HCA Healthcare (HCA) 10-Q 6 May 16 2016 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2016	Apr. 30, 2016
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q1
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		391,053,900

Condensed Consolidated Income S

Condensed Consolidated Income Statements (Unaudited) - USD ($) shares in Thousands, $ in Millions	Dec. 09, 2015	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015	Mar. 31, 2014	Dec. 31, 2012
Income Statement [Abstract]
Revenues before provision for doubtful accounts		$ 11,050		$ 10,322
Provision for doubtful accounts		790		646
Revenues		10,260		9,676
Salaries and benefits		4,702		4,398
Supplies		1,714		1,638
Other operating expenses		1,857		1,717
Electronic health record incentive income		(4)		(19)
Equity in earnings of affiliates		(12)		(19)
Depreciation and amortization		479		473
Interest expense		416		419
Losses (gains) on sales of facilities		1		(9)
Legal claim costs	$ 434	12	$ 120		$ 78	$ 175
Total expenses including equity in earnings of affiliates		9,165		8,598
Income before income taxes		1,095		1,078
Provision for income taxes		284		358
Net income		811		720
Net income attributable to noncontrolling interests		117		129
Net income attributable to HCA Holdings, Inc.		$ 694		$ 591
Per share data:
Basic earnings per share		$ 1.75		$ 1.41
Diluted earnings per share		$ 1.69		$ 1.36
Shares used in earnings per share calculations (in millions):
Basic		396,397		420,148
Diluted		410,575		435,309

Condensed Consolidated Comprehe

Condensed Consolidated Comprehensive Income Statements (Unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Statement of Comprehensive Income [Abstract]
Net income	$ 811	$ 720
Other comprehensive income (loss) before taxes:
Foreign currency translation	(43)	(51)
Unrealized gains on available-for-sale securities	2	1
Defined benefit plans	0	0
Pension costs included in salaries and benefits	4	6
Total defined benefit plans	4	6
Change in fair value of derivative financial instruments	(38)	(23)
Interest costs included in interest expense	28	31
Total change in fair value of derivative financial instruments	(10)	8
Other comprehensive loss before taxes	(47)	(36)
Income tax benefits related to other comprehensive income items	(18)	(15)
Other comprehensive loss	(29)	(21)
Comprehensive income	782	699
Comprehensive income attributable to noncontrolling interests	117	129
Comprehensive income attributable to HCA Holdings, Inc.	$ 665	$ 570

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 852	$ 741
Accounts receivable, less allowance for doubtful accounts of $5,205 and $5,326	5,880	5,889
Inventories	1,415	1,439
Other	1,054	1,163
Total current assets	9,201	9,232
Property and equipment, at cost	34,978	34,614
Accumulated depreciation	(19,921)	(19,600)
Property and equipment, net	15,057	15,014
Investments of insurance subsidiaries	425	432
Investments in and advances to affiliates	174	178
Goodwill and other intangible assets	6,713	6,731
Other	1,206	1,157
Total assets	32,776	32,744
Current liabilities:
Accounts payable	1,944	2,170
Accrued salaries	1,309	1,233
Other accrued expenses	1,919	1,880
Long-term debt due within one year	226	233
Total current liabilities	5,398	5,516
Long-term debt, less net debt issuance costs of $179 and $167	30,328	30,255
Professional liability risks	1,116	1,115
Income taxes and other liabilities	1,933	1,904
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 393,650,000 shares in 2016 and 398,738,700 shares in 2015	4	4
Accumulated other comprehensive loss	(294)	(265)
Retained deficit	(7,266)	(7,338)
Stockholders' deficit attributable to HCA Holdings, Inc.	(7,556)	(7,599)
Noncontrolling interests	1,557	1,553
Total stockholders' deficit	(5,999)	(6,046)
Total liabilities and stockholders' deficit	$ 32,776	$ 32,744

Condensed Consolidated Balance5

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Allowance for Accounts receivable	$ 5,205	$ 5,326
Debt issuance cost	$ 179	$ 167
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	393,650,000	398,738,700

Condensed Consolidated Statemen

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Cash flows from operating activities:
Net income	$ 811	$ 720
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(789)	(895)
Provision for doubtful accounts	790	646
Accounts receivable, net	1	(249)
Inventories and other assets	14	(106)
Accounts payable and accrued expenses	(371)	(312)
Depreciation and amortization	479	473
Income taxes	360	438
Losses (gains) on sales of facilities	1	(9)
Legal claim costs	12
Amortization of debt issuance costs	10	10
Share-based compensation	65	48
Other	17	5
Net cash provided by operating activities	1,399	1,018
Cash flows from investing activities:
Purchase of property and equipment	(509)	(446)
Acquisition of hospitals and health care entities	(9)	(28)
Disposal of hospitals and health care entities	4	15
Change in investments	11	22
Other	7	5
Net cash used in investing activities	(496)	(432)
Cash flows from financing activities:
Issuances of long-term debt	3,000	1,000
Net change in revolving bank credit facilities	(930)	(260)
Repayment of long-term debt	(2,011)	(791)
Distributions to noncontrolling interests	(111)	(132)
Payment of debt issuance costs	(22)	(11)
Repurchases of common stock	(621)	(366)
Other	(97)	(6)
Net cash used in financing activities	(792)	(566)
Change in cash and cash equivalents	111	20
Cash and cash equivalents at beginning of period	741	566
Cash and cash equivalents at end of period	852	586
Interest payments	490	487
Income tax refunds, net	$ (76)	$ (118)

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	3 Months Ended
	Mar. 31, 2016
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 March 31, 2016, these affiliates owned and operated 168 hospitals, 116 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 $85 million and $74 million for the quarters ended March 31, 2016 and 2015, respectively. Operating results for the quarter ended March 31, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. 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, 2015. 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 (including 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 ended March 31, 2016 and 2015 are summarized in the following table (dollars in millions): 2016 Ratio 2015 Ratio Medicare $ 2,266 22.1 % $ 2,234 23.1 % Managed Medicare 1,104 10.8 1,052 10.9 Medicaid 427 4.2 452 4.7 Managed Medicaid 597 5.8 549 5.7 Managed care and other insurers 5,702 55.6 5,216 53.9 International (managed care and other insurers) 317 3.1 321 3.3 10,413 101.6 9,824 101.6 Uninsured 189 1.8 68 0.7 Other 448 4.4 430 4.4 Revenues before provision for doubtful accounts 11,050 107.8 10,322 106.7 Provision for doubtful accounts (790 ) (7.8 ) (646 ) (6.7 ) Revenues $ 10,260 100.0 % $ 9,676 100.0 % 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 continuing amendments to 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 November 2015, the FASB issued Accounting Standards Update 2015-17, Balance Sheet Classification of Deferred Taxes In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases In March 2016, the FASB issued Accounting Standards Update 2016-05, Derivatives and Hedging (Topic 815): Effect of Derivative Contract Novations on Existing Hedge Accounting Relationships In March 2016, the FASB issued Accounting Standards Update 2016-09, Improvements to Employee Share-Based Payment Accounting Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Acquisitions and Dispositions

Acquisitions and Dispositions	3 Months Ended
	Mar. 31, 2016
Business Combinations [Abstract]
Acquisitions and Dispositions	NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the quarters ended March 31, 2016 and 2015, we paid $9 million and $28 million, respectively, to acquire other nonhospital health care entities. During the quarter ended March 31, 2016, we received proceeds of $4 million and recognized a net pretax loss of $1 million related to sales of real estate and other investments. During the quarter ended March 31, 2015, we received proceeds of $15 million and recognized net pretax gains of $9 million related to sales of real estate and other investments.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2016
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 $537 million, including accrued interest of $67 million, as of March 31, 2016 ($554 million and $73 million, respectively, as of December 31, 2015). Unrecognized tax benefits of $215 million ($233 million as of December 31, 2015) would affect the effective rate, if recognized. The provision for income taxes also reflects a $6 million ($4 million net of tax) reduction in interest expense related to taxing authority examinations for the quarter ended March 31, 2016. Our provision for income taxes for the first quarter of 2016 included a tax benefit of $74 million related to the adoption of ASU 2016-09, which changes how companies account for certain aspects of share-based payments to employees. Under ASU 2016-09, we no longer record excess tax benefits (when the deductible amount related to the settlement of employee equity awards for tax purposes exceeds the cumulative compensation cost recognized for financial reporting purposes) in equity. Instead, we recognize these tax benefits (and deficiencies, if applicable) as a component of our tax provision. This reporting change is applied prospectively and prior period amounts are not restated (the excess tax benefit for the first quarter of 2015, related to the settlement of employee equity awards, was $70 million and was recorded in equity). ASU 2016-09 requires companies to present excess tax benefits as an operating activity on the statement of cash flows rather than as a financing activity, as previously required. We have elected to apply the change to the statement of cash flows presentation prospectively. 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	3 Months Ended
	Mar. 31, 2016
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 equity awards and potential shares, computed using the treasury stock method. The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2016 and 2015 (dollars and shares in millions, except per share amounts): 2016 2015 Net income attributable to HCA Holdings, Inc. $ 694 $ 591 Weighted average common shares outstanding 396.397 420.148 Effect of dilutive incremental shares 14.178 15.161 Shares used for diluted earnings per share 410.575 435.309 Earnings per share: Basic earnings per share $ 1.75 $ 1.41 Diluted earnings per share $ 1.69 $ 1.36

Investments of Insurance Subsid

Investments of Insurance Subsidiaries	3 Months Ended
	Mar. 31, 2016
Investments, Debt and Equity Securities [Abstract]
Investments of Insurance Subsidiaries	NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES A summary of our insurance subsidiaries’ investments at March 31, 2016 and December 31, 2015 follows (dollars in millions): March 31, 2016 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 415 $ 20 $ (1 ) $ 434 Money market funds 39 — — 39 454 20 (1 ) 473 Equity securities 1 3 — 4 $ 455 $ 23 $ (1 ) 477 Amounts classified as current assets (52 ) Investment carrying value $ 425 December 31, 2015 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 428 $ 17 $ (1 ) $ 444 Money market funds 34 — — 34 462 17 (1 ) 478 Equity securities — 4 — 4 $ 462 $ 21 $ (1 ) 482 Amounts classified as current assets (50 ) Investment carrying value $ 432 At March 31, 2016 and December 31, 2015, 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 March 31, 2016 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 92 $ 92 Due after one year through five years 152 156 Due after five years through ten years 135 146 Due after ten years 75 79 $ 454 $ 473 The average expected maturity of the investments in debt securities at March 31, 2016 was 3.8 years, compared to the average scheduled maturity of 5.4 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	3 Months Ended
	Mar. 31, 2016
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. Interest Rate Swap Agreements (continued) The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2016 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 3,000 December 2016 $ (68 ) Pay-fixed interest rate swaps 1,000 December 2017 (28 ) Pay-fixed interest rate swaps (starting in December 2016) 2,000 December 2021 (24 ) During the next 12 months, we estimate $89 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 quarter ended March 31, 2016 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Loss Amount of Loss Interest rate swaps $ 24 Interest expense $ 28 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 March 31, 2016, we have not been required to post any collateral related to these agreements. If we had breached these provisions at March 31, 2016, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $122 million.

Assets and Liabilities Measured

Assets and Liabilities Measured at Fair Value	3 Months Ended
	Mar. 31, 2016
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 March 31, 2016 and December 31, 2015, 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 March 31, 2016 and December 31, 2015, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): March 31, 2016 Fair Value Fair Value Measurements Using Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 434 $ — $ 429 $ 5 Money market funds 39 39 — — 473 39 429 5 Equity securities 4 4 — — Investments of insurance subsidiaries 477 43 429 5 Less amounts classified as current assets (52 ) (39 ) (13 ) — $ 425 $ 4 $ 416 $ 5 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 120 $ — $ 120 $ — December 31, 2015 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 444 $ — $ 438 $ 6 Money market funds 34 34 — — 478 34 438 6 Equity securities 4 4 — — Investments of insurance subsidiaries 482 38 438 6 Less amounts classified as current assets (50 ) (34 ) (16 ) — $ 432 $ 4 $ 422 $ 6 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 110 $ — $ 110 $ — We had $1 million of settlements related to the investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the quarter ended March 31, 2016. The estimated fair value of our long-term debt was $31.858 billion and $31.411 billion at March 31, 2016 and December 31, 2015, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $30.733 billion and $30.655 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	3 Months Ended
	Mar. 31, 2016
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 8 — LONG-TERM DEBT A summary of long-term debt at March 31, 2016 and December 31, 2015, including related interest rates at March 31, 2016, follows (dollars in millions): March 31, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 1.8%) $ 2,100 $ 3,030 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 5.3%) 5,161 5,639 Senior secured first lien notes (effective interest rate of 5.5%) 12,600 11,100 Other senior secured debt (effective interest rate of 5.7%) 620 634 First lien debt 20,481 20,403 Senior unsecured notes (effective interest rate of 6.5%) 10,252 10,252 Net debt issuance costs (179 ) (167 ) Total debt (average life of 6.6 years, rates averaging 5.5%) 30,554 30,488 Less amounts due within one year 226 233 $ 30,328 $ 30,255 2016 Activity During March 2016, we issued $1.500 billion aggregate principal amount of 5.250% senior secured notes due 2026. We used the net proceeds for general corporate purposes and to retire a portion of one of our senior secured term loans. We also entered into a joinder agreement to retire the remaining portion of this senior secured term loan using proceeds from a new $1.500 billion senior secured term loan facility maturing in March 2023. 2015 Activity During December 2015, we issued $500 million aggregate principal amount of 5.875% senior notes due 2026. We used the net proceeds for general corporate purposes. During November 2015, we issued $1.000 billion aggregate principal amount of 5.875% senior notes due 2026. We used the net proceeds to redeem all $1.000 billion aggregate principal amount of our outstanding 6.500% senior notes due 2016. 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 in June 2020. 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 our outstanding 7 3 / 4 % senior notes due 2021. 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 our $750 million aggregate principal amount of 6.375% senior notes due 2015.

Contingencies and Legal Claim C

Contingencies and Legal Claim Costs	3 Months Ended
	Mar. 31, 2016
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, financial position or liquidity. 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 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 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. In November 2015, following consideration of additional evidence, the Authority issued a provisional decision that again found there were adverse effects on competition in the private hospital market in central London. The November 2015 provisional decision modified some of the Authority’s earlier factual conclusions and acknowledged certain mitigating factors for some of the effects noted in the prior decision. The November 2015 provisional decision also offered additional potential remedies, which continued to include divestment of one or more of HCA’s London hospitals. Following a period of consultation on the potential additional remedies, the Authority concluded, in a provisional decision issued March 22, 2016, that none of the additional remedies, including divestiture, would be both effective and proportionate. A final decision is anticipated in May or June of 2016. Should HCA or any other party disagree with the Authority’s final decision, there would be an opportunity to appeal to the Competitive Appeal Tribunal. 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 asserted 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 alleged 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. Following the close of discovery, plaintiffs and defendants each filed motions for summary judgment and to strike certain of the expert witnesses. In addition to the above described consolidated shareholder class action, 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 alleged 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 was 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 did not act on the motion. On November 3, 2015, the Company reached a preliminary agreement in principle to settle the Schuh Sutton, Schroeder Bagot Schuh Bagot The monetary terms of the settlement in the Schuh 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 commitment. 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 accrued 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. The court granted the plaintiff’s motion for an award of additional pre-judgment interest, but did not specify whether the interest awarded was simple interest or would be compounded. The court subsequently concluded that interest was to be compounded, and on December 9, 2015, the court entered judgment in the case in the total sum of $434 million, with interest continuing to accrue at 9% per annum, compounded annually, from and after November 19, 2015, until the matter is resolved. At March 31, 2016 and December 31, 2015, the Company had accrued liabilities of $448 million and $438 million, respectively, for the damages, costs and interest related to this litigation. On January 15, 2016, the Company filed a Notice of Appeal in the Missouri Court of Appeals for the Western District. The Court of Appeals has set a schedule that would complete the parties’ briefing by November 2016. Briefing will likely be followed by oral argument, which has not yet been scheduled.

Capital Structure

Capital Structure	3 Months Ended
	Mar. 31, 2016
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 Attributable to Noncontrolling Interests Total Common Stock Capital in Par Value Accumulated Other Comprehensive Loss Retained Shares Par Value Balances at December 31, 2015 398.739 $ 4 $ — $ (265 ) $ (7,338 ) $ 1,553 $ (6,046 ) Comprehensive income — — — (29 ) 694 117 782 Repurchase of common stock (8.921 ) — — — (621 ) — (621 ) Distributions — — — — — (111 ) (111 ) Share-based benefit plans 3.832 — (2 ) — — — (2 ) Other — — 2 — (1 ) (2 ) (1 ) Balances at March 31, 2016 393.650 $ 4 $ — $ (294 ) $ (7,266 ) $ 1,557 $ (5,999 ) During the quarter ended March 31, 2016, we repurchased 8,921,200 shares of our common stock at an average price of $69.56 per share through market purchases pursuant to the $3.0 billion share repurchase program authorized during October 2015. At March 31, 2016, we had $1.983 billion of repurchase authorization available under the October 2015 authorization. The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Gains on Available- for-Sale Securities Foreign Currency Translation Adjustments Defined Benefit Plans Change in Fair Value of Derivative Instruments Total Balances at December 31, 2015 $ 13 $ (74 ) $ (135 ) $ (69 ) $ (265 ) Unrealized gains on available-for-sale securities, net of income taxes 2 — — — 2 Foreign currency translation adjustments, net of $17 income tax benefit — (26 ) — — (26 ) Change in fair value of derivative instruments, net of $14 income tax benefit — — — (24 ) (24 ) Expense reclassified into operations from other comprehensive income, net of $2 and $11, respectively, income tax benefits — — 2 17 19 Balances at March 31, 2016 $ 15 $ (100 ) $ (133 ) $ (76 ) $ (294 )

Segment and Geographic Informat

Segment and Geographic Information	3 Months Ended
	Mar. 31, 2016
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 84 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 78 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, 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 ended March 31, 2016 and 2015 are summarized in the following table (dollars in millions): 2016 2015 Revenues: National Group $ 4,967 $ 4,650 American Group 4,780 4,501 Corporate and other 513 525 $ 10,260 $ 9,676 Equity in earnings of affiliates: National Group $ (2 ) $ (3 ) American Group (9 ) (8 ) Corporate and other (1 ) (8 ) $ (12 ) $ (19 ) Adjusted segment EBITDA: National Group $ 1,138 $ 1,081 American Group 983 949 Corporate and other (118 ) (69 ) $ 2,003 $ 1,961 Depreciation and amortization: National Group $ 197 $ 189 American Group 218 221 Corporate and other 64 63 $ 479 $ 473 Adjusted segment EBITDA $ 2,003 $ 1,961 Depreciation and amortization 479 473 Interest expense 416 419 Losses (gains) on sales of facilities 1 (9 ) Legal claim costs 12 — Income before income taxes $ 1,095 $ 1,078

Supplemental Condensed Consolid

Supplemental Condensed Consolidating Financial Information	3 Months Ended
	Mar. 31, 2016
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, which were redeemed in full during May 2015. During December 2012, HCA Holdings, Inc. issued $1.000 billion aggregate principal amount of 6.250% 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 ended March 31, 2016 and 2015, condensed consolidating balance sheets at March 31, 2016 and December 31, 2015 and condensed consolidating statements of cash flows for the quarters ended March 31, 2016 and 2015, 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 MARCH 31, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,673 $ 5,377 $ — $ 11,050 Provision for doubtful accounts — — 494 296 — 790 Revenues — — 5,179 5,081 — 10,260 Salaries and benefits — — 2,354 2,348 — 4,702 Supplies — — 898 816 — 1,714 Other operating expenses 2 — 860 995 — 1,857 Electronic health record incentive income — — (3 ) (1 ) — (4 ) Equity in earnings of affiliates (629 ) — (2 ) (10 ) 629 (12 ) Depreciation and amortization — — 227 252 — 479 Interest expense 16 650 (207 ) (43 ) — 416 Losses (gains) on sales of facilities — — 2 (1 ) — 1 Legal claim costs — 12 — — — 12 Management fees — — (160 ) 160 — — (611 ) 662 3,969 4,516 629 9,165 Income (loss) before income taxes 611 (662 ) 1,210 565 (629 ) 1,095 Provision (benefit) for income taxes (83 ) (244 ) 438 173 — 284 Net income (loss) 694 (418 ) 772 392 (629 ) 811 Net income attributable to noncontrolling interests — — 22 95 — 117 Net income (loss) attributable to HCA Holdings, Inc. $ 694 $ (418 ) $ 750 $ 297 $ (629 ) $ 694 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 665 $ (425 ) $ 752 $ 273 $ (600 ) $ 665 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,201 $ 5,121 $ — $ 10,322 Provision for doubtful accounts — — 296 350 — 646 Revenues — — 4,905 4,771 — 9,676 Salaries and benefits — — 2,217 2,181 — 4,398 Supplies — — 854 784 — 1,638 Other operating expenses 6 — 820 891 — 1,717 Electronic health record incentive income — — (13 ) (6 ) — (19 ) Equity in earnings of affiliates (623 ) — (1 ) (18 ) 623 (19 ) Depreciation and amortization — — 230 243 — 473 Interest expense 46 595 (174 ) (48 ) — 419 Gains on sales of facilities — — (9 ) — — (9 ) Management fees — — (178 ) 178 — — (571 ) 595 3,746 4,205 623 8,598 Income (loss) before income taxes 571 (595 ) 1,159 566 (623 ) 1,078 Provision (benefit) for income taxes (20 ) (224 ) 428 174 — 358 Net income (loss) 591 (371 ) 731 392 (623 ) 720 Net income attributable to noncontrolling interests — — 23 106 — 129 Net income (loss) attributable to HCA Holdings, Inc. $ 591 $ (371 ) $ 708 $ 286 $ (623 ) $ 591 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 570 $ (366 ) $ 712 $ 256 $ (602 ) $ 570 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET MARCH 31, 2016 (Dollars in millions) HCA Holdings, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated ASSETS Current assets: Cash and cash equivalents $ 1 $ — $ 221 $ 630 $ — $ 852 Accounts receivable, net — — 3,041 2,839 — 5,880 Inventories — — 834 581 — 1,415 Other — — 454 600 — 1,054 1 — 4,550 4,650 — 9,201 Property and equipment, net — — 8,267 6,790 — 15,057 Investments of insurance subsidiaries — — — 425 — 425 Investments in and advances to affiliates 24,980 — 18 156 (24,980 ) 174 Goodwill and other intangible assets — — 1,702 5,011 — 6,713 Other 973 — 19 214 — 1,206 $ 25,954 $ — $ 14,556 $ 17,246 $ (24,980 ) $ 32,776 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 1 $ — $ 1,199 $ 744 $ — $ 1,944 Accrued salaries — — 729 580 — 1,309 Other accrued expenses 303 271 450 895 — 1,919 Long-term debt due within one year — 109 62 55 — 226 304 380 2,440 2,274 — 5,398 Long-term debt, net 992 28,833 212 291 — 30,328 Intercompany balances 31,677 (10,764 ) (23,936 ) 3,023 — — Professional liability risks — — — 1,116 — 1,116 Income taxes and other liabilities 537 568 426 402 — 1,933 33,510 19,017 (20,858 ) 7,106 — 38,775 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,556 ) (19,017 ) 35,280 8,717 (24,980 ) (7,556 ) Noncontrolling interests — — 134 1,423 — 1,557 (7,556 ) (19,017 ) 35,414 10,140 (24,980 ) (5,999 ) $ 25,954 $ — $ 14,556 $ 17,246 $ (24,980 ) $ 32,776 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 155 $ 586 $ — $ 741 Accounts receivable, net — — 2,982 2,907 — 5,889 Inventories — — 852 587 — 1,439 Other 223 — 403 537 — 1,163 223 — 4,392 4,617 — 9,232 Property and equipment, net — — 8,328 6,686 — 15,014 Investments of insurance subsidiaries — — — 432 — 432 Investments in and advances to affiliates 24,380 — 14 164 (24,380 ) 178 Goodwill and other intangible assets — — 1,703 5,028 — 6,731 Other 943 — 19 195 — 1,157 $ 25,546 $ — $ 14,456 $ 17,122 $ (24,380 ) $ 32,744 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 2 $ — $ 1,375 $ 793 $ — $ 2,170 Accrued salaries — — 712 521 — 1,233 Other accrued expenses 172 340 458 910 — 1,880 Long-term debt due within one year — 114 65 54 — 233 174 454 2,610 2,278 — 5,516 Long-term debt, net 984 28,756 226 289 — 30,255 Intercompany balances 31,432 (11,171 ) (23,435 ) 3,174 — — Professional liability risks — — — 1,115 — 1,115 Income taxes and other liabilities 555 548 417 384 — 1,904 33,145 18,587 (20,182) 7,240 — 38,790 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,599 ) (18,587 ) 34,510 8,457 (24,380 ) (7,599 ) Noncontrolling interests — — 128 1,425 — 1,553 (7,599) (18,587) 34,638 9,882 (24,380) (6,046) $ 25,546 $ — $ 14,456 $ 17,122 $ (24,380 ) $ 32,744 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2016 (Dollars in millions) HCA Holdings, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated Cash flows from operating activities: Net income (loss) $ 694 $ (418 ) $ 772 $ 392 $ (629 ) $ 811 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (36 ) (67 ) (740 ) (303 ) — (1,146 ) Provision for doubtful accounts — — 494 296 — 790 Depreciation and amortization — — 227 252 — 479 Income taxes 360 — — — — 360 Losses (gains) on sales of facilities — — 2 (1 ) — 1 Legal claim costs — 12 — — — 12 Amortization of debt issuance costs — 10 — — — 10 Share-based compensation — — 65 — — 65 Equity in earnings of affiliates (629 ) — — — 629 — Other 19 — (4 ) 2 — 17 Net cash provided by (used in) operating activities 408 (463 ) 816 638 — 1,399 Cash flows from investing activities: Purchase of property and equipment — — (161 ) (348 ) — (509 ) Acquisition of hospitals and health care entities — — — (9 ) — (9 ) Disposition of hospitals and health care entities — — — 4 — 4 Change in investments — — — 11 — 11 Other — — — 7 — 7 Net cash used in investing activities — — (161 ) (335 ) — (496 ) Cash flows from financing activities: Issuance of long-term debt — 3,000 — — — 3,000 Net change in revolving credit facilities — (930 ) — — — (930 ) Repayment of long-term debt — (1,980 ) (17 ) (14 ) — (2,011 ) Distributions to noncontrolling interests — — (16 ) (95 ) — (111 ) Payment of debt issuance costs — (22 ) — — — (22 ) Repurchases of common stock (621 ) — — — — (621 ) Changes in intercompany balances with affiliates, net 311 395 (556 ) (150 ) — — Other (97 ) — — — — (97 ) Net cash (used in) provided by financing activities (407 ) 463 (589 ) (259 ) — (792 ) Change in cash and cash equivalents 1 — 66 44 — 111 Cash and cash equivalents at beginning of period — — 155 586 — 741 Cash and cash equivalents at end of period $ 1 $ — $ 221 $ 630 $ — $ 852 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 570 $ (371 ) $ 731 $ 392 $ (602 ) $ 720 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities 17 (79 ) (739 ) (512 ) — (1,313 ) Provision for doubtful accounts — — 296 350 — 646 Depreciation and amortization — — 230 243 — 473 Income taxes 438 — — — — 438 Gains on sales of facilities — — (9 ) — — (9 ) Amortization of debt issuance costs 1 9 — — — 10 Share-based compensation — — 48 — — 48 Equity in earnings of affiliates (602 ) — — — 602 — Other 16 — — (11 ) — 5 Net cash provided by (used in) operating activities 440 (441 ) 557 462 — 1,018 Cash flows from investing activities: Purchase of property and equipment — — (182 ) (264 ) — (446 ) Acquisition of hospitals and health care entities — — (10 ) (18 ) — (28 ) Disposition of hospitals and health care entities — — 14 1 — 15 Change in investments — — 6 16 — 22 Other — — — 5 — 5 Net cash used in investing activities — — (172 ) (260 ) — (432 ) Cash flows from financing activities: Issuance of long-term debt — 1,000 — — — 1,000 Net change in revolving credit facilities — (260 ) — — — (260 ) Repayment of long-term debt — (771 ) (12 ) (8 ) — (791 ) Distributions to noncontrolling interests — — (32 ) (100 ) — (132 ) Payment of debt issuance costs — (11 ) — — — (11 ) Repurchases of common stock (366 ) — — — — (366 ) Changes in intercompany balances with affiliates, net (68 ) 483 (317 ) (98 ) — — Other (6 ) — — — — (6 ) Net cash (used in) provided by financing activities (440 ) 441 (361 ) (206 ) — (566 ) Change in cash and cash equivalents — — 24 (4 ) — 20 Cash and cash equivalents at beginning of period — — 87 479 — 566 Cash and cash equivalents at end of period $ — $ — $ 111 $ 475 $ — $ 586

Basis of Presentation and Sig19

Basis of Presentation and Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2016
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 $85 million and $74 million for the quarters ended March 31, 2016 and 2015, respectively. Operating results for the quarter ended March 31, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. 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, 2015.
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 (including 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 ended March 31, 2016 and 2015 are summarized in the following table (dollars in millions): 2016 Ratio 2015 Ratio Medicare $ 2,266 22.1 % $ 2,234 23.1 % Managed Medicare 1,104 10.8 1,052 10.9 Medicaid 427 4.2 452 4.7 Managed Medicaid 597 5.8 549 5.7 Managed care and other insurers 5,702 55.6 5,216 53.9 International (managed care and other insurers) 317 3.1 321 3.3 10,413 101.6 9,824 101.6 Uninsured 189 1.8 68 0.7 Other 448 4.4 430 4.4 Revenues before provision for doubtful accounts 11,050 107.8 10,322 106.7 Provision for doubtful accounts (790 ) (7.8 ) (646 ) (6.7 ) Revenues $ 10,260 100.0 % $ 9,676 100.0 %
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 continuing amendments to 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 November 2015, the FASB issued Accounting Standards Update 2015-17, Balance Sheet Classification of Deferred Taxes In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases In March 2016, the FASB issued Accounting Standards Update 2016-05, Derivatives and Hedging (Topic 815): Effect of Derivative Contract Novations on Existing Hedge Accounting Relationships In March 2016, the FASB issued Accounting Standards Update 2016-09, Improvements to Employee Share-Based Payment Accounting
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 equity awards and potential shares, 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 March 31, 2016 and December 31, 2015, 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)	3 Months Ended
	Mar. 31, 2016
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 ended March 31, 2016 and 2015 are summarized in the following table (dollars in millions): 2016 Ratio 2015 Ratio Medicare $ 2,266 22.1 % $ 2,234 23.1 % Managed Medicare 1,104 10.8 1,052 10.9 Medicaid 427 4.2 452 4.7 Managed Medicaid 597 5.8 549 5.7 Managed care and other insurers 5,702 55.6 5,216 53.9 International (managed care and other insurers) 317 3.1 321 3.3 10,413 101.6 9,824 101.6 Uninsured 189 1.8 68 0.7 Other 448 4.4 430 4.4 Revenues before provision for doubtful accounts 11,050 107.8 10,322 106.7 Provision for doubtful accounts (790 ) (7.8 ) (646 ) (6.7 ) Revenues $ 10,260 100.0 % $ 9,676 100.0 %

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2016
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 ended March 31, 2016 and 2015 (dollars and shares in millions, except per share amounts): 2016 2015 Net income attributable to HCA Holdings, Inc. $ 694 $ 591 Weighted average common shares outstanding 396.397 420.148 Effect of dilutive incremental shares 14.178 15.161 Shares used for diluted earnings per share 410.575 435.309 Earnings per share: Basic earnings per share $ 1.75 $ 1.41 Diluted earnings per share $ 1.69 $ 1.36

Investments of Insurance Subs22

Investments of Insurance Subsidiaries (Tables)	3 Months Ended
	Mar. 31, 2016
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	A summary of our insurance subsidiaries’ investments at March 31, 2016 and December 31, 2015 follows (dollars in millions): March 31, 2016 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 415 $ 20 $ (1 ) $ 434 Money market funds 39 — — 39 454 20 (1 ) 473 Equity securities 1 3 — 4 $ 455 $ 23 $ (1 ) 477 Amounts classified as current assets (52 ) Investment carrying value $ 425 December 31, 2015 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 428 $ 17 $ (1 ) $ 444 Money market funds 34 — — 34 462 17 (1 ) 478 Equity securities — 4 — 4 $ 462 $ 21 $ (1 ) 482 Amounts classified as current assets (50 ) Investment carrying value $ 432
Schedule of Maturities of Investments	Scheduled maturities of investments in debt securities at March 31, 2016 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 92 $ 92 Due after one year through five years 152 156 Due after five years through ten years 135 146 Due after ten years 75 79 $ 454 $ 473

Financial Instruments (Tables)

Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2016
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 March 31, 2016 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 3,000 December 2016 $ (68 ) Pay-fixed interest rate swaps 1,000 December 2017 (28 ) Pay-fixed interest rate swaps (starting in December 2016) 2,000 December 2021 (24 )
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 quarter ended March 31, 2016 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Loss Amount of Loss Interest rate swaps $ 24 Interest expense $ 28

Assets and Liabilities Measur24

Assets and Liabilities Measured at Fair Value (Tables)	3 Months Ended
	Mar. 31, 2016
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 March 31, 2016 and December 31, 2015, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): March 31, 2016 Fair Value Fair Value Measurements Using Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 434 $ — $ 429 $ 5 Money market funds 39 39 — — 473 39 429 5 Equity securities 4 4 — — Investments of insurance subsidiaries 477 43 429 5 Less amounts classified as current assets (52 ) (39 ) (13 ) — $ 425 $ 4 $ 416 $ 5 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 120 $ — $ 120 $ — December 31, 2015 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 444 $ — $ 438 $ 6 Money market funds 34 34 — — 478 34 438 6 Equity securities 4 4 — — Investments of insurance subsidiaries 482 38 438 6 Less amounts classified as current assets (50 ) (34 ) (16 ) — $ 432 $ 4 $ 422 $ 6 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 110 $ — $ 110 $ —

Long-Term Debt (Tables)

Long-Term Debt (Tables)	3 Months Ended
	Mar. 31, 2016
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	A summary of long-term debt at March 31, 2016 and December 31, 2015, including related interest rates at March 31, 2016, follows (dollars in millions): March 31, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 1.8%) $ 2,100 $ 3,030 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 5.3%) 5,161 5,639 Senior secured first lien notes (effective interest rate of 5.5%) 12,600 11,100 Other senior secured debt (effective interest rate of 5.7%) 620 634 First lien debt 20,481 20,403 Senior unsecured notes (effective interest rate of 6.5%) 10,252 10,252 Net debt issuance costs (179 ) (167 ) Total debt (average life of 6.6 years, rates averaging 5.5%) 30,554 30,488 Less amounts due within one year 226 233 $ 30,328 $ 30,255

Capital Structure (Tables)

Capital Structure (Tables)	3 Months Ended
	Mar. 31, 2016
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 Attributable to Noncontrolling Interests Total Common Stock Capital in Par Value Accumulated Other Comprehensive Loss Retained Shares Par Value Balances at December 31, 2015 398.739 $ 4 $ — $ (265 ) $ (7,338 ) $ 1,553 $ (6,046 ) Comprehensive income — — — (29 ) 694 117 782 Repurchase of common stock (8.921 ) — — — (621 ) — (621 ) Distributions — — — — — (111 ) (111 ) Share-based benefit plans 3.832 — (2 ) — — — (2 ) Other — — 2 — (1 ) (2 ) (1 ) Balances at March 31, 2016 393.650 $ 4 $ — $ (294 ) $ (7,266 ) $ 1,557 $ (5,999 )
Components of Accumulated Other Comprehensive Loss	The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Gains on Available- for-Sale Securities Foreign Currency Translation Adjustments Defined Benefit Plans Change in Fair Value of Derivative Instruments Total Balances at December 31, 2015 $ 13 $ (74 ) $ (135 ) $ (69 ) $ (265 ) Unrealized gains on available-for-sale securities, net of income taxes 2 — — — 2 Foreign currency translation adjustments, net of $17 income tax benefit — (26 ) — — (26 ) Change in fair value of derivative instruments, net of $14 income tax benefit — — — (24 ) (24 ) Expense reclassified into operations from other comprehensive income, net of $2 and $11, respectively, income tax benefits — — 2 17 19 Balances at March 31, 2016 $ 15 $ (100 ) $ (133 ) $ (76 ) $ (294 )

Segment and Geographic Inform27

Segment and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2016
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 ended March 31, 2016 and 2015 are summarized in the following table (dollars in millions): 2016 2015 Revenues: National Group $ 4,967 $ 4,650 American Group 4,780 4,501 Corporate and other 513 525 $ 10,260 $ 9,676 Equity in earnings of affiliates: National Group $ (2 ) $ (3 ) American Group (9 ) (8 ) Corporate and other (1 ) (8 ) $ (12 ) $ (19 ) Adjusted segment EBITDA: National Group $ 1,138 $ 1,081 American Group 983 949 Corporate and other (118 ) (69 ) $ 2,003 $ 1,961 Depreciation and amortization: National Group $ 197 $ 189 American Group 218 221 Corporate and other 64 63 $ 479 $ 473 Adjusted segment EBITDA $ 2,003 $ 1,961 Depreciation and amortization 479 473 Interest expense 416 419 Losses (gains) on sales of facilities 1 (9 ) Legal claim costs 12 — Income before income taxes $ 1,095 $ 1,078

Supplemental Condensed Consol28

Supplemental Condensed Consolidating Financial Information (Tables)	3 Months Ended
	Mar. 31, 2016
Text Block [Abstract]
Schedule of Condensed Consolidating Comprehensive Income Statement	HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,673 $ 5,377 $ — $ 11,050 Provision for doubtful accounts — — 494 296 — 790 Revenues — — 5,179 5,081 — 10,260 Salaries and benefits — — 2,354 2,348 — 4,702 Supplies — — 898 816 — 1,714 Other operating expenses 2 — 860 995 — 1,857 Electronic health record incentive income — — (3 ) (1 ) — (4 ) Equity in earnings of affiliates (629 ) — (2 ) (10 ) 629 (12 ) Depreciation and amortization — — 227 252 — 479 Interest expense 16 650 (207 ) (43 ) — 416 Losses (gains) on sales of facilities — — 2 (1 ) — 1 Legal claim costs — 12 — — — 12 Management fees — — (160 ) 160 — — (611 ) 662 3,969 4,516 629 9,165 Income (loss) before income taxes 611 (662 ) 1,210 565 (629 ) 1,095 Provision (benefit) for income taxes (83 ) (244 ) 438 173 — 284 Net income (loss) 694 (418 ) 772 392 (629 ) 811 Net income attributable to noncontrolling interests — — 22 95 — 117 Net income (loss) attributable to HCA Holdings, Inc. $ 694 $ (418 ) $ 750 $ 297 $ (629 ) $ 694 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 665 $ (425 ) $ 752 $ 273 $ (600 ) $ 665 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,201 $ 5,121 $ — $ 10,322 Provision for doubtful accounts — — 296 350 — 646 Revenues — — 4,905 4,771 — 9,676 Salaries and benefits — — 2,217 2,181 — 4,398 Supplies — — 854 784 — 1,638 Other operating expenses 6 — 820 891 — 1,717 Electronic health record incentive income — — (13 ) (6 ) — (19 ) Equity in earnings of affiliates (623 ) — (1 ) (18 ) 623 (19 ) Depreciation and amortization — — 230 243 — 473 Interest expense 46 595 (174 ) (48 ) — 419 Gains on sales of facilities — — (9 ) — — (9 ) Management fees — — (178 ) 178 — — (571 ) 595 3,746 4,205 623 8,598 Income (loss) before income taxes 571 (595 ) 1,159 566 (623 ) 1,078 Provision (benefit) for income taxes (20 ) (224 ) 428 174 — 358 Net income (loss) 591 (371 ) 731 392 (623 ) 720 Net income attributable to noncontrolling interests — — 23 106 — 129 Net income (loss) attributable to HCA Holdings, Inc. $ 591 $ (371 ) $ 708 $ 286 $ (623 ) $ 591 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 570 $ (366 ) $ 712 $ 256 $ (602 ) $ 570
Schedule of Condensed Consolidating Balance Sheet	HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET MARCH 31, 2016 (Dollars in millions) HCA Holdings, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated ASSETS Current assets: Cash and cash equivalents $ 1 $ — $ 221 $ 630 $ — $ 852 Accounts receivable, net — — 3,041 2,839 — 5,880 Inventories — — 834 581 — 1,415 Other — — 454 600 — 1,054 1 — 4,550 4,650 — 9,201 Property and equipment, net — — 8,267 6,790 — 15,057 Investments of insurance subsidiaries — — — 425 — 425 Investments in and advances to affiliates 24,980 — 18 156 (24,980 ) 174 Goodwill and other intangible assets — — 1,702 5,011 — 6,713 Other 973 — 19 214 — 1,206 $ 25,954 $ — $ 14,556 $ 17,246 $ (24,980 ) $ 32,776 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 1 $ — $ 1,199 $ 744 $ — $ 1,944 Accrued salaries — — 729 580 — 1,309 Other accrued expenses 303 271 450 895 — 1,919 Long-term debt due within one year — 109 62 55 — 226 304 380 2,440 2,274 — 5,398 Long-term debt, net 992 28,833 212 291 — 30,328 Intercompany balances 31,677 (10,764 ) (23,936 ) 3,023 — — Professional liability risks — — — 1,116 — 1,116 Income taxes and other liabilities 537 568 426 402 — 1,933 33,510 19,017 (20,858 ) 7,106 — 38,775 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,556 ) (19,017 ) 35,280 8,717 (24,980 ) (7,556 ) Noncontrolling interests — — 134 1,423 — 1,557 (7,556 ) (19,017 ) 35,414 10,140 (24,980 ) (5,999 ) $ 25,954 $ — $ 14,556 $ 17,246 $ (24,980 ) $ 32,776 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 155 $ 586 $ — $ 741 Accounts receivable, net — — 2,982 2,907 — 5,889 Inventories — — 852 587 — 1,439 Other 223 — 403 537 — 1,163 223 — 4,392 4,617 — 9,232 Property and equipment, net — — 8,328 6,686 — 15,014 Investments of insurance subsidiaries — — — 432 — 432 Investments in and advances to affiliates 24,380 — 14 164 (24,380 ) 178 Goodwill and other intangible assets — — 1,703 5,028 — 6,731 Other 943 — 19 195 — 1,157 $ 25,546 $ — $ 14,456 $ 17,122 $ (24,380 ) $ 32,744 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ 2 $ — $ 1,375 $ 793 $ — $ 2,170 Accrued salaries — — 712 521 — 1,233 Other accrued expenses 172 340 458 910 — 1,880 Long-term debt due within one year — 114 65 54 — 233 174 454 2,610 2,278 — 5,516 Long-term debt, net 984 28,756 226 289 — 30,255 Intercompany balances 31,432 (11,171 ) (23,435 ) 3,174 — — Professional liability risks — — — 1,115 — 1,115 Income taxes and other liabilities 555 548 417 384 — 1,904 33,145 18,587 (20,182) 7,240 — 38,790 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (7,599 ) (18,587 ) 34,510 8,457 (24,380 ) (7,599 ) Noncontrolling interests — — 128 1,425 — 1,553 (7,599) (18,587) 34,638 9,882 (24,380) (6,046) $ 25,546 $ — $ 14,456 $ 17,122 $ (24,380 ) $ 32,744
Schedule of Condensed Consolidating Statement of Cash Flows	HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2016 (Dollars in millions) HCA Holdings, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated Cash flows from operating activities: Net income (loss) $ 694 $ (418 ) $ 772 $ 392 $ (629 ) $ 811 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (36 ) (67 ) (740 ) (303 ) — (1,146 ) Provision for doubtful accounts — — 494 296 — 790 Depreciation and amortization — — 227 252 — 479 Income taxes 360 — — — — 360 Losses (gains) on sales of facilities — — 2 (1 ) — 1 Legal claim costs — 12 — — — 12 Amortization of debt issuance costs — 10 — — — 10 Share-based compensation — — 65 — — 65 Equity in earnings of affiliates (629 ) — — — 629 — Other 19 — (4 ) 2 — 17 Net cash provided by (used in) operating activities 408 (463 ) 816 638 — 1,399 Cash flows from investing activities: Purchase of property and equipment — — (161 ) (348 ) — (509 ) Acquisition of hospitals and health care entities — — — (9 ) — (9 ) Disposition of hospitals and health care entities — — — 4 — 4 Change in investments — — — 11 — 11 Other — — — 7 — 7 Net cash used in investing activities — — (161 ) (335 ) — (496 ) Cash flows from financing activities: Issuance of long-term debt — 3,000 — — — 3,000 Net change in revolving credit facilities — (930 ) — — — (930 ) Repayment of long-term debt — (1,980 ) (17 ) (14 ) — (2,011 ) Distributions to noncontrolling interests — — (16 ) (95 ) — (111 ) Payment of debt issuance costs — (22 ) — — — (22 ) Repurchases of common stock (621 ) — — — — (621 ) Changes in intercompany balances with affiliates, net 311 395 (556 ) (150 ) — — Other (97 ) — — — — (97 ) Net cash (used in) provided by financing activities (407 ) 463 (589 ) (259 ) — (792 ) Change in cash and cash equivalents 1 — 66 44 — 111 Cash and cash equivalents at beginning of period — — 155 586 — 741 Cash and cash equivalents at end of period $ 1 $ — $ 221 $ 630 $ — $ 852 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 570 $ (371 ) $ 731 $ 392 $ (602 ) $ 720 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities 17 (79 ) (739 ) (512 ) — (1,313 ) Provision for doubtful accounts — — 296 350 — 646 Depreciation and amortization — — 230 243 — 473 Income taxes 438 — — — — 438 Gains on sales of facilities — — (9 ) — — (9 ) Amortization of debt issuance costs 1 9 — — — 10 Share-based compensation — — 48 — — 48 Equity in earnings of affiliates (602 ) — — — 602 — Other 16 — — (11 ) — 5 Net cash provided by (used in) operating activities 440 (441 ) 557 462 — 1,018 Cash flows from investing activities: Purchase of property and equipment — — (182 ) (264 ) — (446 ) Acquisition of hospitals and health care entities — — (10 ) (18 ) — (28 ) Disposition of hospitals and health care entities — — 14 1 — 15 Change in investments — — 6 16 — 22 Other — — — 5 — 5 Net cash used in investing activities — — (172 ) (260 ) — (432 ) Cash flows from financing activities: Issuance of long-term debt — 1,000 — — — 1,000 Net change in revolving credit facilities — (260 ) — — — (260 ) Repayment of long-term debt — (771 ) (12 ) (8 ) — (791 ) Distributions to noncontrolling interests — — (32 ) (100 ) — (132 ) Payment of debt issuance costs — (11 ) — — — (11 ) Repurchases of common stock (366 ) — — — — (366 ) Changes in intercompany balances with affiliates, net (68 ) 483 (317 ) (98 ) — — Other (6 ) — — — — (6 ) Net cash (used in) provided by financing activities (440 ) 441 (361 ) (206 ) — (566 ) Change in cash and cash equivalents — — 24 (4 ) — 20 Cash and cash equivalents at beginning of period — — 87 479 — 566 Cash and cash equivalents at end of period $ — $ — $ 111 $ 475 $ — $ 586

Basis of Presentation and Sig29

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2016USD ($)HospitalStateSurgery_Center	Mar. 31, 2015USD ($)
Accounting Policies [Abstract]
Number of owned and operated hospitals | Hospital	168
Number of freestanding surgery centers | Surgery_Center	116
Number of facilities locations | State	20
General and administrative expense | $	$ 85	$ 74

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
	Mar. 31, 2016	Mar. 31, 2015
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 10,413	$ 9,824
Uninsured	189	68
Other	448	430
Revenues before provision for doubtful accounts	11,050	10,322
Provision for doubtful accounts	(790)	(646)
Revenues	$ 10,260	$ 9,676
Revenues from third party payers, Ratio	101.60%	101.60%
Uninsured, Ratio	1.80%	0.70%
Other, Ratio	4.40%	4.40%
Revenues before provision for doubtful accounts, Ratio	107.80%	106.70%
Provision for doubtful accounts, Ratio	(7.80%)	(6.70%)
Revenues ratio from third party payers	100.00%	100.00%
Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 2,266	$ 2,234
Revenues from third party payers, Ratio	22.10%	23.10%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 1,104	$ 1,052
Revenues from third party payers, Ratio	10.80%	10.90%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 427	$ 452
Revenues from third party payers, Ratio	4.20%	4.70%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 597	$ 549
Revenues from third party payers, Ratio	5.80%	5.70%
Managed Care and Other Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 5,702	$ 5,216
Revenues from third party payers, Ratio	55.60%	53.90%
International (Managed Care and Other Insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 317	$ 321
Revenues from third party payers, Ratio	3.10%	3.30%

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Business Acquisition [Line Items]
Proceeds from sale of business	$ 4	$ 15
Nonhospital Health Care [Member]
Business Acquisition [Line Items]
Cash paid for acquisition	9	28
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	(1)	9
Proceeds from sale of business	$ 4	$ 15

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Income Tax Contingency [Line Items]
Liability for unrecognized tax benefits	$ 537		$ 554
Unrecognized tax benefits, accrued interest	67		73
Unrecognized tax benefits that would impact effective tax rate	215		$ 233
Reduction in interest related to taxing authority examinations	6
Reduction in interest related to taxing authority examinations, net of tax	4
Provision (benefit) for income taxes	284	$ 358
Excess tax benefits		$ 70
Accounting Standards Update 2016-09 [Member]
Income Tax Contingency [Line Items]
Provision (benefit) for income taxes	$ (74)

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
	Mar. 31, 2016	Mar. 31, 2015
Earnings Per Share [Abstract]
Net income attributable to HCA Holdings, Inc.	$ 694	$ 591
Weighted average common shares outstanding	396,397	420,148
Effect of dilutive incremental shares	14,178	15,161
Shares used for diluted earnings per share	410,575	435,309
Basic earnings per share	$ 1.75	$ 1.41
Diluted earnings per share	$ 1.69	$ 1.36

Investments of Insurance Subs34

Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	$ 455		$ 462
Unrealized Amounts, Gains	23		21
Unrealized Amounts, Losses	(1)		(1)
Fair Value	477	$ 482	482
Amounts classified as current assets	(52)	(50)	(50)
Investment carrying value	425	432	432
Debt Securities [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	454		462
Unrealized Amounts, Gains	20		17
Unrealized Amounts, Losses	(1)		(1)
Fair Value	473	478	478
Debt Securities [Member] | States and Municipalities [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	415		428
Unrealized Amounts, Gains	20		17
Unrealized Amounts, Losses	(1)		(1)
Fair Value	434	444	444
Debt Securities [Member] | Money Market Funds [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	39		34
Fair Value	39	34	34
Equity Securities [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Amortized Cost	1
Unrealized Amounts, Gains	3		4
Fair Value	$ 4	$ 4	$ 4

Investments of Insurance Subs35

Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Mar. 31, 2016USD ($)
Amortized Cost and Fair Value Debt Securities [Abstract]
Due in one year or less, Amortized Cost	$ 92
Due after one year through five years, Amortized Cost	152
Due after five years through ten years, Amortized Cost	135
Due after ten years, Amortized Cost	75
Amortized Cost, Total	454
Due in one year or less, Fair Value	92
Due after one year through five years, Fair Value	156
Due after five years through ten years, Fair Value	146
Due after ten years, Fair Value	79
Fair Value, Total	$ 473

Investments of Insurance Subs36

Investments of Insurance Subsidiaries - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2016
Amortized Cost and Fair Value Debt Securities [Abstract]
Available for sale securities expected maturity of debt securities	3 years 9 months 18 days
Available for sale securities average scheduled maturity	5 years 4 months 24 days

Financial Instruments - Schedul

Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member]	3 Months Ended
	Mar. 31, 2016USD ($)
Maturity Date, 2016 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 3,000,000,000
Fair Value	$ (68,000,000)
Maturity Date	Dec. 31, 2016
Maturity Date, 2017 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 1,000,000,000
Fair Value	$ (28,000,000)
Maturity Date	Dec. 31, 2017
Maturity Date, 2021 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 2,000,000,000
Fair Value	$ (24,000,000)
Maturity Date	Dec. 31, 2021

Financial Instruments - Additio

Financial Instruments - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2016USD ($)
Offsetting [Abstract]
Estimated amount reclassified from other comprehensive income to interest expense	$ 89
Estimated termination value if there is breach of provision related to derivative agreement	$ 122

Financial Instruments - Effect

Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Derivative Instruments, Gain (Loss) [Line Items]
Interest expense	$ 416	$ 419
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss Recognized in OCI on Derivatives, Net of Tax	24
Reclassification out of Accumulated Other Comprehensive Income [Member] | Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest expense	$ 28

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	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	$ 477	$ 482	$ 482
Less amounts classified as current assets	(52)	(50)	(50)
Investments of insurance subsidiaries, noncurrent	425	432	432
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Liabilities, Fair Value	120	110
Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	473	478	478
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	434	444	444
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	39	34	34
Equity Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	4	4	$ 4
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	43	38
Less amounts classified as current assets	(39)	(34)
Investments of insurance subsidiaries, noncurrent	4	4
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	39	34
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	39	34
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	4	4
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	429	438
Less amounts classified as current assets	(13)	(16)
Investments of insurance subsidiaries, noncurrent	416	422
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	120	110
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	429	438
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	429	438
Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	5	6
Investments of insurance subsidiaries, noncurrent	5	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	5	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	$ 5	$ 6

Assets and Liabilities Measur41

Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Estimated fair value of long-term debt	$ 31,858	$ 31,411
Carrying amounts of long-term debt	30,733	30,655
Investments of insurance subsidiaries	477	482	$ 482
Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Investments of insurance subsidiaries	$ 5	$ 6

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
First lien debt	$ 20,481	$ 20,403
Net debt issuance costs	(179)	(167)
Total debt (average life of 6.6 years, rates averaging 5.5%)	30,554	30,488
Less amounts due within one year	226	233
Long-term debt	30,328	30,255
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	2,100	3,030
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Term loans	5,161	5,639
Senior Secured First Lien Notes [Member]
Debt Instrument [Line Items]
First lien debt	12,600	11,100
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	620	634
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 10,252	$ 10,252

Long-Term Debt - Schedule of 43

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2016
Debt Instrument [Line Items]
Total debt average term	6 years 7 months 6 days
Total debt average rate	5.50%
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	1.80%
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Effective interest rate	5.30%
Senior Secured First Lien Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.50%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	5.70%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	6.50%

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail) - Senior Notes [Member] - USD ($)	3 Months Ended
	Mar. 31, 2016	Dec. 31, 2015	Nov. 30, 2015	Jun. 30, 2015	May. 31, 2015	Jan. 31, 2015
Debt Instrument [Line Items]
Debt instrument maturity date	Mar. 31, 2023
Senior Secured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 1,500,000,000	$ 500,000,000	$ 1,000,000,000
Debt instrument, stated interest	5.25%	5.875%
Senior Secured Notes Due 2016 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest			6.50%
Debt instrument, principal amount			$ 1,000,000,000
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. 30, 2020
Senior Secured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount					$ 1,600,000,000	$ 1,000,000,000
Debt instrument, stated interest					5.375%	5.375%
Senior Secured Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest					7.75%
Debt instrument, principal amount					$ 1,525,000,000
Senior Secured Notes Due 2015 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest						6.375%
Debt instrument, principal amount						$ 750,000,000
Senior Secured Notes Due 2023 [Member]
Debt Instrument [Line Items]
Proceeds from new term loan	$ 1,500,000,000

Contingencies and Legal Claim45

Contingencies and Legal Claim Costs - Additional Information (Detail) $ in Millions	Dec. 09, 2015USD ($)	Nov. 03, 2015USD ($)	Feb. 09, 2015USD ($)	Jan. 24, 2013USD ($)	Oct. 28, 2011Cases	Apr. 25, 2014USD ($)	Mar. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Mar. 31, 2014USD ($)	Dec. 31, 2012USD ($)	Oct. 31, 2009USD ($)
Loss Contingencies [Line Items]
Number of claims filed | Cases					3
Payment for legal settlements		$ 215
Insurance claim receivables		19
Attorney's fees		$ 5.5
Legal claim costs	$ 434						$ 12	$ 120	$ 78	$ 175
Capital commitment in connection with purchase of hospitals											$ 450
Additional shortfall related to capital expenditures						$ 78
Period of agreed capital commitments							5 years
Number of year under court-supervisor accounting for expenditures following the purchase							10 years
Percentage of legal claim costs	9.00%
Dispute settlement amount			$ 15
Accrued Liability							$ 448	$ 438
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%

Capital Structure - Schedule of

Capital Structure - Schedule of Changes in Stockholders' Deficit and Equity (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Capital Structure [Line Items]
Beginning Balances	$ (6,046)
Comprehensive income	782	$ 699
Repurchase of common stock	(621)
Distributions	(111)
Share-based benefit plans	(2)
Other	(1)
Ending Balances	(5,999)
Common Stock [Member]
Capital Structure [Line Items]
Beginning Balances	4
Ending Balances	$ 4
Beginning Balances, Shares	398,739,000
Repurchase of common stock, Shares	(8,921,000)
Share-based benefit plans, Shares	3,832,000
Ending Balances, Shares	393,650,000
Capital in Excess of Par Value [Member]
Capital Structure [Line Items]
Share-based benefit plans	$ (2)
Other	2
Accumulated Other Comprehensive Loss [Member]
Capital Structure [Line Items]
Beginning Balances	(265)
Comprehensive income	(29)
Ending Balances	(294)
Retained Deficit [Member]
Capital Structure [Line Items]
Beginning Balances	(7,338)
Comprehensive income	694
Repurchase of common stock	(621)
Other	(1)
Ending Balances	(7,266)
Equity Attributable to Noncontrolling Interests [Member]
Capital Structure [Line Items]
Beginning Balances	1,553
Comprehensive income	117
Distributions	(111)
Other	(2)
Ending Balances	$ 1,557

Capital Structure - Additional

Capital Structure - Additional Information (Detail) - October 2015 Repurchase Authorization [Member]	3 Months Ended
	Mar. 31, 2016USD ($)$ / sharesshares
Capital Structure [Line Items]
Repurchase of common stock, shares | shares	8,921,200
Repurchase price of common stock, per share | $ / shares	$ 69.56
Share repurchase program authorized amount	$ 3,000,000,000
Remaining repurchase of common stock	$ 1,983,000,000

Capital Structure - Components

Capital Structure - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2016USD ($)
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	15
Foreign currency translation adjustments, beginning balances	(74)
Foreign currency translation adjustments	(26)
Foreign currency translation adjustments, ending balances	(100)
Defined benefit plans, beginning balances	(135)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	2
Defined benefit plans, ending balances	(133)
Change in fair value of derivative instruments, beginning balances	(69)
Change in fair value of derivative instruments	(24)
Change in fair value of derivatives instruments, (income) expense reclassified into operations from other comprehensive income	17
Change in fair value of derivative instruments, ending balances	(76)
Accumulated other comprehensive income, net of tax, beginning balances	(265)
Unrealized losses on available-for-sale securities, net of income tax benefit	2
Foreign currency translation adjustments	(26)
Change in fair value of derivative instruments	(24)
Expense reclassified into operations from other comprehensive income, Total	19
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (294)

Capital Structure - Component49

Capital Structure - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2016USD ($)
Equity [Abstract]
Foreign currency translation adjustments, income tax benefit	$ 17
Defined benefit plans, income tax benefit	2
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, income tax benefit	11
Change in fair value of derivative instruments, income tax benefit	$ 14

Segment and Geographic Inform50

Segment and Geographic Information - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2016Hospital
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	84
Reorganization Group [Member] | American Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	78
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	Dec. 09, 2015	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015	Mar. 31, 2014	Dec. 31, 2012
Segment Reporting Information [Line Items]
Revenues		$ 10,260		$ 9,676
Equity in earnings of affiliates		12		19
Adjusted segment EBITDA		2,003		1,961
Depreciation and amortization		479		473
Interest expense		416		419
Losses (gains) on sales of facilities		1		(9)
Legal claim costs	$ 434	12	$ 120		$ 78	$ 175
Income before income taxes		1,095		1,078
National Group [Member]
Segment Reporting Information [Line Items]
Revenues		4,967		4,650
Equity in earnings of affiliates		(2)		(3)
Adjusted segment EBITDA		1,138		1,081
Depreciation and amortization		197		189
American Group [Member]
Segment Reporting Information [Line Items]
Revenues		4,780		4,501
Equity in earnings of affiliates		(9)		(8)
Adjusted segment EBITDA		983		949
Depreciation and amortization		218		221
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues		513		525
Equity in earnings of affiliates		(1)		(8)
Adjusted segment EBITDA		(118)		(69)
Depreciation and amortization		$ 64		$ 63

Supplemental Condensed Consol52

Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2012	Nov. 30, 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		6.25%	7.75%

Supplemental Condensed Consol53

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) - USD ($) $ in Millions	Dec. 09, 2015	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015	Mar. 31, 2014	Dec. 31, 2012
Supplemental Condensed Consolidating Financial Information [Line Items]
Revenues before provision for doubtful accounts		$ 11,050		$ 10,322
Provision for doubtful accounts		790		646
Revenues		10,260		9,676
Salaries and benefits		4,702		4,398
Supplies		1,714		1,638
Other operating expenses		1,857		1,717
Electronic health record incentive income		(4)		(19)
Equity in earnings of affiliates		(12)		(19)
Depreciation and amortization		479		473
Interest expense (revenue)		416		419
Losses (gains) on sales of facilities		1		(9)
Legal claim costs	$ 434	12	$ 120		$ 78	$ 175
Total expenses including equity in earnings of affiliates		9,165		8,598
Income (loss) before income taxes		1,095		1,078
Provision (benefit) for income taxes		284		358
Net income (loss)		811		720
Net income attributable to noncontrolling interests		117		129
Net income (loss) attributable to HCA Holdings, Inc.		694		591
Comprehensive income (loss) attributable to HCA Holdings, Inc.		665		570
HCA Holdings, Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Other operating expenses		2		6
Equity in earnings of affiliates		(629)		(623)
Interest expense (revenue)		16		46
Total expenses including equity in earnings of affiliates		(611)		(571)
Income (loss) before income taxes		611		571
Provision (benefit) for income taxes		(83)		(20)
Net income (loss)		694		591
Net income (loss) attributable to HCA Holdings, Inc.		694		591
Comprehensive income (loss) attributable to HCA Holdings, Inc.		665		570
HCA Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Interest expense (revenue)		650		595
Legal claim costs		12
Total expenses including equity in earnings of affiliates		662		595
Income (loss) before income taxes		(662)		(595)
Provision (benefit) for income taxes		(244)		(224)
Net income (loss)		(418)		(371)
Net income (loss) attributable to HCA Holdings, Inc.		(418)		(371)
Comprehensive income (loss) attributable to HCA Holdings, Inc.		(425)		(366)
Subsidiary Guarantors [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Revenues before provision for doubtful accounts		5,673		5,201
Provision for doubtful accounts		494		296
Revenues		5,179		4,905
Salaries and benefits		2,354		2,217
Supplies		898		854
Other operating expenses		860		820
Electronic health record incentive income		(3)		(13)
Equity in earnings of affiliates		(2)		(1)
Depreciation and amortization		227		230
Interest expense (revenue)		(207)		(174)
Losses (gains) on sales of facilities		2		(9)
Management fees		(160)		(178)
Total expenses including equity in earnings of affiliates		3,969		3,746
Income (loss) before income taxes		1,210		1,159
Provision (benefit) for income taxes		438		428
Net income (loss)		772		731
Net income attributable to noncontrolling interests		22		23
Net income (loss) attributable to HCA Holdings, Inc.		750		708
Comprehensive income (loss) attributable to HCA Holdings, Inc.		752		712
Subsidiary Non-Guarantors [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Revenues before provision for doubtful accounts		5,377		5,121
Provision for doubtful accounts		296		350
Revenues		5,081		4,771
Salaries and benefits		2,348		2,181
Supplies		816		784
Other operating expenses		995		891
Electronic health record incentive income		(1)		(6)
Equity in earnings of affiliates		(10)		(18)
Depreciation and amortization		252		243
Interest expense (revenue)		(43)		(48)
Losses (gains) on sales of facilities		(1)
Management fees		160		178
Total expenses including equity in earnings of affiliates		4,516		4,205
Income (loss) before income taxes		565		566
Provision (benefit) for income taxes		173		174
Net income (loss)		392		392
Net income attributable to noncontrolling interests		95		106
Net income (loss) attributable to HCA Holdings, Inc.		297		286
Comprehensive income (loss) attributable to HCA Holdings, Inc.		273		256
Eliminations [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Equity in earnings of affiliates		629		623
Total expenses including equity in earnings of affiliates		629		623
Income (loss) before income taxes		(629)		(623)
Net income (loss)		(629)		(623)
Net income (loss) attributable to HCA Holdings, Inc.		(629)		(623)
Comprehensive income (loss) attributable to HCA Holdings, Inc.		$ (600)		$ (602)

Supplemental Condensed Consol54

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015	Dec. 31, 2014
Current assets:
Cash and cash equivalents	$ 852	$ 741	$ 586	$ 566
Accounts receivable, net	5,880	5,889
Inventories	1,415	1,439
Other	1,054	1,163
Total current assets	9,201	9,232
Property and equipment, net	15,057	15,014
Investments of insurance subsidiaries	425	432	432
Investments in and advances to affiliates	174	178
Goodwill and other intangible assets	6,713	6,731
Other	1,206	1,157
Total assets	32,776	32,744
Current liabilities:
Accounts payable	1,944	2,170
Accrued salaries	1,309	1,233
Other accrued expenses	1,919	1,880
Long-term debt due within one year	226	233
Total current liabilities	5,398	5,516
Long-term debt, net	30,328	30,255
Professional liability risks	1,116	1,115
Income taxes and other liabilities	1,933	1,904
Total liabilities	38,775	38,790
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(7,556)	(7,599)
Noncontrolling interests	1,557	1,553
Total stockholders' deficit	(5,999)	(6,046)
Total liabilities and stockholders' deficit	32,776	32,744
HCA Holdings, Inc. Issuer [Member]
Current assets:
Cash and cash equivalents	1
Other		223
Total current assets	1	223
Investments in and advances to affiliates	24,980	24,380
Other	973	943
Total assets	25,954	25,546
Current liabilities:
Accounts payable	1	2
Other accrued expenses	303	172
Total current liabilities	304	174
Long-term debt, net	992	984
Intercompany balances	31,677	31,432
Income taxes and other liabilities	537	555
Total liabilities	33,510	33,145
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(7,556)	(7,599)
Total stockholders' deficit	(7,556)	(7,599)
Total liabilities and stockholders' deficit	25,954	25,546
HCA Inc. Issuer [Member]
Current liabilities:
Other accrued expenses	271	340
Long-term debt due within one year	109	114
Total current liabilities	380	454
Long-term debt, net	28,833	28,756
Intercompany balances	(10,764)	(11,171)
Income taxes and other liabilities	568	548
Total liabilities	19,017	18,587
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(19,017)	(18,587)
Total stockholders' deficit	(19,017)	(18,587)
Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	221	155	111	87
Accounts receivable, net	3,041	2,982
Inventories	834	852
Other	454	403
Total current assets	4,550	4,392
Property and equipment, net	8,267	8,328
Investments in and advances to affiliates	18	14
Goodwill and other intangible assets	1,702	1,703
Other	19	19
Total assets	14,556	14,456
Current liabilities:
Accounts payable	1,199	1,375
Accrued salaries	729	712
Other accrued expenses	450	458
Long-term debt due within one year	62	65
Total current liabilities	2,440	2,610
Long-term debt, net	212	226
Intercompany balances	(23,936)	(23,435)
Income taxes and other liabilities	426	417
Total liabilities	(20,858)	(20,182)
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	35,280	34,510
Noncontrolling interests	134	128
Total stockholders' deficit	35,414	34,638
Total liabilities and stockholders' deficit	14,556	14,456
Subsidiary Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	630	586	$ 475	$ 479
Accounts receivable, net	2,839	2,907
Inventories	581	587
Other	600	537
Total current assets	4,650	4,617
Property and equipment, net	6,790	6,686
Investments of insurance subsidiaries	425	432
Investments in and advances to affiliates	156	164
Goodwill and other intangible assets	5,011	5,028
Other	214	195
Total assets	17,246	17,122
Current liabilities:
Accounts payable	744	793
Accrued salaries	580	521
Other accrued expenses	895	910
Long-term debt due within one year	55	54
Total current liabilities	2,274	2,278
Long-term debt, net	291	289
Intercompany balances	3,023	3,174
Professional liability risks	1,116	1,115
Income taxes and other liabilities	402	384
Total liabilities	7,106	7,240
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	8,717	8,457
Noncontrolling interests	1,423	1,425
Total stockholders' deficit	10,140	9,882
Total liabilities and stockholders' deficit	17,246	17,122
Eliminations [Member]
Current assets:
Investments in and advances to affiliates	(24,980)	(24,380)
Total assets	(24,980)	(24,380)
Current liabilities:
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(24,980)	(24,380)
Total stockholders' deficit	(24,980)	(24,380)
Total liabilities and stockholders' deficit	$ (24,980)	$ (24,380)

Supplemental Condensed Consol55

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Cash flows from operating activities:
Net income (loss)	$ 811	$ 720
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(1,146)	(1,313)
Provision for doubtful accounts	790	646
Depreciation and amortization	479	473
Income taxes	360	438
Gains on sales of facilities	1	(9)
Legal claim costs	12
Amortization of debt issuance costs	10	10
Share-based compensation	65	48
Other	17	5
Net cash provided by operating activities	1,399	1,018
Cash flows from investing activities:
Purchase of property and equipment	(509)	(446)
Acquisition of hospitals and health care entities	(9)	(28)
Disposition of hospitals and health care entities	4	15
Change in investments	11	22
Other	7	5
Net cash used in investing activities	(496)	(432)
Cash flows from financing activities:
Issuance of long-term debt	3,000	1,000
Net change in revolving credit facilities	(930)	(260)
Repayment of long-term debt	(2,011)	(791)
Distributions to noncontrolling interests	(111)	(132)
Payment of debt issuance costs	(22)	(11)
Repurchases of common stock	(621)	(366)
Other	(97)	(6)
Net cash used in financing activities	(792)	(566)
Change in cash and cash equivalents	111	20
Cash and cash equivalents at beginning of period	741	566
Cash and cash equivalents at end of period	852	586
Eliminations [Member]
Cash flows from operating activities:
Net income (loss)	(629)	(623)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in earnings of affiliates	629	602
HCA Holdings, Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	694	591
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(36)	17
Income taxes	360	438
Amortization of debt issuance costs		1
Equity in earnings of affiliates	(629)	(602)
Other	19	16
Net cash provided by operating activities	408	440
Cash flows from financing activities:
Repurchases of common stock	(621)	(366)
Changes in intercompany balances with affiliates, net	311	(68)
Other	(97)	(6)
Net cash used in financing activities	(407)	(440)
Change in cash and cash equivalents	1
Cash and cash equivalents at end of period	1
HCA Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	(418)	(371)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(67)	(79)
Legal claim costs	12
Amortization of debt issuance costs	10	9
Net cash provided by operating activities	(463)	(441)
Cash flows from financing activities:
Issuance of long-term debt	3,000	1,000
Net change in revolving credit facilities	(930)	(260)
Repayment of long-term debt	(1,980)	(771)
Payment of debt issuance costs	(22)	(11)
Changes in intercompany balances with affiliates, net	395	483
Net cash used in financing activities	463	441
Subsidiary Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	772	731
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(740)	(739)
Provision for doubtful accounts	494	296
Depreciation and amortization	227	230
Gains on sales of facilities	2	(9)
Share-based compensation	65	48
Other	(4)
Net cash provided by operating activities	816	557
Cash flows from investing activities:
Purchase of property and equipment	(161)	(182)
Acquisition of hospitals and health care entities		(10)
Disposition of hospitals and health care entities		14
Change in investments		6
Net cash used in investing activities	(161)	(172)
Cash flows from financing activities:
Repayment of long-term debt	(17)	(12)
Distributions to noncontrolling interests	(16)	(32)
Changes in intercompany balances with affiliates, net	(556)	(317)
Net cash used in financing activities	(589)	(361)
Change in cash and cash equivalents	66	24
Cash and cash equivalents at beginning of period	155	87
Cash and cash equivalents at end of period	221	111
Subsidiary Non-Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	392	392
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(303)	(512)
Provision for doubtful accounts	296	350
Depreciation and amortization	252	243
Gains on sales of facilities	(1)
Other	2	(11)
Net cash provided by operating activities	638	462
Cash flows from investing activities:
Purchase of property and equipment	(348)	(264)
Acquisition of hospitals and health care entities	(9)	(18)
Disposition of hospitals and health care entities	4	1
Change in investments	11	16
Other	7	5
Net cash used in investing activities	(335)	(260)
Cash flows from financing activities:
Repayment of long-term debt	(14)	(8)
Distributions to noncontrolling interests	(95)	(100)
Changes in intercompany balances with affiliates, net	(150)	(98)
Net cash used in financing activities	(259)	(206)
Change in cash and cash equivalents	44	(4)
Cash and cash equivalents at beginning of period	586	479
Cash and cash equivalents at end of period	$ 630	$ 475