HCA Healthcare (HCA) 10-Q 6 Nov 18 2018 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Oct. 31, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Trading Symbol	HCA
Entity Registrant Name	HCA Healthcare, Inc.
Entity Central Index Key	860,730
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		344,160,500

Condensed Consolidated Income S

Condensed Consolidated Income Statements - USD ($) shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Income Statement [Abstract]
Revenues	$ 11,451	$ 10,696	$ 34,403	$ 32,052
Salaries and benefits	5,377	5,081	15,940	14,878
Supplies	1,890	1,777	5,722	5,369
Other operating expenses	2,097	2,075	6,325	5,970
Equity in earnings of affiliates	(9)	(13)	(25)	(36)
Depreciation and amortization	582	539	1,697	1,581
Interest expense	442	427	1,309	1,257
Gain on sales of facilities	(6)	(7)	(420)	(10)
Losses on retirement of debt	9	39	9	39
Total expenses including equity in earnings of affiliates	10,382	9,918	30,557	29,048
Income before income taxes	1,069	778	3,846	3,004
Provision for income taxes	173	248	702	902
Net income	896	530	3,144	2,102
Net income attributable to noncontrolling interests	137	104	421	360
Net income attributable to HCA Healthcare, Inc.	$ 759	$ 426	$ 2,723	$ 1,742
Per share data:
Basic earnings	$ 2.20	$ 1.18	$ 7.82	$ 4.77
Diluted earnings	$ 2.15	$ 1.15	$ 7.65	$ 4.64
Shares used in earnings per share calculations (in millions):
Basic	345,823	360,170	348,411	365,398
Diluted	353,639	369,834	356,124	375,013

Condensed Consolidated Comprehe

Condensed Consolidated Comprehensive Income Statements - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Statement of Comprehensive Income [Abstract]
Net income	$ 896	$ 530	$ 3,144	$ 2,102
Other comprehensive income (loss) before taxes:
Foreign currency translation	(13)	32	(35)	87
Unrealized (losses) gains on available-for-sale securities	(2)		(8)	5
Defined benefit plans	0	0	0	0
Pension costs included in salaries and benefits	5	5	15	14
Total defined benefit plans	5	5	15	14
Change in fair value of derivative financial instruments	10	(1)	60	(9)
Interest (benefits) costs included in interest expense	(3)	4	(5)	17
Total change in fair value of derivative financial instruments	7	3	55	8
Other comprehensive (loss) income before taxes	(3)	40	27	114
Income taxes related to other comprehensive income items	2	15	15	44
Other comprehensive (loss) income	(5)	25	12	70
Comprehensive income	891	555	3,156	2,172
Comprehensive income attributable to noncontrolling interests	137	104	421	360
Comprehensive income attributable to HCA Healthcare, Inc.	$ 754	$ 451	$ 2,735	$ 1,812

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 578	$ 732
Accounts receivable	6,532	6,501
Inventories	1,634	1,573
Other	1,266	1,171
Total current assets	10,010	9,977
Property and equipment, at cost	41,978	40,084
Accumulated depreciation	(22,937)	(22,189)
Property and equipment, net	19,041	17,895
Investments of insurance subsidiaries	367	418
Investments in and advances to affiliates	238	199
Goodwill and other intangible assets	7,759	7,394
Other	629	710
Total assets	38,044	36,593
Current liabilities:
Accounts payable	2,414	2,606
Accrued salaries	1,456	1,369
Other accrued expenses	2,170	1,983
Long-term debt due within one year	191	200
Total current liabilities	6,231	6,158
Long-term debt, less net debt issuance costs of $163 and $164	32,916	32,858
Professional liability risks	1,239	1,198
Income taxes and other liabilities	1,388	1,374
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 345,085,800 shares in 2018 and 350,091,600 shares in 2017	3	4
Accumulated other comprehensive loss	(266)	(278)
Retained deficit	(5,342)	(6,532)
Stockholders' deficit attributable to HCA Healthcare, Inc.	(5,605)	(6,806)
Noncontrolling interests	1,875	1,811
Total stockholders' deficit	(3,730)	(4,995)
Total liabilities and stockholders' deficit	$ 38,044	$ 36,593

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Debt issuance cost	$ 163	$ 164
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	345,085,800	350,091,600

Condensed Consolidated Statemen

Condensed Consolidated Statements of Stockholders' Deficit - USD ($) $ in Millions	Total	Common Stock [Member]	Capital in Excess of Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Retained Deficit [Member]	Equity Attributable to Noncontrolling Interests [Member]
Balances at Dec. 31, 2016	$ (5,633)	$ 4		$ (338)	$ (6,968)	$ 1,669
Balance, shares at Dec. 31, 2016		370,536,000
Comprehensive income	795			18	659	118
Repurchase of common stock	(424)		$ (32)		(392)
Repurchase of common stock, shares		(5,121,000)
Share-based benefit plans	35		35
Share-based benefit plans, shares		3,280,000
Distributions	(145)					(145)
Other	15		(3)			18
Balance at Mar. 31, 2017	(5,357)	$ 4		(320)	(6,701)	1,660
Balance, shares at Mar. 31, 2017		368,695,000
Balances at Dec. 31, 2016	(5,633)	$ 4		(338)	(6,968)	1,669
Balance, shares at Dec. 31, 2016		370,536,000
Comprehensive income	2,172
Balance at Sep. 30, 2017	(5,066)	$ 4		(268)	(6,516)	1,714
Balance, shares at Sep. 30, 2017		356,980,000
Balances at Mar. 31, 2017	(5,357)	$ 4		(320)	(6,701)	1,660
Balance, shares at Mar. 31, 2017		368,695,000
Comprehensive income	822			27	657	138
Repurchase of common stock	(542)		(83)		(459)
Repurchase of common stock, shares		(6,404,000)
Share-based benefit plans	82		82
Share-based benefit plans, shares		604,000
Distributions	(103)					(103)
Other	(19)		(1)			(18)
Balance at Jun. 30, 2017	(5,079)	$ 4		(293)	(6,503)	1,713
Balance, shares at Jun. 30, 2017		362,895,000
Comprehensive income	555			25	426	104
Repurchase of common stock	(509)		(70)		(439)
Repurchase of common stock, shares		(6,322,000)
Share-based benefit plans	71		71
Share-based benefit plans, shares		407,000
Distributions	(115)					(115)
Other	(11)		1			(12)
Balance at Sep. 30, 2017	(5,066)	$ 4		(268)	(6,516)	1,714
Balance, shares at Sep. 30, 2017		356,980,000
Comprehensive income	631			(10)	474	167
Repurchase of common stock	(576)		(86)		(490)
Repurchase of common stock, shares		(7,245,000)
Share-based benefit plans	93		93
Share-based benefit plans, shares		357,000
Distributions	(85)					(85)
Other	(8)		7			(15)
Balance at Dec. 31, 2017	(4,995)	$ 4		(278)	(6,532)	1,811
Balance, shares at Dec. 31, 2017		350,092,000
Comprehensive income	1,363			81	1,144	138
Repurchase of common stock	(423)				(423)
Repurchase of common stock, shares		(4,370,000)
Share-based benefit plans	(114)				(114)
Share-based benefit plans, shares		5,265,000
Cash dividends declared ($0.35 per share)	(126)				(126)
Distributions	(92)					(92)
Other	47					47
Balance at Mar. 31, 2018	(4,434)	$ 4		(197)	(6,051)	1,810
Balance, shares at Mar. 31, 2018		350,987,000
Balances at Dec. 31, 2017	(4,995)	$ 4		(278)	(6,532)	1,811
Balance, shares at Dec. 31, 2017		350,092,000
Comprehensive income	$ 3,156
Repurchase of common stock, shares	(11,558,000)
Balance at Sep. 30, 2018	$ (3,730)	$ 3		(266)	(5,342)	1,875
Balance, shares at Sep. 30, 2018		345,086,000
Balances at Mar. 31, 2018	(4,434)	$ 4		(197)	(6,051)	1,810
Balance, shares at Mar. 31, 2018		350,987,000
Comprehensive income	902			(64)	820	146
Repurchase of common stock	(470)	$ (1)	(93)		(376)
Repurchase of common stock, shares		(4,670,000)
Share-based benefit plans	96		96
Share-based benefit plans, shares		443,000
Cash dividends declared ($0.35 per share)	(124)				(124)
Distributions	(93)					(93)
Other	2		3			(1)
Balance at Jun. 30, 2018	(4,125)	$ 3		(261)	(5,731)	1,864
Balance, shares at Jun. 30, 2018		346,760,000
Comprehensive income	891			(5)	759	137
Repurchase of common stock	(302)		(55)		(247)
Repurchase of common stock, shares		(2,518,000)
Share-based benefit plans	54		54
Share-based benefit plans, shares		844,000
Cash dividends declared ($0.35 per share)	(123)				(123)
Distributions	(130)					(130)
Other	(5)		$ (1)			(4)
Balance at Sep. 30, 2018	$ (3,730)	$ 3		$ (266)	$ (5,342)	$ 1,875
Balance, shares at Sep. 30, 2018		345,086,000

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Deficit (Parenthetical) - $ / shares	3 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018
Statement of Stockholders' Equity [Abstract]
Cash dividends declared, per share	$ 0.35	$ 0.35	$ 0.35

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net income	$ 3,144	$ 2,102
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(161)	(70)
Inventories and other assets	(136)	(50)
Accounts payable and accrued expenses	150	(169)
Depreciation and amortization	1,697	1,581
Income taxes		(9)
Gain on sales of facilities	(420)	(10)
Losses on retirement of debt	9	39
Amortization of debt issuance costs	23	23
Share-based compensation	204	195
Other	76	60
Net cash provided by (used in) operating activities	4,586	3,692
Cash flows from investing activities:
Purchase of property and equipment	(2,420)	(2,033)
Acquisition of hospitals and health care entities	(1,056)	(1,142)
Disposal of hospitals and health care entities	802	24
Change in investments	65	(15)
Other	(6)	(6)
Net cash used in investing activities	(2,615)	(3,172)
Cash flows from financing activities:
Issuances of long-term debt	2,000	1,502
Net change in revolving bank credit facilities	(330)	650
Repayment of long-term debt	(1,652)	(700)
Distributions to noncontrolling interests	(315)	(363)
Payment of debt issuance costs	(24)	(25)
Payment of cash dividends	(366)
Repurchases of common stock	(1,195)	(1,475)
Other	(232)	(37)
Net cash (used in) provided by financing activities	(2,114)	(448)
Effect of exchange rate changes on cash and cash equivalents	(11)
Change in cash and cash equivalents	(154)	72
Cash and cash equivalents at beginning of period	732	646
Cash and cash equivalents at end of period	578	718
Interest payments	1,422	1,383
Income tax payments, net	$ 702	$ 911

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES Reporting Entity HCA Healthcare, 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 Healthcare, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At September 30, 2018, these affiliates owned and operated 179 hospitals, 122 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Healthcare, 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 Healthcare, 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 Regulation S-X. 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 $90 million and $83 million for the quarters ended September 30, 2018 and 2017, respectively, and $254 million and $247 million for the nine months ended September 30, 2018 and 2017, respectively. Operating results for the quarter and nine months ended September 30, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K Revenues In May 2014, the Financial Accounting Standards Board (“FASB”) issued a new standard related to revenue recognition. We adopted the new standard effective January 1, 2018, using the full retrospective method. The adoption of the new standard did not have an impact on our recognition of net revenues for any periods prior to adoption. The most significant impact of adopting the new standard is to the presentation of our consolidated income statements, where we no longer present the “Provision for doubtful accounts” as a separate line item and our “Revenues” are presented net of estimated implicit price concession revenue deductions. We also have eliminated the related presentation of “allowances for doubtful accounts” on our consolidated balance sheets as a result of the adoption of the new standard. Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay Quarter 2018 Ratio 2017 Ratio Medicare $ 2,404 21.0 % $ 2,298 21.5 % Managed Medicare 1,344 11.7 1,122 10.5 Medicaid 338 3.0 286 2.7 Managed Medicaid 622 5.4 537 5.0 Managed care and insurers 6,026 52.6 5,605 52.4 International (managed care and insurers) 273 2.4 276 2.6 Other 444 3.9 572 5.3 Revenues $ 11,451 100.0 % $ 10,696 100.0 % Nine Months 2018 Ratio 2017 Ratio Medicare $ 7,353 21.4 % $ 6,931 21.6 % Managed Medicare 4,088 11.9 3,463 10.8 Medicaid 976 2.8 956 3.0 Managed Medicaid 1,769 5.1 1,653 5.2 Managed care and insurers 18,081 52.6 16,957 52.9 International (managed care and insurers) 873 2.5 814 2.5 Other 1,263 3.7 1,278 4.0 Revenues $ 34,403 100.0 % $ 32,052 100.0 % Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Prior to November 2017, patients treated at hospitals for non-elective The collection of outstanding receivables for Medicare, Medicaid, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients. Estimated implicit price concessions are recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management’s assessment of historical writeoffs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical writeoffs and collections at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. We believe our quarterly updates to the estimated implicit price concession amounts at each of our hospital facilities provide reasonable estimates of our revenues and valuations of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material adjustments to the valuations of our accounts receivable or period-to-period To quantify the total impact of the trends related to uninsured accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters and nine months ended September 30, 2018 and 2017 follows (dollars in millions): Quarter Nine Months 2018 2017 2018 2017 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 9,946 $ 9,472 $ 29,684 $ 27,798 Cost-to-charges 12.7 % 13.4 % 12.6 % 13.1 % Total uncompensated care $ 6,786 $ 6,089 $ 19,524 $ 17,137 Multiply by the cost-to-charges 12.7 % 13.4 % 12.6 % 13.1 % Estimated cost of total uncompensated care $ 862 $ 816 $ 2,460 $ 2,245 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 37.2% and 36.3% for the quarters ended September 30, 2018 and 2017, respectively, and 36.2% and 34.8% for the nine months ended September 30, 2018 and 2017, respectively. The total uncompensated care amounts include charity care of $2.314 billion and $1.235 billion, and the related estimated costs of charity care were $295 million and $167 million for the quarters ended September 30, 2018 and 2017, respectively, and charity care of $6.170 billion and $3.494 billion, and the related estimated costs of charity care were $777 million and $458 million for the nine months ended September 30, 2018 and 2017, respectively. Recent Pronouncements In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases 2016-02”), 2016-02 2016-02 right-of-use During October 2018, the SEC adopted a final rule affecting interim financial statements which requires a reconciliation of changes in stockholders’ equity in the notes to the financial statements or as a separate statement. We have included a single statement presentation of our condensed consolidated statements of stockholders’ deficit for the quarters and nine months ended September 30, 2018 and 2017. Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Acquisitions and Dispositions

Acquisitions and Dispositions	9 Months Ended
	Sep. 30, 2018
Business Combinations [Abstract]
Acquisitions and Dispositions	NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the nine months ended September 30, 2018, we paid $788 million to acquire two hospital facilities and $268 million to acquire other nonhospital health care entities. During the nine months ended September 30, 2017, we paid $1.000 billion to acquire seven hospital facilities and $142 million to acquire other nonhospital health care entities. Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values. The purchase price paid in excess of the fair value of identifiable net assets of these acquired entities aggregated $433 million and $655 million for the nine months ended September 30, 2018 and 2017, respectively. The consolidated financial statements include the accounts and operations of the acquired entities subsequent to the respective acquisition dates. The pro forma effects of these acquired entities on our results of operations for periods prior to the respective acquisition dates were not significant. During the nine months ended September 30, 2018, we received proceeds of $758 million and recognized a net pretax gain of $372 million related to the sale of the two hospital facilities in our Oklahoma market. During the nine months ended September 30, 2018, we also received proceeds of $44 million and recognized a net pretax gain of $48 million related to sales of real estate and other investments. During the nine months ended September 30, 2017, we received proceeds of $24 million and recognized a net pretax gain of $10 million related to sales of real estate and other investments.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2018
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 3 — INCOME TAXES Our provision for income taxes for the quarters ended September 30, 2018 and 2017, was $173 million and $248 million, respectively, and the effective tax rates were 18.6% and 36.7%, respectively. Our provision for income taxes for the nine months ended September 30, 2018 and 2017, was $702 million and $902 million, respectively, and the effective tax rates were 20.5% and 34.1%, respectively. The reductions in the effective tax rates for 2018 periods were primarily related to the estimated impact of tax rate changes under the 2017 Tax Cuts and Jobs Act (the “Tax Act”). Our provision for income taxes for the quarter and nine months ended September 30, 2018 included tax benefits, of $132 million and $377 million, respectively, related to the reduction in our effective tax rate associated with the impact of the Tax Act. Our provision for income taxes also included tax benefits related to the settlement of employee equity awards of $23 million and $4 million for the quarters ended September 30, 2018 and 2017, respectively, and $119 million and $80 million for the nine months ended September 30, 2018 and 2017, respectively. We also recorded a reduction to the provision for income taxes of $28 million during the quarter ended September 30, 2018 for tax credits related to certain 2017 hurricane-related expenses. The Tax Act was enacted on December 22, 2017, and it significantly revised U.S. corporate income taxes, including lowering the federal statutory corporate tax rate from 35% to 21% beginning in 2018. Due to the complexity and uncertainty regarding numerous provisions of the Tax Act, we have not completed our accounting for its effects. However, we have made reasonable estimates and recorded provisional amounts in our financial statements as of September 30, 2018. As we complete our analysis of the Tax Act, we may make adjustments to the provisional amounts and record additional amounts for those federal, state, and foreign tax assets and liabilities for which we were unable to make reasonable estimates as of September 30, 2018. Any adjustments or additional amounts recorded may materially impact our provision for income taxes and effective tax rate in the periods in which they are made. Our liability for unrecognized tax benefits was $440 million, including accrued interest of $45 million, as of September 30, 2018 ($439 million and $44 million, respectively, as of December 31, 2017). Unrecognized tax benefits of $145 million ($145 million as of December 31, 2017) would affect the effective rate, if recognized. We are subject to examination by federal, state and foreign taxing authorities. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2018
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 nine months ended September 30, 2018 and 2017 (dollars and shares in millions, except per share amounts): Quarter Nine Months 2018 2017 2018 2017 Net income attributable to HCA Healthcare, Inc. $ 759 $ 426 $ 2,723 $ 1,742 Weighted average common shares outstanding 345.823 360.170 348.411 365.398 Effect of dilutive incremental shares 7.816 9.664 7.713 9.615 Shares used for diluted earnings per share 353.639 369.834 356.124 375.013 Earnings per share: Basic earnings $ 2.20 $ 1.18 $ 7.82 $ 4.77 Diluted earnings $ 2.15 $ 1.15 $ 7.65 $ 4.64

Investments of Insurance Subsid

Investments of Insurance Subsidiaries	9 Months Ended
	Sep. 30, 2018
Investments, Debt and Equity Securities [Abstract]
Investments of Insurance Subsidiaries	NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES A summary of our insurance subsidiaries’ investments at September 30, 2018 and December 31, 2017 follows (dollars in millions): September 30, 2018 Amortized Unrealized Fair Gains Losses Debt securities $ 343 $ 4 $ (2 ) $ 345 Money market funds and other 68 — — 68 $ 411 $ 4 $ (2 ) 413 Amounts classified as current assets (46 ) Investment carrying value $ 367 December 31, 2017 Amortized Unrealized Fair Gains Losses Debt securities $ 361 $ 10 $ — $ 371 Money market funds and other 101 — — 101 $ 462 $ 10 $ — 472 Amounts classified as current assets (54 ) Investment carrying value $ 418 At September 30, 2018 and December 31, 2017, the investments of our insurance subsidiaries were classified as “available-for-sale.” Scheduled maturities of investments in debt securities at September 30, 2018 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 9 $ 9 Due after one year through five years 57 58 Due after five years through ten years 210 212 Due after ten years 67 66 $ 343 $ 345 The average expected maturity of the investments in debt securities at September 30, 2018 was 5.7 years, compared to the average scheduled maturity of 10.1 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date.

Financial Instruments

Financial Instruments	9 Months Ended
	Sep. 30, 2018
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 The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at September 30, 2018 (dollars in millions): Notional Maturity Date Fair Pay-fixed $ 2,000 December 2021 $ 88 Pay-fixed 500 December 2022 17 During the next 12 months, we estimate $26 million will be reclassified from other comprehensive income (“OCI”) and will reduce interest expense. Derivatives — Results of Operations The following table presents the effect of our interest rate swaps on our results of operations for the nine months ended September 30, 2018 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Gain Location of Gain Amount of Gain Interest rate swaps $ 46 Interest expense $ 5

Assets and Liabilities Measured

Assets and Liabilities Measured at Fair Value	9 Months Ended
	Sep. 30, 2018
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. 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. 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 of these instruments. Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at September 30, 2018 and December 31, 2017, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. The following tables summarize our assets measured at fair value on a recurring basis as of September 30, 2018 and December 31, 2017, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): September 30, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 345 $ — $ 345 $ — Money market funds and other 68 68 — — Investments of insurance subsidiaries 413 68 345 — Less amounts classified as current assets (46 ) (46 ) — — $ 367 22 $ 345 $ — Interest rate swaps (Other) $ 105 $ — $ 105 $ — December 31, 2017 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 371 $ — $ 371 $ — Money market funds and other 101 101 — — Investments of insurance subsidiaries 472 101 371 — Less amounts classified as current assets (54 ) (54 ) — — $ 418 $ 47 $ 371 $ — Interest rate swaps (Other) $ 50 $ — $ 50 $ — The estimated fair value of our long-term debt was $34.125 billion and $34.689 billion at September 30, 2018 and December 31, 2017, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $33.270 billion and $33.222 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 8 — LONG-TERM DEBT A summary of long-term debt at September 30, 2018 and December 31, 2017, including related interest rates at September 30, 2018, follows (dollars in millions): September 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.7%) $ 3,350 $ 3,680 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 3.6%) 3,825 3,891 Senior secured notes (effective interest rate of 5.6%) 13,800 15,300 Other senior secured debt (effective interest rate of 5.8%) 543 599 Senior secured debt 21,518 23,470 Senior unsecured notes (effective interest rate of 6.3%) 11,752 9,752 Net debt issuance costs (163 ) (164 ) Total debt (average life of 6.6 years, rates averaging 5.4%) 33,107 33,058 Less amounts due within one year 191 200 $ 32,916 $ 32,858 During August 2018, we issued $2.000 billion aggregate principal amount of senior notes comprised of $1.000 billion aggregate principal amount of 5.375% notes due 2026 and $1.000 billion aggregate principal amount of 5.625% notes due 2028. We used the net proceeds for general corporate purposes, including funding the purchase of a hospital, and the redemption of all $1.500 billion aggregate principal amount of our existing 3.750% senior secured notes maturing in March 2019. The pretax loss on retirement of debt was $9 million.

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2018
Commitments and Contingencies Disclosure [Abstract]
Contingencies	NOTE 9 — CONTINGENCIES 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 also subject to claims by various taxing authorities 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. Health care companies are subject to numerous investigations by various governmental agencies. Under the federal False Claims Act, private parties have the right to bring qui tam

Share Repurchases Transactions

Share Repurchases Transactions and Other Comprehensive Loss	9 Months Ended
	Sep. 30, 2018
Federal Home Loan Banks [Abstract]
Share Repurchases Transactions and Other Comprehensive Loss	NOTE 10 — SHARE REPURCHASES TRANSACTIONS AND OTHER COMPREHENSIVE LOSS During the nine months ended September 30, 2018, we repurchased 11.558 million shares of our common stock at an average price of $103.42 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during October 2017. At September 30, 2018, we had $607 million of repurchase authorization available under the October 2017 authorization. The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized for-Sale Foreign Defined Change Total Balances at December 31, 2017 $ 7 $ (149 ) $ (168 ) $ 32 $ (278 ) Unrealized losses on available-for-sale (7 ) — — — (7 ) Foreign currency translation adjustments — (35 ) — — (35 ) Change in fair value of derivative instruments, net of $14 of income taxes — — — 46 46 Expense (income) reclassified into operations from other comprehensive income, net of $3 income tax benefit and $1 of income taxes, respectively — — 12 (4 ) 8 Balances at September 30, 2018 $ — $ (184 ) $ (156 ) $ 74 $ (266 )

Segment and Geographic Informat

Segment and Geographic Information	9 Months Ended
	Sep. 30, 2018
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 88 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 85 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, 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, gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2018 and 2017 are summarized in the following table (dollars in millions): Quarter Nine Months 2018 2017 2018 2017 Revenues: National Group $ 5,542 $ 5,036 $ 16,719 $ 15,344 American Group 5,396 5,180 16,113 15,268 Corporate and other 513 480 1,571 1,440 $ 11,451 $ 10,696 $ 34,403 $ 32,052 Equity in earnings of affiliates: National Group $ (1 ) $ (8 ) $ (5 ) $ (17 ) American Group (10 ) (9 ) (29 ) (27 ) Corporate and other 2 4 9 8 $ (9 ) $ (13 ) $ (25 ) $ (36 ) Adjusted segment EBITDA: National Group $ 1,127 $ 975 $ 3,593 $ 3,268 American Group 1,072 930 3,250 2,977 Corporate and other (103 ) (129 ) (402 ) (374 ) $ 2,096 $ 1,776 $ 6,441 $ 5,871 Depreciation and amortization: National Group $ 245 $ 219 $ 702 $ 650 American Group 258 251 765 727 Corporate and other 79 69 230 204 $ 582 $ 539 $ 1,697 $ 1,581 Adjusted segment EBITDA $ 2,096 $ 1,776 $ 6,441 $ 5,871 Depreciation and amortization 582 539 1,697 1,581 Interest expense 442 427 1,309 1,257 Gains on sales of facilities (6 ) (7 ) (420 ) (10 ) Losses on retirement of debt 9 39 9 39 Income before income taxes $ 1,069 $ 778 $ 3,846 $ 3,004

Supplemental Condensed Consolid

Supplemental Condensed Consolidating Financial Information	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental Condensed Consolidating Financial Information	NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION During December 2012, HCA Healthcare, 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 Healthcare, 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 Healthcare, Inc.). The senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guaranteed by HCA Healthcare, Inc. The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, 100% owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our senior secured asset-based revolving credit facility). Our summarized condensed consolidating comprehensive income statements for the quarters and nine months ended September 30, 2018 and 2017, condensed consolidating balance sheets at September 30, 2018 and December 31, 2017 and condensed consolidating statements of cash flows for the nine months ended September 30, 2018 and 2017, segregating HCA Healthcare, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 6,747 $ 4,704 $ — $ 11,451 Salaries and benefits — — 3,090 2,287 — 5,377 Supplies — — 1,115 775 — 1,890 Other operating expenses 2 — 1,137 958 — 2,097 Equity in earnings of affiliates (728 ) — (2 ) (7 ) 728 (9 ) Depreciation and amortization — — 340 242 — 582 Interest expense (income) 16 913 (423 ) (64 ) — 442 Losses (gains) on sales of facilities — — (6 ) — — (6 ) Losses on retirement of debt — 9 — — — 9 Management fees — — (158 ) 158 — — (710 ) 922 5,093 4,349 728 10,382 Income (loss) before income taxes 710 (922 ) 1,654 355 (728 ) 1,069 Provision (benefit) for income taxes (49 ) (214 ) 379 57 — 173 Net income (loss) 759 (708 ) 1,275 298 (728 ) 896 Net income attributable to noncontrolling interests — — 22 115 — 137 Net income (loss) attributable to HCA Healthcare, Inc. $ 759 $ (708 ) $ 1,253 $ 183 $ (728 ) $ 759 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 754 $ (703 ) $ 1,258 $ 168 $ (723 ) $ 754 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED SEPTEMBER 30, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Revenues $ — $ — $ 6,303 $ 4,393 $ — $ 10,696 Salaries and benefits — — 2,915 2,166 — 5,081 Supplies — — 1,033 744 — 1,777 Other operating expenses — — 1,093 982 — 2,075 Equity in earnings of affiliates (436 ) — (1 ) (12 ) 436 (13 ) Depreciation and amortization — — 311 228 — 539 Interest expense (income) 16 792 (342 ) (39 ) — 427 Gains on sales of facilities — — (3 ) (4 ) — (7 ) Losses on retirement of debt — 39 — — — 39 Management fees — — (159 ) 159 — — (420 ) 831 4,847 4,224 436 9,918 Income (loss) before income taxes 420 (831 ) 1,456 169 (436 ) 778 Provision (benefit) for income taxes (6 ) (307 ) 528 33 — 248 Net income (loss) 426 (524 ) 928 136 (436 ) 530 Net income attributable to noncontrolling interests — — 24 80 — 104 Net income (loss) attributable to HCA Healthcare, Inc. $ 426 $ (524 ) $ 904 $ 56 $ (436 ) $ 426 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 451 $ (522 ) $ 907 $ 76 $ (461 ) $ 451 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 20,297 $ 14,106 $ — $ 34,403 Salaries and benefits — — 9,184 6,756 — 15,940 Supplies — — 3,383 2,339 — 5,722 Other operating expenses 7 — 3,387 2,931 — 6,325 Equity in earnings of affiliates (2,670 ) — (5 ) (20 ) 2,670 (25 ) Depreciation and amortization — — 992 705 — 1,697 Interest expense (income) 48 2,617 (1,179 ) (177 ) — 1,309 Gains on sales of facilities — — (378 ) (42 ) — (420 ) Losses on retirement of debt — 9 — — — 9 Management fees — — (473 ) 473 — — (2,615 ) 2,626 14,911 12,965 2,670 30,557 Income (loss) before income taxes 2,615 (2,626 ) 5,386 1,141 (2,670 ) 3,846 Provision (benefit) for income taxes (108 ) (610 ) 1,235 185 — 702 Net income (loss) 2,723 (2,016 ) 4,151 956 (2,670 ) 3,144 Net income attributable to noncontrolling interests — — 72 349 — 421 Net income (loss) attributable to HCA Healthcare, Inc. $ 2,723 $ (2,016 ) $ 4,079 $ 607 $ (2,670 ) $ 2,723 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 2,735 $ (1,974 ) $ 4,091 $ 565 $ (2,682 ) $ 2,735 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Revenues $ — $ — $ 19,008 $ 13,044 $ — $ 32,052 Salaries and benefits — — 8,689 6,189 — 14,878 Supplies — — 3,163 2,206 — 5,369 Other operating expenses 5 — 3,207 2,758 — 5,970 Equity in earnings of affiliates (1,702 ) — (4 ) (32 ) 1,702 (36 ) Depreciation and amortization — — 923 658 — 1,581 Interest expense (income) 48 2,280 (947 ) (124 ) — 1,257 Gains on sales of facilities — — (6 ) (4 ) — (10 ) Losses on retirement of debt — 39 — — — 39 Management fees — — (479 ) 479 — — (1,649 ) 2,319 14,546 12,130 1,702 29,048 Income (loss) before income taxes 1,649 (2,319 ) 4,462 914 (1,702 ) 3,004 Provision (benefit) for income taxes (93 ) (856 ) 1,619 232 — 902 Net income (loss) 1,742 (1,463 ) 2,843 682 (1,702 ) 2,102 Net income attributable to noncontrolling interests — — 74 286 — 360 Net income (loss) attributable to HCA Healthcare, Inc. $ 1,742 $ (1,463 ) $ 2,769 $ 396 $ (1,702 ) $ 1,742 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 1,812 $ (1,458 ) $ 2,778 $ 452 $ (1,772 ) $ 1,812 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 105 $ 473 $ — $ 578 Accounts receivable — — 3,854 2,678 — 6,532 Inventories — — 1,088 546 — 1,634 Other 47 — 667 552 — 1,266 47 — 5,714 4,249 — 10,010 Property and equipment, net — — 12,192 6,849 — 19,041 Investments of insurance subsidiaries — — — 367 — 367 Investments in and advances to affiliates 32,263 — 29 209 (32,263 ) 238 Goodwill and other intangible assets — — 5,736 2,023 — 7,759 Other 389 106 29 105 — 629 $ 32,699 $ 106 $ 23,700 $ 13,802 $ (32,263 ) $ 38,044 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,627 $ 787 $ — $ 2,414 Accrued salaries — — 914 542 — 1,456 Other accrued expenses 10 296 790 1,074 — 2,170 Long-term debt due within one year — 97 61 33 — 191 10 393 3,392 2,436 — 6,231 Long-term debt, net 996 31,471 281 168 — 32,916 Intercompany balances 36,790 (7,734 ) (27,263 ) (1,793 ) — — Professional liability risks — — — 1,239 — 1,239 Income taxes and other liabilities 508 — 364 516 — 1,388 38,304 24,130 (23,226 ) 2,566 — 41,774 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (5,605 ) (24,024 ) 46,846 9,441 (32,263 ) (5,605 ) Noncontrolling interests — — 80 1,795 — 1,875 (5,605 ) (24,024 ) 46,926 11,236 (32,263 ) (3,730 ) $ 32,699 $ 106 $ 23,700 $ 13,802 $ (32,263 ) $ 38,044 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ 1 $ — $ 112 $ 619 $ — $ 732 Accounts receivable — — 3,693 2,808 — 6,501 Inventories — — 1,030 543 — 1,573 Other — — 663 508 — 1,171 1 — 5,498 4,478 — 9,977 Property and equipment, net — — 11,110 6,785 — 17,895 Investments of insurance subsidiaries — — — 418 — 418 Investments in and advances to affiliates 29,581 — 22 177 (29,581 ) 199 Goodwill and other intangible assets — — 4,893 2,501 — 7,394 Other 510 50 47 103 — 710 $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,793 $ 813 $ — $ 2,606 Accrued salaries — — 862 507 — 1,369 Other accrued expenses 29 378 536 1,040 — 1,983 Long-term debt due within one year — 97 64 39 — 200 29 475 3,255 2,399 — 6,158 Long-term debt, net 995 31,367 307 189 — 32,858 Intercompany balances 35,322 (9,742 ) (25,228 ) (352 ) — — Professional liability risks — — — 1,198 — 1,198 Income taxes and other liabilities 552 — 357 465 — 1,374 36,898 22,100 (21,309) 3,899 — 41,588 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (6,806 ) (22,050 ) 42,755 8,876 (29,581 ) (6,806 ) Noncontrolling interests — — 124 1,687 — 1,811 (6,806 ) (22,050 ) 42,879 10,563 (29,581 ) (4,995 ) $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 2,723 $ (2,016 ) $ 4,151 $ 956 $ (2,670 ) $ 3,144 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (83 ) (154 ) 105 — (147 ) Depreciation and amortization — — 992 705 — 1,697 Gains on sales of facilities — — (378 ) (42 ) — (420 ) Losses on retirement of debt — 9 — — — 9 Amortization of debt issuance costs — 23 — — — 23 Share-based compensation — — 204 — — 204 Equity in earnings of affiliates (2,670 ) — — — 2,670 — Other 67 — — 9 — 76 Net cash provided by (used in) operating activities 105 (2,067 ) 4,815 1,733 — 4,586 Cash flows from investing activities: Purchase of property and equipment — — (1,425 ) (995 ) — (2,420 ) Acquisition of hospitals and health care entities — — (894 ) (162 ) — (1,056 ) Disposition of hospitals and health care entities — — 770 32 — 802 Change in investments — — 19 46 — 65 Other — — (18 ) 12 — (6 ) Net cash used in investing activities — — (1,548 ) (1,067 ) — (2,615 ) Cash flows from financing activities: Issuance of long-term debt — 2,000 — — — 2,000 Net change in revolving credit facilities — (330 ) — — — (330 ) Repayment of long-term debt — (1,566 ) (44 ) (42 ) — (1,652 ) Distributions to noncontrolling interests — — (63 ) (252 ) — (315 ) Payment of debt issuance costs — (24 ) — — — (24 ) Payment of cash dividends (366 ) — — — — (366 ) Repurchases of common stock (1,195 ) — — — — (1,195 ) Changes in intercompany balances with affiliates, net 1,697 1,987 (3,167 ) (517 ) — — Other (242 ) — — 10 — (232 ) Net cash (used in) provided by financing activities (106 ) 2,067 (3,274 ) (801 ) — (2,114 ) Effect on exchange rate changes on cash and cash equivalents — — — (11 ) — (11 ) Change in cash and cash equivalents (1 ) — (7 ) (146 ) — (154 ) Cash and cash equivalents at beginning of period 1 — 112 619 — 732 Cash and cash equivalents at end of period $ — $ — $ 105 $ 473 $ — $ 578 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,742 $ (1,463 ) $ 2,843 $ 682 $ (1,702 ) $ 2,102 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (293 ) (191 ) 210 — (289 ) Depreciation and amortization — — 923 658 — 1,581 Income taxes (9 ) — — — — (9 ) Gains on sales of facilities — — (6 ) (4 ) — (10 ) Losses on retirement of debt — 39 — — — 39 Amortization of debt issuance costs — 23 — — — 23 Share-based compensation — — 195 — — 195 Equity in earnings of affiliates (1,702 ) — — — 1,702 — Other 58 — 2 — — 60 Net cash provided by (used in) operating activities 74 (1,694 ) 3,766 1,546 — 3,692 Cash flows from investing activities: Purchase of property and equipment — — (1,161 ) (872 ) — (2,033 ) Acquisition of hospitals and health care entities — — (9 ) (1,133 ) — (1,142 ) Disposition of hospitals and health care entities — — 12 12 — 24 Change in investments — — 1 (16 ) — (15 ) Other — — (7 ) 1 — (6 ) Net cash used in investing activities — — (1,164 ) (2,008 ) — (3,172 ) Cash flows from financing activities: Issuance of long-term debt — 1,500 — 2 — 1,502 Net change in revolving credit facilities — 650 — — — 650 Repayment of long-term debt — (604 ) (54 ) (42 ) — (700 ) Distributions to noncontrolling interests — — (105 ) (258 ) — (363 ) Payment of debt issuance costs — (25 ) — — — (25 ) Repurchases of common stock (1,475 ) — — — — (1,475 ) Changes in intercompany balances with affiliates, net 1,468 173 (2,439 ) 798 — — Other (66 ) — 1 28 — (37 ) Net cash (used in) provided by financing activities (73 ) 1,694 (2,597 ) 528 — (448 ) Change in cash and cash equivalents 1 — 5 66 — 72 Cash and cash equivalents at beginning of period — — 114 532 — 646 Cash and cash equivalents at end of period $ 1 $ — $ 119 $ 598 $ — $ 718 The above supplemental condensed consolidating financial information for the quarter and nine months ended September 30, 2017 has been adjusted to properly record the impact of certain subsidiaries that were non-guarantors non-guarantor Non-Guarantors As Adjustment As Adjusted Quarter ended September 30, 2017 Net income (loss) attributable to HCA Healthcare, Inc.: HCA Healthcare, Inc. Issuer $ 426 $ — $ 426 HCA Inc. Issuer (524 ) — (524 ) Subsidiary Guarantors 787 117 904 Subsidiary Non-Guarantors 173 (117 ) 56 Eliminations (436 ) — (436 ) Condensed Consolidated $ 426 $ — $ 426 As Adjustment As Adjusted Nine months ended September 30, 2017 Net income (loss) attributable to HCA Healthcare, Inc.: HCA Healthcare, Inc. Issuer $ 1,742 $ — $ 1,742 HCA Inc. Issuer (1,463 ) — (1,463 ) Subsidiary Guarantors 2,467 302 2,769 Subsidiary Non-Guarantors 698 (302 ) 396 Eliminations (1,702 ) — (1,702 ) Condensed Consolidated $ 1,742 $ — $ 1,742 As Adjustment As Adjusted Nine months ended September 30, 2017 Net cash provided (used in) operating activities: HCA Healthcare, Inc. Issuer $ 74 $ — $ 74 HCA Inc. Issuer (1,694 ) — (1,694 ) Subsidiary Guarantors 3,342 424 3,766 Subsidiary Non-Guarantors 1,970 (424 ) 1,546 Eliminations — — — Condensed Consolidated $ 3,692 $ — $ 3,692

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2018
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 Regulation S-X. 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 $90 million and $83 million for the quarters ended September 30, 2018 and 2017, respectively, and $254 million and $247 million for the nine months ended September 30, 2018 and 2017, respectively. Operating results for the quarter and nine months ended September 30, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K
Revenues	Revenues In May 2014, the Financial Accounting Standards Board (“FASB”) issued a new standard related to revenue recognition. We adopted the new standard effective January 1, 2018, using the full retrospective method. The adoption of the new standard did not have an impact on our recognition of net revenues for any periods prior to adoption. The most significant impact of adopting the new standard is to the presentation of our consolidated income statements, where we no longer present the “Provision for doubtful accounts” as a separate line item and our “Revenues” are presented net of estimated implicit price concession revenue deductions. We also have eliminated the related presentation of “allowances for doubtful accounts” on our consolidated balance sheets as a result of the adoption of the new standard. Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay Quarter 2018 Ratio 2017 Ratio Medicare $ 2,404 21.0 % $ 2,298 21.5 % Managed Medicare 1,344 11.7 1,122 10.5 Medicaid 338 3.0 286 2.7 Managed Medicaid 622 5.4 537 5.0 Managed care and insurers 6,026 52.6 5,605 52.4 International (managed care and insurers) 273 2.4 276 2.6 Other 444 3.9 572 5.3 Revenues $ 11,451 100.0 % $ 10,696 100.0 % Nine Months 2018 Ratio 2017 Ratio Medicare $ 7,353 21.4 % $ 6,931 21.6 % Managed Medicare 4,088 11.9 3,463 10.8 Medicaid 976 2.8 956 3.0 Managed Medicaid 1,769 5.1 1,653 5.2 Managed care and insurers 18,081 52.6 16,957 52.9 International (managed care and insurers) 873 2.5 814 2.5 Other 1,263 3.7 1,278 4.0 Revenues $ 34,403 100.0 % $ 32,052 100.0 % Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Prior to November 2017, patients treated at hospitals for non-elective The collection of outstanding receivables for Medicare, Medicaid, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients. Estimated implicit price concessions are recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management’s assessment of historical writeoffs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical writeoffs and collections at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. We believe our quarterly updates to the estimated implicit price concession amounts at each of our hospital facilities provide reasonable estimates of our revenues and valuations of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material adjustments to the valuations of our accounts receivable or period-to-period To quantify the total impact of the trends related to uninsured accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters and nine months ended September 30, 2018 and 2017 follows (dollars in millions): Quarter Nine Months 2018 2017 2018 2017 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 9,946 $ 9,472 $ 29,684 $ 27,798 Cost-to-charges 12.7 % 13.4 % 12.6 % 13.1 % Total uncompensated care $ 6,786 $ 6,089 $ 19,524 $ 17,137 Multiply by the cost-to-charges 12.7 % 13.4 % 12.6 % 13.1 % Estimated cost of total uncompensated care $ 862 $ 816 $ 2,460 $ 2,245 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 37.2% and 36.3% for the quarters ended September 30, 2018 and 2017, respectively, and 36.2% and 34.8% for the nine months ended September 30, 2018 and 2017, respectively. The total uncompensated care amounts include charity care of $2.314 billion and $1.235 billion, and the related estimated costs of charity care were $295 million and $167 million for the quarters ended September 30, 2018 and 2017, respectively, and charity care of $6.170 billion and $3.494 billion, and the related estimated costs of charity care were $777 million and $458 million for the nine months ended September 30, 2018 and 2017, respectively.
Recent Pronouncements	Recent Pronouncements In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases 2016-02”), 2016-02 2016-02 right-of-use During October 2018, the SEC adopted a final rule affecting interim financial statements which requires a reconciliation of changes in stockholders’ equity in the notes to the financial statements or as a separate statement. We have included a single statement presentation of our condensed consolidated statements of stockholders’ deficit for the quarters and nine months ended September 30, 2018 and 2017.
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.
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.
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 of these instruments. Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at September 30, 2018 and December 31, 2017, 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

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Schedule of Revenues from Third Party Payers, Uninsured and Other Payers	Our revenues from third-party payers and others (including uninsured patients) for the quarters and nine months ended September 30, 2018 and 2017 are summarized in the following table (dollars in millions): Quarter 2018 Ratio 2017 Ratio Medicare $ 2,404 21.0 % $ 2,298 21.5 % Managed Medicare 1,344 11.7 1,122 10.5 Medicaid 338 3.0 286 2.7 Managed Medicaid 622 5.4 537 5.0 Managed care and insurers 6,026 52.6 5,605 52.4 International (managed care and insurers) 273 2.4 276 2.6 Other 444 3.9 572 5.3 Revenues $ 11,451 100.0 % $ 10,696 100.0 % Nine Months 2018 Ratio 2017 Ratio Medicare $ 7,353 21.4 % $ 6,931 21.6 % Managed Medicare 4,088 11.9 3,463 10.8 Medicaid 976 2.8 956 3.0 Managed Medicaid 1,769 5.1 1,653 5.2 Managed care and insurers 18,081 52.6 16,957 52.9 International (managed care and insurers) 873 2.5 814 2.5 Other 1,263 3.7 1,278 4.0 Revenues $ 34,403 100.0 % $ 32,052 100.0 %
Schedule of Estimated Cost of Uncompensated Care	A summary of the estimated cost of total uncompensated care for the quarters and nine months ended September 30, 2018 and 2017 follows (dollars in millions): Quarter Nine Months 2018 2017 2018 2017 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 9,946 $ 9,472 $ 29,684 $ 27,798 Cost-to-charges 12.7 % 13.4 % 12.6 % 13.1 % Total uncompensated care $ 6,786 $ 6,089 $ 19,524 $ 17,137 Multiply by the cost-to-charges 12.7 % 13.4 % 12.6 % 13.1 % Estimated cost of total uncompensated care $ 862 $ 816 $ 2,460 $ 2,245

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Schedule of Computations of Basic and Diluted Earnings Per Share	The following table sets forth the computation of basic and diluted earnings per share for the quarters and nine months ended September 30, 2018 and 2017 (dollars and shares in millions, except per share amounts): Quarter Nine Months 2018 2017 2018 2017 Net income attributable to HCA Healthcare, Inc. $ 759 $ 426 $ 2,723 $ 1,742 Weighted average common shares outstanding 345.823 360.170 348.411 365.398 Effect of dilutive incremental shares 7.816 9.664 7.713 9.615 Shares used for diluted earnings per share 353.639 369.834 356.124 375.013 Earnings per share: Basic earnings $ 2.20 $ 1.18 $ 7.82 $ 4.77 Diluted earnings $ 2.15 $ 1.15 $ 7.65 $ 4.64

Investments of Insurance Subs_2

Investments of Insurance Subsidiaries (Tables)	9 Months Ended
	Sep. 30, 2018
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	A summary of our insurance subsidiaries’ investments at September 30, 2018 and December 31, 2017 follows (dollars in millions): September 30, 2018 Amortized Unrealized Fair Gains Losses Debt securities $ 343 $ 4 $ (2 ) $ 345 Money market funds and other 68 — — 68 $ 411 $ 4 $ (2 ) 413 Amounts classified as current assets (46 ) Investment carrying value $ 367 December 31, 2017 Amortized Unrealized Fair Gains Losses Debt securities $ 361 $ 10 $ — $ 371 Money market funds and other 101 — — 101 $ 462 $ 10 $ — 472 Amounts classified as current assets (54 ) Investment carrying value $ 418
Schedule of Maturities of Investments	Scheduled maturities of investments in debt securities at September 30, 2018 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 9 $ 9 Due after one year through five years 57 58 Due after five years through ten years 210 212 Due after ten years 67 66 $ 343 $ 345

Financial Instruments (Tables)

Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2018
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges	The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at September 30, 2018 (dollars in millions): Notional Maturity Date Fair Pay-fixed $ 2,000 December 2021 $ 88 Pay-fixed 500 December 2022 17
Effect of Interest Rate on Results of Operations	The following table presents the effect of our interest rate swaps on our results of operations for the nine months ended September 30, 2018 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Gain Location of Gain Amount of Gain Interest rate swaps $ 46 Interest expense $ 5

Assets and Liabilities Measur_2

Assets and Liabilities Measured at Fair Value (Tables)	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Schedule of Assets Measured at Fair Value on Recurring Basis	The following tables summarize our assets measured at fair value on a recurring basis as of September 30, 2018 and December 31, 2017, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): September 30, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 345 $ — $ 345 $ — Money market funds and other 68 68 — — Investments of insurance subsidiaries 413 68 345 — Less amounts classified as current assets (46 ) (46 ) — — $ 367 22 $ 345 $ — Interest rate swaps (Other) $ 105 $ — $ 105 $ — December 31, 2017 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 371 $ — $ 371 $ — Money market funds and other 101 101 — — Investments of insurance subsidiaries 472 101 371 — Less amounts classified as current assets (54 ) (54 ) — — $ 418 $ 47 $ 371 $ — Interest rate swaps (Other) $ 50 $ — $ 50 $ —

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	A summary of long-term debt at September 30, 2018 and December 31, 2017, including related interest rates at September 30, 2018, follows (dollars in millions): September 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.7%) $ 3,350 $ 3,680 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 3.6%) 3,825 3,891 Senior secured notes (effective interest rate of 5.6%) 13,800 15,300 Other senior secured debt (effective interest rate of 5.8%) 543 599 Senior secured debt 21,518 23,470 Senior unsecured notes (effective interest rate of 6.3%) 11,752 9,752 Net debt issuance costs (163 ) (164 ) Total debt (average life of 6.6 years, rates averaging 5.4%) 33,107 33,058 Less amounts due within one year 191 200 $ 32,916 $ 32,858

Share Repurchases Transaction_2

Share Repurchases Transactions and Other Comprehensive Loss (Tables)	9 Months Ended
	Sep. 30, 2018
Federal Home Loan Banks [Abstract]
Components of Accumulated Other Comprehensive Loss	The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized for-Sale Foreign Defined Change Total Balances at December 31, 2017 $ 7 $ (149 ) $ (168 ) $ 32 $ (278 ) Unrealized losses on available-for-sale (7 ) — — — (7 ) Foreign currency translation adjustments — (35 ) — — (35 ) Change in fair value of derivative instruments, net of $14 of income taxes — — — 46 46 Expense (income) reclassified into operations from other comprehensive income, net of $3 income tax benefit and $1 of income taxes, respectively — — 12 (4 ) 8 Balances at September 30, 2018 $ — $ (184 ) $ (156 ) $ 74 $ (266 )

Segment and Geographic Inform_2

Segment and Geographic Information (Tables)	9 Months Ended
	Sep. 30, 2018
Segment Reporting [Abstract]
Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA and Depreciation and Amortization	The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and nine months ended September 30, 2018 and 2017 are summarized in the following table (dollars in millions): Quarter Nine Months 2018 2017 2018 2017 Revenues: National Group $ 5,542 $ 5,036 $ 16,719 $ 15,344 American Group 5,396 5,180 16,113 15,268 Corporate and other 513 480 1,571 1,440 $ 11,451 $ 10,696 $ 34,403 $ 32,052 Equity in earnings of affiliates: National Group $ (1 ) $ (8 ) $ (5 ) $ (17 ) American Group (10 ) (9 ) (29 ) (27 ) Corporate and other 2 4 9 8 $ (9 ) $ (13 ) $ (25 ) $ (36 ) Adjusted segment EBITDA: National Group $ 1,127 $ 975 $ 3,593 $ 3,268 American Group 1,072 930 3,250 2,977 Corporate and other (103 ) (129 ) (402 ) (374 ) $ 2,096 $ 1,776 $ 6,441 $ 5,871 Depreciation and amortization: National Group $ 245 $ 219 $ 702 $ 650 American Group 258 251 765 727 Corporate and other 79 69 230 204 $ 582 $ 539 $ 1,697 $ 1,581 Adjusted segment EBITDA $ 2,096 $ 1,776 $ 6,441 $ 5,871 Depreciation and amortization 582 539 1,697 1,581 Interest expense 442 427 1,309 1,257 Gains on sales of facilities (6 ) (7 ) (420 ) (10 ) Losses on retirement of debt 9 39 9 39 Income before income taxes $ 1,069 $ 778 $ 3,846 $ 3,004

Supplemental Condensed Consol_2

Supplemental Condensed Consolidating Financial Information (Tables)	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Condensed Consolidating Comprehensive Income Statement	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 6,747 $ 4,704 $ — $ 11,451 Salaries and benefits — — 3,090 2,287 — 5,377 Supplies — — 1,115 775 — 1,890 Other operating expenses 2 — 1,137 958 — 2,097 Equity in earnings of affiliates (728 ) — (2 ) (7 ) 728 (9 ) Depreciation and amortization — — 340 242 — 582 Interest expense (income) 16 913 (423 ) (64 ) — 442 Losses (gains) on sales of facilities — — (6 ) — — (6 ) Losses on retirement of debt — 9 — — — 9 Management fees — — (158 ) 158 — — (710 ) 922 5,093 4,349 728 10,382 Income (loss) before income taxes 710 (922 ) 1,654 355 (728 ) 1,069 Provision (benefit) for income taxes (49 ) (214 ) 379 57 — 173 Net income (loss) 759 (708 ) 1,275 298 (728 ) 896 Net income attributable to noncontrolling interests — — 22 115 — 137 Net income (loss) attributable to HCA Healthcare, Inc. $ 759 $ (708 ) $ 1,253 $ 183 $ (728 ) $ 759 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 754 $ (703 ) $ 1,258 $ 168 $ (723 ) $ 754 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED SEPTEMBER 30, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Revenues $ — $ — $ 6,303 $ 4,393 $ — $ 10,696 Salaries and benefits — — 2,915 2,166 — 5,081 Supplies — — 1,033 744 — 1,777 Other operating expenses — — 1,093 982 — 2,075 Equity in earnings of affiliates (436 ) — (1 ) (12 ) 436 (13 ) Depreciation and amortization — — 311 228 — 539 Interest expense (income) 16 792 (342 ) (39 ) — 427 Gains on sales of facilities — — (3 ) (4 ) — (7 ) Losses on retirement of debt — 39 — — — 39 Management fees — — (159 ) 159 — — (420 ) 831 4,847 4,224 436 9,918 Income (loss) before income taxes 420 (831 ) 1,456 169 (436 ) 778 Provision (benefit) for income taxes (6 ) (307 ) 528 33 — 248 Net income (loss) 426 (524 ) 928 136 (436 ) 530 Net income attributable to noncontrolling interests — — 24 80 — 104 Net income (loss) attributable to HCA Healthcare, Inc. $ 426 $ (524 ) $ 904 $ 56 $ (436 ) $ 426 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 451 $ (522 ) $ 907 $ 76 $ (461 ) $ 451 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 20,297 $ 14,106 $ — $ 34,403 Salaries and benefits — — 9,184 6,756 — 15,940 Supplies — — 3,383 2,339 — 5,722 Other operating expenses 7 — 3,387 2,931 — 6,325 Equity in earnings of affiliates (2,670 ) — (5 ) (20 ) 2,670 (25 ) Depreciation and amortization — — 992 705 — 1,697 Interest expense (income) 48 2,617 (1,179 ) (177 ) — 1,309 Gains on sales of facilities — — (378 ) (42 ) — (420 ) Losses on retirement of debt — 9 — — — 9 Management fees — — (473 ) 473 — — (2,615 ) 2,626 14,911 12,965 2,670 30,557 Income (loss) before income taxes 2,615 (2,626 ) 5,386 1,141 (2,670 ) 3,846 Provision (benefit) for income taxes (108 ) (610 ) 1,235 185 — 702 Net income (loss) 2,723 (2,016 ) 4,151 956 (2,670 ) 3,144 Net income attributable to noncontrolling interests — — 72 349 — 421 Net income (loss) attributable to HCA Healthcare, Inc. $ 2,723 $ (2,016 ) $ 4,079 $ 607 $ (2,670 ) $ 2,723 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 2,735 $ (1,974 ) $ 4,091 $ 565 $ (2,682 ) $ 2,735 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Revenues $ — $ — $ 19,008 $ 13,044 $ — $ 32,052 Salaries and benefits — — 8,689 6,189 — 14,878 Supplies — — 3,163 2,206 — 5,369 Other operating expenses 5 — 3,207 2,758 — 5,970 Equity in earnings of affiliates (1,702 ) — (4 ) (32 ) 1,702 (36 ) Depreciation and amortization — — 923 658 — 1,581 Interest expense (income) 48 2,280 (947 ) (124 ) — 1,257 Gains on sales of facilities — — (6 ) (4 ) — (10 ) Losses on retirement of debt — 39 — — — 39 Management fees — — (479 ) 479 — — (1,649 ) 2,319 14,546 12,130 1,702 29,048 Income (loss) before income taxes 1,649 (2,319 ) 4,462 914 (1,702 ) 3,004 Provision (benefit) for income taxes (93 ) (856 ) 1,619 232 — 902 Net income (loss) 1,742 (1,463 ) 2,843 682 (1,702 ) 2,102 Net income attributable to noncontrolling interests — — 74 286 — 360 Net income (loss) attributable to HCA Healthcare, Inc. $ 1,742 $ (1,463 ) $ 2,769 $ 396 $ (1,702 ) $ 1,742 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 1,812 $ (1,458 ) $ 2,778 $ 452 $ (1,772 ) $ 1,812
Schedule of Condensed Consolidating Balance Sheet	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 105 $ 473 $ — $ 578 Accounts receivable — — 3,854 2,678 — 6,532 Inventories — — 1,088 546 — 1,634 Other 47 — 667 552 — 1,266 47 — 5,714 4,249 — 10,010 Property and equipment, net — — 12,192 6,849 — 19,041 Investments of insurance subsidiaries — — — 367 — 367 Investments in and advances to affiliates 32,263 — 29 209 (32,263 ) 238 Goodwill and other intangible assets — — 5,736 2,023 — 7,759 Other 389 106 29 105 — 629 $ 32,699 $ 106 $ 23,700 $ 13,802 $ (32,263 ) $ 38,044 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,627 $ 787 $ — $ 2,414 Accrued salaries — — 914 542 — 1,456 Other accrued expenses 10 296 790 1,074 — 2,170 Long-term debt due within one year — 97 61 33 — 191 10 393 3,392 2,436 — 6,231 Long-term debt, net 996 31,471 281 168 — 32,916 Intercompany balances 36,790 (7,734 ) (27,263 ) (1,793 ) — — Professional liability risks — — — 1,239 — 1,239 Income taxes and other liabilities 508 — 364 516 — 1,388 38,304 24,130 (23,226 ) 2,566 — 41,774 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (5,605 ) (24,024 ) 46,846 9,441 (32,263 ) (5,605 ) Noncontrolling interests — — 80 1,795 — 1,875 (5,605 ) (24,024 ) 46,926 11,236 (32,263 ) (3,730 ) $ 32,699 $ 106 $ 23,700 $ 13,802 $ (32,263 ) $ 38,044 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ 1 $ — $ 112 $ 619 $ — $ 732 Accounts receivable — — 3,693 2,808 — 6,501 Inventories — — 1,030 543 — 1,573 Other — — 663 508 — 1,171 1 — 5,498 4,478 — 9,977 Property and equipment, net — — 11,110 6,785 — 17,895 Investments of insurance subsidiaries — — — 418 — 418 Investments in and advances to affiliates 29,581 — 22 177 (29,581 ) 199 Goodwill and other intangible assets — — 4,893 2,501 — 7,394 Other 510 50 47 103 — 710 $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,793 $ 813 $ — $ 2,606 Accrued salaries — — 862 507 — 1,369 Other accrued expenses 29 378 536 1,040 — 1,983 Long-term debt due within one year — 97 64 39 — 200 29 475 3,255 2,399 — 6,158 Long-term debt, net 995 31,367 307 189 — 32,858 Intercompany balances 35,322 (9,742 ) (25,228 ) (352 ) — — Professional liability risks — — — 1,198 — 1,198 Income taxes and other liabilities 552 — 357 465 — 1,374 36,898 22,100 (21,309) 3,899 — 41,588 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (6,806 ) (22,050 ) 42,755 8,876 (29,581 ) (6,806 ) Noncontrolling interests — — 124 1,687 — 1,811 (6,806 ) (22,050 ) 42,879 10,563 (29,581 ) (4,995 ) $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593
Schedule of Condensed Consolidating Statement of Cash Flows	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 2,723 $ (2,016 ) $ 4,151 $ 956 $ (2,670 ) $ 3,144 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (83 ) (154 ) 105 — (147 ) Depreciation and amortization — — 992 705 — 1,697 Gains on sales of facilities — — (378 ) (42 ) — (420 ) Losses on retirement of debt — 9 — — — 9 Amortization of debt issuance costs — 23 — — — 23 Share-based compensation — — 204 — — 204 Equity in earnings of affiliates (2,670 ) — — — 2,670 — Other 67 — — 9 — 76 Net cash provided by (used in) operating activities 105 (2,067 ) 4,815 1,733 — 4,586 Cash flows from investing activities: Purchase of property and equipment — — (1,425 ) (995 ) — (2,420 ) Acquisition of hospitals and health care entities — — (894 ) (162 ) — (1,056 ) Disposition of hospitals and health care entities — — 770 32 — 802 Change in investments — — 19 46 — 65 Other — — (18 ) 12 — (6 ) Net cash used in investing activities — — (1,548 ) (1,067 ) — (2,615 ) Cash flows from financing activities: Issuance of long-term debt — 2,000 — — — 2,000 Net change in revolving credit facilities — (330 ) — — — (330 ) Repayment of long-term debt — (1,566 ) (44 ) (42 ) — (1,652 ) Distributions to noncontrolling interests — — (63 ) (252 ) — (315 ) Payment of debt issuance costs — (24 ) — — — (24 ) Payment of cash dividends (366 ) — — — — (366 ) Repurchases of common stock (1,195 ) — — — — (1,195 ) Changes in intercompany balances with affiliates, net 1,697 1,987 (3,167 ) (517 ) — — Other (242 ) — — 10 — (232 ) Net cash (used in) provided by financing activities (106 ) 2,067 (3,274 ) (801 ) — (2,114 ) Effect on exchange rate changes on cash and cash equivalents — — — (11 ) — (11 ) Change in cash and cash equivalents (1 ) — (7 ) (146 ) — (154 ) Cash and cash equivalents at beginning of period 1 — 112 619 — 732 Cash and cash equivalents at end of period $ — $ — $ 105 $ 473 $ — $ 578 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,742 $ (1,463 ) $ 2,843 $ 682 $ (1,702 ) $ 2,102 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (293 ) (191 ) 210 — (289 ) Depreciation and amortization — — 923 658 — 1,581 Income taxes (9 ) — — — — (9 ) Gains on sales of facilities — — (6 ) (4 ) — (10 ) Losses on retirement of debt — 39 — — — 39 Amortization of debt issuance costs — 23 — — — 23 Share-based compensation — — 195 — — 195 Equity in earnings of affiliates (1,702 ) — — — 1,702 — Other 58 — 2 — — 60 Net cash provided by (used in) operating activities 74 (1,694 ) 3,766 1,546 — 3,692 Cash flows from investing activities: Purchase of property and equipment — — (1,161 ) (872 ) — (2,033 ) Acquisition of hospitals and health care entities — — (9 ) (1,133 ) — (1,142 ) Disposition of hospitals and health care entities — — 12 12 — 24 Change in investments — — 1 (16 ) — (15 ) Other — — (7 ) 1 — (6 ) Net cash used in investing activities — — (1,164 ) (2,008 ) — (3,172 ) Cash flows from financing activities: Issuance of long-term debt — 1,500 — 2 — 1,502 Net change in revolving credit facilities — 650 — — — 650 Repayment of long-term debt — (604 ) (54 ) (42 ) — (700 ) Distributions to noncontrolling interests — — (105 ) (258 ) — (363 ) Payment of debt issuance costs — (25 ) — — — (25 ) Repurchases of common stock (1,475 ) — — — — (1,475 ) Changes in intercompany balances with affiliates, net 1,468 173 (2,439 ) 798 — — Other (66 ) — 1 28 — (37 ) Net cash (used in) provided by financing activities (73 ) 1,694 (2,597 ) 528 — (448 ) Change in cash and cash equivalents 1 — 5 66 — 72 Cash and cash equivalents at beginning of period — — 114 532 — 646 Cash and cash equivalents at end of period $ 1 $ — $ 119 $ 598 $ — $ 718
Summary of Restatement Adjustments to Financial Statements	The application of these adjustments to the consolidating information for the quarter and nine months ended September 30, 2017 is summarized as follows (dollars in millions): As Adjustment As Adjusted Quarter ended September 30, 2017 Net income (loss) attributable to HCA Healthcare, Inc.: HCA Healthcare, Inc. Issuer $ 426 $ — $ 426 HCA Inc. Issuer (524 ) — (524 ) Subsidiary Guarantors 787 117 904 Subsidiary Non-Guarantors 173 (117 ) 56 Eliminations (436 ) — (436 ) Condensed Consolidated $ 426 $ — $ 426 As Adjustment As Adjusted Nine months ended September 30, 2017 Net income (loss) attributable to HCA Healthcare, Inc.: HCA Healthcare, Inc. Issuer $ 1,742 $ — $ 1,742 HCA Inc. Issuer (1,463 ) — (1,463 ) Subsidiary Guarantors 2,467 302 2,769 Subsidiary Non-Guarantors 698 (302 ) 396 Eliminations (1,702 ) — (1,702 ) Condensed Consolidated $ 1,742 $ — $ 1,742 As Adjustment As Adjusted Nine months ended September 30, 2017 Net cash provided (used in) operating activities: HCA Healthcare, Inc. Issuer $ 74 $ — $ 74 HCA Inc. Issuer (1,694 ) — (1,694 ) Subsidiary Guarantors 3,342 424 3,766 Subsidiary Non-Guarantors 1,970 (424 ) 1,546 Eliminations — — — Condensed Consolidated $ 3,692 $ — $ 3,692

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions	Oct. 31, 2017	Nov. 30, 2017	Sep. 30, 2018USD ($)StateHospitalSurgery_Center	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)StateHospitalSurgery_Center	Sep. 30, 2017USD ($)	Dec. 31, 2017USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of owned and operated hospitals | Hospital			179		179
Number of freestanding surgery centers | Surgery_Center			122		122
Number of facilities locations | State			20		20
General and administrative expense			$ 90	$ 83	$ 254	$ 247
Estimated implicit price concessions recorded as reductions to revenues and accounts receivable					$ 5,781		$ 5,488
Percentage of sum of revenues and uncompensated care			37.20%	36.30%	36.20%	34.80%
Charity care amount			$ 2,314	$ 1,235	$ 6,170	$ 3,494
Estimated costs of charity care			$ 295	$ 167	$ 777	$ 458
Inpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period			5 days		5 days
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of income of federal poverty level eligible for charity care	200.00%	400.00%
Maximum [Member] | Outpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period			1 day		1 day
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of income of federal poverty level eligible for charity care		200.00%

Basis of Presentation and Sig_5

Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 11,451	$ 10,696	$ 34,403	$ 32,052
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	$ 2,404	$ 2,298	$ 7,353	$ 6,931
Revenues from third party payers, Ratio	21.00%	21.50%	21.40%	21.60%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 1,344	$ 1,122	$ 4,088	$ 3,463
Revenues from third party payers, Ratio	11.70%	10.50%	11.90%	10.80%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 338	$ 286	$ 976	$ 956
Revenues from third party payers, Ratio	3.00%	2.70%	2.80%	3.00%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 622	$ 537	$ 1,769	$ 1,653
Revenues from third party payers, Ratio	5.40%	5.00%	5.10%	5.20%
Managed Care and Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 6,026	$ 5,605	$ 18,081	$ 16,957
Revenues from third party payers, Ratio	52.60%	52.40%	52.60%	52.90%
International (Managed Care and Other Insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 273	$ 276	$ 873	$ 814
Revenues from third party payers, Ratio	2.40%	2.60%	2.50%	2.50%
Product and Service, Other [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 444	$ 572	$ 1,263	$ 1,278
Other, Ratio	3.90%	5.30%	3.70%	4.00%
Health Care, Patient Service [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 11,451	$ 10,696	$ 34,403	$ 32,052

Basis of Presentation and Sig_6

Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Accounting Policies [Abstract]
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$ 9,946	$ 9,472	$ 29,684	$ 27,798
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)	12.70%	13.40%	12.60%	13.10%
Total uncompensated care	$ 6,786	$ 6,089	$ 19,524	$ 17,137
Multiply by the cost-to-charges ratio	12.70%	13.40%	12.60%	13.10%
Estimated cost of total uncompensated care	$ 862	$ 816	$ 2,460	$ 2,245

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)Hospital	Sep. 30, 2017USD ($)Hospital
Business Acquisition [Line Items]
Number of hospitals purchased | Hospital	2	7
Proceeds from sale of business	$ 802,000	$ 24,000
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	48,000	10,000
Proceeds from sale of business	44,000	24,000
Discontinued Operations, Disposed of by Sale [Member] | Oklahoma [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	372,000
Proceeds from sale of business	$ 758,000
Number of hospitals sold | Hospital	2
Hospitals [Member]
Business Acquisition [Line Items]
Aggregate purchase price	$ 788,000	1,000,000
Nonhospital Health Care [Member]
Business Acquisition [Line Items]
Aggregate purchase price	268,000	142,000
Other [Member]
Business Acquisition [Line Items]
Fair value of identifiable net assets of acquired entities	$ 433,000	$ 655,000

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Provision for income taxes	$ 173	$ 248	$ 702	$ 902
Effective tax rates	18.60%	36.70%	20.50%	34.10%
Provision for income tax benefit excluding gains on sale	$ 132		$ 377
Provision for tax benefits related to settlement of employee awards	23	$ 4	$ 119	$ 80
Reduction to provision for income taxes for tax credits	28
Effective tax rate			21.00%		35.00%
Liability for unrecognized tax benefits	440		$ 440		$ 439
Unrecognized tax benefits, accrued interest	45		45		44
Unrecognized tax benefits that would impact effective tax rate	$ 145		$ 145		$ 145

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Computations of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Earnings Per Share [Abstract]
Net income attributable to HCA Healthcare, Inc.	$ 759	$ 426	$ 2,723	$ 1,742
Weighted average common shares outstanding	345,823	360,170	348,411	365,398
Effect of dilutive incremental shares	7,816	9,664	7,713	9,615
Shares used for diluted earnings per share	353,639	369,834	356,124	375,013
Basic earnings	$ 2.20	$ 1.18	$ 7.82	$ 4.77
Diluted earnings	$ 2.15	$ 1.15	$ 7.65	$ 4.64

Investments of Insurance Subs_3

Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Debt Securities, Available-for-sale [Line Items]
Amounts classified as current assets	$ (46)	$ (54)
Investment carrying value	367	418
Amortized Cost	411	462
Unrealized Amounts, Gains	4	10
Unrealized Amounts, Losses	(2)
Fair Value	413	472
Money Market Funds and Other [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	68	101
Fair Value	68	101
Debt Securities [Member] | States and Municipalities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	343	361
Unrealized Amounts, Gains	4	10
Unrealized Amounts, Losses	(2)
Fair Value	$ 345	$ 371

Investments of Insurance Subs_4

Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Sep. 30, 2018USD ($)
Investments, Debt and Equity Securities [Abstract]
Due in one year or less, Amortized Cost	$ 9
Due after one year through five years, Amortized Cost	57
Due after five years through ten years, Amortized Cost	210
Due after ten years, Amortized Cost	67
Amortized Cost, Total	343
Due in one year or less, Fair Value	9
Due after one year through five years, Fair Value	58
Due after five years through ten years, Fair Value	212
Due after ten years, Fair Value	66
Fair Value, Total	$ 345

Investments of Insurance Subs_5

Investments of Insurance Subsidiaries - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2018
Investments, Debt and Equity Securities [Abstract]
Available for sale securities expected maturity of debt securities	5 years 8 months 12 days
Available for sale securities average scheduled maturity	10 years 1 month 6 days

Financial Instruments - Schedul

Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member]	9 Months Ended
	Sep. 30, 2018USD ($)
Maturity Date, 2021 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 2,000,000,000
Fair Value	$ 88,000,000
Maturity Date	Dec. 31, 2021
Maturity Date, 2022 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 500,000,000
Fair Value	$ 17,000,000
Maturity Date	Dec. 31, 2022

Financial Instruments - Additio

Financial Instruments - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2018USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Estimated amount reclassified from other comprehensive income and reduce interest expense	$ 26

Financial Instruments - Effect

Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	$ 10	$ (1)	$ 60	$ (9)
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax			46
Interest Rate Swaps [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest rate swaps			$ 5

Assets and Liabilities Measur_3

Assets and Liabilities Measured at Fair Value - Schedule of Assets Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	$ 413	$ 472
Less amounts classified as current assets	(46)	(54)
Investments of insurance subsidiaries, noncurrent	367	418
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Derivative Asset	105	50
States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	345	371
Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	68	101
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	68	101
Less amounts classified as current assets	(46)	(54)
Investments of insurance subsidiaries, noncurrent	22	47
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	68	101
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 Disclosure	345	371
Investments of insurance subsidiaries, noncurrent	345	371
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]
Derivative Asset	105	50
Significant Other Observable Inputs (Level 2) [Member] | States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	$ 345	$ 371

Assets and Liabilities Measur_4

Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Estimated fair value of long-term debt	$ 34,125	$ 34,689
Carrying amounts of long-term debt	$ 33,270	$ 33,222

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Senior secured debt	$ 21,518	$ 23,470
Net debt issuance costs	(163)	(164)
Total debt (average life of 6.6 years, rates averaging 5.4%)	33,107	33,058
Less amounts due within one year	191	200
Long-term debt	32,916	32,858
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	3,350	3,680
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Senior secured debt	3,825	3,891
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Senior secured debt	13,800	15,300
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	543	599
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 11,752	$ 9,752

Long-Term Debt - Schedule of _2

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	9 Months Ended
	Sep. 30, 2018
Debt Instrument [Line Items]
Total debt average term	6 years 7 months 6 days
Total debt average rate	5.40%
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	3.70%
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Effective interest rate	3.60%
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.60%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	5.80%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	6.30%

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended		9 Months Ended
	Aug. 31, 2018	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Debt Instrument [Line Items]
Pretax loss on retirement of debt		$ (9,000,000)	$ (39,000,000)	$ (9,000,000)	$ (39,000,000)
Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 2,000,000,000
Senior Notes [Member] | 5.375% Senior Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 1,000,000,000
Debt instrument, stated interest	5.375%
Senior Notes [Member] | 5.625% Senior Notes Due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 1,000,000,000
Debt instrument, stated interest	5.625%
Senior Notes [Member] | Senior Notes Due2019 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest	3.75%
Proceeds from new term loan	$ 1,500,000,000
Pretax loss on retirement of debt	$ 9,000,000

Share Repurchases Transaction_3

Share Repurchases Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($)	9 Months Ended
	Sep. 30, 2018	Oct. 31, 2017
Equity [Abstract]
Repurchase of common stock, shares	11,558,000
Repurchase price of common stock, per share	$ 103.42
Share repurchase program, remaining authorized repurchase amount	$ 607,000,000
Share repurchase program authorized amount		$ 2,000,000,000

Share Repurchases Transaction_4

Share Repurchases Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2018USD ($)
Equity [Abstract]
Unrealized gains on available-for-sale securities, beginning balances	$ 7
Unrealized losses on available-for-sale securities, net of income tax benefit	(7)
Foreign currency translation adjustments, beginning balances	(149)
Foreign currency translation adjustments	(35)
Foreign currency translation adjustments, ending balances	(184)
Defined benefit plans, beginning balances	(168)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	12
Defined benefit plans, ending balances	(156)
Change in fair value of derivative instruments, beginning balances	32
Change in fair value of derivative instruments net of income taxes	46
Change in fair value of derivative instruments, ending balances	74
Accumulated other comprehensive income, net of tax, beginning balances	(278)
Unrealized losses on available-for-sale securities, net of income tax benefit	(7)
Foreign currency translation adjustments	(35)
Change in fair value of derivative instruments	46
Expense (income) reclassified into operations from other comprehensive income, Total	8
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (266)

Share Repurchases Transaction_5

Share Repurchases Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2018USD ($)
Equity [Abstract]
Unrealized losses on available-for-sale securities, tax benefit portion	$ 1
Defined benefit plans, Expense (income) reclassified into operations from other comprehensive income, Income tax benefit	3
Defined benefit plans, Expense (income) reclassified into operations from other comprehensive income, net of Income taxes	1
Change in fair value of derivative instruments, change in fair value of derivative instruments, income taxes	$ 4

Segment and Geographic Inform_3

Segment and Geographic Information - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2018Hospital
Segment Reporting Information [Line Items]
Number of geographically organized groups	2
Number of owned and operated hospitals	179
Reorganization Group [Member] | National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	88
Reorganization Group [Member] | American Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	85
Reorganization Group [Member] | Corporate and Other [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	6

Segment and Geographic Inform_4

Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Segment Reporting Information [Line Items]
Revenues	$ 11,451	$ 10,696	$ 34,403	$ 32,052
Equity in earnings of affiliates	9	13	25	36
Adjusted segment EBITDA	2,096	1,776	6,441	5,871
Depreciation and amortization	582	539	1,697	1,581
Interest expense	442	427	1,309	1,257
Gain on sales of facilities	(6)	(7)	(420)	(10)
Losses on retirement of debt	9	39	9	39
Income before income taxes	1,069	778	3,846	3,004
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,542	5,036	16,719	15,344
Equity in earnings of affiliates	(1)	(8)	(5)	(17)
Adjusted segment EBITDA	1,127	975	3,593	3,268
Depreciation and amortization	245	219	702	650
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,396	5,180	16,113	15,268
Equity in earnings of affiliates	(10)	(9)	(29)	(27)
Adjusted segment EBITDA	1,072	930	3,250	2,977
Depreciation and amortization	258	251	765	727
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	513	480	1,571	1,440
Equity in earnings of affiliates	2	4	9	8
Adjusted segment EBITDA	(103)	(129)	(402)	(374)
Depreciation and amortization	$ 79	$ 69	$ 230	$ 204

Supplemental Condensed Consol_3

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Additional Information (Detail) - USD ($)	Sep. 30, 2018	Dec. 31, 2012
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		$ 1,000,000,000
Debt instrument, stated interest		6.25%

Supplemental Condensed Consol_4

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Condensed Statement of Income Captions [Line Items]
Revenues	$ 11,451	$ 10,696	$ 34,403	$ 32,052
Salaries and benefits	5,377	5,081	15,940	14,878
Supplies	1,890	1,777	5,722	5,369
Other operating expenses	2,097	2,075	6,325	5,970
Equity in earnings of affiliates	(9)	(13)	(25)	(36)
Depreciation and amortization	582	539	1,697	1,581
Interest expense (income)	442	427	1,309	1,257
Losses (gains) on sales of facilities	(6)	(7)	(420)	(10)
Losses on retirement of debt	9	39	9	39
Total expenses including equity in earnings of affiliates	10,382	9,918	30,557	29,048
Income (loss) before income taxes	1,069	778	3,846	3,004
Provision (benefit) for income taxes	173	248	702	902
Net income (loss)	896	530	3,144	2,102
Net income attributable to noncontrolling interests	137	104	421	360
Net income (loss) attributable to HCA Healthcare, Inc.	759	426	2,723	1,742
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	754	451	2,735	1,812
Health Care, Patient Service [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	11,451	10,696	34,403	32,052
HCA Healthcare, Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Other operating expenses	2		7	5
Equity in earnings of affiliates	(728)	(436)	(2,670)	(1,702)
Interest expense (income)	16	16	48	48
Total expenses including equity in earnings of affiliates	(710)	(420)	(2,615)	(1,649)
Income (loss) before income taxes	710	420	2,615	1,649
Provision (benefit) for income taxes	(49)	(6)	(108)	(93)
Net income (loss)	759	426	2,723	1,742
Net income (loss) attributable to HCA Healthcare, Inc.	759	426	2,723	1,742
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	754	451	2,735	1,812
HCA Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Interest expense (income)	913	792	2,617	2,280
Losses on retirement of debt	9	39	9	39
Total expenses including equity in earnings of affiliates	922	831	2,626	2,319
Income (loss) before income taxes	(922)	(831)	(2,626)	(2,319)
Provision (benefit) for income taxes	(214)	(307)	(610)	(856)
Net income (loss)	(708)	(524)	(2,016)	(1,463)
Net income (loss) attributable to HCA Healthcare, Inc.	(708)	(524)	(2,016)	(1,463)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	(703)	(522)	(1,974)	(1,458)
Subsidiary Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Salaries and benefits	3,090	2,915	9,184	8,689
Supplies	1,115	1,033	3,383	3,163
Other operating expenses	1,137	1,093	3,387	3,207
Equity in earnings of affiliates	(2)	(1)	(5)	(4)
Depreciation and amortization	340	311	992	923
Interest expense (income)	(423)	(342)	(1,179)	(947)
Losses (gains) on sales of facilities	(6)	(3)	(378)	(6)
Management fees	(158)	(159)	(473)	(479)
Total expenses including equity in earnings of affiliates	5,093	4,847	14,911	14,546
Income (loss) before income taxes	1,654	1,456	5,386	4,462
Provision (benefit) for income taxes	379	528	1,235	1,619
Net income (loss)	1,275	928	4,151	2,843
Net income attributable to noncontrolling interests	22	24	72	74
Net income (loss) attributable to HCA Healthcare, Inc.	1,253	904	4,079	2,769
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,258	907	4,091	2,778
Subsidiary Guarantors [Member] | Health Care, Patient Service [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	6,747	6,303	20,297	19,008
Subsidiary Non-Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Salaries and benefits	2,287	2,166	6,756	6,189
Supplies	775	744	2,339	2,206
Other operating expenses	958	982	2,931	2,758
Equity in earnings of affiliates	(7)	(12)	(20)	(32)
Depreciation and amortization	242	228	705	658
Interest expense (income)	(64)	(39)	(177)	(124)
Losses (gains) on sales of facilities		(4)	(42)	(4)
Management fees	158	159	473	479
Total expenses including equity in earnings of affiliates	4,349	4,224	12,965	12,130
Income (loss) before income taxes	355	169	1,141	914
Provision (benefit) for income taxes	57	33	185	232
Net income (loss)	298	136	956	682
Net income attributable to noncontrolling interests	115	80	349	286
Net income (loss) attributable to HCA Healthcare, Inc.	183	56	607	396
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	168	76	565	452
Subsidiary Non-Guarantors [Member] | Health Care, Patient Service [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	4,704	4,393	14,106	13,044
Eliminations [Member]
Condensed Statement of Income Captions [Line Items]
Equity in earnings of affiliates	728	436	2,670	1,702
Total expenses including equity in earnings of affiliates	728	436	2,670	1,702
Income (loss) before income taxes	(728)	(436)	(2,670)	(1,702)
Net income (loss)	(728)	(436)	(2,670)	(1,702)
Net income (loss) attributable to HCA Healthcare, Inc.	(728)	(436)	(2,670)	(1,702)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	$ (723)	$ (461)	$ (2,682)	$ (1,772)

Supplemental Condensed Consol_5

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 578			$ 732
Accounts receivable	6,532			6,501
Inventories	1,634			1,573
Other	1,266			1,171
Total current assets	10,010			9,977
Property and equipment, net	19,041			17,895
Investments of insurance subsidiaries	367			418
Investments in and advances to affiliates	238			199
Goodwill and other intangible assets	7,759			7,394
Other	629			710
Total assets	38,044			36,593
Current liabilities:
Accounts payable	2,414			2,606
Accrued salaries	1,456			1,369
Other accrued expenses	2,170			1,983
Long-term debt due within one year	191			200
Total current liabilities	6,231			6,158
Long-term debt, net	32,916			32,858
Professional liability risks	1,239			1,198
Income taxes and other liabilities	1,388			1,374
Total liabilities	41,774			41,588
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(5,605)			(6,806)
Noncontrolling interests	1,875			1,811
Total stockholders' deficit	(3,730)	$ (4,125)	$ (4,434)	(4,995)	$ (5,066)	$ (5,079)	$ (5,357)	$ (5,633)
Total liabilities and stockholders' deficit	38,044			36,593
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(5,605)			(6,806)
Noncontrolling interests	1,875			1,811
Total stockholders' deficit	(3,730)	$ (4,125)	$ (4,434)	(4,995)	$ (5,066)	$ (5,079)	$ (5,357)	$ (5,633)
Total liabilities and stockholders' deficit	38,044			36,593
HCA Healthcare, Inc. Issuer [Member]
Current assets:
Cash and cash equivalents				1
Other	47
Total current assets	47			1
Investments in and advances to affiliates	32,263			29,581
Other	389			510
Total assets	32,699			30,092
Current liabilities:
Other accrued expenses	10			29
Total current liabilities	10			29
Long-term debt, net	996			995
Intercompany balances	36,790			35,322
Income taxes and other liabilities	508			552
Total liabilities	38,304			36,898
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(5,605)			(6,806)
Total stockholders' deficit	(5,605)			(6,806)
Total liabilities and stockholders' deficit	32,699			30,092
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(5,605)			(6,806)
Total stockholders' deficit	(5,605)			(6,806)
Total liabilities and stockholders' deficit	32,699			30,092
HCA Inc. Issuer [Member]
Current assets:
Other	106			50
Total assets	106			50
Current liabilities:
Other accrued expenses	296			378
Long-term debt due within one year	97			97
Total current liabilities	393			475
Long-term debt, net	31,471			31,367
Intercompany balances	(7,734)			(9,742)
Total liabilities	24,130			22,100
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(24,024)			(22,050)
Total stockholders' deficit	(24,024)			(22,050)
Total liabilities and stockholders' deficit	106			50
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(24,024)			(22,050)
Total stockholders' deficit	(24,024)			(22,050)
Total liabilities and stockholders' deficit	106			50
Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	105			112
Accounts receivable	3,854			3,693
Inventories	1,088			1,030
Other	667			663
Total current assets	5,714			5,498
Property and equipment, net	12,192			11,110
Investments in and advances to affiliates	29			22
Goodwill and other intangible assets	5,736			4,893
Other	29			47
Total assets	23,700			21,570
Current liabilities:
Accounts payable	1,627			1,793
Accrued salaries	914			862
Other accrued expenses	790			536
Long-term debt due within one year	61			64
Total current liabilities	3,392			3,255
Long-term debt, net	281			307
Intercompany balances	(27,263)			(25,228)
Income taxes and other liabilities	364			357
Total liabilities	(23,226)			(21,309)
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	46,846			42,755
Noncontrolling interests	80			124
Total stockholders' deficit	46,926			42,879
Total liabilities and stockholders' deficit	23,700			21,570
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	46,846			42,755
Noncontrolling interests	80			124
Total stockholders' deficit	46,926			42,879
Total liabilities and stockholders' deficit	23,700			21,570
Subsidiary Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	473			619
Accounts receivable	2,678			2,808
Inventories	546			543
Other	552			508
Total current assets	4,249			4,478
Property and equipment, net	6,849			6,785
Investments of insurance subsidiaries	367			418
Investments in and advances to affiliates	209			177
Goodwill and other intangible assets	2,023			2,501
Other	105			103
Total assets	13,802			14,462
Current liabilities:
Accounts payable	787			813
Accrued salaries	542			507
Other accrued expenses	1,074			1,040
Long-term debt due within one year	33			39
Total current liabilities	2,436			2,399
Long-term debt, net	168			189
Intercompany balances	(1,793)			(352)
Professional liability risks	1,239			1,198
Income taxes and other liabilities	516			465
Total liabilities	2,566			3,899
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	9,441			8,876
Noncontrolling interests	1,795			1,687
Total stockholders' deficit	11,236			10,563
Total liabilities and stockholders' deficit	13,802			14,462
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	9,441			8,876
Noncontrolling interests	1,795			1,687
Total stockholders' deficit	11,236			10,563
Total liabilities and stockholders' deficit	13,802			14,462
Eliminations [Member]
Current assets:
Investments in and advances to affiliates	(32,263)			(29,581)
Total assets	(32,263)			(29,581)
Current liabilities:
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(32,263)			(29,581)
Total stockholders' deficit	(32,263)			(29,581)
Total liabilities and stockholders' deficit	(32,263)			(29,581)
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(32,263)			(29,581)
Total stockholders' deficit	(32,263)			(29,581)
Total liabilities and stockholders' deficit	$ (32,263)			$ (29,581)

Supplemental Condensed Consol_6

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net income (loss)	$ 896	$ 530	$ 3,144	$ 2,102
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(147)	(289)
Depreciation and amortization	582	539	1,697	1,581
Income taxes				(9)
Gain on sales of facilities	(6)	(7)	(420)	(10)
Losses on retirement of debt	9	39	9	39
Amortization of debt issuance costs			23	23
Share-based compensation			204	195
Other			76	60
Net cash provided by (used in) operating activities			4,586	3,692
Cash flows from investing activities:
Purchase of property and equipment			(2,420)	(2,033)
Acquisition of hospitals and health care entities			(1,056)	(1,142)
Disposition of hospitals and health care entities			802	24
Change in investments			65	(15)
Other			(6)	(6)
Net cash used in investing activities			(2,615)	(3,172)
Cash flows from financing activities:
Issuance of long-term debt			2,000	1,502
Net change in revolving credit facilities			(330)	650
Repayment of long-term debt			(1,652)	(700)
Distributions to noncontrolling interests			(315)	(363)
Payment of debt issuance costs			(24)	(25)
Payment of cash dividends			(366)
Repurchases of common stock			(1,195)	(1,475)
Other			(232)	(37)
Net cash (used in) provided by financing activities			(2,114)	(448)
Effect on exchange rate changes on cash and cash equivalents			(11)
Change in cash and cash equivalents			(154)	72
Cash and cash equivalents at beginning of period			732	646
Cash and cash equivalents at end of period	578	718	578	718
Eliminations [Member]
Cash flows from operating activities:
Net income (loss)	(728)	(436)	(2,670)	(1,702)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in earnings of affiliates			2,670	1,702
HCA Healthcare, Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	759	426	2,723	1,742
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(15)	(15)
Income taxes				(9)
Equity in earnings of affiliates			(2,670)	(1,702)
Other			67	58
Net cash provided by (used in) operating activities			105	74
Cash flows from financing activities:
Payment of cash dividends			(366)
Repurchases of common stock			(1,195)	(1,475)
Changes in intercompany balances with affiliates, net			1,697	1,468
Other			(242)	(66)
Net cash (used in) provided by financing activities			(106)	(73)
Change in cash and cash equivalents			(1)	1
Cash and cash equivalents at beginning of period			1
Cash and cash equivalents at end of period		1		1
HCA Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	(708)	(524)	(2,016)	(1,463)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(83)	(293)
Losses on retirement of debt	9	39	9	39
Amortization of debt issuance costs			23	23
Net cash provided by (used in) operating activities			(2,067)	(1,694)
Cash flows from financing activities:
Issuance of long-term debt			2,000	1,500
Net change in revolving credit facilities			(330)	650
Repayment of long-term debt			(1,566)	(604)
Payment of debt issuance costs			(24)	(25)
Changes in intercompany balances with affiliates, net			1,987	173
Net cash (used in) provided by financing activities			2,067	1,694
Subsidiary Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	1,275	928	4,151	2,843
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(154)	(191)
Depreciation and amortization	340	311	992	923
Gain on sales of facilities	(6)	(3)	(378)	(6)
Share-based compensation			204	195
Other				2
Net cash provided by (used in) operating activities			4,815	3,766
Cash flows from investing activities:
Purchase of property and equipment			(1,425)	(1,161)
Acquisition of hospitals and health care entities			(894)	(9)
Disposition of hospitals and health care entities			770	12
Change in investments			19	1
Other			(18)	(7)
Net cash used in investing activities			(1,548)	(1,164)
Cash flows from financing activities:
Repayment of long-term debt			(44)	(54)
Distributions to noncontrolling interests			(63)	(105)
Changes in intercompany balances with affiliates, net			(3,167)	(2,439)
Other				1
Net cash (used in) provided by financing activities			(3,274)	(2,597)
Change in cash and cash equivalents			(7)	5
Cash and cash equivalents at beginning of period			112	114
Cash and cash equivalents at end of period	105	119	105	119
Subsidiary Non-Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	298	136	956	682
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			105	210
Depreciation and amortization	242	228	705	658
Gain on sales of facilities		(4)	(42)	(4)
Other			9
Net cash provided by (used in) operating activities			1,733	1,546
Cash flows from investing activities:
Purchase of property and equipment			(995)	(872)
Acquisition of hospitals and health care entities			(162)	(1,133)
Disposition of hospitals and health care entities			32	12
Change in investments			46	(16)
Other			12	1
Net cash used in investing activities			(1,067)	(2,008)
Cash flows from financing activities:
Issuance of long-term debt				2
Repayment of long-term debt			(42)	(42)
Distributions to noncontrolling interests			(252)	(258)
Changes in intercompany balances with affiliates, net			(517)	798
Other			10	28
Net cash (used in) provided by financing activities			(801)	528
Effect on exchange rate changes on cash and cash equivalents			(11)
Change in cash and cash equivalents			(146)	66
Cash and cash equivalents at beginning of period			619	532
Cash and cash equivalents at end of period	$ 473	$ 598	$ 473	$ 598

Supplemental Condensed Consol_7

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Summary of Restatement Adjustments to Financial Statements (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	$ 759	$ 426	$ 2,723	$ 1,742
Net cash provided by operating activities				3,692
HCA Healthcare, Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	759	426	2,723	1,742
Net cash provided by operating activities				74
HCA Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	(708)	(524)	(2,016)	(1,463)
Net cash provided by operating activities				(1,694)
Subsidiary Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	1,253	904	4,079	2,769
Net cash provided by operating activities				3,766
Subsidiary Non-Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	183	56	607	396
Net cash provided by operating activities				1,546
Eliminations [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	$ (728)	(436)	$ (2,670)	(1,702)
As Previously Reported [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		426		1,742
Net cash provided by operating activities				3,692
As Previously Reported [Member] | HCA Healthcare, Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		426		1,742
Net cash provided by operating activities				74
As Previously Reported [Member] | HCA Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		(524)		(1,463)
Net cash provided by operating activities				(1,694)
As Previously Reported [Member] | Subsidiary Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		787		2,467
Net cash provided by operating activities				3,342
As Previously Reported [Member] | Subsidiary Non-Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		173		698
Net cash provided by operating activities				1,970
As Previously Reported [Member] | Eliminations [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		(436)		(1,702)
Adjustment [Member] | Subsidiary Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		117		302
Net cash provided by operating activities				424
Adjustment [Member] | Subsidiary Non-Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		$ (117)		(302)
Net cash provided by operating activities				$ (424)