Document_and_Entity_Informatio
Document and Entity Information | 9 Months Ended | |
Sep. 30, 2013 | Oct. 31, 2013 | |
Document And Entity Information [Abstract] | ' | ' |
Document Type | '10-Q | ' |
Amendment Flag | 'false | ' |
Document Period End Date | 30-Sep-13 | ' |
Document Fiscal Year Focus | '2013 | ' |
Document Fiscal Period Focus | 'Q3 | ' |
Entity Registrant Name | 'HCA HOLDINGS, INC. | ' |
Entity Central Index Key | '0000860730 | ' |
Current Fiscal Year End Date | '--12-31 | ' |
Entity Filer Category | 'Large Accelerated Filer | ' |
Entity Common Stock, Shares Outstanding | ' | 447,838,000 |
Condensed_Consolidated_Income_
Condensed Consolidated Income Statements (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, except Share data in Thousands, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Income Statement [Abstract] | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | $9,411 | $8,893 | $28,078 | $27,245 |
Provision for doubtful accounts | 955 | 831 | 2,732 | 2,666 |
Revenues | 8,456 | 8,062 | 25,346 | 24,579 |
Salaries and benefits | 3,916 | 3,781 | 11,681 | 11,224 |
Supplies | 1,457 | 1,375 | 4,406 | 4,216 |
Other operating expenses | 1,564 | 1,510 | 4,594 | 4,496 |
Electronic health record incentive income | -75 | -131 | -166 | -256 |
Equity in earnings of affiliates | -9 | -6 | -29 | -26 |
Depreciation and amortization | 443 | 417 | 1,292 | 1,254 |
Interest expense | 458 | 446 | 1,392 | 1,336 |
Losses (gains) on sales of facilities | 1 | -7 | 13 | -4 |
Loss on retirement of debt | ' | ' | 17 | ' |
Total expenses including equity in earnings of a affiliates | 7,755 | 7,385 | 23,200 | 22,240 |
Income before income taxes | 701 | 677 | 2,146 | 2,339 |
Provision for income taxes | 234 | 222 | 704 | 760 |
Net income | 467 | 455 | 1,442 | 1,579 |
Net income attributable to noncontrolling interests | 102 | 95 | 310 | 288 |
Net income attributable to HCA Holdings, Inc. | $365 | $360 | $1,132 | $1,291 |
Per share data: | ' | ' | ' | ' |
Basic earnings per share | $0.82 | $0.82 | $2.54 | $2.94 |
Diluted earnings per share | $0.79 | $0.78 | $2.44 | $2.81 |
Cash dividends declared per share | ' | ' | ' | $2 |
Shares used in earnings per share calculations (in thousands): | ' | ' | ' | ' |
Basic | 447,329 | 440,899 | 446,125 | 439,441 |
Diluted | 463,569 | 459,515 | 463,051 | 458,822 |
Condensed_Consolidated_Compreh
Condensed Consolidated Comprehensive Income Statements (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Statement Of Income And Comprehensive Income [Abstract] | ' | ' | ' | ' |
Net income | $467 | $455 | $1,442 | $1,579 |
Other comprehensive income (loss) before taxes: | ' | ' | ' | ' |
Foreign currency translation | 60 | 30 | ' | 37 |
Unrealized (losses) gains on available-for-sale securities | 1 | 3 | -7 | 8 |
Defined benefit plans | 8 | ' | 8 | ' |
Pension costs included in salaries and benefits | 9 | 7 | 24 | 21 |
Total defined benefit plans | 17 | 7 | 32 | 21 |
Change in fair value of derivative financial instruments | -31 | -56 | 9 | -158 |
Interest costs included in interest expense | 33 | 30 | 97 | 90 |
Total change in fair value of derivative financial instruments | 2 | -26 | 106 | -68 |
Other comprehensive income (loss) before taxes | 80 | 14 | 131 | -2 |
Income taxes (benefits) related to other comprehensive income items | 28 | 5 | 48 | -2 |
Other comprehensive income | 52 | 9 | 83 | ' |
Comprehensive income | 519 | 464 | 1,525 | 1,579 |
Comprehensive income attributable to noncontrolling interests | 102 | 95 | 310 | 288 |
Comprehensive income attributable to HCA Holdings, Inc. | $417 | $369 | $1,215 | $1,291 |
Condensed_Consolidated_Balance
Condensed Consolidated Balance Sheets (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Current assets: | ' | ' |
Cash and cash equivalents | $484 | $705 |
Accounts receivable, less allowance for doubtful accounts of $5,105 and $4,846 | 4,924 | 4,672 |
Inventories | 1,135 | 1,086 |
Deferred income taxes | 400 | 385 |
Other | 828 | 915 |
Total current assets | 7,771 | 7,763 |
Property and equipment, at cost | 30,472 | 29,527 |
Accumulated depreciation | -17,150 | -16,342 |
Property and equipment, net | 13,322 | 13,185 |
Investments of insurance subsidiaries | 402 | 515 |
Investments in and advances to affiliates | 125 | 104 |
Goodwill and other intangible assets | 5,832 | 5,539 |
Deferred loan costs | 250 | 290 |
Other | 691 | 679 |
Total assets | 28,393 | 28,075 |
Current liabilities: | ' | ' |
Accounts payable | 1,582 | 1,768 |
Accrued salaries | 1,085 | 1,120 |
Other accrued expenses | 1,764 | 1,849 |
Long-term debt due within one year | 988 | 1,435 |
Total current liabilities | 5,419 | 6,172 |
Long-term debt | 27,389 | 27,495 |
Professional liability risks | 959 | 973 |
Income taxes and other liabilities | 1,670 | 1,776 |
Stockholders' deficit: | ' | ' |
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 447,573,400 shares in 2013 and 443,200,200 shares in 2012 | 4 | 4 |
Capital in excess of par value | 1,821 | 1,753 |
Accumulated other comprehensive loss | -374 | -457 |
Retained deficit | -9,827 | -10,960 |
Stockholders' deficit attributable to HCA Holdings, Inc. | -8,376 | -9,660 |
Noncontrolling interests | 1,332 | 1,319 |
Total stockholders' deficit | -7,044 | -8,341 |
Total liabilities and stockholders' deficit | $28,393 | $28,075 |
Condensed_Consolidated_Balance1
Condensed Consolidated Balance Sheets (Parenthetical) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, except Share data, unless otherwise specified | ||
Statement Of Financial Position [Abstract] | ' | ' |
Allowance for Accounts receivable | $5,105 | $4,846 |
Common stock, par value | $0.01 | $0.01 |
Common stock, shares authorized | 1,800,000,000 | 1,800,000,000 |
Common stock, shares outstanding | 447,573,400 | 443,200,200 |
Condensed_Consolidated_Stateme
Condensed Consolidated Statements of Cash Flows (USD $) | 9 Months Ended | |
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 |
Cash flows from operating activities: | ' | ' |
Net income | $1,442 | $1,579 |
Adjustments to reconcile net income to net cash provided by operating activities: | ' | ' |
Changes in operating assets and liabilities | -3,319 | -2,923 |
Provision for doubtful accounts | 2,732 | 2,666 |
Depreciation and amortization | 1,292 | 1,254 |
Income taxes | 158 | 250 |
Losses (gains) on sales of facilities | 13 | -4 |
Loss on retirement of debt | 17 | ' |
Amortization of deferred loan costs | 41 | 44 |
Share-based compensation | 81 | 39 |
Other | -3 | 7 |
Net cash provided by (used in) operating activities | 2,454 | 2,912 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -1,347 | -1,268 |
Acquisition of hospitals and health care entities | -463 | -167 |
Disposition of hospitals and health care entities | 31 | 17 |
Change in investments | 97 | 73 |
Other | 8 | 5 |
Net cash used in investing activities | -1,674 | -1,340 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | 1,350 |
Net change in revolving credit facilities | 630 | -875 |
Repayment of long-term debt | -1,300 | -689 |
Distributions to noncontrolling interests | -308 | -303 |
Payment of debt issuance costs | -5 | -20 |
Distributions to stockholders | -13 | -983 |
Income tax benefits | 70 | 82 |
Other | -75 | -35 |
Net cash (used in) provided by financing activities | -1,001 | -1,473 |
Change in cash and cash equivalents | -221 | 99 |
Cash and cash equivalents at beginning of period | 705 | 373 |
Cash and cash equivalents at end of period | 484 | 472 |
Interest payments | 1,464 | 1,404 |
Income tax payments, net | $476 | $428 |
Interim_Condensed_Consolidated
Interim Condensed Consolidated Financial Statements | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Quarterly Financial Information Disclosure [Abstract] | ' | ||||||||||||||||
Interim Condensed Consolidated Financial Statements | ' | ||||||||||||||||
NOTE 1 — INTERIM CONDENSED CONSOLIDATED FINANCIAL STATEMENTS | |||||||||||||||||
Reporting Entity | |||||||||||||||||
On November 17, 2006, HCA Inc. was acquired by a private investor group, including affiliates of or funds sponsored by Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co., BAML Capital Partners and HCA founder, Dr. Thomas F. Frist Jr. and by members of management and certain other investors. The transaction was accounted for as a recapitalization in our financial statements, with no adjustments to the historical basis of our assets and liabilities. | |||||||||||||||||
On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure (the “Corporate Reorganization”). HCA Holdings, Inc. became the new parent company, and HCA Inc. became HCA Holdings, Inc.’s 100% owned direct subsidiary. As part of the Corporate Reorganization, HCA Inc.’s outstanding shares of common stock were automatically converted, on a share for share basis, into identical shares of HCA Holdings, Inc.’s common stock. As a result of the Corporate Reorganization, HCA Holdings, Inc. was deemed the successor registrant to HCA Inc. under the Securities Exchange Act of 1934. | |||||||||||||||||
During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock. Upon the completion of a secondary offering in February 2013, we no longer qualify as a “controlled company” under the applicable New York Stock Exchange (“NYSE”) listing standards and will be required to appoint a board of directors comprised of a majority of independent members within one year of such date. Our common stock is traded on the NYSE (symbol “HCA”). | |||||||||||||||||
HCA Holdings, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Holdings, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At September 30, 2013, these affiliates owned and operated 162 hospitals, 114 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Holdings, Inc.’s facilities are located in 20 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Inc. and its affiliates prior to the Corporate Reorganization and to HCA Holdings, Inc. and its affiliates after the Corporate Reorganization. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA. | |||||||||||||||||
Basis of Presentation | |||||||||||||||||
The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature. | |||||||||||||||||
The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $76 million and $62 million for the quarters ended September 30, 2013 and 2012, respectively, and $207 million and $174 million for the nine months ended September 30, 2013 and 2012, respectively. Operating results for the quarter and the nine months ended September 30, 2013 are not necessarily indicative of the results that may be expected for the year ending December 31, 2013. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2012. | |||||||||||||||||
Basis of Presentation (continued) | |||||||||||||||||
Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under Medicare, Medicaid and other programs), managed care health plans, commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record a provision for doubtful accounts related to uninsured accounts to record the net self pay revenues at the estimated amounts we expect to collect. Our revenues from third-party payers and the uninsured for the quarters and nine months ended September 30, 2013 and 2012 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | |||||||||||||||||
2013 | Ratio | 2012 | Ratio | ||||||||||||||
Medicare | $ | 1,847 | 21.8 | % | $ | 1,949 | 24.2 | % | |||||||||
Managed Medicare | 794 | 9.4 | 720 | 8.9 | |||||||||||||
Medicaid | 401 | 4.7 | 378 | 4.7 | |||||||||||||
Managed Medicaid | 386 | 4.6 | 380 | 4.7 | |||||||||||||
Managed care and other insurers | 4,636 | 54.8 | 4,422 | 54.8 | |||||||||||||
International (managed care and other insurers) | 287 | 3.4 | 253 | 3.1 | |||||||||||||
8,351 | 98.7 | 8,102 | 100.4 | ||||||||||||||
Uninsured | 717 | 8.5 | 576 | 7.1 | |||||||||||||
Other | 343 | 4.1 | 215 | 2.7 | |||||||||||||
Revenues before provision for doubtful accounts | 9,411 | 111.3 | 8,893 | 110.2 | |||||||||||||
Provision for doubtful accounts | (955 | ) | (11.3 | ) | (831 | ) | (10.2 | ) | |||||||||
Revenues | $ | 8,456 | 100 | % | $ | 8,062 | 100 | % | |||||||||
Nine Months | |||||||||||||||||
2013 | Ratio | 2012 | Ratio | ||||||||||||||
Medicare | $ | 5,961 | 23.5 | % | $ | 6,251 | 25.4 | % | |||||||||
Managed Medicare | 2,441 | 9.6 | 2,199 | 8.9 | |||||||||||||
Medicaid | 1,098 | 4.3 | 1,188 | 4.8 | |||||||||||||
Managed Medicaid | 1,165 | 4.6 | 1,080 | 4.4 | |||||||||||||
Managed care and other insurers | 13,777 | 54.4 | 13,340 | 54.3 | |||||||||||||
International (managed care and other insurers) | 868 | 3.4 | 779 | 3.2 | |||||||||||||
25,310 | 99.8 | 24,837 | 101 | ||||||||||||||
Uninsured | 1,809 | 7.1 | 1,757 | 7.1 | |||||||||||||
Other | 959 | 3.8 | 651 | 2.7 | |||||||||||||
Revenues before provision for doubtful accounts | 28,078 | 110.7 | 27,245 | 110.8 | |||||||||||||
Provision for doubtful accounts | (2,732 | ) | (10.7 | ) | (2,666 | ) | (10.8 | ) | |||||||||
Revenues | $ | 25,346 | 100 | % | $ | 24,579 | 100 | % | |||||||||
Medicare revenues for the nine months ended September 30, 2012 were impacted by two adjustments to Medicare revenues (the Rural Floor Provision Settlement which increased revenues by approximately $271 million and the implementation of revised Supplemental Security Income ratios which reduced revenues by approximately $83 million). The net effect of these Medicare adjustments was an increase of $188 million to revenues. The net effect of these adjustments (and related expenses) added $170 million to income before income taxes, or $0.22 per diluted share, for the nine months ended September 30, 2012. | |||||||||||||||||
Certain prior year amounts have been reclassified to conform to the current year presentation. |
Acquisitions_and_Dispositions
Acquisitions and Dispositions | 9 Months Ended |
Sep. 30, 2013 | |
Business Combinations [Abstract] | ' |
Acquisitions and Dispositions | ' |
NOTE 2 — ACQUISITIONS AND DISPOSITIONS | |
During the nine months ended September 30, 2013, we paid $278 million and recorded goodwill and identifiable intangible assets of $180 million and $113 million, respectively, related to the acquisition of The Outsource Group, which was acquired by our Parallon Business Solutions affiliate and is included in the Corporate and other Group. During the nine months ended September 30, 2013, we also paid $39 million to acquire nonhospital health care entities and $146 million related to the acquisition of three hospitals which became effective October 1, 2013. During the nine months ended September 30, 2012, we paid $58 million, assumed liabilities of $33 million and recorded goodwill of $53 million related to the acquisition of a hospital facility in the American Group, and we paid $109 million to acquire nonhospital health care entities. | |
During the nine months ended September 30, 2013, we received proceeds of $31 million and recognized a net pretax loss of $13 million related to the sale of a hospital facility and other real estate investments. During the nine months ended September 30, 2012, we received proceeds of $17 million and recognized a net pretax gain of $4 million related to sales of real estate investments. |
Income_Taxes
Income Taxes | 9 Months Ended |
Sep. 30, 2013 | |
Income Tax Disclosure [Abstract] | ' |
Income Taxes | ' |
NOTE 3 — INCOME TAXES | |
During the nine months ended September 30, 2013, we finalized settlements with the IRS resolving all outstanding issues for HCA Inc.’s 2007, 2008 and 2009 tax years. We expect the IRS Examination Division will begin an audit of HCA Holdings, Inc.’s 2011 federal income tax return in 2014. | |
Our liability for unrecognized tax benefits was $417 million, including accrued interest of $26 million, as of September 30, 2013 ($426 million and $14 million, respectively, as of December 31, 2012). Unrecognized tax benefits of $151 million ($125 million as of December 31, 2012) would affect the effective rate, if recognized. The provision for income taxes reflects $7 million and $1 million ($4 million and none, respectively, net of tax) of interest expense related to taxing authority examinations for the quarters ended September 30, 2013 and 2012, respectively, and $8 million and $20 million ($5 million and $13 million, respectively, net of tax) of reductions in interest expense related to taxing authority examinations for the nine months ended September 30, 2013 and 2012, respectively. | |
Depending on the completion of examinations by federal, state or international taxing authorities, the resolution of any tax disputes, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible our liability for unrecognized tax benefits may significantly increase or decline within the next 12 months. However, we are currently unable to estimate the range of any possible change. |
Earnings_Per_Share
Earnings Per Share | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Earnings Per Share [Abstract] | ' | ||||||||||||||||
Earnings Per Share | ' | ||||||||||||||||
NOTE 4 — EARNINGS PER SHARE | |||||||||||||||||
We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding stock options, stock appreciation rights and restricted share units, computed using the treasury stock method. | |||||||||||||||||
The following table sets forth the computation of basic and diluted earnings per share for the quarters and nine months ended September 30, 2013 and 2012 (dollars in millions, except per share amounts, and shares in thousands): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2013 | 2012 | 2013 | 2012 | ||||||||||||||
Net income attributable to HCA Holdings, Inc. | $ | 365 | $ | 360 | $ | 1,132 | $ | 1,291 | |||||||||
Weighted average common shares outstanding | 447,329 | 440,899 | 446,125 | 439,441 | |||||||||||||
Effect of dilutive incremental shares | 16,240 | 18,616 | 16,926 | 19,381 | |||||||||||||
Shares used for diluted earnings per share | 463,569 | 459,515 | 463,051 | 458,822 | |||||||||||||
Earnings per share: | |||||||||||||||||
Basic earnings per share | $ | 0.82 | $ | 0.82 | $ | 2.54 | $ | 2.94 | |||||||||
Diluted earnings per share | $ | 0.79 | $ | 0.78 | $ | 2.44 | $ | 2.81 |
Investments_of_Insurance_Subsi
Investments of Insurance Subsidiaries | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Investments Debt And Equity Securities [Abstract] | ' | ||||||||||||||||
Investments of Insurance Subsidiaries | ' | ||||||||||||||||
NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES | |||||||||||||||||
A summary of our insurance subsidiaries’ investments at September 30, 2013 and December 31, 2012 follows (dollars in millions): | |||||||||||||||||
September 30, 2013 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 383 | $ | 12 | $ | (2 | ) | $ | 393 | ||||||||
Auction rate securities | 32 | — | — | 32 | |||||||||||||
Asset-backed securities | 13 | — | — | 13 | |||||||||||||
Money market funds | 24 | — | — | 24 | |||||||||||||
452 | 12 | (2 | ) | 462 | |||||||||||||
Equity securities | 2 | 1 | — | 3 | |||||||||||||
$ | 454 | $ | 13 | $ | (2 | ) | 465 | ||||||||||
Amounts classified as current assets | (63 | ) | |||||||||||||||
Investment carrying value | $ | 402 | |||||||||||||||
December 31, 2012 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 395 | $ | 23 | $ | — | $ | 418 | |||||||||
Auction rate securities | 74 | — | (6 | ) | 68 | ||||||||||||
Asset-backed securities | 14 | — | — | 14 | |||||||||||||
Money market funds | 67 | — | — | 67 | |||||||||||||
550 | 23 | (6 | ) | 567 | |||||||||||||
Equity securities | 2 | 1 | — | 3 | |||||||||||||
$ | 552 | $ | 24 | $ | (6 | ) | 570 | ||||||||||
Amounts classified as current assets | (55 | ) | |||||||||||||||
Investment carrying value | $ | 515 | |||||||||||||||
At September 30, 2013 and December 31, 2012, the investments of our insurance subsidiaries were classified as “available-for-sale.” Changes in temporary unrealized gains and losses are recorded as adjustments to other comprehensive income. At September 30, 2013 and December 31, 2012, $1 million and $9 million, respectively, of our money market fund investments were subject to restrictions included in insurance bond collateralization and assumed reinsurance contracts. | |||||||||||||||||
Scheduled maturities of investments in debt securities at September 30, 2013 were as follows (dollars in millions): | |||||||||||||||||
Amortized | Fair | ||||||||||||||||
Cost | Value | ||||||||||||||||
Due in one year or less | $ | 41 | $ | 41 | |||||||||||||
Due after one year through five years | 176 | 182 | |||||||||||||||
Due after five years through ten years | 108 | 111 | |||||||||||||||
Due after ten years | 82 | 83 | |||||||||||||||
407 | 417 | ||||||||||||||||
Auction rate securities | 32 | 32 | |||||||||||||||
Asset-backed securities | 13 | 13 | |||||||||||||||
$ | 452 | $ | 462 | ||||||||||||||
The average expected maturity of the investments in debt securities at September 30, 2013 was 4.0 years, compared to the average scheduled maturity of 7.1 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to the scheduled maturity date. The average expected maturities for our auction rate and asset-backed securities were derived from valuation models of expected cash flows and involved management’s judgment. At September 30, 2013, the average expected maturities for our auction rate and asset-backed securities were 1.4 years and 3.9 years, respectively, compared to average scheduled maturities of 22.1 years and 22.7 years, respectively. |
Financial_Instruments
Financial Instruments | 9 Months Ended | ||||||||||||
Sep. 30, 2013 | |||||||||||||
Derivative Instruments And Hedging Activities Disclosure [Abstract] | ' | ||||||||||||
Financial Instruments | ' | ||||||||||||
NOTE 6 — FINANCIAL INSTRUMENTS | |||||||||||||
Interest Rate Swap Agreements | |||||||||||||
We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert LIBOR indexed variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions. | |||||||||||||
The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at September 30, 2013 (dollars in millions): | |||||||||||||
Notional | Maturity Date | Fair | |||||||||||
Amount | Value | ||||||||||||
Pay-fixed interest rate swaps | $ | 500 | December 2014 | $ | (6 | ) | |||||||
Pay-fixed interest rate swaps | 3,000 | Dec-16 | (269 | ) | |||||||||
Pay-fixed interest rate swaps | 1,000 | Dec-17 | (48 | ) | |||||||||
During the next 12 months, we estimate $127 million will be reclassified from other comprehensive income (“OCI”) to interest expense. | |||||||||||||
Cross Currency Swaps | |||||||||||||
The Company and certain subsidiaries have incurred obligations and entered into various intercompany transactions where such obligations are denominated in currencies, other than the functional currencies of the parties executing the trade. In order to mitigate the currency exposure risks and better match the cash flows of our obligations and intercompany transactions with cash flows from operations, we enter into cross currency swaps. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions. Our cross currency swap is not designated as a hedge, and changes in fair value are recognized in results of operations. The following table sets forth our cross currency swap agreement at September 30, 2013 (amounts in millions): | |||||||||||||
Notional | Maturity Date | Fair | |||||||||||
Amount | Value | ||||||||||||
Euro — United States dollar currency swap | 241 Euro | November 2013 | $ | (4 | ) | ||||||||
Derivatives — Results of Operations | |||||||||||||
The following tables present the effect of our interest rate and cross currency swaps on our results of operations for the nine months ended September 30, 2013 (dollars in millions): | |||||||||||||
Derivatives in Cash Flow Hedging Relationships | Amount of Gain | Location of Loss | Amount of Loss | ||||||||||
Recognized in OCI on | Reclassified from | Reclassified from | |||||||||||
Derivatives, Net of Tax | Accumulated OCI | Accumulated OCI | |||||||||||
into Operations | into Operations | ||||||||||||
Interest rate swaps | $ | 6 | Interest expense | $ | 97 | ||||||||
Derivatives — Results of Operations (continued) | |||||||||||||
Derivatives Not Designated as Hedging Instruments | Location of Gain Recognized | Amount of Gain | |||||||||||
in Operations on Derivatives | Recognized in | ||||||||||||
Operations on | |||||||||||||
Derivatives | |||||||||||||
Cross currency swap | Other operating expenses | $ | 9 | ||||||||||
Credit-risk-related Contingent Features | |||||||||||||
We have agreements with each of our derivative counterparties that contain a provision where we could be declared in default on our derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to our default on the indebtedness. As of September 30, 2013, we have not been required to post any collateral related to these agreements. If we had breached these provisions at September 30, 2013, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $341 million. |
Assets_and_Liabilities_Measure
Assets and Liabilities Measured at Fair Value | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Fair Value Disclosures [Abstract] | ' | ||||||||||||||||
Assets and Liabilities Measured at Fair Value | ' | ||||||||||||||||
NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE | |||||||||||||||||
Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”) defines fair value, establishes a framework for measuring fair value and expands disclosures about fair value measurements. ASC 820 applies to reported balances that are required or permitted to be measured at fair value under existing accounting pronouncements. | |||||||||||||||||
ASC 820 emphasizes fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, ASC 820 establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). | |||||||||||||||||
Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment, and considers factors specific to the asset or liability. | |||||||||||||||||
Cash Traded Investments | |||||||||||||||||
Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency. Certain types of cash traded instruments are classified within Level 3 of the fair value hierarchy because they trade infrequently and therefore have little or no price transparency. The valuation of these securities involves management’s judgment, after consideration of market factors and the absence of market transparency, market liquidity and observable inputs. Our valuation models derived fair market values compared to tax-equivalent yields of other securities of similar credit worthiness and similar effective maturities. | |||||||||||||||||
Derivative Financial Instruments | |||||||||||||||||
We have entered into interest rate and cross currency swap agreements to manage our exposure to fluctuations in interest rates and foreign currency risks. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves, foreign exchange rates and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. | |||||||||||||||||
Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at September 30, 2013 and December 31, 2012, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. | |||||||||||||||||
Derivative Financial Instruments (continued) | |||||||||||||||||
The following table summarizes our assets and liabilities measured at fair value on a recurring basis as of September 30, 2013 and December 31, 2012, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): | |||||||||||||||||
September 30, 2013 | |||||||||||||||||
Fair Value Measurements Using | |||||||||||||||||
Fair Value | Quoted Prices in | Significant Other | Significant | ||||||||||||||
Active Markets for | Observable Inputs | Unobservable Inputs | |||||||||||||||
Identical Assets | (Level 2) | (Level 3) | |||||||||||||||
and Liabilities | |||||||||||||||||
(Level 1) | |||||||||||||||||
Assets: | |||||||||||||||||
Investments of insurance subsidiaries: | |||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 393 | $ | — | $ | 393 | $ | — | |||||||||
Auction rate securities | 32 | — | — | 32 | |||||||||||||
Asset-backed securities | 13 | — | 13 | — | |||||||||||||
Money market funds | 24 | 24 | — | — | |||||||||||||
462 | 24 | 406 | 32 | ||||||||||||||
Equity securities | 3 | 2 | — | 1 | |||||||||||||
Investments of insurance subsidiaries | 465 | 26 | 406 | 33 | |||||||||||||
Less amounts classified as current assets | (63 | ) | (24 | ) | (39 | ) | — | ||||||||||
$ | 402 | $ | 2 | $ | 367 | $ | 33 | ||||||||||
Liabilities: | |||||||||||||||||
Cross currency swap (Income taxes and other liabilities) | $ | 4 | $ | — | $ | 4 | $ | — | |||||||||
Interest rate swaps (Income taxes and other liabilities) | 323 | — | 323 | — | |||||||||||||
Derivative Financial Instruments (continued) | |||||||||||||||||
December 31, 2012 | |||||||||||||||||
Fair Value | Fair Value Measurements Using | ||||||||||||||||
Quoted Prices in | Significant Other | Significant | |||||||||||||||
Active Markets for | Observable Inputs | Unobservable Inputs | |||||||||||||||
Identical Assets | (Level 2) | (Level 3) | |||||||||||||||
and Liabilities | |||||||||||||||||
(Level 1) | |||||||||||||||||
Assets: | |||||||||||||||||
Investments of insurance subsidiaries: | |||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 418 | $ | — | $ | 418 | $ | — | |||||||||
Auction rate securities | 68 | — | — | 68 | |||||||||||||
Asset-backed securities | 14 | — | 14 | — | |||||||||||||
Money market funds | 67 | 67 | — | — | |||||||||||||
567 | 67 | 432 | 68 | ||||||||||||||
Equity securities | 3 | 1 | — | 2 | |||||||||||||
Investments of insurance subsidiaries | 570 | 68 | 432 | 70 | |||||||||||||
Less amounts classified as current assets | (55 | ) | (55 | ) | — | — | |||||||||||
$ | 515 | $ | 13 | $ | 432 | $ | 70 | ||||||||||
Liabilities: | |||||||||||||||||
Cross currency swap (Income taxes and other liabilities) | $ | 13 | $ | — | $ | 13 | $ | — | |||||||||
Interest rate swaps (Income taxes and other liabilities) | 429 | — | 429 | — | |||||||||||||
The following table summarizes the activity related to the auction rate and equity securities investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the nine months ended September 30, 2013 (dollars in millions): | |||||||||||||||||
Asset balances at December 31, 2012 | $70 | ||||||||||||||||
Unrealized gains included in other comprehensive income | 6 | ||||||||||||||||
Settlements | (43 | ) | |||||||||||||||
Asset balances at September 30, 2013 | $ | 33 | |||||||||||||||
The estimated fair value of our long-term debt was $29.492 billion and $30.781 billion at September 30, 2013 and December 31, 2012, respectively, compared to carrying amounts aggregating $28.377 billion and $28.930 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities. |
LongTerm_Debt
Long-Term Debt | 9 Months Ended | ||||||||
Sep. 30, 2013 | |||||||||
Debt Disclosure [Abstract] | ' | ||||||||
Long-Term Debt | ' | ||||||||
NOTE 8 — LONG-TERM DEBT | |||||||||
A summary of long-term debt at September 30, 2013 and December 31, 2012, including related interest rates at September 30, 2013, follows (dollars in millions): | |||||||||
September 30, | December 31, | ||||||||
2013 | 2012 | ||||||||
Senior secured asset-based revolving credit facility (effective interest rate of 1.7%) | $ | 2,100 | $ | 1,470 | |||||
Senior secured revolving credit facility | — | — | |||||||
Senior secured term loan facilities (effective interest rate of 5.1%) | 5,944 | 5,958 | |||||||
Senior secured first lien notes (effective interest rate of 7.1%) | 9,693 | 9,688 | |||||||
Other senior secured debt (effective interest rate of 6.8%) | 446 | 423 | |||||||
First lien debt | 18,183 | 17,539 | |||||||
Senior secured second lien notes | — | 197 | |||||||
Senior unsecured notes (effective interest rate of 7.2%) | 10,194 | 11,194 | |||||||
Total debt (average life of 6.5 years, rates averaging 6.3%) | 28,377 | 28,930 | |||||||
Less amounts due within one year | 988 | 1,435 | |||||||
$ | 27,389 | $ | 27,495 | ||||||
2013 Activity | |||||||||
During March 2013, we redeemed all $201 million aggregate principal amount of our 9 7/8% senior secured second lien notes due 2017, at a redemption price of 104.938% of the principal amount. The pretax loss on retirement of debt related to this redemption was $17 million. |
Contingencies_and_Legal_Claim_
Contingencies and Legal Claim Costs | 9 Months Ended |
Sep. 30, 2013 | |
Commitments And Contingencies Disclosure [Abstract] | ' |
Contingencies and Legal Claim Costs | ' |
NOTE 9 — CONTINGENCIES AND LEGAL CLAIM COSTS | |
We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations or financial position. | |
Government Investigations, Claims and Litigation | |
Health care companies are subject to numerous investigations by various governmental agencies. Further, under the federal False Claims Act (“FCA”), private parties have the right to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions. Certain of our individual facilities have received, and from time to time, other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our financial position, results of operations and liquidity. | |
As initially disclosed in 2010, the Civil Division of the Department of Justice (“DOJ”) has contacted the Company in connection with its nationwide review of whether, in certain cases, hospital charges to the federal government relating to implantable cardio-defibrillators (“ICDs”) met the CMS criteria. In connection with this nationwide review, the DOJ has indicated that it will be reviewing certain ICD billing and medical records at 95 HCA hospitals; the review covers the period from October 2003 to the present. In August 2012, HCA, along with non-HCA hospitals across the country subject to the DOJ’s review, received from the DOJ a proposed framework for resolving the DOJ’s review of ICDs. The Company is cooperating in the review. The review could potentially give rise to claims against the Company under the federal FCA or other statutes, regulations or laws. At this time, we cannot predict what effect, if any, this review or any resulting claims could have on the Company. | |
In July 2012, the Civil Division of the U.S. Attorney’s Office in Miami requested information on reviews assessing the medical necessity of interventional cardiology services provided at any Company facility (other than peer reviews). The Company is cooperating with the government’s request and is currently producing medical records associated with particular reviews at eight hospitals, located primarily in Florida. At this time, we cannot predict what effect, if any, the request or any resulting claims, including any potential claims under the federal FCA, other statutes, regulations or laws, could have on the Company. | |
Securities Class Action Litigation | |
On October 28, 2011, a shareholder action, Schuh v. HCA Holdings, Inc. et al., was filed in the United States District Court for the Middle District of Tennessee seeking monetary relief. The case sought to include as a class all persons who acquired the Company’s stock pursuant or traceable to the Company’s Registration Statement issued in connection with the March 9, 2011 initial public offering. The lawsuit asserted a claim under Section 11 of the Securities Act of 1933 against the Company, certain members of the board of directors, and certain underwriters in the offering. It further asserted a claim under Section 15 of the Securities Act of 1933 against the same members of the board of directors. The action alleged various deficiencies in the Company’s disclosures in the Registration Statement. Subsequently, two additional class action complaints, Kishtah v. HCA Holdings, Inc. et al. and Daniels v. HCA Holdings, Inc. et al., setting forth substantially similar claims against substantially the same defendants were filed in the same federal court on November 16, 2011 and December 12, 2011, respectively. All three of the cases were consolidated. On May 3, 2012, the court appointed New England Teamsters & Trucking Industry Pension Fund as Lead Plaintiff for the consolidated action. On July 13, 2012, the lead plaintiff filed an amended complaint asserting claims under Sections 11 and 12(a)(2) of the Securities Act of 1933 against the Company, certain members of the board of directors, and certain underwriters in the offering. It further asserts a claim under Section 15 of the Securities Act of 1933 against the same members of the board of directors and Hercules Holdings II, LLC, a majority shareholder of the Company at the time of the initial public offering. The consolidated complaint alleges deficiencies in the Company’s disclosures in the Registration Statement and Prospectus relating to: (1) the accounting for the Company’s 2006 recapitalization and 2010 reorganization; (2) the Company’s failure to maintain effective internal controls relating to its accounting for such transactions; and (3) the Company’s Medicare and Medicaid revenue growth rates. The Company and other defendants moved to dismiss the amended complaint on September 11, 2012. The Court granted the motion in part on May 28, 2013. The action is proceeding to discovery on the remaining claims. | |
In addition to the above described shareholder class actions, on December 8, 2011, a federal shareholder derivative action, Sutton v. Bracken, et al., putatively initiated in the name of the Company, was filed in the United States District Court for the Middle District of Tennessee against certain officers and present and former directors of the Company seeking monetary relief. The action alleges breaches of fiduciary duties by the named officers and directors in connection with the accounting and earnings claims set forth in the shareholder class actions. Setting forth substantially similar claims against substantially the same defendants, an additional federal derivative action, Schroeder v. Bracken, et al., was filed in the United States District Court for the Middle District of Tennessee on December 16, 2011, and a state derivative action, Bagot v. Bracken, et al., was filed in Tennessee state court in the Davidson County Circuit Court on December 20, 2011. The federal derivative actions were consolidated in the Middle District of Tennessee and stayed pending developments in the shareholder class actions. The state derivative action had also been stayed pending developments in the shareholder class actions, but that stay has expired. The plaintiff in the state derivative action subsequently filed an amended complaint on September 9, 2013 that added additional allegations made in the shareholder class actions. The Company has filed a motion to again stay the state derivative action pending developments in the class action, but the Court has not yet acted on that motion. On September 24, 2013, an additional state derivative action, Steinberg v. Bracken, et al., was filed in Tennessee state court in the Davidson County Circuit Court. This action against our board of directors is substantially similar to the earlier filed state derivative action and the Company is attempting to consolidate the two state actions. | |
Health Midwest Litigation | |
In October 2009, the Health Care Foundation of Greater Kansas City, a nonprofit health foundation, filed suit against HCA Inc. in the Circuit Court of Jackson County, Missouri and alleged that HCA did not fund the level of capital expenditures and uncompensated care agreed to in connection with HCA’s purchase of hospitals from Health Midwest in 2003. The central issue in the case was whether HCA’s construction of new hospitals counted towards its $450 million five-year capital commitments. In addition, the plaintiff alleged that HCA did not make its required capital expenditures in a timely fashion. On January 24, 2013, the Court ruled in favor of the plaintiff and awarded at least $162 million. The Court also ordered a court-supervised accounting of HCA’s capital expenditures, as well as of expenditures on charity and uncompensated care during the ten years following the purchase. Should the accounting fail to satisfy the Court concerning HCA’s compliance with its capital and charity care commitments, the amount of the judgment award could substantially increase. The Court also indicated it would award plaintiff attorneys fees, which the parties have stipulated are about $12 million. HCA recorded $175 million of legal claim costs in the fourth quarter of 2012 related to this ruling. The accounting for HCA’s capital expenditures and charity and uncompensated care is ongoing and will likely not be concluded before the end of 2013. HCA plans to appeal the trial court’s ruling on the breach of contract claim and order for the accounting once the trial court rules on the accounting and enters final judgment. |
Capital_Structure
Capital Structure | 9 Months Ended | ||||||||||||||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||||||||||||||
Text Block [Abstract] | ' | ||||||||||||||||||||||||||||
Capital Structure | ' | ||||||||||||||||||||||||||||
NOTE 10 — CAPITAL STRUCTURE | |||||||||||||||||||||||||||||
The changes in stockholders’ deficit, including changes in stockholders’ deficit attributable to HCA Holdings, Inc. and changes in equity attributable to noncontrolling interests, are as follows (dollars in millions): | |||||||||||||||||||||||||||||
Equity (Deficit) Attributable to HCA Holdings, Inc. | Equity | Total | |||||||||||||||||||||||||||
Attributable to | |||||||||||||||||||||||||||||
Common Stock | Capital in | Accumulated | Retained | Noncontrolling | |||||||||||||||||||||||||
Excess of | Other | Deficit | Interests | ||||||||||||||||||||||||||
Par | Comprehensive | ||||||||||||||||||||||||||||
Shares | Par Value | Value | Loss | ||||||||||||||||||||||||||
0 | |||||||||||||||||||||||||||||
Balances at December 31, 2012 | 443,200 | $ | 4 | $ | 1,753 | $ | (457 | ) | $ | (10,960 | ) | $ | 1,319 | $ | (8,341 | ) | |||||||||||||
Net income | — | — | — | — | 1,132 | 310 | 1,442 | ||||||||||||||||||||||
Other comprehensive income | — | — | — | 83 | — | — | 83 | ||||||||||||||||||||||
Distributions | — | — | — | — | — | (308 | ) | (308 | ) | ||||||||||||||||||||
Share-based benefit plans | 4,373 | — | 71 | — | — | — | 71 | ||||||||||||||||||||||
Other | — | — | (3 | ) | — | 1 | 11 | 9 | |||||||||||||||||||||
Balances at September 30, 2013 | 447,573 | $ | 4 | $ | 1,821 | $ | (374 | ) | $ | (9,827 | ) | $ | 1,332 | $ | (7,044 | ) | |||||||||||||
The components of accumulated other comprehensive loss are as follows (dollars in millions): | |||||||||||||||||||||||||||||
Unrealized | Foreign | Defined | Change | Total | |||||||||||||||||||||||||
Gains on | Currency | Benefit | in Fair | ||||||||||||||||||||||||||
Available- | Translation | Plans | Value of | ||||||||||||||||||||||||||
for-Sale | Adjustments | Derivative | |||||||||||||||||||||||||||
Securities | Instruments | ||||||||||||||||||||||||||||
Balances at December 31, 2012 | $ | 11 | $ | (1 | ) | $ | (196 | ) | $ | (271 | ) | $ | (457 | ) | |||||||||||||||
Unrealized losses on available-for-sale securities, net of $3 income tax benefit | (4 | ) | — | — | — | (4 | ) | ||||||||||||||||||||||
Defined benefit plans, net of $3 of income taxes | — | — | 5 | — | 5 | ||||||||||||||||||||||||
Change in fair value of derivative instruments, net of $3 of income taxes | — | — | — | 6 | 6 | ||||||||||||||||||||||||
Expense reclassified into operations from other comprehensive income, net of $9 and $36, respectively, income tax benefits | — | — | 15 | 61 | 76 | ||||||||||||||||||||||||
Balances at September 30, 2013 | $ | 7 | $ | (1 | ) | $ | (176 | ) | $ | (204 | ) | $ | (374 | ) | |||||||||||||||
Segment_and_Geographic_Informa
Segment and Geographic Information | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Segment Reporting [Abstract] | ' | ||||||||||||||||
Segment and Geographic Information | ' | ||||||||||||||||
NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION | |||||||||||||||||
We operate in one line of business, which is operating hospitals and related health care entities. Effective January 1, 2013, we reorganized our operational groups into two geographically organized groups: the National and American Groups. The National Group includes 77 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, South Carolina, Utah and Virginia, and the American Group includes 79 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and Texas. We also operate six hospitals in England, and these facilities are included in the Corporate and other group. | |||||||||||||||||
Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, loss on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2013 and 2012 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2013 | 2012 | 2013 | 2012 | ||||||||||||||
Revenues: | |||||||||||||||||
National Group | $ | 3,930 | $ | 3,755 | $ | 11,875 | $ | 11,553 | |||||||||
American Group | 4,082 | 3,982 | 12,181 | 12,033 | |||||||||||||
Corporate and other | 444 | 325 | 1,290 | 993 | |||||||||||||
$ | 8,456 | $ | 8,062 | $ | 25,346 | $ | 24,579 | ||||||||||
Equity in earnings of affiliates: | |||||||||||||||||
National Group | $ | (3 | ) | $ | — | $ | (8 | ) | $ | (7 | ) | ||||||
American Group | (6 | ) | (6 | ) | (19 | ) | (20 | ) | |||||||||
Corporate and other | — | — | (2 | ) | 1 | ||||||||||||
$ | (9 | ) | $ | (6 | ) | $ | (29 | ) | $ | (26 | ) | ||||||
Adjusted segment EBITDA: | |||||||||||||||||
National Group | $ | 805 | $ | 768 | $ | 2,440 | $ | 2,478 | |||||||||
American Group | 910 | 843 | 2,654 | 2,657 | |||||||||||||
Corporate and other | (112 | ) | (78 | ) | (234 | ) | (210 | ) | |||||||||
$ | 1,603 | $ | 1,533 | $ | 4,860 | $ | 4,925 | ||||||||||
Depreciation and amortization: | |||||||||||||||||
National Group | $ | 181 | $ | 171 | $ | 532 | $ | 520 | |||||||||
American Group | 206 | 207 | 610 | 612 | |||||||||||||
Corporate and other | 56 | 39 | 150 | 122 | |||||||||||||
$ | 443 | $ | 417 | $ | 1,292 | $ | 1,254 | ||||||||||
Adjusted segment EBITDA | $ | 1,603 | $ | 1,533 | $ | 4,860 | $ | 4,925 | |||||||||
Depreciation and amortization | 443 | 417 | 1,292 | 1,254 | |||||||||||||
Interest expense | 458 | 446 | 1,392 | 1,336 | |||||||||||||
Losses (gains) on sales of facilities | 1 | (7 | ) | 13 | (4 | ) | |||||||||||
Loss on retirement of debt | — | — | 17 | — | |||||||||||||
Income before income taxes | $ | 701 | $ | 677 | $ | 2,146 | $ | 2,339 | |||||||||
Supplemental_Condensed_Consoli
Supplemental Condensed Consolidating Financial Information | 9 Months Ended | ||||||||||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||||||||||
Text Block [Abstract] | ' | ||||||||||||||||||||||||
Supplemental Condensed Consolidating Financial Information | ' | ||||||||||||||||||||||||
NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION | |||||||||||||||||||||||||
On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure. HCA Holdings, Inc. became the parent company, and HCA Inc. became HCA Holdings, Inc.’s 100% owned direct subsidiary. On November 23, 2010, HCA Holdings, Inc. issued $1.525 billion aggregate principal amount of 7 3/4% senior unsecured notes due 2021. On December 6, 2012, HCA Holdings, Inc. issued $1.000 billion aggregate principal amount of 6.25% senior unsecured notes due 2021. These notes are senior unsecured obligations and are not guaranteed by any of our subsidiaries. | |||||||||||||||||||||||||
The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, 100% owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our senior secured asset-based revolving credit facility). | |||||||||||||||||||||||||
Our summarized condensed consolidating comprehensive income statements for the quarters and nine months ended September 30, 2013 and 2012, condensed consolidating balance sheets at September 30, 2013 and December 31, 2012 and condensed consolidating statements of cash flows for the nine months ended September 30, 2013 and 2012, segregating HCA Holdings, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors and eliminations, follow: | |||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE QUARTER ENDED SEPTEMBER 30, 2013 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 4,945 | $ | 4,466 | $ | — | $ | 9,411 | |||||||||||||
Provision for doubtful accounts | — | — | 560 | 395 | — | 955 | |||||||||||||||||||
Revenues | — | — | 4,385 | 4,071 | — | 8,456 | |||||||||||||||||||
Salaries and benefits | — | — | 2,090 | 1,826 | — | 3,916 | |||||||||||||||||||
Supplies | — | — | 773 | 684 | — | 1,457 | |||||||||||||||||||
Other operating expenses | 2 | (1 | ) | 771 | 792 | — | 1,564 | ||||||||||||||||||
Electronic health record incentive income | — | — | (53 | ) | (22 | ) | — | (75 | ) | ||||||||||||||||
Equity in earnings of affiliates | (443 | ) | — | — | (9 | ) | 443 | (9 | ) | ||||||||||||||||
Depreciation and amortization | — | — | 216 | 227 | — | 443 | |||||||||||||||||||
Interest expense | 41 | 549 | (104 | ) | (28 | ) | — | 458 | |||||||||||||||||
Losses on sales of facilities | — | — | 1 | — | — | 1 | |||||||||||||||||||
Management fees | — | — | (183 | ) | 183 | — | — | ||||||||||||||||||
(400 | ) | 548 | 3,511 | 3,653 | 443 | 7,755 | |||||||||||||||||||
Income (loss) before income taxes | 400 | (548 | ) | 874 | 418 | (443 | ) | 701 | |||||||||||||||||
Provision (benefit) for income taxes | (17 | ) | (214 | ) | 334 | 131 | — | 234 | |||||||||||||||||
Net income (loss) | 417 | (334 | ) | 540 | 287 | (443 | ) | 467 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 19 | 83 | — | 102 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 417 | $ | (334 | ) | $ | 521 | $ | 204 | $ | (443 | ) | $ | 365 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 417 | $ | (331 | ) | $ | 532 | $ | 242 | $ | (443 | ) | $ | 417 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE QUARTER ENDED SEPTEMBER 30, 2012 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 4,672 | $ | 4,221 | $ | — | $ | 8,893 | |||||||||||||
Provision for doubtful accounts | — | — | 484 | 347 | — | 831 | |||||||||||||||||||
Revenues | — | — | 4,188 | 3,874 | — | 8,062 | |||||||||||||||||||
Salaries and benefits | — | — | 1,995 | 1,786 | — | 3,781 | |||||||||||||||||||
Supplies | — | — | 711 | 664 | — | 1,375 | |||||||||||||||||||
Other operating expenses | — | 3 | 761 | 746 | — | 1,510 | |||||||||||||||||||
Electronic health record incentive income | — | — | (85 | ) | (46 | ) | — | (131 | ) | ||||||||||||||||
Equity in earnings of affiliates | (379 | ) | — | (1 | ) | (5 | ) | 379 | (6 | ) | |||||||||||||||
Depreciation and amortization | — | — | 205 | 212 | — | 417 | |||||||||||||||||||
Interest expense | 30 | 545 | (98 | ) | (31 | ) | — | 446 | |||||||||||||||||
Gains on sales of facilities | — | — | — | (7 | ) | — | (7 | ) | |||||||||||||||||
Management fees | — | — | (170 | ) | 170 | — | — | ||||||||||||||||||
(349 | ) | 548 | 3,318 | 3,489 | 379 | 7,385 | |||||||||||||||||||
Income (loss) before income taxes | 349 | (548 | ) | 870 | 385 | (379 | ) | 677 | |||||||||||||||||
Provision (benefit) for income taxes | (11 | ) | (208 | ) | 325 | 116 | — | 222 | |||||||||||||||||
Net income (loss) | 360 | (340 | ) | 545 | 269 | (379 | ) | 455 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 18 | 77 | — | 95 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 360 | $ | (340 | ) | $ | 527 | $ | 192 | $ | (379 | ) | $ | 360 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 360 | $ | (357 | ) | $ | 531 | $ | 214 | $ | (379 | ) | $ | 369 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2013 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 14,829 | $ | 13,249 | $ | — | $ | 28,078 | |||||||||||||
Provision for doubtful accounts | — | — | 1,611 | 1,121 | — | 2,732 | |||||||||||||||||||
Revenues | — | — | 13,218 | 12,128 | — | 25,346 | |||||||||||||||||||
Salaries and benefits | — | — | 6,275 | 5,406 | — | 11,681 | |||||||||||||||||||
Supplies | — | — | 2,340 | 2,066 | — | 4,406 | |||||||||||||||||||
Other operating expenses | 4 | (1 | ) | 2,260 | 2,331 | — | 4,594 | ||||||||||||||||||
Electronic health record incentive income | — | — | (115 | ) | (51 | ) | — | (166 | ) | ||||||||||||||||
Equity in earnings of affiliates | (1,303 | ) | — | (2 | ) | (27 | ) | 1,303 | (29 | ) | |||||||||||||||
Depreciation and amortization | — | — | 636 | 656 | — | 1,292 | |||||||||||||||||||
Interest expense | 138 | 1,651 | (319 | ) | (78 | ) | — | 1,392 | |||||||||||||||||
Losses (gains) on sales of facilities | — | — | 20 | (7 | ) | — | 13 | ||||||||||||||||||
Loss on retirement of debt | — | 17 | — | — | — | 17 | |||||||||||||||||||
Management fees | — | — | (547 | ) | 547 | — | — | ||||||||||||||||||
(1,161 | ) | 1,667 | 10,548 | 10,843 | 1,303 | 23,200 | |||||||||||||||||||
Income (loss) before income taxes | 1,161 | (1,667 | ) | 2,670 | 1,285 | (1,303 | ) | 2,146 | |||||||||||||||||
Provision (benefit) for income taxes | (54 | ) | (639 | ) | 1,005 | 392 | — | 704 | |||||||||||||||||
Net income (loss) | 1,215 | (1,028 | ) | 1,665 | 893 | (1,303 | ) | 1,442 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 48 | 262 | — | 310 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 1,215 | $ | (1,028 | ) | $ | 1,617 | $ | 631 | $ | (1,303 | ) | $ | 1,132 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 1,215 | $ | (961 | ) | $ | 1,637 | $ | 627 | $ | (1,303 | ) | $ | 1,215 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2012 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 14,328 | $ | 12,917 | $ | — | $ | 27,245 | |||||||||||||
Provision for doubtful accounts | — | — | 1,505 | 1,161 | — | 2,666 | |||||||||||||||||||
Revenues | — | — | 12,823 | 11,756 | — | 24,579 | |||||||||||||||||||
Salaries and benefits | — | — | 5,928 | 5,296 | — | 11,224 | |||||||||||||||||||
Supplies | — | — | 2,202 | 2,014 | — | 4,216 | |||||||||||||||||||
Other operating expenses | — | 7 | 2,241 | 2,248 | — | 4,496 | |||||||||||||||||||
Electronic health record incentive income | — | — | (174 | ) | (82 | ) | — | (256 | ) | ||||||||||||||||
Equity in earnings of affiliates | (1,348 | ) | — | (4 | ) | (22 | ) | 1,348 | (26 | ) | |||||||||||||||
Depreciation and amortization | — | — | 614 | 640 | — | 1,254 | |||||||||||||||||||
Interest expense | 90 | 1,603 | (274 | ) | (83 | ) | — | 1,336 | |||||||||||||||||
Losses (gains) on sales of facilities | — | — | 3 | (7 | ) | — | (4 | ) | |||||||||||||||||
Management fees | — | — | (498 | ) | 498 | — | — | ||||||||||||||||||
(1,258 | ) | 1,610 | 10,038 | 10,502 | 1,348 | 22,240 | |||||||||||||||||||
Income (loss) before income taxes | 1,258 | (1,610 | ) | 2,785 | 1,254 | (1,348 | ) | 2,339 | |||||||||||||||||
Provision (benefit) for income taxes | (33 | ) | (597 | ) | 1,014 | 376 | — | 760 | |||||||||||||||||
Net income (loss) | 1,291 | (1,013 | ) | 1,771 | 878 | (1,348 | ) | 1,579 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 51 | 237 | — | 288 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 1,291 | $ | (1,013 | ) | $ | 1,720 | $ | 641 | $ | (1,348 | ) | $ | 1,291 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 1,291 | $ | (1,055 | ) | $ | 1,733 | $ | 670 | $ | (1,348 | ) | $ | 1,291 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
30-Sep-13 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
ASSETS | |||||||||||||||||||||||||
Current assets: | |||||||||||||||||||||||||
Cash and cash equivalents | $ | — | $ | — | $ | 167 | $ | 317 | $ | — | $ | 484 | |||||||||||||
Accounts receivable, net | — | — | 2,481 | 2,443 | — | 4,924 | |||||||||||||||||||
Inventories | — | — | 667 | 468 | — | 1,135 | |||||||||||||||||||
Deferred income taxes | 400 | — | — | — | — | 400 | |||||||||||||||||||
Other | 6 | — | 327 | 495 | — | 828 | |||||||||||||||||||
406 | — | 3,642 | 3,723 | — | 7,771 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,467 | 5,855 | — | 13,322 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 402 | — | 402 | |||||||||||||||||||
Investments in and advances to affiliates | 19,784 | — | 15 | 110 | (19,784 | ) | 125 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,695 | 4,137 | — | 5,832 | |||||||||||||||||||
Deferred loan costs | 30 | 220 | — | — | — | 250 | |||||||||||||||||||
Other | 315 | — | 37 | 339 | — | 691 | |||||||||||||||||||
$ | 20,535 | $ | 220 | $ | 12,856 | $ | 14,566 | $ | (19,784 | ) | $ | 28,393 | |||||||||||||
LIABILITIES AND | |||||||||||||||||||||||||
STOCKHOLDERS’ (DEFICIT) | |||||||||||||||||||||||||
EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | 1 | $ | — | $ | 1,012 | $ | 569 | $ | — | $ | 1,582 | |||||||||||||
Accrued salaries | — | — | 634 | 451 | — | 1,085 | |||||||||||||||||||
Other accrued expenses | 255 | 259 | 441 | 809 | — | 1,764 | |||||||||||||||||||
Long-term debt due within one year | — | 906 | 43 | 39 | — | 988 | |||||||||||||||||||
256 | 1,165 | 2,130 | 1,868 | — | 5,419 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,174 | 165 | 525 | — | 27,389 | |||||||||||||||||||
Intercompany balances | 25,682 | (10,477 | ) | (18,677 | ) | 3,472 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 959 | — | 959 | |||||||||||||||||||
Income taxes and other liabilities | 448 | 327 | 639 | 256 | — | 1,670 | |||||||||||||||||||
28,911 | 15,189 | (15,743 | ) | 7,080 | — | 35,437 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (8,376 | ) | (14,969 | ) | 28,484 | 6,269 | (19,784 | ) | (8,376 | ) | |||||||||||||||
Noncontrolling interests | — | — | 115 | 1,217 | — | 1,332 | |||||||||||||||||||
(8,376 | ) | (14,969 | ) | 28,599 | 7,486 | (19,784 | ) | (7,044 | ) | ||||||||||||||||
$ | 20,535 | $ | 220 | $ | 12,856 | $ | 14,566 | $ | (19,784 | ) | $ | 28,393 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
31-Dec-12 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
ASSETS | |||||||||||||||||||||||||
Current assets: | |||||||||||||||||||||||||
Cash and cash equivalents | $ | 22 | $ | — | $ | 383 | $ | 300 | $ | — | $ | 705 | |||||||||||||
Accounts receivable, net | — | — | 2,448 | 2,224 | — | 4,672 | |||||||||||||||||||
Inventories | — | — | 629 | 457 | — | 1,086 | |||||||||||||||||||
Deferred income taxes | 385 | — | — | — | — | 385 | |||||||||||||||||||
Other | 122 | — | 342 | 451 | — | 915 | |||||||||||||||||||
529 | — | 3,802 | 3,432 | — | 7,763 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,417 | 5,768 | — | 13,185 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 515 | — | 515 | |||||||||||||||||||
Investments in and advances to affiliates | 18,481 | — | 16 | 88 | (18,481 | ) | 104 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,697 | 3,842 | — | 5,539 | |||||||||||||||||||
Deferred loan costs | 32 | 258 | — | — | — | 290 | |||||||||||||||||||
Other | 469 | — | 31 | 179 | — | 679 | |||||||||||||||||||
$ | 19,511 | $ | 258 | $ | 12,963 | $ | 13,824 | $ | (18,481 | ) | $ | 28,075 | |||||||||||||
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) | |||||||||||||||||||||||||
EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | — | $ | — | $ | 1,203 | $ | 565 | $ | — | $ | 1,768 | |||||||||||||
Accrued salaries | — | — | 638 | 482 | — | 1,120 | |||||||||||||||||||
Other accrued expenses | 30 | 567 | 464 | 788 | — | 1,849 | |||||||||||||||||||
Long-term debt due within one year | — | 1,360 | 39 | 36 | — | 1,435 | |||||||||||||||||||
30 | 1,927 | 2,344 | 1,871 | — | 6,172 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,304 | 173 | 493 | — | 27,495 | |||||||||||||||||||
Intercompany balances | 26,131 | (12,407 | ) | (17,130 | ) | 3,406 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 973 | — | 973 | |||||||||||||||||||
Income taxes and other liabilities | 485 | 442 | 629 | 220 | — | 1,776 | |||||||||||||||||||
29,171 | 14,266 | (13,984 | ) | 6,963 | — | 36,416 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (9,660 | ) | (14,008 | ) | 26,847 | 5,642 | (18,481 | ) | (9,660 | ) | |||||||||||||||
Noncontrolling interests | — | — | 100 | 1,219 | — | 1,319 | |||||||||||||||||||
(9,660 | ) | (14,008 | ) | 26,947 | 6,861 | (18,481 | ) | (8,341 | ) | ||||||||||||||||
$ | 19,511 | $ | 258 | $ | 12,963 | $ | 13,824 | $ | (18,481 | ) | $ | 28,075 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2013 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||||||||
Net income (loss) | $ | 1,215 | $ | (1,028 | ) | $ | 1,665 | $ | 893 | $ | (1,303 | ) | $ | 1,442 | |||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||||||||||||||||||||
Changes in operating assets and liabilities | 47 | (126 | ) | (1,848 | ) | (1,392 | ) | — | (3,319 | ) | |||||||||||||||
Provision for doubtful accounts | — | — | 1,611 | 1,121 | — | 2,732 | |||||||||||||||||||
Depreciation and amortization | — | — | 636 | 656 | — | 1,292 | |||||||||||||||||||
Income taxes | 158 | — | — | — | — | 158 | |||||||||||||||||||
Losses (gains) on sales of facilities | — | — | 20 | (7 | ) | — | 13 | ||||||||||||||||||
Loss on retirement of debt | — | 17 | — | — | — | 17 | |||||||||||||||||||
Amortization of deferred loan costs | 3 | 38 | — | — | — | 41 | |||||||||||||||||||
Share-based compensation | 81 | — | — | — | — | 81 | |||||||||||||||||||
Equity in earnings of affiliates | (1,303 | ) | — | — | — | 1,303 | — | ||||||||||||||||||
Other | — | 7 | — | (10 | ) | — | (3 | ) | |||||||||||||||||
Net cash provided by (used in) operating activities | 201 | (1,092 | ) | 2,084 | 1,261 | — | 2,454 | ||||||||||||||||||
Cash flows from investing activities: | |||||||||||||||||||||||||
Purchase of property and equipment | — | — | (684 | ) | (663 | ) | — | (1,347 | ) | ||||||||||||||||
Acquisition of hospitals and health care entities | — | — | — | (463 | ) | — | (463 | ) | |||||||||||||||||
Disposition of hospitals and health care entities | — | — | 17 | 14 | — | 31 | |||||||||||||||||||
Change in investments | — | — | (6 | ) | 103 | — | 97 | ||||||||||||||||||
Other | — | — | — | 8 | — | 8 | |||||||||||||||||||
Net cash used in investing activities | — | — | (673 | ) | (1,001 | ) | — | (1,674 | ) | ||||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||||||||
Net change in revolving bank credit facilities | — | 630 | — | — | — | 630 | |||||||||||||||||||
Repayment of long-term debt | — | (1,243 | ) | (34 | ) | (23 | ) | — | (1,300 | ) | |||||||||||||||
Distributions to noncontrolling interests | — | — | (34 | ) | (274 | ) | — | (308 | ) | ||||||||||||||||
Payment of debt issuance costs | — | (5 | ) | — | — | — | (5 | ) | |||||||||||||||||
Distributions to stockholders | (13 | ) | — | — | — | — | (13 | ) | |||||||||||||||||
Changes in intercompany balances with affiliates, net | (199 | ) | 1,710 | (1,559 | ) | 48 | — | — | |||||||||||||||||
Income tax benefits | 70 | — | — | — | — | 70 | |||||||||||||||||||
Other | (81 | ) | — | — | 6 | — | (75 | ) | |||||||||||||||||
Net cash (used in) provided by financing activities | (223 | ) | 1,092 | (1,627 | ) | (243 | ) | — | (1,001 | ) | |||||||||||||||
Change in cash and cash equivalents | (22 | ) | — | (216 | ) | 17 | — | (221 | ) | ||||||||||||||||
Cash and cash equivalents at beginning of period | 22 | — | 383 | 300 | — | 705 | |||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 167 | $ | 317 | $ | — | $ | 484 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2012 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||||||||
Net income (loss) | $ | 1,291 | $ | (1,013 | ) | $ | 1,771 | $ | 878 | $ | (1,348 | ) | $ | 1,579 | |||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||||||||||||||||||||
Changes in operating assets and liabilities | 30 | (131 | ) | (1,475 | ) | (1,347 | ) | — | (2,923 | ) | |||||||||||||||
Provision for doubtful accounts | — | — | 1,505 | 1,161 | — | 2,666 | |||||||||||||||||||
Depreciation and amortization | — | — | 614 | 640 | — | 1,254 | |||||||||||||||||||
Income taxes | 250 | — | — | — | — | 250 | |||||||||||||||||||
Losses (gains) on sales of facilities | — | — | 3 | (7 | ) | — | (4 | ) | |||||||||||||||||
Amortization of deferred loan costs | 1 | 43 | — | — | — | 44 | |||||||||||||||||||
Share-based compensation | 39 | — | — | — | — | 39 | |||||||||||||||||||
Equity in earnings of affiliates | (1,348 | ) | — | — | — | 1,348 | — | ||||||||||||||||||
Other | — | 11 | — | (4 | ) | — | 7 | ||||||||||||||||||
Net cash provided by (used in) operating activities | 263 | (1,090 | ) | 2,418 | 1,321 | — | 2,912 | ||||||||||||||||||
Cash flows from investing activities: | |||||||||||||||||||||||||
Purchase of property and equipment | — | — | (685 | ) | (583 | ) | — | (1,268 | ) | ||||||||||||||||
Acquisition of hospitals and health care entities | — | — | (72 | ) | (95 | ) | — | (167 | ) | ||||||||||||||||
Disposition of hospitals and health care entities | — | — | 1 | 16 | — | 17 | |||||||||||||||||||
Change in investments | — | — | (9 | ) | 82 | — | 73 | ||||||||||||||||||
Other | — | — | (1 | ) | 6 | — | 5 | ||||||||||||||||||
Net cash used in investing activities | — | — | (766 | ) | (574 | ) | — | (1,340 | ) | ||||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||||||||
Issuance of long-term debt | — | 1,350 | — | — | — | 1,350 | |||||||||||||||||||
Net change in revolving bank credit facilities | — | (875 | ) | — | — | — | (875 | ) | |||||||||||||||||
Repayment of long-term debt | — | (604 | ) | (16 | ) | (69 | ) | — | (689 | ) | |||||||||||||||
Distributions to noncontrolling interests | — | — | (46 | ) | (257 | ) | — | (303 | ) | ||||||||||||||||
Payment of debt issuance costs | — | (20 | ) | — | — | — | (20 | ) | |||||||||||||||||
Distributions to stockholders | (983 | ) | — | — | — | — | (983 | ) | |||||||||||||||||
Changes in intercompany balances with affiliates, net | 675 | 1,239 | (1,556 | ) | (358 | ) | — | — | |||||||||||||||||
Income tax benefits | 82 | — | — | — | — | 82 | |||||||||||||||||||
Other | (37 | ) | — | — | 2 | — | (35 | ) | |||||||||||||||||
Net cash (used in) provided by financing activities | (263 | ) | 1,090 | (1,618 | ) | (682 | ) | — | (1,473 | ) | |||||||||||||||
Change in cash and cash equivalents | — | — | 34 | 65 | — | 99 | |||||||||||||||||||
Cash and cash equivalents at beginning of period | — | — | 115 | 258 | — | 373 | |||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 149 | $ | 323 | $ | — | $ | 472 | |||||||||||||
Subsequent_Event
Subsequent Event | 9 Months Ended |
Sep. 30, 2013 | |
Subsequent Events [Abstract] | ' |
Subsequent Event | ' |
NOTE 13 — SUBSEQUENT EVENT | |
On November 1, 2013, certain of the Company’s stockholders, consisting principally of affiliates of, or funds sponsored by, Bain Capital Partners, LLC and Kohlberg Kravis Roberts & Co. (the “Selling Stockholders”), sold in an underwritten secondary offering, 30 million shares of its common stock pursuant to the Company’s shelf registration statement filed with the Securities and Exchange Commission. The Selling Stockholders received all of the proceeds from this offering. Concurrent with the closing of the secondary offering, the Company repurchased approximately $500 million of additional shares (approximately 10,656,400 shares) of its common stock from the Selling Stockholders at the net offering price ($46.92 per share). |
Interim_Condensed_Consolidated1
Interim Condensed Consolidated Financial Statements (Policies) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Fair Value Disclosures [Abstract] | ' | ||||||||||||||||
Basis of Presentation | ' | ||||||||||||||||
Basis of Presentation | |||||||||||||||||
The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature. | |||||||||||||||||
The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $76 million and $62 million for the quarters ended September 30, 2013 and 2012, respectively, and $207 million and $174 million for the nine months ended September 30, 2013 and 2012, respectively. Operating results for the quarter and the nine months ended September 30, 2013 are not necessarily indicative of the results that may be expected for the year ending December 31, 2013. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2012. | |||||||||||||||||
Basis of Presentation (continued) | |||||||||||||||||
Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under Medicare, Medicaid and other programs), managed care health plans, commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record a provision for doubtful accounts related to uninsured accounts to record the net self pay revenues at the estimated amounts we expect to collect. Our revenues from third-party payers and the uninsured for the quarters and nine months ended September 30, 2013 and 2012 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | |||||||||||||||||
2013 | Ratio | 2012 | Ratio | ||||||||||||||
Medicare | $ | 1,847 | 21.8 | % | $ | 1,949 | 24.2 | % | |||||||||
Managed Medicare | 794 | 9.4 | 720 | 8.9 | |||||||||||||
Medicaid | 401 | 4.7 | 378 | 4.7 | |||||||||||||
Managed Medicaid | 386 | 4.6 | 380 | 4.7 | |||||||||||||
Managed care and other insurers | 4,636 | 54.8 | 4,422 | 54.8 | |||||||||||||
International (managed care and other insurers) | 287 | 3.4 | 253 | 3.1 | |||||||||||||
8,351 | 98.7 | 8,102 | 100.4 | ||||||||||||||
Uninsured | 717 | 8.5 | 576 | 7.1 | |||||||||||||
Other | 343 | 4.1 | 215 | 2.7 | |||||||||||||
Revenues before provision for doubtful accounts | 9,411 | 111.3 | 8,893 | 110.2 | |||||||||||||
Provision for doubtful accounts | (955 | ) | (11.3 | ) | (831 | ) | (10.2 | ) | |||||||||
Revenues | $ | 8,456 | 100 | % | $ | 8,062 | 100 | % | |||||||||
Nine Months | |||||||||||||||||
2013 | Ratio | 2012 | Ratio | ||||||||||||||
Medicare | $ | 5,961 | 23.5 | % | $ | 6,251 | 25.4 | % | |||||||||
Managed Medicare | 2,441 | 9.6 | 2,199 | 8.9 | |||||||||||||
Medicaid | 1,098 | 4.3 | 1,188 | 4.8 | |||||||||||||
Managed Medicaid | 1,165 | 4.6 | 1,080 | 4.4 | |||||||||||||
Managed care and other insurers | 13,777 | 54.4 | 13,340 | 54.3 | |||||||||||||
International (managed care and other insurers) | 868 | 3.4 | 779 | 3.2 | |||||||||||||
25,310 | 99.8 | 24,837 | 101 | ||||||||||||||
Uninsured | 1,809 | 7.1 | 1,757 | 7.1 | |||||||||||||
Other | 959 | 3.8 | 651 | 2.7 | |||||||||||||
Revenues before provision for doubtful accounts | 28,078 | 110.7 | 27,245 | 110.8 | |||||||||||||
Provision for doubtful accounts | (2,732 | ) | (10.7 | ) | (2,666 | ) | (10.8 | ) | |||||||||
Revenues | $ | 25,346 | 100 | % | $ | 24,579 | 100 | % | |||||||||
Medicare revenues for the nine months ended September 30, 2012 were impacted by two adjustments to Medicare revenues (the Rural Floor Provision Settlement which increased revenues by approximately $271 million and the implementation of revised Supplemental Security Income ratios which reduced revenues by approximately $83 million). The net effect of these Medicare adjustments was an increase of $188 million to revenues. The net effect of these adjustments (and related expenses) added $170 million to income before income taxes, or $0.22 per diluted share, for the nine months ended September 30, 2012. | |||||||||||||||||
Certain prior year amounts have been reclassified to conform to the current year presentation. | |||||||||||||||||
Fair Value Measurements and Disclosures | ' | ||||||||||||||||
Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”) defines fair value, establishes a framework for measuring fair value and expands disclosures about fair value measurements. ASC 820 applies to reported balances that are required or permitted to be measured at fair value under existing accounting pronouncements. | |||||||||||||||||
ASC 820 emphasizes fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, ASC 820 establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). | |||||||||||||||||
Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment, and considers factors specific to the asset or liability. | |||||||||||||||||
Cash Traded Investments | ' | ||||||||||||||||
Cash Traded Investments | |||||||||||||||||
Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency. Certain types of cash traded instruments are classified within Level 3 of the fair value hierarchy because they trade infrequently and therefore have little or no price transparency. The valuation of these securities involves management’s judgment, after consideration of market factors and the absence of market transparency, market liquidity and observable inputs. Our valuation models derived fair market values compared to tax-equivalent yields of other securities of similar credit worthiness and similar effective maturities. | |||||||||||||||||
Derivative Financial Instruments | ' | ||||||||||||||||
Derivative Financial Instruments | |||||||||||||||||
We have entered into interest rate and cross currency swap agreements to manage our exposure to fluctuations in interest rates and foreign currency risks. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves, foreign exchange rates and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. | |||||||||||||||||
Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at September 30, 2013 and December 31, 2012, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. |
Interim_Condensed_Consolidated2
Interim Condensed Consolidated Financial Statements (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Quarterly Financial Information Disclosure [Abstract] | ' | ||||||||||||||||
Schedule of Revenues from Third Party Payers and Uninsured | ' | ||||||||||||||||
revenues at the estimated amounts we expect to collect. Our revenues from third-party payers and the uninsured for the quarters and nine months ended September 30, 2013 and 2012 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | |||||||||||||||||
2013 | Ratio | 2012 | Ratio | ||||||||||||||
Medicare | $ | 1,847 | 21.8 | % | $ | 1,949 | 24.2 | % | |||||||||
Managed Medicare | 794 | 9.4 | 720 | 8.9 | |||||||||||||
Medicaid | 401 | 4.7 | 378 | 4.7 | |||||||||||||
Managed Medicaid | 386 | 4.6 | 380 | 4.7 | |||||||||||||
Managed care and other insurers | 4,636 | 54.8 | 4,422 | 54.8 | |||||||||||||
International (managed care and other insurers) | 287 | 3.4 | 253 | 3.1 | |||||||||||||
8,351 | 98.7 | 8,102 | 100.4 | ||||||||||||||
Uninsured | 717 | 8.5 | 576 | 7.1 | |||||||||||||
Other | 343 | 4.1 | 215 | 2.7 | |||||||||||||
Revenues before provision for doubtful accounts | 9,411 | 111.3 | 8,893 | 110.2 | |||||||||||||
Provision for doubtful accounts | (955 | ) | (11.3 | ) | (831 | ) | (10.2 | ) | |||||||||
Revenues | $ | 8,456 | 100 | % | $ | 8,062 | 100 | % | |||||||||
Nine Months | |||||||||||||||||
2013 | Ratio | 2012 | Ratio | ||||||||||||||
Medicare | $ | 5,961 | 23.5 | % | $ | 6,251 | 25.4 | % | |||||||||
Managed Medicare | 2,441 | 9.6 | 2,199 | 8.9 | |||||||||||||
Medicaid | 1,098 | 4.3 | 1,188 | 4.8 | |||||||||||||
Managed Medicaid | 1,165 | 4.6 | 1,080 | 4.4 | |||||||||||||
Managed care and other insurers | 13,777 | 54.4 | 13,340 | 54.3 | |||||||||||||
International (managed care and other insurers) | 868 | 3.4 | 779 | 3.2 | |||||||||||||
25,310 | 99.8 | 24,837 | 101 | ||||||||||||||
Uninsured | 1,809 | 7.1 | 1,757 | 7.1 | |||||||||||||
Other | 959 | 3.8 | 651 | 2.7 | |||||||||||||
Revenues before provision for doubtful accounts | 28,078 | 110.7 | 27,245 | 110.8 | |||||||||||||
Provision for doubtful accounts | (2,732 | ) | (10.7 | ) | (2,666 | ) | (10.8 | ) | |||||||||
Revenues | $ | 25,346 | 100 | % | $ | 24,579 | 100 | % | |||||||||
Earnings_Per_Share_Tables
Earnings Per Share (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Earnings Per Share [Abstract] | ' | ||||||||||||||||
Schedule of Computations of Basic and Diluted Earnings Per Share | ' | ||||||||||||||||
The following table sets forth the computation of basic and diluted earnings per share for the quarters and nine months ended September 30, 2013 and 2012 (dollars in millions, except per share amounts, and shares in thousands): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2013 | 2012 | 2013 | 2012 | ||||||||||||||
Net income attributable to HCA Holdings, Inc. | $ | 365 | $ | 360 | $ | 1,132 | $ | 1,291 | |||||||||
Weighted average common shares outstanding | 447,329 | 440,899 | 446,125 | 439,441 | |||||||||||||
Effect of dilutive incremental shares | 16,240 | 18,616 | 16,926 | 19,381 | |||||||||||||
Shares used for diluted earnings per share | 463,569 | 459,515 | 463,051 | 458,822 | |||||||||||||
Earnings per share: | |||||||||||||||||
Basic earnings per share | $ | 0.82 | $ | 0.82 | $ | 2.54 | $ | 2.94 | |||||||||
Diluted earnings per share | $ | 0.79 | $ | 0.78 | $ | 2.44 | $ | 2.81 |
Investments_of_Insurance_Subsi1
Investments of Insurance Subsidiaries (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Investments Debt And Equity Securities [Abstract] | ' | ||||||||||||||||
Schedule of Investments | ' | ||||||||||||||||
A summary of our insurance subsidiaries’ investments at September 30, 2013 and December 31, 2012 follows (dollars in millions): | |||||||||||||||||
September 30, 2013 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 383 | $ | 12 | $ | (2 | ) | $ | 393 | ||||||||
Auction rate securities | 32 | — | — | 32 | |||||||||||||
Asset-backed securities | 13 | — | — | 13 | |||||||||||||
Money market funds | 24 | — | — | 24 | |||||||||||||
452 | 12 | (2 | ) | 462 | |||||||||||||
Equity securities | 2 | 1 | — | 3 | |||||||||||||
$ | 454 | $ | 13 | $ | (2 | ) | 465 | ||||||||||
Amounts classified as current assets | (63 | ) | |||||||||||||||
Investment carrying value | $ | 402 | |||||||||||||||
December 31, 2012 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 395 | $ | 23 | $ | — | $ | 418 | |||||||||
Auction rate securities | 74 | — | (6 | ) | 68 | ||||||||||||
Asset-backed securities | 14 | — | — | 14 | |||||||||||||
Money market funds | 67 | — | — | 67 | |||||||||||||
550 | 23 | (6 | ) | 567 | |||||||||||||
Equity securities | 2 | 1 | — | 3 | |||||||||||||
$ | 552 | $ | 24 | $ | (6 | ) | 570 | ||||||||||
Amounts classified as current assets | (55 | ) | |||||||||||||||
Investment carrying value | $ | 515 | |||||||||||||||
Schedule of Maturities of Investments | ' | ||||||||||||||||
Scheduled maturities of investments in debt securities at September 30, 2013 were as follows (dollars in millions): | |||||||||||||||||
Amortized | Fair | ||||||||||||||||
Cost | Value | ||||||||||||||||
Due in one year or less | $ | 41 | $ | 41 | |||||||||||||
Due after one year through five years | 176 | 182 | |||||||||||||||
Due after five years through ten years | 108 | 111 | |||||||||||||||
Due after ten years | 82 | 83 | |||||||||||||||
407 | 417 | ||||||||||||||||
Auction rate securities | 32 | 32 | |||||||||||||||
Asset-backed securities | 13 | 13 | |||||||||||||||
$ | 452 | $ | 462 | ||||||||||||||
Financial_Instruments_Tables
Financial Instruments (Tables) | 9 Months Ended | ||||||||||||
Sep. 30, 2013 | |||||||||||||
Derivative Instruments And Hedging Activities Disclosure [Abstract] | ' | ||||||||||||
Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges | ' | ||||||||||||
The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at September 30, 2013 (dollars in millions): | |||||||||||||
Notional | Maturity Date | Fair | |||||||||||
Amount | Value | ||||||||||||
Pay-fixed interest rate swaps | $ | 500 | December 2014 | $ | (6 | ) | |||||||
Pay-fixed interest rate swaps | 3,000 | Dec-16 | (269 | ) | |||||||||
Pay-fixed interest rate swaps | 1,000 | Dec-17 | (48 | ) | |||||||||
Schedule of Cross Currency Swap Agreement Not Designated as Hedge | ' | ||||||||||||
Our cross currency swap is not designated as a hedge, and changes in fair value are recognized in results of operations. The following table sets forth our cross currency swap agreement at September 30, 2013 (amounts in millions): | |||||||||||||
Notional | Maturity Date | Fair | |||||||||||
Amount | Value | ||||||||||||
Euro — United States dollar currency swap | 241 Euro | November 2013 | $ | (4 | ) | ||||||||
Effect of Interest Rate and Cross Currency Swaps on Results of Operations | ' | ||||||||||||
The following tables present the effect of our interest rate and cross currency swaps on our results of operations for the nine months ended September 30, 2013 (dollars in millions): | |||||||||||||
Derivatives in Cash Flow Hedging Relationships | Amount of Gain | Location of Loss | Amount of Loss | ||||||||||
Recognized in OCI on | Reclassified from | Reclassified from | |||||||||||
Derivatives, Net of Tax | Accumulated OCI | Accumulated OCI | |||||||||||
into Operations | into Operations | ||||||||||||
Interest rate swaps | $ | 6 | Interest expense | $ | 97 | ||||||||
Derivatives — Results of Operations (continued) | |||||||||||||
Derivatives Not Designated as Hedging Instruments | Location of Gain Recognized | Amount of Gain | |||||||||||
in Operations on Derivatives | Recognized in | ||||||||||||
Operations on | |||||||||||||
Derivatives | |||||||||||||
Cross currency swap | Other operating expenses | $ | 9 |
Assets_and_Liabilities_Measure1
Assets and Liabilities Measured at Fair Value (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Fair Value Disclosures [Abstract] | ' | ||||||||||||||||
Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis | ' | ||||||||||||||||
The following table summarizes our assets and liabilities measured at fair value on a recurring basis as of September 30, 2013 and December 31, 2012, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): | |||||||||||||||||
September 30, 2013 | |||||||||||||||||
Fair Value Measurements Using | |||||||||||||||||
Fair Value | Quoted Prices in | Significant Other | Significant | ||||||||||||||
Active Markets for | Observable Inputs | Unobservable Inputs | |||||||||||||||
Identical Assets | (Level 2) | (Level 3) | |||||||||||||||
and Liabilities | |||||||||||||||||
(Level 1) | |||||||||||||||||
Assets: | |||||||||||||||||
Investments of insurance subsidiaries: | |||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 393 | $ | — | $ | 393 | $ | — | |||||||||
Auction rate securities | 32 | — | — | 32 | |||||||||||||
Asset-backed securities | 13 | — | 13 | — | |||||||||||||
Money market funds | 24 | 24 | — | — | |||||||||||||
462 | 24 | 406 | 32 | ||||||||||||||
Equity securities | 3 | 2 | — | 1 | |||||||||||||
Investments of insurance subsidiaries | 465 | 26 | 406 | 33 | |||||||||||||
Less amounts classified as current assets | (63 | ) | (24 | ) | (39 | ) | — | ||||||||||
$ | 402 | $ | 2 | $ | 367 | $ | 33 | ||||||||||
Liabilities: | |||||||||||||||||
Cross currency swap (Income taxes and other liabilities) | $ | 4 | $ | — | $ | 4 | $ | — | |||||||||
Interest rate swaps (Income taxes and other liabilities) | 323 | — | 323 | — | |||||||||||||
Derivative Financial Instruments (continued) | |||||||||||||||||
December 31, 2012 | |||||||||||||||||
Fair Value | Fair Value Measurements Using | ||||||||||||||||
Quoted Prices in | Significant Other | Significant | |||||||||||||||
Active Markets for | Observable Inputs | Unobservable Inputs | |||||||||||||||
Identical Assets | (Level 2) | (Level 3) | |||||||||||||||
and Liabilities | |||||||||||||||||
(Level 1) | |||||||||||||||||
Assets: | |||||||||||||||||
Investments of insurance subsidiaries: | |||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 418 | $ | — | $ | 418 | $ | — | |||||||||
Auction rate securities | 68 | — | — | 68 | |||||||||||||
Asset-backed securities | 14 | — | 14 | — | |||||||||||||
Money market funds | 67 | 67 | — | — | |||||||||||||
567 | 67 | 432 | 68 | ||||||||||||||
Equity securities | 3 | 1 | — | 2 | |||||||||||||
Investments of insurance subsidiaries | 570 | 68 | 432 | 70 | |||||||||||||
Less amounts classified as current assets | (55 | ) | (55 | ) | — | — | |||||||||||
$ | 515 | $ | 13 | $ | 432 | $ | 70 | ||||||||||
Liabilities: | |||||||||||||||||
Cross currency swap (Income taxes and other liabilities) | $ | 13 | $ | — | $ | 13 | $ | — | |||||||||
Interest rate swaps (Income taxes and other liabilities) | 429 | — | 429 | — | |||||||||||||
Schedule Related to Auction Rate and Equity Securities Investments of Insurance Subsidiaries at Fair Value | ' | ||||||||||||||||
The following table summarizes the activity related to the auction rate and equity securities investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the nine months ended September 30, 2013 (dollars in millions): | |||||||||||||||||
Asset balances at December 31, 2012 | $70 | ||||||||||||||||
Unrealized gains included in other comprehensive income | 6 | ||||||||||||||||
Settlements | (43 | ) | |||||||||||||||
Asset balances at September 30, 2013 | $ | 33 | |||||||||||||||
LongTerm_Debt_Tables
Long-Term Debt (Tables) | 9 Months Ended | ||||||||
Sep. 30, 2013 | |||||||||
Debt Disclosure [Abstract] | ' | ||||||||
Schedule of Long-Term Debt | ' | ||||||||
A summary of long-term debt at September 30, 2013 and December 31, 2012, including related interest rates at September 30, 2013, follows (dollars in millions): | |||||||||
September 30, | December 31, | ||||||||
2013 | 2012 | ||||||||
Senior secured asset-based revolving credit facility (effective interest rate of 1.7%) | $ | 2,100 | $ | 1,470 | |||||
Senior secured revolving credit facility | — | — | |||||||
Senior secured term loan facilities (effective interest rate of 5.1%) | 5,944 | 5,958 | |||||||
Senior secured first lien notes (effective interest rate of 7.1%) | 9,693 | 9,688 | |||||||
Other senior secured debt (effective interest rate of 6.8%) | 446 | 423 | |||||||
First lien debt | 18,183 | 17,539 | |||||||
Senior secured second lien notes | — | 197 | |||||||
Senior unsecured notes (effective interest rate of 7.2%) | 10,194 | 11,194 | |||||||
Total debt (average life of 6.5 years, rates averaging 6.3%) | 28,377 | 28,930 | |||||||
Less amounts due within one year | 988 | 1,435 | |||||||
$ | 27,389 | $ | 27,495 | ||||||
Capital_Structure_Tables
Capital Structure (Tables) | 9 Months Ended | ||||||||||||||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||||||||||||||
Text Block [Abstract] | ' | ||||||||||||||||||||||||||||
Schedule of Changes in Stockholders' Deficit and Equity | ' | ||||||||||||||||||||||||||||
The changes in stockholders’ deficit, including changes in stockholders’ deficit attributable to HCA Holdings, Inc. and changes in equity attributable to noncontrolling interests, are as follows (dollars in millions): | |||||||||||||||||||||||||||||
Equity (Deficit) Attributable to HCA Holdings, Inc. | Equity | Total | |||||||||||||||||||||||||||
Attributable to | |||||||||||||||||||||||||||||
Common Stock | Capital in | Accumulated | Retained | Noncontrolling | |||||||||||||||||||||||||
Excess of | Other | Deficit | Interests | ||||||||||||||||||||||||||
Par | Comprehensive | ||||||||||||||||||||||||||||
Shares | Par Value | Value | Loss | ||||||||||||||||||||||||||
0 | |||||||||||||||||||||||||||||
Balances at December 31, 2012 | 443,200 | $ | 4 | $ | 1,753 | $ | (457 | ) | $ | (10,960 | ) | $ | 1,319 | $ | (8,341 | ) | |||||||||||||
Net income | — | — | — | — | 1,132 | 310 | 1,442 | ||||||||||||||||||||||
Other comprehensive income | — | — | — | 83 | — | — | 83 | ||||||||||||||||||||||
Distributions | — | — | — | — | — | (308 | ) | (308 | ) | ||||||||||||||||||||
Share-based benefit plans | 4,373 | — | 71 | — | — | — | 71 | ||||||||||||||||||||||
Other | — | — | (3 | ) | — | 1 | 11 | 9 | |||||||||||||||||||||
Balances at September 30, 2013 | 447,573 | $ | 4 | $ | 1,821 | $ | (374 | ) | $ | (9,827 | ) | $ | 1,332 | $ | (7,044 | ) | |||||||||||||
Components of Accumulated Other Comprehensive Loss | ' | ||||||||||||||||||||||||||||
The components of accumulated other comprehensive loss are as follows (dollars in millions): | |||||||||||||||||||||||||||||
Unrealized | Foreign | Defined | Change | Total | |||||||||||||||||||||||||
Gains on | Currency | Benefit | in Fair | ||||||||||||||||||||||||||
Available- | Translation | Plans | Value of | ||||||||||||||||||||||||||
for-Sale | Adjustments | Derivative | |||||||||||||||||||||||||||
Securities | Instruments | ||||||||||||||||||||||||||||
Balances at December 31, 2012 | $ | 11 | $ | (1 | ) | $ | (196 | ) | $ | (271 | ) | $ | (457 | ) | |||||||||||||||
Unrealized losses on available-for-sale securities, net of $3 income tax benefit | (4 | ) | — | — | — | (4 | ) | ||||||||||||||||||||||
Defined benefit plans, net of $3 of income taxes | — | — | 5 | — | 5 | ||||||||||||||||||||||||
Change in fair value of derivative instruments, net of $3 of income taxes | — | — | — | 6 | 6 | ||||||||||||||||||||||||
Expense reclassified into operations from other comprehensive income, net of $9 and $36, respectively, income tax benefits | — | — | 15 | 61 | 76 | ||||||||||||||||||||||||
Balances at September 30, 2013 | $ | 7 | $ | (1 | ) | $ | (176 | ) | $ | (204 | ) | $ | (374 | ) | |||||||||||||||
Segment_and_Geographic_Informa1
Segment and Geographic Information (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||
Segment Reporting [Abstract] | ' | ||||||||||||||||
Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets | ' | ||||||||||||||||
The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2013 and 2012 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2013 | 2012 | 2013 | 2012 | ||||||||||||||
Revenues: | |||||||||||||||||
National Group | $ | 3,930 | $ | 3,755 | $ | 11,875 | $ | 11,553 | |||||||||
American Group | 4,082 | 3,982 | 12,181 | 12,033 | |||||||||||||
Corporate and other | 444 | 325 | 1,290 | 993 | |||||||||||||
$ | 8,456 | $ | 8,062 | $ | 25,346 | $ | 24,579 | ||||||||||
Equity in earnings of affiliates: | |||||||||||||||||
National Group | $ | (3 | ) | $ | — | $ | (8 | ) | $ | (7 | ) | ||||||
American Group | (6 | ) | (6 | ) | (19 | ) | (20 | ) | |||||||||
Corporate and other | — | — | (2 | ) | 1 | ||||||||||||
$ | (9 | ) | $ | (6 | ) | $ | (29 | ) | $ | (26 | ) | ||||||
Adjusted segment EBITDA: | |||||||||||||||||
National Group | $ | 805 | $ | 768 | $ | 2,440 | $ | 2,478 | |||||||||
American Group | 910 | 843 | 2,654 | 2,657 | |||||||||||||
Corporate and other | (112 | ) | (78 | ) | (234 | ) | (210 | ) | |||||||||
$ | 1,603 | $ | 1,533 | $ | 4,860 | $ | 4,925 | ||||||||||
Depreciation and amortization: | |||||||||||||||||
National Group | $ | 181 | $ | 171 | $ | 532 | $ | 520 | |||||||||
American Group | 206 | 207 | 610 | 612 | |||||||||||||
Corporate and other | 56 | 39 | 150 | 122 | |||||||||||||
$ | 443 | $ | 417 | $ | 1,292 | $ | 1,254 | ||||||||||
Adjusted segment EBITDA | $ | 1,603 | $ | 1,533 | $ | 4,860 | $ | 4,925 | |||||||||
Depreciation and amortization | 443 | 417 | 1,292 | 1,254 | |||||||||||||
Interest expense | 458 | 446 | 1,392 | 1,336 | |||||||||||||
Losses (gains) on sales of facilities | 1 | (7 | ) | 13 | (4 | ) | |||||||||||
Loss on retirement of debt | — | — | 17 | — | |||||||||||||
Income before income taxes | $ | 701 | $ | 677 | $ | 2,146 | $ | 2,339 | |||||||||
Supplemental_Condensed_Consoli1
Supplemental Condensed Consolidating Financial Information (Tables) | 9 Months Ended | ||||||||||||||||||||||||
Sep. 30, 2013 | |||||||||||||||||||||||||
Text Block [Abstract] | ' | ||||||||||||||||||||||||
Schedule of Condensed Consolidating Comprehensive Income Statement | ' | ||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE QUARTER ENDED SEPTEMBER 30, 2013 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 4,945 | $ | 4,466 | $ | — | $ | 9,411 | |||||||||||||
Provision for doubtful accounts | — | — | 560 | 395 | — | 955 | |||||||||||||||||||
Revenues | — | — | 4,385 | 4,071 | — | 8,456 | |||||||||||||||||||
Salaries and benefits | — | — | 2,090 | 1,826 | — | 3,916 | |||||||||||||||||||
Supplies | — | — | 773 | 684 | — | 1,457 | |||||||||||||||||||
Other operating expenses | 2 | (1 | ) | 771 | 792 | — | 1,564 | ||||||||||||||||||
Electronic health record incentive income | — | — | (53 | ) | (22 | ) | — | (75 | ) | ||||||||||||||||
Equity in earnings of affiliates | (443 | ) | — | — | (9 | ) | 443 | (9 | ) | ||||||||||||||||
Depreciation and amortization | — | — | 216 | 227 | — | 443 | |||||||||||||||||||
Interest expense | 41 | 549 | (104 | ) | (28 | ) | — | 458 | |||||||||||||||||
Losses on sales of facilities | — | — | 1 | — | — | 1 | |||||||||||||||||||
Management fees | — | — | (183 | ) | 183 | — | — | ||||||||||||||||||
(400 | ) | 548 | 3,511 | 3,653 | 443 | 7,755 | |||||||||||||||||||
Income (loss) before income taxes | 400 | (548 | ) | 874 | 418 | (443 | ) | 701 | |||||||||||||||||
Provision (benefit) for income taxes | (17 | ) | (214 | ) | 334 | 131 | — | 234 | |||||||||||||||||
Net income (loss) | 417 | (334 | ) | 540 | 287 | (443 | ) | 467 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 19 | 83 | — | 102 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 417 | $ | (334 | ) | $ | 521 | $ | 204 | $ | (443 | ) | $ | 365 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 417 | $ | (331 | ) | $ | 532 | $ | 242 | $ | (443 | ) | $ | 417 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE QUARTER ENDED SEPTEMBER 30, 2012 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 4,672 | $ | 4,221 | $ | — | $ | 8,893 | |||||||||||||
Provision for doubtful accounts | — | — | 484 | 347 | — | 831 | |||||||||||||||||||
Revenues | — | — | 4,188 | 3,874 | — | 8,062 | |||||||||||||||||||
Salaries and benefits | — | — | 1,995 | 1,786 | — | 3,781 | |||||||||||||||||||
Supplies | — | — | 711 | 664 | — | 1,375 | |||||||||||||||||||
Other operating expenses | — | 3 | 761 | 746 | — | 1,510 | |||||||||||||||||||
Electronic health record incentive income | — | — | (85 | ) | (46 | ) | — | (131 | ) | ||||||||||||||||
Equity in earnings of affiliates | (379 | ) | — | (1 | ) | (5 | ) | 379 | (6 | ) | |||||||||||||||
Depreciation and amortization | — | — | 205 | 212 | — | 417 | |||||||||||||||||||
Interest expense | 30 | 545 | (98 | ) | (31 | ) | — | 446 | |||||||||||||||||
Gains on sales of facilities | — | — | — | (7 | ) | — | (7 | ) | |||||||||||||||||
Management fees | — | — | (170 | ) | 170 | — | — | ||||||||||||||||||
(349 | ) | 548 | 3,318 | 3,489 | 379 | 7,385 | |||||||||||||||||||
Income (loss) before income taxes | 349 | (548 | ) | 870 | 385 | (379 | ) | 677 | |||||||||||||||||
Provision (benefit) for income taxes | (11 | ) | (208 | ) | 325 | 116 | — | 222 | |||||||||||||||||
Net income (loss) | 360 | (340 | ) | 545 | 269 | (379 | ) | 455 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 18 | 77 | — | 95 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 360 | $ | (340 | ) | $ | 527 | $ | 192 | $ | (379 | ) | $ | 360 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 360 | $ | (357 | ) | $ | 531 | $ | 214 | $ | (379 | ) | $ | 369 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2013 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 14,829 | $ | 13,249 | $ | — | $ | 28,078 | |||||||||||||
Provision for doubtful accounts | — | — | 1,611 | 1,121 | — | 2,732 | |||||||||||||||||||
Revenues | — | — | 13,218 | 12,128 | — | 25,346 | |||||||||||||||||||
Salaries and benefits | — | — | 6,275 | 5,406 | — | 11,681 | |||||||||||||||||||
Supplies | — | — | 2,340 | 2,066 | — | 4,406 | |||||||||||||||||||
Other operating expenses | 4 | (1 | ) | 2,260 | 2,331 | — | 4,594 | ||||||||||||||||||
Electronic health record incentive income | — | — | (115 | ) | (51 | ) | — | (166 | ) | ||||||||||||||||
Equity in earnings of affiliates | (1,303 | ) | — | (2 | ) | (27 | ) | 1,303 | (29 | ) | |||||||||||||||
Depreciation and amortization | — | — | 636 | 656 | — | 1,292 | |||||||||||||||||||
Interest expense | 138 | 1,651 | (319 | ) | (78 | ) | — | 1,392 | |||||||||||||||||
Losses (gains) on sales of facilities | — | — | 20 | (7 | ) | — | 13 | ||||||||||||||||||
Loss on retirement of debt | — | 17 | — | — | — | 17 | |||||||||||||||||||
Management fees | — | — | (547 | ) | 547 | — | — | ||||||||||||||||||
(1,161 | ) | 1,667 | 10,548 | 10,843 | 1,303 | 23,200 | |||||||||||||||||||
Income (loss) before income taxes | 1,161 | (1,667 | ) | 2,670 | 1,285 | (1,303 | ) | 2,146 | |||||||||||||||||
Provision (benefit) for income taxes | (54 | ) | (639 | ) | 1,005 | 392 | — | 704 | |||||||||||||||||
Net income (loss) | 1,215 | (1,028 | ) | 1,665 | 893 | (1,303 | ) | 1,442 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 48 | 262 | — | 310 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 1,215 | $ | (1,028 | ) | $ | 1,617 | $ | 631 | $ | (1,303 | ) | $ | 1,132 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 1,215 | $ | (961 | ) | $ | 1,637 | $ | 627 | $ | (1,303 | ) | $ | 1,215 | |||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2012 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 14,328 | $ | 12,917 | $ | — | $ | 27,245 | |||||||||||||
Provision for doubtful accounts | — | — | 1,505 | 1,161 | — | 2,666 | |||||||||||||||||||
Revenues | — | — | 12,823 | 11,756 | — | 24,579 | |||||||||||||||||||
Salaries and benefits | — | — | 5,928 | 5,296 | — | 11,224 | |||||||||||||||||||
Supplies | — | — | 2,202 | 2,014 | — | 4,216 | |||||||||||||||||||
Other operating expenses | — | 7 | 2,241 | 2,248 | — | 4,496 | |||||||||||||||||||
Electronic health record incentive income | — | — | (174 | ) | (82 | ) | — | (256 | ) | ||||||||||||||||
Equity in earnings of affiliates | (1,348 | ) | — | (4 | ) | (22 | ) | 1,348 | (26 | ) | |||||||||||||||
Depreciation and amortization | — | — | 614 | 640 | — | 1,254 | |||||||||||||||||||
Interest expense | 90 | 1,603 | (274 | ) | (83 | ) | — | 1,336 | |||||||||||||||||
Losses (gains) on sales of facilities | — | — | 3 | (7 | ) | — | (4 | ) | |||||||||||||||||
Management fees | — | — | (498 | ) | 498 | — | — | ||||||||||||||||||
(1,258 | ) | 1,610 | 10,038 | 10,502 | 1,348 | 22,240 | |||||||||||||||||||
Income (loss) before income taxes | 1,258 | (1,610 | ) | 2,785 | 1,254 | (1,348 | ) | 2,339 | |||||||||||||||||
Provision (benefit) for income taxes | (33 | ) | (597 | ) | 1,014 | 376 | — | 760 | |||||||||||||||||
Net income (loss) | 1,291 | (1,013 | ) | 1,771 | 878 | (1,348 | ) | 1,579 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 51 | 237 | — | 288 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 1,291 | $ | (1,013 | ) | $ | 1,720 | $ | 641 | $ | (1,348 | ) | $ | 1,291 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 1,291 | $ | (1,055 | ) | $ | 1,733 | $ | 670 | $ | (1,348 | ) | $ | 1,291 | |||||||||||
Schedule of Condensed Consolidating Balance Sheet | ' | ||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
30-Sep-13 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
ASSETS | |||||||||||||||||||||||||
Current assets: | |||||||||||||||||||||||||
Cash and cash equivalents | $ | — | $ | — | $ | 167 | $ | 317 | $ | — | $ | 484 | |||||||||||||
Accounts receivable, net | — | — | 2,481 | 2,443 | — | 4,924 | |||||||||||||||||||
Inventories | — | — | 667 | 468 | — | 1,135 | |||||||||||||||||||
Deferred income taxes | 400 | — | — | — | — | 400 | |||||||||||||||||||
Other | 6 | — | 327 | 495 | — | 828 | |||||||||||||||||||
406 | — | 3,642 | 3,723 | — | 7,771 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,467 | 5,855 | — | 13,322 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 402 | — | 402 | |||||||||||||||||||
Investments in and advances to affiliates | 19,784 | — | 15 | 110 | (19,784 | ) | 125 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,695 | 4,137 | — | 5,832 | |||||||||||||||||||
Deferred loan costs | 30 | 220 | — | — | — | 250 | |||||||||||||||||||
Other | 315 | — | 37 | 339 | — | 691 | |||||||||||||||||||
$ | 20,535 | $ | 220 | $ | 12,856 | $ | 14,566 | $ | (19,784 | ) | $ | 28,393 | |||||||||||||
LIABILITIES AND | |||||||||||||||||||||||||
STOCKHOLDERS’ (DEFICIT) | |||||||||||||||||||||||||
EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | 1 | $ | — | $ | 1,012 | $ | 569 | $ | — | $ | 1,582 | |||||||||||||
Accrued salaries | — | — | 634 | 451 | — | 1,085 | |||||||||||||||||||
Other accrued expenses | 255 | 259 | 441 | 809 | — | 1,764 | |||||||||||||||||||
Long-term debt due within one year | — | 906 | 43 | 39 | — | 988 | |||||||||||||||||||
256 | 1,165 | 2,130 | 1,868 | — | 5,419 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,174 | 165 | 525 | — | 27,389 | |||||||||||||||||||
Intercompany balances | 25,682 | (10,477 | ) | (18,677 | ) | 3,472 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 959 | — | 959 | |||||||||||||||||||
Income taxes and other liabilities | 448 | 327 | 639 | 256 | — | 1,670 | |||||||||||||||||||
28,911 | 15,189 | (15,743 | ) | 7,080 | — | 35,437 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (8,376 | ) | (14,969 | ) | 28,484 | 6,269 | (19,784 | ) | (8,376 | ) | |||||||||||||||
Noncontrolling interests | — | — | 115 | 1,217 | — | 1,332 | |||||||||||||||||||
(8,376 | ) | (14,969 | ) | 28,599 | 7,486 | (19,784 | ) | (7,044 | ) | ||||||||||||||||
$ | 20,535 | $ | 220 | $ | 12,856 | $ | 14,566 | $ | (19,784 | ) | $ | 28,393 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
31-Dec-12 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
ASSETS | |||||||||||||||||||||||||
Current assets: | |||||||||||||||||||||||||
Cash and cash equivalents | $ | 22 | $ | — | $ | 383 | $ | 300 | $ | — | $ | 705 | |||||||||||||
Accounts receivable, net | — | — | 2,448 | 2,224 | — | 4,672 | |||||||||||||||||||
Inventories | — | — | 629 | 457 | — | 1,086 | |||||||||||||||||||
Deferred income taxes | 385 | — | — | — | — | 385 | |||||||||||||||||||
Other | 122 | — | 342 | 451 | — | 915 | |||||||||||||||||||
529 | — | 3,802 | 3,432 | — | 7,763 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,417 | 5,768 | — | 13,185 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 515 | — | 515 | |||||||||||||||||||
Investments in and advances to affiliates | 18,481 | — | 16 | 88 | (18,481 | ) | 104 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,697 | 3,842 | — | 5,539 | |||||||||||||||||||
Deferred loan costs | 32 | 258 | — | — | — | 290 | |||||||||||||||||||
Other | 469 | — | 31 | 179 | — | 679 | |||||||||||||||||||
$ | 19,511 | $ | 258 | $ | 12,963 | $ | 13,824 | $ | (18,481 | ) | $ | 28,075 | |||||||||||||
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) | |||||||||||||||||||||||||
EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | — | $ | — | $ | 1,203 | $ | 565 | $ | — | $ | 1,768 | |||||||||||||
Accrued salaries | — | — | 638 | 482 | — | 1,120 | |||||||||||||||||||
Other accrued expenses | 30 | 567 | 464 | 788 | — | 1,849 | |||||||||||||||||||
Long-term debt due within one year | — | 1,360 | 39 | 36 | — | 1,435 | |||||||||||||||||||
30 | 1,927 | 2,344 | 1,871 | — | 6,172 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,304 | 173 | 493 | — | 27,495 | |||||||||||||||||||
Intercompany balances | 26,131 | (12,407 | ) | (17,130 | ) | 3,406 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 973 | — | 973 | |||||||||||||||||||
Income taxes and other liabilities | 485 | 442 | 629 | 220 | — | 1,776 | |||||||||||||||||||
29,171 | 14,266 | (13,984 | ) | 6,963 | — | 36,416 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (9,660 | ) | (14,008 | ) | 26,847 | 5,642 | (18,481 | ) | (9,660 | ) | |||||||||||||||
Noncontrolling interests | — | — | 100 | 1,219 | — | 1,319 | |||||||||||||||||||
(9,660 | ) | (14,008 | ) | 26,947 | 6,861 | (18,481 | ) | (8,341 | ) | ||||||||||||||||
$ | 19,511 | $ | 258 | $ | 12,963 | $ | 13,824 | $ | (18,481 | ) | $ | 28,075 | |||||||||||||
Schedule of Condensed Consolidating Statement of Cash Flows | ' | ||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2013 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||||||||
Net income (loss) | $ | 1,215 | $ | (1,028 | ) | $ | 1,665 | $ | 893 | $ | (1,303 | ) | $ | 1,442 | |||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||||||||||||||||||||
Changes in operating assets and liabilities | 47 | (126 | ) | (1,848 | ) | (1,392 | ) | — | (3,319 | ) | |||||||||||||||
Provision for doubtful accounts | — | — | 1,611 | 1,121 | — | 2,732 | |||||||||||||||||||
Depreciation and amortization | — | — | 636 | 656 | — | 1,292 | |||||||||||||||||||
Income taxes | 158 | — | — | — | — | 158 | |||||||||||||||||||
Losses (gains) on sales of facilities | — | — | 20 | (7 | ) | — | 13 | ||||||||||||||||||
Loss on retirement of debt | — | 17 | — | — | — | 17 | |||||||||||||||||||
Amortization of deferred loan costs | 3 | 38 | — | — | — | 41 | |||||||||||||||||||
Share-based compensation | 81 | — | — | — | — | 81 | |||||||||||||||||||
Equity in earnings of affiliates | (1,303 | ) | — | — | — | 1,303 | — | ||||||||||||||||||
Other | — | 7 | — | (10 | ) | — | (3 | ) | |||||||||||||||||
Net cash provided by (used in) operating activities | 201 | (1,092 | ) | 2,084 | 1,261 | — | 2,454 | ||||||||||||||||||
Cash flows from investing activities: | |||||||||||||||||||||||||
Purchase of property and equipment | — | — | (684 | ) | (663 | ) | — | (1,347 | ) | ||||||||||||||||
Acquisition of hospitals and health care entities | — | — | — | (463 | ) | — | (463 | ) | |||||||||||||||||
Disposition of hospitals and health care entities | — | — | 17 | 14 | — | 31 | |||||||||||||||||||
Change in investments | — | — | (6 | ) | 103 | — | 97 | ||||||||||||||||||
Other | — | — | — | 8 | — | 8 | |||||||||||||||||||
Net cash used in investing activities | — | — | (673 | ) | (1,001 | ) | — | (1,674 | ) | ||||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||||||||
Net change in revolving bank credit facilities | — | 630 | — | — | — | 630 | |||||||||||||||||||
Repayment of long-term debt | — | (1,243 | ) | (34 | ) | (23 | ) | — | (1,300 | ) | |||||||||||||||
Distributions to noncontrolling interests | — | — | (34 | ) | (274 | ) | — | (308 | ) | ||||||||||||||||
Payment of debt issuance costs | — | (5 | ) | — | — | — | (5 | ) | |||||||||||||||||
Distributions to stockholders | (13 | ) | — | — | — | — | (13 | ) | |||||||||||||||||
Changes in intercompany balances with affiliates, net | (199 | ) | 1,710 | (1,559 | ) | 48 | — | — | |||||||||||||||||
Income tax benefits | 70 | — | — | — | — | 70 | |||||||||||||||||||
Other | (81 | ) | — | — | 6 | — | (75 | ) | |||||||||||||||||
Net cash (used in) provided by financing activities | (223 | ) | 1,092 | (1,627 | ) | (243 | ) | — | (1,001 | ) | |||||||||||||||
Change in cash and cash equivalents | (22 | ) | — | (216 | ) | 17 | — | (221 | ) | ||||||||||||||||
Cash and cash equivalents at beginning of period | 22 | — | 383 | 300 | — | 705 | |||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 167 | $ | 317 | $ | — | $ | 484 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2012 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||||||||
Net income (loss) | $ | 1,291 | $ | (1,013 | ) | $ | 1,771 | $ | 878 | $ | (1,348 | ) | $ | 1,579 | |||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||||||||||||||||||||
Changes in operating assets and liabilities | 30 | (131 | ) | (1,475 | ) | (1,347 | ) | — | (2,923 | ) | |||||||||||||||
Provision for doubtful accounts | — | — | 1,505 | 1,161 | — | 2,666 | |||||||||||||||||||
Depreciation and amortization | — | — | 614 | 640 | — | 1,254 | |||||||||||||||||||
Income taxes | 250 | — | — | — | — | 250 | |||||||||||||||||||
Losses (gains) on sales of facilities | — | — | 3 | (7 | ) | — | (4 | ) | |||||||||||||||||
Amortization of deferred loan costs | 1 | 43 | — | — | — | 44 | |||||||||||||||||||
Share-based compensation | 39 | — | — | — | — | 39 | |||||||||||||||||||
Equity in earnings of affiliates | (1,348 | ) | — | — | — | 1,348 | — | ||||||||||||||||||
Other | — | 11 | — | (4 | ) | — | 7 | ||||||||||||||||||
Net cash provided by (used in) operating activities | 263 | (1,090 | ) | 2,418 | 1,321 | — | 2,912 | ||||||||||||||||||
Cash flows from investing activities: | |||||||||||||||||||||||||
Purchase of property and equipment | — | — | (685 | ) | (583 | ) | — | (1,268 | ) | ||||||||||||||||
Acquisition of hospitals and health care entities | — | — | (72 | ) | (95 | ) | — | (167 | ) | ||||||||||||||||
Disposition of hospitals and health care entities | — | — | 1 | 16 | — | 17 | |||||||||||||||||||
Change in investments | — | — | (9 | ) | 82 | — | 73 | ||||||||||||||||||
Other | — | — | (1 | ) | 6 | — | 5 | ||||||||||||||||||
Net cash used in investing activities | — | — | (766 | ) | (574 | ) | — | (1,340 | ) | ||||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||||||||
Issuance of long-term debt | — | 1,350 | — | — | — | 1,350 | |||||||||||||||||||
Net change in revolving bank credit facilities | — | (875 | ) | — | — | — | (875 | ) | |||||||||||||||||
Repayment of long-term debt | — | (604 | ) | (16 | ) | (69 | ) | — | (689 | ) | |||||||||||||||
Distributions to noncontrolling interests | — | — | (46 | ) | (257 | ) | — | (303 | ) | ||||||||||||||||
Payment of debt issuance costs | — | (20 | ) | — | — | — | (20 | ) | |||||||||||||||||
Distributions to stockholders | (983 | ) | — | — | — | — | (983 | ) | |||||||||||||||||
Changes in intercompany balances with affiliates, net | 675 | 1,239 | (1,556 | ) | (358 | ) | — | — | |||||||||||||||||
Income tax benefits | 82 | — | — | — | — | 82 | |||||||||||||||||||
Other | (37 | ) | — | — | 2 | — | (35 | ) | |||||||||||||||||
Net cash (used in) provided by financing activities | (263 | ) | 1,090 | (1,618 | ) | (682 | ) | — | (1,473 | ) | |||||||||||||||
Change in cash and cash equivalents | — | — | 34 | 65 | — | 99 | |||||||||||||||||||
Cash and cash equivalents at beginning of period | — | — | 115 | 258 | — | 373 | |||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 149 | $ | 323 | $ | — | $ | 472 | |||||||||||||
Interim_Condensed_Consolidated3
Interim Condensed Consolidated Financial Statements - Additional Information (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||||
In Millions, except Share data, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Mar. 31, 2011 | Sep. 30, 2013 | Sep. 30, 2012 | Nov. 22, 2010 |
Hospital | State | |||||
Surgery_Center | ||||||
Hospital | ||||||
Summary Of Significant Accounting Policies [Line Items] | ' | ' | ' | ' | ' | ' |
Ownership Percentage held by parent | ' | ' | ' | ' | ' | 100.00% |
Initial public offering of shares common stock | ' | ' | 87,719,300 | ' | ' | ' |
Number of owned and operated hospitals | 162 | ' | ' | 162 | ' | ' |
Number of freestanding surgery centers | ' | ' | ' | 114 | ' | ' |
Number of facilities locations | ' | ' | ' | 20 | ' | ' |
General and administrative expense | $76 | $62 | ' | $207 | $174 | ' |
Adjustments to Medicare revenues | ' | ' | ' | ' | 188 | ' |
Adjustment and related expenses added to income before income taxes | ' | ' | ' | ' | 170 | ' |
Adjustment and related expenses added to income before income taxes in diluted per share | ' | ' | ' | ' | $0.22 | ' |
Rural Floor Provision Settlement Effect [Member] | ' | ' | ' | ' | ' | ' |
Summary Of Significant Accounting Policies [Line Items] | ' | ' | ' | ' | ' | ' |
Adjustments to Medicare revenues | ' | ' | ' | ' | 271 | ' |
Implementation of Revised Supplemental Security Income Ratios [Member] | ' | ' | ' | ' | ' | ' |
Summary Of Significant Accounting Policies [Line Items] | ' | ' | ' | ' | ' | ' |
Adjustments to Medicare revenues | ' | ' | ' | ' | $83 | ' |
Interim_Condensed_Consolidated4
Interim Condensed Consolidated Financial Statements - Schedule of Revenues from Third Party Payers and Uninsured (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | $8,351 | $8,102 | $25,310 | $24,837 |
Uninsured | 717 | 576 | 1,809 | 1,757 |
Other | 343 | 215 | 959 | 651 |
Revenues before provision for doubtful accounts | 9,411 | 8,893 | 28,078 | 27,245 |
Provision for doubtful accounts | -955 | -831 | -2,732 | -2,666 |
Revenues | 8,456 | 8,062 | 25,346 | 24,579 |
Revenues from third party payers, ratio | 98.70% | 100.40% | 99.80% | 101.00% |
Uninsured Ratio | 8.50% | 7.10% | 7.10% | 7.10% |
Other Ratio | 4.10% | 2.70% | 3.80% | 2.70% |
Revenues before provision for doubtful accounts, ratio | 111.30% | 110.20% | 110.70% | 110.80% |
Provision for doubtful accounts Ratio | -11.30% | -10.20% | -10.70% | -10.80% |
Revenues ratio from third party payers | 100.00% | 100.00% | 100.00% | 100.00% |
Medicare [Member] | ' | ' | ' | ' |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 1,847 | 1,949 | 5,961 | 6,251 |
Revenues from third party payers, ratio | 21.80% | 24.20% | 23.50% | 25.40% |
Managed Medicare [Member] | ' | ' | ' | ' |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 794 | 720 | 2,441 | 2,199 |
Revenues from third party payers, ratio | 9.40% | 8.90% | 9.60% | 8.90% |
Medicaid [Member] | ' | ' | ' | ' |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 401 | 378 | 1,098 | 1,188 |
Revenues from third party payers, ratio | 4.70% | 4.70% | 4.30% | 4.80% |
Managed Medicaid [Member] | ' | ' | ' | ' |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 386 | 380 | 1,165 | 1,080 |
Revenues from third party payers, ratio | 4.60% | 4.70% | 4.60% | 4.40% |
Managed Care and Other Insurers [Member] | ' | ' | ' | ' |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 4,636 | 4,422 | 13,777 | 13,340 |
Revenues from third party payers, ratio | 54.80% | 54.80% | 54.40% | 54.30% |
International (Managed Care and Other Insurers) [Member] | ' | ' | ' | ' |
Revenues [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | $287 | $253 | $868 | $779 |
Revenues from third party payers, ratio | 3.40% | 3.10% | 3.40% | 3.20% |
Acquisitions_and_Dispositions_
Acquisitions and Dispositions - Additional Information (Detail) (USD $) | 9 Months Ended | |
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 |
Hospitals [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Cash paid for acquisition | ' | $58 |
Goodwill recorded on acquisition | ' | 53 |
Payment to acquire hospitals | 146 | ' |
Liability assumed on acquisition | ' | 33 |
Pretax gain on sales of business | 13 | ' |
Proceeds from sale of business | 31 | ' |
Real Estate [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Pretax gain on sales of business | ' | 4 |
Proceeds from sale of business | ' | 17 |
Outsource Group (Member) | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Cash paid for acquisition | 278 | ' |
Goodwill recorded on acquisition | 180 | ' |
Payment to acquire intangible assets | 113 | ' |
Other Healthcare Entity [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Cash paid for acquisition | $39 | $109 |
Number of Hospital acquired | 3 | ' |
Income_Taxes_Additional_Inform
Income Taxes - Additional Information (Detail) (USD $) | 3 Months Ended | 9 Months Ended | |||
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 | Dec. 31, 2012 |
Income Tax Disclosure [Abstract] | ' | ' | ' | ' | ' |
Liability for unrecognized tax benefits | $417 | ' | $417 | ' | $426 |
Unrecognized tax benefits, accrued interest | 26 | ' | 26 | ' | 14 |
Unrecognized tax benefits that would impact effective tax rate | 151 | ' | 151 | ' | 125 |
Reductions in interest related to taxing authority examinations | 7 | 1 | -8 | -20 | ' |
Reductions in interest related to taxing authority examinations net of tax | $4 | $0 | ($5) | ($13) | ' |
Earnings_Per_Share_Schedule_of
Earnings Per Share - Schedule of Computations of Basic and Diluted Earnings Per Share (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, except Share data in Thousands, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Earnings Per Share [Abstract] | ' | ' | ' | ' |
Net income attributable to HCA Holdings, Inc. | $365 | $360 | $1,132 | $1,291 |
Weighted average common shares outstanding | 447,329 | 440,899 | 446,125 | 439,441 |
Effect of dilutive incremental shares | 16,240 | 18,616 | 16,926 | 19,381 |
Shares used for diluted earnings per share | 463,569 | 459,515 | 463,051 | 458,822 |
Basic earnings per share | $0.82 | $0.82 | $2.54 | $2.94 |
Diluted earnings per share | $0.79 | $0.78 | $2.44 | $2.81 |
Investments_of_Insurance_Subsi2
Investments of Insurance Subsidiaries - Schedule of Investments (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | $454 | $552 |
Unrealized Amounts, Gains | 13 | 24 |
Unrealized Amounts, Losses | -2 | -6 |
Fair Value | 465 | 570 |
Amounts classified as current assets | -63 | -55 |
Investment carrying value | 402 | 515 |
Debt Securities [Member] | ' | ' |
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | 452 | 550 |
Unrealized Amounts, Gains | 12 | 23 |
Unrealized Amounts, Losses | -2 | -6 |
Fair Value | 462 | 567 |
Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | 383 | 395 |
Unrealized Amounts, Gains | 12 | 23 |
Unrealized Amounts, Losses | -2 | ' |
Fair Value | 393 | 418 |
Debt Securities [Member] | Auction Rate Securities [Member] | ' | ' |
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | 32 | 74 |
Unrealized Amounts, Gains | ' | ' |
Unrealized Amounts, Losses | ' | -6 |
Fair Value | 32 | 68 |
Debt Securities [Member] | Asset-Backed Securities [Member] | ' | ' |
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | 13 | 14 |
Unrealized Amounts, Gains | ' | ' |
Unrealized Amounts, Losses | ' | ' |
Fair Value | 13 | 14 |
Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | 24 | 67 |
Unrealized Amounts, Gains | ' | ' |
Unrealized Amounts, Losses | ' | ' |
Fair Value | 24 | 67 |
Equity Securities [Member] | ' | ' |
Available For Sale Securities [Line Items] | ' | ' |
Amortized Cost | 2 | 2 |
Unrealized Amounts, Gains | 1 | 1 |
Unrealized Amounts, Losses | ' | ' |
Fair Value | $3 | $3 |
Investments_of_Insurance_Subsi3
Investments of Insurance Subsidiaries - Additional Information (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Investments subject to restrictions | $1 | $9 |
Available for sale securities expected maturity of debt securities | '4 years | ' |
Available for sale securities average scheduled maturity | '7 years 1 month 6 days | ' |
Auction Rate Securities [Member] | ' | ' |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Available for sale securities expected maturity of debt securities | '1 year 4 months 24 days | ' |
Available for sale securities average scheduled maturity | '22 years 1 month 6 days | ' |
Asset-Backed Securities [Member] | ' | ' |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Available for sale securities expected maturity of debt securities | '3 years 10 months 24 days | ' |
Available for sale securities average scheduled maturity | '22 years 8 months 12 days | ' |
Investments_of_Insurance_Subsi4
Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Schedule of Available-for-sale Securities [Line Items] | ' | ' |
Due in one year or less, Amortized Cost | $41 | ' |
Due after one year through five years, Amortized Cost | 176 | ' |
Due after five years through ten years, Amortized Cost | 108 | ' |
Due after ten years, Amortized Cost | 82 | ' |
Amortized Cost, Total | 407 | ' |
Amortized Cost | 452 | ' |
Due in one year or less, Fair Value | 41 | ' |
Fair Value | 465 | 570 |
Due after one year through five years, Fair Value | 182 | ' |
Due after five years through ten years, Fair Value | 111 | ' |
Due after ten years, Fair Value | 83 | ' |
Fair Value, Total | 417 | ' |
Fair Value | 462 | ' |
Auction Rate Securities [Member] | ' | ' |
Schedule of Available-for-sale Securities [Line Items] | ' | ' |
Amortized Cost | 32 | ' |
Fair Value | 32 | ' |
Asset-Backed Securities [Member] | ' | ' |
Schedule of Available-for-sale Securities [Line Items] | ' | ' |
Amortized Cost | 13 | ' |
Fair Value | $13 | ' |
Financial_Instruments_Schedule
Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) (Pay-Fixed Interest Rate Swaps [Member], USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2013 |
Maturity Date, 2014 [Member] | ' |
Derivative Instruments [Line Items] | ' |
Fair Value | ($6) |
Notional Amount | 500 |
Pay-fixed interest rate swaps | 31-Dec-14 |
Maturity Date, 2016 [Member] | ' |
Derivative Instruments [Line Items] | ' |
Fair Value | -269 |
Notional Amount | 3,000 |
Pay-fixed interest rate swaps | 31-Dec-16 |
Maturity Date, 2017 [Member] | ' |
Derivative Instruments [Line Items] | ' |
Fair Value | -48 |
Notional Amount | $1,000 |
Pay-fixed interest rate swaps | 31-Dec-17 |
Financial_Instruments_Addition
Financial Instruments - Additional Information (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2013 |
Offsetting [Abstract] | ' |
Estimated amount reclassified from other comprehensive income to interest expense | $127 |
Estimated termination value if there is breach of provision related to derivative agreement | $341 |
Financial_Instruments_Schedule1
Financial Instruments - Schedule of Cross Currency Swap Agreement Not Designated as Hedge (Detail) (Euro - United States Dollar Currency Swap [Member], Maturity Date, November 2013 [Member]) | 9 Months Ended | |
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2013 |
USD ($) | EUR (€) | |
Derivative Instruments, Gain (Loss) [Line Items] | ' | ' |
Fair Value | ($4) | ' |
Maturity Date | 30-Nov-13 | 30-Nov-13 |
Notional amount for foreign currency derivatives | ' | € 241 |
Financial_Instruments_Effect_o
Financial Instruments - Effect of Interest Rate and Cross Currency Swaps on Results of Operations (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2013 |
Cross Currency Swap (Income Taxes and Other Liabilities) [Member] | Other Operating Expenses [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Amount of Loss Recognized in Operations on Derivatives | $9 |
Interest Rate Swaps [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Amount of Gain Recognized in OCI on Derivatives, Net of Tax | 6 |
Interest Rate Swaps [Member] | Interest Expense [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Amount of Loss Reclassified from Accumulated OCI into Operations | $97 |
Assets_and_Liabilities_Measure2
Assets and Liabilities Measured at Fair Value - Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | $465 | $570 |
Less amounts classified as current assets | -63 | -55 |
Investments of insurance subsidiaries, noncurrent | 402 | 515 |
Cross Currency Swap (Income Taxes and Other Liabilities) [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | 4 | 13 |
Interest Rate Swaps [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | 323 | 429 |
Equity Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 3 | 3 |
Debt Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 462 | 567 |
Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 393 | 418 |
Debt Securities [Member] | Auction Rate Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 32 | 68 |
Debt Securities [Member] | Asset-Backed Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 13 | 14 |
Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 24 | 67 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 26 | 68 |
Less amounts classified as current assets | -24 | -55 |
Investments of insurance subsidiaries, noncurrent | 2 | 13 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Equity Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 2 | 1 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 24 | 67 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 24 | 67 |
Significant Other Observable Inputs (Level 2) [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 406 | 432 |
Less amounts classified as current assets | -39 | ' |
Investments of insurance subsidiaries, noncurrent | 367 | 432 |
Significant Other Observable Inputs (Level 2) [Member] | Cross Currency Swap (Income Taxes and Other Liabilities) [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | 4 | 13 |
Significant Other Observable Inputs (Level 2) [Member] | Interest Rate Swaps [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | 323 | 429 |
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 406 | 432 |
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 393 | 418 |
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | Asset-Backed Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 13 | 14 |
Significant Unobservable Inputs (Level 3) [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 33 | 70 |
Investments of insurance subsidiaries, noncurrent | 33 | 70 |
Significant Unobservable Inputs (Level 3) [Member] | Equity Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 1 | 2 |
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 32 | 68 |
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member] | Auction Rate Securities [Member] | ' | ' |
Fair Value Assets Measured On Recurring Basis [Line Items] | ' | ' |
Assets, Fair Value | $32 | $68 |
Assets_and_Liabilities_Measure3
Assets and Liabilities Measured at Fair Value - Schedule Related to Auction Rate and Equity Securities Investments of Insurance Subsidiaries at Fair Value (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2013 |
Fair Value Disclosures [Abstract] | ' |
Asset, Beginning Balance | $70 |
Unrealized gains included in other comprehensive income | 6 |
Settlements | -43 |
Asset, Ending Balance | $33 |
Assets_and_Liabilities_Measure4
Assets and Liabilities Measured at Fair Value - Additional Information (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Fair Value Disclosures [Abstract] | ' | ' |
Estimated fair value of long-term debt | $29,492 | $30,781 |
Carrying amounts of long-term debt | $28,377 | $28,930 |
LongTerm_Debt_Schedule_of_Long
Long-Term Debt - Schedule of Long-Term Debt (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||
Debt Instrument [Line Items] | ' | ' |
First lien debt | $18,183 | $17,539 |
Total debt (average life of 6.5 years, rates averaging 6.3%) | 28,377 | 28,930 |
Less amounts due within one year | 988 | 1,435 |
Long-term debt | 27,389 | 27,495 |
Senior Secured Asset-Based Revolving Credit Facility [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Long-term line of credit | 2,100 | 1,470 |
Senior Secured Revolving Credit Facility [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Long-term line of credit | ' | ' |
Senior Secured Term Loan Facilities [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Term loans | 5,944 | 5,958 |
Senior Secured First Lien Notes [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Senior secured first lien notes | 9,693 | 9,688 |
Other Senior Secured Debt [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Other senior secured debt (effective interest rate of 6.8%) | 446 | 423 |
Senior Secured Second Lien Notes [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Senior secured second lien notes | ' | 197 |
Senior Unsecured Notes [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Senior unsecured notes | $10,194 | $11,194 |
LongTerm_Debt_Schedule_of_Long1
Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail) | Sep. 30, 2013 |
Debt Instrument [Line Items] | ' |
Total debt average term | '6 years 6 months |
Total debt average rate | 6.30% |
Senior Secured Asset-Based Revolving Credit Facility [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 1.70% |
Senior Secured Term Loan Facilities [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 5.10% |
Senior Secured First Lien Notes [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 7.10% |
Other Senior Secured Debt [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 6.80% |
Senior Unsecured Notes [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 7.20% |
LongTerm_Debt_Additional_Infor
Long-Term Debt - Additional Information (Detail) (USD $) | 1 Months Ended | 9 Months Ended |
In Millions, unless otherwise specified | Mar. 31, 2013 | Sep. 30, 2013 |
Proforma Debt Instrument [Line Items] | ' | ' |
Pretax loss on retirement of debt | ($17) | ($17) |
Senior Secured Second Lien Notes Due 2017 [Member] | ' | ' |
Proforma Debt Instrument [Line Items] | ' | ' |
Redemption of aggregate principal amount | $201 | ' |
Debt instrument , Stated interest | 9.88% | ' |
Percentage of Redemption of principal amount | 104.94% | ' |
Contingencies_and_Legal_Claim_1
Contingencies and Legal Claim Costs - Additional Information (Detail) (USD $) | 0 Months Ended | 3 Months Ended | 12 Months Ended | 3 Months Ended | |||
In Millions, unless otherwise specified | Oct. 28, 2011 | Dec. 31, 2012 | Dec. 31, 2012 | Sep. 30, 2013 | Dec. 31, 2003 | Jul. 31, 2012 | Dec. 31, 2012 |
Cases | Hospital | FLORIDA | Pending Litigation [Member] | ||||
Hospital | Health Care Foundation of Greater Kansas City [Member] | ||||||
Schedule Of Activities Related To Claims Filed [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Number of owned and operated hospitals reviewed | ' | ' | ' | 95 | ' | 8 | ' |
Number of claims filed | 3 | ' | ' | ' | ' | ' | ' |
Capital commitments in connection with purchase of hospitals | ' | ' | ' | ' | $450 | ' | ' |
Legal claim costs | ' | 175 | ' | ' | ' | ' | ' |
Judgment award by the court | ' | ' | ' | ' | ' | ' | 162 |
Period of agreed capital commitments | ' | ' | '5 years | ' | ' | ' | ' |
Number of year under court-supervisor accounting for expenditures following the purchase | ' | ' | '10 years | ' | ' | ' | ' |
Plaintiff attorneys fees award | ' | ' | ' | ' | ' | ' | $12 |
Capital_Structure_Schedule_of_
Capital Structure - Schedule of Changes in Stockholders' Deficit and Equity (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, except Share data in Thousands, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balance | ' | ' | ($8,341) | ' |
Net income | 467 | 455 | 1,442 | 1,579 |
Other comprehensive income | 52 | 9 | 83 | ' |
Distributions | ' | ' | -308 | ' |
Share-based benefit plans | ' | ' | 71 | ' |
Other | ' | ' | 9 | ' |
Ending Balance | -7,044 | ' | -7,044 | ' |
Common Stock [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balance | ' | ' | 4 | ' |
Ending Balance | 4 | ' | 4 | ' |
Beginning Balance, Shares | ' | ' | 443,200 | ' |
Share-based benefit plans, Shares | ' | ' | 4,373 | ' |
Ending Balance, Shares | 447,573 | ' | 447,573 | ' |
Capital in Excess of Par Value [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balance | ' | ' | 1,753 | ' |
Share-based benefit plans | ' | ' | 71 | ' |
Other | ' | ' | -3 | ' |
Ending Balance | 1,821 | ' | 1,821 | ' |
Accumulated Other Comprehensive Loss [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balance | ' | ' | -457 | ' |
Other comprehensive income | ' | ' | 83 | ' |
Ending Balance | -374 | ' | -374 | ' |
Retained Deficit [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balance | ' | ' | -10,960 | ' |
Net income | ' | ' | 1,132 | ' |
Other | ' | ' | 1 | ' |
Ending Balance | -9,827 | ' | -9,827 | ' |
Equity Attributable to Noncontrolling Interests [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balance | ' | ' | 1,319 | ' |
Net income | ' | ' | 310 | ' |
Distributions | ' | ' | -308 | ' |
Other | ' | ' | 11 | ' |
Ending Balance | $1,332 | ' | $1,332 | ' |
Capital_Structure_Components_o
Capital Structure - Components of Accumulated Other Comprehensive Loss (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2013 |
Equity [Abstract] | ' |
Unrealized gains on available-for-sale securities, beginning balance | $11 |
Unrealized losses on available-for-sale securities, net of income taxes | -4 |
Unrealized gains on available-for-sale securities, ending balance | 7 |
Foreign currency translation adjustments, beginning balance | -1 |
Foreign currency translation adjustments | ' |
Foreign currency translation adjustments, ending balance | -1 |
Defined benefit plans, beginning balance | -196 |
Defined benefit plans | 5 |
Expense reclassified into operations from other comprehensive income, net of $9 and $36, respectively, income tax benefits | 15 |
Balances at September 30, 2013 | -176 |
Change in fair value of derivative instruments, beginning balance | -271 |
Change in fair value of derivative instruments | 6 |
Change in fair value of derivative instruments, expense reclassified into operations from other comprehensive income | 61 |
Change in fair value of derivative instruments, ending balance | -204 |
Accumulated other comprehensive income, net of tax, beginning balance | -457 |
Unrealized losses on available-for-sale securities, net of $3 income tax benefit | -4 |
Defined benefit plans, net of $3 of income taxes | 5 |
Change in fair value of derivative instruments, net of $3 of income taxes | 6 |
Expense reclassified into operations from other comprehensive income, Total | 76 |
Accumulated other comprehensive income, net of tax, Ending balance | ($374) |
Capital_Structure_Components_o1
Capital Structure - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2013 |
Equity [Abstract] | ' |
Defined benefit plans, income taxes | $3 |
Change in fair value of derivative instruments, (income)expense reclassified into other comprehensive income, Tax Portion | 36 |
Unrealized losses on available-for-Sale Securities, Tax portion | 3 |
Defined benefit plans, income taxes | 3 |
Change in fair value of derivative instruments, income tax benefit | 3 |
Defined Benefit Plan, (Income) expense reclassified into operations from other comprehensive income, Tax portion | 9 |
Change in fair value of derivative instruments,(income)expense reclassified into other comprehensive income, Tax Portion | $36 |
Segment_and_Geographic_Informa2
Segment and Geographic Information - Additional Information (Detail) | 0 Months Ended |
Sep. 30, 2013 | |
Hospital | |
Segment Reporting Information [Line Items] | ' |
Number of geographically organized groups | 2 |
Number of owned and operated hospitals | 162 |
Reorganization Group [Member] | National Group [Member] | ' |
Segment Reporting Information [Line Items] | ' |
Number of owned and operated hospitals | 77 |
Reorganization Group [Member] | American Group [Member] | ' |
Segment Reporting Information [Line Items] | ' |
Number of owned and operated hospitals | 79 |
Reorganization Group [Member] | Corporate and Other [Member] | ' |
Segment Reporting Information [Line Items] | ' |
Number of owned and operated hospitals | 6 |
Segment_and_Geographic_Informa3
Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) (USD $) | 1 Months Ended | 3 Months Ended | 9 Months Ended | ||
In Millions, unless otherwise specified | Mar. 31, 2013 | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' |
Revenues | ' | $8,456 | $8,062 | $25,346 | $24,579 |
Equity in earnings of affiliates | ' | -9 | -6 | -29 | -26 |
Adjusted segment EBITDA | ' | 1,603 | 1,533 | 4,860 | 4,925 |
Depreciation and amortization | ' | 443 | 417 | 1,292 | 1,254 |
Adjusted segment EBITDA | ' | 1,603 | 1,533 | 4,860 | 4,925 |
Depreciation and amortization | ' | 443 | 417 | 1,292 | 1,254 |
Interest expense | ' | 458 | 446 | 1,392 | 1,336 |
Losses (gains) on sales of facilities | ' | 1 | -7 | 13 | -4 |
Loss on retirement of debt | 17 | ' | ' | 17 | ' |
Income before income taxes | ' | 701 | 677 | 2,146 | 2,339 |
National Group [Member] | ' | ' | ' | ' | ' |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' |
Revenues | ' | 3,930 | 3,755 | 11,875 | 11,553 |
Equity in earnings of affiliates | ' | -3 | ' | -8 | -7 |
Adjusted segment EBITDA | ' | 805 | 768 | 2,440 | 2,478 |
Depreciation and amortization | ' | 181 | 171 | 532 | 520 |
Adjusted segment EBITDA | ' | 805 | 768 | 2,440 | 2,478 |
Depreciation and amortization | ' | 181 | 171 | 532 | 520 |
American Group [Member] | ' | ' | ' | ' | ' |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' |
Revenues | ' | 4,082 | 3,982 | 12,181 | 12,033 |
Equity in earnings of affiliates | ' | -6 | -6 | -19 | -20 |
Adjusted segment EBITDA | ' | 910 | 843 | 2,654 | 2,657 |
Depreciation and amortization | ' | 206 | 207 | 610 | 612 |
Adjusted segment EBITDA | ' | 910 | 843 | 2,654 | 2,657 |
Depreciation and amortization | ' | 206 | 207 | 610 | 612 |
Corporate and Other [Member] | ' | ' | ' | ' | ' |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' |
Revenues | ' | 444 | 325 | 1,290 | 993 |
Equity in earnings of affiliates | ' | ' | ' | -2 | 1 |
Adjusted segment EBITDA | ' | -112 | -78 | -234 | -210 |
Depreciation and amortization | ' | 56 | 39 | 150 | 122 |
Adjusted segment EBITDA | ' | -112 | -78 | -234 | -210 |
Depreciation and amortization | ' | $56 | $39 | $150 | $122 |
Supplemental_Condensed_Consoli2
Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) (USD $) | Nov. 22, 2010 | Dec. 06, 2012 | Nov. 23, 2010 |
In Millions, unless otherwise specified | Senior Unsecured Notes Due 2021 [Member] | Senior Unsecured Notes Due 2021 [Member] | |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' |
Debt instrument, principal amount | ' | $1,000 | $1,525 |
Debt instrument, stated interest | ' | 6.25% | 7.75% |
Ownership Percentage held by parent | 100.00% | ' | ' |
Supplemental_Condensed_Consoli3
Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) (USD $) | 1 Months Ended | 3 Months Ended | 9 Months Ended | ||
In Millions, unless otherwise specified | Mar. 31, 2013 | Sep. 30, 2013 | Sep. 30, 2012 | Sep. 30, 2013 | Sep. 30, 2012 |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | ' | $9,411 | $8,893 | $28,078 | $27,245 |
Provision for doubtful accounts | ' | 955 | 831 | 2,732 | 2,666 |
Revenues | ' | 8,456 | 8,062 | 25,346 | 24,579 |
Salaries and benefits | ' | 3,916 | 3,781 | 11,681 | 11,224 |
Supplies | ' | 1,457 | 1,375 | 4,406 | 4,216 |
Other operating expenses | ' | 1,564 | 1,510 | 4,594 | 4,496 |
Electronic health record incentive income | ' | -75 | -131 | -166 | -256 |
Equity in earnings of affiliates | ' | -9 | -6 | -29 | -26 |
Depreciation and amortization | ' | 443 | 417 | 1,292 | 1,254 |
Interest expense | ' | 458 | 446 | 1,392 | 1,336 |
Losses (gains) on sales of facilities | ' | 1 | -7 | 13 | -4 |
Loss on retirement of debt | 17 | ' | ' | 17 | ' |
Management fees | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of a affiliates | ' | 7,755 | 7,385 | 23,200 | 22,240 |
Income (loss) before income taxes | ' | 701 | 677 | 2,146 | 2,339 |
Provision (benefit) for income taxes | ' | 234 | 222 | 704 | 760 |
Net income (loss) | ' | 467 | 455 | 1,442 | 1,579 |
Net income attributable to noncontrolling interests | ' | 102 | 95 | 310 | 288 |
Net income (loss) attributable to HCA Holdings, Inc. | ' | 365 | 360 | 1,132 | 1,291 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ' | 417 | 369 | 1,215 | 1,291 |
HCA Holdings, Inc. Issuer [Member] | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | ' | ' | ' | ' | ' |
Provision for doubtful accounts | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' |
Supplies | ' | ' | ' | ' | ' |
Other operating expenses | ' | 2 | ' | 4 | ' |
Electronic health record incentive income | ' | ' | ' | ' | ' |
Equity in earnings of affiliates | ' | -443 | -379 | -1,303 | -1,348 |
Depreciation and amortization | ' | ' | ' | ' | ' |
Interest expense | ' | 41 | 30 | 138 | 90 |
Losses (gains) on sales of facilities | ' | ' | ' | ' | ' |
Loss on retirement of debt | ' | ' | ' | ' | ' |
Management fees | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of a affiliates | ' | -400 | -349 | -1,161 | -1,258 |
Income (loss) before income taxes | ' | 400 | 349 | 1,161 | 1,258 |
Provision (benefit) for income taxes | ' | -17 | -11 | -54 | -33 |
Net income (loss) | ' | 417 | 360 | 1,215 | 1,291 |
Net income attributable to noncontrolling interests | ' | ' | ' | ' | ' |
Net income (loss) attributable to HCA Holdings, Inc. | ' | 417 | 360 | 1,215 | 1,291 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ' | 417 | 360 | 1,215 | 1,291 |
HCA Inc. Issuer [Member] | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | ' | ' | ' | ' | ' |
Provision for doubtful accounts | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' |
Supplies | ' | ' | ' | ' | ' |
Other operating expenses | ' | -1 | 3 | -1 | 7 |
Electronic health record incentive income | ' | ' | ' | ' | ' |
Equity in earnings of affiliates | ' | ' | ' | ' | ' |
Depreciation and amortization | ' | ' | ' | ' | ' |
Interest expense | ' | 549 | 545 | 1,651 | 1,603 |
Losses (gains) on sales of facilities | ' | ' | ' | ' | ' |
Loss on retirement of debt | ' | ' | ' | 17 | ' |
Management fees | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of a affiliates | ' | 548 | 548 | 1,667 | 1,610 |
Income (loss) before income taxes | ' | -548 | -548 | -1,667 | -1,610 |
Provision (benefit) for income taxes | ' | -214 | -208 | -639 | -597 |
Net income (loss) | ' | -334 | -340 | -1,028 | -1,013 |
Net income attributable to noncontrolling interests | ' | ' | ' | ' | ' |
Net income (loss) attributable to HCA Holdings, Inc. | ' | -334 | -340 | -1,028 | -1,013 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ' | -331 | -357 | -961 | -1,055 |
Subsidiary Guarantors [Member] | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | ' | 4,945 | 4,672 | 14,829 | 14,328 |
Provision for doubtful accounts | ' | 560 | 484 | 1,611 | 1,505 |
Revenues | ' | 4,385 | 4,188 | 13,218 | 12,823 |
Salaries and benefits | ' | 2,090 | 1,995 | 6,275 | 5,928 |
Supplies | ' | 773 | 711 | 2,340 | 2,202 |
Other operating expenses | ' | 771 | 761 | 2,260 | 2,241 |
Electronic health record incentive income | ' | -53 | -85 | -115 | -174 |
Equity in earnings of affiliates | ' | ' | -1 | -2 | -4 |
Depreciation and amortization | ' | 216 | 205 | 636 | 614 |
Interest expense | ' | -104 | -98 | -319 | -274 |
Losses (gains) on sales of facilities | ' | 1 | ' | 20 | 3 |
Loss on retirement of debt | ' | ' | ' | ' | ' |
Management fees | ' | -183 | -170 | -547 | -498 |
Total expenses including equity in earnings of a affiliates | ' | 3,511 | 3,318 | 10,548 | 10,038 |
Income (loss) before income taxes | ' | 874 | 870 | 2,670 | 2,785 |
Provision (benefit) for income taxes | ' | 334 | 325 | 1,005 | 1,014 |
Net income (loss) | ' | 540 | 545 | 1,665 | 1,771 |
Net income attributable to noncontrolling interests | ' | 19 | 18 | 48 | 51 |
Net income (loss) attributable to HCA Holdings, Inc. | ' | 521 | 527 | 1,617 | 1,720 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ' | 532 | 531 | 1,637 | 1,733 |
Subsidiary Non-Guarantors [Member] | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | ' | 4,466 | 4,221 | 13,249 | 12,917 |
Provision for doubtful accounts | ' | 395 | 347 | 1,121 | 1,161 |
Revenues | ' | 4,071 | 3,874 | 12,128 | 11,756 |
Salaries and benefits | ' | 1,826 | 1,786 | 5,406 | 5,296 |
Supplies | ' | 684 | 664 | 2,066 | 2,014 |
Other operating expenses | ' | 792 | 746 | 2,331 | 2,248 |
Electronic health record incentive income | ' | -22 | -46 | -51 | -82 |
Equity in earnings of affiliates | ' | -9 | -5 | -27 | -22 |
Depreciation and amortization | ' | 227 | 212 | 656 | 640 |
Interest expense | ' | -28 | -31 | -78 | -83 |
Losses (gains) on sales of facilities | ' | ' | -7 | -7 | -7 |
Loss on retirement of debt | ' | ' | ' | ' | ' |
Management fees | ' | 183 | 170 | 547 | 498 |
Total expenses including equity in earnings of a affiliates | ' | 3,653 | 3,489 | 10,843 | 10,502 |
Income (loss) before income taxes | ' | 418 | 385 | 1,285 | 1,254 |
Provision (benefit) for income taxes | ' | 131 | 116 | 392 | 376 |
Net income (loss) | ' | 287 | 269 | 893 | 878 |
Net income attributable to noncontrolling interests | ' | 83 | 77 | 262 | 237 |
Net income (loss) attributable to HCA Holdings, Inc. | ' | 204 | 192 | 631 | 641 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ' | 242 | 214 | 627 | 670 |
Eliminations [Member] | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | ' | ' | ' | ' | ' |
Provision for doubtful accounts | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' |
Supplies | ' | ' | ' | ' | ' |
Other operating expenses | ' | ' | ' | ' | ' |
Electronic health record incentive income | ' | ' | ' | ' | ' |
Equity in earnings of affiliates | ' | 443 | 379 | 1,303 | 1,348 |
Depreciation and amortization | ' | ' | ' | ' | ' |
Interest expense | ' | ' | ' | ' | ' |
Losses (gains) on sales of facilities | ' | ' | ' | ' | ' |
Loss on retirement of debt | ' | ' | ' | ' | ' |
Management fees | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of a affiliates | ' | 443 | 379 | 1,303 | 1,348 |
Income (loss) before income taxes | ' | -443 | -379 | -1,303 | -1,348 |
Provision (benefit) for income taxes | ' | ' | ' | ' | ' |
Net income (loss) | ' | -443 | -379 | -1,303 | -1,348 |
Net income attributable to noncontrolling interests | ' | ' | ' | ' | ' |
Net income (loss) attributable to HCA Holdings, Inc. | ' | -443 | -379 | -1,303 | -1,348 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ' | ($443) | ($379) | ($1,303) | ($1,348) |
Supplemental_Condensed_Consoli4
Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) (USD $) | Sep. 30, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Dec. 31, 2011 |
In Millions, unless otherwise specified | ||||
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | $484 | $705 | $472 | $373 |
Accounts receivable, net | 4,924 | 4,672 | ' | ' |
Inventories | 1,135 | 1,086 | ' | ' |
Deferred income taxes | 400 | 385 | ' | ' |
Other | 828 | 915 | ' | ' |
Total current assets | 7,771 | 7,763 | ' | ' |
Property and equipment, net | 13,322 | 13,185 | ' | ' |
Investments of insurance subsidiaries | 402 | 515 | ' | ' |
Investments in and advances to affiliates | 125 | 104 | ' | ' |
Goodwill and other intangible assets | 5,832 | 5,539 | ' | ' |
Deferred loan costs | 250 | 290 | ' | ' |
Other | 691 | 679 | ' | ' |
Total assets | 28,393 | 28,075 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 1,582 | 1,768 | ' | ' |
Accrued salaries | 1,085 | 1,120 | ' | ' |
Other accrued expenses | 1,764 | 1,849 | ' | ' |
Long-term debt due within one year | 988 | 1,435 | ' | ' |
Total current liabilities | 5,419 | 6,172 | ' | ' |
Long-term debt | 27,389 | 27,495 | ' | ' |
Intercompany balances | ' | ' | ' | ' |
Professional liability risks | 959 | 973 | ' | ' |
Income taxes and other liabilities | 1,670 | 1,776 | ' | ' |
Total liabilities | 35,437 | 36,416 | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -8,376 | -9,660 | ' | ' |
Noncontrolling interests | 1,332 | 1,319 | ' | ' |
Total stockholders' deficit | -7,044 | -8,341 | ' | ' |
Total liabilities and stockholders' deficit | 28,393 | 28,075 | ' | ' |
HCA Holdings, Inc. Issuer [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | ' | 22 | ' | ' |
Accounts receivable, net | ' | ' | ' | ' |
Inventories | ' | ' | ' | ' |
Deferred income taxes | 400 | 385 | ' | ' |
Other | 6 | 122 | ' | ' |
Total current assets | 406 | 529 | ' | ' |
Property and equipment, net | ' | ' | ' | ' |
Investments of insurance subsidiaries | ' | ' | ' | ' |
Investments in and advances to affiliates | 19,784 | 18,481 | ' | ' |
Goodwill and other intangible assets | ' | ' | ' | ' |
Deferred loan costs | 30 | 32 | ' | ' |
Other | 315 | 469 | ' | ' |
Total assets | 20,535 | 19,511 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 1 | ' | ' | ' |
Accrued salaries | ' | ' | ' | ' |
Other accrued expenses | 255 | 30 | ' | ' |
Long-term debt due within one year | ' | ' | ' | ' |
Total current liabilities | 256 | 30 | ' | ' |
Long-term debt | 2,525 | 2,525 | ' | ' |
Intercompany balances | 25,682 | 26,131 | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | 448 | 485 | ' | ' |
Total liabilities | 28,911 | 29,171 | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -8,376 | -9,660 | ' | ' |
Noncontrolling interests | ' | ' | ' | ' |
Total stockholders' deficit | -8,376 | -9,660 | ' | ' |
Total liabilities and stockholders' deficit | 20,535 | 19,511 | ' | ' |
HCA Inc. Issuer [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | ' | ' | ' | ' |
Accounts receivable, net | ' | ' | ' | ' |
Inventories | ' | ' | ' | ' |
Deferred income taxes | ' | ' | ' | ' |
Other | ' | ' | ' | ' |
Total current assets | ' | ' | ' | ' |
Property and equipment, net | ' | ' | ' | ' |
Investments of insurance subsidiaries | ' | ' | ' | ' |
Investments in and advances to affiliates | ' | ' | ' | ' |
Goodwill and other intangible assets | ' | ' | ' | ' |
Deferred loan costs | 220 | 258 | ' | ' |
Other | ' | ' | ' | ' |
Total assets | 220 | 258 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | ' | ' | ' | ' |
Accrued salaries | ' | ' | ' | ' |
Other accrued expenses | 259 | 567 | ' | ' |
Long-term debt due within one year | 906 | 1,360 | ' | ' |
Total current liabilities | 1,165 | 1,927 | ' | ' |
Long-term debt | 24,174 | 24,304 | ' | ' |
Intercompany balances | -10,477 | -12,407 | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | 327 | 442 | ' | ' |
Total liabilities | 15,189 | 14,266 | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -14,969 | -14,008 | ' | ' |
Noncontrolling interests | ' | ' | ' | ' |
Total stockholders' deficit | -14,969 | -14,008 | ' | ' |
Total liabilities and stockholders' deficit | 220 | 258 | ' | ' |
Subsidiary Guarantors [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | 167 | 383 | 149 | 115 |
Accounts receivable, net | 2,481 | 2,448 | ' | ' |
Inventories | 667 | 629 | ' | ' |
Deferred income taxes | ' | ' | ' | ' |
Other | 327 | 342 | ' | ' |
Total current assets | 3,642 | 3,802 | ' | ' |
Property and equipment, net | 7,467 | 7,417 | ' | ' |
Investments of insurance subsidiaries | ' | ' | ' | ' |
Investments in and advances to affiliates | 15 | 16 | ' | ' |
Goodwill and other intangible assets | 1,695 | 1,697 | ' | ' |
Deferred loan costs | ' | ' | ' | ' |
Other | 37 | 31 | ' | ' |
Total assets | 12,856 | 12,963 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 1,012 | 1,203 | ' | ' |
Accrued salaries | 634 | 638 | ' | ' |
Other accrued expenses | 441 | 464 | ' | ' |
Long-term debt due within one year | 43 | 39 | ' | ' |
Total current liabilities | 2,130 | 2,344 | ' | ' |
Long-term debt | 165 | 173 | ' | ' |
Intercompany balances | -18,677 | -17,130 | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | 639 | 629 | ' | ' |
Total liabilities | -15,743 | -13,984 | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | 28,484 | 26,847 | ' | ' |
Noncontrolling interests | 115 | 100 | ' | ' |
Total stockholders' deficit | 28,599 | 26,947 | ' | ' |
Total liabilities and stockholders' deficit | 12,856 | 12,963 | ' | ' |
Subsidiary Non-Guarantors [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | 317 | 300 | 323 | 258 |
Accounts receivable, net | 2,443 | 2,224 | ' | ' |
Inventories | 468 | 457 | ' | ' |
Deferred income taxes | ' | ' | ' | ' |
Other | 495 | 451 | ' | ' |
Total current assets | 3,723 | 3,432 | ' | ' |
Property and equipment, net | 5,855 | 5,768 | ' | ' |
Investments of insurance subsidiaries | 402 | 515 | ' | ' |
Investments in and advances to affiliates | 110 | 88 | ' | ' |
Goodwill and other intangible assets | 4,137 | 3,842 | ' | ' |
Deferred loan costs | ' | ' | ' | ' |
Other | 339 | 179 | ' | ' |
Total assets | 14,566 | 13,824 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 569 | 565 | ' | ' |
Accrued salaries | 451 | 482 | ' | ' |
Other accrued expenses | 809 | 788 | ' | ' |
Long-term debt due within one year | 39 | 36 | ' | ' |
Total current liabilities | 1,868 | 1,871 | ' | ' |
Long-term debt | 525 | 493 | ' | ' |
Intercompany balances | 3,472 | 3,406 | ' | ' |
Professional liability risks | 959 | 973 | ' | ' |
Income taxes and other liabilities | 256 | 220 | ' | ' |
Total liabilities | 7,080 | 6,963 | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | 6,269 | 5,642 | ' | ' |
Noncontrolling interests | 1,217 | 1,219 | ' | ' |
Total stockholders' deficit | 7,486 | 6,861 | ' | ' |
Total liabilities and stockholders' deficit | 14,566 | 13,824 | ' | ' |
Eliminations [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | ' | ' | ' | ' |
Accounts receivable, net | ' | ' | ' | ' |
Inventories | ' | ' | ' | ' |
Deferred income taxes | ' | ' | ' | ' |
Other | ' | ' | ' | ' |
Total current assets | ' | ' | ' | ' |
Property and equipment, net | ' | ' | ' | ' |
Investments of insurance subsidiaries | ' | ' | ' | ' |
Investments in and advances to affiliates | -19,784 | -18,481 | ' | ' |
Goodwill and other intangible assets | ' | ' | ' | ' |
Deferred loan costs | ' | ' | ' | ' |
Other | ' | ' | ' | ' |
Total assets | -19,784 | -18,481 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | ' | ' | ' | ' |
Accrued salaries | ' | ' | ' | ' |
Other accrued expenses | ' | ' | ' | ' |
Long-term debt due within one year | ' | ' | ' | ' |
Total current liabilities | ' | ' | ' | ' |
Long-term debt | ' | ' | ' | ' |
Intercompany balances | ' | ' | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | ' | ' | ' | ' |
Total liabilities | ' | ' | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -19,784 | -18,481 | ' | ' |
Noncontrolling interests | ' | ' | ' | ' |
Total stockholders' deficit | -19,784 | -18,481 | ' | ' |
Total liabilities and stockholders' deficit | ($19,784) | ($18,481) | ' | ' |
Supplemental_Condensed_Consoli5
Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) (USD $) | 9 Months Ended | |
In Millions, unless otherwise specified | Sep. 30, 2013 | Sep. 30, 2012 |
Cash flows from operating activities: | ' | ' |
Net income (loss) | $1,442 | $1,579 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -3,319 | -2,923 |
Provision for doubtful accounts | 2,732 | 2,666 |
Depreciation and amortization | 1,292 | 1,254 |
Income taxes | 158 | 250 |
Losses (gains) on sales of facilities | 13 | -4 |
Loss on retirement of debt | 17 | ' |
Amortization of deferred loan costs | 41 | 44 |
Share-based compensation | 81 | 39 |
Equity in earnings of affiliates | -29 | -26 |
Other | -3 | 7 |
Net cash provided by (used in) operating activities | 2,454 | 2,912 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -1,347 | -1,268 |
Acquisition of hospitals and health care entities | -463 | -167 |
Disposition of hospitals and health care entities | 31 | 17 |
Change in investments | 97 | 73 |
Other | 8 | 5 |
Net cash used in investing activities | -1,674 | -1,340 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | 1,350 |
Net change in revolving bank credit facilities | 630 | -875 |
Repayment of long-term debt | -1,300 | -689 |
Distributions to noncontrolling interests | -308 | -303 |
Payment of debt issuance costs | -5 | -20 |
Distributions to stockholders | -13 | -983 |
Income tax benefits | 70 | 82 |
Other | -75 | -35 |
Net cash (used in) provided by financing activities | -1,001 | -1,473 |
Change in cash and cash equivalents | -221 | 99 |
Cash and cash equivalents at beginning of period | 705 | 373 |
Cash and cash equivalents at end of period | 484 | 472 |
HCA Holdings, Inc. Issuer [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | 1,215 | 1,291 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | 47 | 30 |
Provision for doubtful accounts | ' | ' |
Depreciation and amortization | ' | ' |
Income taxes | 158 | 250 |
Losses (gains) on sales of facilities | ' | ' |
Loss on retirement of debt | ' | ' |
Amortization of deferred loan costs | 3 | 1 |
Share-based compensation | 81 | 39 |
Equity in earnings of affiliates | -1,303 | -1,348 |
Other | ' | ' |
Net cash provided by (used in) operating activities | 201 | 263 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | ' | ' |
Acquisition of hospitals and health care entities | ' | ' |
Disposition of hospitals and health care entities | ' | ' |
Change in investments | ' | ' |
Other | ' | ' |
Net cash used in investing activities | ' | ' |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | ' |
Net change in revolving bank credit facilities | ' | ' |
Repayment of long-term debt | ' | ' |
Distributions to noncontrolling interests | ' | ' |
Payment of debt issuance costs | ' | ' |
Distributions to stockholders | -13 | -983 |
Changes in intercompany balances with affiliates, net | -199 | 675 |
Income tax benefits | 70 | 82 |
Other | -81 | -37 |
Net cash (used in) provided by financing activities | -223 | -263 |
Change in cash and cash equivalents | -22 | ' |
Cash and cash equivalents at beginning of period | 22 | ' |
Cash and cash equivalents at end of period | ' | ' |
HCA Inc. Issuer [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | -1,028 | -1,013 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -126 | -131 |
Provision for doubtful accounts | ' | ' |
Depreciation and amortization | ' | ' |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | ' | ' |
Loss on retirement of debt | 17 | ' |
Amortization of deferred loan costs | 38 | 43 |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | ' | ' |
Other | 7 | 11 |
Net cash provided by (used in) operating activities | -1,092 | -1,090 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | ' | ' |
Acquisition of hospitals and health care entities | ' | ' |
Disposition of hospitals and health care entities | ' | ' |
Change in investments | ' | ' |
Other | ' | ' |
Net cash used in investing activities | ' | ' |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | 1,350 |
Net change in revolving bank credit facilities | 630 | -875 |
Repayment of long-term debt | -1,243 | -604 |
Distributions to noncontrolling interests | ' | ' |
Payment of debt issuance costs | -5 | -20 |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | 1,710 | 1,239 |
Income tax benefits | ' | ' |
Other | ' | ' |
Net cash (used in) provided by financing activities | 1,092 | 1,090 |
Change in cash and cash equivalents | ' | ' |
Cash and cash equivalents at beginning of period | ' | ' |
Cash and cash equivalents at end of period | ' | ' |
Subsidiary Guarantors [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | 1,665 | 1,771 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -1,848 | -1,475 |
Provision for doubtful accounts | 1,611 | 1,505 |
Depreciation and amortization | 636 | 614 |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | 20 | 3 |
Loss on retirement of debt | ' | ' |
Amortization of deferred loan costs | ' | ' |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | -2 | -4 |
Other | ' | ' |
Net cash provided by (used in) operating activities | 2,084 | 2,418 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -684 | -685 |
Acquisition of hospitals and health care entities | ' | -72 |
Disposition of hospitals and health care entities | 17 | 1 |
Change in investments | -6 | -9 |
Other | ' | -1 |
Net cash used in investing activities | -673 | -766 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | ' |
Net change in revolving bank credit facilities | ' | ' |
Repayment of long-term debt | -34 | -16 |
Distributions to noncontrolling interests | -34 | -46 |
Payment of debt issuance costs | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | -1,559 | -1,556 |
Income tax benefits | ' | ' |
Other | ' | ' |
Net cash (used in) provided by financing activities | -1,627 | -1,618 |
Change in cash and cash equivalents | -216 | 34 |
Cash and cash equivalents at beginning of period | 383 | 115 |
Cash and cash equivalents at end of period | 167 | 149 |
Subsidiary Non-Guarantors [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | 893 | 878 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -1,392 | -1,347 |
Provision for doubtful accounts | 1,121 | 1,161 |
Depreciation and amortization | 656 | 640 |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | -7 | -7 |
Loss on retirement of debt | ' | ' |
Amortization of deferred loan costs | ' | ' |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | -27 | -22 |
Other | -10 | -4 |
Net cash provided by (used in) operating activities | 1,261 | 1,321 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -663 | -583 |
Acquisition of hospitals and health care entities | -463 | -95 |
Disposition of hospitals and health care entities | 14 | 16 |
Change in investments | 103 | 82 |
Other | 8 | 6 |
Net cash used in investing activities | -1,001 | -574 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | ' |
Net change in revolving bank credit facilities | ' | ' |
Repayment of long-term debt | -23 | -69 |
Distributions to noncontrolling interests | -274 | -257 |
Payment of debt issuance costs | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | 48 | -358 |
Income tax benefits | ' | ' |
Other | 6 | 2 |
Net cash (used in) provided by financing activities | -243 | -682 |
Change in cash and cash equivalents | 17 | 65 |
Cash and cash equivalents at beginning of period | 300 | 258 |
Cash and cash equivalents at end of period | 317 | 323 |
Eliminations [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | -1,303 | -1,348 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | ' | ' |
Provision for doubtful accounts | ' | ' |
Depreciation and amortization | ' | ' |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | ' | ' |
Loss on retirement of debt | ' | ' |
Amortization of deferred loan costs | ' | ' |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | 1,303 | 1,348 |
Other | ' | ' |
Net cash provided by (used in) operating activities | ' | ' |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | ' | ' |
Acquisition of hospitals and health care entities | ' | ' |
Disposition of hospitals and health care entities | ' | ' |
Change in investments | ' | ' |
Other | ' | ' |
Net cash used in investing activities | ' | ' |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | ' |
Net change in revolving bank credit facilities | ' | ' |
Repayment of long-term debt | ' | ' |
Distributions to noncontrolling interests | ' | ' |
Payment of debt issuance costs | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | ' | ' |
Income tax benefits | ' | ' |
Other | ' | ' |
Net cash (used in) provided by financing activities | ' | ' |
Change in cash and cash equivalents | ' | ' |
Cash and cash equivalents at beginning of period | ' | ' |
Cash and cash equivalents at end of period | ' | ' |
Subsequent_Event_Additional_In
Subsequent Event - Additional Information (Detail) (Subsequent Event [Member], USD $) | 0 Months Ended |
In Millions, except Share data, unless otherwise specified | Nov. 02, 2013 |
Subsequent Event [Member] | ' |
Subsequent Event [Line Items] | ' |
Underwritten secondary offering | 30,000,000 |
Company repurchased additional shares amount | $500 |
Company repurchased additional shares | 10,656,400 |
Repurchase price per share | $46.92 |