Form 10-Q
Table of Contents

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

Form 10-Q

 

 

(Mark One)

x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2016

Or

 

¨ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                to                 

Commission file number 1-11239

 

 

HCA Holdings, Inc.

(Exact name of registrant as specified in its charter)

 

 

 

Delaware   27-3865930

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer

Identification No.)

One Park Plaza

Nashville, Tennessee

  37203
(Address of principal executive offices)   (Zip Code)

(615) 344-9551

(Registrant’s telephone number, including area code)

Not Applicable

(Former name, former address and former fiscal year, if changed since last report)

 

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x    No  ¨

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes  x    No  ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.

 

Large accelerated filer

 

x

  

Accelerated filer

 

¨

Non-accelerated filer

 

¨  (Do not check if a smaller reporting company)

  

Smaller reporting company

 

¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ¨    No  x

Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.

 

Class of Common Stock

  

Outstanding at October 31, 2016

Voting common stock, $.01 par value    374,685,700 shares

 

 

 


Table of Contents

HCA HOLDINGS, INC.

Form 10-Q

September 30, 2016

 

         Page of
Form  10-Q
 

Part I.

  Financial Information   

Item 1.

  Financial Statements (Unaudited):   
 

Condensed Consolidated Income Statements — for the quarters and nine months ended September  30, 2016 and 2015

     2   
 

Condensed Consolidated Comprehensive Income Statements — for the quarters and nine months ended September 30, 2016 and 2015

     3   
 

Condensed Consolidated Balance Sheets — September 30, 2016 and December 31, 2015

     4   
 

Condensed Consolidated Statements of Cash Flows — for the nine months ended September  30, 2016 and 2015

     5   
 

Notes to Condensed Consolidated Financial Statements

     6   

Item 2.

 

Management’s Discussion and Analysis of Financial Condition and Results of Operations

     29   

Item 3.

 

Quantitative and Qualitative Disclosures About Market Risk

     48   

Item 4.

 

Controls and Procedures

     48   

Part II.

  Other Information   

Item 1.

 

Legal Proceedings

     48   

Item 1A.

 

Risk Factors

     49   

Item 2.

 

Unregistered Sales of Equity Securities and Use of Proceeds

     50   

Item 6.

 

Exhibits

     51   

Signatures

     52   

 

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Table of Contents

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATED INCOME STATEMENTS

FOR THE QUARTERS AND NINE MONTHS ENDED SEPTEMBER 30, 2016 AND 2015

Unaudited

(Dollars in millions, except per share amounts)

 

     Quarter     Nine Months  
     2016     2015     2016     2015  

Revenues before provision for doubtful accounts

   $ 11,110      $ 11,014      $ 33,241      $ 32,268   

Provision for doubtful accounts

     840        1,158        2,392        2,839   
  

 

 

   

 

 

   

 

 

   

 

 

 

Revenues

     10,270        9,856        30,849        29,429   

Salaries and benefits

     4,740        4,619        14,133        13,509   

Supplies

     1,699        1,644        5,131        4,952   

Other operating expenses

     1,897        1,796        5,627        5,268   

Electronic health record incentive income

     (1     (9     (10     (46

Equity in earnings of affiliates

     (22     (9     (44     (38

Depreciation and amortization

     495        482        1,463        1,424   

Interest expense

     432        411        1,275        1,255   

Losses (gains) on sales of facilities

     (3     2        (8     (2

Losses on retirement of debt

     4               4        125   

Legal claim costs

     11        77        33        77   
  

 

 

   

 

 

   

 

 

   

 

 

 
     9,252        9,013        27,604        26,524   
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     1,018        843        3,245        2,905   

Provision for income taxes

     273        270        898        947   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     745        573        2,347        1,958   

Net income attributable to noncontrolling interests

     127        124        377        411   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to HCA Holdings, Inc.

   $ 618      $ 449      $ 1,970      $ 1,547   
  

 

 

   

 

 

   

 

 

   

 

 

 

Per share data:

        

Basic earnings per share

   $ 1.63      $ 1.08      $ 5.09      $ 3.71   

Diluted earnings per share

   $ 1.59      $ 1.05      $ 4.93      $ 3.60   

Shares used in earnings per share calculations (in millions):

        

Basic

     378.199        414.939        386.968        417.146   

Diluted

     389.592        426.441        399.577        430.354   

See accompanying notes.

 

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HCA HOLDINGS, INC.

CONDENSED CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS

FOR THE QUARTERS AND NINE MONTHS ENDED SEPTEMBER 30, 2016 AND 2015

Unaudited

(Dollars in millions)

 

     Quarter     Nine Months  
     2016     2015     2016     2015  

Net income

   $ 745      $ 573      $ 2,347      $ 1,958   

Other comprehensive income (loss) before taxes:

        

Foreign currency translation

     (40     (54     (169     (41

Unrealized gains (losses) on available-for-sale securities

     (2     2        3        (2

Defined benefit plans

                            

Pension costs included in salaries and benefits

     4        6        13        17   
  

 

 

   

 

 

   

 

 

   

 

 

 
     4        6        13        17   

Change in fair value of derivative financial instruments

     13        (17     (57     (47

Interest costs included in interest expense

     28        31        84        93   
  

 

 

   

 

 

   

 

 

   

 

 

 
     41        14        27        46   
  

 

 

   

 

 

   

 

 

   

 

 

 

Other comprehensive income (loss) before taxes

     3        (32     (126     20   

Income taxes (benefits) related to other comprehensive income items

            (13     (50     6   
  

 

 

   

 

 

   

 

 

   

 

 

 

Other comprehensive income (loss)

     3        (19     (76     14   
  

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income

     748        554        2,271        1,972   

Comprehensive income attributable to noncontrolling interests

     127        124        377        411   
  

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income attributable to HCA Holdings, Inc.

   $ 621      $ 430      $ 1,894      $ 1,561   
  

 

 

   

 

 

   

 

 

   

 

 

 

See accompanying notes.

 

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HCA HOLDINGS, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

Unaudited

(Dollars in millions)

 

     September 30,
2016
    December 31,
2015
 
ASSETS     

Current assets:

    

Cash and cash equivalents

   $ 677      $ 741   

Accounts receivable, less allowance for doubtful accounts of $5,011 and $5,326

     5,503        5,889   

Inventories

     1,503        1,439   

Other

     1,160        1,163   
  

 

 

   

 

 

 
     8,843        9,232   

Property and equipment, at cost

     36,449        34,614   

Accumulated depreciation

     (20,574     (19,600
  

 

 

   

 

 

 
     15,875        15,014   

Investments of insurance subsidiaries

     354        432   

Investments in and advances to affiliates

     216        178   

Goodwill and other intangible assets

     6,691        6,731   

Other

     1,148        1,157   
  

 

 

   

 

 

 
   $ 33,127      $ 32,744   
  

 

 

   

 

 

 
LIABILITIES AND STOCKHOLDERS’ DEFICIT     

Current liabilities:

    

Accounts payable

   $ 1,950      $ 2,170   

Accrued salaries

     1,241        1,233   

Other accrued expenses

     1,748        1,880   

Long-term debt due within one year

     216        233   
  

 

 

   

 

 

 
     5,155        5,516   

Long-term debt, less net debt issuance costs of $178 and $167

     31,225        30,255   

Professional liability risks

     1,164        1,115   

Income taxes and other liabilities

     1,746        1,904   

Stockholders’ deficit:

    

Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 376,140,800 shares in 2016 and 398,738,700 shares in 2015

     4        4   

Accumulated other comprehensive loss

     (341     (265

Retained deficit

     (7,426     (7,338
  

 

 

   

 

 

 

Stockholders’ deficit attributable to HCA Holdings, Inc.

     (7,763     (7,599

Noncontrolling interests

     1,600        1,553   
  

 

 

   

 

 

 
     (6,163     (6,046
  

 

 

   

 

 

 
   $ 33,127      $ 32,744   
  

 

 

   

 

 

 

See accompanying notes.

 

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HCA HOLDINGS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2016 AND 2015

Unaudited

(Dollars in millions)

 

     2016     2015  

Cash flows from operating activities:

    

Net income

   $ 2,347      $ 1,958   

Adjustments to reconcile net income to net cash provided by operating activities:

    

Increase (decrease) in cash from operating assets and liabilities:

    

Accounts receivable

     (2,044     (2,976

Provision for doubtful accounts

     2,392        2,839   
  

 

 

   

 

 

 

Accounts receivable, net

     348        (137

Inventories and other assets

     (161     (205

Accounts payable and accrued expenses

     (341     (152

Depreciation and amortization

     1,463        1,424   

Income taxes

     8        (148

Gains on sales of facilities

     (8     (2

Losses on retirement of debt

     4        125   

Legal claim costs

     33        77   

Amortization of debt issuance costs

     26        27   

Share-based compensation

     196        171   

Other

     39        38   
  

 

 

   

 

 

 

Net cash provided by operating activities

     3,954        3,176   
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchase of property and equipment

     (1,884     (1,571

Acquisition of hospitals and health care entities

     (468     (184

Disposal of hospitals and health care entities

     23        27   

Change in investments

     78        94   

Other

     17        3   
  

 

 

   

 

 

 

Net cash used in investing activities

     (2,234     (1,631
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Issuances of long-term debt

     5,400        4,048   

Net change in revolving bank credit facilities

     (70     (270

Repayment of long-term debt

     (4,424     (3,702

Distributions to noncontrolling interests

     (342     (367

Payment of debt issuance costs

     (40     (34

Repurchases of common stock

     (2,213     (1,386

Other

     (95     188   
  

 

 

   

 

 

 

Net cash used in financing activities

     (1,784     (1,523
  

 

 

   

 

 

 

Change in cash and cash equivalents

     (64     22   

Cash and cash equivalents at beginning of period

     741        566   
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 677      $ 588   
  

 

 

   

 

 

 

Interest payments

   $ 1,339      $ 1,349   

Income tax payments, net

   $ 890      $ 864   

See accompanying notes.

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Reporting Entity

HCA Holdings, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Holdings, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At September 30, 2016, these affiliates owned and operated 169 hospitals, 117 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Holdings, Inc.’s facilities are located in 20 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Holdings, Inc. and its affiliates. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $94 million and $79 million for the quarters ended September 30, 2016 and 2015, respectively, and $272 million and $237 million for the nine months ended September 30, 2016 and 2015, respectively. Operating results for the quarter and the nine months ended September 30, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2015.

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)

 

Revenues

Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under Medicare, Medicaid and other programs), managed care health plans (including the health insurance exchanges), commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record a provision for doubtful accounts related to uninsured accounts to record the net self-pay revenues at the estimated amounts we expect to collect. Our revenues from third-party payers, the uninsured and other payers for the quarters and nine months ended September 30, 2016 and 2015 are summarized in the following table (dollars in millions):

 

     Quarter  
     2016      Ratio     2015      Ratio  

Medicare

   $ 2,158         21.0   $ 2,122         21.5

Managed Medicare

     1,068         10.4        1,031         10.5   

Medicaid

     405         3.9        402         4.1   

Managed Medicaid

     611         6.0        553         5.6   

Managed care and other insurers

     5,863         57.1        5,457         55.4   

International (managed care and other insurers)

     285         2.8        316         3.2   
  

 

 

    

 

 

   

 

 

    

 

 

 
     10,390         101.2        9,881         100.3   

Uninsured

     336         3.3        695         7.0   

Other

     384         3.7        438         4.4   
  

 

 

    

 

 

   

 

 

    

 

 

 

Revenues before provision for doubtful accounts

     11,110         108.2        11,014         111.7   

Provision for doubtful accounts

     (840      (8.2     (1,158      (11.7
  

 

 

    

 

 

   

 

 

    

 

 

 

Revenues

   $ 10,270         100.0   $ 9,856         100.0
  

 

 

    

 

 

   

 

 

    

 

 

 

 

     Nine Months  
     2016      Ratio     2015      Ratio  

Medicare

   $ 6,641         21.5   $ 6,500         22.1

Managed Medicare

     3,250         10.5        3,099         10.5   

Medicaid

     1,248         4.0        1,262         4.3   

Managed Medicaid

     1,816         5.9        1,673         5.7   

Managed care and other insurers

     17,324         56.2        16,134         54.8   

International (managed care and other insurers)

     926         3.0        964         3.3   
  

 

 

    

 

 

   

 

 

    

 

 

 
     31,205         101.1        29,632         100.7   

Uninsured

     750         2.4        1,321         4.5   

Other

     1,286         4.2        1,315         4.5   
  

 

 

    

 

 

   

 

 

    

 

 

 

Revenues before provision for doubtful accounts

     33,241         107.7        32,268         109.7   

Provision for doubtful accounts

     (2,392      (7.7     (2,839      (9.7
  

 

 

    

 

 

   

 

 

    

 

 

 

Revenues

   $ 30,849         100.0   $ 29,429         100.0
  

 

 

    

 

 

   

 

 

    

 

 

 

Recent Pronouncements

In May 2014, the Financial Accounting Standards Board (“FASB”) and the International Accounting Standards Board issued a final, converged, principles-based standard on revenue recognition. Companies across

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)

Recent Pronouncements (continued)

 

all industries will use a five-step model to recognize revenue from customer contracts. The new standard, which replaces nearly all existing United States Generally Accepted Accounting Principles (“US GAAP”) and International Financial Reporting Standards revenue recognition guidance, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The standard was originally scheduled to become effective for public entities for annual and interim periods beginning after December 15, 2016. Early adoption was originally not to be permitted under US GAAP. In July 2015, the FASB decided to defer the effective date of the new revenue standard by one year, but will permit entities to adopt one year earlier if they choose (i.e., the original effective date). The FASB decided, based on its outreach to various stakeholders and continuing amendments to the new revenue standard, that a deferral was necessary to provide adequate time to effectively implement the new standard. We are continuing to evaluate the effects the adoption of this standard will have on our financial statements and financial disclosures, and we do not believe the adoption will have a significant impact on our recognition of net revenues.

In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases (“ASU 2016-02”), which requires lessees to recognize assets and liabilities for most leases. ASU 2016-02 is effective for public business entities for annual and interim periods beginning after December 15, 2018 (calendar year 2019). Early adoption is permitted. ASU 2016-02’s transition provisions will be applied using a modified retrospective approach at the beginning of the earliest comparative period presented in the financial statements. We are currently evaluating the provisions of ASU 2016-02 to determine how our financial statements will be affected, and we believe the primary effect of adopting the new standard will be to record assets and obligations for current operating leases.

In March 2016, the FASB issued Accounting Standards Update 2016-05, Derivatives and Hedging (Topic 815): Effect of Derivative Contract Novations on Existing Hedge Accounting Relationships (“ASU 2016-05”), which clarified that a novation of a derivative contract in a hedge accounting relationship does not, in and of itself, represent a termination of the original derivative instrument or a change in the critical terms of the hedge relationship. We elected to adopt ASU 2016-05 prospectively effective January 1, 2016.

In March 2016, the FASB issued Accounting Standards Update 2016-09, Improvements to Employee Share-Based Payment Accounting (“ASU 2016-09”), which requires changes to how companies account for certain aspects of share-based payments to employees, including the accounting for income taxes, forfeitures and statutory tax withholding requirements, as well as classification in the statement of cash flows. We elected to adopt ASU 2016-09 prospectively effective January 1, 2016.

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

During the nine months ended September 30, 2016, we paid $343 million to acquire three hospital facilities and $125 million to acquire other nonhospital health care entities. During the nine months ended September 30, 2015, we paid $15 million to acquire a hospital and $169 million to acquire other nonhospital health care entities.

During the nine months ended September 30, 2016, we received proceeds of $23 million and recognized a net pretax gain of $8 million related to sales of real estate and other investments. During the nine months ended September 30, 2015, we received proceeds of $27 million and recognized a net pretax gain of $2 million related to sales of real estate and other investments.

 

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HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

 

NOTE 3 — INCOME TAXES

Our liability for unrecognized tax benefits was $414 million, including accrued interest of $41 million, as of September 30, 2016 ($554 million and $73 million, respectively, as of December 31, 2015). Unrecognized tax benefits of $136 million ($233 million as of December 31, 2015) would affect the effective rate, if recognized.

Our provision for income taxes for the quarter and nine months ended September 30, 2016 included tax benefits of $11 million and $129 million, respectively, related to the adoption of ASU 2016-09, which changes how companies account for certain aspects of share-based payments to employees. Under ASU 2016-09, we no longer record excess tax benefits (when the deductible amount related to the settlement of employee equity awards for tax purposes exceeds the cumulative compensation cost recognized for financial reporting purposes) in equity. Instead, we recognize these tax benefits (and deficiencies, if applicable) as a component of our tax provision. This reporting change is applied prospectively and prior period amounts are not restated (the excess tax benefits for the quarter and nine months ending September 30, 2015, related to the settlement of employee equity awards, were $34 million and $219 million, respectively, and were recorded in equity). ASU 2016-09 requires companies to present excess tax benefits as an operating activity on the statement of cash flows rather than as a financing activity, as previously required. We have elected to apply the change to the statement of cash flows presentation prospectively.

During the quarter ended September 30, 2016, the IRS completed its examination, resolving all outstanding federal tax issues for our 2011 and 2012 tax years. We reduced our provision for income taxes for the quarter and the nine months ended September 30, 2016 by $51 million, including interest of $27 million ($17 million, net of tax) primarily as a result of this resolution. We are also subject to examination by state and foreign taxing authorities. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

NOTE 4 — EARNINGS PER SHARE

We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards and potential shares, computed using the treasury stock method.

The following table sets forth the computation of basic and diluted earnings per share for the quarters and nine months ended September 30, 2016 and 2015 (dollars and shares in millions, except per share amounts):

 

     Quarter      Nine Months  
     2016      2015      2016      2015  

Net income attributable to HCA Holdings, Inc.

   $ 618       $ 449       $ 1,970       $ 1,547   

Weighted average common shares outstanding

     378.199         414.939         386.968         417.146   

Effect of dilutive incremental shares

     11.393         11.502         12.609         13.208   
  

 

 

    

 

 

    

 

 

    

 

 

 

Shares used for diluted earnings per share

     389.592         426.441         399.577         430.354   
  

 

 

    

 

 

    

 

 

    

 

 

 

Earnings per share:

           

Basic earnings per share

   $ 1.63       $ 1.08       $ 5.09       $ 3.71   

Diluted earnings per share

   $ 1.59       $ 1.05       $ 4.93       $ 3.60   

 

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HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

 

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of our insurance subsidiaries’ investments at September 30, 2016 and December 31, 2015 follows (dollars in millions):

 

     September 30, 2016  
     Amortized
Cost
     Unrealized
Amounts
     Fair
Value
 
        Gains      Losses     

Debt securities:

           

States and municipalities

   $ 368         $20         $—       $ 388   

Money market funds

     11                         11   
  

 

 

    

 

 

    

 

 

    

 

 

 
     379         20                 399   

Equity securities

     1         3                 4   
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 380         $23         $—         403   
  

 

 

    

 

 

    

 

 

    

Amounts classified as current assets

              (49
           

 

 

 

Investment carrying value

            $ 354   
           

 

 

 
     December 31, 2015  
     Amortized
Cost
     Unrealized
Amounts
     Fair
Value
 
        Gains      Losses     

Debt securities:

           

States and municipalities

   $ 428         $17         $(1    $ 444   

Money market funds

     34                         34   
  

 

 

    

 

 

    

 

 

    

 

 

 
     462         17         (1      478   

Equity securities

             4                 4   
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 462         $21         $(1      482   
  

 

 

    

 

 

    

 

 

    

Amounts classified as current assets

              (50
           

 

 

 

Investment carrying value

            $ 432   
           

 

 

 

At September 30, 2016 and December 31, 2015, the investments of our insurance subsidiaries were classified as “available-for-sale.” Changes in temporary unrealized gains and losses are recorded as adjustments to other comprehensive income (loss).

Scheduled maturities of investments in debt securities at September 30, 2016 were as follows (dollars in millions):

 

     Amortized
Cost
     Fair
Value
 

Due in one year or less

   $ 66       $ 66   

Due after one year through five years

     123         127   

Due after five years through ten years

     140         152   

Due after ten years

     50         54   
  

 

 

    

 

 

 
   $ 379       $ 399   
  

 

 

    

 

 

 

 

10


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)

 

The average expected maturity of the investments in debt securities at September 30, 2016 was 3.9 years, compared to the average scheduled maturity of 5.6 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date.

NOTE 6 — FINANCIAL INSTRUMENTS

Interest Rate Swap Agreements

We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert LIBOR indexed variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at September 30, 2016 (dollars in millions):

 

     Notional
Amount
     Maturity Date      Fair
Value
 

Pay-fixed interest rate swaps

   $ 3,000         December 2016       $ (22

Pay-fixed interest rate swaps

     1,000         December 2017         (18

Pay-fixed interest rate swaps (starting in December 2016)

     2,000         December 2021         (43

During the next 12 months, we estimate $48 million will be reclassified from other comprehensive income (“OCI”) to interest expense.

Derivatives — Results of Operations

The following table presents the effect of our interest rate swaps on our results of operations for the nine months ended September 30, 2016 (dollars in millions):

 

Derivatives in Cash Flow Hedging Relationships

   Amount of Loss
Recognized  in OCI on
Derivatives, Net of Tax
     Location of Loss
Reclassified from
Accumulated  OCI
into Operations
     Amount of Loss
Reclassified from
Accumulated  OCI
into Operations
 

Interest rate swaps

   $ 36         Interest expense       $ 84   

Credit-risk-related Contingent Features

We have agreements with each of our derivative counterparties that contain a provision where we could be declared in default on our derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to our default on the indebtedness. As of September 30, 2016, we have not been required to post any collateral related to these agreements. If we had breached these provisions at September 30, 2016, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $85 million.

 

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HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

 

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”) emphasizes fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, ASC 820 establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment, and considers factors specific to the asset or liability.

Cash Traded Investments

Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency. Certain types of cash traded instruments are classified within Level 3 of the fair value hierarchy because they trade infrequently and therefore have little or no price transparency. The valuation of these securities involves management’s judgment, after consideration of market factors and the absence of market transparency, market liquidity and observable inputs. Our valuation models derived fair market values compared to tax-equivalent yields of other securities of similar credit worthiness and similar effective maturities.

Derivative Financial Instruments

We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements.

Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at September 30, 2016 and December 31, 2015, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives.

 

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HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)

 

The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of September 30, 2016 and December 31, 2015, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

 

    September 30, 2016  
    Fair Value     Fair Value Measurements Using  
      Quoted Prices  in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
    Significant  Other
Observable Inputs
(Level 2)
    Significant
Unobservable  Inputs
(Level 3)
 

Assets:

       

Investments of insurance subsidiaries:

       

Debt securities:

       

States and municipalities

  $ 388      $      $ 382      $ 6   

Money market funds

    11        11                 
 

 

 

   

 

 

   

 

 

   

 

 

 
    399        11        382        6   

Equity securities

    4        4                 
 

 

 

   

 

 

   

 

 

   

 

 

 

Investments of insurance subsidiaries

    403        15        382        6   

Less amounts classified as current assets

    (49     (11     (38       
 

 

 

   

 

 

   

 

 

   

 

 

 
  $ 354      $ 4      $ 344      $ 6   
 

 

 

   

 

 

   

 

 

   

 

 

 

Liabilities:

       

Interest rate swaps (Income taxes and other liabilities)

  $ 83      $      $ 83      $   
    December 31, 2015  
          Fair Value Measurements Using  
    Fair Value     Quoted Prices  in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
    Significant  Other
Observable Inputs
(Level 2)
    Significant
Unobservable  Inputs
(Level 3)
 

Assets:

       

Investments of insurance subsidiaries:

       

Debt securities:

       

States and municipalities

  $ 444      $      $ 438      $ 6   

Money market funds

    34        34                 
 

 

 

   

 

 

   

 

 

   

 

 

 
    478        34        438        6   

Equity securities

    4        4                 
 

 

 

   

 

 

   

 

 

   

 

 

 

Investments of insurance subsidiaries

    482        38        438        6   

Less amounts classified as current assets

    (50     (34     (16       
 

 

 

   

 

 

   

 

 

   

 

 

 
  $ 432      $ 4      $ 422      $ 6   
 

 

 

   

 

 

   

 

 

   

 

 

 

Liabilities:

       

Interest rate swaps (Income taxes and other liabilities)

  $ 110      $      $ 110      $   

 

13


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)

 

The estimated fair value of our long-term debt was $33.343 billion and $31.411 billion at September 30, 2016 and December 31, 2015, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $31.619 billion and $30.655 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities.

NOTE 8 — LONG-TERM DEBT

A summary of long-term debt at September 30, 2016 and December 31, 2015, including related interest rates at September 30, 2016, follows (dollars in millions):

 

    September 30,
2016
    December 31,
2015
 

Senior secured asset-based revolving credit facility (effective interest rate
of 3.0%)

  $ 2,960      $ 3,030   

Senior secured revolving credit facility

             

Senior secured term loan facilities (effective interest rate of 5.1%)

    4,005        5,639   

Senior secured first lien notes (effective interest rate of 5.4%)

    13,800        11,100   

Other senior secured debt (effective interest rate of 5.7%)

    602        634   
 

 

 

   

 

 

 

First lien debt

    21,367        20,403   

Senior unsecured notes (effective interest rate of 6.5%)

    10,252        10,252   

Net debt issuance costs

    (178     (167
 

 

 

   

 

 

 

Total debt (average life of 6.6 years, rates averaging 5.5%)

    31,441        30,488   

Less amounts due within one year

    216        233   
 

 

 

   

 

 

 
  $ 31,225      $ 30,255   
 

 

 

   

 

 

 

2016 Activity

During August 2016, we issued $1.200 billion aggregate principal amount of 4.500% senior secured notes due 2027. We used the net proceeds for general corporate purposes and to retire a portion of one of our senior secured term loans. We also entered into a joinder agreement to retire the remaining portion of this senior secured term loan using proceeds from a new $1.200 billion senior secured term loan facility maturing in February 2024. The pretax loss on retirement of debt was $4 million.

During March 2016, we issued $1.500 billion aggregate principal amount of 5.250% senior secured notes due 2026. We used the net proceeds for general corporate purposes and to retire a portion of one of our senior secured term loans. We also entered into a joinder agreement to retire the remaining portion of this senior secured term loan using proceeds from a new $1.500 billion senior secured term loan facility maturing in March 2023.

2015 Activity

During December 2015, we issued $500 million aggregate principal amount of 5.875% senior notes due 2026. We used the net proceeds for general corporate purposes.

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 8 — LONG-TERM DEBT (continued)

2015 Activity (continued)

 

During November 2015, we issued $1.000 billion aggregate principal amount of 5.875% senior notes due 2026. We used the net proceeds to redeem all $1.000 billion aggregate principal amount of our outstanding 6.500% senior notes due 2016.

During June 2015, we entered into a joinder agreement to retire certain of our existing senior secured term loans using proceeds from a new $1.400 billion senior secured term loan credit facility maturing in June 2020. The pretax loss on retirement of debt was $3 million.

During May 2015, we issued $1.600 billion aggregate principal amount of 5.375% senior notes due 2025. We used the net proceeds to redeem all $1.525 billion aggregate principal amount of our outstanding 7 3/4% senior notes due 2021. The pretax loss on retirement of debt related to this redemption was $122 million.

During January 2015, we issued $1.000 billion aggregate principal amount of 5.375% senior notes due 2025. We used a portion of the net proceeds to repay at maturity our $750 million aggregate principal amount of 6.375% senior notes due 2015.

NOTE 9 — CONTINGENCIES AND LEGAL CLAIM COSTS

We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. We are subject to claims for additional taxes and related interest and penalties. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations, financial position or liquidity.

Government Investigations, Claims and Litigation

Health care companies are subject to numerous investigations by various governmental agencies. Further, under the federal False Claims Act (“FCA”), private parties have the right to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions. Certain of our individual facilities have received, and from time to time, other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position or liquidity.

On April 2, 2014, the UK Competition and Markets Authority (“Authority”) issued a final report on its investigation of the private health care market in London. It concluded, among other things, that many private hospitals face little competition in central London, and that there are high barriers to entry. As part of its remedies package, the Authority ordered HCA to sell either: (a) its London Bridge and Princess Grace hospitals; or (b) its Wellington Hospital, including the Platinum Medical Centre. It also imposed other remedial conditions on HCA and other private health care providers, including: regulation of incentives to referring physicians; increased access to information about fees and performance; and restrictions on future arrangements between private providers and National Health Service private patient units. HCA disagrees with the Authority’s

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 9 — CONTINGENCIES AND LEGAL CLAIM COSTS (continued)

Government Investigations, Claims and Litigation (continued)

 

assessment of the competitive conditions for hospitals in London, as well as its proposed divestiture remedy, and appealed the decision to the Competition Appeal Tribunal. The Competition Appeal Tribunal overturned certain of the Authority’s findings and sent the matter back to the Authority for further proceedings. In November 2015, following consideration of additional evidence, the Authority issued a provisional decision that again found there were adverse effects on competition in the private hospital market in central London. The November 2015 provisional decision modified some of the Authority’s earlier factual conclusions and acknowledged certain mitigating factors for some of the effects noted in the prior decision. The November 2015 provisional decision also offered additional potential remedies, which continued to include divestment of one or more of HCA’s London hospitals. Following a period of consultation on the potential additional remedies, the Authority concluded, in a provisional decision issued March 22, 2016, that none of the additional remedies, including divestiture, would be both effective and proportionate. A final decision was issued on September 5, 2016 confirming the terms of the provisional decision. No appeal has been notified by the Competition Appeal Tribunal as of yet. Third parties have until November 4, 2016 to challenge the decision (subject to any extensions).

Health Midwest Litigation

In October 2009, the Health Care Foundation of Greater Kansas City, a nonprofit health foundation, filed suit against HCA Inc. in the Circuit Court of Jackson County, Missouri and alleged that HCA did not fund the level of capital expenditures and uncompensated care agreed to in connection with HCA’s purchase of hospitals from Health Midwest in 2003. The central issue in the case was whether HCA’s construction of new hospitals counted towards its $450 million five-year capital commitment. In addition, the plaintiff alleged that HCA did not make its required capital expenditures in a timely fashion. On January 24, 2013, the court ruled in favor of the plaintiff and awarded at least $162 million. The court also ordered a court-supervised accounting of HCA’s capital expenditures, as well as of expenditures on charity and uncompensated care during the ten years following the purchase. The court also indicated it would award plaintiff attorneys fees, which the parties have stipulated are approximately $12 million for the trial phase. HCA recorded $175 million of legal claim costs in the fourth quarter of 2012 related to this ruling, and, consistent with the judge’s order, began accruing interest on that sum at 9% per annum. On April 25, 2014, the parties stipulated to an additional $78 million shortfall relating to the capital expenditures issue. HCA recorded $78 million of legal claims costs in the first quarter of 2014 as a result of the stipulation, and accrued interest on that amount at 9% per annum. Pursuant to the terms of the stipulation, the parties preserved their respective rights to contest the judge’s underlying ruling, whether through motions in the trial court or on appeal. On February 9, 2015, the parties reached an agreement to settle the part of their dispute relating to charity and uncompensated care for $15 million. The foundation is required to use that amount, net of attorneys’ fees, for charitable activities in the Kansas City area. The parties also agreed on an additional amount for attorneys’ fees for the plaintiff for the accounting phase of the case. The parties filed post-trial motions, on which the court ruled on October 21, 2015. The court denied defendants’ motion to have the court change its rulings on liability and damages related to the capital expenditures issue. The court granted the plaintiff’s motion for an award of additional pre-judgment interest, but did not specify whether the interest awarded was simple interest or would be compounded. The court subsequently concluded that interest was to be compounded, and on December 9, 2015, the court entered judgment in the case in the total sum of $434 million, with interest continuing to accrue at 9% per annum, compounded annually, from and after November 19, 2015, until the matter is resolved. At September 30, 2016, the Company had accrued liabilities of $468 million for the damages, costs and interest related to this litigation. On January 15, 2016, the Company filed a Notice of Appeal in the Missouri Court of Appeals for the Western District. The Court of Appeals has scheduled December 20, 2016 for oral arguments.

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

 

NOTE 10 — CAPITAL STRUCTURE

The changes in stockholders’ deficit, including changes in stockholders’ deficit attributable to HCA Holdings, Inc. and changes in equity attributable to noncontrolling interests, are as follows (dollars and shares in millions):

 

    Equity (Deficit) Attributable to HCA Holdings, Inc.     Equity
Attributable  to
Noncontrolling
Interests
    Total  
    Common Stock     Capital in
Excess  of
Par
Value
    Accumulated
Other
Comprehensive
Loss
    Retained
Deficit
     
    Shares     Par Value            

Balances at December 31, 2015

    398.739      $ 4      $      $ (265   $ (7,338   $ 1,553      $ (6,046

Comprehensive income

                         (76     1,970        377        2,271   

Repurchase of common stock

    (29.064            (155            (2,058            (2,213

Distributions

                                       (342     (342

Share-based benefit plans

    6.466               157                             157   

Other

                  (2                   12        10   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Balances at September 30, 2016

    376.141      $ 4      $      $ (341   $ (7,426   $ 1,600      $ (6,163
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

On October 26, 2015, our board of directors authorized a share repurchase program for up to $3 billion of our outstanding common stock. During May 2016, the Company repurchased 9.361 million shares of its common stock beneficially owned by affiliates of Kohlberg Kravis Roberts & Co. at a purchase price of $80.12 per share, the closing price of the Company’s common stock on the New York Stock Exchange on May 10, 2016, less a discount of 1%. During the nine months ended September 30, 2016, we also repurchased 19.703 million shares of our common stock at an average price of $74.28 per share through market purchases, resulting in total repurchases of 29.064 million shares of our common stock at an average price of $76.16 per share for the nine months ended September 30, 2016 pursuant to the $3.0 billion share repurchase program authorized during October 2015. At September 30, 2016, we had $390 million of repurchase authorization available under the October 2015 authorization.

The components of accumulated other comprehensive loss are as follows (dollars in millions):

 

     Unrealized
Gains on
Available-
for-Sale
Securities
     Foreign
Currency
Translation
Adjustments
    Defined
Benefit
Plans
    Change
in Fair
Value of
Derivative
Instruments
    Total  

Balances at December 31, 2015

   $ 13       $ (74   $ (135   $ (69   $ (265

Unrealized gains on available-for-sale securities, net of $1 of income taxes

     2         —          —          —          2   

Foreign currency translation adjustments, net of $66 income tax benefit

     —           (103     —          —          (103

Change in fair value of derivative instruments, net of $21 income tax benefit

     —           —          —          (36     (36

Expense reclassified into operations from other comprehensive income, net of $5 and $31, respectively, income tax benefits

     —           —          8        53        61   
  

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Balances at September 30, 2016

   $ 15       $ (177   $ (127   $ (52   $ (341
  

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

 

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 84 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, South Carolina, Utah and Virginia, and the American Group includes 79 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and Texas. We also operate six hospitals in England, and these facilities are included in the Corporate and other group.

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2016 and 2015 are summarized in the following table (dollars in millions):

 

     Quarter      Nine Months  
     2016      2015      2016      2015  

Revenues:

           

National Group

   $ 4,882       $ 4,580       $ 14,780       $ 13,928   

American Group

     4,904         4,772         14,539         13,972   

Corporate and other

     484         504         1,530         1,529   
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 10,270       $ 9,856       $ 30,849       $ 29,429   
  

 

 

    

 

 

    

 

 

    

 

 

 

Equity in earnings of affiliates:

           

National Group

   $ (13    $ (1    $ (17    $ (8

American Group

     (9      (9      (26      (25

Corporate and other

             1         (1      (5
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ (22    $ (9    $ (44    $ (38
  

 

 

    

 

 

    

 

 

    

 

 

 

Adjusted segment EBITDA:

           

National Group

   $ 1,073       $ 920       $ 3,342       $ 3,089   

American Group

     1,018         1,036         3,005         3,029   

Corporate and other

     (134      (141      (335      (334
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 1,957       $ 1,815       $ 6,012       $ 5,784   
  

 

 

    

 

 

    

 

 

    

 

 

 

 

18


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

     Quarter      Nine Months  
     2016      2015      2016      2015  

Depreciation and amortization:

           

National Group

   $ 204       $ 195       $ 602       $ 572   

American Group

     230         219         673         662   

Corporate and other

     61         68         188         190   
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 495       $ 482       $ 1,463       $ 1,424   
  

 

 

    

 

 

    

 

 

    

 

 

 

Adjusted segment EBITDA

   $ 1,957       $ 1,815       $ 6,012       $ 5,784   

Depreciation and amortization

     495         482         1,463         1,424   

Interest expense

     432         411         1,275         1,255   

Losses (gains) on sales of facilities

     (3      2         (8      (2

Losses on retirement of debt

     4                 4         125   

Legal claim costs

     11         77         33         77   
  

 

 

    

 

 

    

 

 

    

 

 

 

Income before income taxes

   $ 1,018       $ 843       $ 3,245       $ 2,905   
  

 

 

    

 

 

    

 

 

    

 

 

 

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION

During November 2010, HCA Holdings, Inc. issued $1.525 billion aggregate principal amount of 7 3/4% senior unsecured notes due 2021, which were redeemed in full during May 2015. During December 2012, HCA Holdings, Inc. issued $1.000 billion aggregate principal amount of 6.250% senior unsecured notes due 2021. These notes are senior unsecured obligations and are not guaranteed by any of our subsidiaries.

HCA Inc., a direct wholly-owned subsidiary of HCA Holdings, Inc., is the obligor under a significant portion of our other indebtedness, including our senior secured credit facilities, senior secured notes and senior unsecured notes (other than the senior unsecured notes issued by HCA Holdings, Inc.). The senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guaranteed by HCA Holdings, Inc. The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, 100% owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our senior secured asset-based revolving credit facility).

 

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Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

Our summarized condensed consolidating comprehensive income statements for the quarters and nine months ended September 30, 2016 and 2015, condensed consolidating balance sheets at September 30, 2016 and December 31, 2015 and condensed consolidating statements of cash flows for the nine months ended September 30, 2016 and 2015, segregating HCA Holdings, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors and eliminations, follow:

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT

FOR THE QUARTER ENDED SEPTEMBER 30, 2016

(Dollars in millions)

 

     HCA
Holdings, Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
    Eliminations     Condensed
Consolidated
 

Revenues before provision for doubtful accounts

   $      $      $ 5,591      $ 5,519      $      $ 11,110   

Provision for doubtful accounts

                   391        449               840   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Revenues

                   5,200        5,070               10,270   

Salaries and benefits

                   2,373        2,367               4,740   

Supplies

                   888        811               1,699   

Other operating expenses

     1               905        991               1,897   

Electronic health record incentive income

                   (1                   (1

Equity in earnings of affiliates

     (573            (1     (21     573        (22

Depreciation and amortization

                   242        253               495   

Interest expense

     16        711        (235     (60            432   

Gains on sales of facilities

                          (3            (3

Losses on retirement of debt

            4                             4   

Legal claim costs

            11                             11   

Management fees

                   (206     206                 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
     (556     726        3,965        4,544        573        9,252   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     556        (726     1,235        526        (573     1,018   

Provision (benefit) for income taxes

     (62     (268     447        156               273   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     618        (458     788        370        (573     745   

Net income attributable to noncontrolling interests

                   24        103               127   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) attributable to HCA Holdings, Inc.

   $ 618      $ (458   $ 764      $ 267      $ (573   $ 618   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income (loss) attributable to HCA Holdings, Inc.

   $ 621      $ (432   $ 766      $ 242      $ (576   $ 621   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

20


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT

FOR THE QUARTER ENDED SEPTEMBER 30, 2015

(Dollars in millions)

 

     HCA
Holdings, Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
    Eliminations     Condensed
Consolidated
 

Revenues before provision for doubtful accounts

   $      $      $ 5,721      $ 5,293      $      $ 11,014   

Provision for doubtful accounts

                   689        469               1,158   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Revenues

                   5,032        4,824               9,856   

Salaries and benefits

                   2,357        2,262               4,619   

Supplies

                   853        791               1,644   

Other operating expenses

     7               865        924               1,796   

Electronic health record incentive income

                   (6     (3            (9

Equity in earnings of affiliates

     (464            (1     (8     464        (9

Depreciation and amortization

                   230        252               482   

Interest expense

     16        608        (156     (57            411   

Losses (gains) on sales of facilities

                   (1     3               2   

Legal claim costs

            77                             77   

Management fees

                   (178     178                 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
     (441     685        3,963        4,342        464        9,013   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     441        (685     1,069        482        (464     843   

Provision (benefit) for income taxes

     (8     (258     394        142               270   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     449        (427     675        340        (464     573   

Net income attributable to noncontrolling interests

                   21        103               124   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) attributable to HCA Holdings, Inc.

   $ 449      $ (427   $ 654      $ 237      $ (464   $ 449   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income (loss) attributable to HCA Holdings, Inc.

   $ 430      $ (418   $ 657      $ 206      $ (445   $ 430   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

21


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT

FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2016

(Dollars in millions)

 

     HCA
Holdings, Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
    Eliminations     Condensed
Consolidated
 

Revenues before provision for doubtful accounts

   $      $      $ 16,957      $ 16,284      $      $ 33,241   

Provision for doubtful accounts

                   1,383        1,009               2,392   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Revenues

                   15,574        15,275               30,849   

Salaries and benefits

                   7,074        7,059               14,133   

Supplies

                   2,672        2,459               5,131   

Other operating expenses

     5               2,660        2,962               5,627   

Electronic health record incentive income

                   (6     (4            (10

Equity in earnings of affiliates

     (1,843            (4     (40     1,843        (44

Depreciation and amortization

                   707        756               1,463   

Interest expense

     48        2,031        (646     (158            1,275   

Gains on sales of facilities

                          (8            (8

Losses on retirement of debt

            4                             4   

Legal claim costs

            33                             33   

Management fees

                   (601     601                 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
     (1,790     2,068        11,856        13,627        1,843        27,604   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     1,790        (2,068     3,718        1,648        (1,843     3,245   

Provision (benefit) for income taxes

     (180     (763     1,347        494               898   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     1,970        (1,305     2,371        1,154        (1,843     2,347   

Net income attributable to noncontrolling interests

                   67        310               377   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) attributable to HCA Holdings, Inc.

   $ 1,970      $ (1,305   $ 2,304      $ 844      $ (1,843   $ 1,970   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income (loss) attributable to HCA Holdings, Inc.

   $ 1,894      $ (1,288   $ 2,312      $ 743      $ (1,767   $ 1,894   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

22


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT

FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015

(Dollars in millions)

 

     HCA
Holdings, Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
    Eliminations     Condensed
Consolidated
 

Revenues before provision for doubtful accounts

   $      $      $ 16,519      $ 15,749      $      $ 32,268   

Provision for doubtful accounts

                   1,535        1,304               2,839   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Revenues

                   14,984        14,445               29,429   

Salaries and benefits

                   6,824        6,685               13,509   

Supplies

                   2,576        2,376               4,952   

Other operating expenses

     9               2,523        2,736               5,268   

Electronic health record incentive income

                   (31     (15            (46

Equity in earnings of affiliates

     (1,690            (4     (34     1,690        (38

Depreciation and amortization

                   683        741               1,424   

Interest expense

     100        1,807        (498     (154            1,255   

Losses (gains) on sales of facilities

                   (5     3               (2

Losses on retirement of debt

     122        3                             125   

Legal claim costs

            77                             77   

Management fees

                   (534     534                 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
     (1,459     1,887        11,534        12,872        1,690        26,524   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     1,459        (1,887     3,450        1,573        (1,690     2,905   

Provision (benefit) for income taxes

     (88     (716     1,284        467               947   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     1,547        (1,171     2,166        1,106        (1,690     1,958   

Net income attributable to noncontrolling interests

                   68        343               411   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss) attributable to HCA Holdings, Inc.

   $ 1,547      $ (1,171   $ 2,098      $ 763      $ (1,690   $ 1,547   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income (loss) attributable to HCA Holdings, Inc.

   $ 1,561      $ (1,142   $ 2,109      $ 737      $ (1,704   $ 1,561   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

23


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING BALANCE SHEET

SEPTEMBER 30, 2016

(Dollars in millions)

 

     HCA
Holdings,  Inc.
Issuer
    HCA  Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
     Eliminations     Condensed
Consolidated
 
ASSETS              

Current assets:

             

Cash and cash equivalents

   $ 1      $      $ 138      $ 538       $      $ 677   

Accounts receivable, net

                   2,844        2,659                5,503   

Inventories

                   905        598                1,503   

Other

                   534        626                1,160   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     1               4,421        4,421                8,843   

Property and equipment, net

                   8,681        7,194                15,875   

Investments of insurance subsidiaries

                          354                354   

Investments in and advances to

affiliates

     26,147               16        200         (26,147     216   

Goodwill and other intangible assets

                   1,710        4,981                6,691   

Other

     962               21        165                1,148   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
   $ 27,110      $      $ 14,849      $ 17,315       $ (26,147   $ 33,127   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 

LIABILITIES AND

STOCKHOLDERS’ (DEFICIT)

EQUITY

             

Current liabilities:

             

Accounts payable

   $      $      $ 1,152      $ 798       $      $ 1,950   

Accrued salaries

                   689        552                1,241   

Other accrued expenses

     15        294        541        898                1,748   

Long-term debt due within one year

            97        60        59                216   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     15        391        2,442        2,307                5,155   

Long-term debt, net

     993        29,749        200        283                31,225   

Intercompany balances

     33,451        (10,811     (25,144     2,504                  

Professional liability risks

                          1,164                1,164   

Income taxes and other liabilities

     414        551        362        419                1,746   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     34,873        19,880        (22,140     6,677                39,290   

Stockholders’ (deficit) equity attributable to HCA Holdings, Inc.

     (7,763     (19,880     36,840        9,187         (26,147     (7,763

Noncontrolling interests

                   149        1,451                1,600   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     (7,763     (19,880     36,989        10,638         (26,147     (6,163
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
   $ 27,110      $      $ 14,849      $ 17,315       $ (26,147   $ 33,127   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 

 

24


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING BALANCE SHEET

DECEMBER 31, 2015

(Dollars in millions)

 

     HCA
Holdings,  Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
     Eliminations     Condensed
Consolidated
 
ASSETS              

Current assets:

             

Cash and cash equivalents

   $      $      $ 155      $ 586       $      $ 741   

Accounts receivable, net

                   2,982        2,907                5,889   

Inventories

                   852        587                1,439   

Other

     223               403        537                1,163   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     223               4,392        4,617                9,232   

Property and equipment, net

                   8,328        6,686                15,014   

Investments of insurance subsidiaries

                          432                432   

Investments in and advances to

affiliates

     24,380               14        164         (24,380     178   

Goodwill and other intangible assets

                   1,703        5,028                6,731   

Other

     943               19        195                1,157   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
   $ 25,546      $      $ 14,456      $ 17,122       $ (24,380   $ 32,744   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 

LIABILITIES AND STOCKHOLDERS’ (DEFICIT)

EQUITY

             

Current liabilities:

             

Accounts payable

   $ 2      $      $ 1,375      $ 793       $      $ 2,170   

Accrued salaries

                   712        521                1,233   

Other accrued expenses

     172        340        458        910                1,880   

Long-term debt due within one year

            114        65        54                233   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     174        454        2,610        2,278                5,516   

Long-term debt, net

     984        28,756        226        289                30,255   

Intercompany balances

     31,432        (11,171     (23,435     3,174                  

Professional liability risks

                          1,115                1,115   

Income taxes and other liabilities

     555        548        417        384                1,904   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     33,145        18,587        (20,182     7,240                38,790   

Stockholders’ (deficit) equity attributable to HCA Holdings, Inc.

     (7,599     (18,587     34,510        8,457         (24,380     (7,599

Noncontrolling interests

                   128        1,425                1,553   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
     (7,599     (18,587     34,638        9,882         (24,380     (6,046
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 
   $ 25,546      $      $ 14,456      $ 17,122       $ (24,380   $ 32,744   
  

 

 

   

 

 

   

 

 

   

 

 

    

 

 

   

 

 

 

 

25


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2016

(Dollars in millions)

 

    HCA
Holdings, Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
    Eliminations     Condensed
Consolidated
 

Cash flows from operating activities:

           

Net income (loss)

  $ 1,970      $ (1,305   $ 2,371      $ 1,154      $ (1,843   $ 2,347   

Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:

           

Changes in operating assets and liabilities

    (40     (49     (1,628     (829            (2,546

Provision for doubtful accounts

                  1,383        1,009               2,392   

Depreciation and amortization

                  707        756               1,463   

Income taxes

    8                                    8   

Gains on sales of facilities

                         (8            (8

Losses on retirement of debt

           4                             4   

Legal claim costs

           33                             33   

Amortization of debt issuance costs

           26                             26   

Share-based compensation

                  196                      196   

Equity in earnings of affiliates

    (1,843                          1,843          

Other

    53               (3     (11            39   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash provided by (used in) operating activities

    148        (1,291     3,026        2,071               3,954   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from investing activities:

           

Purchase of property and equipment

                  (892     (992            (1,884

Acquisition of hospitals and health care entities

                  (164     (304            (468

Disposition of hospitals and health care entities

                  10        13               23   

Change in investments

                  (2     80               78   

Other

                         17               17   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash used in investing activities

                  (1,048     (1,186            (2,234
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from financing activities:

           

Issuance of long-term debt

           5,400                             5,400   

Net change in revolving credit facilities

           (70                          (70

Repayment of long-term debt

           (4,334     (54     (36            (4,424

Distributions to noncontrolling interests

                  (46     (296            (342

Payment of debt issuance costs

           (40                          (40

Repurchases of common stock

    (2,213                                 (2,213

Changes in intercompany balances with affiliates, net

    2,171        335        (1,895     (611              

Other

    (105                   10               (95
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash (used in) provided by financing activities

    (147     1,291        (1,995     (933            (1,784
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Change in cash and cash equivalents

    1               (17     (48            (64

Cash and cash equivalents at beginning of period

                  155        586               741   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash and cash equivalents at end of period

  $ 1      $  —      $ 138      $ 538      $  —      $ 677   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

26


Table of Contents

HCA HOLDINGS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION (continued)

 

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015

(Dollars in millions)

 

    HCA
Holdings, Inc.
Issuer
    HCA Inc.
Issuer
    Subsidiary
Guarantors
    Subsidiary
Non-
Guarantors
    Eliminations     Condensed
Consolidated
 

Cash flows from operating activities:

           

Net income (loss)

  $ 1,547      $ (1,171   $ 2,166      $ 1,106      $ (1,690   $ 1,958   

Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:

           

Changes in operating assets and liabilities

    (22     (56     (1,959     (1,296            (3,333

Provision for doubtful accounts

                  1,535        1,304               2,839   

Depreciation and amortization

                  683        741               1,424   

Income taxes

    (148                                 (148

Losses (gains) on sales of facilities

                  (5     3               (2

Losses on retirement of debt

    122        3                             125   

Legal claim costs

           77                             77   

Amortization of debt issuance costs

    3        24                             27   

Share-based compensation

                  171                      171   

Equity in earnings of affiliates

    (1,690                          1,690          

Other

    49        3               (14            38   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash (used in) provided by operating activities

    (139     (1,120     2,591        1,844               3,176   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from investing activities:

           

Purchase of property and equipment

                  (764     (807            (1,571

Acquisition of hospitals and health care entities

                  (51     (133