Same store uncompensated care as a percentage of net patient revenues (prior to the uncompensated care deductions) increased from 17.9 percent during the first quarter of fiscal 2012 to 20.8 percent during the first quarter of fiscal 2013 primarily due to an increase in uninsured discharges as a percentage of total discharges.
Balance Sheet and Cash Flows
As of September 30, 2012, we had cash of $330.2 million and total debt of $2,704.6 million.
Cash flows from operating activities improved by $31.4 million during the first quarter of fiscal 2013 compared to the prior year period. Changes in net operating assets and liabilities negatively impacted operating cash flows by $144.6 million during the first quarter of fiscal 2013 compared to a negative impact of $166.5 million during the prior year period. We made $89.0 million of interest and income tax payments during the first quarter of fiscal 2013, which was $17.9 million higher than these payments during the prior year period. Cash flows from operations during the first quarter of fiscal 2013 were negatively impacted by the timing of payments of accounts payable and certain accrued expenses and significant employer contributions to The Detroit Medical Center (“DMC”) defined benefit pension plan, but were positively impacted by improved cash collections of accounts receivable and the receipt of certain settlement receivables from the federal government.
Capital expenditures increased 30.4 percent to $82.7 million during the first quarter of fiscal 2013 compared to the prior year period due to increased spending related to the DMC specified capital project commitments and the start of construction of a new hospital in New Braunfels, Texas.
Outlook for Fiscal Year 2013
We are confirming our previously issued fiscal year 2013 outlook for ranges of projected Adjusted EBITDA, projected net income attributable to Vanguard Health Systems, Inc. stockholders, projected diluted earnings per share and projected capital expenditures.