XML 13 R6.htm IDEA: XBRL DOCUMENT v3.19.3
Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Cash flows from operating activities:    
Net (loss) income $ (1,507,033) $ 208,415
Loss (income) from discontinued operations 323,956 (11,466)
Adjustments to reconcile net income to net cash from operating activities:    
Depreciation and amortization 59,450 62,399
Goodwill impairment 1,449,215 0
Amortization of premiums, discounts and issuance costs 4,293 3,314
Stock-based compensation expense 28,972 28,754
Deferred income taxes (154,689) (18,031)
Other (1,069) (3,030)
Changes in assets and liabilities:    
Accounts receivable 12,024 (25,563)
Prepaid expenses and other current assets (7,620) (5,696)
Other long-term assets 30,528 (2,131)
Accounts payable and accrued expenses 24,479 (10,947)
Income taxes payable (25,837) (70,186)
Payments of contingent consideration liabilities (764) (686)
Long-term professional liabilities 821 (2,608)
Other liabilities (25,880) (2,095)
Net cash provided by operating activities – continuing operations 210,846 150,442
Net cash provided by operating activities - discontinued operations 8,170 11,889
Net cash provided by operating activities 219,016 162,331
Cash flows from investing activities:    
Acquisition payments, net of cash acquired (31,200) (27,035)
Purchases of investments (13,907) (15,884)
Proceeds from maturities or sales of investments 26,240 10,510
Purchases of property and equipment (25,009) (24,818)
Proceeds from sale of controlling interest in assets   22,764
Net cash used in investing activities – continuing operations (43,876) (34,463)
Net cash used in investing activities - discontinued operations (10,646) (13,317)
Net cash used in investing activities (54,522) (47,780)
Cash flows from financing activities:    
Borrowings on credit agreement 1,225,800 1,364,500
Payments on credit agreement (1,755,500) (1,211,000)
Proceeds from issuance of senior notes 500,000  
Payments for financing costs (9,194)  
Payments of contingent consideration liabilities (8,726) (3,869)
Payments on finance lease obligations (183) (996)
Proceeds from issuance of common stock 9,157 13,253
Repurchases of common stock (144,925) (302,160)
Net cash used in financing activities – continuing operations (183,571) (140,272)
Net cash used in financing activities - discontinued operations   (17)
Net cash used in financing activities (183,571) (140,289)
Net decrease in cash and cash equivalents (19,077) (25,738)
Cash, cash equivalents and restricted cash at beginning of period 56,745 80,200
Less cash and cash equivalents of discontinued operations at end of period (8,778) (12,399)
Cash and cash equivalents of continuing operations at end of period $ 28,890 $ 42,063