Cash Flow Statement

The cash flow statement provides information about a company cash receipts and cash payments during an accounting period, showing how these cash flows link the ending cash balance to the beginning balance shown on the company balance sheet.

The cash flow statement consists of three parts: cash flows provided by (used in) operating activities, cash flows provided by (used in) investing activities, and cash flows provided by (used in) financing activities.

HCA Healthcare Inc., consolidated cash flow statement

US$ in millions

12 months ended:	Dec 31, 2021	Dec 31, 2020	Dec 31, 2019	Dec 31, 2018	Dec 31, 2017
Net income	7,721)	4,387)	4,145)	4,389)	2,743)
Accounts receivable	(962)	327)	(326)	(423)	(601)
Inventories and other assets	(540)	(304)	(158)	(242)	(69)
Accounts payable and accrued expenses	999)	1,255)	396)	698)	374)
Increase (decrease) in cash from operating assets and liabilities	(503)	1,278)	(88)	33)	(296)
Depreciation and amortization	2,853)	2,721)	2,596)	2,278)	2,131)
Income taxes	(70)	41)	250)	74)	433)
(Gains) losses on sales of facilities	(1,620)	7)	(18)	(428)	(8)
Losses on retirement of debt	12)	295)	211)	9)	39)
Amortization of debt issuance costs	27)	30)	30)	31)	31)
Share-based compensation	440)	362)	347)	268)	270)
Other	99)	111)	129)	107)	83)
Adjustments to reconcile net income to net cash provided by operating activities	1,238)	4,845)	3,457)	2,372)	2,683)
Net cash provided by operating activities	8,959)	9,232)	7,602)	6,761)	5,426)
Purchase of property and equipment	(3,577)	(2,835)	(4,158)	(3,573)	(3,015)
Acquisition of hospitals and health care entities	(1,105)	(568)	(1,682)	(1,253)	(1,212)
Sales of hospitals and health care entities	2,160)	68)	61)	808)	25)
Change in investments	(117)	(20)	25)	57)	(73)
Other	(4)	(38)	34)	60)	(4)
Net cash used in investing activities	(2,643)	(3,393)	(5,720)	(3,901)	(4,279)
Issuances of long-term debt	4,344)	2,700)	6,451)	2,000)	1,502)
Net change in revolving credit facilities	2,780)	(2,480)	(560)	(640)	760)
Repayment of long-term debt	(3,869)	(3,437)	(5,324)	(1,704)	(753)
Distributions to noncontrolling interests	(749)	(626)	(542)	(441)	(448)
Payment of debt issuance costs	(38)	(35)	(73)	(25)	(26)
Payment of dividends	(624)	(153)	(550)	(487)	—)
Repurchase of common stock	(8,215)	(441)	(1,031)	(1,530)	(2,051)
Other	(284)	(205)	(142)	(248)	(45)
Net cash used in financing activities	(6,655)	(4,677)	(1,771)	(3,075)	(1,061)
Effect of exchange rate changes on cash and cash equivalents	(3)	10)	8)	(15)	—)
Change in cash and cash equivalents	(342)	1,172)	119)	(230)	86)
Cash and cash equivalents at beginning of period	1,793)	621)	502)	732)	646)
Cash and cash equivalents at end of period	1,451)	1,793)	621)	502)	732)

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).

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Cash flow statement item	Description	The company
Net cash provided by operating activities	Amount of cash inflow (outflow) from operating activities, excluding discontinued operations. Operating activity cash flows include transactions, adjustments, and changes in value not defined as investing or financing activities.	HCA Healthcare Inc. net cash provided by operating activities increased from 2019 to 2020 but then slightly decreased from 2020 to 2021.
Net cash used in investing activities	Amount of cash inflow (outflow) of investing activities, excluding discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets.	HCA Healthcare Inc. net cash used in investing activities increased from 2019 to 2020 and from 2020 to 2021.
Net cash used in financing activities	Amount of cash inflow (outflow) of financing activities, excluding discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit.	HCA Healthcare Inc. net cash used in financing activities decreased from 2019 to 2020 and from 2020 to 2021.

HCA Healthcare Inc. (NYSE:HCA)

Cash Flow Statement