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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities:    
Net income (loss) $ 516 $ (334)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization 317 357
Deferred income taxes (261) (129)
Stock-based compensation expense 7 12
Impairment and (gain) loss on sale of businesses, net (242) 294
Gain from early extinguishment of debt (105) (25)
Other non-cash expenses, net 134 142
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:    
Patient accounts receivable 75 126
Supplies, prepaid expenses and other current assets 5 (48)
Accounts payable, accrued liabilities and income taxes (86) (119)
Other (83) (12)
Net cash provided by operating activities 277 264
Cash flows from investing activities:    
Acquisitions of facilities and other related businesses (1) (1)
Purchases of property and equipment (241) (251)
Proceeds from disposition of hospitals and other ancillary operations 1,012 174
Proceeds from sale of property and equipment 8 5
Purchases of available-for-sale debt securities and equity securities (107) (54)
Proceeds from sales of available-for-sale debt securities and equity securities 87 54
Purchases of investments in unconsolidated affiliates 0 (4)
Increase in other investments (53) (55)
Net cash provided by (used in) investing activities 705 (132)
Cash flows from financing activities:    
Repurchase of restricted stock shares for payroll tax withholding requirements (2) (2)
Deferred financing costs and other debt-related costs (9) (8)
Proceeds from noncontrolling investors in joint ventures 2 1
Redemption of noncontrolling investments in joint ventures (2) (3)
Distributions to noncontrolling investors in joint ventures (120) (121)
Other borrowings 16 18
Issuance of long-term debt 2,470 1,236
Proceeds from ABL Facility 3,021 2,662
Repayments of long-term indebtedness (6,272) (3,920)
Net cash used in financing activities (896) (137)
Net change in cash and cash equivalents 86 (5)
Cash and cash equivalents at beginning of period 37 38
Cash and cash equivalents at end of period 123 33
Supplemental disclosure of cash flow information:    
Interest payments (622) (562)
Income tax payments, net $ (192) $ (132)