HCA Holdings 2011 Annual Report Download - page 82

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HCA HOLDINGS, INC.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATIONS — (Continued)
Liquidity and Capital Resources (Continued)
$384 million decline from changes in operating assets and liabilities and the provision for doubtful accounts.
Cash payments for interest and income taxes declined $780 million for 2011 compared to 2010 and declined
$387 million for 2010 compared to 2009.
Cash used in investing activities was $2.995 billion, $1.039 billion and $1.035 billion in 2011, 2010 and
2009, respectively. Excluding acquisitions, capital expenditures were $1.679 billion in 2011, $1.325 billion in
2010 and $1.317 billion in 2009. We expended $1.682 billion, $233 million and $61 million for acquisitions of
hospitals and health care entities during 2011, 2010 and 2009, respectively. Expenditures for acquisitions in 2011
included eight hospital facilities, seven of which were related to the acquisition of the remaining interests in our
joint venture in the Denver market. Expenditures for acquisitions in 2010 included two hospital facilities and in
2009 were generally comprised of outpatient and ancillary services entities. Planned capital expenditures are
expected to approximate $1.9 billion in 2012. At December 31, 2011, there were projects under construction
which had an estimated additional cost to complete and equip over the next five years of approximately
$1.5 billion. We expect to finance capital expenditures with internally generated and borrowed funds.
During 2011, we received cash of $281 million from sales of one hospital, other health care entities and real
estate investments. We also received net cash proceeds of $80 million related to net changes in our investments.
During 2010, we received cash proceeds of $37 million from sales of other health care entities and real estate
investments. We also received net cash proceeds of $472 million related to net changes in our investments.
During 2009, we received cash proceeds of $41 million from dispositions of three hospitals and sales of other
health care entities and real estate investments. We also received net cash proceeds of $303 million related to net
changes in our investments.
Cash used in financing activities totaled $976 million in 2011, $1.947 billion in 2010 and $1.865 billion in
2009. During 2011, we received cash of $2.506 billion related to the issuance of common stock in conjunction
with our initial public offering; we used cash of $1.503 billion for repurchases of common stock; and we used
cash proceeds from issuance of common stock and available cash provided by operations to make net debt
repayments of $1.589 billion. During 2010, we received net proceeds of $2.533 billion from our debt issuance
and debt repayment activities. During 2009, we used cash proceeds from sales of facilities and available cash
provided by operations to make net debt repayments of $1.459 billion. During 2011 and 2010, we paid $31
million and $4.257 billion, respectively, in distributions to our stockholders. During 2010, we received
contributions from noncontrolling interests of $57 million. During 2011, 2010 and 2009, we made distributions
to noncontrolling interests of $378 million, $342 million and $330 million, respectively. We paid debt issuance
costs of $92 million, $50 million and $70 million for 2011, 2010 and 2009, respectively. During 2011 and 2010,
we received income tax benefits of $63 million and $114 million, respectively, for certain items (primarily the
cash distributions to holders of our stock options and exercises of stock options) that were deductible expenses
for tax purposes, but were recognized as adjustments to stockholders’ deficit for financial reporting purposes. We
or our affiliates, including affiliates of the Sponsors, may in the future repurchase portions of our debt or equity
securities, subject to certain limitations, from time to time in either the open market or through privately
negotiated transactions, in accordance with applicable SEC and other legal requirements. The timing, prices, and
sizes of purchases depend upon prevailing trading prices, general economic and market conditions, and other
factors, including applicable securities laws. Funds for the repurchase of debt or equity securities have, and are
expected to, come primarily from cash generated from operations and borrowed funds.
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