HCA Healthcare (HCA) 10-Q 29 Oct 15 2015 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2015	Oct. 23, 2015
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2015
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	Q3
Trading Symbol	HCA
Entity Registrant Name	HCA HOLDINGS, INC.
Entity Central Index Key	860,730
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		407,667,700

Condensed Consolidated Income S

Condensed Consolidated Income Statements (Unaudited) - USD ($) shares in Thousands, $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Mar. 31, 2014	Dec. 31, 2012	Sep. 30, 2015	Sep. 30, 2014
Income Statement [Abstract]
Revenues before provision for doubtful accounts	$ 11,014	$ 9,978			$ 32,268	$ 29,619
Provision for doubtful accounts	1,158	758			2,839	2,337
Revenues	9,856	9,220			29,429	27,282
Salaries and benefits	4,619	4,211			13,509	12,359
Supplies	1,644	1,539			4,952	4,603
Other operating expenses	1,796	1,688			5,268	4,977
Electronic health record incentive income	(9)	(32)			(46)	(97)
Equity in earnings of affiliates	(9)	(14)			(38)	(32)
Depreciation and amortization	482	460			1,424	1,361
Interest expense	411	427			1,255	1,314
Losses (gains) on sales of facilities	2	12			(2)	(20)
Losses on retirement of debt					125	226
Legal claim costs	77		$ 78	$ 175	77	78
Total expenses including equity in earnings of affiliates	9,013	8,291			26,524	24,769
Income before income taxes	843	929			2,905	2,513
Provision for income taxes	270	318			947	816
Net income	573	611			1,958	1,697
Net income attributable to noncontrolling interests	124	93			411	349
Net income attributable to HCA Holdings, Inc.	$ 449	$ 518			$ 1,547	$ 1,348
Per share data:
Basic earnings per share	$ 1.08	$ 1.20			$ 3.71	$ 3.08
Diluted earnings per share	$ 1.05	$ 1.16			$ 3.60	$ 2.98
Shares used in earnings per share calculations (in millions):
Basic	414,939	432,617			417,146	437,832
Diluted	426,441	447,260			430,354	452,538

Condensed Consolidated Comprehe

Condensed Consolidated Comprehensive Income Statements (Unaudited) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Statement of Comprehensive Income [Abstract]
Net income	$ 573	$ 611	$ 1,958	$ 1,697
Other comprehensive income (loss) before taxes:
Foreign currency translation	(54)	(58)	(41)	(18)
Unrealized gains (losses) on available-for-sale securities	2	2	(2)	10
Defined benefit plans	0	0	0	0
Pension costs included in salaries and benefits	6	3	17	11
Total defined benefit plans	6	3	17	11
Change in fair value of derivative financial instruments	(17)	8	(47)	(21)
Interest costs included in interest expense	31	34	93	99
Total change in fair value of derivative financial instruments	14	42	46	78
Other comprehensive income (loss) before taxes	(32)	(11)	20	81
Income taxes (benefits) related to other comprehensive income items	(13)	(4)	6	30
Other comprehensive income (loss)	(19)	(7)	14	51
Comprehensive income	554	604	1,972	1,748
Comprehensive income attributable to noncontrolling interests	124	93	411	349
Comprehensive income attributable to HCA Holdings, Inc.	$ 430	$ 511	$ 1,561	$ 1,399

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions	Sep. 30, 2015	Dec. 31, 2014
Current assets:
Cash and cash equivalents	$ 588	$ 566
Accounts receivable, less allowance for doubtful accounts of $5,111 and $5,011	5,827	5,694
Inventories	1,379	1,279
Deferred income taxes	412	366
Other	1,015	1,025
Total current assets	9,221	8,930
Property and equipment, at cost	34,207	32,980
Accumulated depreciation	(19,503)	(18,625)
Property and equipment, net	14,704	14,355
Investments of insurance subsidiaries	409	494
Investments in and advances to affiliates	186	165
Goodwill and other intangible assets	6,540	6,416
Other	836	620
Total assets	31,896	30,980
Current liabilities:
Accounts payable	1,877	2,035
Accrued salaries	1,358	1,370
Other accrued expenses	1,701	1,737
Long-term debt due within one year	1,377	338
Total current liabilities	6,313	5,480
Long-term debt, less net debt issuance costs of $160 and $219	28,375	29,088
Professional liability risks	1,117	1,078
Income taxes and other liabilities	1,903	1,832
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 412,638,300 shares in 2015 and 420,477,900 shares in 2014	4	4
Accumulated other comprehensive loss	(309)	(323)
Retained deficit	(6,989)	(7,575)
Stockholders' deficit attributable to HCA Holdings, Inc.	(7,294)	(7,894)
Noncontrolling interests	1,482	1,396
Total stockholders' deficit	(5,812)	(6,498)
Total liabilities and stockholders' deficit	$ 31,896	$ 30,980

Condensed Consolidated Balance5

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2015	Dec. 31, 2014
Statement of Financial Position [Abstract]
Allowance for Accounts receivable	$ 5,111	$ 5,011
Debt issuance cost	$ 160	$ 219
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	412,638,300	420,477,900

Condensed Consolidated Statemen

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Cash flows from operating activities:
Net income	$ 1,958	$ 1,697
Decrease in cash from operating assets and liabilities:
Accounts receivable	(2,976)	(2,655)
Provision for doubtful accounts	2,839	2,337
Accounts receivable, net	(137)	(318)
Inventories and other assets	(205)	(248)
Accounts payable and accrued expenses	(152)	(42)
Depreciation and amortization	1,424	1,361
Income taxes	(148)	(61)
Gains on sales of facilities	(2)	(20)
Losses on retirement of debt	125	226
Legal claim costs	77	78
Amortization of debt issuance costs	27	33
Share-based compensation	171	118
Other	38	(3)
Net cash provided by operating activities	3,176	2,821
Cash flows from investing activities:
Purchase of property and equipment	(1,571)	(1,482)
Acquisition of hospitals and health care entities	(184)	(97)
Disposal of hospitals and health care entities	27	38
Change in investments	94	22
Other	3	7
Net cash used in investing activities	(1,631)	(1,512)
Cash flows from financing activities:
Issuances of long-term debt	4,048	3,502
Net change in revolving bank credit facilities	(270)	(160)
Repayment of long-term debt	(3,702)	(3,525)
Distributions to noncontrolling interests	(367)	(325)
Payment of debt issuance costs	(34)	(49)
Repurchases of common stock	(1,386)	(750)
Income tax benefits	231	119
Other	(43)	(20)
Net cash used in financing activities	(1,523)	(1,208)
Change in cash and cash equivalents	22	101
Cash and cash equivalents at beginning of period	566	414
Cash and cash equivalents at end of period	588	515
Interest payments	1,349	1,441
Income tax payments, net	$ 864	$ 758

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	9 Months Ended
	Sep. 30, 2015
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, 2015, these affiliates owned and operated 168 hospitals, 114 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Holdings, Inc.’s facilities are located in 20 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA 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 $79 million and $71 million for the quarters ended September 30, 2015 and 2014, respectively, and $237 million and $206 million for the nine months ended September 30, 2015 and 2014, respectively. Operating results for the quarter and nine months ended September 30, 2015 are not necessarily indicative of the results that may be expected for the year ending December 31, 2015. 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, 2014. Revenues 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), 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, the uninsured and other payers for the quarters and nine months ended September 30, 2015 and 2014 are summarized in the following table (dollars in millions): Quarter 2015 Ratio 2014 Ratio Medicare $ 2,122 21.5 % $ 2,120 23.0 % Managed Medicare 1,031 10.5 901 9.8 Medicaid 402 4.1 372 4.0 Managed Medicaid 553 5.6 510 5.5 Managed care and other insurers 5,457 55.4 5,073 55.0 International (managed care and other insurers) 316 3.2 323 3.5 9,881 100.3 9,299 100.8 Uninsured 695 7.0 313 3.4 Other 438 4.4 366 4.0 Revenues before provision for doubtful accounts 11,014 111.7 9,978 108.2 Provision for doubtful accounts (1,158 ) (11.7 ) (758 ) (8.2 ) Revenues $ 9,856 100.0 % $ 9,220 100.0 % Nine Months 2015 Ratio 2014 Ratio Medicare $ 6,500 22.1 % $ 6,285 23.0 % Managed Medicare 3,099 10.5 2,706 9.9 Medicaid 1,262 4.3 1,404 5.1 Managed Medicaid 1,673 5.7 1,383 5.1 Managed care and other insurers 16,134 54.8 14,742 54.0 International (managed care and other insurers) 964 3.3 983 3.6 29,632 100.7 27,503 100.7 Uninsured 1,321 4.5 1,019 3.7 Other 1,315 4.5 1,097 4.0 Revenues before provision for doubtful accounts 32,268 109.7 29,619 108.4 Provision for doubtful accounts (2,839 ) (9.7 ) (2,337 ) (8.4 ) Revenues $ 29,429 100.0 % $ 27,282 100.0 % The decline in Medicaid revenues for the nine months ended September 30, 2015 compared to the nine months ended September 30, 2014 was primarily due to our recording of an adjustment to increase Medicaid revenues during the quarter ended June 30, 2014 by $142 million, or $0.20 per diluted share, related to the receipt of reimbursements in excess of our estimates for the indigent care component of the Texas Medicaid Waiver Program for the program year ended September 30, 2013. Recent Pronouncements In May 2014, the Financial Accounting Standards Board (“FASB”) 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 was originally scheduled to become effective for public entities for annual and interim periods beginning after December 15, 2016. Early adoption was originally not to be permitted under US GAAP. In July 2015, the FASB decided to defer the effective date of the new revenue standard by one year, but will permit entities to adopt one year earlier if they choose (i.e., the original effective date). The FASB decided, based on its outreach to various stakeholders and forthcoming exposure drafts, which amend the new revenue standard, that a deferral was necessary to provide adequate time to effectively implement the new standard. We are continuing to evaluate the effects the adoption of this standard will have on our financial statements and financial disclosures. In April 2015, the FASB issued Accounting Standards Update 2015-03, Simplifying the Presentation of Debt Issuance Costs Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Acquisitions and Dispositions

Acquisitions and Dispositions	9 Months Ended
	Sep. 30, 2015
Business Combinations [Abstract]
Acquisitions and Dispositions	NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the nine months ended September 30, 2015, we paid $15 million to acquire a hospital and $169 million to acquire other nonhospital health care entities. 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, 2015, we received proceeds of $27 million and recognized net pretax gains of $2 million related to sales of real estate and other investments. 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.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2015
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 3 — INCOME TAXES During 2014, the IRS Examination Division began an audit of HCA Holdings Inc.’s 2011 and 2012 federal income tax returns. We are also subject to examination by state and foreign taxing authorities. Our liability for unrecognized tax benefits was $541 million, including accrued interest of $69 million, as of September 30, 2015 ($548 million and $58 million, respectively, as of December 31, 2014). Unrecognized tax benefits of $228 million ($205 million as of December 31, 2014) would affect the effective rate, if recognized. The provision for income taxes reflects $2 million and $3 million ($1 million and $2 million, respectively, net of tax) of interest expense related to taxing authority examinations for the quarters ended September 30, 2015 and 2014, respectively. The provision for income taxes reflects $6 million and $11 million ($4 million and $7 million, net of tax) of interest expense related to taxing authority examinations for the nine months ended September 30, 2015 and 2014, respectively. Depending on the resolution of any IRS, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease 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, 2015
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, 2015 and 2014 (dollars and shares in millions, except per share amounts): Quarter Nine Months 2015 2014 2015 2014 Net income attributable to HCA Holdings, Inc. $ 449 $ 518 $ 1,547 $ 1,348 Weighted average common shares outstanding 414.939 432.617 417.146 437.832 Effect of dilutive incremental shares 11.502 14.643 13.208 14.706 Shares used for diluted earnings per share 426.441 447.260 430.354 452.538 Earnings per share: Basic earnings per share $ 1.08 $ 1.20 $ 3.71 $ 3.08 Diluted earnings per share $ 1.05 $ 1.16 $ 3.60 $ 2.98

Investments of Insurance Subsid

Investments of Insurance Subsidiaries	9 Months Ended
	Sep. 30, 2015
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, 2015 and December 31, 2014 follows (dollars in millions): September 30, 2015 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 429 $ 16 $ (1 ) $ 444 Money market funds 13 — — 13 442 16 (1 ) 457 Equity securities 1 2 — 3 $ 443 $ 18 $ (1 ) 460 Amounts classified as current assets (51 ) Investment carrying value $ 409 December 31, 2014 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 477 $ 18 $ (1 ) $ 494 Money market funds 61 — — 61 538 18 (1 ) 555 Equity securities 1 2 — 3 $ 539 $ 20 $ (1 ) 558 Amounts classified as current assets (64 ) Investment carrying value $ 494 At September 30, 2015 and December 31, 2014, 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, 2015 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 61 $ 61 Due after one year through five years 172 177 Due after five years through ten years 108 114 Due after ten years 101 105 $ 442 $ 457 The average expected maturity of the investments in debt securities at September 30, 2015 was 4.2 years, compared to the average scheduled maturity of 5.8 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, 2015
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, 2015 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 3,000 December 2016 $ (118 ) Pay-fixed interest rate swaps 1,000 December 2017 (35 ) During the next 12 months, we estimate $115 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, 2015 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Loss Amount of Loss Interest rate swaps $ 30 Interest expense $ 93 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, 2015, we have not been required to post any collateral related to these agreements. If we had breached these provisions at September 30, 2015, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $155 million.

Assets and Liabilities Measured

Assets and Liabilities Measured at Fair Value	9 Months Ended
	Sep. 30, 2015
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 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, 2015 and December 31, 2014, 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, 2015 and December 31, 2014, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): September 30, 2015 Fair Value Fair Value Measurements Using Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 444 $ — $ 438 $ 6 Money market funds 13 13 — — 457 13 438 6 Equity securities 3 3 — — Investments of insurance subsidiaries 460 16 438 6 Less amounts classified as current assets (51 ) (13 ) (38 ) — $ 409 $ 3 $ 400 $ 6 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 153 $ — $ 153 $ — December 31, 2014 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 494 $ — $ 488 $ 6 Money market funds 61 61 — — 555 61 488 6 Equity securities 3 3 — — Investments of insurance subsidiaries 558 64 488 6 Less amounts classified as current assets (64 ) (61 ) (3 ) — $ 494 $ 3 $ 485 $ 6 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 199 $ — $ 199 $ — The estimated fair value of our long-term debt was $30.765 billion and $30.861 billion at September 30, 2015 and December 31, 2014, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $29.912 billion and $29.645 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.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2015
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 8 — LONG-TERM DEBT A summary of long-term debt at September 30, 2015 and December 31, 2014, including related interest rates at September 30, 2015, follows (dollars in millions): September 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 1.7%) $ 2,610 $ 2,880 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 4.9%) 5,668 5,517 Senior secured first lien notes (effective interest rate of 5.5%) 11,100 11,100 Other senior secured debt (effective interest rate of 5.9%) 632 573 First lien debt 20,010 20,070 Senior unsecured notes (effective interest rate of 6.6%) 9,902 9,575 Less net debt issuance costs (160 ) (219 ) Total debt (average life of 6.1 years, rates averaging 5.4%) 29,752 29,426 Less amounts due within one year 1,377 338 $ 28,375 $ 29,088 2015 Activity During June 2015, we entered into a joinder agreement to retire certain of our existing senior secured term loans using proceeds from a new $1.400 billion senior secured term loan credit facility maturing on June 10, 2020. The pretax loss on retirement of debt was $3 million. During May 2015, we issued $1.600 billion aggregate principal amount of 5.375% senior notes due 2025. We used the net proceeds to redeem all $1.525 billion aggregate principal amount of 7 3 / 4 % senior notes due 2021 of HCA Holdings, Inc. The pretax loss on retirement of debt related to this redemption was $122 million. During January 2015, we issued $1.000 billion aggregate principal amount of 5.375% senior notes due 2025. We used a portion of the net proceeds to repay at maturity $750 million aggregate principal amount of 6.375% senior unsecured notes due 2015. 2014 Activity During October 2014, we issued $600 million aggregate principal amount of 4.25% senior secured notes due 2019 and $1.400 billion aggregate principal amount of 5.25% senior secured notes due 2025. During November 2014, we used a portion of the proceeds from the October 2014 debt issuances to redeem all $1.400 billion aggregate principal amount of our outstanding 7 1 / 4 % senior secured notes due 2020. The pretax loss on retirement of debt related to this redemption was $109 million. During March 2014, we issued $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.

Contingencies and Legal Claim C

Contingencies and Legal Claim Costs	9 Months Ended
	Sep. 30, 2015
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. We are subject to claims for additional taxes and related interest and penalties. 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 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 cooperated with the government’s request and produced medical records associated with particular reviews at eight hospitals, located primarily in Florida. On February 24, 2015, the United States District Court for the Southern District of Florida unsealed a qui tam qui tam qui tam qui tam 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 appealed the decision to the Competition Appeal Tribunal. The Competition Appeal Tribunal overturned certain of the Authority’s findings and sent the matter back to the Authority for further proceedings, which are ongoing. A decision is anticipated in early 2016. 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 Holding 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. A request to the court of appeals to hear an immediate appeal of this ruling was denied. Plaintiffs and defendants have each filed motions for summary judgment and to strike certain of the expert witnesses. If the case is not otherwise resolved, trial is likely to occur in 2016. 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 described above. 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 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. On February 9, 2015, the parties reached an agreement to settle the part of their dispute relating to charity and uncompensated care for $15 million. The foundation is required to use that amount, net of attorneys fees, for charitable activities in the Kansas City area. The parties also agreed on an additional amount for attorneys fees for the plaintiff for the accounting phase of the case. The parties filed post-trial motions, on which the court ruled on October 21, 2015. The court denied defendants’ motion to have the court change its rulings on liability and damages related to the capital expenditures issue, and granted the plaintiff’s motion for an award of additional pre-judgment interest. As a result of the court’s ruling on pre-judgment interest, the Company recognized $77 million of legal claim costs in its condensed consolidated income statements for the quarter and nine months ended September 30, 2015, and will continue to accrue interest at 9% per annum until the matter is resolved. At September 30, 2015, the Company had an accrued liability of $382 million in connection with this litigation. Once final judgment is entered, the Company plans to pursue an appeal.

Capital Structure

Capital Structure	9 Months Ended
	Sep. 30, 2015
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 and shares in millions): Equity (Deficit) Attributable to HCA Holdings, Inc. Equity Total Common Stock Capital in Accumulated Retained Shares Par Value Balances at December 31, 2014 420.478 $ 4 $ — $ (323 ) $ (7,575 ) $ 1,396 $ (6,498 ) Comprehensive income — — — 14 1,547 411 1,972 Repurchase of common stock (17.629 ) — (425 ) — (961 ) — (1,386 ) Distributions — — — — — (367 ) (367 ) Share-based benefit plans 9.789 — 433 — — — 433 Other — — (8 ) — — 42 34 Balances at September 30, 2015 412.638 $ 4 $ — $ (309 ) $ (6,989 ) $ 1,482 $ (5,812 ) On April 18, 2015, the Company entered into an agreement to repurchase 3,806,460 shares of its common stock beneficially owned by affiliates of Bain Capital Investors, LLC (“the Bain Entities”) and certain charitable organizations that received shares of common stock as charitable contributions from certain partners and other employees of the Bain Entities at a purchase price of $77.26 per share, the closing price of the Company’s common stock on the New York Stock Exchange on April 17, 2015, less a discount of 1% (the “Share Repurchase”). The Share Repurchase was made pursuant to the authorization of our Board of Directors in February 2015 to repurchase up to $1.0 billion of our outstanding common stock. During May 2015, our Board of Directors authorized an additional share repurchase program for up to $1.0 billion of our outstanding common stock. During the nine months ended September 30, 2015, we repurchased 13,822,818 shares of our common stock at an average price of $78.96 per share through market purchases, resulting in total repurchases pursuant to the February 2015 and May 2015 authorizations of 17,629,278 shares of our common stock at an average price of $78.60 per share. At September 30, 2015, we had no repurchase authorization remaining under the $1.0 billion February 2015 authorization and $614 million of repurchase authorization available under the $1.0 billion May 2015 authorization. The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Foreign Defined Change Total Balances at December 31, 2014 $ 13 $ (36 ) $ (174 ) $ (126 ) $ (323 ) Unrealized losses on available-for-sale securities, net of income tax benefit (2 ) — — — (2 ) Foreign currency translation adjustments, net of $17 income tax benefit — (24 ) — — (24 ) Change in fair value of derivative instruments, net of $17 income tax benefit — — — (30 ) (30 ) Expense reclassified into operations from other comprehensive income, net of $6 and $34, respectively, income tax benefits — — 11 59 70 Balances at September 30, 2015 $ 11 $ (60 ) $ (163 ) $ (97 ) $ (309 )

Segment and Geographic Informat

Segment and Geographic Information	9 Months Ended
	Sep. 30, 2015
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. We operate in two geographically organized groups: the National and American Groups. The National Group includes 83 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, South Carolina, Utah and Virginia, and the American Group includes 79 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and Texas. We also operate six hospitals in England, and these facilities are included in the Corporate and other group. Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, 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, 2015 and 2014 are summarized in the following table (dollars in millions): Quarter Nine Months 2015 2014 2015 2014 Revenues: National Group $ 4,580 $ 4,334 $ 13,928 $ 12,766 American Group 4,772 4,350 13,972 12,949 Corporate and other 504 536 1,529 1,567 $ 9,856 $ 9,220 $ 29,429 $ 27,282 Equity in earnings of affiliates: National Group $ (1 ) $ (6 ) $ (8 ) $ (12 ) American Group (9 ) (8 ) (25 ) (23 ) Corporate and other 1 — (5 ) 3 $ (9 ) $ (14 ) $ (38 ) $ (32 ) Adjusted segment EBITDA: National Group $ 919 $ 952 $ 3,084 $ 2,755 American Group 1,035 959 3,026 2,942 Corporate and other (139 ) (83 ) (326 ) (225 ) $ 1,815 $ 1,828 $ 5,784 $ 5,472 Depreciation and amortization: National Group $ 195 $ 187 $ 572 $ 564 American Group 219 212 662 627 Corporate and other 68 61 190 170 $ 482 $ 460 $ 1,424 $ 1,361 Adjusted segment EBITDA $ 1,815 $ 1,828 $ 5,784 $ 5,472 Depreciation and amortization 482 460 1,424 1,361 Interest expense 411 427 1,255 1,314 Losses (gains) on sales of facilities 2 12 (2 ) (20 ) Losses on retirement of debt — — 125 226 Legal claim costs 77 — 77 78 Income before income taxes $ 843 $ 929 $ 2,905 $ 2,513

Supplemental Condensed Consolid

Supplemental Condensed Consolidating Financial Information	9 Months Ended
	Sep. 30, 2015
Text Block [Abstract]
Supplemental Condensed Consolidating Financial Information	NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION During November 2010, HCA Holdings, Inc. issued $1.525 billion aggregate principal amount of 7 3 / 4 % senior unsecured notes due 2021. During May 2015, we redeemed all $1.525 billion aggregate principal amount of 7 3 / 4 % unsecured senior notes due 2021. During December 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, 2015 and 2014, condensed consolidating balance sheets at September 30, 2015 and December 31, 2014 and condensed consolidating statements of cash flows for the nine months ended September 30, 2015 and 2014, 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, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,721 $ 5,293 $ — $ 11,014 Provision for doubtful accounts — — 689 469 — 1,158 Revenues — — 5,032 4,824 — 9,856 Salaries and benefits — — 2,357 2,262 — 4,619 Supplies — — 853 791 — 1,644 Other operating expenses 7 — 865 924 — 1,796 Electronic health record incentive income — — (6 ) (3 ) — (9 ) Equity in earnings of affiliates (464 ) — (1 ) (8 ) 464 (9 ) Depreciation and amortization — — 230 252 — 482 Interest expense 16 608 (156 ) (57 ) — 411 Losses (gains) on sales of facilities — — (1 ) 3 — 2 Legal claim costs — 77 — — — 77 Management fees — — (178 ) 178 — — (441 ) 685 3,963 4,342 464 9,013 Income (loss) before income taxes 441 (685 ) 1,069 482 (464 ) 843 Provision (benefit) for income taxes (8 ) (258 ) 394 142 — 270 Net income (loss) 449 (427 ) 675 340 (464 ) 573 Net income attributable to noncontrolling interests — — 21 103 — 124 Net income (loss) attributable to HCA Holdings, Inc. $ 449 $ (427 ) $ 654 $ 237 $ (464 ) $ 449 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 430 $ (418 ) $ 657 $ 206 $ (445 ) $ 430 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 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 (549 ) — (3 ) (11 ) 549 (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 — — (499 ) 536 3,700 4,005 549 8,291 Income (loss) before income taxes 499 (536 ) 976 539 (549 ) 929 Provision (benefit) for income taxes (19 ) (205 ) 365 177 — 318 Net income (loss) 518 (331 ) 611 362 (549 ) 611 Net income attributable to noncontrolling interests — — 18 75 — 93 Net income (loss) attributable to HCA Holdings, Inc. $ 518 $ (331 ) $ 593 $ 287 $ (549 ) $ 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 NINE MONTHS ENDED SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 16,519 $ 15,749 $ — $ 32,268 Provision for doubtful accounts — — 1,535 1,304 — 2,839 Revenues — — 14,984 14,445 — 29,429 Salaries and benefits — — 6,824 6,685 — 13,509 Supplies — — 2,576 2,376 — 4,952 Other operating expenses 9 — 2,523 2,736 — 5,268 Electronic health record incentive income — — (31 ) (15 ) — (46 ) Equity in earnings of affiliates (1,690 ) — (4 ) (34 ) 1,690 (38 ) Depreciation and amortization — — 683 741 — 1,424 Interest expense 100 1,807 (498 ) (154 ) — 1,255 Losses (gains) on sales of facilities — — (5 ) 3 — (2 ) Losses on retirement of debt 122 3 — — — 125 Legal claim costs — 77 — — — 77 Management fees — — (534 ) 534 — — (1,459 ) 1,887 11,534 12,872 1,690 26,524 Income (loss) before income taxes 1,459 (1,887 ) 3,450 1,573 (1,690 ) 2,905 Provision (benefit) for income taxes (88 ) (716 ) 1,284 467 — 947 Net income (loss) 1,547 (1,171 ) 2,166 1,106 (1,690 ) 1,958 Net income attributable to noncontrolling interests — — 68 343 — 411 Net income (loss) attributable to HCA Holdings, Inc. $ 1,547 $ (1,171 ) $ 2,098 $ 763 $ (1,690 ) $ 1,547 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,561 $ (1,142 ) $ 2,109 $ 737 $ (1,704 ) $ 1,561 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 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 (1,443 ) — (5 ) (27 ) 1,443 (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 — — (1,291 ) 1,933 10,876 11,808 1,443 24,769 Income (loss) before income taxes 1,291 (1,933 ) 2,978 1,620 (1,443 ) 2,513 Provision (benefit) for income taxes (57 ) (729 ) 1,098 504 — 816 Net income (loss) 1,348 (1,204 ) 1,880 1,116 (1,443 ) 1,697 Net income attributable to noncontrolling interests — — 65 284 — 349 Net income (loss) attributable to HCA Holdings, Inc. $ 1,348 $ (1,204 ) $ 1,815 $ 832 $ (1,443 ) $ 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 BALANCE SHEET SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 109 $ 479 $ — $ 588 Accounts receivable, net — — 2,874 2,953 — 5,827 Inventories — — 821 558 — 1,379 Deferred income taxes 412 — — — — 412 Other 13 — 428 574 — 1,015 425 — 4,232 4,564 — 9,221 Property and equipment, net — — 8,078 6,626 — 14,704 Investments of insurance subsidiaries — — — 409 — 409 Investments in and advances to affiliates 23,674 — 17 169 (23,674 ) 186 Goodwill and other intangible assets — — 1,703 4,837 — 6,540 Other 625 — 24 187 — 836 $ 24,724 $ — $ 14,054 $ 16,792 $ (23,674 ) $ 31,896 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 9 $ — $ 1,165 $ 703 $ — $ 1,877 Accrued salaries — — 770 588 — 1,358 Other accrued expenses 14 245 540 902 — 1,701 Long-term debt due within one year — 1,264 61 52 — 1,377 23 1,509 2,536 2,245 — 6,313 Long-term debt, net 982 26,874 222 297 — 28,375 Intercompany balances 30,472 (10,757 ) (22,877 ) 3,162 — — Professional liability risks — — — 1,117 — 1,117 Income taxes and other liabilities 541 534 428 400 — 1,903 32,018 18,160 (19,691 ) 7,221 — 37,708 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,294 ) (18,160 ) 33,626 8,208 (23,674 ) (7,294 ) Noncontrolling interests — — 119 1,363 — 1,482 (7,294 ) (18,160 ) 33,745 9,571 (23,674 ) (5,812 ) $ 24,724 $ — $ 14,054 $ 16,792 $ (23,674 ) $ 31,896 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2014 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 87 $ 479 $ — $ 566 Accounts receivable, net — — 2,812 2,882 — 5,694 Inventories — — 756 523 — 1,279 Deferred income taxes 366 — — — — 366 Other 118 — 376 531 — 1,025 484 — 4,031 4,415 — 8,930 Property and equipment, net — — 7,871 6,484 — 14,355 Investments of insurance subsidiaries — — — 494 — 494 Investments in and advances to affiliates 21,970 — 16 149 (21,970 ) 165 Goodwill and other intangible assets — — 1,705 4,711 — 6,416 Other 435 — 27 158 — 620 $ 22,889 $ — $ 13,650 $ 16,411 $ (21,970 ) $ 30,980 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 1 $ — $ 1,272 $ 762 $ — $ 2,035 Accrued salaries — — 783 587 — 1,370 Other accrued expenses 45 317 517 858 — 1,737 Long-term debt due within one year — 231 56 51 — 338 46 548 2,628 2,258 — 5,480 Long-term debt, net 2,499 26,124 185 280 — 29,088 Intercompany balances 27,685 (10,141 ) (21,405 ) 3,861 — — Professional liability risks — — — 1,078 — 1,078 Income taxes and other liabilities 553 487 605 187 — 1,832 30,783 17,018 (17,987 ) 7,664 — 37,478 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,894 ) (17,018 ) 31,516 7,472 (21,970 ) (7,894 ) Noncontrolling interests — — 121 1,275 — 1,396 (7,894 ) (17,018 ) 31,637 8,747 (21,970 ) (6,498 ) $ 22,889 $ — $ 13,650 $ 16,411 $ (21,970 ) $ 30,980 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,547 $ (1,171 ) $ 2,166 $ 1,106 $ (1,690 ) $ 1,958 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (22 ) (56 ) (1,959 ) (1,296 ) — (3,333 ) Provision for doubtful accounts — — 1,535 1,304 — 2,839 Depreciation and amortization — — 683 741 — 1,424 Income taxes (148 ) — — — — (148 ) Losses (gains) on sales of facilities — — (5 ) 3 — (2 ) Losses on retirement of debt 122 3 — — — 125 Legal claim costs — 77 — — — 77 Amortization of debt issuance costs 3 24 — — — 27 Share-based compensation 171 — — — — 171 Equity in earnings of affiliates (1,690 ) — — — 1,690 — Other 49 3 — (14 ) — 38 Net cash provided by (used in) operating activities 32 (1,120 ) 2,420 1,844 — 3,176 Cash flows from investing activities: Purchase of property and equipment — — (764 ) (807 ) — (1,571 ) Acquisition of hospitals and health care entities — — (51 ) (133 ) — (184 ) Disposition of hospitals and health care entities — — 19 8 — 27 Change in investments — — 2 92 — 94 Other — — (6 ) 9 — 3 Net cash used in investing activities — — (800 ) (831 ) — (1,631 ) Cash flows from financing activities: Issuance of long-term debt — 4,048 — — — 4,048 Net change in revolving credit facilities — (270 ) — — — (270 ) Repayment of long-term debt (1,632 ) (2,001 ) (45 ) (24 ) — (3,702 ) Distributions to noncontrolling interests — — (70 ) (297 ) — (367 ) Payment of debt issuance costs — (34 ) — — — (34 ) Repurchases of common stock (1,386 ) — — — — (1,386 ) Changes in intercompany balances with affiliates, net 2,784 (623) (1,483 ) (678 ) — — Income tax benefits 231 — — — — 231 Other (29 ) — — (14 ) — (43 ) Net cash (used in) provided by financing activities (32 ) 1,120 (1,598 ) (1,013 ) — (1,523 ) Change in cash and cash equivalents — — 22 — — 22 Cash and cash equivalents at beginning of period — — 87 479 — 566 Cash and cash equivalents at end of period $ — $ — $ 109 $ 479 $ — $ 588 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 Cash flows from operating activities: Net income (loss) $ 1,348 $ (1,204 ) $ 1,880 $ 1,116 $ (1,443 ) $ 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 (1,443 ) — — — 1,443 — 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 ) Changes in intercompany balances with affiliates, net 654 1,186 (1,331 ) (509 ) — — Income tax benefits 119 — — — — 119 Other (5 ) — — (15 ) — (20 ) 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

Basis of Presentation and Sig19

Basis of Presentation and Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2015
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 $79 million and $71 million for the quarters ended September 30, 2015 and 2014, respectively, and $237 million and $206 million for the nine months ended September 30, 2015 and 2014, respectively. Operating results for the quarter and nine months ended September 30, 2015 are not necessarily indicative of the results that may be expected for the year ending December 31, 2015. 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, 2014.
Revenues	Revenues 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), 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, the uninsured and other payers for the quarters and nine months ended September 30, 2015 and 2014 are summarized in the following table (dollars in millions): Quarter 2015 Ratio 2014 Ratio Medicare $ 2,122 21.5 % $ 2,120 23.0 % Managed Medicare 1,031 10.5 901 9.8 Medicaid 402 4.1 372 4.0 Managed Medicaid 553 5.6 510 5.5 Managed care and other insurers 5,457 55.4 5,073 55.0 International (managed care and other insurers) 316 3.2 323 3.5 9,881 100.3 9,299 100.8 Uninsured 695 7.0 313 3.4 Other 438 4.4 366 4.0 Revenues before provision for doubtful accounts 11,014 111.7 9,978 108.2 Provision for doubtful accounts (1,158 ) (11.7 ) (758 ) (8.2 ) Revenues $ 9,856 100.0 % $ 9,220 100.0 % Nine Months 2015 Ratio 2014 Ratio Medicare $ 6,500 22.1 % $ 6,285 23.0 % Managed Medicare 3,099 10.5 2,706 9.9 Medicaid 1,262 4.3 1,404 5.1 Managed Medicaid 1,673 5.7 1,383 5.1 Managed care and other insurers 16,134 54.8 14,742 54.0 International (managed care and other insurers) 964 3.3 983 3.6 29,632 100.7 27,503 100.7 Uninsured 1,321 4.5 1,019 3.7 Other 1,315 4.5 1,097 4.0 Revenues before provision for doubtful accounts 32,268 109.7 29,619 108.4 Provision for doubtful accounts (2,839 ) (9.7 ) (2,337 ) (8.4 ) Revenues $ 29,429 100.0 % $ 27,282 100.0 % The decline in Medicaid revenues for the nine months ended September 30, 2015 compared to the nine months ended September 30, 2014 was primarily due to our recording of an adjustment to increase Medicaid revenues during the quarter ended June 30, 2014 by $142 million, or $0.20 per diluted share, related to the receipt of reimbursements in excess of our estimates for the indigent care component of the Texas Medicaid Waiver Program for the program year ended September 30, 2013.
Recent Pronouncements	Recent Pronouncements In May 2014, the Financial Accounting Standards Board (“FASB”) 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 was originally scheduled to become effective for public entities for annual and interim periods beginning after December 15, 2016. Early adoption was originally not to be permitted under US GAAP. In July 2015, the FASB decided to defer the effective date of the new revenue standard by one year, but will permit entities to adopt one year earlier if they choose (i.e., the original effective date). The FASB decided, based on its outreach to various stakeholders and forthcoming exposure drafts, which amend the new revenue standard, that a deferral was necessary to provide adequate time to effectively implement the new standard. We are continuing to evaluate the effects the adoption of this standard will have on our financial statements and financial disclosures. In April 2015, the FASB issued Accounting Standards Update 2015-03, Simplifying the Presentation of Debt Issuance Costs
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.
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.
Fair Value Measurements and Disclosures	Accounting Standards Codification 820, Fair Value Measurements and Disclosures 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, 2015 and December 31, 2014, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives.
Interest Rate Swaps [Member]
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.

Basis of Presentation and Sig20

Basis of Presentation and Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2015
Accounting Policies [Abstract]
Schedule of Revenues from Third Party Payers, Uninsured and Other Payers	Our revenues from third-party payers, the uninsured and other payers for the quarters and nine months ended September 30, 2015 and 2014 are summarized in the following table (dollars in millions): Quarter 2015 Ratio 2014 Ratio Medicare $ 2,122 21.5 % $ 2,120 23.0 % Managed Medicare 1,031 10.5 901 9.8 Medicaid 402 4.1 372 4.0 Managed Medicaid 553 5.6 510 5.5 Managed care and other insurers 5,457 55.4 5,073 55.0 International (managed care and other insurers) 316 3.2 323 3.5 9,881 100.3 9,299 100.8 Uninsured 695 7.0 313 3.4 Other 438 4.4 366 4.0 Revenues before provision for doubtful accounts 11,014 111.7 9,978 108.2 Provision for doubtful accounts (1,158 ) (11.7 ) (758 ) (8.2 ) Revenues $ 9,856 100.0 % $ 9,220 100.0 % Nine Months 2015 Ratio 2014 Ratio Medicare $ 6,500 22.1 % $ 6,285 23.0 % Managed Medicare 3,099 10.5 2,706 9.9 Medicaid 1,262 4.3 1,404 5.1 Managed Medicaid 1,673 5.7 1,383 5.1 Managed care and other insurers 16,134 54.8 14,742 54.0 International (managed care and other insurers) 964 3.3 983 3.6 29,632 100.7 27,503 100.7 Uninsured 1,321 4.5 1,019 3.7 Other 1,315 4.5 1,097 4.0 Revenues before provision for doubtful accounts 32,268 109.7 29,619 108.4 Provision for doubtful accounts (2,839 ) (9.7 ) (2,337 ) (8.4 ) Revenues $ 29,429 100.0 % $ 27,282 100.0 %

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2015
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, 2015 and 2014 (dollars and shares in millions, except per share amounts): Quarter Nine Months 2015 2014 2015 2014 Net income attributable to HCA Holdings, Inc. $ 449 $ 518 $ 1,547 $ 1,348 Weighted average common shares outstanding 414.939 432.617 417.146 437.832 Effect of dilutive incremental shares 11.502 14.643 13.208 14.706 Shares used for diluted earnings per share 426.441 447.260 430.354 452.538 Earnings per share: Basic earnings per share $ 1.08 $ 1.20 $ 3.71 $ 3.08 Diluted earnings per share $ 1.05 $ 1.16 $ 3.60 $ 2.98

Investments of Insurance Subs22

Investments of Insurance Subsidiaries (Tables)	9 Months Ended
	Sep. 30, 2015
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	A summary of our insurance subsidiaries’ investments at September 30, 2015 and December 31, 2014 follows (dollars in millions): September 30, 2015 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 429 $ 16 $ (1 ) $ 444 Money market funds 13 — — 13 442 16 (1 ) 457 Equity securities 1 2 — 3 $ 443 $ 18 $ (1 ) 460 Amounts classified as current assets (51 ) Investment carrying value $ 409 December 31, 2014 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 477 $ 18 $ (1 ) $ 494 Money market funds 61 — — 61 538 18 (1 ) 555 Equity securities 1 2 — 3 $ 539 $ 20 $ (1 ) 558 Amounts classified as current assets (64 ) Investment carrying value $ 494
Schedule of Maturities of Investments	Scheduled maturities of investments in debt securities at September 30, 2015 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 61 $ 61 Due after one year through five years 172 177 Due after five years through ten years 108 114 Due after ten years 101 105 $ 442 $ 457

Financial Instruments (Tables)

Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2015
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, 2015 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 3,000 December 2016 $ (118 ) Pay-fixed interest rate swaps 1,000 December 2017 (35 )
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, 2015 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Loss Amount of Loss Interest rate swaps $ 30 Interest expense $ 93

Assets and Liabilities Measur24

Assets and Liabilities Measured at Fair Value (Tables)	9 Months Ended
	Sep. 30, 2015
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, 2015 and December 31, 2014, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): September 30, 2015 Fair Value Fair Value Measurements Using Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 444 $ — $ 438 $ 6 Money market funds 13 13 — — 457 13 438 6 Equity securities 3 3 — — Investments of insurance subsidiaries 460 16 438 6 Less amounts classified as current assets (51 ) (13 ) (38 ) — $ 409 $ 3 $ 400 $ 6 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 153 $ — $ 153 $ — December 31, 2014 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 494 $ — $ 488 $ 6 Money market funds 61 61 — — 555 61 488 6 Equity securities 3 3 — — Investments of insurance subsidiaries 558 64 488 6 Less amounts classified as current assets (64 ) (61 ) (3 ) — $ 494 $ 3 $ 485 $ 6 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 199 $ — $ 199 $ —

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2015
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	A summary of long-term debt at September 30, 2015 and December 31, 2014, including related interest rates at September 30, 2015, follows (dollars in millions): September 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 1.7%) $ 2,610 $ 2,880 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 4.9%) 5,668 5,517 Senior secured first lien notes (effective interest rate of 5.5%) 11,100 11,100 Other senior secured debt (effective interest rate of 5.9%) 632 573 First lien debt 20,010 20,070 Senior unsecured notes (effective interest rate of 6.6%) 9,902 9,575 Less net debt issuance costs (160 ) (219 ) Total debt (average life of 6.1 years, rates averaging 5.4%) 29,752 29,426 Less amounts due within one year 1,377 338 $ 28,375 $ 29,088

Capital Structure (Tables)

Capital Structure (Tables)	9 Months Ended
	Sep. 30, 2015
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 and shares in millions): Equity (Deficit) Attributable to HCA Holdings, Inc. Equity Total Common Stock Capital in Accumulated Retained Shares Par Value Balances at December 31, 2014 420.478 $ 4 $ — $ (323 ) $ (7,575 ) $ 1,396 $ (6,498 ) Comprehensive income — — — 14 1,547 411 1,972 Repurchase of common stock (17.629 ) — (425 ) — (961 ) — (1,386 ) Distributions — — — — — (367 ) (367 ) Share-based benefit plans 9.789 — 433 — — — 433 Other — — (8 ) — — 42 34 Balances at September 30, 2015 412.638 $ 4 $ — $ (309 ) $ (6,989 ) $ 1,482 $ (5,812 )
Components of Accumulated Other Comprehensive Loss	The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Foreign Defined Change Total Balances at December 31, 2014 $ 13 $ (36 ) $ (174 ) $ (126 ) $ (323 ) Unrealized losses on available-for-sale securities, net of income tax benefit (2 ) — — — (2 ) Foreign currency translation adjustments, net of $17 income tax benefit — (24 ) — — (24 ) Change in fair value of derivative instruments, net of $17 income tax benefit — — — (30 ) (30 ) Expense reclassified into operations from other comprehensive income, net of $6 and $34, respectively, income tax benefits — — 11 59 70 Balances at September 30, 2015 $ 11 $ (60 ) $ (163 ) $ (97 ) $ (309 )

Segment and Geographic Inform27

Segment and Geographic Information (Tables)	9 Months Ended
	Sep. 30, 2015
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, 2015 and 2014 are summarized in the following table (dollars in millions): Quarter Nine Months 2015 2014 2015 2014 Revenues: National Group $ 4,580 $ 4,334 $ 13,928 $ 12,766 American Group 4,772 4,350 13,972 12,949 Corporate and other 504 536 1,529 1,567 $ 9,856 $ 9,220 $ 29,429 $ 27,282 Equity in earnings of affiliates: National Group $ (1 ) $ (6 ) $ (8 ) $ (12 ) American Group (9 ) (8 ) (25 ) (23 ) Corporate and other 1 — (5 ) 3 $ (9 ) $ (14 ) $ (38 ) $ (32 ) Adjusted segment EBITDA: National Group $ 919 $ 952 $ 3,084 $ 2,755 American Group 1,035 959 3,026 2,942 Corporate and other (139 ) (83 ) (326 ) (225 ) $ 1,815 $ 1,828 $ 5,784 $ 5,472 Depreciation and amortization: National Group $ 195 $ 187 $ 572 $ 564 American Group 219 212 662 627 Corporate and other 68 61 190 170 $ 482 $ 460 $ 1,424 $ 1,361 Adjusted segment EBITDA $ 1,815 $ 1,828 $ 5,784 $ 5,472 Depreciation and amortization 482 460 1,424 1,361 Interest expense 411 427 1,255 1,314 Losses (gains) on sales of facilities 2 12 (2 ) (20 ) Losses on retirement of debt — — 125 226 Legal claim costs 77 — 77 78 Income before income taxes $ 843 $ 929 $ 2,905 $ 2,513

Supplemental Condensed Consol28

Supplemental Condensed Consolidating Financial Information (Tables)	9 Months Ended
	Sep. 30, 2015
Text Block [Abstract]
Schedule of Condensed Consolidating Comprehensive Income Statement	HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,721 $ 5,293 $ — $ 11,014 Provision for doubtful accounts — — 689 469 — 1,158 Revenues — — 5,032 4,824 — 9,856 Salaries and benefits — — 2,357 2,262 — 4,619 Supplies — — 853 791 — 1,644 Other operating expenses 7 — 865 924 — 1,796 Electronic health record incentive income — — (6 ) (3 ) — (9 ) Equity in earnings of affiliates (464 ) — (1 ) (8 ) 464 (9 ) Depreciation and amortization — — 230 252 — 482 Interest expense 16 608 (156 ) (57 ) — 411 Losses (gains) on sales of facilities — — (1 ) 3 — 2 Legal claim costs — 77 — — — 77 Management fees — — (178 ) 178 — — (441 ) 685 3,963 4,342 464 9,013 Income (loss) before income taxes 441 (685 ) 1,069 482 (464 ) 843 Provision (benefit) for income taxes (8 ) (258 ) 394 142 — 270 Net income (loss) 449 (427 ) 675 340 (464 ) 573 Net income attributable to noncontrolling interests — — 21 103 — 124 Net income (loss) attributable to HCA Holdings, Inc. $ 449 $ (427 ) $ 654 $ 237 $ (464 ) $ 449 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 430 $ (418 ) $ 657 $ 206 $ (445 ) $ 430 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 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 (549 ) — (3 ) (11 ) 549 (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 — — (499 ) 536 3,700 4,005 549 8,291 Income (loss) before income taxes 499 (536 ) 976 539 (549 ) 929 Provision (benefit) for income taxes (19 ) (205 ) 365 177 — 318 Net income (loss) 518 (331 ) 611 362 (549 ) 611 Net income attributable to noncontrolling interests — — 18 75 — 93 Net income (loss) attributable to HCA Holdings, Inc. $ 518 $ (331 ) $ 593 $ 287 $ (549 ) $ 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 NINE MONTHS ENDED SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 16,519 $ 15,749 $ — $ 32,268 Provision for doubtful accounts — — 1,535 1,304 — 2,839 Revenues — — 14,984 14,445 — 29,429 Salaries and benefits — — 6,824 6,685 — 13,509 Supplies — — 2,576 2,376 — 4,952 Other operating expenses 9 — 2,523 2,736 — 5,268 Electronic health record incentive income — — (31 ) (15 ) — (46 ) Equity in earnings of affiliates (1,690 ) — (4 ) (34 ) 1,690 (38 ) Depreciation and amortization — — 683 741 — 1,424 Interest expense 100 1,807 (498 ) (154 ) — 1,255 Losses (gains) on sales of facilities — — (5 ) 3 — (2 ) Losses on retirement of debt 122 3 — — — 125 Legal claim costs — 77 — — — 77 Management fees — — (534 ) 534 — — (1,459 ) 1,887 11,534 12,872 1,690 26,524 Income (loss) before income taxes 1,459 (1,887 ) 3,450 1,573 (1,690 ) 2,905 Provision (benefit) for income taxes (88 ) (716 ) 1,284 467 — 947 Net income (loss) 1,547 (1,171 ) 2,166 1,106 (1,690 ) 1,958 Net income attributable to noncontrolling interests — — 68 343 — 411 Net income (loss) attributable to HCA Holdings, Inc. $ 1,547 $ (1,171 ) $ 2,098 $ 763 $ (1,690 ) $ 1,547 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,561 $ (1,142 ) $ 2,109 $ 737 $ (1,704 ) $ 1,561 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 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 (1,443 ) — (5 ) (27 ) 1,443 (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 — — (1,291 ) 1,933 10,876 11,808 1,443 24,769 Income (loss) before income taxes 1,291 (1,933 ) 2,978 1,620 (1,443 ) 2,513 Provision (benefit) for income taxes (57 ) (729 ) 1,098 504 — 816 Net income (loss) 1,348 (1,204 ) 1,880 1,116 (1,443 ) 1,697 Net income attributable to noncontrolling interests — — 65 284 — 349 Net income (loss) attributable to HCA Holdings, Inc. $ 1,348 $ (1,204 ) $ 1,815 $ 832 $ (1,443 ) $ 1,348 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,399 $ (1,154 ) $ 1,822 $ 826 $ (1,494 ) $ 1,399
Schedule of Condensed Consolidating Balance Sheet	HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 109 $ 479 $ — $ 588 Accounts receivable, net — — 2,874 2,953 — 5,827 Inventories — — 821 558 — 1,379 Deferred income taxes 412 — — — — 412 Other 13 — 428 574 — 1,015 425 — 4,232 4,564 — 9,221 Property and equipment, net — — 8,078 6,626 — 14,704 Investments of insurance subsidiaries — — — 409 — 409 Investments in and advances to affiliates 23,674 — 17 169 (23,674 ) 186 Goodwill and other intangible assets — — 1,703 4,837 — 6,540 Other 625 — 24 187 — 836 $ 24,724 $ — $ 14,054 $ 16,792 $ (23,674 ) $ 31,896 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 9 $ — $ 1,165 $ 703 $ — $ 1,877 Accrued salaries — — 770 588 — 1,358 Other accrued expenses 14 245 540 902 — 1,701 Long-term debt due within one year — 1,264 61 52 — 1,377 23 1,509 2,536 2,245 — 6,313 Long-term debt, net 982 26,874 222 297 — 28,375 Intercompany balances 30,472 (10,757 ) (22,877 ) 3,162 — — Professional liability risks — — — 1,117 — 1,117 Income taxes and other liabilities 541 534 428 400 — 1,903 32,018 18,160 (19,691 ) 7,221 — 37,708 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,294 ) (18,160 ) 33,626 8,208 (23,674 ) (7,294 ) Noncontrolling interests — — 119 1,363 — 1,482 (7,294 ) (18,160 ) 33,745 9,571 (23,674 ) (5,812 ) $ 24,724 $ — $ 14,054 $ 16,792 $ (23,674 ) $ 31,896 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2014 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 87 $ 479 $ — $ 566 Accounts receivable, net — — 2,812 2,882 — 5,694 Inventories — — 756 523 — 1,279 Deferred income taxes 366 — — — — 366 Other 118 — 376 531 — 1,025 484 — 4,031 4,415 — 8,930 Property and equipment, net — — 7,871 6,484 — 14,355 Investments of insurance subsidiaries — — — 494 — 494 Investments in and advances to affiliates 21,970 — 16 149 (21,970 ) 165 Goodwill and other intangible assets — — 1,705 4,711 — 6,416 Other 435 — 27 158 — 620 $ 22,889 $ — $ 13,650 $ 16,411 $ (21,970 ) $ 30,980 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 1 $ — $ 1,272 $ 762 $ — $ 2,035 Accrued salaries — — 783 587 — 1,370 Other accrued expenses 45 317 517 858 — 1,737 Long-term debt due within one year — 231 56 51 — 338 46 548 2,628 2,258 — 5,480 Long-term debt, net 2,499 26,124 185 280 — 29,088 Intercompany balances 27,685 (10,141 ) (21,405 ) 3,861 — — Professional liability risks — — — 1,078 — 1,078 Income taxes and other liabilities 553 487 605 187 — 1,832 30,783 17,018 (17,987 ) 7,664 — 37,478 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,894 ) (17,018 ) 31,516 7,472 (21,970 ) (7,894 ) Noncontrolling interests — — 121 1,275 — 1,396 (7,894 ) (17,018 ) 31,637 8,747 (21,970 ) (6,498 ) $ 22,889 $ — $ 13,650 $ 16,411 $ (21,970 ) $ 30,980
Schedule of Condensed Consolidating Statement of Cash Flows	HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,547 $ (1,171 ) $ 2,166 $ 1,106 $ (1,690 ) $ 1,958 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (22 ) (56 ) (1,959 ) (1,296 ) — (3,333 ) Provision for doubtful accounts — — 1,535 1,304 — 2,839 Depreciation and amortization — — 683 741 — 1,424 Income taxes (148 ) — — — — (148 ) Losses (gains) on sales of facilities — — (5 ) 3 — (2 ) Losses on retirement of debt 122 3 — — — 125 Legal claim costs — 77 — — — 77 Amortization of debt issuance costs 3 24 — — — 27 Share-based compensation 171 — — — — 171 Equity in earnings of affiliates (1,690 ) — — — 1,690 — Other 49 3 — (14 ) — 38 Net cash provided by (used in) operating activities 32 (1,120 ) 2,420 1,844 — 3,176 Cash flows from investing activities: Purchase of property and equipment — — (764 ) (807 ) — (1,571 ) Acquisition of hospitals and health care entities — — (51 ) (133 ) — (184 ) Disposition of hospitals and health care entities — — 19 8 — 27 Change in investments — — 2 92 — 94 Other — — (6 ) 9 — 3 Net cash used in investing activities — — (800 ) (831 ) — (1,631 ) Cash flows from financing activities: Issuance of long-term debt — 4,048 — — — 4,048 Net change in revolving credit facilities — (270 ) — — — (270 ) Repayment of long-term debt (1,632 ) (2,001 ) (45 ) (24 ) — (3,702 ) Distributions to noncontrolling interests — — (70 ) (297 ) — (367 ) Payment of debt issuance costs — (34 ) — — — (34 ) Repurchases of common stock (1,386 ) — — — — (1,386 ) Changes in intercompany balances with affiliates, net 2,784 (623) (1,483 ) (678 ) — — Income tax benefits 231 — — — — 231 Other (29 ) — — (14 ) — (43 ) Net cash (used in) provided by financing activities (32 ) 1,120 (1,598 ) (1,013 ) — (1,523 ) Change in cash and cash equivalents — — 22 — — 22 Cash and cash equivalents at beginning of period — — 87 479 — 566 Cash and cash equivalents at end of period $ — $ — $ 109 $ 479 $ — $ 588 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 Cash flows from operating activities: Net income (loss) $ 1,348 $ (1,204 ) $ 1,880 $ 1,116 $ (1,443 ) $ 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 (1,443 ) — — — 1,443 — 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 ) Changes in intercompany balances with affiliates, net 654 1,186 (1,331 ) (509 ) — — Income tax benefits 119 — — — — 119 Other (5 ) — — (15 ) — (20 ) 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

Basis of Presentation and Sig29

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ / shares in Units, $ in Millions	3 Months Ended			9 Months Ended
	Sep. 30, 2015USD ($)HospitalStateSurgery_Center	Sep. 30, 2014USD ($)	Jun. 30, 2014USD ($)$ / shares	Sep. 30, 2015USD ($)$ / sharesHospitalStateSurgery_Center	Sep. 30, 2014USD ($)
Accounting Policies [Abstract]
Number of owned and operated hospitals | Hospital	168			168
Number of freestanding surgery centers | Surgery_Center	114			114
Number of facilities locations | State	20			20
General and administrative expense	$ 79	$ 71		$ 237	$ 206
Adjustments to Medicare revenues			$ 142	$ 142
Adjustment to increase Medicaid revenues in diluted per share | $ / shares			$ 0.20	$ 0.20

Basis of Presentation and Sig30

Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 9,881	$ 9,299	$ 29,632	$ 27,503
Uninsured	695	313	1,321	1,019
Other	438	366	1,315	1,097
Revenues before provision for doubtful accounts	11,014	9,978	32,268	29,619
Provision for doubtful accounts	(1,158)	(758)	(2,839)	(2,337)
Revenues	$ 9,856	$ 9,220	$ 29,429	$ 27,282
Revenues from third party payers, Ratio	100.30%	100.80%	100.70%	100.70%
Uninsured, Ratio	7.00%	3.40%	4.50%	3.70%
Other, Ratio	4.40%	4.00%	4.50%	4.00%
Revenues before provision for doubtful accounts, Ratio	111.70%	108.20%	109.70%	108.40%
Provision for doubtful accounts, Ratio	(11.70%)	(8.20%)	(9.70%)	(8.40%)
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	$ 2,122	$ 2,120	$ 6,500	$ 6,285
Revenues from third party payers, Ratio	21.50%	23.00%	22.10%	23.00%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 1,031	$ 901	$ 3,099	$ 2,706
Revenues from third party payers, Ratio	10.50%	9.80%	10.50%	9.90%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 402	$ 372	$ 1,262	$ 1,404
Revenues from third party payers, Ratio	4.10%	4.00%	4.30%	5.10%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 553	$ 510	$ 1,673	$ 1,383
Revenues from third party payers, Ratio	5.60%	5.50%	5.70%	5.10%
Managed Care and Other Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 5,457	$ 5,073	$ 16,134	$ 14,742
Revenues from third party payers, Ratio	55.40%	55.00%	54.80%	54.00%
International (Managed Care and Other Insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 316	$ 323	$ 964	$ 983
Revenues from third party payers, Ratio	3.20%	3.50%	3.30%	3.60%

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Business Acquisition [Line Items]
Proceeds from sale of business	$ 27	$ 38
Nonhospital Health Care [Member]
Business Acquisition [Line Items]
Cash paid for acquisition	169	83
Hospitals [Member]
Business Acquisition [Line Items]
Cash paid for acquisition	15	14
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	2	20
Proceeds from sale of business	$ 27	$ 38

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Liability for unrecognized tax benefits	$ 541		$ 541		$ 548
Unrecognized tax benefits, accrued interest	69		69		58
Unrecognized tax benefits that would impact effective tax rate	228		228		$ 205
Interest expense related to taxing authority examinations	2	$ 3	6	$ 11
Interest expense related to taxing authority examinations, net of tax	$ 1	$ 2	$ 4	$ 7

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Computations of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Earnings Per Share [Abstract]
Net income attributable to HCA Holdings, Inc.	$ 449	$ 518	$ 1,547	$ 1,348
Weighted average common shares outstanding	414,939	432,617	417,146	437,832
Effect of dilutive incremental shares	11,502	14,643	13,208	14,706
Shares used for diluted earnings per share	426,441	447,260	430,354	452,538
Basic earnings per share	$ 1.08	$ 1.20	$ 3.71	$ 3.08
Diluted earnings per share	$ 1.05	$ 1.16	$ 3.60	$ 2.98

Investments of Insurance Subs34

Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Sep. 30, 2015	Dec. 31, 2014
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	$ 443	$ 539
Unrealized Amounts, Gains	18	20
Unrealized Amounts, Losses	(1)	(1)
Fair Value	460	558
Amounts classified as current assets	(51)	(64)
Investment carrying value	409	494
Debt Securities [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	442	538
Unrealized Amounts, Gains	16	18
Unrealized Amounts, Losses	(1)	(1)
Fair Value	457	555
Debt Securities [Member] | States and Municipalities [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	429	477
Unrealized Amounts, Gains	16	18
Unrealized Amounts, Losses	(1)	(1)
Fair Value	444	494
Debt Securities [Member] | Money Market Funds [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	13	61
Fair Value	13	61
Equity Securities [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	1	1
Unrealized Amounts, Gains	2	2
Fair Value	$ 3	$ 3

Investments of Insurance Subs35

Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Sep. 30, 2015USD ($)
Amortized Cost and Fair Value Debt Securities [Abstract]
Due in one year or less, Amortized Cost	$ 61
Due after one year through five years, Amortized Cost	172
Due after five years through ten years, Amortized Cost	108
Due after ten years, Amortized Cost	101
Amortized Cost, Total	442
Due in one year or less, Fair Value	61
Due after one year through five years, Fair Value	177
Due after five years through ten years, Fair Value	114
Due after ten years, Fair Value	105
Fair Value, Total	$ 457

Investments of Insurance Subs36

Investments of Insurance Subsidiaries - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2015
Amortized Cost and Fair Value Debt Securities [Abstract]
Available for sale securities expected maturity of debt securities	4 years 2 months 12 days
Available for sale securities average scheduled maturity	5 years 9 months 18 days

Financial Instruments - Schedul

Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member]	9 Months Ended
	Sep. 30, 2015USD ($)
Maturity Date, 2016 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 3,000,000,000
Fair Value	$ (118,000,000)
Maturity Date	Dec. 31, 2016
Maturity Date, 2017 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 1,000,000,000
Fair Value	$ (35,000,000)
Maturity Date	Dec. 31, 2017

Financial Instruments - Additio

Financial Instruments - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2015USD ($)
Offsetting [Abstract]
Estimated amount reclassified from other comprehensive income to interest expense	$ 115
Estimated termination value if there is breach of provision related to derivative agreement	$ 155

Financial Instruments - Effect

Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Derivative Instruments, Gain (Loss) [Line Items]
Interest expense	$ 411	$ 427	$ 1,255	$ 1,314
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss Recognized in OCI on Derivatives, Net of Tax			30
Reclassification out of Accumulated Other Comprehensive Income [Member] | Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest expense			$ 93

Assets and Liabilities Measur40

Assets and Liabilities Measured at Fair Value - Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2015	Dec. 31, 2014
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	$ 460	$ 558
Less amounts classified as current assets	(51)	(64)
Investments of insurance subsidiaries, noncurrent	409	494
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Liabilities, Fair Value	153	199
Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	457	555
Debt Securities [Member] | States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	444	494
Debt Securities [Member] | Money Market Funds [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	13	61
Equity Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	3	3
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	16	64
Less amounts classified as current assets	(13)	(61)
Investments of insurance subsidiaries, noncurrent	3	3
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	13	61
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Debt Securities [Member] | Money Market Funds [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	13	61
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Equity Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	3	3
Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	438	488
Less amounts classified as current assets	(38)	(3)
Investments of insurance subsidiaries, noncurrent	400	485
Significant Other Observable Inputs (Level 2) [Member] | Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Liabilities, Fair Value	153	199
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	438	488
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	438	488
Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	6	6
Investments of insurance subsidiaries, noncurrent	6	6
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	6	6
Significant Unobservable Inputs (Level 3) [Member] | Debt Securities [Member] | States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	$ 6	$ 6

Assets and Liabilities Measur41

Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2015	Dec. 31, 2014
Fair Value Disclosures [Abstract]
Estimated fair value of long-term debt	$ 30,765	$ 30,861
Carrying amounts of long-term debt	$ 29,912	$ 29,645

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
First lien debt	$ 20,010	$ 20,070
Less net debt issuance costs	(160)	(219)
Total debt (average life of 6.1 years, rates averaging 5.4%)	29,752	29,426
Less amounts due within one year	1,377	338
Long-term debt	28,375	29,088
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	2,610	2,880
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Term loans	5,668	5,517
Senior Secured First Lien Notes [Member]
Debt Instrument [Line Items]
Senior secured first lien notes	11,100	11,100
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt (effective interest rate of 5.9%)	632	573
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 9,902	$ 9,575

Long-Term Debt - Schedule of 43

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	9 Months Ended
	Sep. 30, 2015
Debt Instrument [Line Items]
Total debt average term	6 years 1 month 6 days
Total debt average rate	5.40%
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	4.90%
Senior Secured First Lien Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.50%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	5.90%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	6.60%

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail) - USD ($)	3 Months Ended	9 Months Ended
	Mar. 31, 2014	Sep. 30, 2015	Sep. 30, 2014	Jun. 30, 2015	May. 31, 2015	Jan. 31, 2015	Nov. 30, 2014	Oct. 31, 2014	Apr. 30, 2014
Debt Instrument [Line Items]
Pretax loss on retirement of debt		$ 125,000,000	$ 226,000,000
Debt instrument, repayment amount		$ 3,702,000,000	$ 3,525,000,000
Senior Notes [Member] | Senior Secured Term Loan Facility Maturing on June 10, 2020 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount				$ 1,400,000,000
Debt instrument maturity date		Jun. 10, 2020
Pretax loss on retirement of debt		$ 3,000,000
Senior Notes [Member] | Senior Secured Notes Due 2019 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 1,500,000,000							$ 600,000,000
Debt instrument, stated interest	3.75%							4.25%	8.50%
Redemption of aggregate principal amount									$ 1,500,000,000
Senior Notes [Member] | Senior Secured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 2,000,000,000
Pretax loss on retirement of debt		226,000,000
Debt instrument, stated interest	5.00%
Senior Notes [Member] | Senior Unsecured Notes Due 2014 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest	5.75%
Debt instrument, repayment amount	$ 500,000,000
Senior Notes [Member] | Senior Secured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Pretax loss on retirement of debt		109,000,000
Debt instrument, stated interest							7.25%		7.875%
Redemption of aggregate principal amount							$ 1,400,000,000		$ 1,250,000,000
Senior Notes [Member] | Senior Secured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount					$ 1,600,000,000	$ 1,000,000,000		$ 1,400,000,000
Debt instrument, stated interest					5.375%	5.375%		5.25%
Senior Notes [Member] | Senior Unsecured Notes Due 2015 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount						$ 750,000,000
Debt instrument, stated interest						6.375%
Senior Notes [Member] | Senior Secured Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount					$ 1,525,000,000
Pretax loss on retirement of debt		$ 122,000,000
Debt instrument, stated interest					7.75%

Contingencies and Legal Claim45

Contingencies and Legal Claim Costs - Additional Information (Detail) $ in Millions	Feb. 09, 2015USD ($)	Apr. 25, 2014USD ($)	Jan. 24, 2013USD ($)	Oct. 28, 2011Cases	Sep. 30, 2015USD ($)	Mar. 31, 2014USD ($)	Dec. 31, 2012USD ($)	Sep. 30, 2015USD ($)	Sep. 30, 2014USD ($)	Jul. 31, 2012Hospital	Oct. 31, 2009USD ($)
Loss Contingencies [Line Items]
Number of claims filed | Cases				3
Capital commitments in connection with purchase of hospitals											$ 450
Additional shortfall related to capital expenditures		$ 78
Legal claim costs					$ 77	$ 78	$ 175	$ 77	$ 78
Period of agreed capital commitments								5 years
Number of year under court-supervisor accounting for expenditures following the purchase								10 years
Dispute settlement amount	$ 15
Pending Litigation [Member]
Loss Contingencies [Line Items]
Accrued liabilities in connection with litigation					$ 382			$ 382
Health Care Foundation of Greater Kansas City [Member] | Pending Litigation [Member]
Loss Contingencies [Line Items]
Judgment award by the court			$ 162
Plaintiff attorneys fees award								$ 12
Percentage of legal claim costs					9.00%	9.00%	9.00%	9.00%
Florida [Member]
Loss Contingencies [Line Items]
Number of owned and operated hospitals reviewed | Hospital										8
Florida [Member] | Qui Tam Action [Member]
Loss Contingencies [Line Items]
Number of owned and operated hospitals reviewed | Hospital										2

Capital Structure - Schedule of

Capital Structure - Schedule of Changes in Stockholders' Deficit and Equity (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Capital Structure [Line Items]
Beginning Balances			$ (6,498)
Comprehensive income	$ 554	$ 604	1,972	$ 1,748
Repurchase of common stock			(1,386)
Distributions			(367)
Share-based benefit plans			433
Other			34
Ending Balances	(5,812)		(5,812)
Common Stock [Member]
Capital Structure [Line Items]
Beginning Balances			4
Ending Balances	$ 4		$ 4
Beginning Balances, Shares			420,478,000
Repurchase of common stock, Shares			(17,629,000)
Share-based benefit plans, Shares			9,789,000
Ending Balances, Shares	412,638,000		412,638,000
Capital in Excess of Par Value [Member]
Capital Structure [Line Items]
Repurchase of common stock			$ (425)
Share-based benefit plans			433
Other			(8)
Accumulated Other Comprehensive Loss [Member]
Capital Structure [Line Items]
Beginning Balances			(323)
Comprehensive income			14
Ending Balances	$ (309)		(309)
Retained Deficit [Member]
Capital Structure [Line Items]
Beginning Balances			(7,575)
Comprehensive income			1,547
Repurchase of common stock			(961)
Ending Balances	(6,989)		(6,989)
Equity Attributable to Noncontrolling Interests [Member]
Capital Structure [Line Items]
Beginning Balances			1,396
Comprehensive income			411
Distributions			(367)
Other			42
Ending Balances	$ 1,482		$ 1,482

Capital Structure - Additional

Capital Structure - Additional Information (Detail) - USD ($)	Apr. 18, 2015	Sep. 30, 2015
Capital Structure [Line Items]
Repurchase of common stock, shares		13,822,818
Repurchase of common stock, per share		$ 78.96
The Bain Entities [Member]
Capital Structure [Line Items]
Repurchase of common stock, shares	3,806,460
Repurchase of common stock, per share	$ 77.26
Percentage of discount on share repurchase	1.00%
Share repurchase program authorized amount	$ 1,000,000,000
February 2015 and May 2015 Repurchase Authorizations [Member]
Capital Structure [Line Items]
Repurchase of common stock, per share		$ 78.60
Repurchase of common stock		17,629,278
February 2015 Repurchase Authorization [Member]
Capital Structure [Line Items]
Remaining repurchase of common stock		$ 0
May 2015 Repurchase Authorization [Member]
Capital Structure [Line Items]
Remaining repurchase of common stock		614,000,000
May 2015 Repurchase Authorization [Member] | Maximum [Member]
Capital Structure [Line Items]
Share repurchase program authorized amount		$ 1,000,000,000

Capital Structure - Components

Capital Structure - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2015USD ($)
Equity [Abstract]
Unrealized gains on available-for-sale securities, beginning balances	$ 13
Unrealized losses on available-for-sale securities, net of income tax benefit	(2)
Unrealized gains on available-for-sale securities, ending balances	11
Foreign currency translation adjustments, beginning balances	(36)
Foreign currency translation adjustments	(24)
Foreign currency translation adjustments, ending balances	(60)
Defined benefit plans, beginning balances	(174)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	11
Defined benefit plans, ending balances	(163)
Change in fair value of derivative instruments, beginning balances	(126)
Change in fair value of derivative instruments	(30)
Change in fair value of derivatives instruments, (income) expense reclassified into operations from other comprehensive income	59
Change in fair value of derivative instruments, ending balances	(97)
Accumulated other comprehensive income, net of tax, beginning balances	(323)
Unrealized losses on available-for-sale securities, net of income tax benefit	(2)
Foreign currency translation adjustments	(24)
Change in fair value of derivative instruments	(30)
Expense reclassified into operations from other comprehensive income, Total	70
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (309)

Capital Structure - Component49

Capital Structure - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2015USD ($)
Equity [Abstract]
Foreign currency translation adjustments, income tax benefit	$ 17
Defined benefit plans, income tax benefit	6
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, income tax benefit	34
Change in fair value of derivative instruments, income tax benefit	$ 17

Segment and Geographic Inform50

Segment and Geographic Information - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2015Hospital
Segment Reporting Information [Line Items]
Number of geographically organized groups	2
Number of owned and operated hospitals	168
Reorganization Group [Member] | National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	83
Reorganization Group [Member] | American Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	79
Reorganization Group [Member] | Corporate and Other [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	6

Segment and Geographic Inform51

Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Mar. 31, 2014	Dec. 31, 2012	Sep. 30, 2015	Sep. 30, 2014
Segment Reporting Information [Line Items]
Revenues	$ 9,856	$ 9,220			$ 29,429	$ 27,282
Equity in earnings of affiliates	(9)	(14)			(38)	(32)
Adjusted segment EBITDA	1,815	1,828			5,784	5,472
Depreciation and amortization	482	460			1,424	1,361
Interest expense	411	427			1,255	1,314
Losses (gains) on sales of facilities	2	12			(2)	(20)
Losses on retirement of debt					125	226
Legal claim costs	77		$ 78	$ 175	77	78
Income before income taxes	843	929			2,905	2,513
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	4,580	4,334			13,928	12,766
Equity in earnings of affiliates	(1)	(6)			(8)	(12)
Adjusted segment EBITDA	919	952			3,084	2,755
Depreciation and amortization	195	187			572	564
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	4,772	4,350			13,972	12,949
Equity in earnings of affiliates	(9)	(8)			(25)	(23)
Adjusted segment EBITDA	1,035	959			3,026	2,942
Depreciation and amortization	219	212			662	627
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	504	536			1,529	1,567
Equity in earnings of affiliates	1				(5)	3
Adjusted segment EBITDA	(139)	(83)			(326)	(225)
Depreciation and amortization	$ 68	$ 61			$ 190	$ 170

Supplemental Condensed Consol52

Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) - USD ($) $ in Millions	May. 31, 2015	Dec. 31, 2012	Nov. 30, 2010	Nov. 23, 2010
Supplemental Condensed Consolidating Financial Information [Line Items]
Ownership percentage held by parent				100.00%
Senior Unsecured Notes Due 2021 [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Debt instrument, principal amount		$ 1,000	$ 1,525
Debt instrument, stated interest	7.75%	6.25%	7.75%
Debt instrument, redeemed amount	$ 1,525

Supplemental Condensed Consol53

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) - USD ($) $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Mar. 31, 2014	Dec. 31, 2012	Sep. 30, 2015	Sep. 30, 2014
Supplemental Condensed Consolidating Financial Information [Line Items]
Revenues before provision for doubtful accounts	$ 11,014	$ 9,978			$ 32,268	$ 29,619
Provision for doubtful accounts	1,158	758			2,839	2,337
Revenues	9,856	9,220			29,429	27,282
Salaries and benefits	4,619	4,211			13,509	12,359
Supplies	1,644	1,539			4,952	4,603
Other operating expenses	1,796	1,688			5,268	4,977
Electronic health record incentive income	(9)	(32)			(46)	(97)
Equity in earnings of affiliates	(9)	(14)			(38)	(32)
Depreciation and amortization	482	460			1,424	1,361
Interest expense (revenue)	411	427			1,255	1,314
Losses (gains) on sales of facilities	2	12			(2)	(20)
Losses on retirement of debt					125	226
Legal claim costs	77		$ 78	$ 175	77	78
Total expenses including equity in earnings of affiliates	9,013	8,291			26,524	24,769
Income (loss) before income taxes	843	929			2,905	2,513
Provision (benefit) for income taxes	270	318			947	816
Net income (loss)	573	611			1,958	1,697
Net income attributable to noncontrolling interests	124	93			411	349
Net income (loss) attributable to HCA Holdings, Inc.	449	518			1,547	1,348
Comprehensive income (loss) attributable to HCA Holdings, Inc.	430	511			1,561	1,399
HCA Holdings, Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Other operating expenses	7	4			9	14
Equity in earnings of affiliates	(464)	(549)			(1,690)	(1,443)
Interest expense (revenue)	16	46			100	138
Losses on retirement of debt					122
Total expenses including equity in earnings of affiliates	(441)	(499)			(1,459)	(1,291)
Income (loss) before income taxes	441	499			1,459	1,291
Provision (benefit) for income taxes	(8)	(19)			(88)	(57)
Net income (loss)	449	518			1,547	1,348
Net income (loss) attributable to HCA Holdings, Inc.	449	518			1,547	1,348
Comprehensive income (loss) attributable to HCA Holdings, Inc.	430	511			1,561	1,399
HCA Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Interest expense (revenue)	608	536			1,807	1,629
Losses on retirement of debt					3	226
Legal claim costs	77				77	78
Total expenses including equity in earnings of affiliates	685	536			1,887	1,933
Income (loss) before income taxes	(685)	(536)			(1,887)	(1,933)
Provision (benefit) for income taxes	(258)	(205)			(716)	(729)
Net income (loss)	(427)	(331)			(1,171)	(1,204)
Net income (loss) attributable to HCA Holdings, Inc.	(427)	(331)			(1,171)	(1,204)
Comprehensive income (loss) attributable to HCA Holdings, Inc.	(418)	(303)			(1,142)	(1,154)
Subsidiary Guarantors [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Revenues before provision for doubtful accounts	5,721	5,133			16,519	15,242
Provision for doubtful accounts	689	457			1,535	1,388
Revenues	5,032	4,676			14,984	13,854
Salaries and benefits	2,357	2,176			6,824	6,393
Supplies	853	797			2,576	2,416
Other operating expenses	865	804			2,523	2,366
Electronic health record incentive income	(6)	(22)			(31)	(68)
Equity in earnings of affiliates	(1)	(3)			(4)	(5)
Depreciation and amortization	230	225			683	667
Interest expense (revenue)	(156)	(115)			(498)	(349)
Losses (gains) on sales of facilities	(1)	16			(5)	(16)
Management fee revenue	(178)	(178)			(534)	(528)
Total expenses including equity in earnings of affiliates	3,963	3,700			11,534	10,876
Income (loss) before income taxes	1,069	976			3,450	2,978
Provision (benefit) for income taxes	394	365			1,284	1,098
Net income (loss)	675	611			2,166	1,880
Net income attributable to noncontrolling interests	21	18			68	65
Net income (loss) attributable to HCA Holdings, Inc.	654	593			2,098	1,815
Comprehensive income (loss) attributable to HCA Holdings, Inc.	657	595			2,109	1,822
Subsidiary Non-Guarantors [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Revenues before provision for doubtful accounts	5,293	4,845			15,749	14,377
Provision for doubtful accounts	469	301			1,304	949
Revenues	4,824	4,544			14,445	13,428
Salaries and benefits	2,262	2,035			6,685	5,966
Supplies	791	742			2,376	2,187
Other operating expenses	924	880			2,736	2,597
Electronic health record incentive income	(3)	(10)			(15)	(29)
Equity in earnings of affiliates	(8)	(11)			(34)	(27)
Depreciation and amortization	252	235			741	694
Interest expense (revenue)	(57)	(40)			(154)	(104)
Losses (gains) on sales of facilities	3	(4)			3	(4)
Management fee expense	178	178			534	528
Total expenses including equity in earnings of affiliates	4,342	4,005			12,872	11,808
Income (loss) before income taxes	482	539			1,573	1,620
Provision (benefit) for income taxes	142	177			467	504
Net income (loss)	340	362			1,106	1,116
Net income attributable to noncontrolling interests	103	75			343	284
Net income (loss) attributable to HCA Holdings, Inc.	237	287			763	832
Comprehensive income (loss) attributable to HCA Holdings, Inc.	206	250			737	826
Eliminations [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Equity in earnings of affiliates	464	549			1,690	1,443
Total expenses including equity in earnings of affiliates	464	549			1,690	1,443
Income (loss) before income taxes	(464)	(549)			(1,690)	(1,443)
Net income (loss)	(464)	(549)			(1,690)	(1,443)
Net income (loss) attributable to HCA Holdings, Inc.	(464)	(549)			(1,690)	(1,443)
Comprehensive income (loss) attributable to HCA Holdings, Inc.	$ (445)	$ (542)			$ (1,704)	$ (1,494)

Supplemental Condensed Consol54

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions	Sep. 30, 2015	Dec. 31, 2014	Sep. 30, 2014	Dec. 31, 2013
Current assets:
Cash and cash equivalents	$ 588	$ 566	$ 515	$ 414
Accounts receivable, net	5,827	5,694
Inventories	1,379	1,279
Deferred income taxes	412	366
Other	1,015	1,025
Total current assets	9,221	8,930
Property and equipment, net	14,704	14,355
Investments of insurance subsidiaries	409	494
Investments in and advances to affiliates	186	165
Goodwill and other intangible assets	6,540	6,416
Other	836	620
Total assets	31,896	30,980
Current liabilities:
Accounts payable	1,877	2,035
Accrued salaries	1,358	1,370
Other accrued expenses	1,701	1,737
Long-term debt due within one year	1,377	338
Total current liabilities	6,313	5,480
Long-term debt, net	28,375	29,088
Professional liability risks	1,117	1,078
Income taxes and other liabilities	1,903	1,832
Total liabilities	37,708	37,478
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(7,294)	(7,894)
Noncontrolling interests	1,482	1,396
Total stockholders' deficit	(5,812)	(6,498)
Total liabilities and stockholders' deficit	31,896	30,980
HCA Holdings, Inc. Issuer [Member]
Current assets:
Deferred income taxes	412	366
Other	13	118
Total current assets	425	484
Investments in and advances to affiliates	23,674	21,970
Other	625	435
Total assets	24,724	22,889
Current liabilities:
Accounts payable	9	1
Other accrued expenses	14	45
Total current liabilities	23	46
Long-term debt, net	982	2,499
Intercompany balances	30,472	27,685
Income taxes and other liabilities	541	553
Total liabilities	32,018	30,783
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(7,294)	(7,894)
Total stockholders' deficit	(7,294)	(7,894)
Total liabilities and stockholders' deficit	24,724	22,889
HCA Inc. Issuer [Member]
Current liabilities:
Other accrued expenses	245	317
Long-term debt due within one year	1,264	231
Total current liabilities	1,509	548
Long-term debt, net	26,874	26,124
Intercompany balances	(10,757)	(10,141)
Income taxes and other liabilities	534	487
Total liabilities	18,160	17,018
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(18,160)	(17,018)
Total stockholders' deficit	(18,160)	(17,018)
Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	109	87	113	112
Accounts receivable, net	2,874	2,812
Inventories	821	756
Other	428	376
Total current assets	4,232	4,031
Property and equipment, net	8,078	7,871
Investments in and advances to affiliates	17	16
Goodwill and other intangible assets	1,703	1,705
Other	24	27
Total assets	14,054	13,650
Current liabilities:
Accounts payable	1,165	1,272
Accrued salaries	770	783
Other accrued expenses	540	517
Long-term debt due within one year	61	56
Total current liabilities	2,536	2,628
Long-term debt, net	222	185
Intercompany balances	(22,877)	(21,405)
Income taxes and other liabilities	428	605
Total liabilities	(19,691)	(17,987)
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	33,626	31,516
Noncontrolling interests	119	121
Total stockholders' deficit	33,745	31,637
Total liabilities and stockholders' deficit	14,054	13,650
Subsidiary Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	479	479	$ 402	$ 302
Accounts receivable, net	2,953	2,882
Inventories	558	523
Other	574	531
Total current assets	4,564	4,415
Property and equipment, net	6,626	6,484
Investments of insurance subsidiaries	409	494
Investments in and advances to affiliates	169	149
Goodwill and other intangible assets	4,837	4,711
Other	187	158
Total assets	16,792	16,411
Current liabilities:
Accounts payable	703	762
Accrued salaries	588	587
Other accrued expenses	902	858
Long-term debt due within one year	52	51
Total current liabilities	2,245	2,258
Long-term debt, net	297	280
Intercompany balances	3,162	3,861
Professional liability risks	1,117	1,078
Income taxes and other liabilities	400	187
Total liabilities	7,221	7,664
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	8,208	7,472
Noncontrolling interests	1,363	1,275
Total stockholders' deficit	9,571	8,747
Total liabilities and stockholders' deficit	16,792	16,411
Eliminations [Member]
Current assets:
Investments in and advances to affiliates	(23,674)	(21,970)
Total assets	(23,674)	(21,970)
Current liabilities:
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(23,674)	(21,970)
Total stockholders' deficit	(23,674)	(21,970)
Total liabilities and stockholders' deficit	$ (23,674)	$ (21,970)

Supplemental Condensed Consol55

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Mar. 31, 2014	Dec. 31, 2012	Sep. 30, 2015	Sep. 30, 2014
Cash flows from operating activities:
Net income (loss)	$ 573	$ 611			$ 1,958	$ 1,697
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities					(3,333)	(2,945)
Provision for doubtful accounts					2,839	2,337
Depreciation and amortization	482	460			1,424	1,361
Income taxes					(148)	(61)
Losses (gains) on sales of facilities	2	12			(2)	(20)
Losses on retirement of debt					125	226
Legal claim costs	77		$ 78	$ 175	77	78
Amortization of debt issuance costs					27	33
Share-based compensation					171	118
Equity in earnings of affiliates	(9)	(14)			(38)	(32)
Other					38	(3)
Net cash provided by operating activities					3,176	2,821
Cash flows from investing activities:
Purchase of property and equipment					(1,571)	(1,482)
Acquisition of hospitals and health care entities					(184)	(97)
Disposition of hospitals and health care entities					27	38
Change in investments					94	22
Other					3	7
Net cash used in investing activities					(1,631)	(1,512)
Cash flows from financing activities:
Issuance of long-term debt					4,048	3,502
Net change in revolving credit facilities					(270)	(160)
Repayment of long-term debt					(3,702)	(3,525)
Distributions to noncontrolling interests					(367)	(325)
Payment of debt issuance costs					(34)	(49)
Repurchases of common stock					(1,386)	(750)
Income tax benefits					231	119
Other					(43)	(20)
Net cash used in financing activities					(1,523)	(1,208)
Change in cash and cash equivalents					22	101
Cash and cash equivalents at beginning of period			414		566	414
Cash and cash equivalents at end of period	588	515			588	515
Eliminations [Member]
Cash flows from operating activities:
Net income (loss)	(464)	(549)			(1,690)	(1,443)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in earnings of affiliates	464	549			1,690	1,443
HCA Holdings, Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	449	518			1,547	1,348
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities					(22)	18
Income taxes					(148)	(61)
Losses on retirement of debt					122
Amortization of debt issuance costs					3	2
Share-based compensation					171	118
Equity in earnings of affiliates	(464)	(549)			(1,690)	(1,443)
Other					49
Net cash provided by operating activities					32	(18)
Cash flows from financing activities:
Repayment of long-term debt					(1,632)
Repurchases of common stock					(1,386)	(750)
Changes in intercompany balances with affiliates, net					2,784	654
Income tax benefits					231	119
Other					(29)	(5)
Net cash used in financing activities					(32)	18
HCA Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	(427)	(331)			(1,171)	(1,204)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities					(56)	(151)
Losses on retirement of debt					3	226
Legal claim costs	77				77	78
Amortization of debt issuance costs					24	31
Other					3	3
Net cash provided by operating activities					(1,120)	(1,017)
Cash flows from financing activities:
Issuance of long-term debt					4,048	3,502
Net change in revolving credit facilities					(270)	(160)
Repayment of long-term debt					(2,001)	(3,462)
Payment of debt issuance costs					(34)	(49)
Changes in intercompany balances with affiliates, net					(623)	1,186
Net cash used in financing activities					1,120	1,017
Subsidiary Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	675	611			2,166	1,880
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities					(1,959)	(1,660)
Provision for doubtful accounts					1,535	1,388
Depreciation and amortization	230	225			683	667
Losses (gains) on sales of facilities	(1)	16			(5)	(16)
Equity in earnings of affiliates	(1)	(3)			(4)	(5)
Net cash provided by operating activities					2,420	2,259
Cash flows from investing activities:
Purchase of property and equipment					(764)	(893)
Acquisition of hospitals and health care entities					(51)	(7)
Disposition of hospitals and health care entities					19	31
Change in investments					2	22
Other					(6)
Net cash used in investing activities					(800)	(847)
Cash flows from financing activities:
Repayment of long-term debt					(45)	(35)
Distributions to noncontrolling interests					(70)	(45)
Changes in intercompany balances with affiliates, net					(1,483)	(1,331)
Net cash used in financing activities					(1,598)	(1,411)
Change in cash and cash equivalents					22	1
Cash and cash equivalents at beginning of period			112		87	112
Cash and cash equivalents at end of period	109	113			109	113
Subsidiary Non-Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	340	362			1,106	1,116
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities					(1,296)	(1,152)
Provision for doubtful accounts					1,304	949
Depreciation and amortization	252	235			741	694
Losses (gains) on sales of facilities	3	(4)			3	(4)
Equity in earnings of affiliates	(8)	(11)			(34)	(27)
Other					(14)	(6)
Net cash provided by operating activities					1,844	1,597
Cash flows from investing activities:
Purchase of property and equipment					(807)	(589)
Acquisition of hospitals and health care entities					(133)	(90)
Disposition of hospitals and health care entities					8	7
Change in investments					92
Other					9	7
Net cash used in investing activities					(831)	(665)
Cash flows from financing activities:
Repayment of long-term debt					(24)	(28)
Distributions to noncontrolling interests					(297)	(280)
Changes in intercompany balances with affiliates, net					(678)	(509)
Other					(14)	(15)
Net cash used in financing activities					(1,013)	(832)
Change in cash and cash equivalents						100
Cash and cash equivalents at beginning of period			$ 302		479	302
Cash and cash equivalents at end of period	$ 479	$ 402			$ 479	$ 402