HCA Healthcare, Inc. (HCA) FY2025 Annual Statement of Cash Flows

Income StatementCash FlowBalance Sheet

Statement of Cash Flows

2025-01-01 to 2025-12-31

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HCA Healthcare, Inc. cash flow reconciliation, Jan 1, 2025 through Dec 31, 2025One connected Sankey reconciles operating, investing and financing net cash flows through a shared cash pool, from beginning cash to ending cash. Ribbons flow left to right on one dollar scale. Activity totals are dark gray; beginning and ending cash are blue. Cash basis for beginning and ending balances and net cash change: Cash, cash equivalents, and restricted cash. Intermediate calculation bars are lighter gray. Net income is green for profit and red for loss. Identified asset purchases, sales and maturities are blue in either cash direction. Purple identifies capital transactions such as borrowing, repayments, share issuance and dividends. Free cash flow is a separate comparison, not an added cash flow. Read chart description and values below for full signed amounts, including zero items.Net income → Net cash from operating activities: $7,782,000,000.00Depreciation and amortization → Operating adjustments reconciliation: $3,523,000,000.00Accounts payable and accrued expenses → Operating adjustments reconciliation: $666,000,000.00Share-based compensation → Operating adjustments reconciliation: $401,000,000.00Income taxes → Operating adjustments reconciliation: $310,000,000.00Other → Operating adjustments reconciliation: $195,000,000.00Amortization of debt issuance costs and discounts → Operating adjustments reconciliation: $44,000,000.00Operating adjustments reconciliation → Net cash from operating activities: $4,854,000,000.00Operating adjustments reconciliation → Inventories and other assets: $154,000,000.00Operating adjustments reconciliation → Accounts receivable: $94,000,000.00Operating adjustments reconciliation → Losses (gains) on sales of facilities: $37,000,000.00Sales of hospitals and health care entities → investing reconciliation: $269,000,000.00Change in investments → investing reconciliation: $72,000,000.00Other → investing reconciliation: $12,000,000.00investing reconciliation → Purchase of property and equipment: $4,944,000,000.00investing reconciliation → Acquisition of hospitals and health care entities: $397,000,000.00Net cash used in financing activities → financing reconciliation: $8,550,000,000.00Issuances of long-term debt → financing reconciliation: $8,474,000,000.00Net change in short-term borrowings and revolving credit facilities → financing reconciliation: $2,202,000,000.00financing reconciliation → Repurchase of common stock: $10,067,000,000.00financing reconciliation → Repayment of long-term debt: $7,389,000,000.00financing reconciliation → Distributions to noncontrolling interests: $827,000,000.00financing reconciliation → Payment of dividends: $679,000,000.00financing reconciliation → Other: $185,000,000.00financing reconciliation → Payment of debt issuance costs: $79,000,000.00Net cash used in investing activities → investing reconciliation: $4,988,000,000.00Exchange-rate effect → Cash sources and uses: $9,000,000.00Beginning cash: Cash, cash equivalents, and restricted cash → Cash sources and uses: $1,933,000,000.00Net cash from operating activities → Cash sources and uses: $12,636,000,000.00Cash sources and uses → Ending cash: Cash, cash equivalents, and restricted cash: $1,040,000,000.00Cash sources and uses → Net cash used in investing activities: $4,988,000,000.00Cash sources and uses → Net cash used in financing activities: $8,550,000,000.00Depreciation and amortization: $3,523,000,000.00Depreciation & amortization+$3.52 BIncome taxes: $310,000,000.00Deferred taxes & credits+$310.00 MLosses (gains) on sales of facilities: -$37,000,000.00Asset sale gain & loss−$37.00 MAmortization of debt issuance costs and discounts: $44,000,000.00Debt cost amortization+$44.00 MShare-based compensation: $401,000,000.00Stock-based compensation+$401.00 MOther: $195,000,000.00Other non-cash items+$195.00 MAccounts receivable: -$94,000,000.00Accounts receivable−$94.00 MInventories and other assets: -$154,000,000.00Inventories & other assets−$154.00 MAccounts payable and accrued expenses: $666,000,000.00Payables & accrued liabilities+$666.00 MNet income: $7,782,000,000.00Net income+$7.78 BNet cash from operating activities: $12,636,000,000.00Operating cash+$12.64 BOperating adjustments reconciliation: $5,139,000,000.00Issuances of long-term debt: $8,474,000,000.00Long-term debt issued+$8.47 BNet change in short-term borrowings and revolving credit facilities: $2,202,000,000.00Credit lines, net+$2.20 BRepayment of long-term debt: -$7,389,000,000.00Long-term debt repaid−$7.39 BDistributions to noncontrolling interests: -$827,000,000.00Paid to noncontrolling interests−$827.00 MPayment of debt issuance costs: -$79,000,000.00Debt issuance costs−$79.00 MPayment of dividends: -$679,000,000.00Dividends paid−$679.00 MRepurchase of common stock: -$10,067,000,000.00Common stock repurchases−$10.07 BOther: -$185,000,000.00Other financing, net−$185.00 MNet cash used in financing activities: -$8,550,000,000.00. Cash required to fund net payments.Financing cash−$8.55 Bfinancing reconciliation: $19,226,000,000.00Purchase of property and equipment: -$4,944,000,000.00PP&E purchases−$4.94 BAcquisition of hospitals and health care entities: -$397,000,000.00Investments in affiliates−$397.00 MSales of hospitals and health care entities: $269,000,000.00Business sales+$269.00 MChange in investments: $72,000,000.00Investments, net+$72.00 MOther: $12,000,000.00Other investing, net+$12.00 MNet cash used in investing activities: -$4,988,000,000.00. Cash required to fund net payments.Investing cash−$4.99 Binvesting reconciliation: $5,341,000,000.00Cash sources and uses: $14,578,000,000.00Beginning cash: Cash, cash equivalents, and restricted cash: $1,933,000,000.00Beginning cash$1.93 BEnding cash: Cash, cash equivalents, and restricted cash: $1,040,000,000.00Ending cash$1.04 BExchange-rate effect: $9,000,000.00FX effect+$9.00 MCASH RECONCILIATIONOperatingflowsInvestingflowsFinancingflowsFree cash flow$7.69 BOperating cash − cash spent on PP&ECash flow / Net income1.62×Operating cash flow ÷ net incomeNet cash change−$893.00 MEnding cash − beginning cash
Chart details

HCA Healthcare, Inc. cash flow reconciliation, Jan 1, 2025 through Dec 31, 2025

Cash flows for Jan 1, 2025 through Dec 31, 2025. Cash basis: Cash, cash equivalents, and restricted cash. Beginning cash: Dec 31, 2024. Ending cash: Dec 31, 2025. Beginning and ending cash are dated balances. Positive cash flows add cash; negative cash flows reduce it.

Beginning cash on Dec 31, 2024
1,933,000,000 US dollars. Beginning cash: Cash, cash equivalents, and restricted cash
Operating activities
12,636,000,000 US dollars. Net cash provided.
Depreciation and amortization
3,523,000,000 US dollars
Income taxes
310,000,000 US dollars
Losses (gains) on sales of facilities
negative 37,000,000 US dollars
Amortization of debt issuance costs and discounts
44,000,000 US dollars
Share-based compensation
401,000,000 US dollars
Other
195,000,000 US dollars
Accounts receivable
negative 94,000,000 US dollars
Inventories and other assets
negative 154,000,000 US dollars
Accounts payable and accrued expenses
666,000,000 US dollars
Net income
7,782,000,000 US dollars
Investing activities
negative 4,988,000,000 US dollars. Net cash used.
Purchase of property and equipment
negative 4,944,000,000 US dollars
Acquisition of hospitals and health care entities
negative 397,000,000 US dollars
Sales of hospitals and health care entities
269,000,000 US dollars
Change in investments
72,000,000 US dollars
Other
12,000,000 US dollars
Financing activities
negative 8,550,000,000 US dollars. Net cash used.
Issuances of long-term debt
8,474,000,000 US dollars
Net change in short-term borrowings and revolving credit facilities
2,202,000,000 US dollars
Repayment of long-term debt
negative 7,389,000,000 US dollars
Distributions to noncontrolling interests
negative 827,000,000 US dollars
Payment of debt issuance costs
negative 79,000,000 US dollars
Payment of dividends
negative 679,000,000 US dollars
Repurchase of common stock
negative 10,067,000,000 US dollars
Other
negative 185,000,000 US dollars
Operating adjustment reconciliation
5,139,000,000 US dollars. Intermediate calculation joining the operating reconciliation branches. Its gross amount includes any portion of net income routed through this junction. It is not an additional cash source or use.
financing gross reconciliation
19,226,000,000 US dollars. Gross amount at the activity's junction before offsetting its receipts and deductions. It is not an additional cash source or use.
investing gross reconciliation
5,341,000,000 US dollars. Gross amount at the activity's junction before offsetting its receipts and deductions. It is not an additional cash source or use.
Exchange-rate effect
9,000,000 US dollars
Ending cash on Dec 31, 2025
1,040,000,000 US dollars. Ending cash: Cash, cash equivalents, and restricted cash
Cash sources and uses
14,578,000,000 US dollars. Opening cash plus net sources, equal to net uses plus ending cash.
Net cash change
negative 893,000,000 US dollars. Ending cash minus beginning cash.
Cash flow / Net income
1.62×. Operating cash flow divided by reconciliation net income for the same period. Black from 0.90× through 1.10×; green above 1.10×; red below 0.90×. Color uses the unrounded ratio.
Operating cash flow
12,636,000,000 US dollars. Operating cash flow used in the free cash flow calculation.
Cash purchases of property, plant and equipment
4,944,000,000 US dollars. These cash purchases are already included in investing activities above.
Free cash flow
7,692,000,000 US dollars. A supplemental measure; finance-lease payments are excluded from this definition.

Chart connections

  • Beginning cash plus operating, investing and financing cash flows plus the exchange-rate effect equals ending cash. Negative amounts reduce cash.
  • Financing contributions meet at a reconciliation junction before connecting to the net cash total.
  • Investing contributions meet at a reconciliation junction before connecting to the net cash total.
  • Operating reconciliation adjustments are not all independent cash receipts.
  • Net income enters operating cash directly in the reconciliation. The adjustment junction contributes the remaining $4.85B after reconciling the other positive and negative adjustments. These connections depict an accounting reconciliation, not traced cash receipts.
  • Each activity has one net cash bar connected to the shared cash pool. Positive activity totals enter the pool; negative activity totals leave the pool to fund that activity's net payments. The central pool does not assign a particular funding source to a particular payment.
  • The intermediate calculation bars include both sides of the displayed activity breakdowns; they are not additional cash flows.
  • Operating cash flow minus cash purchases of property, plant and equipment equals free cash flow: 12,636,000,000 US dollars minus 4,944,000,000 US dollars equals 7,692,000,000 US dollars.
HCA Healthcare, Inc. (HCA) FY2025 Annual Statement of Cash Flows Sankey chart
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