Community Health Systems 2015 Annual Report Download - page 87

flow were partially offset by a net improvement in accounts receivable compared to the prior year. Total cash
paid for interest during the year ended December 31, 2015 increased to approximately $925 million compared to
$831 million for the year ended December 31, 2014, which is related to the timing of additional interest
payments made in 2015 for the debt financing in January 2014 for the acquisition of HMA. Approximately $12
million was paid for income taxes for the year ended December 31, 2015, compared to a net tax refund of $180
million for the year ended December 31, 2014, where such decreases is related to the timing and recognition of
net operating losses in the prior year. Included in net cash provided by operating activities for the year ended
December 31, 2015 was $75 million of cash received for HITECH incentive reimbursements, compared to $253
million received for the year ended December 31, 2014.
The cash used in investing activities decreased $3.3 billion, from approximately $4.4 billion for the year ended
December 31, 2014 to approximately $1.1 billion for the year ended December 31, 2015. The decrease in cash
used in investing activities was primarily due to a decrease in cash paid for acquisitions of facilities and other
related equipment of $3.0 billion as a result of the acquisition of HMA during the year ended December 31,
2014, compared to no hospital acquisitions during the year ended December 31, 2015, as well as an increase in
2015 in proceeds from the disposition of hospitals and other ancillary operations of $67 million, a decrease in the
net impact of the purchases and sales of available-for-sale securities of $28 million and a decrease in cash used
for other investments (primarily from internal-use software expenditures) of $306 million for the year ended
December 31, 2015. These decreases were offset by a decrease in proceeds from the sale of property and
equipment of $35 million and an increase in the cash used for the purchase of property and equipment of $100
million. Included in cash outflows for other investments for the year ended December 31, 2015 is approximately
$19 million of capital expenditures related to the purchase and implementation of certified EHR technology,
including implementation of Cerner software at several hospital locations. The remaining cash outflows for other
investments for the year ended December 31, 2015 consists primarily of purchases and development of other
internal-use software and payments made under non-employee physician recruiting agreements of $186 million.
We anticipate being able to fund future routine capital expenditures with cash flows generated from operations.
Our net cash used by financing activities was $195 million for the year ended December 31, 2015, compared
to net cash provided by financing activities of $2.9 billion for the year ended December 31, 2014. The decrease
in cash provided by financing activities, in comparison to the prior year, is primarily due to a reduction in our
long-term borrowings and issuance of long-term debt totaling $8.2 billion, which was mostly offset by a
reduction in the repayments of our long-term debt of $4.9 billion, all of which was impacted by the financing
transactions in 2014 related to the HMA merger. We also experienced a decrease in the proceeds from the
exercise of stock options of $40 million and an increase in cash paid to repurchase stock of $150 million. These
decreases were offset by a reduction in cash paid for deferred financing costs and other debt-related costs of $246
million and a reduction in cash paid for the redemption of noncontrolling investments in joint ventures of $122
million.
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