grepcent public filings, reorganized for comparison

STRYKER CORP (SYK) FY 2021 MD&A

Verbatim Item 7 Management's Discussion and Analysis from STRYKER CORP's 10-K for fiscal year 2021. Filing date: 2022-02-11. Report date: 2021-12-31. Accession: 0000310764-22-000028.

This page reproduces the company's own Item 7 MD&A text from the linked SEC filing. It is filer text, not grepcent analysis, scoring, or investment advice.

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Published MD&A gate trimmed front/tail over-capture. Confidence: high.

Company profile: SYK · All MD&A years: index · Next year: FY 2022

ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.

About Stryker

Stryker is one of the world's leading medical technology companies and, together with our customers, we are driven to make healthcare better. We offer innovative products and services in Medical and Surgical, Neurotechnology, Orthopaedics and Spine that help improve patient and hospital outcomes. Our goal is to achieve sales growth at the high-end of the medical technology (MedTech) industry and maintain our long-term capital allocation strategy that prioritizes: (1) Acquisitions, (2) Dividends and (3) Share repurchases.

COVID-19 Pandemic

The COVID-19 pandemic has led to severe disruptions in the market and the global and United States economies that may continue for a prolonged duration and trigger a recession or a period of economic slowdown. In response, various governmental authorities and private enterprises have implemented numerous measures to contain the pandemic, such as travel bans and restrictions, quarantines, shelter-in-place orders and shutdowns. A significant number of our customers, global suppliers, vendors, distributors and manufacturing facilities are located in regions that have been affected by the pandemic. Those operations have been materially adversely affected by restrictive government and private enterprise measures implemented in response to the pandemic.

Some of our products are particularly sensitive to reductions in elective medical procedures. Elective medical procedures were suspended in the first quarter of 2020 in many of the markets where our products are marketed and sold, which negatively affected our business, cash flows, financial condition and results of operations through the first quarter of 2021. In the second quarter of 2021 we saw partial recovery of elective procedures in most geographies; however, in the third quarter of 2021 we saw hospitalization rates increase, especially in the United States, as a result of the Delta variant. This, along with the Omicron variant, has continued to adversely impact elective procedures and increased inflationary pressure on our gross margin, including an increase in freight and transportation costs as well as increased absenteeism in the fourth quarter of 2021.

Overview of 2021

In 2021 we achieved reported net sales growth of 19.2%. Excluding the impact of acquisitions and divestitures, sales grew 12.6% in constant currency. We reported net earnings of $1,994 and net earnings per diluted share of $5.21. Excluding the impact of certain items, we achieved adjusted net earnings(1) of $3,474

and adjusted net earnings per diluted share(1) of $9.09 representing growth of 22.3%.

Effective December 31, 2021 we changed our reportable business segments to (i) MedSurg and Neurotechnology and (ii) Orthopaedics and Spine to align to our new internal reporting structure. Refer to Note 14 to our Consolidated Financial Statements for further information.

We continued our capital allocation strategy by investing $339 in acquisitions and paying $950 in dividends to our shareholders.

In 2021 we had total long-term debt repayments of $1,151. In October 2021 we entered into a new revolving credit agreement that replaces our previous agreement dated August 19, 2016. Refer to Note 10 to our Consolidated Financial Statements for further information.

In 2021 we completed acquisitions for total net cash consideration of $339 and $54 in future milestone payments primarily due upon the achievement of certain regulatory and commercial milestones. In September 2021 we completed the acquisition of Gauss Surgical, Inc. (Gauss) for $120 in cash and up to $40 in future milestone payments. Gauss is a medical device company that has developed Triton, an artificial intelligence-enabled platform for real-time monitoring of blood loss during surgery. Gauss is part of our Instruments business within MedSurg and Neurotechnology. In January 2022 we announced a definitive merger agreement to acquire all of the issued and outstanding common shares of Vocera Communications, Inc. (Vocera) for $79.25 per share, or an aggregate purchase price of approximately $3.1 billion (including convertible notes). Refer to Note 6 to our Consolidated Financial Statements for further information.

In 2021 we did not repurchase any shares of our common stock under our authorized repurchase program. The total dollar value of shares of our common stock that could be acquired under our authorized repurchase program was $1,033 as of December 31, 2021.

In 2021 we recorded asset impairments of $264, $105 for certain long-lived and intangible assets related to the China volume-based procurement program and the remaining consisting primarily of in-process research and development, other intangible assets and property, plant and equipment as a result of COVID-19-related demand impacts on in-process product development and certain other divestiture and restructuring activities. Refer to Note 15 to our Consolidated Financial Statements for further information.

(1)    Refer to "Non-GAAP Financial Measures" for a discussion of non-GAAP financial measures used in this report and a reconciliation to the most directly comparable GAAP financial measure.

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STRYKER CORPORATION 2021 FORM 10-K

CONSOLIDATED RESULTS OF OPERATIONS

Percent Net SalesPercentage Change
2021202020192021202020192021 vs. 20202020 vs. 2019
Net sales$17,108$14,351$14,884100.0%100.0%100.0%19.2%(3.6)%
Gross profit10,9689,0579,69664.163.165.121.1(6.6)
Research, development and engineering expenses1,2359849717.26.96.525.51.3
Selling, general and administrative expenses6,4275,3615,35637.637.436.019.90.1
Recall charges, net of insurance proceeds103171920.60.11.3nm(91.1)
Amortization of intangible assets6194724643.63.33.131.11.7
Other income (expense), net(303)(269)(151)(1.8)(1.9)(1.0)12.678.1
Income taxes287355479(19.2)(25.9)
Net earnings$1,994$1,599$2,08311.7%11.1%14.0%24.7%(23.2)%
Net earnings per diluted share$5.21$4.20$5.4824.0%(23.4)%
Adjusted net earnings per diluted share(1)$9.09$7.43$8.2622.3%(10.0)%
Geographic and Segment Net SalesPercentage Change
2021 vs. 20202020 vs. 2019
202120202019As ReportedConstant CurrencyAs ReportedConstant Currency
Geographic:
United States$12,321$10,455$10,95717.9%17.9%(4.6)%(4.6)%
International4,7873,8963,92722.818.8(0.8)(0.9)
Total$17,108$14,351$14,88419.2%18.1%(3.6)%(3.6)%
Segment:
MedSurg and Neurotechnology$9,538$8,345$8,47514.3%13.3%(1.5)%(1.5)%
Orthopaedics and Spine7,5706,0066,40926.024.8(6.3)(6.4)
Total$17,108$14,351$14,88419.2%18.1%(3.6)%(3.6)%
Supplemental Net Sales Growth Information
Percentage Change
2021 vs. 20202020 vs. 2019
United StatesInternationalUnited StatesInternational
202120202019As ReportedConstant CurrencyAs ReportedAs ReportedConstant CurrencyAs ReportedConstant CurrencyAs ReportedAs ReportedConstant Currency
MedSurg and Neurotechnology:
Instruments$2,111$1,863$1,95913.4%12.5%11.3%20.9%16.6%(5.0)%(5.0)%(4.7)%(6.1)%(6.2)%
Endoscopy2,1411,7631,98321.520.818.632.729.4(11.1)(11.0)(10.7)(12.5)(12.2)
Medical2,6072,5242,2643.32.25.1(2.4)(6.6)11.511.86.928.930.3
Neurovascular1,18897392422.019.518.324.420.35.34.9(2.4)11.110.1
Neuro Cranial1,2149721,05924.924.323.432.428.6(8.2)(8.3)(10.1)1.21.0
Other27725028610.410.310.048.940.8(12.3)(12.3)(12.4)(2.2)
$9,538$8,345$8,47514.3%13.3%13.0%18.1%14.0%(1.5)%(1.5)%(3.9)%6.1%6.2%
Orthopaedics and Spine:
Knees$1,848$1,567$1,81518.0%16.9%15.4%25.5%21.3%(13.7)%(13.7)%(13.1)%(15.3)%(15.5)%
Hips1,3421,2061,38311.29.95.821.117.2(12.8)(12.7)(12.0)(14.1)(13.8)
Trauma and Extremities2,6641,7221,63954.653.063.836.832.35.14.78.4(0.9)(1.9)
Spine1,1671,0471,15711.510.58.719.115.2(9.5)(9.6)(12.5)(0.6)(0.9)
Other54946441518.218.010.158.857.411.711.415.8(4.9)(6.5)
$7,570$6,006$6,40926.0%24.8%25.0%28.6%24.5%(6.3)%(6.4)%(5.6)%(8.0)%(8.4)%
Total$17,108$14,351$14,88419.2%18.1%17.9%22.8%18.8%(3.6)%(3.6)%(4.6)%(0.8)%(0.9)%

nm - not meaningful

Consolidated Net Sales

Consolidated net sales increased 19.2% as reported and 18.1% in constant currency. Excluding the 5.5% impact of acquisitions and divestitures, net sales in constant currency increased by 13.4% from increased unit volume partially offset by 0.8% due to lower prices. The unit volume increase was primarily due to higher shipments across all product lines.

Consolidated net sales in 2020 were significantly negatively impacted by the global response to the COVID-19 pandemic. Consolidated net sales decreased 3.6% as reported and in constant currency. Excluding the 1.2% impact of acquisitions, net

sales in constant currency decreased by 4.1% from decreased unit volume and 0.7% due to lower prices. The unit volume decrease was primarily due to lower shipments of instruments, endoscopy, neurotechnology, spine, knee and hip products partially offset by higher shipments of medical products.

MedSurg and Neurotechnology Net Sales

MedSurg and Neurotechnology net sales in 2021 increased 14.3% as reported and 13.3% in constant currency, as foreign currency exchange rates positively impacted net sales by 1.0%. Excluding the 0.2% impact of acquisitions and divestitures, net sales in constant currency increased by 13.6% from increased

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STRYKER CORPORATION 2021 FORM 10-K

unit volume partially offset by 0.5% due to lower prices. The unit volume increase was primarily due to higher shipments across all medsurg and neurotechnology product lines.

MedSurg and Neurotechnology net sales in 2020 decreased 1.5% as reported and 1.5% in constant currency. Excluding the 0.4% impact of acquisitions, net sales in constant currency decreased by 1.8% from decreased unit volume and 0.1% due to lower prices. The unit volume decrease was primarily due to lower shipments of instruments, endoscopy and other medsurg and neurotechnology products partially offset by higher shipments of medical products.

Orthopaedics and Spine Net Sales

Orthopaedics and Spine net sales in 2021 increased 26.0% as reported and 24.8% in constant currency, as foreign currency exchange rates positively impacted net sales by 1.2%. Excluding the 12.8% impact of acquisitions and divestitures, net sales in constant currency increased by 13.2% from increased unit volume partially offset by 1.2% due to lower prices. The unit volume increase was primarily due to higher shipments across all orthopaedics and spine products.

Orthopaedics and Spine net sales in 2020 decreased 6.3% as reported and 6.4% in constant currency, as foreign currency exchange rates positively impacted net sales by 0.1%. Excluding the 2.3% impact of acquisitions, net sales in constant currency decreased by 7.1% from unit volume and 1.6% due to lower prices. The unit volume decrease was due to lower shipments of knees, hips and spine products partially offset by higher shipments of other orthopaedic and spine products.

Gross Profit

Gross profit as a percentage of net sales increased to 64.1% in 2021 from 63.1% in 2020. Excluding the impact of the items noted below, gross profit increased to 65.9% from 63.8% in 2020 primarily due to leverage from higher sales volumes and favorable product mix, partially offset by lower selling prices.

Gross profit was significantly negatively impacted by the global response to the COVID-19 pandemic in 2020, decreasing as a percentage of net sales to 63.1% from 65.1% in 2019. Excluding the impact of the items noted below, gross profit decreased to 63.8% from 65.9% in 2019 primarily due to lower sales volumes, lower selling prices, lower manufacturing volumes and unfavorable product mix due to the postponement of elective medical procedures.

Percent Net Sales
202120202019202120202019
Reported$10,968$9,057$9,69664.1%63.1%65.1%
Inventory stepped up to fair value26648671.60.30.5
Restructuring-related and other charges2853380.20.40.3
Medical device regulations526
Adjusted$11,267$9,160$9,80765.9%63.8%65.9%

Research, Development and Engineering Expenses

Research, development and engineering expenses as a percentage of net sales increased to 7.2% in 2021 from 6.9% in 2020 and 6.5% in 2019. Excluding the impact of the items noted below, expenses increased to 6.6% in 2021 from 6.3% in 2020 and 6.1% in 2019. Disciplined ramp up in spending to facilitate our growth, including projects to develop new products, investments in new technologies and integration of recent acquisitions contributed to the increase.

Percent Net Sales
202120202019202120202019
Reported$1,235$984$9717.2%6.9%6.5%
Medical device regulations(102)(79)(56)(0.6)(0.6)(0.4)
Adjusted$1,133$905$9156.6%6.3%6.1%

Selling, General and Administrative Expenses

Selling, general and administrative expenses as a percentage of net sales in 2021 increased to 37.6% from 37.4% in 2020 and 36.0% in 2019. Both 2021 and 2020 included charges related to certain asset impairments. Refer to Note 15 to our Consolidated Financial Statements for further information. Excluding the impact of the items noted below, expenses increased to 33.6% in 2021 from 33.1% in 2020 and 33.5% in 2019 primarily due to disciplined ramp up in spending to facilitate our growth.

Percent Net Sales
202120202019202120202019
Reported$6,427$5,361$5,35637.6%37.4%36.0%
Other acquisition and integration-related(319)(194)(208)(1.9)(1.4)(1.4)
Restructuring-related and other charges(358)(406)(188)(2.1)(2.9)(1.3)
Regulatory and legal matters2(6)240.2
Adjusted$5,752$4,755$4,98433.6%33.1%33.5%

Recall Charges, Net of Insurance Proceeds

Recall charges were $103, $17 and $192 in 2021, 2020 and 2019. Charges were primarily due to the previously disclosed Rejuvenate and ABGII Modular-Neck hip stems and LFIT V40 femoral head voluntary recalls. Refer to Note 7 to our Consolidated Financial Statements for further information.

Amortization of Intangible Assets

Amortization of intangible assets was $619, $472 and $464 in 2021, 2020 and 2019. The increase in 2021 was primarily due to the acquisition of Wright Medical Group N.V. (Wright) in the fourth quarter of 2020. Refer to Notes 6 and 8 to our Consolidated Financial Statements for further information.

Operating Income

Operating income decreased as a percentage of sales to 15.1% in 2021 from 15.5% in 2020. Excluding the impact of the items noted below, operating income increased to 25.6% of sales in 2021 from 24.4% in 2020, primarily due to leverage from higher sales volumes partially offset by disciplined spending to facilitate our growth.

Operating income as a percentage of sales in 2020 decreased to 15.5% from 18.2% in 2019. Excluding the impact of the items noted below, operating income decreased to 24.4% in 2020 from 26.3% in 2019 due to unfavorable product mix and the impact of lower sales volumes from the postponement of elective medical procedures partially offset by continued focus on our operating expense savings actions.

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STRYKER CORPORATION 2021 FORM 10-K

Percent Net Sales
202120202019202120202019
Reported$2,584$2,223$2,71315.1%15.5%18.2%
Inventory stepped up to fair value26648671.60.30.5
Other acquisition and integration-related3191942081.91.41.4
Amortization of intangible assets6194724643.53.33.2
Restructuring-related and other charges3864582262.33.21.5
Medical device regulations10781620.60.60.4
Recall-related matters103171920.60.11.3
Regulatory and legal matters(2)6(24)(0.2)
Adjusted$4,382$3,499$3,90825.6%24.4%26.3%

Other Income (Expense), Net

Other income (expense), net was ($303), ($269) and ($151) in 2021, 2020 and 2019. The increase in net expense in 2021 was primarily due to increased interest expense driven by the additional debt from the bond offerings completed in June 2020 and November 2020. Refer to Note 10 to our Consolidated Financial Statements for further information.

Income Taxes

Our effective tax rate was 12.6%, 18.2% and 18.7% for 2021, 2020 and 2019. The effective income tax rate for 2021 reflects the continued lower effective income tax rates as a result of our European operations, certain discrete tax benefits, the tax effect related to the transfer of intellectual property between tax jurisdictions and the tax effect of future remittances of the undistributed earnings of foreign subsidiaries.

The effective income tax rate for 2020 and 2019 reflects the tax effect related to the transfer of intellectual properties between tax jurisdictions, the effective income tax rates as a result of our European operations and the tax effect of future remittances of the undistributed earnings of foreign subsidiaries.

Net Earnings

Net earnings increased to $1,994 or $5.21 per diluted share from $1,599 or $4.20 per diluted share in 2020 and decreased from $2,083 or $5.48 per diluted share in 2019. Adjusted net earnings per diluted share(1) of $9.09 increased 22.3% from $7.43 in 2020 compared to $8.26 in 2019. The impact of foreign currency exchange rates increased net earnings per diluted share by approximately $0.19 in 2021 and reduced net earnings per diluted share by approximately $0.02 and $0.14 in 2020 and 2019.

Percent Net Sales
202120202019202120202019
Reported$1,994$1,599$2,08311.7%11.1%14.0%
Inventory stepped up to fair value20336511.20.30.3
Other acquisition and integration-related2441571601.41.11.1
Amortization of intangible assets4893813752.92.62.6
Restructuring-related and other charges3453971802.02.81.2
Medical device regulations9063480.50.40.3
Recall-related matters89131540.50.11.0
Regulatory and legal matters(12)8(33)(0.1)0.1(0.2)
Tax matters321731210.21.20.8
Adjusted$3,474$2,827$3,13920.3%19.7%21.1%

Non-GAAP Financial Measures

We supplement the reporting of our financial information determined under accounting principles generally accepted in the United States (GAAP) with certain non-GAAP financial measures, including percentage sales growth in constant currency; percentage organic sales growth; adjusted gross profit; adjusted selling, general and administrative expenses; adjusted research, development and engineering expenses; adjusted operating income; adjusted other income (expense), net; adjusted effective income tax rate; adjusted net earnings; adjusted net earnings per diluted share (Diluted EPS); free cash flow; and free cash flow conversion. We believe these non-GAAP financial measures provide meaningful information to assist investors and shareholders in understanding our financial results and assessing our prospects for future performance. Management believes percentage sales growth in constant currency and the other adjusted measures described above are important indicators of our operations because they exclude items that may not be indicative of or are unrelated to our core operating results and provide a baseline for analyzing trends in our underlying businesses. Management uses these non-GAAP financial measures for reviewing the operating results of reportable business segments and analyzing potential future business trends in connection with our budget process and bases certain management incentive compensation on these non-GAAP financial measures. To measure percentage sales growth in constant currency, we remove the impact of changes in foreign currency exchange rates that affect the comparability and trend of sales. Percentage sales growth in constant currency is calculated by translating current and prior year results at the same foreign currency exchange rate. To measure percentage organic sales growth, we remove the impact of changes in foreign currency exchange rates, acquisitions and divestitures, which affect the comparability and trend of sales. Percentage organic sales growth is calculated by translating current year and prior year results at the same foreign currency exchange rates excluding the impact of acquisitions and divestitures. To measure earnings performance on a consistent and comparable basis, we exclude certain items that affect the comparability of operating results and the trend of earnings. To measure free cash flow, we adjust cash provided by operating activities by the amount of purchases of property, plant and equipment and proceeds from long-lived asset disposals and remove the impact of certain legal settlements and recall payments. To measure free cash flow conversion we divide free cash flow by adjusted net earnings. These adjustments are irregular in timing and may not be

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STRYKER CORPORATION 2021 FORM 10-K

indicative of our past and future performance. The following are examples of the types of adjustments that may be included in a period:

1.Acquisition and integration-related costs. Costs related to integrating recently acquired businesses (e.g., costs associated with the termination of sales relationships, workforce reductions and other integration-related activities) and specific costs (e.g., inventory step-up and deal costs) related to the consummation of the acquisition process.

2.Amortization of purchased intangible assets. Periodic amortization expense related to purchased intangible assets.

3.Restructuring-related and other charges. Costs associated with the termination of sales relationships in certain countries, workforce reductions, elimination of product lines, certain long-lived and intangible asset impairments and associated costs and other restructuring-related activities.

4.Medical device regulations. Costs specific to updating our quality system, product labeling, asset write-offs and product remanufacturing to comply with the new medical device reporting regulations and other requirements of the European Union and the more stringent regulations for medical devices in China.

5.Recall-related matters. Our best estimate of the minimum of the range of probable loss to resolve the Rejuvenate, LFIT V40 and other product recalls.

6.Regulatory and legal matters. Our best estimate of the

minimum of the range of probable loss to resolve certain regulatory matters and other legal settlements.

7.Tax matters. Charges represent the impact of accounting for certain significant and discrete tax items.

Because non-GAAP financial measures are not standardized, it may not be possible to compare these financial measures with other companies' non-GAAP financial measures having the same or similar names. These adjusted financial measures should not be considered in isolation or as a substitute for reported sales growth, gross profit, selling, general and administrative expenses, research, development and engineering expenses, operating income, other income (expense), net, effective income tax rate, net earnings and net earnings per diluted share, the most directly comparable GAAP financial measures. These non-GAAP financial measures are an additional way of viewing aspects of our operations when viewed with our GAAP results and the reconciliations to corresponding GAAP financial measures at the end of the discussion of Consolidated Results of Operations below. We strongly encourage investors and shareholders to review our financial statements and publicly-filed reports in their entirety and not to rely on any single financial measure.

The weighted-average diluted shares outstanding used in the calculation of non-GAAP net earnings per diluted share are the same as those used in the calculation of reported net earnings per diluted share for the respective period.

Reconciliation of the Most Directly Comparable GAAP Financial Measure to Non-GAAP Financial Measure

2021Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective Tax RateDiluted EPS
Reported$10,968$6,427$1,235$2,584$(303)$1,99412.6%$5.21
Acquisition and integration-related costs:
Inventory stepped-up to fair value2662662031.00.53
Other acquisition and integration-related(319)3192441.20.64
Amortization of purchased intangible assets6194891.61.28
Restructuring-related and other charges28(358)38611345(0.3)0.90
Medical device regulations5(102)107900.24
Recall-related matters103890.23
Regulatory and legal matters2(2)(7)(12)0.2(0.02)
Tax matters32(1.4)0.08
Adjusted$11,267$5,752$1,133$4,382$(299)$3,47414.9%$9.09
2020Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective Tax RateDiluted EPS
Reported$9,057$5,361$984$2,223$(269)$1,59918.2%$4.20
Acquisition and integration-related costs:
Inventory stepped-up to fair value4848360.30.10
Other acquisition and integration-related(194)1941570.70.41
Amortization of purchased intangible assets4723811.61.00
Restructuring-related and other charges53(406)4583970.21.04
Medical device regulations2(79)81630.40.17
Recall-related matters17130.10.03
Regulatory and legal matters(6)68(0.1)0.02
Tax matters4173(8.8)0.46
Adjusted$9,160$4,755$905$3,499$(265)$2,82712.6%$7.43
Column 1Column 2
Dollar amounts in millions except per share amounts or as otherwise specified.16

STRYKER CORPORATION 2021 FORM 10-K

2019Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective Tax RateDiluted EPS
Reported$9,696$5,356$971$2,713$(151)$2,08318.7%$5.48
Acquisition and integration-related costs:
Inventory stepped-up to fair value6767510.20.13
Other acquisition and integration-related(208)2081600.60.42
Amortization of purchased intangible assets4643750.60.99
Restructuring-related and other charges38(188)2261800.40.47
Medical device regulations6(56)62480.20.13
Recall-related matters1921540.30.41
Regulatory and legal matters24(24)(33)0.5(0.09)
Tax matters(30)121(5.7)0.32
Adjusted$9,807$4,984$915$3,908$(181)$3,13915.8%$8.26

FINANCIAL CONDITION AND LIQUIDITY

202120202019
Net cash provided by operating activities$3,263$3,277$2,191
Net cash used in investing activities(859)(4,701)(1,455)
Net cash provided by (used in) financing activities(2,365)(11)3
Effect of exchange rate changes(38)41(18)
Change in cash and cash equivalents$1$(1,394)$721

We believe our financial condition continues to be of high quality, as evidenced by our ability to generate substantial cash from operations and to readily access capital markets at competitive rates despite the COVID-19 pandemic. Operating cash flow provides the primary source of cash to fund operating needs and capital expenditures. Excess operating cash is used first to fund acquisitions to complement our portfolio of businesses. Other discretionary uses include dividends and share repurchases. We supplement operating cash flow with debt to fund our activities as necessary. Our overall cash position reflects our business results and a global cash management strategy that takes into account liquidity management, economic factors and tax considerations.

Operating Activities

Cash provided by operating activities was $3,263, $3,277 and $2,191 in 2021, 2020 and 2019. The slight decrease from 2020 was primarily due to higher accounts receivable, partially offset by increased net earnings and accounts payable.

Investing Activities

Cash used in investing activities was $859, $4,701 and $1,455 in 2021, 2020 and 2019. The decrease in cash used in 2021 was primarily due to decreased payments for acquisitions and certain other businesses and related assets. In 2020 we acquired Wright, while in 2019 we acquired Mobius Imaging and Cardan Robotics and certain other businesses and related assets.

Financing Activities

Cash provided by (used in) financing activities was ($2,365), ($11) and $3 in 2021, 2020 and 2019. The increase in cash used in financing activities was primarily driven by long-term debt repayments of $1,151 and dividend payments of $950 in 2021. In 2020 we secured a $400 term loan in November, issued $600 of notes in November and $2,300 of notes in June, which was offset by total debt repayments of $2,297 and dividend payments of $863. There were no share repurchases in 2021 or 2020.

We maintain debt levels that we consider appropriate after evaluating a number of factors including cash requirements for ongoing operations, investment and financing plans (including acquisitions and share repurchase activities) and overall cost of capital. Refer to Note 10 to our Consolidated Financial Statements for further information.

202120202019
Dividends paid per common share$2.52$2.30$2.08
Total dividends paid to common shareholders$950$863$778
Total amount paid to repurchase common stock$$$307
Shares of repurchased common stock (in millions)1.9

Liquidity

Cash, cash equivalents and marketable securities were $3,019 and $3,024, and our current assets exceeded current liabilities by $5,468 and $4,666 on December 31, 2021 and 2020. We anticipate being able to support our short-term liquidity and operating needs from a variety of sources including cash from operations, commercial paper and existing credit lines. In October 2021 we entered into a new revolving credit agreement that replaces our previous agreement dated August 19, 2016. The primary changes were to increase the aggregate principal amount of the facility by $750 to $2,250, extend the maturity date to October 26, 2026, increase the leverage ratio to 3.75 and provide LIBOR replacement language.

We raised funds in the capital markets in 2020 and 2019 and may continue to do so from time-to-time. We continue to have strong investment-grade short-term and long-term debt ratings that we believe should enable us to refinance our debt as needed.

Our cash, cash equivalents and marketable securities held in locations outside the United States was approximately 26% and 30% on December 31, 2021 and 2020. We intend to use this cash to expand operations organically and through acquisitions.

Guarantees and Other Off-Balance Sheet Arrangements

We do not have guarantees or other off-balance sheet financing arrangements, including variable interest entities, of a magnitude that we believe could have a material impact on our financial condition or liquidity.

CONTRACTUAL OBLIGATIONS AND FORWARD-LOOKING CASH REQUIREMENTS

As further described in Note 7 to our Consolidated Financial Statements, in 2021 we recorded charges to earnings related to the Rejuvenate and ABG II and LFIT Anatomic CoCr V40 Femoral Heads recall matters and recorded product liabilities relating to Wright legacy hip products claims. Recorded reserves represent the minimum of the range of probable cost remaining to resolve these matters. The final outcome of these matters is dependent on many variables that are difficult to predict. The ultimate cost to entirely resolve these matters may be materially different from the amount of the current estimates and could have a material adverse effect on our financial position, results of operations and cash flows. We are not able to reasonably estimate the future periods in which payments will be made.

As further described in Note 11 to our Consolidated Financial Statements, on December 31, 2021 we had a reserve for

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STRYKER CORPORATION 2021 FORM 10-K

uncertain income tax positions of $444. Due to uncertainties regarding the ultimate resolution of income tax audits, we are not able to reasonably estimate the future periods in which any income tax payments to settle these uncertain income tax positions will be made.

As further described in Note 12 to our Consolidated Financial Statements, on December 31, 2021 our defined benefit pension plans were underfunded by $493, of which approximately $491 related to plans outside the United States. Due to the rules affecting tax-deductible contributions in the jurisdictions in which the plans are offered and the impact of future plan asset performance, changes in interest rates and potential changes in legislation in the United States and other foreign jurisdictions, we are not able to reasonably estimate the amounts that may be required to fund defined benefit pension plans.

Contractual ObligationsTotal20222023 - 20242025 - 2026After 2026
Total debt$12,589$7$2,790$2,400$7,392
Interest payments3,5112945684682,181
Unconditional purchase obligations2,1071,88912395
Operating leases4021121467272
United States Tax Cuts and Jobs Act Transition Tax53163277191
Other19151912155
Total$19,331$2,370$3,923$3,238$9,800

CRITICAL ACCOUNTING POLICIES AND ESTIMATES

In preparing our financial statements in accordance with generally accepted accounting principles, there are certain accounting policies, which may require substantial judgment or estimation in their application. We believe these accounting policies and the others set forth in Note 1 to our Consolidated Financial Statements are critical to understanding our results of operations and financial condition. Actual results could differ from our estimates and assumptions, and any such differences could be material to our results of operations and financial condition.

Inventory Reserves

We maintain reserves for excess and obsolete inventory resulting from the potential inability to sell certain products at prices in excess of current carrying costs. We make estimates regarding the future recoverability of the costs of these products and record provisions based on historical experience, expiration of sterilization dates and expected future trends. If actual product life cycles, product demand or acceptance of new product introductions are less favorable than projected by management, additional inventory write downs may be required, which could unfavorably affect future operating results.

Income Taxes

Our annual tax rate is determined based on our income, statutory tax rates and the tax impacts of items treated differently for tax purposes than for financial reporting purposes. Tax law requires certain items be included in the tax return at different times than the items are reflected in the financial statements. Some of these differences are permanent, such as expenses that are not deductible in our tax return, and some differences are temporary and reverse over time, such as depreciation expense. These temporary differences create deferred tax assets and liabilities.

Deferred tax assets generally represent the tax effect of items that can be used as a tax deduction or credit in future years for which we have already recorded the tax benefit in our income statement. Deferred tax liabilities generally represent tax expense recognized in our financial statements for which payment was deferred, the tax effect of expenditures for which a deduction was taken in our tax return but has not yet been recognized in our

financial statements or assets recorded at fair value in business combinations for which there was no corresponding tax basis adjustment.

Inherent in determining our annual tax rate are judgments regarding business plans, tax planning opportunities and expectations about future outcomes. Realization of certain deferred tax assets is dependent upon generating sufficient taxable income in the appropriate jurisdiction prior to the expiration of the carryforward periods. Although realization is not assured, management believes it is more likely than not that our deferred tax assets, net of valuation allowances, will be realized.

We operate in multiple jurisdictions with complex tax policy and regulatory environments. In certain of these jurisdictions, we may take tax positions that management believes are supportable but are potentially subject to successful challenge by the applicable taxing authority. These differences of interpretation with the respective governmental taxing authorities can be impacted by the local economic and fiscal environment. We evaluate our tax positions and establish liabilities in accordance with the applicable accounting guidance on uncertainty in income taxes. We review these tax uncertainties in light of changing facts and circumstances, such as the progress of tax audits, and adjust them accordingly. We have a number of audits in process in various jurisdictions. Although the resolution of these tax positions is uncertain, based on currently available information, we believe that it is more likely than not that the ultimate outcomes will not have a material adverse effect on our financial position, results of operations or cash flows.

Due to the number of estimates and assumptions inherent in calculating the various components of our tax provision, certain changes or future events, such as changes in tax legislation, geographic mix of earnings, completion of tax audits or earnings repatriation plans, could have an impact on those estimates and our effective tax rate.

Acquisitions, Goodwill and Intangibles, and Long-Lived Assets

Our financial statements include the operations of an acquired business starting from the completion of the acquisition. In addition, the assets acquired and liabilities assumed are recorded on the date of acquisition at their respective estimated fair values, with any excess of the purchase price over the estimated fair values of the net assets acquired recorded as goodwill.

Significant judgment is required in estimating the fair value of intangible assets and in assigning their respective useful lives. Accordingly, we typically obtain the assistance of third-party valuation specialists for significant items. The fair value estimates are based on available historical information and on future expectations and assumptions deemed reasonable by management but are inherently uncertain. We typically use an income method to estimate the fair value of intangible assets, which is based on forecasts of the expected future cash flows attributable to the respective assets. Significant estimates and assumptions inherent in the valuations reflect a consideration of other marketplace participants and include the amount and timing of future cash flows (including expected growth rates and profitability), the underlying product or technology life cycles, the economic barriers to entry and the discount rate applied to the cash flows. Unanticipated market or macroeconomic events and circumstances may occur that could affect the accuracy or validity of the estimates and assumptions.

Determining the useful life of an intangible asset also requires judgment. With the exception of certain trade names, the majority of our acquired intangible assets (e.g., certain trademarks or

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STRYKER CORPORATION 2021 FORM 10-K

brands, customer and distributor relationships, patents and technologies) are expected to have determinable useful lives. Our assessment as to the useful lives of these intangible assets is based on a number of factors including competitive environment, market share, trademark, brand history, underlying product life cycles, operating plans and the macroeconomic environment of the countries in which the trademarked or branded products are sold. Our estimates of the useful lives of determinable-lived intangibles are primarily based on these same factors. Determinable-lived intangible assets are amortized to expense over their estimated useful life.

In some of our acquisitions, we acquire in-process research and development (IPRD) intangible assets. For acquisitions accounted for as business combinations, IPRD is considered to be an indefinite-lived intangible asset until the research is completed (then it becomes a determinable-lived intangible asset) or determined to have no future use (then it is impaired). For asset acquisitions, IPRD is expensed immediately unless there is an alternative future use.

The value of indefinite-lived intangible assets and goodwill is not amortized but is tested at least annually for impairment. Our impairment testing for goodwill is performed separately from our impairment testing of indefinite-lived intangibles. We perform our annual impairment test for goodwill in the fourth quarter of each year. We consider qualitative indicators of the fair value of a reporting unit when it is unlikely that a reporting unit has impaired goodwill and periodically corroborate that assessment with quantitative information. In certain circumstances, we also use a discounted cash flow analysis that requires certain assumptions and estimates be made regarding market conditions and our future profitability. In those circumstances we test goodwill for impairment by reviewing the carrying value compared to the fair value at the reporting unit level. We test individual indefinite-lived intangibles by reviewing the individual carrying values compared to the fair value. We determine the fair value of our reporting units and indefinite-lived intangible assets based on the income approach. Under the income approach, we calculate the fair value of our reporting units and indefinite-lived intangible assets based on the present value of estimated future cash flows. Considerable management judgment is necessary to evaluate the impact of operating and macroeconomic changes and to estimate future cash flows to measure fair value. Assumptions used in our impairment evaluations, such as forecasted growth rates and cost of capital, are consistent with internal projections and operating plans. We believe such assumptions and estimates are also comparable to those that would be used by other marketplace participants.

Our annual impairment testing indicated that all reporting unit goodwill fair values significantly exceeded their respective recorded values. Future changes in the judgments, assumptions and estimates that are used in our impairment testing for goodwill and indefinite-lived intangible assets, including discount and tax rates and future cash flow projections, could result in significantly different estimates of the fair values. A significant reduction in the estimated fair values could result in impairment charges that could materially affect our results of operations.

We review our other long-lived assets for indicators of impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The evaluation is performed at the lowest level of identifiable cash flows, which is at the individual asset level or the asset group level. The undiscounted cash flows expected to be generated by the related assets are estimated over their useful life based on updated projections. If the evaluation indicates that the carrying amount of

the assets may not be recoverable, any potential impairment is measured based upon the fair value of the related assets or asset group as determined by an appropriate market appraisal or other valuation technique. Assets classified as held for sale, if any, are recorded at the lower of carrying amount or fair value less costs to sell.

Legal and Other Contingencies

We are involved in various ongoing proceedings, legal actions and claims arising in the normal course of business, including proceedings related to product, labor and intellectual property, and other matters that are more fully described in Note 7 to our Consolidated Financial Statements. The outcomes of these matters will generally not be known for prolonged periods of time. In certain of the legal proceedings, the claimants seek damages, as well as other compensatory and equitable relief, that could result in the payment of significant claims and settlements and/or the imposition of injunctions or other equitable relief. For legal matters for which management had sufficient information to reasonably estimate our future obligations, a liability representing management's best estimate of the probable loss, or the minimum of the range of probable losses when a best estimate within the range is not known, for the resolution of these legal matters is recorded. The estimates are based on consultation with legal counsel, previous settlement experience and settlement strategies. If actual outcomes are less favorable than those projected by management, additional expense may be incurred, which could unfavorably affect future operating results. We are currently self-insured for certain claims and expenses. The ultimate cost to us with respect to product liability claims could be materially different than the amount of the current estimates and accruals and could have a material adverse effect on our financial position, results of operations and cash flows.

NEW ACCOUNTING PRONOUNCEMENTS

Refer to Note 1 to our Consolidated Financial Statements for further information.

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