Document and Entity Information
Document and Entity Information - shares | 6 Months Ended | |
Jun. 30, 2016 | Jul. 31, 2016 | |
Document And Entity Information [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Jun. 30, 2016 | |
Document Fiscal Year Focus | 2,016 | |
Document Fiscal Period Focus | Q2 | |
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 | 378,646,200 |
Condensed Consolidated Income S
Condensed Consolidated Income Statements (Unaudited) - USD ($) shares in Thousands, $ in Millions | Dec. 09, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | Mar. 31, 2014 | Dec. 31, 2012 | Jun. 30, 2016 | Jun. 30, 2015 |
Income Statement [Abstract] | |||||||
Revenues before provision for doubtful accounts | $ 11,081 | $ 10,932 | $ 22,131 | $ 21,254 | |||
Provision for doubtful accounts | 762 | 1,035 | 1,552 | 1,681 | |||
Revenues | 10,319 | 9,897 | 20,579 | 19,573 | |||
Salaries and benefits | 4,691 | 4,492 | 9,393 | 8,890 | |||
Supplies | 1,718 | 1,670 | 3,432 | 3,308 | |||
Other operating expenses | 1,873 | 1,755 | 3,730 | 3,472 | |||
Electronic health record incentive income | (5) | (18) | (9) | (37) | |||
Equity in earnings of affiliates | (10) | (10) | (22) | (29) | |||
Depreciation and amortization | 489 | 469 | 968 | 942 | |||
Interest expense | 427 | 425 | 843 | 844 | |||
Losses (gains) on sales of facilities | (6) | 5 | (5) | (4) | |||
Losses on retirement of debt | 125 | 125 | |||||
Legal claim costs | $ 434 | 10 | $ 78 | $ 175 | 22 | ||
Total expenses including equity in earnings of affiliates | 9,187 | 8,913 | 18,352 | 17,511 | |||
Income before income taxes | 1,132 | 984 | 2,227 | 2,062 | |||
Provision for income taxes | 341 | 319 | 625 | 677 | |||
Net income | 791 | 665 | 1,602 | 1,385 | |||
Net income attributable to noncontrolling interests | 133 | 158 | 250 | 287 | |||
Net income attributable to HCA Holdings, Inc. | $ 658 | $ 507 | $ 1,352 | $ 1,098 | |||
Per share data: | |||||||
Basic earnings per share | $ 1.70 | $ 1.22 | $ 3.45 | $ 2.63 | |||
Diluted earnings per share | $ 1.65 | $ 1.18 | $ 3.34 | $ 2.54 | |||
Shares used in earnings per share calculations (in millions): | |||||||
Basic | 386,406 | 416,407 | 391,401 | 418,267 | |||
Diluted | 398,659 | 429,369 | 404,617 | 432,329 |
Condensed Consolidated Comprehe
Condensed Consolidated Comprehensive Income Statements (Unaudited) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income | $ 791 | $ 665 | $ 1,602 | $ 1,385 |
Other comprehensive income (loss) before taxes: | ||||
Foreign currency translation | (86) | 64 | (129) | 13 |
Unrealized gains (losses) on available-for-sale securities | 3 | (5) | 5 | (4) |
Defined benefit plans | 0 | 0 | 0 | 0 |
Pension costs included in salaries and benefits | 5 | 5 | 9 | 11 |
Total defined benefit plans | 5 | 5 | 9 | 11 |
Change in fair value of derivative financial instruments | (32) | (7) | (70) | (30) |
Interest costs included in interest expense | 28 | 31 | 56 | 62 |
Total change in fair value of derivative financial instruments | (4) | 24 | (14) | 32 |
Other comprehensive income (loss) before taxes | (82) | 88 | (129) | 52 |
Income taxes (benefits) related to other comprehensive income items | (32) | 34 | (50) | 19 |
Other comprehensive income (loss) | (50) | 54 | (79) | 33 |
Comprehensive income | 741 | 719 | 1,523 | 1,418 |
Comprehensive income attributable to noncontrolling interests | 133 | 158 | 250 | 287 |
Comprehensive income attributable to HCA Holdings, Inc. | $ 608 | $ 561 | $ 1,273 | $ 1,131 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions | Jun. 30, 2016 | Dec. 31, 2015 |
Current assets: | ||
Cash and cash equivalents | $ 691 | $ 741 |
Accounts receivable, less allowance for doubtful accounts of $5,046 and $5,326 | 5,669 | 5,889 |
Inventories | 1,481 | 1,439 |
Other | 1,254 | 1,163 |
Total current assets | 9,095 | 9,232 |
Property and equipment, at cost | 35,873 | 34,614 |
Accumulated depreciation | (20,249) | (19,600) |
Property and equipment, net | 15,624 | 15,014 |
Investments of insurance subsidiaries | 341 | 432 |
Investments in and advances to affiliates | 201 | 178 |
Goodwill and other intangible assets | 6,694 | 6,731 |
Other | 1,250 | 1,157 |
Total assets | 33,205 | 32,744 |
Current liabilities: | ||
Accounts payable | 1,934 | 2,170 |
Accrued salaries | 1,405 | 1,233 |
Other accrued expenses | 1,833 | 1,880 |
Long-term debt due within one year | 224 | 233 |
Total current liabilities | 5,396 | 5,516 |
Long-term debt, less net debt issuance costs of $173 and $167 | 31,228 | 30,255 |
Professional liability risks | 1,126 | 1,115 |
Income taxes and other liabilities | 1,953 | 1,904 |
Stockholders' deficit: | ||
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 380,061,600 shares in 2016 and 398,738,700 shares in 2015 | 4 | 4 |
Accumulated other comprehensive loss | (344) | (265) |
Retained deficit | (7,767) | (7,338) |
Stockholders' deficit attributable to HCA Holdings, Inc. | (8,107) | (7,599) |
Noncontrolling interests | 1,609 | 1,553 |
Total stockholders' deficit | (6,498) | (6,046) |
Total liabilities and stockholders' deficit | $ 33,205 | $ 32,744 |
Condensed Consolidated Balance5
Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Millions | Jun. 30, 2016 | Dec. 31, 2015 |
Statement of Financial Position [Abstract] | ||
Allowance for Accounts receivable | $ 5,046 | $ 5,326 |
Debt issuance cost | $ 173 | $ 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 | 380,061,600 | 398,738,700 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions | 6 Months Ended | |
Jun. 30, 2016 | Jun. 30, 2015 | |
Cash flows from operating activities: | ||
Net income | $ 1,602 | $ 1,385 |
Increase (decrease) in cash from operating assets and liabilities: | ||
Accounts receivable | (1,364) | (1,784) |
Provision for doubtful accounts | 1,552 | 1,681 |
Accounts receivable, net | 188 | (103) |
Inventories and other assets | (176) | (195) |
Accounts payable and accrued expenses | (102) | (117) |
Depreciation and amortization | 968 | 942 |
Income taxes | 67 | (101) |
Gains on sales of facilities | (5) | (4) |
Losses on retirement of debt | 125 | |
Legal claim costs | 22 | |
Amortization of debt issuance costs | 18 | 19 |
Share-based compensation | 129 | 103 |
Other | 37 | 21 |
Net cash provided by operating activities | 2,748 | 2,075 |
Cash flows from investing activities: | ||
Purchase of property and equipment | (1,172) | (1,004) |
Acquisition of hospitals and health care entities | (430) | (95) |
Disposal of hospitals and health care entities | 14 | 22 |
Change in investments | 18 | 67 |
Other | 15 | 1 |
Net cash used in investing activities | (1,555) | (1,009) |
Cash flows from financing activities: | ||
Issuances of long-term debt | 3,000 | 4,048 |
Net change in revolving bank credit facilities | (300) | |
Repayment of long-term debt | (2,065) | (3,644) |
Distributions to noncontrolling interests | (205) | (237) |
Payment of debt issuance costs | (24) | (33) |
Repurchases of common stock | (1,858) | (940) |
Other | (91) | 147 |
Net cash used in financing activities | (1,243) | (959) |
Change in cash and cash equivalents | (50) | 107 |
Cash and cash equivalents at beginning of period | 741 | 566 |
Cash and cash equivalents at end of period | 691 | 673 |
Interest payments | 767 | 810 |
Income tax payments, net | $ 558 | $ 581 |
Basis of Presentation and Signi
Basis of Presentation and Significant Accounting Policies | 6 Months Ended |
Jun. 30, 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 June 30, 2016, these affiliates owned and operated 169 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 $93 million and $84 million for the quarters ended June 30, 2016 and 2015, respectively, and $178 million and $158 million for the six months ended June 30, 2016 and 2015, respectively. Operating results for the quarter and the six months ended June 30, 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 and six months ended June 30, 2016 and 2015 are summarized in the following table (dollars in millions): Quarter 2016 Ratio 2015 Ratio Medicare $ 2,217 21.5 % $ 2,144 21.7 % Managed Medicare 1,078 10.4 1,016 10.3 Medicaid 416 4.0 408 4.1 Managed Medicaid 608 5.9 571 5.8 Managed care and other insurers 5,759 55.8 5,461 55.1 International (managed care and other insurers) 324 3.1 327 3.3 10,402 100.7 9,927 100.3 Uninsured 225 2.2 558 5.6 Other 454 4.4 447 4.5 Revenues before provision for doubtful accounts 11,081 107.3 10,932 110.4 Provision for doubtful accounts (762 ) (7.3 ) (1,035 ) (10.4 ) Revenues $ 10,319 100.0 % $ 9,897 100.0 % Six Months 2016 Ratio 2015 Ratio Medicare $ 4,483 21.8 % $ 4,378 22.4 % Managed Medicare 2,182 10.6 2,068 10.6 Medicaid 843 4.1 860 4.4 Managed Medicaid 1,205 5.9 1,120 5.7 Managed care and other insurers 11,461 55.7 10,677 54.5 International (managed care and other insurers) 641 3.1 648 3.3 20,815 101.2 19,751 100.9 Uninsured 414 2.0 626 3.2 Other 902 4.4 877 4.5 Revenues before provision for doubtful accounts 22,131 107.6 21,254 108.6 Provision for doubtful accounts (1,552 ) (7.6 ) (1,681 ) (8.6 ) Revenues $ 20,579 100.0 % $ 19,573 100.0 % 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. While we are continuing to evaluate the effects the adoption of this standard will have on our financial statements and financial disclosures, we do not believe the adoption will have a significant impact on our recognition of net revenues. 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 | 6 Months Ended |
Jun. 30, 2016 | |
Business Combinations [Abstract] | |
Acquisitions and Dispositions | NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the six months ended June 30, 2016, we paid $343 million to acquire three hospital facilities and $87 million to acquire other nonhospital health care entities. During the six months ended June 30, 2015, we paid $15 million to acquire a hospital and $80 million to acquire other nonhospital health care entities. During the six months ended June 30, 2016, we received proceeds of $14 million and recognized a net pretax gain of $5 million related to sales of real estate and other investments. During the six months ended June 30, 2015, we received proceeds of $22 million and recognized a net pretax gain of $4 million related to sales of real estate and other investments. |
Income Taxes
Income Taxes | 6 Months Ended |
Jun. 30, 2016 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | NOTE 3 — INCOME TAXES Our liability for unrecognized tax benefits was $542 million, including accrued interest of $71 million, as of June 30, 2016 ($554 million and $73 million, respectively, as of December 31, 2015). Unrecognized tax benefits of $223 million ($233 million as of December 31, 2015) would affect the effective rate, if recognized. Our provision for income taxes for the quarter and six months ended June 30, 2016 included tax benefits of $44 million and $118 million, respectively, 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 benefits for the quarter and six months ending June 30, 2015, related to the settlement of employee equity awards, were $115 million and $185 million, respectively, and were 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. 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. 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 | 6 Months Ended |
Jun. 30, 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 and six months ended June 30, 2016 and 2015 (dollars and shares in millions, except per share amounts): Quarter Six Months 2016 2015 2016 2015 Net income attributable to HCA Holdings, Inc. $ 658 $ 507 $ 1,352 $ 1,098 Weighted average common shares outstanding 386.406 416.407 391.401 418.267 Effect of dilutive incremental shares 12.253 12.962 13.216 14.062 Shares used for diluted earnings per share 398.659 429.369 404.617 432.329 Earnings per share: Basic earnings per share $ 1.70 $ 1.22 $ 3.45 $ 2.63 Diluted earnings per share $ 1.65 $ 1.18 $ 3.34 $ 2.54 |
Investments of Insurance Subsid
Investments of Insurance Subsidiaries | 6 Months Ended |
Jun. 30, 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 June 30, 2016 and December 31, 2015 follows (dollars in millions): June 30, 2016 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 392 $ 22 $ — $ 414 Money market funds 49 — — 49 441 22 — 463 Equity securities 1 3 — 4 $ 442 $ 25 $ — 467 Amounts classified as current assets (126 ) Investment carrying value $ 341 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 June 30, 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). Amounts classified as current assets at June 30, 2016 include $75 million to be distributed to the Company from a 100% owned insurance subsidiary. Scheduled maturities of investments in debt securities at June 30, 2016 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 88 $ 88 Due after one year through five years 160 165 Due after five years through ten years 124 136 Due after ten years 69 74 $ 441 $ 463 The average expected maturity of the investments in debt securities at June 30, 2016 was 3.7 years, compared to the average scheduled maturity of 5.2 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 | 6 Months Ended |
Jun. 30, 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. The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at June 30, 2016 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 3,000 December 2016 $ (46 ) Pay-fixed interest rate swaps 1,000 December 2017 (26 ) Pay-fixed interest rate swaps (starting in December 2016) 2,000 December 2021 (52 ) During the next 12 months, we estimate $73 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 six months ended June 30, 2016 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Loss Amount of Loss Interest rate swaps $ 44 Interest expense $ 56 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 June 30, 2016, we have not been required to post any collateral related to these agreements. If we had breached these provisions at June 30, 2016, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $126 million. |
Assets and Liabilities Measured
Assets and Liabilities Measured at Fair Value | 6 Months Ended |
Jun. 30, 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 June 30, 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 June 30, 2016 and December 31, 2015, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): June 30, 2016 Fair Value Fair Value Measurements Using Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 414 $ — $ 409 $ 5 Money market funds 49 49 — — 463 49 409 5 Equity securities 4 4 — — Investments of insurance subsidiaries 467 53 409 5 Less amounts classified as current assets (126 ) (49 ) (77 ) — $ 341 $ 4 $ 332 $ 5 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 124 $ — $ 124 $ — 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 $ 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 six months ended June 30, 2016. The estimated fair value of our long-term debt was $33.018 billion and $31.411 billion at June 30, 2016 and December 31, 2015, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $31.625 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 | 6 Months Ended |
Jun. 30, 2016 | |
Debt Disclosure [Abstract] | |
Long-Term Debt | NOTE 8 — LONG-TERM DEBT A summary of long-term debt at June 30, 2016 and December 31, 2015, including related interest rates at June 30, 2016, follows (dollars in millions): June 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 1.9%) $ 3,030 $ 3,030 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 5.3%) 5,134 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%) 609 634 First lien debt 21,373 20,403 Senior unsecured notes (effective interest rate of 6.5%) 10,252 10,252 Net debt issuance costs (173 ) (167 ) Total debt (average life of 6.3 years, rates averaging 5.5%) 31,452 30,488 Less amounts due within one year 224 233 $ 31,228 $ 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. The pretax loss on retirement of debt was $3 million. During May 2015, we issued $1.600 billion aggregate principal amount of 5.375% senior notes due 2025. We used the net proceeds to redeem all $1.525 billion aggregate principal amount of our outstanding 7 3 / 4 % senior notes due 2021. The pretax loss on retirement of debt related to this redemption was $122 million. During January 2015, we issued $1.000 billion aggregate principal amount of 5.375% senior notes due 2025. We used a portion of the net proceeds to repay at maturity our $750 million aggregate principal amount of 6.375% senior notes due 2015. |
Contingencies and Legal Claim C
Contingencies and Legal Claim Costs | 6 Months Ended |
Jun. 30, 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 expected during the third quarter 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. 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, began 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 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 June 30, 2016, the Company had accrued liabilities of $458 million 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 | 6 Months Ended |
Jun. 30, 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 Total Common Stock Capital in Accumulated Retained Shares Par Value Balances at December 31, 2015 398.739 $ 4 $ — $ (265 ) $ (7,338 ) $ 1,553 $ (6,046 ) Comprehensive income — — — (79 ) 1,352 250 1,523 Repurchase of common stock (24.427 ) — (77 ) — (1,781 ) — (1,858 ) Distributions — — — — — (205 ) (205 ) Share-based benefit plans 5.750 — 74 — — — 74 Other — — 3 — — 11 14 Balances at June 30, 2016 380.062 $ 4 $ — $ (344 ) $ (7,767 ) $ 1,609 $ (6,498 ) During May 2016, we repurchased 9.361 million shares of our common stock beneficially owned by affiliates of Kohlberg Kravis Roberts & Co. at a purchase price of $80.12 per share, the closing price of our common stock on the New York Stock Exchange on May 10, 2016, less a discount of 1%. During the six months ended June 30, 2016, we also repurchased 15.066 million shares of our common stock at an average price of $73.51 per share through market purchases, resulting in total repurchases of 24.427 million shares of our common stock at an average price of $76.04 per share for the six months ended June 30, 2016 pursuant to the $3.0 billion share repurchase program authorized during October 2015. At June 30, 2016, we had $746 million of repurchase authorization available under the October 2015 authorization. The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Foreign Defined Change Total Balances at December 31, 2015 $ 13 $ (74 ) $ (135 ) $ (69 ) $ (265 ) Unrealized gains on available-for-sale securities, net of $2 of income taxes 3 — — — 3 Foreign currency translation adjustments, net of $50 income tax benefit — (79 ) — — (79 ) Change in fair value of derivative instruments, net of $26 income tax benefit — — — (44 ) (44 ) Expense reclassified into operations from other comprehensive income, net of $3 and $21, respectively, income tax benefits — — 6 35 41 Balances at June 30, 2016 $ 16 $ (153 ) $ (129 ) $ (78 ) $ (344 ) |
Segment and Geographic Informat
Segment and Geographic Information | 6 Months Ended |
Jun. 30, 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 79 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and Texas. We also operate six hospitals in England, and these facilities are included in the Corporate and other group. Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and six months ended June 30, 2016 and 2015 are summarized in the following table (dollars in millions): Quarter Six Months 2016 2015 2016 2015 Revenues: National Group $ 4,931 $ 4,698 $ 9,898 $ 9,348 American Group 4,855 4,699 9,635 9,200 Corporate and other 533 500 1,046 1,025 $ 10,319 $ 9,897 $ 20,579 $ 19,573 Equity in earnings of affiliates: National Group $ (2 ) $ (4 ) $ (4 ) $ (7 ) American Group (8 ) (8 ) (17 ) (16 ) Corporate and other — 2 (1 ) (6 ) $ (10 ) $ (10 ) $ (22 ) $ (29 ) Adjusted segment EBITDA: National Group $ 1,131 $ 1,088 $ 2,269 $ 2,169 American Group 1,004 1,044 1,987 1,993 Corporate and other (83 ) (124 ) (201 ) (193 ) $ 2,052 $ 2,008 $ 4,055 $ 3,969 Depreciation and amortization: National Group $ 201 $ 188 $ 398 $ 377 American Group 225 222 443 443 Corporate and other 63 59 127 122 $ 489 $ 469 $ 968 $ 942 Adjusted segment EBITDA $ 2,052 $ 2,008 $ 4,055 $ 3,969 Depreciation and amortization 489 469 968 942 Interest expense 427 425 843 844 Losses (gains) on sales of facilities (6 ) 5 (5 ) (4 ) Losses on retirement of debt — 125 — 125 Legal claim costs 10 — 22 — Income before income taxes $ 1,132 $ 984 $ 2,227 $ 2,062 |
Supplemental Condensed Consolid
Supplemental Condensed Consolidating Financial Information | 6 Months Ended |
Jun. 30, 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 and six months ended June 30, 2016 and 2015, condensed consolidating balance sheets at June 30, 2016 and December 31, 2015 and condensed consolidating statements of cash flows for the six months ended June 30, 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 JUNE 30, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,693 $ 5,388 $ — $ 11,081 Provision for doubtful accounts — — 498 264 — 762 Revenues — — 5,195 5,124 — 10,319 Salaries and benefits — — 2,347 2,344 — 4,691 Supplies — — 886 832 — 1,718 Other operating expenses 2 — 895 976 — 1,873 Electronic health record incentive income — — (2 ) (3 ) — (5 ) Equity in earnings of affiliates (563 ) — (1 ) (9 ) 563 (10 ) Depreciation and amortization — — 238 251 — 489 Interest expense 16 670 (204 ) (55 ) — 427 Gains on sales of facilities — — (2 ) (4 ) — (6 ) Legal claim costs — 10 — — — 10 Management fees — — (235 ) 235 — — (545 ) 680 3,922 4,567 563 9,187 Income (loss) before income taxes 545 (680 ) 1,273 557 (563 ) 1,132 Provision (benefit) for income taxes (113 ) (303 ) 555 202 — 341 Net income (loss) 658 (377 ) 718 355 (563 ) 791 Net income attributable to noncontrolling interests — — 21 112 — 133 Net income (loss) attributable to HCA Holdings, Inc. $ 658 $ (377 ) $ 697 $ 243 $ (563 ) $ 658 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 608 $ (379 ) $ 701 $ 191 $ (513 ) $ 608 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED JUNE 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,597 $ 5,335 $ — $ 10,932 Provision for doubtful accounts — — 550 485 — 1,035 Revenues — — 5,047 4,850 — 9,897 Salaries and benefits — — 2,250 2,242 — 4,492 Supplies — — 869 801 — 1,670 Other operating expenses (4 ) — 838 921 — 1,755 Electronic health record incentive income — — (12 ) (6 ) — (18 ) Equity in earnings of affiliates (603 ) — (2 ) (8 ) 603 (10 ) Depreciation and amortization — — 223 246 — 469 Interest expense 38 604 (168 ) (49 ) — 425 Losses on sales of facilities — — 5 — — 5 Losses on retirement of debt 122 3 — — — 125 Management fees — — (178 ) 178 — — (447 ) 607 3,825 4,325 603 8,913 Income (loss) before income taxes 447 (607 ) 1,222 525 (603 ) 984 Provision (benefit) for income taxes (60 ) (234 ) 462 151 — 319 Net income (loss) 507 (373 ) 760 374 (603 ) 665 Net income attributable to noncontrolling interests — — 24 134 — 158 Net income (loss) attributable to HCA Holdings, Inc. $ 507 $ (373 ) $ 736 $ 240 $ (603 ) $ 507 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 561 $ (358 ) $ 740 $ 275 $ (657 ) $ 561 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE SIX MONTHS ENDED JUNE 30, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 11,366 $ 10,765 $ — $ 22,131 Provision for doubtful accounts — — 992 560 — 1,552 Revenues — — 10,374 10,205 — 20,579 Salaries and benefits — — 4,701 4,692 — 9,393 Supplies — — 1,784 1,648 — 3,432 Other operating expenses 4 — 1,755 1,971 — 3,730 Electronic health record incentive income — — (5 ) (4 ) — (9 ) Equity in earnings of affiliates (1,270 ) — (3 ) (19 ) 1,270 (22 ) Depreciation and amortization — — 465 503 — 968 Interest expense 32 1,320 (411 ) (98 ) — 843 Gains on sales of facilities — — — (5 ) — (5 ) Legal claim costs — 22 — — — 22 Management fees — — (395 ) 395 — — (1,234 ) 1,342 7,891 9,083 1,270 18,352 Income (loss) before income taxes 1,234 (1,342 ) 2,483 1,122 (1,270 ) 2,227 Provision (benefit) for income taxes (118 ) (495 ) 900 338 — 625 Net income (loss) 1,352 (847 ) 1,583 784 (1,270 ) 1,602 Net income attributable to noncontrolling interests — — 43 207 — 250 Net income (loss) attributable to HCA Holdings, Inc. $ 1,352 $ (847 ) $ 1,540 $ 577 $ (1,270 ) $ 1,352 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,273 $ (856 ) $ 1,546 $ 501 $ (1,191 ) $ 1,273 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE SIX MONTHS ENDED JUNE 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 10,798 $ 10,456 $ — $ 21,254 Provision for doubtful accounts — — 846 835 — 1,681 Revenues — — 9,952 9,621 — 19,573 Salaries and benefits — — 4,467 4,423 — 8,890 Supplies — — 1,723 1,585 — 3,308 Other operating expenses 2 — 1,658 1,812 — 3,472 Electronic health record incentive — — (25 ) (12 ) — (37 ) Equity in earnings of affiliates (1,226 ) — (3 ) (26 ) 1,226 (29 ) Depreciation and amortization — — 453 489 — 942 Interest expense 84 1,199 (342 ) (97 ) — 844 Gains on sales of facilities — — (4 ) — — (4 ) Losses on retirement of debt 122 3 — — — 125 Management fees — — (356 ) 356 — — (1,018 ) 1,202 7,571 8,530 1,226 17,511 Income (loss) before income taxes 1,018 (1,202 ) 2,381 1,091 (1,226 ) 2,062 Provision (benefit) for income taxes (80 ) (458 ) 890 325 — 677 Net income (loss) 1,098 (744 ) 1,491 766 (1,226 ) 1,385 Net income attributable to noncontrolling interests — — 47 240 — 287 Net income (loss) attributable to HCA Holdings, Inc. $ 1,098 $ (744 ) $ 1,444 $ 526 $ (1,226 ) $ 1,098 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,131 $ (724 ) $ 1,452 $ 531 $ (1,259 ) $ 1,131 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET JUNE 30, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 82 $ 609 $ — $ 691 Accounts receivable, net — — 2,917 2,752 — 5,669 Inventories — — 885 596 — 1,481 Other — — 530 724 — 1,254 — — 4,414 4,681 — 9,095 Property and equipment, net — — 8,491 7,133 — 15,624 Investments of insurance subsidiaries — — — 341 — 341 Investments in and advances to affiliates 25,571 — 16 185 (25,571 ) 201 Goodwill and other intangible assets — — 1,705 4,989 — 6,694 Other 1,041 — 16 193 — 1,250 $ 26,612 $ — $ 14,642 $ 17,522 $ (25,571 ) $ 33,205 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,210 $ 724 $ — $ 1,934 Accrued salaries — — 775 630 — 1,405 Other accrued expenses 46 406 486 895 — 1,833 Long-term debt due within one year — 109 60 55 — 224 46 515 2,531 2,304 — 5,396 Long-term debt, net 992 29,742 201 293 — 31,228 Intercompany balances 33,138 (11,391 ) (24,731 ) 2,984 — — Professional liability risks — — — 1,126 — 1,126 Income taxes and other liabilities 543 582 425 403 — 1,953 34,719 19,448 (21,574 ) 7,110 — 39,703 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (8,107 ) (19,448 ) 36,074 8,945 (25,571 ) (8,107 ) Noncontrolling interests — — 142 1,467 — 1,609 (8,107 ) (19,448 ) 36,216 10,412 (25,571 ) (6,498 ) $ 26,612 $ — $ 14,642 $ 17,522 $ (25,571 ) $ 33,205 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 SIX MONTHS ENDED JUNE 30, 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) $ 1,352 $ (847 ) $ 1,583 $ 784 $ (1,270 ) $ 1,602 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (23 ) 66 (1,140 ) (545 ) — (1,642 ) Provision for doubtful accounts — — 992 560 — 1,552 Depreciation and amortization — — 465 503 — 968 Income taxes 67 — — — — 67 Gains on sales of facilities — — — (5 ) — (5 ) Legal claim costs — 22 — — — 22 Amortization of debt issuance costs — 18 — — — 18 Share-based compensation — — 129 — — 129 Equity in earnings of affiliates (1,270 ) — — — 1,270 — Other 37 — (2 ) 2 — 37 Net cash provided by (used in) operating activities 163 (741 ) 2,027 1,299 — 2,748 Cash flows from investing activities: Purchase of property and equipment — — (482 ) (690 ) — (1,172 ) Acquisition of hospitals and health care entities — — (148 ) (282 ) — (430 ) Disposition of hospitals and health care entities — — 9 5 — 14 Change in investments — — 3 15 — 18 Other — — (1 ) 16 — 15 Net cash used in investing activities — — (619 ) (936 ) — (1,555 ) Cash flows from financing activities: Issuance of long-term debt — 3,000 — — — 3,000 Repayment of long-term debt — (2,005 ) (38 ) (22 ) — (2,065 ) Distributions to noncontrolling interests — — (29 ) (176 ) — (205 ) Payment of debt issuance costs — (24 ) — — — (24 ) Repurchases of common stock (1,858 ) — — — — (1,858 ) Changes in intercompany balances with affiliates, net 1,799 (230) (1,414 ) (155 ) — — Other (104 ) — — 13 — (91 ) Net cash (used in) provided by financing activities (163 ) 741 (1,481 ) (340 ) — (1,243 ) Change in cash and cash equivalents — — (73 ) 23 — (50 ) Cash and cash equivalents at beginning of period — — 155 586 — 741 Cash and cash equivalents at end of period $ — $ — $ 82 $ 609 $ — $ 691 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE SIX MONTHS ENDED JUNE 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,098 $ (744 ) $ 1,491 $ 766 $ (1,226 ) $ 1,385 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities 21 22 (1,360 ) (779 ) — (2,096 ) Provision for doubtful accounts — — 846 835 — 1,681 Depreciation and amortization — — 453 489 — 942 Income taxes (101 ) — — — — (101 ) Gains on sales of facilities — — (4 ) — — (4 ) Losses on retirement of debt 122 3 — — — 125 Amortization of debt issuance costs 2 17 — — — 19 Share-based compensation 103 — — — — 103 Equity in earnings of affiliates (1,226 ) — — — 1,226 — Other 34 — (2 ) (11 ) — 21 Net cash provided by (used in) operating activities 53 (702 ) 1,424 1,300 — 2,075 Cash flows from investing activities: Purchase of property and equipment — — (470 ) (534 ) — (1,004 ) Acquisition of hospitals and health care entities — — (16 ) (79 ) — (95 ) Disposition of hospitals and health care entities — — 14 8 — 22 Change in investments — — 6 61 — 67 Other — — (6 ) 7 — 1 Net cash used in investing activities — — (472 ) (537 ) — (1,009 ) Cash flows from financing activities: Issuance of long-term debt — 4,048 — — — 4,048 Net change in revolving credit facilities — (300 ) — — — (300 ) Repayment of long-term debt (1,632 ) (1,971 ) (24 ) (17 ) — (3,644 ) Distributions to noncontrolling interests — — (46 ) (191 ) — (237 ) Payment of debt issuance costs — (33 ) — — — (33 ) Repurchases of common stock (940 ) — — — — (940 ) Changes in intercompany balances with affiliates, net 2,354 (1,042) (839 ) (473 ) — — Other 165 — — (18 ) — 147 Net cash (used in) provided by financing activities (53 ) 702 (909 ) (699 ) — (959 ) Change in cash and cash equivalents — — 43 64 — 107 Cash and cash equivalents at beginning of period — — 87 479 — 566 Cash and cash equivalents at end of period $ — $ — $ 130 $ 543 $ — $ 673 |
Basis of Presentation and Sig19
Basis of Presentation and Significant Accounting Policies (Policies) | 6 Months Ended |
Jun. 30, 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 $93 million and $84 million for the quarters ended June 30, 2016 and 2015, respectively, and $178 million and $158 million for the six months ended June 30, 2016 and 2015, respectively. Operating results for the quarter and the six months ended June 30, 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 and six months ended June 30, 2016 and 2015 are summarized in the following table (dollars in millions): Quarter 2016 Ratio 2015 Ratio Medicare $ 2,217 21.5 % $ 2,144 21.7 % Managed Medicare 1,078 10.4 1,016 10.3 Medicaid 416 4.0 408 4.1 Managed Medicaid 608 5.9 571 5.8 Managed care and other insurers 5,759 55.8 5,461 55.1 International (managed care and other insurers) 324 3.1 327 3.3 10,402 100.7 9,927 100.3 Uninsured 225 2.2 558 5.6 Other 454 4.4 447 4.5 Revenues before provision for doubtful accounts 11,081 107.3 10,932 110.4 Provision for doubtful accounts (762 ) (7.3 ) (1,035 ) (10.4 ) Revenues $ 10,319 100.0 % $ 9,897 100.0 % Six Months 2016 Ratio 2015 Ratio Medicare $ 4,483 21.8 % $ 4,378 22.4 % Managed Medicare 2,182 10.6 2,068 10.6 Medicaid 843 4.1 860 4.4 Managed Medicaid 1,205 5.9 1,120 5.7 Managed care and other insurers 11,461 55.7 10,677 54.5 International (managed care and other insurers) 641 3.1 648 3.3 20,815 101.2 19,751 100.9 Uninsured 414 2.0 626 3.2 Other 902 4.4 877 4.5 Revenues before provision for doubtful accounts 22,131 107.6 21,254 108.6 Provision for doubtful accounts (1,552 ) (7.6 ) (1,681 ) (8.6 ) Revenues $ 20,579 100.0 % $ 19,573 100.0 % |
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. While we are continuing to evaluate the effects the adoption of this standard will have on our financial statements and financial disclosures, we do not believe the adoption will have a significant impact on our recognition of net revenues. 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 June 30, 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) | 6 Months Ended |
Jun. 30, 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 and six months ended June 30, 2016 and 2015 are summarized in the following table (dollars in millions): Quarter 2016 Ratio 2015 Ratio Medicare $ 2,217 21.5 % $ 2,144 21.7 % Managed Medicare 1,078 10.4 1,016 10.3 Medicaid 416 4.0 408 4.1 Managed Medicaid 608 5.9 571 5.8 Managed care and other insurers 5,759 55.8 5,461 55.1 International (managed care and other insurers) 324 3.1 327 3.3 10,402 100.7 9,927 100.3 Uninsured 225 2.2 558 5.6 Other 454 4.4 447 4.5 Revenues before provision for doubtful accounts 11,081 107.3 10,932 110.4 Provision for doubtful accounts (762 ) (7.3 ) (1,035 ) (10.4 ) Revenues $ 10,319 100.0 % $ 9,897 100.0 % Six Months 2016 Ratio 2015 Ratio Medicare $ 4,483 21.8 % $ 4,378 22.4 % Managed Medicare 2,182 10.6 2,068 10.6 Medicaid 843 4.1 860 4.4 Managed Medicaid 1,205 5.9 1,120 5.7 Managed care and other insurers 11,461 55.7 10,677 54.5 International (managed care and other insurers) 641 3.1 648 3.3 20,815 101.2 19,751 100.9 Uninsured 414 2.0 626 3.2 Other 902 4.4 877 4.5 Revenues before provision for doubtful accounts 22,131 107.6 21,254 108.6 Provision for doubtful accounts (1,552 ) (7.6 ) (1,681 ) (8.6 ) Revenues $ 20,579 100.0 % $ 19,573 100.0 % |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 6 Months Ended |
Jun. 30, 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 and six months ended June 30, 2016 and 2015 (dollars and shares in millions, except per share amounts): Quarter Six Months 2016 2015 2016 2015 Net income attributable to HCA Holdings, Inc. $ 658 $ 507 $ 1,352 $ 1,098 Weighted average common shares outstanding 386.406 416.407 391.401 418.267 Effect of dilutive incremental shares 12.253 12.962 13.216 14.062 Shares used for diluted earnings per share 398.659 429.369 404.617 432.329 Earnings per share: Basic earnings per share $ 1.70 $ 1.22 $ 3.45 $ 2.63 Diluted earnings per share $ 1.65 $ 1.18 $ 3.34 $ 2.54 |
Investments of Insurance Subs22
Investments of Insurance Subsidiaries (Tables) | 6 Months Ended |
Jun. 30, 2016 | |
Investments, Debt and Equity Securities [Abstract] | |
Schedule of Investments | A summary of our insurance subsidiaries’ investments at June 30, 2016 and December 31, 2015 follows (dollars in millions): June 30, 2016 Amortized Unrealized Fair Gains Losses Debt securities: States and municipalities $ 392 $ 22 $ — $ 414 Money market funds 49 — — 49 441 22 — 463 Equity securities 1 3 — 4 $ 442 $ 25 $ — 467 Amounts classified as current assets (126 ) Investment carrying value $ 341 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 June 30, 2016 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 88 $ 88 Due after one year through five years 160 165 Due after five years through ten years 124 136 Due after ten years 69 74 $ 441 $ 463 |
Financial Instruments (Tables)
Financial Instruments (Tables) | 6 Months Ended |
Jun. 30, 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 June 30, 2016 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 3,000 December 2016 $ (46 ) Pay-fixed interest rate swaps 1,000 December 2017 (26 ) Pay-fixed interest rate swaps (starting in December 2016) 2,000 December 2021 (52 ) |
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 six months ended June 30, 2016 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Loss Amount of Loss Interest rate swaps $ 44 Interest expense $ 56 |
Assets and Liabilities Measur24
Assets and Liabilities Measured at Fair Value (Tables) | 6 Months Ended |
Jun. 30, 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 June 30, 2016 and December 31, 2015, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): June 30, 2016 Fair Value Fair Value Measurements Using Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities: States and municipalities $ 414 $ — $ 409 $ 5 Money market funds 49 49 — — 463 49 409 5 Equity securities 4 4 — — Investments of insurance subsidiaries 467 53 409 5 Less amounts classified as current assets (126 ) (49 ) (77 ) — $ 341 $ 4 $ 332 $ 5 Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 124 $ — $ 124 $ — 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 $ 110 $ — $ 110 $ — |
Long-Term Debt (Tables)
Long-Term Debt (Tables) | 6 Months Ended |
Jun. 30, 2016 | |
Debt Disclosure [Abstract] | |
Schedule of Long-Term Debt | A summary of long-term debt at June 30, 2016 and December 31, 2015, including related interest rates at June 30, 2016, follows (dollars in millions): June 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 1.9%) $ 3,030 $ 3,030 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 5.3%) 5,134 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%) 609 634 First lien debt 21,373 20,403 Senior unsecured notes (effective interest rate of 6.5%) 10,252 10,252 Net debt issuance costs (173 ) (167 ) Total debt (average life of 6.3 years, rates averaging 5.5%) 31,452 30,488 Less amounts due within one year 224 233 $ 31,228 $ 30,255 |
Capital Structure (Tables)
Capital Structure (Tables) | 6 Months Ended |
Jun. 30, 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 Total Common Stock Capital in Accumulated Retained Shares Par Value Balances at December 31, 2015 398.739 $ 4 $ — $ (265 ) $ (7,338 ) $ 1,553 $ (6,046 ) Comprehensive income — — — (79 ) 1,352 250 1,523 Repurchase of common stock (24.427 ) — (77 ) — (1,781 ) — (1,858 ) Distributions — — — — — (205 ) (205 ) Share-based benefit plans 5.750 — 74 — — — 74 Other — — 3 — — 11 14 Balances at June 30, 2016 380.062 $ 4 $ — $ (344 ) $ (7,767 ) $ 1,609 $ (6,498 ) |
Components of Accumulated Other Comprehensive Loss | The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Foreign Defined Change Total Balances at December 31, 2015 $ 13 $ (74 ) $ (135 ) $ (69 ) $ (265 ) Unrealized gains on available-for-sale securities, net of $2 of income taxes 3 — — — 3 Foreign currency translation adjustments, net of $50 income tax benefit — (79 ) — — (79 ) Change in fair value of derivative instruments, net of $26 income tax benefit — — — (44 ) (44 ) Expense reclassified into operations from other comprehensive income, net of $3 and $21, respectively, income tax benefits — — 6 35 41 Balances at June 30, 2016 $ 16 $ (153 ) $ (129 ) $ (78 ) $ (344 ) |
Segment and Geographic Inform27
Segment and Geographic Information (Tables) | 6 Months Ended |
Jun. 30, 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 and six months ended June 30, 2016 and 2015 are summarized in the following table (dollars in millions): Quarter Six Months 2016 2015 2016 2015 Revenues: National Group $ 4,931 $ 4,698 $ 9,898 $ 9,348 American Group 4,855 4,699 9,635 9,200 Corporate and other 533 500 1,046 1,025 $ 10,319 $ 9,897 $ 20,579 $ 19,573 Equity in earnings of affiliates: National Group $ (2 ) $ (4 ) $ (4 ) $ (7 ) American Group (8 ) (8 ) (17 ) (16 ) Corporate and other — 2 (1 ) (6 ) $ (10 ) $ (10 ) $ (22 ) $ (29 ) Adjusted segment EBITDA: National Group $ 1,131 $ 1,088 $ 2,269 $ 2,169 American Group 1,004 1,044 1,987 1,993 Corporate and other (83 ) (124 ) (201 ) (193 ) $ 2,052 $ 2,008 $ 4,055 $ 3,969 Depreciation and amortization: National Group $ 201 $ 188 $ 398 $ 377 American Group 225 222 443 443 Corporate and other 63 59 127 122 $ 489 $ 469 $ 968 $ 942 Adjusted segment EBITDA $ 2,052 $ 2,008 $ 4,055 $ 3,969 Depreciation and amortization 489 469 968 942 Interest expense 427 425 843 844 Losses (gains) on sales of facilities (6 ) 5 (5 ) (4 ) Losses on retirement of debt — 125 — 125 Legal claim costs 10 — 22 — Income before income taxes $ 1,132 $ 984 $ 2,227 $ 2,062 |
Supplemental Condensed Consol28
Supplemental Condensed Consolidating Financial Information (Tables) | 6 Months Ended |
Jun. 30, 2016 | |
Text Block [Abstract] | |
Schedule of Condensed Consolidating Comprehensive Income Statement | HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED JUNE 30, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,693 $ 5,388 $ — $ 11,081 Provision for doubtful accounts — — 498 264 — 762 Revenues — — 5,195 5,124 — 10,319 Salaries and benefits — — 2,347 2,344 — 4,691 Supplies — — 886 832 — 1,718 Other operating expenses 2 — 895 976 — 1,873 Electronic health record incentive income — — (2 ) (3 ) — (5 ) Equity in earnings of affiliates (563 ) — (1 ) (9 ) 563 (10 ) Depreciation and amortization — — 238 251 — 489 Interest expense 16 670 (204 ) (55 ) — 427 Gains on sales of facilities — — (2 ) (4 ) — (6 ) Legal claim costs — 10 — — — 10 Management fees — — (235 ) 235 — — (545 ) 680 3,922 4,567 563 9,187 Income (loss) before income taxes 545 (680 ) 1,273 557 (563 ) 1,132 Provision (benefit) for income taxes (113 ) (303 ) 555 202 — 341 Net income (loss) 658 (377 ) 718 355 (563 ) 791 Net income attributable to noncontrolling interests — — 21 112 — 133 Net income (loss) attributable to HCA Holdings, Inc. $ 658 $ (377 ) $ 697 $ 243 $ (563 ) $ 658 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 608 $ (379 ) $ 701 $ 191 $ (513 ) $ 608 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED JUNE 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 5,597 $ 5,335 $ — $ 10,932 Provision for doubtful accounts — — 550 485 — 1,035 Revenues — — 5,047 4,850 — 9,897 Salaries and benefits — — 2,250 2,242 — 4,492 Supplies — — 869 801 — 1,670 Other operating expenses (4 ) — 838 921 — 1,755 Electronic health record incentive income — — (12 ) (6 ) — (18 ) Equity in earnings of affiliates (603 ) — (2 ) (8 ) 603 (10 ) Depreciation and amortization — — 223 246 — 469 Interest expense 38 604 (168 ) (49 ) — 425 Losses on sales of facilities — — 5 — — 5 Losses on retirement of debt 122 3 — — — 125 Management fees — — (178 ) 178 — — (447 ) 607 3,825 4,325 603 8,913 Income (loss) before income taxes 447 (607 ) 1,222 525 (603 ) 984 Provision (benefit) for income taxes (60 ) (234 ) 462 151 — 319 Net income (loss) 507 (373 ) 760 374 (603 ) 665 Net income attributable to noncontrolling interests — — 24 134 — 158 Net income (loss) attributable to HCA Holdings, Inc. $ 507 $ (373 ) $ 736 $ 240 $ (603 ) $ 507 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 561 $ (358 ) $ 740 $ 275 $ (657 ) $ 561 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE SIX MONTHS ENDED JUNE 30, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 11,366 $ 10,765 $ — $ 22,131 Provision for doubtful accounts — — 992 560 — 1,552 Revenues — — 10,374 10,205 — 20,579 Salaries and benefits — — 4,701 4,692 — 9,393 Supplies — — 1,784 1,648 — 3,432 Other operating expenses 4 — 1,755 1,971 — 3,730 Electronic health record incentive income — — (5 ) (4 ) — (9 ) Equity in earnings of affiliates (1,270 ) — (3 ) (19 ) 1,270 (22 ) Depreciation and amortization — — 465 503 — 968 Interest expense 32 1,320 (411 ) (98 ) — 843 Gains on sales of facilities — — — (5 ) — (5 ) Legal claim costs — 22 — — — 22 Management fees — — (395 ) 395 — — (1,234 ) 1,342 7,891 9,083 1,270 18,352 Income (loss) before income taxes 1,234 (1,342 ) 2,483 1,122 (1,270 ) 2,227 Provision (benefit) for income taxes (118 ) (495 ) 900 338 — 625 Net income (loss) 1,352 (847 ) 1,583 784 (1,270 ) 1,602 Net income attributable to noncontrolling interests — — 43 207 — 250 Net income (loss) attributable to HCA Holdings, Inc. $ 1,352 $ (847 ) $ 1,540 $ 577 $ (1,270 ) $ 1,352 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,273 $ (856 ) $ 1,546 $ 501 $ (1,191 ) $ 1,273 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE SIX MONTHS ENDED JUNE 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues before provision for doubtful accounts $ — $ — $ 10,798 $ 10,456 $ — $ 21,254 Provision for doubtful accounts — — 846 835 — 1,681 Revenues — — 9,952 9,621 — 19,573 Salaries and benefits — — 4,467 4,423 — 8,890 Supplies — — 1,723 1,585 — 3,308 Other operating expenses 2 — 1,658 1,812 — 3,472 Electronic health record incentive — — (25 ) (12 ) — (37 ) Equity in earnings of affiliates (1,226 ) — (3 ) (26 ) 1,226 (29 ) Depreciation and amortization — — 453 489 — 942 Interest expense 84 1,199 (342 ) (97 ) — 844 Gains on sales of facilities — — (4 ) — — (4 ) Losses on retirement of debt 122 3 — — — 125 Management fees — — (356 ) 356 — — (1,018 ) 1,202 7,571 8,530 1,226 17,511 Income (loss) before income taxes 1,018 (1,202 ) 2,381 1,091 (1,226 ) 2,062 Provision (benefit) for income taxes (80 ) (458 ) 890 325 — 677 Net income (loss) 1,098 (744 ) 1,491 766 (1,226 ) 1,385 Net income attributable to noncontrolling interests — — 47 240 — 287 Net income (loss) attributable to HCA Holdings, Inc. $ 1,098 $ (744 ) $ 1,444 $ 526 $ (1,226 ) $ 1,098 Comprehensive income (loss) attributable to HCA Holdings, Inc. $ 1,131 $ (724 ) $ 1,452 $ 531 $ (1,259 ) $ 1,131 |
Schedule of Condensed Consolidating Balance Sheet | HCA HOLDINGS, INC. CONDENSED CONSOLIDATING BALANCE SHEET JUNE 30, 2016 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 82 $ 609 $ — $ 691 Accounts receivable, net — — 2,917 2,752 — 5,669 Inventories — — 885 596 — 1,481 Other — — 530 724 — 1,254 — — 4,414 4,681 — 9,095 Property and equipment, net — — 8,491 7,133 — 15,624 Investments of insurance subsidiaries — — — 341 — 341 Investments in and advances to affiliates 25,571 — 16 185 (25,571 ) 201 Goodwill and other intangible assets — — 1,705 4,989 — 6,694 Other 1,041 — 16 193 — 1,250 $ 26,612 $ — $ 14,642 $ 17,522 $ (25,571 ) $ 33,205 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,210 $ 724 $ — $ 1,934 Accrued salaries — — 775 630 — 1,405 Other accrued expenses 46 406 486 895 — 1,833 Long-term debt due within one year — 109 60 55 — 224 46 515 2,531 2,304 — 5,396 Long-term debt, net 992 29,742 201 293 — 31,228 Intercompany balances 33,138 (11,391 ) (24,731 ) 2,984 — — Professional liability risks — — — 1,126 — 1,126 Income taxes and other liabilities 543 582 425 403 — 1,953 34,719 19,448 (21,574 ) 7,110 — 39,703 Stockholders’ (deficit) equity attributable to HCA Holdings, Inc. (8,107 ) (19,448 ) 36,074 8,945 (25,571 ) (8,107 ) Noncontrolling interests — — 142 1,467 — 1,609 (8,107 ) (19,448 ) 36,216 10,412 (25,571 ) (6,498 ) $ 26,612 $ — $ 14,642 $ 17,522 $ (25,571 ) $ 33,205 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 SIX MONTHS ENDED JUNE 30, 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) $ 1,352 $ (847 ) $ 1,583 $ 784 $ (1,270 ) $ 1,602 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (23 ) 66 (1,140 ) (545 ) — (1,642 ) Provision for doubtful accounts — — 992 560 — 1,552 Depreciation and amortization — — 465 503 — 968 Income taxes 67 — — — — 67 Gains on sales of facilities — — — (5 ) — (5 ) Legal claim costs — 22 — — — 22 Amortization of debt issuance costs — 18 — — — 18 Share-based compensation — — 129 — — 129 Equity in earnings of affiliates (1,270 ) — — — 1,270 — Other 37 — (2 ) 2 — 37 Net cash provided by (used in) operating activities 163 (741 ) 2,027 1,299 — 2,748 Cash flows from investing activities: Purchase of property and equipment — — (482 ) (690 ) — (1,172 ) Acquisition of hospitals and health care entities — — (148 ) (282 ) — (430 ) Disposition of hospitals and health care entities — — 9 5 — 14 Change in investments — — 3 15 — 18 Other — — (1 ) 16 — 15 Net cash used in investing activities — — (619 ) (936 ) — (1,555 ) Cash flows from financing activities: Issuance of long-term debt — 3,000 — — — 3,000 Repayment of long-term debt — (2,005 ) (38 ) (22 ) — (2,065 ) Distributions to noncontrolling interests — — (29 ) (176 ) — (205 ) Payment of debt issuance costs — (24 ) — — — (24 ) Repurchases of common stock (1,858 ) — — — — (1,858 ) Changes in intercompany balances with affiliates, net 1,799 (230) (1,414 ) (155 ) — — Other (104 ) — — 13 — (91 ) Net cash (used in) provided by financing activities (163 ) 741 (1,481 ) (340 ) — (1,243 ) Change in cash and cash equivalents — — (73 ) 23 — (50 ) Cash and cash equivalents at beginning of period — — 155 586 — 741 Cash and cash equivalents at end of period $ — $ — $ 82 $ 609 $ — $ 691 HCA HOLDINGS, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE SIX MONTHS ENDED JUNE 30, 2015 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,098 $ (744 ) $ 1,491 $ 766 $ (1,226 ) $ 1,385 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities 21 22 (1,360 ) (779 ) — (2,096 ) Provision for doubtful accounts — — 846 835 — 1,681 Depreciation and amortization — — 453 489 — 942 Income taxes (101 ) — — — — (101 ) Gains on sales of facilities — — (4 ) — — (4 ) Losses on retirement of debt 122 3 — — — 125 Amortization of debt issuance costs 2 17 — — — 19 Share-based compensation 103 — — — — 103 Equity in earnings of affiliates (1,226 ) — — — 1,226 — Other 34 — (2 ) (11 ) — 21 Net cash provided by (used in) operating activities 53 (702 ) 1,424 1,300 — 2,075 Cash flows from investing activities: Purchase of property and equipment — — (470 ) (534 ) — (1,004 ) Acquisition of hospitals and health care entities — — (16 ) (79 ) — (95 ) Disposition of hospitals and health care entities — — 14 8 — 22 Change in investments — — 6 61 — 67 Other — — (6 ) 7 — 1 Net cash used in investing activities — — (472 ) (537 ) — (1,009 ) Cash flows from financing activities: Issuance of long-term debt — 4,048 — — — 4,048 Net change in revolving credit facilities — (300 ) — — — (300 ) Repayment of long-term debt (1,632 ) (1,971 ) (24 ) (17 ) — (3,644 ) Distributions to noncontrolling interests — — (46 ) (191 ) — (237 ) Payment of debt issuance costs — (33 ) — — — (33 ) Repurchases of common stock (940 ) — — — — (940 ) Changes in intercompany balances with affiliates, net 2,354 (1,042) (839 ) (473 ) — — Other 165 — — (18 ) — 147 Net cash (used in) provided by financing activities (53 ) 702 (909 ) (699 ) — (959 ) Change in cash and cash equivalents — — 43 64 — 107 Cash and cash equivalents at beginning of period — — 87 479 — 566 Cash and cash equivalents at end of period $ — $ — $ 130 $ 543 $ — $ 673 |
Basis of Presentation and Sig29
Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2016USD ($)HospitalStateSurgery_Center | Jun. 30, 2015USD ($) | Jun. 30, 2016USD ($)HospitalStateSurgery_Center | Jun. 30, 2015USD ($) | |
Accounting Policies [Abstract] | ||||
Number of owned and operated hospitals | Hospital | 169 | 169 | ||
Number of freestanding surgery centers | Surgery_Center | 116 | 116 | ||
Number of facilities locations | State | 20 | 20 | ||
General and administrative expense | $ | $ 93 | $ 84 | $ 178 | $ 158 |
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 | 6 Months Ended | ||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | |
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 10,402 | $ 9,927 | $ 20,815 | $ 19,751 |
Uninsured | 225 | 558 | 414 | 626 |
Other | 454 | 447 | 902 | 877 |
Revenues before provision for doubtful accounts | 11,081 | 10,932 | 22,131 | 21,254 |
Provision for doubtful accounts | (762) | (1,035) | (1,552) | (1,681) |
Revenues | $ 10,319 | $ 9,897 | $ 20,579 | $ 19,573 |
Revenues from third party payers, Ratio | 100.70% | 100.30% | 101.20% | 100.90% |
Uninsured, Ratio | 2.20% | 5.60% | 2.00% | 3.20% |
Other, Ratio | 4.40% | 4.50% | 4.40% | 4.50% |
Revenues before provision for doubtful accounts, Ratio | 107.30% | 110.40% | 107.60% | 108.60% |
Provision for doubtful accounts, Ratio | (7.30%) | (10.40%) | (7.60%) | (8.60%) |
Revenues ratio from third party payers | 100.00% | 100.00% | 100.00% | 100.00% |
Medicare [Member] | ||||
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 2,217 | $ 2,144 | $ 4,483 | $ 4,378 |
Revenues from third party payers, Ratio | 21.50% | 21.70% | 21.80% | 22.40% |
Managed Medicare [Member] | ||||
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 1,078 | $ 1,016 | $ 2,182 | $ 2,068 |
Revenues from third party payers, Ratio | 10.40% | 10.30% | 10.60% | 10.60% |
Medicaid [Member] | ||||
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 416 | $ 408 | $ 843 | $ 860 |
Revenues from third party payers, Ratio | 4.00% | 4.10% | 4.10% | 4.40% |
Managed Medicaid [Member] | ||||
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 608 | $ 571 | $ 1,205 | $ 1,120 |
Revenues from third party payers, Ratio | 5.90% | 5.80% | 5.90% | 5.70% |
Managed Care and Other Insurers [Member] | ||||
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 5,759 | $ 5,461 | $ 11,461 | $ 10,677 |
Revenues from third party payers, Ratio | 55.80% | 55.10% | 55.70% | 54.50% |
International (Managed Care and Other Insurers) [Member] | ||||
Revenues From Third Party Payers [Line Items] | ||||
Revenues from third party payers | $ 324 | $ 327 | $ 641 | $ 648 |
Revenues from third party payers, Ratio | 3.10% | 3.30% | 3.10% | 3.30% |
Acquisitions and Dispositions -
Acquisitions and Dispositions - Additional Information (Detail) $ in Millions | 6 Months Ended | |
Jun. 30, 2016USD ($)Hospital | Jun. 30, 2015USD ($)Hospital | |
Business Acquisition [Line Items] | ||
Number of hospitals acquired | Hospital | 3 | 1 |
Proceeds from sale of business | $ 14 | $ 22 |
Hospitals [Member] | ||
Business Acquisition [Line Items] | ||
Cash paid for acquisition | 343 | 15 |
Nonhospital Health Care [Member] | ||
Business Acquisition [Line Items] | ||
Cash paid for acquisition | 87 | 80 |
Real Estate and Other Investments [Member] | ||
Business Acquisition [Line Items] | ||
Pretax gain (loss) on sales of business | 5 | 4 |
Proceeds from sale of business | $ 14 | $ 22 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | Dec. 31, 2015 | |
Income Tax Contingency [Line Items] | |||||
Liability for unrecognized tax benefits | $ 542 | $ 542 | $ 554 | ||
Unrecognized tax benefits, accrued interest | 71 | 71 | 73 | ||
Unrecognized tax benefits that would impact effective tax rate | 223 | 223 | $ 233 | ||
Provision (benefit) for income taxes | 341 | $ 319 | 625 | $ 677 | |
Excess tax benefits | $ 115 | $ 185 | |||
Accounting Standards Update 2016-09 [Member] | |||||
Income Tax Contingency [Line Items] | |||||
Provision (benefit) for income taxes | $ (44) | $ (118) |
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 | 6 Months Ended | ||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | |
Earnings Per Share [Abstract] | ||||
Net income attributable to HCA Holdings, Inc. | $ 658 | $ 507 | $ 1,352 | $ 1,098 |
Weighted average common shares outstanding | 386,406 | 416,407 | 391,401 | 418,267 |
Effect of dilutive incremental shares | 12,253 | 12,962 | 13,216 | 14,062 |
Shares used for diluted earnings per share | 398,659 | 429,369 | 404,617 | 432,329 |
Basic earnings per share | $ 1.70 | $ 1.22 | $ 3.45 | $ 2.63 |
Diluted earnings per share | $ 1.65 | $ 1.18 | $ 3.34 | $ 2.54 |
Investments of Insurance Subs34
Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions | Jun. 30, 2016 | Dec. 31, 2015 |
Schedule of Trading Securities and Other Trading Assets [Line Items] | ||
Amortized Cost | $ 442 | $ 462 |
Unrealized Amounts, Gains | 25 | 21 |
Unrealized Amounts, Losses | (1) | |
Fair Value | 467 | 482 |
Amounts classified as current assets | (126) | (50) |
Investment carrying value | 341 | 432 |
Debt Securities [Member] | ||
Schedule of Trading Securities and Other Trading Assets [Line Items] | ||
Amortized Cost | 441 | 462 |
Unrealized Amounts, Gains | 22 | 17 |
Unrealized Amounts, Losses | (1) | |
Fair Value | 463 | 478 |
Debt Securities [Member] | States and Municipalities [Member] | ||
Schedule of Trading Securities and Other Trading Assets [Line Items] | ||
Amortized Cost | 392 | 428 |
Unrealized Amounts, Gains | 22 | 17 |
Unrealized Amounts, Losses | (1) | |
Fair Value | 414 | 444 |
Debt Securities [Member] | Money Market Funds [Member] | ||
Schedule of Trading Securities and Other Trading Assets [Line Items] | ||
Amortized Cost | 49 | 34 |
Fair Value | 49 | 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 |
Investments of Insurance Subs35
Investments of Insurance Subsidiaries - Additional Information (Detail) $ in Millions | 6 Months Ended |
Jun. 30, 2016USD ($) | |
Schedule of Trading Securities and Other Trading Assets [Line Items] | |
Ownership percentage held by parent | 100.00% |
Available for sale securities expected maturity of debt securities | 3 years 8 months 12 days |
Available for sale securities average scheduled maturity | 5 years 2 months 12 days |
Receivable from Insurance Subsidiary [Member] | |
Schedule of Trading Securities and Other Trading Assets [Line Items] | |
Amounts classified as current assets | $ 75 |
Investments of Insurance Subs36
Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions | Jun. 30, 2016USD ($) |
Amortized Cost and Fair Value Debt Securities [Abstract] | |
Due in one year or less, Amortized Cost | $ 88 |
Due after one year through five years, Amortized Cost | 160 |
Due after five years through ten years, Amortized Cost | 124 |
Due after ten years, Amortized Cost | 69 |
Amortized Cost, Total | 441 |
Due in one year or less, Fair Value | 88 |
Due after one year through five years, Fair Value | 165 |
Due after five years through ten years, Fair Value | 136 |
Due after ten years, Fair Value | 74 |
Fair Value, Total | $ 463 |
Financial Instruments - Schedul
Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member] | 6 Months Ended |
Jun. 30, 2016USD ($) | |
Maturity Date, 2016 [Member] | |
Derivative Instruments, Gain (Loss) [Line Items] | |
Notional Amount | $ 3,000,000,000 |
Fair Value | $ (46,000,000) |
Maturity Date | Dec. 31, 2016 |
Maturity Date, 2017 [Member] | |
Derivative Instruments, Gain (Loss) [Line Items] | |
Notional Amount | $ 1,000,000,000 |
Fair Value | $ (26,000,000) |
Maturity Date | Dec. 31, 2017 |
Maturity Date, 2021 [Member] | |
Derivative Instruments, Gain (Loss) [Line Items] | |
Notional Amount | $ 2,000,000,000 |
Fair Value | $ (52,000,000) |
Maturity Date | Dec. 31, 2021 |
Financial Instruments - Additio
Financial Instruments - Additional Information (Detail) $ in Millions | 6 Months Ended |
Jun. 30, 2016USD ($) | |
Offsetting [Abstract] | |
Estimated amount reclassified from other comprehensive income to interest expense | $ 73 |
Estimated termination value if there is breach of provision related to derivative agreement | $ 126 |
Financial Instruments - Effect
Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | |
Derivative Instruments, Gain (Loss) [Line Items] | ||||
Interest expense | $ 427 | $ 425 | $ 843 | $ 844 |
Interest Rate Swaps [Member] | ||||
Derivative Instruments, Gain (Loss) [Line Items] | ||||
Amount of Loss Recognized in OCI on Derivatives, Net of Tax | 44 | |||
Reclassification out of Accumulated Other Comprehensive Income [Member] | Interest Rate Swaps [Member] | ||||
Derivative Instruments, Gain (Loss) [Line Items] | ||||
Interest expense | $ 56 |
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 | Jun. 30, 2016 | Dec. 31, 2015 |
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items] | ||
Assets, Fair Value | $ 467 | $ 482 |
Less amounts classified as current assets | (126) | (50) |
Investments of insurance subsidiaries, noncurrent | 341 | 432 |
Interest Rate Swaps [Member] | ||
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items] | ||
Liabilities, Fair Value | 124 | 110 |
Debt Securities [Member] | ||
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items] | ||
Assets, Fair Value | 463 | 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 | 414 | 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 | 49 | 34 |
Equity Securities [Member] | ||
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items] | ||
Assets, Fair Value | 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 | 53 | 38 |
Less amounts classified as current assets | (49) | (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 | 49 | 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 | 49 | 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 | 409 | 438 |
Less amounts classified as current assets | (77) | (16) |
Investments of insurance subsidiaries, noncurrent | 332 | 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 | 124 | 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 | 409 | 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 | 409 | 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 | Jun. 30, 2016 | Dec. 31, 2015 |
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items] | ||
Estimated fair value of long-term debt | $ 33,018 | $ 31,411 |
Carrying amounts of long-term debt | 31,625 | 30,655 |
Investments of insurance subsidiaries | 467 | 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 | Jun. 30, 2016 | Dec. 31, 2015 |
Debt Instrument [Line Items] | ||
First lien debt | $ 21,373 | $ 20,403 |
Net debt issuance costs | (173) | (167) |
Total debt (average life of 6.6 years, rates averaging 5.5%) | 31,452 | 30,488 |
Less amounts due within one year | 224 | 233 |
Long-term debt | 31,228 | 30,255 |
Senior Secured Asset-Based Revolving Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Long-term line of credit | 3,030 | 3,030 |
Senior Secured Term Loan Facilities [Member] | ||
Debt Instrument [Line Items] | ||
Term loans | 5,134 | 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 | 609 | 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) | 6 Months Ended |
Jun. 30, 2016 | |
Debt Instrument [Line Items] | |
Total debt average term | 6 years 3 months 18 days |
Total debt average rate | 5.50% |
Senior Secured Asset-Based Revolving Credit Facility [Member] | |
Debt Instrument [Line Items] | |
Effective interest rate | 1.90% |
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) - USD ($) | 3 Months Ended | 6 Months Ended | ||||||
Mar. 31, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | Dec. 31, 2015 | Nov. 30, 2015 | May 31, 2015 | Jan. 31, 2015 | |
Debt Instrument [Line Items] | ||||||||
Pretax loss on retirement of debt | $ 125,000,000 | $ 125,000,000 | ||||||
Senior Notes [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Debt instrument maturity date | Mar. 31, 2023 | |||||||
Senior Notes [Member] | 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 Notes [Member] | 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 Notes [Member] | Senior Secured Term Loan Facility Maturing in June 2020 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Debt instrument, principal amount | $ 1,400,000,000 | $ 1,400,000,000 | ||||||
Debt instrument maturity date | Jun. 30, 2020 | |||||||
Pretax loss on retirement of debt | $ 3,000,000 | |||||||
Senior Notes [Member] | Senior Secured Notes Due 2025 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Debt instrument, principal amount | $ 1,600,000,000 | $ 1,000,000,000 | ||||||
Debt instrument, stated interest | 5.375% | 5.375% | ||||||
Senior Notes [Member] | Senior Secured Notes Due 2021 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Debt instrument, stated interest | 7.75% | |||||||
Debt instrument, principal amount | $ 1,525,000,000 | |||||||
Pretax loss on retirement of debt | $ 122,000,000 | |||||||
Senior Notes [Member] | Senior Secured Notes Due 2015 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Debt instrument, stated interest | 6.375% | |||||||
Debt instrument, principal amount | $ 750,000,000 | |||||||
Senior Notes [Member] | 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) - USD ($) $ in Millions | Dec. 09, 2015 | Feb. 09, 2015 | Jan. 24, 2013 | Apr. 25, 2014 | Jun. 30, 2016 | Mar. 31, 2014 | Dec. 31, 2012 | Jun. 30, 2016 | Oct. 31, 2009 |
Loss Contingencies [Line Items] | |||||||||
Capital commitment in connection with purchase of hospitals | $ 450 | ||||||||
Additional shortfall related to capital expenditures | $ 78 | ||||||||
Legal claim costs | $ 434 | $ 10 | $ 78 | $ 175 | $ 22 | ||||
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 | $ 458 | $ 458 | |||||||
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 | 6 Months Ended | ||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | |
Capital Structure [Line Items] | ||||
Beginning Balances | $ (6,046) | |||
Comprehensive income | $ 741 | $ 719 | 1,523 | $ 1,418 |
Repurchase of common stock | (1,858) | |||
Distributions | (205) | |||
Share-based benefit plans | 74 | |||
Other | 14 | |||
Ending Balances | (6,498) | (6,498) | ||
Common Stock [Member] | ||||
Capital Structure [Line Items] | ||||
Beginning Balances | 4 | |||
Ending Balances | $ 4 | $ 4 | ||
Beginning Balances, Shares | 398,739,000 | |||
Repurchase of common stock, shares | (24,427,000) | |||
Share-based benefit plans, Shares | 5,750,000 | |||
Ending Balances, Shares | 380,062,000 | 380,062,000 | ||
Capital in Excess of Par Value [Member] | ||||
Capital Structure [Line Items] | ||||
Repurchase of common stock | $ (77) | |||
Share-based benefit plans | 74 | |||
Other | 3 | |||
Accumulated Other Comprehensive Loss [Member] | ||||
Capital Structure [Line Items] | ||||
Beginning Balances | (265) | |||
Comprehensive income | (79) | |||
Ending Balances | $ (344) | (344) | ||
Retained Deficit [Member] | ||||
Capital Structure [Line Items] | ||||
Beginning Balances | (7,338) | |||
Comprehensive income | 1,352 | |||
Repurchase of common stock | (1,781) | |||
Ending Balances | (7,767) | (7,767) | ||
Equity Attributable to Noncontrolling Interests [Member] | ||||
Capital Structure [Line Items] | ||||
Beginning Balances | 1,553 | |||
Comprehensive income | 250 | |||
Distributions | (205) | |||
Other | 11 | |||
Ending Balances | $ 1,609 | $ 1,609 |
Capital Structure - Additional
Capital Structure - Additional Information (Detail) - Common Stock [Member] - USD ($) | 1 Months Ended | 6 Months Ended | |
May 31, 2016 | Jun. 30, 2016 | Oct. 31, 2015 | |
Capital Structure [Line Items] | |||
Repurchase of common stock, shares | (24,427,000) | ||
Repurchase price of common stock, per share | $ 76.04 | ||
Share repurchase program authorized amount | $ 3,000,000,000 | ||
Share repurchase program, remaining authorized repurchase amount | $ 746,000,000 | ||
Share Repurchase Program Two [Member] | |||
Capital Structure [Line Items] | |||
Repurchase of common stock, shares | (15,066,000) | ||
Repurchase price of common stock, per share | $ 73.51 | ||
Kohlberg Kravis Roberts & Co [Member] | Share Repurchase Program One [Member] | |||
Capital Structure [Line Items] | |||
Repurchase of common stock, shares | (9,361,000) | ||
Repurchase price of common stock, per share | $ 80.12 | ||
Percentage of discount on share repurchase | 1.00% |
Capital Structure - Components
Capital Structure - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions | 6 Months Ended |
Jun. 30, 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 | 3 |
Unrealized gains on available-for-sale securities, ending balances | 16 |
Foreign currency translation adjustments, beginning balances | (74) |
Foreign currency translation adjustments | (79) |
Foreign currency translation adjustments, ending balances | (153) |
Defined benefit plans, beginning balances | (135) |
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income | 6 |
Defined benefit plans, ending balances | (129) |
Change in fair value of derivative instruments, beginning balances | (69) |
Change in fair value of derivative instruments | (44) |
Change in fair value of derivatives instruments, (income) expense reclassified into operations from other comprehensive income | 35 |
Change in fair value of derivative instruments, ending balances | (78) |
Accumulated other comprehensive income, net of tax, beginning balances | (265) |
Unrealized losses on available-for-sale securities, net of income tax benefit | 3 |
Foreign currency translation adjustments | (79) |
Change in fair value of derivative instruments | (44) |
Expense reclassified into operations from other comprehensive income, Total | 41 |
Accumulated other comprehensive income (loss), net of tax, ending balances | $ (344) |
Capital Structure - Component49
Capital Structure - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions | 6 Months Ended |
Jun. 30, 2016USD ($) | |
Equity [Abstract] | |
Foreign currency translation adjustments, income tax benefit | $ 50 |
Defined benefit plans, income tax benefit | 3 |
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, income tax benefit | 21 |
Change in fair value of derivative instruments, income tax benefit | $ 26 |
Segment and Geographic Inform50
Segment and Geographic Information - Additional Information (Detail) | 6 Months Ended |
Jun. 30, 2016Hospital | |
Segment Reporting Information [Line Items] | |
Number of geographically organized groups | 2 |
Number of owned and operated hospitals | 169 |
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 | 79 |
Reorganization Group [Member] | Corporate and Other [Member] | |
Segment Reporting Information [Line Items] | |
Number of owned and operated hospitals | 6 |
Segment and Geographic Inform51
Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions | Dec. 09, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | Mar. 31, 2014 | Dec. 31, 2012 | Jun. 30, 2016 | Jun. 30, 2015 |
Segment Reporting Information [Line Items] | |||||||
Revenues | $ 10,319 | $ 9,897 | $ 20,579 | $ 19,573 | |||
Equity in earnings of affiliates | 10 | 10 | 22 | 29 | |||
Adjusted segment EBITDA | 2,052 | 2,008 | 4,055 | 3,969 | |||
Depreciation and amortization | 489 | 469 | 968 | 942 | |||
Interest expense | 427 | 425 | 843 | 844 | |||
Losses (gains) on sales of facilities | (6) | 5 | (5) | (4) | |||
Losses on retirement of debt | 125 | 125 | |||||
Legal claim costs | $ 434 | 10 | $ 78 | $ 175 | 22 | ||
Income before income taxes | 1,132 | 984 | 2,227 | 2,062 | |||
National Group [Member] | |||||||
Segment Reporting Information [Line Items] | |||||||
Revenues | 4,931 | 4,698 | 9,898 | 9,348 | |||
Equity in earnings of affiliates | (2) | (4) | (4) | (7) | |||
Adjusted segment EBITDA | 1,131 | 1,088 | 2,269 | 2,169 | |||
Depreciation and amortization | 201 | 188 | 398 | 377 | |||
American Group [Member] | |||||||
Segment Reporting Information [Line Items] | |||||||
Revenues | 4,855 | 4,699 | 9,635 | 9,200 | |||
Equity in earnings of affiliates | (8) | (8) | (17) | (16) | |||
Adjusted segment EBITDA | 1,004 | 1,044 | 1,987 | 1,993 | |||
Depreciation and amortization | 225 | 222 | 443 | 443 | |||
Corporate and Other [Member] | |||||||
Segment Reporting Information [Line Items] | |||||||
Revenues | 533 | 500 | 1,046 | 1,025 | |||
Equity in earnings of affiliates | 2 | (1) | (6) | ||||
Adjusted segment EBITDA | (83) | (124) | (201) | (193) | |||
Depreciation and amortization | $ 63 | $ 59 | $ 127 | $ 122 |
Supplemental Condensed Consol52
Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) - USD ($) $ in Millions | Jun. 30, 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 | Jun. 30, 2016 | Jun. 30, 2015 | Mar. 31, 2014 | Dec. 31, 2012 | Jun. 30, 2016 | Jun. 30, 2015 |
Supplemental Condensed Consolidating Financial Information [Line Items] | |||||||
Revenues before provision for doubtful accounts | $ 11,081 | $ 10,932 | $ 22,131 | $ 21,254 | |||
Provision for doubtful accounts | 762 | 1,035 | 1,552 | 1,681 | |||
Revenues | 10,319 | 9,897 | 20,579 | 19,573 | |||
Salaries and benefits | 4,691 | 4,492 | 9,393 | 8,890 | |||
Supplies | 1,718 | 1,670 | 3,432 | 3,308 | |||
Other operating expenses | 1,873 | 1,755 | 3,730 | 3,472 | |||
Electronic health record incentive income | (5) | (18) | (9) | (37) | |||
Equity in earnings of affiliates | (10) | (10) | (22) | (29) | |||
Depreciation and amortization | 489 | 469 | 968 | 942 | |||
Interest expense (revenue) | 427 | 425 | 843 | 844 | |||
Losses (gains) on sales of facilities | (6) | 5 | (5) | (4) | |||
Legal claim costs | $ 434 | 10 | $ 78 | $ 175 | 22 | ||
Losses on retirement of debt | 125 | 125 | |||||
Total expenses including equity in earnings of affiliates | 9,187 | 8,913 | 18,352 | 17,511 | |||
Income (loss) before income taxes | 1,132 | 984 | 2,227 | 2,062 | |||
Provision (benefit) for income taxes | 341 | 319 | 625 | 677 | |||
Net income (loss) | 791 | 665 | 1,602 | 1,385 | |||
Net income attributable to noncontrolling interests | 133 | 158 | 250 | 287 | |||
Net income (loss) attributable to HCA Holdings, Inc. | 658 | 507 | 1,352 | 1,098 | |||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 608 | 561 | 1,273 | 1,131 | |||
HCA Holdings, Inc. Issuer [Member] | |||||||
Supplemental Condensed Consolidating Financial Information [Line Items] | |||||||
Other operating expenses | 2 | (4) | 4 | 2 | |||
Equity in earnings of affiliates | (563) | (603) | (1,270) | (1,226) | |||
Interest expense (revenue) | 16 | 38 | 32 | 84 | |||
Losses on retirement of debt | 122 | 122 | |||||
Total expenses including equity in earnings of affiliates | (545) | (447) | (1,234) | (1,018) | |||
Income (loss) before income taxes | 545 | 447 | 1,234 | 1,018 | |||
Provision (benefit) for income taxes | (113) | (60) | (118) | (80) | |||
Net income (loss) | 658 | 507 | 1,352 | 1,098 | |||
Net income (loss) attributable to HCA Holdings, Inc. | 658 | 507 | 1,352 | 1,098 | |||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 608 | 561 | 1,273 | 1,131 | |||
HCA Inc. Issuer [Member] | |||||||
Supplemental Condensed Consolidating Financial Information [Line Items] | |||||||
Interest expense (revenue) | 670 | 604 | 1,320 | 1,199 | |||
Legal claim costs | 10 | 22 | |||||
Losses on retirement of debt | 3 | 3 | |||||
Total expenses including equity in earnings of affiliates | 680 | 607 | 1,342 | 1,202 | |||
Income (loss) before income taxes | (680) | (607) | (1,342) | (1,202) | |||
Provision (benefit) for income taxes | (303) | (234) | (495) | (458) | |||
Net income (loss) | (377) | (373) | (847) | (744) | |||
Net income (loss) attributable to HCA Holdings, Inc. | (377) | (373) | (847) | (744) | |||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | (379) | (358) | (856) | (724) | |||
Subsidiary Guarantors [Member] | |||||||
Supplemental Condensed Consolidating Financial Information [Line Items] | |||||||
Revenues before provision for doubtful accounts | 5,693 | 5,597 | 11,366 | 10,798 | |||
Provision for doubtful accounts | 498 | 550 | 992 | 846 | |||
Revenues | 5,195 | 5,047 | 10,374 | 9,952 | |||
Salaries and benefits | 2,347 | 2,250 | 4,701 | 4,467 | |||
Supplies | 886 | 869 | 1,784 | 1,723 | |||
Other operating expenses | 895 | 838 | 1,755 | 1,658 | |||
Electronic health record incentive income | (2) | (12) | (5) | (25) | |||
Equity in earnings of affiliates | (1) | (2) | (3) | (3) | |||
Depreciation and amortization | 238 | 223 | 465 | 453 | |||
Interest expense (revenue) | (204) | (168) | (411) | (342) | |||
Losses (gains) on sales of facilities | (2) | 5 | (4) | ||||
Management fees | (235) | (178) | (395) | (356) | |||
Total expenses including equity in earnings of affiliates | 3,922 | 3,825 | 7,891 | 7,571 | |||
Income (loss) before income taxes | 1,273 | 1,222 | 2,483 | 2,381 | |||
Provision (benefit) for income taxes | 555 | 462 | 900 | 890 | |||
Net income (loss) | 718 | 760 | 1,583 | 1,491 | |||
Net income attributable to noncontrolling interests | 21 | 24 | 43 | 47 | |||
Net income (loss) attributable to HCA Holdings, Inc. | 697 | 736 | 1,540 | 1,444 | |||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 701 | 740 | 1,546 | 1,452 | |||
Subsidiary Non-Guarantors [Member] | |||||||
Supplemental Condensed Consolidating Financial Information [Line Items] | |||||||
Revenues before provision for doubtful accounts | 5,388 | 5,335 | 10,765 | 10,456 | |||
Provision for doubtful accounts | 264 | 485 | 560 | 835 | |||
Revenues | 5,124 | 4,850 | 10,205 | 9,621 | |||
Salaries and benefits | 2,344 | 2,242 | 4,692 | 4,423 | |||
Supplies | 832 | 801 | 1,648 | 1,585 | |||
Other operating expenses | 976 | 921 | 1,971 | 1,812 | |||
Electronic health record incentive income | (3) | (6) | (4) | (12) | |||
Equity in earnings of affiliates | (9) | (8) | (19) | (26) | |||
Depreciation and amortization | 251 | 246 | 503 | 489 | |||
Interest expense (revenue) | (55) | (49) | (98) | (97) | |||
Losses (gains) on sales of facilities | (4) | (5) | |||||
Management fees | 235 | 178 | 395 | 356 | |||
Total expenses including equity in earnings of affiliates | 4,567 | 4,325 | 9,083 | 8,530 | |||
Income (loss) before income taxes | 557 | 525 | 1,122 | 1,091 | |||
Provision (benefit) for income taxes | 202 | 151 | 338 | 325 | |||
Net income (loss) | 355 | 374 | 784 | 766 | |||
Net income attributable to noncontrolling interests | 112 | 134 | 207 | 240 | |||
Net income (loss) attributable to HCA Holdings, Inc. | 243 | 240 | 577 | 526 | |||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | 191 | 275 | 501 | 531 | |||
Eliminations [Member] | |||||||
Supplemental Condensed Consolidating Financial Information [Line Items] | |||||||
Equity in earnings of affiliates | 563 | 603 | 1,270 | 1,226 | |||
Total expenses including equity in earnings of affiliates | 563 | 603 | 1,270 | 1,226 | |||
Income (loss) before income taxes | (563) | (603) | (1,270) | (1,226) | |||
Net income (loss) | (563) | (603) | (1,270) | (1,226) | |||
Net income (loss) attributable to HCA Holdings, Inc. | (563) | (603) | (1,270) | (1,226) | |||
Comprehensive income (loss) attributable to HCA Holdings, Inc. | $ (513) | $ (657) | $ (1,191) | $ (1,259) |
Supplemental Condensed Consol54
Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions | Jun. 30, 2016 | Dec. 31, 2015 | Jun. 30, 2015 | Dec. 31, 2014 |
Current assets: | ||||
Cash and cash equivalents | $ 691 | $ 741 | $ 673 | $ 566 |
Accounts receivable, net | 5,669 | 5,889 | ||
Inventories | 1,481 | 1,439 | ||
Other | 1,254 | 1,163 | ||
Total current assets | 9,095 | 9,232 | ||
Property and equipment, net | 15,624 | 15,014 | ||
Investments of insurance subsidiaries | 341 | 432 | ||
Investments in and advances to affiliates | 201 | 178 | ||
Goodwill and other intangible assets | 6,694 | 6,731 | ||
Other | 1,250 | 1,157 | ||
Total assets | 33,205 | 32,744 | ||
Current liabilities: | ||||
Accounts payable | 1,934 | 2,170 | ||
Accrued salaries | 1,405 | 1,233 | ||
Other accrued expenses | 1,833 | 1,880 | ||
Long-term debt due within one year | 224 | 233 | ||
Total current liabilities | 5,396 | 5,516 | ||
Long-term debt, net | 31,228 | 30,255 | ||
Professional liability risks | 1,126 | 1,115 | ||
Income taxes and other liabilities | 1,953 | 1,904 | ||
Total liabilities | 39,703 | 38,790 | ||
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | (8,107) | (7,599) | ||
Noncontrolling interests | 1,609 | 1,553 | ||
Total stockholders' deficit | (6,498) | (6,046) | ||
Total liabilities and stockholders' deficit | 33,205 | 32,744 | ||
HCA Holdings, Inc. Issuer [Member] | ||||
Current assets: | ||||
Other | 223 | |||
Total current assets | 223 | |||
Investments in and advances to affiliates | 25,571 | 24,380 | ||
Other | 1,041 | 943 | ||
Total assets | 26,612 | 25,546 | ||
Current liabilities: | ||||
Accounts payable | 2 | |||
Other accrued expenses | 46 | 172 | ||
Total current liabilities | 46 | 174 | ||
Long-term debt, net | 992 | 984 | ||
Intercompany balances | 33,138 | 31,432 | ||
Income taxes and other liabilities | 543 | 555 | ||
Total liabilities | 34,719 | 33,145 | ||
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | (8,107) | (7,599) | ||
Total stockholders' deficit | (8,107) | (7,599) | ||
Total liabilities and stockholders' deficit | 26,612 | 25,546 | ||
HCA Inc. Issuer [Member] | ||||
Current liabilities: | ||||
Other accrued expenses | 406 | 340 | ||
Long-term debt due within one year | 109 | 114 | ||
Total current liabilities | 515 | 454 | ||
Long-term debt, net | 29,742 | 28,756 | ||
Intercompany balances | (11,391) | (11,171) | ||
Income taxes and other liabilities | 582 | 548 | ||
Total liabilities | 19,448 | 18,587 | ||
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | (19,448) | (18,587) | ||
Total stockholders' deficit | (19,448) | (18,587) | ||
Subsidiary Guarantors [Member] | ||||
Current assets: | ||||
Cash and cash equivalents | 82 | 155 | 130 | 87 |
Accounts receivable, net | 2,917 | 2,982 | ||
Inventories | 885 | 852 | ||
Other | 530 | 403 | ||
Total current assets | 4,414 | 4,392 | ||
Property and equipment, net | 8,491 | 8,328 | ||
Investments in and advances to affiliates | 16 | 14 | ||
Goodwill and other intangible assets | 1,705 | 1,703 | ||
Other | 16 | 19 | ||
Total assets | 14,642 | 14,456 | ||
Current liabilities: | ||||
Accounts payable | 1,210 | 1,375 | ||
Accrued salaries | 775 | 712 | ||
Other accrued expenses | 486 | 458 | ||
Long-term debt due within one year | 60 | 65 | ||
Total current liabilities | 2,531 | 2,610 | ||
Long-term debt, net | 201 | 226 | ||
Intercompany balances | (24,731) | (23,435) | ||
Income taxes and other liabilities | 425 | 417 | ||
Total liabilities | (21,574) | (20,182) | ||
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | 36,074 | 34,510 | ||
Noncontrolling interests | 142 | 128 | ||
Total stockholders' deficit | 36,216 | 34,638 | ||
Total liabilities and stockholders' deficit | 14,642 | 14,456 | ||
Subsidiary Non-Guarantors [Member] | ||||
Current assets: | ||||
Cash and cash equivalents | 609 | 586 | $ 543 | $ 479 |
Accounts receivable, net | 2,752 | 2,907 | ||
Inventories | 596 | 587 | ||
Other | 724 | 537 | ||
Total current assets | 4,681 | 4,617 | ||
Property and equipment, net | 7,133 | 6,686 | ||
Investments of insurance subsidiaries | 341 | 432 | ||
Investments in and advances to affiliates | 185 | 164 | ||
Goodwill and other intangible assets | 4,989 | 5,028 | ||
Other | 193 | 195 | ||
Total assets | 17,522 | 17,122 | ||
Current liabilities: | ||||
Accounts payable | 724 | 793 | ||
Accrued salaries | 630 | 521 | ||
Other accrued expenses | 895 | 910 | ||
Long-term debt due within one year | 55 | 54 | ||
Total current liabilities | 2,304 | 2,278 | ||
Long-term debt, net | 293 | 289 | ||
Intercompany balances | 2,984 | 3,174 | ||
Professional liability risks | 1,126 | 1,115 | ||
Income taxes and other liabilities | 403 | 384 | ||
Total liabilities | 7,110 | 7,240 | ||
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | 8,945 | 8,457 | ||
Noncontrolling interests | 1,467 | 1,425 | ||
Total stockholders' deficit | 10,412 | 9,882 | ||
Total liabilities and stockholders' deficit | 17,522 | 17,122 | ||
Eliminations [Member] | ||||
Current assets: | ||||
Investments in and advances to affiliates | (25,571) | (24,380) | ||
Total assets | (25,571) | (24,380) | ||
Current liabilities: | ||||
Stockholders' (deficit) equity attributable to HCA Holdings, Inc. | (25,571) | (24,380) | ||
Total stockholders' deficit | (25,571) | (24,380) | ||
Total liabilities and stockholders' deficit | $ (25,571) | $ (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 | 6 Months Ended | ||
Jun. 30, 2016 | Jun. 30, 2015 | Jun. 30, 2016 | Jun. 30, 2015 | |
Cash flows from operating activities: | ||||
Net income (loss) | $ 791 | $ 665 | $ 1,602 | $ 1,385 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||
Changes in operating assets and liabilities | (1,642) | (2,096) | ||
Provision for doubtful accounts | 762 | 1,035 | 1,552 | 1,681 |
Depreciation and amortization | 489 | 469 | 968 | 942 |
Income taxes | 67 | (101) | ||
Gains on sales of facilities | (6) | 5 | (5) | (4) |
Losses on retirement of debt | 125 | 125 | ||
Legal claim costs | 22 | |||
Amortization of debt issuance costs | 18 | 19 | ||
Share-based compensation | 129 | 103 | ||
Other | 37 | 21 | ||
Net cash provided by operating activities | 2,748 | 2,075 | ||
Cash flows from investing activities: | ||||
Purchase of property and equipment | (1,172) | (1,004) | ||
Acquisition of hospitals and health care entities | (430) | (95) | ||
Disposition of hospitals and health care entities | 14 | 22 | ||
Change in investments | 18 | 67 | ||
Other | 15 | 1 | ||
Net cash used in investing activities | (1,555) | (1,009) | ||
Cash flows from financing activities: | ||||
Issuance of long-term debt | 3,000 | 4,048 | ||
Net change in revolving credit facilities | (300) | |||
Repayment of long-term debt | (2,065) | (3,644) | ||
Distributions to noncontrolling interests | (205) | (237) | ||
Payment of debt issuance costs | (24) | (33) | ||
Repurchases of common stock | (1,858) | (940) | ||
Other | (91) | 147 | ||
Net cash used in financing activities | (1,243) | (959) | ||
Change in cash and cash equivalents | (50) | 107 | ||
Cash and cash equivalents at beginning of period | 741 | 566 | ||
Cash and cash equivalents at end of period | 691 | 673 | 691 | 673 |
Eliminations [Member] | ||||
Cash flows from operating activities: | ||||
Net income (loss) | (563) | (603) | (1,270) | (1,226) |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||
Equity in earnings of affiliates | 1,270 | 1,226 | ||
HCA Holdings, Inc. Issuer [Member] | ||||
Cash flows from operating activities: | ||||
Net income (loss) | 658 | 507 | 1,352 | 1,098 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||
Changes in operating assets and liabilities | (23) | 21 | ||
Income taxes | 67 | (101) | ||
Losses on retirement of debt | 122 | 122 | ||
Amortization of debt issuance costs | 2 | |||
Share-based compensation | 103 | |||
Equity in earnings of affiliates | (1,270) | (1,226) | ||
Other | 37 | 34 | ||
Net cash provided by operating activities | 163 | 53 | ||
Cash flows from financing activities: | ||||
Repayment of long-term debt | (1,632) | |||
Repurchases of common stock | (1,858) | (940) | ||
Changes in intercompany balances with affiliates, net | 1,799 | 2,354 | ||
Other | (104) | 165 | ||
Net cash used in financing activities | (163) | (53) | ||
HCA Inc. Issuer [Member] | ||||
Cash flows from operating activities: | ||||
Net income (loss) | (377) | (373) | (847) | (744) |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||
Changes in operating assets and liabilities | 66 | 22 | ||
Losses on retirement of debt | 3 | 3 | ||
Legal claim costs | 22 | |||
Amortization of debt issuance costs | 18 | 17 | ||
Net cash provided by operating activities | (741) | (702) | ||
Cash flows from financing activities: | ||||
Issuance of long-term debt | 3,000 | 4,048 | ||
Net change in revolving credit facilities | (300) | |||
Repayment of long-term debt | (2,005) | (1,971) | ||
Payment of debt issuance costs | (24) | (33) | ||
Changes in intercompany balances with affiliates, net | (230) | (1,042) | ||
Net cash used in financing activities | 741 | 702 | ||
Subsidiary Guarantors [Member] | ||||
Cash flows from operating activities: | ||||
Net income (loss) | 718 | 760 | 1,583 | 1,491 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||
Changes in operating assets and liabilities | (1,140) | (1,360) | ||
Provision for doubtful accounts | 498 | 550 | 992 | 846 |
Depreciation and amortization | 238 | 223 | 465 | 453 |
Gains on sales of facilities | (2) | 5 | (4) | |
Share-based compensation | 129 | |||
Other | (2) | (2) | ||
Net cash provided by operating activities | 2,027 | 1,424 | ||
Cash flows from investing activities: | ||||
Purchase of property and equipment | (482) | (470) | ||
Acquisition of hospitals and health care entities | (148) | (16) | ||
Disposition of hospitals and health care entities | 9 | 14 | ||
Change in investments | 3 | 6 | ||
Other | (1) | (6) | ||
Net cash used in investing activities | (619) | (472) | ||
Cash flows from financing activities: | ||||
Repayment of long-term debt | (38) | (24) | ||
Distributions to noncontrolling interests | (29) | (46) | ||
Changes in intercompany balances with affiliates, net | (1,414) | (839) | ||
Net cash used in financing activities | (1,481) | (909) | ||
Change in cash and cash equivalents | (73) | 43 | ||
Cash and cash equivalents at beginning of period | 155 | 87 | ||
Cash and cash equivalents at end of period | 82 | 130 | 82 | 130 |
Subsidiary Non-Guarantors [Member] | ||||
Cash flows from operating activities: | ||||
Net income (loss) | 355 | 374 | 784 | 766 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||
Changes in operating assets and liabilities | (545) | (779) | ||
Provision for doubtful accounts | 264 | 485 | 560 | 835 |
Depreciation and amortization | 251 | 246 | 503 | 489 |
Gains on sales of facilities | (4) | (5) | ||
Other | 2 | (11) | ||
Net cash provided by operating activities | 1,299 | 1,300 | ||
Cash flows from investing activities: | ||||
Purchase of property and equipment | (690) | (534) | ||
Acquisition of hospitals and health care entities | (282) | (79) | ||
Disposition of hospitals and health care entities | 5 | 8 | ||
Change in investments | 15 | 61 | ||
Other | 16 | 7 | ||
Net cash used in investing activities | (936) | (537) | ||
Cash flows from financing activities: | ||||
Repayment of long-term debt | (22) | (17) | ||
Distributions to noncontrolling interests | (176) | (191) | ||
Changes in intercompany balances with affiliates, net | (155) | (473) | ||
Other | 13 | (18) | ||
Net cash used in financing activities | (340) | (699) | ||
Change in cash and cash equivalents | 23 | 64 | ||
Cash and cash equivalents at beginning of period | 586 | 479 | ||
Cash and cash equivalents at end of period | $ 609 | $ 543 | $ 609 | $ 543 |