0001564590-21-006686 | 10-K | XBRL Viewer | Community Health Systems INC

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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2020	Feb. 12, 2021	Jun. 30, 2020
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Transition Report	false
Document Period End Date	Dec. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
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		129,615,003
Entity Central Index Key	0001108109
Amendment Flag	false
Entity Public Float			$ 336,683,731
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
ICFR Auditor Attestation Flag	true
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Certain information required for Part III of this annual report is incorporated by reference to portions of the Registrant’s definitive proxy statement for its 2021 annual meeting of stockholders to be filed with the Securities and Exchange Commission within 120 days after the end of the Registrant’s fiscal year ended December 31, 2020.

Consolidated Statements of Income (Loss) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
Net operating revenues	$ 11,789	$ 13,210	$ 14,155
Operating costs and expenses:
Salaries and benefits	5,411	5,947	6,384
Supplies	1,963	2,151	2,355
Other operating expenses	2,957	3,303	3,496
Government and other legal settlements and related costs		93	11
Electronic health records incentive reimbursement		(1)	(4)
Lease cost and rent	327	321	337
Pandemic relief funds	(601)
Depreciation and amortization	558	608	700
Impairment and (gain) loss on sale of businesses, net	48	138	668
Total operating costs and expenses	10,663	12,560	13,947
Income from operations	1,126	650	208
Interest expense, net of interest income of $3 in both 2020 and 2019 and $7 in 2018	1,031	1,041	976
(Gain) loss from early extinguishment of debt	(317)	54	(31)
Equity in earnings of unconsolidated affiliates	(10)	(15)	(22)
Income (loss) before income taxes	422	(430)	(715)
(Benefit from) provision for income taxes	(185)	160	(11)
Net income (loss)	607	(590)	(704)
Less: Net income attributable to noncontrolling interests	96	85	84
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$ 511	$ (675)	$ (788)
Earnings (loss) per share attributable to Community Health Systems, Inc. common stockholders:
Basic	$ 4.43	$ (5.93)	$ (6.99)
Diluted	$ 4.39	$ (5.93)	$ (6.99)
Weighted-average number of shares outstanding:
Basic	115,491,022	113,739,046	112,728,274
Diluted	116,544,561	113,739,046	112,728,274

Consolidated Statements of Income (Loss) (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
Interest income	$ 3	$ 3	$ 7

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss)	$ 607	$ (590)	$ (704)
Other comprehensive (loss) income, net of income taxes:
Net change in fair value of interest rate swaps, net of tax of $0, $1 and $6 for the years ended December 31, 2020, 2019 and 2018, respectively	(1)	(3)	20
Net change in fair value of available-for-sale debt securities, net of tax	4	4	(2)
Amortization and recognition of unrecognized pension cost components, net of tax of $2, $0 and $1 for the years ended December 31, 2020, 2019, and 2018, respectively	(7)		(1)
Other comprehensive (loss) income	(4)	1	17
Comprehensive income (loss)	603	(589)	(687)
Less: Comprehensive income attributable to noncontrolling interests	96	85	84
Comprehensive income (loss) attributable to Community Health Systems, Inc. stockholders	$ 507	$ (674)	$ (771)

Consolidated Statements of Comprehensive Income (Loss) (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net change in fair value of interest rate swaps, tax	$ 0	$ 1	$ 6
Amortization and recognition of unrecognized pension cost components, tax	$ 2	$ 0	$ 1

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 1,676	$ 216
Patient accounts receivable	1,927	2,258
Supplies	335	354
Prepaid income taxes	50	48
Prepaid expenses and taxes	184	193
Other current assets	338	358
Total current assets	4,510	3,427
Property and equipment
Land and improvements	515	560
Buildings and improvements	5,749	5,878
Equipment and fixtures	3,088	3,215
Property and equipment	9,352	9,653
Less accumulated depreciation and amortization	(4,030)	(4,045)
Property and equipment, net	5,322	5,608
Goodwill	4,219	4,328
Deferred income taxes	59	38
Other assets, net of accumulated amortization of $1,118 and $981 at December 31, 2020 and 2019, respectively	1,896	2,208
Total assets	16,006	15,609
Current liabilities:
Current maturities of long-term debt	123	20
Current operating lease liabilities	142	136
Accounts payable	783	811
Accrued liabilities:
Employee compensation	637	594
Accrued interest	150	189
Other	980	532
Total current liabilities	2,815	2,282
Long-term debt	12,093	13,385
Deferred income taxes	29	200
Long-term operating lease liabilities	524	487
Other long-term liabilities	1,599	894
Total liabilities	17,060	17,248
Redeemable noncontrolling interests in equity of consolidated subsidiaries	484	502
Commitments and contingencies (Note 15)
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; 129,612,117 shares issued and outstanding at December 31, 2020, and 117,822,631 shares issued and outstanding at December 31, 2019	1	1
Additional paid-in capital	2,094	2,008
Accumulated other comprehensive loss	(13)	(9)
Accumulated deficit	(3,707)	(4,218)
Total Community Health Systems, Inc. stockholders’ deficit	(1,625)	(2,218)
Noncontrolling interests in equity of consolidated subsidiaries	87	77
Total stockholders’ deficit	(1,538)	(2,141)
Total liabilities and stockholders’ deficit	$ 16,006	$ 15,609

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Accumulated amortization	$ 1,118	$ 981
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	129,612,117	117,822,631
Common stock, shares outstanding	129,612,117	117,822,631

Consolidated Statements of Stockholders' (Deficit) Equity - USD ($) $ in Millions	Total	Redeemable Noncontrolling Interests (Non- Equity)	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Other Comprehensive Income (Loss) Cumulative Effect, Period of Adoption, Adjustment [Member]	Accumulated Deficit	Accumulated Deficit Cumulative Effect, Period of Adoption, Adjustment [Member]	Noncontrolling Interest
Equity, beginning balance at Dec. 31, 2017	$ (692)		$ 1	$ 2,014	$ (21)	$ (6)	$ (2,761)	$ 6	$ 75
Redeemable Noncontrolling Interests, beginning balance at Dec. 31, 2017		$ 527
Shares, outstanding, beginning balance at Dec. 31, 2017			114,651,004
Comprehensive income (loss)	(741)				17		(788)		30
Comprehensive income (loss) attributable to redeemable noncontrolling interest		54
Contributions from redeemable noncontrolling interests		3
Distributions to noncontrolling interests	(28)								(28)
Distributions to redeemable noncontrolling interests		(68)
Purchase of subsidiary shares from noncontrolling interests	(7)	(24)		(4)					(3)
Other reclassifications of noncontrolling interests	(2)								(2)
Other reclassifications of redeemable noncontrolling interests		1
Noncontrolling interests in acquired entity		6
Adjustment to redemption value of redeemable noncontrolling interests	(5)	5		(5)
Cancellation of restricted stock for tax withholdings on vested shares	(1)			(1)
Cancellation of restricted stock for tax withholdings on vested shares, shares			(293,735)
Income tax payable increase from vesting of restricted shares			333
Stock-based compensation	13			13
Stock-based compensation, shares			1,890,774
Equity, ending balance at Dec. 31, 2018	(1,463)		$ 1	2,017	(10)		(3,543)		72
Redeemable Noncontrolling Interests, ending balance at Dec. 31, 2018		504
Shares, outstanding, ending balance at Dec. 31, 2018			116,248,376
Comprehensive income (loss)	(641)				1		(675)		33
Comprehensive income (loss) attributable to redeemable noncontrolling interest		52
Contributions from noncontrolling interests	7								7
Contributions from redeemable noncontrolling interests		3
Distributions to noncontrolling interests	(31)								(31)
Distributions to redeemable noncontrolling interests		(68)
Purchase of subsidiary shares from noncontrolling interests	(3)	(8)		3					(6)
Other reclassifications of noncontrolling interests	2								2
Other reclassifications of redeemable noncontrolling interests		(2)
Adjustment to redemption value of redeemable noncontrolling interests	(21)	21		(21)
Cancellation of restricted stock for tax withholdings on vested shares	(1)			(1)
Cancellation of restricted stock for tax withholdings on vested shares, shares			(298,182)
Income tax payable increase from vesting of restricted shares			333
Stock-based compensation	10			10
Stock-based compensation, shares			1,872,104
Equity, ending balance at Dec. 31, 2019	(2,141)		$ 1	2,008	(9)		(4,218)		77
Redeemable Noncontrolling Interests, ending balance at Dec. 31, 2019	502	502
Shares, outstanding, ending balance at Dec. 31, 2019			117,822,631
Comprehensive income (loss)	545				(4)		511		38
Comprehensive income (loss) attributable to redeemable noncontrolling interest		58
Contributions from noncontrolling interests	15								15
Distributions to noncontrolling interests	(34)								(34)
Distributions to redeemable noncontrolling interests		(82)
Purchase of subsidiary shares from noncontrolling interests	3	(4)		3
Other reclassifications of noncontrolling interests	(9)								(9)
Other reclassifications of redeemable noncontrolling interests		9
Disposition of less-than-wholly owned hospital		(14)
Adjustment to redemption value of redeemable noncontrolling interests	(15)	15		(15)
Cancellation of restricted stock for tax withholdings on vested shares	(1)			(1)
Cancellation of restricted stock for tax withholdings on vested shares, shares			(288,859)
Issuance of common stock in connection with the exercise of stock options, shares			18,166
Income tax payable increase from vesting of restricted shares			333
Section 3(a)(9) exchange	86			86
Section 3(a)(9) exchange, shares			10,000,000
Stock-based compensation	13			13
Stock-based compensation, shares			2,059,846
Equity, ending balance at Dec. 31, 2020	(1,538)		$ 1	$ 2,094	$ (13)		$ (3,707)		$ 87
Redeemable Noncontrolling Interests, ending balance at Dec. 31, 2020	$ 484	$ 484
Shares, outstanding, ending balance at Dec. 31, 2020			129,612,117

Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash flows from operating activities:
Net income (loss)	$ 607	$ (590)	$ (704)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	558	608	700
Deferred income taxes	(187)	203	(3)
Government and other legal settlements and related costs		51	11
Stock-based compensation expense	13	10	13
Impairment and (gain) loss on sale of businesses, net	48	138	668
(Gain) loss from early extinguishment of debt	(317)	54	(31)
Other non-cash expenses, net	131	182	38
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	309	93	31
Supplies, prepaid expenses and other current assets	(15)	38	16
Medicare accelerated payments	1,158
Repayment/derecognition of Medicare accelerated payments	(77)
Unrecognized pandemic relief funds	104
Accounts payable, accrued liabilities and income taxes	(67)	(157)	(163)
Payment of HMA legal settlement			(266)
Other	(87)	(245)	(36)
Net cash provided by operating activities	2,178	385	274
Cash flows from investing activities:
Acquisitions of facilities and other related businesses	(1)	(13)	(26)
Purchases of property and equipment	(440)	(438)	(527)
Proceeds from disposition of hospitals and other ancillary operations	648	604	405
Proceeds from sale of property and equipment	4	3	8
Purchases of available-for-sale debt securities and equity securities	(178)	(80)	(78)
Proceeds from sales of available-for-sale debt securities and equity securities	194	92	114
Increase in other investments	(50)	(170)	(141)
Net cash provided by (used in) investing activities	177	(2)	(245)
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(1)	(1)	(1)
Deferred financing costs and other debt-related costs	(156)	(46)	(96)
Proceeds from noncontrolling investors in joint ventures	15	10	3
Redemption of noncontrolling investments in joint ventures	(1)	(11)	(31)
Distributions to noncontrolling investors in joint ventures	(116)	(99)	(96)
Proceeds from sale-lease back	2	60
Other borrowings	53	37	28
Issuance of long-term debt	4,262	3,042	1,033
Proceeds from ABL Facility	540	202	797
Repayments of long-term indebtedness	(5,493)	(3,557)	(2,033)
Net cash used in financing activities	(895)	(363)	(396)
Net change in cash and cash equivalents	1,460	20	(367)
Cash and cash equivalents at beginning of period	216	196	563
Cash and cash equivalents at end of period	1,676	216	196
Supplemental disclosure of cash flow information:
Interest payments	(1,039)	(1,011)	(936)
Income tax refunds (payments), net	$ (2)	$ 3	$ 19

Basis of Presentation and Significant Accounting Policies

12 Months Ended

Dec. 31, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

1. BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Business. Community Health Systems, Inc. is a holding company and operates no business in its own name. On a consolidated basis, Community Health Systems, Inc. and its subsidiaries (collectively the “Company”) own, lease and operate general acute care hospitals in communities across the country. As of December 31, 2020, the Company owned or leased 89 hospitals, including two stand-alone rehabilitation or psychiatric hospitals, licensed for 14,110 beds in 16 states. Throughout these notes to the consolidated financial statements, Community Health Systems, Inc. (the “Parent”) 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, and management services provided, by distinct and indirect subsidiaries of Community Health Systems, Inc.

As of December 31, 2020, Indiana, Florida and Texas represent the only areas of significant geographic concentration. Net operating revenues generated by the Company’s hospitals in Indiana, as a percentage of consolidated net operating revenues, were 15.0% in 2020, 13.7% in 2019 and 12.5% in 2018. Net operating revenues generated by the Company’s hospitals in Florida, as a percentage of consolidated net operating revenues, were 13.0% in 2020 and 14.3% in both 2019 and 2018. Net operating revenues generated by the Company’s hospitals in Texas, as a percentage of consolidated net operating revenues, were 12.2% in both 2020 and 2019 and 11.7% in 2018.

Use of Estimates. The preparation of financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements. Actual results could differ from these estimates under different assumptions or conditions.

Principles of Consolidation. The consolidated financial statements include the accounts of the Parent, its subsidiaries, all of which are controlled by the Parent through majority voting control, and variable interest entities for which the Company is the primary beneficiary. All intercompany accounts, profits and transactions have been eliminated. Noncontrolling interests in less-than-wholly-owned consolidated subsidiaries of the Parent are presented as a component of total equity to distinguish between the interests of the Parent and the interests of the noncontrolling owners. Revenues, expenses and income from these subsidiaries are included in the consolidated amounts as presented on the consolidated statements of income (loss), along with a net income measure that separately presents the amounts attributable to the controlling interests and the amounts attributable to the noncontrolling interests for each of the periods presented. 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 consolidated balance sheets.

Cost of Revenue. 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 would include the Company’s corporate office costs at its Franklin, Tennessee office which were collectively $190 million, $184 million and $181 million for the years ended December 31, 2020, 2019 and 2018, respectively. Included in these corporate office costs is stock-based compensation of $13 million, $10 million and $13 million for the years ended December 31, 2020, 2019 and 2018, respectively.

Cash Equivalents. The Company considers highly liquid investments with original maturities of three months or less to be cash equivalents.

Supplies. Supplies, principally medical supplies, are stated at the lower of cost (first-in, first-out basis) or market.

Marketable Securities. The Company’s marketable securities consist of debt securities that are classified as trading or available-for-sale and equity securities. Available-for-sale debt securities are carried at fair value as determined by quoted market prices, with unrealized gains and losses reported as a separate component of stockholders’ (deficit) equity. Trading securities are reported at fair value with unrealized gains and losses included in earnings. Other comprehensive loss, net of tax, included an unrealized gain of $4 million for both of the years ended December 31, 2020 and 2019, and an unrealized loss of $2 million during the year ended December 31, 2018, related to these available-for-sale debt securities.

Property and Equipment. Property and equipment are recorded at cost. Depreciation is recognized using the straight-line method over the estimated useful lives of the land and improvements (3 to 20 years), buildings and improvements (5 to 40 years) and equipment and fixtures (3 to 18 years). Costs capitalized as construction in progress were $194 million and $219 million at December 31, 2020 and 2019, respectively. Expenditures for renovations and other significant improvements are capitalized; however, maintenance and repairs which do not improve or extend the useful lives of the respective assets are charged to operations as incurred. Interest capitalized related to construction in progress was $15 million, $20 million and $15 million for the years ended December 31,

2020, 2019 and 2018, respectively. Purchases of property and equipment and internal-use software accrued in accounts payable and not yet paid were $100 million and $93 million at December 31, 2020 and 2019, respectively.

The Company also leases certain facilities and equipment under finance leases (see Note 9). Such assets are amortized on a straight-line basis over the lesser of the term of the lease or the remaining useful lives of the applicable assets. During the year ended December 31, 2020, the Company had non-cash investing activity of $22 million related to certain facility and equipment additions that were financed through finance leases and other debt.

Goodwill. Goodwill represents the excess of the fair value of the consideration conveyed in the acquisition over the fair value of net assets acquired. Goodwill arising from business combinations is not amortized. Goodwill is required to be evaluated for impairment at the same time every year and when an event occurs or circumstances change such that it is more likely than not that impairment may exist. The Company performs its annual testing of impairment for goodwill in the fourth quarter of each year. There was no goodwill impairment charge during the years ended December 31, 2020, 2019 and 2018 as a result of the Company’s annual impairment evaluation.

Other Assets. Other assets consist of the insurance recovery receivable from excess insurance carriers related to the Company’s self-insured malpractice general liability and workers’ compensation insurance liability; costs to recruit physicians to the Company’s markets, which are deferred and expensed over the term of the respective physician recruitment contract, generally three years, and included in amortization expense; equity method investments; and capitalized internal-use software costs, which are expensed over the expected useful life, which is generally three years for routine software, and included in amortization expense.

Revenue Recognition. On January 1, 2018, the Company adopted the new revenue recognition accounting standard issued by the Financial Accounting Standards Board (“FASB”) and codified in the FASB Accounting Standards Codification (“ASC”) as topic 606 (“ASC 606”). The revenue recognition standard in ASC 606 outlines a single comprehensive model for recognizing revenue as performance obligations, defined in a contract with a customer as goods or services transferred to the customer in exchange for consideration, are satisfied. The standard also requires expanded disclosures regarding the Company’s revenue recognition policies and significant judgments employed in the determination of revenue.

The Company applied the modified retrospective approach to all contracts when adopting ASC 606. As a result, upon the Company’s adoption of ASC 606 the majority of what was previously classified as the provision for bad debts in the statement of operations is now reflected as implicit price concessions (as defined in ASC 606) and therefore was included as a reduction to net operating revenues in 2019 and 2018. For changes in credit issues not assessed at the date of service, the Company prospectively recognizes those amounts in other operating expenses on the statement of operations.

As part of the adoption of ASC 606, the Company elected two of the available practical expedients provided for in the standard. First, the Company does not adjust the transaction price for any financing components as those were deemed to be insignificant. Additionally, the Company expenses all incremental customer contract acquisition costs as incurred because such costs are not material and would be amortized over a period less than one year.

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 years ended December 31, 2020, 2019 and 2018, 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 & 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 years ended December 31, 2020, 2019 and 2018 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):

	Year Ended December 31,
	2020			2019		2018
Medicare	$	2,813		$	3,331	$	3,730
Medicaid		1,578			1,736		1,876
Managed Care and other third-party payors		7,400			8,014		8,349
Self-pay		(2	)		129		200
Total	$	11,789		$	13,210	$	14,155

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 $98 million and $83 million as of December 31, 2020 and December 31, 2019, respectively, and these amounts are included in accrued liabilities-other in the accompanying consolidated balance sheets. Amounts due from third-party payors were $136 million and $137 million as of December 31, 2020 and December 31, 2019, respectively, and are included in other current assets in the accompanying 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 based on the patient’s household income relative to the federal poverty level guidelines, as established by the federal government. The Company updated its policy during the year ended December 31, 2020 in a manner which increased the number of accounts qualifying for charity care. This resulted in an increase in charity care services during the year ended December 31, 2020 compared to 2019 and previous years.

These charity care services are estimated to be $1.0 billion, $540 million and $491 million for the years ended December 31, 2020, 2019 and 2018, 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 $122 million, $66 million and $62 million for the years ended December 31, 2020, 2019 and 2018, 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.

Electronic Health Records Incentive Reimbursement. The federal government has implemented a number of regulations and programs designed to promote the use of electronic health records (“EHR”) technology and, pursuant to the Health Information Technology for Economic and Clinical Health Act (“HITECH”), established requirements for a Medicare and Medicaid incentive

payments program for eligible hospitals and professionals that adopt and meaningfully use certified EHR technology. The Company utilizes a gain contingency model to recognize EHR incentive payments. Recognition occurs when the eligible hospitals adopt or demonstrate meaningful use of certified EHR technology.

Leases. On January 1, 2019, the Company adopted the cumulative accounting standard updates initially issued by the FASB in February 2016 that amend the accounting for leases and are codified as Accounting Standards Codification Topic 842 (“ASC 842”). These changes to the lease accounting model require operating leases be recorded on the balance sheet through recognition of a liability for the discounted present value of future fixed lease payments and a corresponding right-of-use (“ROU”) asset. The Company’s accounting for finance leases remained substantially unchanged from its prior accounting for capital leases. The ROU asset recorded at commencement of the lease represents the right to use the underlying asset over the lease term in exchange for the lease payments. Leases with an initial term of 12 months or less that do not have an option to purchase the underlying asset that is deemed reasonably certain to be exercised are not recorded on the balance sheet; rather, rent expense for these leases is recognized on a straight-line basis over the lease term, or when incurred if a month-to-month lease. When readily determinable, the Company uses the interest rate implicit in a lease to determine the present value of future lease payments. For leases where the implicit rate is not readily determinable, the Company’s incremental borrowing rate is utilized. The Company calculates its incremental borrowing rate on a quarterly basis using a third-party financial model that estimates the rate of interest the Company would have to pay to borrow an amount equal to the total lease payments on a collateralized basis over a term similar to the lease. The Company’s lease agreements do not contain any material residual value guarantees or material restrictive covenants.

The Company elected the amended transition requirements allowed for by the FASB in ASU 2018-11, which provide entities relief by allowing them not to recast prior comparative periods from the adoption of ASC 842. As a result, the prior year comparative financial statements have not been restated to reflect the adoption of ASC 842. Additionally, the Company elected the package of practical expedients available in ASC 842 upon adoption whereby an entity need not reassess expired contracts for lease identification or classification as a finance or operating lease, or for the reassessment of initial direct costs. The Company has not elected the practical expedient to use hindsight to determine the lease term for its leases at transition. Certain of the Company’s lease agreements have lease and non-lease components, which for the majority of leases the Company accounts for separately when the actual lease and non-lease components are determinable. For equipment leases with immaterial non-lease components incorporated into the fixed rent payment, the Company accounts for the lease and non-lease components as a single lease component in determining the lease payment. Additionally, for certain individually insignificant equipment leases such as copiers, the Company applies a portfolio approach to effectively record the operating lease liability and ROU asset.

The adoption of ASC 842 had a material impact on the Company’s consolidated balance sheet through the recording of the operating lease liabilities and related ROU assets for leases in effect at January 1, 2019, but the adoption did not have a material impact on the Company’s consolidated statement of income (loss) or consolidated statement of cash flows for the year ended December 31, 2019. The Company recorded approximately $673 million of operating lease liabilities and ROU assets on January 1, 2019 upon adoption of ASC 842, with no impact on accumulated deficit.

Physician Income Guarantees. The Company enters into physician recruiting agreements under which it supplements physician income to a minimum amount over a period of time, typically one year, while the physicians establish themselves in the community. As part of the agreements, the physicians are committed to practice in the community for a period of time, typically three years, which extends beyond their income guarantee period. The Company records an asset and liability for the estimated fair value of minimum revenue guarantees on new agreements. Adjustments to the ultimate value of the guarantee paid to physicians are recognized in the period that the change in estimate is identified. The Company amortizes an asset over the life of the agreement. As of December 31, 2020 and 2019, the unamortized portion of these physician income guarantees was $16 million and $20 million, respectively, and is recorded in other assets in the consolidated balance sheet.

Concentrations of Credit Risk. The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s facilities and are insured under third-party payor agreements. Because of the economic diversity of the Company’s facilities and non-governmental third-party payors, Medicare represents the only significant concentration of credit risk from payors. Accounts receivable, net of contractual allowances, from Medicare was $232 million and $268 million at December 31, 2020 and 2019, respectively, representing 6% and 5% of consolidated net accounts receivable at December 31, 2020 and 2019, respectively.

Accounting for the Impairment or Disposal of Long-Lived Assets. During the year ended December 31, 2020, the Company recorded a total combined net impairment charge and loss on disposal of approximately $48 million, of which (i) approximately $59 million was recorded to reduce the carrying value of closed hospitals and certain hospitals that have been sold or 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, (ii) approximately $74 million was recorded primarily to adjust the carrying value of other long-lived assets at several underperforming hospitals or where the Company was in discussions with potential buyers for divestiture at a sales price that indicated

a fair value below carrying value, (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 $89 million related primarily to three hospitals sold on January 1, 2020, one hospital sold on July 1, 2020 and two hospitals sold on October 27, 2020. During the year ended December 31, 2020, a net allocation of approximately $110 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 year ended December 31, 2019, the Company recorded a total combined impairment charge and loss on disposal of approximately $138 million, of which (i) approximately $92 million was recorded to reduce the carrying value of closed hospitals and certain hospitals that have been sold or 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 and (ii) approximately $46 million was recorded primarily to adjust the carrying value of other long-lived assets at several underperforming hospitals or where the Company was in discussions with potential buyers for divestiture at a sales price that indicated a fair value below carrying value. During the year ended December 31, 2019, a net allocation of approximately $235 million of goodwill was allocated from the hospital operations reporting unit goodwill 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.

Income Taxes. The Company accounts for income taxes under the asset and liability method, in which deferred income tax assets and liabilities are recognized for the tax consequences of “temporary differences” by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax bases of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in the consolidated statement of income (loss) during the period in which the tax rate change becomes law.

Comprehensive Loss. Comprehensive loss is the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources.

Segment Reporting. A public company is required to report annual and interim financial and descriptive information about its reportable operating segments. Operating segments, as defined, are components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker in deciding how to allocate resources and in assessing performance. Aggregation of similar operating segments into a single reportable operating segment is permitted if the businesses have similar economic characteristics and meet the criteria established by U.S. GAAP. The Company operates a single operating segment represented by hospital operations (which includes the Company's acute care hospitals and related healthcare entities that provide inpatient and outpatient healthcare services).

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 year ended December 31, 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, the Paycheck Protection Program and Health Care Enhancement Act (the “PPPHCE Act”), which was enacted on April 24, 2020, and the Consolidated Appropriations Act, 2021 (the “CAA”), which was enacted on December 27, 2020. In total, the CARES Act, PPPHCE Act and the CAA authorize $178 billion in funding to be distributed to hospitals and other healthcare providers through the Public Health and Social Services Emergency Fund (the “PHSSEF”). In addition, the CARES Act provide for an expansion of the Medicare Accelerated and Advance Payment Program whereby inpatient acute care hospitals and other eligible providers were able to 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 year ended December 31, 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:

Pandemic Relief Funds

During the year ended December 31, 2020, the Company received approximately $705 million in payments through the PHSSEF and various state and local programs, net of amounts that have or will be repaid to HHS and various state and local agencies either voluntarily or in relation to entities that were previously divested. Approximately $601 million of the PHSSEF payments were recognized as a reduction in operating costs and expenses during the year ended December 31, 2020, which is denoted by the caption “pandemic relief funds” within the consolidated statements of income (loss). 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 have been met.

The Company’s assessment of whether the terms and conditions for amounts received are reasonably assured of having been met considers, among other things, the CARES Act, the CAA and all frequently asked questions and other interpretive guidance issued by HHS, including the Post-Payment Notice of Reporting Requirements issued on January 15, 2021 (the “January 15, 2021 Notice”) and frequently asked questions issued by HHS on January 28, 2021 which clarified previously issued guidance, as well as expenses incurred attributable to the coronavirus and the Company’s results of operations during such period as compared to the Company’s budget. Such guidance, specifically the various Post-Payment Notice of Reporting Requirements and frequently asked questions issued by HHS, set forth the allowable methods for quantifying eligible healthcare related expenses and lost revenues. Only healthcare related expenses attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse are eligible to be claimed. On the basis of guidance available at the time, the Company’s estimate of lost revenues for 2020 was first based on the negative change in year-over-year net patient care operating revenue (year-to-date June 2020), then on the negative change in year-over-year net patient care operating income (year-to-date September 2020) and finally on the difference between budgeted and actual revenue for calendar year 2020 (year-to-date December 2020). The calculation as of December 31, 2020 is in accordance with the CAA which indicates that lost revenues may be calculated pursuant to frequently asked questions published by HHS in June 2020, including the difference between a provider’s budgeted and actual revenue if such budget had been established prior to March 27, 2020. The use of funds calculation as of December 31, 2020 takes into account expenses attributable to each respective entity, which primarily relate to incremental labor and supply costs, as well as lost revenues. General fund distributions were allocated among subsidiaries according to total unreimbursed losses. Targeted distributions were not allocated or transferred among subsidiaries. While the CAA, January 15, 2021 Notice and frequently asked questions published by HHS on January 28, 2021 indicate that targeted distribution payments may be allocated or transferred to subsidiaries, distinct conditions exist for such allocations or transfers including that the parent organization have a “direct ownership relationship” with the subsidiary who received the targeted distribution payment. Additionally, the subsidiary that was the recipient of the targeted distribution payment retains responsibility for reporting to HHS on the use of such funds even if they are transferred or allocated to other subsidiaries. There are significant uncertainties as to the meaning and interpretation of conditions specific to the allocation or transfer of targeted distribution payments such that as of December 31, 2020, the Company is not reasonably assured that it can or will choose to comply with such conditions in order to allocate or transfer targeted distribution payments.

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 or the various state and local agencies as of December 31, 2020, are reflected within accrued liabilities-other in the 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. 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 and approximately $77 million of amounts previously received was repaid to CMS or assumed by buyers 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. 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 (or 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 December 31, 2020, approximately $425 million of Medicare accelerated payments are reflected within accrued liabilities-other in the consolidated balance sheet while the remaining approximately $656 million are included within other long-term liabilities. The Company’s estimate of the current liability is a function of historical cash receipts from Medicare and the repayment terms set forth above.

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 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 consolidated financial position or results of operations.

Accounting for Stock-Based Compensation

12 Months Ended

Dec. 31, 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 December 31, 2020, 10,451,760 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 has been 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):

	Year Ended December 31,
	2020			2019			2018
Effect on income (loss) before income taxes	$	(13	)	$	(10	)	$	(13	)
Effect on net income (loss)	$	(10	)	$	(8	)	$	(10	)

At December 31, 2020, $16 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 22 months. Of that amount, $3 million related to outstanding unvested stock options was expected to be

recognized over a weighted-average period of 23 months and $13 million related to outstanding unvested restricted stock and restricted stock units was expected to be recognized over a weighted-average period of 22 months. There were no modifications to awards during the years ended December 31, 2020, 2019 and 2018.

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 years ended December 31, 2020, 2019 and 2018:

	Year Ended December 31,
	2020		2019			2018
Expected volatility	73.5%			68.4	%	N/A%
Expected dividends		-		-		N/A
Expected term	6.0 years		5.6 years			N/A
Risk-free interest rate	1.0%			2.6	%	N/A%

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 December 31, 2020, and changes during each of the years in the three-year period prior to December 31, 2020, were as follows (in millions, except share and per share data):

	Shares			Weighted- Average Exercise Price		Weighted- Average Remaining Contractual Term	Aggregate Intrinsic Value as of December 31, 2020
Outstanding at December 31, 2017		1,115,667		$	31.56
Granted		-			-
Exercised		-			-
Forfeited and cancelled		(490,729	)		32.01
Outstanding at December 31, 2018		624,938			31.21
Granted		658,500			4.95
Exercised		-			-
Forfeited and cancelled		(173,304	)		23.04
Outstanding at December 31, 2019		1,110,134			16.90
Granted		946,500			4.93
Exercised		(18,166	)		4.99
Forfeited and cancelled		(220,943	)		33.52
Outstanding at December 31, 2020		1,817,525		$	8.77	7.6 years	$	4
Exercisable at December 31, 2020		455,021		$	20.24	3.7 years	$	-

The weighted-average grant date fair value of stock options granted during the year ended December 31, 2020 and 2019, respectively, was $3.17 and $3.05. No stock options were granted during the year ended December 31, 2018. 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 ($7.43) 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 December

31, 2020. This amount changes based on the market value of the Company’s common stock. The aggregate intrinsic value of options exercised during the year ended December 31, 2020 was less than $1 million. There were no options exercised during the years ended December 31, 2019 and 2018. 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. All of the restricted stock awards subject to performance objectives granted on March 1, 2017 were forfeited following the year ended December 31, 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 December 31, 2020, and changes during each of the years in the three-year period prior to December 31, 2020, were as follows:

	Shares			Weighted- Average Grant Date Fair Value
Unvested at December 31, 2017		2,643,919		$	16.17
Granted		1,987,000			4.54
Vested		(1,154,670	)		23.22
Forfeited		(167,342	)		10.29
Unvested at December 31, 2018		3,308,907			7.00
Granted		1,989,000			4.94
Vested		(1,160,667	)		8.89
Forfeited		(279,838	)		5.60
Unvested at December 31, 2019		3,857,402			5.47
Granted		2,205,500			4.90
Vested		(1,123,329	)		5.84
Forfeited		(383,838	)		8.58
Unvested at December 31, 2020		4,555,735			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 37,118 RSUs, 34,068 RSUs and 34,483 RSUs on March 1, 2018, 2019 and 2020, respectively. Each of the 2018, 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 grants made during 2020, 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. A total of five directors elected to defer the receipt of RSUs granted on March 1, 2020 to a future date.

RSUs outstanding under the 2009 Plan as of December 31, 2020, and changes during each of the years in the three-year period prior to December 31, 2020, were as follows:

	Shares			Weighted- Average Grant Date Fair Value
Unvested at December 31, 2017		172,078		$	12.78
Granted		296,944			4.58
Vested		(71,116	)		15.51
Forfeited		-			-
Unvested at December 31, 2018		397,906			6.17
Granted		306,612			4.99
Vested		(162,942	)		7.42
Forfeited		-			-
Unvested at December 31, 2019		541,576			5.13
Granted		310,347			4.93
Vested		(238,184	)		5.47
Forfeited		-			-
Unvested at December 31, 2020		613,739			4.89

Acquisitions and Divestitures

12 Months Ended

Dec. 31, 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 consolidated statements of income (loss) were less than $1 million, $2 million and $3 million for the years ended December 31, 2020, 2019 and 2018, respectively.

Effective June 1, 2019, one or more subsidiaries of the Company completed the acquisition of Northwest Mississippi Medical Center in Clarksdale, Mississippi. This healthcare system includes 181 licensed beds and other outpatient and ancillary services. The total cash consideration paid for operating assets was approximately $2 million with additional consideration of $9 million in assumed liabilities, for a total consideration of $11 million. This hospital was acquired in conjunction with the bankruptcy proceedings for the previous owner that acquired the hospital from the Company in 2017 as part of an agreement with the local county government associated with its lease of the hospital building. Based on the Company’s final purchase price allocation relating to this acquisition as of December 31, 2019, no goodwill has been recorded. Prior to the completion of the acquisition, the Company initiated a plan to sell this hospital and as such the hospital was classified as held for sale at December 31, 2019 and 2020. This disposition was completed on February 1, 2021, as further described below.

Other Acquisitions

During the years ended December 31, 2020, 2019 and 2018, one or more subsidiaries of the Company paid approximately $1 million, $8 million and $26 million, respectively, 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. In connection with these acquisitions, during the year ended December 31, 2020, the Company allocated the majority of the purchase price to goodwill. In connection with these acquisitions, during the year ended December 31, 2019, the Company allocated approximately $4 million of the consideration paid to property and equipment and net working capital and the remainder, approximately $4 million consisting of intangible assets that do not qualify for separate recognition, to goodwill. In connection with these acquisitions, during the year ended December 31, 2018, the Company allocated approximately $10 million of the consideration paid to property and

equipment and net working capital and the remainder, approximately $22 million consisting of intangible assets that do not qualify for separate recognition, to goodwill. The value of noncontrolling interests acquired in these acquisitions was $6 million.

Divestitures

The following table provides a summary of hospitals that the Company divested during the years ended December 31, 2020, 2019 and 2018.

Hospital	Buyer	City, State	Licensed Beds		Effective Date
2020 Divestitures:
Berwick Hospital Center	Fayette Holdings, Inc.	Berwick, PA		90	December 1, 2020
Brownwood Regional Medical Center	Hendrick Health System	Brownwood, TX		188	October 27, 2020
Abilene Regional Medical Center	Hendrick Health System	Abilene, TX		231	October 27, 2020
San Angelo Community Medical Center	Shannon Health System	San Angelo, TX		171	October 24, 2020
Bayfront Health St. Petersburg	Orlando Health, Inc.	St. Petersburg, FL		480	October 1, 2020
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	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

2018 Divestitures:
Sparks Regional Medical Center	Baptist Health	Fort Smith, AR		492	November 1, 2018
Sparks Medical Center - Van Buren	Baptist Health	Van Buren, AR		103	November 1, 2018
AllianceHealth Deaconess	INTEGRIS Health	Oklahoma City, OK		238	October 1, 2018
Munroe Regional Medical Center	Adventist Health System	Ocala, FL		425	August 1, 2018
Tennova Healthcare - Dyersburg Regional	West Tennessee Healthcare	Dyersburg, TN		225	June 1, 2018
Tennova Healthcare - Regional Jackson	West Tennessee Healthcare	Jackson, TN		150	June 1, 2018
Tennova Healthcare - Volunteer Martin	West Tennessee Healthcare	Martin, TN		100	June 1, 2018
Williamson Memorial Hospital	Mingo Health Partners, LLC	Williamson, WV		76	June 1, 2018
Byrd Regional Hospital	Allegiance Health Management	Leesville, LA		60	June 1, 2018
Tennova Healthcare - Jamestown	Rennova Health, Inc.	Jamestown, TN		85	June 1, 2018
Bayfront Health Dade City	Adventist Health System	Dade City, FL		120	April 1, 2018

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. This disposition was completed on January 1, 2021, as further described in Note 16 below.

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. These dispositions were completed on January 1, 2021, as further described in Note 16 below.

On October 30, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of Northwest Mississippi Medical Center (181 licensed beds) in Clarksdale, Mississippi, to affiliates of Delta Health System. This disposition was completed on February 1, 2021, as further described in Note 16 below.

On December 8, 2020, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of AllianceHealth Midwest (255 licensed beds) in Midwest City, Oklahoma, to affiliates of SSM Health Care of Oklahoma, Inc.

The following table discloses amounts included in the consolidated balance sheets for the hospitals classified as held for sale as of December 31, 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.

	December 31,
	2020		2019
Other current assets	$	12	$	25
Other assets, net		11		262
Accrued liabilities		16		43

Financial and statistical data reported in this Annual Report on Form 10-K (“Form 10-K”) includes operating results for hospitals held for sale at December 31, 2020 and for the 36 hospitals that were divested during 2020, 2019 and 2018 through the effective date of each respective transaction. Summary financial results of these hospitals for the periods included in the accompanying consolidated statements of income (loss) are as follows (in millions):

	Year Ended December 31,
	2020			2019			2018
Loss before income taxes	$	(144	)	$	(103	)	$	(465	)
Less: Loss attributable to noncontrolling interests		(6	)		(8	)		(5)
Loss from operations before income taxes attributable
to Community Health Systems, Inc. stockholders	$	(138	)	$	(95	)	$	(460	)

The operating results for these held for sale or divested hospitals included impairment charges of approximately $41 million, $102 million and $415 million that were allocated to the divestitures during the years ended December 31, 2020, 2019 and 2018, respectively.

On November 30, 2020, one or more subsidiaries of the Company completed 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 pursuant to the terms of a definitive agreement which was entered into October 12, 2020. Merit Health Biloxi and its associated healthcare businesses will remain consolidated entities of the Company.

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 year ended December 31, 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.

During the three months ended June 30, 2018, the Company completed the planned closure of Twin Rivers Regional Medical Center in Kennett, Missouri. The Company recorded an impairment charge of approximately $4 million during the three months ended

June 30, 2018, to adjust the fair value of the supplies, inventory and long-lived assets of this hospital, including property and equipment and capitalized software costs, based on their estimated fair value and future utilization.

Goodwill and Other Intangible Assets

12 Months Ended

Dec. 31, 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 years ended December 31, 2020 and 2019 are as follows (in millions):

Balance, beginning balance	2020			2019
Goodwill	$	7,142		$	7,373
Accumulated impairment losses		(2,814	)		(2,814	)
		4,328			4,559
Goodwill acquired as part of acquisitions during current year		1			4
Goodwill allocated to hospitals held for sale		(110	)		(235	)

Balance, end of year
Goodwill		7,033			7,142
Accumulated impairment losses		(2,814	)		(2,814	)
	$	4,219		$	4,328

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 December 31, 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 2020 using an October 31, 2020 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.

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 December 31, 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 year ended December 31, 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 December 31, 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 the Company’s stock price and the fair value of its long-term debt, an increase in the volatility of the Company’s stock price and the fair value of its long-term debt, lower than expected hospital volumes and/or net operating revenues, 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 years ended December 31, 2020 and 2019. The gross carrying amount of the Company’s other intangible assets subject to amortization was $1 million at both December 31, 2020 and 2019, and the net carrying amount was less than $1 million at December 31, 2020 and 2019. The carrying amount of the Company’s other intangible assets not subject to amortization was $53 million and $63 million at December 31, 2020 and 2019, respectively. Other intangible assets are included in other assets, net on the Company’s 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 weighted-average remaining amortization period for the intangible assets subject to amortization is approximately one year. There are no expected residual values related to these intangible assets. Amortization expense on these intangible assets was less than $1 million, $1 million and $3 million during the years ended December 31, 2020, 2019 and 2018, respectively. Amortization expense on intangible assets is estimated to be less than $1 million in 2021.

The gross carrying amount of capitalized software for internal use was approximately $1.1 billion at both December 31, 2020 and 2019, and the net carrying amount was approximately $251 million and $321 million at December 31, 2020 and 2019, respectively. The estimated amortization period for capitalized internal-use software is generally three years. There is no expected residual value for capitalized internal-use software. At December 31, 2020, there were approximately $11 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 $123 million, $121 million and $140 million during the years ended December 31, 2020, 2019 and 2018, respectively. Amortization expense on capitalized internal-use software is estimated to be $123 million in 2021, $75 million in 2022, $34 million in 2023, $9 million in 2024, $7 million in 2025 and $3 million thereafter.

Income Taxes

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

INCOME TAXES

5. INCOME TAXES

The (benefit from) provision for income taxes consists of the following (in millions):

	Year Ended December 31,
	2020			2019			2018
Current:
Federal	$	(1	)	$	(38	)	$	1
State		3			(5	)		(9	)
		2			(43	)		(8	)
Deferred:
Federal		(162	)		179			50
State		(25	)		24			(53	)
		(187	)		203			(3	)
Total (benefit from) provision for income taxes for income (loss)	$	(185	)	$	160		$	(11	)

The following table reconciles the differences between the statutory federal income tax rate and the effective tax rate (dollars in millions):

	Year Ended December 31,
	2020						2019						2018
	Amount			%			Amount			%			Amount			%
Provision for (benefit from) income taxes at statutory federal rate	$	89			21.0	%	$	(90	)		21.0	%	$	(150	)		21.0	%
State income taxes, net of federal income tax benefit		(15	)		(3.6	)		(104	)		24.3			(114	)		16.0
Net income attributable to noncontrolling interests		(20	)		(4.7	)		(18	)		4.2			(18	)		2.5
Change in valuation allowance		(267	)		(63.2	)		340			(79.2	)		212			(29.7	)
Change in uncertain tax position		-			-			-			-			9			(1.3	)
Federal and state tax credits		-			-			-			-			(17	)		2.4
Nondeductible goodwill		41			9.8			11			(2.6	)		30			(4.2	)
Nondeductible settlements		-			-			-			-			22			(3.1	)
Nondeductible loss on divestiture		(15	)		(3.4	)		15			(3.5	)		-			-
Other		2			0.3			6			(1.4	)		15			(2.1	)
(Benefit from) provision for income taxes and effective tax rate for income (loss)	$	(185	)		(43.8	)%	$	160			(37.2	)%	$	(11	)		1.5	%

The Company’s effective tax rates were (43.8)%, (37.2)% and 1.5% for the years ended December 31, 2020, 2019 and 2018, respectively. The decrease in the Company’s effective tax rate for the year ended December 31, 2020, when compared to the year ended December 31, 2019, was primarily due to a decrease in the valuation allowance recognized on IRC Section 163(j) interest carryforwards and original issue discount deferred tax asset as a result of (i) 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 and (ii) tax impacts of 2020 financing activity. The decrease in the Company’s effective tax rate for the year ended December 31, 2019, when compared to the year ended December 31, 2018, was primarily due to an increase in the valuation allowance recognized on (i) IRC Section 163(j) interest carryforwards and (ii) original issue discount deferred tax asset generated with the 2019 Exchange Offer.

Deferred income taxes are based on the estimated future tax effects of differences between the financial statement and tax bases of assets and liabilities under the provisions of the enacted tax laws. Deferred income taxes as of December 31, 2020 and 2019 consist of (in millions):

	December 31,
	2020					2019
	Assets			Liabilities		Assets			Liabilities
Net operating loss and credit carryforwards	$	873		$	-	$	775		$	-
Property and equipment		-			300		-			335
Self-insurance liabilities		58			-		48			-
Prepaid expenses		-			29		-			30
Intangibles		-			127		-			149
Investments in unconsolidated affiliates		-			57		-			57
Other liabilities		-			9		-			9
IRC Section 481(a) - mixed service cost		-			106		-			216
Long-term debt and interest		154			-		312			-
Accounts receivable		52			-		62			-
IRC Section 163(j) interest limitation		108			-		296			-
Accrued vacation		22			-		24			-
Accrued bonus		32			-		31			-
Other comprehensive income		6			-		5			-
Right-of-use assets		-			150		-			145
Right-of-use liability		155			-		149			-
Stock-based compensation		4			-		5			-
Deferred compensation		69			-		70			-
Other		57			-		51			-
Total		1,590			778		1,828			941
Valuation allowance		(781	)		-		(1,049	)		-
Total deferred income taxes	$	809		$	778	$	779		$	941

The Company believes that the net deferred tax assets will ultimately be realized, except as noted below. Its conclusion is based on its estimate of future taxable income and the expected timing of temporary difference reversals. The Company has gross federal net operating loss carryforwards of approximately $881 million and state net operating loss carryforwards of approximately $9 billion, which expire from 2021 to 2040. The Company’s tax affected federal and state net operating loss and credit carryforwards are approximately $217 million and $656 million, respectively. A valuation allowance of approximately $781 million has been recognized for state net operating loss carryforwards, state credit carryforwards and federal and state deferred tax assets that the Company does not expect to be able to utilize prior to the expiration of the carryforward period. With respect to the deferred tax liability pertaining to intangibles, as included above, goodwill purchased in connection with certain of the Company’s business acquisitions is amortizable for income tax reporting purposes. However, for financial reporting purposes, there is no corresponding amortization allowed with respect to such purchased goodwill.

The valuation allowance for federal and state jurisdictions where the Company concluded that the associated deferred tax assets would not be realized decreased by $265 million and $2 million, respectively, for the year ended December 31, 2020, and increased by $221 million and $127 million, respectively, for the year ended December 31, 2019.

The total amount of unrecognized benefit that would affect the effective tax rate, if recognized, was less than $1 million as of December 31, 2020. A total of less than $1 million of interest and penalties is included in the amount of the liability for uncertain tax positions at December 31, 2020. It is the Company’s policy to recognize interest and penalties related to unrecognized benefits in its 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 consolidated results of operations or consolidated financial position.

The following is a tabular reconciliation of the total amount of unrecognized tax benefit for the years ended December 31, 2020, 2019 and 2018 (in millions):

	Year Ended December 31,
	2020		2019			2018
Unrecognized tax benefit, beginning of year	$	26	$	29		$	18
Gross increases — tax positions in current period		19		10			11
Settlements		-		(13	)		-
Unrecognized tax benefit, end of year	$	45	$	26		$	29

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 consolidated 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 consolidated results of operations or consolidated financial position. The Company has extended the federal statute of limitations through December 31, 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.

Cash paid for income taxes, net of refunds received, resulted in a net cash paid of $2 million during the year ended December 31, 2020, and a net refund of $3 million and $19 million during the years ended December 31, 2019 and 2018, 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

12 Months Ended

Dec. 31, 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):

	December 31,
	2020			2019
5⅛% Senior Secured Notes due 2021	$	-		$	1,000
6⅞% Senior Notes due 2022		126			231
6¼% Senior Secured Notes due 2023		95			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
5⅝% Senior Secured Notes due 2027		1,900			-
6⅞% Senior Notes due 2028		767			1,700
6% Senior Secured Notes due 2029		900			-
9⅞% Junior-Priority Secured Notes due 2023		1,769			1,770
8⅛% Junior-Priority Secured Notes due 2024		1,348			1,355
ABL Facility		-			273
Finance lease and financing obligations		239			272
Other		26			17
Less: Unamortized deferred debt issuance costs and note premium		(250	)		(147	)
Total debt		12,216			13,405
Less: Current maturities		(123	)		(20	)
Total long-term debt	$	12,093		$	13,385

5⅛% Senior Secured Notes due 2021

On January 27, 2014, CHS completed a private offering of $1.0 billion aggregate principal amount of 5⅛% Senior Secured Notes due August 1, 2021 (the “5⅛% Senior Secured Notes due 2021”). The net proceeds from this issuance were used to finance the Company’s acquisition by merger of Health Management Associates, Inc. (“HMA”). The 5⅛% Senior Secured Notes due 2021 bear interest at a rate of 5.125% per annum, payable semi-annually in arrears on February 1 and August 1 of each year. Interest on the 5⅛% Senior Secured Notes due 2021 accrues from the date of original issuance. Interest is calculated on the basis of a 360-day year comprised of twelve 30-day months. The 5⅛% Senior Secured Notes due 2021 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 ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 5⅛% Senior Secured Notes due 2021 and the related guarantees were secured by shared (i) first-priority liens on the collateral (the “Non-ABL Priority Collateral”) that also secures on a first-priority basis CHS’ senior-priority secured notes and (ii) second-priority liens on the collateral (the “ABL-Priority Collateral”) that secures on a first-priority basis the ABL Facility (and also secures on a second-priority basis CHS’s senior-priority secured notes), in each case subject to permitted liens described in the indenture governing the 5⅛% Senior Secured Notes due 2021.

CHS was entitled, at its option, to redeem all or a portion of the 5⅛% Senior Secured Notes due 2021 upon not less than 30 nor more than 60 days’ notice, at a 100% redemption price (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date).

Pursuant to a registration rights agreement entered into at the time of the issuance of the 5⅛% Senior Secured Notes due 2021, as a result of an exchange offer made by CHS, all of the 5⅛% Senior Secured Notes due 2021 issued in January 2014 were exchanged in October 2014 for new notes (the “2021 Exchange Notes”) having terms substantially identical in all material respects to the 5⅛% Senior Secured Notes due 2021 (except that the exchange notes were issued under a registration statement pursuant to the 1933 Act). References to the 5⅛% Senior Secured Notes due 2021 shall be deemed to be the 2021 Exchange Notes unless the context provides otherwise.

On January 23, 2020, CHS commenced a cash tender offer for any and all of the outstanding 5⅛% Senior Secured Notes due 2021 and issued a conditional notice of redemption to redeem all of the 5⅛% Senior Secured Notes due 2021 not purchased by CHS in the tender offer at a redemption price of 100.000% of the principal amount thereof plus accrued interest to, but not including, February 22, 2020. As noted below, the proceeds from the issuance of the 6⅝% Senior Secured Notes due 2025 were used in February 2020 to (i) purchase any and all of the 5⅛% Senior Secured Notes due 2021 validly tendered and not validly withdrawn in the cash tender offer announced on January 23, 2020, and (ii) redeem all of the 5⅛% Senior Secured Notes due 2021 that were not purchased pursuant to such tender offer.

6⅞% Senior Notes due 2022

On January 27, 2014, CHS completed a private offering of $3.0 billion aggregate principal amount of 6⅞% Senior Notes due February 1, 2022 (the “6⅞% Senior Notes due 2022”). The net proceeds from this issuance were used to finance the HMA merger. The 6⅞% Senior Notes due 2022 bear interest at a rate of 6.875% per annum, payable semiannually in arrears on February 1 and August 1 of each year. Interest on the 6⅞% Senior Notes due 2022 accrues from the date of original issuance. Interest is calculated on the basis of a 360-day year comprised of twelve 30-day months. The 6⅞% Senior Notes due 2022 are unconditionally guaranteed on a senior-priority unsecured basis by the Company and each of the CHS current and future domestic subsidiaries that provide guarantees under the ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

CHS is entitled, at its option, to redeem all or a portion of the 6⅞% Senior Notes due 2022 upon not less than 30 nor more than 60 days’ notice, at a redemption price of 100% (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed prior to the maturity date.

Pursuant to a registration rights agreement entered into at the time of the issuance of the 6⅞% Senior Notes due 2022, as a result of an exchange offer made by CHS, all of the 6⅞% Senior Notes due 2022 issued in January 2014 were exchanged in October 2014 for new notes (the “6⅞% Exchange Notes”) having terms substantially identical in all material respects to the 6⅞% Senior Notes due 2022 (except that the exchange notes were issued under a registration statement pursuant to the 1933 Act). References to the 6⅞% Senior Notes due 2022 shall be deemed to be the 6⅞% Exchange Notes unless the context provides otherwise.

On June 22, 2018, CHS issued approximately $276 million aggregate principal amount of the 8⅛% Junior-Priority Secured Notes due 2024 in exchange for approximately $368 million of 6⅞% Senior Notes due 2022.

On November 19, 2019, CHS issued approximately $700 million aggregate principal amount of 8% Senior Secured Notes due December 15, 2027 (the “8% Senior Secured Notes due 2027”) and approximately $1.7 billion aggregate principal amount of 6⅞% Senior Notes due April 1, 2028 (the “6⅞% Senior Notes due 2028”) in exchange for approximately $2.4 billion of 6⅞% Senior Notes

due 2022 (the “2019 Exchange Offer”). Following the 2019 Exchange Offer, CHS had approximately $231 million aggregate principal amount of 6⅞% Senior Notes due 2022 outstanding.

During the year ended December 31, 2020, the Company extinguished $34 million in principal related to the 6⅞% Secured Notes due 2022 through open market repurchases and approximately $72 million via a tender offer which commenced on October 30, 2020, and expired on November 30, 2020.

As described in Note 16, the Company issued a notice of redemption on January 29, 2021 to redeem on February 28, 2021 all of the 6⅞% Secured Notes due 2022 then outstanding at a redemption price of 100% of the principal amount thereof plus accrued and unpaid interest to, but not including, February 28, 2021.

6¼% Senior Secured Notes due 2023

On March 16, 2017, CHS completed a public offering of $2.2 billion aggregate principal amount of 6¼% Senior Secured Notes due March 31, 2023 (the “6¼% Senior Secured Notes due 2023”). The net proceeds from this issuance were used to finance the purchase or redemption of $700 million aggregate principal amount of CHS’ then outstanding 5⅛% Senior Secured Notes due 2018 and related fees and expenses, and the repayment of $1.445 billion of the then outstanding Term F Facility. On May 12, 2017, CHS completed a tack-on offering of $900 million aggregate principal amount of 6¼% Senior Secured Notes due 2023, increasing the total aggregate principal amount of 6¼% Senior Secured Notes due 2023 to $3.1 billion. A portion of the net proceeds from this issuance were used to finance the repayment of approximately $713 million aggregate principal amount of CHS’ then outstanding Term A Facility and related fees and expenses. The tack-on notes have identical terms, other than issue date and issue price, as the 6¼% Senior Secured Notes due 2023 issued on March 16, 2017. The 6¼% Senior Secured Notes due 2023 bear interest at a rate of 6.250% per annum, payable semiannually in arrears on March 31 and September 30 of each year. Interest on the 6¼% Senior Secured Notes due 2023 accrues from the date of original issuance. Interest is calculated on the basis of a 360-day year comprised of twelve 30-day months. The 6¼% Senior Secured Notes due 2023 are scheduled to mature on March 31, 2023. The 6¼% Senior Secured Notes due 2023 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 ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 6¼% Senior Secured Notes due 2023 and the related guarantees are secured by shared (i) first-priority liens on the Non-ABL Priority Collateral that also secures on a first-priority basis CHS’s senior-priority secured notes and (ii) second-priority liens on the ABL Collateral, in each case subject to permitted liens described in the indenture governing the 6¼% Senior Secured Notes due 2023.

CHS is entitled, at its option, to redeem all or a portion of the 6¼% Senior Secured Notes due 2023 at any time prior to March 31, 2020, upon not less than 30 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 6¼% Senior Secured Notes due 2023 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 6¼% Senior Secured Notes due 2023. In addition, CHS may redeem up to 40% of the aggregate principal amount of the 6¼% Senior Secured Notes due 2023 at any time prior to March 31, 2020 using the net proceeds from certain equity offerings at the redemption price of 106.250% of the principal amount of the 6¼% Senior Secured Notes due 2023 redeemed, plus accrued and unpaid interest, if any.

CHS may redeem some or all of the 6¼% Senior Secured Notes due 2023 at any time on or after March 31, 2020 upon not less than 30 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
March 31, 2020 to March 30, 2021		103.125	%
March 31, 2021 to March 30, 2022		101.563	%
March 31, 2022 to March 30, 2023		100.000	%

Approximately $426 million aggregate principal amount of 6¼% Senior Secured Notes due 2023 were purchased in one or more privately negotiated transactions on February 6, 2020.

On December 28, 2020, the Company redeemed approximately $2.579 billion of the 6¼% Senior Secured Notes due 2023 using proceeds from the issuance of $1.9 billion aggregate principal amount of 5⅝% Senior Secured Notes due 2027 and $900 million aggregate principal amount of 6% Senior Secured Notes due 2029. The remaining principal value of 6¼% Senior Secured Notes due 2023 that were not redeemed on December 28, 2020 were redeemed on January, 28, 2021 as further described in Note 16.

9⅞% Junior-Priority Secured Notes due 2023

On June 22, 2018, CHS completed a private offering of $1.770 billion aggregate principal amount of the 9⅞% Junior-Priority Secured Notes due June 30, 2023 (the “9⅞% Junior-Priority Secured Notes due 2023”) in exchange for the same amount of 8% Senior Notes due 2019. The 9⅞% Junior-Priority Secured Notes due 2023 bore interest at a rate of 11.000% per annum, solely for the period from the issue date of such 9⅞% Junior-Priority Secured Notes due 2023 to, but excluding, June 22, 2019, after which they bear interest at a rate of 9.875% per annum. Interest is payable semi-annually in arrears on June 30 and December 31 of each year. The 9⅞% Junior-Priority Secured Notes due 2023 are scheduled to mature on June 20, 2023. The 9⅞% Junior-Priority Secured Notes due 2023 are unconditionally guaranteed on a junior-priority secured basis by the Company and each of the CHS current and future domestic subsidiaries that provide guarantees under CHS᾿ ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 9⅞% Junior-Priority Secured Notes due 2023 and the related guarantees are secured by shared (i) second-priority liens on the Non-ABL Priority Collateral that secures on a first-priority basis the CHS’s senior-priority secured notes and (ii) third-priority liens on the ABL-Priority Collateral that secures on a first-priority basis the ABL Facility (and also secures on a second-priority basis CHS’s senior-priority secured notes), in each case subject to permitted liens described in the indenture governing the 9⅞% Junior-Priority Secured Notes due 2023.

Prior to June 30, 2020, CHS may redeem some or all of the 9⅞% Junior-Priority Secured Notes due 2023 at a redemption price equal to 100% of the principal amount of the notes redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 9⅞% Junior-Priority Secured Notes due 2023. In addition, at any time prior to June 30, 2020, CHS may redeem up to 40% of the aggregate principal amount of the 9⅞% Junior-Priority Secured Notes due 2023 with the proceeds from certain equity offerings at the redemption price of 109.875%, plus accrued and unpaid interest, if any, to, but excluding, the applicable redemption date.

After June 30, 2020, CHS is entitled, at its option, to redeem all or a portion of the 9⅞% Junior-Priority Secured Notes due 2023 upon not less than 15 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
June 30, 2020 to June 29, 2021		107.406	%
June 30, 2021 to June 29, 2022		103.703	%
June 30, 2022 to June 29, 2023		100.000	%

The Company redeemed approximately $2 million of the 9⅞% Junior-Priority Secured Notes due 2023 via a tender offer which commenced on October 30, 2020, and expired on November 30, 2020.

As further described in Note 16 and in conjunction with the issuance of $1.775 billion aggregate principal amount of 6⅞% Junior-Priority Secured Notes due 2029, all remaining 9⅞% Junior-Priority Secured Notes due 2023 were purchased pursuant to a tender offer on February 2, 2021 or, to the extent not tendered, pursuant to a notice of redemption as completed on February 4, 2021.

8⅛% Junior-Priority Secured Notes due 2024

On June 22, 2018, CHS completed a private offering of $1.355 billion aggregate principal amount of the 8⅛% Junior-Priority Secured Notes due June 30, 2024 (the “8⅛% Junior-Priority Secured Notes due 2024”) in exchange for approximately $1.079 billion of 7⅛% Senior Notes due 2020 and approximately $368 million of 6⅞% Senior Notes due 2022. The 8⅛% Junior-Priority Secured Notes due 2024 bear interest at a rate of 8.125% per annum, payable semi-annually in arrears on June 30 and December 31 of each year. The 8⅛% Junior-Priority Secured Notes due 2024 are scheduled to mature on June 20, 2024. The 8⅛% Junior-Priority Secured Notes due 2024 are unconditionally guaranteed on a junior-priority secured basis by the Company and each of the CHS current and future domestic subsidiaries that provide guarantees under CHS᾿ ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 8⅛% Junior-Priority Secured Notes due 2024 and the related guarantees are secured by shared (i) second-priority liens on the Non-ABL Priority Collateral that secures on a first-priority basis the CHS’s senior-priority secured notes and (ii) third-priority liens on the ABL-Priority Collateral that secures on a first-priority basis the ABL Facility (and also secures on a second-priority basis CHS’s

senior-priority secured notes), in each case subject to permitted liens described in the indenture governing the 8⅛% Junior-Priority Secured Notes due 2024.

Prior to June 30, 2021, CHS may redeem some or all of the 8⅛% Junior-Priority Secured Notes due 2024 at a redemption price equal to 100% of the principal amount of the notes redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 8⅛% Junior-Priority Secured Notes due 2024. In addition, at any time prior to June 30, 2021, CHS may redeem up to 40% of the aggregate principal amount of the 8⅛% Junior-Priority Secured Notes due 2024 with the proceeds from certain equity offerings at the redemption price of 108.125%, plus accrued and unpaid interest, if any, to, but excluding, the applicable redemption date.

After June 30, 2021, CHS is entitled, at its option, to redeem all or a portion of the 8⅛% Junior-Priority Secured Notes due 2024 upon not less than 15 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
June 30, 2021 to June 29, 2022		104.063	%
June 30, 2022 to June 29, 2023		102.031	%
June 30, 2023 to June 29, 2024		100.000	%

The indentures governing each of the 9⅞% Junior-Priority Secured Notes due 2023 and 8⅛% Junior-Priority Secured Notes due 2024 also prohibited CHS from purchasing, repurchasing, redeeming, defeasing or otherwise acquiring or retiring any outstanding 7⅛% Senior Notes due 2020 with: (a) cash or cash equivalents on hand as of the consummation of such 2018 exchange offers; (b) cash generated from operations; (c) proceeds from assets sales; or (d) proceeds from the issuance of, or in exchange for, secured debt, in each case, prior to May 15, 2020. CHS received a waiver from requisite holders of each series of the 9⅞% Junior-Priority Secured Notes due 2023 and 8⅛% Junior-Priority Secured Notes due 2024 waiving these restrictions prior to consummating the 2019 Exchange Offer.

During the year ended December 31, 2020, the Company extinguished $1 million in principal related to the 8⅛% Junior-Priority Secured Notes due 2024 through open market repurchases and approximately $6 million via a tender offer which commenced on October 30, 2020, and expired on November 30, 2020.

8⅝% Senior Secured Notes due 2024

On July 6, 2018, CHS completed a private offering of $1.033 billion aggregate principal amount of 8⅝% Senior Secured Notes due January 15, 2024 (the “8⅝% Senior Secured Notes due 2024”). The 8⅝% Senior Secured Notes due 2024 bear interest at a rate of 8.625% per annum payable semi-annually in arrears on January 15 and July 15 of each year. The 8⅝% Senior Secured Notes due 2024 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 CHS᾿ ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 8⅝% Senior Secured Notes due 2024 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 8⅝% Senior Secured Notes due 2024.

Prior to January 15, 2021, CHS may redeem some or all of the 8⅝% Senior Secured Notes due 2024 at a redemption price equal to 100% of the principal amount of the notes redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 8⅝% Senior Secured Notes due 2024. In addition, at any time prior to January 15, 2021, CHS may redeem up to 40% of the aggregate principal amount of the 8⅝% Senior Secured Notes due 2024 with the proceeds from certain equity offerings at the redemption price of 108.625%, plus accrued and unpaid interest, if any, to, but excluding, the applicable redemption date.

After January 15, 2021, CHS is entitled, at its option, to redeem all or a portion of the 8⅝% Senior Secured Notes due 2024 upon not less than 15 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on

the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
January 15, 2021 to January 14, 2022		104.313	%
January 15, 2022 to January 14, 2023		102.156	%
January 15, 2023 to January 14, 2024		100.000	%

As further described in Note 16 and in conjunction with the issuance of $1.095 billion aggregate principal amount of 4¾% Senior Secured Notes due February 15, 2031, all remaining 8⅝% Senior Secured Notes due 2024 were redeemed on February 9, 2021.

6⅝% Senior Secured Notes due 2025

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	%

8% Senior Secured Notes due 2026

On March 6, 2019, CHS completed a private offering of $1.601 billion aggregate principal amount of the 8% Senior Secured Notes due March 15, 2026 (the “8% Senior Secured Notes due 2026”). The net proceeds from this issuance were used to finance the repayment of approximately $1.557 billion aggregate principal amount of CHS’ then outstanding Term H Facility and related fees and expenses. On November 19, 2019, CHS completed a tack-on offering of $500 million aggregate principal amount of the Additional 2026 Notes, increasing the total aggregate principal amount of the 8% Senior Secured Notes due 2026 to $2.101 billion. CHS used the proceeds from the Additional 2026 Notes to repay amounts outstanding under the Revolving Facility, redeem all $121 million aggregate principal amount of CHS’ then outstanding 7⅛% Senior Notes due 2020 and repay borrowings outstanding under the ABL Facility. The Additional 2026 Notes have identical terms, other than issue date, issue price and the date from which interest initially accrued, as the 8% Senior Secured Notes due 2026 issued on March 6, 2019. The 8% Senior Secured Notes due 2026 bear interest at a rate of 8.000% per annum, payable semi-annually in arrears on March 15 and September 15 of each year. Interest on the 8% Senior Secured Notes due 2026 accrues from the initial issuance date of the 8% Senior Secured Notes due 2026. Interest is calculated on the

basis of a 360-day year comprised of twelve 30-day months. The 8% Senior Secured Notes due 2026 are scheduled to mature on March 15, 2026.

The 8% Senior Secured Notes due 2026 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 ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 8% Senior Secured Notes due 2026 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 8% Senior Secured Notes due 2026.

Prior to March 15, 2022, CHS may redeem some or all of the 8% Senior Secured Notes due 2026 at a redemption price equal to 100% of the principal amount of the notes redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 8% Senior Secured Notes due 2026. In addition, at any time prior to March 15, 2022, CHS may redeem up to 40% of the aggregate principal amount of the 8% Senior Secured Notes due 2026 with the proceeds from certain equity offerings at the redemption price of 108.000%, plus accrued and unpaid interest, if any, to, but excluding, the applicable redemption date.

After March 15, 2022, CHS is entitled, at its option, to redeem all or a portion of the 8% Senior Secured Notes due 2026 upon not less than 15 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
March 15, 2022 to March 14, 2023		104.000	%
March 15, 2023 to March 14, 2024		102.000	%
March 15, 2024 to March 14, 2026		100.000	%

8% Senior Secured Notes due 2027

On November 19, 2019, CHS issued approximately $700 million aggregate principal amount of the 8% Senior Secured Notes due December 15, 2027 (the “8% Senior Secured Notes due 2027”) in connection with the 2019 Exchange Offer. No cash proceeds were received from the 2019 Exchange Offer. The 8% Senior Secured Notes due 2027 bear interest at a rate of 8.000% per annum, payable semi-annually in arrears on June 15 and December 15 of each year. Interest on the 8% Senior Secured Notes due 2027 accrues from the initial issuance date of the 8% Senior Secured Notes due 2027. Interest is calculated on the basis of a 360-day year comprised of twelve 30-day months. The 8% Senior Secured Notes due 2027 are scheduled to mature on December 15, 2027. The 8% Senior Secured Notes due 2027 are unconditionally guaranteed on a senior-priority secured basis by the Company and each of CHS’ current and future domestic subsidiaries that provide guarantees under the ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

The 8% Senior Secured Notes due 2027 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 8% Senior Secured Notes due 2027.

CHS is entitled, at its option, to redeem all or a portion of the 8% Senior Secured Notes due 2027 at any time prior to December 15, 2022, upon not less than 15 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 8% Senior Secured Notes due 2027 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 8% Senior Secured Notes due 2027. In addition, CHS may redeem up to 40% of the aggregate principal amount of the 8% Senior Secured Notes due 2027 at any time prior to December 15, 2022 using the net proceeds from certain equity offerings at the redemption price of 108.000% of the principal amount of the 8% Senior Secured Notes due 2027 redeemed, plus accrued and unpaid interest, if any.

CHS may redeem some or all of the 8% Senior Secured Notes due 2027 at any time on or after December 15, 2022 upon not less than 15 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on the

redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
December 15, 2022 to December 14, 2023		104.000	%
December 15, 2023 to December 14, 2024		102.000	%
December 15, 2024 to December 14, 2027		100.000	%

5⅝% Senior Secured Notes due 2027

On December 28, 2020, the Company completed a private offering of $1.9 billion aggregate principal amount of 5⅝% Senior Secured Notes due March 15, 2027 (the “5⅝% Senior Secured Notes due 2027”). The proceeds of the offering were used to repurchase approximately $2.579 billion of the outstanding principal amount of 6¼% Senior Secured Notes due 2023 that were validly tendered and accepted for purchase pursuant to the early tender deadline of a tender offer that launched on December 11, 2020, and to pay related fees. The remaining principal value of 6¼% Senior Secured Notes due 2023 that were not validly tendered as of the early tender deadline were redeemed or repurchased via the completion of the tender offer on January 11, 2021 or redemption on January, 28, 2021. The 5⅝% Senior Secured Notes due 2027, which mature on March 15, 2027, bear interest at a rate of 5⅝% per year payable semi-annually in arrears on March 15 and September 15 of each year, commencing on September 15, 2021. The 5⅝% Senior Secured Notes due 2027 are unconditionally guaranteed on a senior-priority secured basis by the Company and each of CHS’ current and future domestic subsidiaries that provide guarantees under the ABL facility, any capital market debt securities of CHS (including CHS’ outstanding senior notes) and certain other long-term debt of CHS.

The 5⅝% Senior Secured Notes due 2027 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 5⅝% Senior Secured Notes due 2027.

CHS is entitled, at its option, to redeem all or a portion of the 5⅝% Senior Secured Notes due 2027 at any time prior to December 15, 2023, upon not less than 15 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 5⅝% Senior Secured Notes due 2027 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 5⅝% Senior Secured Notes due 2027. In addition, CHS may redeem up to 40% of the aggregate principal amount of the 5⅝% Senior Secured Notes due 2027 at any time prior to December 15, 2023 using the net proceeds from certain equity offerings at the redemption price of 105.625% of the principal amount of the 5⅝% Senior Secured Notes due 2027 redeemed, plus accrued and unpaid interest, if any.

At any time and from time to time on or after December 15, 2023, CHS may redeem the 5⅝% Senior Secured Notes due 2027 in whole or in part, upon not less than 15 no more than 60 days’ prior written notice at a redemption price equal to the percentage of principal amount set forth below plus accrued and unpaid interest, if any, on the 5⅝% Senior Secured Notes due 2027 redeemed, to, but excluding, the applicable date of redemption, if redeemed during the twelve-month period beginning on December 15 of the years indicated below:

Period	Redemption Price
December 15, 2023 to December 14, 2024		102.813	%
December 15, 2024 to December 14, 2025		101.406	%
December 15, 2025 to December 14, 2027		100.000	%

6⅞% Senior Notes due 2028

On November 19, 2019, CHS issued approximately $1.7 billion aggregate principal amount of the 6⅞% Senior Notes due April 1, 2028 (“the 6⅞% Senior Notes due 2028”) in connection with the 2019 Exchange Offer. No cash proceeds were received in the 2019 Exchange Offer. The 6⅞% Senior Notes due 2028 bear interest at a rate of 6.875% per annum, payable semi-annually in arrears on April 1 and October 1 of each year. Interest on the 6⅞% Senior 2028 Notes accrues from the initial issuance date of the 6⅞% Senior Notes due 2028. Interest is calculated on the basis of a 360-day year comprised of twelve 30-day months. The 6⅞% Senior Notes due 2028 are scheduled to mature on April 1, 2028.

The 6⅞% Senior Notes due 2028 are unconditionally guaranteed on a senior-priority unsecured basis by the Company and each of the CHS current and future domestic subsidiaries that provide guarantees under the ABL Facility, any capital market debt securities of CHS (including CHS᾿ outstanding senior notes) and certain other long-term debt of CHS.

CHS is entitled, at its option, to redeem all or a portion of the 6⅞% Senior Notes due 2028 at any time prior to April 1, 2023, upon not less than 15 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 6⅞% Senior Notes due 2028 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 6⅞% Senior Notes due 2028. In addition, the Issuer may redeem up to 40% of the aggregate principal amount of the 6⅞% Senior Notes due 2028 at any time prior to April 1, 2023 using the net proceeds from certain equity offerings at the redemption price of 106.875% of the principal amount of the 6⅞% Senior Notes due 2028 redeemed, plus accrued and unpaid interest, if any.

CHS may redeem some or all of the 6⅞% Senior Notes due 2028 at any time on or after April 1, 2023 upon not less than 15 nor more than 60 days’ notice, at the following redemption prices (expressed as a percentage of principal amount on the redemption date), plus accrued and unpaid interest, if any, to the redemption date (subject to the right of holders of record on the relevant record date to receive interest due on the relevant interest payment date), if redeemed during the periods set forth below:

Period	Redemption Price
April 1, 2023 to March 31, 2024		103.438	%
April 1, 2024 to March 31, 2025		101.719	%
April 1, 2025 to March 31, 2028		100.000	%

On December 7, 2020, CHS entered into a privately negotiated agreement with a multi-asset investment manager who has certain funds and accounts which are holders (the “Holders”) of the 6⅞% Senior Notes due 2028. Pursuant to the agreement, the Company exchanged $700 million aggregate principal amount of the 6⅞% Senior Notes due 2028 for an aggregate consideration of $400 million of cash and 10 million newly issued shares of the Company’s common stock. The exchange transaction was completed on December 9, 2020 and the shares of common stock issued in the exchange were not, and are not required to be, registered under the Securities Act of 1933 pursuant to an exemption from registration provisions via Section 3(a)(9) of the Securities Act of 1933. A gain from early extinguishment of debt of approximately $205 million was recognized associated with this exchange.

During the year ended December 31, 2020, the Company extinguished $226 million in principal of the 6⅞% Senior Notes due 2028 through open market repurchases and approximately $7 million via a tender offer which commenced on October 30, 2020 and expired on November 30, 2020.

6% Senior Secured Notes due 2029

On December 28, 2020, the Company completed a private offering of $900 million aggregate principal amount of 6% Senior Secured Notes due January 15, 2029 (the “6% Senior Secured Notes due 2029”). The proceeds of the offering were used, together with proceeds from the 5⅝% Senior Secured Notes due 2027 described above, to repurchase approximately $2.579 billion of the outstanding principal amount of 6¼% Senior Secured Notes due 2023 that were validly tendered and accepted for purchase pursuant to the early tender deadline of a tender offer that launched on December 11, 2020, and to pay related fees. The remaining principal value of 6¼% Senior Secured Notes due 2023 that were not validly tendered as of the early tender deadline were redeemed or repurchased via the completion of the tender offer on January 11, 2021 or redemption on January, 28, 2021. The 6% Senior Secured Notes due 2029, which mature on January 15, 2029, bear interest at a rate of 6% per year payable semi-annually in arrears on January 15 and July 15 of each year, commencing on July 15, 2021. The 6% Senior Secured Notes due 2029 are unconditionally guaranteed on a senior-priority secured basis by each of CHS’ current and future domestic subsidiaries that provide guarantees under the ABL facility, any capital market debt securities of CHS (including CHS’ outstanding senior notes) and certain other long-term debt of CHS.

The 6% Senior Secured Notes due 2029 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 6% Senior Secured Notes due 2029.

CHS is entitled, at its option, to redeem all or a portion of the 6% Senior Secured Notes due 2029 at any time prior to January 15, 2024, upon not less than 15 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 6% Senior Secured Notes due 2029 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 6% Senior Secured Notes due 2029. In addition, CHS may redeem up to 40% of the aggregate principal amount of the 6% Senior Secured Notes due 2029 at any time prior to January 15, 2024 using the net proceeds from certain equity offerings at the redemption price of 106.000% of the principal amount of the 6% Senior Secured Notes due 2029 redeemed, plus accrued and unpaid interest, if any.

At any time and from time to time on or after January 15, 2024, CHS may redeem the 6% Senior Secured Notes due 2029 in whole or in part, upon not less than 15 nor more than 60 days’ prior written notice at a redemption price equal to the percentage of principal amount set forth below plus accrued and unpaid interest, if any, on the 6% Senior Secured Notes due 2029 redeemed, to, but excluding, the applicable date of redemption, if redeemed during the twelve-month period beginning on January 15 of the years indicated below:

Period	Redemption Price
January 15, 2024 to January 14, 2025		103.000	%
January 15, 2025 to January 14, 2026		101.500	%
January 15, 2026 to January14, 2029		100.000	%

ABL Facility

On April 3, 2018, the Company and CHS entered into an asset-based loan (ABL) credit agreement (the “ABL Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent, and the lenders and other agents party thereto. Pursuant to the ABL Credit Agreement, the lenders have extended to CHS a revolving asset-based loan facility (the “ABL Facility”) in the maximum aggregate principal amount of $1.0 billion, subject to borrowing base capacity. On November 12, 2019, the Company and CHS entered into Amendment No. 2 to the ABL Facility, resulting in an increase of the portion of the commitments under the ABL Facility that are available in the form of letters of credit from $50 million to $200 million. CHS and all domestic subsidiaries of CHS that guarantee CHS’ other outstanding senior and senior secured indebtedness guarantee the obligations of CHS under the ABL Facility. Subject to certain exceptions, all obligations under the ABL Facility and the related guarantees are secured by a perfected first-priority security interest in substantially all of the receivables, deposit, collection and other accounts and contract rights, books, records and other instruments related to the foregoing of the Company, CHS and the guarantors, as well as a perfected junior-priority security interest in substantially all of the other assets of the Company, CHS and the guarantors, subject to customary exceptions and intercreditor arrangements. In connection with entering into the ABL Credit Agreement and the ABL Facility, the Company repaid in full and terminated its accounts receivable loan agreement with a group of lenders and banks. At December 31, 2020, the available borrowing base under the ABL Facility was $679 million, of which the Company had no outstanding borrowings and letters of credit issued of $150 million. The issued letters of credit were primarily in support of potential insurance-related claims and certain bonds. As further described in Note 16, $30 million of our outstanding letters of credit of $150 million was cancelled on January 6, 2021 in relation to a professional liability claim that was settled and funded in the three months ended December 31, 2020.

Borrowings under the ABL Facility bear interest at a rate per annum equal to an applicable percentage, plus, at the Borrower’s option, either (a) an Alternative base rate or (b) a LIBOR rate. From and after December 31, 2018, the applicable percentage under the ABL Facility is determined based on excess availability as a percentage of the maximum commitment amount under the ABL Facility at a rate per annum of 1.25%, 1.50% and 1.75% for loans based on the Alternative base rate and 2.25%, 2.50% and 2.75% for loans based on the LIBOR rate. From and after September 30, 2018, the applicable commitment fee rate under the ABL Facility is determined based on average utilization as a percentage of the maximum commitment amount under the ABL Facility at a rate per annum of either 0.50% or 0.625% times the unused portion of the ABL Facility.

Principal amounts outstanding under the ABL Facility will be due and payable in full on April 3, 2023. The ABL Facility includes a 91-day springing maturity applicable if more than $250 million in the aggregate principal amount of the 5⅛% Senior Secured Notes due 2021, 6⅞% Senior Notes due 2022 or 6¼% Senior Secured Notes due 2023 or any indebtedness incurred to refinance the foregoing are scheduled to mature or similarly become due on a date prior to April 3, 2023. In such event, principal amounts outstanding under the ABL Facility will be accelerated and all amounts outstanding under the ABL Facility will become immediately due and payable.

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 and (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 December 31, 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 December 31, 2020.

In addition, in the event the amount of borrowings and letters of credit outstanding at any time under the ABL Facility exceeds the borrowing base at such time, the Company will be required to, first, repay outstanding borrowings and, second, replace or cash collateralize outstanding letters of credit, in an aggregate amount sufficient to eliminate such excess.

Events of default under the ABL Facility include, but are not limited to, (1) CHS’ failure to pay principal, interest, fees or other amounts under the ABL Facility Agreement when due (taking into account any applicable grace period), (2) any representation or warranty proving to have been materially incorrect when made, (3) covenant defaults subject, with respect to certain covenants, to an available cure and applicable grace periods, (4) bankruptcy and insolvency events, (5) a cross default to certain other debt, (6) certain undischarged judgments (not paid within an applicable grace period), (7) a change of control (as defined), (8) certain ERISA-related defaults and (9) the invalidity or impairment of specified security interests, guarantees or subordination provisions in favor of the ABL Agent or lenders under the ABL Facility.

Financing and repayment transactions discussed above resulted in a pre-tax and after-tax gain from early extinguishment of debt of $317 million and $352 million, respectively, for year ended December 31, 2020, a pre-tax and after-tax loss from early extinguishment of $54 million and $42 million, respectively, for the year ended December 31, 2019, and a pre-tax and after-tax gain from early extinguishment of $31 million and $23 million, respectively, for the year ended December 31, 2018.

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.

As of December 31, 2020, the scheduled maturities of long-term debt outstanding, including finance lease obligations for each of the next five years and thereafter are as follows (in millions):

Year Ending December 31,	Amount
2021	$	123
2022		137
2023		1,776
2024		2,387
2025		1,469
Thereafter		6,574
Total maturities		12,466
Less: Deferred debt issuance costs		(230	)
Plus: Unamortized note premium		(20	)
Total long-term debt	$	12,216

The Company paid interest of $1.0 billion on borrowings for both of the years ended December 31, 2020 and 2019 and $936 million on borrowings during the year ended December 31, 2018.

Various financing transactions were completed subsequent to December 31, 2020 which are set forth in Note 16.

Fair Value of Financial Instruments

12 Months Ended

Dec. 31, 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 December 31, 2020 and 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):

	December 31, 2020				December 31, 2019
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	1,676	$	1,676	$	216	$	216
Investments in equity securities		129		129		141		141
Available-for-sale debt securities		110		110		101		101
Trading securities		12		12		12		12
Liabilities:
5⅛% Senior Secured Notes due 2021		-		-		990		1,003
6⅞% Senior Notes due 2022		125		125		229		188
6¼% Senior Secured Notes due 2023		95		99		3,074		3,148
8⅝% Senior Secured Notes due 2024		1,025		1,080		1,023		1,099
6⅝% Senior Secured Notes due 2025		1,427		1,543		-		-
8% Senior Secured Notes due 2026		2,074		2,275		2,070		2,182
8% Senior Secured Notes due 2027		692		760		691		700
5⅝% Senior Secured Notes due 2027		1,809		2,048		-		-
6⅞% Senior Notes due 2028		758		618		1,678		1,700
6% Senior Secured Notes due 2029		857		973		-		-
9⅞% Junior-Priority Secured Notes due 2023		1,756		1,861		1,754		1,539
8⅛% Junior-Priority Secured Notes due 2024		1,336		1,408		1,340		1,113
ABL Facility and other debt		23		23		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.

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 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 (loss) gain recognized as a component of OCI during the years ended December 31, 2020, 2019 and 2018 (in millions):

	Amount of Pre-Tax (Loss) Gain
	Recognized in OCI (Effective Portion)
	Year Ended December 31,
Derivatives in Cash Flow Hedging Relationships	2020		2019			2019
Interest rate swaps	$	-	$	(3	)	$	17

The following tabular disclosure provides the location of the effective portion of the pre-tax loss reclassified from accumulated other comprehensive loss (“AOCL”) into interest expense on the consolidated statements of income (loss) during the years ended December 31, 2020, 2019 and 2018 (in millions):

	Amount of Pre-Tax Loss Reclassified
	from AOCL into Income (Effective Portion)
Location of Loss Reclassified from	Year Ended December 31,
AOCL into Income (Effective Portion)	2020		2019		2018
Interest expense, net	$	2	$	-	$	2

- 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

12 Months Ended

Dec. 31, 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 years ending December 31, 2020 or December 31, 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 December 31, 2020 and 2019 (in millions):

	December 31, 2020		Level 1		Level 2		Level 3
Investments in equity securities	$	129	$	129	$	-	$	-
Available-for-sale debt securities		110		-		110		-
Trading securities		12		-		12		-
Total assets	$	251	$	129	$	122	$	-

	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.

Supplemental information regarding the Company’s available-for-sale debt securities (all of which had no withdrawal restrictions) is set forth in the table below (in millions):

			Gross		Gross		Estimated
	Amortized		Unrealized		Unrealized		Fair
	Cost		Gains		Losses		Values
As of December 31, 2020:
Debt securities
Government	$	48	$	2	$	-	$	50
Corporate		38		2		-		40
Mortgage and asset-backed securities		19		1		-		20
Total	$	105	$	5	$	-	$	110

			Gross		Gross			Estimated
	Amortized		Unrealized		Unrealized			Fair
	Cost		Gains		Losses			Values
As of December 31, 2019:
Debt securities
Government	$	54	$	1	$	(1	)	$	54
Corporate		33		1		-			34
Mortgage and asset-backed securities		13		-		-			13
Total	$	100	$	2	$	(1	)	$	101

As of December 31, 2020 and 2019, investments with aggregate estimated fair values of approximately $7 million (11 investments) and $51 million (71 investments), respectively, generated the gross unrealized losses disclosed in the above table. At each reporting date, the Company performs an evaluation of impaired securities to determine if the unrealized losses are other-than-temporary. This

evaluation considers a number of factors including, but not limited to, the length of time and extent to which the fair value has been less than cost, and management’s ability and intent to hold the securities until fair value recovers. Based on the results of this evaluation, management concluded that as of December 31, 2020, there were no other-than-temporary losses related to available-for-sale debt securities. The recent declines in value of the securities and/or length of time they have been below cost, as well as the Company’s ability and intent to hold the securities for a reasonable period of time sufficient for a projected recovery of fair value, have caused management to conclude that the securities, that have generated gross unrealized losses, were not other-than-temporarily impaired. Management will continue to monitor and evaluate the recoverability of the Company’s available-for-sale debt securities.

The contractual maturities of debt-based securities held by the Company as of December 31, 2020 and 2019, excluding mutual fund holdings, are set forth in the table below (in millions). Expected maturities will differ from contractual maturities because the issuers of the debt securities may have the right to prepay their obligations without prepayment penalties.

	December 31, 2020				December 31, 2019
	Amortized		Estimated		Amortized		Estimated
	Cost		Fair Values		Cost		Fair Values
Within 1 year	$	3	$	3	$	9	$	9
After 1 year and through year 5		26		27		19		20
After 5 years and through year 10		30		32		29		29
After 10 years		46		48		43		43

Gross realized gains and losses on sales of available-for-sale debt securities are summarized in the table below (in millions):

	Year Ended December 31,
	2020			2019		2018
Realized gains	$	2		$	-	$	-
Realized losses		(1	)		-		-

Other investment income, which includes interest and dividends, related to all investment securities were $6 million, $7 million and $7 million for the years ended December 31, 2020, 2019 and 2018, respectively.

Net gains and losses recognized during the years ended December 31, 2020 and 2019 for investments in equity securities, which are broken out between investments sold during the year and investments held at the end of the year, are summarized in the table below (in millions):

	Year Ended December 31,
	2020			2019
Net gains and (losses), beginning of year	$	9		$	15
Less: Net gains and (losses) recognized during the year on equity securities sold during the year		14			2
Unrealized gains and (losses) recognized during the year on equity securities held, end of year	$	(5	)	$	13

Leases

12 Months Ended

Dec. 31, 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. All lease agreements generally require the Company to pay maintenance, repairs, property taxes and insurance costs, which are variable amounts based on actual costs incurred during each applicable period. Such costs are not included in the determination of the ROU asset or lease liability. Variable lease cost also includes escalating rent payments that are not fixed at commencement but are based on an index that is determined in future periods over the lease term based on changes in the Consumer Price Index or other measures of cost inflation. Most leases include one or more options to renew the lease at the end of the initial term, with renewal terms that generally extend the lease at the then market rate of rental payment. Certain leases also include an option to buy the underlying asset at or a short time prior to the termination of the lease. All such options are at the Company’s discretion and are evaluated at the commencement of the lease, with only those that are reasonably certain of exercise included in determining the appropriate lease term. 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 year ended December 31, 2020, concessions of approximately $7 million were recognized as a reduction to variable rent expense.

The components of lease cost and rent expense for the year ended December 31, 2020 and 2019 are as follows (in millions):

	Year Ended December 31,
Lease Cost	2020			2019
Operating lease cost:
Operating lease cost	$	203		$	194
Short-term rent expense		104			114
Variable lease cost		26			18
Sublease income		(6	)		(5	)
Total operating lease cost	$	327		$	321
Finance lease cost:
Amortization of right-of-use assets	$	10		$	12
Interest on finance lease liabilities		8			7
Total finance lease cost	$	18		$	19

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

	Balance Sheet Classification	December 31, 2020			December 31, 2019
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	642		$	607

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		134			154
	Equipment and fixtures		8			11
	Property and equipment		150			173
	Less accumulated depreciation and amortization		(46	)		(56	)
	Property and equipment, net	$	104		$	117

Current finance lease liabilities	Current maturities of long-term debt	$	5		$	6
Long-term finance lease liabilities	Long-term debt		74			107

Supplemental cash flow information related to leases for the year ended December 31, 2020 and 2019 are as follows (in millions):

	Year Ended December 31,
Cash flow information	2020			2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases (1)	$	188		$	167
Operating cash flows from finance leases		8			7
Financing cash flows from finance leases		7			9
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		150			122
Weighted-average remaining lease term:
Operating leases	7 years			6 years
Finance leases	19 years			20 years
Weighted-average discount rate:
Operating leases		9.0	%		9.1	%
Finance leases		8.4	%		5.6	%

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

On September 19, 2019, the Company completed the sale and leaseback of four medical office buildings for net proceeds of $56 million to Carter Validus Mission Critical REIT II, Inc. The buildings, with a combined total of 285,337 square feet, are located in three states and support a wide array of diagnostic, medical and surgical services in an outpatient setting for the respective nearby hospitals. Based on the Company’s assessment of the control transfer principle in these leased buildings, the transaction did not qualify for sale treatment and the related leases have been recorded as financing obligations in long-term debt in the Company’s consolidated balance sheet at December 31, 2019. In addition, on December 18, 2019, the Company completed the sale and leaseback of one medical office building for net proceeds of approximately $4 million to an affiliate of Catalyst Healthcare Real Estate. The 30,000 square foot building is located in Arkansas and supports a wide array of diagnostic, medical and surgical services in an outpatient setting for the nearby hospital. Based on the Company’s assessment of the control transfer principle in this leased building, the transaction does not qualify for sale treatment and the related lease has been recorded as a financing obligation in long-term debt in the accompanying consolidated balance sheet at December 31, 2019.

Commitments relating to noncancellable operating and finance leases and financing obligations for each of the next five years and thereafter are as follows (in millions):

							Financing
Year Ending December 31,	Operating			Finance			Obligations
2021	$	193		$	10		$	12
2022		161			9			12
2023		127			8			13
2024		93			8			13
2025		77			8			13
Thereafter		253			150			103
Total minimum future payments		904			193			166
Less: Imputed interest		(238	)		(114	)		(6	)
Total liabilities		666			79			160
Less: Current portion		(142	)		(5	)		(2	)
Long-term liabilities	$	524		$	74		$	158

As of December 31, 2020, there were approximately $17 million of assets underlying approved but pending leases that have not yet commenced, primarily for medical equipment.

Employee Benefit Plans

12 Months Ended

Dec. 31, 2020

Compensation And Retirement Disclosure [Abstract]

Employee Benefit Plans

10. EMPLOYEE BENEFIT PLANS

The Company maintains various benefit plans, including defined contribution plans, defined benefit plans and deferred compensation plans, for which certain of the Company’s subsidiaries are the plan sponsors. The CHS/Community Health Systems, Inc. Retirement Savings Plan is a defined contribution plan which covers the majority of the Company’s employees. Employees at

these locations whose employment is covered by collective bargaining agreements are generally eligible to participate in the CHS/Community Health Systems, Inc. Standard 401(k) Plan. Total expense to the Company under the 401(k) plans was $74 million, $85 million and $90 million for the years ended December 31, 2020, 2019 and 2018, respectively, and is recorded in salaries and benefits expense on the consolidated statements of income (loss).

The Company maintains unfunded deferred compensation plans that allow participants to defer receipt of a portion of their compensation. The liability for the deferred compensation plans was $176 million and $175 million as of December 31, 2020 and 2019, respectively, and is included in other long-term liabilities on the consolidated balance sheets. Assets designated to pay benefits under this plan are discussed below.

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 $7 million, $7 million and $9 million for the years ended December 31, 2020, 2019 and 2018, respectively. The accrued benefit liability for the SERP totaled $89 million and $72 million at December 31, 2020 and 2019, respectively, and is included in other long-term liabilities on the consolidated balance sheets. The weighted-average assumptions used in determining net periodic cost for the years ended December 31, 2020 and 2019 were a discount rate of 3.1% and 4.2% and an annual salary increase of 3.0%.

During 2018, certain members of executive management of the Company that were participants in the SERP retired and met the requirements for payout of their SERP retirement benefit. The SERP payout provisions require payment to the participant in an actuarially determined lump sum amount six months after the participant retires from the Company. Such amounts were paid out of the rabbi trust. As required by the pension accounting rules in U.S. GAAP, the Company recognized a non-cash settlement loss of approximately $2 million during the year ended December 31, 2018. There were no settlement losses during the years ended December 31, 2020 and 2019.

The Company had assets of $243 million as of December 31, 2020, in a non-qualified plan trust generally designated to pay benefits of the deferred compensation plans and the SERP, consisting of equity securities of $95 million as of December 31, 2020, and company-owned life insurance contracts of $148 million as of December 31, 2020.

The Company had assets of $153 million as of December 31, 2019, in a non-qualified plan trust generally designated to pay benefits of the deferred compensation plans, consisting of equity securities of $23 million as of December 31, 2019, and company-owned life insurance contracts of $130 million as of December 31, 2019. The Company had equity securities in a rabbi trust generally designated to pay benefits of the SERP in the amount of $84 million as of December 31, 2019.

The Company maintains the CHS/Community Health Systems, Inc. Retirement Income Plan (“Pension Plan”), which is a defined benefit, non-contributory pension plan that covers certain employees at three of its formerly owned hospitals. The Pension Plan provides benefits to covered individuals satisfying certain age and service requirements. Employer contributions to the Pension Plan are in accordance with the minimum funding requirements of the Employee Retirement Income Security Act of 1974, as amended. The Company does not expect to make contributions to the Pension Plan in 2021. 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 Pension Plan. Variances from actuarially assumed rates will result in increases or decreases in benefit obligations, net periodic cost and funding requirements in future periods. Benefits expense under the Pension Plan was approximately $1 million during the year ended December 31, 2020 and less than $1 million for the years ended December 31, 2019 and 2018. The accrued benefit liability for the Pension Plan totaled $5 million and $12 million at December 31, 2020 and 2019, respectively, and is included in other long-term liabilities on the consolidated balance sheets. The weighted-average assumptions used for determining the net periodic cost for the year ended December 31, 2020 was a discount rate of 3.2% and the expected long-term rate of return on assets of 6.0%.

- Definition

The entire disclosure for retirement benefits.

+ References

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+ Details

Stockholders' Deficit

12 Months Ended

Dec. 31, 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 December 31, 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 December 31, 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 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):

	Year Ended December 31,
	2020		2019			2018
Net income (loss) attributable to Community Health Systems,
Inc. stockholders	$	511	$	(675	)	$	(788	)
Transfers to the noncontrolling interests:
Net increase (decrease) in Community Health
Systems, Inc. paid-in-capital for
purchase of subsidiary partnership interests		3		3			(4	)
Net transfers to the noncontrolling interests		3		3			(4	)
Change to Community Health Systems, Inc.
stockholders’ deficit from net income (loss) attributable to
Community Health Systems, Inc. stockholders
and transfers to noncontrolling interests	$	514	$	(672	)	$	(792	)

Earnings Per Share

12 Months Ended

Dec. 31, 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:

	Year Ended December 31,
	2020		2019		2018
Weighted-average number of shares outstanding — basic		115,491,022		113,739,046		112,728,274
Effect of dilutive securities:
Restricted stock awards		905,903		-		-
Employee stock options		122,785		-		-
Other equity-based awards		24,851		-		-
Weighted-average number of shares outstanding — diluted		116,544,561		113,739,046		112,728,274

The Company generated a loss attributable to Community Health Systems, Inc. common stockholders for the years ended December 31, 2019 and 2018, so the effect of dilutive securities is not considered because their effect would be antidilutive. If the Company had generated income during the years ended December 31, 2019 and 2018, 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 133,866 and 68,687, respectively.

	Year Ended December 31,
	2020		2019		2018
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		2,821,511		3,508,968		2,152,408

Equity Investments

12 Months Ended

Dec. 31, 2020

Equity Method Investments And Joint Ventures [Abstract]

Equity Investments

13. EQUITY INVESTMENTS

As of December 31, 2020, the Company owned equity interests of 38.0% in two hospitals in Macon, Georgia, in which HCA owns the majority interest. On December 31, 2016, the Company sold 80% of its ownership interest in the legal entity that owned and operated its home care agency business. As part of the divestiture of its controlling interest in the home care agency business, the Company recorded an equity method investment representing its remaining 20% ownership. Since December 31, 2016 and primarily in conjunction with the divestiture of hospitals, the Company has divested of its remaining 20% ownership in certain home care agency businesses.

In March 2005, the Company began purchasing items, primarily medical supplies, medical equipment and pharmaceuticals, under an agreement with HealthTrust Purchasing Group, L.P. (“HealthTrust”), a group purchasing organization in which the Company is a noncontrolling partner. As of December 31, 2020, the Company had a 13.9% ownership interest in HealthTrust.

The Company’s investment in all of its unconsolidated affiliates was $190 million and $199 million at December 31, 2020 and 2019, respectively, and is included in other assets, net in the accompanying consolidated balance sheets. Included in the Company’s results of operations is the Company’s equity in pre-tax earnings from all of its investments in unconsolidated affiliates, which was $10 million, $15 million and $22 million for the years ended December 31, 2020, 2019 and 2018, respectively.

Other Comprehensive Income

12 Months Ended

Dec. 31, 2020

Equity [Abstract]

Other Comprehensive Income

14. OTHER COMPREHENSIVE INCOME

The following tables present information about items reclassified out of accumulated other comprehensive loss by component for the years ended December 31, 2020 and 2019 (in millions, net of tax):

				Change in
				Fair Value of			Change in			Accumulated
	Change in Fair			Available-for-Sale			Unrecognized			Other
	Value of Interest			Debt			Pension Cost			Comprehensive
	Rate Swaps (1)			Securities (1)			Components			(Loss) Income
Balance as of December 31, 2019	$	2		$	(3	)	$	(8	)	$	(9	)
Other comprehensive (loss)
income before reclassifications		(1	)		6			(1	)		4
Amounts reclassified from
accumulated other
comprehensive (loss) income		-			(2	)		(6	)		(8	)
Net current-period other
comprehensive (loss) income		(1	)		4			(7	)		(4	)
Balance as of December 31, 2020	$	-		$	2		$	(15	)	$	(13	)

(1) Totals may not add due to rounding.

				Change in			Change in			Accumulated
	Change in Fair			Fair Value of			Unrecognized			Other
	Value of Interest			Available-for-Sale			Pension Cost			Comprehensive
	Rate Swaps			Debt Securities			Components			(Loss) Income
Balance as of December 31, 2018	$	5		$	(7	)	$	(8	)	$	(10	)
Other comprehensive (loss)
income before reclassifications		(3	)		5			(1	)		1
Amounts reclassified from
accumulated other
comprehensive (loss) income		-			(1	)		1			-
Net current-period other
comprehensive (loss) income		(3	)		4			-			1
Balance as of December 31, 2019	$	2		$	(3	)	$	(8	)	$	(9	)

The following tables present a subtotal for each significant reclassification to net income (loss) out of AOCL and the line item affected in the accompanying consolidated statements of income (loss) for the years ended December 31, 2020 and 2019 (in millions):

	Amount reclassified
	from AOCL			Affected line item in the
Details about accumulated other	Year Ended			statement where net
comprehensive income (loss) components	December 31, 2020			income (loss) is presented
Amortization of defined benefit pension items
Prior service costs	$	(1	)	Salaries and benefits
Settlement losses recognized		(3	)	Salaries and benefits
		(4	)	Total before tax
		10		Tax benefit
	$	6		Net of tax

	Amount reclassified
	from AOCL			Affected line item in the
Details about accumulated other	Year Ended			statement where net
comprehensive income (loss) components	December 31, 2019			income (loss) is presented
Gains and losses on cash flow hedges
Interest rate swaps	$	-		Interest expense, net
		-		Tax benefit
	$	-		Net of tax

Amortization of defined benefit pension items
Prior service costs	$	(1	)	Salaries and benefits
Settlement losses recognized		-		Salaries and benefits
		(1	)	Total before tax
		-		Tax benefit
	$	(1	)	Net of tax

Commitments and Contingencies

12 Months Ended

Dec. 31, 2020

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

15. COMMITMENTS AND CONTINGENCIES

Construction and Other Capital Commitments. Pursuant to a hospital purchase agreement from our March 1, 2016 acquisition of Northwest Health - La Porte, formerly known as La Porte Hospital, and Northwest Health – Starke, formerly known as Starke Hospital, the Company is committed to build replacement facilities in both La Porte, Indiana and Knox, Indiana. Under the terms of such agreement, construction of the replacement hospital for Northwest Health - La Porte was required to be completed within five years of the date of acquisition, or March 2021. The completion of the replacement facility for Northwest Health - La Porte in La Porte, Indiana, and transfer of operations, including renaming the hospital to Northwest Health – La Porte, was completed on October 24, 2020. In addition, construction of the replacement facility for Northwest Health - Starke is required to be completed within five years of the date the Company entered into a new lease with Starke County, Indiana, the hospital lessor, or in the event the Company does not enter into a new lease with Starke County, or is required to be completed by September 30, 2026. The Company has not entered into a new lease with the lessor for Northwest Health - Starke and currently anticipate completing construction of the Northwest Health - Starke replacement facility in 2026. Construction costs, including equipment costs, for the Northwest Health - La Porte totaled approximately $126 million as of December 31, 2020. Construction costs for the Northwest Health - Starke replacement facility is currently estimated to be approximately $15 million.

Physician Recruiting Commitments. As part of its physician recruitment strategy, the Company provides income guarantee agreements to certain physicians who agree to relocate to its communities and commit to remain in practice there. Under such agreements, the Company is required to make payments to the physicians in excess of the amounts they earned in their practice up to the amount of the income guarantee. These income guarantee periods are typically for 12 months. Such payments are recoverable by the Company from physicians who do not fulfill their commitment period, which is typically three years, to the respective community. At December 31, 2020, the maximum potential amount of future payments under these guarantees in excess of the liability recorded is $17 million.

Professional Liability Claims. As part of the Company’s business of owning and operating hospitals, it is subject to legal actions alleging liability on its part. The Company accrues for losses resulting from such liability claims, as well as loss adjustment expenses that are out-of-pocket and directly related to such liability claims. These direct out-of-pocket expenses include fees of outside counsel and experts. The Company does not accrue for costs that are part of corporate overhead, such as the costs of in-house legal and risk management departments. The losses resulting from professional liability claims primarily consist of estimates for known claims, as well as estimates for incurred but not reported claims. The estimates are based on specific claim facts, historical claim reporting and payment patterns, the nature and level of hospital operations and actuarially determined projections. The actuarially determined projections are based on the Company’s actual claim data, including historic reporting and payment patterns which have been gathered over an approximate 20-year period. As discussed below, since the Company purchases excess insurance on a claims-made basis that transfers risk to third-party insurers, the liability it accrues does include an amount for the losses covered by its excess insurance. The Company also records a receivable for the expected reimbursement of losses covered by excess insurance. Since the Company believes that the amount and timing of its future claims payments are reliably determinable, it discounts the amount accrued for losses resulting from professional liability claims using the risk-free interest rate corresponding to the timing of expected payments.

The net present value of the projected payments was discounted using a weighted-average risk-free rate of 1.8%, 2.6% and 3.1% in 2020, 2019 and 2018, respectively. This liability is adjusted for new claims information in the period such information becomes known. The Company’s estimated liability for professional and general liability claims was $602 million and $612 million as of December 31, 2020 and 2019, respectively. The estimated undiscounted claims liability was $629 million and $663 million as of December 31, 2020 and 2019, respectively. The current portion of the liability for professional and general liability claims was $177 million and $169 million as of December 31, 2020 and 2019, respectively, and is included in other accrued liabilities in the accompanying consolidated balance sheets, with the long-term portion recorded in other long-term liabilities. Professional malpractice expense includes the losses resulting from professional liability claims and loss adjustment expense, as well as paid excess insurance premiums, and is presented within other operating expenses in the accompanying consolidated statements of income (loss).

The Company’s processes for obtaining and analyzing claims and incident data are standardized across all of its hospitals and have been consistent for many years. The Company monitors the outcomes of the medical care services that it provides and for each reported claim, the Company obtains various information concerning the facts and circumstances related to that claim. In addition, the Company routinely monitors current key statistics and volume indicators in its assessment of utilizing historical trends. The average lag period between claim occurrence and payment of a final settlement is between three and four years, although the facts and circumstances of individual claims could result in the timing of such payments being different from this average. Since claims are paid promptly after settlement with the claimant is reached, settled claims represent less than 1.0% of the total liability at the end of any period.

For purposes of estimating its individual claim accruals, the Company utilizes specific claim information, including the nature of the claim, the expected claim amount, the year in which the claim occurred and the laws of the jurisdiction in which the claim occurred. Once the case accruals for known claims are determined, information is stratified by loss layers and retentions, accident years, reported years, geography and claims relating to the acquired HMA hospitals versus claims relating to the Company’s other hospitals. Several actuarial methods are used against this data to produce estimates of ultimate paid losses and reserves for incurred but not reported claims. Each of these methods uses company-specific historical claims data and other information. This company-specific data includes information regarding the Company’s business, including historical paid losses and loss adjustment expenses, historical and current case loss reserves, actual and projected hospital statistical data, a variety of hospital census information, employed physician information, professional liability retentions for each policy year, geographic information and other data.

Based on these analyses the Company determines its estimate of the professional liability claims. The determination of management’s estimate, including the preparation of the reserve analysis that supports such estimate, involves subjective judgment of the management. Changes in reserving data or the trends and factors that influence reserving data may signal fundamental shifts in the Company’s future claim development patterns or may simply reflect single-period anomalies. Even if a change reflects a fundamental shift, the full extent of the change may not become evident until years later. Moreover, since the Company’s methods and models use different types of data and the Company selects its liability from the results of all of these methods, it typically cannot quantify the precise impact of such factors on its estimates of the liability. Due to the Company’s standardized and consistent processes for handling claims and the long history and depth of company-specific data, the Company’s methodologies have produced reliably determinable estimates of ultimate paid losses. Management considers any changes in the amount and pattern of its historical paid losses up through the most recent reporting period to identify any fundamental shifts or trends in claim development experience in determining the estimate of professional liability claims. However, due to the subjective nature of this estimate and the impact that previously unforeseen shifts in actual claim experience can have, future estimates of professional liability could be adversely impacted when actual paid losses develop unexpectedly based on assumptions and settlement events that were not previously known or anticipated.

During the year ended December 31, 2020, the Company incurred expenses in the amount of approximately $50 million related to the settlement of a professional liability claim for which the Company’s third-party insurers’ obligation to provide coverage to the Company in connection with the underlying loss is being litigated. In the ordinary course of business, the Company’s expense with respect to professional liability claims, which is actuarially determined, is limited to amounts not covered by third-party insurance policies, which typically provide coverage for professional liability claims. The subject of the litigation for the recovery of the full amount of the $50 million settlement is whether the claim is covered under the subject policies. Aside from this matter, there were no significant changes in the Company’s estimate of the reserve for professional liability claims during the year ended December 31, 2020.

During the nine months ended September 30, 2019, the Company experienced a significant increase in the amounts paid to settle outstanding professional liability claims, compared to the same period in the prior year and to previous actuarially determined estimates. This increase in claims paid related to claims incurred in 2016 and prior years and was primarily related to divested hospitals. The settlement of these claims at amounts greater than the previously determined actuarial estimates resulted in the Company recording a $70 million change in estimate during the three months ended June 30, 2019, and an additional $20 million change in estimate during the three months ended September 30, 2019 based on updated actuarial estimates. No additional change in estimate related to these claims was recorded during the three months ended December 31, 2019.

The Company is primarily self-insured for these claims; however, the Company obtain excess insurance that transfers the risk of loss to a third-party insurer for claims in excess of our self-insured retentions. The Company’s excess insurance is underwritten on a claims-made basis. For claims reported prior to June 1, 2002, substantially all of the Company’s professional and general liability risks were subject to a less than $1 million per occurrence self-insured retention and for claims reported from June 1, 2002 through June 1, 2003, these self-insured retentions were $2 million per occurrence. Substantially all claims reported after June 1, 2003 and before June 1, 2005 are self-insured up to $4 million per claim. Substantially all claims reported on or after June 1, 2005 and before June 1, 2014 are self-insured up to $5 million per claim. Substantially all claims reported on or after June 1, 2014 and before June 1, 2018 are self-insured up to $10 million per claim. Substantially all claims reported on or after June 1, 2018 are self-insured up to $15 million per claim. Management, on occasion, has selectively increased the insured risk at certain hospitals based upon insurance pricing and other factors and may continue that practice in the future. Excess insurance for all hospitals has been purchased through commercial insurance companies and generally covers the Company’s for liabilities in excess of the self-insured retentions. The excess coverage consists of multiple layers of insurance, the sum of which totals up to $95 million per occurrence and in the aggregate for claims reported on or after June 1, 2003, up to $145 million per occurrence and in the aggregate for claims reported on or after January 1, 2008, up to $195 million per occurrence and in the aggregate for claims reported on or after June 1, 2010, and up to at least $215 million per occurrence and in the aggregate for claims reported on or after June 1, 2015. In addition, for integrated occurrence malpractice claims, there is an additional $50 million of excess coverage for claims reported on or after June 1, 2014 and an additional $75 million of excess coverage for claims reported on or after June 1, 2015 through June 1, 2020. The $75 million in integrated occurrence coverage will also apply to claims reported between June 1, 2020 and May 31, 2021 for events that occurred prior to June 1, 2020 but which were not previously known or reported. For certain policy years prior to June 1, 2014, if the first aggregate layer of excess coverage becomes fully utilized, then the self-insured retention will increase to $10 million per claim for any subsequent claims in that policy year until the Company’s total aggregate coverage is met. Beginning June 1, 2018, this drop-down provision in the excess policies attaches over the $15 million per claim self-insured retention.

Effective June 1, 2014, the hospitals acquired from HMA were insured on a claims-made basis as described above and through commercial insurance companies as described above for substantially all claims reported on or after June 1, 2014 except for physician-related claims with an occurrence date prior to June 1, 2014. Prior to June 1, 2014, the former HMA hospitals obtained insurance coverage through a wholly-owned captive insurance subsidiary and a risk retention group subsidiary which are domiciled in the Cayman Islands and South Carolina, respectively. Those insurance subsidiaries, which are collectively referred to as the “Insurance Subsidiaries,” provided (i) claims-made coverage to all of the former HMA hospitals and (ii) occurrence-basis coverage to most of the physicians employed by the former HMA hospitals. The employed physicians not covered by the Insurance Subsidiaries generally maintained claims-made policies with unrelated third party insurance companies. To mitigate the exposure of the program covering the former HMA hospitals and other healthcare facilities, the Insurance Subsidiaries bought claims-made reinsurance policies from unrelated third parties for claims above self-retention levels of $10 million or $15 million per claim, depending on the policy year.

Effective January 1, 2008, the former Triad hospitals were insured on a claims-made basis as described above and through commercial insurance companies as described above for substantially all claims occurring on or after January 1, 2002 and reported on or after January 1, 2008. Substantially all losses for the former Triad hospitals in periods prior to May 1, 1999 were insured through a wholly-owned insurance subsidiary of HCA, Triad’s owner prior to that time, and excess loss policies maintained by HCA. HCA has agreed to indemnify the former Triad hospitals in respect of claims covered by such insurance policies arising prior to May 1, 1999. From May 1, 1999 through December 31, 2006, the former Triad hospitals obtained insurance coverage on a claims incurred basis from HCA’s wholly-owned insurance subsidiary, with excess coverage obtained from other carriers that is subject to certain

deductibles. Effective for claims incurred after December 31, 2006, Triad began insuring its claims from $1 million to $5 million through its wholly-owned captive insurance company, replacing the coverage provided by HCA. Substantially all claims occurring during 2007 were self-insured up to $10 million per claim.

Legal Matters. 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 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.

Summary of Recorded Amounts

The table below presents a reconciliation of the beginning and ending liability balances (in millions) during the years ended December 31, 2020 and 2019, 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 December 31, 2020 is comprised of individually insignificant amounts for various matters.

	Probable
	Contingencies
Balance as of December 31, 2018	$	19
Expense		87
Reserve for insured claim		(4	)
Cash payments		(34	)
Balance as of December 31, 2019		68
Expense		14
Reserve for insured claim		11
Cash payments		(82	)
Balance as of December 31, 2020	$	11

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 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 consolidated balance sheet.

In the aggregate, attorneys’ fees and other costs incurred but not included in the table above related to probable contingencies totaled $3 million, $21 million and $2 million during the years ended December 31, 2020, 2019 and 2018, respectively, and are included in other operating expenses in the accompanying consolidated statements of income (loss).

Subsequent Events

12 Months Ended

Dec. 31, 2020

Subsequent Events [Abstract]

Subsequent Events

16. SUBSEQUENT EVENTS

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

Divestitures:

On January 1, 2021, one or more affiliates of the Company completed 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 pursuant to the terms of a definitive agreement which was entered into September 8, 2020. The net proceeds from this sale were received at a preliminary closing on December 31, 2020.

On January 1, 2021, one or more affiliates of the Company completed 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 pursuant to the terms of a definitive agreement which was entered into September 30, 2020. The net proceeds from this sale were received at a preliminary closing on December 31, 2020.

On February 1, 2021, one or more affiliates of the Company completed the sale of substantially all of the assets of Northwest Mississippi Medical Center (181 licensed beds) in Clarksdale, Mississippi to affiliates of Delta Health System pursuant to the terms of a definitive agreement which was entered into October 30, 2020, as referenced above.

Financing Transactions:

On January 6, 2021, $30 million of the Company’s outstanding letters of credit of $150 million issued as of December 31, 2020 was cancelled in relation to a professional liability claim that was settled and funded in the three months ended December 31, 2020.

On January 28, 2021, the remaining principal amount of the 6¼% Senior Secured Notes due 2023 of approximately $95 million was redeemed using proceeds from the issuance of the 5⅝% Senior Secured Notes due 2027 and 6% Senior Secured Notes due 2029 which was completed on December 28, 2020.

On January 29, 2021, the Company issued a notice of redemption to redeem on February 28, 2021 all of the 6⅞% Secured Notes due 2022 then outstanding at a redemption price of 100% of the principal amount thereof plus accrued and unpaid interest to, but not including, February 28, 2021.

On February 2, 2021, the Company completed a private offering of $1.775 billion aggregate principal amount of 6⅞% Junior-Priority Secured Notes due April 15, 2029 (the “6⅞% Junior-Priority Secured Notes due 2029”). The proceeds of the offering were used to redeem the 9⅞% Junior-Priority Secured Notes due 2023 via a tender offer which was funded on February 2, 2021, or to the extent not tendered, to fund the redemption of the remaining notes on February 4, 2021. The 6⅞% Junior-Priority Secured Notes due 2029 bear interest at a rate of 6⅞% per year payable semi-annually in arrears on April 15 and October 15 of each year, commencing on October 15, 2021. The 6⅞% Junior-Priority Secured Notes due 2029 are unconditionally guaranteed on a junior-priority secured basis by the Company and each of CHS’ current and future domestic subsidiaries that provide guarantees under the CHS’ ABL Facility, any capital market debt securities of CHS (including CHS’ outstanding senior notes) and certain other long-term debt of CHS.

The 6⅞% Junior-Priority Secured Notes due 2029 and the related guarantees are secured by shared (i) second-priority liens on the Non-ABL Priority Collateral that secures on a first-priority basis the CHS’s senior-priority secured notes and (ii) third-priority liens on the ABL-Priority Collateral that secures on a first-priority basis the ABL Facility (and also secures on a second-priority basis CHS’s senior-priority secured notes), in each case subject to permitted liens described in the indenture governing the 6⅞% Junior-Priority Secured Notes due 2029.

At any time and from time to time prior to April 15, 2024, CHS may redeem the 6⅞% Junior-Priority Secured Notes due 2029 in whole or in part, at its option, upon not less than 15 nor more than 60 days’ prior written notice at a redemption price equal to 100% of the principal amount of the 6⅞% Junior-Priority Secured Notes due 2029 to be redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 6⅞% Junior-Priority Secured Notes due 2029. In addition, CHS may redeem up to 40% of the aggregate principal amount of the 6⅞% Junior-Priority Secured Notes due 2029 at any time prior to April 15, 2024 using the net proceeds from certain equity offerings at a redemption price of 106.875% of the principal amount of the 6⅞% Junior-Priority Secured Notes due 2029 redeemed, plus accrued and unpaid interest, if any.

At any time and from time to time on or after April 15, 2024, CHS may redeem the 6⅞% Junior-Priority Secured Notes due 2029 in whole or in part, upon not less than 15 nor more than 60 days’ prior written notice at a redemption price equal to the percentage of principal amount set forth below plus accrued and unpaid interest, if any, on the 6⅞% Junior-Priority Secured Notes due 2029 redeemed, to, but excluding, the applicable date of redemption, if redeemed during the twelve-month period beginning on April 15 of the years indicated below:

Period	Redemption Price
April 15, 2024 to April 14, 2025		103.438	%
April 15, 2025 to April 14, 2026		101.719	%
April 15, 2026 to April 14, 2029		100.000	%

On February 9, 2021, the Company completed a private offering of $1.095 billion aggregate principal amount of 4¾% Senior Secured Notes due February 15, 2031 (the “4¾% Senior Secured Notes due 2031”). The proceeds of the offering were used to redeem the 8⅝% Senior Secured Notes due 2024 on February 9, 2021. The 4¾% Senior Secured Notes due 2031 bear interest at a rate of 4¾% per year payable semi-annually in arrears on February 15 and August 15, commencing on August 15, 2021. The 4¾% Senior Secured Notes due 2031 are unconditionally guaranteed on a senior-priority secured basis by each of CHS’ current and future domestic subsidiaries that provide guarantees under the ABL facility, any capital market debt securities of CHS (including CHS’ outstanding senior notes) and certain other long-term debt of CHS.

The 4¾% Senior Secured Notes due 2031 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 4¾% Senior Secured Notes due 2031.

CHS is entitled, at its option, to redeem all or a portion of the 4¾% Senior Secured Notes due 2031 at any time prior to February 15, 2026, upon not less than 15 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 4¾% Senior Secured Notes due 2031 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 4¾% Senior Secured Notes due 2031.

CHS may redeem up to 40% of the aggregate principal amount of the 4¾% Senior Secured Notes due 2031 at any time prior to February 15, 2024 using the net proceeds from certain equity offerings at a redemption price of 104.750% of the principal amount of the 4¾% Senior Secured Notes due 2031 redeemed, plus accrued and unpaid interest, if any. In addition, any time prior to February 15, 2026, but not more than once during each twelve-month period, the issuer may redeem up to 10% of the original aggregate principal amount of the 4¾% Senior Secured Notes due 2031 at a redemption price equal to 103% of the principal amount of the 4¾% Senior Secured Notes due 2031 to be redeemed, plus accrued and unpaid interest, if any.

At any time and from time to time on or after February 15, 2026, CHS may redeem the 4¾% Senior Secured Notes due 2031 in whole or in part, upon not less than 15 nor more than 60 days’ prior written notice at a redemption price equal to the percentage of principal amount set forth below plus accrued and unpaid interest, if any, on the 4¾% Senior Secured Notes due 2031 redeemed, to, but excluding, the applicable date of redemption, if redeemed during the twelve-month period beginning on February 15 of the years indicated below:

Period	Redemption Price
February 15, 2026 to February 14, 2027		102.375	%
February 15, 2027 to February 14, 2028		101.583	%
February 15, 2028 to February 14, 2029		100.792	%
February 15, 2029 to February 14, 2031		100.000	%

Condensed Financial Information of Parent

12 Months Ended

Dec. 31, 2020

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Condensed Financial Information of Parent

17. CONDENSED FINANCIAL INFORMATION OF PARENT

Parent Company Only
Condensed Balance Sheet
(In millions)
	December 31,
	2020			2019
ASSETS
Prepaid income taxes	$	50		$	48
Total current assets		50			48
Deferred income taxes		59			38
Other assets, net		(3	)		(4	)
Total assets	$	106		$	82
LIABILITIES AND (DEFICIT) EQUITY
Intercompany payable	$	1,701		$	2,099
Deferred income taxes		29			200
Other long-term liabilities		1			1
Total liabilities		1,731			2,300
Community Health Systems, Inc. stockholders’ (deficit) equity:
Preferred stock		-			-
Common stock		1			1
Additional paid-in capital		2,094			2,008
Accumulated other comprehensive (loss) income		(13	)		(9	)
(Accumulated deficit) retained earnings		(3,707	)		(4,218	)
Total Community Health Systems, Inc. stockholders’ (deficit) equity		(1,625	)		(2,218	)
Total liabilities and (deficit) equity	$	106		$	82

See note to condensed financial statements of parent company.

Parent Company Only
Condensed Statements of Income (Loss)
(In millions)
	Year Ended December 31,
	2020			2019			2018
Net operating revenues	$	-		$	-		$	-
Operating costs and expenses:
Salaries and benefits		-			-			-
Supplies		-			-			-
Other operating expenses		-			-			-
Government and other legal settlements and related costs		-			-			-
Electronic health records incentive reimbursement		-			-			-
Lease cost and rent		-			-			-
Pandemic relief funds		-			-			-
Depreciation and amortization		-			-			-
Impairment and (gain) loss on sale of businesses, net		-			-			-
Total operating costs and expenses		-			-			-
Income from operations		-			-			-
Interest expense, net		-			-			-
(Gain) loss from early extinguishment of debt		-			-			-
Equity in earnings of unconsolidated affiliates		(511	)		675			788
Income (loss) before income taxes		511			(675	)		(788	)
(Benefit from) provision for income taxes		-			-			-
Net income (loss)		511			(675	)		(788	)
Less: Net income attributable to noncontrolling interests		-			-			-
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$	511		$	(675	)	$	(788	)

See note to condensed financial statements of parent company.

Parent Company Only
Condensed Statements of Comprehensive Income (Loss)
(In millions)
	Year Ended December 31,
	2020			2019			2018
				(In millions)
Net income (loss)	$	511		$	(675	)	$	(788	)
Equity in other comprehensive (loss) income of affiliates, net of income taxes:
Net change in fair value of interest rate swaps, net of tax		(1	)		(3	)		20
Net change in fair value of available-for-sale debt securities, net of tax		4			4			(2	)
Amortization and recognition of unrecognized pension cost components, net of tax		(7	)		-			(1	)
Other comprehensive (loss) income		(4	)		1			17
Comprehensive income (loss)		507			(674	)		(771	)
Less: Comprehensive income attributable to noncontrolling interests		-			-			-
Comprehensive income (loss) attributable to Community Health Systems, Inc. stockholders	$	507		$	(674	)	$	(771	)

See note to condensed financial statements of parent company.

Parent Company Only
Condensed Statements of Cash Flows
(In millions)
	Year Ended December 31,
	2020			2019			2018
Cash flows from operating activities:
Net cash (used in) provided by operating activities	$	(12	)	$	(4	)	$	40
Cash flows from investing activities:
Net cash provided by (used in) investing activities		-			-			-
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements		(1	)		(1	)		(1	)
Changes in intercompany balances with affiliates, net		13			5			(39	)
Net cash provided by (used in) financing activities		12			4			(40	)
Net change in cash and cash equivalents		-			-			-
Cash and cash equivalents at beginning of period		-			-			-
Cash and cash equivalents at end of period	$	-		$	-		$	-

See note to condensed financial statements of parent company.

Basis of Presentation

Community Health Systems, Inc. (the “Parent Company”) is a holding company and operates no business in its own name; all of the Company’s business operations are conducted through subsidiaries of the Parent Company. The Company’s outstanding indebtedness restricts the ability of subsidiaries to dividend or otherwise provide funds to the Parent Company. Accordingly, these financial statements have been presented on a “parent-only” basis. Under parent-only presentation, the Parent Company’s investments in its consolidated subsidiaries are presented under the equity method of accounting. These parent-only financial statements should be read in conjunction with consolidated financial statements of Community Health Systems, Inc.

Basis of Presentation and Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Basis of Accounting

Use of Estimates

Principles of Consolidation

Cost of Revenue

Cash Equivalents

Cash Equivalents. The Company considers highly liquid investments with original maturities of three months or less to be cash equivalents.

Supplies

Supplies. Supplies, principally medical supplies, are stated at the lower of cost (first-in, first-out basis) or market.

Marketable Securities

Property and Equipment

Goodwill

Other Assets

Revenue Recognition

Net Operating Revenues

	Year Ended December 31,
	2020			2019		2018
Medicare	$	2,813		$	3,331	$	3,730
Medicaid		1,578			1,736		1,876
Managed Care and other third-party payors		7,400			8,014		8,349
Self-pay		(2	)		129		200
Total	$	11,789		$	13,210	$	14,155

Patient Accounts Receivable

Charity Care

Electronic Health Records Incentive Reimbursement

Leases

Physician Income Guarantees

Concentrations of Credit Risk

Accounting for the Impairment or Disposal of Long-Lived Assets

Income Taxes

Comprehensive Loss

Comprehensive Loss. Comprehensive loss is the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources.

Segment Reporting

COVID-19 Pandemic

Pandemic Relief Funds

Medicare Accelerated Payments

New Accounting Pronouncements

Acquisitions

Fair Value of Financial Instruments

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.

Fair Value

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.

Legal Matters

Basis of Presentation and Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Net Operating Revenues

	Year Ended December 31,
	2020			2019		2018
Medicare	$	2,813		$	3,331	$	3,730
Medicaid		1,578			1,736		1,876
Managed Care and other third-party payors		7,400			8,014		8,349
Self-pay		(2	)		129		200
Total	$	11,789		$	13,210	$	14,155

Accounting for Stock-Based Compensation (Tables)

12 Months Ended

Dec. 31, 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):

	Year Ended December 31,
	2020			2019			2018
Effect on income (loss) before income taxes	$	(13	)	$	(10	)	$	(13	)
Effect on net income (loss)	$	(10	)	$	(8	)	$	(10	)

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

	Year Ended December 31,
	2020		2019			2018
Expected volatility	73.5%			68.4	%	N/A%
Expected dividends		-		-		N/A
Expected term	6.0 years		5.6 years			N/A
Risk-free interest rate	1.0%			2.6	%	N/A%

Schedule of Share-based Compensation, Stock Options, Activity

	Shares			Weighted- Average Exercise Price		Weighted- Average Remaining Contractual Term	Aggregate Intrinsic Value as of December 31, 2020
Outstanding at December 31, 2017		1,115,667		$	31.56
Granted		-			-
Exercised		-			-
Forfeited and cancelled		(490,729	)		32.01
Outstanding at December 31, 2018		624,938			31.21
Granted		658,500			4.95
Exercised		-			-
Forfeited and cancelled		(173,304	)		23.04
Outstanding at December 31, 2019		1,110,134			16.90
Granted		946,500			4.93
Exercised		(18,166	)		4.99
Forfeited and cancelled		(220,943	)		33.52
Outstanding at December 31, 2020		1,817,525		$	8.77	7.6 years	$	4
Exercisable at December 31, 2020		455,021		$	20.24	3.7 years	$	-

Schedule of Share-based Compensation, Restricted Stock, Activity

Restricted stock outstanding under the 2009 Plan as of December 31, 2020, and changes during each of the years in the three-year period prior to December 31, 2020, were as follows:

	Shares			Weighted- Average Grant Date Fair Value
Unvested at December 31, 2017		2,643,919		$	16.17
Granted		1,987,000			4.54
Vested		(1,154,670	)		23.22
Forfeited		(167,342	)		10.29
Unvested at December 31, 2018		3,308,907			7.00
Granted		1,989,000			4.94
Vested		(1,160,667	)		8.89
Forfeited		(279,838	)		5.60
Unvested at December 31, 2019		3,857,402			5.47
Granted		2,205,500			4.90
Vested		(1,123,329	)		5.84
Forfeited		(383,838	)		8.58
Unvested at December 31, 2020		4,555,735			4.84

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

RSUs outstanding under the 2009 Plan as of December 31, 2020, and changes during each of the years in the three-year period prior to December 31, 2020, were as follows:

	Shares			Weighted- Average Grant Date Fair Value
Unvested at December 31, 2017		172,078		$	12.78
Granted		296,944			4.58
Vested		(71,116	)		15.51
Forfeited		-			-
Unvested at December 31, 2018		397,906			6.17
Granted		306,612			4.99
Vested		(162,942	)		7.42
Forfeited		-			-
Unvested at December 31, 2019		541,576			5.13
Granted		310,347			4.93
Vested		(238,184	)		5.47
Forfeited		-			-
Unvested at December 31, 2020		613,739			4.89

Acquisitions and Divestitures (Tables)

12 Months Ended

Dec. 31, 2020

Schedule of Divestitures

The following table provides a summary of hospitals that the Company divested during the years ended December 31, 2020, 2019 and 2018.

Hospital	Buyer	City, State	Licensed Beds		Effective Date
2020 Divestitures:
Berwick Hospital Center	Fayette Holdings, Inc.	Berwick, PA		90	December 1, 2020
Brownwood Regional Medical Center	Hendrick Health System	Brownwood, TX		188	October 27, 2020
Abilene Regional Medical Center	Hendrick Health System	Abilene, TX		231	October 27, 2020
San Angelo Community Medical Center	Shannon Health System	San Angelo, TX		171	October 24, 2020
Bayfront Health St. Petersburg	Orlando Health, Inc.	St. Petersburg, FL		480	October 1, 2020
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	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

2018 Divestitures:
Sparks Regional Medical Center	Baptist Health	Fort Smith, AR		492	November 1, 2018
Sparks Medical Center - Van Buren	Baptist Health	Van Buren, AR		103	November 1, 2018
AllianceHealth Deaconess	INTEGRIS Health	Oklahoma City, OK		238	October 1, 2018
Munroe Regional Medical Center	Adventist Health System	Ocala, FL		425	August 1, 2018
Tennova Healthcare - Dyersburg Regional	West Tennessee Healthcare	Dyersburg, TN		225	June 1, 2018
Tennova Healthcare - Regional Jackson	West Tennessee Healthcare	Jackson, TN		150	June 1, 2018
Tennova Healthcare - Volunteer Martin	West Tennessee Healthcare	Martin, TN		100	June 1, 2018
Williamson Memorial Hospital	Mingo Health Partners, LLC	Williamson, WV		76	June 1, 2018
Byrd Regional Hospital	Allegiance Health Management	Leesville, LA		60	June 1, 2018
Tennova Healthcare - Jamestown	Rennova Health, Inc.	Jamestown, TN		85	June 1, 2018
Bayfront Health Dade City	Adventist Health System	Dade City, FL		120	April 1, 2018

Schedule of Balance Sheet Items Classified as Held for Sale

	December 31,
	2020		2019
Other current assets	$	12	$	25
Other assets, net		11		262
Accrued liabilities		16		43

Hospitals Included in Continuing Operations [Member]

Schedule Of Operating Results Included In Consolidated Statement Of Income

Summary financial results of these hospitals for the periods included in the accompanying consolidated statements of income (loss) are as follows (in millions):

	Year Ended December 31,
	2020			2019			2018
Loss before income taxes	$	(144	)	$	(103	)	$	(465	)
Less: Loss attributable to noncontrolling interests		(6	)		(8	)		(5)
Loss from operations before income taxes attributable
to Community Health Systems, Inc. stockholders	$	(138	)	$	(95	)	$	(460	)

- 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.

+ References

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+ Details

Goodwill and Other Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

The changes in the carrying amount of goodwill for the years ended December 31, 2020 and 2019 are as follows (in millions):

Balance, beginning balance	2020			2019
Goodwill	$	7,142		$	7,373
Accumulated impairment losses		(2,814	)		(2,814	)
		4,328			4,559
Goodwill acquired as part of acquisitions during current year		1			4
Goodwill allocated to hospitals held for sale		(110	)		(235	)

Balance, end of year
Goodwill		7,033			7,142
Accumulated impairment losses		(2,814	)		(2,814	)
	$	4,219		$	4,328

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Schedule of (Benefit from) Provision for Income Taxes

The (benefit from) provision for income taxes consists of the following (in millions):

	Year Ended December 31,
	2020			2019			2018
Current:
Federal	$	(1	)	$	(38	)	$	1
State		3			(5	)		(9	)
		2			(43	)		(8	)
Deferred:
Federal		(162	)		179			50
State		(25	)		24			(53	)
		(187	)		203			(3	)
Total (benefit from) provision for income taxes for income (loss)	$	(185	)	$	160		$	(11	)

Schedule of Reconciliation between the Statutory Federal Income Tax Rate and the Effective Tax Rate

The following table reconciles the differences between the statutory federal income tax rate and the effective tax rate (dollars in millions):

	Year Ended December 31,
	2020						2019						2018
	Amount			%			Amount			%			Amount			%
Provision for (benefit from) income taxes at statutory federal rate	$	89			21.0	%	$	(90	)		21.0	%	$	(150	)		21.0	%
State income taxes, net of federal income tax benefit		(15	)		(3.6	)		(104	)		24.3			(114	)		16.0
Net income attributable to noncontrolling interests		(20	)		(4.7	)		(18	)		4.2			(18	)		2.5
Change in valuation allowance		(267	)		(63.2	)		340			(79.2	)		212			(29.7	)
Change in uncertain tax position		-			-			-			-			9			(1.3	)
Federal and state tax credits		-			-			-			-			(17	)		2.4
Nondeductible goodwill		41			9.8			11			(2.6	)		30			(4.2	)
Nondeductible settlements		-			-			-			-			22			(3.1	)
Nondeductible loss on divestiture		(15	)		(3.4	)		15			(3.5	)		-			-
Other		2			0.3			6			(1.4	)		15			(2.1	)
(Benefit from) provision for income taxes and effective tax rate for income (loss)	$	(185	)		(43.8	)%	$	160			(37.2	)%	$	(11	)		1.5	%

Schedule of Components of Deferred Income Taxes

	December 31,
	2020					2019
	Assets			Liabilities		Assets			Liabilities
Net operating loss and credit carryforwards	$	873		$	-	$	775		$	-
Property and equipment		-			300		-			335
Self-insurance liabilities		58			-		48			-
Prepaid expenses		-			29		-			30
Intangibles		-			127		-			149
Investments in unconsolidated affiliates		-			57		-			57
Other liabilities		-			9		-			9
IRC Section 481(a) - mixed service cost		-			106		-			216
Long-term debt and interest		154			-		312			-
Accounts receivable		52			-		62			-
IRC Section 163(j) interest limitation		108			-		296			-
Accrued vacation		22			-		24			-
Accrued bonus		32			-		31			-
Other comprehensive income		6			-		5			-
Right-of-use assets		-			150		-			145
Right-of-use liability		155			-		149			-
Stock-based compensation		4			-		5			-
Deferred compensation		69			-		70			-
Other		57			-		51			-
Total		1,590			778		1,828			941
Valuation allowance		(781	)		-		(1,049	)		-
Total deferred income taxes	$	809		$	778	$	779		$	941

Schedule of Reconciliation of the Total Amount of Unrecognized Tax Benefit

The following is a tabular reconciliation of the total amount of unrecognized tax benefit for the years ended December 31, 2020, 2019 and 2018 (in millions):

	Year Ended December 31,
	2020		2019			2018
Unrecognized tax benefit, beginning of year	$	26	$	29		$	18
Gross increases — tax positions in current period		19		10			11
Settlements		-		(13	)		-
Unrecognized tax benefit, end of year	$	45	$	26		$	29

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2020

Debt Instrument [Line Items]

Schedule of Debt

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

	December 31,
	2020			2019
5⅛% Senior Secured Notes due 2021	$	-		$	1,000
6⅞% Senior Notes due 2022		126			231
6¼% Senior Secured Notes due 2023		95			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
5⅝% Senior Secured Notes due 2027		1,900			-
6⅞% Senior Notes due 2028		767			1,700
6% Senior Secured Notes due 2029		900			-
9⅞% Junior-Priority Secured Notes due 2023		1,769			1,770
8⅛% Junior-Priority Secured Notes due 2024		1,348			1,355
ABL Facility		-			273
Finance lease and financing obligations		239			272
Other		26			17
Less: Unamortized deferred debt issuance costs and note premium		(250	)		(147	)
Total debt		12,216			13,405
Less: Current maturities		(123	)		(20	)
Total long-term debt	$	12,093		$	13,385

Schedule of Maturities of Long-term Debt

As of December 31, 2020, the scheduled maturities of long-term debt outstanding, including finance lease obligations for each of the next five years and thereafter are as follows (in millions):

Year Ending December 31,	Amount
2021	$	123
2022		137
2023		1,776
2024		2,387
2025		1,469
Thereafter		6,574
Total maturities		12,466
Less: Deferred debt issuance costs		(230	)
Plus: Unamortized note premium		(20	)
Total long-term debt	$	12,216

Senior Secured Notes at 5.125%, Due 2021 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Senior Notes at 6.875%, Due 2022 | Senior Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Senior Secured Notes at 6.25%, Due 2023 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
March 31, 2020 to March 30, 2021		103.125	%
March 31, 2021 to March 30, 2022		101.563	%
March 31, 2022 to March 30, 2023		100.000	%

Junior-Priority Secured Notes at 9.875% Due 2023 | Junior-Priority Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
June 30, 2020 to June 29, 2021		107.406	%
June 30, 2021 to June 29, 2022		103.703	%
June 30, 2022 to June 29, 2023		100.000	%

Junior-Priority Secured Notes at 8.125% Due 2024 | Junior-Priority Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
June 30, 2021 to June 29, 2022		104.063	%
June 30, 2022 to June 29, 2023		102.031	%
June 30, 2023 to June 29, 2024		100.000	%

Senior Secured Notes at 8.625%, Due 2024 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
January 15, 2021 to January 14, 2022		104.313	%
January 15, 2022 to January 14, 2023		102.156	%
January 15, 2023 to January 14, 2024		100.000	%

Senior Secured Notes at 6.625% Due 2025 | Senior Secured Notes

Debt Instrument [Line Items]

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	%

Senior Secured Notes at 8%, Due 2026 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
March 15, 2022 to March 14, 2023		104.000	%
March 15, 2023 to March 14, 2024		102.000	%
March 15, 2024 to March 14, 2026		100.000	%

Senior Secured Notes at 8% Due 2027 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
December 15, 2022 to December 14, 2023		104.000	%
December 15, 2023 to December 14, 2024		102.000	%
December 15, 2024 to December 14, 2027		100.000	%

5⅝% Senior Secured Notes due 2027 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
December 15, 2023 to December 14, 2024		102.813	%
December 15, 2024 to December 14, 2025		101.406	%
December 15, 2025 to December 14, 2027		100.000	%

Senior Notes at 6.875% Due 2028 | Senior Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
April 1, 2023 to March 31, 2024		103.438	%
April 1, 2024 to March 31, 2025		101.719	%
April 1, 2025 to March 31, 2028		100.000	%

6% Senior Secured Notes due 2029 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
January 15, 2024 to January 14, 2025		103.000	%
January 15, 2025 to January 14, 2026		101.500	%
January 15, 2026 to January14, 2029		100.000	%

Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2020

Fair Value Disclosures [Abstract]

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

	December 31, 2020				December 31, 2019
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	1,676	$	1,676	$	216	$	216
Investments in equity securities		129		129		141		141
Available-for-sale debt securities		110		110		101		101
Trading securities		12		12		12		12
Liabilities:
5⅛% Senior Secured Notes due 2021		-		-		990		1,003
6⅞% Senior Notes due 2022		125		125		229		188
6¼% Senior Secured Notes due 2023		95		99		3,074		3,148
8⅝% Senior Secured Notes due 2024		1,025		1,080		1,023		1,099
6⅝% Senior Secured Notes due 2025		1,427		1,543		-		-
8% Senior Secured Notes due 2026		2,074		2,275		2,070		2,182
8% Senior Secured Notes due 2027		692		760		691		700
5⅝% Senior Secured Notes due 2027		1,809		2,048		-		-
6⅞% Senior Notes due 2028		758		618		1,678		1,700
6% Senior Secured Notes due 2029		857		973		-		-
9⅞% Junior-Priority Secured Notes due 2023		1,756		1,861		1,754		1,539
8⅛% Junior-Priority Secured Notes due 2024		1,336		1,408		1,340		1,113
ABL Facility and other debt		23		23		285		285

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

The following tabular disclosure provides the amount of pre-tax (loss) gain recognized as a component of OCI during the years ended December 31, 2020, 2019 and 2018 (in millions):

	Amount of Pre-Tax (Loss) Gain
	Recognized in OCI (Effective Portion)
	Year Ended December 31,
Derivatives in Cash Flow Hedging Relationships	2020		2019			2019
Interest rate swaps	$	-	$	(3	)	$	17

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

	Amount of Pre-Tax Loss Reclassified
	from AOCL into Income (Effective Portion)
Location of Loss Reclassified from	Year Ended December 31,
AOCL into Income (Effective Portion)	2020		2019		2018
Interest expense, net	$	2	$	-	$	2

Fair Value (Tables)

12 Months Ended

Dec. 31, 2020

Fair Value Disclosures [Abstract]

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

	December 31, 2020		Level 1		Level 2		Level 3
Investments in equity securities	$	129	$	129	$	-	$	-
Available-for-sale debt securities		110		-		110		-
Trading securities		12		-		12		-
Total assets	$	251	$	129	$	122	$	-

	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	$	-

Supplemental Information Regarding Available-for-Sale Debt Securities

Supplemental information regarding the Company’s available-for-sale debt securities (all of which had no withdrawal restrictions) is set forth in the table below (in millions):

			Gross		Gross		Estimated
	Amortized		Unrealized		Unrealized		Fair
	Cost		Gains		Losses		Values
As of December 31, 2020:
Debt securities
Government	$	48	$	2	$	-	$	50
Corporate		38		2		-		40
Mortgage and asset-backed securities		19		1		-		20
Total	$	105	$	5	$	-	$	110

			Gross		Gross			Estimated
	Amortized		Unrealized		Unrealized			Fair
	Cost		Gains		Losses			Values
As of December 31, 2019:
Debt securities
Government	$	54	$	1	$	(1	)	$	54
Corporate		33		1		-			34
Mortgage and asset-backed securities		13		-		-			13
Total	$	100	$	2	$	(1	)	$	101

Contractual Maturities of Debt Securities

	December 31, 2020				December 31, 2019
	Amortized		Estimated		Amortized		Estimated
	Cost		Fair Values		Cost		Fair Values
Within 1 year	$	3	$	3	$	9	$	9
After 1 year and through year 5		26		27		19		20
After 5 years and through year 10		30		32		29		29
After 10 years		46		48		43		43

Gross Realized Gains and Losses and Investment Income on Available-for-Sale Debt Securities

Gross realized gains and losses on sales of available-for-sale debt securities are summarized in the table below (in millions):

	Year Ended December 31,
	2020			2019		2018
Realized gains	$	2		$	-	$	-
Realized losses		(1	)		-		-

Net Gains and Losses Recognized for Investments in Equity Securities

	Year Ended December 31,
	2020			2019
Net gains and (losses), beginning of year	$	9		$	15
Less: Net gains and (losses) recognized during the year on equity securities sold during the year		14			2
Unrealized gains and (losses) recognized during the year on equity securities held, end of year	$	(5	)	$	13

Leases (Tables)

12 Months Ended

Dec. 31, 2020

Leases [Abstract]

Components of Lease Cost and Rent Expense

The components of lease cost and rent expense for the year ended December 31, 2020 and 2019 are as follows (in millions):

	Year Ended December 31,
Lease Cost	2020			2019
Operating lease cost:
Operating lease cost	$	203		$	194
Short-term rent expense		104			114
Variable lease cost		26			18
Sublease income		(6	)		(5	)
Total operating lease cost	$	327		$	321
Finance lease cost:
Amortization of right-of-use assets	$	10		$	12
Interest on finance lease liabilities		8			7
Total finance lease cost	$	18		$	19

Supplemental Balance Sheet Information Related to Leases

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

	Balance Sheet Classification	December 31, 2020			December 31, 2019
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	642		$	607

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		134			154
	Equipment and fixtures		8			11
	Property and equipment		150			173
	Less accumulated depreciation and amortization		(46	)		(56	)
	Property and equipment, net	$	104		$	117

Current finance lease liabilities	Current maturities of long-term debt	$	5		$	6
Long-term finance lease liabilities	Long-term debt		74			107

Supplemental Cash Flow and Other Information Related to Leases

Supplemental cash flow information related to leases for the year ended December 31, 2020 and 2019 are as follows (in millions):

	Year Ended December 31,
Cash flow information	2020			2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases (1)	$	188		$	167
Operating cash flows from finance leases		8			7
Financing cash flows from finance leases		7			9
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		150			122
Weighted-average remaining lease term:
Operating leases	7 years			6 years
Finance leases	19 years			20 years
Weighted-average discount rate:
Operating leases		9.0	%		9.1	%
Finance leases		8.4	%		5.6	%

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

Commitments Relating To Noncancellable Operating And Finance Leases And Financing Obligations

Commitments relating to noncancellable operating and finance leases and financing obligations for each of the next five years and thereafter are as follows (in millions):

							Financing
Year Ending December 31,	Operating			Finance			Obligations
2021	$	193		$	10		$	12
2022		161			9			12
2023		127			8			13
2024		93			8			13
2025		77			8			13
Thereafter		253			150			103
Total minimum future payments		904			193			166
Less: Imputed interest		(238	)		(114	)		(6	)
Total liabilities		666			79			160
Less: Current portion		(142	)		(5	)		(2	)
Long-term liabilities	$	524		$	74		$	158

Stockholders' Deficit (Tables)

12 Months Ended

Dec. 31, 2020

Equity [Abstract]

Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit

	Year Ended December 31,
	2020		2019			2018
Net income (loss) attributable to Community Health Systems,
Inc. stockholders	$	511	$	(675	)	$	(788	)
Transfers to the noncontrolling interests:
Net increase (decrease) in Community Health
Systems, Inc. paid-in-capital for
purchase of subsidiary partnership interests		3		3			(4	)
Net transfers to the noncontrolling interests		3		3			(4	)
Change to Community Health Systems, Inc.
stockholders’ deficit from net income (loss) attributable to
Community Health Systems, Inc. stockholders
and transfers to noncontrolling interests	$	514	$	(672	)	$	(792	)

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

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

	Year Ended December 31,
	2020		2019		2018
Weighted-average number of shares outstanding — basic		115,491,022		113,739,046		112,728,274
Effect of dilutive securities:
Restricted stock awards		905,903		-		-
Employee stock options		122,785		-		-
Other equity-based awards		24,851		-		-
Weighted-average number of shares outstanding — diluted		116,544,561		113,739,046		112,728,274

Schedule of Antidilutive Securities

	Year Ended December 31,
	2020		2019		2018
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		2,821,511		3,508,968		2,152,408

Other Comprehensive Income (Tables)

12 Months Ended

Dec. 31, 2020

Equity [Abstract]

Schedule of Changes in Accumulated Other Comprehensive Income (Loss) by Component

The following tables present information about items reclassified out of accumulated other comprehensive loss by component for the years ended December 31, 2020 and 2019 (in millions, net of tax):

				Change in
				Fair Value of			Change in			Accumulated
	Change in Fair			Available-for-Sale			Unrecognized			Other
	Value of Interest			Debt			Pension Cost			Comprehensive
	Rate Swaps (1)			Securities (1)			Components			(Loss) Income
Balance as of December 31, 2019	$	2		$	(3	)	$	(8	)	$	(9	)
Other comprehensive (loss)
income before reclassifications		(1	)		6			(1	)		4
Amounts reclassified from
accumulated other
comprehensive (loss) income		-			(2	)		(6	)		(8	)
Net current-period other
comprehensive (loss) income		(1	)		4			(7	)		(4	)
Balance as of December 31, 2020	$	-		$	2		$	(15	)	$	(13	)

(1) Totals may not add due to rounding.

				Change in			Change in			Accumulated
	Change in Fair			Fair Value of			Unrecognized			Other
	Value of Interest			Available-for-Sale			Pension Cost			Comprehensive
	Rate Swaps			Debt Securities			Components			(Loss) Income
Balance as of December 31, 2018	$	5		$	(7	)	$	(8	)	$	(10	)
Other comprehensive (loss)
income before reclassifications		(3	)		5			(1	)		1
Amounts reclassified from
accumulated other
comprehensive (loss) income		-			(1	)		1			-
Net current-period other
comprehensive (loss) income		(3	)		4			-			1
Balance as of December 31, 2019	$	2		$	(3	)	$	(8	)	$	(9	)

Schedule of Amounts Reclassified Out of Accumulated Other Comprehensive Income (Loss)

	Amount reclassified
	from AOCL			Affected line item in the
Details about accumulated other	Year Ended			statement where net
comprehensive income (loss) components	December 31, 2020			income (loss) is presented
Amortization of defined benefit pension items
Prior service costs	$	(1	)	Salaries and benefits
Settlement losses recognized		(3	)	Salaries and benefits
		(4	)	Total before tax
		10		Tax benefit
	$	6		Net of tax

	Amount reclassified
	from AOCL			Affected line item in the
Details about accumulated other	Year Ended			statement where net
comprehensive income (loss) components	December 31, 2019			income (loss) is presented
Gains and losses on cash flow hedges
Interest rate swaps	$	-		Interest expense, net
		-		Tax benefit
	$	-		Net of tax

Amortization of defined benefit pension items
Prior service costs	$	(1	)	Salaries and benefits
Settlement losses recognized		-		Salaries and benefits
		(1	)	Total before tax
		-		Tax benefit
	$	(1	)	Net of tax

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2020

Commitments And Contingencies Disclosure [Abstract]

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

	Probable
	Contingencies
Balance as of December 31, 2018	$	19
Expense		87
Reserve for insured claim		(4	)
Cash payments		(34	)
Balance as of December 31, 2019		68
Expense		14
Reserve for insured claim		11
Cash payments		(82	)
Balance as of December 31, 2020	$	11

- 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
-Topic 450
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-URI http://asc.fasb.org/extlink&oid=121555522&loc=d3e12053-110248

+ Details

Subsequent Events (Tables)

12 Months Ended

Dec. 31, 2020

Junior-Priority Secured Notes at 6.875% Due 2029 | Junior-Priority Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
April 15, 2024 to April 14, 2025		103.438	%
April 15, 2025 to April 14, 2026		101.719	%
April 15, 2026 to April 14, 2029		100.000	%

Senior Secured Notes at 4.75%, Due 2031 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
February 15, 2026 to February 14, 2027		102.375	%
February 15, 2027 to February 14, 2028		101.583	%
February 15, 2028 to February 14, 2029		100.792	%
February 15, 2029 to February 14, 2031		100.000	%

Condensed Financial Information of Parent (Tables)

12 Months Ended

Dec. 31, 2020

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Condensed Balance Sheets

Parent Company Only
Condensed Balance Sheet
(In millions)
	December 31,
	2020			2019
ASSETS
Prepaid income taxes	$	50		$	48
Total current assets		50			48
Deferred income taxes		59			38
Other assets, net		(3	)		(4	)
Total assets	$	106		$	82
LIABILITIES AND (DEFICIT) EQUITY
Intercompany payable	$	1,701		$	2,099
Deferred income taxes		29			200
Other long-term liabilities		1			1
Total liabilities		1,731			2,300
Community Health Systems, Inc. stockholders’ (deficit) equity:
Preferred stock		-			-
Common stock		1			1
Additional paid-in capital		2,094			2,008
Accumulated other comprehensive (loss) income		(13	)		(9	)
(Accumulated deficit) retained earnings		(3,707	)		(4,218	)
Total Community Health Systems, Inc. stockholders’ (deficit) equity		(1,625	)		(2,218	)
Total liabilities and (deficit) equity	$	106		$	82

See note to condensed financial statements of parent company.

Condensed Statements of Income (Loss)

Parent Company Only
Condensed Statements of Income (Loss)
(In millions)
	Year Ended December 31,
	2020			2019			2018
Net operating revenues	$	-		$	-		$	-
Operating costs and expenses:
Salaries and benefits		-			-			-
Supplies		-			-			-
Other operating expenses		-			-			-
Government and other legal settlements and related costs		-			-			-
Electronic health records incentive reimbursement		-			-			-
Lease cost and rent		-			-			-
Pandemic relief funds		-			-			-
Depreciation and amortization		-			-			-
Impairment and (gain) loss on sale of businesses, net		-			-			-
Total operating costs and expenses		-			-			-
Income from operations		-			-			-
Interest expense, net		-			-			-
(Gain) loss from early extinguishment of debt		-			-			-
Equity in earnings of unconsolidated affiliates		(511	)		675			788
Income (loss) before income taxes		511			(675	)		(788	)
(Benefit from) provision for income taxes		-			-			-
Net income (loss)		511			(675	)		(788	)
Less: Net income attributable to noncontrolling interests		-			-			-
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$	511		$	(675	)	$	(788	)

See note to condensed financial statements of parent company.

Condensed Statements of Comprehensive Income (Loss)

Parent Company Only
Condensed Statements of Comprehensive Income (Loss)
(In millions)
	Year Ended December 31,
	2020			2019			2018
				(In millions)
Net income (loss)	$	511		$	(675	)	$	(788	)
Equity in other comprehensive (loss) income of affiliates, net of income taxes:
Net change in fair value of interest rate swaps, net of tax		(1	)		(3	)		20
Net change in fair value of available-for-sale debt securities, net of tax		4			4			(2	)
Amortization and recognition of unrecognized pension cost components, net of tax		(7	)		-			(1	)
Other comprehensive (loss) income		(4	)		1			17
Comprehensive income (loss)		507			(674	)		(771	)
Less: Comprehensive income attributable to noncontrolling interests		-			-			-
Comprehensive income (loss) attributable to Community Health Systems, Inc. stockholders	$	507		$	(674	)	$	(771	)

See note to condensed financial statements of parent company.

Condensed Statement of Cash Flows

Parent Company Only
Condensed Statements of Cash Flows
(In millions)
	Year Ended December 31,
	2020			2019			2018
Cash flows from operating activities:
Net cash (used in) provided by operating activities	$	(12	)	$	(4	)	$	40
Cash flows from investing activities:
Net cash provided by (used in) investing activities		-			-			-
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements		(1	)		(1	)		(1	)
Changes in intercompany balances with affiliates, net		13			5			(39	)
Net cash provided by (used in) financing activities		12			4			(40	)
Net change in cash and cash equivalents		-			-			-
Cash and cash equivalents at beginning of period		-			-			-
Cash and cash equivalents at end of period	$	-		$	-		$	-

See note to condensed financial statements of parent company.

Basis of Presentation and Significant Accounting Policies - Additional Information (Details)					1 Months Ended	10 Months Ended	12 Months Ended
	Oct. 27, 2020 Item	Sep. 30, 2020 USD ($)	Jul. 01, 2020 Item	Jan. 01, 2020 Item	Apr. 30, 2020 USD ($)	Oct. 27, 2020 USD ($)	Dec. 31, 2020 USD ($) Item State	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Jan. 01, 2019 USD ($)
Business Description [Abstract]
Number of hospitals owned and leased by the Company \| Item							89
Number of stand alone rehabilitation or psychiatric hospitals \| Item							2
Number of licensed beds \| Item							14,110
Number of states in which entity operates \| State							16
Cost of Revenue, Policy [Abstract]
Corporate Office Costs							$ 190,000,000	$ 184,000,000	$ 181,000,000
Stock-based compensation expense							13,000,000	10,000,000	13,000,000
Marketable Securities, Policy [Abstract]
Net change in fair value of available-for-sale debt securities, net of tax							4,000,000	4,000,000	(2,000,000)
Property and Equipment, Policy [Abstract]
Construction in Progress, Gross							194,000,000	219,000,000
Interest Costs Capitalized							15,000,000	20,000,000	15,000,000
Purchases of property and equipment and internal-use software accrued in accounts payable							100,000,000	93,000,000
Goodwill, Policy [Abstract]
Impairment of goodwill							0	0	0
Third Party Reimbursement [Abstract]
Amounts due to third party payors							98,000,000	83,000,000
Amounts due from third party payors							136,000,000	137,000,000
Net Operating Revenues, Policy [Abstract]
Charity care services charges excluded from net operating revenues							1,000,000,000.0	540,000,000	491,000,000
Value of charity care services at the Company's standard charges included in contractual allowances							122,000,000	66,000,000	$ 62,000,000
New Accounting Pronouncements, Policy [Abstract]
Operating lease right-of-use asset							642,000,000	607,000,000
Operating lease liability							666,000,000
Concentration of Credit Risk, Policy [Abstract]
Accounts receivable, net of contractual allowances							1,927,000,000	2,258,000,000
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business							(48,000,000)
Goodwill allocated to hospital disposal group held for sale							$ 110,000,000
Medicare Accelerated Payments [Abstract]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]							true
Change in Accounting Principle, Accounting Standards Update, Adoption Date							Mar. 12, 2020
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false]							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
CARES Act \| Long-term Liabilities
Medicare Accelerated Payments [Abstract]
Medicare accelerated outstanding estimated amount under cares act							656,000,000
CARES Act \| Accrued Liabilities and Other
Medicare Accelerated Payments [Abstract]
Medicare accelerated payments under cares act							$ 425,000,000
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							$ 178,000,000,000
CARES Act and PPPHCE Act Funds [Abstract]
Payments through the PHSSEF and various state and local programs							705,000,000
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]
Payments through the PHSSEF and various state and local programs							601,000,000
Certain Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale								138,000,000
Goodwill allocated to hospital disposal group held for sale								235,000,000
Hospitals Closed
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business		$ (3,000,000)
Shared Service Center
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business							(1,000,000)
Hospitals Sold or Deemed Held for Sale
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business						$ 89,000,000	(59,000,000)
Number of hospitals sold \| Item	2		1	3
Hospitals Sold or Deemed Held for Sale \| Certain Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale								92,000,000
Adjustment for Carrying Value of Other Long-Lived Assets at Underperforming Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale							74,000,000
Adjustment for Carrying Value of Other Long-Lived Assets at Underperforming Hospitals \| Certain Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale								46,000,000
Medicare
Concentration of Credit Risk, Policy [Abstract]
Accounts receivable, net of contractual allowances							$ 232,000,000	$ 268,000,000
Accounts receivable net of contractual allowances, percent							6.00%	5.00%
Centers for Medicare & Medicaid Services \| CARES Act
Medicare Accelerated Payments [Abstract]
Medicare accelerated repayment under cares act							$ 77,000,000
Medicare accelerated payment recouped description							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 (or 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%
ASU 2016-02
New Accounting Pronouncements, Policy [Abstract]
Operating lease right-of-use asset										$ 673,000,000
Operating lease liability										$ 673,000,000
Physician Recruitment Contracts
Other Assets, Policy [Abstract]
Term of Physician Recruitment Contract							3 years
Physician Income Guarantees, Policy [Abstract]
Physicians recruitment agreement period							1 year
Term of Physician Recruitment Contract							3 years
Finite-lived intangible assets, net							$ 16,000,000	$ 20,000,000
Capitalized Internal Use Software, Significant System Conversions
Other Assets, Policy [Abstract]
Finite-Lived Intangible Assets, Weighted-Average Useful Life							3 years
Capitalized Internal Use Software Except Significant System Conversions
Other Assets, Policy [Abstract]
Finite-Lived Intangible Assets, Weighted-Average Useful Life							3 years
Maximum
Physician Income Guarantees, Policy [Abstract]
Finite-lived intangible assets, net							$ 1,000,000	$ 1,000,000
Land Improvements \| Minimum
Property and Equipment, Policy [Abstract]
Property, Plant and Equipment, Useful Life							3 years
Land Improvements \| Maximum
Property and Equipment, Policy [Abstract]
Property, Plant and Equipment, Useful Life							20 years
Building and Building Improvements \| Minimum
Property and Equipment, Policy [Abstract]
Property, Plant and Equipment, Useful Life							5 years
Building and Building Improvements \| Maximum
Property and Equipment, Policy [Abstract]
Property, Plant and Equipment, Useful Life							40 years
Equipment and Fixtures \| Minimum
Property and Equipment, Policy [Abstract]
Property, Plant and Equipment, Useful Life							3 years
Equipment and Fixtures \| Maximum
Property and Equipment, Policy [Abstract]
Property, Plant and Equipment, Useful Life							18 years
Certain Facility
Property and Equipment, Policy [Abstract]
Non-cash investing activity through capital leases							$ 22,000,000
Geographic Concentration Risk \| Indiana \| Sales Revenue, Net
Business Description [Abstract]
Concentration Risk, Percentage							15.00%	13.70%	12.50%
Geographic Concentration Risk \| Florida \| Sales Revenue, Net
Business Description [Abstract]
Concentration Risk, Percentage							13.00%	14.30%	14.30%
Geographic Concentration Risk \| Texas \| Sales Revenue, Net
Business Description [Abstract]
Concentration Risk, Percentage							12.20%	12.20%	11.70%

Basis of Presentation and Significant Accounting Policies - Schedule of Net Operating Revenues (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 11,789	$ 13,210	$ 14,155
Medicare
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	2,813	3,331	3,730
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	1,578	1,736	1,876
Managed Care and Other Third Party Payors
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	7,400	8,014	8,349
Self-Pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ (2)	$ 129	$ 200

- 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
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+ Details

Accounting for Stock-Based Compensation - Additional Information (Details)				12 Months Ended
	Mar. 01, 2020 USD ($) Director shares	Mar. 01, 2019 USD ($) shares	Mar. 01, 2018 USD ($) shares	Dec. 31, 2020 USD ($) Item $ / shares shares	Dec. 31, 2019 USD ($) Item $ / shares shares	Dec. 31, 2018 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				$ 16,000,000
Employee service share-based compensation total compensation cost not yet recognized, period for recognition				22 months
Employee service share-based compensation, nonvested awards, modifications to awards \| Item				0	0	0
Aggregate intrinsic value of options exercised					$ 0	$ 0
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of options exercised				$ 1,000,000
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				23 months
Employee service share-based compensation, unrecognized compensation costs on nonvested stock options				$ 3,000,000
Share-based compensation arrangement by share-based payment award, options, grants in period \| shares				946,500	658,500	0
Weighted-average grant date fair value of stock options \| $ / shares				$ 3.17	$ 3.05
Share Price \| $ / shares				$ 7.43
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				22 months
Employee service share-based compensation, unrecognized compensation costs on nonvested awards other than options				$ 13,000,000
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				310,347	306,612	296,944
Number of directors elected to defer the receipt of RSUs granted \| Director	5
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				2,205,500	1,989,000	1,987,000
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				10,451,760
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	37,118
Fair value of units granted	$ 170,000	$ 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	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Effect on income (loss) before income taxes	$ (13)	$ (10)	$ (13)
Effect on net income (loss)	$ (10)	$ (8)	$ (10)

Accounting for Stock-Based Compensation - Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions (Details) - Employee Stock Option	12 Months Ended
	Dec. 31, 2020	Dec. 31, 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 - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Shares	1,110,134	624,938	1,115,667
Granted, Shares	946,500	658,500	0
Exercised, Shares	18,166
Forfeited and cancelled, Shares	(220,943)	(173,304)	(490,729)
Ending Balance, Shares	1,817,525	1,110,134	624,938
Exercised, Shares	(18,166)
Exercisable, Shares	455,021
Beginning of Period, Weighted Average Exercise Price	$ 16.90	$ 31.21	$ 31.56
Granted, Weighted Average Exercise Price	4.93	4.95
Exercised, Weighted Average Exercise Price	4.99
Forfeited and Cancelled, Weighted Average Exercise Price	33.52	23.04	32.01
End of Period, Weighted Average Exercise Price	8.77	$ 16.90	$ 31.21
Exercisable, Weighted Average Exercise Price	$ 20.24
Weighted Average Remaining Contractual Term	7 years 7 months 6 days
Exercisable, Weighted Average Remaining Contractual Term	3 years 8 months 12 days
Outstanding, Aggregate Intrinsic Value as of December 31, 2020	$ 4

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock, Activity (Details) - Restricted Stock - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	3,857,402	3,308,907	2,643,919
Granted, Shares	2,205,500	1,989,000	1,987,000
Vested, Shares	(1,123,329)	(1,160,667)	(1,154,670)
Forfeited, Shares	(383,838)	(279,838)	(167,342)
Ending Balance, Unvested Shares	4,555,735	3,857,402	3,308,907
Beginning of Period, Weighted Average Grant Date Fair Value	$ 5.47	$ 7.00	$ 16.17
Granted, Weighted Average Grant Date Fair Value	4.90	4.94	4.54
Vested, Weighted Average Grant Date Fair Value	5.84	8.89	23.22
Forfeited, Weighted Average Grant Date Fair Value	8.58	5.60	10.29
End of Period, Weighted Average Grant Date Fair Value	$ 4.84	$ 5.47	$ 7.00

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock Units, Activity (Details) - Restricted Stock Units (RSUs) - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	541,576	397,906	172,078
Granted, Shares	310,347	306,612	296,944
Vested, Shares	(238,184)	(162,942)	(71,116)
Ending Balance, Unvested Shares	613,739	541,576	397,906
Beginning of Period, Weighted Average Grant Date Fair Value	$ 5.13	$ 6.17	$ 12.78
Granted, Weighted Average Grant Date Fair Value	4.93	4.99	4.58
Vested, Weighted Average Grant Date Fair Value	5.47	7.42	15.51
End of Period, Weighted Average Grant Date Fair Value	$ 4.89	$ 5.13	$ 6.17

Acquisitions and Divestitures - Acquisitions - Additional Information (Details)		12 Months Ended
	Jun. 01, 2019 USD ($) Item	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Dec. 08, 2020 Item	Oct. 30, 2020 Item	Sep. 30, 2020 Item	Sep. 08, 2020 Item
Acquisitions and Divestitures [Line Items]
Goodwill		$ 4,219,000,000	$ 4,328,000,000	$ 4,559,000,000
Lea Regional Medical Center \| Hobbs, New Mexico
Acquisitions and Divestitures [Line Items]
Number of licensed beds \| Item								68
Clarksdale Mississippi To Affiliates Of Delta Health System
Acquisitions and Divestitures [Line Items]
Number of licensed beds \| Item						181
Tennova Healthcare, Tullahoma \| Tullahoma, Tennessee
Acquisitions and Divestitures [Line Items]
Number of licensed beds \| Item							135
Midwest City Oklahoma To Affiliates Of S S M Health Care Of Oklahoma Inc
Acquisitions and Divestitures [Line Items]
Number of licensed beds \| Item					255
Tennova Healthcare – Shelbyville \| Shelbyville, Tennessee
Acquisitions and Divestitures [Line Items]
Number of licensed beds \| Item							60
Northwest Mississippi Medical Center [Member]
Acquisitions and Divestitures [Line Items]
Business acquisition number of licensed beds \| Item	181
Business acquisition cash paid for operating assets	$ 2,000,000
Business acquisition liabilities assumed	9,000,000
Business acquisition, cost of acquired entity, purchase price	$ 11,000,000
Goodwill			0
Physician Practices Clinics and Other Ancillary Businesses
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price		1,000,000	8,000,000	26,000,000
Purchase price allocation, property and equipment			4,000,000	10,000,000
Business acquisition, purchase price allocation, intangible assets, other than goodwill			4,000,000	22,000,000
Business Combination, Assumed Noncontrolling Interest, Fair Value				6,000,000
Maximum
Acquisitions and Divestitures [Line Items]
Acquisition and integration expenses related to prospective and closed acquisitions		$ 1,000,000	$ 2,000,000	$ 3,000,000

Acquisitions and Divestitures - Schedule of Divestitures (Details) - Item	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Berwick Hospital Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	90
Effective Date	Dec. 01, 2020
Brownwood Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	188
Effective Date	Oct. 27, 2020
Abilene Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	231
Effective Date	Oct. 27, 2020
San Angelo Community Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	171
Effective Date	Oct. 24, 2020
Bayfront Health St. Petersburg
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	480
Effective Date	Oct. 01, 2020
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
Sparks Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			492
Effective Date			Nov. 01, 2018
Sparks Medical Center - Van Buren
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			103
Effective Date			Nov. 01, 2018
AllianceHealth Deaconess
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			238
Effective Date			Oct. 01, 2018
Munroe Regional Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			425
Effective Date			Aug. 01, 2018
Tennova Healthcare - Dyersburg Regional
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			225
Effective Date			Jun. 01, 2018
Tennova Healthcare - Regional Jackson
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			150
Effective Date			Jun. 01, 2018
Tennova Healthcare - Volunteer Martin
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			100
Effective Date			Jun. 01, 2018
Williamson Memorial Hospital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			76
Effective Date			Jun. 01, 2018
Byrd Regional Hospital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			60
Effective Date			Jun. 01, 2018
Tennova Healthcare - Jamestown
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			85
Effective Date			Jun. 01, 2018
Bayfront Health Dade City
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			120
Effective Date			Apr. 01, 2018

Acquisitions and Divestitures - Schedule of Balance Sheet Items Classified as Held for Sale (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Acquisitions And Divestitures [Abstract]
Other current assets	$ 12	$ 25
Other assets, net	11	262
Accrued liabilities	$ 16	$ 43

Acquisitions and Divestitures - Divestitures - Additional Information (Details) $ in Millions		3 Months Ended		12 Months Ended
	Nov. 30, 2020 Item	Dec. 31, 2018 USD ($)	Jun. 30, 2018 USD ($)	Dec. 31, 2020 USD ($) Item	Dec. 31, 2019 USD ($) Item	Dec. 31, 2018 USD ($) Item	Sep. 30, 2020 Item
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment and (gain) loss on sale of businesses, net				$ 48	$ 138	$ 668
Hospitals Included in Continuing Operations [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment and (gain) loss on sale of businesses, net				41	102	$ 415
Biloxi Mississippi To Memorial Properties Inc
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds \| Item	153
Agreement date	Oct. 12, 2020
Biloxi Mississippi To Memorial Properties Inc \| Merit Health Biloxi
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Ownership Interest percentage by parent	50.00%
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 \| Item							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
Twin Rivers 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			$ 4
Divested Through Twenty Nineteen And Twenty Eighteen
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of hospitals sold \| Item				36	36	36

Acquisitions and Divestitures - Schedule of Net Operating Revenues and Loss and Assets and Liabilities Classified as Discontinued Operations) (Details) - Hospitals Included in Continuing Operations [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups
Loss before income taxes	$ (144)	$ (103)	$ (465)
Less: Loss attributable to noncontrolling interests	(6)	(8)	(5)
Loss from operations before income taxes attributable to Community Health Systems, Inc. stockholders	$ (138)	$ (95)	$ (460)

Goodwill and Other Intangible Assets - Schedule of Goodwill (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill [Roll Forward]
Goodwill	$ 7,033	$ 7,142	$ 7,373
Accumulated impairment losses	(2,814)	(2,814)	(2,814)
Goodwill, total	4,219	4,328	$ 4,559
Goodwill acquired as part of acquisitions during current year	1	4
Goodwill allocated to hospitals held for sale	$ (110)	$ (235)

Goodwill and Other Intangible Assets - Goodwill - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill	$ 4,219,000,000	$ 4,328,000,000	$ 4,559,000,000
Impairment of goodwill	$ 0	$ 0	$ 0

Goodwill and Other Intangible Assets - Intangible Assets - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
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
Net, intangible asset not subject to amortization	53,000,000	63,000,000
Gross carrying amount of capitalized software	1,100,000,000	1,100,000,000
Capitalized computer software, net	251,000,000	321,000,000
Capitalized computer software, development stage costs	11,000,000
Finite-Lived Intangible Assets, Except Capitalized Internal-Use Software
Finite Lived Intangible Assets [Line Items]
Amortization expense	$ 1,000,000	1,000,000	$ 3,000,000
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]
Amortization expense	$ 123,000,000	121,000,000	$ 140,000,000
Amortization expense for 2021	123,000,000
Acquired finite-lived intangible asset, residual value	0
Amortization expense for 2022	75,000,000
Amortization expense for 2023	34,000,000
Amortization expense for 2024	9,000,000
Amortization expense for 2025	7,000,000
Amortization expense thereafter	3,000,000
Maximum
Finite Lived Intangible Assets [Line Items]
Finite-Lived intangible assets, net	1,000,000	$ 1,000,000
Maximum \| Finite-Lived Intangible Assets, Except Capitalized Internal-Use Software
Finite Lived Intangible Assets [Line Items]
Amortization expense for 2021	$ 1,000,000

Income Taxes - Schedule of (Benefit from) Provision for Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Current:
Federal	$ (1)	$ (38)	$ 1
State	3	(5)	(9)
Total, Current	2	(43)	(8)
Deferred:
Federal	(162)	179	50
State	(25)	24	(53)
Total, Deferred	(187)	203	(3)
Total (benefit from) provision for income taxes for income (loss)	$ (185)	$ 160	$ (11)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Income Taxes - Schedule of Reconciliation between the Statutory Federal Income Tax Rate and the Effective Tax Rate (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Differences between the statutory federal income tax rate and the effective tax rate
Provision for (benefit from) income taxes at statutory federal rate, Amount	$ 89	$ (90)	$ (150)
State income taxes, net of federal income tax benefit, Amount	(15)	(104)	(114)
Net income attributable to noncontrolling interests, Amount	(20)	(18)	(18)
Change in valuation allowance, Amount	(267)	340	212
Change in uncertain tax position, Amount			9
Federal and state tax credits, Amount			(17)
Nondeductible goodwill, Amount	41	11	30
Nondeductible settlements, Amount			22
Nondeductible loss on divestiture, Amount	(15)	15
Other, Amount	2	6	15
Total (benefit from) provision for income taxes for income (loss)	$ (185)	$ 160	$ (11)
Provision for (benefit from) income taxes at statutory federal rate, Percentage	21.00%	21.00%	21.00%
State income taxes, net of federal income tax benefit, Percentage	(3.60%)	24.30%	16.00%
Net income attributable to noncontrolling interests, Percentage	(4.70%)	4.20%	2.50%
Change in valuation allowance, Percentage	(63.20%)	(79.20%)	(29.70%)
Change in uncertain tax position, Percentage			(1.30%)
Federal and state tax credits, Percentage			2.40%
Nondeductible goodwill, Percentage	9.80%	(2.60%)	(4.20%)
Nondeductible settlements, Percentage			(3.10%)
Nondeductible loss on divestiture, Percentage	(3.40%)	(3.50%)
Other, Percentage	0.30%	(1.40%)	(2.10%)
(Benefit from) provision for income taxes and effective tax rate for income (loss), Percentage	(43.80%)	(37.20%)	1.50%

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Taxes [Line Items]
Effective income tax rate	(43.80%)	(37.20%)	1.50%
Operating loss carryforwards, valuation allowance	$ 781,000,000
Income tax refunds (payments), net	$ (2,000,000)	$ 3,000,000	$ 19,000,000
Minimum
Income Taxes [Line Items]
Operating loss carryforwards, expiration date	Jan. 01, 2021
Maximum
Income Taxes [Line Items]
Operating loss carryforwards, expiration date	Dec. 31, 2040
Unrecognized benefit that would affect the effective tax rate	$ 1,000,000
Amount of interest and penalties included in liabilities for uncertain tax positions	1,000,000
Federal
Income Taxes [Line Items]
Net operating loss and credit carryforwards	881,000,000
Operating loss carryforwards expected to be utilized	217,000,000
Valuation allowance increase (decrease)	$ (265,000,000)	221,000,000
Federal \| Tax Year 2014
Income Taxes [Line Items]
Open tax year	2014
Federal \| Tax Year 2015
Income Taxes [Line Items]
Open tax year	2015
Federal \| Tax Year 2018
Income Taxes [Line Items]
Open tax year	2018
State and Local Jurisdiction
Income Taxes [Line Items]
Net operating loss and credit carryforwards	$ 9,000,000,000
Operating loss carryforwards expected to be utilized	656,000,000
Valuation allowance increase (decrease)	$ (2,000,000)	$ 127,000,000

Income Taxes - Schedule of Components of Deferred Income Taxes (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Assets
Net operating loss and credit carryforwards	$ 873	$ 775
Self-insurance liabilities	58	48
Long-term debt and interest	154	312
Accounts receivable	52	62
IRC Section 163(j) interest limitation	108	296
Accrued vacation	22	24
Accrued bonus	32	31
Other comprehensive income	6	5
Right-of-use liability	155	149
Stock-based compensation	4	5
Deferred compensation	69	70
Other	57	51
Total	1,590	1,828
Valuation allowance	(781)	(1,049)
Total Deferred Income Tax Assets, Net	809	779
Liabilities
Property and equipment	300	335
Prepaid expenses	29	30
Intangibles	127	149
Investments in unconsolidated affiliates	57	57
Other liabilities	9	9
IRC Section 481(a) - mixed service cost	106	216
Right-of-use assets	150	145
Total Deferred Income Tax Liabilities, Gross	$ 778	$ 941

Income Taxes - Schedule of Reconciliation of the Total Amount of Unrecognized Tax Benefit (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Unrecognized tax benefit, beginning of year	$ 26	$ 29	$ 18
Gross increases — tax positions in current period	19	10	11
Settlements		(13)
Unrecognized tax benefit, end of year	$ 45	$ 26	$ 29

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Debt and lease obligations	$ 12,216	$ 13,405
Less: Unamortized deferred debt issuance costs and note premium	(250)	(147)
Less: Current maturities	(123)	(20)
Total long-term debt	12,093	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	95	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 Secured Notes \| 5⅝% Senior Secured Notes due 2027
Debt Instrument [Line Items]
Debt and lease obligations	1,900
Senior Secured Notes \| 6% Senior Secured Notes due 2029
Debt Instrument [Line Items]
Debt and lease obligations	900
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt and lease obligations	126	231
Senior Notes \| Senior Notes at 6.875% Due 2028
Debt Instrument [Line Items]
Debt and lease obligations	767	1,700
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Debt Instrument [Line Items]
Debt and lease obligations	1,769	1,770
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt and lease obligations	1,348	1,355
Finance Lease and Financing Obligations
Debt Instrument [Line Items]
Debt and lease obligations	239	272
Other
Debt Instrument [Line Items]
Debt and lease obligations	$ 26	$ 17

Long-Term Debt - Schedule of Debt (Parenthetical) (Details)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Nov. 19, 2019	Jun. 23, 2019	Mar. 06, 2019	Jun. 22, 2018	Jan. 27, 2014
Senior Secured Notes at 8% Due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage			8.00%
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%					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%
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%			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%	8.00%
Debt instrument, maturity year	2027	2027
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	5.625%	5.625%
Debt instrument, maturity year	2027	2027
Senior Secured Notes \| 6% Senior Secured Notes due 2029
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.00%	6.00%
Debt instrument, maturity year	2029	2029
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%	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%		9.875%		11.00%
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 - 5.125% Senior Secured Notes, Due 2021 - Additional Information (Details) - Senior Secured Notes at 5.125%, Due 2021 - Senior Secured Notes - USD ($)		12 Months Ended
	Jan. 27, 2014	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Debt instrument, offering date		Jan. 27, 2014
Debt instrument aggregate principal amount	$ 1,000,000,000.0
Debt instrument stated interest rate	5.125%	5.125%	5.125%
Debt instrument redemption price percentage	100.00%
Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Minimum period notice for redemption of debt	30 days
Maximum period notice for redemption of debt	60 days
Debt instrument redemption price percentage	100.00%

Long-Term Debt - 6.875% Senior Notes, Due 2022 - Additional Information (Details) - USD ($)				12 Months Ended
	Nov. 19, 2019	Jun. 22, 2018	Jan. 27, 2014	Dec. 31, 2020	Dec. 07, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Long-term debt outstanding				$ 12,216,000,000
Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Extinguishment of debt amount	$ 2,400,000,000			$ 34,000,000
Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument aggregate principal amount		$ 276,000,000
Senior Secured Notes at 8% Due 2027
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 700,000,000
Debt instrument stated interest rate	8.00%
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt instrument, offering date				Jan. 27, 2014
Debt instrument aggregate principal amount			$ 3,000,000,000.0
Debt instrument stated interest rate			6.875%	6.875%		6.875%
Debt instrument redemption price percentage				100.00%
Extinguishment of debt amount		$ 368,000,000
Long-term debt outstanding	$ 231,000,000
Extinguishment of debt amount via tender offer				$ 72,000,000
Tender offer commencement date				Oct. 30, 2020
Tender offer expiration date				Nov. 30, 2020
Debt instrument redemption notice date				Jan. 29, 2021
Debt instrument redemption date				Feb. 28, 2021
Senior Notes \| Senior Notes at 6.875%, Due 2022 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Minimum period notice for redemption of debt			30 days
Maximum period notice for redemption of debt			60 days
Debt instrument redemption price percentage			100.00%
Senior Notes \| Senior Notes at 6.875%, Due 2028
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 1,700,000,000				$ 700,000,000
Debt instrument stated interest rate	6.875%
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Extinguishment of debt amount				$ 226,000,000
Extinguishment of debt amount via tender offer				$ 7,000,000
Tender offer commencement date				Oct. 30, 2020
Tender offer expiration date				Nov. 30, 2020
Senior Notes \| Senior Notes at 6.875%, Due 2028 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	106.875%

Long-Term Debt - 6.25% Senior Secured Notes, Due 2023 - Additional Information (Details) - USD ($)					12 Months Ended
	Dec. 28, 2020	Feb. 06, 2020	May 12, 2017	Mar. 16, 2017	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Issuance of long-term debt					$ 4,262,000,000	$ 3,042,000,000	$ 1,033,000,000
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Debt instrument, offering date					Mar. 16, 2017
Debt instrument aggregate principal amount			$ 3,100,000,000	$ 2,200,000,000
Extinguishment of debt amount	$ 2,579,000,000	$ 426,000,000
Issuance of long-term debt			900,000,000
Debt instrument stated interest rate				6.25%
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Minimum period notice for redemption of debt				30 days
Maximum period notice for redemption of debt				60 days
Debt instrument redemption price percentage				100.00%
Debt instrument redemption description					plus a “make-whole” premium, as described in the indenture governing the 6¼% Senior Secured Notes due 2023.
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage				106.25%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount				40.00%
Senior Secured Notes \| Senior Secured Notes at 5.125% Due 2018
Debt Instrument [Line Items]
Extinguishment of debt amount				$ 700,000,000
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027
Debt Instrument [Line Items]
Debt instrument, offering date					Dec. 28, 2020
Debt instrument aggregate principal amount	$ 1,900,000,000
Debt instrument stated interest rate					5.625%	5.625%
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Debt instrument redemption description					plus a “make-whole” premium, as described in the indenture governing the 5⅝% Senior Secured Notes due 2027.
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%				102.813%
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	105.625%				101.406%
Secured Debt \| Credit Facility, Term Loan F
Debt Instrument [Line Items]
Extinguishment of debt amount				$ 1,445,000,000
Secured Debt \| Credit Facility, Term Loan A
Debt Instrument [Line Items]
Extinguishment of debt amount			$ 713,000,000
Senior Notes \| 6% Senior Secured Notes due 2029
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 900,000,000
Debt instrument stated interest rate	6.00%
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Debt instrument redemption description					plus a “make-whole” premium, as described in the indenture governing the 6% Senior Secured Notes due 2029.
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%
Senior Notes \| 6% Senior Secured Notes due 2029 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%
Senior Notes \| 6% Senior Secured Notes due 2029 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	106.00%

Long-Term Debt - Schedule of Early Redemption Prices on 6.25% Senior Secured Notes due 2023 (Details) - Senior Secured Notes at 6.25%, Due 2023 - Senior Secured Notes	12 Months Ended
	Dec. 31, 2020
Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Debt Instrument Redemption Price Percentage	103.125%
Debt Instrument, Redemption Period, Start Date	Mar. 31, 2020
Debt Instrument, Redemption Period, End Date	Mar. 31, 2021
Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Debt Instrument Redemption Price Percentage	101.563%
Debt Instrument, Redemption Period, Start Date	Mar. 31, 2021
Debt Instrument, Redemption Period, End Date	Mar. 30, 2022
Debt Instrument, Redemption, Period Five
Debt Instrument [Line Items]
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Mar. 31, 2022
Debt Instrument, Redemption Period, End Date	Mar. 30, 2023

Long-Term Debt - 9.875% Junior-Priority Secured Notes, Due 2023 - Additional Information (Details) - Junior-Priority Secured Notes - USD ($) $ in Millions				12 Months Ended
	Feb. 02, 2021	Jun. 29, 2020	Jun. 22, 2018	Dec. 31, 2020	Dec. 31, 2019	Jun. 23, 2019
Junior-Priority Secured Notes at 9.875% Due 2023
Debt Instrument [Line Items]
Debt instrument, offering date				Jun. 22, 2018
Debt instrument aggregate principal amount			$ 1,770
Debt instrument stated interest rate			11.00%	9.875%	9.875%	9.875%
Debt instrument redemption description				plus a “make-whole” premium, as described in the indenture governing the 9⅞% Junior-Priority Secured Notes due 2023.
Extinguishment of debt amount				$ 2
Tender offer commencement date				Oct. 30, 2020
Tender offer expiration date				Nov. 30, 2020
Junior-Priority Secured Notes at 9.875% Due 2023 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage		109.875%	100.00%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount		40.00%
Junior-Priority Secured Notes at 9.875% Due 2023 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Minimum period notice for redemption of debt			15 days
Maximum period notice for redemption of debt			60 days
Junior-Priority Secured Notes at 6.875% Due 2029
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 1,775
Junior-Priority Secured Notes at 6.875% Due 2029 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument, offering date	Apr. 15, 2024
Debt instrument stated interest rate	6.875%
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days

Long-Term Debt - Schedule of Early Redemption Prices on Junior-Priority Secured Notes due 2023 (Details) - Junior-Priority Secured Notes at 9.875% Due 2023 - Junior-Priority Secured Notes	12 Months Ended
	Dec. 31, 2020
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	107.406%
Debt Instrument, Redemption Period, Start Date	Jun. 30, 2020
Debt Instrument, Redemption Period, End Date	Jun. 29, 2021
Debt Instrument, Redemption, Period Four
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	103.703%
Debt Instrument, Redemption Period, Start Date	Jun. 30, 2021
Debt Instrument, Redemption Period, End Date	Jun. 29, 2022
Debt Instrument, Redemption, Period Five
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Jun. 30, 2022
Debt Instrument, Redemption Period, End Date	Jun. 29, 2023

Long-Term Debt - 8.125% Junior-Priority Secured Notes Due 2024 - Additional Information (Details) - USD ($)				12 Months Ended
	Nov. 19, 2019	Jun. 22, 2018	Jan. 27, 2014	Dec. 31, 2020	Dec. 31, 2019
Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument aggregate principal amount		$ 276,000,000
Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Extinguishment of debt amount	$ 2,400,000,000			$ 34,000,000
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument, offering date				Jun. 22, 2018
Extinguishment of debt amount				$ 1,000,000
Debt instrument stated interest rate		8.125%
Debt instrument redemption description				plus a “make-whole” premium, as described in the indenture governing the 8⅛% Junior-Priority Secured Notes due 2024.
Minimum period notice for redemption of debt		15 days
Maximum period notice for redemption of debt		60 days
Extinguishment of debt amount via tender offer				$ 6,000,000
Tender offer commencement date				Oct. 30, 2020
Tender offer expiration date				Nov. 30, 2020
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage		108.125%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount		40.00%
Junior Priority Secured Notes Two \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument aggregate principal amount		$ 1,355,000,000
Debt instrument redemption price percentage				100.00%
Junior Priority Secured Notes One \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument aggregate principal amount		1,079,000,000.000
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt instrument, offering date				Jan. 27, 2014
Debt instrument aggregate principal amount			$ 3,000,000,000.0
Extinguishment of debt amount		$ 368,000,000
Debt instrument stated interest rate			6.875%	6.875%	6.875%
Debt instrument redemption price percentage				100.00%
Extinguishment of debt amount via tender offer				$ 72,000,000
Tender offer commencement date				Oct. 30, 2020
Tender offer expiration date				Nov. 30, 2020
Senior Notes \| Senior Notes at 6.875%, Due 2022 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage			100.00%
Minimum period notice for redemption of debt			30 days
Maximum period notice for redemption of debt			60 days

Long-Term Debt - Schedule of Early Redemption Prices on 8.125% Junior-Priority Secured Notes due 2024 (Details) - Junior-Priority Secured Notes at 8.125% Due 2024 - Junior-Priority Secured Notes	12 Months Ended
	Dec. 31, 2020
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	104.063%
Debt Instrument, Redemption Period, Start Date	Jun. 30, 2021
Debt Instrument, Redemption Period, End Date	Jun. 29, 2022
Debt Instrument, Redemption, Period Four
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	102.031%
Debt Instrument, Redemption Period, Start Date	Jun. 30, 2022
Debt Instrument, Redemption Period, End Date	Jun. 29, 2023
Debt Instrument, Redemption, Period Five
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Jun. 30, 2023
Debt Instrument, Redemption Period, End Date	Jun. 29, 2024

Long-Term Debt - 8.625% Senior Secured Notes Due 2024 - Additional Information (Details) - Senior Secured Notes - USD ($)			12 Months Ended
	Feb. 09, 2021	Jul. 06, 2018	Dec. 31, 2020
Senior Secured Notes at 8.625%, Due 2024
Debt Instrument [Line Items]
Debt instrument, offering date			Jul. 06, 2018
Debt instrument aggregate principal amount		$ 1,033,000,000.000
Debt instrument stated interest rate		8.625%
Debt instrument, maturity date			Jan. 15, 2024
Debt instrument redemption description			plus a “make-whole” premium, as described in the indenture governing the 8⅝% Senior Secured Notes due 2024.
Debt instrument redemption price percentage		108.625%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount		40.00%
Minimum period notice for redemption of debt		15 days
Maximum period notice for redemption of debt		60 days
Senior Secured Notes at 8.625%, Due 2024 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage		100.00%
Senior Secured Notes at 4.75%, Due 2031 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, offering date	Feb. 09, 2021
Debt instrument aggregate principal amount	$ 1,095,000,000.000
Debt instrument stated interest rate	4.75%
Debt instrument, maturity date	Feb. 15, 2031
Debt instrument redemption description	The 4¾% Senior Secured Notes due 2031 bear interest at a rate of 4¾% per year payable semi-annually in arrears on February 15 and August 15, commencing on August 15, 2021

Long-Term Debt - Schedule of Early Redemption Prices on 8.625% Senior Secured Notes due 2024 (Details) - Senior Secured Notes at 8.625%, Due 2024 - Senior Secured Notes		12 Months Ended
	Jul. 06, 2018	Dec. 31, 2020
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	108.625%
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage		104.313%
Debt Instrument, Redemption Period, Start Date		Jan. 15, 2021
Debt Instrument, Redemption Period, End Date		Jan. 14, 2022
Debt Instrument, Redemption, Period Four
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage		102.156%
Debt Instrument, Redemption Period, Start Date		Jan. 15, 2022
Debt Instrument, Redemption Period, End Date		Jan. 14, 2023
Debt Instrument, Redemption, Period Five
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage		100.00%
Debt Instrument, Redemption Period, Start Date		Jan. 15, 2023
Debt Instrument, Redemption Period, End Date		Jan. 14, 2024

Long-Term Debt - 6.625% Senior Secured Notes, Due 2025 - Additional Information (Details) - USD ($)		12 Months Ended
	Feb. 06, 2020	Dec. 31, 2020
Senior Secured Notes at 6.625% Due 2025 \| Senior Secured Notes
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%
Debt instrument, maturity date		Feb. 15, 2025
Debt instrument redemption price percentage		100.00%
Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Extinguishment of debt amount	$ 426,000,000

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	12 Months Ended
	Dec. 31, 2020
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 - 8% Senior Secured Notes, Due 2026 - Additional Information (Details) - USD ($)			12 Months Ended
	Nov. 19, 2019	Mar. 06, 2019	Dec. 31, 2020	Dec. 31, 2019
Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 500,000,000
Credit Facility, Term Loan H
Debt Instrument [Line Items]
Extinguishment of debt amount		$ 1,557,000,000
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt instrument, offering date			Mar. 06, 2019
Debt instrument aggregate principal amount	2,101,000,000	$ 1,601,000,000
Debt instrument stated interest rate		8.00%	8.00%	8.00%
Debt instrument redemption price percentage		108.00%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount		40.00%
Debt instrument redemption description			plus a “make-whole” premium, as described in the indenture governing the 8% Senior Secured Notes due 2026.
Senior Secured Notes \| Senior Notes at 7.125%, Due 2020
Debt Instrument [Line Items]
Extinguishment of debt amount	$ 121,000,000

Long-Term Debt - Schedule of Early Redemption Prices on 8% Senior Secured Notes due 2026 (Details) - Senior Secured Notes at 8%, Due 2026 - Senior Secured Notes		12 Months Ended
	Mar. 06, 2019	Dec. 31, 2020
Debt Instrument Redemption Price Percentage	108.00%
Debt Instrument, Redemption, Period One
Debt Instrument Redemption Price Percentage		104.00%
Debt Instrument, Redemption Period, Start Date		Mar. 15, 2022
Debt Instrument, Redemption Period, End Date		Mar. 14, 2023
Debt Instrument, Redemption, Period Two
Debt Instrument Redemption Price Percentage		102.00%
Debt Instrument, Redemption Period, Start Date		Mar. 15, 2023
Debt Instrument, Redemption Period, End Date		Mar. 14, 2024
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption Price Percentage		100.00%
Debt Instrument, Redemption Period, Start Date		Mar. 15, 2024
Debt Instrument, Redemption Period, End Date		Mar. 14, 2026

Long-Term Debt - 8% Senior Secured Notes, Due 2027 - Additional Information (Details) - Senior Secured Notes at 8% Due 2027 - USD ($)		12 Months Ended
	Nov. 19, 2019	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 700,000,000
Debt instrument stated interest rate	8.00%
Senior Secured Notes
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 700,000,000
Debt instrument stated interest rate	8.00%	8.00%	8.00%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%
Debt instrument redemption description		plus a “make-whole” premium, as described in the indenture governing the 8% Senior Secured Notes due 2027.
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Senior Secured Notes \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	108.00%	102.00%
Senior Secured Notes \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%	104.00%

Long-Term Debt - Schedule of Early Redemption Prices on 8% Senior Secured Notes due 2027 (Details) - Senior Secured Notes at 8% Due 2027 - Senior Secured Notes		12 Months Ended
	Nov. 19, 2019	Dec. 31, 2020
Debt Instrument, Redemption, Period One
Debt Instrument Redemption Price Percentage	100.00%	104.00%
Debt Instrument, Redemption Period, Start Date		Dec. 15, 2022
Debt Instrument, Redemption Period, End Date		Dec. 14, 2023
Debt Instrument, Redemption, Period Two
Debt Instrument Redemption Price Percentage	108.00%	102.00%
Debt Instrument, Redemption Period, Start Date		Dec. 15, 2023
Debt Instrument, Redemption Period, End Date		Dec. 14, 2024
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption Price Percentage		100.00%
Debt Instrument, Redemption Period, Start Date		Dec. 15, 2024
Debt Instrument, Redemption Period, End Date		Dec. 14, 2027

Long-Term Debt - 5.625% Senior Secured Notes, Due 2027 - Additional Information (Details) - Senior Secured Notes - USD ($)		12 Months Ended
	Dec. 28, 2020	Dec. 31, 2020
5⅝% Senior Secured Notes due 2027
Debt Instrument [Line Items]
Debt instrument, offering date		Dec. 28, 2020
Debt instrument, maturity date		Mar. 15, 2027
Debt instrument aggregate principal amount	$ 1,900,000,000
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%
Debt instrument redemption description		plus a “make-whole” premium, as described in the indenture governing the 5⅝% Senior Secured Notes due 2027.
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
5⅝% Senior Secured Notes due 2027 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	105.625%	101.406%
5⅝% Senior Secured Notes due 2027 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%	102.813%
Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 2,579,000,000

Long-Term Debt - Schedule of Early Redemption Prices on 5.625% Senior Secured Notes Due 2027 (Details) - 5⅝% Senior Secured Notes due 2027 - Senior Secured Notes		12 Months Ended
	Dec. 28, 2020	Dec. 31, 2020
Debt Instrument, Redemption, Period One
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	100.00%	102.813%
Debt Instrument, Redemption Period, Start Date		Dec. 15, 2023
Debt Instrument, Redemption Period, End Date		Dec. 14, 2024
Debt Instrument, Redemption, Period Two
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	105.625%	101.406%
Debt Instrument, Redemption Period, Start Date		Dec. 15, 2024
Debt Instrument, Redemption Period, End Date		Dec. 14, 2025
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage		100.00%
Debt Instrument, Redemption Period, Start Date		Dec. 15, 2025
Debt Instrument, Redemption Period, End Date		Dec. 14, 2027

Long-Term Debt - 6.875% Senior Notes, Due 2028 - Additional Information (Details) - USD ($) shares in Millions			12 Months Ended
	Dec. 07, 2020	Nov. 19, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Gain (loss) on early extinguishment of debt			$ 317,000,000	$ (54,000,000)	$ 31,000,000
Senior Notes \| Senior Notes at 6.875%, Due 2028
Debt Instrument [Line Items]
Debt instrument aggregate principal amount	$ 700,000,000	$ 1,700,000,000
Debt instrument stated interest rate		6.875%
Cash proceeds received in exchange offer		$ 0
Debt instrument, maturity date		Apr. 01, 2028
Minimum period notice for redemption of debt		15 days
Maximum period notice for redemption of debt		60 days
Debt instrument redemption description			plus a “make-whole” premium, as described in the indenture governing the 6⅞% Senior Notes due 2028.
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount		40.00%
Aggregate consideration from debt instrument exchanged for cash	$ 400,000,000
Debt instrument converted into shares of common stock	10
Gain (loss) on early extinguishment of debt	$ 205,000,000
Extinguishment of debt amount			$ 226,000,000
Extinguishment of debt amount via tender offer			$ 7,000,000
Tender offer commencement date			Oct. 30, 2020
Tender offer expiration date			Nov. 30, 2020
Senior Notes \| Senior Notes at 6.875%, Due 2028 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage		100.00%
Senior Notes \| Senior Notes at 6.875%, Due 2028 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage		106.875%

Long-Term Debt - Schedule of Early Redemption Prices on 6.875% Senior Notes Due 2028 (Details) - Senior Notes at 6.875%, Due 2028 - Senior Notes	12 Months Ended
	Dec. 31, 2020
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption Price Percentage	103.438%
Debt Instrument, Redemption Period, Start Date	Apr. 01, 2023
Debt Instrument, Redemption Period, End Date	Mar. 31, 2024
Debt Instrument, Redemption, Period Four
Debt Instrument Redemption Price Percentage	101.719%
Debt Instrument, Redemption Period, Start Date	Apr. 01, 2024
Debt Instrument, Redemption Period, End Date	Mar. 31, 2025
Debt Instrument, Redemption, Period Five
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Apr. 01, 2025
Debt Instrument, Redemption Period, End Date	Mar. 31, 2028

Long-Term Debt - 6% Senior Secured Notes, Due 2029 - Additional Information - (Details) - Senior Notes - USD ($)		12 Months Ended
	Dec. 28, 2020	Dec. 31, 2020
6% Senior Secured Notes due 2029
Debt instrument aggregate principal amount	$ 900,000,000
Debt instrument, maturity date	Jan. 15, 2029
Debt instrument stated interest rate	6.00%
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Debt instrument redemption description		plus a “make-whole” premium, as described in the indenture governing the 6% Senior Secured Notes due 2029.
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%
6% Senior Secured Notes due 2029 \| Debt Instrument, Redemption, Period One
Debt instrument redemption price percentage	100.00%
6% Senior Secured Notes due 2029 \| Debt Instrument, Redemption, Period Two
Debt instrument redemption price percentage	106.00%
6% Senior Secured Notes due 2029 and 5.625% Senior Secured Notes due 2027
Debt instrument, repurchase amount	$ 2,579,000,000

Long-Term Debt - Schedule of Early Redemption Prices on 6.0% Senior Notes Due 2029 (Details) - 6% Senior Secured Notes due 2029 - Senior Secured Notes	12 Months Ended
	Dec. 31, 2020
Debt Instrument, Redemption, Period One
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	103.00%
Debt Instrument, Redemption Period, Start Date	Jan. 15, 2024
Debt Instrument, Redemption Period, End Date	Jan. 14, 2025
Debt Instrument, Redemption, Period Two
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	101.50%
Debt Instrument, Redemption Period, Start Date	Jan. 15, 2025
Debt Instrument, Redemption Period, End Date	Jan. 14, 2026
Debt Instrument, Redemption, Period Three
Debt Instrument Redemption [Line Items]
Debt Instrument Redemption Price Percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Jan. 15, 2026
Debt Instrument, Redemption Period, End Date	Jan. 14, 2029

Long-Term Debt - ABL Facility - Additional Information (Details) - USD ($)		12 Months Ended
	Apr. 03, 2018	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Jan. 06, 2021	Nov. 12, 2019
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 150,000,000
Gain (loss) on early extinguishment of debt		317,000,000	$ (54,000,000)	$ 31,000,000
After-tax gain (loss) from extinguishment of debt		352,000,000	(42,000,000)	23,000,000
Interest paid on borrowings		1,039,000,000	$ 1,011,000,000	$ 936,000,000
ABL Credit Agreement
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 1,000,000,000.0
Aggregate principal amount for springing maturity	250,000,000
ABL Credit Agreement \| ABL Facility Customary Covenants
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 95,000,000
Debt instrument variable interest rate	10.00%
ABL Credit Agreement \| Minimum
Debt Instrument [Line Items]
Line of credit facility, unused capacity, commitment fee percentage				0.50%
ABL Credit Agreement \| Maximum
Debt Instrument [Line Items]
Line of credit facility, unused capacity, commitment fee percentage				0.625%
ABL Credit Agreement \| Alternate Base Rate
Debt Instrument [Line Items]
Percentage of the maximum commitment of excess availability, one				1.25%
Percentage of the maximum commitment of excess availability, two				1.50%
Percentage of the maximum commitment of excess availability, three				1.75%
ABL Credit Agreement \| London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Percentage of the maximum commitment of excess availability, one				2.25%
Percentage of the maximum commitment of excess availability, two				2.50%
Percentage of the maximum commitment of excess availability, three				2.75%
ABL Credit Agreement \| ABL Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity		679,000,000
Line of credit outstanding amount		0
Letter of Credit \| ABL Credit Agreement
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 150,000,000			$ 30,000,000
Letter of Credit \| ABL Credit Agreement \| Credit Facility, Type of Debt, Amendment No. 2
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 50,000,000					$ 200,000,000

Long-Term Debt - Schedule of Maturities of Long-Term Debt (Details) $ in Millions	Dec. 31, 2020 USD ($)
Debt Disclosure [Abstract]
2021	$ 123
2022	137
2023	1,776
2024	2,387
2025	1,469
Thereafter	6,574
Total maturities	12,466
Less: Deferred debt issuance costs	(230)
Plus: Unamortized note premium	(20)
Total long-term debt	$ 12,216

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Assets:
Available-for-sale debt securities	$ 110	$ 101
Carrying Amount
Assets:
Cash and cash equivalents	1,676	216
Investments in equity securities	129	141
Available-for-sale debt securities	110	101
Trading securities	12	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	95	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	1,427
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,074	2,070
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	692	691
Carrying Amount \| Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027
Liabilities:
Notes payable, fair value disclosure	1,809
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 6%, Due 2029
Liabilities:
Notes payable, fair value disclosure	857
Carrying Amount \| Senior Notes \| Senior Notes at 6.875%, Due 2022
Liabilities:
Notes payable, fair value disclosure	125	229
Carrying Amount \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	758	1,678
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Liabilities:
Notes payable, fair value disclosure	1,756	1,754
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Liabilities:
Notes payable, fair value disclosure	1,336	1,340
Carrying Amount \| Receivables Facility and Other Debt, Type \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	23	285
Estimated Fair Value
Assets:
Cash and cash equivalents	1,676	216
Investments in equity securities	129	141
Available-for-sale debt securities	110	101
Trading securities	12	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	99	3,148
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Liabilities:
Notes payable, fair value disclosure	1,080	1,099
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure	1,543
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,275	2,182
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	760	700
Estimated Fair Value \| Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027
Liabilities:
Notes payable, fair value disclosure	2,048
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6%, Due 2029
Liabilities:
Notes payable, fair value disclosure	973
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875%, Due 2022
Liabilities:
Notes payable, fair value disclosure	125	188
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	618	1,700
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Liabilities:
Notes payable, fair value disclosure	1,861	1,539
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Liabilities:
Notes payable, fair value disclosure	1,408	1,113
Estimated Fair Value \| Receivables Facility and Other Debt, Type \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	$ 23	$ 285

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Parenthetical) (Details)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Nov. 19, 2019	Jun. 23, 2019	Mar. 06, 2019	Jun. 22, 2018	Jan. 27, 2014
Senior Secured Notes at 8% Due 2027
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate			8.00%
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%					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%
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%			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%	8.00%
Debt instrument maturity year	2027	2027
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	5.625%	5.625%
Debt instrument maturity year	2027	2027
Senior Secured Notes \| Senior Secured Notes at 6%, Due 2029
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	6.00%
Debt instrument maturity year	2029
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%					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%		9.875%		11.00%
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 terminated	1

Fair Value of Financial Instruments - Schedule of Pre-tax (Loss) Gain Recognized as a Component of Other Comprehensive Income (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Cash Flow Hedging \| Interest Rate Swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Pre-Tax (Loss) Gain Recognized in OCI (Effective Portion)	$ (3)	$ 17

Fair Value of Financial Instruments - Schedule of Effective Portion of the Pre-tax Loss Reclassified from AOCL into Interest Expense on the Consolidated Statements of Income (Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2018
Interest Expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Pre-Tax Loss Reclassified from AOCL into Income (Effective Portion)	$ 2	$ 2

Fair Value - Additional Information (Details)	12 Months Ended
Fair Value - Additional Information (Details)	Dec. 31, 2020 USD ($) Item	Dec. 31, 2019 USD ($) Item	Dec. 31, 2018 USD ($)
Fair Value Disclosures [Line Items]
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
Available-for-sale Securities, Continuous Unrealized Loss Position, Fair Value	$ 7,000,000	$ 51,000,000
Available-for-sale, Securities in Unrealized Loss Positions, Qualitative Disclosure, Number of Positions \| Item	11	71
Other Investment Income
Fair Value Disclosures [Line Items]
Investment Income, Interest and Dividend	$ 6,000,000	$ 7,000,000	$ 7,000,000
Available-for-sale Securities
Fair Value Disclosures [Line Items]
Other than Temporary Impairment, Credit Losses Recognized in Earnings, Credit Losses on Debt Securities Held	$ 0

Fair Value - Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available-for-sale debt securities	$ 110	$ 101
Fair Value, Measurements, Recurring
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	129	141
Available-for-sale debt securities	110	101
Trading securities	12	12
Total assets	251	254
Fair value of interest rate swap agreement		2
Total liabilities		2
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	129	141
Total assets	129	141
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available-for-sale debt securities	110	101
Trading securities	12	12
Total assets	$ 122	113
Fair value of interest rate swap agreement		2
Total liabilities		$ 2

Fair Value - Supplemental Information Regarding Available-for-Sale Debt Securities (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	$ 105	$ 100
Gross Unrealized Gains	5	2
Gross Unrealized Losses		(1)
Estimated Fair Value	110	101
Government
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	48	54
Gross Unrealized Gains	2	1
Gross Unrealized Losses		(1)
Estimated Fair Value	50	54
Corporate
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	38	33
Gross Unrealized Gains	2	1
Estimated Fair Value	40	34
Mortgage and Asset-Backed Securities
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	19	13
Gross Unrealized Gains	1
Estimated Fair Value	$ 20	$ 13

Fair Value - Contractual Maturities of Debt Securities (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Within 1 year, Amortized Cost	$ 3	$ 9
After 1 year and through year 5, Amortized Cost	26	19
After 5 years and through year 10, Amortized Cost	30	29
After 10 years, Amortized Cost	46	43
Within 1 year, Fair Value	3	9
After 1 year and through year 5, Fair Value	27	20
After 5 years and through year 10, Fair Value	32	29
After 10 years, Fair Value	$ 48	$ 43

Fair Value - Gross Realized Gains and Losses and Investment Income on Available-for-Sale Debt Securities (Details) $ in Millions	12 Months Ended
	Dec. 31, 2020 USD ($)
Fair Value Disclosures [Abstract]
Realized gains	$ 2
Realized losses	$ (1)

Fair Value - Net Gains and Losses Recognized for Investments in Equity Securities (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Equity Securities, FV-NI, Realized Gain (Loss)	$ 9	$ 15
Available-for-sale Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Equity Securities, FV-NI, Realized Gain (Loss)	14	2
Held-to-maturity Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Equity Securities, FV-NI, Unrealized Gain (Loss)	$ (5)	$ 13

Leases - Additional Information (Details) $ in Millions			12 Months Ended
Leases - Additional Information (Details) $ in Millions	Dec. 18, 2019 USD ($) ft² Item	Sep. 19, 2019 USD ($) ft² Item State	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)
Capital Leased Assets [Line Items]
Reduction to variable rent expense recognized			$ 7
Proceeds from sale-lease back			2	$ 60
Operating lease right of use asset pending leases that have not yet commenced			$ 17
Carter Validus Mission Critical REIT II, Inc [Member]
Capital Leased Assets [Line Items]
Number of medical office buildings divested \| Item		4
Proceeds from sale-lease back		$ 56
Area of real estate property \| ft²		285,337
Number of financing obligations remain outstanding \| State		3
Catalyst Healthcare Real Estate [Member] \| Arkansas [Member]
Capital Leased Assets [Line Items]
Number of medical office buildings divested \| Item	1
Proceeds from sale-lease back	$ 4
Area of real estate property \| ft²	30,000

Leases - Components of Lease Cost and Rent Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Leases [Abstract]
Operating lease cost	$ 203	$ 194
Short-term rent expense	104	114
Variable lease cost	26	18
Sublease income	(6)	(5)
Total operating lease cost	327	321
Finance lease cost:
Amortization of right-of-use assets	10	12
Interest on finance lease liabilities	8	7
Total finance lease cost	$ 18	$ 19

Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Operating Leases:
Operating Lease ROU Assets	$ 642	$ 607
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssetsNoncurrent	us-gaap:OtherAssetsNoncurrent
Finance Leases:
Property and equipment	$ 9,352	$ 9,653
Less accumulated depreciation and amortization	(4,030)	(4,045)
Property and equipment, net	5,322	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	$ 74	$ 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	$ 150	$ 173
Less accumulated depreciation and amortization	(46)	(56)
Property and equipment, net	104	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
Finance Leases:
Property and equipment	134	154
Finance Lease ROU Assets [Member] \| Equipment and Fixtures
Finance Leases:
Property and equipment	$ 8	$ 11

Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 188	$ 167
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from finance leases	8	7
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows from finance leases	7	9
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	$ 150	$ 122
Weighted-average remaining lease term: Operating leases	7 years	6 years
Weighted-average remaining lease term: Finance leases	19 years	20 years
Weighted-average discount rate: Operating leases	9.00%	9.10%
Weighted-average discount rate: Finance leases	8.40%	5.60%

Leases - Commitments Relating to Noncancellable Lease Obligations (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Operating Leases
2021	$ 193
2022	161
2023	127
2024	93
2025	77
Thereafter	253
Total minimum future payments	904
Less: Imputed interest	(238)
Total liabilities	666
Less: Current portion	(142)	$ (136)
Long-term liabilities	524	487
Finance Leases
2021	10
2022	9
2023	8
2024	8
2025	8
Thereafter	150
Total minimum future payments	193
Less: Imputed interest	(114)
Total liabilities	79
Less: Current portion	(5)	(6)
Long-term liabilities	74	$ 107
Financing Obligations
2021	12
2022	12
2023	13
2024	13
2025	13
Thereafter	103
Total minimum future payments	166
Less: Imputed interest	(6)
Total liabilities	160
Less: Current portion	(2)
Long-term liabilities	$ 158

Employee Benefit Plans - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Defined Benefit Plan Disclosure [Line Items]
Defined Contribution Plan, Cost Recognized	$ 74	$ 85	$ 90
Liability for deferred compensation plans	176	175
Defined benefit plan, noncash settlement loss	0	0	2
Equity securities held in rabbi trust		84
Pension Plans, Defined Benefit [Member]
Defined Benefit Plan Disclosure [Line Items]
Net periodic benefit cost	1	1	1
Accrued benefits liabilities	$ 5	12
Defined benefit plans and other post-retirement plans, weighted-average assumptions to determine net periodic cost, discount rate	3.20%
Expected long-term rate of return on assets	6.00%
Deferred Compensation Plans Equity Securities [Member]
Defined Benefit Plan Disclosure [Line Items]
Liability for deferred compensation plans	$ 95	23
Deferred Compensation Company-Owned Life Insurance Contracts [Member]
Defined Benefit Plan Disclosure [Line Items]
Liability for deferred compensation plans	148	130
Trust for Benefit of Employees [Member] \| Pension Plans, Defined Benefit [Member]
Defined Benefit Plan Disclosure [Line Items]
Defined benefit plan assets designated to pay benefits of the deferred compensation plans	243	153
Supplemental Employee Retirement Plans, Defined Benefit [Member]
Defined Benefit Plan Disclosure [Line Items]
Net periodic benefit cost	7	7	$ 9
Accrued benefits liabilities	$ 89	$ 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%

Stockholders' Deficit - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Dec. 31, 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 Impact of Noncontrolling Interest to Stockholders' Deficit (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Equity [Abstract]
Net income (loss) attributable to Community Health Systems,Inc. stockholders	$ 511	$ (675)	$ (788)
Net increase (decrease) in Community Health Systems,Inc. paid-in-capital for purchase of subsidiary partnership interests	3	3	(4)
Net transfers to the noncontrolling interests	3	3	(4)
Change to Community Health Systems, Inc. stockholders' deficit from net income (loss) attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$ 514	$ (672)	$ (792)

- 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
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-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/exampleRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
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-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
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Subparagraph (a)
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SX 210.7-04(18))
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Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 13: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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+ Details

Earnings Per Share - Schedule of Components of Denominator for Computation of Basic and Diluted Earnings Per Share (Details) - shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Effect of dilutive securities:
Weighted-average number of shares outstanding — basic	115,491,022	113,739,046	112,728,274
Restricted stock awards	905,903
Employee stock options	122,785
Other equity-based awards	24,851
Weighted-average number of shares outstanding — diluted	116,544,561	113,739,046	112,728,274

Earnings Per Share - Additional Information (Details) - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Earnings Per Share [Abstract]
Increase in number of shares to diluted shares calculation if income would have been generated	133,866	68,687

Earnings Per Share - Schedule of Antidilutive Securities (Details) - shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Earnings Per Share [Abstract]
Employee stock options and restricted stock awards excluded from computation of earnings per share amount	2,821,511	3,508,968	2,152,408

Equity Investments - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended				48 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2016	Dec. 31, 2020
Schedule Of Equity Method Investments [Line Items]
Equity method investment	$ 190	$ 199			$ 190
Equity in earnings of unconsolidated affiliates	$ 10	$ 15	$ 22
Home Care [Member]
Schedule Of Equity Method Investments [Line Items]
Equity method investment ownership percentage				20.00%
Percentage of ownership interest sold				80.00%	20.00%
Disposal date	Dec. 31, 2016
Three Hospitals in Macon Georgia, [Member]
Schedule Of Equity Method Investments [Line Items]
Equity method investment ownership percentage	38.00%				38.00%
HealthTrust [Member]
Schedule Of Equity Method Investments [Line Items]
Equity method investment ownership percentage	13.90%				13.90%

Other Comprehensive Income - Schedule of Changes in Accumulated Other Comprehensive Income (Loss) by Component (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Accumulated Other Comprehensive Income Loss [Line Items]
Accumulated Other Comprehensive Income (Loss), Beginning Balance	$ (9)	$ (10)
Other comprehensive (loss) income before reclassifications	4	1
Amounts reclassified from accumulated other comprehensive (loss) income	(8)
Other comprehensive (loss) income	(4)	1	$ 17
Accumulated Other Comprehensive Income (Loss), Ending Balance	(13)	(9)	(10)
Change in Fair Value of Interest Rate Swaps
Accumulated Other Comprehensive Income Loss [Line Items]
Accumulated Other Comprehensive Income (Loss), Beginning Balance	2	5
Other comprehensive (loss) income before reclassifications	(1)	(3)
Other comprehensive (loss) income	(1)	(3)
Accumulated Other Comprehensive Income (Loss), Ending Balance		2	5
Change in Fair Value of Available for Sale Debt Securities
Accumulated Other Comprehensive Income Loss [Line Items]
Accumulated Other Comprehensive Income (Loss), Beginning Balance	(3)	(7)
Other comprehensive (loss) income before reclassifications	6	5
Amounts reclassified from accumulated other comprehensive (loss) income	(2)	(1)
Other comprehensive (loss) income	4	4
Accumulated Other Comprehensive Income (Loss), Ending Balance	2	(3)	(7)
Change in Unrecognized Pension Cost Components
Accumulated Other Comprehensive Income Loss [Line Items]
Accumulated Other Comprehensive Income (Loss), Beginning Balance	(8)	(8)
Other comprehensive (loss) income before reclassifications	(1)	(1)
Amounts reclassified from accumulated other comprehensive (loss) income	(6)	1
Other comprehensive (loss) income	(7)
Accumulated Other Comprehensive Income (Loss), Ending Balance	$ (15)	$ (8)	$ (8)

- Definition

Accumulated change in equity from transactions and other events and circumstances from non-owner sources, net of tax effect, at period end. Excludes Net Income (Loss), and accumulated changes in equity from transactions resulting from investments by owners and distributions to owners. Includes foreign currency translation items, certain pension adjustments, unrealized gains and losses on certain investments in debt and equity securities, other than temporary impairment (OTTI) losses related to factors other than credit losses on available-for-sale and held-to-maturity debt securities that an entity does not intend to sell and it is not more likely than not that the entity will be required to sell before recovery of the amortized cost basis, as well as changes in the fair value of derivatives related to the effective portion of a designated cash flow hedge.

+ References + Details

- Definition

Amount after tax and reclassification adjustments of other comprehensive income (loss).

+ References

+ Details

Other Comprehensive Income - Schedule of Amounts Reclassified Out of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Reclassification Adjustment Out Of Accumulated Other Comprehensive Income [Line Items]
Reclassification, net of tax	$ 8
Interest expense, net	(1,031)	$ (1,041)	$ (976)
(Benefit from) provision for income taxes	(185)	160	(11)
Net income (loss) attributable to Community Health Systems, Inc. stockholders	511	(675)	$ (788)
Pension Plans, Defined Benefit [Member]
Reclassification Adjustment Out Of Accumulated Other Comprehensive Income [Line Items]
Reclassification, Total before tax	(4)	(1)
Tax benefit	10
Reclassification, net of tax	6	(1)
Accumulated Defined Benefit Plans Adjustment, Net Prior Service Attributable to Parent [Member] \| Pension Plans, Defined Benefit [Member]
Reclassification Adjustment Out Of Accumulated Other Comprehensive Income [Line Items]
Reclassification, Total before tax	(1)	$ (1)
Accumulated Defined Benefit Plans Adjustment, Settlement Losses Recognized [Member] \| Pension Plans, Defined Benefit [Member]
Reclassification Adjustment Out Of Accumulated Other Comprehensive Income [Line Items]
Reclassification, Total before tax	$ (3)

Commitments and Contingencies - Additional Information (Details) - USD ($)		3 Months Ended			12 Months Ended
	Jun. 01, 2018	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Commitments And Contingencies [Line Items]
Physician recruiting commitment, physician income guarantee period					12 months
Physician recruiting commitment, period of recoverability of physician income guarantee for noncommitment					3 years
Physician recruiting commitment, maximum potential future payments in excess of liability recorded					$ 17,000,000
Malpractice loss contingency, historical claims period used by actuary to estimate liability	20 years
Malpractice Loss Contingency, Discount Rate					1.80%	2.60%	3.10%
Malpractice Loss Contingency, Accrual, Discounted		$ 612,000,000			$ 602,000,000	$ 612,000,000
Malpractice Loss Contingency, Accrual, Undiscounted		663,000,000			629,000,000	663,000,000
Malpractice Loss Contingency, Accrual, Discounted, Current		169,000,000			177,000,000	169,000,000
Expenses related to settlement of professional liability claim					50,000,000
Recovery of full settlement amount					50,000,000
Change in estimate reserve for professional liability claims					0
Change in settlement liability claims estimate amount		$ 0	$ 20,000,000	$ 70,000,000
Pending Litigation [Member] \| Litigation Matters Where Negative Outcome Is Reasonably Possible [Member]
Commitments And Contingencies [Line Items]
Attorneys' fees and other costs incurred					3,000,000	$ 21,000,000	$ 2,000,000
Professional and general liability self-insured claims reported prior to June 1, 2002, per occurrence [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					1,000,000
Professional and general liability self-insured reported from June 1, 2002 through June 1, 2003, per occurrence [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					2,000,000
Professional and general liability self-insured reported from June 1, 2003 and before June 1, 2005, per occurrence [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					4,000,000
Professional and general liability self-insured claims reported on or after June 1, 2005, per occurrence [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					5,000,000
Professional and general liability claims reported on or after June 1, 2014 [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					10,000,000
Professional and general liability claims reported on or after June 1, 2003 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Maximum Coverage Per Incident					95,000,000
Professional and general liability claims incurred and reported after January 1, 2008 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Maximum Coverage Per Incident					145,000,000
Professional and general liability claims incurred and reported after June 1, 2010 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Maximum Coverage Per Incident					195,000,000
Professional and general liability claims reported on or after June 1, 2015 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Maximum Coverage Per Incident					215,000,000
Integrated occurrence claims reported on or after June 1, 2014 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Annual Coverage Limit					50,000,000
Integrated occurrence claims reported on or after June 1, 2015 through June 1, 2020 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Annual Coverage Limit					75,000,000
Integrated occurrence claims reported between June 1,2020 and May 31, 2021 [Member]
Commitments And Contingencies [Line Items]
Malpractice Insurance, Annual Coverage Limit					75,000,000
Professional and general liability self-insured claims under certain policy terms until Company total aggregate coverage is met if first aggregate layer becomes fully utilized [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					10,000,000
Triad professional and general liability self-insured claims during 2007 [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					$ 10,000,000
Maximum
Commitments And Contingencies [Line Items]
Malpractice loss contingency, average lag period from occurrence to settlement					4 years
Malpractice loss contingency, settled claims as percent of total liability					1.00%
Malpractice loss contingency, self-insured retention					$ 15,000,000
Maximum \| Professional And General Liability Claims Incurred And Reported On Or After June 1, 2008 [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					15,000,000
Maximum \| Triad professional and general liability self-insured claims after December 31, 2006 [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					$ 5,000,000
Minimum
Commitments And Contingencies [Line Items]
Malpractice loss contingency, average lag period from occurrence to settlement					3 years
Malpractice loss contingency, self-insured retention					$ 10,000,000
Minimum \| Professional and general liability self-insured claims under certain policy terms until Company total aggregate coverage is met if first aggregate layer becomes fully utilized [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					15,000,000
Minimum \| Triad professional and general liability self-insured claims after December 31, 2006 [Member]
Commitments And Contingencies [Line Items]
Malpractice loss contingency, self-insured retention					$ 1,000,000
Northwest Health - La Porte [Member]
Commitments And Contingencies [Line Items]
Capital commitment, future period after acquisition for completing open capital improvement projects month and year					2021-03
Capital commitment, post-acquisition estimated cost of replacement hospital					$ 126,000,000
Northwest Health - La Porte [Member] \| Maximum
Commitments And Contingencies [Line Items]
Capital commitment, future period after acquisition for completing open capital improvement projects					5 years
Northwest Health – Starke [Member]
Commitments And Contingencies [Line Items]
Capital commitment, future period after acquisition for completing open capital improvement projects date					Sep. 30, 2026
Capital commitment, post-acquisition estimated cost of replacement hospital					$ 15,000,000
Northwest Health – Starke [Member] \| Maximum
Commitments And Contingencies [Line Items]
Capital commitment, future period after acquisition for completing open capital improvement projects					5 years

Commitments and Contingencies - Schedule of Reconciliation of the Beginning and Ending Liability Balances in Connection with Probable Contingencies (Details) - Pending Litigation [Member] - Other Probable Contingencies [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Loss Contingency Accrual [Roll Forward]
Beginning Balance	$ 68	$ 19
Expense	14	87
Reserve for insured claim	11	(4)
Cash payments	(82)	(34)
Ending Balance	$ 11	$ 68

Subsequent Events - Additional Information (Details)									12 Months Ended
Subsequent Events - Additional Information (Details)	Feb. 09, 2021 USD ($)	Feb. 02, 2021 USD ($)	Jan. 29, 2021	Jan. 28, 2021 USD ($)	Jan. 06, 2021 USD ($)	Dec. 28, 2020 USD ($)	Jun. 29, 2020	Jun. 22, 2018 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2019	Feb. 01, 2021 Item	Jan. 01, 2021 Item	Jun. 23, 2019
Subsequent Event [Line Items]
Line of credit outstanding amount									$ 150,000,000
Senior Notes \| Senior Notes at 6.875% Due 2028
Subsequent Event [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 6.875% Due 2029
Subsequent Event [Line Items]
Debt instrument aggregate principal amount		$ 1,775,000,000
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029 \| Debt Instrument, Redemption, Period One
Subsequent Event [Line Items]
Debt instrument stated interest rate		6.875%
Debt instrument, maturity year		2029
Debt instrument, offering date		Apr. 15, 2024
Maximum period notice for redemption of debt		60 days
Minimum period notice for redemption of debt		15 days
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Subsequent Event [Line Items]
Debt instrument stated interest rate								11.00%	9.875%	9.875%			9.875%
Debt instrument, maturity year									2023	2023
Debt instrument, offering date									Jun. 22, 2018
Debt instrument aggregate principal amount								$ 1,770,000,000
Debt instrument redemption description									plus a “make-whole” premium, as described in the indenture governing the 9⅞% Junior-Priority Secured Notes due 2023.
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023 \| Debt Instrument, Redemption, Period One
Subsequent Event [Line Items]
Debt instrument redemption price percentage							109.875%	100.00%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount							40.00%
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023 \| Debt Instrument, Redemption, Period Two
Subsequent Event [Line Items]
Maximum period notice for redemption of debt								60 days
Minimum period notice for redemption of debt								15 days
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Subsequent Event [Line Items]
Debt instrument stated interest rate									6.25%	6.25%
Debt instrument, maturity year									2023	2023
Debt instrument aggregate principal amount						$ 2,579,000,000
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027
Subsequent Event [Line Items]
Debt instrument stated interest rate									5.625%	5.625%
Debt instrument, maturity year									2027	2027
Debt instrument, offering date									Dec. 28, 2020
Debt instrument aggregate principal amount						$ 1,900,000,000
Debt instrument, maturity date									Mar. 15, 2027
Maximum period notice for redemption of debt						60 days
Minimum period notice for redemption of debt						15 days
Debt instrument redemption description									plus a “make-whole” premium, as described in the indenture governing the 5⅝% Senior Secured Notes due 2027.
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount						40.00%
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027 \| Debt Instrument, Redemption, Period One
Subsequent Event [Line Items]
Debt instrument redemption price percentage						100.00%			102.813%
Senior Secured Notes \| 5⅝% Senior Secured Notes due 2027 \| Debt Instrument, Redemption, Period Two
Subsequent Event [Line Items]
Debt instrument redemption price percentage						105.625%			101.406%
Senior Secured Notes \| 6% Senior Secured Notes due 2029
Subsequent Event [Line Items]
Debt instrument stated interest rate									6.00%	6.00%
Debt instrument, maturity year									2029	2029
Senior Secured Notes \| 6% Senior Secured Notes due 2029 \| Debt Instrument, Redemption, Period One
Subsequent Event [Line Items]
Debt instrument redemption price percentage									103.00%
Senior Secured Notes \| 6% Senior Secured Notes due 2029 \| Debt Instrument, Redemption, Period Two
Subsequent Event [Line Items]
Debt instrument redemption price percentage									101.50%
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031 \| Debt Instrument, Redemption, Period Six
Subsequent Event [Line Items]
Debt instrument stated interest rate	4.75%
Debt instrument, maturity year	2031
Debt instrument, offering date	Feb. 15, 2026
Debt instrument redemption price percentage	100.00%
Maximum period notice for redemption of debt	60 days
Minimum period notice for redemption of debt	15 days
Debt instrument redemption description	plus a “make-whole” premium, as described in the indenture governing the 4¾% Senior Secured Notes due 2031
Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Subsequent Event [Line Items]
Debt instrument stated interest rate									8.625%	8.625%
Debt instrument, maturity year									2024	2024
Subsequent Event
Subsequent Event [Line Items]
Line of credit cancelled					$ 30,000,000
Subsequent Event \| Senior Notes \| Senior Secured Notes at 6.25%, Due 2023
Subsequent Event [Line Items]
Debt instrument stated interest rate				6.25%
Debt instrument, maturity year				2023
Debt instrument, redemption value				$ 95,000,000
Subsequent Event \| Senior Notes \| 5⅝% Senior Secured Notes due 2027
Subsequent Event [Line Items]
Debt instrument stated interest rate				5.625%
Debt instrument, maturity year				2027
Subsequent Event \| Senior Notes \| 6% Senior Secured Notes due 2029
Subsequent Event [Line Items]
Debt instrument stated interest rate				6.00%
Debt instrument, maturity year				2029
Subsequent Event \| Senior Notes \| Senior Notes at 6.875% Due 2028
Subsequent Event [Line Items]
Debt instrument stated interest rate			6.875%
Debt instrument, maturity year			2022
Debt instrument, offering date			Feb. 28, 2021
Debt instrument redemption price percentage			100.00%
Subsequent Event \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Subsequent Event [Line Items]
Debt instrument stated interest rate		6.875%
Debt instrument, maturity year		2029
Debt instrument, offering date		Feb. 02, 2021
Debt instrument aggregate principal amount		$ 1,775,000,000
Debt instrument, maturity date		Apr. 15, 2029
Subsequent Event \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029 \| Debt Instrument, Redemption, Period One
Subsequent Event [Line Items]
Debt instrument stated interest rate		6.875%
Debt instrument, maturity year		2029
Debt instrument, offering date		Apr. 15, 2024
Debt instrument redemption price percentage		100.00%
Maximum period notice for redemption of debt		60 days
Minimum period notice for redemption of debt		15 days
Debt instrument redemption description		plus a “make-whole” premium, as described in the indenture governing the 6⅞% Junior-Priority Secured Notes due 2029
Subsequent Event \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029 \| Debt Instrument, Redemption, Period Two
Subsequent Event [Line Items]
Debt instrument, offering date		Apr. 15, 2024
Debt instrument redemption price percentage		106.875%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount		40.00%
Subsequent Event \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Subsequent Event [Line Items]
Debt instrument stated interest rate		9.875%
Debt instrument, maturity year		2023
Subsequent Event \| Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Subsequent Event [Line Items]
Debt instrument stated interest rate	4.75%
Debt instrument, maturity year	2031
Debt instrument, offering date	Feb. 09, 2021
Debt instrument aggregate principal amount	$ 1,095,000,000.000
Debt instrument, maturity date	Feb. 15, 2031
Debt instrument redemption description	The 4¾% Senior Secured Notes due 2031 bear interest at a rate of 4¾% per year payable semi-annually in arrears on February 15 and August 15, commencing on August 15, 2021
Subsequent Event \| Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031 \| Debt Instrument, Redemption, Period Seven
Subsequent Event [Line Items]
Debt instrument stated interest rate	4.75%
Debt instrument, maturity year	2031
Debt instrument, offering date	Feb. 15, 2024
Debt instrument redemption price percentage	104.75%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%
Subsequent Event \| Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031 \| Debt Instrument, Redemption, Period Eight
Subsequent Event [Line Items]
Debt instrument redemption price percentage	103.00%
Debt instrument redemption description	plus accrued and unpaid interest, if any. In addition, any time prior to February 15, 2026, but not more than once during each twelve-month period
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	10.00%
Subsequent Event \| Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031 \| Debt Instrument, Redemption, Period Nine
Subsequent Event [Line Items]
Debt instrument stated interest rate	4.75%
Debt instrument, maturity year	2031
Debt instrument, offering date	Feb. 15, 2026
Maximum period notice for redemption of debt	60 days
Minimum period notice for redemption of debt	15 days
Subsequent Event \| Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Subsequent Event [Line Items]
Debt instrument stated interest rate	8.625%
Debt instrument, maturity year	2024
Debt instrument, offering date	Feb. 09, 2021
Lea Regional Medical Center \| Subsequent Event \| Hobbs, New Mexico
Subsequent Event [Line Items]
Number of licensed beds sold \| Item												68
Tennova Healthcare, Tullahoma \| Subsequent Event \| Tullahoma, Tennessee
Subsequent Event [Line Items]
Number of licensed beds sold \| Item												135
Tennova Healthcare – Shelbyville \| Subsequent Event \| Shelbyville, Tennessee
Subsequent Event [Line Items]
Number of licensed beds sold \| Item												60
Northwest Mississippi Medical Center \| Subsequent Event \| Clarksdale Mississippi
Subsequent Event [Line Items]
Number of licensed beds sold \| Item											181

Subsequent Events - Schedule of Early Redemption Prices on 6.785% Senior Notes due 2022 (Details) - Junior-Priority Secured Notes - Subsequent Event - Junior-Priority Secured Notes at 6.875% Due 2029	Feb. 02, 2021
Debt Instrument, Redemption, Period Three
Subsequent Event [Line Items]
Debt instrument redemption price percentage	103.438%
Debt instrument, redemption period, start date	Apr. 15, 2024
Debt instrument, redemption period, end date	Apr. 14, 2025
Debt Instrument, Redemption, Period Four
Subsequent Event [Line Items]
Debt instrument redemption price percentage	101.719%
Debt instrument, redemption period, start date	Apr. 15, 2025
Debt instrument, redemption period, end date	Apr. 14, 2026
Debt Instrument, Redemption, Period Five
Subsequent Event [Line Items]
Debt instrument redemption price percentage	100.00%
Debt instrument, redemption period, start date	Apr. 15, 2026
Debt instrument, redemption period, end date	Apr. 14, 2029

Subsequent Events - Schedule of Early Redemption Prices on 4.75% Senior Notes due 2031 (Details) - Senior Secured Notes - Subsequent Event - Senior Secured Notes at 4.75%, Due 2031	Feb. 09, 2021
Debt Instrument, Redemption, Period Ten
Subsequent Event [Line Items]
Debt instrument redemption price percentage	102.375%
Debt instrument, redemption period, start date	Feb. 15, 2026
Debt instrument, redemption period, end date	Feb. 14, 2027
Debt Instrument, Redemption, Period Eleven
Subsequent Event [Line Items]
Debt instrument redemption price percentage	101.583%
Debt instrument, redemption period, start date	Feb. 15, 2027
Debt instrument, redemption period, end date	Feb. 14, 2028
Debt Instrument, Redemption, Period Twelve
Subsequent Event [Line Items]
Debt instrument redemption price percentage	100.792%
Debt instrument, redemption period, start date	Feb. 15, 2028
Debt instrument, redemption period, end date	Feb. 14, 2029
Debt Instrument, Redemption, Period Thirteen
Subsequent Event [Line Items]
Debt instrument redemption price percentage	100.00%
Debt instrument, redemption period, start date	Feb. 15, 2029
Debt instrument, redemption period, end date	Feb. 14, 2031

Condensed Financial Information of Parent - Condensed Balance Sheets (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
ASSETS
Prepaid income taxes	$ 50	$ 48
Total current assets	4,510	3,427
Deferred income taxes	59	38
Other assets, net	1,896	2,208
Total assets	16,006	15,609
LIABILITIES AND STOCKHOLDERS’ DEFICIT
Deferred income taxes	29	200
Other long-term liabilities	1,599	894
Total liabilities	17,060	17,248
Community Health Systems, Inc. stockholders’ deficit:
Preferred stock
Common stock	1	1
Additional paid-in capital	2,094	2,008
Accumulated other comprehensive loss	(13)	(9)	$ (10)
Accumulated deficit	(3,707)	(4,218)
Total Community Health Systems, Inc. stockholders’ deficit	(1,625)	(2,218)
Total liabilities and stockholders’ deficit	16,006	15,609
Parent Company
ASSETS
Prepaid income taxes	50	48
Total current assets	50	48
Deferred income taxes	59	38
Other assets, net	(3)	(4)
Total assets	106	82
LIABILITIES AND STOCKHOLDERS’ DEFICIT
Intercompany payable	1,701	2,099
Deferred income taxes	29	200
Other long-term liabilities	1	1
Total liabilities	1,731	2,300
Community Health Systems, Inc. stockholders’ deficit:
Preferred stock
Common stock	1	1
Additional paid-in capital	2,094	2,008
Accumulated other comprehensive loss	(13)	(9)
Accumulated deficit	(3,707)	(4,218)
Total Community Health Systems, Inc. stockholders’ deficit	(1,625)	(2,218)
Total liabilities and stockholders’ deficit	$ 106	$ 82

Condensed Financial Information of Parent - Condensed Statement of Income (Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Condensed Income Statements Captions [Line Items]
Net operating revenues	$ 11,789	$ 13,210	$ 14,155
Operating costs and expenses:
Salaries and benefits	5,411	5,947	6,384
Supplies	1,963	2,151	2,355
Other operating expenses	2,957	3,303	3,496
Government and other legal settlements and related costs		93	11
Electronic health records incentive reimbursement		(1)	(4)
Lease cost and rent	327	321	337
Pandemic relief funds	(601)
Depreciation and amortization	558	608	700
Impairment and (gain) loss on sale of businesses, net	48	138	668
Total operating costs and expenses	10,663	12,560	13,947
Income from operations	1,126	650	208
Interest expense, net	1,031	1,041	976
(Gain) loss from early extinguishment of debt	(317)	54	(31)
Equity in earnings of unconsolidated affiliates	(10)	(15)	(22)
Income (loss) before income taxes	422	(430)	(715)
(Benefit from) provision for income taxes	(185)	160	(11)
Net income (loss)	607	(590)	(704)
Less: Net income attributable to noncontrolling interests	96	85	84
Net income (loss) attributable to Community Health Systems, Inc. stockholders	511	(675)	(788)
Parent Company
Operating costs and expenses:
Equity in earnings of unconsolidated affiliates	(511)	675	788
Income (loss) before income taxes	511	(675)	(788)
Net income (loss)	511	(675)	(788)
Net income (loss) attributable to Community Health Systems, Inc. stockholders	$ 511	$ (675)	$ (788)

Condensed Financial Information of Parent - Condensed Statements of Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	$ 607	$ (590)	$ (704)
Equity in other comprehensive (loss) income of affiliates, net of income taxes:
Net change in fair value of interest rate swaps, net of tax	(1)	(3)	20
Net change in fair value of available-for-sale debt securities, net of tax	4	4	(2)
Amortization and recognition of unrecognized pension cost components, net of tax	(7)		(1)
Other comprehensive (loss) income	(4)	1	17
Comprehensive income (loss)	603	(589)	(687)
Less: Comprehensive income attributable to noncontrolling interests	96	85	84
Comprehensive income (loss) attributable to Community Health Systems, Inc. stockholders	507	(674)	(771)
Parent Company
Condensed Statement Of Income Captions [Line Items]
Net income (loss)	511	(675)	(788)
Equity in other comprehensive (loss) income of affiliates, net of income taxes:
Net change in fair value of interest rate swaps, net of tax	(1)	(3)	20
Net change in fair value of available-for-sale debt securities, net of tax	4	4	(2)
Amortization and recognition of unrecognized pension cost components, net of tax	(7)		(1)
Other comprehensive (loss) income	(4)	1	17
Comprehensive income (loss)	507	(674)	(771)
Comprehensive income (loss) attributable to Community Health Systems, Inc. stockholders	$ 507	$ (674)	$ (771)

Condensed Financial Information of Parent - Condensed Statement of Cash Flows (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash flows from operating activities:
Net cash (used in) provided by operating activities	$ 2,178	$ 385	$ 274
Cash flows from investing activities:
Net cash provided by (used in) investing activities	177	(2)	(245)
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(1)	(1)	(1)
Net cash used in financing activities	(895)	(363)	(396)
Net change in cash and cash equivalents	1,460	20	(367)
Cash and cash equivalents at beginning of period	1,676	216	196	$ 563
Parent Company
Cash flows from operating activities:
Net cash (used in) provided by operating activities	(12)	(4)	40
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(1)	(1)	(1)
Changes in intercompany balances with affiliates, net	13	5	(39)
Net cash used in financing activities	$ 12	$ 4	$ (40)