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v3.25.0.1

Consolidated Statements of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2024 | Dec. 31, 2023 | Dec. 31, 2022
Cash flows from operating activities: |  |  |
Net (loss) income | $ (362) | $ 16 | $ 179
Adjustments to reconcile net (loss) income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 486 | 505 | 534
Deferred income taxes | (116) | 35 | 165
Stock-based compensation expense | 17 | 22 | 20
Impairment and (gain) loss on sale of businesses, net | 301 | (87) | 71
Gain from early extinguishment of debt | (25) | (72) | (253)
Gain from CoreTrust Transaction |  |  | (119)
Other non-cash expenses, net | 188 | 181 | 182
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures: |  |  |
Patient accounts receivable | (66) | (193) | 22
Supplies, prepaid expenses and other current assets | (75) | (82) | (128)
Accounts payable, accrued liabilities and income taxes | 137 | (50) | (158)
Other | (5) | (65) | (215)
Net cash provided by operating activities | 480 | 210 | 300
Cash flows from investing activities: |  |  |
Acquisitions of facilities and other related businesses | (25) | (38) | (9)
Purchases of property and equipment | (360) | (467) | (415)
Proceeds from disposition of hospitals and other ancillary operations | 174 | 432 | 89
Proceeds from sale of property and equipment | 5 | 28 | 38
Purchases of available-for-sale debt securities and equity securities | (81) | (137) | (114)
Proceeds from sales of available-for-sale debt securities and equity securities | 80 | 232 | 110
Purchases of investments in unconsolidated affiliates | (9) | (11) | (19)
Distribution of CoreTrust Transaction proceeds |  |  | 121
Increase in other investments | (59) | (65) | (60)
Net cash used in investing activities | (275) | (26) | (259)
Cash flows from financing activities: |  |  |
Repurchase of restricted stock shares for payroll tax withholding requirements | (1) | (4) | (8)
Deferred financing costs and other debt-related costs | (9) | (3) | (74)
Proceeds from noncontrolling investors in joint ventures | 1 | 5 | 13
Redemption of noncontrolling investments in joint ventures | (3) | (1) | (5)
Distributions to noncontrolling investors in joint ventures | (155) | (141) | (125)
Other borrowings | 25 | 39 | 48
Issuance of long-term debt | 1,236 | 989 | 1,535
Proceeds from ABL Facility | 3,763 | 3,176 | 542
Repayments of long-term indebtedness | (5,063) | (4,324) | (2,356)
Net cash used in financing activities | (206) | (264) | (430)
Net change in cash and cash equivalents | (1) | (80) | (389)
Cash and cash equivalents at beginning of period | 38 | 118 | 507
Cash and cash equivalents at end of period | 37 | 38 | 118
Supplemental disclosure of cash flow information: |  |  |
Interest payments | (741) | (801) | (835)
Income tax payments, net of refunds | $ (171) | $ (91) | $ (6)

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