Name: HCA Healthcare Inc. (NYSE:HCA) | Cash Flow Statement (Quarterly)
Creator: Stock Analysis on Net

Cash Flow Statement
Quarterly Data

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.

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HCA Healthcare Inc., consolidated cash flow statement (quarterly data)

US$ in millions

3 months ended:	Mar 31, 2022	Dec 31, 2021	Sep 30, 2021	Jun 30, 2021	Mar 31, 2021	Dec 31, 2020	Sep 30, 2020	Jun 30, 2020	Mar 31, 2020	Dec 31, 2019	Sep 30, 2019	Jun 30, 2019	Mar 31, 2019	Dec 31, 2018	Sep 30, 2018	Jun 30, 2018	Mar 31, 2018	Dec 31, 2017	Sep 30, 2017	Jun 30, 2017	Mar 31, 2017
Net income	1,465)	2,005)	2,472)	1,664)	1,580)	1,694)	779)	1,216)	698)	1,273)	764)	927)	1,181)	1,245)	896)	966)	1,282)	641)	530)	795)	777)
Accounts receivable	(427)	350)	(745)	(196)	(371)	(603)	(285)	751)	464)	(233)	81)	195)	(369)	(262)	72)	(229)	(4)	(531)	(151)	(87)	168)
Inventories and other assets	(121)	(207)	(120)	(128)	(85)	(268)	21)	139)	(196)	(63)	136)	(57)	(174)	(106)	64)	18)	(218)	(19)	128)	(181)	3)
Accounts payable and accrued expenses	(771)	268)	682)	420)	(371)	713)	878)	448)	(784)	514)	120)	413)	(651)	548)	119)	294)	(263)	543)	129)	293)	(591)
Contract liabilities, deferred revenues	—)	—)	—)	—)	—)	(6,123)	1,124)	4,999)	—)	—)	—)	—)	—)	—)	—)	—)	—)	—)	—)	—)	—)
Increase (decrease) in cash from operating assets and liabilities	(1,319)	411)	(183)	96)	(827)	(6,281)	1,738)	6,337)	(516)	218)	337)	551)	(1,194)	180)	255)	83)	(485)	(7)	106)	25)	(420)
Depreciation and amortization	732)	728)	716)	712)	697)	662)	694)	691)	674)	694)	647)	636)	619)	581)	582)	562)	553)	550)	539)	521)	521)
Income taxes	346)	(255)	183)	(404)	406)	155)	(586)	351)	121)	199)	24)	(242)	269)	74)	(118)	(128)	246)	442)	(276)	(25)	292)
(Gains) losses on sales of facilities	(10)	(563)	(1,047)	(8)	(2)	1)	(14)	27)	(7)	(1)	—)	(18)	1)	(8)	(6)	(9)	(405)	2)	(7)	(2)	(1)
Losses on retirement of debt	—)	—)	—)	12)	—)	—)	—)	—)	295)	—)	211)	—)	—)	—)	9)	—)	—)	—)	39)	—)	—)
Amortization of debt issuance costs and discounts	7)	6)	7)	6)	8)	8)	8)	7)	7)	7)	7)	8)	8)	8)	8)	7)	8)	8)	7)	8)	8)
Share-based compensation	86)	99)	115)	129)	97)	133)	81)	66)	82)	84)	105)	96)	62)	64)	70)	74)	60)	75)	55)	67)	73)
Other	38)	12)	14)	44)	29)	45)	17)	28)	21)	31)	31)	39)	28)	31)	25)	27)	24)	23)	15)	15)	30)
Adjustments to reconcile net income to net cash provided by operating activities	(120)	438)	(195)	587)	408)	(5,277)	1,938)	7,507)	677)	1,232)	1,362)	1,070)	(207)	930)	825)	616)	1)	1,093)	478)	609)	503)
Net cash provided by operating activities	1,345)	2,443)	2,277)	2,251)	1,988)	(3,583)	2,717)	8,723)	1,375)	2,505)	2,126)	1,997)	974)	2,175)	1,721)	1,582)	1,283)	1,734)	1,008)	1,404)	1,280)
Purchase of property and equipment	(861)	(1,192)	(889)	(842)	(654)	(748)	(489)	(745)	(853)	(1,274)	(1,139)	(964)	(781)	(1,153)	(846)	(880)	(694)	(982)	(729)	(733)	(571)
Acquisition of hospitals and health care entities	(2)	(617)	(390)	(76)	(22)	(188)	(34)	(18)	(328)	(90)	(88)	(30)	(1,474)	(197)	(518)	(159)	(379)	(70)	(847)	(205)	(90)
Sales of hospitals and health care entities	14)	180)	1,950)	10)	20)	—)	29)	4)	35)	12)	8)	11)	30)	6)	3)	32)	767)	1)	10)	10)	4)
Change in investments	10)	(79)	(26)	(10)	(2)	20)	(29)	(10)	(1)	(10)	(24)	23)	36)	(8)	42)	12)	11)	(58)	(4)	8)	(19)
Other	(6)	(6)	(5)	(2)	9)	6)	(7)	(39)	2)	17)	(19)	12)	24)	66)	19)	15)	(40)	2)	(11)	(2)	7)
Net cash used in investing activities	(845)	(1,714)	640)	(920)	(649)	(910)	(530)	(808)	(1,145)	(1,345)	(1,262)	(948)	(2,165)	(1,286)	(1,300)	(980)	(335)	(1,107)	(1,581)	(922)	(669)
Issuances of long-term debt	5,966)	7)	—)	4,337)	—)	—)	—)	—)	2,700)	—)	—)	4,951)	1,500)	—)	2,000)	—)	—)	—)	—)	1,502)	—)
Net change in revolving credit facilities	(2,780)	2,280)	(300)	720)	80)	—)	—)	(3,920)	1,440)	(530)	3,010)	(3,500)	460)	(310)	(540)	(60)	270)	110)	1,810)	(1,320)	160)
Repayment of long-term debt	(66)	(82)	(56)	(3,684)	(47)	(34)	(39)	(37)	(3,327)	(35)	(5,191)	(49)	(49)	(52)	(1,551)	(51)	(50)	(53)	(605)	(52)	(43)
Distributions to noncontrolling interests	(171)	(248)	(144)	(123)	(234)	(233)	(194)	(45)	(154)	(138)	(157)	(111)	(136)	(126)	(130)	(93)	(92)	(85)	(115)	(103)	(145)
Payment of debt issuance costs	(49)	—)	(6)	(32)	—)	—)	—)	(1)	(34)	(2)	(8)	(41)	(22)	(1)	(22)	—)	(2)	(1)	—)	(23)	(2)
Payment of dividends	(177)	(148)	(151)	(156)	(169)	—)	—)	(1)	(152)	(136)	(136)	(137)	(141)	(121)	(121)	(122)	(123)	—)	—)	—)	—)
Repurchase of common stock	(2,101)	(2,072)	(2,329)	(2,287)	(1,527)	—)	—)	—)	(441)	(272)	(239)	(242)	(278)	(335)	(302)	(470)	(423)	(576)	(509)	(542)	(424)
Other	(197)	(43)	(17)	(17)	(207)	(49)	(12)	(3)	(141)	3)	(10)	(17)	(118)	(16)	(40)	(1)	(191)	(8)	5)	8)	(50)
Net cash provided by (used in) financing activities	425)	(306)	(3,003)	(1,242)	(2,104)	(316)	(245)	(4,007)	(109)	(1,110)	(2,731)	854)	1,216)	(961)	(706)	(797)	(611)	(613)	586)	(530)	(504)
Effect of exchange rate changes on cash and cash equivalents	(5)	1)	(7)	1)	2)	14)	8)	(1)	(11)	12)	(4)	(4)	4)	(4)	(5)	(23)	17)	—)	—)	—)	—)
Change in cash and cash equivalents	920)	424)	(93)	90)	(763)	(4,795)	1,950)	3,907)	110)	62)	(1,871)	1,899)	29)	(76)	(290)	(218)	354)	14)	13)	(48)	107)

The financial data reveals a general upward trajectory in profitability and operational cash generation from early 2017 through early 2022, characterized by significant volatility in 2020 and a strategic shift in capital allocation starting in 2021.

Operating Performance and Cash Flow: Net income exhibited a consistent growth trend, rising from a range of 530 million to 795 million US dollars in 2017 to a peak of 2,472 million US dollars in the third quarter of 2021. Net cash provided by operating activities generally mirrored this growth, although 2020 presented extreme fluctuations. A significant spike in operating cash flow occurred in June 2020, reaching 8,723 million US dollars, which corresponds directly to a 4,999 million US dollar increase in contract liabilities and deferred revenues. This was largely offset in December 2020, where operating cash flow dropped to negative 3,583 million US dollars due to a 6,123 million US dollar reduction in those same liabilities.; Depreciation and amortization costs showed a steady quarterly increase, moving from approximately 521 million US dollars in early 2017 to 732 million US dollars by March 2022, indicating a continuous expansion of the company's physical asset base.
Investing Activities and Capital Expenditure: Investing activities remained predominantly negative, reflecting a consistent commitment to capital expenditures. Purchases of property and equipment were sustained at high levels, typically ranging between 600 million and 1.2 billion US dollars per quarter. Acquisition activity was frequent but varied in scale, with a notable peak in spending during the first quarter of 2019 at 1,474 million US dollars.; A significant deviation in investing trends occurred in the third quarter of 2021, where the sale of hospitals and healthcare entities generated 1,950 million US dollars. This windfall resulted in a rare positive net cash flow from investing activities for that period, totaling 640 million US dollars.
Financing Strategies and Shareholder Returns: Financing activities demonstrate a transition toward more aggressive shareholder returns. While dividend payments remained relatively stable, increasing modestly from approximately 120 million to 177 million US dollars per quarter, stock repurchases accelerated sharply in 2021. Repurchase volumes increased from quarterly averages of 200 million to 400 million US dollars in prior years to over 2 billion US dollars per quarter starting in March 2021.; To support these activities and maintain liquidity, the company utilized a combination of long-term debt issuances and revolving credit facilities. Significant debt issuances were observed in June 2019 (4,951 million US dollars), June 2021 (4,337 million US dollars), and March 2022 (5,966 million US dollars), often coinciding with periods of increased share buybacks or strategic investments.

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HCA Healthcare Inc. (NYSE:HCA)

Cash Flow StatementQuarterly Data

Cash Flow Statement
Quarterly Data