EXHIBIT 99.3
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Item 8. | Financial Statements and Supplementary Data |
HCA INC.
INDEX TO CONSOLIDATED FINANCIAL STATEMENTS
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Consolidated Financial Statements: | | | | |
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| | | F-4 | |
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F-1
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
The Board of Directors and Stockholders
HCA Inc.
We have audited the accompanying consolidated balance sheets of HCA Inc. as of December 31, 2008 and 2007, and the related consolidated statements of income, stockholders’ (deficit) equity, and cash flows for each of the three years in the period ended December 31, 2008. These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material respects, the consolidated financial position of HCA Inc. at December 31, 2008 and 2007, and the consolidated results of its operations and its cash flows for each of the three years in the period ended December 31, 2008, in conformity with U.S. generally accepted accounting principles.
As discussed in Note 18, the accompanying consolidated statements of cash flows have been restated to correct the presentation of distributions to and certain other transactions with noncontrolling interests in the Company’s retrospective adoption of the presentation and disclosure requirements of FASB Statement No. 160, “Noncontrolling Interests in Consolidated Financial Statements, an amendment of ARB No. 51” (“SFAS 160”).
As discussed in paragraphs 6 and 31 of Note 1, effective January 1, 2009, the Company retrospectively adopted the presentation and disclosure requirements of SFAS 160.
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), HCA Inc.’s internal control over financial reporting as of December 31, 2008, based on criteria established in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission, and our report dated March 3, 2009 expressed an unqualified opinion thereon.
/s/ Ernst & Young LLP
Nashville, Tennessee
March 3, 2009, except for paragraphs 6 and 31 of Note 1, as to which the date is May 21, 2009, and except for Note 18, as to which the date is August 14, 2009
F-2
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| | 2008 | | | 2007 | | | 2006 | |
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Revenues | | $ | 28,374 | | | $ | 26,858 | | | $ | 25,477 | |
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Salaries and benefits | | | 11,440 | | | | 10,714 | | | | 10,409 | |
Supplies | | | 4,620 | | | | 4,395 | | | | 4,322 | |
Other operating expenses | | | 4,554 | | | | 4,241 | | | | 4,056 | |
Provision for doubtful accounts | | | 3,409 | | | | 3,130 | | | | 2,660 | |
Equity in earnings of affiliates | | | (223 | ) | | | (206 | ) | | | (197 | ) |
Gains on sales of investments | | | — | | | | (8 | ) | | | (243 | ) |
Depreciation and amortization | | | 1,416 | | | | 1,426 | | | | 1,391 | |
Interest expense | | | 2,021 | | | | 2,215 | | | | 955 | |
Gains on sales of facilities | | | (97 | ) | | | (471 | ) | | | (205 | ) |
Impairment of long-lived assets | | | 64 | | | | 24 | | | | 24 | |
Transaction costs | | | — | | | | — | | | | 442 | |
| | | | | | | | | | | | |
| | | 27,204 | | | | 25,460 | | | | 23,614 | |
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Income before income taxes | | | 1,170 | | | | 1,398 | | | | 1,863 | |
Provision for income taxes | | | 268 | | | | 316 | | | | 626 | |
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Net income | | | 902 | | | | 1,082 | | | | 1,237 | |
Net income attributable to noncontrolling interests | | | 229 | | | | 208 | | | | 201 | |
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Net income attributable to HCA Inc. | | $ | 673 | | | $ | 874 | | | $ | 1,036 | |
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The accompanying notes are an integral part of the consolidated financial statements.
F-3
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| | 2008 | | | 2007 | |
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ASSETS |
Current assets: | | | | | | | | |
Cash and cash equivalents | | $ | 465 | | | $ | 393 | |
Accounts receivable, less allowance for doubtful accounts of $5,435 and $4,289 | | | 3,780 | | | | 3,895 | |
Inventories | | | 737 | | | | 710 | |
Deferred income taxes | | | 914 | | | | 592 | |
Other | | | 405 | | | | 615 | |
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| | | 6,301 | | | | 6,205 | |
Property and equipment, at cost: | | | | | | | | |
Land | | | 1,189 | | | | 1,240 | |
Buildings | | | 8,670 | | | | 8,518 | |
Equipment | | | 12,833 | | | | 12,088 | |
Construction in progress | | | 1,022 | | | | 733 | |
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| | | 23,714 | | | | 22,579 | |
Accumulated depreciations | | | (12,185 | ) | | | (11,137 | ) |
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| | | 11,529 | | | | 11,442 | |
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Investments of insurance subsidiary | | | 1,422 | | | | 1,669 | |
Investments in and advances to affiliates | | | 842 | | | | 688 | |
Goodwill | | | 2,580 | | | | 2,629 | |
Deferred loan costs | | | 458 | | | | 539 | |
Other | | | 1,148 | | | | 853 | |
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| | $ | 24,280 | | | $ | 24,025 | |
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LIABILITIES AND STOCKHOLDERS’ DEFICIT |
Current liabilities: | | | | | | | | |
Accounts payable | | $ | 1,370 | | | $ | 1,370 | |
Accrued salaries | | | 854 | | | | 780 | |
Other accrued expenses | | | 1,282 | | | | 1,391 | |
Long-term debt due within one year | | | 404 | | | | 308 | |
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| | | 3,910 | | | | 3,849 | |
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Long-term debt | | | 26,585 | | | | 27,000 | |
Professional liability risks | | | 1,108 | | | | 1,233 | |
Income taxes and other liabilities | | | 1,782 | | | | 1,379 | |
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Equity securities with contingent redemption rights | | | 155 | | | | 164 | |
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Stockholders’ deficit: | | | | | | | | |
Common stock $0.01 par; authorized 125,000,000 shares — 2008 and 2007; outstanding 94,367,500 shares — 2008 and 94,182,400 shares — 2007 | | | 1 | | | | 1 | |
Capital in excess of par value | | | 165 | | | | 112 | |
Accumulated other comprehensive loss | | | (604 | ) | | | (172 | ) |
Retained deficit | | | (9,817 | ) | | | (10,479 | ) |
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Stockholders’ deficit attributable to HCA Inc. | | | (10,255 | ) | | | (10,538 | ) |
Noncontrolling interests | | | 995 | | | | 938 | |
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| | | (9,260 | ) | | | (9,600 | ) |
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| | $ | 24,280 | | | $ | 24,025 | |
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The accompanying notes are an integral part of the consolidated financial statements.
F-4
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| | (Deficit) Equity Attributable to HCA Inc. | | | | | | | |
| | | | | | | | | | | Accumulated
| | | | | | Equity
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| | Common Stock | | | Capital in
| | | Other
| | | Retained
| | | Attributable to
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| | Shares
| | | Par
| | | Excess of
| | | Comprehensive
| | | Earnings
| | | Noncontrolling
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| | (000) | | | Value | | | Par Value | | | Income (Loss) | | | (Deficit) | | | Interests | | | Total | |
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Balances, December 31, 2005 | | | 417,513 | | | $ | 4 | | | $ | — | | | $ | 130 | | | $ | 4,729 | | | $ | 828 | | | $ | 5,691 | |
Comprehensive income: | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Net income | | | | | | | | | | | | | | | | | | | 1,036 | | | | 201 | | | | 1,237 | |
Other comprehensive income: | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Change in net unrealized gains on investment securities | | | | | | | | | | | | | | | (102 | ) | | | | | | | | | | | (102 | ) |
Foreign currency translation adjustments | | | | | | | | | | | | | | | 19 | | | | | | | | | | | | 19 | |
Defined benefit plans | | | | | | | | | | | | | | | 9 | | | | | | | | | | | | 9 | |
Change in fair value of derivative instruments | | | | | | | | | | | | | | | 18 | | | | | | | | | | | | 18 | |
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Total comprehensive income | | | | | | | | | | | | | | | (56 | ) | | | 1,036 | | | | 201 | | | | 1,181 | |
Recapitalization — repurchase of common stock | | | (411,957 | ) | | | (4 | ) | | | (5,005 | ) | | | | | | | (16,364 | ) | | | | | | | (21,373 | ) |
Recapitalization — new equity | | | 92,218 | | | | 1 | | | | 4,476 | | | | | | | | | | | | | | | | 4,477 | |
Cash dividends | | | | | | | | | | | | | | | | | | | (139 | ) | | | | | | | (139 | ) |
Stock repurchases | | | (13,057 | ) | | | | | | | | | | | | | | | (653 | ) | | | | | | | (653 | ) |
Stock options exercised, net | | | 3,970 | | | | | | | | 163 | | | | | | | | | | | | | | | | 163 | |
Employee benefit plan issuances | | | 3,531 | | | | | | | | 366 | | | | | | | | | | | | | | | | 366 | |
Adjustment to initially apply FAS 158 | | | | | | | | | | | | | | | (58 | ) | | | | | | | | | | | (58 | ) |
Distributions | | | | | | | | | | | | | | | | | | | | | | | (148 | ) | | | (148 | ) |
Other | | | | | | | | | | | | | | | | | | | | | | | 26 | | | | 26 | |
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Balances, December 31, 2006 | | | 92,218 | | | | 1 | | | | — | | | | 16 | | | | (11,391 | ) | | | 907 | | | | (10,467 | ) |
Comprehensive income: | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Net income | | | | | | | | | | | | | | | | | | | 874 | | | | 208 | | | | 1,082 | |
Other comprehensive income: | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Change in net unrealized gains on investment securities | | | | | | | | | | | | | | | (2 | ) | | | | | | | | | | | (2 | ) |
Foreign currency translation adjustments | | | | | | | | | | | | | | | (15 | ) | | | | | | | | | | | (15 | ) |
Defined benefit plans | | | | | | | | | | | | | | | 23 | | | | | | | | | | | | 23 | |
Change in fair value of derivative instruments | | | | | | | | | | | | | | | (194 | ) | | | | | | | | | | | (194 | ) |
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Total comprehensive income | | | | | | | | | | | | | | | (188 | ) | | | 874 | | | | 208 | | | | 894 | |
Equity contributions | | | 1,961 | | | | | | | | 60 | | | | | | | | | | | | | | | | 60 | |
Share-based benefit plans | | | | | | | | | | | 24 | | | | | | | | | | | | | | | | 24 | |
Adjustment to initially apply FIN 48 | | | | | | | | | | | | | | | | | | | 38 | | | | | | | | 38 | |
Distributions | | | | | | | | | | | | | | | | | | | | | | | (152 | ) | | | (152 | ) |
Other | | | 3 | | | | | | | | 28 | | | | | | | | | | | | (25 | ) | | | 3 | |
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Balances, December 31, 2007 | | | 94,182 | | | | 1 | | | | 112 | | | | (172 | ) | | | (10,479 | ) | | | 938 | | | | (9,600 | ) |
Comprehensive income: | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Net income | | | | | | | | | | | | | | | | | | | 673 | | | | 229 | | | | 902 | |
Other comprehensive income: | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Change in net unrealized gains and losses on investment securities | | | | | | | | | | | | | | | (44 | ) | | | | | | | | | | | (44 | ) |
Foreign currency translation adjustments | | | | | | | | | | | | | | | (62 | ) | | | | | | | | | | | (62 | ) |
Defined benefit plans | | | | | | | | | | | | | | | (62 | ) | | | | | | | | | | | (62 | ) |
Change in fair value of derivative instruments | | | | | | | | | | | | | | | (264 | ) | | | | | | | | | | | (264 | ) |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Total comprehensive income | | | | | | | | | | | | | | | (432 | ) | | | 673 | | | | 229 | | | | 470 | |
Share-based benefit plans | | | 185 | | | | | | | | 40 | | | | | | | | | | | | | | | | 40 | |
Distributions | | | | | | | | | | | | | | | | | | | | | | | (178 | ) | | | (178 | ) |
Other | | | | | | | | | | | 13 | | | | | | | | (11 | ) | | | 6 | | | | 8 | |
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Balances, December 31, 2008 | | | 94,367 | | | $ | 1 | | | $ | 165 | | | $ | (604 | ) | | $ | (9,817 | ) | | $ | 995 | | | $ | (9,260 | ) |
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The accompanying notes are an integral part of the consolidated financial statements.
F-5
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| | 2008 | | | 2007 | | | 2006 | |
| | As Restated (See Note 18) | |
|
Cash flows from operating activities: | | | | | | | | | | | | |
Net income | | $ | 902 | | | $ | 1,082 | | | $ | 1,237 | |
Adjustments to reconcile net income to net cash provided by operating activities: | | | | | | | | | | | | |
Provision for doubtful accounts | | | 3,409 | | | | 3,130 | | | | 2,660 | |
Depreciation and amortization | | | 1,416 | | | | 1,426 | | | | 1,391 | |
Income taxes | | | (448 | ) | | | (105 | ) | | | (552 | ) |
Gains on sales of facilities | | | (97 | ) | | | (471 | ) | | | (205 | ) |
Impairment of long-lived assets | | | 64 | | | | 24 | | | | 24 | |
Amortization of deferred loan costs | | | 79 | | | | 78 | | | | 18 | |
Share-based compensation | | | 32 | | | | 24 | | | | 324 | |
Increase (decrease) in cash from operating assets and liabilities: | | | | | | | | | | | | |
Accounts receivable | | | (3,328 | ) | | | (3,345 | ) | | | (3,043 | ) |
Inventories and other assets | | | 159 | | | | (241 | ) | | | (12 | ) |
Accounts payable and accrued expenses | | | (198 | ) | | | (29 | ) | | | 115 | |
Other | | | — | | | | (9 | ) | | | 31 | |
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Net cash provided by operating activities | | | 1,990 | | | | 1,564 | | | | 1,988 | |
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Cash flows from investing activities: | | | | | | | | | | | | |
Purchase of property and equipment | | | (1,600 | ) | | | (1,444 | ) | | | (1,865 | ) |
Acquisition of hospitals and health care entities | | | (85 | ) | | | (32 | ) | | | (112 | ) |
Disposal of hospitals and health care entities | | | 193 | | | | 767 | | | | 651 | |
Change in investments | | | 21 | | | | 207 | | | | 26 | |
Other | | | 4 | | | | 23 | | | | (7 | ) |
| | | | | | | | | | | | |
Net cash used in investing activities | | | (1,467 | ) | | | (479 | ) | | | (1,307 | ) |
| | | | | | | | | | | | |
Cash flows from financing activities: | | | | | | | | | | | | |
Issuances of long-term debt | | | — | | | | — | | | | 21,758 | |
Net change in revolving bank credit facility | | | 700 | | | | (520 | ) | | | (435 | ) |
Repayment of long-term debt | | | (960 | ) | | | (750 | ) | | | (3,728 | ) |
Distributions to noncontrolling interests | | | (178 | ) | | | (152 | ) | | | (148 | ) |
Issuances of common stock | | | — | | | | 100 | | | | 108 | |
Repurchases of common stock | | | — | | | | — | | | | (653 | ) |
Recapitalization-repurchase of common stock | | | — | | | | — | | | | (20,364 | ) |
Recapitalization-equity contributions | | | — | | | | — | | | | 3,782 | |
Payment of debt issuance costs | | | — | | | | — | | | | (586 | ) |
Payment of cash dividends | | | — | | | | — | | | | (201 | ) |
Other | | | (13 | ) | | | (4 | ) | | | 84 | |
| | | | | | | | | | | | |
Net cash used in financing activities | | | (451 | ) | | | (1,326 | ) | | | (383 | ) |
| | | | | | | | | | | | |
Change in cash and cash equivalents | | | 72 | | | | (241 | ) | | | 298 | |
Cash and cash equivalents at beginning of period | | | 393 | | | | 634 | | | | 336 | |
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Cash and cash equivalents at end of period | | $ | 465 | | | $ | 393 | | | $ | 634 | |
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Interest payments | | $ | 1,979 | | | $ | 2,163 | | | $ | 893 | |
Income tax payments, net of refunds | | $ | 716 | | | $ | 421 | | | $ | 1,087 | |
The accompanying notes are an integral part of the consolidated financial statements.
F-6
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
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NOTE 1 — | ACCOUNTING POLICIES |
Merger, Recapitalization and Reporting Entity
On November 17, 2006 HCA Inc. (the “Company”) completed its merger (the “Merger”) with Hercules Acquisition Corporation, pursuant to which the Company was acquired by Hercules Holding II, LLC, a Delaware limited liability company owned by a private investor group including affiliates of Bain Capital Partners, Kohlberg Kravis Roberts & Co., Merrill Lynch Global Private Equity (each a “Sponsor”) and affiliates of HCA founder, Dr. Thomas F. Frist Jr., (the “Frist Entities,” and together with the Sponsors, the “Investors”), and by members of management and certain other investors. The Merger, the financing transactions related to the Merger and other related transactions are collectively referred to in this annual report as the “Recapitalization.” The Merger was accounted for as a recapitalization in our financial statements, with no adjustments to the historical basis of our assets and liabilities. As a result of the Recapitalization, our outstanding capital stock is owned by the Investors, certain members of management and key employees and certain other investors. On April 29, 2008, we registered our common stock pursuant to Section 12(g) of the Securities Exchange Act of 1934, thus subjecting us to the reporting requirements of Section 13(a) of the Securities Exchange Act of 1934. Our common stock is not traded on a national securities exchange.
HCA Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Inc. and partnerships and joint ventures in which such subsidiaries are partners. At December 31, 2008, these affiliates owned and operated 158 hospitals, 97 freestanding surgery centers and provided extensive outpatient and ancillary services. Affiliates of HCA are also partners in joint ventures that own and operate eight hospitals and eight freestanding surgery centers, which are accounted for using the equity method. The Company’s facilities are located in 20 states and England. The terms “HCA,” “Company,” “we,” “our” or “us,” as used in this annual report onForm 10-K, refer to HCA Inc. and its affiliates unless otherwise stated or indicated by context.
Basis of Presentation
The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.
The consolidated financial statements include all subsidiaries and entities controlled by HCA. We generally define “control” as ownership of a majority of the voting interest of an entity. The consolidated financial statements include entities in which we absorb a majority of the entity’s expected losses, receive a majority of the entity’s expected residual returns, or both, as a result of ownership, contractual or other financial interests in the entity. Significant intercompany transactions have been eliminated. Investments in entities that we do not control, but in which we have a substantial ownership interest and can exercise significant influence, are accounted for using the equity method.
We have completed various acquisitions and joint venture transactions. The accounts of these entities have been included in our consolidated financial statements for periods subsequent to our acquisition of controlling interests. The majority of our expenses are “cost of revenue” items. Costs that could be classified as general and administrative include our corporate office costs, which were $174 million, $169 million and $187 million for the years ended December 31, 2008, 2007 and 2006, respectively.
As discussed in “Recent Pronouncements,” we have adopted the provisions of FASB Statement No. 160, “Noncontrolling Interests in Consolidated Financial Statements — an Amendment of ARB No. 51,” effective January 1, 2009. All periods presented in this Form 8-K have been reclassified in accordance with the presentation and disclosure provisions of this pronouncement.
F-7
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 1 — | ACCOUNTING POLICIES (Continued) |
Revenues
Revenues consist primarily of net patient service revenues that are recorded based upon established billing rates less allowances for contractual adjustments. Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Contractual payment terms in managed care agreements are generally based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates.
Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change by a material amount. The estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). The adjustments to estimated reimbursement amounts, which resulted in net increases to revenues, related primarily to cost reports filed during the respective year were $32 million, $47 million and $55 million in 2008, 2007 and 2006, respectively. The adjustments to estimated reimbursement amounts, which resulted in net increases to revenues, related primarily to cost reports filed during previous years were $35 million, $83 million and $62 million in 2008, 2007 and 2006, respectively.
The Emergency Medical Treatment and Active Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations, including but not limited to EMTALA, require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Patients treated at hospitals for nonelective care, who have income at or below 200% of the federal poverty level, are eligible for charity care. The federal poverty level is established by the federal government and is based on income and family size. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. These discounts are similar to those provided to many local managed care plans. In implementing the discount policy, we first attempt to qualify uninsured patients for Medicaid, other federal or state assistance or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.
Cash and Cash Equivalents
Cash and cash equivalents include highly liquid investments with a maturity of three months or less when purchased. Our insurance subsidiary’s cash equivalent investments in excess of the amounts required to pay estimated professional liability claims during the next twelve months are not included in cash and cash equivalents as these funds are not available for general corporate purposes. Carrying values of cash and cash equivalents approximate fair value due to the short-term nature of these instruments.
Our cash management system provides for daily investment of available balances and the funding of outstanding checks when presented for payment. Outstanding, but unpresented, checks totaling $382 million and $370 million at December 31, 2008 and 2007, respectively, have been included in “accounts payable” in the
F-8
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 1 — | ACCOUNTING POLICIES (Continued) |
Cash and Cash Equivalents (Continued)
consolidated balance sheets. Upon presentation for payment, these checks are funded through available cash balances or our credit facility.
Accounts Receivable
We receive payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. During the years ended December 31, 2008, 2007 and 2006, 23%, 24% and 25%, respectively, of our revenues related to patients participating in the fee-for-service Medicare program and 6%, 5% and 5%, respectively, of our revenues related to patients participating in managed Medicare programs. We recognize that revenues and receivables from government agencies are significant to our operations, but do not believe there are significant credit risks associated with these government agencies. We do not believe there are any other significant concentrations of revenues from any particular payer that would subject us to any significant credit risks in the collection of our accounts receivable.
Additions to the allowance for doubtful accounts are made by means of the provision for doubtful accounts. Accounts written off as uncollectible are deducted from the allowance for doubtful accounts and subsequent recoveries are added. The amount of the provision for doubtful accounts is based upon management’s assessment of historical and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. The provision for doubtful accounts and the allowance for doubtful accounts relate primarily to “uninsured” amounts (including copayment and deductible amounts from patients who have health care coverage) due directly from patients. Accounts are written off when all reasonable internal and external collection efforts have been performed. We consider the return of an account from the secondary external collection agency to be the culmination of our reasonable collection efforts and the timing basis for writing off the account balance (prior to 2007, we wrote accounts off upon their return from the primary external agency). Writeoffs are based upon specific identification and the writeoff process requires a writeoff adjustment entry to the patient accounting system. Management relies on the results of detailed reviews of historical writeoffs and recoveries at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information to utilize in estimating the collectibility of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. At December 31, 2008 and 2007, our allowance for doubtful accounts represented approximately 93% and 89%, respectively, of the $5.838 billion and $4.825 billion, respectively, patient due accounts receivable balance, including accounts, net of estimated contractual discounts, related to patients for which eligibility for Medicaid coverage was being evaluated (“pending Medicaid accounts”). Revenue days in accounts receivable were 49 days, 53 days and 53 days at December 31, 2008, 2007 and 2006, respectively. Adverse changes in general economic conditions, patient accounting service center operations, payer mix or trends in federal or state governmental health care coverage could affect our collection of accounts receivable, cash flows and results of operations.
Inventories
Inventories are stated at the lower of cost(first-in, first-out) or market.
Property and Equipment and Amortizable Intangibles
Depreciation expense, computed using the straight-line method, was $1.412 billion in 2008, $1.421 billion in 2007, and $1.384 billion in 2006. Buildings and improvements are depreciated over estimated useful lives ranging generally from 10 to 40 years. Estimated useful lives of equipment vary generally from four to 10 years.
F-9
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 1 — | ACCOUNTING POLICIES (Continued) |
Property and Equipment and Amortizable Intangibles (Continued)
Debt issuance costs are amortized based upon the terms of the respective debt obligations. The gross carrying amount of deferred loan costs at December 31, 2008 and 2007 was $650 million and $652 million, respectively, and accumulated amortization was $192 million and $113 million, respectively. Amortization of deferred loan costs is included in interest expense and was $79 million, $78 million and $18 million for 2008, 2007 and 2006, respectively.
When events, circumstances or operating results indicate the carrying values of certain long-lived assets and related identifiable intangible assets (excluding goodwill) expected to be held and used, might be impaired, we prepare projections of the undiscounted future cash flows expected to result from the use of the assets and their eventual disposition. If the projections indicate the recorded amounts are not expected to be recoverable, such amounts are reduced to estimated fair value. Fair value may be estimated based upon internal evaluations that include quantitative analyses of revenues and cash flows, reviews of recent sales of similar facilities and independent appraisals.
Long-lived assets to be disposed of are reported at the lower of their carrying amounts or fair value less costs to sell or close. The estimates of fair value are usually based upon recent sales of similar assets and market responses based upon discussions with and offers received from potential buyers.
Investments of Insurance Subsidiary
At December 31, 2008 and 2007, the investments of our wholly-owned insurance subsidiary were classified as “available-for-sale” as defined in Statement of Financial Accounting Standards No. 115, “Accounting for Certain Investments in Debt and Equity Securities” and are recorded at fair value. The investment securities are held for the purpose of providing the funding source to pay professional liability claims covered by the insurance subsidiary. We perform a quarterly assessment of individual investment securities to determine whether declines in market value are temporary or other-than-temporary. Our investment securities evaluation process involves multiple subjective judgments, often involves estimating the outcome of future events, and requires a significant level of professional judgment in determining whether an impairment has occurred. We evaluate, among other things, the financial position and near term prospects of the issuer, conditions in the issuer’s industry, liquidity of the investment, changes in the amount or timing of expected future cash flows from the investment, and recent downgrades of the issuer by a rating agency, to determine if, and when, a decline in the fair value of an investment below amortized cost is considered other-than-temporary. The length of time and extent to which the fair value of the investment is less than amortized cost and our ability and intent to retain the investment, to allow for any anticipated recovery of the investment’s fair value, are important components of our investment securities evaluation process.
Goodwill
Goodwill is not amortized, but is subject to annual impairment tests. In addition to the annual impairment review, impairment reviews are performed whenever circumstances indicate a possible impairment may exist. Impairment testing for goodwill is done at the reporting unit level. Reporting units are one level below the business segment level, and our impairment testing is performed at the operating division or market level. We compare the fair value of the reporting unit assets to the carrying amount, on at least an annual basis, to determine if there is potential impairment. If the fair value of the reporting unit assets is less than their carrying value, we compare the fair value of the goodwill to its carrying value. If the fair value of the goodwill is less than its carrying value, an impairment loss is recognized. Fair value of goodwill is estimated based upon internal evaluations of the related long-lived assets for each reporting unit that include quantitative analyses of revenues and cash flows and reviews of recent sales of similar facilities. We recognized goodwill impairments of $48 million during 2008. No goodwill impairments were recognized during 2007 and 2006.
F-10
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 1 — | ACCOUNTING POLICIES (Continued) |
Goodwill (Continued)
During 2008, goodwill increased by $43 million related to acquisitions, decreased by $14 million related to facility sales, decreased by $48 million related to impairments and decreased by $30 million related to foreign currency translation and other adjustments. During 2007, goodwill increased by $44 million related to acquisitions, decreased by $45 million related to facility sales and increased by $29 million related to foreign currency translation and other adjustments.
Physician Recruiting Agreements
In order to recruit physicians to meet the needs of our hospitals and the communities they serve, we enter into minimum revenue guarantee arrangements to assist the recruited physicians during the period they are relocating and establishing their practices. A guarantor is required to recognize, at the inception of a guarantee, a liability for the fair value of the stand-ready obligation undertaken in issuing the guarantee. We expense the total estimated guarantee liability amount at the time the physician recruiting agreement becomes effective as we are not able to justify recording a contract-based asset based upon our analysis of the related control, regulatory and legal considerations.
The physician recruiting liability amounts of $27 million and $22 million at December 31, 2008 and 2007, respectively, represent the amount of expense recognized in excess of payments made through December 31, 2008 and 2007, respectively. At December 31, 2008 the maximum amount of all effective minimum revenue guarantees that could be paid prospectively was $66 million.
Professional Liability Claims
Reserves for professional liability risks were $1.387 billion and $1.513 billion at December 31, 2008 and 2007, respectively. The current portion of the reserves, $279 million and $280 million at December 31, 2008 and 2007, respectively, is included in “other accrued expenses” in the consolidated balance sheet. Provisions for losses related to professional liability risks were $175 million, $163 million and $217 million for 2008, 2007 and 2006, respectively, and are included in “other operating expenses” in our consolidated income statement. Provisions for losses related to professional liability risks are based upon actuarially determined estimates. Loss and loss expense reserves represent the estimated ultimate net cost of all reported and unreported losses incurred through the respective consolidated balance sheet dates. The reserves for unpaid losses and loss expenses are estimated using individual case-basis valuations and actuarial analyses. Those estimates are subject to the effects of trends in loss severity and frequency. The estimates are continually reviewed and adjustments are recorded as experience develops or new information becomes known. Adjustments to the estimated reserve amounts are included in current operating results. The reserves for professional liability risks cover approximately 2,800 and 2,600 individual claims at December 31, 2008 and 2007, respectively, and estimates for unreported potential claims. The time period required to resolve these claims can vary depending upon the jurisdiction and whether the claim is settled or litigated. During 2008 and 2007, $314 million and $236 million, respectively, of net payments were made for professional and general liability claims. The estimation of the timing of payments beyond a year can vary significantly. Although considerable variability is inherent in professional liability reserve estimates, we believe the reserves for losses and loss expenses are adequate; however, there can be no assurance that the ultimate liability will not exceed our estimates.
A portion of our professional liability risks is insured through a wholly-owned insurance subsidiary. Subject to a $5 million per occurrence self-insured retention (in place since January 1, 2007), our facilities are insured by our wholly-owned insurance subsidiary for losses up to $50 million per occurrence. The insurance subsidiary has obtained reinsurance for professional liability risks generally above a retention level of $15 million per occurrence.
F-11
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 1 — | ACCOUNTING POLICIES (Continued) |
Professional Liability Claims (Continued)
We also maintain professional liability insurance with unrelated commercial carriers for losses in excess of amounts insured by our insurance subsidiary.
The obligations covered by reinsurance contracts are included in the reserves for professional liability risks, as the insurance subsidiary remains liable to the extent the reinsurers do not meet their obligations under the reinsurance contracts. The amounts receivable under the reinsurance contracts include $28 million and $14 million at December 31, 2008 and 2007, respectively, recorded in “other assets” and $29 million and $30 million at December 31, 2008 and 2007, respectively, recorded in “other current assets”.
Financial Instruments
Derivative financial instruments are employed to manage risks, including interest rate and foreign currency exposures, and are not used for trading or speculative purposes. We recognize derivative instruments, such as interest rate swap agreements and foreign exchange contracts, in the consolidated balance sheets at fair value. Changes in the fair value of derivatives are recognized periodically either in earnings or in stockholders’ equity, as a component of other comprehensive income, depending on whether the derivative financial instrument qualifies for hedge accounting, and if so, whether it qualifies as a fair value hedge or a cash flow hedge. Generally, changes in fair values of derivatives accounted for as fair value hedges are recorded in earnings, along with the changes in the fair value of the hedged items that relate to the hedged risk. Gains and losses on derivatives designated as cash flow hedges, to the extent they are effective, are recorded in other comprehensive income, and subsequently reclassified to earnings to offset the impact of the forecasted transactions when they occur. In the event the forecasted transaction to which a cash flow hedge relates is no longer likely, the amount in other comprehensive income is recognized in earnings and generally the derivative is terminated. Changes in the fair value of derivatives not qualifying as hedges, and for any portion of a hedge that is ineffective, are reported in earnings.
The net interest paid or received on interest rate swaps is recognized as interest expense. Gains and losses resulting from the early termination of interest rate swap agreements are deferred and amortized as adjustments to interest expense over the remaining term of the debt originally covered by the terminated swap.
Noncontrolling Interests in Consolidated Entities
The consolidated financial statements include all assets, liabilities, revenues and expenses of less than 100% owned entities that we control. Accordingly, we have recorded noncontrolling interests in the earnings and equity of such entities.
Recent Pronouncements
In December 2007, the Financial Accounting Standards Board (the “FASB”) issued Statement of Financial Accounting Standards No. 141(R), “Business Combinations” (“SFAS 141(R)”). This new standard will change the financial accounting and reporting of business combination transactions in consolidated financial statements. SFAS 141(R) replaces FASB Statement No. 141, “Business Combinations” (“SFAS 141”). SFAS 141(R) retains the fundamental requirements in SFAS 141 that the acquisition method of accounting (which SFAS 141 called the purchase method) be used for all business combinations and for an acquirer to be identified for each business combination. SFAS 141(R) defines the acquirer as the entity that obtains control of one or more businesses in the business combination and establishes the acquisition date as the date the acquirer achieves control. The scope of SFAS 141(R) is broader than that of SFAS 141, which applied only to business combinations in which control was obtained by transferring consideration. SFAS 141(R) applies the acquisition method to all transactions and other events in which one entity obtains control over one or more other businesses. SFAS 141(R) is effective for business
F-12
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 1 — | ACCOUNTING POLICIES (Continued) |
Recent Pronouncements (Continued)
combination transactions for which the acquisition date is on or after the beginning of the first annual reporting period beginning on or after December 15, 2008.
In December 2007, the FASB issued Statement of Financial Accounting Standards No. 160, “Noncontrolling Interests in Consolidated Financial Statements, an amendment of ARB No. 51” (“SFAS 160”). This new standard will change the financial accounting and reporting of noncontrolling (or minority) interests in consolidated financial statements. SFAS 160 applies to all entities that prepare consolidated financial statements, except not-for-profit organizations. SFAS 160 amends certain of ARB No. 51’s consolidation procedures to provide consistency with the requirements of SFAS 141(R). SFAS 160 is required to be adopted concurrently with SFAS 141(R) and is effective for fiscal years and interim periods beginning on or after December 15, 2008. SFAS 160 applies prospectively, except for the presentation and disclosure requirements, which are applied retrospectively. We adopted SFAS 160 effective January 1, 2009. Under SFAS 160, we report minority interests (now called noncontrolling interests) in equity of consolidated entities as a separate component of stockholders’ (deficit) equity in the consolidated financial statements and present both net income attributable to noncontrolling interests and net income attributable to HCA Inc. in the consolidated income statements.
In March 2008, the FASB issued Statement of Financial Accounting Standards No. 161, “Disclosures about Derivative Instruments and Hedging Activities, an amendment of FASB Statement No. 133” (“SFAS 161”). This new standard will require entities to provide enhanced disclosures about (a) how and why an entity uses derivatives instruments, (b) how derivative instruments and related hedged items are accounted for and (c) how derivative instruments and related hedged items affect an entity’s financial position, financial performance and cash flows. SFAS 161 is effective for financial statements issued for fiscal years and interim periods beginning after November 15, 2008. We do not expect the adoption of SFAS 161 to have a material effect on our financial position or results of operations.
Reclassifications
Certain prior year amounts have been reclassified to conform to the 2008 presentation.
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NOTE 2 — | MERGER AND RECAPITALIZATION |
On July 24, 2006, we entered into an Agreement and Plan of Merger (the “Merger Agreement”) with Hercules Holding II, LLC, a Delaware limited liability company (“Hercules Holding”), and Hercules Acquisition Corporation, a Delaware corporation and a wholly-owned subsidiary of Hercules Holding (“Merger Sub”). Our board of directors approved the Merger Agreement on the unanimous recommendation of a special committee comprised entirely of disinterested directors. The Merger was approved by a majority of HCA’s shareholders at a special meeting of shareholders held on November 16, 2006.
On November 17, 2006, pursuant to the terms of the Merger Agreement, the Investors consummated the acquisition of the Company through the merger of Merger Sub with and into the Company. The Company was the surviving corporation in the Merger. At December 31, 2008, 97.3% of our common stock is owned by the Investors and certain other investors, with the remainder being owned by certain members of management and employees of the Company.
Rollover and Stockholder Agreements And Equity Securities with Contingent Redemption Rights
In connection with the Merger, the Frist Entities and certain members of our management entered into agreements with the Companyand/or Hercules Holding, pursuant to which they elected to invest in the Company, as the surviving corporation in the Merger, through a rollover of employee stock options, a rollover of shares of
F-13
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 2 — | MERGER AND RECAPITALIZATION (Continued) |
Rollover and Stockholder Agreements And Equity Securities with Contingent Redemption Rights (Continued)
common stock of the Company, or a combination thereof. Pursuant to the rollover agreements the Frist Entities and management team made rollover investments of $885 million and $125 million, respectively.
The stockholder agreements, among other things, contain agreements among the parties with respect to restrictions on the transfer of shares, including tag along rights and drag along rights, registration rights (including customary indemnification provisions) and other rights. Pursuant to the management stockholder agreements, the applicable employees can elect to have the Company redeem their common stock and vested stock options in the events of death or permanent disability, prior to the consummation of the initial public offering of common stock by the Company. At December 31, 2008, 1,698,400 common shares and 2,937,000 vested stock options were subject to these contingent redemption terms.
Management Agreement
Affiliates of the Investors entered into a management agreement with us pursuant to which such affiliates will provide us with management services. Under the management agreement, the affiliates of the Investors are entitled to receive an aggregate annual management fee of $15 million, which amount will increase annually, beginning in 2008, at a rate equal to the percentage increase in Adjusted EBITDA (as defined in the Management Agreement) in the applicable year compared to the preceding year, and reimbursement of out-of-pocket expenses incurred in connection with the provision of services pursuant to the agreement. The management agreement has an initial term expiring on December 31, 2016, provided that the term will be extended annually for one additional year unless we or the Investors provide notice to the other of their desire not to automatically extend the term. In addition, the management agreement provides that the affiliates of the Investors are entitled to receive a fee equal to 1% of the gross transaction value in connection with certain financing, acquisition, disposition, and change of control transactions, as well as a termination fee based on the net present value of future payment obligations under the management agreement in the event of an initial public offering or under certain other circumstances. The agreement also contains customary exculpation and indemnification provisions in favor of the Investors and their affiliates.
Recapitalization Transaction Costs
For the year ended December 31, 2006, our results of operations include the following expenses related to the Recapitalization (dollars in millions):
| | | | |
Compensation expense related to accelerated vesting of stock options and restricted stock, and other employee benefits | | $ | 258 | |
Consulting, legal, accounting and other transaction costs | | | 131 | |
Loss on extinguishment of debt | | | 53 | |
| | | | |
Total | | $ | 442 | |
| | | | |
In addition to these amounts, approximately $77 million of transaction costs were recorded directly to shareholders’ deficit, and an additional $568 million of transaction costs were capitalized as deferred loan costs.
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NOTE 3 — | SHARE-BASED COMPENSATION |
Effective January 1, 2006, we adopted Statement of Financial Accounting Standards No. 123(R), “Share-Based Payment” (“SFAS 123(R)”), using the modified prospective application transition method. Under this method, compensation cost is recognized, beginning January 1, 2006, based on the requirements of SFAS 123(R) for all share-based awards granted after the effective date, and based on Statement of Financial Accounting
F-14
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 3 — | SHARE-BASED COMPENSATION (Continued) |
Standards No. 123, “Accounting for Stock-Based Compensation” (“SFAS 123”), for all awards granted to employees prior to January 1, 2006 that were unvested on the effective date.
Upon consummation of the Merger, all outstanding stock options (other than certain options held by certain rollover shareholders) became fully vested, were cancelled and converted into the right to receive a cash payment equal to the number of shares underlying the options multiplied by the amount (if any) by which $51.00 exceeded the option exercise price. The acceleration of vesting of stock options resulted in the recognition of $42 million of additional share-based compensation expense for 2006.
Certain management holders of outstanding HCA stock options were permitted to retain certain of their stock options (the “Rollover Options”) in lieu of receiving the merger consideration (the amount, if any, by which $51.00 exceeded the option exercise price). The Rollover Options remain outstanding in accordance with the terms of the governing stock incentive plans and grant agreements pursuant to which the holder originally received the stock option grants, except the exercise price and number of shares subject to the rollover option agreement were adjusted so that the aggregate intrinsic value for each applicable option holder was maintained and the exercise price for substantially all the options was adjusted to $12.75 per option. Pursuant to the rollover option agreement, 10,967,500 prerecapitalization HCA stock options were converted into 2,285,200 Rollover Options, of which 1,797,200 are outstanding and exercisable at December 31, 2008.
SFAS 123(R) requires that the benefits of tax deductions in excess of amounts recognized as compensation cost be reported as a financing cash flow. Tax benefits of $7 million, $1 million and $97 million from tax deductions in excess of amounts recognized as compensation cost were reported as financing cash flows in 2008, 2007 and 2006, respectively.
2006 Stock Incentive Plan
In connection with the Recapitalization, the 2006 Stock Incentive Plan for Key Employees of HCA Inc. and its Affiliates (the “2006 Plan”) was established. The 2006 Plan is designed to promote the long term financial interests and growth of the Company and its subsidiaries by attracting and retaining management and other personnel and key service providers and to motivate management personnel by means of incentives to achieve long range goals and further the alignment of interests of participants with those of our stockholders through opportunities for increased stock, or stock-based, ownership in the Company. A portion of the options under the 2006 Plan vests solely based upon continued employment over a specific period of time, and a portion of the options vests based both upon continued employment over a specific period of time and upon the achievement of predetermined financial and Investor return targets over time. We granted 357,500 and 9,328,000 options under the 2006 Plan during 2008 and 2007, respectively. As of December 31, 2008, 1,186,200 options granted under the 2006 Plan have vested, and there were 1,788,300 shares available for future grants under the 2006 Plan.
2005 Equity Incentive Plan
Prior to the Recapitalization, the HCA 2005 Equity Incentive Plan was the primary plan under which stock options and restricted stock were granted to officers, employees and directors. Upon consummation of the Recapitalization, all shares of restricted stock became fully vested, were cancelled and converted into the right to receive a cash payment of $51.00 per restricted share. During 2006, we recognized $247 million of compensation costs related to restricted share grants. The acceleration of vesting of restricted stock resulted in the recognition of $201 million of the total compensation expense related to restricted stock for 2006.
F-15
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 3 — | SHARE-BASED COMPENSATION (Continued) |
2005 Equity Incentive Plan (Continued)
A summary of restricted share activity during 2006 follows (share amounts in thousands):
| | | | | | | | |
| | | | | Weighted Average
| |
| | Number of
| | | Grant Date Fair
| |
| | Shares | | | Value | |
|
Restricted shares, December 31, 2005 | | | 3,748 | | | $ | 43.42 | |
Granted | | | 2,979 | | | | 49.11 | |
Vested | | | (494 | ) | | | 41.40 | |
Cancelled | | | (232 | ) | | | 45.98 | |
Settled in Recapitalization | | | (6,001 | ) | | | 46.31 | |
| | | | | | | | |
Restricted shares, December 31, 2006 | | | — | | | | — | |
| | | | | | | | |
Stock Option Activity — All Plans
The fair value of each stock option award is estimated on the grant date, using option valuation models and the weighted average assumptions indicated in the following table. Awards under the 2006 Plan generally vest based on continued employment and based upon achievement of certain financial and Investor return-based targets. Each grant is valued as a single award with an expected term equal to the average expected term of the component vesting tranches. We use historical option exercise behavior data and other factors to estimate the expected term of the options. The expected term of the option is limited by the contractual term, and employee post-vesting termination behavior is incorporated in the historical option exercise behavior data. Compensation cost is recognized on the straight-line attribution method. The straight-line attribution method requires that total compensation expense recognized must at least equal the vested portion of the grant-date fair value. The expected volatility is derived using historical stock price information of certain peer group companies for a period of time equal to the expected option term. The risk-free interest rate is the approximate yield on United States Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised.
| | | | | | | | | | | | |
| | 2008 | | | 2007 | | | 2006 | |
|
Risk-free interest rate | | | 2.50 | % | | | 4.86 | % | | | 4.70 | % |
Expected volatility | | | 30 | % | | | 30 | % | | | 24 | % |
Expected life, in years | | | 4 | | | | 5 | | | | 5 | |
Expected dividend yield | | | — | | | | — | | | | 1.09 | % |
F-16
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 3 — | SHARE-BASED COMPENSATION (Continued) |
Stock Option Activity — All Plans (Continued)
Information regarding stock option activity during 2008, 2007 and 2006 is summarized below (share amounts in thousands):
| | | | | | | | | | | | | | | | |
| | | | | Weighted
| | | Weighted
| | | | |
| | | | | Average
| | | Average
| | | Aggregate
| |
| | Stock
| | | Exercise
| | | Remaining
| | | Intrinsic Value
| |
| | Options | | | Price | | | Contractual Term | | | (dollars in millions) | |
|
Options outstanding, December 31, 2005 | | | 27,806 | | | $ | 36.35 | | | | | | | | | |
Granted | | | 2,566 | | | | 48.64 | | | | | | | | | |
Exercised | | | (5,220 | ) | | | 26.24 | | | | | | | | | |
Cancelled | | | (1,008 | ) | | | 49.76 | | | | | | | | | |
Settled in Recapitalization | | | (13,177 | ) | | | 36.22 | | | | | | | | | |
Rolled over in Recapitalization — existing | | | (10,967 | ) | | | 42.98 | | | | | | | | | |
Rolled over in Recapitalization — new | | | 2,285 | | | | 12.50 | | | | | | | | | |
| | | | | | | | | | | | | | | | |
Options outstanding, December 31, 2006 | | | 2,285 | | | | 12.50 | | | | | | | | | |
Granted | | | 9,328 | | | | 51.34 | | | | | | | | | |
Exercised | | | (36 | ) | | | 12.75 | | | | | | | | | |
Cancelled | | | (405 | ) | | | 51.00 | | | | | | | | | |
| | | | | | | | | | | | | | | | |
Options outstanding, December 31, 2007 | | | 11,172 | | | | 43.54 | | | | | | | | | |
Granted | | | 357 | | | | 58.21 | | | | | | | | | |
Exercised | | | (480 | ) | | | 15.01 | | | | | | | | | |
Cancelled | | | (412 | ) | | | 51.14 | | | | | | | | | |
| | | | | | | | | | | | | | | | |
Options outstanding, December 31, 2008 | | | 10,637 | | | | 45.02 | | | | 7.5 years | | | $ | 115 | |
| | | | | | | | | | | | | | | | |
Options exercisable, December 31, 2008 | | | 2,937 | | | $ | 27.55 | | | | 5.6 years | | | $ | 83 | |
The weighted average fair values of stock options granted during 2008, 2007 and 2006 were $14.01, $16.01 and $10.76 per share, respectively. The total intrinsic value of stock options exercised in the year ended December 31, 2008 was $20 million.
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NOTE 4 — | ACQUISITIONS AND DISPOSITIONS |
During 2008, we paid $18 million to acquire one hospital and $67 million to acquire other health care entities. During 2007, we did not acquire any hospitals, but paid $32 million for other health care entities. During 2006, we paid $63 million to acquire three hospitals and $49 million to acquire other health care entities. Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values. The purchase price paid in excess of the fair value of identifiable net assets of acquired entities aggregated $43 million, $44 million and $38 million in 2008, 2007 and 2006, respectively. The consolidated financial statements include the accounts and operations of the acquired entities subsequent to the respective acquisition dates. The pro forma effects of the acquired entities on our results of operations for periods prior to the respective acquisition dates were not significant.
During 2008, we received proceeds of $143 million and recognized a net pretax gain of $81 million ($48 million after tax) on the sales of two hospitals. We also received proceeds of $50 million and recognized a net pretax gain of $16 million ($10 million after tax) from sales of other health care entities and real estate investments. During 2007, we received proceeds of $661 million and recognized a net pretax gain of $443 million ($272 million after tax) from sales of three hospitals. We also received proceeds of $106 million and recognized a
F-17
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
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NOTE 4 — | ACQUISITIONS AND DISPOSITIONS (Continued) |
net pretax gain of $28 million ($18 million after tax) from sales of real estate investments. During 2006, we received proceeds of $560 million and recognized a net pretax gain of $176 million ($85 million after tax) on the sales of nine hospitals. We also received proceeds of $91 million and recognized a net pretax gain of $29 million ($18 million after tax) from sales of real estate investments and our equity investment in a hospital joint venture.
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NOTE 5 — | IMPAIRMENTS OF LONG-LIVED ASSETS |
During 2008, we recorded pretax charges of $64 million to reduce the carrying value of identified assets to estimated fair value. The $64 million asset impairment includes $55 million related to other health care entity investments in our Eastern Group and $9 million related to certain hospital facilities in our Central Group. During 2007, we recorded a pretax charge of $24 million to adjust the value of a building in our Central Group to estimated fair value. During 2006, the carrying value for a closed hospital was reduced to fair value, based upon estimates of sales value, resulting in a pretax charge of $16 million that affected our Corporate and Other Group. During 2006, we also decided to terminate a construction project and incurred a pretax charge of $8 million that affected our Corporate and Other Group.
The asset impairment charges did not have a significant impact on our operations or cash flows and are not expected to significantly impact cash flows for future periods. The impairment charges affected our property and equipment asset category by $16 million, $24 million and $24 million in 2008, 2007 and 2006, respectively.
The provision for income taxes consists of the following (dollars in millions):
| | | | | | | | | | | | |
| | 2008 | | | 2007 | | | 2006 | |
|
Current: | | | | | | | | | | | | |
Federal | | $ | 699 | | | $ | 566 | | | $ | 993 | |
State | | | 56 | | | | 37 | | | | 62 | |
Foreign | | | 25 | | | | 32 | | | | 35 | |
Deferred: | | | | | | | | | | | | |
Federal | | | (505 | ) | | | (391 | ) | | | (426 | ) |
State | | | (29 | ) | | | (62 | ) | | | (43 | ) |
Foreign | | | 22 | | | | 134 | | | | 5 | |
| | | | | | | | | | | | |
| | $ | 268 | | | $ | 316 | | | $ | 626 | |
| | | | | | | | | | | | |
A reconciliation of the federal statutory rate to the effective income tax rate follows:
| | | | | | | | | | | | |
| | 2008 | | | 2007 | | | 2006 | |
|
Federal statutory rate | | | 35.0 | % | | | 35.0 | % | | | 35.0 | % |
State income taxes, net of federal tax benefit | | | 3.7 | | | | 0.2 | | | | 0.4 | |
Change in liability for uncertain tax positions | | | (7.4 | ) | | | (7.2 | ) | | | — | |
Nondeductible intangible assets | | | 0.4 | | | | — | | | | 1.5 | |
Tax exempt interest income | | | (2.5 | ) | | | (2.1 | ) | | | (1.1 | ) |
Income attributable to noncontrolling interests from consolidated partnerships | | | (5.6 | ) | | | (4.0 | ) | | | (4.0 | ) |
Other items, net | | | (0.7 | ) | | | 0.7 | | | | 1.8 | |
| | | | | | | | | | | | |
Effective income tax rate | | | 22.9 | % | | | 22.6 | % | | | 33.6 | % |
| | | | | | | | | | | | |
F-18
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 6 — | INCOME TAXES (Continued) |
As a result of a settlement reached with the Appeals Division of the Internal Revenue Service (the “IRS”) and the revision of a proposed IRS adjustment related to prior taxable years, we reduced our provision for income taxes by $69 million in 2008. Our 2007 provision for income taxes was reduced by $85 million, principally based on new information received related to tax positions taken in a prior taxable year, and by an additional $39 million to adjust 2006 state tax accruals to the amounts reported on completed tax returns and based upon an analysis of the Recapitalization costs.
A summary of the items comprising the deferred tax assets and liabilities at December 31 follows (dollars in millions):
| | | | | | | | | | | | | | | | |
| | 2008 | | | 2007 | |
| | Assets | | | Liabilities | | | Assets | | | Liabilities | |
|
Depreciation and fixed asset basis differences | | $ | — | | | $ | 324 | | | $ | — | | | $ | 329 | |
Allowances for professional liability and other risks | | | 244 | | | | — | | | | 197 | | | | — | |
Accounts receivable | | | 1,263 | | | | — | | | | 884 | | | | — | |
Compensation | | | 201 | | | | — | | | | 156 | | | | — | |
Other | | | 786 | | | | 287 | | | | 633 | | | | 259 | |
| | | | | | | | | | | | | | | | |
| | $ | 2,494 | | | $ | 611 | | | $ | 1,870 | | | $ | 588 | |
| | | | | | | | | | | | | | | | |
At December 31, 2008, state net operating loss carryforwards (expiring in years 2009 through 2028) available to offset future taxable income approximated $145 million. Utilization of net operating loss carryforwards in any one year may be limited and, in certain cases, result in an adjustment to intangible assets. Net deferred tax assets related to such carryforwards are not significant.
We are currently contesting before the IRS Appeals Division certain claimed deficiencies and adjustments proposed by the IRS in connection with its examination of the 2003 and 2004 federal income tax returns for HCA and 17 affiliates that are treated as partnerships for federal income tax purposes (“affiliated partnerships”). The disputed items include the timing of recognition of certain patient service revenues and our method for calculating the tax allowance for doubtful accounts.
Eight taxable periods of HCA and its predecessors ended in 1995 through 2002 and the 2002 taxable year for 13 affiliated partnerships, for which the primary remaining issue is the computation of the tax allowance for doubtful accounts, are pending before the IRS Examination Division or the United States Tax Court as of December 31, 2008. The IRS began an audit of the 2005 and 2006 federal income tax returns for HCA and seven affiliated partnerships during 2008.
Effective January 1, 2007, we adopted FASB Interpretation No. 48, “Accounting for Uncertainty in Income Taxes” (“FIN 48”). FIN 48 creates a single model to address uncertainty in income tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. FIN 48 applies to all tax positions related to income taxes subject to FASB Statement No. 109, “Accounting for Income Taxes.” The provision for income taxes reflects a $20 million ($12 million net of tax) reduction in interest related to taxing authority examinations for the year ended December 31, 2008 and interest expense of $17 million ($11 million net of tax) for the year ended December 31, 2007.
F-19
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 6 — | INCOME TAXES (Continued) |
The following table summarizes the activity related to our unrecognized tax benefits (dollars in millions):
| | | | | | | | |
| | 2008 | | | 2007 | |
|
Balance at January 1 | | $ | 622 | | | $ | 555 | |
Additions based on tax positions related to the current year | | | 32 | | | | 70 | |
Additions for tax positions of prior years | | | 55 | | | | 112 | |
Reductions for tax positions of prior years | | | (57 | ) | | | (101 | ) |
Settlements | | | (162 | ) | | | 2 | |
Lapse of applicable statutes of limitations | | | (8 | ) | | | (16 | ) |
| | | | | | | | |
Balance at December 31 | | $ | 482 | | | $ | 622 | |
| | | | | | | | |
During 2008, we reached a settlement with the IRS Appeals Division relating to the deductibility of the 2001 government settlement payment, the timing of recognition of certain patient service revenues for 2001 and 2002, and the amount of insurance expense deducted in 2001 and 2002. As a result of the settlement, $111 million of the $215 million refundable deposit made in 2006 has been applied to tax and interest due for the 2001 and 2002 taxable years.
Our liability for unrecognized tax benefits was $625 million, including accrued interest of $156 million and excluding $13 million that was recorded as reductions of the related deferred tax assets, as of December 31, 2008 ($828 million, $218 million and $12 million, respectively, as of December 31, 2007). Unrecognized tax benefits of $264 million ($489 million as of December 31, 2007) would affect the effective rate, if recognized. The liability for unrecognized tax benefits does not reflect deferred tax assets related to deductible interest and state income taxes or the balance of a refundable deposit we made in 2006, which is recorded in noncurrent assets.
Depending on the resolution of the IRS disputes, the completion of examinations by federal, state or international taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next twelve months. However, we are currently unable to estimate the range of any possible change.
F-20
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 7 — | INVESTMENTS OF INSURANCE SUBSIDIARY |
A summary of the insurance subsidiary’s investments at December 31 follows (dollars in millions):
| | | | | | | | | | | | | | | | |
| | 2008 | |
| | | | | Unrealized
| | | | |
| | Amortized
| | | Amounts | | | Fair
| |
| | Cost | | | Gains | | | Losses | | | Value | |
|
Debt securities: | | | | | | | | | | | | | | | | |
States and municipalities | | $ | 808 | | | $ | 20 | | | $ | (23 | ) | | $ | 805 | |
Auction rate securities | | | 576 | | | | — | | | | (40 | ) | | | 536 | |
Asset-backed securities | | | 51 | | | | 1 | | | | (5 | ) | | | 47 | |
Money market funds | | | 226 | | | | — | | | | — | | | | 226 | |
| | | | | | | | | | | | | | | | |
| | | 1,661 | | | | 21 | | | | (68 | ) | | | 1,614 | |
| | | | | | | | | | | | | | | | |
Equity securities: | | | | | | | | | | | | | | | | |
Preferred stocks | | | 6 | | | | — | | | | (1 | ) | | | 5 | |
Common stocks and other equities | | | 3 | | | | — | | | | — | | | | 3 | |
| | | | | | | | | | | | | | | | |
| | | 9 | | | | — | | | | (1 | ) | | | 8 | |
| | | | | | | | | | | | | | | | |
| | $ | 1,670 | | | $ | 21 | | | $ | (69 | ) | | | 1,622 | |
| | | | | | | | | | | | | | | | |
Amounts classified as current assets | | | | | | | | | | | | | | | (200 | ) |
| | | | | | | | | | | | | | | | |
Investment carrying value | | | | | | | | | | | | | | $ | 1,422 | |
| | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | |
| | 2007 | |
| | | | | Unrealized
| | | | |
| | Amortized
| | | Amounts | | | Fair
| |
| | Cost | | | Gains | | | Losses | | | Value | |
|
Debt securities: | | | | | | | | | | | | | | | | |
States and municipalities | | $ | 944 | | | $ | 23 | | | $ | (2 | ) | | $ | 965 | |
Auction rate securities | | | 731 | | | | — | | | | — | | | | 731 | |
Asset-backed securities | | | 59 | | | | 1 | | | | — | | | | 60 | |
Corporate | | | 2 | | | | — | | | | — | | | | 2 | |
Money market funds | | | 109 | | | | — | | | | — | | | | 109 | |
| | | | | | | | | | | | | | | | |
| | | 1,845 | | | | 24 | | | | (2 | ) | | | 1,867 | |
| | | | | | | | | | | | | | | | |
Equity securities: | | | | | | | | | | | | | | | | |
Preferred stocks | | | 26 | | | | — | | | | (1 | ) | | | 25 | |
Common stocks and other equities | | | 7 | | | | — | | | | — | | | | 7 | |
| | | | | | | | | | | | | | | | |
| | | 33 | | | | — | | | | (1 | ) | | | 32 | |
| | | | | | | | | | | | | | | | |
| | $ | 1,878 | | | $ | 24 | | | $ | (3 | ) | | | 1,899 | |
| | | | | | | | | | | | | | | | |
Amounts classified as current assets | | | | | | | | | | | | | | | (230 | ) |
| | | | | | | | | | | | | | | | |
Investment carrying value | | | | | | | | | | | | | | $ | 1,669 | |
| | | | | | | | | | | | | | | | |
At December 31, 2008 and 2007 the investments of our insurance subsidiary were classified as “available-for-sale.” Changes in temporary unrealized gains and losses are recorded as adjustments to other comprehensive
F-21
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 7 — | INVESTMENTS OF INSURANCE SUBSIDIARY (Continued) |
income. At December 31, 2008 and 2007, $119 million and $106 million, respectively, of our investments were subject to the restrictions included in insurance bond collateralization and assumed reinsurance contracts.
Scheduled maturities of investments in debt securities at December 31, 2008 were as follows (dollars in millions):
| | | | | | | | |
| | Amortized
| | | Fair
| |
| | Cost | | | Value | |
|
Due in one year or less | | $ | 313 | | | $ | 314 | |
Due after one year through five years | | | 305 | | | | 311 | |
Due after five years through ten years | | | 252 | | | | 254 | |
Due after ten years | | | 164 | | | | 152 | |
| | | | | | | | |
| | | 1,034 | | | | 1,031 | |
Auction rate securities | | | 576 | | | | 536 | |
Asset-backed securities | | | 51 | | | | 47 | |
| | | | | | | | |
| | $ | 1,661 | | | $ | 1,614 | |
| | | | | | | | |
The average expected maturity of the investments in debt securities at December 31, 2008 was 3.9 years, compared to the average scheduled maturity of 12.8 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date. The average expected maturities for our auction rate and asset-backed securities were derived from valuation models of expected cash flows and involved management’s judgment. The average expected maturities for our auction rate and asset-backed securities at December 31, 2008 were 5.5 years and 6.9 years, respectively, compared to average scheduled maturities of 25.5 years and 26.2 years, respectively.
The cost of securities sold is based on the specific identification method. Sales of securities for the years ended December 31 are summarized below (dollars in millions):
| | | | | | | | | | | | |
| | 2008 | | 2007 | | 2006 |
|
Debt securities: | | | | | | | | | | | | |
Cash proceeds | | $ | 23 | | | $ | 272 | | | $ | 401 | |
Gross realized gains | | | — | | | | 8 | | | | 1 | |
Gross realized losses | | | — | | | | 1 | | | | 2 | |
Equity securities: | | | | | | | | | | | | |
Cash proceeds | | $ | 4 | | | $ | 87 | | | $ | 1,509 | |
Gross realized gains | | | 2 | | | | 1 | | | | 256 | |
Gross realized losses | | | 2 | | | | — | | | | 12 | |
| |
NOTE 8 — | FINANCIAL INSTRUMENTS |
Interest Rate Swap Agreements
We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert LIBOR indexed variable rate instruments to fixed interest rate obligations. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our
F-22
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 8 — | FINANCIAL INSTRUMENTS (Continued) |
Interest Rate Swap Agreements (Continued)
credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions. The interest payments under these agreements are settled on a net basis.
The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at December 31, 2008 (dollars in millions):
| | | | | | | | | | | | |
| | Notional
| | | | Fair
|
| | Amount | | Termination Date | | Value |
|
Pay-fixed interest rate swap | | $ | 4,000 | | | | November 2011 | | | $ | (327 | ) |
Pay-fixed interest rate swap | | | 4,000 | | | | November 2011 | | | | (301 | ) |
Pay-fixed interest rate swap | | | 500 | | | | March 2011 | | | | (15 | ) |
Pay-fixed interest rate swap | | | 500 | | | | March 2011 | | | | (14 | ) |
The fair value of the interest rate swaps at December 31, 2008 represents the estimated amounts we would pay upon termination of these agreements.
Cross Currency Swaps
The Company and certain subsidiaries have incurred obligations and entered into various intercompany transactions where such obligations are denominated in currencies (Great Britain Pound and Euro), other than the functional currencies (United States Dollar and Great Britain Pound) of the parties executing the trade. In order to better match the cash flows of our obligations and intercompany transactions with cash flows from operations, we entered into various cross currency swaps. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.
Certain of our cross currency swaps were not designated as hedges, and changes in fair value are recognized in results of operations. The following table sets forth these cross currency swap agreements at December 31, 2008 (amounts in millions):
| | | | | | | | | | | | |
| | Notional
| | | | Fair
|
| | Amount | | Termination Date | | Value |
|
Euro — United States Dollar Currency Swap | | | 557 Euro | | | | December 2011 | | | $ | 81 | |
Euro — Great Britain Pound (GBP) Currency Swap | | | 27 GBP | | | | December 2011 | | | | 16 | |
The following table sets forth our cross currency swap agreements, which have been designated as cash flow hedges, at December 31, 2008 (amounts in millions):
| | | | | | | | | | | | |
| | Notional
| | | | Fair
|
| | Amount | | Termination Date | | Value |
|
GBP — United States Dollar Currency Swap | | | 50 GBP | | | | November 2010 | | | $ | (13 | ) |
GBP — United States Dollar Currency Swap | | | 50 GBP | | | | November 2010 | | | | (13 | ) |
The fair value of the cross currency swaps at December 31, 2008 represents the estimated amounts we would receive (pay) upon termination of these agreements.
| |
NOTE 9 — | ASSETS AND LIABILITIES MEASURED AT FAIR VALUE |
On January 1, 2008, we adopted Statement of Financial Accounting Standards No. 157, “Fair Value Measurements” (“SFAS 157”). SFAS 157 defines fair value, establishes a framework for measuring fair value, and expands disclosures about fair value measurements. SFAS 157 applies to reported balances that are required or permitted to be measured at fair value under existing accounting pronouncements.
F-23
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 9 — | ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (Continued) |
SFAS 157 emphasizes that fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, SFAS 157 establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).
Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs that are observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment, and considers factors specific to the asset or liability.
Cash Traded Investments
Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency. Certain types of cash traded instruments are classified within Level 3 of the fair value hierarchy because they trade infrequently and therefore have little or no price transparency. Such instruments include auction rate securities (“ARS”) and limited partnership investments. The transaction price is initially used as the best estimate of fair value.
Our wholly-owned insurance subsidiary had investments in municipal, tax-exempt ARS, that are backed by student loans substantially guaranteed by the federal government, of $536 million ($573 million par value) at December 31, 2008. We do not currently intend to attempt to sell the ARS as the liquidity needs of our insurance subsidiary are expected to be met by other investments in its investment portfolio. These securities continue to accrue and pay interest semi-annually based on the failed auction maximum rate formulas stated in their respective Official Statements. During 2008, certain issuers of our ARS redeemed $93 million of our securities at par value. The valuation of these securities involved management’s judgment, after consideration of market factors and the absence of market transparency, market liquidity and observable inputs. Our valuation models derived a fair market value compared to tax-equivalent yields of other student loan backed variable rate securities of similar credit worthiness.
Derivative Financial Instruments
We have entered into interest rate and cross currency swap agreements to manage our exposure to fluctuations in interest rates and foreign currency risks. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves, foreign exchange rates and implied volatilities. To comply with the provisions of SFAS 157, we incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements.
F-24
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 9 — | ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (Continued) |
Derivative Financial Instruments (Continued)
Although we have determined that the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We have assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and have determined that the credit valuation adjustments are significant to the overall valuation of our derivatives. As a result, we have determined that our derivative valuations in their entirety are classified in Level 3 of the fair value hierarchy at December 31, 2008.
The following table summarizes our assets and liabilities measured at fair value on a recurring basis as of December 31, 2008, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):
| | | | | | | | | | | | | | | | |
| | | | | Fair Value Measurements Using | |
| | | | | Quoted Prices in
| | | | | | | |
| | | | | Active Markets for
| | | | | | | |
| | | | | Identical Assets
| | | Significant Other
| | | Significant
| |
| | | | | and Liabilities
| | | Observable Inputs
| | | Unobservable Inputs
| |
| | Fair Value | | | (Level 1) | | | (Level 2) | | | (Level 3) | |
|
Assets: | | | | | | | | | | | | | | | | |
Investments of insurance subsidiary | | $ | 1,622 | | | $ | 227 | | | $ | 857 | | | $ | 538 | |
Less amounts classified as current assets | | | (200 | ) | | | (200 | ) | | | — | | | | — | |
| | | | | | | | | | | | | | | | |
| | | 1,422 | | | | 27 | | | | 857 | | | | 538 | |
Cross currency swaps (Other assets) | | | 97 | | | | — | | | | — | | | | 97 | |
Liabilities: | | | | | | | | | | | | | | | | |
Interest rate swaps (Income taxes and other liabilities) | | | 657 | | | | — | | | | — | | | | 657 | |
Cross currency swaps (Income taxes and other liabilities) | | | 26 | | | | — | | | | — | | | | 26 | |
The following table summarizes the activity related to the investments of our insurance subsidiary and our cross currency and interest rate swaps which have fair value measurements based on significant unobservable inputs (Level 3) during the year ended December 31, 2008 (dollars in millions):
| | | | | | | | | | | | |
| | Investments
| | | Cross
| | | Interest
| |
| | of Insurance
| | | Currency
| | | Rate
| |
| | Subsidiary | | | Swaps (net) | | | Swaps | |
|
Balance at December 31, 2007 | | $ | 4 | | | $ | — | | | $ | — | |
Realized gains and losses included in earnings | | | 2 | | | | — | | | | — | |
Unrealized gains and losses included in other comprehensive income | | | (41 | ) | | | — | | | | — | |
Purchases, issuances and settlements | | | (95 | ) | | | — | | | | — | |
Transfers into Level 3 | | | 668 | | | | 71 | | | | 657 | |
| | | | | | | | | | | | |
Balance at December 31, 2008 | | $ | 538 | | | $ | 71 | | | $ | 657 | |
| | | | | | | | | | | | |
F-25
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
A summary of long-term debt at December 31, including related interest rates at December 31, 2008, follows (dollars in millions):
| | | | | | | | |
| | 2008 | | | 2007 | |
|
Senior secured asset-based revolving credit facility (effective interest rate of 2.8%) | | $ | 2,000 | | | $ | 1,350 | |
Senior secured revolving credit facility (effective interest rate of 2.7%) | | | 50 | | | | — | |
Senior secured term loan facilities (effective interest rate of 6.0%) | | | 12,002 | | | | 12,317 | |
Other senior secured debt (effective interest rate of 6.8%) | | | 406 | | | | 427 | |
| | | | | | | | |
First lien debt | | | 14,458 | | | | 14,094 | |
| | | | | | | | |
Senior secured cash-pay notes (effective interest rate of 9.6%) | | | 4,200 | | | | 4,200 | |
Senior secured toggle notes (effective interest rate of 10.0%) | | | 1,500 | | | | 1,500 | |
| | | | | | | | |
Second lien debt | | | 5,700 | | | | 5,700 | |
| | | | | | | | |
Senior unsecured notes payable through 2095 (effective interest rate of 7.2%) | | | 6,831 | | | | 7,514 | |
| | | | | | | | |
Total debt (average life of six years, rates averaging 6.9%) | | | 26,989 | | | | 27,308 | |
Less amounts due within one year | | | 404 | | | | 308 | |
| | | | | | | | |
| | $ | 26,585 | | | $ | 27,000 | |
| | | | | | | | |
Senior Secured Credit Facilities
In connection with the Recapitalization, we entered into (i) a $2.000 billion senior secured asset-based revolving credit facility with a borrowing base of 85% of eligible accounts receivable, subject to customary reserves and eligibility criteria (fully utilized at December 31, 2008) (the “ABL credit facility”) and (ii) a senior secured credit agreement (the “cash flow credit facility” and, together with the ABL credit facility, the “senior secured credit facilities”), consisting of a $2.000 billion revolving credit facility ($1.858 billion available at December 31, 2008 after giving effect to certain outstanding letters of credit), a $2.750 billion term loan A ($2.525 billion outstanding at December 31, 2008), a $8.800 billion term loan B ($8.624 billion outstanding at December 31, 2008) and a €1.000 billion European term loan (€611 million, or $853 million, outstanding at December 31, 2008) under which one of our European subsidiaries is the borrower.
Borrowings under the senior secured credit facilities bear interest at a rate equal to, as determined by the type of borrowing, either an applicable margin plus, at our option, either (a) a base rate determined by reference to the higher of (1) the federal funds rate plus1/2 of 1% or (2) the prime rate of Bank of America or (b) a LIBOR rate for the currency of such borrowing for the relevant interest period, plus, in each case, an applicable margin. The applicable margin for borrowings under the senior secured credit facilities, with the exception of term loan B where the margin is static, may be reduced subject to attaining certain leverage ratios.
The ABL facility and the $2.000 billion revolving credit facility portion of the cash flow credit facility expire November 2012. The term loan facilities require quarterly installment payments. The final payment under term loan A is in November 2012. The final payments under term loan B and the European term loan are in November 2013. The senior secured credit facilities contain a number of covenants that restrict, subject to certain exceptions, our (and some or all of our subsidiaries’) ability to incur additional indebtedness, repay subordinated indebtedness, create liens on assets, sell assets, make investments, loans or advances, engage in certain transactions with affiliates, pay dividends and distributions, and enter into sale and leaseback transactions. In addition, we are required to satisfy and maintain a maximum total leverage ratio covenant under the cash flow facility and, in certain situations under the ABL credit facility, a minimum interest coverage ratio covenant.
F-26
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 10 — | LONG-TERM DEBT (Continued) |
Senior Secured Credit Facilities (Continued)
We use interest rate swap agreements to manage the floating rate exposure of our debt portfolio. We entered into interest rate swap agreements, in a total notional amount of $9 billion, in order to hedge a portion of our exposure to variable rate interest payments associated with the senior secured credit facility. The effect of the interest rate swaps is reflected in the effective interest rate for the senior secured credit facilities.
Senior Secured Notes
In November 2006, we issued $4.200 billion of senior secured notes (comprised of $1.000��billion of 91/8% notes due 2014 and $3.200 billion of 91/4% notes due 2016), and $1.500 billion of 95/8% cash/103/8% in-kind senior secured toggle notes (which allow us, at our option, to pay interest in-kind during the first five years) due 2016, which are subject to certain standard covenants. In November 2008, we elected to make an interest payment for the interest period ending in May 2009 by paying in-kind instead of paying interest in cash.
General Information
The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, wholly-owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our ABL credit facility). In addition, borrowings under the European term loan are guaranteed by all material, wholly-owned European subsidiaries.
Maturities of long-term debt in years 2010 through 2013 are $1.144 billion, $896 million, $4.707 billion and $10.095 billion, respectively.
The estimated fair value of our long-term debt was $20.225 billion and $26.127 billion at December 31, 2008 and 2007, respectively, compared to carrying amounts aggregating $26.989 billion and $27.308 billion, respectively. The estimates of fair value are generally based upon the quoted market prices for the same or similar issues of long-term debt with the same maturities.
We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse affect on our results of operations or financial position in a given period.
We are subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. It is management’s opinion that the ultimate resolution of these pending claims and legal proceedings will not have a material, adverse effect on our results of operations or financial position.
| |
NOTE 12 — | CAPITAL STOCK AND STOCK REPURCHASES |
Capital Stock
The Company’s certificate of incorporation and by-laws were amended and restated, effective March 27, 2008 and March 26, 2008, respectively. The amended and restated certificate of incorporation authorizes the Company to issue up to 125,000,000 shares of common stock, and the amended and restated by-laws set the number of directors constituting the board of directors of the Company at not less than one nor more than 15.
F-27
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 12 — | CAPITAL STOCK AND STOCK REPURCHASES (Continued) |
Stock Repurchase Program
In 2005, we announced the authorization of a modified “Dutch” auction tender offer to purchase up to $2.500 billion of our common stock. During 2006, we repurchased 13.0 million shares of our common stock for $653 million, through open market purchases, which completed this authorization.
| |
NOTE 13 — | EMPLOYEE BENEFIT PLANS |
We maintained a noncontributory, defined contribution retirement plan which covered substantially all employees. Benefits were determined as a percentage of a participant’s salary and vest over specified periods of employee service. Retirement plan expense was $46 million for 2008, $203 million for 2007 and $190 million for 2006. Amounts approximately equal to retirement plan expense are funded annually. Effective April 1, 2008, the noncontributory plan and the related participant account balances were merged into the contributory HCA 401(k) Plan.
We maintain contributory, defined contribution benefit plans that are available to employees who meet certain minimum requirements. Certain of the plans require that we match specified percentages of participant contributions up to certain maximum levels (generally, 100% of the first 3% to 9%, depending upon years of vesting service, of compensation deferred by participants for periods subsequent to March 31, 2008, and 50% of the first 3% of compensation deferred by participants for periods prior to April 1, 2008). The cost of these plans totaled $233 million for 2008, $86 million for 2007 and $71 million for 2006. Our contributions are funded periodically during each year.
We maintain a Supplemental Executive Retirement Plan (“SERP”) for certain executives. The plan is designed to ensure that upon retirement the participant receives the value of a prescribed life annuity from the combination of the SERP and our other benefit plans. Compensation expense under the plan was $20 million for 2008, $20 million for 2007 and $15 million for 2006. Accrued benefits liabilities under this plan totaled $133 million at December 31, 2008 and $109 million at December 31, 2007.
We maintain defined benefit pension plans which resulted from certain hospital acquisitions in prior years. Compensation expense under these plans was $24 million for 2008, $27 million for 2007, and $31 million for 2006. Accrued benefits liabilities under these plans totaled $142 million at December 31, 2008 and $48 million at December 31, 2007.
| |
NOTE 14 — | SEGMENT AND GEOGRAPHIC INFORMATION |
We operate in one line of business, which is operating hospitals and related health care entities. During the years ended December 31, 2008, 2007 and 2006, approximately 23%, 24% and 25%, respectively, of our revenues related to patients participating in the fee-for-service Medicare program.
Our operations are structured into three geographically organized groups: the Eastern Group includes 48 consolidating hospitals located in the Eastern United States, the Central Group includes 51 consolidating hospitals located in the Central United States and the Western Group includes 53 consolidating hospitals located in the Western United States. We also operate six consolidating hospitals in England, and these facilities are included in the Corporate and other group.
Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains on sales of facilities, impairment of long-lived assets, transaction costs, income taxes and noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted
F-28
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 14 — | SEGMENT AND GEOGRAPHIC INFORMATION (Continued) |
accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization, assets and goodwill are summarized in the following table (dollars in millions):
| | | | | | | | | | | | |
| | For the Years Ended December 31, | |
| | 2008 | | | 2007 | | | 2006 | |
|
Revenues: | | | | | | | | | | | | |
Eastern Group | | $ | 8,570 | | | $ | 8,204 | | | $ | 7,775 | |
Central Group | | | 6,740 | | | | 6,302 | | | | 5,917 | |
Western Group | | | 12,118 | | | | 11,378 | | | | 10,495 | |
Corporate and other | | | 946 | | | | 974 | | | | 1,290 | |
| | | | | | | | | | | | |
| | $ | 28,374 | | | $ | 26,858 | | | $ | 25,477 | |
| | | | | | | | | | | | |
Equity in earnings of affiliates: | | | | | | | | | | | | |
Eastern Group | | $ | (2 | ) | | $ | (2 | ) | | $ | (6 | ) |
Central Group | | | (2 | ) | | | 8 | | | | (3 | ) |
Western Group | | | (219 | ) | | | (212 | ) | | | (187 | ) |
Corporate and other | | | — | | | | — | | | | (1 | ) |
| | | | | | | | | | | | |
| | $ | (223 | ) | | $ | (206 | ) | | $ | (197 | ) |
| | | | | | | | | | | | |
Adjusted segment EBITDA: | | | | | | | | | | | | |
Eastern Group | | $ | 1,288 | | | $ | 1,268 | | | $ | 1,196 | |
Central Group | | | 1,061 | | | | 1,082 | | | | 975 | |
Western Group | | | 2,270 | | | | 2,196 | | | | 2,088 | |
Corporate and other | | | (45 | ) | | | 46 | | | | 211 | |
| | | | | | | | | | | | |
| | $ | 4,574 | | | $ | 4,592 | | | $ | 4,470 | |
| | | | | | | | | | | | |
Depreciation and amortization: | | | | | | | | | | | | |
Eastern Group | | $ | 358 | | | $ | 369 | | | $ | 363 | |
Central Group | | | 359 | | | | 364 | | | | 329 | |
Western Group | | | 552 | | | | 529 | | | | 492 | |
Corporate and other | | | 147 | | | | 164 | | | | 207 | |
| | | | | | | | | | | | |
| | $ | 1,416 | | | $ | 1,426 | | | $ | 1,391 | |
| | | | | | | | | | | | |
Adjusted segment EBITDA | | $ | 4,574 | | | $ | 4,592 | | | $ | 4,470 | |
Depreciation and amortization | | | 1,416 | | | | 1,426 | | | | 1,391 | |
Interest expense | | | 2,021 | | | | 2,215 | | | | 955 | |
Gains on sales of facilities | | | (97 | ) | | | (471 | ) | | | (205 | ) |
Impairment of long-lived assets | | | 64 | | | | 24 | | | | 24 | |
Transaction costs | | | — | | | | — | | | | 442 | |
| | | | | | | | | | | | |
Income before income taxes | | $ | 1,170 | | | $ | 1,398 | | | $ | 1,863 | |
| | | | | | | | | | | | |
F-29
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 14 — | SEGMENT AND GEOGRAPHIC INFORMATION (Continued) |
| | | | | | | | |
| | As of December 31, | |
| | 2008 | | | 2007 | |
|
Assets: | | | | | | | | |
Eastern Group | | $ | 4,906 | | | $ | 4,928 | |
Central Group | | | 5,251 | | | | 5,157 | |
Western Group | | | 8,597 | | | | 8,152 | |
Corporate and other | | | 5,526 | | | | 5,788 | |
| | | | | | | | |
| | $ | 24,280 | | | $ | 24,025 | |
| | | | | | | | |
| | | | | | | | | | | | | | | | | | | | |
| | Eastern
| | | Central
| | | Western
| | | Corporate
| | | | |
| | Group | | | Group | | | Group | | | and Other | | | Total | |
|
Goodwill: | | | | | | | | | | | | | | | | | | | | |
Balance at December 31, 2007 | | $ | 628 | | | $ | 1,015 | | | $ | 749 | | | $ | 237 | | | $ | 2,629 | |
Acquisitions | | | 38 | | | | — | | | | 5 | | | | — | | | | 43 | |
Sales | | | (14 | ) | | | — | | | | — | | | | — | | | | (14 | ) |
Impairments | | | (48 | ) | | | — | | | | — | | | | — | | | | (48 | ) |
Foreign currency translation and other | | | (2 | ) | | | (2 | ) | | | — | | | | (26 | ) | | | (30 | ) |
| | | | | | | | | | | | | | | | | | | | |
Balance at December 31, 2008 | | $ | 602 | | | $ | 1,013 | | | $ | 754 | | | $ | 211 | | | $ | 2,580 | |
| | | | | | | | | | | | | | | | | | | | |
F-30
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 15 — | OTHER COMPREHENSIVE INCOME (LOSS) |
The components of accumulated other comprehensive income (loss) are as follows (dollars in millions):
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | Change
| | | | |
| | Unrealized
| | | Foreign
| | | | | | in Fair
| | | | |
| | Gains (Losses) on
| | | Currency
| | | Defined
| | | Value of
| | | | |
| | Available-for-Sale
| | | Translation
| | | Benefit
| | | Derivative
| | | | |
| | Securities | | | Adjustments | | | Plans | | | Instruments | | | Total | |
|
Balances at December 31, 2005 | | $ | 118 | | | $ | 30 | | | $ | (18 | ) | | $ | — | | | $ | 130 | |
Unrealized gains on available-for-sale securities, net of $30 of income taxes | | | 53 | | | | — | | | | — | | | | — | | | | 53 | |
Gains reclassified into earnings from other comprehensive income, net of $88 of income taxes | | | (155 | ) | | | — | | | | — | | | | — | | | | (155 | ) |
Foreign currency translation adjustments, net of $10 of income taxes | | | — | | | | 19 | | | | — | | | | — | | | | 19 | |
Defined benefit plans, net of $30 income tax benefit | | | — | | | | — | | | | (49 | ) | | | — | | | | (49 | ) |
Change in fair value of derivative instruments, net of $10 of income taxes | | | — | | | | — | | | | — | | | | 18 | | | | 18 | |
| | | | | | | | | | | | | | | | | | | | |
Balances at December 31, 2006 | | | 16 | | | | 49 | | | | (67 | ) | | | 18 | | | | 16 | |
Unrealized gains on available-for-sale securities, net of $1 of income taxes | | | 3 | | | | — | | | | — | | | | — | | | | 3 | |
Foreign currency translation adjustments, net of $3 income tax benefit | | | — | | | | (7 | ) | | | — | | | | — | | | | (7 | ) |
Gains reclassified into earnings from other comprehensive income, net of $3 and $5, respectively, of income taxes | | | (5 | ) | | | (8 | ) | | | — | | | | — | | | | (13 | ) |
Defined benefit plans, net of $14 of income taxes | | | — | | | | — | | | | 23 | | | | — | | | | 23 | |
Change in fair value of derivative instruments, net of $112 income tax benefit | | | — | | | | — | | | | — | | | | (194 | ) | | | (194 | ) |
| | | | | | | | | | | | | | | | | | | | |
Balances at December 31, 2007 | | | 14 | | | | 34 | | | | (44 | ) | | | (176 | ) | | | (172 | ) |
Unrealized losses on available-for-sale securities, net of $25 income tax benefit | | | (44 | ) | | | — | | | | — | | | | — | | | | (44 | ) |
Foreign currency translation adjustments, net of $33 income tax benefit | | | — | | | | (62 | ) | | | — | | | | — | | | | (62 | ) |
Defined benefit plans, net of $36 income tax benefit | | | — | | | | — | | | | (62 | ) | | | — | | | | (62 | ) |
Change in fair value of derivative instruments, net of $152 income tax benefit | | | — | | | | — | | | | — | | | | (264 | ) | | | (264 | ) |
| | | | | | | | | | | | | | | | | | | | |
Balances at December 31, 2008 | | $ | (30 | ) | | $ | (28 | ) | | $ | (106 | ) | | $ | (440 | ) | | $ | (604 | ) |
| | | | | | | | | | | | | | | | | | | | |
F-31
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 16 — | ACCRUED EXPENSES AND ALLOWANCE FOR DOUBTFUL ACCOUNTS |
A summary of other accrued expenses at December 31 follows (dollars in millions):
| | | | | | | | |
| | 2008 | | | 2007 | |
|
Professional liability risks | | $ | 279 | | | $ | 280 | |
Interest | | | 212 | | | | 223 | |
Employee benefit plans | | | 89 | | | | 217 | |
Income taxes | | | 224 | | | | 190 | |
Taxes other than income | | | 189 | | | | 139 | |
Other | | | 289 | | | | 342 | |
| | | | | | | | |
| | $ | 1,282 | | | $ | 1,391 | |
| | | | | | | | |
A summary of activity for the allowance of doubtful accounts follows (dollars in millions):
| | | | | | | | | | | | | | | | |
| | | | | Provision
| | | Accounts
| | | | |
| | Balance at
| | | for
| | | Written off,
| | | Balance
| |
| | Beginning
| | | Doubtful
| | | Net of
| | | at End
| |
| | of Year | | | Accounts | | | Recoveries | | | of Year | |
|
Allowance for doubtful accounts: | | | | | | | | | | | | | | | | |
Year ended December 31, 2006 | | $ | 2,897 | | | $ | 2,660 | | | $ | (2,129 | ) | | $ | 3,428 | |
Year ended December 31, 2007 | | | 3,428 | | | | 3,130 | | | | (2,269 | ) | | | 4,289 | |
Year ended December 31, 2008 | | | 4,289 | | | | 3,409 | | | | (2,263 | ) | | | 5,435 | |
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION |
The senior secured credit facilities and senior secured notes described in Note 10 are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, wholly-owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our ABL credit facility).
Our condensed consolidating balance sheets at December 31, 2008 and 2007 and condensed consolidating statements of income and cash flows for each of the three years in the period ended December 31, 2008, segregating the parent company issuer, the subsidiary guarantors, the subsidiary non-guarantors and eliminations, follow.
F-32
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING INCOME STATEMENT
For The Year Ended December 31, 2008
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
Revenues | | $ | — | | | $ | 16,507 | | | $ | 11,867 | | | $ | — | | | $ | 28,374 | |
| | | | | | | | | | | | | | | | | | | | |
Salaries and benefits | | | — | | | | 6,846 | | | | 4,594 | | | | — | | | | 11,440 | |
Supplies | | | — | | | | 2,671 | | | | 1,949 | | | | — | | | | 4,620 | |
Other operating expenses | | | (6 | ) | | | 2,444 | | | | 2,116 | | | | — | | | | 4,554 | |
Provision for doubtful accounts | | | — | | | | 2,073 | | | | 1,336 | | | | — | | | | 3,409 | |
Equity in earnings of affiliates | | | (2,100 | ) | | | (82 | ) | | | (141 | ) | | | 2,100 | | | | (223 | ) |
Gains on investments | | | — | | | | 1 | | | | (1 | ) | | | — | | | | — | |
Depreciation and amortization | | | — | | | | 776 | | | | 640 | | | | — | | | | 1,416 | |
Interest expense | | | 2,190 | | | | (328 | ) | | | 159 | | | | — | | | | 2,021 | |
Gains on sales of facilities | | | — | | | | (5 | ) | | | (92 | ) | | | — | | | | (97 | ) |
Impairment of long-lived assets | | | — | | | | — | | | | 64 | | | | — | | | | 64 | |
Management fees | | | — | | | | (426 | ) | | | 426 | | | | — | | | | — | |
| | | | | | | | | | | | | | | | | | | | |
| | | 84 | | | | 13,970 | | | | 11,050 | | | | 2,100 | | | | 27,204 | |
| | | | | | | | | | | | | | | | | | | | |
Income (loss) before income taxes | | | (84 | ) | | | 2,537 | | | | 817 | | | | (2,100 | ) | | | 1,170 | |
Provision for income taxes | | | (757 | ) | | | 803 | | | | 222 | | | | — | | | | 268 | |
| | | | | | | | | | | | | | | | | | | | |
Net income | | | 673 | | | | 1,734 | | | | 595 | | | | (2,100 | ) | | | 902 | |
Net income attributable to noncontrolling interests | | | — | | | | 53 | | | | 176 | | | | — | | | | 229 | |
| | | | | | | | | | | | | | | | | | | | |
Net income attributable to HCA Inc. | | $ | 673 | | | $ | 1,681 | | | $ | 419 | | | $ | (2,100 | ) | | $ | 673 | |
| | | | | | | | | | | | | | | | | | | | |
F-33
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING INCOME STATEMENT
For The Year Ended December 31, 2007
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
Revenues | | $ | — | | | $ | 15,598 | | | $ | 11,260 | | | $ | — | | | $ | 26,858 | |
| | | | | | | | | | | | | | | | | | | | |
Salaries and benefits | | | — | | | | 6,441 | | | | 4,273 | | | | — | | | | 10,714 | |
Supplies | | | — | | | | 2,549 | | | | 1,846 | | | | — | | | | 4,395 | |
Other operating expenses | | | (2 | ) | | | 2,279 | | | | 1,964 | | | | — | | | | 4,241 | |
Provision for doubtful accounts | | | — | | | | 1,942 | | | | 1,188 | | | | — | | | | 3,130 | |
Equity in earnings of affiliates | | | (2,245 | ) | | | (90 | ) | | | (116 | ) | | | 2,245 | | | | (206 | ) |
Gains on investments | | | — | | | | — | | | | (8 | ) | | | — | | | | (8 | ) |
Depreciation and amortization | | | — | | | | 779 | | | | 647 | | | | — | | | | 1,426 | |
Interest expense | | | 2,161 | | | | (95 | ) | | | 149 | | | | — | | | | 2,215 | |
Gains on sales of facilities | | | — | | | | (3 | ) | | | (468 | ) | | | — | | | | (471 | ) |
Impairment of long-lived assets | | | — | | | | — | | | | 24 | | | | — | | | | 24 | |
Management fees | | | — | | | | (392 | ) | | | 392 | | | | — | | | | — | |
| | | | | | | | | | | | | | | | | | | | |
| | | (86 | ) | | | 13,410 | | | | 9,891 | | | | 2,245 | | | | 25,460 | |
| | | | | | | | | | | | | | | | | | | | |
Income before income taxes | | | 86 | | | | 2,188 | | | | 1,369 | | | | (2,245 | ) | | | 1,398 | |
Provision for income taxes | | | (788 | ) | | | 712 | | | | 392 | | | | — | | | | 316 | |
| | | | | | | | | | | | | | | | | | | | |
Net income | | | 874 | | | | 1,476 | | | | 977 | | | | (2,245 | ) | | | 1,082 | |
Net income attributable to noncontrolling interests | | | — | | | | 28 | | | | 180 | | | | — | | | | 208 | |
| | | | | | | | | | | | | | | | | | | | |
Net income attributable to HCA Inc. | | $ | 874 | | | $ | 1,448 | | | $ | 797 | | | $ | (2,245 | ) | | $ | 874 | |
| | | | | | | | | | | | | | | | | | | | |
F-34
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING INCOME STATEMENT
For The Year Ended December 31, 2006
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
Revenues | | $ | — | | | $ | 14,913 | | | $ | 10,564 | | | $ | — | | | $ | 25,477 | |
| | | | | | | | | | | | | | | | | | | | |
Salaries and benefits | | | — | | | | 6,319 | | | | 4,090 | | | | — | | | | 10,409 | |
Supplies | | | — | | | | 2,487 | | | | 1,835 | | | | — | | | | 4,322 | |
Other operating expenses | | | — | | | | 2,253 | | | | 1,803 | | | | — | | | | 4,056 | |
Provision for doubtful accounts | | | — | | | | 1,652 | | | | 1,008 | | | | — | | | | 2,660 | |
Equity in earnings of affiliates | | | (1,995 | ) | | | (79 | ) | | | (118 | ) | | | 1,995 | | | | (197 | ) |
Gains on investments | | | — | | | | — | | | | (243 | ) | | | — | | | | (243 | ) |
Depreciation and amortization | | | — | | | | 755 | | | | 636 | | | | — | | | | 1,391 | |
Interest expense | | | 895 | | | | (99 | ) | | | 159 | | | | — | | | | 955 | |
Gains on sales of facilities | | | — | | | | 7 | | | | (212 | ) | | | — | | | | (205 | ) |
Impairment of long-lived assets | | | — | | | | 5 | | | | 19 | | | | — | | | | 24 | |
Transaction costs | | | 429 | | | | 25 | | | | (12 | ) | | | — | | | | 442 | |
Management fees | | | — | | | | (377 | ) | | | 377 | | | | — | | | | — | |
| | | | | | | | | | | | | | | | | | | | |
| | | (671 | ) | | | 12,948 | | | | 9,342 | | | | 1,995 | | | | 23,614 | |
| | | | | | | | | | | | | | | | | | | | |
Income before income taxes | | | 671 | | | | 1,965 | | | | 1,222 | | | | (1,995 | ) | | | 1,863 | |
Provision for income taxes | | | (365 | ) | | | 612 | | | | 379 | | | | — | | | | 626 | |
| | | | | | | | | | | | | | | | | | | | |
Net income | | | 1,036 | | | | 1,353 | | | | 843 | | | | (1,995 | ) | | | 1,237 | |
Net income attributable to noncontrolling interests | | | — | | | | 21 | | | | 180 | | | | — | | | | 201 | |
| | | | | | | | | | | | | | | | | | | | |
Net income attributable to HCA Inc. | | $ | 1,036 | | | $ | 1,332 | | | $ | 663 | | | $ | (1,995 | ) | | $ | 1,036 | |
| | | | | | | | | | | | | | | | | | | | |
F-35
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING BALANCE SHEET
DECEMBER 31, 2008
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
ASSETS | | | | | | | | | | | | | | | | | | | | |
Current assets: | | | | | | | | | | | | | | | | | | | | |
Cash and cash equivalents | | $ | — | | | $ | 134 | | | $ | 331 | | | $ | — | | | $ | 465 | |
Accounts receivable, net | | | — | | | | 2,214 | | | | 1,566 | | | | — | | | | 3,780 | |
Inventories | | | — | | | | 455 | | | | 282 | | | | — | | | | 737 | |
Deferred income taxes | | | 914 | | | | — | | | | — | | | | — | | | | 914 | |
Other | | | — | | | | 140 | | | | 265 | | | | — | | | | 405 | |
| | | | | | | | | | | | | | | | | | | | |
| | | 914 | | | | 2,943 | | | | 2,444 | | | | — | | | | 6,301 | |
| | | | | | | | | | | | | | | | | | | | |
Property and equipment, net | | | — | | | | 7,122 | | | | 4,407 | | | | — | | | | 11,529 | |
Investments of insurance subsidiary | | | — | | | | — | | | | 1,422 | | | | — | | | | 1,422 | |
Investments in and advances to affiliates | | | — | | | | 243 | | | | 599 | | | | — | | | | 842 | |
Goodwill | | | — | | | | 1,643 | | | | 937 | | | | — | | | | 2,580 | |
Deferred loan costs | | | 458 | | | | — | | | | — | | | | — | | | | 458 | |
Investments in and advances to subsidiaries | | | 19,290 | | | | — | | | | — | | | | (19,290 | ) | | | — | |
Other | | | 1,050 | | | | 31 | | | | 67 | | | | — | | | | 1,148 | |
| | | | | | | | | | | | | | | | | | | | |
| | $ | 21,712 | | | $ | 11,982 | | | $ | 9,876 | | | $ | (19,290 | ) | | $ | 24,280 | |
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | |
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | | | | | | | | | | | | | | | | | | | | |
Current liabilities: | | | | | | | | | | | | | | | | | | | | |
Accounts payable | | $ | — | | | $ | 881 | | | $ | 489 | | | $ | — | | | $ | 1,370 | |
Accrued salaries | | | — | | | | 549 | | | | 305 | | | | — | | | | 854 | |
Other accrued expenses | | | 435 | | | | 284 | | | | 563 | | | | — | | | | 1,282 | |
Long-term debt due within one year | | | 355 | | | | — | | | | 49 | | | | — | | | | 404 | |
| | | | | | | | | | | | | | | | | | | | |
| | | 790 | | | | 1,714 | | | | 1,406 | | | | — | | | | 3,910 | |
Long-term debt | | | 26,089 | | | | 99 | | | | 397 | | | | — | | | | 26,585 | |
Intercompany balances | | | 3,663 | | | | (8,136 | ) | | | 4,473 | | | | — | | | | — | |
Professional liability risks | | | — | | | | — | | | | 1,108 | | | | — | | | | 1,108 | |
Income taxes and other liabilities | | | 1,270 | | | | 379 | | | | 133 | | | | — | | | | 1,782 | |
| | | | | | | | | | | | | | | | | | | | |
| | | 31,812 | | | | (5,944 | ) | | | 7,517 | | | | — | | | | 33,385 | |
Equity securities with contingent redemption rights | | | 155 | | | | — | | | | — | | | | — | | | | 155 | |
| | | | | | | | | | | | | | | | | | | | |
Stockholders’ (deficit) equity attributable to HCA Inc. | | | (10,255 | ) | | | 17,788 | | | | 1,502 | | | | (19,290 | ) | | | (10,255 | ) |
Noncontrolling interests | | | — | | | | 138 | | | | 857 | | | | — | | | | 995 | |
| | | | | | | | | | | | | | | | | | | | |
| | | (10,255 | ) | | | 17,926 | | | | 2,359 | | | | (19,290 | ) | | | (9,260 | ) |
| | | | | | | | | | | | | | | | | | | | |
| | $ | 21,712 | | | $ | 11,982 | | | $ | 9,876 | | | $ | (19,290 | ) | | $ | 24,280 | |
| | | | | | | | | | | | | | | | | | | | |
F-36
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING BALANCE SHEET
DECEMBER 31, 2007
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
ASSETS | | | | | | | | | | | | | | | | | | | | |
Current assets: | | | | | | | | | | | | | | | | | | | | |
Cash and cash equivalents | | $ | — | | | $ | 165 | | | $ | 228 | | | $ | — | | | $ | 393 | |
Accounts receivable, net | | | — | | | | 2,248 | | | | 1,647 | | | | — | | | | 3,895 | |
Inventories | | | — | | | | 432 | | | | 278 | | | | — | | | | 710 | |
Deferred income taxes | | | 592 | | | | — | | | | — | | | | — | | | | 592 | |
Other | | | — | | | | 123 | | | | 492 | | | | — | | | | 615 | |
| | | | | | | | | | | | | | | | | | | | |
| | | 592 | | | | 2,968 | | | | 2,645 | | | | — | | | | 6,205 | |
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | |
Property and equipment, net | | | — | | | | 6,960 | | | | 4,482 | | | | — | | | | 11,442 | |
Investments of insurance subsidiary | | | — | | | | — | | | | 1,669 | | | | — | | | | 1,669 | |
Investments in and advances to affiliates | | | — | | | | 221 | | | | 467 | | | | — | | | | 688 | |
Goodwill | | | — | | | | 1,644 | | | | 985 | | | | — | | | | 2,629 | |
Deferred loan costs | | | 539 | | | | — | | | | — | | | | — | | | | 539 | |
Investments in and advances to subsidiaries | | | 17,190 | | | | — | | | | — | | | | (17,190 | ) | | | — | |
Other | | | 798 | | | | 18 | | | | 37 | | | | — | | | | 853 | |
| | | | | | | | | | | | | | | | | | | | |
| | $ | 19,119 | | | $ | 11,811 | | | $ | 10,285 | | | $ | (17,190 | ) | | $ | 24,025 | |
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | |
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | | | | | | | | | | | | | | | | | | | | |
Current liabilities: | | | | | | | | | | | | | | | | | | | | |
Accounts payable | | $ | — | | | $ | 883 | | | $ | 487 | | | $ | — | | | $ | 1,370 | |
Accrued salaries | | | — | | | | 515 | | | | 265 | | | | — | | | | 780 | |
Other accrued expenses | | | 411 | | | | 372 | | | | 608 | | | | — | | | | 1,391 | |
Long-term debt due within one year | | | 271 | | | | — | | | | 37 | | | | — | | | | 308 | |
| | | | | | | | | | | | | | | | | | | | |
| | | 682 | | | | 1,770 | | | | 1,397 | | | | — | | | | 3,849 | |
Long-term debt | | | 26,439 | | | | 103 | | | | 458 | | | | — | | | | 27,000 | |
Intercompany balances | | | 1,368 | | | | (6,524 | ) | | | 5,156 | | | | — | | | | — | |
Professional liability risks | | | — | | | | — | | | | 1,233 | | | | — | | | | 1,233 | |
Income taxes and other liabilities | | | 1,004 | | | | 238 | | | | 137 | | | | — | | | | 1,379 | |
| | | | | | | | | | | | | | | | | | | | |
| | | 29,493 | | | | (4,413 | ) | | | 8,381 | | | | — | | | | 33,461 | |
Equity securities with contingent redemption rights | | | 164 | | | | — | | | | — | | | | — | | | | 164 | |
| | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | |
Stockholders’ (deficit) equity attributable to HCA Inc. | | | (10,538 | ) | | | 16,107 | | | | 1,083 | | | | (17,190 | ) | | | (10,538 | ) |
Noncontrolling interests | | | — | | | | 117 | | | | 821 | | | | — | | | | 938 | |
| | | | | | | | | | | | | | | | | | | | |
| | | (10,538 | ) | | | 16,224 | | | | 1,904 | | | | (17,190 | ) | | | (9,600 | ) |
| | | | | | | | | | | | | | | | | | | | |
| | $ | 19,119 | | | $ | 11,811 | | | $ | 10,285 | | | $ | (17,190 | ) | | $ | 24,025 | |
| | | | | | | | | | | | | | | | | | | | |
F-37
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS
For The Year Ended December 31, 2008
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | As Restated (see Note 18) | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
Cash flows from operating activities: | | | | | | | | | | | | | | | | | | | | |
Net income | | $ | 673 | | | $ | 1,734 | | | $ | 595 | | | $ | (2,100 | ) | | $ | 902 | |
Adjustments to reconcile net income to net cash provided by (used in) operating activities: | | | | | | | | | | | | | | | | | | | | |
Provision for doubtful accounts | | | — | | | | 2,073 | | | | 1,336 | | | | — | | | | 3,409 | |
Depreciation and amortization | | | — | | | | 776 | | | | 640 | | | | — | | | | 1,416 | |
Income taxes | | | (448 | ) | | | — | | | | — | | | | — | | | | (448 | ) |
Gains on sales of facilities | | | — | | | | (5 | ) | | | (92 | ) | | | — | | | | (97 | ) |
Impairment of long-lived assets | | | — | | | | — | | | | 64 | | | | — | | | | 64 | |
Amortization of deferred loan costs | | | 79 | | | | — | | | | — | | | | — | | | | 79 | |
Share-based compensation | | | 32 | | | | — | | | | — | | | | — | | | | 32 | |
Equity in earnings of affiliates | | | (2,100 | ) | | | — | | | | — | | | | 2,100 | | | | — | |
Decrease in cash from operating assets and liabilities | | | (11 | ) | | | (2,085 | ) | | | (1,271 | ) | | | — | | | | (3,367 | ) |
Other | | | — | | | | (19 | ) | | | 19 | | | | — | | | | — | |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) operating activities | | | (1,775 | ) | | | 2,474 | | | | 1,291 | | | | — | | | | 1,990 | |
| | | | | | | | | | | | | | | | | | | | |
Cash flows from investing activities: | | | | | | | | | | | | | | | | | | | | |
Purchase of property and equipment | | | — | | | | (927 | ) | | | (673 | ) | | | — | | | | (1,600 | ) |
Acquisition of hospitals and health care entities | | | — | | | | (34 | ) | | | (51 | ) | | | — | | | | (85 | ) |
Disposal of hospitals and health care entities | | | — | | | | 27 | | | | 166 | | | | — | | | | 193 | |
Change in investments | | | — | | | | (26 | ) | | | 47 | | | | — | | | | 21 | |
Other | | | — | | | | (4 | ) | | | 8 | | | | — | | | | 4 | |
| | | | | | | | | | | | | | | | | | | | |
Net cash used in investing activities | | | — | | | | (964 | ) | | | (503 | ) | | | — | | | | (1,467 | ) |
| | | | | | | | | | | | | | | | | | | | |
Cash flows from financing activities: | | | | | | | | | | | | | | | | | | | | |
Net change in revolving bank credit facility | | | 700 | | | | — | | | | — | | | | — | | | | 700 | |
Repayment of long-term debt | | | (851 | ) | | | (4 | ) | | | (105 | ) | | | — | | | | (960 | ) |
Distributions to noncontrolling interests | | | — | | | | (32 | ) | | | (146 | ) | | | — | | | | (178 | ) |
Changes in intercompany balances with affiliates, net | | | 1,935 | | | | (1,505 | ) | | | (430 | ) | | | — | | | | — | |
Other | | | (9 | ) | | | — | | | | (4 | ) | | | — | | | | (13 | ) |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) financing activities | | | 1,775 | | | | (1,541 | ) | | | (685 | ) | | | — | | | | (451 | ) |
| | | | | | | | | | | | | | | | | | | | |
Change in cash and cash equivalents | | | — | | | | (31 | ) | | | 103 | | | | — | | | | 72 | |
Cash and cash equivalents at beginning of period | | | — | | | | 165 | | | | 228 | | | | — | | | | 393 | |
| | | | | | | | | | | | | | | | | | | | |
Cash and cash equivalents at end of period | | $ | — | | | $ | 134 | | | $ | 331 | | | $ | — | | | $ | 465 | |
| | | | | | | | | | | | | | | | | | | | |
F-38
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS
For The Year Ended December 31, 2007
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | As Restated (see Note 18) | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
Cash flows from operating activities: | | | | | | | | | | | | | | | | | | | | |
Net income | | $ | 874 | | | $ | 1,476 | | | $ | 977 | | | $ | (2,245 | ) | | $ | 1,082 | |
Adjustments to reconcile net income to net cash provided by (used in) operating activities: | | | | | | | | | | | | | | | | | | | | |
Provision for doubtful accounts | | | — | | | | 1,942 | | | | 1,188 | | | | — | | | | 3,130 | |
Depreciation and amortization | | | — | | | | 779 | | | | 647 | | | | — | | | | 1,426 | |
Income taxes | | | (105 | ) | | | — | | | | — | | | | — | | | | (105 | ) |
Gains on sales of facilities | | | — | | | | (3 | ) | | | (468 | ) | | | — | | | | (471 | ) |
Impairment of long-lived assets | | | — | | | | — | | | | 24 | | | | — | | | | 24 | |
Amortization of deferred loan costs | | | 78 | | | | — | | | | — | | | | — | | | | 78 | |
Share-based compensation | | | 24 | | | | — | | | | — | | | | — | | | | 24 | |
Equity in earnings of affiliates | | | (2,245 | ) | | | — | | | | — | | | | 2,245 | | | | — | |
Decrease in cash from operating assets and liabilities | | | (6 | ) | | | (2,127 | ) | | | (1,482 | ) | | | — | | | | (3,615 | ) |
Other | | | 7 | | | | 18 | | | | (34 | ) | | | — | | | | (9 | ) |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) operating activities | | | (1,373 | ) | | | 2,085 | | | | 852 | | | | — | | | | 1,564 | |
| | | | | | | | | | | | | | | | | | | | |
Cash flows from investing activities: | | | | | | | | | | | | | | | | | | | | |
Purchase of property and equipment | | | — | | | | (640 | ) | | | (804 | ) | | | — | | | | (1,444 | ) |
Acquisition of hospitals and health care entities | | | — | | | | (11 | ) | | | (21 | ) | | | — | | | | (32 | ) |
Disposal of hospitals and health care entities | | | — | | | | 24 | | | | 743 | | | | — | | | | 767 | |
Change in investments | | | — | | | | 3 | | | | 204 | | | | — | | | | 207 | |
Other | | | — | | | | (8 | ) | | | 31 | | | | — | | | | 23 | |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) investing activities | | | — | | | | (632 | ) | | | 153 | | | | — | | | | (479 | ) |
| | | | | | | | | | | | | | | | | | | | |
Cash flows from financing activities: | | | | | | | | | | | | | | | | | | | | |
Net change in revolving bank credit facility | | | (520 | ) | | | — | | | | — | | | | — | | | | (520 | ) |
Repayment of long-term debt | | | (255 | ) | | | (4 | ) | | | (491 | ) | | | — | | | | (750 | ) |
Issuances of common stock | | | 100 | | | | — | | | | — | | | | — | | | | 100 | |
Distributions to noncontrolling interests | | | — | | | | (12 | ) | | | (140 | ) | | | — | | | | (152 | ) |
Changes in intercompany balances with affiliates, net | | | 2,059 | | | | (1,554 | ) | | | (505 | ) | | | — | | | | — | |
Other | | | (11 | ) | | | — | | | | 7 | | | | — | | | | (4 | ) |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) financing activities | | | 1,373 | | | | (1,570 | ) | | | (1,129 | ) | | | — | | | | (1,326 | ) |
| | | | | | | | | | | | | | | | | | | | |
Change in cash and cash equivalents | | | — | | | | (117 | ) | | | (124 | ) | | | — | | | | (241 | ) |
Cash and cash equivalents at beginning of period | | | — | | | | 282 | | | | 352 | | | | — | | | | 634 | |
| | | | | | | | | | | | | | | | | | | | |
Cash and cash equivalents at end of period | | $ | — | | | $ | 165 | | | $ | 228 | | | $ | — | | | $ | 393 | |
| | | | | | | | | | | | | | | | | | | | |
F-39
HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
HCA INC.
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS
For The Year Ended December 31, 2006
(Dollars in millions)
| | | | | | | | | | | | | | | | | | | | |
| | As Restated (see Note 18) | |
| | | | | | | | Subsidiary
| | | | | | | |
| | Parent
| | | Subsidiary
| | | Non-
| | | | | | Condensed
| |
| | Issuer | | | Guarantors | | | Guarantors | | | Eliminations | | | Consolidated | |
|
Cash flows from operating activities: | | | | | | | | | | | | | | | | | | | | |
Net income | | $ | 1,036 | | | $ | 1,353 | | | $ | 843 | | | $ | (1,995 | ) | | $ | 1,237 | |
Adjustments to reconcile net income to net cash provided by (used in) operating activities: | | | | | | | | | | | | | | | | | | | | |
Provision for doubtful accounts | | | — | | | | 1,652 | | | | 1,008 | | | | — | | | | 2,660 | |
Depreciation and amortization | | | — | | | | 755 | | | | 636 | | | | — | | | | 1,391 | |
Income taxes | | | (552 | ) | | | — | | | | — | | | | — | | | | (552 | ) |
Gains on sales of facilities | | | — | | | | 7 | | | | (212 | ) | | | — | | | | (205 | ) |
Impairment of long-lived assets | | | — | | | | 5 | | | | 19 | | | | — | | | | 24 | |
Amortization of deferred loan costs | | | 18 | | | | — | | | | — | | | | — | | | | 18 | |
Share-based compensation | | | 324 | | | | — | | | | — | | | | — | | | | 324 | |
Equity in earnings of affiliates | | | (1,995 | ) | | | — | | | | — | | | | 1,995 | | | | — | |
Increase (decrease) in cash from operating assets and liabilities | | | 78 | | | | (1,552 | ) | | | (1,466 | ) | | | — | | | | (2,940 | ) |
Other | | | 56 | | | | 2 | | | | (27 | ) | | | — | | | | 31 | |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) operating activities | | | (1,035 | ) | | | 2,222 | | | | 801 | | | | — | | | | 1,988 | |
| | | | | | | | | | | | | | | | | | | | |
Cash flows from investing activities: | | | | | | | | | | | | | | | | | | | | |
Purchase of property and equipment | | | — | | | | (1,058 | ) | | | (807 | ) | | | — | | | | (1,865 | ) |
Acquisition of hospitals and health care entities | | | — | | | | (29 | ) | | | (83 | ) | | | — | | | | (112 | ) |
Disposal of hospitals and health care entities | | | — | | | | 108 | | | | 543 | | | | — | | | | 651 | |
Change in investments | | | — | | | | 13 | | | | 13 | | | | — | | | | 26 | |
Other | | | — | | | | (4 | ) | | | (3 | ) | | | — | | | | (7 | ) |
| | | | | | | | | | | | | | | | | | | | |
Net cash used in investing activities | | | — | | | | (970 | ) | | | (337 | ) | | | — | | | | (1,307 | ) |
| | | | | | | | | | | | | | | | | | | | |
Cash flows from financing activities: | | | | | | | | | | | | | | | | | | | | |
Issuances of long-term debt | | | 21,207 | | | | — | | | | 551 | | | | — | | | | 21,758 | |
Net change in revolving bank credit facility | | | (435 | ) | | | — | | | | — | | | | — | | | | (435 | ) |
Repayment of long-term debt | | | (3,621 | ) | | | (3 | ) | | | (104 | ) | | | — | | | | (3,728 | ) |
Issuances of common stock | | | 108 | | | | — | | | | — | | | | — | | | | 108 | |
Repurchases of common stock | | | (653 | ) | | | — | | | | — | | | | — | | | | (653 | ) |
Recapitalization-repurchase of common stock | | | (20,364 | ) | | | — | | | | — | | | | — | | | | (20,364 | ) |
Recapitalization-equity contributions | | | 3,782 | | | | — | | | | — | | | | — | | | | 3,782 | |
Payment of debt issuance costs | | | (586 | ) | | | — | | | | — | | | | — | | | | (586 | ) |
Payment of cash dividends | | | (201 | ) | | | — | | | | — | | | | — | | | | (201 | ) |
Distributions to noncontrolling interests | | | — | | | | (3 | ) | | | (145 | ) | | | — | | | | (148 | ) |
Changes in intercompany balances with affiliates, net | | | 1,719 | | | | (1,095 | ) | | | (624 | ) | | | — | | | | — | |
Other | | | 79 | | | | — | | | | 5 | | | | — | | | | 84 | |
| | | | | | | | | | | | | | | | | | | | |
Net cash provided by (used in) financing activities | | | 1,035 | | | | (1,101 | ) | | | (317 | ) | | | — | | | | (383 | ) |
| | | | | | | | | | | | | | | | | | | | |
Change in cash and cash equivalents | | | — | | | | 151 | | | | 147 | | | | — | | | | 298 | |
Cash and cash equivalents at beginning of period | | | — | | | | 131 | | | | 205 | | | | — | | | | 336 | |
| | | | | | | | | | | | | | | | | | | | |
Cash and cash equivalents at end of period | | $ | — | | | $ | 282 | | | $ | 352 | | | $ | — | | | $ | 634 | |
| | | | | | | | | | | | | | | | | | | | |
Healthtrust, Inc. — The Hospital Company (“Healthtrust”) is the first-tier subsidiary of HCA Inc. The common stock of Healthtrust has been pledged as collateral for the senior secured credit facilities and senior secured notes
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HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
| |
NOTE 17 — | SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued) |
described in Note 10.Rule 3-16 ofRegulation S-X under the Securities Act requires the filing of separate financial statements for any affiliate of the registrant whose securities constitute a substantial portion of the collateral for any class of securities registered or being registered. We believe the separate financial statements requirement applies to Healthtrust due to the pledge of its common stock as collateral for the senior secured notes. Due to the corporate structure relationship of HCA and Healthtrust, HCA’s operating subsidiaries are also the operating subsidiaries of Healthtrust. The corporate structure relationship, combined with the application of push-down accounting in Healthtrust’s consolidated financial statements related to HCA’s debt and financial instruments, results in the consolidated financial statements of Healthtrust being substantially identical to the consolidated financial statements of HCA. The consolidated financial statements of HCA and Healthtrust present the identical amounts for revenues, expenses, net income, assets, liabilities, total stockholders’ (deficit) equity, net cash provided by operating activities, net cash used in investing activities and net cash used in financing activities. Certain individual line items in the HCA consolidated statements of stockholders’ (deficit) equity and cash flows are combined into one line item in the Healthtrust consolidated statements of stockholder’s (deficit) equity and cash flows.
Reconciliations of the HCA Inc. Consolidated Statements of Stockholders’ (Deficit) Equity and Consolidated Statements of Cash Flows presentations to the Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder’s (Deficit) Equity and Consolidated Statements of Cash Flows presentations for the years ended December 31, 2008, 2007 and 2006 are as follows (dollars in millions):
| | | | | | | | | | | | |
| | 2008 | | | 2007 | | | 2006 | |
|
Presentation in HCA Inc. Consolidated Statements of Stockholders’ (Deficit) Equity: | | | | | | | | | | | | |
Recapitalization-repurchase of common stock | | $ | — | | | $ | — | | | $ | (21,373 | ) |
Recapitalization-equity contribution | | | — | | | | — | | | | 4,477 | |
Cash dividends declared | | | — | | | | — | | | | (139 | ) |
Stock repurchases | | | — | | | | — | | | | (653 | ) |
Stock options exercised | | | — | | | | — | | | | 163 | |
Employee benefit plan issuances | | | — | | | | — | | | | 366 | |
Equity contributions | | | — | | | | 60 | | | | — | |
Share-based benefit plans | | | 40 | | | | 24 | | | | — | |
Other | | | 2 | | | | 28 | | | | — | |
| | | | | | | | | | | | |
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder’s (Deficit) Equity: | | | | | | | | | | | | |
Distributions from (to) HCA Inc., net of contributions to (from) HCA Inc. | | $ | 42 | | | $ | 112 | | | $ | (17,159 | ) |
| | | | | | | | | | | | |
Presentation in HCA Inc. Consolidated Statements of Cash Flows (cash flows from financing activities): | | | | | | | | | | | | |
Issuances of common stock | | $ | — | | | $ | 100 | | | $ | 108 | |
Repurchases of common stock | | | — | | | | — | | | | (653 | ) |
Recapitalization-repurchase of common stock | | | — | | | | — | | | | (20,364 | ) |
Recapitalization-equity contributions | | | — | | | | — | | | | 3,782 | |
Payment of cash dividends | | | — | | | | — | | | | (201 | ) |
Other | | | (9 | ) | | | (2 | ) | | | — | |
| | | | �� | | | | | | | | |
Presentation in Healthtrust Inc. — The Hospital Company Consolidated Statements of Cash Flows (cash flows from financing activities): | | | | | | | | | | | | |
Net cash distributions from (to) HCA Inc. | | $ | (9 | ) | | $ | 98 | | | $ | (17,328 | ) |
| | | | | | | | | | | | |
Due to the consolidated financial statements of Healthtrust being substantially identical to the consolidated financial statements of HCA, except for the items presented in the tables above, the separate consolidated financial statements of Healthtrust are not presented.
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HCA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)
NOTE 18 — RESTATEMENT OF CONSOLIDATED STATEMENTS OF CASH FLOWS
We have restated our Consolidated Statements of Cash Flows for each of the three years in the period ended December 31, 2008 due to errors we made in our retrospective application of certain presentation provisions of SFAS 160. SFAS 160 requires that distributions to and certain other transactions with noncontrolling interests, which we previously presented as operating activities in our Consolidated Statements of Cash Flows, be presented as financing activities. Distributions to and certain other transactions with noncontrolling interests of $193 million, $168 million and $143 million for the years ended December 31, 2008, 2007 and 2006, respectively, have been reclassified from operating activities to financing activities in our Consolidated Statements of Cash Flows. The impact of these reclassifications was to increase net cash provided by operating activities and increase net cash used in financing activities by the amount reclassified for each respective year.
F-42
| | | | | | | | | | | | | | | | |
| | 2008 |
| | First | | Second | | Third | | Fourth |
|
Revenues | | $ | 7,127 | | | $ | 6,980 | | | $ | 7,002 | | | $ | 7,265 | |
Net income attributable to HCA Inc. | | $ | 170 | (a) | | $ | 141 | (b) | | $ | 86 | (c) | | $ | 276 | (d) |
| | | | | | | | | | | | | | | | |
| | 2007 |
| | First | | Second | | Third | | Fourth |
|
Revenues | | $ | 6,677 | | | $ | 6,729 | | | $ | 6,569 | | | $ | 6,883 | |
Net income attributable to HCA Inc. | | $ | 180 | (e) | | $ | 116 | (f) | | $ | 300 | (g) | | $ | 278 | (h) |
| | |
(a) | | First quarter results include $30 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements). |
|
(b) | | Second quarter results include $6 million of losses on sales of facilities (See NOTE 4 of the notes to consolidated financial statements) and $6 million of costs related to the impairment of long-lived assets (See NOTE 5 of the notes to consolidated financial statements). |
|
(c) | | Third quarter results include $29 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements) and $28 million of costs related to the impairment of long-lived assets (See NOTE 5 of the notes to consolidated financial statements). |
|
(d) | | Fourth quarter results include $5 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements) and $6 million of costs related to the impairment of long-lived assets (See NOTE 5 of the notes to consolidated financial statements). |
|
(e) | | First quarter results include $2 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements). |
|
(f) | | Second quarter results include $7 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements) and $15 million of costs related to the impairment of long-lived assets (See NOTE 5 of the notes to consolidated financial statements). |
|
(g) | | Third quarter results include $193 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements). |
|
(h) | | Fourth quarter results include $88 million of gains on sales of facilities (See NOTE 4 of the notes to consolidated financial statements). |
F-43