Quorum Health (QHCCQ) 10-Q 7 Nov 19 2019 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Nov. 06, 2019
Cover [Abstract]
Entity Registrant Name	QUORUM HEALTH CORPORATION
Entity Central Index Key	0001650445
Document Type	10-Q
Document Period End Date	Sep. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Security Exchange Name	NYSE
Trading Symbol	QHC
Amendment Flag	false
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		32,916,020
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity File Number	001-37550
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	47-4725208
Entity Address, Address Line One	1573 Mallory Lane Brentwood
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37027
City Area Code	615
Local Phone Number	221-1400
Document Quarterly Report	true
Document Transition Report	false

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Net operating revenues	$ 419,900	$ 460,507	$ 1,304,875	$ 1,419,959
Operating costs and expenses:
Salaries and benefits	215,457	226,237	653,943	705,868
Supplies	47,818	48,949	149,405	160,732
Other operating expenses	139,671	143,716	383,414	440,910
Depreciation and amortization	15,028	16,612	44,167	52,015
Lease costs and rent	11,121	11,661	34,279	35,551
Electronic health records incentives	(17)	(31)	592	(617)
Legal, professional and settlement costs	5,191	1,519	6,480	10,349
Impairment of long-lived assets and goodwill	8,010	32,438	42,820	72,198
Loss (gain) on sale of hospitals, net	1,206	805	2,346	8,927
Loss on closure of hospitals, net	18,414	1,111	18,414	18,195
Total operating costs and expenses	461,899	483,017	1,335,860	1,504,128
Income (loss) from operations	(41,999)	(22,510)	(30,985)	(84,169)
Interest expense, net	33,056	32,450	98,904	95,307
Income (loss) before income taxes	(75,055)	(54,960)	(129,889)	(179,476)
Provision for (benefit from) income taxes	137	(1,074)	386	(1,162)
Net income (loss)	(75,192)	(53,886)	(130,275)	(178,314)
Less: Net income (loss) attributable to noncontrolling interests	736	54	1,532	1,200
Net income (loss) attributable to Quorum Health Corporation	$ (75,928)	$ (53,940)	$ (131,807)	$ (179,514)
Earnings (loss) per share attributable to Quorum Health Corporation stockholders:
Basic and diluted	$ (2.52)	$ (1.85)	$ (4.41)	$ (6.21)
Weighted-average shares outstanding:
Basic and diluted	30,178,229	29,215,823	29,875,196	28,891,363

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss)	$ (75,192)	$ (53,886)	$ (130,275)	$ (178,314)
Amortization and recognition of unrecognized pension cost components, net of income taxes	49	114	146	39
Comprehensive income (loss)	(75,143)	(53,772)	(130,129)	(178,275)
Less: Comprehensive income (loss) attributable to noncontrolling interests	736	54	1,532	1,200
Comprehensive income (loss) attributable to Quorum Health Corporation	$ (75,879)	$ (53,826)	$ (131,661)	$ (179,475)

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 44,431			$ 3,203
Patient accounts receivable	283,701			322,608
Inventories	39,324			45,646
Prepaid expenses	20,412			19,683
Due from third-party payors	26,449			63,443
Other current assets	33,643			36,405
Total current assets	447,960			490,988
Property and equipment, net	485,495			559,438
Goodwill	391,701			401,073
Intangible assets, net	47,807			48,289
Operating lease right-of-use assets	78,606			0
Other long-term assets	70,199			74,306
Total assets	1,521,768			1,574,094
Current liabilities:
Current maturities of long-term debt	1,646			1,697
Current portion of operating lease liabilities	24,835			0
Accounts payable	153,645			143,917
Accrued liabilities:
Accrued salaries and benefits	68,273			76,908
Accrued interest	33,580			10,024
Due to third-party payors	41,998			45,852
Other current liabilities	46,623			43,336
Total current liabilities	370,600			321,734
Long-term debt	1,195,407			1,191,777
Long-term operating lease liabilities	56,346			0
Deferred income tax liabilities, net	7,049			6,736
Other long-term liabilities	93,454			126,499
Total liabilities	1,722,856			1,646,746
Redeemable noncontrolling interests	2,278	$ 2,278	$ 2,278	2,278	$ 2,279	$ 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; 32,908,366 shares issued and outstanding at September 30, 2019, and 31,521,398 shares issued and outstanding at December 31, 2018	3			3
Additional paid-in capital	561,081			557,309
Accumulated other comprehensive income (loss)	905			759
Accumulated deficit	(780,999)			(648,464)
Total Quorum Health Corporation stockholders' equity (deficit)	(219,010)			(90,393)
Nonredeemable noncontrolling interests	15,644			15,463
Total equity (deficit)	(203,366)	$ (129,800)	$ (114,129)	(74,930)	$ (60,293)	$ (8,595)	$ 16,073	$ 113,410
Total liabilities and equity	$ 1,521,768			$ 1,574,094

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) (Unaudited) - $ / shares	Sep. 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	32,908,366	31,521,398
Common stock, shares outstanding	32,908,366	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
Comprehensive income (loss)	(53,395)			114	(53,940)	431
Stock-based compensation expense	2,766		2,766
Stock-based compensation expense, shares		636,890
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(36)		(36)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares, shares		(7,715)
Cash distributions to noncontrolling investors	(639)					(639)
Adjustments to redemption values of redeemable noncontrolling interests	(394)		(394)
Stockholders' equity, ending balance at Sep. 30, 2018	(60,293)	$ 3	554,847	(1,917)	(627,730)	14,504
Stockholders' equity, ending balance, shares at Sep. 30, 2018		31,527,885
Redeemable Noncontrolling Interests, Comprehensive income (loss)	(377)
Redeemable Noncontrolling Interests, Cash distributions to noncontrolling investors	(39)
Redeemable Noncontrolling Interests, Adjustments to redemption values of redeemable noncontrolling interests	394
Redeemable noncontrolling interests, ending balance at Sep. 30, 2018	2,279
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
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
Comprehensive income (loss)	(75,160)			49	(75,928)	719
Stock-based compensation expense	1,744		1,744
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(24)		(24)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares, shares		(18,323)
Adjustments to redemption values of redeemable noncontrolling interests	(126)		(126)
Stockholders' equity, ending balance at Sep. 30, 2019	$ (203,366)	$ 3	$ 561,081	$ 905	$ (780,999)	$ 15,644
Stockholders' equity, ending balance, shares at Sep. 30, 2019	32,908,366	32,908,366
Redeemable Noncontrolling Interests, Comprehensive income (loss)	$ 17
Redeemable Noncontrolling Interests, Cash distributions to noncontrolling investors	(143)
Redeemable Noncontrolling Interests, Adjustments to redemption values of redeemable noncontrolling interests	126
Redeemable noncontrolling interests, ending balance at Sep. 30, 2019	$ 2,278

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income (loss)	$ (75,192)	$ (53,886)	$ (130,275)	$ (178,314)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	15,028	16,612	44,167	52,015
Non-cash interest expense, net	2,306	1,860	6,625	6,394
Provision for (benefit from) deferred income taxes	71	(1,129)	192	(1,104)
Stock-based compensation expense	1,744	2,766	4,708	7,986
Impairment of long-lived assets and goodwill	8,010	32,438	42,820	72,198
Loss (gain) on sale of hospitals, net	1,206	805	2,346	8,927
Non-cash portion of loss (gain) on hospital closures	11,781	0	11,781	6,394
Changes in reserves for self-insurance claims, net of payments	(119)	4,623	(25,922)	15,003
Other non-cash expense (income), net	3,237	380	1,414	387
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Patient accounts receivable	8,166	9,206	26,946	30,280
Due from and due to third-party payors, net	10,120	8,344	7,858	29,322
Inventories, prepaid expenses and other current assets	5,726	(7,353)	5,494	(7,582)
Accounts payable and accrued liabilities	44,793	12,108	36,009	2,394
Long-term assets and liabilities, net	(11,721)	1,560	(11,323)	(1,365)
Net cash provided by (used in) operating activities	25,156	28,334	22,840	42,935
Cash flows from investing activities:
Capital expenditures for property and equipment	(7,720)	(9,576)	(25,831)	(34,895)
Capital expenditures for software	(1,843)	(483)	(5,360)	(1,527)
Acquisitions, net of cash acquired	(76)	(63)	(531)	(121)
Proceeds from the sale of hospitals	40,992	0	52,733	39,170
Other investing activities, net	3,643	10	3,260	259
Net cash provided by (used in) investing activities	34,996	(10,112)	24,271	2,886
Cash flows from financing activities:
Borrowings under revolving credit facilities	138,000	121,000	465,000	368,000
Repayments under revolving credit facilities	(155,000)	(135,000)	(454,000)	(368,000)
Borrowings of long-term debt	0	90	186	157
Repayments of long-term debt	(445)	(354)	(14,408)	(31,801)
Payments of debt issuance costs	0	0	0	(2,268)
Payments on purchase contracts	(374)	0	(374)	0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares	(24)	(36)	(588)	(1,979)
Cash distributions to noncontrolling investors	(143)	(678)	(1,699)	(1,481)
Net cash provided by (used in) financing activities	(17,986)	(14,978)	(5,883)	(37,372)
Net change in cash, cash equivalents and restricted cash	42,166	3,244	41,228	8,449
Cash, cash equivalents and restricted cash at beginning of period	2,265	10,822	3,203	5,617
Cash, cash equivalents and restricted cash at end of period	44,431	14,066	44,431	14,066
Supplemental cash flow information:
Interest payments, net	7,663	18,702	68,724	77,413
Income tax payments, net	$ 0	$ 46	$ 189	$ 533

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	9 Months Ended
	Sep. 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 September 30, 2019, the Company owned or leased a diversified portfolio of 24 hospitals in rural and mid-sized markets, which are located in 14 states and have a total of 2,038 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 Standards 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 credit agreement (the “CS Agreement”), among the Company, the lenders party thereto and Credit Suisse AG, Cayman Islands Branch, as administrative agent and collateral agent, 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 September 30, 2019. Management’s evaluation of the Company’s ability to comply with the Secured Net Leverage Ratio for the one year period following the date these financial statements are issued included, but was not limited to, consideration of the following factors: • Management’s intention to enter into discussions with the Company’s lenders to modify the maximum Secured Net Leverage Ratio; • Cost savings and improvement in net patient revenues through improvements in operational effectiveness and efficiencies as a result the Company’s partnership with R1 RCM. On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. Effective October 1, 2019, the Company transitioned it’s billing and collection services from CHS to R1 RCM; • Cost savings resulting from the sale or closure of underperforming facilities. The Company sold or closed two facilities on September 30, 2019 and is evaluating additional facilities for potential divestiture. The sale or closure of additional 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’s plans to achieve cost savings over the next twelve months through a reduction in corporate and operating costs. Management’s plans in relation to costs savings and improvement in net patient revenues have been initiated, documented and approved as indicated above. No formal documentation or approval of management’s intention to modify the Company’s maximum Secured Net Leverage has occurred on or before September 30, 2019, and therefore the results remain uncertain. 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 were outsourced to CHS under a transition services agreement that was entered into in connection with the Spin-off through September 30, 2019. 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 September 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 121,812 29.0 % $ 123,788 26.9 % Medicaid 86,280 20.5 % 97,803 21.2 % Managed care and commercial plans 168,050 40.0 % 185,493 40.3 % Self-pay and self-pay after insurance 25,410 6.1 % 33,647 7.3 % Non-patient 18,348 4.4 % 19,776 4.3 % Total net operating revenues $ 419,900 100.0 % $ 460,507 100.0 % Nine Months Ended September 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 370,743 28.4 % $ 398,477 28.1 % Medicaid 264,998 20.3 % 270,047 19.0 % Managed care and commercial plans 516,783 39.6 % 560,445 39.5 % Self-pay and self-pay after insurance 95,081 7.3 % 125,619 8.8 % Non-patient 57,270 4.4 % 65,371 4.6 % Total net operating revenues $ 1,304,875 100.0 % $ 1,419,959 100.0 % 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. 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. 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 nine months ended September 30, 2019 and 2018 was not material and is included in other operating expenses in the Company’s consolidated statements of income. Billing and collections were outsourced to CHS under a transition services agreement that was put in place by CHS in connection with the Spin-off through September 30, 2019. 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 has, among other things, allowed 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. Effective October 1, 2019, the Company transitioned its billing and collection services from CHS to R1 RCM. 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 $0.2 million and $(0.5) million during the three months ended September 30, 2019 and 2018, respectively and by $2.3 million and $(0.4) million during the nine months ended September 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): September 30, December 31, 2019 2018 Amounts due from third-party payors: Previous program reimbursements and final cost report settlements $ 11,410 $ 14,374 State supplemental payment programs 15,039 49,069 Total amounts due from third-party payors $ 26,449 $ 63,443 Amounts due to third-party payors: Previous program reimbursements and final cost report settlements $ 36,886 $ 32,174 State supplemental payment programs 5,112 13,678 Total amounts due to third-party payors $ 41,998 $ 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Medicaid state supplemental payment program revenues $ 37,217 $ 57,555 $ 132,496 $ 158,186 Provider taxes and other expenses 15,415 19,131 53,008 55,326 Reimbursements attributable to state supplemental payment programs, net of expenses $ 21,802 $ 38,424 $ 79,488 $ 102,860 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. The current phase of the HQAF program expired on June 30, 2019 and the next phase of the program, Phase VI, began July 1, 2019 and is expected to be a 30 month program. Due to insufficient modeling and other statistical information as of September 30, 2019, the Company has not recognized revenue under Phase VI of the HQAF program. In future quarters as more information becomes available, the Company will reassess its ability to estimate revenue under Phase VI of the HQAF program. Upon consideration of the additional information, revenue will be recognized under ASC 606 when uncertainty of a future revenue reversal is subsequently resolved. The Company recognized $2.0 million of Medicaid revenues for the three months ended September 30, 2019 and $5.9 million of Medicaid revenues in the nine months ended September 30, 2019 related to the sale of Illinois property tax credits. The Company recognized $7.3 million of Medicaid revenues related to the sale of Illinois property tax credits in the three and nine months ended September 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 $7.5 million and $7.6 million for the three months ended September 30, 2019 and 2018, respectively, and $19.8 million and $26.9 million for the nine months ended September 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 and R1 RCM’s business office operations, including their 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 were outsourced to CHS under a transition services agreement that was established with the Spin-off through September 30, 2019. 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 has, among other things, allowed 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. Effective October 1, 2019, the Company transitioned its billing and collection services from CHS to R1 RCM. The Company has elected the practical expedient allowed under Financial Accounting Standards Board’s (“FASB”) 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 $51.7 million and $58.2 million, or 18.2% and 18.0% of total patient accounts receivable as of September 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 $20.1 million and $24.5 million, or 7.1% and 7.6% of total patient accounts receivable as of September 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 $5.2 million and $37.8 million, or 19.8% and 59.6% of total due from third-party payors, as of September 30, 2019 and December 31, 2018, respectively. The decline in the program receivables from California Medicaid are due to the sale of Watsonville Community Hospital on September 30, 2019. See Note 3 — Divestitures for additional information on the sale of Watsonville Community Hospital. 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 Nine Months Ended September 30, Hospitals at 2019 2018 September 30, 2019 $ Amount % of Total $ Amount % of Total Illinois 7 $ 496,671 39.8 % $ 554,909 41.0 % Oregon 1 178,442 14.3 % 172,319 12.7 % California 1 126,892 10.2 % 136,357 10.1 % Kentucky 3 84,835 6.8 % 87,935 6.5 % Other Operating Expenses The following table provides a summary of the major components of other operating expenses (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Purchased services $ 41,975 $ 37,955 $ 121,399 $ 116,537 Taxes and insurance 27,251 33,631 62,861 100,313 Medical specialist fees 25,428 26,078 76,652 79,459 Transition services agreements 11,554 14,101 26,580 43,284 Repairs and maintenance 9,188 8,962 28,041 27,659 Utilities 6,420 6,559 16,961 18,274 Other miscellaneous operating expenses 17,855 16,430 50,920 55,384 Total other operating expenses $ 139,671 $ 143,716 $ 383,414 $ 440,910 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 $13.7 million and $14.2 million during the three months ended September 30, 2019 and 2018, respectively, and $35.7 million and $49.1 million during the nine months ended September 30, 2019 and 2018, respectively. General and administrative costs of the Company include executive severance costs at the corporate office of $1.3 million and $1.6 million during the three months ended September 30, 2019 and 2018, respectively, and $1.3 million and $6.2 million during the nine months ended September 30, 2019 and 2018, respectively. 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, strategic iniatives and other litigation matters. Loss (Gain) on Sale of Hospitals,

Impairment of Long-Lived Assets

Impairment of Long-Lived Assets and Goodwill	9 Months Ended
	Sep. 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 September 30, 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 $8.0 million during the three months ended September 30, 2019, which consisted of $7.4 million of property and equipment and $0.6 million of capitalized software costs. During the three months ended June June 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 September 30, 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 $32.4 million during the three months ended September 30, 2018, which consisted of $31.5 million of property and equipment and $0.9 million of capitalized software costs. 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	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
Divestitures	NOTE 3 –DIVESTITURES Watsonville Community Hospital On September 30, 2019, the Company sold 106-bed Watsonville Community Hospital and its affiliated entities (“Watsonville”), located in Watsonville, California, for proceeds of $46.0 million. Total proceeds include a $5.0 million note receivable which is included in other long-term assets on the consolidated balance sheet. For the three months ended September 30, 2019 and 2018, the Company’s operating results included pre-tax income (losses) of $(7.9) million and $3.3 million, respectively, related to Watsonville, and pre-tax income (losses) of $(10.3) million and $2.0 million for the nine months ended September 30, 2019 and 2018, respectively. In addition to the above, the Company recorded a $1.1 million loss on sale of Watsonville in the nine months ended September 30, 2019. MetroSouth Medical Center On September 30, 2019, the Company ceased operations at 314-bed MetroSouth Medical Center and its affiliated entities (“MetroSouth”), located in Blue Island, Illinois. For the three months ended September 30, 2019 and 2018, the Company’s operating results included pre-tax losses of $22.6 million and $3.9 million, respectively, related to MetroSouth, and pre-tax losses of $25.8 million and $5.7 million for the nine months ended September 30, 2019 and 2018, respectively. Included in the pre-tax loss for the nine months ended September 30, 2019 was $18.4 million of closure costs related to the closure of MetroSouth. These costs include $11.8 million of non-cash losses associated with the disposal or write down of assets that have no future value to the Company, $4.7 million of severance and salary continuation costs and $1.9 million of other costs and fees related to the termination of contracts and other miscellaneous costs. The Company anticipates that in the remainder of 2019 it will incur costs, beyond those already incurred, of approximately $3.0 million to $5.0 million. In addition, beyond 2019, the Company is obligated to maintain patient health records for approximately 25 years with an estimated annual cost of $0.2 million and may incur additional costs to maintain the existing facilities until such time the facility is sold with an estimated annual cost of $1.0 million. Scenic Mountain Medical Center On April 12, 2019, the Company sold 146-bed Scenic Mountain Medical Center and its affiliated entities (“Scenic Mountain”), located in Big Spring, Texas, for proceeds of $11.7 million. For the three months ended September 30, 2019 and 2018, the Company’s operating results included pre-tax losses of $2.3 million and $1.4 million, respectively, related to Scenic Mountain, and pre-tax losses of $6.4 million and $1.5 million for the nine months ended September 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 nine months ended September 30, 2019, which includes a write-off of allocated goodwill of $3.3 million.

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 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): September 30, December 31, 2019 2018 Property and equipment, at cost: Land and improvements $ 41,636 $ 49,637 Building and improvements 637,111 723,345 Equipment and fixtures 433,439 498,139 Construction in progress 9,188 16,208 Total property and equipment, at cost 1,121,374 1,287,329 Less: Accumulated depreciation and amortization (635,879 ) (727,891 ) Total property and equipment, net $ 485,495 $ 559,438 Depreciation expense was $10.9 million and $12.4 million for the three months ended September 30, 2019 and 2018, respectively, and $32.1 million and $37.6 million for the nine months ended September 30, 2019 and 2018, respectively. See Note 5 Purchases of property and equipment accrued in accounts payable were $4.8 million and $4.9 million as of September 30, 2019 and December 31, 2018, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 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): Nine Months Ended September 30, 2019 Balance at beginning of period $ 401,073 Acquisitions 418 Divestitures (3,300 ) Impairment (6,490 ) Balance at end of period $ 391,701 Goodwill related to the Company’s hospital operations reporting unit was $358.3 million and $367.8 million as of September 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 September 30, 2019 and December 31, 2018. Total accumulated goodwill impairment losses were $133.5 million and $126.9 million as of September 30, 2019 and December 31, 2018, respectively. Intangible Assets The following table provides a summary of the components of intangible assets (in thousands): September 30, 2019 Accumulated Net Book Cost Amortization Value Finite-lived intangible assets: Capitalized software costs $ 140,361 $ (104,793 ) $ 35,568 Physician guarantee contracts 3,269 (1,468 ) 1,801 Other finite-lived intangible assets 43,212 (37,900 ) 5,312 Total finite-lived intangible assets, net 186,842 (144,161 ) 42,681 Indefinite-lives intangible assets: Tradenames 4,000 — 4,000 Licenses and other indefinite-lived intangible assets 1,126 — 1,126 Total indefinite-lived intangible assets 5,126 — 5,126 Total intangible assets $ 191,968 $ (144,161 ) $ 47,807 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 September 30, 2019, the Company had $10.6 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Amortization of finite-lived intangible assets: Capitalized software costs $ 2,540 $ 2,416 $ 6,861 $ 8,515 Physician guarantee contracts 351 497 1,397 1,942 Other finite-lived intangible assets 471 508 1,415 1,522 Total amortization expense related to finite-lived intangible assets 3,362 3,421 9,673 11,979 Amortization of leasehold improvements and property and equipment assets held under finance lease obligations 777 792 2,346 2,468 Total amortization expense $ 4,139 $ 4,213 $ 12,019 $ 14,447 As of September 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 2.8 years.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 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): September 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 25,000 14,000 Senior Notes, maturing 2023 400,000 400,000 Unamortized debt issuance costs and discounts (28,665 ) (35,537 ) Finance lease obligations 22,574 23,386 Other debt 458 874 Total debt 1,197,053 1,193,474 Less: Current maturities of long-term debt (1,646 ) (1,697 ) Total long-term debt $ 1,195,407 $ 1,191,777 Senior Credit Facility In connection with the Spin-off, on April 29, 2016, the Company entered into the CS Agreement. 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 September 30, 2019, the Company had a Secured Net Leverage Ratio of 4.49 to 1.00 implying additional borrowing capacity of $89.6 million as of September 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 9.50% as of September 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 September 30, 2019, the Company had no borrowings outstanding on the Revolving Credit Facility and had $15.2 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 September 30, 2019, the Company had borrowing capacity under its Revolving Credit Facility of $47.3 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 September 30, 2019, the Company had $25.0 million of borrowings outstanding on the ABL Credit Facility and borrowing capacity of $77.0 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 September 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): September 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 (30,404 ) (23,532 ) Total unamortized debt issuance costs and discounts $ 28,665 $ 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 September 30, 2019 and December 31, 2018, this finance lease obligation was $16.5 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): September 30, 2019 Remainder of 2019 $ 413 2020 1,641 2021 26,629 2022 779,133 2023 401,348 Thereafter 16,554 Total debt, excluding unamortized debt issuance costs and discounts $ 1,225,718 Interest Expense, Net The following table provides a summary of the components of interest expense, net (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Senior Credit Facility: Revolving Credit Facility $ 61 $ 63 $ 183 $ 205 Term Loan Facility 18,031 18,121 54,589 53,174 ABL Credit Facility 612 276 1,659 1,115 Senior Notes 11,626 11,626 34,878 34,865 Amortization of debt issuance costs and discounts 2,229 2,079 6,872 7,249 All other interest expense (income), net 497 285 723 (1,301 ) Total interest expense, net $ 33,056 $ 32,450 $ 98,904 $ 95,307

Leases

Leases	9 Months Ended
	Sep. 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 Nine Months Ended September 30, 2019 September 30, 2019 Operating lease costs: Operating lease cost $ 8,838 $ 27,040 Variable lease cost 655 1,954 Short-term rent expense 1,628 5,285 Total operating lease costs $ 11,121 $ 34,279 Finance lease costs: Amortization of right-of-use assets $ 389 $ 1,167 Interest on lease liabilities 380 1,138 Total finance lease costs $ 769 $ 2,305 The following table provides supplemental balance sheet information related to finance leases (in thousands): Balance Sheet Classification September 30, 2019 Finance Leases: Finance lease ROU assets Property and equipment $ 29,358 Accumulated amortization Accumulated depreciation and amortization 6,922 Current finance lease liabilities Current maturities of long-term debt 1,369 Long-term finance lease liabilities Long-term debt 21,205 The following table provides supplemental cash flow information related to leases (in thousands): Three Months Ended Nine Months Ended September 30, 2019 September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 8,828 $ 27,060 Operating cash flows from finance leases 329 992 Financing cash flows from finance leases 327 1,011 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 2,084 $ 10,710 Finance leases 120 199 The following table provides the weighted-average lease terms and discount rates used for the Company’s operating and finance leases: September 30, 2019 Weighted-average remaining lease term (years): Operating leases 5.0 Finance leases 7.4 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 $ 7,424 $ 659 2020 30,611 2,645 2021 21,412 2,670 2022 13,400 2,367 2023 7,914 6,997 Thereafter 24,901 13,723 Total lease payments 105,662 29,061 Less: Imputed interest (24,481 ) (6,487 ) Total lease obligations 81,181 22,574 Less: Current portion (24,835 ) (1,369 ) Total long-term lease obligations $ 56,346 $ 21,205 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	9 Months Ended
	Sep. 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): September 30, December 31, 2019 2018 Receivable for professional and general liability insurance reserves indemnified by CHS $ 22,678 $ 34,535 Assets of deferred compensation plan 15,397 14,980 Receivable for workers' compensation liability insurance reserves indemnified by CHS 11,223 12,118 Notes receivable 5,487 501 Other miscellaneous long-term assets 15,414 12,172 Total other long-term assets $ 70,199 $ 74,306 The following table provides a summary of the components of other long-term liabilities (in thousands): September 30, December 31, 2019 2018 Professional and general liability insurance reserves $ 48,583 $ 82,828 Workers' compensation liability insurance reserves 15,611 16,819 Benefit plan liabilities 20,453 22,712 Software license liabilities 5,936 — Other miscellaneous long-term liabilities 2,871 4,140 Total other long-term liabilities $ 93,454 $ 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	9 Months Ended
	Sep. 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 nine months ended September 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): September 30, 2019 December 31, 2018 Carrying Estimated Carrying Estimated Amount Fair Value Amount Fair Value Revolving Credit Facility $ — $ — $ — $ — Term Loan Facility 777,686 766,511 790,751 784,821 ABL Credit Facility 25,000 25,000 14,000 14,000 Senior Notes 400,000 363,780 400,000 382,984 Other debt 23,032 23,032 24,260 24,260 Total debt, excluding unamortized debt issuance costs and discounts $ 1,225,718 $ 1,178,323 $ 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	9 Months Ended
	Sep. 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 September 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 September 30, 2019 and December 31, 2018, the Company had 32,908,366 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	9 Months Ended
	Sep. 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 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 (0.2)% and 2.0% for the three months ended September 30, 2019 and 2018, respectively, and (0.3)% and 0.6% for the nine months ended September 30, 2019 and 2018, respectively. The Company’s deferred income tax liabilities, net were $7.0 million as of September 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, net of book impairments and disposals of certain indefinite-lived intangible assets. 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 nine months ended September 30, 2019 and 2018.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Numerator: Net income (loss) $ (75,192 ) $ (53,886 ) $ (130,275 ) $ (178,314 ) Less: Net income (loss) attributable to noncontrolling interests 736 54 1,532 1,200 Net income (loss) attributable to Quorum Health Corporation $ (75,928 ) $ (53,940 ) $ (131,807 ) $ (179,514 ) Denominator: Weighted-average shares outstanding - basic and diluted 30,178,229 29,215,823 29,875,196 28,891,363 Earnings (loss) per share attributable to Quorum Health Corporation stockholders - basic and diluted $ (2.52 ) $ (1.85 ) $ (4.41 ) $ (6.21 ) Due to the net losses attributable to Quorum Health Corporation in the three and nine months ended September 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	9 Months Ended
	Sep. 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net operating revenues: Hospital operations $ 404,101 $ 442,802 $ 1,256,872 $ 1,363,628 QHR operations 15,711 16,937 45,742 55,145 All other 88 768 2,261 1,186 Total net operating revenues $ 419,900 $ 460,507 $ 1,304,875 $ 1,419,959 Adjusted EBITDA: Hospital operations $ 18,261 $ 39,137 $ 88,338 $ 109,455 QHR operations 5,310 4,715 13,517 13,518 All other (9,883 ) (9,710 ) (34,107 ) (34,088 ) Total Adjusted EBITDA $ 13,688 $ 34,142 $ 67,748 $ 88,885 September 30, December 31, 2019 2018 Assets: Hospital operations $ 1,342,939 $ 1,453,693 QHR operations 52,465 55,823 All other 126,364 64,578 Total assets $ 1,521,768 $ 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net income (loss) $ (75,192 ) $ (53,886 ) $ (130,275 ) $ (178,314 ) Interest expense, net 33,056 32,450 98,904 95,307 Provision for (benefit from) income taxes 137 (1,074 ) 386 (1,162 ) Depreciation and amortization 15,028 16,612 44,167 52,015 EBITDA (26,971 ) (5,898 ) 13,182 (32,154 ) Legal, professional and settlement costs 5,191 1,519 6,480 10,349 Impairment of long-lived assets and goodwill 8,010 32,438 42,820 72,198 Loss (gain) on sale of hospitals, net 1,206 805 2,346 8,927 Loss on closure of hospitals, net 18,414 1,111 18,414 18,195 Transition of transition services agreements 6,445 2,445 8,421 3,682 Change in actuarial estimates — — (26,880 ) — Headcount reductions and executive severance 1,393 1,722 2,965 7,688 Adjusted EBITDA $ 13,688 $ 34,142 $ 67,748 $ 88,885

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 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 April 22, 2016 (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 nine months ended September 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 September 30, 2019 — The following table provides a summary of the activity related to unvested restricted stock awards during the nine months ended September 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 (889,892 ) 7.72 Forfeited (283,178 ) 8.53 Unvested restricted stock awards at September 30, 2019 2,723,393 $ 3.39 During the nine months ended September 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 or restricted stock unit 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Stock-based compensation resulting from the Spin-off $ — $ — $ — $ 372 Stock-based compensation related to grants following the Spin-off 1,744 2,766 4,708 7,614 Total stock-based compensation expense $ 1,744 $ 2,766 $ 4,708 $ 7,986 Stock-based compensation expense is recognized as a component of salaries and benefits expenses in the consolidated statements of income. As of September 30, 2019, the Company had unrecognized stock-based compensation expense of $5.8 million related to restricted stock awards.

Benefit Plans

Benefit Plans	9 Months Ended
	Sep. 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 $0.5 million and $3.8 million for the three months ended September 30, 2019 and 2018, respectively, and $1.3 million and $8.1 million for the nine months ended September 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 September 30, 2019, the assets and liabilities under this plan were $15.4 million and $16.7 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 $0.3 million for the three months ended September 30, 2019 and 2018, respectively, and $0.7 million and $0.9 million for the nine months ended September 30, 2019 and 2018, respectively, 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 $3.7 million and $3.1 million as of September 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 September 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 As of September 30, 2019, 93,409 restricted stock units have been accrued under the Director’s Plan 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 September 30, 2019 and 2018 and $0.2 million for both the nine months ended September 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). Effective September 30, 2019, the Pension Plan’s accrued benefit liability was transferred to the new owners as part of the sale of Watsonville. Therefore, there was no accrued benefit liability for the Pension Plan as of September 30, 2019. The accrued benefit liability for the Pension Plan was $1.2 million at December 31, 2018.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 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 $11.6 million and $14.1 million for the three months ended September 30, 2019 and 2018, respectively, and $26.6 million and $43.3 million for the nine months ended September 30, 2019 and 2018, respectively.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 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 was finalized on August 16, 2019, and on August 21, 2019, the Court entered an Order dismissing the Quorum Defendants from the lawsuit with prejudice. • 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. • 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 • Health Grid, LLC vs. QHCCS, LLC . Complaint filed by Health Grid, LLC, on August 8, 2019 in the Chancery Court of Williamson County, Tennessee, alleging claims of breach of contract, quantum meruit and unjust enrichment against QHCCS for technology services allegedly performed by Health Grid pursuant to a contract. The Complaint seeks $2,240,000 plus pre judgment interest and costs. QHCCS answered the Complaint on September 30, 2019 and asserted defenses and counterclaims for breach of contract and negligent misrepresentation against Health Grid, asserting not more than $15 million in damages related to its counterclaim, plus certain fees and costs. While the litigation is in early stages, the Company believes Health Grid’s claims to be without merit, and intends to vigorously defend against the claims, and vigorously pursue the Company’s counterclaims. 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. • 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): September 30, 2019 Current Long-Term Current Long-Term Receivable Receivable Liability Liability Professional and general liability: Insurance reserves indemnified by CHS, Inc. $ 12,357 $ 22,678 $ 12,357 $ 22,678 All other self-insurance reserves — — 4,782 25,905 Total insurance reserves for professional and general liability 12,357 22,678 17,139 48,583 Workers' compensation liability: Insurance reserves indemnified by CHS, Inc. 1,152 11,223 1,152 11,223 All other self-insurance reserves — — 1,886 4,388 Total insurance reserves for workers' compensation liability 1,152 11,223 3,038 15,611 Total self-insurance reserves $ 13,509 $ 33,901 $ 20,177 $ 64,194 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 September 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 September 30, 2019, the Company did not incur costs related to this project. During the three months ended September 30, 2018, the Company incurred costs of $3.6 million related to this project. During the nine months ended September 30, 2019 and 2018, the Company incurred costs of $2.4 million and $14.3 million, respectively, related to this project. As of September 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 September 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 currently utilizes MEDHOST INC.’s (“Medhost”) software through its IT TSA with CHS. In connection with the Company’s planned transition from the Computer and Data Processing Transition Services Agreement (or “IT TSA”) with CHS, the Company entered into an agreement with Medhost to deploy Medhost’s Electronic Health Record management platform. This agreement includes software license and service fees. The implementation of the Medhost software is expected to be completed by the end of the first quarter of 2021. As of September 30, 2019, the Company has capitalized $10.3 million of costs related to the implementation of the Medhost software, which are included in intangible assets, net on the consolidated balance sheet. The total additional cost of this project, including software licenses and implementation fees, are estimated to be approximately $37.4 million. In addition, the Company has entered into various cloud computing arrangements related to the transition of the Company’s information technology infrastructure, such as financial reporting and budgeting, payroll, compliance and revenue management services. As of September 30, 2019, the Company has capitalized $1.5 million of implementation costs related to these cloud computing arrangements, which are included in other long-term assets on the consolidated balance sheet. The total additional costs of these arrangements, including hosting and implementation fees, are estimated to be approximately $2.2 million. The Company will incur additional costs to establish the remainder of its information technology systems which includes additional information technology infrastructure costs, among other things. As of September 30, 2019, the Company has capitalized $4.4 million of information technology infrastructure costs and estimates additional costs of contracts incurred to date to be approximately $13.8 million. The Company expects the transition from CHS to be completed by the end of the first quarter of 2021. Upon completion, the Company does not anticipate a significant change in its operating costs related to information technology.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2019
Subsequent Events [Abstract]
Subsequent Events	NOTE 18 - SUBSEQUENT EVENTS On September 11, 2019, the Company entered into an agreement with CHS to terminate the Shared Service Centers Transition Services Agreement, effective October 1, 2019. As part of this termination agreement, the Company agreed to pay an early termination fee of $1.7 million which was paid in September 2019 and wind down costs of approximately $2.6 million which will be paid in the fourth quarter of 2019. These services were replaced by R1 RCM and the Company believes that through this partnership, it will achieve cost savings and improve net patient revenues through improvements in operational effectiveness and efficiencies. In October 2019, the Company utilized proceeds from divestitures to pay down $39.3 million of principal on the Company’s Term Loan Facility.

Guarantor and Non-Guarantor Sup

Guarantor and Non-Guarantor Supplemental Information	9 Months Ended
	Sep. 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 September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 309,686 $ 110,214 $ — $ 419,900 Operating costs and expenses: Salaries and benefits — 144,241 71,216 — 215,457 Supplies — 31,244 16,574 — 47,818 Other operating expenses 98 113,909 25,664 — 139,671 Depreciation and amortization — 11,268 3,760 — 15,028 Lease costs and rent — 6,250 4,871 — 11,121 Electronic health records incentives — — (17 ) — (17 ) Legal, professional and settlement costs — 5,174 17 — 5,191 Impairment of long-lived assets and goodwill — 8,010 — — 8,010 Loss (gain) on sale of hospitals, net — 1,206 — — 1,206 Loss on closure of hospitals, net — 18,414 — — 18,414 Total operating costs and expenses 98 339,716 122,085 — 461,899 Income (loss) from operations (98 ) (30,030 ) (11,871 ) — (41,999 ) Interest expense, net 32,531 541 (16 ) — 33,056 Equity in earnings of affiliates 43,088 (2,753 ) — (40,335 ) — Income (loss) before income taxes (75,717 ) (27,818 ) (11,855 ) 40,335 (75,055 ) Provision for (benefit from) income taxes 211 (51 ) (23 ) — 137 Net income (loss) (75,928 ) (27,767 ) (11,832 ) 40,335 (75,192 ) Less: Net income (loss) attributable to noncontrolling interests — — 736 — 736 Net income (loss) attributable to Quorum Health Corporation $ (75,928 ) $ (27,767 ) $ (12,568 ) $ 40,335 $ (75,928 ) Condensed Consolidating Statement of Income (Loss) Three Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 356,986 $ 103,521 $ — $ 460,507 Operating costs and expenses: Salaries and benefits — 154,547 71,690 — 226,237 Supplies — 35,237 13,712 — 48,949 Other operating expenses — 115,994 27,722 — 143,716 Depreciation and amortization — 12,431 4,181 — 16,612 Rent — 6,580 5,081 — 11,661 Electronic health records incentives — 14 (45 ) — (31 ) Legal, professional and settlement costs — 1,399 120 — 1,519 Impairment of long-lived assets and goodwill — 32,438 — — 32,438 Loss (gain) on sale of hospitals, net — 805 — — 805 Loss on closure of hospitals, net — 1,111 — — 1,111 Total operating costs and expenses — 360,556 122,461 — 483,017 Income (loss) from operations — (3,570 ) (18,940 ) — (22,510 ) Interest expense, net 32,204 245 1 — 32,450 Equity in earnings of affiliates 22,932 (2,483 ) — (20,449 ) — Income (loss) before income taxes (55,136 ) (1,332 ) (18,941 ) 20,449 (54,960 ) Provision for (benefit from) income taxes (1,196 ) 8 114 — (1,074 ) Net income (loss) (53,940 ) (1,340 ) (19,055 ) 20,449 (53,886 ) Less: Net income (loss) attributable to noncontrolling interests — — 54 — 54 Net income (loss) attributable to Quorum Health Corporation $ (53,940 ) $ (1,340 ) $ (19,109 ) $ 20,449 $ (53,940 ) Condensed Consolidating Statement of Income (Loss) Nine Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 984,133 $ 320,742 $ — $ 1,304,875 Operating costs and expenses: Salaries and benefits — 442,224 211,719 — 653,943 Supplies — 101,532 47,873 — 149,405 Other operating expenses 114 314,673 68,627 — 383,414 Depreciation and amortization — 33,803 10,364 — 44,167 Lease costs and rent — 19,640 14,639 — 34,279 Electronic health records incentives — 599 (7 ) — 592 Legal, professional and settlement costs — 6,388 92 — 6,480 Impairment of long-lived assets and goodwill — 42,820 — — 42,820 Loss (gain) on sale of hospitals, net — 2,351 (5 ) — 2,346 Loss on closure of hospitals, net — 18,414 — — 18,414 Total operating costs and expenses 114 982,444 353,302 — 1,335,860 Income (loss) from operations (114 ) 1,689 (32,560 ) — (30,985 ) Interest expense, net 98,195 800 (91 ) — 98,904 Equity in earnings of affiliates 33,124 (5,838 ) — (27,286 ) — Income (loss) before income taxes (131,433 ) 6,727 (32,469 ) 27,286 (129,889 ) Provision for (benefit from) income taxes 374 132 (120 ) — 386 Net income (loss) (131,807 ) 6,595 (32,349 ) 27,286 (130,275 ) Less: Net income (loss) attributable to noncontrolling interests — — 1,532 — 1,532 Net income (loss) attributable to Quorum Health Corporation $ (131,807 ) $ 6,595 $ (33,881 ) $ 27,286 $ (131,807 ) Condensed Consolidating Statement of Income (Loss) Nine Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 1,091,781 $ 328,178 $ — $ 1,419,959 Operating costs and expenses: Salaries and benefits — 484,728 221,140 — 705,868 Supplies — 114,678 46,054 — 160,732 Other operating expenses 1,897 355,090 83,923 — 440,910 Depreciation and amortization — 40,956 11,059 — 52,015 Rent — 20,464 15,087 — 35,551 Electronic health records incentives — (416 ) (201 ) — (617 ) Legal, professional and settlement costs — 10,229 120 — 10,349 Impairment of long-lived assets and goodwill — 70,398 1,800 — 72,198 Loss (gain) on sale of hospitals, net — 8,933 (6 ) — 8,927 Loss on closure of hospitals, net — 18,195 — — 18,195 Total operating costs and expenses 1,897 1,123,255 378,976 — 1,504,128 Income (loss) from operations (1,897 ) (31,474 ) (50,798 ) — (84,169 ) Interest expense, net 96,612 (1,303 ) (2 ) — 95,307 Equity in earnings of affiliates 81,849 38,348 — (120,197 ) — Income (loss) before income taxes (180,358 ) (68,519 ) (50,796 ) 120,197 (179,476 ) Provision for (benefit from) income taxes (844 ) (412 ) 94 — (1,162 ) Net income (loss) (179,514 ) (68,107 ) (50,890 ) 120,197 (178,314 ) Less: Net income (loss) attributable to noncontrolling interests — — 1,200 — 1,200 Net income (loss) attributable to Quorum Health Corporation $ (179,514 ) $ (68,107 ) $ (52,090 ) $ 120,197 $ (179,514 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (75,928 ) $ (27,767 ) $ (11,832 ) $ 40,335 $ (75,192 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 49 49 — (49 ) 49 Comprehensive income (loss) (75,879 ) (27,718 ) (11,832 ) 40,286 (75,143 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 736 — 736 Comprehensive income (loss) attributable to Quorum Health Corporation $ (75,879 ) $ (27,718 ) $ (12,568 ) $ 40,286 $ (75,879 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (53,940 ) $ (1,340 ) $ (19,055 ) $ 20,449 $ (53,886 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 114 114 — (114 ) 114 Comprehensive income (loss) (53,826 ) (1,226 ) (19,055 ) 20,335 (53,772 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 54 — 54 Comprehensive income (loss) attributable to Quorum Health Corporation $ (53,826 ) $ (1,226 ) $ (19,109 ) $ 20,335 $ (53,826 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Nine Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (131,807 ) $ 6,595 $ (32,349 ) $ 27,286 $ (130,275 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 146 146 — (146 ) 146 Comprehensive income (loss) (131,661 ) 6,741 (32,349 ) 27,140 (130,129 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 1,532 — 1,532 Comprehensive income (loss) attributable to Quorum Health Corporation $ (131,661 ) $ 6,741 $ (33,881 ) $ 27,140 $ (131,661 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Nine Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (179,514 ) $ (68,107 ) $ (50,890 ) $ 120,197 $ (178,314 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 39 39 — (39 ) 39 Comprehensive income (loss) (179,475 ) (68,068 ) (50,890 ) 120,158 (178,275 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 1,200 — 1,200 Comprehensive income (loss) attributable to Quorum Health Corporation $ (179,475 ) $ (68,068 ) $ (52,090 ) $ 120,158 $ (179,475 ) Condensed Consolidating Balance Sheet September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated ASSETS Current assets: Cash and cash equivalents $ 41,173 $ 2,096 $ 1,162 $ — $ 44,431 Patient accounts receivable — 199,091 84,610 — 283,701 Inventories — 30,354 8,970 — 39,324 Prepaid expenses — 15,114 5,298 — 20,412 Due from third-party payors — 20,713 5,736 — 26,449 Other current assets 2,183 21,504 9,956 — 33,643 Total current assets 43,356 288,872 115,732 — 447,960 Intercompany receivable 3 856,771 448,116 (1,304,890 ) — Property and equipment, net — 348,088 137,407 — 485,495 Goodwill — 225,628 166,073 — 391,701 Intangible assets, net — 43,338 4,469 — 47,807 Operating lease right-of-use assets — 44,872 33,734 — 78,606 Other long-term assets — 53,025 17,174 — 70,199 Net investment in subsidiaries 1,398,752 — — (1,398,752 ) — Total assets $ 1,442,111 $ 1,860,594 $ 922,705 $ (2,703,642 ) $ 1,521,768 LIABILITIES AND EQUITY Current liabilities: Current maturities of long-term debt $ — $ 1,504 $ 142 $ — $ 1,646 Current portion of operating lease liabilities — 16,399 8,436 — 24,835 Accounts payable 80 126,998 26,567 — 153,645 Accrued liabilities: Accrued salaries and benefits — 43,577 24,696 — 68,273 Accrued interest 33,580 — — — 33,580 Due to third-party payors — 34,656 7,342 — 41,998 Other current liabilities — 31,431 15,192 — 46,623 Total current liabilities 33,660 254,565 82,375 — 370,600 Long-term debt 1,174,021 21,270 116 — 1,195,407 Long-term operating lease liabilities — 29,644 26,702 — 56,346 Intercompany payable 446,391 448,119 410,380 (1,304,890 ) — Deferred income tax liabilities, net 7,049 — — — 7,049 Other long-term liabilities — 181,975 24,488 (113,009 ) 93,454 Total liabilities 1,661,121 935,573 544,061 (1,417,899 ) 1,722,856 Redeemable noncontrolling interests — — 2,278 — 2,278 Equity: Quorum Health Corporation stockholders' equity (deficit): Preferred stock — — — — — Common stock 3 — — — 3 Additional paid-in capital 561,081 1,049,547 718,668 (1,768,215 ) 561,081 Accumulated other comprehensive income (loss) 905 943 (38 ) (905 ) 905 Accumulated deficit (780,999 ) (125,469 ) (357,908 ) 483,377 (780,999 ) Total Quorum Health Corporation stockholders' equity (deficit) (219,010 ) 925,021 360,722 (1,285,743 ) (219,010 ) Nonredeemable noncontrolling interests — — 15,644 — 15,644 Total equity (deficit) (219,010 ) 925,021 376,366 (1,285,743 ) (203,366 ) Total liabilities and equity $ 1,442,111 $ 1,860,594 $ 922,705 $ (2,703,642 ) $ 1,521,768 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 Nine Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (70,067 ) $ 135,677 $ (42,770 ) $ — $ 22,840 Cash flows from investing activities: Capital expenditures for property and equipment — (18,833 ) (6,998 ) — (25,831 ) Capital expenditures for software — (4,759 ) (601 ) — (5,360 ) Acquisitions, net of cash acquired — — (531 ) — (531 ) Proceeds from the sale of hospitals — 52,733 — — 52,733 Other investing activities, net — 260 3,000 — 3,260 Changes in intercompany balances with affiliates, net — (162,395 ) — 162,395 — Net cash provided by (used in) investing activities — (132,994 ) (5,130 ) 162,395 24,271 Cash flows from financing activities: Borrowings under revolving credit facilities 465,000 — — — 465,000 Repayments under revolving credit facilities (454,000 ) — — — (454,000 ) Borrowings of long-term debt — 161 25 — 186 Repayments of long-term debt (13,065 ) (1,243 ) (100 ) — (14,408 ) Payments on purchase contracts — (374 ) — — (374 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (588 ) — — (588 ) Cash distributions to noncontrolling investors — — (1,699 ) — (1,699 ) Changes in intercompany balances with affiliates, net 112,096 — 50,299 (162,395 ) — Net cash provided by (used in) financing activities 110,031 (2,044 ) 48,525 (162,395 ) (5,883 ) Net change in cash and cash equivalents 39,964 639 625 — 41,228 Cash and cash equivalents at beginning of period 1,209 1,457 537 — 3,203 Cash and cash equivalents at end of period $ 41,173 $ 2,096 $ 1,162 $ — $ 44,431 Condensed Consolidating Statement of Cash Flows Nine Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (80,781 ) $ 124,538 $ (822 ) $ — $ 42,935 Cash flows from investing activities: Capital expenditures for property and equipment — (21,193 ) (13,702 ) — (34,895 ) Capital expenditures for software — (1,400 ) (127 ) — (1,527 ) Acquisitions, net of cash acquired — (42 ) (79 ) — (121 ) Proceeds from the sale of hospitals — 39,384 (214 ) — 39,170 Other investing activities, net — 190 69 — 259 Changes in intercompany balances with affiliates, net — (137,364 ) — 137,364 — Net cash provided by (used in) investing activities — (120,425 ) (14,053 ) 137,364 2,886 Cash flows from financing activities: Borrowings under revolving credit facilities 368,000 — — — 368,000 Repayments under revolving credit facilities (368,000 ) — — — (368,000 ) Borrowings of long-term debt — 102 55 — 157 Repayments of long-term debt (30,463 ) (1,182 ) (156 ) — (31,801 ) Payments of debt issuance costs (2,268 ) — — — (2,268 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (1,979 ) — — (1,979 ) Cash distributions to noncontrolling investors — — (1,481 ) — (1,481 ) Changes in intercompany balances with affiliates, net 112,682 — 24,682 (137,364 ) — Net cash provided by (used in) financing activities 79,951 (3,059 ) 23,100 (137,364 ) (37,372 ) Net change in cash, cash equivalents and restricted cash (830 ) 1,054 8,225 — 8,449 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 $ 221 $ 5,276 $ 8,569 $ — $ 14,066

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 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 Standards 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 credit agreement (the “CS Agreement”), among the Company, the lenders party thereto and Credit Suisse AG, Cayman Islands Branch, as administrative agent and collateral agent, 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 September 30, 2019. Management’s evaluation of the Company’s ability to comply with the Secured Net Leverage Ratio for the one year period following the date these financial statements are issued included, but was not limited to, consideration of the following factors: • Management’s intention to enter into discussions with the Company’s lenders to modify the maximum Secured Net Leverage Ratio; • Cost savings and improvement in net patient revenues through improvements in operational effectiveness and efficiencies as a result the Company’s partnership with R1 RCM. On May 8, 2019, the Company entered into an agreement with R1 RCM to receive end-to-end revenue cycle management services. Effective October 1, 2019, the Company transitioned it’s billing and collection services from CHS to R1 RCM; • Cost savings resulting from the sale or closure of underperforming facilities. The Company sold or closed two facilities on September 30, 2019 and is evaluating additional facilities for potential divestiture. The sale or closure of additional 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’s plans to achieve cost savings over the next twelve months through a reduction in corporate and operating costs. Management’s plans in relation to costs savings and improvement in net patient revenues have been initiated, documented and approved as indicated above. No formal documentation or approval of management’s intention to modify the Company’s maximum Secured Net Leverage has occurred on or before September 30, 2019, and therefore the results remain uncertain.
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 were outsourced to CHS under a transition services agreement that was entered into in connection with the Spin-off through September 30, 2019. 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. 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. 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 nine months ended September 30, 2019 and 2018 was not material and is included in other operating expenses in the Company’s consolidated statements of income. Billing and collections were outsourced to CHS under a transition services agreement that was put in place by CHS in connection with the Spin-off through September 30, 2019. 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 has, among other things, allowed 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. Effective October 1, 2019, the Company transitioned its billing and collection services from CHS to R1 RCM. 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 $0.2 million and $(0.5) million during the three months ended September 30, 2019 and 2018, respectively and by $2.3 million and $(0.4) million during the nine months ended September 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. The current phase of the HQAF program expired on June 30, 2019 and the next phase of the program, Phase VI, began July 1, 2019 and is expected to be a 30 month program. Due to insufficient modeling and other statistical information as of September 30, 2019, the Company has not recognized revenue under Phase VI of the HQAF program. In future quarters as more information becomes available, the Company will reassess its ability to estimate revenue under Phase VI of the HQAF program. Upon consideration of the additional information, revenue will be recognized under ASC 606 when uncertainty of a future revenue reversal is subsequently resolved. The Company recognized $2.0 million of Medicaid revenues for the three months ended September 30, 2019 and $5.9 million of Medicaid revenues in the nine months ended September 30, 2019 related to the sale of Illinois property tax credits. The Company recognized $7.3 million of Medicaid revenues related to the sale of Illinois property tax credits in the three and nine months ended September 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 $7.5 million and $7.6 million for the three months ended September 30, 2019 and 2018, respectively, and $19.8 million and $26.9 million for the nine months ended September 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 and R1 RCM’s business office operations, including their 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 were outsourced to CHS under a transition services agreement that was established with the Spin-off through September 30, 2019. 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 has, among other things, allowed 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. Effective October 1, 2019, the Company transitioned its billing and collection services from CHS to R1 RCM. The Company has elected the practical expedient allowed under Financial Accounting Standards Board’s (“FASB”) 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 $51.7 million and $58.2 million, or 18.2% and 18.0% of total patient accounts receivable as of September 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 $20.1 million and $24.5 million, or 7.1% and 7.6% of total patient accounts receivable as of September 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 $5.2 million and $37.8 million, or 19.8% and 59.6% of total due from third-party payors, as of September 30, 2019 and December 31, 2018, respectively. The decline in the program receivables from California Medicaid are due to the sale of Watsonville Community Hospital on September 30, 2019. See Note 3 — Divestitures for additional information on the sale of Watsonville Community Hospital. 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 $13.7 million and $14.2 million during the three months ended September 30, 2019 and 2018, respectively, and $35.7 million and $49.1 million during the nine months ended September 30, 2019 and 2018, respectively. General and administrative costs of the Company include executive severance costs at the corporate office of $1.3 million and $1.6 million during the three months ended September 30, 2019 and 2018, respectively, and $1.3 million and $6.2 million during the nine months ended September 30, 2019 and 2018, respectively.
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, strategic iniatives 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 consideration received 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, contract termination fees 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.
Cloud Computing Costs	Cloud Computing Costs The Company is in the process of transitioning its information technology services from the IT TSA with CHS. As such, the Company has entered into various cloud computing arrangements related to the Company’s information technology infrastructure, such as financial reporting and budgeting, payroll, compliance and revenue management services. The Company capitalizes certain costs associated with cloud computing arrangements, including, among other items, employee compensation and related benefits and third party consulting costs that are part of the application development stage. These costs are included in other long-term assets on the consolidated balance sheet and are amortized over the period of the hosting service contract which is generally 5 years. The Company reviews the amounts capitalized for impairment whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be recoverable. As of September 30, 2019, the Company has capitalized $1.5 million of implementation costs related to the implementation of cloud computing arrangements.
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 $8.2 million and $10.4 million as of September 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 public business 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 January 1, 2019. As of September 30, 2019, the Company has capitalized $1.5 million of implementation costs related to the implementation of cloud computing arrangements which are included in other long-term assets on the consolidated balance sheet. 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)	9 Months Ended
	Sep. 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 September 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 121,812 29.0 % $ 123,788 26.9 % Medicaid 86,280 20.5 % 97,803 21.2 % Managed care and commercial plans 168,050 40.0 % 185,493 40.3 % Self-pay and self-pay after insurance 25,410 6.1 % 33,647 7.3 % Non-patient 18,348 4.4 % 19,776 4.3 % Total net operating revenues $ 419,900 100.0 % $ 460,507 100.0 % Nine Months Ended September 30, 2019 2018 $ Amount % of Total $ Amount % of Total Medicare $ 370,743 28.4 % $ 398,477 28.1 % Medicaid 264,998 20.3 % 270,047 19.0 % Managed care and commercial plans 516,783 39.6 % 560,445 39.5 % Self-pay and self-pay after insurance 95,081 7.3 % 125,619 8.8 % Non-patient 57,270 4.4 % 65,371 4.6 % Total net operating revenues $ 1,304,875 100.0 % $ 1,419,959 100.0 %
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): September 30, December 31, 2019 2018 Amounts due from third-party payors: Previous program reimbursements and final cost report settlements $ 11,410 $ 14,374 State supplemental payment programs 15,039 49,069 Total amounts due from third-party payors $ 26,449 $ 63,443 Amounts due to third-party payors: Previous program reimbursements and final cost report settlements $ 36,886 $ 32,174 State supplemental payment programs 5,112 13,678 Total amounts due to third-party payors $ 41,998 $ 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Medicaid state supplemental payment program revenues $ 37,217 $ 57,555 $ 132,496 $ 158,186 Provider taxes and other expenses 15,415 19,131 53,008 55,326 Reimbursements attributable to state supplemental payment programs, net of expenses $ 21,802 $ 38,424 $ 79,488 $ 102,860
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 Nine Months Ended September 30, Hospitals at 2019 2018 September 30, 2019 $ Amount % of Total $ Amount % of Total Illinois 7 $ 496,671 39.8 % $ 554,909 41.0 % Oregon 1 178,442 14.3 % 172,319 12.7 % California 1 126,892 10.2 % 136,357 10.1 % Kentucky 3 84,835 6.8 % 87,935 6.5 %
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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Purchased services $ 41,975 $ 37,955 $ 121,399 $ 116,537 Taxes and insurance 27,251 33,631 62,861 100,313 Medical specialist fees 25,428 26,078 76,652 79,459 Transition services agreements 11,554 14,101 26,580 43,284 Repairs and maintenance 9,188 8,962 28,041 27,659 Utilities 6,420 6,559 16,961 18,274 Other miscellaneous operating expenses 17,855 16,430 50,920 55,384 Total other operating expenses $ 139,671 $ 143,716 $ 383,414 $ 440,910

Property and Equipment (Tables)

Property and Equipment (Tables)	9 Months Ended
	Sep. 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): September 30, December 31, 2019 2018 Property and equipment, at cost: Land and improvements $ 41,636 $ 49,637 Building and improvements 637,111 723,345 Equipment and fixtures 433,439 498,139 Construction in progress 9,188 16,208 Total property and equipment, at cost 1,121,374 1,287,329 Less: Accumulated depreciation and amortization (635,879 ) (727,891 ) Total property and equipment, net $ 485,495 $ 559,438

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 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): Nine Months Ended September 30, 2019 Balance at beginning of period $ 401,073 Acquisitions 418 Divestitures (3,300 ) Impairment (6,490 ) Balance at end of period $ 391,701
Summary of the Components of Intangible Assets	The following table provides a summary of the components of intangible assets (in thousands): September 30, 2019 Accumulated Net Book Cost Amortization Value Finite-lived intangible assets: Capitalized software costs $ 140,361 $ (104,793 ) $ 35,568 Physician guarantee contracts 3,269 (1,468 ) 1,801 Other finite-lived intangible assets 43,212 (37,900 ) 5,312 Total finite-lived intangible assets, net 186,842 (144,161 ) 42,681 Indefinite-lives intangible assets: Tradenames 4,000 — 4,000 Licenses and other indefinite-lived intangible assets 1,126 — 1,126 Total indefinite-lived intangible assets 5,126 — 5,126 Total intangible assets $ 191,968 $ (144,161 ) $ 47,807 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Amortization of finite-lived intangible assets: Capitalized software costs $ 2,540 $ 2,416 $ 6,861 $ 8,515 Physician guarantee contracts 351 497 1,397 1,942 Other finite-lived intangible assets 471 508 1,415 1,522 Total amortization expense related to finite-lived intangible assets 3,362 3,421 9,673 11,979 Amortization of leasehold improvements and property and equipment assets held under finance lease obligations 777 792 2,346 2,468 Total amortization expense $ 4,139 $ 4,213 $ 12,019 $ 14,447

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 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): September 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 25,000 14,000 Senior Notes, maturing 2023 400,000 400,000 Unamortized debt issuance costs and discounts (28,665 ) (35,537 ) Finance lease obligations 22,574 23,386 Other debt 458 874 Total debt 1,197,053 1,193,474 Less: Current maturities of long-term debt (1,646 ) (1,697 ) Total long-term debt $ 1,195,407 $ 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): September 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 (30,404 ) (23,532 ) Total unamortized debt issuance costs and discounts $ 28,665 $ 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): September 30, 2019 Remainder of 2019 $ 413 2020 1,641 2021 26,629 2022 779,133 2023 401,348 Thereafter 16,554 Total debt, excluding unamortized debt issuance costs and discounts $ 1,225,718
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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Senior Credit Facility: Revolving Credit Facility $ 61 $ 63 $ 183 $ 205 Term Loan Facility 18,031 18,121 54,589 53,174 ABL Credit Facility 612 276 1,659 1,115 Senior Notes 11,626 11,626 34,878 34,865 Amortization of debt issuance costs and discounts 2,229 2,079 6,872 7,249 All other interest expense (income), net 497 285 723 (1,301 ) Total interest expense, net $ 33,056 $ 32,450 $ 98,904 $ 95,307

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 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 Nine Months Ended September 30, 2019 September 30, 2019 Operating lease costs: Operating lease cost $ 8,838 $ 27,040 Variable lease cost 655 1,954 Short-term rent expense 1,628 5,285 Total operating lease costs $ 11,121 $ 34,279 Finance lease costs: Amortization of right-of-use assets $ 389 $ 1,167 Interest on lease liabilities 380 1,138 Total finance lease costs $ 769 $ 2,305
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 September 30, 2019 Finance Leases: Finance lease ROU assets Property and equipment $ 29,358 Accumulated amortization Accumulated depreciation and amortization 6,922 Current finance lease liabilities Current maturities of long-term debt 1,369 Long-term finance lease liabilities Long-term debt 21,205
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 Nine Months Ended September 30, 2019 September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 8,828 $ 27,060 Operating cash flows from finance leases 329 992 Financing cash flows from finance leases 327 1,011 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 2,084 $ 10,710 Finance leases 120 199
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: September 30, 2019 Weighted-average remaining lease term (years): Operating leases 5.0 Finance leases 7.4 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 $ 7,424 $ 659 2020 30,611 2,645 2021 21,412 2,670 2022 13,400 2,367 2023 7,914 6,997 Thereafter 24,901 13,723 Total lease payments 105,662 29,061 Less: Imputed interest (24,481 ) (6,487 ) Total lease obligations 81,181 22,574 Less: Current portion (24,835 ) (1,369 ) Total long-term lease obligations $ 56,346 $ 21,205
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)	9 Months Ended
	Sep. 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): September 30, December 31, 2019 2018 Receivable for professional and general liability insurance reserves indemnified by CHS $ 22,678 $ 34,535 Assets of deferred compensation plan 15,397 14,980 Receivable for workers' compensation liability insurance reserves indemnified by CHS 11,223 12,118 Notes receivable 5,487 501 Other miscellaneous long-term assets 15,414 12,172 Total other long-term assets $ 70,199 $ 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): September 30, December 31, 2019 2018 Professional and general liability insurance reserves $ 48,583 $ 82,828 Workers' compensation liability insurance reserves 15,611 16,819 Benefit plan liabilities 20,453 22,712 Software license liabilities 5,936 — Other miscellaneous long-term liabilities 2,871 4,140 Total other long-term liabilities $ 93,454 $ 126,499

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 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): September 30, 2019 December 31, 2018 Carrying Estimated Carrying Estimated Amount Fair Value Amount Fair Value Revolving Credit Facility $ — $ — $ — $ — Term Loan Facility 777,686 766,511 790,751 784,821 ABL Credit Facility 25,000 25,000 14,000 14,000 Senior Notes 400,000 363,780 400,000 382,984 Other debt 23,032 23,032 24,260 24,260 Total debt, excluding unamortized debt issuance costs and discounts $ 1,225,718 $ 1,178,323 $ 1,229,011 $ 1,206,065

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Numerator: Net income (loss) $ (75,192 ) $ (53,886 ) $ (130,275 ) $ (178,314 ) Less: Net income (loss) attributable to noncontrolling interests 736 54 1,532 1,200 Net income (loss) attributable to Quorum Health Corporation $ (75,928 ) $ (53,940 ) $ (131,807 ) $ (179,514 ) Denominator: Weighted-average shares outstanding - basic and diluted 30,178,229 29,215,823 29,875,196 28,891,363 Earnings (loss) per share attributable to Quorum Health Corporation stockholders - basic and diluted $ (2.52 ) $ (1.85 ) $ (4.41 ) $ (6.21 )

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net operating revenues: Hospital operations $ 404,101 $ 442,802 $ 1,256,872 $ 1,363,628 QHR operations 15,711 16,937 45,742 55,145 All other 88 768 2,261 1,186 Total net operating revenues $ 419,900 $ 460,507 $ 1,304,875 $ 1,419,959 Adjusted EBITDA: Hospital operations $ 18,261 $ 39,137 $ 88,338 $ 109,455 QHR operations 5,310 4,715 13,517 13,518 All other (9,883 ) (9,710 ) (34,107 ) (34,088 ) Total Adjusted EBITDA $ 13,688 $ 34,142 $ 67,748 $ 88,885 September 30, December 31, 2019 2018 Assets: Hospital operations $ 1,342,939 $ 1,453,693 QHR operations 52,465 55,823 All other 126,364 64,578 Total assets $ 1,521,768 $ 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net income (loss) $ (75,192 ) $ (53,886 ) $ (130,275 ) $ (178,314 ) Interest expense, net 33,056 32,450 98,904 95,307 Provision for (benefit from) income taxes 137 (1,074 ) 386 (1,162 ) Depreciation and amortization 15,028 16,612 44,167 52,015 EBITDA (26,971 ) (5,898 ) 13,182 (32,154 ) Legal, professional and settlement costs 5,191 1,519 6,480 10,349 Impairment of long-lived assets and goodwill 8,010 32,438 42,820 72,198 Loss (gain) on sale of hospitals, net 1,206 805 2,346 8,927 Loss on closure of hospitals, net 18,414 1,111 18,414 18,195 Transition of transition services agreements 6,445 2,445 8,421 3,682 Change in actuarial estimates — — (26,880 ) — Headcount reductions and executive severance 1,393 1,722 2,965 7,688 Adjusted EBITDA $ 13,688 $ 34,142 $ 67,748 $ 88,885

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 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 September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Stock-based compensation resulting from the Spin-off $ — $ — $ — $ 372 Stock-based compensation related to grants following the Spin-off 1,744 2,766 4,708 7,614 Total stock-based compensation expense $ 1,744 $ 2,766 $ 4,708 $ 7,986
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 nine months ended September 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 September 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 nine months ended September 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 (889,892 ) 7.72 Forfeited (283,178 ) 8.53 Unvested restricted stock awards at September 30, 2019 2,723,393 $ 3.39

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 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): September 30, 2019 Current Long-Term Current Long-Term Receivable Receivable Liability Liability Professional and general liability: Insurance reserves indemnified by CHS, Inc. $ 12,357 $ 22,678 $ 12,357 $ 22,678 All other self-insurance reserves — — 4,782 25,905 Total insurance reserves for professional and general liability 12,357 22,678 17,139 48,583 Workers' compensation liability: Insurance reserves indemnified by CHS, Inc. 1,152 11,223 1,152 11,223 All other self-insurance reserves — — 1,886 4,388 Total insurance reserves for workers' compensation liability 1,152 11,223 3,038 15,611 Total self-insurance reserves $ 13,509 $ 33,901 $ 20,177 $ 64,194 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)	9 Months Ended
	Sep. 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 September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 309,686 $ 110,214 $ — $ 419,900 Operating costs and expenses: Salaries and benefits — 144,241 71,216 — 215,457 Supplies — 31,244 16,574 — 47,818 Other operating expenses 98 113,909 25,664 — 139,671 Depreciation and amortization — 11,268 3,760 — 15,028 Lease costs and rent — 6,250 4,871 — 11,121 Electronic health records incentives — — (17 ) — (17 ) Legal, professional and settlement costs — 5,174 17 — 5,191 Impairment of long-lived assets and goodwill — 8,010 — — 8,010 Loss (gain) on sale of hospitals, net — 1,206 — — 1,206 Loss on closure of hospitals, net — 18,414 — — 18,414 Total operating costs and expenses 98 339,716 122,085 — 461,899 Income (loss) from operations (98 ) (30,030 ) (11,871 ) — (41,999 ) Interest expense, net 32,531 541 (16 ) — 33,056 Equity in earnings of affiliates 43,088 (2,753 ) — (40,335 ) — Income (loss) before income taxes (75,717 ) (27,818 ) (11,855 ) 40,335 (75,055 ) Provision for (benefit from) income taxes 211 (51 ) (23 ) — 137 Net income (loss) (75,928 ) (27,767 ) (11,832 ) 40,335 (75,192 ) Less: Net income (loss) attributable to noncontrolling interests — — 736 — 736 Net income (loss) attributable to Quorum Health Corporation $ (75,928 ) $ (27,767 ) $ (12,568 ) $ 40,335 $ (75,928 ) Condensed Consolidating Statement of Income (Loss) Three Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 356,986 $ 103,521 $ — $ 460,507 Operating costs and expenses: Salaries and benefits — 154,547 71,690 — 226,237 Supplies — 35,237 13,712 — 48,949 Other operating expenses — 115,994 27,722 — 143,716 Depreciation and amortization — 12,431 4,181 — 16,612 Rent — 6,580 5,081 — 11,661 Electronic health records incentives — 14 (45 ) — (31 ) Legal, professional and settlement costs — 1,399 120 — 1,519 Impairment of long-lived assets and goodwill — 32,438 — — 32,438 Loss (gain) on sale of hospitals, net — 805 — — 805 Loss on closure of hospitals, net — 1,111 — — 1,111 Total operating costs and expenses — 360,556 122,461 — 483,017 Income (loss) from operations — (3,570 ) (18,940 ) — (22,510 ) Interest expense, net 32,204 245 1 — 32,450 Equity in earnings of affiliates 22,932 (2,483 ) — (20,449 ) — Income (loss) before income taxes (55,136 ) (1,332 ) (18,941 ) 20,449 (54,960 ) Provision for (benefit from) income taxes (1,196 ) 8 114 — (1,074 ) Net income (loss) (53,940 ) (1,340 ) (19,055 ) 20,449 (53,886 ) Less: Net income (loss) attributable to noncontrolling interests — — 54 — 54 Net income (loss) attributable to Quorum Health Corporation $ (53,940 ) $ (1,340 ) $ (19,109 ) $ 20,449 $ (53,940 ) Condensed Consolidating Statement of Income (Loss) Nine Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 984,133 $ 320,742 $ — $ 1,304,875 Operating costs and expenses: Salaries and benefits — 442,224 211,719 — 653,943 Supplies — 101,532 47,873 — 149,405 Other operating expenses 114 314,673 68,627 — 383,414 Depreciation and amortization — 33,803 10,364 — 44,167 Lease costs and rent — 19,640 14,639 — 34,279 Electronic health records incentives — 599 (7 ) — 592 Legal, professional and settlement costs — 6,388 92 — 6,480 Impairment of long-lived assets and goodwill — 42,820 — — 42,820 Loss (gain) on sale of hospitals, net — 2,351 (5 ) — 2,346 Loss on closure of hospitals, net — 18,414 — — 18,414 Total operating costs and expenses 114 982,444 353,302 — 1,335,860 Income (loss) from operations (114 ) 1,689 (32,560 ) — (30,985 ) Interest expense, net 98,195 800 (91 ) — 98,904 Equity in earnings of affiliates 33,124 (5,838 ) — (27,286 ) — Income (loss) before income taxes (131,433 ) 6,727 (32,469 ) 27,286 (129,889 ) Provision for (benefit from) income taxes 374 132 (120 ) — 386 Net income (loss) (131,807 ) 6,595 (32,349 ) 27,286 (130,275 ) Less: Net income (loss) attributable to noncontrolling interests — — 1,532 — 1,532 Net income (loss) attributable to Quorum Health Corporation $ (131,807 ) $ 6,595 $ (33,881 ) $ 27,286 $ (131,807 ) Condensed Consolidating Statement of Income (Loss) Nine Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net operating revenues $ — $ 1,091,781 $ 328,178 $ — $ 1,419,959 Operating costs and expenses: Salaries and benefits — 484,728 221,140 — 705,868 Supplies — 114,678 46,054 — 160,732 Other operating expenses 1,897 355,090 83,923 — 440,910 Depreciation and amortization — 40,956 11,059 — 52,015 Rent — 20,464 15,087 — 35,551 Electronic health records incentives — (416 ) (201 ) — (617 ) Legal, professional and settlement costs — 10,229 120 — 10,349 Impairment of long-lived assets and goodwill — 70,398 1,800 — 72,198 Loss (gain) on sale of hospitals, net — 8,933 (6 ) — 8,927 Loss on closure of hospitals, net — 18,195 — — 18,195 Total operating costs and expenses 1,897 1,123,255 378,976 — 1,504,128 Income (loss) from operations (1,897 ) (31,474 ) (50,798 ) — (84,169 ) Interest expense, net 96,612 (1,303 ) (2 ) — 95,307 Equity in earnings of affiliates 81,849 38,348 — (120,197 ) — Income (loss) before income taxes (180,358 ) (68,519 ) (50,796 ) 120,197 (179,476 ) Provision for (benefit from) income taxes (844 ) (412 ) 94 — (1,162 ) Net income (loss) (179,514 ) (68,107 ) (50,890 ) 120,197 (178,314 ) Less: Net income (loss) attributable to noncontrolling interests — — 1,200 — 1,200 Net income (loss) attributable to Quorum Health Corporation $ (179,514 ) $ (68,107 ) $ (52,090 ) $ 120,197 $ (179,514 )
Schedule of Condensed Consolidating Statement of Comprehensive Income (Loss)	Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (75,928 ) $ (27,767 ) $ (11,832 ) $ 40,335 $ (75,192 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 49 49 — (49 ) 49 Comprehensive income (loss) (75,879 ) (27,718 ) (11,832 ) 40,286 (75,143 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 736 — 736 Comprehensive income (loss) attributable to Quorum Health Corporation $ (75,879 ) $ (27,718 ) $ (12,568 ) $ 40,286 $ (75,879 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (53,940 ) $ (1,340 ) $ (19,055 ) $ 20,449 $ (53,886 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 114 114 — (114 ) 114 Comprehensive income (loss) (53,826 ) (1,226 ) (19,055 ) 20,335 (53,772 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 54 — 54 Comprehensive income (loss) attributable to Quorum Health Corporation $ (53,826 ) $ (1,226 ) $ (19,109 ) $ 20,335 $ (53,826 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Nine Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (131,807 ) $ 6,595 $ (32,349 ) $ 27,286 $ (130,275 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 146 146 — (146 ) 146 Comprehensive income (loss) (131,661 ) 6,741 (32,349 ) 27,140 (130,129 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 1,532 — 1,532 Comprehensive income (loss) attributable to Quorum Health Corporation $ (131,661 ) $ 6,741 $ (33,881 ) $ 27,140 $ (131,661 ) Condensed Consolidating Statement of Comprehensive Income (Loss) Nine Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net income (loss) $ (179,514 ) $ (68,107 ) $ (50,890 ) $ 120,197 $ (178,314 ) Amortization and recognition of unrecognized pension cost components, net of income taxes 39 39 — (39 ) 39 Comprehensive income (loss) (179,475 ) (68,068 ) (50,890 ) 120,158 (178,275 ) Less: Comprehensive income (loss) attributable to noncontrolling interests — — 1,200 — 1,200 Comprehensive income (loss) attributable to Quorum Health Corporation $ (179,475 ) $ (68,068 ) $ (52,090 ) $ 120,158 $ (179,475 )
Schedule of Condensed Consolidating Balance Sheet	Condensed Consolidating Balance Sheet September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated ASSETS Current assets: Cash and cash equivalents $ 41,173 $ 2,096 $ 1,162 $ — $ 44,431 Patient accounts receivable — 199,091 84,610 — 283,701 Inventories — 30,354 8,970 — 39,324 Prepaid expenses — 15,114 5,298 — 20,412 Due from third-party payors — 20,713 5,736 — 26,449 Other current assets 2,183 21,504 9,956 — 33,643 Total current assets 43,356 288,872 115,732 — 447,960 Intercompany receivable 3 856,771 448,116 (1,304,890 ) — Property and equipment, net — 348,088 137,407 — 485,495 Goodwill — 225,628 166,073 — 391,701 Intangible assets, net — 43,338 4,469 — 47,807 Operating lease right-of-use assets — 44,872 33,734 — 78,606 Other long-term assets — 53,025 17,174 — 70,199 Net investment in subsidiaries 1,398,752 — — (1,398,752 ) — Total assets $ 1,442,111 $ 1,860,594 $ 922,705 $ (2,703,642 ) $ 1,521,768 LIABILITIES AND EQUITY Current liabilities: Current maturities of long-term debt $ — $ 1,504 $ 142 $ — $ 1,646 Current portion of operating lease liabilities — 16,399 8,436 — 24,835 Accounts payable 80 126,998 26,567 — 153,645 Accrued liabilities: Accrued salaries and benefits — 43,577 24,696 — 68,273 Accrued interest 33,580 — — — 33,580 Due to third-party payors — 34,656 7,342 — 41,998 Other current liabilities — 31,431 15,192 — 46,623 Total current liabilities 33,660 254,565 82,375 — 370,600 Long-term debt 1,174,021 21,270 116 — 1,195,407 Long-term operating lease liabilities — 29,644 26,702 — 56,346 Intercompany payable 446,391 448,119 410,380 (1,304,890 ) — Deferred income tax liabilities, net 7,049 — — — 7,049 Other long-term liabilities — 181,975 24,488 (113,009 ) 93,454 Total liabilities 1,661,121 935,573 544,061 (1,417,899 ) 1,722,856 Redeemable noncontrolling interests — — 2,278 — 2,278 Equity: Quorum Health Corporation stockholders' equity (deficit): Preferred stock — — — — — Common stock 3 — — — 3 Additional paid-in capital 561,081 1,049,547 718,668 (1,768,215 ) 561,081 Accumulated other comprehensive income (loss) 905 943 (38 ) (905 ) 905 Accumulated deficit (780,999 ) (125,469 ) (357,908 ) 483,377 (780,999 ) Total Quorum Health Corporation stockholders' equity (deficit) (219,010 ) 925,021 360,722 (1,285,743 ) (219,010 ) Nonredeemable noncontrolling interests — — 15,644 — 15,644 Total equity (deficit) (219,010 ) 925,021 376,366 (1,285,743 ) (203,366 ) Total liabilities and equity $ 1,442,111 $ 1,860,594 $ 922,705 $ (2,703,642 ) $ 1,521,768 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 Nine Months Ended September 30, 2019 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (70,067 ) $ 135,677 $ (42,770 ) $ — $ 22,840 Cash flows from investing activities: Capital expenditures for property and equipment — (18,833 ) (6,998 ) — (25,831 ) Capital expenditures for software — (4,759 ) (601 ) — (5,360 ) Acquisitions, net of cash acquired — — (531 ) — (531 ) Proceeds from the sale of hospitals — 52,733 — — 52,733 Other investing activities, net — 260 3,000 — 3,260 Changes in intercompany balances with affiliates, net — (162,395 ) — 162,395 — Net cash provided by (used in) investing activities — (132,994 ) (5,130 ) 162,395 24,271 Cash flows from financing activities: Borrowings under revolving credit facilities 465,000 — — — 465,000 Repayments under revolving credit facilities (454,000 ) — — — (454,000 ) Borrowings of long-term debt — 161 25 — 186 Repayments of long-term debt (13,065 ) (1,243 ) (100 ) — (14,408 ) Payments on purchase contracts — (374 ) — — (374 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (588 ) — — (588 ) Cash distributions to noncontrolling investors — — (1,699 ) — (1,699 ) Changes in intercompany balances with affiliates, net 112,096 — 50,299 (162,395 ) — Net cash provided by (used in) financing activities 110,031 (2,044 ) 48,525 (162,395 ) (5,883 ) Net change in cash and cash equivalents 39,964 639 625 — 41,228 Cash and cash equivalents at beginning of period 1,209 1,457 537 — 3,203 Cash and cash equivalents at end of period $ 41,173 $ 2,096 $ 1,162 $ — $ 44,431 Condensed Consolidating Statement of Cash Flows Nine Months Ended September 30, 2018 (In Thousands) Parent Issuer Other Guarantors Non- Guarantors Eliminations Consolidated Net cash provided by (used in) operating activities $ (80,781 ) $ 124,538 $ (822 ) $ — $ 42,935 Cash flows from investing activities: Capital expenditures for property and equipment — (21,193 ) (13,702 ) — (34,895 ) Capital expenditures for software — (1,400 ) (127 ) — (1,527 ) Acquisitions, net of cash acquired — (42 ) (79 ) — (121 ) Proceeds from the sale of hospitals — 39,384 (214 ) — 39,170 Other investing activities, net — 190 69 — 259 Changes in intercompany balances with affiliates, net — (137,364 ) — 137,364 — Net cash provided by (used in) investing activities — (120,425 ) (14,053 ) 137,364 2,886 Cash flows from financing activities: Borrowings under revolving credit facilities 368,000 — — — 368,000 Repayments under revolving credit facilities (368,000 ) — — — (368,000 ) Borrowings of long-term debt — 102 55 — 157 Repayments of long-term debt (30,463 ) (1,182 ) (156 ) — (31,801 ) Payments of debt issuance costs (2,268 ) — — — (2,268 ) Cancellation of restricted stock awards for payroll tax withholdings on vested shares — (1,979 ) — — (1,979 ) Cash distributions to noncontrolling investors — — (1,481 ) — (1,481 ) Changes in intercompany balances with affiliates, net 112,682 — 24,682 (137,364 ) — Net cash provided by (used in) financing activities 79,951 (3,059 ) 23,100 (137,364 ) (37,372 ) Net change in cash, cash equivalents and restricted cash (830 ) 1,054 8,225 — 8,449 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 $ 221 $ 5,276 $ 8,569 $ — $ 14,066

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies (Narrative) (Details)	Jan. 01, 2019USD ($)	Apr. 29, 2016Hospital	Sep. 30, 2019USD ($)Hospitalstatebed	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)HospitalstatebedFacility	Sep. 30, 2018USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2014Hospital
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital			24		24
Number of states in which entity operates | state			14		14
Number of licensed beds | bed			2,038		2,038
Number of facilities closed or sold | Facility					2
Increase (decrease) in net operating revenues during period for transaction price adjustments related to estimated cost report settlements			$ 200,000	$ (500,000)	$ 2,300,000	$ (400,000)
Net operating revenues			419,900,000	460,507,000	1,304,875,000	1,419,959,000
Provider taxes			27,251,000	33,631,000	62,861,000	100,313,000
Gross amounts of charity care revenues			7,500,000	7,600,000	19,800,000	26,900,000
Accounts receivable, net of contractual adjustments			283,701,000		283,701,000		$ 322,608,000
Due from third-party payors			26,449,000		26,449,000		63,443,000
General and administrative costs			13,700,000	14,200,000	35,700,000	49,100,000
Severance costs			1,393,000	1,722,000	2,965,000	7,688,000
Operating lease right-of-use assets			78,606,000		78,606,000		0
Operating lease liabilities			81,181,000		81,181,000
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			8,200,000		$ 8,200,000		10,400,000
Cloud Computing Arrangements [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized cloud computing costs amortization period					5 years
Cloud Computing Arrangements [Member] | Other Long-Term Assets [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Implementation costs capitalized			$ 1,500,000		$ 1,500,000
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
Illinois [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital			7		7
Net operating revenues					$ 496,671,000	554,909,000
California [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Number of hospitals owned or leased | Hospital			1		1
Net operating revenues					$ 126,892,000	136,357,000
California Hospital Quality Assurance Fee [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues				8,700,000	16,000,000	24,400,000
Provider taxes				100,000	4,400,000	4,400,000
Watsonville Community Hospital [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues					7,300,000	14,400,000
Illinois Hospital Credit Program [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			$ 2,000,000	7,300,000	5,900,000	7,300,000
Medicare [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			121,812,000	123,788,000	370,743,000	398,477,000
Accounts receivable, net of contractual adjustments			51,700,000		51,700,000		58,200,000
Medicaid [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			86,280,000	97,803,000	264,998,000	270,047,000
Medicaid [Member] | Illinois [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Accounts receivable, net of contractual adjustments			20,100,000		20,100,000		24,500,000
Medicaid [Member] | California [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Due from third-party payors			5,200,000		5,200,000		$ 37,800,000
Hospital Operations Reporting Unit [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Net operating revenues			404,101,000	442,802,000	1,256,872,000	1,363,628,000
Corporate Office [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Severance costs			$ 1,300,000	$ 1,600,000	$ 1,300,000	$ 6,200,000
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					18.20%		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					7.10%		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					19.80%		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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 419,900	$ 460,507	$ 1,304,875	$ 1,419,959
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	$ 121,812	$ 123,788	$ 370,743	$ 398,477
Medicare [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	29.00%	26.90%	28.40%	28.10%
Medicaid [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 86,280	$ 97,803	$ 264,998	$ 270,047
Medicaid [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	20.50%	21.20%	20.30%	19.00%
Managed Care and Commercial Plans [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 168,050	$ 185,493	$ 516,783	$ 560,445
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	40.00%	40.30%	39.60%	39.50%
Self-Pay and Self-Pay After Insurance [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 25,410	$ 33,647	$ 95,081	$ 125,619
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	6.10%	7.30%	7.30%	8.80%
Non-Patient [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Net operating revenues	$ 18,348	$ 19,776	$ 57,270	$ 65,371
Non-Patient [Member] | Sales Revenue, Net [Member] | Payor Concentration Risk [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Concentration risk, percentage	4.40%	4.30%	4.40%	4.60%

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	Sep. 30, 2019	Dec. 31, 2018
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Due from third-party payors	$ 26,449	$ 63,443
Due to third-party payors	41,998	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	11,410	14,374
Due to third-party payors	36,886	32,174
State Supplemental Payment Programs [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Due from third-party payors	15,039	49,069
Due to third-party payors	$ 5,112	$ 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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Medicaid state supplemental payment program revenues	$ 419,900	$ 460,507	$ 1,304,875	$ 1,419,959
Provider taxes and other expenses	27,251	33,631	62,861	100,313
State Supplemental Payment Programs [Member]
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Medicaid state supplemental payment program revenues	37,217	57,555	132,496	158,186
Provider taxes and other expenses	15,415	19,131	53,008	55,326
Reimbursements attributable to state supplemental payment programs, net of expenses	$ 21,802	$ 38,424	$ 79,488	$ 102,860

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		9 Months Ended
	Sep. 30, 2019USD ($)Hospital	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)Hospital	Sep. 30, 2018USD ($)
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	24		24
Total net operating revenues before the provision for bad debts, Amount | $	$ 419,900	$ 460,507	$ 1,304,875	$ 1,419,959
Illinois [Member]
Concentration Risk [Line Items]
Number of hospitals owned or leased | Hospital	7		7
Total net operating revenues before the provision for bad debts, Amount | $			$ 496,671	$ 554,909
Illinois [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			39.80%	41.00%
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 | $			$ 178,442	$ 172,319
Oregon [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			14.30%	12.70%
California [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 | $			$ 126,892	$ 136,357
California [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			10.20%	10.10%
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 | $			$ 84,835	$ 87,935
Kentucky [Member] | Sales Revenue, Net [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			6.80%	6.50%

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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Other Operating Expenses [Line Items]
Taxes and insurance	$ 27,251	$ 33,631	$ 62,861	$ 100,313
Repairs and maintenance	9,188	8,962	28,041	27,659
Utilities	6,420	6,559	16,961	18,274
Other miscellaneous operating expenses	17,855	16,430	50,920	55,384
Other operating expenses	139,671	143,716	383,414	440,910
Purchased Services [Member]
Other Operating Expenses [Line Items]
Professional fees	41,975	37,955	121,399	116,537
Medical Specialist Fees [Member]
Other Operating Expenses [Line Items]
Professional fees	25,428	26,078	76,652	79,459
Community Health Systems, Inc [Member]
Other Operating Expenses [Line Items]
Transition services agreements	$ 11,554	$ 14,101	$ 26,580	$ 43,284

Impairment of Long-Lived Asse_2

Impairment of Long-Lived Assets and Goodwill (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Impairment Of Long Lived Assets And Goodwill [Abstract]
Impairment of long-lived assets and goodwill	$ 8,010	$ 26,000	$ 8,900	$ 32,438	$ 0	$ 39,800	$ 42,820	$ 72,198
Impairment of long-lived assets	7,400	15,300	8,400	31,500	$ 0	34,700
Impairment of capitalized software costs	$ 600	4,200	$ 500	$ 900		$ 5,100
Impairment of goodwill		$ 6,500					$ 6,490

Divestitures (Narrative) (Detai

Divestitures (Narrative) (Details) $ in Thousands	Apr. 12, 2019USD ($)bed	Sep. 30, 2019USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)bed	Sep. 30, 2018USD ($)
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Proceeds from the sale of hospitals		$ 40,992	$ 0	$ 52,733	$ 39,170
Loss (gain) on sale of hospitals, net		1,206	805	2,346	8,927
Severance and salary continuation costs		1,393	1,722	2,965	7,688
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
Notes Receivable, Related Parties		5,000		$ 5,000
Proceeds from the sale of hospitals				46,000
Pre-tax income (losses) from disposal of discontinued operation		(7,900)	3,300	(10,300)	2,000
Loss (gain) on sale of hospitals, net				1,100
MetroSouth Medical Center [Member] | Illinois [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Pre-tax income (losses) from disposal of discontinued operation		(22,600)	(3,900)	$ (25,800)	(5,700)
Number of beds in facilities where operation is ceased | bed				314
Business closure costs				$ 18,400
Non Cash Losses Related To Write Down Of Assets				11,800
Severance and salary continuation costs				4,700
Other costs and fees related to termination of contracts and other miscellaneous costs				$ 1,900
MetroSouth Medical Center [Member] | Illinois [Member] | Facility Closing [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Health records maintenance obligation term from year two onwards				25 years
Annual cost related to closure beyond the current fiscal year				$ 200
MetroSouth Medical Center [Member] | Illinois [Member] | Facility Closing [Member] | Maximum [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Future additional costs associated with closure of business		3,000		3,000
MetroSouth Medical Center [Member] | Illinois [Member] | Facility Closing [Member] | Minimum [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Future additional costs associated with closure of business		5,000		5,000
Additional annual cost that may be incurred to maintain existing facilities until they are sold				1,000
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
Proceeds from the sale of hospitals	$ 11,700
Pre-tax income (losses) from disposal of discontinued operation		$ (2,300)	$ (1,400)	(6,400)	$ (1,500)
Loss (gain) on sale of hospitals, net				1,100
Goodwill written off				$ 3,300

Property and Equipment (Summary

Property and Equipment (Summary of Components of Property and Equipment) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	$ 1,121,374	$ 1,287,329
Less: Accumulated depreciation and amortization	(635,879)	(727,891)
Total property and equipment, net	485,495	559,438
Land and Improvements [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	41,636	49,637
Buildings and Improvements [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	637,111	723,345
Equipment and Fixtures [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	433,439	498,139
Construction in progress [Member]
Property Plant And Equipment [Line Items]
Total property and equipment, at cost	$ 9,188	$ 16,208

Property and Equipment (Narrati

Property and Equipment (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Depreciation expense	$ 10.9	$ 12.4	$ 32.1	$ 37.6
Purchases of property and equipment accrued in accounts payable			$ 4.8		$ 4.9

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Changes in Goodwill) (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Jun. 30, 2019	Sep. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill, beginning balance		$ 401,073
Acquisitions		418
Divestitures		(3,300)
Impairment	$ (6,500)	(6,490)
Goodwill, ending balance		$ 391,701

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Goodwill Narrative) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Goodwill [Line Items]
Goodwill	$ 391,701	$ 401,073
Goodwill accumulated impairment loss	133,500	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	Sep. 30, 2019	Dec. 31, 2018
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	$ 186,842	$ 194,024
Accumulated Amortization	(144,161)	(150,849)
Total finite-lived intangible assets, net	42,681	43,175
Cost	5,126	5,114
Total indefinite-lived intangible assets	5,126	5,114
Cost	191,968	199,138
Total intangible assets	47,807	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	1,126	1,114
Total indefinite-lived intangible assets	1,126	1,114
Capitalized Software Costs [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	140,361	145,795
Accumulated Amortization	(104,793)	(111,658)
Total finite-lived intangible assets, net	35,568	34,137
Physician Income Guarantee Contracts [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	3,269	5,008
Accumulated Amortization	(1,468)	(2,679)
Total finite-lived intangible assets, net	1,801	2,329
Other Finite-Lived Intangible Assets [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Cost	43,212	43,221
Accumulated Amortization	(37,900)	(36,512)
Total finite-lived intangible assets, net	$ 5,312	$ 6,709

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets (Intangible Assets Narrative) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross	$ 186,842	$ 194,024
Capitalized Software Costs in Development Stage [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross	$ 10,600

Goodwill and Intangible Asset_6

Goodwill and Intangible Assets (Summary of the Components of Amortization Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	$ 3,362	$ 3,421	$ 9,673	$ 11,979
Amortization of leasehold improvements and property and equipment assets held under finance lease obligations	777	792	2,346	2,468
Total amortization expense	4,139	4,213	12,019	14,447
Capitalized Software Costs [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	2,540	2,416	6,861	8,515
Physician Income Guarantee Contracts [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	351	497	1,397	1,942
Other Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expense related to finite-lived intangible assets	$ 471	$ 508	$ 1,415	$ 1,522

Goodwill and Intangible Asset_7

Goodwill and Intangible Assets (Amortization Expense Narrative) (Details)	9 Months Ended
	Sep. 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	2 years 9 months 18 days

Long-Term Debt (Summary of Comp

Long-Term Debt (Summary of Components of Long-Term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Total debt, excluding debt issuance costs and discounts	$ 1,225,718	$ 1,229,011
Unamortized debt issuance costs and discounts	(28,665)	(35,537)
Finance lease obligations	22,574	23,386
Other debt	458	874
Total debt	1,197,053	1,193,474
Less: Current maturities of long-term debt	(1,646)	(1,697)
Long-term debt	1,195,407	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	25,000	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	Sep. 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		449.00%
Line of credit, borrowing capacity		$ 89,600,000
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		$ 15,200,000
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		9.50%
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		$ 47,300,000
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]	Sep. 30, 2019
Debt Instrument [Line Items]
Secured net leverage ratio	449.00%
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	Sep. 30, 2019
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	$ 125,000,000	$ 77,000,000
Line of credit, outstanding balance		25,000,000
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	Sep. 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	Sep. 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]	9 Months Ended
	Sep. 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	Sep. 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	(30,404)	(23,532)
Total unamortized debt issuance costs and discounts	$ 28,665	$ 35,537

Long-Term Debt (Finance Lease O

Long-Term Debt (Finance Lease Obligations and Other Debt Narrative) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Finance lease obligations	$ 22,574	$ 23,386
New Corporate Office [Member] | Brentwood, Tennessee [Member]
Debt Instrument [Line Items]
Finance lease obligations	$ 16,500	$ 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	Sep. 30, 2019	Dec. 31, 2018
Debt Disclosure [Abstract]
Remainder of 2019	$ 413
2020	1,641
2021	26,629
2022	779,133
2023	401,348
Thereafter	16,554
Total debt, excluding unamortized debt issuance costs and discounts	$ 1,225,718	$ 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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Debt Instrument [Line Items]
Amortization of debt issuance costs and discounts	$ 2,229	$ 2,079	$ 6,872	$ 7,249
All other interest expense (income), net	497	285	723	(1,301)
Interest expense, net	33,056	32,450	98,904	95,307
Senior Notes, maturing 2023 [Member]
Debt Instrument [Line Items]
Interest expense	11,626	11,626	34,878	34,865
ABL Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Interest expense	612	276	1,659	1,115
Senior Credit Facility [Member] | Revolving Credit Facility, maturing 2021 [Member]
Debt Instrument [Line Items]
Interest expense	61	63	183	205
Senior Credit Facility [Member] | Term Loan Facility, maturing 2022 [Member]
Debt Instrument [Line Items]
Interest expense	$ 18,031	$ 18,121	$ 54,589	$ 53,174

Leases (Summary of Components o

Leases (Summary of Components of Lease Costs and Rent) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Operating lease costs:
Operating lease cost	$ 8,838		$ 27,040
Variable lease cost	655		1,954
Short-term rent expense	1,628		5,285
Total operating lease costs	11,121	$ 11,661	34,279	$ 35,551
Finance lease costs:
Amortization of right-of-use assets	389		1,167
Interest on lease liabilities	380		1,138
Total finance lease costs	$ 769		$ 2,305

Leases (Schedule of Balance She

Leases (Schedule of Balance Sheet Information Related to Finance Leases) (Details) $ in Thousands	Sep. 30, 2019USD ($)
Finance lease costs:
Accumulated amortization	$ 6,922
Current finance lease liabilities	1,369
Long-term finance lease liabilities	21,205
Property and Equipment [Member]
Finance lease costs:
Finance lease ROU assets	29,358
Current Maturities of Long-term Debt [Member]
Finance lease costs:
Current finance lease liabilities	1,369
Long-term Debt [Member]
Finance lease costs:
Long-term finance lease liabilities	$ 21,205

Leases (Supplemental Cash Flow

Leases (Supplemental Cash Flow Information Related to Leases) (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 8,828	$ 27,060
Operating cash flows from finance leases	329	992
Financing cash flows from finance leases	327	1,011
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	2,084	10,710
Finance leases	$ 120	$ 199

Leases (Schedule of Weighted-Av

Leases (Schedule of Weighted-Average Lease Terms and Discount Rates Used for Operating and Finance Leases) (Details)	Sep. 30, 2019
Weighted-average remaining lease term (years):
Operating leases	5 years
Finance leases	7 years 4 months 24 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	Sep. 30, 2019	Dec. 31, 2018
Operating Lease
Remainder of 2019	$ 7,424
2020	30,611
2021	21,412
2022	13,400
2023	7,914
Thereafter	24,901
Total lease payments	105,662
Less: Imputed interest	(24,481)
Total lease obligations	81,181
Less: Current portion	(24,835)	$ 0
Total long-term lease obligations	56,346	0
Finance Leases
Remainder of 2019	659
2020	2,645
2021	2,670
2022	2,367
2023	6,997
Thereafter	13,723
Total lease payments	29,061
Less: Imputed interest	(6,487)
Total lease obligations	22,574	$ 23,386
Less: Current portion	(1,369)
Total long-term lease obligations	$ 21,205

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	Sep. 30, 2019	Dec. 31, 2018
Other Assets Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term receivable	$ 22,678	$ 34,535
Assets of deferred compensation plan	15,397	14,980
Insurance reserves for workers' compensation liability, long-term receivable	11,223	12,118
Notes receivable	5,487	501
Other miscellaneous long-term assets	15,414	12,172
Total other long-term assets	70,199	74,306
Insurance Reserves Indemnified By CHS [Member]
Other Assets Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term receivable	22,678	34,535
Insurance reserves for workers' compensation liability, long-term receivable	$ 11,223	$ 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	Sep. 30, 2019	Dec. 31, 2018
Other Liabilities Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term liability	$ 48,583	$ 82,828
Insurance reserves for workers' compensation liability, long-term liability	15,611	16,819
Benefit plan liabilities	20,453	22,712
Software license liabilities	5,936	0
Other miscellaneous long-term liabilities	2,871	4,140
Total other long-term liabilities	93,454	126,499
Professional and General Liability Insurance [Member]
Other Liabilities Noncurrent [Line Items]
Insurance reserves for professional and general liability, long-term liability	$ 48,583	$ 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	Sep. 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	$ 1,225,718	$ 1,229,011
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	1,178,323	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	25,000	14,000
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	25,000	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	363,780	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	23,032	24,260
Total debt, excluding unamortized debt issuance costs and discounts, Estimated Fair Value	23,032	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	$ 766,511	$ 784,821

Equity (Narrative) (Details)

Equity (Narrative) (Details)	9 Months Ended
	Sep. 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	32,908,366	31,521,398
Common stock, shares outstanding	32,908,366	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		9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 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	(0.20%)	2.00%	(0.30%)	0.60%
Deferred income tax liabilities, net	$ 7,049,000		$ 7,049,000		$ 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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Numerator:
Net income (loss)	$ (75,192)	$ (53,886)	$ (130,275)	$ (178,314)
Less: Net income (loss) attributable to noncontrolling interests	736	54	1,532	1,200
Net income (loss) attributable to Quorum Health Corporation	$ (75,928)	$ (53,940)	$ (131,807)	$ (179,514)
Denominator:
Weighted-average shares outstanding - basic and diluted	30,178,229	29,215,823	29,875,196	28,891,363
Earnings (loss) per share attributable to Quorum Health Corporation stockholders - basic and diluted	$ (2.52)	$ (1.85)	$ (4.41)	$ (6.21)

Earnings Per Share (Narrative)

Earnings Per Share (Narrative) (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Earnings Per Share [Abstract]
Dilutive Shares	0	0	0	0

Segments (Narrative) (Details)

Segments (Narrative) (Details)	9 Months Ended
	Sep. 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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Segment Reporting Information [Line Items]
Net operating revenues	$ 419,900	$ 460,507	$ 1,304,875	$ 1,419,959
Total Adjusted EBITDA	13,688	34,142	67,748	88,885
Total assets	1,521,768		1,521,768		$ 1,574,094
Hospital Operations Reporting Unit [Member]
Segment Reporting Information [Line Items]
Net operating revenues	404,101	442,802	1,256,872	1,363,628
Total Adjusted EBITDA	18,261	39,137	88,338	109,455
Total assets	1,342,939		1,342,939		1,453,693
Quorum Health Resources [Member]
Segment Reporting Information [Line Items]
Net operating revenues	15,711	16,937	45,742	55,145
Total Adjusted EBITDA	5,310	4,715	13,517	13,518
Total assets	52,465		52,465		55,823
All Other Operations [Member]
Segment Reporting Information [Line Items]
Net operating revenues	88	768	2,261	1,186
Total Adjusted EBITDA	(9,883)	$ (9,710)	(34,107)	$ (34,088)
Total assets	$ 126,364		$ 126,364		$ 64,578

Segments (Summary of Reconcilia

Segments (Summary of Reconciliation of Adjusted EBITDA to Net Income (Loss)) (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting [Abstract]
Net income (loss)	$ (75,192)			$ (53,886)			$ (130,275)	$ (178,314)
Interest expense, net	33,056			32,450			98,904	95,307
Provision for (benefit from) income taxes	137			(1,074)			386	(1,162)
Depreciation and amortization	15,028			16,612			44,167	52,015
EBITDA	(26,971)			(5,898)			13,182	(32,154)
Legal, professional and settlement costs	5,191			1,519			6,480	10,349
Impairment of long-lived assets and goodwill	8,010	$ 26,000	$ 8,900	32,438	$ 0	$ 39,800	42,820	72,198
Loss (gain) on sale of hospitals, net	1,206			805			2,346	8,927
Loss on closure of hospitals, net	18,414			1,111			18,414	18,195
Transition of transition services agreements	6,445			2,445			8,421	3,682
Change in actuarial estimates	0			0			(26,880)	0
Headcount reductions and executive severance	1,393			1,722			2,965	7,688
Total Adjusted EBITDA	$ 13,688			$ 34,142			$ 67,748	$ 88,885

Stock-Based Compensation (Narra

Stock-Based Compensation (Narrative) (Details) - USD ($) $ in Millions	Feb. 14, 2019	Sep. 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 Restricted Stock Awards Granted Following Spin-off [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Restricted stock units, shares granted		1,689,346
Unrecognized stock-based compensation expense		$ 5.8
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)	9 Months Ended
	Sep. 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	(889,892)
Forfeited, Shares	(283,178)
Unvested restricted stock awards at end of period, Shares	2,723,393
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	7.72
Forfeited, Weighted Average Grant Date Fair Value Per Share | $ / shares	8.53
Unvested restricted stock awards at end of period, Weighted Average Grant Date Fair Value Per Share | $ / shares	$ 3.39

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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 1,744	$ 2,766	$ 4,708	$ 7,986
Resulting from Spin-off [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	0	0	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	$ 1,744	$ 2,766	$ 4,708	$ 7,614

Benefit Plans (Narrative) (Deta

Benefit Plans (Narrative) (Details)	Sep. 16, 2016Installmentshares	Aug. 18, 2016	Apr. 29, 2016USD ($)	Sep. 30, 2019USD ($)Hospital	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2018USD ($)	Dec. 31, 2018USD ($)
Defined Benefit Plan Disclosure [Line Items]
Defined contribution plan, total expense				$ 500,000	$ 3,800,000	$ 1,300,000	$ 8,100,000
Pension Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Defined benefit plan net periodic benefit cost				$ 100,000	100,000	200,000	200,000
Number of hospitals | Hospital				1
Accrued benefit obligation liability				$ 0		0		$ 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	$ 300,000	700,000	$ 900,000
Director's Plan [Member] | Restricted Stock Units [Member]
Defined Benefit Plan Disclosure [Line Items]
Restricted stock units accrued | shares	93,409
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				3,700,000		3,700,000		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				16,700,000		16,700,000		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				$ 15,400,000		$ 15,400,000		$ 15,000,000

Related Party Transactions (Nar

Related Party Transactions (Narrative) (Details) - Community Health Systems, Inc [Member] - USD ($) $ in Millions	Apr. 29, 2016	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Related Party Transaction [Line Items]
Total expenses incurred		$ 11.6	$ 14.1	$ 26.6	$ 43.3
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 ($)	Aug. 08, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Other Commitments [Line Items]
Loss contingency, damages sought, value	$ 2,240,000
Capitalized information technology infrastructure			$ 4,400,000
Estimated additional contract costs to be incurred			13,800,000
Agreement with MEDHOST INC. [Member]
Other Commitments [Line Items]
Estimated total additional cost of project, including software licenses and implementation fees			37,400,000
Agreement with MEDHOST INC. [Member] | Intangible Assets, Net [Member]
Other Commitments [Line Items]
Capitalized software costs			10,300,000
Cloud Computing Arrangements [Member]
Other Commitments [Line Items]
Estimated total additional costs of arrangements, including hosting and implementation fees			2,200,000
Cloud Computing Arrangements [Member] | Other Long-Term Assets [Member]
Other Commitments [Line Items]
Implementation costs capitalized			1,500,000
McKenzie Willamette Medical Center Project [Member] | Asset Under Construction [Member] | Construction and Capital Commitments [Member]
Other Commitments [Line Items]
Construction costs incurred		$ 3,600,000	2,400,000	$ 14,300,000
Cumulative project cost			103,200,000
Project placed into service			103,000,000
Total estimated costs of project, including equipment costs			105,000,000
Anticipated remaining costs on project in 2019			1,800,000
Professional and General Liability Insurance [Member]
Other Commitments [Line Items]
Self-insured retention level			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
Worker's Compensation Liability [Member]
Other Commitments [Line Items]
Self-insured retention level			500,000
Maximum [Member]
Other Commitments [Line Items]
Loss contingency, counterclaim sought, value	$ 15,000,000
Penalty per false claim violation and attorneys' fees			$ 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	Sep. 30, 2019	Dec. 31, 2018
Loss Contingencies [Line Items]
Insurance reserves for professional and general liability, current receivable	$ 12,357	$ 20,200
Insurance reserves for workers' compensation liability, current receivable	1,152	1,412
Total self-insurance reserves, current receivable	13,509	21,612
Insurance reserves for professional and general liability, long-term receivable	22,678	34,535
Insurance reserves for workers' compensation liability, long-term receivable	11,223	12,118
Total self-insurance reserves, long-term receivable	33,901	46,653
Insurance reserves for professional and general liability, current liability	17,139	25,395
Insurance reserves for workers' compensation liability, current liability	3,038	3,937
Total self-insurance reserves, current liability	20,177	29,332
Insurance reserves for professional and general liability, long-term liability	48,583	82,828
Insurance reserves for workers' compensation liability, long-term liability	15,611	16,819
Total self-insurance reserves, long-term liability	64,194	99,647
Insurance Reserves Indemnified By CHS, Inc. [Member]
Loss Contingencies [Line Items]
Insurance reserves for professional and general liability, current receivable	12,357	20,200
Insurance reserves for workers' compensation liability, current receivable	1,152	1,412
Insurance reserves for professional and general liability, long-term receivable	22,678	34,535
Insurance reserves for workers' compensation liability, long-term receivable	11,223	12,118
Insurance reserves for professional and general liability, current liability	12,357	20,200
Insurance reserves for workers' compensation liability, current liability	1,152	1,412
Insurance reserves for professional and general liability, long-term liability	22,678	34,535
Insurance reserves for workers' compensation liability, long-term liability	11,223	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	4,782	5,195
Insurance reserves for workers' compensation liability, current liability	1,886	2,525
Insurance reserves for professional and general liability, long-term liability	25,905	48,293
Insurance reserves for workers' compensation liability, long-term liability	$ 4,388	$ 4,701

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - USD ($) $ in Thousands	Oct. 01, 2019	Oct. 31, 2019	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Subsequent Event [Line Items]
Pay down of term loan			$ 445	$ 354	$ 14,408	$ 31,801
Subsequent Event [Member]
Subsequent Event [Line Items]
Early termination fee	$ 1,700
Wind down costs	$ 2,600
Subsequent Event [Member] | Term Loan Facility [Member]
Subsequent Event [Line Items]
Pay down of term loan		$ 39,300

Guarantor and Non-Guarantor S_3

Guarantor and Non-Guarantor Supplemental Information (Narrative) (Details)	9 Months Ended
	Sep. 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						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Condensed Income Statements Captions [Line Items]
Net operating revenues	$ 419,900			$ 460,507			$ 1,304,875	$ 1,419,959
Operating costs and expenses:
Salaries and benefits	215,457			226,237			653,943	705,868
Supplies	47,818			48,949			149,405	160,732
Other operating expenses	139,671			143,716			383,414	440,910
Depreciation and amortization	15,028			16,612			44,167	52,015
Lease costs and rent	11,121			11,661			34,279	35,551
Electronic health records incentives	(17)			(31)			592	(617)
Legal, professional and settlement costs	5,191			1,519			6,480	10,349
Impairment of long-lived assets and goodwill	8,010	$ 26,000	$ 8,900	32,438	$ 0	$ 39,800	42,820	72,198
Loss (gain) on sale of hospitals, net	1,206			805			2,346	8,927
Loss on closure of hospitals, net	18,414			1,111			18,414	18,195
Total operating costs and expenses	461,899			483,017			1,335,860	1,504,128
Income (loss) from operations	(41,999)			(22,510)			(30,985)	(84,169)
Interest expense, net	33,056			32,450			98,904	95,307
Equity in earnings of affiliates	0			0			0	0
Income (loss) before income taxes	(75,055)			(54,960)			(129,889)	(179,476)
Provision for (benefit from) income taxes	137			(1,074)			386	(1,162)
Net income (loss)	(75,192)			(53,886)			(130,275)	(178,314)
Less: Net income (loss) attributable to noncontrolling interests	736			54			1,532	1,200
Net income (loss) attributable to Quorum Health Corporation	(75,928)			(53,940)			(131,807)	(179,514)
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	98			0			114	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			0	0
Total operating costs and expenses	98			0			114	1,897
Income (loss) from operations	(98)			0			(114)	(1,897)
Interest expense, net	32,531			32,204			98,195	96,612
Equity in earnings of affiliates	43,088			22,932			33,124	81,849
Income (loss) before income taxes	(75,717)			(55,136)			(131,433)	(180,358)
Provision for (benefit from) income taxes	211			(1,196)			374	(844)
Net income (loss)	(75,928)			(53,940)			(131,807)	(179,514)
Less: Net income (loss) attributable to noncontrolling interests	0			0			0	0
Net income (loss) attributable to Quorum Health Corporation	(75,928)			(53,940)			(131,807)	(179,514)
Reportable Legal Entities [Member] | Other Guarantors [Member]
Condensed Income Statements Captions [Line Items]
Net operating revenues	309,686			356,986			984,133	1,091,781
Operating costs and expenses:
Salaries and benefits	144,241			154,547			442,224	484,728
Supplies	31,244			35,237			101,532	114,678
Other operating expenses	113,909			115,994			314,673	355,090
Depreciation and amortization	11,268			12,431			33,803	40,956
Lease costs and rent	6,250			6,580			19,640	20,464
Electronic health records incentives	0			14			599	(416)
Legal, professional and settlement costs	5,174			1,399			6,388	10,229
Impairment of long-lived assets and goodwill	8,010			32,438			42,820	70,398
Loss (gain) on sale of hospitals, net	1,206			805			2,351	8,933
Loss on closure of hospitals, net	18,414			1,111			18,414	18,195
Total operating costs and expenses	339,716			360,556			982,444	1,123,255
Income (loss) from operations	(30,030)			(3,570)			1,689	(31,474)
Interest expense, net	541			245			800	(1,303)
Equity in earnings of affiliates	(2,753)			(2,483)			(5,838)	38,348
Income (loss) before income taxes	(27,818)			(1,332)			6,727	(68,519)
Provision for (benefit from) income taxes	(51)			8			132	(412)
Net income (loss)	(27,767)			(1,340)			6,595	(68,107)
Less: Net income (loss) attributable to noncontrolling interests	0			0			0	0
Net income (loss) attributable to Quorum Health Corporation	(27,767)			(1,340)			6,595	(68,107)
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Condensed Income Statements Captions [Line Items]
Net operating revenues	110,214			103,521			320,742	328,178
Operating costs and expenses:
Salaries and benefits	71,216			71,690			211,719	221,140
Supplies	16,574			13,712			47,873	46,054
Other operating expenses	25,664			27,722			68,627	83,923
Depreciation and amortization	3,760			4,181			10,364	11,059
Lease costs and rent	4,871			5,081			14,639	15,087
Electronic health records incentives	(17)			(45)			(7)	(201)
Legal, professional and settlement costs	17			120			92	120
Impairment of long-lived assets and goodwill	0			0			0	1,800
Loss (gain) on sale of hospitals, net	0			0			(5)	(6)
Loss on closure of hospitals, net	0			0			0	0
Total operating costs and expenses	122,085			122,461			353,302	378,976
Income (loss) from operations	(11,871)			(18,940)			(32,560)	(50,798)
Interest expense, net	(16)			1			(91)	(2)
Equity in earnings of affiliates	0			0			0	0
Income (loss) before income taxes	(11,855)			(18,941)			(32,469)	(50,796)
Provision for (benefit from) income taxes	(23)			114			(120)	94
Net income (loss)	(11,832)			(19,055)			(32,349)	(50,890)
Less: Net income (loss) attributable to noncontrolling interests	736			54			1,532	1,200
Net income (loss) attributable to Quorum Health Corporation	(12,568)			(19,109)			(33,881)	(52,090)
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			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	(40,335)			(20,449)			(27,286)	(120,197)
Income (loss) before income taxes	40,335			20,449			27,286	120,197
Provision for (benefit from) income taxes	0			0			0	0
Net income (loss)	40,335			20,449			27,286	120,197
Less: Net income (loss) attributable to noncontrolling interests	0			0			0	0
Net income (loss) attributable to Quorum Health Corporation	$ 40,335			$ 20,449			$ 27,286	$ 120,197

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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	$ (75,192)	$ (53,886)	$ (130,275)	$ (178,314)
Amortization and recognition of unrecognized pension cost components, net of income taxes	49	114	146	39
Comprehensive income (loss)	(75,143)	(53,772)	(130,129)	(178,275)
Less: Comprehensive income (loss) attributable to noncontrolling interests	736	54	1,532	1,200
Comprehensive income (loss) attributable to Quorum Health Corporation	(75,879)	(53,826)	(131,661)	(179,475)
Reportable Legal Entities [Member] | Parent Issuer [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	(75,928)	(53,940)	(131,807)	(179,514)
Amortization and recognition of unrecognized pension cost components, net of income taxes	49	114	146	39
Comprehensive income (loss)	(75,879)	(53,826)	(131,661)	(179,475)
Less: Comprehensive income (loss) attributable to noncontrolling interests	0	0	0	0
Comprehensive income (loss) attributable to Quorum Health Corporation	(75,879)	(53,826)	(131,661)	(179,475)
Reportable Legal Entities [Member] | Other Guarantors [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	(27,767)	(1,340)	6,595	(68,107)
Amortization and recognition of unrecognized pension cost components, net of income taxes	49	114	146	39
Comprehensive income (loss)	(27,718)	(1,226)	6,741	(68,068)
Less: Comprehensive income (loss) attributable to noncontrolling interests	0	0	0	0
Comprehensive income (loss) attributable to Quorum Health Corporation	(27,718)	(1,226)	6,741	(68,068)
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	(11,832)	(19,055)	(32,349)	(50,890)
Amortization and recognition of unrecognized pension cost components, net of income taxes	0	0	0	0
Comprehensive income (loss)	(11,832)	(19,055)	(32,349)	(50,890)
Less: Comprehensive income (loss) attributable to noncontrolling interests	736	54	1,532	1,200
Comprehensive income (loss) attributable to Quorum Health Corporation	(12,568)	(19,109)	(33,881)	(52,090)
Eliminations [Member]
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	40,335	20,449	27,286	120,197
Amortization and recognition of unrecognized pension cost components, net of income taxes	(49)	(114)	(146)	(39)
Comprehensive income (loss)	40,286	20,335	27,140	120,158
Less: Comprehensive income (loss) attributable to noncontrolling interests	0	0	0	0
Comprehensive income (loss) attributable to Quorum Health Corporation	$ 40,286	$ 20,335	$ 27,140	$ 120,158

Guarantor and Non-Guarantor S_6

Guarantor and Non-Guarantor Supplemental Information (Schedule of Condensed Consolidating Balance Sheet) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 44,431			$ 3,203
Patient accounts receivable	283,701			322,608
Inventories	39,324			45,646
Prepaid expenses	20,412			19,683
Due from third-party payors	26,449			63,443
Other current assets	33,643			36,405
Total current assets	447,960			490,988
Intercompany receivable	0			0
Property and equipment, net	485,495			559,438
Goodwill	391,701			401,073
Intangible assets, net	47,807			48,289
Operating lease right-of-use assets	78,606			0
Other long-term assets	70,199			74,306
Net investment in subsidiaries	0			0
Total assets	1,521,768			1,574,094
Current liabilities:
Current maturities of long-term debt	1,646			1,697
Current portion of operating lease liabilities	24,835			0
Accounts payable	153,645			143,917
Accrued liabilities:
Accrued salaries and benefits	68,273			76,908
Accrued interest	33,580			10,024
Due to third-party payors	41,998			45,852
Other current liabilities	46,623			43,336
Total current liabilities	370,600			321,734
Long-term debt	1,195,407			1,191,777
Long-term operating lease liabilities	56,346			0
Intercompany payable	0			0
Deferred income tax liabilities, net	7,049			6,736
Other long-term liabilities	93,454			126,499
Total liabilities	1,722,856			1,646,746
Redeemable noncontrolling interests	2,278	$ 2,278	$ 2,278	2,278	$ 2,279	$ 2,301	$ 2,316	$ 2,325
Quorum Health Corporation stockholders' equity (deficit):
Preferred stock	0			0
Common stock	3			3
Additional paid-in capital	561,081			557,309
Accumulated other comprehensive income (loss)	905			759
Accumulated deficit	(780,999)			(648,464)
Total Quorum Health Corporation stockholders' equity (deficit)	(219,010)			(90,393)
Nonredeemable noncontrolling interests	15,644			15,463
Total equity (deficit)	(203,366)	$ (129,800)	$ (114,129)	(74,930)	$ (60,293)	$ (8,595)	$ 16,073	$ 113,410
Total liabilities and equity	1,521,768			1,574,094
Reportable Legal Entities [Member] | Parent Issuer [Member]
Current assets:
Cash and cash equivalents	41,173			1,209
Patient accounts receivable	0			0
Inventories	0			0
Prepaid expenses	0			33
Due from third-party payors	0			0
Other current assets	2,183			314
Total current assets	43,356			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
Other long-term assets	0			0
Net investment in subsidiaries	1,398,752			1,428,675
Total assets	1,442,111			1,430,234
Current liabilities:
Current maturities of long-term debt	0			0
Current portion of operating lease liabilities	0
Accounts payable	80			121
Accrued liabilities:
Accrued salaries and benefits	0			0
Accrued interest	33,580			10,024
Due to third-party payors	0			0
Other current liabilities	0			248
Total current liabilities	33,660			10,393
Long-term debt	1,174,021			1,169,214
Long-term operating lease liabilities	0
Intercompany payable	446,391			334,284
Deferred income tax liabilities, net	7,049			6,736
Other long-term liabilities	0			0
Total liabilities	1,661,121			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	561,081			557,309
Accumulated other comprehensive income (loss)	905			759
Accumulated deficit	(780,999)			(648,464)
Total Quorum Health Corporation stockholders' equity (deficit)	(219,010)			(90,393)
Nonredeemable noncontrolling interests	0			0
Total equity (deficit)	(219,010)			(90,393)
Total liabilities and equity	1,442,111			1,430,234
Reportable Legal Entities [Member] | Other Guarantors [Member]
Current assets:
Cash and cash equivalents	2,096			1,457
Patient accounts receivable	199,091			260,339
Inventories	30,354			36,349
Prepaid expenses	15,114			15,269
Due from third-party payors	20,713			57,049
Other current assets	21,504			23,714
Total current assets	288,872			394,177
Intercompany receivable	856,771			661,887
Property and equipment, net	348,088			419,292
Goodwill	225,628			235,418
Intangible assets, net	43,338			43,575
Operating lease right-of-use assets	44,872
Other long-term assets	53,025			57,047
Net investment in subsidiaries	0			0
Total assets	1,860,594			1,811,396
Current liabilities:
Current maturities of long-term debt	1,504			1,557
Current portion of operating lease liabilities	16,399
Accounts payable	126,998			122,999
Accrued liabilities:
Accrued salaries and benefits	43,577			55,780
Accrued interest	0			0
Due to third-party payors	34,656			38,560
Other current liabilities	31,431			28,713
Total current liabilities	254,565			247,609
Long-term debt	21,270			22,370
Long-term operating lease liabilities	29,644
Intercompany payable	448,119			303,063
Deferred income tax liabilities, net	0			0
Other long-term liabilities	181,975			212,240
Total liabilities	935,573			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	1,049,547			1,183,608
Accumulated other comprehensive income (loss)	943			759
Accumulated deficit	(125,469)			(158,253)
Total Quorum Health Corporation stockholders' equity (deficit)	925,021			1,026,114
Nonredeemable noncontrolling interests	0			0
Total equity (deficit)	925,021			1,026,114
Total liabilities and equity	1,860,594			1,811,396
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	1,162			537
Patient accounts receivable	84,610			62,269
Inventories	8,970			9,297
Prepaid expenses	5,298			4,381
Due from third-party payors	5,736			6,394
Other current assets	9,956			12,377
Total current assets	115,732			95,255
Intercompany receivable	448,116			303,059
Property and equipment, net	137,407			140,146
Goodwill	166,073			165,655
Intangible assets, net	4,469			4,714
Operating lease right-of-use assets	33,734
Other long-term assets	17,174			17,259
Net investment in subsidiaries	0			0
Total assets	922,705			726,088
Current liabilities:
Current maturities of long-term debt	142			140
Current portion of operating lease liabilities	8,436
Accounts payable	26,567			20,797
Accrued liabilities:
Accrued salaries and benefits	24,696			21,128
Accrued interest	0			0
Due to third-party payors	7,342			7,292
Other current liabilities	15,192			14,375
Total current liabilities	82,375			63,732
Long-term debt	116			193
Long-term operating lease liabilities	26,702
Intercompany payable	410,380			327,602
Deferred income tax liabilities, net	0			0
Other long-term liabilities	24,488			33,106
Total liabilities	544,061			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	718,668			580,824
Accumulated other comprehensive income (loss)	(38)			0
Accumulated deficit	(357,908)			(297,110)
Total Quorum Health Corporation stockholders' equity (deficit)	360,722			283,714
Nonredeemable noncontrolling interests	15,644			15,463
Total equity (deficit)	376,366			299,177
Total liabilities and equity	922,705			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
Other current assets	0			0
Total current assets	0			0
Intercompany receivable	(1,304,890)			(964,949)
Property and equipment, net	0			0
Goodwill	0			0
Intangible assets, net	0			0
Operating lease right-of-use assets	0
Other long-term assets	0			0
Net investment in subsidiaries	(1,398,752)			(1,428,675)
Total assets	(2,703,642)			(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
Other current liabilities	0			0
Total current liabilities	0			0
Long-term debt	0			0
Long-term operating lease liabilities	0
Intercompany payable	(1,304,890)			(964,949)
Deferred income tax liabilities, net	0			0
Other long-term liabilities	(113,009)			(118,847)
Total liabilities	(1,417,899)			(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	(1,768,215)			(1,764,432)
Accumulated other comprehensive income (loss)	(905)			(759)
Accumulated deficit	483,377			455,363
Total Quorum Health Corporation stockholders' equity (deficit)	(1,285,743)			(1,309,828)
Nonredeemable noncontrolling interests	0			0
Total equity (deficit)	(1,285,743)			(1,309,828)
Total liabilities and equity	$ (2,703,642)			$ (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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities	$ 25,156	$ 28,334	$ 22,840	$ 42,935
Cash flows from investing activities:
Capital expenditures for property and equipment	(7,720)	(9,576)	(25,831)	(34,895)
Capital expenditures for software	(1,843)	(483)	(5,360)	(1,527)
Acquisitions, net of cash acquired	(76)	(63)	(531)	(121)
Proceeds from the sale of hospitals	40,992	0	52,733	39,170
Other investing activities, net	3,643	10	3,260	259
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) investing activities	34,996	(10,112)	24,271	2,886
Cash flows from financing activities:
Borrowings under revolving credit facilities	138,000	121,000	465,000	368,000
Repayments under revolving credit facilities	(155,000)	(135,000)	(454,000)	(368,000)
Borrowings of long-term debt	0	90	186	157
Repayments of long-term debt	(445)	(354)	(14,408)	(31,801)
Payments of debt issuance costs	0	0	0	(2,268)
Payments on purchase contracts	(374)	0	(374)	0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			(588)	(1,979)
Cash distributions to noncontrolling investors	(143)	(678)	(1,699)	(1,481)
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) financing activities	(17,986)	(14,978)	(5,883)	(37,372)
Net change in cash, cash equivalents and restricted cash	42,166	3,244	41,228	8,449
Cash, cash equivalents and restricted cash at beginning of period	2,265	10,822	3,203	5,617
Cash, cash equivalents and restricted cash at end of period	44,431	14,066	44,431	14,066
Reportable Legal Entities [Member] | Parent Issuer [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			(70,067)	(80,781)
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			465,000	368,000
Repayments under revolving credit facilities			(454,000)	(368,000)
Borrowings of long-term debt			0	0
Repayments of long-term debt			(13,065)	(30,463)
Payments of debt issuance costs				(2,268)
Payments on purchase contracts			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			112,096	112,682
Net cash provided by (used in) financing activities			110,031	79,951
Net change in cash, cash equivalents and restricted cash			39,964	(830)
Cash, cash equivalents and restricted cash at beginning of period			1,209	1,051
Cash, cash equivalents and restricted cash at end of period	41,173	221	41,173	221
Reportable Legal Entities [Member] | Other Guarantors [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			135,677	124,538
Cash flows from investing activities:
Capital expenditures for property and equipment			(18,833)	(21,193)
Capital expenditures for software			(4,759)	(1,400)
Acquisitions, net of cash acquired			0	(42)
Proceeds from the sale of hospitals			52,733	39,384
Other investing activities, net			260	190
Changes in intercompany balances with affiliates, net			(162,395)	(137,364)
Net cash provided by (used in) investing activities			(132,994)	(120,425)
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	102
Repayments of long-term debt			(1,243)	(1,182)
Payments of debt issuance costs				0
Payments on purchase contracts			(374)
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			(588)	(1,979)
Cash distributions to noncontrolling investors			0	0
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) financing activities			(2,044)	(3,059)
Net change in cash, cash equivalents and restricted cash			639	1,054
Cash, cash equivalents and restricted cash at beginning of period			1,457	4,222
Cash, cash equivalents and restricted cash at end of period	2,096	5,276	2,096	5,276
Reportable Legal Entities [Member] | Non-Guarantors [Member]
Condensed Cash Flow Statements Captions [Line Items]
Net cash provided by (used in) operating activities			(42,770)	(822)
Cash flows from investing activities:
Capital expenditures for property and equipment			(6,998)	(13,702)
Capital expenditures for software			(601)	(127)
Acquisitions, net of cash acquired			(531)	(79)
Proceeds from the sale of hospitals			0	(214)
Other investing activities, net			3,000	69
Changes in intercompany balances with affiliates, net			0	0
Net cash provided by (used in) investing activities			(5,130)	(14,053)
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			(100)	(156)
Payments of debt issuance costs				0
Payments on purchase contracts			0
Cancellation of restricted stock awards for payroll tax withholdings on vested shares			0	0
Cash distributions to noncontrolling investors			(1,699)	(1,481)
Changes in intercompany balances with affiliates, net			50,299	24,682
Net cash provided by (used in) financing activities			48,525	23,100
Net change in cash, cash equivalents and restricted cash			625	8,225
Cash, cash equivalents and restricted cash at beginning of period			537	344
Cash, cash equivalents and restricted cash at end of period	1,162	8,569	1,162	8,569
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			162,395	137,364
Net cash provided by (used in) investing activities			162,395	137,364
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
Payments on purchase contracts			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			(162,395)	(137,364)
Net cash provided by (used in) financing activities			(162,395)	(137,364)
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