0001564590-20-048373 | 10-Q | XBRL Viewer | Community Health Systems INC

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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2020	Oct. 22, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity File Number	001-15925
Entity Registrant Name	COMMUNITY HEALTH SYSTEMS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-3893191
Entity Address, Address Line One	4000 Meridian Boulevard
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	465-7000
Title of 12(b) Security	Common Stock, $.01 par value
Trading Symbol	CYH
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		119,620,952
Entity Central Index Key	0001108109
Amendment Flag	false

Condensed Consolidated Statements of Income (Loss) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Statement [Abstract]
Net operating revenues	$ 3,126	$ 3,246	$ 8,670	$ 9,925
Operating costs and expenses:
Salaries and benefits	1,365	1,469	4,054	4,499
Supplies	523	526	1,439	1,623
Other operating expenses	736	812	2,211	2,516
Government and other legal settlements and related costs		26	4	35
Lease cost and rent	85	79	248	240
Pandemic relief funds			(448)
Depreciation and amortization	139	151	424	456
Impairment and (gain) loss on sale of businesses, net	(7)	(1)	48	70
Total operating costs and expenses	2,841	3,062	7,980	9,439
Income from operations	285	184	690	486
Interest expense, net	257	259	779	782
(Gain) loss from early extinguishment of debt	(115)		(111)	31
Equity in earnings of unconsolidated affiliates	(5)	(3)	(11)	(12)
Income (loss) before income taxes	148	(72)	33	(315)
Provision for (benefit from) income taxes	20	(74)	(221)	(71)
Net income (loss)	128	2	254	(244)
Less: Net income attributable to noncontrolling interests	16	19	54	58
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$ 112	$ (17)	$ 200	$ (302)
Earnings (loss) per share attributable to Community Health Systems, Inc. common stockholders:
Basic	$ 0.98	$ (0.15)	$ 1.74	$ (2.66)
Diluted	$ 0.97	$ (0.15)	$ 1.74	$ (2.66)
Weighted-average number of shares outstanding:
Basic	115,015,460	113,891,721	114,764,050	113,672,798
Diluted	115,640,852	113,891,721	115,012,202	113,672,798

Condensed Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss)	$ 128	$ 2	$ 254	$ (244)
Other comprehensive (loss) income, net of income taxes:
Net change in fair value of interest rate swaps, net of tax		(1)		(3)
Net change in fair value of available-for-sale debt securities, net of tax		1	3	5
Amortization and recognition of unrecognized pension cost components, net of tax			1
Other comprehensive income			4	2
Comprehensive income (loss)	128	2	258	(242)
Less: Comprehensive income attributable to noncontrolling interests	16	19	54	58
Comprehensive income (loss) attributable to Community Health Systems, Inc. stockholders	$ 112	$ (17)	$ 204	$ (300)

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 1,823	$ 216
Patient accounts receivable	1,956	2,258
Supplies	337	354
Prepaid income taxes	50	48
Prepaid expenses and taxes	166	193
Other current assets	360	358
Total current assets	4,692	3,427
Property and equipment	9,293	9,653
Less accumulated depreciation and amortization	(4,003)	(4,045)
Property and equipment, net	5,290	5,608
Goodwill	4,220	4,328
Deferred income taxes	88	38
Other assets, net	2,226	2,208
Total assets	16,516	15,609
Current liabilities:
Current maturities of long-term debt	19	20
Current operating lease liabilities	131	136
Accounts payable	710	811
Accrued liabilities:
Employee compensation	580	594
Accrued interest	180	189
Other	2,009	532
Total current liabilities	3,629	2,282
Long-term debt	12,860	13,385
Deferred income taxes	29	200
Long-term operating lease liabilities	523	487
Other long-term liabilities	951	894
Total liabilities	17,992	17,248
Redeemable noncontrolling interests in equity of consolidated subsidiaries	481	502
Community Health Systems, Inc. stockholders’ deficit:
Preferred stock, $.01 par value per share, 100,000,000 shares authorized; none issued
Common stock, $.01 par value per share, 300,000,000 shares authorized; 119,604,720 shares issued and outstanding at September 30, 2020, and 117,822,631 shares issued and outstanding at December 31, 2019	1	1
Additional paid-in capital	2,005	2,008
Accumulated other comprehensive loss	(5)	(9)
Accumulated deficit	(4,018)	(4,218)
Total Community Health Systems, Inc. stockholders’ deficit	(2,017)	(2,218)
Noncontrolling interests in equity of consolidated subsidiaries	60	77
Total stockholders’ deficit	(1,957)	(2,141)
Total liabilities and stockholders’ deficit	$ 16,516	$ 15,609

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Preferred stock, par value per share	$ 0.01	$ 0.01
Preferred stock, shares authorized	100,000,000	100,000,000
Preferred stock, shares issued	0	0
Common stock, par value per share	$ 0.01	$ 0.01
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares issued	119,604,720	117,822,631
Common stock, shares outstanding	119,604,720	117,822,631

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities:
Net income (loss)	$ 254	$ (244)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	424	456
Deferred income taxes	(223)	(73)
Government and other legal settlements and related costs	4	25
Stock-based compensation expense	8	8
Impairment and (gain) loss on sale of businesses, net	48	70
(Gain) loss from early extinguishment of debt	(111)	31
Other non-cash expenses, net	99	140
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	281	82
Supplies, prepaid expenses and other current assets	16	40
Medicare accelerated payments	1,159
Repayment/derecognition of Medicare accelerated payments	(22)
Unrecognized pandemic relief funds	271
Accounts payable, accrued liabilities and income taxes	(81)	(242)
Other	(25)	(102)
Net cash provided by operating activities	2,102	191
Cash flows from investing activities:
Acquisitions of facilities and other related businesses	(1)	(13)
Purchases of property and equipment	(317)	(322)
Proceeds from disposition of hospitals and other ancillary operations	347	363
Proceeds from sale of property and equipment	4	1
Purchases of available-for-sale debt securities and equity securities	(68)	(58)
Proceeds from sales of available-for-sale debt securities and equity securities	80	72
Increase in other investments	(36)	(146)
Net cash provided by (used in) investing activities	9	(103)
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(1)	(1)
Deferred financing costs and other debt-related costs	(32)	(28)
Proceeds from noncontrolling investors in joint ventures		10
Redemption of noncontrolling investments in joint ventures	(4)	(6)
Distributions to noncontrolling investors in joint ventures	(84)	(78)
Proceeds from sale-lease back	2	56
Other borrowings	31	26
Issuance of long-term debt	1,462	2,489
Proceeds from ABL Facility	540	25
Repayments of long-term indebtedness	(2,418)	(2,620)
Net cash used in financing activities	(504)	(127)
Net change in cash and cash equivalents	1,607	(39)
Cash and cash equivalents at beginning of period	216	196
Cash and cash equivalents at end of period	1,823	157
Supplemental disclosure of cash flow information:
Interest payments	(765)	(810)
Income tax refunds (payments), net	$ (2)	$ 3

Basis of Presentation and Significant Accounting Policies

9 Months Ended

Sep. 30, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

1. BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

The unaudited condensed consolidated financial statements of Community Health Systems, Inc. (the “Parent” or “Parent Company”) and its subsidiaries (the “Company”) as of September 30, 2020 and December 31, 2019 and for the three-month and nine-month periods ended September 30, 2020 and 2019, have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). In the opinion of management, such information contains all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for such periods. All intercompany transactions and balances have been eliminated. The results of operations for the three and nine months ended September 30, 2020, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2020. The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements. Actual results could differ from these estimates under different assumptions or conditions.

Certain information and disclosures normally included in the notes to the consolidated financial statements have been condensed or omitted as permitted by the rules and regulations of the Securities and Exchange Commission (the “SEC”). The Company believes the disclosures are adequate to make the information presented not misleading. The accompanying unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2019, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 20, 2020 (“2019 Form 10-K”). Certain prior period amounts have been reclassified to conform to the current period presentation within the condensed consolidated statements of cash flows.

During the first quarter of 2020, the Company early adopted the SEC’s Financial Disclosures About Guarantors and Issuers of Guaranteed Securities and Affiliates Whose Securities Collateralize a Registrant’s Securities rules, which simplify the disclosure requirements related to the Company’s registered debt securities under Rule 3-10 of Regulation S-X (see Note 15).

Noncontrolling interests in less-than-wholly-owned consolidated subsidiaries of the Parent are presented as a component of total equity on the condensed consolidated balance sheets to distinguish between the interests of the Parent Company and the interests of the noncontrolling owners. Noncontrolling interests that are redeemable or may become redeemable at a fixed or determinable price at the option of the holder or upon the occurrence of an event outside of the control of the Company are presented in mezzanine equity on the condensed consolidated balance sheets.

Substantially all of the Company’s operating costs and expenses are “cost of revenue” items. Operating costs that could be classified as general and administrative by the Company include the Company’s corporate office costs at its Franklin, Tennessee office, which were $41 million and $48 million for the three months ended September 30, 2020 and 2019, respectively, and $136 million and $135 million for the nine months ended September 30, 2020 and 2019, respectively. Included in these corporate office costs is stock-based compensation of $3 million and $2 million for the three months ended September 30, 2020 and 2019, respectively, and $8 million for both of the nine-month periods ended September 30, 2020 and 2019.

Throughout these notes to the unaudited condensed consolidated financial statements, Community Health Systems, Inc., and its consolidated subsidiaries are referred to on a collective basis as the “Company.” This drafting style is not meant to indicate that the publicly traded Parent or any particular subsidiary of the Parent owns or operates any asset, business, or property. The hospitals, operations and businesses described in this filing are owned and operated by distinct and indirect subsidiaries of Community Health Systems, Inc.

Revenue Recognition.

Net Operating Revenues

Net operating revenues are recorded at the transaction price estimated by the Company to reflect the total consideration due from patients and third-party payors in exchange for providing goods and services in patient care. These services are considered to be a single performance obligation and have a duration of less than one year. Revenues are recorded as these goods and services are provided. The transaction price, which involves significant estimates, is determined based on the Company’s standard charges for the goods and services provided, with a reduction recorded for price concessions related to third party contractual arrangements as well as patient discounts and other patient price concessions. During each of the three and nine month periods ended September 30, 2020 and September 30, 2019, the impact of changes to the inputs used to determine the transaction price was considered immaterial.

Currently, several states utilize supplemental reimbursement programs for the purpose of providing reimbursement to providers that is not specifically tied to an individual’s care, some of which offsets a portion of the cost of providing care to Medicaid and indigent patients. These programs are designed with input from the Centers for Medicare and Medicaid Services (“CMS”) and are funded with a combination of state and federal resources, including, in certain instances, fees or taxes levied on the providers. Under these supplemental programs, the Company recognizes revenue and related expenses in the period in which amounts are estimable and collection is reasonably assured. Reimbursement under these programs is reflected in net operating revenues and fees, taxes or other program-related costs are reflected in other operating expenses.

The Company’s net operating revenues during the three and nine months ended September 30, 2020 and 2019 have been presented in the following table based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in millions):

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2020		2019		2020			2019
Medicare	$	723	$	811	$	2,086		$	2,519
Medicaid		419		437		1,167			1,316
Managed Care and other third-party payors		1,967		1,971		5,425			5,991
Self-pay		17		27		(8	)		99
Total	$	3,126	$	3,246	$	8,670		$	9,925

Patient Accounts Receivable

Patient accounts receivable are recorded at net realizable value based on certain assumptions determined by each payor. For third-party payors including Medicare, Medicaid, and Managed Care, the net realizable value is based on the estimated contractual reimbursement percentage, which is based on current contract prices or historical paid claims data by payor. For self-pay accounts receivable, which includes patients who are uninsured and the patient responsibility portion for patients with insurance, the net realizable value is determined using estimates of historical collection experience without regard to aging category. These estimates are adjusted for estimated conversions of patient responsibility portions, expected recoveries and any anticipated changes in trends.

Patient accounts receivable can be impacted by the effectiveness of the Company’s collection efforts. Additionally, significant changes in payor mix, business office operations, economic conditions or trends in federal and state governmental healthcare coverage could affect the net realizable value of accounts receivable. The Company also continually reviews the net realizable value of accounts receivable by monitoring historical cash collections as a percentage of trailing net operating revenues, as well as by analyzing current period net revenue and admissions by payor classification, days revenue outstanding, the composition of self-pay receivables between pure self-pay patients and the patient responsibility portion of third-party insured receivables, the impact of recent acquisitions and dispositions and the impact of current economic and other events.

Final settlements for some payors and programs are subject to adjustment based on administrative review and audit by third parties. As a result of these final settlements, the Company has recorded amounts due to third-party payors of $94 million and $83 million as of September 30, 2020 and December 31, 2019, respectively, and these amounts are included in accrued liabilities-other in the accompanying condensed consolidated balance sheets. Amounts due from third-party payors were $124 million and $137 million as of September 30, 2020 and December 31, 2019, respectively, and are included in other current assets in the accompanying condensed consolidated balance sheets. Substantially all Medicare and Medicaid cost reports are final settled through 2016.

Charity Care

In the ordinary course of business, the Company renders services to patients who are financially unable to pay for hospital care. The Company’s policy is to not pursue collections for such amounts; therefore, the related charges for those patients who are financially unable to pay and that otherwise do not qualify for reimbursement from a governmental program are not reported in net operating revenues, and are thus classified as charity care. The Company determines amounts that qualify for charity care primarily based on the patient’s household income relative to the federal poverty level guidelines, as established by the federal government.

These charity care services are estimated to be $285 million and $126 million for the three months ended September 30, 2020 and 2019, respectively, and $751 million and $410 million for the nine months ended September 30, 2020 and 2019, respectively, representing the value (at the Company’s standard charges) of these charity care services that are excluded from net operating revenues. The estimated cost incurred by the Company to provide these charity care services to patients who are unable to pay was approximately $36 million and $16 million during the three months ended September 30, 2020 and 2019, respectively, and $90 million and $50 million during the nine months ended September 30, 2020 and 2019, respectively. The estimated cost of these charity care services was determined using a ratio of cost to gross charges and applying that ratio to the gross charges associated with providing care to charity patients for the period.

Accounting for the Impairment or Disposal of Long-Lived Assets. During the nine months ended September 30, 2020, the Company recorded a total combined net impairment charge and loss on disposal of approximately $48 million, of which (i) approximately $74 million was recorded to adjust the carrying value of long-lived assets at several hospitals where the Company is in discussions with potential buyers for divestiture at a sales price that indicates a fair value below carrying value, (ii) approximately $43 million was recorded related to certain hospitals that have been classified as held for sale based on the difference between the carrying value of the hospital disposal groups compared to their estimated fair value less costs to sell, (iii) approximately $3 million was recorded related to a hospital that closed on September 30, 2020, and (iv) approximately $1 million was recorded related to a shared service center that closed on July 31, 2020. The impairment charge was partially offset by a gain of approximately $73 million related to three hospitals sold on January 1, 2020 and one hospital sold on July 1, 2020. During the nine months ended September 30, 2020, a net allocation of approximately $109 million of goodwill was allocated from the hospital operations reporting unit based on a calculation of each disposal groups’ relative fair value compared to the total reporting unit. The Company will continue to evaluate the potential for further impairment of the long-lived assets of underperforming hospitals as well as evaluate offers for potential sales. Based on such analysis, additional impairment charges may be recorded in the future.

During the nine months ended September 30, 2019, the Company recorded a total combined impairment charge and loss on disposal of approximately $70 million to reduce the carrying value of closed hospitals and certain hospitals that have been deemed held for sale based on the difference between the carrying value of the hospital disposal groups compared to estimated fair value less costs to sell. Included in the carrying value of the hospital disposal groups at September 30, 2019 is a net allocation of approximately $68 million of goodwill allocated from the hospital operations reporting unit goodwill based on a calculation of the disposal groups’ relative fair value compared to the total reporting unit.

COVID-19 Pandemic.

In January 2020, the Secretary of the U.S. Department of Health and Human Services (“HHS”) declared a national public health emergency due to a novel strain of coronavirus. In March 2020, the World Health Organization declared the outbreak of COVID-19, a disease caused by this coronavirus, a pandemic. The resulting measures to contain the spread and impact of COVID-19 and other developments related to COVID-19 have materially affected the Company’s results of operations during 2020. Where applicable, the impact resulting from the COVID-19 pandemic during the three and nine months ended September 30, 2020, has been considered, including updated assessments of the recoverability of assets and evaluation of potential credit losses. As a result of the COVID-19 pandemic, federal and state governments have passed legislation, promulgated regulations and taken other administrative actions intended to assist healthcare providers in providing care to COVID-19 and other patients during the public health emergency. Sources of relief include the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”), which was enacted on March 27, 2020, and the Paycheck Protection Program and Health Care Enhancement Act (the “PPPHCE Act”), which was enacted on April 24, 2020. Together, the CARES Act and the PPPHCE Act include $175 billion in funding to be distributed to eligible providers through the Public Health and Social Services Emergency Fund (the “PHSSEF”). In addition, the CARES Act provides for an expansion of the Medicare Accelerated and Advance Payment Program whereby inpatient acute care hospitals and other eligible providers may request accelerated payment of up to 100% of their Medicare payment amount for a six-month period to be repaid through withholding of future Medicare fee-for-service payments. Various other state and local programs also exist to provide relief, either independently or through distribution of monies received via the CARES Act. During the three and nine-month periods ended September 30, 2020, the Company was a beneficiary of these stimulus measures, including the Medicare Accelerated and Advance Payment Program. The Company’s accounting policies for the recognition of these stimulus monies is as follows:

CARES Act and PPPHCE Act Funds

During the nine months ended September 30, 2020, the Company received approximately $719 million in payments through the PHSSEF and various state and local programs, net of amounts that have or will be repaid to HHS related to entities that are held-for-sale or that were previously divested. The Company previously recognized approximately $448 million of these payments as a reduction in operating costs and expenses during the six months ended June 30, 2020, which is denoted by the caption “pandemic relief funds” within the condensed consolidated statements of income (loss). While $155 million in such payments were received

during the three months ended September 30, 2020, the net effect of changes in the Company’s estimate on the basis of revised guidance from HHS in September 2020 (discussed below), the Company’s results of operations during such period and the receipt of additional payments, resulted in no additional pandemic relief funds being recognized during the three months ended September 30, 2020. The recognition of amounts received is conditioned upon the provision of care for individuals with possible or actual cases of COVID-19 after January 31, 2020, certification that payment will be used to prevent, prepare for and respond to coronavirus and shall reimburse the recipient only for healthcare-related expenses or lost revenues, as defined by HHS, that are attributable to coronavirus, as well as receipt of the funds. Amounts are recognized as a reduction to operating costs and expenses only to the extent the Company is reasonably assured that underlying conditions are met.

The Company’s assessment of whether the terms and conditions for amounts received have been met considers all frequently asked questions and other interpretive guidance issued by HHS. On September 19, 2020, HHS issued a Post-Payment Notice of Reporting Requirements (the “September 19, 2020 Notice”) which indicates that providers may recognize reimbursement for healthcare-related expenses, as defined therein, attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse. Additionally, amounts received from the PHSSEF that are not fully expended on eligible healthcare-related expenses may be recognized as reimbursement for lost revenues, represented as a negative change in year-over-year net patient care operating income. This represents a substantial change in the definition of lost revenues which served as the basis of amounts recognized by the Company during the six months ended June 30, 2020. Providers may apply payments to lost revenues up to the amount of the 2019 net gain from healthcare-related sources or, for entities that reported a negative net operating gain in 2019, receipts from the PHSSEF may be recognized up to a net zero gain/loss in 2020. During the three months ended September 30, 2020, the Company’s estimate of the amount for which it is reasonably assured of meeting the underlying terms and conditions was updated based on, among other things, the September 19, 2020 Notice, the Company’s results of operations during such period and the receipt of additional payments during such period. Taking into account these countervailing factors, the Company believes that the amount previously recognized of approximately $448 million remains an appropriate estimate as of September 30, 2020. However, if the facts and circumstances that serve as the basis of the Company’s estimate as of September 30, 2020 had been applied to the estimate as of June 30, 2020, taking into account the September 19, 2020 Notice, the Company estimates that the pandemic relief funds recognized as a reduction to operating costs and expenses as of such date would have been reduced by approximately $66 million as of June 30, 2020.

On October 22, 2020, HHS issued an updated Post-Payment Notice of Reporting Requirements and a Reporting Requirements Policy Update (together, the “October 22, 2020 Notice”) which, among other changes, effectively reinstates the definition of lost revenues that was the basis for the $448 million of pandemic relief funds recognized during the three and six months ended June 30, 2020. As a non-recognizable subsequent event, the Company’s estimate as of September 30, 2020, as set forth above, has not been updated for the October 22, 2020 Notice; additional information is included in Note 14.

Amounts received through the PHSSEF or state and local programs that have not yet been recognized as a reduction to operating costs and expenses or otherwise have not been refunded to HHS as of September 30, 2020, are reflected within accrued liabilities-other in the condensed consolidated balance sheet, and such unrecognized amounts may be recognized as a reduction in operating costs and expenses in future periods if the underlying conditions for recognition are met. As evidenced by the October 22, 2020 Notice, HHS’ interpretation of the underlying terms and conditions of such PHSSEF payments, including auditing and reporting requirements, continues to evolve. Additional guidance or new and amended interpretations of existing guidance on the terms and conditions of such PHSSEF payments may result in changes in the Company’s estimate of amounts for which the terms and conditions are reasonably assured of being met, and any such changes may be material. Additionally, any such changes may result in the Company’s inability to recognize additional PHSSEF payments or may result in the derecognition of amounts previously recognized, which (in any such case) may be material.

Medicare Accelerated Payments

Medicare accelerated payments of approximately $1.2 billion were received by the Company in April 2020. No additional Medicare accelerated payments have been received by the Company since such time, including during the three months ended September 30, 2020, and approximately $22 million of amounts previously received was repaid to CMS or assumed by buyers during the three months ended September 30, 2020 related to divested entities. Effective October 8, 2020, CMS is no longer accepting new applications for accelerated payments. Accordingly, the Company does not expect to receive additional Medicare accelerated payments. Payments under the Medicare Accelerated and Advance Payment program are advances that must be repaid. As of September 30, 2020, the program required CMS to begin recouping payments 120 days after receipt by the provider although no payments were recouped during the three or nine months ended September 30, 2020. Effective October 1, 2020, the program was amended such that providers are required to repay accelerated payments beginning one year after the payment was issued. After such one-year period, Medicare payments owed to providers will be recouped according to the repayment terms. The repayment terms specify that for the first 11 months after repayment begins, repayment will occur through an automatic recoupment of 25% of Medicare payments otherwise owed to the provider. At the end of the eleven-month period, recoupment will increase to 50% for six

months. At the end of the six months (29 months from the receipt of the initial accelerated payment), Medicare will issue a letter for full repayment of any remaining balance, as applicable. In such event, if payment is not received within 30 days, interest will accrue at the annual percentage rate of four percent (4%) from the date the letter was issued, and will be assessed for each full 30-day period that the balance remains unpaid. As of September 30, 2020, approximately $1.1 billion of Medicare accelerated payments are reflected within accrued liabilities-other in the condensed consolidated balance sheet. If the program requirements enacted on October 1, 2020 had been effective as of September 30, 2020, the Company estimates that approximately $873 million of the amount outstanding would be classified as a long-term liability. Such amount is based on an estimate of the total consideration for providing goods and services in patient care that will not be due from Medicare and used to offset the Medicare accelerated payments within one year.

New Accounting Pronouncements. In March 2020, the FASB issued Accounting Standards Update (“ASU”) 2020-04, “Reference Rate Reform: Facilitation of the Effects of Reference Rate Reform on Financial Reporting.” This ASU provides optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, subject to meeting certain criteria that reference the London Interbank Offered Rate (“LIBOR”) or another rate that is expected to be discontinued. The amendments in the ASU are effective for all entities as of March 12, 2020 through December 31, 2022. The adoption of this guidance did not have a material impact on the Company’s condensed consolidated financial position or results of operations.

The Company has evaluated all other recently issued, but not yet effective, ASUs and does not expect the eventual adoption of these ASUs to have a material impact on its condensed consolidated financial position or results of operations.

Accounting for Stock-Based Compensation

9 Months Ended

Sep. 30, 2020

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

ACCOUNTING FOR STOCK-BASED COMPENSATION

2. ACCOUNTING FOR STOCK-BASED COMPENSATION

Stock-based compensation awards have been granted under the Community Health Systems, Inc. Amended and Restated 2000 Stock Option and Award Plan, amended and restated as of March 20, 2013 (the “2000 Plan”), and the Community Health Systems, Inc. Amended and Restated 2009 Stock Option and Award Plan, which was amended and restated as of March 20, 2020 and approved by the Company’s stockholders at the annual meeting of stockholders held on May 12, 2020 (the “2009 Plan”).

The 2000 Plan allowed for the grant of incentive stock options intended to qualify under Section 422 of the Internal Revenue Code (the “IRC”), as well as stock options which did not so qualify, stock appreciation rights, restricted stock, restricted stock units, performance-based shares or units and other share awards. Persons eligible to receive grants under the 2000 Plan included the Company’s directors, officers, employees and consultants. All options granted under the 2000 Plan were “nonqualified” stock options for tax purposes. Generally, vesting of these granted options occurred in one-third increments on each of the first three anniversaries of the award date. Options granted since 2008 had a 10-year contractual term. Pursuant to the amendment and restatement of the 2000 Plan dated March 20, 2013, no further grants will be awarded under the 2000 Plan.

The 2009 Plan provides for the grant of incentive stock options intended to qualify under Section 422 of the IRC and for the grant of stock options which do not so qualify, stock appreciation rights, restricted stock, restricted stock units, performance-based shares or units and other share awards. Persons eligible to receive grants under the 2009 Plan include the Company’s directors, officers, employees and consultants. To date, all options granted under the 2009 Plan have been “nonqualified” stock options for tax purposes. Generally, vesting of these granted options occurs in one-third increments on each of the first three anniversaries of the award date. Options granted in 2011 or later have a 10-year contractual term. As of September 30, 2020, 10,423,344 shares of unissued common stock were reserved for future grants under the 2009 Plan.

The exercise price of all options granted under the 2000 Plan and the 2009 Plan is equal to the fair value of the Company’s common stock on the option grant date.

The following table reflects the impact of total compensation expense related to stock-based equity plans on the reported operating results for the respective periods (in millions):

	Three Months Ended						Nine Months Ended
	September 30,						September 30,
	2020			2019			2020			2019
Effect on loss before income taxes	$	(3	)	$	(2	)	$	(8	)	$	(8	)
Effect on net income (loss)	$	(2	)	$	(2	)	$	(6	)	$	(6	)

At September 30, 2020, $19 million of unrecognized stock-based compensation expense related to outstanding unvested stock options, restricted stock and restricted stock units (the terms of which are summarized below) was expected to be recognized over a weighted-average period of 24 months. Of that amount, $3 million related to outstanding unvested stock options was expected to be

recognized over a weighted-average period of 26 months and $16 million related to outstanding unvested restricted stock and restricted stock units was expected to be recognized over a weighted-average period of 24 months. There were no modifications to awards during the three or nine months ended September 30, 2020 and 2019.

The fair value of stock options was estimated using the Black Scholes option pricing model with the following assumptions and weighted-average fair values during the three and nine months ended September 30, 2020 and 2019:

	Three Months Ended September 30,		Nine Months Ended September 30,
	2020	2019	2020			2019
Expected volatility	N/A	N/A		73.5	%		68.4	%
Expected dividends	N/A	N/A		—			—
Expected term	N/A	N/A	6 years			5.6 years
Risk-free interest rate	N/A	N/A		1.0	%		2.6	%

In determining the expected term, the Company examined concentrations of option holdings and historical patterns of option exercises and forfeitures, as well as forward-looking factors, in an effort to determine if there were any discernable employee populations. From this analysis, the Company identified two primary employee populations, one consisting of certain senior executives and the other consisting of substantially all other recipients.

The expected volatility rate was estimated based on historical volatility. In determining expected volatility, the Company also reviewed the market-based implied volatility of actively traded options of its common stock and determined that historical volatility utilized to estimate the expected volatility rate did not differ significantly from the implied volatility.

The expected term computation is based on historical exercise and cancellation patterns and forward-looking factors, where present, for each population identified. The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the time of the grant. The pre-vesting forfeiture rate is based on historical rates and forward-looking factors for each population identified. The Company adjusts the estimated forfeiture rate to its actual experience.

Options outstanding and exercisable under the 2000 Plan and the 2009 Plan as of September 30, 2020, and changes during each of the three-month periods following December 31, 2019, was as follows (in millions, except share and per share data):

						Weighted-	Aggregate
				Weighted-		Average	Intrinsic
				Average		Remaining	Value as of
				Exercise		Contractual	September 30,
	Shares			Price		Term	2020
Outstanding at December 31, 2019		1,110,134			16.90	5.6 years
Granted		946,500			4.93
Exercised		—			—
Forfeited and cancelled		(159,938	)		33.90
Outstanding at March 31, 2020		1,896,696			9.50
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(31,667	)		31.90
Outstanding at June 30, 2020		1,865,029			9.12
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(7,003	)		32.58
Outstanding at September 30, 2020		1,858,026		$	9.03	7.7 years	$	—
Exercisable at September 30, 2020		495,522		$	20.28	4.0 years	$	—

No stock options were granted during the three months ended September 30, 2020 and 2019. The weighted-average grant date fair value of stock options granted during the nine months ended September 30, 2020 and 2019 was $3.17 and $3.05, respectively. The aggregate intrinsic value (calculated as the number of in-the-money stock options multiplied by the difference between the Company’s

closing stock price on the last trading day of the reporting period ($4.22) and the exercise price of the respective stock options) in the table above represents the amount that would have been received by the option holders had all option holders exercised their options on September 30, 2020. This amount changes based on the market value of the Company’s common stock. There were no options exercised during the three or nine months ended September 30, 2020 and 2019. The aggregate intrinsic value of options vested and expected to vest approximates that of the outstanding options.

The Company has also awarded restricted stock under the 2009 Plan to employees of certain subsidiaries. With respect to time-based vesting restricted stock that has been awarded under the 2009 Plan, the restrictions on these shares have generally lapsed in one-third increments on each of the first three anniversaries of the award date. In addition, certain of the restricted stock awards granted to the Company’s senior executives have contained performance objectives required to be met in addition to any time-based vesting requirements. If the applicable performance objectives are not attained, these awards will be forfeited in their entirety. For performance-based awards, the performance objectives are measured cumulatively over a three-year period. With respect to performance-based awards, if the applicable target performance objective is met at the end of the three-year period, then the restricted stock award subject to such performance objective will vest in full on the third anniversary of the award date. Additionally, for these performance-based awards, based on the level of achievement for the applicable performance objective within the parameters specified in the award agreement, the number of shares to be issued in connection with the vesting of the award may be adjusted to decrease or increase the number of shares specified in the original award. Notwithstanding the above-mentioned performance objectives and vesting requirements, the restrictions with respect to restricted stock granted under the 2009 Plan may lapse earlier in the event of death, disability or termination of employment by the Company for any reason other than for cause of the holder of the restricted stock, or change in control of the Company. The entire restricted stock awards subject to performance objectives granted on March 1, 2017 were forfeited during the nine months ended September 30, 2020 as a result of the minimum level of the applicable cumulative performance objectives for the 2017-2019 performance period not having been met. Restricted stock awards subject to performance objectives that have not yet been satisfied are not considered outstanding for purposes of determining earnings per share until the performance objectives have been satisfied.

Restricted stock outstanding under the 2009 Plan as of September 30, 2020, and changes during each of the three-month periods following December 31, 2019, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2019		3,857,402		$	5.47
Granted		2,197,500			4.90
Vested		(988,650	)		5.77
Forfeited		(328,500	)		9.19
Unvested at March 31, 2020		4,737,752			4.89
Granted		4,000			3.19
Vested		(96,677	)		6.81
Forfeited		(26,335	)		5.00
Unvested at June 30, 2020		4,618,740			4.84
Granted		—			—
Vested		(11,001	)		4.53
Forfeited		(21,002	)		5.01
Unvested at September 30, 2020		4,586,737			4.84

Restricted stock units (“RSUs”) have been granted to the Company’s non-management directors under the 2009 Plan. Each of the Company’s then serving non-management directors received grants under the 2009 Plan of 34,068 RSUs and 34,483 RSUs on March 1, 2019 and 2020, respectively. Each of the 2019 and 2020 grants had a grant date fair value of approximately $170,000. Vesting of these RSUs occurs in one-third increments on each of the first three anniversaries of the award date or upon the director’s earlier cessation of service on the board, other than for cause. Beginning with the 2020 grant, each non-management director may elect, prior to the beginning of the calendar year in which the award is granted, to defer the receipt of shares of the Company’s common stock issuable upon vesting until either his or her (i) separation from service with the Company or (ii) attainment of an age specified in advance by the non-management director.

RSUs outstanding under the 2009 Plan as of September 30, 2020, and changes during each of the three-month periods following December 31, 2019, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2019		541,576		$	5.13
Granted		310,347			4.93
Vested		(238,184	)		5.47
Forfeited		—			—
Unvested at March 31, 2020		613,739			4.89
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at June 30, 2020		613,739			4.89
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at September 30, 2020		613,739			4.89

Acquisitions and Divestitures

9 Months Ended

Sep. 30, 2020

Acquisitions And Divestitures [Abstract]

ACQUISITIONS AND DIVESTITURES

3. ACQUISITIONS AND DIVESTITURES

Acquisitions

The Company accounts for all transactions that represent business combinations using the acquisition method of accounting, where the identifiable assets acquired, the liabilities assumed and any noncontrolling interest in the acquired entity are recognized and measured at their fair values on the date the Company obtains control in the acquiree. Such fair values that are not finalized for reporting periods following the acquisition date are estimated and recorded as provisional amounts. Adjustments to these provisional amounts during the measurement period (defined as the date through which all information required to identify and measure the consideration transferred, the assets acquired, the liabilities assumed and any noncontrolling interests has been obtained, limited to one year from the acquisition date) are recorded when identified. Goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired.

Acquisition and integration expenses related to prospective and closed acquisitions included in other operating expenses on the condensed consolidated statements of income (loss) were less than $1 million during both of the three-month periods ended September 30, 2020 and 2019, and less than $1 million and approximately $3 million for the nine months ended September 30, 2020 and 2019, respectively.

During the nine months ended September 30, 2020, one or more subsidiaries of the Company paid approximately $1 million to acquire the operating assets and related businesses of certain physician practices, clinics and other ancillary businesses that operate within the communities served by the Company’s affiliated hospitals. The Company allocated the purchase price to property and equipment, working capital and goodwill.

Divestitures

The following table provides a summary of hospitals that the Company divested during the nine months ended September 30, 2020 and the year ended December 31, 2019:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2020 Divestitures:

Hill Regional Hospital	AHRK Holdings, LLC	Hillsboro, TX	25	August 1, 2020
St. Cloud Regional Medical Center	Orlando Health, Inc.	St. Cloud, FL	84	July 1, 2020
Northern Louisiana Medical Center	Allegiance Health Management, Inc.	Ruston, LA	130	July 1, 2020
Shands Live Oak Regional Medical Center	HCA Healthcare, Inc. (“HCA”)	Live Oak, FL	25	May 1, 2020
Shands Starke Regional Medical Center	HCA	Starke, FL	49	May 1, 2020
Southside Regional Medical Center	Bon Secours Mercy Health System	Petersburg, VA	300	January 1, 2020
Southampton Memorial Hospital	Bon Secours Mercy Health System	Franklin, VA	105	January 1, 2020
Southern Virginia Regional Medical Center	Bon Secours Mercy Health System	Emporia, VA	80	January 1, 2020

2019 Divestitures:

Bluefield Regional Medical Center	Princeton Community Hospital Association	Bluefield, WV	92	October 1, 2019
Lake Wales Medical Center	Adventist Health System	Lake Wales, FL	160	September 1, 2019
Heart of Florida Regional Medical Center	Adventist Health System	Davenport, FL	193	September 1, 2019
College Station Medical Center	St. Joseph Regional Health Center	College Station, TX	167	August 1, 2019
Tennova Healthcare - Lebanon	Vanderbilt University Medical Center	Lebanon, TN	245	August 1, 2019
Chester Regional Medical Center	Medical University Hospital Authority	Chester, SC	82	March 1, 2019
Carolinas Hospital System - Florence	Medical University Hospital Authority	Florence, SC	396	March 1, 2019
Springs Memorial Hospital	Medical University Hospital Authority	Lancaster, SC	225	March 1, 2019
Carolinas Hospital System - Marion	Medical University Hospital Authority	Mullins, SC	124	March 1, 2019
Memorial Hospital of Salem County	Community Healthcare Associates, LLC	Salem, NJ	126	January 31, 2019
Mary Black Health System - Spartanburg	Spartanburg Regional Healthcare System	Spartanburg, SC	207	January 1, 2019
Mary Black Health System - Gaffney	Spartanburg Regional Healthcare System	Gaffney, SC	125	January 1, 2019

On April 20, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of San Angelo Community Medical Center (171 licensed beds) in San Angelo, Texas to subsidiaries of Shannon Health System. This disposition was completed on October 24, 2020, as further described in Note 14 below.

On April 27, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of each of Abilene Regional Medical Center (231 licensed beds) in Abilene, Texas and Brownwood Regional Medical Center (188 licensed beds) in Brownwood, Texas to subsidiaries of Hendrick Health System. This disposition was completed on October 27, 2020, as further described in Note 14 below.

On June 25, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of Bayfront Health St. Petersburg (480 licensed beds) in St. Petersburg, Florida to affiliates of Orlando Health, Inc. This disposition was completed on October 1, 2020, as further described in Note 14 below.

On September 8, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of Lea Regional Medical Center (68 licensed beds) in Hobbs, New Mexico to affiliates of Covenant Health System.

On September 30, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of each of Tennova Healthcare - Tullahoma (135 licensed beds) in Tullahoma, Tennessee and Tennova Healthcare – Shelbyville (60 licensed beds) in Shelbyville, Tennessee to Vanderbilt University Medical Center.

The following table discloses amounts included in the condensed consolidated balance sheets for the hospitals classified as held for sale as of September 30, 2020 and December 31, 2019 (in millions). Other assets, net primarily includes the net property and

equipment for hospitals held for sale. No divestitures or potential divestitures meet the criteria for reporting as a discontinued operation.

	September 30, 2020		December 31, 2019
Other current assets	$	32	$	25
Other assets, net		341		262
Accrued liabilities		114		43

Other Hospital Closures

Effective September 30, 2020, one or more affiliates of the Company finalized an agreement to terminate the lease and cease operations of Shands Lake Shore Regional Medical Center (99 licensed beds) in Lake City, Florida, including transferring leased assets back to the landlord, the Lake Shore Hospital Authority. The Company recorded an impairment charge of approximately $3 million during the three months ended September 30, 2020 in conjunction with exiting the lease to operate this hospital.

During the three months ended December 31, 2018, the Company completed the planned closure of Tennova – Physicians Regional Medical Center in Knoxville, Tennessee and Tennova – Lakeway Regional Medical Center in Morristown, Tennessee. The Company recorded an impairment charge of $27 million during the three months ended December 31, 2018, to adjust the fair value of the supplies, inventory and long-lived assets of these hospitals, including property and equipment and capitalized software costs, based on their estimated fair value and future utilization. During 2019, the Company recorded an impairment charge of approximately $9 million to further adjust the fair value of the supplies, inventory and long-lived assets of these hospitals, including property and equipment and capitalized software costs, based on the Company’s updated evaluation of their estimated fair value and future utilization and consideration of costs to dispose of such assets.

Goodwill and Other Intangible Assets

9 Months Ended

Sep. 30, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

4. GOODWILL AND OTHER INTANGIBLE ASSETS

Goodwill

The changes in the carrying amount of goodwill for the nine months ended September 30, 2020 are as follows (in millions):

Balance, as of December 31, 2019
Goodwill	$	7,142
Accumulated impairment losses		(2,814	)
		4,328

Goodwill acquired as part of acquisitions during current year		1
Goodwill allocated to hospitals held for sale		(109	)

Balance, as of September 30, 2020
Goodwill		7,034
Accumulated impairment losses		(2,814	)
	$	4,220

Goodwill is allocated to each identified reporting unit, which is defined as an operating segment or one level below the operating segment (referred to as a component of the entity). Management has determined that the Company’s operating segment meets the criteria to be classified as a reporting unit. At September 30, 2020, after giving effect to 2020 divestiture activity, the Company had approximately $4.2 billion of goodwill recorded.

Goodwill is evaluated for impairment annually and when an event occurs or circumstances change that, more likely than not, reduce the fair value of the reporting unit below its carrying value. The Company performed its last annual goodwill impairment evaluation during the fourth quarter of 2019 using an October 31, 2019 measurement date, which indicated no impairment.

The Company estimates the fair value of the reporting unit using both a discounted cash flow model as well as a market multiple model. The cash flow forecasts are adjusted by an appropriate discount rate based on the Company’s estimate of a market participant’s weighted-average cost of capital. These models are both based on the Company’s best estimate of future revenues and operating costs and are reconciled to the Company’s consolidated market capitalization, with consideration of the amount a potential acquirer would be required to pay, in the form of a control premium, in order to gain sufficient ownership to set policies, direct operations and control management decisions.

While no impairment was indicated in the Company’s annual goodwill evaluation as of the October 31, 2019 measurement date, the reduction in the Company’s fair value and the resulting goodwill impairment charges recorded in 2016 and 2017 reduced the carrying value of the Company’s hospital operations reporting unit to an amount equal to its estimated fair value as of such prior year measurement dates. This increases the risk that future declines in fair value could result in goodwill impairment. The determination of fair value in the Company’s goodwill impairment analysis is based on an estimate of fair value for each reporting unit utilizing known and estimated inputs at the evaluation date. Some of those inputs include, but are not limited to, the most recent price of the Company’s common stock and fair value of long-term debt, estimates of future revenue and expense growth, estimated market multiples, expected capital expenditures, income tax rates, and costs of invested capital. A detailed evaluation of potential impairment indicators was performed as of September 30, 2020, which specifically considered the volatility of the fair market value of the Company’s outstanding senior secured and unsecured notes and common stock during the nine months ended September 30, 2020, as well as declines in patient volumes and net operating revenues resulting from the COVID-19 pandemic. On the basis of available evidence as of September 30, 2020, no indicators of impairment were identified.

Future estimates of fair value could be adversely affected if the actual outcome of one or more of the assumptions described above changes materially in the future, including a decline in or volatility of the Company’s stock price and the fair value of its long-term debt, lower than expected hospital volumes, higher market interest rates or increased operating costs. Such changes impacting the calculation of fair value, the risks of which are amplified by the COVID-19 pandemic, could result in a material impairment charge in the future.

The determination of fair value of the Company’s hospital operations reporting unit as part of its goodwill impairment measurement represents a Level 3 fair value measurement in the fair value hierarchy due to its use of internal projections and unobservable measurement inputs.

Intangible Assets

No intangible assets other than goodwill were acquired during the nine months ended September 30, 2020. The gross carrying amount of the Company’s other intangible assets subject to amortization was $1 million at both September 30, 2020 and December 31, 2019, and the net carrying amount was less than $1 million at both September 30, 2020 and December 31, 2019. The carrying amount of the Company’s other intangible assets not subject to amortization was $55 million and $63 million at September 30, 2020 and December 31, 2019, respectively. Other intangible assets are included in other assets, net on the Company’s condensed consolidated balance sheets. Substantially all of the Company’s intangible assets are contract-based intangible assets related to operating licenses, management contracts, or non-compete agreements entered into in connection with prior acquisitions.

The gross carrying amount of capitalized software for internal use was approximately $1.1 billion at both September 30, 2020 and December 31, 2019, and the net carrying amount was approximately $270 million and $321 million at September 30, 2020 and December 31, 2019, respectively. The estimated amortization period for capitalized internal-use software is generally three years, except for capitalized costs related to significant system conversions, which is generally eight to ten years. There is no expected residual value for capitalized internal-use software. At September 30, 2020, there was approximately $13 million of capitalized costs for internal-use software that is currently in the development stage and will begin amortization once the software project is complete and ready for its intended use. Amortization expense on capitalized internal-use software was $34 million and $30 million during the three months ended September 30, 2020 and 2019, respectively, and $96 million and $91 million during the nine months ended September 30, 2020 and 2019, respectively. Amortization expense on capitalized internal-use software is estimated to be $30 million for the remainder of 2020, $111 million in 2021, $69 million in 2022, $34 million in 2023, $11 million in 2024, $9 million in 2025 and $6 million thereafter.

Income Taxes

9 Months Ended

Sep. 30, 2020

Income Tax Disclosure [Abstract]

INCOME TAXES

5. INCOME TAXES

The total amount of unrecognized benefit that would affect the effective tax rate, if recognized, was approximately $1 million as of September 30, 2020. A total of approximately $1 million of interest and penalties is included in the amount of the liability for uncertain tax positions at September 30, 2020. It is the Company’s policy to recognize interest and penalties related to unrecognized benefits in its condensed consolidated statements of income (loss) as income tax expense.

It is possible the amount of unrecognized tax benefit could change in the next 12 months as a result of a lapse of the statute of limitations and settlements with taxing authorities; however, the Company does not anticipate the change will have a material impact on the Company’s condensed consolidated results of operations or financial position.

The Company’s federal income tax returns for the 2009 and 2010 tax years have been settled with the Internal Revenue Service. The results of these examinations were not material to the Company’s consolidated results of operations or financial position. The Company’s federal income tax returns for the 2014 and 2015 tax years remain under examination by the Internal Revenue Service. The Company believes the results of these examinations will not be material to its condensed consolidated results of operations or financial position. The Company has extended the federal statute of limitations through June 30, 2021 for Community Health Systems, Inc. for the tax periods ended December 31, 2014 and 2015. The Company’s federal income tax return for the 2018 tax year is under examination by the Internal Revenue Service.

The Company’s effective tax rates were 13.5% and 102.8% for the three months ended September 30, 2020 and 2019, respectively, and (669.7)% and 22.5% for the nine months ended September 30, 2020 and 2019, respectively. The difference in the Company’s effective tax rate for the three and nine months ended September 30, 2020, when compared to the three and nine months ended September 30, 2019, was primarily due to changes in tax benefits as a result of an increase to the deductible interest expense allowed for 2019 and 2020 under the CARES Act that was enacted during the three months ended March 31, 2020.

Cash paid for income taxes, net of refunds received, resulted in a net payment of approximately $3 million and less than $1 million during the three months ended September 30, 2020 and 2019, respectively, and a net payment of $2 million and a net refund of $3 million during the nine months ended September 30, 2020 and 2019, respectively.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References + Details

Long-Term Debt

9 Months Ended

Sep. 30, 2020

Long Term Debt And Capital Lease Obligations [Abstract]

LONG-TERM DEBT

6. LONG-TERM DEBT

Long-term debt, net of unamortized debt issuance costs and discounts or premiums, consists of the following (in millions):

	September 30,			December 31,
	2020			2019
5⅛% Senior Secured Notes due 2021	$	—		$	1,000
6⅞% Senior Notes due 2022		197			231
6¼% Senior Secured Notes due 2023		2,675			3,100
8⅝% Senior Secured Notes due 2024		1,033			1,033
6⅝% Senior Secured Notes due 2025		1,462			—
8% Senior Secured Notes due 2026		2,101			2,101
8% Senior Secured Notes due 2027		700			700
6⅞% Senior Notes due 2028		1,474			1,700
9⅞% Junior-Priority Secured Notes due 2023		1,770			1,770
8⅛% Junior-Priority Secured Notes due 2024		1,354			1,355
ABL Facility		—			273
Finance lease and financing obligations		241			272
Other		20			17
Less: Unamortized deferred debt issuance costs and note premium		(148	)		(147	)
Total debt		12,879			13,405
Less: Current maturities		(19	)		(20	)
Total long-term debt	$	12,860		$	13,385

On February 6, 2020, CHS/Community Health Systems, Inc. (“CHS”) completed a private offering of $1.462 billion aggregate principal amount of 6⅝% Senior Secured Notes due February 15, 2025 (the “6⅝% Senior Secured Notes due 2025”). CHS used the net proceeds of the offering of the 6⅝% Senior Secured Notes due 2025 to (i) purchase any and all of its 5⅛% Senior Secured Notes due 2021 validly tendered and not validly withdrawn in the cash tender offer announced on January 23, 2020, (ii) redeem all of the 5⅛% Senior Secured Notes due 2021 that were not purchased pursuant to such tender offer, (iii) purchase in one or more privately negotiated transactions approximately $426 million aggregate principal amount of its 6¼% Senior Secured Notes due 2023 and (iv) pay related fees and expenses.

The 6⅝% Senior Secured Notes due 2025 bear interest at a rate of 6.625% per annum, payable semi-annually in arrears on February 15 and August 15 of each year, commencing on August 15, 2020. The 6⅝% Senior Secured Notes are scheduled to mature on February 15, 2025. The 6⅝% Senior Secured Notes due 2025 are unconditionally guaranteed on a senior-priority secured basis by the Company and each of the CHS current and future domestic subsidiaries that provide guarantees under the revolving asset-based loan facility (the “ABL Facility”), any capital market debt securities of CHS (including CHS’ outstanding senior notes) and certain other long-term debt of CHS. The 6⅝% Senior Secured Notes due 2025 and the related guarantees are secured by shared (i) first-priority liens on the Non-ABL Priority Collateral and (ii) second-priority liens on the ABL Priority Collateral that secures on a first-priority basis the ABL Facility, in each case subject to permitted liens described in the indenture governing the 6⅝% Senior Secured Notes due 2025.

At any time prior to February 15, 2022, CHS may redeem some or all of the 6⅝% Senior Secured Notes due 2025 at a price equal to 100% of their principal amount plus accrued and unpaid interest, if any, to, but excluding the applicable redemption date plus a make-whole premium as defined in the indenture agreement dated February 6, 2020. After February 15, 2022, CHS is entitled, at its option, to redeem some or all of the 6⅝% Senior Secured Notes at a redemption price equal to the percentage of principal amount below plus accrued and unpaid interest, if any, to, but excluding the applicable redemption date, if redeemed during the twelve-month period beginning on February 15 of the years set forth below:

Period	Redemption Price
February 15, 2022 to February 14, 2023		103.313	%
February 15, 2023 to February 14, 2024		101.656	%
February 15, 2024 to February 14, 2025		100.000	%

During the three months ended September 30, 2020, the Company extinguished a portion of certain series of its outstanding notes through open market repurchases, as follows (in millions):

	Principal Amount
6⅞% Senior Notes due 2028	$	226
8⅛% Junior-Priority Secured Notes due 2024		1
6⅞% Senior Notes due 2022		34
Total principal amount of debt extinguished	$	261

Financing and repayment transactions discussed above resulted in a pre-tax and after-tax gain from early extinguishment of debt of $115 million and $100 million, respectively, for the three months ended September 30, 2020 and a pre-tax and after-tax gain from early extinguishment of $111 million and $97 million, respectively, for the nine months ended September 30, 2020.

Financing and repayment transactions in the prior year resulted in a pre-tax and after-tax loss from early extinguishment of debt of less than $1 million for the three months ended September 30, 2019 and a pre-tax and after-tax loss of $31 million and $25 million, respectively, for the nine months ended September 30, 2019.

The maximum aggregate principal amount under the ABL Facility is $1.0 billion. At September 30, 2020, the available borrowing base under the ABL Facility was $654 million, of which the Company had no outstanding borrowings and letters of credit issued of $151 million. The issued letters of credit were primarily in support of potential insurance-related claims and certain bonds.

The ABL Facility contains customary representations and warranties, subject to limitations and exceptions, and customary covenants restricting the Company’s ability, subject to certain exceptions, to, among other things (1) declare dividends, make distributions or redeem or repurchase capital stock, (2) prepay, redeem or repurchase other debt, (3) incur liens or grant negative pledges, (4) make loans and investments and enter into acquisitions and joint ventures, (5) incur additional indebtedness or provide certain guarantees, (6) engage in mergers, acquisitions and asset sales, (7) conduct transactions with affiliates, (8) alter the nature of the Company’s, CHS’ or the guarantors’ businesses, (9) grant certain guarantees with respect to physician practices, (10) engage in sale and leaseback transactions or (11) change the Company’s fiscal year. The Company is also required to comply with a consolidated fixed coverage ratio, upon certain triggering events described below, and various affirmative covenants. The consolidated fixed coverage ratio is calculated as the ratio of (x) consolidated EBITDA (as defined in the ABL Facility) less capital expenditures to (y) the sum of consolidated interest expense (as defined in the ABL Facility), scheduled principal payments, income taxes and restricted payments made in cash or in permitted investments. For purposes of calculating the consolidated fixed charge coverage ratio, the calculation of consolidated EBITDA as defined in the ABL Facility is a trailing 12-month calculation that begins with the Company’s consolidated net income, with certain adjustments for interest, taxes, depreciation and amortization, net income

attributable to noncontrolling interests, stock compensation expense, restructuring costs, and the financial impact of other non-cash or non-recurring items recorded during any such 12-month period. The consolidated fixed charge coverage ratio is a required covenant only in periods where the total borrowings outstanding under the ABL Facility reduce the amount available in the facility to less than the greater of (i) $95 million or (ii) 10% of the calculated borrowing base. As a result, in the event the Company has less than $95 million available under the ABL Facility, the Company would need to comply with the consolidated fixed charge coverage ratio. At September 30, 2020, the Company is not subject to the consolidated fixed charge coverage ratio as such triggering event had not occurred during the last twelve months ended September 30, 2020.

The Company’s single remaining interest rate swap agreement terminated effective August 30, 2020. The Company received a variable rate of interest on this swap based on the three-month LIBOR in exchange for the payment of a fixed rate of interest. See Note 7 for additional information regarding this swap.

The Company paid interest of $279 million and $492 million on borrowings during the three months ended September 30, 2020 and 2019, respectively, and $765 million and $810 million on borrowings during the nine months ended September 30, 2020 and 2019, respectively.

Fair Value of Financial Instruments

9 Months Ended

Sep. 30, 2020

Fair Value Disclosures [Abstract]

FAIR VALUE OF FINANCIAL INSTRUMENTS

7. FAIR VALUE OF FINANCIAL INSTRUMENTS

The fair value of financial instruments has been estimated by the Company using available market information as of September 30, 2020 and December 31, 2019, and valuation methodologies considered appropriate. The estimates presented in the table below are not necessarily indicative of amounts the Company could realize in a current market exchange (in millions):

	September 30, 2020				December 31, 2019
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	1,823	$	1,823	$	216	$	216
Investments in equity securities		124		124		141		141
Available-for-sale debt securities		105		105		101		101
Trading securities		13		13		12		12
Liabilities:
5⅛% Senior Secured Notes due 2021		—		—		990		1,003
6⅞% Senior Notes due 2022		196		176		229		188
6¼% Senior Secured Notes due 2023		2,657		2,617		3,074		3,148
8⅝% Senior Secured Notes due 2024		1,025		1,028		1,023		1,099
6⅝% Senior Secured Notes due 2025		1,425		1,417		—		—
8% Senior Secured Notes due 2026		2,073		2,070		2,070		2,182
8% Senior Secured Notes due 2027		691		685		691		700
6⅞% Senior Notes due 2028		1,456		697		1,678		1,700
9⅞% Junior-Priority Secured Notes due 2023		1,757		1,402		1,754		1,539
8⅛% Junior-Priority Secured Notes due 2024		1,341		990		1,340		1,113
ABL Facility and other debt		17		17		285		285

The carrying value of the Company’s long-term debt in the above table is presented net of unamortized deferred debt issuance costs. The estimated fair value is determined using the methodologies discussed below in accordance with accounting standards related to the determination of fair value based on the U.S. GAAP fair value hierarchy as discussed in Note 8. The estimated fair value for financial instruments with a fair value that does not equal its carrying value is considered a Level 1 valuation. The Company utilizes the market approach and obtains indicative pricing through publicly available subscription services such as Bloomberg to determine fair values where relevant.

Cash and cash equivalents. The carrying amount approximates fair value due to the short-term maturity of these instruments (less than three months).

Investments in equity securities. Estimated fair value is based on closing price as quoted in public markets.

Available-for-sale debt securities. Estimated fair value is based on closing price as quoted in public markets or other various valuation techniques.

Trading securities. Estimated fair value is based on closing price as quoted in public markets.

Senior Notes, Senior Secured Notes and Junior-Priority Secured Notes. Estimated fair value is based on the closing market price for these notes.

ABL Facility and other debt. The carrying amount of the ABL Facility and all other debt approximates fair value due to the nature of these obligations.

As discussed in Note 6, the Company’s single remaining interest rate swap terminated effective August 30, 2020.

The Company is exposed to certain risks relating to its ongoing business operations. The risk managed by using derivative instruments is interest rate risk. Companies are required to recognize all derivative instruments as either assets or liabilities at fair value in the condensed consolidated statement of financial position. For derivative instruments that are designated and qualify as cash flow hedges, the effective portion of the gain or loss on the derivative is reported as a component of other comprehensive income (“OCI”) and reclassified into earnings in the same period or periods during which the hedged transactions affect earnings. Gains and losses on the derivative representing either ineffectiveness or hedge components excluded from the assessment of effectiveness are recognized in current earnings.

The following tabular disclosure provides the amount of pre-tax gain (loss) recognized as a component of OCI during the three and nine months ended September 30, 2020 and 2019 (in millions):

	Amount of Pre-Tax Gain (Loss) Recognized in OCI (Effective Portion)
Derivatives in Cash Flow Hedging	Three Months Ended September 30,				Nine Months Ended September 30,
Relationships	2020		2019		2020		2019
Interest rate swaps	$	—	$	—	$	—	$	(4	)

The following tabular disclosure provides the location of the effective portion of the pre-tax loss (gain) reclassified from accumulated other comprehensive loss (“AOCL”) into interest expense on the condensed consolidated statements of income (loss) during the three and nine months ended September 30, 2020 and 2019 (in millions):

	Amount of Pre-Tax Loss (Gain) Reclassified
	from AOCL into Income (Effective Portion)
Location of Loss (Gain) Reclassified from	Three Months Ended September 30,				Nine Months Ended September 30,
AOCL into Income (Effective Portion)	2020		2019		2020		2019
Interest expense, net	$	1	$	—	$	2	$	(1	)

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Fair Value

9 Months Ended

Sep. 30, 2020

Fair Value Disclosures [Abstract]

FAIR VALUE

8. FAIR VALUE

Fair Value Hierarchy

Fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, the Company utilizes the U.S. GAAP fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumption about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

The inputs used to measure fair value are classified into the following fair value hierarchy:

Level 1: Quoted market prices in active markets for identical assets or liabilities.

Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data.

Level 3: Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities. Level 3 includes values determined using pricing models, discounted cash flow methodologies, or similar techniques reflecting the Company’s own assumptions.

In instances where the determination of the fair value hierarchy 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 that is significant to the fair value measurement in its entirety. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment of factors specific to the asset or liability. Transfers between levels within the fair value hierarchy are recognized by the Company on the date of the change in circumstances that requires such transfer. There were no transfers between levels during the nine-month periods ended September 30, 2020 or September 30, 2019.

The following table sets forth, by level within the fair value hierarchy, the financial assets and liabilities recorded at fair value on a recurring basis as of September 30, 2020 and December 31, 2019 (in millions):

	September 30, 2020		Level 1		Level 2		Level 3
Investments in equity securities	$	124	$	124	$	—	$	—
Available-for-sale debt securities		105		—		105		—
Trading securities		13		—		13		—
Total assets	$	242	$	124	$	118	$	—

	December 31, 2019		Level 1		Level 2		Level 3
Investments in equity securities	$	141	$	141	$	—	$	—
Available-for-sale debt securities		101		—		101		—
Trading securities		12		—		12		—
Total assets	$	254	$	141	$	113	$	—

Fair value of interest rate swap agreement	$	2	$	—	$	2	$	—
Total liabilities	$	2	$	—	$	2	$	—

Investments in Equity Securities, Available-for-Sale Debt Securities and Trading Securities

Investments in equity securities and trading securities classified as Level 1 are measured using quoted market prices. Level 2 available-for-sale debt securities and trading securities primarily consisted of bonds and notes issued by the United States government and its agencies and domestic and foreign corporations. The estimated fair values of these securities are determined using various valuation techniques, including a multi-dimensional relational model that incorporates standard observable inputs and assumptions such as benchmark yields, reported trades, broker/dealer quotes, issuer spreads, benchmark securities, bids/offers and other pertinent reference data.

Leases

9 Months Ended

Sep. 30, 2020

Leases [Abstract]

LEASES

9. LEASES

The Company utilizes operating and finance leases for the use of certain hospitals, medical office buildings, and medical equipment. The Company has elected to account for COVID-19 related concessions as though the enforceable rights and obligations for those concessions are explicit within the underlying contract. During the three and nine months ended September 30, 2020, concessions of approximately $4 million and $6 million, respectively, were recognized as a reduction to variable rent expense.

The components of lease cost and rent expense for the three and nine months ended September 30, 2020 and 2019 are as follows (in millions):

	Three Months Ended September 30,						Nine Months Ended September 30,
Lease Cost	2020			2019			2020			2019
Operating lease cost:
Operating lease cost	$	50		$	49		$	152		$	143
Short-term rent expense		27			28			80			87
Variable lease cost		9			3			20			13
Sublease income		(1	)		(1	)		(4	)		(3	)
Total operating lease cost	$	85		$	79		$	248		$	240
Finance lease cost:
Amortization of right-of-use assets	$	2		$	3		$	8		$	9
Interest on finance lease liabilities		2			2			6			6
Total finance lease cost	$	4		$	5		$	14		$	15

Supplemental balance sheet information related to leases was as follows (in millions):

	Balance Sheet Classification	September 30, 2020			December 31, 2019
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	633		$	607

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		134			154
	Equipment and fixtures		9			11
	Property and equipment		151			173
	Less accumulated depreciation and amortization		(45	)		(56	)
	Property and equipment, net	$	106		$	117

Current finance lease liabilities	Current maturities of long-term debt	$	5		$	6
Long-term finance lease liabilities	Long-term debt		75			107

Supplemental cash flow information related to leases for the nine months ended September 30, 2020 and 2019 are as follows (in millions):

	Nine Months Ended September 30,
Cash flow information	2020		2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	141	$	127
Operating cash flows from finance leases		6		6
Financing cash flows from finance leases		5		7
Right-of-use assets obtained in exchange for new finance lease liabilities		22		2
Right-of-use assets obtained in exchange for new operating lease liabilities		119		86

(1)	Included in the change in other operating assets and liabilities in the condensed consolidated statement of cash flows.

Employee Benefit Plans

9 Months Ended

Sep. 30, 2020

Compensation And Retirement Disclosure [Abstract]

Employee Benefit Plans

10. EMPLOYEE BENEFIT PLANS

The Company provides an unfunded Supplemental Executive Retirement Plan (“SERP”) for certain members of its executive management. The Company uses a December 31 measurement date for the benefit obligations and a January 1 measurement date for its net periodic costs for the SERP. Variances from actuarially assumed rates will result in increases or decreases in benefit obligations and net periodic cost in future periods. Benefits expense under the SERP was $2 million for both of the three-month periods ended September 30, 2020 and 2019, and $5 million for both of the nine-month periods ended September 30, 2020 and 2019. The accrued benefit liability for the SERP totaled $77 million and $72 million at September 30, 2020 and December 31, 2019, respectively, and is included in other long-term liabilities on the condensed consolidated balance sheets. The weighted-average assumptions used in determining net periodic cost for the nine months ended September 30, 2020 and September 30, 2019 were a discount rate of 3.1% and 4.2%, respectively, and an annual salary increase of 3.0%. The Company had equity investment securities in a rabbi trust generally designated to pay benefits of the SERP in the amounts of $87 million and $84 million at September 30, 2020 and December 31, 2019, respectively. These amounts are included in other assets, net on the condensed consolidated balance sheets.

- Definition

The entire disclosure for retirement benefits.

+ References

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+ Details

Stockholders' Deficit

9 Months Ended

Sep. 30, 2020

Equity [Abstract]

STOCKHOLDERS' DEFICIT

11. STOCKHOLDERS’ DEFICIT

Authorized capital shares of the Company include 400,000,000 shares of capital stock consisting of 300,000,000 shares of common stock and 100,000,000 shares of preferred stock. Each of the aforementioned classes of capital stock has a par value of $0.01 per share. Shares of preferred stock, none of which were outstanding as of September 30, 2020, may be issued in one or more series having such rights, preferences and other provisions as determined by the Board of Directors without approval by the holders of common stock.

The Company is a holding company which operates through its subsidiaries. The Company’s ABL Facility and the indentures governing each series of the Company’s outstanding notes contain various covenants under which the assets of the subsidiaries of the Company are subject to certain restrictions relating to, among other matters, dividends and distributions, as referenced in the paragraph below.

The ABL Facility and the indentures governing each series of the Company’s outstanding notes restrict the Company’s subsidiaries from, among other matters, paying dividends and making distributions to the Company, which thereby limits the Company’s ability to pay dividends and/or repurchase stock. As of September 30, 2020, under the most restrictive test in these agreements (and subject to certain exceptions), the Company has approximately $200 million of capacity to pay permitted dividends and/or repurchase shares of stock or make other restricted payments.

The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company, and equity attributable to the noncontrolling interests as of September 30, 2020, and during each of the three-month periods following December 31, 2019 (in millions):

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit (1)			Noncontrolling Interest			Total Stockholders’ Deficit (1)
Balance, December 31, 2019	$	502		$	1	$	2,008		$	(9	)	$	(4,218	)	$	77		$	(2,141	)
Comprehensive income		8			—		—			2			18			8			28
Distributions to noncontrolling interests		(22	)		—		—			—			—			(8	)		(8	)
Purchase of subsidiary shares from noncontrolling interests		(1	)		—		(1	)		—			—			—			(1	)
Other reclassifications of noncontrolling interests		8			—		—			—			—			(8	)		(8	)
Adjustment to redemption value of redeemable noncontrolling interests		7			—		(7	)		—			—			—			(7	)
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(1	)		—			—			—			(1	)
Share-based compensation		—			—		2			—			—			—			2
Balance, March 31, 2020		502			1		2,001			(7	)		(4,200	)		69			(2,136	)
Comprehensive income		7			—		—			2			69			16			87
Distributions to noncontrolling interests		(17	)		—		—			—			—			(10	)		(10	)
Purchase of subsidiary shares from noncontrolling interests		(1	)		—		1			—			—			—			1
Other reclassifications of noncontrolling interests		1			—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		(3	)		—		3			—			—			—			3
Share-based compensation		—			—		3			—			—			—			3
Balance, June 30, 2020		489			1		2,008			(5	)		(4,131	)		75			(2,052	)
Comprehensive income (loss)		23			—		—			—			112			(8	)		104
Distributions to noncontrolling interests		(20	)		—		—			—			—			(7	)		(7	)
Purchase of subsidiary shares from noncontrolling interests		(2	)		—		—			—			—			—			—
Disposition of less-than-wholly owned hospital		(15	)		—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		6			—		(6	)		—			—			—			(6	)
Share-based compensation		—			—		3			—			—			—			3
Balance, September 30, 2020	$	481		$	1	$	2,005		$	(5	)	$	(4,018	)	$	60		$	(1,957	)

(1) Totals may not add due to rounding.

The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company, and equity attributable to the noncontrolling interests as of September 30, 2019, and during each of the three-month periods following December 31, 2018 (in millions):

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 2018	$	504		$	1	$	2,017		$	(10	)	$	(3,543	)	$	72		$	(1,463	)
Comprehensive income (loss)		9		—		—			—				(118	)		8			(110	)
Contributions from noncontrolling interests		1		—		—			—			—			—			—
Distributions to noncontrolling interests		(19	)	—		—			—			—				(8	)		(8	)
Purchase of subsidiary shares from noncontrolling interests		(1	)	—		—			—			—			—			—
Other reclassifications of noncontrolling interests		(1	)	—		—			—			—				1			1
Adjustment to redemption value of redeemable noncontrolling interests		12		—			(12	)	—			—			—				(12	)
Cancellation of restricted stock for tax withholdings on vested shares	—			—			(1	)	—			—			—				(1	)
Share-based compensation	—			—			3		—			—			—				3
Balance, March 31, 2019		505			1		2,007			(10	)		(3,661	)		73			(1,590	)
Comprehensive income (loss)		14		—		—				2			(167	)		8			(157	)
Contributions from noncontrolling interests		1		—		—			—			—			—			—
Distributions to noncontrolling interests		(22	)	—		—			—			—				(8	)		(8	)
Purchase of subsidiary shares from noncontrolling interests	—			—			(1	)	—			—			—				(1	)
Other reclassifications of noncontrolling interests		(1	)	—			(1	)	—			—				1		—
Adjustment to redemption value of redeemable noncontrolling interests		6		—			(6	)	—			—			—				(6	)
Share-based compensation	—			—			3		—			—			—				3
Balance, June 30, 2019		503			1		2,002			(8	)		(3,828	)		74			(1,759	)
Comprehensive income (loss)		11		—		—			—				(17	)		8			(9	)
Contributions from noncontrolling interests		1		—		—			—			—				7			7
Distributions to noncontrolling interests		(14	)	—		—			—			—				(7	)		(7	)
Purchase of subsidiary shares from noncontrolling interests		(6	)	—			2		—			—				1			3
Other reclassifications of noncontrolling interests	—			—			1		—			—			—				1
Adjustment to redemption value of redeemable noncontrolling interests		3		—			(3	)	—			—			—				(3	)
Share-based compensation	—			—			2		—			—			—				2
Balance, September 30, 2019	$	498		$	1	$	2,004		$	(8	)	$	(3,845	)	$	83		$	(1,765	)

The following schedule discloses the effects of changes in the Company’s ownership interest in its less-than-wholly-owned subsidiaries on Community Health Systems, Inc. stockholders’ deficit (in millions):

	Three Months Ended					Nine Months Ended
	September 30,					September 30,
	2020		2019			2020		2019
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$	112	$	(17	)	$	200	$	(302	)
Transfers to the noncontrolling interests:
Net increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		—		2			—		1
Net transfers to the noncontrolling interests		—		2			—		1
Change to Community Health Systems, Inc. stockholders' deficit from net income (loss) attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	112	$	(15	)	$	200	$	(301	)

Earnings Per Share

9 Months Ended

Sep. 30, 2020

Earnings Per Share [Abstract]

Earnings Per Share

12. EARNINGS PER SHARE

The following table sets forth the components of the denominator for the computation of basic and diluted earnings per share for net income (loss) attributable to Community Health Systems, Inc. common stockholders:

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2020		2019		2020		2019
Weighted-average number of shares outstanding — basic		115,015,460		113,891,721		114,764,050		113,672,798
Effect of dilutive securities:
Restricted stock awards		500,857	—			205,600	—
Employee stock options		2,193	—			890	—
Other equity-based awards		122,342	—			41,662	—
Weighted-average number of shares outstanding — diluted		115,640,852		113,891,721		115,012,202		113,672,798

The Company generated a loss attributable to Community Health Systems, Inc. common stockholders for the three and nine months ended September 30, 2019, so the effect of dilutive securities is not considered because their effect would be antidilutive. If the Company had generated income during the three and nine months ended September 30, 2019, the effect of restricted stock awards, employee stock options, and other equity-based awards on the diluted shares calculation would have been an increase in shares of 69,042 and 52,925, respectively.

	Three Months Ended			Nine Months Ended
	September 30,			September 30,
	2020		2019	2020		2019
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		1,846,026	3,916,277		3,673,618	3,911,242

Contingencies

9 Months Ended

Sep. 30, 2020

Commitments And Contingencies Disclosure [Abstract]

Contingencies

13. CONTINGENCIES

The Company is a party to various legal, regulatory and governmental proceedings incidental to its business. Based on current knowledge, management does not believe that loss contingencies arising from pending legal, regulatory and governmental matters, including the matters described herein, will have a material adverse effect on the condensed consolidated financial position or liquidity of the Company. However, in light of the inherent uncertainties involved in pending legal, regulatory and governmental matters, some of which are beyond the Company’s control, and the very large or indeterminate damages sought in some of these matters, an adverse outcome in one or more of these matters could be material to the Company’s results of operations or cash flows for any particular reporting period.

With respect to all legal, regulatory and governmental proceedings, the Company considers the likelihood of a negative outcome. If the Company determines the likelihood of a negative outcome with respect to any such matter is probable and the amount of the loss can be reasonably estimated, the Company records an accrual for the estimated loss for the expected outcome of the matter. If the likelihood of a negative outcome with respect to material matters is reasonably possible and the Company is able to determine an estimate of the possible loss or a range of loss, whether in excess of a related accrued liability or where there is no accrued liability, the Company discloses the estimate of the possible loss or range of loss. However, the Company is unable to estimate a possible loss or range of loss in some instances based on the significant uncertainties involved in, and/or the preliminary nature of, certain legal, regulatory and governmental matters.

In connection with the spin-off of Quorum Health Corporation (“QHC”), the Company agreed to indemnify QHC for certain liabilities relating to outcomes or events occurring prior to April 29, 2016, the closing date of the spin-off, including (i) certain claims and proceedings that were known to be outstanding at or prior to the consummation of the spin-off and involved multiple facilities and (ii) certain claims, proceedings and investigations by governmental authorities or private plaintiffs related to activities occurring at or related to QHC’s healthcare facilities prior to the closing date of the spin-off, but only to the extent, in the case of clause (ii), that such claims are covered by insurance policies maintained by the Company, including professional liability and employer practices. Notwithstanding the foregoing, the Company is not required to indemnify QHC in respect of any claims or proceedings arising out of or related to the business operations of Quorum Health Resources, LLC at any time or QHC’s compliance with the corporate integrity agreement. Subsequent to the spin-off of QHC, the Office of the Inspector General provided the Company with written assurance that it would look solely at QHC for compliance for its facilities under the Company’s Corporate Integrity Agreement; however, the Office of the Inspector General declined to enter into a separate corporate integrity agreement with QHC.

Probable Contingencies

The table below presents a reconciliation of the beginning and ending liability balances (in millions) during the nine months ended September 30, 2020, with respect to the Company’s determination of the contingencies of the Company in respect of which an accrual has been recorded. The liability as of September 30, 2020 is comprised of individually insignificant amounts for various matters.

Summary of Recorded Amounts

	Probable
	Contingencies
Balance as of December 31, 2019	$	68
Expense		11
Reserve for insured claim		10
Cash payments		(63	)
Balance as of September 30, 2020	$	26

In accordance with applicable accounting guidance, the Company establishes a liability for litigation, regulatory and governmental matters for which, based on information currently available, the Company believes that a negative outcome is known or is probable and the amount of the loss is reasonably estimable. For all such matters (whether or not discussed in this contingencies footnote), such amounts have been recorded in other accrued liabilities on the condensed consolidated balance sheet and are included in the table above. Due to the uncertainties and difficulty in predicting the ultimate resolution of these contingencies, the actual amount could differ from the estimated amount reflected as a liability on the condensed consolidated balance sheet.

In the aggregate, attorneys’ fees and other costs incurred but not included in the table above related to probable contingencies and Contingent Value Right-related contingencies totaled $2 million and $7 million for the three months ended September 30, 2020 and 2019, respectively, and $3 million and $11 million for the nine months ended September 30, 2020 and 2019, respectively, and are included in other operating expenses in the accompanying condensed consolidated statements of income (loss).

Matters for which an Outcome Cannot be Assessed

For the following legal matter, due to the uncertainties surrounding the ultimate outcome of the case, the Company cannot at this time assess what the outcome may be and is further unable to reasonably estimate any loss or range of loss.

Steadfast Insurance Company, et al v. Community Health Systems, Inc., CHS/Community Health Systems, Inc., CHSPSC, LLC and Pecos Valley of New Mexico, LLC; Community Health Systems, Inc., et al v. Steadfast Insurance Company, et al; Anne Sperling, et al v. Community Insurance Group SPC, Ltd. These cases are filed in the Superior Court for the State of Delaware, the Chancery Court for the State of Delaware, and the First Judicial District Court for the State of New Mexico, respectively, and involve insurance coverage disputes related to a $73 million judgment rendered against Pecos Valley of New Mexico, LLC in Anne Sperling, et al v. Pecos Valley of New Mexico, LLC (“Sperling I”). The first case was brought by Steadfast Insurance Company in Delaware Superior Court seeking a declaration that the Sperling I judgment is not a covered loss as defined by the insurance policies that are the subject of the case. The second case, filed by the Company in Delaware Chancery Court, seeks reformation of the subject policies. The third case (“Sperling II”), filed by the plaintiffs in Sperling I, seeks recovery from Pecos Valley of New Mexico, LLC’s insurers for the judgment awarded the plaintiffs in their separate, previous action against Pecos Valley of New Mexico, LLC. The Steadfast complaint was served on November 30, 2018. On December 13, 2018, Admiral Insurance Company, Endurance Specialty Insurance Ltd, and Illinois Union Insurance Company moved to intervene in the suit as petitioners. The Company has initiated counterclaims against each insurer in that case, including for bad faith against Steadfast. The Company filed the Community Health Systems complaint on January 22, 2020. Sperling II was filed on July 24, 2019. Plaintiffs amended their complaint to add Pecos Valley of New Mexico, LLC as a defendant in that action on May 21, 2020, and Pecos Valley of New Mexico, LLC filed a third party action against certain insurer defendants in the case on July 6, 2020. The judgment in Sperling I against Pecos Valley of New Mexico, LLC, which was rendered on September 5, 2018, in the First Judicial Court of the State of New Mexico, is currently on appeal to the Court of Appeals of the State of New Mexico. Consolidated trial of the Steadfast and Community Health Systems, Inc. cases is set for July 26, 2021. The Company believes the insurers’ claims in the Steadfast, Community Health Systems, Inc. and Sperling II litigation are without merit and will vigorously defend and prosecute those cases.

Subsequent Events

9 Months Ended

Sep. 30, 2020

Subsequent Events [Abstract]

Subsequent Events

14. SUBSEQUENT EVENTS

The Company has evaluated all material events occurring subsequent to the balance sheet date for events requiring disclosure or recognition in the condensed consolidated financial statements.

CARES Act and PPPHCE Act Funds:

In comparison to the September 19, 2020 Notice on which the Company’s estimate of pandemic relief funds as of September 30, 2020 is based, the October 22, 2020 Notice discussed in Note 1 includes two primary changes: (1) the definition of lost revenue is changed to refer to the negative year-over-year difference in 2019 and 2020 actual revenue from patient care related sources as opposed to the negative year-over-year change in net patient care operating income, and (2) the definition of reporting entities is broadened to include the parent of one or more subsidiary tax identification numbers that received general distribution payments, entities having providers associated with it that provide diagnoses, testing or treatment for cases of COVID-19, or entities that can otherwise attest to the terms and conditions. While now codified in the October 22, 2020 Notice, guidance permitting parent companies to allocate general fund distributions to subsidiaries was previously set forth in FAQs published by HHS and as such, the Company’s estimate of pandemic relief funds as of September 30, 2020 includes the allocation of certain general funds among subsidiaries. Regarding the amended definition of lost revenues, such change serves to increase amounts eligible to be recognized as a reduction to operating costs and expenses, as compared to the September 19, 2020 Notice. The Company’s evaluation of the October 22, 2020 Notice is ongoing and the amount by which the approximately $271 million of PHSSEF and other unrecognized relief payments as of September 30, 2020 may be recognized as a result of the October 22, 2020 Notice is not yet known. U.S. GAAP does not permit amounts recognized as of September 30, 2020 to be updated on the basis of new information in the October 22, 2020 Notice.

Divestitures and hospital closures:

On October 1, 2020, one or more affiliates of the Company sold substantially all of the assets of Bayfront Health St. Petersburg (480 licensed beds) in St. Petersburg, Florida to affiliates of Orlando Health, Inc., pursuant to the terms of a definitive agreement which was entered into on June 25, 2020, as referenced above. The net proceeds from this sale were received at a preliminary closing on September 30, 2020.

On October 8, 2020, one or more subsidiaries of the Company entered into a definitive agreement for the sale of the Company’s ownership interest in Berwick Hospital Center (90 licensed beds) in Berwick, Pennsylvania to affiliates of Sant Partners, LLC.

On October 24, 2020, one or more affiliates of the Company sold substantially all of the assets of San Angelo Community Medical Center (171 licensed beds) in San Angelo, Texas, to subsidiaries of Shannon Health System pursuant to the terms of a definitive agreement which was entered into on April 20, 2020, as referenced above.

On October 27, 2020, one or more affiliates of the Company sold substantially all of the assets of each of Abilene Regional Medical Center (231 licensed beds) in Abilene, Texas, and Brownwood Regional Medical Center (188 licensed beds) in Brownwood, Texas, to subsidiaries of Hendrick Health System pursuant to the terms of a definitive agreement which was entered into on April 27, 2020, as referenced above.

Other events:

On October 12, 2020, one or more subsidiaries of the Company entered into a definitive agreement for the sale of 50% ownership interest in Merit Health Biloxi (153 licensed beds) and its associated healthcare businesses in Biloxi, Mississippi to Memorial Properties, Inc., an affiliate of Memorial Hospital of Gulfport. This transaction is expected to be completed in the fourth quarter of 2020. Merit Health Biloxi and its associated healthcare businesses will remain consolidated entities of the Company.

Pursuant to a hospital purchase agreement from the March 1, 2016 acquisition of La Porte Hospital, the Company committed to build a replacement facility in La Porte, Indiana. The completion of the replacement facility and transfer of operations was completed on October 24, 2020 and La Porte Hospital was renamed to Northwest Health – La Porte. Construction costs, including equipment costs, totaled approximately $119 million as of September 30, 2020.

Summarized Financial Information

9 Months Ended

Sep. 30, 2020

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Summarized Financial Information

15. SUMMARIZED FINANCIAL INFORMATION

The 6⅞% Senior Notes due 2022, which are senior unsecured obligations of CHS, and the 6¼% Senior Secured Notes due 2023, which are senior secured obligations of CHS (collectively, “the Notes”) are guaranteed on a senior basis by the Company and by certain of its existing and subsequently acquired or organized 100% owned domestic subsidiaries (collectively, the “subsidiary guarantors”). In addition, equity interests held by the Company in non-guarantor subsidiaries have been pledged as collateral under the Notes, except for equity interests held in three hospitals owned jointly with non-profit, health organizations. The Notes are fully and unconditionally guaranteed on a joint and several basis, with exceptions considered customary for such guarantees, limited to the release of the guarantee when a subsidiary guarantor’s capital stock is sold, or a sale of all of the subsidiary guarantor’s assets used in operations. There are no significant restrictions on the ability of the subsidiary guarantors to make distributions to the issuer. Summarized financial information is provided for Community Health Systems, Inc. (parent guarantor), CHS (issuer) and the subsidiary guarantors on a combined basis in accordance with SEC Regulation S-X Rules 3-10 and 13-01.

The accounting policies used in the preparation of this summarized financial information are consistent with those elsewhere in the condensed consolidated financial statements of the Company, except that intercompany transactions and balances of the parent, issuer and subsidiary guarantor entities with non-guarantors entities have not been eliminated. Equity in earnings from investments in non-guarantors entities has not been presented.

From time to time, subsidiaries of the Company sell and/or repurchase noncontrolling interests in consolidated subsidiaries, which may change subsidiaries between guarantors and non-guarantors. Amounts for prior periods have been revised to reflect the status of guarantors and non-guarantors as of September 30, 2020.

Summarized statements of income (loss) (in millions):

	Nine Months Ended
	September 30, 2020
Net operating revenues	$	5,746
Income from operations		753
Net income		220
Net income attributable to Community Health Systems, Inc. Stockholders		220

Summarized balance sheets (in millions):

	September 30, 2020		December 31, 2019
Current assets	$	3,931	$	2,464
Noncurrent assets (a)		14,443		14,596
Current liabilities		2,553		1,472
Noncurrent liabilities (b)		14,353		15,800

(a)	Includes amounts due from non-guarantor subsidiaries of $6.3 billion and $6.5 billion as of September 30, 2020 and December 31, 2019, respectively.

(b)	Includes amounts due to non-guarantor subsidiaries of $0.4 billion and $1.4 billion as of September 30, 2020 and December 31, 2019, respectively.

Basis of Presentation and Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Basis of Accounting

Consolidation

Revenue Recognition

Revenue Recognition.

Net Operating Revenues

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2020		2019		2020			2019
Medicare	$	723	$	811	$	2,086		$	2,519
Medicaid		419		437		1,167			1,316
Managed Care and other third-party payors		1,967		1,971		5,425			5,991
Self-pay		17		27		(8	)		99
Total	$	3,126	$	3,246	$	8,670		$	9,925

Patient Accounts Receivable

Charity Care

Accounting for the Impairment or Disposal of Long-Lived Assets

COVID-19 Pandemic.

CARES Act and PPPHCE Act Funds

Medicare Accelerated Payments

New Accounting Pronouncements

Basis of Presentation and Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Net Operating Revenues

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2020		2019		2020			2019
Medicare	$	723	$	811	$	2,086		$	2,519
Medicaid		419		437		1,167			1,316
Managed Care and other third-party payors		1,967		1,971		5,425			5,991
Self-pay		17		27		(8	)		99
Total	$	3,126	$	3,246	$	8,670		$	9,925

Accounting for Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2020

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Schedule of Share-based Compensation Expense

The following table reflects the impact of total compensation expense related to stock-based equity plans on the reported operating results for the respective periods (in millions):

	Three Months Ended						Nine Months Ended
	September 30,						September 30,
	2020			2019			2020			2019
Effect on loss before income taxes	$	(3	)	$	(2	)	$	(8	)	$	(8	)
Effect on net income (loss)	$	(2	)	$	(2	)	$	(6	)	$	(6	)

Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions

	Three Months Ended September 30,		Nine Months Ended September 30,
	2020	2019	2020			2019
Expected volatility	N/A	N/A		73.5	%		68.4	%
Expected dividends	N/A	N/A		—			—
Expected term	N/A	N/A	6 years			5.6 years
Risk-free interest rate	N/A	N/A		1.0	%		2.6	%

Schedule of Share-based Compensation, Stock Options, Activity

						Weighted-	Aggregate
				Weighted-		Average	Intrinsic
				Average		Remaining	Value as of
				Exercise		Contractual	September 30,
	Shares			Price		Term	2020
Outstanding at December 31, 2019		1,110,134			16.90	5.6 years
Granted		946,500			4.93
Exercised		—			—
Forfeited and cancelled		(159,938	)		33.90
Outstanding at March 31, 2020		1,896,696			9.50
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(31,667	)		31.90
Outstanding at June 30, 2020		1,865,029			9.12
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(7,003	)		32.58
Outstanding at September 30, 2020		1,858,026		$	9.03	7.7 years	$	—
Exercisable at September 30, 2020		495,522		$	20.28	4.0 years	$	—

Schedule of Share-based Compensation, Restricted Stock, Activity

Restricted stock outstanding under the 2009 Plan as of September 30, 2020, and changes during each of the three-month periods following December 31, 2019, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2019		3,857,402		$	5.47
Granted		2,197,500			4.90
Vested		(988,650	)		5.77
Forfeited		(328,500	)		9.19
Unvested at March 31, 2020		4,737,752			4.89
Granted		4,000			3.19
Vested		(96,677	)		6.81
Forfeited		(26,335	)		5.00
Unvested at June 30, 2020		4,618,740			4.84
Granted		—			—
Vested		(11,001	)		4.53
Forfeited		(21,002	)		5.01
Unvested at September 30, 2020		4,586,737			4.84

Schedule of Share-based Compensation, Restricted Stock Units, Activity

RSUs outstanding under the 2009 Plan as of September 30, 2020, and changes during each of the three-month periods following December 31, 2019, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2019		541,576		$	5.13
Granted		310,347			4.93
Vested		(238,184	)		5.47
Forfeited		—			—
Unvested at March 31, 2020		613,739			4.89
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at June 30, 2020		613,739			4.89
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at September 30, 2020		613,739			4.89

Acquisitions and Divestitures (Tables)

9 Months Ended

Sep. 30, 2020

Acquisitions And Divestitures [Abstract]

Schedule of Divestitures

The following table provides a summary of hospitals that the Company divested during the nine months ended September 30, 2020 and the year ended December 31, 2019:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2020 Divestitures:

Hill Regional Hospital	AHRK Holdings, LLC	Hillsboro, TX	25	August 1, 2020
St. Cloud Regional Medical Center	Orlando Health, Inc.	St. Cloud, FL	84	July 1, 2020
Northern Louisiana Medical Center	Allegiance Health Management, Inc.	Ruston, LA	130	July 1, 2020
Shands Live Oak Regional Medical Center	HCA Healthcare, Inc. (“HCA”)	Live Oak, FL	25	May 1, 2020
Shands Starke Regional Medical Center	HCA	Starke, FL	49	May 1, 2020
Southside Regional Medical Center	Bon Secours Mercy Health System	Petersburg, VA	300	January 1, 2020
Southampton Memorial Hospital	Bon Secours Mercy Health System	Franklin, VA	105	January 1, 2020
Southern Virginia Regional Medical Center	Bon Secours Mercy Health System	Emporia, VA	80	January 1, 2020

2019 Divestitures:

Bluefield Regional Medical Center	Princeton Community Hospital Association	Bluefield, WV	92	October 1, 2019
Lake Wales Medical Center	Adventist Health System	Lake Wales, FL	160	September 1, 2019
Heart of Florida Regional Medical Center	Adventist Health System	Davenport, FL	193	September 1, 2019
College Station Medical Center	St. Joseph Regional Health Center	College Station, TX	167	August 1, 2019
Tennova Healthcare - Lebanon	Vanderbilt University Medical Center	Lebanon, TN	245	August 1, 2019
Chester Regional Medical Center	Medical University Hospital Authority	Chester, SC	82	March 1, 2019
Carolinas Hospital System - Florence	Medical University Hospital Authority	Florence, SC	396	March 1, 2019
Springs Memorial Hospital	Medical University Hospital Authority	Lancaster, SC	225	March 1, 2019
Carolinas Hospital System - Marion	Medical University Hospital Authority	Mullins, SC	124	March 1, 2019
Memorial Hospital of Salem County	Community Healthcare Associates, LLC	Salem, NJ	126	January 31, 2019
Mary Black Health System - Spartanburg	Spartanburg Regional Healthcare System	Spartanburg, SC	207	January 1, 2019
Mary Black Health System - Gaffney	Spartanburg Regional Healthcare System	Gaffney, SC	125	January 1, 2019

Schedule of Balance Sheet Items Classified as Held for Sale

equipment for hospitals held for sale. No divestitures or potential divestitures meet the criteria for reporting as a discontinued operation.

	September 30, 2020		December 31, 2019
Other current assets	$	32	$	25
Other assets, net		341		262
Accrued liabilities		114		43

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

Goodwill and Other Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

The changes in the carrying amount of goodwill for the nine months ended September 30, 2020 are as follows (in millions):

Balance, as of December 31, 2019
Goodwill	$	7,142
Accumulated impairment losses		(2,814	)
		4,328

Goodwill acquired as part of acquisitions during current year		1
Goodwill allocated to hospitals held for sale		(109	)

Balance, as of September 30, 2020
Goodwill		7,034
Accumulated impairment losses		(2,814	)
	$	4,220

Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2020

Long Term Debt And Capital Lease Obligations [Abstract]

Schedule of Debt

Long-term debt, net of unamortized debt issuance costs and discounts or premiums, consists of the following (in millions):

	September 30,			December 31,
	2020			2019
5⅛% Senior Secured Notes due 2021	$	—		$	1,000
6⅞% Senior Notes due 2022		197			231
6¼% Senior Secured Notes due 2023		2,675			3,100
8⅝% Senior Secured Notes due 2024		1,033			1,033
6⅝% Senior Secured Notes due 2025		1,462			—
8% Senior Secured Notes due 2026		2,101			2,101
8% Senior Secured Notes due 2027		700			700
6⅞% Senior Notes due 2028		1,474			1,700
9⅞% Junior-Priority Secured Notes due 2023		1,770			1,770
8⅛% Junior-Priority Secured Notes due 2024		1,354			1,355
ABL Facility		—			273
Finance lease and financing obligations		241			272
Other		20			17
Less: Unamortized deferred debt issuance costs and note premium		(148	)		(147	)
Total debt		12,879			13,405
Less: Current maturities		(19	)		(20	)
Total long-term debt	$	12,860		$	13,385

Schedule of Early Redemption Prices on Notes

After February 15, 2022, CHS is entitled, at its option, to redeem some or all of the 6⅝% Senior Secured Notes at a redemption price equal to the percentage of principal amount below plus accrued and unpaid interest, if any, to, but excluding the applicable redemption date, if redeemed during the twelve-month period beginning on February 15 of the years set forth below:

Period	Redemption Price
February 15, 2022 to February 14, 2023		103.313	%
February 15, 2023 to February 14, 2024		101.656	%
February 15, 2024 to February 14, 2025		100.000	%

Schedule of Extinguished Portion of Certain Series of Outstanding Notes

During the three months ended September 30, 2020, the Company extinguished a portion of certain series of its outstanding notes through open market repurchases, as follows (in millions):

	Principal Amount
6⅞% Senior Notes due 2028	$	226
8⅛% Junior-Priority Secured Notes due 2024		1
6⅞% Senior Notes due 2022		34
Total principal amount of debt extinguished	$	261

Fair Value of Financial Instruments (Tables)

9 Months Ended

Sep. 30, 2020

Fair Value Disclosures [Abstract]

Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping

	September 30, 2020				December 31, 2019
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	1,823	$	1,823	$	216	$	216
Investments in equity securities		124		124		141		141
Available-for-sale debt securities		105		105		101		101
Trading securities		13		13		12		12
Liabilities:
5⅛% Senior Secured Notes due 2021		—		—		990		1,003
6⅞% Senior Notes due 2022		196		176		229		188
6¼% Senior Secured Notes due 2023		2,657		2,617		3,074		3,148
8⅝% Senior Secured Notes due 2024		1,025		1,028		1,023		1,099
6⅝% Senior Secured Notes due 2025		1,425		1,417		—		—
8% Senior Secured Notes due 2026		2,073		2,070		2,070		2,182
8% Senior Secured Notes due 2027		691		685		691		700
6⅞% Senior Notes due 2028		1,456		697		1,678		1,700
9⅞% Junior-Priority Secured Notes due 2023		1,757		1,402		1,754		1,539
8⅛% Junior-Priority Secured Notes due 2024		1,341		990		1,340		1,113
ABL Facility and other debt		17		17		285		285

Schedule of Pre-tax Gain (Loss) Recognized as a Component of Other Comprehensive Income

The following tabular disclosure provides the amount of pre-tax gain (loss) recognized as a component of OCI during the three and nine months ended September 30, 2020 and 2019 (in millions):

	Amount of Pre-Tax Gain (Loss) Recognized in OCI (Effective Portion)
Derivatives in Cash Flow Hedging	Three Months Ended September 30,				Nine Months Ended September 30,
Relationships	2020		2019		2020		2019
Interest rate swaps	$	—	$	—	$	—	$	(4	)

Schedule of Effective Portion of the Pre-tax Loss (Gain) Reclassified from AOCL into Interest Expense on the Consolidated Statements of Income

	Amount of Pre-Tax Loss (Gain) Reclassified
	from AOCL into Income (Effective Portion)
Location of Loss (Gain) Reclassified from	Three Months Ended September 30,				Nine Months Ended September 30,
AOCL into Income (Effective Portion)	2020		2019		2020		2019
Interest expense, net	$	1	$	—	$	2	$	(1	)

Fair Value (Tables)

9 Months Ended

Sep. 30, 2020

Fair Value Disclosures [Abstract]

Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis

	September 30, 2020		Level 1		Level 2		Level 3
Investments in equity securities	$	124	$	124	$	—	$	—
Available-for-sale debt securities		105		—		105		—
Trading securities		13		—		13		—
Total assets	$	242	$	124	$	118	$	—

	December 31, 2019		Level 1		Level 2		Level 3
Investments in equity securities	$	141	$	141	$	—	$	—
Available-for-sale debt securities		101		—		101		—
Trading securities		12		—		12		—
Total assets	$	254	$	141	$	113	$	—

Fair value of interest rate swap agreement	$	2	$	—	$	2	$	—
Total liabilities	$	2	$	—	$	2	$	—

Leases (Tables)

9 Months Ended

Sep. 30, 2020

Leases [Abstract]

Components of Lease Cost and Rent Expense

The components of lease cost and rent expense for the three and nine months ended September 30, 2020 and 2019 are as follows (in millions):

	Three Months Ended September 30,						Nine Months Ended September 30,
Lease Cost	2020			2019			2020			2019
Operating lease cost:
Operating lease cost	$	50		$	49		$	152		$	143
Short-term rent expense		27			28			80			87
Variable lease cost		9			3			20			13
Sublease income		(1	)		(1	)		(4	)		(3	)
Total operating lease cost	$	85		$	79		$	248		$	240
Finance lease cost:
Amortization of right-of-use assets	$	2		$	3		$	8		$	9
Interest on finance lease liabilities		2			2			6			6
Total finance lease cost	$	4		$	5		$	14		$	15

Supplemental Balance Sheet Information Related to Leases

Supplemental balance sheet information related to leases was as follows (in millions):

	Balance Sheet Classification	September 30, 2020			December 31, 2019
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	633		$	607

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		134			154
	Equipment and fixtures		9			11
	Property and equipment		151			173
	Less accumulated depreciation and amortization		(45	)		(56	)
	Property and equipment, net	$	106		$	117

Current finance lease liabilities	Current maturities of long-term debt	$	5		$	6
Long-term finance lease liabilities	Long-term debt		75			107

Supplemental Cash Flow and Other Information Related to Leases

Supplemental cash flow information related to leases for the nine months ended September 30, 2020 and 2019 are as follows (in millions):

	Nine Months Ended September 30,
Cash flow information	2020		2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	141	$	127
Operating cash flows from finance leases		6		6
Financing cash flows from finance leases		5		7
Right-of-use assets obtained in exchange for new finance lease liabilities		22		2
Right-of-use assets obtained in exchange for new operating lease liabilities		119		86

(1)	Included in the change in other operating assets and liabilities in the condensed consolidated statement of cash flows.

Stockholders' Deficit (Tables)

9 Months Ended

Sep. 30, 2020

Equity [Abstract]

Schedule of Stockholders' Deficit

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit (1)			Noncontrolling Interest			Total Stockholders’ Deficit (1)
Balance, December 31, 2019	$	502		$	1	$	2,008		$	(9	)	$	(4,218	)	$	77		$	(2,141	)
Comprehensive income		8			—		—			2			18			8			28
Distributions to noncontrolling interests		(22	)		—		—			—			—			(8	)		(8	)
Purchase of subsidiary shares from noncontrolling interests		(1	)		—		(1	)		—			—			—			(1	)
Other reclassifications of noncontrolling interests		8			—		—			—			—			(8	)		(8	)
Adjustment to redemption value of redeemable noncontrolling interests		7			—		(7	)		—			—			—			(7	)
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(1	)		—			—			—			(1	)
Share-based compensation		—			—		2			—			—			—			2
Balance, March 31, 2020		502			1		2,001			(7	)		(4,200	)		69			(2,136	)
Comprehensive income		7			—		—			2			69			16			87
Distributions to noncontrolling interests		(17	)		—		—			—			—			(10	)		(10	)
Purchase of subsidiary shares from noncontrolling interests		(1	)		—		1			—			—			—			1
Other reclassifications of noncontrolling interests		1			—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		(3	)		—		3			—			—			—			3
Share-based compensation		—			—		3			—			—			—			3
Balance, June 30, 2020		489			1		2,008			(5	)		(4,131	)		75			(2,052	)
Comprehensive income (loss)		23			—		—			—			112			(8	)		104
Distributions to noncontrolling interests		(20	)		—		—			—			—			(7	)		(7	)
Purchase of subsidiary shares from noncontrolling interests		(2	)		—		—			—			—			—			—
Disposition of less-than-wholly owned hospital		(15	)		—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		6			—		(6	)		—			—			—			(6	)
Share-based compensation		—			—		3			—			—			—			3
Balance, September 30, 2020	$	481		$	1	$	2,005		$	(5	)	$	(4,018	)	$	60		$	(1,957	)

(1) Totals may not add due to rounding.

The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company, and equity attributable to the noncontrolling interests as of September 30, 2019, and during each of the three-month periods following December 31, 2018 (in millions):

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 2018	$	504		$	1	$	2,017		$	(10	)	$	(3,543	)	$	72		$	(1,463	)
Comprehensive income (loss)		9		—		—			—				(118	)		8			(110	)
Contributions from noncontrolling interests		1		—		—			—			—			—			—
Distributions to noncontrolling interests		(19	)	—		—			—			—				(8	)		(8	)
Purchase of subsidiary shares from noncontrolling interests		(1	)	—		—			—			—			—			—
Other reclassifications of noncontrolling interests		(1	)	—		—			—			—				1			1
Adjustment to redemption value of redeemable noncontrolling interests		12		—			(12	)	—			—			—				(12	)
Cancellation of restricted stock for tax withholdings on vested shares	—			—			(1	)	—			—			—				(1	)
Share-based compensation	—			—			3		—			—			—				3
Balance, March 31, 2019		505			1		2,007			(10	)		(3,661	)		73			(1,590	)
Comprehensive income (loss)		14		—		—				2			(167	)		8			(157	)
Contributions from noncontrolling interests		1		—		—			—			—			—			—
Distributions to noncontrolling interests		(22	)	—		—			—			—				(8	)		(8	)
Purchase of subsidiary shares from noncontrolling interests	—			—			(1	)	—			—			—				(1	)
Other reclassifications of noncontrolling interests		(1	)	—			(1	)	—			—				1		—
Adjustment to redemption value of redeemable noncontrolling interests		6		—			(6	)	—			—			—				(6	)
Share-based compensation	—			—			3		—			—			—				3
Balance, June 30, 2019		503			1		2,002			(8	)		(3,828	)		74			(1,759	)
Comprehensive income (loss)		11		—		—			—				(17	)		8			(9	)
Contributions from noncontrolling interests		1		—		—			—			—				7			7
Distributions to noncontrolling interests		(14	)	—		—			—			—				(7	)		(7	)
Purchase of subsidiary shares from noncontrolling interests		(6	)	—			2		—			—				1			3
Other reclassifications of noncontrolling interests	—			—			1		—			—			—				1
Adjustment to redemption value of redeemable noncontrolling interests		3		—			(3	)	—			—			—				(3	)
Share-based compensation	—			—			2		—			—			—				2
Balance, September 30, 2019	$	498		$	1	$	2,004		$	(8	)	$	(3,845	)	$	83		$	(1,765	)

Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit

	Three Months Ended					Nine Months Ended
	September 30,					September 30,
	2020		2019			2020		2019
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$	112	$	(17	)	$	200	$	(302	)
Transfers to the noncontrolling interests:
Net increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		—		2			—		1
Net transfers to the noncontrolling interests		—		2			—		1
Change to Community Health Systems, Inc. stockholders' deficit from net income (loss) attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	112	$	(15	)	$	200	$	(301	)

Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2020

Earnings Per Share [Abstract]

Schedule of Components of Denominator for Computation of Basic and Diluted Loss Per Share

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2020		2019		2020		2019
Weighted-average number of shares outstanding — basic		115,015,460		113,891,721		114,764,050		113,672,798
Effect of dilutive securities:
Restricted stock awards		500,857	—			205,600	—
Employee stock options		2,193	—			890	—
Other equity-based awards		122,342	—			41,662	—
Weighted-average number of shares outstanding — diluted		115,640,852		113,891,721		115,012,202		113,672,798

Schedule of Antidilutive Securities

	Three Months Ended			Nine Months Ended
	September 30,			September 30,
	2020		2019	2020		2019
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		1,846,026	3,916,277		3,673,618	3,911,242

Contingencies (Tables)

9 Months Ended

Sep. 30, 2020

Commitments And Contingencies Disclosure [Abstract]

Schedule of Reconciliation of the Beginning and Ending Liability Balances in Connection with Probable Contingencies

Summary of Recorded Amounts

	Probable
	Contingencies
Balance as of December 31, 2019	$	68
Expense		11
Reserve for insured claim		10
Cash payments		(63	)
Balance as of September 30, 2020	$	26

- Definition

Tabular disclosure of the loss contingencies that were reported in the period or disclosed as of the balance sheet date.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
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+ Details

Summarized Financial Information (Tables)

9 Months Ended

Sep. 30, 2020

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Summarized Statements of Income (Loss)

Summarized statements of income (loss) (in millions):

	Nine Months Ended
	September 30, 2020
Net operating revenues	$	5,746
Income from operations		753
Net income		220
Net income attributable to Community Health Systems, Inc. Stockholders		220

Summarized Balance Sheets

Summarized balance sheets (in millions):

	September 30, 2020		December 31, 2019
Current assets	$	3,931	$	2,464
Noncurrent assets (a)		14,443		14,596
Current liabilities		2,553		1,472
Noncurrent liabilities (b)		14,353		15,800

(a)	Includes amounts due from non-guarantor subsidiaries of $6.3 billion and $6.5 billion as of September 30, 2020 and December 31, 2019, respectively.

(b)	Includes amounts due to non-guarantor subsidiaries of $0.4 billion and $1.4 billion as of September 30, 2020 and December 31, 2019, respectively.

Basis of Presentation and Significant Accounting Policies - Additional Information (Details)				1 Months Ended	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2020 USD ($)	Jul. 01, 2020 Item	Jan. 01, 2020 Item	Apr. 30, 2020 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2019 USD ($)	Jul. 02, 2020 USD ($)	Jun. 30, 2020 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2019 USD ($)	Dec. 31, 2019 USD ($)
Cost of Revenue [Abstract]
Corporate office costs					$ 41,000,000	$ 48,000,000			$ 136,000,000	$ 135,000,000
Stock-based compensation expense					3,000,000	2,000,000			8,000,000	8,000,000
Third-Party Reimbursement [Abstract]
Amounts due to third party payors	$ 94,000,000				94,000,000				94,000,000		$ 83,000,000
Amounts due from third party payors	124,000,000				124,000,000				124,000,000		$ 137,000,000
Net Operating Revenues, Policy [Abstract]
Charity care services charges excluded from net operating revenues					285,000,000	126,000,000			751,000,000	410,000,000
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business									(48,000,000)	(70,000,000)
Goodwill allocated to hospital disposal group held for sale	$ 109,000,000				$ 109,000,000	68,000,000			$ 109,000,000	68,000,000
Medicare Accelerated Payments [Abstract]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true				true				true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Mar. 12, 2020				Mar. 12, 2020				Mar. 12, 2020
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false]	true				true				true
Accounting Standards Update [Extensible List]									cyh:AccountingStandardsUpdate202004Member
CARES Act
Medicare Accelerated Payments [Abstract]
Medicare accelerated payments received under the Cares Act				$ 1,200,000,000	$ 0
Medicare accelerated payments period									1 year
CARES Act \| Long-term Liability
Medicare Accelerated Payments [Abstract]
Medicare accelerated outstanding estimated amount under cares act	$ 873,000,000				873,000,000				$ 873,000,000
CARES Act \| Accrued Liabilities and Other
Medicare Accelerated Payments [Abstract]
Medicare accelerated payments under cares act	1,100,000,000				1,100,000,000				$ 1,100,000,000
CARES Act \| Paycheck Protection Program and Health Care Enhancement Act
COVID-19 Pandemic [Abstract]
Percentage of maximum accelerated payment									100.00%
Medicare accelerated and advance payment program period									6 months
Public Health and Social Services Emergency Fund (the "PHSSEF") \| CARES Act \| Paycheck Protection Program and Health Care Enhancement Act
COVID-19 Pandemic [Abstract]
CARES Act and PPPHCE Act of 2020 Aid, amount									$ 175,000,000,000
CARES Act and PPPHCE Act Funds [Abstract]
Accelerated payments received under the Cares Act									719,000,000
Estimated decrease in relief funds recognized under Cares Act								$ 66,000,000
Relief funds recognized					448,000,000				448,000,000
Public Health and Social Services Emergency Fund (the "PHSSEF") \| CARES Act \| Paycheck Protection Program and Health Care Enhancement Act \| Operating Costs and Expenses
CARES Act and PPPHCE Act Funds [Abstract]
Accelerated payments received under the Cares Act					155,000,000			$ 448,000,000	448,000,000
Hospitals Closed
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business	$ (3,000,000)
Hospitals Sold or Deemed Held for Sale
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business							$ 73,000,000		(43,000,000)
Number of hospitals sold \| Item		1	3
Adjustment for Carrying Value of Other Long-Lived Assets at Underperforming Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment and gain (loss) on sale of businesses, net									74,000,000
Shared Service Center
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business									(1,000,000)
Health Care, Patient Service
Net Operating Revenues, Policy [Abstract]
Value of charity care services at the Company's standard charges included in contractual allowances					36,000,000	$ 16,000,000			90,000,000	$ 50,000,000
Centers for Medicare & Medicaid Services \| CARES Act
Medicare Accelerated Payments [Abstract]
Medicare accelerated repayment under cares act					22,000,000
Medicare accelerated payments recouped under cares act					$ 0				$ 0
Medicare accelerated payment recouped description									As of September 30, 2020, the program required CMS to begin recouping payments 120 days after receipt by the provider although no payments were recouped during the three or nine months ended September 30, 2020. Effective October 1, 2020, the program was amended such that providers are required to repay accelerated payments beginning one year after the payment was issued. After such one-year period, Medicare payments owed to providers will be recouped according to the repayment terms. The repayment terms specify that for the first 11 months after repayment begins, repayment will occur through an automatic recoupment of 25% of Medicare payments otherwise owed to the provider. At the end of the eleven-month period, recoupment will increase to 50% for six months. At the end of the six months (29 months from the receipt of the initial accelerated payment), Medicare will issue a letter for full repayment of any remaining balance, as applicable. In such event, if payment is not received within 30 days, interest will accrue at the annual percentage rate of four percent (4%) from the date the letter was issued, and will be assessed for each full 30-day period that the balance remains unpaid.
Medicare accelerated percentage of repayment will occur through an automatic recoupment									25.00%
Medicare accelerated percentage of recoupment will increase									50.00%
Medicare accelerated payments interest rate from the date letter was issued									4.00%

Basis of Presentation and Significant Accounting Policies - Schedule of Net Operating Revenues (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 3,126	$ 3,246	$ 8,670	$ 9,925
Medicare
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	723	811	2,086	2,519
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	419	437	1,167	1,316
Managed Care and Other Third Party Payors
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	1,967	1,971	5,425	5,991
Self-Pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 17	$ 27	$ (8)	$ 99

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=75031198&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9031-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8906-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9054-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 235
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI http://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(1))
-URI http://asc.fasb.org/extlink&oid=120395209&loc=SL114868664-224227

+ Details

Accounting for Stock-Based Compensation - Additional Information (Details)			3 Months Ended				9 Months Ended
	Mar. 01, 2020 USD ($) shares	Mar. 01, 2019 USD ($) shares	Sep. 30, 2020 USD ($) $ / shares shares	Jun. 30, 2020 shares	Mar. 31, 2020 shares	Sep. 30, 2019 USD ($) shares	Sep. 30, 2020 USD ($) Item $ / shares shares	Sep. 30, 2019 USD ($) Item $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee service share-based compensation, unrecognized compensation costs on nonvested awards \| $			$ 19,000,000				$ 19,000,000
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							24 months
Employee service share-based compensation, nonvested awards, modifications to awards \| Item							0	0
Aggregate intrinsic value of options exercised \| $			0			$ 0	$ 0	$ 0
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							26 months
Employee service share-based compensation, unrecognized compensation costs on nonvested stock options \| $			$ 3,000,000				$ 3,000,000
Share-based compensation arrangement by share-based payment award, options, grants in period \| shares			0		946,500	0
Weighted-average grant date fair value of stock options \| $ / shares							$ 3.17	$ 3.05
Share Price \| $ / shares			$ 4.22				$ 4.22
Restricted Stock and Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							24 months
Employee service share-based compensation, unrecognized compensation costs on nonvested awards other than options \| $			$ 16,000,000				$ 16,000,000
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, number of shares received by each director \| shares			0	0	310,347
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement award vesting rights							one-third increments on each of the first three anniversaries of the award date
Share-based compensation, number of shares received by each director \| shares				4,000	2,197,500
Plan 2000
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement award vesting rights							one-third increments on each of the first three anniversaries of the award date
Plan 2000 \| Contractual Term Of Option Granted Since 2008
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Contractual term of option granted							10 years
Plan 2009
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement award vesting rights							one-third increments on each of the first three anniversaries of the award date
Unissued common stock reserved for grants \| shares			10,423,344				10,423,344
Plan 2009 \| Restricted Stock Units (RSUs) \| Non-management Directors
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, number of shares received by each director \| shares	34,483	34,068
Fair value of units granted \| $	$ 170,000	$ 170,000
Plan 2009 \| Contractual Term of Option Granted in 2011 or Later
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Contractual term of option granted							10 years
Performance-Based Awards Granted On Or After March 1, 2017 \| Restricted Stock, Performance-Based Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by payment award, performance objective measurement period							3 years

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Effect on loss before income taxes	$ (3)	$ (2)	$ (8)	$ (8)
Effect on net income (loss)	$ (2)	$ (2)	$ (6)	$ (6)

Accounting for Stock-Based Compensation - Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions (Details) - Employee Stock Option	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	73.50%	68.40%
Expected term	6 years	5 years 7 months 6 days
Risk-free interest rate	1.00%	2.60%

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Stock Options, Activity (Details) - Employee Stock Option - $ / shares	3 Months Ended				9 Months Ended	12 Months Ended
	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2019	Sep. 30, 2020	Dec. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Shares	1,865,029	1,896,696	1,110,134		1,110,134
Granted, Shares	0		946,500	0
Forfeited and cancelled, Shares	(7,003)	(31,667)	(159,938)
Ending Balance, Shares	1,858,026	1,865,029	1,896,696		1,858,026	1,110,134
Exercisable, Shares	495,522				495,522
Beginning of Period, Weighted Average Exercise Price	$ 9.12	$ 9.50	$ 16.90		$ 16.90
Granted, Weighted Average Exercise Price			4.93
Forfeited and Cancelled, Weighted Average Exercise Price	32.58	31.90	33.90
End of Period, Weighted Average Exercise Price	9.03	$ 9.12	$ 9.50		9.03	$ 16.90
Exercisable, Weighted Average Exercise Price	$ 20.28				$ 20.28
Weighted Average Remaining Contractual Term					7 years 8 months 12 days	5 years 7 months 6 days
Exercisable, Weighted Average Remaining Contractual Term					4 years

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock, Activity (Details) - Restricted Stock - $ / shares	3 Months Ended
	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	4,618,740	4,737,752	3,857,402
Granted, Shares		4,000	2,197,500
Vested, Shares	(11,001)	(96,677)	(988,650)
Forfeited, Shares	(21,002)	(26,335)	(328,500)
Ending Balance, Unvested Shares	4,586,737	4,618,740	4,737,752
Beginning of Period, Weighted Average Grant Date Fair Value	$ 4.84	$ 4.89	$ 5.47
Granted, Weighted Average Grant Date Fair Value		3.19	4.90
Vested, Weighted Average Grant Date Fair Value	4.53	6.81	5.77
Forfeited, Weighted Average Grant Date Fair Value	5.01	5.00	9.19
End of Period, Weighted Average Grant Date Fair Value	$ 4.84	$ 4.84	$ 4.89

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock Units, Activity (Details) - Restricted Stock Units (RSUs) - $ / shares	3 Months Ended
	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	613,739	613,739	541,576
Granted, Shares	0	0	310,347
Vested, Shares	0	0	(238,184)
Ending Balance, Unvested Shares	613,739	613,739	613,739
Beginning of Period, Weighted Average Grant Date Fair Value	$ 4.89	$ 4.89	$ 5.13
Granted, Weighted Average Grant Date Fair Value	0	0	4.93
Vested, Weighted Average Grant Date Fair Value	0	0	5.47
End of Period, Weighted Average Grant Date Fair Value	$ 4.89	$ 4.89	$ 4.89

Acquisitions and Divestitures - Acquisitions - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Acquisitions and Divestitures [Line Items]
Acquisition and integration expenses related to prospective and closed acquisitions	$ 1	$ 1	$ 1	$ 3
Physician Practices Clinics and Other Ancillary Businesses
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price			$ 1

Acquisitions and Divestitures - Schedule of Divestitures (Details) - Item	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Hill Regional Hospital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	25
Effective Date	Aug. 01, 2020
St. Cloud Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	84
Effective Date	Jul. 01, 2020
Northern Louisiana Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	130
Effective Date	Jul. 01, 2020
Shands Live Oak Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	25
Effective Date	May 01, 2020
Shands Starke Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	49
Effective Date	May 01, 2020
Southside Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	300
Effective Date	Jan. 01, 2020
Southampton Memorial Hospital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	105
Effective Date	Jan. 01, 2020
Southern Virginia Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	80
Effective Date	Jan. 01, 2020
Bluefield Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		92
Effective Date		Oct. 01, 2019
Lake Wales Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		160
Effective Date		Sep. 01, 2019
Heart of Florida Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		193
Effective Date		Sep. 01, 2019
College Station Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		167
Effective Date		Aug. 01, 2019
Tennova Healthcare Lebanon
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		245
Effective Date		Aug. 01, 2019
Chester Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		82
Effective Date		Mar. 01, 2019
Carolinas Hospital System - Florence
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		396
Effective Date		Mar. 01, 2019
Springs Memorial Hospital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		225
Effective Date		Mar. 01, 2019
Carolinas Hospital System - Marion
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		124
Effective Date		Mar. 01, 2019
Memorial Hospital of Salem County
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		126
Effective Date		Jan. 31, 2019
Mary Black Health System - Spartanburg
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		207
Effective Date		Jan. 01, 2019
Mary Black Health System - Gaffney
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		125
Effective Date		Jan. 01, 2019

Acquisitions and Divestitures - Divestitures - Additional Information (Details) $ in Millions				3 Months Ended		12 Months Ended
	Jun. 25, 2020 Item	Apr. 27, 2020 Item	Apr. 20, 2020 Item	Sep. 30, 2020 USD ($) Item	Dec. 31, 2018 USD ($)	Dec. 31, 2019 USD ($)	Sep. 08, 2020 Item
Northern Louisiana Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds				130
San Angelo Community Medical Center \| San Angelo, Texas
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			171
Disposition completion date			Oct. 24, 2020
Abilene Regional Medical Center \| Abilene, Texas
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		231
Disposition completion date		Oct. 27, 2020
Brownwood Regional Medical Center \| Brownwood, Texas
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		188
Disposition completion date		Oct. 27, 2020
Lea Regional Medical Center \| Hobbs, New Mexico
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds							68
Bayfront Health St Petersburg \| St. Petersburg, Florida
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	480
Disposition completion date	Oct. 01, 2020
Tennova Healthcare - Tullahoma \| Tullahoma, Tennessee
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds				135
Tennova Healthcare – Shelbyville \| Shelbyville, Tennessee
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds				60
Shands Lake Shore Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge recorded on the sale or closure of hospitals \| $				$ 3
Shands Lake Shore Regional Medical Center \| Lake City, Florida
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds				99
Tennova Healthcare
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge recorded on the sale or closure of hospitals \| $					$ 27	$ 9

Acquisitions and Divestitures - Schedule of Balance Sheet Items Classified as Held for Sale (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Acquisitions And Divestitures [Abstract]
Other current assets	$ 32	$ 25
Other assets, net	341	262
Accrued liabilities	$ 114	$ 43

Goodwill and Other Intangible Assets - Schedule of Goodwill (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Goodwill [Roll Forward]
Goodwill	$ 7,034	$ 7,142
Accumulated impairment losses	(2,814)	(2,814)
Goodwill, total	4,220	$ 4,328
Goodwill acquired as part of acquisitions during current year	1
Goodwill allocated to hospitals held for sale	$ (109)

Goodwill and Other Intangible Assets - Goodwill - Additional Information (Details) - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill	$ 4,220,000,000	$ 4,328,000,000
Impairment of goodwill	$ 0	$ 0

Goodwill and Other Intangible Assets - Intangible Assets - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets acquired during the year			$ 0
Finite-lived intangible assets, gross	$ 1,000,000		1,000,000		$ 1,000,000
Net, intangible asset not subject to amortization	55,000,000		55,000,000		63,000,000
Gross carrying amount of capitalized software	1,100,000,000		1,100,000,000		1,100,000,000
Capitalized computer software, net	270,000,000		270,000,000		321,000,000
Capitalized computer software, development stage costs	13,000,000		$ 13,000,000
Capitalized Internal Use Software, Significant System Conversions
Finite-Lived Intangible Assets [Line Items]
Weighted-average amortization period			3 years
Capitalized Internal Use Software
Finite-Lived Intangible Assets [Line Items]
Acquired finite-lived intangible asset, residual value	0		$ 0
Amortization expense	34,000,000	$ 30,000,000	96,000,000	$ 91,000,000
Amortization expense for remainder 2020	30,000,000		30,000,000
Amortization expense for 2021	111,000,000		111,000,000
Amortization expense for 2022	69,000,000		69,000,000
Amortization expense for 2023	34,000,000		34,000,000
Amortization expense for 2024	11,000,000		11,000,000
Amortization expense for 2025	9,000,000		9,000,000
Amortization expense thereafter	6,000,000		6,000,000
Maximum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived intangible assets, net	$ 1,000,000		$ 1,000,000		$ 1,000,000
Maximum \| Capitalized Internal Use Software, Significant System Conversions
Finite-Lived Intangible Assets [Line Items]
Weighted-average amortization period			10 years
Minimum [Member] \| Capitalized Internal Use Software, Significant System Conversions
Finite-Lived Intangible Assets [Line Items]
Weighted-average amortization period			8 years

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Taxes [Line Items]
Unrecognized benefit that would affect the effective tax rate	$ 1		$ 1
Amount of interest and penalties included in liabilities for uncertain tax positions	$ 1		$ 1
Effective income tax rate	13.50%	102.80%	(669.70%)	22.50%
Income tax refunds (payments), net	$ (3)	$ (1)	$ (2)	$ 3
Federal \| Tax Year 2014
Income Taxes [Line Items]
Open tax year			2014
Federal \| Tax Year 2015
Income Taxes [Line Items]
Open tax year			2015

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Debt and lease obligations	$ 12,879	$ 13,405
Less: Unamortized deferred debt issuance costs and note premium	(148)	(147)
Less: Current maturities	(19)	(20)
Total long-term debt	12,860	13,385
ABL Facility
Debt Instrument [Line Items]
Debt and lease obligations		273
Senior Secured Notes \| Senior Secured Notes at 5.125%, Due 2021
Debt Instrument [Line Items]
Debt and lease obligations		1,000
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Debt and lease obligations	2,675	3,100
Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Debt Instrument [Line Items]
Debt and lease obligations	1,033	1,033
Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Debt Instrument [Line Items]
Debt and lease obligations	1,462
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt and lease obligations	2,101	2,101
Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Debt Instrument [Line Items]
Debt and lease obligations	700	700
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt and lease obligations	197	231
Senior Notes \| Senior Notes at 6.875% Due 2028
Debt Instrument [Line Items]
Debt and lease obligations	1,474	1,700
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Debt Instrument [Line Items]
Debt and lease obligations	1,770	1,770
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt and lease obligations	1,354	1,355
Finance Lease and Financing Obligations
Debt Instrument [Line Items]
Debt and lease obligations	241	272
Other
Debt Instrument [Line Items]
Debt and lease obligations	$ 20	$ 17

Long-Term Debt - Schedule of Debt (Parenthetical) (Details)	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019	Feb. 06, 2020
Senior Secured Notes \| Senior Secured Notes at 5.125%, Due 2021
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	5.125%	5.125%
Debt instrument, maturity year	2021	2021
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.25%	6.25%
Debt instrument, maturity year	2023	2023
Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.625%	8.625%
Debt instrument, maturity year	2024	2024
Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.625%	6.625%	6.625%
Debt instrument, maturity year	2025	2025
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.00%	8.00%
Debt instrument, maturity year	2026	2026
Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.00%	8.00%
Debt instrument, maturity year	2027	2027
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%	6.875%
Debt instrument, maturity year	2022	2022
Senior Notes \| Senior Notes at 6.875% Due 2028
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%	6.875%
Debt instrument, maturity year	2028	2028
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	9.875%	9.875%
Debt instrument, maturity year	2023	2023
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.125%	8.125%
Debt instrument, maturity year	2024	2024

Long-Term Debt - 6.625% Senior Secured Notes, Due 2025 - Additional Information (Details) - USD ($)		3 Months Ended		9 Months Ended
	Feb. 06, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Debt Instrument [Line Items]
Extinguishment of debt amount		$ 261,000,000
Pre-tax gain (loss) from extinguishment of debt		$ 115,000,000		$ 111,000,000	$ (31,000,000)
Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Extinguishment of debt amount	$ 426,000,000
Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Debt Instrument [Line Items]
Debt instrument, offering date				Feb. 06, 2020
Debt instrument aggregate principal amount	$ 1,462,000,000
Debt instrument stated interest rate	6.625%	6.625%		6.625%		6.625%
Debt instrument, maturity date				Feb. 15, 2025
Extinguishment of debt amount			$ 1,000,000
Debt instrument redemption price percentage				100.00%
Pre-tax gain (loss) from extinguishment of debt		$ 115,000,000		$ 111,000,000	(31,000,000)
After-tax gain (loss) from extinguishment of debt		$ 100,000,000		$ 97,000,000	$ (25,000,000)
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Debt instrument stated interest rate		6.25%		6.25%		6.25%

Long-Term Debt - Schedule of Early Redemption Prices on 6.625% Senior Secured Notes due 2025 (Details) - Senior Secured Notes at 6.625% Due 2025 - Senior Secured Notes	9 Months Ended
	Sep. 30, 2020
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption, Period One
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	103.313%
Debt Instrument, Redemption Period, Start Date	Feb. 15, 2022
Debt Instrument, Redemption Period, End Date	Feb. 14, 2023
Debt Instrument, Redemption, Period Two
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	101.656%
Debt Instrument, Redemption Period, Start Date	Feb. 15, 2023
Debt Instrument, Redemption Period, End Date	Feb. 14, 2024
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Feb. 15, 2024
Debt Instrument, Redemption Period, End Date	Feb. 14, 2025

Long-Term Debt - Schedule of Extinguished Portion of Certain Series of Outstanding Notes (Details) $ in Millions	3 Months Ended
	Sep. 30, 2020 USD ($)
Debt Instrument [Line Items]
Total principal amount of debt extinguished	$ 261
Senior Notes \| 6.875% Senior Notes due 2028
Debt Instrument [Line Items]
Total principal amount of debt extinguished	226
Senior Notes \| 6.875% Senior Notes due 2022
Debt Instrument [Line Items]
Total principal amount of debt extinguished	34
Junior-Priority Secured Notes \| 8.125% Junior-Priority Secured Notes due 2024
Debt Instrument [Line Items]
Total principal amount of debt extinguished	$ 1

Long-Term Debt - Schedule of Extinguished Portion of Certain Series of Outstanding Notes (Parenthetical) (Details)	3 Months Ended
	Sep. 30, 2020
Senior Secured Notes \| 6.875% Senior Notes due 2028
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%
Debt instrument, maturity year	2028
Senior Secured Notes \| 6.875% Senior Notes due 2022
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%
Debt instrument, maturity year	2022
Junior-Priority Secured Notes \| 8.125% Junior-Priority Secured Notes due 2024
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.125%
Debt instrument, maturity year	2024

Long-Term Debt - Other Debt - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2020 USD ($)	Sep. 30, 2019 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2019 USD ($)	Aug. 30, 2020 Agreement
Debt Instrument [Line Items]
Interest paid on borrowings	$ 279,000,000	$ 492,000,000	$ 765,000,000	$ 810,000,000
Interest Rate Swap
Debt Instrument [Line Items]
Number of interest rate swaps \| Agreement					1
ABL Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	1,000,000,000.0		1,000,000,000.0
Debt instrument available borrowing base	654,000,000		654,000,000
Outstanding borrowings	0		0
ABL Facility \| ABL Facility Customary Covenants
Debt Instrument [Line Items]
Debt instrument available borrowing base	95,000,000		$ 95,000,000
Debt instrument variable interest rate			10.00%
ABL Facility \| ABL Facility Customary Covenants \| Maximum
Debt Instrument [Line Items]
Debt instrument available borrowing base	95,000,000		$ 95,000,000
ABL Facility \| Letter of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 151,000,000		$ 151,000,000

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Carrying Amount
Assets:
Cash and cash equivalents	$ 1,823	$ 216
Investments in equity securities	124	141
Available-for-sale debt securities	105	101
Trading securities	13	12
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 5.125%, Due 2021
Liabilities:
Notes payable, fair value disclosure		990
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Liabilities:
Notes payable, fair value disclosure	2,657	3,074
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Liabilities:
Notes payable, fair value disclosure	1,025	1,023
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure	1,425
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,073	2,070
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	691	691
Carrying Amount \| Senior Notes \| Senior Notes at 6.875%, Due 2022
Liabilities:
Notes payable, fair value disclosure	196	229
Carrying Amount \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	1,456	1,678
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Liabilities:
Notes payable, fair value disclosure	1,757	1,754
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Liabilities:
Notes payable, fair value disclosure	1,341	1,340
Carrying Amount \| Receivables Facility and Other Debt, Type \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	17	285
Estimated Fair Value
Assets:
Cash and cash equivalents	1,823	216
Investments in equity securities	124	141
Available-for-sale debt securities	105	101
Trading securities	13	12
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 5.125%, Due 2021
Liabilities:
Notes payable, fair value disclosure		1,003
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Liabilities:
Notes payable, fair value disclosure	2,617	3,148
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Liabilities:
Notes payable, fair value disclosure	1,028	1,099
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure	1,417
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,070	2,182
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875%, Due 2022
Liabilities:
Notes payable, fair value disclosure	176	188
Estimated Fair Value \| Senior Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	685	700
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	697	1,700
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Liabilities:
Notes payable, fair value disclosure	1,402	1,539
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Liabilities:
Notes payable, fair value disclosure	990	1,113
Estimated Fair Value \| Receivables Facility and Other Debt, Type \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	$ 17	$ 285

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Parenthetical) (Details)	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019	Feb. 06, 2020
Senior Secured Notes \| Senior Secured Notes at 5.125%, Due 2021
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	5.125%	5.125%
Debt instrument maturity year	2021	2021
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	6.25%	6.25%
Debt instrument maturity year	2023	2023
Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	8.625%	8.625%
Debt instrument maturity year	2024	2024
Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	6.625%	6.625%	6.625%
Debt instrument maturity year	2025	2025
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	8.00%	8.00%
Debt instrument maturity year	2026	2026
Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	8.00%	8.00%
Debt instrument maturity year	2027	2027
Senior Notes \| Senior Notes at 6.875%, Due 2022
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	6.875%	6.875%
Debt instrument maturity year	2022	2022
Senior Notes \| Senior Notes at 6.875% Due 2028
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	6.875%	6.875%
Debt instrument maturity year	2028	2028
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	9.875%	9.875%
Debt instrument maturity year	2023	2023
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	8.125%	8.125%
Debt instrument maturity year	2024	2024

Fair Value of Financial Instruments - Additional Information (Details)	Aug. 30, 2020 Agreement
Interest Rate Swap
Derivative [Line Items]
Number of interest rate swaps	1

Fair Value of Financial Instruments - Schedule of Pre-tax Gain (Loss) Recognized as a Component of Other Comprehensive Income (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019 USD ($)
Cash Flow Hedging \| Interest Rate Swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Pre-Tax Gain (Loss) Recognized in OCI (Effective Portion)	$ (4)

Fair Value of Financial Instruments - Schedule of Effective Portion of the Pre-tax Loss (Gain) Reclassified from AOCL into Interest Expense on the Consolidated Statements of Income (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2020	Sep. 30, 2019
Interest Expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Pre-Tax Loss (Gain) Reclassified from AOCL into Income (Effective Portion)	$ 1	$ 2	$ (1)

Fair Value - Additional Information (Details) - USD ($)	Sep. 30, 2020	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Fair value, assets, level 1 to level 2 transfers, amount	$ 0	$ 0
Fair value, assets, level 2 to level 1 transfers, amount	0	0
Fair value, liabilities, level 1 to level 2 transfers, amount	0	0
Fair value, liabilities, level 2 to level 1 transfers, amount	$ 0	$ 0

Fair Value - Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in equity securities	$ 124	$ 141
Available-for-sale debt securities	105	101
Trading securities	13	12
Total assets	242	254
Fair value of interest rate swap agreement		2
Total liabilities		2
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in equity securities	124	141
Total assets	124	141
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Available-for-sale debt securities	105	101
Trading securities	13	12
Total assets	$ 118	113
Fair value of interest rate swap agreement		2
Total liabilities		$ 2

Leases - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2020
Leases [Abstract]
Reduction to variable rent expense recognized	$ 4	$ 6

Leases - Components of Lease Cost and Rent Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Leases [Abstract]
Operating lease cost	$ 50	$ 49	$ 152	$ 143
Short-term rent expense	27	28	80	87
Variable lease cost	9	3	20	13
Sublease income	(1)	(1)	(4)	(3)
Total operating lease cost	85	79	248	240
Finance lease cost:
Amortization of right-of-use assets	2	3	8	9
Interest on finance lease liabilities	2	2	6	6
Total finance lease cost	$ 4	$ 5	$ 14	$ 15

Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Operating Leases:
Operating Lease ROU Assets	$ 633	$ 607
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssetsNoncurrent	us-gaap:OtherAssetsNoncurrent
Finance Leases:
Property and equipment	$ 9,293	$ 9,653
Less accumulated depreciation and amortization	(4,003)	(4,045)
Property and equipment, net	5,290	5,608
Current finance lease liabilities	$ 5	$ 6
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]	us-gaap:LongTermDebtAndCapitalLeaseObligationsCurrent	us-gaap:LongTermDebtAndCapitalLeaseObligationsCurrent
Long-term finance lease liabilities	$ 75	$ 107
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	us-gaap:LongTermDebtNoncurrent	us-gaap:LongTermDebtNoncurrent
Finance Lease ROU Assets [Member]
Finance Leases:
Property and equipment	$ 151	$ 173
Less accumulated depreciation and amortization	(45)	(56)
Property and equipment, net	106	117
Finance Lease ROU Assets [Member] \| Land and Improvements [Member]
Finance Leases:
Property and equipment	8	8
Finance Lease ROU Assets [Member] \| Building and Building Improvements [Member]
Finance Leases:
Property and equipment	134	154
Finance Lease ROU Assets [Member] \| Equipment and Fixtures [Member]
Finance Leases:
Property and equipment	$ 9	$ 11

Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 141	$ 127
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from finance leases	6	6
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows from finance leases	5	7
Right-of-use assets obtained in exchange for new finance lease liabilities	22	2
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 119	$ 86

Employee Benefit Plans - Additional Information (Details) - Supplemental Employee Retirement Plans, Defined Benefit [Member] - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Defined Benefit Plan Disclosure [Line Items]
Net periodic benefit cost	$ 2	$ 2	$ 5	$ 5
Accrued benefits liabilities	77		$ 77		$ 72
Defined benefit plans and other post-retirement plans, weighted-average assumptions to determine net periodic cost, discount rate			3.10%	4.20%
Defined benefit plans and other post-retirement plans, weighted-average assumptions to determine net periodic cost, rate of compensation increase			3.00%	3.00%
Assets in a rabbi trust generally designated to pay benefits of the SERP	$ 87		$ 87		$ 84

Stockholders' Deficit - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Equity [Abstract]
Capital stock, shares authorized	400,000,000
Common stock, shares authorized	300,000,000	300,000,000
Preferred stock, shares authorized	100,000,000	100,000,000
Common stock, par value per share	$ 0.01	$ 0.01
Preferred stock, par value per share	$ 0.01	$ 0.01
Preferred stock, shares outstanding	0
Amount available for dividend payments, stock repurchases at period end	$ 200

Stockholders' Deficit - Schedule of Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended
	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019
Equity, beginning balance	$ (2,052)	$ (2,136)	$ (2,141)	$ (1,759)	$ (1,590)	$ (1,463)
Redeemable Noncontrolling Interests, beginning balance			502
Comprehensive income (loss)	104	87	28	(9)	(157)	(110)
Contributions from noncontrolling interests				7
Distributions to noncontrolling interests	(7)	(10)	(8)	(7)	(8)	(8)
Purchase of subsidiary shares from noncontrolling interests		1	(1)	3	(1)
Other reclassifications of noncontrolling interests			(8)	1		1
Adjustment to redemption value of redeemable noncontrolling interests	(6)	3	(7)	(3)	(6)	(12)
Cancellation of restricted stock for tax withholdings on vested shares			(1)			(1)
Share-based compensation	3	3	2	2	3	3
Equity, ending balance	(1,957)	(2,052)	(2,136)	(1,765)	(1,759)	(1,590)
Redeemable Noncontrolling Interests, ending balance	481
Redeemable Noncontrolling Interests (Non- Equity)
Redeemable Noncontrolling Interests, beginning balance	489	502	502	503	505	504
Comprehensive income (loss)	23
Comprehensive income (loss) attributable to redeemable noncontrolling interest		7	8	11	14	9
Contributions from noncontrolling interests				1	1	1
Distributions to redeemable noncontrolling interests	(20)	(17)	(22)	(14)	(22)	(19)
Purchase of subsidiary shares from noncontrolling interests	(2)	(1)	(1)	(6)		(1)
Disposition of less-than-wholly owned hospital	(15)
Other reclassifications of redeemable noncontrolling interests		1	8		(1)	(1)
Adjustment to redemption value of redeemable noncontrolling interests	6	(3)	7	3	6	12
Redeemable Noncontrolling Interests, ending balance	481	489	502	498	503	505
Common Stock
Equity, beginning balance	1	1	1	1	1	1
Equity, ending balance	1	1	1	1	1	1
Additional Paid-in Capital
Equity, beginning balance	2,008	2,001	2,008	2,002	2,007	2,017
Purchase of subsidiary shares from noncontrolling interests		1	(1)	2	(1)
Other reclassifications of noncontrolling interests				1	(1)
Adjustment to redemption value of redeemable noncontrolling interests	(6)	3	(7)	(3)	(6)	(12)
Cancellation of restricted stock for tax withholdings on vested shares			(1)			(1)
Share-based compensation	3	3	2	2	3	3
Equity, ending balance	2,005	2,008	2,001	2,004	2,002	2,007
Accumulated Other Comprehensive Income (Loss)
Equity, beginning balance	(5)	(7)	(9)	(8)	(10)	(10)
Comprehensive income (loss)		2	2		2
Equity, ending balance	(5)	(5)	(7)	(8)	(8)	(10)
Accumulated Deficit
Equity, beginning balance	(4,131)	(4,200)	(4,218)	(3,828)	(3,661)	(3,543)
Comprehensive income (loss)	112	69	18	(17)	(167)	(118)
Equity, ending balance	(4,018)	(4,131)	(4,200)	(3,845)	(3,828)	(3,661)
Noncontrolling Interest
Equity, beginning balance	75	69	77	74	73	72
Comprehensive income (loss)	(8)	16	8	8	8	8
Contributions from noncontrolling interests				7
Distributions to noncontrolling interests	(7)	(10)	(8)	(7)	(8)	(8)
Purchase of subsidiary shares from noncontrolling interests				1
Other reclassifications of noncontrolling interests			(8)		1	1
Equity, ending balance	$ 60	$ 75	$ 69	$ 83	$ 74	$ 73

Stockholders' Deficit - Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Equity [Abstract]
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$ 112	$ (17)	$ 200	$ (302)
Net increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		2		1
Net transfers to the noncontrolling interests		2		1
Change to Community Health Systems, Inc. stockholders' deficit from net income (loss) attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$ 112	$ (15)	$ 200	$ (301)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section 45
-Paragraph 1A
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121641772&loc=SL7669619-108580

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8924-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 11
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22694-107794

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(22))
-URI http://asc.fasb.org/extlink&oid=120399700&loc=SL114874048-224260

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 11
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22694-107794

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
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+ Details

Earnings Per Share - Schedule of Components of Denominator for Computation of Basic and Diluted Loss Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Effect of dilutive securities:
Weighted-average number of shares outstanding — basic	115,015,460	113,891,721	114,764,050	113,672,798
Restricted stock awards	500,857		205,600
Employee stock options	2,193		890
Other equity-based awards	122,342		41,662
Weighted-average number of shares outstanding — diluted	115,640,852	113,891,721	115,012,202	113,672,798

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Earnings Per Share [Abstract]
Increase in number of shares to diluted shares calculation if income would have been generated	69,042	52,925

Earnings Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Earnings Per Share [Abstract]
Employee stock options and restricted stock awards excluded from computation of earnings per share amount	1,846,026	3,916,277	3,673,618	3,911,242

Contingencies - Schedule of Reconciliation of the Beginning and Ending Liability Balances in Connection with Probable Contingencies (Details) - Pending Litigation [Member] - Other Probable Contingencies [Member] $ in Millions	9 Months Ended
	Sep. 30, 2020 USD ($)
Loss Contingency Accrual [Roll Forward]
Beginning Balance	$ 68
Expense	11
Reserve for insured claim	10
Cash payments	(63)
Ending Balance	$ 26

Contingencies - Additional Information (Details) - Pending Litigation [Member] - USD ($) $ in Millions	1 Months Ended	3 Months Ended		9 Months Ended
	Nov. 30, 2018	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Litigation Matters Where Negative Outcome Is Reasonably Possible [Member]
Loss Contingencies [Line Items]
Attorneys' fees and other costs incurred		$ 2	$ 7	$ 3	$ 11
Litigation Matters For Which An Outcome Cannot Be Assessed [Member] \| Steadfast Insurance Company, et al v. Community Health Systems, Inc. [Member]
Loss Contingencies [Line Items]
Loss contingency damages sought value	$ 73

Subsequent Events - Additional Information (Details) $ in Millions	Oct. 12, 2020 Item	Oct. 27, 2020 Item	Oct. 24, 2020 Item	Oct. 08, 2020 Item	Oct. 01, 2020 Item	Sep. 30, 2020 USD ($)	Jun. 25, 2020 Item	Apr. 20, 2020 Item
Subsequent Event [Line Items]
Unrecognized pandemic relief funds \| $						$ 271
La Porte, Indiana Hospital
Subsequent Event [Line Items]
Capital commitment, post-acquisition cost of replacement hospital \| $						$ 119
Bayfront Health St Petersburg \| St. Petersburg, Florida
Subsequent Event [Line Items]
Number of licensed beds							480
San Angelo Community Medical Center \| San Angelo, Texas
Subsequent Event [Line Items]
Number of licensed beds								171
Subsequent Event \| Bayfront Health St Petersburg \| St. Petersburg, Florida
Subsequent Event [Line Items]
Number of licensed beds sold					480
Subsequent Event \| Berwick Hospital Center \| Berwick, Pennsylvania
Subsequent Event [Line Items]
Number of licensed beds				90
Subsequent Event \| San Angelo Community Medical Center \| San Angelo, Texas
Subsequent Event [Line Items]
Number of licensed beds sold			171
Subsequent Event \| Abilene Regional Medical Center \| Texas
Subsequent Event [Line Items]
Number of licensed beds sold		231
Subsequent Event \| Brownwood Regional Medical Center \| Texas
Subsequent Event [Line Items]
Number of licensed beds sold		188
Subsequent Event \| Merit Health Biloxi \| Biloxi, Mississippi
Subsequent Event [Line Items]
Number of licensed beds	153
Agreement for sale ownership percentage	50.00%

Summarized Financial Information - Additional Information (Details)	9 Months Ended
	Sep. 30, 2020 Item
Condensed Financial Statements Captions [Line Items]
Percentage of owned domestic subsidiaries which guaranteed senior notes	100.00%
Number of hospitals jointly owned with non-profit health organizations	3
Senior Notes due 2022
Condensed Financial Statements Captions [Line Items]
Debt instrument, interest rate, stated percentage	6.875%
Senior Secured Notes due 2023
Condensed Financial Statements Captions [Line Items]
Debt instrument, interest rate, stated percentage	6.25%

Summarized Financial Information - Summarized Statements of Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Condensed Financial Statements Captions [Line Items]
Net operating revenues	$ 3,126	$ 3,246	$ 8,670	$ 9,925
Income from operations	285	184	690	486
Net income	128	2	254	(244)
Net income attributable to Community Health Systems, Inc. Stockholders	$ 112	$ (17)	200	$ (302)
Parent Company, Subsidiary Issuer And Guarantor Subsidiaries [Member]
Condensed Financial Statements Captions [Line Items]
Net operating revenues			5,746
Income from operations			753
Net income			220
Net income attributable to Community Health Systems, Inc. Stockholders			$ 220

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

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Summarized Financial Information - Summarized Balance Sheets (Details) - USD ($)
$ in Millions

Sep. 30, 2020

Dec. 31, 2019

Condensed Financial Statements Captions [Line Items]

Current assets

$ 4,692

$ 3,427

Current liabilities

3,629

2,282

Parent Company, Subsidiary Issuer And Guarantor Subsidiaries [Member]

Condensed Financial Statements Captions [Line Items]

Current assets

3,931

2,464

Noncurrent assets

^[1]

14,443

14,596

Current liabilities

2,553

1,472

Noncurrent liabilities

^[2]

$ 14,353

$ 15,800

[1]	Includes amounts due from non-guarantor subsidiaries of $6.3 billion and $6.5 billion as of September 30, 2020 and December 31, 2019, respectively.
[2]	Includes amounts due to non-guarantor subsidiaries of $0.4 billion and $1.4 billion as of September 30, 2020 and December 31, 2019, respectively.

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Sum of the carrying amounts as of the balance sheet date of all assets that are expected to be realized in cash, sold, or consumed within one year (or the normal operating cycle, if longer). Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.

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Sum of the carrying amounts as of the balance sheet date of all assets that are expected to be realized in cash, sold or consumed after one year or beyond the normal operating cycle, if longer.

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- Definition

Total obligations incurred as part of normal operations that are expected to be paid during the following twelve months or within one business cycle, if longer.

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Amount of obligation due after one year or beyond the normal operating cycle, if longer.

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Summarized Financial Information - Summarized Balance Sheets (Parenthetical) (Details) - Non-Guarantor Subsidiaries [Member] - USD ($) $ in Billions	Sep. 30, 2020	Dec. 31, 2019
Condensed Financial Statements Captions [Line Items]
Noncurrent assets	$ 6.3	$ 6.5
Noncurrent liabilities	$ 0.4	$ 1.4

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Sum of the carrying amounts as of the balance sheet date of all assets that are expected to be realized in cash, sold or consumed after one year or beyond the normal operating cycle, if longer.

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Amount of obligation due after one year or beyond the normal operating cycle, if longer.

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