HCA Healthcare (HCA) 10-Q1 Nov 192019 Q3 Quarterly reportFinancial data

Company Profile

Cover Page

Cover Page - shares	9 Months Ended
Cover Page - shares	Sep. 30, 2019	Oct. 31, 2019
Cover [Abstract]
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2019
Amendment Flag	false
Document Type	10-Q
Entity Central Index Key	0000860730
Document Period End Date	Sep. 30, 2019
Current Fiscal Year End Date	--12-31
Trading Symbol	HCA
Entity Registrant Name	HCA Healthcare, Inc.
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		339,178,300
Entity Interactive Data Current	Yes
Entity File Number	1-11239
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-3865930
Entity Address, Address Line One	One Park Plaza
Entity Address, City or Town	Nashville
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37203
City Area Code	615
Local Phone Number	344-9551
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Voting common stock
Security Exchange Name	NYSE

Condensed Consolidated Income S

Condensed Consolidated Income Statements - USD ($) shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Revenues	$ 12,694	$ 11,451	$ 37,813	$ 34,403
Salaries and benefits	5,971	5,377	17,455	15,940
Supplies	2,090	1,890	6,249	5,722
Other operating expenses	2,352	2,097	7,013	6,325
Equity in earnings of affiliates	(4)	(9)	(23)	(25)
Depreciation and amortization	647	582	1,902	1,697
Interest expense	448	442	1,386	1,309
Gains on sales of facilities		(6)	(17)	(420)
Losses on retirement of debt	211	9	211	9
Total expenses including equity in earnings of affiliates	11,715	10,382	34,176	30,557
Income before income taxes	979	1,069	3,637	3,846
Provision for income taxes	215	173	765	702
Net income	764	896	2,872	3,144
Net income attributable to noncontrolling interests	152	137	438	421
Net income attributable to HCA Healthcare, Inc.	$ 612	$ 759	$ 2,434	$ 2,723
Per share data:
Basic earnings	$ 1.80	$ 2.20	$ 7.12	$ 7.82
Diluted earnings	$ 1.76	$ 2.15	$ 6.98	$ 7.65
Shares used in earnings per share calculations (in millions):
Basic	340,789	345,823	341,932	348,411
Diluted	347,487	353,639	348,712	356,124

Condensed Consolidated Comprehe

Condensed Consolidated Comprehensive Income Statements - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement of Comprehensive Income [Abstract]
Net income	$ 764	$ 896	$ 2,872	$ 3,144
Other comprehensive income (loss) before taxes:
Foreign currency translation	(30)	(13)	(48)	(35)
Unrealized gains (losses) on available-for-salesecurities	2	(2)	16	(8)
Defined benefit plans	0		0
Pension costs included in salaries and benefits	3	5	10	15
Total defined benefit plans	3	5	10	15
Change in fair value of derivative financial instruments	(7)	10	(59)	60
Interest benefits included in interest expense	(4)	(3)	(15)	(5)
Total change in fair value of derivative financial instruments	(11)	7	(74)	55
Other comprehensive (loss) income before taxes	(36)	(3)	(96)	27
Income taxes (benefits) related to other comprehensive income items	(6)	2	(16)	15
Other comprehensive (loss) income	(30)	(5)	(80)	12
Comprehensive income	734	891	2,792	3,156
Comprehensive income attributable to noncontrolling interests	152	137	438	421
Comprehensive income attributable to HCA Healthcare, Inc.	$ 582	$ 754	$ 2,354	$ 2,735

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 559	$ 502
Accounts receivable	7,131	6,789
Inventories	1,769	1,732
Other	1,310	1,190
Total current assets	10,769	10,213
Property and equipment, at cost	46,295	42,965
Accumulated depreciation	(24,293)	(23,208)
Property and equipment, net	22,002	19,757
Investments of insurance subsidiaries	357	362
Investments in and advances to affiliates	243	232
Goodwill and other intangible assets	8,160	7,953
Right-of-use operating lease assets	1,770
Other	611	690
Total assets	43,912	39,207
Current liabilities:
Accounts payable	2,610	2,577
Accrued salaries	1,669	1,580
Other accrued expenses	2,697	2,624
Long-term debt due within one year	148	788
Total current liabilities	7,124	7,569
Long-term debt, less debt issuance costs and discounts of $244 and $157	34,097	32,033
Professional liability risks	1,349	1,275
Right-of-use operating lease obligations	1,440
Income taxes and other liabilities	1,349	1,248
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 340,053,100 shares in 2019 and 342,895,200 shares in 2018	3	3
Accumulated other comprehensive loss	(461)	(381)
Retained deficit	(3,107)	(4,572)
Stockholders' deficit attributable to HCA Healthcare, Inc.	(3,565)	(4,950)
Noncontrolling interests	2,118	2,032
Total stockholders' deficit	(1,447)	(2,918)
Total liabilities and stockholders' deficit	$ 43,912	$ 39,207

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Debt issuance costs	$ 244	$ 157
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	340,053,100	342,895,200

Condensed Consolidated Statemen

Condensed Consolidated Statements of Stockholders' Deficit - USD ($) shares in Thousands, $ 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, 2017	$ (4,995)	$ 4		$ (278)	$ (6,532)	$ 1,811
Balance, shares at Dec. 31, 2017		350,092
Comprehensive income (loss)	1,363			81	1,144	138
Repurchase of common stock	(423)		$ 114		(537)
Repurchase of common stock, shares		(4,370)
Share-based benefit plans	(114)		(114)
Share-based benefit plans, shares		5,265
Cash dividends declared	(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
Balances at Dec. 31, 2017	(4,995)	$ 4		(278)	(6,532)	1,811
Balance, shares at Dec. 31, 2017		350,092
Comprehensive income (loss)	3,156
Balance at Sep. 30, 2018	(3,730)	$ 3		(266)	(5,342)	1,875
Balance, shares at Sep. 30, 2018		345,086
Balances at Mar. 31, 2018	(4,434)	$ 4		(197)	(6,051)	1,810
Balance, shares at Mar. 31, 2018		350,987
Comprehensive income (loss)	902			(64)	820	146
Repurchase of common stock	(470)	$ (1)	(93)		(376)
Repurchase of common stock, shares		(4,670)
Share-based benefit plans	96		96
Share-based benefit plans, shares		443
Cash dividends declared	(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
Comprehensive income (loss)	891			(5)	759	137
Repurchase of common stock	(302)		(55)		(247)
Repurchase of common stock, shares		(2,518)
Share-based benefit plans	54		54
Share-based benefit plans, shares		844
Cash dividends declared	(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
Comprehensive income (loss)	1,225			(20)	1,064	181
Repurchase of common stock	(335)		(69)		(266)
Repurchase of common stock, shares		(2,512)
Share-based benefit plans	79		79
Share-based benefit plans, shares		321
Cash dividends declared	(123)				(123)
Distributions	(126)					(126)
Other	92		(10)	(95)	95	102
Balance at Dec. 31, 2018	(2,918)	$ 3		(381)	(4,572)	2,032
Balance, shares at Dec. 31, 2018		342,895
Comprehensive income (loss)	1,188			7	1,039	142
Repurchase of common stock	(278)		32		(310)
Repurchase of common stock, shares		(2,106)
Share-based benefit plans	(29)		(29)
Share-based benefit plans, shares		2,242
Cash dividends declared	(140)				(140)
Distributions	(136)					(136)
Other	58		(3)			61
Balance at Mar. 31, 2019	(2,255)	$ 3		(374)	(3,983)	2,099
Balance, shares at Mar. 31, 2019		343,031
Balances at Dec. 31, 2018	(2,918)	$ 3		(381)	(4,572)	2,032
Balance, shares at Dec. 31, 2018		342,895
Comprehensive income (loss)	$ 2,792
Repurchase of common stock, shares	(5,880)
Balance at Sep. 30, 2019	$ (1,447)	$ 3		(461)	(3,107)	2,118
Balance, shares at Sep. 30, 2019		340,053
Balances at Mar. 31, 2019	(2,255)	$ 3		(374)	(3,983)	2,099
Balance, shares at Mar. 31, 2019		343,031
Comprehensive income (loss)	870			(57)	783	144
Repurchase of common stock	(242)		(107)		(135)
Repurchase of common stock, shares		(1,928)
Share-based benefit plans	118		118
Share-based benefit plans, shares		414
Cash dividends declared	(139)				(139)
Distributions	(111)					(111)
Other	(11)		(11)
Balance at Jun. 30, 2019	(1,770)	$ 3		(431)	(3,474)	2,132
Balance, shares at Jun. 30, 2019		341,517
Comprehensive income (loss)	734			(30)	612	152
Repurchase of common stock	(239)		(132)		(107)
Repurchase of common stock, shares		(1,846)
Share-based benefit plans	128		128
Share-based benefit plans, shares		382
Cash dividends declared	(138)				(138)
Distributions	(157)					(157)
Other	(5)		$ 4			(9)
Balance at Sep. 30, 2019	$ (1,447)	$ 3		$ (461)	$ (3,107)	$ 2,118
Balance, shares at Sep. 30, 2019		340,053

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Deficit (Parenthetical) - $ / shares	3 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018
Statement of Stockholders' Equity [Abstract]
Cash dividends declared, per share	$ 0.40	$ 0.40	$ 0.40	$ 0.35	$ 0.35	$ 0.35	$ 0.35

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income	$ 2,872	$ 3,144
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(93)	(161)
Inventories and other assets	(95)	(136)
Accounts payable and accrued expenses	(118)	150
Depreciation and amortization	1,902	1,697
Income taxes	51
Gains on sales of facilities	(17)	(420)
Losses on retirement of debt	211	9
Amortization of debt issuance costs and discounts	23	23
Share-based compensation	263	204
Other	98	76
Net cash provided by (used in) operating activities	5,097	4,586
Cash flows from investing activities:
Purchase of property and equipment	(2,884)	(2,420)
Acquisition of hospitals and health care entities	(1,592)	(1,056)
Disposal of hospitals and health care entities	49	802
Change in investments	35	65
Other	17	(6)
Net cash used in investing activities	(4,375)	(2,615)
Cash flows from financing activities:
Issuances of long-term debt	6,451	2,000
Net change in revolving bank credit facilities	(30)	(330)
Repayment of long-term debt	(5,289)	(1,652)
Distributions to noncontrolling interests	(404)	(315)
Payment of debt issuance costs	(71)	(24)
Payment of cash dividends	(414)	(366)
Repurchases of common stock	(759)	(1,195)
Other	(145)	(232)
Net cash (used in) provided by financing activities	(661)	(2,114)
Effect of exchange rate changes on cash and cash equivalents	(4)	(11)
Change in cash and cash equivalents	57	(154)
Cash and cash equivalents at beginning of period	502	732
Cash and cash equivalents at end of period	559	578
Interest payments	1,492	1,422
Income tax payments, net	$ 714	$ 702

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	9 Months Ended
Basis of Presentation and Significant Accounting Policies	Sep. 30, 2019
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, 2019, these affiliates owned and operated 184 hospitals, 125 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 21 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 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 $88 million and $90 million for the quarters ended September 30, 2019 and 2018, respectively, and $268 million and $254 million for the nine months ended September 30, 2019 and 2018, respectively. Operating results for the quarter and nine months ended September 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K Revenues 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 out-of-network reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. 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 2019 Ratio 2018 Ratio Medicare $ 2,592 20.4 % $ 2,404 21.0 % Managed Medicare 1,615 12.7 1,344 11.7 Medicaid 361 2.8 338 3.0 Managed Medicaid 641 5.0 622 5.4 Managed care and insurers 6,554 51.7 6,026 52.6 International (managed care and insurers) 282 2.2 273 2.4 Other 649 5.2 444 3.9 Revenues $ 12,694 100.0 % $ 11,451 100.0 % Nine Months 2019 Ratio 2018 Ratio Medicare $ 7,997 21.2 % $ 7,353 21.4 % Managed Medicare 4,799 12.7 4,088 11.9 Medicaid 1,124 3.0 976 2.8 Managed Medicaid 1,808 4.8 1,769 5.1 Managed care and insurers 19,405 51.1 18,081 52.6 International (managed care and insurers) 863 2.3 873 2.5 Other 1,817 4.9 1,263 3.7 Revenues $ 37,813 100.0 % $ 34,403 100.0 % 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, 2019 and 2018 follows (dollars in millions): Quarter Nine Months 2019 2018 2019 2018 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 11,060 $ 9,946 $ 32,619 $ 29,684 Cost-to-charges 12.3 % 12.7 % 12.1 % 12.6 % Total uncompensated care $ 7,923 $ 6,786 $ 22,703 $ 19,524 Multiply by the cost-to-charges 12.3 % 12.7 % 12.1 % 12.6 % Estimated cost of total uncompensated care $ 975 $ 862 $ 2,747 $ 2,460 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 38.4% and 37.2% for the quarters ended September 30, 2019 and 2018, respectively, and 37.5% and 36.2% for the nine months ended September 30, 2019 and 2018, respectively. The total uncompensated care amounts include charity care of $3.425 billion and $2.314 billion, and the related estimated costs of charity care were $421 million and $295 million, for the quarters ended September 30, 2019 and 2018, respectively. The total uncompensated care amounts include charity care of $9.641 billion and $6.170 billion, and the related estimated costs of charity care were $1.167 billion and $777 million, for the nine months ended September 30, 2019 and 2018, respectively. Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Acquisitions and Dispositions

Acquisitions and Dispositions	9 Months Ended
Acquisitions and Dispositions	Sep. 30, 2019
Business Combinations [Abstract]
Acquisitions and Dispositions	NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the nine months ended September 30, 2019, we paid $1.399 billion to acquire a seven-hospital health system in North Carolina and $193 million to acquire other nonhospital health care entities. 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. 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 $231 million for the nine months ended September 30, 2019. 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, 2019, we received proceeds of $25 million and recognized a net pretax loss of $1 million related to a sale of a hospital facility in one of our Louisiana markets. During the nine months ended September 30, 2019, we also received proceeds of $24 million and recognized a net pretax gain of $18 million related to sales of real estate and other investments. 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

Income Taxes

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 3 — INCOME TAXES Our provision for income taxes for the quarters ended September 30, 2019 and 2018 was $215 million and $173 million, respectively, and the effective tax rates were 26.0% and 18.6%, respectively. Our provision for income taxes for the nine months ended September 30, 2019 and 2018 was $765 million and $702 million, respectively, and the effective tax rates were 23.9% and 20.5%, respectively. Our provision for income taxes included tax benefits related to the settlement of employee equity awards of $3 million and $23 million for the quarters ended September 30, 2019 and 2018, respectively, and $56 million and $119 million for the nine months ended September 30, 2019 and 2018, 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. Our liability for unrecognized tax benefits was $540 million, including accrued interest of $56 million, as of September 30, 2019 ($435 million and $48 million, respectively, as of December 31, 2018). Unrecognized tax benefits of $147 million ($137 million as of December 31, 2018) would affect the effective rate, if recognized. The Internal Revenue Service began an examination of the Company’s 2016 and 2017 federal income tax returns during 2019. We are also subject to examination by 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
Earnings Per Share	Sep. 30, 2019
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, 2019 and 2018 (dollars and shares in millions, except per share amounts): Quarter Nine Months 2019 2018 2019 2018 Net income attributable to HCA Healthcare, Inc. $ 612 $ 759 $ 2,434 $ 2,723 Weighted average common shares outstanding 340.789 345.823 341.932 348.411 Effect of dilutive incremental shares 6.698 7.816 6.780 7.713 Shares used for diluted earnings per share 347.487 353.639 348.712 356.124 Earnings per share: Basic earnings $ 1.80 $ 2.20 $ 7.12 $ 7.82 Diluted earnings $ 1.76 $ 2.15 $ 6.98 $ 7.65

Investments of Insurance Subsid

Investments of Insurance Subsidiaries	9 Months Ended
Investments of Insurance Subsidiaries	Sep. 30, 2019
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, 2019 and December 31, 2018 follows (dollars in millions): September 30, 2019 Amortized Unrealized Fair Gains Losses Debt securities $ 337 $ 19 $ — $ 356 Money market funds and other 97 — — 97 $ 434 $ 19 $ — 453 Amounts classified as current assets (96 ) Investment carrying value $ 357 December 31, 2018 Amortized Unrealized Fair Gains Losses Debt securities $ 338 $ 5 $ (2 ) $ 341 Money market funds and other 68 — — 68 $ 406 $ 5 $ (2 ) 409 Amounts classified as current assets (47 ) Investment carrying value $ 362 At September 30, 2019 and December 31, 2018, the investments of our insurance subsidiaries were classified as “available-for-sale.” Scheduled maturities of investments in debt securities at September 30, 2019 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 12 $ 12 Due after one year through five years 76 79 Due after five years through ten years 183 195 Due after ten years 66 70 $ 337 $ 356 The average expected maturity of the investments in debt securities at September 30, 2019 was 5.6 years, compared to the average scheduled maturity of 10.0 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
Financial Instruments	Sep. 30, 2019
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, 2019 (dollars in millions): Notional Maturity Date Fair Pay-fixed $ 2,000 December 2021 $ (1 ) Pay-fixed 500 December 2022 (10 ) During the next 12 months, we estimate $2 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, 2019 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Gain Amount of Gain Interest rate swaps $ 45 Interest expense $ 15 Credit-risk-related Contingent Features We have agreements with each of our derivative counterparties that contain a provision where we could be declared in default on our derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to our default on the indebtedness. As of September 30, 2019, we have not been required to post any collateral related to these agreements. If we had breached these provisions at September 30, 2019, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $ 11

Assets and Liabilities Measured

Assets and Liabilities Measured at Fair Value	9 Months Ended
Assets and Liabilities Measured at Fair Value	Sep. 30, 2019
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 of the reporting entity (observable inputs classified within Levels and of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level of the hierarchy). Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment. 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, 2019 and December 31, 2018, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of September 30, 2019 and December 31, 2018, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): September 30, 2019 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 356 $ — $ 356 $ — Money market funds and other 97 97 — — Investments of insurance subsidiaries 453 97 356 — Less amounts classified as current assets (96 ) (96 ) — — $ 357 $ 1 $ 356 $ — Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 11 $ — $ 11 $ — December 31, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 341 $ — $ 341 $ — Money market funds and other 68 68 — — Investments of insurance subsidiaries 409 68 341 — Less amounts classified as current assets (47 ) (47 ) — — $ 362 $ 21 $ 341 $ — Interest rate swaps (Other) $ 63 $ — $ 63 $ — The estimated fair value of our long-term debt was $37.162 billion and $32.887 billion at September 30, 2019 and December 31, 2018, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $34.489 billion and $32.978 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
Long-Term Debt	Sep. 30, 2019
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 8 — LONG-TERM DEBT A summary of long-term debt at September 30, 2019 and December 31, 2018, including related interest rates at September 30, 2019, follows (dollars in millions): September 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.3%) $ 3,010 $ 3,040 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 3.5%) 3,739 3,801 Senior secured notes (effective interest rate of 5.1%) 13,850 13,800 Other senior secured debt (effective interest rate of 5.5%) 638 585 Senior secured debt 21,237 21,226 Senior unsecured notes (effective interest rate of 6.3%) 13,252 11,752 Debt issuance costs and discounts (244 ) (157 ) Total debt (average life of 8.7 years, rates averaging 5.2%) 34,245 32,821 Less amounts due within one year 148 788 $ 34,097 $ 32,033 During January 2019, we issued $1.500 billion aggregate principal amount of senior unsecured notes comprised of $1.000 billion aggregate principal amount of 5.875% notes due 2029 and $500 million aggregate principal amount of 5.625% notes due 2028. We used the net proceeds to fund the purchase of a seven-hospital health system located in western North Carolina. During June 2019, we issued $5.000 billion aggregate principal amount of senior secured notes comprised of $2.000 billion aggregate principal amount of 4 1/8 5 1/8 5 1/4

Leases

Leases	9 Months Ended
Leases	Sep. 30, 2019
Leases [Abstract]
Leases	NOTE 9 — LEASES We adopted ASU No. 2016-02, Leases (Topic 842) We lease property and equipment under finance and operating leases. For leases with terms greater than 12 months, we record the related right-of-use right-of-use Generally, we use our estimated incremental borrowing rate to discount the lease payments based on information available at lease commencement, as most of our leases do not provide a readily determinable implicit interest rate . The following table presents our lease-related assets and liabilities at September 30, 2019 (dollars in millions): Balance Sheet Classification September 30, 2019 Assets: Operating leases Right-of-use $ 1,770 Finance leases Property and equipment 486 Total lease assets $ 2,256 Liabilities: Current: Operating leases Other accrued expenses $ 344 Finance leases Long-term debt due within one year 89 Noncurrent: Operating leases Right-of-use 1,440 Finance leases Long-term debt 451 Total lease liabilities $ 2,324 Weighted-average remaining term: Operating leases 10.8 years Finance leases 10.6 years Weighted-average discount rate: Operating leases(1) 5.4 % Finance leases 6.1 % (1) Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019. The following table presents certain information related to lease expense for finance and operating leases for the quarter and nine months ended September 30, 2019 (dollars in millions): 2019 Quarter Nine Finance lease expense: Amortization of leased assets $ 33 $ 70 Interest on lease liabilities 9 24 Operating leases(2) 94 287 Short-term lease expense(2) 82 235 Variable lease expense(2) 40 114 $ 258 $ 730 (2) Expenses are included in “other operating expenses” in our condensed consolidated income statements. Other Information The following table presents supplemental cash flow information for the nine months ended September 30, 2019 (dollars in millions): 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 293 Operating cash flows for finance leases 24 Financing cash flows for finance leases 58 Maturities of Lease Liabilities The following table reconciles the undiscounted cash flows to the finance lease liabilities and operating lease liabilities recorded on the balance sheet at September 30, 2019 (dollars in millions): Operating Finance Year 1 $ 388 $ 107 Year 2 339 102 Year 3 279 97 Year 4 221 57 Year 5 175 61 Thereafter 1,038 353 Total minimum lease payments 2,440 777 Less: amount of lease payments representing interest (656 ) (237 ) Present value of future minimum lease payments 1,784 540 Less: current obligations under leases (344 ) (89 ) Long-term lease obligations $ 1,440 $ 451

Contingencies

Contingencies	9 Months Ended
Contingencies	Sep. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Contingencies	NOTE 10 — 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 (“FCA”), private parties have the right to bring qui tam Texas operates a state Medicaid program pursuant to a waiver from CMS under Section 1115 of the Social Security Act (“Program”). The Program includes uncompensated-care pools; payments from these pools are intended to defray the uncompensated costs of services provided by our and other hospitals to Medicaid eligible or uninsured individuals. Separately, we and other hospitals provide charity care services in several communities in the state. We believe that our participation is and has been consistent with the requirements of the Program. In 2018, the Civil Division of the U.S. Department of Justice and the U.S. Attorney’s Office for the Southern District of Texas requested information about whether the Program, as operated in Harris County, complied with the laws and regulations applicable to provider related donations, and the Company cooperated with that request. On May 21, 2019, a qui tam qui tam . T lawsuit being pursued by the relator qui tam

Share Repurchase Transactions a

Share Repurchase Transactions and Other Comprehensive Loss	9 Months Ended
Share Repurchase Transactions and Other Comprehensive Loss	Sep. 30, 2019
Federal Home Loan Banks [Abstract]
Share Repurchases Transactions and Other Comprehensive Loss	NOTE 11 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS During January 2019, our Board of Directors authorized a share repurchase program for up to $2 billion of our outstanding common stock. During the nine months ended September 30, 2019, we repurchased 5.880 million shares of our common stock at an average price of $129.12 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during October 2017 (which was completed during 2019) and the $2.0 billion share repurchase program authorized during January 2019. At September 30, 2019, we had $1.513 billion of repurchase authorization available under the January 2019 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, 2018 $ 3 $ (283 ) $ (148 ) $ 47 $ (381 ) Unrealized gains on available-for-sale 12 — — — 12 Foreign currency translation adjustments, net of $5 income tax benefit — (43 ) — — (43 ) Change in fair value of derivative instruments, net of $14 income tax benefit — — — (45 ) (45 ) Expense (income) reclassified into operations from other comprehensive income, net of $2 income tax benefit and $3 of income taxes, respectively — — 8 (12 ) (4 ) Balances at September 30, 2019 $ 15 $ (326 ) $ (140 ) $ (10 ) $ (461 )

Segment and Geographic Informat

Segment and Geographic Information	9 Months Ended
Segment and Geographic Information	Sep. 30, 2019
Segment Reporting [Abstract]
Segment and Geographic Information	NOTE 12 — 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 95 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 83 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, 2019 and 2018 are summarized in the following table (dollars in millions): Quarter Nine Months 2019 2018 2019 2018 Revenues: National Group $ 6,398 $ 5,542 $ 19,159 $ 16,719 American Group 5,780 5,396 17,001 16,113 Corporate and other 516 513 1,653 1,571 $ 12,694 $ 11,451 $ 37,813 $ 34,403 Equity in earnings of affiliates: National Group $ 2 $ (1 ) $ (3 ) $ (5 ) American Group (10 ) (10 ) (32 ) (29 ) Corporate and other 4 2 12 9 $ (4 ) $ (9 ) $ (23 ) $ (25 ) Adjusted segment EBITDA: National Group $ 1,270 $ 1,127 $ 4,088 $ 3,593 American Group 1,185 1,072 3,443 3,250 Corporate and other (170 ) (103 ) (412 ) (402 ) $ 2,285 $ 2,096 $ 7,119 $ 6,441 Depreciation and amortization: National Group $ 291 $ 245 $ 839 $ 702 American Group 277 258 828 765 Corporate and other 79 79 235 230 $ 647 $ 582 $ 1,902 $ 1,697 Adjusted segment EBITDA $ 2,285 $ 2,096 $ 7,119 $ 6,441 Depreciation and amortization 647 582 1,902 1,697 Interest expense 448 442 1,386 1,309 Gains on sales of facilities — (6 ) (17 ) (420 ) Losses on retirement of debt 211 9 211 9 Income before income taxes $ 979 $ 1,069 $ 3,637 $ 3,846

Supplemental Condensed Consolid

Supplemental Condensed Consolidating Financial Information	9 Months Ended
Supplemental Condensed Consolidating Financial Information	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental Condensed Consolidating Financial Information And Other Collateral-related Information	NOTE 13 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION HCA Healthcare, Inc. has $1.000 billion aggregate principal amount of 6.250% senior unsecured notes due 2021 outstanding. 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, 2019 and 2018, condensed consolidating balance sheets at September 30, 2019 and December 31, 2018 and condensed consolidating statements of cash flows for the nine months ended September 30, 2019 and 2018, 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, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 7,196 $ 5,498 $ — $ 12,694 Salaries and benefits — — 3,272 2,699 — 5,971 Supplies — — 1,174 916 — 2,090 Other operating expenses 4 — 1,178 1,170 — 2,352 Equity in earnings of affiliates (656 ) — (2 ) (2 ) 656 (4 ) Depreciation and amortization — — 362 285 — 647 Interest expense (income) 16 1,014 (505 ) (77 ) — 448 Losses (gains) on sales of facilities — — (2 ) 2 — — Losses on retirement of debt — 211 — — — 211 Management fees — — (197 ) 197 — — (636 ) 1,225 5,280 5,190 656 11,715 Income (loss) before income taxes 636 (1,225 ) 1,916 308 (656 ) 979 Provision (benefit) for income taxes 24 (279 ) 429 41 — 215 Net income (loss) 612 (946 ) 1,487 267 (656 ) 764 Net income attributable to noncontrolling interests — — 23 129 — 152 Net income (loss) attributable to HCA Healthcare, $ 612 $ (946 ) $ 1,464 $ 138 $ (656 ) $ 612 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 582 $ (954 ) $ 1,467 $ 113 $ (626 ) $ 582 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 NINE MONTHS ENDED SEPTEMBER 30, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 21,549 $ 16,264 $ — $ 37,813 Salaries and benefits — — 9,608 7,847 — 17,455 Supplies — — 3,540 2,709 — 6,249 Other operating expenses 7 — 3,481 3,525 — 7,013 Equity in earnings of affiliates (2,504 ) — (5 ) (18 ) 2,504 (23 ) Depreciation and amortization — — 1,071 831 — 1,902 Interest expense (income) 48 3,019 (1,489 ) (192 ) — 1,386 Gains on sales of facilities — — (9 ) (8 ) — (17 ) Losses on retirement of debt — 211 — — — 211 Management fees — — (573 ) 573 — — (2,449 ) 3,230 15,624 15,267 2,504 34,176 Income (loss) before income taxes 2,449 (3,230 ) 5,925 997 (2,504 ) 3,637 Provision (benefit) for income taxes 15 (745 ) 1,351 144 — 765 Net income (loss) 2,434 (2,485 ) 4,574 853 (2,504 ) 2,872 Net income attributable to noncontrolling interests — — 64 374 — 438 Net income (loss) attributable to HCA Healthcare, Inc. $ 2,434 $ (2,485 ) $ 4,510 $ 479 $ (2,504 ) $ 2,434 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 2,354 $ (2,542 ) $ 4,518 $ 448 $ (2,424 ) $ 2,354 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 BALANCE SHEET SEPTEMBER 30, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 130 $ 429 $ — $ 559 Accounts receivable — — 3,970 3,161 — 7,131 Inventories — — 1,154 615 — 1,769 Other — — 644 666 — 1,310 — — 5,898 4,871 — 10,769 Property and equipment, net — — 13,074 8,928 — 22,002 Investments of insurance subsidiaries — — — 357 — 357 Investments in and advances to affiliates 35,590 — 29 214 (35,590 ) 243 Goodwill and other intangible assets — — 5,719 2,441 — 8,160 Right-of-use — — 436 1,334 — 1,770 Other 434 — 34 143 — 611 $ 36,024 $ — $ 25,190 $ 18,288 $ (35,590 ) $ 43,912 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,699 $ 911 $ — $ 2,610 Accrued salaries — — 993 676 — 1,669 Other accrued expenses 15 332 896 1,454 — 2,697 Long-term debt due within one year — 55 49 44 — 148 15 387 3,637 3,085 — 7,124 Long-term debt, net 997 32,555 213 332 — 34,097 Intercompany balances 37,967 (5,621 ) (32,198 ) (148 ) — — Professional liability risks — — — 1,349 — 1,349 Right-of-use — — 330 1,110 — 1,440 Income taxes and other liabilities 610 11 181 547 — 1,349 39,589 27,332 (27,837 ) 6,275 — 45,359 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (3,565 ) (27,332 ) 52,955 9,967 (35,590 ) (3,565 ) Noncontrolling interests — — 72 2,046 — 2,118 (3,565 ) (27,332 ) 53,027 12,013 (35,590 ) (1,447 ) $ 36,024 $ — $ 25,190 $ 18,288 $ (35,590 ) $ 43,912 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 174 $ 328 $ — $ 502 Accounts receivable — — 3,964 2,825 — 6,789 Inventories — — 1,178 554 — 1,732 Other — — 669 521 — 1,190 — — 5,985 4,228 — 10,213 Property and equipment, net — — 12,450 7,307 — 19,757 Investments of insurance subsidiaries — — — 362 — 362 Investments in and advances to affiliates 33,166 — 29 203 (33,166 ) 232 Goodwill and other intangible assets — — 5,724 2,229 — 7,953 Other 478 64 35 113 — 690 $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207 LIABILITIES AND Current liabilities: Accounts payable $ — $ — $ 1,721 $ 856 $ — $ 2,577 Accrued salaries — — 998 582 — 1,580 Other accrued expenses 142 403 905 1,174 — 2,624 Long-term debt due within one year — 696 55 37 — 788 142 1,099 3,679 2,649 — 7,569 Long-term debt, net 996 30,544 212 281 — 32,033 Intercompany balances 36,951 (6,789 ) (28,415 ) (1,747 ) — — Professional liability risks — — — 1,275 — 1,275 Income taxes and other liabilities 505 — 223 520 — 1,248 38,594 24,854 (24,301 ) 2,978 — 42,125 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (4,950 ) (24,790 ) 48,437 9,519 (33,166 ) (4,950 ) Noncontrolling interests — — 87 1,945 — 2,032 (4,950 ) (24,790 ) 48,524 11,464 (33,166 ) (2,918 ) $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 2,434 $ (2,485 ) $ 4,574 $ 853 $ (2,504 ) $ 2,872 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (69 ) (137 ) (85 ) — (306 ) Depreciation and amortization — — 1,071 831 — 1,902 Income taxes 51 — — — — 51 Gains on sales of facilities — — (9 ) (8 ) — (17 ) Losses on retirement of debt — 211 — — — 211 Amortization of debt issuance costs and discounts — 23 — — — 23 Share-based compensation — — 263 — — 263 Equity in earnings of affiliates (2,504 ) — — — 2,504 — Other 82 — 13 3 — 98 Net cash provided by (used in) operating activities 48 (2,320 ) 5,775 1,594 — 5,097 Cash flows from investing activities: Purchase of property and equipment — — (1,634 ) (1,250 ) — (2,884 ) Acquisition of hospitals and health care entities — — (39 ) (1,553 ) — (1,592 ) Disposition of hospitals and health care entities — — 31 18 — 49 Change in investments — — 1 34 — 35 Other — — (7 ) 24 — 17 Net cash used in investing activities — — (1,648 ) (2,727 ) — (4,375 ) Cash flows from financing activities: Issuance of long-term debt — 6,451 — — — 6,451 Net change in revolving credit facilities — (30 ) — — — (30 ) Repayment of long-term debt — (5,213 ) (45 ) (31 ) — (5,289 ) Distributions to noncontrolling interests — — (79 ) (325 ) — (404 ) Payment of debt issuance costs — (71 ) — — — (71 ) Payment of cash dividends (414 ) — — — — (414 ) Repurchases of common stock (759 ) — — — — (759 ) Changes in intercompany balances with affiliates, net 1,253 1,183 (4,047 ) 1,611 — — Other (128 ) — — (17 ) — (145 ) Net cash ( u ) (48 ) 2,320 (4,171 ) 1,238 — (661 ) Effect on exchange rate changes on cash and cash equivalents — — — (4 ) — (4 ) Change in cash and cash equivalents — — (44 ) 101 — 57 Cash and cash equivalents at beginning of period — — 174 328 — 502 Cash and cash equivalents at end of period $ — $ — $ 130 $ 429 $ — $ 559 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

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2019
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 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 $88 million and $90 million for the quarters ended September 30, 2019 and 2018, respectively, and $268 million and $254 million for the nine months ended September 30, 2019 and 2018, respectively. Operating results for the quarter and nine months ended September 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K
Revenues	Revenues 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 out-of-network reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. 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 2019 Ratio 2018 Ratio Medicare $ 2,592 20.4 % $ 2,404 21.0 % Managed Medicare 1,615 12.7 1,344 11.7 Medicaid 361 2.8 338 3.0 Managed Medicaid 641 5.0 622 5.4 Managed care and insurers 6,554 51.7 6,026 52.6 International (managed care and insurers) 282 2.2 273 2.4 Other 649 5.2 444 3.9 Revenues $ 12,694 100.0 % $ 11,451 100.0 % Nine Months 2019 Ratio 2018 Ratio Medicare $ 7,997 21.2 % $ 7,353 21.4 % Managed Medicare 4,799 12.7 4,088 11.9 Medicaid 1,124 3.0 976 2.8 Managed Medicaid 1,808 4.8 1,769 5.1 Managed care and insurers 19,405 51.1 18,081 52.6 International (managed care and insurers) 863 2.3 873 2.5 Other 1,817 4.9 1,263 3.7 Revenues $ 37,813 100.0 % $ 34,403 100.0 % 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, 2019 and 2018 follows (dollars in millions): Quarter Nine Months 2019 2018 2019 2018 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 11,060 $ 9,946 $ 32,619 $ 29,684 Cost-to-charges 12.3 % 12.7 % 12.1 % 12.6 % Total uncompensated care $ 7,923 $ 6,786 $ 22,703 $ 19,524 Multiply by the cost-to-charges 12.3 % 12.7 % 12.1 % 12.6 % Estimated cost of total uncompensated care $ 975 $ 862 $ 2,747 $ 2,460 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 38.4% and 37.2% for the quarters ended September 30, 2019 and 2018, respectively, and 37.5% and 36.2% for the nine months ended September 30, 2019 and 2018, respectively. The total uncompensated care amounts include charity care of $3.425 billion and $2.314 billion, and the related estimated costs of charity care were $421 million and $295 million, for the quarters ended September 30, 2019 and 2018, respectively. The total uncompensated care amounts include charity care of $9.641 billion and $6.170 billion, and the related estimated costs of charity care were $1.167 billion and $777 million, for the nine months ended September 30, 2019 and 2018, respectively.
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2019 and 2018 are summarized in the following table (dollars in millions): Quarter 2019 Ratio 2018 Ratio Medicare $ 2,592 20.4 % $ 2,404 21.0 % Managed Medicare 1,615 12.7 1,344 11.7 Medicaid 361 2.8 338 3.0 Managed Medicaid 641 5.0 622 5.4 Managed care and insurers 6,554 51.7 6,026 52.6 International (managed care and insurers) 282 2.2 273 2.4 Other 649 5.2 444 3.9 Revenues $ 12,694 100.0 % $ 11,451 100.0 % Nine Months 2019 Ratio 2018 Ratio Medicare $ 7,997 21.2 % $ 7,353 21.4 % Managed Medicare 4,799 12.7 4,088 11.9 Medicaid 1,124 3.0 976 2.8 Managed Medicaid 1,808 4.8 1,769 5.1 Managed care and insurers 19,405 51.1 18,081 52.6 International (managed care and insurers) 863 2.3 873 2.5 Other 1,817 4.9 1,263 3.7 Revenues $ 37,813 100.0 % $ 34,403 100.0 %
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, 2019 and 2018 follows (dollars in millions): Quarter Nine Months 2019 2018 2019 2018 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 11,060 $ 9,946 $ 32,619 $ 29,684 Cost-to-charges 12.3 % 12.7 % 12.1 % 12.6 % Total uncompensated care $ 7,923 $ 6,786 $ 22,703 $ 19,524 Multiply by the cost-to-charges 12.3 % 12.7 % 12.1 % 12.6 % Estimated cost of total uncompensated care $ 975 $ 862 $ 2,747 $ 2,460

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
Earnings Per Share (Tables)	Sep. 30, 2019
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, 2019 and 2018 (dollars and shares in millions, except per share amounts): Quarter Nine Months 2019 2018 2019 2018 Net income attributable to HCA Healthcare, Inc. $ 612 $ 759 $ 2,434 $ 2,723 Weighted average common shares outstanding 340.789 345.823 341.932 348.411 Effect of dilutive incremental shares 6.698 7.816 6.780 7.713 Shares used for diluted earnings per share 347.487 353.639 348.712 356.124 Earnings per share: Basic earnings $ 1.80 $ 2.20 $ 7.12 $ 7.82 Diluted earnings $ 1.76 $ 2.15 $ 6.98 $ 7.65

Investments of Insurance Subs_2

Investments of Insurance Subsidiaries (Tables)	9 Months Ended
Investments of Insurance Subsidiaries (Tables)	Sep. 30, 2019
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	A summary of our insurance subsidiaries’ investments at September 30, 2019 and December 31, 2018 follows (dollars in millions): September 30, 2019 Amortized Unrealized Fair Gains Losses Debt securities $ 337 $ 19 $ — $ 356 Money market funds and other 97 — — 97 $ 434 $ 19 $ — 453 Amounts classified as current assets (96 ) Investment carrying value $ 357 December 31, 2018 Amortized Unrealized Fair Gains Losses Debt securities $ 338 $ 5 $ (2 ) $ 341 Money market funds and other 68 — — 68 $ 406 $ 5 $ (2 ) 409 Amounts classified as current assets (47 ) Investment carrying value $ 362
Schedule of Maturities of Investments	Scheduled maturities of investments in debt securities at September 30, 2019 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 12 $ 12 Due after one year through five years 76 79 Due after five years through ten years 183 195 Due after ten years 66 70 $ 337 $ 356

Financial Instruments (Tables)

Financial Instruments (Tables)	9 Months Ended
Financial Instruments (Tables)	Sep. 30, 2019
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, 2019 (dollars in millions): Notional Maturity Date Fair Pay-fixed $ 2,000 December 2021 $ (1 ) Pay-fixed 500 December 2022 (10 )
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, 2019 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Gain Amount of Gain Interest rate swaps $ 45 Interest expense $ 15

Assets and Liabilities Measur_2

Assets and Liabilities Measured at Fair Value (Tables)	9 Months Ended
Assets and Liabilities Measured at Fair Value (Tables)	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Schedule of Assets Measured at Fair Value on Recurring Basis	The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of September 30, 2019 and December 31, 2018, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): September 30, 2019 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 356 $ — $ 356 $ — Money market funds and other 97 97 — — Investments of insurance subsidiaries 453 97 356 — Less amounts classified as current assets (96 ) (96 ) — — $ 357 $ 1 $ 356 $ — Liabilities: Interest rate swaps (Income taxes and other liabilities) $ 11 $ — $ 11 $ — December 31, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 341 $ — $ 341 $ — Money market funds and other 68 68 — — Investments of insurance subsidiaries 409 68 341 — Less amounts classified as current assets (47 ) (47 ) — — $ 362 $ 21 $ 341 $ — Interest rate swaps (Other) $ 63 $ — $ 63 $ —

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
Long-Term Debt (Tables)	Sep. 30, 2019
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	A summary of long-term debt at September 30, 2019 and December 31, 2018, including related interest rates at September 30, 2019, follows (dollars in millions): September 30, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.3%) $ 3,010 $ 3,040 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 3.5%) 3,739 3,801 Senior secured notes (effective interest rate of 5.1%) 13,850 13,800 Other senior secured debt (effective interest rate of 5.5%) 638 585 Senior secured debt 21,237 21,226 Senior unsecured notes (effective interest rate of 6.3%) 13,252 11,752 Debt issuance costs and discounts (244 ) (157 ) Total debt (average life of 8.7 years, rates averaging 5.2%) 34,245 32,821 Less amounts due within one year 148 788 $ 34,097 $ 32,033

Leases (Tables)

Leases (Tables)	9 Months Ended
Leases (Tables)	Sep. 30, 2019
Leases [Abstract]
Schedule of lease-related assets and liabilities	The following table presents our lease-related assets and liabilities at September 30, 2019 (dollars in millions): Balance Sheet Classification September 30, 2019 Assets: Operating leases Right-of-use $ 1,770 Finance leases Property and equipment 486 Total lease assets $ 2,256 Liabilities: Current: Operating leases Other accrued expenses $ 344 Finance leases Long-term debt due within one year 89 Noncurrent: Operating leases Right-of-use 1,440 Finance leases Long-term debt 451 Total lease liabilities $ 2,324 Weighted-average remaining term: Operating leases 10.8 years Finance leases 10.6 years Weighted-average discount rate: Operating leases(1) 5.4 % Finance leases 6.1 % (1) Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019.
Schedule of lease expense for finance and operating leases	The following table presents certain information related to lease expense for finance and operating leases for the quarter and nine months ended September 30, 2019 (dollars in millions): 2019 Quarter Nine Finance lease expense: Amortization of leased assets $ 33 $ 70 Interest on lease liabilities 9 24 Operating leases(2) 94 287 Short-term lease expense(2) 82 235 Variable lease expense(2) 40 114 $ 258 $ 730 (2) Expenses are included in “other operating expenses” in our condensed consolidated income statements.
Schedule of supplemental cash flow information	The following table presents supplemental cash flow information for the nine months ended September 30, 2019 (dollars in millions): 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 293 Operating cash flows for finance leases 24 Financing cash flows for finance leases 58
Schedule of undiscounted cash flows to the finance lease liabilities and operating lease liabilities recorded on balance sheet	The following table reconciles the undiscounted cash flows to the finance lease liabilities and operating lease liabilities recorded on the balance sheet at September 30, 2019 (dollars in millions): Operating Finance Year 1 $ 388 $ 107 Year 2 339 102 Year 3 279 97 Year 4 221 57 Year 5 175 61 Thereafter 1,038 353 Total minimum lease payments 2,440 777 Less: amount of lease payments representing interest (656 ) (237 ) Present value of future minimum lease payments 1,784 540 Less: current obligations under leases (344 ) (89 ) Long-term lease obligations $ 1,440 $ 451

Share Repurchase Transactions_2

Share Repurchase Transactions and Other Comprehensive Loss (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2018 $ 3 $ (283 ) $ (148 ) $ 47 $ (381 ) Unrealized gains on available-for-sale 12 — — — 12 Foreign currency translation adjustments, net of $5 income tax benefit — (43 ) — — (43 ) Change in fair value of derivative instruments, net of $14 income tax benefit — — — (45 ) (45 ) Expense (income) reclassified into operations from other comprehensive income, net of $2 income tax benefit and $3 of income taxes, respectively — — 8 (12 ) (4 ) Balances at September 30, 2019 $ 15 $ (326 ) $ (140 ) $ (10 ) $ (461 )

Segment and Geographic Inform_2

Segment and Geographic Information (Tables)	9 Months Ended
Segment and Geographic Information (Tables)	Sep. 30, 2019
Segment Reporting [Abstract]
Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA and Depreciation and Amortization	depreciation and amortization for the quarters and nine months ended September 30, 2019 and 2018 are summarized in the following table (dollars in millions): Quarter Nine Months 2019 2018 2019 2018 Revenues: National Group $ 6,398 $ 5,542 $ 19,159 $ 16,719 American Group 5,780 5,396 17,001 16,113 Corporate and other 516 513 1,653 1,571 $ 12,694 $ 11,451 $ 37,813 $ 34,403 Equity in earnings of affiliates: National Group $ 2 $ (1 ) $ (3 ) $ (5 ) American Group (10 ) (10 ) (32 ) (29 ) Corporate and other 4 2 12 9 $ (4 ) $ (9 ) $ (23 ) $ (25 ) Adjusted segment EBITDA: National Group $ 1,270 $ 1,127 $ 4,088 $ 3,593 American Group 1,185 1,072 3,443 3,250 Corporate and other (170 ) (103 ) (412 ) (402 ) $ 2,285 $ 2,096 $ 7,119 $ 6,441 Depreciation and amortization: National Group $ 291 $ 245 $ 839 $ 702 American Group 277 258 828 765 Corporate and other 79 79 235 230 $ 647 $ 582 $ 1,902 $ 1,697 Adjusted segment EBITDA $ 2,285 $ 2,096 $ 7,119 $ 6,441 Depreciation and amortization 647 582 1,902 1,697 Interest expense 448 442 1,386 1,309 Gains on sales of facilities — (6 ) (17 ) (420 ) Losses on retirement of debt 211 9 211 9 Income before income taxes $ 979 $ 1,069 $ 3,637 $ 3,846

Supplemental Condensed Consol_2

Supplemental Condensed Consolidating Financial Information (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 7,196 $ 5,498 $ — $ 12,694 Salaries and benefits — — 3,272 2,699 — 5,971 Supplies — — 1,174 916 — 2,090 Other operating expenses 4 — 1,178 1,170 — 2,352 Equity in earnings of affiliates (656 ) — (2 ) (2 ) 656 (4 ) Depreciation and amortization — — 362 285 — 647 Interest expense (income) 16 1,014 (505 ) (77 ) — 448 Losses (gains) on sales of facilities — — (2 ) 2 — — Losses on retirement of debt — 211 — — — 211 Management fees — — (197 ) 197 — — (636 ) 1,225 5,280 5,190 656 11,715 Income (loss) before income taxes 636 (1,225 ) 1,916 308 (656 ) 979 Provision (benefit) for income taxes 24 (279 ) 429 41 — 215 Net income (loss) 612 (946 ) 1,487 267 (656 ) 764 Net income attributable to noncontrolling interests — — 23 129 — 152 Net income (loss) attributable to HCA Healthcare, $ 612 $ (946 ) $ 1,464 $ 138 $ (656 ) $ 612 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 582 $ (954 ) $ 1,467 $ 113 $ (626 ) $ 582 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 NINE MONTHS ENDED SEPTEMBER 30, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 21,549 $ 16,264 $ — $ 37,813 Salaries and benefits — — 9,608 7,847 — 17,455 Supplies — — 3,540 2,709 — 6,249 Other operating expenses 7 — 3,481 3,525 — 7,013 Equity in earnings of affiliates (2,504 ) — (5 ) (18 ) 2,504 (23 ) Depreciation and amortization — — 1,071 831 — 1,902 Interest expense (income) 48 3,019 (1,489 ) (192 ) — 1,386 Gains on sales of facilities — — (9 ) (8 ) — (17 ) Losses on retirement of debt — 211 — — — 211 Management fees — — (573 ) 573 — — (2,449 ) 3,230 15,624 15,267 2,504 34,176 Income (loss) before income taxes 2,449 (3,230 ) 5,925 997 (2,504 ) 3,637 Provision (benefit) for income taxes 15 (745 ) 1,351 144 — 765 Net income (loss) 2,434 (2,485 ) 4,574 853 (2,504 ) 2,872 Net income attributable to noncontrolling interests — — 64 374 — 438 Net income (loss) attributable to HCA Healthcare, Inc. $ 2,434 $ (2,485 ) $ 4,510 $ 479 $ (2,504 ) $ 2,434 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 2,354 $ (2,542 ) $ 4,518 $ 448 $ (2,424 ) $ 2,354 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
Schedule of Condensed Consolidating Balance Sheet	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET SEPTEMBER 30, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 130 $ 429 $ — $ 559 Accounts receivable — — 3,970 3,161 — 7,131 Inventories — — 1,154 615 — 1,769 Other — — 644 666 — 1,310 — — 5,898 4,871 — 10,769 Property and equipment, net — — 13,074 8,928 — 22,002 Investments of insurance subsidiaries — — — 357 — 357 Investments in and advances to affiliates 35,590 — 29 214 (35,590 ) 243 Goodwill and other intangible assets — — 5,719 2,441 — 8,160 Right-of-use — — 436 1,334 — 1,770 Other 434 — 34 143 — 611 $ 36,024 $ — $ 25,190 $ 18,288 $ (35,590 ) $ 43,912 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,699 $ 911 $ — $ 2,610 Accrued salaries — — 993 676 — 1,669 Other accrued expenses 15 332 896 1,454 — 2,697 Long-term debt due within one year — 55 49 44 — 148 15 387 3,637 3,085 — 7,124 Long-term debt, net 997 32,555 213 332 — 34,097 Intercompany balances 37,967 (5,621 ) (32,198 ) (148 ) — — Professional liability risks — — — 1,349 — 1,349 Right-of-use — — 330 1,110 — 1,440 Income taxes and other liabilities 610 11 181 547 — 1,349 39,589 27,332 (27,837 ) 6,275 — 45,359 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (3,565 ) (27,332 ) 52,955 9,967 (35,590 ) (3,565 ) Noncontrolling interests — — 72 2,046 — 2,118 (3,565 ) (27,332 ) 53,027 12,013 (35,590 ) (1,447 ) $ 36,024 $ — $ 25,190 $ 18,288 $ (35,590 ) $ 43,912 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 174 $ 328 $ — $ 502 Accounts receivable — — 3,964 2,825 — 6,789 Inventories — — 1,178 554 — 1,732 Other — — 669 521 — 1,190 — — 5,985 4,228 — 10,213 Property and equipment, net — — 12,450 7,307 — 19,757 Investments of insurance subsidiaries — — — 362 — 362 Investments in and advances to affiliates 33,166 — 29 203 (33,166 ) 232 Goodwill and other intangible assets — — 5,724 2,229 — 7,953 Other 478 64 35 113 — 690 $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207 LIABILITIES AND Current liabilities: Accounts payable $ — $ — $ 1,721 $ 856 $ — $ 2,577 Accrued salaries — — 998 582 — 1,580 Other accrued expenses 142 403 905 1,174 — 2,624 Long-term debt due within one year — 696 55 37 — 788 142 1,099 3,679 2,649 — 7,569 Long-term debt, net 996 30,544 212 281 — 32,033 Intercompany balances 36,951 (6,789 ) (28,415 ) (1,747 ) — — Professional liability risks — — — 1,275 — 1,275 Income taxes and other liabilities 505 — 223 520 — 1,248 38,594 24,854 (24,301 ) 2,978 — 42,125 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (4,950 ) (24,790 ) 48,437 9,519 (33,166 ) (4,950 ) Noncontrolling interests — — 87 1,945 — 2,032 (4,950 ) (24,790 ) 48,524 11,464 (33,166 ) (2,918 ) $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207
Schedule of Condensed Consolidating Statement of Cash Flows	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 2,434 $ (2,485 ) $ 4,574 $ 853 $ (2,504 ) $ 2,872 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (69 ) (137 ) (85 ) — (306 ) Depreciation and amortization — — 1,071 831 — 1,902 Income taxes 51 — — — — 51 Gains on sales of facilities — — (9 ) (8 ) — (17 ) Losses on retirement of debt — 211 — — — 211 Amortization of debt issuance costs and discounts — 23 — — — 23 Share-based compensation — — 263 — — 263 Equity in earnings of affiliates (2,504 ) — — — 2,504 — Other 82 — 13 3 — 98 Net cash provided by (used in) operating activities 48 (2,320 ) 5,775 1,594 — 5,097 Cash flows from investing activities: Purchase of property and equipment — — (1,634 ) (1,250 ) — (2,884 ) Acquisition of hospitals and health care entities — — (39 ) (1,553 ) — (1,592 ) Disposition of hospitals and health care entities — — 31 18 — 49 Change in investments — — 1 34 — 35 Other — — (7 ) 24 — 17 Net cash used in investing activities — — (1,648 ) (2,727 ) — (4,375 ) Cash flows from financing activities: Issuance of long-term debt — 6,451 — — — 6,451 Net change in revolving credit facilities — (30 ) — — — (30 ) Repayment of long-term debt — (5,213 ) (45 ) (31 ) — (5,289 ) Distributions to noncontrolling interests — — (79 ) (325 ) — (404 ) Payment of debt issuance costs — (71 ) — — — (71 ) Payment of cash dividends (414 ) — — — — (414 ) Repurchases of common stock (759 ) — — — — (759 ) Changes in intercompany balances with affiliates, net 1,253 1,183 (4,047 ) 1,611 — — Other (128 ) — — (17 ) — (145 ) Net cash ( u ) (48 ) 2,320 (4,171 ) 1,238 — (661 ) Effect on exchange rate changes on cash and cash equivalents — — — (4 ) — (4 ) Change in cash and cash equivalents — — (44 ) 101 — 57 Cash and cash equivalents at beginning of period — — 174 328 — 502 Cash and cash equivalents at end of period $ — $ — $ 130 $ 429 $ — $ 559 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

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019USD ($)HospitalSurgery_CenterState	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)HospitalSurgery_CenterState	Sep. 30, 2018USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of owned and operated hospitals \| Hospital	184		184
Number of freestanding surgery centers \| Surgery_Center	125		125
Number of facilities locations \| State	21		21
General and administrative expense	$ 88	$ 90	$ 268	$ 254
Percentage of sum of revenues and uncompensated care	38.40%	37.20%	37.50%	36.20%
Charity care amount	$ 3,425	$ 2,314	$ 9,641	$ 6,170
Estimated costs of charity care	$ 421	$ 295	$ 1,167	$ 777
Inpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period			5 days
Out of Network Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Revenues			$ 86
Maximum [Member] \| Outpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period			1 day

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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 12,694	$ 11,451	$ 37,813	$ 34,403
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	$ 2,592	$ 2,404	$ 7,997	$ 7,353
Revenues from third party payers, Ratio	20.40%	21.00%	21.20%	21.40%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 1,615	$ 1,344	$ 4,799	$ 4,088
Revenues from third party payers, Ratio	12.70%	11.70%	12.70%	11.90%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 361	$ 338	$ 1,124	$ 976
Revenues from third party payers, Ratio	2.80%	3.00%	3.00%	2.80%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 641	$ 622	$ 1,808	$ 1,769
Revenues from third party payers, Ratio	5.00%	5.40%	4.80%	5.10%
Managed Care and Other Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 6,554	$ 6,026	$ 19,405	$ 18,081
Revenues from third party payers, Ratio	51.70%	52.60%	51.10%	52.60%
International (Managed Care and Other Insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 282	$ 273	$ 863	$ 873
Revenues from third party payers, Ratio	2.20%	2.40%	2.30%	2.50%
Product and Service, Other [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 649	$ 444	$ 1,817	$ 1,263
Other, Ratio	5.20%	3.90%	4.90%	3.70%

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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Accounting Policies [Abstract]
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$ 11,060	$ 9,946	$ 32,619	$ 29,684
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)	12.30%	12.70%	12.10%	12.60%
Total uncompensated care	$ 7,923	$ 6,786	$ 22,703	$ 19,524
Multiply by the cost-to-charges ratio	12.30%	12.70%	12.10%	12.60%
Estimated cost of total uncompensated care	$ 975	$ 862	$ 2,747	$ 2,460

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)Hospital	Sep. 30, 2018USD ($)Hospital
Business Acquisition [Line Items]
Number of hospitals purchased \| Hospital	7	2
Proceeds from sale of business	$ 49	$ 802
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Proceeds from sale of business	24	44
Pretax gain (loss) on sales of business	18	48
Real Estate and Other Investments [Member] \| Louisiana Markets [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	(1)
Discontinued Operations, Disposed of by Sale [Member] \| Louisiana Markets [Member]
Business Acquisition [Line Items]
Proceeds from sale of business	25
Discontinued Operations, Disposed of by Sale [Member] \| Oklahoma [Member]
Business Acquisition [Line Items]
Proceeds from sale of business		758
Pretax gain (loss) on sales of business		372
Hospitals [Member]
Business Acquisition [Line Items]
Aggregate purchase price	1,399	788
Non hospital Health Care [Member]
Business Acquisition [Line Items]
Aggregate purchase price	193	$ 268
Other [Member]
Business Acquisition [Line Items]
Goodwill	$ 231

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Income Tax Contingency [Line Items]
Effective tax rate	26.00%	18.60%	23.90%	20.50%
Reduction to provision for income taxes for tax credits			$ 28
Provision for tax benefits related to settlement of employee awards	$ 3	$ 23	56	$ 119
Liability for unrecognized tax benefits	540		540		$ 435
Unrecognized tax benefits, accrued interest	56		56		48
Unrecognized tax benefits that would impact effective tax rate	147		147		$ 137
Provision for income taxes	$ 215	$ 173	$ 765	$ 702

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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Earnings Per Share [Abstract]
Net income attributable to HCA Healthcare, Inc.	$ 612	$ 759	$ 2,434	$ 2,723
Weighted average common shares outstanding	340,789	345,823	341,932	348,411
Effect of dilutive incremental shares	6,698	7,816	6,780	7,713
Shares used for diluted earnings per share	347,487	353,639	348,712	356,124
Basic earnings per share	$ 1.80	$ 2.20	$ 7.12	$ 7.82
Diluted earnings per share	$ 1.76	$ 2.15	$ 6.98	$ 7.65

Investments of Insurance Subs_3

Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Debt Securities, Available-for-sale [Line Items]
Amounts classified as current assets	$ (96)	$ (47)
Investment carrying value	357	362
Amortized Cost	434	406
Unrealized Amounts, Gains	19	5
Unrealized Amounts, Losses		(2)
Fair Value	453	409
Money Market Funds and Other [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	97	68
Fair Value	97	68
Debt Securities [Member] \| States and Municipalities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	337	338
Unrealized Amounts, Gains	19	5
Unrealized Amounts, Losses		(2)
Fair Value	$ 356	$ 341

Investments of Insurance Subs_4

Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Sep. 30, 2019USD ($)
Investments, Debt and Equity Securities [Abstract]
Due in one year or less, Amortized Cost	$ 12
Due after one year through five years, Amortized Cost	76
Due after five years through ten years, Amortized Cost	183
Due after ten years, Amortized Cost	66
Amortized Cost, Total	337
Due in one year or less, Fair Value	12
Due after one year through five years, Fair Value	79
Due after five years through ten years, Fair Value	195
Due after ten years, Fair Value	70
Fair Value, Total	$ 356

Investments of Insurance Subs_5

Investments of Insurance Subsidiaries - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2019
Investments, Debt and Equity Securities [Abstract]
Available for sale securities expected maturity of debt securities	5 years 7 months 6 days
Available for sale securities average scheduled maturity	10 years

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, 2019USD ($)
Maturity Date, 2021 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 2,000
Fair Value	$ (1)
Maturity Date	2021-12
Maturity Date, 2022 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 500
Fair Value	$ (10)
Maturity Date	2022-12

Financial Instruments - Additio

Financial Instruments - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Estimated amount reclassified from other comprehensive income and reduce interest expense	$ 2
Estimated termination value	$ 11

Financial Instruments - Effect

Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	$ (45)
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	45
Interest Rate Swaps [Member] \| Reclassification out of Accumulated Other Comprehensive Income [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest rate swaps	$ 15

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, 2019	Dec. 31, 2018
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	$ 453	$ 409
Less amounts classified as current assets	(96)	(47)
Investments of insurance subsidiaries, noncurrent	357	362
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Derivative Asset		63
Derivative Liability	11
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	97	68
Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	356	341
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	97	68
Less amounts classified as current assets	(96)	(47)
Investments of insurance subsidiaries, noncurrent	1	21
Quoted Prices in Active Markets for Identical Assets and Liabilities (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	97	68
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	356	341
Investments of insurance subsidiaries, noncurrent	356	341
Derivative Liability	11
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		63
Significant Other Observable Inputs (Level 2) [Member] \| Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	$ 356	$ 341

Assets and Liabilities Measur_4

Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Estimated fair value of long-term debt	$ 37,162	$ 32,887
Carrying amounts of long-term debt	$ 34,489	$ 32,978

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Senior secured debt	$ 21,237	$ 21,226
Debt issuance costs and discounts	(244)	(157)
Total debt (average life of 6.4 years, rates averaging 5.5%)	34,245	32,821
Less amounts due within one year	148	788
Long-term debt	34,097	32,033
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	3,010	3,040
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Senior secured debt	3,739	3,801
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Senior secured debt	13,850	13,800
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	638	585
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 13,252	$ 11,752

Long-Term Debt - Schedule of _2

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	9 Months Ended
	Sep. 30, 2019
Debt Instrument [Line Items]
Total debt average term	8 years 8 months 12 days
Total debt average rate	5.20%
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	3.30%
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Effective interest rate	3.50%
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.10%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	5.50%
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 ($) $ in Millions	1 Months Ended	3 Months Ended		9 Months Ended
	Jul. 31, 2019	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Jun. 30, 2019	Jan. 31, 2019
Debt Instrument [Line Items]
Pretax loss on retirement of debt		$ 211	$ 9	$ 211	$ 9
5.625% Senior Notes Due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount						$ 1,000	$ 500
Debt instrument, stated interest							5.625%
5.875% Senior Notes Due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount						$ 2,000	$ 1,000
Debt instrument, stated interest							5.875%
4.250% Senior Notes Due 2019 [Member]
Debt Instrument [Line Items]
Early Repayment of Senior Debt	$ 600
Debt Instrument, Redemption Price, Percentage	4.25%
6.500% Senior Notes Due 2020 [Member]
Debt Instrument [Line Items]
Early Repayment of Senior Debt	$ 3,000
Debt Instrument, Redemption Price, Percentage	6.50%
5.875% Senior Notes Due 2022 [Member]
Debt Instrument [Line Items]
Early Repayment of Senior Debt	$ 1,350
Debt Instrument, Redemption Price, Percentage	5.875%
Secured Debt [Member]
Debt Instrument [Line Items]
Pretax loss on retirement of debt		$ 211
4.13% Senior Notes Due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest						4.13%
5.13% Senior Notes Due 2039 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest						5.13%
5.25% Senior Notes Due 2049 [Member]
Debt Instrument [Line Items]
Debt instrument, stated interest		5.25%		5.25%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount						$ 5,000	$ 1,500

Leases - Schedule Of Lease-Rel

Leases - Schedule Of Lease-Related Assets And Liabilities (Detail) $ in Millions	Sep. 30, 2019USD ($)
Assets:
Operating leases	$ 1,770
Finance leases	486
Total lease assets	2,256
Liabilities
Operating leases	344
Finance leases	89
Operating leases	1,440
Finance leases	451
Total lease liabilities	$ 2,324
Weighted-average remaining term:
Operating leases	10 years 9 months 18 days
Finance leases	10 years 7 months 6 days
Weighted-average discount rate:
Operating leases	5.40%	[1]
Finance leases	6.10%

[1]	Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019.

Leases - Schedule Of Lease Expe

Leases - Schedule Of Lease Expense For Finance And Operating Leases (Detail) - USD ($) $ in Millions		3 Months Ended	9 Months Ended
		Sep. 30, 2019	Sep. 30, 2019
Finance lease expense:
Amortization of leased assets		$ 33	$ 70
Interest on lease liabilities		9	24
Operating leases	[1]	94	287
Short-term lease expense	[1]	82	235
Variable lease expense	[1]	40	114
Total lease expense		$ 258	$ 730

[1]	Expenses are included in “other operating expenses” in our condensed consolidated income statements.

Leases - Schedule Of Supplement

Leases - Schedule Of Supplemental Cash Flow Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Cash Paid For Amounts Included In Measurement Of Lease Liabilities [Abstract]
Operating cash flows for operating leases	$ 293
Operating cash flows for finance leases	24
Financing cash flows for finance leases	$ 58

Leases - Schedule of undiscount

Leases - Schedule of undiscounted cash flows to the finance lease liabilities and operating lease liabilities (Detail) $ in Millions	Sep. 30, 2019USD ($)
Operating Lease Liabilities, Payments Due [Abstract]
Year 1	$ 388
Year 2	339
Year 3	279
Year 4	221
Year 5	175
Thereafter	1,038
Total minimum lease payments	2,440
Less: amount of lease payments representing interest	(656)
Present value of future minimum lease payments	1,784
Less: current obligations under leases	(344)
Long-term lease obligations	1,440
Finance Lease Liabilities, Payments, Due [Abstract]
Year 1	107
Year 2	102
Year 3	97
Year 4	57
Year 5	61
Thereafter	353
Total minimum lease payments	777
Less: amount of lease payments representing interest	(237)
Present value of future minimum lease payments	540
Less: current obligations under leases	(89)
Long-term lease obligations	$ 451

Share Repurchase Transactions_3

Share Repurchase Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	9 Months Ended
	Sep. 30, 2019	Jan. 31, 2019	Oct. 31, 2017
Repurchase of common stock, shares	5,880
Repurchase price of common stock, per share	$ 129.12
Share repurchase program, remaining authorized repurchase amount	$ 1,513
Share repurchase program authorized amount		$ 2,000	$ 2,000
Board of Directors Chairman [Member]
Share repurchase program, remaining authorized repurchase amount		$ 2,000

Share Repurchase Transactions_4

Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Equity [Abstract]
Unrealized gains on available-for-sale securities, beginning balances	$ 3
Unrealized gains on available-for-sale securities, net of income tax benefit	12
Unrealized gains on available-for-sale securities, ending balances	15
Foreign currency translation adjustments, beginning balances	(283)
Foreign currency translation adjustments	(43)
Foreign currency translation adjustments, ending balances	(326)
Defined benefit plans, beginning balances	(148)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	8
Defined benefit plans, ending balances	(140)
Change in fair value of derivative instruments, beginning balances	47
Change in fair value of derivative instruments	(45)
Change in fair value of derivative instruments, (income) expense reclassified into operations from other comprehensive income	(12)
Change in fair value of derivative instruments, ending balances	(10)
Accumulated other comprehensive income (loss), net of tax, beginning balances	(381)
Unrealized losses on available-for-sale securities, net of income taxes	12
Foreign currency translation adjustments	(43)
Change in fair value of derivative instruments	(45)
Expense (income) reclassified into operations from other comprehensive income, Total	(4)
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (461)

Share Repurchase Transactions_5

Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Equity [Abstract]
Unrealized losses on available-for-sale securities, tax benefit portion	$ 4
Foreign currency translation adjustments, income tax benefit	5
Change in fair value of derivative instruments, income tax expense (benefit)	14
Defined benefit plans, Expense reclassified into operations from other comprehensive income, Income tax benefits	2
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, Income tax benefits	$ 3

Segment and Geographic Inform_3

Segment and Geographic Information - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2019Hospital
Segment Reporting Information [Line Items]
Number of geographically organized groups	2
Number of owned and operated hospitals	184
Reorganization Group [Member] \| National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	95
Reorganization Group [Member] \| American Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	83
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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting Information [Line Items]
Revenues	$ 12,694	$ 11,451	$ 37,813	$ 34,403
Equity in earnings of affiliates	(4)	(9)	(23)	(25)
Adjusted segment EBITDA	2,285	2,096	7,119	6,441
Depreciation and amortization	647	582	1,902	1,697
Interest expense	448	442	1,386	1,309
Gains on sales of facilities		(6)	(17)	(420)
Losses on retirement of debt	211	9	211	9
Income before income taxes	979	1,069	3,637	3,846
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	6,398	5,542	19,159	16,719
Equity in earnings of affiliates	2	(1)	(3)	(5)
Adjusted segment EBITDA	1,270	1,127	4,088	3,593
Depreciation and amortization	291	245	839	702
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,780	5,396	17,001	16,113
Equity in earnings of affiliates	(10)	(10)	(32)	(29)
Adjusted segment EBITDA	1,185	1,072	3,443	3,250
Depreciation and amortization	277	258	828	765
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	516	513	1,653	1,571
Equity in earnings of affiliates	4	2	12	9
Adjusted segment EBITDA	(170)	(103)	(412)	(402)
Depreciation and amortization	$ 79	$ 79	$ 235	$ 230

Supplemental Condensed Consol_3

Supplemental Condensed Consolidating Financial Information - Additional Information (Detail)	Sep. 30, 2019USD ($)
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 - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Condensed Statement of Income Captions [Line Items]
Revenues	$ 12,694	$ 11,451	$ 37,813	$ 34,403
Salaries and benefits	5,971	5,377	17,455	15,940
Supplies	2,090	1,890	6,249	5,722
Other operating expenses	2,352	2,097	7,013	6,325
Equity in earnings of affiliates	(4)	(9)	(23)	(25)
Depreciation and amortization	647	582	1,902	1,697
Interest expense (income)	448	442	1,386	1,309
Losses (gains) on sales of facilities		(6)	(17)	(420)
Losses on retirement of debt	211	9	211	9
Total expenses including equity in earnings of affiliates	11,715	10,382	34,176	30,557
Income (loss) before income taxes	979	1,069	3,637	3,846
Provision (benefit) for income taxes	215	173	765	702
Net income (loss)	764	896	2,872	3,144
Net income attributable to noncontrolling interests	152	137	438	421
Net income (loss) attributable to HCA Healthcare, Inc.	612	759	2,434	2,723
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	582	754	2,354	2,735
HCA Healthcare, Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Other operating expenses	4	2	7	7
Equity in earnings of affiliates	(656)	(728)	(2,504)	(2,670)
Interest expense (income)	16	16	48	48
Total expenses including equity in earnings of affiliates	(636)	(710)	(2,449)	(2,615)
Income (loss) before income taxes	636	710	2,449	2,615
Provision (benefit) for income taxes	24	(49)	15	(108)
Net income (loss)	612	759	2,434	2,723
Net income (loss) attributable to HCA Healthcare, Inc.	612	759	2,434	2,723
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	582	754	2,354	2,735
HCA Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Interest expense (income)	1,014	913	3,019	2,617
Losses on retirement of debt	211	9	211	9
Total expenses including equity in earnings of affiliates	1,225	922	3,230	2,626
Income (loss) before income taxes	(1,225)	(922)	(3,230)	(2,626)
Provision (benefit) for income taxes	(279)	(214)	(745)	(610)
Net income (loss)	(946)	(708)	(2,485)	(2,016)
Net income (loss) attributable to HCA Healthcare, Inc.	(946)	(708)	(2,485)	(2,016)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	(954)	(703)	(2,542)	(1,974)
Subsidiary Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	7,196	6,747	21,549	20,297
Salaries and benefits	3,272	3,090	9,608	9,184
Supplies	1,174	1,115	3,540	3,383
Other operating expenses	1,178	1,137	3,481	3,387
Equity in earnings of affiliates	(2)	(2)	(5)	(5)
Depreciation and amortization	362	340	1,071	992
Interest expense (income)	(505)	(423)	(1,489)	(1,179)
Losses (gains) on sales of facilities	(2)	(6)	(9)	(378)
Management fees	(197)	(158)	(573)	(473)
Total expenses including equity in earnings of affiliates	5,280	5,093	15,624	14,911
Income (loss) before income taxes	1,916	1,654	5,925	5,386
Provision (benefit) for income taxes	429	379	1,351	1,235
Net income (loss)	1,487	1,275	4,574	4,151
Net income attributable to noncontrolling interests	23	22	64	72
Net income (loss) attributable to HCA Healthcare, Inc.	1,464	1,253	4,510	4,079
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,467	1,258	4,518	4,091
Subsidiary Non-Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	5,498	4,704	16,264	14,106
Salaries and benefits	2,699	2,287	7,847	6,756
Supplies	916	775	2,709	2,339
Other operating expenses	1,170	958	3,525	2,931
Equity in earnings of affiliates	(2)	(7)	(18)	(20)
Depreciation and amortization	285	242	831	705
Interest expense (income)	(77)	(64)	(192)	(177)
Losses (gains) on sales of facilities	2	0	(8)	(42)
Management fees	197	158	573	473
Total expenses including equity in earnings of affiliates	5,190	4,349	15,267	12,965
Income (loss) before income taxes	308	355	997	1,141
Provision (benefit) for income taxes	41	57	144	185
Net income (loss)	267	298	853	956
Net income attributable to noncontrolling interests	129	115	374	349
Net income (loss) attributable to HCA Healthcare, Inc.	138	183	479	607
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	113	168	448	565
Eliminations [Member]
Condensed Statement of Income Captions [Line Items]
Equity in earnings of affiliates	656	728	2,504	2,670
Total expenses including equity in earnings of affiliates	656	728	2,504	2,670
Income (loss) before income taxes	(656)	(728)	(2,504)	(2,670)
Net income (loss)	(656)	(728)	(2,504)	(2,670)
Net income (loss) attributable to HCA Healthcare, Inc.	(656)	(728)	(2,504)	(2,670)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	$ (626)	$ (723)	$ (2,424)	$ (2,682)

Supplemental Condensed Consol_5

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 559			$ 502
Accounts receivable	7,131			6,789
Inventories	1,769			1,732
Other	1,310			1,190
Total current assets	10,769			10,213
Property and equipment, net	22,002			19,757
Investments of insurance subsidiaries	357			362
Investments in and advances to affiliates	243			232
Goodwill and other intangible assets	8,160			7,953
Right-of-use operating lease assets	1,770
Other	611			690
Total assets	43,912			39,207
Current liabilities:
Accounts payable	2,610			2,577
Accrued salaries	1,669			1,580
Other accrued expenses	2,697			2,624
Long-term debt due within one year	148			788
Total current liabilities	7,124			7,569
Long-term debt, net	34,097			32,033
Professional liability risks	1,349			1,275
Right-of-use operating lease obligations	1,440
Income taxes and other liabilities	1,349			1,248
Total liabilities	45,359			42,125
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(3,565)			(4,950)
Noncontrolling interests	2,118			2,032
Total stockholders' deficit	(1,447)	$ (1,770)	$ (2,255)	(2,918)	$ (3,730)	$ (4,125)	$ (4,434)	$ (4,995)
Total liabilities and stockholders' deficit	43,912			39,207
HCA Healthcare, Inc. Issuer [Member]
Current assets:
Investments in and advances to affiliates	35,590			33,166
Other	434			478
Total assets	36,024			33,644
Current liabilities:
Other accrued expenses	15			142
Total current liabilities	15			142
Long-term debt, net	997			996
Intercompany balances	37,967			36,951
Income taxes and other liabilities	610			505
Total liabilities	39,589			38,594
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(3,565)			(4,950)
Total stockholders' deficit	(3,565)			(4,950)
Total liabilities and stockholders' deficit	36,024			33,644
HCA Inc. Issuer [Member]
Current assets:
Other	0			64
Total assets	0			64
Current liabilities:
Other accrued expenses	332			403
Long-term debt due within one year	55			696
Total current liabilities	387			1,099
Long-term debt, net	32,555			30,544
Intercompany balances	(5,621)			(6,789)
Income taxes and other liabilities	11
Total liabilities	27,332			24,854
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(27,332)			(24,790)
Total stockholders' deficit	(27,332)			(24,790)
Total liabilities and stockholders' deficit	0			64
Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	130			174
Accounts receivable	3,970			3,964
Inventories	1,154			1,178
Other	644			669
Total current assets	5,898			5,985
Property and equipment, net	13,074			12,450
Investments in and advances to affiliates	29			29
Goodwill and other intangible assets	5,719			5,724
Right-of-use operating lease assets	436
Other	34			35
Total assets	25,190			24,223
Current liabilities:
Accounts payable	1,699			1,721
Accrued salaries	993			998
Other accrued expenses	896			905
Long-term debt due within one year	49			55
Total current liabilities	3,637			3,679
Long-term debt, net	213			212
Intercompany balances	(32,198)			(28,415)
Right-of-use operating lease obligations	330
Income taxes and other liabilities	181			223
Total liabilities	(27,837)			(24,301)
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	52,955			48,437
Noncontrolling interests	72			87
Total stockholders' deficit	53,027			48,524
Total liabilities and stockholders' deficit	25,190			24,223
Subsidiary Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	429			328
Accounts receivable	3,161			2,825
Inventories	615			554
Other	666			521
Total current assets	4,871			4,228
Property and equipment, net	8,928			7,307
Investments of insurance subsidiaries	357			362
Investments in and advances to affiliates	214			203
Goodwill and other intangible assets	2,441			2,229
Right-of-use operating lease assets	1,334
Other	143			113
Total assets	18,288			14,442
Current liabilities:
Accounts payable	911			856
Accrued salaries	676			582
Other accrued expenses	1,454			1,174
Long-term debt due within one year	44			37
Total current liabilities	3,085			2,649
Long-term debt, net	332			281
Intercompany balances	(148)			(1,747)
Professional liability risks	1,349			1,275
Right-of-use operating lease obligations	1,110
Income taxes and other liabilities	547			520
Total liabilities	6,275			2,978
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	9,967			9,519
Noncontrolling interests	2,046			1,945
Total stockholders' deficit	12,013			11,464
Total liabilities and stockholders' deficit	18,288			14,442
Eliminations [Member]
Current assets:
Investments in and advances to affiliates	(35,590)			(33,166)
Total assets	(35,590)			(33,166)
Current liabilities:
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(35,590)			(33,166)
Total stockholders' deficit	(35,590)			(33,166)
Total liabilities and stockholders' deficit	$ (35,590)			$ (33,166)

Supplemental Condensed Consol_6

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income (loss)	$ 764	$ 896	$ 2,872	$ 3,144
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(306)	(147)
Depreciation and amortization	647	582	1,902	1,697
Income taxes			51
Losses (gains) on sales of facilities		(6)	(17)	(420)
Losses on retirement of debt	211	9	211	9
Amortization of debt issuance costs and discounts			23	23
Share-based compensation			263	204
Other			98	76
Net cash provided by (used in) operating activities			5,097	4,586
Cash flows from investing activities:
Purchase of property and equipment			(2,884)	(2,420)
Acquisition of hospitals and health care entities			(1,592)	(1,056)
Disposition of hospitals and health care entities			49	802
Change in investments			35	65
Other			17	(6)
Net cash used in investing activities			(4,375)	(2,615)
Cash flows from financing activities:
Issuance of long-term debt			6,451	2,000
Net change in revolving credit facilities			(30)	(330)
Repayment of long-term debt			(5,289)	(1,652)
Distributions to noncontrolling interests			(404)	(315)
Payment of debt issuance costs			(71)	(24)
Payment of cash dividends			(414)	(366)
Repurchases of common stock			(759)	(1,195)
Other			(145)	(232)
Net cash (used in) provided by financing activities			(661)	(2,114)
Effect on exchange rate changes on cash and cash equivalents			(4)	(11)
Change in cash and cash equivalents			57	(154)
Cash and cash equivalents at beginning of period			502	732
Cash and cash equivalents at end of period	559	578	559	578
HCA Healthcare, Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	612	759	2,434	2,723
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			51
Equity in earnings of affiliates			(2,504)	(2,670)
Other			82	67
Net cash provided by (used in) operating activities			48	105
Cash flows from financing activities:
Payment of cash dividends			(414)	(366)
Repurchases of common stock			(759)	(1,195)
Changes in intercompany balances with affiliates, net			1,253	1,697
Other			(128)	(242)
Net cash (used in) provided by financing activities			(48)	(106)
Effect on exchange rate changes on cash and cash equivalents			0
Change in cash and cash equivalents			0	(1)
Cash and cash equivalents at beginning of period				1
Cash and cash equivalents at end of period	0		0
HCA Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	(946)	(708)	(2,485)	(2,016)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(69)	(83)
Losses on retirement of debt	211	9	211	9
Amortization of debt issuance costs and discounts			23	23
Net cash provided by (used in) operating activities			(2,320)	(2,067)
Cash flows from financing activities:
Issuance of long-term debt			6,451	2,000
Net change in revolving credit facilities			(30)	(330)
Repayment of long-term debt			(5,213)	(1,566)
Payment of debt issuance costs			(71)	(24)
Changes in intercompany balances with affiliates, net			1,183	1,987
Net cash (used in) provided by financing activities			2,320	2,067
Subsidiary Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	1,487	1,275	4,574	4,151
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(137)	(154)
Depreciation and amortization	362	340	1,071	992
Losses (gains) on sales of facilities	(2)	(6)	(9)	(378)
Share-based compensation			263	204
Other			13
Net cash provided by (used in) operating activities			5,775	4,815
Cash flows from investing activities:
Purchase of property and equipment			(1,634)	(1,425)
Acquisition of hospitals and health care entities			(39)	(894)
Disposition of hospitals and health care entities			31	770
Change in investments			1	19
Other			(7)	(18)
Net cash used in investing activities			(1,648)	(1,548)
Cash flows from financing activities:
Repayment of long-term debt			(45)	(44)
Distributions to noncontrolling interests			(79)	(63)
Changes in intercompany balances with affiliates, net			(4,047)	(3,167)
Net cash (used in) provided by financing activities			(4,171)	(3,274)
Change in cash and cash equivalents			(44)	(7)
Cash and cash equivalents at beginning of period			174	112
Cash and cash equivalents at end of period	130	105	130	105
Subsidiary Non-Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	267	298	853	956
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities			(85)	105
Depreciation and amortization	285	242	831	705
Losses (gains) on sales of facilities	2	0	(8)	(42)
Other			3	9
Net cash provided by (used in) operating activities			1,594	1,733
Cash flows from investing activities:
Purchase of property and equipment			(1,250)	(995)
Acquisition of hospitals and health care entities			(1,553)	(162)
Disposition of hospitals and health care entities			18
Change in investments			34	46
Other			24	12
Net cash used in investing activities			(2,727)	(1,067)
Cash flows from financing activities:
Repayment of long-term debt			(31)	(42)
Distributions to noncontrolling interests			(325)	(252)
Changes in intercompany balances with affiliates, net			1,611	(517)
Other			(17)	10
Net cash (used in) provided by financing activities			1,238	(801)
Effect on exchange rate changes on cash and cash equivalents			(4)	(11)
Change in cash and cash equivalents			101	(146)
Cash and cash equivalents at beginning of period			328	619
Cash and cash equivalents at end of period	429	473	429	473
Eliminations [Member]
Cash flows from operating activities:
Net income (loss)	$ (656)	$ (728)	(2,504)	(2,670)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in earnings of affiliates			$ 2,504	$ 2,670