Quorum Health (QHCCQ) 10-Q 7 Aug 19 2019 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2019	Aug. 02, 2019
Document And Entity Information [Abstract]
Entity Registrant Name	QUORUM HEALTH CORPORATION
Entity Central Index Key	0001650445
Document Type	10-Q
Document Period End Date	Jun. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q2
Current Fiscal Year End Date	--12-31
Trading Symbol	QHC
Amendment Flag	false
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		32,912,073
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity File Number	001-37550
Entity Tax Identification Number	474725208
Entity Address, Address Line One	1573 Mallory Lane Brentwood
Entity Address, State or Province	Tennessee
Entity Address, Postal Zip Code	37027
City Area Code	615
Local Phone Number	221-1400

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Income Statement [Abstract]
Net operating revenues	$ 442,170	$ 472,632	$ 884,975	$ 959,452
Operating costs and expenses:
Salaries and benefits	213,411	232,631	438,486	479,631
Supplies	50,202	52,897	101,587	111,783
Other operating expenses	106,954	144,456	243,743	297,194
Depreciation and amortization	14,500	17,142	29,139	35,403
Lease costs and rent	11,627	11,358	23,158	23,890
Electronic health records incentives	583	(445)	609	(586)
Legal, professional and settlement costs	604	5,417	1,289	8,830
Impairment of long-lived assets and goodwill	25,950	0	34,810	39,760
Loss (gain) on sale of hospitals, net	1,140	307	1,140	8,122
Loss on closure of hospitals, net	0	3,338	0	17,084
Total operating costs and expenses	424,971	467,101	873,961	1,021,111
Income (loss) from operations	17,199	5,531	11,014	(61,659)
Interest expense, net	33,582	31,926	65,848	62,857
Income (loss) before income taxes	(16,383)	(26,395)	(54,834)	(124,516)
Provision for (benefit from) income taxes	94	(454)	249	(88)
Net income (loss)	(16,477)	(25,941)	(55,083)	(124,428)
Less: Net income (loss) attributable to noncontrolling interests	396	665	796	1,146
Net income (loss) attributable to Quorum Health Corporation	$ (16,873)	$ (26,606)	$ (55,879)	$ (125,574)
Earnings (loss) per share attributable to Quorum Health Corporation stockholders:
Basic and diluted	$ (0.56)	$ (0.92)	$ (1.88)	$ (4.37)
Weighted-average shares outstanding:
Basic and diluted	30,001,208	28,995,564	29,721,167	28,726,445

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss)	$ (16,477)	$ (25,941)	$ (55,083)	$ (124,428)
Amortization and recognition of unrecognized pension cost components, net of income taxes	48	(189)	97	(75)
Comprehensive income (loss)	(16,429)	(26,130)	(54,986)	(124,503)
Less: Comprehensive income (loss) attributable to noncontrolling interests	396	665	796	1,146
Comprehensive income (loss) attributable to Quorum Health Corporation	$ (16,825)	$ (26,795)	$ (55,782)	$ (125,649)

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 2,265		$ 3,203
Patient accounts receivable	270,923		322,608
Inventories	41,447		45,646
Prepaid expenses	21,653		19,683
Due from third-party payors	57,071		63,443
Current assets of hospitals held for sale	35,380		0
Other current assets	33,604		36,405
Total current assets	462,343		490,988
Property and equipment, net	496,555		559,438
Goodwill	391,658		401,073
Intangible assets, net	41,066		48,289
Operating lease right-of-use assets	84,854		0
Long-term assets of hospitals held for sale	25,796		0
Other long-term assets	65,954		74,306
Total assets	1,568,226		1,574,094
Current liabilities:
Current maturities of long-term debt	1,646		1,697
Current portion of operating lease liabilities	23,797		0
Accounts payable	140,768		143,917
Accrued liabilities:
Accrued salaries and benefits	61,006		76,908
Accrued interest	10,517		10,024
Due to third-party payors	37,218		45,852
Current liabilities of hospitals held for sale	10,675		0
Other current liabilities	38,573		43,336
Total current liabilities	324,200		321,734
Long-term debt	1,210,523		1,191,777
Long-term operating lease liabilities	61,554		0
Deferred income tax liabilities, net	6,978		6,736
Long-term liabilities of hospitals held for sale	3,248		0
Other long-term liabilities	89,245		126,499
Total liabilities	1,695,748		1,646,746
Redeemable noncontrolling interests	2,278	$ 2,278	2,278	$ 2,301	$ 2,316	$ 2,325
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock, $0.0001 par value per share, 100,000,000 shares authorized, none issued	0		0
Common stock, $0.0001 par value per share, 300,000,000 shares authorized; 32,926,689 shares issued and outstanding at June 30, 2019, and 31,521,398 shares issued and outstanding at December 31, 2018	3		3
Additional paid-in capital	559,487		557,309
Accumulated other comprehensive income (loss)	856		759
Accumulated deficit	(705,071)		(648,464)
Total Quorum Health Corporation stockholders' equity (deficit)	(144,725)		(90,393)
Nonredeemable noncontrolling interests	14,925		15,463
Total equity (deficit)	(129,800)	$ (114,129)	(74,930)	$ (8,595)	$ 16,073	$ 113,410
Total liabilities and equity	$ 1,568,226		$ 1,574,094

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) (Unaudited) - $ / shares	Jun. 30, 2019	Dec. 31, 2018
Statement Of Financial Position [Abstract]
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	100,000,000	100,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares issued	32,926,689	31,521,398
Common stock, shares outstanding	32,926,689	31,521,398

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENT OF EQUITY (DEFICIT) (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Accumulated Deficit [Member]	Nonredeemable Noncontrolling Interests [Member]
Stockholders' equity, beginning balance at Dec. 31, 2017	$ 113,410	$ 3	$ 549,610	$ (1,956)	$ (448,216)	$ 13,969
Stockholders' equity, beginning balance, shares at Dec. 31, 2017		30,294,895
Comprehensive income (loss)	(98,252)			114	(98,968)	602
Stock-based compensation expense	2,464		2,464
Stock-based compensation expense, shares		979,817
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(634)		(634)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares, shares		(112,221)
Cash distributions to noncontrolling investors	(741)					(741)
Adjustments to redemption values of redeemable noncontrolling interests	(174)		(174)
Stockholders' equity, ending balance at Mar. 31, 2018	16,073	$ 3	551,266	(1,842)	(547,184)	13,830
Stockholders' equity, ending balance, shares at Mar. 31, 2018		31,162,491
Redeemable noncontrolling interests, beginning balance at Dec. 31, 2017	2,325
Redeemable Noncontrolling Interests, Comprehensive income (loss)	(121)
Redeemable Noncontrolling Interests, Cash distributions to noncontrolling investors	(62)
Redeemable Noncontrolling Interests, Adjustments to redemption values of redeemable noncontrolling interests	174
Redeemable noncontrolling interests, ending balance at Mar. 31, 2018	2,316
Comprehensive income (loss)	(25,913)			(189)	(26,606)	882
Stock-based compensation expense	2,756		2,756
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(1,309)		(1,309)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares, shares		(263,781)
Adjustments to redemption values of redeemable noncontrolling interests	(202)		(202)
Stockholders' equity, ending balance at Jun. 30, 2018	(8,595)	$ 3	552,511	(2,031)	(573,790)	14,712
Stockholders' equity, ending balance, shares at Jun. 30, 2018		30,898,710
Redeemable Noncontrolling Interests, Comprehensive income (loss)	(217)
Redeemable Noncontrolling Interests, Adjustments to redemption values of redeemable noncontrolling interests	202
Redeemable noncontrolling interests, ending balance at Jun. 30, 2018	2,301
Stockholders' equity, beginning balance at Dec. 31, 2018	$ (74,930)	$ 3	557,309	759	(648,464)	15,463
Stockholders' equity, beginning balance, shares at Dec. 31, 2018	31,521,398	31,521,398
Comprehensive income (loss)	$ (38,483)			49	(39,006)	474
Adoption of ASC Topic 842	(728)				(728)
Stock-based compensation expense	1,770		1,770
Stock-based compensation expense, shares		5,000
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(461)		(461)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares, shares		(231,729)
Cash distributions to noncontrolling investors	(1,177)					(1,177)
Adjustments to redemption values of redeemable noncontrolling interests	(120)		(120)
Stockholders' equity, ending balance at Mar. 31, 2019	(114,129)	$ 3	558,498	808	(688,198)	14,760
Stockholders' equity, ending balance, shares at Mar. 31, 2019		31,294,669
Redeemable noncontrolling interests, beginning balance at Dec. 31, 2018	2,278
Redeemable Noncontrolling Interests, Comprehensive income (loss)	(74)
Redeemable Noncontrolling Interests, Cash distributions to noncontrolling investors	(46)
Redeemable Noncontrolling Interests, Adjustments to redemption values of redeemable noncontrolling interests	120
Redeemable noncontrolling interests, ending balance at Mar. 31, 2019	2,278
Comprehensive income (loss)	(16,328)			48	(16,873)	497
Stock-based compensation expense	1,194		1,194
Stock-based compensation expense, shares		1,684,346
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(103)		(103)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares, shares		(52,326)
Cash distributions to noncontrolling investors	(332)					(332)
Adjustments to redemption values of redeemable noncontrolling interests	(102)		(102)
Stockholders' equity, ending balance at Jun. 30, 2019	$ (129,800)	$ 3	$ 559,487	$ 856	$ (705,071)	$ 14,925
Stockholders' equity, ending balance, shares at Jun. 30, 2019	32,926,689	32,926,689
Redeemable Noncontrolling Interests, Comprehensive income (loss)	$ (101)
Redeemable Noncontrolling Interests, Cash distributions to noncontrolling investors	(1)
Redeemable Noncontrolling Interests, Adjustments to redemption values of redeemable noncontrolling interests	102
Redeemable noncontrolling interests, ending balance at Jun. 30, 2019	$ 2,278

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Cash flows from operating activities:
Net income (loss)	$ (16,477)	$ (25,941)	$ (55,083)	$ (124,428)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	14,500	17,142	29,139	35,403
Non-cash interest expense, net	2,380	2,723	4,319	4,534
Provision for (benefit from) deferred income taxes	31	(511)	121	25
Stock-based compensation expense	1,194	2,756	2,964	5,220
Impairment of long-lived assets and goodwill	25,950	0	34,810	39,760
Loss (gain) on sale of hospitals, net	1,140	307	1,140	8,122
Non-cash portion of loss (gain) on hospital closures	0	1,089	(567)	6,394
Changes in reserves for self-insurance claims, net of payments	(29,963)	4,355	(25,803)	10,380
Other non-cash expense (income), net	116	56	(1,256)	7
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Patient accounts receivable	22,766	19,645	18,780	21,074
Due from and due to third-party payors, net	2,159	19,761	(2,262)	20,978
Inventories, prepaid expenses and other current assets	(5,143)	(1,519)	(232)	(229)
Accounts payable and accrued liabilities	(28,930)	(19,301)	(8,784)	(9,714)
Long-term assets and liabilities, net	(117)	(3,368)	398	(2,925)
Net cash provided by (used in) operating activities	(10,394)	17,194	(2,316)	14,601
Cash flows from investing activities:
Capital expenditures for property and equipment	(9,819)	(10,791)	(18,111)	(25,319)
Capital expenditures for software	(2,326)	(531)	(3,517)	(1,044)
Acquisitions, net of cash acquired	0	(26)	(455)	(58)
Proceeds from the sale of hospitals	11,741	507	11,741	39,170
Other investing activities, net	(2,112)	52	(383)	249
Net cash provided by (used in) investing activities	(2,516)	(10,789)	(10,725)	12,998
Cash flows from financing activities:
Borrowings under revolving credit facilities	175,000	115,000	327,000	247,000
Repayments under revolving credit facilities	(149,000)	(119,000)	(299,000)	(233,000)
Borrowings of long-term debt	25	55	186	67
Repayments of long-term debt	(12,130)	(30,820)	(13,963)	(31,447)
Payments of debt issuance costs	0	0	0	(2,268)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(103)	(1,309)	(564)	(1,943)
Cash distributions to noncontrolling investors	(333)	0	(1,556)	(803)
Net cash provided by (used in) financing activities	13,459	(36,074)	12,103	(22,394)
Net change in cash, cash equivalents and restricted cash	549	(29,669)	(938)	5,205
Cash, cash equivalents and restricted cash at beginning of period	1,716	40,491	3,203	5,617
Cash, cash equivalents and restricted cash at end of period	2,265	10,822	2,265	10,822
Supplemental cash flow information:
Interest payments, net	42,846	41,224	61,061	58,711
Income tax payments, net	$ 189	$ 341	$ 189	$ 487

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	6 Months Ended
	Jun. 30, 2019
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	NOTE 1 - BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES Description of the Business On April 29, 2016, Community Health Systems, Inc. (“CHS”) completed the spin-off of 38 hospitals, including their affiliated facilities, and Quorum Health Resources, LLC to form Quorum Health Corporation through the distribution of 100% of the common stock of QHC to CHS stockholders of record as of the close of business on April 22, 2016 (the “Spin-off”). The principal business of Quorum Health Corporation, a Delaware corporation, and its subsidiaries (collectively, “QHC” or the “Company”) is to provide hospital and outpatient healthcare services in its markets across the United States. As of June 30, 2019, the Company owned or leased a diversified portfolio of 26 hospitals in rural and mid-sized markets, which are located in 14 states and have a total of 2,458 licensed beds. The Company provides outpatient healthcare services through its hospitals and affiliated facilities, including urgent care centers, diagnostic and imaging centers, physician clinics and surgery centers. The Company’s wholly-owned subsidiary, Quorum Health Resources, LLC (“QHR”), provides hospital management advisory and healthcare consulting services to non-affiliated hospitals located throughout the United States. Over 95% of the Company’s net operating revenues are attributable to its hospital operations business. Basis of Presentation The condensed consolidated financial statements and accompanying notes of the Company presented herein have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP” or “GAAP”). In the opinion of the Company’s management, the condensed consolidated financial information presented herein includes all adjustments necessary to present fairly the results of operations, financial position and cash flows of the Company for the interim periods presented. Results of operations for interim periods should not be considered indicative of the results of operations expected for the full year ending December 31, 2019. Certain information and disclosures have been condensed or omitted as presented herein and as permitted by the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim period presentation. The Company’s management believes the financial statements and disclosures presented herein are adequate in order to make the information presented not misleading. The condensed consolidated financial statements should be read in conjunction with the consolidated and combined financial statements and accompanying notes thereto for the year ended December 31, 2018, contained in the Company’s Annual Report on Form 10-K filed with the SEC on March 12, 2019 (the “2018 Annual Report on Form 10-K”). The Company’s financial statements have been prepared under the assumption that it will continue as a going concern. In accordance with Accounting Standard Codification (“ASC”) 205-40, Presentation of Financial Statements — Going Concern, management concluded that there were probable conditions or events that raised substantial doubt about the Company’s ability to continue as a going concern due to the fact that the Company’s maximum Secured Net Leverage Ratio permitted under the CS Agreement is reduced to 4.50 from 5.00 in the first quarter of 2020. The measurement date for the Company’s required compliance with the Secured Net Leverage Ratio is as of the last day of each fiscal quarter. The Company is in compliance with its financial covenants as of June 30, 2019 and believes that it is probable that the Company’s current and anticipated future operating results alleviate the substantial doubt about the Company’s ability to continue as a going concern for the one year period following the date these financial statements are issued. Management’s evaluation of the Company’s ability to comply with the Secured Net Leverage Ratio included, but was not limited to, the following factors: • On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. The Company believes that through its partnership with R1 RCM, it will achieve costs savings and improve net patient revenues through improvements in operational effectiveness and efficiencies; • The sale or closure of underperforming facilities will continue to generate additional costs savings and the decision to close facilities within the next twelve months is within the control of the Company; and • Management has a plan to achieve cost savings over the next twelve months through a reduction in corporate and operating costs. Principles of Consolidation The condensed consolidated financial statements include the accounts of the Company and its subsidiaries in which it holds either a direct or indirect ownership of a majority voting interest. Investments in less-than-wholly-owned consolidated subsidiaries of QHC are presented separately in the equity component of the Company’s consolidated balance sheets to distinguish between the interests of QHC and the interests of the noncontrolling investors. Revenues and expenses from these subsidiaries are included in the respective individual line items of the Company’s consolidated statements of income, and net income is presented both in total and separately to distinguish the amounts attributable to the Company and the amounts attributable to the interests of the noncontrolling investors. Noncontrolling interests that are redeemable or may become redeemable at a fixed or determinable price at the option of the holder or upon the occurrence of an event outside of the control of the Company, are presented in mezzanine equity in the Company’s consolidated balance sheets. Intercompany transactions and accounts of the Company are eliminated in consolidation. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the Company’s consolidated financial statements and accompanying notes. Actual results could differ from those estimates under different assumptions or conditions. Revenues and Accounts Receivable Revenue Recognition The Company reports revenues from patient services at its hospitals and affiliated facilities at the amount that reflects the consideration to which the Company expects to be entitled in exchange for providing patient care. These amounts are due from patients, governmental programs and third-party payors such as Medicare, Medicaid, health maintenance organizations, preferred provider organizations, private insurers and others, and include variable consideration for retroactive revenue adjustments due to settlements of audits, reviews and investigations. Generally, the Company bills the patient and third-party payors several days after the services are performed or the patient is discharged. Revenue is recognized as the performance obligations are satisfied. Billings and collections are outsourced to CHS under a transition services agreement that was entered into in connection with the Spin-off. Performance obligations are determined based on the nature of the services provided by the Company. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges for services anticipated to be provided. The Company believes that this method provides a faithful depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients in the Company’s hospitals receiving inpatient acute care services. The Company measures the performance obligation from admission into the hospital to the point when it is no longer required to provide services to that patient, which is generally at the time of discharge. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided, and the Company does not believe it is required to provide additional goods or services to the patient. Because all of its performance obligations relate to contracts with a duration of less than one year, the Company has elected to apply the optional exemption provided in ASC 606-10-50-14(a) and, therefore, is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patient is discharged, which generally occurs within days or weeks following the end of the reporting period. The Company determines the transaction price based on standard billing rates for goods and services provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and patient responsibility after insurance in accordance with the Company’s policy, and/or implicit price concessions provided to uninsured patients and patient responsibility after insurance. The Company determines its estimates of contractual adjustments and discounts based on contractual agreements, its discount policies and historical experience. The Company determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. The Company recognizes revenues related to its QHR business when either the performance obligation has been satisfied or over time as the hospital management advisory and healthcare consulting services are provided and reports these revenues at the amount expected to be collected from the non-affiliated hospital clients of QHR. Payor Sources The primary sources of payment for patient healthcare services are third-party payors, including federal and state agencies administering the Medicare and Medicaid programs, other governmental agencies, managed care health plans, commercial insurance companies, workers’ compensation carriers and employers. Self-pay revenues are the portion of patient service revenues derived from patients who do not have health insurance coverage and the patient responsibility portion of services that are not covered by health insurance plans. Non-patient revenues primarily include revenues from QHR’s hospital management advisory and healthcare consulting services business, rental income and hospital cafeteria sales . The following table provides a summary of net operating revenues by payor source (dollars in thousands): Three Months Ended June 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 119,885 27.1 % $ 130,106 27.5 % Medicaid 96,794 21.9 % 87,141 18.4 % Managed care and commercial plans 174,658 39.5 % 189,726 40.3 % Self-pay and self-pay after insurance 32,534 7.4 % 42,288 8.9 % Non-patient 18,299 4.1 % 23,371 4.9 % Total net operating revenues $ 442,170 100.0 % $ 472,632 100.0 % Six Months Ended June 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 248,931 28.1 % $ 274,689 28.6 % Medicaid 178,718 20.2 % 172,244 18.0 % Managed care and commercial plans 348,733 39.4 % 374,952 39.0 % Self-pay and self-pay after insurance 69,671 7.9 % 91,972 9.6 % Non-patient 38,922 4.4 % 45,595 4.8 % Total net operating revenues $ 884,975 100.0 % $ 959,452 100.0 % Contractual Adjustments and Discounts Agreements with third-party payors typically provide for payments at amounts less than standard billing rates. A summary of the payment arrangements with major third-party payors follows: • Medicare: • Medicaid: • Other: Government programs, including Medicare and Medicaid programs, which represent a large portion of the Company’s operating revenues, are highly complex programs to administer and are subject to interpretation of federal and state-specific reimbursement rates, new legislation and final cost report settlements. As a result of investigations by governmental agencies, various health care organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations. In some instances, these investigations have resulted in organizations entering into significant settlement agreements or findings of criminal and civil liability. Compliance with such laws and regulations may be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties, and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge the Company’s compliance with these laws and regulations, and it is not possible to determine the impact (if any) such claims or penalties could have on the Company. Contractual adjustments, or differences in standard billing rates and the payments derived from contractual terms with governmental and non-governmental third-party payors, are recorded based on management’s best estimates in the period in which services are performed and a payment methodology is established with the patient. Recorded estimates for past contractual adjustments are subject to change, in large part, due to ongoing contract negotiations and regulation changes, which are typical in the U.S. healthcare industry. Revisions to estimates are recorded as contractual adjustments in the periods in which they become known and may be subject to further revisions. In addition, the contracts the Company has with commercial insurance payors may provide for retroactive audit and review of claims. Subsequent changes in estimates for third-party payors that are determined to be the result of an adverse change in a payor’s ability to pay are recorded as bad debt expense. Bad debt expense for the three months and six months ended June 30, 2019 and 2018 were not material and are included in other operating expenses in the Company’s consolidated statements of income. Billing and collections are outsourced to CHS under a transition services agreement that was put in place by CHS in connection with the Spin-off. The Company’s contractual adjustments are impacted by the timing and ability of CHS to monitor the classification and collection of the Company’s patient accounts receivable. Self-pay and other payor discounts are incentives offered by the Company to uninsured or underinsured patients and other payors to reduce their costs of healthcare services. On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. The agreement with R1 RCM will, among other things, allow for the Company to transition its billing and collection services from CHS to R1 RCM. In July 2019, R1 RCM began providing limited services to the Company, such as status review on aged accounts receivable and insurance denials. The Company expects to fully transition billing and collection services from CHS to R1 RCM during the fourth quarter of 2019, which has been mutually agreed upon by both parties. Third-Party Program Reimbursements Cost report settlements under reimbursement programs with Medicare, Medicaid and other managed care plans for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and the Company’s historical experience, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as new information becomes available, or as years are settled or are no longer subject to such audits, reviews, and investigations. Previous program reimbursements and final cost report settlements are included in due from and due to third-party payors in the consolidated balance sheets. Net adjustments arising from a change in the transaction price for estimated cost report settlements favorably (unfavorably) impacted net operating revenues by $0.3 million and $(0.4) million during the three months ended June 30, 2019 and 2018, respectively and by $2.1 million and $0.1 million during the six months ended June 30, 2019 and 2018, respectively. Currently, several states have established supplemental payment programs, including disproportionate share programs, for the purpose of providing reimbursement to providers to offset a portion of the cost of providing care to Medicaid and indigent patients. These programs are designed with input from CMS and are funded with a combination of federal and state resources, including, in certain instances, taxes, fees or other program expenses (collectively, “provider taxes”) levied on the providers. The receivables and payables associated with these programs are included in due from and due to third-party payors in the consolidated balance sheets. The following table provides a summary of the components of amounts due from and due to third-party payors, as presented in the consolidated balance sheets (in thousands): June 30, December 31, 2019 2018 Amounts due from third-party payors: Previous program reimbursements and final cost report settlements $ 13,643 $ 14,374 State supplemental payment programs 43,428 49,069 Total amounts due from third-party payors $ 57,071 $ 63,443 Amounts due to third-party payors: Previous program reimbursements and final cost report settlements $ 26,042 $ 32,174 State supplemental payment programs 11,176 13,678 Total amounts due to third-party payors $ 37,218 $ 45,852 After a state supplemental payment program is approved and fully authorized by the appropriate state legislative or governmental agency, the Company recognizes the revenue and related expenses based on the terms of each program in the period in which the amounts are estimable and revenue collection is reasonably assured. The revenues earned by the Company under these programs are included in net operating revenues and the expenses associated with these programs are included in other operating expenses in the consolidated statements of income. The following table provides a summary of the portion of Medicaid reimbursements included in the consolidated statements of income that are attributable to state supplemental payment programs (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Medicaid state supplemental payment program revenues $ 47,589 $ 52,070 $ 95,279 $ 100,631 Provider taxes and other expenses 18,727 17,051 37,593 36,195 Reimbursements attributable to state supplemental payment programs, net of expenses $ 28,862 $ 35,019 $ 57,686 $ 64,436 The California Department of Health Care Services administers the Hospital Quality Assurance Fee (“HQAF”) program, imposing a fee on certain general and acute care California hospitals. Revenues generated from these fees provide funding for the non-federal supplemental payments to California hospitals that serve California’s Medi-Cal and uninsured patients. Under the HQAF program, the Company recognized $8.0 million of Medicaid revenues and $2.2 million of provider taxes for the three months ended June 30, 2019, and $7.9 million of Medicaid revenues and $2.1 million of provider taxes for the three months ended June 30, 2018. The Company recognized $16.0 million of Medicaid revenues and $4.4 million of provider taxes for the six months ended June 30, 2019, and $15.8 million of Medicaid revenues and $4.2 million of provider taxes for the six months ended June 30, 2018. The current phase of the HQAF program expired on June 30, 2019. Although a state constitutional amendment indefinitely extended the program, CMS is required to approve the next phase of the program, Phase VI, which begins July 1, 2019 and is expected to cover 24 to 36 months, although the precise duration is unknown at this time. The CMS approval process can be lengthy, and the Company is unable to recognize revenue until CMS approves each phase of the program. The Company recognized $2.0 million of Medicaid revenues for the three months ended June 30, 2019 and $4.0 million of Medicaid revenues in the six months ended June 30, 2019 related to the sale of Illinois property tax credits with no corresponding amount recognized in the three or six months ended June 30, 2018 as the revenues for the full year 2018 were recognized in the third quarter of 2018. Self-Pay and Self-Pay After Insurance Generally, patients who are covered by third-party payors are responsible for related co-pays and deductibles, which vary in amount. The Company also provides services to uninsured patients, and offers those uninsured patients a discount, either by policy or law, from the Company’s standard billing rates. The Company estimates the transaction price for patients with co-pays and deductibles and for uninsured patients based on historical collection experience and current market conditions. The initial estimate of the transaction price is determined by reducing the Company’s standard charges by any contractual adjustments, discounts, and implicit price concessions. Subsequent changes to the estimate of the transaction price, if any, are generally recorded as an adjustment to patient service revenue in the period of the change . Charity Care In the ordinary course of business, the Company provides services to patients who are financially unable to pay for hospital care. The related charges for those patients who are financially unable to pay that otherwise do not qualify for reimbursement from a governmental program are classified as charity care. The Company determines amounts that qualify for charity care primarily based on the patient’s household income relative to the poverty level guidelines established by the federal government. The Company’s policy is to not pursue collections for such amounts. The related charges which are recorded in operating revenues at the standard billing rates and fully offset in contractual allowances were $7.4 million and $6.0 million for the three months ended June 30, 2019 and 2018, respectively, and $12.3 million and $19.3 million for the six months ended June 30, 2019 and 2018, respectively. Accounts Receivable Substantially all of the Company’s receivables are related to providing healthcare services to patients at its hospitals and affiliated outpatient facilities. For self-pay and self-pay after insurance receivables, the Company estimates the implicit price concession by reserving a percentage of all self-pay and self-pay after insurance accounts receivable without regard to aging category. The estimate of the implicit price concession is based on a model that considers historical cash collections, expected recoveries and any anticipated changes in trends. The Company’s ability to estimate the implicit price concessions is not significantly impacted by the aging of accounts receivable, as management believes that substantially all of the risk exists at the point in time such accounts are identified as self-pay. Significant changes in payor mix, CHS’s business office operations, including the CHS shared services centers’ efforts in collecting the Company’s accounts receivables, economic conditions, or trends in federal and state governmental healthcare coverage, among others, could affect the Company’s estimates of implicit price concessions for self-pay and self-pay after insurance accounts receivable. The Company continually reviews its overall estimate of implicit price concessions by monitoring historical cash collections as a percentage of trailing net operating revenues, as well as by analyzing current period net operating revenues and admissions by payor classification, aged accounts receivable by payor, days revenue outstanding, the composition of self-pay receivables between pure self-pay patients and the patient responsibility portion of third-party insured receivables, and the impact of recent divestitures. Collections are impacted by the economic ability of patients to pay, the effectiveness of the Company’s billing and collection efforts, which are outsourced to a third party, including their current policies on billings, accounts receivable payor classification and collections. Our results are also affected by third party collection agencies and by the ability of the Company to further attempt collection efforts. Billings and collections are outsourced to CHS under a transition services agreement that was established with the Spin-off and are being transitioned to R1 RCM. See Note 16 — Related Party Transactions for additional information on the CHS TSA agreement. On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. The agreement with R1 RCM will, among other things, allow for the Company to transition its billing and collection services from CHS to R1 RCM. In July 2019, R1 RCM began providing limited services to the Company, such as status review on aged accounts receivable and insurance denials. The Company expects to fully transition billing and collection services from CHS to R1 RCM during the fourth quarter of 2019, which has been mutually agreed upon by both parties. The Company has elected the practical expedient allowed under Financial Accounting Standards Board’s (“FASB”) Accounting Standards Codification (“ASC”) Topic 606 and does not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to the Company’s expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less. However, the Company does, in certain instances, enter into payment agreements with patients that allow payments in excess of one year. For those cases, the financing component is not deemed to be significant to the contract. The Company has applied the practical expedient provided by FASB ASC Topic 340 and all incremental customer contract acquisition costs are expensed as incurred, as the amortization period of the asset that the Company otherwise would have recognized is one year or less in duration. Concentration of Credit Risk The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s hospitals and affiliated outpatient facilities and are insured under third-party payor agreements. Because of the economic diversity of the Company’s markets and non-governmental third-party payors, Medicare receivables are a significant concentration of credit risk. Accounts receivable, net of contractual adjustments, from Medicare were $49.5 million and $58.2 million, or 18.3% and 18.0% of total patient accounts receivable as of June 30, 2019 and December 31, 2018, respectively. Additionally, the Company believes Illinois Medicaid represents a significant concentration of credit risk to the Company due to the fiscal problems in the state of Illinois that affect the timing and extent of payments due to providers, which are administered by the state of Illinois under the Medicaid program. The Company’s accounts receivable, net of contractual adjustments, from Illinois Medicaid were $22.3 million and $24.5 million, or 8.3% and 7.6% of total patient accounts receivable as of June 30, 2019 and December 31, 2018, respectively. The Company also believes California state supplemental program receivables represent a significant concentration of credit risk due to the timing and extent of the receivables. The Company’s state supplemental program receivables from California Medicaid were $31.3 million and $37.8 million, or 54.8% and 59.6% of total due from third-party payors, as of June 30, 2019 and December 31, 2018, respectively. The Company’s revenues are particularly sensitive to regulatory and economic changes in certain states where the Company generates significant revenues. Accordingly, any changes in the current demographic, economic, competitive or regulatory conditions in certain states in which revenues are significant could have an adverse effect on the Company’s results of operations, financial condition or cash flows. Changes to the Medicaid and other government-managed payor programs in these states, including reductions in reimbursement rates or delays in reimbursement payments under state supplemental payment or other programs, could also have a similar adverse effect. The following table provides a summary of the states in which the Company generates more than 5% of its total net patient revenues as determined in the most recent period (dollars in thousands): Number of Six Months Ended June 30, Hospitals at 2019 2018 June 30, 2019 $ Amount % of Total $ Amount % of Total Illinois 8 $ 337,928 39.9 % $ 373,372 40.9 % Oregon 1 117,469 13.9 % 116,013 12.7 % California 2 89,676 10.6 % 89,972 9.8 % Kentucky 3 55,660 6.6 % 58,115 6.4 % Other Operating Expenses The following table provides a summary of the major components of other operating expenses (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Purchased services $ 41,582 $ 37,502 $ 79,424 $ 78,582 Taxes and insurance 1,646 33,627 35,610 66,682 Medical specialist fees 25,154 26,433 51,224 53,381 Transition services agreements 7,177 14,066 15,026 29,183 Repairs and maintenance 9,318 9,060 18,853 18,697 Utilities 5,239 5,592 10,541 11,715 Other miscellaneous operating expenses 16,838 18,176 33,065 38,954 Total other operating expenses $ 106,954 $ 144,456 $ 243,743 $ 297,194 The Company records costs associated with the transition services agreements and other ancillary agreements with CHS in accordance with the terms of these agreements. These costs, which primarily include the costs of providing information technology, patient billing and collections and payroll services, are included in “Transition services agreements” in the table above. See Note 16 — Related Party Transactions for additional information on the transition services agreements with CHS. So Note 17 — Commitments and Contingencies — Insurance Reserves for additional information related to our insurance reserves and related expenses. General and Administrative Costs Substantially all of the Company’s operating costs and expenses are “cost of revenues” items. Operating expenses that could be classified as general and administrative by the Company are costs related to corporate office functions, including, but not limited to tax, treasury, audit, risk management, legal and human resources. These costs are primarily salaries and benefits expenses associated with these corporate office functions. General and administrative costs of the Company were $11.4 million and $20.0 million during the three months ended June 30, 2019 and 2018, respectively, and $24.0 million and $34.9 million during the six months ended June 30, 2019 and 2018, respectively. General and administrative costs of the Company include executive severance costs at the corporate office of $2.7 million and $4.6 million during the three and six months ended June 30, 2018, respectively. There were no executive severance costs at the corporate office during the three and six months ended June 30, 2019. Legal, Professional and Settlement Costs Legal, professional and settlement costs in the Company’s consolidated statements of income primarily include legal costs and related settlements, if any, associated with arbitration, regulatory claims, government investigations into reimbursement payments and other litigation matters. Loss (Gain) on Sale of Hospitals, Net Loss (gain) on sale of hospitals, net is the loss (gain) incurred by the Company’s divestiture of hospitals and outpatient facilities. It is calculated as the difference between the cash proceeds from the sale and the carrying values of the associated net assets sold at the date of sale, less certain incremental direct selling costs. Loss on Closure of Hospitals, Net Loss on closure of hospitals, net relates to costs incurred by the Company for closure of hospitals and outpatient facilities, and includes severance, loss on disposal of property and equipment, write-down of assets, l

Impairment of Long-Lived Assets

Impairment of Long-Lived Assets and Goodwill	6 Months Ended
	Jun. 30, 2019
Disclosure Text Block Supplement [Abstract]
Impairment of Long-Lived Assets and Goodwill	NOTE 2 – IMPAIRMENT OF LONG-LIVED ASSETS AND GOODWILL 2019 Impairment During the three months ended June 30, 2019, the Company evaluated the fair value of hospitals intended for divestiture. In connection with this evaluation, the Company recognized long-lived asset and goodwill impairment of $26.0 million during the three months ended June 30, 2019, which consisted of $15.3 million of property and equipment, $4.2 million of capitalized software costs and $6.5 million of goodwill. During the three months ended March 31, 2019, the Company evaluated the fair value of hospitals intended for divestiture. In connection with this evaluation, the Company recognized long-lived asset impairment of $8.9 million during the three months ended March 31, 2019, which consisted of $8.4 million of property and equipment and $0.5 million of capitalized software costs. 2018 Impairment During the three months ended June 30, 2018, the Company evaluated the fair value of hospitals intended for divestiture. In connection with this evaluation, the Company determined that there were no indicators of impairment as of June 30, 2018. During the three months ended March 31, 2018, the Company evaluated the fair value of hospitals intended for divestiture. In connection with this evaluation, the Company recognized long-lived asset impairment of $39.8 million during the three months ended March 31, 2018, which consisted of $34.7 million of property and equipment and $5.1 million of capitalized software costs.

Divestitures

Divestitures	6 Months Ended
	Jun. 30, 2019
Business Combinations [Abstract]
Divestitures	NOTE 3 –DIVESTITURES Scenic Mountain Medical Center On April 12, 2019, the Company sold 146-bed Scenic Mountain Medical Center and its affiliated facilities (“Scenic Mountain”), located in Big Spring, Texas, for proceeds of $11.7 million. For the three months ended June 30, 2019 and 2018, the Company’s operating results included pre-tax losses of $4.5 million and $0.4 million, respectively, related to Scenic Mountain, and pre-tax losses of $4.1 million and $0.2 million for the six months ended June 30, 2019 and 2018, respectively. In addition to the above, the Company recorded a $1.1 million loss on sale of Scenic Mountain in the six months ended June 30, 2019, which includes a write-off of allocated goodwill of $3.3 million. Watsonville Community Hospital On June 7, 2019, the Company announced that it had entered into a definitive agreement to sell the stock interests of 106-bed Watsonville Community Hospital and its affiliated entities (“Watsonville”), located in Watsonville, California. On July 18, 2019, the Company received notification from the Pajaro Valley Community Health Trust (“Trust”) that it had exercised its Right of First Refusal to purchase the stock interests of Watsonville. If the terms of the Right of First Refusal are not met, the Company’s definitive agreement entered into on May 31, 2019 will remain in effect. The Company currently anticipates completing the sale of Watsonville by the end of 2019. The Company has classified the assets and liabilities subject to the sale as held for sale in the consolidated balance sheets. MetroSouth Medical Center On June 12, 2019, the Company announced that MetroSouth Medical Center (“MetroSouth”), located in Blue Island, Illinois, filed an application with the Illinois Health Facilities and Service Review Board to discontinue hospital operations. The Company anticipates discontinuing all operations by the end of the third quarter of 2019. The Company expects to complete its assessment of the closure of MetroSouth by the end of the third quarter, including any potential impacts on the Company’s results of operations, financial position and cash flows

Property and Equipment

Property and Equipment	6 Months Ended
	Jun. 30, 2019
Property Plant And Equipment [Abstract]
Property and Equipment	NOTE 4 – PROPERTY AND EQUIPMENT The following table provides a summary of the components of property and equipment (in thousands): June 30, December 31, 2019 2018 Property and equipment, at cost: Land and improvements $ 44,185 $ 49,637 Building and improvements 651,804 723,345 Equipment and fixtures 463,998 498,139 Construction in progress 7,391 16,208 Total property and equipment, at cost 1,167,378 1,287,329 Less: Accumulated depreciation and amortization (670,823 ) (727,891 ) Total property and equipment, net $ 496,555 $ 559,438 Depreciation expense was $10.6 million and $12.2 million for the three months ended June 30, 2019 and 2018, respectively, and $21.3 million and $25.2 million for the six months ended June 30, 2019 and 2018, respectively. See Note 5 Purchases of property and equipment accrued in accounts payable were $2.1 million and $4.9 million as of June 30, 2019 and December 31, 2018, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	NOTE 5 – GOODWILL AND INTANGIBLE ASSETS Goodwill The following table provides a summary of changes in goodwill (in thousands): Six Months Ended June 30, 2019 Balance at beginning of period $ 401,073 Acquisitions 375 Divestitures (3,300 ) Impairment (6,490 ) Balance at end of period $ 391,658 Goodwill related to the Company’s hospital operations reporting unit was $358.3 million and $367.8 million as of June 30, 2019 and December 31, 2018, respectively. Goodwill related to the hospital management advisory and healthcare consulting services reporting unit was $33.3 million at both June 30, 2019 and December 31, 2018. Total accumulated goodwill impairment losses were $133.4 million and $126.9 million as of June 30, 2019 and December 31, 2018, respectively. Intangible Assets The following table provides a summary of the components of intangible assets (in thousands): June 30, 2019 Accumulated Net Book Cost Amortization Value Finite-lived intangible assets: Capitalized software costs $ 136,547 $ (108,589 ) $ 27,958 Physician guarantee contracts 5,320 (3,131 ) 2,189 Other finite-lived intangible assets 43,222 (37,443 ) 5,779 Total finite-lived intangible assets, net 185,089 (149,163 ) 35,926 Indefinite-lives intangible assets: Tradenames 4,000 — 4,000 Licenses and other indefinite-lived intangible assets 1,140 — 1,140 Total indefinite-lived intangible assets 5,140 — 5,140 Total intangible assets $ 190,229 $ (149,163 ) $ 41,066 December 31, 2018 Accumulated Net Book Cost Amortization Value Finite-lived intangible assets: Capitalized software costs $ 145,795 $ (111,658 ) $ 34,137 Physician guarantee contracts 5,008 (2,679 ) 2,329 Other finite-lived intangible assets 43,221 (36,512 ) 6,709 Total finite-lived intangible assets, net 194,024 (150,849 ) 43,175 Indefinite-lives intangible assets: Tradenames 4,000 — 4,000 Licenses and other indefinite-lived intangible assets 1,114 — 1,114 Total indefinite-lived intangible assets 5,114 — 5,114 Total intangible assets $ 199,138 $ (150,849 ) $ 48,289 As of June 30, 2019, the Company had $1.5 million of capitalized software costs that are currently in the development stage. Amortization of these costs will begin once the software projects are complete and ready for their intended use. Amortization Expense The following table provides a summary of the components of amortization expense (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Amortization of finite-lived intangible assets: Capitalized software costs $ 2,115 $ 2,775 $ 4,320 $ 6,099 Physician guarantee contracts 537 916 1,046 1,445 Other finite-lived intangible assets 471 507 945 1,014 Total amortization expense related to finite-lived intangible assets 3,123 4,198 6,311 8,558 Amortization of leasehold improvements and property and equipment assets held under finance lease obligations 783 783 1,569 1,676 Total amortization expense $ 3,906 $ 4,981 $ 7,880 $ 10,234 As of June 30, 2019, the weighted-average remaining amortization period of the Company’s intangible assets subject to amortization, except for capitalized software costs and physician guarantee contracts, was approximately 3.1 years.

Long-Term Debt

Long-Term Debt	6 Months Ended
	Jun. 30, 2019
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 6 – LONG-TERM DEBT The following table provides a summary of the components of long-term debt (in thousands): June 30, December 31, 2019 2018 Senior Credit Facility: Revolving Credit Facility, maturing 2021 $ — $ — Term Loan Facility, maturing 2022 777,686 790,751 ABL Credit Facility, maturing 2021 42,000 14,000 Senior Notes, maturing 2023 400,000 400,000 Unamortized debt issuance costs and discounts (30,894 ) (35,537 ) Finance lease obligations 22,781 23,386 Other debt 596 874 Total debt 1,212,169 1,193,474 Less: Current maturities of long-term debt (1,646 ) (1,697 ) Total long-term debt $ 1,210,523 $ 1,191,777 Senior Credit Facility In connection with the Spin-off, on April 29, 2016, the Company entered into a credit agreement (the “CS Agreement”), among the Company, the lenders party thereto and Credit Suisse AG, Cayman Islands Branch (“Credit Suisse”), as administrative agent and collateral agent. On April 11, 2017, the Company executed an agreement with its Senior Credit Facility lenders to amend certain provisions of its Senior Credit Facility (the “CS Amendment”), as described below. On March 14, 2018, the Company executed a second agreement with its Senior Credit Facility lenders to amend certain provisions of its Senior Credit Facility (the “CS Second Amendment”), as described below. The CS Agreement initially provided for an $880 million senior secured term loan facility (the “Term Loan Facility”) and a $100 million senior secured revolving credit facility (the “Revolving Credit Facility” and, together with the Term Loan Facility, the “Senior Credit Facility”). The Term Loan Facility was issued at a discount of $17.6 million, or 98% of par value, and has a maturity date of April 29, 2022, subject to customary acceleration events and repayment, extension or refinancing. The Revolving Credit Facility has a maturity date of April 29, 2021, subject to certain customary acceleration events and repayment, extension or refinancing. The CS Amendment reduced the Revolving Credit Facility’s capacity from $100 million to $87.5 million until December 31, 2017, at which time the capacity decreased to $75.0 million. The CS Second Amendment further reduced the Revolving Credit Facility’s capacity to $62.5 million through maturity, effective with the execution of the amendment on March 14, 2018. The CS Agreement contains customary covenants, including a maximum permitted Secured Net Leverage Ratio, as determined based on 12 month trailing Consolidated EBITDA, as defined in the CS Agreement. On April 11, 2017, the Company executed the CS Amendment with its Senior Credit Facility lenders to amend the calculation of the Secured Net Leverage Ratio beginning July 1, 2017 through maturity, among other provisions. In addition, the CS Amendment raised the minimum Secured Net Leverage Ratio required for the Company to remain in compliance for certain periods, and also changed the calculation of compliance for specified periods. The CS Second Amendment, which was executed on March 14, 2018, amended the Secured Net Leverage Ratio for the period July 1, 2017 through maturity. As of June 30, 2019, the Company had a Secured Net Leverage Ratio of 4.85 to 1.00 implying additional borrowing capacity of $25.9 million as of June 30, 2019. After giving effect to the CS Amendment and the CS Second Amendment, the maximum Secured Net Leverage Ratio permitted under the CS Agreement, as determined based on 12 month trailing Consolidated EBITDA measured as of the last day of each fiscal quarter and as defined in the CS Agreement follows: Maximum Secured Net Period Leverage Ratio Period from July 1, 2018 to December 31, 2019 5.00 to 1.00 Period from January 1, 2020 and thereafter 4.50 to 1.00 In addition to amending the calculation of the Secured Net Leverage Ratio and the Maximum Secured Net Leverage Ratio, the CS Amendment and the CS Second Amendment also affected other terms of the CS Agreement as follows: • Through April 29, 2022, the Company is required to use asset sales proceeds to make mandatory redemptions under the Term Loan Facility. • The Company may request to exercise Incremental Term Loan Commitments for the greater of $100 million or an amount which would produce a Secured Net Leverage Ratio of 3.35 to 1.00. • The Company may incur Permitted Additional Debt so long as the Total Leverage Ratio, adjusted for the Permitted Additional Debt, is below 5.50 to 1.00. Prior to the CS Amendment, interest under the Term Loan Facility accrued, at the option of the Company, at adjusted LIBOR, subject to statutory reserves and a floor of 1% plus 5.75%, or the alternate base rate plus 4.75%. Following the CS Amendment, interest under the Term Loan Facility accrues, at the option of the Company, at adjusted LIBOR, subject to statutory reserves and a floor of 1% plus 6.75%, or the alternate base rate plus 5.75%. The effective interest rate on the Term Loan Facility was 9.66% as of June 30, 2019. Interest on outstanding borrowings under the Revolving Credit Facility accrues, at the option of the Company, at adjusted LIBOR, subject to statutory reserves and a floor of 0% plus 2.75%, or the alternate base rate plus 1.75%, and remains unchanged under the CS Amendment and the CS Second Amendment. Borrowings from the Revolving Credit Facility are used for working capital and general corporate purposes. As of June 30, 2019, the Company had no borrowings outstanding on the Revolving Credit Facility and had $14.2 million of letters of credit outstanding that were primarily related to the self-insured retention levels of professional and general liability and workers’ compensation liability insurance as security for the payment of claims. As of June 30, 2019, the Company had borrowing capacity under its Revolving Credit Facility of $48.3 million subject to the restraint of the overall borrowing capacity calculated by the Secured Net Leverage Ratio. ABL Credit Facility In connection with the Spin-off, on April 29, 2016, the Company entered into an ABL Credit Agreement (the “UBS Agreement,” and together with the CS Agreement, collectively, the “Credit Agreements”), among the Company, the lenders party thereto and UBS AG, Stamford Branch (“UBS”), as administrative agent and collateral agent. On April 11, 2017, we executed an amendment to the UBS Agreement with its lender party thereto, which aligned the provisions of the UBS Agreement with the CS Amendment. The UBS Agreement provides for a $125 million senior secured asset-based revolving credit facility (the “ABL Credit Facility”). The available borrowings from the ABL Credit Facility, which are based on eligible patient accounts receivable, are used for working capital and general corporate purposes. As of June 30, 2019, the Company had $42.0 million of borrowings outstanding on the ABL Credit Facility and borrowing capacity of $68.2 million subject to the restraint of the overall borrowing capacity calculated by the Secured Net Leverage Ratio. The ABL Credit Facility has a maturity date of April 29, 2021, subject to customary acceleration events and repayment, extension or refinancing. Interest on outstanding borrowings under the ABL Credit Facility accrues, at the option of the Company, at a base rate or LIBOR, subject to statutory reserves The ABL Credit Facility has a “Covenant Trigger Event” definition that requires the Company to maintain excess availability under the ABL Credit Facility equal to or greater than the greater of (i) $12.5 million and (ii) 10% of the aggregate commitments under the ABL Credit Facility. If a Covenant Trigger Event occurs, then the Company is required to maintain a minimum Consolidated Fixed Charge Ratio of 1.10 to 1.00 until such time that a Covenant Trigger Event is no longer continuing. In addition, if excess availability under the ABL Credit Facility were to fall below the greater of (i) 12.5% of the aggregate commitments under the ABL Credit Facility and (ii) $15.0 million, then a “Cash Dominion Event” would be triggered upon which the lenders could assume control of the Company’s cash. Credit Agreement Covenants In addition to the specific covenants described above, the Credit Agreements contain customary negative covenants which limit the Company’s ability to, among other things, incur additional indebtedness, create liens, make investments, transfer assets, merge or acquire assets, and make restricted payments, including dividends, distributions and specified payments on other indebtedness. They include customary events of default, including payment defaults, material breaches of representations and warranties, covenant defaults, default on other material indebtedness, customary Employee Retirement Income Security Act (“ERISA”) Senior Notes On April 22, 2016, QHC issued $400 million aggregate principal amount of 11.625% Senior Notes due 2023, pursuant to the Indenture. The Senior Notes were issued at a discount of $6.9 million, or 1.734%, in a private placement and are senior unsecured obligations of the Company guaranteed on a senior basis by certain of the Company’s subsidiaries (the “Guarantors”). The Senior Notes mature on April 15, 2023 and bear interest at a rate of 11.625% per annum, payable semi-annually in arrears on April 15 and October 15 of each year, beginning on October 15, 2016. Interest on the Senior Notes accrues from the date of original issuance and is calculated on the basis of a 360-day year comprised of twelve 30-day months. The effective interest rate on the Senior Notes was 12.49% as of June 30, 2019. The Indenture contains covenants that, among other things, limit the ability of the Company and certain of its subsidiaries to incur or guarantee additional indebtedness, pay dividends or make other restricted payments, make certain investments, create or incur certain liens, sell assets and subsidiary stock, transfer all or substantially all of its assets or enter into merger or consolidation transactions. On May 17, 2017, the Company exchanged the 11.625% Senior Notes due 2023 (the “Initial Notes”) in the aggregate principal amount of $400 million, which were not registered under the Securities Act of 1933, as amended (the “Securities Act”), for a like principal amount of 11.625% Senior Notes due 2023 (the “Exchange Notes”), which have been registered under the Securities Act. The Initial Notes were substantially identical to the Exchange Notes, except that the Exchange Notes are registered under the Securities Act and are not subject to the transfer restrictions and certain registration rights agreement provisions applicable to the Initial Notes. On and after April 15, 2019, the Company is entitled, at its option, to redeem all or a portion of the Senior Notes upon not less than 30 nor more than 60 days’ notice, at the following redemption prices specified in the table below, plus accrued and unpaid interest, if any, to the redemption date. The redemption prices are expressed as a percentage of the principal amount on the redemption date. Holders of record on the relevant record date have the right to receive interest due on the relevant interest payment date. In addition, prior to April 15, 2019, the Company could have redeemed some or all of the Senior Notes at a price equal to 100% of the principal amount thereof, plus accrued and unpaid interest, if any, plus a “make whole” premium, as set forth in the Indenture. The Company was entitled to redeem up to 35% of the aggregate principal amount of the Senior Notes until April 15, 2019 with the net proceeds from certain equity offerings at the redemption price set forth in the Indenture. The following table provides a summary of the redemption periods and prices related to the Senior Notes: Redemption Period Prices Period from April 15, 2019 to April 14, 2020 108.719 % Period from April 15, 2020 to April 14, 2021 105.813 % Period from April 15, 2021 to April 14, 2022 102.906 % Period from April 15, 2022 to April 14, 2023 100.000 % Debt Issuance Costs and Discounts The following table provides a summary of unamortized debt issuance costs and discounts (in thousands): June 30, December 31, 2019 2018 Debt issuance costs $ 34,533 $ 34,533 Debt discounts 24,536 24,536 Total debt issuance costs and discounts at origination 59,069 59,069 Less: Amortization of debt issuance costs and discounts (28,175 ) (23,532 ) Total unamortized debt issuance costs and discounts $ 30,894 $ 35,537 Finance Lease Obligations and Other Debt The Company’s debt arising from finance lease obligations primarily relates to its corporate office in Brentwood, Tennessee. As of June 30, 2019 and December 31, 2018, this finance lease obligation was $16.7 million and $17.2 million, respectively. The remainder of the Company’s finance lease obligations relate to property and equipment at its hospitals and corporate office. Other debt consists of physician loans and miscellaneous notes payable to banks. Debt Maturities The following table provides a summary of debt maturities for the next five years and thereafter (in thousands): June 30, 2019 Remainder of 2019 $ 823 2020 1,632 2021 43,625 2022 779,111 2023 401,327 Thereafter 16,545 Total debt, excluding unamortized debt issuance costs and discounts $ 1,243,063 Interest Expense, Net The following table provides a summary of the components of interest expense, net (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Senior Credit Facility: Revolving Credit Facility $ 62 $ 64 $ 122 $ 142 Term Loan Facility 18,226 17,653 36,558 35,053 ABL Credit Facility 661 511 1,047 839 Senior Notes 11,626 11,626 23,252 23,239 Amortization of debt issuance costs and discounts 2,482 3,064 4,643 5,170 All other interest expense (income), net 525 (992 ) 226 (1,586 ) Total interest expense, net $ 33,582 $ 31,926 $ 65,848 $ 62,857

Leases

Leases	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Leases	NOTE 7 – LEASES The Company has operating and finance leases for its corporate office, certain of its hospitals, medical office buildings, medical equipment and office equipment. The following table provides a summary of the components of lease costs and rent (in thousands): Three Months Ended Six Months Ended June 30, 2019 June 30, 2019 Operating lease costs: Operating lease cost $ 9,126 $ 18,202 Variable lease cost 694 1,299 Short-term rent expense 1,807 3,657 Total operating lease costs $ 11,627 $ 23,158 Finance lease costs: Amortization of right-of-use assets $ 389 $ 778 Interest on lease liabilities 380 758 Total finance lease costs $ 769 $ 1,536 The following table provides supplemental balance sheet information related to finance leases (in thousands): Balance Sheet Classification June 30, 2019 Finance Leases: Finance lease ROU assets Property and equipment $ 29,358 Accumulated amortization Accumulated depreciation and amortization 6,450 Current finance lease liabilities Current maturities of long-term debt 1,309 Long-term finance lease liabilities Long-term debt 21,472 The following table provides supplemental cash flow information related to leases (in thousands): Three Months Ended Six Months Ended June 30, 2019 June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 9,126 $ 18,232 Operating cash flows from finance leases 331 663 Financing cash flows from finance leases 309 684 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 3,358 $ 8,626 Finance leases — 79 The following table provides the weighted-average lease terms and discount rates used for the Company’s operating and finance leases: June 30, 2019 Weighted-average remaining lease term (years): Operating leases 4.9 Finance leases 8.1 Weighted-average discount rate: Operating leases 10.3 % Finance leases 6.2 % The following table provides a summary of lease liability maturities for the next five years and thereafter (in thousands): Operating Finance Leases Leases Remainder of 2019 $ 16,372 $ 1,292 2020 31,314 2,610 2021 20,865 2,647 2022 13,141 2,344 2023 7,601 6,974 Thereafter 24,045 13,715 Total lease payments 113,338 29,582 Less: Imputed interest (26,174 ) (6,801 ) Total lease obligations 87,164 22,781 Less: Lease obligations held-for-sale (1,813 ) — Total lease obligations excluding held-for-sale 85,351 22,781 Less: Current portion (23,797 ) (1,309 ) Total Long-term lease obligations excluding held-for-sale $ 61,554 $ 21,472 As previously disclosed in the Company’s 2018 Annual Report on Form 10-K, which followed the lease accounting standard prior to the adoption of ASC Topic 842 (ASC Topic 840), future commitments related to non-cancellable operating and capital leases for each for the next five years and thereafter as of December 31, 2018 were as follows (in thousands): Operating Finance Leases (1) Leases 2019 $ 34,885 $ 2,549 2020 29,609 2,587 2021 20,098 2,625 2022 12,932 2,328 2023 7,588 6,974 Thereafter 26,469 13,716 Total minimum future payments obligations $ 131,581 30,779 Less: Imputed interest (7,393 ) Total capital lease obligations 23,386 Less: Current portion of capital lease obligations (1,304 ) Total long-term capital lease obligations $ 22,082 (1) Minimum lease payment obligations have not been reduced by minimum sublease rentals due in the future of $0.8 million.

Other Long-Term Assets and Othe

Other Long-Term Assets and Other Long-Term Liabilities	6 Months Ended
	Jun. 30, 2019
Other Noncurrent Assets And Other Noncurrent Liabilities Disclosure [Abstract]
Other Long-Term Assets and Other Long-Term Liabilities	NOTE 8 – OTHER LONG-TERM ASSETS AND OTHER LONG-TERM LIABILITIES The following table provides a summary of the components of other long-term assets (in thousands): June 30, December 31, 2019 2018 Receivable for professional and general liability insurance reserves indemnified by CHS $ 23,310 $ 34,535 Assets of deferred compensation plan 15,829 14,980 Receivable for workers' compensation liability insurance reserves indemnified by CHS 11,642 12,118 Other miscellaneous long-term assets 15,173 12,673 Total other long-term assets $ 65,954 $ 74,306 The following table provides a summary of the components of other long-term liabilities (in thousands): June 30, December 31, 2019 2018 Professional and general liability insurance reserves $ 48,836 $ 82,828 Workers' compensation liability insurance reserves 15,869 16,819 Benefit plan liabilities 21,661 22,712 Other miscellaneous long-term liabilities 2,879 4,140 Total other long-term liabilities $ 89,245 $ 126,499 See Note 17 — Commitments and Contingencies for additional information about the Company’s insurance reserves and Note 15 — Benefit Plans for additional information about the Company’s benefit plan liabilities.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	NOTE 9 – FAIR VALUE OF FINANCIAL INSTRUMENTS The carrying amounts of the Company’s cash and cash equivalents, patient accounts receivable, amounts due from and due to third-party payors, restricted cash and accounts payable approximate their fair values due to the short-term maturity of these financial instruments. The Company recorded impairment related to long-lived assets and goodwill during the three and six months ended June 30, 2019 and 2018. See Note 2 — Impairment of Long-Lived Assets and Goodwill for additional information on these impairments. The assessment of fair value was based on Level 3 inputs, as the valuation methodologies used to determine impairment were based on internal projections and unobservable inputs. The portion of the impairment related to hospital assets held for sale was determined based on Level 2 inputs, as the valuation methodologies used to determine impairment considered letters of intent received on these hospitals. The following table provides a summary of the carrying amounts and estimated fair values of the Company’s long-term debt (in thousands): June 30, 2019 December 31, 2018 Carrying Estimated Carrying Estimated Amount Fair Value Amount Fair Value Revolving Credit Facility $ — $ — $ — $ — Term Loan Facility 777,686 769,909 790,751 784,821 ABL Credit Facility 42,000 42,000 14,000 14,000 Senior Notes 400,000 349,424 400,000 382,984 Other debt 23,377 23,377 24,260 24,260 Total debt, excluding unamortized debt issuance costs and discounts $ 1,243,063 $ 1,184,710 $ 1,229,011 $ 1,206,065 The Company considers its long-term debt instruments to be measured based on Level 2 inputs. Information about the valuation methodologies used in the determination of the fair values for the Company’s long-term debt instruments follows: • Term Loan Facility . • Senior Notes . • All other debt .

Equity

Equity	6 Months Ended
	Jun. 30, 2019
Equity [Abstract]
Equity	NOTE 10 – EQUITY Authorized capital shares of the Company include 400,000,000 shares of capital stock consisting of 300,000,000 shares of common stock and 100,000,000 shares of preferred stock. Each of the aforementioned classes of capital stock has a par value of $0.0001 per share. Shares of preferred stock, none of which were outstanding as of June 30, 2019 or December 31, 2018, may be issued in one or more series having such rights, preferences, privileges and restrictions, including voting rights, dividend rights, conversion rights, redemption privileges and liquidation preferences as determined by the Board of Directors, subject to limitations prescribed by Delaware law and by the Company’s amended and restated certificate of incorporation. As of June 30, 2019 and December 31, 2018, the Company had 32,926,689 shares and 31,521,398 shares, respectively, of common stock issued and outstanding. Holders of the Company’s common stock are entitled to one vote for each share held of record on all matters for which stockholders may vote. Holders of the Company’s common stock do not have cumulative voting rights in the election of directors. There are no preemptive rights, conversion, redemption or sinking fund provisions applicable to the common stock. In the event of liquidation, dissolution or winding up, holders of common stock are entitled to share ratably in the assets available for distribution. Delaware law prohibits the Company from paying any dividends unless it has capital surplus or net profits available for this purpose. In addition, the Company’s Credit Agreements and the Indenture impose restrictions on its ability to pay dividends.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 11 – INCOME TAXES The Company and its subsidiaries are subject to U.S. federal income tax and income tax of multiple state and local jurisdictions. The Company provides for income taxes based on the enacted tax laws and rates in jurisdictions in which it conducts its operations. On December 22, 2017, the Tax Cuts and Jobs Act (the “Tax Act”) was signed into law, resulting in significant changes from previous law. The most notable change was a reduction of the U.S. corporate income tax rate from 35% to 21% for corporations effective January 1, 2018. The Tax Act also provides for other changes which include limitations on the deductibility of interest expense, an increased limitation on the deductibility of executive compensation, and acceleration of depreciation for certain assets placed in service after September 27, 2017. As permitted by SEC Staff Accounting Bulletin 118, Income Tax Accounting Implications of the Tax Cuts and Jobs Act, the Company recorded provisional estimates in its 2017 financial statements for the effects of the Tax Act. The Company recorded a total income tax benefit of $24.0 million as of December 31, 2017 for the estimated impact of the Tax Act using current available information and technical guidance on the interpretations of the Tax Act. The total tax benefit of $24.0 million was comprised of a tax benefit of $10.9 million from the reduction of the Company’s net deferred tax liabilities measured at the new 21% tax rate, and a $13.1 million tax benefit for the reduction in valuation allowance attributable to the net realizability of deferred tax assets. The Company completed its analysis of the Tax Act during 2018 and has included its effects in the consolidated financial statements. Adjustments made during 2018 for the finalization of our analysis were not material to the Company’s consolidated financial statements. One key aspect of the Tax Act that impacts the Company is the limitation on the deductibility of interest expense. The Tax Act provides that net interest expense is limited to 30% of Adjusted Taxable Income (“ATI”). ATI is defined as taxable income computed without regard to deductions for (1) business interest expense and income, (2) net operating losses allowable under Internal Revenue Code Section 172, and (3) depreciation, amortization, or depletion (for years beginning before January 1, 2022). The Company has calculated an estimated excess interest expense of approximately $91.2 million for 2018 which may be carried forward for an indefinite number of years. The Company’s effective tax rates were (0.6)% and 1.7% for the three months ended June 30, 2019 and 2018, respectively, and (0.5)% and 0.1% for the six months ended June 30, 2019 and 2018, respectively. The Company’s deferred income tax liabilities, net were $7.0 million as of June 30, 2019, compared to $6.7 million as of December 31, 2018, a $0.3 million increase. This increase was a result of an increase in deferred tax liabilities during the period due to tax deductible amortization on indefinite-lived intangibles including goodwill and the reclassification of refundable alternative minimum tax (“AMT”) credit. In the ordinary course of business, there is inherent uncertainty in quantifying the Company’s income tax positions. The Company assesses its income tax positions and records income tax benefits for all tax years subject to examination based on management’s evaluation of the facts, circumstances, and information available at the reporting date. The Company is not aware of any unrecognized income tax benefits; therefore, it has not recorded any such amounts for the three and six months ended June 30, 2019 and 2018.

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 2019
Earnings Per Share [Abstract]
Earnings Per Share	NOTE 12 – EARNINGS PER SHARE The following table provides a summary of the computation of basic and diluted earnings (loss) per share (in thousands, except earnings per share and shares): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Numerator: Net income (loss) $ (16,477 ) $ (25,941 ) $ (55,083 ) $ (124,428 ) Less: Net income (loss) attributable to noncontrolling interests 396 665 796 1,146 Net income (loss) attributable to Quorum Health Corporation $ (16,873 ) $ (26,606 ) $ (55,879 ) $ (125,574 ) Denominator: Weighted-average shares outstanding - basic and diluted 30,001,208 28,995,564 29,721,167 28,726,445 Earnings (loss) per share attributable to Quorum Health Corporation stockholders - basic and diluted $ (0.56 ) $ (0.92 ) $ (1.88 ) $ (4.37 ) Due to the net losses attributable to Quorum Health Corporation in the three and six months ended June 30, 2019 and 2018, no incremental shares were included in diluted earnings (loss) per share for these periods because the net effect of the shares would be anti-dilutive.

Segments

Segments	6 Months Ended
	Jun. 30, 2019
Segment Reporting [Abstract]
Segments	NOTE 13 – SEGMENTS The Company’s operations consist of two distinct operating segments, its hospital operations business and its hospital management advisory and healthcare consulting services business. The hospital operations segment includes the operations of the Company’s owned and leased hospitals and their affiliated outpatient facilities that provide inpatient and outpatient healthcare services. The hospital management advisory and healthcare consulting services segment includes the operations of QHR. Both segments meet the criteria to be classified as a separate reportable segment. The financial information for the Company’s corporate functions has been reported in the tables below as part of the all other reportable segment. The following tables provide a summary of financial information related to the Company’s reportable segments (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net operating revenues: Hospital operations $ 426,618 $ 453,660 $ 852,771 $ 920,826 QHR operations 14,974 18,620 30,031 38,208 All other 578 352 2,173 418 Total net operating revenues $ 442,170 $ 472,632 $ 884,975 $ 959,452 Adjusted EBITDA: Hospital operations $ 41,744 $ 44,035 $ 70,077 $ 70,318 QHR operations 4,128 4,451 8,207 8,803 All other (12,443 ) (12,163 ) (24,224 ) (24,378 ) Total Adjusted EBITDA $ 33,429 $ 36,323 $ 54,060 $ 54,743 June 30, December 31, 2019 2018 Assets: Hospital operations $ 1,458,118 $ 1,453,693 QHR operations 53,592 55,823 All other 56,516 64,578 Total assets $ 1,568,226 $ 1,574,094 The following table provides a reconciliation of Adjusted EBITDA to net income (loss), the most directly comparable U.S. GAAP financial measure (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net income (loss) $ (16,477 ) $ (25,941 ) $ (55,083 ) $ (124,428 ) Interest expense, net 33,582 31,926 65,848 62,857 Provision for (benefit from) income taxes 94 (454 ) 249 (88 ) Depreciation and amortization 14,500 17,142 29,139 35,403 EBITDA 31,699 22,673 40,153 (26,256 ) Legal, professional and settlement costs 604 5,417 1,289 8,830 Impairment of long-lived assets and goodwill 25,950 — 34,810 39,760 Loss (gain) on sale of hospitals, net 1,140 307 1,140 8,122 Loss on closure of hospitals, net — 3,338 — 17,084 Transition of transition services agreements 834 520 1,976 1,237 Change in actuarial estimates (26,880 ) — (26,880 ) — Headcount reductions and executive severance 82 4,068 1,572 5,966 Adjusted EBITDA $ 33,429 $ 36,323 $ 54,060 $ 54,743

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	NOTE 14 – STOCK-BASED COMPENSATION On April 1, 2016, the Company adopted the Quorum Health Corporation 2016 Stock Award Plan (“2016 Stock Award Plan”). The Company filed a Registration Statement on Form S-8 on April 29, 2016 to register 4,700,000 shares of QHC common stock that may be issued under the 2016 Stock Award Plan. On February 14, 2019, the Company adopted the Quorum Health Corporation Amended and Restated 2016 Stock Award Plan (the “Amended and Restated 2016 Stock Award Plan”), which was approved by the Company’s stockholders on May 31, 2019. The Company filed a Registration Statement on Form S-8 on February 14, 2019 to register an additional 3,700,000 shares of QHC common stock that may be issued under the Amended and Restated 2016 Stock Award Plan. On December 17, 2018, the Company adopted the Quorum Health Corporation 2018 Restricted Stock Plan (the “2018 Stock Plan”) effective December 18, 2018, which was approved by the Company’s stockholders on May 31, 2019. The Company filed a Registration Statement on Form S-8 on December 18, 2018 to register 625,000 shares of QHC common stock that may be issued under the 2018 Stock Plan. As defined in the Separation and Distribution Agreement, QHC and CHS employees who held CHS restricted stock awards on the Record Date received QHC restricted stock awards for the number of whole shares, rounded down, of QHC common stock that they would have received as a shareholder of CHS as if the underlying CHS stock were unrestricted on the Record Date, except, that with respect to a portion of CHS restricted stock awards granted to any QHC employees on March 1, 2016 that were cancelled and forfeited on the Spin-off date. The QHC restricted stock awards received by QHC and CHS employees in connection with the Spin-off vest on the same terms as the CHS restricted stock awards to which they relate, through the continued service by such employees with their respective employer. CHS restricted stock awards were adjusted by increasing the number of shares of CHS stock subject to restricted stock awards by an amount of whole shares, rounded down, necessary to preserve the intrinsic value of such awards at the Spin-off date. QHC did not issue any stock options as part of the distribution of shares to holders of CHS stock options in connection with the Spin-off. The following table provides a summary of the activity related to unvested QHC restricted stock awards held by QHC and CHS employees during the six months ended June 30, 2019 that were distributed in the Spin-off (in shares): QHC Awards Distributed in Spin-off Unvested restricted stock awards at December 31, 2018 80,350 Vested (61,150 ) Forfeited (19,200 ) Unvested restricted stock awards at June 30, 2019 — The following table provides a summary of the activity related to unvested restricted stock awards during the six months ended June 30, 2019 that were granted to QHC employees subsequent to the Spin-off: QHC Awards Granted Subsequent to Spin-off Weighted- Average Grant Date Fair Value Shares Per Share Unvested restricted stock awards at December 31, 2018 2,207,117 $ 7.04 Granted 1,689,346 1.76 Vested (842,377 ) 7.79 Forfeited (264,855 ) 8.67 Unvested restricted stock awards at June 30, 2019 2,789,231 $ 3.46 During the six months ended June 30, 2019, the Company granted 125,000 performance-based restricted stock awards to certain of its executive officers. If the performance-based objectives are attained in accordance with the targets set forth in the performance-based restricted stock award agreements, the restrictions on the restricted stock awards will lapse on February 14, 2021. In addition, the Company granted 1,260,000 time-based restricted stock awards to certain of its executive officers and other employees in which the restrictions will lapse in equal installments on each of the first three anniversaries of February 14, 2019. In addition, the Company granted 304,346 time-based restricted stock awards to its non-employee directors in which the restrictions will lapse on February 14, 2020. The following table provides a summary of stock-based compensation expense for the periods subsequent to the Spin-off (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Stock-based compensation resulting from the Spin-off $ — $ 2 $ — $ 372 Stock-based compensation related to grants following the Spin-off 1,194 2,754 2,964 4,848 Total stock-based compensation expense $ 1,194 $ 2,756 $ 2,964 $ 5,220 Stock-based compensation expense is recognized as a component of salaries and benefits expenses in the consolidated statements of income. As of June 30, 2019, the Company had unrecognized stock-based compensation expense of $7.6 million related to restricted stock awards.

Benefit Plans

Benefit Plans	6 Months Ended
	Jun. 30, 2019
Compensation And Retirement Disclosure [Abstract]
Benefit Plans	NOTE 15 – BENEFIT PLANS The Company maintains various benefit plans, including defined contribution plans, deferred compensation plans, a supplemental executive retirement plan and a defined benefit plan . Defined Contribution Plans The Quorum Health Retirement Savings Plan (the “Retirement Savings Plan”) is a defined contribution plan, which was established on January 1, 2016 by CHS in anticipation of the Spin-off. Prior to the Spin-off, the cumulative liability for these benefit costs was recorded in Due to Parent, net. The assets and liabilities under this plan were transferred to QHC in connection with the Spin-off. The Retirement Savings Plan covers the majority of the employees at the Company’s subsidiaries. The Company has other minor defined contribution plans at certain of its hospitals that cover employees under the terms of these individual plans. Total expenses to the Company under all defined contribution plans were $0.3 million and $4.2 million for the three months ended June 30, 2019 and 2018, respectively, and $0.8 million and $4.3 million for the six months ended June 30, 2019 and 2018, respectively. The benefit costs associated with these defined contribution plans are recorded as salaries and benefits expenses in the consolidated statements of income. Deferred Compensation Plans On August 18, 2016, the Compensation Committee of the Board of Directors adopted the Executive Nonqualified Excess Plan Adoption Agreement (the “Adoption Agreement”) and the Executive Nonqualified Excess Plan Document (the “Plan Document”), that together, the Adoption Agreement names as the QHCCS, LLC Nonqualified Deferred Compensation Plan (the “NQDCP”). The NQDCP is an unfunded, nonqualified deferred compensation plan that provides deferred compensation benefits for a select group of management, highly compensated employees and independent contractors of the Company’s wholly-owned subsidiary, QHCCS, LLC, a Delaware limited liability company (“QHCCS”), including the Company’s named executive officers. The NQDCP permits participants to defer a portion of their annual base salary, service bonus and performance-based compensation, as well as up to 100% As of June 30, 2019, the assets and liabilities under this plan were $15.8 million and $17.1 million, respectively. As of December 31, 2018, the assets and liabilities under this plan were $15.0 million and $16.2 million, respectively. . Supplemental Executive Retirement Plan On April 1, 2016, the Board adopted the Quorum Health Corporation Supplemental Executive Retirement Plan (the “Original SERP Plan”). Pursuant to the Employee Matters Agreement between the Company and CHS, the Company assumed the liabilities for all obligations under the Original SERP Plan as of April 29, 2016, the Spin-off date, which related to QHC employees, as defined in the Employee Matters Agreement. In addition, as defined by the Employee Matters Agreement, no additional benefits were to accrue under the Original SERP Plan following the Spin-off and no assets were transferred to the Company related to the Original SERP Plan. The accrued benefit liability transferred to the Company for the Original SERP Plan was $6.0 million. On May 24, 2016, the Board approved the Company’s Amended and Restated Supplemental Executive Retirement Plan (the “Amended and Restated SERP”), in order to accrue additional benefits with respect to QHC Employees who otherwise qualify as “Participants” under the Amended and Restated SERP. The Amended and Restated SERP is a noncontributory non-qualified deferred compensation plan under Section 409A of the Internal Revenue Code. The benefit costs under the Amended and Restated SERP were $0.2 million and $0.1 million for the three months ended June 30, 2019 and 2018, respectively, and $0.5 million for both the six months ended June 30, 2019 and 2018, and are included in salaries and benefits expenses in the consolidated statements of income. The long-term portion of the benefit liability for the Amended and Restated SERP was $3.5 million and $3.1 million as of June 30, 2019 and December 31, 2018, respectively, and is included in other long-term liabilities in the consolidated balance sheets. There was no current portion of the benefit liability as of June 30, 2019 and December 31, 2018. Director’s Fees Deferral Plan On September 16, 2016, the Board adopted the Quorum Health Corporation Director’s Fees Deferral Plan (the “Director’s Plan”). Pursuant to the Director’s Plan, members of the Board may elect to defer and accumulate fees and stock units, including retainer fees and fees for attendance at Board meetings and Board committees. Under this plan, a director may elect that all or any specified portion of the director’s fees to be earned during a calendar year be credited to a director’s cash account and/or a director’s stock unit account maintained on the individual director’s behalf in lieu of payment. Payment of amounts credited to a director’s cash account and stock unit account will be made upon a payment commencement event, as defined in the Director’s Plan, in accordance with the payment method elected by each director, either in lump sum or in a number of annual installments, not to exceed 15 150,000 Defined Benefit Pension Plan The Company provides benefits to employees at one of its hospitals through a defined benefit plan (the “Pension Plan”). The Pension Plan provides benefits to covered individuals satisfying certain age and service requirements. Employer contributions to the Pension Plan are made by the Company in accordance with the minimum funding requirements of ERISA. Benefit costs related to the Pension Plan were $0.1 million for both the three months ended June 30, 2019 and 2018 and $0.1 million for both the six months ended June 30, 2019 and 2018. The Company recognizes the unfunded liability of the Pension Plan in other long-term liabilities in the consolidated balance sheets. Unrecognized gains (losses) and prior service credits (costs) are recorded as other comprehensive income (loss). The accrued benefit liability for the Pension Plan was $1.1 million and $1.2 million at June 30, 2019 and December 31, 2018, respectively.

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2019
Related Party Transactions [Abstract]
Related Party Transactions	NOTE 16 – RELATED PARTY TRANSACTIONS CHS was a related party to QHC prior to the Spin-off. The agreements between QHC and CHS as of and subsequent to the Spin-off are described below. Agreements with CHS Related to the Spin-off In connection with the Spin-off and effective as of April 29, 2016, the Company entered into certain agreements with CHS that allocated between the Company and CHS the various assets, employees, liabilities and obligations (including investments, property, employee benefits and tax-related assets and liabilities) that were previously part of CHS. In addition, these agreements govern certain relationships between, and activities of, the Company and CHS for a definitive period of time after the Spin-off, as specified by each individual agreement. The agreements were as follows: • Separation and Distribution Agreement. • Tax Matters Agreement • Employee Matters Agreement. In addition to the agreements referenced above, the Company entered into certain transition services agreements and other ancillary agreements with CHS, as described below, defining agreed upon services to be provided by CHS to certain or all QHC hospitals, as determined by each agreement, commencing on the Spin-off date. Certain of these agreements have been terminated as described below. The remaining agreements have terms through April 2021, unless early termination is mutually agreed upon by both parties. A summary of the major provisions of the transition services agreements follows: • Shared Service Centers Transition Services Agreement. • Computer and Data Processing Transition Services Agreement. • Receivables Collection Agreement (“PASI”). • Billing and Collection Agreement (“PPSI”). • Employee Service Center Agreement. • Eligibility Screening Services Agreement. The total expenses recorded by the Company under the transition services agreements with CHS were $7.2 million and $14.1 million for the three months ended June 30, 2019 and 2018, respectively, and $15.0 million and $29.2 million for the six months ended June 30, 2019 and 2018, respectively.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2019
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	NOTE 17 - COMMITMENTS AND CONTINGENCIES Legal Matters The Company is a party to various legal, regulatory and governmental proceedings incidental to its business. Based on current knowledge, management does not believe that loss contingencies arising from pending legal, regulatory and governmental proceedings, including the matters described herein, will have a material adverse effect on the operating results, financial position or liquidity of the Company. However, in light of the inherent uncertainties involved in these matters, some of which are beyond the Company’s control, and the very large or indeterminate damages sought in some of these matters, an adverse outcome in one or more of these matters could be material to the Company’s consolidated financial position, results of operations or cash flows for any particular reporting period. In connection with the Spin-off, CHS agreed to indemnify QHC for certain liabilities relating to outcomes or events occurring prior to the closing of the Spin-off, including (i) certain claims and proceedings known to be outstanding on or prior to the closing date of the Spin-off and (ii) certain claims, proceedings and investigations by governmental authorities or private plaintiffs related to activities occurring at or related to the Company’s healthcare facilities prior to the closing date of the Spin-off, but only to the extent, in the case of clause (ii), that such claims are covered by insurance policies maintained by CHS, including professional and general liability and workers’ compensation liability. In this regard, CHS will continue to be responsible for certain Health Management Associates, Inc. legal matters covered by its contingent value rights agreement that relate to the portion of CHS’s business now held by QHC. Notwithstanding the foregoing, CHS is not indemnifying QHC in respect of any claims or proceedings arising out of, or related to, the business operations of QHR at any time or QHC’s compliance with the Corporate Integrity Agreement (“CIA”) . Subsequent to the Spin-off, the OIG entered into an “Assumption of CIA Liability Letter” with the Company reiterating the applicability of the CIA to certain of the Company’s hospitals, although the OIG declined to enter into a separate agreement with the Company. With respect to all legal, regulatory and governmental proceedings, the Company considers the likelihood of a negative outcome. If the Company determines the likelihood of a negative outcome with respect to any such matter is probable and the amount of the loss can be reasonably estimated, the Company records an accrual for the estimated amount of loss. If the likelihood of a negative outcome with respect to material matters is reasonably possible and the Company is able to determine an estimate of the amount of possible loss or a range of loss, whether in excess of a related accrued liability or where there is no accrued liability, the Company discloses the estimate of the amount of possible loss or range of loss. However, the Company is unable to estimate an amount of possible loss or range of loss in some instances based on the significant uncertainties involved in, or the preliminary nature of, certain legal, regulatory and governmental matters. Commercial Litigation and Other Lawsuits • Zwick Partners LP and Aparna Rao, Individually and On Behalf of All Others Similarly Situated v. Quorum Health Corporation, Community Health Systems, Inc., Wayne T. Smith, W. Larry Cash, Thomas D. Miller and Michael J. Culotta • R2 Investments, LDC v. Quorum Health Corporation, Community Health Systems, Inc., Wayne T. Smith, W. Larry Cash, Thomas D. Miller, Michael J. Culotta, John A. Clerico, James S. Ely, III, John A. Fry, William Norris Jennings, Julia B. North, H. Mitchell Watson, Jr. and H. James Williams . On October 25, 2017, a shareholder filed an action in the Circuit Court of Williamson County, Tennessee against the Company, Thomas D. Miller, and Michael J. Culotta (the “Quorum Defendants”) and CHS and certain of its officers and directors. The complaint alleges that the defendants violated the Tennessee Securities Act and common law by, among other things, making alleged false and/or misleading statements and failing to disclose certain information regarding aspects of the Company’s business, operations and financial condition. Plaintiff is seeking rescissionary, compensatory and punitive damages. On July 9, 2019, the Quorum Defendants reached a settlement in principle with Plaintiff that resolves the claims against the Quorum Defendants in their entirety in exchange for a confidential settlement payment that will be paid by the Quorum Defendants’ insurers. The settlement is subject to the execution of a definitive settlement agreement. • Harvey Horwitz, Derivatively on Behalf of Quorum Health Corporation v. Thomas D. Miller, Michael J. Culotta, Barbara R. Paul, R. Lawrence Van Horn, William S. Hussey, James T. Breedlove, William M. Gracey, Joseph A. Hastings, and Adam Feinstein, and Quorum Health Corporation, as Nominal Defendant . On September 17, 2018, a purported shareholder filed a derivative action on behalf of the Company in the United States District Court for the Middle District of Tennessee. The complaint alleges claims for violation of Section 29(a) of the Exchange Act, breach of fiduciary duty, waste of corporate assets, unjust enrichment, and indemnification and contribution. Plaintiff seeks damages allegedly sustained by the Company, rescission of the Separation Agreement with CHS, corporate governance reforms, equitable and/or injunctive relief, restitution, and attorneys’ fees and costs. On October 26, 2018, the Court entered an order granting a stay of the case pending entry of an order on any motions for summary judgment in the Rao v. Quorum Health Corporation case described above. Once the stay is lifted, the Company intends to move to transfer the action to Delaware consistent with the Company’s by-laws. The Company is vigorously defending itself in this matter. The Company is unable to predict the outcome of this matter. However, it is reasonably possible that the Company may incur a loss. The Company is unable to reasonably estimate the amount or range of such possible loss because the case remains in its early stages. Under some circumstances, losses incurred in connection with adverse outcomes in this matter could be material. • Reda Slone v. Kentucky River Medical Center (an assumed name of Jackson Hospital Corporation) • Mary Della-Maggiora, as an individual and on behalf of all others similarly situated, v. Watsonville Community Hospital, entity unknown, and DOES 1 through 50, inclusive (Superior Court of the State of California for the County of Santa Cruz) • Nedal Alqalqili v. Hospital of Barstow, Inc., dba Barstow Community Hospital; Quorum Health Corp.; Carrie Howell, an individual; and DOES 1 through 10, inclusive (Superior Court of the State of California for the County of San Bernardino) et seq • U.S. ex rel Derek Lewis and Joey Neiman v. Community Health Systems, Inc., Medhost, Inc., et al. Insurance Reserves As part of the business of owning and operating hospitals, the Company is subject to potential professional and general liability and workers’ compensation liability claims or other legal actions alleging liability on its part. The Company is also subject to similar liabilities related to its QHR business. Prior to the Spin-off, CHS provided professional and general liability insurance and workers’ compensation liability insurance to QHC and indemnified QHC from losses under these insurance arrangements related to the hospital operations business assumed by QHC in the Spin-off. The liabilities for claims prior to the Spin-off and related to QHC’s hospital operations business are determined based on an actuarial study of QHC’s operations and historical claims experience at its hospitals, including during the period of ownership by CHS. Corresponding receivables from CHS are established to reflect the indemnification by CHS for each of these liabilities for claims that related to events and circumstances that occurred prior to the Spin-off. After the Spin-off, QHC entered into its own professional and general liability insurance and workers’ compensation liability insurance arrangements to mitigate the risk for claims exceeding its self-insured retention levels. The Company maintains a self-insured retention level for professional and general liability claims of $5 million per claim and maintains a $0.5 million per claim, high deductible program for workers’ compensation liability claims. Due to the differing nature of its business, the Company maintains separate insurance arrangements for professional and general liability claims related to its subsidiary, QHR. The self-insured retention level for QHR is $6 million for professional and general liability insurance. The following table provides a summary of the Company’s insurance reserves related to professional and general liability and workers’ compensation liability, distinguished between those indemnified by CHS and those related to the Company’s own risks (in thousands): June 30, 2019 Current Long-Term Current Long-Term Receivable Receivable Liability Liability Professional and general liability: Insurance reserves indemnified by CHS, Inc. $ 11,994 $ 23,310 $ 11,994 $ 23,310 All other self-insurance reserves — — 4,789 25,526 Total insurance reserves for professional and general liability 11,994 23,310 16,783 48,836 Workers' compensation liability: Insurance reserves indemnified by CHS, Inc. 1,084 11,642 1,084 11,642 All other self-insurance reserves — — 1,817 4,227 Total insurance reserves for workers' compensation liability 1,084 11,642 2,901 15,869 Total self-insurance reserves $ 13,078 $ 34,952 $ 19,684 $ 64,705 December 31, 2018 Current Long-Term Current Long-Term Receivable Receivable Liability Liability Professional and general liability: Insurance reserves indemnified by CHS, Inc. $ 20,200 $ 34,535 $ 20,200 $ 34,535 All other self-insurance reserves — — 5,195 48,293 Total insurance reserves for professional and general liability 20,200 34,535 25,395 82,828 Workers' compensation liability: Insurance reserves indemnified by CHS, Inc. 1,412 12,118 1,412 12,118 All other self-insurance reserves — — 2,525 4,701 Total insurance reserves for workers' compensation liability 1,412 12,118 3,937 16,819 Total self-insurance reserves $ 21,612 $ 46,653 $ 29,332 $ 99,647 The receivables from CHS are included in other current assets and other long-term assets in the consolidated balance sheets. The liability for the current portion of professional and general liability claims is included in other current liabilities, while the current portion of the liability for workers’ compensation claims is included in accrued salaries and benefits. The long-term portions of both claims liabilities are included in other long-term liabilities. The professional and general liability reserves as of June 30, 2019 included a reduction of $26.9 million related to prior periods resulting from the Company’s most recent actuarial analysis utilizing updated data through April 30, 2019 Factors contributing to the change in estimate include the use of valuation techniques that place more emphasis on the Company’s claims subsequent to the Spin-off compared to historical trends, as well as more reliance on industry trend factors. The reduction in the frequency and severity of the Company’s claims is the result of internal initiatives in the areas of patient safety, risk management, and claims management, as well as external factors such as tort reform in certain key states. Construction and Capital Commitments The Company has substantially completed construction of a new patient tower and expanded surgical capacity at McKenzie – Willamette Medical Center, its hospital in Springfield, Oregon. During the three months ended June 30, 2019 and 2018, the Company incurred costs of $0.3 million and $4.6 million, respectively, and incurred costs of $2.4 million and $10.8 million during the six months ended June 30, 2019 and 2018, respectively, related to this project. As of June 30, 2019, the Company has incurred a total of $103.2 million of costs for this project, of which $103.0 million has been placed into service as of June 30, 2019. The total estimated cost of this project, including equipment costs, is estimated to be approximately $105.0 million. The Company’s anticipated remaining costs on the project in 2019 are $1.8 million. Commitments Related to Information Technology The Company entered into an agreement with MEDHOST Inc. (“Medhost”) to deploy their Electronic Health Record management platform in connection with the Company’s planned transition from the Computer and Data Processing Transition Services Agreement (or “IT TSA”) with CHS. The Company will spend approximately $39.0 million under this agreement beginning in 2019 and continuing through 2024. The Company currently utilizes Medhost’s software through its IT TSA with CHS. The Company will incur additional costs to establish the remainder of its information technology systems. The Company expects the transition to be completed by the end of the first quarter of 2021.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2019
Subsequent Events [Abstract]
Subsequent Events	NOTE 18 - SUBSEQUENT EVENTS On June 7, 2019, the Company announced that it has entered into a definitive agreement to sell the stock interests of 106-bed Watsonville Community Hospital and its affiliated facilities (“Watsonville”), located in Watsonville, California. On July 18, 2019, the Company received notification from the Pajaro Valley Community Health Trust (“Trust”) that it had exercised its Right of First Refusal to purchase the stock interests of Watsonville. If the terms of the Right of First Refusal are not met, the Company’s definitive agreement entered into on May 31, 2019 will remain in effect. The Company currently anticipates completing the sale of Watsonville by the end of 2019.

Guarantor and Non-Guarantor Sup

Guarantor and Non-Guarantor Supplemental Information	6 Months Ended
	Jun. 30, 2019
Condensed Financial Information Of Parent Company Only Disclosure [Abstract]
Guarantor and Non-Guarantor Supplemental Information	NOTE 19 - GUARANTOR AND NON-GUARANTOR SUPPLEMENTAL INFORMATION The Senior Notes are senior unsecured obligations of the Company guaranteed on a senior basis by certain of its existing and subsequently acquired or organized 100% owned domestic subsidiaries (the “Guarantors”). The Senior Notes are fully and unconditionally guaranteed on a joint and several basis, with exceptions considered customary for such guarantees, limited to the release of the guarantee when a subsidiary guarantor’s capital stock is sold, or when a sale of all of the subsidiary guarantor’s assets used in operations occurs. The condensed consolidating financial statements have been prepared and presented in accordance with SEC Regulation S-X Rule 3-10 “Financial Statements of Guarantors and Issuers of Guaranteed Securities Registered or Being Registered.” The accounting policies used in the preparation of this financial information are consistent with the accompanying condensed consolidated financial statements of the Company, except as follows: • Intercompany receivables and payables are presented gross in the supplemental condensed consolidating balance sheets. • Investments in consolidated subsidiaries, as well as guarantor subsidiaries’ investments in non-guarantor subsidiaries, are presented under the equity method of accounting with the related investments presented within the line items net investment in subsidiaries and other long-term liabilities in the supplemental condensed consolidating balance sheets. • Income tax expense is allocated from the parent issuer to the income producing operations (other guarantors and non-guarantors) through stockholders’ equity. As this approach represents an allocation, the income tax expense allocation is considered non-cash for statement of cash flow purposes. The Company’s intercompany activity consists primarily of daily cash transfers, the allocation of certain expenses and expenditures paid by the parent issuer on behalf of its subsidiaries, and the push down of investment in its subsidiaries. The parent issuer’s investment in its subsidiaries reflects the activity since the Spin-off. Likewise, the parent issuer’s equity in earnings of unconsolidated affiliates represents the Company’s earnings since the Spin-off. Condensed Consolidating Statement of Income (Loss) Three Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 336,512 $ 105,658 $ — $ 442,170 Operating costs and expenses: Salaries and benefits — 143,881 69,530 — 213,411 Supplies — 33,939 16,263 — 50,202 Other operating expenses 3 89,839 17,112 — 106,954 Depreciation and amortization — 11,179 3,321 — 14,500 Lease costs and rent — 6,762 4,865 — 11,627 Electronic health records incentives — 590 (7 ) — 583 Legal, professional and settlement costs — 530 74 — 604 Impairment of long-lived assets and goodwill — 25,950 — — 25,950 Loss (gain) on sale of hospitals, net — 1,145 (5 ) — 1,140 Total operating costs and expenses 3 313,815 111,153 — 424,971 Income (loss) from operations (3 ) 22,697 (5,495 ) — 17,199 Interest expense, net 33,084 488 10 — 33,582 Equity in earnings of affiliates (16,195 ) (3,411 ) — 19,606 — Income (loss) before income taxes (16,892 ) 25,620 (5,505 ) (19,606 ) (16,383 ) Provision for (benefit from) income taxes (19 ) 147 (34 ) — 94 Net income (loss) (16,873 ) 25,473 (5,471 ) (19,606 ) (16,477 ) Less: Net income (loss) attributable to noncontrolling interests — — 396 — 396 Net income (loss) attributable to Quorum Health Corporation $ (16,873 ) $ 25,473 $ (5,867 ) $ (19,606 ) $ (16,873 ) Condensed Consolidating Statement of Income (Loss) Three Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 362,258 $ 110,374 $ — $ 472,632 Operating costs and expenses: Salaries and benefits — 160,448 72,183 — 232,631 Supplies — 36,841 16,056 — 52,897 Other operating expenses 27 116,930 27,499 — 144,456 Depreciation and amortization — 13,820 3,322 — 17,142 Rent — 6,567 4,791 — 11,358 Electronic health records incentives — (381 ) (64 ) — (445 ) Legal, professional and settlement costs — 5,417 — — 5,417 Impairment of long-lived assets and goodwill — — — — - Loss (gain) on sale of hospitals, net — 313 (6 ) — 307 Loss on closure of hospitals, net — 3,338 — — 3,338 Total operating costs and expenses 27 343,293 123,781 — 467,101 Income (loss) from operations (27 ) 18,965 (13,407 ) — 5,531 Interest expense, net 32,934 (1,026 ) 18 — 31,926 Equity in earnings of affiliates (5,934 ) (3,022 ) — 8,956 — Income (loss) before income taxes (27,027 ) 23,013 (13,425 ) (8,956 ) (26,395 ) Provision for (benefit from) income taxes (421 ) (84 ) 51 — (454 ) Net income (loss) (26,606 ) 23,097 (13,476 ) (8,956 ) (25,941 ) Less: Net income (loss) attributable to noncontrolling interests — — 665 — 665 Net income (loss) attributable to Quorum Health Corporation $ (26,606 ) $ 23,097 $ (14,141 ) $ (8,956 ) $ (26,606 ) Condensed Consolidating Statement of Income (Loss) Six Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 674,447 $ 210,528 $ — $ 884,975 Operating costs and expenses: Salaries and benefits — 297,983 140,503 — 438,486 Supplies — 70,288 31,299 — 101,587 Other operating expenses 16 200,764 42,963 — 243,743 Depreciation and amortization — 22,535 6,604 — 29,139 Lease costs and rent — 13,390 9,768 — 23,158 Electronic health records incentives — 599 10 — 609 Legal, professional and settlement costs — 1,214 75 — 1,289 Impairment of long-lived assets and goodwill — 34,810 — — 34,810 Loss (gain) on sale of hospitals, net — 1,145 (5 ) — 1,140 Total operating costs and expenses 16 642,728 231,217 — 873,961 Income (loss) from operations (16 ) 31,719 (20,689 ) — 11,014 Interest expense, net 65,664 259 (75 ) — 65,848 Equity in earnings of affiliates (9,964 ) (3,085 ) — 13,049 — Income (loss) before income taxes (55,716 ) 34,545 (20,614 ) (13,049 ) (54,834 ) Provision for (benefit from) income taxes 163 183 (97 ) — 249 Net income (loss) (55,879 ) 34,362 (20,517 ) (13,049 ) (55,083 ) Less: Net income (loss) attributable to noncontrolling interests — — 796 — 796 Net income (loss) attributable to Quorum Health Corporation $ (55,879 ) $ 34,362 $ (21,313 ) $ (13,049 ) $ (55,879 ) Condensed Consolidating Statement of Income (Loss) Six Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 734,795 $ 224,657 $ — $ 959,452 Operating costs and expenses: Salaries and benefits — 330,181 149,450 — 479,631 Supplies — 79,441 32,342 — 111,783 Other operating expenses 1,897 239,096 56,201 — 297,194 Depreciation and amortization — 28,525 6,878 — 35,403 Rent — 13,884 10,006 — 23,890 Electronic health records incentives — (430 ) (156 ) — (586 ) Legal, professional and settlement costs — 8,830 — — 8,830 Impairment of long-lived assets and goodwill — 37,960 1,800 — 39,760 Loss (gain) on sale of hospitals, net — 8,128 (6 ) — 8,122 Loss on closure of hospitals, net — 17,084 — — 17,084 Total operating costs and expenses 1,897 762,699 256,515 — 1,021,111 Income (loss) from operations (1,897 ) (27,904 ) (31,858 ) — (61,659 ) Interest expense, net 64,408 (1,548 ) (3 ) — 62,857 Equity in earnings of affiliates 58,917 40,831 — (99,748 ) — Income (loss) before income taxes (125,222 ) (67,187 ) (31,855 ) 99,748 (124,516 ) Provision for (benefit from) income taxes 352 (420 ) (20 ) — (88 ) Net income (loss) (125,574 ) (66,767 ) (31,835 ) 99,748 (124,428 ) Less: Net income (loss) attributable to noncontrolling interests — — 1,146 — 1,146 Net income (loss) attributable to Quorum Health Corporation $ (125,574 ) $ (66,767 ) $ (32,981 ) $ 99,748 $ (125,574 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (16,873 ) $ 25,473 $ (5,471 ) $ (19,606 ) $ (16,477 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 48 48 — (48 ) 48 Comprehensive income (loss) (16,825 ) 25,521 (5,471 ) (19,654 ) (16,429 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 396 — 396 Comprehensive income (loss) attributable to Quorum Health Corporation $ (16,825 ) $ 25,521 $ (5,867 ) $ (19,654 ) $ (16,825 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (26,606 ) $ 23,097 $ (13,476 ) $ (8,956 ) $ (25,941 ) Amortization and recognition of unrecognized pension cost components, net of income taxes (189 ) (189 ) — 189 (189 ) Comprehensive income (loss) (26,795 ) 22,908 (13,476 ) (8,767 ) (26,130 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 665 — 665 Comprehensive income (loss) attributable to Quorum Health Corporation $ (26,795 ) $ 22,908 $ (14,141 ) $ (8,767 ) $ (26,795 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Six Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (55,879 ) $ 34,362 $ (20,517 ) $ (13,049 ) $ (55,083 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 97 97 — (97 ) 97 Comprehensive income (loss) (55,782 ) 34,459 (20,517 ) (13,146 ) (54,986 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 796 — 796 Comprehensive income (loss) attributable to Quorum Health Corporation $ (55,782 ) $ 34,459 $ (21,313 ) $ (13,146 ) $ (55,782 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Six Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (125,574 ) $ (66,767 ) $ (31,835 ) $ 99,748 $ (124,428 ) Amortization and recognition of unrecognized pension cost components, net of income taxes (75 ) (75 ) — 75 (75 ) Comprehensive income (loss) (125,649 ) (66,842 ) (31,835 ) 99,823 (124,503 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 1,146 — 1,146 Comprehensive income (loss) attributable to Quorum Health Corporation $ (125,649 ) $ (66,842 ) $ (32,981 ) $ 99,823 $ (125,649 ) Condensed Consolidating Balance Sheet June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated ASSETS Current assets: Cash and cash equivalents $ 1,240 $ 729 $ 296 $ — $ 2,265 Patient accounts receivable — 186,644 84,279 — 270,923 Inventories — 32,566 8,881 — 41,447 Prepaid expenses — 16,400 5,253 — 21,653 Due from third-party payors — 53,009 4,062 — 57,071 Current assets of hospitals held for sale — 35,380 — — 35,380 Other current assets 247 23,280 10,077 — 33,604 Total current assets 1,487 348,008 112,848 — 462,343 Intercompany receivable 3 766,108 333,740 (1,099,851 ) — Property and equipment, net — 356,467 140,088 — 496,555 Goodwill — 225,628 166,030 — 391,658 Intangible assets, net — 36,288 4,778 — 41,066 Operating lease right-of-use assets — 49,396 35,458 — 84,854 Long-term assets of hospitals held for sale — 25,796 — — 25,796 Other long-term assets — 50,150 15,804 — 65,954 Net investment in subsidiaries 1,440,271 — — (1,440,271 ) — Total assets $ 1,441,761 $ 1,857,841 $ 808,746 $ (2,540,122 ) $ 1,568,226 LIABILITIES AND EQUITY Current liabilities: Current maturities of long-term debt $ — $ 1,499 $ 147 $ — $ 1,646 Current portion of operating lease liabilities — 15,694 8,103 — 23,797 Accounts payable 56 120,049 20,663 — 140,768 Accrued liabilities: Accrued salaries and benefits — 41,264 19,742 — 61,006 Accrued interest 10,517 — — — 10,517 Due to third-party payors — 30,968 6,250 — 37,218 Current liabilities of hospitals held for sale — 10,675 — — 10,675 Other current liabilities — 26,755 11,818 — 38,573 Total current liabilities 10,573 246,904 66,723 — 324,200 Long-term debt 1,188,792 21,586 145 — 1,210,523 Long-term operating lease liabilities — 33,672 27,882 — 61,554 Intercompany payable 380,143 333,743 385,965 (1,099,851 ) — Deferred income tax liabilities, net 6,978 — — — 6,978 Long-term liabilities of hospitals held for sale — 3,248 — — 3,248 Other long-term liabilities — 183,318 21,689 (115,762 ) 89,245 Total liabilities 1,586,486 822,471 502,404 (1,215,613 ) 1,695,748 Redeemable noncontrolling interests — — 2,278 — 2,278 Equity: Quorum Health Corporation stockholders' equity (deficit): Preferred stock — — — — — Common stock 3 — — — 3 Additional paid-in capital 559,487 1,134,816 631,879 (1,766,695 ) 559,487 Accumulated other comprehensive income (loss) 856 856 — (856 ) 856 Accumulated deficit (705,071 ) (100,302 ) (342,740 ) 443,042 (705,071 ) Total Quorum Health Corporation stockholders' equity (deficit) (144,725 ) 1,035,370 289,139 (1,324,509 ) (144,725 ) Nonredeemable noncontrolling interests — — 14,925 — 14,925 Total equity (deficit) (144,725 ) 1,035,370 304,064 (1,324,509 ) (129,800 ) Total liabilities and equity $ 1,441,761 $ 1,857,841 $ 808,746 $ (2,540,122 ) $ 1,568,226 Condensed Consolidating Balance Sheet December 31, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated ASSETS Current assets: Cash and cash equivalents $ 1,209 $ 1,457 $ 537 $ — $ 3,203 Patient accounts receivable — 260,339 62,269 — 322,608 Inventories — 36,349 9,297 — 45,646 Prepaid expenses 33 15,269 4,381 — 19,683 Due from third-party payors — 57,049 6,394 — 63,443 Other current assets 314 23,714 12,377 — 36,405 Total current assets 1,556 394,177 95,255 — 490,988 Intercompany receivable 3 661,887 303,059 (964,949 ) — Property and equipment, net — 419,292 140,146 — 559,438 Goodwill — 235,418 165,655 — 401,073 Intangible assets, net — 43,575 4,714 — 48,289 Other long-term assets — 57,047 17,259 — 74,306 Net investment in subsidiaries 1,428,675 — — (1,428,675 ) — Total assets $ 1,430,234 $ 1,811,396 $ 726,088 $ (2,393,624 ) $ 1,574,094 LIABILITIES AND EQUITY Current liabilities: Current maturities of long-term debt $ - $ 1,557 $ 140 $ — $ 1,697 Accounts payable 121 122,999 20,797 — 143,917 Accrued liabilities: Accrued salaries and benefits — 55,780 21,128 — 76,908 Accrued interest 10,024 — — — 10,024 Due to third-party payors — 38,560 7,292 — 45,852 Other current liabilities 248 28,713 14,375 — 43,336 Total current liabilities 10,393 247,609 63,732 — 321,734 Long-term debt 1,169,214 22,370 193 — 1,191,777 Intercompany payable 334,284 303,063 327,602 (964,949 ) — Deferred income tax liabilities, net 6,736 — — — 6,736 Other long-term liabilities — 212,240 33,106 (118,847 ) 126,499 Total liabilities 1,520,627 785,282 424,633 (1,083,796 ) 1,646,746 Redeemable noncontrolling interests — — 2,278 — 2,278 Equity: Quorum Health Corporation stockholders' equity: Preferred stock — — — — — Common stock 3 — — — 3 Additional paid-in capital 557,309 1,183,608 580,824 (1,764,432 ) 557,309 Accumulated other comprehensive income (loss) 759 759 — (759 ) 759 Accumulated deficit (648,464 ) (158,253 ) (297,110 ) 455,363 (648,464 ) Total Quorum Health Corporation stockholders' equity (deficit) (90,393 ) 1,026,114 283,714 (1,309,828 ) (90,393 ) Nonredeemable noncontrolling interests — — 15,463 — 15,463 Total equity (deficit) (90,393 ) 1,026,114 299,177 (1,309,828 ) (74,930 ) Total liabilities and equity $ 1,430,234 $ 1,811,396 $ 726,088 $ (2,393,624 ) $ 1,574,094 Condensed Consolidating Statement of Cash Flows Six Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (60,677 ) $ 99,615 $ (41,254 ) $ — $ (2,316 ) Cash flows from investing activities: Capital expenditures for property and equipment — (12,486 ) (5,625 ) — (18,111 ) Capital expenditures for software — (3,017 ) (500 ) — (3,517 ) Acquisitions, net of cash acquired — — (455 ) — (455 ) Proceeds from the sale of hospitals — 11,741 — — 11,741 Other investing activities, net — 1,708 (2,091 ) — (383 ) Changes in intercompany balances with affiliates, net — (97,055 ) — 97,055 — Net cash provided by (used in) investing activities — (99,109 ) (8,671 ) 97,055 (10,725 ) Cash flows from financing activities: Borrowings under revolving credit facilities 327,000 — — — 327,000 Repayments under revolving credit facilities (299,000 ) — — — (299,000 ) Borrowings of long-term debt — 161 25 — 186 Repayments of long-term debt (13,066 ) (831 ) (66 ) — (13,963 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (564 ) — — (564 ) Cash distributions to noncontrolling investors — — (1,556 ) — (1,556 ) Changes in intercompany balances with affiliates, net 45,774 — 51,281 (97,055 ) — Net cash provided by (used in) financing activities 60,708 (1,234 ) 49,684 (97,055 ) 12,103 Net change in cash and cash equivalents 31 (728 ) (241 ) — (938 ) Cash and cash equivalents at beginning of period 1,209 1,457 537 — 3,203 Cash and cash equivalents at end of period $ 1,240 $ 729 $ 296 $ — $ 2,265 Condensed Consolidating Statement of Cash Flows Six Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (62,144 ) $ 75,865 $ 880 $ — $ 14,601 Cash flows from investing activities: Capital expenditures for property and equipment — (16,707 ) (8,612 ) — (25,319 ) Capital expenditures for software — (957 ) (87 ) — (1,044 ) Acquisitions, net of cash acquired — — (58 ) — (58 ) Proceeds from the sale of hospitals — 38,612 558 — 39,170 Other investing activities, net — 262 (13 ) — 249 Changes in intercompany balances with affiliates, net — (97,540 ) — 97,540 — Net cash provided by (used in) investing activities — (76,330 ) (8,212 ) 97,540 12,998 Cash flows from financing activities: Borrowings under revolving credit facilities 247,000 — — — 247,000 Repayments under revolving credit facilities (233,000 ) — — — (233,000 ) Borrowings of long-term debt — 12 55 — 67 Repayments of long-term debt (30,463 ) (868 ) (116 ) — (31,447 ) Payments of debt issuance costs (2,268 ) — — — (2,268 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (1,943 ) — — (1,943 ) Cash distributions to noncontrolling investors — — (803 ) — (803 ) Changes in intercompany balances with affiliates, net 81,279 — 16,261 (97,540 ) — Net cash provided by (used in) financing activities 62,548 (2,799 ) 15,397 (97,540 ) (22,394 ) Net change in cash, cash equivalents and restricted cash 404 (3,264 ) 8,065 — 5,205 Cash, cash equivalents and restricted cash at beginning of period 1,051 4,222 344 — 5,617 Cash, cash equivalents and restricted cash at end of period $ 1,455 $ 958 $ 8,409 $ — $ 10,822

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2019
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements and accompanying notes of the Company presented herein have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP” or “GAAP”). In the opinion of the Company’s management, the condensed consolidated financial information presented herein includes all adjustments necessary to present fairly the results of operations, financial position and cash flows of the Company for the interim periods presented. Results of operations for interim periods should not be considered indicative of the results of operations expected for the full year ending December 31, 2019. Certain information and disclosures have been condensed or omitted as presented herein and as permitted by the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim period presentation. The Company’s management believes the financial statements and disclosures presented herein are adequate in order to make the information presented not misleading. The condensed consolidated financial statements should be read in conjunction with the consolidated and combined financial statements and accompanying notes thereto for the year ended December 31, 2018, contained in the Company’s Annual Report on Form 10-K filed with the SEC on March 12, 2019 (the “2018 Annual Report on Form 10-K”). The Company’s financial statements have been prepared under the assumption that it will continue as a going concern. In accordance with Accounting Standard Codification (“ASC”) 205-40, Presentation of Financial Statements — Going Concern, management concluded that there were probable conditions or events that raised substantial doubt about the Company’s ability to continue as a going concern due to the fact that the Company’s maximum Secured Net Leverage Ratio permitted under the CS Agreement is reduced to 4.50 from 5.00 in the first quarter of 2020. The measurement date for the Company’s required compliance with the Secured Net Leverage Ratio is as of the last day of each fiscal quarter. The Company is in compliance with its financial covenants as of June 30, 2019 and believes that it is probable that the Company’s current and anticipated future operating results alleviate the substantial doubt about the Company’s ability to continue as a going concern for the one year period following the date these financial statements are issued. Management’s evaluation of the Company’s ability to comply with the Secured Net Leverage Ratio included, but was not limited to, the following factors: • On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. The Company believes that through its partnership with R1 RCM, it will achieve costs savings and improve net patient revenues through improvements in operational effectiveness and efficiencies; • The sale or closure of underperforming facilities will continue to generate additional costs savings and the decision to close facilities within the next twelve months is within the control of the Company; and • Management has a plan to achieve cost savings over the next twelve months through a reduction in corporate and operating costs.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of the Company and its subsidiaries in which it holds either a direct or indirect ownership of a majority voting interest. Investments in less-than-wholly-owned consolidated subsidiaries of QHC are presented separately in the equity component of the Company’s consolidated balance sheets to distinguish between the interests of QHC and the interests of the noncontrolling investors. Revenues and expenses from these subsidiaries are included in the respective individual line items of the Company’s consolidated statements of income, and net income is presented both in total and separately to distinguish the amounts attributable to the Company and the amounts attributable to the interests of the noncontrolling investors. Noncontrolling interests that are redeemable or may become redeemable at a fixed or determinable price at the option of the holder or upon the occurrence of an event outside of the control of the Company, are presented in mezzanine equity in the Company’s consolidated balance sheets. Intercompany transactions and accounts of the Company are eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the Company’s consolidated financial statements and accompanying notes. Actual results could differ from those estimates under different assumptions or conditions.
Revenue Recognition	Revenue Recognition The Company reports revenues from patient services at its hospitals and affiliated facilities at the amount that reflects the consideration to which the Company expects to be entitled in exchange for providing patient care. These amounts are due from patients, governmental programs and third-party payors such as Medicare, Medicaid, health maintenance organizations, preferred provider organizations, private insurers and others, and include variable consideration for retroactive revenue adjustments due to settlements of audits, reviews and investigations. Generally, the Company bills the patient and third-party payors several days after the services are performed or the patient is discharged. Revenue is recognized as the performance obligations are satisfied. Billings and collections are outsourced to CHS under a transition services agreement that was entered into in connection with the Spin-off. Performance obligations are determined based on the nature of the services provided by the Company. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges for services anticipated to be provided. The Company believes that this method provides a faithful depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients in the Company’s hospitals receiving inpatient acute care services. The Company measures the performance obligation from admission into the hospital to the point when it is no longer required to provide services to that patient, which is generally at the time of discharge. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided, and the Company does not believe it is required to provide additional goods or services to the patient. Because all of its performance obligations relate to contracts with a duration of less than one year, the Company has elected to apply the optional exemption provided in ASC 606-10-50-14(a) and, therefore, is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patient is discharged, which generally occurs within days or weeks following the end of the reporting period. The Company determines the transaction price based on standard billing rates for goods and services provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and patient responsibility after insurance in accordance with the Company’s policy, and/or implicit price concessions provided to uninsured patients and patient responsibility after insurance. The Company determines its estimates of contractual adjustments and discounts based on contractual agreements, its discount policies and historical experience. The Company determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. The Company recognizes revenues related to its QHR business when either the performance obligation has been satisfied or over time as the hospital management advisory and healthcare consulting services are provided and reports these revenues at the amount expected to be collected from the non-affiliated hospital clients of QHR. Payor Sources The primary sources of payment for patient healthcare services are third-party payors, including federal and state agencies administering the Medicare and Medicaid programs, other governmental agencies, managed care health plans, commercial insurance companies, workers’ compensation carriers and employers. Self-pay revenues are the portion of patient service revenues derived from patients who do not have health insurance coverage and the patient responsibility portion of services that are not covered by health insurance plans. Non-patient revenues primarily include revenues from QHR’s hospital management advisory and healthcare consulting services business, rental income and hospital cafeteria sales . Contractual Adjustments and Discounts Agreements with third-party payors typically provide for payments at amounts less than standard billing rates. A summary of the payment arrangements with major third-party payors follows: • Medicare: • Medicaid: • Other: Government programs, including Medicare and Medicaid programs, which represent a large portion of the Company’s operating revenues, are highly complex programs to administer and are subject to interpretation of federal and state-specific reimbursement rates, new legislation and final cost report settlements. As a result of investigations by governmental agencies, various health care organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations. In some instances, these investigations have resulted in organizations entering into significant settlement agreements or findings of criminal and civil liability. Compliance with such laws and regulations may be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties, and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge the Company’s compliance with these laws and regulations, and it is not possible to determine the impact (if any) such claims or penalties could have on the Company. Contractual adjustments, or differences in standard billing rates and the payments derived from contractual terms with governmental and non-governmental third-party payors, are recorded based on management’s best estimates in the period in which services are performed and a payment methodology is established with the patient. Recorded estimates for past contractual adjustments are subject to change, in large part, due to ongoing contract negotiations and regulation changes, which are typical in the U.S. healthcare industry. Revisions to estimates are recorded as contractual adjustments in the periods in which they become known and may be subject to further revisions. In addition, the contracts the Company has with commercial insurance payors may provide for retroactive audit and review of claims. Subsequent changes in estimates for third-party payors that are determined to be the result of an adverse change in a payor’s ability to pay are recorded as bad debt expense. Bad debt expense for the three months and six months ended June 30, 2019 and 2018 were not material and are included in other operating expenses in the Company’s consolidated statements of income. Billing and collections are outsourced to CHS under a transition services agreement that was put in place by CHS in connection with the Spin-off. The Company’s contractual adjustments are impacted by the timing and ability of CHS to monitor the classification and collection of the Company’s patient accounts receivable. Self-pay and other payor discounts are incentives offered by the Company to uninsured or underinsured patients and other payors to reduce their costs of healthcare services. On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. The agreement with R1 RCM will, among other things, allow for the Company to transition its billing and collection services from CHS to R1 RCM. In July 2019, R1 RCM began providing limited services to the Company, such as status review on aged accounts receivable and insurance denials. The Company expects to fully transition billing and collection services from CHS to R1 RCM during the fourth quarter of 2019, which has been mutually agreed upon by both parties. Third-Party Program Reimbursements Cost report settlements under reimbursement programs with Medicare, Medicaid and other managed care plans for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and the Company’s historical experience, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as new information becomes available, or as years are settled or are no longer subject to such audits, reviews, and investigations. Previous program reimbursements and final cost report settlements are included in due from and due to third-party payors in the consolidated balance sheets. Net adjustments arising from a change in the transaction price for estimated cost report settlements favorably (unfavorably) impacted net operating revenues by $0.3 million and $(0.4) million during the three months ended June 30, 2019 and 2018, respectively and by $2.1 million and $0.1 million during the six months ended June 30, 2019 and 2018, respectively. Currently, several states have established supplemental payment programs, including disproportionate share programs, for the purpose of providing reimbursement to providers to offset a portion of the cost of providing care to Medicaid and indigent patients. These programs are designed with input from CMS and are funded with a combination of federal and state resources, including, in certain instances, taxes, fees or other program expenses (collectively, “provider taxes”) levied on the providers. The receivables and payables associated with these programs are included in due from and due to third-party payors in the consolidated balance sheets. After a state supplemental payment program is approved and fully authorized by the appropriate state legislative or governmental agency, the Company recognizes the revenue and related expenses based on the terms of each program in the period in which the amounts are estimable and revenue collection is reasonably assured. The revenues earned by the Company under these programs are included in net operating revenues and the expenses associated with these programs are included in other operating expenses in the consolidated statements of income. The California Department of Health Care Services administers the Hospital Quality Assurance Fee (“HQAF”) program, imposing a fee on certain general and acute care California hospitals. Revenues generated from these fees provide funding for the non-federal supplemental payments to California hospitals that serve California’s Medi-Cal and uninsured patients. Under the HQAF program, the Company recognized $8.0 million of Medicaid revenues and $2.2 million of provider taxes for the three months ended June 30, 2019, and $7.9 million of Medicaid revenues and $2.1 million of provider taxes for the three months ended June 30, 2018. The Company recognized $16.0 million of Medicaid revenues and $4.4 million of provider taxes for the six months ended June 30, 2019, and $15.8 million of Medicaid revenues and $4.2 million of provider taxes for the six months ended June 30, 2018. The current phase of the HQAF program expired on June 30, 2019. Although a state constitutional amendment indefinitely extended the program, CMS is required to approve the next phase of the program, Phase VI, which begins July 1, 2019 and is expected to cover 24 to 36 months, although the precise duration is unknown at this time. The CMS approval process can be lengthy, and the Company is unable to recognize revenue until CMS approves each phase of the program. The Company recognized $2.0 million of Medicaid revenues for the three months ended June 30, 2019 and $4.0 million of Medicaid revenues in the six months ended June 30, 2019 related to the sale of Illinois property tax credits with no corresponding amount recognized in the three or six months ended June 30, 2018 as the revenues for the full year 2018 were recognized in the third quarter of 2018. Self-Pay and Self-Pay After Insurance Generally, patients who are covered by third-party payors are responsible for related co-pays and deductibles, which vary in amount. The Company also provides services to uninsured patients, and offers those uninsured patients a discount, either by policy or law, from the Company’s standard billing rates. The Company estimates the transaction price for patients with co-pays and deductibles and for uninsured patients based on historical collection experience and current market conditions. The initial estimate of the transaction price is determined by reducing the Company’s standard charges by any contractual adjustments, discounts, and implicit price concessions. Subsequent changes to the estimate of the transaction price, if any, are generally recorded as an adjustment to patient service revenue in the period of the change . Charity Care In the ordinary course of business, the Company provides services to patients who are financially unable to pay for hospital care. The related charges for those patients who are financially unable to pay that otherwise do not qualify for reimbursement from a governmental program are classified as charity care. The Company determines amounts that qualify for charity care primarily based on the patient’s household income relative to the poverty level guidelines established by the federal government. The Company’s policy is to not pursue collections for such amounts. The related charges which are recorded in operating revenues at the standard billing rates and fully offset in contractual allowances were $7.4 million and $6.0 million for the three months ended June 30, 2019 and 2018, respectively, and $12.3 million and $19.3 million for the six months ended June 30, 2019 and 2018, respectively.
Accounts Receivable	Accounts Receivable Substantially all of the Company’s receivables are related to providing healthcare services to patients at its hospitals and affiliated outpatient facilities. For self-pay and self-pay after insurance receivables, the Company estimates the implicit price concession by reserving a percentage of all self-pay and self-pay after insurance accounts receivable without regard to aging category. The estimate of the implicit price concession is based on a model that considers historical cash collections, expected recoveries and any anticipated changes in trends. The Company’s ability to estimate the implicit price concessions is not significantly impacted by the aging of accounts receivable, as management believes that substantially all of the risk exists at the point in time such accounts are identified as self-pay. Significant changes in payor mix, CHS’s business office operations, including the CHS shared services centers’ efforts in collecting the Company’s accounts receivables, economic conditions, or trends in federal and state governmental healthcare coverage, among others, could affect the Company’s estimates of implicit price concessions for self-pay and self-pay after insurance accounts receivable. The Company continually reviews its overall estimate of implicit price concessions by monitoring historical cash collections as a percentage of trailing net operating revenues, as well as by analyzing current period net operating revenues and admissions by payor classification, aged accounts receivable by payor, days revenue outstanding, the composition of self-pay receivables between pure self-pay patients and the patient responsibility portion of third-party insured receivables, and the impact of recent divestitures. Collections are impacted by the economic ability of patients to pay, the effectiveness of the Company’s billing and collection efforts, which are outsourced to a third party, including their current policies on billings, accounts receivable payor classification and collections. Our results are also affected by third party collection agencies and by the ability of the Company to further attempt collection efforts. Billings and collections are outsourced to CHS under a transition services agreement that was established with the Spin-off and are being transitioned to R1 RCM. See Note 16 — Related Party Transactions for additional information on the CHS TSA agreement. On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. The agreement with R1 RCM will, among other things, allow for the Company to transition its billing and collection services from CHS to R1 RCM. In July 2019, R1 RCM began providing limited services to the Company, such as status review on aged accounts receivable and insurance denials. The Company expects to fully transition billing and collection services from CHS to R1 RCM during the fourth quarter of 2019, which has been mutually agreed upon by both parties. The Company has elected the practical expedient allowed under Financial Accounting Standards Board’s (“FASB”) Accounting Standards Codification (“ASC”) Topic 606 and does not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to the Company’s expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less. However, the Company does, in certain instances, enter into payment agreements with patients that allow payments in excess of one year. For those cases, the financing component is not deemed to be significant to the contract. The Company has applied the practical expedient provided by FASB ASC Topic 340 and all incremental customer contract acquisition costs are expensed as incurred, as the amortization period of the asset that the Company otherwise would have recognized is one year or less in duration.
Concentration of Credit Risk	Concentration of Credit Risk The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s hospitals and affiliated outpatient facilities and are insured under third-party payor agreements. Because of the economic diversity of the Company’s markets and non-governmental third-party payors, Medicare receivables are a significant concentration of credit risk. Accounts receivable, net of contractual adjustments, from Medicare were $49.5 million and $58.2 million, or 18.3% and 18.0% of total patient accounts receivable as of June 30, 2019 and December 31, 2018, respectively. Additionally, the Company believes Illinois Medicaid represents a significant concentration of credit risk to the Company due to the fiscal problems in the state of Illinois that affect the timing and extent of payments due to providers, which are administered by the state of Illinois under the Medicaid program. The Company’s accounts receivable, net of contractual adjustments, from Illinois Medicaid were $22.3 million and $24.5 million, or 8.3% and 7.6% of total patient accounts receivable as of June 30, 2019 and December 31, 2018, respectively. The Company also believes California state supplemental program receivables represent a significant concentration of credit risk due to the timing and extent of the receivables. The Company’s state supplemental program receivables from California Medicaid were $31.3 million and $37.8 million, or 54.8% and 59.6% of total due from third-party payors, as of June 30, 2019 and December 31, 2018, respectively. The Company’s revenues are particularly sensitive to regulatory and economic changes in certain states where the Company generates significant revenues. Accordingly, any changes in the current demographic, economic, competitive or regulatory conditions in certain states in which revenues are significant could have an adverse effect on the Company’s results of operations, financial condition or cash flows. Changes to the Medicaid and other government-managed payor programs in these states, including reductions in reimbursement rates or delays in reimbursement payments under state supplemental payment or other programs, could also have a similar adverse effect.
Other Operating Expenses	Other Operating Expenses The Company records costs associated with the transition services agreements and other ancillary agreements with CHS in accordance with the terms of these agreements. These costs, which primarily include the costs of providing information technology, patient billing and collections and payroll services, are included in “Transition services agreements” in the table above. See Note 16 — Related Party Transactions for additional information on the transition services agreements with CHS. So Note 17 — Commitments and Contingencies — Insurance Reserves for additional information related to our insurance reserves and related expenses.
General and Administrative Costs	General and Administrative Costs Substantially all of the Company’s operating costs and expenses are “cost of revenues” items. Operating expenses that could be classified as general and administrative by the Company are costs related to corporate office functions, including, but not limited to tax, treasury, audit, risk management, legal and human resources. These costs are primarily salaries and benefits expenses associated with these corporate office functions. General and administrative costs of the Company were $11.4 million and $20.0 million during the three months ended June 30, 2019 and 2018, respectively, and $24.0 million and $34.9 million during the six months ended June 30, 2019 and 2018, respectively. General and administrative costs of the Company include executive severance costs at the corporate office of $2.7 million and $4.6 million during the three and six months ended June 30, 2018, respectively. There were no executive severance costs at the corporate office during the three and six months ended June 30, 2019.
Legal, Professional and Settlement Costs	Legal, Professional and Settlement Costs Legal, professional and settlement costs in the Company’s consolidated statements of income primarily include legal costs and related settlements, if any, associated with arbitration, regulatory claims, government investigations into reimbursement payments and other litigation matters.
Loss (Gain) on Sale of Hospitals, Net	Loss (Gain) on Sale of Hospitals, Net Loss (gain) on sale of hospitals, net is the loss (gain) incurred by the Company’s divestiture of hospitals and outpatient facilities. It is calculated as the difference between the cash proceeds from the sale and the carrying values of the associated net assets sold at the date of sale, less certain incremental direct selling costs.
Loss on Closure of Hospitals, Net	Loss on Closure of Hospitals, Net Loss on closure of hospitals, net relates to costs incurred by the Company for closure of hospitals and outpatient facilities, and includes severance, loss on disposal of property and equipment, write-down of assets, legal costs and other costs incurred by the Company related to the closure .
Income Taxes	Income Taxes The Company accounts for income taxes using the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying values of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in the provision for (benefit from) income taxes in the consolidated statements of income in the period that includes the enactment date. The Company assesses the likelihood that deferred tax assets will be recovered from future taxable income. To the extent the Company believes that recovery is not likely, a valuation allowance is established. To the extent the Company establishes a valuation allowance or increases this allowance, the related expense is included in the provision for (benefit from) income taxes in the consolidated statements of income. The Company classifies interest and penalties, if any, related to its tax positions as a component of provision for (benefit from) income taxes .
Cash and Cash Equivalents	Cash and Cash Equivalents Cash includes cash on hand and cash with banks. Cash equivalents are short-term, highly liquid investments with a maturity of three months or less from the date acquired that are subject to an insignificant risk of change in value.
Restricted Cash	Restricted Cash Restricted cash consists of cash held in escrow accounts to secure the Company’s indemnification obligations under purchase agreements related to the sale of hospitals.
Property and Equipment, Net	Property and Equipment, Net Purchases of property and equipment are recorded at cost. Property and equipment acquired in a business combination are recorded at estimated fair value. Routine maintenance and repairs are expensed as incurred. Expenditures that increase capacities or extend useful lives are capitalized. The Company capitalizes interest related to financing of major capital additions with the respective asset. Depreciation is recognized using the straight-line method over the estimated useful life of an asset. The Company depreciates land improvements over 3 to 20 years, buildings and improvements over 5 to 40 years, and equipment and fixtures over 3 to 18 years. The Company also leases certain facilities and equipment under capital lease obligations. These assets are amortized on a straight-line basis over the lesser of the lease term or the remaining useful life of the asset. Property and equipment assets that are held for sale are not depreciated.
Leases	Leases In February 2016, the FASB issued a new accounting standard, ASC Topic 842, related to leases to increase transparency and comparability among organizations by requiring the recognition of right-of-use (“ROU”) assets and lease liabilities on the balance sheet. Most significant among the changes in the standard is the recognition of ROU assets and lease liabilities by lessees for those leases classified as operating leases under previous U.S. GAAP. Under the new standard, disclosures are required to meet the objective of enabling users of financial statements to assess the amount, timing, and uncertainty of cash flows arising from leases. The Company adopted ASC Topic 842 effective January 1, 2019 using the modified retrospective transition approach as of the period of adoption. The Company’s financial statements prior to January 1, 2019 were not modified for the application of the new lease standard. Upon adoption of ASC Topic 842, the Company recognized $93.7 million of ROU assets and $95.6 million of lease liabilities associated with operating leases. The accounting for capital leases remained substantially unchanged. In addition, the Company recognized a $0.7 million cumulative effect adjustment that increased accumulated deficit in its consolidated balance sheet at January 1, 2019. The Company determines if an arrangement is a lease at inception of the contract. Operating leases are included in operating lease ROU assets, current portion of operating lease liabilities, and long-term operating lease liabilities in the consolidated balance sheets. Finance leases are included in property and equipment, current portion of long-term debt, and long-term debt in the consolidated balance sheets. ROU assets represent the Company’s right to use underlying assets for the lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the leases. ROU assets and lease liabilities are recognized at the commencement date based on the present value of lease payments over the lease term. As most of the Company’s leases do not provide an implicit rate, the Company uses an estimated incremental borrowing rate, which is derived from information available at the lease commencement date, in determining the present value of lease payments. The Company uses the implicit rate when readily determinable. The Company enters into operating leases for real estate, medical office buildings, other administrative offices, as well as medical and office equipment. The Company’s finance leases consist primarily of the Corporate office and other long-term building leases. The Company’s real estate leases typically have initial lease terms of 5 to 10 years, and equipment leases typically have an initial term of 3 years. The Company’s real estate leases may include one or more options to renew, with renewals extending the lease term for an additional 5 to 10 years. The exercise of lease renewal options is at the Company’s sole discretion. In general, the Company does not consider renewal options to be reasonably likely to be exercised, therefore renewal options are generally not recognized as part of the ROU assets and lease liabilities. Lease costs for lease payments are recognized on a straight-line basis over the lease term, unless there is a transfer of title or purchase option reasonably certain to be exercised. The Company does not record operating leases with an initial term of 12 months or less (“short-term leases”) in the consolidated balance sheets. Certain of the Company’s lease agreements contain both lease and non-lease components, which are generally accounted for separately. For certain equipment leases, such as medical devices, the lease and non-lease components are accounted for as a single lease component. Additionally, for certain equipment leases containing multiple assets, we apply a portfolio approach to account for the assets as one leased asset.
Goodwill	Goodwill The Company’s hospital operations and QHR’s management advisory and healthcare consulting services operations meet the criteria for classification and separate reporting units for goodwill. Goodwill was initially determined for QHC’s hospital operations reporting unit based on a relative fair value approach as of September 30, 2013 (CHS’s goodwill impairment testing date). Additional goodwill was allocated on a similar basis for four hospitals acquired by CHS in 2014 that were included in the group of hospitals spun-off to QHC. For the QHR reporting unit, goodwill was allocated based on the amount recorded by CHS at the time of its acquisition in 2007. All subsequent goodwill generated from hospital, physician practice or other ancillary business acquisitions is recorded at fair value at the time of acquisition and is tested for impairment at least annually.
Intangible Assets, Net	Intangible Assets, Net The Company’s intangible assets primarily consist of purchase and development costs of software for internal use and contract-based intangible assets, including physician guarantee contracts, medical licenses, hospital management contracts, non-compete agreements and certificates of need. There are no expected residual values related to the Company’s intangible assets. Capitalized software costs are generally amortized over three years, except for software costs for significant system conversions, which are amortized over 8 to 10 years. Capitalized software costs that are in the development stage are not amortized until the related projects are complete. Assets related to physician guarantee contracts, hospital management contracts, non-compete agreements and certificates of need are amortized over the life of the individual contracts. Intangible assets held for sale are not amortized.
Impairment of Long-Lived Assets and Goodwill	Impairment of Long-Lived Assets and Goodwill Whenever an event occurs or changes in circumstances indicate that the carrying values of certain long-lived assets may be impaired, the Company projects the undiscounted cash flows expected to be generated by these assets. If the projections indicate that the carrying values are not expected to be recovered, such amounts are reduced to their estimated fair value based on a quoted market price, if available, or an estimated fair value based on valuation techniques available in the circumstances. Goodwill arising from business combinations is not amortized. Goodwill is evaluated for impairment at the same time every year and when an event occurs or circumstances change that, more likely than not, reduce the fair value of the reporting unit below its carrying value. There is a two-step method for determining goodwill impairment. Step one is to compare the fair value of the reporting unit with the unit’s carrying value, including goodwill. If this test indicates the fair value is less than the carrying value, then step two is required to compare the implied fair value of the reporting unit’s goodwill with the carrying value of the reporting unit’s goodwill. The Company performs its annual testing of impairment for goodwill in the fourth quarter of each year. The fair value of the Company’s reporting units is estimated using both a discounted cash flow model as well as a multiple model based on earnings before interest, taxes, depreciation and amortization. The cash flow forecasts are adjusted by an appropriate discount rate based on the Company’s best estimate of a market participant’s weighted-average cost of capital. Both models are based on the Company’s best estimate of future revenues and operating costs and are reconciled to the Company’s consolidated market capitalization, with consideration of the amount a potential acquirer would be required to pay, in the form of a control premium, in order to gain sufficient ownership to set policies, direct operations and control management decisions of the Company. See Note 2 —
Professional and General Liability Insurance and Workers' Compensation Liability Insurance Reserves	Professional and General Liability Insurance and Workers’ Compensation Liability Insurance Reserves As part of the business of owning and operating hospitals, the Company is subject to legal actions alleging liability on its part. To mitigate a portion of these risks, the Company maintains insurance exceeding a self-insured retention level for these types of claims. The Company’s self-insurance reserves reflect the current estimate of all outstanding losses, including incurred but not reported losses, based on actuarial calculations as of period end. The loss estimates included in the actuarial calculations may change in the future based on updated facts and circumstances, including the Company’s claims experience post Spin-off. The Company’s insurance expense includes the actuarially determined estimates of losses for the current year, including claims incurred but not reported, the change in the estimates of losses for prior years based upon actual claims development experience as compared to prior actuarial projections, the insurance premiums for losses in excess of the Company’s self-insured retention levels, the administrative costs of the insurance programs, and interest expense related to the discounted portion of the liability. The Company’s reserves for professional and general liability and workers’ compensation liability claims are based on semi-annual actuarial calculations, which are discounted to present value and consider historical claims data, demographic factors, severity factors and other actuarial assumptions. The reserves for self-insured claims are discounted based on the Company’s risk-free interest rate that corresponds to the period when the self-insured claims are incurred and projected to be paid See Note 17 — Commitments and Contingencies for information related to the portion of the Company’s insurance reserves for professional and general liability and workers’ compensation liability that are indemnified by CHS. Self-Insured Employee Health Benefits The Company is self-insured for substantially all of the medical benefits of its employees. The Company maintains a liability for its current estimate of incurred but not reported employee health claims based on historical claims data provided by third-party administrators. The undiscounted reserve for self-insured employee health benefits was $9.0 million and $10.4 million as of June 30, 2019 and December 31, 2018, respectively, and is included in accrued salaries and benefits in the consolidated balance sheets. Expense each period is based on the actual claims received during the period plus the impact of any adjustment to the liability for incurred but not reported employee health claims.
Noncontrolling Interests and Redeemable Noncontrolling Interests	Noncontrolling Interests and Redeemable Noncontrolling Interests The Company’s consolidated financial statements include all assets, liabilities, revenues and expenses of less than 100% owned entities that it controls. Certain of the Company’s consolidated subsidiaries have noncontrolling physician ownership interests with redemption features that require the Company to deliver cash upon the occurrence of certain events outside its control, such as the retirement, death, or disability of a physician-owner. The carrying amount of redeemable noncontrolling interests is recognized in the Company’s consolidated balance sheets at the greater of: (1) the initial carrying amount of these investments, increased or decreased for the noncontrolling interests' share of cumulative net income (loss), net of cumulative amounts distributed to the noncontrolling interest partners, if any, or (2) the redemption value of the investments held by the noncontrolling interest partners.
Assets and Liabilities of Hospitals Held for Sale	Assets and Liabilities of Hospitals Held for Sale The Company reports separately from other assets in the consolidated balance sheet those assets that meet the criteria for classification as held for sale. Generally, assets that meet the criteria include those for which the carrying amount will be settled principally through a sale transaction rather than through continuing use. The asset must be available for immediate sale in its present condition, subject to usual or customary terms, and the sale must be probable to occur in the next 12 months. Similarly, the liabilities of a disposal group are classified as held for sale upon meeting these criteria. Immediately following classification as held for sale, the Company remeasures these assets and liabilities and adjusts the value to the lesser of the carrying amount or fair value less costs to sell. The assets and liabilities classified as held for sale are no longer depreciated or amortized into expense. The carrying values of assets classified as held for sale are reported net of impairment in the consolidated balance sheets.
Stock-Based Compensation	Stock-Based Compensation The Company issues restricted stock awards to key employees and directors and recognizes stock-based compensation expense over each of the restricted stock award’s requisite service periods based on the estimated grant date fair value of each restricted stock award. See Note 14 — Stock-Based Compensation for additional information related to stock-based compensation.
Benefit Plans	Benefit Plans The Company maintains various benefit plans, including defined contribution plans, deferred compensation plans, a supplemental executive retirement plan and a defined benefit plan, for which certain of the Company’s subsidiaries are the plan sponsors. The rights and obligations of these plans were transferred from CHS to the Company, pursuant to the Separation and Distribution Agreement, which was entered into with CHS in connection with the Spin-off which governed or continue to govern the allocation of employees, assets and liabilities that were transferred to QHC from CHS. Benefits costs are recorded as salaries and benefits expenses in the consolidated statements of income. The cumulative liability for these benefit costs is recorded in other long-term liabilities in the consolidated balance sheets. The Company recognizes the unfunded liability of its defined benefit plan in other long-term liabilities in the consolidated balance sheets. Unrecognized gains (losses) and prior service credits (costs) are recorded as changes in other comprehensive income (loss). The measurement date of the plan’s assets and liabilities coincides with the Company’s year end. The Company’s pension benefit obligation is measured using actuarial calculations that incorporate discount rates, rate of compensation increases and expected long-term returns on plan assets. The calculations additionally consider expectations related to the retirement age and mortality of plan participants. The Company records pension benefit costs related to all of its plans as salaries and benefits expenses in the consolidated statements of income.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company utilizes the U.S. GAAP fair value hierarchy to measure the fair value of its financial instruments. The fair value hierarchy 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 assumption about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). The inputs used to measure fair value are classified into the following fair value hierarchy: • Level 1 • Level 2 • Level 3
Segment Reporting	Segment Reporting The principal business of the Company is to provide healthcare services at its hospitals and outpatient service facilities. The Company’s only other line of business is the hospital management advisory and healthcare consulting services it provides through QHR. The Company has determined that its hospital operations business and QHR business meets the criteria for separate segment reporting. The Company’s corporate functions have been reported in the all other reportable segment. See Note 13 — Segments for additional information related to the Company’s segment reporting.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In August 2018, the FASB issued ASU No. 2018-15, Intangibles — Goodwill and Other — Internal Use Software: Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract, to provide guidance on the accounting for implementation costs incurred in a cloud computing arrangement that is accounted for as a service contract. This ASU requires entities to account for such costs consistent with the guidance on capitalizing costs associated with developing or obtaining internal-use software. The ASU is effective for all entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years, with early adoption permitted. The Company adopted ASU No. 2018-15 on January 1, 2019 on a prospective basis. There was no material impact on the Company’s consolidated financial position and results of operations as a result of adoption of ASU No. 2018-15 as of June 30, 2019. As the Company’s transitions from the TSAs with CHS, the Company anticipates that it will incur material costs associated with cloud computing arrangements. In February 2018, the FASB issued ASU No. 2018-02, Income Statement — Reporting Comprehensive Income, which allows for reclassification from accumulated other comprehensive income to retained earnings of the stranded tax effects in accumulated other comprehensive income resulting from the enactment of the comprehensive tax legislation commonly referred to as the Tax Cuts and Jobs Act (the “Tax Act”) and corresponding accounting treatment recorded in the fourth quarter of 2017. The Company adopted ASU No. 2018-02 on January 1, 2019. The adoption of ASU No. 2018-02 did not have a significant impact on the Company’s consolidated balance sheet. In January 2017, the FASB issued ASU No. 2017-04, Intangibles — Goodwill and Other: Simplifying the Test for Goodwill Impairment, which simplifies the accounting for goodwill impairment by eliminating step two from the goodwill impairment test. This ASU instead permits an entity to recognize goodwill impairment as the excess of a reporting unit’s carrying value over the estimated fair value of the reporting unit, to the extent this amount does not exceed the carrying amount of goodwill. The new guidance continues to allow an entity to perform a qualitative assessment of goodwill impairment indicators in lieu of a quantitative assessment in certain situations. The ASU is effective for annual and interim reporting periods beginning after December 15, 2019, with early adoption permitted. The Company currently does not expect ASU No. 2017-04 to have a material impact on its consolidated results of operations and financial position.
Guarantor and Non Guarantor Supplemental Information	The condensed consolidating financial statements have been prepared and presented in accordance with SEC Regulation S-X Rule 3-10 “Financial Statements of Guarantors and Issuers of Guaranteed Securities Registered or Being Registered.” The accounting policies used in the preparation of this financial information are consistent with the accompanying condensed consolidated financial statements of the Company, except as follows: • Intercompany receivables and payables are presented gross in the supplemental condensed consolidating balance sheets. • Investments in consolidated subsidiaries, as well as guarantor subsidiaries’ investments in non-guarantor subsidiaries, are presented under the equity method of accounting with the related investments presented within the line items net investment in subsidiaries and other long-term liabilities in the supplemental condensed consolidating balance sheets. • Income tax expense is allocated from the parent issuer to the income producing operations (other guarantors and non-guarantors) through stockholders’ equity. As this approach represents an allocation, the income tax expense allocation is considered non-cash for statement of cash flow purposes.

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2019
Accounting Policies [Abstract]
Summary of Net Operating Revenues by Payor Source	The following table provides a summary of net operating revenues by payor source (dollars in thousands): Three Months Ended June 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 119,885 27.1 % $ 130,106 27.5 % Medicaid 96,794 21.9 % 87,141 18.4 % Managed care and commercial plans 174,658 39.5 % 189,726 40.3 % Self-pay and self-pay after insurance 32,534 7.4 % 42,288 8.9 % Non-patient 18,299 4.1 % 23,371 4.9 % Total net operating revenues $ 442,170 100.0 % $ 472,632 100.0 % Six Months Ended June 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 248,931 28.1 % $ 274,689 28.6 % Medicaid 178,718 20.2 % 172,244 18.0 % Managed care and commercial plans 348,733 39.4 % 374,952 39.0 % Self-pay and self-pay after insurance 69,671 7.9 % 91,972 9.6 % Non-patient 38,922 4.4 % 45,595 4.8 % Total net operating revenues $ 884,975 100.0 % $ 959,452 100.0 %
Summary of Components of Amounts Due from and Due to Third-Party Payors	The following table provides a summary of the components of amounts due from and due to third-party payors, as presented in the consolidated balance sheets (in thousands): June 30, December 31, 2019 2018 Amounts due from third-party payors: Previous program reimbursements and final cost report settlements $ 13,643 $ 14,374 State supplemental payment programs 43,428 49,069 Total amounts due from third-party payors $ 57,071 $ 63,443 Amounts due to third-party payors: Previous program reimbursements and final cost report settlements $ 26,042 $ 32,174 State supplemental payment programs 11,176 13,678 Total amounts due to third-party payors $ 37,218 $ 45,852
Summary of Portion of Medicaid Reimbursements Included in Consolidated Statements of Income that are Attributable to State Supplemental Payment Programs	The following table provides a summary of the portion of Medicaid reimbursements included in the consolidated statements of income that are attributable to state supplemental payment programs (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Medicaid state supplemental payment program revenues $ 47,589 $ 52,070 $ 95,279 $ 100,631 Provider taxes and other expenses 18,727 17,051 37,593 36,195 Reimbursements attributable to state supplemental payment programs, net of expenses $ 28,862 $ 35,019 $ 57,686 $ 64,436
Summary of States in Which Company Generates More Than 5% of its Total Revenues	The following table provides a summary of the states in which the Company generates more than 5% of its total net patient revenues as determined in the most recent period (dollars in thousands): Number of Six Months Ended June 30, Hospitals at 2019 2018 June 30, 2019 $ Amount % of Total $ Amount % of Total Illinois 8 $ 337,928 39.9 % $ 373,372 40.9 % Oregon 1 117,469 13.9 % 116,013 12.7 % California 2 89,676 10.6 % 89,972 9.8 % Kentucky 3 55,660 6.6 % 58,115 6.4 %
Summary of Major Components of Other Operating Expenses	The following table provides a summary of the major components of other operating expenses (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Purchased services $ 41,582 $ 37,502 $ 79,424 $ 78,582 Taxes and insurance 1,646 33,627 35,610 66,682 Medical specialist fees 25,154 26,433 51,224 53,381 Transition services agreements 7,177 14,066 15,026 29,183 Repairs and maintenance 9,318 9,060 18,853 18,697 Utilities 5,239 5,592 10,541 11,715 Other miscellaneous operating expenses 16,838 18,176 33,065 38,954 Total other operating expenses $ 106,954 $ 144,456 $ 243,743 $ 297,194

Property and Equipment (Tables)

Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2019
Property Plant And Equipment [Abstract]
Summary of Components of Property and Equipment	The following table provides a summary of the components of property and equipment (in thousands): June 30, December 31, 2019 2018 Property and equipment, at cost: Land and improvements $ 44,185 $ 49,637 Building and improvements 651,804 723,345 Equipment and fixtures 463,998 498,139 Construction in progress 7,391 16,208 Total property and equipment, at cost 1,167,378 1,287,329 Less: Accumulated depreciation and amortization (670,823 ) (727,891 ) Total property and equipment, net $ 496,555 $ 559,438

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Summary of Changes in Goodwill	The following table provides a summary of changes in goodwill (in thousands): Six Months Ended June 30, 2019 Balance at beginning of period $ 401,073 Acquisitions 375 Divestitures (3,300 ) Impairment (6,490 ) Balance at end of period $ 391,658
Summary of the Components of Intangible Assets	The following table provides a summary of the components of intangible assets (in thousands): June 30, 2019 Accumulated Net Book Cost Amortization Value Finite-lived intangible assets: Capitalized software costs $ 136,547 $ (108,589 ) $ 27,958 Physician guarantee contracts 5,320 (3,131 ) 2,189 Other finite-lived intangible assets 43,222 (37,443 ) 5,779 Total finite-lived intangible assets, net 185,089 (149,163 ) 35,926 Indefinite-lives intangible assets: Tradenames 4,000 — 4,000 Licenses and other indefinite-lived intangible assets 1,140 — 1,140 Total indefinite-lived intangible assets 5,140 — 5,140 Total intangible assets $ 190,229 $ (149,163 ) $ 41,066 December 31, 2018 Accumulated Net Book Cost Amortization Value Finite-lived intangible assets: Capitalized software costs $ 145,795 $ (111,658 ) $ 34,137 Physician guarantee contracts 5,008 (2,679 ) 2,329 Other finite-lived intangible assets 43,221 (36,512 ) 6,709 Total finite-lived intangible assets, net 194,024 (150,849 ) 43,175 Indefinite-lives intangible assets: Tradenames 4,000 — 4,000 Licenses and other indefinite-lived intangible assets 1,114 — 1,114 Total indefinite-lived intangible assets 5,114 — 5,114 Total intangible assets $ 199,138 $ (150,849 ) $ 48,289
Summary of the Components of Amortization Expense	The following table provides a summary of the components of amortization expense (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Amortization of finite-lived intangible assets: Capitalized software costs $ 2,115 $ 2,775 $ 4,320 $ 6,099 Physician guarantee contracts 537 916 1,046 1,445 Other finite-lived intangible assets 471 507 945 1,014 Total amortization expense related to finite-lived intangible assets 3,123 4,198 6,311 8,558 Amortization of leasehold improvements and property and equipment assets held under finance lease obligations 783 783 1,569 1,676 Total amortization expense $ 3,906 $ 4,981 $ 7,880 $ 10,234

Long-Term Debt (Tables)

Long-Term Debt (Tables)	6 Months Ended
	Jun. 30, 2019
Debt Disclosure [Abstract]
Summary of Components of Long-Term Debt	The following table provides a summary of the components of long-term debt (in thousands): June 30, December 31, 2019 2018 Senior Credit Facility: Revolving Credit Facility, maturing 2021 $ — $ — Term Loan Facility, maturing 2022 777,686 790,751 ABL Credit Facility, maturing 2021 42,000 14,000 Senior Notes, maturing 2023 400,000 400,000 Unamortized debt issuance costs and discounts (30,894 ) (35,537 ) Finance lease obligations 22,781 23,386 Other debt 596 874 Total debt 1,212,169 1,193,474 Less: Current maturities of long-term debt (1,646 ) (1,697 ) Total long-term debt $ 1,210,523 $ 1,191,777
Summary of Maximum Secured Net Leverage Ratio Permitted Under Credit Facility	After giving effect to the CS Amendment and the CS Second Amendment, the maximum Secured Net Leverage Ratio permitted under the CS Agreement, as determined based on 12 month trailing Consolidated EBITDA measured as of the last day of each fiscal quarter and as defined in the CS Agreement follows: Maximum Secured Net Period Leverage Ratio Period from July 1, 2018 to December 31, 2019 5.00 to 1.00 Period from January 1, 2020 and thereafter 4.50 to 1.00
Summary of Redemption Dates and Prices of Senior Notes	The following table provides a summary of the redemption periods and prices related to the Senior Notes: Redemption Period Prices Period from April 15, 2019 to April 14, 2020 108.719 % Period from April 15, 2020 to April 14, 2021 105.813 % Period from April 15, 2021 to April 14, 2022 102.906 % Period from April 15, 2022 to April 14, 2023 100.000 %
Summary of Unamortized Debt Issuance Costs and Discounts	The following table provides a summary of unamortized debt issuance costs and discounts (in thousands): June 30, December 31, 2019 2018 Debt issuance costs $ 34,533 $ 34,533 Debt discounts 24,536 24,536 Total debt issuance costs and discounts at origination 59,069 59,069 Less: Amortization of debt issuance costs and discounts (28,175 ) (23,532 ) Total unamortized debt issuance costs and discounts $ 30,894 $ 35,537
Summary of Debt Maturities for Next Five Years and Thereafter	The following table provides a summary of debt maturities for the next five years and thereafter (in thousands): June 30, 2019 Remainder of 2019 $ 823 2020 1,632 2021 43,625 2022 779,111 2023 401,327 Thereafter 16,545 Total debt, excluding unamortized debt issuance costs and discounts $ 1,243,063
Summary of Components of Interest Expense, Net	The following table provides a summary of the components of interest expense, net (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Senior Credit Facility: Revolving Credit Facility $ 62 $ 64 $ 122 $ 142 Term Loan Facility 18,226 17,653 36,558 35,053 ABL Credit Facility 661 511 1,047 839 Senior Notes 11,626 11,626 23,252 23,239 Amortization of debt issuance costs and discounts 2,482 3,064 4,643 5,170 All other interest expense (income), net 525 (992 ) 226 (1,586 ) Total interest expense, net $ 33,582 $ 31,926 $ 65,848 $ 62,857

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Summary of Components of Lease Costs and Rent	The following table provides a summary of the components of lease costs and rent (in thousands): Three Months Ended Six Months Ended June 30, 2019 June 30, 2019 Operating lease costs: Operating lease cost $ 9,126 $ 18,202 Variable lease cost 694 1,299 Short-term rent expense 1,807 3,657 Total operating lease costs $ 11,627 $ 23,158 Finance lease costs: Amortization of right-of-use assets $ 389 $ 778 Interest on lease liabilities 380 758 Total finance lease costs $ 769 $ 1,536
Supplemental Balance Sheet Information Related to Finance Leases	The following table provides supplemental balance sheet information related to finance leases (in thousands): Balance Sheet Classification June 30, 2019 Finance Leases: Finance lease ROU assets Property and equipment $ 29,358 Accumulated amortization Accumulated depreciation and amortization 6,450 Current finance lease liabilities Current maturities of long-term debt 1,309 Long-term finance lease liabilities Long-term debt 21,472
Schedule of Supplemental Cash Flow Information Related to Leases	The following table provides supplemental cash flow information related to leases (in thousands): Three Months Ended Six Months Ended June 30, 2019 June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 9,126 $ 18,232 Operating cash flows from finance leases 331 663 Financing cash flows from finance leases 309 684 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 3,358 $ 8,626 Finance leases — 79
Schedule Of Weighted Average Lease Terms and Discount Rates of Operating and Finance Leases	The following table provides the weighted-average lease terms and discount rates used for the Company’s operating and finance leases: June 30, 2019 Weighted-average remaining lease term (years): Operating leases 4.9 Finance leases 8.1 Weighted-average discount rate: Operating leases 10.3 % Finance leases 6.2 %
Summary of Lease Liability Maturities	The following table provides a summary of lease liability maturities for the next five years and thereafter (in thousands): Operating Finance Leases Leases Remainder of 2019 $ 16,372 $ 1,292 2020 31,314 2,610 2021 20,865 2,647 2022 13,141 2,344 2023 7,601 6,974 Thereafter 24,045 13,715 Total lease payments 113,338 29,582 Less: Imputed interest (26,174 ) (6,801 ) Total lease obligations 87,164 22,781 Less: Lease obligations held-for-sale (1,813 ) — Total lease obligations excluding held-for-sale 85,351 22,781 Less: Current portion (23,797 ) (1,309 ) Total Long-term lease obligations excluding held-for-sale $ 61,554 $ 21,472
Schedule of Future Commitments Related to Non-Cancellable Operating and Capital Leases, Which Followed Lease Accounting Standard Prior to Adoption of ASC Topic 842	As previously disclosed in the Company’s 2018 Annual Report on Form 10-K, which followed the lease accounting standard prior to the adoption of ASC Topic 842 (ASC Topic 840), future commitments related to non-cancellable operating and capital leases for each for the next five years and thereafter as of December 31, 2018 were as follows (in thousands): Operating Finance Leases (1) Leases 2019 $ 34,885 $ 2,549 2020 29,609 2,587 2021 20,098 2,625 2022 12,932 2,328 2023 7,588 6,974 Thereafter 26,469 13,716 Total minimum future payments obligations $ 131,581 30,779 Less: Imputed interest (7,393 ) Total capital lease obligations 23,386 Less: Current portion of capital lease obligations (1,304 ) Total long-term capital lease obligations $ 22,082 (1) Minimum lease payment obligations have not been reduced by minimum sublease rentals due in the future of $0.8 million.

Other Long-Term Assets and Ot_2

Other Long-Term Assets and Other Long-Term Liabilities (Tables)	6 Months Ended
	Jun. 30, 2019
Other Noncurrent Assets And Other Noncurrent Liabilities Disclosure [Abstract]
Summary of Components of Other Long-Term Assets	The following table provides a summary of the components of other long-term assets (in thousands): June 30, December 31, 2019 2018 Receivable for professional and general liability insurance reserves indemnified by CHS $ 23,310 $ 34,535 Assets of deferred compensation plan 15,829 14,980 Receivable for workers' compensation liability insurance reserves indemnified by CHS 11,642 12,118 Other miscellaneous long-term assets 15,173 12,673 Total other long-term assets $ 65,954 $ 74,306
Summary of Components of Other Long-Term Liabilities	The following table provides a summary of the components of other long-term liabilities (in thousands): June 30, December 31, 2019 2018 Professional and general liability insurance reserves $ 48,836 $ 82,828 Workers' compensation liability insurance reserves 15,869 16,819 Benefit plan liabilities 21,661 22,712 Other miscellaneous long-term liabilities 2,879 4,140 Total other long-term liabilities $ 89,245 $ 126,499

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2019
Fair Value Disclosures [Abstract]
Summary of Carrying Amounts and Estimated Fair Values of Long-Term Debt	The following table provides a summary of the carrying amounts and estimated fair values of the Company’s long-term debt (in thousands): June 30, 2019 December 31, 2018 Carrying Estimated Carrying Estimated Amount Fair Value Amount Fair Value Revolving Credit Facility $ — $ — $ — $ — Term Loan Facility 777,686 769,909 790,751 784,821 ABL Credit Facility 42,000 42,000 14,000 14,000 Senior Notes 400,000 349,424 400,000 382,984 Other debt 23,377 23,377 24,260 24,260 Total debt, excluding unamortized debt issuance costs and discounts $ 1,243,063 $ 1,184,710 $ 1,229,011 $ 1,206,065

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2019
Earnings Per Share [Abstract]
Summary of Computation of Basic and Diluted Earnings (Loss) Per Share	The following table provides a summary of the computation of basic and diluted earnings (loss) per share (in thousands, except earnings per share and shares): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Numerator: Net income (loss) $ (16,477 ) $ (25,941 ) $ (55,083 ) $ (124,428 ) Less: Net income (loss) attributable to noncontrolling interests 396 665 796 1,146 Net income (loss) attributable to Quorum Health Corporation $ (16,873 ) $ (26,606 ) $ (55,879 ) $ (125,574 ) Denominator: Weighted-average shares outstanding - basic and diluted 30,001,208 28,995,564 29,721,167 28,726,445 Earnings (loss) per share attributable to Quorum Health Corporation stockholders - basic and diluted $ (0.56 ) $ (0.92 ) $ (1.88 ) $ (4.37 )

Segments (Tables)

Segments (Tables)	6 Months Ended
	Jun. 30, 2019
Segment Reporting [Abstract]
Summary of Financial Information Related to Segments	The following tables provide a summary of financial information related to the Company’s reportable segments (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net operating revenues: Hospital operations $ 426,618 $ 453,660 $ 852,771 $ 920,826 QHR operations 14,974 18,620 30,031 38,208 All other 578 352 2,173 418 Total net operating revenues $ 442,170 $ 472,632 $ 884,975 $ 959,452 Adjusted EBITDA: Hospital operations $ 41,744 $ 44,035 $ 70,077 $ 70,318 QHR operations 4,128 4,451 8,207 8,803 All other (12,443 ) (12,163 ) (24,224 ) (24,378 ) Total Adjusted EBITDA $ 33,429 $ 36,323 $ 54,060 $ 54,743 June 30, December 31, 2019 2018 Assets: Hospital operations $ 1,458,118 $ 1,453,693 QHR operations 53,592 55,823 All other 56,516 64,578 Total assets $ 1,568,226 $ 1,574,094
Summary of Reconciliation of Adjusted EBITDA to Net Income (Loss)	The following table provides a reconciliation of Adjusted EBITDA to net income (loss), the most directly comparable U.S. GAAP financial measure (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net income (loss) $ (16,477 ) $ (25,941 ) $ (55,083 ) $ (124,428 ) Interest expense, net 33,582 31,926 65,848 62,857 Provision for (benefit from) income taxes 94 (454 ) 249 (88 ) Depreciation and amortization 14,500 17,142 29,139 35,403 EBITDA 31,699 22,673 40,153 (26,256 ) Legal, professional and settlement costs 604 5,417 1,289 8,830 Impairment of long-lived assets and goodwill 25,950 — 34,810 39,760 Loss (gain) on sale of hospitals, net 1,140 307 1,140 8,122 Loss on closure of hospitals, net — 3,338 — 17,084 Transition of transition services agreements 834 520 1,976 1,237 Change in actuarial estimates (26,880 ) — (26,880 ) — Headcount reductions and executive severance 82 4,068 1,572 5,966 Adjusted EBITDA $ 33,429 $ 36,323 $ 54,060 $ 54,743

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2019
Summary of Stock-Based Compensation Expense for Periods Subsequent to Spin-Off	The following table provides a summary of stock-based compensation expense for the periods subsequent to the Spin-off (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Stock-based compensation resulting from the Spin-off $ — $ 2 $ — $ 372 Stock-based compensation related to grants following the Spin-off 1,194 2,754 2,964 4,848 Total stock-based compensation expense $ 1,194 $ 2,756 $ 2,964 $ 5,220
QHC Awards Distributed in Spin-off [Member]
Summary of Activity Related to Unvested Restricted Stock Awards	The following table provides a summary of the activity related to unvested QHC restricted stock awards held by QHC and CHS employees during the six months ended June 30, 2019 that were distributed in the Spin-off (in shares): QHC Awards Distributed in Spin-off Unvested restricted stock awards at December 31, 2018 80,350 Vested (61,150 ) Forfeited (19,200 ) Unvested restricted stock awards at June 30, 2019 —
QHC Restricted Stock Awards Granted Following Spin-off [Member]
Summary of Activity Related to Unvested Restricted Stock Awards	The following table provides a summary of the activity related to unvested restricted stock awards during the six months ended June 30, 2019 that were granted to QHC employees subsequent to the Spin-off: QHC Awards Granted Subsequent to Spin-off Weighted- Average Grant Date Fair Value Shares Per Share Unvested restricted stock awards at December 31, 2018 2,207,117 $ 7.04 Granted 1,689,346 1.76 Vested (842,377 ) 7.79 Forfeited (264,855 ) 8.67 Unvested restricted stock awards at June 30, 2019 2,789,231 $ 3.46

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2019
Commitments And Contingencies Disclosure [Abstract]
Summary of Insurance Reserves Related to Professional and General Liability Claims and Workers' Compensation Claims	The following table provides a summary of the Company’s insurance reserves related to professional and general liability and workers’ compensation liability, distinguished between those indemnified by CHS and those related to the Company’s own risks (in thousands): June 30, 2019 Current Long-Term Current Long-Term Receivable Receivable Liability Liability Professional and general liability: Insurance reserves indemnified by CHS, Inc. $ 11,994 $ 23,310 $ 11,994 $ 23,310 All other self-insurance reserves — — 4,789 25,526 Total insurance reserves for professional and general liability 11,994 23,310 16,783 48,836 Workers' compensation liability: Insurance reserves indemnified by CHS, Inc. 1,084 11,642 1,084 11,642 All other self-insurance reserves — — 1,817 4,227 Total insurance reserves for workers' compensation liability 1,084 11,642 2,901 15,869 Total self-insurance reserves $ 13,078 $ 34,952 $ 19,684 $ 64,705 December 31, 2018 Current Long-Term Current Long-Term Receivable Receivable Liability Liability Professional and general liability: Insurance reserves indemnified by CHS, Inc. $ 20,200 $ 34,535 $ 20,200 $ 34,535 All other self-insurance reserves — — 5,195 48,293 Total insurance reserves for professional and general liability 20,200 34,535 25,395 82,828 Workers' compensation liability: Insurance reserves indemnified by CHS, Inc. 1,412 12,118 1,412 12,118 All other self-insurance reserves — — 2,525 4,701 Total insurance reserves for workers' compensation liability 1,412 12,118 3,937 16,819 Total self-insurance reserves $ 21,612 $ 46,653 $ 29,332 $ 99,647

Guarantor and Non-Guarantor S_2

Guarantor and Non-Guarantor Supplemental Information (Tables)	6 Months Ended
	Jun. 30, 2019
Condensed Financial Information Of Parent Company Only Disclosure [Abstract]
Schedule of Condensed Consolidating Statement of Income (Loss)	Condensed Consolidating Statement of Income (Loss) Three Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 336,512 $ 105,658 $ — $ 442,170 Operating costs and expenses: Salaries and benefits — 143,881 69,530 — 213,411 Supplies — 33,939 16,263 — 50,202 Other operating expenses 3 89,839 17,112 — 106,954 Depreciation and amortization — 11,179 3,321 — 14,500 Lease costs and rent — 6,762 4,865 — 11,627 Electronic health records incentives — 590 (7 ) — 583 Legal, professional and settlement costs — 530 74 — 604 Impairment of long-lived assets and goodwill — 25,950 — — 25,950 Loss (gain) on sale of hospitals, net — 1,145 (5 ) — 1,140 Total operating costs and expenses 3 313,815 111,153 — 424,971 Income (loss) from operations (3 ) 22,697 (5,495 ) — 17,199 Interest expense, net 33,084 488 10 — 33,582 Equity in earnings of affiliates (16,195 ) (3,411 ) — 19,606 — Income (loss) before income taxes (16,892 ) 25,620 (5,505 ) (19,606 ) (16,383 ) Provision for (benefit from) income taxes (19 ) 147 (34 ) — 94 Net income (loss) (16,873 ) 25,473 (5,471 ) (19,606 ) (16,477 ) Less: Net income (loss) attributable to noncontrolling interests — — 396 — 396 Net income (loss) attributable to Quorum Health Corporation $ (16,873 ) $ 25,473 $ (5,867 ) $ (19,606 ) $ (16,873 ) Condensed Consolidating Statement of Income (Loss) Three Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 362,258 $ 110,374 $ — $ 472,632 Operating costs and expenses: Salaries and benefits — 160,448 72,183 — 232,631 Supplies — 36,841 16,056 — 52,897 Other operating expenses 27 116,930 27,499 — 144,456 Depreciation and amortization — 13,820 3,322 — 17,142 Rent — 6,567 4,791 — 11,358 Electronic health records incentives — (381 ) (64 ) — (445 ) Legal, professional and settlement costs — 5,417 — — 5,417 Impairment of long-lived assets and goodwill — — — — - Loss (gain) on sale of hospitals, net — 313 (6 ) — 307 Loss on closure of hospitals, net — 3,338 — — 3,338 Total operating costs and expenses 27 343,293 123,781 — 467,101 Income (loss) from operations (27 ) 18,965 (13,407 ) — 5,531 Interest expense, net 32,934 (1,026 ) 18 — 31,926 Equity in earnings of affiliates (5,934 ) (3,022 ) — 8,956 — Income (loss) before income taxes (27,027 ) 23,013 (13,425 ) (8,956 ) (26,395 ) Provision for (benefit from) income taxes (421 ) (84 ) 51 — (454 ) Net income (loss) (26,606 ) 23,097 (13,476 ) (8,956 ) (25,941 ) Less: Net income (loss) attributable to noncontrolling interests — — 665 — 665 Net income (loss) attributable to Quorum Health Corporation $ (26,606 ) $ 23,097 $ (14,141 ) $ (8,956 ) $ (26,606 ) Condensed Consolidating Statement of Income (Loss) Six Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 674,447 $ 210,528 $ — $ 884,975 Operating costs and expenses: Salaries and benefits — 297,983 140,503 — 438,486 Supplies — 70,288 31,299 — 101,587 Other operating expenses 16 200,764 42,963 — 243,743 Depreciation and amortization — 22,535 6,604 — 29,139 Lease costs and rent — 13,390 9,768 — 23,158 Electronic health records incentives — 599 10 — 609 Legal, professional and settlement costs — 1,214 75 — 1,289 Impairment of long-lived assets and goodwill — 34,810 — — 34,810 Loss (gain) on sale of hospitals, net — 1,145 (5 ) — 1,140 Total operating costs and expenses 16 642,728 231,217 — 873,961 Income (loss) from operations (16 ) 31,719 (20,689 ) — 11,014 Interest expense, net 65,664 259 (75 ) — 65,848 Equity in earnings of affiliates (9,964 ) (3,085 ) — 13,049 — Income (loss) before income taxes (55,716 ) 34,545 (20,614 ) (13,049 ) (54,834 ) Provision for (benefit from) income taxes 163 183 (97 ) — 249 Net income (loss) (55,879 ) 34,362 (20,517 ) (13,049 ) (55,083 ) Less: Net income (loss) attributable to noncontrolling interests — — 796 — 796 Net income (loss) attributable to Quorum Health Corporation $ (55,879 ) $ 34,362 $ (21,313 ) $ (13,049 ) $ (55,879 ) Condensed Consolidating Statement of Income (Loss) Six Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 734,795 $ 224,657 $ — $ 959,452 Operating costs and expenses: Salaries and benefits — 330,181 149,450 — 479,631 Supplies — 79,441 32,342 — 111,783 Other operating expenses 1,897 239,096 56,201 — 297,194 Depreciation and amortization — 28,525 6,878 — 35,403 Rent — 13,884 10,006 — 23,890 Electronic health records incentives — (430 ) (156 ) — (586 ) Legal, professional and settlement costs — 8,830 — — 8,830 Impairment of long-lived assets and goodwill — 37,960 1,800 — 39,760 Loss (gain) on sale of hospitals, net — 8,128 (6 ) — 8,122 Loss on closure of hospitals, net — 17,084 — — 17,084 Total operating costs and expenses 1,897 762,699 256,515 — 1,021,111 Income (loss) from operations (1,897 ) (27,904 ) (31,858 ) — (61,659 ) Interest expense, net 64,408 (1,548 ) (3 ) — 62,857 Equity in earnings of affiliates 58,917 40,831 — (99,748 ) — Income (loss) before income taxes (125,222 ) (67,187 ) (31,855 ) 99,748 (124,516 ) Provision for (benefit from) income taxes 352 (420 ) (20 ) — (88 ) Net income (loss) (125,574 ) (66,767 ) (31,835 ) 99,748 (124,428 ) Less: Net income (loss) attributable to noncontrolling interests — — 1,146 — 1,146 Net income (loss) attributable to Quorum Health Corporation $ (125,574 ) $ (66,767 ) $ (32,981 ) $ 99,748 $ (125,574 )
Schedule of Condensed Consolidating Statement of Comprehensive Income (Loss)	Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (16,873 ) $ 25,473 $ (5,471 ) $ (19,606 ) $ (16,477 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 48 48 — (48 ) 48 Comprehensive income (loss) (16,825 ) 25,521 (5,471 ) (19,654 ) (16,429 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 396 — 396 Comprehensive income (loss) attributable to Quorum Health Corporation $ (16,825 ) $ 25,521 $ (5,867 ) $ (19,654 ) $ (16,825 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (26,606 ) $ 23,097 $ (13,476 ) $ (8,956 ) $ (25,941 ) Amortization and recognition of unrecognized pension cost components, net of income taxes (189 ) (189 ) — 189 (189 ) Comprehensive income (loss) (26,795 ) 22,908 (13,476 ) (8,767 ) (26,130 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 665 — 665 Comprehensive income (loss) attributable to Quorum Health Corporation $ (26,795 ) $ 22,908 $ (14,141 ) $ (8,767 ) $ (26,795 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Six Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (55,879 ) $ 34,362 $ (20,517 ) $ (13,049 ) $ (55,083 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 97 97 — (97 ) 97 Comprehensive income (loss) (55,782 ) 34,459 (20,517 ) (13,146 ) (54,986 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 796 — 796 Comprehensive income (loss) attributable to Quorum Health Corporation $ (55,782 ) $ 34,459 $ (21,313 ) $ (13,146 ) $ (55,782 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Six Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (125,574 ) $ (66,767 ) $ (31,835 ) $ 99,748 $ (124,428 ) Amortization and recognition of unrecognized pension cost components, net of income taxes (75 ) (75 ) — 75 (75 ) Comprehensive income (loss) (125,649 ) (66,842 ) (31,835 ) 99,823 (124,503 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 1,146 — 1,146 Comprehensive income (loss) attributable to Quorum Health Corporation $ (125,649 ) $ (66,842 ) $ (32,981 ) $ 99,823 $ (125,649 )
Schedule of Condensed Consolidating Balance Sheet	Condensed Consolidating Balance Sheet June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated ASSETS Current assets: Cash and cash equivalents $ 1,240 $ 729 $ 296 $ — $ 2,265 Patient accounts receivable — 186,644 84,279 — 270,923 Inventories — 32,566 8,881 — 41,447 Prepaid expenses — 16,400 5,253 — 21,653 Due from third-party payors — 53,009 4,062 — 57,071 Current assets of hospitals held for sale — 35,380 — — 35,380 Other current assets 247 23,280 10,077 — 33,604 Total current assets 1,487 348,008 112,848 — 462,343 Intercompany receivable 3 766,108 333,740 (1,099,851 ) — Property and equipment, net — 356,467 140,088 — 496,555 Goodwill — 225,628 166,030 — 391,658 Intangible assets, net — 36,288 4,778 — 41,066 Operating lease right-of-use assets — 49,396 35,458 — 84,854 Long-term assets of hospitals held for sale — 25,796 — — 25,796 Other long-term assets — 50,150 15,804 — 65,954 Net investment in subsidiaries 1,440,271 — — (1,440,271 ) — Total assets $ 1,441,761 $ 1,857,841 $ 808,746 $ (2,540,122 ) $ 1,568,226 LIABILITIES AND EQUITY Current liabilities: Current maturities of long-term debt $ — $ 1,499 $ 147 $ — $ 1,646 Current portion of operating lease liabilities — 15,694 8,103 — 23,797 Accounts payable 56 120,049 20,663 — 140,768 Accrued liabilities: Accrued salaries and benefits — 41,264 19,742 — 61,006 Accrued interest 10,517 — — — 10,517 Due to third-party payors — 30,968 6,250 — 37,218 Current liabilities of hospitals held for sale — 10,675 — — 10,675 Other current liabilities — 26,755 11,818 — 38,573 Total current liabilities 10,573 246,904 66,723 — 324,200 Long-term debt 1,188,792 21,586 145 — 1,210,523 Long-term operating lease liabilities — 33,672 27,882 — 61,554 Intercompany payable 380,143 333,743 385,965 (1,099,851 ) — Deferred income tax liabilities, net 6,978 — — — 6,978 Long-term liabilities of hospitals held for sale — 3,248 — — 3,248 Other long-term liabilities — 183,318 21,689 (115,762 ) 89,245 Total liabilities 1,586,486 822,471 502,404 (1,215,613 ) 1,695,748 Redeemable noncontrolling interests — — 2,278 — 2,278 Equity: Quorum Health Corporation stockholders' equity (deficit): Preferred stock — — — — — Common stock 3 — — — 3 Additional paid-in capital 559,487 1,134,816 631,879 (1,766,695 ) 559,487 Accumulated other comprehensive income (loss) 856 856 — (856 ) 856 Accumulated deficit (705,071 ) (100,302 ) (342,740 ) 443,042 (705,071 ) Total Quorum Health Corporation stockholders' equity (deficit) (144,725 ) 1,035,370 289,139 (1,324,509 ) (144,725 ) Nonredeemable noncontrolling interests — — 14,925 — 14,925 Total equity (deficit) (144,725 ) 1,035,370 304,064 (1,324,509 ) (129,800 ) Total liabilities and equity $ 1,441,761 $ 1,857,841 $ 808,746 $ (2,540,122 ) $ 1,568,226 Condensed Consolidating Balance Sheet December 31, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated ASSETS Current assets: Cash and cash equivalents $ 1,209 $ 1,457 $ 537 $ — $ 3,203 Patient accounts receivable — 260,339 62,269 — 322,608 Inventories — 36,349 9,297 — 45,646 Prepaid expenses 33 15,269 4,381 — 19,683 Due from third-party payors — 57,049 6,394 — 63,443 Other current assets 314 23,714 12,377 — 36,405 Total current assets 1,556 394,177 95,255 — 490,988 Intercompany receivable 3 661,887 303,059 (964,949 ) — Property and equipment, net — 419,292 140,146 — 559,438 Goodwill — 235,418 165,655 — 401,073 Intangible assets, net — 43,575 4,714 — 48,289 Other long-term assets — 57,047 17,259 — 74,306 Net investment in subsidiaries 1,428,675 — — (1,428,675 ) — Total assets $ 1,430,234 $ 1,811,396 $ 726,088 $ (2,393,624 ) $ 1,574,094 LIABILITIES AND EQUITY Current liabilities: Current maturities of long-term debt $ - $ 1,557 $ 140 $ — $ 1,697 Accounts payable 121 122,999 20,797 — 143,917 Accrued liabilities: Accrued salaries and benefits — 55,780 21,128 — 76,908 Accrued interest 10,024 — — — 10,024 Due to third-party payors — 38,560 7,292 — 45,852 Other current liabilities 248 28,713 14,375 — 43,336 Total current liabilities 10,393 247,609 63,732 — 321,734 Long-term debt 1,169,214 22,370 193 — 1,191,777 Intercompany payable 334,284 303,063 327,602 (964,949 ) — Deferred income tax liabilities, net 6,736 — — — 6,736 Other long-term liabilities — 212,240 33,106 (118,847 ) 126,499 Total liabilities 1,520,627 785,282 424,633 (1,083,796 ) 1,646,746 Redeemable noncontrolling interests — — 2,278 — 2,278 Equity: Quorum Health Corporation stockholders' equity: Preferred stock — — — — — Common stock 3 — — — 3 Additional paid-in capital 557,309 1,183,608 580,824 (1,764,432 ) 557,309 Accumulated other comprehensive income (loss) 759 759 — (759 ) 759 Accumulated deficit (648,464 ) (158,253 ) (297,110 ) 455,363 (648,464 ) Total Quorum Health Corporation stockholders' equity (deficit) (90,393 ) 1,026,114 283,714 (1,309,828 ) (90,393 ) Nonredeemable noncontrolling interests — — 15,463 — 15,463 Total equity (deficit) (90,393 ) 1,026,114 299,177 (1,309,828 ) (74,930 ) Total liabilities and equity $ 1,430,234 $ 1,811,396 $ 726,088 $ (2,393,624 ) $ 1,574,094
Schedule of Condensed Consolidating Statement of Cash Flows	Condensed Consolidating Statement of Cash Flows Six Months Ended June 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (60,677 ) $ 99,615 $ (41,254 ) $ — $ (2,316 ) Cash flows from investing activities: Capital expenditures for property and equipment — (12,486 ) (5,625 ) — (18,111 ) Capital expenditures for software — (3,017 ) (500 ) — (3,517 ) Acquisitions, net of cash acquired — — (455 ) — (455 ) Proceeds from the sale of hospitals — 11,741 — — 11,741 Other investing activities, net — 1,708 (2,091 ) — (383 ) Changes in intercompany balances with affiliates, net — (97,055 ) — 97,055 — Net cash provided by (used in) investing activities — (99,109 ) (8,671 ) 97,055 (10,725 ) Cash flows from financing activities: Borrowings under revolving credit facilities 327,000 — — — 327,000 Repayments under revolving credit facilities (299,000 ) — — — (299,000 ) Borrowings of long-term debt — 161 25 — 186 Repayments of long-term debt (13,066 ) (831 ) (66 ) — (13,963 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (564 ) — — (564 ) Cash distributions to noncontrolling investors — — (1,556 ) — (1,556 ) Changes in intercompany balances with affiliates, net 45,774 — 51,281 (97,055 ) — Net cash provided by (used in) financing activities 60,708 (1,234 ) 49,684 (97,055 ) 12,103 Net change in cash and cash equivalents 31 (728 ) (241 ) — (938 ) Cash and cash equivalents at beginning of period 1,209 1,457 537 — 3,203 Cash and cash equivalents at end of period $ 1,240 $ 729 $ 296 $ — $ 2,265 Condensed Consolidating Statement of Cash Flows Six Months Ended June 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (62,144 ) $ 75,865 $ 880 $ — $ 14,601 Cash flows from investing activities: Capital expenditures for property and equipment — (16,707 ) (8,612 ) — (25,319 ) Capital expenditures for software — (957 ) (87 ) — (1,044 ) Acquisitions, net of cash acquired — — (58 ) — (58 ) Proceeds from the sale of hospitals — 38,612 558 — 39,170 Other investing activities, net — 262 (13 ) — 249 Changes in intercompany balances with affiliates, net — (97,540 ) — 97,540 — Net cash provided by (used in) investing activities — (76,330 ) (8,212 ) 97,540 12,998 Cash flows from financing activities: Borrowings under revolving credit facilities 247,000 — — — 247,000 Repayments under revolving credit facilities (233,000 ) — — — (233,000 ) Borrowings of long-term debt — 12 55 — 67 Repayments of long-term debt (30,463 ) (868 ) (116 ) — (31,447 ) Payments of debt issuance costs (2,268 ) — — — (2,268 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (1,943 ) — — (1,943 ) Cash distributions to noncontrolling investors — — (803 ) — (803 ) Changes in intercompany balances with affiliates, net 81,279 — 16,261 (97,540 ) — Net cash provided by (used in) financing activities 62,548 (2,799 ) 15,397 (97,540 ) (22,394 ) Net change in cash, cash equivalents and restricted cash 404 (3,264 ) 8,065 — 5,205 Cash, cash equivalents and restricted cash at beginning of period 1,051 4,222 344 — 5,617 Cash, cash equivalents and restricted cash at end of period $ 1,455 $ 958 $ 8,409 $ — $ 10,822

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies (Narrative) (Details)	Jan. 01, 2019USD ($)	Apr. 29, 2016Hospital	Jun. 30, 2019USD ($)Hospitalstatebed	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)Hospitalstatebed	Jun. 30, 2018USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2014Hospital
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital			26		26
Number of states in which entity operates | state			14		14
Number of licensed beds | bed			2,458		2,458
Increase (decrease) in net operating revenues during period for transaction price adjustments related to estimated cost report settlements			$ 300,000	$ 400,000	$ 2,100,000	$ 100,000
Net operating revenues			442,170,000	472,632,000	884,975,000	959,452,000
Provider taxes			1,646,000	33,627,000	35,610,000	66,682,000
Gross amounts of charity care revenues			7,400,000	6,000,000	12,300,000	19,300,000
Accounts receivable, net of contractual adjustments			270,923,000		270,923,000		$ 322,608,000
Due from third-party payors			57,071,000		57,071,000		63,443,000
General and administrative costs			11,400,000	20,000,000	24,000,000	34,900,000
Severance costs			82,000	4,068,000	1,572,000	5,966,000
Operating lease right-of-use assets			84,854,000		84,854,000		0
Operating lease liabilities			87,164,000		87,164,000
Acquired finite-lived intangible asset, residual value			0		$ 0
New date of annual goodwill impairment test					The Company performs its annual testing of impairment for goodwill in the fourth quarter of each year.
Noncontrolling interests and redeemable noncontrolling interests					The Company’s consolidated financial statements include all assets, liabilities, revenues and expenses of less than 100% owned entities that it controls.
Maximum period during which assets held for sale sold					12 months
Accrued Salaries and Benefits [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Undiscounted reserve for self-insured employee health benefits			$ 9,000,000		$ 9,000,000		10,400,000
Capitalized Internal Use Software, Except Significant System Conversions [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Finite-lived intangible assets, useful life					3 years
Community Health Systems, Inc [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of Hospitals | Hospital								4
Accounting Standards Update 2016-02 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Operating lease right-of-use assets	$ 93,700,000
Operating lease liabilities	95,600,000
Cumulative effect adjustment that increased accumulated deficit	$ 700,000
Equipment Leases [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Operating lease, initial term			3 years		3 years
Minimum [Member] | Capitalized Internal Use Software, Significant System Conversions [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Finite-lived intangible assets, useful life					8 years
Minimum [Member] | Land Improvements [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful life of asset					3 years
Minimum [Member] | Buildings and Improvements [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful life of asset					5 years
Minimum [Member] | Equipment and Fixtures [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful life of asset					3 years
Minimum [Member] | Real Estate Leases [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Operating lease, initial term			5 years		5 years
Operating lease, renewal term			5 years		5 years
Maximum [Member] | Capitalized Internal Use Software, Significant System Conversions [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Finite-lived intangible assets, useful life					10 years
Maximum [Member] | Land Improvements [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful life of asset					20 years
Maximum [Member] | Buildings and Improvements [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful life of asset					40 years
Maximum [Member] | Equipment and Fixtures [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful life of asset					18 years
Maximum [Member] | Real Estate Leases [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Operating lease, initial term			10 years		10 years
Operating lease, renewal term			10 years		10 years
Corporate Office [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Severance costs			$ 0	2,700,000	$ 0	4,600,000
Illinois [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital			8		8
Net operating revenues					$ 337,928,000	373,372,000
California [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital			2		2
Net operating revenues					$ 89,676,000	89,972,000
California Hospital Quality Assurance Fee [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			$ 8,000,000	7,900,000	16,000,000	15,800,000
Provider taxes			2,200,000	2,100,000	4,400,000	4,200,000
Illinois Hospital Credit Program [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			2,000,000	0	4,000,000	0
Medicare [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			119,885,000	130,106,000	248,931,000	274,689,000
Accounts receivable, net of contractual adjustments			49,500,000		49,500,000		58,200,000
Medicaid [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			96,794,000	87,141,000	178,718,000	172,244,000
Medicaid [Member] | Illinois [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Accounts receivable, net of contractual adjustments			22,300,000		22,300,000		24,500,000
Medicaid [Member] | California [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Due from third-party payors			31,300,000		31,300,000		$ 37,800,000
Hospital Operations Reporting Unit [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			$ 426,618,000	$ 453,660,000	$ 852,771,000	$ 920,826,000
Sales Revenue, Segment [Member] | Segment Concentration Risk [Member] | Hospital Operations Reporting Unit [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Concentration risk, percentage					95.00%
Accounts Receivable [Member] | Credit Concentration Risk [Member] | Medicare [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Concentration risk, percentage					18.30%		18.00%
Accounts Receivable [Member] | Credit Concentration Risk [Member] | Medicaid [Member] | Illinois [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Concentration risk, percentage					8.30%		7.60%
Supplemental Program Receivables | Credit Concentration Risk [Member] | Medicaid [Member] | California [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Concentration risk, percentage					54.80%		59.60%
Spin-off from CHS [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital		38
Percentage ownership of number of stock shares held by the parent		100.00%
Record date for stockholders of the parent to be eligible to receive share distribution in spin-off		Apr. 22, 2016

Basis of Presentation and Sig_5

Basis of Presentation and Significant Accounting Policies (Summary of Net Operating Revenues by Payor Source) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 442,170	$ 472,632	$ 884,975	$ 959,452
Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Medicare [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 119,885	$ 130,106	$ 248,931	$ 274,689
Medicare [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	27.10%	27.50%	28.10%	28.60%
Medicaid [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 96,794	$ 87,141	$ 178,718	$ 172,244
Medicaid [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	21.90%	18.40%	20.20%	18.00%
Managed Care and Commercial Plans [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 174,658	$ 189,726	$ 348,733	$ 374,952
Managed Care and Commercial Plans [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	39.50%	40.30%	39.40%	39.00%
Self-Pay and Self-Pay After Insurance [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 32,534	$ 42,288	$ 69,671	$ 91,972
Self-Pay and Self-Pay After Insurance [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	7.40%	8.90%	7.90%	9.60%
Non-Patient [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 18,299	$ 23,371	$ 38,922	$ 45,595
Non-Patient [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	4.10%	4.90%	4.40%	4.80%

Basis of Presentation and Sig_6

Basis of Presentation and Significant Accounting Policies (Summary of Components of Amounts Due from and Due to Third-Party Payors) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Due from third-party payors	$ 57,071	$ 63,443
Due to third-party payors	37,218	45,852
Previous Program Reimbursements and Final Cost Report Settlements [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Due from third-party payors	13,643	14,374
Due to third-party payors	26,042	32,174
State Supplemental Payment Programs [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Due from third-party payors	43,428	49,069
Due to third-party payors	$ 11,176	$ 13,678

Basis of Presentation and Sig_7

Basis of Presentation and Significant Accounting Policies (Summary of Portion of Medicaid Reimbursements Included in Consolidated Statements of Income that are Attributable to State Supplemental Payment Programs) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Medicaid state supplemental payment program revenues	$ 442,170	$ 472,632	$ 884,975	$ 959,452
Provider taxes and other expenses	1,646	33,627	35,610	66,682
State Supplemental Payment Programs [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Medicaid state supplemental payment program revenues	47,589	52,070	95,279	100,631
Provider taxes and other expenses	18,727	17,051	37,593	36,195
Reimbursements attributable to state supplemental payment programs, net of expenses	$ 28,862	$ 35,019	$ 57,686	$ 64,436

Basis of Presentation and Sig_8

Basis of Presentation and Significant Accounting Policies (Summary of States in Which Company Generates More Than 5% of its Total Revenues) (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019USD ($)Hospital	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)Hospital	Jun. 30, 2018USD ($)
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	26		26
Total net operating revenues before the provision for bad debts, Amount | $	$ 442,170	$ 472,632	$ 884,975	$ 959,452
Illinois [Member]
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	8		8
Total net operating revenues before the provision for bad debts, Amount | $			$ 337,928	$ 373,372
Illinois [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			39.90%	40.90%
Oregon [Member]
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	1		1
Total net operating revenues before the provision for bad debts, Amount | $			$ 117,469	$ 116,013
Oregon [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			13.90%	12.70%
California [Member]
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	2		2
Total net operating revenues before the provision for bad debts, Amount | $			$ 89,676	$ 89,972
California [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			10.60%	9.80%
Kentucky [Member]
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	3		3
Total net operating revenues before the provision for bad debts, Amount | $			$ 55,660	$ 58,115
Kentucky [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			6.60%	6.40%

Basis of Presentation and Sig_9

Basis of Presentation and Significant Accounting Policies (Summary of Major Components of Other Operating Expenses) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Other Operating Expenses [Line Items]
Taxes and insurance	$ 1,646	$ 33,627	$ 35,610	$ 66,682
Repairs and maintenance	9,318	9,060	18,853	18,697
Utilities	5,239	5,592	10,541	11,715
Other miscellaneous operating expenses	16,838	18,176	33,065	38,954
Total other operating expenses	106,954	144,456	243,743	297,194
Purchased Services [Member]
Other Operating Expenses [Line Items]
Professional fees	41,582	37,502	79,424	78,582
Medical Specialist Fees [Member]
Other Operating Expenses [Line Items]
Professional fees	25,154	26,433	51,224	53,381
Community Health Systems, Inc [Member]
Other Operating Expenses [Line Items]
Transition services agreements	$ 7,177	$ 14,066	$ 15,026	$ 29,183

Impairment of Long-Lived Asse_2

Impairment of Long-Lived Assets and Goodwill (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2019	Jun. 30, 2018
Impairment Of Long Lived Assets And Goodwill [Abstract]
Impairment of long-lived assets and goodwill	$ 25,950	$ 8,900	$ 0	$ 39,800	$ 34,810	$ 39,760
Impairment of long-lived assets	15,300	8,400	$ 0	34,700
Impairment of capitalized software costs	4,200	$ 500		$ 5,100
Impairment of goodwill	$ 6,500				$ 6,490

Divestitures (Narrative) (Detai

Divestitures (Narrative) (Details) $ in Thousands	Jun. 12, 2019	Jun. 07, 2019bed	Apr. 12, 2019USD ($)bed	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Proceeds from the sale of hospitals				$ 11,741	$ 507	$ 11,741	$ 39,170
Loss (gain) on sale of hospitals, net				1,140	307	1,140	8,122
Goodwill written off						3,300
Scenic Mountain Medical Center [Member] | Texas [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Number of beds in hospital sold | bed			146
Pre-tax loss from disposal of discontinued operation				$ 4,500	$ 400	4,100	$ 200
Proceeds from the sale of hospitals			$ 11,700
Loss (gain) on sale of hospitals, net						1,100
Goodwill written off						$ 3,300
Watsonville Community Hospital [Member] | California [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Number of beds in hospital sold | bed		106
Announcement date of plan to dispose		Jun. 7, 2019
MetroSouth Medical Center [Member] | Illinois [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Announcement date of plan to dispose	Jun. 12, 2019

Property and Equipment (Summary

Property and Equipment (Summary of Components of Property and Equipment) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	$ 1,167,378	$ 1,287,329
Less: Accumulated depreciation and amortization	(670,823)	(727,891)
Total property and equipment, net	496,555	559,438
Land and Improvements [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	44,185	49,637
Buildings and Improvements [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	651,804	723,345
Equipment and Fixtures [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	463,998	498,139
Construction in progress [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	$ 7,391	$ 16,208

Property and Equipment (Narrati

Property and Equipment (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Depreciation expense	$ 10.6	$ 12.2	$ 21.3	$ 25.2
Purchases of property and equipment accrued in accounts payable			$ 2.1		$ 4.9

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Changes in Goodwill) (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill, beginning balance		$ 401,073
Acquisitions		375
Divestitures		(3,300)
Impairment	$ (6,500)	(6,490)
Goodwill, ending balance	$ 391,658	$ 391,658

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Goodwill Narrative) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Goodwill [Line Items]
Goodwill	$ 391,658	$ 401,073
Goodwill accumulated impairment loss	133,400	126,900
Hospital Operations Reporting Unit [Member]
Goodwill [Line Items]
Goodwill	358,300	367,800
Hospital Management Advisory and Healthcare Consulting Services Reporting Unit [Member]
Goodwill [Line Items]
Goodwill	$ 33,300	$ 33,300

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets (Summary of the Components of Intangible Assets ) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	$ 185,089	$ 194,024
Accumulated Amortization	(149,163)	(150,849)
Total finite-lived intangible assets, net	35,926	43,175
Cost	5,140	5,114
Total indefinite-lived intangible assets	5,140	5,114
Cost	190,229	199,138
Total intangible assets	41,066	48,289
Trade Names [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	4,000	4,000
Total indefinite-lived intangible assets	4,000	4,000
Licenses And Other Indefinite-Lived Intangible Assets [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	1,140	1,114
Total indefinite-lived intangible assets	1,140	1,114
Capitalized Software Costs [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	136,547	145,795
Accumulated Amortization	(108,589)	(111,658)
Total finite-lived intangible assets, net	27,958	34,137
Physician Income Guarantee Contracts [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	5,320	5,008
Accumulated Amortization	(3,131)	(2,679)
Total finite-lived intangible assets, net	2,189	2,329
Other Finite-Lived Intangible Assets [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	43,222	43,221
Accumulated Amortization	(37,443)	(36,512)
Total finite-lived intangible assets, net	$ 5,779	$ 6,709

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets (Intangible Assets Narrative) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross	$ 185,089	$ 194,024
Capitalized Software Costs in Development Stage [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross	$ 1,500

Goodwill and Intangible Asset_6

Goodwill and Intangible Assets (Summary of the Components of Amortization Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	$ 3,123	$ 4,198	$ 6,311	$ 8,558
Amortization of leasehold improvements and property and equipment assets held under finance lease obligations	783	783	1,569	1,676
Total amortization expense	3,906	4,981	7,880	10,234
Capitalized Software Costs [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	2,115	2,775	4,320	6,099
Physician Income Guarantee Contracts [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	537	916	1,046	1,445
Other Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	$ 471	$ 507	$ 945	$ 1,014

Goodwill and Intangible Asset_7

Goodwill and Intangible Assets (Amortization Expense Narrative) (Details)	6 Months Ended
	Jun. 30, 2019
Intangible Assets Except Software Costs and Physician Income Guarantee Contracts [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, weighted-average useful life	3 years 1 month 6 days

Long-Term Debt (Summary of Comp

Long-Term Debt (Summary of Components of Long-Term Debt) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Total debt, excluding debt issuance costs and discounts	$ 1,243,063	$ 1,229,011
Unamortized debt issuance costs and discounts	(30,894)	(35,537)
Finance lease obligations	22,781	23,386
Other debt	596	874
Total debt	1,212,169	1,193,474
Less: Current maturities of long-term debt	(1,646)	(1,697)
Long-term debt	1,210,523	1,191,777
Senior Notes, maturing 2023 [Member]
Debt Instrument [Line Items]
Total debt, excluding debt issuance costs and discounts	400,000	400,000
ABL Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Total debt, excluding debt issuance costs and discounts	42,000	14,000
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Total debt, excluding debt issuance costs and discounts	0	0
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member]
Debt Instrument [Line Items]
Total debt, excluding debt issuance costs and discounts	$ 777,686	$ 790,751

Long-Term Debt (Senior Credit F

Long-Term Debt (Senior Credit Facility Narrative) (Details) - USD ($)	Apr. 29, 2016	Jun. 30, 2019	Dec. 31, 2018	Mar. 14, 2018	Jan. 01, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount		$ 24,536,000	$ 24,536,000
Secured net leverage ratio after December 31, 2018		335.00%
Leverage ratio to incur permitted additional debt description		The Company may incur Permitted Additional Debt so long as the Total Leverage Ratio, adjusted for the Permitted Additional Debt, is below 5.50 to 1.00.
Minimum [Member]
Debt Instrument [Line Items]
Incremental term loan commitments		$ 100,000,000
Maximum [Member]
Debt Instrument [Line Items]
Leverage ratio to incur permitted additional debt after December 31, 2018		550.00%
Senior Credit Facility [Member]
Debt Instrument [Line Items]
Secured net leverage ratio		485.00%
Line of credit, borrowing capacity		$ 25,900,000
Secured net leverage ratio to exercise incremental term loan commitments description		The Company may request to exercise Incremental Term Loan Commitments for the greater of $100 million or an amount which would produce a Secured Net Leverage Ratio of 3.35 to 1.00.
Letters of credit outstanding		$ 14,200,000
Senior Credit Facility [Member] | CS Second Amendment [Member]
Debt Instrument [Line Items]
Debt instrument agreement, date of amendment		Mar. 14, 2018
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount	$ 880,000,000
Debt Instrument, Unamortized Discount	$ 17,600,000
Term Facility Issued Percentage on Par Value	98.00%
Debt Instrument, Maturity Date		Apr. 29, 2022
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member] | CS Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage		9.66%
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member] | CS Agreement [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	5.75%
Derivative, Floor Interest Rate	1.00%
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member] | CS Agreement [Member] | Alternate Base Rate [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	4.75%
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member] | CS Amendment [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		6.75%
Derivative, Floor Interest Rate		1.00%
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member] | CS Amendment [Member] | Alternate Base Rate [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		5.75%
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	$ 100,000,000			$ 62,500,000	$ 75,000,000	$ 87,500,000
Debt Instrument, Maturity Date		Apr. 29, 2021
Line of credit, borrowing capacity		$ 48,300,000
Line of credit, outstanding balance		$ 0
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member] | CS Amendment [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		2.75%
Derivative, Floor Interest Rate		0.00%
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member] | CS Amendment [Member] | Alternate Base Rate [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		1.75%

Long-Term Debt (Maximum Secured

Long-Term Debt (Maximum Secured Net Leverage Ratio Permitted) (Details) - Senior Credit Facility [Member]	Jun. 30, 2019
Debt Instrument [Line Items]
Secured net leverage ratio	485.00%
Period from July 1, 2018 to December 31, 2019 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Secured net leverage ratio	500.00%
Period from January 1, 2020 and thereafter [Member] | Maximum [Member]
Debt Instrument [Line Items]
Secured net leverage ratio	450.00%

Long-Term Debt (ABL Credit Faci

Long-Term Debt (ABL Credit Facility Narrative) (Details) - ABL Credit Facility, maturing 2021 [Member] - USD ($)	Apr. 29, 2016	Jun. 30, 2019
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	$ 125,000,000	$ 68,200,000
Line of credit, outstanding balance		42,000,000
Line of Credit Facility, Maturity Date	Apr. 29, 2021
Covenant Trigger Event, minimum required excess availability amount		$ 12,500,000
Covenant Trigger Event, minimum required excess availability as percentage of aggregate commitments		10.00%
Minimum Consolidated Fixed Charge Ratio required to be maintained if covenant trigger event occurs		110.00%
Cash Dominion Trigger Event, minimum required excess availability as percentage of aggregate commitments		12.50%
Cash Dominion Trigger Event, minimum required excess availability amount		$ 15,000,000
London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Derivative, Floor Interest Rate	0.00%
London Interbank Offered Rate (LIBOR) [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.75%
London Interbank Offered Rate (LIBOR) [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	2.25%
Base Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	0.75%
Base Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.25%
UBS Agreement [Member]
Debt Instrument [Line Items]
Debt instrument agreement, date of amendment		Apr. 11, 2017

Long-Term Debt (Senior Notes Na

Long-Term Debt (Senior Notes Narrative) (Details) - USD ($)	May 17, 2017	Apr. 22, 2016	Jun. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount			$ 24,536,000	$ 24,536,000
Senior Notes, maturing 2023 [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount		$ 400,000,000
Debt Instrument, Interest Rate, Stated Percentage		11.625%
Debt Instrument, Unamortized Discount		$ 6,900,000
Debt Instrument Issue Discount Percentage		1.734%
Debt Instrument, Maturity Date		Apr. 15, 2023
Debt Instrument, Payment Terms			Payable semi-annually in arrears on April 15 and October 15 of each year, beginning on October 15, 2016.
Debt Instrument, Frequency of Periodic Payment			semi-annually
Debt Instrument, Date of First Required Payment		Oct. 15, 2016
Debt Instrument, Interest Rate, Effective Percentage			12.49%
Debt Instrument, Redemption Price Percentage		100.00%
Senior Notes, maturing 2023 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt Instrument, Redemption Price Percentage		35.00%
Debt Instrument, Redemption Notice Period			60 days
Senior Notes, maturing 2023 [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt Instrument, Redemption Notice Period			30 days
Senior Notes, maturing 2023 [Member] | Initial Notes [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount	$ 400,000,000
Debt Instrument, Interest Rate, Stated Percentage	11.625%
Debt instrument due date	2023
Senior Notes, maturing 2023 [Member] | Exchange Notes [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage	11.625%
Debt instrument due date	2023

Long-Term Debt (Summary of Rede

Long-Term Debt (Summary of Redemption Dates and Prices of Senior Notes) (Details) - Senior Notes, maturing 2023 [Member]	Apr. 22, 2016	Jun. 30, 2019
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Price Percentage	100.00%
Period from April 15, 2019 to April 14, 2020 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Price Percentage		108.719%
Period from April 15, 2020 to April 14, 2021 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Price Percentage		105.813%
Period from April 15, 2021 to April 14, 2022 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Price Percentage		102.906%
Period from April 15, 2022 to April 14, 2023 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Price Percentage		100.00%

Long-Term Debt (Summary of Re_2

Long-Term Debt (Summary of Redemption Dates and Prices of Senior Notes) (Parenthetical) (Details) - Senior Notes, maturing 2023 [Member]	6 Months Ended
	Jun. 30, 2019
Period from April 15, 2019 to April 14, 2020 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Period, Start Date	Apr. 15, 2019
Debt Instrument, Redemption Period, End Date	Apr. 14, 2020
Period from April 15, 2020 to April 14, 2021 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Period, Start Date	Apr. 15, 2020
Debt Instrument, Redemption Period, End Date	Apr. 14, 2021
Period from April 15, 2021 to April 14, 2022 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Period, Start Date	Apr. 15, 2021
Debt Instrument, Redemption Period, End Date	Apr. 14, 2022
Period from April 15, 2022 to April 14, 2023 [Member]
Debt Instrument Redemption [Line Items]
Debt Instrument, Redemption Period, Start Date	Apr. 15, 2022
Debt Instrument, Redemption Period, End Date	Apr. 14, 2023

Long-Term Debt (Summary of Unam

Long-Term Debt (Summary of Unamortized Debt Issuance Costs and Discounts) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Debt Disclosure [Abstract]
Debt issuance costs	$ 34,533	$ 34,533
Debt discounts	24,536	24,536
Total debt issuance costs and discounts at origination	59,069	59,069
Less: Amortization of debt issuance costs and discounts	(28,175)	(23,532)
Total unamortized debt issuance costs and discounts	$ 30,894	$ 35,537

Long-Term Debt (Finance Lease O

Long-Term Debt (Finance Lease Obligations and Other Debt Narrative) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Finance lease obligations	$ 22,781	$ 23,386
New Corporate Office [Member] | Brentwood, Tennessee [Member]
Debt Instrument [Line Items]
Finance lease obligations	$ 16,700	$ 17,200

Long-Term Debt (Summary of Debt

Long-Term Debt (Summary of Debt Maturities for Next Five Years and Thereafter) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Debt Disclosure [Abstract]
Remainder of 2019	$ 823
2020	1,632
2021	43,625
2022	779,111
2023	401,327
Thereafter	16,545
Total debt, excluding unamortized debt issuance costs and discounts	$ 1,243,063	$ 1,229,011

Long-Term Debt (Summary of Co_2

Long-Term Debt (Summary of Components of Interest Expense, Net) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Debt Instrument [Line Items]
Amortization of debt issuance costs and discounts	$ 2,482	$ 3,064	$ 4,643	$ 5,170
All other interest expense (income), net	525	(992)	226	(1,586)
Total interest expense, net	33,582	31,926	65,848	62,857
Senior Notes, maturing 2023 [Member]
Debt Instrument [Line Items]
Interest expense	11,626	11,626	23,252	23,239
ABL Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Interest expense	661	511	1,047	839
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Interest expense	62	64	122	142
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member]
Debt Instrument [Line Items]
Interest expense	$ 18,226	$ 17,653	$ 36,558	$ 35,053

Leases (Summary of Components o

Leases (Summary of Components of Lease Costs and Rent) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Operating lease costs:
Operating lease cost	$ 9,126		$ 18,202
Variable lease cost	694		1,299
Short-term rent expense	1,807		3,657
Total operating lease costs	11,627	$ 11,358	23,158	$ 23,890
Finance lease costs:
Amortization of right-of-use assets	389		778
Interest on lease liabilities	380		758
Total finance lease costs	$ 769		$ 1,536

Leases (Schedule of Balance She

Leases (Schedule of Balance Sheet Information Related to Finance Leases) (Details) $ in Thousands	Jun. 30, 2019USD ($)
Finance lease costs:
Current finance lease liabilities	$ 1,309
Long-term finance lease liabilities	21,472
Property and Equipment [Member]
Finance lease costs:
Finance lease ROU assets	29,358
Accumulated Depreciation and Amortization [Member]
Finance lease costs:
Accumulated amortization	6,450
Current Maturities of Long-term Debt [Member]
Finance lease costs:
Current finance lease liabilities	1,309
Long-term Debt [Member]
Finance lease costs:
Long-term finance lease liabilities	$ 21,472

Leases (Supplemental Cash Flow

Leases (Supplemental Cash Flow Information Related to Leases) (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 9,126	$ 18,232
Operating cash flows from finance leases	331	663
Financing cash flows from finance leases	309	684
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	3,358	8,626
Finance leases	$ 0	$ 79

Leases (Schedule of Weighted-Av

Leases (Schedule of Weighted-Average Lease Terms and Discount Rates Used for Operating and Finance Leases) (Details)	Jun. 30, 2019
Weighted-average remaining lease term (years):
Operating leases	4 years 10 months 24 days
Finance leases	8 years 1 month 6 days
Weighted-average discount rate:
Operating leases	10.30%
Finance leases	6.20%

Leases (Summary of Lease Liabil

Leases (Summary of Lease Liability Maturities) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Operating Lease
Remainder of 2019	$ 16,372
2020	31,314
2021	20,865
2022	13,141
2023	7,601
Thereafter	24,045
Total lease payments	113,338
Less: Imputed interest	(26,174)
Total lease obligations	87,164
Less: Lease obligations held-for-sale	(1,813)
Total lease obligations excluding held-for-sale	85,351
Less: Current portion	(23,797)	$ 0
Total Long-term lease obligations excluding held-for-sale	61,554	0
Finance Leases
Remainder of 2019	1,292
2020	2,610
2021	2,647
2022	2,344
2023	6,974
Thereafter	13,715
Total lease payments	29,582
Less: Imputed interest	(6,801)
Total lease obligations	22,781	$ 23,386
Less: Lease obligations held-for-sale	0
Total lease obligations excluding held-for-sale	22,781
Less: Current portion	(1,309)
Total Long-term lease obligations excluding held-for-sale	$ 21,472

Leases (Schedule of Future Comm

Leases (Schedule of Future Commitments Related to Non-Cancellable Operating and Capital Leases, Which Followed Lease Accounting Standard Prior to Adoption of ASC Topic 842) (Details) $ in Thousands	Dec. 31, 2018USD ($)
Operating Leases
2019	$ 34,885	[1]
2020	29,609	[1]
2021	20,098	[1]
2022	12,932	[1]
2023	7,588	[1]
Thereafter	26,469	[1]
Total minimum future payments obligations	131,581	[1]
Finance Leases
2019	2,549
2020	2,587
2021	2,625
2022	2,328
2023	6,974
Thereafter	13,716
Total minimum future payments obligations	30,779
Less: Imputed interest	(7,393)
Total capital lease obligations	23,386
Less: Current portion of capital lease obligations	(1,304)
Total long-term capital lease obligations	$ 22,082
[1]	Minimum lease payment obligations have not been reduced by minimum sublease rentals due in the future of $0.8 million

Leases (Schedule of Future Co_2

Leases (Schedule of Future Commitments Related to Non-Cancellable Operating and Capital Leases, Which Followed Lease Accounting Standard Prior to Adoption of ASC Topic 842) (Parenthetical) (Details) $ in Millions	Dec. 31, 2018USD ($)
Leases [Abstract]
Operating leases, future minimum sublease rentals due	$ 0.8

Other Long-Term Assets and Ot_3

Other Long-Term Assets and Other Long-Term Liabilities (Summary of Components of Other Long-Term Assets) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Other Assets Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term receivable	$ 23,310	$ 34,535
Assets of deferred compensation plan	15,829	14,980
Insurance reserves for workers' compensation liability, long-term receivable	11,642	12,118
Other miscellaneous long-term assets	15,173	12,673
Total other long-term assets	65,954	74,306
Insurance Reserves Indemnified By CHS [Member]
Other Assets Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term receivable	23,310	34,535
Insurance reserves for workers' compensation liability, long-term receivable	$ 11,642	$ 12,118

Other Long-Term Assets and Ot_4

Other Long-Term Assets and Other Long-Term Liabilities (Summary of Components of Other Long-Term Liabilities) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Other Liabilities Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term liability	$ 48,836	$ 82,828
Insurance reserves for workers' compensation liability, long-term liability	15,869	16,819
Benefit plan liabilities	21,661	22,712
Other miscellaneous long-term liabilities	2,879	4,140
Total other long-term liabilities	89,245	126,499
Professional and General Liability Insurance [Member]
Other Liabilities Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term liability	$ 48,836	$ 82,828

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Summary of Carrying Amounts and Estimated Fair Values of Long-Term Debt) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Total debt, excluding unamortized debt issuance costs and discounts, Carrying Amount	$ 1,243,063	$ 1,229,011
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	1,184,710	1,206,065
ABL Credit Facility, maturing 2021 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Total debt, excluding unamortized debt issuance costs and discounts, Carrying Amount	42,000	14,000
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	42,000	14,000
Senior Notes, maturing 2023 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Total debt, excluding unamortized debt issuance costs and discounts, Carrying Amount	400,000	400,000
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	349,424	382,984
Other debt [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Total debt, excluding unamortized debt issuance costs and discounts, Carrying Amount	23,377	24,260
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	23,377	24,260
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Total debt, excluding unamortized debt issuance costs and discounts, Carrying Amount	0	0
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	0	0
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Total debt, excluding unamortized debt issuance costs and discounts, Carrying Amount	777,686	790,751
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	$ 769,909	$ 784,821

Equity (Narrative) (Details)

Equity (Narrative) (Details)	6 Months Ended
	Jun. 30, 2019vote / shares$ / sharesshares	Dec. 31, 2018$ / sharesshares
Equity [Abstract]
Capital units, authorized	400,000,000
Common stock, shares authorized	300,000,000	300,000,000
Preferred stock, shares authorized	100,000,000	100,000,000
Preferred stock, par value | $ / shares	$ 0.0001	$ 0.0001
Common stock, par value | $ / shares	$ 0.0001	$ 0.0001
Preferred stock, shares outstanding	0	0
Common stock, shares issued	32,926,689	31,521,398
Common stock, shares outstanding	32,926,689	31,521,398
Common stock voting description	Holders of the Company’s common stock are entitled to one vote for each share held of record on all matters for which stockholders may vote. Holders of the Company’s common stock do not have cumulative voting rights in the election of directors.
Number of vote | vote / shares	1

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income tax rate, percent			21.00%			35.00%
Tax Cuts and Jobs Act of 2017, incomplete accounting, provisional income tax benefit						$ 24,000,000
Tax Cuts and Jobs Act of 2017, incomplete accounting, change in tax rate, deferred tax liability, income tax benefit						10,900,000
Tax Cuts and Job Acts of 2017, change in deferred Tax assets valuation allowance, income tax benefit						$ 13,100,000
Estimated interest expense in excess of deductibility limitation amount					$ 91,200,000
Effective income tax rate, continuing operations	(0.60%)	1.70%	(0.50%)	0.10%
Deferred income tax liabilities, net	$ 6,978,000		$ 6,978,000		$ 6,736,000
Increase in deferred tax liabilities			300,000
Unrecognized income tax benefit	$ 0	$ 0	$ 0	$ 0

Earnings Per Share (Summary of

Earnings Per Share (Summary of Computation of Basic and Diluted Earnings (Loss) Per Share) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Numerator:
Net income (loss)	$ (16,477)	$ (25,941)	$ (55,083)	$ (124,428)
Less: Net income (loss) attributable to noncontrolling interests	396	665	796	1,146
Net income (loss) attributable to Quorum Health Corporation	$ (16,873)	$ (26,606)	$ (55,879)	$ (125,574)
Denominator:
Weighted-average shares outstanding - basic and diluted	30,001,208	28,995,564	29,721,167	28,726,445
Earnings (loss) per share attributable to Quorum Health Corporation stockholders - basic and diluted	$ (0.56)	$ (0.92)	$ (1.88)	$ (4.37)

Earnings Per Share (Narrative)

Earnings Per Share (Narrative) (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Earnings Per Share [Abstract]
Dilutive Shares	0	0	0	0

Segments (Narrative) (Details)

Segments (Narrative) (Details)	6 Months Ended
	Jun. 30, 2019segment
Segment Reporting [Abstract]
Number of operating segments	2

Segments (Summary of Financial

Segments (Summary of Financial Information Related to the Company`s Segments) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Segment Reporting Information [Line Items]
Net operating revenues	$ 442,170	$ 472,632	$ 884,975	$ 959,452
Total Adjusted EBITDA	33,429	36,323	54,060	54,743
Total assets	1,568,226		1,568,226		$ 1,574,094
Hospital Operations Reporting Unit [Member]
Segment Reporting Information [Line Items]
Net operating revenues	426,618	453,660	852,771	920,826
Total Adjusted EBITDA	41,744	44,035	70,077	70,318
Total assets	1,458,118		1,458,118		1,453,693
Quorum Health Resources [Member]
Segment Reporting Information [Line Items]
Net operating revenues	14,974	18,620	30,031	38,208
Total Adjusted EBITDA	4,128	4,451	8,207	8,803
Total assets	53,592		53,592		55,823
All Other Operations [Member]
Segment Reporting Information [Line Items]
Net operating revenues	578	352	2,173	418
Total Adjusted EBITDA	(12,443)	$ (12,163)	(24,224)	$ (24,378)
Total assets	$ 56,516		$ 56,516		$ 64,578

Segments (Summary of Reconcilia

Segments (Summary of Reconciliation of Adjusted EBITDA to Net Income (Loss)) (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2019	Jun. 30, 2018
Segment Reporting [Abstract]
Net income (loss)	$ (16,477)		$ (25,941)		$ (55,083)	$ (124,428)
Interest expense, net	33,582		31,926		65,848	62,857
Provision for (benefit from) income taxes	94		(454)		249	(88)
Depreciation and amortization	14,500		17,142		29,139	35,403
EBITDA	31,699		22,673		40,153	(26,256)
Legal, professional and settlement costs	604		5,417		1,289	8,830
Impairment of long-lived assets and goodwill	25,950	$ 8,900	0	$ 39,800	34,810	39,760
Loss (gain) on sale of hospitals, net	1,140		307		1,140	8,122
Loss on closure of hospitals, net	0		3,338		0	17,084
Transition of transition services agreements	834		520		1,976	1,237
Change in actuarial estimates	(26,880)		0		(26,880)	0
Headcount reductions and executive severance	82		4,068		1,572	5,966
Total Adjusted EBITDA	$ 33,429		$ 36,323		$ 54,060	$ 54,743

Stock-Based Compensation (Narra

Stock-Based Compensation (Narrative) (Details) - USD ($) $ in Millions	Feb. 14, 2019	Jun. 30, 2019	Dec. 18, 2018	Apr. 29, 2016
Restricted Stock [Member] | Performance based awards [Member] | Executive Officer [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Restricted stock units, shares granted		125,000
Share-based compensation, vesting description		lapse on February 14, 2021
Restricted Stock [Member] | Time Based Vesting Lapse in Equal Installments on Each of First Three Anniversaries [Member] | Executive Officers and Other Employees [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Restricted stock units, shares granted		1,260,000
Share-based compensation, vesting description		lapse in equal installments on each of the first three anniversaries of February 14, 2019
Share-based compensation, vesting period		3 years
Restricted Stock [Member] | Time based awards [Member] | Non-Employee Director [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Restricted stock units, shares granted		304,346
Share-based compensation, vesting description		lapse on February 14, 2020
QHC and CHS Restricted Stock Awards Held By QHC Employees as of Spin-off Date [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized stock-based compensation expense		$ 7.6
2016 Stock Award Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock that may be issued under stock award plan				4,700,000
Additional common stock that may be issued under stock award plan	3,700,000
2018 Stock Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock that may be issued under stock award plan			625,000

Stock-Based Compensation (Summa

Stock-Based Compensation (Summary of Activity Related to Unvested Restricted Stock Awards) (Details)	6 Months Ended
	Jun. 30, 2019$ / sharesshares
QHC Awards Distributed in Spin-off [Member] | QHC and CHS Employees [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unvested restricted stock awards at beginning of period, Shares	80,350
Vested, Shares	(61,150)
Forfeited, Shares	(19,200)
Unvested restricted stock awards at end of period, Shares	0
QHC Restricted Stock Awards Granted Following Spin-off [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unvested restricted stock awards at beginning of period, Shares	2,207,117
Granted, Shares	1,689,346
Vested, Shares	(842,377)
Forfeited, Shares	(264,855)
Unvested restricted stock awards at end of period, Shares	2,789,231
Unvested restricted stock awards at beginning of period, Weighted Average Grant Date Fair Value Per Share | $ / shares	$ 7.04
Granted, Weighted Average Grant Date Fair Value Per Share | $ / shares	1.76
Vested, Weighted Average Grant Date Fair Value Per Share | $ / shares	7.79
Forfeited, Weighted Average Grant Date Fair Value Per Share | $ / shares	8.67
Unvested restricted stock awards at end of period, Weighted Average Grant Date Fair Value Per Share | $ / shares	$ 3.46

Stock-Based Compensation (Sum_2

Stock-Based Compensation (Summary of Stock-Based Compensation Expense for Periods Subsequent to Spin-Off) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 1,194	$ 2,756	$ 2,964	$ 5,220
Resulting from Spin-off [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	0	2	0	372
Related to Grants Following Spin-off [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 1,194	$ 2,754	$ 2,964	$ 4,848

Benefit Plans (Narrative) (Deta

Benefit Plans (Narrative) (Details)	Sep. 16, 2016Installmentshares	Aug. 18, 2016	Apr. 29, 2016USD ($)	Jun. 30, 2019USD ($)Hospital	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)	Dec. 31, 2018USD ($)
Defined Benefit Plan Disclosure [Line Items]
Defined contribution plan, total expense				$ 300,000	$ 4,200,000	$ 800,000	$ 4,300,000
Pension Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Defined benefit plan net periodic benefit cost				$ 100,000	100,000	100,000	100,000
Number of hospitals | Hospital				1
Accrued benefit obligation liability				$ 1,100,000		1,100,000		$ 1,200,000
Original SERP Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Accrued benefit liability			$ 6,000,000
Defined benefit plan, assets transferred			0
Additional defined benefit plan obligation			$ 0
Amended and Restated SERP [Member]
Defined Benefit Plan Disclosure [Line Items]
Current portion of benefit liability				0		0		0
Amended and Restated SERP [Member] | Salaries and Benefits Expenses [Member]
Defined Benefit Plan Disclosure [Line Items]
Defined benefit plan net periodic benefit cost				200,000	$ 100,000	500,000	$ 500,000
Maximum [Member] | Director's Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Number of annual installments | Installment	15
Common stock shares available for issuance | shares	150,000
Other long-term liabilities [Member] | Amended and Restated SERP [Member]
Defined Benefit Plan Disclosure [Line Items]
Accrued benefit liability				3,500,000		3,500,000		3,100,000
QHCCS, LLC Nonqualified Deferred Compensation Plan [Member] | Maximum [Member]
Defined Benefit Plan Disclosure [Line Items]
Percentage of incentive compensation participants are permitted to defer		100.00%
QHCCS, LLC Nonqualified Deferred Compensation Plan [Member] | Other long-term liabilities [Member]
Defined Benefit Plan Disclosure [Line Items]
Accrued benefit liability				17,100,000		17,100,000		16,200,000
QHCCS, LLC Nonqualified Deferred Compensation Plan [Member] | Other long-term Assets [Member]
Defined Benefit Plan Disclosure [Line Items]
Long-term portion of benefit asset				$ 15,800,000		$ 15,800,000		$ 15,000,000

Related Party Transactions (Nar

Related Party Transactions (Narrative) (Details) - Community Health Systems, Inc [Member] - USD ($) $ in Millions	Apr. 29, 2016	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Related Party Transaction [Line Items]
Total expenses incurred		$ 7.2	$ 14.1	$ 15	$ 29.2
Transition Services Agreements [Member]
Related Party Transaction [Line Items]
Terms of transitional service agreements	Apr. 30, 2021

Commitments and Contingencies_2

Commitments and Contingencies (Narrative) (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Agreement with MEDHOST Inc. [Member]
Other Commitments [Line Items]
Commitments beginning in 2019 and continuing through 2024	$ 39,000,000		$ 39,000,000
McKenzie Willamette Medical Center Project [Member] | Asset Under Construction [Member] | Construction and Capital Commitments [Member]
Other Commitments [Line Items]
Construction costs incurred	300,000	$ 4,600,000	2,400,000	$ 10,800,000
Cumulative project cost	103,200,000		103,200,000
Project placed into service			103,000,000
Total estimated costs of project, including equipment costs	105,000,000		105,000,000
Anticipated remaining costs on project in 2019	1,800,000		1,800,000
Professional and General Liability Insurance [Member]
Other Commitments [Line Items]
Self-insured retention level	5,000,000		5,000,000
Reduction in professional and general liability reserves			26,900,000
Professional and General Liability Insurance [Member] | Quorum Health Resources [Member]
Other Commitments [Line Items]
Self-insured retention level	6,000,000		6,000,000
Worker's Compensation Liability [Member]
Other Commitments [Line Items]
Self-insured retention level	500,000		500,000
Maximum [Member]
Other Commitments [Line Items]
Penalty per false claim violation and attorneys' fees	$ 22,927		$ 22,927

Commitments and Contingencies_3

Commitments and Contingencies (Summary of Insurance Reserves Related to Professional and General Liability and Workers Compensation Liability) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Loss Contingencies [Line Items]
Insurance reserves for professional and general liability, current receivable	$ 11,994	$ 20,200
Insurance reserves for workers' compensation liability, current receivable	1,084	1,412
Total self-insurance reserves, current receivable	13,078	21,612
Insurance reserves for professional and general liability, long-term receivable	23,310	34,535
Insurance reserves for workers' compensation liability, long-term receivable	11,642	12,118
Total self-insurance reserves, long-term receivable	34,952	46,653
Insurance reserves for professional and general liability, current liability	16,783	25,395
Insurance reserves for workers' compensation liability, current liability	2,901	3,937
Total self-insurance reserves, current liability	19,684	29,332
Insurance reserves for professional and general liability, long-term liability	48,836	82,828
Insurance reserves for workers' compensation liability, long-term liability	15,869	16,819
Total self-insurance reserves, long-term liability	64,705	99,647
Insurance Reserves Indemnified By CHS, Inc. [Member]
Loss Contingencies [Line Items]
Insurance reserves for professional and general liability, current receivable	11,994	20,200
Insurance reserves for workers' compensation liability, current receivable	1,084	1,412
Insurance reserves for professional and general liability, long-term receivable	23,310	34,535
Insurance reserves for workers' compensation liability, long-term receivable	11,642	12,118
Insurance reserves for professional and general liability, current liability	11,994	20,200
Insurance reserves for workers' compensation liability, current liability	1,084	1,412
Insurance reserves for professional and general liability, long-term liability	23,310	34,535
Insurance reserves for workers' compensation liability, long-term liability	11,642	12,118
All Other Self-insurance Reserves [Member]
Loss Contingencies [Line Items]
Insurance reserves for professional and general liability, current receivable	0	0
Insurance reserves for workers' compensation liability, current receivable	0	0
Insurance reserves for professional and general liability, long-term receivable	0	0
Insurance reserves for workers' compensation liability, long-term receivable	0	0
Insurance reserves for professional and general liability, current liability	4,789	5,195
Insurance reserves for workers' compensation liability, current liability	1,817	2,525
Insurance reserves for professional and general liability, long-term liability	25,526	48,293
Insurance reserves for workers' compensation liability, long-term liability	$ 4,227	$ 4,701

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - Watsonville Community Hospital [Member] - California [Member]	Jun. 07, 2019bed
Subsequent Event [Line Items]
Announcement date of plan to dispose	Jun. 7, 2019
Number of beds in hospital sold	106

Guarantor and Non-Guarantor S_3

Guarantor and Non-Guarantor Supplemental Information (Narrative) (Details)	6 Months Ended
	Jun. 30, 2019
Condensed Financial Information Of Parent Company Only Disclosure [Abstract]
Percentage of owned domestic subsidiaries which guaranteed senior notes	100.00%

Guarantor and Non-Guarantor S_4

Guarantor and Non-Guarantor Supplemental Information (Schedule of Condensed Consolidating Statement of Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2019	Jun. 30, 2018
Condensed Income Statements Captions [Line Items]
Net operating revenues	$ 442,170		$ 472,632		$ 884,975	$ 959,452
Operating costs and expenses:
Salaries and benefits	213,411		232,631		438,486	479,631
Supplies	50,202		52,897		101,587	111,783
Other operating expenses	106,954		144,456		243,743	297,194
Depreciation and amortization	14,500		17,142		29,139	35,403
Lease costs and rent	11,627		11,358		23,158	23,890
Electronic health records incentives	583		(445)		609	(586)
Legal, professional and settlement costs	604		5,417		1,289	8,830
Impairment of long-lived assets and goodwill	25,950	$ 8,900	0	$ 39,800	34,810	39,760
Loss (gain) on sale of hospitals, net	1,140		307		1,140	8,122
Loss on closure of hospitals, net	0		3,338		0	17,084
Total operating costs and expenses	424,971		467,101		873,961	1,021,111
Income (loss) from operations	17,199		5,531		11,014	(61,659)
Interest expense, net	33,582		31,926		65,848	62,857
Equity in earnings of affiliates	0		0		0	0
Income (loss) before income taxes	(16,383)		(26,395)		(54,834)	(124,516)
Provision for (benefit from) income taxes	94		(454)		249	(88)
Net income (loss)	(16,477)		(25,941)		(55,083)	(124,428)
Less: Net income (loss) attributable to noncontrolling interests	396		665		796	1,146
Net income (loss) attributable to Quorum Health Corporation	(16,873)		(26,606)		(55,879)	(125,574)
Reportable Legal Entities [Member] | Parent Issuer [Member]
Condensed Income Statements Captions [Line Items]
Net operating revenues	0		0		0	0
Operating costs and expenses:
Salaries and benefits	0		0		0	0
Supplies	0		0		0	0
Other operating expenses	3		27		16	1,897
Depreciation and amortization	0		0		0	0
Lease costs and rent	0		0		0	0
Electronic health records incentives	0		0		0	0
Legal, professional and settlement costs	0		0		0	0
Impairment of long-lived assets and goodwill	0		0		0	0
Loss (gain) on sale of hospitals, net	0		0		0	0
Loss on closure of hospitals, net			0			0
Total operating costs and expenses	3		27		16	1,897
Income (loss) from operations	(3)		(27)		(16)	(1,897)
Interest expense, net	33,084		32,934		65,664	64,408
Equity in earnings of affiliates	(16,195)		(5,934)		(9,964)	58,917
Income (loss) before income taxes	(16,892)		(27,027)		(55,716)	(125,222)
Provision for (benefit from) income taxes	(19)		(421)		163	352
Net income (loss)	(16,873)		(26,606)		(55,879)	(125,574)
Less: Net income (loss) attributable to noncontrolling interests	0		0		0	0
Net income (loss) attributable to Quorum Health Corporation	(16,873)		(26,606)		(55,879)	(125,574)
Reportable Legal Entities [Member] | Other Guarantors [Member]
Condensed Income Statements Captions [Line Items]
Net operating revenues	336,512		362,258		674,447	734,795
Operating costs and expenses:
Salaries and benefits	143,881		160,448		297,983	330,181
Supplies	33,939		36,841		70,288	79,441
Other operating expenses	89,839		116,930		200,764	239,096
Depreciation and amortization	11,179		13,820		22,535	28,525
Lease costs and rent	6,762		6,567		13,390	13,884
Electronic health records incentives	590		(381)		599	(430)
Legal, professional and settlement costs	530		5,417		1,214	8,830
Impairment of long-lived assets and goodwill	25,950		0		34,810	37,960
Loss (gain) on sale of hospitals, net	1,145		313		1,145	8,128
Loss on closure of hospitals, net			3,338			17,084
Total operating costs and expenses	313,815		343,293		642,728	762,699
Income (loss) from operations	22,697		18,965		31,719	(27,904)
Interest expense, net	488		(1,026)		259	(1,548)
Equity in earnings of affiliates	(3,411)		(3,022)		(3,085)	40,831
Income (loss) before income taxes	25,620		23,013		34,545	(67,187)
Provision for (benefit from) income taxes	147		(84)		183	(420)
Net income (loss)	25,473		23,097		34,362	(66,767)
Less: Net income (loss) attributable to noncontrolling interests	0		0		0	0
Net income (loss) attributable to Quorum Health Corporation	25,473		23,097		34,362	(66,767)
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Condensed Income Statements Captions [Line Items]
Net operating revenues	105,658		110,374		210,528	224,657
Operating costs and expenses:
Salaries and benefits	69,530		72,183		140,503	149,450
Supplies	16,263		16,056		31,299	32,342
Other operating expenses	17,112		27,499		42,963	56,201
Depreciation and amortization	3,321		3,322		6,604	6,878
Lease costs and rent	4,865		4,791		9,768	10,006
Electronic health records incentives	(7)		(64)		10	(156)
Legal, professional and settlement costs	74		0		75	0
Impairment of long-lived assets and goodwill	0		0		0	1,800
Loss (gain) on sale of hospitals, net	(5)		(6)		(5)	(6)
Loss on closure of hospitals, net			0			0
Total operating costs and expenses	111,153		123,781		231,217	256,515
Income (loss) from operations	(5,495)		(13,407)		(20,689)	(31,858)
Interest expense, net	10		18		(75)	(3)
Equity in earnings of affiliates	0		0		0	0
Income (loss) before income taxes	(5,505)		(13,425)		(20,614)	(31,855)
Provision for (benefit from) income taxes	(34)		51		(97)	(20)
Net income (loss)	(5,471)		(13,476)		(20,517)	(31,835)
Less: Net income (loss) attributable to noncontrolling interests	396		665		796	1,146
Net income (loss) attributable to Quorum Health Corporation	(5,867)		(14,141)		(21,313)	(32,981)
Eliminations [Member]
Condensed Income Statements Captions [Line Items]
Net operating revenues	0		0		0	0
Operating costs and expenses:
Salaries and benefits	0		0		0	0
Supplies	0		0		0	0
Other operating expenses	0		0		0	0
Depreciation and amortization	0		0		0	0
Lease costs and rent	0		0		0	0
Electronic health records incentives	0		0		0	0
Legal, professional and settlement costs	0		0		0	0
Impairment of long-lived assets and goodwill	0		0		0	0
Loss (gain) on sale of hospitals, net	0		0		0	0
Loss on closure of hospitals, net			0			0
Total operating costs and expenses	0		0		0	0
Income (loss) from operations	0		0		0	0
Interest expense, net	0		0		0	0
Equity in earnings of affiliates	19,606		8,956		13,049	(99,748)
Income (loss) before income taxes	(19,606)		(8,956)		(13,049)	99,748
Provision for (benefit from) income taxes	0		0		0	0
Net income (loss)	(19,606)		(8,956)		(13,049)	99,748
Less: Net income (loss) attributable to noncontrolling interests	0		0		0	0
Net income (loss) attributable to Quorum Health Corporation	$ (19,606)		$ (8,956)		$ (13,049)	$ 99,748

Guarantor and Non-Guarantor S_5

Guarantor and Non-Guarantor Supplemental Information (Schedule of Condensed Consolidating Statement of Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	$ (16,477)	$ (25,941)	$ (55,083)	$ (124,428)
Amortization and recognition of unrecognized pension cost components, net of income taxes	48	(189)	97	(75)
Comprehensive income (loss)	(16,429)	(26,130)	(54,986)	(124,503)
Less: Comprehensive income (loss) attributable to noncontrolling interests	396	665	796	1,146
Comprehensive income (loss) attributable to Quorum Health Corporation	(16,825)	(26,795)	(55,782)	(125,649)
Reportable Legal Entities [Member] | Parent Issuer [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	(16,873)	(26,606)	(55,879)	(125,574)
Amortization and recognition of unrecognized pension cost components, net of income taxes	48	(189)	97	(75)
Comprehensive income (loss)	(16,825)	(26,795)	(55,782)	(125,649)
Less: Comprehensive income (loss) attributable to noncontrolling interests	0	0	0	0
Comprehensive income (loss) attributable to Quorum Health Corporation	(16,825)	(26,795)	(55,782)	(125,649)
Reportable Legal Entities [Member] | Other Guarantors [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	25,473	23,097	34,362	(66,767)
Amortization and recognition of unrecognized pension cost components, net of income taxes	48	(189)	97	(75)
Comprehensive income (loss)	25,521	22,908	34,459	(66,842)
Less: Comprehensive income (loss) attributable to noncontrolling interests	0	0	0	0
Comprehensive income (loss) attributable to Quorum Health Corporation	25,521	22,908	34,459	(66,842)
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	(5,471)	(13,476)	(20,517)	(31,835)
Amortization and recognition of unrecognized pension cost components, net of income taxes	0	0	0	0
Comprehensive income (loss)	(5,471)	(13,476)	(20,517)	(31,835)
Less: Comprehensive income (loss) attributable to noncontrolling interests	396	665	796	1,146
Comprehensive income (loss) attributable to Quorum Health Corporation	(5,867)	(14,141)	(21,313)	(32,981)
Eliminations [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	(19,606)	(8,956)	(13,049)	99,748
Amortization and recognition of unrecognized pension cost components, net of income taxes	(48)	189	(97)	75
Comprehensive income (loss)	(19,654)	(8,767)	(13,146)	99,823
Less: Comprehensive income (loss) attributable to noncontrolling interests	0	0	0	0
Comprehensive income (loss) attributable to Quorum Health Corporation	$ (19,654)	$ (8,767)	$ (13,146)	$ 99,823

Guarantor and Non-Guarantor S_6

Guarantor and Non-Guarantor Supplemental Information (Schedule of Condensed Consolidating Balance Sheet) (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 2,265		$ 3,203
Patient accounts receivable	270,923		322,608
Inventories	41,447		45,646
Prepaid expenses	21,653		19,683
Due from third-party payors	57,071		63,443
Current assets of hospitals held for sale	35,380		0
Other current assets	33,604		36,405
Total current assets	462,343		490,988
Intercompany receivable	0		0
Property and equipment, net	496,555		559,438
Goodwill	391,658		401,073
Intangible assets, net	41,066		48,289
Operating lease right-of-use assets	84,854		0
Long-term assets of hospitals held for sale	25,796		0
Other long-term assets	65,954		74,306
Net investment in subsidiaries	0		0
Total assets	1,568,226		1,574,094
Current liabilities:
Current maturities of long-term debt	1,646		1,697
Current portion of operating lease liabilities	23,797		0
Accounts payable	140,768		143,917
Accrued liabilities:
Accrued salaries and benefits	61,006		76,908
Accrued interest	10,517		10,024
Due to third-party payors	37,218		45,852
Current liabilities of hospitals held for sale	10,675		0
Other current liabilities	38,573		43,336
Total current liabilities	324,200		321,734
Long-term debt	1,210,523		1,191,777
Long-term operating lease liabilities	61,554		0
Intercompany payable	0		0
Deferred income tax liabilities, net	6,978		6,736
Long-term liabilities of hospitals held for sale	3,248		0
Other long-term liabilities	89,245		126,499
Total liabilities	1,695,748		1,646,746
Redeemable noncontrolling interests	2,278	$ 2,278	2,278	$ 2,301	$ 2,316	$ 2,325
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock	0		0
Common stock	3		3
Additional paid-in capital	559,487		557,309
Accumulated other comprehensive income (loss)	856		759
Accumulated deficit	(705,071)		(648,464)
Total Quorum Health Corporation stockholders' equity (deficit)	(144,725)		(90,393)
Nonredeemable noncontrolling interests	14,925		15,463
Total equity (deficit)	(129,800)	$ (114,129)	(74,930)	$ (8,595)	$ 16,073	$ 113,410
Total liabilities and equity	1,568,226		1,574,094
Reportable Legal Entities [Member] | Parent Issuer [Member]
Current assets:
Cash and cash equivalents	1,240		1,209
Patient accounts receivable	0		0
Inventories	0		0
Prepaid expenses	0		33
Due from third-party payors	0		0
Current assets of hospitals held for sale	0
Other current assets	247		314
Total current assets	1,487		1,556
Intercompany receivable	3		3
Property and equipment, net	0		0
Goodwill	0		0
Intangible assets, net	0		0
Operating lease right-of-use assets	0
Long-term assets of hospitals held for sale	0
Other long-term assets	0		0
Net investment in subsidiaries	1,440,271		1,428,675
Total assets	1,441,761		1,430,234
Current liabilities:
Current maturities of long-term debt	0		0
Current portion of operating lease liabilities	0
Accounts payable	56		121
Accrued liabilities:
Accrued salaries and benefits	0		0
Accrued interest	10,517		10,024
Due to third-party payors	0		0
Current liabilities of hospitals held for sale	0
Other current liabilities	0		248
Total current liabilities	10,573		10,393
Long-term debt	1,188,792		1,169,214
Long-term operating lease liabilities	0
Intercompany payable	380,143		334,284
Deferred income tax liabilities, net	6,978		6,736
Long-term liabilities of hospitals held for sale	0
Other long-term liabilities	0		0
Total liabilities	1,586,486		1,520,627
Redeemable noncontrolling interests	0		0
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock	0		0
Common stock	3		3
Additional paid-in capital	559,487		557,309
Accumulated other comprehensive income (loss)	856		759
Accumulated deficit	(705,071)		(648,464)
Total Quorum Health Corporation stockholders' equity (deficit)	(144,725)		(90,393)
Nonredeemable noncontrolling interests	0		0
Total equity (deficit)	(144,725)		(90,393)
Total liabilities and equity	1,441,761		1,430,234
Reportable Legal Entities [Member] | Other Guarantors [Member]
Current assets:
Cash and cash equivalents	729		1,457
Patient accounts receivable	186,644		260,339
Inventories	32,566		36,349
Prepaid expenses	16,400		15,269
Due from third-party payors	53,009		57,049
Current assets of hospitals held for sale	35,380
Other current assets	23,280		23,714
Total current assets	348,008		394,177
Intercompany receivable	766,108		661,887
Property and equipment, net	356,467		419,292
Goodwill	225,628		235,418
Intangible assets, net	36,288		43,575
Operating lease right-of-use assets	49,396
Long-term assets of hospitals held for sale	25,796
Other long-term assets	50,150		57,047
Net investment in subsidiaries	0		0
Total assets	1,857,841		1,811,396
Current liabilities:
Current maturities of long-term debt	1,499		1,557
Current portion of operating lease liabilities	15,694
Accounts payable	120,049		122,999
Accrued liabilities:
Accrued salaries and benefits	41,264		55,780
Accrued interest	0		0
Due to third-party payors	30,968		38,560
Current liabilities of hospitals held for sale	10,675
Other current liabilities	26,755		28,713
Total current liabilities	246,904		247,609
Long-term debt	21,586		22,370
Long-term operating lease liabilities	33,672
Intercompany payable	333,743		303,063
Deferred income tax liabilities, net	0		0
Long-term liabilities of hospitals held for sale	3,248
Other long-term liabilities	183,318		212,240
Total liabilities	822,471		785,282
Redeemable noncontrolling interests	0		0
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock	0		0
Common stock	0		0
Additional paid-in capital	1,134,816		1,183,608
Accumulated other comprehensive income (loss)	856		759
Accumulated deficit	(100,302)		(158,253)
Total Quorum Health Corporation stockholders' equity (deficit)	1,035,370		1,026,114
Nonredeemable noncontrolling interests	0		0
Total equity (deficit)	1,035,370		1,026,114
Total liabilities and equity	1,857,841		1,811,396
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	296		537
Patient accounts receivable	84,279		62,269
Inventories	8,881		9,297
Prepaid expenses	5,253		4,381
Due from third-party payors	4,062		6,394
Current assets of hospitals held for sale	0
Other current assets	10,077		12,377
Total current assets	112,848		95,255
Intercompany receivable	333,740		303,059
Property and equipment, net	140,088		140,146
Goodwill	166,030		165,655
Intangible assets, net	4,778		4,714
Operating lease right-of-use assets	35,458
Long-term assets of hospitals held for sale	0
Other long-term assets	15,804		17,259
Net investment in subsidiaries	0		0
Total assets	808,746		726,088
Current liabilities:
Current maturities of long-term debt	147		140
Current portion of operating lease liabilities	8,103
Accounts payable	20,663		20,797
Accrued liabilities:
Accrued salaries and benefits	19,742		21,128
Accrued interest	0		0
Due to third-party payors	6,250		7,292
Current liabilities of hospitals held for sale	0
Other current liabilities	11,818		14,375
Total current liabilities	66,723		63,732
Long-term debt	145		193
Long-term operating lease liabilities	27,882
Intercompany payable	385,965		327,602
Deferred income tax liabilities, net	0		0
Long-term liabilities of hospitals held for sale	0
Other long-term liabilities	21,689		33,106
Total liabilities	502,404		424,633
Redeemable noncontrolling interests	2,278		2,278
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock	0		0
Common stock	0		0
Additional paid-in capital	631,879		580,824
Accumulated other comprehensive income (loss)	0		0
Accumulated deficit	(342,740)		(297,110)
Total Quorum Health Corporation stockholders' equity (deficit)	289,139		283,714
Nonredeemable noncontrolling interests	14,925		15,463
Total equity (deficit)	304,064		299,177
Total liabilities and equity	808,746		726,088
Eliminations [Member]
Current assets:
Cash and cash equivalents	0		0
Patient accounts receivable	0		0
Inventories	0		0
Prepaid expenses	0		0
Due from third-party payors	0		0
Current assets of hospitals held for sale	0
Other current assets	0		0
Total current assets	0		0
Intercompany receivable	(1,099,851)		(964,949)
Property and equipment, net	0		0
Goodwill	0		0
Intangible assets, net	0		0
Operating lease right-of-use assets	0
Long-term assets of hospitals held for sale	0
Other long-term assets	0		0
Net investment in subsidiaries	(1,440,271)		(1,428,675)
Total assets	(2,540,122)		(2,393,624)
Current liabilities:
Current maturities of long-term debt	0		0
Current portion of operating lease liabilities	0
Accounts payable	0		0
Accrued liabilities:
Accrued salaries and benefits	0		0
Accrued interest	0		0
Due to third-party payors	0		0
Current liabilities of hospitals held for sale	0
Other current liabilities	0		0
Total current liabilities	0		0
Long-term debt	0		0
Long-term operating lease liabilities	0
Intercompany payable	(1,099,851)		(964,949)
Deferred income tax liabilities, net	0		0
Long-term liabilities of hospitals held for sale	0
Other long-term liabilities	(115,762)		(118,847)
Total liabilities	(1,215,613)		(1,083,796)
Redeemable noncontrolling interests	0		0
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock	0		0
Common stock	0		0
Additional paid-in capital	(1,766,695)		(1,764,432)
Accumulated other comprehensive income (loss)	(856)		(759)
Accumulated deficit	443,042		455,363
Total Quorum Health Corporation stockholders' equity (deficit)	(1,324,509)		(1,309,828)
Nonredeemable noncontrolling interests	0		0
Total equity (deficit)	(1,324,509)		(1,309,828)
Total liabilities and equity	$ (2,540,122)		$ (2,393,624)

Guarantor and Non-Guarantor S_7

Guarantor and Non-Guarantor Supplemental Information (Schedule of Condensed Consolidating Statement of Cash Flows (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities	$ (10,394)	$ 17,194	$ (2,316)	$ 14,601
Cash flows from investing activities:
Capital expenditures for property and equipment	(9,819)	(10,791)	(18,111)	(25,319)
Capital expenditures for software	(2,326)	(531)	(3,517)	(1,044)
Acquisitions, net of cash acquired	0	(26)	(455)	(58)
Proceeds from the sale of hospitals	11,741	507	11,741	39,170
Other investing activities, net	(2,112)	52	(383)	249
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) investing activities	(2,516)	(10,789)	(10,725)	12,998
Cash flows from financing activities:
Borrowings under revolving credit facilities	175,000	115,000	327,000	247,000
Repayments under revolving credit facilities	(149,000)	(119,000)	(299,000)	(233,000)
Borrowings of long-term debt	25	55	186	67
Repayments of long-term debt	(12,130)	(30,820)	(13,963)	(31,447)
Payments of debt issuance costs	0	0	0	(2,268)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(103)	(1,309)	(564)	(1,943)
Cash distributions to noncontrolling investors	(333)	0	(1,556)	(803)
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) financing activities	13,459	(36,074)	12,103	(22,394)
Net change in cash, cash equivalents and restricted cash	549	(29,669)	(938)	5,205
Cash, cash equivalents and restricted cash at beginning of period	1,716	40,491	3,203	5,617
Cash, cash equivalents and restricted cash at end of period	2,265	10,822	2,265	10,822
Reportable Legal Entities [Member] | Parent Issuer [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			(60,677)	(62,144)
Cash flows from investing activities:
Capital expenditures for property and equipment			0	0
Capital expenditures for software			0	0
Acquisitions, net of cash acquired			0	0
Proceeds from the sale of hospitals			0	0
Other investing activities, net			0	0
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) investing activities			0	0
Cash flows from financing activities:
Borrowings under revolving credit facilities			327,000	247,000
Repayments under revolving credit facilities			(299,000)	(233,000)
Borrowings of long-term debt			0	0
Repayments of long-term debt			(13,066)	(30,463)
Payments of debt issuance costs				(2,268)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			0	0
Cash distributions to noncontrolling investors			0	0
Changes in intercompany balances with affiliates, net			45,774	81,279
Net cash provided by (used in) financing activities			60,708	62,548
Net change in cash, cash equivalents and restricted cash			31	404
Cash, cash equivalents and restricted cash at beginning of period			1,209	1,051
Cash, cash equivalents and restricted cash at end of period	1,240	1,455	1,240	1,455
Reportable Legal Entities [Member] | Other Guarantors [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			99,615	75,865
Cash flows from investing activities:
Capital expenditures for property and equipment			(12,486)	(16,707)
Capital expenditures for software			(3,017)	(957)
Acquisitions, net of cash acquired			0	0
Proceeds from the sale of hospitals			11,741	38,612
Other investing activities, net			1,708	262
Changes in intercompany balances with affiliates, net			(97,055)	(97,540)
Net cash provided by (used in) investing activities			(99,109)	(76,330)
Cash flows from financing activities:
Borrowings under revolving credit facilities			0	0
Repayments under revolving credit facilities			0	0
Borrowings of long-term debt			161	12
Repayments of long-term debt			(831)	(868)
Payments of debt issuance costs				0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			(564)	(1,943)
Cash distributions to noncontrolling investors			0	0
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) financing activities			(1,234)	(2,799)
Net change in cash, cash equivalents and restricted cash			(728)	(3,264)
Cash, cash equivalents and restricted cash at beginning of period			1,457	4,222
Cash, cash equivalents and restricted cash at end of period	729	958	729	958
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			(41,254)	880
Cash flows from investing activities:
Capital expenditures for property and equipment			(5,625)	(8,612)
Capital expenditures for software			(500)	(87)
Acquisitions, net of cash acquired			(455)	(58)
Proceeds from the sale of hospitals			0	558
Other investing activities, net			(2,091)	(13)
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) investing activities			(8,671)	(8,212)
Cash flows from financing activities:
Borrowings under revolving credit facilities			0	0
Repayments under revolving credit facilities			0	0
Borrowings of long-term debt			25	55
Repayments of long-term debt			(66)	(116)
Payments of debt issuance costs				0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			0	0
Cash distributions to noncontrolling investors			(1,556)	(803)
Changes in intercompany balances with affiliates, net			51,281	16,261
Net cash provided by (used in) financing activities			49,684	15,397
Net change in cash, cash equivalents and restricted cash			(241)	8,065
Cash, cash equivalents and restricted cash at beginning of period			537	344
Cash, cash equivalents and restricted cash at end of period	296	8,409	296	8,409
Eliminations [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			0	0
Cash flows from investing activities:
Capital expenditures for property and equipment			0	0
Capital expenditures for software			0	0
Acquisitions, net of cash acquired			0	0
Proceeds from the sale of hospitals			0	0
Other investing activities, net			0	0
Changes in intercompany balances with affiliates, net			97,055	97,540
Net cash provided by (used in) investing activities			97,055	97,540
Cash flows from financing activities:
Borrowings under revolving credit facilities			0	0
Repayments under revolving credit facilities			0	0
Borrowings of long-term debt			0	0
Repayments of long-term debt			0	0
Payments of debt issuance costs				0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			0	0
Cash distributions to noncontrolling investors			0	0
Changes in intercompany balances with affiliates, net			(97,055)	(97,540)
Net cash provided by (used in) financing activities			(97,055)	(97,540)
Net change in cash, cash equivalents and restricted cash			0	0
Cash, cash equivalents and restricted cash at beginning of period			0	0
Cash, cash equivalents and restricted cash at end of period	$ 0	$ 0	$ 0	$ 0