities:
 
 
 
 
 
 
 
 
 
 
Net income
 
$
574,698

 
$
490,409

 
$
335,377

 
$
(738,574
)
 
$
661,910

Changes in operating assets and liabilities and non-cash
items included in net income
 
(429,399
)
 
37,851

 
6,121

 
738,574

 
353,147

Net cash provided by operating activities
 
145,299

 
528,260

 
341,498

 

 
1,015,057

Cash flows from investing activities:
 
 

 
 

 
 

 
 

 
 

Additions of property and equipment
 
(50,966
)
 
(182,494
)
 
(165,480
)
 

 
(398,940
)
Acquisitions
 

 
(538,450
)
 
(81,389
)
 

 
(619,839
)
Proceeds from asset and business sales, net of cash
divested
 

 
70,127

 
109

 

 
70,236

Proceeds (purchases) from investment sales and other
items, net
 
49,036

 
(2,933
)
 
50,833

 

 
96,936

Net cash used in investing activities
 
(1,930
)
 
(653,750
)
 
(195,927
)
 

 
(851,607
)
Cash flows from financing activities:
 
 

 
 

 
 

 
 

 
 

Long-term debt and related financing costs, net
 
(54,992
)
 
(6,893
)
 
(2,147
)
 

 
(64,032
)
Intercompany (payments) borrowing
 
(39,814
)
 
117,661

 
(77,847
)
 

 

Other items
 
(223,511
)
 
(1,432
)
 
(76,203
)
 

 
(301,146
)
Net cash (used in) provided by financing activities
 
(318,317
)
 
109,336

 
(156,197
)
 

 
(365,178
)
Effect of exchange rate changes on cash, cash
equivalents and restricted cash
 

 

 
4,192

 

 
4,192

Net decrease in cash, cash equivalents and restricted cash
 
(174,948
)
 
(16,154
)
 
(6,434
)
 

 
(197,536
)
Less: Net (decrease) increase in cash, cash equivalents
and restricted cash from discontinued operations
 

 
(16,194
)
 
48,914

 

 
32,720

Net (decrease) increase in cash, cash equivalents and
restricted cash from continuing operations
 
(174,948
)
 
40

 
(55,348
)
 

 
(230,256
)
Cash, cash equivalents and restricted cash of continuing
operations at beginning of the year
 
549,921

 
8,687

 
124,855

 

 
683,463

Cash, cash equivalents and restricted cash of continuing
operations at end of the period
 
$
374,973

 
$
8,727

 
$
69,507

 
$

 
$
453,207


Condensed Consolidating Statements of Cash Flows
 
 
Consolidated
Total
 
Physician
Groups
 
Unrestricted
Subsidiaries
 
Company and
Restricted Subsidiaries(1)
For The Six Months Ended June 30, 2018
 
 
 
 
Cash flows from operating activities:
 
 
 
 
 
 
 
 
Net income
 
$
531,551

 
$
16,466

 
$
323

 
$
514,762

Changes in operating and intercompany assets and liabilities and
non-cash items included in net income
 
393,024

 
101,201

 
(323
)
 
292,146

Net cash provided by (used in) operating activities
 
924,575

 
117,667

 

 
806,908

Cash flows from investing activities:
 
 

 
 

 
 

 
 

Additions of property and equipment
 
(473,977
)
 
(2,097
)
 

 
(471,880
)
Acquisitions
 
(89,465
)
 

 

 
(89,465
)
Proceeds from asset and business sales
 
116,241

 

 

 
116,241

Investments and other items
 
23,137

 
(1,021
)
 

 
24,158

Net cash used in investing activities
 
(424,064
)
 
(3,118
)
 

 
(420,946
)
Cash flows from financing activities:
 
 

 
 

 
 

 
 

Long-term debt
 
573,981

 

 

 
573,981

Intercompany
 

 
57,783

 

 
(57,783
)
Other items
 
(879,890
)
 

 

 
(879,890
)
Net cash (used in) provided by financing activities
 
(305,909
)
 
57,783

 

 
(363,692
)
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
 
191,129

 
172,332

 

 
18,797

Less: Net increase in cash, cash equivalents and
restricted cash from discontinued operations
 
229,901

 
172,332

 

 
57,569

Net decrease in cash, cash equivalents and restricted cash from
continuing operations
 
(38,772
)
 

 

 
(38,772
)
Cash, cash equivalents and restricted cash of continuing operations
at beginning of the year
 
518,920

 

 

 
518,920

Cash, cash equivalents and restricted cash of continuing operations
at end of the period
 
$
480,148

 
$

 
$

 
$
480,148

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