0001564590-22-035470 | 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, 2022	Oct. 20, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2022
Document Fiscal Year Focus	2022
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	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		134,713,179
Entity Central Index Key	0001108109
Amendment Flag	false

Condensed Consolidated Statements of (Loss) Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Statement [Abstract]
Net operating revenues	$ 3,025	$ 3,115	$ 9,069	$ 9,135
Operating costs and expenses:
Salaries and benefits	1,352	1,336	3,972	3,905
Supplies	492	529	1,477	1,521
Other operating expenses	828	716	2,511	2,170
Lease cost and rent	80	75	236	231
Pandemic relief funds	(115)	(19)	(171)	(102)
Depreciation and amortization	137	137	398	408
Impairment and (gain) loss on sale of businesses, net	47	1	54	24
Total operating costs and expenses	2,821	2,775	8,477	8,157
Income from operations	204	340	592	978
Interest expense, net	217	216	652	666
(Gain) loss from early extinguishment of debt	(78)		(73)	79
Gain on sale of equity interests in Macon Healthcare, LLC		(26)		(26)
Equity in earnings of unconsolidated affiliates	(5)	(4)	(11)	(19)
Income before income taxes	70	154	24	278
Provision for income taxes	70	10	291	132
Net income (loss)	0	144	(267)	146
Less: Net income attributable to noncontrolling interests	42	33	102	94
Net (loss) income attributable to Community Health Systems, Inc. stockholders	$ (42)	$ 111	$ (369)	$ 52
(Loss) earnings per share attributable to Community Health Systems, Inc. stockholders:
Basic	$ (0.32)	$ 0.87	$ (2.86)	$ 0.41
Diluted	$ (0.32)	$ 0.85	$ (2.86)	$ 0.40
Weighted-average number of shares outstanding:
Basic	129,141,673	127,077,786	128,689,999	126,638,291
Diluted	129,141,673	130,885,139	128,689,999	129,885,951

Condensed Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss)	$ 0	$ 144	$ (267)	$ 146
Other comprehensive (loss) income, net of income taxes:
Net change in fair value of available-for-sale debt securities, net of tax	(6)	(1)	(20)	(4)
Amortization and recognition of unrecognized pension cost components, net of tax	0	2	1	3
Other comprehensive (loss) income	(6)	1	(19)	(1)
Comprehensive (loss) income	(6)	145	(286)	145
Less: Comprehensive income attributable to noncontrolling interests	42	33	102	94
Comprehensive (loss) income attributable to Community Health Systems, Inc. stockholders	$ (48)	$ 112	$ (388)	$ 51

- 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, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 300	$ 507
Patient accounts receivable	1,969	2,062
Supplies	355	355
Prepaid income taxes	98	94
Prepaid expenses and taxes	246	192
Other current assets	301	269
Total current assets	3,269	3,479
Property and equipment	9,727	9,757
Less accumulated depreciation and amortization	(4,277)	(4,204)
Property and equipment, net	5,450	5,553
Goodwill	4,201	4,219
Deferred income taxes	53	53
Other assets, net	1,941	1,913
Total assets	14,914	15,217
Current liabilities:
Current maturities of long-term debt	21	31
Current operating lease liabilities	151	147
Accounts payable	820	830
Accrued liabilities:
Employee compensation	601	655
Accrued interest	218	225
Other	572	476
Total current liabilities	2,383	2,364
Long-term debt	11,943	12,109
Deferred income taxes	477	192
Long-term operating lease liabilities	563	535
Other long-term liabilities	726	827
Total liabilities	16,092	16,027
Redeemable noncontrolling interests in equity of consolidated subsidiaries	516	480
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; 134,698,067 shares issued and outstanding at September 30, 2022, and 132,146,282 shares issued and outstanding at December 31, 2021	1	1
Additional paid-in capital	2,091	2,118
Accumulated other comprehensive loss	(33)	(14)
Accumulated deficit	(3,845)	(3,477)
Total Community Health Systems, Inc. stockholders’ deficit	(1,786)	(1,372)
Noncontrolling interests in equity of consolidated subsidiaries	92	82
Total stockholders’ deficit	(1,694)	(1,290)
Total liabilities and stockholders’ deficit	$ 14,914	$ 15,217

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2022	Dec. 31, 2021
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	134,698,067	132,146,282
Common stock, shares outstanding	134,698,067	132,146,282

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net (loss) income	$ (267)	$ 146
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	398	408
Deferred income taxes	290	123
Stock-based compensation expense	14	18
Impairment and (gain) loss on sale of businesses, net	54	24
(Gain) loss from early extinguishment of debt	(73)	79
Gain on sale of equity interests in Macon Healthcare, LLC		(26)
Other non-cash expenses, net	140	22
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	93	(99)
Supplies, prepaid expenses and other current assets	(94)	14
Repayment/derecognition of Medicare accelerated payments		(267)
Accounts payable, accrued liabilities and income taxes	(90)	85
Other	(174)	(127)
Net cash provided by operating activities	291	400
Cash flows from investing activities:
Acquisitions of facilities and other related businesses	(9)	(3)
Purchases of property and equipment	(284)	(334)
Proceeds from disposition of hospitals and other ancillary operations	3	17
Proceeds from sale of property and equipment	30	7
Purchases of available-for-sale debt securities and equity securities	(73)	(135)
Proceeds from sales of available-for-sale debt securities and equity securities	62	86
Proceeds from sale of equity interests in Macon Healthcare, LLC		110
Distribution of CoreTrust proceeds	121
Purchases of investments in unconsolidated affiliates	(18)	(4)
Increase in other investments	(39)	(57)
Net cash used in investing activities	(207)	(313)
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(8)	(5)
Deferred financing costs and other debt-related costs	(73)	(310)
Proceeds from noncontrolling investors in joint ventures	10	1
Redemption of noncontrolling investments in joint ventures	(2)	(5)
Distributions to noncontrolling investors in joint ventures	(105)	(95)
Other borrowings	35	50
Issuance of long-term debt	1,535	4,310
Repayments of long-term indebtedness	(1,683)	(4,415)
Net cash used in financing activities	(291)	(469)
Net change in cash and cash equivalents	(207)	(382)
Cash and cash equivalents at beginning of period	507	1,676
Cash and cash equivalents at end of period	300	1,294
Supplemental disclosure of cash flow information:
Interest payments	(614)	(572)
Income tax payments, net	$ (6)	$ (3)

Basis of Presentation and Significant Accounting Policies

9 Months Ended

Sep. 30, 2022

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, 2022 and December 31, 2021 and for the three-month and nine-month periods ended September 30, 2022 and 2021, have been prepared in accordance with accounting principles generally accepted in the United States of America (“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, 2022, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2022. The preparation of financial statements in conformity with 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, 2021, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 17, 2022 (“2021 Form 10-K”).

Reclassifications. Certain prior period amounts have been reclassified to conform to the current period presentation within the condensed consolidated statements of cash flows.

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 $60 million and $56 million for the three months ended September 30, 2022 and 2021, respectively, and $179 million and $168 million for the nine months ended September 30, 2022 and 2021, respectively.

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, 2022 and 2021, 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 payment is reasonably assured. Reimbursement under these programs is reflected in net operating revenues. 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, 2022 and 2021 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,
	2022		2021		2022		2021
Medicare	$	644	$	653	$	1,928	$	1,988
Medicaid		449		412		1,362		1,223
Managed Care and other third-party payors		1,925		2,010		5,719		5,845
Self-pay		7		40		60		79
Total	$	3,025	$	3,115	$	9,069	$	9,135

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 $115 million and $118 million as of September 30, 2022 and December 31, 2021, respectively, and these amounts are included in accrued liabilities-other in the accompanying condensed consolidated balance sheets. Amounts due from third-party payors were $102 million and $114 million as of September 30, 2022 and December 31, 2021, 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 2017.

Charity Care

In the ordinary course of business, the Company renders services to patients who are financially unable to pay for hospital care. The Company’s policy is to not pursue collections for such amounts; therefore, the related charges for those patients who are financially unable to pay and that otherwise do not qualify for reimbursement from a governmental program are not reported in net operating revenues, and are thus classified as charity care. The Company determines amounts that qualify for charity care based on the patient’s household income relative to the federal poverty level guidelines, as established by the federal government. The Company updated its policy during the three months ended March 31, 2022 in a manner which increased the number of accounts qualifying for charity care. This resulted in an increase in charity care services during the three and nine months ended September 30, 2022, compared to the same periods in 2021.

These charity care services are estimated to be $285 million and $215 million for the three months ended September 30, 2022 and 2021, respectively, and $1.1 billion and $659 million for the nine months ended September 30, 2022 and 2021, 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 $33 million and $25 million during the three months ended September 30, 2022 and 2021, respectively, and $121 million and $77 million during the nine months ended September 30, 2022 and 2021, 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, 2022, the Company recorded an impairment charge of approximately $54 million, which consists of $6 million to adjust the carrying value of long-lived assets at a hospital that was sold at a sales price below carrying value and $48 million primarily related to the hospital closures discussed in Note 3.

During the nine months ended September 30, 2021, the Company recorded a total combined 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.

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

Pandemic Relief Funds

The Company received (returned) pandemic relief fund payments through various federal, state and local programs of approximately $108 million and $(4) million during the three months ended September 30, 2022 and 2021, respectively, and approximately $160 million and $4 million for the nine months ended September 30, 2022 and 2021, respectively. Approximately $115 million and $19 million during the three months September 30, 2022 and 2021, respectively, and $171 million and $102 million during the nine months ended September 30, 2022 and 2021, respectively, was recognized as a reduction to operating costs and expenses, as denoted by the caption “pandemic relief funds” within the condensed consolidated statements of (loss) income. Approximately $4 million of unrecognized pandemic relief funds received are reflected within accrued liabilities-other in the condensed consolidated balance sheet as of September 30, 2022. Such unrecognized amounts may either be returned or may be recognized in future periods if the underlying conditions for recognition are reasonably assured of having been met. The Company’s accounting policies for the recognition of pandemic relief funds is unchanged from the policies described in Note 1 to the Company’s consolidated financial statements included in the 2021 Form 10-K.

New Accounting Pronouncements

In September 2022, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2022-04, “Liabilities – Supplier Finance Programs (Subtopic 405-50), Disclosure of Supplier Finance Program Obligations.” This ASU provides specific authoritative guidance for disclosure of supplier finance programs including key terms of such programs, amounts outstanding, and where the obligations are presented in the statement of financial position. This ASU is effective for all entities for financial statements issued for annual periods beginning after December 15, 2022, including interim periods, except for the disclosure of rollforward information, which is effective for annual periods beginning after December 15, 2023. Certain components of this guidance must be applied retrospectively while others may be applied prospectively. Early adoption is permitted. The Company is currently evaluating the impact that adoption of this ASU will have on its condensed consolidated financial statements.

Accounting for Stock-Based Compensation

9 Months Ended

Sep. 30, 2022

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 Internal Revenue Code (“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. As of September 30, 2022, 6,941,141 shares of unissued common stock were reserved for future grants under the 2009 Plan.

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,
	2022			2021			2022			2021
Effect on income before income taxes	$	(6	)	$	(5	)	$	(14	)	$	(18	)
Effect on net (loss) income	$	(5	)	$	(4	)	$	(11	)	$	(14	)

At September 30, 2022, $39 million of unrecognized stock-based compensation expense related to outstanding unvested stock options, restricted stock and restricted stock units (the terms of which are summarized below) was expected to be recognized over a weighted-average period of 24 months. Of that amount, $6 million relates to outstanding unvested stock options expected to be recognized over a weighted-average period of 24 months and $33 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, 2022 and 2021.

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. 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 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, 2022 and 2021:

Three Months Ended

September 30,

Nine Months Ended

September 30,

2022

2021

2022

2021

Expected volatility

N/A

84.3% - 87.5%

84.3% - 88.9%

Expected dividends

N/A

—

Expected term

N/A

3 - 6 years

Risk-free interest rate

N/A

1.5% - 1.6%

0.3% - 0.9%

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, 2022, and changes during each of the three-month periods following December 31, 2021, 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	2022
Outstanding at December 31, 2021		2,301,753		$	6.77
Granted		760,000			10.18
Exercised		(56,500	)		4.97
Forfeited and cancelled		(151,002	)		14.67
Outstanding at March 31, 2022		2,854,251			7.30
Granted		—			—
Exercised		—			—
Forfeited and cancelled		—			—
Outstanding at June 30, 2022		2,854,251			7.30
Granted		—			—
Exercised		—			—
Forfeited and cancelled		—			—
Outstanding at September 30, 2022		2,854,251		$	7.30	8.0 years	$	—
Exercisable at September 30, 2022		1,320,912		$	5.63	7.2 years	$	—

No stock options were granted during the three months ended September 30, 2022 and 2021. The weighted-average grant date fair value of stock options granted during the nine months ended September 30, 2022 and 2021 was $7.25 and $6.22, 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 ($2.15) 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, 2022. This amount changes based on the market value of the Company’s common stock. The aggregate intrinsic value of options exercised was less than $1 million during both of the nine-month periods ended September 30, 2022 and 2021. No options were exercised during the three-month periods ended September 30, 2022 and 2021. The aggregate intrinsic value of options vested and expected to vest approximates that of the outstanding options.

The Company has also awarded restricted stock under the 2009 Plan to employees of certain subsidiaries. With respect to time-based vesting restricted stock that has been awarded under the 2009 Plan, the restrictions on these shares have generally lapsed in one-third increments on each of the first three anniversaries of the award date. In addition, certain of the restricted stock awards granted to the Company’s senior executives have contained performance objectives required to be met in addition to any time-based vesting requirements. If the applicable performance objectives are not attained, these awards will be forfeited in their entirety. For performance-based awards, the performance objectives are measured cumulatively over a three-year period. 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 or disability of the holder of the restricted stock, or change in control of the Company. On March 1, 2022, restricted stock awards subject to performance objectives granted on March 1, 2019 vested at 200% of the shares originally granted based on the Company’s cumulative performance compared to objectives for the 2019 through 2021 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, 2022, and changes during each of the three-month periods following December 31, 2021, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2021		4,995,314		$	6.30
Granted		3,179,000			9.05
Vested		(2,516,247	)		5.62
Forfeited		(30,000	)		6.87
Unvested at March 31, 2022		5,628,067			8.61
Granted		41,000			5.00
Vested		(17,000	)		10.65
Forfeited		(72,670	)		9.77
Unvested at June 30, 2022		5,579,397			8.56
Granted		—			—
Vested		—			—
Forfeited		(23,003	)		8.10
Unvested at September 30, 2022		5,556,394			8.56

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 17,682 RSUs and 19,296 RSUs on March 1, 2022 and 2021, respectively. The March 2022 and 2021 grants had a grant date fair value of approximately $180,000 and $170,000, respectively. On June 1, 2022, a new non-management director received a grant of 17,682 RSUs with a grant date fair value of approximately $88,000. 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. 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 three directors elected to defer the receipt of RSUs granted on March 1, 2022 to a future date and a total of four directors elected to defer the receipt of RSUs granted on March 1, 2021 to a future date.

RSUs outstanding under the 2009 Plan as of September 30, 2022, and changes during each of the three-month periods following December 31, 2021, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2021		486,598		$	6.17
Granted		159,138			10.18
Vested		(151,058	)		5.63
Forfeited		—			—
Unvested at March 31, 2022		494,678			7.63
Granted		17,682			5.00
Vested		—			—
Forfeited		—			—
Unvested at June 30, 2022		512,360			7.54
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at September 30, 2022		512,360			7.54

Acquisitions, Divestitures and Closures

9 Months Ended

Sep. 30, 2022

Acquisitions Divestitures And Closures [Abstract]

ACQUISITIONS, DIVESTITURES AND CLOSURES

3. ACQUISITIONS, DIVESTITURES AND CLOSURES

Acquisitions

The Company accounts for all transactions that represent business combinations using the acquisition method of accounting, where the identifiable assets acquired, the liabilities assumed and any noncontrolling interest in the acquired entity are recognized and measured at their fair values on the date the Company obtains control of 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, 2022, one or more subsidiaries of the Company paid approximately $9 million to acquire the operating assets and related businesses of certain physician practices, clinics, ambulatory surgery centers 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, 2022 and the year ended December 31, 2021:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2022 Divestiture:
AllianceHealth Seminole	SSM Health Care of Oklahoma	Seminole, OK	32	July 1, 2022

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

On July 1, 2022, one or more affiliates of the Company sold substantially all of the assets of AllianceHealth Seminole (32 licensed beds) in Seminole, Oklahoma, to affiliates of SSM Health Care of Oklahoma. The net proceeds from this sale were received at a preliminary closing on June 30, 2022.

On September 14, 2022, one or more affiliates of the Company entered into a definitive agreement for the sale of substantially all of the assets of Greenbrier Valley Medical Center (122 licensed beds) in Ronceverte, West Virginia, to Vandalia Health, Inc. This hospital is classified as held for sale as of September 30, 2022.

The following table discloses amounts included in the condensed consolidated balance sheet for the hospital classified as held for sale as of September 30, 2022 (in millions). Other assets, net primarily includes the net property and equipment and goodwill for the hospital held for sale. No divestitures or potential divestitures meet the criteria for reporting as a discontinued operation as of September 30, 2022.

	September 30, 2022
Other current assets	$	3
Other assets, net		57
Accrued liabilities		(3	)

Closures

During the three months ended September 30, 2022, the Company completed the closure of Shorepoint Health Venice hospital (312 licensed beds) in Venice, Florida. The Company recorded an impairment charge of approximately $25 million during the three months ended September 30, 2022, to adjust the fair value of the long-lived assets of this hospital, including property and equipment and capitalized software costs, based on their estimated fair value and future utilization.

During the three months ended September 30, 2022, the provision of inpatient services and substantially all outpatient services ceased at First Hospital Wyoming Valley (psychiatric hospital) (149 licensed beds) in Wilkes-Barre, Pennsylvania, resulting in the closure of this facility being substantially complete as of September 30, 2022. The Company expects to complete the closure of First Hospital Wyoming Valley during the three months ending December 31, 2022. The Company recorded an impairment charge of approximately $18 million during the three months ended September 30, 2022, to adjust the fair value of the long-lived assets of this hospital, including property and equipment and capitalized software costs, based on their estimated fair value and future utilization.

Goodwill

9 Months Ended

Sep. 30, 2022

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill

4. GOODWILL

The changes in the carrying amount of goodwill for the nine months ended September 30, 2022 are as follows (in millions):

Balance, as of December 31, 2021
Goodwill	$	7,033
Accumulated impairment losses		(2,814	)
		4,219
Goodwill acquired as part of acquisitions during current year		13
Goodwill allocated to hospitals held for sale or divested		(31	)
Balance, as of September 30, 2022
Goodwill		7,015
Accumulated impairment losses		(2,814	)
	$	4,201

Goodwill is allocated to each identified reporting unit, which is defined as an operating segment or one level below the operating segment (referred to as a component of the entity). Management has determined that the Company’s operating segment meets the criteria to be classified as a reporting unit.

Goodwill is evaluated for impairment annually and when an event occurs or circumstances change that, more likely than not, reduce the fair value of the reporting unit below its carrying value. The Company performed its last annual goodwill impairment evaluation during the fourth quarter of 2021 using an October 31, 2021 measurement date, which indicated no impairment.

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

The determination of fair value in the Company’s goodwill impairment analysis is based on an estimate of fair value for the reporting unit utilizing known and estimated inputs at the evaluation date. Some of those inputs include, but are not limited to, the most recent price of the Company’s common stock and fair value of long-term debt, recent financial results of the Company, estimates of future revenue and expense growth, estimated market multiples, expected capital expenditures, income tax rates, and costs of invested capital.

A detailed evaluation of potential impairment indicators was performed as of September 30, 2022, which specifically considered declines in the fair market value of the Company’s outstanding senior secured and unsecured notes and common stock during the nine months ended September 30, 2022, as well as macroeconomic conditions and the Company’s recent financial results, including the effect of increased wage and contract labor expense. On the basis of available evidence, as of September 30, 2022, the Company concluded that the fair value of the reporting unit was not more likely than not reduced to an amount less than its carrying value.

Future estimates of fair value could be adversely affected if the actual outcome of one or more of the assumptions described above changes materially in the future, including a continued decline in the Company’s stock price and the fair value of its long-term debt, an increase in the volatility of the Company’s stock price and the fair value of its long-term debt, lower than expected volumes and/or net operating revenues, higher market interest rates or increased operating costs. Such changes impacting the calculation of fair value could result in a material impairment charge in the future.

Income Taxes

9 Months Ended

Sep. 30, 2022

Income Tax Disclosure [Abstract]

INCOME TAXES

5. INCOME TAXES

The total amount of unrecognized benefit that would affect the effective tax rate, if recognized, was less than $1 million at September 30, 2022. 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, 2022. It is the Company’s policy to recognize interest and penalties related to unrecognized benefits in its condensed consolidated statements of (loss) 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 return for the 2018 tax year remains under examination by the Internal Revenue Service. The Company believes the result of this examination will not be material to its consolidated results of operations or consolidated financial position. The Company has extended the federal statute of limitations through December 31, 2023 for the tax period ended December 31, 2018.

The Company’s provision for income taxes was $70 million and $10 million for the three months ended September 30, 2022 and 2021, respectively, and $291 million and $132 million for the nine months ended September 30, 2022 and 2021, respectively. The Company’s effective tax rates were 100.0% and 6.5% for the three months ended September 30, 2022 and 2021, respectively, and 1,212.5% and 47.5% for the nine months ended September 30, 2022 and 2021, respectively. The increase in the provision for income taxes for the three and nine months ended September 30, 2022, compared to the same periods in 2021 was primarily due to an increase in non-deductible interest for 2022 compared to 2021, compounded by an adverse change in the IRC Section 163(j) limit for deductible interest expense beginning in 2022. The difference in the Company’s effective tax rate for the three and nine months ended September 30, 2022, compared to the same periods in 2021 is due to the aforementioned increase in the provision for income taxes and the decline in income before taxes.

Cash paid for income taxes, net of refunds received, resulted in a net payment of approximately less than $1 million and $1 million during the three-month periods ended September 30, 2022 and 2021, respectively, and $6 million and $3 million during the nine-month periods ended September 30, 2022 and 2021, 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 https://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 https://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 https://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 https://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 https://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 https://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 https://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 https://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 https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Long-Term Debt

9 Months Ended

Sep. 30, 2022

Long Term Debt And Capital Lease Obligations [Abstract]

LONG-TERM DEBT

6. LONG-TERM DEBT

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

	September 30,			December 31,
	2022			2021
6⅝% Senior Secured Notes due 2025	$	—		$	1,462
8% Senior Secured Notes due 2026		2,101			2,101
8% Senior Secured Notes due 2027		700			700
5⅝% Senior Secured Notes due 2027		1,900			1,900
6⅞% Senior Notes due 2028		756			767
6% Senior Secured Notes due 2029		900			900
5¼% Senior Secured Notes due 2030		1,535			—
4¾% Senior Secured Notes due 2031		1,058			1,095
6⅞% Junior-Priority Secured Notes due 2029		1,665			1,775
6⅛% Junior-Priority Secured Notes due 2030		1,331			1,440
ABL Facility		—			—
Finance lease and financing obligations		425			398
Other		36			37
Less: Unamortized deferred debt issuance costs and note premium		(443	)		(435	)
Total debt		11,964			12,140
Less: Current maturities		(21	)		(31	)
Total long-term debt	$	11,943		$	12,109

On February 4, 2022, CHS/Community Health Systems, Inc. (“CHS”) completed a private offering of $1.535 billion aggregate principal amount of 5¼% Senior Secured Notes due May 15, 2030 (the “5¼% Senior Secured Notes due 2030”). The proceeds of the offering were used to redeem the 6⅝% Senior Secured Notes due 2025 on February 4, 2022, and to pay related fees and expenses. The 5¼% Senior Secured Notes due 2030 bear interest at a rate of 5.250% per year payable semi-annually in arrears on May 15 and November 15, commencing on November 15, 2022. The 5¼% Senior Secured Notes due 2030 are unconditionally guaranteed on a senior-priority secured basis by the Company and each of the current and future domestic subsidiaries of CHS that provide guarantees under the revolving asset-based loan facility (the “ABL Facility”), any capital market debt securities of CHS (including CHS’ outstanding senior notes) and certain other long-term debt of CHS.

The 5¼% Senior Secured Notes due 2030 and the related guarantees are secured by shared (i) first-priority liens on the collateral that also secures on a first-priority basis CHS’ senior-priority secured notes and (ii) second-priority liens on the collateral that secures on a first-priority basis the ABL Facility, in each case subject to permitted liens described in the indenture governing the 5¼% Senior Secured Notes due 2030.

CHS is entitled, at its option, to redeem all or a portion of the 5¼% Senior Secured Notes due 2030 at any time prior to May 15, 2025, upon not less than 10 nor more than 60 days’ notice, at a price equal to 100% of the principal amount of the 5¼% Senior Secured Notes due 2030 redeemed plus accrued and unpaid interest, if any, plus a “make-whole” premium, as described in the indenture governing the 5¼% Senior Secured Notes due 2030.

CHS may redeem up to 40% of the aggregate principal amount of the 5¼% Senior Secured Notes due 2030 at any time prior to May 15, 2025 using the net proceeds from certain equity offerings at a redemption price of 105.250% of the principal amount of the 5¼% Senior Secured Notes due 2030 redeemed, plus accrued and unpaid interest, if any. In addition, any time prior to May 15, 2025, but not more than once during each twelve-month period, CHS may redeem up to 10% of the original aggregate principal amount of the 5¼% Senior Secured Notes due 2030 at a redemption price equal to 103% of the principal amount of the 5¼% Senior Secured Notes due 2030 to be redeemed, plus accrued and unpaid interest, if any.

At any time and from time to time on or after May 15, 2025, CHS may redeem the 5¼% Senior Secured Notes due 2030 in whole or in part, upon not less than 10 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 5¼% Senior Secured Notes due 2030 redeemed, to, but excluding, the applicable date of redemption, if redeemed during the twelve-month period beginning on May 15 of the years indicated below:

Period		Redemption Price
May 15, 2025 to May 14, 2026		102.625%
May 15, 2026 to May 14, 2027		101.313%
May 15, 2027 to May 14, 2030		100.000%

During the three months ended September 30, 2022, the Company extinguished a portion of certain series of its outstanding notes through open market repurchases, as follows (in millions):

	Principal Amount
6⅞% Senior Notes due 2028	$	11
4¾% Senior Secured Notes due 2031		37
6⅞% Junior-Priority Secured Notes due 2029		110
6⅛% Junior-Priority Secured Notes due 2030		109
Total principal amount of debt extinguished	$	267

The Company recognized a pre-tax and after-tax gain from early extinguishment of debt associated with these open market repurchases of $78 million and $68 million, respectively, during the three months ended September 30, 2022.

The maximum aggregate principal amount under the ABL Facility is $1.0 billion. At September 30, 2022, the available borrowing base under the ABL Facility was $935 million, of which $83 million was reserved for outstanding letters of credit and $852 million represented excess availability. Letters of credit were reduced during the nine months ended September 30, 2022 by $30 million due to a reduction in an insurance-related letter of credit. The Company had no outstanding borrowings as of September 30, 2022. 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, 2022, the Company is not subject to the consolidated fixed charge coverage ratio as such triggering event had not occurred during the twelve months ended September 30, 2022.

The Company paid interest of $204 million and $268 million on borrowings during the three months ended September 30, 2022 and 2021, respectively, and $614 million and $572 million on borrowings during the nine months ended September 30, 2022 and 2021, respectively.

Fair Value of Financial Instruments

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

FAIR VALUE OF FINANCIAL INSTRUMENTS

7. FAIR VALUE OF FINANCIAL INSTRUMENTS

The fair value of financial instruments has been estimated by the Company using available market information as of September 30, 2022 and December 31, 2021, 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, 2022				December 31, 2021
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	300	$	300	$	507	$	507
Investments in equity securities		104		104		144		144
Available-for-sale debt securities		172		172		178		178
Trading securities		12		12		13		13
Liabilities:
6⅝% Senior Secured Notes due 2025		—		—		1,434		1,517
8% Senior Secured Notes due 2026		2,082		1,827		2,078		2,210
8% Senior Secured Notes due 2027		693		556		692		758
5⅝% Senior Secured Notes due 2027		1,829		1,469		1,819		2,011
6⅞% Senior Notes due 2028		749		359		759		758
6% Senior Secured Notes due 2029		864		661		860		966
5¼% Senior Secured Notes due 2030		1,446		1,067		—		—
4¾% Senior Secured Notes due 2031		1,053		710		1,090		1,108
6⅞% Junior-Priority Secured Notes due 2029		1,536		828		1,625		1,823
6⅛% Junior-Priority Secured Notes due 2030		1,255		642		1,352		1,431
ABL Facility and other debt		31		31		32		32

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 GAAP fair value hierarchy as discussed in Note 8. The estimated fair value for financial instruments with a fair value that does not equal its carrying value is considered a Level 1 valuation. The Company utilizes the market approach and obtains indicative pricing through publicly available subscription services such as Bloomberg to determine fair values where relevant.

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

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

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

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

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

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

- 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, 2022

Fair Value Disclosures [Abstract]

FAIR VALUE

8. FAIR VALUE

Fair Value Hierarchy

Fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, the Company utilizes the 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, 2022 or 2021.

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, 2022 and December 31, 2021 (in millions):

	September 30, 2022		Level 1		Level 2		Level 3
Investments in equity securities	$	104	$	104	$	—	$	—
Available-for-sale debt securities		172		—		172		—
Trading securities		12		—		12		—
Total assets	$	288	$	104	$	184	$	—

	December 31, 2021		Level 1		Level 2		Level 3
Investments in equity securities	$	144	$	144	$	—	$	—
Available-for-sale debt securities		178		—		178		—
Trading securities		13		—		13		—
Total assets	$	335	$	144	$	191	$	—

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 consist 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, 2022

Leases [Abstract]

LEASES

9. LEASES

The Company utilizes operating and finance leases for the use of certain hospitals, medical office buildings, and medical equipment. The components of lease cost and rent expense for the three and nine months ended September 30, 2022 and 2021 are as follows (in millions):

	Three Months Ended September 30,						Nine Months Ended September 30,
Lease Cost	2022			2021			2022			2021
Operating lease cost:
Operating lease cost	$	53		$	49		$	157		$	147
Short-term rent expense		21			22			66			70
Variable lease cost		7			5			16			17
Sublease income		(1	)		(1	)		(3	)		(3	)
Total operating lease cost	$	80		$	75		$	236		$	231
Finance lease cost:
Amortization of right-of-use assets	$	3		$	2		$	10		$	6
Interest on finance lease liabilities		4			2			12			5
Total finance lease cost	$	7		$	4		$	22		$	11

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

	Balance Sheet Classification	September 30, 2022			December 31, 2021
Operating Leases:
Operating lease right-of-use assets	Other assets, net	$	701		$	668

Finance Leases:
Finance lease right-of-use assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		324			289
	Equipment and fixtures		12			17
	Property and equipment		344			314
	Less accumulated depreciation and amortization		(63	)		(54	)
	Property and equipment, net	$	281		$	260

Current finance lease liabilities	Current maturities of long-term debt	$	2		$	8
Long-term finance lease liabilities	Long-term debt		267			233

Supplemental cash flow information related to leases for the nine months ended September 30, 2022 and 2021 is as follows (in millions):

	Nine Months Ended September 30,
Cash flow information	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	152	$	149
Operating cash flows from finance leases		12		5
Financing cash flows from finance leases		9		4
Right-of-use assets obtained in exchange for new finance lease liabilities		42		46
Right-of-use assets obtained in exchange for new operating lease liabilities		105		118

_______________________________

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

Stockholders' Deficit

9 Months Ended

Sep. 30, 2022

Equity [Abstract]

STOCKHOLDERS' DEFICIT

10. 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, 2022, 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 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, 2022, under the most restrictive test in these agreements (and subject to certain exceptions), the Company has approximately $300 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, 2022, and during each of the three-month periods following December 31, 2021 (in millions):

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income) (1)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit (1)
Balance, December 31, 2021	$	480		$	1	$	2,118		$	(14	)	$	(3,477	)	$	82		$	(1,290	)
Comprehensive income (loss)		16			—		—			(8	)		(1	)		15			6
Distributions to noncontrolling interests		(12	)		—		—			—			—			(17	)		(17	)
Purchases of subsidiary shares from noncontrolling interests		1			—		(1	)		—			—			—			(1	)
Contributions from noncontrolling interests		1			—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		7			—		(7	)		—			—			—			(7	)
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(8	)		—			—			—			(8	)
Share-based compensation		—			—		5			—			—			—			5
Balance, March 31, 2022		493			1		2,107			(22	)		(3,478	)		80			(1,312	)
Comprehensive income (loss)		21			—		—			(6	)		(326	)		7			(324	)
Distributions to noncontrolling interests		(39	)		—		—			—			—			(5	)		(5	)
Noncontrolling interest in acquired entity		3			—		—			—			—			2			2
Adjustment to redemption value of redeemable noncontrolling interests		20			—		(20	)		—			—			—			(20	)
Share-based compensation		—			—		3			—			—			—			3
Balance, June 30, 2022		498			1		2,090			(27	)		(3,804	)		84			(1,656	)
Comprehensive income (loss)		30			—		—			(6	)		(41	)		12			(35	)
Contributions from noncontrolling interests		1			—		—			—			—			8			8
Distributions to noncontrolling interests		(20	)		—		—			—			—			(12	)		(12	)
Purchase of subsidiary shares from noncontrolling interests		(1	)		—		(1	)		—			—			—			(1	)
Adjustment to redemption value of redeemable noncontrolling interests		4			—		(4	)		—			—			—			(4	)
Noncontrolling interest in acquired entity		4			—		—			—			—			—			—
Share-based compensation		—			—		6			—			—			—			6
Balance, September 30, 2022	$	516		$	1	$	2,091		$	(33	)	$	(3,845	)	$	92		$	(1,694	)

___________________________________

(1) Totals may not add due to rounding.

The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company’s stockholders, and equity attributable to the 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			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 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,
	2022			2021		2022			2021
Net (loss) income attributable to Community Health Systems, Inc. stockholders	$	(42	)	$	111	$	(369	)	$	52
Transfers to the noncontrolling interests:
Net (decrease) increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		(1	)		9		(2	)		9
Net transfers to the noncontrolling interests		(1	)		9		(2	)		9
Change to Community Health Systems, Inc. stockholders' deficit from net (loss) income attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	(43	)	$	120	$	(371	)	$	61

- 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.

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+ Details

Earnings Per Share

9 Months Ended

Sep. 30, 2022

Earnings Per Share [Abstract]

Earnings Per Share

11. 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 (loss) income attributable to Community Health Systems, Inc. stockholders:

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2022		2021		2022		2021
Weighted-average number of shares outstanding — basic		129,141,673		127,077,786		128,689,999		126,638,291
Effect of dilutive securities:
Restricted stock awards		—		2,652,676		—		2,249,117
Employee stock options		—		795,471		—		698,941
Other equity-based awards		—		359,206		—		299,602
Weighted-average number of shares outstanding — diluted		129,141,673		130,885,139		128,689,999		129,885,951

The Company generated a loss attributable to Community Health Systems, Inc. stockholders for the three and nine months ended September 30, 2022, so the effect of dilutive securities is not considered because their effect would be antidilutive. If the Company had generated income during the three and nine months ended September 30, 2022, the effect of restricted stock awards, employee stock options, and other equity-based awards on the diluted shares calculation would have been an increase of 565,641 shares and 1,305,604 shares, respectively.

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2022		2021		2022		2021
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		5,764,161		748,002		3,826,769		784,752

Contingencies

9 Months Ended

Sep. 30, 2022

Commitments And Contingencies Disclosure [Abstract]

Contingencies

12. 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, 2022, 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, 2022 is comprised of individually insignificant amounts for various matters.

Summary of Recorded Amounts

	Probable
	Contingencies
Balance as of December 31, 2021	$	20
Expense		9
Cash payments		(12	)
Balance as of September 30, 2022	$	17

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, 2022

Subsequent Events [Abstract]

Subsequent Events

13. 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.

Effective October 1, 2022, Healthtrust Purchasing Group, L.P. (“HPG”), a group purchasing organization in which the Company is a noncontrolling partner, completed the sale of a majority interest in CoreTrust Holdings, LLC (“CoreTrust”) to a third party. Proceeds for the sale of interest in CoreTrust were distributed to members of HPG at a preliminary closing on September 30, 2022 and the Company received approximately $121 million in connection with such distribution. Completion of the transaction represents a nonrecognized subsequent event and therefore, proceeds received by the Company are recorded in accrued liabilities – other in the condensed consolidated balance sheets as of September 30, 2022. The Company expects to recognize the majority of the proceeds into income during the three months ending December 31, 2022.

Basis of Presentation and Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2022

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Basis of Accounting

Reclassifications

Reclassifications. Certain prior period amounts have been reclassified to conform to the current period presentation within the condensed consolidated statements of cash flows.

Consolidation

Revenue Recognition

Revenue Recognition.

Net Operating Revenues

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2022		2021		2022		2021
Medicare	$	644	$	653	$	1,928	$	1,988
Medicaid		449		412		1,362		1,223
Managed Care and other third-party payors		1,925		2,010		5,719		5,845
Self-pay		7		40		60		79
Total	$	3,025	$	3,115	$	9,069	$	9,135

Patient Accounts Receivable

Charity Care

Accounting for the Impairment or Disposal of Long-Lived Assets

Pandemic Relief Funds

New Accounting Pronouncements

Acquisitions

Fair Value of Financial Instruments

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

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

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

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

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

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

Basis of Presentation and Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2022

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Net Operating Revenues

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2022		2021		2022		2021
Medicare	$	644	$	653	$	1,928	$	1,988
Medicaid		449		412		1,362		1,223
Managed Care and other third-party payors		1,925		2,010		5,719		5,845
Self-pay		7		40		60		79
Total	$	3,025	$	3,115	$	9,069	$	9,135

Accounting for Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2022

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,
	2022			2021			2022			2021
Effect on income before income taxes	$	(6	)	$	(5	)	$	(14	)	$	(18	)
Effect on net (loss) income	$	(5	)	$	(4	)	$	(11	)	$	(14	)

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

Three Months Ended

September 30,

Nine Months Ended

September 30,

2022

2021

2022

2021

Expected volatility

N/A

84.3% - 87.5%

84.3% - 88.9%

Expected dividends

N/A

—

Expected term

N/A

3 - 6 years

Risk-free interest rate

N/A

1.5% - 1.6%

0.3% - 0.9%

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	2022
Outstanding at December 31, 2021		2,301,753		$	6.77
Granted		760,000			10.18
Exercised		(56,500	)		4.97
Forfeited and cancelled		(151,002	)		14.67
Outstanding at March 31, 2022		2,854,251			7.30
Granted		—			—
Exercised		—			—
Forfeited and cancelled		—			—
Outstanding at June 30, 2022		2,854,251			7.30
Granted		—			—
Exercised		—			—
Forfeited and cancelled		—			—
Outstanding at September 30, 2022		2,854,251		$	7.30	8.0 years	$	—
Exercisable at September 30, 2022		1,320,912		$	5.63	7.2 years	$	—

Schedule of Share-based Compensation, Restricted Stock, Activity

Restricted stock outstanding under the 2009 Plan as of September 30, 2022, and changes during each of the three-month periods following December 31, 2021, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2021		4,995,314		$	6.30
Granted		3,179,000			9.05
Vested		(2,516,247	)		5.62
Forfeited		(30,000	)		6.87
Unvested at March 31, 2022		5,628,067			8.61
Granted		41,000			5.00
Vested		(17,000	)		10.65
Forfeited		(72,670	)		9.77
Unvested at June 30, 2022		5,579,397			8.56
Granted		—			—
Vested		—			—
Forfeited		(23,003	)		8.10
Unvested at September 30, 2022		5,556,394			8.56

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

RSUs outstanding under the 2009 Plan as of September 30, 2022, and changes during each of the three-month periods following December 31, 2021, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2021		486,598		$	6.17
Granted		159,138			10.18
Vested		(151,058	)		5.63
Forfeited		—			—
Unvested at March 31, 2022		494,678			7.63
Granted		17,682			5.00
Vested		—			—
Forfeited		—			—
Unvested at June 30, 2022		512,360			7.54
Granted		—			—
Vested		—			—
Forfeited		—			—
Unvested at September 30, 2022		512,360			7.54

Acquisitions, Divestitures and Closures (Tables)

9 Months Ended

Sep. 30, 2022

Acquisitions Divestitures And Closures [Abstract]

Schedule of Divestitures

The following table provides a summary of hospitals that the Company divested during the nine months ended September 30, 2022 and the year ended December 31, 2021:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2022 Divestiture:
AllianceHealth Seminole	SSM Health Care of Oklahoma	Seminole, OK	32	July 1, 2022

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

Schedule of Balance Sheet Items Classified as Held for Sale

	September 30, 2022
Other current assets	$	3
Other assets, net		57
Accrued liabilities		(3	)

- Definition

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

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+ Details

Goodwill (Tables)

9 Months Ended

Sep. 30, 2022

Goodwill And Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

The changes in the carrying amount of goodwill for the nine months ended September 30, 2022 are as follows (in millions):

Balance, as of December 31, 2021
Goodwill	$	7,033
Accumulated impairment losses		(2,814	)
		4,219
Goodwill acquired as part of acquisitions during current year		13
Goodwill allocated to hospitals held for sale or divested		(31	)
Balance, as of September 30, 2022
Goodwill		7,015
Accumulated impairment losses		(2,814	)
	$	4,201

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

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-URI https://asc.fasb.org/extlink&oid=122137925&loc=d3e14258-109268

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=121556970&loc=d3e13816-109267

+ Details

Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2022

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,
	2022			2021
6⅝% Senior Secured Notes due 2025	$	—		$	1,462
8% Senior Secured Notes due 2026		2,101			2,101
8% Senior Secured Notes due 2027		700			700
5⅝% Senior Secured Notes due 2027		1,900			1,900
6⅞% Senior Notes due 2028		756			767
6% Senior Secured Notes due 2029		900			900
5¼% Senior Secured Notes due 2030		1,535			—
4¾% Senior Secured Notes due 2031		1,058			1,095
6⅞% Junior-Priority Secured Notes due 2029		1,665			1,775
6⅛% Junior-Priority Secured Notes due 2030		1,331			1,440
ABL Facility		—			—
Finance lease and financing obligations		425			398
Other		36			37
Less: Unamortized deferred debt issuance costs and note premium		(443	)		(435	)
Total debt		11,964			12,140
Less: Current maturities		(21	)		(31	)
Total long-term debt	$	11,943		$	12,109

Summary of Extinguished Portion of Certain Series of Outstanding Notes

During the three months ended September 30, 2022, the Company extinguished a portion of certain series of its outstanding notes through open market repurchases, as follows (in millions):

	Principal Amount
6⅞% Senior Notes due 2028	$	11
4¾% Senior Secured Notes due 2031		37
6⅞% Junior-Priority Secured Notes due 2029		110
6⅛% Junior-Priority Secured Notes due 2030		109
Total principal amount of debt extinguished	$	267

Senior Secured Notes 5.250%, Due 2030 | Senior Secured Notes

Debt Instrument [Line Items]

Schedule of Early Redemption Prices on Notes

Period		Redemption Price
May 15, 2025 to May 14, 2026		102.625%
May 15, 2026 to May 14, 2027		101.313%
May 15, 2027 to May 14, 2030		100.000%

Fair Value of Financial Instruments (Tables)

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

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

	September 30, 2022				December 31, 2021
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	300	$	300	$	507	$	507
Investments in equity securities		104		104		144		144
Available-for-sale debt securities		172		172		178		178
Trading securities		12		12		13		13
Liabilities:
6⅝% Senior Secured Notes due 2025		—		—		1,434		1,517
8% Senior Secured Notes due 2026		2,082		1,827		2,078		2,210
8% Senior Secured Notes due 2027		693		556		692		758
5⅝% Senior Secured Notes due 2027		1,829		1,469		1,819		2,011
6⅞% Senior Notes due 2028		749		359		759		758
6% Senior Secured Notes due 2029		864		661		860		966
5¼% Senior Secured Notes due 2030		1,446		1,067		—		—
4¾% Senior Secured Notes due 2031		1,053		710		1,090		1,108
6⅞% Junior-Priority Secured Notes due 2029		1,536		828		1,625		1,823
6⅛% Junior-Priority Secured Notes due 2030		1,255		642		1,352		1,431
ABL Facility and other debt		31		31		32		32

Fair Value (Tables)

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

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

	September 30, 2022		Level 1		Level 2		Level 3
Investments in equity securities	$	104	$	104	$	—	$	—
Available-for-sale debt securities		172		—		172		—
Trading securities		12		—		12		—
Total assets	$	288	$	104	$	184	$	—

	December 31, 2021		Level 1		Level 2		Level 3
Investments in equity securities	$	144	$	144	$	—	$	—
Available-for-sale debt securities		178		—		178		—
Trading securities		13		—		13		—
Total assets	$	335	$	144	$	191	$	—

Leases (Tables)

9 Months Ended

Sep. 30, 2022

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, 2022 and 2021 are as follows (in millions):

	Three Months Ended September 30,						Nine Months Ended September 30,
Lease Cost	2022			2021			2022			2021
Operating lease cost:
Operating lease cost	$	53		$	49		$	157		$	147
Short-term rent expense		21			22			66			70
Variable lease cost		7			5			16			17
Sublease income		(1	)		(1	)		(3	)		(3	)
Total operating lease cost	$	80		$	75		$	236		$	231
Finance lease cost:
Amortization of right-of-use assets	$	3		$	2		$	10		$	6
Interest on finance lease liabilities		4			2			12			5
Total finance lease cost	$	7		$	4		$	22		$	11

Supplemental Balance Sheet Information Related to Leases

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

	Balance Sheet Classification	September 30, 2022			December 31, 2021
Operating Leases:
Operating lease right-of-use assets	Other assets, net	$	701		$	668

Finance Leases:
Finance lease right-of-use assets	Property and equipment
	Land and improvements	$	8		$	8
	Buildings and improvements		324			289
	Equipment and fixtures		12			17
	Property and equipment		344			314
	Less accumulated depreciation and amortization		(63	)		(54	)
	Property and equipment, net	$	281		$	260

Current finance lease liabilities	Current maturities of long-term debt	$	2		$	8
Long-term finance lease liabilities	Long-term debt		267			233

Supplemental Cash Flow and Other Information Related to Leases

Supplemental cash flow information related to leases for the nine months ended September 30, 2022 and 2021 is as follows (in millions):

	Nine Months Ended September 30,
Cash flow information	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	152	$	149
Operating cash flows from finance leases		12		5
Financing cash flows from finance leases		9		4
Right-of-use assets obtained in exchange for new finance lease liabilities		42		46
Right-of-use assets obtained in exchange for new operating lease liabilities		105		118

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

Stockholders' Deficit (Tables)

9 Months Ended

Sep. 30, 2022

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) (1)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit (1)
Balance, December 31, 2021	$	480		$	1	$	2,118		$	(14	)	$	(3,477	)	$	82		$	(1,290	)
Comprehensive income (loss)		16			—		—			(8	)		(1	)		15			6
Distributions to noncontrolling interests		(12	)		—		—			—			—			(17	)		(17	)
Purchases of subsidiary shares from noncontrolling interests		1			—		(1	)		—			—			—			(1	)
Contributions from noncontrolling interests		1			—		—			—			—			—			—
Adjustment to redemption value of redeemable noncontrolling interests		7			—		(7	)		—			—			—			(7	)
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(8	)		—			—			—			(8	)
Share-based compensation		—			—		5			—			—			—			5
Balance, March 31, 2022		493			1		2,107			(22	)		(3,478	)		80			(1,312	)
Comprehensive income (loss)		21			—		—			(6	)		(326	)		7			(324	)
Distributions to noncontrolling interests		(39	)		—		—			—			—			(5	)		(5	)
Noncontrolling interest in acquired entity		3			—		—			—			—			2			2
Adjustment to redemption value of redeemable noncontrolling interests		20			—		(20	)		—			—			—			(20	)
Share-based compensation		—			—		3			—			—			—			3
Balance, June 30, 2022		498			1		2,090			(27	)		(3,804	)		84			(1,656	)
Comprehensive income (loss)		30			—		—			(6	)		(41	)		12			(35	)
Contributions from noncontrolling interests		1			—		—			—			—			8			8
Distributions to noncontrolling interests		(20	)		—		—			—			—			(12	)		(12	)
Purchase of subsidiary shares from noncontrolling interests		(1	)		—		(1	)		—			—			—			(1	)
Adjustment to redemption value of redeemable noncontrolling interests		4			—		(4	)		—			—			—			(4	)
Noncontrolling interest in acquired entity		4			—		—			—			—			—			—
Share-based compensation		—			—		6			—			—			—			6
Balance, September 30, 2022	$	516		$	1	$	2,091		$	(33	)	$	(3,845	)	$	92		$	(1,694	)

___________________________________

(1) Totals may not add due to rounding.

				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, 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	)

Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit

	Three Months Ended					Nine Months Ended
	September 30,					September 30,
	2022			2021		2022			2021
Net (loss) income attributable to Community Health Systems, Inc. stockholders	$	(42	)	$	111	$	(369	)	$	52
Transfers to the noncontrolling interests:
Net (decrease) increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		(1	)		9		(2	)		9
Net transfers to the noncontrolling interests		(1	)		9		(2	)		9
Change to Community Health Systems, Inc. stockholders' deficit from net (loss) income attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	(43	)	$	120	$	(371	)	$	61

Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2022

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,
	2022		2021		2022		2021
Weighted-average number of shares outstanding — basic		129,141,673		127,077,786		128,689,999		126,638,291
Effect of dilutive securities:
Restricted stock awards		—		2,652,676		—		2,249,117
Employee stock options		—		795,471		—		698,941
Other equity-based awards		—		359,206		—		299,602
Weighted-average number of shares outstanding — diluted		129,141,673		130,885,139		128,689,999		129,885,951

Schedule of Antidilutive Securities

	Three Months Ended				Nine Months Ended
	September 30,				September 30,
	2022		2021		2022		2021
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		5,764,161		748,002		3,826,769		784,752

Contingencies (Tables)

9 Months Ended

Sep. 30, 2022

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, 2021	$	20
Expense		9
Cash payments		(12	)
Balance as of September 30, 2022	$	17

Basis of Presentation and Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Cost of Revenue, Policy [Abstract]
Corporate office costs	$ 60	$ 56	$ 179	$ 168
Third Party Reimbursement [Abstract]
Amounts due to third party payors	115		115		$ 118
Amounts due from third party payors	102		102		$ 114
Net Operating Revenues, Policy [Abstract]
Charity care services charges excluded from net operating revenues	285	215	1,100	659
Value of charity care services at the Company's standard charges included in contractual allowances	33	25	121	77
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business				(24)
Impairment charge of long-lived assets sold			54
Amount related to closure of hospitals			48
CARES Act \| Public Health And Social Services Emergency Fund \| Paycheck Protection Program and Health Care Enhancement Act
CARES Act and PPPHCE Act Funds [Abstract]
Payments through the PHSSEF and various state and local programs	108	(4)	160	4
CARES Act \| Public Health And Social Services Emergency Fund \| Accrued Liabilities - Other \| Paycheck Protection Program and Health Care Enhancement Act
CARES Act and PPPHCE Act Funds [Abstract]
Payments through the PHSSEF and various state and local programs			4
CARES Act \| Operating Costs and Expenses \| Public Health And Social Services Emergency Fund \| Paycheck Protection Program and Health Care Enhancement Act
CARES Act and PPPHCE Act Funds [Abstract]
Payments through the PHSSEF and various state and local programs	$ 115	$ 19	171	102
Adjustment for Carrying Value of Other Long-Lived Assets at Underperforming Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale			$ 6	29
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				(3)
Hospitals Closed
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business				8
Shared Service Center
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business				$ 7

Basis of Presentation and Significant Accounting Policies - Schedule of Net Operating Revenues (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 3,025	$ 3,115	$ 9,069	$ 9,135
Medicare
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	644	653	1,928	1,988
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	449	412	1,362	1,223
Managed Care and Other Third Party Payors
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	1,925	2,010	5,719	5,845
Self-Pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 7	$ 40	$ 60	$ 79

- 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 https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 6: 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)(iv))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iv))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 9: 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)(iii)(A))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(i))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

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))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

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 https://asc.fasb.org/extlink&oid=126901519&loc=d3e8906-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Section S99
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-Subparagraph (SX 210.13-02(a)(5))
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-Name Accounting Standards Codification
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-Publisher FASB
-Name Accounting Standards Codification
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-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iii)(A))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(5))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599

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-Publisher FASB
-Name Accounting Standards Codification
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-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
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-Publisher FASB
-Name Accounting Standards Codification
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-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI https://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 21: 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)(iii)(B))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 22: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(ii))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(1))
-URI https://asc.fasb.org/extlink&oid=126953954&loc=SL114868664-224227

+ Details

Accounting for Stock-Based Compensation - Additional Information (Details)				3 Months Ended				9 Months Ended
	Jun. 01, 2022 USD ($) shares	Mar. 01, 2022 USD ($) Director shares	Mar. 01, 2021 USD ($) Director shares	Sep. 30, 2022 USD ($) $ / shares shares	Jun. 30, 2022 shares	Mar. 31, 2022 shares	Sep. 30, 2021 USD ($) shares	Sep. 30, 2022 USD ($) Item $ / shares shares	Sep. 30, 2021 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				$ 39,000,000				$ 39,000,000
Employee service share-based compensation total compensation cost not yet recognized, period for recognition								24 months
Employee service share-based compensation, nonvested awards, modifications to awards \| Item								0	0
Aggregate intrinsic value of options exercised				0			$ 0
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of options exercised								$ 1,000,000	$ 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								24 months
Employee service share-based compensation, unrecognized compensation costs on nonvested stock options				$ 6,000,000				$ 6,000,000
Granted, Shares \| shares				0	0	760,000	0
Weighted-average grant date fair value of stock options \| $ / shares								$ 7.25	$ 6.22
Share Price \| $ / shares				$ 2.15				$ 2.15
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				$ 33,000,000				$ 33,000,000
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					17,682	159,138
Number of directors elected to defer the receipt of RSUs granted \| Director		3	4
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					41,000	3,179,000
Plan 2009
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unissued common stock reserved for grants \| shares				6,941,141				6,941,141
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
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	17,682	17,682	19,296
Fair value of units granted	$ 88,000	$ 180,000	$ 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, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Effect on income before income taxes	$ (6)	$ (5)	$ (14)	$ (18)
Effect on net (loss) income	$ (5)	$ (4)	$ (11)	$ (14)

Accounting for Stock-Based Compensation - Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions (Details) - Employee Stock Option	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility, minimum	84.30%	84.30%
Expected volatility, maximum	87.50%	88.90%
Risk-free interest rate, minimum	1.50%	0.30%
Risk-free interest rate, maximum	1.60%	0.90%
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	3 years	3 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	6 years	6 years

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Stock Options, Activity (Details) - Employee Stock Option - $ / shares	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Shares	2,854,251	2,854,251	2,301,753
Granted, Shares	0	0	760,000	0
Exercised, Shares	0	0	(56,500)
Forfeited and cancelled, Shares	0	0	(151,002)
Ending Balance, Shares	2,854,251	2,854,251	2,854,251
Exercisable, Shares	1,320,912
Beginning of Period, Weighted Average Exercise Price	$ 7.30	$ 7.30	$ 6.77
Granted, Weighted Average Exercise Price	0	0	10.18
Exercised, Weighted Average Exercise Price	0	0	4.97
Forfeited and Cancelled, Weighted Average Exercise Price	0	0	14.67
End of Period, Weighted Average Exercise Price	7.30	$ 7.30	$ 7.30
Exercisable, Weighted Average Exercise Price	$ 5.63
Weighted Average Remaining Contractual Term	8 years
Exercisable, Weighted Average Remaining Contractual Term	7 years 2 months 12 days

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock, Activity (Details) - Restricted Stock - $ / shares	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	5,579,397	5,628,067	4,995,314
Granted, Shares		41,000	3,179,000
Vested, Shares		(17,000)	(2,516,247)
Forfeited, Shares	(23,003)	(72,670)	(30,000)
Ending Balance, Unvested Shares	5,556,394	5,579,397	5,628,067
Beginning of Period, Weighted Average Grant Date Fair Value	$ 8.56	$ 8.61	$ 6.30
Granted, Weighted Average Grant Date Fair Value		5.00	9.05
Vested, Weighted Average Grant Date Fair Value		10.65	5.62
Forfeited, Weighted Average Grant Date Fair Value	8.10	9.77	6.87
End of Period, Weighted Average Grant Date Fair Value	$ 8.56	$ 8.56	$ 8.61

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, 2022	Jun. 30, 2022	Mar. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	512,360	494,678	486,598
Granted, Shares		17,682	159,138
Vested, Shares			(151,058)
Ending Balance, Unvested Shares	512,360	512,360	494,678
Beginning of Period, Weighted Average Grant Date Fair Value	$ 7.54	$ 7.63	$ 6.17
Granted, Weighted Average Grant Date Fair Value		5.00	10.18
Vested, Weighted Average Grant Date Fair Value			5.63
End of Period, Weighted Average Grant Date Fair Value	$ 7.54	$ 7.54	$ 7.63

Acquisitions, Divestitures and Closures - Acquisitions - Additional Information (Details) $ in Millions	9 Months Ended
	Sep. 30, 2022 USD ($)
Physician Practices Clinics and Other Ancillary Businesses
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price	$ 9

Acquisitions, Divestitures and Closures - Schedule of Divestitures (Details) - Item	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
AllianceHealth Seminole
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	32
Effective Date	Jul. 01, 2022
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
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

Acquisitions, Divestitures and Closures - Divestitures - Additional Information (Details)	Sep. 30, 2022 Item
AllianceHealth Seminole
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	32
AllianceHealth Seminole \| Seminole, Oklahoma
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	32
Greenbrier Valley Medical Center \| Ronceverte, West Virginia
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	122

Acquisitions, Divestitures and Closures - Schedule of Balance Sheet Items Classified as Held for Sale (Details) $ in Millions	Sep. 30, 2022 USD ($)
Acquisitions Divestitures And Closures [Abstract]
Other current assets	$ 3
Other assets, net	57
Accrued liabilities	$ (3)

Acquisitions, Divestitures and Closures - Closures - Additional Information (Details) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2022 USD ($) Item	Sep. 30, 2022 USD ($) Item
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge of long-lived assets sold		$ 54
Shorepoint Health Venice \| Venice, Florida
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds \| Item	312	312
Impairment charge of long-lived assets sold	$ 25
First Hospital Wyoming Valley (Psychiatric) \| Wilkes-Barre, Pennsylvania
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds \| Item	149	149
Impairment charge of long-lived assets sold	$ 18

Goodwill - Schedule of Goodwill (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Goodwill Roll Forward
Goodwill	$ 7,015	$ 7,033
Accumulated impairment losses	(2,814)	(2,814)
Goodwill	4,201	$ 4,219
Goodwill acquired as part of acquisitions during current year	13
Goodwill allocated to hospitals held for sale or divested	$ (31)

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Goodwill - Additional Information (Details)	3 Months Ended
Goodwill - Additional Information (Details)	Dec. 31, 2021 USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Impairment of goodwill	$ 0

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Taxes [Line Items]
Provision for income taxes	$ 70,000,000	$ 10,000,000	$ 291,000,000	$ 132,000,000
Effective income tax rate	100.00%	6.50%	1212.50%	47.50%
Income tax refunds (payments), net		$ (1,000,000)	$ (6,000,000)	$ (3,000,000)
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
Income tax refunds (payments), net	$ (1,000,000)

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Debt and lease obligations	$ 11,964	$ 12,140
Less: Unamortized deferred debt issuance costs and note premium	(443)	(435)
Less: Current maturities	(21)	(31)
Total long-term debt	11,943	12,109
Senior Secured Notes \| Senior Secured Notes at 6.625%, Due 2025
Debt Instrument [Line Items]
Debt and lease obligations		1,462
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt and lease obligations	2,101	2,101
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Debt Instrument [Line Items]
Debt and lease obligations	700	700
Senior Secured Notes \| 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 5.250%, Due 2030
Debt Instrument [Line Items]
Debt and lease obligations	1,535
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Debt Instrument [Line Items]
Debt and lease obligations	1,058	1,095
Senior Notes \| Senior Notes at 6.875%, Due 2028
Debt Instrument [Line Items]
Debt and lease obligations	756	767
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875%, Due 2029
Debt Instrument [Line Items]
Debt and lease obligations	1,665	1,775
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125%, Due 2030
Debt Instrument [Line Items]
Debt and lease obligations	1,331	1,440
Finance Lease and Financing Obligations
Debt Instrument [Line Items]
Debt and lease obligations	425	398
Other
Debt Instrument [Line Items]
Debt and lease obligations	$ 36	$ 37

Long-Term Debt - Schedule of Debt (Parenthetical) (Details)		3 Months Ended	9 Months Ended	12 Months Ended
	Feb. 04, 2022	Sep. 30, 2022	Sep. 30, 2022	Dec. 31, 2021
Senior Secured Notes \| Senior Secured Notes at 6.625%, Due 2025
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.625%	6.625%	6.625%	6.625%
Debt instrument, maturity year	2025		2025	2025
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		8.00%	8.00%	8.00%
Debt instrument, maturity year			2026	2026
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		8.00%	8.00%	8.00%
Debt instrument, maturity year			2027	2027
Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		5.625%	5.625%	5.625%
Debt instrument, maturity year			2027	2027
Senior Secured Notes \| Senior Secured Notes 5.250%, Due 2030
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	5.25%	5.25%	5.25%	5.25%
Debt instrument, maturity year	2030		2030	2030
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		4.75%	4.75%	4.75%
Debt instrument, maturity year		2031	2031	2031
Senior Secured Notes \| Senior Secured Notes at 6%, Due 2029
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		6.00%	6.00%	6.00%
Debt instrument, maturity year			2029	2029
Senior Notes \| Senior Notes at 6.875%, Due 2028
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage		6.875%	6.875%	6.875%
Debt instrument, maturity year			2028	2028
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%	6.875%
Debt instrument, maturity year		2029	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%	6.125%
Debt instrument, maturity year		2030	2030	2030

Long-Term Debt - 5.250% Senior Secured Notes, Due 2030 - Additional Information (Details) - Senior Secured Notes - USD ($) $ in Millions		9 Months Ended	12 Months Ended
	Feb. 04, 2022	Sep. 30, 2022	Dec. 31, 2021
Senior Secured Notes 5.250%, Due 2030
Debt Instrument [Line Items]
Debt instrument, offering date	Feb. 04, 2022
Debt instrument aggregate principal amount	$ 1,535
Debt instrument stated interest rate	5.25%	5.25%	5.25%
Debt instrument, maturity date	May 15, 2030
Debt instrument, maturity year	2030	2030	2030
Debt instrument optional redemption date	May 15, 2025
Minimum period notice for redemption of debt	10 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 5¼% Senior Secured Notes due 2030.
Minimum period notice for redemption of debt	10 days
Maximum period notice for redemption of debt	60 days
Senior Secured Notes 5.250%, Due 2030 \| Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument stated interest rate	5.25%
Debt instrument, maturity year	2030
Debt instrument optional redemption date	May 15, 2025
Debt instrument redemption price percentage	105.25%
Debt instrument redemption description		plus accrued and unpaid interest, if any. In addition, any time prior to May 15, 2025, but not more than once during each twelve-month period
Debt Instrument Redemption Price Percentage Of Principal Amount Redeemed	40.00%
Senior Secured Notes 5.250%, Due 2030 \| Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	103.00%
Debt Instrument Redemption Price Percentage Of Principal Amount Redeemed	10.00%
Senior Secured Notes at 6.625%, Due 2025
Debt Instrument [Line Items]
Debt instrument stated interest rate	6.625%	6.625%	6.625%
Debt instrument, maturity year	2025	2025	2025
Debt instrument redemption date	Feb. 04, 2022

Long-Term Debt - Schedule of Early Redemption Prices on 5.250% Senior Notes, Due 2030 (Details) - Senior Secured Notes - Senior Secured Notes 5.250%, Due 2030	Feb. 04, 2022
Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Debt instrument redemption price percentage	102.625%
Debt Instrument, Redemption Period, Start Date	May 15, 2025
Debt Instrument, Redemption Period, End Date	May 14, 2026
Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Debt instrument redemption price percentage	101.313%
Debt Instrument, Redemption Period, Start Date	May 15, 2026
Debt Instrument, Redemption Period, End Date	May 14, 2027
Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Debt instrument redemption price percentage	100.00%
Debt Instrument, Redemption Period, Start Date	May 15, 2027
Debt Instrument, Redemption Period, End Date	May 14, 2030

Long-Term Debt - Summary of Extinguished Portion of Certain Series of Outstanding Notes (Details) $ in Millions	3 Months Ended
	Sep. 30, 2022 USD ($)
Extinguishment Of Debt [Line Items]
Total principal amount of debt extinguished	$ 267
Senior Notes \| 6.875% Senior Notes due 2028
Extinguishment Of Debt [Line Items]
Total principal amount of debt extinguished	11
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Extinguishment Of Debt [Line Items]
Total principal amount of debt extinguished	37
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875%, Due 2029
Extinguishment Of Debt [Line Items]
Total principal amount of debt extinguished	110
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125%, Due 2030
Extinguishment Of Debt [Line Items]
Total principal amount of debt extinguished	$ 109

Long-Term Debt - Summary of Extinguished Portion of Certain Series of Outstanding Notes (Parenthetical) (Details)	3 Months Ended	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Sep. 30, 2022	Dec. 31, 2021
Senior Notes \| 6.875% Senior Notes due 2028
Extinguishment Of Debt [Line Items]
Debt instrument, interest rate, stated percentage	6.875%	6.875%
Debt instrument, maturity year	2028
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Extinguishment Of Debt [Line Items]
Debt instrument, interest rate, stated percentage	4.75%	4.75%	4.75%
Debt instrument, maturity year	2031	2031	2031
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875%, Due 2029
Extinguishment Of Debt [Line Items]
Debt instrument, interest rate, stated percentage	6.875%	6.875%	6.875%
Debt instrument, maturity year	2029	2029	2029
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125%, Due 2030
Extinguishment Of Debt [Line Items]
Debt instrument, interest rate, stated percentage	6.125%	6.125%	6.125%
Debt instrument, maturity year	2030	2030	2030

Long-Term Debt - Other Debt - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Apr. 03, 2018
Debt Instrument [Line Items]
Pre-tax gain from early extinguishment of debt	$ 78,000,000		$ 73,000,000	$ (79,000,000)
After-tax gain from early extinguishment of debt	68,000,000
Interest paid on borrowings	204,000,000	$ 268,000,000	614,000,000	$ 572,000,000
ABL Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	935,000,000		935,000,000		$ 1,000,000,000.0
Line of credit facility, excess availability	852,000,000		852,000,000
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	$ 83,000,000		$ 83,000,000
Reduction in letters of credit			$ 30,000,000

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Carrying Amount
Assets:
Cash and cash equivalents	$ 300	$ 507
Investments in equity securities	104	144
Available-for-sale debt securities	172	178
Trading securities	12	13
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure		1,434
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,082	2,078
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	693	692
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,829	1,819
Carrying Amount \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	864	860
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes 5.25%, Due 2030
Liabilities:
Notes payable, fair value disclosure	1,446
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	1,053	1,090
Carrying Amount \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	749	759
Carrying Amount \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	1,536	1,625
Carrying Amount \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	1,255	1,352
Carrying Amount \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	31	32
Estimated Fair Value
Assets:
Cash and cash equivalents	300	507
Investments in equity securities	104	144
Available-for-sale debt securities	172	178
Trading securities	12	13
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 6.625% Due 2025
Liabilities:
Notes payable, fair value disclosure		1,517
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	1,827	2,210
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8% Due 2027
Liabilities:
Notes payable, fair value disclosure	556	758
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,469	2,011
Estimated Fair Value \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	661	966
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes 5.25%, Due 2030
Liabilities:
Notes payable, fair value disclosure	1,067
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	710	1,108
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	359	758
Estimated Fair Value \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	828	1,823
Estimated Fair Value \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	642	1,431
Estimated Fair Value \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	$ 31	$ 32

Fair Value - Additional Information (Details) - USD ($)	Sep. 30, 2022	Sep. 30, 2021
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, 2022	Dec. 31, 2021
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	$ 104	$ 144
Available-for-sale debt securities	172	178
Trading securities	12	13
Total assets	288	335
Fair Value, Inputs, Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	104	144
Total assets	104	144
Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available-for-sale debt securities	172	178
Trading securities	12	13
Total assets	$ 184	$ 191

Leases - Components of Lease Cost and Rent Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Leases [Abstract]
Operating lease cost	$ 53	$ 49	$ 157	$ 147
Short-term rent expense	21	22	66	70
Variable lease cost	7	5	16	17
Sublease income	(1)	(1)	(3)	(3)
Total operating lease cost	80	75	236	231
Finance lease cost:
Amortization of right-of-use assets	3	2	10	6
Interest on finance lease liabilities	4	2	12	5
Total finance lease cost	$ 7	$ 4	$ 22	$ 11

Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Operating Leases:
Operating lease right-of-use assets	$ 701	$ 668
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other assets, net	Other assets, net
Finance Leases:
Property and equipment	$ 9,727	$ 9,757
Less accumulated depreciation and amortization	(4,277)	(4,204)
Property and equipment, net	5,450	5,553
Current finance lease liabilities	$ 2	$ 8
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Current maturities of long-term debt	Current maturities of long-term debt
Long-term finance lease liabilities	$ 267	$ 233
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Long-term debt	Long-term debt
Finance Lease right-of-use Assets
Finance Leases:
Property and equipment	$ 344	$ 314
Less accumulated depreciation and amortization	(63)	(54)
Property and equipment, net	281	260
Finance Lease right-of-use Assets \| Land and Improvements
Finance Leases:
Property and equipment	8	8
Finance Lease right-of-use Assets \| Building and Improvements
Finance Leases:
Property and equipment	324	289
Finance Lease right-of-use Assets \| Equipment and Fixtures
Finance Leases:
Property and equipment	$ 12	$ 17

Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 152	$ 149
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from finance leases	12	5
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows from finance leases	9	4
Right-of-use assets obtained in exchange for new finance lease liabilities	42	46
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 105	$ 118

Stockholders' Deficit - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Sep. 30, 2022	Dec. 31, 2021
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	$ 300

Stockholders' Deficit - Schedule of Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021
Equity, beginning balance	$ (1,656)	$ (1,312)	$ (1,290)	$ (1,616)	$ (1,595)	$ (1,538)
Redeemable Noncontrolling Interests, beginning balance			480
Comprehensive income (loss)	(35)	(324)	6	125	14	(59)
Distributions to noncontrolling interests	(12)	(5)	(17)	(10)	(14)	(9)
Purchases of subsidiary shares from noncontrolling interests	(1)		(1)	9
Contributions from noncontrolling interests	8
Other reclassifications of noncontrolling interests					(1)
Noncontrolling interest in acquired entity		2
Adjustment to redemption value of redeemable noncontrolling interests	(4)	(20)	(7)	(6)	(25)	7
Cancellation of restricted stock for tax withholdings on vested shares			(8)			(4)
Share-based compensation	6	3	5	5	5	8
Equity, ending balance	(1,694)	(1,656)	(1,312)	(1,493)	(1,616)	(1,595)
Redeemable Noncontrolling Interests, ending balance	516
Redeemable Noncontrolling Interests (Non- Equity)
Redeemable Noncontrolling Interests, beginning balance	498	493	480	498	481	484
Comprehensive income (loss)	30	21
Comprehensive income (loss) attributable to redeemable noncontrolling interest			16	20	24	21
Distributions to noncontrolling interests	(20)	(39)
Distributions to redeemable noncontrolling interests			(12)	(19)	(31)	(12)
Dispositions of less-than-wholly owned business						(7)
Purchases of subsidiary shares from noncontrolling interests	(1)		1	(13)	(2)
Contributions from noncontrolling interests	1		1	1
Other reclassifications of redeemable noncontrolling interests					1
Noncontrolling interest in acquired entity	4	3				2
Adjustment to redemption value of redeemable noncontrolling interests	4	20	7	6	25	(7)
Redeemable Noncontrolling Interests, ending balance	516	498	493	493	498	481
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	2,090	2,107	2,118	2,084	2,105	2,094
Purchases of subsidiary shares from noncontrolling interests	(1)		(1)	9
Other reclassifications of noncontrolling interests					(1)
Adjustment to redemption value of redeemable noncontrolling interests	(4)	(20)	(7)	(6)	(25)	7
Cancellation of restricted stock for tax withholdings on vested shares			(8)			(4)
Share-based compensation	6	3	5	5	5	8
Equity, ending balance	2,091	2,090	2,107	2,092	2,084	2,105
Accumulated Other Comprehensive (Income) Loss
Equity, beginning balance	(27)	(22)	(14)	(15)	(16)	(13)
Comprehensive income (loss)	(6)	(6)	(8)	1	1	(3)
Equity, ending balance	(33)	(27)	(22)	(14)	(15)	(16)
Accumulated Deficit
Equity, beginning balance	(3,804)	(3,478)	(3,477)	(3,765)	(3,771)	(3,707)
Comprehensive income (loss)	(41)	(326)	(1)	110	6	(64)
Equity, ending balance	(3,845)	(3,804)	(3,478)	(3,655)	(3,765)	(3,771)
Noncontrolling Interest
Equity, beginning balance	84	80	82	79	86	87
Comprehensive income (loss)	12	7	15	14	7	8
Distributions to noncontrolling interests	(12)	(5)	(17)	(10)	(14)	(9)
Contributions from noncontrolling interests	8
Noncontrolling interest in acquired entity		2
Equity, ending balance	$ 92	$ 84	$ 80	$ 83	$ 79	$ 86

Stockholders' Deficit - Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Equity [Abstract]
Net (loss) income attributable to Community Health Systems, Inc. stockholders	$ (42)	$ 111	$ (369)	$ 52
Net (decrease) increase in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests	(1)	9	(2)	9
Net transfers to the noncontrolling interests	(1)	9	(2)	9
Change to Community Health Systems, Inc. stockholders' deficit from net (loss) income attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$ (43)	$ 120	$ (371)	$ 61

- Definition

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

+ References

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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, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Effect of dilutive securities:
Weighted-average number of shares outstanding — basic	129,141,673	127,077,786	128,689,999	126,638,291
Restricted stock awards		2,652,676		2,249,117
Employee stock options		795,471		698,941
Other equity-based awards		359,206		299,602
Weighted-average number of shares outstanding — diluted	129,141,673	130,885,139	128,689,999	129,885,951

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2022
Earnings Per Share [Abstract]
Increase in number of shares to diluted shares calculation if income would have been generated	565,641	1,305,604

Earnings Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Earnings Per Share [Abstract]
Employee stock options and restricted stock awards excluded from computation of earnings per share amount	5,764,161	748,002	3,826,769	784,752

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, 2022 USD ($)
Loss Contingency Accrual [Roll Forward]
Beginning Balance	$ 20
Expense	9
Cash payments	(12)
Ending Balance	$ 17

Subsequent Events - Additional Information (Details) $ in Millions	9 Months Ended
	Sep. 30, 2022 USD ($)
Subsequent Events [Abstract]
Distribution of CoreTrust proceeds	$ 121