0001564590-21-052633 | 10-Q | XBRL Viewer | Community Health Systems INC

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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2021	Oct. 22, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity File Number	001-15925
Entity Registrant Name	COMMUNITY HEALTH SYSTEMS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-3893191
Entity Address, Address Line One	4000 Meridian Boulevard
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	465-7000
Title of 12(b) Security	Common Stock, $.01 par value
Trading Symbol	CYH
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		132,107,916
Entity Central Index Key	0001108109
Amendment Flag	false

Condensed Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Net operating revenues	$ 3,115	$ 3,126	$ 9,135	$ 8,670
Operating costs and expenses:
Salaries and benefits	1,336	1,365	3,905	4,054
Supplies	529	523	1,521	1,439
Other operating expenses	716	736	2,170	2,211
Government and other legal settlements and related costs				4
Lease cost and rent	75	85	231	248
Pandemic relief funds	(19)		(102)	(448)
Depreciation and amortization	137	139	408	424
Impairment and (gain) loss on sale of businesses, net	1	(7)	24	48
Total operating costs and expenses	2,775	2,841	8,157	7,980
Income from operations	340	285	978	690
Interest expense, net	216	257	666	779
Loss (gain) from early extinguishment of debt		(115)	79	(111)
Gain on sale of investments in unconsolidated affiliates	(26)		(26)
Equity in earnings of unconsolidated affiliates	(4)	(5)	(19)	(11)
Income before income taxes	154	148	278	33
Provision for (benefit from) income taxes	10	20	132	(221)
Net income	144	128	146	254
Less: Net income attributable to noncontrolling interests	33	16	94	54
Net income attributable to Community Health Systems, Inc. stockholders	$ 111	$ 112	$ 52	$ 200
Earnings per share attributable to Community Health Systems, Inc. common stockholders:
Basic	$ 0.87	$ 0.98	$ 0.41	$ 1.74
Diluted	$ 0.85	$ 0.97	$ 0.40	$ 1.74
Weighted-average number of shares outstanding:
Basic	127,077,786	115,015,460	126,638,291	114,764,050
Diluted	130,885,139	115,640,852	129,885,951	115,012,202

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 144	$ 128	$ 146	$ 254
Other comprehensive income (loss), net of income taxes:
Net change in fair value of available-for-sale debt securities, net of tax	(1)		(4)	3
Amortization and recognition of unrecognized pension cost components, net of tax	2		3	1
Other comprehensive income (loss)	1		(1)	4
Comprehensive income	145	128	145	258
Less: Comprehensive income attributable to noncontrolling interests	33	16	94	54
Comprehensive income attributable to Community Health Systems, Inc. stockholders	$ 112	$ 112	$ 51	$ 204

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income (loss) and other comprehensive income (loss), attributable to noncontrolling interests. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

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

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+ Details

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 1,294	$ 1,676
Patient accounts receivable	2,024	1,927
Supplies	341	335
Prepaid income taxes	44	50
Prepaid expenses and taxes	189	184
Other current assets	285	338
Total current assets	4,177	4,510
Property and equipment	9,536	9,352
Less accumulated depreciation and amortization	(4,168)	(4,030)
Property and equipment, net	5,368	5,322
Goodwill	4,219	4,219
Deferred income taxes	59	59
Other assets, net	1,847	1,896
Total assets	15,670	16,006
Current liabilities:
Current maturities of long-term debt	35	123
Current operating lease liabilities	142	142
Accounts payable	763	783
Accrued liabilities:
Employee compensation	687	637
Accrued interest	198	150
Other	1,265	980
Total current liabilities	3,090	2,815
Long-term debt	11,976	12,093
Deferred income taxes	152	29
Long-term operating lease liabilities	538	524
Other long-term liabilities	914	1,599
Total liabilities	16,670	17,060
Redeemable noncontrolling interests in equity of consolidated subsidiaries	493	484
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; 132,041,102 shares issued and outstanding at September 30, 2021, and 129,612,117 shares issued and outstanding at December 31, 2020	1	1
Additional paid-in capital	2,092	2,094
Accumulated other comprehensive loss	(14)	(13)
Accumulated deficit	(3,655)	(3,707)
Total Community Health Systems, Inc. stockholders’ deficit	(1,576)	(1,625)
Noncontrolling interests in equity of consolidated subsidiaries	83	87
Total stockholders’ deficit	(1,493)	(1,538)
Total liabilities and stockholders’ deficit	$ 15,670	$ 16,006

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
Statement Of Financial Position [Abstract]
Preferred stock, par value per share	$ 0.01	$ 0.01
Preferred stock, shares authorized	100,000,000	100,000,000
Preferred stock, shares issued	0	0
Common stock, par value per share	$ 0.01	$ 0.01
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares issued	132,041,102	129,612,117
Common stock, shares outstanding	132,041,102	129,612,117

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income	$ 146	$ 254
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	408	424
Deferred income taxes	123	(223)
Government and other legal settlements and related costs		4
Stock-based compensation expense	18	8
Impairment and (gain) loss on sale of businesses, net	24	48
Loss (gain) from early extinguishment of debt	79	(111)
Gain on sale of investments in unconsolidated affiliates	(26)
Other non-cash expenses, net	22	99
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	(99)	281
Supplies, prepaid expenses and other current assets	14	16
Medicare accelerated payments		1,159
Repayment/derecognition of Medicare accelerated payments	(267)	(22)
Pandemic relief funds		271
Accounts payable, accrued liabilities and income taxes	85	(81)
Other	(127)	(25)
Net cash provided by operating activities	400	2,102
Cash flows from investing activities:
Acquisitions of facilities and other related businesses	(3)	(1)
Purchases of property and equipment	(334)	(317)
Proceeds from disposition of hospitals and other ancillary operations	17	347
Proceeds from sale of property and equipment	7	4
Purchases of available-for-sale debt securities and equity securities	(135)	(68)
Proceeds from sales of available-for-sale debt securities and equity securities	86	80
Proceeds from sale of investments in unconsolidated affiliates	110
Increase in other investments	(61)	(36)
Net cash (used in) provided by investing activities	(313)	9
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(5)	(1)
Deferred financing costs and other debt-related costs	(310)	(32)
Proceeds from noncontrolling investors in joint ventures	1
Redemption of noncontrolling investments in joint ventures	(5)	(4)
Distributions to noncontrolling investors in joint ventures	(95)	(84)
Proceeds from sale-lease back		2
Other borrowings	50	31
Issuance of long-term debt	4,310	1,462
Proceeds from ABL Facility		540
Repayments of long-term indebtedness	(4,415)	(2,418)
Net cash used in financing activities	(469)	(504)
Net change in cash and cash equivalents	(382)	1,607
Cash and cash equivalents at beginning of period	1,676	216
Cash and cash equivalents at end of period	1,294	1,823
Supplemental disclosure of cash flow information:
Interest payments	(572)	(765)
Income tax payments, net	$ (3)	$ (2)

Basis of Presentation and Significant Accounting Policies

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

1. BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

The unaudited condensed consolidated financial statements of Community Health Systems, Inc. (the “Parent” or “Parent Company”) and its subsidiaries (the “Company”) as of September 30, 2021 and December 31, 2020 and for the three-month and nine-month periods ended September 30, 2021 and 2020, have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). In the opinion of management, such information contains all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for such periods. All intercompany transactions and balances have been eliminated. The results of operations for the three and nine months ended September 30, 2021, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2021. The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements. Actual results could differ from these estimates under different assumptions or conditions.

Certain information and disclosures normally included in the notes to the consolidated financial statements have been condensed or omitted as permitted by the rules and regulations of the Securities and Exchange Commission (the “SEC”). The Company believes the disclosures are adequate to make the information presented not misleading. The accompanying unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2020, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 18, 2021 (“2020 Form 10-K”).

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

Substantially all of the Company’s operating costs and expenses are “cost of revenue” items. Operating costs that could be classified as general and administrative by the Company include the Company’s corporate office costs at its Franklin, Tennessee office, which were $56 million and $41 million for the three months ended September 30, 2021 and 2020, respectively, and $168 million and $136 million for the nine months ended September 30, 2021 and 2020, respectively. Operating costs during the nine months ended September 30, 2021 reflect increased stock compensation and annual cash incentive compensation compared to the nine months ended September 30, 2020.

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

Revenue Recognition.

Net Operating Revenues

Net operating revenues are recorded at the transaction price estimated by the Company to reflect the total consideration due from patients and third-party payors in exchange for providing goods and services in patient care. These services are considered to be a single performance obligation and have a duration of less than one year. Revenues are recorded as these goods and services are provided. The transaction price, which involves significant estimates, is determined based on the Company’s standard charges for the goods and services provided, with a reduction recorded for price concessions related to third party contractual arrangements as well as patient discounts and other patient price concessions. During each of the three and nine-month periods ended September 30, 2021 and 2020, 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 or payment is reasonably assured. Reimbursement under these programs is reflected in net operating revenues and fees, taxes or other program-related costs are reflected in other operating expenses.

The Company’s net operating revenues during the three and nine months ended September 30, 2021 and 2020 have been presented in the following table based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in millions):

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Medicare	$	653	$	723	$	1,988	$	2,086
Medicaid		412		419		1,223		1,167
Managed Care and other third-party payors		2,010		1,967		5,845		5,425
Self-pay		40		17		79		(8	)
Total	$	3,115	$	3,126	$	9,135	$	8,670

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 $111 million and $98 million as of September 30, 2021 and December 31, 2020, respectively, and these amounts are included in accrued liabilities-other in the accompanying condensed consolidated balance sheets. Amounts due from third-party payors were $109 million and $136 million as of September 30, 2021 and December 31, 2020, respectively, and are included in other current assets in the accompanying condensed consolidated balance sheets. Substantially all Medicare and Medicaid cost reports are final settled through 2016.

Charity Care

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

These charity care services are estimated to be $215 million and $285 million for the three months ended September 30, 2021 and 2020, respectively, and $659 million and $751 million for the nine months ended September 30, 2021 and 2020, 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 $25 million and $36 million during the three months ended September 30, 2021 and 2020, respectively, and $77 million and $90 million during the nine months ended September 30, 2021 and 2020, respectively. The estimated cost of these charity care services was determined using a ratio of cost to gross charges and applying that ratio to the gross charges associated with providing care to charity patients for the period.

Accounting for the Impairment or Disposal of Long-Lived Assets. During the nine months ended September 30, 2021, the Company recorded a net loss on disposal of approximately $24 million, of which (i) approximately $29 million was recorded to adjust the carrying value of long-lived assets at several hospitals that were sold at a sales price below carrying value, (ii) approximately $3 million was recorded related to divestiture related expenses, and (iii) approximately $8 million of gain was recorded related to the disposal of the Company’s majority interest in a surgery center that was sold on January 1, 2021. Approximately $7 million of goodwill was allocated to facilities disposed of during the nine months ended September 30, 2021.

During the nine months ended September 30, 2020, the Company recorded a total combined net impairment charge and loss on disposal of approximately $48 million, of which (i) approximately $74 million was recorded primarily to adjust the carrying value of long-lived assets at several hospitals where the Company was in discussions with potential buyers for divestiture at a sales price that indicated a fair value below carrying value, (ii) approximately $43 million was recorded related to certain hospitals that were classified as held for sale based on the difference between the carrying value of the hospital disposal groups compared to their estimated fair value less costs to sell, (iii) approximately $3 million was recorded related to a hospital that closed on September 30, 2020, and (iv) approximately $1 million was recorded related to a shared service center that closed on July 31, 2020. The impairment charge was partially offset by a gain of approximately $73 million related to three hospitals sold on January 1, 2020 and one hospital sold on July 1, 2020.

The Company will continue to evaluate the potential for impairment of the long-lived assets of underperforming hospitals as well as evaluate offers for potential sales, as applicable. Based on such analysis, additional impairment charges may be recorded in the future.

COVID-19 Pandemic.

COVID-19, a disease caused by a novel strain of coronavirus, materially affected the Company’s results of operations during 2020 and continued to affect the Company’s results of operations during the nine months ended September 30, 2021. 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, the Consolidated Appropriations Act, 2021 (the “CAA”), which was enacted on December 27, 2020, and the American Rescue Plan Act of 2021 (the “ARPA”), which was enacted on March 11, 2021. Together, these stimulus laws authorize over $178 billion in funding to be distributed to hospitals and other healthcare providers through the Public Health and Social Services Emergency Fund (the “PHSSEF” or “Provider Relief Fund”). In addition to the relief funding, the CARES Act provided 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 state and local programs also exist to provide relief, either independently or through distribution of monies received via the CARES Act and other enacted federal legislation. The Company’s accounting policies for the recognition of these stimulus monies are as follows:

Pandemic Relief Funds

Through September 30, 2021, net of amounts that have been repaid to the respective federal, state, or local agency, the Company received approximately $709 million in payments through the PHSSEF and various state and local programs on a cumulative basis since their enactment. Of the net amount received to-date, approximately $705 million was received during the year ended December 31, 2020 and the remainder was received during the nine months ended September 30, 2021.

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 the U.S. Department of Health and Human

Services Agency (“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. Amounts recognized are denoted by the caption “pandemic relief funds” within the condensed consolidated statements of income.

The Company’s assessment of whether the terms and conditions for amounts received are reasonably assured of having been met is updated each reporting period and considers, among other things, the requirements set forth in the CARES Act and subsequent relief legislation, responses to all applicable frequently asked questions and other interpretive guidance issued by HHS, including the various Post-Payment Notices of Reporting Requirements, the Company’s expenses incurred attributable to the coronavirus, the Company’s results of operations during such period as compared to the Company’s 2020 budget, and the allocation of general and targeted fund distribution payments among subsidiaries of the Company during such period. The HHS guidance, specifically the various Post-Payment Notices of Reporting Requirements and frequently asked questions, 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. The use of funds calculation takes into account expenses attributable to each respective entity, which for the Company primarily relate to incremental labor and supply costs, as well as lost revenues. The deadlines for using and required timelines for reporting on the use of funds depend on the dates of receipt of the funds. During the year ended December 31, 2020, pandemic relief funds of approximately $601 million were recognized up to the amount which the Company was reasonably assured that it could or would choose to comply with conditions underlying amounts received. This included the allocation of general fund distributions among subsidiaries according to total unreimbursed losses but not the allocation of targeted fund distributions due to significant uncertainties as to the meaning and interpretation of conditions specific to the allocation of such targeted distribution payments, as previously disclosed. During the three months ended March 31, 2021, pandemic relief funds of approximately $82 million were recognized on the basis of the Company’s facility-by-facility assessment of uncertainties associated with the allocation of targeted distribution payments having been updated for additional facts and circumstances in the period. On the basis of this updated assessment, the Company was reasonably assured that underlying conditions for the allocation of targeted distribution payments were met as of March 31, 2021 (which conclusion has not changed). Pandemic relief funds of approximately $1 million were recognized during the three months ended June 30, 2021.

During the three and nine months ended September 30, 2021, pandemic relief funds of approximately $19 million and $102 million, respectively, were recognized. Such amounts were recognized on the basis of expenses incurred in the periods attributable to the coronavirus, the Company’s results of operations during such periods as compared to the Company’s 2020 budget for the same period and the allocation of targeted distribution payments to various subsidiaries. During the nine months ended September 30, 2020, pandemic relief funds of approximately $448 million were recognized on the basis of facts and circumstances at that time. No pandemic relief funds were recognized during the three months ended September 30, 2020.

Amounts received through the PHSSEF or state and local programs that have not yet been recognized or otherwise have not been refunded to HHS or the various state and local agencies as of September 30, 2021, are reflected within accrued liabilities-other in the condensed consolidated balance sheet. Such unrecognized amounts may either be returned to HHS or the respective state or local agency, as applicable, or may be recognized in future periods if the underlying conditions for recognition are reasonably assured of having been 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, including during the three and nine months ended September 30, 2021. 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.

In April 2021, CMS began recouping Medicare accelerated payments previously received by the Company. As of September 30, 2021, approximately $249 million has been recouped from the Company by CMS subject to the aforementioned repayment terms. Additionally, approximately $18 million and $77 million of amounts previously received were repaid by the Company to CMS or assumed by buyers related to hospitals the Company divested during the nine months ended September 30, 2021 and the year ended December 31, 2020, respectively. As of September 30, 2021, approximately $814 million of Medicare accelerated payments are reflected within accrued liabilities-other in the condensed consolidated balance sheet. As described further in Note 12, the outstanding balance of Medicare accelerated payments was paid in full to CMS in October 2021, prior to the date of this Quarterly Report on Form 10-Q (the “Form 10-Q”).

Accounting for Stock-Based Compensation

9 Months Ended

Sep. 30, 2021

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 2009 Stock Option and Award Plan, which was amended and restated as of March 17, 2021 and approved by the Company’s stockholders at the annual meeting of stockholders held on May 11, 2021 (the “2009 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, these options vest in one-third increments on each of the first three anniversaries of the award date and have a 10-year contractual term. As of September 30, 2021, 12,614,521 shares of unissued common stock were reserved for future grants under the 2009 Plan.

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

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

	Three Months Ended						Nine Months Ended
	September 30,						September 30,
	2021			2020			2021			2020
Effect on income before income taxes	$	(5	)	$	(3	)	$	(18	)	$	(8	)
Effect on net income	$	(4	)	$	(2	)	$	(14	)	$	(6	)

At September 30, 2021, $29 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 25 months. Of that amount, $5 million relates to outstanding unvested stock options expected to be recognized over a weighted-average period of 25 months and $24 million relates to outstanding unvested restricted stock and restricted stock units expected to be recognized over a weighted-average period of 24 months. There were no modifications to awards during the nine months ended September 30, 2021 and 2020.

The fair value of stock options was estimated using the Black Scholes option pricing model with the following assumptions and weighted-average fair values during the three and nine months ended September 30, 2021 and 2020:

	Three Months Ended September 30,		Nine Months Ended September 30,
	2021	2020	2021		2020
Expected volatility	N/A	N/A	84.3% - 88.9%			73.5	%
Expected dividends	N/A	N/A		—		—
Expected term	N/A	N/A	3 - 6 years		6 years
Risk-free interest rate	N/A	N/A	0.3% - 0.9%			1.0	%

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 2009 Plan as of September 30, 2021, and changes during each of the three-month periods following December 31, 2020, was as follows (in millions, except share and per share data):

						Weighted-	Aggregate
				Weighted-		Average	Intrinsic
				Average		Remaining	Value as of
				Exercise		Contractual	September 30,
	Shares			Price		Term	2021
Outstanding at December 31, 2020		1,817,525		$	8.77
Granted		749,250			8.81
Exercised		(65,165	)		4.97
Forfeited and cancelled		(173,189	)		34.66
Outstanding at March 31, 2021		2,328,421			6.96
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(22,334	)		24.23
Outstanding at June 30, 2021		2,306,087			6.79
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(2,000	)		17.95
Outstanding at September 30, 2021		2,304,087		$	6.78	8.2 years	$	12
Exercisable at September 30, 2021		733,162		$	6.79	7.0 years	$	4

No stock options were granted during the three months ended September 30, 2021 and 2020.The weighted-average grant date fair value of stock options granted during the nine months ended September 30, 2021 and 2020 was $6.22 and $3.17, respectively. The aggregate intrinsic value (calculated as the number of in-the-money stock options multiplied by the difference between the Company’s closing stock price on the last trading day of the reporting period ($11.70) and the exercise price of the respective stock options) in the table above represents the amount that would have been received by the option holders had all option holders exercised their options on September 30, 2021. This amount changes based on the market value of the Company’s common stock. The aggregate intrinsic value of options exercised during the nine months ended September 30, 2021 was less than $1 million; no options were exercised during the three months ended September 30, 2021. There were no options exercised during the three or nine months ended September 30, 2020. The aggregate intrinsic value of options vested and expected to vest approximates that of the outstanding options.

The Company has 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. 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. On March 1, 2021, restricted stock awards subject to performance objectives granted on March 1, 2018 vested at 200% of the shares originally granted based on the Company’s cumulative performance compared to objectives for the 2018-2020 performance period. Restricted stock awards subject to performance objectives that have not yet been satisfied are not considered outstanding for purposes of determining earnings per share unless the performance objectives have been satisfied on the basis of results through the end of each respective reporting period.

Restricted stock outstanding under the 2009 Plan as of September 30, 2021, and changes during each of the three-month periods following December 31, 2020, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2020		4,555,735		$	4.84
Granted		2,829,250			7.97
Vested		(2,264,992	)		4.70
Forfeited		(37,334	)		4.94
Unvested at March 31, 2021		5,082,659			6.65
Granted		30,000			16.18
Vested		(17,335	)		3.48
Forfeited		(47,670	)		6.81
Unvested at June 30, 2021		5,047,654			6.72
Granted		—			—
Vested		—			—
Forfeited		(84,338	)		6.61
Unvested at September 30, 2021		4,963,316			6.72

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 19,296 RSUs and 34,483 RSUs on March 1, 2021 and 2020, respectively. Each of the 2021 and 2020 grants had a grant date fair value of approximately $170,000. Vesting of these RSUs occurs in one-third increments on each of the first three anniversaries of the award date or upon the director’s earlier cessation of service on the board, other than for cause. Beginning with the 2020 grant, each non-management director may elect, prior to the beginning of the calendar year in which the award is granted, to defer the receipt of shares of the Company’s common stock issuable upon vesting until either his or her (i) separation from service with the Company or (ii) attainment of an age specified in advance by the non-management director. A total of four directors elected to defer the receipt of RSUs granted on March 1, 2021 to a future date and 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 September 30, 2021, and changes during each of the three-month periods following December 31, 2020, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2020		613,739		$	4.89
Granted		173,664			8.81
Vested		(247,164	)		4.81
Forfeited		—			—
Unvested at March 31, 2021		540,239			6.19
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at June 30, 2021		540,239			6.19
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at September 30, 2021		540,239			6.19

Acquisitions and Divestitures

9 Months Ended

Sep. 30, 2021

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 a controlling interest 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.

During the nine months ended September 30, 2021, one or more subsidiaries of the Company paid approximately $3 million to acquire the operating assets and related businesses of certain physician practices, clinics and other ancillary businesses that operate within the communities served by the Company’s affiliated hospitals. The Company allocated the purchase price to property and equipment, working capital, noncontrolling interests and goodwill.

Divestitures

The following table provides a summary of hospitals that the Company divested during the nine months ended September 30, 2021 and the year ended December 31, 2020:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2021 Divestitures:
Lea Regional Medical Center	Covenant Health System	Hobbs, NM	84	January 1, 2021
Tennova Healthcare - Tullahoma	Vanderbilt University Medical Center	Tullahoma, TN	135	January 1, 2021
Tennova Healthcare - Shelbyville	Vanderbilt University Medical Center	Shelbyville, TN	60	January 1, 2021
Northwest Mississippi Medical Center	Delta Health System	Clarksdale, MS	181	February 1, 2021
AllianceHealth Midwest	SSM Health Care of Oklahoma	Midwest City, OK	255	April 1, 2021

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 Healthcare, Inc. (“HCA”)	Live Oak, FL	25	May 1, 2020
Shands Starke Regional Medical Center	HCA	Starke, FL	49	May 1, 2020
Southside Regional Medical Center	Bon Secours Mercy Health System	Petersburg, VA	300	January 1, 2020
Southampton Memorial Hospital	Bon Secours Mercy Health System	Franklin, VA	105	January 1, 2020
Southern Virginia Regional Medical Center	Bon Secours Mercy Health System	Emporia, VA	80	January 1, 2020

Other

On July 30, 2021, the Company sold its unconsolidated minority equity interests in Macon Healthcare, LLC, a joint venture with certain subsidiaries of HCA representing two hospitals in Macon, Georgia, in which the Company held a 38% interest. The Company received $110 million in cash in connection with the sale of its equity interests and, as a result, recognized a pre-tax gain of approximately $26 million on the sale of investments in unconsolidated affiliates during the three and nine months ended September 30, 2021.

Income Taxes

9 Months Ended

Sep. 30, 2021

Income Tax Disclosure [Abstract]

INCOME TAXES

4. INCOME TAXES

The total amount of unrecognized benefit that would affect the effective tax rate, if recognized, was less than $1 million as of September 30, 2021. A total of less than $1 million of interest and penalties is included in the amount of the liability for uncertain tax positions at September 30, 2021. It is the Company’s policy to recognize interest and penalties related to unrecognized benefits in its condensed consolidated statements of income as income tax expense.

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

The Company’s federal income tax returns for the 2014, 2015 and 2018 tax years are under examination by the Internal Revenue Service. The Company believes the results of these examinations will not be material to its condensed consolidated results of operations or financial position. The Company has extended the federal statute of limitations through December 31, 2021 for Community Health Systems, Inc. for the tax periods ended December 31, 2014 and 2015.

The Company’s effective tax rates were 6.5% and 13.5% for the three months ended September 30, 2021 and 2020, respectively, and 47.5% and (669.7)% for the nine months ended September 30, 2021 and 2020, respectively. The difference in the Company’s effective tax rate for the three and nine months ended September 30, 2021, when compared to the three and nine months ended September 30, 2020, was primarily due to an increase in the valuation allowance recognized on IRC Section 163(j) interest carryforwards created as a result of the financing transactions completed during the three months ended September 30, 2020. The difference in the Company’s effective tax rate for the nine months ended September 30, 2021, when compared to the nine months ended September 30, 2020, was primarily due to the changes in tax benefits as a result of an increase to the deductible interest expense allowed for 2019 and 2020 under the CARES Act that was enacted during the three months ended March 31, 2020.

Cash paid for income taxes, net of refunds received, resulted in a net payment of approximately $1 million and $3 million during the three months ended September 30, 2021 and 2020, respectively, and a net payment of approximately $3 million and $2 million during the nine months ended September 30, 2021 and 2020, 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

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 21
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32857-109319

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330215-122817

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 17
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32809-109319

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330036-122817

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 14
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32705-109319

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 270
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6424409&loc=d3e44925-109338

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-URI http://asc.fasb.org/topic&trid=2144680

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=6424122&loc=d3e41874-109331

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Long-Term Debt

9 Months Ended

Sep. 30, 2021

Long Term Debt And Capital Lease Obligations [Abstract]

LONG-TERM DEBT

5. LONG-TERM DEBT

Long-term debt, net of unamortized deferred debt issuance costs, consists of the following (in millions):

	September 30,			December 31,
	2021			2020
6⅞% Senior Notes due 2022	$	—		$	126
6¼% Senior Secured Notes due 2023		—			95
8⅝% Senior Secured Notes due 2024		—			1,033
6⅝% Senior Secured Notes due 2025		1,462			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			1,900
6⅞% Senior Notes due 2028		767			767
6% Senior Secured Notes due 2029		900			900
4¾% Senior Secured Notes due 2031		1,095			—
9⅞% Junior-Priority Secured Notes due 2023		—			1,769
8⅛% Junior-Priority Secured Notes due 2024		—			1,348
6⅞% Junior-Priority Secured Notes due 2029		1,775			—
6⅛% Junior-Priority Secured Notes due 2030		1,440			—
ABL Facility		—			—
Finance lease and financing obligations		279			239
Other		37			26
Less: Unamortized deferred debt issuance costs and note premium		(445	)		(250	)
Total debt		12,011			12,216
Less: Current maturities		(35	)		(123	)
Total long-term debt	$	11,976		$	12,093

On January 28, 2021, the remaining principal amount of the 6¼% Senior Secured Notes due 2023 of approximately $95 million was redeemed using cash on hand.

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, together with cash on hand, were used to redeem the 9⅞% Junior-Priority Secured Notes due 2023 in February 2021 and to pay related fees and expenses. The 6⅞% Junior-Priority Secured Notes due 2029 bear interest at a rate of 6.875% 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 the current and future domestic subsidiaries of CHS/Community Health Systems, Inc. (“CHS”) 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 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 CHS’ 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’ 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, together with cash on hand, were used to redeem the 8⅝% Senior Secured Notes due 2024 on February 9, 2021, and to pay related fees and expenses. The 4¾% Senior Secured Notes due 2031 bear interest at a rate of 4.750% 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, CHS 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	%

On March 1, 2021, the Company redeemed the remaining principal amount of the 6⅞% Senior Notes due 2022 of approximately $126 million using cash on hand.

On May 19, 2021, the Company completed a private offering of $1.440 billion aggregate principal amount of 6⅛% Junior-Priority Secured Notes due April 1, 2030 (the “6⅛% Junior-Priority Secured Notes due 2030”). The proceeds of the offering, together with cash on hand, were used to redeem the 8⅛% Junior-Priority Secured Notes due 2024 on May 19, 2021, and to pay related fees and

expenses. The 6⅛% Junior-Priority Secured Notes due 2030 bear interest at a rate of 6.125% per year payable semi-annually in arrears on April 1 and October 1, commencing on October 1, 2021. The 6⅛% Junior-Priority Secured Notes due 2030 are unconditionally guaranteed on a junior-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 6⅛% Junior-Priority Secured Notes due 2030 and the related guarantees are secured by shared (i) second-priority liens on the Non-ABL Priority Collateral and (ii) third-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 6⅛% Junior-Priority Secured Notes due 2030.

CHS is entitled, at its option, to redeem all or a portion of the 6⅛% Junior-Priority Secured Notes due 2030 at any time prior to April 1, 2025, upon not less than 15 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 6⅛% Junior-Priority Secured Notes due 2030 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 6⅛% Junior-Priority Secured Notes due 2030.

CHS may redeem up to 40% of the aggregate principal amount of the 6⅛% Junior-Priority Secured Notes due 2030 at any time prior to May 15, 2024 using the net proceeds from certain equity offerings at a redemption price of 106.125% of the principal amount of the 6⅛% Junior-Priority Secured Notes due 2030 redeemed, plus accrued and unpaid interest, if any.

At any time and from time to time on or after April 1, 2025, CHS may redeem the 6⅛% Junior-Priority Secured Notes due 2030 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 6⅛% Junior-Priority Secured Notes due 2030 redeemed, to, but excluding, the applicable date of redemption, if redeemed during the twelve-month period beginning on April 1 of the years indicated below:

Period	Redemption Price
April 1, 2025 to March 31, 2026		103.063	%
April 1, 2026 to March 31, 2027		101.531	%
April 1, 2027 to March 31, 2030		100.000	%

The maximum aggregate principal amount under the ABL Facility is $1.0 billion. At September 30, 2021, the available borrowing base under the ABL Facility was $836 million, of which $108 million was reserved for outstanding letters of credit and $728 million represented excess availability. The Company had no outstanding borrowings as of September 30, 2021. Letters of credit were reduced during the nine months ended September 30, 2021 by $42 million, primarily in relation to a professional liability claim that was settled and funded during the three months ended December 31, 2020. The issued letters of credit are primarily in support of potential insurance-related claims and certain bonds.

The ABL Facility contains customary representations and warranties, subject to limitations and exceptions, and customary covenants restricting the Company’s ability, subject to certain exceptions, to, among other things (1) declare dividends, make distributions or redeem or repurchase capital stock, (2) prepay, redeem or repurchase other debt, (3) incur liens or grant negative pledges, (4) make loans and investments and enter into acquisitions and joint ventures, (5) incur additional indebtedness or provide certain guarantees, (6) engage in mergers, acquisitions and asset sales, (7) conduct transactions with affiliates, (8) alter the nature of the Company’s, CHS’ or the guarantors’ businesses, (9) grant certain guarantees with respect to physician practices, (10) engage in sale and leaseback transactions or (11) change the Company’s fiscal year. The Company is also required to comply with a consolidated fixed charge coverage ratio, upon certain triggering events described below, and various affirmative covenants. The consolidated fixed charge coverage ratio is calculated as the ratio of (x) consolidated EBITDA (as defined in the ABL Facility) less capital expenditures to (y) the sum of consolidated interest expense (as defined in the ABL Facility), scheduled principal payments, income taxes and restricted payments made in cash or in permitted investments. For purposes of calculating the consolidated fixed charge coverage ratio, the calculation of consolidated EBITDA as defined in the ABL Facility is a trailing 12-month calculation that begins with the Company’s consolidated net income, with certain adjustments for interest, taxes, depreciation and amortization, net income attributable to noncontrolling interests, stock compensation expense, restructuring costs, and the financial impact of other non-cash or non-recurring items recorded during any such 12-month period. The consolidated fixed charge coverage ratio is a required covenant only in periods where the total borrowings outstanding under the ABL Facility reduce the amount available in the facility to less than the greater of (i) $95 million or (ii) 10% of the calculated borrowing base. As a result, in the event the Company has less than $95 million available under the ABL Facility, the Company would need to comply with the consolidated fixed charge coverage ratio. At September 30, 2021, the Company is not subject to the consolidated fixed charge coverage ratio as such triggering event had not occurred during the last twelve months ended September 30, 2021.

The Company paid interest of $268 million and $279 million on borrowings during the three months ended September 30, 2021 and 2020, respectively, and $572 million and $765 million on borrowings during the nine months ended September 30, 2021 and 2020, respectively.

Fair Value of Financial Instruments

9 Months Ended

Sep. 30, 2021

Fair Value Disclosures [Abstract]

FAIR VALUE OF FINANCIAL INSTRUMENTS

6. FAIR VALUE OF FINANCIAL INSTRUMENTS

The fair value of financial instruments has been estimated by the Company using available market information as of September 30, 2021 and December 31, 2020, and valuation methodologies considered appropriate. The estimates presented in the table below are not necessarily indicative of amounts the Company could realize in a current market exchange (in millions):

	September 30, 2021				December 31, 2020
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	1,294	$	1,294	$	1,676	$	1,676
Investments in equity securities		126		126		129		129
Available-for-sale debt securities		169		169		110		110
Trading securities		12		12		12		12
Liabilities:
6⅞% Senior Notes due 2022		—		—		125		125
6¼% Senior Secured Notes due 2023		—		—		95		99
8⅝% Senior Secured Notes due 2024		—		—		1,025		1,080
6⅝% Senior Secured Notes due 2025		1,432		1,532		1,427		1,543
8% Senior Secured Notes due 2026		2,077		2,229		2,074		2,275
8% Senior Secured Notes due 2027		692		767		692		760
5⅝% Senior Secured Notes due 2027		1,816		1,997		1,809		2,048
6⅞% Senior Notes due 2028		759		739		758		618
6% Senior Secured Notes due 2029		859		957		857		973
4¾% Senior Secured Notes due 2031		1,090		1,107		—		—
9⅞% Junior-Priority Secured Notes due 2023		—		—		1,756		1,861
8⅛% Junior-Priority Secured Notes due 2024		—		—		1,336		1,408
6⅞% Junior-Priority Secured Notes due 2029		1,621		1,781		—		—
6⅛% Junior-Priority Secured Notes due 2030		1,350		1,401		—		—
ABL Facility and other debt		35		35		23		23

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

- Definition

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

+ References + Details

Fair Value

9 Months Ended

Sep. 30, 2021

Fair Value Disclosures [Abstract]

FAIR VALUE

7. FAIR VALUE

Fair Value Hierarchy

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

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

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

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

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

In instances where the determination of the fair value hierarchy measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment of factors specific to the asset or liability. Transfers between levels within the fair value hierarchy are recognized by the Company on the date of the change in circumstances that requires such transfer. There were no transfers between levels during the nine-month periods ended September 30, 2021 or 2020.

The following table sets forth, by level within the fair value hierarchy, the financial assets and liabilities recorded at fair value on a recurring basis as of September 30, 2021 and December 31, 2020 (in millions):

	September 30, 2021		Level 1		Level 2		Level 3
Investments in equity securities	$	126	$	126	$	—	$	—
Available-for-sale debt securities		169		—		169		—
Trading securities		12		—		12		—
Total assets	$	307	$	126	$	181	$	—

	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	$	—

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

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

Leases

9 Months Ended

Sep. 30, 2021

Leases [Abstract]

LEASES

8. LEASES

The Company utilizes operating and finance leases for the use of certain hospitals, medical office buildings, and medical equipment. The components of lease cost and rent expense for the three and nine months ended September 30, 2021 and 2020 are as follows (in millions):

	Three Months Ended September 30,						Nine Months Ended September 30,
Lease Cost	2021			2020			2021			2020
Operating lease cost:
Operating lease cost	$	49		$	50		$	147		$	152
Short-term rent expense		22			27			70			80
Variable lease cost		5			9			17			20
Sublease income		(1	)		(1	)		(3	)		(4	)
Total operating lease cost	$	75		$	85		$	231		$	248
Finance lease cost:
Amortization of right-of-use assets	$	2		$	2		$	6		$	8
Interest on finance lease liabilities		2			2			5			6
Total finance lease cost	$	4		$	4		$	11		$	14

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

	Balance Sheet Classification	September 30, 2021			December 31, 2020
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	667		$	642

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		173			134
	Equipment and fixtures		14			8
	Property and equipment		195			150
	Less accumulated depreciation and amortization		(51	)		(46	)
	Property and equipment, net	$	144		$	104

Current finance lease liabilities	Current maturities of long-term debt	$	9		$	5
Long-term finance lease liabilities	Long-term debt		112			74

Supplemental cash flow information related to leases for the nine months ended September 30, 2021 and 2020 is as follows (in millions):

	Nine Months Ended September 30,
Cash flow information	2021		2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	149	$	141
Operating cash flows from finance leases		5		6
Financing cash flows from finance leases		4		5
Right-of-use assets obtained in exchange for new finance lease liabilities		46		22
Right-of-use assets obtained in exchange for new operating lease liabilities		118		119

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

Stockholders' Deficit

9 Months Ended

Sep. 30, 2021

Equity [Abstract]

STOCKHOLDERS' DEFICIT

9. STOCKHOLDERS’ DEFICIT

Authorized capital shares of the Company include 400,000,000 shares of capital stock consisting of 300,000,000 shares of common stock and 100,000,000 shares of preferred stock. Each of the aforementioned classes of capital stock has a par value of $0.01 per share. Shares of preferred stock, none of which were outstanding as of September 30, 2021, may be issued in one or more series having such rights, preferences and other provisions as determined by the Board of Directors without approval by the holders of common stock.

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

The ABL Facility and the indentures governing each series of the Company’s outstanding notes restrict the Company’s subsidiaries from, among other matters, paying dividends and making distributions to the Company, which thereby limits the Company’s ability to pay dividends and/or repurchase stock. As of September 30, 2021, under the most restrictive test in these agreements (and subject to certain exceptions), the Company has approximately $200 million of capacity to pay permitted dividends and/or repurchase shares of stock or make other restricted payments.

The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company’s stockholders, and equity attributable to noncontrolling interests as of September 30, 2021, and during each of the three-month periods following December 31, 2020 (in millions):

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 2020	$	484		$	1	$	2,094		$	(13	)	$	(3,707	)	$	87		$	(1,538	)
Comprehensive income (loss)		21			—		—			(3	)		(64	)		8			(59	)
Distributions to noncontrolling interests		(12	)		—		—			—			—			(9	)		(9	)
Dispositions of less-than-wholly owned business		(7	)		—		—			—			—			—			—
Noncontrolling interest in acquired entity		2			—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		(7	)		—		7			—			—			—			7
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(4	)		—			—			—			(4	)
Share-based compensation		—			—		8			—			—			—			8
Balance, March 31, 2021		481			1		2,105			(16	)		(3,771	)		86			(1,595	)
Comprehensive income		24			—		—			1			6			7			14
Distributions to noncontrolling interests		(31	)		—		—			—			—			(14	)		(14	)
Purchase of subsidiary shares from noncontrolling interests		(2	)		—		—			—			—			—			—
Other reclassifications of noncontrolling interests		1			—		(1	)		—			—			—			(1	)
Adjustment to redemption value of redeemable noncontrolling interests		25			—		(25	)		—			—			—			(25	)
Share-based compensation		—			—		5			—			—			—			5
Balance, June 30, 2021		498			1		2,084			(15	)		(3,765	)		79			(1,616	)
Comprehensive income		20			—		—			1			110			14			125
Contributions from noncontrolling interests		1			—		—			—			—			—			—
Distributions to noncontrolling interests		(19	)		—		—			—			—			(10	)		(10	)
Purchase of subsidiary shares from noncontrolling interests		(13	)		—		9			—			—			—			9
Adjustment to redemption value of redeemable noncontrolling interests		6			—		(6	)		—			—			—			(6	)
Share-based compensation		—			—		5			—			—			—			5
Balance, September 30, 2021	$	493		$	1	$	2,092		$	(14	)	$	(3,655	)	$	83		$	(1,493	)

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

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

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

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Net income attributable to Community Health Systems, Inc. stockholders	$	111	$	112	$	52	$	200
Transfers to the noncontrolling interests:
Net increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		9		—		9		—
Net transfers to the noncontrolling interests		9		—		9		—
Change to Community Health Systems, Inc. stockholders' deficit from net income attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	120	$	112	$	61	$	200

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

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-Name Accounting Standards Codification
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-Name Accounting Standards Codification
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+ Details

Earnings Per Share

9 Months Ended

Sep. 30, 2021

Earnings Per Share [Abstract]

Earnings Per Share

10. 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 attributable to Community Health Systems, Inc. common stockholders:

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Weighted-average number of shares outstanding — basic		127,077,786		115,015,460		126,638,291		114,764,050
Effect of dilutive securities:
Restricted stock awards		2,652,676		500,857		2,249,117		205,600
Employee stock options		795,471		2,193		698,941		890
Other equity-based awards		359,206		122,342		299,602		41,662
Weighted-average number of shares outstanding — diluted		130,885,139		115,640,852		129,885,951		115,012,202

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		748,002		1,846,026		784,752		3,673,618

Contingencies

9 Months Ended

Sep. 30, 2021

Commitments And Contingencies Disclosure [Abstract]

Contingencies

11. CONTINGENCIES

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

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

Probable Contingencies

The table below presents a reconciliation of the beginning and ending liability balances (in millions) during the nine months ended September 30, 2021, with respect to the Company’s determination of the contingencies of the Company in respect of which an accrual has been recorded. The liability as of September 30, 2021 is comprised of individually insignificant amounts for various matters.

Summary of Recorded Amounts

	Probable
	Contingencies
Balance as of December 31, 2020	$	11
Expense		1
Reserve for insured claim		(1	)
Cash payments		(1	)
Balance as of September 30, 2021	$	10

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

Subsequent Events

9 Months Ended

Sep. 30, 2021

Subsequent Events [Abstract]

Subsequent Events

12. SUBSEQUENT EVENTS

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

On October 1, 2021, Tyler Memorial Hospital in Tunkhannock, Pennsylvania, which previously offered inpatient care and surgical services as a stand-alone acute care hospital, began operating as a campus of Regional Hospital of Scranton, in Scranton, Pennsylvania, offering emergency room and outpatient services such as primary care, laboratory and imaging. Effective with this change, the Company owns or leases 83 hospitals, comprised of 81 general acute care hospitals and two stand-alone rehabilitation or psychiatric hospitals.

Pandemic Relief Funds and Medicare Accelerated Payments:

In October 2021, the Company submitted a combined application for Phase 4 of the Provider Relief Fund (“PRF Phase 4”) and amounts appropriated by the ARPA for providers serving rural healthcare patients (“ARP Rural”). No amounts have been received by the Company for the PRF Phase 4 or ARP Rural programs as of the date of this Form 10-Q, and the Company is not able to predict the extent to which it may receive amounts pursuant to such programs, if any.

The outstanding balance of Medicare accelerated payments of $814 million as of September 30, 2021 was repaid in full to CMS in October 2021, prior to the date of this Form 10-Q, through a combination of recoupments via Medicare remittances and lump-sum payments.

Basis of Presentation and Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Basis of Accounting

Consolidation

Revenue Recognition

Revenue Recognition.

Net Operating Revenues

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Medicare	$	653	$	723	$	1,988	$	2,086
Medicaid		412		419		1,223		1,167
Managed Care and other third-party payors		2,010		1,967		5,845		5,425
Self-pay		40		17		79		(8	)
Total	$	3,115	$	3,126	$	9,135	$	8,670

Patient Accounts Receivable

Charity Care

Accounting for the Impairment or Disposal of Long-Lived Assets

COVID-19 Pandemic

COVID-19 Pandemic.

Pandemic Relief Funds

Medicare Accelerated Payments

Basis of Presentation and Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Net Operating Revenues

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Medicare	$	653	$	723	$	1,988	$	2,086
Medicaid		412		419		1,223		1,167
Managed Care and other third-party payors		2,010		1,967		5,845		5,425
Self-pay		40		17		79		(8	)
Total	$	3,115	$	3,126	$	9,135	$	8,670

Accounting for Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2021

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Schedule of Share-based Compensation Expense

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

	Three Months Ended						Nine Months Ended
	September 30,						September 30,
	2021			2020			2021			2020
Effect on income before income taxes	$	(5	)	$	(3	)	$	(18	)	$	(8	)
Effect on net income	$	(4	)	$	(2	)	$	(14	)	$	(6	)

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

	Three Months Ended September 30,		Nine Months Ended September 30,
	2021	2020	2021		2020
Expected volatility	N/A	N/A	84.3% - 88.9%			73.5	%
Expected dividends	N/A	N/A		—		—
Expected term	N/A	N/A	3 - 6 years		6 years
Risk-free interest rate	N/A	N/A	0.3% - 0.9%			1.0	%

Schedule of Share-based Compensation, Stock Options, Activity

						Weighted-	Aggregate
				Weighted-		Average	Intrinsic
				Average		Remaining	Value as of
				Exercise		Contractual	September 30,
	Shares			Price		Term	2021
Outstanding at December 31, 2020		1,817,525		$	8.77
Granted		749,250			8.81
Exercised		(65,165	)		4.97
Forfeited and cancelled		(173,189	)		34.66
Outstanding at March 31, 2021		2,328,421			6.96
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(22,334	)		24.23
Outstanding at June 30, 2021		2,306,087			6.79
Granted		—			—
Exercised		—			—
Forfeited and cancelled		(2,000	)		17.95
Outstanding at September 30, 2021		2,304,087		$	6.78	8.2 years	$	12
Exercisable at September 30, 2021		733,162		$	6.79	7.0 years	$	4

Schedule of Share-based Compensation, Restricted Stock, Activity

Restricted stock outstanding under the 2009 Plan as of September 30, 2021, and changes during each of the three-month periods following December 31, 2020, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2020		4,555,735		$	4.84
Granted		2,829,250			7.97
Vested		(2,264,992	)		4.70
Forfeited		(37,334	)		4.94
Unvested at March 31, 2021		5,082,659			6.65
Granted		30,000			16.18
Vested		(17,335	)		3.48
Forfeited		(47,670	)		6.81
Unvested at June 30, 2021		5,047,654			6.72
Granted		—			—
Vested		—			—
Forfeited		(84,338	)		6.61
Unvested at September 30, 2021		4,963,316			6.72

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

RSUs outstanding under the 2009 Plan as of September 30, 2021, and changes during each of the three-month periods following December 31, 2020, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2020		613,739		$	4.89
Granted		173,664			8.81
Vested		(247,164	)		4.81
Forfeited		—			—
Unvested at March 31, 2021		540,239			6.19
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at June 30, 2021		540,239			6.19
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at September 30, 2021		540,239			6.19

Acquisitions and Divestitures (Tables)

9 Months Ended

Sep. 30, 2021

Acquisitions And Divestitures [Abstract]

Schedule of Divestitures

The following table provides a summary of hospitals that the Company divested during the nine months ended September 30, 2021 and the year ended December 31, 2020:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2021 Divestitures:
Lea Regional Medical Center	Covenant Health System	Hobbs, NM	84	January 1, 2021
Tennova Healthcare - Tullahoma	Vanderbilt University Medical Center	Tullahoma, TN	135	January 1, 2021
Tennova Healthcare - Shelbyville	Vanderbilt University Medical Center	Shelbyville, TN	60	January 1, 2021
Northwest Mississippi Medical Center	Delta Health System	Clarksdale, MS	181	February 1, 2021
AllianceHealth Midwest	SSM Health Care of Oklahoma	Midwest City, OK	255	April 1, 2021

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 Healthcare, Inc. (“HCA”)	Live Oak, FL	25	May 1, 2020
Shands Starke Regional Medical Center	HCA	Starke, FL	49	May 1, 2020
Southside Regional Medical Center	Bon Secours Mercy Health System	Petersburg, VA	300	January 1, 2020
Southampton Memorial Hospital	Bon Secours Mercy Health System	Franklin, VA	105	January 1, 2020
Southern Virginia Regional Medical Center	Bon Secours Mercy Health System	Emporia, VA	80	January 1, 2020

- Definition

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

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+ Details

Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2021

Debt Instrument [Line Items]

Schedule of Debt

Long-term debt, net of unamortized deferred debt issuance costs, consists of the following (in millions):

	September 30,			December 31,
	2021			2020
6⅞% Senior Notes due 2022	$	—		$	126
6¼% Senior Secured Notes due 2023		—			95
8⅝% Senior Secured Notes due 2024		—			1,033
6⅝% Senior Secured Notes due 2025		1,462			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			1,900
6⅞% Senior Notes due 2028		767			767
6% Senior Secured Notes due 2029		900			900
4¾% Senior Secured Notes due 2031		1,095			—
9⅞% Junior-Priority Secured Notes due 2023		—			1,769
8⅛% Junior-Priority Secured Notes due 2024		—			1,348
6⅞% Junior-Priority Secured Notes due 2029		1,775			—
6⅛% Junior-Priority Secured Notes due 2030		1,440			—
ABL Facility		—			—
Finance lease and financing obligations		279			239
Other		37			26
Less: Unamortized deferred debt issuance costs and note premium		(445	)		(250	)
Total debt		12,011			12,216
Less: Current maturities		(35	)		(123	)
Total long-term debt	$	11,976		$	12,093

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

Junior-Priority Secured Notes at 6.125% Due 2030 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period	Redemption Price
April 1, 2025 to March 31, 2026		103.063	%
April 1, 2026 to March 31, 2027		101.531	%
April 1, 2027 to March 31, 2030		100.000	%

Fair Value of Financial Instruments (Tables)

9 Months Ended

Sep. 30, 2021

Fair Value Disclosures [Abstract]

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

	September 30, 2021				December 31, 2020
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	1,294	$	1,294	$	1,676	$	1,676
Investments in equity securities		126		126		129		129
Available-for-sale debt securities		169		169		110		110
Trading securities		12		12		12		12
Liabilities:
6⅞% Senior Notes due 2022		—		—		125		125
6¼% Senior Secured Notes due 2023		—		—		95		99
8⅝% Senior Secured Notes due 2024		—		—		1,025		1,080
6⅝% Senior Secured Notes due 2025		1,432		1,532		1,427		1,543
8% Senior Secured Notes due 2026		2,077		2,229		2,074		2,275
8% Senior Secured Notes due 2027		692		767		692		760
5⅝% Senior Secured Notes due 2027		1,816		1,997		1,809		2,048
6⅞% Senior Notes due 2028		759		739		758		618
6% Senior Secured Notes due 2029		859		957		857		973
4¾% Senior Secured Notes due 2031		1,090		1,107		—		—
9⅞% Junior-Priority Secured Notes due 2023		—		—		1,756		1,861
8⅛% Junior-Priority Secured Notes due 2024		—		—		1,336		1,408
6⅞% Junior-Priority Secured Notes due 2029		1,621		1,781		—		—
6⅛% Junior-Priority Secured Notes due 2030		1,350		1,401		—		—
ABL Facility and other debt		35		35		23		23

Fair Value (Tables)

9 Months Ended

Sep. 30, 2021

Fair Value Disclosures [Abstract]

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

	September 30, 2021		Level 1		Level 2		Level 3
Investments in equity securities	$	126	$	126	$	—	$	—
Available-for-sale debt securities		169		—		169		—
Trading securities		12		—		12		—
Total assets	$	307	$	126	$	181	$	—

	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	$	—

Leases (Tables)

9 Months Ended

Sep. 30, 2021

Leases [Abstract]

Components of Lease Cost and Rent Expense

The components of lease cost and rent expense for the three and nine months ended September 30, 2021 and 2020 are as follows (in millions):

	Three Months Ended September 30,						Nine Months Ended September 30,
Lease Cost	2021			2020			2021			2020
Operating lease cost:
Operating lease cost	$	49		$	50		$	147		$	152
Short-term rent expense		22			27			70			80
Variable lease cost		5			9			17			20
Sublease income		(1	)		(1	)		(3	)		(4	)
Total operating lease cost	$	75		$	85		$	231		$	248
Finance lease cost:
Amortization of right-of-use assets	$	2		$	2		$	6		$	8
Interest on finance lease liabilities		2			2			5			6
Total finance lease cost	$	4		$	4		$	11		$	14

Supplemental Balance Sheet Information Related to Leases

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

	Balance Sheet Classification	September 30, 2021			December 31, 2020
Operating Leases:
Operating Lease ROU Assets	Other assets, net	$	667		$	642

Finance Leases:
Finance Lease ROU Assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		173			134
	Equipment and fixtures		14			8
	Property and equipment		195			150
	Less accumulated depreciation and amortization		(51	)		(46	)
	Property and equipment, net	$	144		$	104

Current finance lease liabilities	Current maturities of long-term debt	$	9		$	5
Long-term finance lease liabilities	Long-term debt		112			74

Supplemental Cash Flow and Other Information Related to Leases

Supplemental cash flow information related to leases for the nine months ended September 30, 2021 and 2020 is as follows (in millions):

	Nine Months Ended September 30,
Cash flow information	2021		2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	149	$	141
Operating cash flows from finance leases		5		6
Financing cash flows from finance leases		4		5
Right-of-use assets obtained in exchange for new finance lease liabilities		46		22
Right-of-use assets obtained in exchange for new operating lease liabilities		118		119

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

Stockholders' Deficit (Tables)

9 Months Ended

Sep. 30, 2021

Equity [Abstract]

Schedule of Stockholders' Deficit

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 2020	$	484		$	1	$	2,094		$	(13	)	$	(3,707	)	$	87		$	(1,538	)
Comprehensive income (loss)		21			—		—			(3	)		(64	)		8			(59	)
Distributions to noncontrolling interests		(12	)		—		—			—			—			(9	)		(9	)
Dispositions of less-than-wholly owned business		(7	)		—		—			—			—			—			—
Noncontrolling interest in acquired entity		2			—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		(7	)		—		7			—			—			—			7
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(4	)		—			—			—			(4	)
Share-based compensation		—			—		8			—			—			—			8
Balance, March 31, 2021		481			1		2,105			(16	)		(3,771	)		86			(1,595	)
Comprehensive income		24			—		—			1			6			7			14
Distributions to noncontrolling interests		(31	)		—		—			—			—			(14	)		(14	)
Purchase of subsidiary shares from noncontrolling interests		(2	)		—		—			—			—			—			—
Other reclassifications of noncontrolling interests		1			—		(1	)		—			—			—			(1	)
Adjustment to redemption value of redeemable noncontrolling interests		25			—		(25	)		—			—			—			(25	)
Share-based compensation		—			—		5			—			—			—			5
Balance, June 30, 2021		498			1		2,084			(15	)		(3,765	)		79			(1,616	)
Comprehensive income		20			—		—			1			110			14			125
Contributions from noncontrolling interests		1			—		—			—			—			—			—
Distributions to noncontrolling interests		(19	)		—		—			—			—			(10	)		(10	)
Purchase of subsidiary shares from noncontrolling interests		(13	)		—		9			—			—			—			9
Adjustment to redemption value of redeemable noncontrolling interests		6			—		(6	)		—			—			—			(6	)
Share-based compensation		—			—		5			—			—			—			5
Balance, September 30, 2021	$	493		$	1	$	2,092		$	(14	)	$	(3,655	)	$	83		$	(1,493	)

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

Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Net income attributable to Community Health Systems, Inc. stockholders	$	111	$	112	$	52	$	200
Transfers to the noncontrolling interests:
Net increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		9		—		9		—
Net transfers to the noncontrolling interests		9		—		9		—
Change to Community Health Systems, Inc. stockholders' deficit from net income attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	120	$	112	$	61	$	200

Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2021

Earnings Per Share [Abstract]

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

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Weighted-average number of shares outstanding — basic		127,077,786		115,015,460		126,638,291		114,764,050
Effect of dilutive securities:
Restricted stock awards		2,652,676		500,857		2,249,117		205,600
Employee stock options		795,471		2,193		698,941		890
Other equity-based awards		359,206		122,342		299,602		41,662
Weighted-average number of shares outstanding — diluted		130,885,139		115,640,852		129,885,951		115,012,202

Schedule of Antidilutive Securities

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2021		2020		2021		2020
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		748,002		1,846,026		784,752		3,673,618

Contingencies (Tables)

9 Months Ended

Sep. 30, 2021

Commitments And Contingencies Disclosure [Abstract]

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

Summary of Recorded Amounts

	Probable
	Contingencies
Balance as of December 31, 2020	$	11
Expense		1
Reserve for insured claim		(1	)
Cash payments		(1	)
Balance as of September 30, 2021	$	10

- 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
-SubTopic 20
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+ Details

Basis of Presentation and Significant Accounting Policies - Additional Information (Details)			1 Months Ended	3 Months Ended				9 Months Ended		12 Months Ended	17 Months Ended
	Jul. 01, 2020 Item	Jan. 01, 2020 Item	Apr. 30, 2020 USD ($)	Sep. 30, 2021 USD ($)	Jun. 30, 2021 USD ($)	Mar. 31, 2021 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)	Dec. 31, 2020 USD ($)	Sep. 30, 2021 USD ($)
Cost of Revenue, Policy [Abstract]
Corporate office costs				$ 56,000,000			$ 41,000,000	$ 168,000,000	$ 136,000,000
Third Party Reimbursement [Abstract]
Amounts due to third party payors				111,000,000				111,000,000		$ 98,000,000	$ 111,000,000
Amounts due from third party payors				109,000,000				109,000,000		136,000,000	109,000,000
Net Operating Revenues, Policy [Abstract]
Charity care services charges excluded from net operating revenues				215,000,000			285,000,000	659,000,000	751,000,000
Value of charity care services at the Company's standard charges included in contractual allowances				25,000,000			36,000,000	77,000,000	90,000,000
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business								(24,000,000)	(48,000,000)
Impairment of long-lived assets sold								29,000,000
Divestiture related expenses								3,000,000
Goodwill allocated to facilities disposed of				7,000,000				7,000,000			7,000,000
CARES Act
Medicare Accelerated Payments [Abstract]
Medicare accelerated payments received under the Cares Act			$ 1,200,000,000	0				0
Medicare accelerated payments under cares act				814,000,000				814,000,000			814,000,000
Medicare accelerated payments, recouped subject to the aforementioned repayment terms				249,000,000				249,000,000			249,000,000
CARES Act \| Accrued Liabilities and Other
Medicare Accelerated Payments [Abstract]
Medicare accelerated payments under cares act				814,000,000				814,000,000			814,000,000
CARES Act \| Centers for Medicare & Medicaid Services
Medicare Accelerated Payments [Abstract]
Medicare accelerated repayment under cares act								$ 18,000,000		77,000,000
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%
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" or “Provider Relief Fund”) \| CARES Act \| Paycheck Protection Program and Health Care Enhancement Act
COVID-19 Pandemic [Abstract]
CARES Act, PPPHCE Act of 2020 Aid, amount, CAA and ARPA								$ 178,000,000,000
CARES Act and PPPHCE Act Funds [Abstract]
Payments through the PHSSEF and various state and local programs										705,000,000	$ 709,000,000
Public Health and Social Services Emergency Fund (the "PHSSEF" or “Provider Relief Fund”) \| 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				$ 19,000,000	$ 1,000,000	$ 82,000,000	$ 0	102,000,000	448,000,000	$ 601,000,000
Adjustment for Carrying Value of Other Long-Lived Assets at Underperforming Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment and gain (loss) on sale of businesses, net									74,000,000
Hospitals Sold or Deemed Held for Sale
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business								$ 8,000,000	73,000,000
Number of hospitals sold \| Item	1	3
Hospitals Sold or Deemed Held for Sale \| Certain Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business									(43,000,000)
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)

Basis of Presentation and Significant Accounting Policies - Schedule of Net Operating Revenues (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 3,115	$ 3,126	$ 9,135	$ 8,670
Medicare
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	653	723	1,988	2,086
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	412	419	1,223	1,167
Managed Care and Other Third Party Payors
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	2,010	1,967	5,845	5,425
Self-Pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 40	$ 17	$ 79	$ (8)

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

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

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Topic 825
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-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Subparagraph (a)
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
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-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

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 (SX 210.13-02(a)(4)(iii)(A))
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Subparagraph (SX 210.13-01(a)(4)(i))
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(i))
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9038-108599

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
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-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(1))
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

+ Details

Accounting for Stock-Based Compensation - Additional Information (Details)			3 Months Ended				9 Months Ended
	Mar. 01, 2021 USD ($) Director shares	Mar. 01, 2020 USD ($) Director shares	Sep. 30, 2021 USD ($) $ / shares shares	Jun. 30, 2021 shares	Mar. 31, 2021 shares	Sep. 30, 2020 USD ($) shares	Sep. 30, 2021 USD ($) Item $ / shares shares	Sep. 30, 2020 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			$ 29,000,000				$ 29,000,000
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							25 months
Employee service share-based compensation, nonvested awards, modifications to awards \| Item							0	0
Aggregate intrinsic value of options exercised			0			$ 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							25 months
Employee service share-based compensation, unrecognized compensation costs on nonvested stock options			$ 5,000,000				$ 5,000,000
Share-based compensation arrangement by share-based payment award, options, grants in period \| shares			0		749,250	0
Weighted-average grant date fair value of stock options \| $ / shares							$ 6.22	$ 3.17
Share Price \| $ / shares			$ 11.70				$ 11.70
Restricted Stock and Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							24 months
Employee service share-based compensation, unrecognized compensation costs on nonvested awards other than options			$ 24,000,000				$ 24,000,000
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
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, number of grants \| shares					173,664
Number of directors elected to defer the receipt of RSUs granted \| Director	4	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 grants \| shares				30,000	2,829,250
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
Contractual term of option granted							10 years
Unissued common stock reserved for grants \| shares			12,614,521				12,614,521
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 grants \| shares	19,296	34,483
Fair value of units granted	$ 170,000	$ 170,000
Performance-Based Awards Granted On March 1, 2018 \| Restricted Stock, Performance-Based Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement award vesting rights, percentage	200.00%

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Effect on income before income taxes	$ (5)	$ (3)	$ (18)	$ (8)
Effect on net income	$ (4)	$ (2)	$ (14)	$ (6)

Accounting for Stock-Based Compensation - Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions (Details) - Employee Stock Option	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility		73.50%
Expected volatility, minimum	84.30%
Expected volatility, maximum	88.90%
Expected term		6 years
Risk-free interest rate		1.00%
Risk-free interest rate, minimum	0.30%
Risk-free interest rate, maximum	0.90%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	3 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	6 years

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Stock Options, Activity (Details) - Employee Stock Option - USD ($) $ / shares in Units, $ in Millions	3 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Shares	2,306,087	2,328,421	1,817,525
Granted, Shares	0		749,250	0
Exercised, Shares			(65,165)
Forfeited and cancelled, Shares	(2,000)	(22,334)	(173,189)
Ending Balance, Shares	2,304,087	2,306,087	2,328,421
Exercisable, Shares	733,162
Beginning of Period, Weighted Average Exercise Price	$ 6.79	$ 6.96	$ 8.77
Granted, Weighted Average Exercise Price			8.81
Exercised, Weighted Average Exercise Price			4.97
Forfeited and Cancelled, Weighted Average Exercise Price	17.95	24.23	34.66
End of Period, Weighted Average Exercise Price	6.78	$ 6.79	$ 6.96
Exercisable, Weighted Average Exercise Price	$ 6.79
Weighted Average Remaining Contractual Term	8 years 2 months 12 days
Exercisable, Weighted Average Remaining Contractual Term	7 years
Outstanding, Aggregate Intrinsic Value as of June 30, 2021	$ 12
Exercisable, Aggregate Intrinsic Value as of June 30, 2021	$ 4

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock, Activity (Details) - Restricted Stock - $ / shares	3 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	5,047,654	5,082,659	4,555,735
Granted, Shares		30,000	2,829,250
Vested, Shares		(17,335)	(2,264,992)
Forfeited, Shares	(84,338)	(47,670)	(37,334)
Ending Balance, Unvested Shares	4,963,316	5,047,654	5,082,659
Beginning of Period, Weighted Average Grant Date Fair Value	$ 6.72	$ 6.65	$ 4.84
Granted, Weighted Average Grant Date Fair Value		16.18	7.97
Vested, Weighted Average Grant Date Fair Value		3.48	4.70
Forfeited, Weighted Average Grant Date Fair Value	6.61	6.81	4.94
End of Period, Weighted Average Grant Date Fair Value	$ 6.72	$ 6.72	$ 6.65

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock Units, Activity (Details) - Restricted Stock Units (RSUs) - $ / shares	3 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	540,239	540,239	613,739
Granted, Shares			173,664
Vested, Shares			(247,164)
Ending Balance, Unvested Shares	540,239	540,239	540,239
Beginning of Period, Weighted Average Grant Date Fair Value	$ 6.19	$ 6.19	$ 4.89
Granted, Weighted Average Grant Date Fair Value			8.81
Vested, Weighted Average Grant Date Fair Value			4.81
End of Period, Weighted Average Grant Date Fair Value	$ 6.19	$ 6.19	$ 6.19

Acquisitions and Divestitures - Acquisitions - Additional Information (Details) $ in Millions		3 Months Ended	9 Months Ended
	Jul. 30, 2021 USD ($) Hospital	Sep. 30, 2021 USD ($)	Sep. 30, 2021 USD ($)
Acquisitions and Divestitures [Line Items]
Proceeds from sale of investments in unconsolidated affiliates			$ 110
Pre tax gain on sale of investments		$ 26	26
Two Hospitals in Macon Georgia
Acquisitions and Divestitures [Line Items]
Effective Date	Jul. 30, 2021
Number of hospitals sold \| Hospital	2
Percentage of ownership interest sold	38.00%
Proceeds from sale of investments in unconsolidated affiliates	$ 110
Pre tax gain on sale of investments		$ 26	26
Physician Practices Clinics and Other Ancillary Businesses
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price			$ 3

Acquisitions and Divestitures - Schedule of Divestitures (Details) - Item	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Lea 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	Jan. 01, 2021
Tennova Healthcare - Tullahoma
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	135
Effective Date	Jan. 01, 2021
Tennova Healthcare - Shelbyville
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	60
Effective Date	Jan. 01, 2021
Northwest Mississippi Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	181
Effective Date	Feb. 01, 2021
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
Alliance Health Midwest
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	255
Effective Date	Apr. 01, 2021
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

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Taxes [Line Items]
Effective income tax rate	6.50%	13.50%	47.50%	(669.70%)
Income tax refunds (payments), net	$ (1,000,000)	$ (3,000,000)	$ (3,000,000)	$ (2,000,000)
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
Maximum
Income Taxes [Line Items]
Unrecognized benefit that would affect the effective tax rate	1,000,000		$ 1,000,000
Amount of interest and penalties included in liabilities for uncertain tax positions	$ 1,000,000		$ 1,000,000

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Debt and lease obligations	$ 12,011	$ 12,216
Less: Unamortized deferred debt issuance costs and note premium	(445)	(250)
Less: Current maturities	(35)	(123)
Total long-term debt	11,976	12,093
Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Debt Instrument [Line Items]
Debt and lease obligations		95
Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Debt Instrument [Line Items]
Debt and lease obligations		1,033
Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Debt Instrument [Line Items]
Debt and lease obligations	1,462	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 \| Senior Secured Notes at 5.625% due 2027
Debt Instrument [Line Items]
Debt and lease obligations	1,900	1,900
Senior Secured Notes \| Senior Secured Notes at 6% due 2029
Debt Instrument [Line Items]
Debt and lease obligations	900	900
Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Debt Instrument [Line Items]
Debt and lease obligations	1,095
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt and lease obligations		126
Senior Notes \| Senior Notes at 6.875% Due 2028
Debt Instrument [Line Items]
Debt and lease obligations	767	767
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt and lease obligations		1,348
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Debt Instrument [Line Items]
Debt and lease obligations	1,775
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Debt Instrument [Line Items]
Debt and lease obligations		1,769
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Debt Instrument [Line Items]
Debt and lease obligations	1,440
Finance Lease and Financing Obligations
Debt Instrument [Line Items]
Debt and lease obligations	279	239
Other
Debt Instrument [Line Items]
Debt and lease obligations	$ 37	$ 26

Long-Term Debt - Schedule of Debt (Parenthetical) (Details)						9 Months Ended	12 Months Ended
	May 19, 2021	Mar. 01, 2021	Feb. 09, 2021	Feb. 02, 2021	Jan. 28, 2021	Sep. 30, 2021	Dec. 31, 2020
Senior Notes \| Senior Notes at 6.875%, Due 2022
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		6.875%					6.875%
Debt instrument, maturity year		2022					2022
Senior Notes \| Senior Notes at 6.875% Due 2028
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage						6.875%	6.875%
Debt instrument, maturity year						2028	2028
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%
Debt instrument, maturity year						2026	2026
Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage						8.00%	8.00%
Debt instrument, maturity year						2027	2027
Senior Secured Notes \| Senior Secured Notes at 5.625% 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 \| Senior Secured Notes at 6% due 2029
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage						6.00%	6.00%
Debt instrument, maturity year						2029	2029
Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage			4.75%			4.75%
Debt instrument, maturity year			2031			2031
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage				9.875%			9.875%
Debt instrument, maturity year				2023			2023
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage							8.125%
Debt instrument, maturity year							2024
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage				6.875%		6.875%
Debt instrument, maturity year				2029		2029
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.125%					6.125%
Debt instrument, maturity year	2030					2030

Long-Term Debt - 6.25% Senior Secured Notes, Due 2023 - Additional Information (Details) - Senior Secured Notes - Senior Secured Notes at 6.25%, Due 2023 - USD ($) $ in Millions		12 Months Ended
	Jan. 28, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Debt instrument stated interest rate	6.25%	6.25%
Debt instrument, maturity year	2023	2023
Debt instrument, redemption value	$ 95

Long-Term Debt - 6.875% Junior-Priority Secured Notes, Due 2029 - Additional Information (Details) - Junior-Priority Secured Notes - USD ($) $ in Millions		9 Months Ended	12 Months Ended
	Feb. 02, 2021	Sep. 30, 2021	Dec. 31, 2020
Junior-Priority Secured Notes at 6.875% Due 2029
Debt Instrument [Line Items]
Debt instrument, offering date		Feb. 02, 2021
Debt instrument aggregate principal amount	$ 1,775
Debt instrument stated interest rate	6.875%	6.875%
Debt instrument, maturity date	Apr. 15, 2029
Debt instrument, maturity year	2029	2029
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Debt instrument redemption price percentage	100.00%
Debt instrument optional redemption date	Apr. 15, 2024
Debt instrument redemption description		plus a “make-whole” premium, as described in the indenture governing the 6⅞% Junior-Priority Secured Notes due 2029.
Junior-Priority Secured Notes at 6.875% Due 2029 \| Redeem Up to 40% Principal Amount Prior to April 15, 2024
Debt Instrument [Line Items]
Debt instrument redemption price percentage	106.875%
Debt instrument optional redemption date	Apr. 15, 2024
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 [Line Items]
Debt instrument stated interest rate	9.875%		9.875%
Debt instrument, maturity year	2023		2023

Long-Term Debt - Schedule of Early Redemption Prices 6.875% Junior-Priority Secured Notes due 2029 (Details) - Junior-Priority Secured Notes at 6.875% Due 2029 - Junior-Priority Secured Notes	Feb. 02, 2021
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%
Debt Instrument, Redemption, Period One
Debt Instrument [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 Two
Debt Instrument [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 Three
Debt Instrument [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

Long-Term Debt - 4.750% Senior Secured Notes, Due 2031 - Additional Information (Details) - Senior Secured Notes - USD ($) $ in Millions		9 Months Ended	12 Months Ended
	Feb. 09, 2021	Sep. 30, 2021	Dec. 31, 2020
Redeem All or portion 100% Principal Amount Prior to February 15, 2026
Debt Instrument [Line Items]
Debt instrument stated interest rate	4.75%
Debt instrument, maturity year	2031
Debt instrument redemption description		plus a “make-whole” premium, as described in the indenture governing the 4¾% Senior Secured Notes due 2031
Debt instrument optional redemption date	Feb. 15, 2026
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Debt instrument redemption price percentage	100.00%
Senior Secured Notes at 4.750% due 2031
Debt Instrument [Line Items]
Debt instrument, offering date	Feb. 09, 2021
Debt instrument aggregate principal amount	$ 1,095
Debt instrument stated interest rate	4.75%	4.75%
Debt instrument, maturity date	Feb. 15, 2031
Debt instrument, maturity year	2031	2031
Debt instrument redemption description		The 4¾% Senior Secured Notes due 2031 bear interest at a rate of 4.750% per year payable semi-annually in arrears on February 15 and August 15, commencing on August 15, 2021.
Debt instrument optional redemption date	Feb. 15, 2026
Minimum period notice for redemption of debt	15 days
Maximum period notice for redemption of debt	60 days
Senior Secured Notes at 4.750% due 2031 \| Redeem up to 10% Principal Amount Prior to February 15, 2026
Debt Instrument [Line Items]
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
Debt instrument redemption price percentage	103.00%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	10.00%
Senior Secured Notes at 4.750% due 2031 \| Redeem up to 40% Principal Amount Prior to February 15, 2024
Debt Instrument [Line Items]
Debt instrument stated interest rate	4.75%
Debt instrument, maturity year	2031
Debt instrument optional redemption 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%
Senior Secured Notes at 8.625%, Due 2024
Debt Instrument [Line Items]
Debt instrument stated interest rate	8.625%		8.625%
Debt instrument, maturity year	2024		2024
Debt instrument redemption date	Feb. 09, 2021

Long-Term Debt - Schedule of Early Redemption Prices on 4.750% Senior Notes due 2031 (Details) - Senior Secured Notes - Senior Secured Notes at 4.750% due 2031	Feb. 09, 2021
Debt Instrument, Redemption, Period One
Debt Instrument [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 Two
Debt Instrument [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 Three
Debt Instrument [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 Four
Debt Instrument [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

Long-Term Debt - 6.875% Senior Notes, Due 2022 - Additional Information (Details) - Senior Notes - Senior Notes at 6.875%, Due 2022 - USD ($) $ in Millions		12 Months Ended
	Mar. 01, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%	6.875%
Debt instrument, redemption value	$ 126
Debt instrument, maturity year	2022	2022

Long-Term Debt - 6.125% Junior-Priority Secured Notes, Due 2030 - Additional Information (Details) - Junior-Priority Secured Notes - Junior-Priority Secured Notes at 6.125% Due 2030 - USD ($) $ in Millions		9 Months Ended
	May 19, 2021	Sep. 30, 2021
Debt Instrument [Line Items]
Debt instrument, offering date	May 19, 2021
Debt instrument aggregate principal amount	$ 1,440
Debt instrument stated interest rate	6.125%	6.125%
Debt instrument, maturity date	Apr. 01, 2030
Debt instrument, maturity year	2030	2030
Debt instrument, frequency of periodic payment		The 6⅛% Junior-Priority Secured Notes due 2030 bear interest at a rate of 6.125% per year payable semi-annually in arrears on April 1 and October 1, commencing on October 1, 2021
Debt instrument optional redemption date	Apr. 01, 2025
Minimum period notice for redemption of debt	15 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 6⅛% Junior-Priority Secured Notes due 2030.
Redeem up to 40% Principal Amount Prior to May 15, 2024
Debt Instrument [Line Items]
Debt instrument optional redemption date	May 15, 2024
Debt instrument redemption price percentage	106.125%
Maximum principal redeemable using proceeds from a public equity offering, as a percentage of principal amount	40.00%

Long-Term Debt - Schedule of Early Redemption Prices 6.125% Junior-Priority Secured Notes due 2030 (Details) - Junior-Priority Secured Notes at 6.125% Due 2030 - Junior-Priority Secured Notes	May 19, 2021
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%
Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage	103.063%
Debt Instrument, Redemption Period, Start Date	Apr. 01, 2025
Debt Instrument, Redemption Period, End Date	Mar. 31, 2026
Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	101.531%
Debt Instrument, Redemption Period, Start Date	Apr. 01, 2026
Debt Instrument, Redemption Period, End Date	Mar. 31, 2027
Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%
Debt Instrument, Redemption Period, Start Date	Apr. 01, 2027
Debt Instrument, Redemption Period, End Date	Mar. 31, 2030

Long-Term Debt - Other Debt - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Apr. 03, 2018
Debt Instrument [Line Items]
Interest paid on borrowings	$ 268,000,000	$ 279,000,000	$ 572,000,000	$ 765,000,000
ABL Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	836,000,000		836,000,000		$ 1,000,000,000.0
Line of credit facility, excess availability	728,000,000		728,000,000
Line of credit outstanding amount	0		0
ABL Facility \| ABL Facility Customary Covenants
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	95,000,000		$ 95,000,000
Debt instrument variable interest rate			10.00%
ABL Facility \| Letter of Credit
Debt Instrument [Line Items]
Line of credit outstanding amount	$ 108,000,000		$ 108,000,000
Reduction in letters of credit			$ 42,000,000

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Carrying Amount
Assets:
Cash and cash equivalents	$ 1,294	$ 1,676
Investments in equity securities	126	129
Available-for-sale debt securities	169	110
Trading securities	12	12
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Liabilities:
Notes payable, fair value disclosure		95
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Liabilities:
Notes payable, fair value disclosure		1,025
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure	1,432	1,427
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,077	2,074
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	692	692
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,816	1,809
Carrying Amount \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	859	857
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	1,090
Carrying Amount \| Senior Notes \| Senior Notes at 6.875%, Due 2022
Liabilities:
Notes payable, fair value disclosure		125
Carrying Amount \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	759	758
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Liabilities:
Notes payable, fair value disclosure		1,756
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Liabilities:
Notes payable, fair value disclosure		1,336
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	1,621
Carrying Amount \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	1,350
Carrying Amount \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	35	23
Estimated Fair Value
Assets:
Cash and cash equivalents	1,294	1,676
Investments in equity securities	126	129
Available-for-sale debt securities	169	110
Trading securities	12	12
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6.25%, Due 2023
Liabilities:
Notes payable, fair value disclosure		99
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8.625%, Due 2024
Liabilities:
Notes payable, fair value disclosure		1,080
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure	1,532	1,543
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,229	2,275
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	767	760
Estimated Fair Value \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	957	973
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	1,107
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875%, Due 2022
Liabilities:
Notes payable, fair value disclosure		125
Estimated Fair Value \| Senior Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,997	2,048
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	739	618
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Liabilities:
Notes payable, fair value disclosure		1,861
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Liabilities:
Notes payable, fair value disclosure		1,408
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	1,781
Estimated Fair Value \| Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	1,401
Estimated Fair Value \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	$ 35	$ 23

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Parenthetical) (Details)						9 Months Ended	12 Months Ended
	May 19, 2021	Mar. 01, 2021	Feb. 09, 2021	Feb. 02, 2021	Jan. 28, 2021	Sep. 30, 2021	Dec. 31, 2020
Senior Notes \| Senior Notes at 6.875%, Due 2022
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate		6.875%					6.875%
Debt instrument maturity year		2022					2022
Senior Notes \| Senior Notes at 6.875% Due 2028
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate						6.875%	6.875%
Debt instrument maturity year						2028	2028
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%
Debt instrument maturity year						2026	2026
Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate						8.00%	8.00%
Debt instrument maturity year						2027	2027
Senior Secured Notes \| Senior Secured Notes at 5.625% 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 Notes at 6% Due 2029
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate						6.00%	6.00%
Debt instrument maturity year						2029	2029
Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate			4.75%			4.75%
Debt instrument maturity year			2031			2031
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 9.875% Due 2023
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate				9.875%			9.875%
Debt instrument maturity year				2023			2023
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 8.125% Due 2024
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate							8.125%
Debt instrument maturity year							2024
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate				6.875%		6.875%
Debt instrument maturity year				2029		2029
Junior-Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Debt instrument stated interest rate	6.125%					6.125%
Debt instrument maturity year	2030					2030

Fair Value - Additional Information (Details) - USD ($)	Sep. 30, 2021	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair value, assets, level 1 to level 2 transfers, amount	$ 0	$ 0
Fair value, assets, level 2 to level 1 transfers, amount	0	0
Fair value, liabilities, level 1 to level 2 transfers, amount	0	0
Fair value, liabilities, level 2 to level 1 transfers, amount	$ 0	$ 0

Fair Value - Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	$ 126	$ 129
Available-for-sale debt securities	169	110
Trading securities	12	12
Total assets	307	251
Fair Value, Inputs, Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	126	129
Total assets	126	129
Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available-for-sale debt securities	169	110
Trading securities	12	12
Total assets	$ 181	$ 122

Leases - Components of Lease Cost and Rent Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Leases [Abstract]
Operating lease cost	$ 49	$ 50	$ 147	$ 152
Short-term rent expense	22	27	70	80
Variable lease cost	5	9	17	20
Sublease income	(1)	(1)	(3)	(4)
Total operating lease cost	75	85	231	248
Finance lease cost:
Amortization of right-of-use assets	2	2	6	8
Interest on finance lease liabilities	2	2	5	6
Total finance lease cost	$ 4	$ 4	$ 11	$ 14

Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Operating Leases:
Operating Lease ROU Assets	$ 667	$ 642
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherAssets	us-gaap:OtherAssets
Finance Leases:
Property and equipment	$ 9,536	$ 9,352
Less accumulated depreciation and amortization	(4,168)	(4,030)
Property and equipment, net	5,368	5,322
Current finance lease liabilities	$ 9	$ 5
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	us-gaap:DebtCurrent	us-gaap:DebtCurrent
Long-term finance lease liabilities	$ 112	$ 74
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Long-term debt	Long-term debt
Finance Lease ROU Assets
Finance Leases:
Property and equipment	$ 195	$ 150
Less accumulated depreciation and amortization	(51)	(46)
Property and equipment, net	144	104
Finance Lease ROU Assets \| Land and Improvements
Finance Leases:
Property and equipment	8	8
Finance Lease ROU Assets \| Building and Improvements
Finance Leases:
Property and equipment	173	134
Finance Lease ROU Assets \| Equipment and Fixtures
Finance Leases:
Property and equipment	$ 14	$ 8

Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 149	$ 141
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from finance leases	5	6
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows from finance leases	4	5
Right-of-use assets obtained in exchange for new finance lease liabilities	46	22
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 118	$ 119

Stockholders' Deficit - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Equity [Abstract]
Capital stock, shares authorized	400,000,000
Common stock, shares authorized	300,000,000	300,000,000
Preferred stock, shares authorized	100,000,000	100,000,000
Common stock, par value per share	$ 0.01	$ 0.01
Preferred stock, par value per share	$ 0.01	$ 0.01
Preferred stock, shares outstanding	0
Amount available for dividend payments, stock repurchases at period end	$ 200

Stockholders' Deficit - Schedule of Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020
Equity, beginning balance	$ (1,616)	$ (1,595)	$ (1,538)	$ (2,052)	$ (2,136)	$ (2,141)
Redeemable Noncontrolling Interests, beginning balance			484
Comprehensive income (loss)	125	14	(59)	104	87	28
Distributions to noncontrolling interests	(10)	(14)	(9)	(7)	(10)	(8)
Purchase of subsidiary shares from noncontrolling interests	9				1	(1)
Other reclassifications of noncontrolling interests		(1)				(8)
Adjustment to redemption value of redeemable noncontrolling interests	(6)	(25)	7	(6)	3	(7)
Cancellation of restricted stock for tax withholdings on vested shares			(4)			(1)
Share-based compensation	5	5	8	3	3	2
Equity, ending balance	(1,493)	(1,616)	(1,595)	(1,957)	(2,052)	(2,136)
Redeemable Noncontrolling Interests, ending balance	493
Redeemable Noncontrolling Interests (Non- Equity)
Redeemable Noncontrolling Interests, beginning balance	498	481	484	489	502	502
Comprehensive income (loss) attributable to redeemable noncontrolling interest	20	24	21	23	7	8
Contributions from redeemable noncontrolling interests	1
Distributions to redeemable noncontrolling interests	(19)	(31)	(12)	(20)	(17)	(22)
Purchase of subsidiary shares from noncontrolling interests	(13)	(2)		(2)	(1)	(1)
Dispositions of less-than-wholly owned business			(7)	(15)
Noncontrolling interest in acquired entity			2
Other reclassifications of noncontrolling interests		1
Other reclassifications of redeemable noncontrolling interests					1	8
Adjustment to redemption value of redeemable noncontrolling interests	6	25	(7)	6	(3)	7
Redeemable Noncontrolling Interests, ending balance	493	498	481	481	489	502
Common Stock
Equity, beginning balance	1	1	1	1	1	1
Equity, ending balance	1	1	1	1	1	1
Additional Paid-in Capital
Equity, beginning balance	2,084	2,105	2,094	2,008	2,001	2,008
Purchase of subsidiary shares from noncontrolling interests	9				1	(1)
Other reclassifications of noncontrolling interests		(1)
Adjustment to redemption value of redeemable noncontrolling interests	(6)	(25)	7	(6)	3	(7)
Cancellation of restricted stock for tax withholdings on vested shares			(4)			(1)
Share-based compensation	5	5	8	3	3	2
Equity, ending balance	2,092	2,084	2,105	2,005	2,008	2,001
Accumulated Other Comprehensive (Income) Loss
Equity, beginning balance	(15)	(16)	(13)	(5)	(7)	(9)
Comprehensive income (loss)	1	1	(3)		2	2
Equity, ending balance	(14)	(15)	(16)	(5)	(5)	(7)
Accumulated Deficit
Equity, beginning balance	(3,765)	(3,771)	(3,707)	(4,131)	(4,200)	(4,218)
Comprehensive income (loss)	110	6	(64)	112	69	18
Equity, ending balance	(3,655)	(3,765)	(3,771)	(4,018)	(4,131)	(4,200)
Noncontrolling Interest
Equity, beginning balance	79	86	87	75	69	77
Comprehensive income (loss)	14	7	8	(8)	16	8
Distributions to noncontrolling interests	(10)	(14)	(9)	(7)	(10)	(8)
Other reclassifications of noncontrolling interests						(8)
Equity, ending balance	$ 83	$ 79	$ 86	$ 60	$ 75	$ 69

Stockholders' Deficit - Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Equity [Abstract]
Net income attributable to Community Health Systems, Inc. stockholders	$ 111	$ 112	$ 52	$ 200
Net increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests	9		9
Net transfers to the noncontrolling interests	9		9
Change to Community Health Systems, Inc. stockholders' deficit from net income attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$ 120	$ 112	$ 61	$ 200

- Definition

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

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+ Details

Earnings Per Share - Schedule of Components of Denominator for Computation of Basic and Diluted Earnings Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Effect of dilutive securities:
Weighted-average number of shares outstanding — basic	127,077,786	115,015,460	126,638,291	114,764,050
Restricted stock awards	2,652,676	500,857	2,249,117	205,600
Employee stock options	795,471	2,193	698,941	890
Other equity-based awards	359,206	122,342	299,602	41,662
Weighted-average number of shares outstanding — diluted	130,885,139	115,640,852	129,885,951	115,012,202

Earnings Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Employee stock options and restricted stock awards excluded from computation of earnings per share amount	748,002	1,846,026	784,752	3,673,618

Contingencies - Schedule of Reconciliation of the Beginning and Ending Liability Balances in Connection with Probable Contingencies (Details) - Pending Litigation [Member] - Other Probable Contingencies [Member] $ in Millions	9 Months Ended
	Sep. 30, 2021 USD ($)
Loss Contingency Accrual [Roll Forward]
Beginning Balance	$ 11
Expense	1
Reserve for insured claim	(1)
Cash payments	(1)
Ending Balance	$ 10

Subsequent Events - Additional Information (Details) $ in Millions	Oct. 01, 2021 USD ($) Item	Sep. 30, 2021 USD ($)
CARES Act
Subsequent Event [Line Items]
Medicare accelerated payments outstanding \| $		$ 814
Subsequent Event
Subsequent Event [Line Items]
Number of hospitals owned and leased by the Company	83
Number of general acute care hospitals	81
Number of stand alone rehabilitation or psychiatric hospitals	2
Subsequent Event \| CARES Act
Subsequent Event [Line Items]
Medicare accelerated repayment \| $	$ 814