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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-K

(Mark One)
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 20192021
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 1-4448

bax-20211231_g1.jpg    
Baxter International Inc.
(Exact Name of Registrant as Specified in its Charter)

_____________________________________________________________________________________________
Delaware36-0781620
(State or Other Jurisdiction of
Incorporation or Organization)
(I.R.S. Employer
Identification No.)
One Baxter Parkway,Deerfield,Illinois60015
(Address of Principal Executive Offices)(Zip Code)
Registrant’s telephone number, including area code 224.948.2000
Securities registered pursuant to Section 12(b) of the Act:
Title of Each ClassTrading Symbol(s)Name of Each Exchange on Which Registered
Common stock, $1.00 par valueBAX (NYSE)New York Stock Exchange
Chicago Stock Exchange
0.4% Global Notes due 2024BAX 24New York Stock Exchange
1.3% Global Notes due 2025BAX 25New York Stock Exchange
1.3% Global Notes due 2029BAX 29New York Stock Exchange
3.95% Global Notes due 2030BAX 30New York Stock Exchange
1.73% Global Notes due 2031BAX 31New York Stock Exchange
Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes   ☐    No  ☑
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Act.    Yes  ☐    No  ☑
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  ☑     No  ☐
Indicate by check mark whether registrant has submitted electronically every Interactive Data File required to be submitted and pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files)     Yes  ☑      No  ☐





Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.   ☐
Indicate by check mark whether the registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report.  ☑
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐    No  ☑
The aggregate market value of the voting common equity held by non-affiliates of the registrant as of June 28, 201930, 2021 (the last business day of the registrant’s most recently completed second fiscal quarter), based on the per share closing sale price of $81.90$80.50 on that date and the assumption for the purpose of this computation only that all of the registrant’s directors and executive officers are affiliates, was approximately $42$40 billion. The number of shares of the registrant’s common stock, $1.00 par value, outstanding as of February 29, 2020January 31, 2022 was 507,263,731.502,293,624.
DOCUMENTS INCORPORATED BY REFERENCE
Portions of the registrant’s definitive 20202022 proxy statement for use in connection with its Annual Meeting of Stockholders expected to be held on May 5, 20203, 2022 are incorporated by reference into Part III of this report.




TABLE OF CONTENTS
Page
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Explanatory Note
General
On February 13, 2020, we concluded, in consultation with the Audit Committee of our Board of Directors, that our consolidated financial statements as of December 31, 2018 and 2017, for the years ended December 31, 2018, 2017 and 2016, as of and for the interim periods within the years ended December 31, 2018 and 2017 and the interim periods ended June 30 and March 31, 2019 should no longer be relied upon because of misstatements to our previously reported foreign exchange gains and losses as described below.
Restatement
This Annual Report on Form 10-K for the year ended December 31, 2019 includes the following restated financial information:
audited consolidated financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017;
unaudited interim financial information as of and for the quarterly periods ended June 30, 2019, March 31, 2019, June 30, 2018, and March 31, 2018, for the quarterly period ended December 31, 2018, for the six months ended June 30, 2019 and 2018, and as of September 30, 2018; and
unaudited selected financial data as of December 31, 2017 and as of and for the years ended December 31, 2016 and 2015. Selected financial data as of December 31, 2018 and for the years ended December 31, 2018 and 2017 is derived from our audited consolidated financial statements included in this Annual Report on Form 10-K.
Refer to our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2019, filed on March 17, 2020, for our unaudited restated interim financial statements for the three and nine months ended September 30, 2018 and related information.
Restatement Background
On October 24, 2019, we reported that we had commenced an internal investigation into certain intra-company transactions that impacted our previously reported non-operating foreign exchange gains and losses. Our internal investigation, as it pertains to the evaluation of related financial statement impacts, is complete.

We previously had applied a longstanding convention for the initial measurement of foreign exchange transactions and the subsequent remeasurement of foreign currency denominated monetary assets and liabilities that was not consistent with U.S. Generally Accepted Accounting Principles (U.S. GAAP). Beginning years after the adoption of that convention, certain intra-company transactions were undertaken, after the related exchange rates were already known, solely for the purpose of generating non-operating foreign exchange gains or avoiding foreign exchange losses. We believe that the use of our previous exchange rate convention to generate non-operating foreign exchange gains and avoid losses had occurred for at least ten years. The cumulative impact of correcting misstatements of non-operating foreign exchange gains and losses in periods prior to 2017 has been recorded as a reduction to our opening retained earnings in the consolidated financial statements included herein.
As previously disclosed, we voluntarily advised the staff of the Securities and Exchange Commission (SEC) of our internal investigation and are continuing to cooperate with the staff of the SEC.
Restatement of Previously Issued Consolidated Financial Statements
As described above, this Annual Report on Form 10-K includes audited restated financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017. In addition to the correction of misstatements related to non-operating foreign exchange gains and losses, we corrected additional misstatements that were immaterial, individually and in the aggregate, to our previously issued financial statements. Those other immaterial misstatements relate to (i) equipment leased to customers under operating leases, (ii) classification of foreign exchange gains and losses on cash balances and intra-company receivables and payables in our consolidated statements of cash flows, (iii) translation of the financial position and results of operations of our foreign operations into U.S. dollars, (iv) statement of income classification of transition services income related to the separation of Baxalta Incorporated in 2015 and (v) other miscellaneous adjustments. See Note 2, Restatement of Previously Issued Consolidated Financial Statements, in Item 8, Financial Statements and Supplementary Data, for additional information.
Unaudited interim financial information as of and for the quarterly periods ended June 30, 2019, March 31, 2019, June 30, 2018, and March 31, 2018, for the quarterly period ended December 31, 2018, for the six months ended June 30, 2019 and 2018, and as of September 30, 2018 has also been restated. See Note 19, Quarterly Financial Data (Unaudited), in Item 8, Financial Statements and Supplementary Data, for additional information.
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The restatement resulted in the following decreases to our previously reported income from continuing operations and diluted earnings per share from continuing operations (in millions, except per share data):

Six months ended June 30, 2019Year ended December 31, 2018Year ended December 31, 2017
Income from continuing operations$(35) $(78) $(115) 
Diluted earnings per share from continuing operations$(0.07) $(0.15) $(0.20) 
Control Considerations
In connection with the restatement, management has reassessed its conclusions regarding the effectiveness of our internal control over financial reporting as of December 31, 2018 and has determined that a material weakness in our internal control over financial reporting existed as of that date. As a result of the material weakness, our disclosure controls and procedures were not effective as of December 31, 2018 and throughout 2019. Management has been implementing changes to strengthen our internal controls and remediate the material weakness, which continued to exist as of December 31, 2019. See Item 9A, Controls and Procedures, for additional information related to the material weakness in internal control over financial reporting and our related remediation activities.

PART I
Item 1.    Business.
Company Overview
Baxter International Inc., through its subsidiaries, provides a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile intravenous (IV) solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products.products, advanced surgical equipment; smart bed systems; patient monitoring and diagnostic technologies; and respiratory health devices. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and by patients at home under physician supervision. Our global footprint and the critical nature of our products and services play a key role in expanding access to healthcare in emerging and developed countries. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and by patients at home under physician supervision. As of December 31, 2019,2021, we manufactured products in over 20 countries and sold them in over 100 countries.
Baxter International Inc. was incorporated under Delaware law in 1931. As used in this report, “Baxter International” means Baxter International Inc. and “we", "our” or "us" means Baxter International and its consolidated subsidiaries, (after giving effect to the separation and distribution of Baxalta Incorporated (Baxalta), as further described below), unless the context otherwise requires.
COVID-19
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus (COVID-19) and its variants. COVID-19 and its variants have had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and have increased and we expect will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments are taking. Initial measures taken by businesses and governments beginning in 2020 led to unprecedented restrictions on, disruptions in, and other related impacts on business and personal activities, including a shift in healthcare priorities, which resulted in a significant decline in elective medical procedures in 2020. Some of these disruptions and impacts (including the suspension or postponement of elective medical procedures) in certain of our principal markets have continued into 2021. The pandemic has created significant volatility in the demand for our products. For further information about our revenues by product category, refer to Note 10 in Item 8 of this Annual Report on Form 10-K. Significant uncertainty remains regarding the duration and overall impact of the COVID-19 pandemic. For example, concerns remain regarding the pace of economic recovery due to virus resurgence across the globe from the Delta and Omicron variants and other virus mutations as well as vaccine distribution and hesitancy. The U.S. and other governments may continue existing measures or implement new restrictions and other requirements in light of the continuing spread of the pandemic (including with respect to mandatory vaccinations for certain of our employees and moratoriums on elective procedures). Due to the uncertainty caused by the pandemic, our operating performance and financial results, particularly in the short term, may be subject to volatility. We have experienced significant challenges, including lengthy delays, shortages and interruptions, posed by the pandemic and other exogenous factors (including significant weather events and disruptions to certain ports of call around the world) to our global supply chain, including the cost and availability of raw materials and component parts (including resins and electromechanical devices) and higher transportation costs, and may experience these and other challenges in future periods. Many of our manufacturing plant and distribution center personnel are currently unvaccinated, and we may also experience employee resistance in complying with current and future government vaccine and testing mandates, which may cause labor shortages significantly impacting manufacturing production and distribution center productivity for us and our suppliers. We expect that these challenges as well as evolving governmental restrictions and requirements, among other factors, may continue to have an adverse effect on our business. For further discussion, refer to Item 1A of this Annual Report on Form 10-K.
Acquisition of Hillrom
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hill-Rom Holdings, Inc. (Hillrom) for a purchase price of $10.5 billion. Including the assumption of Hillrom's outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Under the
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terms of the transaction agreement, Hillrom shareholders received $156.00 in cash per each outstanding Hillrom common share.
Prior to our acquisition of Hillrom, Hillrom was a global medical technology leader whose products and services help enable earlier diagnosis and treatment, optimize surgical efficiency, and accelerate patient recovery while simplifying clinical communication and shifting care closer to home. Hillrom made those outcomes possible through digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices, advanced equipment for the surgical space and more, delivering actionable, real-time insights at the point of care.
See Note 2 and Note 5 in Item 8 of this Annual Report on Form 10-K for additional information about the Hillrom acquisition and related financing arrangements.
Business Segments and Products
We manage our businessglobal operations based on threefour segments, consisting of the following geographic segments:segments related to our legacy Baxter business: Americas (North and South America), EMEA (Europe, Middle East and Africa) and APAC (Asia-Pacific)., and a new global segment for our recently acquired Hillrom business.
Each of ourThe Americas, EMEA and APAC segments providesprovide a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. The Hillrom segment provides digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices and advanced equipment for the surgical space.
For financial information about our segments, see Note 1817 in Item 8 of this Annual Report on Form 10-K.
Sales and Distribution
We have our own direct sales force and also make sales to and through independent distributors, drug wholesalers acting as sales agents and specialty pharmacy or other alternate site providers. In the United States, third parties, such as Cardinal Health, Inc., warehouse and ship a significant portion of our products through their distribution centers. These centers are generally stocked with adequate inventories to facilitate prompt customer service. Sales and distribution methods include frequent contact by sales and customer service representatives, automated communications via various electronic purchasing systems, circulation of catalogs and merchandising bulletins, direct-mail campaigns, trade publication presence and advertising.
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Sales are made and products are distributed on a direct basis or through independent distributors or sales agents in more than 100 countries as of December 31, 2019.2021.
International Operations
The majority of our revenues are generated outside of the United States and geographic expansion remains a component of our strategy. Our presence includes operations in Europe, the Middle East, Africa, Asia-Pacific, Latin America and Canada. We are subject to certain risks inherent in conducting business outside the United States. For more information on these risks, see the information under the captions “Risks Related to Baxter’s Business —We are subject to risks associated with doing business globally” and “—Changes in foreign currency exchange rates and interest rates could have a material adverse effect on our operating results and liquidity” in Item 1A of this Annual Report on Form 10-K.
For financial information about our foreign and domestic operationsrevenues and geographicsegment information, see Note 1817 in Item 8 of this Annual Report on Form 10-K. For more information regarding foreign currency exchange risk, refer to the discussion under the caption entitled “Financial Instrument Market Risk” in Item 7 of this Annual Report on Form 10-K.
Contractual Arrangements
Our products are sold through contracts with customers, both within and outside the United States. Some of these contracts have terms of more than one year and place limits on our ability to increase prices. In the case of
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hospitals, governments and other facilities, these contracts may specify minimum quantities of a particular product or categories of products to be purchased by the customer.
In keeping with the increased emphasis on cost-effectiveness in healthcare delivery, many hospitals and other customers of medical products in the United States have joined group purchasing organizations (GPOs), or formed integrated delivery networks (IDNs), to enhance purchasing power. GPOs and IDNs negotiate pricing arrangements with manufacturers and distributors and the negotiated prices are made available to members. We have purchasing agreements with several of the major GPOs in the United States. GPOs may have agreements with more than one supplier for certain products. Accordingly, in these cases, we face competition from other suppliers even where a customer is a member of a GPO under contract with us. Purchasing power is similarly consolidated in many other countries. For example, public contracting authorities often act as the purchasing entities for the hospitals and other customers of medical products in their region and many hospitals and other customers have joined joint procurement entities and buying consortia. The result is that demand for healthcare products is increasingly concentrated across our markets globally. Additionally, our contractual pricing arrangements with GPOs, IDNs and public contracting authorities limit our ability to increase prices in order to offset raw materials or component price increases or otherwise.
Raw Materials and Component Parts
Raw materials and component parts essential to our business are purchased from numerous suppliers worldwide in the ordinary course of business. Although mostWhile many of these materials are generally available, we at timeshave experienced and may in the future experience shortages of supply. Additionally, certain of these materials are secured from single source suppliers or on a spot basis and not pursuant to a contractual arrangement. In an effort to manage risk associated with raw materials and component supply, we work closely with our suppliers to help ensure availability and continuity of supply while maintaining high quality and reliability. We also seek to develop new and alternative sources of supply where beneficial to our overall raw materials procurement strategy. Refer to Item 1A. Risk Factors of this Annual Report on Form 10-K for further information regarding risks related to the supply chain, raw materials and component parts.
We are not always able to recover cost increases for raw materials and component parts through customer pricing due to contractual limits, where applicable, and market forces. Accordingly, weWe seek to utilize long-term supply contracts with some suppliers to help maintain continuity of supply and manage the risk of price increases.
In connection with the separation and distribution of Baxalta, we entered into a long-term manufacturing and supply agreement with Baxalta. Baxalta manufactures and supplies us with ARTISS, TISSEEL, FLOSEAL and stand-alone thrombin, on a cost-plus basis, under that manufacturing and supply agreement.
Competition and Healthcare Cost Containment
Our businesses benefit from a number of competitive advantages, including the breadth and depth of our product offerings and our strong relationships with customers, including hospitals and clinics, GPOs, IDNs, physicians, and patients, many of whom self-administer home-based therapies that we supply. We also benefit from efficiencies and cost advantages resulting from shared manufacturing facilities and the technological advantages of our products.
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Although no single company competes with us in all of our businesses, we face substantial competition in each of our segments from international and domestic healthcare, medical products and pharmaceutical companies and providers of all sizes, and these competitors often differ across our businesses. In addition, global and regional competitors continue to expand their manufacturing capacity and sales and marketing channels. Competition isWe believe customer purchasing decisions are primarily focused on cost-effectiveness, price, service, product performance, and technological innovation. There has been increasing consolidation in our customer base and by our competitors, which continues to result in pricing and market pressures.
Global efforts toward healthcare cost containment continue to exert pressure on product pricing. Governments around the world use various mechanisms to control healthcare expenditures, such as price controls, the formation of public contracting authorities, product formularies (lists of recommended or approved products), and competitive tenders which require the submission of a bid to sell products. Sales of our products are dependent, in part, on the availability of reimbursement by government agencies and healthcare programs, as well as insurance companies and other private payers. In the United States, the federal and many state governments have adopted or proposed initiatives relating to Medicaid and other health programs that may limit reimbursement or increase rebates that we and other providers are required to pay to the state. In addition to government regulation, managed care organizations in the United States, which include medical insurance companies, medical plan administrators, health-maintenance organizations, hospital and physician alliances and pharmacy benefit managers, continue to put pressure on the price and usage of healthcare products. Managed care organizations seek to contain healthcare expenditures, and their purchasing strength has been increasing due to their consolidation into fewer, larger
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organizations and a growing number of enrolled patients. We face similar issues outside of the United States. In Europe and Latin America, for example, the government provides healthcare at low cost to patients, and controls its expenditures by purchasing products through public tenders, collective purchasing, regulating prices, setting reference prices in public tenders or limiting reimbursement or patient access to certain products. For further discussion, refer to Item 1A of this Annual Report on Form 10-K.
Intellectual Property
Patents and other proprietary rights are essential to our business. We rely on patents, trademarks, copyrights, trade secrets, know-how and confidentiality agreements to develop, maintain and strengthen our competitive position. We own a number of patents and trademarks throughout the world and have entered into license arrangements relating to various third-party patents and technologies. Products manufactured by us are sold primarily under our own trademarks and trade names. Some products distributed by us are sold under our trade names, while others are sold under trade names owned by our suppliers or partners. Trade secret protection of unpatented confidential and proprietary information is also important to us. We maintain certain details about our processes, products and technology as trade secrets and generally require employees, consultants, and business partners to enter into confidentiality agreements. These agreements may be breached and we may not have adequate remedies for any breach. In addition, our trade secrets may otherwise become known or be independently discovered by competitors. To the extent that our employees, consultants, and business partners use intellectual property owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions.
Our policy is to protect our products and technology through patents and trademarks on a worldwide basis. This protection is sought in a manner that balances the cost of such protection against obtaining the greatest value for us. We also recognize the need to promote the enforcement of our patents and trademarks and take commercially reasonable steps to enforce our patents and trademarks around the world against potential infringers, including judicial or administrative action where appropriate.
We operate in an industry susceptible to significant patent litigation. At any given time, we are involved as either a plaintiff or defendant in a number of patent infringement and other intellectual property-related actions. Such litigation can result in significant royalty or other payments or result in injunctions that can prevent the sale of products. For more information on patent and other litigation, see Note 97 in Item 8 of this Annual Report on Form 10-K.
Research and Development
Our investment in research and development (R&D), consistent with our portfolio optimization and capital allocation strategies, helps fuel our future growth and our ability to remain competitive in each of our product categories. Accordingly, we continue to focus our investment on select R&D programs to enhance future growth through clinical differentiation. Expenditures for our R&D activities were $534 million in 2021, $521 million in 2020, and $595 million in 2019, $654 million in 2018, and $615 million in 2017.2019. These expenditures include costs associated with R&D activities performed at our R&D centers located
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around the world, which include facilities in Belgium, Sweden, India, Italy, Germany, China, Japan and the United States, as well as in-licensing, milestone and reimbursement payments made to partners for R&D work performed at non-Baxter locations.
For more information on our R&D activities, refer to the discussion under the caption entitled “Strategic Objectives” in Item 7 of this Annual Report on Form 10-K.
Quality Management
Our continued success depends upon the quality of our products. Quality management plays an essential role in determining and meeting customer requirements, preventinghelping to prevent defects, facilitating continuouscontinuing improvement of our processes, products and services, and assuringhelping to assure the safety and efficacy of our products. Our quality system enables the design, development, manufacturing, packaging, sterilization, handling, distribution and labeling of our products to ensure that they conform to customer requirements. In order to continuallyconsistently improve the effectiveness and efficiency of our quality system, various measurement, monitoring and analysis methods, such as management reviews and internal, external and vendor audits, are employed at local and central levels.
Each product that we market is required to meet specific quality standards, both in packaging and in product integrity and quality. If any of those is determined to be compromised at any time, we endeavor to take corrective and preventive actions designed to ensure compliance with regulatory requirements and to meet customer
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expectations. For more information on corrective actions taken by us, refer to the discussion under the caption entitled “Certain Regulatory Matters” in Item 7 of this Annual Report on Form 10-K.
Government Regulation
Our operations and many of the products manufactured or sold by us are subject to extensive regulation by numerous government agencies, both within and outside the United States. The Food and Drug Administration (FDA) in the United States, the European Medicines Agency (EMA) in Europe, the China Food and Drug Administration (CFDA) in China and other government agencies, inside and outside of the United States, administer requirements covering the testing, safety, effectiveness, manufacturing, labeling, promotion and advertising, distribution and post-market surveillance of our products. We must obtain specific approval from FDA and non-U.S. regulatory authorities before we can market and sell most of our products in a particular country. Even after we obtain regulatory approval to market a product, the product and our manufacturing processes and quality systems are subject to continued review by FDA and other regulatory authorities globally, including additional 510(k) and other regulatory submissions, and approvals or the time needed to secure approvals are not certain. State agencies in the United States also regulate our facilities, operations, employees, products and services within their respective states. We, along with our facilities, are subject to periodic inspections and possible administrative and legal actions by FDA and other regulatory agencies inside and outside the United States. Such actions may include warning letters, product recalls or seizures, monetary sanctions, injunctions to halt the manufacture and distribution of products, civil or criminal sanctions, refusal of a government to grant approvals or licenses, restrictions on operations or withdrawal of existing approvals and licenses. As situations require, we take steps to ensure safety and efficacy of our products, such as removing products found not to meet applicable requirements from the market and improving the effectiveness of quality systems. For more information on compliance actions taken by us, refer to the discussion under the caption entitled “Certain Regulatory Matters” in Item 7 of this Annual Report on Form 10-K.
We are also subject to various laws inside and outside the United States concerning our relationships with healthcare professionals and government officials, price reporting and regulation, the promotion, sales and marketing of our products and services, the importation and exportation of products, the operation of our facilities and distribution of products. In the United States, we are subject to the oversight of FDA, Office of the Inspector General within the Department of Health and Human Services (OIG), the Center for Medicare/Medicaid Services (CMS), the Department of Justice (DOJ), Environmental Protection Agency, Department of Defense and Customs and Border Protection in addition to others. We supply products and services to healthcare providers that are reimbursed by federally funded programs such as Medicare. As a result, our activities are subject to regulation by CMS and enforcement by OIG and DOJ. In each jurisdiction outside the United States, our activities are subject to regulation by government agencies including the EMA in Europe, CFDA in China and other agencies in other jurisdictions. Many of the agencies enforcing these laws have increased their enforcement activities with respect to healthcare companies in recent years. These actions appear to be part of a general trend toward increased enforcement activity globally.
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Our operations involve the use of substances regulated under environmental laws, primarily in manufacturing and sterilization processes. Our environmental policies require compliance with all applicable environmental regulations and contemplate, among other things, appropriate capital expenditures for environmental protection.
Separation For example, we made $33 million and $10 million of Baxalta
On July 1, 2015, we completed the distribution of approximately 80.5%capital expenditures in 2021 and 2020, respectively, related to a new ethylene oxide emissions control system at our Mountain Home, Arkansas facility. All material elements of the outstanding common stocknew system are expected to be completed in 2022 and we currently expect to incur an additional $10 million of Baxaltacapital expenditures related to our stockholders (the Distribution). The Distribution was made to our stockholders of record as of the close of business on June 17, 2015 (the Record Date), who received one share of Baxalta common stock for each of our shares held as of the Record Date. As a result of the distribution, Baxalta became an independent public company.this project.
In 2016, we disposed of our remaining 19.5% interest in Baxalta through a series of transactions, including debt-for-equity exchanges, an equity-for-equity exchange and a contribution to our U.S. pension plan. As a result of these transactions, we extinguished approximately $3.65 billion of our indebtedness, repurchased 11,526,638 of our shares and contributed 17,145,570 Baxalta shares to our U.S. pension plan. On June 3, 2016, Baxalta became a wholly-owned subsidiary of Shire plc (Shire). In January 2019, Takeda Pharmaceutical Company Limited (Takeda) acquired Shire.
As a result of the separation, the consolidated statements of income, consolidated balance sheets, consolidated statements of cash flow, and related financial information reflect Baxalta’s operations, assets and liabilities, and cash flows as discontinued operations for all periods presented.
Refer to Note 3 in Item 8 of this Annual Report on Form 10-K for additional information regarding the separation of Baxalta.
EmployeesHuman Capital Management
As of December 31, 2019, Baxter2021, we employed approximately 50,000 people.60,000 people globally, with approximately 19,000 employees in the United States and approximately 41,000 employees outside of the United States. Approximately, 10,000 of those employees joined our organization in December 2021 in connection with our acquisition of Hillrom. Our employees are our most important assets and set the foundation for our ability to achieve our strategic objectives. They contribute to our success and, in particular, the employees in our manufacturing, sales, R&D and quality assurance departments are instrumental in driving operational execution and strong financial performance, advancing innovation and maintaining a strong quality and compliance program.

The success and growth of our business depends in large part on our ability to attract, retain and develop a diverse population of talented and high-performing employees at all levels of our organization, including the individuals who
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comprise our global workforce as well as executive officers and other key personnel. To succeed in a competitive labor market, we have developed recruitment and retention strategies, objectives and measures that we focus on as part of the overall management of our business. These strategies, objectives and measures form our human capital management framework and are advanced through the following programs, policies and initiatives:

Competitive Pay and Benefits. Our compensation programs are designed to align the compensation of our employees with our performance and to provide the proper incentives to attract, retain and motivate employees to achieve superior results. The structure of our compensation programs balances incentive earnings for both short-term and long-term performance.
Activating Change Today (ACT). Building on our strong diversity and inclusion platform, our senior leadership is working in close collaboration with the Baxter Black Alliance business resource group and colleagues from across the company on a multidimensional program to advance inclusion and racial justice. The ACT initiative is focused on driving results across four key areas – Workforce, Workplace, Community and Marketplace – encompassing employees, external stakeholders, and the markets and communities we serve.
Health and Safety. Health and safety are firmly rooted across our global footprint. In response to the COVID-19 pandemic and related mitigation measures, we implemented changes in our business in 2020 in an effort to better protect our employees and customers, and to support appropriate health and safety protocols. For example, we installed physical barriers between employees in production facilities, implemented extensive cleaning and sanitation processes for both production and office administration spaces and implemented broad work-from-home initiatives for employees in our administrative functions. While our essential workers (production and field service employees) have continued to work at our facilities and provide vital services to our customers, most employees in our administrative functions have effectively worked remotely since March 2020.
Recruitment, Training and Development. We use recruitment vehicles to attract diverse talent to our organization and we invest in learning opportunities that foster a growth mindset. Our formal offerings include a tuition reimbursement program, an e-learning platform known as BaxU and virtual workshops that support our culture, strategy and the development of crucial skills. To assess the impact of the investments we make in our people, and to help us consistently improve our human resources programs, we regularly conduct anonymous surveys of our global workforce to seek feedback on a variety of topics including confidence in our leadership, competitiveness of our compensation and benefits packages, career growth opportunities and improvements on how we can make our company an employer of choice. Administered and analyzed by an independent third-party, the survey results are reviewed by our senior leaders, which include our executive officers. The results of this engagement survey are also shared with individual managers, who are then tasked with taking action based on their employees’ anonymous feedback (both quantitative and qualitative). By paying close attention to the results both at an aggregate enterprise level as well as at a department/business/work group level, we have been able to enhance our culture of respect, help educate employees more effectively about our benefits offerings as well as our learning and development opportunities and further improve our communications content, mechanisms and frequency.
Available Information
We make available free of charge on our website at www.baxter.com our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and amendments to those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended (Exchange Act), as soon as reasonably practicable after electronically filing or furnishing such material with the Securities and Exchange Commission. These reports are also available free of charge via EDGAR through the Securities and Exchange Commission website (www.sec.gov).  In addition, our Corporate Governance Guidelines, Code of Conduct, and the charters for the committees of our Board of Directors are available on our website at www.baxter.com under “About Baxter—About us — Governance.” All the foregoing materials will be made available to stockholders in print upon request by writing to: Corporate Secretary, Baxter International Inc., One Baxter Parkway, Deerfield, Illinois 60015. Information contained on our website shall not be deemed incorporated into, or to be a part of, this Annual Report on Form 10-K.
Item 1A.    Risk Factors.
In addition to the other information in this Annual Report on Form 10-K (Annual Report), stockholders or prospective investors should carefully consider the following risk factors. If any of the events described below occurs, our business, financial condition, results of operations, future growth prospects and stock price could suffer.
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Risks Relating to the COVID-19 Pandemic
The effects of the COVID-19 pandemic have had, and we expect will continue to have, a material adverse effect on our business. The nature and extent of future impacts are uncertain and unpredictable.
Our global operations expose us to risks associated with public health crises, including epidemics and pandemics, such as the COVID-19 pandemic. COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and will continue to increase our expenses, including due to preventive and precautionary measures that we, other businesses and governments have taken and may continue to take. These measures have led to unprecedented restrictions on, disruptions in, and other related impacts on businesses and personal activities. We expect that evolving restrictions and precautions, as well as the corresponding need to adapt to new methods of conducting business remotely, will continue to have an adverse effect on our business. Risks associated with COVID-19 include, but are not limited to, the following:
We have experienced, and expect to continue to experience, significant and unpredictable reductions or increases in demand for certain of our products as healthcare customers re-prioritize the treatment of patients. Some of our products are particularly sensitive to reductions in elective medical procedures. For example, due to the recent spread of the Omicron variant, many elective procedures have been suspended or postponed in our principal markets as hospital systems prioritize treatment of COVID-19 patients again or otherwise comply with changing government guidelines. It is not possible to predict the timing of a broad resumption of elective medical procedures or whether, once resumed, further delays or cancellations may occur in the future in connection with the spread of new variants. If patients and hospital systems continue to de-prioritize, delay or cancel elective procedures, our business, financial condition and results of operations would continue to be negatively affected.
A significant number of our suppliers, manufacturers, distributors and vendors have been adversely affected by the COVID-19 pandemic, including with respect to increased absenteeism among their employees and other obstacles relating to their ability to maintain the continuity of their on-site operations. These impacts have caused interruptions and delays in our supply chain, and may continue to do so, resulting in more expensive alternative sources of labor and materials and heightened supply chain costs. Any delay or shortage in the supply of components or materials or other operational or logistical challenges impacts our ability to satisfy consumer demand for our products in a timely manner or at all, which could harm our reputation, future sales and profitability. For example, we have experienced and expect to continue to experience supply constraints for amino acid raw materials used in our parenteral nutrition products, as such materials are being used to produce COVID-19 vaccines. These constraints have resulted in certain product backorders and may do so in the future.
We could experience a loss of sales and profitability due to delayed payments, reduced demand or insolvency of healthcare professionals, hospitals and other customers, and suppliers and vendors facing liquidity or other financial issues. These liquidity or other financial issues could be exacerbated if prolonged high levels of unemployment or loss of insurance coverage impact patients’ ability to access treatments that use our products and services.
COVID-19 has adversely impacted the continued service and availability of skilled personnel necessary to run our operations. For example, we have faced increased absenteeism in connection with the rise of recent COVID-19 variants. Although we have sought to mitigate these staffing challenges through overtime and enlisting contingent labor, staffing shortages have strained our operations and increased our expenses. In addition, we may be unable to retain employees who object to governmental vaccine mandates or heightened safety protocols.Vaccination is currently required for employees who are customer-facing and/or directly engaged with hospitals and medical care providers covered by the Centers for Medicare and Medicaid Services (CMS). To the extent our management or other personnel are impacted in significant numbers by COVID-19 and are not available to perform their professional duties, we could experience further disruptions in our manufacturing operations or disruptions in other activities and other functions.
We face increased operational challenges as we continue to take measures to support and protect employee health and safety, including through office closures, vaccine mandates and work from home policies. For example, remote working arrangements heighten our risks associated with information technology systems and networks, including cyber-attacks, computer viruses, malicious software, security breaches, and telecommunication failures, both for systems and networks we control directly and for those
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that employees and third-party developers rely on to work remotely. Any failure to prevent or mitigate security breaches or cyber risks or detect, or respond adequately to, a security breach or cyber risk, or any other disruptions to our information technology systems and networks (as a result of remote working arrangements or otherwise), can have adverse effects on our business and cause reputational and financial harm. These risks are particularly heightened due to COVID‑19 as cybercriminals attempt to profit from COVID-related disruptions.
Any of these and other impacts of the pandemic could have a material adverse effect on our business, financial condition and results of operations. Finally, to the extent COVID-19 adversely affects our operations and global economic conditions more generally, many of the other risks described in this “Risk Factors” section may be heightened.
Risks Related to Our Ability to Grow Our Business
If we are unable to successfully introduce new products or fail to keep pace with changing consumer preferences and needs and advances in technology, our business, financial condition and results of operations could be adversely affected.

We need to successfully introduce new products to achieve our strategic business objectives. ProductWe can provide no assurances that our new products will achieve commercial acceptance in the marketplace. In addition, difficulties in manufacturing or in obtaining regulatory approvals, including as a result of the COVID-19 pandemic, might delay or prohibit introduction of new products into the marketplace. We may not be able to obtain patent protection on our new products or be able to defend our intellectual property rights globally. Warranty claims and service costs relating to our new products might be greater than anticipated, and we might be required to devote significant resources to address any quality issues associated with our new products, which could reduce the resources available for further new product development and other matters. In addition, the introduction of new products might also cause customers to defer purchases of existing products. Our future financial performance will also depend in part on our ability to influence, anticipate, identify and respond to changing consumer preferences and needs, including those impacted by the COVID-19 pandemic. We might not correctly anticipate or identify trends in customer preferences or needs or might identify them later than competitors do.
Failure to successfully introduce new products in a cost-effective manner, or delays in customer purchasing decisions related to the evaluation of new products, could cause us to lose market share and could materially adversely affect our business. Furthermore, product development requires substantial investment and there is inherent risk in the R&D process. A successful product development process further depends on many other factors, including our ability to properly anticipate and satisfy customer needs, adapt to new technologies, obtain regulatory approvals on a timely basis, demonstrate satisfactory clinical results manufacture products in an economical and timely manner and differentiate our products from those of our competitors. If we cannot successfully introduce new products or adapt to changing technologies, our products may become obsolete and our revenue and profitability could suffer.

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Issues with product supply or quality could have an adverse effect on our business subject us to regulatory actions, or cause a loss of customer confidence in us or our products, among other negative consequences.

Our success depends upon the availability and quality of our products.products and the underlying raw materials and component parts. The pharmaceuticalmedical products and medical productspharmaceutical industries are competitive and subject to complex market dynamics and varying demand levels. These levels vary in response to macro-economiceconomic conditions, regulatory requirements, (including the availability of private or public reimbursement), seasonality, natural disasters, pandemics, epidemics and other matters. For example, for many of our suppliers, the COVID-19 pandemic has created increased employee absenteeism rates and other obstacles relating to their ability to maintain the continuity of their on-site operations. These increased rates and other obstacles have increased the cost of certain raw materials and component parts and caused us to incur increased freight costs. They may, in the future, prevent suppliers from providing good and services to us on reasonable terms or at all.
Additionally, the development of new or enhanced products involves a lengthy regulatory process and is capital intensive. As a result, our ability to match our production levels and capacity to market demand is imprecise and may result in a failure to meet market demand or satisfy customer requirements for our products or, alternatively, an oversupply of inventory. Increased costs relating to freight, raw materials or component parts and difficulties hiring and retaining staff have had and may continue to have a negative impact on product supply. Failure to meet market demand may result in customers transitioning to available competitive products, loss of market share, negative publicity, reputational damage, loss of customer confidence or other negative consequences (including a decline in stock price). In the event of an oversupply, we may be forced to lower our prices, record asset impairment charges or take other actions, which may adversely affect our business, financial condition and results of operations.
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Additionally,Our success also depends on our ability to maintain and routinely improve product quality and our quality management program. Quality management plays an essential role in determining and meeting customer requirements, preventing defects, improving our products and services and assuring the safety and efficacy of our products. Our future success depends on our ability to maintain and continuously improve our quality management program. While we have a quality system that covers the lifecycle of our products, quality and safety issues have and may in the future occur with respect to our products. New or unintended uses of our products (for example, in response to COVID-19 or changing clinical practice) may also raise quality or safety issues. A quality or safety issue may result in adverse inspection reports, voluntary or official action indicated, warning letters, import bans, product recalls (either voluntary or required by FDA or similar governmental authorities in other countries) or seizures, monetary sanctions, injunctions to halt manufacture and distribution of products, civil or criminal sanctions (which may include corporate integrity agreements), costly litigation, refusal of a government to grant approvals and licenses, restrictions on operations or withdrawal of existing approvals and licenses. See “—Risks Related to Legal and Regulatory Matters.” An inability to address a quality or safety issue in an effective and timely manner may also cause negative publicity, a loss of customer confidence in us or our current or future products, which may result in the loss of sales and difficulty in successfully launching new products. Additionally, Baxter haswe have made and continuescontinue to make significant investments in assets, including inventory and property, plant and equipment, which relate to potential new products or modifications to existing products. Product quality or safety issues may restrict us from being able to realize the expected returns from these investments, potentially resulting in asset impairments in the future.

Unaffiliated third partythird-party suppliers provide a number of goods and services to our R&D, clinical and manufacturing organizations. Thirdorganizations, many of whom do so on a spot basis and not pursuant to a contractual arrangement. Our ability to receive goods or services at all or on reasonable financial terms from these third parties will be impacted if they are unable or refuse to supply or service us. Moreover, we may have limited or no recourse if the goods or services are not subject to contractual terms. If we are unable to identify an alternative provider on reasonable terms, our ability to meet our obligations to our customers could be negatively impacted, which could adversely affect our financial results and our reputation. Additionally, third party suppliers are required to comply with our quality standards. Failure of a third partythird-party supplier to provide compliant raw materials, component parts or supplies could result in delays, service interruptions or other quality related issues that may negatively impact our business results.

For more information on regulatory matters currently affecting us, including quality-related matters, refer to the discussion under the caption entitled “Certain Regulatory Matters” in Item 7 of this Annual Report on Form 10-K.

If we are unable to obtain sufficient components or raw materials on a timely basis or for a cost-effective price or if we experience other manufacturing, sterilization or supply difficulties, our business and results of operations may be adversely affected.

The manufacture of our products requires, among other things, the timely supply or delivery of sufficient amounts of quality components and materials. We manufacture our products in approximately 50 manufacturing facilities around the world. We acquire our components, materials and other requirements for manufacturing from many suppliers and vendors in various countries, including sometimes from ourselves for self-supplied requirements. We endeavor, either alone or working closely with our suppliers, to ensure the continuity of our inputs and supplies but we cannot guarantee these efforts will always be successful. Further, while efforts are made to diversify certain of our sources of components and materials, in certain instances there is only a sole source or supplier with no alternatives yet identified. For most of our components and materials for which a single source or supplier is used, alternative sources or suppliers may exist, but we have made a strategic determination to use the single source or supplier. Although we do carry strategic inventory and maintain insurance to help mitigate the potential risk related to any related supply disruption, there can be no assurance that such measures will be sufficient or effective. A reduction or interruption in supply and an inability to quickly develop acceptable alternative sources for such supply, could adversely affect our ability to manufacture and distribute our products in a timely or cost-effective manner, and our ability to make product sales. Additionally, volatility in our costs of energy, transportation/freight, components, raw materials and other supply, manufacturing and distribution costs could adversely affect our results of operations. Climate change (including laws or regulations passed in response thereto) could increase our costs, in particular our
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costs of supply, energy and transportation/freight. Material or sustained increases in the price of oil could have an adverse impact on the cost of many of the plastic materials we use to make and package our products, as well as our transportation/freight costs. These outcomes may in turn result in customers transitioning to available competitive products, loss of market share, negative publicity, reputational damage, loss of customer confidence or other negative consequences (including a decline in stock price).

Many of our products are difficult to manufacture. This is due to the complex nature of manufacturing pharmaceuticals, including biologics, and devices, as well as the strict regulatory regime governing our manufacturing operations. Variations in the manufacturing process may result in production failures which could lead to launch delays, product shortage, unanticipated costs, lost revenues and damage to our reputation. A failure to identify and address manufacturing problems prior to the release of products to our customers may also result in a quality or safety issue of the type discussed above.

Some of our products are manufactured at a single manufacturing facility or stored at a single storage site. Loss or damage to a manufacturing facility or storage site due to a natural disaster, such as we experienced as a result of Hurricane Maria, or otherwise could adversely affect our ability to manufacture sufficient quantities of key products or deliver products to meet customer demand or contractual requirements which may result in a loss of revenue and other adverse business consequences (including those identified in the paragraphs above). Our manufacturing capacity may also be adversely affected by public health crises and epidemics/pandemics, such as the novel strain of coronavirus (COVID-19), as a result of which we may be unable to obtain sufficient components or raw materials on a timely basis or at a cost-effective price. Although we have not experienced significant manufacturing or supply difficulties as a result of COVID-19, the degree and duration of disruptions to business activity are unknown at this time. In addition, several of our manufacturing facilities are leased and we may not be able to renew leases on favorable terms or at all. Because of the time required to approve and license a manufacturing facility, a third party manufacturer may not be available on a timely basis (if at all) to replace production capacity in the event we lose manufacturing capacity or products are otherwise unavailable. Any of the foregoing could adversely affect our business, financial condition and results of operations.

Some of our products require sterilization prior to sale or distribution, and we utilize both Baxter-owned and third-party facilities for this process. If an event occurs that results in damage to or closure, whether temporarily or permanent, of one or more of these facilities, we may be unable to manufacture or sterilize the relevant products at prior levels or at all, and a third party may not be available on a timely basis (if at all) to replace sterilization capacity. For example, in February 2020, certain air emission control technology used to reduce ethylene oxide emissions from sterilization equipment at our facility in Mountain Home, Arkansas, was tested and determined not to operate in accordance with applicable emission limitations in our state-issued air permit. Although we received a temporary variance and have recommenced operations, these events or other disruptions of manufacturing or sterilization processes that we or third parties may experience, whether due to lack of capacity, environmental, regulatory or compliance issues or otherwise, could result in product shortage, unanticipated costs, loss of revenues, litigation and damage to our reputation, all of which could have a material adverse effect on our business, financial condition and results of operations.

We are increasingly dependent on information technology systems and subject to privacy and security laws, and our systems and infrastructure face certain risks, including from cyber security breaches and data leakage.

We increasingly rely upon technology systems and infrastructure, including support provided by our partners and third parties, to support our business, our products and our customers. For example, we routinely rely on our technology systems and infrastructure to aid us in the collection, use, storage and transfer, disclosure and other processing of voluminous amounts of data including confidential, business, financial, personal, patient and other sensitive information (collectively, Confidential Information). We also rely on systems for manufacturing, customer orders, shipping, regulatory compliance and various other matters. Certain of our products and systems collect data regarding patients and their therapy and some are internet enabled or connect to our systems for maintenance and other purposes.

Additionally, the legal and regulatory environment surrounding information security and privacy is increasingly demanding, with the imposition of new and changing requirements across businesses. We are required to comply with increasingly complex and changing legal and regulatory requirements that govern the collection, use, storage, security, transfer, disclosure and other processing of personal data in the United States and in other countries, including, but not limited to, The Health Insurance Portability and Accountability Act, as amended, The Health Information Technology for Economic and Clinical Health Act (HIPAA), the California Consumer Privacy Act (CCPA), and the European Union’s General Data Protection Regulation (GDPR). The GDPR imposes stringent European Union data protection requirements and provides for significant penalties for noncompliance. HIPAA also imposes
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stringent data privacy and security requirements and the regulatory authority has imposed significant fines and penalties on organizations found to be out of compliance. CCPA provides consumers with a private right of action against companies who have a security breach due to lack of appropriate security measures.We or our third-party providers and business partners may also be subjected to audits or investigations by one or more domestic or foreign government agencies relating to compliance with information security and privacy laws and regulations, and noncompliance with the laws and regulations could result in substantial and material fines or class action litigation. The increasing use and evolution of technology, including cloud-based computing, and reliance on third parties creates additional opportunities for the unintentional, intentional and/or unauthorized exposure, dissemination and/or destruction of Confidential Information stored in our devices, systems, servers, infrastructure and products (collectively, Technology). Security threats, including cyber and other attacks, are becoming increasingly sophisticated, frequent, and adaptive. Our Technology (and that of third parties that we use) is vulnerable to breakdown, interruption, cyber and other security attacks, system malfunction, unauthorized access, inadvertent exposure or disclosure of information, theft and other events. Any such vulnerability could compromise our Technology and could expose Confidential Information to unauthorized third parties and/or cause permanent loss of such data. In addition to loss of Confidential Information, unauthorized access to or interference with our Technology may cause product functionality issues that may result in risk to patient safety, field actions and/or product recalls. We have, like other large multi-national companies, experienced cyber incidents in the past and may experience them in the future. Although the prior incidents have not had a material effect on our business and we have invested and continue to invest in the protection of data and Technology, there can be no assurance that our efforts will prevent breakdowns, attacks, breaches in our Technology, cyber incidents or other incidents or ensure compliance with all applicable security and privacy laws, regulations and standards, including with respect to third party service providers that host or process Confidential Information on our behalf. Such incidents could result in unauthorized access to patient data and other Confidential Information and could pose a risk to patient safety. Any failure to protect against such incidents can lead to substantial and material regulatory fines and penalties, business disruption, reputational harm, financial loss, litigation as well as other damages. Misappropriation or other loss of our intellectual property from any of the foregoing may have an adverse effect on our competitive position and may cause us to incur substantial litigation costs. We could also suffer strained relationships with customers and business partners, increased costs (for security measures, remediation or otherwise), litigation (including class actions and stockholder derivative actions) or other negative consequences (including a decline in stock price) from breaches, cyber and other security attacks, industrial espionage, ransomware, email or phishing scams, malware or other cyber incidents, which may compromise our system infrastructure or lead to data leakage, either internally or at our third-party providers or other business partners.

In addition, significant implementation issues may arise as we continue to consolidate and outsource certain computer operations and application support activities. We also face all of the same risks listed above and other heightened risks when acquiring a company, in particular if we need to transition or implement certain processes or controls with the acquired company.

We identified certain misstatements to our previously issued financial statements and have restated the financial statements described below, which has exposed us to a number of additional risks and uncertainties.

As discussed in the Explanatory Note, in Note 2, Restatement of Previously Issued Consolidated Financial Statements, and in Note 19, Quarterly Financial Data (Unaudited) in this Annual Report on Form 10-K, we restated our previously issued audited consolidated financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017, unaudited interim financial information as of and for the quarterly periods ended June 30, 2019, March 31, 2019, December 31, 2018, June 30, 2018 and March 31, 2018, for the six months ended June 30, 2019 and 2018, and as of September 30, 2018 within the notes to the financial statements, and unaudited selected financial data as of December 31, 2017 and as of and for the years ended December 31, 2016 and 2015 within Item 6, Selected Financial Data. In our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2019, we also restated our unaudited financial statements for the quarterly and year-to-date periods ended September 30, 2018. We concluded that these previous periods should be restated to correct misstatements of certain foreign exchange gains and losses from foreign currency denominated intra-company loan receivables and payables, cash balances and gains and losses from foreign currency derivative contracts, which we determined were material to these periods. The restatement also included corrections for certain items, including items that affect operating income and operating cash flows, that were immaterial, individually and in the aggregate, to our previously issued financial statements.

As a result of the misstatements and the restatement, we have become subject to a number of additional risks and uncertainties and unanticipated costs for accounting, legal and other fees and expenses, including as a result of a
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pending class-action lawsuit and a stockholder request for inspection of our books and records. As initially disclosed on October 24, 2019, we also voluntarily advised the staff of the SEC of our previously disclosed internal investigation and we are continuing to cooperate with the staff of the SEC. We may become subject to enforcement proceedings brought by the SEC or other regulatory or governmental authorities, or subject to other legal proceedings, as a result of the events leading to our internal investigation, the misstatements or the related restatement, and actions and proceedings could also be brought against our current and former employees, officers, or directors. These actions, lawsuits or other legal proceedings related to the misstatements or the restatement could result in reputational harm, additional defense and other costs, regardless of the outcome of the lawsuit or proceeding. If we do not prevail in any such lawsuit or proceeding, we could be subject to substantial damages or settlement costs, criminal and civil penalties and other remedial measures, including, but not limited to, injunctive relief, disgorgement, civil and criminal fines and penalties. In addition, we continue to be at risk for loss of investor confidence, loss of key employees, changes in management or our board of directors and other reputational issues, all of which could have a material adverse effect on our business, financial position and results of operations.

We identified a material weakness in our internal control over financial reporting. If we are unable to remediate the material weakness, or if we experience additional material weaknesses in the future, our business may be harmed.

Our management is responsible for establishing and maintaining adequate internal control over financial reporting and for evaluating and reporting on the effectiveness of our system of internal control. Our internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external reporting purposes in accordance with U.S. GAAP. As a public company, we are required to comply with the Sarbanes-Oxley Act and other rules that govern public companies. In particular, we are required to certify our compliance with Section 404 of the Sarbanes-Oxley Act, which requires us to furnish annually a report by management on the effectiveness of our internal control over financial reporting. In addition, our independent registered public accounting firm is required to report on the effectiveness of our internal control over financial reporting.

Management performed an assessment of the effectiveness of our internal control over financial reporting as of December 31, 2019 and concluded that our internal control over financial reporting was not effective as of December 31, 2019 due to the material weakness related to the accounting for certain foreign exchange gains and losses. Specifically, we did not have controls in place to monitor and quantify the difference between the foreign exchange gains and losses that we reported and the foreign exchange gains and losses that we would have reported using exchange rates determined in accordance with U.S. GAAP. Additionally, our policies and controls related to approvals and monitoring of intra-company transactions were insufficient to prevent or detect intra-company transactions undertaken solely for the purpose of generating foreign exchange gains or avoiding losses under our historical exchange rate convention. We have taken and continue to take remedial steps to improve our internal control over financial reporting. For further discussion of the material weakness identified and our remedial efforts, see Item 9A, Controls and Procedures.

Remediation efforts place a significant burden on management and add increased pressure to our financial resources and processes. If we are unable to successfully remediate our existing material weakness or any additional material weaknesses in our internal control over financial reporting that may be identified in the future in a timely manner, the accuracy and timing of our financial reporting may be adversely affected; our liquidity, our access to capital markets, the perceptions of our creditworthiness and our ability to complete acquisitions may be adversely affected; we may be unable to maintain or regain compliance with applicable securities laws, the listing requirements of the New York Stock Exchange and the covenants under our debt instruments or derivative arrangements regarding the timely filing of periodic reports; we may be subject to regulatory investigations and penalties; investors may lose confidence in our financial reporting; our reputation may be harmed; we may suffer defaults, accelerations or cross-accelerations under our debt instruments or derivative arrangements to the extent we are unable to obtain additional waivers from the required creditors or counterparties or are unable to cure any breaches; and our stock price may decline.

Our failure to prepare and timely file our periodic reports with the SEC limits our access to the public markets to raise debt or equity capital.

We did not file our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2019 within the timeframe required by the SEC; thus, we have not remained current in our reporting requirements with the SEC. Although we regained status as a current filer on March 17, 2020 by filing this Annual Report on Form 10-K (within
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the extended time period provided for by Rule 12b-25) and our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2019, we are not currently eligible to use a registration statement on Form S-3 that would allow us to continuously incorporate by reference our SEC reports into the registration statement, or to use “shelf” registration statements to conduct offerings, until approximately one year from the date we regained and maintain status as a current filer. If we wish to pursue an offering now, we would be required to conduct the offering on an exempt basis, such as in accordance with Rule 144A, or file a registration statement on Form S-1. Using a Form S-1 registration statement for a public offering would likely take significantly longer than using a registration statement on Form S-3 and increase our transaction costs, and could, to the extent we are not able to conduct offerings using alternative methods, adversely impact our ability to raise capital or complete acquisitions of other companies in a timely manner.

We are subject to a number of existing laws and regulations, non-compliance with which could adversely affect our business, financial condition and results of operations, and we are susceptible to a changing regulatory environment.

As a participant in the healthcare industry, our operations and products, and those of our customers, are regulated by numerous government agencies, both inside and outside the United States. The impact of this on us is direct to the extent we are subject to these laws and regulations, and indirect in that in a number of situations, even though we may not be directly regulated by specific healthcare laws and regulations, our products must be capable of being used by our customers in a manner that complies with those laws and regulations.

The manufacture, distribution, marketing and use of our products are subject to extensive regulation and scrutiny by FDA and other regulatory authorities globally. Any new product must undergo lengthy and rigorous testing and other extensive, costly and time-consuming procedures mandated by FDA and foreign regulatory authorities. The same testing and procedures sometimes apply to current products that are up for authorization or renewal or are subject to changes in laws or regulations (for example certain of our medical devices will have to comply with the new European Union Medical Device Regulation). Changes to current products may be subject to vigorous review, including additional 510(k) and other regulatory submissions, and approvals or the time needed to secure approvals are not certain. Our facilities must be approved and licensed prior to production and remain subject to inspection from time to time thereafter. Failure to comply with the requirements of FDA or other regulatory authorities, including a failed inspection or a failure in our adverse event reporting system, could result in adverse inspection reports, voluntary or official action indicated, warning letters, import bans, product recalls or seizures, monetary sanctions, reputational damage, injunctions to halt the manufacture and distribution of products, civil or criminal sanctions, refusal of a government to grant approvals or licenses, restrictions on operations or withdrawal of existing approvals and licenses. Any of these actions could cause a loss of customer confidence in us and our products, which could adversely affect our sales. The requirements of regulatory authorities, including interpretative guidance, are subject to change and compliance with additional or changing requirements or interpretative guidance may subject us to further review, result in product launch delays or otherwise increase our costs. For information on current regulatory issues affecting us, please refer to the caption entitled “Certain Regulatory Matters” in Item 7 of this Annual Report on Form 10-K. In connection with these issues, there can be no assurance that additional costs or civil and criminal penalties will not be incurred, that additional regulatory actions with respect to us will not occur, that we will not face civil claims for damages from purchasers or users, that substantial additional charges or significant asset impairments may not be required, that sales of other products may not be adversely affected, or that additional regulation will not be introduced that may adversely affect our operations and consolidated financial statements.

The sales, marketing and pricing of products and relationships that pharmaceutical and medical device companies have with healthcare providers are under increased scrutiny by federal, state and foreign government agencies. Compliance with the Anti-Kickback Statute, False Claims Act, Food, Drug and Cosmetic Act (including as these laws relate to off-label promotion of products) and other healthcare related laws, as well as competition, data and patient privacy and export and import laws, is under increased focus by the agencies charged with overseeing such activities, including FDA, OIG, DOJ and the Federal Trade Commission. The DOJ and the Securities and Exchange Commission have also increased their focus on the enforcement of the U.S. Foreign Corrupt Practices Act (FCPA), particularly as it relates to the conduct of pharmaceutical and medical product companies. The FCPA and similar anti-bribery laws generally prohibit companies and their employees, contractors or agents from making improper payments to government officials for the purpose of obtaining or retaining business. Healthcare professionals in many countries are employed by the government and consequently may be considered government officials. Foreign governments have also increased their scrutiny of pharmaceutical and medical product companies’ sales and marketing activities and relationships with healthcare providers and competitive practices generally. The laws and standards governing the promotion, pricing, sale and reimbursement of our products and those governing our relationships with healthcare providers and governments, including the Sunshine Act enacted under the Patient
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Protection and Affordable Care Act (as amended, the PPACA), can be complicated, are subject to frequent change and may be violated unknowingly.

Additionally, the U.S. Department of the Treasury’s Office of Foreign Control and the Bureau of Industry and Security at the U.S. Department of Commerce administer laws and regulations that restrict U.S. persons and, in some instances, non-U.S. persons, in conducting activities, transacting business or making investments in certain countries, or with governments, entities and individuals subject to U.S. economic sanctions. From time to time, certain of our subsidiaries have limited business dealings with countries subject to these sanctions, including Iran, Sudan, Syria, Russia and Cuba. These dealings represent an insignificant amount of our consolidated revenues and income but expose us to an increased risk of operating in these countries, including foreign exchange risks or restrictions or limitations on our ability to access funds generated in these jurisdictions, or the risk of violating applicable sanctions or regulations, which are complex and subject to frequent change. Additional restrictions may be enacted, enforced or interpreted in a way that may adversely affect our operations.

We have compliance programs in place, including policies, training and various forms of monitoring, designed to address the risks discussed above. Nonetheless, these programs and policies may not always protect us from conduct by individual employees that violate these laws. Violations or allegations of violations of these laws may result in large civil and criminal penalties, debarment from participating in government programs, diversion of management time, attention and resources and may otherwise have an adverse effect on our business, financial condition and results of operations. For more information related to our ongoing government investigations, please refer to Note 9 in Item 8 of this Annual Report on Form 10-K.

The laws and regulations discussed above are broad in scope and subject to evolving interpretations, which could require us to incur substantial cost associated with compliance or to alter one or more of our sales and marketing practices and may subject us to enforcement actions or litigation which could adversely affect our business, financial condition and results of operations.

If reimbursement or other payment for our current or future products is reduced or modified in the United States or in foreign countries, including through the implementation or repeal of government-sponsored healthcare reform or other similar actions, cost containment measures, or changes to policies with respect to pricing, taxation or rebates, our business could suffer.

Sales of our products depend, in part, on the extent to which the costs of our products are paid by both public and private payers. These payers include Medicare, Medicaid, and private healthcare insurers in the United States and foreign governments and third-party payers outside the United States. Our work with government payers carries various risks inherent in working with government entities and agencies, including government reporting and auditing, additional regulatory oversight, mandated contractual terms, failure of government appropriations or other complex procedural requirements.

Public and private payers are increasingly challenging the prices charged for medical products and services. We may continue to experience downward pricing pressures from any or all of these payers which could result in an adverse effect on our business, financial condition and operational results.

Global efforts toward healthcare cost containment continue to exert pressure on product pricing. Governments around the world use various mechanisms to control healthcare expenditures, such as price controls, the formation of public contracting authorities, product formularies, which are lists of recommended or approved products, and competitive tenders which require the submission of a bid to sell products. Sales of our products are dependent, in part, on the availability of reimbursement by government agencies and healthcare programs, as well as insurance companies and other private payers. In much of Europe, Latin America, Asia and Australia, for example, the government provides healthcare at low cost to patients, and controls its expenditures by purchasing products through public tenders, collective purchasing, regulating prices, setting reference prices in public tenders or limiting reimbursement or patient access to certain products. Additionally, austerity measures or other reforms by foreign governments may limit, reduce or eliminate payments for our products and adversely affect both pricing flexibility and demand for our products.

The PPACA includes several provisions which impact our businesses in the United States, including increased Medicaid rebates and an expansion of the 340B Drug Pricing Program which provides certain qualified entities, such as hospitals serving disadvantaged populations, with discounts on the purchase of drugs for outpatient use and an excise tax on the sale of certain drugs. The PPACA reduces Medicare and Medicaid payments to hospitals and other providers, which may cause us to experience downward pricing pressure. Certain portions of the PPACA could negatively impact the demand for our products, and therefore our results of operations and financial position.

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The eventual impact of the current U.S. presidential administration on coverage, reimbursement and other matters related to the PPACA and/or healthcare reform in general, remains uncertain. Following an executive order from President Donald Trump, the U.S. Department of Health and Human Services announced the launch of a new kidney health initiative. Proposed regulatory changes in kidney health policy and reimbursement may substantially change the U.S. end stage renal disease market and could impact demand for our peritoneal dialysis products, necessitating significant multi-year capital expenditures. Any such changes and the corresponding impact and related expenses are difficult to estimate in advance.

In addition, a substantial portion of our revenues is dependent on federal healthcare program reimbursement, and any disruptions in federal government operations, including a federal government shutdown or failure of the U.S. government to enact annual appropriations, could have a material adverse effect on our business, financial condition and results of operations. Additionally, disruptions in federal government operations may negatively impact regulatory approvals and guidance that are important to our operations, and create uncertainty about the pace of upcoming healthcare regulatory developments or approvals.

As a result of these and other measures, including future measures or reforms that cannot be predicted, reimbursement may not be available or sufficient to allow us to sell our products on a competitive basis. Legislation and regulations affecting reimbursement for our products may change at any time and in ways that may be adverse to us. We cannot predict the impact of these pressures and initiatives, or any negative effects of any additional regulations that may affect our business.

There is substantial competition in the product markets in which we operate.

operate and the risk of declining demand and pricing pressures could adversely affect our operating results.
Although no single company competes with us in all of our businesses, we face substantial competition in all of our markets from international and domestic healthcare medical products and pharmaceutical companies and providers of all sizes, and these competitors often differ across our businesses. Competition is primarily focused on cost-effectiveness, price, service, product performance, and technological innovation.

Competition may increase further as additional companies begin to enter our markets or modify their existing products to compete directly with ours. If our competitors respond more quickly to new or emerging technologies and changes in customer requirements or we do not introduce new versions or upgrades to our product portfolio in response to those requirements, our products may be rendered obsolete or non-competitive. If our competitors develop more effective or affordable products or achieve earlier patent protection or product commercialization than we do, our business, financial condition and operations will likely be negatively affected. If we are forced to reduce our prices due to increased competition, our business could become less profitable. Our sales could be adversely affected if any of our contracts with GPOs, IDNs or other customers are terminated due to increased competition or otherwise.

In addition, many health carehealthcare industry companies, including health carehealthcare systems, distributors, manufacturers, providers, and insurers, are consolidating or have formed strategic alliances. As the health carehealthcare industry consolidates, competition to provide goods and services to industry participants will become more intense. Further, this consolidation creates larger enterprises with greater negotiating power, which they can use to negotiate price concessions. If we face an increase in costs or must reduce our prices because of industry consolidation, or if we lose customers as a result of consolidation, our business, financial condition and results of operations could be adversely affected.
Demand for our products and services depends in large part on overall demand in the healthcare market. With the healthcare market’s increased focus on hospital asset and resource efficiency as well as reimbursement constraints, spending for some of our products could decline over time. Further, the competitive pressures in our industry could cause us to lose market share unless we increase our commercial investments or reduce our prices, which could adversely impact our operating results. These factors, along with possible legislative developments and others, might result in significant shifts in market share among the industry’s major participants, which includes us. Accordingly, if we are unable to effectively differentiate ourselves from our competitors in terms of new products and
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diversification of our product portfolio through business acquisitions, then our market share, sales and profitability could be adversely impacted through lower volume or decreased prices.
We may fail to realize the anticipated benefits of the Hillrom acquisition.
During 2021, we completed the acquisition of Hillrom. The success of this acquisition depends on, among other things, our ability to integrate Hillrom in a manner that facilitates growth opportunities, realizes anticipated cost and revenue synergies (some of which are still being identified) and achieves certain previously communicated net leverage targets without adversely affecting current revenues and investments in future growth. If we are not able to successfully achieve these objectives, the anticipated benefits of the Hillrom acquisition may not be realized fully or at all or may take longer to realize than expected.
There is a significant degree of difficulty and management distraction inherent in the process of integrating an acquisition. These difficulties include challenges consolidating certain operations and functions (including regulatory and other corporate functions), integrating technologies (including differing IT systems and processes), organizations, procedures, policies and operations, addressing differences in the business cultures of the two companies and retaining key personnel. The integration may be complex and time consuming and involve delays or additional and unforeseen expenses. The integration process and other disruptions resulting from the Hillrom acquisition may also disrupt our ongoing businesses or cause inconsistencies in standards, controls, procedures and policies that adversely affect our relationships with market participants, employees, regulators and others with whom we and Hillrom have business or other dealings. Any failure to successfully or cost-effectively integrate Hillrom could have a material adverse effect on our business and cause reputational harm.
If our business development activities are unsuccessful, we may not realize the intended benefits.

We expect to continue to engage in business development activities, including evaluating acquisitions, joint development opportunities, technology licensing arrangements and other opportunities. These activities may result in substantial investment of our resources. Our success developing products or expanding into new markets from such activities will depend on a number of factors, including our ability to find suitable opportunities for acquisition, investment or alliance; competition from other companies in the industries in which we operate that are seeking similar opportunities; whether we are able to complete an acquisition, investment or alliance on terms that are satisfactory to us; the strength of the other company’s underlying technology, products and ability to execute its business strategies; any intellectual property and litigation related to the other company’s products or technology; and our ability to successfully integrate the acquired company, business, product, technology or research into our existing operations, including the ability to adequately fund acquired in-process R&D projects and to maintain adequate controls over the combined operations. Certain of these activities are subject to antitrust and competition laws, which laws could impact our ability to pursue strategic transactions and could result in mandated divestitures
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in the context of proposed acquisitions. If we are unsuccessful in our business development activities, we may not realize the intended benefits of such activities, including that acquisition and integration costs may be greater than expected or the possibility that expected return on investment, synergies and accretion will not be realized or will not be realized within the expected timeframes.

For more information, on recent business development activities, see Note 42 in Item 8 of this Annual ReportReport.
If we fail to attract and retain key employees our business may suffer.
Our ability to compete effectively depends on Form 10-K.our ability to attract and retain key employees, including people in senior management, sales, marketing, information technology and R&D positions and from the recently acquired Hillrom business. Competition for top talent in the healthcare industry can be intense. Our ability to recruit and retain such talent will depend on a number of factors, including hiring practices of our competitors, compensation and benefits, work location, work environment (including our competitors’ policies regarding remote work arrangements and COVID-19 protocols) and industry economic conditions. If we cannot effectively recruit and retain qualified employees, our business could suffer.
Risks Related to Our Business Operations
Segments of our business are significantlydependent on major contracts with GPOs, IDNs, and certain other distributors and purchasers.
A portion of our U.S. hospital sales and rentals are made pursuant to contracts with hospital GPOs. At any given time, we are typically at various stages of responding to bids, negotiating and renewing expiring GPO agreements. Failure to be included in certain of these agreements could have a material adverse effect on our business,
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including product sales and service and rental revenue. In addition, we have faced and continue to face challenges related to increasing costs associated with these agreements (associated with ongoing supply chain challenges), which negatively impact our revenues.
Our participation in such programs often requires increased discounting or restrictions on our ability to raise prices, and failure to participate or to be selected for participation in such programs might result in a reduction of sales to the member hospitals. In addition, the industry is showing an increased focus on contracting directly with health systems or IDNs (which typically represent influential members and owners of GPOs). IDNs and health systems often make key purchasing decisions and have influence over the GPO’s contract decisions, and often request additional discounts or other enhancements. Further, certain other distributors and purchasers have similar processes to the GPOs and IDNs and failure to be included in agreements with these other purchasers could have a material adverse effect on our business.
We may not be successful in achieving expected operating efficiencies and sustaining or improving operating expense reductions, and might experience business disruptions and adverse tax consequences associated with restructuring, realignment and cost reduction activities.
Portions of our business have been, and following the Hillrom acquisition may be, the subject of restructuring, realignment and cost reduction initiatives. While we initiate these actions with the goal of realizing efficiencies, we may not be successful in achieving the full efficiencies and cost reduction benefits we expect. Further, such benefits might be realized later than expected, and the ongoing costs of implementing these measures might be greater than anticipated. If these measures are not successful or sustainable, we might undertake additional realignment and cost reduction efforts, which could result in future charges. Moreover, our ability to achieve our other strategic goals and business plans might be adversely affected, and we could experience business disruptions, if our restructuring and realignment efforts and our cost reduction activities prove ineffective. These actions, the resulting costs, and potential delays or potential lower than anticipated benefits might also impact our foreign tax positions and might require us to record tax reserves against certain deferred tax assets in our international business.

We have incurred a substantial amount of debt in connection with the Hillrom acquisition, which could adversely affect our business, financial condition or results of operations.
We have incurred acquisition-related debt financing of approximately $11.8 billion to fund the cash consideration for the Hillrom acquisition, refinance certain indebtedness of Hillrom and pay related fees and expenses. Our substantially increased indebtedness and higher debt-to-equity ratio following the acquisition has the effect, among other things, of reducing our flexibility to respond to changing business and economic conditions and has increased our borrowing costs (including as a result of the downgrade in our senior debt credit ratings). The increased levels of indebtedness could also reduce funds available for investments in product development, capital expenditures, dividend payments, acquisitions, share repurchases and other activities and may create competitive disadvantages for us relative to other companies with lower debt levels. In addition, until we achieve our commitment to reduce our indebtedness following the Hillrom acquisition, our capital allocation activities and operational flexibility may be limited. There can be no assurance that we will be successful in doing so on a timely basis or at all.
If we are unable to obtain sufficient components or raw materials on a timely basis or for a cost-effective price or if we experience other manufacturing, sterilization, supply or distribution difficulties, our business and results of operations may be adversely affected.
The manufacture of our products requires, among other things, the timely supply or delivery of sufficient amounts of quality components and materials. We manufacture our products in approximately 50 manufacturing facilities around the world. We acquire our components, materials and other requirements for manufacturing from many suppliers and vendors in various countries, including sometimes from ourselves for self-supplied requirements. We endeavor, either alone or working closely with our suppliers, to ensure the continuity of our inputs and supplies but we cannot guarantee these efforts will always be successful. Further, while efforts are made to diversify certain of our sources of components and materials, in certain instances there is only a sole source or supplier with no alternatives yet identified. Additionally, we obtain certain components and materials on a spot basis from third party suppliers with whom we do not have a contractual arrangement. For most of our components and materials for which a single source or supplier is used, alternative sources or suppliers may exist, but we have made a strategic determination to use the single source or supplier. Although we do carry strategic inventory and maintain insurance to help mitigate the potential risk related to any supply disruption, such measures may not be sufficient or effective. A reduction, interruption or suspension in supply, other supply chain issues, including those due to the revocation of distribution facilities’ licenses, and our inability to quickly develop acceptable alternative sources for such supply
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could adversely affect our ability to manufacture, distribute and sell our products in a timely or cost-effective manner. We have faced difficulties obtaining supplies of key materials such as electromechanical components, active ingredients for pharmaceuticals and resins due to the COVID-19 pandemic and related supply chain disruptions. Moreover, changes in regulation, world trade policies, international taxes and government-to-government relations and issues with export and import activities could negatively impact our ability to distribute products within a country and across countries. See “—Risks Related to Legal and Regulatory Matters.”
Additionally, volatility in our costs of energy, transportation/freight, components, raw materials and other supply, manufacturing and distribution costs have had and could in the future adversely affect our results of operations. These prices might continue to fluctuate based on many factors beyond our control, including, but not limited to, changes in general economic conditions, labor costs, delivery costs, competition and currency exchange rates.
Significant increases in the cost of raw materials, sub-assemblies or materials used in the production of our products that cannot be recovered through increased prices of our products (or the unavailability of those raw materials, sub-assemblies or production materials) could adversely affect our results of operations. There can be no assurance that the marketplace will support higher prices or that such prices and productivity gains will fully offset any commodity cost increases in the future. We may from time to time engage in hedging transactions with respect to raw material purchases but do enter into fixed price supply contracts at times. Future decisions not to engage in hedging transactions or ineffective hedging transactions might result in increased cost volatility, potentially adversely impacting our profitability.
Many of our products are difficult to manufacture. This is due to the complex nature of manufacturing devices and pharmaceuticals, including biologics, as well as the strict regulatory regime governing our manufacturing operations. Variations in the manufacturing process may result in production failures which could lead to launch delays, product shortage, unanticipated costs, lost revenues and damage to our reputation. A failure to identify and address manufacturing problems prior to the release of products to our customers may also result in a quality or safety issue of the type discussed above.
Some of our products are manufactured at a single manufacturing facility or stored at a single storage site. Additionally, some of our manufacturing facilities are located in the same geographic area. Loss or damage to, or closure of, a manufacturing facility or storage site due to a natural disaster, such as we experienced as a result of Hurricane Maria, a pandemic, such as COVID-19, or otherwise could adversely affect our ability to manufacture sufficient quantities of key products or deliver products to meet customer demand or contractual requirements, which may result in a loss of revenue and other adverse business consequences (including those identified in the paragraphs above). We might be unable to transfer manufacturing of the relevant products to another facility or location in a cost-effective or timely manner, if at all. This potential inability to transfer production could occur for several reasons, including but not limited to a lack of necessary relevant manufacturing capability at another facility, or the regulatoryrequirements of the FDA or other governmental regulatory bodies. Such an event could materially negatively impact our financial condition, results of operations and cash flows.
In addition, several of our manufacturing facilities are leased and we may not be able to renew leases on favorable terms or at all. Because of the time required to approve and license a manufacturing facility, a third-party manufacturer may not be available on a timely basis (if at all) to replace production capacity in the event we lose manufacturing capacity or products are otherwise unavailable. Any of the foregoing could adversely affect our business, financial condition and results of operations.
Some of our products require sterilization prior to sale or distribution, and we utilize both Baxter-owned and third-party facilities for this process. If an event occurs that results in damage to or closure, whether temporarily or permanent, of one or more of these facilities, we may be unable to manufacture or sterilize the relevant products at prior levels or at all, and a third party may not be available on a timely basis (if at all) to replace sterilization capacity.
For example, in May 2021, our facility in Mountain Home, Arkansas, entered into a Consent Administrative Order with the Arkansas Division of Environmental Quality relating to certain air emission control technology used to reduce ethylene oxide-emissions from sterilization equipment. Although the events giving rise to the Consent Administrative Order only caused a temporary pause in operations, these events or other disruptions of manufacturing or sterilization processes that we or third parties may experience, whether due to lack of capacity, environmental, regulatory or compliance issues or otherwise, could result in product shortage, unanticipated costs, loss of revenues, litigation and damage to our reputation, all of which could have a material adverse effect on our business, financial condition and results of operations.
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Climate change, or legal, regulatory or market measures to address climate change, could adversely affect our business, results of operations and financial condition.
The long-term effects of climate change are difficult to predict and may be widespread. The impacts of climate change may include physical risks (e.g., rising sea levels or frequency and severity of extreme weather conditions, including natural disasters), social and human effects (e.g., population dislocations or harm to health and well-being), compliance costs and transition risks (e.g., regulatory or technology changes), shifts in market trends (e.g., customers increasingly prioritize purchasing products that are sustainably made) and other adverse effects. Such impacts may disrupt our supply chain and operations by adversely affecting our ability to procure goods or services required for the operation of our business at the quantities and levels we require, due to impairment of the availability and cost of certain products, materials, commodities and energy. For example, material or sustained increases in the price of oil could have an adverse impact on the cost of many of the plastic materials or resins we use to make and package our products, as well as our transportation/freight costs. These outcomes may in turn result in customers transitioning to available competitive products, loss of market share, negative publicity, reputational damage, loss of customer confidence or other negative consequences (including a decline in stock price).
In addition, the increasing concern over climate change has resulted and may continue to result in more regional, federal, and/or global legal and regulatory requirements relating to climate change, including regulating greenhouse gas emissions (and the establishment of enhanced internal processes or systems to track them), alternative energy policies and sustainability initiatives. If legislation or regulations are enacted or promulgated in the United States or in any other jurisdictions in which we do business that impose more stringent restrictions and requirements than our current legal or regulatory obligations, we may experience disruptions in, or increases in the costs associated with, sourcing, manufacturing and distributing our products, which could have a material adverse effect on our business, financial condition or result of operations. Any such regulatory changes could have a significant effect on our operating and financial decisions, including those involving capital expenditures to reduce emissions and comply with other regulatory requirements.
Breaches and breakdowns affecting our information technology systems or protected data, including from cyber security breaches and data leakage, could have a material adverse effect on our business, results of operations, financial condition, cash flows, reputation and competitive position.
We rely upon information technology systems and infrastructure, including support provided by our partners and third parties, to support our business, products and customers. For example, we routinely rely on technology systems and infrastructure in the collection, use, storage and transfer, disclosure and other processing of voluminous amounts of data including confidential, business, financial, personal and other sensitive information (collectively, Confidential Information). We also rely on systems for manufacturing, customer orders, shipping, regulatory compliance and various other matters. Certain of our products and systems collect data regarding patients and their therapy and some are internet enabled or connect to our systems for maintenance and other purposes. Some of our products, even though not internet enabled nor connected to our systems, connect to hospital networks, electronic medical records or electronic health records. The continuing evolution of technology we use, including cloud-based computing, and reliance on third parties creates additional opportunities for the unintentional, intentional and/or unauthorized exposure, dissemination and/or destruction of Confidential Information stored in our devices, systems, servers, infrastructure and products (collectively, Technology). Security threats, including cyber and other attacks, are becoming increasingly sophisticated, frequent and adaptive.
Our Technology is vulnerable to breakdown, interruption, cyber and other security attacks, system malfunction, unauthorized access, inadvertent exposure or disclosure of information, theft and other events. Third-party systems that we rely upon could also become vulnerable to the same risks and may contain defects in design or manufacture or other problems that could result in system disruption or compromise the information security of our own systems. Any such vulnerability could compromise our Technology and could expose Confidential Information to unauthorized third parties and/or cause permanent loss of such data. In addition to loss of Confidential Information, unauthorized access to or interference with our Technology may cause product functionality issues that may result in risk to patient safety, field actions and/or product recalls. We have, like other large multi-national companies, experienced cyber incidents in the past and may experience them in the future, which have exposed and may continue to expose vulnerabilities in our information technology systems. Although the prior incidents have not had a material effect on our business and we have invested and continue to invest in the protection of data and Technology, there can be no assurance that our efforts have prevented or will prevent breakdowns, attacks, breaches in our Technology, cyber incidents or other incidents or ensure compliance with all applicable security and
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privacy laws, regulations and standards, including with respect to third-party service providers that host or process Confidential Information on our behalf. Such incidents could result in unauthorized access to patient data and other Confidential Information and could pose a risk to patient safety. Any failure to protect against such incidents can lead to substantial and material regulatory fines and penalties, business disruption, reputational harm, financial loss, litigation as well as other damages. Misappropriation or other loss of our intellectual property from any of the foregoing may have an adverse effect on our competitive position and may cause us to incur substantial litigation costs. See “—Risks Related to Legal and Regulatory Matters.” As the FDA, other regulators and our customers become more sensitive to risks related to cybersecurity, our ability to meet certain information technology safety standards could affect our products’ marketability and competitiveness. We could also suffer strained relationships with customers, business partners, physicians and other healthcare professionals, increased costs (for security measures, remediation or otherwise), litigation (including class actions and stockholder derivative actions) or other negative consequences (including a decline in stock price) from breaches, cyber and other security attacks, industrial espionage, ransomware, email or phishing scams, malware or other cyber incidents, which may compromise our system infrastructure or lead to data leakage, either internally or at our third-party providers or other business partners.
In addition, significant implementation issues may arise as we continue to consolidate and outsource certain computer operations and application support activities. Further, a greater number of our employees are working remotely in response to the COVID-19 pandemic and the emergence of related variants, which (among other things) could expose us to greater risks related to cybersecurity and our information technology systems. We also face all of the same risks listed above and other heightened risks when acquiring a company, in particular if we need to transition or implement certain processes or controls with the acquired company. For example, as we integrate Hillrom into our business, we may identify vulnerabilities or other issues as we transition its information technology systems and processes to our processes and controls, including with respect to cybersecurity and privacy. Any such vulnerabilities if unidentified or unremediated could have a material adverse effect on our business, results of operations or financial condition.
We are subject to risks associated with doing business globally.
Our operations are subject to risks inherent in conducting business globally and under the laws, regulations and customs of various jurisdictions and geographies. These risks include changes in exchange controls and other governmental actions, loss of business in government and public tenders that are held annually in many cases, increasingly complex labor environments, availability of raw materials and component parts, changes in taxation, tariffs, export control restrictions, changes in or violations of U.S. or local laws, dependence on a few government entities as customers, pricing restrictions, economic and political instability, monetary or currency volatility or instability (including as it relates to the U.S. dollar, the Euro, the Yuan and currencies in emerging market countries (including the Turkish Lira)), disputes between countries, trade relationships and conflicts, diminished or insufficient protection of intellectual property, and disruption or destruction of operations in a significant geographic region regardless of cause, including natural disaster, pandemic, power loss, cyber-attack, data breach, war, terrorism, riot, labor disruption, civil insurrection or social unrest. Failure to comply with, or material changes to, the laws and regulations that affect our global operations could have an adverse effect on our business, financial condition or results of operations.
The escalating global economic competition and trade tensions between the U.S., China and Russia could have an adverse effect on our business, financial condition or results of operations. Although we have been able to mitigate some of the impact from increased duties imposed by these countries (through petitioning the governments for tariff exclusions and other mitigations), the risk remains of additional tariffs and other kinds of restrictions. Tariff exclusions awarded to us by the U.S. Government require annual renewal, and policies for granting exclusions could shift. The U.S., China and Russia could impose other types of restrictions such as limitations on government procurement or technology export restrictions, which could affect our access to the markets.
More generally, several governments have raised the possibility of policies to induce “re-shoring” of supply chains, less reliance on imported supplies, and greater national production. For example, the Chinese government has issued a series of policies in the past several years to promote local medical devices or suggest government procurement budget for local products. Another example would be the stronger “Buy American” requirements in the U.S. (pursuant to a U.S. executive order by the new Administration on January 25, 2021) or U.S. withdrawal from the World Trade Organization Agreement on Government Procurement (GPA). If such steps triggered retaliation in other markets, such as by restricting access to foreign products in purchases by their government-owned healthcare systems, the outcomes could have an adverse effect on our business, financial condition or results of operations.
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A portion of our workforce is unionized, and we could face labordisruptions that would interfere with our operations.
Some of our employees both in and outside of the United States (including contingent workers) work under collective bargaining agreements and/or national trade union agreements. Although we have not recently experienced any significant work stoppages as a result of labor disagreements, we cannot ensure that such a stoppage will not occur in the future. Two collective bargaining agreements for one of our U.S. manufacturing facilities are scheduled to expire in February 2022 and January 2024, respectively. On February 23, 2022, union members are scheduled to vote on whether to enter into a new collective bargaining agreement (in place of the one scheduled to expire in February 2022) or to authorize a potential strike. Our inability to negotiate satisfactory new agreements or a labor disturbance at any of our manufacturing facilities (including at the facility with a collective bargaining agreement scheduled to expire in February 2022) could have a material adverse effect on our operations.
Risks Related to Legal and Regulatory Matters
We are subject to a number of laws and regulations, non-compliance with which could adversely affect our business, financial condition and results of operations, and we are susceptible to a changing regulatory environment.
As a participant in the healthcare industry, our operations and products, and those of our customers, are regulated by numerous government agencies, both inside and outside the United States.
Laws and regulations include the Patient Protection and Affordable Health Care Act (H.R. 3590) and the Health Care and Education Reconciliation Act (H.R. 4872) (collectively, the Healthcare Reform Act) which aim to decrease costs through comparative effectiveness research and pilot programs to evaluate alternative payment methodologies. Compliance with these and similar regulations could result in pricing pressure or negatively impact the demand for our products. In a number of situations, even though specific laws and regulations may not directly apply to us, our products must be capable of being used by our customers in a manner that complies with those laws and regulations.
The manufacture, distribution, marketing and use of our products are subject to extensive regulation and scrutiny by FDA and other regulatory authorities globally. Any new product must undergo lengthy and rigorous testing and other extensive, costly and time-consuming procedures mandated by FDA and foreign regulatory authorities. The same testing and procedures sometimes apply to current products that are up for authorization or renewal or are subject to changes in laws or regulations. For example, certain of our medical devices have to comply with the new European Union Medical Device Regulation that entered into force in May 2021. These regulations require companies that wish to manufacture and distribute medical devices in EU member states to meet certain quality system and safety requirements and ongoing product monitoring responsibilities, and obtain a “CE” marking (i.e., a mandatory conformity marking for certain products sold within the European Economic Area) for their products. Various penalties exist for non-compliance with the laws implementing the European Medical Device Regulations which if incurred, could have a material adverse impact on portions of our business, results of operations and cash flows. Changes to current products may be subject to vigorous review, including additional 510(k) and other regulatory submissions, and approvals or the time needed to secure approvals are not certain. Our facilities must be approved and licensed prior to production and remain subject to inspection from time to time thereafter. Failure to comply with the requirements of FDA or other regulatory authorities, including a failed inspection or a failure in our adverse event reporting system, could result in adverse inspection reports, voluntary or official action indicated, warning letters, import bans, product recalls or seizures, monetary sanctions, reputational damage, injunctions to halt the manufacture and distribution of products, civil or criminal sanctions, refusal of a government to grant approvals or licenses, restrictions on operations or withdrawal of existing approvals and licenses. In addition, our efforts to comply with FDA regulations have been challenged by the ongoing COVID-19 pandemic. For example, our attempts to rectify an outstanding warning letter for our facility in Ahmedabad have been thwarted as the FDA inspectors cannot travel to the site to evaluate our remediation efforts. The failure of our suppliers to comply with regulations could also adversely affect segments of our business as regulatory actions taken by the FDA against those manufacturers can result in product shortages, recalls or modifications. Any of these actions could cause a loss of customer confidence in us and our products, which could adversely affect our sales.
Our business is also subject to risks associated with U.S. and foreign legislation, regulations and trade agreements relating to the materials we import, including quotas, duties, tariffs or taxes, other charges or restrictions on imports and the nature of materials that can be used in our products, which could adversely affect our operations and our
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ability to import materials used in our products at current or increased levels. We cannot predict whether additional U.S. and foreign customs quotas, duties (including antidumping or countervailing duties), tariffs, taxes or other charges or restrictions, requirements as to where raw materials and component parts must be purchased, additional workplace regulations or other restrictions on our imports will be imposed in the future or adversely modified, or what effect such actions would have on our costs of operations. Future quotas, duties or tariffs may have a material adverse effect on our business, financial condition, results of operations or cash flows. Future trade agreements could also provide our competitors with an advantage over us, or increase our costs, either of which could have a material adverse effect on our business, financial condition, results of operations or cash flows.
The sales, marketing and pricing of products and relationships that medical device and pharmaceutical companies have with healthcare providers are under increased scrutiny by federal, state and foreign government agencies. Compliance with the Anti-Kickback Statute, False Claims Act, Food, Drug and Cosmetic Act (including as these laws relate to off-label promotion of products) and other healthcare related laws, as well as competition, data and patient privacy and export and import laws, is under increased focus by the agencies charged with overseeing such activities. The DOJ and the SEC have also increased their focus on the enforcement of the U.S. Foreign Corrupt Practices Act (FCPA), particularly as it relates to the conduct of medical product and pharmaceutical companies. The FCPA and similar anti-bribery laws generally prohibit companies and their employees, contractors or agents from making improper payments to government officials for the purpose of obtaining or retaining business. Healthcare professionals in many countries are employed by the government and consequently may be considered government officials. Foreign governments have also increased their scrutiny of medical product and pharmaceutical companies’ sales and marketing activities and relationships with healthcare providers and competitive practices generally. The laws and standards governing the promotion, pricing, sale and reimbursement of our products and those governing our relationships with healthcare providers and governments, including the Physician Payments Sunshine Act, can be complicated, are subject to frequent change and may be violated unknowingly.
We are also subject to environmental laws, which are becoming more stringent throughout the world. For example, the EPA regulates the use of ethylene oxide for sterilization of medical devices, as is increasingly focused on reducing emissions from the ethylene oxide sterilization process, which has increased our costs of operations and necessitated changes to our manufacturing plants and processes. Other environmental laws may have similar consequences to us or our suppliers, or result in liability to us.
Additionally, the U.S. Department of the Treasury’s Office of Foreign Control and the Bureau of Industry and Security at the U.S. Department of Commerce administer laws and regulations that restrict U.S. persons and, in some instances, non-U.S. persons, in conducting activities, transacting business or making investments in certain countries, or with governments, entities and individuals subject to U.S. economic sanctions. From time to time, certain of our subsidiaries have limited business dealings with countries subject to these sanctions, including Iran, Sudan, Syria, Russia and Cuba. These dealings represent an insignificant amount of our consolidated revenues and income but expose us to an increased risk of operating in these countries, including foreign exchange risks or restrictions or limitations on our ability to access funds generated in these jurisdictions, or the risk of violating applicable sanctions or regulations, which are complex and subject to frequent change.
We have compliance programs in place, including policies, training and various forms of monitoring, designed to address the risks discussed above. Nonetheless, these programs and policies may not always protect us from conduct by individual employees that violate these laws. Violations or allegations of violations of these laws may result in large civil and criminal penalties, debarment or exclusion from participating in government programs, diversion of management time, attention and resources and may otherwise have an adverse effect on our business, financial condition and results of operations.
The laws and regulations discussed above are broad in scope and subject to evolving interpretations and changes, which may be violated unknowingly, could require us to incur substantial costs regarding compliance or to alter our sales and marketing practices and may subject us to enforcement actions or litigation which could adversely affect our business, financial condition and results of operations. We cannot predict with certainty what laws, regulations and healthcare initiatives, if any, will be implemented, or what the ultimate effect of healthcare reform or any future legislation or regulation will have on us. For more information related to ongoing government investigations, see Note 7 in Item 8 of this Annual Report. For more information on regulatory matters currently affecting us, including quality-related matters, see “Certain Regulatory Matters” in Item 7 of this Annual Report.
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Increasing regulatory focus on privacy and security issues and expanding laws could impact our business and expose us to increased liability.
As a global company, we are subject to global data privacy and security laws, regulations and codes of conduct that apply to our businesses. We are required to comply with increasingly complex and changing legal and regulatory requirements that govern the collection, use, storage, security, transfer, disclosure and other processing of personal data in the United States and in other countries, including, but not limited to, The Health Insurance Portability and Accountability Act, as amended (HIPAA), The Health Information Technology for Economic and Clinical Health Act, the California Consumer Privacy Act (CCPA), and the European Union’s General Data Protection Regulation (GDPR). The GDPR imposes stringent European Union data protection requirements and provides for significant penalties for noncompliance. HIPAA also imposes stringent data privacy and security requirements and the regulatory authority has imposed significant fines and penalties on organizations found to be out of compliance. CCPA provides consumers with a private right of action against companies who have a security breach due to lack of appropriate security measures. We or our third-party providers and business partners may also be subjected to audits or investigations by one or more domestic or foreign government agencies relating to compliance with information security and privacy laws and regulations, and noncompliance with the laws and regulations could result in substantial and material fines or class action litigation.
If reimbursement or other payment for our current or future products is reduced or modified in the United States or in foreign countries, including through the implementation or repeal of government-sponsored healthcare reform or other similar actions, cost containment measures, or changes to policies with respect to pricing, taxation or rebates, our business could suffer.
Sales of our products depend, in part, on the extent to which the costs of our products are paid by both public and private payers. These payers include Medicare, Medicaid, and private healthcare insurers in the United States and foreign governments and third-party payers outside the United States. Our work with government payers carries various risks inherent in working with government entities and agencies, including government reporting and auditing, additional regulatory oversight, mandated contractual terms, failure of government appropriations or other complex procedural requirements.
Public and private payers are increasingly challenging the prices charged for medical products and services. We may continue to experience downward pricing pressures from any or all of these payers which could result in an adverse effect on our business, financial condition and operational results.
Global efforts toward healthcare cost containment continue to exert pressure on product pricing. Governments around the world use various mechanisms to control healthcare expenditures, such as price controls, the formation of public contracting authorities, product formularies, which are lists of recommended or approved products, and competitive tenders which require the submission of a bid to sell products. Sales of our products are dependent, in part, on the availability of reimbursement by government agencies and healthcare programs, as well as insurance companies and other private payers. In much of Europe, Latin America, Asia and Australia, the government provides healthcare at low cost to patients, and controls its expenditures by purchasing products through public tenders, collective purchasing, regulating prices, setting reference prices in public tenders or limiting reimbursement or patient access to certain products. For example, China has been implementing volume-based procurement policies, a series of centralized reforms being instituted in China on both a national and regional basis that has resulted in significant price cuts for pharmaceuticals and medical consumables. Additionally, austerity measures or other reforms by foreign governments may limit, reduce or eliminate payments for our products and adversely affect both pricing flexibility and demand for our products. In addition, our recent acquisition of Hillrom has increased our exposure to risks related to reimbursement (as certain portions of that business directly bill various government agencies).
The Healthcare Reform Act includes several provisions which impact our businesses in the United States, including increased Medicaid rebates and an expansion of the 340B Drug Pricing Program which provides certain qualified entities with discounts on the purchase of drugs for outpatient use and an excise tax on the sale of certain drugs. The Healthcare Reform Act reduces Medicare and Medicaid payments to hospitals and other providers, which may cause us to experience downward pricing pressure. Certain portions of the Healthcare Reform Act could negatively impact the demand for our products, and therefore our results of operations and financial position.
In 2019, the U.S. Department of Health and Human Services launched a new kidney health initiative. The CMS published the final end stage renal disease Treatment Choices mandatory payment model (ETC) in 2020. The ETC launched in 30% of dialysis clinics across the country on January 1, 2021 and creates payment incentives for the
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greater use of home dialysis and kidney transplants for those new to and already on dialysis. CMS also announced the implementation of four voluntary payment models with the stated goal of helping healthcare providers reduce the cost and improve the quality of care for patients with late-stage chronic kidney disease and ESRD. CMS has stated these payment models are aimed to prevent or delay the need for dialysis and encourage kidney transplantation. CMS launched the program on January 1, 2022, at which time 85 entities (or potential customers) were enrolled as participants. These proposed regulatory changes in kidney health policy and reimbursement may substantially change the U.S. end stage renal disease market and could increase demand for our peritoneal dialysis products, necessitating significant multi-year capital expenditures in order to meet that demand. However, the impact of such changes and related expenses are difficult to estimate in advance.
In addition, a substantial portion of our revenues is dependent on federal healthcare program reimbursement, and any disruptions in federal government operations, including a federal government shutdown or failure of the U.S. government to enact annual appropriations, could have a material adverse effect on our business, financial condition and results of operations. Additionally, disruptions in federal government operations may negatively impact regulatory approvals and guidance that are important to our operations, and create uncertainty about the pace of upcoming healthcare regulatory developments or approvals.
As a result of these and other measures, including future measures or reforms that cannot be predicted, reimbursement may not be available or sufficient to allow us to sell our products on a competitive basis. Legislation and regulations affecting reimbursement for our products may change at any time and in ways that may be adverse to us. We cannot predict the impact of these pressures and initiatives, or any negative effects of any additional regulations that may affect our business.
We could be subject to fines or damages and possible exclusion from participation in federal or state healthcare programs if we fail to comply with the laws and regulations applicable to our business.
Portions of our business are subject to stringent laws and regulations at the federal or state levels governing the participation of durable medical equipment suppliers and independent diagnostic testing facilities in federal and state healthcare programs. From time to time, the government seeks additional information related to our claims submissions, and in some instances government contractors perform audits of payments made to us under Medicare, Medicaid, and other federal healthcare programs. On occasion, these reviews identify overpayments for which we submit refunds. At other times, our own internal audits identify the need to refund payments. We believe the frequency and intensity of government audits and review processes has grown and we expect this will continue in the future, due to increased resources allocated to these activities at both the federal and state Medicaid level, and greater sophistication in data review techniques.
In addition, our business contracts with foreign and U.S. federal, state and local government entities and is subject to specific rules, regulations and approvals applicable to government contractors. Our failure to comply with these could result in contract terminations, suspension or debarment from contracting with these entities, civil fines and damages, criminal prosecution and possible exclusion from participation in federal healthcare programs such as Medicare and Medicaid, as well as possible recoupment of any overpayments related to such violations. While we believe that our practices materially comply with applicable state and federal requirements, the requirements might be interpreted in a manner inconsistent with our interpretation. Failure to comply with applicable laws and regulations, even if inadvertent, could have a material adverse impact on our business.
If we are unable to protect our patents or other proprietary rights, or if we infringe the patents or other proprietary rights of others, our competitiveness and business prospects may be materially damaged.

Patent and other proprietary rights are essential to our business. Our success depends to a significant degree on our ability to obtain and enforce patents and licenses to patent rights, both in the United States and in other countries. We cannot guarantee that pending patent applications will result in issued patents, that patents issued or licensed will not be challenged or circumvented by competitors, that our patents will not be found to be invalid or that the intellectual property rights of others will not prevent us from selling certain products or including key features in our products.

The patent position of a healthcare company is often uncertain and involves complex legal and factual questions. Significant litigation concerning patents and products is pervasive in our industry. Patent claims include challenges to the coverage and validity of our patents on products or processes as well as allegations that our products infringe patents held by competitors or other third parties. An unfavorable litigation outcome in any of these types of cases could result in a loss of patent protection or the ability to market products, which could lead to a significant loss of
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sales, or otherwise materially affect future results of operations. We also rely on trademarks, copyrights, trade secrets and know-how to develop, maintain and strengthen our competitive positions. Third parties may know, discover or independently develop equivalent proprietary information or techniques, or they may gain access to our trade secrets or disclose our trade secrets to the public.

Although our employees, consultants, parties to collaboration agreements and other business partners are generally subject to confidentiality or similar agreements to protect our confidential and proprietary information, these agreements may be breached, and we may not have adequate remedies for any breach. To the extent that our employees, consultants, parties to collaboration agreements and other business partners use intellectual property owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions.

Furthermore, our intellectual property, other proprietary technology and other sensitive company data is potentially vulnerable to loss, damage or misappropriation from system malfunction, computer viruses and unauthorized access to our data or misappropriation or misuse thereof by those with permitted access and other events. While we have invested to protect our intellectual property, confidential information and other data, and continue to work diligently in this area, there can be no assurance that our precautionary measures will prevent breakdowns, breaches, cyber incidents or other events. Such events could have a material adverse effect on our reputation, business, financial condition or results of operations.

Misappropriation or other loss of our intellectual property from any of the foregoing would have an adverse effect on our competitive position and may cause us to incur substantial litigation costs.

We are subject to risks associated with doing business globally.

Our operations are subject to risks inherent in conducting business globally and under the laws, regulations and customs of various jurisdictions and geographies. These risks include changes in exchange controls and other governmental actions, loss of business in government and public tenders that are held annually in many cases, increasingly complex labor environments, availability of raw materials, changes in taxation, tariffs, export control restrictions, changes in or violations of U.S. or local laws, including the FCPA, the United Kingdom Bribery Act, GDPR and other data privacy laws, dependence on a few government entities as customers, pricing restrictions, economic and political instability, monetary or currency volatility or instability (including as it relates to the U.S. dollar, the Euro, the Yuan and currencies in emerging market countries), disputes between countries, trade relationships and conflicts, diminished or insufficient protection of intellectual property, and disruption or destruction of operations in a significant geographic region regardless of cause, including natural disaster, pandemic, power loss, cyber-attack, data breach, war, terrorism, riot, labor disruption, civil insurrection or social unrest. Failure to comply with, or material changes to, the laws and regulations that affect our global operations could have an adverse effect on our business, financial condition or results of operations.

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The United Kingdom’s (UK) withdrawal from the European Union (EU) (commonly known as Brexit) effective January 31, 2020 and subsequent transition period through December 31, 2020 continues to create uncertainties affecting business operations in the EU. The withdrawal by the UK from the EU, particularly if the transition period expires without a trade agreement between the UK and the EU, could result in the deterioration of economic conditions, volatility in currency exchange rates, and increased regulatory complexities, as well as the potential for product shortages, increased costs or other similar effects. These outcomes could have an adverse effect on our business, financial condition or results of operations.

We are subject to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus that recently originated in China.

Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus that recently originated in China (COVID-19). COVID-19 may have an adverse impact on our operations, supply chains and distribution systems and increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments are taking. Due to these impacts and measures, we may experience significant and unpredictable reductions or increases in demand for certain of our products as health care customers re-prioritize the treatment of patients. For example, elective surgeries are being de-prioritized which will negatively impact the usage of certain of our products, while other of our products are experiencing an increase in demand which we may not be able to meet in accordance with the customer’s desired timing. In addition to existing travel restrictions, countries may close borders, impose prolonged quarantines, and further restrict travel, which may significantly impact the ability of our employees to get to their places of work to produce products, or may significantly hamper our products from moving through the supply chain. As a result, while the financial impact on us has not been significant to date, given the rapid and evolving nature of the virus, COVID-19 could negatively affect our sales, and it is uncertain how COVID-19 will affect our global operations generally if these impacts persist or exacerbate over an extended period of time. Any of these impacts could have a material adverse effect on our business, financial condition and results of operations. For further discussion, see the risk factor entitled “—If we are unable to obtain sufficient components or raw materials on a timely basis or for a cost-effective price or if we experience other manufacturing, sterilization or supply difficulties, our business and results of operations may be adversely affected.”

Changes in foreign currency exchange rates and interest rates could have a material adverse effect on our operating results and liquidity.

We generate the majority of our revenue and profit outside the United States. As a result, our financial results have been and may in the future be adversely affected by fluctuations in foreign currency exchange rates. We cannot predict with any certainty changes in foreign currency exchange rates or our ability to mitigate these risks. We may experience additional volatility as a result of inflationary pressures and other macroeconomic factors, including in emerging market countries. We are also exposed to changes in interest rates, and our ability to access the money markets and capital markets could be impeded if market conditions are not favorable. A discussion of the financial impact of foreign exchange rate and interest rate fluctuations, and the ways and extent to which we attempt to mitigate such impact is contained under the caption “Financial Instrument Market Risk” in Item 7 of this Annual Report on Form 10-K.

Changes in tax laws or exposure to additional income tax liabilities may have a negative impact on our operating results.

Changes to the tax laws in the United States or other countries in which we operate could have an adverse effect on our operating results. In particular,For example, the Tax Cuts and Jobs Act of 2017 and the regulations issued thereunder (collectively, 2017 Tax Act), including, among other things, certain changes in tax rates, deductibility of interest, deductibility of executive compensation expense, expensing of capital expenditures, the ability to use certain tax credits, taxation on earnings from international business operations, and the treatment of deductible payments madeBuild Back Better framework, if enacted as proposed by our U.S. affiliates to our foreign affiliatesPresident Biden, could adversely affect our financial condition and results of operations. In certain instances, the 2017 Tax Act could have a negative effect on our tax rate and the carrying value of tax balances. Any of these changes could adversely affect our financial performance. There remains some uncertainty regarding the implementation of the 2017 Tax Act and its impact on us. We cannot currently predict the full impact that the 2017 Tax Act may have over time on our business, including revenues, profit margins, profitability, operating cash flows and results of operations. For more information regarding the impact of the 2017 Tax Act, see Note 14 in Item 8 of this Annual Report on Form 10-K. Similarly, the outcome of various initiatives currently being undertaken by the Organization of Economic Cooperation and Development could significantly impact how we allocate profits across multiple jurisdictions, which could adversely impact our global tax obligations.

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Taxing authorities may audit us from time to time and may disagree with certain positions we have taken in respect of our tax liabilities. Our tax liabilities are affected by many factors, including the amounts we charge in intra-company transactions for inventory, services, licenses, funding and other items, which are subject to the use of assumptions and judgment. Because we operate in multiple income tax jurisdictions both inside and outside the United States, cross border transactions among our affiliates are a significant part of the manner in which we operate. Although we believe that we transact intra-company business in accordance with arm's-length principles, tax authorities may disagree with our intra-company charges, cross-jurisdictional transfer pricing or other matters, and may assess additional taxes as a result, including in connection with their review of the restated financial statements we have filed as part of thisour 2019 Annual Report on Form 10-K.

We regularly assess the likely outcomes of these audits in order to determine the appropriateness of our tax provision. However, we may not accurately predict the outcome of these audits and, as a result, the actual outcome of these audits may have an adverse impact on our financial results. For more information on ongoing audits, see Note 1412 in Item 8 of this Annual Report on Form 10-K.

If we fail to attract and retain key employees our business may suffer.

Our ability to compete effectively depends on our ability to attract and retain key employees, including people in senior management, sales, marketing, information technology and R&D positions. Competition for top talent in the healthcare industry can be intense. Our ability to recruit and retain such talent will depend on a number of factors, including hiring practices of our competitors, compensation and benefits, work location, work environment and industry economic conditions. If we cannot effectively recruit and retain qualified employees, our business could suffer.

Report.
We are party to a number of pending lawsuits and other disputes which may have an adverse impact on our business, operations or financial condition.

We are party to a number of pending lawsuits, settlement discussions, mediations, arbitrations and other disputes.disputes, including for example, the Superfund cases, opioid litigation, ethylene oxide litigation, Linet antitrust litigation and a stockholder request for inspection of our books and records related to the restatement of certain of our financial statements, as set forth in Note 7 in Item 8 of this Annual Report. In addition, in the future we may be party to suchadditional lawsuits, disputes or other matters, including patent, product liability or other lawsuits. These current and future matters may result in a loss of patent protection, reduced revenue, incurrence of significant liabilities and diversion of our management’s time, attention and resources. Given the uncertain nature of litigation and other disputes generally, we are not able in all cases to estimate the amount or range of loss that could result from an unfavorable outcome in theseour current matters. In view of these uncertainties, the outcome of these current matters may result in charges in excess of any established reserves, and, to the extent available, liability insurance. We also continue to be self-insured with respect to product liability claims. The absence of third-party insurance coverage for current or future claims increases our potential exposure to unanticipated claims and adverse decisions. Protracted litigation and other disputes, including any adverse outcomes, may have an adverse impact on our business,
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operations or financial condition. Even claims without merit could subject us to adverse publicity and require us to incur significant legal fees. See Note 9
Risks Related to the Economy and Our Financial Performance
Current or worsening economic conditions may adversely affect our business and financial condition.
Our ability to generate cash flows from operations could be affected if there is a material decline in the demand for our products, in the solvency of our customers or suppliers, or deterioration in our key financial ratios or credit ratings. Current or worsening economic conditions may adversely affect the ability of our customers (including governments) to pay for our products and services, and the amount spent on healthcare generally, which could result in decreased demand for our products and services, declining cash flows, longer sales cycles, slower adoption of new technologies and increased price competition. These conditions may also adversely affect certain of our suppliers, which could disrupt our ability to produce products. We continue to do business with foreign governments in certain countries, including Greece and Italy, which have experienced deterioration in credit and economic conditions. While global economic conditions have not significantly impacted our ability to collect receivables, liquidity issues in certain countries have resulted, and may continue to result, in delays in the collection of receivables and credit losses, and may also impact the stability of the U.S. dollar, Euro or Yuan.
Changes in foreign currency exchange rates and interest rates could have a material adverse effect on our operating results and liquidity.
We generate the majority of our revenue and profit outside the United States. As a result, our financial results have been and may in the future be adversely affected by fluctuations in foreign currency exchange rates. We cannot predict with any certainty changes in foreign currency exchange rates or our ability to mitigate these risks. We may experience additional volatility as a result of inflationary pressures and other macroeconomic factors, including in emerging market countries. We are also exposed to changes in interest rates, and our ability to access the money markets and capital markets could be impeded if market conditions are not favorable. For more information see “Financial Instrument Market Risk” in Item 87 of this Annual Report on Form 10-K for more information regarding current lawsuits.

Report.
Our operating results and financial condition may fluctuate.

Our operating results and financial condition may fluctuate from quarter to quarter and year to year for a number of reasons. Events, such as a delay in product development, changes to our expectations or strategy or even a relatively small revenue shortfall or increase in supply chain or other costs may cause financial results for a period to be below our expectations or projections. As a result, we believe that period-to-period comparisons of our results of operations are not necessarily meaningful, and these comparisonsnor should notthey be relied upon as an indication of future performance. Our operating results and financial condition are also subject to fluctuation from all of the risks described throughout this section. These fluctuations may adversely affect our results of operations and financial condition and our stock price.

We may not achieve our financial goals.

Since the spin-off of Baxalta, we have been executing on plans to enhance profitability and returns for our stockholders. We continue to evaluate and refine both our short-term and long-term financial objectives.objectives, including our stated commitment to achieve certain net leverage targets after completion of the Hillrom acquisition. Our strategyability to achieve these objectives is focusedtargets depends, in part, on strengtheningour ability to realize the anticipated benefits of the acquisition (and related cost and revenue synergy targets) while continuing to strengthen our portfolio and extendingextend our impact through transformative innovation that spans prevention to recovery. As part of this strategy, we will be investing in portfolio innovation and market development and entering adjacencies while continuing to drive operational excellence through ongoing business transformation efforts and organization optimization. We will also look to unlock additional
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value through strategic capital deployment.innovation. We may fail to achieve our targeted financial results if we are unsuccessful in implementing our strategies, our estimates or assumptions change or for any other reason. Our failure to achieve our financial goals could have a material adverse effect on our business, financial condition and results of operations.

Future material impairments in the value of our long-lived assets, including goodwill, could negatively affect our operating results.

We regularly review our long-lived assets, including identifiable intangible assets, goodwill (which results from our acquisition activity) and property, plant and equipment, for impairment. Goodwill and acquired indefinite life intangible assets are subject to impairment review on an annual basis and whenever potential impairment indicators are present. Other long-lived assets are reviewed when there is an indication that impairment may have occurred. Changes in market conditions or other changes in the future outlook of value may lead to impairment charges in the
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future. In addition, we may from time to time sell assets that we determine are not critical to our strategy, including in connection with certain strategic exits. Future events or decisions may lead to asset impairments and/or related charges. Certain non-cash impairments may result from a change in our strategic goals, business direction or other factors relating to the overall business environment. Material impairment charges could negatively affect our results of operations. For more information on the valuation and impairment of long-lived assets, refer to the discussion under the caption entitledsee “Critical Accounting Policies” in Item 7 of this Annual Report on Form 10-K.

Current or worsening economic conditions may adversely affect our business and financial condition.

Our ability to generate cash flows from operations could be affected if there is a material decline in the demand for our products, in the solvency of our customers or suppliers, or deterioration in our key financial ratios or credit ratings. Current or worsening economic conditions may adversely affect the ability of our customers (including governments) to pay for our products and services, and the amount spent on healthcare generally. This could result in a decrease in the demand for our products and services, declining cash flows, longer sales cycles, slower adoption of new technologies and increased price competition. These conditions may also adversely affect certain of our suppliers, which could cause a disruption in our ability to produce our products. We continue to do business with foreign governments in certain countries, including Greece, Spain, Portugal, and Italy, which have experienced deterioration in credit and economic conditions. While global economic conditions have not significantly impacted our ability to collect receivables, liquidity issues in certain countries have resulted, and may continue to result, in delays in the collection of receivables and credit losses. These conditions may also impact the stability of the U.S. dollar, Euro or Yuan.

We may incur operational difficulties or be exposed to claims and liabilities as a result of the separation and distribution of Baxalta.

On July 1, 2015, we distributed approximately 80.5% of the outstanding shares of Baxalta common stock to Baxter stockholders in connection with the separation of our biopharmaceuticals business. We disposed of our remaining 19.5% stake in Baxalta (Retained Shares) in 2016, in connection with a series of transactions, including debt-for-equity exchanges, an equity-for-equity exchange and a contribution to our U.S. pension plan (Retained Shares Transactions). Shire plc (Shire) acquired Baxalta in June 2016, after completion of the last Retained Shares Transaction, and in January 2019, Takeda Pharmaceutical Company Limited (Takeda) acquired Shire. In connection with the July 2015 distribution, we entered into a separation and distribution agreement and various other agreements (including a tax matters agreement, a long-term services agreement, a manufacturing and supply agreement, a trademark license agreement, a Galaxy license agreement, an international commercial operations agreement and certain other commercial agreements) with Baxalta. These agreements govern the separation and distribution and the relationship between the companies going forward, including with respect to potential tax-related losses associated with the separation and distribution and the Retained Shares Transactions. They also provide for the performance of services by each company for the benefit of the other for a period of time (including under the manufacturing and supply agreement pursuant to which Shire now manufactures and sells certain products and materials to us).

The separation and distribution agreement provides for indemnification obligations designed to make Baxalta financially responsible for many liabilities that may exist relating to its business activities, whether incurred prior to or after the distribution, including any pending or future litigation. In addition, the separation and distribution agreement provides for certain indemnification obligations of Baxter, which may be significant. It is possible that a court would disregard the allocation agreed to between us and Baxalta and require us to assume responsibility for obligations allocated to Baxalta. Third parties could also seek to hold us responsible for any of these liabilities or obligations, and we may be unsuccessful in obtaining indemnification or the indemnity rights we have under the separation and
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distribution agreement may not be sufficient to fully cover all of these liabilities and obligations. Even if we are successful in obtaining indemnification, we may have to bear costs. These risks could negatively affect our business, financial condition or results of operations.

The separation and distribution of Baxalta continues to involve a number of risks, including, among other things, the indemnification risks described above. Certain of the agreements described above provide for the performance of services by each company for the benefit of the other for a period of time. Takeda may elect to extend the term for which we provide services to Baxalta under these agreements. If Baxalta is unable to satisfy its obligations under these agreements, including its indemnification obligations, we could incur losses. These arrangements could also lead to disputes over rights to certain shared property and over the allocation of costs and revenues for products and operations.

There could be significant liability if the separation and distribution or any Retained Shares Transaction is determined to be a taxable transaction. Baxalta has indemnified us for certain potential liabilities that may arise, and such indemnification obligation is guaranteed by Shire, but Baxalta and Shire may be unable to satisfy their indemnification obligations to us in the future.

The separation and distribution and the Retained Shares Transactions (collectively, the Baxter Transactions) qualify for tax-free treatment to Baxter and its stockholders under the Internal Revenue Code of 1986, as amended (the Code). Completion of the separation and distribution was conditioned upon, among other things, the receipt of a private letter ruling from the IRS regarding certain issues relating to the tax-free treatment of the Baxter Transactions. Although the IRS private letter ruling is generally binding on the IRS, the continuing validity of such ruling is subject to the accuracy of factual representations and assumptions made in the ruling. Completion of the distribution was also conditioned upon Baxter’s receipt of a tax opinion from KPMG LLP regarding certain aspects of the Baxalta separation not covered by the IRS private letter ruling. The opinion was based upon various factual representations and assumptions, as well as certain undertakings made by Baxter and Baxalta. If any of the factual representations or assumptions in the IRS private letter ruling or tax opinion is untrue or incomplete in any material respect, if any undertaking is not complied with, or if the facts upon which the IRS private letter ruling or tax opinion are based are materially different from the actual facts relating to the Baxter Transactions, the opinion or IRS private letter ruling may not be valid. Moreover, opinions of a tax advisor are not binding on the IRS. As a result, the conclusions expressed in the opinion of a tax advisor could be successfully challenged by the IRS.

If the Baxter Transactions are determined to be taxable, Baxter and its stockholders could incur significant tax liabilities. Pursuant to the tax matters agreement, Baxalta agreed to indemnify us for certain tax-related losses incurred if Baxalta’s actions cause the separation and distribution and certain related transactions to fail to qualify for tax-free status under the applicable provisions of the Code.

In anticipation of the merger between Baxalta and Shire (the Merger), we entered into a letter agreement with Shire and Baxalta (the Letter Agreement). Under the Letter Agreement, Baxalta agreed to indemnify, and Shire agreed to guarantee such indemnity to, Baxter and each of its affiliates and each of their respective officers, directors and employees against certain tax-related losses attributable to or resulting from (in whole or in part) the Merger as further described in the Letter Agreement. If the Baxter Transactions are determined to be taxable as a result (in whole or in part) of the Merger (for example, if the Merger is deemed to be part of a plan (or series of related transactions) that includes the Baxter Transactions), Baxter and its stockholders could incur significant tax liabilities. Although Baxalta and Shire may be required to indemnify Baxter under the tax matters agreement and the Letter Agreement for any such tax liabilities incurred by Baxter, there can be no assurance that the indemnity from Baxalta or the guarantee thereof by Shire will be sufficient to protect us against all or a part of the amount of such liabilities, or that either Baxalta or Shire will fully satisfy their respective obligations.

Even if we ultimately succeed in recovering from Baxalta or Shire any amounts for which we are held liable, we may be required to bear these costs initially, which could negatively affect our business, results of operations and financial condition.Report.
Item 1B.    Unresolved Staff Comments.
None.
Item 2.    Properties.
Our corporate offices are owned and located at One Baxter Parkway, Deerfield, Illinois 60015.
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We manage our global operations based on four segments, consisting of the following geographic segments related to our legacy Baxter business: Americas, EMEA and APAC, and a new global segment for our recently acquired Hillrom business.
We own or have long-term leases on all of our manufacturing facilities. Thefacilities and the location of the principal manufacturing facilities of each of our geographic segments are listed below:below:
RegionSegmentsLocationOwned/Leased
Americas
Aibonito, Puerto RicoLeased
Alliston, CanadaOwned
Cali, ColombiaOwned
Cartago, Costa RicaOwned
Cuernavaca, MexicoOwned
Guayama, Puerto RicoOwned
Haina, Dominican RepublicLeased
Hayward, CaliforniaLeased
Round Lake, IllinoisOwned
Bloomington, Indiana
Owned/Leased(1)
Cleveland, MississippiLeased
Medina, New YorkLeased
Jayuya, Puerto RicoLeased
Opelika, AlabamaOwned
Brooklyn Park, MinnesotaLeased
Pesa, MexicoLeased
Sao Paulo, BrazilOwned
Tijuana, MexicoOwned
Mountain Home, Arkansas
Owned/Leased(1)
North Cove, North CarolinaOwned
St. Paul, MinnesotaLeased
Irvine, CaliforniaOwned
Mountain View, CaliforniaLeased
APAC
Ahmedabad, IndiaOwned
Guangzhou, ChinaOwned
Shanghai, ChinaOwned
Suzhou, ChinaOwned
Toongabbie, AustraliaOwned
Woodlands, Singapore
Owned/Leased(2)
Canlubang, PhilippinesLeased
Amata, ThailandOwned
Tianjin, ChinaOwned
Miyazaki, JapanOwned
EMEA
Castlebar, IrelandOwned
Grosotto, ItalyOwned
Halle, GermanyOwned
Hechingen, GermanyLeased
Lessines, BelgiumOwned
Liverpool, United KingdomLeased
Lund, SwedenLeased
Marsa, MaltaOwned
Medolla, ItalyOwned
Meyzieu, FranceOwned
Rostock, GermanyLeased
Sabinanigo, SpainOwned
San Vittore, SwitzerlandOwned
Sondalo, ItalyOwned
Swinford, IrelandOwned
Thetford, United KingdomOwned
Tel Aviv, IsraelLeased
Elstree, United KingdomLeased
Tunis, TunisiaOwned
Dammam, Saudi ArabiaOwned
Hillrom
Acton, MassachusettsLeased
Batesville, IndianaOwned
Bellevue, WashingtonLeased
Cary, North CarolinaLeased
Charleston, South CarolinaLeased
Chicago, IllinoisLeased
Milwaukee, WisconsinOwned
Sarasota, FloridaLeased
St. Paul, MinnesotaLeased
Skaneateles Falls, New YorkOwned
Suzhou, ChinaLeased
Taicang, ChinaLeased
Pluvigner, FranceOwned
Puchheim, GermanyLeased
Saalfeld, GermanyOwned
Navan, County Meath, IrelandOwned
Bologna, ItalyLeased
Tijuana, MexicoOwned
Monterrey, MexicoOwned
Amsterdam, NetherlandsLeased
SingaporeLeased
Luleå, SwedenOwned
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(1)Includes both owned and leased facilities.
(2)We own the facility located at Woodlands, Singapore and lease the property upon which it rests.
We also own or operate shared distribution facilities throughout the world. In the United States and Puerto Rico, there are six shared distribution facilities with the principal facilities located in Memphis, Tennessee; Cataño, Puerto Rico; North Cove, North Carolina; and Round Lake, Illinois. Internationally, we have more than 100 shared distribution facilities located in Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, China, Colombia, Costa Rica, the Czech Republic, Ecuador, France, Germany, Greece, Guatemala, Hong Kong, India, Ireland, Italy, Japan, Korea, Mexico, New Zealand, Panama, the Philippines, Poland, Portugal, Russia, Singapore, Spain, Sweden, Switzerland, Thailand, Turkey, the United Arab Emirates, and the United Kingdom.
We continually evaluate our plants and production lines and believe that our current facilities plus any planned expansions are generally sufficient to meet our expected needs and expected near-term growth. Expansion projects and facility closings will be undertaken as necessary in response to market needs.
Item 3.    Legal Proceedings.
Incorporated by reference to Note 97 in Item 8 of this Annual Report on Form 10-K.
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Item 4.    Mine Safety Disclosures.
Not Applicable.
Executive Officers of the Registrant
As of March 17, 2020,February 23, 2022, the following serve as Baxter’s executive officers:
José E. Almeida, age 57,59, is Chairman, President and Chief Executive Officer, having served in that capacity since January 2016. He began serving as an executive officer of the companyBaxter in October 2015. He served as Senior Advisor with The Carlyle Group from May 2015 until October 2015. Previously, he served as the Chairman, President and Chief Executive Officer of Covidien plc (Covidien), a global health care products company, from March 2012 to January 2015, prior to Medtronic plc’s (Medtronic)the acquisition of Covidien by Medtronic plc (Medtronic), and President and Chief Executive Officer of Covidien from July 2011 to March 2012. Mr. Almeida served in other executive roles with Covidien (formerly Tyco Healthcare (Tyco)) between April 2004 and June 2011. Mr. Almeida ispreviously served as a member of the Board of Directors of Walgreens Boots Alliance, Inc., and the board of trustees of Partners in Health.He also previously served as director and chairman of the Board for the Advanced Medical Technology Association (AdvaMed).
Giuseppe Accogli, age 49, is Senior51, was appointed in 2021 to a newly created role of Executive Vice President and President,Chief Operating Officer with responsibility of Baxter’s eight global business units and the Americas. Prior to his current role, Mr. Accogli served as Senior Vice President and President, Americas and Global Business Units. In 2020, his role was expanded to include President of Baxter’s Global Businesses, a position he held from 2017 to 2019. He also served as Corporate Vice President and President, Renal from 2016 to 2017 and as Head of the U.S. region for Baxter’s Renal business from 2015 to 2016. Mr. Accogli joined Baxter in 2007 as Renal business unit Director in Italy, and assumed positions of increasing responsibility with the Renal business in Europe, including Head of the EMEAEurope, Middle East and Africa (“EMEA”) region for Baxter’s Renal business from 2013 to 2015. Previously hePrior to joining Baxter, Mr. Accogli worked as a Business Unit Manager and Sales and Marketing Manager for Medtronic plc in Italy, and in several sales, product and marketing roles for Tyco and then Covidien in Italy and EMEA.Mr. Accogli has servedserves as a director to AdvaMed, an American medical device trade association, which he has done since September 25, 2019.
James Borzi, age 59, is Senior Vice President, Chief Supply Chain Officer. He joined Baxter in August 2020 from GE Healthcare, where he served as Vice President, Chief Supply Chain Officer from 2019 to 2020. Prior to joining GE Healthcare, he spent five years with Becton Dickinson (BD) in various manufacturing operations leadership roles; his last role with BD was Executive Vice President of Global Operations and Chief Supply Chain Officer. Earlier in his career, he was Senior Vice President of Operations & Technology at Hydro Aluminum and Executive Vice President of Worldwide Operations at Lennox International. Prior to that, he was the Chief Operating Officer at AEES and Senior Vice President of Americas Operations at Alcoa.
Cristiano Franzi, age 57,59, is Senior Vice President and President, EMEA. Mr. Franzi joined Baxter in September 2017 from Medtronic, where he served as Vice President and President, Minimally Invasive Therapies Group EMEA from 2015 to August 2017. He served as President EMEA at Covidien prior to Medtronic’s acquisition of Covidien. He joined Covidien in 2009 and held roles of increasing responsibility during his tenure. He held a number of commercial and functional roles across Europe, the Middle East and Africa at ev3 Endovascular, Inc., Boston Scientific Corporation and Becton, Dickinson & Co. earlier in his career. He served as a member of the board of Eucomed Medical Technology from 2013 to 2015 and again from 2018 to 2019.
Andrew Frye, age 54,56, is Senior Vice President and President, APAC. Mr. Frye joined Baxter in 2017 from DKSH Holdings Ltd., where he served as Global Head of Healthcare from 2015 to 2017. In that role, he oversaw a portfolio of pharmaceuticals, over-the-counter and device products across 13 countries. Previously, he served as Vice President of Business Development from 2011 to 2014 for DKSH Healthcare. Earlier in his career, he held a number of commercial roles with increasing responsibility at Abbott Laboratories’ Pharmaceutical and Nutrition divisions.

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Jacqueline Kunzler, Ph.D., age 54,56, is Senior Vice President and Chief Quality Officer. Ms. Kunzler joined Baxter in 1993 and has served in roles of increasing responsibility across Baxter’s research & development, international marketing, and quality organizations, most recently as Senior Vice President, Chief Quality Officer.
Sean Martin, age 57,59, is Senior Vice President and General Counsel. Mr. Martin joined Baxter in 2017 from Apollo Education Group, Inc., where he served as Senior Vice President, General Counsel and Secretary from 2010 to 2017. Previously, he served as Assistant Secretary (2010), Vice President of Corporate Law (2009 to 2010) and Vice President of Commercial Law (2005 to 2009) for Amgen Inc. He also served as Vice President and Deputy
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General Counsel at Fresenius Medical Care North America from 2000 to 2005. Mr. Martin was a Partner at the law firm Foley & Lardner LLP from 1998 to 2000 and served eight years as Assistant U.S. Attorney for the Northern District of Illinois.
Jeanne K. Mason, Ph.D., age 64,66, is Senior Vice President, Human Resources. Ms. Mason joined Baxter in 2006 from GE Insurance Solutions, a primary insurance and reinsurance business, where she was responsible for global human resource functions. Ms. Mason began her career with General Electric (GE) in 1988 after serving with the U.S. General Accounting Office in Washington, D.C. Her GE experience included leadership roles in Europe for GE Information Services and GE Capital Real Estate. She is a member of the Board of Directors of Family Service of Lake County and is a member of the Executive Advisory Council for the Chicago Chapter of National Association of African Americans in Human Resources.
James K. Saccaro, age 47,49, is Executive Vice President and Chief Financial Officer. Mr. Saccaro was Senior Vice President and Chief Financial Officer at Hill-Rom Corporation prior to rejoining Baxter in 2014. He originally joined the companyBaxter in 2002 as Manager of Strategy for the company’sour BioScience business, and over the years assumed positions of increasing responsibility, including Vice President of Financial Planning, Vice President of Finance for the company’sour operations in Europe, the Middle East and Africa and Corporate Vice President and Treasurer. He previously held strategy and business development positions at Clear Channel Communications and the Walt Disney Company.
All executive officers hold office until the next annual election of officers and until their respective successors are elected and qualified.
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PART II
Item 5.    Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities.
The following table includes information about our common stock repurchases during the three-month period ended December 31, 2019.
PeriodTotal Number of Shares Purchased(1)Average Price Paid per ShareTotal Number of Shares Purchased as Part of Publicly
Announced Programs(1)
Approximate Dollar Value of Shares that may
yet be Purchased Under the Program(1)
October 1, 2019 through October 31, 20192,369,658  $86.02  2,369,658  
November 1, 2019 through November 30, 2019—  $—  —  
December 1, 2019 through December 31, 2019—  $—  —  
Total2,369,658  $86.02  2,369,658  $897,396,644  
Issuer Purchases of Equity Securities
(1)
On July 25, 2012, we announced that our Board of Directors authorized us to repurchase up to $2.0 billion of our common stock on the open market or in private transactions. The Board of Directors increased this authority by $1.5 billion in each of November 2016 and February 2018, and by an additional $2.0 billion in November 2018.2018 and by an additional $1.5 billion in October 2020. During the fourth quarter of 2019,2021, we repurchased approximately 2.4 milliondid not repurchase any shares for $204 million in cash pursuant tounder this authority through Rule 10b5-1 purchase plans.authority. The remaining authorization under this program totaled approximately $897 million$1.3 billion at December 31, 2019.2021. This program does not have an expiration date.

Market Information and Holders of our Common Stock
Our common stock is listed on the New York, Chicago and SIX Swiss stock exchanges. The New York Stock Exchange is the principal market on which our common stock is traded under the symbol “BAX”. At February 29, 2020,As of January 31, 2022, there were 22,81820,939 holders of record of our common stock.
Performance Graph
The following graph compares the change in our cumulative total stockholder return (including reinvested dividends) on our common stock with the Standard & Poor’s 500 Composite Index and the Standard & Poor’s 500 Health Care Index over the past five years. Performance through June 30, 2015 has been adjusted for the Baxalta separation which occurred on July 1, 2015.
bax-20191231_g2.jpgbax-20211231_g2.jpg
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Item 6.    Selected Financial Data.
The following selected consolidated financial data should be read in conjunction with our consolidated financial statements and the accompanying notes thereto in Item 8 of this Annual Report on Form 10-K, and the information contained in Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations of this Annual Report on Form 10-K.
As Restated 1
Unaudited
as of or for the years ended December 31
2019 2
2018
2017 3
2016 3,4,5
2015 6
Operating ResultsNet sales$11,362  11,099  10,584  10,133  9,918  
(in millions)Income from continuing operations$1,011  1,552  609  4,936  254  
(Loss) income from discontinued operations, net of tax$—  (6) (7) (1) 571  
Net income attributable to Baxter stockholders$1,001  1,546  602  4,935  825  
Earnings per share from continuing operations
    Basic$1.97  2.91  1.12  9.04  0.47  
    Diluted$1.93  2.84  1.10  8.96  0.46  
(Loss) earnings per share from discontinued 
operations
    Basic$—  (0.01) (0.01) —  1.04  
    Diluted$—  (0.01) (0.02) —  1.04  
Earnings per share
    Basic$1.97  2.90  1.11  9.04  1.51  
    Diluted$1.93  2.83  1.08  8.96  1.50  
Weighted-average 
number of shares outstanding
    Basic509  534  543  546  545  
    Diluted519  546  555  551  549  
Balance Sheet InformationTotal assets$18,193  15,720  17,102  15,459  20,941  
(in millions)Total liabilities$10,281  7,854  7,993  7,238  12,089  
Total equity$7,912  7,866  9,109  8,221  8,852  
Long-term debt and finance lease obligations$4,809  3,481  3,512  2,774  3,923  
Cash Flow InformationCash flows from operations - continuing operations$2,110  2,017  1,730  1,588  1,211  
(in millions)Cash flows from investing activities - continuing operations$(1,100) (916) (1,292) (716) (855) 
Cash flows from financing activities$498  (2,603) 93  (324) (481) 
Capital expenditures - continuing operations$(696) (659) (616) (705) (905) 
Common Stock InformationCash dividends declared per share$0.850  $0.730  $0.610  $0.505  $1.270  

1.We have restated in this Annual Report on Form 10-K our previously issued audited financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017 and selected previously reported financial information as of December 31, 2017, 2016 and 2015 and for the years ended December 31, 2016 and 2015. In addition to the correction of misstatements related to non-operating foreign exchange gains and losses, we also corrected other misstatements that were immaterial, individually and in the aggregate, to our previously issued financial statements. See Note 2, Restatement of Previously Issued Consolidated Financial Statements, in Item 8, Financial Statements and Supplementary Data, for additional information.
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2.Income from continuing operations for the year ended December 31, 2019 included a charge of $755 million related to the annuitization of a portion of our U.S. pension plan.
3.As of December 31, 2017, total assets have changed from $17,111 million as originally reported to $17,102 million as restated, total liabilities have changed from $7,995 million as originally reported to $7,993 million as restated, total equity has changed from $9,116 million as originally reported to $9,109 million as restated, and long-term debt and finance lease obligations have changed from $3,509 million as originally reported to $3,512 million as restated. See Note 2, Restatement of Previously Issued Consolidated Financial Statements, in Item 8, Financial Statements and Supplementary Data, for information related to the restatement impacts on operating results and cash flow information for the year ended December 31, 2017. Balance sheet information as of December 31, 2017 is unaudited.
4.As of and for the year ended December 31, 2016, net sales have changed from $10,163 million as originally reported to $10,133 million as restated, income from continuing operations has changed from $4,966 million as originally reported to $4,936 million as restated, net income attributable to Baxter stockholders has changed from $4,965 million as originally reported to $4,935 million as restated, basic earnings per share from continuing operations has changed from $9.10 as originally reported to $9.04 as restated, diluted earnings per share from continuing operations has changed from $9.01 as originally reported to $8.96 as restated, basic loss per share from discontinued operations has changed from $(0.01) as originally reported to $0.00 as restated, basic earnings per share has changed from $9.09 as originally reported to $9.04 as restated, diluted earnings per share has changed from $9.01 as originally reported to $8.96 as restated, total assets have changed from $15,546 million as originally reported to $15,459 million as restated, total liabilities have changed from $7,266 million as originally reported to $7,238 million as restated, total equity has changed from $8,280 million as originally reported to $8,221 million as restated, long-term debt and finance lease obligations have changed from $2,779 million as originally reported to $2,774 million as restated, cash inflows from operations - continuing operations has changed from $1,624 million as originally reported to $1,588 million as restated, cash outflows from investing activities - continuing operations has changed from $730 million as originally reported to $716 million as restated, and capital expenditures - continuing operations has changed from $719 million as originally reported to $705 million as restated.
5.For the year ended December 31, 2016, income from continuing operations included net realized gains of $4.4 billion related to the disposition of our formerly retained shares in Baxalta (Baxalta Retained Shares).
6.As of and for the year ended December 31, 2015, net sales have changed from $9,968 million as originally reported to $9,918 million as restated, income from continuing operations has changed from $393 million as originally reported to $254 million as restated, net income attributable to Baxter stockholders has changed from $968 million as originally reported to $825 million as restated, basic earnings per share from continuing operations has changed from $0.72 as originally reported to $0.47 as restated, diluted earnings per share from continuing operations has changed from $0.72 as originally reported to $0.46 as restated, basic earnings per share from discontinued operations has changed from $1.06 as originally reported to $1.04 as restated, basic earnings per share has changed from $1.78 as originally reported to $1.51 as restated, diluted earnings per share has changed from $1.76 as originally reported to $1.50 as restated, total assets have changed from $20,962 million as originally reported to $20,941 million as restated, total liabilities have changed from $12,097 million as originally reported to $12,089 million as restated, total equity has changed from $8,865 million as originally reported to $8,852 million as restated, long-term debt and finance lease obligations have changed from $3,922 million as originally reported to $3,923 million as restated, cash inflows from operations - continuing operations has changed from $1,253 million as originally reported to $1,211 million as restated, cash outflows from investing activities - continuing operations has changed from $861 million as originally reported to $855 million as restated, and capital expenditures - continuing operations has changed from $911 million as originally reported to $905 million as restated.Reserved.
Item 7.    Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The following commentary should be read in conjunction with the consolidated financial statements and accompanying notes. The discussion and analysis of our financial condition as of December 31, 2020 and results of operations for the year ended December 31, 2020 compared to the year ended December 31, 2019, included in Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations, can be found in our Current Report on Form 8-K filed with the SEC on April 29, 2021 (2020 Annual Report), which revised and superseded the Management's Discussion and Analysis of Financial Condition and Results of Operations section of the Annual Report on Form 10-K for the year ended December 31, 2020.
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EXECUTIVE OVERVIEW
Restatement of Previously Issued Consolidated Financial Statements
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We have restated our previously issued consolidated financial statements contained in this Annual Report on Form 10-K. Refer to the “Explanatory Note” preceding Item 1, Business, for background on the restatement, the periods impacted, control considerations, and other information. In addition, we have restated certain previously reported financial information as of December 31, 2018 and for the fiscal years ended December 31, 2018 and December 31, 2017 in this Item 7, Management’s Discussion and Analysis of Financial Condition and Results of Operations, including but not limited to information within the Results of Operations section. See Note 2, Restatement of Previously Issued Consolidated Financial Statements, in Item 8, Financial Statements and Supplementary Data, for additional information related to the restatement, including descriptions of the misstatements and the impacts on our consolidated financial statements.
Description of the Company and Business Segments
We manage our businessglobal operations based on threefour segments, consisting of the following geographic segments:segments related to our legacy Baxter business: Americas, (North and South America), EMEA (Europe, Middle East and Africa) and APAC, (Asia-Pacific). Each ofand a new global segment for our recently acquired Hillrom business. The Americas, EMEA and APAC segments providesprovide a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and patients at home under physician supervision. The Hillrom segment provides digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices and advanced equipment for the surgical space. Our global footprint and the critical nature of our products and services play a key role in expanding access to healthcare in emerging and developed countries. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ officesWe expect to continue to evaluate our business structure as we integrate Hillrom and patients at home under physician supervision.any changes as a result of that evaluation could impact the composition of our reportable segments in the future.
For financial information about our segments, see Note 1817 in Item 8 of this Annual Report on Form 10-K.
Recent Business Combinations and Asset Acquisitions
Cheetah MedicalHillrom
In October 2019,On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hillrom for a purchase price of $10.5 billion. Including the assumption of Hillrom's outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Under the terms of the transaction agreement, Hillrom shareholders received $156.00 in cash per each outstanding Hillrom common share.
Prior to our acquisition of Hillrom, Hillrom was a global medical technology leader whose products and services help enable earlier diagnosis and treatment, optimize surgical efficiency, and accelerate patient recovery while simplifying clinical communication and shifting care closer to home. Hillrom made those outcomes possible through digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices, advanced equipment for the surgical space and more, delivering actionable, real-time insights at the point of care. Refer to Note 2 and Note 5 in Item 8 of this Annual Report on Form 10-K for additional information on the Hillrom acquisition and related financing arrangements.
PerClot
On July 29, 2021, we acquired 100 percentcertain assets related to PerClot Polysaccharide Hemostatic System (PerClot), including distribution rights for the U.S. and specified territories outside of Cheetah Medical,the U.S., from CryoLife, Inc. (Cheetah) for totalan upfront cash considerationpurchase price of $195$25 million net of cash acquired, withand the potential for additional cash consideration of up to $40$36 million, which had an acquisition-date fair value of $28 million, based on clinicalupon regulatory and commercial milestonesmilestones. PerClot is an absorbable powder hemostat indicated for which the acquisition date fair value was $18 million. Cheetahuse in surgical procedures, including cardiac, vascular, orthopedic, spinal, neurological, gynecological, ENT and trauma surgery as an adjunct hemostat when control of bleeding from capillary, venous, or arteriolar vessels by pressure, ligature, and other conventional means is a leading provider of hemodynamic monitoring technologies.either ineffective or impractical. Refer to Note 42 in Item 8 of this Annual Report on Form 10-K for additional information regarding the acquisition of Cheetah.PerClot.
Recothrom and PreveleakTransderm Scop
InOn March 2018,31, 2021, we acquired two hemostatthe rights to Transderm Scop (TDS) for the U.S. and sealant productsspecified territories outside of the U.S. from Mallinckrodt plc: RECOTHROM Thrombin topical (Recombinant), the first and only stand-alone recombinant thrombin, and PREVELEAK Surgical Sealant, which is used in vascular reconstruction. Thesubsidiaries of GlaxoSmithKline for an upfront purchase price includedof $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an upfront paymentacquisition-date fair value of approximately $163$24 million, based upon regulatory approval of a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. TDS is indicated for post-operative nausea and potential contingent paymentsvomiting in the future.U.S. and motion sickness in European markets. Refer to Note 42 in Item 8 of this Annual Report on Form 10-K for additional information regarding the acquisition of the RECOTHROMTDS.
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Caelyx and PREVELEAK products.Doxil
Claris Injectables Limited
In July 2017,On February 17, 2021, we acquired 100 percentthe rights to Caelyx and Doxil, the branded versions of Claris Injectables Limited (Claris),liposomal doxorubicin, from a wholly owned subsidiary of Claris Lifesciences Limited,Johnson & Johnson for total cash considerationspecified territories outside of the U.S for approximately $629$325 million netin cash. We previously acquired the U.S. rights to this product in 2019. Liposomal doxorubicin is a chemotherapy medicine used to treat various types of cash acquired. Through the acquisition, we added capabilities in production of essential generic injectable medicines, such as anesthesia and analgesics, renal, anti-infectives and critical care in a variety of presentations including bags, vials and ampoules.cancer. Refer to Note 42 in Item 8 of this Annual Report on Form 10-K for additional information regarding the acquisition of Claris.Caelyx and Doxil.
Seprafilm Adhesion Barrier
In December 2019,February 2020, we entered into a definitive agreementcompleted the acquisition of the product rights to acquire Seprafilm Adhesion Barrier (Seprafilm) from Sanofi. The transaction closedSanofi for approximately $342 million in February 2020 and we paid approximately $345 million for the acquired assets, subject to a post-close adjustment.cash. Seprafilm is indicated for use in patients undergoing abdominal or pelvic laparotomy as an adjunct intended to reduce the incidence, extent and severity of postoperative adhesions between the abdominal wall and the underlying viscera such as omentum, small bowel, bladder, and stomach, and between the uterus and surrounding structures such as tubes and ovaries, large bowel, and bladder. AsRefer to Note 2 in Item 8 of this Annual Report on Form 10-K for additional information regarding the acquisition was completed after December 31, 2019, our consolidated financial statements do not include the financial condition or results of operations of Seprafilm in any of the periods presented herein.Seprafilm.
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Financial Results
Our global net sales totaled $11.4$12.8 billion in 2019,2021, an increase of 2%10% over 20182020 on a reported basis and 5%7% on a constant currency basis. International sales totaled $6.5$7.6 billion in 2019,2021, an increase of 3%12% compared to 20182020 on a reported basis and 7%8% on a constant currency basis. Sales in the United States totaled $4.8$5.2 billion in 2019,2021, an increase of 2%6% compared to 2018.2020. Refer to the Net Sales discussion in the Results of Operations section below for more information related to changes in net sales on a constant currency basis.
OurNet income from continuing operationsattributable to Baxter stockholders totaled $1.0$1.3 billion, or $1.93$2.53 per diluted share, in 2019. Income from continuing operations2021. Net income in 20192021 included special items which resulted in a net decrease to net income from continuing operations of $716$552 million, or $1.38$1.08 per diluted share. Our special items are discussed in the Results of Operations section below.
Our financial results included R&D expenses totaling $595$534 million in 2019,2021, which reflects our focus on balancing increased investments to support our new product pipeline with efforts to optimize overall R&D spending.
Our financial position remains strong, with operating cash flows from continuing operations totaling $2.1$2.2 billion in 2019.2021. We have continued to execute on our disciplined capital allocation framework, which is designed to optimize stockholder value creation through reinvestment in our businesses, dividends and share repurchases, as well as acquisitions and other business development initiatives as discussed in the Strategic Objectives section below.
Capital expenditures totaled $696$743 million in 20192021 as we continue to invest across our businesses to support future growth, including additional investments in support of new and existing product capacity expansions. Our investments in capital expenditures in 20192021 were focused on projects that improve production efficiency and enhance manufacturing capabilities to support our strategy of geographic expansion with select investments in growing markets.business growth.
We also continued to return value to our stockholders in the form of dividends. During 2019,2021, we paid cash dividends to our stockholders totaling $423$530 million. Additionally, in 20192021 we repurchased 16.57.3 million shares through cash repurchases pursuant to Rule 10b5-1 repurchase plans, an accelerated share repurchase plan and otherwise.plans. For information on our share repurchase plans, see Note 108 in Item 8 of this Annual Report on Form 10-K.
Strategic Objectives
We continue to focus on several key objectives to successfully execute our long-term strategy to achieve sustainable growth and deliver enhanced stockholder value. Our diversified and broad portfolio of medical products that treat life-threatening acute or chronic conditions and our global presence are core components of our strategy to achieve these objectives. We are focused on three strategic factors as part of our pursuit of industry leading performance: optimizing our core portfolio globally; operational excellence focused on streamlining our cost structure and enhancing operational efficiency; and maintaining a disciplined and balanced approach to capital allocation.
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Optimizing the Core Portfolio Globally
Our global product portfolio optimization strategy identifies products that we believe to have characteristics of core growth, products that we expect to provide us with a core return on capital, products that we intend to maintain or manage differently and products that we consider to be strategic bets. For products with core growth characteristics, we look to invest for long-term, higher margin growth. For products that we expect to generate a core return on capital, we seek to optimize our return on investment and to maintain or enhance our market position. For products that we intend to maintain or manage differently, we look to sustain or reposition our underlying investment. Finally, we are evaluating our market position and investment strategy for products that we consider to be strategic bets.
As part of our portfolio management strategy, we seek to optimize our position in product areas where we have a stable, profitable business model and identify and alter investments in products that have reached the end of their life cycles or for which market positions have evolved unfavorably. In the course of doing so, we expect to continue to reallocate capital to more promising opportunities or business groupings, as described above.
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Additionally, to the extent we identify areas that do not align with our longer-term objectives, we will look to exit or divest these businesses while also continuing to identify new opportunities to enhance future performance.
As part of this strategy, we are shifting our investments to drive innovation in product areas where we have compelling opportunities to serve patients and healthcare professionals while advancing theour business and we are accelerating the pace in which we bring these advances to market. We are in the midst of launching several new products, geographic expansions and line extensions by 2023 including in such areas as chronic and acute renal care, smart pump technology, hospital pharmaceuticals and nutritionals, surgical sealants, and more. These comprise a mix of entirely new offerings, improvements on existing technologies, and the expansion of current products into new geographies. We are also evaluating product development opportunities that leverage the newly acquired Hillrom portfolio.
Operational Excellence
WeIn recent years, we have undertaken a comprehensive review of all aspects of our operations and are actively implementing changes in line with our business goals. As part of our pursuit of improved margin performance, we are working to optimize our cost structure and we are critically assessing optimal support levels in light of our ongoing portfolio optimization efforts.efforts and the Hillrom integration. We intend to continue to actively manage our cost structure to help ensure that we are committing resources to the highest value uses. Such high value activities include supporting innovation, building out the portfolio, expanding patient access and accelerating growth for our stockholders.
Maintaining Disciplined and Balanced Capital Allocation
OurSubject to market conditions and our investment grade targets, our capital allocation strategies include the following:
reinvest in the business by funding opportunities that are positioned to deliver sustainable growth, support our innovation efforts and improve margin performance;
return capital to stockholders through dividends which we expect to meaningfully increase with earnings growth;
and share repurchases; and
identify and pursue accretive merger and acquisition (M&A) opportunities.
Responsible Corporate CitizenResponsibility at Baxter
We strive for continuedDriven by our mission to save and sustain lives, Baxter's corporate responsibility strategy focuses on tackling the environmental, social and governance (ESG) issues that affect our patients, customers, employees, communities and other stakeholders. Our corporate responsibility approach supports our business priorities to achieve top quartile results relative to industry peers and other comparators across four dimensions: patient safety and quality, growth through innovation, best place to work, and profitability, while furtheringindustry-leading performance. Advancing our focus on acting as a responsible corporate citizen. To us, sustainability means creating lastingresponsibility goals contributes to business, social environmental and economic value, including through employee attraction and retention, enhanced operational efficiency, and implementation of enterprise risk management strategies, among others.
In 2021, we launched our 2030 CR Commitment featuring ten goals for focused action, anchored by addressingthree pillars - Empower Our Patients, Protect Our Planet and Champion Our People and Communities - on the needsfoundation of
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principles of Ethics and Compliance, Human Rights, Inclusion and Diversity, and Privacy and Data Protection. The 2030 Commitment and Goals highlight Baxter's corporate responsibility focus and help to further advance our ESG performance. Our progress against these goals is published annually in our Corporate Responsibility Report which is available on our website under "Our Story-Corporate Responsibility". The Corporate Responsibility Report is not incorporated by reference into this Annual Report on Form 10-K or any other document filed with the SEC.
Risks and Uncertainties Related to COVID-19
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the COVID-19 pandemic. COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and we expect will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments have taken and continue to take. Initial measures taken in 2020 led to unprecedented restrictions on, disruptions in, and other related impacts on business and personal activities, including a shift in healthcare priorities, which resulted in a significant decline in medical procedures in 2020. Some of these disruptions and impacts (including the suspension or postponement of elective medical procedures) in certain of our wide-ranging stakeholder base. Our comprehensive sustainability program is focused on areasprincipal markets have continued into 2021. The pandemic has created significant volatility in which we are uniquely positionedthe demand for our products. For further discussion, refer to make a positive impact. Priorities include providing employees a safe, healthythe Product Category Net Sales Reporting section below. Significant uncertainty remains regarding the duration and inclusive workplace, fostering a culture that drives integrity, strengthening accessoverall impact of the COVID-19 pandemic. For example, concerns remain regarding the pace of economic recovery due to healthcare, enhancing math and science education, and driving environmental performancevirus resurgence across the product life cycle, including development, manufacturingglobe from the Delta and transport. AlongOmicron variants and other virus mutations as well as vaccine distribution and hesitancy. The U.S. and other governments may continue existing measures or implement new restrictions and other requirements in light of the continuing spread of the pandemic (including with the Baxter International Foundation, we provide financial supportrespect to mandatory vaccinations for certain of our employees and product donations in support of critical needs, from assisting underserved communities to providing emergency relief for countries experiencing natural disasters.
Throughout 2019, we continued to implement a range of water conservation strategies and facility-based energy saving initiatives. In the area of product stewardship and life cycle management, we are pursuing efforts such as sustainable design and reduced packaging. We are also respondingmoratoriums on elective procedures). Due to the uncertainty caused by the pandemic, our operating performance and financial results, particularly in the short term, may be subject to volatility. We have experienced significant challenges, including lengthy delays, shortages and interruptions, posed by the pandemic and other exogenous factors (including significant weather events and disruptions to certain ports of climate change through innovative greenhouse gas emissions-reduction programs, suchcall around the world) to our global supply chain, including the cost and availability of raw materials and component parts (including resins and electromechanical devices) and higher transportation costs, and may experience these and other challenges in future periods. We expect that these challenges as shiftingwell as evolving governmental restrictions and requirements, among other factors, may continue to less carbon-intensive energy sources in manufacturing and transport. Additionally, we developed new long-term goalshave an adverse effect on our business. For further discussion, refer to drive continued environmental stewardship while creating healthier, more sustainable communities where our employees work and live.Item 1A of this Annual Report on Form 10-K.
Risk Factors
Our ability to sustain long-term growth and successfully execute the strategies discussed above depends in part on our ability to manage within an increasingly competitive and regulated environment and to address the other risk factors described in Item 1A of this Annual Report on Form 10-K.
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RESULTS OF OPERATIONS
Special Items
The following table provides a summary of our special items and the related impact by line item on our results of continuing operations for 2019, 20182021 and 2017.
years ended December 31 (in millions)201920182017
Gross Margin
Intangible asset amortization expense$(183) $(169) $(154) 
Intangible asset impairment1
(31) —  —  
Business optimization items2
(69) (49) (53) 
Separation-related costs3
—  —  (1) 
Product-related items4
—   (17) 
Acquisition and integration expenses5
(30) (27) (8) 
Litigation and contractual disputes6
—  (8) —  
Hurricane Maria insurance recoveries (costs)7
—  32  (32) 
European medical devices regulation8
(25) (6) —  
Total Special Items$(338) $(221) $(265) 
Impact on Gross Margin Ratio(3.0 pts) (2.0 pts) (2.5 pts) 
Selling, General and Administrative (SG&A) Expenses
Business optimization items2
$70  $145  $116  
Separation-related costs3
—  —  18  
Acquisition and integration expenses5
20  23  20  
Litigation and contractual disputes6
—   21  
Investigation-related costs13
 —  —  
Historical reserve adjustments9
—  —  (12) 
Total Special Items$98  $170  $163  
Impact on SG&A Expense Ratio0.9 pts  1.5 pts  1.5 pts  
R&D Expenses
Business optimization items2
$45  $26  $—  
Acquisition and integration expenses5
  —  
European medical devices regulation8
—   —  
Total Special Items$53  $36  $—  
Impact on R&D Expense Ratio0.4 pts  0.3 pts  0.0 pts  
Other Operating Income, net
Acquisition and integration expenses5
$(4) $—  $—  
Hurricane Maria insurance recoveries7
(100) (10) —  
Claris Settlement10
—  (80) —  
Insurance recoveries from a legacy product-related matter11
(37) —  —  
Total Special Items$(141) $(90) $—  
Other (Income) Expense, Net
Acquisition and integration activities5
$—  $(24) $—  
Pension settlement14
755  —  —  
Venezuela deconsolidation12
—  —  33  
Total Special Items$755  $(24) $33  
Income Tax Expense
Tax effects of special items and impact of U.S. Tax Reform15
$(387) $(277) $191  
Total Special Items$(387) $(277) $191  
Impact on Effective Tax Rate(20.9 pts) (13.7) pts 25.4 pts  
2020.
years ended December 31 (in millions)20212020
Gross Margin
Intangible asset amortization expense$(287)$(222)
Intangible asset impairment1
— (17)
Business optimization items2
(53)(53)
Product-related items3
— (29)
Acquisition and integration expenses4
(50)(11)
European medical devices regulation5
(42)(33)
Investigation and related costs6
— (3)
Total Special Items$(432)$(368)
Impact on Gross Margin Ratio(3.4 pts)(3.1 pts)
Selling, General and Administrative (SG&A) Expenses
Intangible asset amortization expense$11 $— 
Business optimization items2
60 78 
Acquisition and integration expenses4
144 
Investigation and related costs6
31 19 
Litigation matter7
13 — 
Total Special Items$259 $106 
Impact on SG&A Expense Ratio2.0 pts1.0 pts
R&D Expenses
Business optimization items2
$$
Acquisition and integration expenses4
22 
Investigation and related costs6
— 
Total Special Items$$26 
Impact on R&D Expense Ratio0.1 pts0.3 pts
Other Operating Income, net
Business optimization items2
$— $(17)
Acquisition and integration expenses4
(6)(2)
Total Special Items$(6)$(19)
Interest Expense, Net
Acquisition and integration expenses4
$48 $— 
Total Special Items$48 $— 
Other Expense, Net
Pension settlements8
— 43 
Loss on debt extinguishment9
110 
Total Special Items$$153 
Income Tax Expense
Tax matters10
$(54)$— 
Tax effects of special items11
(137)(139)
Total Special Items$(191)$(139)
Impact on Effective Tax Rate(4.5 pts)(2.6 pts)
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Intangible asset amortization expense is identified as a special item to facilitate an evaluation of current and past operating performance and is consistent with how management and our Board of Directors internally assess performance. Additional special items are identified above because they are highly variable, difficult to predict and of a size that may substantially impact our results of operations for a period. Management believes that providing the separate impact of the above items on our results in accordance with U.S. GAAP may provide a more complete understanding of our operations and can facilitate a fuller analysis of our results of operations, particularly in evaluating performance from one period to another.

1OurIn 2020, our results in 2019 included a $31charge of $17 million for an asset impairment related to a developed-technology intangible asset.

Refer to Note 4 in Item 8 of this Annual Report on Form 10-K for further information regarding this asset impairment.
2In 2019, 20182021 and 2017,2020, our results were impacted by costs associated with our execution of programs to optimize our organization and cost structure on a global basis.structure. These actions included streamlining our international operations, rationalizing our manufacturing and distribution facilities, reducing our general and administrative infrastructure, re-aligning certain R&D activities and canceling certain R&D programs. Our results in 2019, 20182021 and 20172020 included business optimization charges of $184 million, $220$114 million and $169$134 million, respectively. Additionally, we recognized a gain of $17 million in 2020 for property we sold in conjunction with our business optimization initiatives. Refer to Note 12 of this Annual Report on Form 10-K in Item 8 for further information regarding these charges and related liabilities.

3Our results in 2017 included costs related to the Baxalta separation of $19 million. Refer to Note 311 in Item 8 of this Annual Report on Form 10-K for further information regarding these charges and related liabilities.
3Our results in 2020 included a charge of $29 million related to the separation of Baxalta.  Sigma Spectrum infusion pump inspection and remediation activities.
4Our results in 20182021 included a net benefitacquisition, integration and related financing expenses of $6 million$240 million. This included acquisition, integration and related financing expenses for our acquisition of Hillrom and the acquisition of the rights to an adjustment to our accrualCaelyx and Doxil for SIGMA SPECTRUM infusion pump inspection and remediation activities.specified territories outside of the U.S. These expenses were partially offset by benefits from changes in the estimated fair value of contingent consideration liabilities. Our results in 20172020 included a net charge of $17 million related to SIGMA SPECTRUM infusion pump inspection and remediation activities and other historical product reserves.  
5Our results in 2019 included $54$40 million of acquisition and integration expenses. This included acquisition and integration expenses relaterelated to our acquisitions of Claris and the RECOTHROM and PREVELEAK products in prior periods, as well as the 2019 acquisitions of Cheetah Medical, Inc. (Cheetah), Seprafilm and in-process R&D assets, partially offset by a benefit related to the change in the estimated fair value of contingent consideration liabilities. Our results in 2018 included $33 million of acquisition and integration costs related to our acquisitions of Claris and the RECOTHROM and PREVELEAK products, upfront payments related to R&D collaborations and license agreements, and a gain from remeasuring our previously held investment to fair value upon acquisition of a controlling interest in our joint venture in Saudi Arabia. Our results in 2017 included acquisition and integration expenses of $28 million related to our acquisition of Claris. Refer to Note 42 in Item 8 of this Annual Report on Form 10-K for further information regarding business development activities.
65Our results in 2018 included charges of $10 million related to certain product litigation. Our results in 2017 included charges of $21 million related to litigation2021 and contractual disputes for businesses or arrangements in which we are no longer engaged or a party thereto.
7Our results in 2019 and 2018 included benefits of $100 million and $42 million, respectively, related to insurance recoveries as a result of losses incurred due to Hurricane Maria. Our results in 2017 included a charge of $32 million related to the impact of Hurricane Maria on our operations in Puerto Rico.  The costs primarily included inventory and fixed asset impairments as well as idle facility costs. Refer to Note 9 in Item 8 of this Annual Report on Form 10-K for further information regarding the impact of Hurricane Maria.
8Our results in 2019 and 20182020 included costs of $25$42 million and $9$33 million, respectively, related to updating our quality systems and product labeling to comply with the new medical device reporting regulation and other requirements of the European Union’s regulations for medical devices that will become effective in 2020.stages beginning in 2021.
96Our results in 20172021 included a benefitcharges of $12$31 million for investigation and related costs. Those costs related to an adjustment tomatters associated with our historical rebatespreviously announced investigation of foreign exchange gains and discounts reserve.
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10losses, including the settlement of shareholder litigation, a civil penalty from the SEC and related professional fees. Our results in 20182020 included a benefit of $80$23 million for investigation and related costs. Those costs primarily included professional fees for the settlementinvestigation and related matters, as well as incremental stock compensation expense as we extended the terms of certain claims relatedstock options that were scheduled to expire in the acquired operationsfirst quarter of Claris.2020. Refer to Note 4Notes 7 and 8 in Item 8 of this Annual Report on Form 10-K for further information regarding the acquisition of Claris.investigation and stock compensation expense.
117Our results in 20192021 included legal charges of approximately $13 million associated with claimants alleging injuries as a benefitresult of $37 million forproximity to one of our allocation of insurance proceeds received pursuant to a settlement and cost-sharing arrangement for a legacy product-related matter. Refer to Note 9 in Item 8 of this Annual Report on Form 10-K for further information.plants.
128Our results in 20172020 included a charge of $33$43 million related to the deconsolidation of our Venezuelan operations.lump-sum settlement distributions made to certain former U.S. employees with vested pension benefits. Refer to Note 112 in Item 8 of this Annual Report on Form 10-K for further information regarding the deconsolidation of our Venezuelan operations.lump-sum settlements.
139Our results in 20192021 included costsa loss of $8$5 million related to our internal investigationon the early extinguishment of foreign exchange gains and losses associated with certain intra-company transactions.the $2.4 billion debt assumed as part of the Hillrom acquisition. Our results in 2020 included a loss of $110 million on the November 2020 early extinguishment of $750 million of 3.75% senior notes that were issued in March 2020. Refer to Note 95 in Item 8 of this Annual Report on Form 10-K for further information regarding the internal investigation.information.
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14
10Our results in 20192021 included a charge of $755$58 million income tax benefit related to the annuitization of a portion of ourtax-deductible foreign statutory loss on an investment in a foreign subsidiary and an $18 million income tax benefit related to a change in U.S. pension plan. Referforeign tax credit regulations, partially offset by a $22 million income tax expense related to Note 13 in Item 8 of this Annual Report on Form 10-Kan unfavorable court ruling for further information regarding the pension annuitization.an uncertain tax position.
1511Reflected in this item is the income tax impact of the special items identified in this table. Additionally, our results in 2019 included a net tax benefit of $125 million related to income tax reform in Switzerland and India and an adjustment for U.S. federal tax reform. Our results in 2018 included a net tax benefit of $196 million related to updates to the estimated impact of U.S. federal tax reform previously made in 2017.  Our results in 2017 included a net tax charge of $322 million related to the estimated impact of U.S. federal tax reform on our tax related assets and liabilities. The tax effect of each adjustmentspecial item is based on the jurisdiction in which the adjustment isitem was incurred and the tax laws in effect for each such jurisdiction.
Net Sales
As restatedPercent change
At actual
currency rates
At constant
currency rates
Percent change
years ended December 31 (in millions)years ended December 31 (in millions)2019201820172019201820192018years ended December 31 (in millions)20212020At actual
currency rates
At constant
currency rates
United StatesUnited States$4,826  $4,723  $4,510  %%%%United States$5,180 $4,878 6 %6 %
InternationalInternational6,536  6,376  6,074  %%%%International7,604 6,795 12 %8 %
Total net salesTotal net sales$11,362  $11,099  $10,584  %%%%Total net sales$12,784 $11,673 10 %7 %
Net sales for the year ended December 31, 20192021 increased 2% at actual rates and 5% at constant currency rates. Net sales for the year ended December 31, 2018 increased 5%10% at actual and 4%7% at constant currency rates.
Foreign currency exchange rates unfavorablyfavorably impacted 2019 net sales growth by three3 percentage points during 2021 compared to the prior-year period principally due to the strengtheningweakening of the U.SU.S. Dollar relative to the Euro, Australian Dollar, British Pound, Chinese YuanRenminbi and Colombian Peso. Changes in foreign currency exchange rates favorably impacted 2018 net sales growth by one percentage point, principally due to the weakening of the U.S dollar relative to the Euro, British Pound and Chinese Yuan, partially offset by the strengthening of the U.S. Dollar relative to the Brazilian Real, Turkish Lira and AustralianCanadian Dollar.
The comparisons presented at constant currency rates reflect current year local currency sales at the prior year’s foreign exchange rates. This measure provides information on the change in net sales assuming that foreign currency exchange rates had not changed between the prior and the current period. We believe that the non-GAAP measure of change in net sales at constant currency rates, when used in conjunction with the U.S. GAAP measure of change in net sales at actual currency rates, may provide a more complete understanding and facilitate a fuller analysis of our results of operations, particularly in evaluating performance from one period to another.
In 2019,2021, the acquisition of Cheetah had an insignificant impact on reported revenues. The RECOTHROMHillrom and PREVELEAK products acquired in 2018the rights to Caleyx and Doxil for specified territories outside of the U.S. contributed $80$212 million and $52$108 million, of revenuesrespectively, in 2019 and 2018, respectively. The acquisition of Claris contributed $140 million and $57 million of revenues in 2018 and 2017, respectively.net sales.
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Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus that recently originated in China (COVID-19). COVID-19 may have an adverse impact on our operations, supply chains and distribution systems and increase our expenses, including asAs a result of impacts associated with preventivethe increase in COVID-19 cases in late 2021 and precautionary measures thatearly 2022, we other businesses and governments are taking. Due to these impacts and measures, we may experience significant and unpredictable reductions or increases in demand for certainhave experienced higher levels of absenteeism at our manufacturing facilities. In addition, a number of our products as health care customers re-prioritizesuppliers are experiencing similar staffing challenges, which, together with other supply chain constraints in the treatment of patients. For example, elective surgeries are being de-prioritized which will negatively impactcurrent environment, has limited the usageavailability of certain ofraw materials and component parts used in our products, while other ofproducts. These conditions have decreased our products are experiencing an increase in demandcurrent production levels, which we may not be ableexpect to meet in accordance with the customer’s desired timing. In addition to existing travel restrictions, countries may close borders, impose prolonged quarantines, and further restrict travel, which may significantlyadversely impact the ability of our employees to get to their places of work to produce products, or may significantly hamper our products from moving through the supply chain. As a result, while the financial impact on us has not been significant to date, given the rapid and evolving nature of the virus, COVID-19 could negatively affect our sales growth during the first quarter of 2022. We currently expect these conditions to improve and it is uncertain how COVID-19 will affect our global operations generally if these impacts persist or exacerbateproduction levels to normalize over an extended periodthe course of time. For further discussion, refer to Item 1A of this Annual Report on Form 10-K.2022.
Global Business UnitProduct Category Net Sales Reporting
OurBeginning in the first quarter of 2021, our product category net sales disclosures (previously referred to as global business units (GBUs)) separately present net sales from our BioPharma Solutions business, which was previously included within Other. Concurrent with that disaggregation of net sales from our BioPharma Solutions business, we have also allocated certain previously unallocated sales deductions from Other to various categories, primarily based on their respective net sales. Net sales for 2020 have been recast to conform to the current period presentation. Additionally, with the acquisition of Hillrom in December 2021, we have added three new product categories: Patient Support Systems, Front Line Care and Surgical Solutions.
Our product categories include the following:
Renal Care includes sales of our peritoneal dialysis (PD), hemodialysis (HD) and additional dialysis therapies and services.
Medication Delivery includes sales of our intravenous (IV) therapies, infusion pumps, administration sets and drug reconstitution devices.
Pharmaceuticals includes sales of our premixed and oncology drug platforms, inhaled anesthesia and critical care products and pharmacy compounding services.
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Clinical Nutrition includes sales of our parenteral nutrition (PN) therapies and related products.
Advanced Surgery includes sales of our biological products and medical devices used in surgical procedures for hemostasis, tissue sealing and adhesion prevention.
Acute Therapies includes sales of our continuous renal replacement therapies (CRRT) and other organ support therapies focused in the intensive care unit (ICU).
OtherBioPharma Solutions primarily includes sales of contract manufacturingcontracted services fromwe provide to various pharmaceutical and biopharmaceutical companies.
Patient Support Systems includes sales of our pharmaceutical partnering business.connected care solutions: devices, software, communications and integration technologies.
Front Line Care includes sales of our integrated patient monitoring and diagnostic technologies to help diagnose, treat and manage a wide variety of illness and diseases, including respiratory therapy, cardiology, vision screening and physical assessment.
Surgical Solutions includes sales of our surgical video technologies, tables, lights, pendants, precision positioning devices and other accessories.
Other includes sales of other miscellaneous product and service offerings.
The following is a summary of net sales by GBU.product category.
Percent change
years ended December 31 (in millions)20212020At actual
currency rates
At constant
currency rates
Renal Care$3,900 $3,757 %%
Medication Delivery2,880 2,691 %%
Pharmaceuticals2,291 2,098 %%
Clinical Nutrition964 910 %%
Advanced Surgery977 886 10 %%
Acute Therapies782 740 %%
BioPharma Solutions669 486 38 %35 %
Patient Support Systems115 — n/an/a
Front Line Care70 — n/an/a
Surgical Solutions27 — n/an/a
Other109 105 %%
Total Baxter$12,784 $11,673 10 %7 %
As restatedPercent change
At actual
currency rates
At constant
currency rates
years ended December 31 (in millions)2019201820172019201820192018
Renal Care$3,639  $3,651  $3,491  — %%%%
Medication Delivery2,799  2,664  2,700  %(1)%%(2)%
Pharmaceuticals2,155  2,087  1,886  %11 %%10 %
Clinical Nutrition872  875  885  — %(1)%%(3)%
Advanced Surgery877  798  708  10 %13 %12 %12 %
Acute Therapies535  515  457  %13 %%12 %
Other485  509  457  (5)%11 %(2)%10 %
Total Baxter$11,362  $11,099  $10,584  %%%%
Foreign exchange rates unfavorably impacted Renal Care net sales 3% in 2019 and favorably impacted net sales 1% in 2018, respectively. Excluding the impact of foreign exchange rates, Renal Care net sales increased 4% in 2019 and 2018.2021, as compared to the prior-year period. The increase in 20192021 was driven by a 2% positive impact from foreign exchange rate changes, as compared to the prior-year period, and global patient growth in PD, partially offset by lower U.S. in-center HD sales. The increase in 2018 was primarily driven by global growth in the PD business as well as increased international sales in the HD business.
Foreign exchange rates unfavorably impacted Medication Delivery net sales 2%increased 7% in 20192021, as compared to the prior-year period. The increase in 2021 was due to a favorable comparison to the comparable period of 2020 which was more severely impacted from lower demand for our infusion systems and favorably impacted net sales 1%related IV administration sets and solutions due to lower hospital admission rates and a reduction in 2018, respectively. Excludingelective surgeries resulting from the impact ofCOVID-19 pandemic. Additionally, foreign exchange rates had a favorable impact on Medication Delivery net sales of 1% in 2021, as compared to the prior-year period.
Pharmaceuticals net sales increased 9% in 2021, as compared to the prior-year period. The increase in 2021 was driven by the acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S., which contributed $108 million of net sales in 2021. Additionally, foreign exchange rates had a favorable impact on Pharmaceuticals net sales of 4% in 2021, as compared to the prior-year period. Partially offsetting this increase was a significant nonrecurring purchase from the U.S. government in the prior year.
Clinical Nutrition net sales increased 6% in 2021, as compared to the prior-year period. The increase in 2021 was driven by growth in the U.S. for our PN therapies and related products and a 2% positive impact from foreign exchange rate changes, as compared to the prior-year period. The increase was partially offset by lower international sales of vitamins resulting from supply constraints.
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increased in 2019 and decreased in 2018. The increase in 2019 was attributable to increased sales of our Spectrum IQ Infusion System in the U.S. and EVO IQ Infusion System internationally and related IV access administration sets. The decrease in 2018 was partially attributable to supply constraints associated with our small volume parenterals (SVPs) due to Hurricane Maria as well as lower international sales resulting from a reallocation of volume to the U.S.
Foreign exchange rates unfavorably impacted Pharmaceuticals net sales 3% in 2019 and favorably impacted net sales 1% in 2018, respectively. Excluding the impact of foreign exchange rates, Pharmaceuticals net sales increased in 2019 and 2018. The increase in 2019 was due to growth in international pharmacy compounding sales and increased sales of our generic injectables. Partially offsetting those increases were reduced sales of inhaled anesthetics as well as BREVIBLOC and U.S. cylophosphamide due to increased generic competition. The increase in 2018 was a result of the benefit from the acquisition of Claris, increased sales of our premixed injectables and inhaled anesthetics, as well as increased demand for pharmacy compounding services.  The acquisition of Claris in 2017 contributed $140 million of net sales in 2018 compared to $57 million of net sales in 2017. Partially offsetting the increase in 2018 was reduced sales of U.S. cyclophosphamide.
Foreign exchange rates unfavorably impacted Clinical Nutrition net sales 3% in 2019 and favorably impacted net sales 2% in 2018, respectively. Excluding the impact of foreign exchange rates, Clinical Nutrition net sales increased in 2019 and decreased in 2018. The increase in 2019 was due to the launch of new products. The decrease in 2018 was driven by the impact of Hurricane Maria related supply constraints which resulted in some customers in the U.S. changing protocols for PN therapies or shifting to outsourced nutrition compounding centers and competitive products, partially offset by improved volumes internationally for our nutritional therapies.
Foreign exchange rates unfavorably impacted Advanced Surgery net sales 2% in 2019 and favorably impacted net sales 1% in 2018, respectively. Excluding the impact of foreign exchange rates, Advanced Surgery net sales increased 10% in 2019 and 2018.2021, as compared to the prior-year period. The increase in 20192021 was primarily driven by higher salesa recovery in elective surgeries, as many had been previously postponed due to the COVID-19 pandemic, and a result of a temporary supply disruption of a competitor. The increase in 2018 was primarily driven by1% positive impact from foreign exchange rate changes, as compared to the prior-year period. Additionally, the acquisition of RECOTHROM and PREVELEAK from Mallinckrodt, whichSeprafilm in February of 2020 contributed $52$8 million of netincremental sales in 2018, and improved sales for our core hemostats and sealants. the first quarter of 2021.
Foreign exchange rates unfavorably impacted Acute Therapies net sales 3% in 2019 and favorably impacted net sales 1% in 2018, respectively. Excluding the impact of foreign exchange rates, Acute Therapies net sales increased 6% in 2019 and 2018.2021, as compared to the prior-year period. The increase in 20192021 was due to higherdriven by increased global demand for our CRRT systems to treat acute kidney injuries, includingduring the launch of PrisMax in several countries across the Americas, EuropeCOVID-19 pandemic and Asia. The increase in 2018 was due to higher demand for our CRRT systems to treat acute kidney injuries and higher demand for other productsa 3% positive impact from an intense flu season.
Foreign exchange rates unfavorably impacted Other net sales 3% in 2019 and favorably impacted net sales 1% in 2018, respectively. Excluding the impact of foreign exchange rates, Other net sales decreased in 2019 in comparisonrate changes, as compared to strong sales performance in the prior year. On a constant currency basis, Otherprior-year period.
BioPharma Solutions net sales increased 38% in 2018 due primarily2021, as compared to favorable volumes for products manufacturedthe prior-year period. The increase was driven by usmanufacturing services and supply packaging related to the production of COVID-19 vaccines on behalf of ourmultiple pharmaceutical partners, includingcompanies and a 3% positive impact from foreign exchange rate changes, as compared to the impactprior-year period.
Patient Support Systems net sales were $115 million in 2021 and resulted from the acquisition of those customers increasing safety stock levelsHillrom in December 2021.
Front Line Care net sales were $70 million in 2021 and resulted from the acquisition of select products.  Hillrom in December 2021.
Surgical Solutions net sales were $27 million in 2021 and resulted from the acquisition of Hillrom in December 2021.
Gross Margin and Expense Ratios
As restated20192018
years ended December 312019% of net sales2018% of net sales2017% of net sales$ change% change$ change% change
Gross margin$4,761  41.9 %$4,759  42.9 %$4,474  42.3 %$ — %$285  6.4 %
SG&A$2,535  22.3 %$2,620  23.6 %$2,627  24.8 %$(85) (3.2)%$(7) (0.3)%
R&D$595  5.2 %$654  5.9 %$615  5.8 %$(59) (9.0)%$39  6.3 %
years ended December 312021% of net sales2020% of net sales$ change% change
Gross margin$5,105 39.9 %$4,587 39.3 %$518 11.3 %
SG&A$2,867 22.4 %$2,469 21.2 %$398 16.1 %
R&D$534 4.2 %$521 4.5 %$13 2.5 %
Gross Margin
The gross margin ratio was 41.9%, 42.9%39.9% and 42.3%39.3% in 2019, 20182021 and 2017,2020, respectively. The special items identified above had an unfavorable impact of 3.0, 2.03.4 and 2.53.1 percentage points on the gross margin ratio in 2019, 20182021 and 2017,2020, respectively. Refer to the Special Items section above for additional detail.
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Excluding the impact of the special items, the gross margin ratio was unchanged in 2019 compared to 2018. The gross margin ratio was impacted by an unfavorable product mix as well as inventory write-downs and incremental costs relating to improvements at a dialyzer facility in the U.S. that experienced manufacturing issues during the second quarter of 2019, offset by manufacturing efficiencies.
Excluding the impact of the special items, the gross margin ratio increased 0.10.9 percentage points in 2018. The gross margin ratio increased primarily2021 compared to 2020 due to a favorable product mix and manufacturing efficiencies,that was partially offset by the negative impact of foreign exchange rates, incrementalhigher manufacturing and supply chain costs andresulting from the impact of lost sales due to Hurricane Maria.COVID-19 pandemic.
SG&A
The SG&A expenses ratio was 22.3%, 23.6%22.4% and 24.8%21.2% in 2019, 20182021 and 2017,2020, respectively. The special items identified above had an unfavorable impact of 0.9, 1.52.0 and 1.51.0 percentage points on the SG&A expenses ratio in 2019, 20182021 and 2017,2020, respectively. Refer to the Special Items section above for additional detail.
Excluding the impact of the special items, the SG&A expenses ratio decreased 0.7increased 0.2 percentage points in 20192021 primarily due to actions we took to restructurehigher bonus accruals under our cost position and focus on expense management.
Excluding the impact of the special items, the SG&A expenses ratio decreased 1.2 percentage points in 2018 due to the actions taken by us to restructure our cost position and focus on expense management. These savings were partially offset by decreased benefits to the SG&A expenses ratio from increased freight expenses as we worked to ensure adequate product availability to meet customer needs.  In addition, a change in the estimated useful life of our ERP systems in 2018 contributed to the reduction in the SG&A expenses ratio.annual employee incentive compensation plans.
R&D
The R&D expenses ratio was 5.2%, 5.9%4.2% and 5.8%4.5% in 2019, 20182021 and 2017,2020, respectively. The special items identified above had an unfavorable impact of 0.4,0.1 and 0.3 and 0.0 percentage points on the R&D expenses ratio in 2019, 20182021 and 2017,2020, respectively. Refer to the Special Items section above for additional detail.
Excluding the impact of the special items, the R&D expenses ratio decreased by 0.80.1 percentage points in 20192021 as a result of reduceddecreased project-related expenditures compared to the prior year and actions we took to restructure our cost position and focus on expense management.
Excluding the impact of special items, the R&D expenses ratio decreased by 0.2 percentage points in 2018 as a result of actions we took to restructure our cost position and focus on expense management,that was partially offset by an increase in project-related expenditures.higher bonus accruals under our annual employee incentive compensation plans.
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Business Optimization Items
In recent years, we have undertaken actions to transform our cost structure and enhance our operational efficiency. These efforts includehave included restructuring the organization, optimizing our manufacturing footprint, R&D operations and supply chain network, employing disciplined cost management, and centralizing and streamlining certain support functions. From the commencement of our business optimization actions in the second half of 2015 through December 31, 2019,2021, we have incurred cumulative pre-tax costs of $980 million$1.2 billion related to these actions. The costs consisted primarily of employee termination costs, implementation costs, contract termination costs, asset impairments, and accelerated depreciation. We currently expect to incur additional pre-tax costs of approximately $50$30 million related to thesethrough the completion of the initiatives that are currently underway, primarily related to employee termination costs and implementation costs. ToWe continue to pursue cost savings initiatives and, to the extent further cost savings opportunities are identified, we may incur additional restructuring charges and costs to implement business optimization expenses.programs in future periods. The reductions in our cost base from these actions in the aggregate are expected to provide cumulative annual pretax savings of approximatelymore than $1.2 billion once the remaining actions are complete. The savings from these actions will impacthave reduced cost of sales, SG&A expenses, and R&D expenses. Approximately 9599 percent of the expected annual pre-tax savings has been realized through December 31, 2019,2021, with the remainder expected to be realized by the end of 2023.2022. Refer to Note 1211 in Item 8 of this Annual Report on Form 10-K for additional information regarding our business optimization programs.
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Other Operating Income, Net
Other operating income, net was $141 million, $99$6 million and $56$19 million in 2019, 20182021 and 2017,2020, respectively. In 20192021 and 2018,2020, we recognized $100benefits of $6 million and $10$2 million, respectively, of insurance recoveries related to losses incurred due to Hurricane Maria within Other operating income, net. In 2019, we also recognized a benefit of $37 million when our share of the proceeds under a cost-sharing agreement became realizable following the resolution of a dispute with an insurer related to a legacy product-related matter. In 2018, we settled certain claims with the seller related to the acquired operationschange in the estimated fair value of Claris, which resultedcontingent consideration liabilities. Additionally, in 2020, we recognized a benefit$17 million gain on the sale of $80 million. Additionally, includedproperty in other operating incomeconjunction with our business optimization initiatives.
In September 2013, we entered into an agreement with Celerity Pharmaceutical, LLC (Celerity) to develop certain acute care generic injectable premix and oncolytic products through regulatory approval. We transferred our rights in 2018these products to Celerity and 2017 was $9Celerity assumed ownership and responsibility for development of the products. We are obligated to purchase the individual product rights from Celerity if the products obtain regulatory approval. In December 2020, we entered into an agreement with a third party to divest one of the products that is currently being developed by Celerity if that product receives regulatory approval in the U.S. and/or European Union. If regulatory approval is obtained, we would incur a loss ranging from $30 million to $60 million for the difference between our purchase price and $56 million, respectively, of transition service income earnedthe divestiture proceeds in connection with our separationthat transaction. Refer to Note 2 in Item 8 of Baxalta in 2015. The agreementthis Annual Report on Form 10-K for these services terminated as of July 1, 2018.additional information regarding this agreement.
Interest Expense, Net
Interest expense, net was $71 million, $45$192 million and $55$134 million in 2019, 20182021 and 2017,2020, respectively. The increase in 20192021 was primarily driven by higher average debt outstanding as a result offinancing-related fees incurred in connection with the issuance of €750Hillrom acquisition, which totaled $59 million, of 0.40% senior notes due May 2024 and €750 million of 1.3% senior notes due May 2029. The decrease in 2018 was primarily driven by higherlower interest income earned as a result of favorabledue to lower interest rates. Refer to Note 5 in Item 8 of this Annual Report on Form 10-K for a summary of the components of interest expense, net for 2019, 20182021 and 2017.2020.
Other (Income) Expense, Net
Other (income) expense, net was an expense of $731$41 million and $190 million in 2019, income of $78 million in 20182021 and an expense of $133 million in 2017.2020, respectively. The increase innet expense in 20192021 was primarily driven by foreign exchange net losses and pension and OPEB net expenses. The net expense in 2020 was primarily driven by a $755$110 million pension settlement chargeloss on the early extinguishment of debt related to the transferour November 2020 redemption of U.S. pension plan liabilities to an insurance company and $37$750 million of senior notes that were issued in March 2020, foreign exchange net losses of $49 million and $46 million of pension settlement charges, which included a $43 million charge related to lump-sum settlement distributions made to certain former U.S. employees with vested pension benefits.These expenses in the current year,2020 were partially offset by an impairmentnet unrealized gains of an investment in the prior year. Favorable results in 2018 were primarily driven by $49$13 million of pension and other postretirement (OPEB) benefits resulting from the split and freeze of our U.S. pension plans announced in January 2018, a $24 million gain from remeasuring our previously held investmentrelated to fair value upon acquisition of a controlling interest in our joint venture in Saudi Arabia and $14 million of foreign exchange net gains.marketable equity securities.
We expect expenses from pension and OPEB plans to increasedecrease in 20202022 primarily due to lower discount rates and a lower expected return on assets attributable to the transfer of U.S. pension plan liabilities to an insurance company.prior year actuarial gains that will reduce ongoing benefit costs. Refer to Note 1312 in Item 8 of this Annual Report on Form 10-K for further information regarding pension and OPEB plan expenses.
The following unaudited quarterly financial information is presented to update our previous discussion and analysis giving effect to our restated results, which primarily impacted other (income) expense, net. The related misstatements are described in more detail in Note 2, Restatement of Previously Issued Consolidated Financial Statements, in Item 8, Financial Statements and Supplementary Data.
As Restated
(in millions)For the six months ended June 30, 2019For the three months ended June 30, 2019For the three months ended March 31, 2019
Foreign exchange losses (gains)$14  $15  $(1) 
Pension and other postretirement benefit plans(31) (15) (16) 
Other—   (4) 
Other (income) expense, net$(17) $ $(21) 

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As Restated
(in millions)For the six months ended June 30, 2018For the three months ended June 30, 2018For the three months ended March 31, 2018
Foreign exchange losses (gains)$(29) $(26) $(3) 
Pension and other postretirement benefit plans(26) (14) (12) 
Other11    
Other (income) expense, net$(44) $(38) $(6) 

As Restated
(in millions)For the six months ended June 30, 2017For the three months ended June 30, 2017For the three months ended March 31, 2017
Foreign exchange losses (gains)$42  $19  $23  
Pension and other postretirement benefit plans17    
Venezuela deconsolidation33  33  —  
Other   
Other (income) expense, net$97  $63  $34  
Other (income)In the first quarter of 2021, we began to wind down our operations in Argentina. Upon substantial liquidation of those operations in the future, we expect to reclassify currency translation adjustments (CTA) from accumulated other comprehensive (loss) income to other expense, net and recognize a non-cash charge. As of December 31, 2021, the CTA for our Argentina operations was an expensein excess of $4 million in the three months ended June 30, 2019 compared to income of $38 million in the three months ended June 30, 2018. The change was primarily due to $15 million of foreign exchange net losses in 2019 compared to $26 million of foreign exchange net gains in 2018. Other (income) expense, net was income of $21 million and $6 million in the three months ended March 31, 2019 and 2018, respectively. The increase in 2019 was primarily due to favorable fair value adjustments on marketable equity securities in 2019, an investment impairment in 2018, and higher pension benefits in 2019.$60 million.
Other (income) expense, net was income of $38 million in the three months ended June 30, 2018 compared to expense of $63 million in the three months ended June 30, 2017. The change was primarily due to a $33 million charge related to the deconsolidation of our Venezuelan subsidiary in 2017 and $26 million of foreign exchange net gains in 2018 compared to $19 million of foreign exchange net losses in 2017. Other (income) expense was income of $6 million and expense of $34 million in the three months ended March 31, 2018 and 2017, respectively. The increase in 2018 was primarily due to $3 million of foreign exchange net gains in 2018 compared to $23 million of foreign exchange net losses in 2017. Additionally, we recognized a benefit related to pension and OPEB plans in 2018 compared to a charge in 2017 as a result of the split and freeze of our U.S. pension plans announced in January 2018.
Income Taxes
The effective income tax rate for continuing operations was (4.2%)12.3% in 2019, 4.0%2021 and 14.1% in 2018, and 44.6% in 2017.2020. The special items identified above had a favorable impact of 20.94.5 and 13.72.6 percentage points on the effective income tax rate in 20192021 and 2018 and an unfavorable impact of 25.4 percentage points in 2017.2020, respectively. Refer to the Special Items section above for additional detail.
Our provision foreffective income taxes and our effectivetax rate decreased in 2019 compared to 2018 primarilycan differ from the 21% U.S. federal statutory rate due to special items, the most significanta number of which was the impact of recently enactedfactors, including foreign rate differences, tax reformincentives, increases or decreases in Switzerlandvaluation allowances and India. We recognized a deferredliabilities for uncertain tax benefit of $90 million to reflect a tax basis step-up, net of a valuation allowance, partially offset by a $5 million deferred tax revaluation to reflect an increase in the statutory tax rate, under the newly enacted Swiss tax laws. We also recognized a net deferred tax benefit of $24 million associated with deferred tax revaluation in India to reflect a decrease in the statutory tax rate.
In addition to the Swiss and Indian tax reform impacts, our provision for income taxes and our effective rate decreased in 2019 compared to 2018 due to the recognition of tax benefits associated with a favorable tax ruling, a benefit related to a notional interest deduction on the share capital of a foreign subsidiary,positions and excess tax benefits on stock compensation awards. Partially offsetting
For the decrease intwelve months ended December 31, 2021, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to favorable geographic earnings mix, a partial valuation allowance release against our U.S.$58 million tax benefit related to a tax-deductible foreign deferredstatutory loss on an investment in a foreign subsidiary, a tax assetsbenefit related to a change in 2018 which did not recur in 2019.
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Our provision for income taxes and our effective rate decreased in 2018 compared to 2017 primarily due to special items, the most significant of which was our finalization of our provisional adjustments resulting from the 2017 Tax Act.  SEC Staff Accounting Bulletin 118 (SAB 118) allowed a one-year measurement period from the December 22, 2017 Tax Act enactment date to refine the provisional amounts recognized in the 2017 financial statements.  
We recorded several SAB 118 measurement period provisional adjustments in 2018.  First, after further studying the 2017 Tax Act and related U.S. Treasury Regulations, we refined our provisional estimate of a full valuation allowance against our U.S. foreign tax credit deferredregulations and excess tax assets and releasedbenefits on stock compensation awards, partially offset by an unfavorable court decision in a $194 million valuation allowance dueforeign jurisdiction related to an uncertain tax position.
For the twelve months ended December 31, 2020, the difference between our ability to utilize a portion of our U.S. foreign tax credit deferred tax assets. Second, the 2017 Tax Act requires us to pay U.S. income taxes on accumulated foreign subsidiary earnings not previously subject to U.S.effective income tax at a rate of 15.5% to the extent of foreign cash and certain other net current assets and 8% on the remaining earnings. In 2017, we recognized a provisional charge for our one-time transitional tax expense of $529 million, the majority of which was non-cash.  During 2018, we refined our estimated one-time transition tax expense, recognizing a benefit of $5 million. Third, the 2017 Tax Act lowered the U.S. federal statutory rate from 35%was primarily attributable to 21%favorable geographic earnings mix and generally exempts foreign income from U.S. taxation. We finalized our provisional revaluation of U.S. deferredexcess tax assets, recording an additional $8 million benefit.  benefits on stock compensation awards.
Our tax provisions for 20192021 and 20182020 do not include any tax charges related to either the Base Erosion and Anti-Abuse Tax (BEAT) or Global Intangible Low Taxed Income (GILTI) provisions, except for the inability to fully utilize foreign tax credits against such GILTI.
In additionOur accounting policy is to the 2017 Tax Act SAB 118 measurement period adjustments, our provision for income taxes and our effective rate decreased in 2018 compared to 2017 due to a settlement of a 2008 through 2010 transfer pricing Competent Authority proceeding between the U.S. and Germany, the reversal of a foreign valuation allowancerecognize any GILTI charge as a result of continued profit improvements, and the receipt of tax-free income from the settlement of Claris contingent matters.  Partially offsetting the decrease in the effective tax rate was a decrease in benefits related to deductions in excess of share-based compensation costs (windfall tax benefits), the revaluation of Swedish net deferred tax assets and miscellaneous transfer pricing-related income tax accruals. Refer to Note 14 in Item 8 of this Annual Report on Form 10-K for further information related to the 2017 Tax Act and the finalization of associated SAB 118 provisional adjustments.period cost.
We anticipate that our effective income tax rate, from continuing operations, calculated in accordance with U.S. GAAP, will be approximately 17.5%17% in 2020.2022.  This rate may be further impacted by a number of factors including discrete items, such as tax windfalls or deficiencies attributable to stock compensation exercises as well asawards, additional audit developments, or the tax effects of any future special items.
Net Income from Continuing Operations and Earnings per Diluted Share
Income from continuing operationsNet income was $1.0$1.3 billion in 2019, $1.62021 and $1.1 billion in 2018 and $609 million in 2017. Earnings2020. Diluted earnings per share from continuing operations was $1.93$2.53 in 2019, $2.842021 and $2.13 in 2018 and $1.10 in 2017.2020. The significant factors and events causing the net changes from 20182020 to 2019 and 2017 to 20182021 are discussed above. Additionally, earnings per share from continuing operations was positively impacted by the repurchase of 35.87.3 million shares in 20182021 and 6.3 million shares in 2020 through Rule 10b5-1 purchase plans, an accelerated share repurchase plan and otherwise and the repurchase of 16.5 million shares in 2019 through Rule 10b5-1 purchase plans, an accelerated share repurchase plan and otherwise.plans. Refer to Note 108 in Item 8 of this Annual Report on Form 10-K for further information regarding our stock repurchases.
Loss from Discontinued Operations
Loss from discontinued operations, net of tax was $6 million in 2018 and $7 million in 2017. The operating results related to Baxalta, which have been reflected as discontinued operations, on a net of tax basis, were a loss of $6 million in 2018 and income of $3 million in 2017. Refer to Note 3 in Item 8 of this Annual Report on Form 10-K for additional information regarding the separation of Baxalta. In addition, we recognized an expense of $10 million, net of tax, within discontinued operations in 2017 related to environmental clean-up costs at a former location.  Refer to Note 9 in Item 8 of this Annual Report on Form 10-K for additional information regarding environmental liabilities.
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Segment results
We manage our global operations based on four segments, consisting of the following geographic segments related to our legacy Baxter business: Americas, EMEA and APAC, and a new global segment for our recently acquired Hillrom business. We use net sales and operating income on a segment basis to make resource allocation decisions and assess the ongoing performance of our segments. In the first quarter of 2021, the information provided to our Chief Executive Officer for purposes of allocating resources and assessing performance was updated to reallocate contracted services activities performed at a German manufacturing facility from our EMEA segment to our Americas segment. The contracted services performed at that facility are part of our BioPharma Solutions business, which is managed as part of the Americas segment. Accordingly, the reported financial results of the Americas segment now include the contracted services activities performed at that facility. Segment results for 2020 have been recast to conform to this presentation. Refer to Note 1817 in Item 8 of this Annual Report on Form 10-K for additional details regarding our segments.
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The following is a summary of significant factors impactingfinancial information for our reportable segments’ financial results.
As restatedAs restated
Net salesOperating income
years ended December 31 (in millions)201920182017201920182017
Americas$6,094  $5,951  $5,718  $2,374  $2,411  $2,238  
EMEA2,968  2,946  2,752  652  666  562  
APAC2,300  2,202  2,114  549  532  510  
Corporate and other—  —  —  (1,803) (2,025) (2,022) 
Total$11,362  $11,099  $10,584  $1,772  $1,584  $1,288  
segments.
Net salesOperating income
years ended December 31 (in millions)2021202020212020
Americas$6,666 $6,321 $2,612 $2,389 
EMEA3,115 2,877 632 523 
APAC2,791 2,475 623 591 
Hillrom212  (80)— 
Corporate and other—  (2,077)(1,887)
Total$12,784 $11,673 $1,710 $1,616 
Americas
Segment net sales and operating income in 2021 was $2,374 million, $2,411 million$6.7 billion and $2,238 million$2.6 billion, respectively. Segment net sales and operating income in 2019, 20182020 was $6.3 billion and 2017,$2.4 billion, respectively. The decreaseincrease in 2019operating profit in 2021 was primarily driven by lowerfavorable sales and gross marginperformance in Pharmaceuticals and lower U.S. in-center HD sales, partially offset by favorable performance inour BioPharma Solutions, Medication Delivery and Advanced Surgery primarily due to a temporary supply disruption of a competitor. Additionally, results in 2019 were adversely impactedproduct categories, partially offset by unfavorable foreign exchange rates.performance in Pharmaceuticals.
EMEA
Segment net sales and operating income in 2021 was $3.1 billion and $632 million, respectively. Segment net sales and operating income in 2020 was $2.9 billion and $523 million, respectively. The increase in 2018operating profit in 2021 was primarily driven by increaseddue to the favorable impact of foreign exchange rates on results as compared to the prior-year period and the acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S., which contributed $93 million of net sales and gross margin as a result ofoperating profit to the Claris and RECOTHROM and PREVELEAK acquisitions and higherregion, respectively.
APAC
Segment net sales related to premix injectables. Also driving performance was improved performance in Renal Care, driven primarily by PD growth, and Acute Therapies. Negatively impacting performance in 2018 were the sales challenges in the Medication Delivery and Clinical Nutrition GBUs as previously described.
EMEA
Segment operating income in 2021 was $652$2.8 billion and $623 million, $666respectively. Segment net sales and operating income in 2020 was $2.5 billion and $591 million, and $562 million in 2019, 2018 and 2017, respectively. The decreaseincrease in 2019operating profit in 2021 was primarily driven by unfavorabledue to the favorable impact of foreign exchange rates partially offset by increased local currencyon results as compared to the prior-year period and the acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S., which contributed $13 million of net sales and gross margin in Renal Careoperating profit to the region, respectively.
Hillrom
Segment net sales and Pharmaceuticals.operating loss for 2021 was $212 million and $80 million, respectively. The increase in 2018operating loss in 2021 was primarily driven by higher net sales across multiple GBUs, and improved margins primarily as a resultdue to the acquisition of product mix.
APAC
Segment operating income was $549 million, $532 million and $510 millionHillrom in 2019, 2018 and 2017, respectively. Results in 2019 were driven by higher sales and gross margin, primarily from China and Australia, in Renal Care and Pharmaceuticals. Results in 2018 were driven by higher sales, primarily from China, in Renal Care and Clinical Nutrition.December 2021.
Corporate and other
Certain items are maintained at Corporate and are not allocated to a segment. They primarily include certain foreign currency hedging activities, corporate headquartersheadquarter costs, certain R&D costs, certain GBUproduct categories support costs, stock compensation expense, certain employee benefit plan costs, certain foreign currency hedging activities, and certain gains, losses, and other charges (such as business optimization, acquisition and integration costs, intangible asset amortization and asset impairments). The operating loss in 2019 decreased2021 was higher than 2020 primarily due to higher Hurricane Maria insurance recoveries in the current year, a benefit for our allocation of insurance proceeds received pursuant to a settlement and cost-sharing arrangement for a legacy product-related matter in the current year, lower SG&A and R&D expenses in the current year and lower business optimization charges in the current year, partially offset by an impairment of a developed-technology intangible asset in the current year and the benefit from the Claris settlement in the prior year. The operating loss in 2018 increased due to higher acquisition and integration costs,expenses related to the Hillrom acquisition, higher intangible asset amortization expense and higher business optimization charges, partially offset by Hurricane Maria insurance recoveries and a benefit frombonus accruals under our annual employee incentive compensation plans in the Claris settlement.current year.
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LIQUIDITY AND CAPITAL RESOURCES
Cash Flows from Operations — Continuing Operations
In 2019, 20182021 and 2017,2020, cash provided by operating activities was $2.1 billion, $2.0$2.2 billion and $1.7$1.9 billion, respectively.  Operating cash flows increased in 20192021 primarily due to a lower increase in inventories in 2021 compared to 2020, an increase in our operatingnet income which included the insurance recoveriesin 2021, payments of $173 million to settle interest rate derivative contracts in 2020 and lower
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employee incentive compensation payments in 2021 compared to 2020, partially offset by cash outflows of approximately $47 million in 2021 related to Hurricane MariaHillrom acquisition and a legacy product-related matter. Operating cash flows increased in 2018 compared to 2017 primarily due to an increase in our operating income, which included the Claris settlement received in 2018, and due to lower pension contributions.integration costs.
Cash Flows from Investing Activities
In 2019,2021, cash used for investing activities included payments for acquisitions and investments of $418 million,$10.5 billion, primarily related to CheetahHillrom, Caleyx and multiple product acquisitions,Doxil, Transderm Scop and PerClot, and capital expenditures of $696$743 million. In 2018,2020, cash used for investing activities included payments for acquisitions and investments of $268$494 million, primarily related to RECOTHROMSeprafilm and PREVELEAK and certain molecules from Celerity Pharmaceuticals, LLC (Celerity),multiple product acquisitions, and capital expenditures of $659 million. In 2017, cash used in investing activities included payments for acquisitions of $686 million, primarily related to Claris and the rights to certain molecules from Celerity, and capital expenditures of $616 million.
In December 2019, we entered into a definitive agreement to acquire Seprafilm from Sanofi. The transaction closed in February 2020 and we paid approximately $345 million for the acquired assets, subject to a post-close adjustment. In January 2020, we acquired the U.S. rights to an additional product for $60$709 million.
We expect that our capital expenditures will increase in 20202022 as we make investments in our manufacturing capacity in response to proposed regulatory changes of the U.S. Department of Health and Human Services in kidney health policy and reimbursement, which may substantially change the U.S. end stage renal disease market and demand for our peritoneal dialysis products.
Refer to Note 4 in Item 8 of this Annual Report on Form 10-K for further information about our significant acquisitions and other arrangements.
Cash Flows from Financing Activities
In 2019,2021, cash generated from financing activities included $1.7$11.8 billion to fund the consideration for the Hillrom acquisition, repay certain indebtedness of Hillrom, and to pay fees and expenses related to the foregoing. In September 2021, we entered into a term loan credit agreement (the Term Loan Credit Agreement), pursuant to which a syndicate of financial institutions has committed to provide us with a senior unsecured term loan facility in net proceeds from the issuancean aggregate principal amount of €750$4.0 billion (the Term Loan Facility), consisting of a $2.0 billion three-year term loan and a $2.0 billion five-year term loan. In December 2021, we issued $800 million ofsenior notes due in 2023, $1.4 billion senior notes due in 2024, and €750 million of$1.45 billion senior notes due in 2029, $2222027, $1.25 billion senior notes due in 2028, $1.55 billion senior notes due in 2032, $750 million senior notes due in 2051, $300 million floating rate senior notes due in 2023 and $300 million floating rate senior notes due in 2024. We also had net proceeds from commercial paper borrowings of borrowings under our Euro-denominated credit facility,$300 million and stock issued under employee benefit plansrepaid debt obligations of $356 million, partially offset by$2.8 billion, including $2.4 billion of debt that was assumed in the Hillrom acquisition. Financing activities in 2021 also included payments for treasury stock repurchases of $1.3 billion and$600 million, dividend payments of $423 million. In 2018, cash used for financing activities included payments for stock repurchases of $2.5 billion$530 million and dividend payments of $376 million, partially offset by the proceedsreceipts from stock issued under employee benefit plans of $258$187 million.
In 2017,2020, cash generated from financing activities included $665 million in$1.2 billion of net proceeds from the March 2020 issuance of €600$750 million of senior notes due in May 2025 and $500 million of senior notes due in 2030. In November 2020, we issued $650 million of senior notes due in 2031 and used the proceeds, along with cash on hand, to redeem the $750 million senior notes due in 2025 that were issued in March 2020 for $854 million, which included a $104 million make-whole premium. We have used the net proceeds from those senior notes issuances and redemptions for general corporate purposes, including to strengthen our balance sheet as a precautionary measure in light of the COVID-19 pandemic. In 2020, we also repaid $322 million of variable rate notes that matured and the borrowings under our Euro-denominated credit facility of €200 million ($225 million). Financing activities in 2020 also included payments for stock repurchases of $500 million, dividend payments of $473 million and receipts from stock issued under employee benefit plans of $347 million, partially offset by payments for stock repurchases of $564 million and dividend payments of $315$202 million.
As authorized by the Board of Directors, we repurchase our stock depending upon our cash flows, net debt levels and market conditions. In July 2012, the Board of Directors authorized the repurchase of up to $2.0 billion of our common stock. The Board of Directors increased this authority by an additional $1.5 billion in each of November 2016 and February 2018, and by an additional $2.0 billion in November 2018.2018 and by an additional $1.5 billion in October 2020. We paid $1.3 billion$600 million in cash to repurchase approximately 16.57.3 million shares under this authority pursuant to Rule 10b5-1 plans and otherwise in 20192021 and had $897 million$1.3 billion remaining available under this authorization as of December 31, 2019.
In December 2018, we entered into a $300 million accelerated share repurchase agreement (ASR Agreement) with an investment bank. We funded the ASR Agreement with available cash. Under the ASR Agreement, we received 3.6 million shares upon execution. Based on the volume-weighted average price of our common stock during the term of the ASR Agreement, we received an additional 0.6 million shares from the investment bank at settlement on May 7, 2019.
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2021.
Credit Facilities and Access to Capital and Credit Ratings
Credit Facilities
As of December 31, 2019, ourOn September 30, 2021, we entered into a new U.S. dollar-denominated revolving credit facility had capacity of $2.0 billion.(the USD Revolver) and on October 1, 2021, we amended our existing Euro-denominated revolving credit facility (as amended, the Euro Revolver). As of December 31, 2019,2021, our Euro-denominated senior revolving credit facilityUSD Revolver had capacity of $2.5 billion and our Euro Revolver had a capacity of approximately €200 million. Each of the facilities matures in 2024. There was no amount outstanding2026. The facilities enable us to borrow funds on an unsecured basis at variable interest rates, and contain various covenants, including a maximum net
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leverage ratio. Fees under our U.S. dollar-denominatedthe credit facilityfacilities are 0.09% annually as of December 31, 20192021 and are based on our credit ratings and the total capacity of the facility. Prior to entering into the USD Revolver and the Euro Revolver, our previous U.S. dollar-denominated revolving credit facility and Euro-denominated senior revolving credit facility had a maximum capacity of $2.0 billion and €200 million, ($224 million) outstanding at a 0.9% interest raterespectively. Fees under our Euro-denominatedthese credit facilityfacilities were 0.09% annually as of December 31, 2019.2020 and were based on our credit ratings and the total capacity of the facility. There were no amounts outstandingborrowings under ourthese credit facilities as of December 31, 2018.2021 or December 31, 2020. As of December 31, 2019,2021, we were in compliance with the financial covenants in these agreements. The non-performance of any financial institution supporting either of the credit facilities would reduce the maximum capacity of these facilities by eachthe institution’s respective commitment.  
We also maintain other credit arrangements, as described in Note 75 in Item 8 of this Annual Report on Form 10-K.
Access to Capital and Credit Ratings
We intend to fund short-term and long-term obligations as they mature through cash on hand and future cash flows from operations or by issuing additional debt. We had $3.3$3.0 billion of cash and cash equivalents as of December 31, 2019,2021, with adequate cash available to meet operating requirements in each jurisdiction in which we operate. We invest our excess cash in money market and other funds and diversify the concentration of cash among different financial institutions. As of December 31, 2021, we had approximately $17.7 billion of long-term debt and finance lease obligations, including current maturities, and short-term debt. Subject to market conditions and our investment grade targets, we regularly evaluate opportunities with respect to our capital structure.
Our ability to generate cash flows from operations, issue debt, including commercial paper, or enter into other financing arrangements on acceptable terms could be adversely affected if there is a material decline in the demand for our products or in the solvency of our customers or suppliers, deterioration in our key financial ratios or credit ratings or other significantly unfavorable changes in conditions. However, we believe we have sufficient financial flexibility to issue debt, enter into other financing arrangements and attract long-term capital on acceptable terms to support our growth objectives.objectives and reduce our post-acquisition debt levels.
Our credit ratings at December 31, 20192021 were as follows:
Standard & Poor’sFitchMoody’s
Ratings
Senior debtA-BBBA-BBBBaa1Baa2
Short-term debtA2F2P2
OutlookStableStableStable
Our senior debt credit ratings were downgraded in 2021 as a result of the debt we issued to fund the Hillrom acquisition.
LIBOR Reform

In 2017, the United Kingdom’s Financial Conduct Authority announced that after 2021 it would no longer compel banks to submit the rates required to calculate the London Interbank Offered Rate (LIBOR) and other interbank offered rates, which have been widely used as reference rates for various securities and financial contracts, including loans, debt and derivatives. This announcement indicated that the continuation of LIBOR on the current basis was not guaranteed after 2021. Regulators in the U.S. and other jurisdictions have been working to replace these rates with alternative reference interest rates that are supported by transactions in liquid and observable markets, such as the Secured Overnight Financing Rate (SOFR). In 2020, it was announced that certain U.S. dollar LIBOR tenors would not cease until 2023. Currently, our $2.5 billion U.S. dollar-denominated revolving credit facility, our €200 million Euro-denominated revolving credit facility and our $4.0 billion Term Loan Credit Agreement reference LIBOR-based rates. The discontinuation of LIBOR will require these arrangements to be modified in order to replace LIBOR with an alternative reference interest rate, which could impact our cost of funds. Our credit facilities and term loan credit agreement include provisions related to the determination of a successor LIBOR rate.
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Contractual Obligations
As of December 31, 2019,2021, we had contractual obligations, excluding accounts payable and accrued expenses and other current liabilities, payable or maturing in the following periods.
(in millions)(in millions)TotalLess than
one year
One to
three years
Three to
five years
More than
five years
(in millions)TotalLess than
one year
More than one year
Short-term debt$226  $226  $—  $—  $—  
Long-term debt and finance lease obligations, including current maturitiesLong-term debt and finance lease obligations, including current maturities5,160  315  609  843  3,393  Long-term debt and finance lease obligations, including current maturities$17,754 $513 $17,241 
Interest on short- and long-term debt and finance lease obligations 1
Interest on short- and long-term debt and finance lease obligations 1
1,436  112  209  194  921  
Interest on short- and long-term debt and finance lease obligations 1
3,036 347 2,689 
Operating leasesOperating leases676  112  176  121  267  Operating leases706 141 565 
Other non-current liabilities2
Other non-current liabilities2
407  —  127  50  230  
Other non-current liabilities2
590 — 590 
Purchase obligations3
Purchase obligations3
571  311  163  90   
Purchase obligations3
1,530 761 769 
Contractual obligations2
Contractual obligations2
$8,476  $1,076  $1,284  $1,298  $4,818  
Contractual obligations2
$23,616 $1,762 $21,854 
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1.
1.Interest payments on debt and finance lease obligations are calculated for future periods using interest rates in effect at the end of 2019.2021. Certain of these projected interest payments may differ in the future based on changes in floating interest rates, foreign currency fluctuations or other factors or events. The projected interest payments only pertain to obligations and agreements outstanding at December 31, 2019.2021. Refer to Note 75 and Note 8,6, respectively, in Item 8 of this Annual Report on Form 10-K for further discussion regarding our debt instruments outstanding and finance lease obligations at December 31, 2019.2021.
2.The primary components of other non-current liabilities in our consolidated balance sheet as of December 31, 20192021 are pension and other postretirement benefits, deferred tax liabilities, long-term tax liabilities, interest rate contracts, and litigation and environmental reserves. We projected the timing of the related future cash payments based on contractual maturity dates (where applicable) and estimates of the timing of payments (for liabilities with no contractual maturity dates). The actual timing of payments could differ from our estimates.
We contributed $69 million, $51$73 million and $242$74 million to our defined benefit pension plans in 2019, 2018,2021 and 2017,2020, respectively. The timing of funding in future periods is uncertain and is dependent on future movements in interest rates, investment returns, changes in laws and regulations, and other variables. Therefore, the table above excludes cash outflows related to our pension plans. The amount included within other non-current liabilities (and excluded from the table above) related to our pension plan liabilities was $1.1 billion$858 million as of December 31, 2019.2021. In 2020,2022, we have no obligation to fund our principal plans in the United States and we expect to make contributions of at least $5 million to our Puerto Rico plans and $41 million to our foreign pension plans. Additionally, we have excluded long-term tax liabilities, related towhich include liabilities for unrecognized tax positions, and deferred tax liabilities from the table above because we are unable to estimate the timing of the related cash outflows. The amounts of long-term tax liabilities related to unrecognized tax positions and deferred tax liabilities included within other non-current liabilities (and excluded from the table above) were $81$80 million and $192$962 million, respectively, as of December 31, 2019.2021.
3.Includes our significant contractual unconditional purchase obligations. For cancellable agreements, any penalty due upon cancellation is included. These commitments do not exceed our projected requirements and are in the normal course of business. Examples include firm commitments for raw material and component part purchases, utility agreements and service contracts.
Off-Balance Sheet Arrangements
We periodically enter into off-balance sheet arrangements. Certain contingencies arise in the normal course of business and are not recorded in the consolidated balance sheets in accordance with U.S. GAAP (such as contingent joint development and commercialization arrangement payments). Also, upon resolution of uncertainties, we may incur charges in excess of presently established liabilities for certain matters (such as contractual indemnifications). For a discussion of our significant off-balance sheet arrangements, refer to Note 1615 in Item 8 of this Annual Report on Form 10-K for information regarding receivable transactions, and Note 42 and Note 97 in Item 8 of this Annual Report on Form 10-K for information regarding joint development and commercialization arrangements, indemnifications and legal contingencies.
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FINANCIAL INSTRUMENT MARKET RISK
We operate on a global basis and are exposed to the risk that our earnings, cash flows and equity could be adversely impacted by fluctuations in foreign exchange and interest rates. Our hedging policy attempts to manage these risks to an acceptable level based on our judgment of the appropriate trade-off between risk, opportunity and costs. Refer to Note 1615 and Note 1716 in Item 8 of this Annual Report on Form 10-K for further information regarding our financial instruments and hedging strategies.
Currency Risk
We are primarily exposed to foreign exchange risk with respect to revenues generated outside of the United States denominated in the Euro, British Pound, Chinese Yuan,Renminbi, Korean Won, Australian Dollar, Canadian Dollar, Japanese Yen, Colombian Peso, Brazilian Real, Mexican Peso, Turkish Lira, Indian Rupee and Swedish Krona. We manage our foreign currency exposures on a consolidated basis, which allows us to net exposures and take advantage of any natural offsets. In addition, we use derivative and nonderivative financial instruments to further reduce the net exposure to foreign exchange.exchange, however these instruments may be unavailable or inefficient in emerging or volatile markets. Gains and losses on the hedging instruments offset losses and gains on the hedged transactions and reduce the earnings and stockholders’ equity volatility relating to foreign exchange. However, we don't hedge our
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entire foreign exchange exposure and are still subject to earnings and stockholders' equity volatility relating to foreign exchange risk. Financial market and currency volatility may limit our ability to cost-effectively hedge these exposures.
We use options and forwards to hedge the foreign exchange risk to earnings relating to forecasted transactions denominated in foreign currencies and recognized assets and liabilities.liabilities denominated in foreign currencies. The maximum term over which we have cash flow hedge contracts in place related to foreign exchange risk on forecasted transactions as of December 31, 20192021 is 12 months. We also enter into derivative instruments to hedge foreign exchange risk on certain intra-company and third-party receivables and payables and debt denominated in foreign currencies.
As part of our risk-management program, we perform sensitivity analyses to assess potential changes in the fair value of our foreign exchange instruments relating to hypothetical and reasonably possible near-term movements in foreign exchange rates.
A sensitivity analysis of changes in the fair value of foreign exchange option and forward contracts outstanding as of December 31, 2019,2021, while not predictive in nature, indicated that if the U.S. Dollar uniformly weakened by 10% against all currencies, on a net-of-tax basis, the net pre-tax asset balance of $7$3 million with respect to those contracts would decreasechange by $15 million, resulting in a net liability position.$34 million. A similar analysis performed with respect to option and forward contracts outstanding as of December 31, 20182020 indicated that, on a net-of-taxpre-tax basis, the net assetliability balance of $16$8 million would decreasechange by $26 million, resulting in a net liability position.$32 million.
The sensitivity analysis model recalculates the fair value of the foreign exchange option and forward contracts outstanding as of December 31, 20192021 by replacing the actual exchange rates as of December 31, 20192021 with exchange rates that are 10% weaker compared to the actual exchange rates for each applicable currency. All other factors are held constant. These sensitivity analyses disregard the possibility that currency exchange rates can move in opposite directions and that gains from one currency may or may not be offset by losses from another currency. The analyses also disregard the offsetting change in value of the underlying hedged transactions and balances.
Our operationssubsidiary in Argentina areis reported using highly inflationary accounting effective July 1, 2018.  Changes in the value of the Argentine peso applied to our peso-denominated net monetary asset positions are recorded in income at the time of the change.  As of December 31, 2019,2021, our net monetary assets denominated in Argentine pesos are not significant.
Interest Rate and Other RisksRisk
We are also exposed to the risk that our earnings and cash flows could be adversely impacted by fluctuations in interest rates. Our policy is to manage interest costs using athe mix of fixed- and floating-rate debt that we believe is appropriate.appropriate at that time. To manage this mix in a cost-efficient manner, we periodically enter into interest rate swaps in which we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount. We also periodically use forward-starting interest rate swaps and treasury rate locks to hedge the risk to earnings associated with fluctuations in interest rates relating to anticipated issuances of term debt.
As of December 31, 2019, $4.8 billion of our outstanding debt obligations2021, there were at fixed interest rates, representing approximately 94 percent of our total debt. We hadno interest rate derivative instrumentscontracts outstanding with a notional amountand we had approximately $4.9 billion of $550 million and $150 million as of December 31, 2019 and 2018, respectively.outstanding floating rate debt. A one percent100 basis point change in
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interest rates would impact the fair value of our interest rate derivative contractsout pre-tax earnings and cash flows by approximately $116 million.$49 million over a one-year period.
CHANGES IN ACCOUNTING STANDARDS
Refer to Note 1 in Item 8 of this Annual Report on Form 10-K for information on changes in accounting standards.
RECENT ACCOUNTING PRONOUNCEMENTS
In June 2016,July 2021, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2016-13, Financial Instruments - Credit Losses,2021-05, Leases (Topic 842), which requires a lessor to classify a lease with variable lease payments (that do not depend on an index or rate) as an operating lease if (1) the measurement of expected credit losseslease would have been classified as a sales-type or direct financing lease, and (2) the lessor would have recognized a selling loss at lease commencement. These changes are intended to avoid recognizing a day-one loss for financial instruments held ata lease with variable payments even though the reporting date based on historical experience, current conditions and reasonable forecasts. The main objective of this ASU is to provide financial statement users with more decision-useful information aboutlessor expects the expected credit losses on financial instruments and other commitments to extend credit held
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by a reporting entity at each reporting date.arrangement will be profitable overall. The standard is effective for our financial statements beginning in 2020.2022. The impact of the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software, which aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The standard is effective for our financial statements beginning in 2020. Our policies for capitalizing implementation costs incurred in a hosting arrangement are not expected to be impacted by this ASU. However, we have historically classified those capitalized costs within property, plant and equipment, net on our consolidated balance sheets and as capital expenditures on our consolidated statements of cash flows. Under the new ASU, those capitalized costs will be presented as other non-current assets on our consolidated balance sheets and within operating cash flows on our consolidated statements of cash flows. The impact of those classification changes following the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
CRITICAL ACCOUNTING POLICIES
The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses. A summary of our significant accounting policies is included in Note 1 in Item 8 of this Annual Report on Form 10-K. Certain of our accounting policies are considered critical, as these policies are the most important to the depiction of our financial statements and require significant, difficult or complex judgments by us, often employing the use of estimates about the effects of matters that are inherently uncertain. Actual results that differ from our estimates could have an unfavorable effect on our results of operations and financial position. The following is a summary of accounting policies that we consider critical to the consolidated financial statements.
Revenue Recognition and Related Provisions and Allowances
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates product returns, sales discounts and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales. Our estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. Additionally, our contracts with customers often include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately and determining the allocation of the transaction price may require significant judgment.
The new standard related to revenue recognition that was effective January 1, 2018 has not had a material impact on our consolidated financial statements as compared to historical revenue recognition guidelines. Refer to Note 1 within Item 8 of this Annual Report on Form 10-K for further information.
Pension and OPEB Plans
We provide pension and other postretirement benefits to certain of our employees. The service component of employee benefit expenses is reported in the same line items in the consolidated income statements as the applicable employee’s compensation expense. All other components of these employee benefit expenses are reported in other (income) expense, net in our consolidated statements of income. The valuation of the funded status and net periodic benefit cost for the plans is calculated using actuarial assumptions. These assumptions are reviewed annually and revised if appropriate. The significant assumptions include the following:
interest rates used to discount pension and OPEB plan liabilities;
the long-term rate of return on pension plan assets;
rates of increases in employee compensation (used in estimating liabilities);
anticipated future healthcare trend rates (used in estimating the OPEB plan liability); and
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other assumptions involving demographic factors such as retirement, mortality and turnover (used in estimating liabilities).
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Selecting assumptions involves an analysis of both short-term and long-term historical trends and known economic and market conditions at the time of the valuation (also called the measurement date). The use of different assumptions would result in different measures of the funded status and net cost. Actual results in the future could differ from expected results.
Our key assumptions are listed in Note 1312 in Item 8 of this Annual Report on Form 10-K. The most critical assumptions relate to the plans covering U.S. and Puerto Rico employees, because these plans are the most significant to our consolidated financial statements.
Discount Rate Assumption
Effective for the December 31, 20192021 measurement date, we utilized discount rates of 3.44%3.01% and 3.16%2.76% to measure our benefit obligations for theour most significant U.S. and Puerto Rico pension plans and OPEB plan, respectively. We used a broad population of approximately 200 Aa-rated corporate bonds as of December 31, 20192021 to determine the discount rate assumption. All bonds were denominated in U.S. dollars, with a minimum amount outstanding of $50 million. This population of bonds was narrowed from a broader universe of approximately 700 Moody’s Aa rated, non-callable (or callable with make-whole provisions) bonds by eliminating the top 10th percentile and bottom 40th percentile to adjust for any pricing anomalies and to represent the bonds we would most likely select if we were to actually annuitize our pension and OPEB plan liabilities. This portfolio of bonds was used to generate a yield curve and associated spot rate curve to discount the projected benefit payments for the U.S. and Puerto Rico plans. The discount rate is the single level rate that produces the same result as the spot rate curve.
For plans in Canada, Japan, the United Kingdom and other European countries, we use a method essentially the same as that described for the U.S. and Puerto Rico plans. For our other international plans, the discount rate is generally determined by reviewing country- and region-specific government and corporate bond interest rates.
To understand the impact of changes in discount rates on pension and OPEB plan cost, we perform a sensitivity analysis. Holding all other assumptions constant, for each 50 basis point (i.e., one-half of one percent) increase in the discount rate, global pre-tax pension and OPEB plan cost would decrease by approximately $22$30 million, and for each 50 basis point decrease in the discount rate, global pre-tax pension and OPEB plan cost would increase by approximately $28$35 million.
Return on Plan Assets Assumption
In measuring the net periodic cost for 2019,2021, we used a long-term expected rate of return of 6.29%5.5% for theour most significant pension plans covering U.S. and Puerto Rico employees. This assumption will increasedecrease to 6.50%5% in 2020.2022. This assumption is not applicable to our OPEB plan because it is not funded.
We establish the long-term asset return assumption based on a review of historical compound average asset returns, both company-specific and relating to the broad market (based on our asset allocation), as well as an analysis of current market and economic information and future expectations. The current asset return assumption is supported by historical market experience for both our actual and targeted asset allocation. In calculating net pension cost, the expected return on assets is applied to a calculated value of plan assets, which recognizes changes in the fair value of plan assets in a systematic manner over five years. The difference between this expected return and the actual return on plan assets is a component of the total net unrecognized gain or loss and is subject to amortization in the future.
To understand the impact of changes in the expected asset return assumption on net cost, we perform a sensitivity analysis. Holding all other assumptions constant, for each 50 basis point increase (decrease) in the asset return assumption, global pre-tax pension plan cost would decrease (increase) by approximately $13$15 million.
Other Assumptions
For the U.S. and Puerto Rico plans, beginning with the December 31, 2019 measurement date, we used the Pri-2012 combined mortality table with improvements projected using the MP-2019 projection scale adjusted to a
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long-term improvement of 0.8%. as of December 31, 2021. For all other pension plans, we utilized country- and region-specific mortality tables to calculate the plans’ benefit obligations. We periodically analyze and update our assumptions concerning demographic factors such as retirement, mortality and turnover, considering historical experience as well as anticipated future trends.
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The assumptions relating to employee compensation increases and future healthcare costs are based on historical experience, market trends, and anticipated future company actions. Refer to Note 13 in Item 8 of this Annual Report on Form 10-K for information regarding the sensitivity of the OPEB plan obligation and the total of the service and interest cost components of OPEB plan cost to potential changes in future healthcare trend rates.
Deferred Tax Asset Valuation Allowances and Reserves for Uncertain Tax Positions and Tax Reform
We maintain valuation allowances unless it is more likely than not that all or a portion of the deferred tax asset will be realized. Changes in valuation allowances are included in our tax provision in the period of change. In determining whether a valuation allowance is warranted, we evaluate factors such as prior earnings history, expected future earnings, carryback and carryforward periods, and tax strategies that could potentially enhance the likelihood of realization of a deferred tax asset. The realizability assessments made at a given balance sheet date are subject to change in the future, particularly if earnings of a subsidiary are significantly higher or lower than expected, or if we take operational or tax planning actions that could impact the future taxable earnings of a subsidiary.
In the normal course of business, we are audited by federal, state and foreign tax authorities, and are periodically challenged regarding the amount of taxes due. These challenges relate to the timing and amount of deductions and the allocation of income among various tax jurisdictions. We believe our tax positions comply with applicable tax law and we intend to defend our positions. In evaluating the exposure associated with various tax filing positions, we record reserves for uncertain tax positions in accordance with U.S. GAAP based on the technical support for the positions, our past audit experience with similar situations, and potential interest and penalties related to the matters. Our results of operations and effective tax rate in a given period could be impacted if, upon final resolution with taxing authorities, we prevail in positions for which reserves have been established, or we are required to pay amounts in excess of established reserves.
OnRealization of the U.S. and foreign operating loss and tax credit carryforwards depends on generating sufficient future earnings. A valuation allowance of $401 million and $454 million was recognized as of December 22, 2017,31, 2021 and 2020, respectively, to reduce the 2017 Tax Act was enacted into lawdeferred tax assets associated with net operating loss and tax credit carryforwards because we do not believe it is more likely than not that these assets will be fully realized prior to expiration. After evaluating relevant U.S. tax laws, any elections or other opportunities that may be available, and the new legislation contains several keyfuture expiration of certain U.S. tax provisions that affected us, including a one-time mandatory transitionwill impact the utilization of our U.S. foreign tax on accumulated foreign earnings and a reductioncredit carryforwards, management expects to be able to realize some, but not all, of the U.S. corporate incomeforeign tax rate to 21% effective January 1, 2018, among others. We were required to recognize the effect of the tax law changes in the period of enactment, such as determining the transition tax, remeasuring our U.S.credit deferred tax assets up to its overall domestic loss (ODL) balance plus other recurring and liabilitiesnon-recurring foreign inclusions. Therefore, a valuation allowance of $98 million and reassessing$157 million was recognized with respect to the realizabilityforeign tax credit carryforwards as of our deferred tax assets. In December 2017,31, 2021 and 2020, respectively. We will continue to evaluate the SEC staff issued SAB 118 which allowed us to record provisional amounts during a measurement period not to extend beyond one year ofneed for additional valuation allowances and, as circumstances change, the enactment date. We completed our analysis in accordance with SAB 118 and finalized the accounting for the initial impact of the 2017 Tax Act in 2018. Refer to Note 14 within Item 8 of this Annual Report on Form 10-K for further information.valuation allowance may change.
Valuation of Intangible Assets, Including IPR&D
As a result of our acquisition of Hillrom in December 2021, our intangible asset balance increased to $7.8 billion as of December 31, 2021 compared to $1.7 billion as of December 31, 2020. We record acquired intangible assets at fair value in business combinations and at cost in asset acquisitions. Valuations are generally completed for intangible assets acquired in business acquisitions using a discounted cash flow analysis (an income approach), incorporating the stage of completion and consideration of market participant assumptions. The most significant estimates and assumptions inherent in a discounted cash flow analysis (an income approach) include the amount and timing of projected future cash flows, the discount rate used to measure the risks inherent in the future cash flows, the assessment of the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and the competitive and other trends impacting the asset, including consideration of technical, legal, regulatory, economic and other factors.customer attrition rate. Each of these factors and assumptions can significantly affect the value of the intangible asset.
Acquired in-process R&D (IPR&D) is the value assigned to acquired technology or products under development which have not received regulatory approval and have no alternative future use. Acquired IPR&D includedacquired in a business combination is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval of the related technology or product, the indefinite-lived intangible asset is then accounted for as a finite-lived intangible asset and amortized on a straight-line basis over its estimated useful life. If the R&D project is abandoned, the indefinite-lived intangible asset is charged to expense.
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IPR&D acquired in transactions that are not business combinations is expensed immediately. For such transactions, payments made to third parties on or after regulatory approval are capitalized as intangible assets and amortized over the remaining useful life of the related asset, and are classified as intangible assets.asset.
Due to the inherent uncertainty associated with R&D projects, there is no assurance that actual results will not differ materially from the underlying assumptions used to prepare discounted cash flow analyses, nor that the R&D project will result in a successful commercial product.
Due to a change in the timing and amount of projected cash flows associated with $140 million of acquired in-process R&D intangible assets from a historical acquisition, we updated the estimated fair values of these assets in 2021. While no impairment has been recorded because the estimated fair values of those assets exceeded their carrying values, the estimated excess of fair value over carrying value of these assets further declined in 2021 and are at risk of future impairment should the estimated timing or amount of projected cash flows further deteriorate.
In 2021, we changed the measurement date of our annual indefinite-lived intangible asset impairment tests from December 31st to November 1st. This change better aligns the timing of the impairment tests with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
CERTAIN REGULATORY MATTERS

The U.S. Food and Drug Administration (FDA) commenced an inspection of Claris’ facilities in Ahmedabad, India in July 2017, immediately prior to the closing of the Claris acquisition. FDA completed the inspection and subsequently issued a Warning Letter based on observations identified in the 2017 inspection (Claris Warning Letter).1 While¹ Due to challenges with the ongoing COVID-19 pandemic, FDA has not yet re-inspected the facilities and management cannot speculate on when the Claris Warning Letter will be lifted. However, we are continuing to implement corrective and preventive actions to address FDA’s prior observations and other items we identified in connection with integrating Claris into our quality systems.
While management cannot speculate on when the Claris Warning Letter will be lifted,and management continues to pursue and implement other manufacturing locations, including contract manufacturing organizations, to support the production of new products for distribution in the U.S. in the meantime. As of December 31, 2019,previously disclosed, we have secured alternative locations to produce a majority of the planned new products to be manufactured in Ahmedabad for distribution into the U.S.
On May 6, 2019, we received a Show Cause Notice under the Drugs & Cosmetics Act, 1940 and Rules thereunder (Show Cause Notice)are producing new products from the Commissioner of the Food & Drugs Control Administration in the Gujarat State in Gandhinagar, India (Commissioner). The Show Cause Notice was issued regarding an April 9, 2019 inspection of our Claris facilities in Ahmedabad, India by the Commissioner. The Show Cause Notice contained a number of observations of alleged Good Manufacturing Practice related issues across a variety of areas, some of which overlap with the areas covered in the Claris 483 or the Claris Warning Letter. We responded to the Show Cause Notice and a follow up inspection occurred in July 2019.No further action has been undertaken by the Gujarat authorities.
In June 2013, we received a Warning Letter from FDA regarding operations and processes at our North Cove, North Carolina and Jayuya, Puerto Rico facilities. We attended Regulatory Meetings with FDA regarding one or both of these facilities in October 2014, November 2015, July 2017, April 2018 and October 2018. The Warning Letter addresses observations related to Current Good Manufacturing Practice violations at the two facilities. The Warning Letter was closed out in September 2019.
As previously disclosed, in the fourth quarter of 2012, we received two investigative demands from the United States Attorney for the Western District of North Carolina for information regarding our quality and manufacturing practices and procedures at our North Cove facility. In January 2017, the parties resolved the matter by entering into a deferred prosecution agreement and a civil settlement whereby we agreed to pay approximately $18 million and implement certain enhanced compliance measures. In July 2019, the deferred prosecution agreement expired and, based on our fulfillment of the terms of the agreement, the court dismissed the criminal information previously filed in the case with prejudice.those locations.
Refer to Item 1A of this Annual Report on Form 10-K for additional discussion of regulatory matters and how they may impact us.
1 Available online at https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm613538.htm
FORWARD-LOOKING INFORMATION
This annual report includes forward-looking statements. Use of the words “may,” “will,” “would,” “could,” “should,” “believes,” “estimates,” “projects,” “potential,” “expects,” “plans,” “seeks,” “intends,” “evaluates,” “pursues,” “anticipates,” “continues,” “designs,” “impacts,” “affects,” “forecasts,” “target,” “outlook,” “initiative,” “objective,” “designed,” “priorities,” “goal,” or the negative of those words or other similar expressions is intended to identify forward-looking statements that represent our current judgment about possible future events. These forward-looking statements may include statements with respect to accounting estimates and assumptions, impacts of the COVID-19 pandemic, litigation-related matters including outcomes, impacts of the internal investigation related to foreign exchange gains and losses, and the
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material weakness identified as a result thereof, future regulatory filings and our R&D pipeline, strategic objectives, sales from new product offerings, credit exposure to foreign governments, potential developments with respect to credit ratings, investment of foreign earnings, estimates of liabilities including those related to uncertain tax positions, contingent payments, future pension plan contributions, costs, discount rates and rates of return, our exposure to financial market volatility and foreign currency and interest rate risks, potential tax liability associated with the separation of our biopharmaceuticals and medical products businesses, the impact of competition, future sales growth, business development activities (including the acquisitions of Cheetah, Seprafilm, certain outside of the U.S. (OUS) rights to Caelyx and Seprafilm from Sanofi)Doxil, full U.S. and specific OUS rights to Transderm Scop, PerClot and Hillrom), business optimization initiatives, cost saving initiatives, future capital and R&D expenditures, future debt issuances, manufacturing expansion, the sufficiency of our facilities and financial flexibility, the adequacy of credit facilities, tax provisions and reserves, the effective tax rate and all other statements that do not relate to historical facts.

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These forward-looking statements are based on certain assumptions and analyses made in light of our experience and perception of historical trends, current conditions, and expected future developments as well as other factors that we believe are appropriate in the circumstances. While these statements represent our judgment on what the future may hold, and we believe these judgments are reasonable, these statements are not guarantees of any events or financial results. Whether actual future results and developments will conform to expectations and predictions is subject to a number of risks and uncertainties, including the following factors, many of which are beyond our control:

failure to achieve our long-term financial improvement goals;

demand for and market acceptance risks for and competitive pressures related to new and existing products (including challenges with our ability to accurately predict these pressureschanging consumer preferences and needs and advances in technology and the resulting impact on customer inventory levels)levels and the impact of reduced hospital admission rates and elective surgery volumes), and the impact of those products on quality and patient safety concerns;

product development risks, including satisfactory clinical performance, the ability to manufacture at appropriate scale, and the general unpredictability associated with the product development cycle;

our ability to finance and develop new products or enhancements on commercially acceptable terms or at all;

our ability to identify business development and growth opportunities and to successfully execute on business development strategies;

product quality or patient safety issues, leading to product recalls, withdrawals, launch delays, warning letters, import bans, sanctions, seizures, litigation, or declining sales;

the impact of global economic conditions (including potential trade wars) and public health crises and epidemics, such as the ongoing COVID-19 pandemic, on us and our employees, customers and suppliers, including foreign governments in countries in which we operate;
the continuity, availability and pricing of acceptable raw materials and component supply,parts, and the related continuity of our manufacturing and distribution;distribution (including impacts from COVID-19) and those of our suppliers;

inability to create additional production capacity in a timely manner or the occurrence of other manufacturing, sterilization or supply difficulties (including as a result of natural disaster, public health crises and epidemics/pandemics, regulatory actions or otherwise);

our ability to identify business development and growth opportunities and to successfully execute on business development strategies (including the Hillrom acquisition and related restructuring activities);
product quality or patient safety issues, leading to product recalls, withdrawals, launch delays, warning letters, import bans, sanctions, seizures, litigation, or declining sales;
breaches or failures of our information technology systems or products, including by cyber-attack, data leakage, unauthorized access or theft;theft (as a result of increased remote working arrangements or otherwise);

future actions of (or failures to act or delays in acting by) FDA, the European Medicines Agency or any other regulatory body or government authority (including the SEC, DOJ or the Attorney General of any State) that could delay, limit or suspend product development, manufacturing or sale or result in seizures, recalls, injunctions, monetary sanctions or criminal or civil liabilities, including the continued delay in lifting the warning letter at our Ahmedabad facility or proceedings related to the misstatements in previously reported non-operating income related to foreign exchange gains and losses;facility;

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the impacts of the material weakness identified as a result of the internal investigation related to foreign exchange gains and losses and our remediation efforts, including the risk that we may experience additional material weaknesses;

developments that would require the correction of additional misstatements in our previously issued financial statements;

failures with respect to our environmental, quality, compliance or ethics programs;
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future actions of third parties, including third-party payers and our customers and distributors (including GPOs and IDNs), the impact of healthcare reform and its implementation, suspension, repeal, replacement, amendment, modification and other similar actions undertaken by the United States or foreign governments, including with respect to pricing, reimbursement, taxation and rebate policies; legislation, regulation and other governmental pressures in the United States or globally, including the cost of compliance and potential penalties for purported noncompliance thereof, all of which may affect pricing, reimbursement, taxation and rebate policies of government agencies and private payers or other elements of our business, including new or amended laws, rules and regulations (such as the California Consumer Privacy Act of 2018, the European Union’s General Data Protection Regulation and proposed regulatory changes of the U.S. Department of Health and Human Services in kidney health policy and reimbursement, which may substantially change the U.S. end stage renal disease market and demand for our peritoneal dialysis products, necessitating significant multi-year capital expenditures, which are difficult to estimate in advance, for example)advance);

the outcome of pending or future litigation, including the opioid litigation and current or future ethylene oxide litigation or other claims;
the outcome of pending or future litigation or government investigations, including the opioid litigationfailure to achieve our short- and litigation long-term financial improvement goals;related to our internal investigation of foreign exchange gains and losses;

the impact of competitive products and pricing, including generic competition, drug reimportation and disruptive technologies;

global regulatory, trade and tax policies;policies (including with respect to climate change and other sustainability matters);

the ability to protect or enforce our owned or in-licensed patent or other proprietary rights (including trademarks, copyrights, trade secrets and know-how) or patents of third parties preventing or restricting our manufacture, sale or use of affected products or technology;

the impact of any goodwill or other intangible asset impairments on our operating results;

any failure by Baxalta or Shire to satisfy its obligations under the separation agreements, including the tax matters agreement, or that certain letter agreement entered into with Shire and Baxalta;

the impact of global economic conditions (including potential trade wars) and public health crises and epidemics, such as the novel strain of coronavirus that recently originated in China (COVID-19), on us and our customers and suppliers, including foreign governments in countries in which we operate;

fluctuations in foreign exchange and interest rates;

any changes in law concerning the taxation of income (whether with respect to current or future tax reform), including income earned outside the United States and potential taxes associated with the Base Erosion and Anti-Abuse Tax;Tax or the Build Back Better framework;

actions by tax authorities in connection with ongoing tax audits;

loss of key employees, the occurrence of labor disruptions or the inability to identify and recruit new employees;

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other factors identified elsewhere in this Annual Report on Form 10-K including those factors described in Item 1A and other filings with the SEC, all of which are available on our website.

Actual results may differ materially from those projected in the forward-looking statements. We do not undertake to update our forward-looking statements.

Item 7A.    Quantitative and Qualitative Disclosures About Market Risk.
Incorporated by reference to the section entitled “Financial Instrument Market Risk” in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Item 7 of this Annual Report on Form 10-K.

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Item 8.    Financial Statements and Supplementary Data.
CONSOLIDATED BALANCE SHEETS
As Restated
as of December 31 (in millions, except share information)20192018
Current assets:
Cash and cash equivalents$3,335  $1,838  
Accounts receivable, net1,896  1,840  
Inventories1,653  1,667  
Prepaid expenses and other current assets619  614  
Total current assets7,503  5,959  
Property, plant and equipment, net4,512  4,530  
Goodwill3,030  3,002  
Other intangible assets, net1,471  1,410  
Operating lease right-of-use assets608  —  
Other non-current assets1,069  819  
Total assets$18,193  $15,720  
Current liabilities:
Short-term debt$226  $ 
Current maturities of long-term debt and finance lease obligations315   
Accounts payable and accrued liabilities2,689  2,810  
Total current liabilities3,230  2,814  
Long-term debt and finance lease obligations4,809  3,481  
Operating lease liabilities510  —  
Other non-current liabilities1,732  1,559  
Total liabilities10,281  7,854  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares in 2019 and 2018683  683  
Common stock in treasury, at cost, 177,340,358 shares in 2019 and 170,495,859 shares in 2018(10,764) (9,989) 
Additional contributed capital5,955  5,898  
Retained earnings15,718  15,075  
Accumulated other comprehensive (loss) income(3,710) (3,823) 
Total Baxter stockholders’ equity7,882  7,844  
Noncontrolling interests30  22  
Total equity7,912  7,866  
Total liabilities and equity$18,193  $15,720  
as of December 31 (in millions, except share information)20212020
Current assets:
Cash and cash equivalents$2,951 $3,730 
Accounts receivable, net of allowance of $122 in 2021 and $125 in 20202,629 2,007 
Inventories2,453 1,916 
Prepaid expenses and other current assets839 758 
Total current assets8,872 8,411 
Property, plant and equipment, net5,178 4,722 
Goodwill9,836 3,217 
Other intangible assets, net7,792 1,671 
Operating lease right-of-use assets630 603 
Other non-current assets1,213 1,395 
Total assets$33,521 $20,019 
Current liabilities:
Short-term debt$301 $— 
Current maturities of long-term debt and finance lease obligations210 406 
Accounts payable1,246 1,043 
Accrued expenses and other current liabilities2,479 1,884 
Total current liabilities4,236 3,333 
Long-term debt and finance lease obligations17,149 5,786 
Operating lease liabilities522 501 
Other non-current liabilities2,493 1,673 
Total liabilities24,400 11,293 
Commitments and contingencies00
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares in 2021 and 2020683 683 
Common stock in treasury, at cost, 181,879,516 shares in 2021 and 178,580,208 shares in 2020(11,488)(11,051)
Additional contributed capital6,197 6,043 
Retained earnings17,065 16,328 
Accumulated other comprehensive (loss) income(3,380)(3,314)
Total Baxter stockholders’ equity9,077 8,689 
Noncontrolling interests44 37 
Total equity9,121 8,726 
Total liabilities and equity$33,521 $20,019 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF INCOME
As Restated
years ended December 31 (in millions, except per share data)201920182017
Net sales$11,362  $11,099  $10,584  
Cost of sales6,601  6,340  6,110  
Gross margin4,761  4,759  4,474  
Selling, general and administrative expenses2,535  2,620  2,627  
Research and development expenses595  654  615  
Other operating income, net(141) (99) (56) 
Operating income1,772  1,584  1,288  
Interest expense, net71  45  55  
Other (income) expense, net731  (78) 133  
Income from continuing operations before income taxes970  1,617  1,100  
Income tax expense (benefit)(41) 65  491  
Income from continuing operations1,011  1,552  609  
Loss from discontinued operations, net of tax—  (6) (7) 
Net income1,011  1,546  602  
Less: Net income attributable to noncontrolling interests10  —  —  
Net income attributable to Baxter stockholders$1,001  $1,546  $602  
Earnings per share from continuing operations
Basic$1.97  $2.91  $1.12  
Diluted$1.93  $2.84  $1.10  
Loss per share from discontinued operations
Basic$—  $(0.01) $(0.01) 
Diluted$—  $(0.01) $(0.02) 
Earnings per share
Basic$1.97  $2.90  $1.11  
Diluted$1.93  $2.83  $1.08  
Weighted-average number of shares outstanding
Basic509  534  543  
Diluted519  546  555  
years ended December 31 (in millions, except per share data)202120202019
Net sales$12,784 $11,673 $11,362 
Cost of sales7,679 7,086 6,601 
Gross margin5,105 4,587 4,761 
Selling, general and administrative expenses2,867 2,469 2,535 
Research and development expenses534 521 595 
Other operating income, net(6)(19)(141)
Operating income1,710 1,616 1,772 
Interest expense, net192 134 71 
Other expense, net41 190 731 
Income before income taxes1,477 1,292 970 
Income tax expense (benefit)182 182 (41)
Net income1,295 1,110 1,011 
Net income attributable to noncontrolling interests11 10 
Net income attributable to Baxter stockholders$1,284 $1,102 $1,001 
Earnings per share
Basic$2.56 $2.17 $1.97 
Diluted$2.53 $2.13 $1.93 
Weighted-average number of shares outstanding
Basic502 509 509 
Diluted508 517 519 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
As Restated
years ended December 31 (in millions)201920182017
Net income$1,011  $1,546  $602  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments, net of tax expense (benefit) of ($5) in 2019, ($52) in 2018 and $89 in 2017(95) (323) 599  
Pension and other postretirement benefit plans, net of tax expense of $130 in 2019, $10 in 2018, and $60 in 2017408  33  134  
Hedging activities, net of tax expense (benefit) of ($11) in 2019, $3 in 2018, and ($6) in 2017(39)  (13) 
Available-for-sale securities, net of tax expense of 0 in 2019, 2018 and 2017, respectively—  —   
Total other comprehensive (loss) income, net of tax274  (281) 722  
Comprehensive income1,285  1,265  1,324  
Less: Comprehensive income attributable to noncontrolling interests10  —  —  
Comprehensive income attributable to Baxter stockholders$1,275  $1,265  $1,324  
years ended December 31 (in millions)202120202019
Net income$1,295 $1,110 $1,011 
Other comprehensive (loss) income, net of tax:
Currency translation adjustments, net of tax expense (benefit) of $30 in 2021, ($51) in 2020 and $(5) in 2019(320)367 (95)
Pension and other postretirement benefit plans, net of tax expense of $60 in 2021 $40 in 2020 and $130 in 2019227 141 408 
Hedging activities, net of tax expense (benefit) of $7 in 2021, $(34) in 2020 and ($11) in 201927 (112)(39)
Total other comprehensive (loss) income, net of tax(66)396 274 
Comprehensive income1,229 1,506 1,285 
Less: Comprehensive income attributable to noncontrolling interests11 10 
Comprehensive income attributable to Baxter stockholders$1,218 $1,498 $1,275 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY
Baxter International Inc. stockholders' equity  
(in millions)Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
Balance as of January 1, 2017 (As Restated)683  $683  144  $(7,995) $5,958  $13,846  $(4,261) $8,231  $(10) $8,221  
Net income—  —  —  —  —  602  —  $602  —  $602  
Other comprehensive income (loss)—  —  —  —  —  —  722  722  —  722  
Purchases of treasury stock—  —   (564) —  —  —  (564) —  (564) 
Stock issued under employee benefit plans and other—  —  (11) 578  (18) (134) —  426  —  426  
Dividends declared on common stock—  —  —  —  —  (334) —  (334) —  (334) 
Distribution of Baxalta—  —  —  —  —  34  —  34  —  34  
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of December 31, 2017 (As Restated)683  $683  $142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
Adoption of new accounting standards—  —  —  —  —  (22) (3) (25) —  (25) 
Net income—  —  —  —  —  1,546  —  1,546  —  1,546  
Other comprehensive income (loss)—  —  —  —  —  —  (281) (281) —  (281) 
Purchases of treasury stock—  —  36  (2,415) (60) —  —  (2,475) —  (2,475) 
Stock issued under employee benefit plans and other—  —  (8) 407  18  (71) —  354  —  354  
Dividends declared on common stock—  —  —  —  —  (392) —  (392) —  (392) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  30  30  
Balance as of December 31, 2018 (As Restated)683  $683  $170  $(9,989) $5,898  $15,075  $(3,823) $7,844  $22  $7,866  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  1,001  —  1,001  10  1,011  
Other comprehensive income (loss)—  —  —  —  —  —  274  274  —  274  
Purchases of treasury stock—  —  16  (1,293) 46  —  —  (1,247) —  (1,247) 
Stock issued under employee benefit plans and other—  —  (9) 518  11  (84) —  445  —  445  
Dividends declared on common stock—  —  —  —  —  (435) —  (435) —  (435) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  (2) (2) 
Balance as of December 31, 2019683  $683  177  $(10,764) $5,955  $15,718  $(3,710) $7,882  $30  $7,912  
Baxter International Inc. stockholders' equity
(in millions)Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2019683 $683 170 $(9,989)$5,898 $15,075 $(3,823)$7,844 $22 $7,866 
Adoption of new accounting standard— — — — — 161 (161)$— — $— 
Net income— — — — — 1,001 — $1,001 10 $1,011 
Other comprehensive income (loss)— — — — — — 274 274 — 274 
Purchases of treasury stock— — 16 (1,293)46 — — (1,247)— (1,247)
Stock issued under employee benefit plans and other— — (9)518 11 (84)— 445 — 445 
Dividends declared on common stock— — — — — (435)— (435)— (435)
Changes in noncontrolling interests— — — — — — — — (2)(2)
Balance as of December 31, 2019683 $683 177 $(10,764)$5,955 $15,718 $(3,710)$7,882 $30 $7,912 
Adoption of new accounting standard— — — — — (4)— (4)— (4)
Net income— — — — — 1,102 — 1,102 1,110 
Other comprehensive income (loss)— — — — — — 396 396 — 396 
Purchases of treasury stock— — (500)— — — (500)— (500)
Stock issued under employee benefit plans and other— — (4)213 88 — — 301 — 301 
Dividends declared on common stock— — — — — (488)— (488)— (488)
Changes in noncontrolling interests— — — — — — — — (1)(1)
Balance as of December 31, 2020683 $683 179 $(11,051)$6,043 $16,328 $(3,314)$8,689 $37 $8,726 
Net income— — — — — 1,284 — 1,284 11 1,295 
Other comprehensive income (loss)— — — — — — (66)(66)— (66)
Purchases of treasury stock— — (600)— — — (600)— (600)
Stock issued under employee benefit plans and other— — (4)163 154 — — 317 — 317 
Dividends declared on common stock— — — — — (547)— (547)— (547)
Changes in noncontrolling interests— — — — — — — — (4)(4)
Balance as of December 31, 2021683 $683 182 $(11,488)$6,197 $17,065 $(3,380)$9,077 $44 $9,121 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF CASH FLOWS
years ended December 31 (in millions)202120202019
Cash flows from operations
Net income$1,295 $1,110 $1,011 
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization890 823 789 
Pension settlement charges46 755 
Net periodic pension benefit and other postretirement costs99 81 22 
Deferred income taxes(146)(88)(310)
Stock compensation146 130 122 
Loss on debt extinguishment110 — 
Intangible asset impairments— 17 31 
Settlement of interest rate derivative contracts— (173)— 
Other92 86 115 
Changes in balance sheet items:
Accounts receivable, net(170)(119)(52)
Inventories(37)(162)
Prepaid expenses and other current assets(41)(37)(31)
Accounts payable104 57 (23)
Accrued expenses and other current liabilities108 86 (196)
Other(125)(97)(127)
Cash flows from operations – continuing operations2,222 1,870 2,110 
Cash flows from operations – discontinued operations— (2)(6)
Cash flows from operations2,222 1,868 2,104 
Cash flows from investing activities
Capital expenditures(743)(709)(696)
Acquisitions, net of cash acquired, and investments(10,502)(494)(418)
Other investing activities, net45 24 14 
Cash flows from investing activities(11,200)(1,179)(1,100)
Cash flows from financing activities
Issuances of debt11,903 1,885 1,661 
Repayments of debt(2,823)(1,181)— 
Net increase (decrease) in debt with original maturities of three months or less246 (226)222 
Cash dividends on common stock(530)(473)(423)
Proceeds from stock issued under employee benefit plans187 202 356 
Purchases of treasury stock(600)(500)(1,270)
Debt issuance costs(98)(5)(2)
Other financing activities, net(40)(47)(46)
Cash flows from financing activities8,245 (345)498 
Effect of foreign exchange rate changes on cash, cash equivalents and restricted cash(47)57 (5)
Increase (decrease) in cash, cash equivalents and restricted cash(780)401 1,497 
Cash, cash equivalents and restricted cash at beginning of year (1)
3,736 3,335 1,838 
Cash, cash equivalents and restricted cash at end of year (1)
$2,956 $3,736 $3,335 
As Restated
years ended December 31 (in millions)201920182017
Cash flows from operations
Net income$1,011  $1,546  $602  
Adjustments to reconcile income from continuing operations to net cash from operating activities:
Loss from discontinued operations, net of tax—    
Depreciation and amortization789  771  750  
Pension settlement charges755    
Net periodic pension benefit and other postretirement costs22  39  123  
Deferred income taxes(310) (263) 211  
Stock compensation122  115  107  
Intangible asset impairment31  —  —  
Other115  50  38  
Changes in balance sheet items:
Accounts receivable, net(65) (12) 30  
Inventories (197) 76  
Accounts payable and accrued liabilities(212) 60  11  
Other(152) (99) (227) 
Cash flows from operations – continuing operations2,110  2,017  1,730  
Cash flows from operations – discontinued operations(6) —  (16) 
Cash flows from operations2,104  2,017  1,714  
Cash flows from investing activities
Capital expenditures(696) (659) (616) 
Acquisitions and investments, net of cash acquired(418) (268) (686) 
Other investing activities, net14  11  10  
Cash flows from investing activities(1,100) (916) (1,292) 
Cash flows from financing activities
Issuances of long-term debt1,661  —  665  
Borrowings under revolving credit facility222  —  —  
Cash dividends on common stock(423) (376) (315) 
Proceeds from stock issued under employee benefit plans356  258  347  
Purchases of treasury stock(1,270) (2,452) (564) 
Other financing activities, net(48) (33) (40) 
Cash flows from financing activities498  (2,603) 93  
Effect of foreign exchange rate changes on cash and cash equivalents(5) (63) 102  
Increase (decrease) in cash and cash equivalents1,497  (1,565) 617  
Cash and cash equivalents at beginning of year1,838  3,403  2,786  
Cash and cash equivalents at end of year$3,335  $1,838  $3,403  
Other supplemental information
Interest paid, net of portion capitalized$103  $94  $80  
Income taxes paid$294  $301  $253  
(1) We did not have restricted cash balances as of December 31, 2019. The following table provides a reconciliation of cash, cash equivalents and restricted cash amounts as shown in the consolidated statement of cash flows to the
amount reported in the consolidated balance sheet as of December 31, 2021 and 2020:
As of December 31 (in millions)20212020
Cash and cash equivalents$2,951 $3,730 
Restricted cash included in prepaid expenses and other current assets
Cash, cash equivalents and restricted cash$2,956 $3,736 
The accompanying notes are an integral part of these consolidated financial statements.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Nature of Operations
Baxter International Inc., through our subsidiaries (collectively, Baxter, we, our or us), provides a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile intravenous (IV) solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products.products, advanced surgical equipment; smart bed systems; patient monitoring and diagnostic technologies; and respiratory health devices. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and patients at home under physician supervision. Our global footprint and the critical nature of our products and services play a key role in expanding access to healthcare in emerging and developed countries. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and patients at home under physician supervision. We operate in 34 segments: Americas, EMEA, APAC and APAC,Hillrom which are described in Note 18.17.
Risks and Uncertainties Related to COVID-19
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus (COVID-19). COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and we expect will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments have taken and continue to take. Initial measures taken in 2020 led to unprecedented restrictions on, disruptions in, and other related impacts on business and personal activities, including a shift in healthcare priorities, which resulted in a significant decline in medical procedures in 2020. The pandemic has created significant volatility in the demand for our products. For further information about our revenues by product category, refer to Note 10. Significant uncertainty remains regarding the duration and overall impact of the COVID-19 pandemic. For example, concerns remain regarding the pace of economic recovery due to virus resurgence across the globe from the Omicron and Delta variants and other virus mutations as well as vaccine distribution and hesitancy. The U.S. and other governments may continue existing measures or implement new restrictions and other requirements in light of the continuing spread of the pandemic (including with respect to mandatory vaccinations for certain of our employees and moratoriums on elective procedures). Due to the uncertainty caused by the pandemic, our operating performance and financial results, particularly in the short term, may be subject to volatility. We have experienced significant challenges, including lengthy delays, shortages and interruptions, posed by the pandemic and other exogenous factors (including significant weather events and disruptions to certain ports of call around the world) to our global supply chain, including the cost and availability of raw materials and component parts (including resins and electromechanical devices) and higher transportation costs, and may experience these and other challenges in future periods. Many of our manufacturing plant and distribution center personnel are currently unvaccinated, and we may also experience employee resistance in complying with current and future government vaccine and testing mandates, which may cause labor shortages significantly impacting manufacturing production and distribution center productivity. We expect that these challenges as well as evolving governmental restrictions and requirements, among other factors, may continue to have an adverse effect on our business.
Use of Estimates
The preparation of the financial statements in conformity with U.S. Generally Accepted Accounting Principles (U.S. GAAP) requires us to make estimates and assumptions that affect reported amounts and related disclosures. Actual results could differ from those estimates.
Basis of Presentation
The consolidated financial statements include the accounts of Baxter and our majority-owned subsidiaries that we control, after elimination of intra-company transactions. Certain reclassifications have been made to conform the prior period consolidated financial statements to the current period presentation.
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hill-Rom Holdings, Inc. (Hillrom) for a purchase price of $10.5 billion. Including the assumption of Hillrom's
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outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Beginning December 13, 2021, our financial statements include the assets, liabilities and operating results of Hillrom. Refer to Note 2 for additional information.
On July 29, 2021, we acquired certain assets related to PerClot Polysaccharide Hemostatic System (PerClot), including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million, which had an acquisition-date fair value of $28 million, based upon regulatory and commercial milestones. Beginning July 29, 2021, our financial statements include the assets, liabilities and operating results of PerClot. Refer to Note 2 for additional information.
On March 31, 2021, we acquired the rights to Transderm Scop (TDS) for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval of a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. Beginning on March 31, 2021, our financial statements include the assets, liabilities and operating results of TDS. Refer to Note 2 for additional information.
On February 17, 2021, we acquired the rights to Caelyx and Doxil, the branded versions of liposomal doxorubicin, from a subsidiary of Johnson & Johnson for specified territories outside of the U.S for approximately $325 million in cash. Beginning February 17, 2021, our financial statements include the assets, liabilities and operating results of Caelyx and Doxil. Refer to Note 2 for additional information.
On February 14, 2020, we completed the acquisition of the product rights to Seprafilm Adhesion Barrier (Seprafilm) from Sanofi for approximately $342 million in cash. Beginning February 14, 2020, our financial statements include the assets, liabilities and operating results of Seprafilm. Refer to Note 2 for additional information.
On October 25, 2019, we acquired 100 percent of Cheetah Medical, Inc. (Cheetah) for total upfront cash consideration of $195$188 million, net of cash acquired, with the potential for additional cash consideration, up to $40 million, based on clinical and commercial milestones for which the acquisition date fair value was $18 million. Beginning October 25, 2019, our financial statements include the assets, liabilities and operating results of Cheetah. Refer to Note 42 for additional information.
On November 18, 2018, we acquired a controlling financial interest in our joint venture in Saudi Arabia. The acquisition allows us to increase manufacturing output and utilize the facilities for additional capacity for certain products in the region. Beginning November 18, 2018, we consolidated the financial statements of the joint venture with our consolidated financial statements. Refer to Note 4 for additional information.
On March 16, 2018, we acquired 2 hemostat and sealant products from Mallinckrodt plc: RECOTHROM Thrombin topical (Recombinant) and PREVELEAK Surgical Sealant for total consideration of $184 million.  Beginning March 16, 2018, our financial statements include the assets, liabilities and operating results of RECOTHROM and PREVELEAK.  Refer to Note 4 for additional information.
On July 27, 2017, we acquired 100 percent of Claris Injectables Limited (Claris), a wholly owned subsidiary of Claris Lifesciences Limited, for total cash consideration of approximately $629 million, net of cash acquired.  Beginning July 27, 2017, our financial statements include the assets, liabilities and operating results of Claris.  Refer to Note 4 for additional information.
Currency restrictions enacted in Venezuela require approval from the Venezuelan government to exchange Venezuelan bolivars for U.S. dollars. Due to a decline in transactions to exchange Venezuelan bolivars for U.S. dollars, and limitations on our ability to repatriate funds generated by our Venezuela operations, we concluded in the second quarter of 2017 that we no longer met the accounting criteria for control over our business in Venezuela and we deconsolidated our Venezuelan operations on June 30, 2017. As a result of deconsolidating the Venezuelan operations, we recorded a pre-tax charge of $33 million in other (income) expense, net in 2017. This charge included the write-off of our investment in our Venezuelan operations, related cumulative translation adjustments and elimination of intra-company amounts. Beginning in the third quarter of 2017, we no longer included the results of our Venezuelan business in our consolidated financial statements. In 2018, we liquidated our subsidiary in
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Venezuela and currently sell direct to distributors in that country through legal entities outside of Venezuela.  The distributors purchase our products in U.S. dollars and are responsible for importing those products into Venezuela.
Revenue Recognition
We adopted Accounting Standards Update (ASU) No. 2014-9, Revenue from Contracts with Customers (Topic 606) as of January 1, 2018.  Results for the years ended December 31, 2019 and 2018 are presented under Topic 606, while the 2017 period is presented under previous guidance. See further discussion of the impact of Topic 606 below under the header “New Accounting Standards.”
Revenue is measured as the amount of consideration we expect to receive in exchange for transferring goods or providing services. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in the contract. A contract’s transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. Some of our contracts have multiple performance obligations. For contracts with multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our global payment terms are typically between 30-90 days.
The majority of our performance obligations are satisfied at a point in time. This includes sales of our broad portfolio of essential healthcare products across our geographic segments, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. For a majority of these sales, our performance obligation is satisfied upon delivery to the customer. Shipping and handling activities are considered to be fulfillment activities and are not considered to be a separate performance obligation.
To a lesser extent, in all of our segments, we enter into other types of contracts, including contract manufacturing arrangements, equipment leases, and certain subscription software and licensing arrangements. We recognize revenue for these arrangements over time or at a point in time depending on our evaluation of when the customer obtains control of the promised goods or services. Revenue is recognized over time when we are creating or enhancing an asset that the customer controls as the asset is created or enhanced or when our performance does not create an asset with an alternative use and we have an enforceable right to payment for performance completed.
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As of December 31, 2019,2021, we had $8.6$7.8 billion of transaction price allocated to remaining performance obligations related to executed contracts with an original duration of one year or more, which are primarily included in the Americas segment. Some contracts in the United States included in this amount contain index-dependent price increases, which are not known at this time. We expect to recognize approximately 25%35% of this amount as revenue in each of 2020 and 2021, 20%2022, 30% in 2023, 15% in each of 20222024 and 2023,2025, and 5% in 2024, and the remaining balance thereafter.2026.
Significant Judgments
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates product returns, sales discounts and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales and are included in accrued expenses and other current liabilities and accounts receivable, net and accounts payable and accrued liabilities on the consolidated balance sheets. Management's estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract using the expected value method. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. Revenue recognized in the years ended December 31, 20192021, 2020 and 20182019 related to performance obligations satisfied in prior periods was not material.
Contract Balances
The timing of revenue recognition, billings Additionally, our contracts with customers often include promises to transfer multiple products and cash collections results in the recognition of trade accounts receivable, unbilled receivables, contract assets,services to a customer. Determining whether products and customer advances and deposits (contract liabilities) on our consolidated balance sheets. Net trade accounts receivable was $1.8 billion as of December 31, 2019 and 2018.
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For contract manufacturing arrangements, revenue is primarily recognized throughout the production cycle, which typically lasts up to 90 days, resulting in the recognition of contract assets until the related services are completedconsidered distinct performance obligations that should be accounted for separately and determining the customers are billed. Additionally, for arrangements containing a performance obligation to deliver software that can be used with medical devices, we recognize revenue upon deliveryallocation of the software, which results in the recognition of contract assets when customers are billed over time, generally over one to five years. For bundled contracts involving equipment delivered up-front and consumable medical products to be delivered over time, total contract revenue is allocated between the equipment and consumable medical products. In certain of those arrangements, a contract asset is created for the difference between the amount of equipment revenue recognized upon delivery and the amount of consideration initially receivable from the customer. In those arrangements, the contract asset becomes a trade account receivable as consumable medical products are provided and billed, generally over one to seven years. Our contract asset balances totaled $131 million as of December 31, 2019, of which $36 million related to contract manufacturing services, $43 million related to software sales and $52 million related to bundled equipment and consumable medical products contracts. Our contract asset balances totaled $80 million as of December 31, 2018, of which $33 million related to contract manufacturing services and $47 million related to software sales. Contract assets are presented within accounts receivable, net ($63 million and $50 million as of December 31, 2019 and 2018, respectively) and other non-current assets ($68 million and $30 million as of December 31, 2019 and 2018, respectively) on the consolidated balance sheets. Contract liabilities were $12 million as of December 31, 2019 and were included in other non-current liabilities on the consolidated balance sheet. Contract liabilities as of December 31, 2018 were 0t significant.transaction price may require significant judgment.
Practical Expedients
We apply a practical expedient to expense as incurred costs to obtain a contract with a customer when the amortization period would have been one year or less. We do not disclose the value of the transaction price that is allocated to unsatisfied performance obligations for contracts with an original expected length of less than one year or less.year. We have elected to use the practical expedient to not adjust the promised amount of consideration for the effects of a significant financing component if it is expected, at contract inception, that the period between when we transfer a promised good or service to a customer and when the customer pays for that good or service will be one year or less. Additionally, all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected from a customer are excluded from revenue.
Disaggregation of Net Sales
The following tables disaggregate our net sales from contracts with customers by Global Business Unit (GBU) between the U.S. and international:
As Restated
201920182017
years ended December 31 (in millions)U.S.InternationalTotalU.S.InternationalTotalU.S.InternationalTotal
Renal Care1
$791  $2,848  $3,639  $816  $2,835  $3,651  $754  $2,737  $3,491  
Medication Delivery2
1,822  977  2,799  1,690  974  2,664  1,698  1,002  2,700  
Pharmaceuticals3
940  1,215  2,155  996  1,091  2,087  892  994  1,886  
Clinical Nutrition4
320  552  872  321  554  875  359  526  885  
Advanced Surgery5
535  342  877  466  332  798  403  305  708  
Acute Therapies6
184  351  535  174  341  515  147  310  457  
Other7
234  251  485  260  249  509  257  200  457  
Total Baxter$4,826  $6,536  $11,362  $4,723  $6,376  $11,099  $4,510  $6,074  $10,584  
1 Renal Care includes sales of our peritoneal dialysis (PD), hemodialysis (HD) and additional dialysis therapies and services.
2 Medication Delivery includes sales of our IV therapies, infusion pumps, administration sets and drug reconstitution devices.
3 Pharmaceuticals includes sales of our premixed and oncology drug platforms, inhaled anesthesia and critical care products and pharmacy compounding services.
4 Clinical Nutrition includes sales of our parenteral nutrition (PN) therapies and related products.
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5 Advanced Surgery includes sales of our biological products and medical devices used in surgical procedures for hemostasis, tissue sealing and adhesion prevention.
6 Acute Therapies includes sales of our continuous renal replacement therapies (CRRT) and other organ support therapies focused in the intensive care unit (ICU).
7 Other primarily includes sales of contract manufacturing services from our pharmaceutical partnering business.
Accounts Receivable and Allowance for Doubtful Accounts
In the normal course of business, we provide credit to our customers, perform credit evaluations of these customers and maintain reserves for potential credit losses. In determining the amount of the allowance for doubtful accounts, we consider, among other items, historical credit losses, the past-due status of receivables, payment histories, and other customer-specific information.information, current economic conditions and reasonable and supportable future forecasts. Receivables are written off when we determine they are uncollectible.
The following table summarizes the allowance for doubtful accounts was $112 million and $110 million as of December 31, 2019 and 2018, respectively.accounts.
years ended December 31
(in millions)
20212020
Balance at beginning of period$125 $112 
Acquisition13 — 
Adoption of new accounting standard— 
Charged to costs and expenses(2)11 
Write-offs(5)(4)
Currency translation adjustments(9)
Balance at end of period$122 $125 

Shipping and Handling Costs
Shipping costs, which are costs incurred to physically move product from our premises to the customer’s premises, are classified as selling, general and administrative (SG&A) expenses. Handling costs, which are costs incurred to
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store, move and prepare products for shipment, are classified as cost of sales. Approximately $381 million in 2021, $325 million in 2020 and $324 million in 2019 $329 million in 2018 and $292 million in 2017 of shipping costs were classified in SG&A expenses.
Cash, and Cash Equivalents and Restricted Cash
Cash and cash equivalents include cash, certificates of deposit and money market and other short-term funds with original maturities of three months or less. Restricted cash represents cash balances restricted as to withdrawal or use and are included in prepaid expenses and other current assets on the consolidated balance sheets.

Inventories
Inventories are stated at the lower of cost or net realizable value determined by the first-in, first-out method. We review inventories on hand at least quarterly and record provisions for estimated excess, slow-moving and obsolete inventory, as well as inventory with a carrying value in excess of net realizable value.
Property, Plant and Equipment, Net
Property, plant and equipment are stated at cost. Depreciation expense is calculated using the straight-line method over the estimated useful lives of the related assets, which range from 20 to 50 years for buildings and improvements and from three3 to 15 years for machinery and equipment. Leasehold improvements are amortized over the life of the related facility lease (including any renewal periods, if appropriate) or the asset, whichever is shorter. We capitalize certain computer software and software development costs incurred in connection with developing or obtaining software for internal use. Capitalized software costs are included within machinery and equipment and are amortized on a straight-line basis over the estimated useful lives of the software, which generally range from three to five years.
Research and Development
Research and development (R&D) costs, including R&D acquired in transactions that are not business combinations, are expensed as incurred. Pre-regulatory approval contingent milestone obligations to counterparties in collaborative arrangements, which include acquired R&D, are expensed when the milestone is probable to be achieved. Contingent milestone payments made to such counterparties on or after regulatory approval are capitalized and amortized over the remaining useful life of the related product. Amounts capitalized for such payments are included in other intangible assets, net.
Acquired in-process R&D (IPR&D) is the value assigned to technology or products under development acquired in a business combination which have not received regulatory approval and have no alternative future use. Acquired IPR&D is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval of the related technology or product, the indefinite-lived intangible asset is accounted for as a finite-lived intangible asset and amortized on a straight-line basis over the
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estimated economic life of the related technology or product, subject to annual impairment reviews as discussed below. If the R&D project is abandoned, the indefinite-lived asset is charged to expense.
Collaborative Arrangements
We enter into collaborative arrangements in the normal course of business. These collaborative arrangements take a number of forms and structures and are designed to enhance and expedite long-term sales and profitability growth. These arrangements may provide for us to obtain commercialization rights to a product under development, and require us to make upfront payments, contingent milestone payments, profit-sharing, and/or royalty payments. We may be responsible for ongoing costs associated with the arrangements, including R&D cost reimbursements to the counterparty. See the R&D section of this note regarding the accounting treatment of upfront and contingent milestone payments. Any royalty and profit-sharing payments during the commercialization phase are expensed as cost of sales when they become due and payable.
Restructuring Charges
We record liabilities for costs associated with exit or disposal activities in the period in which the liability is incurred. Employee termination costs are primarily recorded when actions are probable and estimable. Costs for one-time
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termination benefits in which the employee is required to render service until termination in order to receive the benefits are recognized ratably over the future service period. Refer to the discussion below regarding the accounting for asset impairment charges.
Goodwill, Intangible Assets, and Other Long-Lived Assets
Goodwill is the excess of the purchase price over the fair value of acquired assets and liabilities in a business combination.  Goodwill is not amortized but is subject to an impairment review annually and whenever indicators of impairment exist. We have the option to assess goodwill for impairment by initially performing a qualitative assessment to determine whether it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount. If we determine that it is not more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, then the two-stepquantitative goodwill impairment test is not required to be performed. If we determine that it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, or if we do not elect the option to perform an initial qualitative assessment, we perform the two-stepa quantitative goodwill impairment test.  In the first step,quantitative impairment test, we calculate the estimated fair value of the reporting unit is compared with its book value including goodwill. If the fair value of the reporting unit is in excess of its book value, the related goodwill is not impaired and no further analysis is necessary. If the fair value of the reporting unit is less than its book value, there is an indication of potential impairment and a second step is performed. When required, the second step of testing involves calculating the implied fair value of goodwill for the reporting unit. The implied fair value of goodwill is determined in the same manner as goodwill recognized in a business combination, which is the excess of the fair value of the reporting unit determined in step one over the fair value of its net assets, including identifiable intangible assets, as if the reporting unit had been acquired. If the carrying amount of the reporting unit'sunit exceeds the estimated fair value, an impairment charge is recorded for the amount that its carrying amount, including goodwill, exceeds the impliedits fair value, limited to the total amount of goodwill allocated to that reporting unit. In 2021, we changed the measurement date of our annual goodwill impairment test from December 31st to November 1st. This change better aligns the timing of the goodwill impairment test with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment loss is recognized in an amount equal to that excess.charge.
Indefinite-lived intangible assets, such as IPR&D acquired in business combinations and certain trademarks with indefinite lives, are subject to an impairment review annually and whenever indicators of impairment exist. We have the option to assess indefinite-lived intangible assets for impairment by first performing qualitative assessments to determine whether it is more-likely-than-not that the fair values of itsthe indefinite-lived intangible assets are less than the carrying amounts. If we determine that it is more-likely-than-not that an indefinite-lived intangible asset is impaired, or if we elect not to perform an initial qualitative assessment, we then perform the quantitative impairment test by comparing the fair value of the indefinite-lived intangible asset with its carrying amount. If the carrying amount exceeds the fair value of the indefinite-lived intangible asset, we write the carrying amount down to the fair value. In 2021, we changed the measurement date of our annual indefinite-lived intangible asset impairment tests from December 31st to November 1st. This change better aligns the timing of the impairment tests with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
We review the carrying amounts of long-lived assets, other than goodwill and intangible assets not subject to amortization, for potential impairment when events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. In evaluating recoverability, we group assets and liabilities at the lowest level such that the identifiable cash flows relating to the group are largely independent of the cash flows of other assets and liabilities. We then compare the carrying amounts of the assets or asset groups with the related estimated undiscounted future cash flows. In the event impairment exists, an impairment charge is recorded as the amount by which the carrying amount of the asset or asset group exceeds the fair value.
Investments in Equity Securities
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Our investments in marketable equity securities are classified as other non-current assets and are measured at fair value with gains and losses recognized in other expense, net. We have elected to apply the measurement alternative to equity securities without readily determinable fair values. As such, our non-marketable equity securities are measured at cost, less any impairment, and are adjusted for changes in fair value resulting from observable transactions for identical or similar investments of the same issuer. Gains and losses on non-marketable equity securities are also recognized in other expense, net. Noncontrolling investments in common stock or in-substance common stock are accounted for under the equity method if we have the ability to exercise significant influence over the operating and financial policies of the investee.
Income Taxes
Deferred taxes are recognized for the future tax effects of temporary differences between financial and income tax reporting based on enacted tax laws and rates. We maintain valuation allowances unless it is more-likely-than-not that the deferred tax asset will be realized. With respect to uncertain tax positions, we determine whether the position is more-likely-than-not to be sustained upon examination based on the technical merits of the position. Any
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tax position that meets the more-likely-than-not recognition threshold is measured and recognized in the consolidated financial statements at the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement. The liability relating to uncertain tax positions is classified as current in the consolidated balance sheets to the extent that we anticipate making a payment within one year. Interest and penalties associated with income taxes are classified in the income tax expense line in the consolidated statements of income.
Refer to the Recently Adopted Accounting Pronouncements section of this note and Note 14 for additional information related to the Tax Cuts and Jobs Act of 2017 (2017 Tax Act).
Foreign Currency Translation
Currency translation adjustments (CTA) related to foreign operations are included in other comprehensive income (OCI). For foreign operations in highly inflationary economies, translation gains and losses are included in other (income) expense, net, and were not material in 2019, 20182021, 2020 and 2017.2019.
Derivatives and Hedging Activities
All derivative instruments are recognized as either assets or liabilities at fair value in the consolidated balance sheets and are generally classified as short-term or long-term based on the scheduled maturity of the instrument. We designate certain of our derivatives and foreign-currency denominated debt instruments as hedging instruments in cash flow, fair value or net investment hedges.
For each derivative instrument that is designated and effective as a cash flow hedge, the gain or loss on the derivative is recorded in accumulated other comprehensive income (AOCI) and then recognized in earnings consistent with the underlying hedged item. Option premiums or net premiums paid are initially recorded as assets and reclassified to OCI over the life of the option, and then recognized in earnings consistent with the underlying hedged item. Cash flow hedges are classified in cost of sales and interest expense, net, and are primarily related to forecasted third-party sales denominated in foreign currencies, forecasted intra-company sales denominated in foreign currencies and forecasted interest payments on anticipated issuances of debt, respectively.
For each derivative instrument that is designated and effective as a fair value hedge, the gain or loss on the derivative is recognized immediately to earnings, and offsets changes in fair value attributable to a particular risk, such as changes in interest rates, of the hedged item, which are also recognized in earnings. FairChanges in the fair value of hedge instruments designated as fair value hedges are classified in interest expense, net, as they hedge the interest rate risk associated with certain of our fixed-rate debt.
We have designated our Euro-denominated senior notes as hedges of our net investment in our European operations and, as a result, mark to spot rate adjustments on the outstanding debt balances are recorded as a component of AOCI.
For derivative instruments that are not designated as hedges, the change in fair value is recorded directly to other (income) expense, net.
If it is determined that a derivative or nonderivative hedging instrument is no longer highly effective as a hedge, we discontinue hedge accounting prospectively. Gains or losses relating to terminations of effective cash flow hedges generally continue to be deferred and are recognized consistent with the loss or income recognition of the underlying hedged items. However, if it is probable that the hedged forecasted transactions will not occur, any gains or losses would be immediately reclassified from AOCI to earnings. If we terminate a fair value hedge, an amount equal to the cumulative fair value adjustment to the hedged item at the date of termination is amortized to earnings over the remaining term of the hedged item. If we remove a net investment hedge designation, any gains or losses recognized in AOCI are not reclassified to earnings until we sell, liquidate, or deconsolidate the foreign investments that were being hedged.
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Derivatives,Cash flows related to the settlement of derivative instruments designated as net investment hedges of foreign operations are classified in the consolidated statements of cash flows within investing activities. Cash flows for all other derivatives, including those that are not designated as a hedge, are principally classified in the operating sectionsame line item as the cash flows of the consolidated statements of cash flows.related hedged item, which is generally within operating activities.
Refer to Note 1615 for further information regarding our derivative and hedging activities.
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New Accounting Standards
Recently issued accounting standards not yet adopted
In July 2021, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2021-05, Leases (Topic 842), which requires a lessor to classify a lease with variable lease payments (that do not depend on an index or rate) as an operating lease if (1) the lease would have been classified as a sales-type or direct financing lease, and (2) the lessor would have recognized a selling loss at lease commencement. These changes are intended to avoid recognizing a day-one loss for a lease with variable payments even though the lessor expects the arrangement will be profitable overall. The standard is effective for our financial statements beginning in 2022. The impact of the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
Recently adopted accounting pronouncements 
In the fourth quarter of 2021, we adopted ASU 2021-08, Business Combinations - Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. This ASU requires an entity to recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Topic 606 (Revenue from Contracts with Customers). This ASU is expected to reduce diversity in practice and increase comparability for both the recognition and measurement of acquired revenue contracts with customers at the date of and after a business combination. In accordance with this ASU we recognized contract liabilities of $142 million as part of the Hillrom acquisition in December 2021. We did not acquire contract assets or liabilities in connection with other acquisitions completed in 2021.
As of January 1, 2020, we adopted ASU No. 2016-13, Financial Instruments - Credit Losses, which requires the measurement of expected lifetime credit losses, rather than incurred losses, for financial instruments held at the reporting date based on historical experience, current conditions and reasonable forecasts. The main objective of this ASU is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. We adopted this ASU using the modified retrospective approach. The impact of the adoption of this ASU was an increase to our allowance for doubtful accounts and a decrease to retained earnings of $4 million.
As of January 1, 2020, we adopted ASU No. 2018-15, Intangibles-Goodwill and Other-Internal-Use Software, which aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. Our policies for capitalizing implementation costs incurred in a hosting arrangement were not impacted by this ASU. However, we have historically classified those capitalized costs within property, plant and equipment, net on our consolidated balance sheets and as capital expenditures on our consolidated statements of cash flows. Under the new ASU, those capitalized costs are presented as other non-current assets on our consolidated balance sheets and within operating cash flows on our consolidated statements of cash flows. We adopted this ASU on a prospective basis and capitalized $45 million and $44 million of implementation costs related to hosting arrangements that are service contracts during the years ended December 31, 2021 and 2020, respectively.
As of January 1, 2020, we adopted ASU No. 2017-04, Intangibles – Goodwill and Other, Simplifying the Test for Goodwill Impairment. This standard eliminates Step 2 of the goodwill impairment test and requires a goodwill impairment to be measured as the amount by which a reporting unit’s carrying amount exceeds its fair value, not to exceed the carrying amount of its goodwill. The adoption of this standard did not impact our consolidated financial statements.
As of January 1, 2020, we adopted ASU No. 2018-14, Compensation – Retirement Benefits – Defined Benefit Plans – General (Topic 715-20): Disclosure Framework – Changes to the Disclosure Requirements for Defined Benefit Plans. This ASU amends ASC 715 to remove certain disclosures, clarify certain existing disclosures and add additional disclosures. The adoption of this standard did not have a material impact on our consolidated financial statements.
As of January 1, 2019, we adopted Accounting Standards Update (ASU)ASU No. 2016-02, Leases (Topic 842). Under this guidance, lessees are required to recognize a right-of-use asset and a lease liability on the balance sheet for all operating leases, other than those that meet the definition of a short-term lease. We adopted Topic 842 using the modified retrospective method. We elected the following practical expedients when assessing the transition impact: i) not to reassess whether any expired or existing contracts as of the adoption date are or contain leases; ii) not to reassess the lease
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classification for any expired or existing leases as of the adoption date; and iii) not to reassess initial direct costs for any existing leases as of the adoption date. The adjustment to record operating lease right-of-use assets and operating lease liabilities was $502 million as of January 1, 2019. The impact to the consolidated statements of income was not material and there was no net impact to the consolidated statements of cash flows.
As of January 1, 2019, we adopted ASU No. 2017-12, Targeted Improvements to Accounting for Hedging Activities. The purpose of this ASU is to better align a company’s risk management activities and financial reporting for hedging relationships, simplify the hedge accounting requirements, and improve the disclosures of hedging arrangements. The adoption of this standard did not have a material impact on our consolidated financial statements.
As of January 1, 2019, we adopted ASU No. 2018-02, Reclassification of Certain Tax Effects from AOCI. As a result of the enactment of the U.S. Tax Cuts and Jobs Act of 2017 (the 2017 Tax Act), thisThis guidance provides for a reclassification of certain tax effects from AOCI to retained earnings. The impact of the adoption of this standard was a $161 million increase to retained earnings.
As of January 1, 2018, we adopted ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other than Inventory (ASU No. 2016-16) using the modified retrospective method. ASU No. 2016-16 generally accelerates the recognition of income tax consequences for intra-company asset transfers other than inventory. We recorded a $70 million reduction to retained earnings upon adoption of the standard on January 1, 2018 related to the unrecognized income tax effects of asset transfers that occurred prior to adoption. Net income increased $14 million for the year ended December 31, 2018 as a result of the adoption of the standard.
As of January 1, 2018, we adopted ASU No. 2016-01, Financial Instruments: Recognition and Measurement of Financial Assets and Liabilities. The new standard amends certain aspects of accounting and disclosure requirements of financial instruments, including the requirement that equity investments with readily determinable fair values be measured at fair value with changes in fair value recognized in earnings. For privately-held securities, we elected the measurement alternative approach for our investments, which is applied prospectively upon adoption. This approach requires entities to measure their investments at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer. The adoption of this standard did not have a material impact on our consolidated financial statements.
As of January 1, 2018, we adopted Topic 606, which amends the existing accounting standards for revenue recognition. ASU No. 2014-09 is based on principles that govern the recognition of revenue at an amount an entity expects to be entitled to receive when products are transferred to customers. The primary impact of the new standard relates to our contract manufacturing operations and software arrangements. Certain contract manufacturing arrangements require revenue recognition over-time in situations in which we produce products that have no alternative use and we have an enforceable right to payment for performance completed to date, inclusive of a reasonable profit margin. This results in an acceleration of revenue recognition for certain contractual arrangements as compared to recognition under prior accounting literature. The new guidance also impacts our arrangements subject to previous software revenue recognition guidance, as we are required to recognize as revenue a significant portion of the contract consideration upon delivery of the software compared to the previous practice of recognizing the contract consideration ratably over time for certain arrangements. We adopted Topic 606 using the modified retrospective method. The adjustment upon adoption increased our opening balance of retained
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earnings by approximately $45 million, net of tax, on January 1, 2018. The impact to net sales as a result of the adoption was an increase of $7 million for the year ended December 31, 2018.  The impact to cost of sales was not material for the year ended December 31, 2018.
In December 2017, the SEC issued guidance for situations where the accounting for certain elements of the 2017 Tax Act could not be completed prior to the release of a company's financial statements. For specific elements of the 2017 Tax Act, we determined a reasonable estimate for certain effects and recorded that estimate as a provisional amount in 2017. The guidance provided a measurement period to allow a company to account for these specific elements, which began in the reporting period that included the enactment of the 2017 Tax Act and ended when we obtained, prepared and analyzed the information needed in order to complete its accounting assessments or one year, whichever occurred sooner. The resulting tax effects were to be recognized in the period the assessment was complete, and included in income tax expense, accompanied by appropriate disclosures.  The measurement period closed in 2018 and we recorded adjustments to reduce income tax expense by $207 million in 2018. Refer to Note 14 for additional information related to the 2017 Tax Act.
NOTE 2
RESTATEMENT OF PREVIOUSLY ISSUED CONSOLIDATED FINANCIAL STATEMENTS
We have restated herein our consolidated financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017. We have also restated impacted amounts within the accompanying notes to the consolidated financial statements, as applicable.
Restatement Background
On October 24, 2019, we reported that we had commenced an internal investigation into certain intra-company transactions that impacted our previously reported non-operating foreign exchange gains and losses. Our internal investigation, as it pertains to the evaluation of related financial statement impacts, is complete.
We previously had applied a longstanding convention for the initial measurement of foreign currency transactions and the subsequent remeasurement of foreign currency denominated monetary assets and liabilities (collectively, our historical exchange rate convention) that was not consistent with U.S. GAAP. U.S. GAAP requires that foreign currency transactions be initially measured and recorded in an entity’s functional currency using the exchange rate on the date of the transaction and it requires that foreign currency denominated monetary assets and liabilities be remeasured at the end of each reporting period using the exchange rate at that date. Under our historical exchange rate convention, all foreign currency transactions in a given month were initially measured using exchange rates from a specified date near the middle of the previous month. Additionally, all foreign currency denominated monetary assets and liabilities were subsequently remeasured at the end of each month using exchange rates from a specified date near the middle of the then current month. Beginning years after the adoption of our historical exchange rate convention, certain intra-company transactions were undertaken, after the related exchange rates were already known, solely for the purpose of generating non-operating foreign exchange gains or avoiding foreign exchange losses.
We identified misstatements relating to foreign currency denominated monetary assets and liabilities and foreign currency derivative contracts that caused our Other income (expense), net and Income from continuing operations before income taxes to be overstated by $59 million and $113 million, respectively, for the years ended December 31, 2018 and 2017. Our quantification of those misstatements to our previously reported foreign exchange gains and losses was not limited to intra-company transactions undertaken for the purpose of generating foreign exchange gains or avoiding foreign exchange losses after the related exchange rates were already known. Rather, we identified every legal entity within our consolidated group that had foreign exchange gains or losses above an immaterial threshold and, for those entities, we remeasured all foreign exchange gains and losses from foreign currency denominated cash balances and intra-company loan receivables and payables using the exchange rates required by U.S. GAAP. For those entities, we also quantified misstatements to our previously reported gains and losses on foreign currency derivative contracts, which had used foreign exchange rates determined under our historical exchange rate convention as inputs to the fair value measurements of those contracts. Our quantification of misstatements to the consolidated financial statements did not include foreign currency gains or losses from short-term third-party and intra-company trade receivables and trade payables denominated in foreign currencies. We determined that any potential misstatements relating to such balances that arise in the ordinary course of business and are ultimately settled for cash within a short period of time, generally thirty to sixty days, would not be material to our consolidated financial statements.
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In order to correct our previously issued financial statements, we have restated herein our consolidated financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017, in accordance with Accounting Standards Codification (ASC) Topic 250, Accounting Changes and Error Corrections. In addition to the misstatements described above relating to foreign exchange gains and losses, we corrected additional misstatements that were not material, individually or in the aggregate, to our previously issued consolidated financial statements. Those other immaterial misstatements relate to equipment leased to customers under operating leases, classification of foreign currency gains and losses on cash balances and intra-company loan receivables and payables in our consolidated statements of cash flows, translation of the financial position and results of operations of our foreign operations into U.S. dollars, income statement classification of transition services income related to the separation of Baxalta in 2015, other miscellaneous adjustments, and the income tax effects of those items.
We believe that the use of our historical exchange rate convention to generate non-operating foreign exchange gains and avoid losses had occurred for at least ten years. The cumulative impact of misstatements related to non-operating foreign exchange gains and losses that we corrected for periods earlier than 2017, as well as the cumulative impact of correcting other immaterial misstatements relating to those earlier periods, have been recorded as a reduction to our opening retained earnings as of January 1, 2017.
Restated interim financial information for the quarterly periods ended June 30, 2019, March 31, 2019, December 31, 2018, June 30, 2018, and March 31, 2018 is included in Note 19, Quarterly Financial Results (Unaudited).
The categories of misstatements and their impact on our previously issued consolidated financial statements are described in more detail below.
Description of Misstatements
Misstatements of Foreign Exchange Gains and Losses
(a) Foreign Currency Denominated Monetary Assets and Liabilities
As discussed above, we recorded adjustments to correct foreign exchange gains and losses on monetary assets and liabilities denominated in a foreign currency to reflect the gains and losses resulting from application of the exchange rates required by U.S. GAAP. The impacts of the foreign currency gain or loss misstatements on each period are discussed in restatement reference (a) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
(b) Foreign Currency Derivative Contracts
As discussed above, we recorded adjustments to correct gains and losses on foreign currency derivative contracts by using current exchange rates at the applicable measurement dates as inputs to the related fair value measurements. The impacts of the foreign currency derivative contract gain or loss misstatements on each period are discussed in restatement reference (b) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
Additional Misstatements
(c) Equipment Leased to Customers under Operating Leases
Our manufacturing subsidiaries often sell products to commercial subsidiaries within our consolidated group which then sell or lease those products to third-party customers. Under U.S. GAAP, intra-company sales, intra-company cost of sales, and any step-ups in the carrying amount of inventory from intra-company transactions are eliminated in consolidation. If we subsequently sell the products to a third-party customer, the related intra-company profit previously eliminated in consolidation is recognized in our consolidated statements of income. For transactions in which we lease, rather than sell, our products to customers under operating lease arrangements, no profit or loss should be recognized at inception of the arrangement and any intra-company profit previously eliminated in consolidation should be recognized as a reduction to the carrying amount of the related leased assets. Prior to the third quarter of 2019, our international operations incorrectly recognized intra-company profit previously eliminated in consolidation as a reduction of cost of sales, rather than as a reduction of leased assets, at inception of operating lease arrangements. Accordingly, we have recorded adjustments to increase cost of sales and decrease property, plant, and equipment, net in our consolidated financial statements. Those adjustments include corrections of depreciation expense and accumulated depreciation resulting from the decreases to the carrying amounts of the
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related leased equipment. The impacts of the operating lease misstatements on each period are discussed in restatement reference (c) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows
We previously included foreign exchange gains and losses related to intra-company receivables and payables and cash balances within our cash flows from operations. In the accompanying consolidated statements of cash flows, foreign exchange gains and losses, as restated, related to intra-company receivables and payables and cash balances are presented as reconciling items between income from continuing operations and cash flows from operations. The impacts of those misclassifications on our operating cash flows for each period are discussed in restatement reference (d) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars
U.S. GAAP specifies that the income statement of a foreign operation should be translated into the reporting currency using the exchange rates on the dates the income or expense was recognized and indicates that the use of weighted-average exchange rates during the period is generally appropriate. Similar to our convention for the initial measurement of foreign currency transactions, we historically translated the results of operations of our foreign operations for a given month into U.S. dollars using exchange rates from a specified date near the middle of the previous month. Accordingly, we have recorded adjustments to translate the income statements of our foreign operations into U.S. dollars using the applicable average foreign exchange rates for each month.
U.S. GAAP specifies that the assets and liabilities of foreign operations be translated into the reporting currency at the end of each reporting period using the exchange rate at that date. Similar to our convention for the subsequent remeasurement of foreign currency denominated monetary assets and liabilities, our financial reporting systems were previously configured to translate assets and liabilities at the end of each month using exchange rates from a specified date near the middle of the current month. In recent years, we separately computed the impact of translating assets and liabilities at period-end exchange rates and adjusted our consolidated balance sheets to reflect that difference. However, due to an incorrect input in those manual calculations as of December 31, 2018, our balance sheet was misstated as of that date.
The impacts of misstatements related to the translation of the financial position and results of operations of our foreign operations on each period are discussed in restatement reference (e) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
(f) Income Statement Classification of Transition Services Income
We entered into a transition services agreement (TSA) with Baxalta in connection with the July 1, 2015 separation transaction. Services we provided under the TSA included, among others, finance, information technology, human resources, quality, supply chain, and certain other administrative services. Those services generally commenced on July 1, 2015 and concluded on July 1, 2018. As previously disclosed, we recognized income of approximately $9 million and $56 million, respectively, under the TSA for the years ended December 31, 2018 and 2017. The amounts earned for those services were previously presented as a reduction of Selling, general, and administrative expenses (which we previously referred to as “Marketing and administrative expenses”) in our consolidated statements of income. The accompanying restated consolidated statements of income for the years ended December 31, 2018 and 2017 present the amounts earned for those services within Other operating income, net, rather than as a reduction of Selling, general, and administrative expenses. The impacts of the income statement misclassification of TSA income on each period are discussed in restatement reference (f) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
(g) Other Miscellaneous Adjustments
We recorded adjustments to correct other out-of-period items and previously uncorrected misstatements that were not material, individually or in the aggregate, to our consolidated financial statements. Those other misstatements were primarily related to a historical restructuring liability and amounts related to our separation of Baxalta in 2015. The impacts of the other miscellaneous adjustments on each period are discussed in restatement reference (g) throughout this note and in Note 19, Quarterly Financial Results (Unaudited).
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Description of Restatement Tables
The following tables present the impact of the adjustments described above to our previously reported consolidated balance sheet as of December 31, 2018 and the consolidated statements of income, comprehensive income, changes in equity, and cash flows for the years ended December 31, 2018 and 2017.
Following the restated consolidated financial statement tables, we have presented reconciliations from our prior periods as previously reported to the restated amounts. The amounts as previously reported for the years ended December 31, 2018 and 2017 were derived from our Annual Report on Form 10-K for the year ended December 31, 2018 filed on February 21, 2019.

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Baxter International Inc.
Consolidated Balance Sheet
(in millions, except per share)
December 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Current assets:
Cash and cash equivalents$1,832  $ (e) $1,838  
Accounts receivable, net1,812  28  (e)(g) 1,840  
Inventories1,653  14  (e)(g) 1,667  
Prepaid expenses and other current assets622  (8) (b)(e)(g) 614  
Total current assets5,919  40  5,959  
Property, plant and equipment, net4,542  (12) (c)(e) 4,530  
Goodwill2,958  44  (e) 3,002  
Other intangible assets, net1,398  12  (e)(g) 1,410  
Other non-current assets824  (5) (a)(c)(e)(g) 819  
Total assets$15,641  $79  $15,720  
Current liabilities:
Short-term debt$ $—  $ 
Current maturities of long-term debt and finance lease obligations —   
Accounts payable and accrued liabilities2,832  (22) (b)(e)(g) 2,810  
Total current liabilities2,836  (22) 2,814  
Long-term debt and finance lease obligations3,473   (e) 3,481  
Other non-current liabilities1,516  43  (a)(c)(e)(g) 1,559  
Total liabilities7,825  29  7,854  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares683  —  683  
Common stock in treasury, at cost, 170,495,859 shares(9,989) —  (9,989) 
Additional contributed capital5,898 ��—  5,898  
Retained earnings15,626  (551) (a)(b)(c)(e)(g) 15,075  
Accumulated other comprehensive (loss) income(4,424) 601  (a)(e) (3,823) 
Total Baxter stockholders’ equity7,794  50  7,844  
Noncontrolling interests22  —  22  
Total equity7,816  50  7,866  
Total liabilities and equity$15,641  $79  $15,720  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to retained earnings of $487 million and accumulated other comprehensive loss of $482 million and increases to other non-current assets of $8 million and other non-current liabilities of $13 million as of December 31, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to prepaid expenses and other current assets of $2 million, accounts payable and accrued liabilities of $1 million, and retained earnings of $1 million as of December 31, 2018.
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(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to property, plant and equipment, net of $53 million, other non-current liabilities of $5 million, and retained earnings of $38 million and an increase to other non-current assets of $10 million as of December 31, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to cash and cash equivalents of $6 million, accounts receivable, net of $22 million, inventories of $19 million, prepaid expenses and other current assets of $2 million, property, plant and equipment of $41 million, goodwill of $44 million, other intangible assets, net of $13 million, other non-current assets of $6 million, accounts payable and accrued liabilities of $24 million, long-term debt and finance lease obligations of $8 million and other non-current liabilities of $19 million as of December 31, 2018. The correction of these misstatements also resulted in decreases to retained earnings of $17 million and accumulated other comprehensive loss of $119 million as of December 31, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in decreases to inventories of $5 million, prepaid expenses and other current assets of $12 million, other intangible assets, net of $1 million, other non-current assets of $29 million, accounts payable and accrued liabilities of $47 million, and retained earnings of $10 million, and increases to accounts receivable, net of $6 million and other non-current liabilities of $16 million as of December 31, 2018.


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Baxter International Inc.
Consolidated Statement of Income
(in millions, except per share)
Year ended December 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$11,127  $(28) (e)$11,099  
Cost of sales6,346  (6) (c)(e)6,340  
Gross margin4,781  (22) 4,759  
Selling, general and administrative expenses2,617   (e)(f)2,620  
Research and development expenses655  (1) (e)654  
Other operating income, net(90) (9) (f)(99) 
Operating income1,599  (15) 1,584  
Interest expense, net45  —  45  
Other (income) expense, net(139) 61  (a)(b)(e)(78) 
Income from continuing operations before income taxes1,693  (76) 1,617  
Income tax expense (benefit)63   (c)(e)(g)65  
Income from continuing operations1,630  (78) 1,552  
Loss from discontinued operations, net of tax(6) —  (6) 
Net income$1,624  $(78) $1,546  
Earnings per share from continuing operations
Basic$3.05  $(0.14) $2.91  
Diluted$2.99  $(0.15) $2.84  
Loss per share from discontinued operations
Basic$(0.01) $—  $(0.01) 
Diluted$(0.02) $0.01  $(0.01) 
Earnings per share
Basic$3.04  $(0.14) $2.90  
Diluted$2.97  $(0.14) $2.83  
Weighted-average number of shares outstanding
Basic534  —  534  
Diluted546  —  546  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in a decrease to other (income) expense, net of $64 million for the year ended December 31, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in an increase to other (income) expense, net of $5 million for the year ended December 31, 2018.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $11 million and a decrease to income tax expense of $3 million for the year ended December 31, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in decreases to net sales of $28 million, cost of sales of $17 million, SG&A expense of $6 million, R&D expense of $1 million, other (income) expense, net of $2 million, and income tax expense of $2 million for the year ended December 31, 2018.
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(f) Income Statement Classification of Transition Services Income—The correction of these misstatements resulted in increases to SG&A expense and other operating income, net of $9 million for the year ended December 31, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in an increase to income tax expense of $7 million for the year ended December 31, 2018.



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Baxter International Inc.
Consolidated Statement of Income
(in millions, except per share)
Year ended December 31, 2017
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$10,561  $23  (e) $10,584  
Cost of sales6,091  19  (c)(e) 6,110  
Gross margin4,470   4,474  
Selling, general and administrative expenses2,566  61  (e)(f) 2,627  
Research and development expenses613   (e) 615  
Other operating income, net—  (56) (f) (56) 
Operating income1,291  (3) 1,288  
Interest expense, net55  —  55  
Other (income) expense, net19  114  (a)(b)(e) 133  
Income from continuing operations before income taxes1,217  (117) 1,100  
Income tax expense (benefit)493  (2) (c)(e) 491  
Income from continuing operations724  (115) 609  
Loss from discontinued operations, net of tax(7) $—  (7) 
Net income$717  $(115) $602  
Earnings per share from continuing operations
Basic$1.33  $(0.21) $1.12  
Diluted$1.30  $(0.20) $1.10  
Loss per share from discontinued operations
Basic$(0.01) $—  $(0.01) 
Diluted$(0.01) $(0.01) $(0.02) 
Earnings per share
Basic$1.32  $(0.21) $1.11  
Diluted$1.29  $(0.21) $1.08  
Weighted-average number of shares outstanding
Basic543—  543  
Diluted555—  555  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to other (income) expense, net of $96 million.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in an increase to other (income) expense, net of $17 million.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $8 million and a decrease to income tax expense of $3 million for the year ended December 31, 2017.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to net sales of $23 million, cost of sales of $11 million, SG&A expense of $5 million, R&D expense of $2 million, other (income) expense, net of $1 million and income tax expense of $1 million for the year ended December 31, 2017.
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(f) Income Statement Classification of Transition Services Income—The correction of these misstatements resulted in increases to SG&A expense and other operating income, net of $56 million for the year ended December 31, 2017.


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Baxter International Inc.
Consolidated Statement of Comprehensive Income
(in millions)
Year ended December 31, 2018
As previously reportedRestatement impactsAs restated
Net income$1,624  $(78) $1,546  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(461) 138  (323) 
Pension and other postretirement benefit plans32   33  
Hedging activities —   
Total other comprehensive (loss) income, net of tax(420) 139  (281) 
Comprehensive income$1,204  $61  $1,265  
The $78 million decrease to net income was driven by the items described above in the consolidated statement of income for the year ended December 31, 2018 section.
The $138 million decrease to currency translation adjustments for the year ended December 31, 2018 is comprised of a $74 million decrease to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars and a $64 million decrease from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses.
The $1 million increase to pension and other postretirement benefit plans for the year ended December 31, 2018 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.


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Baxter International Inc.
Consolidated Statement of Comprehensive Income
(in millions)
Year ended December 31, 2017
As previously reportedRestatement impactsAs restated
Net income$717  $(115) $602  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments425  174  599  
Pension and other postretirement benefit plans141  (7) 134  
Hedging activities(13) —  (13) 
Available-for-sale securities —   
Total other comprehensive (loss) income, net of tax555  167  722  
Comprehensive income$1,272  $52  $1,324  
The $115 million decrease to net income was driven by the items described above in the consolidated statement of income for the year ended December 31, 2017 section.
The $174 million increase to currency translation adjustments for the year ended December 31, 2017 is comprised of a $78 million increase to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars and a $96 million increase from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses.
The $7 million decrease to pension and other postretirement benefit plans for the year ended December 31, 2017 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.


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Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,483  $(4,001) $9,124  $(8) $9,116  
Adoption of new accounting standards—  —  —  —  —  (18) (3) (21) —  (21) 
Net income—  —  —  —  —  1,624  —  1,624  —  1,624  
Other comprehensive income (loss)—  —  —  —  —  —  (420) (420) —  (420) 
Purchases of treasury stock—  —  36  (2,415) (60) —  —  (2,475) —  (2,475) 
Stock issued under employee benefit plans and other—  —  (8) 407  18  (71) —  354  —  354  
Dividends declared on common stock—  —  —  —  —  (392) —  (392) —  (392) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  30  30  
Balance as of December 31, 2018683  $683  170  $(9,989) $5,898  $15,626  $(4,424) $7,794  $22  $7,816  
Restatement impacts
Balance as of January 1, 2018—  $—  —  $—  $—  $(469) $462  $(7) $—  $(7) 
Adoption of new accounting standards—  —  —  —  —  (4) —  (4) —  (4) 
Net income—  —  —  —  —  (78) —  (78) —  (78) 
Other comprehensive income (loss)—  —  —  —  —  —  139  139  —  139  
Balance as of December 31, 2018—  $—  —  $—  $—  $(551) $601  $50  $—  $50  
As restated
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
Adoption of new accounting standards—  —  —  —  —  (22) (3) (25) —  (25) 
Net income—  —  —  —  —  1,546  —  1,546  —  1,546  
Other comprehensive income (loss)—  —  —  —  —  —  (281) (281) —  (281) 
Purchases of treasury stock—  —  36  (2,415) (60) —  —  (2,475) —  (2,475) 
Stock issued under employee benefit plans and other—  —  (8) 407  18  (71) —  354  —  354  
Dividends declared on common stock—  —  —  —  —  (392) —  (392) —  (392) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  30  30  
Balance as of December 31, 2018683  683  170  (9,989) 5,898  15,075  (3,823) 7,844  22  7,866  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the year ended December 31, 2018 sections above. Additionally, we recorded an adjustment to the opening balance of retained earnings on January 1, 2018 for the adoption of ASU No. 2016-16, which was impacted by our adjustments to equipment leased to customers under operating leases.
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Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of January 1, 2017683  $683  144  $(7,995) $5,958  $14,200  $(4,556) $8,290  $(10) $8,280  
Net income—  —  —  —  —  717  —  $717  —  $717  
Other comprehensive income (loss)—  —  —  —  —  —  555  555  —  555  
Purchases of treasury stock—  —   (564) —  —  —  (564) —  (564) 
Stock issued under employee benefit plans and other—  —  (11) 578  (18) (134) —  426  —  426  
Dividends declared on common stock—  —  —  —  —  (334) —  (334) —  (334) 
Distribution of Baxalta—  —  —  —  —  34  —  34  —  34  
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of December 31, 2017683  $683  142  $(7,981) $5,940  $14,483  $(4,001) $9,124  $(8) $9,116  
Restatement impacts
Balance as of January 1, 2017—  $—  —  $—  $—  $(354) $295  $(59) $—  $(59) 
Net income—  —  —  —  —  (115) —  (115) —  (115) 
Other comprehensive income (loss)—  —  —  —  —  —  167  167  —  167  
Balance as of December 31, 2017—  $—  —  $—  $—  $(469) $462  $(7) $—  $(7) 
As restated
Balance as of January 1, 2017683  $683  144  $(7,995) $5,958  $13,846  $(4,261) $8,231  $(10) $8,221  
Net income—  —  —  —  —  602  —  602  —  602  
Other comprehensive income (loss)—  —  —  —  —  —  722  722  —  722  
Purchases of treasury stock—  —   (564) —  —  —  (564) —  (564) 
Stock issued under employee benefit plans and other—  —  (11) 578  (18) (134) —  426  —  426  
Dividends declared on common stock—  —  —  —  —  (334) —  (334) —  (334) 
Distribution of Baxalta—  —  —  —  —  34  —  34  —  34  
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of December 31, 2017683  $683  142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
The adjustment to the January 1, 2017 retained earnings and accumulated other comprehensive loss represent the cumulative impacts of foreign exchange gains and losses and the translation of our financial position and results of operations for our foreign operations into U.S. dollars for the periods prior to January 1, 2017. Retained earnings also includes the cumulative impacts of equipment leased to customers under operating leases and other miscellaneous adjustments for the periods prior to January 1, 2017.
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the year ended December 31, 2017 sections above.

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Baxter International Inc.
Consolidated Statement of Cash Flows
(in millions)
Year ended December 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Cash flows from operations
Net income$1,624  $(78) $1,546  
Adjustments to reconcile income from continuing operations to net cash from operating activities:
Loss from discontinued operations, net of tax —   
Depreciation and amortization785  (14) (c)(g) 771  
Pension settlement charges —   
Net periodic pension benefit and other postretirement costs39  —  39  
Deferred income taxes(267)  (c)(g) (263) 
Stock compensation115  —  115  
Other43   (d) 50  
Changes in balance sheet items:
Accounts receivable, net(12) —  (12) 
Inventories(197) —  (197) 
Accounts payable and accrued liabilities64  (4) (b) 60  
Other(105)  (b)(e)(g) (99) 
Cash flows from operations2,096  (79) 2,017  
Cash flows from investing activities
Capital expenditures(681) 22  (c) (659) 
Acquisitions and investments, net of cash acquired(268) —  (268) 
Other investing activities, net11  —  11  
Cash flows from investing activities(938) 22  (916) 
Cash flows from financing activities
Cash dividends on common stock(376) —  (376) 
Proceeds from stock issued under employee benefit plans258  —  258  
Purchases of treasury stock(2,452) —  (2,452) 
Other financing activities, net(33) —  (33) 
Cash flows from financing activities(2,603) —  (2,603) 
Effect of foreign exchange rate changes on cash and cash equivalents(117) 54  (a)(d)(e) (63) 
Increase (decrease) in cash and cash equivalents(1,562) (3) (1,565) 
Cash and cash equivalents at beginning of year3,394   (e) 3,403  
Cash and cash equivalents at end of year$1,832  $ (e) $1,838  
Other supplemental information
Interest paid, net of portion capitalized$94  —  $94  
Income taxes paid$302  (1) (e) $301  




The $78 million decrease to net income was driven by the items described above in the consolidated statement of income for the year ended December 31, 2018 section.

(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents of $64 million for the year ended December 31, 2018.

(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in decreases to changes in accounts payable and accrued liabilities of $4 million and other changes in balance sheet items of $1 million for the year ended December 31, 2018.

(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to depreciation and amortization of $11 million, deferred income taxes of $3 million and capital expenditures of $22 million for the year ended December 31, 2018.

(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows - The corrections of these misstatements resulted in a decrease to the effect of foreign exchange rate changes on cash and cash equivalents and an increase to other adjustments to reconcile net income to net cash from operating activities of $7 million for the year ended December 31, 2018.

(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars - The corrections of these misstatements resulted in increases to cash and cash equivalents at the beginning of the period of $9 million, at the end of the period of $6 million, and to other changes in balance sheet items of $4 million and decreases in the effect of foreign exchange rate changes on cash and cash equivalents of $3 million and income taxes paid of $1 million for the year ended December 31, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in a decrease to depreciation and amortization of $3 million and increases to deferred income taxes of $7 million and other changes in balance sheet items of $3 million for the year ended December 31, 2018.





Baxter International Inc.
Consolidated Statement of Cash Flows
(in millions)
Year ended December 31, 2017
As previously reportedRestatement impactsRestatement referenceAs restated
Cash flows from operations
Net income$717  $(115) $602  
Adjustments to reconcile income from continuing operations to net cash from operating activities:
Loss from discontinued operations, net of tax —   
Depreciation and amortization761  (11) (c)(g) 750  
Pension settlement charges —   
Net periodic pension benefit and other postretirement costs123  —  123  
Deferred income taxes211  —  211  
Stock compensation107  —  107  
Other43  (5) (d)(g) 38  
Changes in balance sheet items:
Accounts receivable, net30  —  30  
Inventories76  —  76  
Accounts payable and accrued liabilities  (b) 11  
Other(229)  (b)(c)(e) (227) 
Cash flows from operations - continuing operations1,853  (123) 1,730  
Cash flows from operations - discontinued operations(16) —  (16) 
Cash flows from operations1,837  (123) 1,714  
Cash flows from investing activities
Capital expenditures(634) 18  (c) (616) 
Acquisitions and investments, net of cash acquired(686) —  (686) 
Other investing activities, net10  —  10  
Cash flows from investing activities(1,310) 18  (1,292) 
Cash flows from financing activities
Issuances of debt633  32  (a) 665  
Cash dividends on common stock(315) —  (315) 
Proceeds from stock issued under employee benefit plans347  —  347  
Purchases of treasury stock(564) —  (564) 
Other financing activities, net(40) —  (40) 
Cash flows from financing activities61  32  93  
Effect of foreign exchange rate changes on cash and cash equivalents 97  (a)(d)(e) 102  
Increase (decrease) in cash and cash equivalents593  24  617  
Cash and cash equivalents at beginning of year2,801  (15) (e) 2,786  
Cash and cash equivalents at end of year$3,394  $ (e) $3,403  
Other supplemental information
Interest paid, net of portion capitalized$80  —  $80  
Income taxes paid$255  (2) (e) $253  



The $115 million decrease to net income was driven by the items described above in the consolidated statement of income for the year ended December 31, 2017 section.

(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents of $99 million for the year ended December 31, 2017. Additionally, issuances of debt increased $32 million with an offsetting decrease to the effect of foreign exchange rate changes on cash and cash equivalents to remeasure the proceeds received from the issuance of our Euro-denominated senior notes in May 2017.

(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to changes in accounts payable and accrued liabilities of $6 million and other changes in balance sheet items of $8 million for the year ended December 31, 2017.

(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to depreciation and amortization of $10 million, other changes in balance sheet items of $3 million and capital expenditures of $18 million for the year ended December 31, 2017.

(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows - The corrections of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents and a decrease to other adjustments to reconcile net income to net cash from operating activities of $6 million for the year ended December 31, 2017.

(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars - The corrections of these misstatements resulted in increases in cash and cash equivalents at the end of the period of $9 million and the effect of foreign exchange rate changes on cash and cash equivalents of $24 million and decreases to cash and cash equivalents at the beginning of the period of $15 million, other changes in balance sheet items of $3 million and income taxes paid of $2 million for the year ended December 31, 2017.

(g) Other miscellaneous adjustments - The correction of these misstatements resulted in a decrease to depreciation and amortization and an increase to other adjustments to reconcile net income to net changes from operating activities of $1 million for the year ended December 31, 2017.

NOTE 3
SEPARATION OF BAXALTA
On July 1, 2015, we completed the distribution of approximately 80.5% of the outstanding common stock of Baxalta to our stockholders (the Distribution). After giving effect to the Distribution, we retained 19.5% of the outstanding common stock, or 131,902,719 shares of Baxalta (Retained Shares).  The Distribution was made to our stockholders of record as of the close of business on June 17, 2015 (Record Date), who received 1 share of Baxalta common stock for each of our shares held as of the Record Date. As a result of the Distribution, Baxalta became an independent public company. In 2016, we disposed of our remaining 19.5% interest in Baxalta through a series of transactions including debt-for-equity exchanges, an equity-for-equity exchange and a contribution to our U.S. pension plan.
We entered into several additional agreements with Baxalta as a result of the July 1, 2015 separation, including a transition services agreement (TSA), separation and distribution agreement, manufacturing and supply agreements (MSA), tax matters agreement and a long-term services agreement.
Pursuant to the TSA, we and our subsidiaries, along with Baxalta and their respective subsidiaries, provided to each other, on an interim, transitional basis, various services. Services provided by us included, among others, finance, information technology, human resources, quality, supply chain and certain other administrative services. The services generally commenced on the Distribution date and terminated as of July 1, 2018. Billings by us under the TSA are presented within other operating income, net in the consolidated statements of income. In 2018 and 2017, we recognized approximately $9 million and $56 million, respectively, related to the TSA.
Cash outflows of $6 million, 0 and $16 million in 2019, 2018 and 2017, respectively, were reported in cash flows from operations – discontinued operations. These cash flows relate to payments under the tax matters agreement, non-assignable tenders whereby we remained the seller of Baxalta products, transactions related to importation services we provided in certain countries and trade payables settled following local separation on Baxalta’s behalf.



NOTE 4
ACQUISITIONS AND OTHER ARRANGEMENTS
Results of operations of acquired companies are included in our results of operations as of the respective acquisition dates. The purchase price of each acquisition is allocated to the net assets acquired based on estimates of their fair values (or other measurement attribute required under U.S. GAAP) at the date of the acquisition. Any purchase price in excess of these net assets is recorded as goodwill. The allocation of purchase price in certain cases may be subject to revision based on the final determination of fair values during the measurement period, which may be up to one year from the acquisition date.
Contingent consideration related to business combinations is recognized at its estimated fair value on the acquisition date. Subsequent changes to the fair value of those contingent consideration arrangements are recognized in earnings. Contingent consideration related to acquisitions may consist of development, regulatory and commercial milestone payments, and sales or earnings-based payments, and are valued using discounted cash flow techniques. The fair value of development, regulatory and commercial milestone payments reflects management’s expectations of the probability of payment, and increases or decreases as the probability of payment or expectation of timing or amount of payments changes. The fair value of sales-based payments is based upon probability-weighted future revenue estimates and increases or decreases as revenue estimates or expectation of timing or amount of payments changes.
Hillrom
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hillrom for a purchase price of $10.5 billion. Including the assumption of Hillrom's outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Under the terms of the transaction agreement, Hillrom shareholders received $156.00 in cash per each outstanding Hillrom common share.
Prior to our acquisition of Hillrom, Hillrom was a global medical technology leader whose products and services help enable earlier diagnosis and treatment, optimize surgical efficiency, and accelerate patient recovery while simplifying clinical communication and shifting care closer to home. Hillrom made those outcomes possible through digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices, advanced equipment for the surgical space and more, delivering actionable, real-time insights at the point of care.
The following table summarizes the fair value of the total consideration paid:
(in millions)
Cash consideration paid to Hillrom shareholders(a)
$10,474 
Fair value of equity awards issued to Hillrom equity award holders(b)
Total Consideration$10,476 
(a) Represents cash consideration transferred of $156.00 per outstanding Hillrom common share to existing shareholders and holders of equity awards that vested at closing pursuant to their original terms.
(b) Represents the pre-acquisition service portion of the fair value of 668 thousand replacement restricted stock units issued to Hillrom equity award holders at closing.
The valuation of assets acquired and liabilities assumed has not yet been finalized as of December 31, 2021. As a result, we recorded preliminary estimates for the fair value of assets acquired and liabilities assumed as of the acquisition date. Finalization of the valuation during the measurement period could result in a change in the
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amounts recorded for the acquisition date fair value of intangible assets, goodwill and income taxes among other items. The completion of the valuation will occur no later than one year from the acquisition date. The following table summarizes the preliminary fair values of the assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash and cash equivalents$399 
Accounts receivable591 
Inventories560 
Prepaid expenses and other current assets49 
Property, plant and equipment503 
Goodwill6,785 
Other intangible assets6,022 
Operating lease right-of-use assets74 
Other non-current assets128 
Short-term debt(250)
Accounts payable(140)
Accrued expenses and other current liabilities(552)
Long-term debt and finance lease obligations(2,118)
Operating lease liabilities(57)
Other non-current liabilities(1,518)
Total assets acquired and liabilities assumed$10,476 
We allocated $804 million of the total consideration to developed technology with a weighted-average useful life of 5 years, $1.9 billion to trade names with an indefinite useful life, $62 million to trade names with a weighted-average useful life of 7 years, $3.2 billion to customer relationships with a weighted-average useful life of 15 years and $30 million to IPR&D that is considered an indefinite lived intangible asset. The fair values of the intangible assets were determined using the income approach. We used a discount rate of 8.5% to value the developed technology, trade names and customer relationships and 9.0% to value the IPR&D. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair value. We also recognized $1.3 billion of deferred income tax liabilities in connection with the acquisition, which are included in other non-current liabilities in the accompanying consolidated balance sheet as of December 31, 2021.
The goodwill, which is not deductible for tax purposes, includes the value of an assembled workforce as well as the overall strategic benefits provided to our product portfolio and is included in the Hillrom segment.
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired. The Hillrom acquisition contributed $212 million of net sales and a $96 million of pretax loss, including integration costs and interest expense on acquisition financing, for the year ended December 31, 2021.
Costs directly resulting from the Hillrom acquisition, included acquisition and integration costs of $139 million and the incremental cost of sales relating to inventory fair value step-ups of $42 million in 2021.
The following table presents the unaudited pro forma combined results of Baxter and Hillrom for the years ended December 31, 2021 and 2020 as if the acquisition of Hillrom had occurred on January 1, 2020:
years ended December 31 (in millions)20212020
Net sales$15,574 $14,610 
Net income attributable to Baxter stockholders962 635 
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The acquisition has been accounted for in the unaudited pro forma combined financial information using the acquisition method of accounting with Baxter as the acquirer. In order to reflect the occurrence of the acquisition as if it occurred on January 1, 2020 as required, the unaudited pro forma combined financial information includes adjustments to reflect incremental depreciation and amortization expense based on the current preliminary fair values of the identifiable tangible and intangible assets acquired, additional interest expense associated with the issuance of debt to finance the acquisition, nonrecurring costs directly attributable to the acquisition and the income tax effects of the pro forma adjustments. Those nonrecurring costs, which consist of $201 million of costs from inventory fair value step-ups and $314 million of acquisition-related costs for both Baxter and Hillrom, are reflected in the unaudited pro forma combined financial information for the year ended December 31, 2020. The unaudited pro forma combined financial information is not necessarily indicative of what the consolidated results of operations would have been had the acquisition been completed on January 1, 2020. In addition, the unaudited pro forma combined financial information is not a projection of future results of operations of the combined company nor does it reflect the expected realization of any potential synergies or cost savings associated with the acquisition.
PerClot
On July 29, 2021, we acquired certain assets related to PerClot, including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million, which had an acquisition-date fair value of $28 million, based upon regulatory and commercial milestones. PerClot is an absorbable powder hemostat indicated for use in surgical procedures, including cardiac, vascular, orthopedic, spinal, neurological, gynecological, ENT and trauma surgery as an adjunct hemostat when control of bleeding from capillary, venous, or arteriolar vessels by pressure, ligature, and other conventional means is either ineffective or impractical. PerClot is approved for distribution in the European Union and other markets and was submitted for Pre-Market Approval (PMA) for distribution in the U.S. in the fourth quarter of 2021. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair values of the potential contingent consideration payments were estimated by applying probability-weighted expected payment models and are Level 3 fair value measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$25 
Contingent Consideration28 
Total Consideration$53 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Goodwill$
Other intangible assets49 
Total assets acquired$53 
The valuation of the assets acquired are preliminary and measurement period adjustments may be recorded in the future as we finalize our fair value estimates. The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the year ended December 31, 2021.
We allocated $39 million of the total consideration to an in-process research and development (IPR&D) asset with an indefinite useful life, $9 million to the approved PerClot developed product rights with an estimated useful life of 10 years and $1 million to customer relationships with an estimated useful life of 10 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 18.7% for IPR&D, 16.0% for developed product rights and 15.0% for customer relationships. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
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The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our surgical portfolio of hemostats and sealants and is included in the Americas and EMEA segments.
Transderm Scop
On March 31, 2021, we acquired the rights to TDS for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval of a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. TDS is indicated for post-operative nausea and vomiting in the U.S. and motion sickness in European markets. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair value of the potential contingent consideration payment was estimated by applying a probability-weighted expected payment model and is a Level 3 fair value measurement due to the significant estimates and assumptions used by management in establishing the estimated fair value.
The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$60 
Contingent Consideration24 
Total Consideration$84 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Inventory$16 
Goodwill
Other intangible assets67 
Total assets acquired$84 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the year ended December 31, 2021.
We allocated $64 million of the total consideration to the TDS developed product rights with an estimated useful life of 9 years and $3 million to customer relationships with an estimated useful life of 7 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 22.5% for developed product rights and 15.5% for customer relationships. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our pharmaceutical portfolio and is included in the Americas segment.
Seprafilm Adhesion Barrier
On February 14, 2020, we completed the acquisition of the product rights to Seprafilm Adhesion Barrier (Seprafilm) from Sanofi for approximately $342 million in cash. Seprafilm is indicated for use in patients undergoing abdominal or pelvic laparotomy as an adjunct intended to reduce the incidence, extent and severity of postoperative adhesions between the abdominal wall and the underlying viscera such as omentum, small bowel, bladder, and stomach, and between the uterus and surrounding structures such as tubes and ovaries, large bowel, and bladder. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting.
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The following table summarizes the fair values of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Inventories$18 
Goodwill28 
Other intangible assets296 
Total assets acquired$342 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired. The acquisition contributed $94 million of net sales and $18 million of pretax income for the year ended December 31, 2020. Acquisition and integration costs, primarily incremental cost of sales relating to inventory fair value step-ups, associated with the acquisition were $15 million for the year ended December 31, 2020.
We allocated $286 million and $10 million of the total consideration to the Seprafilm developed product rights and customer relationships with useful lives of 10 and 7 years, respectively. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the developed product rights and customer relationship intangible assets were 14.8% and 11.0%, respectively. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions we used in establishing the estimated fair values.
The goodwill, which is deductible for tax purposes, includes the value of the overall strategic benefits provided to our product portfolio of hemostats and sealants and is included in the Americas and APAC segments.
Cheetah Medical, Inc.
On October 25, 2019, we acquired 100 percent of Cheetah Medical, Inc. (Cheetah), a leading provider of hemodynamic monitoring technologies, for total upfront cash consideration of $195 million, net of cash acquired, with the potential for additional cash consideration, up to $40 million, based on clinical and commercial milestones for which the acquisition date fair value was $18 million. Cheetah isIn 2020, we received $7 million from the sellers as a leading providerresult of hemodynamic monitoring technologies.an acquisition price adjustment in accordance with the acquisition agreement. The fair value of the potential contingent consideration payments was estimated by applying a probability-weighted expected payment model for the clinical milestone and a Monte Carlo simulation model for the commercial milestone, which were then discounted to present value. The fair value measurements were based on Level 3 inputs. Refer to Note 17 for additional information regarding fair value measurements.
The following table summarizes the fair value of consideration transferred:
(in millions)
Cash consideration transferred$197190 
Contingent consideration18 
Total consideration$215208 
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The following table summarizes the fair values of the assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash$
Accounts receivable, net
Inventories
Prepaid expenses and other current assets
Property, plant and equipment
Goodwill11184 
Other intangible assets131 
Operating lease right-of-use assets
Accounts payable and other accrued liabilities(4)
Other non-current liabilities(32)(12)
Total assets acquired and liabilities assumed$215208 
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The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not significant. Acquisition and integration costs associated with the acquisition were $5 million and $3 million in 2019.2020 and 2019, respectively.
We allocated $123 million of the total consideration to the developed product rights with a weighted-average useful life of 15 years and $8 million to customer relationships with a useful life of 13 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 11.0% for developed product rights and 10.0% for customer relationships. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The goodwill, which is not deductible for tax purposes, includes the value of potential future technologies as well as the overall strategic benefits provided to our product portfolio and is included primarily in the Americas segment.
RECOTHROM and PREVELEAK
On March 16, 2018, we acquired 2 hemostat and sealant products from Mallinckrodt plc: RECOTHROM Thrombin topical (Recombinant), the first and only stand-alone recombinant thrombin, and PREVELEAK Surgical Sealant, which is used in vascular reconstruction. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The purchase price included an upfront payment of approximately $163 million in 2018. In addition, the purchase price included new and assumed contingent payments in the future related to inventory and technology transfer milestones and net revenue royalty payments with an estimated fair value of $21 million as of the acquisition date. The maximum aggregate amounts payable for the inventory and technology transfer and net revenue royalties were $7 million, $15 million and $143 million, respectively. The fair value of the potential contingent consideration payments was estimated by applying a probability-weighted expected payment model for the inventory and technology transfer payments and a Monte Carlo simulation model for contingent royalty payments, which were then discounted to present value.
The following table summarizes the fair value of consideration transferred:
(in millions)
Cash consideration transferred$163 
Contingent consideration21 
Total consideration$184 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Accounts receivable, net$
Inventory80 
Goodwill
Other intangible assets100 
Total assets acquired$184 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired. The RECOTHROM and PREVELEAK acquisitions contributed $80 million and $52 million of net sales for the years ended December 31, 2019 and 2018, respectively. Acquisition and integration costs, including incremental cost of sales relating to inventory fair value step-ups, associated with the acquisition were $20 million and $17 million, respectively, in 2019 and 2018.
We allocated $100 million of the total consideration to the RECOTHROM and PREVELEAK developed product rights with a weighted-average useful life of 10 years. The fair value of the intangible assets was determined using the income approach. The discount rates used to measure the RECOTHROM and PREVELEAK intangible assets were 12.5% and 13.0%, respectively. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
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The goodwill, which is deductible for tax purposes, includes the value of potential future technologies as well as the overall strategic benefits provided to our surgical portfolio of hemostats and sealants, and is included in the Americas segment.
Saudi Arabia Joint Venture
In November 2018, we acquired additional equity to obtain a 51% controlling financial interest of our joint venture in Saudi Arabia that was previously accounted for under the equity method of accounting. The acquisition allows us to increase manufacturing output and utilize the facilities for additional capacity for certain products in the region. Beginning in the fourth quarter of 2018, we consolidated the financial statements of the joint venture with our consolidated financial statements. The results of operations of the joint venture have been included in our consolidated statement of income since the date the business was acquired and were not significant.
The guidance on accounting for business combinations requires that an acquirer remeasure its previously held equity interest in an acquiree at its acquisition date fair value and recognize the resulting gain or loss in earnings. Thus, in connection with the acquisition, the carrying amount of our previously held equity interest in the joint venture was remeasured to fair value at the acquisition date, resulting in a gain in the fourth quarter of 2018 of $24 million, which was included in other (income) expense, net in the consolidated statement of income. The fair value of the equity interest on the acquisition date was $39 million and we consider the fair value to be a Level 3 measurement due to the significant estimates and assumptions used by management in establishing the estimated fair value.
The following table summarizes the fair value of consideration transferred:
(in millions)
Consideration transferred
Cash$
Fair value of equity investment39 
Noncontrolling interest39 
Total consideration transferred$80 
The following table summarizes the fair value of assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash$
Accounts receivable, net25 
Inventories
Property, plant and equipment12 
Goodwill17 
Other intangible assets40 
Other non-current assets
Short-term debt(4)
Accounts payable and accrued liabilities(16)
Other non-current liabilities(8)
Total assets acquired and liabilities assumed$80 
The goodwill, which is not deductible for tax purposes, includes the value to create a more fully integrated supply chain and go-to-market business model and is included in the EMEA segment.
In connection with the acquisition, we reacquired certain license rights which had provided the joint venture with the exclusive and perpetual rights to manufacture and distribute our products for sale in specified territories. Reacquired license rights with fair values totaling $10 million were assigned a useful life of 12 years. Other amortizable intangible assets consist of customer relationships and have a weighted-average estimated useful life of 10 years.  The intangible assets were valued using the income approach. The discount rates used to measure the reacquired rights and customer relationship intangible assets were 13.0% and 14.0%, respectively. We consider the
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fair value of each of the acquired intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The fair value of the 49% noncontrolling interest in the joint venture is estimated to be $39 million. The fair value of the noncontrolling interest was estimated using the income approach applied to the projected cash flows of the joint venture. As the joint venture is a private company, the fair value measurement is based on significant inputs that are not observable in the market and thus represents a Level 3 measurement.
Claris Injectables Limited
On July 27, 2017, we acquired 100 percent of Claris, a wholly owned subsidiary of Claris Lifesciences Limited, for total cash consideration of approximately $629 million, net of cash acquired. Through the acquisition, we added capabilities in production of essential generic injectable medicines, such as anesthesia and analgesics, renal, anti-infectives and critical care in a variety of presentations including bags, vials and ampoules.
In the third quarter of 2018, we finalized our valuation of the acquisition date assets acquired and liabilities assumed. The measurement period adjustments in 2018 included a $2 million reduction in property, plant and equipment, a $1 million increase in accounts payable and accrued liabilities and a $2 million increase in other non-current liabilities. These adjustments resulted in a corresponding increase to goodwill of $5 million. The measurement period adjustments did not have a material impact on our results of operations in 2018.
The following table summarizes the fair value of the assets acquired and liabilities assumed as of the acquisition date for our acquisition of Claris:
(in millions)
Assets acquired and liabilities assumed
Cash$11 
Accounts receivable, net16 
Inventories30 
Prepaid expenses and other current assets16 
Property, plant and equipment130 
Goodwill296 
Other intangible assets280 
Other non-current assets20 
Accounts payable and accrued liabilities(23)
Other non-current liabilities(136)
Total assets acquired and liabilities assumed$640 
The results of operations of Claris have been included in our consolidated statement of income since the date the business was acquired. The Claris acquisition contributed $140 million and $57 million, respectively, of net sales for the years ended December 31, 2018 and 2017. Acquisition and integration costs associated with the Claris acquisition were $27 million in 2019, $33 million in 2018 and $28 million in 2017, and were primarily included within SG&A in the consolidated statements of income.
We allocated $280 million of the total consideration to acquired intangible assets. The acquired intangible assets include $140 million of developed technology with a weighted-average useful life of 8 years and $140 million of IPR&D with an indefinite useful life. For the IPR&D, additional R&D will be required prior to technological feasibility.
The fair value of intangible assets was determined using the income approach.  The income approach is a valuation technique that provides an estimate of the fair value of an asset based on market participant expectations of the cash flows an asset will generate over its remaining useful life, discounted to present value. The discount rates used to measure the developed technology and IPR&D intangible assets were 12.0% and 13.0%, respectively. We consider the fair value of each of the acquired intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.  
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The goodwill, which is not deductible for tax purposes, includes the value of potential future technologies as well as the overall strategic benefits to us in the injectables market, and is included in the Americas segment.
In the first quarter of 2018, we settled certain claims with Claris Lifesciences Limited related to the acquired operations and terminated a development agreement with Dorizoe Lifesciences Limited. As a result, we received cash of $73 million in February 2018 and were released from an accrued liability to Claris Lifesciences Limited of $7 million. The total of $80 million is reflected as a benefit within other operating income, net in the 2018 consolidated statement of income.  
Other Business CombinationsCredit Facilities
Total consideration transferredOn September 30, 2021, we entered into a new U.S. dollar-denominated revolving credit facility (the USD Revolver) and on October 1, 2021, we amended our existing Euro-denominated revolving credit facility (as amended, the Euro Revolver). As of December 31, 2021, our USD Revolver had capacity of $2.5 billion and our Euro Revolver had a capacity of approximately €200 million. Each of the facilities matures in 2026. The facilities enable us to borrow funds on an unsecured basis at variable interest rates, and contain various covenants, including a maximum net
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leverage ratio. Fees under the credit facilities are 0.09% annually as of December 31, 2021 and are based on our credit ratings and the total capacity of the facility. Prior to entering into the USD Revolver and the Euro Revolver, our previous U.S. dollar-denominated revolving credit facility and Euro-denominated senior revolving credit facility had a maximum capacity of $2.0 billion and €200 million, respectively. Fees under these credit facilities were 0.09% annually as of December 31, 2020 and were based on our credit ratings and the total capacity of the facility. There were no borrowings under these credit facilities as of December 31, 2021 or December 31, 2020. As of December 31, 2021, we were in compliance with the financial covenants in these agreements. The non-performance of any financial institution supporting either of the credit facilities would reduce the maximum capacity of these facilities by the institution’s respective commitment.  
We also maintain other credit arrangements, as described in Note 5 in Item 8 of this Annual Report on Form 10-K.
Access to Capital and Credit Ratings
We intend to fund short-term and long-term obligations as they mature through cash on hand and future cash flows from operations or by issuing additional debt. We had $3.0 billion of cash and cash equivalents as of December 31, 2021, with adequate cash available to meet operating requirements in each jurisdiction in which we operate. We invest our excess cash in money market and other funds and diversify the concentration of cash among different financial institutions. As of December 31, 2021, we had approximately $17.7 billion of long-term debt and finance lease obligations, including current maturities, and short-term debt. Subject to market conditions and our investment grade targets, we regularly evaluate opportunities with respect to our capital structure.
Our ability to generate cash flows from operations, issue debt, including commercial paper, or enter into other financing arrangements on acceptable terms could be adversely affected if there is a material decline in the demand for our products or in the solvency of our customers or suppliers, deterioration in our key financial ratios or credit ratings or other acquisitions totaled $10significantly unfavorable changes in conditions. However, we believe we have sufficient financial flexibility to issue debt, enter into other financing arrangements and attract long-term capital on acceptable terms to support our growth objectives and reduce our post-acquisition debt levels.
Our credit ratings at December 31, 2021 were as follows:
Standard & Poor’sFitchMoody’s
Ratings
Senior debtBBBBBBBaa2
Short-term debtA2F2P2
OutlookStableStableStable
Our senior debt credit ratings were downgraded in 2021 as a result of the debt we issued to fund the Hillrom acquisition.
LIBOR Reform

In 2017, the United Kingdom’s Financial Conduct Authority announced that after 2021 it would no longer compel banks to submit the rates required to calculate the London Interbank Offered Rate (LIBOR) and other interbank offered rates, which have been widely used as reference rates for various securities and financial contracts, including loans, debt and derivatives. This announcement indicated that the continuation of LIBOR on the current basis was not guaranteed after 2021. Regulators in the U.S. and other jurisdictions have been working to replace these rates with alternative reference interest rates that are supported by transactions in liquid and observable markets, such as the Secured Overnight Financing Rate (SOFR). In 2020, it was announced that certain U.S. dollar LIBOR tenors would not cease until 2023. Currently, our $2.5 billion U.S. dollar-denominated revolving credit facility, our €200 million $36Euro-denominated revolving credit facility and our $4.0 billion Term Loan Credit Agreement reference LIBOR-based rates. The discontinuation of LIBOR will require these arrangements to be modified in order to replace LIBOR with an alternative reference interest rate, which could impact our cost of funds. Our credit facilities and term loan credit agreement include provisions related to the determination of a successor LIBOR rate.
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Contractual Obligations
As of December 31, 2021, we had contractual obligations, excluding accounts payable and accrued expenses and other current liabilities, payable or maturing in the following periods.
(in millions)TotalLess than
one year
More than one year
Long-term debt and finance lease obligations, including current maturities$17,754 $513 $17,241 
Interest on short- and long-term debt and finance lease obligations 1
3,036 347 2,689 
Operating leases706 141 565 
Other non-current liabilities2
590 — 590 
Purchase obligations3
1,530 761 769 
Contractual obligations2
$23,616 $1,762 $21,854 
1.Interest payments on debt and finance lease obligations are calculated for future periods using interest rates in effect at the end of 2021. Certain of these projected interest payments may differ in the future based on foreign currency fluctuations or other factors or events. The projected interest payments only pertain to obligations and agreements outstanding at December 31, 2021. Refer to Note 5 and Note 6, respectively, in Item 8 of this Annual Report on Form 10-K for further discussion regarding our debt instruments outstanding and finance lease obligations at December 31, 2021.
2.The primary components of other non-current liabilities in our consolidated balance sheet as of December 31, 2021 are pension and other postretirement benefits, deferred tax liabilities, long-term tax liabilities, and litigation and environmental reserves. We projected the timing of the related future cash payments based on contractual maturity dates (where applicable) and estimates of the timing of payments (for liabilities with no contractual maturity dates). The actual timing of payments could differ from our estimates.
We contributed $73 million and $16$74 million to our defined benefit pension plans in 2019, 20182021 and 2017, respectively,2020, respectively. The timing of funding in future periods is uncertain and primarily resultedis dependent on future movements in interest rates, investment returns, changes in laws and regulations, and other variables. Therefore, the table above excludes cash outflows related to our pension plans. The amount included within other non-current liabilities (and excluded from the table above) related to our pension plan liabilities was $858 million as of December 31, 2021. In 2022, we have no obligation to fund our principal plans in the recognitionUnited States and we expect to make contributions of intangible assets.at least $41 million to our foreign pension plans. Additionally, we have excluded long-term tax liabilities, which include liabilities for unrecognized tax positions, and deferred tax liabilities from the table above because we are unable to estimate the timing of the related cash outflows. The amounts of long-term tax liabilities and deferred tax liabilities included within other non-current liabilities (and excluded from the table above) were $80 million and $962 million, respectively, as of December 31, 2021.
3.Includes our significant contractual unconditional purchase obligations. For cancellable agreements, any penalty due upon cancellation is included. These acquisitions didcommitments do not materiallyexceed our projected requirements and are in the normal course of business. Examples include firm commitments for raw material and component part purchases, utility agreements and service contracts.
Off-Balance Sheet Arrangements
We periodically enter into off-balance sheet arrangements. Certain contingencies arise in the normal course of business and are not recorded in the consolidated balance sheets in accordance with U.S. GAAP (such as contingent joint development and commercialization arrangement payments). Also, upon resolution of uncertainties, we may incur charges in excess of presently established liabilities for certain matters (such as contractual indemnifications). For a discussion of our significant off-balance sheet arrangements, refer to Note 15 in Item 8 of this Annual Report on Form 10-K for information regarding receivable transactions, and Note 2 and Note 7 in Item 8 of this Annual Report on Form 10-K for information regarding joint development and commercialization arrangements, indemnifications and legal contingencies.
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FINANCIAL INSTRUMENT MARKET RISK
We operate on a global basis and are exposed to the risk that our earnings, cash flows and equity could be adversely impacted by fluctuations in foreign exchange and interest rates. Our hedging policy attempts to manage these risks to an acceptable level based on our judgment of the appropriate trade-off between risk, opportunity and costs. Refer to Note 15 and Note 16 in Item 8 of this Annual Report on Form 10-K for further information regarding our financial instruments and hedging strategies.
Currency Risk
We are primarily exposed to foreign exchange risk with respect to revenues generated outside of the United States denominated in the Euro, British Pound, Chinese Renminbi, Korean Won, Australian Dollar, Canadian Dollar, Japanese Yen, Colombian Peso, Brazilian Real, Mexican Peso, Turkish Lira, Indian Rupee and Swedish Krona. We manage our foreign currency exposures on a consolidated basis, which allows us to net exposures and take advantage of any natural offsets. In addition, we use derivative and nonderivative financial instruments to further reduce the net exposure to foreign exchange, however these instruments may be unavailable or inefficient in emerging or volatile markets. Gains and losses on the hedging instruments offset losses and gains on the hedged transactions and reduce the earnings and stockholders’ equity volatility relating to foreign exchange. However, we don't hedge our entire foreign exchange exposure and are still subject to earnings and stockholders' equity volatility relating to foreign exchange risk. Financial market and currency volatility may limit our ability to cost-effectively hedge these exposures.
We use options and forwards to hedge the foreign exchange risk to earnings relating to forecasted transactions and recognized assets and liabilities denominated in foreign currencies. The maximum term over which we have cash flow hedge contracts in place related to foreign exchange risk on forecasted transactions as of December 31, 2021 is 12 months. We also enter into derivative instruments to hedge foreign exchange risk on certain intra-company and third-party receivables and payables and debt denominated in foreign currencies.
As part of our risk-management program, we perform sensitivity analyses to assess potential changes in the fair value of our foreign exchange instruments relating to hypothetical and reasonably possible near-term movements in foreign exchange rates.
A sensitivity analysis of changes in the fair value of foreign exchange contracts outstanding as of December 31, 2021, while not predictive in nature, indicated that if the U.S. Dollar uniformly weakened by 10% against all currencies, the net pre-tax asset balance of $3 million with respect to those contracts would change by $34 million. A similar analysis performed with respect to contracts outstanding as of December 31, 2020 indicated that, on a pre-tax basis, the net liability balance of $8 million would change by $32 million.
The sensitivity analysis model recalculates the fair value of the foreign exchange contracts outstanding as of December 31, 2021 by replacing the actual exchange rates as of December 31, 2021 with exchange rates that are 10% weaker compared to the actual exchange rates for each applicable currency. All other factors are held constant. These sensitivity analyses disregard the possibility that currency exchange rates can move in opposite directions and that gains from one currency may or may not be offset by losses from another currency. The analyses also disregard the offsetting change in value of the underlying hedged transactions and balances.
Our subsidiary in Argentina is reported using highly inflationary accounting effective July 1, 2018.  Changes in the value of the Argentine peso applied to our peso-denominated net monetary asset positions are recorded in income at the time of the change.  As of December 31, 2021, our net monetary assets denominated in Argentine pesos are not significant.
Interest Rate Risk
We are also exposed to the risk that our earnings and cash flows could be adversely impacted by fluctuations in interest rates. Our policy is to manage interest costs using the mix of fixed- and floating-rate debt that we believe is appropriate at that time. To manage this mix in a cost-efficient manner, we periodically enter into interest rate swaps in which we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount. We also periodically use forward-starting interest rate swaps and treasury rate locks to hedge the risk to earnings associated with fluctuations in interest rates relating to anticipated issuances of term debt. As of December 31, 2021, there were no interest rate derivative contracts outstanding and we had approximately $4.9 billion of outstanding floating rate debt. A 100 basis point change in
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interest rates would impact out pre-tax earnings and cash flows by approximately $49 million over a one-year period.
CHANGES IN ACCOUNTING STANDARDS
Refer to Note 1 in Item 8 of this Annual Report on Form 10-K for information on changes in accounting standards.
RECENT ACCOUNTING PRONOUNCEMENTS
In July 2021, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2021-05, Leases (Topic 842), which requires a lessor to classify a lease with variable lease payments (that do not depend on an index or rate) as an operating lease if (1) the lease would have been classified as a sales-type or direct financing lease, and (2) the lessor would have recognized a selling loss at lease commencement. These changes are intended to avoid recognizing a day-one loss for a lease with variable payments even though the lessor expects the arrangement will be profitable overall. The standard is effective for our financial statements beginning in 2022. The impact of the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
CRITICAL ACCOUNTING POLICIES
The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses. A summary of our significant accounting policies is included in Note 1 in Item 8 of this Annual Report on Form 10-K. Certain of our accounting policies are considered critical, as these policies are the most important to the depiction of our financial statements and require significant, difficult or complex judgments by us, often employing the use of estimates about the effects of matters that are inherently uncertain. Actual results that differ from our estimates could have an unfavorable effect on our results of operations.operations and financial position. The following is a summary of accounting policies that we consider critical to the consolidated financial statements.
Revenue Recognition and Related Provisions and Allowances
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales. Our estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. Additionally, our contracts with customers often include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately and determining the allocation of the transaction price may require significant judgment.
Pension and OPEB Plans
We provide pension and other postretirement benefits to certain of our employees. The service component of employee benefit expenses is reported in the same line items in the consolidated income statements as the applicable employee’s compensation expense. All other components of these employee benefit expenses are reported in other expense, net in our consolidated statements of income. The valuation of the funded status and net periodic benefit cost for the plans is calculated using actuarial assumptions. These assumptions are reviewed annually and revised if appropriate. The significant assumptions include the following:
interest rates used to discount pension and OPEB plan liabilities;
the long-term rate of return on pension plan assets;
rates of increases in employee compensation (used in estimating liabilities);
anticipated future healthcare trend rates (used in estimating the OPEB plan liability); and
other assumptions involving demographic factors such as retirement, mortality and turnover (used in estimating liabilities).
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Selecting assumptions involves an analysis of both short-term and long-term historical trends and known economic and market conditions at the time of the valuation (also called the measurement date). The use of different assumptions would result in different measures of the funded status and net cost. Actual results in the future could differ from expected results.
Our key assumptions are listed in Note 12 in Item 8 of this Annual Report on Form 10-K. The most critical assumptions relate to the plans covering U.S. and Puerto Rico employees, because these plans are the most significant to our consolidated financial statements.
Discount Rate Assumption
Effective for the December 31, 2021 measurement date, we utilized discount rates of 3.01% and 2.76% to measure our benefit obligations for our most significant U.S. and Puerto Rico pension plans and OPEB plan, respectively. We used a broad population of approximately 200 Aa-rated corporate bonds as of December 31, 2021 to determine the discount rate assumption. All bonds were denominated in U.S. dollars, with a minimum amount outstanding of $50 million. This population of bonds was narrowed from a broader universe of approximately 700 Moody’s Aa rated, non-callable (or callable with make-whole provisions) bonds by eliminating the top 10th percentile and bottom 40th percentile to adjust for any pricing anomalies and to represent the bonds we would most likely select if we were to actually annuitize our pension and OPEB plan liabilities. This portfolio of bonds was used to generate a yield curve and associated spot rate curve to discount the projected benefit payments for the U.S. and Puerto Rico plans. The discount rate is the single level rate that produces the same result as the spot rate curve.
For plans in Canada, Japan, the United Kingdom and other European countries, we use a method essentially the same as that described for the U.S. and Puerto Rico plans. For our other international plans, the discount rate is generally determined by reviewing country- and region-specific government and corporate bond interest rates.
To understand the impact of changes in discount rates on pension and OPEB plan cost, we perform a sensitivity analysis. Holding all other assumptions constant, for each 50 basis point (i.e., one-half of one percent) increase in the discount rate, global pre-tax pension and OPEB plan cost would decrease by approximately $30 million, and for each 50 basis point decrease in the discount rate, global pre-tax pension and OPEB plan cost would increase by approximately $35 million.
Return on Plan Assets Assumption
In measuring the net periodic cost for 2021, we used a long-term expected rate of return of 5.5% for our most significant pension plans covering U.S. and Puerto Rico employees. This assumption will decrease to 5% in 2022. This assumption is not applicable to our OPEB plan because it is not funded.
We establish the long-term asset return assumption based on a review of historical compound average asset returns, both company-specific and relating to the broad market (based on our asset allocation), as well as an analysis of current market and economic information and future expectations. The current asset return assumption is supported by historical market experience for both our actual and targeted asset allocation. In calculating net pension cost, the expected return on assets is applied to a calculated value of plan assets, which recognizes changes in the fair value of plan assets in a systematic manner over five years. The difference between this expected return and the actual return on plan assets is a component of the total net unrecognized gain or loss and is subject to amortization in the future.
To understand the impact of changes in the expected asset return assumption on net cost, we perform a sensitivity analysis. Holding all other assumptions constant, for each 50 basis point increase (decrease) in the asset return assumption, global pre-tax pension plan cost would decrease (increase) by approximately $15 million.
Other Assumptions
For the U.S. and Puerto Rico plans, we used the Pri-2012 combined mortality table with improvements projected using the MP-2019 projection scale adjusted to a long-term improvement of 0.8% as of December 31, 2021. For all other pension plans, we utilized country- and region-specific mortality tables to calculate the plans’ benefit obligations. We periodically analyze and update our assumptions concerning demographic factors such as retirement, mortality and turnover, considering historical experience as well as anticipated future trends.
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The assumptions relating to employee compensation increases and future healthcare costs are based on historical experience, market trends, and anticipated future company actions.
Deferred Tax Asset Valuation Allowances and Reserves for Uncertain Tax Positions
We maintain valuation allowances unless it is more likely than not that all or a portion of the deferred tax asset will be realized. Changes in valuation allowances are included in our tax provision in the period of change. In determining whether a valuation allowance is warranted, we evaluate factors such as prior earnings history, expected future earnings, carryback and carryforward periods, and tax strategies that could potentially enhance the likelihood of realization of a deferred tax asset. The realizability assessments made at a given balance sheet date are subject to change in the future, particularly if earnings of a subsidiary are significantly higher or lower than expected, or if we take operational or tax planning actions that could impact the future taxable earnings of a subsidiary.
In the normal course of business, we are audited by federal, state and foreign tax authorities, and are periodically challenged regarding the amount of taxes due. These challenges relate to the timing and amount of deductions and the allocation of income among various tax jurisdictions. We believe our tax positions comply with applicable tax law and we intend to defend our positions. In evaluating the exposure associated with various tax filing positions, we record reserves for uncertain tax positions in accordance with U.S. GAAP based on the technical support for the positions, our past audit experience with similar situations, and potential interest and penalties related to the matters. Our results of operations and effective tax rate in a given period could be impacted if, upon final resolution with taxing authorities, we prevail in positions for which reserves have been established, or we are required to pay amounts in excess of established reserves.
Realization of the U.S. and foreign operating loss and tax credit carryforwards depends on generating sufficient future earnings. A valuation allowance of $401 million and $454 million was recognized as of December 31, 2021 and 2020, respectively, to reduce the deferred tax assets associated with net operating loss and tax credit carryforwards because we do not believe it is more likely than not that these assets will be fully realized prior to expiration. After evaluating relevant U.S. tax laws, any elections or other opportunities that may be available, and the future expiration of certain U.S. tax provisions that will impact the utilization of our U.S. foreign tax credit carryforwards, management expects to be able to realize some, but not all, of the U.S. foreign tax credit deferred tax assets up to its overall domestic loss (ODL) balance plus other recurring and non-recurring foreign inclusions. Therefore, a valuation allowance of $98 million and $157 million was recognized with respect to the foreign tax credit carryforwards as of December 31, 2021 and 2020, respectively. We will continue to evaluate the need for additional valuation allowances and, as circumstances change, the valuation allowance may change.
Valuation of Intangible Assets, Including IPR&D
As a result of our acquisition of Hillrom in December 2021, our intangible asset balance increased to $7.8 billion as of December 31, 2021 compared to $1.7 billion as of December 31, 2020. We record acquired intangible assets at fair value in business combinations and at cost in asset acquisitions. Valuations are generally completed for intangible assets acquired in business acquisitions using a discounted cash flow analysis (an income approach), incorporating the stage of completion and consideration of market participant assumptions. The most significant estimates and assumptions inherent in a discounted cash flow analysis (an income approach) include the amount and timing of projected future cash flows, the discount rate used to measure the risks inherent in the future cash flows, the assessment of the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and customer attrition rate. Each of these factors and assumptions can significantly affect the value of the intangible asset.
Acquired in-process R&D (IPR&D) is the value assigned to acquired technology or products under development which have not presented pro forma financial information for anyreceived regulatory approval and have no alternative future use. IPR&D acquired in a business combination is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval of the 2019, 2018related technology or 2017 acquisitionsproduct, the indefinite-lived intangible asset is then accounted for as a finite-lived intangible asset and amortized on a straight-line basis over its estimated useful life. If the R&D project is abandoned, the indefinite-lived intangible asset is charged to expense.
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IPR&D acquired in transactions that are not business combinations is expensed immediately. For such transactions, payments made to third parties on or after regulatory approval are capitalized as intangible assets and amortized over the remaining useful life of the related asset.
Due to the inherent uncertainty associated with R&D projects, there is no assurance that actual results will not differ materially from the underlying assumptions used to prepare discounted cash flow analyses, nor that the R&D project will result in a successful commercial product.
Due to a change in the timing and amount of projected cash flows associated with $140 million of acquired in-process R&D intangible assets from a historical acquisition, we updated the estimated fair values of these assets in 2021. While no impairment has been recorded because the estimated fair values of those assets exceeded their resultscarrying values, the estimated excess of fair value over carrying value of these assets further declined in 2021 and are at risk of future impairment should the estimated timing or amount of projected cash flows further deteriorate.
In 2021, we changed the measurement date of our annual indefinite-lived intangible asset impairment tests from December 31st to November 1st. This change better aligns the timing of the impairment tests with our long-term business planning process. The change was not material to our consolidated financial statements.statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
Other Business Development Activities
Celerity Pharmaceuticals, LLCCERTAIN REGULATORY MATTERS
In September 2013, we entered into an agreement with Celerity Pharmaceutical, LLC (Celerity) to develop certain acute care generic injectable premix and oncolytic molecules through regulatory approval. We transferred our rights in these molecules to Celerity and Celerity assumed ownership and responsibility for development of the molecules. We are obligated to purchase the individual product rights from Celerity if the products obtain regulatory approval. In 2019, 2018 and 2017, we paid $86 million, $72 million and $20 million, respectively, to acquire the rights to various molecules that have received regulatory approval.
The payment in 2018 for one of the molecules was based on tentative approval from the U.S. Food and Drug Administration (FDA). Full approval from commenced an inspection of Claris’ facilities in Ahmedabad, India in July 2017, immediately prior to the closing of the Claris acquisition. FDA was receivedcompleted the inspection and subsequently issued a Warning Letter based on observations identified in the 2017 inspection (Claris Warning Letter).¹ Due to challenges with the ongoing COVID-19 pandemic, FDA has not yet re-inspected the facilities and management cannot speculate on when the Claris Warning Letter will be lifted. However, we are continuing to implement corrective and preventive actions to address FDA’s prior observations and other items we identified and management continues to pursue and implement other manufacturing locations, including contract manufacturing organizations, to support the production of new products for distribution in the U.S. As previously disclosed, we have secured alternative locations to produce a majority of the planned new products to be manufactured in Ahmedabad for distribution into the U.S. and are producing new products from those locations.
Refer to Item 1A of this Annual Report on Form 10-K for additional discussion of regulatory matters and how they may impact us.
1 Available online at https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm613538.htm
FORWARD-LOOKING INFORMATION
This annual report includes forward-looking statements. Use of the words “may,” “will,” “would,” “could,” “should,” “believes,” “estimates,” “projects,” “potential,” “expects,” “plans,” “seeks,” “intends,” “evaluates,” “pursues,” “anticipates,” “continues,” “designs,” “impacts,” “affects,” “forecasts,” “target,” “outlook,” “initiative,” “objective,” “designed,” “priorities,” “goal,” or the negative of those words or other similar expressions is intended to identify forward-looking statements that represent our current judgment about possible future events. These forward-looking statements may include statements with respect to accounting estimates and assumptions, impacts of the COVID-19 pandemic, litigation-related matters including outcomes, impacts of the internal investigation related to foreign exchange gains and losses, future regulatory filings and our R&D pipeline, strategic objectives, sales from new product offerings, credit exposure to foreign governments, potential developments with respect to credit ratings, investment of foreign earnings, estimates of liabilities including those related to uncertain tax positions, contingent payments, future pension plan contributions, costs, discount rates and rates of return, our exposure to financial market volatility and foreign currency and interest rate risks, the impact of competition, future sales growth, business development activities (including the acquisitions of Cheetah, Seprafilm, certain outside of the U.S. (OUS) rights to Caelyx and Doxil, full U.S. and specific OUS rights to Transderm Scop, PerClot and Hillrom), business optimization initiatives, cost saving initiatives, future capital and R&D expenditures, future debt issuances, manufacturing expansion, the adequacy of credit facilities, tax provisions and reserves, the effective tax rate and all other statements that do not relate to historical facts.

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These forward-looking statements are based on certain assumptions and analyses made in light of our experience and perception of historical trends, current conditions, and expected future developments as well as other factors that we believe are appropriate in the circumstances. While these statements represent our judgment on what the future may hold, and we believe these judgments are reasonable, these statements are not guarantees of any events or financial results. Whether actual future results and developments will conform to expectations and predictions is subject to a number of risks and uncertainties, including the following factors, many of which are beyond our control:
demand for and market acceptance risks for and competitive pressures related to new and existing products (including challenges with our ability to accurately predict changing consumer preferences and needs and advances in technology and the resulting impact on customer inventory levels and the impact of reduced hospital admission rates and elective surgery volumes), and the impact of those products on quality and patient safety concerns;
product development risks, including satisfactory clinical performance, the ability to manufacture at appropriate scale, and the general unpredictability associated with the product development cycle;
our ability to finance and develop new products or enhancements on commercially acceptable terms or at all;
the impact of global economic conditions (including potential trade wars) and public health crises and epidemics, such as the ongoing COVID-19 pandemic, on us and our employees, customers and suppliers, including foreign governments in countries in which we operate;
the continuity, availability and pricing of acceptable raw materials and component parts, and the related continuity of our manufacturing and distribution (including impacts from COVID-19) and those of our suppliers;
inability to create additional production capacity in a timely manner or the occurrence of other manufacturing, sterilization or supply difficulties (including as a result of natural disaster, public health crises and epidemics/pandemics, regulatory actions or otherwise);
our ability to identify business development and growth opportunities and to successfully execute on business development strategies (including the Hillrom acquisition and related restructuring activities);
product quality or patient safety issues, leading to product recalls, withdrawals, launch delays, warning letters, import bans, sanctions, seizures, litigation, or declining sales;
breaches or failures of our information technology systems or products, including by cyber-attack, data leakage, unauthorized access or theft (as a result of increased remote working arrangements or otherwise);
future actions of (or failures to act or delays in acting by) FDA, the European Medicines Agency or any other regulatory body or government authority (including the SEC, DOJ or the Attorney General of any State) that could delay, limit or suspend product development, manufacturing or sale or result in seizures, recalls, injunctions, monetary sanctions or criminal or civil liabilities, including the continued delay in lifting the warning letter at our Ahmedabad facility;
failures with respect to our quality, compliance or ethics programs;
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future actions of third quarterparties, including third-party payers and our customers and distributors (including GPOs and IDNs), the impact of 2018.healthcare reform and its implementation, suspension, repeal, replacement, amendment, modification and other similar actions undertaken by the United States or foreign governments, including with respect to pricing, reimbursement, taxation and rebate policies; legislation, regulation and other governmental pressures in the United States or globally, including the cost of compliance and potential penalties for purported noncompliance thereof, all of which may affect pricing, reimbursement, taxation and rebate policies of government agencies and private payers or other elements of our business, including new or amended laws, rules and regulations (such as the California Consumer Privacy Act of 2018, the European Union’s General Data Protection Regulation and proposed regulatory changes of the U.S. Department of Health and Human Services in kidney health policy and reimbursement, which may substantially change the U.S. end stage renal disease market and demand for our peritoneal dialysis products, necessitating significant multi-year capital expenditures, which are difficult to estimate in advance);
the outcome of pending or future litigation, including the opioid litigation and current or future ethylene oxide litigation or other claims;
failure to achieve our short- and long-term financial improvement goals;
the impact of competitive products and pricing, including generic competition, drug reimportation and disruptive technologies;
global regulatory, trade and tax policies (including with respect to climate change and other sustainability matters);
the ability to protect or enforce our owned or in-licensed patent or other proprietary rights (including trademarks, copyrights, trade secrets and know-how) or patents of third parties preventing or restricting our manufacture, sale or use of affected products or technology;
the impact of any goodwill or other intangible asset impairments on our operating results;
fluctuations in foreign exchange and interest rates;
any changes in law concerning the taxation of income (whether with respect to current or future tax reform), including income earned outside the United States and potential taxes associated with the Base Erosion and Anti-Abuse Tax or the Build Back Better framework;
actions by tax authorities in connection with ongoing tax audits;
loss of key employees, the occurrence of labor disruptions or the inability to identify and recruit new employees;
other factors identified elsewhere in this Annual Report on Form 10-K including those factors described in Item 1A and other filings with the SEC, all of which are available on our website.
Actual results may differ materially from those projected in the forward-looking statements. We capitalizeddo not undertake to update our forward-looking statements.

Item 7A.    Quantitative and Qualitative Disclosures About Market Risk.
Incorporated by reference to the section entitled “Financial Instrument Market Risk” in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Item 7 of this Annual Report on Form 10-K.

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Item 8.    Financial Statements and Supplementary Data.
CONSOLIDATED BALANCE SHEETS
as of December 31 (in millions, except share information)20212020
Current assets:
Cash and cash equivalents$2,951 $3,730 
Accounts receivable, net of allowance of $122 in 2021 and $125 in 20202,629 2,007 
Inventories2,453 1,916 
Prepaid expenses and other current assets839 758 
Total current assets8,872 8,411 
Property, plant and equipment, net5,178 4,722 
Goodwill9,836 3,217 
Other intangible assets, net7,792 1,671 
Operating lease right-of-use assets630 603 
Other non-current assets1,213 1,395 
Total assets$33,521 $20,019 
Current liabilities:
Short-term debt$301 $— 
Current maturities of long-term debt and finance lease obligations210 406 
Accounts payable1,246 1,043 
Accrued expenses and other current liabilities2,479 1,884 
Total current liabilities4,236 3,333 
Long-term debt and finance lease obligations17,149 5,786 
Operating lease liabilities522 501 
Other non-current liabilities2,493 1,673 
Total liabilities24,400 11,293 
Commitments and contingencies00
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares in 2021 and 2020683 683 
Common stock in treasury, at cost, 181,879,516 shares in 2021 and 178,580,208 shares in 2020(11,488)(11,051)
Additional contributed capital6,197 6,043 
Retained earnings17,065 16,328 
Accumulated other comprehensive (loss) income(3,380)(3,314)
Total Baxter stockholders’ equity9,077 8,689 
Noncontrolling interests44 37 
Total equity9,121 8,726 
Total liabilities and equity$33,521 $20,019 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF INCOME
years ended December 31 (in millions, except per share data)202120202019
Net sales$12,784 $11,673 $11,362 
Cost of sales7,679 7,086 6,601 
Gross margin5,105 4,587 4,761 
Selling, general and administrative expenses2,867 2,469 2,535 
Research and development expenses534 521 595 
Other operating income, net(6)(19)(141)
Operating income1,710 1,616 1,772 
Interest expense, net192 134 71 
Other expense, net41 190 731 
Income before income taxes1,477 1,292 970 
Income tax expense (benefit)182 182 (41)
Net income1,295 1,110 1,011 
Net income attributable to noncontrolling interests11 10 
Net income attributable to Baxter stockholders$1,284 $1,102 $1,001 
Earnings per share
Basic$2.56 $2.17 $1.97 
Diluted$2.53 $2.13 $1.93 
Weighted-average number of shares outstanding
Basic502 509 509 
Diluted508 517 519 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
years ended December 31 (in millions)202120202019
Net income$1,295 $1,110 $1,011 
Other comprehensive (loss) income, net of tax:
Currency translation adjustments, net of tax expense (benefit) of $30 in 2021, ($51) in 2020 and $(5) in 2019(320)367 (95)
Pension and other postretirement benefit plans, net of tax expense of $60 in 2021 $40 in 2020 and $130 in 2019227 141 408 
Hedging activities, net of tax expense (benefit) of $7 in 2021, $(34) in 2020 and ($11) in 201927 (112)(39)
Total other comprehensive (loss) income, net of tax(66)396 274 
Comprehensive income1,229 1,506 1,285 
Less: Comprehensive income attributable to noncontrolling interests11 10 
Comprehensive income attributable to Baxter stockholders$1,218 $1,498 $1,275 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY
Baxter International Inc. stockholders' equity
(in millions)Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2019683 $683 170 $(9,989)$5,898 $15,075 $(3,823)$7,844 $22 $7,866 
Adoption of new accounting standard— — — — — 161 (161)$— — $— 
Net income— — — — — 1,001 — $1,001 10 $1,011 
Other comprehensive income (loss)— — — — — — 274 274 — 274 
Purchases of treasury stock— — 16 (1,293)46 — — (1,247)— (1,247)
Stock issued under employee benefit plans and other— — (9)518 11 (84)— 445 — 445 
Dividends declared on common stock— — — — — (435)— (435)— (435)
Changes in noncontrolling interests— — — — — — — — (2)(2)
Balance as of December 31, 2019683 $683 177 $(10,764)$5,955 $15,718 $(3,710)$7,882 $30 $7,912 
Adoption of new accounting standard— — — — — (4)— (4)— (4)
Net income— — — — — 1,102 — 1,102 1,110 
Other comprehensive income (loss)— — — — — — 396 396 — 396 
Purchases of treasury stock— — (500)— — — (500)— (500)
Stock issued under employee benefit plans and other— — (4)213 88 — — 301 — 301 
Dividends declared on common stock— — — — — (488)— (488)— (488)
Changes in noncontrolling interests— — — — — — — — (1)(1)
Balance as of December 31, 2020683 $683 179 $(11,051)$6,043 $16,328 $(3,314)$8,689 $37 $8,726 
Net income— — — — — 1,284 — 1,284 11 1,295 
Other comprehensive income (loss)— — — — — — (66)(66)— (66)
Purchases of treasury stock— — (600)— — — (600)— (600)
Stock issued under employee benefit plans and other— — (4)163 154 — — 317 — 317 
Dividends declared on common stock— — — — — (547)— (547)— (547)
Changes in noncontrolling interests— — — — — — — — (4)(4)
Balance as of December 31, 2021683 $683 182 $(11,488)$6,197 $17,065 $(3,380)$9,077 $44 $9,121 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF CASH FLOWS
years ended December 31 (in millions)202120202019
Cash flows from operations
Net income$1,295 $1,110 $1,011 
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization890 823 789 
Pension settlement charges46 755 
Net periodic pension benefit and other postretirement costs99 81 22 
Deferred income taxes(146)(88)(310)
Stock compensation146 130 122 
Loss on debt extinguishment110 — 
Intangible asset impairments— 17 31 
Settlement of interest rate derivative contracts— (173)— 
Other92 86 115 
Changes in balance sheet items:
Accounts receivable, net(170)(119)(52)
Inventories(37)(162)
Prepaid expenses and other current assets(41)(37)(31)
Accounts payable104 57 (23)
Accrued expenses and other current liabilities108 86 (196)
Other(125)(97)(127)
Cash flows from operations – continuing operations2,222 1,870 2,110 
Cash flows from operations – discontinued operations— (2)(6)
Cash flows from operations2,222 1,868 2,104 
Cash flows from investing activities
Capital expenditures(743)(709)(696)
Acquisitions, net of cash acquired, and investments(10,502)(494)(418)
Other investing activities, net45 24 14 
Cash flows from investing activities(11,200)(1,179)(1,100)
Cash flows from financing activities
Issuances of debt11,903 1,885 1,661 
Repayments of debt(2,823)(1,181)— 
Net increase (decrease) in debt with original maturities of three months or less246 (226)222 
Cash dividends on common stock(530)(473)(423)
Proceeds from stock issued under employee benefit plans187 202 356 
Purchases of treasury stock(600)(500)(1,270)
Debt issuance costs(98)(5)(2)
Other financing activities, net(40)(47)(46)
Cash flows from financing activities8,245 (345)498 
Effect of foreign exchange rate changes on cash, cash equivalents and restricted cash(47)57 (5)
Increase (decrease) in cash, cash equivalents and restricted cash(780)401 1,497 
Cash, cash equivalents and restricted cash at beginning of year (1)
3,736 3,335 1,838 
Cash, cash equivalents and restricted cash at end of year (1)
$2,956 $3,736 $3,335 
(1) We did not have restricted cash balances as of December 31, 2019. The following table provides a reconciliation of cash, cash equivalents and restricted cash amounts as shown in the consolidated statement of cash flows to the
amount reported in the consolidated balance sheet as of December 31, 2021 and 2020:
As of December 31 (in millions)20212020
Cash and cash equivalents$2,951 $3,730 
Restricted cash included in prepaid expenses and other current assets
Cash, cash equivalents and restricted cash$2,956 $3,736 
The accompanying notes are an integral part of these consolidated financial statements.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Nature of Operations
Baxter International Inc., through our subsidiaries (collectively, Baxter, we, our or us), provides a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile intravenous (IV) solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; surgical hemostat and sealant products, advanced surgical equipment; smart bed systems; patient monitoring and diagnostic technologies; and respiratory health devices. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and patients at home under physician supervision. Our global footprint and the critical nature of our products and services play a key role in expanding access to healthcare in emerging and developed countries. We operate in 4 segments: Americas, EMEA, APAC and Hillrom which are described in Note 17.
Risks and Uncertainties Related to COVID-19
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus (COVID-19). COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and we expect will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments have taken and continue to take. Initial measures taken in 2020 led to unprecedented restrictions on, disruptions in, and other related impacts on business and personal activities, including a shift in healthcare priorities, which resulted in a significant decline in medical procedures in 2020. The pandemic has created significant volatility in the demand for our products. For further information about our revenues by product category, refer to Note 10. Significant uncertainty remains regarding the duration and overall impact of the COVID-19 pandemic. For example, concerns remain regarding the pace of economic recovery due to virus resurgence across the globe from the Omicron and Delta variants and other virus mutations as well as vaccine distribution and hesitancy. The U.S. and other governments may continue existing measures or implement new restrictions and other requirements in light of the continuing spread of the pandemic (including with respect to mandatory vaccinations for certain of our employees and moratoriums on elective procedures). Due to the uncertainty caused by the pandemic, our operating performance and financial results, particularly in the short term, may be subject to volatility. We have experienced significant challenges, including lengthy delays, shortages and interruptions, posed by the pandemic and other exogenous factors (including significant weather events and disruptions to certain ports of call around the world) to our global supply chain, including the cost and availability of raw materials and component parts (including resins and electromechanical devices) and higher transportation costs, and may experience these and other challenges in future periods. Many of our manufacturing plant and distribution center personnel are currently unvaccinated, and we may also experience employee resistance in complying with current and future government vaccine and testing mandates, which may cause labor shortages significantly impacting manufacturing production and distribution center productivity. We expect that these challenges as well as evolving governmental restrictions and requirements, among other factors, may continue to have an adverse effect on our business.
Use of Estimates
The preparation of financial statements in conformity with U.S. Generally Accepted Accounting Principles (U.S. GAAP) requires us to make estimates and assumptions that affect reported amounts and related disclosures. Actual results could differ from those estimates.
Basis of Presentation
The consolidated financial statements include the accounts of Baxter and our majority-owned subsidiaries that we control, after elimination of intra-company transactions. Certain reclassifications have been made to conform the prior period consolidated financial statements to the current period presentation.
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hill-Rom Holdings, Inc. (Hillrom) for a purchase pricesprice of products that were purchased$10.5 billion. Including the assumption of Hillrom's
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outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Beginning December 13, 2021, our financial statements include the assets, liabilities and operating results of Hillrom. Refer to Note 2 for additional information.
On July 29, 2021, we acquired certain assets related to PerClot Polysaccharide Hemostatic System (PerClot), including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million, which had an acquisition-date fair value of $28 million, based upon regulatory and commercial milestones. Beginning July 29, 2021, our financial statements include the assets, liabilities and operating results of PerClot. Refer to Note 2 for additional information.
On March 31, 2021, we acquired the rights to Transderm Scop (TDS) for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval as intangible assets and are amortizingof a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. Beginning on March 31, 2021, our financial statements include the assets, over their estimated useful livesliabilities and operating results of 12 years. AsTDS. Refer to Note 2 for additional information.
On February 17, 2021, we acquired the rights to Caelyx and Doxil, the branded versions of December 31, 2019,liposomal doxorubicin, from a subsidiary of Johnson & Johnson for specified territories outside of the U.S for approximately $325 million in cash. Beginning February 17, 2021, our contingent future payments total upfinancial statements include the assets, liabilities and operating results of Caelyx and Doxil. Refer to $79 million upon Celerity’s achievement Note 2 for additional information.
On February 14, 2020, we completed the acquisition of specified regulatory approvals.
Seprafilm Adhesion Barrier
In December 2019, we entered into a definitive agreementthe product rights to acquire Seprafilm Adhesion Barrier (Seprafilm) from Sanofi. Sanofi for approximately $342 million in cash. Beginning February 14, 2020, our financial statements include the assets, liabilities and operating results of Seprafilm. Refer to Note 2 for additional information.
On October 25, 2019, we acquired 100 percent of Cheetah Medical, Inc. (Cheetah) for total cash consideration of $188 million, net of cash acquired, with the potential for additional cash consideration, up to $40 million, based on clinical and commercial milestones for which the acquisition date fair value was $18 million. Beginning October 25, 2019, our financial statements include the assets, liabilities and operating results of Cheetah. Refer to Note 2 for additional information.
Revenue Recognition
Revenue is measured as the amount of consideration we expect to receive in exchange for transferring goods or providing services. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in the contract. A contract’s transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. Some of our contracts have multiple performance obligations. For contracts with multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our global payment terms are typically between 30-90 days.
The majority of our performance obligations are satisfied at a point in time. This includes sales of our broad portfolio of essential healthcare products across our geographic segments, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. For a majority of these sales, our performance obligation is satisfied upon delivery to the customer. Shipping and handling activities are considered to be fulfillment activities and are not considered to be a separate performance obligation.
To a lesser extent, in all of our segments, we enter into other types of contracts, including contract manufacturing arrangements, equipment leases, and certain subscription software and licensing arrangements. We recognize revenue for these arrangements over time or at a point in time depending on our evaluation of when the customer obtains control of the promised goods or services. Revenue is recognized over time when we are creating or enhancing an asset that the customer controls as the asset is created or enhanced or when our performance does not create an asset with an alternative use and we have an enforceable right to payment for performance completed.
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As of December 31, 2021, we had $7.8 billion of transaction closedprice allocated to remaining performance obligations related to executed contracts with an original duration of one year or more, which are primarily included in Februarythe Americas segment. Some contracts in the United States included in this amount contain index-dependent price increases, which are not known at this time. We expect to recognize approximately 35% of this amount as revenue in 2022, 30% in 2023, 15% in each of 2024 and 2025, and 5% in 2026.
Significant Judgments
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales and are included in accrued expenses and other current liabilities and accounts receivable, net on the consolidated balance sheets. Management's estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract using the expected value method. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. Revenue recognized in the years ended December 31, 2021, 2020 and 2019 related to performance obligations satisfied in prior periods was not material. Additionally, our contracts with customers often include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately and determining the allocation of the transaction price may require significant judgment.
Practical Expedients
We apply a practical expedient to expense as incurred costs to obtain a contract with a customer when the amortization period would have been one year or less. We do not disclose the value of the transaction price that is allocated to unsatisfied performance obligations for contracts with an original expected length of less than one year. We have elected to use the practical expedient to not adjust the promised amount of consideration for the effects of a significant financing component if it is expected, at contract inception, that the period between when we transfer a promised good or service to a customer and when the customer pays for that good or service will be one year or less. Additionally, all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected from a customer are excluded from revenue.
Accounts Receivable and Allowance for Doubtful Accounts
In the normal course of business, we provide credit to our customers, perform credit evaluations of these customers and maintain reserves for potential credit losses. In determining the amount of the allowance for doubtful accounts, we consider, among other items, historical credit losses, the past-due status of receivables, payment histories, other customer-specific information, current economic conditions and reasonable and supportable future forecasts. Receivables are written off when we determine they are uncollectible.
The following table summarizes the allowance for doubtful accounts.
years ended December 31
(in millions)
20212020
Balance at beginning of period$125 $112 
Acquisition13 — 
Adoption of new accounting standard— 
Charged to costs and expenses(2)11 
Write-offs(5)(4)
Currency translation adjustments(9)
Balance at end of period$122 $125 

Shipping and Handling Costs
Shipping costs, which are costs incurred to physically move product from our premises to the customer’s premises, are classified as selling, general and administrative (SG&A) expenses. Handling costs, which are costs incurred to
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store, move and prepare products for shipment, are classified as cost of sales. Approximately $381 million in 2021, $325 million in 2020 and $324 million in 2019 of shipping costs were classified in SG&A expenses.
Cash, Cash Equivalents and Restricted Cash
Cash and cash equivalents include cash, certificates of deposit and money market and other short-term funds with original maturities of three months or less. Restricted cash represents cash balances restricted as to withdrawal or use and are included in prepaid expenses and other current assets on the consolidated balance sheets.

Inventories
Inventories are stated at the lower of cost or net realizable value determined by the first-in, first-out method. We review inventories on hand at least quarterly and record provisions for estimated excess, slow-moving and obsolete inventory, as well as inventory with a carrying value in excess of net realizable value.
Property, Plant and Equipment, Net
Property, plant and equipment are stated at cost. Depreciation expense is calculated using the straight-line method over the estimated useful lives of the related assets, which range from 20 to 50 years for buildings and improvements and from 3 to 15 years for machinery and equipment. Leasehold improvements are amortized over the life of the related facility lease (including any renewal periods, if appropriate) or the asset, whichever is shorter. We capitalize certain computer software and software development costs incurred in connection with developing or obtaining software for internal use. Capitalized software costs are included within machinery and equipment and are amortized on a straight-line basis over the estimated useful lives of the software, which generally range from three to five years.
Research and Development
Research and development (R&D) costs, including R&D acquired in transactions that are not business combinations, are expensed as incurred. Pre-regulatory approval contingent milestone obligations to counterparties in collaborative arrangements, which include acquired R&D, are expensed when the milestone is probable to be achieved. Contingent milestone payments made to such counterparties on or after regulatory approval are capitalized and amortized over the remaining useful life of the related product. Amounts capitalized for such payments are included in other intangible assets, net.
Acquired in-process R&D (IPR&D) is the value assigned to technology or products under development acquired in a business combination which have not received regulatory approval and have no alternative future use. Acquired IPR&D is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval of the related technology or product, the indefinite-lived intangible asset is accounted for as a finite-lived intangible asset and amortized on a straight-line basis over the estimated economic life of the related technology or product, subject to annual impairment reviews as discussed below. If the R&D project is abandoned, the indefinite-lived asset is charged to expense.
Collaborative Arrangements
We enter into collaborative arrangements in the normal course of business. These collaborative arrangements take a number of forms and structures and are designed to enhance and expedite long-term sales and profitability growth. These arrangements may provide for us to obtain commercialization rights to a product under development, and require us to make upfront payments, contingent milestone payments, profit-sharing, and/or royalty payments. We may be responsible for ongoing costs associated with the arrangements, including R&D cost reimbursements to the counterparty. See the R&D section of this note regarding the accounting treatment of upfront and contingent milestone payments. Any royalty and profit-sharing payments during the commercialization phase are expensed as cost of sales when they become due and payable.
Restructuring Charges
We record liabilities for costs associated with exit or disposal activities in the period in which the liability is incurred. Employee termination costs are primarily recorded when actions are probable and estimable. Costs for one-time
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termination benefits in which the employee is required to render service until termination in order to receive the benefits are recognized ratably over the future service period. Refer to the discussion below regarding the accounting for asset impairment charges.
Goodwill, Intangible Assets, and Other Long-Lived Assets
Goodwill is the excess of the purchase price over the fair value of acquired assets and liabilities in a business combination.  Goodwill is not amortized but is subject to an impairment review annually and whenever indicators of impairment exist. We have the option to assess goodwill for impairment by initially performing a qualitative assessment to determine whether it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount. If we determine that it is not more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, then the quantitative goodwill impairment test is not required to be performed. If we determine that it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, or if we do not elect the option to perform an initial qualitative assessment, we perform a quantitative goodwill impairment test.  In the quantitative impairment test, we calculate the estimated fair value of the reporting unit. If the carrying amount of the reporting unit exceeds the estimated fair value, an impairment charge is recorded for the amount that its carrying amount, including goodwill, exceeds its fair value, limited to the total amount of goodwill allocated to that reporting unit. In 2021, we changed the measurement date of our annual goodwill impairment test from December 31st to November 1st. This change better aligns the timing of the goodwill impairment test with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
Indefinite-lived intangible assets, such as IPR&D acquired in business combinations and certain trademarks with indefinite lives, are subject to an impairment review annually and whenever indicators of impairment exist. We have the option to assess indefinite-lived intangible assets for impairment by first performing qualitative assessments to determine whether it is more-likely-than-not that the fair values of the indefinite-lived intangible assets are less than the carrying amounts. If we determine that it is more-likely-than-not that an indefinite-lived intangible asset is impaired, or if we elect not to perform an initial qualitative assessment, we then perform the quantitative impairment test by comparing the fair value of the indefinite-lived intangible asset with its carrying amount. If the carrying amount exceeds the fair value of the indefinite-lived intangible asset, we write the carrying amount down to the fair value. In 2021, we changed the measurement date of our annual indefinite-lived intangible asset impairment tests from December 31st to November 1st. This change better aligns the timing of the impairment tests with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
We review the carrying amounts of long-lived assets, other than goodwill and intangible assets not subject to amortization, for potential impairment when events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. In evaluating recoverability, we group assets and liabilities at the lowest level such that the identifiable cash flows relating to the group are largely independent of the cash flows of other assets and liabilities. We then compare the carrying amounts of the assets or asset groups with the related estimated undiscounted future cash flows. In the event impairment exists, an impairment charge is recorded as the amount by which the carrying amount of the asset or asset group exceeds the fair value.
Investments in Equity Securities
Our investments in marketable equity securities are classified as other non-current assets and are measured at fair value with gains and losses recognized in other expense, net. We have elected to apply the measurement alternative to equity securities without readily determinable fair values. As such, our non-marketable equity securities are measured at cost, less any impairment, and are adjusted for changes in fair value resulting from observable transactions for identical or similar investments of the same issuer. Gains and losses on non-marketable equity securities are also recognized in other expense, net. Noncontrolling investments in common stock or in-substance common stock are accounted for under the equity method if we have the ability to exercise significant influence over the operating and financial policies of the investee.
Income Taxes
Deferred taxes are recognized for the future tax effects of temporary differences between financial and income tax reporting based on enacted tax laws and rates. We maintain valuation allowances unless it is more-likely-than-not that the deferred tax asset will be realized. With respect to uncertain tax positions, we determine whether the position is more-likely-than-not to be sustained upon examination based on the technical merits of the position. Any
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tax position that meets the more-likely-than-not recognition threshold is measured and recognized in the consolidated financial statements at the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement. The liability relating to uncertain tax positions is classified as current in the consolidated balance sheets to the extent that we anticipate making a payment within one year. Interest and penalties associated with income taxes are classified in the income tax expense line in the consolidated statements of income.
Foreign Currency Translation
Currency translation adjustments (CTA) related to foreign operations are included in other comprehensive income (OCI). For foreign operations in highly inflationary economies, translation gains and losses are included in other expense, net, and were not material in 2021, 2020 and 2019.
Derivatives and Hedging Activities
All derivative instruments are recognized as either assets or liabilities at fair value in the consolidated balance sheets and are generally classified as short-term or long-term based on the scheduled maturity of the instrument. We designate certain of our derivatives and foreign-currency denominated debt as hedging instruments in cash flow, fair value or net investment hedges.
For each derivative instrument that is designated and effective as a cash flow hedge, the gain or loss on the derivative is recorded in accumulated other comprehensive income (AOCI) and then recognized in earnings consistent with the underlying hedged item. Option premiums or net premiums paid are initially recorded as assets and reclassified to OCI over the life of the option, and then recognized in earnings consistent with the underlying hedged item. Cash flow hedges are classified in cost of sales and interest expense, net, and are primarily related to forecasted intra-company sales denominated in foreign currencies and forecasted interest payments on anticipated issuances of debt, respectively.
For each derivative instrument that is designated and effective as a fair value hedge, the gain or loss on the derivative is recognized immediately to earnings, and offsets changes in fair value attributable to a particular risk, such as changes in interest rates, of the hedged item, which are also recognized in earnings. Changes in the fair value of hedge instruments designated as fair value hedges are classified in interest expense, net, as they hedge the interest rate risk associated with certain of our fixed-rate debt.
We have designated our Euro-denominated senior notes as hedges of our net investment in our European operations and, as a result, mark to spot rate adjustments on the outstanding debt balances are recorded as a component of AOCI.
For derivative instruments that are not designated as hedges, the change in fair value is recorded directly to other expense, net.
If it is determined that a derivative or nonderivative hedging instrument is no longer highly effective as a hedge, we discontinue hedge accounting prospectively. Gains or losses relating to terminations of effective cash flow hedges generally continue to be deferred and are recognized consistent with the loss or income recognition of the underlying hedged items. However, if it is probable that the hedged forecasted transactions will not occur, any gains or losses would be immediately reclassified from AOCI to earnings. If we terminate a fair value hedge, an amount equal to the cumulative fair value adjustment to the hedged item at the date of termination is amortized to earnings over the remaining term of the hedged item. If we remove a net investment hedge designation, any gains or losses recognized in AOCI are not reclassified to earnings until we sell, liquidate, or deconsolidate the foreign investments that were being hedged.
Cash flows related to the settlement of derivative instruments designated as net investment hedges of foreign operations are classified in the consolidated statements of cash flows within investing activities. Cash flows for all other derivatives, including those that are not designated as a hedge, are classified in the same line item as the cash flows of the related hedged item, which is generally within operating activities.
Refer to Note 15 for further information regarding our derivative and hedging activities.
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New Accounting Standards
Recently issued accounting standards not yet adopted
In July 2021, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2021-05, Leases (Topic 842), which requires a lessor to classify a lease with variable lease payments (that do not depend on an index or rate) as an operating lease if (1) the lease would have been classified as a sales-type or direct financing lease, and (2) the lessor would have recognized a selling loss at lease commencement. These changes are intended to avoid recognizing a day-one loss for a lease with variable payments even though the lessor expects the arrangement will be profitable overall. The standard is effective for our financial statements beginning in 2022. The impact of the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
Recently adopted accounting pronouncements
In the fourth quarter of 2021, we adopted ASU 2021-08, Business Combinations - Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. This ASU requires an entity to recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Topic 606 (Revenue from Contracts with Customers). This ASU is expected to reduce diversity in practice and increase comparability for both the recognition and measurement of acquired revenue contracts with customers at the date of and after a business combination. In accordance with this ASU we recognized contract liabilities of $142 million as part of the Hillrom acquisition in December 2021. We did not acquire contract assets or liabilities in connection with other acquisitions completed in 2021.
As of January 1, 2020, we adopted ASU No. 2016-13, Financial Instruments - Credit Losses, which requires the measurement of expected lifetime credit losses, rather than incurred losses, for financial instruments held at the reporting date based on historical experience, current conditions and reasonable forecasts. The main objective of this ASU is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. We adopted this ASU using the modified retrospective approach. The impact of the adoption of this ASU was an increase to our allowance for doubtful accounts and a decrease to retained earnings of $4 million.
As of January 1, 2020, we adopted ASU No. 2018-15, Intangibles-Goodwill and Other-Internal-Use Software, which aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. Our policies for capitalizing implementation costs incurred in a hosting arrangement were not impacted by this ASU. However, we have historically classified those capitalized costs within property, plant and equipment, net on our consolidated balance sheets and as capital expenditures on our consolidated statements of cash flows. Under the new ASU, those capitalized costs are presented as other non-current assets on our consolidated balance sheets and within operating cash flows on our consolidated statements of cash flows. We adopted this ASU on a prospective basis and capitalized $45 million and $44 million of implementation costs related to hosting arrangements that are service contracts during the years ended December 31, 2021 and 2020, respectively.
As of January 1, 2020, we adopted ASU No. 2017-04, Intangibles – Goodwill and Other, Simplifying the Test for Goodwill Impairment. This standard eliminates Step 2 of the goodwill impairment test and requires a goodwill impairment to be measured as the amount by which a reporting unit’s carrying amount exceeds its fair value, not to exceed the carrying amount of its goodwill. The adoption of this standard did not impact our consolidated financial statements.
As of January 1, 2020, we adopted ASU No. 2018-14, Compensation – Retirement Benefits – Defined Benefit Plans – General (Topic 715-20): Disclosure Framework – Changes to the Disclosure Requirements for Defined Benefit Plans. This ASU amends ASC 715 to remove certain disclosures, clarify certain existing disclosures and add additional disclosures. The adoption of this standard did not have a material impact on our consolidated financial statements.
As of January 1, 2019, we adopted ASU No. 2016-02, Leases (Topic 842). Under this guidance, lessees are required to recognize a right-of-use asset and a lease liability on the balance sheet for all operating leases, other than those that meet the definition of a short-term lease. We adopted Topic 842 using the modified retrospective method. We elected the following practical expedients when assessing the transition impact: i) not to reassess whether any expired or existing contracts as of the adoption date are or contain leases; ii) not to reassess the lease
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classification for any expired or existing leases as of the adoption date; and iii) not to reassess initial direct costs for any existing leases as of the adoption date. The impact to the consolidated statements of income was not material and there was no net impact to the consolidated statements of cash flows.
As of January 1, 2019, we adopted ASU No. 2018-02, Reclassification of Certain Tax Effects from AOCI. This guidance provides for a reclassification of certain tax effects from AOCI to retained earnings. The impact of the adoption of this standard was a $161 million increase to retained earnings.
NOTE 2
ACQUISITIONS AND OTHER ARRANGEMENTS
Results of operations of acquired companies are included in our results of operations as of the respective acquisition dates. The purchase price of each acquisition is allocated to the net assets acquired based on estimates of their fair values (or other measurement attribute required under U.S. GAAP) at the date of the acquisition. Any purchase price in excess of these net assets is recorded as goodwill. The allocation of purchase price in certain cases may be subject to revision based on the final determination of fair values during the measurement period, which may be up to one year from the acquisition date.
Contingent consideration related to business combinations is recognized at its estimated fair value on the acquisition date. Subsequent changes to the fair value of those contingent consideration arrangements are recognized in earnings. Contingent consideration related to acquisitions may consist of development, regulatory and commercial milestone payments, and sales or earnings-based payments, and are valued using discounted cash flow techniques. The fair value of development, regulatory and commercial milestone payments reflects management’s expectations of the probability of payment, and increases or decreases as the probability of payment or expectation of timing or amount of payments changes. The fair value of sales-based payments is based upon probability-weighted future revenue estimates and increases or decreases as revenue estimates or expectation of timing or amount of payments changes.
Hillrom
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hillrom for a purchase price of $10.5 billion. Including the assumption of Hillrom's outstanding debt obligations, the enterprise value of the transaction was approximately $345$12.8 billion. Under the terms of the transaction agreement, Hillrom shareholders received $156.00 in cash per each outstanding Hillrom common share.
Prior to our acquisition of Hillrom, Hillrom was a global medical technology leader whose products and services help enable earlier diagnosis and treatment, optimize surgical efficiency, and accelerate patient recovery while simplifying clinical communication and shifting care closer to home. Hillrom made those outcomes possible through digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices, advanced equipment for the surgical space and more, delivering actionable, real-time insights at the point of care.
The following table summarizes the fair value of the total consideration paid:
(in millions)
Cash consideration paid to Hillrom shareholders(a)
$10,474 
Fair value of equity awards issued to Hillrom equity award holders(b)
Total Consideration$10,476 
(a) Represents cash consideration transferred of $156.00 per outstanding Hillrom common share to existing shareholders and holders of equity awards that vested at closing pursuant to their original terms.
(b) Represents the pre-acquisition service portion of the fair value of 668 thousand replacement restricted stock units issued to Hillrom equity award holders at closing.
The valuation of assets acquired and liabilities assumed has not yet been finalized as of December 31, 2021. As a result, we recorded preliminary estimates for the fair value of assets acquired and liabilities assumed as of the acquisition date. Finalization of the valuation during the measurement period could result in a change in the
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amounts recorded for the acquisition date fair value of intangible assets, goodwill and income taxes among other items. The completion of the valuation will occur no later than one year from the acquisition date. The following table summarizes the preliminary fair values of the assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash and cash equivalents$399 
Accounts receivable591 
Inventories560 
Prepaid expenses and other current assets49 
Property, plant and equipment503 
Goodwill6,785 
Other intangible assets6,022 
Operating lease right-of-use assets74 
Other non-current assets128 
Short-term debt(250)
Accounts payable(140)
Accrued expenses and other current liabilities(552)
Long-term debt and finance lease obligations(2,118)
Operating lease liabilities(57)
Other non-current liabilities(1,518)
Total assets acquired and liabilities assumed$10,476 
We allocated $804 million of the total consideration to developed technology with a weighted-average useful life of 5 years, $1.9 billion to trade names with an indefinite useful life, $62 million to trade names with a weighted-average useful life of 7 years, $3.2 billion to customer relationships with a weighted-average useful life of 15 years and $30 million to IPR&D that is considered an indefinite lived intangible asset. The fair values of the intangible assets were determined using the income approach. We used a discount rate of 8.5% to value the developed technology, trade names and customer relationships and 9.0% to value the IPR&D. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair value. We also recognized $1.3 billion of deferred income tax liabilities in connection with the acquisition, which are included in other non-current liabilities in the accompanying consolidated balance sheet as of December 31, 2021.
The goodwill, which is not deductible for tax purposes, includes the value of an assembled workforce as well as the overall strategic benefits provided to our product portfolio and is included in the Hillrom segment.
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired. The Hillrom acquisition contributed $212 million of net sales and a $96 million of pretax loss, including integration costs and interest expense on acquisition financing, for the year ended December 31, 2021.
Costs directly resulting from the Hillrom acquisition, included acquisition and integration costs of $139 million and the incremental cost of sales relating to inventory fair value step-ups of $42 million in 2021.
The following table presents the unaudited pro forma combined results of Baxter and Hillrom for the years ended December 31, 2021 and 2020 as if the acquisition of Hillrom had occurred on January 1, 2020:
years ended December 31 (in millions)20212020
Net sales$15,574 $14,610 
Net income attributable to Baxter stockholders962 635 
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The acquisition has been accounted for in the unaudited pro forma combined financial information using the acquisition method of accounting with Baxter as the acquirer. In order to reflect the occurrence of the acquisition as if it occurred on January 1, 2020 as required, the unaudited pro forma combined financial information includes adjustments to reflect incremental depreciation and amortization expense based on the current preliminary fair values of the identifiable tangible and intangible assets acquired, additional interest expense associated with the issuance of debt to finance the acquisition, nonrecurring costs directly attributable to the acquisition and the income tax effects of the pro forma adjustments. Those nonrecurring costs, which consist of $201 million of costs from inventory fair value step-ups and $314 million of acquisition-related costs for both Baxter and Hillrom, are reflected in the unaudited pro forma combined financial information for the year ended December 31, 2020. The unaudited pro forma combined financial information is not necessarily indicative of what the consolidated results of operations would have been had the acquisition been completed on January 1, 2020. In addition, the unaudited pro forma combined financial information is not a projection of future results of operations of the combined company nor does it reflect the expected realization of any potential synergies or cost savings associated with the acquisition.
PerClot
On July 29, 2021, we acquired certain assets related to PerClot, including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million, which had an acquisition-date fair value of $28 million, based upon regulatory and commercial milestones. PerClot is an absorbable powder hemostat indicated for use in surgical procedures, including cardiac, vascular, orthopedic, spinal, neurological, gynecological, ENT and trauma surgery as an adjunct hemostat when control of bleeding from capillary, venous, or arteriolar vessels by pressure, ligature, and other conventional means is either ineffective or impractical. PerClot is approved for distribution in the European Union and other markets and was submitted for Pre-Market Approval (PMA) for distribution in the U.S. in the fourth quarter of 2021. We concluded that the acquired assets subjectmet the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair values of the potential contingent consideration payments were estimated by applying probability-weighted expected payment models and are Level 3 fair value measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$25 
Contingent Consideration28 
Total Consideration$53 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Goodwill$
Other intangible assets49 
Total assets acquired$53 
The valuation of the assets acquired are preliminary and measurement period adjustments may be recorded in the future as we finalize our fair value estimates. The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the year ended December 31, 2021.
We allocated $39 million of the total consideration to an in-process research and development (IPR&D) asset with an indefinite useful life, $9 million to the approved PerClot developed product rights with an estimated useful life of 10 years and $1 million to customer relationships with an estimated useful life of 10 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 18.7% for IPR&D, 16.0% for developed product rights and 15.0% for customer relationships. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
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The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our surgical portfolio of hemostats and sealants and is included in the Americas and EMEA segments.
Transderm Scop
On March 31, 2021, we acquired the rights to TDS for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval of a post-close adjustment.new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. TDS is indicated for post-operative nausea and vomiting in the U.S. and motion sickness in European markets. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair value of the potential contingent consideration payment was estimated by applying a probability-weighted expected payment model and is a Level 3 fair value measurement due to the significant estimates and assumptions used by management in establishing the estimated fair value.
The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$60 
Contingent Consideration24 
Total Consideration$84 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Inventory$16 
Goodwill
Other intangible assets67 
Total assets acquired$84 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the year ended December 31, 2021.
We allocated $64 million of the total consideration to the TDS developed product rights with an estimated useful life of 9 years and $3 million to customer relationships with an estimated useful life of 7 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 22.5% for developed product rights and 15.5% for customer relationships. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our pharmaceutical portfolio and is included in the Americas segment.
Seprafilm Adhesion Barrier
On February 14, 2020, we completed the acquisition of the product rights to Seprafilm Adhesion Barrier (Seprafilm) from Sanofi for approximately $342 million in cash. Seprafilm is indicated for use in patients undergoing abdominal or pelvic laparotomy as an adjunct intended to reduce the incidence, extent and severity of postoperative adhesions between the abdominal wall and the underlying viscera such as omentum, small bowel, bladder, and stomach, and between the uterus and surrounding structures such as tubes and ovaries, large bowel, and bladder. AsWe concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition was completed after December 31, 2019, our consolidated financial statements do not include the financial condition or resultsmethod of operations of Seprafilm in any of the periods presented herein. We expect that most of the purchase price will be allocated to intangible assets and we are evaluating whether this transaction will be accounted for as an asset acquisition or a business combination.
Other Intangible Acquisitions
During the year ended December 31, 2019, we acquired the rights to multiple products for an aggregate purchase price of $80 million. The purchase prices were capitalized primarily as developed-technology intangible assets and are being amortized over a weighted-average useful of 10 years. Net sales related to these products for the year ended December 31, 2019 were not material.
In January 2020, we acquired the U.S. rights to an additional product for $60 million. The purchase price will be capitalized as a developed-technology intangible asset in the quarter ending March 31, 2020 and will be amortized over its estimated useful life of 11 years.accounting.
8362


Other
In addition toThe following table summarizes the significant arrangements described above, we have entered into several other collaborative arrangements. We could make additional paymentsfair values of up to $26 million upon the achievementassets acquired as of certain development and regulatory milestones, in addition to future payments related to contingent commercialization milestones, profit-sharing and royalties.
NOTE 5
the acquisition date:
SUPPLEMENTAL FINANCIAL INFORMATION
Inventories
As Restated
as of December 31 (in millions)20192018
Raw materials$377  $367  
Work in process185  207  
Finished goods1,091  1,093  
Inventories$1,653  $1,667  
Prepaid Expenses and Other Current Assets
As Restated
as of December 31 (in millions)20192018
Prepaid value added taxes$140  $131  
Prepaid income taxes90  79  
Other389  404  
Prepaid expenses and other current assets$619  $614  
Property, Plant and Equipment, Net
As Restated
as of December 31 (in millions)20192018
Land$148  $142  
Buildings and leasehold improvements1,761  1,703  
Machinery and equipment6,671  6,423  
Equipment with customers1,489  1,364  
Construction in progress591  701  
Total property, plant and equipment, at cost10,660  10,333  
Accumulated depreciation(6,148) (5,803) 
Property, plant and equipment (PP&E), net$4,512  $4,530  
Purchases of property, plant and equipment included in accounts payable and accrued liabilities as of December 31, 2019 and 2018 was $87 million and $97 million, respectively. Depreciation expense was $606 million in 2019, $602 million in 2018 and $596 million in 2017.
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(in millions)
Other Non-Current Assets
As Restated
as of December 31 (in millions)20192018
Deferred tax assets$621  $483  
Non-current receivables, net163  146  
Contract assets68  30  
Investments76  44  
Other141  116  
Other non-current assets$1,069  $819  
Accounts Payable and Accrued Liabilities
As Restated
as of December 31 (in millions)20192018
Accounts payable$892  $998  
Common stock dividends payable111  101  
Employee compensation and withholdings456  486  
Property, payroll and certain other taxes113  131  
Restructuring reserves83  90  
Accrued rebates208  193  
Operating lease liabilities101  —  
Income taxes payable85  104  
Other640  707  
Accounts payable and accrued liabilities$2,689  $2,810  
Other Non-Current Liabilities
As Restated
as of December 31 (in millions)20192018
Pension and other postretirement benefits$1,260  $1,087  
Deferred tax liabilities192  215  
Long-term tax liabilities81  77  
Interest rate contracts52   
Litigation and environmental reserves30  31  
Restructuring reserves 11  
Other108  135  
Other non-current liabilities$1,732  $1,559  
Interest Expense, net
years ended December 31 (in millions)201920182017
Interest costs$120  $105  $98  
Interest costs capitalized(9) (12) (13) 
Interest expense111  93  85  
Interest income(40) (48) (30) 
Interest expense, net$71  $45  $55  
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Other (Income) Expense, net
As Restated
years ended December 31 (in millions)201920182017
Foreign exchange losses (gains), net$37  $(14) $63  
Gain on sale of investments(1) (3) (3) 
Saudi Arabia joint venture gain—  (24) —  
Venezuela deconsolidation—  —  33  
Pension settlement755    
Pension and other postretirement benefit plans(53) (49) 31  
Other, net(7) 11   
Other (income) expense, net$731  $(78) $133  

NOTE 6
GOODWILL AND OTHER INTANGIBLE ASSETS, NETAssets acquired
Inventories$18 
Goodwill28 
Other intangible assets296 
Total assets acquired$342 
Goodwill
The following table is a summaryresults of operations of the activityacquired business have been included in goodwill by segment.
(in millions)AmericasEMEAAPACTotal
December 31, 2017 (As Restated)$2,476  $393  $233  $3,102  
Additions15  17  —  $32  
Currency translation and other adjustments(105) (17) (10) $(132) 
December 31, 2018 (As Restated)$2,386  $393  $223  $3,002  
Additions101  10  —  111  
Currency translation and other adjustments(59) (18) (6) (83) 
December 31, 2019$2,428  $385  $217  $3,030  
As of December 31, 2019, there were 0 reductions in goodwill relating to impairment losses. 
Other Intangible Assets, Net
The following table is a summary of our other intangible assets.
(in millions)Developed technology,
including patents
Other amortized
intangible assets
Indefinite-lived
intangible assets
Total
December 31, 2019
Gross other intangible assets$2,309  $464  $173  $2,946  
Accumulated amortization(1,190) (285) —  $(1,475) 
Other intangible assets, net$1,119  $179  $173  $1,471  
December 31, 2018 (As Restated)
Gross other intangible assets$2,135  $457  $188  $2,780  
Accumulated amortization(1,117) (253) —  $(1,370) 
Other intangible assets, net$1,018  $204  $188  $1,410  
Intangible asset amortization expense was $183 million in 2019, $169 million in 2018, and $154 million in 2017. The anticipated annual amortization expense for definite-lived intangible assets recorded as of December 31, 2019 is $188 million in 2020, $184 million in 2021, $179 million in 2022, $167 million in 2023 and $145 million in 2024.
In the second quarter of 2019, we recognized a $31 million impairment charge related to a developed-technology intangible asset due to a decline in market expectations for the related product. The fair value of the intangible asset was measured using a discounted cash flow approach and the charge is classified within cost of sales in the accompanying consolidated statement of income since the date the business was acquired. The acquisition contributed $94 million of net sales and $18 million of pretax income for the year ended December 31, 2019.2020. Acquisition and integration costs, primarily incremental cost of sales relating to inventory fair value step-ups, associated with the acquisition were $15 million for the year ended December 31, 2020.
We allocated $286 million and $10 million of the total consideration to the Seprafilm developed product rights and customer relationships with useful lives of 10 and 7 years, respectively. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the developed product rights and customer relationship intangible assets were 14.8% and 11.0%, respectively. We consider the fair
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value values of the assetintangible assets to be a Level 3 measurementmeasurements due to the significant estimates and assumptions we used in establishing the estimated fair value.values.
The goodwill, which is deductible for tax purposes, includes the value of the overall strategic benefits provided to our product portfolio of hemostats and sealants and is included in the Americas and APAC segments.
NOTE 7Cheetah Medical, Inc.
On October 25, 2019, we acquired 100 percent of Cheetah Medical, Inc. (Cheetah), a leading provider of hemodynamic monitoring technologies, for total upfront cash consideration of $195 million, net of cash acquired, with the potential for additional cash consideration, up to $40 million, based on clinical and commercial milestones for which the acquisition date fair value was $18 million. In 2020, we received $7 million from the sellers as a result of an acquisition price adjustment in accordance with the acquisition agreement. The fair value of the potential contingent consideration payments was estimated by applying a probability-weighted expected payment model for the clinical milestone and a Monte Carlo simulation model for the commercial milestone, which were then discounted to present value. The fair value measurements were based on Level 3 inputs.
The following table summarizes the fair value of consideration transferred:
DEBT AND CREDIT FACILITIES(in millions)
Cash consideration transferred$190 
Contingent consideration18 
Total consideration$208 
Debt Outstanding
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At December 31,The following table summarizes the fair values of the assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash$
Accounts receivable, net
Inventories
Prepaid expenses and other current assets
Property, plant and equipment
Goodwill84 
Other intangible assets131 
Operating lease right-of-use assets
Accounts payable and accrued liabilities(4)
Other non-current liabilities(12)
Total assets acquired and liabilities assumed$208 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not significant. Acquisition and integration costs associated with the acquisition were $5 million and $3 million in 2020 and 2019, and 2018, we had the following debt outstanding:respectively.
As Restated
as of December 31 (in millions)Effective interest rate in 2019
20191
20181
Variable-rate loan due 20201.0 %$313  $310  
1.7% notes due 20211.9 %398  398  
2.4% notes due 20222.5 %203  202  
0.40% notes due 20240.6 %834  —  
1.3% notes due in 20251.4 %669  684  
2.6% notes due 20262.7 %746  745  
7.65% debentures due 20277.7 %  
6.625% debentures due 20286.7 %98  98  
1.3% notes due 20291.3 %830  —  
6.25% notes due 20376.3 %265  265  
3.65% notes due 20423.7 %  
4.5% notes due 20434.5 %255  255  
3.5% notes due 20463.6 %440  439  
Finance leases and other10.0 %  62  76  
Total debt5,124  3,483  
Current portion(315) (2) 
Long-term portion$4,809  $3,481  
1Book values include any discounts, premiums and adjustments related to hedging instruments.
Significant Debt Issuances
In May 2017, we issued €600We allocated $123 million of 1.3% senior notesthe total consideration to the developed product rights with a weighted-average useful life of 15 years and $8 million to customer relationships with a useful life of 13 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 11.0% for developed product rights and 10.0% for customer relationships. We consider the fair value of the intangible assets to be Level 3 measurements due May 2025. In May 2019, we issued €750 millionto the significant estimates and assumptions used by management in establishing the estimated fair values.
The goodwill, which is not deductible for tax purposes, includes the value of 0.40% senior notes due May 2024potential future technologies as well as the overall strategic benefits provided to our product portfolio and €750 million of 1.3% senior notes due May 2029. We have designated these debt instruments as net investment hedges of our European operations. Refer to Note 16 for additional information.is included primarily in the Americas segment.
Credit Facilities
In December 2019,On September 30, 2021, we entered into a new U.S. and Euro-denominated credit facilities. Our U.S. dollar-denominated revolving credit facility has a(the USD Revolver) and on October 1, 2021, we amended our existing Euro-denominated revolving credit facility (as amended, the Euro Revolver). As of December 31, 2021, our USD Revolver had capacity of $2.0$2.5 billion and our Euro-denominated senior revolving credit facility hasEuro Revolver had a capacity of approximately €200 million. Each of the facilities matures in 2024.2026. The facilities enable us to borrow funds on an unsecured basis at variable interest rates, and contain various covenants, including a maximum net
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leverage ratio. Fees under the credit facilities are 0.09% annually as of December 31, 2021 and are based on our credit ratings and the total capacity of the facility. Prior to entering into the USD Revolver and the Euro Revolver, our previous U.S. dollar-denominated revolving credit facility and Euro-denominated senior revolving credit facility had a maximum capacity of $2.0 billion and €200 million, respectively. Fees under these credit facilities were 0.09% annually as of December 31, 2020 and were based on our credit ratings and the total capacity of the facility. There were no borrowings under these credit facilities as of December 31, 2021 or December 31, 2020. As of December 31, 2021, we were in compliance with the financial covenants in these agreements. The non-performance of any financial institution supporting either of the credit facilities would reduce the maximum capacity of these facilities by the institution’s respective commitment.  
We also maintain other credit arrangements, as described in Note 5 in Item 8 of this Annual Report on Form 10-K.
Access to Capital and Credit Ratings
We intend to fund short-term and long-term obligations as they mature through cash on hand and future cash flows from operations or by issuing additional debt. We had $3.0 billion of cash and cash equivalents as of December 31, 2021, with adequate cash available to meet operating requirements in each jurisdiction in which we operate. We invest our excess cash in money market and other funds and diversify the concentration of cash among different financial institutions. As of December 31, 2021, we had approximately $17.7 billion of long-term debt and finance lease obligations, including current maturities, and short-term debt. Subject to market conditions and our investment grade targets, we regularly evaluate opportunities with respect to our capital structure.
Our ability to generate cash flows from operations, issue debt, including commercial paper, or enter into other financing arrangements on acceptable terms could be adversely affected if there is a material decline in the demand for our products or in the solvency of our customers or suppliers, deterioration in our key financial ratios or credit ratings or other significantly unfavorable changes in conditions. However, we believe we have sufficient financial flexibility to issue debt, enter into other financing arrangements and attract long-term capital on acceptable terms to support our growth objectives and reduce our post-acquisition debt levels.
Our credit ratings at December 31, 2021 were as follows:
Standard & Poor’sFitchMoody’s
Ratings
Senior debtBBBBBBBaa2
Short-term debtA2F2P2
OutlookStableStableStable
Our senior debt credit ratings were downgraded in 2021 as a result of the debt we issued to fund the Hillrom acquisition.
LIBOR Reform

In 2017, the United Kingdom’s Financial Conduct Authority announced that after 2021 it would no longer compel banks to submit the rates required to calculate the London Interbank Offered Rate (LIBOR) and other interbank offered rates, which have been widely used as reference rates for various securities and financial contracts, including loans, debt and derivatives. This announcement indicated that the continuation of LIBOR on the current basis was not guaranteed after 2021. Regulators in the U.S. and other jurisdictions have been working to replace these rates with alternative reference interest rates that are supported by transactions in liquid and observable markets, such as the Secured Overnight Financing Rate (SOFR). In 2020, it was announced that certain U.S. dollar LIBOR tenors would not cease until 2023. Currently, our $2.5 billion U.S. dollar-denominated revolving credit facility, our €200 million Euro-denominated revolving credit facility and our $4.0 billion Term Loan Credit Agreement reference LIBOR-based rates. The discontinuation of LIBOR will require these arrangements to be modified in order to replace LIBOR with an alternative reference interest rate, which could impact our cost of funds. Our credit facilities and term loan credit agreement include provisions related to the determination of a successor LIBOR rate.
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Contractual Obligations
As of December 31, 2021, we had contractual obligations, excluding accounts payable and accrued expenses and other current liabilities, payable or maturing in the following periods.
(in millions)TotalLess than
one year
More than one year
Long-term debt and finance lease obligations, including current maturities$17,754 $513 $17,241 
Interest on short- and long-term debt and finance lease obligations 1
3,036 347 2,689 
Operating leases706 141 565 
Other non-current liabilities2
590 — 590 
Purchase obligations3
1,530 761 769 
Contractual obligations2
$23,616 $1,762 $21,854 
1.Interest payments on debt and finance lease obligations are calculated for future periods using interest rates in effect at the end of 2021. Certain of these projected interest payments may differ in the future based on foreign currency fluctuations or other factors or events. The projected interest payments only pertain to obligations and agreements outstanding at December 31, 2021. Refer to Note 5 and Note 6, respectively, in Item 8 of this Annual Report on Form 10-K for further discussion regarding our debt instruments outstanding and finance lease obligations at December 31, 2021.
2.The primary components of other non-current liabilities in our consolidated balance sheet as of December 31, 2021 are pension and other postretirement benefits, deferred tax liabilities, long-term tax liabilities, and litigation and environmental reserves. We projected the timing of the related future cash payments based on contractual maturity dates (where applicable) and estimates of the timing of payments (for liabilities with no contractual maturity dates). The actual timing of payments could differ from our estimates.
We contributed $73 million and $74 million to our defined benefit pension plans in 2021 and 2020, respectively. The timing of funding in future periods is uncertain and is dependent on future movements in interest rates, investment returns, changes in laws and regulations, and other variables. Therefore, the table above excludes cash outflows related to our pension plans. The amount included within other non-current liabilities (and excluded from the table above) related to our pension plan liabilities was $858 million as of December 31, 2021. In 2022, we have no obligation to fund our principal plans in the United States and we expect to make contributions of at least $41 million to our foreign pension plans. Additionally, we have excluded long-term tax liabilities, which include liabilities for unrecognized tax positions, and deferred tax liabilities from the table above because we are unable to estimate the timing of the related cash outflows. The amounts of long-term tax liabilities and deferred tax liabilities included within other non-current liabilities (and excluded from the table above) were $80 million and $962 million, respectively, as of December 31, 2021.
3.Includes our significant contractual unconditional purchase obligations. For cancellable agreements, any penalty due upon cancellation is included. These commitments do not exceed our projected requirements and are in the normal course of business. Examples include firm commitments for raw material and component part purchases, utility agreements and service contracts.
Off-Balance Sheet Arrangements
We periodically enter into off-balance sheet arrangements. Certain contingencies arise in the normal course of business and are not recorded in the consolidated balance sheets in accordance with U.S. GAAP (such as contingent joint development and commercialization arrangement payments). Also, upon resolution of uncertainties, we may incur charges in excess of presently established liabilities for certain matters (such as contractual indemnifications). For a discussion of our significant off-balance sheet arrangements, refer to Note 15 in Item 8 of this Annual Report on Form 10-K for information regarding receivable transactions, and Note 2 and Note 7 in Item 8 of this Annual Report on Form 10-K for information regarding joint development and commercialization arrangements, indemnifications and legal contingencies.
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FINANCIAL INSTRUMENT MARKET RISK
We operate on a global basis and are exposed to the risk that our earnings, cash flows and equity could be adversely impacted by fluctuations in foreign exchange and interest rates. Our hedging policy attempts to manage these risks to an acceptable level based on our judgment of the appropriate trade-off between risk, opportunity and costs. Refer to Note 15 and Note 16 in Item 8 of this Annual Report on Form 10-K for further information regarding our financial instruments and hedging strategies.
Currency Risk
We are primarily exposed to foreign exchange risk with respect to revenues generated outside of the United States denominated in the Euro, British Pound, Chinese Renminbi, Korean Won, Australian Dollar, Canadian Dollar, Japanese Yen, Colombian Peso, Brazilian Real, Mexican Peso, Turkish Lira, Indian Rupee and Swedish Krona. We manage our foreign currency exposures on a consolidated basis, which allows us to net exposures and take advantage of any natural offsets. In addition, we use derivative and nonderivative financial instruments to further reduce the net exposure to foreign exchange, however these instruments may be unavailable or inefficient in emerging or volatile markets. Gains and losses on the hedging instruments offset losses and gains on the hedged transactions and reduce the earnings and stockholders’ equity volatility relating to foreign exchange. However, we don't hedge our entire foreign exchange exposure and are still subject to earnings and stockholders' equity volatility relating to foreign exchange risk. Financial market and currency volatility may limit our ability to cost-effectively hedge these exposures.
We use options and forwards to hedge the foreign exchange risk to earnings relating to forecasted transactions and recognized assets and liabilities denominated in foreign currencies. The maximum term over which we have cash flow hedge contracts in place related to foreign exchange risk on forecasted transactions as of December 31, 2021 is 12 months. We also enter into derivative instruments to hedge foreign exchange risk on certain intra-company and third-party receivables and payables and debt denominated in foreign currencies.
As part of our risk-management program, we perform sensitivity analyses to assess potential changes in the fair value of our foreign exchange instruments relating to hypothetical and reasonably possible near-term movements in foreign exchange rates.
A sensitivity analysis of changes in the fair value of foreign exchange contracts outstanding as of December 31, 2021, while not predictive in nature, indicated that if the U.S. Dollar uniformly weakened by 10% against all currencies, the net pre-tax asset balance of $3 million with respect to those contracts would change by $34 million. A similar analysis performed with respect to contracts outstanding as of December 31, 2020 indicated that, on a pre-tax basis, the net liability balance of $8 million would change by $32 million.
The sensitivity analysis model recalculates the fair value of the foreign exchange contracts outstanding as of December 31, 2021 by replacing the actual exchange rates as of December 31, 2021 with exchange rates that are 10% weaker compared to the actual exchange rates for each applicable currency. All other factors are held constant. These sensitivity analyses disregard the possibility that currency exchange rates can move in opposite directions and that gains from one currency may or may not be offset by losses from another currency. The analyses also disregard the offsetting change in value of the underlying hedged transactions and balances.
Our subsidiary in Argentina is reported using highly inflationary accounting effective July 1, 2018.  Changes in the value of the Argentine peso applied to our peso-denominated net monetary asset positions are recorded in income at the time of the change.  As of December 31, 2021, our net monetary assets denominated in Argentine pesos are not significant.
Interest Rate Risk
We are also exposed to the risk that our earnings and cash flows could be adversely impacted by fluctuations in interest rates. Our policy is to manage interest costs using the mix of fixed- and floating-rate debt that we believe is appropriate at that time. To manage this mix in a cost-efficient manner, we periodically enter into interest rate swaps in which we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount. We also periodically use forward-starting interest rate swaps and treasury rate locks to hedge the risk to earnings associated with fluctuations in interest rates relating to anticipated issuances of term debt. As of December 31, 2021, there were no interest rate derivative contracts outstanding and we had approximately $4.9 billion of outstanding floating rate debt. A 100 basis point change in
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interest rates would impact out pre-tax earnings and cash flows by approximately $49 million over a one-year period.
CHANGES IN ACCOUNTING STANDARDS
Refer to Note 1 in Item 8 of this Annual Report on Form 10-K for information on changes in accounting standards.
RECENT ACCOUNTING PRONOUNCEMENTS
In July 2021, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2021-05, Leases (Topic 842), which requires a lessor to classify a lease with variable lease payments (that do not depend on an index or rate) as an operating lease if (1) the lease would have been classified as a sales-type or direct financing lease, and (2) the lessor would have recognized a selling loss at lease commencement. These changes are intended to avoid recognizing a day-one loss for a lease with variable payments even though the lessor expects the arrangement will be profitable overall. The standard is effective for our financial statements beginning in 2022. The impact of the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
CRITICAL ACCOUNTING POLICIES
The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses. A summary of our significant accounting policies is included in Note 1 in Item 8 of this Annual Report on Form 10-K. Certain of our accounting policies are considered critical, as these policies are the most important to the depiction of our financial statements and require significant, difficult or complex judgments by us, often employing the use of estimates about the effects of matters that are inherently uncertain. Actual results that differ from our estimates could have an unfavorable effect on our results of operations and financial position. The following is a summary of accounting policies that we consider critical to the consolidated financial statements.
Revenue Recognition and Related Provisions and Allowances
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales. Our estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. Additionally, our contracts with customers often include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately and determining the allocation of the transaction price may require significant judgment.
Pension and OPEB Plans
We provide pension and other postretirement benefits to certain of our employees. The service component of employee benefit expenses is reported in the same line items in the consolidated income statements as the applicable employee’s compensation expense. All other components of these employee benefit expenses are reported in other expense, net in our consolidated statements of income. The valuation of the funded status and net periodic benefit cost for the plans is calculated using actuarial assumptions. These assumptions are reviewed annually and revised if appropriate. The significant assumptions include the following:
interest rates used to discount pension and OPEB plan liabilities;
the long-term rate of return on pension plan assets;
rates of increases in employee compensation (used in estimating liabilities);
anticipated future healthcare trend rates (used in estimating the OPEB plan liability); and
other assumptions involving demographic factors such as retirement, mortality and turnover (used in estimating liabilities).
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Selecting assumptions involves an analysis of both short-term and long-term historical trends and known economic and market conditions at the time of the valuation (also called the measurement date). The use of different assumptions would result in different measures of the funded status and net cost. Actual results in the future could differ from expected results.
Our key assumptions are listed in Note 12 in Item 8 of this Annual Report on Form 10-K. The most critical assumptions relate to the plans covering U.S. and Puerto Rico employees, because these plans are the most significant to our consolidated financial statements.
Discount Rate Assumption
Effective for the December 31, 2021 measurement date, we utilized discount rates of 3.01% and 2.76% to measure our benefit obligations for our most significant U.S. and Puerto Rico pension plans and OPEB plan, respectively. We used a broad population of approximately 200 Aa-rated corporate bonds as of December 31, 2021 to determine the discount rate assumption. All bonds were denominated in U.S. dollars, with a minimum amount outstanding of $50 million. This population of bonds was narrowed from a broader universe of approximately 700 Moody’s Aa rated, non-callable (or callable with make-whole provisions) bonds by eliminating the top 10th percentile and bottom 40th percentile to adjust for any pricing anomalies and to represent the bonds we would most likely select if we were to actually annuitize our pension and OPEB plan liabilities. This portfolio of bonds was used to generate a yield curve and associated spot rate curve to discount the projected benefit payments for the U.S. and Puerto Rico plans. The discount rate is the single level rate that produces the same result as the spot rate curve.
For plans in Canada, Japan, the United Kingdom and other European countries, we use a method essentially the same as that described for the U.S. and Puerto Rico plans. For our other international plans, the discount rate is generally determined by reviewing country- and region-specific government and corporate bond interest rates.
To understand the impact of changes in discount rates on pension and OPEB plan cost, we perform a sensitivity analysis. Holding all other assumptions constant, for each 50 basis point (i.e., one-half of one percent) increase in the discount rate, global pre-tax pension and OPEB plan cost would decrease by approximately $30 million, and for each 50 basis point decrease in the discount rate, global pre-tax pension and OPEB plan cost would increase by approximately $35 million.
Return on Plan Assets Assumption
In measuring the net periodic cost for 2021, we used a long-term expected rate of return of 5.5% for our most significant pension plans covering U.S. and Puerto Rico employees. This assumption will decrease to 5% in 2022. This assumption is not applicable to our OPEB plan because it is not funded.
We establish the long-term asset return assumption based on a review of historical compound average asset returns, both company-specific and relating to the broad market (based on our asset allocation), as well as an analysis of current market and economic information and future expectations. The current asset return assumption is supported by historical market experience for both our actual and targeted asset allocation. In calculating net pension cost, the expected return on assets is applied to a calculated value of plan assets, which recognizes changes in the fair value of plan assets in a systematic manner over five years. The difference between this expected return and the actual return on plan assets is a component of the total net unrecognized gain or loss and is subject to amortization in the future.
To understand the impact of changes in the expected asset return assumption on net cost, we perform a sensitivity analysis. Holding all other assumptions constant, for each 50 basis point increase (decrease) in the asset return assumption, global pre-tax pension plan cost would decrease (increase) by approximately $15 million.
Other Assumptions
For the U.S. and Puerto Rico plans, we used the Pri-2012 combined mortality table with improvements projected using the MP-2019 projection scale adjusted to a long-term improvement of 0.8% as of December 31, 2021. For all other pension plans, we utilized country- and region-specific mortality tables to calculate the plans’ benefit obligations. We periodically analyze and update our assumptions concerning demographic factors such as retirement, mortality and turnover, considering historical experience as well as anticipated future trends.
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The assumptions relating to employee compensation increases and future healthcare costs are based on historical experience, market trends, and anticipated future company actions.
Deferred Tax Asset Valuation Allowances and Reserves for Uncertain Tax Positions
We maintain valuation allowances unless it is more likely than not that all or a portion of the deferred tax asset will be realized. Changes in valuation allowances are included in our tax provision in the period of change. In determining whether a valuation allowance is warranted, we evaluate factors such as prior earnings history, expected future earnings, carryback and carryforward periods, and tax strategies that could potentially enhance the likelihood of realization of a deferred tax asset. The realizability assessments made at a given balance sheet date are subject to change in the future, particularly if earnings of a subsidiary are significantly higher or lower than expected, or if we take operational or tax planning actions that could impact the future taxable earnings of a subsidiary.
In the normal course of business, we are audited by federal, state and foreign tax authorities, and are periodically challenged regarding the amount of taxes due. These challenges relate to the timing and amount of deductions and the allocation of income among various tax jurisdictions. We believe our tax positions comply with applicable tax law and we intend to defend our positions. In evaluating the exposure associated with various tax filing positions, we record reserves for uncertain tax positions in accordance with U.S. GAAP based on the technical support for the positions, our past audit experience with similar situations, and potential interest and penalties related to the matters. Our results of operations and effective tax rate in a given period could be impacted if, upon final resolution with taxing authorities, we prevail in positions for which reserves have been established, or we are required to pay amounts in excess of established reserves.
Realization of the U.S. and foreign operating loss and tax credit carryforwards depends on generating sufficient future earnings. A valuation allowance of $401 million and $454 million was recognized as of December 31, 2021 and 2020, respectively, to reduce the deferred tax assets associated with net operating loss and tax credit carryforwards because we do not believe it is more likely than not that these assets will be fully realized prior to expiration. After evaluating relevant U.S. tax laws, any elections or other opportunities that may be available, and the future expiration of certain U.S. tax provisions that will impact the utilization of our U.S. foreign tax credit carryforwards, management expects to be able to realize some, but not all, of the U.S. foreign tax credit deferred tax assets up to its overall domestic loss (ODL) balance plus other recurring and non-recurring foreign inclusions. Therefore, a valuation allowance of $98 million and $157 million was recognized with respect to the foreign tax credit carryforwards as of December 31, 2021 and 2020, respectively. We will continue to evaluate the need for additional valuation allowances and, as circumstances change, the valuation allowance may change.
Valuation of Intangible Assets, Including IPR&D
As a result of our acquisition of Hillrom in December 2021, our intangible asset balance increased to $7.8 billion as of December 31, 2021 compared to $1.7 billion as of December 31, 2020. We record acquired intangible assets at fair value in business combinations and at cost in asset acquisitions. Valuations are generally completed for intangible assets acquired in business acquisitions using a discounted cash flow analysis (an income approach), incorporating the stage of completion and consideration of market participant assumptions. The most significant estimates and assumptions inherent in a discounted cash flow analysis (an income approach) include the amount and timing of projected future cash flows, the discount rate used to measure the risks inherent in the future cash flows, the assessment of the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and customer attrition rate. Each of these factors and assumptions can significantly affect the value of the intangible asset.
Acquired in-process R&D (IPR&D) is the value assigned to acquired technology or products under development which have not received regulatory approval and have no alternative future use. IPR&D acquired in a business combination is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval of the related technology or product, the indefinite-lived intangible asset is then accounted for as a finite-lived intangible asset and amortized on a straight-line basis over its estimated useful life. If the R&D project is abandoned, the indefinite-lived intangible asset is charged to expense.
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IPR&D acquired in transactions that are not business combinations is expensed immediately. For such transactions, payments made to third parties on or after regulatory approval are capitalized as intangible assets and amortized over the remaining useful life of the related asset.
Due to the inherent uncertainty associated with R&D projects, there is no assurance that actual results will not differ materially from the underlying assumptions used to prepare discounted cash flow analyses, nor that the R&D project will result in a successful commercial product.
Due to a change in the timing and amount of projected cash flows associated with $140 million of acquired in-process R&D intangible assets from a historical acquisition, we updated the estimated fair values of these assets in 2021. While no impairment has been recorded because the estimated fair values of those assets exceeded their carrying values, the estimated excess of fair value over carrying value of these assets further declined in 2021 and are at risk of future impairment should the estimated timing or amount of projected cash flows further deteriorate.
In 2021, we changed the measurement date of our annual indefinite-lived intangible asset impairment tests from December 31st to November 1st. This change better aligns the timing of the impairment tests with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
CERTAIN REGULATORY MATTERS

The U.S. Food and Drug Administration (FDA) commenced an inspection of Claris’ facilities in Ahmedabad, India in July 2017, immediately prior to the closing of the Claris acquisition. FDA completed the inspection and subsequently issued a Warning Letter based on observations identified in the 2017 inspection (Claris Warning Letter).¹ Due to challenges with the ongoing COVID-19 pandemic, FDA has not yet re-inspected the facilities and management cannot speculate on when the Claris Warning Letter will be lifted. However, we are continuing to implement corrective and preventive actions to address FDA’s prior observations and other items we identified and management continues to pursue and implement other manufacturing locations, including contract manufacturing organizations, to support the production of new products for distribution in the U.S. As previously disclosed, we have secured alternative locations to produce a majority of the planned new products to be manufactured in Ahmedabad for distribution into the U.S. and are producing new products from those locations.
Refer to Item 1A of this Annual Report on Form 10-K for additional discussion of regulatory matters and how they may impact us.
1 Available online at https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm613538.htm
FORWARD-LOOKING INFORMATION
This annual report includes forward-looking statements. Use of the words “may,” “will,” “would,” “could,” “should,” “believes,” “estimates,” “projects,” “potential,” “expects,” “plans,” “seeks,” “intends,” “evaluates,” “pursues,” “anticipates,” “continues,” “designs,” “impacts,” “affects,” “forecasts,” “target,” “outlook,” “initiative,” “objective,” “designed,” “priorities,” “goal,” or the negative of those words or other similar expressions is intended to identify forward-looking statements that represent our current judgment about possible future events. These forward-looking statements may include statements with respect to accounting estimates and assumptions, impacts of the COVID-19 pandemic, litigation-related matters including outcomes, impacts of the internal investigation related to foreign exchange gains and losses, future regulatory filings and our R&D pipeline, strategic objectives, sales from new product offerings, credit exposure to foreign governments, potential developments with respect to credit ratings, investment of foreign earnings, estimates of liabilities including those related to uncertain tax positions, contingent payments, future pension plan contributions, costs, discount rates and rates of return, our exposure to financial market volatility and foreign currency and interest rate risks, the impact of competition, future sales growth, business development activities (including the acquisitions of Cheetah, Seprafilm, certain outside of the U.S. (OUS) rights to Caelyx and Doxil, full U.S. and specific OUS rights to Transderm Scop, PerClot and Hillrom), business optimization initiatives, cost saving initiatives, future capital and R&D expenditures, future debt issuances, manufacturing expansion, the adequacy of credit facilities, tax provisions and reserves, the effective tax rate and all other statements that do not relate to historical facts.

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These forward-looking statements are based on certain assumptions and analyses made in light of our experience and perception of historical trends, current conditions, and expected future developments as well as other factors that we believe are appropriate in the circumstances. While these statements represent our judgment on what the future may hold, and we believe these judgments are reasonable, these statements are not guarantees of any events or financial results. Whether actual future results and developments will conform to expectations and predictions is subject to a number of risks and uncertainties, including the following factors, many of which are beyond our control:
demand for and market acceptance risks for and competitive pressures related to new and existing products (including challenges with our ability to accurately predict changing consumer preferences and needs and advances in technology and the resulting impact on customer inventory levels and the impact of reduced hospital admission rates and elective surgery volumes), and the impact of those products on quality and patient safety concerns;
product development risks, including satisfactory clinical performance, the ability to manufacture at appropriate scale, and the general unpredictability associated with the product development cycle;
our ability to finance and develop new products or enhancements on commercially acceptable terms or at all;
the impact of global economic conditions (including potential trade wars) and public health crises and epidemics, such as the ongoing COVID-19 pandemic, on us and our employees, customers and suppliers, including foreign governments in countries in which we operate;
the continuity, availability and pricing of acceptable raw materials and component parts, and the related continuity of our manufacturing and distribution (including impacts from COVID-19) and those of our suppliers;
inability to create additional production capacity in a timely manner or the occurrence of other manufacturing, sterilization or supply difficulties (including as a result of natural disaster, public health crises and epidemics/pandemics, regulatory actions or otherwise);
our ability to identify business development and growth opportunities and to successfully execute on business development strategies (including the Hillrom acquisition and related restructuring activities);
product quality or patient safety issues, leading to product recalls, withdrawals, launch delays, warning letters, import bans, sanctions, seizures, litigation, or declining sales;
breaches or failures of our information technology systems or products, including by cyber-attack, data leakage, unauthorized access or theft (as a result of increased remote working arrangements or otherwise);
future actions of (or failures to act or delays in acting by) FDA, the European Medicines Agency or any other regulatory body or government authority (including the SEC, DOJ or the Attorney General of any State) that could delay, limit or suspend product development, manufacturing or sale or result in seizures, recalls, injunctions, monetary sanctions or criminal or civil liabilities, including the continued delay in lifting the warning letter at our Ahmedabad facility;
failures with respect to our quality, compliance or ethics programs;
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future actions of third parties, including third-party payers and our customers and distributors (including GPOs and IDNs), the impact of healthcare reform and its implementation, suspension, repeal, replacement, amendment, modification and other similar actions undertaken by the United States or foreign governments, including with respect to pricing, reimbursement, taxation and rebate policies; legislation, regulation and other governmental pressures in the United States or globally, including the cost of compliance and potential penalties for purported noncompliance thereof, all of which may affect pricing, reimbursement, taxation and rebate policies of government agencies and private payers or other elements of our business, including new or amended laws, rules and regulations (such as the California Consumer Privacy Act of 2018, the European Union’s General Data Protection Regulation and proposed regulatory changes of the U.S. Department of Health and Human Services in kidney health policy and reimbursement, which may substantially change the U.S. end stage renal disease market and demand for our peritoneal dialysis products, necessitating significant multi-year capital expenditures, which are difficult to estimate in advance);
the outcome of pending or future litigation, including the opioid litigation and current or future ethylene oxide litigation or other claims;
failure to achieve our short- and long-term financial improvement goals;
the impact of competitive products and pricing, including generic competition, drug reimportation and disruptive technologies;
global regulatory, trade and tax policies (including with respect to climate change and other sustainability matters);
the ability to protect or enforce our owned or in-licensed patent or other proprietary rights (including trademarks, copyrights, trade secrets and know-how) or patents of third parties preventing or restricting our manufacture, sale or use of affected products or technology;
the impact of any goodwill or other intangible asset impairments on our operating results;
fluctuations in foreign exchange and interest rates;
any changes in law concerning the taxation of income (whether with respect to current or future tax reform), including income earned outside the United States and potential taxes associated with the Base Erosion and Anti-Abuse Tax or the Build Back Better framework;
actions by tax authorities in connection with ongoing tax audits;
loss of key employees, the occurrence of labor disruptions or the inability to identify and recruit new employees;
other factors identified elsewhere in this Annual Report on Form 10-K including those factors described in Item 1A and other filings with the SEC, all of which are available on our website.
Actual results may differ materially from those projected in the forward-looking statements. We do not undertake to update our forward-looking statements.

Item 7A.    Quantitative and Qualitative Disclosures About Market Risk.
Incorporated by reference to the section entitled “Financial Instrument Market Risk” in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Item 7 of this Annual Report on Form 10-K.

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Item 8.    Financial Statements and Supplementary Data.
CONSOLIDATED BALANCE SHEETS
as of December 31 (in millions, except share information)20212020
Current assets:
Cash and cash equivalents$2,951 $3,730 
Accounts receivable, net of allowance of $122 in 2021 and $125 in 20202,629 2,007 
Inventories2,453 1,916 
Prepaid expenses and other current assets839 758 
Total current assets8,872 8,411 
Property, plant and equipment, net5,178 4,722 
Goodwill9,836 3,217 
Other intangible assets, net7,792 1,671 
Operating lease right-of-use assets630 603 
Other non-current assets1,213 1,395 
Total assets$33,521 $20,019 
Current liabilities:
Short-term debt$301 $— 
Current maturities of long-term debt and finance lease obligations210 406 
Accounts payable1,246 1,043 
Accrued expenses and other current liabilities2,479 1,884 
Total current liabilities4,236 3,333 
Long-term debt and finance lease obligations17,149 5,786 
Operating lease liabilities522 501 
Other non-current liabilities2,493 1,673 
Total liabilities24,400 11,293 
Commitments and contingencies00
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares in 2021 and 2020683 683 
Common stock in treasury, at cost, 181,879,516 shares in 2021 and 178,580,208 shares in 2020(11,488)(11,051)
Additional contributed capital6,197 6,043 
Retained earnings17,065 16,328 
Accumulated other comprehensive (loss) income(3,380)(3,314)
Total Baxter stockholders’ equity9,077 8,689 
Noncontrolling interests44 37 
Total equity9,121 8,726 
Total liabilities and equity$33,521 $20,019 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF INCOME
years ended December 31 (in millions, except per share data)202120202019
Net sales$12,784 $11,673 $11,362 
Cost of sales7,679 7,086 6,601 
Gross margin5,105 4,587 4,761 
Selling, general and administrative expenses2,867 2,469 2,535 
Research and development expenses534 521 595 
Other operating income, net(6)(19)(141)
Operating income1,710 1,616 1,772 
Interest expense, net192 134 71 
Other expense, net41 190 731 
Income before income taxes1,477 1,292 970 
Income tax expense (benefit)182 182 (41)
Net income1,295 1,110 1,011 
Net income attributable to noncontrolling interests11 10 
Net income attributable to Baxter stockholders$1,284 $1,102 $1,001 
Earnings per share
Basic$2.56 $2.17 $1.97 
Diluted$2.53 $2.13 $1.93 
Weighted-average number of shares outstanding
Basic502 509 509 
Diluted508 517 519 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
years ended December 31 (in millions)202120202019
Net income$1,295 $1,110 $1,011 
Other comprehensive (loss) income, net of tax:
Currency translation adjustments, net of tax expense (benefit) of $30 in 2021, ($51) in 2020 and $(5) in 2019(320)367 (95)
Pension and other postretirement benefit plans, net of tax expense of $60 in 2021 $40 in 2020 and $130 in 2019227 141 408 
Hedging activities, net of tax expense (benefit) of $7 in 2021, $(34) in 2020 and ($11) in 201927 (112)(39)
Total other comprehensive (loss) income, net of tax(66)396 274 
Comprehensive income1,229 1,506 1,285 
Less: Comprehensive income attributable to noncontrolling interests11 10 
Comprehensive income attributable to Baxter stockholders$1,218 $1,498 $1,275 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY
Baxter International Inc. stockholders' equity
(in millions)Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2019683 $683 170 $(9,989)$5,898 $15,075 $(3,823)$7,844 $22 $7,866 
Adoption of new accounting standard— — — — — 161 (161)$— — $— 
Net income— — — — — 1,001 — $1,001 10 $1,011 
Other comprehensive income (loss)— — — — — — 274 274 — 274 
Purchases of treasury stock— — 16 (1,293)46 — — (1,247)— (1,247)
Stock issued under employee benefit plans and other— — (9)518 11 (84)— 445 — 445 
Dividends declared on common stock— — — — — (435)— (435)— (435)
Changes in noncontrolling interests— — — — — — — — (2)(2)
Balance as of December 31, 2019683 $683 177 $(10,764)$5,955 $15,718 $(3,710)$7,882 $30 $7,912 
Adoption of new accounting standard— — — — — (4)— (4)— (4)
Net income— — — — — 1,102 — 1,102 1,110 
Other comprehensive income (loss)— — — — — — 396 396 — 396 
Purchases of treasury stock— — (500)— — — (500)— (500)
Stock issued under employee benefit plans and other— — (4)213 88 — — 301 — 301 
Dividends declared on common stock— — — — — (488)— (488)— (488)
Changes in noncontrolling interests— — — — — — — — (1)(1)
Balance as of December 31, 2020683 $683 179 $(11,051)$6,043 $16,328 $(3,314)$8,689 $37 $8,726 
Net income— — — — — 1,284 — 1,284 11 1,295 
Other comprehensive income (loss)— — — — — — (66)(66)— (66)
Purchases of treasury stock— — (600)— — — (600)— (600)
Stock issued under employee benefit plans and other— — (4)163 154 — — 317 — 317 
Dividends declared on common stock— — — — — (547)— (547)— (547)
Changes in noncontrolling interests— — — — — — — — (4)(4)
Balance as of December 31, 2021683 $683 182 $(11,488)$6,197 $17,065 $(3,380)$9,077 $44 $9,121 
The accompanying notes are an integral part of these consolidated financial statements.
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CONSOLIDATED STATEMENTS OF CASH FLOWS
years ended December 31 (in millions)202120202019
Cash flows from operations
Net income$1,295 $1,110 $1,011 
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization890 823 789 
Pension settlement charges46 755 
Net periodic pension benefit and other postretirement costs99 81 22 
Deferred income taxes(146)(88)(310)
Stock compensation146 130 122 
Loss on debt extinguishment110 — 
Intangible asset impairments— 17 31 
Settlement of interest rate derivative contracts— (173)— 
Other92 86 115 
Changes in balance sheet items:
Accounts receivable, net(170)(119)(52)
Inventories(37)(162)
Prepaid expenses and other current assets(41)(37)(31)
Accounts payable104 57 (23)
Accrued expenses and other current liabilities108 86 (196)
Other(125)(97)(127)
Cash flows from operations – continuing operations2,222 1,870 2,110 
Cash flows from operations – discontinued operations— (2)(6)
Cash flows from operations2,222 1,868 2,104 
Cash flows from investing activities
Capital expenditures(743)(709)(696)
Acquisitions, net of cash acquired, and investments(10,502)(494)(418)
Other investing activities, net45 24 14 
Cash flows from investing activities(11,200)(1,179)(1,100)
Cash flows from financing activities
Issuances of debt11,903 1,885 1,661 
Repayments of debt(2,823)(1,181)— 
Net increase (decrease) in debt with original maturities of three months or less246 (226)222 
Cash dividends on common stock(530)(473)(423)
Proceeds from stock issued under employee benefit plans187 202 356 
Purchases of treasury stock(600)(500)(1,270)
Debt issuance costs(98)(5)(2)
Other financing activities, net(40)(47)(46)
Cash flows from financing activities8,245 (345)498 
Effect of foreign exchange rate changes on cash, cash equivalents and restricted cash(47)57 (5)
Increase (decrease) in cash, cash equivalents and restricted cash(780)401 1,497 
Cash, cash equivalents and restricted cash at beginning of year (1)
3,736 3,335 1,838 
Cash, cash equivalents and restricted cash at end of year (1)
$2,956 $3,736 $3,335 
(1) We did not have restricted cash balances as of December 31, 2019. The following table provides a reconciliation of cash, cash equivalents and restricted cash amounts as shown in the consolidated statement of cash flows to the
amount reported in the consolidated balance sheet as of December 31, 2021 and 2020:
As of December 31 (in millions)20212020
Cash and cash equivalents$2,951 $3,730 
Restricted cash included in prepaid expenses and other current assets
Cash, cash equivalents and restricted cash$2,956 $3,736 
The accompanying notes are an integral part of these consolidated financial statements.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Nature of Operations
Baxter International Inc., through our subsidiaries (collectively, Baxter, we, our or us), provides a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile intravenous (IV) solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; surgical hemostat and sealant products, advanced surgical equipment; smart bed systems; patient monitoring and diagnostic technologies; and respiratory health devices. These products are used by hospitals, kidney dialysis centers, nursing homes, rehabilitation centers, doctors’ offices and patients at home under physician supervision. Our global footprint and the critical nature of our products and services play a key role in expanding access to healthcare in emerging and developed countries. We operate in 4 segments: Americas, EMEA, APAC and Hillrom which are described in Note 17.
Risks and Uncertainties Related to COVID-19
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus (COVID-19). COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and we expect will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments have taken and continue to take. Initial measures taken in 2020 led to unprecedented restrictions on, disruptions in, and other related impacts on business and personal activities, including a shift in healthcare priorities, which resulted in a significant decline in medical procedures in 2020. The pandemic has created significant volatility in the demand for our products. For further information about our revenues by product category, refer to Note 10. Significant uncertainty remains regarding the duration and overall impact of the COVID-19 pandemic. For example, concerns remain regarding the pace of economic recovery due to virus resurgence across the globe from the Omicron and Delta variants and other virus mutations as well as vaccine distribution and hesitancy. The U.S. and other governments may continue existing measures or implement new restrictions and other requirements in light of the continuing spread of the pandemic (including with respect to mandatory vaccinations for certain of our employees and moratoriums on elective procedures). Due to the uncertainty caused by the pandemic, our operating performance and financial results, particularly in the short term, may be subject to volatility. We have experienced significant challenges, including lengthy delays, shortages and interruptions, posed by the pandemic and other exogenous factors (including significant weather events and disruptions to certain ports of call around the world) to our global supply chain, including the cost and availability of raw materials and component parts (including resins and electromechanical devices) and higher transportation costs, and may experience these and other challenges in future periods. Many of our manufacturing plant and distribution center personnel are currently unvaccinated, and we may also experience employee resistance in complying with current and future government vaccine and testing mandates, which may cause labor shortages significantly impacting manufacturing production and distribution center productivity. We expect that these challenges as well as evolving governmental restrictions and requirements, among other factors, may continue to have an adverse effect on our business.
Use of Estimates
The preparation of financial statements in conformity with U.S. Generally Accepted Accounting Principles (U.S. GAAP) requires us to make estimates and assumptions that affect reported amounts and related disclosures. Actual results could differ from those estimates.
Basis of Presentation
The consolidated financial statements include the accounts of Baxter and our majority-owned subsidiaries that we control, after elimination of intra-company transactions. Certain reclassifications have been made to conform the prior period consolidated financial statements to the current period presentation.
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hill-Rom Holdings, Inc. (Hillrom) for a purchase price of $10.5 billion. Including the assumption of Hillrom's
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outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Beginning December 13, 2021, our financial statements include the assets, liabilities and operating results of Hillrom. Refer to Note 2 for additional information.
On July 29, 2021, we acquired certain assets related to PerClot Polysaccharide Hemostatic System (PerClot), including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million, which had an acquisition-date fair value of $28 million, based upon regulatory and commercial milestones. Beginning July 29, 2021, our financial statements include the assets, liabilities and operating results of PerClot. Refer to Note 2 for additional information.
On March 31, 2021, we acquired the rights to Transderm Scop (TDS) for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval of a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. Beginning on March 31, 2021, our financial statements include the assets, liabilities and operating results of TDS. Refer to Note 2 for additional information.
On February 17, 2021, we acquired the rights to Caelyx and Doxil, the branded versions of liposomal doxorubicin, from a subsidiary of Johnson & Johnson for specified territories outside of the U.S for approximately $325 million in cash. Beginning February 17, 2021, our financial statements include the assets, liabilities and operating results of Caelyx and Doxil. Refer to Note 2 for additional information.
On February 14, 2020, we completed the acquisition of the product rights to Seprafilm Adhesion Barrier (Seprafilm) from Sanofi for approximately $342 million in cash. Beginning February 14, 2020, our financial statements include the assets, liabilities and operating results of Seprafilm. Refer to Note 2 for additional information.
On October 25, 2019, we acquired 100 percent of Cheetah Medical, Inc. (Cheetah) for total cash consideration of $188 million, net of cash acquired, with the potential for additional cash consideration, up to $40 million, based on clinical and commercial milestones for which the acquisition date fair value was $18 million. Beginning October 25, 2019, our financial statements include the assets, liabilities and operating results of Cheetah. Refer to Note 2 for additional information.
Revenue Recognition
Revenue is measured as the amount of consideration we expect to receive in exchange for transferring goods or providing services. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in the contract. A contract’s transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. Some of our contracts have multiple performance obligations. For contracts with multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our global payment terms are typically between 30-90 days.
The majority of our performance obligations are satisfied at a point in time. This includes sales of our broad portfolio of essential healthcare products across our geographic segments, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. For a majority of these sales, our performance obligation is satisfied upon delivery to the customer. Shipping and handling activities are considered to be fulfillment activities and are not considered to be a separate performance obligation.
To a lesser extent, in all of our segments, we enter into other types of contracts, including contract manufacturing arrangements, equipment leases, and certain subscription software and licensing arrangements. We recognize revenue for these arrangements over time or at a point in time depending on our evaluation of when the customer obtains control of the promised goods or services. Revenue is recognized over time when we are creating or enhancing an asset that the customer controls as the asset is created or enhanced or when our performance does not create an asset with an alternative use and we have an enforceable right to payment for performance completed.
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As of December 31, 2021, we had €200$7.8 billion of transaction price allocated to remaining performance obligations related to executed contracts with an original duration of one year or more, which are primarily included in the Americas segment. Some contracts in the United States included in this amount contain index-dependent price increases, which are not known at this time. We expect to recognize approximately 35% of this amount as revenue in 2022, 30% in 2023, 15% in each of 2024 and 2025, and 5% in 2026.
Significant Judgments
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales and are included in accrued expenses and other current liabilities and accounts receivable, net on the consolidated balance sheets. Management's estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract using the expected value method. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. Revenue recognized in the years ended December 31, 2021, 2020 and 2019 related to performance obligations satisfied in prior periods was not material. Additionally, our contracts with customers often include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately and determining the allocation of the transaction price may require significant judgment.
Practical Expedients
We apply a practical expedient to expense as incurred costs to obtain a contract with a customer when the amortization period would have been one year or less. We do not disclose the value of the transaction price that is allocated to unsatisfied performance obligations for contracts with an original expected length of less than one year. We have elected to use the practical expedient to not adjust the promised amount of consideration for the effects of a significant financing component if it is expected, at contract inception, that the period between when we transfer a promised good or service to a customer and when the customer pays for that good or service will be one year or less. Additionally, all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected from a customer are excluded from revenue.
Accounts Receivable and Allowance for Doubtful Accounts
In the normal course of business, we provide credit to our customers, perform credit evaluations of these customers and maintain reserves for potential credit losses. In determining the amount of the allowance for doubtful accounts, we consider, among other items, historical credit losses, the past-due status of receivables, payment histories, other customer-specific information, current economic conditions and reasonable and supportable future forecasts. Receivables are written off when we determine they are uncollectible.
The following table summarizes the allowance for doubtful accounts.
years ended December 31
(in millions)
20212020
Balance at beginning of period$125 $112 
Acquisition13 — 
Adoption of new accounting standard— 
Charged to costs and expenses(2)11 
Write-offs(5)(4)
Currency translation adjustments(9)
Balance at end of period$122 $125 

Shipping and Handling Costs
Shipping costs, which are costs incurred to physically move product from our premises to the customer’s premises, are classified as selling, general and administrative (SG&A) expenses. Handling costs, which are costs incurred to
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store, move and prepare products for shipment, are classified as cost of sales. Approximately $381 million ($224 million)in 2021, $325 million in 2020 and $324 million in 2019 of shipping costs were classified in SG&A expenses.
Cash, Cash Equivalents and Restricted Cash
Cash and cash equivalents include cash, certificates of deposit and money market and other short-term funds with original maturities of three months or less. Restricted cash represents cash balances restricted as to withdrawal or use and are included in prepaid expenses and other current assets on the consolidated balance sheets.

Inventories
Inventories are stated at the lower of cost or net realizable value determined by the first-in, first-out method. We review inventories on hand at least quarterly and record provisions for estimated excess, slow-moving and obsolete inventory, as well as inventory with a carrying value in excess of net realizable value.
Property, Plant and Equipment, Net
Property, plant and equipment are stated at cost. Depreciation expense is calculated using the straight-line method over the estimated useful lives of the related assets, which range from 20 to 50 years for buildings and improvements and from 3 to 15 years for machinery and equipment. Leasehold improvements are amortized over the life of the related facility lease (including any renewal periods, if appropriate) or the asset, whichever is shorter. We capitalize certain computer software and software development costs incurred in connection with developing or obtaining software for internal use. Capitalized software costs are included within machinery and equipment and are amortized on a straight-line basis over the estimated useful lives of the software, which generally range from three to five years.
Research and Development
Research and development (R&D) costs, including R&D acquired in transactions that are not business combinations, are expensed as incurred. Pre-regulatory approval contingent milestone obligations to counterparties in collaborative arrangements, which include acquired R&D, are expensed when the milestone is probable to be achieved. Contingent milestone payments made to such counterparties on or after regulatory approval are capitalized and amortized over the remaining useful life of the related product. Amounts capitalized for such payments are included in other intangible assets, net.
Acquired in-process R&D (IPR&D) is the value assigned to technology or products under development acquired in a business combination which have not received regulatory approval and have no alternative future use. Acquired IPR&D is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval of the related technology or product, the indefinite-lived intangible asset is accounted for as a finite-lived intangible asset and amortized on a straight-line basis over the estimated economic life of the related technology or product, subject to annual impairment reviews as discussed below. If the R&D project is abandoned, the indefinite-lived asset is charged to expense.
Collaborative Arrangements
We enter into collaborative arrangements in the normal course of business. These collaborative arrangements take a number of forms and structures and are designed to enhance and expedite long-term sales and profitability growth. These arrangements may provide for us to obtain commercialization rights to a product under development, and require us to make upfront payments, contingent milestone payments, profit-sharing, and/or royalty payments. We may be responsible for ongoing costs associated with the arrangements, including R&D cost reimbursements to the counterparty. See the R&D section of this note regarding the accounting treatment of upfront and contingent milestone payments. Any royalty and profit-sharing payments during the commercialization phase are expensed as cost of sales when they become due and payable.
Restructuring Charges
We record liabilities for costs associated with exit or disposal activities in the period in which the liability is incurred. Employee termination costs are primarily recorded when actions are probable and estimable. Costs for one-time
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termination benefits in which the employee is required to render service until termination in order to receive the benefits are recognized ratably over the future service period. Refer to the discussion below regarding the accounting for asset impairment charges.
Goodwill, Intangible Assets, and Other Long-Lived Assets
Goodwill is the excess of the purchase price over the fair value of acquired assets and liabilities in a business combination.  Goodwill is not amortized but is subject to an impairment review annually and whenever indicators of impairment exist. We have the option to assess goodwill for impairment by initially performing a qualitative assessment to determine whether it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount. If we determine that it is not more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, then the quantitative goodwill impairment test is not required to be performed. If we determine that it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, or if we do not elect the option to perform an initial qualitative assessment, we perform a quantitative goodwill impairment test.  In the quantitative impairment test, we calculate the estimated fair value of the reporting unit. If the carrying amount of the reporting unit exceeds the estimated fair value, an impairment charge is recorded for the amount that its carrying amount, including goodwill, exceeds its fair value, limited to the total amount of goodwill allocated to that reporting unit. In 2021, we changed the measurement date of our annual goodwill impairment test from December 31st to November 1st. This change better aligns the timing of the goodwill impairment test with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
Indefinite-lived intangible assets, such as IPR&D acquired in business combinations and certain trademarks with indefinite lives, are subject to an impairment review annually and whenever indicators of impairment exist. We have the option to assess indefinite-lived intangible assets for impairment by first performing qualitative assessments to determine whether it is more-likely-than-not that the fair values of the indefinite-lived intangible assets are less than the carrying amounts. If we determine that it is more-likely-than-not that an indefinite-lived intangible asset is impaired, or if we elect not to perform an initial qualitative assessment, we then perform the quantitative impairment test by comparing the fair value of the indefinite-lived intangible asset with its carrying amount. If the carrying amount exceeds the fair value of the indefinite-lived intangible asset, we write the carrying amount down to the fair value. In 2021, we changed the measurement date of our annual indefinite-lived intangible asset impairment tests from December 31st to November 1st. This change better aligns the timing of the impairment tests with our long-term business planning process. The change was not material to our consolidated financial statements as it did not result in the delay, acceleration or avoidance of an impairment charge.
We review the carrying amounts of long-lived assets, other than goodwill and intangible assets not subject to amortization, for potential impairment when events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. In evaluating recoverability, we group assets and liabilities at the lowest level such that the identifiable cash flows relating to the group are largely independent of the cash flows of other assets and liabilities. We then compare the carrying amounts of the assets or asset groups with the related estimated undiscounted future cash flows. In the event impairment exists, an impairment charge is recorded as the amount by which the carrying amount of the asset or asset group exceeds the fair value.
Investments in Equity Securities
Our investments in marketable equity securities are classified as other non-current assets and are measured at fair value with gains and losses recognized in other expense, net. We have elected to apply the measurement alternative to equity securities without readily determinable fair values. As such, our non-marketable equity securities are measured at cost, less any impairment, and are adjusted for changes in fair value resulting from observable transactions for identical or similar investments of the same issuer. Gains and losses on non-marketable equity securities are also recognized in other expense, net. Noncontrolling investments in common stock or in-substance common stock are accounted for under the equity method if we have the ability to exercise significant influence over the operating and financial policies of the investee.
Income Taxes
Deferred taxes are recognized for the future tax effects of temporary differences between financial and income tax reporting based on enacted tax laws and rates. We maintain valuation allowances unless it is more-likely-than-not that the deferred tax asset will be realized. With respect to uncertain tax positions, we determine whether the position is more-likely-than-not to be sustained upon examination based on the technical merits of the position. Any
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tax position that meets the more-likely-than-not recognition threshold is measured and recognized in the consolidated financial statements at the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement. The liability relating to uncertain tax positions is classified as current in the consolidated balance sheets to the extent that we anticipate making a payment within one year. Interest and penalties associated with income taxes are classified in the income tax expense line in the consolidated statements of income.
Foreign Currency Translation
Currency translation adjustments (CTA) related to foreign operations are included in other comprehensive income (OCI). For foreign operations in highly inflationary economies, translation gains and losses are included in other expense, net, and were not material in 2021, 2020 and 2019.
Derivatives and Hedging Activities
All derivative instruments are recognized as either assets or liabilities at fair value in the consolidated balance sheets and are generally classified as short-term or long-term based on the scheduled maturity of the instrument. We designate certain of our derivatives and foreign-currency denominated debt as hedging instruments in cash flow, fair value or net investment hedges.
For each derivative instrument that is designated and effective as a cash flow hedge, the gain or loss on the derivative is recorded in accumulated other comprehensive income (AOCI) and then recognized in earnings consistent with the underlying hedged item. Option premiums or net premiums paid are initially recorded as assets and reclassified to OCI over the life of the option, and then recognized in earnings consistent with the underlying hedged item. Cash flow hedges are classified in cost of sales and interest expense, net, and are primarily related to forecasted intra-company sales denominated in foreign currencies and forecasted interest payments on anticipated issuances of debt, respectively.
For each derivative instrument that is designated and effective as a fair value hedge, the gain or loss on the derivative is recognized immediately to earnings, and offsets changes in fair value attributable to a particular risk, such as changes in interest rates, of the hedged item, which are also recognized in earnings. Changes in the fair value of hedge instruments designated as fair value hedges are classified in interest expense, net, as they hedge the interest rate risk associated with certain of our fixed-rate debt.
We have designated our Euro-denominated senior notes as hedges of our net investment in our European operations and, as a result, mark to spot rate adjustments on the outstanding debt balances are recorded as a component of AOCI.
For derivative instruments that are not designated as hedges, the change in fair value is recorded directly to other expense, net.
If it is determined that a derivative or nonderivative hedging instrument is no longer highly effective as a hedge, we discontinue hedge accounting prospectively. Gains or losses relating to terminations of effective cash flow hedges generally continue to be deferred and are recognized consistent with the loss or income recognition of the underlying hedged items. However, if it is probable that the hedged forecasted transactions will not occur, any gains or losses would be immediately reclassified from AOCI to earnings. If we terminate a fair value hedge, an amount equal to the cumulative fair value adjustment to the hedged item at the date of termination is amortized to earnings over the remaining term of the hedged item. If we remove a net investment hedge designation, any gains or losses recognized in AOCI are not reclassified to earnings until we sell, liquidate, or deconsolidate the foreign investments that were being hedged.
Cash flows related to the settlement of derivative instruments designated as net investment hedges of foreign operations are classified in the consolidated statements of cash flows within investing activities. Cash flows for all other derivatives, including those that are not designated as a hedge, are classified in the same line item as the cash flows of the related hedged item, which is generally within operating activities.
Refer to Note 15 for further information regarding our derivative and hedging activities.
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New Accounting Standards
Recently issued accounting standards not yet adopted
In July 2021, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2021-05, Leases (Topic 842), which requires a lessor to classify a lease with variable lease payments (that do not depend on an index or rate) as an operating lease if (1) the lease would have been classified as a sales-type or direct financing lease, and (2) the lessor would have recognized a selling loss at lease commencement. These changes are intended to avoid recognizing a day-one loss for a lease with variable payments even though the lessor expects the arrangement will be profitable overall. The standard is effective for our financial statements beginning in 2022. The impact of the adoption of this ASU is not expected to have a material effect on our consolidated financial statements.
Recently adopted accounting pronouncements
In the fourth quarter of 2021, we adopted ASU 2021-08, Business Combinations - Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. This ASU requires an entity to recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Topic 606 (Revenue from Contracts with Customers). This ASU is expected to reduce diversity in practice and increase comparability for both the recognition and measurement of acquired revenue contracts with customers at the date of and after a business combination. In accordance with this ASU we recognized contract liabilities of $142 million as part of the Hillrom acquisition in December 2021. We did not acquire contract assets or liabilities in connection with other acquisitions completed in 2021.
As of January 1, 2020, we adopted ASU No. 2016-13, Financial Instruments - Credit Losses, which requires the measurement of expected lifetime credit losses, rather than incurred losses, for financial instruments held at the reporting date based on historical experience, current conditions and reasonable forecasts. The main objective of this ASU is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. We adopted this ASU using the modified retrospective approach. The impact of the adoption of this ASU was an increase to our allowance for doubtful accounts and a decrease to retained earnings of $4 million.
As of January 1, 2020, we adopted ASU No. 2018-15, Intangibles-Goodwill and Other-Internal-Use Software, which aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. Our policies for capitalizing implementation costs incurred in a hosting arrangement were not impacted by this ASU. However, we have historically classified those capitalized costs within property, plant and equipment, net on our consolidated balance sheets and as capital expenditures on our consolidated statements of cash flows. Under the new ASU, those capitalized costs are presented as other non-current assets on our consolidated balance sheets and within operating cash flows on our consolidated statements of cash flows. We adopted this ASU on a prospective basis and capitalized $45 million and $44 million of implementation costs related to hosting arrangements that are service contracts during the years ended December 31, 2021 and 2020, respectively.
As of January 1, 2020, we adopted ASU No. 2017-04, Intangibles – Goodwill and Other, Simplifying the Test for Goodwill Impairment. This standard eliminates Step 2 of the goodwill impairment test and requires a goodwill impairment to be measured as the amount by which a reporting unit’s carrying amount exceeds its fair value, not to exceed the carrying amount of its goodwill. The adoption of this standard did not impact our consolidated financial statements.
As of January 1, 2020, we adopted ASU No. 2018-14, Compensation – Retirement Benefits – Defined Benefit Plans – General (Topic 715-20): Disclosure Framework – Changes to the Disclosure Requirements for Defined Benefit Plans. This ASU amends ASC 715 to remove certain disclosures, clarify certain existing disclosures and add additional disclosures. The adoption of this standard did not have a material impact on our consolidated financial statements.
As of January 1, 2019, we adopted ASU No. 2016-02, Leases (Topic 842). Under this guidance, lessees are required to recognize a right-of-use asset and a lease liability on the balance sheet for all operating leases, other than those that meet the definition of a short-term lease. We adopted Topic 842 using the modified retrospective method. We elected the following practical expedients when assessing the transition impact: i) not to reassess whether any expired or existing contracts as of the adoption date are or contain leases; ii) not to reassess the lease
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classification for any expired or existing leases as of the adoption date; and iii) not to reassess initial direct costs for any existing leases as of the adoption date. The impact to the consolidated statements of income was not material and there was no net impact to the consolidated statements of cash flows.
As of January 1, 2019, we adopted ASU No. 2018-02, Reclassification of Certain Tax Effects from AOCI. This guidance provides for a reclassification of certain tax effects from AOCI to retained earnings. The impact of the adoption of this standard was a $161 million increase to retained earnings.
NOTE 2
ACQUISITIONS AND OTHER ARRANGEMENTS
Results of operations of acquired companies are included in our results of operations as of the respective acquisition dates. The purchase price of each acquisition is allocated to the net assets acquired based on estimates of their fair values (or other measurement attribute required under U.S. GAAP) at the date of the acquisition. Any purchase price in excess of these net assets is recorded as goodwill. The allocation of purchase price in certain cases may be subject to revision based on the final determination of fair values during the measurement period, which may be up to one year from the acquisition date.
Contingent consideration related to business combinations is recognized at its estimated fair value on the acquisition date. Subsequent changes to the fair value of those contingent consideration arrangements are recognized in earnings. Contingent consideration related to acquisitions may consist of development, regulatory and commercial milestone payments, and sales or earnings-based payments, and are valued using discounted cash flow techniques. The fair value of development, regulatory and commercial milestone payments reflects management’s expectations of the probability of payment, and increases or decreases as the probability of payment or expectation of timing or amount of payments changes. The fair value of sales-based payments is based upon probability-weighted future revenue estimates and increases or decreases as revenue estimates or expectation of timing or amount of payments changes.
Hillrom
On December 13, 2021, we completed the previously announced acquisition of all outstanding equity interests of Hillrom for a purchase price of $10.5 billion. Including the assumption of Hillrom's outstanding debt obligations, the enterprise value of the transaction was approximately $12.8 billion. Under the terms of the transaction agreement, Hillrom shareholders received $156.00 in cash per each outstanding Hillrom common share.
Prior to our acquisition of Hillrom, Hillrom was a global medical technology leader whose products and services help enable earlier diagnosis and treatment, optimize surgical efficiency, and accelerate patient recovery while simplifying clinical communication and shifting care closer to home. Hillrom made those outcomes possible through digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices, advanced equipment for the surgical space and more, delivering actionable, real-time insights at the point of care.
The following table summarizes the fair value of the total consideration paid:
(in millions)
Cash consideration paid to Hillrom shareholders(a)
$10,474 
Fair value of equity awards issued to Hillrom equity award holders(b)
Total Consideration$10,476 
(a) Represents cash consideration transferred of $156.00 per outstanding Hillrom common share to existing shareholders and holders of equity awards that vested at closing pursuant to their original terms.
(b) Represents the pre-acquisition service portion of the fair value of 668 thousand replacement restricted stock units issued to Hillrom equity award holders at closing.
The valuation of assets acquired and liabilities assumed has not yet been finalized as of December 31, 2021. As a result, we recorded preliminary estimates for the fair value of assets acquired and liabilities assumed as of the acquisition date. Finalization of the valuation during the measurement period could result in a change in the
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amounts recorded for the acquisition date fair value of intangible assets, goodwill and income taxes among other items. The completion of the valuation will occur no later than one year from the acquisition date. The following table summarizes the preliminary fair values of the assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash and cash equivalents$399 
Accounts receivable591 
Inventories560 
Prepaid expenses and other current assets49 
Property, plant and equipment503 
Goodwill6,785 
Other intangible assets6,022 
Operating lease right-of-use assets74 
Other non-current assets128 
Short-term debt(250)
Accounts payable(140)
Accrued expenses and other current liabilities(552)
Long-term debt and finance lease obligations(2,118)
Operating lease liabilities(57)
Other non-current liabilities(1,518)
Total assets acquired and liabilities assumed$10,476 
We allocated $804 million of the total consideration to developed technology with a weighted-average useful life of 5 years, $1.9 billion to trade names with an indefinite useful life, $62 million to trade names with a weighted-average useful life of 7 years, $3.2 billion to customer relationships with a weighted-average useful life of 15 years and $30 million to IPR&D that is considered an indefinite lived intangible asset. The fair values of the intangible assets were determined using the income approach. We used a discount rate of 8.5% to value the developed technology, trade names and customer relationships and 9.0% to value the IPR&D. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair value. We also recognized $1.3 billion of deferred income tax liabilities in connection with the acquisition, which are included in other non-current liabilities in the accompanying consolidated balance sheet as of December 31, 2021.
The goodwill, which is not deductible for tax purposes, includes the value of an assembled workforce as well as the overall strategic benefits provided to our product portfolio and is included in the Hillrom segment.
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired. The Hillrom acquisition contributed $212 million of net sales and a $96 million of pretax loss, including integration costs and interest expense on acquisition financing, for the year ended December 31, 2021.
Costs directly resulting from the Hillrom acquisition, included acquisition and integration costs of $139 million and the incremental cost of sales relating to inventory fair value step-ups of $42 million in 2021.
The following table presents the unaudited pro forma combined results of Baxter and Hillrom for the years ended December 31, 2021 and 2020 as if the acquisition of Hillrom had occurred on January 1, 2020:
years ended December 31 (in millions)20212020
Net sales$15,574 $14,610 
Net income attributable to Baxter stockholders962 635 
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The acquisition has been accounted for in the unaudited pro forma combined financial information using the acquisition method of accounting with Baxter as the acquirer. In order to reflect the occurrence of the acquisition as if it occurred on January 1, 2020 as required, the unaudited pro forma combined financial information includes adjustments to reflect incremental depreciation and amortization expense based on the current preliminary fair values of the identifiable tangible and intangible assets acquired, additional interest expense associated with the issuance of debt to finance the acquisition, nonrecurring costs directly attributable to the acquisition and the income tax effects of the pro forma adjustments. Those nonrecurring costs, which consist of $201 million of costs from inventory fair value step-ups and $314 million of acquisition-related costs for both Baxter and Hillrom, are reflected in the unaudited pro forma combined financial information for the year ended December 31, 2020. The unaudited pro forma combined financial information is not necessarily indicative of what the consolidated results of operations would have been had the acquisition been completed on January 1, 2020. In addition, the unaudited pro forma combined financial information is not a projection of future results of operations of the combined company nor does it reflect the expected realization of any potential synergies or cost savings associated with the acquisition.
PerClot
On July 29, 2021, we acquired certain assets related to PerClot, including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million, which had an acquisition-date fair value of $28 million, based upon regulatory and commercial milestones. PerClot is an absorbable powder hemostat indicated for use in surgical procedures, including cardiac, vascular, orthopedic, spinal, neurological, gynecological, ENT and trauma surgery as an adjunct hemostat when control of bleeding from capillary, venous, or arteriolar vessels by pressure, ligature, and other conventional means is either ineffective or impractical. PerClot is approved for distribution in the European Union and other markets and was submitted for Pre-Market Approval (PMA) for distribution in the U.S. in the fourth quarter of 2021. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair values of the potential contingent consideration payments were estimated by applying probability-weighted expected payment models and are Level 3 fair value measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$25 
Contingent Consideration28 
Total Consideration$53 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Goodwill$
Other intangible assets49 
Total assets acquired$53 
The valuation of the assets acquired are preliminary and measurement period adjustments may be recorded in the future as we finalize our fair value estimates. The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the year ended December 31, 2021.
We allocated $39 million of the total consideration to an in-process research and development (IPR&D) asset with an indefinite useful life, $9 million to the approved PerClot developed product rights with an estimated useful life of 10 years and $1 million to customer relationships with an estimated useful life of 10 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 18.7% for IPR&D, 16.0% for developed product rights and 15.0% for customer relationships. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
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The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our surgical portfolio of hemostats and sealants and is included in the Americas and EMEA segments.
Transderm Scop
On March 31, 2021, we acquired the rights to TDS for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval of a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. TDS is indicated for post-operative nausea and vomiting in the U.S. and motion sickness in European markets. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair value of the potential contingent consideration payment was estimated by applying a probability-weighted expected payment model and is a Level 3 fair value measurement due to the significant estimates and assumptions used by management in establishing the estimated fair value.
The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$60 
Contingent Consideration24 
Total Consideration$84 
The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Inventory$16 
Goodwill
Other intangible assets67 
Total assets acquired$84 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the year ended December 31, 2021.
We allocated $64 million of the total consideration to the TDS developed product rights with an estimated useful life of 9 years and $3 million to customer relationships with an estimated useful life of 7 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 22.5% for developed product rights and 15.5% for customer relationships. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our pharmaceutical portfolio and is included in the Americas segment.
Seprafilm Adhesion Barrier
On February 14, 2020, we completed the acquisition of the product rights to Seprafilm Adhesion Barrier (Seprafilm) from Sanofi for approximately $342 million in cash. Seprafilm is indicated for use in patients undergoing abdominal or pelvic laparotomy as an adjunct intended to reduce the incidence, extent and severity of postoperative adhesions between the abdominal wall and the underlying viscera such as omentum, small bowel, bladder, and stomach, and between the uterus and surrounding structures such as tubes and ovaries, large bowel, and bladder. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting.
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The following table summarizes the fair values of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Inventories$18 
Goodwill28 
Other intangible assets296 
Total assets acquired$342 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired. The acquisition contributed $94 million of net sales and $18 million of pretax income for the year ended December 31, 2020. Acquisition and integration costs, primarily incremental cost of sales relating to inventory fair value step-ups, associated with the acquisition were $15 million for the year ended December 31, 2020.
We allocated $286 million and $10 million of the total consideration to the Seprafilm developed product rights and customer relationships with useful lives of 10 and 7 years, respectively. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the developed product rights and customer relationship intangible assets were 14.8% and 11.0%, respectively. We consider the fair values of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions we used in establishing the estimated fair values.
The goodwill, which is deductible for tax purposes, includes the value of the overall strategic benefits provided to our product portfolio of hemostats and sealants and is included in the Americas and APAC segments.
Cheetah Medical, Inc.
On October 25, 2019, we acquired 100 percent of Cheetah Medical, Inc. (Cheetah), a leading provider of hemodynamic monitoring technologies, for total upfront cash consideration of $195 million, net of cash acquired, with the potential for additional cash consideration, up to $40 million, based on clinical and commercial milestones for which the acquisition date fair value was $18 million. In 2020, we received $7 million from the sellers as a result of an acquisition price adjustment in accordance with the acquisition agreement. The fair value of the potential contingent consideration payments was estimated by applying a probability-weighted expected payment model for the clinical milestone and a Monte Carlo simulation model for the commercial milestone, which were then discounted to present value. The fair value measurements were based on Level 3 inputs.
The following table summarizes the fair value of consideration transferred:
(in millions)
Cash consideration transferred$190 
Contingent consideration18 
Total consideration$208 
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The following table summarizes the fair values of the assets acquired and liabilities assumed as of the acquisition date:
(in millions)
Assets acquired and liabilities assumed
Cash$
Accounts receivable, net
Inventories
Prepaid expenses and other current assets
Property, plant and equipment
Goodwill84 
Other intangible assets131 
Operating lease right-of-use assets
Accounts payable and accrued liabilities(4)
Other non-current liabilities(12)
Total assets acquired and liabilities assumed$208 
The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not significant. Acquisition and integration costs associated with the acquisition were $5 million and $3 million in 2020 and 2019, respectively.
We allocated $123 million of the total consideration to the developed product rights with a weighted-average useful life of 15 years and $8 million to customer relationships with a useful life of 13 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 11.0% for developed product rights and 10.0% for customer relationships. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.
The goodwill, which is not deductible for tax purposes, includes the value of potential future technologies as well as the overall strategic benefits provided to our product portfolio and is included primarily in the Americas segment.
Other Business Combinations
Total consideration transferred for other acquisitions totaled $21 million, $18 million and $10 million in 2021, 2020 and 2019, respectively, and primarily resulted in the recognition of goodwill and other intangible assets. These acquisitions did not materially affect our results of operations.
Excluding Hillrom, we have not presented pro forma financial information for any of the 2021, 2020 or 2019 acquisitions because their results are not material to our consolidated financial statements.
Other Business Development Activities
Caelyx and Doxil
On February 17, 2021, we acquired the rights to Caelyx and Doxil, the branded versions of liposomal doxorubicin, from a subsidiary of Johnson & Johnson for specified territories outside of the U.S. We previously acquired the U.S. rights to this product in 2019. Liposomal doxorubicin is a chemotherapy medicine used to treat various types of cancer. The transaction was accounted for as an asset acquisition, as substantially all of the fair value of the gross assets acquired was concentrated in the developed technology intangible asset. The purchase price of $325 million was allocated to the assets acquired, which included a $314 million developed-technology intangible asset with an estimated useful life of 9 years and an $11 million customer relationship intangible asset with an estimated useful life of 8 years. Net sales related to this acquisition were $108 million for the year ended December 31, 2021.
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Celerity Pharmaceuticals, LLC
In September 2013, we entered into an agreement with Celerity Pharmaceutical, LLC (Celerity) to develop certain acute care generic injectable premix and oncolytic products through regulatory approval. We transferred our rights in these products to Celerity and Celerity assumed ownership and responsibility for development of the products. We are obligated to purchase the individual product rights from Celerity if the products obtain regulatory approval. We did not purchase any product rights from Celerity in 2021 or 2020. In 2019, we paid $86 million to acquire the rights to various products that have received regulatory approval. We capitalized the purchase prices of products that were purchased upon regulatory approval as intangible assets and are amortizing the assets over their estimated useful lives of 12 years. As of December 31, 2021, our contingent future payments total up to $77 million upon Celerity’s achievement of specified regulatory approvals. In December 2020, we entered into an agreement with a third party to divest one of the products that is currently being developed by Celerity if that product receives regulatory approval in the U.S. and/or European Union. If regulatory approval is obtained, we would incur a loss ranging from $30 million to $60 million for the difference between our purchase price and the divestiture proceeds in connection with that transaction.
Other Asset Acquisitions
During 2020, we acquired the rights to multiple products for $73 million. The purchase prices were capitalized as developed-technology intangible assets and are being amortized over a weighted-average estimated useful life of 11 years.
During 2021 and 2020, we also entered into distribution license arrangements for multiple products that have not yet obtained regulatory approval for upfront cash payments of $3 million and $22 million, respectively. The cash paid was treated as R&D expenses on our consolidated statements of income. We could make additional payments of up to $35 million upon the achievement of certain development, regulatory or commercial milestones.
During 2019, we acquired the rights to multiple products for an aggregate purchase price of $80 million. The purchase prices were capitalized primarily as developed-technology intangible assets and are being amortized over a weighted-average useful life of 10 years.
Other
In addition to the significant arrangements described above, we have entered into several other collaborative arrangements. We could make additional payments of up to $19 million upon the achievement of certain development and regulatory milestones, in addition to future payments related to contingent commercialization milestones, profit-sharing and royalties.
NOTE 3
SUPPLEMENTAL FINANCIAL INFORMATION
Inventories
as of December 31 (in millions)20212020
Raw materials$591 $460 
Work in process300 196 
Finished goods1,562 1,260 
Inventories$2,453 $1,916 
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Prepaid Expenses and Other Current Assets
as of December 31 (in millions)20212020
Prepaid value added taxes$199 $163 
Prepaid income taxes166 183 
Contract assets84 70 
Other390 342 
Prepaid expenses and other current assets$839 $758 
Property, Plant and Equipment, Net
as of December 31 (in millions)20212020
Land and land improvements$172 $166 
Buildings and leasehold improvements1,915 1,849 
Machinery and equipment7,097 6,884 
Equipment on lease with customers1,684 1,671 
Construction in progress860 701 
Total property, plant and equipment, at cost11,728 11,271 
Accumulated depreciation(6,550)(6,549)
Property, plant and equipment, net$5,178 $4,722 
Depreciation expense was $592 million in 2021, $601 million in 2020 and $606 million in 2019.
Other Non-Current Assets
as of December 31 (in millions)20212020
Deferred tax assets$376 $748 
Non-current receivables, net113 158 
Contract assets111 64 
Capitalized implementation costs in hosting arrangements99 68 
Pension and other postretirement benefits228 155 
Investments154 135 
Other132 67 
Other non-current assets$1,213 $1,395 
Accrued Expenses and Other Current Liabilities
as of December 31 (in millions)20212020
Common stock dividends payable$140 $125 
Employee compensation and withholdings608 415 
Property, payroll and certain other taxes174 148 
Contract liabilities162 32 
Restructuring liabilities97 92 
Accrued rebates312 239 
Operating lease liabilities128 111 
Income taxes payable90 135 
Pension and other postretirement benefits46 48 
Contingent payments related to acquisitions21 16 
Other701 523 
Accrued expenses and other current liabilities$2,479 $1,884 
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Other Non-Current Liabilities
as of December 31 (in millions)20212020
Pension and other postretirement benefits$1,052 $1,214 
Deferred tax liabilities962 143 
Long-term tax liabilities80 84 
Contingent payments related to acquisitions122 14 
Contract liabilities84 34 
Litigation and environmental reserves28 29 
Restructuring liabilities12 21 
Other153 134 
Other non-current liabilities$2,493 $1,673 
Interest Expense, net
years ended December 31 (in millions)202120202019
Interest costs$217 $162 $120 
Interest costs capitalized(11)(9)(9)
Interest expense206 153 111 
Interest income(14)(19)(40)
Interest expense, net$192 $134 $71 
Other Expense, net
years ended December 31 (in millions)202120202019
Foreign exchange (gains) losses, net$19 $49 $37 
Change in fair value of marketable equity securities(13)(1)
Loss on debt extinguishment110 — 
Pension settlements46 755 
Pension and other postretirement benefit plans11 (3)(53)
Other, net(3)(7)
Other expense, net$41 $190 $731 
Supplemental Cash Flow Information
Non-Cash Investing Activities
Purchases of property, plant and equipment included in accounts payable and accrued liabilities as of December 31, 2021, 2020 and 2019 was $79 million, $102 million and $87 million, respectively.
Other Supplemental Information
year ended December 31 (in millions)202120202019
Interest paid, net of portion capitalized$145 $137 $103 
Income taxes paid$282 $249 $294 
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NOTE 4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET
Goodwill
The following is a reconciliation of goodwill by business segment.
(in millions)AmericasEMEAAPACHillromTotal
December 31, 2019$2,428 $385 $217 $— $3,030 
Additions26 — 34 
Acquisition accounting adjustments(45)(6)(2)— (53)
Currency translation165 26 15 — 206 
December 31, 2020$2,574 $406 $237 $— $3,217 
Reallocation of goodwill81 (81)— — — 
Additions— 6,785 6,790 
Currency translation(142)(17)(13)(171)
December 31, 2021$2,517 $309 $224 $6,786 $9,836 
As of December 31, 2021, there were no reductions in goodwill relating to impairment losses. 
As discussed in Note 17 - Segment Information, we made a change to our reportable segments in the first quarter of 2021. As a result of this change, we reallocated goodwill from our EMEA segment to the Americas segment using a relative fair value approach. In addition, we completed an assessment of any potential goodwill impairment for all reporting units immediately prior to and following the reallocation and determined that no impairment existed.
Other Intangible Assets, Net
The following is a summary of our other intangible assets.
(in millions)Developed technology,
including patents
Other amortized
intangible assets
Customer relationshipsIndefinite-lived
intangible assets
Total
December 31, 2021
Gross other intangible assets$3,801 $344 $3,437 $2,140 $9,722 
Accumulated amortization(1,556)(212)(162)— $(1,930)
Other intangible assets, net$2,245 $132 $3,275 $2,140 $7,792 
December 31, 2020
Gross other intangible assets$2,713 $269 $226 $169 $3,377 
Accumulated amortization(1,374)(193)(139)— $(1,706)
Other intangible assets, net$1,339 $76 $87 $169 $1,671 
Intangible asset amortization expense was $298 million in 2021, $222 million in 2020 and $183 million in 2019. The anticipated annual amortization expense for definite-lived intangible assets recorded as of December 31, 2021 is $718 million in 2022, $627 million in 2023, $605 million in 2024, $572 million in 2025 and $542 million in 2026.
In the second quarters of 2020 and 2019, we recognized impairment charges of $17 million and $31 million, respectively, related to developed-technology intangible assets due to declines in market expectations for the related products. The fair values of the intangible assets were measured using a discounted cash flow approach and the charges are classified within cost of sales in the accompanying consolidated statements of income for the years ended December 31, 2020 and 2019. We consider the fair values of the assets to be Level 3 measurements due to the significant estimates and assumptions we used in establishing the estimated fair values.
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NOTE 5
DEBT AND CREDIT FACILITIES
Debt Outstanding
At December 31, 2021 and 2020, we had the following debt outstanding:
as of December 31 (in millions)Effective interest rate in 2021¹
20211
20201
Commercial paper0.3 %$300 $— 
1.7% notes due 20211.9 %— 400 
2.4% notes due 20222.5 %203 203 
0.868% notes due 20231.2 %797 — 
Floating-rate notes due 20231.9 %298 — 
0.4% notes due 20240.6 %846 915 
1.322% notes due 20241.7 %1,393 — 
7.0% notes due 20247.0 %13 — 
Floating-rate notes due 20240.9 %298 — 
Term loan due 20241.8 %1,998 — 
1.3% notes due in 20251.4 %678 734 
2.6% notes due 20262.7 %747 746 
Term loan due 20261.9 %1,998 — 
7.65% debentures due 20277.7 %
1.915% notes due 20272.2 %1,441 — 
6.625% debentures due 20285.6 %96 97 
2.272% notes due 20282.5 %1,241 — 
1.3% notes due 20291.4 %841 912 
3.95% notes due 20304.0 %495 495 
1.73% notes due 20313.2 %644 644 
2.539% notes due 20322.7 %1,537 — 
6.25% notes due 20376.3 %265 265 
3.65% notes due 20423.7 %
4.5% notes due 20434.6 %256 256 
3.5% notes due 20463.6 %441 440 
3.132% notes due 20513.2 %742 — 
Finance leases and other9.3 %81 74 
Total debt17,660 6,192 
Short-term debt(301)— 
Current maturities of long-term debt and finance lease obligations(210)(406)
Long-term debt and finance lease obligations$17,149 $5,786 
1Book values include any discounts, premiums and adjustments related to hedging instruments and effective interest rates reflect amortization of those items.
Significant Debt Activity
In May 2019, we issued €750 million of 0.40% senior notes due May 2024 and €750 million of 1.3% senior notes due May 2029. We have designated these debt instruments as net investment hedges of our European operations. Refer to Note 15 for additional information.
In March 2020, we issued $750 million of 3.75% senior notes due in October 2025 and $500 million of 3.95% senior notes due in April 2030 (collectively, the March 2020 senior notes). Pursuant to a registration rights agreement (the March 2020 Registration Rights Agreement) with the initial purchasers of the March 2020 senior notes, we agreed
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to use our commercially reasonable efforts to file a registration statement with respect to a registered offer to exchange the March 2020 senior notes for new notes with terms substantially identical in all material respects to the March 2020 senior notes and to have such registration statement declared effective under the U.S. Securities Act of 1933. The exchange offer with respect to the notes due April 2030 was completed in May 2021.
In October 2020, we repaid $322 million of variable-rate loans that matured in 2020.
In November 2020, we issued $650 million of 1.73% senior notes due in April 2031 (the November 2020 senior notes). Pursuant to a registration rights agreement (the November 2020 Registration Rights Agreement) with the initial purchasers of the November 2020 senior notes, we agreed to use our commercially reasonable efforts to file a registration statement with respect to a registered offer to exchange the November 2020 senior notes for new notes with terms substantially identical in all material respects to the November 2020 senior notes and to have such registration statement declared effective under the U.S. Securities Act of 1933. The exchange offer with respect to the November 2020 senior notes was completed in May 2021.
We used the proceeds from the November 2020 senior notes, along with cash on hand, to redeem the $750 million of 3.75% senior notes due in October 2025 that were issued in March 2020. In connection with the redemption of the $750 million of 3.75% senior notes due in October 2025, including the payment of a $104 million make-whole premium to the debt holders, we recognized a pre-tax loss of $110 million from the early extinguishment of debt, which is included in other expense, net in 2020.
In July 2021, we redeemed $400 million in 1.7% senior notes due August 2021, which was partially funded by the issuance of commercial paper.
On September 30, 2021, we entered into a term loan credit agreement (the Term Loan Credit Agreement), pursuant to which a syndicate of financial institutions has committed to provide us with a senior unsecured term loan facility in an aggregate principal amount of $4.0 billion (the Term Loan Facility), consisting of a $2.0 billion three-year term loan facility and a $2.0 billion five-year term loan facility. Loans under the Term Loan Facility were funded on the closing date of the Hillrom acquisition to fund a portion of the consideration for the Hillrom acquisition, repay certain indebtedness of Hillrom, and pay fees and expenses related to the foregoing. Loans under the Term Loan Facility bear interest at variable rates, are subject to amortization at a quarterly rate of 0.625% for the first four quarters following the anniversary of our initial borrowing date and 1.25% thereafter (with loans outstanding under our Euro-denominated facilitythe five-year tranche subject to amortization at a 0.91%quarterly rate of 1.875% after the second anniversary of the commencement of amortization and 2.500% after the third anniversary of the commencement of amortization). The Term Loan Credit Agreement contains various covenants, including a maximum net leverage ratio.
In December 2021, we issued $800 million of 0.868% senior notes due in 2023, $1.4 billion of 1.322% senior notes due in 2024, $1.45 billion of 1.915% senior notes due in 2027, $1.25 billion of 2.272% senior notes due in 2028, $1.55 billion of 2.539% senior notes due in 2032, $750 million of 3.132% senior notes due in 2051, $300 million of floating rate senior notes due in 2023 and $300 million of floating rate senior notes due in 2024 (collectively, the Hillrom notes) to fund a portion of the consideration for the Hillrom acquisition, repay certain indebtedness of Hillrom, and pay fees and expenses related to the foregoing. Pursuant to a registration rights agreement (the Hillrom Notes Registration Rights Agreement) with the initial purchasers of the Hillrom notes, we agreed to use our commercially reasonable efforts to file a registration statement with respect to a registered offer to exchange the Hillrom notes for new notes with terms substantially identical in all material respects to the Hillrom notes and to have such registration statement declared effective under the U.S. Securities Act of 1933. If we fail to have such registration statement declared effective by March 25, 2023 (a registration default), the annual interest rate on the Hillrom notes would increase by 0.25% for the 90-day period immediately following such registration default and by an additional 0.25% thereafter. The maximum additional interest rate is 0.50% per annum and if a registration default is corrected, the Hillrom notes would revert to the original interest rates. The payment of additional interest is the sole remedy for the holders of the Hillrom notes in the event of a registration default.
On September 1, 2021, we entered into a bridge facility commitment letter with JPMorgan Chase Bank, N.A. (JP Morgan) and Citigroup Global Markets Inc. (Citi) pursuant to which JP Morgan and Citi committed to provide a 364-day senior unsecured bridge term loan facility in an aggregate principal amount of $11.4 billion (the Bridge Facility) for the purpose of funding the consideration for the Hillrom acquisition, repaying certain indebtedness of Hillrom, and paying fees and expenses related to the foregoing. The Bridge Facility included upfront fees of $40 million. The commitments under the Bridge Facility were reduced by $4.0 billion on September 30, 2021 when we entered into the Term Loan Facility and the remaining commitments were reduced to 0 borrowings outstanding under ouron December 1, 2021 when we issued the Hillrom notes, both in accordance with the terms of the commitment letter. As a result, the Bridge Facility was
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terminated and the remaining unamortized upfront fees related to the Bridge Facility were charged to interest expense, net during the year ended December 31, 2021.
Baxter assumed debt with an acquisition-date fair value of $2.4 billion as part of the acquisition of Hillrom. Baxter used the proceeds from the Hillrom notes, the Term Loan Facility and cash on hand to repay substantially all of this indebtedness, including accrued interest and applicable early redemption premiums, and recognized a net loss on the early extinguishment of debt of $5 million.
Credit Facilities
On September 30, 2021, we entered into a new U.S. dollar-denominated revolving credit facility.facility (the USD Revolver), and on October 1, 2021, we amended our existing Euro-denominated revolving credit facility (as amended, the Euro Revolver). Our USD Revolver has a capacity of $2.5 billion and our Euro Revolver has a capacity of €200 million. Each of the facilities matures in 2026. The facilities enable us to borrow funds on an unsecured basis at variable interest rates, and contain various covenants, including a maximum net leverage ratio. Fees under the credit facilities are 0.09% annually as of December 31, 20192021 and are based on our credit ratings and the total capacity of the facility. Prior to entering into these new credit facilities,the USD Revolver and the Euro Revolver, our previous U.S. dollar-denominated revolving credit facility and Euro-denominated senior revolving credit facility had a maximum capacity of $1.5$2.0 billion and €200 million, respectively. Fees under these credit facilities were 0.10%0.09% annually as of December 31, 20182020 and were based on our credit ratings and the total capacity of the facility. There were no borrowings outstanding under these credit facilities as of December 31, 2018.
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2021 and 2020.
We also maintain other credit arrangements, which totaled approximately $225 million and $200 million as of December 31, 20192021 and 2018,2020, respectively. We had $2 millionThere were no amounts outstanding under these arrangements as of December 31, 20192021 and 2018, respectively.2020.
As of December 31, 2019,2021, we were in compliance with the financial covenants in these agreements. The non-performance of any financial institution supporting any of the credit facilities would reduce the maximum capacity of these facilities by each institution’s respective commitment.
Commercial Paper
As of December 31, 2021, we had $300 million of commercial paper outstanding with a weighted-average interest rate of 0.27% and an original weighted-average term of 88 days. There was no commercial paper outstanding as of December 31, 2020.
Future Debt Maturities
as of and for the years ended December 31 (in millions)Debt maturities
2022$513 
20231,108 
20244,567 
2025684 
20262,754 
Thereafter8,128 
Total obligations and commitments17,754 
Discounts, premiums, and adjustments relating to hedging instruments(94)
Total debt$17,660 
as of and for the years ended December 31 (in millions)Debt maturities
2020$315  
2021402  
2022207  
2023 
2024842  
Thereafter3,393  
Total obligations and commitments5,160  
Discounts, premiums, and adjustments relating to hedging instruments(36) 
Total debt$5,124  
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NOTE 8
6
LEASES
Lessee Activity
We have entered into operating and finance leases primarily for office, manufacturing, warehouse and R&D facilities, vehicles and equipment. Our leases have remaining terms from one1 to 2541 years and some of those leases include options that provide us with the ability to extend the lease term for periods ranging from one1 to 16 years. Such options are included in the lease term when it is reasonably certain that the option will be exercised.
Certain of our leases include provisions for variable lease payments which are based on, but not limited to, maintenance, insurance, taxes, index escalations and usage-based amounts. For all asset classes, we have elected to apply a practical expedient to account for other services within lease contracts as components of the lease. We also have elected to apply a practical expedient for short-term leases whereby we do not recognize a lease liability and right-of-use asset for leases with a term of less than 12 months.
We classify our leases as operating or finance at the lease commencement date. Finance leases are generally those leases for which we will pay substantially all of the underlying asset’s fair value or will use the asset for all or a major part of its economic life, including circumstances in which we will ultimately own the asset. All other leases are operating leases. For finance leases, we recognize interest expense using the effective interest method and we recognize amortization expense on the right-of-use asset over the shorter of the lease term or the useful life of the asset. For operating leases, we recognize lease cost on a straight-line basis over the term of the lease.
Lease liabilities and right-of-use assets are recognized at the lease commencement date based on the present value of minimum lease payments over the lease term. We determine the present value of payments under a lease based on our incremental borrowing rate as of the lease commencement date. The incremental borrowing rate is equal to the rate of interest that we would have to pay to borrow on a collateralized basis over a similar term in an amount equal to the lease payments in a similar economic environment. For operating leases that commenced prior to our adoption of Topic 842, we measured the lease liabilities and right-of-use assets using our incremental borrowing rate as of January 1, 2019.
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The components of lease cost for the yearyears ended December 31, 2021, 2020 and 2019 were:
(in millions)202120202019
Operating lease cost$114 $115 $121 
Finance lease cost
Amortization of right-of-use assets
Interest on lease liabilities
Variable lease cost52 54 89 
Lease cost$178 $179 $220 
(in millions)2019
Operating lease cost$121 
Finance lease cost
Amortization of right-of-use assets
Interest on lease liabilities
Variable lease cost89 
Lease cost$220 
The following table contains supplemental cash flow information related to leases for the yearyears ended December 31, 2021, 2020 and 2019:
(in millions)202120202019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$124 $127 $119 
Operating cash flows from finance leases
Financing cash flows from finance leases
Right-of-use operating lease assets obtained in exchange for lease obligations71 67 207 
Right-of-use finance lease assets obtained in exchange for lease obligations— 
(in millions)2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$119 
Operating cash flows from finance leases
Financing cash flows from finance leases
Right-of-use operating lease assets obtained in exchange for lease obligations207 
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There wereare no material lease transactions that we entered into but have not yet commenced as of December 31, 2019.2021. Supplemental balance sheet information related to leases as of December 31, 2019 includes:2021 and 2020 include:
(in millions)20212020
Operating leases
Operating lease right-of-use assets$630 $603 
Accrued expenses and other current liabilities$128 $111 
Operating lease liabilities522 501 
Total operating lease liabilities$650 $612 
Finance leases
Property, plant and equipment, at cost$86 $76 
Accumulated depreciation(31)(28)
Property, plant and equipment, net$55 $48 
Current maturities of long-term debt and finance lease obligations$$
Long-term debt and finance lease obligations68 64 
Total finance lease liabilities$70 $65 
(in millions)December 31, 2019
Operating leases
Operating lease right-of-use assets$608 
Accounts payable and accrued liabilities$101 
Operating lease liabilities510 
Total operating lease liabilities$611 
Finance leases
Property, plant and equipment, at cost$63 
Accumulated depreciation(19)
Property, plant and equipment, net$44 
Current maturities of long-term debt and finance lease obligations$— 
Long-term debt and finance lease obligations54 
Total finance lease liabilities$54 
Lease term and discount rates as of December 31, 20192021 and 2020 were:
December 31, 2021December 31, 2020
Weighted-average remaining lease term (years)
Operating leases89
Finance leases1213
Weighted-average discount rate
Operating leases1.8 %2.2 %
Finance leases9.3 %10.3 %
December 31, 2019
Weighted-average remaining lease term (years)
Operating leases10
Finance leases15
Weighted-average discount rate
Operating leases2.8 %
Finance leases10.6 %



Maturities of operating and finance lease liabilities as of December 31, 20192021 were:
(in millions)Finance LeasesOperating Leases
2020$ $112  
2021 96  
2022 80  
2023 67  
2024 54  
Thereafter78  267  
Total minimum lease payments111  676  
Less: imputed interest(57) (65) 
Present value of lease liabilities$54  $611  
Maturities of operating and finance lease liabilities as of December 31, 2018 were:
As Restated
(in millions)Capital LeasesOperating Leases
2019$ $123  
2020 94  
2021 86  
2022 72  
2023 64  
Thereafter88  212  
Total minimum lease payments124  $651  
Less: imputed interest(62) 
Present value of lease liabilities$62  
For the years ended December 31, 2018 and 2017, rent expense was $152 million and $155 million, respectively.
(in millions)Finance LeasesOperating Leases
2022$10 $141 
2023118 
202495 
202576 
202660 
Thereafter72 216 
Total minimum lease payments118 706 
Less: imputed interest(48)(56)
Present value of lease liabilities$70 $650 
Lessor Activity
We lease medical equipment, such as renal dialysis equipment and infusion pumps, to customers, primarily in conjunction with arrangements to provide consumable medical products such as dialysis therapies, intravenous (IV) fluids and inhaled anesthetics. Certain of our equipment leases are classified as sales-type leases and the remainder are operating leases. The terms of the related contracts, including the proportion of fixed versus variable payments and any options to shorten or extend the lease term, vary by customer. We allocate revenue between equipment leases and medical products based on their standalone selling prices.
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The components of lease revenue for the yearyears ended December 31, 2021, 2020 and 2019 were:
(in millions)202120202019
Sales-type lease revenue$27 $38 $35 
Operating lease revenue136 84 61 
Variable lease revenue79 80 85 
Total lease revenue$242 $202 $181 
(in millions)2019
Sales-type lease revenue$35 
Operating lease revenue61 
Variable lease revenue85 
Total lease revenue$181 
The components of our net investment in sales-type leases as of December 31, 20192021 and 2020 were:
(in millions)20212020
Minimum lease payments$111 $122 
Unguaranteed residual values12 
Net investment in leases$115 $134 
(in millions)2019
Minimum lease payments$110 
Unguaranteed residual values11 
Net investment in leases$121 



Our net investment in sales-type leases is classified as follows in the accompanying consolidated balance sheets:
(in millions)December 31, 2021December 31, 2020
Accounts receivable, net$40 $39 
Other non-current assets75 95 
Total$115 $134 
(in millions)December 31, 2019
Accounts receivable, net$45 
Other non-current assets76 
Total$121 
Our net investment in sales-type leases was $115 million as of December 31, 2021, of which $13 million originated in 2017 and prior, $24 million in 2018, $24 million in 2019, $32 million in 2020 and $22 million in 2021.
Maturities of sales-type and operating leases as of December 31, 20192021 were:
(in millions)Sales-type LeasesOperating Leases
2020$45  $61  
202132  60  
202222  60  
202314  33  
2024 15  
Thereafter  
Total minimum lease payments121  $233  
Less: imputed interest(11) 
Present value of minimum lease payments$110  

(in millions)Sales-type LeasesOperating Leases
2022$43 $87 
202332 79 
202422 75 
202512 60 
202611 
Thereafter
Total minimum lease payments115 $314 
Less: imputed interest(4)
Present value of minimum lease payments$111 
NOTE 9
7
COMMITMENTS AND CONTINGENCIES
Refer to Note 42 for information regarding our unfunded contingent payments associated with collaborative and other arrangements.
Indemnifications
During the normal course of business, we make indemnities, commitments and guarantees pursuant to which we may be required to make payments related to specific transactions. Indemnifications include: (i) intellectual property indemnities to customers in connection with the use, sales or license of products and services; (ii) indemnities to customers in connection with losses incurred while performing services on their premises; (iii) indemnities to vendors and service providers pertaining to claims based on negligence or willful misconduct; (iv) indemnities involving the representations and warranties in certain contracts; (v) contractual indemnities related to the separation and distribution as set forth in certain of the agreements entered into in connection with such transactions (including the separation and distribution agreement and the tax matters agreement with Baxalta); and (vi)(v) contractual indemnities for our directors and certain of our executive officers for services provided to or at the request of us. In addition, under our Amended and Restated Certificate of Incorporation, and consistent with Delaware General Corporation Law, we have agreed
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to indemnify our directors and officers for certain losses and expenses upon the occurrence of certain prescribed events. The majority of these indemnities, commitments and guarantees do not provide for any limitation on the maximum potential for future payments that we could be obligated to make. To help address some of these risks, we maintain various insurance coverages. Based on historical experience and evaluation of the agreements, we do not believe that any payments related to our indemnities will have a material impact on our financial condition or results of operations.
Legal Contingencies
We are involved in product liability, patent, commercial, and other legal matters that arise in the normal course of our business. We record a liability when a loss is considered probable and the amount can be reasonably estimated. If the reasonable estimate of a probable loss is a range, and no amount within the range is a better estimate, the minimum amount in the range is accrued. If a loss is not probable or a probable loss cannot be reasonably estimated, no liability is recorded. As of December 31, 20192021 and 2018,2020, our total recorded reserves with respect to legal and environmental matters were $56$72 million and $46$40 million, respectively, and there were 0 related receivables. 



respectively. 
We have established reserves for certain of the matters discussed below. We are not able to estimate the amount or range of any loss for certain contingencies for which there is no reserve or additional loss for matters already reserved. While our liability in connection with these claims cannot be estimated and the resolution thereof in any reporting period could have a significant impact on our results of operations and cash flows for that period, the outcome of these legal proceedings is not expected to have a material adverse effect on our consolidated financial position. While we believe that we have valid defenses in the matters set forth below, litigation is inherently uncertain, excessive verdicts do occur, and we may incur material judgments or enter into material settlements of claims.  
In addition to the matters described below, we remain subject to the risk of future administrative and legal actions. With respect to governmental and regulatory matters, these actions may lead to product recalls, injunctions, and other restrictions on our operations and monetary sanctions, including significant civil or criminal penalties.penalties, all of which could materially affect future results of operations. With respect to intellectual property, we may be exposed to significant litigation concerning the scope of our and others’ rights. Such litigation could result in a loss of patent protection or the ability to market products, which could lead to a significant loss of sales, or otherwise materially affect future results of operations.
Environmental
We are involved as a potentially responsible party (PRP) for environmental clean-up costs at 6 Superfund sites. Under the U.S. Superfund statute and many state laws, generators of hazardous waste sent to a disposal or recycling site are liable for site cleanup if contaminants from that property later leak into the environment. The laws generally provide that a PRP may be held jointly and severally liable for the costs of investigating and remediating the site. Separate from the Superfund cases noted above, we are involved in an ongoing voluntary environmental remediationremediations associated with historic operations at certain of our Irvine, California, United States, facility. In 2017, we recorded a pre-tax charge of $15 million related to a former location and included that charge within loss from discontinued operations, net of tax, on the consolidated statement of income.facilities. As of December 31, 20192021 and 2018,2020, our environmental reserves, which are measured on an undiscounted basis, were $18 million and $19$20 million, respectively. After considering these reserves, management is of the opinion that the outcome of these matters willis not expected to have a material adverse effect on our financial position or results of operations.
General litigation
In November 2016, a purportedputative antitrust class action complaint seeking monetary and injunctive relief was filed in the United States District Court for the Northern District of Illinois. The complaint alleges a conspiracy among manufacturers of IV solutions to restrict output and affect pricing in connection with a shortage of such solutions. Similar parallel actions subsequently were filed. In January 2017, a single consolidated complaint covering these matters was filed in the Northern District of Illinois. We filed a motion to dismiss the consolidated complaint in February 2017. The court granted our motion to dismiss the consolidated complaint without prejudice in July 2018. The plaintiffs filed an amended complaint, which we moved to dismiss on September 6,November 9, 2018. We filed aThe court granted our motion to dismiss the amended complaint with prejudice on November 9, 2018.April 3, 2020. The plaintiffs did not file an appeal.
In April 2017, we became aware of a criminal investigation by the U.S. Department of Justice (DOJ), Antitrust Division and a federal grand jury in the United States District Court for the Eastern District of Pennsylvania. We and an employee received subpoenas seeking production of documents and testimony regarding the manufacturing, selling, pricing and shortages of IV solutions and containers (including saline solutions and certain other injectable
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medicines sold by us) and communications with competitors regarding the same. On November 30, 2018, the DOJ notified us that it had closed the investigation. The New York Attorney General has also requested that we provide information regarding business practices in the IV saline industry. We are cooperatingcooperated with that request and have been advised that the New York Attorney General.  matter has now been closed.
In August 2019, we were named in an amended complaint filed by Fayette County, Georgia in the MDL In re: National Prescription Opiate Litigation pending in the U.S. District Court, Northern District of Ohio. The complaint alleges that multiple manufacturers and distributors of opiate products improperly marketed and diverted these products, which caused harm to Fayette County. The complaint is limited in its allegations as to Baxter and does not distinguish between injectable opiate products and orally administered opiates. We manufactured generic injectable opiate products in our facility in Cherry Hill, NJ, which we divested in 2011.
In November 2019, we and certain of our officers were named in a class action complaint captioned Ethan E. Silverman et al. v. Baxter International Inc. et al. that was filed in the United States District Court for the Northern District of Illinois. The plaintiff, who allegedly purchased shares of our common stock during the specified class
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period, filed this putative class action on behalf of himself and shareholders who acquired Baxter common stock between February 21, 2019 and October 23, 2019. The plaintiff alleges that we and certain officers violated Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and Rule 10b-5 promulgated thereunder by making allegedly false and misleading statements and failing to disclose material facts relating to certain intra-company transactions undertaken for the purpose of generating foreign exchange gains or avoiding foreign exchange losses, as well as our internal controls over financial reporting. On January 29, 2020, the Court appointed Varma Mutual Pension Insurance Company and Louisiana Municipal Police Employees Retirement System as lead plaintiffs in the case. Plaintiffs filed an amended complaint on June 25, 2020 containing substantially the same allegations. On August 24, 2020, we filed a motion to dismiss the amended complaint. On January 12, 2021, the Court granted our motion to dismiss the amended complaint but gave plaintiffs an opportunity to file a further-amended complaint. The parties reached an agreement to settle the case for $16 million, subject to the completion of confirmatory discovery and final approval by the Court. The Court granted final approval of the settlement on August 11, 2021 and the settlement became effective on September 13, 2021.
In addition, we have received a stockholder request for inspection of our books and records in connection with the announcement made in our Form 8-K on October 24, 2019 that we had commenced an internal investigation into certain intra-company transactions that impacted our previously reported non-operating foreign exchange gains and losses. As initially disclosed on October 24, 2019, we also voluntarily advised the staff of the SEC of our previously disclosed internal investigation and we are continuing to cooperatehave been cooperating with the staff of the SEC. On February 18, 2022, we reached a settlement with the SEC, which resolved the SEC’s investigation into related matters. Without admitting or denying the findings in the administrative order issued by the SEC, we agreed to pay a civil penalty of $18 million and to cease and desist from violations of specified provisions of the federal securities laws and related rules. In the order, the SEC acknowledged the Company’s cooperation. We are fully accrued for the civil penalty as of December 31, 2021 and we expect to pay the penalty in the first quarter of 2022.
In March 2020, two2 lawsuits were filed against us in the Northern District of Illinois by plaintiffs alleging injuries as a result of exposure to ethylene oxide used in our manufacturing facility in Mountain Home, Arkansas to sterilize certain of our products. The plaintiffs seeksought damages, including compensatory and punitive damages in an unspecified amount, and unspecified injunctive and declaratory relief. The parties reached agreement to settle these lawsuits in the third quarter of 2021 for amounts that are not material to our financial results, which were paid in the fourth quarter of 2021. The settlement of these claims does not preclude potential future lawsuits.
In July 2021, Hill-Rom, Inc.received a subpoena (from the United States Office of Inspector General for the Department of Health and Human Services (the DHHS) requesting documents and information related to compliance with the False Claims Act and the Anti-Kickback Statute. Hillrom has been working with the DHHS and the DOJ to provide information responsive to the subpoena. Hillrom also voluntarily began a related internal review and Hillrom and now Baxter have been cooperating fully with the DHHS and the DOJ with respect to these matters.
The DHHS often issues this type of subpoena when investigating alleged violations of the False Claims Act.
On December 28, 2021, Linet Americas, Inc. (Linet) filed a complaint against Hill-Rom Holdings, Inc., Hill-Rom Company, Inc., and Hill-Rom Services, Inc. in the United States District Court for the Northern District of Illinois, captioned Linet Americas, Inc. v. Hill-Rom Holdings, Inc.; Hill-Rom Company, Inc.; Hill-Rom Services, Inc. Linet alleges that Hillrom violated Sections 1, 2 and 3 of The Sherman Antitrust Act of 1890 and the Illinois Antitrust Act by allegedly engaging in anti-competitive conduct in alleged markets for standard, ICU and birthing beds. Hillrom filed an answer to the complaint on January 28, 2022.
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Other
As previously disclosed, in 2008 we recalled our heparin sodium injection products in the United States. Following the recall, more than 1,000 lawsuits alleging that plaintiffs suffered various reactions to a heparin contaminant, in some cases resulting in fatalities, were filed. In January 2019, the last of these cases was settled. In 2019, following the resolution of an insurance dispute, we received cash proceeds of $39 million for our allocation of the insurance proceeds under a settlement and cost-sharing agreement related to the defense of the heparin product liability cases. We recognized a $37 million gain in connection with the resolution of the dispute with the insurer that is classified within other operating income, net on the consolidated statement of income for the year ended December 31, 2019.
In September 2017, Hurricane Maria caused damage to certain of our assets in Puerto Rico and disrupted operations. Insurance, less applicable deductibles and subject to any coverage exclusions, covered the repair or replacement of our assets that suffered loss or damage, and also provided coverage for interruption to our business, including lost profits, and reimbursement for other expenses and costs that have been incurred relating to the damages and losses suffered. In 2017, we recorded $32 million of pre-tax charges related to damages caused by the hurricane, including $11 million related to the impairment of damaged inventory and fixed assets as well as $21 million of idle facility and other costs. These amounts were recorded as a component of cost of sales in the consolidated statement of income for year ended December 31, 2017. In 2019, and 2018, we recognized $100 million and $42 million, respectively, of insurance recoveries related to the previously mentioned asset impairments and idle facility and other costs suffered as a result oflosses from the hurricane. These benefits were recorded as a reduction of cost of sales andhurricane, which are classified within other operating income, net on the consolidated statementsstatement of income for the years ended December 31, 2019 and 2018. No further insurance recoveries are expected.income.
NOTE 10
8
STOCKHOLDERS’ EQUITY
Stock-Based Compensation
Our stock-based compensation generally includes stock options, restricted stock units (RSUs), performance share units (PSUs) and purchases under our employee stock purchase plan. Shares issued relating to our stock-based plans are generally issued out of treasury stock.
As of December 31, 2019,2021, approximately 2451 million authorized shares are available for future awards under our stock-based compensation plans.
Stock Compensation Expense
Stock compensation expense was $146 million, $130 million and $122 million $115 millionin 2021, 2020 and $107 million in 2019, 2018 and 2017, respectively. The related tax benefit recognized was $36 million in 2021, $53 million in 2020 and $70 million in 2019, $61 million in 2018 and $87 million in 2017.2019. Included in the benefit in 2019, 20182021, 2020 and 20172019 were realized excess tax benefits for stock-based compensation of $13 million, $27 million and $54 million, $40 million and $56 million, respectively.
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Stock compensation expense is recorded at the corporate level and is not allocated to the segments. Approximately 80%75% of stock compensation expense is classified in SG&A expenses, with the remainder classified in cost of sales and R&D expenses. Costs capitalized in the consolidated balance sheets at December 31, 20192021 and 20182020 were not material.
Stock compensation expense is based on awards expected to vest, and therefore has been reduced by estimated forfeitures.
Stock Options
Stock options are granted to employees and non-employee directors with exercise prices equal to 100% of the market value on the date of grant. Stock options granted to employees generally vest in one-third increments over a three-yearthree-year period. Stock options granted to non-employee directors generally vest immediately on the grant date and are issued with a six-monthsix-month claw-back provision. Stock options typically have a contractual term of 10 years. The grant-date fair value, adjusted for estimated forfeitures, is recognized as expense on a straight-line basis over the substantive vesting period.
The fair value of stock options is determined using the Black-Scholes model. The weighted-average assumptions used in estimating the fair value of stock options granted during each year, along with the weighted-average grant-dategrant-
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date fair values, were as follows:
years ended December 31202120202019
Expected volatility24 %26 %19 %
Expected life (in years)5.55.55.5
Risk-free interest rate0.8 %0.6 %2.5 %
Dividend yield1.3 %1.2 %1.0 %
Fair value per stock option$16 $16 $15 
years ended December 31201920182017
Expected volatility19 %18 %19 %
Expected life (in years)5.55.55.5
Risk-free interest rate2.5 %2.6 %2.1 %
Dividend yield1.0 %1.0 %1.0 %
Fair value per stock option$15  $13  $10  
The following table summarizes stock option activity for the year ended December 31, 20192021 and the outstanding stock options as of December 31, 2019.
(options and aggregate intrinsic values in thousands)OptionsWeighted-
average
exercise
price
Weighted-
average
remaining
contractual
term
(in years)
Aggregate
intrinsic
value
Outstanding as of January 1, 201925,314  $43.76  
Granted3,801  $75.03  
Exercised(8,043) $38.52  
Forfeited(596) $66.91  
Expired(132) $46.44  
Outstanding as of December 31, 201920,344  $50.99  6.1$663,620  
Vested or expected to vest as of December 31, 201920,029  $50.66  6.0$660,342  
Exercisable as of December 31, 201912,945  $41.74  4.9$542,128  
2021.
(options and aggregate intrinsic values in thousands)OptionsWeighted-
average
exercise
price
Weighted-
average
remaining
contractual
term
(in years)
Aggregate
intrinsic
value
Outstanding as of January 1, 202120,196 $56.88 
Granted4,034 $77.32 
Exercised(2,759)$49.68 
Forfeited(729)$76.33 
Expired(46)$53.75 
Outstanding as of December 31, 202120,696 $61.14 5.9$511,187 
Vested or expected to vest as of December 31, 202120,391 $60.91 5.9$508,645 
Exercisable as of December 31, 202113,821 $53.46 4.6$447,799 
The aggregate intrinsic value in the table above represents the difference between the exercise price and our closing stock price on the last trading day of the year. The total intrinsic value of options exercised in 2021, 2020 and 2019 2018 and 2017 was $272$78 million, $222$131 million and $203$272 million, respectively.
As of December 31, 2019, $552021, $60 million of unrecognized compensation cost related to stock options is expected to be recognized as expense over a weighted-average period of approximately 1.7 years.
RSUs
RSUs are granted to employees and non-employee directors. RSUs granted to employees generally vest in one-third increments over a three-yearthree-year period. RSUs granted to non-employee directors generally vest immediately on the grant date and are issued with a six-monthsix-month claw-back provision. The grant-date fair value, adjusted for estimated forfeitures, is recognized as expense on a straight-line basis over the substantive vesting period. The fair
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value of RSUs is determined based on the number of shares granted and the closing price of our common stock on the date of grant.
The following table summarizes nonvested RSU activity for the year ended December 31, 2019.2021.
(share units in thousands)Share unitsWeighted-
average
grant-date
fair value
Nonvested RSUs as of January 1, 20211,138 $73.11 
Granted714 $77.84 
Replacement RSUs granted in acquisition668 $80.86 
Vested(591)$71.63 
Forfeited(131)$77.75 
Nonvested RSUs as of December 31, 20211,798 $78.01 
(share units in thousands)Share unitsWeighted-
average
grant-date
fair value
Nonvested RSUs as of January 1, 20191,611  $56.45  
Granted537  $75.60  
Vested(740) $51.82  
Forfeited(134) $63.90  
Nonvested RSUs as of December 31, 20191,274  $66.46  
In connection with the Hillrom acquisition, during the fourth quarter of 2021, we issued 668 thousand replacement RSUs to holders of Hillrom equity awards. Refer to Note 2 for additional information regarding the Hillrom acquisition.
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As of December 31, 2019, $462021, $82 million of unrecognized compensation cost related to RSUs is expected to be recognized as expense over a weighted-average period of approximately 1.72.1 years. The weighted-average grant-date fair value of RSUs granted in 2021, 2020 and 2019 2018was $79.30, $77.51 and 2017 was $75.60, $67.11 and $55.11, respectively. The fair value of RSUs vested in 2021, 2020 and 2019 2018 and 2017 was $57$47 million, $69$52 million and $88$57 million, respectively.
PSUs
Our annual equity awards stock compensation program for senior management includes the issuance of PSUs. In 2020 and 2021, the PSUs awarded were based on our compound annual sales growth rate (CAGR) performance, our adjusted return on invested capital (ROIC) performance and on our stock performance relative to our peer group. PSUs awarded between 2017 and 2019 were based on adjusted operating margin as well as stock performance relative to our peer group. Fifty percent of the PSUs granted in 2015 were based on return on invested capital (ROIC) instead of adjusted operating margin. The vesting condition for adjusted operating margin orCAGR and ROIC PSUs is set at the beginning of the 3-year service period while the vesting condition for adjusted operating margin is set at the beginning of each year for each tranche of the award during the 3-year service period. Compensation cost for the CAGR, adjusted ROIC and adjusted operating margin or ROIC PSUs is measured based on the fair value of the awards on the date that the specific vesting terms for each tranche of the award are established. Theestablished and the fair value of the awards is determined based on the quoted price of our stock on the grant date for each tranche of the award. The compensation cost for CAGR, adjusted ROIC and adjusted operating margin or ROIC PSUs is adjusted at each reporting date to reflect the estimated vesting outcome.
The fair value for PSUs based on our stock performance relative to our peer group is determined using a Monte Carlo model. The assumptions used in estimating the fair value of these PSUs granted during the period, along with the grant-date fair values, were as follows:
years ended December 31202120202019
Baxter volatility28 %26 %19 %
Peer group volatility26%-81%23%-95%18%-113%
Correlation of returns0.05-0.650.19-0.700.13-0.63
Risk-free interest rate0.3 %0.4 %2.5 %
Fair value per PSU$86 $108 $106 
years ended December 31201920182017
Baxter volatility19 %19 %19 %
Peer group volatility18%-113%16%-53%16%-54%
Correlation of returns0.13-0.630.16-0.610.19-0.58
Risk-free interest rate2.5 %2.3 %1.6 %
Fair value per PSU$106  $90  $69  
Unrecognized compensation cost related to all unvested PSUs of $18 million at December 31, 2019 is expected to be recognized as expense over a weighted-average period of 1.6 years.
The following table summarizes nonvested PSU activity for the year ended December 31, 2019.2021.
(share units in thousands)Share unitsWeighted-
average
grant-date
fair value
Nonvested PSUs as of January 1, 2021760 $86.69 
Granted241 $78.24 
Vested(178)$78.41 
Forfeited(91)$87.63 
Nonvested PSUs as of December 31, 2021732 $85.87 
(share units in thousands)Share unitsWeighted-
average
grant-date
fair value
Nonvested PSUs as of January 1, 2019913  $63.88  
Granted626  $69.36  
Vested(559) $46.47  
Forfeited(50) $77.70  
Nonvested PSUs as of December 31, 2019930  $75.50  
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Unrecognized compensation cost related to all unvested PSUs of $23 million at December 31, 2021 is expected to be recognized as expense over a weighted-average period of 1.5 years.
Employee Stock Purchase Plan
Nearly all employees are eligible to participate in our employee stock purchase plan. The employee purchase price is 85% of the closing market price on the purchase date.
The Baxter International Inc. Employee Stock Purchase Plan provides for 1020 million shares of common stock available for issuance to eligible participants, of which approximately 311 million shares were available for future purchases as of December 31, 2019.2021.
During 2019, 2018,2021, 2020, and 2017,2019, we issued approximately 0.7 million, 0.80.7 million and 0.80.7 million shares, respectively, under the employee stock purchase plan.
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Stock Options Award Modification
In the first quarter of 2020, we modified the terms of stock option awards granted to 123 employees. Specifically, we extended the term for certain stock options that were scheduled to expire in the first quarter of 2020 as applicable employees were not permitted to exercise these awards due to our announcement in February 2020 that our previously issued financial statements should no longer be relied upon. The stock options were extended in order to allow impacted employees to exercise their stock option awards for a brief period once we became current with our SEC reporting obligations, which occurred in March 2020. As a result of the modifications, we recognized an additional $8 million of stock compensation expense during the first quarter of 2020.
Cash Dividends
Total cash dividends declared per share for 2021, 2020, and 2019 2018,were $1.085, $0.955 and 2017 were $0.85, $0.73 and $0.61,$0.850, respectively.
A quarterly dividend of $0.19$0.245 per share ($0.760.98 on an annualized basis) was declared in February 20192021 and was paid in April 2019.2021. Quarterly dividends of $0.22$0.28 per share ($0.881.12 on an annualized basis) were declared in May and July of 20192021 and were paid in July and October of 2019,2021, respectively. Our Board of Directors declared a quarterly dividend of $0.22$0.28 per share in November of 2019,2021, which was paid in January of 2020.2022.
Stock Repurchase Programs
As authorized by the Board of Directors, we repurchase our stock depending on our cash flows, net debt level and market conditions. In July 2012, the Board of Directors authorized the repurchase of up to $2.0 billion of our common stock. The Board of Directors increased this authority by an additional $1.5 billion in each of November 2016 and February 2018, and by an additional $2.0 billion in November 2018.2018 and by an additional $1.5 billion in October 2020. We repurchased 7.3 million shares under this authority pursuant to Rule 10b5-1 plans for $600 million in cash in 2021, 6.3 million shares under this authority pursuant to a Rule 10b5-1 plan for $500 million in cash in 2020 and 16.5 million shares under this authority pursuant to Rule 10b5-1 plans and otherwise for $1.3 billion in cash in 2019, 35.8 million shares under this authority pursuant to Rule 10b5-1 plans and otherwise for $2.5 billion in cash in 2018 and 9.2 million shares under this authority pursuant to Rule 10b5-1 plans for $564 million in cash in 2017. As of December 31, 2018, we recognized a liability within accounts payable and accrued liabilities of $23 million for share repurchases that settled in early January 2019. We had $897 million$1.3 billion of purchase authority available as of December 31, 2019.2021.  
Accelerated Share Repurchase Agreement 
In December 2018, we entered into a $300 million accelerated share repurchase agreement (ASR Agreement) with an investment bank. We funded the ASR Agreement with available cash. The ASR Agreement was executed pursuant to the 2012 Repurchase Authorization described above. Under the ASR Agreement, we received 3.6 million shares upon execution. Based on the volume-weighted average price of our common stock during the term of the ASR Agreement, we received an additional 0.6 million shares from the investment bank at settlement onin May 7, 2019.
Other
In addition to common stock, our authorized capital structure includes 100 million shares of preferred stock, no par value. As of December 31, 2021 and 2020, 0 shares of preferred stock were outstanding.
NOTE 11
9
ACCUMULATED OTHER COMPREHENSIVE INCOME
Comprehensive income includes all changes in stockholders’ equity that do not arise from transactions with stockholders, and consists of net income, CTA, certain gains and losses from other postretirement employee benefit (OPEB) plans and gains and losses on cash flow hedges and, prior to 2018, unrealized gains and losses on available-for-sale equity securities. As a result of changes in accounting guidance related to available-for-sale equity securities, the unrealized gains and losses associated with these assets are no longer recognized in AOCI beginning January 1, 2018. hedges.
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The following table is a net-of-tax summary of the changes in AOCI by component for the years ended December 31, 20192021 and 2018.2020.
(in millions)CTAPension and OPEB plansHedging
activities
Total
Gains (losses)
Balance as of December 31, 2020$(2,587)$(574)$(153)$(3,314)
Other comprehensive (loss) income before reclassifications(320)160 (156)
Amounts reclassified from AOCI (a)— 67 23 90 
Net other comprehensive (loss) income(320)227 27 (66)
Balance as of December 31, 2021$(2,907)$(347)$(126)$(3,380)
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(in millions)CTAPension and OPEB plansHedging
activities
Total
Gains (losses)
Balance as of December 31, 2018 (as restated)$(2,868) $(954) $(1) $(3,823) 
Adoption of new accounting standard (169) (1) (161) 
Other comprehensive (loss) income before reclassifications(95) (184) (36) (315) 
Amounts reclassified from AOCI (a)—  592  (3) 589  
Net other comprehensive (loss) income(95) 408  (39) 274  
Balance as of December 31, 2019$(2,954) $(715) $(41) $(3,710) 

As Restated
(in millions)(in millions)CTAPension and OPEB plansHedging
activities
Available-for-
sale-equity
securities
Total(in millions)CTAPension and OPEB plansHedging
activities
Total
Gains (losses)Gains (losses)Gains (losses)
Balance as of December 31, 2017$(2,545) $(987) $(10) $ $(3,539) 
Adoption of new accounting standard—  —  —  (3) (3) 
Balance as of December 31, 2019Balance as of December 31, 2019$(2,954)$(715)$(41)$(3,710)
Other comprehensive income (loss) before reclassificationsOther comprehensive income (loss) before reclassifications(323) (23) (1) —  (347) Other comprehensive income (loss) before reclassifications367 59 (117)309 
Amounts reclassified from AOCI (a)Amounts reclassified from AOCI (a)—  56  10  —  66  Amounts reclassified from AOCI (a)— 82 87 
Net other comprehensive (loss) incomeNet other comprehensive (loss) income(323) 33   —  (281) Net other comprehensive (loss) income367 141 (112)396 
Balance as of December 31, 2018$(2,868) $(954) $(1) $—  $(3,823) 
Balance as of December 31, 2020Balance as of December 31, 2020$(2,587)$(574)$(153)$(3,314)
(a)    See table below for details about these reclassifications.
The following table is a summary of the amounts reclassified from AOCI to net income during the years ended December 31, 20192021 and 2018.
Amounts reclassified from
AOCI (a)
As Restated
(in millions)20192018Location of impact
in income statement
Pension and OPEB items
Amortization of net losses and prior service costs or credits$(31) $(69) Other (income) expense, net
Settlement charge(755) (1) Other (income) expense, net
(786) (70) Total before tax
Less: Tax effect194  14  Income tax expense
$(592) $(56) Net of tax
Gains (losses) on hedging activities 
Foreign exchange contracts$ $(12) Cost of sales
Less: Tax effect(1)  Income tax expense
$ $(10) Net of tax
Total reclassification for the period$(589) $(66) Total net of tax
2020.
Amounts reclassified from
AOCI (a)
(in millions)20212020Location of impact
in income statement
Pension and OPEB items
Amortization of net losses and prior service costs or credits$(82)$(59)Other expense, net
Settlement charges(2)(46)Other expense, net
(84)(105)Total before tax
Less: Tax effect17 23 Income tax expense
$(67)$(82)Net of tax
Gains (losses) on hedging activities 
Foreign exchange contracts$(23)$(5)Cost of sales
Interest rate contracts(6)(1)Interest expense, net
(29)(6)Total before tax
Less: Tax effectIncome tax expense
$(23)$(5)Net of tax
Total reclassification for the period$(90)$(87)Total net of tax
(a)Amounts in parentheses indicate reductions to net income.
Refer to Note 1312 for additional information regarding the amortization of pension and OPEB items and Note 1615 for additional information regarding hedging activity.
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NOTE 10
REVENUES
Contract Balances
The timing of revenue recognition, billings and cash collections results in the recognition of trade accounts receivable, unbilled receivables, contract assets, and customer advances and deposits (contract liabilities) on our consolidated balance sheets. Net trade accounts receivable was $2.4 billion and $1.7 billion as of December 31, 2021 and 2020, respectively.
For contract manufacturing arrangements, revenue is primarily recognized throughout the production cycle, which typically lasts up to 90 days, resulting in the recognition of contract assets until the related services are completed and the customers are billed. Additionally, for arrangements containing a performance obligation to deliver software that can be used with medical devices, we recognize revenue upon delivery of the software, which results in the recognition of contract assets when customers are billed over time, generally over one to five years. For bundled contracts involving equipment delivered up-front and consumable medical products to be delivered over time, total contract revenue is allocated between the equipment and consumable medical products. In certain of those arrangements, a contract asset is created for the difference between the amount of equipment revenue recognized upon delivery and the amount of consideration initially receivable from the customer. In those arrangements, the contract asset becomes a trade account receivable as consumable medical products are provided and billed, generally over one to seven years.
The following table summarizes our contract assets:
as of December 31 (in millions)20212020
Contract manufacturing services$50 $47 
Software sales45 40 
Bundled equipment and consumable medical products contracts100 47 
Contract assets$195 $134 
The following table summarizes the classification of contract assets and contract liabilities as reported in the consolidated balance sheet:
as of December 31 (in millions)20212020
Prepaid expenses and other current assets$84 $70 
Other non-current assets111 64 
Contract assets$195 $134 
Accrued expenses and other current liabilities$162 $32 
Other non-current liabilities84 34 
Contract liabilities$246 $66 
In 2021, $20 million of revenue was recognized that was included in contract liabilities as of December 31, 2020.In 2020 and 2019, the amount of revenue recognized that was included in contract liabilities as of December 31, 2019 and 2018 was not significant.
Disaggregation of Net Sales
Beginning in the first quarter of 2021, our product category net sales disclosures (previously referred to as global business units (GBUs)) separately present net sales from our BioPharma Solutions business, which was previously included within Other. Concurrent with that disaggregation of net sales from our BioPharma Solutions business, we have also allocated certain previously unallocated sales deductions from Other to various categories, primarily based on their respective net sales. Net sales for 2020 and 2019 have been recast to conform to this presentation.
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Additionally, with the acquisition of Hillrom in December 2021, we have added three new product categories: Patient Support Systems, Front Line Care and Surgical Solutions.
The following tables disaggregate our net sales from contracts with customers by product category between the U.S. and international:
202120202019
years ended December 31 (in millions)U.S.InternationalTotalU.S.InternationalTotalU.S.InternationalTotal
Renal Care1
$890 $3,010 $3,900 $848 $2,909 $3,757 $791 $2,848 $3,639 
Medication Delivery2
1,859 1,021 2,880 1,738 953 2,691 1,762 977 2,739 
Pharmaceuticals3
753 1,538 2,291 849 1,249 2,098 904 1,215 2,119 
Clinical Nutrition4
343 621 964 330 580 910 308 552 860 
Advanced Surgery5
545 432 977 516 370 886 533 342 875 
Acute Therapies6
287 495 782 286 454 740 184 351 535 
BioPharma Solutions7
273 396 669 234 252 486 257 212 469 
Patient Support Systems8
86 29 115 — — — — — — 
Front Line Care9
51 19 70 — — — — — — 
Surgical Solutions10
12 15 27 — — — — — — 
Other11
81 28 109 77 28 105 87 39 126 
Total Baxter$5,180 $7,604 $12,784 $4,878 $6,795 $11,673 $4,826 $6,536 $11,362 
1    Renal Care includes sales of our peritoneal dialysis (PD), hemodialysis (HD) and additional dialysis therapies and services.
2    Medication Delivery includes sales of our IV therapies, infusion pumps, administration sets and drug reconstitution devices.
3    Pharmaceuticals includes sales of our premixed and oncology drug platforms, inhaled anesthesia and critical care products and pharmacy compounding services.
4    Clinical Nutrition includes sales of our parenteral nutrition (PN) therapies and related products.
5    Advanced Surgery includes sales of our biological products and medical devices used in surgical procedures for hemostasis, tissue sealing and adhesion prevention.
6    Acute Therapies includes sales of our continuous renal replacement therapies (CRRT) and other organ support therapies focused in the intensive care unit (ICU).
7    BioPharma Solutions includes sales of contracted services we provide to various pharmaceutical and biopharmaceutical companies.
8    Patient Support Systems includes sales of our connected care solutions: devices, software, communications and integration technologies.
9    Front Line Care includes sales of our integrated patient monitoring and diagnostic technologies to help diagnose, treat and manage a wide variety of illness and diseases, including respiratory therapy, cardiology, vision screening and physical assessment.
10    Surgical Solutions includes sales of our surgical video technologies, tables, lights, pendants, precision positioning devices and other accessories.
11    Other includes sales of miscellaneous product and service offerings.
NOTE 12
11
BUSINESS OPTIMIZATION CHARGES
In recent years, we have undertaken actions to transform our cost structure and enhance operational efficiency. These efforts include restructuring the organization, optimizing the manufacturing footprint, R&D operations and supply chain network, employing disciplined cost management, and centralizing and streamlining certain support functions. From the commencement of our business optimization activities in the second half of 2015 through December 31, 2019,2021, we have incurred cumulative pre-tax costs of approximately $980 million$1.2 billion related to these actions. TheThese costs consisted primarily of employee termination costs, implementation costs, contract termination costs, asset impairments and accelerated depreciation. We currently expect to incur additional pre-tax cash costs of
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approximately $50$30 million through the completion of thesethe initiatives under our current program. These costs willthat are currently underway, primarily include employee termination costs,related to implementation costs,costs. We continue to pursue cost savings initiatives and, accelerated depreciation. Toto the extent further cost savings opportunities are identified, we may incur additional restructuring charges and costs to implement business optimization expenses.programs in future periods.
We recorded the following charges related to business optimization programs in 2019, 2018,2021, 2020, and 2017:
years ended December 31 (in millions)201920182017
Restructuring charges$134  $117  $70  
Costs to implement business optimization programs45  94  89  
Accelerated depreciation  10  
Total business optimization charges$184  $220  $169  
2019:
years ended December 31 (in millions)202120202019
Restructuring charges$91 $111 $134 
Costs to implement business optimization programs23 23 45 
Accelerated depreciation— — 
Total business optimization charges$114 $134 $184 
For segment reporting, business optimization charges are unallocated expenses.
Costs to implement business optimization programs for the years ended December 31, 2021, 2020 and 2019, 2018 and 2017,respectively, consisted primarily of external consulting and transition costs, including employee compensation and related costs. The costs were generally included within cost of sales, SG&A expense and R&D expense.
For the yearsyear ended December 31, 2019, 2018 and 2017, we recognized accelerated depreciation, primarily associated with facilities to be closed. The costs were recorded within cost of sales and SG&A expense.
During the years ended December 31, 2019, 20182021, 2020 and 2017,2019, we recorded the following restructuring charges:
2021
(in millions)COGSSG&AR&DTotal
Employee termination costs$37 $35 $$73 
Contract termination and other costs— — 
Asset impairments16 — — 16 
Total restructuring charges$53 $37 $$91 
2020
(in millions)COGSSG&AR&DTotal
Employee termination costs$36 $54 $$92 
Contract termination and other costs— 
Asset impairments— 11 
Total restructuring charges$48 $61 $$111 
2019
(in millions)COGSSG&AR&DTotal
Employee termination costs$13 $37 $25 $75 
Contract termination and other costs10 — 11 
Asset impairments37 48 
Total restructuring charges$60 $40 $34 $134 
2019
(in millions)COGSSG&AR&DTotal
Employee termination costs$13  $37  $25  $75  
Contract termination and other costs10   —  11  
Asset impairments37    48  
Total restructuring charges$60  $40  $34  $134  
2018
(in millions)COGSSG&AR&DTotal
Employee termination costs$30  $51  $19  $100  
Contract termination and other costs  —  10  
Asset impairments  —   
Total restructuring charges$35  $63  $19  $117  
2017
(in millions)COGSSG&AR&DTotal
Employee termination costs$22  $39  $(2) $59  
Contract termination and other costs—   —   
Asset impairments  —   
Total restructuring charges$27  $45  $(2) $70  
In conjunction with our business optimization initiatives, we sold property that resulted in a gain of $17 million in 2020. This benefit is reflected within other operating income, net in our consolidated statement of income for the year ended December 31, 2020.
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The following table summarizes activity in the liability related to our restructuring initiatives.
(in millions)
Liability balance as of December 31, 2016 (As Restated)2018$164 
Charges83 
Payments(140)
Reserve adjustments(19)
Currency translation24 
Liability balance as of December 31, 2017 (As Restated)112 
Charges126 
Payments(96)
Reserve adjustments(16)
Currency translation(25)
Liability balance as of December 31, 2018 (As Restated)101 
Charges113 
Payments(93)
Reserve adjustments(27)
Currency translation(2)
Liability balance as of December 31, 201992 
Charges116 
Payments(86)
Reserve adjustments(16)
Currency translation
Liability balance as of December 31, 2020113 
Assumed in acquisition
Charges94 
Payments(78)
Reserve adjustments(19)
Currency translation(7)
Liability balance as of December 31, 2021$92109 
Reserve adjustments primarily relate to employee termination cost reserves established in prior periods.
Substantially all of our restructuring liabilities as of December 31, 20192021 relate to employee termination costs, with the remaining liabilities attributable to contract termination costs. Substantially all of the cash payments for those liabilities are expected to be disbursed by the end of 2020.2023.
NOTE 13
12
PENSION AND OTHER POSTRETIREMENT BENEFIT PROGRAMS
We sponsor a number of qualified and nonqualified pension plans for eligible employees. We also sponsor certain unfunded contributory healthcare and life insurance benefits for substantially all domestic retired employees. Newly hired employees in the United States and Puerto Rico are not eligible to participate in the pension plans but receive a higher level of company contributions in the defined contribution plans.
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Reconciliation of Pension and Other Postretirement Benefit Plan Obligations, Assets and Funded Status
The benefit plan information in the table below pertains to all of our pension and OPEB plans, both in the United States and in other countries.    
Pension benefitsOPEB
as of and for the years ended December 31 (in millions)2021202020212020
Benefit obligations
Beginning of period$4,313 $3,973 $228 $228 
Service cost87 83 
Interest cost72 95 
Participant contributions— — 
Actuarial (gain) loss(186)401 (14)13 
Benefit payments(103)(109)(19)(20)
Settlements(13)(271)— — 
Curtailment(5)(4)— — 
Acquisitions364 — 11 — 
Plan Amendments15 — — — 
Foreign exchange and other(105)141 — — 
End of period4,443 4,313 211 228 
Fair value of plan assets
Beginning of period3,434 2,973 — — 
Actual return on plan assets141 688 — — 
Employer contributions73 74 19 20 
Participant contributions— — 
Benefit payments(103)(109)(19)(20)
Settlements(13)(271)— — 
Acquisitions305 — — — 
Foreign exchange and other(57)75 — — 
End of period3,784 3,434 — — 
Funded status at December 31$(659)$(879)$(211)$(228)
Amounts recognized in the consolidated balance sheets
Noncurrent asset$228 $155 $— $— 
Current liability(29)(30)(17)(18)
Noncurrent liability(858)(1,004)(194)(210)
Net liability recognized at December 31$(659)$(879)$(211)$(228)
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Pension benefitsOPEB
As Restated
as of and for the years ended December 31 (in millions)2019201820192018
Benefit obligations
Beginning of period$5,635  $6,182  $211  $235  
Service cost74  87    
Interest cost172  178    
Participant contributions  —  —  
Actuarial (gain) loss924  (431) 26  (14) 
Benefit payments(267) (259) (18) (18) 
Settlements(2,550) (6) —  —  
Curtailment(13) (56) —  —  
Foreign exchange and other(6) (65) —  —  
End of period3,973  5,635  228  211  
Fair value of plan assets
Beginning of period4,774  5,261  —  —  
Actual return on plan assets939  (237) —  —  
Employer contributions69  51  18  18  
Participant contributions  —  —  
Benefit payments(267) (259) (18) (18) 
Settlements(2,550) (6) —  —  
Foreign exchange and other (41) —  —  
End of period2,973  4,774  —  —  
Funded status at December 31$(1,000) $(861) $(228) $(211) 
Amounts recognized in the consolidated balance sheets
Noncurrent asset$77  $60  $—  $—  
Current liability(25) (25) (20) (20) 
Noncurrent liability(1,052) (896) (208) (191) 
Net liability recognized at December 31$(1,000) $(861) $(228) $(211) 
Actuarial gains and losses result from changes in actuarial assumptions (such as changes in the discount rate and revised mortality rates). Actuarial gains in 2021 and losses in 2020 related to plan benefit obligations were primarily the result of changes in discount rates.
The pension obligation information in the table above represents the projected benefit obligation (PBO). The PBO incorporates assumptions relating to future compensation levels. The accumulated benefit obligation (ABO) is the same as the PBO except that it includes no assumptions relating to future compensation levels. The ABO for all of our pension plans was $3.7$4.3 billion and $5.4$4.1 billion at the 20192021 and 20182020 measurement dates, respectively.
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The information in the funded status table above represents the totals for all of our pension plans. The following table is information relating to the individual plans in the funded status table above that have an ABO in excess of plan assets.

As Restated
as of December 31 (in millions)as of December 31 (in millions)20192018as of December 31 (in millions)20212020
ABOABO$3,240  $4,981  ABO$2,991 $2,920 
Fair value of plan assetsFair value of plan assets$2,339  $4,246  Fair value of plan assets$2,209 $2,047 
The following table presents information relating to the individual plans in the funded status table above that have a PBO in excess of plan assets (many of which also have an ABO in excess of assets and are therefore also included in the table directly above).

as of December 31 (in millions)20212020
PBO$3,254 $3,421 
Fair value of plan assets$2,366 $2,387 
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As Restated
as of December 31 (in millions)20192018
PBO$3,688  $5,386  
Fair value of plan assets$2,611  $4,465  
Expected Net Pension and OPEB Plan Payments for the Next 10 Years
(in millions)Pension benefitsOPEB
2020$86  $20  
2021104  18  
2022118  17  
2023132  17  
2024149  16  
2024 through 2028917  71  
Total expected net benefit payments for next 10 years$1,506  $159  
(in millions)Pension benefitsOPEB
2022$126 $19 
2023146 17 
2024161 17 
2025166 16 
2026179 15 
2027 through 20311,018 64 
Total expected net benefit payments for next 10 years$1,796 $148 
The expected net benefit payments above reflect the total net benefits expected to be paid from the plans’ assets (for funded plans) or from our assets (for unfunded plans). The federal subsidies relating to the Medicare Prescription Drug, Improvement and Modernization Act are not expected to be significant.
Amounts Recognized in AOCI
The pension and OPEB plans’ gains or losses, prior service costs or credits, and transition assets or obligations not yet recognized in net periodic benefit cost are recognized on a net-of-tax basis in AOCI and will be amortized from AOCI to net periodic benefit cost in the future. For active employees, we utilize the average future working lifetime as the amortization period for prior service. For inactive employees, we utilize the average remaining life expectancy as the amortization period for prior service.
The following table is a summary of the pre-tax losses included in AOCI at December 31, 20192021 and December 31, 2018.2020.
(in millions)Pension benefitsOPEB
Actuarial loss (gain)$509 $(37)
Prior service credit and transition obligation(36)
Total pre-tax loss (gain) recognized in AOCI at December 31, 2021$517 $(73)
Actuarial loss (gain)$811 $(23)
Prior service credit and transition obligation(9)(45)
Total pre-tax loss (gain) recognized in AOCI at December 31, 2020$802 $(68)
(in millions)Pension benefitsOPEB
Actuarial loss (gain)$1,025  $(41) 
Prior service credit and transition obligation(9) (59) 
Total pre-tax loss recognized in AOCI at December 31, 2019$1,016  $(100) 
Actuarial loss (gain)$1,607  $(79) 
Prior service credit and transition obligation(10) (74) 
Total pre-tax loss (gain) recognized in AOCI at December 31, 2018 (As Restated)$1,597  $(153) 
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Refer to Note 119 for the net-of-tax balances included in AOCI as of each of the year-end dates. The following table is a summary of the net-of-tax amounts recorded in OCI relating to pension and OPEB plans.
Year ended December 31 (in millions)202120202019
Gain (loss) arising during the year, net of tax of $43 in 2021, $17 in 2020 and $(64) in 2019$160 $59 $(184)
Amortization of loss to earnings, net of tax of $17 in 2021, $12 in 2020 and $6 in 201965 47 25 
Settlement charges, net of tax of $0 in 2021, $11 in 2020 and $188 in 201935 567 
Pension and other employee benefits$227 $141 $408 
As Restated
Year ended December 31 (in millions)201920182017
Gain (loss) arising during the year, net of tax expense (benefit) of $(64) in 2019, $(4) in 2018 and $25 in 2017$(184) $(22) $32  
Amortization of loss to earnings, net of tax benefit of $6 in 2019, $14 in 2018 and $35 in 201725  55  102  
Settlement charge, net of tax benefit of $188 in 2019$567  $—  $—  
Pension and other employee benefits gain$408  $33  $134  
In 2021 and 2020, OCI activity for pension and OPEB plans was primarily related to actuarial gains and losses. In 2019, OCI activity for pension and OPEB plans was primarily related to the U.S. pension settlement charge further discussed below, and actuarial gains and losses. In 2018 and 2017, OCI activity for pension and OPEB plans was primarily related to actuarial gains and losses.
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Amounts Expected to be Amortized from AOCI to Net Periodic Benefit Cost in 2020
Year ended December 31 (in millions)202120202019
Pension benefits
Service cost$87 $83 $74 
Interest cost72 95 172 
Expected return on plan assets(143)(163)(264)
Amortization of net losses and other deferred amounts91 77 58 
Settlement charges46 755 
Other(4)— — 
Net periodic pension benefit cost$105 $138 $795 
OPEB
Service cost$$$
Interest cost
Amortization of net losses and prior service credit(9)(18)(27)
Net periodic OPEB cost$(4)$(11)$(18)
With respect to the AOCI balance at December 31, 2019, the following table is a summary of the pre-tax amounts expected to be amortized to net periodic benefit cost in 2020.
(in millions)Pension benefitsOPEB
Actuarial loss/(gain)$78  $(4) 
Prior service credit and transition obligation(1) (14) 
Total pre-tax amount expected to be amortized from AOCI to net pension and OPEB cost in 2020$77  $(18) 
Net Periodic Benefit Cost – Continuing Operations
As Restated
Year ended December 31 (in millions)201920182017
Pension benefits
Service cost$74  $87  $91  
Interest cost172  178  180  
Expected return on plan assets(264) (303) (291) 
Amortization of net losses and other deferred amounts58  94  163  
Settlement charges755    
Other—  —  (2) 
Net periodic pension benefit cost$795  $57  $143  
OPEB
Service cost$ $ $ 
Interest cost   
Amortization of net losses and prior service credit(27) (25) (26) 
Net periodic OPEB cost$(18) $(17) $(18) 
Weighted-Average Assumptions Used in Determining Benefit Obligations at the Measurement Date
Pension benefitsOPEB
2019201820192018
Discount rate
U.S. and Puerto Rico plans3.44 %4.31 %3.16 %4.20 %
International plans1.34 %2.02 %n/a  n/a  
Rate of compensation increase
U.S. and Puerto Rico plans3.68 %3.66 %n/a  n/a  
International plans3.03 %3.08 %n/a  n/a  
Annual rate of increase in the per-capita costn/a  n/a  6.75 %7.00 %
Rate decreased ton/a  n/a  5.00 %5.00 %
by the year endedn/a  n/a  20272027
Pension benefitsOPEB
2021202020212020
Discount rate
U.S. and Puerto Rico plans3.01 %2.73 %2.76 %2.33 %
International plans1.47 %1.00 %n/an/a
Rate of compensation increase
U.S. and Puerto Rico plans3.68 %3.68 %n/an/a
International plans3.11 %3.03 %n/an/a
Annual rate of increase in the per-capita costn/an/a6.25 %6.50 %
Rate decreased ton/an/a5.00 %5.00 %
by the year endedn/an/a20272027
The assumptions above, which were used in calculating the December 31, 20192021 measurement date benefit obligations, will be used in the calculation of net periodic benefit cost in 2020.2022.
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Weighted-Average Assumptions Used in Determining Net Periodic Benefit Cost
Pension benefitsOPEB
201920182017201920182017
Discount rate
U.S. and Puerto Rico plans4.18 %3.60 %4.09 %4.20 %3.51 %3.89 %
International plans2.02 %2.02 %2.03 %n/a  n/a  n/a  
Expected return on plan assets
U.S. and Puerto Rico plans6.29 %6.25 %6.50 %n/a  n/a  n/a  
International plans5.45 %5.58 %5.77 %n/a  n/a  n/a  
Rate of compensation increase
U.S. and Puerto Rico plans3.66 %3.42 %3.75 %n/a  n/a  n/a  
International plans3.08 %3.05 %3.11 %n/a  n/a  n/a  
Annual rate of increase in the per-capita costn/a  n/a  n/a  6.75 %7.00 %6.25 %
Rate decreased ton/a  n/a  n/a  5.00 %5.00 %5.00 %
by the year endedn/a  n/a  n/a  202720272023
Pension benefitsOPEB
202120202019202120202019
Discount rate
U.S. and Puerto Rico plans2.73 %3.44 %4.18 %2.33 %3.16 %4.20 %
International plans1.00 %1.34 %2.02 %n/an/an/a
Expected return on plan assets
U.S. and Puerto Rico plans5.50 %6.50 %6.29 %n/an/an/a
International plans3.58 %4.23 %5.45 %n/an/an/a
Rate of compensation increase
U.S. and Puerto Rico plans3.68 %3.68 %3.66 %n/an/an/a
International plans3.03 %3.03 %3.08 %n/an/an/a
Annual rate of increase in the per-capita costn/an/an/a6.25 %6.50 %6.75 %
Rate decreased ton/an/an/a5.00 %5.00 %5.00 %
by the year endedn/an/an/a202720272027
We established the expected return on plan assets assumption primarily based on a review of historical compound average asset returns, both company-specific and relating to the broad market (based on our asset allocation), as well as an analysis of current market and economic information and future expectations. We plan to use a 6.50%5.00% assumption for our U.S. and Puerto Rico plans for 2020.
Actuarial gains and losses result from changes in actuarial assumptions (such as changes in the discount rate and revised mortality rates). Actuarial losses in 2019 and gains in 2018 related to plan benefit obligations were primarily the result of changes in discount rates.
Effect of a One-Percent Change in Assumed Healthcare Cost Trend Rate on the OPEB Plan
The effect of a one-percent change in the assumed healthcare cost trend rate on the service and interest cost components of OPEB cost as well as the OPEB obligation were not significant for 2019 or 2018, respectively.2022.
Pension Plan Assets
An investment committee of members of senior management is responsible for supervising, monitoring and evaluating the invested assets of our funded pension plans. The investment committee, which meets at least quarterly, abides by documented policies and procedures relating to investment goals, targeted asset allocations, risk management practices, allowable and prohibited investment holdings, diversification, use of derivatives, the relationship between plan assets and benefit obligations, and other relevant factors and considerations.
The investment committee’s policies and procedures include the following:
Ability to pay all benefits when due;
Targeted long-term performance expectations relative to applicable market indices, such as Russell, MSCI EAFE, and other indices;
Targeted asset allocation percentage ranges (summarized below), and periodic reviews of these allocations;
Diversification of assets among third-party investment managers, and by geography, industry, stage of business cycle and other measures;
Specified investment holding and transaction prohibitions (for example, private placements or other restricted securities, securities that are not traded in a sufficiently active market, short sales, certain derivatives, commodities and margin transactions);
Specified portfolio percentage limits on holdings in a single corporate or other entity (generally 5% at time of purchase, except for holdings in U.S. government or agency securities);
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Specified average credit quality for the fixed-income securities portfolio (at least A- by Standard & Poor’s or A3 by Moody’s);
Specified portfolio percentage limits on foreign holdings; and
Periodic monitoring of investment manager performance and adherence to the investment committee’s policies.
Plan assets are invested using a total return investment approach whereby a mix of equity securities, debt securities and other investments are used to preserve asset values, diversify risk and exceed the planned benchmark
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investment return. Investment strategies and asset allocations are based on consideration of plan liabilities, the plans’ funded status and other factors, such as the plans’ demographics and liability durations. Investment performance is reviewed by the investment committee on a quarterly basis and asset allocations are reviewed at least annually.
Plan assets are managed in a balanced portfolio comprised of two major components: return-seeking investments and liability hedging investments. The target allocations for plan assets are 53%50% in return-seeking investments and 47%50% in liability hedging investments and other holdings. The documented policy includes an allocation range based on each individual investment type within the major components that allows for a variance from the target allocations depending on the investment type. Return-seeking investments primarily include common stock of U.S. and international companies, common/collective trust funds, mutual funds, hedge funds, and partnership investments. Liability hedging investments and other holdings primarily include cash, money market funds with an original maturity of three months or less, U.S. and foreign government and governmental agency issues, corporate bonds, municipal securities, derivative contracts and asset-backed securities.
While the investment committee provides oversight over plan assets for U.S. and international plans, the summary above is specific to the plans in the United States. The plan assets for international plans are managed and allocated by the entities in each country, with input and oversight provided by the investment committee. The plan assets for the U.S. and international plans are included in the table below.
The following tables summarize our pension plan financial instruments that are measured at fair value on a recurring basis.
Basis of fair value measurement
(in millions)Balance at December 31, 2021Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Measured at NAV (a)
Assets
Fixed income securities
Cash and cash equivalents$368 $50 $318 $— $— 
U.S. government and government agency issues271 — 271 — — 
Corporate bonds573 — 573 — — 
Equity securities
Common stock452 452 — — — 
Mutual funds521 235 286 — 
Common/collective trust funds1,118 — 358 — 760 
Partnership investments329 — — — 329 
Other holdings152 21 122 — 
Fair value of pension plan assets$3,784 $758 $1,928 $$1,089 
(a) Certain assets that are measured at fair value using the NAV per share (or its equivalent) practical expedient have not been classified in the fair value hierarchy.
10490


Basis of fair value measurementBasis of fair value measurement
(in millions)(in millions)Balance at December 31, 2019Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Measured at NAV(in millions)Balance at December 31, 2020Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Measured at NAV (a)
AssetsAssetsAssets
Fixed income securitiesFixed income securitiesFixed income securities
Cash and cash equivalentsCash and cash equivalents$224  $72  $152  $—  $—  Cash and cash equivalents$265 $91 $174 $— $— 
U.S. government and government agency issuesU.S. government and government agency issues452  —  452  —  —  U.S. government and government agency issues280 — 280 — — 
Corporate bondsCorporate bonds352  —  352  —  —  Corporate bonds744 — 744 — — 
Equity securitiesEquity securitiesEquity securities
Common stock:
Large cap231  231  —  —  —  
Mid cap158  158  —  —  —  
Small cap37  37  —  —  —  
Total common stock426  426  —  —  —  
Common stockCommon stock453 453 — — — 
Mutual fundsMutual funds442  189  253  —  —  Mutual funds510 217 293 — 
Common/collective trust fundsCommon/collective trust funds668  19  272  —  377  Common/collective trust funds771 — 341 — 430 
Partnership investmentsPartnership investments333  —  —  —  333  Partnership investments296 — — — 296 
Other holdingsOther holdings76   58  10  —  Other holdings115 22 82 11 — 
Collateral held on loaned securitiesCollateral held on loaned securities —   —  —  Collateral held on loaned securities19 — 19 — — 
LiabilitiesLiabilitiesLiabilities
Collateral to be paid on loaned securitiesCollateral to be paid on loaned securities(9) (9) —  —  —  Collateral to be paid on loaned securities(19)(19)— — — 
Fair value of pension plan assetsFair value of pension plan assets$2,973  $705  $1,548  $10  $710  Fair value of pension plan assets$3,434 $764 $1,933 $11 $726 
(a) Certain assets that are measured at fair value using the NAV per share (or its equivalent) practical expedient have not been classified in the fair value hierarchy.

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As Restated
Basis of fair value measurement
(in millions)Balance at December 31, 2018Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Measured at NAV
Assets
Fixed income securities
Cash and cash equivalents$145  $21  $124  $—  $—  
U.S. government and government agency issues735  —  735  —  —  
Corporate bonds1,127  —  1,127  —  —  
Equity securities
Common stock:
Large cap541  541  —  —  —  
Mid cap298  298  —  —  —  
Small cap91  91  —  —  —  
Total common stock930  930  —  —  —  
Mutual funds356  135  221  —  —  
Common/collective trust funds919  —  210  —  709  
Partnership investments390  —  —  —  390  
Other holdings172  11  151  10  —  
Collateral held on loaned securities196  —  196  —  —  
Liabilities
Collateral to be paid on loaned securities(196) (34) (162) —  —  
Fair value of pension plan assets$4,774  $1,063  $2,602  $10  $1,099  
The following table is a reconciliation of changes in fair value measurements that used significant unobservable inputs (Level 3).
(in millions)TotalCommon/collective
trust funds
Other
holdings
Balance at December 31, 2017$18  $ $10  
Transfers out(8) (8) —  
Balance at December 31, 201810  —  10  
Purchases—  —  —  
Balance at December 31, 2019$10  $—  $10  
(in millions)Other
holdings
Balance at December 31, 2019$10 
Purchases
Balance at December 31, 202011 
Sales(2)
Balance at December 31, 2021$
10691


The assets and liabilities of our pension plans are valued using the following valuation methods:
Investment categoryValuation methodology
Cash and cash equivalentsThese largely consist of a short-term investment fund, U.S. dollars and foreign currency. The fair value of the short-term investment fund is based on the net asset valuevalue.
U.S. government and government agency issuesValues are based on reputable pricing vendors, who typically use pricing matrices or models that use observable inputsinputs.
Corporate bondsValues are based on reputable pricing vendors, who typically use pricing matrices or models that use observable inputsinputs.
Common stockValues are based on the closing prices on the valuation date in an active market on national and international stock exchangesexchanges.
Mutual fundsValues are based on the net asset value of the units held in the respective fund which are obtained from national and international exchanges or based on the net asset value of the underlying assets of the fund provided by the fund managermanager.
Common/collective trust fundsValues are based on the net asset value of the units held at year endend.
Partnership investmentsValues are based on the net asset value of the participation by us in the investment as determined by the general partner or investment manager of the respective partnershippartnership.
Other holdingsThe value of these assets vary by investment type, but primarily are determined by reputable pricing vendors, who use pricing matrices or models that use observable inputsinputs.
Collateral held on loaned securitiesValues are based on the net asset value per unit of the fund in which the collateral is investedinvested.
Collateral to be paid on loaned securitiesValues are based on the fair value of the underlying securities loaned on the valuation datedate.
Expected Pension and OPEB Plan Funding
Our funding policy for our pension plans is to contribute amounts sufficient to meet legal funding requirements, plus any additional amounts that we may determine to be appropriate considering the funded status of the plans, tax deductibility, the cash flows generated by us, and other factors. Volatility in the global financial markets could have an unfavorable impact on future funding requirements. We have no obligation to fund our principal plans in the United States and Puerto Rico in 2020.2022. We continually reassess the amount and timing of any discretionary contributions. In 2020,2022, we expect to make contributions of at least $5 million to our Puerto Rico pension plan and $41 million to our foreign pension plans. We expect to have net cash outflows relating to our OPEB planplans of approximately $20$19 million in 2020.2022.
The following table details the funded status percentage of our pension plans as of December 31, 2019,2021, including certain plans that are unfunded in accordance with the guidelines of our funding policy outlined above.
United States and Puerto RicoInternational
as of December 31, 2019 (in millions)Qualified
plans
Nonqualified
plan
Funded
plans
Unfunded
plans
Total
Fair value of plan assets$2,060  n/a  $913  n/a  $2,973  
PBO2,278  $243  1,001  $451  3,973  
Funded status percentage90 %n/a  91 %n/a  75 %
United States and Puerto RicoInternational
as of December 31, 2021 (in millions)Qualified
plans
Nonqualified
plan
Funded
plans
Unfunded
plans
Total
Fair value of plan assets$2,700 n/a$1,084 n/a$3,784 
PBO2,713 $257 1,015 $458 4,443 
Funded status percentage100 %n/a107 %n/a85 %
Pension AnnuitizationSettlement Transactions
In October 2020, we offered certain former U.S. employees with vested pension benefits a limited-time option to take a lump sum distribution in lieu of future monthly payments. This option expired in November 2020 and approximately 40% of the eligible participants accepted the offer. Payments from plan assets to participants who accepted the offer were made in December 2020 and totaled $252 million. As a result of these transactions, we recognized non-cash pretax pension settlement charges of $43 million in the fourth quarter of 2020.
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As part of our continued effort to reduce pension plan obligations, we transferred approximately $2.4 billion of U.S. qualified pension plan liabilities to an insurance company through the purchase of a group annuity contract in October 2019. As a result of this transaction, we recognized a non-cash pretax pension settlement charge of $755 million in the fourth quarter of 2019.
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Pension Plan Amendments and Other Events
In January 2018, we announced changes to our U.S. pension plans.  We spun off the assets and liabilities of the qualified plan attributable to current employees into a new plan and will freeze the pay and service amounts used to calculate pension benefits for active participants in the U.S. pension plans as of December 31, 2022. The assets and liabilities attributable to retired and former company employees remained with the original qualified plan. Years of additional service earned and eligible compensation received after December 31, 2022 will not be included in the determination of the benefits payable to participants. These changes resulted in a $57 million decline in the PBO upon the effective date of the changes. As a result of these changes, net periodic pension and OPEB expense decreased in 2019 and 2018.
U.S. Defined Contribution Plan
Most U.S. employees are eligible to participate in a qualified defined contribution plan. We recognized expense of $59 million in 2021, $61 million in 2020 and $53 million in 2019 $50 million in 2018 and $45 million in 2017 related to contributions to this plan.
NOTE 14
13
INCOME TAXES
Income from Continuing Operations Before Income Tax Expense (Benefit) by Category
years ended December 31 (in millions)202120202019
United States$(424)$(329)$(586)
International1,901 1,621 1,556 
Income before income taxes$1,477 $1,292 $970 
As Restated
years ended December 31 (in millions)201920182017
United States$(586) $ $(320) 
International1,556  1,610  1,420  
Income from continuing operations before income taxes$970  $1,617  $1,100  
Income Tax Expense Related to Continuing Operations
As Restated
years ended December 31 (in millions)201920182017
Current
United States
Federal$ $21  $ 
State and local (1) 11  
International258  308  261  
Current income tax expense269  328  280  
Deferred
United States
Federal(140) (228) 230  
State and local(29) —   
International(141) (35) (20) 
Deferred income tax expense (benefit)(310) (263) 211  
Income tax expense (benefit)$(41) $65  $491  
(Benefit)
years ended December 31 (in millions)202120202019
Current
United States
Federal$(11)$$
State and local10 (7)
International329 270 258 
Current income tax expense328 270 269 
Deferred
United States
Federal(103)(99)(140)
State and local(8)(29)
International(35)(141)
Deferred income tax expense (benefit)(146)(88)(310)
Income tax expense (benefit)$182 $182 $(41)
10893


Deferred Tax Assets and Liabilities
As Restated
as of December 31 (in millions)20192018
Deferred tax assets
Accrued liabilities and other$209  $227  
Pension and other postretirement benefits258  222  
Tax credit and net operating loss carryforwards928  862  
Swiss tax reform net asset basis step-up159  —  
Operating lease liabilities153  —  
Valuation allowances(420) (310) 
Total deferred tax assets1,287  1,001  
Deferred tax liabilities
Subsidiaries’ unremitted earnings57  43  
Long-lived assets and other649  690  
Operating lease right-of-use assets152  —  
Total deferred tax liabilities858  733  
Net deferred tax asset$429  $268  
as of December 31 (in millions)20212020
Deferred tax assets
Accrued liabilities and other$434 $376 
Pension and other postretirement benefits174 218 
Tax credit and net operating loss carryforwards939 905 
Swiss tax reform net asset basis step-up161 174 
Operating lease liabilities155 148 
Valuation allowances(401)(454)
Total deferred tax assets1,462 1,367 
Deferred tax liabilities
Subsidiaries’ unremitted earnings66 77 
Long-lived assets and other1,831 539 
Operating lease right-of-use assets151 146 
Total deferred tax liabilities2,048 762 
Net deferred tax asset (liability)$(586)$605 
At December 31, 2019,2021, we had U.S. state operating loss carryforwards totaling $1.1 billion, U.S. federal operating loss carryforwards totaling $58$455 million and tax credit carryforwards totaling $410$411 million, which includes a U.S. foreign tax credit carryforward of $395$339 million. The U.S. federal and state operating loss and tax credit carryforwards expire between 20202022 and 2038 and2041, with $334 million of the tax credits expire between 2020 and 2038.operating loss carryforwards having no expiration date.
At December 31, 2019,2021, with respect to our operations outside the U.S., we had foreign operating loss carryforwards totaling $1.3$1.4 billion and foreign tax credit carryforwards totaling $49$15 million. The foreign operating loss carryforwards expire between 20202022 and 20312033 with $814$798 million having no expiration date. TheAll of the foreign tax credits expire between 2021 and 2027 with $48 million havingcredit carryforwards have no expiration date.
Realization of thesethe U.S. and foreign operating loss and tax credit carryforwards depends on generating sufficient future earnings. A valuation allowance of $420$401 million and $310$454 million was recognized as of December 31, 20192021 and 2018,2020, respectively, to reduce the deferred tax assets associated with net operating loss and tax credit carryforwards because we do not believe it is more likely than not that these assets will be fully realized prior to expiration. After evaluating the 2017 Tax Act and relatedrelevant U.S. Treasury Regulations,tax laws, any elections or other opportunities that may be available, and the future expiration of certain U.S. tax provisions that will impact the utilization of our U.S. foreign tax credit carryforwards, management expects to be able to realize some, but not all, of the U.S. foreign tax credit deferred tax assets up to its overall domestic loss (ODL) balance plus other recurring and non-recurring foreign inclusions. Therefore, a valuation allowance of $180$98 million and $175$157 million was recognized with respect to the foreign tax credit carryforwards as of December 31, 20192021 and 2018,2020, respectively. We will continue to evaluate the need for additional valuation allowances and, as circumstances change, the valuation allowance may change.
As a result of Swiss tax reform legislation enacted during 2019, we recognized an $863 million net asset basis step-up that is amortizable as a tax deduction ratably over tax years 2025 through 2029. The net asset basis step-up resulted inAccordingly, a $159 million deferred tax asset.asset of $161 million and $174 million was recognized as of December 31, 2021 and 2020, respectively. We expect to realize some, but not all, of the Swiss deferred tax assets based principally on expected future earnings generated by the Swiss subsidiary during the period in which the tax basis will be amortized. Therefore, a valuation allowance of $69$59 million and $72 million was recognized on the Swiss deferred tax assets as of December 31, 2019, resulting2021 and 2020, respectively.
As part of the acquisition of Hillrom in a net2021, we recorded deferred tax benefitliabilities of $90 million for$1.3 billion related to the year ended December 31, 2019.  step-up in our U.S. GAAP basis of tangible and intangible assets and liabilities to fair market value which is in excess of the assets’ historical tax bases.
10994


Income Tax Expense (Benefit) Reconciliation
years ended December 31 (in millions)202120202019
Income tax expense at U.S. statutory rate$310 $271 $204 
Tax incentives(193)(169)(140)
State and local taxes, net of federal benefit10 (2)(17)
Impact of foreign taxes103 88 65 
Tax-deductible foreign statutory loss on an investment in a foreign subsidiary(58)— — 
Unfavorable court decision in a foreign jurisdiction related to an uncertain tax position22 — — 
Swiss tax reform net asset basis step-up— — (159)
Deferred tax revaluation due to 2017 Tax Act and foreign tax reform— — (19)
Transition tax due to 2017 Tax Act— — (16)
Valuation allowances(61)110 
Stock compensation windfall tax benefits(13)(27)(54)
Research and development tax credits(5)(7)(13)
Unutilized foreign tax credits14 15 
Other, net53 (7)
Income tax expense (benefit)$182 $182 $(41)
As Restated
years ended December 31 (in millions)201920182017
Income tax expense at U.S. statutory rate$204  $340  $383  
Tax incentives(140) (161) (139) 
State and local taxes, net of federal benefit(17)  (6) 
Impact of foreign taxes65  122  (41) 
Swiss tax reform net asset basis step-up(159) —  —  
Deferred tax revaluation due to 2017 Tax Act and foreign tax reform(19) (8) (283) 
Transition tax due to 2017 Tax Act(16) (5) 529  
U.S. valuation allowance due to 2017 Tax Act—  (194) 339  
Other valuation allowances110  21  (6) 
Stock compensation windfall tax benefits(54) (40) (56) 
Foreign tax credits—  —  (246) 
Research and development tax credits(13) (17) (5) 
Other, net(2)  22  
Income tax expense (benefit)$(41) $65  $491  
InWe plan to repatriate our foreign earnings with the above reconciliation, the 2017 income tax expense associated with deferred tax revaluation, the transition tax and the U.S. valuation allowance, allexception of which result directly or indirectly from the enactmentapproximately $286 million of the 2017 Tax Act, included, or were, provisional amounts. In 2018, we completed our one-year measurement period adjustments to the 2017 Tax Act provisional amounts in accordance with SAB 118. In addition, the tax impact of non-deductible corrections of misstatements related to foreign exchange gains and losses for the years ended December 31, 2018 and 2017 is included above within the impact of foreign taxes.
The 2017 Tax Act reduced the U.S. statutory tax rate from 35% to 21% for years after 2017. Accordingly, upon its enactment in 2017, we remeasured our deferred tax assets and liabilitiesaccumulated earnings that are indefinitely reinvested as of December 31, 2017 to reflect the reduced rate that will apply in future periods when these deferred taxes are settled or realized. We recognized a SAB 118 provisional deferred tax benefit of $283 million to reflect the reduced U.S. tax rate and other effects of the 2017 Tax Act. In 2018, we collected all of the necessary data to complete our analysis of the effect of the 2017 Tax Act on the remeasurement of the underlying deferred taxes and recognized an additional deferred tax benefit of $8 million. 
The 2017 Tax Act requires us to pay U.S. income taxes on accumulated foreign subsidiary earnings not previously subject to U.S. income tax at a rate of 15.5% to the extent of foreign cash and certain other net current assets and 8% on the remaining earnings. We recognized a $529 million provisional charge in 2017 for that one-time transitional tax, the majority of which was non-cash. This charge was inclusive of relevant non-U.S. withholding taxes and U.S. state income taxes on the portion of the earnings expected to be repatriated. In 2018, after further study of the 2017 Tax Act and related U.S. Treasury Regulations, and further analysis of historical earnings and profits and tax pools, as well as refinements of the cash portion of the charge, which was provisional due to certain foreign subsidiaries with non-calendar tax year-ends, we reduced our one-time transitional tax expense by $5 million.
Additionally, the 2017 Tax Act changed the rules that enabled taxpayers to generate foreign source income2021 related to export sales that were eligible to utilize foreign tax credits. Consequently, we did not believe in 2017 that it would be more likely than not that we would be able to utilize our existing foreign tax credit deferred tax assets within the applicable carryforward periods. As such, a provisional $339 million U.S. valuation allowance was recognized in respectone of our foreign tax credit deferred tax assets in accordance with SAB118. After studying the 2017 Tax Actoperations. Additional withholding and related U.S. Treasury Regulations and evaluating any elections or other opportunities that maycapital gain taxes of $29 million would be available, we currently expect to be able to realize some, but not all, of the foreign tax credit deferred tax assets up to our overall domestic loss (ODL) balance plus recurring and non-recurring foreign inclusions. Accordingly, we reduced our provisional foreign tax credit deferred tax asset valuation allowance and recognized a 2018 benefit of $194 million.

incurred if such earnings were remitted currently.
Our tax provisions for 20192021, 2020 and 20182019 do not include any tax charges related to either the Base Erosion and Anti-Abuse Tax (BEAT) or Global Intangible Low Taxed Income (GILTI) provisions, except for the inability to fully utilize
110


foreign tax credits against such GILTI. While we are not expecting to be subject to a tax charge under the 2017 Tax Act GILTI provisions in the near term, ourOur accounting policy is to recognize thisany GILTI charge as a period cost.

The enactment ofOur effective income tax rate can differ from the 2017 Tax Act created a territorial tax system that allows companies to repatriate certain foreign earnings without incurring additional21% U.S. federal tax by providing for a 100% dividend exemption. Under the dividend-exemption provision, 100% of the foreign-source portion of dividends paid by certain foreign corporationsstatutory rate due to a U.S. corporate stockholder are exempt from U.S. federal taxation. Asnumber of factors, including foreign rate differences, tax incentives, increases or decreases in valuation allowances and liabilities for uncertain tax positions and excess tax benefits on stock compensation awards.
In 2021, our effective rate was impacted favorably by geographic earnings mix, a result of the U.S. change$58 million tax benefit related to a territorialtax-deductible foreign statutory loss on an investment in a foreign subsidiary, a tax system and the incurrence of the one-time transition tax charge, we plan to repatriate our foreign earnings that were previously considered indefinitely reinvested with the exception of approximately $192 million of accumulated earnings as of December 31, 2019benefit related to one ofa change in U.S. foreign tax credit regulations, which is reflected in the valuation allowances item in the table above, and excess tax benefits on stock compensation awards, partially offset by an unfavorable court decision in a foreign jurisdiction related to an uncertain tax position.
In 2020, our foreign operations. Additional withholding taxes of $19 million would be incurred if sucheffective tax rate was impacted favorably by geographic earnings were remitted currently.mix and excess tax benefits on stock compensation awards.
In 2019, Switzerland and India enacted tax reform legislation that had a material impact on our effective tax rate.We recognized a deferred tax benefit of $90 million to reflect a tax basis step-up, net of a valuation allowance, partially offset by a $5 million deferred tax revaluation to reflect an increase in the statutory tax rate, under the newly enacted Swiss tax laws.We also recognized a net deferred tax benefit of $24 million associated with deferred tax revaluation in India to reflect a decrease in the statutory tax rate. Our effective tax rate was also favorably impacted by $57 million in 2019 related to a notional interest deduction on the share capital of a foreign subsidiary. The gross tax benefit of the deduction is included in the table above within impact of foreign taxes and the portion not expected to be realized is included within other valuation allowances.
95


Unrecognized Tax Benefits
We classify interest and penalties associated with income taxes in income tax expense (benefit) within the consolidated statements of income. Net interest and penalties recognized were not significant during 2019, 20182021, 2020 and 2017.2019. The liability recognized related to interest and penalties was $21$19 million and $22$17 million as of December 31, 20192021 and 2018,2020, respectively. The total amount of gross unrecognized tax benefits that, if recognized, would impact the effective tax rate are $70$39 million, $84$48 million and $88$70 million as of December 31, 2019, 20182021, 2020 and 2017,2019, respectively.
The following table is a reconciliation of our unrecognized tax benefits, including those related to discontinued operations, for the years ended December 31, 2019, 20182021, 2020 and 2017.2019. 
as of and for the years ended (in millions)as of and for the years ended (in millions)201920182017as of and for the years ended (in millions)202120202019
Balance at beginning of the yearBalance at beginning of the year$127  $108  $82  Balance at beginning of the year$90 $111 $127 
Increase due to acquisitionIncrease due to acquisition11 — — 
Increase associated with tax positions taken during the current yearIncrease associated with tax positions taken during the current year 33  33  Increase associated with tax positions taken during the current year31 
Increase (decrease) associated with tax positions taken during a prior yearIncrease (decrease) associated with tax positions taken during a prior year(3) 13   Increase (decrease) associated with tax positions taken during a prior year(3)(1)(3)
SettlementsSettlements(20) (5) (6) Settlements(2)(18)(20)
Decrease associated with lapses in statutes of limitationsDecrease associated with lapses in statutes of limitations(1) (22) (3) Decrease associated with lapses in statutes of limitations(16)(10)(1)
Balance at end of the yearBalance at end of the year$111  $127  $108  Balance at end of the year$111 $90 $111 
Of the gross unrecognized tax benefits, $62$39 million and $68$47 million were recognized as liabilities in the consolidated balance sheets as of December 31, 20192021 and 2018,2020, respectively. We have recognized net indemnification receivables from Baxalta in the amount of $6 million, $6 million and $13 million as of December 31, 2019, 2018 and 2017, respectively, related to the unrecognized tax benefits for which we are the primary obligor but economically relate to Baxalta operations.
Tax Incentives
We have received tax incentives in Puerto Rico, Switzerland, Dominican Republic, Costa Rica and certain other tax jurisdictions outside the United States.Thailand. The financial impact of the reductions as compared to the statutory tax rates is indicated in the income tax expense reconciliation table above. The tax reductions as compared to the local statutory rate favorably impacted earnings per diluted share from continuing operations by $0.38 in 2021, $0.33 in 2020, and $0.27 in 2019, $0.29 in 2018, and $0.25 in 2017.2019. The above grants provide that our manufacturing operations are and will be partially exempt from local taxes with varying expirations from 20252023 to 2027.
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2029.
Examinations of Tax Returns
As of December 31, 2019,2021, we had ongoing audits in the United States, Germany, Sweden, BelgiumUnited Kingdom, China and other jurisdictions. During 2019, Baxter obtained a settlement in a transfer pricing Competent Authority proceeding, covering2021, we closed U.S. tax years 2009-2016 with the period from 2009 through 2013, between the U.S. and Switzerland.IRS with no material adjustments to our financial statements. Tax years 20092017 and forward remain under examination by the IRS while additional Competent Authority proceedings take place.and tax years 2012 and forward remain under examination by various foreign taxing authorities. We believe that it is reasonably possible that our gross unrecognized tax benefits will be reduced within the next 12 months by $27$30 million. While the final outcome of these matters is inherently uncertain, we believe we have made adequate tax provisions for all years subject to examination.
NOTE 15
14
EARNINGS PER SHARE
The numerator for both basic and diluted earnings per share (EPS) is either net income income from continuing operations, or loss from discontinued operations.attributable to Baxter stockholders. The denominator for basic EPS is the weighted-average number of shares outstanding during the period. The dilutive effect of outstanding stock options, RSUs and PSUs is reflected in the denominator for diluted EPS using the treasury stock method.
The following table is a reconciliation of income from continuing operations to net income attributable to Baxter stockholders.
96


years ended December 31(in millions)201920182017
Income from continuing operations$1,011  $1,552  $609  
Less: Income from continuing operations attributable to noncontrolling interests$10  $—  $—  
Income from continuing operations attributable to Baxter stockholders$1,001  $1,552  $609  
Loss from discontinued operations attributable to Baxter stockholders$—  $(6) $(7) 
Net income attributable to Baxter stockholders$1,001  $1,546  $602  
The following table is a reconciliation of basic shares to diluted shares.
years ended December 31(in millions)201920182017
Basic shares509  534  543  
Effect of dilutive securities10  12  12  
Diluted shares519  546  555  
years ended December 31(in millions)202120202019
Basic shares502 509 509 
Effect of dilutive securities10 
Diluted shares508 517 519 
The effect of dilutive securities included unexercised stock options, unvested RSUs and contingently issuable shares related to granted PSUs. The computation of diluted EPS excluded 7 million, 4 million, 3 million, and 24 million equity awards in 2019, 2018,2021, 2020, and 2017,2019, respectively, because their inclusion would have had an anti-dilutive effect on diluted EPS. Refer to Note 108 for additional information regarding items impacting basic shares.
NOTE 16
15
FINANCIAL INSTRUMENTS, DERIVATIVES AND HEDGING ACTIVITIES
Accounts Receivable Sales
For accounts receivable originated in Japan, we have entered into agreements with financial institutions in which the entire interest in and ownership of the receivable is sold. We continue to service the receivables in this arrangement. Servicing assets or liabilities are not recognized because we receive adequate compensation to service the sold receivables. The Japanese arrangement includes limited recourse provisions, which are not material.

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The following is a summary of the activity relating to the arrangement.

As Restated
as of and for the years ended December 31 (in millions)as of and for the years ended December 31 (in millions)201920182017as of and for the years ended December 31 (in millions)202120202019
Sold receivables at beginning of yearSold receivables at beginning of year$69  $70  $67  Sold receivables at beginning of year$96 $79 $69 
Proceeds from sales of receivablesProceeds from sales of receivables$292  $267  $270  Proceeds from sales of receivables339 348 292 
Cash collections (remitted to the owners of the receivables)Cash collections (remitted to the owners of the receivables)$(282) $(270) $(270) Cash collections (remitted to the owners of the receivables)(346)(335)(282)
Effect of foreign exchange rate changesEffect of foreign exchange rate changes$—  $ $ Effect of foreign exchange rate changes(8)— 
Sold receivables at end of yearSold receivables at end of year$79  $69  $70  Sold receivables at end of year$81 $96 $79 

The net losses relating to the sales of accounts receivable were immaterial for each year.
Concentrations of Credit Risk
We invest excess cash in certificates of deposit or money market or other funds and diversify the concentration of cash among different financial institutions. With respect to financial instruments, where appropriate, we have diversified our selection of counterparties, and have arranged collateralization and master-netting agreements to minimize the risk of loss.
Global economic conditions and liquidity issues in certain countries have resulted, and may continue to result, in delays in the collection of receivables and credit losses. Global economic conditions, governmental actions and customer-specific factors may require us to re-evaluate the collectability of our receivables and we could potentially incur additional credit losses. These conditions may also impact the stability of the Euro.
Foreign Currency and Interest Rate Risk Management
We operate on a global basis and are exposed to the risk that our earnings, cash flows and equity could be adversely impacted by fluctuations in foreign exchange and interest rates. Our hedging policy attempts to manage these risks to an acceptable level based on our judgment of the appropriate trade-off between risk, opportunity and costs.
We are primarily exposed to foreign exchange risk with respect to recognized assets and liabilities, forecasted transactions and net assets denominated in the Euro, British Pound, Chinese Yuan,Renminbi, Korean Won, Australian Dollar, Canadian Dollar, Japanese Yen, Colombian Peso, Brazilian Real, Mexican Peso, Turkish Lira, Indian Rupee and Swedish Krona. We manage our foreign currency exposures on a consolidated basis, which allows us to net exposures and take advantage of any natural offsets. In addition, we use derivative and nonderivative instruments to further reduce the net exposure to foreign exchange risk. Gains and losses on the hedging instruments offset
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losses and gains on the hedged transactions and reduce the earnings and equity volatility resulting from changes in foreign exchange rates. Financial market and currency volatility may limit our ability to cost-effectively hedge these exposures.
We are also exposed to the risk that our earnings and cash flows could be adversely impacted by fluctuations in interest rates. Our policy is to manage interest costs using athe mix of fixed- and floating-rate debt that we believe is appropriate.appropriate at that time. To manage this mix in a cost-efficient manner, we periodically enter into interest rate swaps in which we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount.
We do not hold any instruments for trading purposes and none of our outstanding derivative instruments contain credit-risk-related contingent features.
Cash Flow Hedges
We may use options, including collars and purchased options, forwards and cross-currency swaps to hedge the foreign exchange risk to earnings relating to forecasted transactions and recognized assets and liabilities. We periodically use treasury rate locks to hedge the risk to earnings associated with movements in interest rates relating to anticipated issuances of debt.
The notional amounts of foreign exchange contracts designated as cash flow hedges were $617$377 million and $706$345 million as of December 31, 20192021 and 2018,2020, respectively. The maximum term over which we have cash flow hedge
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contracts in place related to forecasted transactions at December 31, 20192021 is 12 months for foreign exchange contracts. The total notional amounts ofThere were no outstanding interest rate contracts designated as cash flow hedges were $550 million and $150 million as of December 31, 20192021 and 2018, respectively. The interest rate contracts have maturity dates in 2022 and hedge the variability in future benchmark interest payments attributable to changes in interest rates on the forecasted issuance of fixed-rate debt.2020.
Fair Value Hedges
We periodically use interest rate swaps to convert a portion of our fixed-rate debt into variable-rate debt. These instruments hedge our earnings from changes in the fair value of debt due to fluctuations in the designated benchmark interest rate.
There were 0no outstanding interest rate contracts designated as fair value hedges as of December 31, 20192021 and 2018.2020.  
Net Investment Hedges
In May 2017, we issued €600 million of senior notes due May 2025. In May 2019, we issued €750 million of senior notes due May 2024 and €750 million of senior notes due May 2029. We have designated these debt obligations as hedges of our net investment in our European operations and, as a result, mark to spot rate adjustments of the outstanding debt balances are recorded as a component of AOCI. As of December 31, 2019,2021, we had an accumulated pre-tax unrealized translation loss in AOCI of $21$45 million related to the Euro-denominated senior notes.
In May 2019, we entered into forward contracts designated as net investment hedges to reduce exposure to changes in currency rates on €1.2 billion of our net investment in our European operations. Those hedges were entered into in advance of the issuance of our senior notes mentioned above, were settled in the second quarter of 2019 and resulted in an insignificant loss.
Dedesignations
If it is determined that a derivative or nonderivative hedging instrument is no longer highly effective as a hedge, we discontinue hedge accounting prospectively. Gains or losses relating to terminations of effective cash flow hedges generally continue to be deferred and are recognized consistent with the loss or income recognition of the underlying hedged items. However, if it is probable that hedged forecasted transactions will not occur, any gains or losses would be immediately reclassified from AOCI to earnings. There were 0no cash flow hedge dedesignations in 2019, 20182021, 2020 or 20172019 resulting from changes in our assessment of the probability that the hedged forecasted transactions would occur. In 2020, we terminated interest rate contracts with a notional amount of $550 million for
98


$173 million in cash payments. The losses relating to these terminations continue to be deferred and are being recognized consistent with the underlying hedged item, interest expense on the issuance of debt.
If we terminate a fair value hedge, an amount equal to the cumulative fair value adjustment to the hedged item at the date of termination is amortized to earnings over the remaining term of the hedged item. There were no fair value hedges terminated in 20192021, 2020 or 2017. In 2018, we terminated our interest rate fair value hedges and the cumulative fair value adjustment to the hedged item was insignificant.2019.
If we terminateremove a net investment hedge designation, any gain or loss recognized in AOCI is not reclassified to earnings until we sell, liquidate, or deconsolidate the foreign investments that were being hedged. In 2019, we dedesignated €1.2 billion of forward contracts designated as a net investment hedge of our European operations. There were no net investment hedge dedesignationshedges terminated in 20182021 or 2017.2020.
Undesignated Derivative Instruments
We use forward contracts to hedge earnings from the effects of foreign exchange gains and losses relating to certain of our intra-company and third-party receivables and payables denominated in a foreign currency. These derivative instruments are generally not formally designated as hedges and the terms of these instruments generally do not exceed one month.
The total notional amount of undesignated derivative instruments was $619$851 million and $487 million$1.0 billion as of December 31, 20192021 and 2018,2020, respectively.
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Gains and Losses on Hedging Instruments and Undesignated Derivative Instruments
The following table summarizestables summarize the income statement locations and gains and losses on our hedging instruments and the classification of those gains and losses within our consolidated financial statements for the years ended December 31, 2019, 2018,2021, 2020, and 2017.2019.
(in millions)Gain (loss)
recognized in OCI
Location of gain
(loss) in
income statement
Gain (loss) reclassified from
AOCI into income
202120202019202120202019
Cash flow hedges
Interest rate contracts$— $(131)$(37)Interest expense, net$(6)$(1)$— 
Foreign exchange contracts(21)(9)Cost of sales(23)(5)
Net investment hedges200 (224)12 Other expense, net— — — 
Total$205 $(376)$(34)$(29)$(6)$
(in millions)Gain (loss)
recognized in OCI
Location of gain
(loss) in
income statement
Gain (loss) reclassified from
AOCI into income
As Restated
201920182017201920182017
Cash flow hedges
Interest rate contracts$(37) $(3) $(3) Interest expense, net$—  $—  $—  
Foreign exchange contracts(9)  (24) Cost of sales (12) (8) 
Net investment hedges12  32  (65) Other (income) expense, net—  —  —  
Total$(34) $32  $(92) $ $(12) $(8) 
Location of gain (loss) in
income statement
Gain (loss) recognized
in income
(in millions)202120202019
Undesignated derivative instruments
Foreign exchange contractsOther expense, net$(36)$49 $17 

Location of gain (loss) in
income statement
Gain (loss) recognized
in income
As Restated
(in millions)201920182017
Fair value hedges
Interest rate contractsInterest expense, net$—  $(4) $(3) 
Undesignated derivative instruments
Foreign exchange contractsOther (income) expense, net$(17) $—  $(37) 
For our fair value hedges, equal and offsetting gains of $4 million and $3 million were recognized in interest expense, net as an adjustment to the underlying hedged items, fixed-rate debt, in 2018 and 2017, respectively.
The following table summarizes net-of-tax activity in AOCI, a component of stockholders’ equity, related to our cash flow hedges.
as of and for the year ended December 31 (in millions)201920182017
Accumulated other comprehensive income (loss) balance at beginning of year$(1) $(10) $ 
Adoption of new accounting standard(1) —  —  
(Loss) gain in fair value of derivatives during the year(36) (1) (18) 
Amount reclassified to earnings during the year(3) 10   
Accumulated other comprehensive income (loss) balance at end of year$(41) $(1) $(10) 
as of and for the year ended December 31 (in millions)202120202019
Accumulated other comprehensive income (loss) balance at beginning of year$(153)$(41)$(1)
Adoption of new accounting standard— — (1)
(Loss) gain in fair value of derivatives during the year(117)(36)
Amount reclassified to earnings during the year23 (3)
Accumulated other comprehensive income (loss) balance at end of year$(126)$(153)$(41)
As of December 31, 2019, $62021, $2 million of deferred, net after-tax losses on derivative instruments included in AOCI are expected to be recognized in earnings during the next 12 months, coinciding with when the hedged items are expected to impact earnings.
11599


Derivative Assets and Liabilities
The following table summarizes the classification and fair value amounts of derivative instruments reported in the consolidated balance sheet as of December 31, 2019.
Derivatives in asset positionsDerivatives in liability positions
(in millions)Balance sheet locationFair valueBalance sheet locationFair value
Derivative instruments designated as hedges
Interest rate contractsOther non-current assets$10  Other non-current liabilities$52  
Foreign exchange contractsPrepaid expenses and other current assets10  Accounts payable and 
accrued liabilities
—  
Foreign exchange contractsOther non-current assets—  Other non-current liabilities—  
Total derivative instruments designated as hedges20  52  
Undesignated derivative instruments
Foreign exchange contractsPrepaid expenses and other current assets Accounts payable and 
accrued liabilities
 
Total derivative instruments$21  $54  
The following table summarizes the classification and fair values of derivative instruments reported in the consolidated balance sheet as of December 31, 2018.2021.
Derivatives in asset positionsDerivatives in liability positions
(in millions)Balance sheet locationFair valueBalance sheet locationFair value
Derivative instruments designated as hedges
Foreign exchange contractsPrepaid expenses and other current assets$Accrued expenses and other current liabilities$
Total derivative instruments designated as hedges
Undesignated derivative instruments
Foreign exchange contractsPrepaid expenses and other current assetsAccrued expenses and other current liabilities
Total derivative instruments$$
Derivatives in asset positionsDerivatives in liability positions
As RestatedAs Restated
(in millions)Balance sheet locationFair valueBalance sheet locationFair value
Derivative instruments designated as hedges
Interest rate contractsOther non-current assets$—  Other non-current
liabilities
$ 
Foreign exchange contractsPrepaid expenses and other current assets22  Accounts payable and 
accrued liabilities
 
Foreign exchange contractsOther non-current assets Other non-current liabilities—  
Total derivative instruments designated as hedges23   
Undesignated derivative instruments
Foreign exchange contractsPrepaid expenses and other current assets Accounts payable and 
accrued liabilities
 
Total derivative instruments$25  $ 
The following table summarizes the classification and fair values of derivative instruments reported in the consolidated balance sheet as of December 31, 2020.
Derivatives in asset positionsDerivatives in liability positions
(in millions)Balance sheet locationFair valueBalance sheet locationFair value
Derivative instruments designated as hedges
Foreign exchange contractsPrepaid expenses and other current assets— Accrued expenses and other current liabilities17 
Total derivative instruments designated as hedges— 17 
Undesignated derivative instruments
Foreign exchange contractsPrepaid expenses and other current assets11 Accrued expenses and other current liabilities
Total derivative instruments$11 $19 
While some of our derivatives are subject to master netting arrangements, we present our assets and liabilities related to derivative instruments on a gross basis within the consolidated balance sheets. Additionally, we are not required to post collateral for any of our outstanding derivatives.
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The following table provides information on our derivative positions as if they were presented on a net basis, allowing for the right of offset by counterparty.
December 31, 2021December 31, 2020
(in millions)AssetLiabilityAssetLiability
Gross amounts recognized in the consolidated balance sheets$$$11 $19 
Gross amount subject to offset in master netting arrangements not offset in the consolidated balance sheets(2)(2)(6)(6)
Total$$$$13 
December 31, 2019December 31, 2018
As Restated
(in millions)AssetLiabilityAssetLiability
Gross amounts recognized in the consolidated balance sheets$21  $54  $25  $ 
Gross amount subject to offset in master netting arrangements not offset in the consolidated balance sheets(11) (11) (3) (3) 
Total$10  $43  $22  $ 
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The following table presents the amounts recorded on the consolidated balance sheets related to fair value hedges:
Carrying amount of hedged itemCumulative amount of fair value hedging adjustment included in the carrying amount of the hedged item (a)
(in millions)Balance as of December 31, 2019Balance as of December 31, 2018Balance as of December 31, 2019Balance as of December 31, 2018
Long-term debt$103  $103  $ $ 
Carrying amount of hedged itemCumulative amount of fair value hedging adjustment included in the carrying amount of the hedged item (a)
(in millions)Balance as of December 31, 2021Balance as of December 31, 2020Balance as of December 31, 2021Balance as of December 31, 2020
Long-term debt$101 $102 $$
(a) These fair value hedges were terminated prior to December 31, 2018.

in 2018 and earlier periods.
NOTE 17
16
FAIR VALUE MEASUREMENTS
The fair value hierarchy under the accounting standard for fair value measurements consists of the following three levels:
Level 1 — Quoted prices in active markets that we have the ability to access for identical assets or liabilities;
Level 2 — Quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-based valuations in which all significant inputs are observable in the market; and
Level 3 — Valuations using significant inputs that are unobservable in the market and include the use of judgment by management about the assumptions market participants would use in pricing the asset or liability.
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The following table summarizes financial instrumentstables summarize our assets and liabilities that are measured at fair value on a recurring basis.
Basis of fair value measurement
(in millions)Balance as of December 31,
2021
Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Assets
Foreign exchange contracts$$— $$— 
Debt securities30 — — 30 
Marketable equity securities10 10 — — 
Total$48 $10 $$30 
Liabilities
Foreign exchange contracts$$— $$— 
Contingent payments related to acquisitions143 — — 143 
Total$148 $— $$143 
Basis of fair value measurement
(in millions)Balance as of December 31,
2019
Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Assets
Foreign exchange contracts$11  $—  $11  $—  
Interest rate contracts10  —  10  —  
Marketable equity securities  —  —  
Total$24  $ $21  $—  
Liabilities
Foreign exchange contracts$ $—  $ $—  
Interest rate contracts52  —  52  —  
Contingent payments related to acquisitions39  —  —  39  
Total$93  $—  $54  $39  
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As Restated
Basis of fair value measurementBasis of fair value measurement
(in millions)(in millions)Balance as of December 31,
2018
Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
(in millions)Balance as of December 31,
2020
Quoted prices
in active
markets for
identical assets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
AssetsAssetsAssets
Foreign exchange contractsForeign exchange contracts$25  $—  $25  $—  Foreign exchange contracts$11 $— $11 $— 
Debt securitiesDebt securities13 — 13 — 
Marketable equity securitiesMarketable equity securities  —  —  Marketable equity securities17 17 — — 
TotalTotal$28  $ $25  $—  Total$41 $17 $24 $— 
LiabilitiesLiabilitiesLiabilities
Foreign exchange contractsForeign exchange contracts$ $—  $ $—  Foreign exchange contracts$19 $— $19 $— 
Interest rate contracts —   —  
Contingent payments related to acquisitionsContingent payments related to acquisitions32  —  —  32  Contingent payments related to acquisitions30 — — 30 
TotalTotal$38  $—  $ $32  Total$49 $— $19 $30 
As of December 31, 20192021 and 2018,2020, cash and cash equivalents of $3.3$3.0 billion and $1.8$3.7 billion, respectively, included money market and other short-term funds of approximately $1.7$816 million and $1.8 billion, and $169 million, respectively, which are considered Level 2 in the fair value hierarchy.
For assets that are measured using quoted prices in active markets, the fair value is the published market price per unit multiplied by the number of units held, without consideration of transaction costs. The majority of the derivatives entered into by us are valued using internal valuation techniques as no quoted market prices exist for such instruments. The principal techniques used to value these instruments are discounted cash flow and Black-Scholes models. The key inputs, which are considered observable and vary depending on the type of derivative, include contractual terms, interest rate yield curves, foreign exchange rates and volatility.
Debt securities were reclassified to Level 3 as of December 31, 2021 because there were no observable transactions for those debt securities near the balance sheet date. There was no change in the estimated fair value of those debt securities for the year ended December 31, 2021.
Contingent payments related to acquisitions, which consist of milestone payments and sales-based payments, are valued using discounted cash flow techniques. The fair value of milestone payments reflects management’s expectations of probability of payment, and increases as the probability of payment increases or the expected timing of payments is accelerated. The fair value of sales-based payments is based upon probability-weighted future revenue estimates, and increases as revenue estimates increase, probability weighting of higher revenue scenarios increases or the expected timing of payment is accelerated. The following table is a reconciliation of our recurring
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fair value measurements that use significant unobservable inputs (Level 3), which consist of contingent payments related to acquisitions.
as of and for the years ended December 31 (in millions)20212020
Fair value at beginning of period$30 $39 
Additions135 
Change in fair value recognized in earnings(6)(2)
Payments(16)(11)
Fair value at end of period$143 $30 
as of and for the years ended December 31 (in millions)20192018
Fair value at beginning of period$32  $ 
Additions18  24  
Change in fair value recognized in earnings(4) —  
Payments(7) (1) 
Fair value at end of period$39  $32  
Equity investments not measured at fair value are comprised of other equity investments without readily determinable fair values and were $73 million and $41 million at December 31, 2019 and 2018, respectively.  These amounts are included in Other non-current assets.
Fair Values of Financial Instruments Not Measured at Fair Value
In addition to the financial instruments that we are required to recognize at fair value in the consolidated balance sheets, we have certain financial instruments that are recognized at amortized cost or some basis other than fair value. For these financial instruments, the following table provides the values recognized in the consolidated
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balance sheets and the estimated fair values.
Book valuesFair values(a)
As RestatedAs Restated
as of December 31 (in millions)2019201820192018
Liabilities
Short-term debt$226  $ $226  $ 
Current maturities of long-term debt and finance lease obligations315   315   
Long-term debt and finance lease obligations4,809  3,481  5,156  3,469  
Book valuesFair values(a)
as of December 31 (in millions)2021202020212020
Liabilities
Short-term debt$301 $— $301 $— 
Current maturities of long-term debt and finance lease obligations210 406 212 409 
Long-term debt and finance lease obligations17,149 5,786 17,568 6,471 
(a)    These fair value amounts are classified as Level 2 within the fair value hierarchy as they are estimated based on observable inputs.
The carrying value of short-term debt approximates its fair value due to the short-term maturities of the obligations. The estimated fair values of current and long-term debt were computed by multiplying price by the notional amount of the respective debt instruments. Price is calculated using the stated terms of the respective debt instrument and yield curves commensurate with our credit risk. The carrying values of other financial instruments, such as accounts receivable and accounts payable, approximate their fair values due to the short-term maturities of most of those assets and liabilities.
Equity investments not measured at fair value are comprised of other equity investments without readily determinable fair values and were $114 million and $105 million at December 31, 2021 and 2020, respectively. These amounts are included in Other non-current assets on our consolidated balance sheets.
NOTE 18
17
SEGMENT INFORMATION
We manage our businessglobal operations based on 3 geographical segments:4 segments, consisting of the following geographic segments related to our legacy Baxter business: Americas (North and South America), EMEA (Europe, Middle East and Africa) and APAC (Asia Pacific). Our(Asia-Pacific), and a new global segment for our recently acquired Hillrom business. The Americas, EMEA and APAC segments provide a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. The Hillrom segment provides digital and connected care solutions and collaboration tools, including smart bed systems, patient monitoring and diagnostic technologies, respiratory health devices, and advanced equipment for the surgical space. In the first quarter of 2021, the information provided to our Chief Executive Officer for purposes of allocating resources and assessing performance was updated to reallocate contracted services activities performed at a German manufacturing facility from our EMEA segment to our Americas segment. The contracted services performed at that facility are part of our BioPharma Solutions business, which is managed as part of the Americas segment. Accordingly, the reported financial results of the Americas segment now include the contracted services activities performed at that facility. Segment results for 2020 and 2019 have been recast to conform to this presentation.
We use operating income on a segment basis to make resource allocation decisions and assess the ongoing performance of our business segments. Intersegment sales are eliminated in consolidation.
Certain items are maintained at Corporate and are not allocated to a segment. They primarily include the majority of foreign currency hedging activities, corporate headquarters costs, certain R&D costs, certain GBUproduct category support costs, stock compensation expense, certain employee benefit plan costs, certain foreign currency hedging activities, and certain gains, losses, and other charges (such as business optimization, acquisition and integration costs, intangible asset amortization and asset impairments).  Our chief operating decision maker does not receive any asset information by operating segment and, accordingly, we do not report asset information by operating segment.
119103


Financial information for our segments is as follows:
for the years ended December 31 (in millions)202120202019
Net sales:   
Americas$6,666 $6,321 $6,306 
EMEA3,115 2,877 2,756 
APAC2,791 2,475 2,300 
Hillrom212 — — 
Total net sales$12,784 $11,673 $11,362 
Operating income:
Americas$2,612 $2,389 $2,499 
EMEA632 523 527 
APAC623 591 549 
Hillrom(80)— — 
Total segment operating income$3,787 $3,503 $3,575 
Depreciation Expense:
Americas$257 $249 $255 
EMEA147 150 149 
APAC98 94 85 
Hillrom— — 
Corporate and other86 108 117 
Total depreciation expense$592 $601 $606 
Capital expenditures:
Americas$394 $380 $325 
EMEA156 157 143 
APAC82 103 98 
Hillrom— — 
Corporate and other72 84 120 
Total capital expenditures$709 $724 $686 
As Restated
for the years ended December 31 (in millions)201920182017
Net sales:   
Americas$6,094  $5,951  $5,718  
EMEA2,968  2,946  2,752  
APAC2,300  2,202  2,114  
Total net sales$11,362  $11,099  $10,584  
Operating income:
Americas$2,374  $2,411  $2,238  
EMEA652  666  562  
APAC549  532  510  
Total segment operating income$3,575  $3,609  $3,310  
Depreciation Expense:
Americas$255  $229  $231  
EMEA149  158  149  
APAC85  95  84  
Corporate and other117  120  132  
Total depreciation expense$606  $602  $596  
Capital expenditures:
Americas$325  $296  $269  
EMEA143  140  141  
APAC98  122  95  
Corporate and other120  134  101  
Total capital expenditures$686  $692  $606  
The following table is a reconciliation of segment operating income to income from continuing operations before income taxes per the consolidated statements of income.
for the years ended December 31 (in millions)202120202019
Total segment operating income$3,787 $3,503 $3,575 
Corporate and other(2,077)(1,887)(1,803)
Total operating income1,710 1,616 1,772 
Net interest expense192 134 71 
Other expense, net41 190 731 
Income before income taxes$1,477 $1,292 $970 
As Restated
for the years ended December 31 (in millions)201920182017
Total segment operating income$3,575  $3,609  $3,310  
Corporate and other(1,803) (2,025) (2,022) 
Total operating income1,772  1,584  1,288  
Net interest expense71  45  55  
Other (income) expense, net731  (78) 133  
Income from continuing operations before income taxes$970  $1,617  $1,100  
Geographic information
As Restated
for the years ended December 31 (in millions)201920182017
Net sales:   
United States$4,826  $4,723  $4,510  
Latin America and Canada1,268  1,228  1,208  
Total Americas$6,094  $5,951  $5,718  
EMEA2,968  2,946  2,752  
APAC2,300  2,202  2,114  
Total net sales$11,362  $11,099  $10,584  

for the years ended December 31 (in millions)202120202019
Net sales:   
United States$5,180 $4,878 $4,826 
Latin America and Canada1,249 1,191 1,268 
EMEA3,552 3,129 2,968 
APAC2,803 2,475 2,300 
Total net sales$12,784 $11,673 $11,362 
120104


As Restated
as of December 31 (in millions)as of December 31 (in millions)20192018as of December 31 (in millions)20212020
PP&E and operating lease right-of-use assets, net: 
Property, plant and equipment and operating lease right-of-use assets, net:Property, plant and equipment and operating lease right-of-use assets, net: 
United StatesUnited States$1,889  $1,786  United States$2,337 $1,888 
EMEAEMEA1,447  1,204  EMEA1,576 1,556 
APACAPAC959  892  APAC978 1,024 
Latin America and CanadaLatin America and Canada825  648  Latin America and Canada917 857 
Consolidated PP&E and operating lease right-of-use assets, net$5,120  $4,530  
Total property, plant and equipment and operating lease right-of-use assets, netTotal property, plant and equipment and operating lease right-of-use assets, net$5,808 $5,325 

105
NOTE 19
QUARTERLY FINANCIAL DATA (UNAUDITED)

As Restated
years ended December 31 (in millions, except per share data)First quarterSecond quarterThird quarterFourth quarter¹Full year
2019     
Net sales$2,638  $2,834  $2,851  $3,039  $11,362  
Gross margin1,080  1,153  1,230  1,298  4,761  
Net income (loss) attributable to Baxter stockholders342  313  369  (23) 1,001  
Earnings (loss) per share
Basic0.67  0.61  0.72  (0.05) 1.97  
Diluted0.66  0.60  0.71  (0.05) 1.93  
Cash dividends declared per share0.190  0.220  0.220  0.220  0.850  
Market price per share
High81.31  82.41  89.78  88.45  89.78  
Low64.48  73.44  81.40  76.70  64.48  
As RestatedAs Restated
First quarterSecond quarterThird quarterFourth quarterFull year
2018
Net sales$2,692  $2,813  $2,761  $2,833  $11,099  
Gross margin1,121  1,223  1,232  1,183  4,759  
Income from continuing operations382  341  518  311  1,552  
Earnings per share from continuing operations
Basic0.71  0.64  0.97  0.59  2.91  
Diluted0.69  0.62  0.95  0.58  2.84  
Loss from discontinued operations, net of tax—  —  —  (6) (6) 
Loss per share from discontinued operations
Basic—  —  —  (0.01) (0.01) 
Diluted—  —  —  (0.01) (0.01) 
Net income382  341  518  305  1,546  
Earnings per share
Basic0.71  0.64  0.97  0.58  2.90  
Diluted0.69  0.62  0.95  0.57  2.83  
Cash dividends declared per share0.160  0.190  0.190  0.190  0.730  
Market price per share
High72.26  75.41  77.75  77.80  77.80  
Low62.56  63.43  70.71  61.45  61.45  
121


¹Results for the fourth quarter and full year of 2019 include a $755 million pre-tax charge related to the annuitization of a portion of our U.S. pension plan.
We are presenting herein restated unaudited condensed consolidated financial information for each quarterly and year-to-date interim period within the six months ended June 30, 2019 and the year ended December 31, 2018, except for the three and nine months ended September 30, 2018. See Note 2, Restatement of Previously Issued Consolidated Financial Statements, for additional information and refer to our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2019, filed on March 17, 2020, for information about the restatement of our unaudited interim financial statements for the three and nine months ended September 30, 2018.
The amounts as previously reported for the quarters ended June 30, 2019 and March 31, 2019 were derived from our Quarterly Reports on Form 10-Q filed on July 30, 2019 and May 8, 2019, respectively. The amounts as previously reported for the quarter ended December 31, 2018 were derived from our Annual Report on Form 10-K for the year ended December 31, 2018 filed on February 21, 2019. The amounts as previously reported as of September 30, 2018 and for the quarters and year-to-date interim periods ended June 30, 2018 and March 31, 2018 were derived from our Quarterly Reports on Form 10-Q filed on November 5, 2018, August 6, 2018 and May 9, 2018, respectively. See Note 2, Restatement of Previously Issued Consolidated Financial Statements, for a description of the misstatements in each category of restatements referenced by (a) through (g).

122


Baxter International Inc.
Condensed Consolidated Balance Sheets
(in millions, except per share)
As Restated
June 30,
2019
March 31,
2019
Current assets:
Cash and cash equivalents$2,934  $1,902  
Accounts receivable, net1,897  1,801  
Inventories1,756  1,743  
Prepaid expenses and other current assets642  614  
Total current assets7,229  6,060  
Property, plant and equipment, net4,485  4,476  
Goodwill2,937  2,929  
Other intangible assets, net1,363  1,440  
Operating lease right-of-use assets595  513  
Other non-current assets894  823  
Total assets$17,503  $16,241  
Current liabilities:
Short-term debt$ $796  
Current maturities of long-term debt and finance lease obligations  
Accounts payable and accrued liabilities2,553  2,478  
Total current liabilities2,557  3,276  
Long-term debt and finance lease obligations5,157  3,451  
Operating lease liabilities496  417  
Other non-current liabilities1,490  1,504  
Total liabilities9,700  8,648  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares at June 30, 2019 and March 31, 2019683  683  
Common stock in treasury, at cost, 173,275,586 shares at June 30, 2019 and 173,447,198 shares at March 31, 2019(10,322) (10,284) 
Additional contributed capital5,906  5,839  
Retained earnings15,598  15,414  
Accumulated other comprehensive (loss) income(4,086) (4,082) 
Total Baxter stockholders’ equity7,779  7,570  
Noncontrolling interests24  23  
Total equity7,803  7,593  
Total liabilities and equity$17,503  $16,241  




123


Baxter International Inc.
Condensed Consolidated Balance Sheets
(in millions, except per share)
As Restated
September 30,
2018
June 30,
2018
March 31,
2018
Current assets:
Cash and cash equivalents$2,863  $2,858  $2,949  
Accounts receivable, net1,837  1,789  1,818  
Inventories1,716  1,616  1,578  
Prepaid expenses and other current assets615  621  610  
Total current assets7,031  6,884  6,955  
Property, plant and equipment, net4,476  4,486  4,576  
Goodwill2,978  2,981  3,103  
Other intangible assets, net1,400  1,424  1,505  
Other non-current assets918  744  704  
Total assets$16,803  $16,519  $16,843  
Current liabilities:
Current maturities of long-term debt and finance lease obligations$ $ $ 
Accounts payable and accrued liabilities2,660  2,583  2,598  
Total current liabilities2,663  2,586  2,601  
Long-term debt and finance lease obligations3,480  3,491  3,550  
Other non-current liabilities1,570  1,612  1,630  
Total liabilities7,713  7,689  7,781  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares at September 30, 2018, June 30, 2018 and March 31, 2018683  683  683  
Common stock in treasury, at cost, 150,213,621 shares at September 30, 2018, 148,485,202 shares at June 30, 2018 and 146,993,164 shares at March 31, 2018(8,639) (8,485) (8,354) 
Additional contributed capital5,931  5,916  5,912  
Retained earnings14,886  14,484  14,254  
Accumulated other comprehensive (loss) income(3,754) (3,756) (3,427) 
Total Baxter stockholders’ equity9,107  8,842  9,068  
Noncontrolling interests(17) (12) (6) 
Total equity9,090  8,830  9,062  
Total liabilities and equity$16,803  $16,519  $16,843  

124


Baxter International Inc.
Condensed Consolidated Statements of Income
(in millions, except per share)
As Restated  
June 30,
2019
March 31,
2019
Six months endedThree months endedThree months ended
Net sales$5,472  $2,834  $2,638  
Cost of sales3,239  1,681  1,558  
Gross margin2,233  1,153  1,080  
Selling, general and administrative expenses1,242  641  601  
Research and development expenses295  166  129  
Other operating income, net(37) (4) (33) 
Operating income733  350  383  
Interest expense, net38  20  18  
Other (income) expense, net(17)  (21) 
Income before income taxes712  326  386  
Income tax expense57  13  44  
Net income$655  $313  $342  
Earnings per share
Basic$1.28  $0.61  $0.67  
Diluted$1.26  $0.60  $0.66  
Weighted-average number of shares outstanding
Basic511  510  512  
Diluted520  519  522  

125


Baxter International Inc.
Condensed Consolidated Statements of Income
(in millions, except per share)
As Restated  
December 31,
2018
June 30,
2018
March 31,
2018
Three months endedSix months endedThree months endedThree months ended
Net sales$2,833  $5,505  $2,813  $2,692  
Cost of sales1,650  3,161  1,590  1,571  
Gross margin1,183  2,344  1,223  1,121  
Selling, general and administrative expenses627  1,309  676  633  
Research and development expenses175  313  172  141  
Other operating income, net(10) (89) (2) (87) 
Operating income391  811  377  434 ��
Interest expense, net11  23  11  12  
Other (income) expense, net(33) (44) (38) (6) 
Income from continuing operations before income taxes413  832  404  428  
Income tax expense102  109  63  46  
Income from continuing operations311  723  341  382  
Loss from discontinued operations, net of tax(6) —  —  —  
Net income$305  $723  $341  $382  
Earnings per share from continuing operations
Basic$0.59  $1.35  $0.64  $0.71  
Diluted$0.58  $1.32  $0.62  $0.69  
Loss per share from discontinued operations
Basic$(0.01) $—  $—  $—  
Diluted$(0.01) $—  $—  $—  
Earnings per share
Basic$0.58  $1.35  $0.64  $0.71  
Diluted$0.57  $1.32  $0.62  $0.69  
Weighted-average number of shares outstanding
Basic528  537  535  539  
Diluted538  549  547  551  

126


Baxter International Inc.
Condensed Consolidated Statements of Comprehensive Income
(in millions)
As Restated  
June 30,
2019
March 31,
2019
Six months endedThree months endedThree months ended
Net income$655  $313  $342  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(95)  (97) 
Pension and other postretirement benefit plans20   14  
Hedging activities(27) (12) (15) 
Total other comprehensive (loss) income, net of tax(102) (4) (98) 
Comprehensive income$553  $309  $244  

Baxter International Inc.
Condensed Consolidated Statements of Comprehensive Income
(in millions)
As Restated  
June 30,
2018
March 31,
2018
Six months endedThree months endedThree months ended
Net income$723  $341  $382  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(305) (368) 63  
Pension and other postretirement benefit plans85  28  57  
Hedging activities 11  (5) 
Total other comprehensive (loss) income, net of tax(214) (329) 115  
Comprehensive income$509  $12  $497  

127


Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity
(in millions)
As Restated
For the Three Months Ended June 30, 2019
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of April 1, 2019683  $683  173  $(10,284) $5,839  $15,414  $(4,082) $7,570  $23  $7,593  
Net income—  —  —  —  —  313  —  313  —  313  
Other comprehensive income (loss)—  —  —  —  —  —  (4) (4) —  (4) 
Purchases of treasury stock—  —   (157) 46  —  —  (111) —  (111) 
Stock issued under employee benefit plans and other—  —  (2) 119  21  (17) —  123  —  123  
Dividends declared on common stock—  —  —  —  —  (112) —  (112) —  (112) 
Change in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of June 30, 2019683  $683  173  $(10,322) $5,906  $15,598  $(4,086) $7,779  $24  $7,803  





Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity
(in millions)
As Restated
For the Six Months Ended June 30, 2019
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2019683  $683  170  $(9,989) $5,898  $15,075  $(3,823) $7,844  $22  $7,866  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  655  —  655  —  655  
Other comprehensive income (loss)—  —  —  —  —  —  (102) (102) —  (102) 
Purchases of treasury stock—  —  10  (743) 46  —  —  (697) —  (697) 
Stock issued under employee benefit plans and other—  —  (7) 410  (38) (83) —  289  —  289  
Dividends declared on common stock—  —  —  —  —  (210) —  (210) —  (210) 
Change in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of June 30, 2019683  $683  173  $(10,322) $5,906  $15,598  $(4,086) $7,779  $24  $7,803  




Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity
(in millions)
As Restated
For the Three Months Ended March 31, 2019
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2019683  $683  170  $(9,989) $5,898  $15,075  $(3,823) $7,844  $22  $7,866  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  342  —  342  —  342  
Other comprehensive income (loss)—  —  —  —  —  —  (98) (98) —  (98) 
Purchases of treasury stock—  —   (586) —  —  —  (586) —  (586) 
Stock issued under employee benefit plans and other—  —  (5) 291  (59) (66) —  166  —  166  
Dividends declared on common stock—  —  —  —  —  (98) —  (98) —  (98) 
Change in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of March 31, 2019683  $683  173  $(10,284) $5,839  $15,414  $(4,082) $7,570  $23  $7,593  






Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity
(in millions)
As Restated
For the Three Months Ended June 30, 2018
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of April 1, 2018683  $683  147  $(8,354) $5,912  $14,254  $(3,427) $9,068  $(6) $9,062  
Net income—  —  —  —  —  341  —  341  —  341  
Other comprehensive income (loss)—  —  —  —  —  —  (329) (329) —  (329) 
Purchases of treasury stock—  —   (259) —  —  —  (259) —  (259) 
Stock issued under employee benefit plans and other—  —  (2) 128   (9) —  123  —  123  
Dividends declared on common stock—  —  —  —  —  (102) —  (102) —  (102) 
Change in noncontrolling interests—  —  —  —  —  —  —  —  (6) (6) 
Balance as of June 30, 2018683  683  148  (8,485) 5,916  14,484  (3,756) 8,842  (12) 8,830  





Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity
(in millions)
As Restated
For the Six Months Ended June 30, 2018
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
Adoption of new accounting standards—  —  —  —  —  (20) (3) (23) —  (23) 
Net income—  —  —  —  —  723  —  723  —  723  
Other comprehensive income (loss)—  —  —  —  —  —  (214) (214) —  (214) 
Purchases of treasury stock—  —  11  (781) —  —  —  (781) —  (781) 
Stock issued under employee benefit plans and other—  —  (5) 277  (24) (45) —  208  —  208  
Dividends declared on common stock—  —  —  —  —  (188) —  (188) —  (188) 
Change in noncontrolling interests—  —  —  —  —  —  —  —  (4) (4) 
Balance as of June 30, 2018683  $683  148  $(8,485) $5,916  $14,484  $(3,756) $8,842  $(12) $8,830  




Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity
(in millions)
As Restated
For the Three Months Ended March 31, 2018
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
Adoption of new accounting standards—  —  —  —  —  (20) (3) (23) —  (23) 
Net income—  —  —  —  —  382  —  382  —  382  
Other comprehensive income (loss)—  —  —  —  —  —  115  115  —  115  
Purchases of treasury stock—  —   (522) —  —  —  (522) —  (522) 
Stock issued under employee benefit plans and other—  —  (3) 149  (28) (36) —  85  —  85  
Dividends declared on common stock—  —  —  —  —  (86) —  (86) —  (86) 
Change in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of March 31, 2018683  $683  147  $(8,354) $5,912  $14,254  $(3,427) $9,068  $(6) $9,062  





Baxter International Inc.
Condensed Consolidated Statements of Cash Flows
(in millions)
As Restated
Six months ended June 30, 2019Three months ended March 31, 2019
Cash flows from operations
Net income$655  $342  
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization385  192  
Deferred income taxes(63) (6) 
Stock compensation57  22  
Net periodic pension benefit and other postretirement costs  
Intangible asset impairment31  —  
Other44  14  
Changes in balance sheet items:
Accounts receivable, net(60) 32  
Inventories(91) (82) 
Accounts payable and accrued liabilities(299) (335) 
Other(86) (48) 
Cash flows from operations – continuing operations580  134  
Cash flows from operations – discontinued operations(6) (6) 
Cash flows from operations574  128  
Cash flows from investing activities
Capital expenditures(338) (193) 
Acquisitions and investments, net of cash acquired(111) (109) 
Other investing activities, net  
Cash flows from investing activities(448) (301) 
Cash flows from financing activities
Issuances of debt1,661  —  
Net increases in debt obligations with original maturities of three months or less—  795  
Cash dividends on common stock(198) (101) 
Proceeds from stock issued under employee benefit plans262  173  
Purchases of treasury stock(720) (597) 
Other financing activities, net(37) (32) 
Cash flows from financing activities968  238  
Effect of foreign exchange rate changes on cash and cash equivalents (1) 
Increase in cash and cash equivalents1,096  64  
Cash and cash equivalents at beginning of period1,838  1,838  
Cash and cash equivalents at end of period$2,934  $1,902  


134


Baxter International Inc.
Condensed Consolidated Statements of Cash Flows
(in millions)
As Restated
Six months ended June 30, 2018Three months ended March 31, 2018
Cash flows from operations
Net income$723  $382  
Adjustments to reconcile income from continuing operations to net cash from operating activities:
Depreciation and amortization382  190  
Deferred income taxes(51) (38) 
Stock compensation54  20  
Net periodic pension benefit and other postretirement costs21  10  
Other—  (1) 
Changes in balance sheet items:
Accounts receivable, net43  76  
Inventories(134) (56) 
Accounts payable and accrued liabilities(124) (119) 
Other(82) (34) 
Cash flows from operations832  430  
Cash flows from investing activities
Capital expenditures(303) (152) 
Acquisitions and investments, net of cash acquired(228) (219) 
Cash flows from investing activities(531) (371) 
Cash flows from financing activities
Cash dividends on common stock(173) (87) 
Proceeds from stock issued under employee benefit plans170  82  
Purchases of treasury stock(781) (522) 
Other financing activities, net(24) (18) 
Cash flows from financing activities(808) (545) 
Effect of foreign exchange rate changes on cash and cash equivalents(38) 32  
Decrease in cash and cash equivalents(545) (454) 
Cash and cash equivalents at beginning of period3,403  3,403  
Cash and cash equivalents at end of period$2,858  $2,949  




135


Baxter International Inc.
Condensed Consolidated Balance Sheet
(in millions, except per share)
June 30, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Current assets:
Cash and cash equivalents$2,925  $ (e) $2,934  
Accounts receivable, net1,885  12  (e)(g) 1,897  
Inventories1,757  (1) (e)(g) 1,756  
Prepaid expenses and other current assets651  (9) (b)(e)(g) 642  
Total current assets7,218  11  7,229  
Property, plant and equipment, net4,541  (56) (c)(e) 4,485  
Goodwill2,938  (1) (e) 2,937  
Other intangible assets, net1,364  (1) (g) 1,363  
Operating lease right-of-use assets588   (e) 595  
Other non-current assets895  (1) (a)(c)(e)(g) 894  
Total assets$17,544  $(41) $17,503  
Current liabilities:
Short-term debt$ $—  $ 
Current maturities of long-term debt and finance lease obligations —   
Accounts payable and accrued liabilities2,593  (40) (b)(e)(g) 2,553  
Total current liabilities2,597  (40) 2,557  
Long-term debt and finance lease obligations5,157  —  5,157  
Operating lease liabilities490   (e) 496  
Other non-current liabilities1,464  26  (a)(c)(e)(g) 1,490  
Total liabilities9,708  (8) 9,700  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares683  —  683  
Common stock in treasury, at cost, 173,275,586 shares(10,322) —  (10,322) 
Additional contributed capital5,906  —  5,906  
Retained earnings16,184  (586) (a)(b)(c)(e)(g) 15,598  
Accumulated other comprehensive (loss) income(4,639) 553  (a)(e) (4,086) 
Total Baxter stockholders’ equity7,812  (33) 7,779  
Noncontrolling interests24  —  24  
Total equity7,836  (33) 7,803  
Total liabilities and equity$17,544  $(41) $17,503  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to retained earnings of $514 million and accumulated other comprehensive loss of $514 million and increases to other non-current assets of $12 million and other non-current liabilities of $12 million as of June 30, 2019.
136


(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to prepaid expenses and other current assets of $2 million and accounts payable and other accrued liabilities of $4 million and a decrease to retained earnings of $2 million as of June 30, 2019.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to property, plant and equipment, net of $61 million, other non-current liabilities of $6 million, and retained earnings of $44 million and an increase to other non-current assets of $11 million as of June 30, 2019.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to cash and cash equivalents of $9 million, accounts receivable, net of $6 million, inventories of $4 million, prepaid expenses and other current assets of $1 million, property, plant and equipment, net of $5 million, operating lease right-of-use assets of $7 million, other non-current assets of $5 million, accounts payable and accrued liabilities of $3 million, operating lease liabilities of $6 million, and other non-current liabilities of $4 million and decreases to goodwill of $1 million, retained earnings of $16 million, and accumulated other comprehensive loss of $39 million as of June 30, 2019.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in increases to accounts receivable, net of $6 million and other non-current liabilities of $16 million and decreases to inventories of $5 million, prepaid expenses and other current assets of $12 million, other intangible assets, net of $1 million, other non-current assets of $29 million, accounts payable and accrued liabilities of $47 million and retained earnings of $10 million as of June 30, 2019.


137


Baxter International Inc.
Condensed Consolidated Balance Sheet
(in millions, except per share)
March 31, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Current assets:
Cash and cash equivalents$1,908  $(6) (e) $1,902  
Accounts receivable, net1,802  (1) (e)(g) 1,801  
Inventories1,751  (8) (e)(g) 1,743  
Prepaid expenses and other current assets626  (12) (b)(e)(g) 614  
Total current assets6,087  (27) 6,060  
Property, plant and equipment, net4,539  (63) (c)(e) 4,476  
Goodwill2,930  (1) (e) 2,929  
Other intangible assets, net1,441  (1) (g) 1,440  
Operating lease right-of-use assets517  (4) (e) 513  
Other non-current assets836  (13) (a)(c)(e)(g) 823  
Total assets$16,350  $(109) $16,241  
Current liabilities:
Short-term debt$796  $—  $796  
Current maturities of long-term debt and finance lease obligations —   
Accounts payable and accrued liabilities2,529  (51) (e)(g) 2,478  
Total current liabilities3,327  (51) 3,276  
Long-term debt and finance lease obligations3,451  —  3,451  
Operating lease liabilities420  (3) (e) 417  
Other non-current liabilities1,483  21  (a)(c)(e)(g) 1,504  
Total liabilities8,681  (33) 8,648  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares683  —  683  
Common stock in treasury, at cost, 173,447,198 shares(10,284) —  (10,284) 
Additional contributed capital5,839  —  5,839  
Retained earnings15,970  (556) (a)(b)(c)(e)(g) 15,414  
Accumulated other comprehensive (loss) income(4,562) 480  (a)(e) (4,082) 
Total Baxter stockholders’ equity7,646  (76) 7,570  
Noncontrolling interests23  —  23  
Total equity7,669  (76) 7,593  
Total liabilities and equity$16,350  $(109) $16,241  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to retained earnings of $491 million and accumulated other comprehensive loss of $487 million and increases to other non-current assets of $9 million and other non-current liabilities of $13 million as of March 31, 2019.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to prepaid expenses and other current assets of $1 million and retained earnings of $1 million as of March 31, 2019.
138


(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to property, plant and equipment, net of $55 million, other non-current liabilities of $5 million, and retained earnings of $40 million and an increase to other non-current assets of $10 million as of March 31, 2019.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in decreases to cash and cash equivalents of $6 million, accounts receivable, net of $7 million, inventories of $3 million, prepaid expenses and other current assets of $1 million, property, plant and equipment, net of $8 million, goodwill of $1 million, operating lease right-of-use assets of $4 million, other non-current assets of $3 million, accounts payable and accrued liabilities of $4 million, operating lease liabilities of $3 million, other non-current liabilities of $3 million, retained earnings of $16 million and an increase to accumulated other comprehensive loss of $7 million as of March 31, 2019.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in increases to accounts receivable, net of $6 million and other non-current liabilities of $16 million and decreases to inventories of $5 million, prepaid expenses and other current assets of $12 million, other intangible assets, net of $1 million, other non-current assets of $29 million, accounts payable and accrued liabilities of $47 million, and retained earnings of $10 million as of March 31, 2019.


139


Baxter International Inc.
Condensed Consolidated Balance Sheet
(in millions, except per share)
September 30, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Current assets:
Cash and cash equivalents$2,860  $ (e) $2,863  
Accounts receivable, net1,826  11  (e)(g) 1,837  
Inventories1,718  (2) (e)(g) 1,716  
Prepaid expenses and other current assets624  (9) (b)(g) 615  
Total current assets7,028   7,031  
Property, plant and equipment, net4,520  (44) (c)(e) 4,476  
Goodwill2,980  (2) (e) 2,978  
Other intangible assets, net1,402  (2) (e)(g) 1,400  
Other non-current assets917   (a)(c)(e)(g) 918  
Total assets$16,847  $(44) $16,803  
Current liabilities:
Current maturities of long-term debt and finance lease obligations$ $—  $ 
Accounts payable and accrued liabilities2,701  (41) (b)(e)(g) 2,660  
Total current liabilities2,704  (41) 2,663  
Long-term debt and finance lease obligations3,485  (5) (e) 3,480  
Other non-current liabilities1,545  25  (a)(c)(e)(g) 1,570  
Total liabilities7,734  (21) 7,713  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares683  —  683  
Common stock in treasury, at cost, 150,213,621 shares(8,639) —  (8,639) 
Additional contributed capital5,931  —  5,931  
Retained earnings15,394  (508) (a)(b)(c)(e)(g) 14,886  
Accumulated other comprehensive (loss) income(4,239) 485  (a)(e) (3,754) 
Total Baxter stockholders’ equity9,130  (23) 9,107  
Noncontrolling interests(17) —  (17) 
Total equity9,113  (23) 9,090  
Total liabilities and equity$16,847  $(44) $16,803  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to retained earnings of $448 million and accumulated other comprehensive loss of $456 million and increases to other non-current assets of $20 million and other non-current liabilities of $12 million as of September 30, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to prepaid expenses and other current assets of $3 million and accounts payable and accrued liabilities of $4 million and a decrease to retained earnings of $1 million as of September 30, 2018.
140


(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to property, plant and equipment, net of $49 million, other non-current liabilities of $2 million, and retained earnings of $35 million and an increase to other non-current assets of $12 million as of September 30, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to cash and cash equivalents of $3 million, accounts receivable, net of $5 million, inventories of $3 million, property, plant and equipment, net of $5 million and accounts payable and accrued liabilities of $2 million and decreases to goodwill of $2 million, other intangible assets, net of $1 million, other non-current assets of $2 million, long-term debt and finance lease obligations of $5 million, other non-current liabilities of $1 million, retained earnings of $14 million, and accumulated other comprehensive loss of $29 million as of September 30, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in increases to accounts receivable, net of $6 million and other non-current liabilities of $16 million and decreases to inventories of $5 million, prepaid expenses and other current assets of $12 million, other intangible assets, net of $1 million, other non-current assets of $29 million, accounts payable and accrued liabilities of $47 million, and retained earnings of $10 million as of September 30, 2018.

141


Baxter International Inc.
Condensed Consolidated Balance Sheet
(in millions, except per share)
June 30, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Current assets:
Cash and cash equivalents$2,857  $ (e) $2,858  
Accounts receivable, net1,783   (g) 1,789  
Inventories1,622  (6) (e)(g) 1,616  
Prepaid expenses and other current assets628  (7) (b)(e)(g) 621  
Total current assets6,890  (6) 6,884  
Property, plant and equipment, net4,531  (45) (c) 4,486  
Goodwill2,984  (3) (e) 2,981  
Other intangible assets, net1,427  (3) (e)(g) 1,424  
Other non-current assets746  (2) (a)(c)(g) 744  
Total assets$16,578  $(59) $16,519  
Current liabilities:
Current maturities of long-term debt and finance lease obligations$ $—  $ 
Accounts payable and accrued liabilities2,626  (43) (b)(g) 2,583  
Total current liabilities2,629  (43) 2,586  
Long-term debt and finance lease obligations3,495  (4) (e) 3,491  
Other non-current liabilities1,585  27  (a)(c)(g) 1,612  
Total liabilities7,709  (20) 7,689  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares683  —  683  
Common stock in treasury, at cost, 148,485,202 shares(8,485) —  (8,485) 
Additional contributed capital5,916  —  5,916  
Retained earnings14,966  (482) (a)(c)(e)(g) 14,484  
Accumulated other comprehensive (loss) income(4,199) 443  (a)(e) (3,756) 
Total Baxter stockholders’ equity8,881  (39) 8,842  
Noncontrolling interests(12) —  (12) 
Total equity8,869  (39) 8,830  
Total liabilities and equity$16,578  $(59) $16,519  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to retained earnings of $425 million and accumulated other comprehensive loss of $428 million and increases to other non-current assets of $16 million and other non-current liabilities of $13 million as of June 30, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to prepaid expenses and other current assets of $4 million and accounts payable and accrued liabilities of $4 million as of June 30, 2018.
142


(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to property, plant and equipment, net of $45 million, other non-current liabilities of $2 million, and retained earnings of $32 million and an increase to other non-current assets of $11 million as of June 30, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to cash and cash equivalents of $1 million and prepaid expenses and other current assets of $1 million and decreases to inventories of $1 million, goodwill of $3 million, other intangible assets, net of $2 million, long-term debt and finance lease obligations of $4 million, retained earnings of $15 million, and accumulated other comprehensive loss of $15 million as of June 30, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in increases to accounts receivable, net of $6 million and other non-current liabilities of $16 million and decreases to inventories of $5 million, prepaid expenses and other current assets of $12 million, other intangible assets, net of $1 million, other non-current assets of $29 million, accounts payable and accrued liabilities of $47 million, and retained earnings of $10 million as of June 30, 2018.

143



Baxter International Inc.
Condensed Consolidated Balance Sheet
(in millions, except per share)
March 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Current assets:
Cash and cash equivalents$2,947  $ (e) $2,949  
Accounts receivable, net1,807  11  (e)(g) 1,818  
Inventories1,581  (3) (e)(g) 1,578  
Prepaid expenses and other current assets621  (11) (b)(g) 610  
Total current assets6,956  (1) 6,955  
Property, plant and equipment, net4,614  (38) (c)(e) 4,576  
Goodwill3,107  (4) (e) 3,103  
Other intangible assets, net1,507  (2) (e)(g) 1,505  
Other non-current assets706  (2) (a)(c)(e)(g) 704  
Total assets$16,890  $(47) $16,843  
Current liabilities:
Current maturities of long-term debt and finance lease obligations$ $—  $ 
Accounts payable and accrued liabilities2,639  (41) (b)(e)(g) 2,598  
Total current liabilities2,642  (41) 2,601  
Long-term debt and finance lease obligations3,550  —  3,550  
Other non-current liabilities1,605  25  (a)(c)(e)(g) 1,630  
Total liabilities7,797  (16) 7,781  
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares683  —  683  
Common stock in treasury, at cost, 146,993,164 shares(8,354) —  (8,354) 
Additional contributed capital5,912  —  5,912  
Retained earnings14,734  (480) (a)(b)(c)(e)(g) 14,254  
Accumulated other comprehensive (loss) income(3,876) 449  (a)(e) (3,427) 
Total Baxter stockholders’ equity9,099  (31) 9,068  
Noncontrolling interests(6) —  (6) 
Total equity9,093  (31) 9,062  
Total liabilities and equity$16,890  $(47) $16,843  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to retained earnings of $426 million and accumulated other comprehensive loss of $432 million and increases to other non-current assets of $20 million and other non-current liabilities of $14 million as of March 31, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to prepaid expenses and other current assets of $1 million and accounts payable and accrued liabilities of $4 million and a decrease to retained earnings of $3 million as of March 31, 2018.
144


(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to property, plant and equipment, net of $44 million, other non-current liabilities of $2 million, and retained earnings of $31 million and an increase to other non-current assets of $11 million as of March 31, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to cash and cash equivalents of $2 million, accounts receivable, net of $5 million, inventories of $2 million, property, plant and equipment, net of $6 million, and accounts payable and accrued liabilities of $2 million and decreases to goodwill of $4 million, other intangible assets, net of $1 million, other non-current assets of $4 million, other non-current liabilities of $3 million, retained earnings of $10 million, and accumulated other comprehensive loss of $17 million as of March 31, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in increases to accounts receivable, net of $6 million and other non-current liabilities of $16 million and decreases to inventories of $5 million, prepaid expenses and other current assets of $12 million, other intangible assets, net of $1 million, other non-current assets of $29 million, accounts payable and accrued liabilities of $47 million, and retained earnings of $10 million as of March 31, 2018.


145


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Three months ended June 30, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$2,840  $(6) (e) $2,834  
Cost of sales1,681  —  (c)(e) 1,681  
Gross margin1,159  (6) 1,153  
Selling, general and administrative expenses642  (1) (e) 641  
Research and development expenses166  —  166  
Other operating income, net(4) —  (4) 
Operating income355  (5) 350  
Interest expense, net20  —  20  
Other (income) expense, net(28) 32  (a)(b)  
Income before income taxes363  (37) 326  
Income tax expense20  (7) (a)(c) 13  
Net income$343  $(30) $313  
Earnings per share
Basic$0.67  $(0.06) $0.61  
Diluted$0.66  $(0.06) $0.60  
Weighted-average number of shares outstanding
Basic510  —  510  
Diluted519  —  519  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in a decrease to other (income) expense, net of $26 million and a decrease to income tax expense of $5 million for the three months ended June 30, 2019.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in a decrease to other (income) expense, net of $6 million for the three months ended June 30, 2019.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $5 million and a decrease to income tax expense of $2 million for the three months ended June 30, 2019.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in decreases to net sales of $6 million, cost of sales of $5 million and SG&A expense of $1 million for the three months ended June 30, 2019.
146


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Six months ended June 30, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$5,472  $—  $5,472  
Cost of sales3,233   (c)(e) 3,239  
Gross margin2,239  (6) 2,233  
Selling, general and administrative expenses1,242  —  1,242  
Research and development expenses295  —  295  
Other operating income, net(37) —  (37) 
Operating income739  (6) 733  
Interest expense, net38  —  38  
Other (income) expense, net(53) 36  (a)(b) (17) 
Income before income taxes754  (42) 712  
Income tax expense64  (7) (a)(b)(c) 57  
Net income$690  $(35) $655  
Earnings per share
Basic$1.35  $(0.07) $1.28  
Diluted$1.33  $(0.07) $1.26  
Weighted-average number of shares outstanding
Basic511  —  511  
Diluted520  —  520  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to other (income) expense, net of $31 million and income tax expense of $4 million for the six months ended June 30, 2019.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in decreases to other (income) expense, net of $5 million and income tax expense of $1 million for the six months ended June 30, 2019.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $7 million and a decrease to income tax expense of $2 million for the six months ended June 30, 2019.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in a decrease to cost of sales of $1 million for the six months ended June 30, 2019.
147


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Three months ended March 31, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$2,632  $ (e) $2,638  
Cost of sales1,552   (c)(e) 1,558  
Gross margin1,080  —  1,080  
Selling, general and administrative expenses600   (e) 601  
Research and development expenses129  —  129  
Other operating income, net(33) —  (33) 
Operating income384  (1) 383  
Interest expense, net18  —  18  
Other (income) expense, net(25)  (a)(b) (21) 
Income before income taxes391  (5) 386  
Income tax expense44  —  44  
Net income$347  $(5) $342  
Earnings per share
Basic$0.68  $(0.01) $0.67  
Diluted$0.66  $—  $0.66  
Weighted-average number of shares outstanding
Basic512  —  512  
Diluted522  —  522  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in a decrease to other (income) expense, net of $5 million for the three months ended March 31, 2019.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in an increase to other (income) expense, net of $1 million for the three months ended March 31, 2019.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $2 million for the three months ended March 31, 2019.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to net sales of $6 million, cost of sales of $4 million and SG&A expense of $1 million for the three months ended March 31, 2019.


148


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Three months ended December 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$2,841  $(8) (e) $2,833  
Cost of sales1,649   (c)(e) 1,650  
Gross margin1,192  (9) 1,183  
Selling, general and administrative expenses629  (2) (e) 627  
Research and development expenses175  —  175  
Other operating income, net(10) —  (10) 
Operating income398  (7) 391  
Interest expense, net11  —  11  
Other (income) expense, net(58) 25  (a)(b) (33) 
Income from continuing operations before income taxes445  (32) 413  
Income tax expense91  11  (a)(c)(g) 102  
Income from continuing operations354  (43) 311  
Loss from discontinued operations(6) —  (6) 
Net income$348  $(43) $305  
Earnings per share from continuing operations
Basic$0.67  $(0.08) $0.59  
Diluted$0.66  $(0.08) $0.58  
Loss per share from discontinued operations
Basic$(0.01) $—  $(0.01) 
Diluted$(0.01) $—  $(0.01) 
Earnings per share
Basic$0.66  $(0.08) $0.58  
Diluted$0.65  $(0.08) $0.57  
Weighted-average number of shares outstanding
Basic528  —  528  
Diluted538  —  538  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in a decrease to other (income) expense, net of $26 million and an increase to income tax expense of $5 million for the three months ended December 31, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in an increase to other (income) expense, net of $1 million.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $4 million and a decrease to income tax expense of $1 million for the three months ended December 31, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in decreases to net sales of $8 million, cost of sales of $3 million and SG&A expense of $2 million for the three months ended December 31, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in an increase to income tax expense of $7 million for the year ended December 31, 2018.

149


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Three months ended June 30, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$2,842  $(29) (e) $2,813  
Cost of sales1,603  (13) (c)(e) 1,590  
Gross margin1,239  (16) 1,223  
Selling, general and administrative expenses681  (5) (e)(f) 676  
Research and development expenses174  (2) (e) 172  
Other operating income, net—  (2) (f) (2) 
Operating income384  (7) 377  
Interest expense, net11  —  11  
Other (income) expense, net(31) (7) (b)(e) (38) 
Income before income taxes404  —  404  
Income tax expense61   (b)(c)(e) 63  
Net income$343  $(2) $341  
Earnings per share
Basic$0.64  $—  $0.64  
Diluted$0.63  $(0.01) $0.62  
Weighted-average number of shares outstanding
Basic535  —  535  
Diluted547  —  547  
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to other (income) expense, net of $8 million and income tax expense of $4 million for the three months ended June 30, 2018.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $2 million and a decrease to income tax expense of $1 million for the three months ended June 30, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in decreases to net sales of $29 million, cost of sales of $15 million, SG&A expense of $7 million, R&D expense of $2 million, other (income) expense, net of $1 million and income tax expense of $1 million for the three months ended June 30, 2018.
(f) Income Statement Classification of Transition Services Income—The correction of these misstatements resulted in increases to SG&A expense and other operating income, net of $2 million for the three months ended June 30, 2018.

150


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Six months ended June 30, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$5,519  $(14) (e) $5,505  
Cost of sales3,166  (5) (c)(e) 3,161  
Gross margin2,353  (9) 2,344  
Selling, general and administrative expenses1,303   (e)(f) 1,309  
Research and development expenses314  (1) (e) 313  
Other operating income, net(80) (9) (f) (89) 
Operating income816  (5) 811  
Interest expense, net23  —  23  
Other (income) expense, net(49)  (a)(b)(e) (44) 
Income before income taxes842  (10) 832  
Income tax expense110  (1) (a)(b)(c)(e) 109  
Net income$732  $(9) $723  
Earnings per share
Basic$1.36  $(0.01) $1.35  
Diluted$1.33  $(0.01) $1.32  
Weighted-average number of shares outstanding
Basic537  —  537  
Diluted549  —  549  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to other (income) expense, net of $9 million and income tax expense of $3 million for the six months ended June 30, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in increases to other (income) expense, net of $5 million and income tax of $4 million for the six months ended June 30, 2018.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $3 million and a decrease to income tax expense of $1 million for the six months ended June 30, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in decreases to net sales of $14 million, cost of sales of $8 million, SG&A expense of $3 million, R&D expense of $1 million, other (income) expense, net of $1 million and income tax expense of $1 million for the six months ended June 30, 2018.
(f) Income Statement Classification of Transition Services Income—The correction of these misstatements resulted in increases to SG&A expense and other operating income, net of $9 million for the six months ended June 30, 2018.

151


Baxter International Inc.
Condensed Consolidated Statement of Income
(in millions, except per share)
Three months ended March 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Net sales$2,677  $15  (e) $2,692  
Cost of sales1,563   (c)(e) 1,571  
Gross margin1,114   1,121  
Selling, general and administrative expenses622  11  (e)(f) 633  
Research and development expenses140   (e) 141  
Other operating income, net(80) (7) (f) (87) 
Operating income432   434  
Interest expense, net12  —  12  
Other (income) expense, net(18) 12  (a)(b) (6) 
Income before income taxes438  (10) 428  
Income tax expense49  (3) (a) 46  
Net income$389  $(7) $382  
Earnings per share
Basic$0.72  $(0.01) $0.71  
Diluted$0.71  $(0.02) $0.69  
Weighted-average number of shares outstanding
Basic539  —  539  
Diluted551  —  551  
(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in decreases to other (income) expense, net of $9 million and income tax expense of $3 million for the three months ended March 31, 2018.
(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in a decrease to other (income) expense, net of $3 million for the three months ended March 31, 2018.
(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in an increase to cost of sales of $1 million for the three months ended March 31, 2018.
(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars—The correction of these misstatements resulted in increases to net sales of $15 million, cost of sales of $7 million, SG&A expense of $4 million and R&D expense of $1 million for the three months ended March 31, 2018.
(f) Income Statement Classification of Transition Services Income—The correction of these misstatements resulted in increases to SG&A expense and other operating income, net of $7 million for the three months ended March 31, 2018.







152


Baxter International Inc.
Condensed Consolidated Statement of Comprehensive Income
(in millions)
Three months ended June 30, 2019
As previously reportedRestatement impactsAs restated
Net income$343  $(30) $313  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(78) 80   
Pension and other postretirement benefit plans13  (7)  
Hedging activities(12) —  (12) 
Total other comprehensive loss, net of tax(77) 73  (4) 
Comprehensive income$266  $43  $309  

The $30 million decrease to net income was driven by the items described above in the consolidated statement of income for the three months ended June 30, 2019 section.
The $80 million decrease to currency translation adjustments for the three months ended June 30, 2019 is comprised of a $54 million decrease to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars and a $26 million decrease from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses on intra-company receivables and payables.
The $7 million decrease to pension and other postretirement benefit plans for the three months ended June 30, 2019 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.


153


Baxter International Inc.
Condensed Consolidated Statement of Comprehensive Income
(in millions)
Six months ended June 30, 2019
As previously reportedRestatement impactsAs restated
Net income$690  $(35) $655  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(48) (47) (95) 
Pension and other postretirement benefit plans21  (1) 20  
Hedging activities(27) —  (27) 
Total other comprehensive loss, net of tax(54) (48) (102) 
Comprehensive income$636  $(83) $553  

The $35 million decrease to net income was driven by the items described above in the consolidated statement of income for the six months ended June 30, 2019 section.
The $47 million increase to currency translation adjustments for the six months ended June 30, 2019 is comprised of a $78 million increase to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars partially offset by a $31 million decrease from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses on intra-company receivables and payables.
The $1 million decrease to pension and other postretirement benefit plans for the six months ended June 30, 2019 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.



154


Baxter International Inc.
Condensed Consolidated Statement of Comprehensive Income
(in millions)
Three months ended March 31, 2019
As previously reportedRestatement impactsAs restated
Net income$347  $(5) $342  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments30  (127) (97) 
Pension and other postretirement benefit plans  14  
Hedging activities(15) —  (15) 
Total other comprehensive (loss) income, net of tax23  (121) (98) 
Comprehensive income$370  $(126) $244  
The $5 million decrease to net income was driven by the items described above in the consolidated statement of income for the three months ended March 31, 2019 section.
The $127 million decrease to currency translation adjustments for the three months ended March 31, 2019 is comprised of a $132 million decrease to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars partially offset by a $5 million increase from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses on intra-company receivables and payables.
The $6 million increase to pension and other postretirement benefit plans for the three months ended March 31, 2019 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.

155



Baxter International Inc.
Condensed Consolidated Statement of Comprehensive Income
(in millions)
Three months ended June 30, 2018
As previously reportedRestatement impactsAs restated
Net income$343  $(2) $341  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(363) (5) (368) 
Pension and other postretirement benefit plans29  (1) 28  
Hedging activities11  —  11  
Total other comprehensive loss, net of tax(323) (6) (329) 
Comprehensive income$20  $(8) $12  
The $2 million decrease to net income was driven by the items described above in the consolidated statement of income for the three months ended June 30, 2018 section.
The $5 million increase to currency translation adjustments for the three months ended June 30, 2018 is comprised of a $5 million increase to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.
The $1 million decrease to pension and other postretirement benefit plans for the three months ended June 30, 2018 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.

156


Baxter International Inc.
Condensed Consolidated Statement of Comprehensive Income
(in millions)
Six months ended June 30, 2018
As previously reportedRestatement impactsAs restated
Net income$732  $(9) $723  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments(282) (23) (305) 
Pension and other postretirement benefit plans81   85  
Hedging activities —   
Total other comprehensive loss, net of tax(195) (19) (214) 
Comprehensive income$537  $(28) $509  
The $9 million decrease to net income was driven by the items described above in the consolidated statement of income for the six months ended June 30, 2018 section.
The $23 million increase to currency translation adjustments for the six months ended June 30, 2018 is comprised of a $32 million increase to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars partially offset by a $9 million decrease from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses on intra-company receivables and payables.
The $4 million increase to pension and other postretirement benefit plans for the six months ended June 30, 2018 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.

157


Baxter International Inc.
Condensed Consolidated Statement of Comprehensive Income
(in millions)
Three months ended March 31, 2018
As previously reportedRestatement impactsAs restated
Net income$389  $(7) $382  
Other comprehensive (loss) income, net of tax:
Currency translation adjustments81  (18) 63  
Pension and other postretirement benefit plans52   57  
Hedging activities(5) —  (5) 
Total other comprehensive income, net of tax128  (13) 115  
Comprehensive income$517  $(20) $497  
The $7 million decrease to net income was driven by the items described above in the consolidated statement of income for the three months ended March 31, 2018 section.
The $18 million decrease to currency translation adjustments for the three months ended March 31, 2018 is comprised of a $27 million decrease to correct the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars partially offset by a $9 million increase from the offsetting balance sheet impact of the adjustments to foreign exchange gains and losses on intra-company receivables and payables.
The $5 million increase to pension and other postretirement benefit plans for the three months ended March 31, 2018 is a result of the correction of the foreign exchange rates used to translate the financial position and results of operations of our foreign operations into U.S. dollars.

158


Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
For the Three Months Ended June 30, 2019
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of April 1, 2019683  $683  173  $(10,284) $5,839  $15,970  $(4,562) $7,646  $23  $7,669  
Net income—  —  —  —  —  343  —  343  —  343  
Other comprehensive income (loss)—  —  —  —  —  —  (77) (77) —  (77) 
Purchases of treasury stock—  —   (157) 46  —  —  (111) —  (111) 
Stock issued under employee benefit plans and other—  —  (2) 119  21  (17) —  123  —  123  
Dividends declared on common stock—  —  —  —  —  (112) —  (112) —  (112) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of June 30, 2019683  $683  173  $(10,322) $5,906  $16,184  $(4,639) $7,812  $24  $7,836  
Restatement impacts
Balance as of April 1, 2019—  $—  —  $—  $—  $(556) $480  $(76) $—  $(76) 
Net income—  —  —  —  —  (30) —  (30) —  (30) 
Other comprehensive income (loss)—  —  —  —  —  —  73  73  —  73  
Balance as of June 30, 2019—  $—  —  $—  $—  $(586) $553  $(33) $—  $(33) 
As restated
Balance as of April 1, 2019683  $683  173  $(10,284) $5,839  $15,414  $(4,082) $7,570  $23  $7,593  
Net income—  —  —  —  —  313  —  313  —  313  
Other comprehensive income (loss)—  —  —  —  —  —  (4) (4) —  (4) 
Purchases of treasury stock—  —   (157) 46  —  —  (111) —  (111) 
Stock issued under employee benefit plans and other—  —  (2) 119  21  (17) —  123  —  123  
Dividends declared on common stock—  —  —  —  —  (112) —  (112) —  (112) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of June 30, 2019683  $683  173  $(10,322) $5,906  $15,598  $(4,086) $7,779  $24  $7,803  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the three months ended June 30, 2019 sections above.

159


Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
For the Six Months Ended June 30, 2019
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of January 1, 2019683  $683  170  $(9,989) $5,898  $15,626  $(4,424) $7,794  $22  $7,816  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  690  —  690  —  690  
Other comprehensive income (loss)—  —  —  —  —  —  (54) (54) —  (54) 
Purchases of treasury stock—  —  10  (743) 46  —  —  (697) —  (697) 
Stock issued under employee benefit plans and other—  —  (7) 410  (38) (83) —  289  —  289  
Dividends declared on common stock—  —  —  —  —  (210) —  (210) —  (210) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of June 30, 2019683  $683  173  $(10,322) $5,906  $16,184  $(4,639) $7,812  $24  $7,836  
Restatement impacts
Balance as of January 1, 2019—  $—  —  $—  $—  $(551) $601  $50  $—  $50  
Net income—  —  —  —  —  (35) —  (35) —  (35) 
Other comprehensive income (loss)—  —  —  —  —  —  (48) (48) —  (48) 
Balance as of June 30, 2019—  $—  —  $—  $—  $(586) $553  $(33) $—  $(33) 
As restated
Balance as of January 1, 2019683  $683  170  $(9,989) $5,898  $15,075  $(3,823) $7,844  $22  $7,866  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  655  —  655  —  655  
Other comprehensive income (loss)—  —  —  —  —  —  (102) (102) —  (102) 
Purchases of treasury stock—  —  10  (743) 46  —  —  (697) —  (697) 
Stock issued under employee benefit plans and other—  —  (7) 410  (38) (83) —  289  —  289  
Dividends declared on common stock—  —  —  —  —  (210) —  (210) —  (210) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of June 30, 2019683  $683  173  $(10,322) $5,906  $15,598  $(4,086) $7,779  $24  $7,803  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the six months ended June 30, 2019 sections above.

160


Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
For the Three Months Ended March 31, 2019
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of January 1, 2019683  $683  170  $(9,989) $5,898  $15,626  $(4,424) $7,794  $22  $7,816  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  347  —  347  —  347  
Other comprehensive income (loss)—  —  —  —  —  —  23  23  —  23  
Purchases of treasury stock—  —   (586) —  —  —  (586) —  (586) 
Stock issued under employee benefit plans and other—  —  (5) 291  (59) (66) —  166  —  166  
Dividends declared on common stock—  —  —  —  —  (98) —  (98) —  (98) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of March 31, 2019683  $683  173  $(10,284) $5,839  $15,970  $(4,562) $7,646  $23  $7,669  
Restatement impacts
Balance as of January 1, 2019—  $—  —  $—  $—  $(551) $601  $50  $—  $50  
Net income—  —  —  —  —  (5) —  (5) —  (5) 
Other comprehensive income (loss)—  —  —  —  —  —  (121) (121) —  (121) 
Balance as of March 31, 2019—  $—  —  $—  $—  $(556) $480  $(76) $—  $(76) 
As restated
Balance as of January 1, 2019683  $683  170  $(9,989) $5,898  $15,075  $(3,823) $7,844  $22  $7,866  
Adoption of new accounting standards—  —  —  —  —  161  (161) —  —  —  
Net income—  —  —  —  —  342  —  342  —  342  
Other comprehensive income (loss)—  —  —  —  —  —  (98) (98) —  (98) 
Purchases of treasury stock—  —   (586) —  —  —  (586) —  (586) 
Stock issued under employee benefit plans and other—  —  (5) 291  (59) (66) —  166  —  166  
Dividends declared on common stock—  —  —  —  —  (98) —  (98) —  (98) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of March 31, 2019683  $683  173  $(10,284) $5,839  $15,414  $(4,082) $7,570  $23  $7,593  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the three months ended March 31, 2019 sections above.



161


Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
For the Three Months Ended June 30, 2018
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of April 1, 2018683  $683  147  $(8,354) $5,912  $14,734  $(3,876) $9,099  $(6) $9,093  
Net income—  —  —  —  —  343  —  343  —  343  
Other comprehensive income (loss)—  —  —  —  —  —  (323) (323) —  (323) 
Purchases of treasury stock—  —   (259) —  —  —  (259) —  (259) 
Stock issued under employee benefit plans and other—  —  (2) 128   (9) —  123  —  123  
Dividends declared on common stock—  —  —  —  —  (102) —  (102) —  (102) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  (6) (6) 
Balance as of June 30, 2018683  $683  148  $(8,485) $5,916  $14,966  $(4,199) $8,881  $(12) $8,869  
Restatement impacts
Balance as of April 1, 2018—  $—  —  $—  $—  $(480) $449  $(31) $—  $(31) 
Net income—  —  —  —  —  (2) —  (2) —  (2) 
Other comprehensive income (loss)—  —  —  —  —  —  (6) (6) —  (6) 
Balance as of June 30, 2018—  $—  —  $—  $—  $(482) $443  $(39) $—  $(39) 
As restated
Balance as of April 1, 2018683  $683  147  $(8,354) $5,912  $14,254  $(3,427) $9,068  $(6) $9,062  
Net income—  —  —  —  —  341  —  341  —  341  
Other comprehensive income (loss)—  —  —  —  —  —  (329) (329) —  (329) 
Purchases of treasury stock—  —   (259) —  —  —  (259) —  (259) 
Stock issued under employee benefit plans and other—  —  (2) 128   (9) —  123  —  123  
Dividends declared on common stock—  —  —  —  —  (102) —  (102) —  (102) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  (6) (6) 
Balance as of June 30, 2018683  $683  148  $(8,485) $5,916  $14,484  $(3,756) $8,842  $(12) $8,830  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the three months ended June 30, 2018 sections above.

162


Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
For the Six Months Ended June 30, 2018
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,483  $(4,001) $9,124  $(8) $9,116  
Adoption of new accounting standards—  —  —  —  —  (16) (3) (19) —  (19) 
Net income—  —  —  —  —  732  —  732  —  732  
Other comprehensive income (loss)—  —  —  —  —  —  (195) (195) —  (195) 
Purchases of treasury stock—  —  11  (781) —  —  —  (781) —  (781) 
Stock issued under employee benefit plans and other—  —  (5) 277  (24) (45) —  208  —  208  
Dividends declared on common stock—  —  —  —  —  (188) —  (188) —  (188) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  (4) (4) 
Balance as of June 30, 2018683  $683  148  $(8,485) $5,916  $14,966  $(4,199) $8,881  $(12) $8,869  
Restatement impacts
Balance as of January 1, 2018—  $—  —  $—  $—  $(469) $462  $(7) $—  $(7) 
Adoption of new accounting standards—  —  —  —  —  (4) —  (4) —  (4) 
Net income—  —  —  —  —  (9) —  (9) —  (9) 
Other comprehensive income (loss)—  —  —  —  —  —  (19) (19) —  (19) 
Balance as of June 30, 2018—  $—  —  $—  $—  $(482) $443  $(39) $—  $(39) 
As restated
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
Adoption of new accounting standards—  —  —  —  —  (20) (3) (23) —  (23) 
Net income—  —  —  —  —  723  —  723  —  723  
Other comprehensive income (loss)—  —  —  —  —  —  (214) (214) —  (214) 
Purchases of treasury stock—  —  11  (781) —  —  —  (781) —  (781) 
Stock issued under employee benefit plans and other—  —  (5) 277  (24) (45) —  208  —  208  
Dividends declared on common stock—  —  —  —  —  (188) —  (188) —  (188) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —  (4) (4) 
Balance as of June 30, 2018683  $683  148  $(8,485) $5,916  $14,484  $(3,756) $8,842  $(12) $8,830  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the six months ended June 30, 2018 sections above. Additionally, we recorded an adjustment to the opening balance of retained earnings on January 1, 2018 for the adoption of ASU No. 2016-16, which was impacted by our adjustments to equipment leased to customers under operating leases.


163


Baxter International Inc.
Consolidated Statement of Changes in Equity
(in millions)
For the Three Months Ended March 31, 2018
Baxter International Inc. stockholders' equity  
Common stock shares  Common stock  Common stock shares in treasury  Common stock in treasury  Additional contributed capital  Retained earningsAccumulated other comprehensive income (loss) Total Baxter stockholders' equityNoncontrolling interests  Total equity
As previously reported
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,483  $(4,001) $9,124  $(8) $9,116  
Adoption of new accounting standards—  —  —  —  —  (16) (3) (19) —  (19) 
Net income—  —  —  —  —  389  —  389  —  389  
Other comprehensive income (loss)—  —  —  —  —  —  128  128  —  128  
Purchases of treasury stock—  —   (522) —  —  —  (522) —  (522) 
Stock issued under employee benefit plans and other—  —  (3) 149  (28) (36) —  85  —  85  
Dividends declared on common stock—  —  —  —  —  (86) —  (86) —  (86) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of March 31, 2018683  $683  147  $(8,354) $5,912  $14,734  $(3,876) $9,099  $(6) $9,093  
Restatement impacts
Balance as of January 1, 2018—  $—  —  $—  $—  $(469) $462  $(7) $—  $(7) 
Adoption of new accounting standards—  —  —  —  —  (4) —  (4) —  (4) 
Net income—  —  —  —  —  (7) —  (7) —  (7) 
Other comprehensive income (loss)—  —  —  —  —  —  (13) (13) —  (13) 
Balance as of March 31, 2018—  $—  —  $—  $—  $(480) $449  $(31) $—  $(31) 
As restated
Balance as of January 1, 2018683  $683  142  $(7,981) $5,940  $14,014  $(3,539) $9,117  $(8) $9,109  
Adoption of new accounting standards—  —  —  —  —  (20) (3) (23) —  (23) 
Net income—  —  —  —  —  382  —  382  —  382  
Other comprehensive income (loss)—  —  —  —  —  —  115  115  —  115  
Purchases of treasury stock—  —   (522) —  —  —  (522) —  (522) 
Stock issued under employee benefit plans and other—  —  (3) 149  (28) (36) —  85  —  85  
Dividends declared on common stock—  —  —  —  —  (86) —  (86) —  (86) 
Changes in noncontrolling interests—  —  —  —  —  —  —  —    
Balance as of March 31, 2018683  $683  147  $(8,354) $5,912  $14,254  $(3,427) $9,068  $(6) $9,062  
See descriptions of the net income and other comprehensive income impacts in the consolidated statement of income and consolidated statement of comprehensive income for the three months ended March 31, 2018 sections above. Additionally, we recorded an adjustment to the opening balance of retained earnings on January 1, 2018 for the adoption of ASU No. 2016-16, which was impacted by our adjustments to equipment leased to customers under operating leases.

164


Baxter International Inc.
Condensed Consolidated Statement of Cash Flows
(in millions)
For the Six Months Ended June 30, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Cash flows from operations
Net income$690  $(35) $655  
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization393  (8) (c)(g) 385  
Deferred income taxes(55) (8) (c)(g) (63) 
Stock compensation57  —  57  
Net periodic pension benefit and other postretirement costs —   
Intangible asset impairment31  —  31  
Other34  10  (d) 44  
Changes in balance sheet items:
Accounts receivable, net(60) —  (60) 
Inventories(91) —  (91) 
Accounts payable and accrued liabilities(303)  (b) (299) 
Other(86) —  (e)(g) (86) 
Cash flows from operations - continuing operations617  (37) 580  
Cash flows from operations - discontinued operations(6) —  (6) 
Cash flows from operations611  (37) 574  
Cash flows from investing activities
Capital expenditures(352) 14  (c) (338) 
Acquisitions and investments, net of cash acquired(111) —  (111) 
Other investing activities, net —   
Cash flows from investing activities(462) 14  (448) 
Cash flows from financing activities
Issuances of debt1,661  —  1,661  
Cash dividends on common stock(198) —  (198) 
Proceeds from stock issued under employee benefit plans262  —  262  
Purchases of treasury stock(720) —  (720) 
Other financing activities, net(37) —  (37) 
Cash flows from financing activities968  —  968  
Effect of foreign exchange rate changes on cash and cash equivalents(24) 26  (a)(d)(e)  
Increase in cash and cash equivalents1,093   1,096  
Cash and cash equivalents at beginning of period1,832   (e) 1,838  
Cash and cash equivalents at end of period$2,925  $ (e) 2,934  



The $35 million decrease to net income was driven by the items described above in the consolidated statement of income for the six months ended June 30, 2019 section.

(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents of $33 million for the six months ended June 30, 2019.

(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in an increase to changes in accounts payable and accrued liabilities of $4 million for the six months ended June 30, 2019.

(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to depreciation and amortization of $7 million, deferred income taxes of $2 million and capital expenditures of $14 million for the six months ended June 30, 2019.

(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows - The corrections of these misstatements resulted in a decrease to the effect of foreign exchange rate changes on cash and cash equivalents and an increase to other adjustments to reconcile net income to net cash from operating activities of $10 million for the six months ended June 30, 2019.

(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars - The corrections of these misstatements resulted in an increase in cash and cash equivalents at the beginning of the period of $6 million, at the end of the period of $9 million and the effect of foreign exchange rate changes on cash and cash equivalents of $3 million and a decrease to other changes in balance sheet items of $1 million for the six months ended June 30, 2019.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in decreases to depreciation and amortization of $1 million and deferred income taxes of $6 million and an increase to other changes in balance sheet items of $1 million for the six months ended June 30, 2019.




Baxter International Inc.
Condensed Consolidated Statement of Cash Flows
(in millions)
For the Three Months Ended March 31, 2019
As previously reportedRestatement impactsRestatement referenceAs restated
Cash flows from operations
Net income$347  $(5) $342  
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization195  (3) (c) 192  
Deferred income taxes(6) —  (6) 
Stock compensation22  —  22  
Net periodic pension benefit and other postretirement costs —   
Other19  (5) (d) 14  
Changes in balance sheet items:
Accounts receivable, net32  —  32  
Inventories(82) —  (82) 
Accounts payable and accrued liabilities(333) (2) (b)(g) (335) 
Other(49)  (b)(e)(g) (48) 
Cash flows from operations - continuing operations148  (14) 134  
Cash flows from operations - discontinued operations(6) —  (6) 
Cash flows from operations142  (14) 128  
Cash flows from investing activities
Capital expenditures(198)  (c) (193) 
Acquisitions and investments, net of cash acquired(109) —  (109) 
Other investing activities, net —   
Cash flows from investing activities(306)  (301) 
Cash flows from financing activities
Net increases in debt obligations with original maturities of three months of less795  —  795  
Cash dividends on common stock(101) —  (101) 
Proceeds from stock issued under employee benefit plans173  —  173  
Purchases of treasury stock(597) —  (597) 
Other financing activities, net(32) —  (32) 
Cash flows from financing activities238  —  238  
Effect of foreign exchange rate changes on cash and cash equivalents (3) (a)(d)(e) (1) 
Increase (decrease) in cash and cash equivalents76  (12) 64  
Cash and cash equivalents at beginning of period1,832   (e) 1,838  
Cash and cash equivalents at end of period$1,908  $(6) (e) 1,902  







The $5 million decrease to net income was driven by the items described above in the consolidated statement of income for the three months ended March 31, 2019 section.

(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents of $4 million for the three months ended March 31, 2019.

(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in a decrease to changes in accounts payable and accrued liabilities of $1 million and an increase in other changes in balance sheet items of $1 million for the three months ended March 31, 2019.

(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to depreciation and amortization of $3 million and capital expenditures of $5 million for the three months ended March 31, 2019.

(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows - The corrections of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents and a decrease to other adjustments to reconcile net income to net cash from operating activities of $5 million for the three months ended March 31, 2019.

(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars - The corrections of these misstatements resulted in an increase in cash and cash equivalents at the beginning of the period of $6 million and decreases to other changes in balance sheet items of $1 million, cash and cash equivalents at the end of the period of $6 million and the effect of foreign exchange rate changes on cash and cash equivalents of $12 million for the three months ended March 31, 2019.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in an increase to other changes in balance sheet items of $1 million and a decrease in changes in accounts payable and accrued liabilities of $1 million for the three months ended March 31, 2019.



Baxter International Inc.
Condensed Consolidated Statement of Cash Flows
(in millions)
For the Six Months Ended June 30, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Cash flows from operations
Net income$732  $(9) $723  
Adjustments to reconcile income from continuing operations to net cash from operating activities:
Depreciation and amortization387  (5) (c) 382  
Deferred income taxes(51) —  (c)(g) (51) 
Stock compensation54  —  54  
Net periodic pension benefit and other postretirement costs21  —  21  
Other10  (10) (d) —  
Changes in balance sheet items:
Accounts receivable, net43  —  43  
Inventories(134) —  (134) 
Accounts payable and accrued liabilities(126)  (b) (124) 
Other(84)  (e) (82) 
Cash flows from operations852  (20) 832  
Cash flows from investing activities
Capital expenditures(311)  (c) (303) 
Acquisitions and investments, net of cash acquired(228) —  (228) 
Cash flows from investing activities(539)  (531) 
Cash flows from financing activities
Cash dividends on common stock(173) —  (173) 
Proceeds from stock issued under employee benefit plans170  —  170  
Purchases of treasury stock(781) —  (781) 
Other financing activities, net(24) —  (24) 
Cash flows from financing activities(808) —  (808) 
Effect of foreign exchange rate changes on cash and cash equivalents(42)  (a)(d)(e) (38) 
Decrease in cash and cash equivalents(537) (8) (545) 
Cash and cash equivalents at beginning of period3,394   (e) 3,403  
Cash and cash equivalents at end of period$2,857  $ (e) 2,858  




The $9 million decrease to net income was driven by the items described above in the consolidated statement of income for the six months ended June 30, 2018 section.

(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents of $2 million for the six months ended June 30, 2018.

(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in an increase to changes in accounts payable and accrued liabilities of $2 million for the six months ended June 30, 2018.

(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to depreciation and amortization of $5 million, deferred income taxes of $1 million and capital expenditures of $8 million for the six months ended June 30, 2018.

(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows - The corrections of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents and a decrease to other adjustments to reconcile net income to net cash from operating activities of $10 million for the six months ended June 30, 2018.

(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars - The corrections of these misstatements resulted in increases in other changes in balance sheet items of $2 million, cash and cash equivalents at the beginning of the period of $9 million and at the end of the period of $1 million and a decrease to the effect of foreign exchange rate changes on cash and cash equivalents of $8 million for the six months ended June 30, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in an increase to deferred income taxes of $1 million for the six months ended June 30, 2018.



Baxter International Inc.
Condensed Consolidated Statement of Cash Flows
(in millions)
For the Three Months Ended March 31, 2018
As previously reportedRestatement impactsRestatement referenceAs restated
Cash flows from operations
Net income$389  $(7) $382  
Adjustments to reconcile income from continuing operations to net cash from operating activities:
Depreciation and amortization192  (2) (c) 190  
Deferred income taxes(33) (5) (g) (38) 
Stock compensation20  —  20  
Net periodic pension benefit and other postretirement costs10  —  10  
Other (3) (d) (1) 
Changes in balance sheet items:
Accounts receivable, net76  —  76  
Inventories(56) —  (56) 
Accounts payable and accrued liabilities(120)  (b)(g) (119) 
Other(33) (1) (b)(e) (34) 
Cash flows from operations447  (17) 430  
Cash flows from investing activities
Capital expenditures(155)  (c) (152) 
Acquisitions and investments, net of cash acquired(219) —  (219) 
Cash flows from investing activities(374)  (371) 
Cash flows from financing activities
Cash dividends on common stock(87) —  (87) 
Proceeds from stock issued under employee benefit plans82  —  82  
Purchases of treasury stock(522) —  (522) 
Other financing activities, net(18) —  (18) 
Cash flows from financing activities(545) —  (545) 
Effect of foreign exchange rate changes on cash and cash equivalents25   (a)(d)(e) 32  
Decrease in cash and cash equivalents(447) (7) (454) 
Cash and cash equivalents at beginning of period3,394   (e) 3,403  
Cash and cash equivalents at end of period$2,947  $ (e) 2,949  



The $7 million decrease to net income was driven by the items described above in the consolidated statement of income for the three months ended March 31, 2018 section.

(a) Foreign Currency Denominated Monetary Assets and Liabilities—The correction of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents of $11 million for the three months ended March 31, 2018.

(b) Foreign Currency Derivative Contracts—The correction of these misstatements resulted in a decrease to changes in accounts payable and accrued liabilities of $1 million and an increase to other changes in balance sheet items of $2 million for the three months ended March 31, 2018.

(c) Equipment Leased to Customers under Operating Leases—The correction of these misstatements resulted in decreases to depreciation and amortization of $2 million and capital expenditures of $3 million for the three months ended March 31, 2018.

(d) Classification of Foreign Currency Gains and Losses in our Consolidated Statements of Cash Flows - The corrections of these misstatements resulted in an increase to the effect of foreign exchange rate changes on cash and cash equivalents and a decrease to other adjustments to reconcile net income to net cash from operating activities of $3 million for the three months ended March 31, 2018.

(e) Translation of the Financial Position and Results of Operations of our Foreign Operations into U.S. Dollars - The corrections of these misstatements resulted in increases in cash and cash equivalents at the beginning of the period of $9 million and at the end of the period of $2 million and decreases to other changes in balance sheet items of $3 million and the effect of foreign exchange rate changes on cash and cash equivalents of $7 million for the three months ended March 31, 2018.
(g) Other miscellaneous adjustments - The correction of these misstatements resulted in a decrease to deferred income taxes of $5 million and an increase to changes in accounts payable and accrued liabilities of $2 million for the three months ended March 31, 2018.



Report of Independent Registered Public Accounting Firm


To the Board of Directors and Stockholders of Baxter International Inc.


Opinions on the Financial Statements and Internal Control over Financial Reporting

We have audited the accompanying consolidated balance sheets of Baxter International Inc. and its subsidiaries (the “Company”) as of December 31, 20192021 and 2018,2020, and the related consolidated statements of income, of comprehensive income, of changes in equity and of cash flows for each of the three years in the period ended December 31, 2019,2021, including the related notes and financial statement schedule listed in the index appearing under Item 15(2)15 (2) (collectively referred to as the “consolidated financial statements”). We also have audited the Company's internal control over financial reporting as of December 31, 2019,2021, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 20192021 and 2018,2020, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 20192021 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company did not maintain,maintained, in all material respects, effective internal control over financial reporting as of December 31, 2019,2021, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO because a material weakness in internal control over financial reporting existed as of that date related to the accounting for certain foreign exchange gains and losses arising from intra-company transactions.

A material weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a material misstatement of the annual or interim financial statements will not be prevented or detected on a timely basis. The material weakness referred to above is described in Management’s Assessment of Internal Control Over Financial Reporting appearing under Item 9A. We considered this material weakness in determining the nature, timing, and extent of audit tests applied in our audit of the 2019 consolidated financial statements, and our opinion regarding the effectiveness of the Company’s internal control over financial reporting does not affect our opinion on those consolidated financial statements.

Restatement of Previously Issued Financial Statements

As discussed in Note 2 to the consolidated financial statements, the Company has restated its 2018 and 2017 financial statements to correct misstatements.

Change in Accounting Principle

As discussed in Note 1 to the consolidated financial statements, the Company changed the manner in which it accounts for leases in 2019.


COSO.
Basis for Opinions

The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in management's report referred to above.Management's Assessment of Internal Control Over Financial Reporting appearing under Item 9A. Our responsibility is to express opinions on the Company’s consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects.

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Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.


As described in Management's Assessment of Internal Control Over Financial Reporting, management has excluded Hill-Rom Holdings, Inc. (Hillrom) from its assessment of internal control over financial reporting as of December 31, 2021 because it was acquired by the Company in a purchase business combination during 2021. We have also excluded Hillrom from our audit of internal control over financial reporting. Hillrom is a wholly-owned subsidiary whose total assets and total revenues excluded from management’s assessment and our audit of internal control over financial reporting represent approximately 6% and 2%, respectively, of the related consolidated financial statement amounts as of and for the year ended December 31, 2021.
Definition and Limitations of Internal Control over Financial Reporting

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable
106


assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.


Critical Audit Matters

The critical audit matters communicated below are matters arising from the current period audit of the consolidated financial statements that were communicated or required to be communicated to the audit committee and that (i) relate to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matters below, providing a separate opinionsopinion on the critical audit matters or on the accounts or disclosures to which they relate.

Foreign exchange gains and losses

As described in Notes 2 and 5 to the consolidated financial statements, on October 24, 2019, the Company reported that it had commenced an internal investigation into certain intra-Company transactions that impacted the Company’s previously reported non-operating foreign exchange gains and losses. As further disclosed by management, certain intra-Company transactions were undertaken, after the related exchange rates were already known, solely for the purpose of generating non-operating foreign exchange gains or avoiding foreign exchange losses. In connection with the internal investigation, the Company identified misstatements relating to foreign currency denominated monetary assets and liabilities and foreign currency derivative contracts that caused Other income (expense), net and Income from continuing operations before income taxes to be overstated by $59 million and $113 million, respectively, for the years ended December 31, 2018 and 2017 and the Company has restated its consolidated financial statements as of December 31, 2018 and for the years ended December 31, 2018 and 2017 to correct misstatements to the Company’s previously reported foreign exchange gains and losses. The quantification of misstatements to the previously reported foreign exchange gains and losses was not limited to intra-Company transactions undertaken for the purpose of generating foreign exchange gains or avoiding foreign exchange losses after the related exchange rates were already known. Rather, management identified every legal entity within the Company’s consolidated group that had foreign exchange gains or losses above an immaterial threshold and for those entities management remeasured all foreign exchange gains and losses from foreign currency denominated cash balances and intra-company loan receivables and payables using the exchange rates required by U.S. GAAP. Management also quantified misstatements to its previously reported gains and losses on
174


foreign currency derivative contracts, which used foreign exchange rates determined under its historical exchange rate convention as inputs to the fair value measurements of those contracts. The Company recorded foreign exchange losses, net, of $37 million for the year ended December 31, 2019.

The principal considerations for our determination that performing procedures relating to foreign exchange gains and losses is a critical audit matter are a high degree of auditor judgment and subjectivity was necessary to evaluate the audit evidence obtained related to the Company’s internal investigation into certain intra-Company transactions that impacted the Company’s non-operating foreign exchange gains and losses, significant audit effort was necessary to evaluate the audit evidence relating to the foreign exchange gains and losses, and the audit effort involved the use of professionals with specialized skill and knowledge to assist in performing these procedures and evaluating the audit evidence obtained from these procedures. As described in the “Opinions on the Financial Statements and Internal Control over Financial Reporting” section, a material weakness was identified related to this matter.

Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These proceduresincluded, among others, evaluating the scope and extent of management’s quantification of the misstatements of foreign exchange gains and losses, testing management’s calculation of the misstatements of foreign exchange gains and losses, agreeing foreign exchange rates used by management to third party sources, and agreeing a sample of foreign currency denominated cash balances, intra-Company loan receivables and payables, and foreign currency derivative contracts to source documents. Professionals with specialized skill and knowledge were used to assist in evaluating the audit evidence related to the scope and extent of management’s quantification of the misstatements of foreign exchange gains and losses.

Valuation AllowancesAllowance on United States (U.S.) Foreign Tax Credit Carryforwards and Swiss Deferred Tax Assets

As described in Note 14Note 13 to the consolidated financial statements, as of December 31, 2019,2021, the Company has $1,707$1,462 million of total deferred tax assets, including $395$339 million of deferred tax assets for U.S. foreign tax credit carryforwards in the United States and $159 million of Swiss deferred tax assets which were established for a step-up in tax basis that resulted from the enactment of new tax laws in Switzerland during 2019.States. The deferred tax assets for U.S. foreign tax credit carryforwards and Swiss deferred tax assets areis partially offset by a valuation allowance of $98 million. As disclosed by management, valuation allowances of $180 million and $69 million, respectively. Management maintains valuation allowancesare maintained unless it is more likely than not that all or a portion of the deferred tax asset will be realized. In determining whether a valuation allowance is warranted, management evaluates factors such as prior earnings history, expected future earnings, carryback and carryforward periods, and tax strategies that could potentially enhance the likelihood of realization of a deferred tax asset. After evaluating the 2017 Tax Act and related U.S. Treasury Regulations, any elections or other opportunities that may be available, and the future expiration of certain U.S. tax provisions that will impact the utilization of the Company’s U.S. foreign tax credit carryforwards, management expects to be able to realize some, but not all, of the U.S. foreign tax credit deferred tax assets up to its overall domestic loss balance plus other recurring and non-recurring foreign inclusions. With regards to the Swiss deferred tax assets, management expects to realize some, but not all, of the Swiss deferred tax assets based principally on expected future earnings generated by the Swiss subsidiary during the period in which the tax basis may be amortized.

The principal considerations for our determination that performing procedures relating to the valuation allowancesallowance on U.S. foreign tax credit carryforwards and Swiss deferred tax assets is a critical audit matter are the significant judgment by management when developing assumptionsassessing factors related to expected future earnings, which in turn led to a high degree of auditor judgment, subjectivity, and audit effort in performing procedures and evaluating audit evidence related to management’s expected future earnings.

175


Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls over the valuation allowancesallowance on U.S. foreign tax credit carryforwards, and Swiss deferred tax assets, including controls over the development of assumptions related to expected future earnings. These procedures also included, among others, evaluating management’s assessment of the realizability of the deferred tax assets, including evaluating the reasonableness of assumptions relating to expected future earnings during the applicable periods. Evaluating management’s assumptionsassumption related to expected future earnings involved evaluating whether the assumptions used by management related to expected future earningsfactors were reasonable considering the current and past performance of the Company and evidence obtained in other areas of the audit.
Valuation of Certain Acquired Intangible Assets - Hill-Rom Holdings, Inc. (Hillrom) Acquisition
As described in Note 2 to the consolidated financial statements, on December 13, 2021, the Company acquired all of the outstanding equity interests of Hillrom for a purchase price of $10.5 billion. Management allocated $804 million of the total consideration to the developed technology with a weighted-average useful life of 5 years, $1.9 billion to trade names with an indefinite useful life, and $3.2 billion to customer relationships with a weighted-average useful life of 15 years. The fair values of the intangible assets were determined using the income approach. Significant estimates and assumptions were used by management in establishing the estimated fair value. As disclosed by management, the significant estimates and assumptions inherent in a discounted cash flow analysis (income approach) include the amount and timing of projected future cash flows, the discount rate used to measure the risks inherent in the future cash flows, the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and customer attrition rates. Each of these factors and assumptions can significantly affect the value of the intangible asset.
107


The principal considerations for our determination that performing procedures relating to the valuation of certain acquired intangible assets in connection with the Hillrom acquisition is a critical audit matter are (i) the significant judgment by management when developing the fair value of the developed technology, trade names and customer relationships intangible assets; (ii) a high degree of auditor judgment, subjectivity and effort in performing procedures and evaluating management’s significant assumptions related to the amount and timing of future projected cash flows for each of the aforementioned intangible assets, the royalty rates for the developed technology and trade names intangible assets, the attrition rates, discount rate and contributory asset charges for the customer relationships intangible asset, and the asset’s life cycle and discount rate for the trade names intangible asset; and (iii) the audit effort involved the use of professionals with specialized skill and knowledge.
Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls relating to acquisition accounting, including controls over management’s valuation of the intangible assets and controls over the development of the assumptions related to the amount and timing of projected future cash flows, the discount rates, the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and customer attrition rates. These procedures also included, among others, (i) reading the purchase agreement, and (ii) testing management’s process for estimating the fair value of intangible assets. Testing management’s process included (i) evaluating the appropriateness of the income approaches used to fair value the intangible assets, (ii) testing the completeness and accuracy of data provided by management, and (iii) evaluating the reasonableness of the significant assumptions related to the amount and timing of projected future cash flows, the discount rates, the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and customer attrition rates. Evaluating management’s assumptions involved evaluating whether the assumptions used were consistentreasonable considering current and past performance of the acquired entity, consistency with external market and industry data, and consistency with evidence obtained in other areas of the audit.audit, as applicable. Professionals with specialized skill and knowledge were used to assist in the evaluation of management’s income approaches and the discount rates, the asset’s life cycle, royalty rates, terminal growth rate, contributory asset charges, and customer attrition rates assumptions.




/s/ PricewaterhouseCoopers LLP
Chicago, Illinois
March 17, 2020February 23, 2022

We have served as the Company’s auditor since 1985.
108
176


Item 9.    Changes in and Disagreements with Accountants on Accounting and Financial Disclosure.
None.
Item 9A.    Controls and Procedures.
Evaluation of Disclosure Controls and Procedures

We have established disclosure controls and procedures that are designed to ensure that information required to be disclosed by us in the reports that we file or submit under the Securities Exchange Act of 1934 (the Exchange Act) is recorded, processed, summarized and reported within the time periods specified in the rules and forms of the SEC, and that such information is communicated to our management, including our Chief Executive Officer and Chief Financial Officer, to allow timely decisions regarding required disclosure. Our management, with the participation of our Chief Executive Officer and our Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended (the Exchange Act)) as of December 31, 2019.

2021. Based on that evaluation, Chief Executive Officer and our Chief Financial Officer concluded that, as of December 31, 2019, due to the material weakness in our internal control over financial reporting described below, our disclosure controls and procedures were not effective to provide reasonable assurance that the information we are required to disclose in the reports that we file or submit under the Exchange Act is recorded, processed, summarized, and reported within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective as appropriate, to allow timely decisions regarding required disclosure.of December 31, 2021.
Management’s Assessment of Internal Control Over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as defined in Rule 13a-15(f) of the Exchange Act. Our internal control over financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP).

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with policies may deteriorate.

Management performed an assessment of the effectiveness of our internal control over financial reporting as of December 31, 2019.2021. In making this assessment, management used the framework in Internal Control-Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on that assessment under the framework in Internal Control-Integrated Framework (2013), management concluded that our internal control over financial reporting was not effective as of December 31, 2019.2021.

A material weakness is a deficiency, or a combinationIn December 2021, Baxter acquired 100 percent of deficiencies,the voting equity interest in Hillrom. As permitted by guidance issued by the SEC, management has excluded the internal controls of Hillrom from its annual assessment of the effectiveness of our internal control over financial reporting such that therefor December 31, 2021. Hillrom is a reasonable possibility that a material misstatementwholly-owned subsidiary whose total assets and total revenues excluded from management’s assessment of our annual or interiminternal control over financial statements would not be prevented or detected on a timely basis.

We did not maintain effective controls overreporting represent approximately 6% and 2%, respectively, of the accounting for certain foreign exchange gains and losses. Specifically, we did not have controls in place to monitor and quantify the difference between the foreign exchange gains and losses that we reported and the foreign exchange gains and losses that we would have reported using exchange rates determined in accordance with U.S. GAAP. Additionally, our policies and controls related to approvals and monitoring of intra-company transactions were insufficient to prevent or detect intra-company transactions undertaken solely for the purpose of generating foreign exchange gains or avoiding losses under our historical exchange rate convention. This material weakness resulted in the restatement of our consolidated financial statementsstatement amounts as of December 31, 2018 and for the years ended December 31, 2018 and 2017 and each of the quarterly and year-to-date periods in the year ended December 31, 2018 and the first two quarters and related year-to-date interim period in the year ended December 31, 2019. Additionally, this material weakness could result in a misstatement of the aforementioned account balances or disclosures that would result in a material misstatement to the annual or interim consolidated financial statements that would not be prevented or detected.2021.

Because of this material weakness, management concluded that we did not maintain effective internal control over financial reporting as of December 31, 2019.

177


The effectiveness of our internal control over financial reporting as of December 31, 20192021 has been audited by PricewaterhouseCoopers LLP, an independent registered public accounting firm, as stated in their report which appears herein.

Remediation of the Material Weakness

Management has been implementing changes to strengthen our internal controls over the accounting for foreign exchange gains and losses. These changes are intended to address the identified material weakness and enhance our overall control environment and include the ongoing activities described below.

Exchange Rate Policy – We have discontinued the use of our historical exchange rate convention and are using the exchange rates determined in accordance with U.S. GAAP for purposes of measuring foreign currency transactions and remeasuring monetary assets and liabilities denominated in a foreign currency.
Automated Feed – We have implemented an automated feed that extracts foreign exchange rates on a daily basis from a recognized third-party exchange rate source.
Daily Rate Comparison – We have implemented a daily rate comparison control that extracts foreign exchange rates from (a) a third-party exchange rate source, (b) our treasury application, and (c) our enterprise resource planning (ERP) system and compares those rates in order to identify any potential differences and provide assurance that the correct rates were captured and are being used in our financial systems.
Intra-company Transaction Approvals – We have updated our policies to require additional approvals of intra-company transactions and implemented a requirement that such transactions be supported by a documented business purpose.
Personnel - We have made personnel changes including hiring a new treasurer from outside Baxter with more than thirty years of treasury experience and responsibility, including at four publicly traded companies. We have also hired another experienced treasury professional in a newly created director role responsible for treasury governance and controls. Additionally, we have created a treasury controller role within our accounting function and are continuing to add resources as appropriate to improve our financial reporting controls related to treasury activities.

While we believe that the above actions will ultimately remediate the material weakness, we intend to continue to refine those controls and monitor their effectiveness for a sufficient period of time prior to reaching any determination as to whether the material weakness has been remediated.

Notwithstanding the identified material weakness, management believes that the consolidated financial statements included in this Annual Report on Form 10-K present fairly, in all material respects, our financial position, results of operations, and cash flows as of and for the periods presented in accordance with U.S. GAAP.

Changes in Internal Control overOver Financial Reporting
As previously disclosed,
During the three months ended December 31, 2021, we are currently implementing an upgrade to our ERP software.implemented the first phase of a new global treasury management system supporting cash management, external debt, and risk management processes. In connectionconjunction with the ERP upgrade,implementation, we are updatingmodified business processes impacted by the processes that constitute our internal control over financial reporting,new system, such as necessary. This normal course of business ERP upgrade is being implemented to remain current withtransaction processing, user access security, authorization procedures and system reporting. In subsequent periods, the latest releaseremaining phases of the software.
As previously disclosed, since 2017, we have been implementing a long-term business transformation project within the finance, human resources, purchasing and information technology functions which will further centralize and standardize business processes and systems across the company.  We are transitioning some processes to our shared services centers while others have been moved to outsourced providers.  This multi-year initiativetreasury management system will be conducted in phases and include modifications to the design and operation of controls over financial reporting.implemented.

Other than as described in the two preceding paragraphs and in the Remediation of Material Weakness section above,paragraph, there have been no changes in our internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) during the quarter ended December 31, 20192021 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
109


Item 9B.    Other Information.

New Almeida Offer LetterNone.
Item 9C.    Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.

178


On March 12, 2020, Baxter entered into a new offer letter with Mr. Almeida that replaced his prior offer letter. The terms of the new offer letter will be effective until December 31, 2023. Under the new letter, Mr. Almeida will continue to serve as Chairman of the Board and President and Chief Executive Officer of the Company. Mr. Almeida’s base salary will remain $1,300,000 per annum. His target bonus and target long-term incentive opportunity were increased starting in 2020 commensurate with such compensation elements for Chief Executive Officers in Baxter’s peer group. Specifically, Mr. Almeida’s target bonus opportunity was increased from 145% of base salary to 165% of base salary, and his long-term incentive opportunity was increased from $10,000,000 to $11,000,000. Mr. Almeida remains eligible to receive benefits to the same extent and on the same terms as those benefits provided to other senior executives. The offer letter also continues to provide Mr. Almeida with the right to receive cash severance equal to two years’ base salary and target bonus in the event of an involuntary termination without cause or termination with good reason prior to December 31, 2023. In addition, beginning with Mr. Almeida’s 2020 equity award grants and for all future annual equity awards granted through the end of 2023, Mr. Almeida will be eligible to receive Baxter’s equity award retirement treatment when he attains 60 years of age (as opposed to 65 years of age), which will provide for continued vesting of his stock option and PSU awards and a longer period of time to exercise his outstanding stock options upon his retirement.Not Applicable.

In addition to these benefits, in accordance with the terms of his change of control agreement, Mr. Almeida remains eligible for certain payments in the event of his termination for good reason or termination without cause following a change in control. Mr. Almeida is also subject to certain restrictive covenants, including non-competition, non-solicitation of customers, suppliers and employees and non-disparagement.

The foregoing summary does not purport to be complete and is qualified in its entirety by reference to the full text of the offer letter, which is filed as Exhibit 10.23 to this Annual Report on Form 10-K and is incorporated into this filing by reference.
PART III
Item 10.    Directors, Executive Officers and Corporate Governance.
Refer to information under the captions entitled “Corporate Governance at Baxter International Inc. — Proposal 1 — Election of Directors,” “— Directors Continuing in Office,” “— Board of Directors — Nomination of Directors,” “— Committees of the Board — Audit Committee,” “— Board Responsibilities — Code of Conduct,” and “Ownership of OurBaxter Stock — Delinquent Section 16(a) Beneficial Ownership Reporting Compliance”Reports” in Baxter’s definitive proxy statement to be filed with the Securities and Exchange Commission and delivered to stockholders in connection with the Annual Meeting of Stockholders expected to be held on May 5, 20203, 2022 (the Proxy Statement), all of which information is incorporated herein by reference. Also refer to information regarding executive officers of Baxter under the caption entitled “Executive Officers of the Registrant” in Part I of this Annual Report on Form 10-K.
Item 11.    Executive Compensation.
Refer to information under the captions entitled “Executive Compensation,” and “Corporate Governance at Baxter International—International Inc.—Director Compensation” in the Proxy Statement, all of which information is incorporated herein by reference.
Item 12.    Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.
The following table provides information relating to shares of common stock that may be issued under our existing equity compensation plans as of December 31, 2019.
179


2021.
Plan CategoryPlan CategoryNumber of Shares
to be Issued upon
Exercise of
Outstanding
Options,
Warrants and
Rights(a)
Weighted-Average
Exercise Price of
Outstanding
Options, Warrants
and Rights(b)
Number of Shares
Remaining
Available for
Future Issuance
Under Equity
Compensation Plans
(Excluding
Shares Reflected in
Column(a)(b))
Plan CategoryNumber of Shares
to be Issued upon
Exercise of
Outstanding
Options,
Warrants and
Rights(a)
Weighted-Average
Exercise Price of
Outstanding
Options, Warrants
and Rights(b)
Number of Shares
Remaining
Available for
Future Issuance
Under Equity
Compensation Plans
(Excluding
Shares Reflected in
Column(a)(b))
Equity Compensation Plans Approved by
Stockholders
Equity Compensation Plans Approved by
Stockholders
22,507,640  (1) $51.08  (2) 23,664,836  (3) 
Equity Compensation Plans Approved by
Stockholders
22,591,682 (1)$61.14 (2)51,437,515 (3)
Equity Compensation Plans Not Approved by
Stockholders
Equity Compensation Plans Not Approved by
Stockholders
86,227  (4) $28.97  —  
Equity Compensation Plans Not Approved by
Stockholders
667,640 (4)$— — 
TotalTotal22,593,867  (5) $50.99  (2) 23,664,836  Total23,259,322 (5)$61.14 (2)51,437,515 
(1)Excludes purchase rights under the Employee Stock Purchase Plan. Under the Employee Stock Purchase Plan, eligible employees may purchase shares of common stock through payroll deductions of up to 15 percent of base pay at a purchase price equal to 85 percent of the closing market price on the purchase date (as defined by the Employee Stock Purchase Plan). A participating employee may not purchase more than $25,000 in fair market value of common stock under the Employee Stock Purchase Plan in any calendar year and may withdraw from the Employee Stock Purchase Plan at any time.
(2)Restricted stock units and performance share units are excluded when determining the weighted-average exercise price of outstanding options.
(3)Includes (i) 2,702,38111,263,584 shares of common stock available for purchase under the Employee Stock Purchase Plan;Plan and (ii) 427,68240,173,931 shares of common stock available under the 2007 Incentive Plan; (iii) 8,597,492 shares of common stock available under the 2011 Incentive Plan; and (iv) 11,937,281 shares of common stock available under the 20152021 Incentive Plan.
(4)Includes shares667,640 replacement RSUs granted to holders of common stock issuable upon exerciseHillrom equity awards at closing of options granted under the 2001 Incentive Compensation Program.Hillrom acquisition. These shares were made available pursuant to an amendment thereto not approved by stockholders. These additional sharesreplacement RSUs were approved by our Board of Directors, not our stockholders, although our stockholders have approved the 2001 Incentive Compensation Program.stockholders.
110


(5)Includes outstanding awards of 20,343,69920,696,747 stock options, which have a weighted-average exercise price of $50.99$61.14 and a weighted-average remaining term of 6.15.9 years, 1,274,4361,797,696 shares of common stock issuable upon vesting of restricted stock units, and 929,665731,651 shares of common stock reserved for issuance in connection with performance share unit grants.
Refer to information under the captions entitled “Ownership of OurBaxter Stock — Security Ownership by Directors and Executive Officers” and “— Security Ownership by Certain Beneficial Owners” in the Proxy Statement, all of which information is incorporated herein by reference.
Item 13.    Certain Relationships and Related Transactions, and Director Independence.
Refer to the information under the first paragraph of the caption entitled “Corporate Governance—at Baxter International Inc.—Board of Directors” and the captions entitled “Corporate Governance at Baxter International Inc.—Board of Directors—Director Independence” and “Corporate Governance at Baxter International Inc.—Other Corporate Governance Information—Certain Relationships and Related Person Transactions” in the Proxy Statement, all of which information is incorporated herein by reference.
Item 14.    Principal Accountant Fees and Services.
Refer to the information under the caption entitled “Audit Matters — Audit and Non-Audit Fees” and “—Pre-Approval of Audit and Permissible Non-Audit Fees” in the Proxy Statement, all of which information is incorporated herein by reference.

PART IV
Item 15.    Exhibits and Financial Statement Schedules.Schedules
The following documents are filed as a part of this report:
180


Page
Number
(1)Financial Statements:
4948 
5049 
5150 
5251 
5352 
54 
173105 
(2)Schedules required by Article 12 of Regulation S-X:
188117 
All other schedules have been omitted because they are not applicable or not required.
(3)Exhibits required by Item 601 of Regulation S-K are listed in the Exhibit Index, which is incorporated herein by reference. Exhibits in the Exhibit Index marked with a “C” in the left margin constitute management contracts or compensatory plans or arrangements contemplated by Item 15(b) of Form 10-K.

Item 16.    Form 10-K Summary.
Not applicable.
111
181


EXHIBIT INDEX
Number and Description of Exhibit
2.1
2.2
3.1
3.2
3.3
4.1(P)Form of Common Stock Certificate of the Company (incorporated by reference to Exhibit(a) to the Company’s Registration Statement on Form S-16 (Registration No. 02-65269), filed on August 17, 1979).
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9* 4.9
10.1
10.2 4.10
10.3* 

182112


Number and Description of Exhibit
10.4 4.11
4.12
4.13
4.14
10.5 4.15
10.6 4.16
10.7* 
10.8* 
10.9 10.1


10.10 10.2
10.3
10.4
10.5
10.11 10.6
10.12 
C 10.1310.7
10.1410.8
1
113


Number and Description of Exhibit
10.1510.9
10.1610.10
 
10.1710.11
10.1810.12
  
10.1910.13
  
10.2010.14
  
183


Number and Description of Exhibit
C 10.2110.15
C 10.22*10.16

C 10.2310.17
C 10.18*
  
10.2410.19
10.25*10.20
  
C 10.26*10.21

C 10.22
10.2710.23
 
10.2810.24
 
C 10.2910.25
10.3010.26
  
10.3110.27
114


Number and Description of Exhibit
C 10.32*10.28R
10.3310.29
10.34*10.30
10.35*10.31
10.36*10.32
10.3710.33
10.3810.34
C 10.35
C 10.36
C 10.37
C 10.38
C 10.39
C 10.40
21*
 
23*
 
31.1*
 
31.2*
 
184


Number and Description of Exhibit
32.1*
 
32.2*
115


Number and Description of Exhibit
  
101.INS*XBRL Instance Document
101.SCH*XBRL Taxonomy Extension Schema Document
101.CAL*XBRL Taxonomy Extension Calculation Linkbase Document
101.LAB*XBRL Taxonomy Extension Label Linkbase Document
101.PRE*XBRL Taxonomy Extension Presentation Linkbase Document
101.DEF*XBRL Taxonomy Extension Definition Linkbase Document

*    Filed herewith.
*R    Filed herewith withIncludes redactions.
C    Management contract or compensatory plan or arrangement.
(P)Paper exhibit
116
185


SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
BAXTER INTERNATIONAL INC.
By:/s/ José E. Almeida
José E. Almeida
Chairman and Chief Executive Officer
DATE: March 17, 2020February 23, 2022
Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities indicated on March 17, 2020.
186


February 23, 2022.
SignatureTitle
 
/s/ José E. AlmeidaChairman and Chief Executive Officer
José E. Almeida(principal executive officer)
 
/s/ James K. SaccaroExecutive Vice President and Chief Financial Officer
James K. Saccaro(principal financial officer)
 
/s/ Brian C. StevensSenior Vice President, Chief Accounting Officer and Controller
Brian C. Stevens(principal accounting officer)
 
/s/ Thomas F. ChenDirector
Thomas F. Chen 
 
/s/ John D. ForsythDirector
John D. Forsyth 
 
/s/ James R. Gavin III, M.D., Ph.D.Director
James R. Gavin III, M.D., Ph.D.
/s/ Peter S. HellmanDirector
Peter S. Hellman 
 
/s/ Michael F. MahoneyDirector
Michael F. Mahoney 
 
/s/ Patricia B. MorrisonDirector
Patricia B. Morrison 
  
/s/ Stephen N. Oesterle, M.D.Director
Stephen N. Oesterle, M.D. 
  
/s/ Nancy SchlichtingDirector
Nancy M. Schlichting
/s/ Cathy R. SmithDirector
Cathy R. Smith 
  
/s/ Thomas T. StallkampDirector
Thomas T. Stallkamp 
 
/s/ Albert P. L. StrouckenDirector
Albert P. L. Stroucken 
 
/s/ Amy A. WendellDirector
Amy A. Wendell
/s/ David S. Wilkes, M.D.Director
David S. Wilkes, M.D.

187117


SCHEDULE II – Qualifying and Valuation accounts for each of the three years in the period ended December 31, 2019
Additions
Valuation and Qualifying Accounts (in millions)Balance at
beginning
of period
Charged to
costs and
expenses
(Credited)
charged
to other
accounts (1)
DeductionsBalance at
end of
period
Year ended December 31, 2019:
Allowance for doubtful accounts$110  18  (8) (8) $112  
Deferred tax asset valuation allowance$310  117  —  (7) $420  
Year ended December 31, 2018:
Allowance for doubtful accounts$120   (7) (7) $110  
Deferred tax asset valuation allowance (as restated)$483  20  (4) (189) $310  
Year ended December 31, 2017:
Allowance for doubtful accounts$127    (19) $120  
Deferred tax asset valuation allowance$150  350  —  (17) $483  
2021
Additions
Valuation and Qualifying Accounts (in millions)Balance at
beginning
of period
AcquisitionCharged to
costs and
expenses
(Credited)
charged
to other
accounts (1)
DeductionsBalance at
end of
period
Year ended December 31, 2021:
Allowance for doubtful accounts$125 13 (2)(9)(5)$122 
Deferred tax asset valuation allowance$454 38 37 (30)(98)$401 
Year ended December 31, 2020:
Allowance for doubtful accounts$112 — 11 (4)$125 
Deferred tax asset valuation allowance$420 — 77 26 (69)$454 
Year ended December 31, 2019:
Allowance for doubtful accounts$110 — 12 (2)(8)$112 
Deferred tax asset valuation allowance$310 — 117 — (7)$420 

(1)Valuation accountsIncludes the adoption of acquired or divested companiesa new accounting pronouncement as of January 1, 2020 and foreign currency translation adjustments.
Reserves are deducted from assets to which they apply.
188118