Document_and_Entity_Informatio
Document and Entity Information | 9 Months Ended | |
Sep. 30, 2014 | Oct. 31, 2014 | |
Document And Entity Information [Abstract] | ' | ' |
Document Type | '10-Q | ' |
Amendment Flag | 'false | ' |
Document Period End Date | 30-Sep-14 | ' |
Document Fiscal Year Focus | '2014 | ' |
Document Fiscal Period Focus | 'Q3 | ' |
Trading Symbol | 'HCA | ' |
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 | ' | 433,563,800 |
Condensed_Consolidated_Income_
Condensed Consolidated Income Statements (Unaudited) (USD $) | 3 Months Ended | 9 Months Ended | |||||
In Millions, except Share data in Thousands, unless otherwise specified | Sep. 30, 2014 | Mar. 31, 2014 | Sep. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2014 | Sep. 30, 2013 |
Income Statement [Abstract] | ' | ' | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | $9,978 | ' | $9,411 | ' | ' | $29,619 | $28,078 |
Provision for doubtful accounts | 758 | ' | 955 | ' | ' | 2,337 | 2,732 |
Revenues | 9,220 | ' | 8,456 | ' | ' | 27,282 | 25,346 |
Salaries and benefits | 4,211 | ' | 3,916 | ' | ' | 12,359 | 11,681 |
Supplies | 1,539 | ' | 1,457 | ' | ' | 4,603 | 4,406 |
Other operating expenses | 1,688 | ' | 1,564 | ' | ' | 4,977 | 4,594 |
Electronic health record incentive income | -32 | ' | -75 | ' | ' | -97 | -166 |
Equity in earnings of affiliates | -14 | ' | -9 | ' | ' | -32 | -29 |
Depreciation and amortization | 460 | ' | 443 | ' | ' | 1,361 | 1,292 |
Interest expense | 427 | ' | 458 | ' | ' | 1,314 | 1,392 |
Losses (gains) on sales of facilities | 12 | ' | 1 | ' | ' | -20 | 13 |
Losses on retirement of debt | ' | ' | ' | 17 | ' | 226 | 17 |
Legal claim costs | ' | 78 | ' | ' | 175 | 78 | ' |
Total expenses including equity in earnings of affiliates | 8,291 | ' | 7,755 | ' | ' | 24,769 | 23,200 |
Income before income taxes | 929 | ' | 701 | ' | ' | 2,513 | 2,146 |
Provision for income taxes | 318 | ' | 234 | ' | ' | 816 | 704 |
Net income | 611 | ' | 467 | ' | ' | 1,697 | 1,442 |
Net income attributable to noncontrolling interests | 93 | ' | 102 | ' | ' | 349 | 310 |
Net income attributable to HCA Holdings, Inc. | $518 | ' | $365 | ' | ' | $1,348 | $1,132 |
Per share data: | ' | ' | ' | ' | ' | ' | ' |
Basic earnings per share | $1.20 | ' | $0.82 | ' | ' | $3.08 | $2.54 |
Diluted earnings per share | $1.16 | ' | $0.79 | ' | ' | $2.98 | $2.44 |
Shares used in earnings per share calculations (in thousands): | ' | ' | ' | ' | ' | ' | ' |
Basic | 432,617 | ' | 447,329 | ' | ' | 437,832 | 446,125 |
Diluted | 447,260 | ' | 463,569 | ' | ' | 452,538 | 463,051 |
Condensed_Consolidated_Compreh
Condensed Consolidated Comprehensive Income Statements (Unaudited) (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 |
Statement of Comprehensive Income [Abstract] | ' | ' | ' | ' |
Net income | $611 | $467 | $1,697 | $1,442 |
Other comprehensive (loss) income before taxes: | ' | ' | ' | ' |
Foreign currency translation | -58 | 60 | -18 | ' |
Unrealized gains (losses) on available-for-sale securities | 2 | 1 | 10 | -7 |
Defined benefit plans | ' | 8 | ' | 8 |
Pension costs included in salaries and benefits | 3 | 9 | 11 | 24 |
Total defined benefit plans | 3 | 17 | 11 | 32 |
Change in fair value of derivative financial instruments | 8 | -31 | -21 | 9 |
Interest costs included in interest expense | 34 | 33 | 99 | 97 |
Total change in fair value of derivative financial instruments | 42 | 2 | 78 | 106 |
Other comprehensive (loss) income before taxes | -11 | 80 | 81 | 131 |
Income taxes (benefits) related to other comprehensive income items | -4 | 28 | 30 | 48 |
Other comprehensive (loss) income | -7 | 52 | 51 | 83 |
Comprehensive income | 604 | 519 | 1,748 | 1,525 |
Comprehensive income attributable to noncontrolling interests | 93 | 102 | 349 | 310 |
Comprehensive income attributable to HCA Holdings, Inc. | $511 | $417 | $1,399 | $1,215 |
Condensed_Consolidated_Balance
Condensed Consolidated Balance Sheets (Unaudited) (USD $) | Sep. 30, 2014 | Dec. 31, 2013 |
In Millions, unless otherwise specified | ||
Current assets: | ' | ' |
Cash and cash equivalents | $515 | $414 |
Accounts receivable, less allowance for doubtful accounts of $5,103 and $5,488 | 5,524 | 5,208 |
Inventories | 1,258 | 1,179 |
Deferred income taxes | 320 | 489 |
Other | 910 | 747 |
Total current assets | 8,527 | 8,037 |
Property and equipment, at cost | 32,301 | 31,073 |
Accumulated depreciation | -18,423 | -17,454 |
Property and equipment, net | 13,878 | 13,619 |
Investments of insurance subsidiaries | 441 | 448 |
Investments in and advances to affiliates | 167 | 121 |
Goodwill and other intangible assets | 5,899 | 5,903 |
Deferred loan costs | 221 | 237 |
Other | 692 | 466 |
Total assets | 29,825 | 28,831 |
Current liabilities: | ' | ' |
Accounts payable | 1,787 | 1,803 |
Accrued salaries | 1,238 | 1,193 |
Other accrued expenses | 1,563 | 1,913 |
Long-term debt due within one year | 1,044 | 786 |
Total current liabilities | 5,632 | 5,695 |
Long-term debt | 27,426 | 27,590 |
Professional liability risks | 1,045 | 949 |
Income taxes and other liabilities | 1,740 | 1,525 |
Stockholders' deficit: | ' | ' |
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 433,378,700 shares in 2014 and 439,604,000 shares in 2013 | 4 | 4 |
Capital in excess of par value | 872 | 1,386 |
Accumulated other comprehensive loss | -206 | -257 |
Retained deficit | -8,054 | -9,403 |
Stockholders' deficit attributable to HCA Holdings, Inc. | -7,384 | -8,270 |
Noncontrolling interests | 1,366 | 1,342 |
Total stockholders' deficit | -6,018 | -6,928 |
Total liabilities and stockholders' deficit | $29,825 | $28,831 |
Condensed_Consolidated_Balance1
Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) (USD $) | Sep. 30, 2014 | Dec. 31, 2013 |
In Millions, except Share data, unless otherwise specified | ||
Statement of Financial Position [Abstract] | ' | ' |
Allowance for Accounts receivable | $5,103 | $5,488 |
Common stock, par value | $0.01 | $0.01 |
Common stock, shares authorized | 1,800,000,000 | 1,800,000,000 |
Common stock, shares outstanding | 433,378,700 | 439,604,000 |
Condensed_Consolidated_Stateme
Condensed Consolidated Statements of Cash Flows (Unaudited) (USD $) | 9 Months Ended | |
In Millions, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 |
Cash flows from operating activities: | ' | ' |
Net income | $1,697 | $1,442 |
Adjustments to reconcile net income to net cash provided by operating activities: | ' | ' |
Changes in operating assets and liabilities | -2,945 | -3,319 |
Provision for doubtful accounts | 2,337 | 2,732 |
Depreciation and amortization | 1,361 | 1,292 |
Income taxes | -61 | 158 |
Losses (gains) on sales of facilities | -20 | 13 |
Losses on retirement of debt | 226 | 17 |
Legal claim costs | 78 | ' |
Amortization of deferred loan costs | 33 | 41 |
Share-based compensation | 118 | 81 |
Other | -3 | -3 |
Net cash provided by operating activities | 2,821 | 2,454 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -1,482 | -1,347 |
Acquisition of hospitals and health care entities | -97 | -463 |
Disposition of hospitals and health care entities | 38 | 31 |
Change in investments | 22 | 97 |
Other | 7 | 8 |
Net cash used in investing activities | -1,512 | -1,674 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | 3,502 | ' |
Net change in revolving credit facilities | -160 | 630 |
Repayment of long-term debt | -3,525 | -1,300 |
Distributions to noncontrolling interests | -325 | -308 |
Payment of debt issuance costs | -49 | -5 |
Repurchase of common stock | -750 | ' |
Distributions to stockholders | -7 | -13 |
Income tax benefits | 119 | 70 |
Other | -13 | -75 |
Net cash used in financing activities | -1,208 | -1,001 |
Change in cash and cash equivalents | 101 | -221 |
Cash and cash equivalents at beginning of period | 414 | 705 |
Cash and cash equivalents at end of period | 515 | 484 |
Interest payments | 1,441 | 1,464 |
Income tax payments, net | $758 | $476 |
Basis_of_Presentation_and_Sign
Basis of Presentation and Significant Accounting Policies | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
Accounting Policies [Abstract] | ' | ||||||||||||||||
Basis of Presentation and Significant Accounting Policies | ' | ||||||||||||||||
NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES | |||||||||||||||||
Reporting Entity | |||||||||||||||||
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, 2014, these affiliates owned and operated 165 hospitals, 113 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 Holdings, Inc. and its affiliates. 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 $71 million and $76 million for the quarters ended September 30, 2014 and 2013, respectively, and $206 million and $207 million for the nine months ended September 30, 2014 and 2013, respectively. Operating results for the quarter and the nine months ended September 30, 2014 are not necessarily indicative of the results that may be expected for the year ending December 31, 2014. 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, 2013. | |||||||||||||||||
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 (includes the health insurance exchanges, beginning with the first quarter of 2014), 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, 2014 and 2013 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | |||||||||||||||||
2014 | Ratio | 2013 | Ratio | ||||||||||||||
Medicare | $ | 2,120 | 23 | % | $ | 1,847 | 21.8 | % | |||||||||
Managed Medicare | 901 | 9.8 | 794 | 9.4 | |||||||||||||
Medicaid | 372 | 4 | 401 | 4.7 | |||||||||||||
Managed Medicaid | 510 | 5.5 | 386 | 4.6 | |||||||||||||
Managed care and other insurers | 5,073 | 55 | 4,636 | 54.8 | |||||||||||||
International (managed care and other insurers) | 323 | 3.5 | 287 | 3.4 | |||||||||||||
9,299 | 100.8 | 8,351 | 98.7 | ||||||||||||||
Uninsured | 313 | 3.4 | 717 | 8.5 | |||||||||||||
Other | 366 | 4 | 343 | 4.1 | |||||||||||||
Revenues before provision for doubtful accounts | 9,978 | 108.2 | 9,411 | 111.3 | |||||||||||||
Provision for doubtful accounts | (758 | ) | (8.2 | ) | (955 | ) | (11.3 | ) | |||||||||
Revenues | $ | 9,220 | 100 | % | $ | 8,456 | 100 | % | |||||||||
Nine Months | |||||||||||||||||
2014 | Ratio | 2013 | Ratio | ||||||||||||||
Medicare | $ | 6,285 | 23 | % | $ | 5,961 | 23.5 | % | |||||||||
Managed Medicare | 2,706 | 9.9 | 2,441 | 9.6 | |||||||||||||
Medicaid | 1,404 | 5.1 | 1,098 | 4.3 | |||||||||||||
Managed Medicaid | 1,383 | 5.1 | 1,165 | 4.6 | |||||||||||||
Managed care and other insurers | 14,742 | 54 | 13,777 | 54.4 | |||||||||||||
International (managed care and other insurers) | 983 | 3.6 | 868 | 3.4 | |||||||||||||
27,503 | 100.7 | 25,310 | 99.8 | ||||||||||||||
Uninsured | 1,019 | 3.7 | 1,809 | 7.1 | |||||||||||||
Other | 1,097 | 4 | 959 | 3.8 | |||||||||||||
Revenues before provision for doubtful accounts | 29,619 | 108.4 | 28,078 | 110.7 | |||||||||||||
Provision for doubtful accounts | (2,337 | ) | (8.4 | ) | (2,732 | ) | (10.7 | ) | |||||||||
Revenues | $ | 27,282 | 100 | % | $ | 25,346 | 100 | % | |||||||||
During the quarter ended September 30, 2014, we recorded two changes in estimates which had the net effect of increasing revenues $26 million. We recorded $94 million, or $0.13 per diluted share, of Medicare revenues as the estimated settlement amount for certain claims denied by Recovery Audit Contractors (“RAC”) entities conducting reviews on behalf of the Centers for Medicare and Medicaid Services (“CMS”) and currently in the pending appeals process. CMS is offering an administrative agreement to providers willing to withdraw their pending appeals in exchange for a timely partial payment (generally, 68% of the claim amount, subject to certain adjustments). We also recorded a reduction of $68 million, or $0.09 per diluted share, to Medicaid revenues related to the Texas Medicaid Waiver Program. On October 1, 2014, the Texas Health and Human Services Commission (“THHSC”) issued a notice to hospitals participating in the Texas Medicaid Waiver Program. According to the notice, a review conducted by CMS identified certain local government/hospital affiliations it believes may be inconsistent with the waiver. As a result of these findings, CMS notified THHSC that it is deferring the federal portion of the Medicaid payments associated with these affiliations while it completes its review. | |||||||||||||||||
Recent Pronouncements | |||||||||||||||||
In May 2014, the Financial Accounting Standards Board and the International Accounting Standards Board issued a final, converged, principles-based standard on revenue recognition. Companies across all industries will use a five-step model to recognize revenue from customer contracts. The new standard, which replaces nearly all existing United States Generally Accepted Accounting Principles (“US GAAP”) and International Financial Reporting Standards revenue recognition guidance, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The standard is effective for public entities for annual and interim periods beginning after December 15, 2016. Early adoption is not permitted under US GAAP. We are evaluating the effects the adoption of this standard will have on our financial statements and financial disclosures. |
Acquisitions_and_Dispositions
Acquisitions and Dispositions | 9 Months Ended |
Sep. 30, 2014 | |
Business Combinations [Abstract] | ' |
Acquisitions and Dispositions | ' |
NOTE 2 — ACQUISITIONS AND DISPOSITIONS | |
During the nine months ended September 30, 2014, we paid $14 million to acquire a hospital and $83 million to acquire other nonhospital health care entities. During the nine months ended September 30, 2013, we paid $317 million and recorded goodwill and identifiable intangible assets of $176 million and $125 million, respectively, related to the acquisitions of nonhospital health care entities and $146 million related to the acquisition of three hospitals. | |
During the nine months ended September 30, 2014, we received proceeds of $38 million and recognized net pretax gains of $20 million related to sales of real estate and other investments. During the nine months ended September 30, 2013, we received proceeds of $31 million and recognized net pretax losses of $13 million related to sales of a hospital facility and real estate and other investments. |
Income_Taxes
Income Taxes | 9 Months Ended |
Sep. 30, 2014 | |
Income Tax Disclosure [Abstract] | ' |
Income Taxes | ' |
NOTE 3 — INCOME TAXES | |
The IRS Examination Division began an audit of HCA Holdings, Inc.’s 2011 and 2012 federal income tax returns during 2014. We are also subject to examination by state and foreign taxing authorities. | |
Our liability for unrecognized tax benefits was $503 million, including accrued interest of $43 million, as of September 30, 2014 ($462 million and $30 million, respectively, as of December 31, 2013). Unrecognized tax benefits of $180 million ($160 million as of December 31, 2013) would affect the effective rate, if recognized. The provision for income taxes reflects $3 million and $7 million ($2 million and $4 million, respectively, net of tax) of interest expense related to taxing authority examinations for the quarters ended September 30, 2014 and 2013, respectively. The provision for income taxes reflects $11 million ($7 million, net of tax) of interest expense related to taxing authority examinations and $8 million ($5 million, net of tax) of reductions in interest expense related to taxing authority examinations for the nine months ended September 30, 2014 and 2013, respectively. | |
Depending on the completion of examinations by federal, state or foreign 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, 2014 | |||||||||||||||||
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, 2014 and 2013 (dollars in millions, except per share amounts, and shares in thousands): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2014 | 2013 | 2014 | 2013 | ||||||||||||||
Net income attributable to HCA Holdings, Inc. | $ | 518 | $ | 365 | $ | 1,348 | $ | 1,132 | |||||||||
Weighted average common shares outstanding | 432,617 | 447,329 | 437,832 | 446,125 | |||||||||||||
Effect of dilutive incremental shares | 14,643 | 16,240 | 14,706 | 16,926 | |||||||||||||
Shares used for diluted earnings per share | 447,260 | 463,569 | 452,538 | 463,051 | |||||||||||||
Earnings per share: | |||||||||||||||||
Basic earnings per share | $ | 1.2 | $ | 0.82 | $ | 3.08 | $ | 2.54 | |||||||||
Diluted earnings per share | $ | 1.16 | $ | 0.79 | $ | 2.98 | $ | 2.44 |
Investments_of_Insurance_Subsi
Investments of Insurance Subsidiaries | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
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, 2014 and December 31, 2013 follows (dollars in millions): | |||||||||||||||||
September 30, 2014 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 449 | $ | 19 | $ | (1 | ) | $ | 467 | ||||||||
Money market funds | 37 | — | — | 37 | |||||||||||||
486 | 19 | (1 | ) | 504 | |||||||||||||
Equity securities | 1 | 2 | — | 3 | |||||||||||||
$ | 487 | $ | 21 | $ | (1 | ) | 507 | ||||||||||
Amounts classified as current assets | (66 | ) | |||||||||||||||
Investment carrying value | $ | 441 | |||||||||||||||
December 31, 2013 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 404 | $ | 11 | $ | (3 | ) | $ | 412 | ||||||||
Money market funds | 94 | — | — | 94 | |||||||||||||
498 | 11 | (3 | ) | 506 | |||||||||||||
Equity securities | 2 | 2 | — | 4 | |||||||||||||
$ | 500 | $ | 13 | $ | (3 | ) | 510 | ||||||||||
Amounts classified as current assets | (62 | ) | |||||||||||||||
Investment carrying value | $ | 448 | |||||||||||||||
At September 30, 2014 and December 31, 2013, 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 (loss). | |||||||||||||||||
Scheduled maturities of investments in debt securities at September 30, 2014 were as follows (dollars in millions): | |||||||||||||||||
Amortized | Fair | ||||||||||||||||
Cost | Value | ||||||||||||||||
Due in one year or less | $ | 59 | $ | 60 | |||||||||||||
Due after one year through five years | 207 | 212 | |||||||||||||||
Due after five years through ten years | 97 | 104 | |||||||||||||||
Due after ten years | 123 | 128 | |||||||||||||||
$ | 486 | $ | 504 | ||||||||||||||
The average expected maturity of the investments in debt securities at September 30, 2014 was 4.1 years, compared to the average scheduled maturity of 6.1 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 their scheduled maturity date. |
Financial_Instruments
Financial Instruments | 9 Months Ended | ||||||||||||
Sep. 30, 2014 | |||||||||||||
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 for the interest rate swap agreements which have been designated as cash flow hedges. 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, 2014 (dollars in millions): | |||||||||||||
Notional | Maturity Date | Fair | |||||||||||
Amount | |||||||||||||
Value | |||||||||||||
Pay-fixed interest rate swaps | $ | 500 | December 2014 | $ | (1 | ) | |||||||
Pay-fixed interest rate swaps | 3,000 | December 2016 | (183 | ) | |||||||||
Pay-fixed interest rate swaps | 1,000 | December 2017 | (33 | ) | |||||||||
During the next 12 months, we estimate $121 million will be reclassified from other comprehensive income (“OCI”) to interest expense. | |||||||||||||
Derivatives — Results of Operations | |||||||||||||
The following table presents the effect of our interest rate swaps on our results of operations for the nine months ended September 30, 2014 (dollars in millions): | |||||||||||||
Derivatives in Cash Flow Hedging Relationships | Amount of Loss | 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 | $ | 13 | Interest expense | $ | 99 | ||||||||
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, 2014, we have not been required to post any collateral related to these agreements. If we had breached these provisions at September 30, 2014, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $224 million. |
Assets_and_Liabilities_Measure
Assets and Liabilities Measured at Fair Value | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
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”) 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 swap agreements to manage our exposure to fluctuations in interest rates. 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 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, 2014 and December 31, 2013, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. | |||||||||||||||||
The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of September 30, 2014 and December 31, 2013, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): | |||||||||||||||||
September 30, 2014 | |||||||||||||||||
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 | $ | 467 | $ | — | $ | 461 | $ | 6 | |||||||||
Money market funds | 37 | 37 | — | — | |||||||||||||
504 | 37 | 461 | 6 | ||||||||||||||
Equity securities | 3 | 3 | — | — | |||||||||||||
Investments of insurance subsidiaries | 507 | 40 | 461 | 6 | |||||||||||||
Less amounts classified as current assets | (66 | ) | (37 | ) | (29 | ) | — | ||||||||||
$ | 441 | $ | 3 | $ | 432 | $ | 6 | ||||||||||
Liabilities: | |||||||||||||||||
Interest rate swaps (Income taxes and other liabilities) | $ | 217 | $ | — | $ | 217 | $ | — | |||||||||
December 31, 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 | $ | 412 | $ | — | $ | 405 | $ | 7 | |||||||||
Money market funds | 94 | 94 | — | — | |||||||||||||
506 | 94 | 405 | 7 | ||||||||||||||
Equity securities | 4 | 3 | — | 1 | |||||||||||||
Investments of insurance subsidiaries | 510 | 97 | 405 | 8 | |||||||||||||
Less amounts classified as current assets | (62 | ) | (62 | ) | — | — | |||||||||||
$ | 448 | $ | 35 | $ | 405 | $ | 8 | ||||||||||
Liabilities: | |||||||||||||||||
Interest rate swaps (Income taxes and other liabilities) | $ | 295 | $ | — | $ | 295 | $ | — | |||||||||
The following table summarizes the activity related to the investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the nine months ended September 30, 2014 (dollars in millions): | |||||||||||||||||
Asset balances at December 31, 2013 | $ | 8 | |||||||||||||||
Settlements | (2 | ) | |||||||||||||||
Asset balances at September 30, 2014 | $ | 6 | |||||||||||||||
The estimated fair value of our long-term debt was $29.369 billion and $29.603 billion at September 30, 2014 and December 31, 2013, respectively, compared to carrying amounts aggregating $28.470 billion and $28.376 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, 2014 | |||||||||
Debt Disclosure [Abstract] | ' | ||||||||
Long-Term Debt | ' | ||||||||
NOTE 8 — LONG-TERM DEBT | |||||||||
A summary of long-term debt at September 30, 2014 and December 31, 2013, including related interest rates at September 30, 2014, follows (dollars in millions): | |||||||||
September 30, | December 31, | ||||||||
2014 | 2013 | ||||||||
Senior secured asset-based revolving credit facility (effective interest rate of 1.7%) | $ | 2,280 | $ | 2,440 | |||||
Senior secured revolving credit facility | — | — | |||||||
Senior secured term loan facilities (effective interest rate of 5.3%) | 5,538 | 5,598 | |||||||
Senior secured first lien notes (effective interest rate of 5.8%) | 10,492 | 9,695 | |||||||
Other senior secured debt (effective interest rate of 6.6%) | 464 | 448 | |||||||
First lien debt | 18,774 | 18,181 | |||||||
Senior unsecured notes (effective interest rate of 7.2%) | 9,696 | 10,195 | |||||||
Total debt (average life of 6.2 years, rates averaging 5.9%) | 28,470 | 28,376 | |||||||
Less amounts due within one year | 1,044 | 786 | |||||||
$ | 27,426 | $ | 27,590 | ||||||
2014 Activity | |||||||||
During March 2014, we issued $3.500 billion aggregate principal amount of notes, comprised of $1.500 billion aggregate principal amount of 3.75% senior secured notes due 2019 and $2.000 billion aggregate principal amount of 5.00% senior secured notes due 2024, and repaid at maturity all $500 million aggregate principal amount of our outstanding 5.75% senior unsecured notes. During April 2014, we used proceeds from the March 2014 debt issuance to redeem all $1.500 billion aggregate principal amount of our outstanding 8 1/2% senior secured notes due 2019 and all $1.250 billion aggregate principal amount of our outstanding 7 7/8% senior secured notes due 2020. The pretax loss on retirement of debt related to these redemptions was $226 million. | |||||||||
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. 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, 2014 | |
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 has produced 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. | |
On April 2, 2014, the UK Competition and Markets Authority (“Authority”) issued a final report on its investigation of the private health care market in London. It concluded, among other things, that many private hospitals face little competition in central London, and that there are high barriers to entry. As part of its remedies package, the Authority ordered HCA to sell either: (a) its London Bridge and Princess Grace hospitals; or (b) its Wellington Hospital, including the Hospital Platinum Medical Centre. It also imposed other remedial conditions on HCA and other private health care providers, including: regulation of incentives to referring physicians; increased access to information about fees and performance; and restrictions on future arrangements between private providers and National Health Service private patient units. HCA disagrees with the Authority’s assessment of the competitive conditions for hospitals in London, as well as its proposed divestiture remedy, and has appealed the decision to the Competition Appeal Tribunal. The appeal is expected to be decided in 2015. | |
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 proceeded to discovery on the remaining claims. The plaintiffs’ motion for class certification was granted on September 22, 2014. The court certified a class consisting of all persons that acquired HCA stock on or before October 28, 2011 (the date of the lawsuit) pursuant to the Registration Statement issued in connection with the March 9, 2011 initial public offering. We have requested permission from the trial court of appeals to immediately appeal this ruling. | |
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. 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 has been consolidated with the earlier filed state derivative action. The plaintiffs in the consolidated action filed a consolidated complaint on December 4, 2013. 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. | |
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. The Court also indicated it would award plaintiff attorneys fees, which the parties have stipulated are approximately $12 million for the trial phase. HCA recorded $175 million of legal claim costs in the fourth quarter of 2012 related to this ruling, and consistent with the judge’s order, has been accruing interest on that sum at 9% per annum. On April 25, 2014, the parties stipulated to an additional $78 million shortfall relating to the capital expenditures issue. HCA recorded $78 million of legal claims costs in the first quarter of 2014 as a result of the stipulation, and is accruing interest on that amount at 9% per annum. Pursuant to the terms of the stipulation, the parties have preserved their respective rights to contest the judge’s underlying ruling, whether through motions in the trial court or on appeal. The accounting for charity and other uncompensated care is ongoing. Final judgment in the case currently is not anticipated before 2015. At this time, we cannot predict what effect, if any, the final judgment could have on the Company. 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 judgment. |
Capital_Structure
Capital Structure | 9 Months Ended | ||||||||||||||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||
Noncontrolling | |||||||||||||||||||||||||||||
Common Stock | Capital in | Accumulated | Retained | ||||||||||||||||||||||||||
Interests | |||||||||||||||||||||||||||||
Excess of | Other | Deficit | |||||||||||||||||||||||||||
Par | Comprehensive | ||||||||||||||||||||||||||||
Shares | Par Value | Value | Loss | ||||||||||||||||||||||||||
0 | |||||||||||||||||||||||||||||
Balances at December 31, 2013 | 439,604 | $ | 4 | $ | 1,386 | $ | (257 | ) | $ | (9,403 | ) | $ | 1,342 | $ | (6,928 | ) | |||||||||||||
Net income | — | — | — | — | 1,348 | 349 | 1,697 | ||||||||||||||||||||||
Repurchase of common stock | (14,555 | ) | — | (750 | ) | — | — | — | (750 | ) | |||||||||||||||||||
Other comprehensive income | — | — | — | 51 | — | — | 51 | ||||||||||||||||||||||
Distributions | — | — | — | — | — | (325 | ) | (325 | ) | ||||||||||||||||||||
Share-based benefit plans | 8,330 | — | 242 | — | — | — | 242 | ||||||||||||||||||||||
Other | — | — | (6 | ) | — | 1 | — | (5 | ) | ||||||||||||||||||||
Balances at September 30, 2014 | 433,379 | $ | 4 | $ | 872 | $ | (206 | ) | $ | (8,054 | ) | $ | 1,366 | $ | (6,018 | ) | |||||||||||||
During May 2014, we repurchased 14,554,628 shares of our common stock at a price of $51.53 per share. | |||||||||||||||||||||||||||||
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, 2013 | $ | 7 | $ | 11 | $ | (88 | ) | $ | (187 | ) | $ | (257 | ) | ||||||||||||||||
Unrealized gains on available-for-sale securities, net of $4 of income taxes | 6 | — | — | — | 6 | ||||||||||||||||||||||||
Foreign currency translation adjustments, net of $6 income tax benefits | — | (12 | ) | — | — | (12 | ) | ||||||||||||||||||||||
Change in fair value of derivative instruments, net of $8 income tax benefits | — | — | — | (13 | ) | (13 | ) | ||||||||||||||||||||||
Expense reclassified into operations from other comprehensive income, net of $4 and $36, respectively, income tax benefits | — | — | 7 | 63 | 70 | ||||||||||||||||||||||||
Balances at September 30, 2014 | $ | 13 | $ | (1 | ) | $ | (81 | ) | $ | (137 | ) | $ | (206 | ) | |||||||||||||||
Segment_and_Geographic_Informa
Segment and Geographic Information | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
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 81 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 77 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and Texas. We also operate seven 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, losses on retirement of debt, legal claim costs, 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, 2014 and 2013 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2014 | 2013 | 2014 | 2013 | ||||||||||||||
Revenues: | |||||||||||||||||
National Group | $ | 4,387 | $ | 3,930 | $ | 12,814 | $ | 11,875 | |||||||||
American Group | 4,319 | 4,082 | 12,918 | 12,181 | |||||||||||||
Corporate and other | 514 | 444 | 1,550 | 1,290 | |||||||||||||
$ | 9,220 | $ | 8,456 | $ | 27,282 | $ | 25,346 | ||||||||||
Equity in earnings of affiliates: | |||||||||||||||||
National Group | $ | (6 | ) | $ | (3 | ) | $ | (12 | ) | $ | (8 | ) | |||||
American Group | (8 | ) | (6 | ) | (23 | ) | (19 | ) | |||||||||
Corporate and other | — | — | 3 | (2 | ) | ||||||||||||
$ | (14 | ) | $ | (9 | ) | $ | (32 | ) | $ | (29 | ) | ||||||
Adjusted segment EBITDA: | |||||||||||||||||
National Group | $ | 1,008 | $ | 805 | $ | 2,810 | $ | 2,440 | |||||||||
American Group | 927 | 910 | 2,911 | 2,654 | |||||||||||||
Corporate and other | (107 | ) | (112 | ) | (249 | ) | (234 | ) | |||||||||
$ | 1,828 | $ | 1,603 | $ | 5,472 | $ | 4,860 | ||||||||||
Depreciation and amortization: | |||||||||||||||||
National Group | $ | 187 | $ | 181 | $ | 564 | $ | 532 | |||||||||
American Group | 210 | 206 | 626 | 610 | |||||||||||||
Corporate and other | 63 | 56 | 171 | 150 | |||||||||||||
$ | 460 | $ | 443 | $ | 1,361 | $ | 1,292 | ||||||||||
Adjusted segment EBITDA | $ | 1,828 | $ | 1,603 | $ | 5,472 | $ | 4,860 | |||||||||
Depreciation and amortization | 460 | 443 | 1,361 | 1,292 | |||||||||||||
Interest expense | 427 | 458 | 1,314 | 1,392 | |||||||||||||
Losses (gains) on sales of facilities | 12 | 1 | (20 | ) | 13 | ||||||||||||
Losses on retirement of debt | — | — | 226 | 17 | |||||||||||||
Legal claim costs | — | — | 78 | — | |||||||||||||
Income before income taxes | $ | 929 | $ | 701 | $ | 2,513 | $ | 2,146 | |||||||||
Supplemental_Condensed_Consoli
Supplemental Condensed Consolidating Financial Information | 9 Months Ended | ||||||||||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||||||||||
Text Block [Abstract] | ' | ||||||||||||||||||||||||
Supplemental Condensed Consolidating Financial Information | ' | ||||||||||||||||||||||||
NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION | |||||||||||||||||||||||||
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. | |||||||||||||||||||||||||
HCA Inc., a direct wholly-owned subsidiary of HCA Holdings, Inc., is the obligor under a significant portion of our other indebtedness, including our senior secured credit facilities, senior secured notes and senior unsecured notes (other than the senior unsecured notes issued by HCA Holdings, Inc.). The senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guaranteed by HCA Holdings, Inc. 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, 2014 and 2013, condensed consolidating balance sheets at September 30, 2014 and December 31, 2013 and condensed consolidating statements of cash flows for the nine months ended September 30, 2014 and 2013, 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, 2014 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 5,133 | $ | 4,845 | $ | — | $ | 9,978 | |||||||||||||
Provision for doubtful accounts | — | — | 457 | 301 | — | 758 | |||||||||||||||||||
Revenues | — | — | 4,676 | 4,544 | — | 9,220 | |||||||||||||||||||
Salaries and benefits | — | — | 2,176 | 2,035 | — | 4,211 | |||||||||||||||||||
Supplies | — | — | 797 | 742 | — | 1,539 | |||||||||||||||||||
Other operating expenses | 4 | — | 804 | 880 | — | 1,688 | |||||||||||||||||||
Electronic health record incentive income | — | — | (22 | ) | (10 | ) | — | (32 | ) | ||||||||||||||||
Equity in earnings of affiliates | (542 | ) | — | (3 | ) | (11 | ) | 542 | (14 | ) | |||||||||||||||
Depreciation and amortization | — | — | 225 | 235 | — | 460 | |||||||||||||||||||
Interest expense | 46 | 536 | (115 | ) | (40 | ) | — | 427 | |||||||||||||||||
Losses (gains) on sales of facilities | — | — | 16 | (4 | ) | — | 12 | ||||||||||||||||||
Management fees | — | — | (178 | ) | 178 | — | — | ||||||||||||||||||
(492 | ) | 536 | 3,700 | 4,005 | 542 | 8,291 | |||||||||||||||||||
Income (loss) before income taxes | 492 | (536 | ) | 976 | 539 | (542 | ) | 929 | |||||||||||||||||
Provision (benefit) for income taxes | (19 | ) | (205 | ) | 365 | 177 | — | 318 | |||||||||||||||||
Net income (loss) | 511 | (331 | ) | 611 | 362 | (542 | ) | 611 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 18 | 75 | — | 93 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 511 | $ | (331 | ) | $ | 593 | $ | 287 | $ | (542 | ) | $ | 518 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 511 | $ | (303 | ) | $ | 595 | $ | 250 | $ | (542 | ) | $ | 511 | |||||||||||
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 NINE MONTHS ENDED SEPTEMBER 30, 2014 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 15,242 | $ | 14,377 | $ | — | $ | 29,619 | |||||||||||||
Provision for doubtful accounts | — | — | 1,388 | 949 | — | 2,337 | |||||||||||||||||||
Revenues | — | — | 13,854 | 13,428 | — | 27,282 | |||||||||||||||||||
Salaries and benefits | — | — | 6,393 | 5,966 | — | 12,359 | |||||||||||||||||||
Supplies | — | — | 2,416 | 2,187 | — | 4,603 | |||||||||||||||||||
Other operating expenses | 14 | — | 2,366 | 2,597 | — | 4,977 | |||||||||||||||||||
Electronic health record incentive income | — | — | (68 | ) | (29 | ) | — | (97 | ) | ||||||||||||||||
Equity in earnings of affiliates | (1,494 | ) | — | (5 | ) | (27 | ) | 1,494 | (32 | ) | |||||||||||||||
Depreciation and amortization | — | — | 667 | 694 | — | 1,361 | |||||||||||||||||||
Interest expense | 138 | 1,629 | (349 | ) | (104 | ) | — | 1,314 | |||||||||||||||||
Gains on sales of facilities | — | — | (16 | ) | (4 | ) | — | (20 | ) | ||||||||||||||||
Losses on retirement of debt | — | 226 | — | — | — | 226 | |||||||||||||||||||
Legal claim costs | — | 78 | — | — | — | 78 | |||||||||||||||||||
Management fees | — | — | (528 | ) | 528 | — | — | ||||||||||||||||||
(1,342 | ) | 1,933 | 10,876 | 11,808 | 1,494 | 24,769 | |||||||||||||||||||
Income (loss) before income taxes | 1,342 | (1,933 | ) | 2,978 | 1,620 | (1,494 | ) | 2,513 | |||||||||||||||||
Provision (benefit) for income taxes | (57 | ) | (729 | ) | 1,098 | 504 | — | 816 | |||||||||||||||||
Net income (loss) | 1,399 | (1,204 | ) | 1,880 | 1,116 | (1,494 | ) | 1,697 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 65 | 284 | — | 349 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 1,399 | $ | (1,204 | ) | $ | 1,815 | $ | 832 | $ | (1,494 | ) | $ | 1,348 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 1,399 | $ | (1,154 | ) | $ | 1,822 | $ | 826 | $ | (1,494 | ) | $ | 1,399 | |||||||||||
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 | ||||||||||||||||||
Losses 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 BALANCE SHEET | |||||||||||||||||||||||||
30-Sep-14 | |||||||||||||||||||||||||
(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 | $ | — | $ | — | $ | 113 | $ | 402 | $ | — | $ | 515 | |||||||||||||
Accounts receivable, net | — | — | 2,671 | 2,853 | — | 5,524 | |||||||||||||||||||
Inventories | — | — | 748 | 510 | — | 1,258 | |||||||||||||||||||
Deferred income taxes | 320 | — | — | — | — | 320 | |||||||||||||||||||
Other | — | — | 369 | 541 | — | 910 | |||||||||||||||||||
320 | — | 3,901 | 4,306 | — | 8,527 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,762 | 6,116 | — | 13,878 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 441 | — | 441 | |||||||||||||||||||
Investments in and advances to affiliates | 21,850 | — | 16 | 151 | (21,850 | ) | 167 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,698 | 4,201 | — | 5,899 | |||||||||||||||||||
Deferred loan costs | 27 | 194 | — | — | — | 221 | |||||||||||||||||||
Other | 476 | — | 21 | 195 | — | 692 | |||||||||||||||||||
$ | 22,673 | $ | 194 | $ | 13,398 | $ | 15,410 | $ | (21,850 | ) | $ | 29,825 | |||||||||||||
LIABILITIES AND | |||||||||||||||||||||||||
STOCKHOLDERS’ (DEFICIT) | |||||||||||||||||||||||||
EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | 3 | $ | — | $ | 1,132 | $ | 652 | $ | — | $ | 1,787 | |||||||||||||
Accrued salaries | — | — | 721 | 517 | — | 1,238 | |||||||||||||||||||
Other accrued expenses | 69 | 197 | 458 | 839 | — | 1,563 | |||||||||||||||||||
Long-term debt due within one year | — | 952 | 51 | 41 | — | 1,044 | |||||||||||||||||||
72 | 1,149 | 2,362 | 2,049 | — | 5,632 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,528 | 187 | 186 | — | 27,426 | |||||||||||||||||||
Intercompany balances | 26,932 | (9,497 | ) | (20,763 | ) | 3,328 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 1,045 | — | 1,045 | |||||||||||||||||||
Income taxes and other liabilities | 528 | 500 | 486 | 226 | — | 1,740 | |||||||||||||||||||
30,057 | 16,680 | (17,728 | ) | 6,834 | — | 35,843 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (7,384 | ) | (16,486 | ) | 31,007 | 7,329 | (21,850 | ) | (7,384 | ) | |||||||||||||||
Noncontrolling interests | — | — | 119 | 1,247 | — | 1,366 | |||||||||||||||||||
(7,384 | ) | (16,486 | ) | 31,126 | 8,576 | (21,850 | ) | (6,018 | ) | ||||||||||||||||
$ | 22,673 | $ | 194 | $ | 13,398 | $ | 15,410 | $ | (21,850 | ) | $ | 29,825 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
31-Dec-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 | $ | — | $ | — | $ | 112 | $ | 302 | $ | — | $ | 414 | |||||||||||||
Accounts receivable, net | — | — | 2,565 | 2,643 | — | 5,208 | |||||||||||||||||||
Inventories | — | — | 692 | 487 | — | 1,179 | |||||||||||||||||||
Deferred income taxes | 489 | — | — | — | — | 489 | |||||||||||||||||||
Other | — | — | 301 | 446 | — | 747 | |||||||||||||||||||
489 | — | 3,670 | 3,878 | — | 8,037 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,504 | 6,115 | — | 13,619 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 448 | — | 448 | |||||||||||||||||||
Investments in and advances to affiliates | 20,356 | — | 13 | 108 | (20,356 | ) | 121 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,695 | 4,208 | — | 5,903 | |||||||||||||||||||
Deferred loan costs | 30 | 207 | — | — | — | 237 | |||||||||||||||||||
Other | 250 | — | 48 | 168 | — | 466 | |||||||||||||||||||
$ | 21,125 | $ | 207 | $ | 12,930 | $ | 14,925 | $ | (20,356 | ) | $ | 28,831 | |||||||||||||
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | 1 | $ | — | $ | 1,169 | $ | 633 | $ | — | $ | 1,803 | |||||||||||||
Accrued salaries | — | — | 694 | 499 | — | 1,193 | |||||||||||||||||||
Other accrued expenses | 272 | 353 | 464 | 824 | — | 1,913 | |||||||||||||||||||
Long-term debt due within one year | — | 702 | 45 | 39 | — | 786 | |||||||||||||||||||
273 | 1,055 | 2,372 | 1,995 | — | 5,695 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,701 | 181 | 183 | — | 27,590 | |||||||||||||||||||
Intercompany balances | 26,107 | (10,513 | ) | (19,428 | ) | 3,834 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 949 | — | 949 | |||||||||||||||||||
Income taxes and other liabilities | 490 | 296 | 521 | 218 | — | 1,525 | |||||||||||||||||||
29,395 | 15,539 | (16,354 | ) | 7,179 | — | 35,759 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (8,270 | ) | (15,332 | ) | 29,185 | 6,503 | (20,356 | ) | (8,270 | ) | |||||||||||||||
Noncontrolling interests | — | — | 99 | 1,243 | — | 1,342 | |||||||||||||||||||
(8,270 | ) | (15,332 | ) | 29,284 | 7,746 | (20,356 | ) | (6,928 | ) | ||||||||||||||||
$ | 21,125 | $ | 207 | $ | 12,930 | $ | 14,925 | $ | (20,356 | ) | $ | 28,831 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 | |||||||||||||||||||||||||
(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) | $ | 1,399 | $ | (1,204 | ) | $ | 1,880 | $ | 1,116 | $ | (1,494 | ) | $ | 1,697 | |||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||||||||||||||||||||
Changes in operating assets and liabilities | 18 | (151 | ) | (1,660 | ) | (1,152 | ) | — | (2,945 | ) | |||||||||||||||
Provision for doubtful accounts | — | — | 1,388 | 949 | — | 2,337 | |||||||||||||||||||
Depreciation and amortization | — | — | 667 | 694 | — | 1,361 | |||||||||||||||||||
Income taxes | (61 | ) | — | — | — | — | (61 | ) | |||||||||||||||||
Gains on sales of facilities | — | — | (16 | ) | (4 | ) | — | (20 | ) | ||||||||||||||||
Losses on retirement of debt | — | 226 | — | — | — | 226 | |||||||||||||||||||
Legal claim costs | — | 78 | — | — | — | 78 | |||||||||||||||||||
Amortization of deferred loan costs | 2 | 31 | — | — | — | 33 | |||||||||||||||||||
Share-based compensation | 118 | — | — | — | — | 118 | |||||||||||||||||||
Equity in earnings of affiliates | (1,494 | ) | — | — | — | 1,494 | — | ||||||||||||||||||
Other | — | 3 | — | (6 | ) | — | (3 | ) | |||||||||||||||||
Net cash (used in) provided by operating activities | (18 | ) | (1,017 | ) | 2,259 | 1,597 | — | 2,821 | |||||||||||||||||
Cash flows from investing activities: | |||||||||||||||||||||||||
Purchase of property and equipment | — | — | (893 | ) | (589 | ) | — | (1,482 | ) | ||||||||||||||||
Acquisition of hospitals and health care entities | — | — | (7 | ) | (90 | ) | — | (97 | ) | ||||||||||||||||
Disposition of hospitals and health care entities | — | — | 31 | 7 | — | 38 | |||||||||||||||||||
Change in investments | — | — | 22 | — | — | 22 | |||||||||||||||||||
Other | — | — | — | 7 | — | 7 | |||||||||||||||||||
Net cash used in investing activities | — | — | (847 | ) | (665 | ) | — | (1,512 | ) | ||||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||||||||
Issuance of long-term debt | — | 3,502 | — | — | — | 3,502 | |||||||||||||||||||
Net change in revolving credit facilities | — | (160 | ) | — | — | — | (160 | ) | |||||||||||||||||
Repayment of long-term debt | — | (3,462 | ) | (35 | ) | (28 | ) | — | (3,525 | ) | |||||||||||||||
Distributions to noncontrolling interests | — | — | (45 | ) | (280 | ) | — | (325 | ) | ||||||||||||||||
Payment of debt issuance costs | — | (49 | ) | — | — | — | (49 | ) | |||||||||||||||||
Repurchase of common stock | (750 | ) | — | — | — | — | (750 | ) | |||||||||||||||||
Distributions to stockholders | (7 | ) | — | — | — | — | (7 | ) | |||||||||||||||||
Changes in intercompany balances with affiliates, net | 654 | 1,186 | (1,331 | ) | (509 | ) | — | — | |||||||||||||||||
Income tax benefits | 119 | — | — | — | — | 119 | |||||||||||||||||||
Other | 2 | — | — | (15 | ) | — | (13 | ) | |||||||||||||||||
Net cash provided by (used in) financing activities | 18 | 1,017 | (1,411 | ) | (832 | ) | — | (1,208 | ) | ||||||||||||||||
Change in cash and cash equivalents | — | — | 1 | 100 | — | 101 | |||||||||||||||||||
Cash and cash equivalents at beginning of period | — | — | 112 | 302 | — | 414 | |||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 113 | $ | 402 | $ | — | $ | 515 | |||||||||||||
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 | ||||||||||||||||||
Losses 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 |
Basis_of_Presentation_and_Sign1
Basis of Presentation and Significant Accounting Policies (Policies) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
Accounting Policies [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 $71 million and $76 million for the quarters ended September 30, 2014 and 2013, respectively, and $206 million and $207 million for the nine months ended September 30, 2014 and 2013, respectively. Operating results for the quarter and the nine months ended September 30, 2014 are not necessarily indicative of the results that may be expected for the year ending December 31, 2014. 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, 2013. | |||||||||||||||||
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 (includes the health insurance exchanges, beginning with the first quarter of 2014), 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, 2014 and 2013 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | |||||||||||||||||
2014 | Ratio | 2013 | Ratio | ||||||||||||||
Medicare | $ | 2,120 | 23 | % | $ | 1,847 | 21.8 | % | |||||||||
Managed Medicare | 901 | 9.8 | 794 | 9.4 | |||||||||||||
Medicaid | 372 | 4 | 401 | 4.7 | |||||||||||||
Managed Medicaid | 510 | 5.5 | 386 | 4.6 | |||||||||||||
Managed care and other insurers | 5,073 | 55 | 4,636 | 54.8 | |||||||||||||
International (managed care and other insurers) | 323 | 3.5 | 287 | 3.4 | |||||||||||||
9,299 | 100.8 | 8,351 | 98.7 | ||||||||||||||
Uninsured | 313 | 3.4 | 717 | 8.5 | |||||||||||||
Other | 366 | 4 | 343 | 4.1 | |||||||||||||
Revenues before provision for doubtful accounts | 9,978 | 108.2 | 9,411 | 111.3 | |||||||||||||
Provision for doubtful accounts | (758 | ) | (8.2 | ) | (955 | ) | (11.3 | ) | |||||||||
Revenues | $ | 9,220 | 100 | % | $ | 8,456 | 100 | % | |||||||||
Nine Months | |||||||||||||||||
2014 | Ratio | 2013 | Ratio | ||||||||||||||
Medicare | $ | 6,285 | 23 | % | $ | 5,961 | 23.5 | % | |||||||||
Managed Medicare | 2,706 | 9.9 | 2,441 | 9.6 | |||||||||||||
Medicaid | 1,404 | 5.1 | 1,098 | 4.3 | |||||||||||||
Managed Medicaid | 1,383 | 5.1 | 1,165 | 4.6 | |||||||||||||
Managed care and other insurers | 14,742 | 54 | 13,777 | 54.4 | |||||||||||||
International (managed care and other insurers) | 983 | 3.6 | 868 | 3.4 | |||||||||||||
27,503 | 100.7 | 25,310 | 99.8 | ||||||||||||||
Uninsured | 1,019 | 3.7 | 1,809 | 7.1 | |||||||||||||
Other | 1,097 | 4 | 959 | 3.8 | |||||||||||||
Revenues before provision for doubtful accounts | 29,619 | 108.4 | 28,078 | 110.7 | |||||||||||||
Provision for doubtful accounts | (2,337 | ) | (8.4 | ) | (2,732 | ) | (10.7 | ) | |||||||||
Revenues | $ | 27,282 | 100 | % | $ | 25,346 | 100 | % | |||||||||
During the quarter ended September 30, 2014, we recorded two changes in estimates which had the net effect of increasing revenues $26 million. We recorded $94 million, or $0.13 per diluted share, of Medicare revenues as the estimated settlement amount for certain claims denied by Recovery Audit Contractors (“RAC”) entities conducting reviews on behalf of the Centers for Medicare and Medicaid Services (“CMS”) and currently in the pending appeals process. CMS is offering an administrative agreement to providers willing to withdraw their pending appeals in exchange for a timely partial payment (generally, 68% of the claim amount, subject to certain adjustments). We also recorded a reduction of $68 million, or $0.09 per diluted share, to Medicaid revenues related to the Texas Medicaid Waiver Program. On October 1, 2014, the Texas Health and Human Services Commission (“THHSC”) issued a notice to hospitals participating in the Texas Medicaid Waiver Program. According to the notice, a review conducted by CMS identified certain local government/hospital affiliations it believes may be inconsistent with the waiver. As a result of these findings, CMS notified THHSC that it is deferring the federal portion of the Medicaid payments associated with these affiliations while it completes its review. | |||||||||||||||||
Recent Pronouncements | ' | ||||||||||||||||
Recent Pronouncements | |||||||||||||||||
In May 2014, the Financial Accounting Standards Board and the International Accounting Standards Board issued a final, converged, principles-based standard on revenue recognition. Companies across all industries will use a five-step model to recognize revenue from customer contracts. The new standard, which replaces nearly all existing United States Generally Accepted Accounting Principles (“US GAAP”) and International Financial Reporting Standards revenue recognition guidance, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The standard is effective for public entities for annual and interim periods beginning after December 15, 2016. Early adoption is not permitted under US GAAP. We are evaluating the effects the adoption of this standard will have on our financial statements and financial disclosures. | |||||||||||||||||
Earning 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. | |||||||||||||||||
Interest Rate Swap Agreements | ' | ||||||||||||||||
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 for the interest rate swap agreements which have been designated as cash flow hedges. 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. | |||||||||||||||||
Fair Value Measurements and Disclosures | ' | ||||||||||||||||
Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“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 swap agreements to manage our exposure to fluctuations in interest rates. 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 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, 2014 and December 31, 2013, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. |
Basis_of_Presentation_and_Sign2
Basis of Presentation and Significant Accounting Policies (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
Accounting Policies [Abstract] | ' | ||||||||||||||||
Schedule of Revenues from Third Party Payers and Uninsured | ' | ||||||||||||||||
Our revenues from third-party payers and the uninsured for the quarters and nine months ended September 30, 2014 and 2013 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | |||||||||||||||||
2014 | Ratio | 2013 | Ratio | ||||||||||||||
Medicare | $ | 2,120 | 23 | % | $ | 1,847 | 21.8 | % | |||||||||
Managed Medicare | 901 | 9.8 | 794 | 9.4 | |||||||||||||
Medicaid | 372 | 4 | 401 | 4.7 | |||||||||||||
Managed Medicaid | 510 | 5.5 | 386 | 4.6 | |||||||||||||
Managed care and other insurers | 5,073 | 55 | 4,636 | 54.8 | |||||||||||||
International (managed care and other insurers) | 323 | 3.5 | 287 | 3.4 | |||||||||||||
9,299 | 100.8 | 8,351 | 98.7 | ||||||||||||||
Uninsured | 313 | 3.4 | 717 | 8.5 | |||||||||||||
Other | 366 | 4 | 343 | 4.1 | |||||||||||||
Revenues before provision for doubtful accounts | 9,978 | 108.2 | 9,411 | 111.3 | |||||||||||||
Provision for doubtful accounts | (758 | ) | (8.2 | ) | (955 | ) | (11.3 | ) | |||||||||
Revenues | $ | 9,220 | 100 | % | $ | 8,456 | 100 | % | |||||||||
Nine Months | |||||||||||||||||
2014 | Ratio | 2013 | Ratio | ||||||||||||||
Medicare | $ | 6,285 | 23 | % | $ | 5,961 | 23.5 | % | |||||||||
Managed Medicare | 2,706 | 9.9 | 2,441 | 9.6 | |||||||||||||
Medicaid | 1,404 | 5.1 | 1,098 | 4.3 | |||||||||||||
Managed Medicaid | 1,383 | 5.1 | 1,165 | 4.6 | |||||||||||||
Managed care and other insurers | 14,742 | 54 | 13,777 | 54.4 | |||||||||||||
International (managed care and other insurers) | 983 | 3.6 | 868 | 3.4 | |||||||||||||
27,503 | 100.7 | 25,310 | 99.8 | ||||||||||||||
Uninsured | 1,019 | 3.7 | 1,809 | 7.1 | |||||||||||||
Other | 1,097 | 4 | 959 | 3.8 | |||||||||||||
Revenues before provision for doubtful accounts | 29,619 | 108.4 | 28,078 | 110.7 | |||||||||||||
Provision for doubtful accounts | (2,337 | ) | (8.4 | ) | (2,732 | ) | (10.7 | ) | |||||||||
Revenues | $ | 27,282 | 100 | % | $ | 25,346 | 100 | % | |||||||||
Earnings_Per_Share_Tables
Earnings Per Share (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
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, 2014 and 2013 (dollars in millions, except per share amounts, and shares in thousands): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2014 | 2013 | 2014 | 2013 | ||||||||||||||
Net income attributable to HCA Holdings, Inc. | $ | 518 | $ | 365 | $ | 1,348 | $ | 1,132 | |||||||||
Weighted average common shares outstanding | 432,617 | 447,329 | 437,832 | 446,125 | |||||||||||||
Effect of dilutive incremental shares | 14,643 | 16,240 | 14,706 | 16,926 | |||||||||||||
Shares used for diluted earnings per share | 447,260 | 463,569 | 452,538 | 463,051 | |||||||||||||
Earnings per share: | |||||||||||||||||
Basic earnings per share | $ | 1.2 | $ | 0.82 | $ | 3.08 | $ | 2.54 | |||||||||
Diluted earnings per share | $ | 1.16 | $ | 0.79 | $ | 2.98 | $ | 2.44 |
Investments_of_Insurance_Subsi1
Investments of Insurance Subsidiaries (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
Investments, Debt and Equity Securities [Abstract] | ' | ||||||||||||||||
Schedule of Investments | ' | ||||||||||||||||
A summary of our insurance subsidiaries’ investments at September 30, 2014 and December 31, 2013 follows (dollars in millions): | |||||||||||||||||
September 30, 2014 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 449 | $ | 19 | $ | (1 | ) | $ | 467 | ||||||||
Money market funds | 37 | — | — | 37 | |||||||||||||
486 | 19 | (1 | ) | 504 | |||||||||||||
Equity securities | 1 | 2 | — | 3 | |||||||||||||
$ | 487 | $ | 21 | $ | (1 | ) | 507 | ||||||||||
Amounts classified as current assets | (66 | ) | |||||||||||||||
Investment carrying value | $ | 441 | |||||||||||||||
December 31, 2013 | |||||||||||||||||
Amortized | Unrealized | Fair | |||||||||||||||
Cost | Amounts | Value | |||||||||||||||
Gains | Losses | ||||||||||||||||
Debt securities: | |||||||||||||||||
States and municipalities | $ | 404 | $ | 11 | $ | (3 | ) | $ | 412 | ||||||||
Money market funds | 94 | — | — | 94 | |||||||||||||
498 | 11 | (3 | ) | 506 | |||||||||||||
Equity securities | 2 | 2 | — | 4 | |||||||||||||
$ | 500 | $ | 13 | $ | (3 | ) | 510 | ||||||||||
Amounts classified as current assets | (62 | ) | |||||||||||||||
Investment carrying value | $ | 448 | |||||||||||||||
Schedule of Maturities of Investments | ' | ||||||||||||||||
Scheduled maturities of investments in debt securities at September 30, 2014 were as follows (dollars in millions): | |||||||||||||||||
Amortized | Fair | ||||||||||||||||
Cost | Value | ||||||||||||||||
Due in one year or less | $ | 59 | $ | 60 | |||||||||||||
Due after one year through five years | 207 | 212 | |||||||||||||||
Due after five years through ten years | 97 | 104 | |||||||||||||||
Due after ten years | 123 | 128 | |||||||||||||||
$ | 486 | $ | 504 | ||||||||||||||
Financial_Instruments_Tables
Financial Instruments (Tables) | 9 Months Ended | ||||||||||||
Sep. 30, 2014 | |||||||||||||
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, 2014 (dollars in millions): | |||||||||||||
Notional | Maturity Date | Fair | |||||||||||
Amount | |||||||||||||
Value | |||||||||||||
Pay-fixed interest rate swaps | $ | 500 | December 2014 | $ | (1 | ) | |||||||
Pay-fixed interest rate swaps | 3,000 | December 2016 | (183 | ) | |||||||||
Pay-fixed interest rate swaps | 1,000 | December 2017 | (33 | ) | |||||||||
Effect of Interest Rate on Results of Operations | ' | ||||||||||||
The following table presents the effect of our interest rate swaps on our results of operations for the nine months ended September 30, 2014 (dollars in millions): | |||||||||||||
Derivatives in Cash Flow Hedging Relationships | Amount of Loss | 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 | $ | 13 | Interest expense | $ | 99 |
Assets_and_Liabilities_Measure1
Assets and Liabilities Measured at Fair Value (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
Fair Value Disclosures [Abstract] | ' | ||||||||||||||||
Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis | ' | ||||||||||||||||
The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of September 30, 2014 and December 31, 2013, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): | |||||||||||||||||
September 30, 2014 | |||||||||||||||||
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 | $ | 467 | $ | — | $ | 461 | $ | 6 | |||||||||
Money market funds | 37 | 37 | — | — | |||||||||||||
504 | 37 | 461 | 6 | ||||||||||||||
Equity securities | 3 | 3 | — | — | |||||||||||||
Investments of insurance subsidiaries | 507 | 40 | 461 | 6 | |||||||||||||
Less amounts classified as current assets | (66 | ) | (37 | ) | (29 | ) | — | ||||||||||
$ | 441 | $ | 3 | $ | 432 | $ | 6 | ||||||||||
Liabilities: | |||||||||||||||||
Interest rate swaps (Income taxes and other liabilities) | $ | 217 | $ | — | $ | 217 | $ | — | |||||||||
December 31, 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 | $ | 412 | $ | — | $ | 405 | $ | 7 | |||||||||
Money market funds | 94 | 94 | — | — | |||||||||||||
506 | 94 | 405 | 7 | ||||||||||||||
Equity securities | 4 | 3 | — | 1 | |||||||||||||
Investments of insurance subsidiaries | 510 | 97 | 405 | 8 | |||||||||||||
Less amounts classified as current assets | (62 | ) | (62 | ) | — | — | |||||||||||
$ | 448 | $ | 35 | $ | 405 | $ | 8 | ||||||||||
Liabilities: | |||||||||||||||||
Interest rate swaps (Income taxes and other liabilities) | $ | 295 | $ | — | $ | 295 | $ | — | |||||||||
Schedule Related to Investments of Insurance Subsidiaries at Fair Value | ' | ||||||||||||||||
The following table summarizes the activity related to the investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the nine months ended September 30, 2014 (dollars in millions): | |||||||||||||||||
Asset balances at December 31, 2013 | $ | 8 | |||||||||||||||
Settlements | (2 | ) | |||||||||||||||
Asset balances at September 30, 2014 | $ | 6 | |||||||||||||||
LongTerm_Debt_Tables
Long-Term Debt (Tables) | 9 Months Ended | ||||||||
Sep. 30, 2014 | |||||||||
Debt Disclosure [Abstract] | ' | ||||||||
Schedule of Long-Term Debt | ' | ||||||||
A summary of long-term debt at September 30, 2014 and December 31, 2013, including related interest rates at September 30, 2014, follows (dollars in millions): | |||||||||
September 30, | December 31, | ||||||||
2014 | 2013 | ||||||||
Senior secured asset-based revolving credit facility (effective interest rate of 1.7%) | $ | 2,280 | $ | 2,440 | |||||
Senior secured revolving credit facility | — | — | |||||||
Senior secured term loan facilities (effective interest rate of 5.3%) | 5,538 | 5,598 | |||||||
Senior secured first lien notes (effective interest rate of 5.8%) | 10,492 | 9,695 | |||||||
Other senior secured debt (effective interest rate of 6.6%) | 464 | 448 | |||||||
First lien debt | 18,774 | 18,181 | |||||||
Senior unsecured notes (effective interest rate of 7.2%) | 9,696 | 10,195 | |||||||
Total debt (average life of 6.2 years, rates averaging 5.9%) | 28,470 | 28,376 | |||||||
Less amounts due within one year | 1,044 | 786 | |||||||
$ | 27,426 | $ | 27,590 | ||||||
Capital_Structure_Tables
Capital Structure (Tables) | 9 Months Ended | ||||||||||||||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||
Noncontrolling | |||||||||||||||||||||||||||||
Common Stock | Capital in | Accumulated | Retained | ||||||||||||||||||||||||||
Interests | |||||||||||||||||||||||||||||
Excess of | Other | Deficit | |||||||||||||||||||||||||||
Par | Comprehensive | ||||||||||||||||||||||||||||
Shares | Par Value | Value | Loss | ||||||||||||||||||||||||||
0 | |||||||||||||||||||||||||||||
Balances at December 31, 2013 | 439,604 | $ | 4 | $ | 1,386 | $ | (257 | ) | $ | (9,403 | ) | $ | 1,342 | $ | (6,928 | ) | |||||||||||||
Net income | — | — | — | — | 1,348 | 349 | 1,697 | ||||||||||||||||||||||
Repurchase of common stock | (14,555 | ) | — | (750 | ) | — | — | — | (750 | ) | |||||||||||||||||||
Other comprehensive income | — | — | — | 51 | — | — | 51 | ||||||||||||||||||||||
Distributions | — | — | — | — | — | (325 | ) | (325 | ) | ||||||||||||||||||||
Share-based benefit plans | 8,330 | — | 242 | — | — | — | 242 | ||||||||||||||||||||||
Other | — | — | (6 | ) | — | 1 | — | (5 | ) | ||||||||||||||||||||
Balances at September 30, 2014 | 433,379 | $ | 4 | $ | 872 | $ | (206 | ) | $ | (8,054 | ) | $ | 1,366 | $ | (6,018 | ) | |||||||||||||
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, 2013 | $ | 7 | $ | 11 | $ | (88 | ) | $ | (187 | ) | $ | (257 | ) | ||||||||||||||||
Unrealized gains on available-for-sale securities, net of $4 of income taxes | 6 | — | — | — | 6 | ||||||||||||||||||||||||
Foreign currency translation adjustments, net of $6 income tax benefits | — | (12 | ) | — | — | (12 | ) | ||||||||||||||||||||||
Change in fair value of derivative instruments, net of $8 income tax benefits | — | — | — | (13 | ) | (13 | ) | ||||||||||||||||||||||
Expense reclassified into operations from other comprehensive income, net of $4 and $36, respectively, income tax benefits | — | — | 7 | 63 | 70 | ||||||||||||||||||||||||
Balances at September 30, 2014 | $ | 13 | $ | (1 | ) | $ | (81 | ) | $ | (137 | ) | $ | (206 | ) | |||||||||||||||
Segment_and_Geographic_Informa1
Segment and Geographic Information (Tables) | 9 Months Ended | ||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||
Segment Reporting [Abstract] | ' | ||||||||||||||||
Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA and Depreciation and Amortization | ' | ||||||||||||||||
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, 2014 and 2013 are summarized in the following table (dollars in millions): | |||||||||||||||||
Quarter | Nine Months | ||||||||||||||||
2014 | 2013 | 2014 | 2013 | ||||||||||||||
Revenues: | |||||||||||||||||
National Group | $ | 4,387 | $ | 3,930 | $ | 12,814 | $ | 11,875 | |||||||||
American Group | 4,319 | 4,082 | 12,918 | 12,181 | |||||||||||||
Corporate and other | 514 | 444 | 1,550 | 1,290 | |||||||||||||
$ | 9,220 | $ | 8,456 | $ | 27,282 | $ | 25,346 | ||||||||||
Equity in earnings of affiliates: | |||||||||||||||||
National Group | $ | (6 | ) | $ | (3 | ) | $ | (12 | ) | $ | (8 | ) | |||||
American Group | (8 | ) | (6 | ) | (23 | ) | (19 | ) | |||||||||
Corporate and other | — | — | 3 | (2 | ) | ||||||||||||
$ | (14 | ) | $ | (9 | ) | $ | (32 | ) | $ | (29 | ) | ||||||
Adjusted segment EBITDA: | |||||||||||||||||
National Group | $ | 1,008 | $ | 805 | $ | 2,810 | $ | 2,440 | |||||||||
American Group | 927 | 910 | 2,911 | 2,654 | |||||||||||||
Corporate and other | (107 | ) | (112 | ) | (249 | ) | (234 | ) | |||||||||
$ | 1,828 | $ | 1,603 | $ | 5,472 | $ | 4,860 | ||||||||||
Depreciation and amortization: | |||||||||||||||||
National Group | $ | 187 | $ | 181 | $ | 564 | $ | 532 | |||||||||
American Group | 210 | 206 | 626 | 610 | |||||||||||||
Corporate and other | 63 | 56 | 171 | 150 | |||||||||||||
$ | 460 | $ | 443 | $ | 1,361 | $ | 1,292 | ||||||||||
Adjusted segment EBITDA | $ | 1,828 | $ | 1,603 | $ | 5,472 | $ | 4,860 | |||||||||
Depreciation and amortization | 460 | 443 | 1,361 | 1,292 | |||||||||||||
Interest expense | 427 | 458 | 1,314 | 1,392 | |||||||||||||
Losses (gains) on sales of facilities | 12 | 1 | (20 | ) | 13 | ||||||||||||
Losses on retirement of debt | — | — | 226 | 17 | |||||||||||||
Legal claim costs | — | — | 78 | — | |||||||||||||
Income before income taxes | $ | 929 | $ | 701 | $ | 2,513 | $ | 2,146 | |||||||||
Supplemental_Condensed_Consoli1
Supplemental Condensed Consolidating Financial Information (Tables) | 9 Months Ended | ||||||||||||||||||||||||
Sep. 30, 2014 | |||||||||||||||||||||||||
Text Block [Abstract] | ' | ||||||||||||||||||||||||
Schedule of Condensed Consolidating Comprehensive Income Statement | ' | ||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT | |||||||||||||||||||||||||
FOR THE QUARTER ENDED SEPTEMBER 30, 2014 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 5,133 | $ | 4,845 | $ | — | $ | 9,978 | |||||||||||||
Provision for doubtful accounts | — | — | 457 | 301 | — | 758 | |||||||||||||||||||
Revenues | — | — | 4,676 | 4,544 | — | 9,220 | |||||||||||||||||||
Salaries and benefits | — | — | 2,176 | 2,035 | — | 4,211 | |||||||||||||||||||
Supplies | — | — | 797 | 742 | — | 1,539 | |||||||||||||||||||
Other operating expenses | 4 | — | 804 | 880 | — | 1,688 | |||||||||||||||||||
Electronic health record incentive income | — | — | (22 | ) | (10 | ) | — | (32 | ) | ||||||||||||||||
Equity in earnings of affiliates | (542 | ) | — | (3 | ) | (11 | ) | 542 | (14 | ) | |||||||||||||||
Depreciation and amortization | — | — | 225 | 235 | — | 460 | |||||||||||||||||||
Interest expense | 46 | 536 | (115 | ) | (40 | ) | — | 427 | |||||||||||||||||
Losses (gains) on sales of facilities | — | — | 16 | (4 | ) | — | 12 | ||||||||||||||||||
Management fees | — | — | (178 | ) | 178 | — | — | ||||||||||||||||||
(492 | ) | 536 | 3,700 | 4,005 | 542 | 8,291 | |||||||||||||||||||
Income (loss) before income taxes | 492 | (536 | ) | 976 | 539 | (542 | ) | 929 | |||||||||||||||||
Provision (benefit) for income taxes | (19 | ) | (205 | ) | 365 | 177 | — | 318 | |||||||||||||||||
Net income (loss) | 511 | (331 | ) | 611 | 362 | (542 | ) | 611 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 18 | 75 | — | 93 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 511 | $ | (331 | ) | $ | 593 | $ | 287 | $ | (542 | ) | $ | 518 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 511 | $ | (303 | ) | $ | 595 | $ | 250 | $ | (542 | ) | $ | 511 | |||||||||||
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 NINE MONTHS ENDED SEPTEMBER 30, 2014 | |||||||||||||||||||||||||
(Dollars in millions) | |||||||||||||||||||||||||
HCA | HCA Inc. | Subsidiary | Subsidiary | Eliminations | Condensed | ||||||||||||||||||||
Holdings, Inc. | Issuer | Guarantors | Non- | Consolidated | |||||||||||||||||||||
Issuer | Guarantors | ||||||||||||||||||||||||
Revenues before provision for doubtful accounts | $ | — | $ | — | $ | 15,242 | $ | 14,377 | $ | — | $ | 29,619 | |||||||||||||
Provision for doubtful accounts | — | — | 1,388 | 949 | — | 2,337 | |||||||||||||||||||
Revenues | — | — | 13,854 | 13,428 | — | 27,282 | |||||||||||||||||||
Salaries and benefits | — | — | 6,393 | 5,966 | — | 12,359 | |||||||||||||||||||
Supplies | — | — | 2,416 | 2,187 | — | 4,603 | |||||||||||||||||||
Other operating expenses | 14 | — | 2,366 | 2,597 | — | 4,977 | |||||||||||||||||||
Electronic health record incentive income | — | — | (68 | ) | (29 | ) | — | (97 | ) | ||||||||||||||||
Equity in earnings of affiliates | (1,494 | ) | — | (5 | ) | (27 | ) | 1,494 | (32 | ) | |||||||||||||||
Depreciation and amortization | — | — | 667 | 694 | — | 1,361 | |||||||||||||||||||
Interest expense | 138 | 1,629 | (349 | ) | (104 | ) | — | 1,314 | |||||||||||||||||
Gains on sales of facilities | — | — | (16 | ) | (4 | ) | — | (20 | ) | ||||||||||||||||
Losses on retirement of debt | — | 226 | — | — | — | 226 | |||||||||||||||||||
Legal claim costs | — | 78 | — | — | — | 78 | |||||||||||||||||||
Management fees | — | — | (528 | ) | 528 | — | — | ||||||||||||||||||
(1,342 | ) | 1,933 | 10,876 | 11,808 | 1,494 | 24,769 | |||||||||||||||||||
Income (loss) before income taxes | 1,342 | (1,933 | ) | 2,978 | 1,620 | (1,494 | ) | 2,513 | |||||||||||||||||
Provision (benefit) for income taxes | (57 | ) | (729 | ) | 1,098 | 504 | — | 816 | |||||||||||||||||
Net income (loss) | 1,399 | (1,204 | ) | 1,880 | 1,116 | (1,494 | ) | 1,697 | |||||||||||||||||
Net income attributable to noncontrolling interests | — | — | 65 | 284 | — | 349 | |||||||||||||||||||
Net income (loss) attributable to HCA Holdings, Inc. | $ | 1,399 | $ | (1,204 | ) | $ | 1,815 | $ | 832 | $ | (1,494 | ) | $ | 1,348 | |||||||||||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ | 1,399 | $ | (1,154 | ) | $ | 1,822 | $ | 826 | $ | (1,494 | ) | $ | 1,399 | |||||||||||
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 | ||||||||||||||||||
Losses 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 | |||||||||||
Schedule of Condensed Consolidating Balance Sheet | ' | ||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
30-Sep-14 | |||||||||||||||||||||||||
(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 | $ | — | $ | — | $ | 113 | $ | 402 | $ | — | $ | 515 | |||||||||||||
Accounts receivable, net | — | — | 2,671 | 2,853 | — | 5,524 | |||||||||||||||||||
Inventories | — | — | 748 | 510 | — | 1,258 | |||||||||||||||||||
Deferred income taxes | 320 | — | — | — | — | 320 | |||||||||||||||||||
Other | — | — | 369 | 541 | — | 910 | |||||||||||||||||||
320 | — | 3,901 | 4,306 | — | 8,527 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,762 | 6,116 | — | 13,878 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 441 | — | 441 | |||||||||||||||||||
Investments in and advances to affiliates | 21,850 | — | 16 | 151 | (21,850 | ) | 167 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,698 | 4,201 | — | 5,899 | |||||||||||||||||||
Deferred loan costs | 27 | 194 | — | — | — | 221 | |||||||||||||||||||
Other | 476 | — | 21 | 195 | — | 692 | |||||||||||||||||||
$ | 22,673 | $ | 194 | $ | 13,398 | $ | 15,410 | $ | (21,850 | ) | $ | 29,825 | |||||||||||||
LIABILITIES AND | |||||||||||||||||||||||||
STOCKHOLDERS’ (DEFICIT) | |||||||||||||||||||||||||
EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | 3 | $ | — | $ | 1,132 | $ | 652 | $ | — | $ | 1,787 | |||||||||||||
Accrued salaries | — | — | 721 | 517 | — | 1,238 | |||||||||||||||||||
Other accrued expenses | 69 | 197 | 458 | 839 | — | 1,563 | |||||||||||||||||||
Long-term debt due within one year | — | 952 | 51 | 41 | — | 1,044 | |||||||||||||||||||
72 | 1,149 | 2,362 | 2,049 | — | 5,632 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,528 | 187 | 186 | — | 27,426 | |||||||||||||||||||
Intercompany balances | 26,932 | (9,497 | ) | (20,763 | ) | 3,328 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 1,045 | — | 1,045 | |||||||||||||||||||
Income taxes and other liabilities | 528 | 500 | 486 | 226 | — | 1,740 | |||||||||||||||||||
30,057 | 16,680 | (17,728 | ) | 6,834 | — | 35,843 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (7,384 | ) | (16,486 | ) | 31,007 | 7,329 | (21,850 | ) | (7,384 | ) | |||||||||||||||
Noncontrolling interests | — | — | 119 | 1,247 | — | 1,366 | |||||||||||||||||||
(7,384 | ) | (16,486 | ) | 31,126 | 8,576 | (21,850 | ) | (6,018 | ) | ||||||||||||||||
$ | 22,673 | $ | 194 | $ | 13,398 | $ | 15,410 | $ | (21,850 | ) | $ | 29,825 | |||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING BALANCE SHEET | |||||||||||||||||||||||||
31-Dec-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 | $ | — | $ | — | $ | 112 | $ | 302 | $ | — | $ | 414 | |||||||||||||
Accounts receivable, net | — | — | 2,565 | 2,643 | — | 5,208 | |||||||||||||||||||
Inventories | — | — | 692 | 487 | — | 1,179 | |||||||||||||||||||
Deferred income taxes | 489 | — | — | — | — | 489 | |||||||||||||||||||
Other | — | — | 301 | 446 | — | 747 | |||||||||||||||||||
489 | — | 3,670 | 3,878 | — | 8,037 | ||||||||||||||||||||
Property and equipment, net | — | — | 7,504 | 6,115 | — | 13,619 | |||||||||||||||||||
Investments of insurance subsidiaries | — | — | — | 448 | — | 448 | |||||||||||||||||||
Investments in and advances to affiliates | 20,356 | — | 13 | 108 | (20,356 | ) | 121 | ||||||||||||||||||
Goodwill and other intangible assets | — | — | 1,695 | 4,208 | — | 5,903 | |||||||||||||||||||
Deferred loan costs | 30 | 207 | — | — | — | 237 | |||||||||||||||||||
Other | 250 | — | 48 | 168 | — | 466 | |||||||||||||||||||
$ | 21,125 | $ | 207 | $ | 12,930 | $ | 14,925 | $ | (20,356 | ) | $ | 28,831 | |||||||||||||
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY | |||||||||||||||||||||||||
Current liabilities: | |||||||||||||||||||||||||
Accounts payable | $ | 1 | $ | — | $ | 1,169 | $ | 633 | $ | — | $ | 1,803 | |||||||||||||
Accrued salaries | — | — | 694 | 499 | — | 1,193 | |||||||||||||||||||
Other accrued expenses | 272 | 353 | 464 | 824 | — | 1,913 | |||||||||||||||||||
Long-term debt due within one year | — | 702 | 45 | 39 | — | 786 | |||||||||||||||||||
273 | 1,055 | 2,372 | 1,995 | — | 5,695 | ||||||||||||||||||||
Long-term debt | 2,525 | 24,701 | 181 | 183 | — | 27,590 | |||||||||||||||||||
Intercompany balances | 26,107 | (10,513 | ) | (19,428 | ) | 3,834 | — | — | |||||||||||||||||
Professional liability risks | — | — | — | 949 | — | 949 | |||||||||||||||||||
Income taxes and other liabilities | 490 | 296 | 521 | 218 | — | 1,525 | |||||||||||||||||||
29,395 | 15,539 | (16,354 | ) | 7,179 | — | 35,759 | |||||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. | (8,270 | ) | (15,332 | ) | 29,185 | 6,503 | (20,356 | ) | (8,270 | ) | |||||||||||||||
Noncontrolling interests | — | — | 99 | 1,243 | — | 1,342 | |||||||||||||||||||
(8,270 | ) | (15,332 | ) | 29,284 | 7,746 | (20,356 | ) | (6,928 | ) | ||||||||||||||||
$ | 21,125 | $ | 207 | $ | 12,930 | $ | 14,925 | $ | (20,356 | ) | $ | 28,831 | |||||||||||||
Schedule of Condensed Consolidating Statement of Cash Flows | ' | ||||||||||||||||||||||||
HCA HOLDINGS, INC. | |||||||||||||||||||||||||
CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS | |||||||||||||||||||||||||
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 | |||||||||||||||||||||||||
(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) | $ | 1,399 | $ | (1,204 | ) | $ | 1,880 | $ | 1,116 | $ | (1,494 | ) | $ | 1,697 | |||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||||||||||||||||||||
Changes in operating assets and liabilities | 18 | (151 | ) | (1,660 | ) | (1,152 | ) | — | (2,945 | ) | |||||||||||||||
Provision for doubtful accounts | — | — | 1,388 | 949 | — | 2,337 | |||||||||||||||||||
Depreciation and amortization | — | — | 667 | 694 | — | 1,361 | |||||||||||||||||||
Income taxes | (61 | ) | — | — | — | — | (61 | ) | |||||||||||||||||
Gains on sales of facilities | — | — | (16 | ) | (4 | ) | — | (20 | ) | ||||||||||||||||
Losses on retirement of debt | — | 226 | — | — | — | 226 | |||||||||||||||||||
Legal claim costs | — | 78 | — | — | — | 78 | |||||||||||||||||||
Amortization of deferred loan costs | 2 | 31 | — | — | — | 33 | |||||||||||||||||||
Share-based compensation | 118 | — | — | — | — | 118 | |||||||||||||||||||
Equity in earnings of affiliates | (1,494 | ) | — | — | — | 1,494 | — | ||||||||||||||||||
Other | — | 3 | — | (6 | ) | — | (3 | ) | |||||||||||||||||
Net cash (used in) provided by operating activities | (18 | ) | (1,017 | ) | 2,259 | 1,597 | — | 2,821 | |||||||||||||||||
Cash flows from investing activities: | |||||||||||||||||||||||||
Purchase of property and equipment | — | — | (893 | ) | (589 | ) | — | (1,482 | ) | ||||||||||||||||
Acquisition of hospitals and health care entities | — | — | (7 | ) | (90 | ) | — | (97 | ) | ||||||||||||||||
Disposition of hospitals and health care entities | — | — | 31 | 7 | — | 38 | |||||||||||||||||||
Change in investments | — | — | 22 | — | — | 22 | |||||||||||||||||||
Other | — | — | — | 7 | — | 7 | |||||||||||||||||||
Net cash used in investing activities | — | — | (847 | ) | (665 | ) | — | (1,512 | ) | ||||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||||||||
Issuance of long-term debt | — | 3,502 | — | — | — | 3,502 | |||||||||||||||||||
Net change in revolving credit facilities | — | (160 | ) | — | — | — | (160 | ) | |||||||||||||||||
Repayment of long-term debt | — | (3,462 | ) | (35 | ) | (28 | ) | — | (3,525 | ) | |||||||||||||||
Distributions to noncontrolling interests | — | — | (45 | ) | (280 | ) | — | (325 | ) | ||||||||||||||||
Payment of debt issuance costs | — | (49 | ) | — | — | — | (49 | ) | |||||||||||||||||
Repurchase of common stock | (750 | ) | — | — | — | — | (750 | ) | |||||||||||||||||
Distributions to stockholders | (7 | ) | — | — | — | — | (7 | ) | |||||||||||||||||
Changes in intercompany balances with affiliates, net | 654 | 1,186 | (1,331 | ) | (509 | ) | — | — | |||||||||||||||||
Income tax benefits | 119 | — | — | — | — | 119 | |||||||||||||||||||
Other | 2 | — | — | (15 | ) | — | (13 | ) | |||||||||||||||||
Net cash provided by (used in) financing activities | 18 | 1,017 | (1,411 | ) | (832 | ) | — | (1,208 | ) | ||||||||||||||||
Change in cash and cash equivalents | — | — | 1 | 100 | — | 101 | |||||||||||||||||||
Cash and cash equivalents at beginning of period | — | — | 112 | 302 | — | 414 | |||||||||||||||||||
Cash and cash equivalents at end of period | $ | — | $ | — | $ | 113 | $ | 402 | $ | — | $ | 515 | |||||||||||||
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 | ||||||||||||||||||
Losses 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 | |||||||||||||
Basis_of_Presentation_and_Sign3
Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, except Per Share data, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 |
Hospital | Hospital | |||
Surgery_Center | Surgery_Center | |||
State | State | |||
Accounting Policies [Abstract] | ' | ' | ' | ' |
Number of owned and operated hospitals | 165 | ' | 165 | ' |
Number of freestanding surgery centers | 113 | ' | 113 | ' |
Number of facilities locations | 20 | ' | 20 | ' |
General and administrative expense | $71 | $76 | $206 | $207 |
Adjustments to Medicare revenues | 94 | ' | ' | ' |
Adjustment to Medicare revenues in diluted per share | $0.13 | ' | ' | ' |
Adjustments to Medicaid revenues | 68 | ' | ' | ' |
Adjustment to Medicaid revenues in diluted per share | $0.09 | ' | ' | ' |
Percentage of adjustment on claim amount | 68.00% | ' | ' | ' |
Revenue increase | $26 | ' | ' | ' |
Basis_of_Presentation_and_Sign4
Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers and Uninsured (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||
In Millions, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | $9,299 | $8,351 | $27,503 | $25,310 |
Uninsured | 313 | 717 | 1,019 | 1,809 |
Other | 366 | 343 | 1,097 | 959 |
Revenues before provision for doubtful accounts | 9,978 | 9,411 | 29,619 | 28,078 |
Provision for doubtful accounts | -758 | -955 | -2,337 | -2,732 |
Revenues | 9,220 | 8,456 | 27,282 | 25,346 |
Revenues from third party payers, Ratio | 100.80% | 98.70% | 100.70% | 99.80% |
Uninsured, Ratio | 3.40% | 8.50% | 3.70% | 7.10% |
Other, Ratio | 4.00% | 4.10% | 4.00% | 3.80% |
Revenues before provision for doubtful accounts, Ratio | 108.20% | 111.30% | 108.40% | 110.70% |
Revenues before provision for doubtful accounts, Ratio | 108.20% | 111.30% | 108.40% | 110.70% |
Provision for doubtful accounts, Ratio | -8.20% | -11.30% | -8.40% | -10.70% |
Revenues ratio from third party payers | 100.00% | 100.00% | 100.00% | 100.00% |
Medicare [Member] | ' | ' | ' | ' |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 2,120 | 1,847 | 6,285 | 5,961 |
Revenues from third party payers, Ratio | 23.00% | 21.80% | 23.00% | 23.50% |
Managed Medicare [Member] | ' | ' | ' | ' |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 901 | 794 | 2,706 | 2,441 |
Revenues from third party payers, Ratio | 9.80% | 9.40% | 9.90% | 9.60% |
Medicaid [Member] | ' | ' | ' | ' |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 372 | 401 | 1,404 | 1,098 |
Revenues from third party payers, Ratio | 4.00% | 4.70% | 5.10% | 4.30% |
Managed Medicaid [Member] | ' | ' | ' | ' |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 510 | 386 | 1,383 | 1,165 |
Revenues from third party payers, Ratio | 5.50% | 4.60% | 5.10% | 4.60% |
Managed Care and Other Insurers [Member] | ' | ' | ' | ' |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | 5,073 | 4,636 | 14,742 | 13,777 |
Revenues from third party payers, Ratio | 55.00% | 54.80% | 54.00% | 54.40% |
International (Managed Care and Other Insurers) [Member] | ' | ' | ' | ' |
Revenues From Third Party Payers [Line Items] | ' | ' | ' | ' |
Revenues from third party payers | $323 | $287 | $983 | $868 |
Revenues from third party payers, Ratio | 3.50% | 3.40% | 3.60% | 3.40% |
Acquisitions_and_Dispositions_
Acquisitions and Dispositions - Additional Information (Detail) (USD $) | 9 Months Ended | |
In Millions, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 |
Business Acquisition [Line Items] | ' | ' |
Proceeds from sale of business | $38 | $31 |
Real Estate and Other Investments [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Pretax gain (loss) on sales of business | 20 | ' |
Proceeds from sale of business | 38 | ' |
Hospitals [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Cash paid for acquisition | 14 | 146 |
Hospitals [Member] | Real Estate and Other Investments [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Pretax gain (loss) on sales of business | ' | 13 |
Proceeds from sale of business | ' | 31 |
Other Nonhospital Health Care [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Cash paid for acquisition | 83 | ' |
Outsource Group [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Cash paid for acquisition | ' | 317 |
Business acquisition, Goodwill | ' | 176 |
Business acquisition, Identifiable intangible assets | ' | $125 |
Income_Taxes_Additional_Inform
Income Taxes - Additional Information (Detail) (USD $) | 3 Months Ended | 9 Months Ended | |||
In Millions, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 | Dec. 31, 2013 |
Income Tax Disclosure [Abstract] | ' | ' | ' | ' | ' |
Liability for unrecognized tax benefits | $503 | ' | $503 | ' | $462 |
Unrecognized tax benefits, accrued interest | 43 | ' | 43 | ' | 30 |
Unrecognized tax benefits that would impact effective tax rate | 180 | ' | 180 | ' | 160 |
Interest expense related to taxing authority examinations | 3 | 7 | ' | ' | ' |
Reductions in interest expense related to taxing authority examinations | ' | ' | 11 | 8 | ' |
Interest expense related to taxing authority examinations, net of tax | 2 | 4 | ' | ' | ' |
Reductions in interest expense related to taxing authority examinations, net of tax | ' | ' | $7 | $5 | ' |
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, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 |
Earnings Per Share [Abstract] | ' | ' | ' | ' |
Net income attributable to HCA Holdings, Inc. | $518 | $365 | $1,348 | $1,132 |
Weighted average common shares outstanding | 432,617 | 447,329 | 437,832 | 446,125 |
Effect of dilutive incremental shares | 14,643 | 16,240 | 14,706 | 16,926 |
Shares used for diluted earnings per share | 447,260 | 463,569 | 452,538 | 463,051 |
Basic earnings per share | $1.20 | $0.82 | $3.08 | $2.54 |
Diluted earnings per share | $1.16 | $0.79 | $2.98 | $2.44 |
Investments_of_Insurance_Subsi2
Investments of Insurance Subsidiaries - Schedule of Investments (Detail) (USD $) | Sep. 30, 2014 | Dec. 31, 2013 |
In Millions, unless otherwise specified | ||
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Amortized Cost | $487 | $500 |
Unrealized Amounts, Gains | 21 | 13 |
Unrealized Amounts, Losses | -1 | -3 |
Fair Value | 507 | 510 |
Amounts classified as current assets | -66 | -62 |
Investment carrying value | 441 | 448 |
Debt Securities [Member] | ' | ' |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Amortized Cost | 486 | 498 |
Unrealized Amounts, Gains | 19 | 11 |
Unrealized Amounts, Losses | -1 | -3 |
Fair Value | 504 | 506 |
Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Amortized Cost | 449 | 404 |
Unrealized Amounts, Gains | 19 | 11 |
Unrealized Amounts, Losses | -1 | -3 |
Fair Value | 467 | 412 |
Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Amortized Cost | 37 | 94 |
Unrealized Amounts, Gains | ' | ' |
Unrealized Amounts, Losses | ' | ' |
Fair Value | 37 | 94 |
Equity Securities [Member] | ' | ' |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ' | ' |
Amortized Cost | 1 | 2 |
Unrealized Amounts, Gains | 2 | 2 |
Unrealized Amounts, Losses | ' | ' |
Fair Value | $3 | $4 |
Investments_of_Insurance_Subsi3
Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) (USD $) | Sep. 30, 2014 |
In Millions, unless otherwise specified | |
Amortized Cost and Fair Value Debt Securities [Abstract] | ' |
Due in one year or less, Amortized Cost | $59 |
Due after one year through five years, Amortized Cost | 207 |
Due after five years through ten years, Amortized Cost | 97 |
Due after ten years, Amortized Cost | 123 |
Amortized Cost, Total | 486 |
Due in one year or less, Fair Value | 60 |
Due after one year through five years, Fair Value | 212 |
Due after five years through ten years, Fair Value | 104 |
Due after ten years, Fair Value | 128 |
Fair Value, Total | $504 |
Investments_of_Insurance_Subsi4
Investments of Insurance Subsidiaries - Additional Information (Detail) | 9 Months Ended |
Sep. 30, 2014 | |
Amortized Cost and Fair Value Debt Securities [Abstract] | ' |
Available for sale securities expected maturity of debt securities | '4 years 1 month 6 days |
Available for sale securities average scheduled maturity | '6 years 1 month 6 days |
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, 2014 |
Maturity Date, 2014 [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Notional Amount | $500 |
Fair Value | -1 |
Maturity Date | 31-Dec-14 |
Maturity Date, 2016 [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Notional Amount | 3,000 |
Fair Value | -183 |
Maturity Date | 31-Dec-16 |
Maturity Date, 2017 [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Notional Amount | 1,000 |
Fair Value | ($33) |
Maturity Date | 31-Dec-17 |
Financial_Instruments_Addition
Financial Instruments - Additional Information (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2014 |
Offsetting [Abstract] | ' |
Estimated amount reclassified from other comprehensive income to interest expense | $121 |
Estimated termination value if there is breach of provision related to derivative agreement | $224 |
Financial_Instruments_Effect_o
Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) (Interest Rate Swaps [Member], USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2014 |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Amount of Loss Recognized in OCI on Derivatives, Net of Tax | $13 |
Interest Expense [Member] | ' |
Derivative Instruments, Gain (Loss) [Line Items] | ' |
Amount of Loss Reclassified from Accumulated OCI into Operations | $99 |
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, 2014 | Dec. 31, 2013 |
In Millions, unless otherwise specified | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | $507 | $510 |
Less amounts classified as current assets | -66 | -62 |
Investments of insurance subsidiaries, noncurrent | 441 | 448 |
Interest Rate Swaps [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | 217 | 295 |
Debt Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 504 | 506 |
Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 467 | 412 |
Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 37 | 94 |
Equity Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 3 | 4 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 40 | 97 |
Less amounts classified as current assets | -37 | -62 |
Investments of insurance subsidiaries, noncurrent | 3 | 35 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Interest Rate Swaps [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | ' | ' |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 37 | 94 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | ' | ' |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 37 | 94 |
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Equity Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 3 | 3 |
Significant Other Observable Inputs (Level 2) [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 461 | 405 |
Less amounts classified as current assets | -29 | ' |
Investments of insurance subsidiaries, noncurrent | 432 | 405 |
Significant Other Observable Inputs (Level 2) [Member] | Interest Rate Swaps [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | 217 | 295 |
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 461 | 405 |
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 461 | 405 |
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | ' | ' |
Significant Other Observable Inputs (Level 2) [Member] | Equity Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | ' | ' |
Significant Unobservable Inputs (Level 3) [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 6 | 8 |
Less amounts classified as current assets | ' | ' |
Investments of insurance subsidiaries, noncurrent | 6 | 8 |
Significant Unobservable Inputs (Level 3) [Member] | Interest Rate Swaps [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Liabilities, Fair Value | ' | ' |
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 6 | 7 |
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member] | States and Municipalities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | 6 | 7 |
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member] | Money Market Funds [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | ' | ' |
Significant Unobservable Inputs (Level 3) [Member] | Equity Securities [Member] | ' | ' |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ' | ' |
Assets, Fair Value | ' | $1 |
Assets_and_Liabilities_Measure3
Assets and Liabilities Measured at Fair Value - Schedule Related to Investments of Insurance Subsidiaries at Fair Value (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2014 |
Fair Value Disclosures [Abstract] | ' |
Asset, Beginning Balance | $8 |
Settlements | -2 |
Asset, Ending Balance | $6 |
Assets_and_Liabilities_Measure4
Assets and Liabilities Measured at Fair Value - Additional Information (Detail) (USD $) | Sep. 30, 2014 | Dec. 31, 2013 |
In Millions, unless otherwise specified | ||
Fair Value Disclosures [Abstract] | ' | ' |
Estimated fair value of long-term debt | $29,369 | $29,603 |
Carrying amounts of long-term debt | $28,470 | $28,376 |
LongTerm_Debt_Schedule_of_Long
Long-Term Debt - Schedule of Long-Term Debt (Detail) (USD $) | Sep. 30, 2014 | Dec. 31, 2013 |
In Millions, unless otherwise specified | ||
Debt Instrument [Line Items] | ' | ' |
First lien debt | $18,774 | $18,181 |
Total debt (average life of 6.2 years, rates averaging 5.9%) | 28,470 | 28,376 |
Total debt (average life of 6.2 years, rates averaging 5.9%) | 28,470 | 28,376 |
Less amounts due within one year | 1,044 | 786 |
Long-term debt | 27,426 | 27,590 |
Senior Secured Asset-Based Revolving Credit Facility [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Long-term line of credit | 2,280 | 2,440 |
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 | 5,538 | 5,598 |
Senior Secured First Lien Notes [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Senior secured first lien notes | 10,492 | 9,695 |
Other Senior Secured Debt [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Other senior secured debt (effective interest rate of 6.6%) | 464 | 448 |
Senior Unsecured Notes [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Senior unsecured notes | $9,696 | $10,195 |
LongTerm_Debt_Schedule_of_Long1
Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail) | 9 Months Ended |
Sep. 30, 2014 | |
Debt Instrument [Line Items] | ' |
Total debt average term | '6 years 2 months 12 days |
Total debt average rate | 5.90% |
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 | 5.30% |
Senior Secured First Lien Notes [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 5.80% |
Other Senior Secured Debt [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 6.60% |
Senior Unsecured Notes [Member] | ' |
Debt Instrument [Line Items] | ' |
Effective interest rate | 7.20% |
LongTerm_Debt_Additional_Infor
Long-Term Debt - Additional Information (Detail) (USD $) | 3 Months Ended | 9 Months Ended | ||||||||
In Millions, unless otherwise specified | Mar. 31, 2013 | Sep. 30, 2014 | Sep. 30, 2013 | Mar. 31, 2014 | Apr. 30, 2014 | Mar. 31, 2014 | Mar. 31, 2014 | Apr. 30, 2014 | Apr. 30, 2014 | Mar. 31, 2013 |
Senior Secured Notes Due 2019 [Member] | Senior Secured Notes Due 2019 [Member] | Senior Secured Notes Due 2024 [Member] | Senior Secured Notes Due 2020 [Member] | Senior Unsecured Notes Due 2014 [Member] | Senior Secured Second Lien Notes Due 2017 [Member] | |||||
Debt Instrument [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Debt instrument, principal amount | ' | ' | ' | $3,500 | ' | $1,500 | $2,000 | ' | ' | ' |
Debt instrument, stated interest | ' | ' | ' | ' | 8.50% | 3.75% | 5.00% | 7.88% | 5.75% | 9.88% |
Redemption of aggregate principal amount | ' | ' | ' | ' | 1,500 | ' | ' | 1,250 | 500 | ' |
Pretax loss on retirement of debt | 17 | 226 | 17 | ' | ' | ' | ' | ' | ' | ' |
Redemption of aggregate principal amount | ' | ' | ' | ' | ' | ' | ' | ' | ' | $201 |
Contingencies_and_Legal_Claim_1
Contingencies and Legal Claim Costs - Additional Information (Detail) (USD $) | 0 Months Ended | 3 Months Ended | 9 Months Ended | 0 Months Ended | 3 Months Ended | 9 Months Ended | |||||
In Millions, unless otherwise specified | Apr. 25, 2014 | Oct. 28, 2011 | Mar. 31, 2014 | Dec. 31, 2012 | Sep. 30, 2014 | Oct. 31, 2009 | Jan. 24, 2013 | Mar. 31, 2014 | Dec. 31, 2012 | Sep. 30, 2014 | Jul. 31, 2012 |
Cases | Hospital | Pending Litigation [Member] | Pending Litigation [Member] | Pending Litigation [Member] | Pending Litigation [Member] | Florida [Member] | |||||
Health Care Foundation of Greater Kansas City [Member] | Health Care Foundation of Greater Kansas City [Member] | Health Care Foundation of Greater Kansas City [Member] | Health Care Foundation of Greater Kansas City [Member] | Hospital | |||||||
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 | ' | ' | ' | ' | ' |
Additional shortfall related to capital expenditures | 78 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Legal claim costs | ' | ' | 78 | 175 | 78 | ' | ' | ' | ' | ' | ' |
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 | ' |
Percentage of legal claim costs | ' | ' | ' | ' | ' | ' | ' | 9.00% | 9.00% | ' | ' |
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, unless otherwise specified | Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balances | ' | ' | ($6,928) | ' |
Net income | 611 | 467 | 1,697 | 1,442 |
Repurchase of common stock | ' | ' | -750 | ' |
Other comprehensive income | -7 | 52 | 51 | 83 |
Distributions | ' | ' | -325 | ' |
Share-based benefit plans | ' | ' | 242 | ' |
Other | ' | ' | -5 | ' |
Ending Balances | -6,018 | ' | -6,018 | ' |
Repurchase of common stock, Shares | ' | ' | 14,554,628 | ' |
Common Stock [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balances | ' | ' | 4 | ' |
Net income | ' | ' | 0 | ' |
Repurchase of common stock | ' | ' | 0 | ' |
Other comprehensive income | ' | ' | 0 | ' |
Distributions | ' | ' | 0 | ' |
Share-based benefit plans | ' | ' | 0 | ' |
Other | ' | ' | 0 | ' |
Ending Balances | 4 | ' | 4 | ' |
Beginning Balances, Shares | ' | ' | 439,604 | ' |
Repurchase of common stock, Shares | ' | ' | -14,555 | ' |
Share-based benefit plans, Shares | ' | ' | 8,330 | ' |
Ending Balances, Shares | 433,379 | ' | 433,379 | ' |
Capital in Excess of Par Value [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balances | ' | ' | 1,386 | ' |
Net income | ' | ' | 0 | ' |
Repurchase of common stock | ' | ' | -750 | ' |
Other comprehensive income | ' | ' | 0 | ' |
Distributions | ' | ' | 0 | ' |
Share-based benefit plans | ' | ' | 242 | ' |
Other | ' | ' | -6 | ' |
Ending Balances | 872 | ' | 872 | ' |
Accumulated Other Comprehensive Loss [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balances | ' | ' | -257 | ' |
Net income | ' | ' | 0 | ' |
Repurchase of common stock | ' | ' | 0 | ' |
Other comprehensive income | ' | ' | 51 | ' |
Distributions | ' | ' | 0 | ' |
Share-based benefit plans | ' | ' | 0 | ' |
Other | ' | ' | 0 | ' |
Ending Balances | -206 | ' | -206 | ' |
Retained Deficit [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balances | ' | ' | -9,403 | ' |
Net income | ' | ' | 1,348 | ' |
Repurchase of common stock | ' | ' | 0 | ' |
Other comprehensive income | ' | ' | 0 | ' |
Distributions | ' | ' | 0 | ' |
Share-based benefit plans | ' | ' | 0 | ' |
Other | ' | ' | 1 | ' |
Ending Balances | -8,054 | ' | -8,054 | ' |
Equity Attributable to Noncontrolling Interests [Member] | ' | ' | ' | ' |
Capital Structure [Line Items] | ' | ' | ' | ' |
Beginning Balances | ' | ' | 1,342 | ' |
Net income | ' | ' | 349 | ' |
Repurchase of common stock | ' | ' | 0 | ' |
Other comprehensive income | ' | ' | 0 | ' |
Distributions | ' | ' | -325 | ' |
Share-based benefit plans | ' | ' | 0 | ' |
Other | ' | ' | 0 | ' |
Ending Balances | $1,366 | ' | $1,366 | ' |
Capital_Structure_Additional_I
Capital Structure - Additional Information (Detail) (USD $) | 9 Months Ended |
Sep. 30, 2014 | |
Equity [Abstract] | ' |
Repurchase of common stock | 14,554,628 |
Repurchase of common stock, per share | $51.53 |
Capital_Structure_Components_o
Capital Structure - Components of Accumulated Other Comprehensive Loss (Detail) (USD $) | 9 Months Ended |
In Millions, unless otherwise specified | Sep. 30, 2014 |
Equity [Abstract] | ' |
Unrealized gains on available-for-sale securities, beginning balances | $7 |
Unrealized gains on available-for-sale securities, net of income taxes | 6 |
Unrealized gains on available-for-sale securities, ending balances | 13 |
Foreign currency translation adjustments, beginning balances | 11 |
Foreign currency translation adjustments | -12 |
Foreign currency translation adjustments, ending balances | -1 |
Defined benefit plans, beginning balances | -88 |
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income | 7 |
Defined benefit plans, ending balances | -81 |
Change in fair value of derivative instruments, beginning balances | -187 |
Change in fair value of derivative instruments | -13 |
Change in fair value of derivatives instruments, (income) expense reclassified into operations from other comprehensive income | 63 |
Change in fair value of derivative instruments, ending balances | -137 |
Accumulated other comprehensive income, net of tax, beginning balances | -257 |
Unrealized gains on available-for-sale securities, net of income taxes | 6 |
Foreign currency translation adjustments | -12 |
Change in fair value of derivative instruments | -13 |
Expense reclassified into operations from other comprehensive income, Total | 70 |
Accumulated other comprehensive income (loss), net of tax, ending balances | ($206) |
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, 2014 |
Equity [Abstract] | ' |
Foreign currency translation adjustments, income tax benefits | $6 |
Defined benefit plans, income tax benefits | 4 |
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, income tax benefits | 36 |
Unrealized gains on available-for-sale securities, income taxes | 4 |
Change in fair value of derivative instruments, income tax benefits | $8 |
Segment_and_Geographic_Informa2
Segment and Geographic Information - Additional Information (Detail) | 9 Months Ended |
Sep. 30, 2014 | |
Hospital | |
Segment Reporting Information [Line Items] | ' |
Number of geographically organized groups | 2 |
Number of owned and operated hospitals | 165 |
National Group [Member] | ' |
Segment Reporting Information [Line Items] | ' |
Number of owned and operated hospitals | 81 |
American Group [Member] | ' |
Segment Reporting Information [Line Items] | ' |
Number of owned and operated hospitals | 77 |
Corporate and Other [Member] | ' |
Segment Reporting Information [Line Items] | ' |
Number of owned and operated hospitals | 7 |
Segment_and_Geographic_Informa3
Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA and Depreciation and Amortization (Detail) (USD $) | 3 Months Ended | 9 Months Ended | |||||
In Millions, unless otherwise specified | Sep. 30, 2014 | Mar. 31, 2014 | Sep. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2014 | Sep. 30, 2013 |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues | $9,220 | ' | $8,456 | ' | ' | $27,282 | $25,346 |
Equity in earnings of affiliates | -14 | ' | -9 | ' | ' | -32 | -29 |
Adjusted segment EBITDA | 1,828 | ' | 1,603 | ' | ' | 5,472 | 4,860 |
Depreciation and amortization | 460 | ' | 443 | ' | ' | 1,361 | 1,292 |
Interest expense | 427 | ' | 458 | ' | ' | 1,314 | 1,392 |
Losses (gains) on sales of facilities | 12 | ' | 1 | ' | ' | -20 | 13 |
Losses on retirement of debt | ' | ' | ' | 17 | ' | 226 | 17 |
Legal claim costs | ' | 78 | ' | ' | 175 | 78 | ' |
Income before income taxes | 929 | ' | 701 | ' | ' | 2,513 | 2,146 |
National Group [Member] | ' | ' | ' | ' | ' | ' | ' |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues | 4,387 | ' | 3,930 | ' | ' | 12,814 | 11,875 |
Equity in earnings of affiliates | -6 | ' | -3 | ' | ' | -12 | -8 |
Adjusted segment EBITDA | 1,008 | ' | 805 | ' | ' | 2,810 | 2,440 |
Depreciation and amortization | 187 | ' | 181 | ' | ' | 564 | 532 |
American Group [Member] | ' | ' | ' | ' | ' | ' | ' |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues | 4,319 | ' | 4,082 | ' | ' | 12,918 | 12,181 |
Equity in earnings of affiliates | -8 | ' | -6 | ' | ' | -23 | -19 |
Adjusted segment EBITDA | 927 | ' | 910 | ' | ' | 2,911 | 2,654 |
Depreciation and amortization | 210 | ' | 206 | ' | ' | 626 | 610 |
Corporate and Other [Member] | ' | ' | ' | ' | ' | ' | ' |
Segment Reporting Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues | 514 | ' | 444 | ' | ' | 1,550 | 1,290 |
Equity in earnings of affiliates | ' | ' | ' | ' | ' | 3 | -2 |
Adjusted segment EBITDA | -107 | ' | -112 | ' | ' | -249 | -234 |
Depreciation and amortization | $63 | ' | $56 | ' | ' | $171 | $150 |
Supplemental_Condensed_Consoli2
Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) (USD $) | Sep. 30, 2014 | Mar. 31, 2014 | 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 | ' | $3,500 | $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 $) | 3 Months Ended | 9 Months Ended | |||||
In Millions, unless otherwise specified | Sep. 30, 2014 | Mar. 31, 2014 | Sep. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2014 | Sep. 30, 2013 |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | $9,978 | ' | $9,411 | ' | ' | $29,619 | $28,078 |
Provision for doubtful accounts | 758 | ' | 955 | ' | ' | 2,337 | 2,732 |
Revenues | 9,220 | ' | 8,456 | ' | ' | 27,282 | 25,346 |
Salaries and benefits | 4,211 | ' | 3,916 | ' | ' | 12,359 | 11,681 |
Supplies | 1,539 | ' | 1,457 | ' | ' | 4,603 | 4,406 |
Other operating expenses | 1,688 | ' | 1,564 | ' | ' | 4,977 | 4,594 |
Electronic health record incentive income | -32 | ' | -75 | ' | ' | -97 | -166 |
Equity in earnings of affiliates | -14 | ' | -9 | ' | ' | -32 | -29 |
Depreciation and amortization | 460 | ' | 443 | ' | ' | 1,361 | 1,292 |
Interest expense | 427 | ' | 458 | ' | ' | 1,314 | 1,392 |
Losses (gains) on sales of facilities | 12 | ' | 1 | ' | ' | -20 | 13 |
Losses on retirement of debt | ' | ' | ' | 17 | ' | 226 | 17 |
Legal claim costs | ' | 78 | ' | ' | 175 | 78 | ' |
Management fees | ' | ' | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of affiliates | 8,291 | ' | 7,755 | ' | ' | 24,769 | 23,200 |
Income (loss) before income taxes | 929 | ' | 701 | ' | ' | 2,513 | 2,146 |
Provision (benefit) for income taxes | 318 | ' | 234 | ' | ' | 816 | 704 |
Net income (loss) | 611 | ' | 467 | ' | ' | 1,697 | 1,442 |
Net income attributable to noncontrolling interests | 93 | ' | 102 | ' | ' | 349 | 310 |
Net income (loss) attributable to HCA Holdings, Inc. | 518 | ' | 365 | ' | ' | 1,348 | 1,132 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 511 | ' | 417 | ' | ' | 1,399 | 1,215 |
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 | 4 | ' | 2 | ' | ' | 14 | 4 |
Electronic health record incentive income | ' | ' | ' | ' | ' | ' | ' |
Equity in earnings of affiliates | -542 | ' | -443 | ' | ' | -1,494 | -1,303 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' |
Interest expense | 46 | ' | 41 | ' | ' | 138 | 138 |
Losses (gains) on sales of facilities | ' | ' | ' | ' | ' | ' | ' |
Losses on retirement of debt | ' | ' | ' | ' | ' | ' | ' |
Legal claim costs | ' | ' | ' | ' | ' | ' | ' |
Management fees | ' | ' | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of affiliates | -492 | ' | -400 | ' | ' | -1,342 | -1,161 |
Income (loss) before income taxes | 492 | ' | 400 | ' | ' | 1,342 | 1,161 |
Provision (benefit) for income taxes | -19 | ' | -17 | ' | ' | -57 | -54 |
Net income (loss) | 511 | ' | 417 | ' | ' | 1,399 | 1,215 |
Net income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' |
Net income (loss) attributable to HCA Holdings, Inc. | 511 | ' | 417 | ' | ' | 1,399 | 1,215 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 511 | ' | 417 | ' | ' | 1,399 | 1,215 |
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 | ' | ' | ' | -1 |
Electronic health record incentive income | ' | ' | ' | ' | ' | ' | ' |
Equity in earnings of affiliates | ' | ' | ' | ' | ' | ' | ' |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' |
Interest expense | 536 | ' | 549 | ' | ' | 1,629 | 1,651 |
Losses (gains) on sales of facilities | ' | ' | ' | ' | ' | ' | ' |
Losses on retirement of debt | ' | ' | ' | ' | ' | 226 | 17 |
Legal claim costs | ' | ' | ' | ' | ' | 78 | ' |
Management fees | ' | ' | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of affiliates | 536 | ' | 548 | ' | ' | 1,933 | 1,667 |
Income (loss) before income taxes | -536 | ' | -548 | ' | ' | -1,933 | -1,667 |
Provision (benefit) for income taxes | -205 | ' | -214 | ' | ' | -729 | -639 |
Net income (loss) | -331 | ' | -334 | ' | ' | -1,204 | -1,028 |
Net income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' |
Net income (loss) attributable to HCA Holdings, Inc. | -331 | ' | -334 | ' | ' | -1,204 | -1,028 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | -303 | ' | -331 | ' | ' | -1,154 | -961 |
Subsidiary Guarantors [Member] | ' | ' | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | 5,133 | ' | 4,945 | ' | ' | 15,242 | 14,829 |
Provision for doubtful accounts | 457 | ' | 560 | ' | ' | 1,388 | 1,611 |
Revenues | 4,676 | ' | 4,385 | ' | ' | 13,854 | 13,218 |
Salaries and benefits | 2,176 | ' | 2,090 | ' | ' | 6,393 | 6,275 |
Supplies | 797 | ' | 773 | ' | ' | 2,416 | 2,340 |
Other operating expenses | 804 | ' | 771 | ' | ' | 2,366 | 2,260 |
Electronic health record incentive income | -22 | ' | -53 | ' | ' | -68 | -115 |
Equity in earnings of affiliates | -3 | ' | ' | ' | ' | -5 | -2 |
Depreciation and amortization | 225 | ' | 216 | ' | ' | 667 | 636 |
Interest expense | -115 | ' | -104 | ' | ' | -349 | -319 |
Losses (gains) on sales of facilities | 16 | ' | 1 | ' | ' | -16 | 20 |
Losses on retirement of debt | ' | ' | ' | ' | ' | ' | ' |
Legal claim costs | ' | ' | ' | ' | ' | ' | ' |
Management fees | -178 | ' | -183 | ' | ' | -528 | -547 |
Total expenses including equity in earnings of affiliates | 3,700 | ' | 3,511 | ' | ' | 10,876 | 10,548 |
Income (loss) before income taxes | 976 | ' | 874 | ' | ' | 2,978 | 2,670 |
Provision (benefit) for income taxes | 365 | ' | 334 | ' | ' | 1,098 | 1,005 |
Net income (loss) | 611 | ' | 540 | ' | ' | 1,880 | 1,665 |
Net income attributable to noncontrolling interests | 18 | ' | 19 | ' | ' | 65 | 48 |
Net income (loss) attributable to HCA Holdings, Inc. | 593 | ' | 521 | ' | ' | 1,815 | 1,617 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 595 | ' | 532 | ' | ' | 1,822 | 1,637 |
Subsidiary Non-Guarantors [Member] | ' | ' | ' | ' | ' | ' | ' |
Supplemental Condensed Consolidating Financial Information [Line Items] | ' | ' | ' | ' | ' | ' | ' |
Revenues before provision for doubtful accounts | 4,845 | ' | 4,466 | ' | ' | 14,377 | 13,249 |
Provision for doubtful accounts | 301 | ' | 395 | ' | ' | 949 | 1,121 |
Revenues | 4,544 | ' | 4,071 | ' | ' | 13,428 | 12,128 |
Salaries and benefits | 2,035 | ' | 1,826 | ' | ' | 5,966 | 5,406 |
Supplies | 742 | ' | 684 | ' | ' | 2,187 | 2,066 |
Other operating expenses | 880 | ' | 792 | ' | ' | 2,597 | 2,331 |
Electronic health record incentive income | -10 | ' | -22 | ' | ' | -29 | -51 |
Equity in earnings of affiliates | -11 | ' | -9 | ' | ' | -27 | -27 |
Depreciation and amortization | 235 | ' | 227 | ' | ' | 694 | 656 |
Interest expense | -40 | ' | -28 | ' | ' | -104 | -78 |
Losses (gains) on sales of facilities | -4 | ' | ' | ' | ' | -4 | -7 |
Losses on retirement of debt | ' | ' | ' | ' | ' | ' | ' |
Legal claim costs | ' | ' | ' | ' | ' | ' | ' |
Management fees | 178 | ' | 183 | ' | ' | 528 | 547 |
Total expenses including equity in earnings of affiliates | 4,005 | ' | 3,653 | ' | ' | 11,808 | 10,843 |
Income (loss) before income taxes | 539 | ' | 418 | ' | ' | 1,620 | 1,285 |
Provision (benefit) for income taxes | 177 | ' | 131 | ' | ' | 504 | 392 |
Net income (loss) | 362 | ' | 287 | ' | ' | 1,116 | 893 |
Net income attributable to noncontrolling interests | 75 | ' | 83 | ' | ' | 284 | 262 |
Net income (loss) attributable to HCA Holdings, Inc. | 287 | ' | 204 | ' | ' | 832 | 631 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 250 | ' | 242 | ' | ' | 826 | 627 |
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 | 542 | ' | 443 | ' | ' | 1,494 | 1,303 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' |
Interest expense | ' | ' | ' | ' | ' | ' | ' |
Losses (gains) on sales of facilities | ' | ' | ' | ' | ' | ' | ' |
Losses on retirement of debt | ' | ' | ' | ' | ' | ' | ' |
Legal claim costs | ' | ' | ' | ' | ' | ' | ' |
Management fees | ' | ' | ' | ' | ' | ' | ' |
Total expenses including equity in earnings of affiliates | 542 | ' | 443 | ' | ' | 1,494 | 1,303 |
Income (loss) before income taxes | -542 | ' | -443 | ' | ' | -1,494 | -1,303 |
Provision (benefit) for income taxes | ' | ' | ' | ' | ' | ' | ' |
Net income (loss) | -542 | ' | -443 | ' | ' | -1,494 | -1,303 |
Net income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' |
Net income (loss) attributable to HCA Holdings, Inc. | -542 | ' | -443 | ' | ' | -1,494 | -1,303 |
Comprehensive income (loss) attributable to HCA Holdings, Inc. | ($542) | ' | ($443) | ' | ' | ($1,494) | ($1,303) |
Supplemental_Condensed_Consoli4
Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) (USD $) | Sep. 30, 2014 | Dec. 31, 2013 | Sep. 30, 2013 | Dec. 31, 2012 |
In Millions, unless otherwise specified | ||||
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | $515 | $414 | $484 | $705 |
Accounts receivable, net | 5,524 | 5,208 | ' | ' |
Inventories | 1,258 | 1,179 | ' | ' |
Deferred income taxes | 320 | 489 | ' | ' |
Other | 910 | 747 | ' | ' |
Total current assets | 8,527 | 8,037 | ' | ' |
Property and equipment, net | 13,878 | 13,619 | ' | ' |
Investments of insurance subsidiaries | 441 | 448 | ' | ' |
Investments in and advances to affiliates | 167 | 121 | ' | ' |
Goodwill and other intangible assets | 5,899 | 5,903 | ' | ' |
Deferred loan costs | 221 | 237 | ' | ' |
Other | 692 | 466 | ' | ' |
Total assets | 29,825 | 28,831 | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 1,787 | 1,803 | ' | ' |
Accrued salaries | 1,238 | 1,193 | ' | ' |
Other accrued expenses | 1,563 | 1,913 | ' | ' |
Long-term debt due within one year | 1,044 | 786 | ' | ' |
Total current liabilities | 5,632 | 5,695 | ' | ' |
Long-term debt | 27,426 | 27,590 | ' | ' |
Intercompany balances | ' | ' | ' | ' |
Professional liability risks | 1,045 | 949 | ' | ' |
Income taxes and other liabilities | 1,740 | 1,525 | ' | ' |
Total liabilities | 35,843 | ' | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -7,384 | -8,270 | ' | ' |
Noncontrolling interests | 1,366 | 1,342 | ' | ' |
Total stockholders' deficit | -6,018 | -6,928 | ' | ' |
Total liabilities and stockholders' deficit | 29,825 | 28,831 | ' | ' |
HCA Holdings, Inc. Issuer [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | ' | ' | ' | 22 |
Accounts receivable, net | ' | ' | ' | ' |
Inventories | ' | ' | ' | ' |
Deferred income taxes | 320 | 489 | ' | ' |
Other | ' | ' | ' | ' |
Total current assets | 320 | ' | ' | ' |
Property and equipment, net | ' | ' | ' | ' |
Investments of insurance subsidiaries | ' | ' | ' | ' |
Investments in and advances to affiliates | 21,850 | 20,356 | ' | ' |
Goodwill and other intangible assets | ' | ' | ' | ' |
Deferred loan costs | 27 | 30 | ' | ' |
Other | 476 | 250 | ' | ' |
Total assets | 22,673 | ' | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 3 | 1 | ' | ' |
Accrued salaries | ' | ' | ' | ' |
Other accrued expenses | 69 | 272 | ' | ' |
Long-term debt due within one year | ' | ' | ' | ' |
Total current liabilities | 72 | ' | ' | ' |
Long-term debt | 2,525 | 2,525 | ' | ' |
Intercompany balances | 26,932 | 26,107 | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | 528 | 490 | ' | ' |
Total liabilities | 30,057 | ' | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -7,384 | -8,270 | ' | ' |
Noncontrolling interests | ' | ' | ' | ' |
Total stockholders' deficit | -7,384 | ' | ' | ' |
Total liabilities and stockholders' deficit | 22,673 | ' | ' | ' |
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 | 194 | 207 | ' | ' |
Other | ' | ' | ' | ' |
Total assets | 194 | ' | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | ' | ' | ' | ' |
Accrued salaries | ' | ' | ' | ' |
Other accrued expenses | 197 | 353 | ' | ' |
Long-term debt due within one year | 952 | 702 | ' | ' |
Total current liabilities | 1,149 | ' | ' | ' |
Long-term debt | 24,528 | 24,701 | ' | ' |
Intercompany balances | -9,497 | -10,513 | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | 500 | 296 | ' | ' |
Total liabilities | 16,680 | ' | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | -16,486 | -15,332 | ' | ' |
Noncontrolling interests | ' | ' | ' | ' |
Total stockholders' deficit | -16,486 | ' | ' | ' |
Total liabilities and stockholders' deficit | 194 | ' | ' | ' |
Subsidiary Guarantors [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | 113 | 112 | 167 | 383 |
Accounts receivable, net | 2,671 | 2,565 | ' | ' |
Inventories | 748 | 692 | ' | ' |
Deferred income taxes | ' | ' | ' | ' |
Other | 369 | 301 | ' | ' |
Total current assets | 3,901 | ' | ' | ' |
Property and equipment, net | 7,762 | 7,504 | ' | ' |
Investments of insurance subsidiaries | ' | ' | ' | ' |
Investments in and advances to affiliates | 16 | 13 | ' | ' |
Goodwill and other intangible assets | 1,698 | 1,695 | ' | ' |
Deferred loan costs | ' | ' | ' | ' |
Other | 21 | 48 | ' | ' |
Total assets | 13,398 | ' | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 1,132 | 1,169 | ' | ' |
Accrued salaries | 721 | 694 | ' | ' |
Other accrued expenses | 458 | 464 | ' | ' |
Long-term debt due within one year | 51 | 45 | ' | ' |
Total current liabilities | 2,362 | ' | ' | ' |
Long-term debt | 187 | 181 | ' | ' |
Intercompany balances | -20,763 | -19,428 | ' | ' |
Professional liability risks | ' | ' | ' | ' |
Income taxes and other liabilities | 486 | 521 | ' | ' |
Total liabilities | -17,728 | ' | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | 31,007 | 29,185 | ' | ' |
Noncontrolling interests | 119 | 99 | ' | ' |
Total stockholders' deficit | 31,126 | ' | ' | ' |
Total liabilities and stockholders' deficit | 13,398 | ' | ' | ' |
Subsidiary Non-Guarantors [Member] | ' | ' | ' | ' |
Current assets: | ' | ' | ' | ' |
Cash and cash equivalents | 402 | 302 | 317 | 300 |
Accounts receivable, net | 2,853 | 2,643 | ' | ' |
Inventories | 510 | 487 | ' | ' |
Deferred income taxes | ' | ' | ' | ' |
Other | 541 | 446 | ' | ' |
Total current assets | 4,306 | ' | ' | ' |
Property and equipment, net | 6,116 | 6,115 | ' | ' |
Investments of insurance subsidiaries | 441 | 448 | ' | ' |
Investments in and advances to affiliates | 151 | 108 | ' | ' |
Goodwill and other intangible assets | 4,201 | 4,208 | ' | ' |
Deferred loan costs | ' | ' | ' | ' |
Other | 195 | 168 | ' | ' |
Total assets | 15,410 | ' | ' | ' |
Current liabilities: | ' | ' | ' | ' |
Accounts payable | 652 | 633 | ' | ' |
Accrued salaries | 517 | 499 | ' | ' |
Other accrued expenses | 839 | 824 | ' | ' |
Long-term debt due within one year | 41 | 39 | ' | ' |
Total current liabilities | 2,049 | ' | ' | ' |
Long-term debt | 186 | 183 | ' | ' |
Intercompany balances | 3,328 | 3,834 | ' | ' |
Professional liability risks | 1,045 | 949 | ' | ' |
Income taxes and other liabilities | 226 | 218 | ' | ' |
Total liabilities | 6,834 | ' | ' | ' |
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | 7,329 | 6,503 | ' | ' |
Noncontrolling interests | 1,247 | 1,243 | ' | ' |
Total stockholders' deficit | 8,576 | ' | ' | ' |
Total liabilities and stockholders' deficit | 15,410 | ' | ' | ' |
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 | -21,850 | -20,356 | ' | ' |
Goodwill and other intangible assets | ' | ' | ' | ' |
Deferred loan costs | ' | ' | ' | ' |
Other | ' | ' | ' | ' |
Total assets | -21,850 | ' | ' | ' |
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. | -21,850 | -20,356 | ' | ' |
Noncontrolling interests | ' | ' | ' | ' |
Total stockholders' deficit | -21,850 | ' | ' | ' |
Total liabilities and stockholders' deficit | ($21,850) | ' | ' | ' |
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, 2014 | Sep. 30, 2013 |
Cash flows from operating activities: | ' | ' |
Net income (loss) | $1,697 | $1,442 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -2,945 | -3,319 |
Provision for doubtful accounts | 2,337 | 2,732 |
Depreciation and amortization | 1,361 | 1,292 |
Income taxes | -61 | 158 |
Losses (gains) on sales of facilities | -20 | 13 |
Losses on retirement of debt | 226 | 17 |
Legal claim costs | 78 | ' |
Amortization of deferred loan costs | 33 | 41 |
Share-based compensation | 118 | 81 |
Equity in earnings of affiliates | ' | ' |
Other | -3 | -3 |
Net cash provided by operating activities | 2,821 | 2,454 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -1,482 | -1,347 |
Acquisition of hospitals and health care entities | -97 | -463 |
Disposition of hospitals and health care entities | 38 | 31 |
Change in investments | 22 | 97 |
Other | 7 | 8 |
Net cash used in investing activities | -1,512 | -1,674 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | 3,502 | ' |
Net change in revolving credit facilities | -160 | 630 |
Repayment of long-term debt | -3,525 | -1,300 |
Distributions to noncontrolling interests | -325 | -308 |
Payment of debt issuance costs | -49 | -5 |
Repurchase of common stock | -750 | ' |
Distributions to stockholders | -7 | -13 |
Changes in intercompany balances with affiliates, net | ' | ' |
Income tax benefits | 119 | 70 |
Other | -13 | -75 |
Net cash used in financing activities | -1,208 | -1,001 |
Change in cash and cash equivalents | 101 | -221 |
Cash and cash equivalents at beginning of period | 414 | 705 |
Cash and cash equivalents at end of period | 515 | 484 |
HCA Holdings, Inc. Issuer [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | 1,399 | 1,215 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | 18 | 47 |
Provision for doubtful accounts | ' | ' |
Depreciation and amortization | ' | ' |
Income taxes | -61 | 158 |
Losses (gains) on sales of facilities | ' | ' |
Losses on retirement of debt | ' | ' |
Legal claim costs | ' | ' |
Amortization of deferred loan costs | 2 | 3 |
Share-based compensation | 118 | 81 |
Equity in earnings of affiliates | -1,494 | -1,303 |
Other | ' | ' |
Net cash provided by operating activities | -18 | 201 |
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 credit facilities | ' | ' |
Repayment of long-term debt | ' | ' |
Distributions to noncontrolling interests | ' | ' |
Payment of debt issuance costs | ' | ' |
Repurchase of common stock | -750 | ' |
Distributions to stockholders | -7 | -13 |
Changes in intercompany balances with affiliates, net | 654 | -199 |
Income tax benefits | 119 | 70 |
Other | 2 | -81 |
Net cash used in financing activities | 18 | -223 |
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) | -1,204 | -1,028 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -151 | -126 |
Provision for doubtful accounts | ' | ' |
Depreciation and amortization | ' | ' |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | ' | ' |
Losses on retirement of debt | 226 | 17 |
Legal claim costs | 78 | ' |
Amortization of deferred loan costs | 31 | 38 |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | ' | ' |
Other | 3 | 7 |
Net cash provided by operating activities | -1,017 | -1,092 |
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 | 3,502 | ' |
Net change in revolving credit facilities | -160 | 630 |
Repayment of long-term debt | -3,462 | -1,243 |
Distributions to noncontrolling interests | ' | ' |
Payment of debt issuance costs | -49 | -5 |
Repurchase of common stock | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | 1,186 | 1,710 |
Income tax benefits | ' | ' |
Other | ' | ' |
Net cash used in financing activities | 1,017 | 1,092 |
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) | 1,880 | 1,665 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -1,660 | -1,848 |
Provision for doubtful accounts | 1,388 | 1,611 |
Depreciation and amortization | 667 | 636 |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | -16 | 20 |
Losses on retirement of debt | ' | ' |
Legal claim costs | ' | ' |
Amortization of deferred loan costs | ' | ' |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | ' | ' |
Other | ' | ' |
Net cash provided by operating activities | 2,259 | 2,084 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -893 | -684 |
Acquisition of hospitals and health care entities | -7 | ' |
Disposition of hospitals and health care entities | 31 | 17 |
Change in investments | 22 | -6 |
Other | ' | ' |
Net cash used in investing activities | -847 | -673 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | ' |
Net change in revolving credit facilities | ' | ' |
Repayment of long-term debt | -35 | -34 |
Distributions to noncontrolling interests | -45 | -34 |
Payment of debt issuance costs | ' | ' |
Repurchase of common stock | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | -1,331 | -1,559 |
Income tax benefits | ' | ' |
Other | ' | ' |
Net cash used in financing activities | -1,411 | -1,627 |
Change in cash and cash equivalents | 1 | -216 |
Cash and cash equivalents at beginning of period | 112 | 383 |
Cash and cash equivalents at end of period | 113 | 167 |
Subsidiary Non-Guarantors [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | 1,116 | 893 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ' | ' |
Changes in operating assets and liabilities | -1,152 | -1,392 |
Provision for doubtful accounts | 949 | 1,121 |
Depreciation and amortization | 694 | 656 |
Income taxes | ' | ' |
Losses (gains) on sales of facilities | -4 | -7 |
Losses on retirement of debt | ' | ' |
Legal claim costs | ' | ' |
Amortization of deferred loan costs | ' | ' |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | ' | ' |
Other | -6 | -10 |
Net cash provided by operating activities | 1,597 | 1,261 |
Cash flows from investing activities: | ' | ' |
Purchase of property and equipment | -589 | -663 |
Acquisition of hospitals and health care entities | -90 | -463 |
Disposition of hospitals and health care entities | 7 | 14 |
Change in investments | ' | 103 |
Other | 7 | 8 |
Net cash used in investing activities | -665 | -1,001 |
Cash flows from financing activities: | ' | ' |
Issuance of long-term debt | ' | ' |
Net change in revolving credit facilities | ' | ' |
Repayment of long-term debt | -28 | -23 |
Distributions to noncontrolling interests | -280 | -274 |
Payment of debt issuance costs | ' | ' |
Repurchase of common stock | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | -509 | 48 |
Income tax benefits | ' | ' |
Other | -15 | 6 |
Net cash used in financing activities | -832 | -243 |
Change in cash and cash equivalents | 100 | 17 |
Cash and cash equivalents at beginning of period | 302 | 300 |
Cash and cash equivalents at end of period | 402 | 317 |
Eliminations [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net income (loss) | -1,494 | -1,303 |
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 | ' | ' |
Losses on retirement of debt | ' | ' |
Legal claim costs | ' | ' |
Amortization of deferred loan costs | ' | ' |
Share-based compensation | ' | ' |
Equity in earnings of affiliates | 1,494 | 1,303 |
Other | ' | ' |
Net cash provided by 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 credit facilities | ' | ' |
Repayment of long-term debt | ' | ' |
Distributions to noncontrolling interests | ' | ' |
Payment of debt issuance costs | ' | ' |
Repurchase of common stock | ' | ' |
Distributions to stockholders | ' | ' |
Changes in intercompany balances with affiliates, net | ' | ' |
Income tax benefits | ' | ' |
Other | ' | ' |
Net cash used in financing activities | ' | ' |
Change in cash and cash equivalents | ' | ' |
Cash and cash equivalents at beginning of period | ' | ' |
Cash and cash equivalents at end of period | ' | ' |